水渍入胃。名为溢饮。滑泄。渴能饮水。水下复泄。泄而大渴。此无药证。当灸大椎。
大椎一穴。一名大椎。在第一椎下陷中。手足三阳督脉之会。针五分。留三呼。泄五吸。灸以
年为壮。
内经云。湿胜则濡泄。甲乙经云。寒气客于下焦。传为濡泄。夫脾为五脏之至阴。其性恶寒湿
。今寒湿之气。内客于脾。故不能裨助胃气。腐熟水谷。致清浊不分。水入肠间。虚莫能制。故洞泄
如水。随气而下。谓之濡泄。法当除湿利小便也。对金饮子主之。
【对金饮子】
平胃散(五钱) 五苓散(二钱半) 草豆蔻(面裹煨。五钱)
上相合作四服。水一盏半。姜三片。枣两个。煎一盏。去渣。温服食前。(上都七月间。史丞
相有此疾。三服而愈)
内经云。清气在下。则生飧泄。又曰。久风入胃中。则为肠风飧泄。夫脾胃、土也。其气冲和
。以化为事。今清气下降而不升。则风邪久而干胃。是木贼土也。故冲和之气不能化。而令物完
出。谓之飧泄。或饮食太过。肠
胃所伤。亦致米谷不化。此俗呼水谷利也。法当下者举之而消克之也。加减木香散主之。
【加减木香散】
木香 良姜 升麻(去腐) 人参(去芦)
槟榔(各二钱半) 神曲(炒。二钱) 肉豆蔻 吴茱萸(泡)
缩砂仁 干姜(炮) 陈皮(各半钱)
上十一味为粗末。每服四钱水一盏半。煎至一盏。去渣。温服。食前。宜加白术。
水湿浸渍入胃,称为溢饮。表现为滑泄不禁,口渴且能饮水,但饮水后随即再次腹泻,腹泻后感到极度口渴。这种情况属于无药可治的证候,应当艾灸大椎穴。
大椎穴,又名大椎,位于第一胸椎下方的凹陷处,是手足三阳经与督脉交会之处。针刺深度五分,留针三呼的时间,泻法操作五吸的时间;艾灸时以“年”为单位计算壮数(即几岁灸几壮)。
《黄帝内经》说:湿气偏盛则导致濡泄。《甲乙经》说:寒气侵袭下焦,传变为濡泄。脾是五脏中至阴之脏,其性质厌恶寒湿。如今寒湿之气内侵于脾,因此不能帮助胃气腐熟水谷,导致清浊不分,水液进入肠间,正气虚弱无法制约,所以出现像水一样直下的洞泄,随着气机下行,称为濡泄。治疗方法应当除湿并通利小便。用对金饮子主治。
【对金饮子】
平胃散(五钱) 五苓散(二钱半) 草豆蔻(面粉包裹煨制,五钱)
以上药物混合制成四剂。每剂用水一盏半,生姜三片,大枣两个,煎煮至一盏量,去渣滓,饭前温服。(上都地区七月间,史丞相患有此病,服用三剂后痊愈)
《黄帝内经》说:清气在下,则产生飧泄。又说:久风侵入胃中,则成为肠风飧泄。脾胃属土,其气冲和,以运化消化为职能。如今清气下降而不能上升,则风邪久留干扰胃腑,这是木气克制土气。因此冲和之气不能运化,导致食物完谷排出,称为飧泄。或者是饮食过量,损伤肠胃,也会导致米谷不化。这就是俗称的水谷利。治疗方法应当提升下陷之气并消食导滞。用加减木香散主治。
【加减木香散】
木香 良姜 升麻(去除腐坏部分) 人参(去除芦头)
槟榔(各二钱半) 神曲(炒制,二钱) 肉豆蔻 吴茱萸(浸泡)
缩砂仁 干姜(炮制) 陈皮(各半钱)
以上十一味药捣成粗末。每次服用四钱,用水一盏半,煎煮至一盏量,去渣滓,温服,饭前服用。适宜加入白术。
Water and dampness infiltrate the stomach. This is termed Yi Yin (Overflowing Drink). It presents with slippery diarrhea, thirst capable of drinking water, but after drinking, diarrhea recurs immediately; following diarrhea, extreme thirst occurs. This condition is considered to have no medicinal indication for treatment; moxibustion on Dazhui (GV14) should be performed instead.
Dazhui (GV14), also known as Dazhui, is located in the depression below the first thoracic vertebra. It is the meeting point of the Hand and Foot Three Yang meridians and the Du Meridian. Needle depth: 5 fen; retain needle for three "hu" (breaths); reduce method: five "xi" (breaths). For moxibustion, the number of cones corresponds to the patient's age in years.
The *Neijing* states: "When dampness prevails, it leads to Ru Xie (Soggy Diarrhea)." The *Jia Yi Jing* states: "When cold qi lodges in the lower jiao, it transmits into Ru Xie." The Spleen is the most yin organ among the five zang organs; its nature dislikes cold and dampness. Now, when cold-damp qi internally invades the spleen, it fails to assist Stomach qi in rotting and ripening food and drink. Consequently, clear and turbid substances are not separated; water enters the intestines, and deficiency prevents control, resulting in Dong Xie (Cavernous Diarrhea) flowing like water, descending with qi, which is called Ru Xie. The therapeutic method should be to eliminate dampness and promote urination. Dui Jin Yin Zi (Golden Mirror Drink) is the principal formula.
[Dui Jin Yin Zi]
Ping Wei San (Wu Wei Powder) (5 qian)
Wu Ling San (Five-Ingredient Powder with Poria) (2.5 qian)
Caodoukou (Tsaiko Fructus) (wrapped in flour and roasted, 5 qian)
Mix the above ingredients to make four doses. For each dose, use 1.5 liang of water, 3 slices of ginger, and 2 dates. Decoct until 1 liang remains, strain, and take warm before meals. (In July in Shangdu, Chancellor Shi suffered from this illness and was cured after taking three doses.)
The *Neijing* states: "When clear qi descends below, it generates Sun Xie (Undigested Food Diarrhea)." It also says: "When wind lingers in the stomach, it becomes Chang Feng Sun Xie (Intestinal Wind Undigested Food Diarrhea)." The Spleen and Stomach belong to Earth; their qi is harmonious and centered on transformation and transportation. Now, if clear qi descends rather than ascends, wind pathogen lingers and harasses the Stomach for a long time; this is Wood overacting on Earth. Therefore, the harmonious qi cannot transform, causing undigested food to be excreted intact, which is called Sun Xie. Alternatively, excessive diet may injure the intestines and stomach, also leading to undigested rice and grain. This is colloquially known as Shui Gu Li (Water and Grain Diarrhea). The therapeutic method should be to lift the sinking qi and digest/accumulate. Jia Jian Mu Xiang San (Modified Costus Root Powder) is the principal formula.
[Jia Jian Mu Xiang San]
Muxiang (Costi Radix)
Liangjiang (Alpiniae Officinarum Rhizoma)
Shengma (Cimicifugae Rhizoma) (remove decay)
Renshen (Ginseng Radix) (remove rhizome)
Binglang (Arecae Semen) (each 2.5 qian)
Shenqu (Massa Medicata Fermentata) (stir-fried, 2 qian)
Roudoukou (Myristicae Semen)
Wuzhuyu (Evodiae Fructus) (soaked)
Suosharen (Amomi Fructus Rotundus)
Ganjiang (Zingiberis Rhizoma) (processed)
Chenpi (Citri Reticulatae Pericarpium) (each 0.5 qian)
Grind the above eleven herbs into coarse powder. Each dose is 4 qian, decocted in 1.5 liang of water until 1 liang remains, strain, and take warm before meals. It is advisable to add Baizhu (Atractylodis Macrocephalae Rhizoma).