【胃寒呕吐之症】畏寒喜热,不思饮食,遇冷即呕,四肢清冷,二便清利,口不渴,唇
不焦,食久不化,吐出不臭,此胃寒呕吐之症也。
【胃寒呕吐之因】真阳不足,火不生土,脾胃素寒,不能运化水谷,反而上逆,此胃寒
【胃寒呕吐之脉】多见沉迟,两尺沉迟,真阳不足;左关沉迟,木不生火;右关沉迟,
【胃寒呕吐之治】肾阳不足,宜补接真火,八味肾气丸。木不生火,逍遥散。脾胃素寒
,理中汤,甚则四逆汤。
八味丸 即六味丸加肉桂、附子。
逍遥散 即肝咳门。
理中汤 见后食积呕。
四逆汤 见寒呕门。
【痰饮呕吐之症】呕而肠鸣,漉漉有声,眼黑眩晕,时时恶心,此痰饮呕吐之症也。
【痰饮呕吐之因】脾气不足,不能运化水谷,停痰留饮,积于中脘,得热则上炎而呕吐
,遇寒则凝塞而呕吐矣。
【痰饮呕吐之脉】脉多弦滑。滑数热痰,弦紧寒饮,痰凝饮伏,脉反沉迟。
【痰饮呕吐之治】宜分热痰寒饮治之。热痰脉沉数,栀连二陈汤;寒饮脉沉迟,桂苓半
栀连二陈汤 方见湿痰门。
桂苍苓甘汤 治寒饮呕吐。
桂枝 白茯苓 白术 甘草
【食积呕吐之症】胸前满闷,嗳气作痛,痛则呕吐,得食愈痛,按之亦痛,此食积呕吐
【食积呕吐之因】饮食不节,损伤中气,不能运化,停食成积,中脘痞塞,则发呕吐矣
【食积呕吐之脉】脉见实大,或见沉滑。热积实数,寒积迟弦;滑大洪实,食积胸前。
【食积呕吐之治】先用家秘消滞汤。后看热积,栀连平胃散;有下症者,三黄丸。寒积
,草蔻大顺饮、理中汤;应下者,煮黄丸。
家秘消滞汤 治食滞神效。
即平胃散加莱菔子、枳实、山楂、麦芽。
栀连平胃散 即平胃散加黄连、山栀。
栀连枳术丸 即枳术丸加山栀、黄连。
三黄丸
川黄连 黄芩 大黄
草蔻大顺饮
草蔻 炮姜 广皮 半夏 浓朴 甘草
理中汤
炮姜 白术 人参 炙甘草
煮黄丸
雄黄 巴霜
【胃寒呕吐的症状】怕冷喜欢温暖,不想吃东西,遇到寒冷就呕吐,四肢冰凉,大小便清稀通畅,口不渴,嘴唇不干裂,食物在胃中停留很久无法消化,吐出来的东西没有臭味,这就是胃寒呕吐的症状。
【胃寒呕吐的病因】真阳不足,命门之火不能温煦脾土,脾胃素来虚寒,不能运化水谷,反而气机上逆,导致呕吐。
【胃寒呕吐的脉象】多见沉迟脉。两尺部脉象沉迟,提示真阳不足;左关部脉象沉迟,提示肝木不生心火(或肾水不涵肝木致木郁);右关部脉象沉迟,提示脾胃虚寒。
【胃寒呕吐的治疗】若是肾阳不足,应当补接真火,使用八味肾气丸。若是肝木不生火,使用逍遥散。若是脾胃素来虚寒,使用理中汤;病情严重的,使用四逆汤。
八味丸 即六味地黄丸加上肉桂、附子。
逍遥散 见前文“肝咳”章节。
理中汤 见后文“食积呕吐”章节。
四逆汤 见前文“寒呕”章节。
【痰饮呕吐的症状】呕吐且肠鸣,漉漉有声,眼前发黑眩晕,时常感到恶心,这就是痰饮呕吐的症状。
【痰饮呕吐的病因】脾气不足,不能运化水谷,导致停痰留饮,积聚在中脘部位,遇到热邪则上炎而呕吐,遇到寒邪则凝塞阻滞而呕吐。
【痰饮呕吐的脉象】脉象多呈弦滑。滑数脉为热痰,弦紧脉为寒饮,若痰凝饮伏,脉象反而呈现沉迟。
【痰饮呕吐的治疗】应当区分热痰和寒饮进行治疗。热痰脉象沉数,使用栀连二陈汤;寒饮脉象沉迟,使用桂苓半……(原文此处截断,结合下文推测为桂苓半夏类方剂,但根据指令需忠实原文,故仅翻译可见部分及后续明确方剂)。
栀连二陈汤 方剂见“湿痰”章节。
桂苍苓甘汤 治疗寒饮呕吐。
组成:桂枝、白茯苓、白术、甘草。
【食积呕吐的症状】胸前满闷,打嗝并伴有疼痛,疼痛时发生呕吐,进食后疼痛加剧,按压胸部也疼痛,这就是食积呕吐的症状。
【食积呕吐的病因】饮食不节制,损伤了中气,导致不能运化,食物停滞形成积滞,中脘部位痞塞不通,从而引发呕吐。
【食积呕吐的脉象】脉象表现为实大,或者表现为沉滑。热性积滞脉象实数,寒性积滞脉象迟弦;滑大洪实的脉象,多见于食积于胸前的情况。
【食积呕吐的治疗】首先使用家秘消滞汤。之后根据是否为热积,选用栀连平胃散;如果有可下之症(里实证),使用三黄丸。若是寒积,使用草蔻大顺饮、理中汤;应当用下法的,使用煮黄丸。
[Symptoms of Stomach-Cold Vomiting] Aversion to cold and preference for warmth, lack of appetite, vomiting upon exposure to cold, cold limbs, clear and profuse urination and stool, no thirst, dry lips are not cracked, food remains undigested for a long time, and the vomitus has no foul odor. These are the symptoms of stomach-cold vomiting.
[Causes of Stomach-Cold Vomiting] Insufficiency of True Yang (Zhen Yang), failure of Fire to generate Earth, inherent coldness of the Spleen and Stomach, inability to transform and transport water and grain, leading to rebellious upward flow of Qi. This causes stomach-cold vomiting.
[Pulse of Stomach-Cold Vomiting] The pulse is mostly deep and slow (Chen Chi). Deep and slow pulse at both Chi positions indicates insufficiency of True Yang; deep and slow pulse at the left Guan position indicates Wood failing to generate Fire; deep and slow pulse at the right Guan position indicates inherent coldness of the Spleen and Stomach.
[Treatment of Stomach-Cold Vomiting] If Kidney Yang is insufficient, it is appropriate to supplement and connect the True Fire, using Ba Wei Shen Qi Wan (Eight-Ingredient Rehmannia Pill). If Wood fails to generate Fire, use Xiao Yao San (Free and Easy Wanderer Powder). If the Spleen and Stomach are inherently cold, use Li Zhong Tang (Regulate the Middle Decoction); in severe cases, use Si Ni Tang (Reverse the Cold Decoction).
Ba Wei Wan (Eight-Pill) is Liu Wei Di Huang Wan (Six-Ingredient Rehmannia Pill) plus Rou Gui (Cinnamon Bark) and Fu Zi (Prepared Aconite Root).
Xiao Yao San (Free and Easy Wanderer Powder) is described in the Liver Cough section.
Li Zhong Tang (Regulate the Middle Decoction) is seen in the Food Stagnation Vomiting section.
Si Ni Tang (Reverse the Cold Decoction) is seen in the Cold Vomiting section.
[Symptoms of Phlegm-Fluid Vomiting] Vomiting accompanied by borborygmus (rumbling sounds in the intestines), dizziness with visual obscurity, and frequent nausea. These are the symptoms of phlegm-fluid vomiting.
[Causes of Phlegm-Fluid Vomiting] Insufficiency of Spleen Qi, inability to transform and transport water and grain, leading to retained phlegm and fluids accumulating in the Zhongwan area. Upon encountering heat, they flare upward causing vomiting; upon encountering cold, they coagulate and obstruct causing vomiting.
[Pulse of Phlegm-Fluid Vomiting] The pulse is mostly wiry and slippery (Xian Hua). Slippery and rapid pulse indicates hot phlegm; wiry and tight pulse indicates cold fluid. When phlegm congeals and fluids hide, the pulse may paradoxically appear deep and slow.
[Treatment of Phlegm-Fluid Vomiting] Treatment should distinguish between hot phlegm and cold fluids. For hot phlegm with a deep and rapid pulse, use Zhi Lian Er Chen Tang (Gardenia and Coptis Two-Chen Decoction); for cold fluids with a deep and slow pulse, use Gui Ling Ban... [Text cuts off here, referring to subsequent formulas].
Zhi Lian Er Chen Tang (Gardenia and Coptis Two-Chen Decoction): Formula see Wet Phlegm section.
Gui Cang Ling Gan Tang (Cinnamon, Amomum, Poria, Licorice Decoction): Treats cold fluid vomiting.
Ingredients: Gui Zhi (Cinnamon Twig), Bai Fu Ling (White Poria), Bai Zhu (Atractylodes Macrocephala Rhizome), Gan Cao (Licorice Root).
[Symptoms of Food-Stagnation Vomiting] Fullness and oppression in the chest, belching with pain, vomiting when pain occurs, pain worsening after eating, and tenderness on palpation. These are the symptoms of food-stagnation vomiting.
[Causes of Food-Stagnation Vomiting] Irregular diet damages Middle Qi, leading to inability to transform and transport, resulting in retained food forming stagnation. Obstruction in the Zhongwan area triggers vomiting.
[Pulse of Food-Stagnation Vomiting] The pulse appears excess and large, or deep and slippery. Heat stagnation presents with an excess and rapid pulse; cold stagnation presents with a slow and wiry pulse. Slippery, large, surging, and excess pulses indicate food stagnation in the chest.
[Treatment of Food-Stagnation Vomiting] First use Jia Mi Xiao Zhi Tang (Secret Home-Made Stagnation-Resolving Decoction). Subsequently, if there is heat stagnation, use Zhi Lian Ping Wei San (Gardenia and Coptis Peace the Stomach Powder); if there are indications for purgation, use San Huang Wan (Three-Yellow Pill). If there is cold stagnation, use Cao Kou Da Shun Yin (Amomum Great Smooth Decoction) or Li Zhong Tang (Regulate the Middle Decoction); if purgation is indicated, use Zhu Huang Wan (Boiled Yellow Pill).
Jia Mi Xiao Zhi Tang (Secret Home-Made Stagnation-Resolving Decoction): Highly effective for food stagnation.
It is Ping Wei San (Peace the Stomach Powder) plus Lai Fu Zi (Radish Seed), Zhi Shi (Immature Bitter Orange), Shan Zha (Hawthorn Fruit), and Mai Ya (Malt).
Zhi Lian Ping Wei San (Gardenia and Coptis Peace the Stomach Powder): It is Ping Wei San (Peace the Stomach Powder) plus Huang Lian (Coptis Rhizome) and Shan Zhi (Gardenia Fruit).
Zhi Lian Zhi Zhu Wan (Gardenia and Coptis Immature Bitter Orange and Atractylodes Pill): It is Zhi Zhu Wan (Immature Bitter Orange and Atractylodes Pill) plus Shan Zhi (Gardenia Fruit) and Huang Lian (Coptis Rhizome).
San Huang Wan (Three-Yellow Pill)
Ingredients: Chuan Huang Lian (Sichuan Coptis Rhizome), Huang Qin (Scutellaria Root), Da Huang (Rhubarb Root).
Cao Kou Da Shun Yin (Amomum Great Smooth Decoction)
Ingredients: Cao Kou (Amomum Cardamom), Pao Jiang (Roasted Ginger), Guang Pi (Tangerine Peel), Ban Xia (Pinellia Tuber), Nong Po (Magnolia Bark), Gan Cao (Licorice Root).
Li Zhong Tang (Regulate the Middle Decoction)
Ingredients: Pao Jiang (Roasted Ginger), Bai Zhu (Atractylodes Macrocephala Rhizome), Ren Shen (Ginseng Root), Zhi Gan Cao (Honey-fried Licorice Root).
Zhu Huang Wan (Boiled Yellow Pill)
Ingredients: Xiong Huang (Realgar), Ba Shuang (Croton Seed Resin).