白术(二钱) 枳实 陈皮 麦芽 山楂 茯苓 神曲 连翘(各一钱) 茵陈 荷叶(各一钱五
分) 泽泻(五分
水煎服。
如兼伤酒,加葛根一钱;若便闭,去白术,加卜子、黄芩。
六君子汤(见类中。
有风寒食不消者,病气退而食自进。有积滞食不消者,祛其积而食自消。古方神术散、
保和汤、枳术丸,皆消积进食之法也。然有脾气虚弱不能消化者,有命门火衰,不能生脾土
而食不消者。东垣云∶胃中元气盛,则能食而不伤,过时而不饥。脾胃俱旺,则能食而肥
脾胃俱衰,则不能食而瘦。坤土虚弱不能消食,岂可更行克伐,宜用六君子、补中益气汤
补之。许学士云∶不能食者,未可专责之脾,肾经元阳不足,不能熏蒸腐化,譬如釜中水谷
底下无火,其何能熟?火为土母,虚则补其母,庶元气蒸腾,饮食增益,八味丸主之。世
俗每见不能食症,辄用枳、朴、黄连,实者当之犹可,虚人得之,祸不旋踵矣。大凡不能食
而吞酸嗳腐,胸膈满闷,未必尽属积食也,多有脾虚、肾弱而致此者,治者详之。
神术散(见类中。
保和汤(见心痛。
枳术丸(见鼓胀。
六君子汤 补中益气汤 八味丸(俱见类中。
有胃不和卧不安者,胃中胀闷疼痛,此食积也,保和汤主之。有心血空虚,卧不安者,
皆由思虑太过,神不藏也,归脾汤主之。有风寒邪热传心,或暑热乘心,以致躁扰不安者,
清之而神自定。有寒气在内而神不安者,温之而神自藏。有惊恐不安卧者,其人梦中惊跳怵
惕是也,安神定志丸主之。有湿痰壅遏,神不安者,其证呕恶气闷,胸膈不利,用二陈汤导
去其痰,其卧立至。更有被褥冷暖太过,天时寒热不匀,皆令不得安卧,非关于病,医家慎
保和汤 归脾汤(俱见心痛。
Bai Zhu (2 qian), Zhi Shi, Chen Pi, Mai Ya, Shan Zha, Fu Ling, Shen Qu, Lian Qiao (each 1 qian), Yin Chen, He Ye (each 1.5 qian), Ze Xie (0.5 qian). Decoct in water and take orally.
If accompanied by alcohol injury, add Ge Gen (1 qian); if constipation occurs, remove Bai Zhu, add Bo Le Zi and Huang Qin.
Liu Jun Zi Tang (see "Lei Zhong").
In cases where food fails to digest due to Wind-Cold, appetite returns naturally as the pathogenic qi recedes. In cases where food fails to digest due to stagnation, digestion resumes naturally after the stagnation is expelled. Ancient formulas such as Shen Shu San, Bao He Tang, and Zhi Zhu Wan are all methods for eliminating stagnation and promoting appetite. However, there are cases of inability to digest due to Spleen Qi deficiency, and cases of inability to digest due to decline of Ming Men Fire, which fails to warm and transform Spleen Earth. Li Dongyuan stated: "When Yuan Qi in the Stomach is abundant, one can eat without injury and not feel hungry past mealtime. When both Spleen and Stomach are robust, one can eat and become plump; when both Spleen and Stomach are depleted, one cannot eat and becomes emaciated." If Kun Earth (Spleen) is weak and unable to digest food, how can one further use attacking and reducing methods? One should use Liu Jun Zi Tang or Bu Zhong Yi Qi Tang to tonify. Scholar Xu stated: "Regarding the symptom of inability to eat, one cannot solely blame the Spleen. If the Original Yang of the Kidney Meridian is insufficient, it cannot steam and rot/cook [food]. It is like water and grain in a pot; without fire underneath, how can it be cooked?" Fire is the mother of Earth; in deficiency, tonify the mother, so that Yuan Qi steams upward and dietary intake increases. Ba Wei Wan is the primary formula. The common people often see the symptom of inability to eat and immediately use Zhi Shi, Hou Po, and Huang Lian. This may be acceptable for excess patterns, but for deficient persons, disaster will follow swiftly. Generally, inability to eat accompanied by acid regurgitation, belching with a putrid odor, and fullness/stuffiness in the chest and diaphragm does not necessarily belong entirely to food stagnation. Many such cases are caused by Spleen deficiency and Kidney weakness; practitioners must examine carefully.
Shen Shu San (see "Lei Zhong").
Bao He Tang (see "Xin Tong").
Zhi Zhu Wan (see "Gu Zhang").
Liu Jun Zi Tang, Bu Zhong Yi Qi Tang, Ba Wei Wan (all see "Lei Zhong").
In cases where disharmony of the Stomach leads to restless sleep, characterized by distension, stuffiness, and pain in the Stomach, this is Food Stagnation, treated primarily with Bao He Tang. In cases where emptiness of Heart Blood leads to restless sleep, it is all due to excessive overthinking, causing the Spirit (Shen) to fail to reside within; this is treated primarily with Gui Pi Tang. In cases where Wind-Cold pathogenic heat transmits to the Heart, or Summer-Heat invades the Heart, causing restlessness and agitation, clearing the heat will cause the Spirit to settle naturally. In cases where internal Cold causes the Spirit to be unsettled, warming the interior will cause the Spirit to reside naturally. In cases of restlessness due to fright and fear, the person jumps and feels terrified in dreams; this is treated primarily with An Shen Ding Zhi Wan. In cases where Phlegm-Dampness obstruction causes the Spirit to be unsettled, symptoms include vomiting, nausea, stifling sensation, and discomfort in the chest and diaphragm; using Er Chen Tang to guide out the phlegm will lead to immediate peaceful sleep. Furthermore, bedding that is too hot or cold, or uneven seasonal temperature changes, can also prevent peaceful sleep; these are not diseases, and physicians must exercise caution.
Bao He Tang, Gui Pi Tang (both see "Xin Tong").