治伤寒汗吐下解后,心下痞硬,噫气不除者。
旋复花(三两) 代赭石(一两) 生姜(五两切) 大枣(十二枚) 人参(二两) 半
夏(半升) 甘草(三两炙) 水一斗,煮六升,去滓再煎,取三升,温分日三服。
旋复代赭汤人参,半夏姜甘大枣临,重以镇逆(代赭石)咸软痞,(旋复花)痞硬噫气
力能禁。
(《灵枢·口问篇》曰∶“寒气客于胃,厥逆从下上散,复出于胃,故为噫。”《素问·宣
明五气篇》曰∶“心为噫。”噫者,上焦病声也。脾失升度,肺失降度,阴盛走于胃,属于
心而为声,俗名“嗳气”。故用旋复咸降肺气,代赭重镇心包络之气,半夏以通胃气,生姜
、大枣以宣脾气,而以人参、甘草奠安阳明,俾阴阳升降,合其常度,则痞硬嗳气悉除矣。
)噫气俗名为嗳气,若兼下利泻心寻。(此与前诸泻心法大略相近。汪 庵《医方集解》引
《本草纲目》云∶“病解后,痞硬噫气,不下利者用此汤,下利者生姜泻心汤。”)镇阴宣阳
扶胃弱,呃逆反胃并宜斟。(此镇阴宣阳方也。呃逆反胃,皆上、中二焦气逆不降所致,用
此镇其阴气,宣发胃阳,则上、中二焦皆得致和矣。)
治太阳与少阳合病,自下利者。
黄芩(三两) 甘草(炙) 芍药(各二两) 大枣(十二枚) 水一斗,煮取三升,
去滓,温服一
治疗伤寒经过发汗、催吐或泻下治疗后,出现胃脘部痞塞胀满且坚硬,嗳气(打饱嗝)持续不缓解的症状。
旋复花(三两) 代赭石(一两) 生姜(五两,切片) 大枣(十二枚) 人参(二两) 半夏(半升) 甘草(三两,炙烤) 用水一斗,煎煮至六升,滤去药渣,再次煎煮浓缩至三升,分三次温服。
旋复代赭汤由人参、半夏、生姜、甘草、大枣组成,重用代赭石以镇降逆气,旋复花味咸能软化痞结,此方能有效消除痞硬和嗳气症状。
《灵枢·口问篇》记载:“寒气侵入胃部,厥逆之气从下向上发散,再出于胃,所以产生嗳气。”《素问·宣明五气篇》说:“心与嗳气有关。”嗳气是上焦病变发出的声音。脾脏失去升清的功能,肺脏失去肃降的功能,阴寒之气走窜入胃,归属于心而发出声音,俗称“嗳气”。因此使用旋复花咸味以降肺气,代赭石重镇以安心包络之气,半夏以疏通胃气,生姜、大枣以宣通脾气,用人参、甘草来稳固中焦阳气,使阴阳升降恢复常态,那么痞硬和嗳气自然全部消除。
嗳气俗称打饱嗝,如果兼有腹泻症状,则应寻找泻心汤类方剂治疗。(这与前面提到的各种泻心汤法大致相近。汪昂在《医方集解》中引用《本草纲目》说:“病后出现痞硬嗳气,没有腹泻的,用此汤;如果有腹泻的,用生姜泻心汤。”)此方具有镇摄阴气、宣发阳气、扶助胃气虚弱的作用,对于呃逆(打嗝)和反胃症状也适宜斟酌使用。(这是一个镇阴宣阳的方剂。呃逆和反胃,都是上、中二焦气机逆乱不降所致,使用此方镇摄阴气,宣发胃阳,那么上、中二焦都能达到和谐状态。)
治疗太阳经与少阳经同时发病(合病),出现自发性腹泻的症状。
Treats the condition where, after the resolution of Taiyang disease (Taiyang Disease) through sweating, vomiting, or purging, there is epigastric fullness and hardness, with persistent belching.
Xuanfuhua (Inulae Flos, 3 liang), Daizheshi (Hematitum, 1 liang), Shengjiang (Zingiberis Rhizoma Recens, 5 liang, sliced), Dazao (Jujubae Fructus, 12 pieces), Renshen (Ginseng Radix et Rhizoma, 2 liang), Banxia (Pinelliae Rhizoma Preparatum, half sheng), Gancao (Glycyrrhizae Radix et Rhizoma Praeparata cum Melle, 3 liang, honey-fried). Use one dou of water, decoct to six sheng, remove dregs, and decoct again to obtain three sheng. Take warm, divided into three doses daily.
Xuanfu Daizhe Tang consists of Renshen, Banxia, Shengjiang, Gancao, and Dazao. Heavy substances like Daizheshi are used to suppress rebellious Qi, while Xuanfuhua's salty flavor softens stagnation. This formula has the power to relieve epigastric hardness and belching.
The *Lingshu: Kouwen* chapter states: "When cold pathogen lodges in the Stomach, rebellious Qi scatters upward from below and re-emerges from the Stomach, thus causing belching." The *Suwen: Xuanming Wuqi* chapter states: "The Heart is associated with belching." Belching is a sound arising from pathology in the Upper Jiao (Upper Burner). When the Spleen loses its ascending function and the Lung loses its descending function, Yin excess moves into the Stomach, associates with the Heart to produce sound, commonly known as "belching" (Oxygen eructation). Therefore, Xuanfuhua is used for its salty nature to descend Lung Qi; Daizheshi is used for its heavy nature to calm the Qi of the Pericardium; Banxia is used to unblock Stomach Qi; Shengjiang and Dazhao are used to disseminate Spleen Qi; and Renshen and Gancao are used to stabilize the Middle Jiao Yang, so that Yin and Yang ascend and descend according to their normal rhythm, thereby eliminating epigastric hardness and belching completely.
Belching is commonly called burping. If accompanied by diarrhea, one should look to the Xiexin Tang (Drain the Epigastrium Decoction) formulas. (This is roughly similar to the previously mentioned Xiexin methods. Wang Ang's *Yifang Jijie* cites *Bencao Gangmu*: "For post-illness epigastric hardness and belching without diarrhea, use this decoction; if there is diarrhea, use Shengjiang Xiexin Tang.") This formula calms Yin, disseminates Yang, and supports weak Stomach Qi; it is also suitable for hiccup (Hiccough) and regurgitation (Regurgitation). (This is a formula that calms Yin and disseminates Yang. Hiccups and regurgitation are both caused by rebellious Qi in the Upper and Middle Jiaos failing to descend. Using this formula to calm Yin Qi and disseminate Stomach Yang allows the Upper and Middle Jiaos to achieve harmony.)
Treats Shaoyang-Taiyang Hebing (Combined Disease of Shaoyang and Taiyang) presenting with spontaneous diarrhea.
Huangqin (Scutellariae Radix, 3 liang), Gancao (Glycyrrhizae Radix et Rhizoma Praeparata cum Melle, prepared), Shaoyao (Paeoniae Radix Alba, 2 liang each), Dazao (Jujubae Fructus, 12 pieces). Use one dou of water, decoct to obtain three sheng, remove dregs, and take one sheng warm.