翻胃之病。所以重于呕吐者。呕吐食入即吐。翻胃则或一日半日食复翻上。不化如故。
腹中
非不欲食。不肯留。胃气不温。不能消食。食既不消。不为糟粕。而入大肠。必随气逆上。
从口而出。故翻胃人胸膈多为冷气所痞。二陈汤。加丁香十粒。枳壳半钱。或治中汤。加枳
壳砂仁各半钱。半夏一钱。入米与生姜同煎。
若胃寒甚服药而翻者。宜附子粳米汤。加丁香十粒砂仁半钱。大便秘者。更加枳壳半钱
若胸膈痞甚而翻。宜谷神嘉禾散。生附一钱。或丁沉透膈汤。五膈宽中散。加生附一钱
仍
以来复丹。升降其阴阳。通其隧道。半硫丸。亦可通之。隧道久不通。名结肠翻胃。半硫丸
尤宜。百药无效。势危笃者。宜桂香。青金散以坠之。一法用胡椒一味。醋浸之。晒干。醋
浸不计遍数。愈多愈好。碾末醋糊为丸。淡醋汤下十丸。加至三四十丸。
脾运食而传于肺。脾气不足。故不喜食。宜启脾丸。煮朴丸。若脾虚而不进食者。当实
脾。
宜鹿茸橘皮煎丸。若脾冷甚而不进食者。理中汤。未效。附子理中汤。加砂仁半钱。或丁香
煮散。心肾虚。致脾气不足以运者。鹿茸橘皮煎丸。脾上交于心。下交于肾者也。
吞酸者。宿食所为。故曰中脘有饮。嘈有宿食。则酸。噫气吞酸。嗳宿腐气。逆咽酸水
亦
有每晨吐清酸水数口。日间无事者。亦有膈间常如酸折。皆饮食伤。兼中脘所致。生料平胃
散。加神曲麦 各半钱。或八味平胃散。
The disease of Fan Wei (Revolving Stomach / Regurgitation) is considered more severe than Ou Tu (Vomiting). In Ou Tu, food is vomited immediately after ingestion; whereas in Fan Wei, food may be regurgitated one or half a day later, remaining undigested as before.
It is not that the patient does not desire to eat, but rather that the food cannot remain in the stomach. This is because the Wei Qi (Stomach Qi) is not warm and fails to digest food. Since the food is not digested, it does not transform into waste entering the Large Intestine, but must rise upwards with rebellious Qi and exit from the mouth. Therefore, patients with Fan Wei often suffer from obstruction and stuffiness in the chest and diaphragm due to Cold Qi. Er Chen Tang (Two-Cured Decoction) can be used, adding ten cloves of Ding Xiang (Caryophylli Flos, Clove) and half a qian of Zhi Ke (Aurantii Fructus, Bitter Orange). Alternatively, Zhi Zhong Tang (Regulate the Middle Decoction) can be used, adding half a qian each of Zhi Ke (Aurantii Fructus, Bitter Orange) and Sha Ren (Amomi Fructus Rotundus, Cardamom), and one qian of Ban Xia (Pinelliae Rhizoma, Pinellia Tuber), decocted together with rice and fresh Sheng Jiang (Zingiberis Rhizoma Recens, Fresh Ginger).
If the Stomach Cold is severe and regurgitation persists despite medication, Fu Zi Jing Mi Tang (Aconite and Rice Decoction) is appropriate, adding ten cloves of Ding Xiang (Caryophylli Flos, Clove) and half a qian of Sha Ren (Amomi Fructus Rotundus, Cardamom). If constipation is present, add another half a qian of Zhi Ke (Aurantii Fructus, Bitter Orange).
If there is severe stuffiness in the chest and diaphragm accompanied by regurgitation, Gu Shen Jia He San (Grain Spirit and Grain Harmony Powder) is suitable, adding one qian of raw Fu Zi (Aconiti Lateralis Radix Praeparata, Prepared Aconite Root). Alternatively, Ding Chen Tou Ge Tang (Cardamom and Agarwood Penetrating Diaphragm Decoction) or Wu Ge Kuan Zhong San (Five Diaphragms Widening Middle Powder) can be used, adding one qian of raw Fu Zi (Aconiti Lateralis Radix Praeparata, Prepared Aconite Root). Simultaneously, Lai Fu Dan (Return to Life Pill) should be used to regulate the ascending and descending of Yin and Yang, and unblock the meridians and collaterals. Ban Liu Wan (Half-Sulfur Pill) can also be used for unblocking. If the meridians and collaterals have been blocked for a long time, it is named Jie Chang Fan Wei (Intestinal Knotting Revolving Stomach); in this case, Ban Liu Wan (Half-Sulfur Pill) is particularly suitable. If all other medicines fail and the condition is critical and severe, Gui Xiang Qing Jin San (Cinnamon Fragrance and Blue Gold Powder) should be used to descend and suppress rebellious Qi. Another method involves using only Hu Jiao (Piperis Longi Fructus, Long Pepper) soaked in vinegar, dried, and repeated soaking until desired; the more repetitions, the better. It is then ground into powder and formed into pills with vinegar paste, taken with light vinegar water, starting with ten pills and gradually increasing to thirty or forty pills.
The Spleen transforms food and transmits it to the Lung. Due to insufficient Pi Qi (Spleen Qi), the patient dislikes eating. Qi Pi Wan (Start Spleen Pill) or Zhu Po Wan (Boiled Magnolia Bark Pill) are appropriate. If deficiency of the Spleen leads to an inability to eat, the Spleen should be fortified; Lu Rong Ju Pi Jian Wan (Deer Antler and Tangerina Peel Decoction Pill) is suitable. If extreme Cold of the Spleen prevents eating, Li Zhong Tang (Regulate the Middle Decoction) is used; if ineffective, Fu Zi Li Zhong Tang (Aconite Regulate the Middle Decoction) with half a qian of Sha Ren (Amomi Fructus Rotundus, Cardamom) is added, or Ding Xiang Zhu San (Cardamom Boiled Powder) is used. If Heart and Kidney deficiency cause insufficient Pi Qi (Spleen Qi) to transform, Lu Rong Ju Pi Jian Wan (Deer Antler and Tangerina Peel Decoction Pill) is used. The Spleen connects upward to the Heart and downward to the Kidney.
Tun Suan (Swallowing Acid) is caused by accumulated food (Su Shi), hence it is said that "Phlegm-Fluid in Zhong Wan causes acid, and Su Shi causes heartburn." Belching with acid swallowing, belching foul rotting gas, and regurgitating acidic water occur. Some patients spit out several mouthfuls of clear acidic water every morning but are fine during the day. Others feel as if their diaphragm is constantly being broken by acidity. All these are caused by dietary injury combined with pathology in Zhong Wan (Middle Jiao/Epigastrium). Sheng Liao Ping Wei San (Raw Material Calming the Stomach Powder) with half a qian each of Shen Qu (Massae Medicamentae Fermentatae, Medicated Leaven) and Mai Ya (Hordei Fructus Germinatus, Sprouted Barley) is suitable. Alternatively, Ba Wei Ping Wei San (Eight-Ingredient Calming the Stomach Powder) can be used.