食积停痰。气实之人,二陈汤,随所伤之物,加以消导。如伤肉食,加山楂、神曲、草
伤米食,加山楂、麦芽;伤面食,加神曲、莱菔子;大便坚加大黄,性热者少加黄连。气虚
人六君子汤加砂仁、木香,不用消导。
夏月阳气在表,如有伤食等证,必痰气凝塞。二陈汤加木香、砂仁、白芍,随其所伤,
再加消导。身热加干葛,或二陈、五苓,合而用之。
验案
一人因饥吃烧酒、冷肉,遂大吐泻,胸膈饱闷,口渴,四肢沉重。用二陈加和中散,加
川连五厘,服愈。盖冷肉滞于胃,故大吐泻,胸膈饱胀,四肢沉重者,脾不运也。用和中、
二陈散,温中醒脾,脾自健运。渴甚者,中焦壅滞,心火不得下降,少用川连,引心火下行
凡酒客初病,发不甚重,解酒足矣;续自病重者,以内伤法立方,少加醒酒药味。
年老酒多,发毒不收口者,葛花解酲汤合补中益气汤服之。
酒多伤风咳嗽,用茶叶三钱,苏叶三钱,元米一把,水煎热服。
酒多而伤风下血者,川乌五钱,荆芥三两,醋糊丸服。
胸膈不宽者,胃虚阳气不升,胸中大气不布而满闷也。当补肺,肺主行营卫阴阳,则气
布而胸舒矣。宜补中益气汤加附子。
凡胸膈饱闷,皆阳气不达于胸,阴气填塞也。盖阳主畅达,阴则凝结矣。
验案
一妇,素常忧郁,胸膈不宽。用川芎、黄 、归身各一钱,甘草、肉桂各五分,苏叶三
一女,年三十,胸膈饱闷,腹内饥饿,上闷不能食,用砂仁一两,人参五钱,共末服。
食积停滞并伴有痰湿。对于体质壮实、正气充足的人,使用二陈汤(燥湿化痰、理气和中的基础方),并根据所伤食物的种类,加入相应的消食导滞药物。例如,因食用肉类受伤,加入山楂、神曲;因食用米食受伤,加入山楂、麦芽;因食用面食受伤,加入神曲、莱菔子;若大便干结坚硬,加入大黄;若患者体质偏热,少量加入黄连。对于体质虚弱的人,使用六君子汤(益气健脾、燥湿化痰的方剂)加入砂仁、木香,不使用消导药物。
夏季阳气浮越于体表,如果出现伤食等证候,往往导致痰气凝结阻塞。使用二陈汤加入木香、砂仁、白芍,并根据所伤食物种类,再加入消导药物。若伴有身体发热,加入干葛(葛根),或者将二陈汤与五苓散(利水渗湿、温阳化气的方剂)合并使用。
验案:
有一人因为饥饿而饮用烧酒、吃冷肉,随即出现剧烈呕吐和腹泻,胸膈部饱胀闷痛,口渴,四肢沉重。使用二陈汤加入和中散,并加入川连(黄连)五厘,服用后痊愈。这是因为冷肉停滞在胃中,导致剧烈吐泻、胸膈饱胀、四肢沉重,这是脾脏运化功能失常的表现。使用中散、二陈散,可以温补中焦、醒脾开胃,脾脏自然恢复健运。如果口渴严重,是因为中焦壅滞,心火不能下降,所以少量使用川连,引导心火下行。
凡是长期饮酒的人初次患病,症状不严重时,解酒即可;如果病情逐渐加重,按照内伤病的法则制定方剂,少量加入醒酒的药物。老年人饮酒过多,导致疮毒溃烂久不愈合的,服用葛花解酲汤(专治酒积的方剂)合补中益气汤(补中益气、升阳举陷的方剂)。
饮酒过多又感受风邪引起咳嗽的,用茶叶三钱、苏叶(紫苏叶)三钱、元米(糯米)一把,加水煎煮后热服。
饮酒过多且因风邪导致下血的,用川乌五钱、荆芥三两,醋制为丸服用。
胸膈部感觉不宽畅的,是因为胃虚导致阳气不能上升,胸中大气不能布散而出现满闷感。应当补益肺脏,因为肺主运行营卫阴阳,肺气通畅则大气布散,胸膈自然舒展。适宜使用补中益气汤加入附子。
凡是胸膈部饱胀闷痛,都是阳气不能通达于胸廓,阴气填塞所致。因为阳气主畅通达,阴气主凝结。
验案:
有一位妇女,平素忧郁,感到胸膈不宽畅。使用川芎、黄芪、当归身各一钱,甘草、肉桂各五分、苏叶三钱……(原文此处似有缺漏或排版错误,依文意推测为组方描述,但仅翻译可见部分)
Food stagnation with retained phlegm. For individuals with robust constitution and sufficient healthy qi, use Erchen Tang (Two-Cured Decoction), adding food-resolving and guiding-out herbs according to the specific ingested substance. For example, if injured by meat, add Hawthorn Fruit (Shanzha) and Medicated Leaven (Shenqu); if injured by rice, add Hawthorn Fruit (Shanzha) and Malt (Maiya); if injured by wheat products, add Medicated Leaven (Shenqu) and Radish Seed (Laifuzi); if stool is hard and dry, add Rhubarb (Dahuang); if the constitution is hot, add a small amount of Coptis Rhizome (Huanglian). For individuals with deficient qi, use Liujunzi Tang (Six-Gentlemen Decoction) added with Amomum Fruit (Sharen) and Aucklandia Root (Muxiang), without using food-resolving methods.
In summer, when yang qi floats on the exterior, symptoms such as food injury often result in condensation and obstruction of phlegm and qi. Use Erchen Tang added with Aucklandia Root (Muxiang), Amomum Fruit (Sharen), and White Peony Root (Baishao), further adding food-resolving herbs based on the specific injury. If accompanied by fever, add Kudzu Root (Gegen), or combine Erchen Tang with Wuling San (Five-Ingredient Powder with Poria).
Clinical Case:
A person, due to hunger, consumed liquor and cold meat, subsequently suffering from severe vomiting and diarrhea, fullness and oppression in the chest and diaphragm, thirst, and heaviness in the four limbs. Erchen Tang was combined with Hezhong San (Harmonizing Middle Powder) with five li of Coptis Rhizome (Chuanlian), which cured the condition. This occurred because cold meat stagnated in the stomach, causing severe vomiting and diarrhea, chest fullness, and limb heaviness, indicating failure of the Spleen to transform and transport. Hezhong San and Erchen Tang warm the middle and awaken the Spleen, allowing the Spleen to resume its normal function. In cases of severe thirst, it is due to congestion in the middle jiao preventing Heart fire from descending; therefore, a small amount of Coptis Rhizome is used to guide Heart fire downward.
For habitual drinkers whose initial illness is not severe, resolving alcohol suffices; if the disease progresses and becomes severe, formulate prescriptions according to internal injury principles, adding a small amount of wine-resolving herbs. For elderly individuals who consume excessive alcohol and develop sores that fail to heal, administer Gegua Jiecheng Tang (Kudua Flower Decoction to Relieve Intoxication) combined with Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction).
Excessive alcohol consumption leading to wind-induced cough can be treated with three qian of Tea Leaves, three qian of Perilla Leaf (Suye), and one handful of Glutinous Rice (Yuanmi), decocted in water and taken hot.
Excessive alcohol consumption combined with wind pathogen causing lower bleeding can be treated with five qian of Aconite Root (Chuanwu) and three liang of Schizonepeta Spike (Jingjie), formed into pills with vinegar paste.
A sensation of narrowness or oppression in the chest and diaphragm arises from deficiency of the Stomach failing to raise yang qi, resulting in the inability of the Great Qi in the chest to circulate, causing fullness and oppression. The Lungs should be tonified, as the Lungs govern the circulation of Ying and Wei, and Yin and Yang; thus, qi circulates and the chest relaxes. Buzhong Yiqi Tang added with Prepared Aconite Root (Fuzi) is appropriate.
Generally, fullness and oppression in the chest and diaphragm occur because yang qi fails to reach the chest, while yin qi fills and obstructs. Yang qi promotes smooth flow, whereas yin qi tends to condense.
Clinical Case:
A woman, prone to depression, experienced a sensation of narrowness in the chest and diaphragm. Chuanxiong, Astragalus Root (Huangqi), and Angelica Sinensis Root Body (Guishen) were each used at one qian, Licorice Root (Gancao) and Cinnamon Bark (Rougui) at five fen, and Perilla Leaf (Suye) at three qian... [Text appears incomplete].
A thirty-year-old woman suffered from fullness and oppression in the chest and diaphragm, a sensation of hunger in the abdomen, but upper obstruction preventing eating. One liang of Amomum Fruit (Sharen) and five qian of Ginseng Root (Renshen) were ground into powder and administered.