开关利膈丸(宝监名人参利膈丸) 治肠胃壅滞。噎膈不通。大便燥结。
木香 槟榔(各七钱) 人参 当归(酒洗) 藿香 甘草(炙。) 枳实(炒。各一
两)
大黄(酒蒸) 浓朴(姜制。各二两)
滴水为丸。梧子大。每服三五十丸。食后米饮下。 按此本小承气加入参、归等味。意在养正
祛邪。而实攻多于补。惟热壅膈塞用之庶为得宜。然噎膈之燥结。皆由五志抑郁。伤耗精气而成。
非有热邪留结。可攻下而除也。用方者审诸。
五噎丸(千金) 治胸中久寒。呕逆妨食。结气不消。
干姜 蜀椒 吴茱萸 桂心 细辛(各一两。) 人参 白术(各二两)
橘皮 茯苓(各一两半) 附子(一枚。炮)
上为细末。炼白蜜丸。梧子大。酒服十五丸。日三服。渐加至三十丸。
五膈丸(千金) 治饮食不得下。手足冷。上气喘息。
麦门冬(三两。去心) 甘草(二两) 蜀椒(炒去汗) 远志肉 桂心 细辛 干姜(
炮。各一两) 附子(一枚。炮) 人参(二两)
上为细末。炼白蜜丸弹子大。先食含一丸。细细咽之。喉中胸中当热。药丸稍尽。再含一丸。
日三夜二服。七日愈。
五噎、五膈二丸。同用参、附、椒辛、姜、桂之属。一以肝气上逆。胃气不下而呕噎。故用萸
、橘以疏肝降逆。苓、术以健胃通津。一以肾气不蒸。肺胃枯槁而不纳。故用冬、草以滋肺和胃。
远志以补火生土。又呕噎而药食可进者。频与小丸调之。膈塞而饮食不纳者。时用大丸噙之。其立
法之详若此。可不辨而忽诸。
旋复代赭石汤(玉函) 治胃虚噫气不除。
旋复花(二钱) 代赭石( 。一钱) 人参(二钱) 甘草(炙。二钱) 半夏(三钱)
生姜(半两) 大枣(四枚。擘)
上七味。水煎去滓。分温日三服。
六君子汤(四君子汤下) 异功散(四君子汤下) 四君子汤(方祖) 指迷七气汤
(局方七气汤下) 局方七气汤(方祖)
四物汤(方祖) 代抵当丸(抵当汤下) 理中汤(方祖) 越鞠丸(郁门) 崔氏八味
丸(方祖)
二陈汤(方祖)
开关利膈丸(即宝监名人参利膈丸):治疗肠胃气机壅滞。噎膈不通畅。大便干燥坚硬难解。
木香、槟榔(各七钱)、人参、当归(用酒清洗)、藿香、甘草(炙烤)、枳实(炒制,各一两)。
大黄(用酒蒸制)、厚朴(用姜汁炮制,各二两)。
滴入清水制成丸药,大小如梧桐子。每次服用三五十丸,饭后用米汤送服。
按语:此方本是在小承气汤基础上加入人参、当归等药物。意在扶助正气以祛除邪气,但实际上攻伐多于补益。只有对于热邪壅塞胸膈的情况使用才适宜。然而,噎膈导致的燥结,多是由于五志(喜、怒、忧、思、恐)抑郁,损伤耗竭精气而形成的,并非有实热邪气留滞结聚,不可以用攻下法来消除。使用此方的医生请审慎考虑。
五噎丸(出自《千金方》):治疗胸中久寒。呕吐逆气妨碍进食。气结不散。
干姜、蜀椒、吴茱萸、桂心、细辛(各一两)。人参、白术(各二两)。
橘皮、茯苓(各一两半)。附子(一枚,炮制)。
以上药物研成细末,用炼过的白蜜制成丸药,大小如梧桐子。用酒送服十五丸,每日三次,逐渐增加至三十丸。
五膈丸(出自《千金方》):治疗饮食无法咽下。手足冰冷。气逆喘息。
麦门冬(三两,去心)、甘草(二两)、蜀椒(炒制去油汗)、远志肉、桂心、细辛、干姜(炮制,各一两)。附子(一枚,炮制)、人参(二两)。
以上药物研成细末,用炼过的白蜜制成弹子大小的丸药。饭前含服一丸,细细吞咽。喉咙和胸部应当感到发热。药丸稍吃完后,再含服一丸。白天三次,夜间两次服药,七天痊愈。
五噎丸与五膈丸,都使用了人参、附子、花椒、细辛、干姜、肉桂这类药物。一方是针对肝气上逆,胃气不降而导致呕吐噎食,所以用吴茱萸、橘皮来疏肝降逆,用茯苓、白术来健运脾胃、通调津液;另一方是针对肾气不能蒸腾气化,导致肺胃干枯消瘦而不能纳食,所以用麦冬、甘草来滋润肺脏、调和胃气,用远志来补命门之火以生脾土。另外,如果是呕吐噎食但还能进食药食的,频繁给予小丸药调理;如果是胸膈闭塞连饮食都无法纳入的,不时用大丸药含化。其立法之详尽如此,怎能不加辨别而疏忽大意呢?
旋复代赭石汤(出自《玉函经》):治疗胃气虚弱,嗳气不止。
旋复花(二钱)、代赭石(一钱)、人参(二钱)、甘草(炙烤,二钱)、半夏(三钱)、生姜(半两)、大枣(四枚,掰开)。
以上七味药,用水煎煮,去渣滓,分三次温服。
六君子汤(见四君子汤下)、异功散(见四君子汤下)、四君子汤(方剂祖方)、指迷七气汤(见局方七气汤下)、局方七气汤(方剂祖方)。
四物汤(方剂祖方)、代抵当丸(见抵当汤下)、理中汤(方剂祖方)、越鞠丸(见郁门)、崔氏八味丸(方剂祖方)。
二陈汤(方剂祖方)。
Kaiguan Lige Wan (Switch-Opening and Diaphragm-Unblocking Pill, also known as Baojian Ming Ren Shen Lige Wan): Treats stagnation in the intestines and stomach. Dysphagia and regurgitation with obstruction. Dry and hard stool.
Muxiang (Aucklandiae Radix), Binglang (Arecae Semen) (each 7 qian); Renshen (Ginseng Radix et Rhizoma), Danggui (Angelicae Sinensis Radix) (washed with wine); Huoxiang (Agastaches Herba), Gancao (Glycyrrhizae Radix et Rhizoma) (roasted); Zhishi (Aurantii Fructus Immaturus) (stir-fried, each 1 liang).
Dahuang (Rhei Radix et Rhizoma) (steamed with wine); Houpo (Magnoliae Officinalis Cortex) (processed with ginger juice, each 2 liang).
Mix with a little water to form pills, size of Sophora japonica seeds. Take 30–50 pills per dose, after meals, washed down with rice drink.
Note: This prescription is originally Xiao Chengqi Tang (Minor Order the Yang Decoction) added with Renshen and Danggui, etc. The intention is to nourish the healthy qi and expel pathogenic factors, but actually the purgative action outweighs the tonifying effect. It is suitable only for cases of heat stagnation blocking the diaphragm. However, the dryness and constipation in dysphagia and regurgitation are all caused by depression of the five emotions (joy, anger, worry, thought, fear), which injure and deplete essence and qi. It is not due to lingering heat pathogens causing accumulation, so it cannot be removed by purgation. Physicians using this formula should exercise caution.
Wuye Wan (Five-Suffocation Pill, from Qianjin Fang): Treats chronic cold in the chest. Vomiting and retching obstructing food intake. Qi knot failing to dissipate.
Ganjiang (Zingiberis Rhizoma), Shujiao (Sichuan Pepper Fruit), Wuzhuyu (Evodiae Fructus), Guixin (Cinnamomi Ramulus), Xixin (Asari Radix et Rhizoma) (each 1 liang). Renshen (Ginseng Radix et Rhizoma), Baizhu (Atractylodis Macrocephalae Rhizoma) (each 2 liang).
Jupi (Citri Reticulatae Pericarpium), Fuling (Poria) (each 1.5 liang). Fuzi (Aconiti Lateralis Radix Praeparata) (one piece, processed).
Grind the above into fine powder. Form pills with refined white honey, size of Sophora japonica seeds. Take 15 pills with wine, three times a day. Gradually increase to 30 pills.
Wuge Wan (Five-Diaphragm Pill, from Qianjin Fang): Treats inability to swallow food. Cold hands and feet. Rising qi and panting.
Maimendong (Ophiopogonis Radix) (3 liang, remove heart); Gancao (Glycyrrhizae Radix et Rhizoma) (2 liang); Shujiao (Sichuan Pepper Fruit) (stir-fried to remove oil/sweat); Yuanzhi (Polygalae Radix), Guixin (Cinnamomi Ramulus), Xixin (Asari Radix et Rhizoma), Ganjiang (Zingiberis Rhizoma) (processed, each 1 liang). Fuzi (Aconiti Lateralis Radix Praeparata) (one piece, processed); Renshen (Ginseng Radix et Rhizoma) (2 liang).
Grind the above into fine powder. Form pills with refined white honey, size of a bullet. Before eating, hold one pill in the mouth and swallow slowly. The throat and chest should feel warm. When the pill is mostly consumed, hold another one. Take three times during the day and two times at night. Cure within seven days.
Both Wuye Wan and Wuge Wan use similar ingredients such as Renshen, Fuzi, Jiaojiao (Sichuan Pepper), Xixin, Ganjiang, and Guixin. One addresses liver qi rebelling upward and stomach qi failing to descend, causing vomiting and suffocation; thus, it uses Wuzhuyu and Jupi to soothe the liver and direct qi downward, and Fuling and Baizhu to strengthen the stomach and circulate fluids. The other addresses kidney qi failing to steam and transform, leading to dryness and withering of the lungs and stomach, preventing ingestion; thus, it uses Maimendong and Gancao to moisten the lungs and harmonize the stomach, and Yuanzhi to tonify fire to generate earth. Furthermore, for cases of vomiting and suffocation where medicine and food can still be taken, frequent administration of small pills is used for regulation; for cases of diaphragmatic blockage where food cannot be taken, large pills are occasionally held in the mouth. The detailed formulation principles are as such; how can they be neglected without discrimination?
Xuanfu Daizhe Shi Tang (Inula and Hematite Decoction, from Yufang Jing): Treats weak stomach qi with persistent belching.
Xuanfuhua (Inulae Flos) (2 qian); Daizhe Shi (Hematitum) (1 qian); Renshen (Ginseng Radix et Rhizoma) (2 qian); Gancao (Glycyrrhizae Radix et Rhizoma) (roasted, 2 qian); Banxia (Pinelliae Rhizoma) (3 qian); Shengjiang (Zingiberis Rhizoma Recens) (half liang); Dazao (Jujubae Fructus) (four pieces, split open).
Boil the above seven ingredients in water, strain off the dregs. Divide into three doses, take warm.
Liujunzi Tang (Six Gentlemen Decoction) (see Si Junzi Tang below); Yigong San (Extraordinary Power Powder) (see Si Junzi Tang below); Si Junzi Tang (Four Gentlemen Decoction) (Ancestral Formula); Zhimi Qi Qi Tang (Confusing Phlegm Seven-Qi Decoction) (see Ju Fang Qi Qi Tang below); Ju Fang Qi Qi Tang (Seven-Qi Decoction from the Bureau Formulas) (Ancestral Formula).
Siwu Tang (Four Substances Decoction) (Ancestral Formula); Dai Didang Wan (Substitute Didang Pill) (see Didang Tang below); Lizhong Tang (Regulate the Middle Decoction) (Ancestral Formula); Yueju Wan (Overcome Stagnation Pill) (see Yu Men below); Cui Shi Bawei Wan (Cui's Eight-Ingredient Pill) (Ancestral Formula).
Erchen Tang (Two Aged Decoction) (Ancestral Formula).