厥阴之为病,消渴,气上冲心,心中疼热,饥不欲食,食则吐蛔。厥阴病,渴欲饮水者,少少
与之,愈。厥阴中风,脉微浮,为欲愈;不浮,为未愈。厥阴病,欲解时,从丑至卯上。
病如桂枝症,头不痛,项不强,寸脉微浮,胸中痞硬,气上冲咽喉不得息者,此为胸有寒也,
当吐之,宜瓜蒂散。
瓜蒂(炒黄) 赤小豆(各一分)
上研为细末,取一钱,用豉一合,汤七合,先渍之,须臾煎稀糜,去渣,取汁相和,温顿服。不
吐,少少加,得快吐乃止。诸亡血虚家,不可与服。
〔《活》〕瓜蒂散,每服一钱匕,药下便卧。欲吐且忍之。良久不吐,取三钱匕,汤二合和服。
以手指探之便吐。不吐,复稍增之,以吐为度。若吐少病不除,明日如前法再吐之,不可令人虚也。
如药力过时不吐,饮热汤一升,以助药力。吐讫,便可食,无更服。若服药过多者,饮水解之。奔豚
气上冲胸,腹痛,往来寒热,奔豚汤主之。(方见积块肾积气条。)
阴阳易,少腹里急,引阴中拘挛,热上冲胸,头重不欲举,眼中生花者,宜烧 散。(论见阴阳易。)
气上冲胸,口噤不得语,欲作刚 者,宜葛根汤。(论见 。)
烧针令其汗,针处被寒,核起而赤者,必发奔豚,气从少腹上冲心者,灸其核各一壮,与桂枝加桂汤
桂枝(二两半) 芍药 生姜(各一两半) 甘草(一两) 大枣(六枚)
上 咀,每服五钱,水煎温服。(桂枝加桂以能泄奔豚气也。)
动气发汗,则气上冲,正在心端。(论见动气。)太阳下后,其气上冲者,可与桂枝汤,方用
前法,若不上冲者,不可与之。
伤寒吐下后,心下逆满,气上冲胸,头眩,脉沉紧,若发汗则动经,身为振摇者,茯苓白术甘草汤。
(论见战振。方见振摇。)伤寒吐下后,发汗虚烦,脉甚微,八九日心下痞硬,胁下痛,气上冲咽喉,
眩冒,经脉动惕者,久而成痿。
厥阴经的病症表现为:口渴多饮,气逆上冲至心脏,心中感觉疼痛且有灼热感,虽有饥饿感但不想进食,进食后则呕吐出蛔虫。患厥阴病时,若患者想喝水,应少量给予饮水,即可痊愈。厥阴病兼见中风症状,若脉象微浮,表示病情即将好转;若不浮,则表示尚未痊愈。厥阴病欲解除的时间段,是从丑时到卯时。
若病症表现类似桂枝汤证,但头部不痛、项部不强硬,寸脉微浮,胸中痞塞且坚硬,气逆上冲至咽喉导致呼吸不畅,这是胸中有寒邪所致,应当采用涌吐法治疗,适宜使用瓜蒂散。
将上述药材研成细末,取一钱药粉,用香豉一合、水七合,先将香豉浸泡片刻,然后煎煮成稀粥状,滤去药渣,取汁液与药粉混合,温服一次顿下。若不呕吐,可少量增加剂量,直到出现剧烈呕吐为止。凡是失血或体质虚弱的人,不可服用此方。
〔《活人书》〕瓜蒂散,每次服用一钱匕的药量,服药后立即躺下。若想吐则暂时忍耐。过了很久仍不呕吐,再取三钱匕药粉,用二合汤水调和服用。用手指探喉催吐,便会吐出。若不吐,再稍微增加药量,以能吐出为度。如果吐得少而病邪未除,第二天按前法再次催吐,不可使病人过度虚弱。若药效过时仍未呕吐,可饮用热汤一升,以助药力。吐完后即可进食,不再服药。若服药过多,可饮水解毒。
奔豚病表现为气从少腹上冲胸部,腹痛,忽冷忽热,宜用奔豚汤主治。(方剂见积块肾积气条。)
阴阳易病,表现为少腹内部拘急紧迫,牵引外阴部痉挛抽搐,热气上冲胸部,头部沉重不想抬起,眼前发黑视物模糊,适宜使用烧裈散治疗。(论述见阴阳易篇。)
气上冲胸部,口噤不能言语,将要发作刚痉病的,适宜用葛根汤治疗。(论述见相关篇章。)
用烧针疗法令其出汗,针孔处受寒,出现红肿如核状,必然引发奔豚病,气从少腹上冲心脏,应在红肿处各灸一壮,并服用桂枝加桂汤。
桂枝(二两半) 芍药 生姜(各一两半) 甘草(一两) 大枣(六枚)
将药材切碎,每次服用五钱,用水煎煮后温服。(桂枝加桂汤之所以有效,是因为它能泄除奔豚之气。)
动气证误用发汗法,会导致气上冲,直冲心窝部位。(论述见动气篇。)太阳病误用下法后,若气上冲的,可与桂枝汤,使用前法;若不上冲的,不可给予。
伤寒经过吐下治疗后,胃脘部逆满,气上冲胸部,头晕目眩,脉象沉紧,若再发汗则会扰动经脉,导致身体震颤摇动者,适用茯苓白术甘草汤。(论述见战振篇。方剂见振摇篇。)伤寒经过吐下治疗后,又发汗导致虚烦,脉象极微,八九日后出现胃脘痞塞坚硬,胁下疼痛,气上冲咽喉,眩晕昏冒,经脉跳动惕惧者,日久将形成痿证。
The disease of Jueyin manifests as excessive thirst, Qi rushing upward to the heart, pain and heat sensation in the heart, hunger without desire to eat, and vomiting of roundworms after eating. In Jueyin disease, if the patient desires water, giving a small amount will lead to recovery. In Jueyin disease complicated by wind strike, if the pulse is slightly floating, it indicates impending recovery; if not floating, it indicates no recovery yet. The time when Jueyin disease tends to resolve is from Chou hour to Mao hour.
If the symptoms resemble those of Guizhi Tang syndrome, but there is no headache or stiffness in the neck, and the cun pulse is slightly floating, with chest oppression and hardness, and Qi rushing upward to the throat causing difficulty in breathing, this is due to cold pathogen in the chest. It should be treated by inducing vomiting, using Gouti San (Melon Seed Powder).
Gouti (stir-fried until yellow) and Chi Xiaodou (Red Bean, each 1 fen).
Grind into fine powder. Take 1 qian of powder. Soak 1 he of Douchi (Fermented Soybean) in 7 he of water for a moment, then boil into a thin porridge. Strain the dregs, mix the juice with the powder, and take warm in one dose. If vomiting does not occur, increase the dose slightly until vigorous vomiting occurs. Do not administer to patients who have lost blood or are constitutionally deficient.
[From *Huoren Shu*] For Gouti San, take 1 qian bi per dose. Lie down immediately after taking the medicine. Endure the urge to vomit. If no vomiting occurs after a long time, take 3 qian bi mixed with 2 he of decoction and swallow. Induce vomiting by probing the throat with fingers. If no vomiting occurs, increase the dose slightly until vomiting is achieved. If little vomiting occurs and the disease persists, repeat the method the next day, avoiding excessive depletion of the patient. If the drug's effect passes without vomiting, drink 1 sheng of hot water to assist the medicinal power. After vomiting, food can be taken; do not take more medicine. If too much medicine is taken, drink water to detoxify.
Ben Tun (Running Piglet) disease presents with Qi rushing from the lower abdomen to the chest, abdominal pain, alternating chills and fever, treated with Bentong Tang (see entry on Masses/Kidney Accumulation Qi).
Yin Yang Yi (Exchange of Yin and Yang) presents with urgency and tension in the lower abdomen, drawing spasm in the external genitalia, heat rushing to the chest, heavy head unwilling to lift, and visual disturbances (seeing spots), treated with Shao Kun San (Burnt Underwear Powder) (see discussion on Yin Yang Yi).
Qi rushing to the chest, trismus (lockjaw) preventing speech, indicating impending Gang Jing (Stiff Spasm), is treated with Gegen Tang (Kudzu Decoction) (see relevant discussion).
Cauterizing needles to induce sweating, followed by cold invading the needle site causing nodular redness, inevitably triggers Ben Tun disease, with Qi rushing from the lower abdomen to the heart. Moxibustion (one zhuang at each nodule) should be applied to the red nodules, along with Guizhi Jia Gui Tang (Cinnamon Twig Decoction plus Cinnamon).
Guizhi (Cinnamon Twig, 2 liang 5 qian), Shaoyao (Peony Root), Shengjiang (Fresh Ginger, each 1 liang 5 qian), Gancao (Licorice Root, 1 liang), Dazao (Jujube, 6 pieces).
Cut into pieces. Take 5 qian per dose, decoct in water and take warm. (Guizhi Jia Gui Tang works because it drains the Qi of Ben Tun.)
In cases of Dong Qi (Moving Qi), inducing sweating causes Qi to rush upward, directly striking the heart region (see discussion on Dong Qi). In Taiyang disease, if Qi rushes upward after incorrect purgation, Guizhi Tang may be given using the previous method; if Qi does not rush upward, it should not be given.
After emesis and purgation in Shanghan (Cold Damage), if there is fullness and rebellion below the heart, Qi rushing to the chest, vertigo, and a deep, tight pulse, further sweating will disturb the channels, causing body tremors. This is treated with Fuling Baizhu Gancao Tang (Poria, Atractylodes Macrocephala, and Licorice Decoction) (see discussion on Trembling/Shaking; formula see entry on Tremors). After emesis, purgation, and sweating in Shanghan leading to deficiency irritability and a very faint pulse, if after eight or nine days there is epigastric oppression and hardness, hypochondriac pain, Qi rushing to the throat, vertigo, and twitching of the meridians, prolonged illness will result in Wei Syndrome (Flaccidity Syndrome).