老人气虚及妇人产后少血,致津液不行,不得通流,故大便常结,切忌行药,是重损其阴也。止服金液丹,
久久自润,或润肠丸亦可。又大小便主肾,肾开窍于二阴,能营运津液,若肾气虚则二便皆不通,亦服金液丹,
肾气壮则大小便自利矣。(有陈姓盐商,年七十六矣。春时患中风脱证,重剂参附二百余服,获痊。至十月大
便闭结不行,日登厕数十次,冷汗大出,面青肢厥。一马姓医,用滋补剂,入生大黄三钱。予深以为不可,戒
之曰∶老年脱后,幸参附救全,不能安养,过于思虑,以致津液枯竭,传送失宜。惟可助气滋津,佐以温化,
自然流通,何事性急,以速其变。若一投大黄,往而不返,恐难于收功矣,姑忍二三日势当自解。病者怪予迟
缓,口出怨咎之辞。至次日不得已,用人参二两、苁蓉一两、当归五钱、松柏仁各五钱、附子三钱、升麻四
钱,煎服;外用绿矾一斤入圊桶,以滚水冲入,扶其坐上,一刻而通。)
凡膏粱人,火热内积,又多房劳,真水既涸,致阴血不静,流入膀胱,从小便而出。可服延寿丹,甚者灸
关元。若少壮人,只作火热治之,然在因病制宜。(火热为积,实证也,一剂寒凉可解;房劳传肾,虚证也,
非温补不可。审证而治,大有分别。)
此由房事太过,肾气不足,致包络凝滞,不能通行水道则成淋也,服槟榔汤、鹿茸丸而愈。若包络闭涩,
则精结成砂子,从茎中出,痛不可忍,可服保命丹,甚者灸关元。(淋浊之证,古人多用寒凉厘清通利之品,
然初起则可,久而虚寒,又当从温补一法。)
老年人因气虚以及妇女产后阴血不足,导致津液运行不畅,无法通畅流动,所以大便经常干结。此时切忌使用泻下药物,因为这会进一步损伤阴液。只需服用金液丹,时间久了自然滋润,或者服用润肠丸也可以。另外,大小便由肾所主,肾开窍于前后二阴,能够营运津液。如果肾气虚弱,则大小便都会不通畅,也应服用金液丹;若肾气强壮,则大小便自然通利。(有一位姓陈的盐商,年龄七十六岁。春季患中风脱证,重用参附汤等药物二百多服后痊愈。到了十月,大便闭结不通,每天上厕所几十次,出大量冷汗,面色发青,四肢厥冷。一位姓马的医生,使用滋补剂,加入生大黄三钱。我认为这非常不可取,告诫他说:“老年人在脱证之后,幸亏用参附救回性命,但不能安心调养,加上过度思虑,导致津液枯竭,传导功能失常。只可帮助益气滋生津液,辅以温阳化气,自然就会流通,何必性急,反而加速病情变化。如果一旦投用大黄,药力一去不返,恐怕难以收功了,暂且忍耐两三天,形势应当自行缓解。”病人责怪我治疗迟缓,口出怨言。到了第二天,不得已之下,用人参二两、肉苁蓉一两、当归五钱、柏子仁与松子仁各五钱、附子三钱、升麻四钱,煎服;外用绿矾一斤放入马桶,用滚水冲入,扶病人坐上去,一刻钟后大便通畅。)
凡是饮食肥甘厚味的人,体内火热积聚,又多房事劳累,真阴之水已经枯竭,导致阴血不安宁,流入膀胱,从小便排出。可以服用延寿丹,严重的灸关元穴。如果是年轻力壮的人,只按火热证治疗,但也要根据具体病因灵活制宜。(火热积滞属于实证,一剂寒凉药即可解除;房劳伤肾属于虚证,非温补不可。仔细审察证候而治疗,区别很大。)
这是由于房事过度,肾气不足,导致心包络凝滞,不能通行水道,从而形成淋证,服用槟榔汤、鹿茸丸而痊愈。如果心包络闭塞涩滞,则精液凝结成砂子,从尿道排出,疼痛难以忍受,可服用保命丹,严重的灸关元穴。(淋浊之证,古人多用寒凉清热通利的药物,但在初起时可以使用,日久转为虚寒,又应当采用温补的方法。)
In the elderly, Qi deficiency and in women after childbirth, a deficiency of Yin-blood, leads to the failure of Jin-Ye (body fluids) to circulate and flow freely, resulting in frequent constipation. One must strictly avoid using purgative drugs, as this would further damage Yin. One should only take Jinye Dan (Golden Fluid Pill); with time, it will naturally moisten the bowels, or Runchang Wan (Intestine-Moistening Pill) may also be used. Furthermore, the large and small intestines are governed by the Kidney, which opens into the two yin passages (anogenital region), and is capable of transporting and transforming Jin-Ye. If Kidney-Qi is deficient, both urination and defecation will be obstructed; in such cases, Jinye Dan should also be taken. If Kidney-Qi is robust, bowel movements and urination will naturally be smooth. (There was a salt merchant surnamed Chen, aged seventy-six. In spring, he suffered from Zhongfeng Tuozheng [Stroke with collapse syndrome], and after taking over two hundred doses of heavy preparations containing Renshen (Ginseng Root) and Fuzi (Aconite Root Lateralis Preparata), he recovered. By October, his stool became closed and obstructed, and he went to the toilet dozens of times daily, sweating cold profusely, with a cyanotic complexion and cold limbs. A physician surnamed Ma used a nourishing preparation but added Sheng Dahuang (Raw Rhubarb Radix et Rhizoma) three qian. I considered this highly inadvisable and warned him: "After the collapse syndrome in an elderly person, although Renshen and Fuzi saved his life, he failed to rest and recuperate properly. Excessive worry has led to the exhaustion of Jin-Ye and dysfunction of transportation. Only by assisting Qi, nourishing Jin-Ye, and aiding warm transformation can natural flow be restored. Why be impatient and hasten the change? If Dahuang is administered, its action will go forth without return, making it difficult to achieve recovery. It is best to endure for two or three days, and the condition will likely resolve itself." The patient blamed my slowness and spoke resentfully. The next day, out of necessity, I prescribed Renshen (Ginseng Root) two liang, Congrong (Cistanche Stem), Danggui (Angelica Sinensis Radix), Songren (Pine Seed) and Baoren (Platycarya Seed) each five qian, Fuzi (Aconite Root Lateralis Preparata) three qian, and Shengma (Cimicifugae Rhizoma) four qian, decocted and taken orally; externally, Lvfan (Green Alum) one jin was placed in the toilet bowl, flushed with boiling water, and the patient was helped to sit on it. After one quarter-hour, defecation occurred.)
For those who consume rich and greasy foods, internal accumulation of Fire-Heat often occurs, compounded by excessive sexual activity. When True Water (Kidney Yin) is depleted, Yin-blood becomes restless and flows into the Bladder, exiting through urination. Yanshou Dan (Longevity Pill) may be taken; in severe cases, moxibustion at Guanyuan (CV4) is indicated. For young and vigorous individuals, treatment should focus solely on clearing Heat, though measures must still be tailored to the specific cause. (Fire-Heat accumulation is an Excess pattern, resolvable with one dose of cooling herbs; sexual fatigue damaging the Kidney is a Deficiency pattern, requiring warming and tonification. Careful differentiation of the syndrome reveals significant differences in treatment.)
This condition arises from excessive sexual intercourse leading to insufficient Kidney-Qi, causing stagnation in the Pericardium (Bao Luo), which fails to allow the free flow of water pathways, resulting in Lin Syndrome (strangury). It can be cured by taking Binglang Tang (Areca Seed Decoction) and Lurong Wan (Deer Antler Pill). If the Pericardium is closed and obstructed, essence condenses into sand-like particles that exit from the urethra, causing unbearable pain. Baoming Dan (Life-Preserving Pill) may be taken; in severe cases, moxibustion at Guanyuan (CV4) is indicated. (Regarding Lin-Zhuo [cloudy strangury] syndromes, ancient physicians often used cold and cool herbs to clear heat and promote diuresis. While suitable for the initial stage, if the condition persists and turns into Deficiency-Cold, the method of warming and tonifying should be adopted.)