生姜 半夏 甘草 人参 黄芩 黄连 干姜 大枣
汗后胃中不和。心下痞硬。干噫食臭。心下有水气。腹中雷鸣不利。 胃为津液之主。
阳气之根。汗后外亡津液。胃中空虚。客气上逆。心下痞硬。中焦未和。不能消谷。故干噫食臭
。水气腹鸣。土弱不能胜水也。
甘草 黄芩 干姜 半夏 黄连 大枣
伤寒中风医反下之。下利日数十行。谷不化。腹中雷鸣。心下痞硬而满。干呕心烦。复
下之。其痞益甚。此非结热。但胃虚气逆故硬也。此汤主之。 邪气在表而反下之。虚其中而邪
内陷也。利下谷不化腹鸣者。里虚胃弱也。痞鞭呕烦者。胃虚气逆也。与泻心汤以攻痞。加
炙甘草以补虚。前以汗后胃虚。是外伤阳气。故加生姜。此以下后胃虚。
是内损阴气。故加甘草。 痞与结胸。有高下之分。邪结在胸中。故曰陷胸。邪留在心下。
故曰泻心。泻心者。必以苦为主。是以黄连为君。黄芩为臣。散痞者必以辛为主。是以半夏
干姜为佐。阴阳不交曰痞。上下不通曰满。欲通上下。交阴阳者。必和其中。中者脾也。脾
不足者。以甘补之。故以人参甘草大枣为使。以补中气。中气安和。则水升火降。痞满自消。
Shengjiang Xie Xin Tang (Ginger Decoction for Draining the Epigastrium): Sheng Jiang (Zingiberis Rhizoma Recens), Ban Xia (Pinelliae Rhizoma), Gan Cao (Glycyrrhizae Radix et Rhizoma), Ren Shen (Ginseng Radix et Rhizoma), Huang Qin (Scutellariae Radix), Huang Lian (Coptidis Rhizoma), Gan Jiang (Zingiberis Rhizoma), Da Zao (Jujubae Fructus).
After sweating, the Stomach Qi is disharmonious. There is epigastric fullness and hardness (Xin Xia Pi Ying). Belching with a smell of undigested food occurs. There is fluid retention in the epigastrium. Borborygmus (rumbling sounds in the abdomen) accompanies diarrhea. The Stomach is the master of body fluids and the root of Yang Qi. After sweating, body fluids are lost externally, leaving the Stomach empty. Pathogenic factors ascend counterflow, causing epigastric fullness and hardness. The Middle Jiao has not yet harmonized and cannot digest grain; thus, belching with a food odor occurs. Water qi causes rumbling in the abdomen because the Earth element (Spleen/Stomach) is weak and cannot control Water.
Gancao Xie Xin Tang (Licorice Decoction for Draining the Epigastrium): Gan Cao (Glycyrrhizae Radix et Rhizoma), Huang Qin (Scutellariae Radix), Gan Jiang (Zingiberis Rhizoma), Ban Xia (Pinelliae Rhizoma), Huang Lian (Coptidis Rhizoma), Da Zao (Jujubae Fructus).
In Taiyang disease or Wind-stroke, if the physician erroneously applies purgation, it results in diarrhea dozens of times a day, with undigested food in the stool (Gu Bu Hua), borborygmus, and epigastric fullness, hardness, and distension. There is dry retching and irritability. If purgation is applied again, the epigastric fullness becomes even more severe. This is not due to accumulated heat, but rather to Stomach deficiency and rebellious Qi causing hardness. This decoction is indicated. When pathogenic factors are at the exterior and purgation is erroneously used, the interior becomes deficient, and pathogens sink inward. Diarrhea with undigested food and borborygmus indicates interior deficiency and weak Stomach function. Epigastric fullness, vomiting, and irritability indicate Stomach deficiency and rebellious Qi. A Xie Xin Tang (Decoction for Draining the Epigastrium) is given to resolve the fullness, and roasted Gan Cao (Zhi Gan Cao) is added to tonify deficiency. In the previous formula (Shengjiang Xie Xin Tang), Stomach deficiency after sweating implies external damage to Yang Qi, hence Sheng Jiang is added. In this case, Stomach deficiency after purgation implies internal damage to Yin Qi, hence Gan Cao is added. There is a distinction in location between Pi Syndrome (Epigastric Fullness) and Jie Xiong (Chest Binding). When pathogens bind in the chest, it is called Xian Xiong (Sunken Chest); when pathogens remain in the epigastrium, it is called Xie Xin (Draining the Heart/Epigastrium). To treat Xie Xin, bitter herbs must be primary; thus, Huang Lian is the Sovereign herb, and Huang Qin is the Minister herb. To dissipate fullness, acrid herbs must be primary; thus, Ban Xia and Gan Jiang are Assistant herbs. When Yin and Yang do not intersect, it is called Pi (fullness); when upper and lower do not communicate, it is called Man (distension). To unblock the upper and lower and facilitate the intersection of Yin and Yang, the Middle Jiao must be harmonized. The Middle Jiao refers to the Spleen. For Spleen insufficiency, sweet herbs are used to tonify; thus, Ren Shen, Gan Cao, and Da Zao are used as Envoy herbs to tonify Middle Qi. When Middle Qi is stable and harmonious, Kidney Water ascends and Heart Fire descends, and epigastric fullness naturally resolves.
Fuzi Xie Xin Tang (Aconite Decoction for Draining the Epigastrium): Da Huang (Rhei Radix et Rhizoma), Huang Lian (Coptidis Rhizoma), Huang Qin (Scutellariae Radix), Fu Zi (Aconiti Lateralis Radix Praeparata).
When there is epigastric fullness accompanied by aversion to cold and sweating, this decoction is indicated. Epigastric fullness is caused by pathogenic heat. Aversion to cold and sweating are signs of Yang deficiency. The three yellows (Da Huang, Huang Lian, Huang Qin) are used to clear pathogenic heat... [Text ends abruptly]