曾氏云∶先吐而后泻者,乃脾胃有热,气促唇红,吐来面赤,脉洪而数,渴饮水浆,此为热也。钱氏以吐泻、
身热、泻黄、多渴作热病治,在夏秋用玉露散、益黄散相间服,在春冬用白术散、大青膏相间服。
〔钱氏〕玉露散(方见前)
〔李刚中〕治夏秋吐泻。
好黄连一两,入虢丹一两,炒丹焦,为细末,面糊丸,如芥子,服二三十粒,壁土姜汤吞。更量数服,不妨。
〔丹溪〕治小儿周岁,吐乳腹泻。
白术 滑石末(各三钱) 干姜(一钱) 陈皮 甘草(炙。各五分)
上为粗末。煎服。
曾氏云∶先泻而后吐者,乃脾胃虚冷,其候先泻白水或白冻,吐亦不多,口气缓而神色慢,额前有汗,六脉沉濡,
此为冷也。钱氏以吐泻、身凉、泻青、不渴作寒病,在秋以益黄散主之,在冬春以益黄散、大青膏相间服。
〔海〕吐利,四肢胀逆,脑门低陷。四君子加藿香、丁香、芍药、等分,煎服。
钱氏益黄散(见脾) 万安膏(见吐)
〔世〕和胃丸 治吐泻不止,欲生慢惊。
丁香 白术(各一两) 半夏(五钱) 藿香 蝎尾(各一钱)
上为末,姜汁打糊、为丸如小豆大。二岁儿三十丸,姜汤下。
理中汤 主温脾暖胃,冷吐冷泻,及胎气虚,中寒腹痛。
人参(去芦) 白术(各一两) 干姜(炮) 粉草(炙。各二钱半)
上件,锉焙为末。每服半钱或一钱,用温白汤空心调服。
理中丸 治吐利不止,米谷不化,手足厥冷。
人参 白术 干姜 甘草(炙各等分)
上为末。面糊为丸,绿豆大。每服十丸,米饮下。或一二十丸,不拘时候。
金液丹 治吐利日久,脾胃虚损,手足厥冷,精神昏塞,多睡露睛,口鼻气凉,欲
成慢惊风。又治大人阳虚阴盛,身冷脉微,自汗吐利,小便不禁。
舶上硫黄(十两,先飞炼去砂石,秤,研为末,用砂盒子盛,令八分满,水和赤石脂、盐泥固封,
晒干,露地先埋一水罐,盛水满,坐盒子在上,又以泥固济讫,常以三斤火养三日三夜,足,加顶火一
斤, 成,冷,取药)
上以柳木捶乳钵研为末。每服二钱,生姜米饮调下。多服取效。大人,药末一两,蒸饼一两水浸,去
水,饼和丸桐子大。晒干,每服五十丸至百丸,米饮空心下。
阎氏云∶吐泻虚极,当速生胃气,宜与理中丸,并研金液丹末,煎生姜米饮调
灌之,惟多服乃效,俟胃气已生,手足渐热,然犹螈 ,即减金液丹一二分,增青州白丸子一二分同研,如上服,
兼用异功散、羌活膏、温白丸、钓藤饮子之类,仍频与粥,虽至危者往往死中得生,十救八九。沈存中论金液丹,
见小儿吐利剧,气已绝,服之得活者数人,须多服方验。
〔钱〕豆蔻散 治吐泻烦渴,腹胀小便少。
舶上硫黄(一钱) 滑石(五分) 丁香 豆蔻(各半分)
上为细末。每服一字至半钱,米饮调下,无时。
〔张涣〕匀胃散 治三焦不调,停寒膈上,乳哺不消,胸膈痞满,甚则喘逆吐利,肌体痿黄。
甘草(炙一钱) 藿香 白豆蔻 人参(各一两) 木香 干姜(炮) 浓朴(姜炙) 丁香(各半两)
上为细末。一钱,水一小盏,姜二片,煎六分,温服。
〔王氏〕治吐逆兼吐利不止。
丁香 藿香(各一分) 木香(一钱) 硫黄(半两,别研极细) 滑石(二钱,研如粉)
上为末。每服一钱或半钱,米饮调下,量大小与之。如泻,即用附子一枚重半两者,炮去皮脐,为末,再用生
姜汁捣成饼子,用白面裹之,慢火煨面熟,去面
不用,只将附子切焙,再捣罗为末。每吐兼泻,即入附子末少许,如药三之一,更量虚实,以米饮调下,神验。
吐如激水者亦定。吐利不止,多成慢惊,宜速疗之,如已成慢惊,兼金液丹与之。
助胃膏 治脾胃虚寒吐泻等证。
人参 白术 白茯苓 甘草(炙) 丁香(各五钱) 砂仁(四十个) 木香(三钱) 白豆蔻(十四个)
干山药(一两) 肉豆蔻(四个,煨)
上为末,蜜、丸芡实大。每服十丸,米饮化下。
曾氏说:先呕吐而后腹泻的,是脾胃有热,表现为气促、嘴唇发红,呕吐时面色潮红,脉象洪大而数,口渴想喝水浆,这是热证。钱乙将呕吐、腹泻、身热、大便色黄、口渴多饮作为热病来治疗,在夏秋季节用玉露散和益黄散交替服用,在春冬季节用白术散和大青膏交替服用。
〔李刚中〕治疗夏秋季的呕吐腹泻。
取优质黄连一两,加入虢丹一两,炒至丹焦,研成细末,用面糊做成丸药,大小如芥菜籽,每次服用二三十粒,用壁土姜汤送服。也可以酌情增加剂量服用,没有妨碍。
〔朱丹溪〕治疗小儿周岁时,吐乳且腹泻。
白术、滑石末(各三钱),干姜(一钱),陈皮,甘草(炙,各五分)。
以上药材捣成粗末。煎煮后服用。
曾氏说:先腹泻而后呕吐的,是脾胃虚冷,其症状是先泻出白水或白色粘液,呕吐量也不多,口气缓和而神色倦怠,额头前有汗,六脉沉濡,这是冷证。钱乙将呕吐、腹泻、身凉、大便色青、不渴作为寒病来治疗,在秋季以益黄散为主治,在冬季春季用益黄散和大青膏交替服用。
〔海藏〕治疗吐利,四肢胀满逆冷,囟门低陷。用四君子汤加藿香、丁香、芍药,等分混合,煎煮服用。
〔世传〕和胃丸 治疗呕吐腹泻不止,想要引发慢惊风。
丁香、白术(各一两),半夏(五钱),藿香,蝎尾(各一钱)。
以上研成粉末,用姜汁打糊,做成如小豆大小的丸药。两岁儿童服用三十丸,用姜汤送下。
理中汤 主要温补脾脏、温暖胃腑,治疗冷性呕吐、冷性腹泻,以及胎气虚弱、中寒腹痛。
人参(去芦头)、白术(各一两),干姜(炮制),粉草(炙,各二钱半)。
以上药材切碎焙干研成粉末。每次服用半钱或一钱,用温开水空腹调服。
理中丸 治疗呕吐腹泻不止,米谷不消化,手足厥冷。
人参、白术、干姜、甘草(炙,各等分)。
以上研成粉末。用面糊做成如绿豆大小的丸药。每次服用十丸,用米汤送下。或者服用一二十丸,不拘泥于固定时间。
金液丹 治疗呕吐腹泻日久,脾胃虚损,手足厥冷,精神昏沉闭塞,嗜睡且眼睛半睁,口鼻气息凉,快要形成慢惊风。又治疗成人阳气虚弱阴气盛,身体寒冷脉象微弱,自汗、呕吐腹泻,小便失禁。
舶上硫黄(十两,先飞炼去除砂石,称重,研为粉末,用砂盒子盛装,令其八分满,用水调和赤石脂、盐泥密封固封,晒干,先在露地埋一个装满水的水罐,将盒子坐在水罐上,再用泥加固密封,经常用三斤火养护三日三夜,完成后,加顶火一斤,制成后冷却,取出药物)。
以上用柳木杵在乳钵中研磨成粉末。每次服用二钱,用生姜米饮调下。多服用见效。成人用药末一两,蒸饼一两用水浸泡,去掉水分,用饼和药末做成如梧桐子大小的丸药。晒干,每次服用五十丸至一百丸,空腹用米饮送下。
阎氏说:呕吐腹泻极度虚弱时,应当迅速生发胃气,适宜给予理中丸,并研磨金液丹粉末,用煎好的生姜米饮调灌服用,只有多服用才有效,等到胃气已生,手足逐渐变热,然而仍有抽搐现象,就减少金液丹一二分,增加青州白丸子一二分共同研磨,像上面那样服用,同时使用异功散、羌活膏、温白丸、钓藤饮子之类的药物,仍然频繁给予粥食,即使是危重患者往往也能死里逃生,十个能救活八九个。沈括论述金液丹,提到见到小儿呕吐腹泻剧烈,气息已绝,服用后得以存活的人数人,必须多服用才能验证效果。
〔钱乙〕豆蔻散 治疗呕吐腹泻烦渴,腹胀小便少。
舶上硫黄(一钱),滑石(五分),丁香,豆蔻(各半分)。
以上研成细末。每次服用一字至半钱,用米饮调下,无固定时间。
〔张涣〕匀胃散 治疗三焦不调,寒气停滞膈上,乳食不消化,胸膈痞满,严重时气喘逆乱、呕吐腹泻,肌肤萎黄。
甘草(炙一钱),藿香,白豆蔻,人参(各一两),木香,干姜(炮制),浓朴(姜炙),丁香(各半两)。
以上研成细末。取一钱,加水一小盏,生姜两片,煎至六分,温服。
〔王氏〕治疗呕吐逆乱兼呕吐腹泻不止。
丁香,藿香(各一分),木香(一钱),硫黄(半两,单独研极细),滑石(二钱,研如粉末)。
以上研成粉末。每次服用一钱或半钱,用米饮调下,根据年龄大小调整剂量。如果腹泻,就用一枚重半两的附子,炮制去皮脐,研成粉末,再用生姜汁捣成饼状,用白面粉包裹,用慢火煨至面熟,去掉面粉不用,只将附子切片焙干,再捣罗成粉末。每次呕吐兼腹泻时,加入少许附子粉末,约为药量的三分之一,再根据虚实情况,用米饮调下,神效。
呕吐如喷射状水流者也能止住。呕吐腹泻不止,多会形成慢惊风,应当迅速治疗,如果已经形成慢惊风,同时给予金液丹。
助胃膏 治疗脾胃虚寒引起的呕吐腹泻等证候。
人参、白术、白茯苓、甘草(炙)、丁香(各五钱),砂仁(四十个),木香(三钱),白豆蔻(十四个),干山药(一两),肉豆蔻(四个,煨制)。
以上研成粉末,用蜂蜜做成如芡实大小的丸药。每次服用十丸,用米饮化开送下。
Zeng stated: Vomiting followed by diarrhea indicates heat in the Spleen and Stomach. Symptoms include shortness of breath, red lips, flushed face during vomiting, a surging (Hong) and rapid pulse, thirst for drinking fluids, which characterizes a Heat syndrome. Qian Yi treated vomiting, diarrhea, fever, yellow stool, and excessive thirst as Heat diseases. In summer and autumn, Yulu San (Jade Dew Powder) and Yihuang San (Yellow Protecting Powder) are administered alternately; in spring and winter, Baizhu San (Atractylodes Macrocephala Powder) and Daqing Gao (Great Cyan Paste) are administered alternately.
[Qian Yi] Yulu San (Formula seen previously).
[Li Gangzhong] Treats vomiting and diarrhea in summer and autumn.
Take high-quality Huanglian (Coptidis Rhizoma) one tael, add Guo Dan (Red Lead), one tael, stir-fry until the lead is scorched, grind into fine powder, make pills with wheat paste, size like mustard seeds. Take 20-30 pills, swallow with ginger water from wall soil. Dosage can be adjusted as needed without harm.
[Danxi] Treats infants aged one year with milk vomiting and diarrhea.
Baizhu (Atractylodis Macrocephalae Rhizoma) and Huashi (Talcum) powder (each 3 qian), Ganjiang (Dried Zingiberis Rhizoma) (1 qian), Chenpi (Citri Reticulatae Pericarpium), Gancao (Licorice Root) (roasted, each 5 fen).
Grind into coarse powder. Decoct and take.
Zeng stated: Diarrhea followed by vomiting indicates deficiency-cold in the Spleen and Stomach. Signs include first passing white watery stool or white mucus, little vomiting, slow breathing and lethargy, sweating on the forehead, deep and soggy pulses in all six positions, which characterizes Cold syndrome. Qian Yi treated vomiting, diarrhea, cool body, green stool, and absence of thirst as Cold diseases. In autumn, Yihuang San (Yellow Protecting Powder) is the primary treatment; in winter and spring, Yihuang San (Yellow Protecting Powder) and Daqing Gao (Great Cyan Paste) are administered alternately.
[Hai Zang] Treats vomiting and purging, distended and cold limbs, sunken fontanelle. Use Sizijunzi Tang (Four Gentlemen Decoction) added with Huoxiang (Agastaches Herba), Dingxiang (Caryophylli Flos), Shaoyao (Paeoniae Radix Alba), equal parts, decoct and take.
Qian Yi's Yihuang San (See Spleen section) Wan'an Gao (See Vomiting section).
[Worldly/General] Hewei Wan (Stomach Harmonizing Pill) treats persistent vomiting and diarrhea, aiming to prevent slow convulsions.
Dingxiang (Caryophylli Flos), Baizhu (Atractylodis Macrocephalae Rhizoma) (each 1 tael), Banxia (Pinelliae Rhizoma) (5 qian), Huoxiang (Agastaches Herba), Xiewei (Scorpion Tail) (each 1 qian).
Grind into powder, make pills with ginger juice paste, size like small beans. Two-year-old children take 30 pills, swallow with ginger water.
Lizhong Tang (Regulate the Middle Decoction) primarily warms the Spleen and warms the Stomach, treating cold vomiting, cold diarrhea, fetal qi deficiency, and abdominal pain due to middle-jiao cold.
Renshen (Ginseng Radix et Rhizoma) (remove rhizome), Baizhu (Atractylodis Macrocephalae Rhizoma) (each 1 tael), Ganjiang (Dried Zingiberis Rhizoma) (processed), Fencao (Licorice Root) (roasted, each 2.5 qian).
Chop and roast the above ingredients, grind into powder. Take half a qian or one qian each time, mix with warm plain water and take on an empty stomach.
Lizhong Wan (Regulate the Middle Pill) treats persistent vomiting and purging, undigested rice and grain, and cold extremities.
Renshen (Ginseng Radix et Rhizoma), Baizhu (Atractylodis Macrocephalae Rhizoma), Ganjiang (Dried Zingiberis Rhizoma), Gancao (Licorice Root) (roasted, equal parts).
Grind into powder. Make pills with wheat paste, size like mung beans. Take ten pills each time, swallow with rice drink. Or take 10-20 pills, at any time.
Jinye Dan (Golden Liquid Pill) treats prolonged vomiting and purging, Spleen and Stomach deficiency damage, cold extremities, mental dullness and obstruction, excessive sleepiness with eyes partially open, cool breath from mouth and nose, approaching slow convulsions. It also treats adults with Yang deficiency and Yin excess, cold body, faint pulse, spontaneous sweating, vomiting and purging, and urinary incontinence.
Boshang Liuhuang (Imported Sulfur) (10 taels, first refined to remove sand and stones, weighed, ground into powder, placed in a clay box filling it eight-tenths full, sealed with water-mixed Chishizhi (Halloysit Rubrum) and salt mud, dried, buried in an open area with a water jar filled with water underneath the box, sealed again with mud, maintained with three jin of fire for three days and nights, then add one jin of top fire, cool after completion, retrieve the medicine).
Grind the above using a willow wood pestle in a mortar into powder. Take two qian each time, mix with ginger rice drink. Multiple doses yield efficacy. For adults, use one tael of medicine powder, soak one tael of steamed cake in water, drain water, mix cake with pill powder to make pills size like paulownia seeds. Dry in sun, take 50-100 pills each time, swallow with rice drink on an empty stomach.
Yan stated: When vomiting and diarrhea cause extreme deficiency, one must quickly generate Stomach Qi. It is appropriate to give Lizhong Wan (Regulate the Middle Pill) and grind Jinye Dan (Golden Liquid Pill) powder, mix with decocted ginger rice drink and administer orally. Only multiple doses are effective. Wait until Stomach Qi is generated and extremities gradually warm. If spasms still occur, reduce Jinye Dan (Golden Liquid Pill) by 1-2 fen, increase Qingzhou Baiwan Zi (Qingzhou White Pills) by 1-2 fen, grind together, and administer as above. Simultaneously use Yigong San (Extraordinary Power Powder), Qianghuo Gao (Notopterygium Paste), Wenbai Wan (Warm White Pill), Gouteng Yinzi (Uncaria Decoction) etc. Continue frequent porridge feeding. Even critical cases often survive, saving 8-9 out of 10. Shen Kuo discussed Jinye Dan (Golden Liquid Pill), noting several cases of children with severe vomiting and purging whose Qi had ceased but revived after taking it; large doses are required for verification.
[Qian Yi] Doukou San (Cardamom Powder) treats vomiting and diarrhea with vexatious thirst, abdominal distension, and scanty urination.
Boshang Liuhuang (Imported Sulfur) (1 qian), Huashi (Talcum) (5 fen), Dingxiang (Caryophylli Flos), Doukou (Amomi Fructus Rotundus) (each 0.5 fen).
Grind into fine powder. Take one zi to half a qian each time, mix with rice drink, no fixed time.
[Zhang Huan] Yunwei San (Stomach Equalizing Powder) treats dysfunction of the Three Jiao, cold stagnation in the diaphragm, indigestion of milk and food, chest and diaphragm fullness and oppression, severe cases with panting, counterflow, vomiting and purging, and sallow emaciated skin.
Gancao (Licorice Root) (roasted 1 qian), Huoxiang (Agastaches Herba), Baidoukou (Amomi Fructus), Renshen (Ginseng Radix et Rhizoma) (each 1 tael), Muxiang (Aucklandiae Radix), Ganjiang (Dried Zingiberis Rhizoma) (processed), Houpo (Magnoliae Officinalis Cortex) (ginger-processed), Dingxiang (Caryophylli Flos) (each 0.5 tael).
Grind into fine powder. Take one qian, add one small cup of water and two slices of ginger, decoct to six-tenths, take warm.
[Wang Shi] Treats vomiting counterflow combined with persistent vomiting and diarrhea.
Dingxiang (Caryophylli Flos), Huoxiang (Agastaches Herba) (each 1 fen), Muxiang (Aucklandiae Radix) (1 qian), Liuhuang (Sulfur) (0.5 tael, separately ground extremely fine), Huashi (Talcum) (2 qian, ground like powder).
Grind into powder. Take one qian or half a qian each time, mix with rice drink, adjust according to age/size. If diarrhea occurs, use one Fuzi (Aconiti Lateralis Radix Praeparata) weighing half a tael, process, remove skin and umbilicus, grind into powder. Mix with fresh ginger juice to form a cake, wrap in white flour, slow-roast until flour is cooked, discard flour, only bake the Fuzi (Aconiti Lateralis Radix Praeparata) slices, then sieve into powder. When vomiting accompanies diarrhea, add a small amount of Fuzi (Aconiti Lateralis Radix Praeparata) powder, about one-third of the medicine quantity, adjust based on deficiency/excess, mix with rice drink, miraculous effect.
Vomiting like spraying water is also controlled. Persistent vomiting and purging often lead to slow convulsions; treat urgently. If slow convulsions have already formed, administer Jinye Dan (Golden Liquid Pill) concurrently.
Zhugao Gao (Stomach Assisting Paste) treats vomiting and diarrhea due to Spleen and Stomach deficiency-cold.
Renshen (Ginseng Radix et Rhizoma), Baizhu (Atractylodis Macrocephalae Rhizoma), Baifuling (Poria), Gancao (Licorice Root) (roasted), Dingxiang (Caryophylli Flos) (each 5 qian), Sharen (Amomi Fructus) (40 pods), Muxiang (Aucklandiae Radix) (3 qian), Baidoukou (Amomi Fructus Rotundus) (14 pods), Ganshanyao (Dioscoreae Rhizoma) (1 tael), Roudoukou (Myristicae Semen) (4 pods, roasted).
Grind into powder, make pills with honey, size like Euryale Seed. Take ten pills each time, dissolve in rice drink and swallow.