脉弦而滑。两手或浮或弦。或浮而滑。或沉而迟。或紧而洪。或洪而数。或沉而
迟。胸中有寒饮。洪数者。痰热在胸膈。时吐酸水。欲成翻胃也。
夫酸者。肝木之味也。由火盛制金。不能平木。则肝木自甚。故为酸也。如饮食热。则
易于
酸矣。或言吐酸为寒者。误也。乃湿热在胃口上。饮食入胃。被湿热郁遏。食不得化。故作
吞酸。如谷肉覆盖在器。湿则易于为酸也。必用吴茱萸。顺其性折之。方为得法。
一论吞酸嘈杂。酸水刺心者。乃痰火郁气也。宜
清郁二陈汤
陈皮 半夏(姜炒) 茯苓 香附 黄连(姜炒) 栀子(炒各一钱) 苍术(米泔浸) 川芎
枳实(炒各八分) 神曲(炒三钱) 白芍(炒七分) 甘草(二分)
上锉一剂。生姜煎服。
一论郁结吐酸者。用
茱连丸
苍术(米泔浸一两) 陈皮(一两) 半夏(姜炒一两) 白茯苓(去皮一两) 黄连(
一两半姜炒夏月倍用) 吴茱萸(炒一两冬月倍用)
上为细末。蒸饼为丸。如绿豆大。每服三五十丸。食后。白滚水送下。
一论噫气吞酸嘈杂。有痰有热。有气有食。胸膈不宽。饮食不化。以
香蔻和中丸
白术(去芦炒) 山楂肉 连翘(各四两) 莱菔子(炒五钱) 白茯苓(去皮) 枳实(去穣
麸炒
)陈皮(去白) 半夏(姜汁炒) 神曲(炒各二两) 干生姜(一两) 白豆蔻(炒五钱) 木香(
五钱)
上为细末。神曲糊为丸。如梧桐子大。每服百丸。食后。白滚汤送下。
一论妇人心酸。乃痰饮积在脾胃间。时时酸心或吐水。用
吴茱萸丸
大麦芽(炒五钱) 肉桂(五钱) 吴萸(一两盐水洗) 苍术(米泔浸一两) 陈皮(去白五
钱) 神曲(炒五钱)
上为细末。稀粥为丸。如梧桐子大。每服五六十丸。米饮送下。
一论酸心。每酸气上攻如酽醋不可当者。用吴茱萸一合。水一盅。煎七分。顿服。纵浓
亦须强饮。曾有人心如螫破。服此方立效。
一治口吐清水。用
苍术(二钱壁土炒) 白术(一钱半去芦炒) 陈皮(一钱五分) 白茯苓(三钱) 滑石(炒三钱
)
水煎服。
一儒者。四时喜极热饮食。或吞酸嗳腐。或大便不实。足指缝湿痒。此脾气虚寒下陷。
用六
君子汤。加姜桂治之而愈。稍为失宜。诸疾仍作。用前药更加附子钱许。数剂则不再发。
一妇人吞酸嗳腐。呕吐痰涎。面色纯白。或用二陈、黄连、枳实之类。加发热作渴。肚
腹胀
满。予曰。此脾胃亏损。末传寒中。不信。仍作火治。肢体肿胀如蛊。余以六君加附子、木
香治之。胃气渐醒。饮食渐进。虚火归原。又以补中益气加炮姜、木香、茯苓、半夏兼服。
全愈。
一治食后吐酸水。用干姜、吴茱萸各二两为末。每服方寸匙。酒调服。日二服。胃冷者
服之立效。
脉象弦而滑。两手脉或浮或弦,或浮而滑,或沉而迟,或紧而洪,或洪而数,或沉而迟。胸中有寒饮停聚。若脉洪数,则是痰热蕴结于胸膈。时常吐出酸水,有发展为翻胃(指饮食入胃后,朝食暮吐或暮食朝吐的病症)的趋势。
酸味,是肝木的本味。由于火气过盛克制了金(肺),导致金不能正常制约木(肝),从而使肝木之气亢盛,因此产生酸味。如果饮食过热,则更容易出现酸味。有人说吐酸是由于寒邪所致,这是错误的。实际上是湿热停留在胃口上方,饮食进入胃中,被湿热郁遏,食物无法消化,所以形成吞酸(指胃中泛酸,伴有嘈杂不适感)。就像谷物和肉类覆盖在容器中,潮湿时容易变酸一样。必须使用吴茱萸,顺应其性来折抑肝木,这才是正确的方法。
另一种观点认为吞酸、嘈杂且酸水刺痛心脏,这是由于痰火郁滞气机所致。适宜使用清郁二陈汤:陈皮、半夏(姜炒)、茯苓、香附、黄连(姜炒)、栀子(炒,各一钱)、苍术(米泔水浸泡)、川芎、枳实(炒,各八分)、神曲(炒,三钱)、白芍(炒,七分)、甘草(二分)。以上药物锉碎为一剂,加生姜煎服。
另一种观点认为因情志郁结导致的吐酸,使用茱连丸:苍术(米泔水浸泡,一两)、陈皮(一两)、半夏(姜炒,一两)、白茯苓(去皮,一两)、黄连(一两半,姜炒,夏季加倍用量)、吴茱萸(炒,一两,冬季加倍用量)。以上药物研为细末,用蒸饼糊制作成丸,如绿豆大小。每次服用三五十丸,饭后用白开水送服。
另一种观点认为嗳气、吞酸、嘈杂,兼有痰、热、气、食积滞,胸膈不宽畅,饮食不消化,使用香蔻和中丸:白术(去芦头,炒)、山楂肉、连翘(各四两)、莱菔子(炒,五钱)、白茯苓(去皮)、枳实(去瓤,麸炒)、陈皮(去白)、半夏(姜汁炒)、神曲(炒,各二两)、干生姜(一两)、白豆蔻(炒,五钱)、木香(五钱)。以上药物研为细末,用神曲糊制作成丸,如梧桐子大小。每次服用一百丸,饭后用白开水送服。
另一种观点认为妇人心脏感觉酸楚,是由于痰饮积聚在脾胃之间,时时感到心口发酸或呕吐清水,使用吴茱萸丸:大麦芽(炒,五钱)、肉桂(五钱)、吴茱萸(一两,盐水洗)、苍术(米泔水浸泡,一两)、陈皮(去白,五钱)、神曲(炒,五钱)。以上药物研为细末,用稀粥糊制作成丸,如梧桐子大小。每次服用五六十丸,用米汤送服。
另一种观点认为心口发酸,每当酸气上冲如浓醋般难以忍受时,使用吴茱萸一合,加水一盅,煎至七分,一次性服用。即使药液浓烈也必须强行喝下。曾有人感觉心脏像被刺破一样疼痛,服用此方立即见效。
另一种治疗口吐清水的方法:苍术(二钱,壁土炒)、白术(一钱半,去芦头,炒)、陈皮(一钱五分)、白茯苓(三钱)、滑石(炒,三钱)。水煎服。
一位儒者,四季都喜欢极热的饮食,有时吞酸、嗳出腐臭气味,有时大便不成形,足趾缝潮湿瘙痒。这是脾气虚寒且下陷所致。使用六君子汤(人参、白术、茯苓、甘草、陈皮、半夏),加入生姜、肉桂治疗而痊愈。稍有不慎,各种疾病仍会发作。使用前药并增加约一钱的附子,服用数剂后不再复发。
一位妇人吞酸、嗳出腐臭气味,呕吐痰涎,面色纯白。有人使用二陈汤、黄连、枳实等药物,导致发热、口渴,肚腹胀满。我说:这是脾胃亏损,最终传变为寒证。患者不信,仍然按火证治疗,导致肢体肿胀如蛊胀病。我用六君子汤加附子、木香治疗,胃气逐渐恢复,饮食慢慢增加,虚火回归本源。后来又服用补中益气汤加炮姜、木香、茯苓、半夏,完全治愈。
另一种治疗进食后吐酸水的方法:干姜、吴茱萸各二两,研为细末。每次服用一方寸匙,用酒调服,每日两次。胃冷者服用后立即见效。
The pulse is wiry and slippery. The pulses at both hands may be floating or wiry, or floating and slippery, or deep and slow, or tight and surging, or surging and rapid, or deep and slow. There is cold-fluid retention in the chest. If the pulse is surging and rapid, it indicates phlegm-heat lodged in the chest and diaphragm. Frequent regurgitation of sour fluid occurs, which may develop into Fanwei (a condition characterized by vomiting undigested food eaten hours earlier).
Sourness is the flavor associated with Liver Wood. It arises when excessive Fire controls Metal (Lung), preventing Metal from properly restraining Wood (Liver), causing Liver Wood to become hyperactive, thus producing sourness. If food and drink are too hot, sourness is more likely to occur. Some claim that vomiting acid is caused by Cold; this is incorrect. In reality, Damp-Heat lingers above the stomach opening. When food enters the stomach, it is constrained by Damp-Heat, failing to digest, thereby causing Tun Suan (acid regurgitation with a sensation of heartburn). Just as grains and meats covered in a vessel easily turn sour when damp, so too does food in the stomach. One must use Evodiae Fructus (Wuzhuyu) to follow its nature and subdue the Liver; this is the correct method.
Another discussion on Tun Suan and Zaocha (a sensation of hunger with discomfort but no desire to eat), where sour fluid pierces the heart: this is due to Phlegm-Fire constraining Qi. Qingyu Erchen Tang (Clearing Stagnation and Resolving Phlegm Decoction) is appropriate: Chenpi (Tangerine Peel), Banxia (Pinellia Rhizome, stir-fried with ginger juice), Fuling (Poria), Xiangfu (Cyperus Rhizome), Huanglian (Coptis Rhizome, stir-fried with ginger juice), Zhizi (Gardenia Fruit, stir-fried, each 1 qian), Cangzhu (Atractylodes Rhizome, soaked in rice water), Chuanxiong (Ligusticum Rhizome), Zhishi (Immature Bitter Orange, stir-fried, each 8 fen), Shenqu (Medicated Leaven, stir-fried, 3 qian), Baishao (White Peony Root, stir-fried, 7 fen), Gancao (Licorice Root, 2 fen). These herbs are cut into pieces for one dose, decocted with fresh ginger, and taken warm.
Another discussion on vomiting acid due to emotional stagnation: Zhulian Wan (Evodia and Coptis Pill) is used. Cangzhu (Atractylodes Rhizome, soaked in rice water, 1 liang), Chenpi (Tangerine Peel, 1 liang), Banxia (Pinellia Rhizome, stir-fried with ginger juice, 1 liang), Baifuling (Poria, peeled, 1 liang), Huanglian (Coptis Rhizome, 1.5 liang, stir-fried with ginger juice, double dose in summer), Wuzhuyu (Evodia Fruit, stir-fried, 1 liang, double dose in winter). These are ground into fine powder, mixed with steamed bread paste to form pills the size of mung beans. Take 30–50 pills after meals, washed down with plain boiled water.
Another discussion on belching, Tun Suan, and Zaocha accompanied by phlegm, heat, Qi stagnation, and food retention, with a feeling of fullness in the chest and diaphragm and indigestion: Xiangkou Hezhong Wan (Fragrant Cardamom Harmonizing the Middle Pill) is used. Baizhu (Atractylodes Macrocephala Rhizome, de-stemmed and stir-fried), Shanzha (Hawthorn Fruit Flesh), Lianqiao (Forsythia Fruit, each 4 liang), Laifuzi (Radish Seed, stir-fried, 5 qian), Baifuling (Poria, peeled), Zhishi (Immature Bitter Orange, de-pithed and stir-fried with bran), Chenpi (Tangerine Peel, de-white), Banxia (Pinellia Rhizome, stir-fried with ginger juice), Shenqu (Medicated Leaven, stir-fried, each 2 liang), Ganshengjiang (Dried Ginger, 1 liang), Baidoukou (White Cardamom Seed, stir-fried, 5 qian), Muxiang (Aucklandia Root, 5 qian). These are ground into fine powder, mixed with Medicated Leaven paste to form pills the size of paulownia seeds. Take 100 pills after meals, washed down with plain boiled water.
Another discussion on women experiencing sourness in the heart: this is due to phlegm-fluid accumulation between the spleen and stomach, causing frequent sour sensations in the heart region or vomiting of clear fluid. Wu Zhu Yu Wan (Evodia Pill) is used. Dayamai (Hordeum Vulgare Sprout, stir-fried, 5 qian), Rougui (Cinnamon Bark, 5 qian), Wuyu (Evodia Fruit, 1 liang, washed with salt water), Cangzhu (Atractylodes Rhizome, soaked in rice water, 1 liang), Chenpi (Tangerine Peel, de-white, 5 qian), Shenqu (Medicated Leaven, stir-fried, 5 qian). These are ground into fine powder, mixed with thin porridge paste to form pills the size of paulownia seeds. Take 50–60 pills, washed down with rice drink.
Another discussion on sourness in the heart region, where sour Qi rushes upward like strong vinegar, unbearable in intensity: Use 1 he of Evodia Fruit, add 1 zhang of water, decoct until 0.7 zhang remains, and take in one dose. Even if the liquid is strong, it must be forced down. There was a case where a patient felt their heart as if pierced; this formula produced immediate results.
Another treatment for vomiting clear fluid: Cangzhu (Atractylodes Rhizome, 2 qian, stir-fried with wall soil), Baizhu (Atractylodes Macrocephala Rhizome, 1.5 qian, de-stemmed and stir-fried), Chenpi (Tangerine Peel, 1.5 qian), Baifuling (Poria, 3 qian), Huashi (Talcum, stir-fried, 3 qian). Decoct in water and take.
A scholar who preferred extremely hot food and drink throughout the four seasons sometimes experienced Tun Suan and belching of putrid smells, loose stools, and damp, itchy spaces between the toes. This was due to deficiency-cold of the Spleen Qi sinking downward. Liujunzi Tang (Six Gentlemen Decoction) was used, added with fresh ginger and cinnamon, resulting in recovery. However, slight dietary indiscretion caused the diseases to recur. Using the previous prescription with the addition of approximately 1 qian of Fuzi (Prepared Aconite Root) for several doses prevented further recurrence.
A woman with Tun Suan, belching of putrid smells, vomiting of phlegm-saliva, and a purely white complexion was treated by others with Erchen Tang (Two-Cured Decoction), Huanglian (Coptis Rhizome), Zhishi (Immature Bitter Orange), etc., leading to fever, thirst, and abdominal distension. I stated: This is damage to the Spleen and Stomach, eventually transmitting to Cold. The patient did not believe me and continued treating it as Heat, resulting in limb swelling resembling Guzhang (Gu Distension). I treated her with Liujunzi Tang added with Fuzi (Prepared Aconite Root) and Muxiang (Aucklandia Root). Her Stomach Qi gradually revived, and her diet slowly increased, returning the deficient fire to its source. Subsequently, she took Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) added with Paojiang (Roasted Ginger), Muxiang (Aucklandia Root), Fuling (Poria), and Banxia (Pinellia Rhizome), achieving complete recovery.
Another treatment for vomiting sour fluid after eating: Ganjiang (Dried Ginger) and Wuzhuyu (Evodia Fruit), each 2 liang, ground into powder. Take one fangcun chi (square-inch spoonful) per dose, mixed with wine, twice daily. For patients with Cold Stomach, immediate effects are seen upon administration.