治干呕吐逆。吐涎沫者。此散主之。
半夏 干姜(各等分。)
上二味。杵为散。取方寸匕。浆水一升半。煮取七合。顿服之。
歌曰 吐而干呕沫涎多。(惟不胸满不头痛。与吴茱萸汤证不同。以虚有微甚。邪有高
下之
(小半夏
治病患胸中似喘不喘。似呕不呕。似哕不哕。彻心中愦愦无奈者。此汤主之。
半夏(半升。) 生姜(汁。一升。)
上二味。以水三升。煮半夏。取二升。内生姜汁。煮取一升半。小冷。分四服。日三夜
一。
歌曰 呕哕都非喘又非。(似呕之状不似呕之有物。似哕之有声不似哕之连声。似喘之
气逆
一升
(参) 与吴茱萸之降浊。干姜之温中不同。盖彼乃虚寒上逆。此乃客邪搏饮也。方即
小半夏汤。不用姜而用汁者。以降逆之力少。散结之力多也。
治干呕哕。若手足厥者。此汤主之。
橘皮(四两。) 生姜(半斤。)
上二味。以水七升。煮取三升。温服一升。下咽即愈。
歌曰 哕而干呕厥相随。气逆于胸阻四肢。(干呕非胃反。厥非无阳。乃气逆于胸不行
于四
元犀按。金匮论哕。与方书不同。专指呃逆而言也。
治哕逆者。此汤主之。
橘皮(二斤。) 竹茹(二升。) 大枣(三十枚。) 生姜(半斤。) 甘草(五两。) 人
参(一
上六味。以水一斗。煮取三升。温服一升。日三服。
歌曰 哕逆因虚热气乘。一参五草八姜胜。枣枚三十二斤橘。生竹青皮(即竹茹也。)
刮二升
犀按。浅注已详。方义不再释。金匮以呃为哕。凡呃逆证。皆是寒热错乱。二气相搏使
然。故方中用生姜、竹茹。一寒一热以祛之。人参、橘皮。一开一阖以分之。甘草、大枣。
奠安中土。使中土有权。而哕逆自平矣。此伊芳圣经方。扁鹊丁香柿蒂散。即从此方套出也。
治疗干呕并伴有呕吐,吐出涎沫的患者。此散剂主治。
半夏、干姜(各等分)。
以上两味药,捣碎成散剂。取一方寸匕的药量,加入浆水一升半,煎煮至七合,一次性服用。
歌诀云:呕吐且干呕,涎沫多。(只有不胸满、不头痛,与吴茱萸汤证不同,因为虚损有轻重,邪气有高下之分。)
治疗患者感觉胸中似喘非喘,似呕非呕,似呃逆非呃逆,心中烦闷无可奈何的情况。此汤剂主治。
半夏(半升)。生姜(取汁,一升)。
以上两味药,用水三升,先煮半夏,取二升药液,再加入生姜汁,煎煮至一升半。待药液稍凉后,分四次服用,白天服三次,夜间服一次。
歌诀云:既非呕吐也非呃逆,又非气喘。(似呕之状却无物吐出,似哕之声却不连续发声,似喘之气逆……)
(人参)与吴茱萸汤的降浊、干姜的温中不同。那是因为彼方针对的是虚寒上逆,而此方针对的是外邪搏结饮邪。方子即小半夏汤,不用生姜块而用生姜汁,是因为其降逆之力较小,而散结之力较大。
治疗干呕、呃逆,若伴有手足厥冷的患者。此汤剂主治。
橘皮(四两)。生姜(半斤)。
以上两味药,用水七升,煎煮至三升。温服一升,药液咽下即愈。
歌诀云:呃逆伴干呕,厥冷随之而来。气逆于胸中,阻滞四肢。(干呕并非胃反病,厥冷并非阳气全无,乃是气逆于胸中,不能运行于四肢。)
元犀按:《金匮要略》论及“哕”,与后世方书不同,专指呃逆而言。
治疗呃逆的患者。此汤剂主治。
橘皮(二斤)。竹茹(二升)。大枣(三十枚)。生姜(半斤)。甘草(五两)。人参(一两)。
以上六味药,用水一斗,煎煮至三升。温服一升,每日服用三次。
歌诀云:呃逆因虚热之气乘袭所致。一人参、五甘草、八生姜可胜之。大枣三十枚,橘皮二斤,竹茹青皮(即竹茹),刮去青色外皮取二升。
元犀按:浅注已详细解释,此处不再阐释方义。《金匮要略》以“呃”为“哕”。凡是呃逆证,都是寒热错乱,阴阳二气相搏所致。所以方中使用生姜、竹茹,一寒一热以祛除病邪;人参、橘皮,一开一阖以分散病势;甘草、大枣,奠安中焦脾胃,使中焦有权柄,则呃逆自然平息。这是伊芳圣经方的经典方剂,扁鹊的丁香柿蒂散即从此方演化而来。
Treats dry retching accompanied by vomiting, where saliva and foam are vomited. This powder is the primary treatment.
Banxia (Pinelliae Rhizoma) and Ganjiang (Zingiberis Rhizoma) in equal parts.
The above two herbs are crushed into a powder. Take one fangcun bi (a square-inch scoop) of the powder, add 1.5 sheng of jiangshui (fermented grain water), and decoct until 0.7 sheng remains. Administer in a single dose.
Verse: Vomiting with dry retching and abundant saliva/foam. (Only when there is no chest fullness or headache, it differs from the Wuzhuyu Tang syndrome; this is because the deficiency varies in severity, and the pathogen differs in location.)
Treats patients who feel as if they are panting but are not, as if they are vomiting but are not, as if they are hiccuping but are not, with a sense of profound discomfort and helplessness in the heart/chest. This decoction is the primary treatment.
Banxia (Pinelliae Rhizoma) (half sheng). Shengjiang (Fresh Zingiberis Rhizoma) (juice, one sheng).
The above two herbs are decocted with three sheng of water. First, decoct Banxia to obtain two sheng of liquid, then add the Shengjiang juice, and decoct again to obtain 1.5 sheng. Allow to cool slightly, then divide into four doses. Take three times during the day and once at night.
Verse: Neither vomiting nor hiccupping, nor panting. (Resembling vomiting but without expelled matter, resembling hiccups but without continuous sound, resembling panting with qi rebellion...)
(Renshen) differs from the descending turbidity action of Wuzhuyu Tang and the warming middle action of Ganjiang. The former addresses upward reversal due to deficiency-cold, whereas this formula addresses external pathogens clashing with retained fluids. The formula is essentially Xiaobanxia Tang; using ginger juice instead of ginger slices is because its power to direct rebellious qi downward is lesser, while its power to dissipate nodules is greater.
Treats dry retching and hiccups, especially when accompanied by cold extremities. This decoction is the primary treatment.
Chenpi (Citri Reticulatae Pericarpium) (four liang). Shengjiang (Fresh Zingiberis Rhizoma) (half jin).
The above two herbs are decocted with seven sheng of water until three sheng remain. Take one sheng warm. Upon swallowing, the condition resolves.
Verse: Hiccups with dry retching are followed by cold extremities. Qi rebels in the chest, obstructing the four limbs. (Dry retching is not stomach reversal; cold extremities do not mean absence of yang, but rather qi rebellion in the chest failing to circulate to the four limbs.)
Yu Xi notes: In *Jin Gui Yao Lue*, "yue" (哕) differs from later medical texts, specifically referring to hiccups.
Treats hiccups. This decoction is the primary treatment.
Chenpi (Citri Reticulatae Pericarpium) (two jin). Zhuru (Bambusae Caulis in Taeniam) (two sheng). Dazao (Jujubae Fructus) (thirty pieces). Shengjiang (Fresh Zingiberis Rhizoma) (half jin). Gancao (Glycyrrhizae Radix et Rhizoma) (five liang). Renshen (Ginseng Radix) (one liang).
The above six herbs are decocted with ten dou of water until three sheng remain. Take one sheng warm, three times daily.
Verse: Hiccups arise from deficiency-heat allowing pathogenic qi to invade. One part Ginseng, five parts Licorice, and eight parts Ginger prevail. Thirty Jujubes, two jin of Tangerine Peel, and two sheng of Bamboo Shavings (Zhuru, scraped of green skin).
Yu Xi notes: The shallow annotation has already explained this in detail; the rationale of the formula will not be re-explained here. In *Jin Gui Yao Lue*, "e" (呃) is referred to as "yue" (哕). All cases of hiccups result from the chaotic interplay of cold and heat, where yin and yang paths clash. Therefore, the formula uses Shengjiang and Zhuru, one cold and one hot, to dispel the pathogen; Renshen and Chenpi, one opening and one closing, to disperse the pathological state; and Gancao and Dazao to stabilize the Middle Jiao (Spleen/Stomach), empowering the central earth so that hiccups naturally subside. This is a classic formula from the *Shang Jing* (Classic of Medical Value); Bian Que's Dingxiang Shidi San (Clove and Persimmon Calyx Powder) was derived from this formula.