胃为水谷之海,上通乎咽,内而不出,如初发热有吐逆之证,此火邪犯胃,其气上逆,治之则易,若自出现以
至收靥有是证者,乃疮集于咽门,攻于胃脘,吞咽不利,治之则难。由于不知预解咽喉之法,渐变为失音呛水,而
不可救矣。初虞世云∶痘疮吐逆,无痰益黄散(脾)。有痰二陈汤(大科痰饮),或橘皮半夏汤。不止者加丁香(胃
寒者、宜之,胃热、宜加芦根茅根枇杷叶黄连)。若吐而泻者,亦宜益黄散及陈氏木香散、异功散。
吐而身热烦渴,腹满喘,大小便涩,面赤者,当利小便。不瘥者,宣风散下之(痘发热)。〔薛〕前证,若手足并冷,渴
饮热汤,或腹作痛,中气虚寒也,宜用益黄散。手足不冷,吐逆痰涎,中气虚弱也,宜用橘皮半夏汤。手足并热,热毒
壅滞也,宜用导赤散。口干,饮乳不彻,胃经气热也,宜用竹茹汤。吐逆不乳,或吐乳酸秽,此脾气
虚而乳食停滞也,宜枳术丸。如初发热,暴吐不止,此火气上逆也,茱连散主之。
茱连散
黄连(半两) 吴茱萸(二钱)
上二味,同炒,研细末。每服半钱,生姜汤调服。
橘皮汤
橘皮(半留白,半去白,炒,二钱) 半夏(一钱) 白茯苓(一钱半)
上锉细。加生姜五分,水一盏,煎七分,去滓,温服。
橘皮汤 治呕吐不止,饮食不入。
陈皮 生姜(各一钱) 人参(五分)
上,水煎,作三四次服之。
橘皮半夏汤
橘皮 半夏(等分)
上,每服三钱,姜枣水煎。
如因饮水过多而呕吐者,此水逆也,五苓散主之。
如因伤食而呕吐者,以丁香脾积丸微利之。
如无上证而呕哕者,人以胃气为本,胃者土也,土败则木来侮之,今木挟相火
之势,上乘乎胃,其气自脐下直犯清道,上出于贲门胃上口也,微则干呕,甚则哕,
土败之象也。《太素》曰∶弦绝者其声嘶败,木陈者其叶落,病深者其声哕,短针无取,毒药无攻,谓不治也。
附方
丁香煮散 治脾胃虚冷,呕吐不食。
丁香(不见火) 红豆 甘草 干姜 青皮 川乌(去皮) 陈皮 良姜 胡椒 益智(各等分)
上锉散。每服三钱,用水一盏,生姜三片,煎六分,加盐一捏,不拘时服。
加味鼠粘子散 治咽中有疮,作呕。
桔梗 射干 山豆根 防风 干葛 陈皮 荆芥 连翘
水煎,细细呷之。
灯心竹叶汤 治干呕。
竹叶(三十片) 灯心(三十根)
水煎服。
秘方治呕吐并吐泻不止,水谷不纳者,速效。
用多年灶心赤色土,为细末,每服二钱,米饮调下,小儿只一钱。
胃被称为水谷之海,向上连接咽喉,食物进入后在内停留而不外泄。如果刚开始发热时出现吐逆的症状,这是火邪侵犯胃部,导致胃气上逆,治疗起来比较容易;如果是从出疹开始直到结痂收靥期间出现这种症状,这是因为痘疮聚集在咽喉门户,攻冲于胃脘部位,导致吞咽困难,治疗起来就比较困难。由于不知道预先解除咽喉病邪的方法,逐渐演变为失音和呛水,就无法救治了。初虞世说:痘疮引起的吐逆,如果没有痰,用益黄散(调理脾脏);如果有痰,用二陈汤(针对大科痰饮),或者橘皮半夏汤。如果服药后吐逆不止,可以加丁香(适用于胃寒者,适宜使用;若是胃热,适宜加芦根、茅根、枇杷叶、黄连)。如果既呕吐又腹泻,也适宜用益黄散以及陈氏木香散、异功散。
如果呕吐且身体发热、烦躁口渴、腹部胀满、气喘、大小便不通畅、面色发红,应当通利小便。如果病情不缓解,用宣风散泻下(针对痘疮发热)。〔薛己〕前面的证候,如果手脚都冷,想喝热汤,或者腹部疼痛,这是中气虚寒,适宜用益黄散。如果手脚不冷,呕吐吐痰涎,这是中气虚弱,适宜用橘皮半夏汤。如果手脚都热,这是热毒壅滞,适宜用导赤散。如果口干,吃奶吃不饱,这是胃经气热,适宜用竹茹汤。如果呕吐不吃奶,或者吐出酸臭秽浊之物,这是脾气虚弱导致乳食停滞,适宜用枳术丸。如果刚开始发热,突然剧烈呕吐不止,这是火气上逆,用茱连散主治。
【方剂】茱连散
黄连(半两) 吴茱萸(二钱)
以上两味药,一起炒制,研成细末。每次服用半钱,用生姜汤调服。
【方剂】橘皮汤
橘皮(一半留白,一半去白,炒制,二钱) 半夏(一钱) 白茯苓(一钱半)
以上切碎。加入生姜五分,水一盏,煎至七分,去掉药渣,温服。
【方剂】橘皮汤 治疗呕吐不止,饮食无法进入。
陈皮 生姜(各一钱) 人参(五分)
以上用水煎煮,分三四次服用。
【方剂】橘皮半夏汤
橘皮 半夏(等量)
以上,每次服用三钱,用姜枣水煎煮。
如果没有上述症状而干呕或呃逆的,人以胃气为本,胃属土,土气败坏则木气来克制它,现在木气挟带相火之势,上乘于胃,其气从脐下直犯清道,向上出于贲门(胃的上口),轻微的是干呕,严重的是呃逆,这是土气败坏的征象。《太素》说:琴弦断绝声音就会嘶哑败坏,树木衰老叶子就会掉落,病入膏肓的人会出现呃逆声,此时短针无效,毒药无攻,指的就是不可治愈的情况。
【附方】丁香煮散 治疗脾胃虚冷,呕吐不想吃东西。
丁香(不经过火炒) 红豆 甘草 干姜 青皮 川乌(去皮) 陈皮 良姜 胡椒 益智(各等分)
以上捣碎成散剂。每次服用三钱,用水一盏,生姜三片,煎至六分,加盐一捏,不拘时间服用。
【附方】加味鼠粘子散 治疗咽喉中有疮疡,引起作呕。
桔梗 射干 山豆根 防风 干葛 陈皮 荆芥 连翘
用水煎煮,细细呷服。
The Stomach is regarded as the Sea of Water and Grain, connecting upwards to the pharynx. Food enters and stays inside without leaking out. If symptoms of vomiting and regurgitation appear during the initial fever stage, this is caused by Fire Evil invading the Stomach, leading to rebellious Qi; treatment is relatively easy. However, if these symptoms persist from the onset of rash until scabbing, it indicates that the pox lesions have gathered at the pharyngeal gate and attacked the epigastrium, causing difficulty in swallowing; treatment is difficult. Due to a lack of knowledge on how to preemptively resolve pharyngeal pathogenic factors, the condition may gradually deteriorate into loss of voice and choking on water, becoming incurable. Chu Yushi stated: For vomiting and regurgitation caused by smallpox, if there is no phlegm, use Yihuang San (Spleen). If there is phlegm, use Erchen Tang (for Phlegm-Fluids in General Practice) or Jupi Banxia Tang. If vomiting does not cease, add Dingxiang (suitable for those with Stomach Cold; for Stomach Heat, it is suitable to add Luzhen, Maogen, Pipaye, and Huanglian). If both vomiting and diarrhea occur, Yihuang San, Chen's Muxiang San, and Yigong San are also suitable.
If vomiting is accompanied by fever, restlessness, thirst, abdominal distension, panting, scanty urination and defecation, and a red face, one should promote diuresis. If the condition does not improve, Xuanfeng San should be used to purge (for smallpox fever). [Xue] Regarding the aforementioned syndromes: if the hands and feet are cold, there is a desire to drink hot soup, or abdominal pain occurs, this indicates deficiency-cold of Middle Qi, and Yihuang San is suitable. If the hands and feet are not cold, but vomiting produces phlegm and saliva, this indicates weakness of Middle Qi, and Jupi Banxia Tang is suitable. If the hands and feet are hot, this indicates stagnation of Heat-Toxin, and Daochi San is suitable. If the mouth is dry and breastfeeding is incomplete, this indicates Qi-Heat in the Stomach Meridian, and Zhuru Tang is suitable. If vomiting prevents breastfeeding, or sour, foul-smelling vomit is expelled, this indicates Spleen Qi deficiency with stagnation of milk and food, and Zhizhu Wan is suitable. If sudden, continuous severe vomiting occurs during the initial fever stage, this is due to rebellious Fire Qi, and Zhulian San is the primary prescription.
[Formula] Zhulian San
Huanglian (Banliang) Wuzhuyu (Erqian)
These two ingredients are stir-fried together, ground into fine powder. Take half a qian each time, mixed with ginger decoction.
[Formula] Jupi Tang
Jupi (half with white pith, half without, stir-fried, Erqian) Banxia (Yiqian) Baifuling (Yiqianban)
Cut into fine pieces. Add Shengjiang (Wufen), one sheng of water, decoct to seven fen, remove dregs, and take warm.
[Formula] Jupi Tang treats persistent vomiting where food and drink cannot enter.
Chenpi Shengjiang (each Yi qian) Renshen (Wufen)
Decoct in water and take in three to four doses.
[Formula] Jupi Banxia Tang
Jupi Banxia (equal parts)
Take three qian each time, decoct with ginger and jujube water.
If vomiting is caused by excessive water intake, this is Water Reversal, treated with Wuling San.
If vomiting is caused by food injury, Dingxiang Pi Ji Wan is used to gently promote bowel movement.
If there are no above symptoms but only dry retching or hiccups, humans rely on Stomach Qi as the root. The Stomach belongs to Earth; when Earth fails, Wood insults it. Now, Wood carries the momentum of Ministerial Fire, attacking the Stomach from above. The Qi rises directly from below the umbilicus through the clear pathways, emerging from the贲门 (cardia/upper stomach opening). Mild cases result in dry retching, while severe cases result in hiccups, which is a sign of Earth failure. *Tai Su* states: "When a string breaks, its sound becomes hoarse and ruined; when a tree ages, its leaves fall; when disease is deep, the patient makes hiccup sounds. Short needles are ineffective, and toxic drugs cannot attack; this refers to an untreatable condition."
[Supplementary Formula] Dingxiang Zhu San treats deficiency-cold of the Spleen and Stomach, vomiting, and anorexia.
Dingxiang (not roasted) Hongdou Ganjiang Gancao Qipi Chuanwu (peeled) Chenpi Liangjiang Hujiao Yizhi (equal parts)
Grind into powder. Take three qian each time, with one sheng of water and three slices of ginger, decoct to six fen, add a pinch of salt, and take at any time.
[Supplementary Formula] Jiawei Niuzaozi San treats sores in the throat causing vomiting.
Jiegeng Shegan Shandougen Fangfeng Gange Chenpi Jingjie Lianqiao
Decoct in water and sip slowly.
[Formula] Dengxin Zhuye Tang treats dry retching.
Zhuye (Thirty leaves) Dengxin (Thirty roots)
Decoct in water and take.
[Secret Recipe] Treats vomiting with persistent vomiting and diarrhea, where water and grain cannot be retained, for rapid effect.
Use earth from the center of a stove that has been burning for many years (Zao Xin Tu), grind into fine powder. Take two qian each time, mixed with rice water; for children, take only one qian.