冶痢。
木香 当归(酒浸) 橡斗子(各一两) 青蒿子(烧存性,四两) 乌梅(焙干) 黄
连(酒
上为细末,用神曲糊为丸,如梧桐子大,每服一百丸,空心用米汤送下,日二三服,先
须服丁香脾积丸,次服立效丸。
治下痢脓血,里急后重,神效。
木香 黄连 川木通 川黄柏 枳壳(麸炒) 陈皮(各四钱半) 大黄(三钱)
上 咀,分作二贴,用水二盏,煎至一盏,去滓,食前温服。
治下痢,势恶窘痛,脓血频并,或久不愈,宜下之。
黄连 黄柏 大黄 甘遂 大戟 芫花(醋炒,各五钱) 轻粉(二钱) 青黛(一两)
牵
上为细末,滴水为丸,如豆大,初服十丸,每加十丸,空心午前临卧三服,以利为度。
《素问》云∶春伤于风,夏必飧泄,邪气留连,乃为洞泄。叔和云∶湿多成五泄,肠走
若雷奔,此因气血虚弱,肌肤不密,邪气搏于肠胃,因虚袭之,遂成此证,但泄泻人为一证
耳,岂知泄者泄漏之义,时时溏泄,或作或愈,泻者一时水去如注泄。名有五,有胃泄,脾
泄,大肠泄,小肠泄,有大瘕泄。胃泄者饮食不化,色黄;脾泄者腹胀满泄注,食即呕吐逆
;大肠泄者食已窘迫,大便色白,肠鸣切痛;小肠泄者溲而便脓血,小腹痛;大瘕泄者里急
后重,数至圊而不能便,茎中痛。又有飧泄,肾泄,洞泄,滞泄,胃寒肠热泄, 溏之分。
且飧泄者,始春之时,风木盛行,脾土受风木之邪,夏以伏阴在内,或当风取凉,过 生冷
,复伤脾胃,不能克化,饮食水谷完出,而脉弦细,名为飧泄;肾泄者,由肾虚,每于五更
时溏泄一二次,而连月经年弗止;水泄者,谓脏腑虚寒,四肢厥冷,暴顿洞下;洞泄者,手
足厥冷,心腹痛,脚转筋; 溏者,少腹生寒,则为此证。盖阴中之至阴脾也,脾胃虚弱,
为风寒所胜,则阴气太盛,阴盛则脏寒,脏寒则糟粕不化,大便黑,状似 溏,大肠有寒证
亦如之。又云∶浊寒之气在上,清热之气在下,则胀满而泄也。且大肠为传送之官,胃为水
谷之海,其精英则流布以养五脏,其糟粕则传送以归大肠。且如伤食一证,因失饥伤饱,胃
不能消则胀满,所下酸臭,可验此证,当疏利消导。前证诸泻,以脉论之,大抵泄泻非特在
脾胃经,亦有当以各类治之。治法以分利为先,实脾土,益元气,用药无不效矣。
治疗痢疾。
木香、当归(用酒浸泡)、橡斗子(各一两)、青蒿子(烧至存性,四两)、乌梅(焙干)、黄连(用酒浸)。
以上药物研成细末,用神曲糊制作成丸药,大小如梧桐子,每次服用一百丸,空腹时用米汤送服,每日二至三次。服药前,先服用丁香脾积丸,再服用立效丸。
治疗下痢脓血,里急后重,效果神奇。
木香、黄连、川木通、川黄柏、枳壳(麸炒)、陈皮(各四钱半)、大黄(三钱)。
将药物切碎,分为两帖,用水两盏,煎煮至一盏,去渣,饭前温服。
治疗痢疾,病情严重且疼痛窘迫,脓血频繁出现,或者久治不愈,适宜采用攻下法。
黄连、黄柏、大黄、甘遂、大戟、芫花(醋炒,各五钱)、轻粉(二钱)、青黛(一两)、牵牛子(未注明剂量,依原文省略或隐含)。
以上药物研成细末,滴水制成丸药,大小如豆粒。初次服用十丸,每次增加十丸,空腹、午前、临睡前分三次服用,以大便通畅为度。
《素问》说:春季感受风邪,夏季必定发生飧泄(完谷不化的泄泻),邪气留连不去,就会变成洞泄(水样直下的泄泻)。王叔和说:湿气多导致五种泄泻,肠鸣声如雷奔,这是因为气血虚弱,肌肤腠理不紧密,邪气与肠胃相搏,因虚而受邪侵袭,从而形成这种证候。但是,人们通常只把泄泻看作一种病证罢了,哪里知道“泄”是泄漏的意思,指时时溏泄,时好时坏;“泻”是指一时之间水液排出如注。泄泻的名称有五种,分别是胃泄、脾泄、大肠泄、小肠泄和大瘕泄。胃泄的症状是饮食不消化,粪便色黄;脾泄的症状是腹部胀满,泄泻如水注,进食后即呕吐逆气;大肠泄的症状是吃完饭后感到窘迫紧迫,大便色白,肠鸣切痛;小肠泄的症状是小便涩痛并伴有便脓血,小腹痛;大瘕泄的症状是里急后重,频繁上厕所却不能排便,尿道疼痛。又有飧泄、肾泄、洞泄、滞泄、胃寒肠热泄、濡泄等分类。飧泄,发生在初春时节,风木之气盛行,脾土受到风木之邪的克制,夏季体内潜伏阴寒之气,或者当风取凉,过食生冷,再次损伤脾胃,不能运化,饮食水谷未经消化完全排出,脉象弦细,称为飧泄;肾泄,是由于肾虚,每在五更时分溏泄一两次,连续数月甚至经年不止;水泄,是指脏腑虚寒,四肢厥冷,突然发生洞泄;洞泄,表现为手足厥冷,心腹疼痛,脚部转筋;濡泄,表现为少腹生寒,则出现此证。脾属于阴中之至阴,脾胃虚弱,被风寒所胜,则阴气太盛,阴盛则内脏寒冷,内脏寒冷则糟粕不能消化,大便黑色,形状类似濡泄,大肠有寒的证候也是如此。又说:浊寒之气在上,清热之气在下,则会出现胀满和泄泻。大肠是传导的官职,胃是水谷的海,其中的精华流布以滋养五脏,其中的糟粕传导归入大肠。比如伤食这一证候,因为饥饱失常,胃不能消化食物则产生胀满,排出的粪便酸臭,可以验证这一证候,应当使用疏利消导的方法。前述各种泄泻,从脉象来论述,大抵泄泻不仅仅在脾胃经,也有应当按其他类别治疗的。治疗方法以分利小便为先,实脾土,益元气,用药没有不有效的。
Treatment of dysentery.
Muxiang (Aucklandiae Radix), Danggui (Angelicae Sinensis Radix) (soaked in wine), Xiangdouzi (Quercus variabilis fruit), Qinghaozi (Artemisiae Annuae Semen) (charred to retain its nature, 4 liang), Wumei (Prunus mume fructus) (roasted dry), Huanglian (Coptidis Rhizoma) (soaked in wine).
Grind the above herbs into a fine powder, use Shenqu (Massa Medicata Fermentata) paste to make pills, sized like Sophora japonica seeds. Take 100 pills per dose, swallowed with rice soup on an empty stomach, two to three times daily. Prior to this, take Dingxiang Pi Ji Wan (Dingxiang Spleen Accumulation Pill), followed by Lixiao Wan (Lixiao Pill).
Treatment for dysentery with pus and blood, tenesmus (里急后重), showing miraculous efficacy.
Muxiang (Aucklandiae Radix), Huanglian (Coptidis Rhizoma), Chuan Mutong (Akebiae Caulis), Chuan Huangbo (Phellodendri Chinensis Cortex), Zhike (Aurantii Fructus) (stir-fried with bran), Chenpi (Citri Reticulatae Pericarpium) (each 4 qian 5 fen), Dahuang (Rhei Radix et Rhizoma) (3 qian).
Cut the herbs into pieces, divide into two doses. Add two cups of water, decoct until one cup remains, remove dregs, and take warm before meals.
Treatment for dysentery with severe condition, distressing pain, frequent pus and blood, or chronic non-healing cases; purgation is appropriate.
Huanglian (Coptidis Rhizoma), Huangbo (Phellodendri Chinensis Cortex), Dahuang (Rhei Radix et Rhizoma), Gansui (Kansui Radix), Daji (Euphorbiae Pekinensis Radix), Yuanhua (Genkwa Flos) (vinegar-fried, each 5 qian), Qingfen (Calomelas, 2 qian), Qingdai (Indigo Naturalis, 1 liang), Qianniu (Pharbitidis Semen) [dose omitted in source].
Grind the above herbs into a fine powder, add drops of water to make pills, sized like beans. Start with 10 pills, increasing by 10 pills each time. Take three times: on an empty stomach, before noon, and before sleep. Stop when bowel movement is achieved.
The *Suwen* states: "If wind pathogen is contracted in spring, suncie (飧泄 - diarrhea with undigested food) will inevitably occur in summer. If the pathogen lingers, it becomes dongxie (洞泄 - watery diarrhea)." Wang Shuhe stated: "Excess dampness leads to five types of diarrhea. Borborygmus sounds like thunder rushing, caused by deficiency of qi and blood, loose skin pores, where pathogenic factors clash with the intestines and stomach, invading due to deficiency, thus forming this syndrome." However, people generally regard diarrhea as a single syndrome. They do not realize that "xie" (泄) implies leakage, referring to frequent loose stools that come and go; whereas "xie" (泻) refers to sudden gushing discharge of water. There are five names for diarrhea: Weixie (Stomach Diarrhea), Pixie (Spleen Diarrhea), Dachangxie (Large Intestine Diarrhea), Xiaochangxie (Small Intestine Diarrhea), and Dajiaxie (Large Mass Diarrhea). Weixie symptoms include undigested food in stool and yellow color; Pixie symptoms include abdominal fullness, pouring diarrhea, and vomiting after eating; Dachangxie symptoms include postprandial urgency, white stool, and sharp intestinal pain; Xiaochangxie symptoms include painful urination with pus and blood in stool, and lower abdominal pain; Dajiaxie symptoms include tenesmus, frequent trips to the toilet without ability to defecate, and penile pain. Other types include suncie, shenxie (Kidney Diarrhea), dongxie, zhixie (Stagnant Diarrhea), weihan changre xie (Stomach Cold Intestine Heat Diarrhea), and rutie (Damp Diarrhea). Suncie occurs in early spring when wind-wood qi prevails, attacking spleen-earth. In summer, yin cold lurks inside. Exposure to wind/coolness or overconsumption of raw/cold foods further damages the spleen and stomach, failing to transform food, resulting in complete excretion of undigested food with wiry-thin pulse, named suncie. Shenxie results from kidney deficiency, causing loose stools once or twice at dawn (fifth watch), persisting for months or years. Shuixie (Water Diarrhea) indicates internal cold of zang-fu, cold limbs, and sudden watery diarrhea. Dongxie presents with cold extremities, heart-abdominal pain, and calf cramps. Rutie presents with cold in the lower abdomen. The Spleen is the extreme yin within yin. When spleen-stomach is weak and overcome by wind-cold, yin qi becomes excessive. Excess yin causes cold in the zang organs. Zang cold prevents transformation of waste, leading to black stool resembling rutie. Large intestine cold syndromes present similarly. It is also said: "Turbid cold qi above, clearing heat qi below" leads to fullness and diarrhea. The Large Intestine is the official of transmission; the Stomach is the sea of water and grain. Essence circulates to nourish the five zang organs, while waste is transmitted to the Large Intestine. For example, food stagnation syndrome, caused by irregular eating, leads to stomach inability to digest, causing fullness and sour-smelling feces; this should be treated with draining and guiding digestion. Regarding previous diarrhea syndromes, analyzed by pulse, diarrhea is not limited to the spleen-stomach meridians but may require treatment according to other categories. Therapeutic methods prioritize separating and draining (urination), strengthening the spleen earth, and benefiting yuan qi. With such medication, efficacy is assured.