《金匮》大黄甘草汤 治食已即吐。
大黄(四两) 甘草(一两)
水三升,煮取一升,分温再服。
此上病疗下之法。夫阳明之气,顺而下行者也,若下焦不通,其气必反而上行,是以食
已即吐。用大黄以通大便,则气复顺而下行矣。所谓浊气自归浊道也。
东垣通幽汤 治幽门不通,上冲吸门,呕吐噎塞,气不得上下,治在幽门。
熟地 生地(各二钱) 红花(五分) 桃仁泥(七粒) 当归 甘草 升麻(各五分) 大黄
(一钱)
上 咀,都作一服,水二大盏,煎至一盏,去滓热服。
《准绳》云∶阴虚邪气逆上,窒塞呕哕,不足之病,此地道不通也。当用生地黄、当归
、桃
仁、红花之类,和血、凉血、润血,兼用甘草以补其气,微加大黄、芒硝以通其闭,大便利
,邪气去,则气逆呕吐自愈矣。
《广济》豆蔻子汤 治反胃呕吐,不下食,腹中气逆。
人参(一两) 白豆蔻(七粒) 甘草(炒,一两) 生姜(五两)
水四升,煮取一升五合,去滓,分温三服,相去如人行五六里。
丁香煮散
丁香 石莲肉(各十四枚) 北枣(七枚) 生姜(七片) 黄秫米(半合)
上以水一碗半,煮稀粥,去药,取粥食之。
《金匮要略》中的大黄甘草汤,用于治疗进食后立即呕吐的症状。
处方:大黄(四两)、甘草(一两)。
用法:用水三升,煎煮至一升,分两次温服。
这是“上病下治”的方法。阳明经之气,本性是顺畅向下运行的。如果下焦不通畅,气机必然逆乱而上行,从而导致进食后立即呕吐。使用大黄来通导大便,气机就能恢复顺畅并向下运行。这就是所谓的“浊气回归其正常的排泄通道”。
李东垣的通幽汤,用于治疗幽门不通畅,气机上冲至吸门,出现呕吐、噎塞感,气机无法上下贯通的情况,治疗重点在于疏通幽门。
处方:熟地黄、生地黄(各二钱)、红花(五分)、桃仁泥(七粒)、当归、甘草、升麻(各五分)、大黄(一钱)。
用法:将药材切碎,作为一剂服用,用两大盏水,煎煮至一盏,滤去药渣,趁热服用。
《医学准绳六要》记载:阴虚导致邪气逆上,造成窒塞、呕吐呃逆,属于正气不足的病症,这是因为地道(肠道)不通畅所致。应当使用生地黄、当归、桃仁、红花等药物,以调和血液、凉血、润燥养血,同时配合甘草来补益气机,稍加大黄、芒硝以通导闭塞。大便通畅后,邪气去除,气逆呕吐自然痊愈。
《广济方》中的豆蔻子汤,用于治疗反胃呕吐,无法进食,腹中气机逆乱。
处方:人参(一两)、白豆蔻(七粒)、甘草(炒制,一两)、生姜(五两)。
用法:用水四升,煎煮至一升五合,滤去药渣,分三次温服,每次服药间隔时间约为行人步行五六里所需的时间。
丁香煮散:由丁香、石莲子肉(各十四枚)、北枣(七枚)、生姜(七片)、黄秫米(半合)组成。
用法:用水一碗半,煮成稀粥,去掉药渣,只喝粥食用。
Anhui Wan (Ascaris-Calming Pill): Composed of Renshen (Ginseng Radix), Baizhu (Atractylodis Macrocephalae Rhizoma), Ganjiang (Zingiberis Rhizoma), Gancao (Glycyrrhizae Radix et Rhizoma), Chuanjiao (Sichuan Pepper), and Wumei (Mume Fructus).
Dahuang Gancao Tang (Rhubarb and Licorice Decoction) from *Jin Gui Yao Lue* (Essential Prescriptions from the Golden Cabinet) is used to treat vomiting immediately after eating.
Prescription: Dahuang (Rhei Radix et Rhizoma, 4 liang); Gancao (Glycyrrhizae Radix et Rhizoma, 1 liang).
Administration: Boil with 3 sheng of water until reduced to 1 sheng; take warm in two divided doses.
This is a method of treating upper disorders by addressing lower pathology. The Qi of the Yangming channel naturally flows downward. If the lower jiao (lower burner) is obstructed, the Qi will inevitably rebel and ascend, leading to immediate vomiting after eating. Using Dahuang to unblock the large intestine allows the Qi to resume its smooth downward flow. This is referred to as "turbid Qi returning to its proper pathway."
Tongyou Tang (Unblocking the Dark Decoction) by Li Dongyuan is used to treat obstruction at the pylorus (Houmen), where Qi rebels upward to the glottis (Ximen), causing vomiting, dysphagia/choking sensations, and inability of Qi to circulate up and down. The treatment focuses on unblocking the pylorus.
Prescription: Shudi (Rehmanniae Radix Praeparata) and Shengdi (Rehmanniae Radix), each 2 qian; Honghua (Carthami Flos), 5 fen; Taoren Ni (Peach Seed Paste), 7 grains; Danggui (Angelicae Sinensis Radix); Gancao (Glycyrrhizae Radix et Rhizoma); Shengma (Cimicifugae Rhizoma), each 5 fen; Dahuang (Rhei Radix et Rhizoma), 1 qian.
Administration: Coarsely crush the herbs, combine as one dose, boil with 2 large zhan of water until reduced to 1 zhan, strain, and take hot.
*Zhunsheng* states: Yin deficiency with rebellious pathogenic Qi causes obstruction, vomiting, and hiccups; this is a deficiency condition caused by the obstruction of the "earthly pathway" (intestines). One should use herbs such as Shengdi, Danggui, Taoren, and Honghua to harmonize blood, cool blood, and moisten blood. Combine with Gancao to tonify Qi, and slightly add Dahuang and Mangxiao (Natrii Sulfas) to unblock closure. Once the stool is free and pathogenic Qi is expelled, the rebellious Qi and vomiting will resolve spontaneously.
Doukouzi Tang (Cardamom Seed Decoction) from *Guang Ji Fang* is used to treat regurgitation/vomiting, inability to retain food, and rebellious Qi in the abdomen.
Prescription: Renshen (Ginseng Radix, 1 liang); Baidoukou (Amomi Fructus Rotundus), 7 grains; Gancao (Glycyrrhizae Radix et Rhizoma, stir-fried, 1 liang); Shengjiang (Zingiberis Rhizoma Recens, 5 liang).
Administration: Boil with 4 sheng of water until reduced to 1.5 sheng, strain, and take warm in three divided doses. The interval between doses should be approximately the time it takes for a person to walk five or six li.
Dingxiang Zhusan (Cloves Boiled Powder): Consists of Dingxiang (Caryophylli Flos), Shilian Rou (Nelumbinis Semen), each 14 pieces; Beizao (Jujubae Fructus), 7 pieces; Shengjiang (Zingiberis Rhizoma Recens), 7 slices; Huangshumi (Sorghum Vulgare), 0.5 he.
Administration: Boil with 1.5 bowls of water to make a thin porridge, remove the medicinal residues, and consume only the porridge.