[总诀]胃司饮食命之根,欲恶之间得病情。单指积停一端说,非吾所谓个中人。
饥而思食,每食又不能多者,脾强而胃弱也。宜重订助胃丸。
苍术(二钱) 甘草(一钱) 砂仁(二钱) 陈皮(二钱) 生姜(一钱) 吴萸(一钱) 半夏(二
钱) 白蔻(一钱) 檀香(一钱) 党参(三钱) 云苓(二钱) 大枣(二枚)
歌曰∶饥思饮食反嫌多,胃弱脾强姜草和。
再入砂陈萸术枣,参苓白蔻夏檀科。
食而善饱,每饱又作反胀者,胃强而脾弱也。宜抑胃扶脾汤。
麦冬(三钱) 黄连(二钱) 党参(三钱) 白术(三钱) 山药(二钱) 木香(一钱) 白
芍(二钱) 麦芽(二钱) 黄精(三钱) 甘草(一钱)
歌曰∶食而善饱胀翻增,弱在脾经谷不胜。
薯术香连参芍草,黄精冬麦效堪凭。
(伯未按∶蜀刻本无山药、黄精、多干姜、肉蔻。)
不善于食,而并不思饮食者,脾胃两皆虚也。宜建中复理汤。)
桂枝(二钱) 白芍(三钱) 饴糖(三钱) 党参(三钱) 白术(三钱) 干姜(一钱) 甘
草(一钱) 大枣(三枚)
歌曰∶不思饮食土全虚,桂芍饴糖暖气嘘。
参术干姜同枣草,建中汤服饭如初。
喜饮冷水,以及消渴不止者,胃中虚热故也。宜原方甘露饮。
生地(三钱) 熟地(三钱) 天冬(三钱) 麦冬(三钱) 黄芩(三钱) 枳壳(一钱) 石斛
(三钱) 茵陈(三钱) 枇杷叶(三钱) 甘草(一钱)
歌曰∶喜吞冷水病中消,二地生津力颇饶。
芩枳二冬茵斛草,枇杷加入病和调。
喜饮热汤,或兼腹痛厥利者,脾部之虚寒也。宜附子理中汤。
附子(三钱) 白术(三钱) 人参(三钱) 生姜(二钱) 甘草(一钱)
歌曰∶脾部虚寒喜热汤,理中术附与生姜。
人参补益同甘草,仲景真方请细详。
伤食腹痛,兼见吐酸嗳腐者,宿食停不去也。宜加减平胃散。
苍术(二钱) 陈皮(二钱) 浓朴(一钱) 甘草(一钱) 大黄(一钱) 生姜(一钱) 神曲
(二钱)
歌曰∶食伤腹痛用陈皮,苍术生姜朴草随。
神曲大黄还共煮,胃平食去此方宜。
食入气呛,因而哽噎不下者,肺气不下降也。宜降脾平胃散。
百合(三钱) 阿胶(二钱) 半夏(三钱) 麦冬(三钱) 杏仁(三钱) 枳壳(一钱) 细辛
(五分) 五味(七分)
歌曰∶食时气呛用辛冬,百合阿胶半夏从。
枳味杏仁同理气,降脾平胃咽方通。
食必饮送,无饮即不下咽者,胃气不下降也。宜甘蜜半夏汤。
半夏(三钱) 党参(三钱) 白蜜(一两) 甘澜水(一斤)
歌曰∶食无饮送即难吞,只取生津不取温。
半夏人参和白蜜,甘澜水服胃阴存。
(伯未按∶若因老年血槁者,用地黄、麦冬、当归浓煎,入乳汁、韭汁、桃仁泥和匀呷下。)
饮伤腹满,兼见小便不利者,膀胱气不化也。宜原方
五苓散。
白术(三钱) 云苓(三钱) 猪苓(三钱) 泽泻(三钱) 桂枝(二钱)
歌曰∶饮伤腹满溺难通,总系膀胱气不融。
白术二苓同桂泽,生津利水有奇功。
【总诀】胃负责受纳饮食,这是生命的根本;在食欲的喜好与厌恶之间,可以探知病情的虚实。如果只片面地谈论食积停滞这一种情况,就不是我所说的精通医理的人。
饥饿时想吃东西,但每次吃又吃不多的人,是脾气强而胃气弱。适宜使用重订助胃丸。
苍术(二钱) 甘草(一钱) 砂仁(二钱) 陈皮(二钱) 生姜(一钱) 吴茱萸(一钱) 半夏(二钱) 白豆蔻(一钱) 檀香(一钱) 党参(三钱) 茯苓(二钱) 大枣(两枚)
歌诀说:饥饿想吃饭却嫌弃食物多,是因为胃弱脾强,用姜和草来调和。
再加入砂仁、陈皮、吴茱萸、苍术和大枣,配合人参、茯苓、白豆蔻、半夏和檀香。
进食后容易饱胀,每次吃饱后又出现反胃胀满感的人,是胃气强而脾气弱。适宜使用抑胃扶脾汤。
麦冬(三钱) 黄连(二钱) 党参(三钱) 白术(三钱) 山药(二钱) 木香(一钱) 白芍(二钱) 麦芽(二钱) 黄精(三钱) 甘草(一钱)
歌诀说:进食后容易饱胀且症状加重,是因为脾经虚弱无法运化谷物。
用山药、白术、木香、黄连、人参、白芍和甘草,配合黄精、麦冬和麦芽,疗效值得依靠。
(伯未按语:蜀刻本中没有山药和黄精,而是多了干姜和肉豆蔻。)
不善于进食,并且完全没有食欲的人,是脾胃两虚。适宜使用建中复理汤。
桂枝(二钱) 白芍(三钱) 饴糖(三钱) 党参(三钱) 白术(三钱) 干姜(一钱) 甘草(一钱) 大枣(三枚)
歌诀说:不想吃东西是因为土气(脾胃)完全虚弱,服用桂枝、白芍和饴糖后暖气缓解。
人参、白术、干姜同大枣和甘草一起,服用建中汤后吃饭能恢复如初。
喜欢喝冷水,以及消渴症(口渴多饮)不止的人,是胃中有虚热所致。适宜使用原方甘露饮。
生地黄(三钱) 熟地黄(三钱) 天冬(三钱) 麦冬(三钱) 黄芩(三钱) 枳壳(一钱) 石斛(三钱) 茵陈(三钱) 枇杷叶(三钱) 甘草(一钱)
歌诀说:喜欢吞服冷水,病中的消渴症状,生地和熟地生津的力量很丰富。
黄芩、枳壳、天冬麦冬、茵陈、石斛和甘草,加入枇杷叶使病情调和。
喜欢喝热汤,或者兼有腹痛和四肢厥冷腹泻的人,是脾部的虚寒证。适宜使用附子理中汤。
附子(三钱) 白术(三钱) 人参(三钱) 生姜(二钱) 甘草(一钱)
歌诀说:脾部虚寒喜欢热汤,理中汤用白术、附子和生姜。
人参补益配合甘草,这是张仲景的真方请仔细详察。
伤食导致腹痛,兼见吐酸水和嗳出腐臭气味的人,是宿食停滞不去。适宜使用加减平胃散。
苍术(二钱) 陈皮(二钱) 厚朴(一钱) 甘草(一钱) 大黄(一钱) 生姜(一钱) 神曲(二钱)
歌诀说:食伤腹痛使用陈皮,苍术、生姜、厚朴和甘草跟随。
神曲和大黄一起煮,服用平胃散去除食积此方适宜。
食物入口引起气逆呛咳,因而哽噎不能下咽的人,是肺气不下降。适宜使用降脾平胃散。
百合(三钱) 阿胶(二钱) 半夏(三钱) 麦冬(三钱) 杏仁(三钱) 枳壳(一钱) 细辛(五分) 五味子(七分)
歌诀说:进食时气逆呛咳使用细辛和麦冬,百合、阿胶和半夏随从。
枳壳、五味子和杏仁共同调理气机,降脾平胃散能使咽喉通畅。
进食必须用水送服,没有水就无法下咽的人,是胃气不下降。适宜使用甘蜜半夏汤。
半夏(三钱) 党参(三钱) 白蜜(一两) 甘澜水(一斤)
歌诀说:没有水送服就难以吞咽,取的是生津而非温补。
半夏、人参和白蜜混合,用甘澜水服用以保存胃阴。
(伯未按语:如果是因年老血枯引起的,用地黄、麦冬、当归浓煎,加入乳汁、韭菜汁、桃仁泥混合均匀小口服用。)
饮水过多导致腹部胀满,兼见小便不利的人,是膀胱气化功能失常。适宜使用原方五苓散。
白术(三钱) 茯苓(三钱) 猪苓(三钱) 泽泻(三钱) 桂枝(二钱)
歌诀说:饮水损伤导致腹部胀满和小便不通,总归是膀胱气化不畅。
白术、二苓(茯苓、猪苓)同桂枝和泽泻,具有生津利水的奇效。
[General Principle] The stomach is responsible for receiving and digesting food, which is the root of life; between the desires and aversions regarding appetite, one can discern the nature of the disease. To discuss only the aspect of food stagnation is not what I mean by being a true expert in medicine.
Those who feel hungry and desire food but cannot eat much at each meal have strong Spleen Qi and weak Stomach Qi. It is appropriate to use the Revised ZHUWEI Wan (Assisting Stomach Pill).
Cangzhu (Atractylodis Rhizoma) (2 qian), Gancao (Glycyrrhizae Radix et Rhizoma) (1 qian), Sharen (Amomi Fructus Rotundus) (2 qian), Chenpi (Citri Reticulatae Pericarpium) (2 qian), Shengjiang (Zingiberis Rhizoma Recens) (1 qian), Wuyu (Evodiae Fructus) (1 qian), Banxia (Pinelliae Rhizoma Preparatum) (2 qian), Baikou (Amomi Fructus) (1 qian), Tanxiang (Santalum Album Lignum) (1 qian), Dangshen (Codonopsis Radix) (3 qian), Yunling (Poria) (2 qian), Dazao (Jujubae Fructus) (2 pieces).
The song says: Hungry yet desiring food but disliking large amounts, due to weak Stomach and strong Spleen, harmonize with Ginger and Licorice.
Add Amomum, Citrus peel, Evodia, Atractylodes, and Jujube, along with Codonopsis, Poria, Cardamom, Pinellia, and Sandalwood.
Those who become full easily after eating and experience regurgitation and bloating when full have strong Stomach Qi and weak Spleen Qi. It is appropriate to use the YIWEI FUPI Tang (Suppressing Stomach and Supporting Spleen Decoction).
Maidong (Ophiopogonis Radix) (3 qian), Huanglian (Coptidis Rhizoma) (2 qian), Dangshen (Codonopsis Radix) (3 qian), Baizhu (Atractylodis Macrocephalae Rhizoma) (3 qian), Shanyao (Dioscoreae Rhizoma) (2 qian), Muxiang (Aucklandiae Radix) (1 qian), Baishao (Paeoniae Radix Alba) (2 qian), Maiya (Hordei Fructus Germinatus) (2 qian), Huangjing (Polygonati Rhizoma) (3 qian), Gancao (Glycyrrhizae Radix et Rhizoma) (1 qian).
The song says: Eating leads to easy fullness and increased bloating, weakness lies in the Spleen meridian unable to overcome grain.
Use Dioscorea, Atractylodes, Aucklandia, Coptis, Codonopsis, Paeonia, and Licorice; Polygonatum, Ophiopogon, and Hordeum provide reliable efficacy.
(Bai's commentary: The Shu edition lacks Dioscorea and Polygonatum, instead containing Dried Ginger and Myristica.)
Those who are poor at eating and have no desire for food have deficiency in both Spleen and Stomach. It is appropriate to use the JIANZHONG FULI Tang (Establishing Middle and Restoring Regulation Decoction).
Guizhi (Cinnamomi Ramulus) (2 qian), Baishao (Paeoniae Radix Alba) (3 qian, Yitang (Maltose) (3 qian), Dangshen (Codonopsis Radix) (3 qian), Baizhu (Atractylodis Macrocephalae Rhizoma) (3 qian), Ganjiang (Zingiberis Rhizoma) (1 qian), Gancao (Glycyrrhizae Radix et Rhizoma) (1 qian), Dazao (Jujubae Fructus) (3 pieces).
The song says: No desire for food indicates total deficiency of Earth (Spleen/Stomach); Guizhi, Baishao, and Maltose alleviate belching.
Codonopsis, Atractylodes, Dried Ginger, Jujube, and Licorice together; taking Jianzhong Decoction restores normal eating.
Those who prefer drinking cold water and suffer from persistent Xiao Ke (Wasting-Thirst) have deficient heat in the Stomach. It is appropriate to use the original Ganlu Yin (Sweet Dew Drink).
Shengdi (Rehmanniae Radix) (3 qian), Shudi (Rehmanniae Radix Preparata) (3 qian), Tiandong (Asparagi Radix) (3 qian), Maidong (Ophiopogonis Radix) (3 qian), Huangqin (Scutellariae Radix) (3 qian), Zhike (Aurantii Fructus) (1 qian), Shihu (Dendrobii Caulis) (3 qian), Yichen (Copdalis Herba) (3 qian), Pipaye (Loquats Folium) (3 qian), Gancao (Glycyrrhizae Radix et Rhizoma) (1 qian).
The song says: Swallowing cold water amidst wasting-thirst; Rehmannia generates fluids with considerable power.
Scutellaria, Aurantium, Asparagus, Ophiopogon, Copdalis, Dendrobium, and Licorice, adding Loquat leaf harmonizes the disease.
Those who prefer drinking hot soup, or have accompanying abdominal pain and cold limbs with diarrhea, have deficiency-cold in the Spleen region. It is appropriate to use the FUZI Lizhong Tang (Aconite Regulating Middle Decoction).
Fuzi (Aconiti Lateralis Radix Preparata) (3 qian), Baizhu (Atractylodis Macrocephalae Rhizoma) (3 qian), Renshen (Panacis Ginseng Radix) (3 qian), Shengjiang (Zingiberis Rhizoma Recens) (2 qian), Gancao (Glycyrrhizae Radix et Rhizoma) (1 qian).
The song says: Spleen deficiency-cold prefers hot soup; Lizhong uses Atractylodes, Aconite, and Ginger.
Panax nourishes and supplements combined with Licorice; this is Zhang Zhongjing's authentic formula, please examine carefully.
Food injury causing abdominal pain, accompanied by acid regurgitation and belching of rotten smells, indicates retained food stagnation. It is appropriate to use the Modified Pingwei San (Peaceful Stomach Powder).
Cangzhu (Atractylodis Rhizoma) (2 qian), Chenpi (Citri Reticulatae Pericarpium) (2 qian), Houpo (Magnoliae Officinalis Cortex) (1 qian), Gancao (Glycyrrhizae Radix et Rhizoma) (1 qian), Dahuang (Rhei Radix et Rhizoma) (1 qian), Shengjiang (Zingiberis Rhizoma Recens) (1 qian), Shenqu (Massa Medicata Fermentata) (2 qian).
The song says: For food-injury abdominal pain use Citrus peel, followed by Atractylodes, Ginger, Magnolia bark, and Licorice.
Boil Massamedica and Rheum together; using Pingwei San to remove food stagnation is suitable.
Food entering causes air choking and subsequent dysphagia (difficulty swallowing), indicating Lung Qi failing to descend. It is appropriate to use JiangPI Pingwei San (Descending Spleen and Peaceful Stomach Powder).
Baihe (Lilii Bulbus) (3 qian), Ejiao (Asini Corii Colla) (2 qian), Banxia (Pinelliae Rhizoma Preparatum) (3 qian), Maidong (Ophiopogonis Radix) (3 qian), Xingren (Armeniacae Semen Amarum) (3 qian), Zhike (Aurantii Fructus) (1 qian), Xixin (Asari Radix et Rhizoma) (5 fen), Wuweizi (Schisandrae Fructus) (7 fen).
The song says: For air-choking during eating use Asarum and Ophiopogon; Lilium, Donkey-hide gelatin, and Pinellia follow.
Aurantium, Schisandra, and Armeniacus seed regulate Qi together; Jiangpi Pingwei San unblocks the throat.
Eating must be washed down with water; without water, it cannot be swallowed, indicating Stomach Qi failing to descend. It is appropriate to use Ganmi Banxia Tang (Honeyed Pinellia Decoction).
Banxia (Pinelliae Rhizoma Preparatum) (3 qian), Dangshen (Codonopsis Radix) (3 qian), Baimi (Mel) (1 liang), Ganlan Shui (Ganlan Water) (1 jin).
The song says: Without water washing down, swallowing is difficult; seek generating fluids rather than warming.
Pinellia, Panax, and White Honey mixed; taken with Ganlan Water to preserve Stomach Yin.
(Bai's commentary: If caused by blood dryness in the elderly, decoct Rehmannia, Ophiopogon, and Angelica strongly, mix with milk, chive juice, and Peach Kernel paste, and sip slowly.)
Excessive drinking leading to abdominal fullness, accompanied by difficulty urinating, indicates failure of Bladder Qi transformation. It is appropriate to use the original Wuling San (Five-Ling Powder).
Baizhu (Atractylodis Macrocephalae Rhizoma) (3 qian), Yunling (Poria) (3 qian), Zhuling (Polyporus) (3 qian), Zexie (Alismatis Rhizoma) (3 qian), Guizhi (Cinnamomi Ramulus) (2 qian).
The song says: Drinking injury causes abdominal fullness and difficult urination; it is generally due to Bladder Qi stagnation.
Atractylodes, the two Lings (Poria and Polyporus), Cinnamon twig, and Alisma have miraculous effects in generating fluids and promoting diuresis.