【湿泻之症】泻水肠鸣,腹反不痛,身重身痛,或呕而不渴,此湿气泄泻也。
【湿泻之因】久雨阴湿,湿土司政,太阴被湿淫所伤,人病泄泻。
【湿泻之脉】多见濡软,或见细涩,或见浮缓。
【湿泻之治】宜燥湿利小便,胃苓散、平胃散。身痛身热,脉浮应汗者,败毒散、羌活
胜湿汤。小便不利,木通煎,调五苓散,或生姜汤,调六一散,利小便,则湿自去,而泻自止
胃苓散 见前风泻门。
平胃散
苍术 浓朴 陈皮 甘草
败毒散 见寒湿肿门。
羌活胜湿汤
苍术 防风 羌活 黄柏 泽泻 白茯苓 陈皮 甘草
寒湿加生姜。湿热加黄连。
五苓散
六一散 二方俱见风泻门。
【积热泄泻之症】发热口渴,肚腹皮热,时或疼痛,小便赤涩,泻下黄沫,肛门重滞,
时结时泻,此积热泄泻之症也。
【积热泄泻之因】膏粱浓味,酒湿辛辣香燥之物,时积于中,积湿成热,热蒸于胃,下
【积热泄泻之脉】脉必沉数,沉则为积,数则为热。右脉沉数,积热在气。左脉沉数,
积热在血。积热内伏,脉乃促结。
【积热泄泻之治】若右脉数大,宜以黄连枳壳汤,加六一散,清其肠胃。兼腹痛,欲便
不得便者,大黄枳壳汤,或加玄明粉,此通因通用之法也。如元气虚而积热又甚,应清者黄
连枳壳汤,加人参,应下者大黄枳壳汤,加人参。若左关脉数,龙胆泻肝汤,右关脉数,清
黄连枳壳汤
黄连 枳壳 浓朴 陈皮 甘草 木通
煎八分,冲调六一散三钱。
大黄枳壳汤
大黄 枳壳 浓朴 陈皮 甘草 木通
调服六一散三钱。
龙胆泻肝汤
黄连 山栀 黄芩 柴胡 青皮 龙胆草 木通 甘草 丹皮 生地 当归 白芍药
清胃汤
升麻 黄连 山栀 甘草
【湿泻的症状】大便如水样,肠鸣音亢进,腹部反而不疼痛,身体沉重且疼痛,或者出现呕吐但不口渴,这是湿气导致的泄泻。
【湿泻的病因】长期阴雨潮湿,湿土之气主令,太阴脾经被湿邪过度侵袭而受伤,人因此患泄泻病。
【湿泻的脉象】多见濡软脉(浮而细软),或见细涩脉(细弱不畅),或见浮缓脉(浮而缓慢)。
【湿泻的治疗】宜采用燥湿和利小便的方法,可用胃苓散、平胃散。若伴有身体疼痛、身热,脉象浮且应当发汗者,用败毒散、羌活胜湿汤。若小便不利,用木通煎剂,配合五苓散服用,或用生姜汤送服六一散,通过利小便使湿气自去,泄泻自然停止。
胃苓散 见前文风泻门。
平胃散
苍术 厚朴 陈皮 甘草
败毒散 见寒湿肿门。
羌活胜湿汤
苍术 防风 羌活 黄柏 泽泻 白茯苓 陈皮 甘草
寒湿证加生姜。湿热证加黄连。
五苓散
六一散 以上两方均见前文风泻门。
【积热泄泻的症状】发热口渴,肚皮摸起来发热,时而腹痛,小便赤红涩痛,泻下黄色泡沫状物,肛门有重坠滞涩感,时而便秘时而腹泻,这是积热泄泻的症状。
【积热泄泻的病因】食用膏粱厚味(油腻精细食物)、酒湿辛辣香燥之物,时常积聚在体内,积湿化热,热气蒸腾于胃,向下……(原文此处截断)
【积热泄泻的脉象】脉象必定沉数(沉取有力且频率快),沉脉主积滞,数脉主热。右脉沉数,表示积热在气分。左脉沉数,表示积热在血分。积热内伏,脉象会出现促结(急促间歇或止无定数)。
【积热泄泻的治疗】如果右脉数大,宜用黄连枳壳汤,加入六一散,以清肠胃之热。兼有腹痛,想排便却排不出来的,用大黄枳壳汤,或加入玄明粉,这是“通因通用”的治疗方法。如果元气虚弱而积热又很严重,该清的用黄连枳壳汤,加入人参;该下的用大黄枳壳汤,加入人参。如果左关脉数,用龙胆泻肝汤;右关脉数,用清胃汤(原文此处似有缺漏或排版错误,结合下文方剂列表推测可能指代清胃类方剂,但原文仅列出“清黄连枳壳汤”及后续组成,此处依原文翻译结构处理,注:原文最后列出的“清胃汤”与前面的“清黄连枳壳汤”名称略有不同,需仔细辨析。原文写的是“右关脉数,清...”,后面紧接方名列表。根据上下文逻辑,右关属脾胃,通常用清胃或清肠之法。原文此处文字为:“右关脉数,清 / 黄连枳壳汤”。这看起来像是排版断裂。再看后文方剂列表有“清胃汤”。通常右关候脾胃,清胃汤主治胃火。但前文提到“清其肠胃”用的是黄连枳壳汤。此处暂按原文字面意思翻译,即右关脉数,适用相关清热方剂,具体见下方方剂说明。)
*注:原文中“右关脉数,清”后直接换行列出方剂,且方剂列表中有一个“清胃汤”,还有一个“黄连枳壳汤”。根据中医常规,右关候脾胃,胃火盛可用清胃汤。但前文治疗积热在气分(右脉)用的是黄连枳壳汤。此处原文可能存在脱文或排版混淆。为了忠实原文,我将把方剂部分单独列出。*
黄连枳壳汤
黄连 枳壳 厚朴 陈皮 甘草 木通
煎至八分,冲调六一散三钱。
大黄枳壳汤
大黄 枳壳 厚朴 陈皮 甘草 木通
调服六一散三钱。
[Symptoms of Dampness Diarrhea] Stools are watery with hyperactive bowel sounds, the abdomen is surprisingly painless, the body feels heavy and painful, or there may be vomiting without thirst; this is diarrhea caused by dampness.
[Etiology of Dampness Diarrhea] Prolonged rainy and humid weather, where the damp earth qi dominates, injures the Taiyin Spleen channel due to excessive dampness invasion, causing people to suffer from diarrhea.
[Pulse of Dampness Diarrhea] Commonly presents as a Ru (Soggy) pulse (floating and fine/soft), or a Xi Se (Fine and Choppy) pulse (fine and unsmooth), or a Fu Huan (Floating and Slow) pulse.
[Treatment of Dampness Diarrhea] The appropriate method is to dry dampness and promote urination. Formulas include Weiling San (Stomach Regulating Powder) and Pingwei San (Stomach-Pacifying Powder). If accompanied by body pain and fever, with a floating pulse indicating the need for sweating, use Baidu San (Decoction to Rescue the Vitality) or Qianghuo Shengshi Tang (Notopterygium Decoction to Overcome Dampness). If urination is difficult, use Mutong Jian (Akebia Decoction) combined with Wuling San (Five-Ingredient Powder with Poria), or take Liuyi San (Six-to-One Powder) with Ginger Decoction. By promoting urination, dampness will naturally depart, and diarrhea will cease.
Weiling San: See Wind Diarrhea section previously.
Pingwei San:
Cangzhu (Rhizoma Atractylodis Macrocephalae), Houpo (Cortex Magnoliae Officinalis), Chenpi (Pericarpium Citri Reticulatae), Gancao (Radix Glycyrrhizae).
Baidu San: See Cold-Damp Swelling section.
Qianghuo Shengshi Tang:
Cangzhu (Rhizoma Atractylodis Macrocephalae), Fangfeng (Radix Saposhnikoviae), Qianghuo (Rhizoma et Radix Notopterygii), Huangbai (Cortex Phellodendri), Zexie (Rhizoma Alismatis), Baifuling (Poria Cum Lignum Pinus et Lignum Quercum), Chenpi (Pericarpium Citri Reticulatae), Gancao (Radix Glycyrrhizae).
For cold-dampness, add Shengjiang (Rhizoma Zingiberis Recens). For damp-heat, add Huanglian (Rhizoma Coptidis).
Wuling San:
Liuyi San: Both formulas are seen in the Wind Diarrhea section previously.
[Symptoms of Accumulated Heat Diarrhea] Fever and thirst, heat felt on the abdominal skin, occasional abdominal pain, red and scanty/difficult urination, passage of yellow frothy stools, a sensation of heaviness and stagnation in the anus, alternating constipation and diarrhea; these are symptoms of accumulated heat diarrhea.
[Etiology of Accumulated Heat Diarrhea] Consumption of rich, greasy, and refined foods, as well as alcoholic, damp, spicy, fragrant, and drying substances, accumulates internally over time. Accumulated dampness transforms into heat, which steams upward in the stomach and moves downward... [Text cuts off here].
[Pulse of Accumulated Heat Diarrhea] The pulse must be Chen Shu (Deep and Rapid). Deep indicates accumulation; rapid indicates heat. A deep-rapid pulse on the right side indicates accumulated heat in the Qi level. A deep-rapid pulse on the left side indicates accumulated heat in the Blood level. When accumulated heat lies dormant internally, the pulse may appear Cu Jie (Hasty and Intermittent).
[Treatment of Accumulated Heat Diarrhea] If the right pulse is rapid and large, use Huanglian Zhike Tang (Coptis and Aurantium Decoction) added with Liuyi San to clear the intestines and stomach. If accompanied by abdominal pain and an urge to defecate but inability to do so, use Dahuang Zhike Tang (Rhubarb and Aurantium Decoction), or add Xuanmingfen (Refined Mirabilite); this employs the "treat obstruction with purgatives" (Tong Yin Tong Yong) method. If vital energy is deficient yet accumulated heat is severe, for clearing heat use Huanglian Zhike Tang with Renshen (Radix Ginseng); for purging, use Dahuang Zhike Tang with Renshen. If the left Guan position pulse is rapid, use Longdan Xiegan Tang (Gentian Liver-Draining Decoction); if the right Guan position pulse is rapid... [Text implies a formula follows, likely Qingwei Tang based on the list below, though the text fragment is ambiguous].
Huanglian Zhike Tang:
Huanglian (Rhizoma Coptidis), Zhike (Fructus Aurantii), Houpo (Cortex Magnoliae Officinalis), Chenpi (Pericarpium Citri Reticulatae), Gancao (Radix Glycyrrhizae), Mutong (Caulis Akebiae).
Decoct until reduced to 80%, then mix in 3 qian of Liuyi San.
Dahuang Zhike Tang:
Dahuang (Radix et Rhizoma Rhei), Zhike (Fructus Aurantii), Houpo (Cortex Magnoliae Officinalis), Chenpi (Pericarpium Citri Reticulatae), Gancao (Radix Glycyrrhizae), Mutong (Caulis Akebiae).
Take mixed with 3 qian of Liuyi San.
Longdan Xiegan Tang:
Huanglian (Rhizoma Coptidis), Shanzhi (Fructus Gardeniae), Huangqin (Radix Scutellariae), Chaihu (Radix Bupleuri), Qingpi (Pericarpium Citri Reticulatae Viride), Longdancao (Radix et Rhizoma Gentianae), Mutong (Caulis Akebiae), Gancao (Radix Glycyrrhizae), Danpi (Cortex Moutan), Shengdi (Radix Rehmanniae Preparata), Danggui (Radix Angelicae Sinensis), Baishao (Radix Paeoniae Alba).
Qingwei Tang (Stomach-Clearing Decoction):
Shengma (Rhizoma Cimicifugae), Huanglian (Rhizoma Coptidis), Shanzhi (Fructus Gardeniae), Gancao (Radix Glycyrrhizae).