感寒湿者水泻,食生冷而不化者溏泻,皆用神术散以治之。
神术散
制苍术(一钱五分) 浓朴(八分,炒) 陈皮(八分) 甘草(五分) 藿香(一钱) 砂仁(五分)
加姜一片煎服(或加茯苓大腹皮)。
泻轻而痢重,痢则里急后重,下痢红白,稠粘臭秽,此积物与热结聚肠胃,气闭不通,宿滞不去。不愈,
初宜葛芍汤,次用消积,再用香连丸。总以能食者轻,食减者重,绝食噤口者死。
葛芍汤
葛根(二钱) 赤芍药(三钱) 广皮(一钱五分) 苦参(一钱) 陈茶叶(二钱)
煎服。不已,再加山楂(三钱,炒),神曲(一钱,炒),或槟榔(五分)。
香连丸
广木香(一两,焙) 川黄连(五钱,焙)
神曲和为丸,每服二钱,米饮汤下。止后随服生地四物汤,以调血分。
人之脏腑安和,心正无思,精神健旺,气血充实,安得有妖魅之邪乘之?惟体本柔弱,精神或乱,或独居静室而多
惊疑,则邪气交侵而受,或梦与鬼交,而成经闭腹大,正如怀子一般。但其妇必面色青黄不泽,脉细涩,或大或小,两
手两样。更改无定,或作寒热之状,攒眉不乐之形,此由肝脾愤郁之气,非胎也。治用雄黄丸攻之,而以各经见症之药
辅助元气。前贤又有斩鬼丹,极妙之用,消去,随服桂附八味,或服六君子汤、归脾汤,以补正心脾,自无他患。虞氏
曰∶此肝肾相火,发为白淫,流入子宫,结为此胎,是本妇之精结,非真有鬼交也。
古人论鬼胎云,皆由其人阳气不足,此语诚然。盖阳衰失其冲和之令,致阴气凝聚,宛若胎形,阴气愈凝,
其腹愈大。用药振其阳气,其胎即化为乌有。或不治,待其人阳气自旺,其胎亦消。曾见一妇,怀妊日久而不
产,一日大便出气,而皤皤大腹,竟因是而消,此即鬼胎者也。(徐评)
雄黄丸
明雄黄 鬼臼 丹砂(水飞,各五钱) 延胡索(七钱) 麝香(一钱) 半夏(一两,姜炒) 川芎(七钱)
共为末,蜜丸,空心服三十丸。
斩鬼丹
吴茱萸 川芎 秦艽 柴胡 芫花(醋煮) 僵蚕 巴豆霜 巴戟天
蜜丸,酒下七丸出恶物愈。
桂附八味(见前小便不通)六君子(见前乳泣异功散加半夏)归脾汤(见前胎漏)。
感受寒湿邪气导致的腹泻表现为水样便,因食用生冷食物且消化不良导致的腹泻表现为稀溏便,这两种情况均使用神术散进行治疗。
神术散
制苍术(一钱五分) 厚朴(八分,炒制) 陈皮(八分) 甘草(五分) 藿香(一钱) 砂仁(五分)
加入生姜一片煎服(也可加茯苓、大腹皮)。
腹泻症状较轻而痢疾症状较重,痢疾表现为里急后重(腹痛窘迫,时时欲泻,肛门重坠),排出红白相间的脓血便,质地稠粘且气味臭秽,这是由于积滞之物与热邪结聚在肠胃,导致气机闭塞不通,宿食积滞无法排出。若病情迁延不愈,初期适宜用葛芍汤,随后使用消积导滞的方法,再使用香连丸。总体原则是:能进食者病情轻,食欲减退者病情重,完全不能进食且口噤不开者预后不良(死证)。
葛芍汤
葛根(二钱) 赤芍药(三钱) 广陈皮(一钱五分) 苦参(一钱) 陈茶叶(二钱)
煎服。如果效果不佳,再加山楂(三钱,炒制)、神曲(一钱,炒制),或者槟榔(五分)。
香连丸
广木香(一两,焙干) 川黄连(五钱,焙干)
用神曲糊丸,每次服用二钱,米汤送下。止痢后随即服用生地四物汤,以调理血分。
人的脏腑功能安和,心神端正无杂念,精神健旺,气血充实,怎么会有妖魅之邪乘虚而入呢?只有体质原本柔弱,精神紊乱,或者独居静室而多惊恐疑虑,才会导致邪气交侵而受病,或者梦见与鬼性交,从而形成经闭腹大,正如怀孕一般。但是该妇女必定面色青黄无光泽,脉象细涩,或者忽大忽小,两手脉象不同。变化无常不定,或者出现寒热往来的症状,皱眉不乐的神情,这是由肝脾愤郁之气所致,并非真正的胎孕。治疗使用雄黄丸攻逐邪气,并配合各经见症的药物辅助元气。前代名医又有斩鬼丹,效用极佳,邪气消除后,随即服用桂附八味丸,或者服用六君子汤、归脾汤,以补益心脾正气,自然没有其他祸患。虞氏说:这是肝肾相火发动,化为白淫(指男子遗精或女子带下清稀量多等症),流入子宫,凝结成此“胎”,是本妇的精气凝结而成,并非真的有鬼与之交合。
古人论述鬼胎,都说因为此人阳气不足,这话确实正确。大概是因为阳衰失去了冲和的生机,导致阴气凝聚,宛若胎形,阴气越凝滞,腹部越大。用药振奋其阳气,这个“胎”就会化为乌有。如果不治疗,等待其人阳气自然旺盛,这个“胎”也会消退。曾见过一位妇女,怀孕日久却不分娩,一天大便时排气,那高高隆起的大腹,竟然因此消退,这就是鬼胎。(徐评注)
雄黄丸
明雄黄 鬼臼 丹砂(水飞法处理,各五钱) 延胡索(七钱) 麝香(一钱) 半夏(一两,姜炒) 川芎(七钱)
共同研为细末,蜂蜜炼丸,空腹服用三十丸。
Diarrhea caused by cold-dampness manifests as watery stools, while diarrhea resulting from the consumption of raw and cold foods that fail to digest presents as loose stools; both conditions are treated with Shenzhu San (Divine Skill Powder).
Shenzhu San (Divine Skill Powder)
Zhi Cangzhu (Prepared Atractylodis Rhizoma, 1.5 qian) Houpo (Magnoliae Officinalis Cortex, 8 fen, stir-fried) Chenpi (Citri Reticulatae Pericarpium, 8 fen) Gancao (Glycyrrhizae Radix et Rhizoma, 5 fen) Huoxiang (Agastaches Herba, 1 qian) Sharen (Amomi Fructus, 5 fen)
Decoct with one slice of fresh ginger and take orally (Fuling Poria and Dafupi Trogopterori Excrement may be added).
Diarrhea is mild, whereas dysentery is severe. Dysentery is characterized by tenesmus (urgent desire to defecate with a feeling of incomplete evacuation), passage of red and white purulent stools that are thick, sticky, and foul-smelling. This occurs because accumulated matter and heat bind together in the intestines and stomach, causing qi obstruction and preventing the expulsion of retained stagnation. If it does not heal, initially Ge Shao Tang (Kudzu and Red Peony Decoction) is suitable, followed by methods to eliminate accumulation, and then Xianglian Wan (Costus and Coptis Pill). Generally, those who can eat have a mild condition, those with reduced appetite have a severe condition, and those who cannot eat at all with locked jaws have a fatal prognosis.
Ge Shao Tang (Kudzu and Red Peony Decoction)
Gegen (Puerariae Lobatae Radix, 2 qian) Chishao (Moutan Cortex or Paeoniae Radix Rubra, here referring to Paeoniae Radix Rubra, 3 qian) Guangpi (Citri Reticulatae Pericarpium, 1.5 qian) Kushen (Sophorae Flavescentis Radix, 1 qian) Chen Chaye (Aged Tea Leaves, 2 qian)
Decoct and take orally. If ineffective, add Shan Zha (Crataegi Fructus, 3 qian, stir-fried), Shen Qu (Massa Medicata Fermentata, 1 qian, stir-fried), or Binglang (Arecae Semen, 5 fen).
Xianglian Wan (Costus and Coptis Pill)
Guangmuxiang (Costi Rhizoma, 1 liang, baked) Chuanhuanglian (Coptidis Rhizoma, 5 qian, baked)
Form pills using Massa Medicata Fermentata as a binder. Take 2 qian per dose, washed down with rice water. After stopping the dysentery, subsequently administer Shengdi Siwu Tang (Rehmannia Four Substances Decoction) to regulate the blood aspect.
When the zang-fu organs are harmonious, the mind is upright without excessive thoughts, spirit is vigorous, and qi and blood are abundant, how could demonic pathogens invade? Only when the constitution is inherently weak, the spirit is chaotic, or one lives alone in a quiet room leading to frequent fear and suspicion, will pathogenic factors invade and cause disease. One might dream of intercourse with ghosts, resulting in amenorrhea and abdominal distension resembling pregnancy. However, such women typically present with a sallow, lusterless complexion, a fine and choppy pulse, or pulses varying in size, differing between the left and right hands. The presentation changes unpredictably, possibly alternating with chills and fever, accompanied by a frowning and unhappy demeanor. This is due to liver and spleen qi stagnation and depression, not a true fetus. Treatment involves using Xionghuang Wan (Realgar Pill) to attack the pathogen, assisted by herbs corresponding to the symptoms of each meridian to support healthy qi. Ancient experts also utilized Zhangu Dan (Ghost-Slaying Elixir), which is extremely effective. After the pathogen is eliminated, subsequently administer Guifu Bawei Wan (Cinnamon Twig and Aconite Eight-Ingredient Pill) or Liujunzi Tang (Six Gentlemen Decoction) and Guipi Tang (Restore the Spleen Decoction) to tonify heart and spleen righteousness, ensuring no further complications. Yu Shi stated: This is the ministerial fire of the liver and kidney flaring up, transforming into "white turbidity" (abnormal vaginal discharge or seminal emission), flowing into the uterus, and knotting to form this "fetus." It is the condensation of the woman's own essence, not a genuine ghostly intercourse.
Ancient discussions on "Ghost Fetus" state that it is always due to insufficient yang qi in the person, which is indeed true. Roughly speaking, when yang declines and loses its harmonizing function, yin qi condenses, resembling a fetal shape. The more the yin qi condenses, the larger the abdomen becomes. Medications that振奋 (stimulate/raise) yang qi will cause this "fetus" to vanish. If untreated, waiting for the person's yang qi to naturally flourish will also cause the "fetus" to dissipate. I once saw a woman who had been pregnant for a long time without delivering. One day, after passing gas during a bowel movement, her distended abdomen suddenly disappeared. This was a case of Ghost Fetus. (Commented by Xu)
Xionghuang Wan (Realgar Pill)
Ming Xionghuang (Realgar, processed) Jiubai (Podophylli Rhizoma) Dansha (Cinnabar, water-ground, 5 qian each) Yanhusuo (Corydalis Rhizoma, 7 qian) Shexiang (Moschus, 1 qian) Banxia (Pinelliae Rhizoma, 1 liang, stir-fried with ginger) Chuanxiong (Ligustici Chuanxiong Rhizoma, 7 qian)
Grind into powder, form pills with honey. Take 30 pills on an empty stomach.
Zhangu Dan (Ghost-Slaying Elixir)
Wuzhuyu (Evodiae Fructus) Chuanxiong (Ligustici Chuanxiong Rhizoma) Qinjiao (Gentianae Macrophyllae Radix) Chaihu (Bupleuri Radix) Yuanhua (Genkwa Flos, boiled in vinegar) Jiangcan (Bombyx Batryticatus) Badoushuang (Crotonis Semen Pulveratum) Bajitian (Morindae Officinalis Radix)
Form pills with honey. Take 7 pills washed down with wine until evil substances are expelled and recovery is achieved.
Guifu Bawei Wan (See section on Urinary Retention previously)
Liujunzi Tang (See section on Abnormal Lactation Yi Gong San plus Banxia previously)
Guipi Tang (See section on Fetal Bleeding previously).