论曰∶《内经》曰,肠痹者,数饮而出不得,中气喘争,时发飧泄。夫大肠者,传导之
官,其所以传导者,皆冲和之气。今风寒湿三气乘虚客于肠间,则邪留而和气闭矣。故其证
数饮而出不得,中气喘争,时发飧泄,大小肠气痹,水道不通,故虽多饮而不得溲便;并气
于大肠,使糟粕不化,故中气喘争,时发飧泄也。
治肠痹寒湿内搏,腹满气急,大便飧泄。吴茱萸散方。
吴茱萸(汤洗,焙干,炒半两) 肉豆蔻仁 干姜(炮) 甘草(炙各半两) 陈橘皮
(汤浸
去白,焙) 浓朴(去粗皮,生姜汁炙) 高良姜(各二两) 缩砂仁 陈曲(炒) 白术
(各
一两)
上一十味,捣罗为散。每服一钱匕,粥饮调下,食前服。
治肠虚寒湿内攻,腹痛飧泄。草豆蔻散方。
草豆蔻 陈橘皮(汤浸去白,焙各一两) 桂(去粗皮) 木香 白术 当归(切,焙)
白
豆蔻仁 丁香 肉豆蔻仁 高良姜(各半两)
上一十味,捣罗为散。每服一钱匕,煎生姜枣汤调下,食前服。
治肠痹腹满喘争,小便不利,大便飧泄。赤茯苓丸方。
赤茯苓(去黑皮) 白术 桂(去粗皮各二两) 木香 诃黎勒(煨,去核) 陈橘皮
(汤浸
去白,焙) 浓朴(去粗皮,生姜汁炙各一两)
上七味,捣罗为末,炼蜜和丸梧桐子大。每服三十丸,米饮下,空心食前,日二。
治肠痹飧泄,腹胀气痛,饮食不化。诃黎勒汤方。
诃黎勒(煨,用皮一两半) 附子(炮裂,去皮脐一两) 当归(切,焙三分) 桔梗
(炒半
两) 肉豆蔻(去壳三分) 木香(半两) 吴茱萸(汤浸七遍,焙干,微炒一分) 陈橘
皮(汤
浸去
上九味,粗捣筛。每服三钱匕,水一中盏,入生姜半分,枣二枚,煎至七分,去滓,食
前稍热服。
治肠痹腹胀 痛,时复飧泄,食不消化。木香丸方。
木香(一两) 诃黎勒(煨,用皮一两半) 白术(一两) 桂(去粗皮一两) 附子
(炮
裂,去皮脐二两) 芜荑(微炒一两) 高良姜(锉一两) 肉豆蔻(去壳半两) 浓朴(去
粗皮,
生姜汁炙过二两) 干姜(炮三分) 甘草(炙,锉半两)
上一十一味,捣罗为末,以曲末煮作糊,和捣三二百杵,丸如梧桐子大。食前生姜枣汤
下二十丸。
治肠痹飧泄,腹胁胀满。诃黎勒丸方。
诃黎勒(煨,用皮一两) 干姜(炮三分) 当归(锉,微妙一两) 黄连(去须一两)
白术
(一两) 木香(三分) 浓朴(去粗皮,生姜汁炙一两)
上七味,捣罗为末,炼蜜和捣三二百下,丸如梧桐子大。每服三十丸,粥饮下,不拘时
候。
治肠痹腹胀飧泄,小便不利。木香散方。
木香(三两) 诃黎勒(煨,用皮半两) 附子(炮裂,去皮脐一两) 干姜(炮一两)
浓
朴(去粗皮,涂生姜汁炙二两) 枳实(去瓤,麸炒一两) 赤茯苓(去黑皮一两) 甘草
(炙,
锉半两) 当归(锉,微炒一两)
上九味,捣罗为细末。每服二钱匕,粥饮调下,食前。
论述说:《黄帝内经》指出,肠痹的症状是频繁饮水却排尿困难,腹部气机逆乱冲撞,时常发生完谷不化的泄泻。大肠是负责传导糟粕的器官,其传导功能依赖于平和冲调之气。如今风寒湿三邪乘人体正气虚弱之际侵入肠道之间,导致邪气滞留而和气闭塞。因此出现频繁饮水却无法排尿的症状;寒湿之气并聚于大肠,使食物糟粕不能正常消化转化,从而导致腹部气机逆乱冲撞,时常发生完谷不化的泄泻。
治疗因寒湿内侵搏结导致的肠痹,症状见腹部胀满、气息急促、大便完谷不化泄泻的方剂:吴茱萸散方。
吴茱萸(用汤洗过,焙干,炒至半两) 肉豆蔻仁 干姜(炮制) 甘草(炙制,各半两) 陈橘皮(用汤浸泡后去白瓤,焙干) 浓朴(去除粗皮,用生姜汁炙制) 高良姜(各二两) 缩砂仁 陈曲(炒制) 白术(各一两)
以上十味药,捣碎过筛制成散剂。每次服用一钱匕,用米粥汤调服,饭前服用。
治疗因肠虚寒湿内攻导致的腹痛、完谷不化泄泻的方剂:草豆蔻散方。
草豆蔻 陈橘皮(用汤浸泡去白瓤,焙干,各一两) 桂枝(去除粗皮) 木香 白术 当归(切片,焙干) 白豆蔻仁 丁香 肉豆蔻仁 高良姜(各半两)
以上十味药,捣碎过筛制成散剂。每次服用一钱匕,煎煮生姜大枣汤调服,饭前服用。
治疗肠痹引起的腹部胀满、气机逆乱冲撞、小便不利、大便完谷不化泄泻的方剂:赤茯苓丸方。
赤茯苓(去除黑皮) 白术 桂枝(去除粗皮,各二两) 木香 诃黎勒(煨制,去核) 陈橘皮(用汤浸泡去白瓤,焙干) 浓朴(去除粗皮,用生姜汁炙制,各一两)
以上七味药,捣碎过筛制成细末,用炼蜜调和制成梧桐子大小的丸剂。每次服用三十丸,用米汤送服,空腹及饭前服用,每日两次。
治疗肠痹引起的完谷不化泄泻、腹胀气痛、饮食不消化的方剂:诃黎勒汤方。
诃黎勒(煨制,使用果皮一两半) 附子(炮制裂开,去皮和脐,一两) 当归(切片,焙干,三分) 桔梗(炒制,半两) 肉豆蔻(去壳,三分) 木香(半两) 吴茱萸(用汤浸泡七遍,焙干,微炒,一分) 陈橘皮(用汤浸泡去白瓤)
以上九味药,粗捣筛选。每次服用三钱匕,用水一中盏,加入生姜半分、大枣两枚,煎煮至七分水量,滤去药渣,饭前稍热时服用。
治疗肠痹引起的腹胀痛、时常完谷不化泄泻、食物不消化的方剂:木香丸方。
木香(一两) 诃黎勒(煨制,使用果皮一两半) 白术(一两) 桂枝(去除粗皮,一两) 附子(炮制裂开,去皮和脐,二两) 芜荑(微炒,一两) 高良姜(锉碎,一两) 肉豆蔻(去壳,半两) 浓朴(去除粗皮,用生姜汁炙制,二两) 干姜(炮制,三分) 甘草(炙制,锉碎,半两)
以上十一味药,捣碎过筛制成细末,用曲末煮成糊状,与药末混合捣击三二百下,制成梧桐子大小的丸剂。饭前用生姜大枣汤送服二十丸。
治疗肠痹引起的完谷不化泄泻、腹部和胁部胀满的方剂:诃黎勒丸方。
诃黎勒(煨制,使用果皮一两) 干姜(炮制,三分) 当归(锉碎,微炒,一两) 黄连(去除须根,一两) 白术(一两) 木香(三分) 浓朴(去除粗皮,用生姜汁炙制,一两)
以上七味药,捣碎过筛制成细末,用炼蜜调和捣击三二百下,制成梧桐子大小的丸剂。每次服用三十丸,用米粥汤送服,不限定具体时间。
治疗肠痹引起的腹胀、完谷不化泄泻、小便不利的方剂:木香散方。
木香(三两) 诃黎勒(煨制,使用果皮半两) 附子(炮制裂开,去皮和脐,一两) 干姜(炮制,一两) 浓朴(去除粗皮,涂生姜汁炙制,二两) 枳实(去除瓤,麸炒,一两) 赤茯苓(去除黑皮,一两) 甘草(炙制,锉碎,半两) 当归(锉碎,微炒,一两)
以上九味药,捣碎过筛制成细末。每次服用二钱匕,用米粥汤调服,饭前服用。
Discussion states: The *Huangdi Neijing* (Yellow Emperor's Inner Canon) points out that the symptoms of Changbi (Intestinal Bi Syndrome, characterized by obstruction and pain in the intestines) include frequent drinking yet inability to urinate, qi counterflow and clashing in the middle jiao (abdomen), and occasional occurrence of undigested stool diarrhea (Sunxie). The Large Intestine is the official organ responsible for conduction; its conductive function relies on harmonious and balanced qi. Currently, when Wind-Cold-Dampness pathogenic factors invade the intestinal space taking advantage of deficiency, pathogenic factors remain stagnant while harmonious qi becomes obstructed. Therefore, symptoms such as frequent drinking but inability to urinate occur; Cold-Dampness qi gathers in the Large Intestine, causing food residues to fail to transform normally, leading to qi counterflow and clashing in the abdomen and occasional undigested stool diarrhea.
Treatment for Changbi caused by internal collision of Cold-Dampness, with symptoms of abdominal fullness, urgent breathing, and undigested stool diarrhea: Wuzhuyu San Formula.
Wuzhuyu (Evodiae Fructus, washed with decoction, dried by baking, stir-fried, half liang) Roudoukou Ren (Myristicae Semen) Ganjiang (Zingiberis Rhizoma Praeparatum, processed) Gancao (Glycyrrhizae Radix et Rhizoma, honey-fried, each half liang) Chenjupi (Citri Reticulatae Pericarpium, soaked in water, white pith removed, dried) Houpo (Magnoliae Officinalis Cortex, coarse bark removed, processed with fresh ginger juice) Gaoliangjiang (Alpiniae Officinarum Rhizoma, each two liang) Suoren (Amomi Fructus Rotundus) Chenqu (Medicated Leaven, stir-fried) Baizhu (Atractylodis Macrocephalae Rhizoma, each one liang)
The above ten ingredients are crushed, sifted, and made into a powder. Each dose is one qianbi (a small measuring spoon), taken with millet gruel broth, before meals.
Treatment for abdominal pain and undigested stool diarrhea caused by internal attack of Cold-Dampness due to intestinal deficiency and emptiness: Caodoukou San Formula.
Caodoukou (Cardamomi Fructus) Chenjupi (Citri Reticulatae Pericarpium, soaked in water, white pith removed, dried, each one liang) Gui (Cinnamomi Ramulus, coarse bark removed) Muxiang (Aucklandiae Radix) Baizhu (Atractylodis Macrocephalae Rhizoma) Danggui (Angelicae Sinensis Radix, sliced, dried) Baidoukou Ren (Cardamomi Alati Fructus) Dingxiang (Caryophylli Flos) Roudoukou Ren (Myristicae Semen) Gaoliangjiang (Alpiniae Officinarum Rhizoma, each half liang)
The above ten ingredients are crushed, sifted, and made into a powder. Each dose is one qianbi, taken with decocted fresh ginger and jujube soup, before meals.
Treatment for Changbi causing abdominal fullness, qi clashing, difficulty in urination, and undigested stool diarrhea: Chifuling Wan Formula.
Chifuling (Poria Cocos with Red Skin, black skin removed) Baizhu (Atractylodis Macrocephalae Rhizoma) Gui (Cinnamomi Ramulus, coarse bark removed, each two liang) Muxiang (Aucklandiae Radix) Helile (Terminaliae Chebulae Fructus, roasted, core removed) Chenjupi (Citri Reticulatae Pericarpium, soaked in water, white pith removed, dried) Houpo (Magnoliae Officinalis Cortex, coarse bark removed, processed with fresh ginger juice, each one liang)
The above seven ingredients are crushed, sifted into fine powder, mixed with refined honey, and kneaded into pills the size of paulownia seeds. Each dose is thirty pills, taken with rice drink, on an empty stomach and before meals, twice daily.
Treatment for Changbi causing undigested stool diarrhea, abdominal distension and painful qi stagnation, and indigestion: Helile Tang Formula.
Helile (Terminaliae Chebulae Fructus, roasted, using peel one and a half liang) Fuzi (Aconiti Lateralis Radix Praeparata, processed until cracked, skin and navel removed, one liang) Danggui (Angelicae Sinensis Radix, sliced, dried, three fen) Jiegeng (Platycodonis Radix, stir-fried, half liang) Roudoukou (Myristicae Semen, shell removed, three fen) Muxiang (Aucklandiae Radix, half liang) Wuzhuyu (Evodiae Fructus, soaked in water seven times, dried, slightly stir-fried, one fen) Chenjupi (Citri Reticulatae Pericarpium, soaked in water, white pith removed)
The above nine ingredients are coarsely crushed and sieved. Each dose is three qianbi, boiled with one zhan of water, adding half a fen of fresh ginger and two jujubes, until reduced to seventy percent volume. Strain the dregs and take warm before meals.
Treatment for Changbi causing abdominal distension and pain, occasional undigested stool diarrhea, and food indigestion: Muxiang Wan Formula.
Muxiang (Aucklandiae Radix, one liang) Helile (Terminaliae Chebulae Fructus, roasted, using peel one and a half liang) Baizhu (Atractylodis Macrocephalae Rhizoma, one liang) Gui (Cinnamomi Ramulus, coarse bark removed, one liang) Fuzi (Aconiti Lateralis Radix Praeparata, processed until cracked, skin and navel removed, two liang) Wuyi (Myrobalani Fructus, slightly stir-fried, one liang) Gaoliangjiang (Alpiniae Officinarum Rhizoma, chopped, one liang) Roudoukou (Myristicae Semen, shell removed, half liang) Houpo (Magnoliae Officinalis Cortex, coarse bark removed, processed with fresh ginger juice, two liang) Ganjiang (Zingiberis Rhizoma Praeparatum, processed, three fen) Gancao (Glycyrrhizae Radix et Rhizoma, honey-fried, chopped, half liang)
The above eleven ingredients are crushed, sifted into fine powder. Cook medicated leaven powder into a paste, mix with the medicine, and pound three or two hundred times. Make pills the size of paulownia seeds. Take twenty pills with fresh ginger and jujube soup before meals.
Treatment for Changbi causing undigested stool diarrhea and abdominal and hypochondriac fullness: Helile Wan Formula.
Helile (Terminaliae Chebulae Fructus, roasted, using peel one liang) Ganjiang (Zingiberis Rhizoma Praeparatum, processed, three fen) Danggui (Angelicae Sinensis Radix, chopped, slightly stir-fried, one liang) Huanglian (Coptidis Rhizoma,须 roots removed, one liang) Baizhu (Atractylodis Macrocephalae Rhizoma, one liang) Muxiang (Aucklandiae Radix, three fen) Houpo (Magnoliae Officinalis Cortex, coarse bark removed, processed with fresh ginger juice, one liang)
The above seven ingredients are crushed, sifted into fine powder, mixed with refined honey, and pounded three or two hundred times. Make pills the size of paulownia seeds. Each dose is thirty pills, taken with millet gruel broth, at any time.
Treatment for Changbi causing abdominal distension, undigested stool diarrhea, and difficulty in urination: Muxiang San Formula.
Muxiang (Aucklandiae Radix, three liang) Helile (Terminaliae Chebulae Fructus, roasted, using peel half liang) Fuzi (Aconiti Lateralis Radix Praeparata, processed until cracked, skin and navel removed, one liang) Ganjiang (Zingiberis Rhizoma Praeparatum, processed, one liang) Houpo (Magnoliae Officinalis Cortex, coarse bark removed, coated with fresh ginger juice and processed, two liang) Zhishi (Aurantii Fructus Immaturus, pulp removed, bran-fried, one liang) Chifuling (Poria Cocos with Red Skin, black skin removed, one liang) Gancao (Glycyrrhizae Radix et Rhizoma, honey-fried, chopped, half liang) Danggui (Angelicae Sinensis Radix, chopped, slightly stir-fried, one liang)
The above nine ingredients are crushed, sifted into fine powder. Each dose is two qianbi, taken with millet gruel broth, before meals.