〔大〕夫妇人心胸嘈杂,此脾胃郁火,滞痰血液泪汗而成,用猪血炒食之,乃以血
导而使之归源尔。旋复花汤尤善。
〔薛〕前证若因食郁,用六君、山楂、山栀。若因胃热,用二陈、姜炒芩、连。若
因六郁,用越鞠丸。(杂病郁。)若因气滞,用四七汤。(杂病气。)桔梗、枳壳。大抵此证属病气。
元气俱不足,须用六君为主,少佐以治痰之药。若以火治之,必变吞酸中满。 一妇人
饮食少思,胸中嘈杂,头晕吐痰,此中气虚而有热。用六君子汤加炒黑山栀、桔梗而愈。
后因劳碌,头晕发热吐痰,用补中益气汤加半夏、茯苓、天麻而痊。 一妇人中脘嘈杂,
口中辛辣,或咳嗽吐痰发喘,面色或白或赤,此脾气虚而肺中伏火也。用六君子加山栀、桔
梗、柴胡及炒黑片芩治之,寻愈。 一妇人嘈杂吞酸,饮食少思,大便不实,此脾气虚
寒而下陷。用补中益气汤加茯苓、半夏、炮姜,渐愈。又常服人参理中丸即安。 一妇
人饮食后嘈杂吞酸,此食郁为痰。用六君子汤送越鞠丸渐愈,又用加味归脾汤而痊。后
因怒,两胁胀痛,中脘作酸,用四君子汤送左金丸渐安,仍用六君子汤送越鞠丸而痊。
旋复花汤 治妇人心胸嘈杂,中脘痰饮冷气,心下汪洋,口中清水自出,腹胁急胀
满痛,不欲饮食。
旋复花 人参 桔梗 白芍药(各一钱) 橘皮(去白,一钱半) 赤茯苓 半夏(各二钱)
官桂(去粗皮) 细辛 甘草(各半钱)
上作一服,水二盅,生姜五片,煎至一盅,食前服。
〔补遗〕予尝以参苏饮二分,四物汤一分交和,每四钱,生姜七片煎服,治一妇人心
胸嘈杂而愈。亦名茯苓补心汤。
【戴元礼】妇女出现心胸嘈杂的症状,这是由于脾胃郁结之火,与滞涩的痰液、血液、泪液和汗液相互搏结而形成的。食用炒制的猪血,是利用“以血导血”的原理,引导离经之血回归本源。旋复花汤对此症尤为有效。
【薛己】上述症状如果是因为饮食积滞郁结所致,使用六君子汤配合山楂、山栀。如果是因为胃热,使用二陈汤配合姜汁炒制的黄芩、黄连。如果是因为六郁(气、血、痰、火、湿、食六种郁结),使用越鞠丸。(参见杂病郁证章节)。如果是因为气机阻滞,使用四七汤。(参见杂病气滞章节),可加桔梗、枳壳。大抵此类病症属于正气不足。元气均显虚弱,必须以六君子汤为主方,少量佐以治痰的药物。如果用寒凉泻火的方法治疗,必然会导致吞酸、中满等变证。
有一位妇人,饮食减少且思食无力,胸中嘈杂,头晕并吐痰,这是中气虚弱而有内热。使用六君子汤加炒黑山栀、桔梗而痊愈。后来因为劳累过度,出现头晕、发热、吐痰,使用补中益气汤加半夏、茯苓、天麻而康复。
有一位妇人中脘部嘈杂,口中感觉辛辣,有时咳嗽吐痰甚至气喘,面色时而发白时而发红,这是脾气虚弱而肺中有伏火。使用六君子汤加山栀、桔梗、柴胡及炒黑的黄芩治疗,不久痊愈。
有一位妇人出现嘈杂、吞酸、饮食减少、大便不成形,这是脾气虚寒且中气下陷。使用补中益气汤加茯苓、半夏、炮姜,逐渐痊愈。平时常服人参理中丸即可安稳。
有一位妇人在进食后出现嘈杂、吞酸,这是食积郁结化为痰浊。使用六君子汤送服越鞠丸,逐渐痊愈,后又用加味归脾汤而康复。后来因为愤怒,出现两胁胀痛、中脘作酸,使用四君子汤送服左金丸,逐渐安稳,仍用六君子汤送服越鞠丸而痊愈。
旋复花汤:治疗妇人心胸嘈杂,中脘有痰饮冷气,心下感觉水声漉漉(汪洋),口中清水自出,腹部和胁肋急胀满痛,不想饮食。
处方组成:旋复花、人参、桔梗、白芍药(各一钱);橘皮(去白,一钱半);赤茯苓、半夏(各二钱);官桂(去粗皮)、细辛、甘草(各半钱)。
制法用法:以上药材为一服的量,加水二盅,生姜五片,煎煮至一盅,饭前服用。
【补遗】我曾将参苏饮与四物汤按二分比一分的比例调和,每次取四钱,加生姜七片煎服,治愈了一位心胸嘈杂的妇人。此方又名茯苓补心汤。
[Dai Yuanli] When women experience a sensation of discomfort and hunger mixed with pain in the chest and heart region (Xiong Za), this is caused by stagnant fire in the Spleen and Stomach, which combines with retained phlegm, blood, tears, and sweat. Eating stir-fried pig's blood utilizes the principle of "using blood to guide blood," directing stray blood back to its source. Xuanfu Hua Tang (Inula Flower Decoction) is particularly effective for this condition.
[Xue Ji] If the aforementioned symptoms are due to food stagnation and depression, use Liu Jun Zi Tang (Six Gentlemen Decoction) combined with Shan Zha (Crataegi Fructus) and Shan Zhi (Gardeniae Fructus). If due to Stomach heat, use Er Chen Tang (Two Aged Substances Decoction) combined with Huang Qin (Scutellariae Radix) fried with ginger juice and Lian (Coptidis Rhizoma). If due to the Six Depressions (Qi, Blood, Phlegm, Fire, Dampness, Food), use Yue Ju Wan (Yueju Pill). (Refer to Miscellaneous Diseases: Depression). If due to Qi stagnation, use Si Qi Tang (Four Seven Decoction). (Refer to Miscellaneous Diseases: Qi Stagnation), optionally adding Jie Geng (Platycodonis Radix) and Zhi Ke (Aurantii Fructus). Generally, this syndrome belongs to deficiency of healthy Qi. Both healthy Qi and Yuan Qi (Original Qi) are insufficient; therefore, Liu Jun Zi Tang should be the primary formula, with a small amount of phlegm-resolving herbs added as adjuvants. If treated with cold-natured herbs to clear fire, it will inevitably lead to complications such as acid regurgitation and epigastric fullness.
One woman had reduced appetite, difficulty desiring food, chest discomfort, dizziness, and expectoration of phlegm. This indicated deficiency of Middle Qi with internal heat. She was cured using Liu Jun Zi Tang (Six Gentlemen Decoction) plus charred Shan Zhi (Gardeniae Fructus) and Jie Geng (Platycodonis Radix). Later, due to overwork, she experienced dizziness, fever, and expectoration of phlegm. She recovered using Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) plus Ban Xia (Pinelliae Rhizoma), Fu Ling (Poria), and Tian Ma (Gastrodiae Rhizoma).
Another woman had epigastric discomfort, a spicy sensation in the mouth, occasional coughing with expectoration and wheezing, and a complexion that alternated between pale and red. This indicated deficiency of Spleen Qi with latent fire in the Lungs. She was treated with Liu Jun Zi Tang (Six Gentlemen Decoction) plus Shan Zhi (Gardeniae Fructus), Jie Geng (Platycodonis Radix), Chai Hu (Bupleuri Radix), and charred Huang Qin (Scutellariae Radix), and recovered shortly after.
Another woman presented with chest discomfort, acid regurgitation, reduced appetite, and loose stools. This indicated deficiency-cold of Spleen Qi with sinking of Qi. She gradually improved using Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) plus Fu Ling (Poria), Ban Xia (Pinelliae Rhizoma), and Pao Jiang (Zingiberis Rhizoma Preparatum). She remained stable by frequently taking Ren Shen Li Zhong Wan (Ginseng Regulate the Middle Pill).
Another woman experienced chest discomfort and acid regurgitation after eating, indicating food stagnation transforming into phlegm turbidity. She gradually improved using Liu Jun Zi Tang (Six Gentlemen Decoction) administered with Yue Ju Wan (Yueju Pill), and subsequently recovered using Jia Wei Gui Pi Tang (Modified Restore the Spleen Decoction). Later, due to anger, she experienced distending pain in both hypochondria and sourness in the epigastrium. She gradually stabilized using Si Jun Zi Tang (Four Gentlemen Decoction) administered with Zuo Jin Wan (Left Metal Pill), and ultimately recovered using Liu Jun Zi Tang (Six Gentlemen Decoction) administered with Yue Ju Wan (Yueju Pill).
Xuanfu Hua Tang (Inula Flower Decoction): Treats women with chest discomfort, cold fluid retention in the epigastrium, a sensation of water splashing in the heart region, spontaneous flow of clear saliva from the mouth, acute distension and pain in the abdomen and hypochondria, and loss of appetite.
Ingredients: Xuan Fu Hua (Inulae Flos), Ren Shen (Ginseng Radix et Rhizoma), Jie Geng (Platycodonis Radix), Bai Shao Yao (Paeoniae Radix Alba) (each 1 qian); Ju Pi (Citri Reticulatae Pericarpium, white pith removed) (1.5 qian); Chi Fu Ling (Poria cum Rubo), Ban Xia (Pinelliae Rhizoma) (each 2 qian); Guan Gui (Cinnamomi Cortex), Xi Xin (Asari Radix et Rhizoma), Gan Cao (Glycyrrhizae Radix et Rhizoma) (each 0.5 qian).
Preparation and Administration: These constitute one dose. Add two cups of water and five slices of fresh ginger. Decoct until one cup remains. Take before meals.
[Supplement] I once treated a woman with chest discomfort by combining Can Su Yin (Periploea and Ginseng Decoction) and Si Wu Tang (Four Substances Decoction) in a ratio of 2:1. Each dose consisted of 4 qian, decocted with seven slices of fresh ginger. The patient recovered. This formula is also known as Fu Ling Bu Xin Tang (Poria Tonifying the Heart Decoction).