Introduction to this issue

Disharmony between the spleen and stomach leads to all kinds of diseases. Let’s take a look at how "Treatise on Febrile Diseases" treats spleen and stomach problems (with medical records included)

Many friends responded in the background and wanted to know more about spleen and stomach conditioning. Indeed, almost all the people now suffer from spleen deficiency. Nine out of ten people have gastrointestinal discomfort, poor digestion, poor absorption, and a dull and unsightly complexion.

We are in a society that pays attention to eating. When greeting others, we often say, have you eaten? This is really a care and reminder for the health of the spleen and stomach.

In addition, who among us is not thinking about the heavy work pressure, heavy study burden and arduous task of supporting a family every day. If you think too much and think too much, your heart will become unbalanced. The so-called worry hurts the spleen. If you are in this kind of worry and anxiety for a long time, the spleen and stomach will be hurt.

How many people today dare to say that they have a strong spleen and stomach?

What's wrong with your stomach?

Good appetite, very good appetite, it tastes good when eaten, and is very edible, but it is not absorbed and does not gain weight after eating it

I am often hungry easily, but I feel bloated after eating.

Although I feel hungry, I don’t want to eat, so I can only force myself to eat.

I have a normal appetite and can eat, but I tend to feel bloated and painful after eating.

I have special gastrointestinal problems I am sensitive. I get upset no matter what I eat when I change places or seasons or when I am nervous.

My stomach is obviously afraid of cold food, but I always want to eat cold food. I like to eat cold food, but I feel uncomfortable after eating it.

I always feel bloated, bloated, burped, and feel a lot of gas in my stomach

Acid reflux, heartburn, burning sensation in my stomach

Stomach pain, bloating, and fear of eating Cold, stomach pain is obvious when eating cold food, and diarrhea occurs

Stomach pain and bloating when emotional stress or anger

Poor bowel movements, frequent diarrhea or constipation, or alternating diarrhea and constipation Attacks, sometimes dry and sometimes thin

Obviously not absorbed, pooping after eating, undigested food residues can be seen in the stool

Constipation for many years, dry stools if not eating fruits , I have been using laxatives

I don’t want to drink water, I feel nauseous and want to vomit when I drink water, or I don’t feel thirsty all day long and drink very little water

Eat too much for dinner You can't sleep well, or you can't eat dinner, and you go to the hospital with stomachache after eating in the middle of the night

Have a history of chronic gastritis, gastric ulcer, duodenal ulcer, enteritis, etc.

You are infected How many?

The symptoms listed above are mainly concentrated in the digestive system. In fact, the "spleen and stomach" mentioned in Chinese medicine and the "stomach" in "Treatise on Febrile Diseases" mean that "if there is stomach qi, there will be gas, and if there is no stomach qi, there will be gas." "Stomach qi will lead to death." It is not just talking about diet, but actually covers the functions of multiple systems, including heart and lungs, digestion, mental psychology, reproduction, etc.

Due to limited space, today we will specifically talk about the "spleen and stomach imbalance" that is characterized by gastrointestinal discomfort and digestive problems.

Why do the spleen and stomach always have these problems

1. Appetite problem

One of the most common symptoms of spleen and stomach disease is appetite problem. How's your appetite?

Eliminating grains and improving hunger means easy hunger and strong appetite. Most of these are manifestations of internal heat. Internal heat eliminates food and increases appetite. For example, "Treatise on Febrile Diseases" mentions "Combining heat will eliminate cereals." "Happiness and hunger" means that if there is heat, the person will be very hungry and eat a lot. It is generally accompanied by symptoms such as thirst and excessive drinking, bad breath, oral ulcers, and constipation.

Anorexia means having no appetite and not wanting to eat much, but can still manage to eat some.

Article 96 of the "Treatise on Febrile Diseases" that everyone is familiar with says: "Cold and heat come and go. Bitterness and fullness in the chest and hypochondrium. Hehehe (silently) No desire to eat. Feeling upset and vomiting... Xiaochaihu Decoction is the main remedy." Poor appetite , don't want to eat, this is a mild stomach deficiency.

The syndrome of "hungry without desire to eat" is generally believed by traditional Chinese medicine to be caused by insufficient stomach yin. Yiwei decoction, yam, Ophiopogon japonicus, etc. are often used to nourish the yin fluid and stomach fluid. So can everything be handled this way?

Article 326 of "Treatise on Febrile Diseases" says: "Jueyin is a disease. It quenches thirst. The upper air hits the heart. There is pain and heat in the heart. Hungry but no desire to eat. When eating, one will spit out roundworms. The benefits from the lower part will not stop. " There is thirst, no desire to eat, feeling hungry but not wanting to eat. Why?

"Hungry but not wanting to eat" is a problem in the middle focus. The mixture of heat (painful heat in the heart) and water (turbulence) affects digestion and causes stomach deficiency. At this time, if you forcefully eat , if you barely eat it, you will vomit. If you use the attack method, it will cause diarrhea and diarrhea.

A relatively special symptom "diabetes" was also mentioned. Many people think of diabetes when they see it. Diabetes syndrome in traditional Chinese medicine includes some types of diabetes, but it cannot be completely equated. "Xiaoke" actually means that the person is thirsty and drinks a lot of water, but it is also accompanied by consumptive urination. If you have the problem of drinking too much and urinating frequently, this is because the disease has entered the lower burner (defecation, men's and gynecological reproductive problems, etc. are all attributed to the lower burner)

Jueyin disease is a combination of cold and heat, with stomach deficiency and inability to feel hungry. If you want to eat, your condition is not just in the middle burner, but has entered the lower burner. This is a more serious and complicated situation that requires specific syndrome differentiation and analysis. It is not simply attributed to the lack of body fluid in the stomach.

Inability to eat, unable to eat, this situation should be divided into cold, heat, deficiency and excess.

For example, item 228 "...feeling upset in my heart. I am hungry and can't eat. But my head is sweating. Gardenia soybean soup is the best remedy." Upset, stomach burning, heartburn, etc. People describe feeling a burning sensation in their stomach, burning like a fire and making them uncomfortable. At the same time, I feel hungry and want to eat, and I have an appetite, but I can't eat.

In this case, it is obvious that there is internal heat, so I feel upset, sweaty, and have heartburn in my stomach. There is also an empty stomach and symptoms of deficiency. I can't eat, I can't eat, because there is heat mixed with water. The tongue coating is generally yellow and thick.

In this situation where wet and hot water drinks are mixed with deficiency, use Gardenia Soybean Soup. Gardenia fermented soybean soup can not only treat burning sensation in the stomach, acid reflux, heartburn, hunger and inability to eat, reflux esophagitis, bile reflux gastritis, etc. that are often mentioned in modern medicine, but can also treat upset, insomnia, regret, and chest tightness. , cough and asthma, etc., as long as they are consistent with the pathogenesis.

The "inedible" condition of Gardenia and Black Bean Soup is mainly due to fire syndrome, partial heat and deficiency, as well as internal cold.

For example, "cannot eat, named Zhonghan" refers to poor appetite and drinking caused by deficiency and coldness in the stomach and internal cold. The digestion of food requires energy to support it. People with cold stomachs have poor ability to digest, absorb and metabolize food, so they may be unable to eat, have no desire to eat or drink water.

If the syndrome differentiation is indeed a problem of cold in Taiyin, "it is because it contains cold. It should be warmed. It is advisable to take the four adverse generations." Use the method of warming the inner, using licorice and dried ginger decoction. , Sini Decoction, Zhenwu Decoction and other warming agents.

Some people may ask, if my spleen and stomach are weak, can I take Chinese patent medicines such as Lizhong Pills and Fuzi Lizhong Pills?

Lizhong decoction (or pills) has three main uses in "Treatise on Febrile Diseases".

The first is cholera and vomiting. The "cholera" mentioned by the ancients is not an infectious disease today, but refers to the symptoms of vomiting and diarrhea, which is called cholera.

The second one is lowering the appetite, which means diarrhea, poor appetite, not wanting to eat, and the cold in the body affects digestion.

The third is that after a serious illness, the person likes to spit for a long time, the saliva increases, vomits frequently, the saliva is thin, and there is coldness in the chest, which can be seen as chest pain and heartache. This is coldness in the upper burner, which may also be accompanied by appetite. Possible symptoms include poor health, less eating, abdominal pain, bloating, loose stools, and frequent urination.

The most common point in these cases is that there is a problem of internal cold, and there is also the use of ginseng in combination with stomach deficiency. Lizhong decoction (pill) plus aconite becomes a fuzi lizhong pill, because the cold and dampness in the inner part is more serious. Use aconite and dried ginger to enhance the strength of warming the inner part.

However, Lizhong Decoction (pills) and Fuzi Lizhong Decoction (pills) are mainly based on Taiyinli cold water drinks, which are partial to the syndrome. Warming agents are not tonics, but methods to eliminate evil and attack evil. It is a disease dominated by cold evil.

If you are already very weak and are not suitable for attacking evil, and are accompanied by vomiting, diarrhea, poor appetite, abdominal pain, bloating, frequent urination and other symptoms, and the weakness is mainly accompanied by internal cold, then use Lizhong Wan. Warming agents like this are not suitable. Instead, you may want to consider Shaoyin’s method of tonifying deficiency.

Teacher Yi Wang handled a medical case of repeated diarrhea. The elderly patient has suffered from irritable bowel syndrome and diarrhea for decades, and the effect of Western medicine has been poor for decades. It is accompanied by long-term symptoms such as excessive sweating, sensitivity to cold, poor sleep, dry mouth, abdominal pain, and fatigue. After syndrome differentiation analysis, the patient used Jiaoai Decoction (which is more tonic, mainly warming and nourishing the blood). The patient's various symptoms improved, and finally the diarrhea stopped, and he never had diarrhea again.

In addition, for some critically ill people who are obviously unable to eat, but are suddenly able to eat, it is necessary to consider whether it is "exclusion". Exclusion is a sign of exhaustion of gastric qi, which is similar to returning to the light. If the stomach qi is not restored after the treatment, it is very dangerous. Without stomach qi, you will die.

Therefore, it is very important to differentiate between deficiency and excess, especially in spleen and stomach diseases. Whether to eliminate evil or tonify deficiency, the pathogenesis of the disease is different, and the theory and method are different, rather than blindly following the same method.

You feel like vomiting after eating, and you have an appetite, but you feel like vomiting after eating, or you vomit immediately after eating.

For example, "The Synopsis of the Golden Chamber" mentions that "for those who vomit immediately after eating, Rhubarb and Licorice Decoction is the best solution." This kind of vomiting and inability to eat, and vomiting after eating, is not the problem of stomach deficiency mentioned above. , but there are real evils, and the heat and fire knot in the body affect eating. If the heat knot is more severe, use rhubarb and licorice together with bitter and sweet medicine to dispel the evil. The role of licorice here is not to replenish the body and replenish qi, but to dispel evil.

There are also water inversion syndromes such as Wuling Powder Syndrome, "vomiting when water enters"; Xiaobanxia Decoction Syndrome, "vomiting, grains cannot be lowered", upper and lower drinking and stomach deficiency; and "vomiting in pregnancy due to pregnancy obstruction". "Not only"; there are also modern medical problems such as esophageal cancer, intestinal obstruction, gastroenteritis, food poisoning, systemic infection, intracranial hypertension, etc., which can cause nausea and vomiting after eating.

Vomiting is not a specific disease, and there is no specific anti-vomiting drug that is suitable for everyone.

For example, ginger, which is known as the "sacred medicine for vomiting", is suitable for vomiting caused by excessive qi on the surface or cold drinks inside, vomiting caused by severe heat, and internal dryness and heat knots accompanied by obvious heartburn, bad breath, and constipation. You cannot use ginger to stop vomiting, as it will increase heat and worsen discomfort.

2. Food preferences

Generally healthy people can eat hot or cold foods, and there are no special taboos.

If you like cold, hate heat, like to eat cold food, and feel no discomfort when eating cold food, it is obvious that you have internal heat.

Like warmth, like to eat hot food, are afraid of cold, and feel uncomfortable eating cold food. This is because there is cold in the body.

But some people are very strange. They like coolness and want to eat cold food, but they are afraid of coldness. Eating cold food will make their stomach uncomfortable. why is that?

If you like cold food and want to eat cold food, it means you are hot. But if you are afraid of cold food and you feel uncomfortable after eating it, it means you have cold food. This kind of person has a mixture of cold and heat. Using dried ginger and aconite to remove heat will help heat, while using rhubarb and coptis to clear away heat will hinder the cold. Reasonable compatibility requires careful dialectical analysis.

I have encountered such a patient before. He likes cold drinks but feels uncomfortable after drinking them. He suffers from stomachache and diarrhea. My appetite is average, sometimes I feel bloated, sometimes I feel like I can eat. Hiccups, acid reflux. My stomach is afraid of coldness, but I want to eat cold food. Difficulty in defecation, dryness and looseness. Later, I used the black plum formula, and the effect was quite good.

Wumei is sour, warm and acidic. It can reduce qi and treat hiccups and vomiting. It can also treat diarrhea and diarrhea. It also has a tonic effect. It can take care of the problems of hot and dry inside, cold inside and water, and stomach deficiency.

Black plums taste sour. Should you avoid sour medicine if you suffer from burping and acid reflux? Not necessarily. When many people see acid reflux, they think it is due to excessive gastric acid secretion, and they subconsciously use so-called antacids, such as corrugated seeds, jellyfish, and bletilla striata. But in fact, acid reflux can include cold or heat, deficiency or excess. As long as the syndrome differentiation is consistent with the pathogenesis, it can be used.

3. Stomach pain, gastric bloating, and abdominal distension

There are many causes of stomach pain, gastric bloating, and abdominal distension. In "Treatise on Febrile Diseases", there are pimple syndrome, chest knot, hidden knot, and chest knot. Paralysis and other explanations all need to distinguish between cold and heat, deficiency and excess.

For example, the "Xinxiapi" of Rhubarb and Coptis Xiexin Decoction has internal heat; the "vomiting and fullness in the lower abdomen cannot be eaten after eating" of Lizhong Decoction has internal cold; Ginger Xiexin Decoction and Banxia Xiexin Decoction , Licorice Xiexin Decoction's "hard and full heart under the heart" is due to the combination of cold and heat; Wuling Powder's "heart under the heart is hard and full." It is due to water knots. "Those with abdominal fullness and fullness after sweating" using Magnolia officinalis, Ginger, Pinellia, Licorice and Ginseng Decoction tend to have gas syndrome, accompanied by slight water drinking...

Here we also introduce several cases treated by Teacher Yi Wang. A medical case.

The first medical case was that after eating unclean food, it caused stomach pain and blockage for 1 week, accompanied by diarrhea. After taking domperidone, the gastric congestion was slightly relieved, but it was still uncomfortable. This person also feels uncomfortable eating cold food and his stomach is afraid of cold, but he likes to eat cold dishes. Loose stools, stomach pain and blockage after defecation are relieved, and the patient feels comfortable after defecation. Teacher Yiwang used Sini Powder, and the patient was cured after taking the medicine, and all the symptoms of discomfort disappeared.

The second is also a medical case for stomach pain and bloating. The patient had stomach pain, slight distension, acid reflux, and was obviously cold when eating. Drinking water is normal, appetite is good, stool is once every 2 to 3 days, sometimes dry and sometimes loose. Accompanied by symptoms such as severe fear of cold and cold hands. Teacher Yiwang used Citrus Aurantium, Sage and White Guizhi Decoction for the patient, and the effect was very good.

The third medical case is a relatively complex and difficult medical case. The patient suffered from abdominal distension, difficulty in defecation, and swelling of the hands and feet. The symptoms lasted for about ten years. When the weather was hot, I got sick, but when the weather was cold, I got better. I have taken enzyme prunes and diuretics, which have certain effects.

Complaint: My stomach feels heavy and bloated at 2 to 3 o'clock every afternoon. I want to urinate but can't do it. At the same time, my whole body feels bloated and I have gained weight.

After eating, I feel full and want to eat and can eat. Feeling mild gastric blockage, bloating, no stomach pain, burping and acid reflux. The stomach is afraid of cold and likes hot food. It is difficult to urinate, and the urine is oliguric and yellow and turbid. If I don't take diuretics, I will wake up once at night. If I take diuretics, I will wake up three or four times at night and feel relaxed the next day. It is difficult to pass stool. If I don't take medicine, it will be difficult to pass stool every two days. It will be dry at first and then sticky, without blood.

Abdominal physical examination: moderate tenderness when pressing the abdomen, and a feeling of distension in the abdomen.

The teacher used Guigan Shi Fangji Decoction. The patient took 10 doses intermittently, and the symptoms disappeared and basically returned to normal.

These three medical cases all have varying degrees of gastric bloating and gastric blockage problems, with the main symptoms being abnormalities in digestion and excretion of food and stool. However, due to different pathogenesis, the final prescriptions chosen are also different. different.

If you follow the general thinking and encounter stomach bloating, you should consider that the stomach qi cannot be normalized and reduced, and the qi movement is stagnant. The main treatment principles are usually to regulate the qi movement and strengthen the spleen and stomach. Use medicines that regulate qi, eliminate accumulation and harmonize the stomach, such as radish seed, magnolia bark, tangerine peel, hawthorn, bergamot, citron and other medicines. However, if we do not comprehensively analyze the person's four diagnostic data and grasp the actual and external conditions of cold and heat, it is easy to go astray or even wrong. Often, it can only achieve temporary results, or even be completely ineffective.

Stomach pain, bloating, bloating, indigestion, nausea, belching... Frequent gastrointestinal problems are not always good, and correct syndrome differentiation is the key.

4. Defecation problem

Finally, let’s talk about defecation problem. Normal stool is once a day, banana-shaped, neither dry nor watery, and the bowel habit is regular. No blood after defecation.

Nowadays, many people have problems, mainly constipation, diarrhea, dry and loose stools, etc. There are also black stools and blood in the stool (digestive tract bleeding diseases must be ruled out first). Bowel problems are generally closely related to gastroenteritis, irritable bowel syndrome, Crohn's disease, ulcerative colitis, bowel cancer, etc. in modern medicine.

Constipation is usually caused by internal knots. It is also necessary to distinguish between cold and heat, deficiency and excess. There are hard stools and difficulty in defecation caused by Yangmingli heat. Physical examination of the abdomen often shows tenderness and resistance to pressure, and epigastric distension. There are also dry stools caused by insufficient intestinal fluid nourishment. Or dry stool may occur due to frequent urination and loss of body fluids. There are also hard stools caused by water knots. At this time, there is usually no obvious abdominal tenderness and resistance to pressing.

For diarrhea, you must first rule out unclean diet. It is easier for everyone to think of the problem of drinking cold water in Taiyin. The body fluid lacks driving energy, and the body fluid stays and becomes watery, and the water flows down. , showing frequent urination and loose stools. For those who mainly use cold medicine, consider the four warming agents.

But in fact, diarrhea can occur in Taiyin disease, Yangming disease, Shaoyang disease, Shaoyin disease, Jueyin disease, etc. It is also necessary to distinguish between cold and heat, deficiency and excess.

The lower benefit of Shaoyin disease is "self-interest and thirst", which is different from Taiyin's "self-interest but no thirst", indicating the problem of Shaoyin deficiency. For those with internal heat and constipation, Dahuang Licorice Decoction and Dahuang Huanglian Xiexin Decoction should be considered. If Shaoyang dampness and heat are beneficial, Scutellaria baicalensis decoction should be considered. Similarly, for the treatment of Jueyin disease, Xiexin decoction, Gardenia soybean soup, Wumei pills, Pulsatilla decoction plus licorice and donkey hide gelatin, etc. should be considered according to the specific situation.

If the stool is sometimes dry and sometimes watery, consider drinking more water. Drinking water is not necessarily cold, it must also be divided into cold and hot conditions. Yangming and Shaoyang may drink hot water. Drinking water can occur when Taiyin is cold. Shaoyin deficiency and fluid deficiency may also cause water drinking due to insufficient body fluid. Jueyin disease may also cause problems with drinking water.

Choose appropriate prescriptions based on the difference in cold, heat, deficiency and excess, instead of just using rhubarb, sodium salt, and aloe vera at the first sign of constipation, or prescribing Maziren pills or Tiaoweichengqi decoction. To stop diarrhea as soon as you see it, use red stone fat, Qinpi, etc. The key is to distinguish clearly.

Finally, I would like to recommend some common foods to nourish the spleen and stomach. It is both food and medicine. "Treatise on Febrile Diseases" contains many therapeutic prescriptions.

1. Ginger

"Qian Jin Yi Fang" describes ginger as "spicy and slightly warm. It is mainly used for typhoid fever, headache, nasal congestion, cough and upper gas, and relieves vomiting. It can be taken for a long time to remove odor. "Connecting the gods."

Ginger is a medicine that takes into account both the exterior and interior, focusing on the exterior. You can go inside and have a cold drink. If you accidentally eat raw or cold food and get a stomachache or vomit water, you can use some ginger. It can also be used by pregnant women who feel nauseated and uncomfortable, who have severe pregnancy reactions, and those who have stomach deficiency and internal cold.

Do not use it if it is obviously hot and dry.

2. Jujube

"Qian Jin Yi Fang": "Jujube is sweet, pungent, hot, smooth and non-toxic. It regulates evil qi in the heart and abdomen, calms the heart and nourishes the spleen, helps the twelve meridians, and calms the stomach. Qi, clears the nine orifices, replenishes body fluids, and relieves constipation and heaviness in the limbs. It can be used with hundreds of medicines to replenish qi, strengthen the mind, and treat hangovers and irritability in the intestines. Eating it will make people thirsty and bloated. People who are suffering from bitterness, cold, heat, and are weak should not eat too much to hurt people."

Jujube is warm and replenishing, but it has a strong bias and cannot be eaten indiscriminately. Do not eat if you have internal heat, dryness, or a weak stomach prone to flatulence and fullness.

Zhang Zhongjing once said that the human body is peaceful, but it must be well taken care of and do not take medicine indiscriminately. If you are not sick, do not take any medicine, including supplements.

Many people take some supplements when they have something to do, thinking it is a good thing. However, they do not know that the medicines are biased and will affect the body's Qi, making them more likely to get sick. Therefore, the key to daily maintenance of the spleen and stomach is to take good care of your diet. Eat three meals regularly, do not overeat, do not eat gas-pressing meals, and reduce unnecessary material desires.