脉
浮而缓者,易治,弦结而按之不鼓者,难治。或结或促或微,皆可治;代者危;右关脉弦者,木乘土位,
难治。肺脉散者,是心火刑肺金,不治。
病
夫咳逆者,气逆上冲而作声也,俗谓之呃逆是也。其发也,或三、五声而止,或七、八声而止,
或连续不绝,收气不回者。然所得之由不同∶有因久病胃虚而得者,有因伤寒失下而得者,有因痰
热内郁火气冲上而得者,有因过服寒剂,胃寒而得者,有因水气停
痰,心下痞悸而得者。大抵咳逆者,不顺之义。
治
治法当以降气化痰、和胃为主,随其所感而用药。其或病久脾
胃衰败,而发咳逆,额上出汗,连声不绝者,最为恶候,不治之证也。
方
鲜陈汤 治呃逆欲死。
半夏(五钱) 生姜(二钱半)
上锉一剂,水煎服。
温中散 治吐泻,及病后胃中虚寒,咳逆至三、四声,或数声相连收气不回者,难治。
丁香(一钱) 柿蒂(一钱) 人参(一钱) 茯苓(一钱) 橘皮(一钱) 良姜(一钱)
半夏(一钱) 生姜(一钱半) 甘草(三分)
上锉一剂,水煎服。
羌活附子汤 治吐利后胃寒发呃。
羌活 附子(泡去皮) 小茴(炒,各一钱) 干姜(泡) 木香(各一钱) 丁香(一钱)
上锉,枣一枚,水煎,入盐少许,不拘时温服。
橘参饮 治吐利后胃虚,膈热而咳逆者。
橘皮(五钱) 人参(二钱) 竹茹(二钱) 甘草(炙,一钱)
上锉作一剂,生姜五片,枣三枚,水煎服。
黄荆散
治伤寒发热而咳逆者。
黄荆子不拘多少,炒水煎服。
嗅法 治咳逆服药无效者。
好硫黄、乳香(各等分) 以酒煎,急令患之嗅之。
雄黄酒
明雄黄(一钱),酒一盏,煎七分,急令患人嗅其热气即止。
脉象浮而缓的,容易治疗;脉象弦紧且重按无力搏动的,难以治疗。或者脉结代、促脉或微细脉的,都可以治疗;出现代脉的则病情危重;右关部脉象弦的,是肝木乘克脾土,难以治疗。肺脉散乱的,是心火刑克肺金,无法治愈。
咳逆这种病,是指气机上逆冲撞而发出声音,俗称呃逆。发作时,有的三五声就停止,有的七八声就停止,有的连续不断,气息收不回来的。然而导致它的原因各不相同:有因为久病导致胃气虚弱而引发的,有因为伤寒失于攻下而引发的,有因为痰热内郁、火气上冲而引发的,有因为过服寒凉药物、导致胃寒而引发的,有因为水气停滞成痰、导致心下痞满悸动而引发的。大抵来说,“咳逆”这个名称,含有气机不顺的含义。
治疗方法应当以降气化痰、调和胃气为主,根据患者感受的不同病因来用药。如果病程长久,脾胃衰败,并发咳逆,额头出汗,连声不停不止的,是最为凶险的征候,属于无法治愈的证候。
鲜陈汤:治疗呃逆剧烈欲死者。
半夏(五钱) 生姜(二钱半)
以上药材锉碎为一剂,加水煎煮后服用。
温中散:治疗呕吐腹泻,以及病后胃中虚寒,咳逆达到三、四声,或数声相连、气息收不回来的,难以治疗。
丁香(一钱) 柿蒂(一钱) 人参(一钱) 茯苓(一钱) 橘皮(一钱) 良姜(一钱)
半夏(一钱) 生姜(一钱半) 甘草(三分)
以上药材锉碎为一剂,加水煎煮后服用。
羌活附子汤:治疗吐泻之后因胃寒引发呃逆。
羌活 附子(炮制去皮) 小茴香(炒,各一钱) 干姜(炮制) 木香(各一钱) 丁香(一钱)
以上药材锉碎,加一枚大枣,加水煎煮,加入少许盐,不拘泥时间温服。
橘参饮:治疗吐泻之后胃气虚弱,膈间有热而咳逆的。
橘皮(五钱) 人参(二钱) 竹茹(二钱) 甘草(炙,一钱)
以上药材锉碎为一剂,加生姜五片,大枣三枚,加水煎煮后服用。
黄荆散:治疗伤寒发热而咳逆的。
黄荆子不限数量,炒过后加水煎煮服用。
Pulse floating and slow indicates a condition that is easy to treat; pulse wiry and knotted, which does not throb upon pressure, indicates a difficult-to-treat condition. Pulse knotted (Jie), rapid (Cu), or faint (Wei) are all treatable; pulse intermittent (Dai) indicates critical danger; wiry pulse at the right Guan position indicates Liver Wood overacting on Spleen Earth, which is difficult to treat. Scattered Lung pulse indicates Heart Fire punishing Lung Metal, which is untreatable.
Ke Ni (Coughing against the Qi / Hiccups) refers to Qi counterflow rushing upward producing sound, commonly known as E Ni (Hiccups). Its onset may cease after three or five sounds, or after seven or eight sounds, or it may continue continuously with no return of inhalation. However, the causes vary: some arise from Stomach deficiency due to prolonged illness; some from failure to purge in Cold Damage (Shang Han); some from internal stagnation of Phlegm-Heat with Fire Qi rushing upward; some from excessive use of cold medicines leading to Stomach Cold; some from water retention transforming into Phlegm, causing epigastric fullness and palpitations. Generally, "Ke Ni" implies the meaning of Qi flow obstruction.
Treatment should primarily focus on descending Qi, resolving Phlegm, and harmonizing the Stomach, prescribing herbs according to the specific pathogenic factors. If the disease has persisted for a long time, leading to Spleen and Stomach collapse, accompanied by Ke Ni, sweating on the forehead, and continuous non-stop sounds, this is the most ominous sign and an untreatable syndrome.
Xian Chen Tang (Fresh-Aged Decoction): Treats severe hiccups bordering on death.
Ban Xia (Pinelliae Rhizoma, 5 qian), Sheng Jiang (Zingiberis Rhizoma Recens, 2.5 qian).
Crush these into one dose, decoct in water, and take orally.
Wen Zhong San (Warm the Middle Powder): Treats vomiting and diarrhea, and post-illness Stomach deficiency-cold, where Ke Ni occurs for three or four sounds, or several sounds in succession with no return of inhalation; this is difficult to treat.
Ding Xiang (Caryophylli Flos, 1 qian), Shi Di (Kaki Calyx, 1 qian), Ren Shen (Ginseng Radix et Rhizoma, 1 qian), Fu Ling (Poria, 1 qian), Ju Pi (Citri Reticulatae Pericarpium, 1 qian), Liang Jiang (Alpiniae Officinarum Rhizoma, 1 qian), Ban Xia (Pinelliae Rhizoma, 1 qian), Sheng Jiang (Zingiberis Rhizoma Recens, 1.5 qian), Gan Cao (Glycyrrhizae Radix et Rhizoma, 3 fen).
Crush these into one dose, decoct in water, and take orally.
Qiang Huo Fu Zi Tang (Notopterygii and Aconiti Lateralis Radix Praeparata Decoction): Treats hiccups arising from Stomach Cold following vomiting and diarrhea.
Qiang Huo (Notopterygii Rhizoma et Radix), Fu Zi (Aconiti Lateralis Radix Praeparata, processed and peeled), Xiao Hui Xiang (Foeniculi Fructus, stir-fried, each 1 qian), Gan Jiang (Zingiberis Rhizoma, processed), Mu Xiang (Aucklandiae Radix, each 1 qian), Ding Xiang (Caryophylli Flos, 1 qian).
Crush these, add one Jujube (Ziziphi Spinosae Fructus), decoct in water, add a little salt, and take warm at any time.
Ju Shen Yin (Citri and Ginseng Drink): Treats Ke Ni arising from Stomach deficiency and Diaphragmatic Heat following vomiting and diarrhea.
Ju Pi (Citri Reticulatae Pericarpium, 5 qian), Ren Shen (Ginseng Radix et Rhizoma, 2 qian), Zhu Ru (Bambusae Caulis in Taenia, 2 qian), Gan Cao (Glycyrrhizae Radix et Rhizoma, roasted, 1 qian).
Crush these into one dose, add five slices of Sheng Jiang (Zingiberis Rhizoma Recens) and three Jujubes (Ziziphi Spinosae Fructus), decoct in water, and take orally.
Huang Jing San (Vitex Fruit Powder): Treats Ke Ni accompanying fever in Cold Damage (Shang Han).
Huang Jing Zi (Viticis Fructus), quantity unrestricted, stir-fry and decoct in water to take.
Sniffing Method: Treats Ke Ni unresponsive to oral medication.
Good quality Liu Huang (Sulfur), Ru Xiang (Boswelliae Resina) (equal parts). Decoct in wine, and urgently have the patient sniff the vapor.
Xiong Huang Jiu (Realgar Wine): Ming Xiong Huang (Realgar, 1 qian), one cup of wine. Decoct until reduced to 70%, and urgently have the patient sniff the hot vapor to stop the hiccups.