(《灵枢·营卫生会篇》)
黄帝曰∶人有热饮食下胃,其气未定汗则出,或出于面,或出于背,或出于身半,其不循卫气之道而出何也?(饮
食入胃,其气各有所行,如《经脉别论》曰,散精于肝,淫气于筋,浊气归心,淫精于脉之类是也。卫气之道,昼行于
阳,夜行于阴,有常度也。今有热饮食者,方入于胃,其气之留行未定而汗辄外泄,出无方所,是不循卫气之道也,故
以为问?)岐伯曰∶此外伤于风,内开腠理,毛蒸理泄,卫气走之,固不得循其道。(风为阳邪,有外热也。热食气悍,
因内热也。热之所聚,则开发腠理,所以毛蒸理泄而卫气走之,故不循其常道也。)此气 悍滑疾,见开而出,故不得从
其道,故命曰漏泄。(此即热食之气也,出不由度,故曰漏泄。 音飘,急也。)
(《素问·腹中论》)
黄帝问曰∶有病心腹满,旦食则不能暮食,此为何病?岐伯对曰∶名为鼓胀。(内伤脾肾,留滞于中,则心腹胀满,
不能再食,其胀如鼓,故名鼓胀。)帝曰∶治之奈何?岐伯曰∶治之以鸡矢醴,一剂知,二剂已。(鸡矢之性,能消积下
气,通利大小二便,盖攻伐实邪之剂也。一剂可知其效,二剂可已其病。凡鼓胀由于停积及湿热有余者,皆宜用之。若
脾肾虚寒发胀及气虚中满等证,最所忌也,误服则死。按《普济方》云∶治脾虚不能制水,水反胜土,水谷不运,气不
宣流,故令中满者,宜鸡矢醴主之。此说不明虚实,殊失经意,不可不察。鸡矢醴法,按《正传》云∶用羯鸡矢一升,
研细,炒焦色,地上出火毒,以百沸汤淋汁,每服一大盏,调木香、槟榔末各一钱,日三服,空腹服,以平为度。又按∶
《医鉴》等书云∶用干羯鸡矢八合,炒微焦,入无灰好酒三碗,共煎干至一半许,用布滤取汁,五更热饮,则腹鸣,辰
巳时行二三次,皆黑水也。次日觉足面渐有皱纹,又饮一次,则渐皱至膝上而病愈矣。此二法,似用后者为便。)帝曰∶
其时有复发者何也?(胀病多反复也。)岐伯曰∶此饮食不节,故时有病也。(鼓胀之病,本因留滞,故不可复纵饮食也。)
虽然其病且已时,故当病气聚于腹也。(病虽将愈而复伤其脾,所以气复聚也。)
(出自《灵枢·营卫生会篇》)
黄帝问道:人吃了热的饮食进入胃中,食物的精气尚未完全输布,汗液就流出了,有的从面部出,有的从背部出,有的从身体半侧出,这为什么不沿着卫气运行的常规路径而出呢?(饮食进入胃后,其精微之气各有不同的运行去向,如《经脉别论》所说:“散精于肝,淫气于筋,浊气归心,淫精于脉”等就是这种情况。卫气的运行规律是白天行于阳分,夜晚行于阴分,有固定的节度。现在有人吃了热食,刚入胃中,其气停留运行尚未定处,汗液却随即外泄,出处没有固定方位,这就是不遵循卫气运行的常道,所以提出疑问。)岐伯回答说:这是因为体表受了风邪侵袭,导致腠理(皮肤纹理及汗孔)内部开放,毛发受热蒸腾,腠理开泄,卫气随之奔走散失,自然不能遵循其正常的运行道路。(风属于阳邪,带有外在的热性。热食之气剽悍滑疾,带有内在的热性。热气聚集之处,就会开发腠理,所以出现毛发蒸热、腠理开泄而卫气奔走的情况,因此不循常道。)这种气剽悍滑疾,遇到腠理开泄就外出,所以不能从正常通道运行,因此命名为漏泄。(这就是热食之气所致,汗出没有节制,所以叫漏泄。音飘,意为急迫。)
(出自《素问·腹中论》)
黄帝问道:有一种病,表现为心腹部胀满,早上吃了饭到了晚上就不能再吃,这是什么病?岐伯回答说:这种病名叫鼓胀。(内伤脾肾,邪气留滞于中焦,导致心腹胀满,无法继续进食,腹部胀大像鼓一样,所以称为鼓胀。)黄帝说:怎么治疗呢?岐伯说:用鸡矢醴(鸡屎酒剂)治疗,服一剂见效,服两剂痊愈。(鸡矢的性质,能够消除积滞、下气,通利大小便,这是攻伐实邪的方剂。服一剂可以知道疗效,服两剂可以治愈疾病。凡是因停积及湿热有余导致的鼓胀,都适宜使用。如果是脾肾虚寒引起的胀满以及气虚导致的中满等症状,是最忌讳使用的,误服会导致死亡。按《普济方》记载:治疗脾虚不能制约水湿,水反克土,水谷运化失常,气机宣通受阻,从而导致中满的,适宜用鸡矢醴主治。这种说法不明确虚实辨证,严重违背了经文原意,不可不仔细考察。鸡矢醴的制作法,按《正传》记载:用羯公鸡屎一升,研细,炒至焦色,在地上放置以去除火毒,用滚开水淋取汁液,每次服用一大盏,调入木香、槟榔末各一钱,每日三次,空腹服用,以症状平复为度。又按:《医鉴》等书记载:用干羯公鸡屎八合,炒至微焦,加入无灰好酒三碗,共同煎煮至剩下一半左右,用布过滤取汁,五更天时热饮,则腹部鸣响,辰时巳时排出二三次,都是黑水。第二天感觉脚面逐渐出现皱纹,再喝一次,皱纹逐渐蔓延至膝盖以上,病就好了。这两种方法,似乎以后一种更为方便。)黄帝说:为什么有时病情会复发呢?(胀病多反复发作。)岐伯说:这是因为饮食不节制,所以时常发病。(鼓胀之病,本因邪气留滞,所以不能再放纵饮食。)虽然此时病情暂时缓解,但病气仍聚结在腹部。(病虽将愈却再次损伤脾脏,所以气机再次聚结。)
(From *Ling Shu: Ying Wei Sheng Hui Pian*)
The Yellow Emperor asked: When a person consumes hot food and drink, before the qi of the food has fully distributed, sweat appears. It may come out from the face, or from the back, or from half of the body. Why does it not follow the pathway of Wei Qi (Defensive Qi)? (After food enters the stomach, its essence qi travels to different destinations. As stated in *Jing Mai Bie Lun*: "Scattering essence to the Liver, flooding sinews with qi, turbid qi returns to the Heart, flooding vessels with essence," etc. The pathway of Wei Qi runs during the day in Yang and at night in Yin, having a constant degree. Now, with hot food just entering the stomach, its qi remains unestablished in its movement, yet sweat immediately leaks out without a fixed location. This is not following the pathway of Wei Qi, hence the question.) Qi Bo replied: This is due to external injury by Wind, which causes the interior opening of Cou Li (skin texture and pores). Hair steams and Cou Li leaks; Wei Qi rushes there, thus certainly cannot follow its normal path. (Wind is a Yang pathogen, possessing external heat. Hot food qi is fierce and rapid, possessing internal heat. Where heat gathers, it opens Cou Li, causing hair steaming and Cou Li leakage with Wei Qi rushing there, hence not following the usual path.) This qi is fierce, slippery, and rapid; seeing an opening, it exits, thus cannot follow its proper channel. Therefore, it is named Lou Xie (Leakage). (This refers to the qi of hot food; exiting without regulation, it is called Leakage. Pronounced 'piao', meaning urgent.)
(From *Su Wen: Fu Zhong Lun*)
The Yellow Emperor asked: There is a disease characterized by fullness in the heart and abdomen, where one can eat in the morning but cannot eat in the evening. What is this disease? Qi Bo answered: It is named Gu Zhang (Drum Distension). (Internal injury to Spleen and Kidney, stagnation remaining in the middle, causes fullness in the heart and abdomen, inability to continue eating, and distension like a drum, hence named Drum Distension.) The Emperor said: How should it be treated? Qi Bo said: Treat it with Ji Shi Li (Chicken Dropping Wine Decoction). One dose brings noticeable effect, two doses cure the disease. (The nature of Chicken Dropping can eliminate accumulation and direct qi downward, promoting urination and defecation; it is a formula for attacking excess pathogens. One dose shows efficacy, two doses cure. For all cases of Drum Distension caused by stagnation and excess damp-heat, it is suitable. However, for distension caused by Spleen and Kidney deficiency-cold, and middle-fullness due to qi deficiency, it is strictly contraindicated; mistaken use leads to death. According to *Pu Ji Fang*: treating middle-fullness caused by Spleen deficiency failing to control water, where water overcomes Earth, leading to failure of grain transport and qi circulation, Ji Shi Li is indicated. This explanation fails to clarify deficiency and excess, greatly deviating from the classic's intent, requiring careful examination. The method for Ji Shi Li, according to *Zheng Chuan*: Use one sheng of male chicken droppings, grind finely, stir-fry until charred, place on ground to remove fire toxicity, pour boiling water to extract juice. Take one large cup per dose, mixed with one qian each of Mu Xiang (Aucklandiae Radix) and Bing Lang (Arecae Semen), three times daily, taken on an empty stomach, stopping when symptoms resolve. Alternatively, according to *Yi Jian* and other books: Use eight he of dry male chicken droppings, stir-fry until slightly charred, add three bowls of good non-ashy wine, boil together until half remains, filter through cloth to obtain juice. Drink hot at wu geng (early morning), causing abdominal borborygmus. During Chen and Si hours (7-11 AM), pass two or three times, all black water. The next day, wrinkles gradually appear on the dorsum of feet. Drink once more, wrinkles extend to above knees, and disease cures. Of these two methods, the latter seems more convenient.) The Emperor said: Why does the disease sometimes recur? (Distension diseases often relapse.) Qi Bo said: This is because of irregular diet, hence the disease occurs occasionally. (The disease of Drum Distension originates from stagnation, so one must not indulge in diet again.) Although the disease is temporarily resolved, the pathogenic qi still gathers in the abdomen. (Although the disease is about to heal, if the Spleen is injured again, qi re-gathers.)