木香 檀香 白蔻仁 丁香(各三两) 砂仁(四两) 甘草(炙) 藿香(各半两)
共为末,每服二钱,盐汤下。
中焦呃逆者,此方主之。
中焦者,水谷之海,仓廪之区也。其呃逆责之谷气,故用砂仁、蔻仁以化食,木香、丁
香、檀香、藿香以调气,甘草以和中,盐汤以润下。或问∶中焦呃逆,与下焦呃逆何以辨?
余曰∶彼则由于大病后,此则得之饮食后也。又中焦之呃逆轻而短,下焦之呃逆恶而长,其
辨判然矣。
叙曰∶翻胃一证,古今难之。若胃脘未枯,皆为可治。借曰枯之,则从容用药,犹可久
延。若造次不察病理,非惟无益,而又害之矣。今着六考,宜于言外而变通之。
韭汁 牛乳(等分)
时呷之。
胃脘有死血,干燥枯槁,食下作痛,翻胃便秘者,此方主之。
翻胃者,胃不能安谷,食下即出之名也。嗜酒燥暴之人,多有此疾。胃脘有死血者,醇
酒渍胃,久积瘀热之所致也。干燥枯槁者,燥急心热之所致也。有枯燥,故令食下作痛。有
积热,故令翻胃便秘。韭汁味辛,能消瘀行血。牛乳甘温,能养血润燥。
驴尿,每服呷二合。
郁火翻胃者,此方主之。
火郁于中,治以辛香开胃之药,益滋其燥,非所宜也。驴尿辛膻,可使开郁,然为浊阴
之所降,则可以济火矣。唐贞观中,许奉御及柴蒋等,时称名医,奉敕治翻胃,竭其术,竟
不能疗,渐至羸惫,死在旦夕。忽有术士云∶服驴子小便极验。旦服二合,午食惟吐一半。
晡时又服二合,人定时食粥,吐即定。后奏知大内中,五六人患翻胃,同服,一时俱瘥。卢
和着《丹溪纂要》,谓入驴尿以防生虫,此未究理者也。
木香、檀香、白蔻仁、丁香(各三两),砂仁(四两),甘草(炙)、藿香(各半两)。
将上述药物共同研磨为细末,每次服用二钱,用盐汤送服。
中焦呃逆者,此方为主治方剂。
中焦,是受纳水谷的海,也是储藏食物的区域。其中的呃逆责源于谷气不和,因此使用砂仁、白蔻仁来消食化滞,木香、丁香、檀香、藿香来调理气机,甘草来调和脾胃,盐汤来润降下行。有人问:中焦呃逆与下焦呃逆如何辨别?
我说:下焦呃逆多由于大病之后发生,而中焦呃逆则是饮食之后发生的。另外,中焦的呃逆症状轻且短促,下焦的呃逆症状重且持久,两者的区别非常明显。
序言说:翻胃这一病症,古今医家都感到棘手。如果胃脘部尚未干枯萎缩,都是可治疗的。假如已经干枯,只要从容用药,还可以长久延续生命。如果仓促之间不仔细考察病理,不仅无益,反而会造成危害。现在著述了六个考证篇章,应当在字面之外灵活变通地运用。
韭菜汁、牛乳(等量)。
时时少量啜饮。
胃脘部有死血(瘀血),导致干燥枯槁,进食后作痛,出现翻胃、便秘者,此方为主治方剂。
所谓翻胃,是指胃不能安受谷物,食物吃下去随即吐出的病名。嗜好饮酒、性情急躁暴烈的人,多有这种疾病。胃脘有死血的成因,是由于醇酒浸泡胃部,日久积聚瘀热所致。干燥枯槁的成因,是由于燥急心热所致。因为有枯燥,所以导致进食后作痛。因为有积热,所以导致翻胃和便秘。韭菜汁味辛,能消散瘀血、运行血液。牛乳味甘性温,能养血润燥。
驴尿,每次服用二合。
郁火型翻胃者,此方为主治方剂。
火邪郁结于中焦,若用辛香开胃的药物来治疗,只会更加滋长其燥热,这是不适宜的。驴尿味辛膻,可以开通郁结,但它属于浊阴之物下降,从而可以济助平息火势。唐贞观年间,许奉御及柴蒋等人,当时被称为名医,奉皇帝诏令治疗翻胃,用尽了他们的医术,最终未能治愈,患者逐渐变得瘦弱疲惫,死亡就在旦夕之间。忽然有位术士说:服用驴子的小便极有效验。早晨服用二合,中午吃饭只吐出一半。傍晚时又服用二合,入定时分喝粥,呕吐就停止了。后来奏知皇宫内廷,有五六人患翻胃,一同服用,一时之间全部痊愈。卢和在《丹溪纂要》中提到加入驴尿是为了防止生虫,这是没有探究事理的表现。
Muxiang (Costus Root), Tanxiang (Sandalwood), Baikouren (White Cardamom Seed), Dingxiang (Clove) (each 3 liang), Sharen (Amomum Fruit) (4 liang), Gancao (Licorice Root, roasted), Huoxiang (Patchouli Herb) (each 0.5 liang).
Grind all ingredients into a fine powder. Take 2 qian per dose, administered with salt water.
This formula is the primary treatment for epigastric hiccups originating from the Middle Jiao (Middle Burner).
The Middle Jiao is the sea of water and grain, the region of granaries. Epigastric hiccups here are attributed to disturbances in grain qi; therefore, Sharen and Baikouren are used to resolve food stagnation, Muxiang, Dingxiang, Tanxiang, and Huoxiang are used to regulate qi, Gancao is used to harmonize the middle jiao, and salt water is used to moisten and direct downward. One might ask: How can one distinguish between epigastric hiccups of the Middle Jiao and those of the Lower Jiao?
I say: Those of the Lower Jiao arise after severe illness, whereas those of the Middle Jiao occur after eating. Furthermore, Middle Jiao hiccups are mild and short, while Lower Jiao hiccups are severe and prolonged; the distinction is clear.
Preface states: Fanwei (Regurgitation/Inverted Stomach) is a condition that has puzzled physicians since ancient times. If the stomach cavity has not yet withered, it is treatable. Even if it has withered, careful medication can still prolong life. However, acting hastily without examining the pathology will not only be ineffective but also harmful. Herein are six examinations; one should apply them flexibly beyond their literal meaning.
Jiuji (Chinese Chive Juice), Niurui (Cow's Milk) (equal parts).
Sip slowly over time.
This formula is the primary treatment for cases where there is dead blood (stagnant blood) in the stomach cavity, leading to dryness and withering, pain upon eating, Fanwei (Regurgitation), and constipation.
Fanwei refers to the condition where the stomach cannot accept grain, causing food to be vomited immediately after ingestion. This disease is common among those who indulge in alcohol and have a dry, irritable, and violent temperament. The presence of stagnant blood in the stomach cavity is caused by strong wine soaking the stomach, leading to the long-term accumulation of stasis and heat. Dryness and withering are caused by dryness and heart heat. Due to dryness, eating causes pain. Due to accumulated heat, Fanwei and constipation result. Chinese chive juice is pungent and can dissolve stasis and promote blood circulation. Cow's milk is sweet and warm, nourishing blood and moistening dryness.
Lvniao (Donkey Urine), take 2 he per dose.
This formula is the primary treatment for Fanwei caused by constrained fire.
When fire is constrained in the middle, treating it with pungent and aromatic herbs to open the appetite will only exacerbate the dryness, which is inappropriate. Donkey urine is pungent and gamey; it can open constraints. As a descending turbid yin substance, it can help quell fire. During the Zhen Guan era of the Tang Dynasty, Xu Fengyu and Chai Jiang, renowned physicians at the time, were ordered by imperial decree to treat Fanwei. Despite exhausting their medical skills, they failed to cure the patients, who gradually became emaciated and weak, facing imminent death. Suddenly, a practitioner claimed that drinking donkey urine was highly effective. Taking 2 he in the morning resulted in vomiting only half the meal at noon. Taking another 2 he in the late afternoon allowed the patient to eat porridge at nightfall without vomiting. Later, this was reported to the imperial court; five or six other patients with Fanwei took it simultaneously and recovered at once. Lu He, in his "Danxi Zuanyao," mentioned adding donkey urine to prevent worm infestation, which demonstrates a lack of thorough investigation into the underlying principles.