范郎中夫人。中统五年八月二十日。先因劳役饮食失节。加之忧思气结。病心腹胀满。旦食则
呕。暮不能食。两胁刺痛。诊其脉弦而细。黄帝针经五乱篇云。清气在阴。浊气在阳。乱于胸中。
是以大 。内经曰。清气在下。则生飧泄。浊气在上。则生 胀。此阴阳返作病之逆从也。至夜。
浊阴之气。当降而不降。 胀尤甚。又云。脏寒生满病。大抵阳主运化精微。聚而不散。故为胀满
。先灸中脘穴。乃胃之募。引胃中生发之气上行。次以此方助之。
【木香顺气汤】
苍术 吴茱萸（各五分。汤洗） 木香 浓朴（姜制）
陈皮 姜屑（各三分） 当归 益智仁
白茯苓（去皮） 泽泻 柴胡 青皮
半夏（汤泡） 升麻 草豆蔻（各二分。面裹煨）
上十五味。 咀。作一服。水二盏。煎至一盏。去渣。稍热服。食前。忌生冷硬物及怒气。数
日良愈。论曰。内经云。留者行之。结者散之。以柴胡、升麻、苦平。行少阳阳明二经。发散清气
。营运阳分。故以为君。生姜、半夏、豆蔻、益智辛甘大温。消散大寒。故以为臣。浓朴、木香、
苍术、青皮辛苦大温。通顺滞气。当归、陈皮、人参辛甘温。调和荣卫。滋养中气。浊气不降。以
苦泄之。吴茱萸。苦热泄之者也。气之薄者。阳中之阴。茯苓甘平。泽泻咸平。气薄。引导浊阴之
气。自上而下。故以为佐使也。气味相合。散之泄之。上之下之。使清浊之气。各安其位也。
范郎中的夫人。在中统五年八月二十日就诊。此前因为劳累过度且饮食不规律，加上忧思导致气机郁结，患上了心腹胀满的病证。早晨进食则呕吐，晚上无法进食，两侧胁肋部有刺痛感。诊察其脉象弦而细。《黄帝针经·五乱篇》说：清气在阴分，浊气在阳分，若扰乱于胸中，就会导致大胀满。《内经》说：清气在下，就会发生完谷不化的泄泻；浊气在上，就会发生胀满。这是阴阳逆乱、病势逆转的表现。到了夜晚，浊阴之气应当下降而不能下降，所以胀满症状更加严重。又云：脏腑虚寒会产生胀满病。大体上阳气主司运化精微物质，如果聚积而不消散，就会形成胀满。先艾灸中脘穴，这是胃的募穴，用以引导胃中生发之气上行。接着用此方剂辅助治疗。
【木香顺气汤】
苍术、吴茱萸（各五分，用热水洗）、木香、浓朴（姜汁制）、陈皮、姜屑（各三分）、当归、益智仁、白茯苓（去皮）、泽泻、柴胡、青皮、半夏（热水泡）、升麻、草豆蔻（各二分，面粉包裹后煨熟）。
以上十五味药，切碎，作为一服量。加水两盏，煎煮至一盏，去渣滓，稍热时服用。饭前服用。忌食生冷硬物及动怒。数日后痊愈。论述说：《内经》说：留滞的病邪要行散它，郁结的要解散它。用柴胡、升麻，味苦性平，运行少阳、阳明二经的气机，发散清气，营运于阳分，所以作为君药。生姜、半夏、豆蔻、益智仁，味辛甘性大温，能消散大寒，所以作为臣药。浓朴、木香、苍术、青皮，味辛苦性大温，能通顺滞气；当归、陈皮、人参（注：原文此处列药与方名不符，方名无参，但论曰中有“人参”，依原文提取），味辛甘性温，调和营卫，滋养中气。浊气不降，用苦味药泄降它，吴茱萸就是苦热泄降的药物。气味薄弱的药物，属于阳中之阴。茯苓味甘平，泽泻味咸平，气味薄弱，能引导浊阴之气自上而下运行，所以作为佐使药。各种气味相配合，起到散泄、上下疏导的作用，使清浊之气各自安守其位。
Madam, wife of Official Fan. On the 20th day of the 8th month in the 5th year of Zhongtong. Previously, due to overwork and irregular diet, compounded by worry and sorrow causing Qi stagnation, she suffered from abdominal distension and fullness. She vomited after eating in the morning and could not eat at night, with stabbing pain in both hypochondriac regions. Her pulse was wiry (Xian) and fine (Xi). The *Huangdi Zhenjing* (Yellow Emperor's Classic of Acupuncture), chapter "Wu Luan" (Five Disorders), states: "Clear Qi is in Yin, turbid Qi is in Yang; if disturbed in the chest, it results in great distension." The *Neijing* (Inner Canon) says: "If Clear Qi is below, it generates stool with undigested food (Sun Xie); if Turbid Qi is above, it generates distension (Zhang)." This is a reversal of Yin and Yang, indicating an inverted disease progression. At night, when Turbid Yin Qi should descend but fails to do so, the distension becomes even more severe. It is also said: "Cold in the Zang organs generates fullness diseases." Generally, Yang governs the transformation and transportation of essence and micro-nutrients; if they accumulate without dispersing, distension and fullness result. First, moxa was applied to the Zhongwan (CV12) acupoint, which is the Front-Mu point of the Stomach, to guide the ascending Qi generated by the Stomach upward. Subsequently, this formula was used to assist.
[Muxiang Shunqi Tang / Wood Fragrance Qi-Smooth Decoction]
Cangzhu (Atractylodis Rhizoma), Wuzhuyu (Evodiae Fructus) (each 5 fen, washed with decoction), Muxiang (Aucklandiae Radix), Houpo (Magnoliae Officinalis Cortex) (processed with ginger juice), Chenpi (Citri Reticulatae Pericarpium), Jiangxi (Ginger residue/shreds) (each 3 fen), Danggui (Angelicae Sinensis Radix), Yizhiren (Alpiniae Oxyphyllae Fructus), Baifuling (Poria) (peeled), Zexie (Alismatis Rhizoma), Chaihu (Bupleuri Radix), Qingpi (Citri Reticulatae Pericarpium Viride), Banxia (Pinelliae Rhizoma) (soaked in hot water), Shengma (Cimicifugae Rhizoma), Caodoukou (Amomi Fructus Rotundus) (each 2 fen, wrapped in flour and roasted).
The above fifteen herbs were chopped (Ju) and prepared as one dose. Added two zhan of water, decocted until one zhan remained, filtered to remove dregs, and taken slightly warm before meals. Avoid cold, raw, hard foods and anger. Recovered well after several days. Commentary: The *Neijing* states: "For retained pathogens, move them; for knotted paths, scatter them." Chaihu and Shengma, bitter and neutral in nature, regulate the Shaoyang and Yangming meridians, disperse Clear Qi, and circulate in the Yang aspect, thus serving as the Jun (Sovereign) herb. Shengjiang (Fresh Ginger), Banxia, Doukou, and Yizhiren are pungent, sweet, and greatly warm, dissipating severe cold, thus serving as the Chen (Minister) herbs. Houpo, Muxiang, Cangzhu, and Qingpi are pungent, bitter, and greatly warm, unblocking stagnant Qi; Danggui, Chenpi, and Renshen (Ginseng Radix et Rhizoma - noted in commentary though absent from prescription list) are pungent, sweet, and warm, harmonizing Ying and Wei, nourishing Middle Qi. To address non-descending Turbid Qi, bitter drugs are used to drain it; Wuzhuyu is a bitter-hot draining agent. Drugs with thin aroma belong to Yin within Yang. Fuling is sweet and neutral; Zexie is salty and neutral. With thin aromas, they guide Turbid Yin Qi downward from above, thus serving as Zuo (Assistant) and Shi (Envoy) herbs. By combining flavors and aromas, scattering and draining, moving up and down, the Clear and Turbid Qi are allowed to reside in their proper positions.