〔《灵》〕黄帝曰∶人之善饥而不嗜食者,何气使然?岐伯曰∶精气并于脾,热气留于胃,
胃热则消谷,谷消故善饥。胃气逆上,则胃脘寒,故不嗜食也。(大惑论)
运气饥不欲食,皆属湿邪伤肾。经云∶太阴司天,湿淫所胜,民病心如悬,饥不欲食,治
以苦热是也。
针灸饥不欲食有二法∶
其一清胃。经云∶胃者,水谷之海。其 ,上在气冲,下至三里。水谷之海不足,则饥不
受谷。审守其 ,调其虚实是也。
其二取肾。经云∶肾足少阴之脉,是动则病饥不欲食,心如悬,若饥状。视盛虚热寒陷下
取之也。
〔东〕饥不能食,饮食不下,呕而雷鸣∶大迎、中极、食窦。又法∶期门、章门。
冬脉不及,为病在中,令人心悬如饥。(全文见治虚实法。)
〔仲〕寸口脉弱迟,弱者胃气微;迟者荣中寒。荣为血,血虚则发热;胃为气,气虚则发厥。
〔《素》〕太阴所谓恶闻食臭者,胃无气,故恶食臭也。
〔丹〕恶食者,胸中有物,导痰补脾,二陈加白苍楂芎汤。
白术 山楂 川芎 苍术 半夏 陈皮 茯苓 甘草
〔垣〕失笑丸 治虚痞恶食。(方见痞门。)
〔《大》〕治妊娠恶食。
人参(四两) 浓朴 生姜 枳壳 甘草(各一两) 水煎服。
凡妊娠恶食者,以所思食任意食之,必愈。
【《灵枢》】黄帝说:人之所以容易感到饥饿但不想吃东西,是什么气造成的?岐伯说:精气汇聚于脾,热气滞留于胃,胃中有热则能消化食物,食物被消化得快所以容易感到饥饿。如果胃气上逆,就会导致胃脘部寒冷,因此不想吃东西。(出自《大惑论》)
因运气(五运六气)导致的饥饿但不想进食,都属于湿邪损伤肾脏。医经说:“当太阴湿土司天之年,湿气过胜,百姓会出现心中空虚如悬、饥饿但不想进食的症状,治疗应用苦味热性药物。”
针灸治疗饥饿但不想进食有两种方法:
第一种是清胃。医经说:“胃是水谷之海。”其经脉,上部在气冲穴,下部至足三里穴。如果水谷之海(胃气)不足,就会饥饿但不能受纳食物。应当仔细诊察该经脉,调理其虚实状态。
第二种是取肾。医经说:“足少阴肾经发生病变时,会出现饥饿但不想进食、心中空虚如悬、像饥饿一样的症状。”应根据脉象的盛虚、寒热或下陷情况来选取穴位进行治疗。
【李东垣】对于饥饿不能进食、饮食难以下咽、呕吐且肠鸣的情况:取大迎穴、中极穴、食窦穴。另一种方法:取期门穴、章门穴。
冬季脉象不及,病位在中焦,会导致心中空虚如饥饿感。(全文见治虚实法章节。)
【张仲景】寸口脉弱而迟,弱脉表示胃气微弱;迟脉表示营分有寒。营属血,血虚则发热;胃属气,气虚则发厥。
【《素问》】太阴篇所说的“厌恶闻食物的气味”,是因为胃中没有正气,所以厌恶食物的气味。
【朱丹溪】厌恶进食的人,胸中有痰浊阻滞,应导痰并补益脾胃,用二陈汤加白术、苍术、山楂、川芎。
药材:白术、山楂、川芎、苍术、半夏、陈皮、茯苓、甘草。
【《大观本草》】治疗妊娠期间厌恶进食。
药材:人参(四两)、厚朴、生姜、枳壳、甘草(各一两),水煎服用。
凡是妊娠期间厌恶进食的,想吃什么都可以随意吃,必定痊愈。
[Ling Shu] The Yellow Emperor said: Why do some people feel hungry easily but have no desire to eat? What qi causes this? Qibo replied: Jing (Essential) Qi converges in the Spleen, and hot qi lingers in the Stomach. When there is heat in the Stomach, it digests food quickly; since food is digested rapidly, one feels hungry easily. If Stomach Qi rebels upward, it causes coldness in the epigastrium, thus leading to a lack of desire to eat. (From "Da Huo Lun")
Hunger without desire to eat caused by Yunqi (Five Movements and Six Qi) all belong to damp pathogen injuring the Kidney. The Classics state: "When Taiyin governs the year, excessive dampness prevails, and the people suffer from a sensation of emptiness in the heart as if hanging, hunger without desire to eat. Treatment should employ bitter-hot methods."
There are two acupuncture methods for treating hunger without desire to eat:
The first is to clear the Stomach. The Classics state: "The Stomach is the Sea of Water and Grain." Its meridian, above at Qichong (ST30), extends below to Zusanli (ST36). If the Sea of Water and Grain (Stomach Qi) is insufficient, one will feel hungry but unable to accept food. One must carefully observe the meridian and regulate its deficiency or excess.
The second is to select points on the Kidney. The Classics state: "When the Foot-Shaoyin Kidney Meridian is affected, disease manifests as hunger without desire to eat, and a sensation of emptiness in the heart as if hanging, resembling hunger." Treatment should be based on observing whether the condition is full or empty, hot or cold, or sunken.
[Li Dongyuan] For symptoms of hunger but inability to eat, food not going down, vomiting, and borborygmus: Da Ying (LI17), Zhong Ji (CV3), Shi Dou (SP15). Another method: Qi Men (LR14), Zhang Men (LR13).
If the Winter pulse is deficient, the disease is in the middle jiao, causing a sensation of emptiness in the heart like hunger. (Full text see Treatise on Deficiency and Excess.)
[Zhang Zhongjing] The Cun Kou pulse is weak and slow. Weakness indicates slight Stomach Qi; slowness indicates cold in the Ying (Nutritive) level. Ying belongs to Blood; blood deficiency generates heat. The Stomach belongs to Qi; qi deficiency leads to Jue (cold extremities/fainting).
[Su Wen] In the chapter on Taiyin, it is stated that "disliking the smell of food" occurs because the Stomach lacks Qi, hence the aversion to food odors.
[Zhu Danxi] Those who dislike eating have phlegm turbidity obstructing the chest. The treatment is to guide out phlegm and tonify the Spleen, using Er Chen Tang plus Bai Zhu, Cang Zhu, Shan Zha, and Chuan Xiong.
Herbs: Atractylodis Macrocephalae Rhizoma (Baizhu), Crataegi Fructus (Shanzha), Ligustici Chuanxiong Rhizoma (Chuanxiong), Atractylodis Rhizoma (Cangzhu), Pinelliae Tuber (Banxia), Citri Reticulatae Pericarpium (Chenpi), Poria (Fuling), Glycyrrhizae Radix et Rhizoma (Gancao).
[Li Gao] Shixiao Wan treats deficiency-type fullness and aversion to eating. (Formula see Men of Fullness.)
[Da Guan Ben Cao] Treatment for aversion to eating during pregnancy.
Herbs: Ginseng Radix et Rhizoma (Renshen, 4 liang), Magnoliae Officinalis Cortex (Houpo), Zingiberis Rhizoma Recens (Shengjiang), Aurantii Fructus Immaturus (Zhiqiao), Glycyrrhizae Radix et Rhizoma (Gancao, each 1 liang). Decoct in water and take orally.
For any case of aversion to eating during pregnancy, allowing the patient to eat whatever they crave will surely lead to recovery.