大黄 黄连
心下痞。按之濡。其脉关上浮者。此汤主之。 濡者。软也。 结言胸。痞言心下。结
言按之
曰。大热受邪。心病生焉。味苦入心。性寒除热。大黄黄连之苦寒。以泻心下之虚热。但以
麻沸汤渍服者。取其清薄而泻虚热也。
芫花 甘遂 大戟
太阳中风。下利呕逆。表解者。乃可攻之。 汗出。发作有时。头痛。痞满。引胁下
痛。干呕短气。汗出。不恶寒者。此表解。里未和也。此汤主之。 杜壬问孙兆曰。十枣汤治何病
。孙曰。治太阳中风。表解里未和。杜曰。何以知里未和。孙曰。头痛。痞满。胁痛。干呕
。汗出。知里未和也。杜曰。此但言病症。而所以里未和之故。总未言也。孙曰。某实未决
。愿听开论。杜曰。里未和者。痰与燥气壅于中焦。故头痛干呕。短气汗出。是痰隔也。非
十枣汤不能治。但此汤不宜轻用。恐损人于倏忽也。
赤石脂 禹余粮
下利心下痞硬。服泻心已。复以它药下之。利不止。治以理中。利益甚。理中者。理中
焦。此利在下焦。与赤石脂禹余粮汤。复下利。当利小便。
旋复花 甘草 人参 代赭石 生姜 半夏 大枣
汗吐下后。心下痞硬。噫气不除。此汤主之。 噫气。俗名嗳气。饱食息也。 硬则气
坚。咸味可以软之。旋复花之咸。以软痞硬。虚则气浮。重剂可以镇之。代赭石之重。以镇虚逆。
生姜半夏。辛以散虚痞。人参大枣。甘以补胃弱。 痞而下利。生姜泻心汤。痞而不下利。
旋复代赭汤。
Rhizoma Rhei Preparata (Dahuang), Folium Coptidis (Huanglian)
Epigastric fullness and oppression, soft upon palpation. If the pulse is floating at the Guan position, this decoction is indicated. "Ru" refers to softness. "Jie" (knotting) refers to hardness and pain in the chest, while "Pi" (stagnation) refers to epigastric fullness. "Jie" implies resistance or pain upon pressure.
When pathogenic heat enters the interior, it affects the Heart. Bitter flavors enter the Heart meridian, and cold nature clears heat. The bitter-cold properties of Rhizoma Rhei Preparata and Folium Coptidis are used to drain deficient heat from the epigastrium. It is soaked only in boiling water for administration to utilize its light and thin aromatic quality to drain deficient heat.
Radix Genkwanis (Yuanhua), Radix Kansui (Gansui), Radix Euphorbiae Pekinensis (Daji)
In Taiyang Wind-stroke syndrome, with diarrhea and vomiting/rebellious qi. Only after the exterior syndrome has resolved can one attack the interior. Sweating, occurring at specific times, headache, epigastric fullness, pain radiating to the hypochondrium, dry retching, shortness of breath, sweating, and absence of aversion to cold indicate that the exterior is resolved but the interior is not harmonized. This decoction is indicated. Du Ren asked Sun Zhao: "What disease does Shizao Tang treat?" Sun replied: "It treats Taiyang Wind-stroke where the exterior is resolved but the interior is not harmonized." Du asked: "How do you know the interior is not harmonized?" Sun said: "Headache, epigastric fullness, hypochondriac pain, dry retching, and sweating indicate that the interior is not harmonized." Du said: "You are merely stating the symptoms, but have not explained the cause of the interior disharmony." Sun said: "I have not fully deliberated on this; I wish to hear your exposition." Du said: "The interior disharmony is due to phlegm-fluids and dry qi obstructing the Middle Jiao, causing headache, dry retching, shortness of breath, and sweating. This is obstruction by phlegm-fluids. Only Shizao Tang can treat it. However, this decoction should not be used lightly, as it may damage the person suddenly."
Lapis Kaolinitis Ruber (Chishizhi), Lapis Haematitatis (Yuyuliang)
Diarrhea with epigastric fullness and hardness. After taking Xiexin Tang, if other purgatives are administered, leading to incessant diarrhea, treating with Lizhong Tang will worsen the diarrhea. Lizhong Tang regulates the Middle Jiao; this diarrhea originates from the Lower Jiao. Administer Chishizhi Yuyuliang Tang. If diarrhea persists, promote urination.
Flos Inulae (Xuanfuhua), Radix Glycyrrhizae Preparata (Gancao), Radix Ginseng (Renshen), Os Draconis (Daizheshi), Rhizoma Zingiberis Recens (Shengjiang), Rhizoma Pinelliae Preparata (Banxia), Fructus Jujubae (Dazao)
After sweating, vomiting, or purging, if epigastric fullness and hardness occur with persistent belching, this decoction is indicated. Belching, commonly known as eructation, is the sound of gas escaping after a full meal. Hardness indicates firm qi; salty flavor can soften it. The salinity of Flos Inulae softens the epigastric hardness. Deficiency leads to floating qi; heavy substances can anchor it. The heaviness of Os Draconis anchors rebellious qi due to deficiency. Rhizoma Zingiberis Recens and Rhizoma Pinelliae Preparata use pungency to disperse deficient stagnation; Radix Ginseng and Fructus Jujubae use sweetness to tonify stomach weakness. For fullness accompanied by diarrhea, Shengjiang Xiexin Tang is used. For fullness without diarrhea, Xuanfu Daizhe Tang is used.