宝鉴炙甘草汤治许伯威中气本弱病伤寒八九日医见其热甚以凉药下之又食梨三枚痛伤脾
胃四
肢冷时发昏愦其脉动而中止有时自还乃结脉也心亦悸动吃逆不绝色变青黄精神减少目不欲开
蜷卧恶人语以此药治之
甘草(炙) 生姜 桂枝 人参 生地黄 阿胶 麦门冬 麻子仁 大枣
成无己云补可以去弱人参大枣之甘以补不足之气桂枝生姜之辛以益正气五脏痿弱荣卫涸
流湿
剂所以润之麻仁阿胶麦门冬地黄之甘润经益血复脉通心也加以人参桂枝急扶正气生地黄减半
恐伤阳气锉一两服之其证减半再服而安
按此心肺药也
谨按咳逆诸方古方唯有治寒之剂至于补虚降火养阴之药及治痰气厥逆之法皆未详也学人
自宜随证用之
严氏云咳逆治法妇人屈乳头向下尽处骨间是穴丈夫及乳小者以一指为率正男左女右与乳
相直间陷中动脉处是穴艾炷如小豆许灸三壮
内经云备化之纪其病痞又云太阴所至为积饮痞膈
按原病式云痞与否同不通泰也谓精神荣卫血气津液出入流行之纹理闭密而为痞也
成无己云伤寒心下满者不经下后则有吐下之殊若下后则有结胸痞气之别经曰病患手足厥
冷脉
乍紧邪结在胸中心满而烦当吐之又云脉浮而大心下反硬有热属脏者攻之此二者不经汗下而心
下满或吐之或下之随其邪气之高下要在泄其邪也又邪气在表未应下而强下之邪气乘虚结于心
下实者硬满而痛为结胸虚者满而不痛为虚痞盖结胸是实邪大陷胸汤主之痞是虚邪须诸泻心汤
散可也
《宝鉴》中的炙甘草汤用于治疗许伯威。他中气原本虚弱，患伤寒病八九日，医生见其热势很重，便用寒凉药物攻下，他又吃了三枚梨，导致脾胃受伤。四肢发冷，时常昏厥神志不清，脉搏跳动时有中止，有时自行恢复，这是结脉。心脏也悸动不安，呃逆不止，面色青黄，精神萎靡，眼睛不想睁开，蜷缩而卧，厌恶听到人说话。用此药治疗。
炙甘草（蜜炙）、生姜、桂枝、人参、生地黄、阿胶、麦门冬、麻子仁、大枣。
成无己说：补法可以消除虚弱，人参、大枣的甘味用来补充不足的气；桂枝、生姜的辛味用来增益正气。五脏痿弱，营卫之气枯竭流动不畅，湿剂（滋润之剂）所以能润燥。麻仁、阿胶、麦门冬、地黄的甘润之性，能够滋养经脉、益血、复脉、通心。再加上人参、桂枝紧急扶持正气，生地黄减半使用，是恐怕损伤阳气。锉碎一两，服用后症状减轻一半，再服则痊愈。
谨按：关于咳逆的各种方剂，古方中只有治疗寒证的药剂，至于补虚、降火、养阴的药物以及治疗痰气厥逆的方法，都没有详细记载。学习的人应当根据证候自行选用。
严氏说：治疗咳逆的穴位，妇人取乳头向下尽头处的骨间穴位，男子及乳房较小者以一指宽度为标准，男性在左侧，女性在右侧，与乳头相对，凹陷中有动脉搏动处即是该穴。用艾炷如小豆大小，灸三壮。
《内经》说：“备化之纪”所发生的疾病是痞满。又说：“太阴所至”表现为积饮、痞膈。
按《原病式》说：痞与否同义，指不通泰。是指精神、营卫、血气、津液出入流行的纹理闭密，从而形成痞证。
成无己说：伤寒病出现心下胀满，如果没有经过攻下治疗，则有呕吐和攻下的区别；如果经过攻下治疗后，则有结胸和痞气的分别。经书说：病人手足厥冷，脉搏突然变紧，邪气结在胸部，心下胀满而烦闷，应当用吐法。又说：脉搏浮大，心下反而硬满，有热象，属于脏病的应当攻下。这两种情况，没有经过汗法和下法而出现心下胀满，或者用吐法，或者用下法，要根据邪气位置的高下，关键在于泄除邪气。另外，邪气在表，本不应攻下却强行攻下，邪气乘虚结聚在心下，实证表现为硬满且疼痛，称为结胸，由大陷胸汤主治；虚证表现为胀满但不疼痛，称为虚痞，需要用各种泻心汤来消散。
The *Zhi Gancao Tang* (Honey-Fried Licorice Decoction) in *Baojian* is used to treat Xu Bowei. His middle qi (Middle Jiao Qi) was originally weak. After suffering from Shanghan disease (Cold Damage) for eight or nine days, the physician, seeing his severe heat, administered cold-natured purgative medicines. He then ate three pears, which injured his spleen and stomach. His four limbs were cold, he frequently experienced fainting and confusion, his pulse beat with intermittent pauses that sometimes recovered spontaneously, which is a knotted pulse (Jie Mai). His heart palpitated, hiccupping was incessant, his complexion was greenish-yellow, his spirit was diminished, he did not wish to open his eyes, curled up in bed, and disliked hearing people speak. This decoction was used to treat him.
Ingredients: Zhi Gancao (Honey-fried Glycyrrhizae Radix et Rhizoma), Shengjiang (Fresh Zingiberis Rhizoma), Guizhi (Cinnamomi Ramulus), Renshen (Ginseng Radix), Shengdihuang (Rehmanniae Radix), Ejiao (Colla Corii Asini), Maimendong (Ophiopogonis Radix), Maziren (Cannabis Fructus), Dazao (Ziziphi Jujubae Fructus).
Cheng Wuji stated: The tonifying method can alleviate weakness; the sweetness of Renshen and Dazao tonifies deficient qi; the pungency of Guizhi and Shengjiang benefits righteous qi. When the five zang organs are atrophic and weak, and Ying and Wei (Nutritive and Defensive Qi) flow exhaustively, moistening agents serve to lubricate. The sweet and moistening properties of Maziren, Ejiao, Maimendong, and Dihuang nourish the meridians, benefit blood, restore the pulse, and unblock the Heart. Furthermore, Renshen and Guizhi urgently support righteous qi; Shengdihuang is halved to avoid damaging Yang Qi. One liang (approx. 30-50g depending on era) is chopped and decocted; after taking it, symptoms reduce by half, and upon further administration, peace is restored.
Commentary: This is a medicine for treating the Heart and Lungs.
Respectfully noted: Regarding formulas for hiccupping, ancient texts only contain agents for treating cold syndromes. Methods involving tonifying deficiency, descending fire, nourishing Yin, and treating phlegm-Qi reversal are not detailed. Practitioners should select treatments according to the specific syndrome.
Yan Shi stated: For treating hiccupping, locate the acupoint between the bones at the end of the line extending downward from the nipple. For men and those with smaller breasts, use one finger's width as the standard. For men, it is on the left; for women, on the right, directly aligned with the nipple, in the depression where the artery beats. Apply moxa cones the size of a small bean, three moxibustion units (zhuang).
The *Neijing* states: In the era of "Bei Hua" (Preparation and Transformation), the disease is Pi (fullness/stagnation). It also states: When Taiyin affects the body, it manifests as fluid retention, Pi, and diaphragmatic obstruction.
According to *Yuanbingshi*, "Pi" is synonymous with "Bu" (lack of smoothness/flow), referring to the blockage of the textures through which spirit, Ying, Wei, blood, qi, and fluids circulate, resulting in Pi syndrome.
Cheng Wuji stated: In Shanghan disease, if fullness below the heart occurs without prior purgation, there is a distinction between emetic and purgative approaches. If it occurs after purgation, there is a distinction between Jie Xiong (Chest Binding) and Pi Qi (Stagnant Qi). The classics state: If a patient has cold extremities and a suddenly tight pulse, with evil Qi binding in the chest causing fullness below the heart and vexation, vomiting should be induced. It also states: If the pulse is floating and large, and fullness below the heart is hard with heat, belonging to the Zang organs, purgation should be applied. In these two cases, where fullness below the heart occurs without sweating or purging, treatment involves either vomiting or purging, depending on the height or depth of the evil Qi, with the key being to drain the evil. Additionally, if evil Qi is in the exterior and purgation is forcibly applied when inappropriate, the evil Qi enters the void and binds below the heart. In excess patterns, hardness, fullness, and pain occur, termed Jie Xiong, treated primarily by Da Xian Xiong Tang (Major Sinking of the Chest Decoction). In deficiency patterns, fullness without pain occurs, termed Xu Pi (Deficiency Stagnation), which requires dispersal using various Xi Xin Tang (Drain the Epigastrium Decoctions).