治食积痞满,及小儿腹大胀满,时常疼痛,脾胃不和等证,此方较枳术丸其效
白术(面炒) 赤芍药(酒炒二两) 枳实(麸炒) 陈皮(一两) 荷叶汤煮黄老米
糊为丸,桐子
参一二两。
(东垣) 治脾积,在于胃脘,大如盘,久不愈,令人四肢不收。或发黄胆,饮食不为
肌肤。(金匮曰∶坚而不移者名积,为脏病。推移不定者名聚,为腑病。按痞病由阴伏阳蓄
,气血不运而成。处心下,位中央,填塞痞满,皆土病也。与胀满有轻重之分。痞惟内觉满
闷,胀满则外有胀急之形也。有中气虚衰,不能运化精微而成痞者。有饮食痰积,不能施
化而成痞者。有湿热太甚,上乘心下而成痞者。古方用黄连黄芩枳实之苦以泄之,浓朴半夏
生姜之辛以散之,人参白术之甘苦温以补之,茯苓泽泻之淡以渗之。惟宜上下分消其气,果
有内实之证,庶可略施疏导。世人苦于痞塞,喜用利药,临时通快。药过滋甚,皆由不察中
气
黄连(八钱) 浓朴(五钱) 吴茱萸(三钱) 白术(土炒) 黄芩(二钱) 茵陈
(酒炒) 干姜(
五分) 桂 巴豆霜(四分
诸泻心汤皆用之。)浓朴砂
萸燥脾而逐冷。姜桂川乌,
巴豆能消有形滞积,为斩
可以去邪也。(洁古曰∶
除吴茱白术茯苓泽泻茵陈川椒砂仁,加菖蒲茯神丹参红豆,名伏梁丸。治心积,起脐上
至心
丸。
紫菀
喘
延
令
人
治疗食积导致的痞满,以及小儿腹部胀大、时常疼痛、脾胃不和等证候。此方比枳术丸(一种健脾消痞的方剂)疗效更佳。
白术(用面粉炒制),赤芍药(用酒炒制,二两),枳实(用麦麸炒制),陈皮(一两)。以上药材研末,用荷叶汤煮黄老米糊作为粘合剂制成丸药,大小如梧桐子。每次服用参一二两(注:此处原文“参”字疑为衍文或量词误植,通常指“服”,即每次服用若干丸)。
(李东垣)治疗脾积,病位在胃脘部,肿块大如盘子,久治不愈,导致四肢无力无法收持。或者出现黄疸,饮食营养不能转化为肌肉。(《金匮要略》说:坚硬且位置不移的称为“积”,属于脏病;位置移动不定的称为“聚”,属于腑病。按:痞病是由于阴气潜伏、阳气蓄积,气血运行不畅而形成的。病位在心下,处于人体中央,填塞不通导致痞满,都属于土(脾胃)的病证。它与胀满有轻重的区别。痞证只是内部感觉满闷,胀满则是外部有胀急的形态。有的因为中气虚衰,不能运化精微物质而形成痞证;有的因为饮食痰湿积聚,不能施化而形成痞证;有的因为湿热太盛,上乘于心下而形成痞证。古方使用黄连、黄芩、枳实的苦味来泄降,厚朴、半夏、生姜的辛味来散结,人参、白术的甘苦温性来补益,茯苓、泽泻的淡味来渗利。只宜上下分消其气机,如果确实有内实证候,才可以稍微施用疏导之法。世人苦于痞塞,喜欢使用通利药物,暂时获得通畅。但药效过后病情加重,这都是因为没有察明中气的缘故。)
黄连(八钱),厚朴(五钱),吴茱萸(三钱),白术(用土炒制),黄芩(二钱),茵陈(用酒炒制),干姜(五分),桂枝,巴豆霜(四分)。
(各种泻心汤都使用这些药物。)厚朴、砂仁……吴茱萸燥脾并驱除寒冷。干姜、桂枝、川乌……巴豆能消除有形的滞积,具有斩关夺隘的作用,可以去邪。(洁古先生曰:去除吴茱萸、白术、茯苓、泽泻、茵陈、川椒、砂仁,加入石菖蒲、茯神、丹参、红豆,名为伏梁丸。治疗心积,起于脐上至心……丸药。紫菀……喘……延……令……人……)
Treats food stagnation leading to epigastric fullness and obstruction (Pi), as well as abdominal distension and enlargement in children, frequent pain, and disharmony of the Spleen and Stomach. This formula is more effective than Zhizhu Wan (Aurantium Decoction).
Baizhu (Coated with flour and stir-fried), Chishao Yao (Stir-fried with wine, 2 liang), Zhishi (Stir-fried with bran, 1 liang), Chenpi (1 liang). Grind into powder, use Huang Laomi paste boiled in He Ye soup as a binder to make pills, size of Torreya seeds. Take approximately 1-2 liang per dose (Note: The character "Shen" here is likely a textual error or variant for dosage instruction, typically implying taking a certain number of pills).
(Li Dongyuan) Treats Pi Ji (Spleen accumulation), located in the epigastrium, large as a plate, persisting for a long time without cure, causing the limbs to become weak and unable to support themselves. Or it may lead to jaundice, where dietary nutrients fail to transform into muscle flesh. (*Jin Gui Yao Lue* states: Hard and immobile masses are called "Ji" (accumulation), which are Zang organ diseases. Mobile and shifting masses are called "Ju" (gathering), which are Fu organ diseases. Analysis: Pi disease arises from the latent Yin and accumulated Yang, resulting in impaired Qi and Blood circulation. Its location is in the epigastrium, central to the body, causing blockage and fullness; these are all disorders of Earth (Spleen/Stomach). There is a distinction in severity between Pi and Zhang Man (distension). Pi is characterized by internal sensation of fullness and oppression, whereas Zhang Man presents with external signs of distension and urgency. Some cases arise from deficiency and decline of Middle Qi, failing to transport and transform subtle essences. Others arise from food and phlegm accumulation that cannot be metabolized. Still others result from excessive Damp-Heat ascending to the epigastrium. Ancient formulas used the bitter nature of Huang Lian, Huang Qin, and Zhishi to drain downward; the acrid nature of Hou Po, Ban Xia, and Sheng Jiang to disperse; the sweet, bitter, and warm nature of Ren Shen and Bai Zhu to tonify; and the bland nature of Fu Ling and Ze Xie to leach out dampness. It is appropriate to dissipate Qi from above and below. Only if there are signs of interior excess can slight guiding and draining methods be applied. People suffering from obstruction often prefer using purgative/diuretic drugs for temporary relief. However, after the drug effect wears off, the condition worsens, due to failure to examine the state of Middle Qi.)
Huang Lian (8 qian), Hou Po (5 qian), Wu Zhu Yu (3 qian), Bai Zhu (Earth-stir-fried), Huang Qin (2 qian), Yin Chen (Wine-stir-fried), Gan Jiang (0.5 qian), Gui Zhi, Ba Dou Shuang (0.4 qian).
(All Xi Xin Tang formulas utilize these ingredients.) Hou Po, Sha Ren... Wu Zhu Yu dries the Spleen and expels cold. Gan Jiang, Gui Zhi, Chuan Wu... Ba Dou can eliminate有形 (material/physical) stagnation and accumulation, possessing a decisive action to remove pathogenic factors. (Jie Gu said: Remove Wu Zhu Yu, Bai Zhu, Fu Ling, Ze Xian, Yin Chen, Chuan Jiao, Sha Ren; add Shi Chang Pu, Fu Shen, Dan Shen, Hong Dou, named Fu Liang Wan. Treats Xin Ji (Heart accumulation), starting from above the navel up to the heart... Pill. Zi Wan... Asthma... Yan... Ling... Ren...)