百一选方云禁口痢是毒瓦斯上冲心肺所致用石莲肉以通心气
按痢而能食知胃未病也若脾胃湿热之毒熏蒸清道而上以致胃口闭塞而成禁口之证理宜除
胃口
之邪热而此云毒瓦斯上冲心肺其毒不知指何者之邪然亦有脾胃虚而得者亦有误服利剂药毒犯胃
者又有服涩热之剂太早而邪气闭遏于胃口者必当求责
丹溪曰吃病气自下冲上属火之象古方恶以胃弱言之殊不知胃弱者阴弱也虚之甚也滞下之
久多见此证乃因久下而阴虚也(详见吃逆本门)
原病式曰泻白为寒青黄红赤黑皆为热也盖泻白者肺之色也由寒水制火不能平金则金肺自
甚故
色白也痢色青者肝木之气由火甚制金不能平木故色青也或言痢色青为寒者误也仲景少阴病
下痢清水色纯青热在里也大承气汤下之及小儿热甚急惊痢色多青为热明矣痢色黄者由火甚则
水必衰而脾土自旺故色黄也痢色红为热心火之色也或亦热深甚也至若痢色黑亦言热者由火热
亢甚则反兼水化制之故色黑也故伤寒阳明病(云云)法当大承气下之大便不黑者难(恐作易)
治诸痢同法
按世人多以泻痢之青白黑三色为寒黄赤二色为热今观河间分五脏之论焕然耳目而知世
人之
非也或曰内经视络脉之色曰寒多则凝泣凝泣则青黑热多则淖泽淖泽则黄赤又曰黄赤则热多白
则
寒世俗之论岂非本于此与愚曰内经论经脉之常色心赤肺白肝青脾黄肾黑也阴络之色应其经但
阳络之色随四时而行应无常色遇天气之寒则经络凝泣故其色多青黑遇天气之热则经络淖溢故
其色多黄赤此盖因外气之寒热而浮络相应而然凡人之在冬月炎天与夫久坐远行其面色相应亦
皆然非痢色之出于脏腑随内气所感而生也况滞下之证多因湿热所致内经曰肺热者色白而毛败
心热者色赤而经络溢肝热者色苍而爪枯脾热者色黄而肉蠕动肾热者色黑而齿槁此虽论痿亦可
见五脏之内热皆能显此五色今滞下之论五色意实相同然此不可与浮络之因外气相应者同语也
《百一选方》记载，禁口痢是由于毒气上冲心肺所致，治疗应用石莲肉来通利心气。
按：患痢疾而能进食，说明胃气未受损；若是脾胃湿热之毒熏蒸清道（指呼吸道及上部空腔），向上导致胃口闭塞，从而形成禁口痢的证候，按理应当清除胃口的邪热。但此处说“毒气上冲心肺”，其中的“毒”不知具体指代哪种邪气。然而也有因脾胃虚弱而患此病的，也有因误服泻下药物、药毒犯胃导致的，还有因过早服用收敛固涩或温热性质的药物，致使邪气闭阻于胃口的情况。对此必须深入探究病因。
朱丹溪说：“呃逆（吃逆）是病气自下向上冲逆，属于火的征象。”古代医方常将其归咎于胃弱，这并不确切。殊不知所谓的“胃弱”，实质是胃阴虚弱，且虚损程度严重。痢疾日久多见此证，是因为长期腹泻导致阴虚所致。（详见《呃逆》本门）。
刘完素在《原病式》中说：“大便泄泻呈白色属寒，青色、黄色、红色、黑色均属热。”因为白色对应肺之色，由寒水克制心火，不能制约肺金，导致肺金偏盛，所以颜色发白。痢疾颜色发青，是肝木之气因心火过盛克制肺金，导致无法制约肝木，所以颜色发青。有人说痢色青属寒，这是错误的。张仲景在《伤寒论》少阴病篇中提到，下痢清水、颜色纯青，是里有实热，应用大承气汤攻下。以及小儿热盛引发急惊风伴发的痢疾，颜色多青，这也明确表明属热。痢色发黄，是因为火盛则水衰，脾土相对旺盛，所以颜色发黄。痢色发红，是心火之色，也可能表示热邪深重。至于痢色发黑也说是热证，是因为火热亢盛至极，反而兼有水化（肾水之色）来制约它，所以颜色发黑。因此，《伤寒论》阳明病篇（云云）指出，法当用大承气汤攻下，若大便不黑者，难以治疗（或作“易治”）。各种痢疾都遵循此法。
按：世人多以泻痢的青、白、黑三色为寒证，黄、赤二色为热证。如今观看河间先生（刘完素）分五脏颜色的论述，令人耳目一新，从而知道世人的观点是错误的。有人问：“《内经》观察络脉的颜色说：寒邪多则血液凝滞，凝滞则呈现青黑色；热邪多则血液润泽，润泽则呈现黄红色。又说：黄赤色表示热多，白色表示寒多。世俗的言论难道不是基于此吗？”我说：“《内经》论述的是经脉的正常颜色：心赤、肺白、肝青、脾黄、肾黑。阴络的颜色应与经脉相应，但阳络的颜色随四季变化而没有固定颜色。遇到天气寒冷，经络凝滞，所以颜色多青黑；遇到天气炎热，经络充盈溢散，所以颜色多黄赤。这是由于外气的寒热导致浮络相应变化的结果。凡人在冬天或炎夏，以及久坐、远行之后，面色也会相应变化，都是如此。这并不是痢疾颜色出于脏腑、随内气感应而产生的。况且痢疾（滞下）多因湿热所致。《内经》说：肺热则色白而毛发败坏；心热则色赤而经络溢散；肝热则色苍（青）而指甲枯槁；脾热则色黄而肌肉跳动；肾热则色黑而牙齿干枯。这虽然是在论述痿证，但也可见五脏的内热都能显现出这五色。如今对痢疾五色（青黄赤白黑）的论述，意思实际上与此相同。但这不可与因外气相应的浮络颜色混为一谈。”
The *Bai Yi Xuan Fang* records that Jin Kou Li (Forbidden Mouth Dysentery) is caused by toxic qi rushing upward to the Heart and Lungs; treatment should use Shi Lian Rou (Stone Lotus Seed Flesh) to unblock Heart Qi.
Note: If a patient with dysentery can eat, it indicates that Stomach Qi is not yet diseased. However, if damp-heat toxicity of the Spleen and Stomach steams upward through the Qing Dao (clear pathways), causing closure of the stomach opening, this results in the syndrome of Jin Kou Li. Theoretically, one should clear the pathogenic heat from the stomach opening. Yet, the text states "toxic qi rushes upward to the Heart and Lungs," leaving unclear which specific pathogen constitutes this "toxin." Nevertheless, there are cases arising from Spleen and Stomach deficiency, cases caused by mistakenly taking purgative medicines where drug toxicity invades the Stomach, and cases where astringent or hot agents were taken too early, trapping pathogenic qi at the stomach opening. In such instances, one must seek the root cause.
Zhu Danxi stated: "E Ni (Hiccups/Reverse Qi) is the pathological qi rushing upward from below, representing an image of Fire." Ancient prescriptions often attributed this to weak Stomach function, which is inaccurate. It is unknown that so-called "Stomach weakness" actually refers to Yin deficiency, specifically severe deficiency. This syndrome is frequently seen after prolonged dysentery, resulting from Yin deficiency due to chronic diarrhea (see detailed discussion under the chapter on E Ni).
Liu Wansu in the *Yuan Bing Shi* stated: "Diarrhea presenting as white is Cold; Green, Yellow, Red, and Black are all Heat." White corresponds to the color of the Lung. When Cold Water suppresses Fire, it fails to control Metal (Lung), causing Lung Metal to become excessive, hence the white color. Dysentery appearing green indicates Liver Wood Qi becoming excessive because Fire over-controls Metal, failing to restrain Wood, hence the green color. Some claim green dysentery indicates Cold; this is erroneous. Zhang Zhongjing, in the Shaoyin Disease section of the *Shanghan Lun*, mentions that passing clear water with pure green stool indicates interior excess Heat, treated with Da Cheng Qi Tang (Major Order the Qi Decoction) to purge. Similarly, acute convulsive diseases in children with high fever accompanied by dysentery often present with green stool, clearly indicating Heat. Yellow dysentery occurs because excessive Fire leads to deficient Water, allowing Spleen Earth to flourish relatively, hence the yellow color. Red dysentery reflects Heart Fire's color, possibly indicating deep-seated Heat. Regarding black dysentery also being classified as Heat: when Fire and Heat are extremely hyperactive, they may paradoxically assume the transformation of Water (Kidney color) to counteract them, hence the black color. Therefore, in the Yangming Disease section of the *Shanghan Lun* (text omitted), it is prescribed to use Da Cheng Qi Tang for purging; if the stool is not black, it is difficult to treat (or possibly "easy to treat"). All types of dysentery follow this principle.
Note: People generally consider green, white, and black diarrhea/dysentery as Cold syndromes, and yellow and red as Heat syndromes. Observing Hejian's (Liu Wansu's) theory on distinguishing five colors by Zang organs clarifies matters and reveals the errors of common opinion. One might ask: "The *Neijing* observes collateral vessel colors, stating that abundant Cold causes stagnation and coagulation, resulting in blue-black colors; abundant Heat causes liquidity and moisture, resulting in yellow-red colors. It also states: yellow-red indicates much Heat, white indicates Cold. Is secular theory not based on this?" I reply: The *Neijing* discusses the normal colors of meridians: Heart is Red, Lung is White, Liver is Green, Spleen is Yellow, Kidney is Black. The color of Yin collaterals should correspond to the meridian, but the color of Yang collaterals varies with the four seasons and has no fixed color. When encountering cold weather, meridians stagnate, so colors tend to be blue-black; when encountering hot weather, meridians overflow, so colors tend to be yellow-red. This is due to superficial collaterals responding to external climatic cold and heat. Everyone's facial color changes accordingly in winter or summer, or after prolonged sitting or long travel. This is not the case for dysentery colors originating from Zang organs and generated by internal Qi responses. Moreover, dysentery (Zhi Xia) is mostly caused by damp-heat. The *Neijing* states: Lung Heat manifests as white color and hair deterioration; Heart Heat manifests as red color and overflowing collaterals; Liver Heat manifests as greenish color and withered nails; Spleen Heat manifests as yellow color and twitching muscles; Kidney Heat manifests as black color and dry teeth. Although this discusses Wei Syndrome (Atrophy Syndrome), it shows that internal Heat in the five Zang organs can manifest these five colors. The current discussion on the five colors of dysentery shares the same underlying meaning. However, this cannot be equated with superficial collaterals responding to external climatic factors.