（附论）
夫时气太阳、少阳并病。脉浮紧。反入里则作痞。痞者心下满也。病发于阴者。不可下。
下之则心下痞。按之自软。但气痞尔。故不可复下也。若热毒瓦斯乘心。则心下痞满。面赤目
黄。狂言恍惚者。此为有实。宜吐下之。
方
鳖甲散（出圣惠方）治时气热毒不退。大便秘涩。心腹痞满。饮食不下。精
神昏乱。恍惚狂言。脉候洪数。
鳖甲（涂醋炙令黄去裙 ） 赤茯苓 桔梗（去芦头） 人参（去芦头） 槟榔 茵陈 白
藓
皮麦门冬（去心） 川大黄（锉碎微炒各一两） 陈橘皮（汤浸去白瓤焙） 枳壳（麸炒
微黄去
瓤） 甘草（炙微赤锉各半两） 上为散。每服五钱。以水一大盏。入生姜汁半分。煎至五
分。
去滓。不计时候。温服。
前胡散（出圣惠方）治时气心下痞满。胸膈不利。
前胡（去芦头一两） 赤芍药（一两） 木香（一两） 青橘皮（汤浸去白瓤焙一两） 槟
榔
（一两） 上为散。每服五钱。以水一中盏。煎至六分。去滓。不计时候。温服。
半夏散（出圣惠方）治时气若吐若下后。发汗后。心下痞满。气上冲胸。起
即头眩。脉沉紧者。
半夏（汤浸七次去滑一两） 白术（一两） 甘草（炙微赤锉一两） 赤茯苓（一两） 桂
心
（一两） 人参（去芦头一两） 诃黎勒（用皮一两） 前胡（去芦头一两） 上为散。每
服五钱。
以水一中盏。入生姜半分。枣三枚。煎至六分。去滓。不计时候。温服。
前胡散（出圣惠方）治时气心腹痞满。身体疼痛。烦热呕逆。
前胡（去芦头） 半夏（汤浸七次去滑） 枳壳（麸炒微黄去瓤） 黄芩 人参（去芦
头） 桔
梗（去芦头） 槟榔（各一两） 赤芍药（五钱） 甘草（炙微赤锉半两） 上为散。每服
五钱。以
水一中盏。入生姜半分。枣三枚。煎至五分。去滓。不计时候。温服。
陈橘皮汤（出圣惠方）治时气已汗下后。脾胃气虚。心下痞满。腹中雷鸣。
陈橘皮（三两汤浸去白瓤焙） 人参（半两去芦） 甘草（炙微赤锉一两） 干姜（炮
锉一两）
赤茯苓（一两） 桔梗（去芦一两） 半夏（汤洗七次去滑一两） 白术（一两） 木香（一
两） 上
为散。每服五钱。以水一中盏。煎至六分。去滓。不计时候。温服。
桔梗散（出圣惠方）治时气心腹痞满。气喘。痰涎不绝。
桔梗（去芦头三分） 半夏（汤洗七次去滑三分） 赤芍药（三分） 前胡（一两去芦）
旋复
花（五钱） 大腹皮（半两锉） 枳壳（麸炒微黄去瓤半两） 赤茯苓（五钱） 甘草（炙
微赤锉五
钱） 上为散。 每服四钱。以水一中盏。入生姜半分。煎至五分。去滓。不计时候。温服。
赤茯苓散（出圣惠方）治时气气壅上冲。心腹痞满。坐卧不安。
赤茯苓（三分） 赤芍药（三分） 紫苏茎叶（三分） 枳壳（麸炒微黄去瓤五钱） 大
腹皮
（半两锉） 甘草（炙微赤锉半两） 百合（一两） 郁李仁（汤浸去皮尖微炒一两） 上
为散。每
服四钱。以水一中盏。煎至六分。去滓。不计时候。温服。
治时气饮水过多。水结心下痞满。（出圣惠方）
川大黄（锉碎微炒） 川朴硝（各一两） 甘遂（一钱煨金黄色） 上为散。每服不计
时候。
温服。调下一钱。以效为度。
治时气饮水过多。心下痞硬疼痛。（出圣惠方）
用芫花半斤。以醋拌令匀。以慢火炒热。用帛裹熨之。冷即更炒。以效为度。
治温气痹肿（出本草）
用赤小豆和桑根白皮。煮食之。
（附论）
所谓时气病中，太阳经与少阳经同时受邪。脉象表现为浮而紧。如果病邪反而内传入里，就会形成痞证。痞证是指心窝部胀满的感觉。凡是病发于阴分的，不可使用攻下法。
如果误用攻下法，会导致心下部痞塞，按压时感觉柔软，这仅仅是气机阻滞形成的痞证，所以不能再进行攻下治疗。如果热毒之气侵袭心脏，导致心下部痞塞胀满，面部发红，眼睛发黄，胡言乱语、神志恍惚的，这属于实证，适宜采用催吐或攻下的方法治疗。
方剂
鳖甲散（出自《圣惠方》），治疗时气病热毒不退，大便秘结涩滞，心腹部痞塞胀满，饮食无法咽下，精神昏沉混乱，神志恍惚，胡言乱语，脉象洪大而数。
药材：鳖甲（涂醋炙至黄色，去除裙边）、赤茯苓、桔梗（去除芦头）、人参（去除芦头）、槟榔、茵陈、白鲜皮、麦门冬（去除心）、川大黄（锉碎，微炒，各一两）、陈橘皮（用汤浸泡，去除白色瓤，焙干）、枳壳（麸炒至微黄，去除瓤）、甘草（炙至微红，锉碎，各半两）。以上药物研为散剂。每次服用五钱，用水一大盏，加入生姜汁半分，煎煮至五分量，去渣滓。不分时候，温服。
前胡散（出自《圣惠方》），治疗时气病心下部痞塞胀满，胸膈部位气机不畅。
药材：前胡（去除芦头，一两）、赤芍药（一两）、木香（一两）、青橘皮（用汤浸泡，去除白色瓤，焙干，一两）、槟榔（一两）。以上药物研为散剂。每次服用五钱，用水一中盏，煎煮至六分量，去渣滓。不分时候，温服。
半夏散（出自《圣惠方》），治疗时气病在呕吐或攻下之后，或发汗之后，出现心下部痞塞胀满，气向上冲撞胸部，起身即感到头晕目眩，脉象沉而紧的情况。
药材：半夏（用汤浸泡七次，去除滑腻感，一两）、白术（一两）、甘草（炙至微红，锉碎，一两）、赤茯苓（一两）、桂心（一两）、人参（去除芦头，一两）、诃黎勒（只用皮，一两）、前胡（去除芦头，一两）。以上药物研为散剂。每次服用五钱，用水一中盏，加入生姜半分，大枣三枚，煎煮至六分量，去渣滓。不分时候，温服。
前胡散（出自《圣惠方》），治疗时气病心腹部痞塞胀满，身体疼痛，烦热，恶心呕吐。
药材：前胡（去除芦头）、半夏（用汤浸泡七次，去除滑腻感）、枳壳（麸炒至微黄，去除瓤）、黄芩、人参（去除芦头）、桔梗（去除芦头）、槟榔（各一两）、赤芍药（五钱）、甘草（炙至微红，锉碎，半两）。以上药物研为散剂。每次服用五钱，用水一中盏，加入生姜半分，大枣三枚，煎煮至五分量，去渣滓。不分时候，温服。
陈橘皮汤（出自《圣惠方》），治疗时气病已经经过发汗和攻下治疗后，脾胃气虚，心下部痞塞胀满，腹中肠鸣如雷。
药材：陈橘皮（三两，用汤浸泡，去除白色瓤，焙干）、人参（半两，去除芦头）、甘草（炙至微红，锉碎，一两）、干姜（炮制，锉碎，一两）、赤茯苓（一两）、桔梗（去除芦头，一两）、半夏（用汤清洗七次，去除滑腻感，一两）、白术（一两）、木香（一两）。以上药物研为散剂。每次服用五钱，用水一中盏，煎煮至六分量，去渣滓。不分时候，温服。
桔梗散（出自《圣惠方》），治疗时气病心腹部痞塞胀满，气喘，痰涎不断。
药材：桔梗（去除芦头，三分）、半夏（用汤清洗七次，去除滑腻感，三分）、赤芍药（三分）、前胡（一两，去除芦头）、旋复花（五钱）、大腹皮（半两，锉碎）、枳壳（麸炒至微黄，去除瓤，半两）、赤茯苓（五钱）、甘草（炙至微红，锉碎，五钱）。以上药物研为散剂。每次服用四钱，用水一中盏，加入生姜半分，煎煮至五分量，去渣滓。不分时候，温服。
赤茯苓散（出自《圣惠方》），治疗时气病气机壅盛上冲，心腹部痞塞胀满，坐卧不安。
药材：赤茯苓（三分）、赤芍药（三分）、紫苏茎叶（三分）、枳壳（麸炒至微黄，去除瓤，五钱）、大腹皮（半两，锉碎）、甘草（炙至微红，锉碎，半两）、百合（一两）、郁李仁（用汤浸泡，去除皮尖，微炒，一两）。以上药物研为散剂。每次服用四钱，用水一中盏，煎煮至六分量，去渣滓。不分时候，温服。
治疗时气病因饮水过多，水饮停聚于心下部导致痞塞胀满。（出自《圣惠方》）
药材：川大黄（锉碎，微炒）、川朴硝（各一两）、甘遂（一钱，煨至金黄色）。以上药物研为散剂。每次服用不分时候，温服。调服一钱，以见效为度。
治疗时气病因饮水过多，心下部痞塞坚硬且疼痛。（出自《圣惠方》）
用法：取芫花半斤，用醋拌匀，用慢火炒热，用布包裹后熨烫患处。变冷后再重新炒热，以见效为度。
(Attached Discussion)
In the context of seasonal qi diseases, when the Taiyang (Greater Yang) and Shaoyang (Lesser Yang) meridians are simultaneously affected, the pulse is floating and tight. If the pathogen instead penetrates inward, it results in a "Pi" syndrome (a sensation of fullness and obstruction in the epigastrium). Pi syndrome refers to fullness in the region below the heart. When a disease originates from Yin patterns, purgation (downward-draining methods) must not be used.
If purgation is mistakenly applied, it leads to epigastric Pi, which feels soft upon palpation; this is merely Qi stagnation forming Pi, so downward-draining methods should not be repeated. If heat-toxin qi attacks the Heart, causing epigastric Pi and fullness, a red face, yellow eyes, delirious speech, and mental confusion, this constitutes an Excess pattern. It is appropriate to employ emetic or purgative treatments.
Formulas
Biejia San (Turtle Shell Powder) [from *Shenghui Fang*]: Treats seasonal qi diseases where heat-toxin persists, accompanied by constipation with dryness, epigastric and abdominal Pi and fullness, inability to ingest food, mental confusion, delirium, and a flooding and rapid pulse.
Ingredients: Bie Jia (Testudinis Carapax et Plastrum, coated with vinegar and roasted until yellow, remove skirt), Chi Fuling (Polyporus), Jiegeng (Platycodonis Radix, remove radicle), Renshen (Ginseng Radix, remove radicle), Binglang (Arecae Semen), Yichen (Artemisiae Scopariae Herba), Baixianpi (Dictamni Cortex), Maimendong (Ophiopogonis Radix, remove heart), Chuan Dahuang (Rhei Radix et Rhizoma, sliced and slightly stir-fried, 1 liang each), Chen Jupi (Citri Reticulatae Pericarpium, soaked in water, remove white pith, dried), Zhike (Aurantii Fructus Immaturus, bran-fried until slightly yellow, remove pith), Gancao (Glycyrrhizae Radix et Rhizoma, roasted until slightly red and sliced, 0.5 liang each). Grind all ingredients into powder. Take 5 qian per dose. Add 1 large cup of water and 0.5 fen of fresh ginger juice. Decoct until 0.5 cup remains. Strain. Take warm at any time.
Qianhu San (Peucedani Radix Powder) [from *Shenghui Fang*]: Treats seasonal qi diseases with epigastric Pi and fullness and discomfort in the chest and diaphragm.
Ingredients: Qianhu (Peucedani Radix, remove radicle, 1 liang), Chi Shaoyao (Paeoniae Radix Rubra, 1 liang), Muxiang (Aucklandiae Radix, 1 liang), Qing Jupi (Citri Reticulatae Pericarpium, soaked in water, remove white pith, dried, 1 liang), Binglang (Arecae Semen, 1 liang). Grind all ingredients into powder. Take 5 qian per dose. Add 1 medium cup of water. Decoct until 0.6 cup remains. Strain. Take warm at any time.
Banxia San (Pinelliae Rhizoma Powder) [from *Shenghui Fang*]: Treats seasonal qi diseases presenting with epigastric Pi and fullness, Qi rushing upward to the chest, dizziness upon rising, and a deep, tight pulse, occurring after vomiting, purgation, or sweating.
Ingredients: Banxia (Pinelliae Rhizoma, soaked in water seven times to remove slipperiness, 1 liang), Baizhu (Atractylodis Macrocephalae Rhizoma, 1 liang), Gancao (Glycyrrhizae Radix et Rhizoma, roasted until slightly red and sliced, 1 liang), Chi Fuling (Polyporus, 1 liang), Guixin (Cinnamomi Ramulus, 1 liang), Renshen (Ginseng Radix, remove radicle, 1 liang), Helile (Terminalia Chebulae Fructus, use peel only, 1 liang), Qianhu (Peucedani Radix, remove radicle, 1 liang). Grind all ingredients into powder. Take 5 qian per dose. Add 1 medium cup of water, 0.5 fen of fresh ginger, and 3 jujubes. Decoct until 0.6 cup remains. Strain. Take warm at any time.
Qianhu San (Peucedani Radix Powder) [from *Shenghui Fang*]: Treats seasonal qi diseases with epigastric and abdominal Pi and fullness, body pain, irritability and fever, nausea, and vomiting.
Ingredients: Qianhu (Peucedani Radix, remove radicle), Banxia (Pinelliae Rhizoma, soaked in water seven times to remove slipperiness), Zhike (Aurantii Fructus Immaturus, bran-fried until slightly yellow, remove pith), Huangqin (Scutellariae Radix), Renshen (Ginseng Radix, remove radicle), Jiegeng (Platycodonis Radix, remove radicle), Binglang (Arecae Semen, 1 liang each), Chi Shaoyao (Paeoniae Radix Rubra, 5 qian), Gancao (Glycyrrhizae Radix et Rhizoma, roasted until slightly red and sliced, 0.5 liang). Grind all ingredients into powder. Take 5 qian per dose. Add 1 medium cup of water, 0.5 fen of fresh ginger, and 3 jujubes. Decoct until 0.5 cup remains. Strain. Take warm at any time.
Chen Jupi Tang (Aged Tangerine Peel Decoction) [from *Shenghui Fang*]: Treats seasonal qi diseases after sweating and purgation, resulting in Spleen and Stomach Qi deficiency, epigastric Pi and fullness, and borborygmus (rumbling in the abdomen).
Ingredients: Chen Jupi (Citri Reticulatae Pericarpium, 3 liang, soaked in water, remove white pith, dried), Renshen (Ginseng Radix, 0.5 liang, remove radicle), Gancao (Glycyrrhizae Radix et Rhizoma, roasted until slightly red and sliced, 1 liang), Ganjiang (Zingiberis Rhizoma, processed and sliced, 1 liang), Chi Fuling (Polyporus, 1 liang), Jiegeng (Platycodonis Radix, remove radicle, 1 liang), Banxia (Pinelliae Rhizoma, washed in water seven times to remove slipperiness, 1 liang), Baizhu (Atractylodis Macrocephalae Rhizoma, 1 liang), Muxiang (Aucklandiae Radix, 1 liang). Grind all ingredients into powder. Take 5 qian per dose. Add 1 medium cup of water. Decoct until 0.6 cup remains. Strain. Take warm at any time.
Jiegeng San (Platycodonis Radix Powder) [from *Shenghui Fang*]: Treats seasonal qi diseases with epigastric and abdominal Pi and fullness, asthma, and incessant phlegm-saliva.
Ingredients: Jiegeng (Platycodonis Radix, remove radicle, 3 fen), Banxia (Pinelliae Rhizoma, washed in water seven times to remove slipperiness, 3 fen), Chi Shaoyao (Paeoniae Radix Rubra, 3 fen), Qianhu (Peucedani Radix, 1 liang, remove radicle), Xuanjinhua (Inulae Flos, 5 qian), Dafupi (Arecae Pericarpium, 0.5 liang, sliced), Zhike (Aurantii Fructus Immaturus, bran-fried until slightly yellow, remove pith, 0.5 liang), Chi Fuling (Polyporus, 5 qian), Gancao (Glycyrrhizae Radix et Rhizoma, roasted until slightly red and sliced, 5 qian). Grind all ingredients into powder. Take 4 qian per dose. Add 1 medium cup of water and 0.5 fen of fresh ginger. Decoct until 0.5 cup remains. Strain. Take warm at any time.
Chi Fuling San (Polyporus Powder) [from *Shenghui Fang*]: Treats seasonal qi diseases with Qi congestion rushing upward, epigastric and abdominal Pi and fullness, and restlessness in sitting and lying down.
Ingredients: Chi Fuling (Polyporus, 3 fen), Chi Shaoyao (Paeoniae Radix Rubra, 3 fen), Zisu Jingye (Perillae Caulis et Folium, 3 fen), Zhike (Aurantii Fructus Immaturus, bran-fried until slightly yellow, remove pith, 5 qian), Dafupi (Arecae Pericarpium, 0.5 liang, sliced), Gancao (Glycyrrhizae Radix et Rhizoma, roasted until slightly red and sliced, 0.5 liang), Baihe (Lilii Bulbus, 1 liang), Yuliren (Prunus Persicae Semen, soaked in water, remove skin and tip, slightly stir-fried, 1 liang). Grind all ingredients into powder. Take 4 qian per dose. Add 1 medium cup of water. Decoct until 0.6 cup remains. Strain. Take warm at any time.
Treatment for seasonal qi disease caused by excessive drinking of water, leading to water accumulation in the epigastrium causing Pi and fullness. [from *Shenghui Fang*]
Ingredients: Chuan Dahuang (Rhei Radix et Rhizoma, sliced and slightly stir-fried), Chuan Poxiao (Natrii Sulfas, 1 liang each), Gansui (Kansui Radix, 1 qian, roasted until golden yellow). Grind all ingredients into powder. Take warm at any time. Mix with water to take 1 qian per dose. Continue until effective.
Treatment for seasonal qi disease caused by excessive drinking of water, leading to hard, painful epigastric Pi. [from *Shenghui Fang*]
Method: Use 0.5 jin of Yuanhua (Genkwa Flos). Mix evenly with vinegar. Stir-fry over slow fire until hot. Wrap in cloth and apply as a compress. Reheat when cold. Continue until effective.
Treatment for Bi swelling caused by Warm Qi [from *Bencao*]
Method: Use Chixiaodou (Vigna Radiata Semen) and Sanggen Baipi (Mori Cortex). Boil and consume.