许(四六)昨用苦辛开痞。呕逆已止。脉象稍清。但胸次按之而痛。此属热邪阻遏中焦。清气为无形质。是与食滞
两岐。
川连(六分) 制半夏(一钱五分) 枳实(一钱) 淡黄芩(一钱) 杏仁(三钱) 栝蒌皮(一钱五分) 浓
朴(一钱)
戴(廿八)脉象短数。脘闷。舌白粘腻。得大便胸次稍舒。此属热结在上。为上焦不行。下脘不通。况肺与大肠。
亦是表里相应。见症拟栀豉汤以解其陈腐之邪。
佩兰叶(三钱) 郁金(一钱) 枳壳(一钱) 炒香淡豉(一钱五分)
杏仁(三钱) 桔梗(一钱) 黑山栀(一钱五分) 栝蒌皮(一钱五分)
马(二六)胃虚痞塞。拟辛以助阳。
姜汁炒川连(五分) 制半夏(一钱五分) 枳实(一钱) 淡干姜(八分)
黄芩(一钱) 鲜竹茹(三钱) 茯苓(三钱)
龚(四一)噎阻不舒。呕吐涎沫。食物格拒。咽中总属不爽。在上清阳日结。拟治肺以展气化。勿与椒梅酸收闭塞
可也。
鲜枇杷叶(三钱) 郁金(一钱) 炒香豉(一钱五分) 杏仁(二钱)
栝蒌皮(一钱五分) 黑山栀(一钱五分) 川贝母(二钱)
蔡(五一)阳明胃衰。纳谷脘中痛。嗳哕频频。气不展舒。胸膈是清阳旋转之处。失其下行为顺之旨。必胃汁先枯。
然后脾阳亦钝。膈症萌矣。拟甘寒生津。以存其阴液。无暇理胃脘之清阳。是亦膈症治法
川石斛(三钱) 鲜生地(五钱) 玉竹(一钱) 麦冬(一钱)
淡天冬(二钱) 柿霜(一钱) 甜杏仁(三钱) 梨汁(半杯临服冲入)
田(二三)早食暮吐。大便不爽。病在中下。
小川连(四分) 制半夏(一钱五分) 桃仁(一钱) 制大黄(五分) 郁金(一钱) 红花(五分) 枳实(一
钱)
许某(四十六岁)昨日使用苦辛法开通痞塞。呕吐逆气已经停止。脉象稍微清晰。但是胸部按压时感到疼痛。这属于热邪阻滞中焦。清气是无形的,这与食滞是两种不同的病理机制。
黄连(六分) 制半夏(一钱五分) 枳实(一钱) 淡黄芩(一钱) 杏仁(三钱) 瓜蒌皮(一钱五分) 厚朴(一钱)
戴某(二十八岁)脉象短促且数。胃脘部闷胀。舌苔白而粘腻。获得大便后胸膈稍感舒畅。这属于热结在上焦,导致上焦气机不行,下脘不通。况且肺与大肠互为表里,相互对应。根据症状拟定栀子豉汤以解除陈腐之邪。
佩兰叶(三钱) 郁金(一钱) 枳壳(一钱) 炒香淡豆豉(一钱五分) 杏仁(三钱) 桔梗(一钱) 黑山栀(一钱五分) 瓜蒌皮(一钱五分)
姜汁炒黄连(五分) 制半夏(一钱五分) 枳实(一钱) 淡干姜(八分) 黄芩(一钱) 鲜竹茹(三钱) 茯苓(三钱)
龚某(四十一岁)噎阻不适。呕吐涎沫。食物格拒不下。咽喉中总觉不爽。在上部的清阳日渐结聚。拟定治疗肺脏以舒展气化功能。不要使用花椒、乌梅等酸收闭塞的药物。
鲜枇杷叶(三钱) 郁金(一钱) 炒香豆豉(一钱五分) 杏仁(二钱) 瓜蒌皮(一钱五分) 黑山栀(一钱五分) 川贝母(二钱)
蔡某(五十一岁)阳明胃气衰弱。进食后胃脘疼痛。嗳气和呃逆频繁。气机不能舒展。胸膈是清阳旋转的地方,失去向下运行的顺承规律。必定是胃液先枯竭,然后脾阳也变得迟钝。膈症(噎膈)的征兆出现了。拟定甘寒生津的方法,以保存阴液。无暇顾及调理胃脘的清阳,这也是治疗膈症的方法。
川石斛(三钱) 鲜生地(五钱) 玉竹(一钱) 麦冬(一钱) 淡天冬(二钱) 柿霜(一钱) 甜杏仁(三钱) 梨汁(半杯,临服时冲入)
田某(二十三岁)早晨吃晚上吐。大便不畅。病位在中下焦。
Mr. Xu (46 years old) used the bitter-pungent method to open stagnation yesterday. The vomiting and regurgitation have stopped. The pulse is slightly clearer. However, there is pain upon pressing the chest. This belongs to heat pathogen obstructing the middle jiao. Clear qi is formless; this differs from food retention in pathology.
Coptidis Rhizoma (Chuanlian, 黄连) (0.6 qian) Pinelliae Rhizoma Preparatum (Zhi Banxia, 制半夏) (1.5 qian) Immature Bitter Orange (Zhishi, 枳实) (1 qian) Scutellariae Radica (Dan Huangqin, 淡黄芩) (1 qian) Armeniacae Semen (Xingren, 杏仁) (3 qian) Trichosanthis Pericarpium (Gualoupi, 瓜蒌皮) (1.5 qian) Magnoliae Officinalis Cortex (Houpo, 厚朴) (1 qian)
Mr. Dai (28 years old) has a short and rapid pulse. There is epigastric stuffiness. The tongue coating is white and sticky. After having a bowel movement, the chest feels slightly relieved. This belongs to heat accumulation in the upper jiao, causing the upper jiao qi mechanism to fail to circulate and the lower stomach opening to be blocked. Moreover, the Lung and Large Intestine are exterior-interior counterparts. Based on the symptoms, Zhi Zi Chi Tang (Gardenia and Fermented Soybean Decoction) is prescribed to resolve stale and corrupt pathogens.
Eupatorii Herba (Peilan Ye, 佩兰叶) (3 qian) Curcumae Aromatae Rhizoma (Yujin, 郁金) (1 qian) Aurantii Fructus (Zhike, 枳壳) (1 qian) Prepared Gardeniae Fructus (Chao Xiang Dan Chi, 炒香淡豉) (1.5 qian) Armeniacae Semen (Xingren, 杏仁) (3 qian) Platycodonis Radix (Jiegeng, 桔梗) (1 qian) Gardeniae Fructus (Hei Shanzhi, 黑山栀) (1.5 qian) Trichosanthis Pericarpium (Gualoupi, 瓜蒌皮) (1.5 qian)
Mr. Ma (26 years old) suffers from stagnation due to stomach deficiency. The prescription uses pungent herbs to assist yang.
Coptidis Rhizoma stir-fried with ginger juice (Jiangzhi Chuanlian, 姜汁炒川连) (0.5 qian) Pinelliae Rhizoma Preparatum (Zhi Banxia, 制半夏) (1.5 qian) Immature Bitter Orange (Zhishi, 枳实) (1 qian) Zingiberis Rhizoma Siccum (Dan Ganjiang, 淡干姜) (0.8 qian) Scutellariae Radix (Huangqin, 黄芩) (1 qian) Fresh Bambusa Textilis Caulis Juice (Xian Zhuru, 鲜竹茹) (3 qian) Poria (Fuling, 茯苓) (3 qian)
Mr. Gong (41 years old) experiences dysphagia and discomfort. He vomits saliva and phlegm. Food is rejected and cannot go down. The throat always feels unsatisfactory. The clear yang in the upper part is daily accumulating. The treatment targets the Lung to expand qi transformation. Do not use acrid-astringent herbs like Zanthoxyli Pericarpium (Jiaojiao, 椒) and Mume Fructus (Mei, 梅) which cause closure and obstruction.
Fresh Loquat Leaf (Xian Pipaye, 鲜枇杷叶) (3 qian) Curcumae Aromatae Rhizoma (Yujin, 郁金) (1 qian) Prepared Gardeniae Fructus (Chao Xiang Chi, 炒香豉) (1.5 qian) Armeniacae Semen (Xingren, 杏仁) (2 qian) Trichosanthis Pericarpium (Gualoupi, 瓜蒌皮) (1.5 qian) Gardeniae Fructus (Hei Shanzhi, 黑山栀) (1.5 qian) Fritillariae Thunbergii Bulbus (Chuan Beimu, 川贝母) (2 qian)
Mr. Cai (51 years old) has declining Yangming Stomach qi. There is pain in the epigastrium after eating. Belching and hiccups are frequent. Qi fails to circulate freely. The chest and diaphragm are where clear yang rotates; losing the principle of downward smooth flow indicates that stomach fluids must first be depleted, then spleen yang becomes dull. Signs of Ge Zheng (Diaphragmatic Disease/Dysphagia) are emerging. The prescription uses sweet-cold methods to generate fluids and preserve yin fluids. There is no time to regulate the clear yang of the stomach; this is also a treatment method for Diaphragmatic Disease.
Dendrobii Caulis (Chuan Shihu, 川石斛) (3 qian) Fresh Rehmanniae Radix (Xian Shengdi, 鲜生地) (5 qian) Polygonati Odorati Rhizoma (Yuzhu, 玉竹) (1 qian) Ophiopogonis Tuber (Maidong, 麦冬) (1 qian) Asparagi Radix (Dan Tiandong, 淡天冬) (2 qian) Diospyros Fruit Frost (Shishuang, 柿霜) (1 qian) Sweet Armeniacae Semen (Tian Xingren, 甜杏仁) (3 qian) Pyri Fructus Juice (Lizhi, 梨汁) (half cup, mixed in before taking)
Mr. Tian (23 years old) eats in the morning and vomits in the evening. Bowel movements are unsmooth. The disease is located in the middle and lower jiao.
Small Coptidis Rhizoma (Xiao Chuanlian, 小川连) (0.4 qian) Pinelliae Rhizoma Preparatum (Zhi Banxia, 制半夏) (1.5 qian) Persicae Semen (Taoren, 桃仁) (1 qian) Prepared Rheomi Radix et Rhizoma (Zhi Dahuang, 制大黄) (0.5 qian) Curcumae Aromatae Rhizoma (Yujin, 郁金) (1 qian) Carthami Flos (Honghua, 红花) (0.5 qian) Immature Bitter Orange (Zhishi, 枳实) (1 qian)