宝鉴枳实理中丸治中脘痞滞气不宣通积寒停饮食不化
人参 干姜(炮) 白术 枳实 甘草(炙各一两)
上为细末炼蜜为丸如鸡子黄大每服一丸细嚼白汤下或沸汤化服活人有茯苓
深师消饮丸治停饮心下痞
方见痰饮门
按以上二方并出阳明饮痞例
活人桔梗枳壳汤治伤寒痞气胸满欲纯
桔梗 枳壳(去穣炒各三两)
上锉水二盏煎至一盏去滓分作二服
按此手太阴经药也出少阴枳壳例活人云审知是痞先用汤尤妙绿枳桔行气下膈先用之无不
验也
海藏云活人用此非治痞也审知错下必成痞是气将陷于胸中故先用此便不至于痞也若已成痞而
用则失之晚胸中之气反痞矣先之一字预早之意也先用此若不应后当以仲景痞药治之若执此治
痞其害深矣
宣明槟榔散治伤寒阴证下后成痞满而不痛按之软虚
槟榔 枳壳(等分)
上为末每服三钱煎黄连汤调下
宝鉴三脘痞气丸治三焦痞滞水饮停积胁下虚满
木香 白豆蔻 青皮(炒) 京三棱(炮各一两) 槟榔(半两) 半夏(汤洗七次)
大腹子 陈皮(各二两) 砂仁 沉香(各半两)
上为末面糊为丸桐子大每服三十丸加至六十丸食后陈皮汤下
按此出太阴调气例药也
秘藏木香消痞丸治因忧气结中脘腹皮浓微痛心下痞满不思饮食
木香(半两) 柴胡(四钱) 橘皮(三钱) 甘草(炙) 半夏(各一两) 干姜(半两) 当归
尾(一钱) 红花(半钱)
上为细末水浸蒸饼丸服之
《宝鉴》枳实理中丸：治疗中脘部痞塞阻滞，气机不能宣通，积寒停留，饮食不消化。
人参、干姜（炮制）、白术、枳实、甘草（炙，各一两）。
以上药物研为细末，用炼蜜制成如鸡子黄大小的丸剂。每次服用一丸，细细咀嚼后以白开水送服；或者用沸水化开服用。《活人书》中还有加入茯苓的用法。
《深师方》消饮丸：治疗停饮导致的心下痞满。
方剂见“痰饮”章节。
按语：以上两个方剂都出自阳明经饮邪致痞的例子。
《活人书》桔梗枳壳汤：治疗伤寒导致的痞气，胸部胀满欲绝。
桔梗、枳壳（去瓤炒，各三两）。
以上药物切碎，用水两盏煎煮至一盏，去渣，分两次服用。
按语：这是手太阴肺经的药物，出自少阴经枳壳的用法。《活人书》说：确知是痞证，先用汤剂尤为巧妙。因为枳壳和桔梗能行气下行于膈膜，先用此方没有不验证有效的。
海藏（张元素）说：《活人书》使用此方并非治疗已成之痞，而是确认误下之后必然形成痞证，此时气机即将陷入胸中，所以先用此方使其不至于形成痞证。如果已经形成痞证再用此方，就失之过晚，胸中之气反而更加痞塞了。“先”字的意思是预防、提早。先用此方若无效，随后应当用张仲景治疗痞证的药物。如果固执地用此方治疗已成的痞证，危害很深。
《宣明论方》槟榔散：治疗伤寒阴证，攻下之后形成痞满但不疼痛，按压时感觉柔软空虚。
槟榔、枳壳（等分）。
以上药物研为粉末，每次服用三钱，用黄连汤调服。
《宝鉴》三脘痞气丸：治疗三焦气机痞滞，水饮停积，胁下虚满。
木香、白豆蔻、青皮（炒）、京三棱（炮制，各一两）、槟榔（半两）、半夏（汤洗七次）、大腹子、陈皮（各二两）、砂仁、沉香（各半两）。
以上药物研为粉末，用面糊制成如梧桐子大小的丸剂。每次服用三十丸，加量至六十丸，饭后用陈皮汤送服。
按语：此方出自太阴经调气的例子。
《秘藏》木香消痞丸：治疗因忧思导致气结于中脘，腹部皮肤紧绷微痛，心下痞满，不思饮食。
木香（半两）、柴胡（四钱）、橘皮（三钱）、甘草（炙）、半夏（各一两）、干姜（半两）、当归尾（一钱）、红花（半钱）。
以上药物研为细末，用水浸泡蒸饼制成丸剂服用。
*Jian* (Precious Mirror) Zhishi Lizhong Wan: Treats epigastric fullness and obstruction with qi stagnation, accumulation of cold pathogen, and indigestion.
Ren Shen (Ginseng Radix), Gan Jiang (Zingiberis Rhizoma Preparatum), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Zhi Shi (Aurantii Fructus Immaturus), Gan Cao (Liquorice Root Preparatum) [each 1 liang].
Grind the above herbs into a fine powder, mix with refined honey to form pills the size of a chicken egg yolk. Take one pill per dose, chew thoroughly, and swallow with warm water; alternatively, dissolve in boiling water. The *Huo Ren Shu* (Book of Vitality) includes the addition of Fu Ling (Poria).
*Shen Shi Fang* (Deep Master's Formulas) Xiaoyin Wan: Treats subcardiac fullness due to retained fluid.
See the "Tan Yin" (Phlegm-Fluid) section for the formula.
Note: Both of the above formulas are examples of Yangming channel fluid retention causing fullness.
*Huo Ren Shu* (Book of Vitality) Jiegeng Zhike Tang: Treats Taiyang disease complicated by Qi stagnation, chest fullness, and impending suffocation.
Jie Geng (Platycodon Root), Zhi Ke (Aurantii Fructus Preparatum, pith removed and stir-fried) [each 3 liang].
Cut the above herbs decoct in two cups of water until reduced to one cup, strain, and divide into two doses.
Note: These are herbs of the Hand-Taiyin Lung channel, derived from Shaoyin channel Zhi Ke usage. The *Huo Ren Shu* states: If it is confirmed as Pi syndrome (fullness), using this decoction first is particularly excellent. Because Zhi Ke and Jie Geng move Qi downward through the diaphragm, using them first proves effective without exception.
Haizang (Zhang Yuansu) said: The *Huo Ren Shu* uses this not to treat established Pi syndrome, but to address cases where mistaken purgation inevitably leads to Pi. At this stage, Qi is about to sink into the chest; using this formula beforehand prevents Pi formation. If used after Pi has already formed, it is too late, and the Qi in the chest will become further obstructed. The character "Xian" (first/early) implies prevention. Use this first; if ineffective, subsequently use Zhang Zhongjing's formulas for Pi. Adhering rigidly to this formula for treating established Pi causes deep harm.
*Xuan Ming Lun Fang* (Treatise on the Manifestations of Illness) Binglang San: Treats Yin syndrome Taiyang disease where Pi-fullness arises after purgation, characterized by non-painful distension and softness upon palpation.
Bing Lang (Areca Seed), Zhi Ke (Aurantii Fructus Preparatum) [equal parts].
Grind the above herbs into powder. Take 3 qian per dose, mixed with Huang Lian Tang (Coptis Decoction).
*Jian* (Precious Mirror) Sanwan Piqi Wan: Treats Sanjiao (Triple Burner) Qi stagnation, retained fluid accumulation, and hypochondriac vacuous fullness.
Mu Xiang (Aucklandiae Radix), Bai Dou Kou (Amomi Fructus Rotundus), Qing Pi (Citri Reticulatae Pericarpium Viride Preparatum), Jing San Leng (Curcumae Radix Preparatum) [each 1 liang], Bing Lang (Areca Seed) [0.5 liang], Ban Xia (Pinelliae Tuber Prepared by Ginger Juice) [washed seven times in hot water], Da Fu Zi (Arecae Pericarpium), Chen Pi (Citri Reticulatae Pericarpium) [each 2 liang], Sha Ren (Amomi Fructus), Chen Xiang (Aquilariae Lignum Resinatum) [each 0.5 liang].
Grind the above herbs into powder, bind with flour paste to form pills the size of Sophora seeds. Take 30 pills per dose, increasing to 60 pills, taken after meals with Chen Pi Tang (Tangerine Peel Decoction).
Note: This formula belongs to the category of regulating Qi in the Taiyin channel.
*Mi Zang* (Secret Repository) Muxiang Xiaopi Wan: Treats epigastric Qi knotting due to worry, tight abdominal skin with slight pain, subcardiac fullness, and loss of appetite.
Mu Xiang (Aucklandiae Radix) [0.5 liang], Chai Hu (Bupleuri Radix) [4 qian], Ju Pi (Citri Reticulatae Pericarpium) [3 qian], Gan Cao (Liquorice Root Preparatum), Ban Xia (Pinelliae Tuber Prepared by Ginger Juice) [each 1 liang], Gan Jiang (Zingiberis Rhizoma Preparatum) [0.5 liang], Dang Gui Wei (Angelica Sinensis Radix Tail) [1 qian], Hong Hua (Carthami Flos) [0.5 qian].
Grind the above herbs into a fine powder, moisten with water, steam steamed bread dough, and form pills.