食谷欲呕者属阳明也吴茱萸汤主之得汤反剧者属上焦也
土败胃逆则作呕吐食谷欲吐者属阳明也吴茱萸汤人参大枣培土而补中茱萸生姜温胃而降逆若得汤反剧者则由上焦之
痞热非关中焦之虚寒也
吴茱萸(一升洗) 生姜(六两) 人参(三两) 大枣(十二枚)
上四味以水七升煮取二升去滓温服七合日三服
伤寒呕多虽有阳明证不可攻之
伤寒经腑郁迫不能容受是以作呕呕缘土虚胃逆虽有阳明里证不可攻之也
太阳病寸缓关浮尺弱其人发热汗出复恶寒不呕但心下痞者此以医下之也如其不下者病患不恶寒而渴者此转属阳明也
小便数者大便必硬不更衣十日无所苦也渴欲饮水少少与之但以法救之渴者宜五苓散(方在太阳四十一)
太阳病寸缓关浮犹是中风之脉而尺弱则肾气不充其人发热汗出复恶寒不呕太阳表证未解而但有心下痞者此以医误下
而成痞非阳明也如其心痞不因攻下外不恶寒而内有渴证者此是太阳表解转属阳明也盖太阳之病表未解而误下则成痞阳明
之病不俟攻下而胃气上逆壅碍胆经降路亦成痞而胃逆必呕土燥必渴胃热外蒸必不恶寒合观诸证故知是转属阳明若其小便
数者其大便必硬然尺弱肾寒原非阳旺虽不更衣十日亦无所苦也其渴欲饮水止可少少与之但以法稍救其口舌干燥而已缘其
渴是土湿而非火升非土燥而水涸宜以五苓散泄水而燥土也
进食后想要呕吐的,属于阳明病,用吴茱萸汤主治。如果服用汤药后症状反而加剧的,属于上焦的病证。
脾土衰败、胃气上逆就会发生呕吐。进食后想要呕吐的,属于阳明病。吴茱萸汤中的人参、大枣培补脾土并补益中气;吴茱萸、生姜温养胃腑并降逆止呕。如果服用汤药后症状反而加剧的,是因为上焦有痞塞热邪,而不是因为中焦的虚寒。
吴茱萸(一升,洗净) 生姜(六两) 人参(三两) 大枣(十二枚)
以上四味药,用水七升,煮取二升,去渣滓,温服七合,每日三次。
伤寒病中呕吐频繁者,即使有阳明病的证候,也不可用攻下法。
伤寒病经腑郁结逼迫,不能容纳受纳,所以发生呕吐。呕吐源于脾土虚弱、胃气上逆,即使有阳明里实证,也不可用攻下法。
太阳病,寸脉缓、关脉浮、尺脉弱,其人发热、汗出、又恶寒,不呕吐,只是心下痞塞的,这是医生误用下法造成的。如果不曾误用下法,病人不恶寒而口渴的,这是转属阳明病。
小便频数的人,大便必定硬结。十天不大便也没有痛苦。想喝水时,少量给予饮水,只需按法治之。口渴者适宜用五苓散(方剂见太阳篇第四十一节)。
太阳病,寸脉缓、关脉浮,仍是中风之脉,但尺脉弱则肾气不充盛。其人发热、汗出、又恶寒,表证未解,却只有心下痞塞,这是医生误用下法而成痞证,并非阳明病。如果心下痞塞不是因为攻下引起,外部不恶寒而内部有口渴证候的,这是太阳表证已解,转属阳明病。大概太阳病表证未解而误用下法,则会形成痞证;阳明病不需要攻下,若胃气上逆壅滞阻碍胆经下降之路,也会形成痞证。胃气上逆必然呕吐,脾土干燥必然口渴,胃热外蒸必然不恶寒。综合观察这些证候,所以知道是转属阳明病。如果小便频数,大便必定硬结。然而尺脉弱说明肾寒,原本就不是阳气旺盛,虽然十天不大便,也没有什么痛苦。那种想喝水的情况,只可少量给予,只需按方法稍微缓解口舌干燥而已。因为这种口渴是由于脾土湿盛而非火气上升,不是脾土干燥导致的水液枯竭,适宜用五苓散利水渗湿并燥湿健脾。
Those who desire to vomit after eating belong to Yangming disease, and Wuzhuyu Tang (Evodia Decoction) is the primary treatment. If symptoms worsen after taking the decoction, it belongs to Upper Jiao (Upper Burner) pathology.
When Earth fails and Stomach Qi rebels, vomiting occurs. Desire to vomit after eating belongs to Yangming disease. In Wuzhuyu Tang, Renshen (Ginseng Root) and Dazao (Jujube Fruit) cultivate Earth and tonify the Middle; Wuzhuyu (Evodia Fruit) and Shengjiang (Fresh Ginger) warm the Stomach and direct rebellious Qi downward. If symptoms worsen after taking the decoction, it is due to Pi Re (Pihotness/Heat with obstruction) in the Upper Jiao, not deficiency-cold in the Middle Jiao.
Wuzhuyu (Evodiae Fructus) (1 sheng, washed), Shengjiang (Zingiberis Rhizoma Recens) (6 liang), Renshen (Ginseng Radix et Rhizoma) (3 liang), Dazao (Ziziphi Jujubae Fructus) (12 pieces).
The above four ingredients are boiled in 7 sheng of water to obtain 2 sheng. Strain the dregs. Take 7 ge warm, three times a day.
In Shaoyang disease, if there is frequent vomiting, even if there are Yangming signs, purgation must not be used.
In Shaoyang disease, depression and pressure in the meridians and fu-organs prevent acceptance, causing vomiting. Vomiting originates from weak Earth and rebellious Stomach Qi; even if there are Yangming interior excess signs, purgation must not be used.
In Taiyang disease, the Cun (inch) pulse is slow, Guan (bar) pulse is floating, and Chi (cubit) pulse is weak. The patient has fever, sweating, and aversion to cold, does not vomit, but has fullness below the heart. This is caused by the physician's erroneous use of purgation. If purgation was not used, and the patient is not averse to cold but is thirsty, this indicates a transition to Yangming disease.
Those with frequent urination will inevitably have hard stools. Even if ten days pass without defecation, they will feel no distress. When desiring to drink water, give small amounts. Treat according to the method. For those with thirst, Wu Ling San (Five-Ingredient Powder with Poria) is appropriate (formula found in Taiyang section 41).
In Taiyang disease, the Cun pulse is slow and Guan pulse is floating, which are still pulses of Wind-stroke, but the weak Chi pulse indicates insufficient Kidney Qi. The patient has fever, sweating, and aversion to cold. The exterior syndrome is unresolved, yet there is only fullness below the heart. This is a Pi Zheng (fullness syndrome) formed by the physician's erroneous purgation, not Yangming disease. If the fullness below the heart is not caused by purgation, and externally there is no aversion to cold while internally there is thirst, this indicates that the Taiyang exterior has resolved and transitioned to Yangming disease. Generally, in Taiyang disease, if the exterior is unresolved and purgation is erroneously used, Pi forms. In Yangming disease, without needing purgation, if Stomach Qi rebels and obstructs the descending pathway of the Gallbladder meridian, Pi also forms. Rebellious Stomach Qi inevitably causes vomiting; dry Earth inevitably causes thirst; external steaming of Stomach Heat inevitably means no aversion to cold. Observing these signs together, we know it is a transition to Yangming disease. If urination is frequent, stools will inevitably be hard. However, the weak Chi pulse indicates Cold in the Kidneys; originally, it is not an abundance of Yang. Although ten days pass without defecation, there is no distress. For such thirst, only small amounts of water should be given, merely to slightly alleviate dryness of the mouth and tongue according to the method. This thirst is due to dampness in Earth rather than rising Fire; it is not dryness of Earth leading to depletion of fluids. Therefore, Wu Ling San is suitable to drain dampness and dry Earth.