(足阳明属腑)
胃属中土。司受化谷食。经云。得谷者昌。失谷则亡。其能受与否。生死系焉。其性与脾同。而畏
木侮。舌之中及牙床并环唇口而交人中。皆其分野。色现黄。
胃为阳明。有经有腑。故有表症。右关脉必浮。伤寒邪入阳明经。其症为目痛鼻干唇焦。嗽水
不欲咽。若他表症。为面浮肿而痛。为 疹。
目痛鼻干唇焦者。邪热作火也。葛根汤主之。面浮肿而痛者。风也。葛根汤主之。 疹者。邪热所化
也。葛根汤加牛蒡子主之。
胃之虚。其唇必白。脉右关必软弱。其症为吐。为噎膈。为不能食。为胃脘痛。为停滞。为湿肿。为
痰。为嘈杂。
吐者。土虚木侮也。香砂六君子汤加柴胡主之。噎膈者。胃脘干槁也。上脘槁。能饮水而食难进。下脘
槁。食可入而久复出。启膈散主之。佐以四君子汤。有郁则逍遥散。不能食者。胃气虚而难受也。六君
子汤主之。胃脘痛者。心悸怔忡喜按。归脾汤或四君子加柴胡、木香。停滞者。土虚不化也。枳术丸
主之。湿肿者。土不胜湿也。香砂六君子汤主之。痰者。土衰湿化也。六君子汤主之。嘈杂者。躁扰
不宁。得食暂已。气促食少。中虚挟痰也。五味异功散主之。
胃之实。脉右关必洪。按胸则痛。其症为结胸。为痞气。为食积。为痰饮。为水肿。为胸胀闷。为胸
胀痛。为胸痛呕脓。为不得卧。为便闭谵语发狂。
结胸者。伤寒下早。邪热结聚也。大小陷胸汤主之。痞气者。脾之积。在胃脘。腹大如盘。和中丸加浓朴
主之。食积者。胀痛拒按也。保和丸主之。痰饮者。咳则痛。转侧有声。小半夏加茯苓汤主之。外台茯
苓饮尤效。水肿者。先肿后喘。或肿而不喘。胃经蓄水也。五皮饮主之。甚则金匮肾气丸。胸胀闷者。
积滞也。保和丸主之。胸胀痛者。蓄血也。泽兰汤主之。胸痛呕脓者。胃脘痈也。不必治而自愈。不
得卧者。胃不和则卧不安也。二陈汤加砂仁主之。便闭谵语发狂者。胃有燥矢也。大承气汤主之。
胃之寒。唇舌必白。脉右关必沉迟。其症为胃脘痛。为呕吐。为霍乱。为吞酸嗳腐。
胃脘痛者。肢冷气冷。绵绵不休。姜附汤加肉桂主之。如吐蛔。加川椒、乌梅、川连、焦术、川楝。呕吐者。食
入复出也。平胃散加煨姜、砂仁主之。霍乱者。寒湿伤胃也。和胃饮主之。吞酸嗳腐者。寒不消食也。
香砂二陈汤主之。
胃之热。唇舌红口臭。脉右关必洪数。其症为三消。为嘈杂。为吐血。为齿痛。为黄胖面肿。为自
汗。为舌黑燥渴。为 疹。为便闭。为呃逆。为头痛。
三消者。燥热结聚也。口渴消水为上消。二冬汤主之。消谷易饥为中消。生地八物汤主之。口渴小便如
膏为下消。六味地黄汤加生脉散主之。嘈杂者。烦扰不宁。口燥唇焦。痰火为患也。二陈汤加山栀、黄
连主之。吐血者。胃火迫血妄行也。白虎汤主之。齿痛者。阳明有余。少阴不足也。玉女煎主之。黄
胖面肿者。湿热也。和中丸主之。自汗者。热而蒸溽也。抽薪饮主之。舌黑燥渴者。胃火炽甚也。白虎
汤主之。发 疹者。火郁而化也。初用葛根汤加牛蒡子以散之。次用犀角大青汤加石膏。或三黄解
毒汤。甚则白虎汤、调胃承气汤。呃逆不止者。胃火上冲也。安胃饮主之。头痛者。头筋扛起。胃火上
冲也。加味升麻汤主之。
(足阳明胃经属于腑)
胃属中土。主管受纳和消化谷物食物。医经说:得到谷气滋养则昌盛,失去谷气则衰亡。胃能否受纳食物,关乎生死。胃的生理特性与脾相同,但畏惧肝木的克制(木侮)。舌的中部、牙床以及环绕嘴唇口角并交于人中的部位,都是胃的对应分野(反映区域)。胃对应的面色呈现黄色。
胃为阳明经,既有经脉又有腑器,所以会有表证。右手关脉必然浮起。伤寒邪气侵入阳明经,症状表现为眼睛疼痛、鼻子干燥、嘴唇焦枯、想漱口喝水但不愿咽下。如果是其他表证,表现为面部浮肿且疼痛,或出现皮疹。
眼睛疼痛、鼻子干燥、嘴唇焦枯,是邪热化火所致。用葛根汤主治。面部浮肿且疼痛,是风邪所致。用葛根汤主治。皮疹,是邪热所化生。用葛根汤加牛蒡子主治。
胃虚时,嘴唇必然发白,右手关脉必然软弱无力。其症状表现为呕吐、噎膈、不能进食、胃脘痛、食滞停滞、湿肿、痰饮、嘈杂感。
呕吐,是脾土虚弱导致肝木乘侮。用香砂六君子汤加柴胡主治。噎膈,是胃脘干枯槁涩。上脘干枯,能喝水但食物难以下咽;下脘干枯,食物可进入但久后复出。用启膈散主治,配合四君子汤。若有郁结,用逍遥散。不能进食,是胃气虚弱难以承受食物。用六君子汤主治。胃脘痛,伴随心悸怔忡、喜欢按压。用归脾汤或四君子汤加柴胡、木香。食滞停滞,是脾土虚弱不能运化。用枳术丸主治。湿肿,是脾土不胜湿气。用香砂六君子汤主治。痰饮,是脾土衰弱湿气转化而成。用六君子汤主治。嘈杂感,是心中躁扰不宁,进食后暂时缓解,气短食少,是中虚夹杂痰饮。用五味异功散主治。
胃实(实证),右手关脉必然洪大有力,按压胸部则疼痛。其症状表现为结胸、痞气、食积、痰饮、水肿、胸腹胀闷、胸胀痛、胸痛呕脓、无法平卧、大便闭塞谵语发狂。
结胸,是伤寒过早使用泻下法,导致邪热结聚。用大陷胸汤或小陷胸汤主治。痞气,是脾之积,位于胃脘,腹部胀大如盘。用和中丸加厚朴主治。食积,表现为胀痛且拒绝按压。用保和丸主治。痰饮,咳嗽时疼痛,身体转动时有水声。用小半夏加茯苓汤主治,外台茯苓饮尤其有效。水肿,先出现浮肿后气喘,或者只肿不喘,是胃经蓄水。用五皮饮主治,严重时用金匮肾气丸。胸腹胀闷,是积滞所致。用保和丸主治。胸胀痛,是蓄血所致。用泽兰汤主治。胸痛呕脓,是胃脘痈疽。不必特殊治疗而能自愈。无法平卧,是因为“胃不和则卧不安”。用二陈汤加砂仁主治。大便闭塞、谵语、发狂,是胃中有燥屎。用大承气汤主治。
胃寒时,嘴唇和舌头必然发白,右手关脉必然沉迟。其症状表现为胃脘痛、呕吐、霍乱、吞酸嗳腐。
胃脘痛,四肢冷、气息冷,绵绵不断。用姜附汤加肉桂主治。如果吐蛔虫,加川椒、乌梅、黄连、炒白术、川楝子。呕吐,是食物吃进去又吐出来。用平胃散加煨姜、砂仁主治。霍乱,是寒湿损伤胃腑。用和胃饮主治。吞酸嗳腐,是寒气不能消化食物。用香砂二陈汤主治。
胃热时,嘴唇和舌头红,口臭,右手关脉必然洪数。其症状表现为三消、嘈杂、吐血、齿痛、黄胖面肿、自汗、舌黑燥渴、皮疹、大便闭塞、呃逆、头痛。
三消,是燥热结聚所致。口渴多饮为上消,用二冬汤主治。消谷善饥为中消,用地黄八物汤主治。口渴且小便如膏状为下消,用六味地黄汤加生脉散主治。嘈杂,是烦扰不宁,口燥唇焦,由痰火引起。用二陈汤加山栀、黄连主治。吐血,是胃火逼迫血液妄行。用白虎汤主治。齿痛,是阳明有余火,少阴不足。用玉女煎主治。黄胖面肿,是湿热所致。用和中丸主治。自汗,是热邪蒸腾湿润所致。用抽薪饮主治。舌黑燥渴,是胃火极盛。用白虎汤主治。发皮疹,是火郁结而化生。初起用葛根汤加牛蒡子以发散,随后用犀角大青汤加石膏,或用三黄解毒汤,严重时用白虎汤、调胃承气汤。呃逆不止,是胃火上冲。用安胃饮主治。头痛,是头部筋脉隆起,因胃火上冲所致。用加味升麻汤主治。
(Foot-Yangming Stomach Meridian belongs to the Fu organs)
The Stomach belongs to Central Earth. It is responsible for receiving and transforming grain and food. The Classics state: "Those who obtain grain thrive; those who lose grain perish." Whether the Stomach can receive food determines life or death. Its physiological nature is the same as the Spleen, but it fears overacting by Liver Wood (Wood insulting Earth). The middle of the tongue, the dental gums, and the area surrounding the lips and mouth intersecting at the philtrum are all its corresponding fields (reflective areas). The complexion associated with the Stomach appears yellow.
The Stomach is Yangming, possessing both a meridian and a fu organ, thus it can present exterior syndromes. The pulse at the right Guan position must be floating. When pathogenic factors from Cold Damage invade the Yangming meridian, symptoms include eye pain, nasal dryness, chapped lips, and a desire to rinse water in the mouth without swallowing. If other exterior syndromes occur, they manifest as facial edema and pain, or rashes.
Eye pain, nasal dryness, and chapped lips indicate pathogenic heat transforming into fire. Ge Gen Tang (Kudzu Root Decoction) is the primary formula. Facial edema and pain indicate wind pathogen. Ge Gen Tang (Kudzu Root Decoction) is the primary formula. Rashes are transformed from pathogenic heat. Ge Gen Tang (Kudzu Root Decoction) added with Niu Bang Zi (Arctii Fructus) is the primary formula.
In cases of Stomach deficiency, the lips will necessarily be white, and the pulse at the right Guan position will necessarily be weak and soft. Symptoms include vomiting, dysphagia (Yi Ge), inability to eat, epigastric pain, food stagnation, dampness-induced edema, phlegm, and gastric discomfort (Zao Re).
Vomiting results from Spleen Earth deficiency leading to Liver Wood overacting. Xiang Sha Liu Jun Zi Tang (Aucklandia and Amomum Six Gentlemen Decoction) added with Chai Hu (Bupleuri Radix) is the primary formula. Dysphagia (Yi Ge) refers to dryness and withering of the stomach cavity. If the upper cavity is withered, one can drink water but food is difficult to advance; if the lower cavity is withered, food enters but regurgitates after a long time. Qi Ge San (Open the Diaphragm Powder) is the primary formula, assisted by Si Jun Zi Tang (Four Gentlemen Decoction). If there is depression/stagnation, Xiao Yao San (Free and Easy Wanderer Powder) is used. Inability to eat indicates Stomach Qi deficiency unable to bear food. Liu Jun Zi Tang (Six Gentlemen Decoction) is the primary formula. Epigastric pain accompanied by palpitations and a preference for pressure is treated with Gui Pi Tang (Restore the Spleen Decoction) or Si Jun Zi Tang (Four Gentlemen Decoction) added with Chai Hu (Bupleuri Radix) and Mu Xiang (Aucklandiae Radix). Food stagnation occurs when Earth deficiency fails to transform. Zhi Zhu Wan (Immature Bitter Orange and Atractylodes Pill) is the primary formula. Dampness edema occurs when Earth cannot overcome dampness. Xiang Sha Liu Jun Zi Tang (Aucklandia and Amomum Six Gentlemen Decoction) is the primary formula. Phlegm arises when Earth declines and dampness transforms. Liu Jun Zi Tang (Six Gentlemen Decoction) is the primary formula. Gastric discomfort (Zao Re) involves restless agitation, temporarily relieved by eating, with shortness of breath and poor appetite, indicating Middle Deficiency with retained phlegm. Wu Wei Yi Gong San (Five-Ingredient Decoction Enhancing Function) is the primary formula.
In cases of Stomach excess (Excess Syndrome), the pulse at the right Guan position will necessarily be surging (Hong), and pressing the chest causes pain. Symptoms include Jie Xiong (Chest Binding), Pi Qi (Stagnant Qi), food accumulation, phlegm-fluid retention, edema, chest distension and oppression, chest distending pain, chest pain with vomiting of pus, inability to lie down, constipation with delirium and madness.
Jie Xiong (Chest Binding) results from premature purgation in Cold Damage, causing pathogenic heat to knot and gather. Da Xian Xiong Tang (Major Chest-Binding Decoction) or Xiao Xian Xiong Tang (Minor Chest-Binding Decoction) is the primary formula. Pi Qi (Stagnant Qi) is an accumulation of the Spleen located in the epigastrium, with the abdomen enlarged like a plate. He Zhong Wan (Harmonize the Center Pill) added with Hou Po (Magnoliae Officinalis Cortex) is the primary formula. Food accumulation presents with distending pain and rejection of pressure. Bao He Wan (Preserve Harmony Pill) is the primary formula. Phlegm-fluid retention causes pain upon coughing and sounds when turning the body. Xiao Ban Xia Jia Fu Ling Tang (Minor Pinellia Decoction Added with Poria) is the primary formula; Wai Tai Fu Ling Yin (External Repository Poria Drink) is particularly effective. Edema begins with swelling followed by asthma, or swelling without asthma, indicating water accumulation in the Stomach meridian. Wu Pi Yin (Five Peel Drink) is the primary formula; in severe cases, Jin Kui Shen Qi Wan (Golden Cabinet Kidney Qi Pill) is used. Chest distension and oppression result from stagnation. Bao He Wan (Preserve Harmony Pill) is the primary formula. Chest distending pain indicates blood stasis. Ze Lan Tang (Lycopus Decoction) is the primary formula. Chest pain with vomiting of pus indicates an abscess in the stomach cavity. It need not be treated specifically and will heal itself. Inability to lie down occurs because "when the Stomach is disharmonious, sleep is uneasy." Er Chen Tang (Two-Cured Decoction) added with Sha Ren (Amomi Fructus) is the primary formula. Constipation, delirium, and madness indicate dry fecal matter in the Stomach. Da Cheng Qi Tang (Major Order the Qi Decoction) is the primary formula.
In cases of Stomach Cold, the lips and tongue will necessarily be white, and the pulse at the right Guan position will necessarily be deep and slow. Symptoms include epigastric pain, vomiting, Huo Luan (Cholera-like disorder), acid regurgitation, and belching of rotten food.
Epigastric pain with cold limbs and cold breath, continuous and unceasing, is treated with Jiang Fu Tang (Ginger and Aconite Decoction) added with Rou Gui (Cinnamomi Cortex). If vomiting roundworms, add Chuan Jiao (Zanthoxyli Pericarpium), Wu Mei (Mume Fructus), Chuan Lian (Meliae Toosendan Fructus), Jiao Zhu (Fried Atractylodis Rhizoma), and Huang Lian (Coptidis Rhizoma). Vomiting, where food enters and returns, is treated with Ping Wei San (Calm the Stomach Powder) added with Wei Jiang (Prepared Ginger) and Sha Ren (Amomi Fructus). Huo Luan (Cholera-like disorder) results from Cold-Damp injuring the Stomach. He Wei Yin (Harmonize the Stomach Drink) is the primary formula. Acid regurgitation and belching of rotten food result from Cold failing to digest food. Xiang Sha Er Chen Tang (Aucklandia and Amomum Two-Cured Decoction) is the primary formula.
In cases of Stomach Heat, the lips and tongue are red, there is bad breath, and the pulse at the right Guan position is necessarily surging and rapid. Symptoms include San Xiao (Three Wasting-Thirst disorders), gastric discomfort, hematemesis, toothache, yellow puffy face and edema, spontaneous sweating, black dry tongue with thirst, rashes, constipation, hiccups, and headache.
San Xiao (Three Wasting-Thirst disorders) result from dryness-heat gathering. Excessive thirst and drinking water characterize Upper Xiao, treated with Er Dong Tang (Two Winter Melon Decoction). Consuming food easily and feeling hungry characterizes Middle Xiao, treated with Sheng Di Ba Wu Tang (Rehmannia Eight Ingredients Decoction). Thirst with urine resembling paste characterizes Lower Xiao, treated with Liu Wei Di Huang Tang (Six-Ingredient Rehmannia Pill) added with Sheng Mai San (Generate the Pulse Powder). Gastric discomfort involves restlessness, dry mouth and lips, caused by Phlegm-Fire. Er Chen Tang (Two-Cured Decoction) added with Shan Zhi (Gardeniae Fructus) and Huang Lian (Coptidis Rhizoma) is the primary formula. Hematemesis results from Stomach Fire forcing blood to move recklessly. Bai Hu Tang (White Tiger Decoction) is the primary formula. Toothache indicates excess in Yangming and insufficiency in Shaoyin. Yu Nu Jian (Jade Woman Decoction) is the primary formula. Yellow puffy face and edema indicate Damp-Heat. He Zhong Wan (Harmonize the Center Pill) is the primary formula. Spontaneous sweating results from heat steaming and moistening. Chou Xin Yin (Draw Down the Fire Drink) is the primary formula. Black dry tongue with thirst indicates extreme Stomach Fire. Bai Hu Tang (White Tiger Decoction) is the primary formula. Eruption of rashes results from constrained fire transforming. Initially, use Ge Gen Tang (Kudzu Root Decoction) added with Niu Bang Zi (Arctii Fructus) to disperse; subsequently, use Xi Jiao Da Qing Tang (Rhinoceros Horn and Isatis Decoction) added with Shi Gao (Gypsum Fibrosum), or San Huang Jie Du Tang (Three Yellows Detoxification Decoction). In severe cases, use Bai Hu Tang (White Tiger Decoction) or Tiao Wei Cheng Qi Tang (Regulate the Stomach Order the Qi Decoction). Unstopping hiccups indicate Stomach Fire rushing upward. An Wei Yin (Calms the Stomach Drink) is the primary formula. Headache with raised tendons in the head is due to Stomach Fire rushing upward. Jia Wei Sheng Ma Tang (Modified Cimicifuga Decoction) is the primary formula.