论曰内经谓小肠移热于大肠为 瘕,夫小肠者,受盛之官,化物出焉,大肠者传道之
官,变化出焉,二者皆以传化为事,今也小肠受热,移于大肠,则阴气虚而津液耗,津液既
耗,不能滑利,故糟粕内结,沉伏而为瘕聚,肠间菀结,大便秘涩是也。
治肠胃受热,气不宣通,瘕聚沉 ,腹胁胀满,大便秘涩,槟榔丸方
槟榔(锉) 大黄(锉炒) 枳壳(去瓤麸炒各二两) 桃仁(去皮尖双仁麸炒研) 大
麻仁(研) 青橘皮(汤浸去白焙) 木香(各一两)
上七味,除桃仁麻子仁研外,捣罗为末,再同研匀炼蜜,丸如梧桐子大,每服二十丸,
温水下,日二服,以知为度。
治大肠 瘕,秘涩不通,及一切热壅,浓朴丸方
浓朴(去粗皮涂生姜汁炙透) 大麻仁(研) 大黄(锉炒) 枳壳(去瓤炒各二两)
上四味,除麻仁外,捣罗为末,再与麻仁同研匀,炼蜜和于臼内,涂酥杵令匀熟,丸如
梧桐子大,每服二十丸,空心温酒下,溏利为度。
治小肠移热于大肠,腹胁胀满,瘕聚秘涩,大黄饮方
大黄(锉绢裹蒸三度焙干微炒) 泽泻 黄芩(去黑心锉碎) 甘草(炙锉各一两半) 石
膏(研四两)
上七味,粗捣筛,每服三钱匕,水一盏半,煎至八分,去滓空心温服,晚再服。
治大肠 瘕,秘涩躁闷,秦艽汤方
秦艽(去苗土一两半) 防风(去叉一两一分) 枳壳(去瓤麸炒一两) 独活(去芦
头一两) 桂(去粗皮三分) 槟榔(炮锉一两一分) 牵牛子(生捣末一分) 朴硝(细
研一两半汤成旋下)
上八味,除朴硝外,粗捣筛,每服三钱匕,水一盏,煎至七分,去滓下朴硝末半钱匕,
更煎两沸,食前温服,日二。
治肠胃受热,瘕聚沉 ,大便秘涩,葶苈丸方
葶苈(隔纸炒一两一分) 大黄(锉炒) 芒硝(研细各一两半) 杏仁(去皮尖双仁
炒研一两一分)
上四味,除杏仁芒硝外,捣罗为末,入杏仁芒硝同研匀,炼蜜和丸,如弹子大,每服一
丸,以水一盏,煎取六分温服。
治 瘕大便秘,二黄汤方
大黄(锉炒一两半) 芒硝(研细) 黄芩(去黑心各一两) 栀子仁(七枚) 甘草
(炙锉半两)
上五味,除芒硝外,粗捣筛,每服三钱匕,水一盏,煎至七分,去滓入芒硝半钱匕,煎
一二沸,温服食后临卧。
治大肠受热,瘕聚沉 ,秘涩不通,槟榔丸方
槟榔(炮锉一两) 大黄(锉炒二两) 木香(半两) 陈橘皮(汤浸去白焙一两) 牵
牛子(二两内一两生捣为末,一两炒令熟别捣为末)
上五味,纳四味捣罗为末,入牵牛子末,和匀炼蜜,和更于臼内涂酥,杵令匀熟,丸如
梧桐子大,每服三十丸,空心温酒下。
论述说:《内经》中提到,小肠的热邪转移到大肠称为“瘕”。小肠是受盛之官,负责消化食物;大肠是传道之官,负责传导变化。这两者都以传化功能为主。现在小肠受热,热邪移入大肠,导致阴气虚弱而津液耗损。津液既然耗损,就不能起到滑利肠道的作用,因此糟粕在体内结聚,沉伏形成瘕聚,表现为肠间郁结,大便秘结涩滞。
治疗肠胃受热,气机不宣通,瘕聚沉伏,腹胁胀满,大便秘结涩滞的槟榔丸方:
槟榔(锉碎) 大黄(锉碎炒制) 枳壳(去瓤,麸炒,各二两) 桃仁(去皮尖,双仁,麸炒后研碎) 大麻仁(研碎) 青橘皮(汤浸后去白焙干) 木香(各一两)
以上七味药,除了桃仁和大麻仁需要研碎外,其余捣碎过筛成末,再一同研匀,用炼蜜调和,制成如梧桐子大小的丸剂。每次服用二十丸,温水送服,每日两次,以见效为度。
治疗大肠瘕,秘涩不通,以及一切热邪壅滞的浓朴丸方:
浓朴(去粗皮,涂生姜汁炙透) 大麻仁(研碎) 大黄(锉碎炒制) 枳壳(去瓤炒制,各二两)
以上四味药,除了麻仁外,捣碎过筛成末,再与麻仁一同研匀,用炼蜜在臼内调和,涂酥杵捣至均匀熟透,制成如梧桐子大小的丸剂。每次服用二十丸,空腹时温酒送服,以大便溏利为度。
治疗小肠热邪移于大肠,腹胁胀满,瘕聚秘涩的大黄饮方:
大黄(锉碎后用绢包裹蒸三次,焙干微炒) 泽泻 黄芩(去黑心锉碎) 甘草(炙后锉碎,各一两半) 石膏(研碎,四两)
以上七味药(注:原文列五味,此处依原文描述处理),粗捣筛过,每次取三钱匕,加水一盏半,煎至八分,去渣,空腹时温服,晚上再服一次。
治疗大肠瘕,秘涩躁闷的秦艽汤方:
秦艽(去苗土,一两半) 防风(去叉,一两一分) 枳壳(去瓤麸炒,一两) 独活(去芦头,一两) 桂(去粗皮,三分) 槟榔(炮制锉碎,一两一分) 牵牛子(生捣末,一分) 朴硝(细研,一两半,汤成时旋下)
以上八味药,除了朴硝外,粗捣筛过,每次取三钱匕,加水一盏,煎至七分,去渣后加入朴硝末半钱匕,再煎两沸,食前温服,每日两次。
治疗肠胃受热,瘕聚沉伏,大便秘结涩滞的葶苈丸方:
葶苈(隔纸炒,一两一分) 大黄(锉碎炒制) 芒硝(研细,各一两半) 杏仁(去皮尖双仁炒研,一两一分)
以上四味药,除了杏仁和芒硝外,捣碎过筛成末,加入杏仁和芒硝一同研匀,用炼蜜和丸,如弹子大小。每次服用一丸,加水一盏,煎取六分温服。
治疗瘕大便秘的二黄汤方:
大黄(锉碎炒制,一两半) 芒硝(研细) 黄芩(去黑心,各一两) 栀子仁(七枚) 甘草(炙锉,半两)
以上五味药,除了芒硝外,粗捣筛过,每次取三钱匕,加水一盏,煎至七分,去渣后加入芒硝半钱匕,煎一二沸,饭后临卧时温服。
治疗大肠受热,瘕聚沉伏,秘涩不通的槟榔丸方:
槟榔(炮制锉碎,一两) 大黄(锉碎炒制,二两) 木香(半两) 陈橘皮(汤浸去白焙,一两) 牵牛子(二两,其中一两生捣为末,一两炒令熟别捣为末)
以上五味药,将前四味捣碎过筛成末,加入牵牛子末,和匀炼蜜,再在臼内涂酥,杵捣至均匀熟透,制成如梧桐子大小的丸剂。每次服用三十丸,空腹时温酒送服。
Commentary states: The *Neijing* (Inner Canon) mentions that when heat from the Small Intestine transfers to the Large Intestine, it is termed "Zha" (abdominal mass). The Small Intestine is the official of reception and transformation, responsible for digesting food; the Large Intestine is the official of transmission, responsible for conducting changes. Both organs are primarily engaged in transmission and transformation functions. Now, if the Small Intestine receives heat, and this heat transfers to the Large Intestine, it leads to deficiency of Yin Qi and consumption of Jin Ye (Body Fluids). Since Jin Ye is consumed, it cannot lubricate the intestines smoothly, causing waste matter to accumulate internally, sink, and form Zha Ju (masses), presenting as stagnation between the intestines and constipation with dryness.
Binglang Wan Formula for treating heat in the stomach and intestines, where Qi fails to circulate freely, Zha Ju sinks, abdominal and hypochondriac distension and fullness occur, and stool is constipated and dry:
Areca Seed (Binglang, Arecae Semen) [crushed]; Rhubarb (Dahuang, Rhei Radix et Rhizoma) [crushed and stir-fried]; Aurantium Fructus Immaturus (Zhike, Aurantii Fructus Immaturus) [pulp removed, bran-fried, 2 liang each]; Peach Kernel (Taoren, Persicae Semen) [skin and tip removed, double-kernel, bran-fried and ground); Hemp Seed (Dama Ren, Cannabis Semen) [ground); Green Tangerina Peel (Qing Jupi, Citri Reticulatae Pericarpium Viride) [soaked in water, white pith removed, dried]; Aucklandia Root (Muxiang, Aucklandiae Radix) [1 liang each].
The above seven herbs, except for Taoren and Dama Ren which are to be ground, are crushed, sifted into powder, then mixed uniformly. Honey is refined and used to bind them into pills the size of Sophora seeds. Take 20 pills per dose, with warm water, twice daily, until efficacy is achieved.
Nongpo Wan Formula for treating Large Intestine Zha, obstruction with dryness and difficulty, and all types of heat congestion:
Magnolia Bark (Nongpo, Magnoliae Officinalis Cortex) [rough bark removed, brushed with ginger juice and roasted thoroughly); Hemp Seed (Dama Ren, Cannabis Semen) [ground); Rhubarb (Dahuang, Rhei Radix et Rhizoma) [crushed and stir-fried); Aurantium Fructus Immaturus (Zhike, Aurantii Fructus Immaturus) [pulp removed, fried, 2 liang each].
The above four herbs, except for Dama Ren, are crushed, sifted into powder, then mixed uniformly with Dama Ren. Honey is refined and mixed in a mortar, coated with butter, and pounded until uniform and cooked. Form into pills the size of Sophora seeds. Take 20 pills per dose, with warm wine on an empty stomach, until loose stools occur.
Dahuang Yin Decoction for treating heat from the Small Intestine transferring to the Large Intestine, abdominal and hypochondriac distension and fullness, Zha Ju with constipation:
Rhubarb (Dahuang, Rhei Radix et Rhizoma) [crushed, wrapped in silk, steamed three times, dried, slightly stir-fried); Alisma Rhizome (Zexie, Alismatis Rhizoma); Scutellaria Root (Huangqin, Scutellariae Radix) [black heart removed, crushed); Licorice Root (Gancao, Glycyrrhizae Radix et Rhizoma) [roasted and crushed, 1.5 liang each); Gypsum (Shigao, Gypsum Fibrosum) [ground, 4 liang].
The above seven herbs (note: text lists five ingredients but says seven, follow original description), coarsely crushed and sifted. Take 3 qian bi per dose, add 1.5 sheng of water, decoct until 0.8 sheng remains, remove dregs, and take warm on an empty stomach. Take again in the evening.
Qinjiao Tang Decoction for treating Large Intestine Zha, constipation with restlessness and oppression:
Kochia Stem (Qinjiao, Gentianae Macrophyllae Radix) [sprouts and soil removed, 1.5 liang); Saposhnikovia Root (Fangfeng, Saposhnikoviae Radix) [forks removed, 1.1 liang); Aurantium Fructus Immaturus (Zhike, Aurantii Fructus Immaturus) [pulp removed, bran-fried, 1 liang); Angelica Pubescens Root (Duhuo, Angelicae Pubescentis Radix) [rhizome removed, 1 liang); Cinnamon Twig (Gui, Cinnamomi Ramulus) [rough bark removed, 3 fen); Areca Seed (Binglang, Arecae Semen) [roasted and crushed, 1.1 liang); Morning Glory Seed (Qianniu Zi, Pharbitidis Semen) [raw, ground into powder, 1 fen); Mirabilite (Puxiao, Natrii Sulfas) [finely ground, 1.5 liang, added just before completion).
The above eight herbs, except for Puxiao, are coarsely crushed and sifted. Take 3 qian bi per dose, add 1 sheng of water, decoct until 0.7 sheng remains, remove dregs, add 0.5 qian bi of Puxiao powder, boil two more times, and take warm before meals, twice daily.
Tingli Wan Formula for treating heat in the stomach and intestines, Zha Ju sinking, and large bowel constipation with dryness:
Lepidium Seed (Tingli, Lepidii Semen) [stir-fried over paper, 1.1 liang); Rhubarb (Dahuang, Rhei Radix et Rhizoma) [crushed and stir-fried); Mirabilite (Mangxiao, Natrii Sulfas) [finely ground, 1.5 liang each); Apricot Kernel (Xingren, Armeniacae Semen Amarum) [skin and tip removed, double-kernel, stir-fried and ground, 1.1 liang).
The above four herbs, except for Xingren and Mangxiao, are crushed, sifted into powder, then mixed uniformly with Xingren and Mangxiao. Honey is refined and used to bind them into pills the size of a bullet. Take one pill per dose, add 1 sheng of water, decoct until 0.6 sheng remains, and take warm.
Erhuang Tang Decoction for treating Zha with large bowel constipation:
Rhubarb (Dahuang, Rhei Radix et Rhizoma) [crushed and stir-fried, 1.5 liang); Mirabilite (Mangxiao, Natrii Sulfas) [finely ground); Scutellaria Root (Huangqin, Scutellariae Radix) [black heart removed, 1 liang each); Gardenia Fruit (Zhizi Ren, Gardeniae Fructus) [seven kernels); Licorice Root (Gancao, Glycyrrhizae Radix et Rhizoma) [roasted and crushed, 0.5 liang).
The above five herbs, except for Mangxiao, are coarsely crushed and sifted. Take 3 qian bi per dose, add 1 sheng of water, decoct until 0.7 sheng remains, remove dregs, add 0.5 qian bi of Mangxiao, boil one or two times, and take warm after meals and before sleep.
Binglang Wan Formula for treating heat in the Large Intestine, Zha Ju sinking, and obstruction with dryness and difficulty:
Areca Seed (Binglang, Arecae Semen) [roasted and crushed, 1 liang); Rhubarb (Dahuang, Rhei Radix et Rhizoma) [crushed and stir-fried, 2 liang); Aucklandia Root (Muxiang, Aucklandiae Radix) [0.5 liang); Aged Tangerina Peel (Chen Jupi, Citri Reticulatae Pericarpium) [soaked in water, white pith removed, dried, 1 liang); Morning Glory Seed (Qianniu Zi, Pharbitidis Semen) [2 liang total, 1 liang raw ground into powder, 1 liang stir-fried and separately ground into powder).
The above five herbs, place the first four into powder by crushing and sifting, add Qianniu Zi powder, mix uniformly with refined honey, coat with butter in a mortar, and pound until uniform and cooked. Form into pills the size of Sophora seeds. Take 30 pills per dose, with warm wine on an empty stomach.