泄泻之候,经中所谓洞泄、飧泄、溏泄、脾泄、胃泄、大肠泄、大瘕泄、小肠泄、水谷注
下,其实一也。原疾之由,因肠胃虚冷而邪气乘之。经云∶寒甚则泄。春伤于风,夏生飧泄。
又云∶寒则溏,热则垢,此得于外也。喜、怒、忧、思、恐,致使脏气隔绝,精神夺散,必致溏
泄,此属内也。如饮食生冷,食伤脾胃而泄者,属不内外也。寒者温之,热者凉之,滑者涩
之,湿者燥之,治泄之法,无是过也。
五苓散分利 六君子汤补脾 治中汤 温中平胃散 行湿,并治泄泻。(方见前泄泻门,通用。)
豆蔻分气饮 治脏腑虚寒,泄泻无度,瘦弱,妇人产后洞泻危笃。
藿香叶 草豆蔻仁(炒) 青皮(各四两) 甘草 丁香(各半两) 乌梅(三十个)
肉豆蔻(面包煨,十个)
上咀,每服四钱,水二盏,糯米一撮,煎七分,温服。
木香散 治脏腑冷极,及久冷伤惫,口干,下泄,米谷不化,饮食无味,肌肉瘦悴,
心多嗔恚,妇人产后虚冷下泄,及一切水泻冷痢。
木香 破故纸 良姜 砂仁 浓朴(制。各三钱) 赤芍药 陈皮 桂心 白术(各半两)
胡椒 吴茱萸(泡七次。各八分) 槟榔(一个) 肉豆蔻(四个,制)
为细末,每服三钱,用不经水猪肝四两,去筋膜,切薄片,重重掺药。以水一碗,醋一
杯,煮肝熟,入盐
一钱,葱白三茎,细切,捣姜五钱同煮,水欲尽,空心顿食之。初服微泄不妨,少时自止,
不可热吃。经年冷利、滑泄一服效。渴饮粥汤,忌生冷油腻。
固肠丸 治男妇久泄不止,无逾于此。
人参 苍术(制) 茯苓 木香 诃子肉(炮) 乌梅肉 肉豆蔻(面包煨) 罂粟壳(去筋
膜。各等分)
上为细末,面糊丸,梧桐子大。每服四十丸,米饮下。
人参豆蔻散 治妇人久泄不止,诸药无效。
人参 肉豆蔻(煨) 干姜 浓朴(姜汁炒) 甘草 陈皮 川芎 桂心 诃子 北茴香(各五分)
为末,水一盏,姜枣同煎六分服。
泄泻的证候,医经中所谓的洞泄、飧泄(完谷不化的腹泻)、溏泄(大便稀薄不成形)、脾泄、胃泄、大肠泄、大瘕泄(里急后重、下痢脓血)、小肠泄、水谷注下(水液和食物直趋而下),其实质都是一样的。探究疾病的起因,是因为肠胃虚寒,邪气趁机侵袭。医经说:寒气极盛就会导致泄泻。春季感受风邪,到了夏季就会发生飧泄。又说:寒邪导致大便稀溏,热邪导致排泄物秽浊黏腻,这是由外感邪气引起的。喜悦、愤怒、忧愁、思虑、恐惧等情志失调,致使脏腑之气隔绝不通,精神耗散,必然导致溏泄,这属于内伤所致。如果饮食生冷,损伤脾胃而导致的泄泻,属于不内外因(既非外感也非纯内伤)。对于寒证用温法治疗,热证用凉法治疗,滑脱不禁的用固涩法治疗,湿盛的用燥湿法治疗,治疗泄泻的方法,没有超过这些原则的。
五苓散(利水渗湿方剂)用于分利小便以止泻;六君子汤(益气健脾方剂)用于补益脾气;治中汤(温中祛寒方剂);温中平胃散(温中和胃方剂)用于行气化湿,以上方剂均用于治疗泄泻。(方剂见前文泄泻章节,为通用方。)
豆蔻分气饮用于治疗脏腑虚寒,泄泻无度,身体瘦弱,以及妇人产后洞泄危重之症。
药材包括:藿香叶、草豆蔻仁(炒制)、青皮(各四两)、甘草、丁香(各半两)、乌梅(三十个)、肉豆蔻(面粉包裹煨熟,十个)。
将上述药材切碎,每次服用四钱,加水二盏,糯米一撮,煎至七分水量,温服。
木香散用于治疗脏腑极冷,以及久病寒冷导致身体疲惫,口干,下部泄泻,米谷不化,饮食无味,肌肉消瘦憔悴,心中容易恼怒,妇人产后虚冷下泄,以及一切水样泻和冷痢。
药材包括:木香、破故纸(补骨脂)、良姜(高良姜)、砂仁、浓朴(厚朴,炮制。各三钱)、赤芍药、陈皮、桂心、白术(各半两)、胡椒、吴茱萸(浸泡七次。各八分)、槟榔(一个)、肉豆蔻(四个,炮制)。
研成细末,每次服用三钱,取未经产血的猪肝四两,去除筋膜,切成薄片,层层裹上药粉。用水一碗,醋一杯,煮肝至熟,加入盐一钱,葱白三茎,切细,捣碎生姜五钱一同煮,待水即将煮干时,空腹一次性服下。初服时轻微泄泻不要紧,稍后自然会停止,不可热吃。多年的冷性痢疾、滑泄,服用一次即见效。口渴时可喝粥汤,忌食生冷油腻食物。
固肠丸用于治疗男女久泻不止,没有比此方更好的了。
药材包括:人参、苍术(炮制)、茯苓、木香、诃子肉(炮制)、乌梅肉、肉豆蔻(面粉包裹煨熟)、罂粟壳(去除筋膜。各等分)。
研成细末,用面糊制作丸药,大小如梧桐子。每次服用四十丸,米汤送服。
人参豆蔻散用于治疗妇人久泻不止,其他药物无效的情况。
药材包括:人参、肉豆蔻(煨制)、干姜、浓朴(厚朴,姜汁炒制)、甘草、陈皮、川芎、桂心、诃子、北茴香(小茴香,各五分)。
研成粉末,用水一盏,加生姜和大枣同煎至六分水量,服用。
The syndrome of diarrhea, referred to in medical classics as Dongxie (profuse watery diarrhea), Xunxie (diarrhea with undigested food), Tangxie (loose stools), Pixie (Spleen diarrhea), Weixie (Stomach diarrhea), Dachangxie (Large Intestine diarrhea), Dajiaxie (tenesmus with dysentery-like symptoms), Xiaochangxie (Small Intestine diarrhea), and Shuigu Zhuxia (water and grain flowing down directly), are essentially the same. The origin of the disease lies in deficiency-cold of the Stomach and Intestines, allowing pathogenic factors to invade. The classics state: "When cold is severe, diarrhea occurs." If wind is injured in Spring, Xunxie will arise in Summer. It also states: "Cold leads to loose stools, heat leads to turbid excrement," which results from external pathogens. Joy, anger, worry, thought, and fear can cause isolation of Zang-Fu Qi and depletion of Spirit, inevitably leading to Tangxie; this belongs to internal causes. If raw or cold food damages the Spleen and Stomach causing diarrhea, it belongs to neither-internal-nor-external causes. For cold patterns, use warming methods; for heat patterns, use cooling methods; for sliding/insecure patterns, use astringent methods; for dampness patterns, use drying methods. These are the principles of treating diarrhea, without exceeding them.
Wuling San (Five-Ingredient Poria Pill) is used to separate clear from turbid by promoting urination; Liu Junzi Tang (Six-Gentleman Decoction) tonifies the Spleen; Zhizhong Tang (Regulate the Middle Decoction); Wenzhong Pingwei San (Warm the Middle and Calm the Stomach Powder) move Qi and resolve dampness; all treat diarrhea. (Formulas see previous section on Diarrhea, general use.)
Doukou Fenqi Yin (Cardamom Distributing Qi Decoction) treats deficiency-cold of the Zang-Fu, uncontrolled diarrhea, emaciation, and critical postpartum profuse diarrhea in women.
Ingredients include: Huoxiang Ye (Agastache Leaf), Caodoukou Ren (Areca Seed/Cardamom Seed, stir-fried), Qingpi (Green Tangerine Peel, 4 liang each), Gancao (Licorice Root), Dingxiang (Clove, half liang each), Wumei (Mume Fruit, 30 pieces), Roudoukou (Nutmeg, baked in flour, 10 pieces).
Crush the ingredients. Take 4 qian per dose, add 2 zhan of water and a pinch of Nuomi (Glutinous Rice), decoct until 7 fen remains, and take warm.
Muxiang San (Costus Root Powder) treats extreme cold of the Zang-Fu, exhaustion from chronic cold injury, dry mouth, lower diarrhea, undigested food, loss of taste, emaciation, irritability, postpartum deficiency-cold lower diarrhea in women, and all types of watery diarrhea and cold dysentery.
Ingredients include: Muxiang (Costus Root), Poguzhi (Kopijia/Bone Setter), Liangjiang (Galangal), Sharen (Amomum Fruit), Nongpu (Magnolia Bark, processed, 3 qian each), Chishaoyao (Red Peony Root), Chenpi (Aged Tangerine Peel), Guixin (Cinnamon Twig Heart), Baizhu (Atractylodes Macrocephala Rhizome, half liang each), Hujiao (Pepper), Wuzhuyu (Evodia Fruit, soaked seven times, 8 fen each), Binglang (Betel Nut, 1 piece), Roudoukou (Nutmeg, 4 pieces, processed).
Grind into fine powder. Take 3 qian per dose. Use 4 liang of fresh pig liver not exposed to menstrual blood, remove fascia, slice thinly, and layer with the medicine. Add 1 bowl of water and 1 cup of vinegar, boil the liver until cooked, add 1 qian of salt, 3 stalks of Congbai (Scallion White), finely chopped, and 5 qian of pounded Shengjiang (Fresh Ginger), boil together. When water is nearly exhausted, consume on an empty stomach in one go. Mild diarrhea upon initial intake is acceptable and will stop shortly. Do not eat hot. One dose is effective for chronic cold diarrhea and slippery discharge. Drink congee soup if thirsty; avoid raw, cold, greasy foods.
Guchang Wan (Intestine-Stabilizing Pill) treats persistent diarrhea in men and women that does not cease; nothing surpasses this formula.
Ingredients include: Renshen (Ginseng Root), Cangzhu (Atractylodes Lancea Rhizome, processed), Fuling (Poria), Muxiang (Costus Root), Hezirou (Chebula Fruit Flesh, roasted), Wumeirou (Mume Fruit Flesh), Roudoukou (Nutmeg, baked in flour), Yingsuke (Poppy Shell, remove veins/fascia, equal parts).
Grind into fine powder, make pills with wheat paste, size of Wutongzi (Chinese Tallow Tree seeds). Take 40 pills per dose, swallow with Mixia (Rice Drink).
Renshen Doukou San (Ginseng and Cardamom Powder) treats persistent diarrhea in women unresponsive to other medicines.
Ingredients include: Renshen (Ginseng Root), Roudoukou (Nutmeg, baked), Ganjiang (Dried Ginger), Nongpu (Magnolia Bark, stir-fried with Ginger Juice), Gancao (Licorice Root), Chenpi (Aged Tangerine Peel), Chuanxiong (Ligusticum Rhizome), Guixin (Cinnamon Twig Heart), Hezi (Chebula Fruit), Beihuixiang (Fennel Fruit, 5 fen each).
Grind into powder. Add 1 zhan of water, decoct with Shengjiang (Fresh Ginger) and Dazao (Jujube) until 6 fen remains, and take.