《活人》败毒散 治下利发热脉浮者。
人参 川芎 羌活 独活 前胡 茯苓 枳壳 桔梗 炙草 柴胡 陈仓米
上 咀,每服五钱,水一盏半,生姜三片,煎至七分,去滓服无时,一名仓禀汤。
藿香正气散
香薷饮
下利虽曰有积有热,如用药不效,即是肠胃有风邪。热者、赤者,与败毒散;冷者、白
者,
不换金正气散。治痢之法,大要经以散风邪,行滞气,开胃脘为先,不可遽用粟壳、龙骨、
牡蛎辈,以闭涩肠胃,邪气得补而愈甚,不为缠扰撮痛,则为里急后重,所以日久淹延而未
已也。(肉蔻、诃子、白术辈,恐其补住寒邪,亦不可遽投。)
葛氏疗痢色白,食不消者,为寒下方。
豉(一斤,绵裹) 薤白(一把)
水三升,煮取二升,及热顿服之。此不从暑毒而发者,或过啖生冷,或坐卧高堂大厦,
寒气
所乘,脾亦不运,故随感而为痢,以葛氏豉薤汤治之,如逾二三日,寒化为热,其病形与暑
毒同也。
黑丸子
乌梅肉 杏仁(去皮尖,另研,十四粒) 巴霜(去油,半钱) 百草霜(六钱)
上为细末,和匀稀糊为丸,如黍米大,每服十五丸加至二十丸,白汤送下。一方有半夏
、缩砂(各十四粒。)
感应丸
理中汤
人参 白术 炮姜 炙草
水煎服。如痢不止,宜加豆蔻、木香。有热加黄连。
真人养脏汤
人参 白术(各六两) 白芍 木香(各一两六钱) 甘草 肉桂(各八钱) 肉豆蔻(面裹
煨,五钱) 御米壳(蜜炙) 诃子肉(一两二钱)
上 咀,每服四钱,水一盏半,煎至八分去渣,食前温服。忌生冷鱼腥酒面油腻之物。
如滑
泄夜起,久不瘥者,可加附子四片。此温补兼收之剂,脏虚滑脱者宜之。若有热者,不可用
也,宜冷涩之剂。
《活人书》中的败毒散,用于治疗下利(痢疾)伴有发热、脉象浮起的症状。
人参 川芎 羌活 独活 前胡 茯苓 枳壳 桔梗 炙甘草 柴胡 陈仓米
以上药材切碎,每次服用五钱,加水一盏半,生姜三片,煎煮至七分满,滤去药渣,随时温服。此方又名仓禀汤。
藿香正气散
香薷饮
下利虽然常说是有积滞和热邪,但如果用药无效,说明是肠胃受风邪侵袭。表现为热证、大便色赤的,给予败毒散;表现为冷证、大便色白的,给予不换金正气散。治疗痢疾的方法,大要以疏散风邪、行气导滞、开胃醒脾为先,不可急于使用粟壳、龙骨、牡蛎等收敛固涩的药物,以免闭门留寇,使邪气更加亢盛,导致腹痛缠绵或里急后重,所以病情日久拖延而不能痊愈。(肉豆蔻、诃子、白术等药物,恐怕会补住寒邪,也不可急于投用。)
葛氏治疗痢疾颜色发白、食物不消化的,属于寒证,使用下方。
豆豉(一斤,用绵布包裹) 薤白(一把)
加水三升,煮取二升,趁热一次性服下。这种痢疾不是由暑毒引起的,或者是过食生冷,或者坐卧于高堂大厦之中,寒气乘虚而入,脾运化功能失常,因此随感而发为痢疾,用葛氏豉薤汤治疗。如果超过两三天,寒邪转化为热邪,其病形就与暑毒引起的痢疾相同了。
黑丸子
乌梅肉 杏仁(去皮尖,单独研磨,十四粒) 巴豆霜(去油,半钱) 百草霜(六钱)
以上研成细末,混合均匀,用稀糊作为粘合剂制成丸药,大小如黍米,每次服用十五丸,可加至二十丸,用白开水送服。另一配方中有半夏、缩砂仁(各十四粒)。
感应丸
理中汤
人参 白术 炮姜 炙甘草
加水煎服。如果痢疾不止,宜加豆蔻、木香。如果有热象,加黄连。
真人养脏汤
人参 白术(各六两) 白芍 木香(各一两六钱) 甘草 肉桂(各八钱) 肉豆蔻(面粉包裹煨熟,五钱) 罂粟壳(蜂蜜炙) 诃子肉(一两二钱)
以上药材切碎,每次服用四钱,加水一盏半,煎至八分,滤去药渣,饭前温服。忌食生冷、鱼腥、酒类、面食及油腻之物。如果出现滑泄、夜间起夜次数多、久治不愈的情况,可加附子四片。这是温补兼收涩的方剂,适用于脏腑虚弱、滑脱不禁的患者。如果有热象,不可使用,宜用清热固涩的方剂。
The Baidu San (Dissipating Toxicity Powder) from the *Ren Shu* is used to treat dysentery accompanied by fever and a floating pulse.
*Ren Shen* (Ginseng Radix), *Chuan Xiong* (Szechwan Lovage Rhizome), *Qiang Huo* (Notopterygium Rhizome), *Du Huo* (Angelica Pubescens Root), *Qian Hu* (Peucedani Radix), *Fu Ling* (Poria), *Zhi Ke* (Aurantii Fructus), *Jie Geng* (Platycodon Root), *Zhi Gan Cao* (Prepared Licorice Root), *Chai Hu* (Bupleuri Radix), *Chen Cang Mi* (Stored Rice).
The above herbs are cut into small pieces. Each dose consists of five qian, boiled with one and a half sheng of water and three slices of fresh ginger until reduced to seven-tenths. Strain and take at any time. This formula is also known as Cang Bin Tang.
Huoxiang Zhengqi San (Agastache Powder to Rectify the Qi)
Xiangru Yin (Mosla Decoction)
Although dysentery is often said to be caused by accumulation and heat, if medication is ineffective, it indicates that wind-pathogen has invaded the intestines and stomach. For cases presenting as heat syndrome or with red stool, administer Baidu San; for cases presenting as cold syndrome or with white stool, administer Buhuanjin Zhengqi San (Powder to Rectify the Qi without Changing the Metal). The general principle in treating dysentery is to first dissipate wind-pathogen, move stagnant qi, and open the stomach. One should not hastily use astringents such as Poppy Capsule (*Yumi Qiao*), Dragon Bone (*Long Gu*), or Oyster Shell (*Muli*) to close and bind the intestines, as this will cause the pathogen to become more severe due to being trapped inside, leading to lingering abdominal pain or tenesmus. Thus, the condition persists for a long time without resolution. (Herbs such as Nutmeg (*Rou Dou Kou*), Chebula Fruit (*He Zi*), and Atractylodes Macrocephala Rhizome (*Bai Zhu*) may trap cold-pathogen and should not be administered hastily.)
Ge Shi's method for treating dysentery with white color and indigestion identifies it as a cold syndrome, prescribing the following formula:
Fermented Soybean (*Chi*, one jin, wrapped in cotton)
Allium Macrostemon Bulb (*Xie Bai*, one handful)
Boil with three sheng of water until two sheng remain. Take hot in one dose. This type of dysentery does not originate from summer-heat toxicity. It may result from excessive consumption of raw and cold foods, or from sitting or lying in high halls where cold-pathogen invades. The spleen fails to transport and transform, leading to dysentery upon contraction of the pathogen. Treat with Ge Shi's Chi Xie Tang (Fermented Soybean and Allium Macrostemon Decoction). If two or three days pass and the cold transforms into heat, the clinical presentation becomes identical to dysentery caused by summer-heat toxicity.
Hei Wan (Black Pill)
Mume Fruit Flesh (*Wu Mei Rou*)
Almond Seed (*Xing Ren*, skin and tip removed, separately ground, fourteen seeds)
Croton Seed Frost (*Ba Shuang*, oil removed, half qian)
Soot from Hundred Herbs (*Bai Cao Shuang*, six qian)
Grind the above into fine powder, mix evenly, and form pills using thin paste, sized like millet seeds. Take fifteen pills per dose, increasing to twenty pills, washed down with warm water. Another prescription includes Pinellia Tuber (*Ban Xia*) and Amomum Fruit (*Suo Sha*, fourteen seeds each).
Ganying Wan (Responsive Pill)
Lizhong Tang (Regulate the Middle Decoction)
*Ren Shen* (Ginseng Radix)
*Atractylodes Macrocephala Rhizome* (*Bai Zhu*)
Prepared Ginger (*Pao Jiang*)
Prepared Licorice Root (*Zhi Gan Cao*)
Decoct in water and take. If dysentery does not cease, add Nutmeg (*Dou Kou*) and Costus Root (*Mu Xiang*). If there is heat, add Coptis Rhizome (*Huang Lian*).
Zhenren Yangzang Tang (True Man's Nourishing Viscera Decoction)
*Ren Shen* (Ginseng Radix)
*Atractylodes Macrocephala Rhizome* (*Bai Zhu*, six liang each)
White Peony Root (*Bai Shao*)
Costus Root (*Mu Xiang*, one liang six qian each)
Licorice Root (*Gan Cao*)
Cinnamon Bark (*Rou Gui*, eight qian each)
Nutmeg (*Rou Dou Kou*, wrapped in flour and roasted, five qian)
Poppy Capsule (*Yu Mi Qiao*, honey-fried)
Chebula Fruit Flesh (*He Zi Rou*, one liang two qian)
Cut the above herbs. Each dose consists of four qian, boiled with one and a half sheng of water until reduced to eight-tenths. Strain and take warm before meals. Avoid raw, cold, fishy, alcoholic, wheat-based, and greasy foods. In cases of slippery diarrhea, frequent nocturia, and chronic non-resolution, add four slices of Prepared Aconite Root (*Fu Zi*). This is a formula combining warming tonification with astringency, suitable for patients with deficient viscera and slipping/dysentery. If heat is present, it must not be used; instead, use cooling and astringent formulas.