怒动肝火,逆于中焦,其症口苦,脉弦,胁及小腹胀满或痛,发则身热气逆是也。
左金丸
黄连(六两) 吴茱萸(一两)
粥为丸,椒目大,每服三十丸,白汤下。
按∶缪刺论谓有所堕坠,恶血留内,腹中满胀,不得前后,先饮利药。此上伤厥阴之脉
,下
伤少阴之络,是火逆之外,又有血滞一症,火无形,以苦辛平之,血有形,故以利药行之。
(新定)
赤芍 生地 归尾 桃仁(各一钱) 红花 香附(童便浸,二钱) 大黄(酒浸,一钱五
分) 丹皮 青皮(醋炒,各八分)
(即气胀)
胸膈胀满也。经云∶浊气在上,则生 胀是也,宜升清降浊。盖清不升则浊不降也。又
七情郁结,气道壅隔,上不得降,下不得升,腹大而四肢瘦削,即气胀也。
木香顺气汤
木香 苍术(各三分) 草蔻(三分) 青皮 益智仁 陈皮 泽泻 茯苓 半夏 干姜
吴茱萸(各二分) 升麻 柴胡(各一分) 浓朴(四分) 人参 当归(各五分)
水二盏,煎一盏,食前温服。
通幽汤 东垣云∶浊阴本归六腑而出下窍,今在上,是浊气反行清道,气乱于中
胀作矣。治在幽门,泄其阴,润其燥,使幽门通利,大便不闭,则浊阴得归下地, 胀腹满
当归 升麻 桃仁(各一钱) 红花 甘草(炙,三分) 生地 熟地(各五分)
一方加枳壳(五分)。本方加大黄、麻仁,名当归润肠汤,治同。
因愤怒引动肝火,导致气机逆乱于中焦,其症状表现为口苦、脉象弦紧,胁部及小腹部胀满或疼痛,发作时身体发热、气机上逆。
左金丸
黄连(六两) 吴茱萸(一两)
用米粥制成丸药,大小如花椒籽,每次服用三十丸,用白开水送服。
按语:《素问·缪刺论》中提到,若有跌坠损伤,恶血留滞体内,导致腹部胀满,二便不通,应先服用通利之药。这是上伤厥阴经脉,下伤少阴络脉所致。因此,除了火气上逆之外,还有血行阻滞这一证候。火邪无形,故用苦辛平调之法;血液有形,故用通利之药以推动其运行。(新定方)
赤芍 生地 归尾 桃仁(各一钱) 红花 香附(童便浸,二钱) 大黄(酒浸,一钱五分) 丹皮 青皮(醋炒,各八分)
(即气胀)
指胸膈部位胀满。经文说:“浊气在上,则生䐜胀”,说的就是这种情况,治疗宜升清降浊。因为清气不升,浊气就不能下降。另外,七情郁结,导致气道壅塞阻隔,气上不得降,下不得升,腹部膨大而四肢消瘦,这就是气胀。
木香顺气汤
木香 苍术(各三分) 草蔻(三分) 青皮 益智仁 陈皮 泽泻 茯苓 半夏 干姜 吴茱萸(各二分) 升麻 柴胡(各一分) 浓朴(四分) 人参 当归(各五分)
加水两盏,煎至一盏,饭前温服。
通幽汤 李东垣说:“浊阴本应归于六腑并从下窍排出,如今却停留在上部,这是浊气反行于清道,气机紊乱于中焦,从而产生胀满。”治疗关键在于幽门,需泄其阴邪,润其燥热,使幽门通畅,大便不闭塞,则浊阴得以回归下部,䐜胀腹满自消。
当归 升麻 桃仁(各一钱) 红花 甘草(炙,三分) 生地 熟地(各五分)
一方中加入枳壳(五分)。本方加大黄、麻仁,名为当归润肠汤,主治相同。
Anger stirs up Liver Fire (Liver Fire), causing rebellion in the Middle Jiao (Middle Burner). The symptoms include bitter taste in the mouth, wiry pulse, distension or pain in the hypochondrium and lower abdomen, and upon onset, fever with rebellious Qi.
Zuojin Wan (Left Metal Pill)
Coptidis Rhizoma (Huanglian, 黄连) (6 liang)
Evodiae Fructus (Wuzhuyu, 吴茱萸) (1 liang)
Form pills with congee, size of Zanthoxyli Semen (Jiaomu, 椒目). Take 30 pills per dose, washed down with plain warm water.
Commentary: The *Miao Ci Lun* chapter of the *Suwen* states that if there is a fall or injury, foul blood remains inside, causing abdominal fullness and inability to pass stool or urine; one should first drink purgative medicines. This indicates injury to the Jueyin (Jueyin Meridian) vessels above and the Shaoyin (Shaoyin Collaterals) below. Thus, besides the rebellion of Fire, there is also a condition of Blood Stasis (Blood Stagnation). Fire is formless, so it is treated with bitter and acrid methods to level it; Blood has form, so it is moved with purgative/laxative medicines. (Newly Formulated)
Paeoniae Radix Rubra (Chishao, 赤芍)
Rehmanniae Radix Preparata (Shengdi, 生地)
Angelicae Sinensis Radix Caudex (Guiwei, 归尾)
Persicae Semen (Taoren, 桃仁) (each 1 qian)
Carthami Flos (Honghua, 红花)
Cyperi Rhizoma (Xiangfu, 香附) (soaked in child's urine, 2 qian)
Rhei Radix et Rhizoma (Dahuang, 大黄) (soaked in wine, 1.5 qian)
Moutan Cortex (Danpi, 丹皮)
Aurantii Fructus Immaturus (Qingpi, 青皮) (stir-fried with vinegar, each 8 fen)
(Also known as Qi Distension)
Refers to distension in the chest and diaphragm. The classics state: "When turbid Qi is above, Danzhang (abdominal distension) arises." This is the case. Treatment should involve raising the Clear and descending the Turbid. If the Clear does not rise, the Turbid cannot descend. Furthermore, emotional stagnation causes obstruction of the Qi mechanism, preventing Qi from descending upwards or ascending downwards, resulting in a large abdomen with emaciated limbs; this is Qi Distension.
Muxiang Shunqi Tang (Costus Descending Qi Decoction)
Aucklandiae Radix (Muxiang, 木香)
Atractylodis Rhizoma (Cangzhu, 苍术) (each 3 fen)
Alpiniae Katsumadai Seed (Caokou, 草蔻) (3 fen)
Aurantii Fructus Immaturus (Qingpi, 青皮)
Alpiniae Oxyphyllae Fructus (Yizhiren, 益智仁)
Chenpi (Tangerine Peel, 陈皮)
Alismatis Rhizoma (Zexie, 泽泻)
Poria (Fuling, 茯苓)
Pinelliae Rhizoma Preparatum (Banxia, 半夏)
Zingiberis Rhizoma Recens (Ganjiang, 干姜)
Evodiae Fructus (Wuzhuyu, 吴茱萸) (each 2 fen)
Bupleuri Radix (Shengma, 升麻)
Bupleuri Radix (Chaihu, 柴胡) (each 1 fen)
Magnoliae Officinalis Cortex (Noupu, 浓朴) (4 fen)
Codonopsis Radix (Renshen, 人参)
Angelicae Sinensis Radix (Danggui, 当归) (each 5 fen)
Add two cups of water, decoct to one cup. Take warm before meals.
Tongyou Tang (Unblocking the Hidden Decoction)
Li Dongyuan stated: "Yin Turbidity originally belongs to the Six Fu Organs and exits through the lower orifices. Now that it is in the upper part, it means Turbid Qi is counter-flowing through the Clear pathways, causing Qi chaos in the middle and generating distension." The treatment focuses on the Youmen point, draining its Yin, moistening its Dryness, ensuring the Youmen is unobstructed and bowel movements are not blocked, so that Yin Turbidity can return to the lower regions, resolving Danzhang and abdominal fullness.
Angelicae Sinensis Radix (Danggui, 当归)
Bupleuri Radix (Shengma, 升麻)
Persicae Semen (Taoren, 桃仁) (each 1 qian)
Carthami Flos (Honghua, 红花)
Glycyrrhizae Radix et Rhizoma (Gancao, 甘草) (roasted, 3 fen)
Rehmanniae Radix Preparata (Shengdi, 生地)
Rehmanniae Radix Preparata (Shudi, 熟地) (each 5 fen)
One prescription adds Aurantii Fructus (Zhike, 枳壳) (5 fen). Adding Rhei Radix et Rhizoma (Dahuang, 大黄) and Cannabis Fructus (Maren, 麻仁) to this formula creates Danggui Runchang Tang (Angelica Intestine-Moistening Decoction), with the same indication.