上 咀。每服一两,水一盏半,煎至一盏,温服无时。如痛,加桂少许。
当归导气汤 治脓血痢无度,小便不通,腹中痛。
当归(一钱) 甘草(一钱半) 芍药(一钱) 青皮 槐花(炒。各七分) 木香 槟榔(各三钱) 泽泻(五
分)
生地黄(钱半或二钱酒浸,阴干)
上为末,水煎,食前温服。如小便利,去泽泻。
〔仲〕下痢腹痛,紫参汤主之。
紫参(半斤) 甘草(三两)
上二味,以水五升,先煮紫参,取三升,内甘草,煮取一升半,分三次温服。
〔洁〕浓朴丸治处暑、秋、冬间腹痛下痢,大效。(方见反胃。)
〔世〕治痢疾,定痛,黑子丸。
黄蜡(五钱) 杏仁 江子 砂仁(各二十一枚)
上三件,香油灯上烧存性,熔蜡和匀,加乳香些少,丸如米大。每服十余粒。
〔《本》〕治积痢,定痛,灵砂丹。
砂 朱砂(各等分。研极细)
上用黄蜡五钱,巴豆三七粒,去壳皮膜,同于银石器内重汤煮一伏时,候巴豆紫黑为度。去二七粒,止用
一七粒,与前药二味同研极匀,再熔蜡和药,旋丸绿豆大。每服二丸至五丸。水泻,生姜汤下。白痢,艾汤。
赤痢,乌梅汤下。服时须极空心,服毕一时不可吃食,临卧尤佳。次食淡粥一日。疟疾,乳香汤,面东,不
发日晚间服。此药不动气,服之泻者止,痢者断,疼者愈,有积者内化,亦不动脏腑。大凡痢有沉积者,不
先去其积,虽暂安后必为害。常记陈侍郎经中,庚戌秋过仪真求诊,初不觉有疾,及诊视肝脉沉弦,附骨取
则牢。予曰∶病在左胁有血积,必发痛。陈曰∶诚如是。前某守九江,被召冒暑涉长江,暨抵行朝,血痢已
数日矣。急欲登对,医者以刚剂燥之。虽得止,数日脐下一块大如杯,旬日如碗大痛,发则不可忍,故急请
公祠以归耳,奈何?予曰∶积痢不可强止,故积血结于脐胁下,非抵当丸不可。渠疑而不肯服,次年竟以此终。
〔罗〕陈曲丸 治腹中冷痛,磨积止痢。
陈曲(一两半,炒) 干姜(炮) 官桂 白术 当归 浓朴 人参 甘草(炙。各半两)
上为细末,炼蜜丸,如桐子大。每服三五十丸,酒送下,或淡醋汤亦得,食前,一日三服。发时不拘增数。
上久病渐推其积方。
〔《脉》〕下痢而腹满为实,当下之。
〔丹〕初下痢腹痛,不可用参、术,然气虚、胃虚者可用。初得之,亦可用大承气、调胃承气下之,看其
气病、血病,然后加减用药。气用参、术,血用四物。因积作后重者,保和丸主之。五日后不可下,脾胃虚故也。
腹痛者,肺经之气,郁在大肠之间者,以苦梗发之,然后用治痢药,气用气药,血用血药。其或痢后糟粕
未实,或食粥稍多,或饥甚方食,肚中作疼,切不可惊恐,当以白术、陈皮各半,煎汤和之,自安。粥多及食
肉作痛者,宜夺食。夺食者,减其粥食,绝其肉味也。
〔垣〕茯苓汤 治因伤冷水泻,变作赤白痢,腹痛减食,热燥,四肢困倦无力。
茯苓(六分) 泽泻 归身(各四分) 芍药(一钱半) 苍术(二分) 生姜(二钱) 肉桂(五分) 黄芩(三
分,生)
猪苓(六分) 甘草(五分,炙) 升麻 柴胡(各一钱)
一本无升麻、柴胡。
上 咀,作二服,水煎稍热,食前服。
〔罗〕神效越桃散 治下痢之后,小便利,而腹中满痛不可忍,此名阴阳反错,不和之甚也。
大栀子 良姜(各三钱)
上为末。米饮或酒调下三钱。
《内经》脓血稠粘,皆属相火。夫太阴主泻,少阴主痢。是先泄亡津液,而火就燥,肾恶燥,居下焦血分,
其受邪者,故便脓血。然赤黄为热,青白为寒,治须两审。治热以坚中丸,豆蔻丸、香连丸,治寒白胶香散。
或多热少寒,水煮木香膏。虚滑频数,宜止宜涩,宜养脏汤。(木香、养脏汤,并见虚滑条。白胶香散未考。)
坚中丸 治脾胃受湿,滑泄注下。
黄连 黄柏 赤茯苓 泽泻 白术(各一两) 陈皮 肉豆蔻 白芍药 人参 官桂 半夏曲(各五钱)
上为末,汤浸蒸饼为丸,桐子大。每服五七十丸,温米饮送下,食前。
〔丹〕下血用四物为主,当凉血、和血,当归、桃仁之属。
〔洁〕溲而便脓血者,小肠泄也,脉得五至以上洪大者,宜七宣丸。脉平和者,立秋至春分,宜香连丸;
春分至立秋,宜芍药柏皮丸;四时皆宜加减平胃散。如有七宣丸症者,亦宜服此药,去其余邪,兼平胃气。
芍药柏皮丸方
芍药 黄柏(各等分)
上为细末,醋糊丸,如桐子大。每服五十丸,食前温汤下。
加减平胃散 经云∶四时皆以胃气为本。久下血则脾胃虚损,血水流于四肢,却入于胃而为血痢,宜服此滋养
脾胃。
白术 浓朴 陈皮(各一两) 槟榔(三钱) 甘草(七钱) 木香(三钱) 桃仁 人参 黄连 阿胶 茯苓(各
五钱)
上 咀。每服五钱,姜三片,枣一枚,水煎,温服无时。血多加桃仁。热泄加黄连。小便涩,加茯苓、泽
泻。气不下后重加槟榔、木香。腹痛加官桂、芍药、甘草。脓多,加阿胶。湿多加白术。脉洪大加大黄。
〔丹〕下血多主食积与热,或有用朴硝者。
苍术 白术 黄芩 芍药 滑石 茯苓 甘草 陈皮 神曲(炒) 煎,下保和丸。
〔世〕治痢食积。
附米 神曲 川芎 栀子 滑石 山楂 红曲 青黛 桃仁 为末,丸服。
〔丹〕青六丸 去三焦湿热,治泄泻,多与清化丸同服,并不单服。兼治产后腹痛或自利者,能补脾、
补血,亦治血痢效。
六一散(三两,即益元散) 红曲(炒,半两,活血)
上饭为丸。一方,酒糊丸。
二十九官,肚痢食少,下坠赤积,身热。
木通(二钱半) 芍药(炒) 陈皮 白术 滑石(各五钱) 甘草(五分)
分四帖,煎,下保和丸与点丸各十丸。
〔洁〕苍术地榆汤 治脾经受湿,下血痢。
苍术(三两) 地榆(一两)
上锉。每一两,水二盏,煎一盏,温服。
槐花丸 治血痢久不止,腹中不痛,不里急后重。
青皮 槐花 荆芥穗(各等分)
上为末,水煎,空心温服。
〔仲〕小肠有寒者,其人下重便血。
〔《集》〕治血痢神效。干姜于火上烧黑,不令成灰,瓷碗合放冷为末。每服一钱,米饮调下。
〔垣〕大便后有白脓,或只便白脓,因劳役气虚伤大肠也。以黄 、人参补之。如里急,频见污衣者,血
虚也,更加当归。如便白脓少而滑,频见污衣者,气脱加附子皮,甚则加御米壳。如气涩者,只以甘药补气,
当安卧不言,以养其气。(气涩忌御米壳,但服甘药,安卧不言。)
〔丹〕丈夫辛苦劳役,肚痢白泻。
滑石(一两) 陈皮 白术(六钱) 芍药(五钱) 黄芩(三钱) 甘草(五分,炙) 桃仁(三十个)
分六帖,水二盏半,煎取一盏,食前服。
孙郎中因饮水过多,腹胀,泻痢带白。
苍术 浓朴 白术 茯苓 滑石 下保和丸。又云,加炒曲、甘草。
治痢热多者。
大黄 黄连 黄柏 黄芩 枳壳 白芍药 当归 滑石 甘草 桃仁 白术
上等分为末,面糊丸。
〔世〕不问赤白痢。用苦 根,不拘生干,捣取汁,生姜蜜水调服。未效,再进半碗许,立愈。
〔《集》〕患赤白痢。山豆根捣末蜜丸,空心煎水下二十丸,三服止。
〔《千》〕治下痢冷热,诸治不瘥方。
乌头 黄连(各一升)
上二味为末,蜜和丸,如桐子大。下二十丸,日三、夜二,神妙。
〔世〕治似痢非痢,挟热者,用苦楝根皮。(去粗皮,晒干。)
上为末,粳米饮为丸,米饮下。
〔罗〕至元乙亥,廉台王千户领兵镇涟水。此地卑湿,因劳役过度,饮食失节,至秋深疟痢并作,月余不
愈,饮食全减,形容羸瘦。时已仲冬,求治于予,具陈其由。诊得脉弦细而微如蛛丝,身体沉重,手足寒逆,
时复麻痹,皮肤痂疥如疠风之状,无力以动,心腹痞闷,呕逆不止。皆寒湿为病久淹,真气衰弱,形气不足,
病气亦不足,阴阳皆不足也。《针经》云∶阴阳皆虚,针所不为,灸之所宜。《内经》云∶损者益之,劳者温之。
《十剂》云∶补可去弱。先以理中汤加附子温养脾胃,散寒湿;涩可去脱,养脏汤加附子固肠胃,止泄痢;
仍灸诸穴以并除之。经曰∶府会太仓。即中脘也。先灸五七壮,以温养脾胃之气,进美饮食。次灸气海百壮,
生发元气,滋荣百脉,充实肌肉。复灸足三里,胃之合也,三七壮,引阳气下交阴分,亦助胃气。后又灸阳辅二
七壮接续阳气,令足胫温暖,除清湿之邪。迨月余,病退平复。
理中汤(方见伤寒部。加附子名附子理中汤。)
〔海〕六脉沉紧,按之不鼓,膀胱胜小肠也。或泻痢不止而腹胀,或纯便赤血,或杂以血脓,小便不多而
不渴,精神短少,或面白色脱,此失血之故也。或面黄气短,此本气损少之故也。小肠者,手太阳丙火也;膀
胱者,足太阳壬水也,是壬水乘丙小肠之位,小肠被壬所克而外走也。诸手经短而足经长,兼五行相克论之,
又足经来克手经,此火投于水,大寒水之症,宜温之可安。其与《难经》一症,寒热相反,亦名曰小肠泻。此
病火投于水,变为寒症,又外伤足太阳膀胱经,左脉俱浮,表阳之候也。忽变为内寒,亦旺火投盛水而屈,丙
就壬化,脉反不浮而微沉,此内病与外病俱有。此火投水例,非精于脉诊者,孰能辨之。
石脂神砂丹
生附子 干姜(各五钱) 赤石脂(两半,水飞) 朱砂(一两,细研)
上细末,酒糊丸,黑豆大。每服十五丸,米白汤下。
〔《太平广记》〕贞观中,太宗苦于气痢,众医不效,诏问群臣中有能治者,当重赏之。有术士进以乳汁煎荜茇
服之,立瘥。
〔世〕治水泄并赤白痢。用草乌大者一两半,将一半烧灰,一半生用,为细末,醋糊丸如绿豆大,每服七
丸。赤痢,甘草汤下;白痢,干姜汤下;水泻,井花水下,并空心服。忌腥臊、热毒、诸冷物。
世俗治夏中暑、痢疾,用黄连香薷饮,加甘草、芍药、生姜神效者,盖夏月之痢多属于暑。洁古治处
暑后、秋冬间下痢,用浓朴丸大效者,盖秋冬之痢多属于寒。《经》所谓必先岁气,毋伐天和者是也。(浓朴丸
方见膈气反胃。)初病大肠闭塞,里急后重。(治法并见前后重多热条。)
〔丹〕其或缠滞退减十之七八,秽积未尽,糟粕未实,当以炒芍药、炒白术、炙甘草、陈皮、茯苓煎汤,
下固肠丸三十粒。然固肠丸性燥,恐尚有滞气未尽行者,但当单饮此汤,固肠丸未宜遽用。盖固肠丸者,虽有
去湿实肠之功,其或久痢,体虚气弱,滑泄不止,又当以诃子、肉豆蔻、白矾、半夏等药涩之,甚者添牡蛎,可
择用之。然须以陈皮为佐,恐太涩亦能作疼。又甚者,灸天枢、气海。(此穴大能止泄。)
〔仲〕下痢便脓血者,桃花汤止之。(方见伤寒。若一服愈,勿再服。丹溪云∶桃花汤,主病属下焦血虚且寒,
非干姜之温、石脂之涩且重不能止血,用粳米之甘以引入肠胃。)
〔罗〕水煮木香膏 治脾胃受湿,脏腑滑泄,腹中疼痛,日夜无度,肠鸣水声,不思饮食,每欲痢时,里急
后重,或下赤黄,或便脓血,并宜服之。
木香 丁香(各一两) 枳实(麸炒,五钱) 当归 乳香 诃子皮(各一两) 肉豆蔻 砂仁(各一两半)
藿香 黄连(炒) 白芍药 青皮 陈皮(去白) 浓朴(制) 甘草(炙,各一两) 干姜(炮,五钱)
御米壳(蜜水炒,六两)
上为细末,炼蜜丸,弹子大。每服一丸,水一大盏,劈破煎至六七分,和渣稍热,食前服。
〔海〕易简断下汤 治下痢赤白,无问新久长幼。
白术 茯苓(各一钱) 甘草(五分) 草果(连皮,一个)
上 咀。用罂粟壳十四枚,去筋膜并萼蒂,剪碎,用醋淹为粗末,用作一服,水一大碗,姜七片,枣子、
乌梅各七个,煎至一大盏,分二服服之。赤痢者,加乌豆二粒;白痢者,加干姜五钱。罂粟壳治痢,服之如
神,但性紧涩,多令人呕逆,既以醋制,加以乌梅,不致为害,然呕吐人则不可服。大率痢疾,古方谓之滞
下,多因肠胃素有积滞而成。此疾始得之时,不可遽止,先以巴豆感应丸十余粒,白梅汤下,令大便微利。
仍以前药服之,无不应手作效。若脾胃素弱,用豆蔻、橘红、罂粟壳各等分为末,醋煮面糊为丸,桐子大,每
服五十丸,乌梅汤下,兼治泄泻暴下不止,一服即愈,更令药力相倍为佳。如觉恶心,却以理中汤、四物汤
加豆蔻、木香辈调其胃气,仍以二陈汤煮木香丸定其呕逆。大凡痢疾乃腹心之患,尊年人尤非所宜,若果首
尾用平和之剂,决难作效,必致危笃,虽欲服此,则已晚矣。其秦艽、地榆、黄柏、木通之类,其性苦寒,
却难轻服。血痢当服胃风汤并胶艾汤之类。白者宜服附子理中汤、震灵丹之属,更宜审而用之。若五色杂下,
上(药材)切碎。每次服用一两,加水一盏半,煎煮至一盏,随时温服。如果疼痛,加少许桂枝。
当归导气汤:治疗脓血痢疾无度(严重),小便不通,腹中疼痛。
当归(一钱) 甘草(一钱半) 芍药(一钱) 青皮 槐花(炒。各七分) 木香 槟榔(各三钱) 泽泻(五分)
生地黄(一钱半或二钱,用酒浸泡,阴干)
以上药物研为细末,用水煎煮,饭前温服。如果小便通畅,去掉泽泻。
〔张仲景〕下痢腹痛,用紫参汤主治。
紫参(半斤) 甘草(三两)
以上两味药,用水五升,先煮紫参,取汁三升,加入甘草,再煮取汁一升半,分三次温服。
〔李杲〕浓朴丸:治疗处暑、秋季、冬季间腹痛下痢,效果显著。(方剂见反胃条。)
〔世传〕治疗痢疾,止痛,用黑子丸。
黄蜡(五钱) 杏仁 江子(巴豆) 砂仁(各二十一枚)
以上三味药,在香油灯上烧至存性(保留药性),熔化黄蜡混合均匀,加少量乳香,制成如米粒大小的丸药。每次服用十余粒。
〔《本草》〕治疗积滞痢,止痛,用灵砂丹。
砂(水银?) 朱砂(各等分。研磨极细)
以上用药,用黄蜡五钱,巴豆三七粒,去壳皮膜,同放在银石器内隔水煮沸一个时辰(约两小时),等到巴豆变成紫黑色为止。取出二七粒(十四粒),只用一七粒(七粒),与前两味药一同研磨极匀,再熔化蜡和药,随即制成绿豆大小的丸药。每次服用二丸至五丸。如果是水样腹泻,用生姜汤送服。白痢,用艾叶汤送服。赤痢,用乌梅汤送服。服药时必须极度空腹,服后一时辰内不可进食,临睡前服用更佳。次日吃一天清淡的粥。疟疾,用乳香汤送服,面向东方,不发病的晚间服用。此药不耗气,服用后腹泻者止住,痢疾者断绝,疼痛者痊愈,有积滞者内部化解,也不损伤脏腑。大凡痢疾有沉积物的,如果不先去除其积滞,虽然暂时安宁,后来必定造成危害。常记得陈侍郎经中,庚戌年秋天经过仪真求诊,起初没觉得有病,等到诊视肝脉沉弦,重按则坚实有力。我说:病在左胁有血积,一定会发作疼痛。陈说:确实是这样。以前某地守备九江,被召见冒暑渡过长江,等到抵达行在,血痢已经好几天了。急着想要登殿应对,医生用刚燥的药物强行止住。虽然止住了,但数日后脐下一块肿块大如杯子,十天如碗大且疼痛,发作时痛不可忍,所以急忙请我回祠庙诊治,怎么办呢?我说:积滞痢不可强行止住,所以积血结于脐胁下,非抵当丸不可。他怀疑不肯服用,第二年竟然因此去世。
〔罗天益〕陈曲丸:治疗腹中冷痛,磨化积滞,止住痢疾。
陈曲(一两半,炒) 干姜(炮制) 官桂 白术 当归 浓朴 人参 甘草(炙。各半两)
以上研为细末,炼蜜为丸,如梧桐子大小。每次服用三五十丸,酒送下,或用淡醋汤也可以,饭前服用,一日三次。发作时不拘泥于数量增加。
以上是针对久病逐渐推求积滞的方剂。
〔朱震亨〕初起下痢腹痛,不可用人参、白术,然而气虚、胃虚者可以使用。初得病时,也可以用大承气汤、调胃承气汤攻下,看是气病还是血病,然后加减用药。气病用人参、白术,血病用四物汤。因积滞导致后重的,用保和丸主治。五日后不可攻下,因为脾胃虚弱。
腹痛者,是肺经之气,郁结在大肠之间,用桔梗宣发它,然后用治痢药,气病用气药,血病用血药。或者痢后糟粕未实,或者喝粥稍多,或者饥饿很久才吃饭,肚中作痛,切不可惊恐,应当用白术、陈皮各一半,煎汤调和,自然安宁。粥多及吃肉作痛的,应当节制饮食。节制饮食,就是减少粥食,断绝肉味。
〔李杲〕茯苓汤:治疗因伤冷水腹泻,变作赤白痢,腹痛减食,热燥,四肢困倦无力。
茯苓(六分) 泽泻 归身(各四分) 芍药(一钱半) 苍术(二分) 生姜(二钱) 肉桂(五分) 黄芩(三分,生用)
猪苓(六分) 甘草(五分,炙) 升麻 柴胡(各一钱)
另一版本没有升麻、柴胡。
以上切碎,分为两服,用水煎煮稍热,饭前服用。
〔罗天益〕神效越桃散:治疗下痢之后,小便通利,而腹中满痛不可忍受,这名叫阴阳反错,不和之甚也。
大栀子 良姜(各三钱)
以上研为细末。米饮或酒调服三钱。
《内经》说:脓血稠粘,都归属于相火。太阴主泄泻,少阴主痢疾。是先泄泻亡失津液,而火就燥,肾恶燥,居于下焦血分,受邪者,所以便脓血。然而赤黄色为热,青白色为寒,治疗必须双重审察。治热用坚中丸、豆蔻丸、香连丸,治寒用白胶香散。或者多热少寒,用水煮木香膏。虚滑频数,宜止宜涩,宜用养脏汤。(木香、养脏汤,并见虚滑条。白胶香散未考证。)
坚中丸:治疗脾胃受湿,滑泄注下。
黄连 黄柏 赤茯苓 泽泻 白术(各一两) 陈皮 肉豆蔻 白芍药 人参 官桂 半夏曲(各五钱)
以上研为细末,汤浸蒸饼为丸,如梧桐子大。每次服用五七十丸,温米饮送下,饭前。
〔朱震亨〕下血用四物汤为主,应当凉血、和血,用当归、桃仁之类。
〔李杲〕小便便脓血者,是小肠泄,脉得五至以上洪大者,宜用七宣丸。脉平和者,立秋至春分,宜用香连丸;春分至立秋,宜用芍药柏皮丸;四季皆宜用加减平胃散。如果有七宣丸症状的,也宜服用此药,去除其余邪,兼平胃气。
芍药柏皮丸方
芍药 黄柏(各等分)
以上研为细末,醋糊为丸,如梧桐子大。每次服用五十丸,饭前温汤送下。
加减平胃散:经文说:四季皆以胃气为本。久下血则脾胃虚损,血水流于四肢,却入于胃而为血痢,宜服用此滋养脾胃。
白术 浓朴 陈皮(各一两) 槟榔(三钱) 甘草(七钱) 木香(三钱) 桃仁 人参 黄连 阿胶 茯苓(各五钱)
以上切碎。每次服用五钱,姜三片,枣一枚,水煎,随时温服。血多加桃仁。热泄加黄连。小便涩,加茯苓、泽泻。气不下后重加槟榔、木香。腹痛加官桂、芍药、甘草。脓多,加阿胶。湿多加白术。脉洪大加大黄。
〔朱震亨〕下血多主食积与热,或者有使用朴硝的。
苍术 白术 黄芩 芍药 滑石 茯苓 甘草 陈皮 神曲(炒) 煎,下保和丸。
〔世传〕治疗痢疾食积。
附米 神曲 川芎 栀子 滑石 山楂 红曲 青黛 桃仁 为末,丸服。
〔朱震亨〕青六丸:去三焦湿热,治疗泄泻,多与清化丸同服,并不单服。兼治产后腹痛或自利者,能补脾、补血,也治疗血痢有效。
六一散(三两,即益元散) 红曲(炒,半两,活血)
以上用饭为丸。一方,用酒糊为丸。
二十九官,肚痢食少,下坠赤积,身热。
木通(二钱半) 芍药(炒) 陈皮 白术 滑石(各五钱) 甘草(五分)
分四帖,煎,下保和丸与点丸各十丸。
〔李杲〕苍术地榆汤:治疗脾经受湿,下血痢。
苍术(三两) 地榆(一两)
以上锉碎。每一两,水二盏,煎一盏,温服。
槐花丸:治疗血痢久不止,腹中不痛,不里急后重。
青皮 槐花 荆芥穗(各等分)
以上研为细末,水煎,空心温服。
〔《集验方》〕治疗血痢神效。干姜在火上烧黑,不让成灰,瓷碗合放冷为末。每次服用一钱,米饮调下。
〔李杲〕大便后有白脓,或只便白脓,因劳役气虚伤大肠也。用黄芪、人参补之。如果里急后重,频繁见到污衣者,是血虚也,再加当归。如果便白脓少而滑,频繁见到污衣者,气脱加附子皮,严重时加御米壳(罂粟壳)。如果气涩者,只用甘药补气,应当安卧不言,以养其气。(气涩忌御米壳,但服甘药,安卧不言。)
〔朱震亨〕丈夫辛苦劳役,肚痢白泻。
滑石(一两) 陈皮 白术(六钱) 芍药(五钱) 黄芩(三钱) 甘草(五分,炙) 桃仁(三十个)
分六帖,水二盏半,煎取一盏,饭前服用。
孙郎中因饮水过多,腹胀,泻痢带白。
苍术 浓朴 白术 茯苓 滑石 下保和丸。又说,加炒曲、甘草。
治疗痢疾热多者。
大黄 黄连 黄柏 黄芩 枳壳 白芍药 当归 滑石 甘草 桃仁 白术
以上研为细末,面糊为丸。
〔世传〕不问赤白痢。用苦楝根,不拘生干,捣取汁,生姜蜜水调服。未效,再进半碗许,立愈。
〔《集验方》〕患赤白痢。山豆根捣末蜜丸,空心煎水下二十丸,三服止。
〔《千金方》〕治疗下痢冷热,诸治不瘥方。
乌头 黄连(各一升)
以上两味为末,蜜和丸,如梧桐子大。下二十丸,日三、夜二,神妙。
〔世传〕治疗似痢非痢,挟热者,用苦楝根皮。(去粗皮,晒干。)
以上为末,粳米饮为丸,米饮下。
〔罗天益〕至元乙亥年,廉台王千户领兵镇守涟水。此地卑湿,因劳役过度,饮食失节,到秋深疟痢并作,月余不愈,饮食全减,形容羸瘦。时已仲冬,求治于我,具陈其由。诊得脉弦细而微如蛛丝,身体沉重,手足寒逆,时复麻痹,皮肤痂疥如疠风之状,无力以动,心腹痞闷,呕逆不止。都是寒湿为病久淹,真气衰弱,形气不足,病气亦不足,阴阳皆不足也。《针经》说:阴阳皆虚,针所不为,灸之所宜。《内经》说:损者益之,劳者温之。《十剂》说:补可去弱。先用理中汤加附子温养脾胃,散寒湿;涩可去脱,养脏汤加附子固肠胃,止泄痢;仍灸诸穴以并除之。经说:府会太仓。即中脘穴。先灸五七壮,以温养脾胃之气,进美饮食。次灸气海百壮,生发元气,滋荣百脉,充实肌肉。复灸足三里,胃之合也,三七壮,引阳气下交阴分,亦助胃气。后又灸阳辅二七壮接续阳气,令足胫温暖,除清湿之邪。等到月余,病退平复。
〔王海藏〕六脉沉紧,按之不鼓,膀胱胜小肠也。或者泻痢不止而腹胀,或者纯便赤血,或者杂以血脓,小便不多而不渴,精神短少,或者面白色脱,这是失血之故也。或者面黄气短,这是本气损少之故也。小肠者,手太阳丙火也;膀胱者,足太阳壬水也,是壬水乘丙小肠之位,小肠被壬所克而外走也。诸手经短而足经长,兼五行相克论之,又足经来克手经,此火投于水,大寒水之症,宜温之可安。其与《难经》一症,寒热相反,亦名曰小肠泻。此病火投于水,变为寒症,又外伤足太阳膀胱经,左脉俱浮,表阳之候也。忽变为内寒,也是旺火投盛水而屈,丙就壬化,脉反不浮而微沉,这是内病与外病俱有。此火投水例,非精于脉诊者,谁能辨之。
石脂神砂丹
生附子 干姜(各五钱) 赤石脂(两半,水飞) 朱砂(一两,细研)
以上细末,酒糊丸,黑豆大。每次服用十五丸,米白汤下。
〔《太平广记》〕贞观年间,太宗苦于气痢,众医不效,诏问群臣中有能治者,当重赏之。有术士进以乳汁煎荜茇服之,立瘥。
〔世传〕治疗水泄并赤白痢。用草乌大者一两半,将一半烧灰,一半生用,为细末,醋糊丸如绿豆大,每次服用七丸。赤痢,甘草汤下;白痢,干姜汤下;水泻,井花水下,并空心服。忌腥臊、热毒、诸冷物。
世俗治疗夏中暑、痢疾,用黄连香薷饮,加甘草、芍药、生姜神效者,盖夏月之痢多属于暑。洁古治疗处暑后、秋冬间下痢,用浓朴丸大效者,盖秋冬之痢多属于寒。《经》所谓必先岁气,毋伐天和者是也。(浓朴丸方见膈气反胃。)初病大肠闭塞,里急后重。(治法并见前后重多热条。)
〔朱震亨〕其或缠滞退减十之七八,秽积未尽,糟粕未实,应当用炒芍药、炒白术、炙甘草、陈皮、茯苓煎汤,下固肠丸三十粒。然而固肠丸性燥,恐怕尚有滞气未尽行者,但应当单饮此汤,固肠丸未宜遽用。盖固肠丸者,虽有去湿实肠之功,其或久痢,体虚气弱,滑泄不止,又当以诃子、肉豆蔻、白矾、半夏等药涩之,甚者添牡蛎,可选择用之。然而须以陈皮为佐,恐怕太涩也能作疼。又甚者,灸天枢、气海。(此穴大能止泄。)
〔张仲景〕下痢便脓血者,桃花汤止之。(方见伤寒。若一服愈,勿再服。丹溪云:桃花汤,主病属下焦血虚且寒,非干姜之温、石脂之涩且重不能止血,用粳米之甘以引入肠胃。)
〔罗天益〕水煮木香膏:治疗脾胃受湿,脏腑滑泄,腹中疼痛,日夜无度,肠鸣水声,不思饮食,每欲痢时,里急后重,或下赤黄,或便脓血,并宜服之。
木香 丁香(各一两) 枳实(麸炒,五钱) 当归 乳香 诃子皮(各一两) 肉豆蔻 砂仁(各一两半)
藿香 黄连(炒) 白芍药 青皮 陈皮(去白) 浓朴(制) 甘草(炙,各一两) 干姜(炮,五钱)
御米壳(蜜水炒,六两)
以上为细末,炼蜜丸,弹子大。每次服用一丸,水一大盏,劈破煎至六七分,和渣稍热,饭前服用。
〔王海藏〕易简断下汤:治疗下痢赤白,无问新久长幼。
白术 茯苓(各一钱) 甘草(五分) 草果(连皮,一个)
以上切碎。用罂粟壳十四枚,去筋膜并萼蒂,剪碎,用醋淹为粗末,用作一服,水一大碗,姜七片,枣子、乌梅各七个,煎至一大盏,分二服服之。赤痢者,加乌豆二粒;白痢者,加干姜五钱。罂粟壳治痢,服之如神,但性紧涩,多令人呕逆,既以醋制,加以乌梅,不致为害,然呕吐人则不可服。大率痢疾,古方谓之滞下,多因肠胃素有积滞而成。此疾始得之时,不可遽止,先以巴豆感应丸十余粒,白梅汤下,令大便微利。仍以前药服之,无不应手作效。若脾胃素弱,用豆蔻、橘红、罂粟壳各等分为末,醋煮面糊为丸,桐子大,每次服用五十丸,乌梅汤下,兼治泄泻暴下不止,一服即愈,更令药力相倍为佳。如觉恶心,却以理中汤、四物汤加豆蔻、木香辈调其胃气,仍以二陈汤煮木香丸定其呕逆。大凡痢疾乃腹心之患,尊年人尤非所宜,若果首尾用平和之剂,决难作效,必致危笃,虽欲服此,则已晚矣。其秦艽、地榆、黄柏、木通之类,其性苦寒,却难轻服。血痢当服胃风汤并胶艾汤之类。白者宜服附子理中汤、震灵丹之属,更宜审而用之。若五色杂下,
Shang (herbs) crushed. Take one liang per dose, add one and a half zhan of water, decoct to one zhan, take warm at any time. If there is pain, add a small amount of Guizhi (Cinnamon Twig).
Danggui Daoqi Tang (Angelica Guiding Qi Decoction): Treats severe dysentery with pus and blood, urinary obstruction, and abdominal pain.
Danggui (Angelica Sinensis Root) (1 qian), Gancao (Licorice Root) (1.5 qian), Shaoyao (Peony Root) (1 qian), Qingpi (Aurantium Peel), Huaihua (Sophora Flower) (stir-fried, each 0.7 fen), Muxiang (Costus Root), Binglang (Areca Seed) (each 3 qian), Zexie (Alisma Rhizome) (0.5 fen), Shengdihuang (Rehmannia Root) (1.5 or 2 qian, soaked in wine, dried in shade).
Crush the above herbs into powder, decoct with water, and take warm before meals. If urination is smooth, remove Zexie.
[Zhang Zhongjing] For dysentery with abdominal pain, treat primarily with Zishen Tang (Purple Ginseng Decoction).
Zishen (Pseudostellaria Root? Note: Historical context suggests *Parthenium* or similar, but literally "Purple Participant") (0.5 jin), Gancao (Licorice Root) (3 liang).
Take these two ingredients, add five sheng of water, first decoct Zishen to obtain three sheng, then add Gancao, decoct to obtain one and a half sheng, divide into three doses and take warm.
[Li Gao] Houpo Wan (Magnolia Pill): Treats abdominal pain and dysentery during Chushu (End of Heat), autumn, and winter; highly effective. (Formula see Fanwei/Regurgitation section.)
[Worldly Transmission] To treat dysentery and relieve pain, use Heizi Wan (Black Seed Pill).
Huangla (Yellow Beeswax) (5 qian), Xingren (Apricot Seed), Jiangzi (Croton Seed/Badous), Sharen (Amomum Fruit) (each 21 grains).
Burn the above three items on an oil lamp until they retain their nature (charred but not ashed), melt the wax and mix evenly, add a little Ruxiang (Frankincense), and form pills the size of rice grains. Take ten-plus pills per dose.
[Bencao Materia Medica] To treat accumulated dysentery and relieve pain, use Lingsha Dan (Spirit Cinnabar Elixir).
Sha (Mercury/Sulfur compound?), Zhusha (Cinnabar) (equal parts, ground extremely fine).
Use five qian of yellow beeswax, seven to three grains of Badous (Croton Seed), remove shell skin and membrane, boil together in a silver or earthenware vessel over double-boiling water for one fushi (two hours), until the Badous turn purple-black. Remove fourteen grains, use only seven grains, grind extremely uniformly with the previous two medicines, melt wax again to mix with medicine, and roll into pills the size of mung beans. Take two to five pills per dose. For watery diarrhea, take with Shengjiang (Ginger) decoction. For white dysentery, take with Aitang (Mugwort Decoction). For red dysentery, take with Wumei (Mume Fruit) decoction. Must be taken on an extremely empty stomach; do not eat for one hour after taking; best taken before sleep. Eat light congee for one day afterwards. For malaria, take with Ruxiang (Frankincense) decoction, facing east, on evenings when no fever occurs. This medicine does not deplete Qi; it stops diarrhea, halts dysentery, cures pain, resolves internal accumulation without damaging the Zang-Fu organs. Generally, if dysentery has sedimentation, if the accumulation is not removed first, although there may be temporary relief, harm will inevitably follow later. I often recall Chen Shilang Jingzhong seeking diagnosis in Yizhen in the autumn of Gengxu year. Initially he felt no illness, but upon examining the Liver pulse, it was deep and wiry, firm when pressed to the bone. I said: There is blood accumulation in the left hypochondrium, which must cause pain. Chen said: Indeed so. Previously, while serving as Prefect of Jiujiang, he was summoned and crossed the Yangtze River in the summer heat. Upon arriving at the imperial court, he had suffered from bloody dysentery for several days. Eager to attend the audience, physicians used harsh, drying agents to stop it forcibly. Although it stopped, a lump appeared below the navel the size of a cup after several days, growing to the size of a bowl after ten days, with unbearable pain upon onset, hence urgently requesting my return to the shrine for treatment. What should be done? I said: Accumulated dysentery cannot be forcibly stopped; thus blood accumulation forms below the navel and hypochondrium. Only Didang Tang (Tribute to Defending Decoction) will suffice. He doubted and refused to take it, and died of this condition the following year.
[Luo Tianyi] Chenqu Wan (Fermented Dough Pill): Treats cold pain in the abdomen, grinds away accumulation, and stops dysentery.
Chenqu (Fermented Dough) (1.5 liang, stir-fried), Ganjiang (Dried Ginger) (processed), Guanzi Gui (Cassia Twig), Baizhu (Atractylodes Macrocephala Rhizome), Danggui (Angelica Sinensis Root), Houpo (Magnolia Bark), Renshen (Ginseng Root), Gancao (Licorice Root) (roasted, each 0.5 liang).
Grind into fine powder, refine honey to make pills the size of paulownia seeds. Take thirty to fifty pills per dose, send down with wine, or light vinegar decoction is also acceptable, before meals, three times a day. Do not restrict increasing the number during attacks.
These are formulas for gradually pushing out accumulation in chronic diseases.
[Maijing Pulse Classic] Dysentery with abdominal fullness indicates excess; it should be purged.
[Zhu Zhenheng] In early dysentery with abdominal pain, Renshen (Ginseng) and Baizhu (Atractylodes) should not be used, unless there is Qi deficiency or Stomach deficiency. At the onset, Dachengqi Tang (Major Order the Qi Decoction) or Tiaoweichengqi Tang (Regulate the Stomach and Order the Qi Decoction) can be used to purge, depending on whether it is a Qi disease or Blood disease, then adjust medications accordingly. Use Renshen and Baizhu for Qi issues, Siwu Tang (Four Substances Decoction) for Blood issues. For tenesmus caused by accumulation, Baohe Wan (Harmonize the Stomach Pill) is primary. After five days, do not purge, as the Spleen and Stomach are deficient.
Abdominal pain is due to Lung Qi stagnating in the Large Intestine; use Jiegeng (Platycodon Root) to disperse it, then use dysentery treatments. Use Qi-moving drugs for Qi disorders, Blood-invigorating drugs for Blood disorders. If loose stools remain unformed after dysentery, or if too much congee is eaten, or eating after extreme hunger causes abdominal pain, do not panic. Use equal parts Baizhu (Atractylodes Macrocephala Rhizome) and Chenpi (Tangerine Peel), decoct and administer to harmonize; comfort will follow naturally. For pain caused by excessive congee or meat consumption, fasting/dietary restriction is appropriate. Fasting means reducing congee intake and eliminating meat flavors.
[Li Gao] Fuling Tang (Poria Decoction): Treats diarrhea caused by cold water injury, transforming into red and white dysentery, with abdominal pain, reduced appetite, heat and dryness, and fatigue/weakness in the four limbs.
Fuling (Poria) (6 fen), Zexie (Alisma Rhizome), Guishen (Angelica Sinensis Root Heart) (each 4 fen), Shaoyao (Peony Root) (1.5 qian), Cangzhu (Atractylodes Lancea Rhizome) (2 fen), Shengjiang (Fresh Ginger) (2 qian), Rougui (Cinnamon Bark) (5 fen), Huangqin (Scutellaria Root) (3 fen, raw), Zhuling (Polyporus) (6 fen), Gancao (Licorice Root) (5 fen, roasted), Shengma (Cimicifuga Rhizome), Chaihu (Bupleurum Root) (each 1 qian).
One version lacks Shengma and Chaihu.
Crush, divide into two doses, decoct with water slightly hot, take before meals.
[Luo Tianyi] Shenxiao YueTao San (Divine Effective Pomelo Powder): Treats post-dysentery where urination is clear but abdominal fullness and pain are unbearable. This is called Yin-Yang reversal, extreme disharmony.
Da Zhizi (Gardenia Fruit) (3 qian), Liangjiang (Galangal Rhizome) (3 qan).
Grind into powder. Mix with rice drink or wine, take 3 qian per dose.
The Neijing states: Pus and blood that are thick and sticky all belong to Ministerial Fire. Taiyin governs diarrhea, Shaoyin governs dysentery. Diarrhea first depletes body fluids, and fire follows dryness. The Kidney dislikes dryness. Located in the Lower Jiao Blood aspect, the pathogen affects this area, causing pus and blood in stool. Red and yellow indicate heat; green and white indicate cold. Treatment requires dual examination. Treat heat with Jianzhong Wan (Strengthen the Middle Pill), Doukou Wan (Cardamom Pill), or Xianglian Wan (Costus-Coptis Pill). Treat cold with Baijiaoxiang San (White Agarwood Powder). If more heat than cold, use Shuizhu Muxiang Gao (Water-Boiled Costum Paste). For deficiency-slippery frequent stools, use astringents and tonics, specifically Yangzang Tang (Nourish the Viscera Decoction). (Muxiang and Yangzang Tang see Slippery Deficiency section. Baijiaoxiang San unverified.)
Jianzhong Wan (Strengthen the Middle Pill): Treats Spleen and Stomach dampness causing slippery diarrhea.
Huanglian (Coptis Rhizome), Huangbai (Phellodendron Bark), Chi Fuling (Red Poria), Zexie (Alisma Rhizome), Baizhu (Atractylodes Macrocephala Rhizome) (each 1 liang), Chenpi (Tangerine Peel), Roudoukou (Nutmeg), Baishaoyao (White Peony Root), Renshen (Ginseng Root), Guanzi Gui (Cassia Twig), Banxiaqu (Pinellia Ferment) (each 5 qian).
Grind into powder, soak in water, steam with leavened bread dough to make pills the size of paulownia seeds. Take fifty to seventy pills per dose, send down with warm rice drink, before meals.
[Zhu Zhenheng] For bleeding, use Siwu Tang (Four Substances Decoction) as the base. Cool the blood and harmonize the blood using Danggui (Angelica Sinensis Root), Taoren (Peach Kernel), etc.
[Li Gao] Urinating pus and blood is Small Intestine leakage. If the pulse is greater than five beats per cycle and surging/large, use Qixuan Wan (Seven Circulations Pill). If the pulse is peaceful, from Start of Autumn to Spring Equinox, use Xianglian Wan (Costus-Coptis Pill); from Spring Equinox to Start of Autumn, use Shaoyao Bopi Wan (Peony-Phellodendron Bark Pill); throughout the four seasons, use Jiajian Pingwei San (Modified Flat Stomach Powder). If symptoms of Qixuan Wan exist, this medicine is also suitable to eliminate residual pathogens and harmonize Stomach Qi.
Shaoyao Bopi Wan Formula
Shaoyao (Peony Root), Huangbai (Phellodendron Bark) (equal parts).
Grind into fine powder, make pills with vinegar paste the size of paulownia seeds. Take fifty pills per dose, send down with warm water before meals.
Jiajian Pingwei San (Modified Flat Stomach Powder): The Classics state: The Stomach Qi is the foundation of the four seasons. Chronic bloody discharge damages Spleen and Stomach; blood fluid flows to the four limbs and returns to the Stomach causing bloody dysentery. Take this to nourish Spleen and Stomach.
Baizhu (Atractylodes Macrocephala Rhizome), Houpo (Magnolia Bark), Chenpi (Tangerine Peel) (each 1 liang), Binglang (Areca Seed) (3 qian), Gancao (Licorice Root) (7 qian), Muxiang (Costus Root) (3 qian), Taoren (Peach Kernel), Renshen (Ginseng Root), Huanglian (Coptis Rhizome), Ejiao (Donkey-Hide Gelatin), Fuling (Poria) (each 5 qian).
Crush. Take 5 qian per dose, with three slices of ginger and one jujube, decoct with water, take warm at any time. Add Taoren (Peach Kernel) if heavy bleeding. Add Huanglian (Coptis Rhizome) for hot diarrhea. Add Fuling (Poria) and Zexie (Alisma Rhizome) for difficult urination. Add Binglang (Areca Seed) and Muxiang (Costus Root) for Qi stagnation and tenesmus. Add Guanzi Gui (Cassia Twig), Shaoyao (Peony Root), and Gancao (Licorice Root) for abdominal pain. Add Ejiao (Donkey-Hide Gelatin) for abundant pus. Add Baizhu (Atractylodes Macrocephala Rhizome) for heavy dampness. Add Dahuang (Rhubarb Root) for surging/large pulse.
[Zhu Zhenheng] Bloody discharge is mostly due to food accumulation and heat; sometimes Poxiao (Mirabilite) is used.
Cangzhu (Atractylodes Lancea Rhizome), Baizhu (Atractylodes Macrocephala Rhizome), Huangqin (Scutellaria Root), Shaoyao (Peony Root), Huashi (Talcum), Fuling (Poria), Gancao (Licorice Root), Chenpi (Tangerine Peel), Shenqu (Medicated Leaven) (stir-fried). Decoct, take with Baohe Wan (Harmonize the Stomach Pill).
[Worldly Transmission] Treat dysentery with food accumulation.
Fumi (Adzuki Bean?), Shenqu (Medicated Leaven), Chuanxiong (Ligusticum Rhizome), Zhizi (Gardenia Fruit), Huashi (Talcum), Shanzha (Hawthorn Fruit), Hongqu (Red Yeast Rice), Qingdai (Indigo Naturalis), Taoren (Peach Kernel). Grind into powder, form pills.
[Zhu Zhenheng] Qingliu Wan (Green Six Pill): Clears damp-heat from the Triple Burner, treats diarrhea. Usually taken with Qinghua Wan (Clear Transformation Pill), not alone. Also treats postpartum abdominal pain or spontaneous diarrhea; tonifies Spleen and Blood, and is effective for bloody dysentery.
Liuyisan (Six-to-One Powder, i.e., YiYuan San) (3 liang), Hongqu (Red Yeast Rice) (stir-fried, 0.5 liang, invigorates blood).
Make pills with cooked rice. Another method uses wine paste.
Official 29: Abdominal dysentery, poor appetite, sensation of falling/red accumulation, body heat.
Mutong (Akebia Stem) (2.5 qian), Shaoyao (Peony Root) (stir-fried), Chenpi (Tangerine Peel), Baizhu (Atractylodes Macrocephala Rhizome), Huashi (Talcum) (each 5 qian), Gancao (Licorice Root) (5 fen).
Divide into four packets, decoct, take with ten Baohe Wan (Harmonize the Stomach Pill) and ten Dian Wan (Dot Pill).
[Li Gao] Cangzhu Diyutang (Atractylodes-Sedge Decoction): Treats Spleen Meridian dampness causing bloody dysentery.
Cangzhu (Atractylodes Lancea Rhizome) (3 liang), Diyü (Sedge Rhizome) (1 liang).
Cut. Take one liang, add two zhan of water, decoct to one zhan, take warm.
Huaihua Wan (Sophora Pill): Treats persistent bloody dysentery without abdominal pain or tenesmus.
Qingpi (Aurantium Peel), Huaihua (Sophora Flower), Jingjie Sui (Schizonepeta Spike) (equal parts).
Grind into powder, decoct with water, take warm on an empty stomach.
[Zhang Zhongjing] Cold in the Small Intestine causes heaviness and bloody stool.
[Ji Yi Fang Collected Experiences] Divine effect for bloody dysentery. Charred Ganjiang (Dried Ginger) on fire until black but not ash, cool in a porcelain bowl, grind to powder. Take 1 qian per dose, mix with rice drink.
[Li Gao] White pus after defecation, or only white pus, is due to labor-induced Qi deficiency injuring the Large Intestine. Tonify with Huangqi (Astragalus Root) and Renshen (Ginseng Root). If there is tenesmus and frequent soiling, it is Blood deficiency; add Danggui (Angelica Sinensis Root). If white pus is scanty and slippery with frequent soiling, Qi collapse; add Fuzi Pi (Aconite Bark), or Yumike (Poppy Shell) in severe cases. If Qi is stagnant, use only sweet medicines to tonify Qi; lie still and speak not to nourish Qi. (Qi stagnation contraindicates Poppy Shell; only use sweet medicines, lie still and speak not.)
[Zhu Zhenheng] Men suffering from hard labor have abdominal dysentery and white diarrhea.
Huashi (Talcum) (1 liang), Chenpi (Tangerine Peel), Baizhu (Atractylodes Macrocephala Rhizome) (6 qian), Shaoyao (Peony Root) (5 qian), Huangqin (Scutellaria Root) (3 qian), Gancao (Licorice Root) (5 fen, roasted), Taoren (Peach Kernel) (30 kernels).
Divide into six packets, add two and a half zhan of water, decoct to one zhan, take before meals.
Sun Langzhong drank too much water, causing abdominal distension and white-tinged diarrhea/dysentery.
Cangzhu (Atractylodes Lancea Rhizome), Houpo (Magnolia Bark), Baizhu (Atractylodes Macrocephala Rhizome), Fuling (Poria), Huashi (Talcum). Take Baohe Wan (Harmonize the Stomach Pill). Also says add stir-fried Shenqu (Medicated Leaven) and Gancao (Licorice Root).
Treat dysentery with predominant heat.
Dahuang (Rhubarb Root), Huanglian (Coptis Rhizome), Huangbai (Phellodendron Bark), Huangqin (Scutellaria Root), Zhiqiao (Bitter Orange Fruit), Baishaoyao (White Peony Root), Danggui (Angelica Sinensis Root), Huashi (Talcum), Gancao (Licorice Root), Taoren (Peach Kernel), Baizhu (Atractylodes Macrocephala Rhizome).
Grind into powder, make pills with flour paste.
[Worldly Transmission] Regardless of red or white dysentery. Use Kulgen (Bitter Tree Root), fresh or dried, crush to extract juice, mix with Ginger and Honey water. If ineffective, take another half bowl; immediate cure.
[Ji Yi Fang Collected Experiences] For red and white dysentery. Sandougeng (Douglas Fir Root Bark?) grind to powder, make honey pills. Take twenty pills with decoction on an empty stomach; stops after three doses.
[Qian Jin Fang Thousand Gold Formulas] Treat cold-heat dysentery refractory to other treatments.
Wutou (Aconite Root), Huanglian (Coptis Rhizome) (each 1 sheng).
Grind to powder, mix with honey to make pills the size of paulownia seeds. Take twenty pills, three times day, twice night; miraculous.
[Worldly Transmission] Treat conditions resembling dysentery but not dysentery, with heat, use Kuelian Genpi (Toosendan Bark). (Remove coarse bark, dry in sun.)
Grind to powder, make pills with glutinous rice drink, take with rice drink.
[Luo Tianyi] In the Yi Hai year of Zhiyuan, Commander Wang of Liantai led troops to garrison Lianshui. The land was low and damp. Due to excessive labor and irregular diet, by late autumn malaria and dysentery occurred together, lasting over a month without improvement. Appetite completely decreased, appearance emaciated. It was mid-winter. Seeking treatment from me, he recounted the history. Pulse was wiry, thin, and faint like a spider's thread. Body heavy, hands and feet cold/reversed, occasional numbness, skin crusts and scabies resembling leprosy, powerless to move, chest/abdominal stuffiness, incessant vomiting/reversal. All due to long-standing cold-damp pathogen, true Qi weakness, insufficient Form and Qi, insufficient Pathogenic Qi, insufficiency of both Yin and Yang. The Zhenjing (Needle Classic) states: When Yin and Yang are both deficient, needles are not suitable, moxibustion is appropriate. The Neijing states: Depleted ones benefit them, labored ones warm them. The Shiji (Ten Categories) states: Tonification removes weakness. First use Lizhong Tang (Regulate the Middle Decoction) plus Fuzi (Aconite Root) to warm/nourish Spleen/Stomach and scatter cold-damp; Astringency removes prolapse, Yangzang Tang (Nourish the Viscera Decoction) plus Fuzi (Aconite Root) to secure intestines/stomach and stop diarrhea/loose stools; also moxa various acupoints to remove them all. The Classics say: Fu meets at Tai Cang. This is Zhongwan (CV12). Moxa five to seven cones first to warm/nourish Spleen/Stomach Qi and promote good diet. Then moxa Qihai (CV6) one hundred cones to generate primal Qi, nourish hundred vessels, fill muscles. Then moxify Zusanli (ST36), the convergence of the Stomach, three times seven cones, to guide Yang Qi to intersect with Yin aspects, also assisting Stomach Qi. Then moxa Yangfu (GB38) two times seven cones to connect Yang Qi, warming calves/shins, clearing cold-damp evil. After over a month, the disease receded and recovered.
Lizhong Tang (Regulate the Middle Decoction) (See Shanghan Section. Plus Fuzi is named Fuzi Lizhong Tang/Aconite Regulate the Middle Decoction.)
[Wang Haizang] Six pulses are deep and tight, not drumming upon pressure; Bladder overwhelms Small Intestine. Or diarrhea/dysentery unceasing with abdominal distension, or pure red blood stool, or mixed with blood/pus, urine not profuse and no thirst, spirit short, or face pale/devoid of color, this is due to blood loss. Or yellow face and short Qi, this is due to fundamental Qi damage/deficiency. Small Intestine is Hand-Taiyang Bing Fire; Bladder is Foot-Taiyang Ren Water. Ren Water occupies Bing Small Intestine position; Small Intestine is overcome by Ren and moves outward. All Hand meridians are short, Foot meridians long. Considering Five Elements overcoming, Foot meridian overcomes Hand meridian. This is Fire thrown into Water, a Great Cold Water syndrome, suitable for warming to stabilize. This contrasts with the syndrome in Nanjing regarding cold/heat, also named Small Intestine Leakage. This disease Fire thrown into Water transforms into Cold syndrome, additionally external injury to Foot-Taiyang Bladder Meridian, Left pulse all floating, indicating Exterior Yang sign. Suddenly transforming into Internal Cold, also vigorous Fire thrown into盛 Water being subdued, Bing transforms to Ren, pulse reverses from floating to slightly deep. This is both Internal and External disease present. This Fire-into-Water example, who but experts in pulse diagnosis can distinguish?
Shizhi Shensha Dan (Red Kaolin Spirit Cinnabar Elixir)
Sheng Fuzi (Raw Aconite Root), Ganjiang (Dried Ginger) (each 5 qian), Chishizhi (Red Kaolin) (1.5 liang, water floated), Zhusha (Cinnabar) (1 liang, finely ground).
Grind finely, make pills with wine paste the size of black beans. Take fifteen pills per dose, send down with rice white soup.
[Taiping Guangji Great Record of Peace] In Zhenguan era, Emperor Taizhou suffered from Qi dysentery, many physicians ineffective. Edict asked ministers if anyone could treat, would reward heavily. A sorcerer presented milk decocted with Bibai (Long Pepper), taken immediately cured.
[Worldly Transmission] Treat watery diarrhea and red/white dysentery. Use large Caowu (Aconite Root) 1.5 liang. Half burnt to ash, half raw, grind to fine powder, make pills with vinegar paste the size of mung beans. Take seven pills per dose. Red dysentery, send down with Gancao (Licorice Root) decoction; White dysentery, send down with Ganjiang (Dried Ginger) decoction; Watery diarrhea, send down with well-water, all on empty stomach. Avoid fishy/foul, hot/toxic, and all cold things.
Secular treatment for summer heatstroke and dysentery uses Huanglian Xiangru Yin (Scutellaria-Epimedium Drink) plus Gancao (Licorice Root), Shaoyao (Peony Root), Shengjiang (Fresh Ginger) with divine effect, because summer dysentery mostly belongs to Summer Heat. Jiegu treated post-Chushu autumn/winter dysentery using Houpo Wan (Magnolia Pill) with great effect, because autumn/winter dysentery mostly belongs to Cold. The Classic says: First must consider annual Qi, do not violate Heavenly Harmony. (Houpo Wan formula see Geqi Fanwei/Diaphragm Gas Regurgitation section.) Initial illness Large Intestine closure, tenesmus. (Treatment methods see Tenesmus Heat section.)
[Zhu Zhenheng] If stagnation reduces by ten to eight parts, filth accumulation not exhausted, chaff not solidified, use stir-fried Shaoyao (Peony Root), stir-fried Baizhu (Atractylodes Macrocephala Rhizome), roasted Gancao (Licorice Root), Chenpi (Tangerine Peel), Fuling (Poria) decoct, take Guochang Wan (Solidify Intestine Pill) thirty pills. However, Guochang Wan is dry/hot in nature, fearing remaining stagnant Qi not yet moved, should only drink this decoction, Guochang Wan should not be used hastily. Guochang Wan, although having damp-removing and intestine-solidifying merit, if chronic dysentery, body weak Qi deficient, slippery diarrhea unceasing, should use Hezi (Chebula Fruit), Roudoukou (Nutmeg), Baifan (Alum), Banxia (Pinellia) and other astringents, add Muli (Oyster Shell) in severe cases, choose to use. However, must use Chenpi (Tangerine Peel) as assistant, fearing too much astringency can cause pain. Even worse, moxa Tianshu (ST25), Qihai (CV6). (This acupoint greatly stops diarrhea.)
[Zhang Zhongjing] Dysentery with pus/blood stool, Taohua Tang (Peach Blossom Decoction) stops it. (Formula see Shanghan. If one dose cures, do not take again. Danxi says: Taohua Tang treats disease belonging to Lower Jiao Blood deficiency and Cold. Without Ganjiang (Dried Ginger) warmth, Shizhi (Kaolin) astringency and weight, it cannot stop bleeding; uses Jingmi (Glutinous Rice) sweetness to guide into intestines/stomach.)
[Luo Tianyi] Shuizhu Muxiang Gao (Water-Boiled Costum Paste): Treats Spleen/Stomach dampness, viscera slippery discharge, abdominal pain, day and night without limit, bowel sounds like water, no desire for food, every time wanting dysentery, tenesmus, or red/yellow discharge, or pus/blood stool, all suitable to take.
Muxiang (Costus Root), Dingxiang (Clove) (each 1 liang), Zhishi (Immature Bitter Orange) (bran fried, 5 qian), Danggui (Angelica Sinensis Root), Ruxiang (Frankincense), Hezi Pi (Chebula Peel) (each 1 liang), Roudoukou (Nutmeg), Sharen (Amomum Fruit) (each 1.5 liang), Huoxiang (Patchouli Leaf), Huanglian (Coptis Rhizome) (fried), Baishaoyao (White Peony Root), Qingpi (Aurantium Peel), Chenpi (Tangerine Peel) (remove white pith), Houpo (Magnolia Bark) (processed), Gancao (Licorice Root) (roasted, each 1 liang), Ganjiang (Dried Ginger) (processed, 5 qian), Yumike (Poppy Shell) (honey water fried, 6 liang).
Grind to fine powder, refine honey to make pills the size of弹子弹 (bullet/pear). Take one pill per dose, one zhan of water, break apart, decoct to six or seven parts, take with dregs slightly warm, before meals.
[Wang Haizang] Yijian Duank Xia Tang (Simple Stop Leakage Decoction): Treats red/white dysentery, regardless of new/old, young/old.
Baizhu (Atractylodes Macrocephala Rhizome), Fuling (Poria) (each 1 qian), Gancao (Licorice Root) (5 fen), Caoguo (Black Cardamom) (with peel, one fruit).
Crush. Use fourteen Yingusu (Poppy Shell), remove membrane and calyx/stem, cut碎碎, soak in vinegar to coarse powder, use as one dose, add one bowl of water, seven slices of ginger, seven jujubes, seven Wumei (Mume Fruit), decoct to one zhan, divide into two doses. For red dysentery, add two Adzuki beans; for white dysentery, add 5 qian Ganjiang (Dried Ginger). Yingusu (Poppy Shell) treats dysentery, takes effect like a god, but nature is tight/astringent, often causes vomiting/reversal. Since processed with vinegar, added Wumei (Mume Fruit), it does not cause harm, but vomiting persons should not take. Generally dysentery, ancient formulas call Zhixia (Stagnant Downward), mostly due to intestinal/stomach inherent accumulation. At initial onset, do not abruptly stop. First use Badous Yinggan Wan (Croton Response Pill) ten-plus pills, send down with Bai Mei Tang (White Plum Decoction), let stool slightly loosen. Still take previous medicine, no response not made effective. If Spleen/Stomach inherently weak, use Doukou (Cardamom), Juhong (Tangerine Red), Yingusu (Poppy Shell) equal parts powder, vinegar boiled flour paste to make pills paulownia seed size, take fifty pills per dose, send down with Wumei (Mume Fruit) decoction, also treats acute diarrhea unceasing, one dose cures, better if drug power doubles. If feeling nausea, use Lizhong Tang (Regulate the Middle Decoction), Siwu Tang (Four Substances Decoction) plus Doukou (Cardamom), Muxiang (Costus Root) to regulate Stomach Qi, still use Erchen Tang (Two Aged Decoction) boiled Muxiang Wan (Costus Pill) to settle vomiting/reversal. Generally dysentery is heart/belly concern, especially unsuitable for elders. If truly using mild/harmonious agents from start to finish, difficult to achieve effect, must lead to critical danger, even if wanting to take this, it is already late. Qinjiao (Gentiana Root), Diyü (Sedge Rhizome), Huangbai (Phellodendron Bark), Mutong (Akebia Stem) etc., their nature is bitter/cold, difficult to lightly take. Bloody dysentery should take Weifeng Tang (Wind-Stomach Decoction) and Jiao Ai Tang (Gelatin-Mugwort Decoction) etc. White [dysentery] should take Fuzi Lizhong Tang (Aconite Regulate the Middle Decoction), Zhenling Dan (Shaking Spirit Elixir) etc., more suitable to examine and use. If five colors mixed discharge,