有痰、有气虚、有阴火。吃逆即咳逆,咳逆者,气逆也,气自脐下直冲上出于口而作声之名也。视有余不足治
之,(详见《格致余论》。)有余并痰者,吐之,人参芦之类;不足者,人参白术汤下大补丸。痰碍气而吃逆,
此燥痰不出故
也,用蜜水探吐之。大概有痰,用陈皮、半夏;气虚,用参、术;阴火,用黄连、滑石、黄柏。痰多,或用吐或用
行痰,虚甚者,用参膏之类。内伤病吃逆不止,补中益气加丁香。虚寒吃逆,丁香柿蒂汤,灸期门穴。气热痰热
者,青箬头七十二个煎服。伤寒血证吃逆不止,舌强短者,桃仁承气汤主之。痰多吃逆不止,半夏、茯苓、陈
皮、桃仁、枇杷叶、姜汁煎服。咳逆自利,人参、白术、芍药、陈皮、甘草、滑石、黄柏、竹沥。心痛饮汤水下作吃逆
者,是有死血在中,桃仁承气汤下之。咳逆无脉,二陈加参、术、麦冬、五味、竹茹、姜煎服;甚者,加柿蒂、丁
香;虚人吃逆无脉,加黄柏、知母。治吃逆,黄腊烧烟熏而咽之;寒者,用硫黄烧烟咽之。一人年近七十患滞下后
发吃逆;一女子暑月因大怒而发吃逆;一人年近五十因怒得滞下病后发吃逆(治法俱见《医要》)。
有痰、有热、有风、有血虚。诸家止言偏头风,而不知所属,故治之多不效。 左属风,荆芥、薄荷;属血虚,
芎、归、芍药;上属痰,苍术、半夏;属热,酒炒黄芩;有属湿痰者,川芎、南星、苍术。偏正头风,以瓜蒂散搐
鼻内。瘦人搐药,软石膏、朴硝各五钱,脑子、檀香皮、荆芥、薄荷各一钱,白芷、细辛各二钱。一粒金治偏正头风,
妙在荜茇、猪胆。天香散治远年头风(二方俱见《医要》)。搐药有单用荜茇、猪胆者。头风方∶酒片芩(一两)
苍术 防风 羌活(各五钱) 苍耳(三钱) 细辛(二钱) 上末之,姜一片捣细,和药末三钱,同擂匀,茶调,
汤荡起服之。一本∶酒芩(一两半) 羌活 苍术 川芎(各五钱) 苍耳 细辛(各三钱) 制如上法。
又方∶酒片芩 苍耳 羌活 酒连 生甘草(各一钱半) 苍术(二钱半) 半夏曲(炒三钱半) 川芎(一钱) 制
如上法。湿痰头风方∶酒片芩(三钱) 苍术(一两) 酒炒川芎 细辛(各二钱) 甘草(少许),上末之,制服
如上法。又头风方∶荆芥、防风、草乌尖、甘草、台芎、蔓荆子、桔梗、麻黄为末,茶调服。头痒风屑发黄,酒炒大黄
末,茶调服。一人头风鼻塞涕下,南星、苍术、酒芩、辛夷、川芎。一膏粱人,头风发即眩重酸痛,二陈加
荆芥、南星、酒芩、防风、苍术、台芎,姜水煎服。后复以酒芩 南星 半夏(各一两) 皂角灰(一钱) 乌梅(二
个) 用巴豆(十粒)同梅煮过,去豆不用,将梅同前药为末,姜曲丸,津咽下。
(第三十四)呃逆的病因主要有痰阻、气虚和阴火。呃逆就是咳逆,所谓咳逆,是指气机上逆;气从脐下直冲而上,出于口部并发出声音,这就是呃逆的名称。治疗时要根据邪气的有余或不足来辨证施治(详见《格致余论》)。如果是实证兼有痰浊,可用吐法,如用人参芦等药物催吐;如果是虚证,可用人参白术汤送服大补丸。如果是痰浊阻碍气机导致的呃逆,这是因为燥痰无法排出所致,可用蜜水探喉催吐。一般来说,有痰者,用陈皮、半夏;气虚者,用人参、白术;阴火者,用黄连、滑石、黄柏。痰多者,或者用吐法,或者用化痰药;虚损严重的,用人参膏之类。内伤疾病引起的呃逆不止,可在补中益气汤中加入丁香。虚寒性呃逆,用丁香柿蒂汤治疗,并灸期门穴。气热或痰热者,用青箬头(竹叶卷心)七十二个煎服。伤寒病伴有出血症状且呃逆不止,舌体僵硬短缩者,用桃仁承气汤主治。痰多且呃逆不止者,用半夏、茯苓、陈皮、桃仁、枇杷叶、姜汁煎服。呃逆伴自利(腹泻),用人参、白术、芍药、陈皮、甘草、滑石、黄柏、竹沥。因心痛饮水后引发呃逆的,是中焦有死血(瘀血),用桃仁承气汤攻下。呃逆且无脉象者,在二陈汤基础上加人参、白术、麦冬、五味子、竹茹、生姜煎服;病情严重者,再加柿蒂、丁香;体质虚弱且呃逆无脉者,再加黄柏、知母。治疗呃逆,还可将黄蜡烧烟让其吸入咽喉;属寒证的,用硫黄烧烟吸入咽喉。有一例年近七十岁的人,患痢疾后出现呃逆;一例女子在暑天因大怒而引发呃逆;一例年近五十岁的人,因愤怒导致痢疾病发后又出现呃逆(这些病例的治法均见于《医要》)。
(第三十五)头风的病因主要有痰、热、风和血虚。各家医书只提到偏头痛,却不清楚其所属脏腑经络,所以治疗效果大多不佳。左侧头痛属风邪,用荆芥、薄荷;属血虚,用川芎、当归、芍药;上部头痛属痰,用苍术、半夏;属热,用酒炒黄芩;有属于湿痰的,用川芎、胆南星、苍术。偏头痛和正头痛,可用瓜蒂散搐鼻。瘦人使用的搐鼻药,配方为软石膏、朴硝各五钱,脑子(冰片)、檀香皮、荆芥、薄荷各一钱,白芷、细辛各二钱。一粒金方治疗偏正头风,妙处在于荜茇和猪胆汁。天香散治疗多年的老式头风(这两个方剂均见于《医要》)。搐鼻药也有单用荜茇和猪胆汁的。头风方:酒洗黄芩一两,苍术、防风、羌活各五钱,苍耳子三钱,细辛二钱。以上研为末,取一片生姜捣细,与药末三钱混合均匀,用茶调匀,开水冲服。另一版本:酒洗黄芩一两半,羌活、苍术、川芎各五钱,苍耳子、细辛各三钱,制作同上法。又一方:酒洗黄芩、苍耳子、羌活、酒黄连、生甘草各一钱半,苍术二钱半,半夏曲(炒)三钱半,川芎一钱,制作同上法。湿痰头风方:酒洗黄芩三钱,苍术一两,酒炒川芎、细辛各二钱,甘草少许,以上研为末,服用方法同上。又一方:荆芥、防风、草乌尖、甘草、台芎(四川产川芎)、蔓荆子、桔梗、麻黄研为末,茶调服。头痒、头皮屑发黄者,用酒炒大黄末,茶调服。有一例头风患者鼻塞流涕,用南星、苍术、酒黄芩、辛夷、川芎治疗。有一位饮食肥甘厚味的人,头风发作时感到眩晕、沉重、酸痛,用二陈汤加荆芥、南星、酒黄芩、防风、苍术、台芎,姜水煎服。后来再用酒黄芩、南星、半夏各一两,皂角灰一钱,乌梅二个,用巴豆十粒同乌梅煮过,去掉巴豆不用,将乌梅与前药研为末,用姜汁和神曲制成丸药,津液送服。
(Chapter 34) The etiology of hiccup (E Ni, 呃逆) involves phlegm (Tan, 痰), Qi deficiency (Qi Xu, 气虚), and Yin fire (Yin Huo, 阴火). Hiccup is also called ke ni (Ke Ni, 咳逆), which refers to the rebellion of Qi; specifically, it is the name for the sound produced when Qi rushes upward from below the umbilicus through the mouth. Treatment should be based on whether the condition is excess or deficiency (see *Gezhi Yulun* for details). If there is excess accompanied by phlegm, emesis (Tu Fa, 吐法) may be used, such as with Ren Shen Lu (Ginseng Rhizome Stalk); if it is deficiency, Da Bu Wan (Great Tonifying Pill) can be administered with Ren Shen Bai Zhu Tang (Ginseng and Atractylodes Macrocephala Decoction). When phlegm obstructs Qi causing hiccup, this is due to dry phlegm failing to exit; honey water can be used to induce vomiting. Generally, for phlegm, use Chen Pi (Tangerine Peel) and Ban Xia (Pinellia Tuber); for Qi deficiency, use Ren Shen (Ginseng) and Bai Zhu (Atractylodes Macrocephala); for Yin fire, use Huang Lian (Coptis Rhizome), Hua Shi (Talcum), and Huang Bo (Phellodendron Bark). For excessive phlegm, either emesis or phlegm-resolving methods are used; for severe deficiency, Ren Shen Gao (Ginseng Paste) is employed. For hiccup persisting due to internal injury diseases, Ding Xiang (Clove) is added to Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction). For cold-deficiency hiccup, Ding Xiang Shi Di Tang (Clove and Persimmon Calyx Decoction) is used, along with moxibustion on Qimen (LR14). For Qi heat or Phlegm heat, seventy-two Qing Ruo Tou (Bamboo Leaf Roll Tips) are decocted and taken. For hiccup persisting in Shang Han (Cold Damage) with blood disorders and a stiff, short tongue, Tao Ren Cheng Qi Tang (Peach Kernel and Magnolia Bark Decoction) is the primary treatment. For hiccup persisting with excessive phlegm, Ban Xia, Fu Ling (Poria), Chen Pi, Tao Ren (Peach Kernel), Pi Pa Ye (Loquat Leaf), and Jiang Zhi (Ginger Juice) are decocted together. For hiccup accompanied by spontaneous diarrhea, Ren Shen, Bai Zhu, Shao Yao (Peony Root), Chen Pi, Gan Cao (Licorice Root), Hua Shi, Huang Bo, and Zhu Li (Bamboo Sap) are used. For hiccup triggered by drinking water due to heart pain, indicating fixed blood (Yu Xue, 瘀血) in the middle jiao, Tao Ren Cheng Qi Tang is used to purge. For hiccup without a pulse, Er Chen Tang (Two-Cured Decoction) is modified with Ren Shen, Bai Zhu, Mai Dong (Ophiopogon Tuber), Wu Wei Zi (Schisandra Berry), Zhu Ru (Bamboo Shavings), and Jiang (Ginger); for severe cases, Shi Di (Persimmon Calyx) and Ding Xiang are added; for deficient individuals with hiccup and no pulse, Huang Bo and Zhi Mu (Anemarrhena Rhizome) are added. To treat hiccup, burning yellow wax and inhaling the smoke into the throat is effective; for cold conditions, burning sulfur and inhaling the smoke is used. One case involved a man near seventy who developed hiccup after dysentery; a woman developed hiccup in summer after great anger; another man near fifty developed hiccup after anger-induced dysentery (treatments for these cases are found in *Yi Yao*).
(Chapter 35) The etiology of head wind (Tou Feng, 头风) involves phlegm, heat, wind, and blood deficiency. Various schools only mention unilateral headache (Pian Tou Feng, 偏头风) without specifying its associated meridians, leading to ineffective treatments. Left-sided headache belongs to wind, treated with Jing Jie (Schizonepeta) and Bo He (Mint); if belonging to blood deficiency, use Xiong (Chuanxiong Rhizome), Dang Gui (Angelica Sinensis), and Shao Yao; upper headache belongs to phlegm, treated with Cang Zhu (Atractylodes Lancea) and Ban Xia; if belonging to heat, use Jiu Chao Huang Qin (Wine-fried Scutellaria Root); for damp-phlegm, use Chuan Xiong, Nan Xing (Arisaema Cum Bile), and Cang Zhu. For both unilateral and central headaches, Gua Di San (Melon Seed Powder) can be insufflated into the nose. For thin individuals, the insufflation powder consists of Ruan Shi Gao (Gypsum Fibrosum) and Po Xiao (Mirabilite) each at 5 qian, Nao Zi (Borneol), Tan Xiang Pi (Sandalwood Bark), Jing Jie, and Bo He each at 1 qian, and Bai Zhi (Angelica Dahurica) and Xi Xin (Asarum) each at 2 qian. Yi Li Jin (One Grain Gold) treats unilateral and central headaches, with its efficacy lying in Bi Bo (Long Pepper Fruit) and Pig Gallbladder. Tian Xiang San (Heavenly Fragrance Powder) treats chronic long-standing headaches (both formulas are in *Yi Yao*). Insufflation powders also exist using only Bi Bo and Pig Gallbladder. Head Wind Formula: Jiu Pian Qin (Wine-sliced Scutellaria) 1 liang, Cang Zhu, Fang Feng (Saposhnikovia), Qiang Huo (Notopterygium) each 5 qian, Cang Er Zi (Xanthium Fruit) 3 qian, Xi Xin 2 qian. These are powdered. One slice of ginger is mashed finely, mixed with 3 qian of the powder, stirred evenly with tea, and taken after being rinsed with hot water. Another version: Jiu Qin 1.5 liang, Qiang Huo, Cang Zhu, Chuan Xiong each 5 qian, Cang Er Zi, Xi Xin each 3 qian, prepared as above. Another formula: Jiu Pian Qin, Cang Er Zi, Qiang Huo, Jiu Lian (Wine-fried Coptis), Sheng Gan Cao (Raw Licorice) each 1.5 qian, Cang Zhu 2.5 qian, Ban Xia Qu (Fermented Pinellia) stir-fried 3.5 qian, Chuan Xiong 1 qian, prepared as above. Damp-Phlegm Head Wind Formula: Jiu Pian Qin 3 qian, Cang Zhu 1 liang, Jiu Chao Chuan Xiong, Xi Xin each 2 qian, Gan Cao a little, powdered and taken as above. Another formula: Jing Jie, Fang Feng, Cao Wu Jian (Aconite Tip), Gan Cao, Tai Xiong (Sichuan Chuanxiong), Man Jing Zi (Vernonia Fruit), Jie Geng (Platycodon Root), Ma Huang (Ephedra) powdered and taken with tea. For itchy head with yellow dandruff, Jiu Chao Da Huang (Wine-fried Rheum) powder is taken with tea. One case of head wind with nasal congestion and runny nose was treated with Nan Xing, Cang Zhu, Jiu Qin, Xin Yi (Magnolia Flower), and Chuan Xiong. A person accustomed to rich food suffered dizziness, heaviness, soreness, and pain upon headache onset; Er Chen Tang was modified with Jing Jie, Nan Xing, Jiu Qin, Fang Feng, Cang Zhu, and Tai Xiong, decocted with ginger water. Later, Jiu Qin, Nan Xing, Ban Xia each 1 liang, Zao Jiao Hui (Soap Pod Ash) 1 qian, Mei Zi (Smoked Plum) 2 pieces were boiled with Ba Dou (Croton Seed) 10 grains; the Croton seeds were discarded, and the plums were powdered with the other herbs, formed into pills with ginger juice and Shen Qu (Medicated Leaven), and swallowed with saliva.