1.有物有声谓之呕, 有物无声吐之征, 无物有声哕干呕, 面青指黑
痛厥凶.
【注】面色青, 指甲黑也, 中痛不止, 肢厥不回, 其凶可知也.
小半夏汤 橘皮半夏汤 大半夏汤 黄连半夏汤 丁萸六均汤
2.呕吐半姜为圣药, 气盛加橘虚蜜参, 热盛姜连便闭下, 寒盛丁萸
姜六君.
【注】便闭, 谓大小二便闭而不行, 宜攻下也. 初吐切不可下, 恐逆
病势也.
五汁饮 硫汞散 化滞丸
3.润燥止吐五汁饮, 芦荠甘蔗竹沥姜, 呕吐不下硫汞坠, 积痛作吐
化滞良.
【注】五汁饮, 即芦锥, 荸荠, 甘蔗, 竹沥, 姜汁也. 呕吐诸药, 汤
水到咽即吐者, 宜用重坠之药, 以石硫黄二钱, 水银一钱, 同研如煤
色极细, 用老酒姜汁调服. 稍点白滚汤, 亦可顿服之, 其药即不能吐
出.次日大便, 出黑色秽物, 诸汤水药服之, 则不吐也. 如不大便黑
色,再服, 以大便利为度. 吐而痛者, 乃积也, 宜化滞丸.
湿泻 濡泻 水泻 洞泻 寒泻 飧泻 脾泻 肾泻
1.湿胜濡泻即水泻, 多水肠呜腹不疼. 寒湿洞泻即寒泻, 鸭溏清彻
痛雷鸣, 完谷不化名飧泻, 土衰木盛不升清. 脾虚腹满食后泻, 肾泻
寒虚晨数行.
【注】濡者, 水也. 洞者, 直倾下也. 鸭溏, 如鸭屎之溏, 澄彻清冷
也.痛, 腹痛也. 雷鸣, 肠鸣甚也. 不升清, 谓清气在下不上升也.
脾泻, 脾虚也. 食泻, 饮食后即泻也. 晨数行, 每至早晨行泻数次也
.
食泻 胃泻 饮泻 痰泻 火泻 暑泻 滑泻 大瘕泻
2.伤食作泻即胃泻, 噫气腹痛秽而粘. 渴饮泻复渴饮泻, 时泻时止
却属痰. 火泻阵阵痛饮冷, 暑泻面垢汗渴烦. 滑泻日久不能禁, 大瘕
今时作痢看.
【注】过食作泻, 名日食泻, 即胃泻也. 秽而粘, 所泻之物臭而粘也
.渴而饮, 饮而泻, 泻而复渴, 渴而复饮, 饮而复泻, 饮泻也. 时或
泻,时或不泻, 属痰泻也. 阵阵, 谓泻一阵, 痛一阵也. 大瘕泻, 即
今时之痢疾病也.
1. Vomiting with both material discharge and sound is termed "Ou" (Vomiting), which is a sign of vomiting; dry heaving without material discharge but with sound is termed "Yue" or "Gan Ou" (Dry Heaving). If the complexion turns cyanotic, fingernails turn black, abdominal pain persists unrelieved, and cold limbs do not recover warmth, it indicates a critical and ominous prognosis.
[Note] A cyanotic complexion and black fingernails indicate persistent severe abdominal pain and irreversible cold extremities, revealing its critical nature.
Xiao Banxia Tang (Minor Pinellia Decoction), Ju Pi Ban Xia Tang (Tangerine Peel and Pinellia Decoction), Da Banxia Tang (Major Pinellia Decoction), Huang Lian Ban Xia Tang (Coptis and Pinellia Decoction), Ding Yu Liu Jun Tang (Clove and Evodia Six-Ingredient Decoction)
2. For treating vomiting, Ban Xia (Pinelliae Rhizoma) and Sheng Jiang (Zingiberis Rhizoma Recens) are considered the supreme remedies. If Qi stagnation is severe, add Chen Pi (Citri Reticulatae Pericarpium); if Qi deficiency exists, add honey and Ren Shen (Ginseng Radix et Rhizoma). If Heat is severe accompanied by constipation, use purgative methods (such as Sheng Jiang and Huang Lian to clear heat and purge); if Cold is severe, use Ding Xiang (Caryophylli Flos) and Wu Zhu Yu (Evodiae Fructus) combined with Liu Jun Zi Tang (Six-Gentlemen Decoction).
[Note] "Bian Bi" refers to the obstruction of both large and small bowel movements, for which purgative therapy is appropriate. However, one must never use purgatives at the initial stage of vomiting, lest it contradict the disease trend and exacerbate the condition.
Wu Zhi Yin (Five-Juice Drink), Liu Hong San (Sulfur and Mercury Powder), Hua Zhi Wan (Stasis-Transforming Pill)
3. To moisten dryness and stop vomiting, Wu Zhi Yin (Five-Juice Drink) can be used, composed of Lu Gen (Imperatae Rhizoma), Bi Qi (Dioscoreae Bulbiferae), Gan Zhe (Sacchari Candi), Zhu Li (Bambusae Succus), and Jiang Zhi (Zingiberis Succus). For cases of severe vomiting where even decoctions and water are vomited immediately upon reaching the throat, heavy-sinking medicines should be employed. Grind Shi Liu Huang (Sulfur) two qian and Shui Yin (Hydrargyrum) one qian together into an extremely fine powder resembling coal color. Mix with aged wine and ginger juice for administration. Add a small amount of plain boiled water, or administer in one dose; this prevents the medicine from being vomited out. On the following day, if black foul matter is excreted in the stool, subsequent intake of other decoctions will no longer induce vomiting. If black stool is not passed, the medicine may be administered again, continuing until the passage of black stool occurs. Vomiting accompanied by pain is due to accumulation/stagnation, and Hua Zhi Wan (Stasis-Transforming Pill) is indicated.
Shi Xie (Damp Diarrhea), Ru Xie (Soft Diarrhea), Shui Xie (Watery Diarrhea), Dong Xie (Sudden/Profuse Diarrhea), Han Xie (Cold Diarrhea), Sun Xie (Undigested Food Diarrhea), Pi Xie (Spleen Diarrhea), Shen Xie (Kidney Diarrhea)
1. Dampness excess leading to Ru Xie (Soft Diarrhea) is essentially Shui Xie (Watery Diarrhea), characterized by excessive water content and borborygmus without abdominal pain. Cold-dampness leading to Dong Xie (Sudden/Profuse Diarrhea) is essentially Han Xie (Cold Diarrhea), characterized by loose stools resembling duck feces that are clear and cold, abdominal pain, and loud borborygmus like thunder. Sun Xie (Undigested Food Diarrhea) is named so because undigested food is passed, caused by Spleen Earth deficiency and Liver Wood excess, resulting in the failure of Clear Qi to ascend. Pi Xie (Spleen Diarrhea) is characterized by abdominal fullness and diarrhea after eating; Shen Xie (Kidney Diarrhea) is due to Kidney Yang deficiency and cold, manifesting as multiple diarrheal episodes every morning.
[Note] "Ru" means watery. "Dong" means pouring down directly. "Ya Tang" refers to loose stools resembling duck feces, clear and cold. "Tong" refers to abdominal pain. "Lei Ming" refers to very loud borborygmus. "Bu Sheng Qing" refers to Clear Qi remaining below and failing to ascend. "Pi Xie" refers to diarrhea due to Spleen deficiency. "Shi Xie" refers to diarrhea occurring immediately after eating. "Chen Shu Xing" refers to having several diarrheal episodes each morning.
Shi Xie (Food Stagnation Diarrhea), Wei Xie (Stomach Diarrhea), Yin Xie (Fluid Retention Diarrhea), Tan Xie (Phlegm Diarrhea), Huo Xie (Fire Diarrhea), Shu Xie (Summerheat Diarrhea), Hua Xie (Slippery/Incontinence Diarrhea), Da Jia Xie (Great Mass Diarrhea)
2. Diarrhea caused by food injury is Wei Xie (Stomach Diarrhea), characterized by belching, abdominal pain, and foul, sticky stools. Thirst followed by drinking, then diarrhea, followed by thirst again, where diarrhea comes and goes intermittently, belongs to Tan Xie (Phlegm Diarrhea). Huo Xie (Fire Diarrhea) is characterized by paroxysmal pain and a preference for cold drinks. Shu Xie (Summerheat Diarrhea) is characterized by a greasy complexion, sweating, thirst, and irritability. Hua Xie (Slippery Diarrhea) refers to chronic diarrhea lasting long periods with loss of control. Da Jia Xie (Great Mass Diarrhea) was viewed as Li Ji (Dysentery) in contemporary times.
[Note] Diarrhea caused by overeating is named Shi Xie (Food Stagnation Diarrhea), which is also Wei Xie (Stomach Diarrhea). "Hui Er Nian" means the excreta are foul-smelling and sticky. "Ke Er Yin, Yin Er Xie..." describes the cycle of thirst-drink-diarrhea-thirst-drink-diarrhea, which is Yin Xie (Fluid Retention Diarrhea). "Shi Huo Xie, Shi Huo Bu Xie" means sometimes diarrhea occurs, sometimes it does not, indicating Tan Xie (Phlegm Diarrhea). "Zhen Zhen" means a bout of diarrhea accompanied by a bout of pain. "Da Jia Xie" refers to the dysentery disease prevalent at that time.