夫胃、大小肠、膀胱者,仓廪之本,营之居也,名曰器,能化糟粕转味入出者也。人或
伤于风寒暑湿,热盛,发汗利小便,走枯津液,致肠胃燥涩,秘塞不通,皆外所因;或脏气
不平,阴阳关格,亦使人大便不通,名曰脏结,背内所因;或饮食燥热而成热中,胃气强
涩,大便坚秘,小便频数,谓之脾约,属不内外因。既涉三因,亦当随其所因而治之,燥则
润之,涩则滑之,秘则通之,约则缓之,各有成法。
治气壅风盛,大便秘涩,后重疼痛,烦闷。此药当量虚实加减。
大黄(四两,麸煨,蒸亦可) 人参(二两) 诃子皮(四两) 麻仁(二两,别研)
上为细末,炼蜜丸,梧子大。每服二十丸,温汤、温酒、米饮皆可下,食后临卧服。
治趺阳脉浮而涩,浮则胃气强,涩则小便数,浮涩相搏,大便则坚,其脾为
约,大便坚,小便利而不渴。
麻子仁(五两,研) 芍药 枳实(麸炒,各八两) 大黄(蒸,一斤) 浓朴(姜制炒,半两) 杏仁
(去皮尖炒,别研,五两半)
上为末,炼蜜丸,如梧子大。每服二十丸,温水下;未知,加五十丸。一法,麻仁一两
半、杏仁三分、大黄一两,枳实、芍药、浓朴各半两。此根据《局方》出。本是汉方,合用大
黄、枳实一斤,正得今二两,浓朴当用四两,杏仁当用六钱一字,麻仁一两二钱半,芍药一
两,乃均制合理,用当以理推。
胃、大肠、小肠、膀胱,是饮食储藏的根本,也是营气所在之处,被称为“器”,能够转化糟粕并调节味道的出入。人如果受到风寒暑湿等外邪侵袭,或者体内热盛,通过发汗或利小便的方法治疗,导致津液耗损枯竭,致使肠胃干燥涩滞,大便闭塞不通,这都属于外因;或者因为脏腑之气不平和,阴阳之气阻隔不通,也使人大便不通,称为“脏结”,这属于内因;或者因为饮食燥热而形成“热中”,胃气强盛且涩滞,导致大便坚硬秘结,小便频数,称为“脾约”,这属于不内外因。既然涉及这三种病因,就应当根据具体的病因进行治疗:干燥的则滋润它,涩滞的则滑利它,秘结的则通导它,约束的则缓急它,各有既定的法则。
治疗气机壅滞、风邪旺盛导致的大便秘涩、排便后重疼痛、烦闷不安。此药应当根据患者虚实情况进行加减用量。
大黄(四两,用麦麸煨炒,蒸也可以)、人参(二两)、诃子皮(四两)、麻仁(二两,单独研磨)。
以上药物研成细末,用炼蜜制成丸药,大小如梧桐子。每次服用二十丸,用温水、温酒或米汤送服,饭后及临睡前服用。
治疗趺阳脉浮而涩,脉浮说明胃气强盛,脉涩说明小便频数,浮脉与涩脉相互搏结,导致大便坚硬,这是“脾约”证,表现为大便坚硬,小便通畅且不口渴。
麻子仁(五两,研磨)、芍药、枳实(用麦麸炒,各八两)、大黄(蒸,一斤)、浓朴(姜汁制炒,半两)、杏仁(去皮尖炒,单独研磨,五两半)。
以上药物研成粉末,用炼蜜制成丸药,大小如梧桐子。每次服用二十丸,用温水送服;如果效果不明显,增加到五十丸。另一种方法:麻仁一两半、杏仁三分、大黄一两,枳实、芍药、浓朴各半两。此方出自《太平惠民和剂局方》。原本汉代方剂,合用大黄、枳实各一斤,相当于现在的二两,浓朴应当用四两,杏仁应当用六钱一分,麻仁一两二钱半,芍药一两,这样剂量均衡合理,用药应当依据医理推导。
The stomach, large intestine, small intestine, and bladder are the foundation of food storage and the residence of Ying Qi (Nutritive Qi), named as "vessels" (Qi), capable of transforming dregs and regulating the entry and exit of flavors. If a person is injured by external pathogens such as Wind-Cold, Summer-Heat, or Dampness, or if internal Heat is excessive, leading to the depletion of body fluids through sweating or promoting urination, causing dryness and涩滞 (astringency/stagnation) in the intestines and stomach, resulting in constipation and blockage, these belong to External Causes (Wai Suo Yin); or due to disharmony of Zang-Fu organ Qi, with obstruction between Yin and Yang, also causing constipation, named Zang Jie (Visceral Knotting), which belongs to Internal Causes (Nei Suo Yin); or due to dry and hot diet forming Re Zhong (Internal Heat), where Stomach Qi is strong and stagnant, leading to hard and constipated stool with frequent urination, named Pi Yue (Spleen Restraint), which belongs to Neither Internal Nor External Causes. Since it involves the Three Causes, treatment should follow the specific cause: for dryness, moisten it; for stagnation, lubricate it; for constipation, unblock it; for restraint, relax it; each has established methods.
Treating severe constipation with astringency, tenesmus, pain, and restlessness caused by Qi stagnation and flourishing Wind. The dosage of this medicine should be adjusted according to deficiency and excess.
Da Huang (Rhei Radix et Rhizoma, 4 liang, stir-fried with bran, steaming is also acceptable), Ren Shen (Ginseng Radix, 2 liang), He Zi Pi (Chebulae Fructus Pericarpium, 4 liang), Ma Ren (Cannabis Semen, 2 liang, ground separately).
Grind the above into fine powder, mix with refined honey to make pills the size of wutong seeds. Take 20 pills per dose, administered with warm water, warm wine, or rice drink, after meals and before bedtime.
Treating Fuyang pulse that is floating and choppy. Floating indicates strong Stomach Qi, choppy indicates frequent urination. The interaction of floating and choppy pulses leads to hard stool, known as Pi Yue (Spleen Restraint), characterized by hard stool, free urination, and no thirst.
Ma Zi Ren (Cannabis Semen, 5 liang, ground), Shao Yao (Paeoniae Radix Alba), Zhi Shi (Aurantii Fructus Immaturus, stir-fried with bran, 8 liang each), Da Huang (Rhei Radix et Rhizoma, steamed, 1 jin), Nong Po (Moutan Cortex / Magnolia Bark - Note: Nong Po usually refers to Houpo/Magnolia Bark, here specified as processed with ginger, 0.5 liang), Xing Ren (Pruni Armeniaci Semen Amarum, peeled, de-seeded, stir-fried, ground separately, 5.5 liang).
Grind the above into powder, mix with refined honey to make pills the size of wutong seeds. Take 20 pills per dose, administered with warm water; if ineffective, increase to 50 pills. Another method: Ma Ren 1.5 liang, Xing Ren 3 fen, Da Huang 1 liang, Zhi Shi, Shao Yao, Nong Po each 0.5 liang. This formula originates from Ju Fang (Formulas of the Bureau). Originally a Han dynasty formula, combining 1 jin each of Da Huang and Zhi Shi, equivalent to 2 liang currently; Nong Po should be 4 liang, Xing Ren should be 6 qian 1 zi, Ma Ren 1.25 liang, Shao Yao 1 liang, making the dosage balanced and reasonable. Medication should be deduced based on medical principles.