【大黄黄连泻心汤】 治心下痞。按之濡。其脉关上浮者。又伤寒大下后。复发汗。心下
痞恶寒者。表未解也。不可攻痞。当先用桂枝汤解表。表解乃可用此汤攻痞。
大黄(二两) 黄连 黄芩(各一两)
(伊芳尹汤液论云,大黄黄连黄芩汤三味。今监本无黄芩。脱落之也)
上 咀。以煎沸汤二大盏。热渍之。一时久。绞去渣(暖动)。分作二服。
【大消痞丸】治一切心下痞闷。及积年久不愈者。
半夏(汤泡七次。四钱) 干生姜 神曲(炒黄) 砂仁
甘草(炙。各一钱) 猪苓(一钱半) 人参 橘皮(各二钱)
浓朴(制。三钱) 枳实(麸炒。五钱) 黄连(去须) 黄芩(去焦。各五钱)
白术 姜黄(各一两) 一方加泽泻(三钱)
上为末。水浸蒸饼丸如桐子大。每服五七十丸至百丸。白汤送下。食后。
【枳实理中丸】治中脘痞滞。气不宣通。积寒停饮。食入不化。
人参(去芦) 干姜(炮) 枳实(麸炒) 甘草(炙)
白术(各等分)
上为细末。炼蜜丸如弹子大。每服一丸细嚼。白汤送下。汤化亦得。不拘时。
【三脘痞气丸】治三焦痞滞。气不升降。水饮停积。不得流行。胁下虚满。或时刺痛。宜
服。
沉香 大腹子 槟榔 缩砂(各半两)
青皮(去白) 陈皮(去白) 木香 白豆蔻
三棱(炮。各一两) 半夏(汤泡七次。二两)
上为末。神曲糊丸如桐子大。每服三十丸。温水送下。陈皮汤亦得。食后。
【枳实消痞丸】治右关脉浮紧。心下虚痞。恶食懒倦。开胃进食。
干生姜(一钱) 人参 白茯苓 甘草(炙)
白术 麦 曲(各二钱) 半夏曲(三钱) 浓朴(制。四钱)
枳实(麸炒) 黄连(各五钱)
上为末。汤浸蒸饼。丸如桐子大。每服三十丸。温水送下。无时。量虚实加减。
【大黄黄连泻心汤】治疗心下痞证。表现为按压时感觉柔软,脉象在关部呈现浮象。另外,若伤寒经过猛烈攻下后,又再次发汗,出现心下痞且伴有恶寒症状的,说明表证尚未解除。此时不可直接攻逐痞结,应当先使用桂枝汤来解表。待表证解除后,方可使用此方来攻治痞结。
药材:大黄(二两)、黄连、黄芩(各一两)。
(据李东垣《汤液本草》记载,大黄黄连黄芩汤由这三味药组成。现在的官刻本中缺少黄芩,这是脱漏所致。)
将上述药材切碎,用两大盏刚沸腾的水浸泡片刻。放置约一顿饭的时间,滤去药渣(保持温热)。分两次服用。
【大消痞丸】治疗各种心下痞闷,以及多年久治不愈的情况。
药材:半夏(用开水烫七次,四钱)、干生姜、神曲(炒至发黄)、砂仁、甘草(炙,各一钱)、猪苓(一钱半)、人参、橘皮(各二钱)、浓朴(炮制,三钱)、枳实(麸皮炒,五钱)、黄连(去须)、黄芩(去焦枯部分,各五钱)、白术、姜黄(各一两)。另一配方加泽泻(三钱)。
将上述药材研为细末,用水浸泡蒸饼制成如梧桐子大小的药丸。每次服用五七十丸至一百丸,用温开水送服,饭后服用。
【枳实理中丸】治疗中脘部位痞塞阻滞,气机不能宣通,寒积停留、水饮内停,食物进入后无法消化。
药材:人参(去芦头)、干姜(炮制)、枳实(麸皮炒)、甘草(炙)、白术(以上五味等量)。
将上述药材研为细末,用炼蜜制成如弹子大小的药丸。每次服用一丸,细细咀嚼,用温开水送服。让药丸在汤水中化开服用也可以。不拘泥于固定时间服用。
【三脘痞气丸】治疗三焦气机痞塞阻滞,气机升降失常,水饮停滞积聚,不能正常流通。表现为胁下虚胀满闷,或偶尔出现刺痛,适宜服用此方。
药材:沉香、大腹子、槟榔、缩砂(即砂仁,各半两)、青皮(去白瓤)、陈皮(去白瓤)、木香、白豆蔻、三棱(炮制,各一两)、半夏(用开水烫七次,二两)。
将上述药材研为细末,用神曲糊制成如梧桐子大小的药丸。每次服用三十丸,用温水送服,饭后服用。用陈皮汤送服也可以。
【枳实消痞丸】治疗右关脉浮紧,心下虚痞感,厌恶饮食,懒倦乏力,旨在开胃进食。
药材:干生姜(一钱)、人参、白茯苓、甘草(炙)、白术、麦芽、神曲(各二钱)、半夏曲(三钱)、浓朴(炮制,四钱)、枳实(麸皮炒)、黄连(各五钱)。
将上述药材研为细末,用汤水浸泡蒸饼,制成如梧桐子大小的药丸。每次服用三十丸,用温水送服,随时可服。根据患者虚实情况增减剂量。
[Da Huang Huang Lian Xie Xin Tang (Rhubarb, Coptis, and Scutellaria Decoction to Drain the Heart)] Treats epigastric fullness-impediment (Xin Xia Pi). The presentation is characterized by softness upon palpation and a floating pulse at the Guan position. Additionally, if after severe purgation for Taiyang disease followed by sweating, epigastric fullness-impediment occurs with aversion to cold, it indicates that the exterior syndrome has not yet resolved. One must not attack the fullness-impediment directly; instead, one should first use Gui Zhi Tang (Cinnamon Twig Decoction) to resolve the exterior. Only after the exterior is resolved can this decoction be used to treat the fullness-impediment.
Ingredients: Da Huang (Rhei Radix et Rhizoma, 2 liang), Huang Lian (Coptidis Rhizoma), Huang Qin (Scutellariae Radix) (each 1 liang).
(Note: Li Dongyuan's *Tang Ye Ben Cao* states that the Da Huang Huang Lian Huang Qin Tang consists of these three herbs. The current official edition lacks Huang Qin, which is an omission.)
Coarsely crush the ingredients. Soak in two large cups of boiling water. Let stand for about the time it takes to eat a meal. Strain off the dregs (keep warm). Divide into two doses.
[Da Xiao Pi Wan (Great Pill to Eliminate Fullness-Impediment)] Treats all types of epigastric fullness-impediment and stagnation, as well as chronic cases lasting years that have not healed.
Ingredients: Ban Xia (Pinelliae Rhizoma, soaked in hot water seven times, 4 qian), Gan Jiang (Zingiberis Rhizoma Recens), Shen Qu (Massae Medicatae Fermentatae, stir-fried until yellow), Sha Ren (Amomi Fructus), Gan Cao (Glycyrrhizae Radix et Rhizoma, honey-fried, each 1 qian), Zhu Ling (Polypori Sclerotium, 1.5 qian), Ren Shen (Ginseng Radix), Ju Pi (Citri Reticulatae Pericarpium, each 2 qian), Hou Po (Magnoliae Officinalis Cortex, processed, 3 qian), Zhi Shi (Aurantii Fructus Immaturus, stir-fried with bran, 5 qian), Huang Lian (Coptidis Rhizoma, remove stamens), Huang Qin (Scutellariae Radix, remove charred parts, each 5 qian), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Jiang Huang (Curcumae Longae Rhizoma) (each 1 liang). Another prescription adds Ze Xie (Alismatis Rhizoma, 3 qian).
Grind the ingredients into fine powder. Mix with steamed dough balls soaked in water to form pills the size of paulownia seeds. Take 50–70 pills up to 100 pills per dose, washed down with warm water, after meals.
[Zhi Shi Li Zhong Wan (Immature Bitter Orange Pill to Regulate the Middle)] Treats epigastric obstruction and stagnation, failure of Qi to circulate freely, accumulation of cold and retention of fluid, and indigestion after eating.
Ingredients: Ren Shen (Ginseng Radix, remove rhizome), Gan Jiang (Zingiberis Rhizoma, processed), Zhi Shi (Aurantii Fructus Immaturus, stir-fried with bran), Gan Cao (Glycyrrhizae Radix et Rhizoma, honey-fried), Bai Zhu (Atractylodis Macrocephalae Rhizoma) (all in equal proportions).
Grind into fine powder. Mix with refined honey to form pills the size of quail eggs. Take one pill per dose, chew thoroughly, and wash down with warm water. It is also acceptable to let the pill dissolve in warm water. Take at any time.
[San Wan Pi Qi Wan (Three Jiao Qi-Stagnation Pill)] Treats stagnation and impediment in the San Jiao (Triple Burner), dysfunction of Qi ascending and descending, retention and accumulation of fluids preventing normal circulation. Manifestations include distension and fullness in the hypochondrium or occasional stabbing pain. This formula is suitable.
Ingredients: Chen Xiang (Aquilariae Lignum Resinatum), Da Fu Zi (Arecae Semen), Bing Lang (Arecae Semen), Suo Sha (Amomi Fructus, each half liang), Qing Pi (Citri Reticulatae Pericarpium Viride, remove white pith), Chen Pi (Citri Reticulatae Pericarpium, remove white pith), Mu Xiang (Aucklandiae Radix), Bai Dou Kou (Amomi Fructus Rotundus), San Leng (Sparganii Rhizoma, processed, each 1 liang), Ban Xia (Pinelliae Rhizoma, soaked in hot water seven times, 2 liang).
Grind into fine powder. Bind with paste made from Shen Qu (Massa Medicata Fermentata) to form pills the size of paulownia seeds. Take 30 pills per dose, washed down with warm water, after meals. Washing down with Chen Pi (Citri Reticulatae Pericarpium) decoction is also acceptable.
[Zhi Shi Xiao Pi Wan (Immature Bitter Orange Pill to Dissipate Fullness-Impediment)] Treats a floating and tight pulse at the right Guan position, deficiency-type epigastric fullness-impediment, aversion to food, lassitude, aiming to open the stomach and promote appetite.
Ingredients: Gan Jiang (Zingiberis Rhizoma Recens, 1 qian), Ren Shen (Ginseng Radix), Bai Fu Ling (Poria, 2 qian each), Gan Cao (Glycyrrhizae Radix et Rhizoma, honey-fried), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Mai Ya (Hordei Fructus Germinatus), Shen Qu (Massae Medicatae Fermentatae, 2 qian each), Ban Xia Qu (Pinelliae Fermentata Massa, 3 qian), Hou Po (Magnoliae Officinalis Cortex, processed, 4 qian), Zhi Shi (Aurantii Fructus Immaturus, stir-fried with bran), Huang Lian (Coptidis Rhizoma, 5 qian each).
Grind into fine powder. Soak steamed dough balls in decoction to bind into pills the size of paulownia seeds. Take 30 pills per dose, washed down with warm water, at any time. Adjust dosage according to the patient's deficiency or excess condition.