脉∶嗳气嘈杂,审右寸关,紧滑可治,弦急则难;两寸弦滑,留饮胸间;脉横在寸,有积上栏。
嗳气者,乃嗳胸膈之气上升也。
嗳气有胃中有火、有痰者,宜二陈汤。(方见痰饮。)根据本方加炒山栀、砂仁、白豆蔻、木香、
益智仁、枳实、黄连、炒浓朴、姜炒香附米。
星半汤 治症同前。
南星 半夏 软石膏 香附 炒桅子
上锉生姜三片,水煎服。或作丸亦可。盖胃中有郁火、膈上有稠痰故也。
嗳气有胃寒者,宜理中汤。(方见中寒。)根据本方加木香、茴香、益智仁、陈皮。浓朴、香附,去人参、茯苓。
破郁丹 治妇人嗳气胸紧,连十余声不尽,嗳出气心头略宽,不嗳即紧宜服。
香附米(醋煮、四两) 栀子仁(炒,四两) 黄连(姜汁炒,二两) 枳实(麸炒,二两) 槟榔(一两)
莪术(一两) 青皮(去穣,一两) 栝蒌仁(一两) 苏子(一两)
上共为末水丸,如梧桐子大。每服三十九,食后滚水送下。
脉∶吞酸脉形多弦而滑;或沉而迟,胸有寒饮;或数而洪,膈有痰热。
吞酸与吐酸不同,吞酸水刺心也;吐酸者,吐出酸水也。俱是饮食入胃,气虚不能运化,郁积已久,湿中生热,
湿热相蒸,故作酸也。用香砂平胃散加减治之。譬如谷肉在器,湿热则易为酸也。若是吞酸吐酸、嘈杂心烦,久而
不治成膈噎翻胃症也。
吞酸者,湿热在胃口,上为酸也。
清郁二陈汤 治酸水刺心及吞酸嘈杂。
陈皮 半夏(姜汁炒) 茯苓(各一钱) 苍术(制,八分) 川芎(八分) 香附(一钱) 神曲(炒,五钱)
枳实(麸炒,八分) 黄连(炒) 栀子(炒。各一钱) 白芍(炒,七分) 甘草(三分)
上锉一剂,生姜三片,水煎服。
香砂平胃散 治吞酸吐酸。(方见伤食。)根据本方加炒黄连、山栀、吴茱萸、去枳壳、木香;有因心痛服
热药过多,后患吞酸病,本方加炒黄连,有因热药过多,涌出酸苦黑水如烂木耳汁者,心痛既愈,乃频作酸,块痞
自胸筑上咽喉甚恶,炒黄连煎浓汁,常服一二匙自安。
平肝顺气保中丸 治郁火伤脾,中气不运,胃中伏火,郁积生痰,致令呕吐吞酸嘈杂、心腹闷。常服顺气
和中、开胃健脾、进食化痰消痞。
香附米(童便浸三日,炒,三两) 小川芎(二两) 陈皮(去白,三两) 白术(土炒,四两) 枳实
(麸炒,二两) 黄连(姜汁炒,二两) 吴茱萸(汤泡,一两) 神曲(炒,一两) 麦芽(炒,七钱)
木香(三钱) 栀子(姜汁炒,一两) 莱菔子(炒,一两) 半夏(姜汁炒,一两半) 白茯苓(去皮,一两)
砂仁(炒,四钱) 干生姜(一两) 竹茹(一两) 甘草(炙,四钱) 一方加山楂(去核,一两)、青皮
(清油炒,六钱),去吴茱萸、竹茹。
上为细末,竹沥打神曲糊为丸,如梧桐子大。每服八九十丸,白汤送下,一日进二次。
吐酸者,吐出酸水,肝木之味也。
苍连汤
苍术(米泔制) 黄连(姜汁炒) 陈皮 半夏(姜汁炒) 茯苓(去皮) 神曲(炒。各一钱) 吴茱萸
(炒) 砂仁(各五分) 甘草(三分)
上锉一剂,生姜三片,水煎温服。
治吐清水
苍术(壁土炒) 白术(炒) 陈皮 白茯苓(去皮) 滑石(炒)
上锉水煎服。
Pulse: Belching accompanied by a sensation of stomach discomfort (zaocao), examine the right cun and guan positions. A tight and slippery pulse indicates treatability, whereas a wiry and rapid pulse indicates difficulty in treatment; if both left and right cun positions are wiry and slippery, it suggests retained fluid in the chest. A horizontal pulse at the cun position indicates accumulation with upward obstruction.
Belching refers to the rising of qi from the chest and diaphragm.
If belching is caused by fire in the stomach and phlegm, Er Chen Tang (Two-Cured Decoction) is appropriate. (Formula see Phlegm-Fluids.) Based on this formula, add fried Gardenia Fruit (Shanzhi), Amomum Fruit (Sharen), White Cardamom Seed (Baidoukou), Aucklandia Root (Muxiang), Alpinia Oxyphylla Fruit (Yizhiren), Immature Bitter Orange (Zhishi), Coptis Rhizome (Huanglian), fried Magnolia Bark (Nongpou), and ginger-processed Cyperus Rhizome (Xiangfu).
Xingban Decoction: Treats the same symptoms as above.
Ingredients: Pinellia Ternata Rhizome processed with alum (Tianxing), Pinellia Tuber (Banxia), Gypsum Fibrosum (Ruanshigao), Cyperus Rhizome (Xiangfu), fried Gardenia Fruit (Zhi Zi).
Preparation: Cut into pieces, add three slices of fresh Ginger (Shengjiang), decoct in water and take orally. Can also be made into pills. This is because there is stagnant fire in the stomach and thick phlegm above the diaphragm.
If belching is caused by stomach cold, Lizhong Tang (Regulate the Middle Decoction) is appropriate. (Formula see Middle Cold.) Based on this formula, add Aucklandia Root (Muxiang), Fennel Fruit (Huixiang), Alpinia Oxyphylla Fruit (Yizhiren), Tangerine Peel (Chenpi), Magnolia Bark (Nongpou), Cyperus Rhizome (Xiangfu); remove Codonopsis Root (Renshen) and Poria (Fuling).
Poyu Dan (Break Stagnation Pill): For women suffering from belching with chest tightness, continuing for more than ten times without relief; after belching, the heart feels slightly relaxed, but tightness returns if belching does not occur. Take this medicine.
Ingredients: Cyperus Rhizome (Xiangfumie) boiled in vinegar (4 liang), Gardenia Seed (Zhiziren) fried (4 liang), Coptis Rhizome (Huanglian) stir-fried with ginger juice (2 liang), Immature Bitter Orange (Zhishi) bran-fried (2 liang), Areca Seed (Binglang) (1 liang), Curcuma Zedoaria Rhizome (Ezhu) (1 liang), Green Tangerine Peel (Qingpi) de-pulped (1 liang), Trichosanthes Seed (Gualouren) (1 liang), Perilla Seed (Suzi) (1 liang).
Preparation: Grind all ingredients into fine powder, make pills with water, size of Sophora japonica seeds. Take 30 pills each time, washed down with boiling water after meals.
Pulse: The pulse of acid regurgitation (tunsuan) is often wiry and slippery; or deep and slow, indicating cold-fluid in the chest; or rapid and surging, indicating phlegm-heat in the diaphragm.
Acid regurgitation differs from vomiting acid. Acid regurgitation involves sour fluid piercing the heart; vomiting acid involves expelling sour fluid. Both result from food entering the stomach where deficient qi fails to transform and transport it. After long-term stagnation, dampness generates heat. Damp-heat steaming together causes acidity. Treat with Xiangsha Pingwei San modified. It is like grain and meat in a container becoming sour easily under damp-heat conditions. If acid regurgitation, vomiting acid, and stomach discomfort persist untreated for a long time, they may develop into dysphagia (geye) or retching (fawei).
Acid regurgitation occurs when damp-heat is located at the stomach opening, rising up as acid.
Qingyu Erchen Tang (Clear Stagnation Two-Cured Decoction): Treats sour fluid piercing the heart, acid regurgitation, and stomach discomfort.
Ingredients: Tangerine Peel (Chenpi), Pinellia Tuber (Banxia) stir-fried with ginger juice, Poria (Fuling) (each 1 qian), Atractylodes Macrocephala Rhizome (Cangzhu) processed (8 fen), Ligusticum Chuanxiong Rhizome (Chuanxiong) (8 fen), Cyperus Rhizome (Xiangfu) (1 qian), Medicated Leaven (Shenqu) fried (5 qian), Immature Bitter Orange (Zhishi) bran-fried (8 fen), Coptis Rhizome (Huanglian) fried, Gardenia Fruit (Zhizi) fried (each 1 qian), White Peony Root (Baishao) fried (7 fen), Licorice Root (Gancao) (3 fen).
Preparation: Cut one dose, add three slices of fresh Ginger (Shengjiang), decoct in water and take.
Xiangsha Pingwei San (Aucklandia and Amomum Regulate the Middle Powder): Treats acid regurgitation and vomiting acid. (Formula see Food Injury.) Based on this formula, add fried Coptis Rhizome (Huanglian), fried Gardenia Fruit (Zhizi), Evodia Fruit (Wuzhuyu); remove Aurantium Imperiale (Zhike) and Aucklandia Root (Muxiang). If acid regurgitation arises after excessive use of hot medicines for heart pain, add fried Coptis Rhizome (Huanglian) to this formula. If excessive hot medicines cause expulsion of sour, bitter, black water resembling rotten wood ear juice, and after heart pain resolves, frequent acid production occurs with palpitations rising from the chest to the throat causing great distress, decoct fried Coptis Rhizome (Huanglian) in strong liquid and take one or two spoons regularly to find relief.
Pinggan Shunqi Baozhong Wan (Liver-Calming Qi-Smoothening Middle-Preserving Pill): Treats stagnant fire injuring the spleen, failure of middle qi to move, latent fire in the stomach, stagnation generating phlegm, leading to vomiting, acid regurgitation, stomach discomfort, and chest/abdominal fullness. Regular use smooths qi and harmonizes the middle, opens the stomach and strengthens the spleen, aids digestion, transforms phlegm, and reduces masses.
Ingredients: Cyperus Rhizome (Xiangfumie) soaked in child's urine for three days, fried (3 liang), Ligusticum Chuanxiong Rhizome (Xiao Chuanxiong) (2 liang), Tangerine Peel (Chenpi) peeled (3 liang), Atractylodes Macrocephala Rhizome (Baizhu) earth-fried (4 liang), Immature Bitter Orange (Zhishi) bran-fried (2 liang), Coptis Rhizome (Huanglian) stir-fried with ginger juice (2 liang), Evodia Fruit (Wuzhuyu) soaked in soup (1 liang), Medicated Leaven (Shenqu) fried (1 liang), Sprouted Barley (Maiya) fried (7 qian), Aucklandia Root (Muxiang) (3 qian), Gardenia Fruit (Zhizi) stir-fried with ginger juice (1 liang), Radish Seed (Laifuzi) fried (1 liang), Pinellia Tuber (Banxia) stir-fried with ginger juice (1.5 liang), White Poria (Baifuling) peeled (1 liang), Amomum Fruit (Sharen) fried (4 qian), Dried Ginger (Ganjiang) (1 liang), Bamboo Shavings (Zhuru) (1 liang), Roasted Licorice Root (Gancao) (4 qian). Another prescription adds Hawthorn Fruit (Shanzha) pitted (1 liang), Green Tangerine Peel (Qingpi) fried with clear oil (6 qian), removing Evodia Fruit (Wuzhuyu) and Bamboo Shavings (Zhuru).
Preparation: Grind into fine powder, use bamboo sap to bind Shenqu paste into pills, size of Sophora japonica seeds. Take 80-90 pills each time, washed down with white water, twice daily.
Vomiting acid involves expelling sour fluid, which is the flavor of Liver Wood.
Canglian Tang (Atractylodes and Coptis Decoction)
Ingredients: Atractylodes Rhizome (Cangzhu) prepared with rice wash water, Coptis Rhizome (Huanglian) stir-fried with ginger juice, Tangerine Peel (Chenpi), Pinellia Tuber (Banxia) stir-fried with ginger juice, Poria (Fuling) peeled, Medicated Leaven (Shenqu) fried (each 1 qian), Evodia Fruit (Wuzhuyu) fried, Amomum Fruit (Sharen) (each 5 fen), Licorice Root (Gancao) (3 fen).
Preparation: Cut one dose, add three slices of fresh Ginger (Shengjiang), decoct in water and take warm.
Treatment for vomiting clear fluid
Ingredients: Atractylodes Rhizome (Cangzhu) fried with wall soil, Atractylodes Macrocephala Rhizome (Baizhu) fried, Tangerine Peel (Chenpi), White Poria (Baifuling) peeled, Talcum (Huashi) fried.
Preparation: Cut into pieces, decoct in water and take.