(有热、有痰、有虚。)
戴云∶恶心者,无声无物,但心中欲吐不吐,欲呕不呕。虽曰恶心,非心经之病,其病皆在胃口上。
宜用生姜,盖能开胃豁痰也。皆用生姜,随证用药。
(即膈噎。膈噎乃翻胃之渐,发挥备言。)
戴云∶翻胃有四∶血虚、气虚、有热、有痰。血虚者,脉必数而无力;气虚者,脉必缓而无力;气血俱
虚者,则口中多出沫,但见沫大出者,必死;有热者,脉数而有力;有痰者,脉滑数;二者可治。血虚者,四
物为主。气虚者,四君子为主。热以解毒为主。痰以二陈为主。大约有四∶血虚、气虚、有热、有痰兼病,必
用童便、竹沥、姜汁、牛羊乳。
粪如羊屎者,断不可治,大肠无血故也。
痰用二陈汤为主。寸关脉沉,或伏而大。
有气滞结者,通气之药皆可用也。寸关脉沉而涩。
气虚,四君子汤为主。血虚,四物汤为主。左手脉无力,大不可用香燥之药,服之必死。宜薄滋味。
马剥儿烧灰存性一钱重,好枣肉,平胃散二钱,温酒调服,食即可下。然后随病源调理,神效。
陈皮(三斤三两) 浓朴(三斤二两) 甘草(三十两) 苍术(五斤)
戴云∶恶食者,胸中有物。导痰补脾。二陈汤加白术、山楂、川芎、苍术。
(食积兼湿。东垣有法有方。)
又痞满方
吴茱萸(三两) 黄连(八两) 粥为丸。
软石膏碾末,醋丸,如绿豆大,泻胃火、食积、痰。
(病因包括热邪、痰饮和虚证。)
戴元礼说:恶心的症状是,没有声音也没有呕吐物,只是心中感觉想吐却吐不出来,想呕却呕不出。虽然称为恶心,但这并非心经的病变,其病位都在胃脘部。
适宜使用生姜,因为生姜能开胃并豁除痰饮。治疗时都以生姜为基础,再根据具体证候配合其他药物使用。
(即膈噎病。膈噎是翻胃的初期阶段,此处详细阐述。)
戴元礼说:翻胃有四种类型:血虚、气虚、有热、有痰。血虚者,脉象必然数而无力;气虚者,脉象必然缓而无力;气血俱虚者,则口中多流出涎沫,如果只见大量涎沫涌出,必定死亡;有热者,脉象数而有力;有痰者,脉象滑数;这两种情况是可以治疗的。血虚者,以四物汤为主方。气虚者,以四君子汤为主方。有热者,以解毒为主。有痰者,以二陈汤为主。大致归纳为四类:血虚、气虚、有热、有痰兼夹发病,必须使用童便、竹沥、姜汁、牛羊乳。
大便像羊屎一样干结的,断定不可治愈,这是因为大肠无血滋润的缘故。
痰证以二陈汤为主方。寸关脉沉,或者伏匿且大。
如果有气滞结聚的情况,所有行气通滞的药物都可以使用。此时寸关脉沉而涩。
气虚,以四君子汤为主方。血虚,以四物汤为主方。左手脉无力,绝对不可以使用香燥的药物,服用后必死。饮食宜清淡。
马剥儿(一种昆虫或药材名)烧灰存性一钱重,配好枣肉,平胃散二钱,用温酒调服,进食即可顺利下行。然后随病源进行调理,效果神奇。
陈皮(三斤三两) 厚朴(三斤二两) 甘草(三十两) 苍术(五斤)
戴元礼说:恶食(厌恶食物)的原因是胸中有积滞之物。治法为导痰补脾。使用二陈汤加白术、山楂、川芎、苍术。
(食积兼夹湿邪。李东垣有相关治法和方剂。)
又附痞满方
吴茱萸(三两) 黄连(八两) 用米粥制成丸剂。
软石膏碾成粉末,用醋泛丸,如绿豆大小,可泻胃火、食积、痰饮。
(Causes include Heat, Phlegm, and Deficiency.)
Dai Yuanli stated: The symptom of nausea is characterized by the absence of sound and vomitus, yet there is a sensation in the heart region of wanting to vomit but being unable to do so. Although termed "nausea," it is not a disease of the Heart Meridian; the pathology resides entirely at the epigastrium (Stomach gate).
Fresh Ginger (Shengjiang) should be used, as it can open the Stomach and resolve Phlegm. Fresh Ginger is employed as a base, with additional herbs prescribed according to the specific syndrome.
(Also known as Ge Ye [Diaphragmatic Obstruction]. Ge Ye is the precursor to Fan Wei [Reverse Stomach], detailed here.)
Dai Yuanli stated: There are four types of Fan Wei [Reverse Stomach]: Blood Deficiency, Qi Deficiency, Heat, and Phlegm. In cases of Blood Deficiency, the pulse is necessarily rapid and forceless; in Qi Deficiency, the pulse is necessarily slow and forceless; in combined Qi and Blood Deficiency, the mouth produces excessive saliva/phlegm; if large amounts of saliva merely flow out, death is certain. In cases of Heat, the pulse is rapid and forceful; in cases of Phlegm, the pulse is slippery and rapid; these two conditions are treatable. For Blood Deficiency, Si Wu Tang (Four Substances Decoction) is the primary formula. For Qi Deficiency, Si Jun Zi Tang (Four Gentlemen Decoction) is the primary formula. For Heat, resolving toxicity is the priority. For Phlegm, Er Chen Tang (Two-Aged Decoction) is the primary formula. Broadly categorized into four: Blood Deficiency, Qi Deficiency, Heat, and combined Phlegm-pathology, Tong Bian (Child's Urine), Zhu Li (Bamboo Sap), Jiang Zhi (Ginger Juice), and Cattle/Sheep Milk must be used.
If feces resemble sheep droppings, it is incurable, due to the lack of Blood in the Large Intestine.
For Phlegm, Er Chen Tang (Two-Aged Decoction) is the primary formula. The Cun and Guan positions of the pulse are deep, or hidden and large.
In cases of Qi Stagnation and knotting, all Qi-moving and unblocking herbs may be used. The Cun and Guan positions of the pulse are deep and choppy.
For Qi Deficiency, Si Jun Zi Tang (Four Gentlemen Decoction) is the primary formula. For Blood Deficiency, Si Wu Tang (Four Substances Decoction) is the primary formula. If the Left-hand pulse is forceless, aromatic and drying herbs must absolutely not be used; administration will lead to death. Diet should be light and bland.
Ma Bo'er (a specific insect/herb name) burned to ash but retaining its nature, one qian; mixed with good Jujube flesh and Ping Wei San (Calm the Stomach Powder), two qian, taken with warm wine to facilitate swallowing. Thereafter, regulate according to the disease source for miraculous efficacy.
Chen Pi (Tangerine Peel, 3 jin 3 liang) Hou Po (Magnolia Bark, 3 jin 2 liang) Gan Cao (Licorice Root, 30 liang) Cang Zhu (Atractylodes Rhizome, 5 jin)
Dai Yuanli stated: The cause of E Shi [aversion to food] is an accumulation in the chest. The treatment method is to guide out Phlegm and tonify the Spleen. Use Er Chen Tang (Two-Aged Decoction) added with Bai Zhu (Atractylodes Macrocephala Rhizome), Shan Zha (Hawthorn Fruit), Chuan Xiong (Ligusticum Rhizome), and Cang Zhu (Atractylodes Rhizome).
(Food Retention combined with Dampness. Li Dongyuan has methods and formulas.)
Another Formula for Pi Man [Fullness and Obstruction]
Wu Zhu Yu (Evodia Fruit, 3 liang) Huang Lian (Coptis Rhizome, 8 liang) Made into pills using rice congee.
Ruan Shi Gao (Soft Gypsum Fibrosum) ground into powder, made into pills with vinegar, size of mung beans, to drain Stomach Fire, Food Retention, and Phlegm.