治黎明腹疼泄泻。
补骨脂(六两酒炒) 吴茱萸(三两,盐炒) 五味子(四两,炒) 肉豆蔻(四两,面裹煨)
花椒(一两微焙) 生硫黄(六钱) 大枣(八十一枚) 生姜(六两,切片)
先煮姜十余沸,入枣同煮,至烂熟去姜,余药为细末,枣肉为丸,桐子大。
人禀天地之气而生,人身一小天地也。天地之一阳生于子,故人至夜半之时,肾系命门之处,有气息息萌
动,即人身之阳气也。至黎明寅时,为三阳之候,人身之阳气,亦应候上升,自下焦而将达中焦。其人或元阳
之根柢素虚,当脐之处,或兼有凝寒遮蔽,即互相薄激,致少腹作疼。久之阳气不胜凝寒,上升之机转为下
降,大便亦即溏下,此黎明作泻之所由来也。夫下焦之阳气少火也,即相火也,其火生于命门,而寄于肝胆。
故四神方中,用补骨脂以补命门,吴茱萸以补肝胆,此培火之基也。然泻者关乎下焦,实又关乎中焦,故又用
肉豆蔻之辛温者,以暖补脾胃。且其味辛而涩,协同五味之酸收者,又能固涩大肠,摄下焦气化。且姜枣同煎,
而丸以枣肉,使辛甘化合,自能引下焦之阳,以达于中焦也。然此药病轻者可愈,病重者服之,间或不愈,以
其补火之力犹微也。故又加花椒、硫黄之大补元阳者以助之,而后药力始能胜病也。
Treats abdominal pain and diarrhea occurring at dawn.
*Psoraleae Fructus* (Bugu Zhi, 补骨脂) [6 liang, stir-fried with wine] *Evodiae Fructus* (Wu Zhu Yu, 吴茱萸) [3 liang, stir-fried with salt] *Schisandrae Fructus* (Wu Wei Zi, 五味子) [4 liang, stir-fried] *Myristicae Semen* (Rou Dou Kou, 肉豆蔻) [4 liang, baked in flour coating] *Zanthoxyli Pericarpium* (Hua Jiao, 花椒) [1 liang, lightly roasted] *Sulfur* (Sheng Liu Huang, 生硫黄) [6 qian] *Jujubae Fructus* (Da Zao, 大枣) [81 pieces] *Zingiberis Rhizoma Recens* (Sheng Jiang, 生姜) [6 liang, sliced]
First, boil the ginger for more than ten boiling cycles, add the jujubes and cook together until soft and cooked through. Remove the ginger. Grind the remaining herbs into a fine powder. Use the pulp of the jujubes as a binder to make pills, sized like sophora seeds.
Humans are born by inheriting the Qi of Heaven and Earth; the human body is a small heaven and earth. The Yang Qi of heaven and earth begins to sprout at the Zi hour (midnight). Thus, when people reach midnight, at the location of the Kidney and Ming Men (Gate of Life), there is a subtle stirring of Qi, which is the Yang Qi of the human body. By the Yin hour (dawn, 3-5 AM), it is the time when the three Yang meridians take command. The Yang Qi of the human body should also rise in accordance with this timing, moving from the Lower Jiao (Lower Burner) towards the Middle Jiao (Middle Burner). If an individual has a constitutionally deficient root of Original Yang (Yuan Yang), there may be congealed cold obstructing the area around the umbilicus. The Yang Qi and cold pathogen mutually clash and irritate each other, causing pain in the lower abdomen. Over time, if the Yang Qi cannot overcome the congealed cold, the mechanism of rising turns into descending, and the stool becomes loose and watery. This is the origin of diarrhea occurring at dawn. The Yang Qi of the Lower Jiao is "Lesser Fire" (Shao Huo), also known as Ministerial Fire (Xiang Huo). This fire originates from the Ming Men but resides in the Liver and Gallbladder. Therefore, in the Si Shen Formula, *Psoraleae Fructus* is used to tonify the Ming Men, and *Evodiae Fructus* is used to tonify the Liver and Gallbladder; this establishes the foundation for nurturing the fire. However, while diarrhea concerns the Lower Jiao, it is actually also related to the Middle Jiao. Thus, the pungent and warm nature of *Myristicae Semen* is used to warm and tonify the Spleen and Stomach. Furthermore, its pungent and astringent flavor, working in synergy with the sour and astringent nature of *Schisandrae Fructus*, can secure and bind the Large Intestine and regulate the Qi transformation of the Lower Jiao. Additionally, decocting ginger and jujube together and using jujube pulp for the pills allows the pungent and sweet flavors to combine, naturally guiding the Yang Qi of the Lower Jiao to reach the Middle Jiao. However, this prescription can cure mild cases, but for severe cases, it may not always be effective because its power to tonify fire is still slight. Therefore, *Zanthoxyli Pericarpium* and *Sulfur*, which greatly tonify Original Yang, are added to assist, so that the medicinal strength can then overcome the disease.