删繁论曰∶下焦如渎,(渎者如沟水决泄也)起胃下管,别回肠,注于膀胱而渗入焉,
故
水谷常并居于胃中,成糟粕而俱下于大肠,主足阳明,灌渗津液,合膀胱主出不主入,别于
清浊,主肝肾之病也,若实则大小便不通利,气逆不续,吐呕不禁,故曰走哺,若虚则大小
便不止,津液气绝,人饮酒亦入胃,谷未熟而小便独先下者,何也,盖酒者熟谷之液也,其
气悍以滑,故后谷入而先谷出也,所以热则泻于肝,寒则补于肾。(千金同)
又疗下焦热,大小便俱不通,柴胡通塞汤方。
柴胡(三两) 黄芩(三两) 橘皮(三两) 泽泻(三两) 栀子仁(四两) 石膏
(六两) 羚
羊角(三两炙) 生地黄(一升) 芒硝(三两) 香豉(一升)
上十味切,以水一斗,煮九味,取三升,去滓,下芒硝,分三服。忌芜荑。(千金同)
又疗下焦热,气逆不续,吐呕不禁,名曰走哺,止呕人参汤方。
人参 生芦根 栀子仁 葳蕤 黄芩 知母 茯苓(各三两) 白术(四两) 石膏(八
两)
上十味切,以水九升,煮取三升,去滓,分三服。忌桃李雀肉醋等。(千金同)
又疗走哺不止,或呕噎,热气冲心满闷,香豉汤方。
香豉(一升) 生地黄(一升) 白术(三两) 甘草(二两炙) 竹叶(一升) 石
膏(八两)
茯苓(三两) 葱白(一升)
上八味切,以水七升,煮取二升五合,去滓,分三服,须利下,如芒硝三两。忌芜荑海
藻菘菜桃李雀肉酢物等。
又疗下焦热,毒痢血如鹅鸭肝不止,升麻汤方。
升麻(三两) 犀角(三两屑) 地榆(四两炙) 绛草(三两) 荷根(四两) 黄
芩(三两) 芭蕉根(切一升) 桔梗(三两) 栀子仁(三七枚)
上九物切,以水九升,煮取三升,去滓,分三服。忌猪肉。(出第四卷中)
千金疗下焦热,或痢下脓血,烦闷恍惚,赤石脂汤方。
赤石脂(八两) 乌梅肉(二十枚) 栀子仁(十四枚) 白术(三两) 干姜(二两)
廪米(
一升) 升麻(三两)
上七味切,以水一斗,煮米取熟,去米取七升,下诸药,煮取二升五合,去滓,分三服。
忌桃李雀肉等。(删繁同)
又疗下焦热,毒痢鱼脑,杂痢鲜血,脐下少腹绞痛不可忍,欲痢不出,香豉汤方。
香豉(一升) 栀子(四两) 薤白(一升) 黄连(三两) 黄柏(三两) 黄芩(四
两) 地榆
(四两炙) 白术(三两) 茜根(三两)
上九味切,以水一斗,煮取三升,分三服。忌猪肉冷水桃李雀肉等。(删繁同出第二十
卷中)
The *Shanfan Lun* (Treatise on Eliminating Redundancy) states: The Lower Jiao (Lower Burner, responsible for excretion) functions like a ditch (a "du" refers to water flowing out and draining away like a canal). It originates from the lower opening of the Stomach, separates from the Ileum, and pours into the Bladder where it permeates. Therefore, food and drink usually reside together in the Stomach; after digestion, they form waste and descend together into the Large Intestine. The Lower Jiao is primarily governed by the Foot-Yangming Meridian, responsible for irrigating and渗泄 (permeating and draining) body fluids, cooperating with the Bladder to govern expulsion rather than intake, distinguishing clear from turbid, and primarily relating to diseases of the Liver and Kidney. If there is excess syndrome in the Lower Jiao, it leads to difficulty in urination and defecation, rebellious Qi that cannot continue, and uncontrollable vomiting; this condition is called "Zoubu" (food going backward/vomiting). If there is deficiency syndrome in the Lower Jiao, it leads to incontinence of urine and feces, and exhaustion of body fluids and Qi. When a person drinks alcohol, the alcohol enters the Stomach. Why does the urine discharge alone before the grain is fully digested? This is because wine is the liquid extracted from cooked grain; its Qi is fierce and slippery. Therefore, although it enters the body later than grain, it exits earlier than grain. Thus, heat syndromes should be treated by purging the Liver, and cold syndromes by tonifying the Kidney. (This view is consistent with *Qianjin Fang*).
Furthermore, Chaihu Tongse Tang (Bupleurum Decoction for Unblocking Obstruction) treats heat in the Lower Jiao where both urination and defecation are blocked.
Chai Hu (Radix Bupleuri, 3 liang), Huang Qin (Radix Scutellariae, 3 liang), Ju Pi (Pericarpium Citri Reticulatae, 3 liang), Ze Xie (Rhizoma Alismatis, 3 liang), Zhi Zi Ren (Semen Gardeniae, 4 liang), Shi Gao (Gypsum Fibrosum, 6 liang), Ling Yang Jiao (Cornu Saigae Tataricae, 3 liang, prepared by roasting), Sheng Di Huang (Radix Rehmanniae Preparata, 1 sheng), Mang Xiao (Natrii Sulfas, 3 liang), Xiang Chi (Fermented Soybean, 1 sheng).
Cut the above ten ingredients. Boil the first nine in one dou of water until three sheng remain. Remove the dregs, add Mang Xiao, and divide into three doses. Avoid Wu Yi (Chrysanthemi Indici Flos). (Consistent with *Qianjin Fang*).
Furthermore, Zhi Ou Renshen Tang (Ginseng Decoction for Stopping Vomiting) treats heat in the Lower Jiao causing rebellious Qi that cannot continue and uncontrollable vomiting, named "Zoubu".
Ren Shen (Radix Ginseng), Sheng Lu Gen (Rhizoma Phragmitis, fresh), Zhi Zi Ren (Semen Gardeniae), Wei Rui (Rhizoma Polygonati Odorati), Huang Qin (Radix Scutellariae), Zhi Mu (Rhizoma Anemarrhenae), Fu Ling (Poria, 3 liang each), Bai Zhu (Rhizoma Atractylodis Macrocephalae, 4 liang), Shi Gao (Gypsum Fibrosum, 8 liang).
Cut the above ten ingredients. Boil in nine sheng of water until three sheng remain. Remove the dregs and divide into three doses. Avoid Li, Tao, Que Rou (sparrow meat), Cu (vinegar), etc. (Consistent with *Qianjin Fang*).
Furthermore, Xiang Chi Tang (Fermented Soybean Decoction) treats persistent "Zoubu", or dysphagia, where hot Qi rushes to the heart causing chest fullness and oppression.
Xiang Chi (Fermented Soybean, 1 sheng), Sheng Di Huang (Radix Rehmanniae Preparata, 1 sheng), Bai Zhu (Rhizoma Atractylodis Macrocephalae, 3 liang), Gan Cao (Radix Glycyrrhizae, 2 liang, prepared by roasting), Zhu Ye (Leaf of Bambusa, 1 sheng), Shi Gao (Gypsum Fibrosum, 8 liang), Fu Ling (Poria, 3 liang), Cong Bai (White part of Allii Fistulosi, 1 sheng).
Cut the above eight ingredients. Boil in seven sheng of water until two sheng five he remain. Remove the dregs and divide into three doses. If laxation is required, add Mang Xiao (Natrii Sulfas, 3 liang). Avoid Wu Yi, Hai Zao (Sargassum), Song Cai (Chinese Cabbage), Li, Tao, Que Rou (sparrow meat), and acidic substances.
Furthermore, Shengma Tang (Cimicifuga Decoction) treats heat in the Lower Jiao with toxic dysentery bleeding resembling goose or duck liver that does not stop.
Sheng Ma (Rhizoma Cimicifugae, 3 liang), Xi Jiao (Cornu Rhinocerotis, 3 liang, powdered), Di Yu (Radix Sanguisorbae, 4 liang, prepared by roasting), Jiang Cao (Radix Rubiae Cordifoliae, 3 liang), He Gen (Rhizoma Nelumbinis, 4 liang), Huang Qin (Radix Scutellariae, 3 liang), Ba Jiao Gen (Radix Musae, cut, 1 sheng), Jie Geng (Radix Platycodonis, 3 liang), Zhi Zi Ren (Semen Gardeniae, 30-70 seeds).
Cut the above nine items. Boil in nine sheng of water until three sheng remain. Remove the dregs and divide into three doses. Avoid pork. (From Volume 4).
*Qianjin Fang* treats heat in the Lower Jiao, or dysentery with pus and blood, accompanied by irritability and confusion, using Chishizhi Tang (Red Halloysite Decoction).
Chi Shi Zhi (Halloysitum Rubrum, 8 liang), Wu Mei Rou (Endocarpium Mume, 20 pieces), Zhi Zi Ren (Semen Gardeniae, 14 pieces), Bai Zhu (Rhizoma Atractylodis Macrocephalae, 3 liang), Gan Jiang (Rhizoma Zingiberis, 2 liang), Lin Mi (Glutinous Rice, 1 sheng), Sheng Ma (Rhizoma Cimicifugae, 3 liang).
Cut the above seven ingredients. Boil in one dou of water with the rice until cooked. Remove the rice to obtain seven sheng of liquid. Add the other herbs and boil until two sheng five he remain. Remove the dregs and divide into three doses. Avoid Li, Tao, Que Rou (sparrow meat), etc. (Consistent with *Shanfan*).
Furthermore, Xiang Chi Tang (Fermented Soybean Decoction) treats heat in the Lower Jiao with toxic dysentery resembling fish brain, mixed bloody dysentery, unbearable cramping pain in the umbilical and hypogastric regions, and the urge to defecate without success.
Xiang Chi (Fermented Soybean, 1 sheng), Zhi Zi (Fructus Gardeniae, 4 liang), Xie Bai (Bulbus Allii Macrostemonis, 1 sheng), Huang Lian (Rhizoma Coptidis, 3 liang), Huang Bo (Cortex Phellodendri, 3 liang), Huang Qin (Radix Scutellariae, 4 liang), Di Yu (Radix Sanguisorbae, 4 liang, prepared by roasting), Bai Zhu (Rhizoma Atractylodis Macrocephalae, 3 liang), Qian Gen (Radix Rubiae Cordifoliae, 3 liang).
Cut the above nine ingredients. Boil in one dou of water until three sheng remain. Divide into three doses. Avoid pork, cold water, Li, Tao, Que Rou (sparrow meat), etc. (Consistent with *Shanfan*, from Volume 20).