(仲景) 治阳明证,食谷欲呕,若得汤反剧者,则属上焦。少阴证,吐利,手足厥
烦躁欲死。厥阴证,干呕,吐涎,头痛。(厥阴之脉挟胃,干呕吐沫,里寒内格也。厥
脉上巅,头痛,寒气上逆也。按三阳皆有头痛,太阴少阴二经之脉,不上循头,故无头
唯厥阴与督脉会于巅,亦有头痛。然风温在少阴,湿温在太阴,而头反痛,是又不可拘
李东垣曰∶太阴头痛,必有痰也。少阴头痛,足寒而气逆也。盖太阴少阴二经,虽不
然痰与气逆壅于膈中,头上气不得畅而为痛也。)
吴茱萸(一升泡) 人参(三两) 大枣(十二枚) 生姜(六两)
喻嘉言曰∶此明呕有太阳,亦有阳明。若食谷而呕,则属胃寒,与太阳之恶寒呕逆,原
为热
热邪,
至于烦
散寒下
又治肝
加附子,名吴茱萸加附子汤。治寒疝,腰痛,牵引睾丸,尺脉沉迟。
(金匮) 治心胸中大寒,痛呕,不能饮食,腹中寒气上冲。皮起出,见有头足,上下
痛而不可触近者。(阳受气于胸中,阳虚则阴邪得以中之。阴寒之气,逆而上冲。横格于中
焦,故见高起痛呕,不可触近之证。心为阳,寒为阴,寒乘于心,冷热相激,故痛。寒乘于
脾,脾冷弱,不消水谷,故痛而呕,复不能饮食也。)
蜀椒(二合) 干姜(四两) 人参(二两) 煎去滓,内饴糖一升。微煎温服。
蜀椒辛热,入肺散寒,入脾暖胃,入肾命补火。干姜辛热,通心助阳,逐冷散逆。人参
甘温
其中
(张仲景)治疗阳明病证,进食后想要呕吐,如果喝了药汤反而加重,这属于上焦病变。少阴病证,出现呕吐、腹泻,手脚冰凉,烦躁得想死。厥阴病证,干呕,吐出涎沫,头痛。(厥阴经脉环绕胃部,干呕吐沫,是里寒内阻格拒所致。厥阴经脉上行至头顶,所以头痛,这是寒气上逆所致。按:三阳经都有头痛的情况,但太阴和少阴两条经脉的循行路线不上达头部,所以通常没有头痛,只有厥阴经与督脉在头顶交会,所以会有头痛。然而风温病在少阴经,湿温病在太阴经,反而出现头痛,这又是不可拘泥于常理的。李东垣说:太阴头痛,一定伴有痰湿。少阴头痛,脚冷且气机上逆。大概太阴和少阴二经,虽然不直接上达头部,但是痰湿和气逆壅塞在胸膈中间,导致头部气血运行不畅而疼痛。)
吴茱萸(一升,浸泡) 人参(三两) 大枣(十二枚) 生姜(六两)
喻嘉言说:这里阐明了呕吐有太阳经和阳明经的区别。如果进食后呕吐,则属于胃寒,这与太阳经的恶寒、呕吐逆气,原本是因为热邪……(此处原文似有缺漏或错简,结合语境推测意为:若属热邪则不同,此处指寒证)。又治疗肝寒……加附子,名为吴茱萸加附子汤。治疗寒疝,腰痛,牵引睾丸,尺脉沉迟。
(《金匮要略》)治疗心胸中剧烈寒冷感,疼痛呕吐,不能饮食,腹中寒气向上冲逆。皮肤隆起,像有头足一样起伏,上下移动,疼痛剧烈且不可触碰靠近。(阳气受生于胸中,阳气虚弱则阴邪得以侵入。阴寒之气,逆行而上冲。横亘阻隔在中焦,所以出现高高隆起、疼痛呕吐、不可触碰的症状。心属阳,寒属阴,寒邪侵袭心脏,冷热相互激荡,所以疼痛。寒邪侵袭脾脏,脾脏寒冷虚弱,不能消化水谷,所以疼痛且呕吐,进而无法进食。)
(Zhang Zhongjing) Treats Yangming disease syndrome, where the patient desires to vomit after eating; if vomiting worsens after taking the decoction, it belongs to a disorder of the Upper Jiao. Shaoyin disease syndrome presents with vomiting and diarrhea, cold extremities, and restlessness so severe that the patient feels as if they are about to die. Jueyin disease syndrome presents with dry retching, spitting of saliva/phlegm, and headache. (The Jueyin meridian loops around the stomach; dry retching and spitting phlegm indicate internal cold obstructing and repelling [Ji Ge]. The Jueyin meridian ascends to the vertex; thus headache is caused by the counterflow of cold qi. Note: Headache occurs in all three Yang meridians. However, the Taiyin and Shaoyin meridians do not ascend to the head, so they typically do not present with headache. Only the Jueyin meridian meets the Du vessel at the vertex, hence headache occurs. Nevertheless, Wind-Warmth affecting the Shaoyin and Damp-Warmth affecting the Taiyin can also present with headache; this cannot be rigidly adhered to. Li Dongyuan stated: Taiyin headache must involve phlegm. Shaoyin headache involves cold feet and counterflow of Qi. Although the Taiyin and Shaoyin meridians do not directly ascend to the head, phlegm and counterflow of Qi congesting the chest and diaphragm prevent smooth Qi flow in the head, causing pain.)
Evodiae Fructus (Wuzhuyu) (1 Sheng, soaked)
Ren Shen (Ginseng Radix et Rhizoma) (3 Liang)
Zao Ren (Jujubae Fructus) (12 pieces)
Sheng Jiang (Zingiberis Rhizoma Recens) (6 Liang)
Yu Jiayan said: This clarifies that vomiting can originate from the Taiyang or Yangming. If vomiting occurs after eating, it belongs to Stomach Cold. This differs from Taiyang aversion to cold with vomiting and counterflow, which originally stems from... [Text fragmentary] ...heat pathogen. It also treats Liver Cold... Adding Fuzi creates Wu Zhu Yu Jia Fu Zi Tang. It treats Cold Hernia, lower back pain radiating to the testicles, with a deep and slow Chi pulse.
(The Jin Gui Yao Lue) Treats severe cold in the heart and chest, pain, vomiting, inability to eat, and upward surging of cold Qi in the abdomen. The skin rises up, appearing with "heads and feet" moving up and down; the pain is severe and cannot be touched or approached. (Yang Qi originates in the chest; when Yang is deficient, Yin pathogens invade. Yin-cold Qi surges upward and counterflows. It obstructs the Middle Jiao horizontally, resulting in protrusion, pain, vomiting, and tenderness upon touch. The Heart is Yang, Cold is Yin. When Cold invades the Heart, Cold and Heat clash, causing pain. When Cold invades the Spleen, the Spleen becomes cold and weak, failing to digest water and grain, causing pain, vomiting, and ultimately an inability to eat.)
Shu Jiao (Sichuan Pepper Fruit / Zanthoxyli Fructus) (2 He)
Gan Jiang (Dried Ginger / Zingiberis Rhizoma) (4 Liang)
Ren Shen (Ginseng Radix et Rhizoma) (2 Liang)
Decoct, remove dregs, add Yi Tang (Maltose / Malt Extractum) 1 Sheng. Simmer slightly and take warm.
Shu Jiao is acrid and hot; it enters the Lung to disperse cold, enters the Spleen to warm the Stomach, and enters the Kidney/Mingmen to tonify Fire. Gan Jiang is acrid and hot; it unblocks the Heart and assists Yang, expels cold, and directs counterflow downward. Ren Shen is sweet and warm... [Text ends abruptly]