主治胸腹胀满也。旁治腹痛。
考 证
大承气汤证曰∶腹胀满。又曰∶腹中满痛。
浓朴三物汤证曰∶痛而闭。
浓朴七物汤证曰∶腹满。
浓朴生姜甘草半夏人参汤证曰∶腹胀满。
以上四方,浓朴皆半斤。
枳实薤白桂枝汤证曰∶胸满。
栀子浓朴汤证曰∶腹满。
以上二方,浓朴皆四两。
半夏浓朴汤证曰∶咽中如有炙脔。
以上一方,浓朴三两。
小承气汤证曰∶腹大满不通。
以上一方,浓朴二两。
上历观此诸方,浓朴主治胀满也明矣。
互 考
浓朴三物汤条,无腹满证。此汤即大承气汤,而无芒硝者也。然则有腹满证,也可知己。
其
辨 误
张元素曰∶浓朴虽除腹胀,若虚弱人,宜斟酌用之,误则脱人之元气也。为则曰∶是
无稽之言也。古语曰∶攻病以毒药,方疾之渐也,元气为其所抑遏,医以毒药攻之,毒尽而
气旺,何怖之有?请举其征。大承气汤,浓朴为君,而有此汤之证者,多有不能食、神气不
旺者,于是施以此汤,则毒除也。毒除能食,能食气旺,往往而然也。浓朴脱人之元气,徒
虚语耳!
品 考
浓朴 汉产为良。本邦所产,非真浓朴也,不堪用矣。或云本邦之产,有二种,其一
则冬月叶不落,是与汉土所产同,比睿山有之。
主治胸腹部胀满。兼治腹痛。
考证
大承气汤证表现为:腹部胀满。又说:腹中胀满疼痛。
浓朴三物汤证表现为:腹痛且大便闭塞不通。
浓朴七物汤证表现为:腹部胀满。
浓朴生姜甘草半夏人参汤证表现为:腹部胀满。
以上四方,浓朴的用量均为半斤。
枳实薤白桂枝汤证表现为:胸部胀满。
栀子浓朴汤证表现为:腹部胀满。
以上二方,浓朴的用量均为四两。
半夏浓朴汤证表现为:咽喉中有如烤肉块堵塞感。
以上一方,浓朴的用量为三两。
小承气汤证表现为:腹部显著胀满且大便不通。
以上一方,浓朴的用量为二两。
纵观上述各方,浓朴的主治功效在于消除胀满,这是很明确的。
互考
浓朴三物汤条文中,没有明确列出“腹满”这一症状。此汤即是去掉芒硝的大承气汤。然而既然有治疗腹满证的逻辑,那么此处也可由此推知。
辨误
张元素说:浓朴虽然能消除腹胀,但对于身体虚弱的人,应当斟酌使用,如果误用则会耗损人的元气。为则(注:指日本医家丹波元简或相关评论者,原文作“为则”,疑为人名或笔误,此处保留音译或直译)说:这是没有根据的话。古语说:用毒药攻治病邪,是疾病初起时的治法,元气被病邪抑制遏制,医生用毒药攻治病邪,待毒邪尽去而元气恢复旺盛,有什么可恐惧的呢?请举出证据。大承气汤以浓朴为君药,而有此汤适应证的患者,多伴有不能进食、精神气息不旺盛的情况,此时施用此汤,则毒邪得以清除。毒邪清除后能进食,能进食则元气旺盛,这种情况往往发生。浓朴会耗损人的元气,这纯属虚妄之语!
品考
浓朴以中国产者为优良。我国(日本)所产的,不是真正的浓朴,不堪药用。有人说我国所产的浓朴有两种,其中一种在冬季叶子不落,这与中国本土所产的相同,比睿山有出产。
Translation of the original text into modern vernacular Chinese has been completed in the previous step. Now translating that vernacular text into academic English based on WHO standards.
Main indications: Chest and abdominal distension and fullness. Secondary indications: Abdominal pain.
Textual Research (Zheng)
The syndrome pattern of Da Cheng Qi Tang (Major Order the Qi Decoction) presents with: abdominal distension and fullness. It also states: abdominal fullness and pain.
The syndrome pattern of Hou Po San Wu Tang (Magnolia Bark Three-Ingredient Decoction) presents with: pain accompanied by constipation (closure).
The syndrome pattern of Hou Po Qi Wu Tang (Magnolia Bark Seven-Ingredient Decoction) presents with: abdominal distension and fullness.
The syndrome pattern of Hou Po Sheng Jiang Gan Cao Ban Xia Ren Shen Tang (Magnolia Bark, Ginger, Licorice, Pinellia, and Ginseng Decoction) presents with: abdominal distension and fullness.
In these four formulas, the dosage of Hou Po (Magnolia Bark) is half a jin (approx. 250g or 16 liang depending on historical context, kept as 'half a jin' for fidelity).
The syndrome pattern of Zhi Shi Xie Bai Gui Zhi Tang (Immature Bitter Orange, Garlic, and Cinnamon Twig Decoction) presents with: chest fullness.
The syndrome pattern of Zhi Zi Hou Po Tang (Gardenia and Magnolia Bark Decoction) presents with: abdominal distension and fullness.
In these two formulas, the dosage of Hou Po (Magnolia Bark) is four liang.
The syndrome pattern of Ban Xia Hou Po Tang (Pinellia and Magnolia Bark Decoction) presents with: a sensation in the throat as if there were a roasted meat lump obstructing it (Plum-pit qi).
In this single formula, the dosage of Hou Po (Magnolia Bark) is three liang.
The syndrome pattern of Xiao Cheng Qi Tang (Minor Order the Qi Decoction) presents with: significant abdominal distension and fullness with bowel obstruction.
In this single formula, the dosage of Hou Po (Magnolia Bark) is two liang.
Having reviewed all these formulas above, it is clear that the main indication of Hou Po (Magnolia Bark) is to treat distension and fullness.
Cross-Reference Examination (Hu Kao)
The clause for Hou Po San Wu Tang (Magnolia Bark Three-Ingredient Decoction) does not explicitly list "abdominal distension and fullness" as a symptom. This decoction is essentially Da Cheng Qi Tang (Major Order the Qi Decoction) without Mang Xiao (Mirabilite). However, since it logically addresses conditions of abdominal distension, this can be inferred.
Correction of Errors (Bian Wu)
Zhang Yuansu stated: Although Hou Po (Magnolia Bark) can eliminate abdominal distension, it should be used with caution in patients with deficiency; misuse may deplete the patient's Yuan Qi (Original Qi). Wei Ze stated: This is baseless talk. An ancient saying goes: Using toxic substances to attack disease pathogens is appropriate when the disease is in its early stages. When Yuan Qi (Original Qi) is suppressed by pathogens, the physician uses toxic substances to attack the pathogens; once the pathogenic toxins are eliminated, the Qi becomes vigorous. What is there to fear? Let us provide evidence. In Da Cheng Qi Tang (Major Order the Qi Decoction), Hou Po (Magnolia Bark) serves as the Jun (Monarch) herb. Patients presenting with the indications for this decoction often suffer from inability to eat and lack of vital spirit/energy. Upon administering this decoction, the pathogenic toxins are removed. Once the toxins are removed, appetite returns; with appetite, Yuan Qi (Original Qi) becomes vigorous. This occurs frequently. The claim that Hou Po (Magnolia Bark) depletes Yuan Qi (Original Qi) is merely empty talk!
Product Examination (Pin Kao)
Hou Po (Magnolia Bark) produced in China is of superior quality. The variety produced in our country (Japan) is not true Hou Po (Magnolia Bark) and is unsuitable for medicinal use. Some say there are two varieties produced in our country; one of them retains its leaves in winter, which is similar to the variety produced in China proper, and it is found on Mount Hiei.