下利清谷,不可攻其表,汗出必胀满。
【注】详见《伤寒论·太阴篇》内,不复释。
下利脉沉而迟,其人面少赤,身有微热,下利清谷者,必郁冒,汗出而解,病患必微
厥,所以然者,其面戴阳,下虚故也。
【注】详见《伤寒论·厥阴篇》内,不复释。
下利腹胀满,身体疼痛者,先温其里,乃攻其表,温里宜四逆汤,攻表宜桂枝汤。
【注】详见《伤寒论·大阴篇》内,不复释。
桂枝汤方
桂枝(三两) 芍药(三两) 甘草(炙,三两) 生姜(三两) 大枣(十二枚)
上五味, 咀,以水七升,微火煮取三升,去滓,适寒温服一升。服已须臾,啜热
稀粥一升,以助药力,温覆令一时许,遍身 微似有汗益佳,不可令如水淋漓。若一
服汗出病瘥,停后服。
下利后更烦,按之心下濡者,为虚烦也,栀子豉汤主之。
【注】详见《伤寒论·太阳中篇》内,不复释。
栀子豉汤方
栀子(十四枚) 香豉(绵裹,四合)
上二味,以水四升,先煮栀子,得二升半,内豉煮取一升半,去滓,分二服,温进
一服,得吐则止。
下利,肺痛,紫参汤主之。
【按】此文脱简不释。
紫参汤方
紫参(半斤) 甘草(三两)
上二味,以水五升,先煮紫参,取二升,内甘草,煮取一升半,分温三服。
下利且排泄物中含有未消化的食物,不可使用攻表法治疗,否则会导致汗出并引发腹部胀满。
【注】详见《伤寒论·太阴篇》内,不再解释。
下利且脉象沉而迟缓,病人面部略带红润,身体有轻微发热,排泄物中含有未消化食物的,必然会出现郁冒(头晕目眩如被物蒙蔽),随后通过出汗而病愈;病人必然会有轻微的四肢厥冷,之所以这样,是因为病人面部呈现“戴阳”(虚阳上浮于面)之象,这是下焦虚寒的缘故。
【注】详见《伤寒论·厥阴篇》内,不再解释。
下利且伴有腹部胀满,身体疼痛的,应当先温补里虚,然后再解表邪;温补里虚适宜用四逆汤,解表邪适宜用桂枝汤。
【注】详见《伤寒论·太阴篇》内,不再解释。
桂枝汤方
桂枝(三两) 芍药(三两) 甘草(炙,三两) 生姜(三两) 大枣(十二枚)
以上五味药,切碎,用水七升,用小火煮取三升,滤去药渣,待温度适宜时服用一升。服药后片刻,喝热稀粥一升,以助药力,覆盖衣被约一顿饭的时间,使全身微微似有汗出为最佳,不可让汗出如水淋漓。如果服一次药后汗出病愈,停止后续服药。
下利之后反而更加烦躁,按压心下部感觉柔软的,属于虚烦,由栀子豉汤主治。
【注】详见《伤寒论·太阳中篇》内,不再解释。
栀子豉汤方
栀子(十四枚) 香豉(绵裹,四合)
以上两味药,用水四升,先煮栀子,取二升半,加入香豉再煮取一升半,滤去药渣,分两次服用,温服一次,如果出现呕吐则停止服药。
Diarrhea with undigested food in the stool: The exterior should not be attacked; if sweating occurs, abdominal fullness will inevitably result.
[Note] See *Shanghan Lun* (Treatise on Cold Damage), Taoyin Chapter, for details; no further explanation is given.
Diarrhea with a deep and slow pulse, where the person's face shows slight redness, the body has slight heat, and the stool contains undigested food: There will inevitably be "Yu Mao" (dizziness and confusion as if covered by something), followed by resolution through sweating. The patient will necessarily have slight cold extremities. The reason for this is that the face exhibits "Dai Yang" (floating yang rising to the face) due to deficiency in the lower jiao.
[Note] See *Shanghan Lun*, Jueyin Chapter, for details; no further explanation is given.
Diarrhea accompanied by abdominal fullness and body pain: First warm the interior, then attack the exterior. To warm the interior, Si Ni Tang (Four Reversal Decoction) is appropriate; to attack the exterior, Gui Zhi Tang (Cinnamon Twig Decoction) is appropriate.
[Note] See *Shanghan Lun*, Taoyin Chapter, for details; no further explanation is given.
Gui Zhi Tang (Cinnamon Twig Decoction) Formula
Guizhi (Cinnamomi Ramulus, 3 liang), Shaoyao (Paeoniae Radix Alba, 3 liang), Gancao (Glycyrrhizae Radix et Rhizoma Preparata, 3 liang), Shengjiang (Zingiberis Rhizoma Recens, 3 liang), Dazao (Jujubae Fructus, 12 pieces).
The above five ingredients are cut into small pieces, boiled in 7 sheng of water with mild fire until 3 sheng remain. Strain the dregs. Take 1 sheng at a suitable temperature. Shortly after taking it, drink 1 sheng of hot thin porridge to assist the medicinal power. Cover with warm clothing for about one hour until a slight sweat pervades the whole body, which is ideal; do not allow profuse sweating like pouring water. If the disease resolves after one dose, stop taking the remaining medicine.
After diarrhea, if restlessness increases, and pressing the epigastrium feels soft, it is considered empty restlessness (Xu Fan). It is treated with Zhi Zi Chi Tang (Gardenia and Fermented Soybean Decoction).
[Note] See *Shanghan Lun*, Taiyang Middle Chapter, for details; no further explanation is given.
Zhi Zi Chi Tang (Gardenia and Fermented Soybean Decoction) Formula
Zhi Zi (Gardeniae Fructus, 14 pieces), Xiang Chi (Sojae Semen Praeparatum, wrapped in cotton, 4 he).
The above two ingredients are boiled in 4 sheng of water. First boil Zhi Zi until 2.5 sheng remain, then add Xiang Chi and boil until 1.5 sheng remain. Strain the dregs. Divide into two doses. Take one dose warm. If vomiting occurs, stop taking it.
Diarrhea accompanied by lung pain is treated with Zi Shen Tang (Ainsliaea Decoction).
[Commentary] This text has missing slips; no explanation is provided.
Zi Shen Tang (Ainsliaea Decoction) Formula
Zi Shen (Ainsliaea fragrans, 0.5 jin), Gancao (Glycyrrhizae Radix et Rhizoma, 3 liang).
The above two ingredients are boiled in 5 sheng of water. First boil Zi Shen until 2 sheng remain, then add Gancao and boil until 1.5 sheng remain. Divide into three warm doses.