治诸泻根据后加减用
陈皮(一钱炒) 苍术(米泔浸去皮切片日晒干盐水炒一钱半) 黄芩(一钱) 泽泻(一
钱)
白术(陈土炒一钱半) 白芍药(酒炒一钱半) 猪苓 赤茯苓 黄连(姜汁炒八分) 半夏(姜
汁炒一钱二分) 甘草(五分) 桂(二分)
上用水二钟姜三片灯心一分煎八分空心温服泄泻注下如水本方加苍术车前子倍加白术
为末空心米汤调下煎服亦可湿热甚肛门如热汤者本方去桂加滑石末(二钱)倍黄芩(一钱)
山栀
(炒一钱)木通(八分)腹中痛下泄清冷喜热于荡熨口不燥渴者乃寒泻也三倍桂加肉豆蔻(面
包煨一钱)病甚者加丁香制附子(各八分)作丸服如人泻谷道不合或脱肛此元气下陷及大
肠不行收令故也用白木芍药神曲(俱炒)陈皮(不去白)肉豆蔻(煨)诃子肉乌梅五倍子(各等分)
为丸以四君子加防风升麻煎汤送下(此法试效)如食积时常腹痛泻积先以木香槟榔丸或枳
实
导滞丸推逐之然后以四苓加浓朴苍术神曲麦芽作丸服以安胃气(二方见袖珍方内五苓去桂冬
四苓)如泻水腹不痛者属气虚四君子倍白术加黄 升麻柴胡防风补而提之
泄泻日夜无度诸药不效者用针砂地龙猪苓各等分为末生葱捣汁调方寸匕贴脐心小便长泻
(即
止)大人小儿吐泻日久垂死灸天枢二穴(在脐两傍各开二寸)气海一穴(在脐下一寸半)中脘穴(
在脐上四寸半)
治疗各种类型的泄泻,根据具体情况在后文所述方剂基础上进行加减用药:
陈皮(一钱,炒制)、苍术(米泔水浸泡后去皮切片,日晒干燥,盐水炒制,一钱半)、黄芩(一钱)、泽泻(一钱);
白术(陈土炒制,一钱半)、白芍药(酒炒制,一钱半)、猪苓、赤茯苓、黄连(姜汁炒制,八分)、半夏(姜汁炒制,一钱二分)、甘草(五分)、桂枝(二分)。
以上药材,用水二钟,生姜三片,灯心草一分,煎至八分,空腹温服。若泄泻如水注下,本方加苍术、车前子,加倍使用白术,研为细末,空腹用米汤调服,煎服亦可。若湿热严重,肛门感觉如热汤烫灼者,本方去掉桂枝,加滑石末(二钱),加倍黄芩(一钱),加山栀(炒制,一钱)、木通(八分)。若腹中疼痛,排泄物清冷,喜欢热敷熨烫,口不干燥口渴者,这是寒性泄泻,三倍桂枝用量,加肉豆蔻(面粉包裹煨制,一钱)。病情严重者,加丁香、制附子(各八分),制成丸剂服用。如果患者肛门松弛不合或脱肛,这是由于元气下陷及大肠固摄功能失常所致,使用白芍药、神曲(均炒制)、陈皮(不去白)、肉豆蔻(煨制)、诃子肉、乌梅、五倍子(各等分),制成丸剂,用四君子汤加防风、升麻煎汤送服(此法经试用有效)。如果是食积导致的时常腹痛,泻下积滞物,先用木香槟榔丸或枳实导滞丸推逐积滞,然后再用四苓散加厚朴、苍术、神曲、麦芽制成丸剂服用,以安养胃气(这两个方剂见《袖珍方》内,五苓散去桂枝即为冬四苓)。如果是泻下水样便但腹部不痛者,属于气虚,用四君子汤加倍白术,加黄芪、升麻、柴胡、防风,采用补益并提升的方法治疗。
若泄泻日夜无度,各种药物无效者,用针砂、地龙、猪苓各等分,研为细末,用生葱捣汁调和,取一方寸匕大小贴敷于脐心,待小便通畅,泄泻即止。
成人小儿吐泻日久,濒临死亡者,灸天枢穴(在脐旁两侧各开二寸)、气海穴(在脐下一寸半)、中脘穴(在脐上四寸半)。
To treat various types of diarrhea (Xie Xie), modify the following prescription based on specific conditions:
Chenpi (Tangerine Peel, 1 qian, stir-fried), Cangzhu (Atractylodis Rhizoma, soaked in rice wash water, peeled, sliced, sun-dried, salt-water stir-fried, 1.5 qian), Huangqin (Scutellariae Radix, 1 qian), Zexie (Alismatis Rhizoma, 1 qian);
Baizhu (Atractylodis Macrocephalae Rhizoma, stir-fried with old soil, 1.5 qian), Baishao Yao (Paeoniae Radix Alba, wine-stir-fried, 1.5 qian), Zhuling (Polyporus, 1 qian equivalent implied by context/listing), Chifuling (Red Polyporus, 1 qian equivalent implied), Huanglian (Coptidis Rhizoma, ginger-juice stir-fried, 8 fen), Banxia (Pinelliae Rhizoma, ginger-juice stir-fried, 1.2 qian), Gancao (Glycyrrhizae Radix et Rhizoma, 5 fen), Guizhi (Cinnamomi Ramulus, 2 fen).
Take the above herbs, add two zhong of water, three slices of Shengjiang (Zingiberis Rhizoma Recens), and one fen of Dengxincao (Junci Medulla), decoct until reduced to eight fen. Take warm on an empty stomach. If diarrhea is profuse like water pouring, add Cangzhu (Atractylodis Rhizoma) and Cheqianzi (Plantaginis Semen) to this formula, double the amount of Baizhu (Atractylodis Macrocephalae Rhizoma), grind into fine powder, take on an empty stomach mixed with rice soup; decoction is also acceptable. If damp-heat is severe and the anus feels as if scalded by hot water, remove Guizhi (Cinnamomi Ramulus) from this formula, add Huashi (Talcum, 2 qian), double Huangqin (Scutellariae Radix to 1 qian), add Shanzhi (Gardeniae Fructus, stir-fried, 1 qian), and Mutong (Akebiae Caulis, 8 fen). If there is abdominal pain, cold clear excrement, preference for heat application, and no dry mouth or thirst, this is cold-type diarrhea (Han Xie). Triple the dosage of Guizhi (Cinnamomi Ramulus), add Roudoukou (Myristicae Semen, baked in flour, 1 qian). For severe cases, add Dingxiang (Caryophylli Flos) and Zhi Fuzi (Prepared Aconiti Lateralis Radix, each 8 fen), make into pills. If the anus is lax or prolapsed due to sinking of Yuanqi (Original Qi) and failure of the Dachang (Large Intestine) to consolidate, use Baishao Yao (Paeoniae Radix Alba), Shenqu (Massa Medicata Fermentata, both stir-fried), Chenpi (Tangerine Peel, keep the white pith), Roudoukou (Myristicae Semen, baked), Hezerou (Arecae Pericarpium), Wumei (Mume Fructus), and Wubeizi (Gallae Chinensis, equal parts), make into pills. Administer with decoction of Sijunzi Tang (Four Gentlemen Decoction) plus Fangfeng (Saposhnikoviae Radix) and Shengma (Cimicifugae Rhizoma) sent down (this method has been tested and proven effective). If food stagnation (Shi Ji) causes frequent abdominal pain and passage of stagnant matter, first use Muxiang Binglang Wan (Costi and Areca Nut Pills) or Zhishi Daozhi Wan (Immature Bitter Orange and Dreg-Guiding Pills) to push out the stagnation, then use Siling San (Four Polyporus Powder) plus Houpo (Magnoliae Officinalis Cortex), Cangzhu (Atractylodis Rhizoma), Shenqu (Massa Medicata Fermentata), and Maiya (Hordei Fructus Germinatus) made into pills to soothe the Weiqi (Stomach Qi) (these two formulas are found in *Xiuzhen Fang*; Siling San minus Guizhi is called Dong Siling). If watery diarrhea occurs without abdominal pain, it belongs to Qixu (Qi Deficiency); use Sijunzi Tang (Four Gentlemen Decoction) with doubled Baizhu (Atractylodis Macrocephalae Rhizoma), added with Huangqi (Astragali Radix), Shengma (Cimicifugae Rhizoma), Chaihu (Bupleuri Radix), and Fangfeng (Saposhnikoviae Radix), employing tonification and lifting methods.
For diarrhea occurring day and night without cessation where all medicines fail, use Zhensha (Needle Sand), Dilong (Pheretima), and Zhuling (Polyporus) in equal parts, grind into powder, mix with juice pressed from raw Congbai (Allii Fistulosi Bulbus), apply a measure of one cun bi (approx. 2.7g) to the center of the umbilicus. When urination becomes long/profuse, diarrhea stops immediately.
For adults and children suffering from prolonged vomiting and diarrhea nearing death, moxa Tian Shu (ST25, 2 cun lateral to the umbilicus), Qi Hai (CV6, 1.5 cun below the umbilicus), and Zhong Wan (CV12, 4.5 cun above the umbilicus).