〔《圣》〕治妊娠尿血。用阿胶炒黄为散,每食前以粥饮调下二钱匕。
〔《大》〕治妊娠尿血。
阿胶 熟地(各等分)
上为末,空心粥饮调二钱。
〔丹〕下血不可用纯寒凉药,必于寒凉药中,加辛味为佐。久不愈者,后用温剂,必兼升举药
中加酒浸炒凉药,如酒煮黄连丸之类。凡用血药,不可单行单止。肠风独在胃与大肠出,治用黄
芩、秦艽、槐角、升麻、青黛。定肠风痛,用苍术、滑石、当归、生地黄、黄芩、甘草。下血属虚
者,当温散之,四物加干姜、升麻。便血过多者,四物加 皮。有热者,四物加山栀、升麻、
秦艽、阿胶。有兼风者,苍术、秦艽、芍药、香附。胃清血,非蓝实不除。
〔《本》〕如下清血色鲜者,肠风也。血浊而色黯者,藏毒也。肛门射如血线者,虫痔也。亦是
一种下部虚,阳气不升,血随气而降者。
仲景云∶脉弦而大者,弦为紧,大为芤,紧则为寒,芤则为虚,寒虚相搏,此名为革,妇
人则半产漏下,
男子则亡血失精,此下部虚而下者也。若得革脉,须宜服温补药。虫痔宜熏,《千金》用
皮艾者佳,予尝用有效。(方见痔。)
〔垣〕升麻补胃汤治宿有肠血症,因五月大热吃杏,肠 下血远三四尺,散漫如筛,腰沉沉然,
腹中不痛,血色紫黑,病名湿毒肠 ,是阳明少阳经血症,升阳汤主之。
升麻(一钱半) 羌活(一钱) 独活(五分) 柴胡 防风(各钱半) 葛根(三分) 肉桂(少许)
白芍药(五分) 牡丹皮(半钱) 黄 (一钱) 熟地 生地(各五分) 归身(三分) 甘草(炙,五分)
上锉如麻子大,作二服,水二盏,煎一盏,去渣,稍热食前服。
和中益胃汤治太阴阳明腹痛,大便常溏泄,若不泄,即秘而难见,在后传作湿热毒,下
鲜红血,腹中微痛,胁下急缩,脉缓而洪弦,中指下得之,按之空虚。
熟地(三钱) 归身(酒洗,三分) 升麻(五分) 柴胡(五分) 苏木(一分) 本(二分)
甘草(炙,三分) 益智(三分)
上作一服,水三大盏,煎至一盏去渣,午食前温服,一帖愈。
升阳除湿和血汤治肠 下血。另作一 ,其血HT 出有力,而远射四散如筛下,春二月中旬,
日下二行,腹中大作痛,乃阳明气冲热毒所作也,当升阳去湿热,和血脉,不两服而愈。
生地 牡丹皮 甘草(各五分) 白芍药(一钱半) 熟地 黄 (一钱) 升麻(七分)
归身 苍术 秦艽 肉桂(各三分) 陈皮(二分) 甘草(炙,五分)
上 咀,作一服,水四大盏,煎一盏稍热,空心服立效。
益智和中汤治肠 下血,红或深紫黑色,腹中痛,腹皮恶寒,右三部脉中指下得之俱弦,
按之无力,关脉甚紧,肌表阳明分凉,腹皮热而喜热物熨之,内寒明矣。
升麻(一钱) 葛根(五分) 白芍药(钱半) 甘草(炙,一钱) 桂枝(四分) 益智(五分)
半夏(五分) 肉桂(一分) 归身(一钱) 黄 (一钱) 干姜(少许) 牡丹皮 柴胡(各五分)
上为粗末,作一服,水三盏,煎一盏,食后温服。
〔丹〕妇人年六十,性多沉怒,大便下血,十余年不止,食减形困,心摇动,或如烟熏,情
性极恶,早起面微浮急。此时便血尤未尽绝,中间若得一二日不来,则意思稍清,但遇稍不如意
事,则血复作,百法不治。左三部脉浮大,稍重手则无,久取之又似滞涩,而至数不匀,右三部沉
涩细弱,寸脉沉绝。予谓气郁生涎,涎郁胸中,清气不升,经脉壅遏不降,心血绝少,不能自养,
所以有如熏之状。非开涎不足以行气,非气行则血不能归隧道,以壮脾为君,诸药佐之。遂以二
陈汤加酒红花、升麻、当归身、酒黄连、青皮、贝母、泽泻、黄 、人参、白术、酒芍药,每
帖生附子一小片煎服,四帖后血止。遂去附子,加干葛、牡丹皮、山栀子,而如熏之状亦除去。
又于前方加缩砂、炒神曲、熟地、木香,倍参、术,服半月而全愈。
治下血。苍术、地黄,同擂细末为丸,不用铁器。
〔《玄》〕大便下血曰肠风,切勿止涩,究其本末症状,先清其表,后攻其里,其血自止。
如脉洪大,宜后方四物合解毒汤调治。(解毒汤方见发热。)
〔《本》〕治肠风泻血。
牵牛(五两) 牙皂(三两,不蛀者,捶碎)
上二味水浸三日后,除皂角不用,将酒一升煮,令干焙为末,炼蜜丸如桐子大。每服七丸,
温酒送下,空心日午夜卧各一服。或转下黄物,不妨。病可后,每日常服五丸,饭饮送下。
〔洁〕黄连汤治大便后下血,腹中不痛者,谓之湿毒下血。
黄连 当归(各五钱) 甘草(炙,二钱半)
上 咀,每服五钱,水煎。
芍药黄连汤治大便下血,腹中痛者,谓热毒下血。
芍药 黄连 当归(各半两) 大黄(一钱) 淡桂(五分) 甘草(炙,二钱)
上 咀,每服五钱,水煎。如痛甚者,调木香、槟榔末一钱服之。
〔垣〕夫肠 者,为水谷与血,另作一 ,如HT 桶涌出也。夏湿热太甚,正当客气盛,而
主气弱,故肠 之病甚也,以凉血地黄汤主之。
黄柏(去皮) 知母(炒。各一钱) 青皮(炒) 槐子(炒) 当归 熟地(各五分)
上 咀,俱作一服,水一盏,煎七分温服。如小便涩,脐下闷,或大便前后重,调木香、
槟榔细末各半钱,稍热于食前空心服。如里急后重,又不去者,当下之。如腹中动摇有水声,而
小便不调者,停饮也,诊是何脏,以去水饮药泻之。假令脉洪大,用泻火利小便之类是也。
如胃虚不能食,而大渴不止,不可用淡渗之药止之,乃胃中元气少故也,与七味白术散补之。
(方见消渴。)如发热恶热烦躁,大渴不止,肌热不欲近衣,其脉洪大,按之无力,或无目
痛鼻干者,非白虎汤症也,此血虚发躁,当以黄 一两,当归二钱, 咀。水煎服。如大便秘
塞,或里急后重,数至圊而不能便,或少有白脓,或少有血,慎勿利之,利之则必致病重,
反郁结不通,以升阳除湿防风汤升其阳,则阴气自降矣。
升阳除湿防风汤
苍术(酒浸,炒,去皮,净,四钱) 白术(一钱) 白茯苓 白芍药(各一钱) 防风(二钱)
上 咀,除苍术另作片,水一碗半,煮至二大盏,纳诸药同煎至一大盏,去渣,稍热空心食前
服。如飧泄不禁,以此药导其湿。如飧泄及泄不止,以风药升阳,苍术益胃去湿。脉实,腹胀
闭塞不通,宜从权,以苦多甘少药泄之。如得通,复以升阳汤助其阳。或不便,以升阳汤中加
泄药通之。
当归和血散治肠 下血,或湿毒下血。
槐花 青皮 荆芥 熟地 白术(各六分) 当归 升麻(各一钱) 川芎(四分)
上为末,每服二三钱,清水饮汤调,食前下。
〔《本》〕治肠风脏毒,槐花散。
槐花(炒) 柏叶(捣烂,焙) 荆芥 枳壳
上等分为末,每服二钱,米饮调,空心食前服。(《经验》治下血,槐花、荆芥等分为末,
酒调下一钱。)
〔《玄》〕大便下血者,肺与大肠受热,宜四物同解毒药,入艾煎,下三黄丸调治之。
〔丹〕治便血久久伤血,并麻风症,癣疮见面者用。
龟板(二两) 升麻 香附(各半两) 白芍药(一两半) 侧柏叶(一两) 椿皮(七钱半)
上为末粥丸,先用四物加白术、黄连、廿草、陈皮等药,作汤送下。
积热便血。苍术 陈皮(各二钱半) 黄柏 黄芩(各七钱半) 连翘(半钱) 生地膏(六两)
上为末,以地黄膏搜为丸。
脉缓大,口渴便血,月经紫色,劳挟湿热。
白术(五钱) 地黄 黄柏(炒) 白芍药(各三钱) 地榆(二钱) 黄芩(一钱) 香附(二钱)
上为末,炊饼为丸。
孙用和治肠风泻血。黄 、黄连等分为末,酒糊丸如绿豆大。每服三十丸,米饮下。
〔罗〕结阴丹治肠风下血,脏毒下血,诸大便血疾。
枳壳(麸炒) 威灵仙 黄 陈皮(去白) 椿根白皮 何首乌 荆芥穗(各半两)
上为末,酒糊丸如桐子大。每服五七十丸,陈米饮入醋少许煎过,放温送下。
〔《本》〕椿皮丸
臭椿皮(刮去粗皮焙,十四两) 苍术 枳壳(各二两)
上为末,醋糊丸如桐子大。空心食前,米饮下三四十丸。
治肠风泻血,久不止,玉屑丸。
槐根白皮(去粗皮) 苦楝根(去皮,各三两) 椿根白皮(四两,三味于九月后二月前取,
软者晒干) 天南星 半夏(各半两,并生用) 威灵仙(一
两) 寒食面(三两)
上为末,滴水丸如桐子大。每服三十丸,以水一盏,煎沸下丸子,煮令浮,以匙抄起,温
温送下不嚼,空心食前服。
顷年有人下血,几盈盆,顿尔疲萎,诸药不效。予曰∶此正肠风,令服玉屑丸,三服而愈。
〔《经》〕治脏毒下血。以苦楝子炒黄为末,蜜丸,米饮下,十丸至二十丸甚妙。
〔《斗》〕治肠风痔泻血。羊蹄根叶,蒸烂一碗,食之立瘥。
〔《外》〕治卒下血不止。龙胆草一虎口,以水五升,煮取二升半,分为五服瘥。
〔《本》〕蕨菜花不以多少,文武火焙干为末,每服三钱,饭饮调下。
〔子和〕一男子脏毒下血,当六月热不可堪,自甘于死,忽思蜜水,猛舍性命饮一大盏,
痛止血住。
〔《素》〕结阴者,便血一升,再结二升,三结三升。(骆龙吉云∶结阴之病,阴气内结不得
外行,血无所禀,渗入肠间,故便血也,其脉虚涩者是也。因血结不行故下。阴阳别论)血泄者
脉急,血无所行也。(从容篇)
〔罗〕真定总管史侯男,年四十二岁,形体本瘦,因勉强饮酸酒得腹痛,次传泄泻,十余日。
便后见血,或红或紫,肠鸣腹痛。医以诸见血皆热,治以芍药柏皮汤之类,前证如故,仍不欲食,
食则呕酸,形体愈瘦。面色青黄不泽,心下痞,恶冷物,口干,时有烦躁,不得安卧。请予治之,
诊得脉弦细而微迟,手足稍冷。《内经》曰∶结阴者,便血一升,再结二升,三结三升。又曰∶
邪至五脏,则阴脉不和,阴脉不和,则血留之。结阴之病,阴气内结,不得外行,血无所禀,
渗入肠间,故便血也,以平胃地榆汤主之。
苍术(一钱) 白术 陈皮 茯苓 浓朴(各五分) 甘草(炙) 干姜 当归 炒曲 白芍药
益智仁 人参(各三分) 地榆(七分) 升麻(一钱) 葛根(五分) 黑附子(炮,一钱)
上作一服,水二盏,生姜三片,枣二枚,煎至一盏去渣,食前温服。此药温中散寒,除湿和
胃,数服病减大半。又灸中脘二七壮,引胃气上升,次灸气海百壮,生发元气,灸则强食生肉,
以还少丹服之,至春再灸
三里二七壮,温脾壮胃,生发元气,次服芳香之剂,慎言语、节饮食而愈。
〔海〕杨师大醉,醒发大渴,饮水三大盏,又饮冰茶三碗,后病便鲜血四次,约一盆。先与吴
茱萸丸,翌日又与平胃五苓各半散,三大服,血止后自利。又与神应丸,四服自利乃止。或问曰∶
何不用黄连之类以解毒?予曰∶若用寒药,其疾大变,难治。寒饮内伤,复用寒药,非其治也。况
血为寒所凝,入大肠间,而便下血,温之乃行,所以得热则自止。杨氏饮冷酒,泻血,服对金
散止。亦理中脘,分利阴阳,安定血脉之意也。
唐生病,因饮酪水,及食生物,下利紫黑血十余行,脾胃受寒湿毒,与六神平胃散半两,加
白术三钱,以利腰脐间血,一服愈。
〔《易》〕胃风汤治大人小儿风冷乘虚入客肠胃,水谷不化,泄泻注下,及肠胃湿毒,下如
豆汁,或下瘀血,日夜无度。
人参 茯苓 川芎 官桂 当归 芍药 白术(各等分)
上 咀,每服二钱,水一大盏,粟米百余粒同煎七分,去渣,稍热空心服,小儿量力增减。
若加熟地、黄 、甘草等分为十味,名十补汤。若虚劳嗽,加五味子。若有痰,加半夏。若发热,
加柴胡。若有汗,加牡蛎。若虚寒,加附子。若寒甚,加干姜,皆根据本方等分。若骨蒸发热,饮食
自若者,用十补汤加柴胡一两。若气弱,加人参。若小便不利,加茯苓。若脉弦涩,加川芎。
若恶风,加官桂。若脉涩,加当归。若腹痛,加白芍药。若胃热湿盛,加白术。
〔洁〕治血下,防风为上使,黄连为中使,地榆为下使。若血瘀色紫者,陈血也,加熟地黄。
若血鲜色红者,新血也,加生地黄。若寒热者,加柴胡。若肌热者,加地骨皮。若脉洪实痛甚者,
加酒浸大黄。
治肠风,乌荆丸。
川乌头(一两,炮,去皮尖) 荆芥穗(二两)
上为末,醋丸桐子大。每服二十丸,温酒送下,熟水亦得。有病发时,食前日三服。无病
时,日一服。
〔仲〕下血,先便后血者,此远血也,黄土汤主之。
甘草 熟地 白术 附子(炮) 阿胶 黄芩(各三两) 灶中黄土(半升)
上七味,以水八升,煮取三升,分温二服。
下血,先血后便者,此近血也,赤小豆当归散主之。
【《圣济总录》】治疗妊娠期间尿血。将阿胶炒至微黄,研成散剂,每次在饭前用米粥水调服二钱匕。
【《大还丹方》】治疗妊娠期间尿血。
阿胶、熟地黄(各等分)
以上药物研为细末,空腹时用米粥水调服二钱。
【朱丹溪】下血证不可单纯使用寒凉药物,必须在寒凉药中加入辛味药物作为佐使。久治不愈者,后续应使用温性药剂,且必须在凉药中加酒浸泡后炒制,如酒煮黄连丸之类。凡使用调理血的药物,不可单独使用或单纯止血。肠风出血仅见于胃与大肠,治疗使用黄芩、秦艽、槐角、升麻、青黛。定肠风痛,使用苍术、滑石、当归、生地黄、黄芩、甘草。属于虚证的下血,应当温散,用四物汤加干姜、升麻。便血过多者,四物汤加地榆皮。有热者,四物汤加山栀、升麻、秦艽、阿胶。兼有风邪者,用苍术、秦艽、芍药、香附。胃中清血,非用蓝实不能清除。
【《本草衍义》】如果大便排出鲜红色血,是肠风。血色浑浊而颜色暗黑的,是脏毒。肛门喷射状出血如血线般的,是虫痔。这也是一种下部虚损,阳气不升,血随气下降的病症。
张仲景说:脉象弦而大的,弦代表紧,大代表芤(中空),紧则为寒,芤则为虚,寒与虚相互搏结,这称为革脉,妇女会出现半产漏下,男子则出现亡血失精,这是下部虚损导致的下血。若出现革脉,必须适宜服用温补药物。虫痔宜用熏法,《千金方》使用艾叶配合地榆效果佳,我曾使用有效。(方剂见痔疮篇。)
【李东垣】升麻补胃汤治疗素来患有肠风血症的人,因五月大热时吃杏子,导致肠道下血,射程远三四尺,散漫如筛孔般,腰部沉重感,腹部不痛,血色紫黑,病名湿毒肠风,属于阳明经和少阳经的血证,主方用升阳汤。
升麻(一钱半)、羌活(一钱)、独活(五分)、柴胡、防风(各一钱半)、葛根(三分)、肉桂(少许)、白芍药(五分)、牡丹皮(半钱)、黄芪(一钱)、熟地黄、生地黄(各五分)、当归身(三分)、甘草(炙,五分)
以上切碎如麻子大小,分为两服,用水两盏,煎至一盏,去渣,稍热后于食前服用。
和中益胃汤治疗太阴经和阳明经腹痛,大便常溏泄,如果不泄,就会便秘且难以看见,后期转化为湿热毒,排出鲜红血,腹部微痛,胁下拘急收缩,脉象缓而洪弦,中指下可感知,按压感觉空虚。
熟地黄(三钱)、当归身(酒洗,三分)、升麻(五分)、柴胡(五分)、苏木(一分)、藁本(二分)、甘草(炙,三分)、益智仁(三分)
以上作一服,用水三大盏,煎至一盏去渣,午食前温服,一帖即可痊愈。
升阳除湿和血汤治疗肠风下血。另外制作一剂,其血喷射而出有力,且远射四散如筛孔落下,春二月月中旬,每日排便两次,腹部剧烈疼痛,这是阳明经气冲热毒所致,应当升阳去除湿热,调和血脉,不到两服即可痊愈。
生地黄、牡丹皮、甘草(各五分)、白芍药(一钱半)、熟地黄、黄芪(一钱)、升麻(七分)、当归身、苍术、秦艽、肉桂(各三分)、陈皮(二分)、甘草(炙,五分)
以上切碎,作一服,用水四大盏,煎至一盏稍热,空腹服用立效。
益智和中汤治疗肠风下血,血色红或深紫黑色,腹部疼痛,腹皮怕冷,右三部脉在中指下均呈弦象,按压无力,关脉甚紧,肌表阳明部分发凉,腹皮发热且喜欢用热物熨烫,内寒非常明显。
升麻(一钱)、葛根(五分)、白芍药(一钱半)、甘草(炙,一钱)、桂枝(四分)、益智仁(五分)、半夏(五分)、肉桂(一分)、当归身(一钱)、黄芪(一钱)、干姜(少许)、牡丹皮、柴胡(各五分)
以上为粗末,作一服,用水三盏,煎至一盏,食后温服。
【朱丹溪】一位六十岁妇人,性格多抑郁易怒,大便下血,十余年不止,食欲减退身体困倦,心神摇动,有时感觉如烟熏一般,性情极恶,早起面部微浮且急迫。此时便血尚未完全断绝,中间若有一两天不来,则神志稍清,但遇到稍不如意的事,血又发作,各种方法都无效。左三部脉浮大,稍重按则无,久取之又似滞涩,而至数不均匀,右三部沉涩细弱,寸脉沉绝。我认为这是气郁生涎,涎郁胸中,清气不升,经脉壅遏不降,心血极少,不能自养,所以有如烟熏的感觉。不开除涎不足以行气,气不行则血不能回归隧道,以壮脾为主药,其他药物辅助。于是用二陈汤加酒红花、升麻、当归身、酒黄连、青皮、贝母、泽泻、黄芪、人参、白术、酒芍药,每帖加一小片生附子煎服,四帖后血止。随后去掉附子,加干葛、牡丹皮、山栀子,烟熏之感也消除了。又在前方加缩砂、炒神曲、熟地黄、木香,加倍人参、白术,服用半月而全愈。
【《玄珠密语》】大便下血叫肠风,切勿使用收敛止涩药,要探究其根本和症状,先清解表邪,后攻里邪,血自然停止。
如脉象洪大,宜用后方四物汤合解毒汤调治。(解毒汤方见发热篇。)
【《本草衍义》】治疗肠风泻血。
牵牛子(五两)、牙皂(三两,不蛀的,捶碎)
以上两味药用水浸泡三天后,除去皂角不用,将酒一升煮药,令药干焙为末,炼蜜丸如梧桐子大。每服七丸,温酒送下,空腹、日中、半夜、卧前各服一次。或者转下黄色物体,不妨碍。病后可日常服用五丸,饭饮送下。
【王洁古】黄连汤治疗大便后下血,腹部不痛的,称为湿毒下血。
黄连、当归(各五钱)、甘草(炙,二钱半)
以上切碎,每服五钱,水煎。
芍药黄连汤治疗大便下血,腹部痛的,称为热毒下血。
芍药、黄连、当归(各半两)、大黄(一钱)、淡桂(五分)、甘草(炙,二钱)
以上切碎,每服五钱,水煎。如果痛甚者,调服木香、槟榔末一钱。
【李东垣】所谓肠风,是水谷与血分开,另成一势,如桶中涌出一样。夏季湿热太盛,正当客气盛而主气弱,所以肠风病严重,以凉血地黄汤主治。
黄柏(去皮)、知母(炒,各一钱)、青皮(炒)、槐子(炒)、当归、熟地黄(各五分)
以上切碎,俱作一服,用水一盏,煎至七分温服。如果小便涩,脐下闷,或大便前后重坠,调服木香、槟榔细末各半钱,稍热于食前空腹服用。如果里急后重,又不去的,应当攻下。如果腹中有水声动摇,而小便不调的,是停饮,诊察是何脏,用去水饮药泻之。假如脉洪大,用泻火利小便之类。如果胃虚不能食,而大渴不止,不可用淡渗药止之,这是胃中元气少,给予七味白术散补之。(方见消渴篇。)如果发热恶热烦躁,大渴不止,肌热不欲近衣,脉洪大,按之无力,或无目痛鼻干的,不是白虎汤证,这是血虚发躁,当用黄芪一两,当归二钱,切碎,水煎服。如果大便秘塞,或里急后重,数至厕所而不能便,或少有白脓,或少有血,千万不要通利,通利则必致病重,反郁结不通,用升阳除湿防风汤升其阳,则阴气自降矣。
升阳除湿防风汤
苍术(酒浸,炒,去皮,净,四钱)、白术(一钱)、白茯苓、白芍药(各一钱)、防风(二钱)
以上切碎,除苍术另作片,用水一碗半,煮至两大盏,纳诸药同煎至一大盏,去渣,稍热空腹食前服。如果飧泄不禁,以此药导其湿。如果飧泄及泄不止,以风药升阳,苍术益胃去湿。脉实,腹胀闭塞不通,宜从权,用苦多甘少药泄之。如果得通,复以升阳汤助其阳。或不便利,以升阳汤中加泄药通之。
当归和血散治疗肠风下血,或湿毒下血。
槐花、青皮、荆芥、熟地黄、白术(各六分)、当归、升麻(各一钱)、川芎(四分)
以上为末,每服二三钱,清水饮汤调,食前下。
【《本草衍义》】治疗肠风脏毒,槐花散。
槐花(炒)、侧柏叶(捣烂,焙)、荆芥、枳壳
以上等分为末,每服二钱,米饮调,空心食前服。(《经验方》治下血,槐花、荆芥等分为末,酒调下一钱。)
【《玄珠密语》】大便下血者,肺与大肠受热,宜四物汤同解毒药,入艾叶煎,下三黄丸调治之。
【朱丹溪】治疗便血久久伤血,并麻风症,癣疮见面者用。
龟板(二两)、升麻、香附(各半两)、白芍药(一两半)、侧柏叶(一两)、椿皮(七钱半)
以上为末粥丸,先用四物汤加白术、黄连、甘草、陈皮等药,作汤送下。
积热便血。苍术、陈皮(各二钱半)、黄柏、黄芩(各七钱半)、连翘(半钱)、生地膏(六两)
以上为末,以地黄膏搜为丸。
脉缓大,口渴便血,月经紫色,劳挟湿热。
白术(五钱)、地黄、黄柏(炒)、白芍药(各三钱)、地榆(二钱)、黄芩(一钱)、香附(二钱)
以上为末,炊饼为丸。
孙用和治疗肠风泻血。黄芪、黄连等分为末,酒糊丸如绿豆大。每服三十丸,米饮下。
【罗天益】结阴丹治疗肠风下血,脏毒下血,诸大便血疾。
枳壳(麸炒)、威灵仙、黄芪、陈皮(去白)、椿根白皮、何首乌、荆芥穗(各半两)
以上为末,酒糊丸如梧桐子大。每服五七十丸,陈米饮入醋少许煎过,放温送下。
【《本草衍义》】椿皮丸
臭椿皮(刮去粗皮焙,十四两)、苍术、枳壳(各二两)
以上为末,醋糊丸如梧桐子大。空心食前,米饮下三四十丸。
治疗肠风泻血,久不止,玉屑丸。
槐根白皮(去粗皮)、苦楝根(去皮,各三两)、椿根白皮(四两,三味于九月后二月前取,软者晒干)、天南星、半夏(各半两,并生用)、威灵仙(一两)、寒食面(三两)
以上为末,滴水丸如梧桐子大。每服三十丸,以水一盏,煎沸下丸子,煮令浮,以匙抄起,温温送下不嚼,空心食前服。
近年有人下血,几乎满盆,顿时疲萎,诸药不效。我说:这正是肠风,令服玉屑丸,三服而愈。
【《内经》】治疗脏毒下血。以苦楝子炒黄为末,蜜丸,米饮下,十丸至二十丸甚妙。
【《斗门方》】治疗肠风痔泻血。羊蹄根叶,蒸烂一碗,食之立瘥。
【《外台秘要》】治疗卒然下血不止。龙胆草一虎口量,以水五升,煮取二升半,分为五服瘥。
【《本草衍义》】蕨菜花不以多少,文武火焙干为末,每服三钱,饭饮调下。
【张子和】一男子脏毒下血,当六月热不可堪,自甘于死,忽思蜜水,猛舍性命饮一大盏,痛止血住。
【《素问》】结阴者,便血一升,再结二升,三结三升。(骆龙吉说:结阴之病,阴气内结不得外行,血无所禀,渗入肠间,故便血也,其脉虚涩者是也。因血结不行故下。阴阳别论)血泄者脉急,血无所行也。(从容篇)
【罗天益】真定总管史侯男,年四十二岁,形体本瘦,因勉强饮酸酒得腹痛,次传泄泻,十余日。便后见血,或红或紫,肠鸣腹痛。医以诸见血皆热,治以芍药柏皮汤之类,前证如故,仍不欲食,食则呕酸,形体愈瘦。面色青黄不泽,心下痞,恶冷物,口干,时有烦躁,不得安卧。请予治之,诊得脉弦细而微迟,手足稍冷。《内经》说:结阴者,便血一升,再结二升,三结三升。又说:邪至五脏,则阴脉不和,阴脉不和,则血留之。结阴之病,阴气内结,不得外行,血无所禀,渗入肠间,故便血也,以平胃地榆汤主治。
苍术(一钱)、白术、陈皮、茯苓、浓朴(各五分)、甘草(炙)、干姜、当归、炒曲、白芍药、益智仁、人参(各三分)、地榆(七分)、升麻(一钱)、葛根(五分)、黑附子(炮,一钱)
以上作一服,用水二盏,生姜三片,枣二枚,煎至一盏去渣,食前温服。此药温中散寒,除湿和胃,数服病减大半。又灸中脘二七壮,引胃气上升,次灸气海百壮,生发元气,灸则强食生肉,以还少丹服之,至春再灸足三里二七壮,温脾壮胃,生发元气,次服芳香之剂,慎言语、节饮食而愈。
【王海藏】杨师大醉,醒发大渴,饮水三大盏,又饮冰茶三碗,后病便鲜血四次,约一盆。先与吴茱萸丸,翌日又与平胃五苓各半散,三大服,血止后自利。又与神应丸,四服自利乃止。或问曰:何不用黄连之类以解毒?我说:若用寒药,其疾大变,难治。寒饮内伤,复用寒药,非其治也。况血为寒所凝,入大肠间,而便下血,温之乃行,所以得热则自止。杨氏饮冷酒,泻血,服对金散止。亦理中脘,分利阴阳,安定血脉之意也。
唐生病,因饮酪水,及食生物,下利紫黑血十余行,脾胃受寒湿毒,与六神平胃散半两,加白术三钱,以利腰脐间血,一服愈。
【《易经》类医书】胃风汤治疗大人小儿风冷乘虚入客肠胃,水谷不化,泄泻注下,及肠胃湿毒,下如豆汁,或下瘀血,日夜无度。
人参、茯苓、川芎、官桂、当归、芍药、白术(各等分)
以上切碎,每服二钱,水一大盏,粟米百余粒同煎七分,去渣,稍热空心服,小儿量力增减。
若加熟地黄、黄芪、甘草等分为十味,名十补汤。若虚劳嗽,加五味子。若有痰,加半夏。若发热,加柴胡。若有汗,加牡蛎。若虚寒,加附子。若寒甚,加干姜,皆根据本方等分。若骨蒸发热,饮食自若者,用十补汤加柴胡一两。若气弱,加人参。若小便不利,加茯苓。若脉弦涩,加川芎。若恶风,加官桂。若脉涩,加当归。若腹痛,加白芍药。若胃热湿盛,加白术。
【王洁古】治血下,防风为上使,黄连为中使,地榆为下使。若血瘀色紫者,陈血也,加熟地黄。若血鲜色红者,新血也,加生地黄。若寒热者,加柴胡。若肌热者,加地骨皮。若脉洪实痛甚者,加酒浸大黄。
治疗肠风,乌荆丸。
川乌头(一两,炮,去皮尖)、荆芥穗(二两)
以上为末,醋丸桐子大。每服二十丸,温酒送下,熟水亦得。有病发时,食前日三服。无病时,日一服。
【张仲景】下血,先便后血者,此远血也,黄土汤主治。
甘草、熟地黄、白术、附子(炮)、阿胶、黄芩(各三两)、灶中黄土(半升)
以上七味,以水八升,煮取三升,分温二服。
[Shengji Zonglu] Treats hematuria during pregnancy. Stir-fry Ejiao (Colla Corii Asini, Donkey-hide Gelatin) until slightly yellow, grind into a powder. Before each meal, take two qianbi with millet gruel water.
[Dahuan Danfang] Treats hematuria during pregnancy.
Ejiao (Colla Corii Asini), Shudi Huang (Rehmanniae Radix Praeparata) in equal parts.
Grind the above herbs into fine powder. Take two qian on an empty stomach with millet gruel water.
[Zhu Danxi] For lower gastrointestinal bleeding, pure cold and bitter drugs should not be used alone; acrid flavors must be added as assistants to cold drugs. For chronic cases that do not heal, warm agents should be used later, specifically cooling drugs soaked in wine and stir-fried, such as Jiu Zhu Huanglian Wan (Wine-Boiled Coptis Pill). When using blood-regulating drugs, one should not use them singly or merely stop bleeding. Intestinal wind bleeding occurs only in the Stomach and Large Intestine; treatment uses Huang Qin (Scutellariae Radix), Qin Jiao (Gentianae Macrophyllae Radix), Huai Jiao (Aescini Fructus), Sheng Ma (Cimicifugae Rhizoma), and Qing Dai (Indici Folium). To relieve intestinal wind pain, use Cang Zhu (Atractylodis Rhizoma), Hua Shi (Talcum), Dang Gui (Angelicae Sinensis Radix), Sheng Di Huang (Rehmanniae Radix), Huang Qin, and Gan Cao (Glycyrrhizae Radix et Rhizoma). For deficiency-type lower bleeding, warm dispersion is indicated: Si Wu Tang (Four Substances Decoction) plus Gan Jiang (Zingiberis Rhizoma) and Sheng Ma. For excessive rectal bleeding, add Di Yu Pi (Sanguisorbae Radix) to Si Wu Tang. For heat patterns, add Shan Zhi (Gardeniae Fructus), Sheng Ma, Qin Jiao, and Ejiao. For patterns with wind, use Cang Zhu, Qin Jiao, Shao Yao (Paeoniae Radix), and Xiang Fu (Cyperi Rhizoma). Clear blood from the Stomach cannot be removed without Lan Shi (Baphicacanthi Cuspidis Folium et Radix).
[Bencao Yan yi] If fresh red blood is passed in stool, it is intestinal wind. If the blood is turbid and dark, it is zang du (visceral toxin). If blood shoots from the anus like a thread, it is chong zhi (worm hemorrhoid). This is also a type of lower jiao deficiency where yang qi fails to ascend, and blood follows qi downward.
Zhang Zhongjing said: A pulse that is xian (wiry) and da (large); xian indicates jin (tight), da indicates kou (hollow). Jin implies cold, kou implies deficiency. Cold and deficiency clashing together is called ge (leather) pulse. In women, this leads to miscarriage and dripping bleeding; in men, it leads to loss of blood and essence. This is lower jiao deficiency causing bleeding. If a ge pulse is found, warm tonifying drugs are required. Chong zhi should be treated with fumigation; Qian Jin Fang suggests using Ai Ye (Artemisiae Argyi Folium) with Di Yu, which I have found effective. (Formula see Hemorrhoids.)
[Li Dongyuan] Shengma Buweitang (Cimicifuga Stomach-Supplementing Decoction) treats chronic intestinal wind blood syndrome. After eating apricots in the intense heat of May, the patient experienced rectal bleeding shooting 3-4 chi away, scattered like a sieve, with a heavy sensation in the waist but no abdominal pain. The blood was purple-black. The disease name is shidu changfeng (damp-toxin intestinal wind), involving the Yangming and Shaoyang meridians. The main formula is Shengyang Tang.
Sheng Ma (1.5 qian), Qiang Huo (1 qian), Du Huo (0.5 qian), Chai Hu, Fang Feng (each 1.5 qian), Ge Gen (0.3 qian), Rou Gui (a little), Bai Shao Yao (0.5 qian), Mu Dan Pi (0.5 qian), Huang Qi (1 qian), Shu Di Huang, Sheng Di Huang (each 0.5 qian), Dang Gui Shen (0.3 qian), Zhi Gan Cao (0.5 qian).
Cut into pieces the size of hemp seeds. Divide into two doses. Boil in 2 liang of water until 1 liang remains. Strain and take warm before meals.
Hezhong Yiwetang (Harmonize Middle and Benefit Stomach Decoction) treats Taiyin and Yangming meridian abdominal pain, frequent loose stools. If not loose, then constipation makes blood hard to see. Later transforming into damp-heat toxin, bright red blood is passed with slight abdominal pain, tightness in the hypochondrium, and a slow, surging, wiry pulse felt at the middle finger, feeling empty upon pressure.
Shu Di Huang (3 qian), Dang Gui Shen (wine-washed, 0.3 qian), Sheng Ma (0.5 qian), Chai Hu (0.5 qian), Su Mu (0.1 qian), Ben Cao (Ligustici Chuanxiong Rhizoma, 0.2 qian), Zhi Gan Cao (0.3 qian), Yi Zhi Ren (0.3 qian).
Make one dose. Boil in 3 large liang of water until 1 liang remains. Strain and take warm before noon meal. One prescription cures.
Shengyang Qushi Hexue Tang (Raise Yang, Dispel Dampness, and Harmonize Blood Decoction) treats intestinal wind bleeding. Another preparation: blood shoots out forcefully and scatters like a sieve. In mid-spring, bowel movements occur twice daily with severe abdominal pain. This is caused by Yangming qi rushing with heat toxin. One must raise yang, dispel damp-heat, and harmonize blood vessels. It heals in less than two doses.
Sheng Di Huang, Mu Dan Pi, Gan Cao (each 0.5 qian), Bai Shao Yao (1.5 qian), Shu Di Huang, Huang Qi (1 qian), Sheng Ma (0.7 qian), Dang Gui Shen, Cang Zhu, Qin Jiao, Rou Gui (each 0.3 qian), Chen Pi (0.2 qian), Zhi Gan Cao (0.5 qian).
Cut into pieces. Make one dose. Boil in 4 large liang of water until 1 liang remains. Take warm on an empty stomach for immediate effect.
Yizhi Hezhong Tang (Wisdom Fruit and Harmonize Middle Decoction) treats intestinal wind bleeding with red or deep purple-black blood, abdominal pain, cold sensitivity of the abdominal skin. The right three positions of the pulse feel wiry at the middle finger, weak upon pressure, with a very tight guan position. The yangming area of the body surface is cool, while the abdominal skin is hot and prefers heat application, indicating obvious internal cold.
Sheng Ma (1 qian), Ge Gen (0.5 qian), Bai Shao Yao (1.5 qian), Zhi Gan Cao (1 qian), Gui Zhi (0.4 qian), Yi Zhi Ren (0.5 qian), Ban Xia (0.5 qian), Rou Gui (0.1 qian), Dang Gui Shen (1 qian), Huang Qi (1 qian), Gan Jiang (a little), Mu Dan Pi, Chai Hu (each 0.5 qian).
Make coarse powder. One dose. Boil in 3 liang of water until 1 liang remains. Take warm after meals.
[Zhu Danxi] A sixty-year-old woman, prone to depression and anger, has had rectal bleeding for over ten years. Appetite decreased, body weary, heart palpitations, sensation of smoke burning, extreme irritability, slight facial puffiness and urgency in the morning. Bleeding had not completely ceased; if it stopped for a day or two, clarity returned, but any minor dissatisfaction triggered bleeding again. All methods failed. Left three positions pulse: floating and large, disappearing with light pressure, sluggish and irregular upon deep pressure. Right three positions: deep, sluggish, fine, weak; cun position pulse is deep and absent. I reasoned that qi stagnation generates phlegm-fluid; phlegm-fluid stagnates in the chest, preventing clear qi from ascending and blocking meridians so they fail to descend. Heart blood is scant and cannot nourish itself, causing the smoke-burning sensation. Without resolving phlegm-fluid, qi cannot move; without qi movement, blood cannot return to its vessels. Tonify Spleen as the sovereign drug, assisted by others. Use Er Chen Tang (Two-Cured Decoction) plus Jiu Hong Hua (Safflower soaked in wine), Sheng Ma, Dang Gui Shen, Jiu Huang Lian (Coptis soaked in wine), Qing Pi (Citri Reticulatae Pericarpium), Bei Mu (Fritillariae Bulbus), Ze Xie (Alismatis Rhizoma), Huang Qi, Ren Shen (Ginseng Radix), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Jiu Shao Yao (Peony soaked in wine). Add one small slice of Sheng Fu Zi (Aconiti Lateralis Radix Preparata) per prescription, boiled together. Bleeding stopped after four prescriptions. Remove Fu Zi, add Ge Gen, Mu Dan Pi, Shan Zhi. The smoke-burning sensation disappeared. Add Su Sha (Amomi Fructus Rotundus), Chao Shen Qu (Fermented Medicinal Leaven stir-fried), Shu Di Huang, Mu Xiang (Aucklandiae Radix), double Ren Shen and Bai Zhu. Taken for half a month, full recovery.
For lower bleeding: Cang Zhu and Di Huang, pounded into fine powder for pills. Do not use iron vessels.
[Xuanzhu Miyu] Rectal bleeding is called chang feng (intestinal wind). Do not use astringents. Investigate the root and symptoms. First clear the exterior, then attack the interior; the blood will stop naturally.
If the pulse is hong da (surging and large), use Si Wu Tang combined with Jiedu Tang (Detoxification Decoction). (Jiedu Tang formula see Fever.)
[Bencao Yan yi] Treats chang feng xie xue (intestinal wind diarrhea with blood).
Qian Niu (Pharbitidis Semen), Ya Zao (Gleditsiae Sinensis Spina) three liang (non-moth-eaten, crushed).
Soak these two ingredients in water for three days. Remove the Gleditsia spines. Boil with one sheng of wine until dry. Roast and grind into powder. Form pills with refined honey the size of paulownia seeds. Take seven pills with warm wine on an empty stomach, at noon, midnight, and before bed. Passing yellow matter is acceptable. After the illness subsides, take five pills daily with rice drink.
[Wang Jiegu] Huanglian Tang (Coptis Decoction) treats rectal bleeding after defecation without abdominal pain, called shidu xiexue (damp-toxin lower bleeding).
Huang Lian (Coptidis Rhizoma), Dang Gui (each 5 qian), Zhi Gan Cao (2.5 qian).
Cut into pieces. Take 5 qian per dose, decoct in water.
Shaoyao Huanglian Tang (Peony and Coptis Decoction) treats rectal bleeding with abdominal pain, called redou xiexue (heat-toxin lower bleeding).
Shaoyao, Huang Lian, Dang Gui (each 0.5 liang), Da Huang (Rhei Radix et Rhizoma, 1 qian), Dan Gui (Cinnamomi Ramulus, 0.5 qian), Zhi Gan Cao (2 qian).
Cut into pieces. Take 5 qian per dose, decoct in water. If pain is severe, mix with 1 qian of Muxiang and Bing Lang (Arecae Semen) powder.
[Li Dongyuan] "Chang feng" refers to water/grain and blood separating into distinct streams, gushing like from a bucket. In summer, damp-heat is excessive. When pathogenic qi is strong and host qi is weak, chang feng disease is severe. Treat with Liangxue Dihuang Tang (Cool Blood and Rehmannia Decoction).
Huang Bo (Phellodendri Cortex), Zhi Mu (Anemarrhenae Rhizoma, fried, each 1 qian), Qing Pi (Citri Reticulatae Pericarpium Viride, fried), Huai Zi (Aescini Semen, fried), Dang Gui, Shu Di Huang (each 0.5 qian).
Cut into pieces. One dose. Boil in 1 liang of water until 0.7 liang remains. Take warm. If urine is difficult, lower abdomen feels stuffy, or there is tenesmus, mix with 0.5 qian each of Muxiang and Bing Lang fine powder. Take warm before meals on an empty stomach. If tenesmus persists, purge. If there is fluid sound in the abdomen and urination is irregular, it is fluid retention. Diagnose which organ and drain fluid with appropriate drugs. If pulse is surging and large, use fire-draining and diuretic methods. If Stomach deficiency prevents eating and thirst is unquenchable, do not use bland diuretics; this is lack of yuan qi in the Stomach. Use Qiwei Baizhu San (Seven-Ingredient Atractylodes Powder) to tonify. (Formula see Xiao Ke/Wasting-Thirst.) If fever, aversion to heat, irritability, unquenchable thirst, skin heat preferring no clothing, pulse surging and large but empty upon pressure, or without eye pain/nasal dryness, this is not Baihu Tang (White Tiger Decoction) syndrome. This is blood deficiency causing agitation. Use Huang Qi (1 liang) and Dang Gui (2 qian), cut, decoct in water. If constipation or tenesmus with frequent trips to toilet without passage, or small amounts of white pus/blood, do NOT purge. Purging will worsen the condition, causing obstruction. Use Shengyang Qushi Fangfeng Tang (Raise Yang, Dispel Dampness, and Saposhnikovia Decoction) to raise yang, so yin qi descends naturally.
Shengyang Qushi Fangfeng Tang
Cang Zhu (wine-soaked, fried, peeled, clean, 4 qian), Bai Zhu (1 qian), Bai Fu Ling (Poria, 1 qian), Bai Shao Yao (1 qian), Fang Feng (Saposhnikoviae Radix, 2 qian).
Cut into pieces. Except Cang Zhu which is sliced separately, boil Cang Zhu in 1.5 bowls of water until 2 large liang remain. Add other herbs, boil until 1 large liang remains. Strain. Take warm before meals on an empty stomach. For uncontrollable undigested diarrhea, use this to guide out dampness. For persistent diarrhea, use wind-drugs to raise yang; Cang Zhu benefits Stomach and dispels dampness. If pulse is solid, abdominal distension and blockage prevail, use bitter-dominant, sweet-minimal drugs to purge temporarily. Once open, assist yang with Shengyang Tang. If still blocked, add purgatives to Shengyang Tang.
Danggui Hexue San (Angelica Harmonizing Blood Powder) treats chang feng bleeding or shidu bleeding.
Huai Hua (Sophorae Flos), Qing Pi, Jing Jie (Schizonepetae Spica), Shu Di Huang, Bai Zhu (each 0.6 fen), Dang Gui, Sheng Ma (each 1 qian), Chuan Xiong (Ligustici Chuanxiong Rhizoma, 0.4 fen).
Grind into powder. Take 2-3 qian mixed with clear water drink before meals.
[Bencao Yan yi] Treats chang feng and zang du, Huaihua San.
Huai Hua (fried), Ce Bai Ye (Biota Tops), Jing Jie, Zhi Qiao (Aurantii Fructus).
Equal parts ground to powder. Take 2 qian mixed with rice drink before meals on an empty stomach. (Experience Formula: for lower bleeding, Huai Hua and Jing Jie equal parts, powder, take 1 qian with wine.)
[Xuanzhu Miyu] Rectal bleeding due to heat in Lung and Large Intestine. Use Si Wu Tang with detoxification drugs, add Ai Ye (Mugwort Leaf) to decoct, followed by Sanhuang Wan (Three-Yellow Pill).
[Zhu Danxi] For chronic rectal bleeding injuring blood, leprosy, and tinea faciei.
Gui Ban (Testudinis Carapax et Plastrum, 2 liang), Sheng Ma, Xiang Fu (each 0.5 liang), Bai Shao Yao (1.5 liang), Ce Bai Ye (1 liang), Chun Pi (Toosendan Fructus Cortex, 0.75 liang).
Grind into powder, make pill with gruel. First, take Si Wu Tang plus Bai Zhu, Huang Lian, Gan Cao, Chen Pi as decoction to send down the pills.
Accumulated Heat Rectal Bleeding. Cang Zhu, Chen Pi (each 2.5 qian), Huang Bo, Huang Qin (each 7.5 qian), Lian Qiao (Forsythiae Fructus, 0.5 qian), Sheng Di Gao (Rehmannia Paste, 6 liang).
Grind into powder, bind with Rehmannia paste to form pills.
Slow and large pulse, thirst, rectal bleeding, purple menstruation, labor complicated by damp-heat.
Bai Zhu (5 qian), Di Huang, Huang Bo (fried), Bai Shao Yao (each 3 qian), Di Yu (Sanguisorbae Radix, 2 qian), Huang Qin (1 qian), Xiang Fu (2 qian).
Grind into powder, bind with steamed bun dough to form pills.
Sun Yonghe treats chang feng xie xue. Huang Qi, Huang Lian equal parts, powder, wine paste pills size of mung beans. Take 30 pills with rice drink.
[Luo Tianyi] Jieyin Dan (Knotting Yin Pill) treats chang feng bleeding, zang du bleeding, all rectal bleeding disorders.
Zhi Qiao (bran-fried), Weiling Xian (Salviae Miltiorrhizae? No, Clematidis Radix et Rhizoma), Huang Qi, Chen Pi (peeled), Chun Gen Bai Pi (Toosendan Root Bark), He Shou Wu (Polygoni Multiflori Radix), Jing Jie Sui (Schizonepeta Spike, each 0.5 liang).
Grind into powder, wine paste pills size of paulownia seeds. Take 50-70 pills with aged rice drink with a little vinegar boiled, warm when taken.
[Bencao Yan yi] Chunpi Wan
Chou Chun Pi (Stinking Toosandan Root Bark, scraped and roasted, 14 liang), Cang Zhu, Zhi Qiao (each 2 liang).
Grind into powder, vinegar paste pills size of paulownia seeds. Take 30-40 pills with rice drink before meals on an empty stomach.
Yu Xie Wan (Jade Dust Pill) for chronic chang feng xie xue not stopping.
Huai Gen Bai Pi (Sophora Root Bark, peeled), Ku Lian Gen (Melia Root Bark, each 3 liang), Chun Gen Bai Pi (4 liang, harvested between Sept-Feb, soft ones dried), Tian Nan Xing (Arisaematis Rhizoma), Ban Xia (Pinelliae Rhizoma, each 0.5 liang, raw), Weiling Xian (1 liang), Han Shi Mian (Cold Food Dough, 3 liang).
Grind into powder, drop-water pills size of paulownia seeds. Take 30 pills. Boil in 1 liang of water, drop pills in, boil until floating. Scoop up with spoon, swallow warm without chewing, before meals on an empty stomach.
Recently, a person bled almost a basin, suddenly became weak and atrophic, all drugs failed. I said: This is exactly chang feng. Prescribed Yu Xie Wan. Cured in three doses.
[Jing Lei] Treats zang du bleeding. Ku Lian Zi (Melia Seed) fried yellow, powder, honey pills, rice drink. 10-20 pills is excellent.
[Doumen Fang] Treats chang feng hemorrhoid bleeding. Yang Ti Gen Ye (Rumex Root and Leaf), steamed until soft, one bowl. Eat immediately, cured.
[Waitai Mi Yao] Treats sudden continuous rectal bleeding. Long Dan Cao (Gentianae Radix) one tiger-mouthful. Boil in 5 sheng of water until 2.5 sheng remains. Divide into five doses. Cured.
[Bencao Yan yi] Jue Cai Hua (Bracken Flower) any amount. Dry roast with gentle/strong fire, grind to powder. Take 3 qian with rice drink.
[Zhang Hezi] A man with zang du bleeding endured unbearable June heat, resigned to death. Suddenly craved honey water. Drank a large cup desperately. Pain stopped, bleeding ceased.
[Suwen] Jieyin (Knotting Yin): rectal bleeding 1 sheng, second knot 2 sheng, third knot 3 sheng. (Luo Longji says: Jieyin disease, yin qi knots internally, cannot circulate externally. Blood has no source, seeps into intestines, hence rectal bleeding. Pulse is deficient and sluggish. Because blood knots and does not flow, it falls. Yin-Yang Differentiation Discussion) Blood leakage pulse is urgent; blood has nowhere to go. (Congrong Chapter)
[Luo Tianyi] Son of Prefect Shi from Zhending, age 42, originally thin. Forced consumption of sour wine caused abdominal pain, then diarrhea for over ten days. Blood seen after defecation, red or purple, borborygmus and abdominal pain. Doctors assumed all bleeding is heat, treated with Shaoyao Bapi Tang etc. Symptoms remained, no appetite, vomiting acid when eating, body wasted further. Complexion green-yellow dull, epigastric fullness, aversion to cold, dry mouth, occasional irritability, unable to sleep peacefully. Consulted me. Pulse wiry, fine, slightly slow. Hands and feet slightly cold. Neijing says: Jieyin... 1, 2, 3 sheng. Also: Pathogen reaches five zang, yin pulses discordant, yin pulses discordant, blood stagnates. Jieyin disease, yin qi knots internally, cannot circulate externally. Blood has no source, seeps into intestines, hence rectal bleeding. Treat with Pingwei Diyutang (Regular Stomach and Sanguisorba Decoction).
Cang Zhu (1 qian), Bai Zhu, Chen Pi, Fu Ling (Poria), Hou Po (Magnoliae Officinalis Cortex, each 0.5 qian), Zhi Gan Cao, Gan Jiang, Dang Gui, Chao Qu (Fermented Leaven), Bai Shao Yao, Yi Zhi Ren, Ren Shen (each 0.3 qian), Di Yu (0.7 qian), Sheng Ma (1 qian), Ge Gen (0.5 qian), Hei Fu Zi (Prepared Black Aconite, 1 qian).
One dose. Water 2 liang, Ginger 3 slices, Jujube 2 fruits. Boil to 1 liang. Strain. Take warm before meals. This drug warms middle, disperses cold, dispels dampness, harmonizes Stomach. After several doses, illness reduced by half. Moxibustion on Zhongwan (CV12) 14 moxa cones to guide Stomach qi upward. Then Moxibustion on Qihai (CV6) 100 cones to generate yuan qi. Moxibustion strengthens eating and flesh growth. Take Huan Shao Dan (Restore Youth Pill). In Spring, moxa Zusanli (ST36) 14 cones to warm Spleen/Stomach, generate yuan qi. Then take aromatic agents. Guard speech, regulate diet. Cured.
[Wang Haicang] Master Yang got drunk, woke thirsty, drank 3 large cups of water, then 3 bowls of iced tea. Later had 4 episodes of bright red rectal bleeding, about a basin. First gave Wuzhuyu Wan (Evodia Pill). Next day gave Pingwei Wuling Gebsan (Half-Half Powder of Regular Stomach and Five-Ingredient Poria Decoction). Three large doses. Bleeding stopped, then spontaneous diarrhea. Then gave Shenyin Wan (Divine Response Pill). Four doses. Spontaneous diarrhea stopped. Asked: Why not use Huang Lian to detoxify? I said: If cold drugs are used, the disease changes drastically and becomes hard to treat. Cold fluids injure internally; adding cold drugs is incorrect. Moreover, blood congeals due to cold, enters Large Intestine, and bleeds. Warming allows it to flow; thus heat stops it. Yang's cold wine drinking caused bloody diarrhea; stopped with Duijin San (Pairing Gold Powder). This also regulates Middle Jiao, separates yin/yang, stabilizes blood vessels.
Tang suffered illness from drinking milk water and eating raw food. Lowered purple-black blood over ten times. Spleen/Stomach affected by cold-damp toxin. Given Ban Liang of Liushen Pingwei San (Six-God Regular Stomach Powder), plus 3 qian Bai Zhu to benefit blood in waist/navel. Cured in one dose.
[Yi Lei] Weifeng Tang (Stomach Wind Decoction) treats adults/children where wind-cold invades Spleen/Stomach due to deficiency. Undigested food/grain, diarrhea, damp-toxin in intestines, discharge like bean dregs or blood clots, day and night without limit.
Ren Shen, Fu Ling, Chuan Xiong, Guan Gui (Cinnamon Twig), Dang Gui, Shao Yao, Bai Zhu (equal parts).
Cut into pieces. Take 2 qian. Water 1 large liang, over 100 millet grains. Decoct to 0.7 liang. Strain. Take warm on empty stomach. Adjust for children.
If adding Shu Di Huang, Huang Qi, Gan Cao equal parts to make ten ingredients, named Shibutu Tang (Ten-Tonifying Decoction). For deficiency cough, add Wu Wei Zi (Schisandrae Fructus). For phlegm, add Ban Xia. For fever, add Chai Hu. For sweating, add Mu Li (Ostreae Concha). For deficiency cold, add Fu Zi. For severe cold, add Gan Jiang. All in equal parts to base formula. For bone-steaming fever with normal appetite, use Shibutu Tang plus 1 liang Chai Hu. For weak qi, add Ren Shen. For difficult urination, add Fu Ling. For wiry/sluggish pulse, add Chuan Xiong. For aversion to wind, add Guan Gui. For sluggish pulse, add Dang Gui. For abdominal pain, add Bai Shao Yao. For Stomach heat/dampness excess, add Bai Zhu.
[Wang Jiegu] For lower bleeding: Fang Feng (Saposhnikoviae Radix) is upper envoy, Huang Lian is middle envoy, Di Yu is lower envoy. If blood is purple (stale blood), add Shu Di Huang. If blood is bright red (fresh blood), add Sheng Di Huang. If chills/fever, add Chai Hu. If skin heat, add Digupi (Lycii Cortex). If pulse surging/solid with severe pain, add Jiu Da Huang (Rhubarb soaked in wine).
Treat chang feng, Wu Jing Wan (Black Pepper and Schizonepeta Pill).
Chuan Wu Tou (Aconiti Kusnezoffii Radix, fried, peeled, 1 liang), Jing Jie Sui (2 liang).
Grind into powder, vinegar pills size of paulownia seeds. Take 20 pills with warm wine or cooked water. When disease flares, take 3 times daily before meals. When asymptomatic, take once daily.
[Zhang Zhongjing] Rectal bleeding, stool precedes blood: this is distant bleeding (yuan xue). Treat with Huangtu Tang (Yellow Earth Decoction).
Gan Cao, Shu Di Huang, Bai Zhu, Fu Zi (fried), Ejiao, Huang Qin (each 3 liang), Zaotong Huangtu (Caolocus Terra, half sheng).
Seven ingredients. Water 8 sheng. Boil to 3 sheng. Divide into two warm doses.
Rectal bleeding, blood precedes stool: this is close bleeding (jin xue). Treat with Chixiaodou Danggui San (Adzuki Bean and Angelica Powder).