《四十九难》曰∶饮食劳倦则伤脾。又云∶饮食自倍,肠胃乃伤。肠 为痔。夫脾
者,行胃津液,磨胃中之谷,主五味也。胃既伤,则饮食不化,口不知味,四肢倦困,心腹
痞满,兀兀欲吐而恶食,或为飧泄,或为肠 ,此胃伤脾亦伤明矣。大抵伤饮伤食,其
治不同。伤饮者,无形之气也。宜发汗,利小便,以导其湿。伤食者,有形之物也。轻则消
化,或损其谷,此最为妙也,重则方可吐下。今立数方,区分类析,以列于后。
治烦渴饮水过多,或水入即吐,心中淡淡,停湿在内,小便不利。
桂(一两) 茯苓 猪苓 白术(以上各一两五钱) 泽泻(二两五钱)
上为细末。每服二钱,热汤调服,不拘时候,服讫,多饮热汤,有汗出即愈。如瘀热在里
,身发黄胆,浓煎茵陈汤调下,食前服之。如疸发渴,及中暑引饮,亦可用水调服。
夫酒者,大热有毒,气味俱阳,乃无形之物也。若伤之,止当发散,汗出则愈矣;其次
莫如利小便,二者乃上下分消其湿。今之酒病者,往往服酒症丸,大热之药下之,又有
用牵牛、大黄下之者,是无形元气受病,反下有形阴血,乖误甚矣!酒性大热,以伤元气,
而复重泻之,况亦损肾水,真阴及有形阴血俱为不足,如此则阴血愈虚,真水愈弱,阳毒之
热大旺,反增其阴火,是以元气消耗折人长命;不然,则虚损之病成矣。酒疸
下之,久久为黑疸。慎不可犯。以葛花解酲汤主之。
《难经·四十九难》说:饮食不节和劳倦过度会损伤脾脏。又说:饮食过量一倍,肠胃就会受到损伤。肠部病变可形成痔疮。脾的功能是传输胃中的津液,研磨胃中的谷物,主管对五味(酸、苦、甘、辛、咸)的感受。如果胃受伤了,就会导致饮食无法消化,口中不知滋味,四肢疲倦困乏,心腹部痞塞胀满,恶心欲吐且厌恶食物,或者发生完谷不化的泄泻(飧泄),或者发生肠澼(痢疾或肠道出血性疾病),这显然是胃受伤导致脾也受伤的明证。大抵来说,伤于饮酒和伤于饮食,治疗方法不同。伤于饮酒,属于无形之气的病变。适宜采用发汗、利小便的方法,以引导湿气排出。伤于饮食,属于有形实物的停滞。轻微时可采用消食化积的方法,或者通过损耗谷物来减轻负担,这是最好的方法;严重时才可以采用催吐或泻下的方法。现在列出几个方剂,分类解析,列在后面。
治疗因烦渴饮水过多,或者水喝进去就吐出来,心中悸动不安,体内停聚湿气,小便不通利的症状。
桂枝(一两) 茯苓 猪苓 白术(以上各一两五钱) 泽泻(二两五钱)
将上述药物研成细末。每次服用二钱,用热开水调服,不限时间,服药后,多喝热开水,如果有汗出则病愈。如果瘀热郁结在体内,身体发黄出现黄疸,可用浓煎的茵陈蒿汤调下药末,饭前服用。如果黄疸发作伴口渴,以及中暑引致大量饮水,也可以用水调服。
酒这种物质,性质大热且有毒,气味都属于阳,属于无形的物质。如果饮酒过量受伤,只应当采用发散的方法,出汗后病就好了;其次不如利小便,这两种方法是从上、下两个途径分消湿气。现在的酒病患者,往往服用治酒症的丸药,用大热的药物来攻下,又有使用牵牛子、大黄来攻下的,这是无形元气受了病,反而用攻下法损伤有形的阴血,错误非常严重!酒的性质大热,会损伤元气,如果再重重地泻下,况且也会损伤肾水,真阴和有形的阴血都会变得不足,这样阴血更加虚弱,真水更加衰弱,阳毒的热势大旺,反而增加了阴火,因此元气消耗折损人的寿命;不然的话,就会形成虚损的病证。酒疸如果用攻下法治疗,久而久之会变成黑疸。千万不可犯此禁忌。以葛花解酲汤为主治方剂。
The *Nan Jing* (Classic of Difficult Issues), Chapter 49, states: Improper diet and fatigue injure the Spleen. It also says: If food and drink intake doubles, the Intestines and Stomach are injured. Lesions in the Intestines can lead to hemorrhoids. The Spleen's function is to transport the fluids of the Stomach, grind the grains within the Stomach, and govern the perception of the Five Flavors (sour, bitter, sweet, pungent, salty). If the Stomach is injured, it leads to the inability to digest food, loss of taste in the mouth, fatigue and heaviness in the four limbs, fullness and stuffiness in the heart and abdomen, nausea with a desire to vomit and aversion to food, or it may result in undigested stool diarrhea (Sun Xie) or intestinal dysentery/bleeding (Chang Pi); this clearly indicates that injury to the Stomach leads to injury to the Spleen. Generally speaking, the treatment for injury from alcohol differs from that for injury from food. Injury from alcohol involves the pathology of formless Qi. It is appropriate to use methods such as inducing sweating and promoting urination to guide out the dampness. Injury from food involves the stagnation of tangible matter. In mild cases, digestion-promoting methods should be used, or the grain burden should be reduced; this is the best approach. In severe cases, emesis or purgation may be employed. Several formulas are now established, categorized and analyzed, and listed below.
For treating excessive drinking due to irritability and thirst, or vomiting immediately after drinking water, palpitations in the chest, internal retention of dampness, and difficult urination:
Guizhi Tang (Cinnamon Twig Decoction) components: Guizhi (Cinnamomi Ramulus, 1 liang), Fuling (Poria, 1.5 liang), Zhuling (Polyporus, 1.5 liang), Baizhu (Atractylodis Macrocephalae Rhizoma, 1.5 liang), Zexie (Alismatis Rhizoma, 2.5 liang).
Grind the above herbs into a fine powder. Take 2 qian per dose, mixed with hot water, at any time. After taking the medicine, drink plenty of hot water; if sweat occurs, the illness will resolve. If stasis-heat is retained internally, causing jaundice with yellowing of the body, mix the powder with strong decoction of Yinchen Hao Tang (Artemisiae Scopariae Decoction) and take it before meals. If jaundice occurs with thirst, or due to heatstroke leading to excessive drinking, it can also be taken mixed with water.
Wine is characterized by great heat and toxicity; its aroma and flavor are purely Yang, making it a formless substance. If injured by it, one should only use dispersing methods; recovery occurs when sweat is produced. Alternatively, promoting urination is effective; these two methods eliminate dampness from the upper and lower pathways respectively. Currently, patients suffering from wine-related illnesses often take pills for wine intoxication, using strongly heating drugs to purge, or use Qian Niu Zi (Pharbitidis Semen) and Dahuang (Rhei Radix et Rhizoma) to purge. This is a grave error: the formless Yuan Qi (Original Qi) is diseased, yet the tangible Yin blood is harmed by purgation! Wine's nature is greatly heating and damages Yuan Qi; additionally, heavy purging further damages Kidney Water (Jin Ye/Yin fluid of the Kidneys), causing deficiency in both True Yin and tangible Yin blood. Consequently, Yin blood becomes more deficient, True Water becomes weaker, Yang-toxic heat flares up, and Yin Fire increases. Thus, Yuan Qi is depleted, shortening life expectancy; otherwise, consumptive diseases develop. If Jiu Dan (Wine Jaundice) is treated with purgation, it eventually turns into Hei Dan (Black Jaundice). This must strictly be avoided. Ge Hua Jie Ying Tang (Kadsura Flower Decoction to Relieve Intoxication) is the primary formula.