痘疮干哕病势沉,毒热上逆正难禁,实热橘皮竹茹剂,虚寒丁香柿蒂神。
【注】干哕者,有声无物,其声重大而长,属阳明胃经也。缘毒热上逆所致。又有胃气
不足,不能容受,复有寒邪客于胃中,使胃气不能中主,上行而哕也。热者,橘皮竹茹
汤主之;寒者,丁香柿蒂汤主之。
橘皮竹茹汤
橘红 半夏(姜制) 麦门冬(去心) 枇杷叶(姜炙) 甘草(生) 竹茹 赤苓 人参
引用芦根,水煎服。
【方歌】橘皮竹茹汤如神,专医胃热呕逆频,橘半麦冬枇杷草,竹茹赤苓与人参。
丁香柿蒂汤
丁香 人参 高良姜 柿蒂
水煎服。
【方歌】丁香柿蒂汤治寒,胃气上逆不得安,丁香良姜人参共,更入柿蒂一同煎。
毒盛呕吐二陈良,吞咽不利鼠粘汤,伤食吐酸大安效,气虚作呕和胃方。
【注】呕者,有物有声;吐者,有物无声,二证皆属于胃。痘初出呕吐者,是火邪犯胃,
毒瓦斯上腾,痘必红紫,宜栀连二陈汤。自起胀至收靥呕吐者,是疮集咽门,吞咽不利所
致,须用鼠粘子汤。若伤食呕吐者,吐必腥酸,宜用木香大安丸。设吐后精神困倦,不
思饮食,乃胃气虚也,以参砂和胃汤主之。
栀连二陈汤
陈皮 半夏(姜制) 茯苓 甘草(生) 栀子(姜炒) 川黄连(姜炒)
引用生姜,水煎服。
【方歌】毒瓦斯冲胃吐频频,医治须宜用二陈,陈半茯苓生甘草,栀连姜炒效如神。
加味鼠粘子汤
桔梗 射干 连翘(去心) 荆芥 防风 山豆根 鼠粘子(炒、研) 干葛
水煎服。
【方歌】加味鼠粘汤极合,桔梗射干同连翘,荆芥防风山豆根,鼠粘子炒配干葛。
木香大安丸(方见惊搐)
参砂和胃汤
人参 白术(土炒) 藿香 茯苓 陈皮 半夏(姜制) 缩砂仁 甘草(炙)
引用煨姜,水煎服。
【方歌】虚吐参砂和胃汤,人参白术共藿香,茯苓陈皮制半夏,缩砂甘草引煨姜。
痘疮出现干哕,病势沉重,毒热之气上逆,正气难以承受。若是实热证,宜用橘皮竹茹汤;若是虚寒证,丁香柿蒂汤疗效神奇。
【注】所谓干哕,是指只有声音而没有呕吐物,其声音宏大且长,属于阳明胃经的病症。这是由于毒热之气上逆所致。另外,也有因胃气不足,不能容纳受纳,加之寒邪客居胃中,导致胃气不能在中焦主持运化,反而上行引发哕症。对于热证,主方为橘皮竹茹汤;对于寒证,主方为丁香柿蒂汤。
橘皮竹茹汤
橘红、半夏(姜制)、麦门冬(去心)、枇杷叶(姜炙)、甘草(生)、竹茹、赤茯苓、人参。
引用芦根,水煎服。
【方歌】橘皮竹茹汤效如神,专治胃热引起的频繁呕逆,方中包含橘红、半夏、麦冬、枇杷叶、甘草、竹茹、赤茯苓与人参。
【方歌】丁香柿蒂汤治疗寒证,缓解胃气上逆带来的不安,方中丁香、良姜、人参共同使用,再加入柿蒂一同煎煮。
毒盛导致的呕吐,用二陈汤效果良好;吞咽不利引起的呕吐,用鼠粘子汤;伤食导致的吐酸,用木香大安丸有效;气虚引起的呕吐,用和胃方调理。
【注】呕吐方面,有物有声称为呕,有物无声称为吐,这两种症状都归属于胃。痘疹初出时发生呕吐,是火邪侵犯胃腑,毒瓦斯向上腾涌,痘色必呈红紫色,宜用栀连二陈汤。从起胀到收靥期间发生呕吐,是因为疮毒聚集于咽门,导致吞咽不利所致,须用鼠粘子汤。若是伤食引起的呕吐,吐出物必有腥酸味,宜用木香大安丸。如果呕吐后精神困倦,不思饮食,这是胃气虚弱,应以参砂和胃汤为主方。
栀连二陈汤
陈皮、半夏(姜制)、茯苓、甘草(生)、栀子(姜炒)、川黄连(姜炒)。
引用生姜,水煎服。
【方歌】毒瓦斯冲犯胃腑导致频繁呕吐,医治适宜使用二陈汤为基础,包含陈皮、半夏、茯苓、生甘草,加上姜炒的栀子与黄连,效验如神。
加味鼠粘子汤
桔梗、射干、连翘(去心)、荆芥、防风、山豆根、鼠粘子(炒、研)、干葛。
水煎服。
【方歌】加味鼠粘汤极为合适,包含桔梗、射干同连翘,荆芥、防风、山豆根,鼠粘子炒制后配伍干葛。
木香大安丸(方见惊搐章节)
When dry heaving occurs in smallpox, the disease condition is severe; toxic heat rebels upward, making it difficult for the healthy qi to withstand. For excess-heat patterns, Chupi Zhuru Tang (Tangerine Peel and Bamboo Shavings Decoction) is indicated; for deficiency-cold patterns, Dingxiang Shidi Tang (Clove and Persimmon Calyx Decoction) is miraculous.
[Note] Dry heaving refers to a sound without vomitus, characterized by a loud and prolonged noise, belonging to the Yangming Stomach Meridian. It is caused by the rebellion of toxic heat upward. Additionally, there are cases where insufficient stomach qi fails to receive and contain, compounded by cold pathogens lodging in the stomach, preventing stomach qi from governing the middle jiao, causing it to rebel upward and induce heaving. For heat patterns, Chupi Zhuru Tang is the primary formula; for cold patterns, Dingxiang Shidi Tang is the primary formula.
Chupi Zhuru Tang (Tangerine Peel and Bamboo Shavings Decoction)
Citri Reticulatae Pericarpium Rubrum (Juhong), Pinelliae Rhizoma Preparatum cum Zingibere (Banxia, processed with ginger), Ophiopogonis Radix (Maidong, heart removed), Eriobotryae Folium (Pipaye, roasted with ginger), Glycyrrhizae Radix et Rhizoma (Gancao, raw), Bambusae Medulla (Zhuru), Poria (Chiling), Ginseng Radix et Rhizoma (Renshen).
Reference: Phragmitis Rhizoma (Lugen), decocted in water and taken orally.
[Fang Ge - Formula Song] Chupi Zhuru Tang is effective as if divine, specifically treating frequent vomiting due to stomach heat; it contains Tangerine Peel, Pinellia, Ophiopogon, Loquat Leaf, Licorice, Bamboo Shavings, Poria, and Ginseng.
Dingxiang Shidi Tang (Clove and Persimmon Calyx Decoction)
Eugeniae Flos (Dingxiang), Ginseng Radix et Rhizoma (Renshen), Alpiniae Officinarum Rhizoma (Gaoliangjiang), Diospyros Fructus Calyx (Shidi).
Decocted in water and taken orally.
[Fang Ge - Formula Song] Dingxiang Shidi Tang treats cold patterns, calming rebellious stomach qi that causes unrest; Clove, Galangal, and Ginseng are combined, along with Persimmon Calyx, decocted together.
For vomiting caused by abundant toxins, Erchen Tang (Two-Aged Decoction) is beneficial; for vomiting accompanied by difficulty in swallowing, Niuzangzi Tang (Arctii Seed Decoction) is used; for vomiting of sour regurgitation due to food stagnation, Muxiang Da'an Wan (Aucklandia Great Peace Pill) is effective; for vomiting due to qi deficiency, Hewei Fang (Stomach-Harmonizing Formula) is employed.
[Note] Vomiting (Ou) involves both sound and matter; spitting up (Tu) involves matter but no sound. Both syndromes belong to the Stomach. When vomiting occurs at the initial eruption stage of smallpox, it is due to fire pathogens invading the stomach and toxic vapors surging upward; the pustules will necessarily appear red or purple, and Zhilian Erchen Tang (Gardenia and Coptis Two-Aged Decoction) should be used. When vomiting occurs from the swelling phase to the crusting phase, it is caused by toxin accumulation at the pharynx leading to dysphagia; Niuzangzi Tang must be used. If vomiting is due to food stagnation, the vomitus will have a fishy and sour odor; Muxiang Da'an Wan should be used. If after vomiting the spirit is fatigued and there is no desire for food, this indicates stomach qi deficiency; Shensha Hewei Tang (Ginseng and Amomum Stomach-Harmonizing Decoction) is the primary treatment.
Zhilian Erchen Tang (Gardenia and Coptis Two-Aged Decoction)
Citri Reticulatae Pericarpium (Chenpi), Pinelliae Rhizoma Preparatum cum Zingibere (Banxia, processed with ginger), Poria (Fuling), Glycyrrhizae Radix et Rhizoma (Gancao, raw), Gardeniae Fructus (Zhizi, stir-fried with ginger), Coptidis Rhizoma (Chuanlianhong, stir-fried with ginger).
Reference: Zingiberis Rhizoma Recens (Shengjiang), decocted in water and taken orally.
[Fang Ge - Formula Song] Toxic vapors rushing into the stomach cause frequent vomiting; treatment requires using Erchen Tang as a base, comprising Chenpi, Banxia, Fuling, Gancao, and Gardenia and Coptis stir-fried with ginger, proving as effective as divine intervention.
Jiawei Niuzangzi Tang (Modified Arctii Seed Decoction)
Platycodonis Radix (Jiegeng), Belamcandae Rhizoma (Shegan), Forsythiae Fructus (Lianqiao, heart removed), Schizonepetae Spica (Jingjie), Saposhnikoviae Radix (Fangfeng), Sophorae Tonkinensis Radix (Shandougen), Arctii Fructus (Niuzangzi, fried and ground), Puerariae Radix (Gange).
Decocted in water and taken orally.
[Fang Ge - Formula Song] Jiawei Niuzang Tang is highly appropriate, combining Jiegeng, Shegan, and Lianqiao, along with Jingjie, Fangfeng, and Shandougen; fried Niuzangzi is paired with Gange.
Muxiang Da'an Wan (See formula in the Convulsions section)
Shensha Hewei Tang (Ginseng and Amomum Stomach-Harmonizing Decoction)
Ginseng Radix et Rhizoma (Renshen), Atractylodis Macrocephalae Rhizoma (Baizhu, stir-fried with earth), Agastaches Herba (Huoxiang), Poria (Fuling), Citri Reticulatae Pericarpium (Chenpi), Pinelliae Rhizoma Preparatum cum Zingibere (Banxia, processed with ginger), Amomi Fructus Rotundus (Suosharen), Glycyrrhizae Radix et Rhizoma (Gancao, roasted).
Reference: Zingiberis Rhizoma Praeparatum (Weijiang), decocted in water and taken orally.
[Fang Ge - Formula Song] For deficiency-type vomiting, use Shensha Hewei Tang; Renshen and Baizhu are combined with Huoxiang, while Fuling, Chenpi, and processed Banxia are included, with Suosharen and Gancao guiding Weijiang into the prescription.