有物有声谓之呕,有物无声吐之征,无物有声哕干呕,面青指黑痛厥凶。
【注】面色青,指甲黑也,中痛不止,肢厥不回,其凶可知也。
小半夏汤 橘皮半夏汤 大半夏汤 黄连半夏汤 丁萸六均汤
呕吐半姜为圣药,气盛加橘虚蜜参,热盛姜连便闭下,寒盛丁萸姜六君。
【注】便闭,谓大小二便闭而不行,宜攻下也。初吐切不可下,恐逆病势也。
五汁饮 硫汞散 化滞丸
润燥止吐五汁饮,芦荠甘蔗竹沥姜,呕吐不下硫汞坠,积痛作吐化滞良。
【注】五汁饮,即芦锥、荸荠、甘蔗、竹沥、姜汁也。呕吐诸药,汤水到咽即吐者,宜
用重坠之药,以石硫黄二钱,水银一钱,同研如煤色极细,用老酒姜汁调服。稍点白滚
汤,亦可顿服之,其药即不能吐出。次日大便出黑色秽物,诸汤水药服之,则不吐也。如
不大便黑色,再服,以大便利为度。吐而痛者,乃积也,宜化滞丸。
湿泻 濡泻 水泻 洞泻 寒泻 飧泻 脾泻 肾泻
湿胜濡泻即水泻,多水肠鸣腹不疼。寒湿洞泻即寒泻,鸭溏清彻痛雷鸣。完谷不化
名飧泻,土衰木盛不升清。脾虚腹满食后泻,肾泻寒虚晨数行。
【注】濡者,水也。洞者,直倾下也。鸭溏,如鸭屎之溏,澄彻清冷也。痛,腹痛也。
雷鸣,肠鸣甚也。不升清,谓清气在下不上升也。脾泻,脾虚也。食泻,饮食后即泻也。
晨数行,每至早晨行泻数次也。
食泻 胃泻 饮泻 痰泻 火泻 暑泻 滑泻 大瘕泻
伤食作泻即胃泻,噫气腹痛秽而粘。渴饮泻复渴饮泻,时泻时止却属痰。火泻阵阵
痛饮冷,暑泻面垢汗渴烦。滑泻日久不能禁,大瘕今时作痢看。
【注】过食作泻,名曰食泻,即胃泻也。秽而粘,所泻之物臭而粘也。渴而饮,饮而
泻,泻而复渴,渴而复饮,饮而复泻,饮泻也,时或泻,时或不泻,属痰泻也。阵阵,谓
泻一阵、痛一阵也。大瘕泻,即今时之痢疾病也。
有实物排出且伴有声音的称为“呕”,有实物排出但没有声音的是“吐”的表现,没有实物排出但有声音的是“哕”或“干呕”,若见面色青、指甲黑、腹痛不止及四肢厥冷,则病情凶险。
【注】面色青,指甲黑,腹部疼痛不止,四肢厥冷不能回温,其凶险程度可想而知。
小半夏汤 橘皮半夏汤 大半夏汤 黄连半夏汤 丁萸六均汤
治疗呕吐以半夏和生姜为圣药,气盛者加陈皮,虚者加蜂蜜和人参,热盛者用姜和黄连,大便闭结者用攻下法,寒盛者用丁香、吴茱萸配合六君子汤。
【注】大便闭结,指大小便闭塞不通,适宜使用攻下法。但初起呕吐时切不可攻下,恐怕会违背病势。
五汁饮 硫汞散 化滞丸
润燥止吐用五汁饮,由芦根、荸荠、甘蔗、竹沥、姜汁组成;呕吐严重至药物无法下咽者,用硫汞散坠降;积滞疼痛导致的呕吐,用化滞丸疗效好。
【注】五汁饮,即芦根、荸荠、甘蔗、竹沥、姜汁。对于各种呕吐,若汤药刚到咽喉就吐出,宜用重坠性质的药物,取石硫黄二钱,水银一钱,共同研磨成煤黑色极细粉末,用老酒和姜汁调服。稍加点白开水,也可以一次性服用,这样药物就不会被吐出。第二天排出黑色秽物后,再服用其他汤药和水药,就不会吐了。如果第二天没有排出黑色大便,可再服用一次,以大便通畅排出黑色秽物为度。呕吐且伴有疼痛的,是积滞所致,适宜用化滞丸。
湿泻 濡泻 水泻 洞泻 寒泻 飧泻 脾泻 肾泻
湿气胜则导致濡泻即水泻,特点是多水、肠鸣但腹部不痛。寒湿导致的洞泻即寒泻,特点是粪便如鸭屎般清彻稀冷,腹痛且肠鸣声如雷鸣。完谷不化称为飧泻,是由于土(脾)衰木(肝)盛,清气不升所致。脾虚导致腹满,食后即泻;肾泻因肾阳虚寒,早晨腹泻数次。
【注】濡,指水样便。洞,指直倾而下。鸭溏,像鸭屎一样的稀便,清澈寒冷。痛,指腹痛。雷鸣,指肠鸣音非常剧烈。不升清,指清气在下而不能上升。脾泻,指脾虚。食泻,指饮食后立即腹泻。晨数行,指每到早晨腹泻数次。
食泻 胃泻 饮泻 痰泻 火泻 暑泻 滑泻 大瘕泻
伤食导致的腹泻即胃泻,特点是嗳气、腹痛,排泄物臭而粘腻。口渴饮水,饮水后腹泻,腹泻后又口渴,时泻时止属于痰泻。火泻阵阵发作,腹痛喜冷饮;暑泻面色垢浊、出汗、口渴、烦躁。滑泻日久,大便失禁不能控制;大瘕泻,现在看作痢疾。
【注】过食导致的腹泻,名叫食泻,也就是胃泻。秽而粘,指排泄物臭且粘腻。渴而饮,饮而泻,泻而复渴,渴而复饮,饮而复泻,这是饮泻;时而腹泻,时而不停泻,属于痰泻。阵阵,指泻一阵、痛一阵。大瘕泻,就是现在的痢疾病。
There is vomiting (ou, vomiting with sound) when there are both substances and sounds; there is spitting (tu, vomiting without sound) when there are substances but no sound; there is hiccup (yue, dry heaving) or dry retching when there are sounds but no substances. If the face appears cyanotic, fingernails turn black, abdominal pain persists, and cold limbs do not recover warmth, the prognosis is ominous.
[Note] A cyanotic complexion and black fingernails indicate severe pathology. Persistent abdominal pain and irreversible cold limbs signify an ominous condition.
Xiao Banxia Tang (Minor Pinellia Decoction), Ju Pi Ban Xia Tang (Tangerine Peel and Pinellia Decoction), Da Banxia Tang (Major Pinellia Decoction), Huang Lian Ban Xia Tang (Coptis and Pinellia Decoction), Ding Yu Liu Jun Tang (Clove and Evodia Six Gentlemen Decoction).
For treating vomiting, Ban Xia (Pinelliae Rhizoma) and Sheng Jiang (Zingiberis Rhizoma Recens) are considered the supreme medicines. For excess Qi, add Chen Pi (Citri Reticulatae Pericarpium); for deficiency, add honey and Ren Shen (Ginseng Radix et Rhizoma). For excess heat, use Sheng Jiang and Huang Lian (Coptidis Rhizoma); for constipation, employ purgation methods. For excess cold, use Ding Xiang (Caryophylli Flos) and Wu Zhu Yu (Evodiae Fructus) combined with Liu Jun Zi Tang (Six Gentlemen Decoction).
[Note] Constipation refers to the blockage of both large and small bowel movements, suitable for purgation. However, purgation must never be used in the initial stage of vomiting, as it may oppose the disease's progression.
Wu Zhi Yin (Five-Juice Drink), Liu Huang San (Sulfur Powder), Hua Zhi Wan (Stasis-Transforming Pill).
To moisten dryness and stop vomiting, use Wu Zhi Yin, composed of Lu Gen (Imperatae Rhizoma), Bi Qi (Dioscoreae Hypoglaucae Rhizoma), Gan Zhe (Sacchari Saccharifluviatilis Caulis), Zhu Li (Bambusae Succus), and Jiang Zhi (Zingiberis Succus). For severe vomiting where liquids cannot stay down, use Liu Huang San to anchor and descend. For vomiting caused by accumulation and pain, Hua Zhi Wan is effective.
[Note] Wu Zhi Yin consists of Lu Gen, Bi Qi, Gan Zhe, Zhu Li, and Jiang Zhi. For various types of vomiting where decoctions are vomited immediately upon reaching the throat, heavy-settling medicines should be used. Grind Shi Liu Huang (Sulfurum, 2 qian) and Shui Yin (Hydrargyrum, 1 qian) into an extremely fine powder resembling coal dust. Mix with aged wine and Jiang Zhi for administration. Add a small amount of boiled water if necessary, or take it all at once; this prevents vomiting. The next day, black foul matter will be excreted in the stool. Subsequently, other decoctions and liquids can be taken without vomiting. If black stool is not passed, administer again until black stool is expelled freely. Vomiting accompanied by pain indicates accumulation, for which Hua Zhi Wan is appropriate.
Shi Xie (Damp Diarrhea), Ru Xie (Soft Diarrhea), Shui Xie (Watery Diarrhea), Dong Xie (Sudden Diarrhea), Han Xie (Cold Diarrhea), Sun Xie (Undigested Food Diarrhea), Pi Xie (Spleen Diarrhea), Shen Xie (Kidney Diarrhea).
Excess dampness leads to Ru Xie, also known as Shui Xie, characterized by watery stools, borborygmus, but no abdominal pain. Cold-dampness causes Dong Xie, also known as Han Xie, characterized by duck-like loose stools that are clear and cold, abdominal pain, and loud borborygmus ("thunderous rumbling"). Undigested food in stool is called Sun Xie, resulting from Spleen Earth deficiency and Liver Wood excess, leading to failure of clear Yang to ascend. Spleen deficiency causes abdominal fullness and diarrhea after eating; Kidney deficiency due to cold leads to frequent morning diarrhea.
[Note] "Ru" refers to watery stool. "Dong" means pouring straight down. "Ya Tang" refers to loose stool resembling duck feces, clear and cold. "Tong" refers to abdominal pain. "Lei Ming" refers to intense borborygmus. "Bu Sheng Qing" means clear Yang fails to ascend. "Pi Xie" refers to Spleen deficiency. "Shi Xie" refers to immediate postprandial diarrhea. "Chen Shu Xing" refers to multiple diarrheal episodes every morning.
Shi Xie (Food Diarrhea), Wei Xie (Stomach Diarrhea), Yin Xie (Fluid Diarrhea), Tan Xie (Phlegm Diarrhea), Huo Xie (Fire Diarrhea), Shu Xie (Summerheat Diarrhea), Hua Xie (Slippery Diarrhea), Da Jia Xie (Great Mass Diarrhea).
Diarrhea caused by food injury is Wei Xie, characterized by belching, abdominal pain, and foul, sticky stools. Thirst followed by drinking, then diarrhea, followed by thirst again, alternating between diarrhea and cessation, belongs to Tan Xie. Huo Xie occurs in paroxysms with abdominal pain and a desire for cold drinks. Shu Xie presents with a greasy complexion, sweating, thirst, and irritability. Hua Xie involves long-standing duration and involuntary loss of stool control. Da Jia Xie is currently regarded as dysentery.
[Note] Diarrhea caused by overeating is named Shi Xie, which is Wei Xie. "Hui Er Nian" means the excrement is foul and sticky. "Ke Er Yin..." describes Yin Xie: thirst, drinking, diarrhea, recurring thirst and drinking. "Shi Huo Xie..." describes Tan Xie: intermittent diarrhea. "Zhen Zhen" means paroxysmal diarrhea and pain. "Da Jia Xie" corresponds to modern dysentery.