黄柏(炒褐色) 知母(蒸,各二两) 肉桂(去皮,一钱
炼蜜丸,如梧桐子大。每服七、八十丸,开水下。
金匮肾气丸 (见水肿。
假苏散 (见淋症。
补中益气汤 (见类中。
茯苓(赤、白,各五钱) 升麻(一钱五分) 当归(二钱) 川芎(一钱) 苎根(三钱
急流水煎服,或琥珀末二钱服,更佳。
(大小肠交 遗尿 脱肛
经曰∶北方黑色,入通于肾,开窍于二阴。是知肾主二便,肾经津液干枯,则大便闭结
矣。然有实闭、虚闭、热闭、冷闭之不同。如阳明胃实,燥渴、谵语,不大便者,实闭也,
小承气汤下之。若老弱人精血不足,新产妇人气血干枯,以致肠胃不润,此虚闭也,四物汤
加松子仁、柏子仁、肉苁蓉、枸杞、人乳之类以润之,或以蜜煎导而通之;若气血两虚,则
用八珍汤。热闭者,口燥、唇焦,舌苔黄,小便赤,喜冷、恶热,此名阳结,宜用清热攻
下之法,三黄枳术丸主之。冷闭者,唇淡、口和,舌苔白,小便清,喜热、恶寒,此名阴结
宜用温药而兼润燥之法,理中汤加归、芍主之。凡虚人不大便,未可勉强通之。大便虽闭
腹无所苦,但与润剂,积久自行,不比伤寒邪热,消烁津液,有不容刻缓之势也。予尝治
老人虚闭,数至圊而不能便者,用四物汤及滋润药加升麻,屡试屡验,此亦救急之良法也。
干枯,大肠结燥,便溺俱自前出,此非交肠,乃血液枯涸之征,气血衰败之候也。多服大剂
八珍汤,或可稍延岁月耳。
遗尿有二症,一因脾胃虚弱,仓禀不固,肠滑而遗者;一因火性急速,逼迫而遗者,宜
分别治之。脾虚,理中汤;火盛,芍药甘草汤加黄连。
脱肛也有二症,一因气虚下陷而脱者,补中益气汤;一因肠胃有火,肿胀下脱者,四
物加升麻、黄芩、荷叶之属。
小承气汤 (见伤寒少阴经证。
四物汤 (见虚劳。
蜜煎导法 (见伤寒。
八珍汤 (见虚劳)
三黄枳术丸 (见腹痛)
理中汤 (见伤寒中寒门。
五苓散 (见太阳腑病。
芍药甘草汤 (见腹痛。
补中益气汤 (见类中。
Huangbai (Cortex Phellodendri, stir-fried until brown) Zhimu (Rhizoma Anemarrhenae, steamed, each 2 liang) Rougui (Cortex Cinnamomi, bark removed, 1 qian)
Processed with refined honey into pills, sized like wutong seeds. Take 70-80 pills per dose, swallowed with warm water.
Jinkui Shenqi Wan (Golden Cabinet Kidney Qi Pill) (See section on Edema).
Jiasu San (Mint Powder) (See section on Lin Syndrome).
Buzhong Yiqi Tang (Decoction for Supplementing the Middle and Augmenting Qi) (See section on Stroke-like Syndromes).
Fuling (Poria, both red and white varieties, each 5 qian) Shengma (Rhizoma Cimicifugae, 1.5 qian) Danggui (Radix Angelicae Sinensis, 2 qian) Chuanxiong (Rhizoma Chuanxiong, 1 qian) Zhu Gen (Root of Boehmeria nivea, 3 qian)
Decoct with rapidly flowing water and take orally. Alternatively, taking it with 2 qian of Hupo (Amber) powder is even better.
(Discussion on Intestinal Cross-over, Enuresis, and Rectal Prolapse)
The *Neijing* states: "The North corresponds to black, connects internally with the Kidney, and opens into the two yin orifices." From this, we know that the Kidney governs the two bowels. If the fluids of the Kidney meridian are dried up, fecal impaction occurs. However, there are differences among Excess Impaction (Shi Bi), Deficiency Impaction (Xu Bi), Heat Impaction (Re Bi), and Cold Impaction (Leng Bi). For instance, in Yangming Stomach Excess syndrome, characterized by dry thirst, delirious speech, and constipation, this is Excess Impaction; treat with Xiaochengqi Tang (Minor Order the Yellow Decoction) to purge. In elderly or weak individuals with insufficient essence and blood, or in postpartum women with dried-up qi and blood causing lack of lubrication in the intestines and stomach, this is Deficiency Impaction; treat with Siwu Tang (Four Substances Decoction) added with Songziren (Pine Seed Kernel), Baiziren (Biota Seed), Rousongrong (Cistanche), Gouqi (Goji Berry), Renru (Human Milk), etc., to moisten, or use Mi Jian Dao (Honey Suppository) method to promote evacuation. If there is a dual deficiency of qi and blood, use Bazhen Tang (Eight Treasures Decoction). Heat Impaction presents with dry mouth, scorched lips, yellow tongue coating, dark urine, preference for cold, and aversion to heat; this is called Yang Knotting. It is suitable to use clearing heat and purging methods, primarily Sanhuang Zhiyu Wan (Three Yellows and Atractylodes Pill). Cold Impaction presents with pale lips, neutral taste in the mouth, white tongue coating, clear urine, preference for heat, and aversion to cold; this is called Yin Knotting. It is suitable to use warming herbs combined with moistening-drying methods, primarily Lizhong Tang (Regulate the Middle Decoction) added with Danggui and Shaoyao. For deficient persons with constipation, one must not forcibly use purgatives. Although the stool is blocked, if the abdomen suffers no pain, simply providing moistening agents will allow natural evacuation over time. This differs from Shanghan (Cold Damage) where pathogenic heat consumes body fluids, creating an urgent situation that cannot be delayed. I once treated an elderly person with deficiency-induced constipation who felt the urge to defecate repeatedly but could not; using Siwu Tang and moistening herbs added with Shengma yielded consistent results. This is also an excellent emergency method.
If the Large Intestine is dried up and dry, causing both stool and urine to exit from the anterior orifice (urethra), this is not Intestinal Cross-over, but a sign of blood exhaustion and a state of qi and blood decline. Taking large doses of Bazhen Tang may slightly prolong life.
Enuresis has two syndromes: one caused by Spleen-Stomach weakness and insecure storage, leading to intestinal slipping and enuresis; the other caused by the rapid nature of Fire forcing urination. These should be treated differently. For Spleen deficiency, use Lizhong Tang; for excessive Fire, use Shaoyao Gancao Tang (Peony and Licorice Decoction) added with Huanglian.
Rectal prolapse also has two syndromes: one caused by qi deficiency and sinking, treated with Buzhong Yiqi Tang; the other caused by fire in the intestines and stomach leading to swelling and prolapse, treated with Siwu Tang added with Shengma, Huangqin, and He Ye (Lotus Leaf).
Xiaochengqi Tang (See section on Shaoyin Meridian Syndromes in Cold Damage).
Siwu Tang (See section on Deficiency Consumption).
Mi Jian Dao Method (See section on Cold Damage).
Bazhen Tang (See section on Deficiency Consumption).
Sanhuang Zhiyu Wan (See section on Abdominal Pain).
Lizhong Tang (See section on Cold Damage - Cold Invasion Chapter).
Wuling San (See section on Taiyang Fu Organ Disease).
Shaoyao Gancao Tang (See section on Abdominal Pain).
Buzhong Yiqi Tang (See section on Stroke-like Syndromes).