问曰。下焦病何谓也。答曰。大便难。若泻。小便不利。若遗溺。及痿 。脚痛。此为下焦所患也。大阳病。桂
枝证。医反下之。利遂不止。脉促者。表未解也。宜葛根黄芩黄连汤主之。
葛根黄芩黄连汤方
葛根（五分） 甘草（五分） 黄芩（五分） 黄连（三分）
上四味。以水二升。先煮葛根。减半升。内诸药。煮取一升。去滓。分温三服。大阳与少阳合病。自下利者。与黄
芩汤。若呕者。黄芩加半夏生姜汤主之。
黄芩汤方
黄芩（三分） 甘草（三分） 芍药（一钱） 大枣（三枚）
上四味。以水二升。煮取一升。去滓。分温服。脉浮小便不利。微热消渴。大便洞泻。其色黄。此为热泻。宜五苓
散主之。发热恶寒。吐泻烦渴。若腹痛者。清宁汤主之。
清宁汤方
葛根（五分） 人叶（三分） 苍术（三分） 茯苓（五分） 木香（三分） 藿香（三分） 甘草（二分）
上七味。以水二升。煮取七合。去滓。分温服。发热汗出不解。心下痞硬。呕吐而下利者。大柴胡汤主之。下利。
脉迟而滑者实也。利未欲止。急下之。宜大承气汤。下利。脉反滑者。当有所去。下乃愈。宜大承气汤。下利已瘥。至
其年月日时。复发者。以痛不尽故也。当下之。宜大承气汤。少阴病。四逆其人或咳。或悸。或小便不利。或腹中痛。
或泄利下重者。四逆散主之。下利脉沉弦者。下重。脉大者。为未止。宜硬饭汤。
硬饭汤方
硬饭（二钱半黑炒半生用） 槟榔（一钱） 芍药（一钱） 枳实（五分） 茯苓（一钱） 甘草（三分） 大枣
（五枚） 生姜（三分）
上八味。以水二升。煮硬饭。减五合。内诸药。煮取一升。去滓。分温服。有热者。加黄连黄苓。有寒者。加附子
干姜。儿大便窘迫。状如胶。而面颜皱者。为痢也。琼脂汤服之。
琼脂汤方
琼脂（五分） 枳实（五分） 芍药（一钱） 槟榔（五分） 大枣（三枚） 甘草（二分） 生姜（三分）
上七味。以水二升。煮取一升。去滓。分温服。大阳病。外证未除。而数下之。遂协热而利。利下不止。心下痞硬。
表里不解者。桂枝人参汤主之。
桂枝人参汤方
桂枝（三分） 甘草（二分） 白术（三分） 人参（二分） 干姜（三分）
上五味。以水二升。先煮四味。取一升。肉桂。更煮。三两沸。去滓。分温服。下利。肠 腥臭。腰髋烦痛。宜
剪红丸。
剪红丸方
蜜香（四钱） 缩砂（四钱） 熊胆（一钱） 阿片（一钱） 龙脑（三分） 麝香（一分） 甘草（三分）
上七味。研筛。以烧酒糊丸。桐子大。每服二三丸。大便后重而节续。烦渴而小便涩。若大便去红者。山漆汤服之。
山漆汤方
山漆根（二钱） 山药（酒制炒一钱） 芍药（二钱） 枳实（五分） 大枣（三枚） 生姜（三分） 甘草（二
分）
上七味。以水二升。煮取一升。去滓。分温服。大便窘迫。腰腹绞痛而烦。取热汤。灌触器仍登器。汤气熏蒸。
腰腹自和。大盒饭快通也。下利。手足微冷。脉涩者。不可更攻。宜 血散。
血散方
当归（四钱） 蝮蛇（三钱黑炒）
上二味。研筛以温酒服之。发热暴泻。脉浮。渴而小便不利者。五苓散主之。发热脉数。腹中痛。屡欲圊便。烦渴
而小便少。此为瘕泄也。瘕泄大便如糜。法须攻之。瘕不竭。痢示不罢也。痢疾为瘀浊。故后重而肠垢。必苦里急。假
令无肠垢者。无后重也。若脉滑而疾者。当屎脓也。腹痛暴泻。恶臭不可近者。为食积也。儿暴泻。难以阳决之。久痢。
难以阴决之。暴泻以多脱阳也。久痢以多瘀热也。小阴病。下利便脓血。若广肠脱出。宜桃花汤主之。
桃花汤方
赤石脂（五分） 干姜（三分） 粳米（三分）
上三味。以水一升。煮米令熟。去滓。温服。下利。如蟹渤。勃勃作声者。此为气痢也。气痢丸主之。
气痢丸方
诃子皮（四钱） 蜜香（二钱） 人参（三分）
上三味。研筛蜜丸桐子大。每服二十丸。痢疾。后重不解。其脉虚而动。此为便血之兆也。小连翘汤主之。
小连翘汤方
小连翘（二钱） 芍药（一钱） 槟榔（二钱） 木香（七分） 甘草（三分）
上五味。以水二升。煮取一升。去滓。分温服。大肠热则致后重。寒则致惊溏。若嗳息者。谷饪也。夏月。腹痛而
泄泻。痛一阵。泄一阵。此为肠间热也。黄连香薷饮主之。发热烦渴。大便如卵黄者。热泻也。无渴而清澄者。惊溏也。
病患为冷食所伤。遂胁寒而利。如鸭屎。此为惊溏也。抉脾汤主之。下利日数十行。血液内竭。脾气空乏。烦渴呕逆。
饮食不能。此为禁口痢也。莲肉饮主之。
莲肉饮方
莲肉（炒二钱） 黄连（三分） 食盐（炒二分）
上三味。以水一升。煮取七合。去滓。内萝卜汗。搅调。分服。下利。阴阳内竭。胸腹悸动。饮食不能。宜熏脐温
之。痢疾。腰腹绞痛。诸方无验者。灸章门京门。若腰腹诸穴。痢下旬余。体瘦血燥。四肢微冷。反面色缘缘正赤。此
为孤阳沸郁所致也。麦门冬汤服之。大便滑泄。胸腹雷鸣。脉沉弦。此为脾冷所致也。薯蓣汤主之。
薯蓣汤方
薯蓣（一钱） 茯苓（一钱） 白术（五分） 人参（三分） 青皮（三分） 半夏（一钱） 缩砂（三分） 香
附子（浸童便灸五分） 藿香（三分） 莲蕊（三分） 甘草（三分） 生姜（三分）
上十一味。以水二升。煮取一升。去滓。分温服。脉微而数。微为阴虚。数为阳动。虚动相搏。孤阳不能独立体肤
自冷瘦。黎明大便溏。此为肾冷然也。宜七成汤主之。小阴病。二三日不已至四五日。腹痛。小便不利。四肢沉重疼痛。
自下利者。此为有水气。真武汤主之。病患。阴阳俱厥。脾气孤弱。五腋注下。下焦不阖。清便飧泄。若腹筑湫而痛者。
参茯白术散主之。
参茯白术散方
人参 白术 茯苓 山药 缩砂 陈皮 干姜 莲肉（各三钱） 藿香 白扁豆 薏苡 甘草（各半减）
上十二味。捣筛为散。或以胶饴。调匀服之。痢疾。禁妄攻。若妄攻者。瘀浊未减而血液必竭也。痢疾。要屡视口
内。若齿焦者。为走马疳也。痢毒疫热。若疮疹毒。宜翘花煎服之。
翘花煎方
翘花（五钱） 白糖（五钱）
上二味。以水二升。煮翘花。去滓。内糖服之。痢热不减。烦渴而昏睡。其脉弦急者。此为发惊之渐也。溏泄家。
要减饮食。若妄食者。为难疗。痢后血液燥竭。脚肉殊脱削。若挛急而疼痛。此为鹤膝风也。痢疾。后重而努力。必致
脱肛。以下焦虚故也。痢下数旬不解。血液干竭。而脉细数者。转属疳泻也。病患脉沉而迟。面少赤。身有微热。下利
清谷者。必郁冒。汗出而解。其人必微热。所以然者。其面戴阳下虚故也。面体羸瘠。脾胃虚弱。饮食减少。苦泻泄者。
宜白术膏服之。
白术膏方
白术（一斤焙） 茯苓（四两） 陈皮（四两）
上三味。以水一斗。熬取三升。滤去渣。又以水八升。熬取二升。将渣捣烂。又以水五升。熬取一升。都合前汁。
再熬至二升。加蜜四两。熬至稠。滴水成珠为度。每服弹丸大。日二三次。泻泄家。小盒饭少。今反多。是欲愈也。痢
疾为恙。以顺气活血为要。其气顺则里急减。其血活则泄利自愈。痢下。数月休作者。为休息痢也。病患泻泄。脉浮而
迟。此为表热里寒。其便必完谷也。四逆汤服之。少阴病。下利清谷。里寒外热。四肢厥。脉微欲绝者。通脉四逆汤主
之。加人参三分。前后二便。易其位而出。名曰交肠。此为脏腑错杂所致也。痢下肠 。如鱼脑。若屋漏。目红唇燥。
此为气血败绝也。痢下。旬余不解。鲜血自利。脉微肩息。多呼少吸者死。下利。手足厥冷。无脉者灸之。不温。若脉
不还。反微喘者死。暴利。脉绝。手足厥冷。 时脉还。手足温者生。脉不还者死。痢下。体瘦脉虚。反能饮食者生。
不能饮食者死。体厥。脉微口渴。下利清谷。短气烦躁者死。痢下。数旬不解。呕哕足跗微肿。若吐蛔者死。问曰。大
便难。何以所致。答曰。脾实则大便难。虚则大便溏。不溏不难。其人必实健也。潮热便难。若谵语。若目中不了了者。
此为邪热在里也。大承气汤主之。病患不大便六七日。头痛有热者。大承气汤主之。孩儿胸腹。 胀硬满。大便不利。
此
为乳癖所致也。白花汤主之。体羸肌燥。大肠血干。大便硬者。宜波淡花 之。波淡花一斤。白糖一斤。捣如泥。盛壶
密盖。每 梅实大。 阳脉。浮而涩。浮则胃气强。涩则小便数。浮涩相搏。大便则难。其脾为约。麻仁丸主之。
麻仁丸方
麻子仁（四钱） 芍药（四钱） 大黄（八钱） 浓朴（二钱） 枳实（一钱） 杏仁（四钱）
上六味为末。炼蜜为丸。桐子大。饮服十丸。日三服。渐加。以和为度。阳明病。自汗出。若发汗小便自利者。此
为津液内竭。虽硬不可攻之。当须自欲大便。宜蜜煎导而通之。
蜜煎导方
蜜（七合）
一味。内铜器中。微火煎之。稍凝似饴状。扰之勿令焦者。欲可丸。并手捻作挺令头锐。大如指长。二寸许。当热
时急作。冷则硬。以内谷道中。以手急抱。欲大便时。乃去之。病患体羸血燥。大便结燥者。以热汤内触器。乘热而登。
须臾当肛润使通也。病患气乏体羸。肠内血燥。大便必硬。宜逐肠丸主之。
逐肠丸方
巴豆（四钱） 硫黄（二钱） 槟榔（二钱） 甘松（二钱） 铁落（四钱） 大黄（四钱）
上六味。捣筛。酒糊丸。枳实大。别蜀椒二钱。以水二升。煮取一升。去滓。洗掌中。拭净更涂胡麻油。仍握一丸。
男左女右。以大便通为度。若不通。更握新者。或左右俱握。若通而不禁者。以冷水。频洗掌中。盒饭顿止。问曰。小
便不利者。何谓也。答曰。膀胱以气化理。寒热虚实。其气不行。仍失转化。小便不利。即是也。病患。脉数身热。渴
而溲便涩者。膀胱有客热。若脉涩而身微肿者。此为风湿也。病患腹硬脉沉。而小便不利。是癖块令然也。病患脉浮微
热消渴。小便不利者。五苓散主之。身肿。小便少。水气在皮肤中。四肢聂聂动者。宜防己茯苓汤。
防己茯苓汤方
防己（一钱） 黄 （一钱） 桂枝（三分） 茯苓（一钱） 甘草（三分） 上五味。以水二升。煮取一升。分
温三服。风湿。脉浮身重。汗出恶风。小便少者。宜防己黄 汤。
防己黄 汤方
防己（一钱） 甘草（三分） 白术（三分） 黄 （五分）
上锉麻豆大。每抄二钱七。生姜一片。大枣一枚。水盏半。煎八分。去滓。分温服。风水恶风。一身悉肿。脉浮不
渴。续自汗出。无大热。越婢汤主之。
越婢汤方
麻黄（一钱） 石膏（一钱） 生姜（三分） 大枣（二枚） 甘草（二分）
上五味。以水二升。先煮麻黄。去上沫。内诸药煮取一升。分温三服。身重。从腰以上。必汗出下无汗。腰髋驰痛。
如有物在皮中状。剧者不能食。身疼重烦燥。小便不利者。桂枝加黄 汤主之。病患溲便涩痛而旁射。是膀胱热也。滑
石汤主之。
滑石汤方
滑石（一钱） 芒硝（三分） 柏实（五分） 茯苓（一钱） 甘草（三分） 生姜（三分）
上六味。以水二升。煮取一升。去滓。分温服。肚腹硬满。腰脚挛急。而小便不利。此脬痹也。病患渗道癃闭所致。
腹满短气者。 麻汤主之。
麻汤方
麻（一钱） 茯苓（二钱） 豆黄卷（三钱） 马舄（二钱） 甘草（三分）
上五味。以水二升。煮取一升。去滓。分温服。病患。元阳减耗。胞胱乏转化。遂腹胀。小便不利。医欲以淡渗利
之。是误也。得之反益剧。短气息迫。宜折水汤主之。
折水汤方
桑白皮（一钱） 吴茱臾（五分） 枳实（七分） 槟榔（一钱） 茯苓（一钱） 缩砂（五分） 香附（五分） 附
子（三分） 生姜（三分） 麦芽（二钱）
上十味。以水二升。先煮麦芽。减五合。内诸药。煮取一升。去滓。分温服。病患胸腹大满。结热不解。若香港脚心
悸。俱与降气散。
降气散方
田螺（去壳黑炒一两） 麝香（三分）
上二味。研均。每钱七。以白汤服之。病肿胀稍解。但足跗难消者。宜附子煎。
附子煎方
附子（四钱） 樟脑（四钱）
上二味。以酒五升。煎取三升。温熟。频频熨之。日五六次。病患。脬转而小便不利者。阴阳熨法主之。疳瘕鼓满。
小便不利者。与黑散。
黑散方
虾蟆（一两） 缩砂（一两）
上二味。为黑炒。存性。研筛。以生姜汤服之。病患。小腹挛急。心胸中动气。此为元脏虚也。溺必如泔汁。宜破
故汤。
破故汤方
破故（一钱） 鹿角霜（五分） 茯苓（一钱） 连蕊（三分） 红曲（五分） 甘草（三分）
上六味。以水二升。煮取一升。去滓。分温服。病患胸腹肿满。如石硬。虽体气虚弱。须先破之。有故无害。此为
霸道也。桃花煎破之。
Question: What is referred to as a disease of the Lower Jiao (Lower Burner)?
Answer: Difficulty in defecation, or diarrhea; difficulty in urination, or urinary incontinence; as well as flaccidity and weakness of the limbs, and pain in the feet. These constitute diseases of the Lower Jiao.
If it is a Taiyang disease (disease of the Taiyang channel), presenting with Guizhi syndrome (characterized by fever, sweating, aversion to wind, and a floating, moderate pulse), and the physician erroneously applies purgative therapy, leading to unceasing diarrhea. If the pulse is rapid/crisp (Cu Mai), it indicates that the exterior pattern has not yet resolved. Ge Gen Huang Qin Huang Lian Tang (Kudzu Root, Scutellaria, and Coptis Decoction) should be administered.
Ge Gen Huang Qin Huang Lian Tang Formula
Ge Gen (Puerariae Lobatae Radix, 5 fen) Gan Cao (Glycyrrhizae Radix et Rhizoma, 5 fen) Huang Qin (Scutellariae Radix, 5 fen) Huang Lian (Coptidis Rhizoma, 3 fen)
Take the above four herbs. Add two sheng of water. First decoct Ge Gen until the volume reduces by half a sheng. Then add the remaining herbs. Decoct to obtain one sheng of liquid. Strain off the dregs. Divide into three warm doses.
If there is a combined disease of Taiyang and Shaoyang (disease of the Shaoyang channel), presenting with spontaneous diarrhea, give Huang Qin Tang (Scutellaria Decoction). If vomiting occurs, Huang Qin Jia Ban Xia Sheng Jiang Tang (Scutellaria Decoction with Added Pinellia and Fresh Ginger) should be administered.
Huang Qin Tang Formula
Huang Qin (Scutellariae Radix, 3 fen) Gan Cao (Glycyrrhizae Radix et Rhizoma, 3 fen) Shao Yao (Paeoniae Radix Alba, 1 qian) Da Zao (Jujubae Fructus, 3 pieces)
Take the above four herbs. Add two sheng of water. Decoct to obtain one sheng of liquid. Strain off the dregs. Divide into warm doses.
If the pulse is floating, urination is difficult, accompanied by slight fever and Xiao Ke (wasting-thirst/polydipsia), and stool is watery diarrhea with a yellow color, this is Re Xie (Heat Diarrhea). Wu Ling San (Five-Ingredient Powder with Poria) should be administered. If there is fever and aversion to cold, vomiting and diarrhea with irritability and thirst, and if abdominal pain is present, Qing Ning Tang should be administered.
Qing Ning Tang Formula
Ge Gen (Puerariae Lobatae Radix, 5 fen) Ren Shen (Panacis Ginseng Radix, 3 fen) Cang Zhu (Atractylodis Rhizoma, 3 fen) Fu Ling (Poria, 5 fen) Mu Xiang (Aucklandiae Radix, 3 fen) Huo Xiang (Agastaches Herba, 3 fen) Gan Cao (Glycyrrhizae Radix et Rhizoma, 2 fen)
Take the above seven herbs. Add two sheng of water. Decoct to obtain seven he of liquid. Strain off the dregs. Divide into warm doses.
If fever and sweating persist without resolution, and there is epigastric fullness and hardness, with vomiting and diarrhea, Da Chai Hu Tang (Greater Bupleurum Decoction) should be administered.
In cases of diarrhea, if the pulse is slow and slippery, it indicates Excess (Shi). Since the diarrhea has not ceased, urgent purgation is required. Da Cheng Qi Tang (Major Order the Qi Decoction) should be administered.
In cases of diarrhea, if the pulse is unexpectedly slippery, it indicates that there are pathogenic accumulations to be expelled; healing will occur after evacuation. Da Cheng Qi Tang should be administered.
If diarrhea has improved but recurs at the same time of year, month, day, or hour, it is because the underlying cause of pain has not been fully eliminated. Purging is indicated. Da Cheng Qi Tang should be administered.
In Shaoyin disease (disease of the Shaoyin channel), presenting with Si Ni (cold extremities), or if the patient coughs, palpitations, difficulty in urination, abdominal pain, or diarrhea with a sensation of heaviness in the anus (Xie Li Xia Zhong), Si Ni San (Four Counterflow Powder) should be administered.
In cases of diarrhea, if the pulse is deep and wiry (Chen Xian), it indicates heaviness in the anus. If the pulse is large, the condition has not ceased. Ying Fan Tang should be administered.
Ying Fan Tang Formula
Ying Fan (Hard Rice, 2.5 qian, half charred black, half raw) Bing Lang (Arecae Semen, 1 qian) Shao Yao (Paeoniae Radix Alba, 1 qian) Zhi Shi (Aurantii Fructus Immaturus, 5 fen) Fu Ling (Poria, 1 qian) Gan Cao (Glycyrrhizae Radix et Rhizoma, 3 fen) Da Zao (Jujubae Fructus, 5 pieces) Sheng Jiang (Zingiberis Rhizoma Recens, 3 fen)
Take the above eight herbs. Add two sheng of water. First decoct the Ying Fan until the volume reduces by five he. Then add the other herbs. Decoct to obtain one sheng of liquid. Strain off the dregs. Divide into warm doses. If there is heat, add Huang Lian (Coptidis Rhizoma) and Huang Qin (Scutellariae Radix). If there is cold, add Fu Zi (Aconiti Lateralis Radix Preparata) and Gan Jiang (Zingiberis Rhizoma).
If an infant experiences tenesmus (urgent, painful straining), with stool resembling glue, and wrinkled facial skin, this is Li Ji (Dysentery). Qiong Zhi Tang should be administered.
Qiong Zhi Tang Formula
Qiong Zhi (Agar, 5 fen) Zhi Shi (Aurantii Fructus Immaturus, 5 fen) Shao Yao (Paeoniae Radix Alba, 1 qian) Bing Lang (Arecae Semen, 5 fen) Da Zao (Jujubae Fructus, 3 pieces) Gan Cao (Glycyrrhizae Radix et Rhizoma, 2 fen) Sheng Jiang (Zingiberis Rhizoma Recens, 3 fen)
Take the above seven herbs. Add two sheng of water. Decoct to obtain one sheng of liquid. Strain off the dregs. Divide into warm doses.
In Taiyang disease, if the exterior syndrome persists but multiple purgatives have been applied, leading to Xie Re Li (Diarrhea accompanying heat), with unceasing diarrhea, epigastric fullness and hardness, and unresolved exterior and interior pathogens, Gui Zhi Ren Shen Tang (Cinnamon Twig and Ginseng Decoction) should be administered.
Gui Zhi Ren Shen Tang Formula
Gui Zhi (Cinnamomi Ramulus, 3 fen) Gan Cao (Glycyrrhizae Radix et Rhizoma, 2 fen) Bai Zhu (Atractylodis Macrocephalae Rhizoma, 3 fen) Ren Shen (Panacis Ginseng Radix, 2 fen) Gan Jiang (Zingiberis Rhizoma, 3 fen)
Take the above five herbs. Add two sheng of water. First decoct the first four herbs to obtain one sheng of liquid. Then add Rou Gui (Cinnamomi Cortex). Boil for three boils. Strain off the dregs. Divide into warm doses.
In cases of diarrhea, if the stool is fishy and foul-smelling, accompanied by irritability and pain in the lower back and hips, Jian Hong Wan should be administered.
Jian Hong Wan Formula
Mi Xiang (Frankincense, 4 qian) Suo Sha (Amomi Fructus Rotundus, 4 qian) Xiong Dan (Ursi Fel, 1 qian) A Pian (Opium, 1 qian) Long Nao (Borneolum Syntheticum, 3 fen) She Xiang (Moschus, 1 fen) Gan Cao (Glycyrrhizae Radix et Rhizoma, 3 fen)
Grind the above seven herbs into powder and sieve. Use hot wine to make a paste for pills, sized like wu-tong seeds. Take 2-3 pills per dose.
If there is tenesmus with intermittent passage, irritability, thirst, and astringent urination, or if red blood appears in the stool, Shan Qi Tang should be administered.
Shan Qi Tang Formula
Shan Qi Gen (Radix Panacis Japonensis, 2 qian) Shan Yao (Dioscoreae Rhizoma, wine-processed and stir-fried, 1 qian) Shao Yao (Paeoniae Radix Alba, 2 qian) Zhi Shi (Aurantii Fructus Immaturus, 5 fen) Da Zao (Jujubae Fructus, 3 pieces) Sheng Jiang (Zingiberis Rhizoma Recens, 3 fen) Gan Cao (Glycyrrhizae Radix et Rhizoma, 2 fen)
Take the above seven herbs. Add two sheng of water. Decoct to obtain one sheng of liquid. Strain off the dregs. Divide into warm doses.
If there is tenesmus, severe cramping pain in the waist and abdomen with irritability, take hot water, place the container against the body, and sit on it. The steam will soothe the waist and abdomen naturally. This is due to the rapid unblocking of the bowels.
In cases of diarrhea, if the hands and feet are slightly cold and the pulse is choppy (Se), do not use further purgation. Zhu Xue San should be administered.
Zhu Xue San Formula
Dang Gui (Angelicae Sinensis Radix, 4 qian) Fu She (Aspis Formosae Venenum, 3 qian, charred black)
Grind the above two herbs into powder and sieve. Take with warm wine.
If there is sudden onset of high fever and diarrhea, with a floating pulse, thirst, and difficulty in urination, Wu Ling San (Five-Ingredient Powder with Poria) should be administered.
If there is fever, a rapid pulse, abdominal pain, frequent urge to defecate, irritability, thirst, and scanty urine, this is Xia Xie (Mass Diarrhea/Dysentery-like diarrhea). The stool resembles porridge. The treatment method requires purging. If the pathogen is not exhausted, the dysentery will not cease. Dysentery is caused by turbid stasis, hence the tenesmus and intestinal mucus. There must be urgency (Li Ji). If there is no intestinal mucus, there is no tenesmus. If the pulse is slippery and rapid, pus and blood should be passed. If there is acute abdominal pain and diarrhea with a foul odor that is unbearable, this is Food Retention (Shi Ji). Sudden diarrhea in infants cannot be determined solely by Yang deficiency. Chronic dysentery cannot be determined solely by Yin deficiency. Sudden diarrhea often leads to massive loss of Yang. Chronic dysentery often involves stasis and heat.
In Shaoyin disease, presenting with diarrhea and passage of pus and blood, or if the rectum prolapses, Tao Hua Tang (Peach Kernel Decoction) should be administered.
Tao Hua Tang Formula
Chi Shi Zhi (Halloysit Rubrum, 5 fen) Gan Jiang (Zingiberis Rhizoma, 3 fen) Jing Mi (Oryza Sativa, 3 fen)
Take the above three herbs. Add one sheng of water. Cook the rice until soft. Strain off the dregs. Take warm.
In cases of diarrhea, if the stool makes a bubbling sound like "ge bu" (a type of aquatic creature), this is Qi Li (Qi Dysentery). Qi Li Wan should be administered.
Qi Li Wan Formula
He Zi Pi (Terminaliae Chebulae Pericarpium, 4 qian) Mi Xiang (Frankincense, 2 qian) Ren Shen (Panacis Ginseng Radix, 3 fen)
Grind the above three herbs into powder and sieve. Make pills with honey, sized like wu-tong seeds. Take 20 pills per dose.
In dysentery, if tenesmus does not resolve, and the pulse is weak and trembling, this is a sign of bloody stool. Xiao Lian Qiao Tang should be administered.
Xiao Lian Qiao Tang Formula
Xiao Lian Qiao (Forsythiae Fructus, 2 qian) Shao Yao (Paeoniae Radix Alba, 1 qian) Bing Lang (Arecae Semen, 2 qian) Mu Xiang (Aucklandiae Radix, 7 fen) Gan Cao (Glycyrrhizae Radix et Rhizoma, 3 fen)
Take the above five herbs. Add two sheng of water. Decoct to obtain one sheng of liquid. Strain off the dregs. Divide into warm doses.
Heat in the Large Intestine causes tenesmus; Cold causes Jing Tang (Startle Loose Stool). If there is belching, it is due to undigested food. In summer, if there is abdominal pain and diarrhea, with pain coming in waves followed by diarrhea, this is Heat in the Intestines. Huang Lian Xiang Ru Yin (Coptis and Elsholtzia Drink) should be administered.
If there is fever, irritability, and thirst, and the stool resembles egg yolk, this is Re Xie (Heat Diarrhea). If there is no thirst and the stool is clear and pure, this is Jing Tang (Startle Loose Stool).
If a patient is injured by cold food, leading to cold in the hypochondrium and diarrhea, with stool resembling duck feces, this is Jing Tang. Jue Pi Tang should be administered.
If there is diarrhea dozens of times a day, internal exhaustion of blood, emptiness and deficiency of Spleen Qi, irritability, thirst, vomiting, and inability to eat, this is Jin Kou Li (Forbidden Mouth Dysentery). Lian Rou Yin should be administered.
Lian Rou Yin Formula
Lian Rou (Nelumbinis Plumula, stir-fried, 2 qian) Huang Lian (Coptidis Rhizoma, 3 fen) Yan Yan (Sal, stir-fried, 2 fen)
Take the above three herbs. Add one sheng of water. Decoct to obtain seven he of liquid. Strain off the dregs. Add radish juice, mix well, and divide into doses.
In cases of diarrhea, if both Yin and Yang are internally exhausted, with palpitations in the chest and abdomen, and inability to eat, moxibustion on the umbilicus should be used to warm the area.
For dysentery with severe waist and abdominal pain where various formulas fail, moxa points Zhang Men and Jing Men.
If after treating the waist and abdomen, dysentery persists for over half a month, with emaciation, dry blood, slightly cold limbs, and a flushed face, this is caused by solitary Yang boiling and stagnating. Mai Men Dong Tang should be administered.
If there is slippery diarrhea, borborygmus in the chest and abdomen, and a deep, wiry pulse, this is caused by Spleen Cold. Shu Yu Tang should be administered.
Shu Yu Tang Formula
Shu Yu (Dioscoreae Rhizoma, 1 qian) Fu Ling (Poria, 1 qian) Bai Zhu (Atractylodis Macrocephalae Rhizoma, 5 fen) Ren Shen (Panacis Ginseng Radix, 3 fen) Qing Pi (Citri Reticulatae Pericarpium Viride, 3 fen) Ban Xia (Pinelliae Rhizoma Preparatum, 1 qian) Suo Sha (Amomi Fructus Rotundus, 3 fen) Xiang Fu Cyperi Rhizoma, soaked in child's urine and moxa-ed, 5 fen) Huo Xiang (Agastaches Herba, 3 fen) Lian Rui (Nelumbinis Plumula, 3 fen) Gan Cao (Glycyrrhizae Radix et Rhizoma, 3 fen) Sheng Jiang (Zingiberis Rhizoma Recens, 3 fen)
Take the above eleven herbs. Add two sheng of water. Decoct to obtain one sheng of liquid. Strain off the dregs. Divide into warm doses.
If the pulse is faint and rapid, faint indicates Yin deficiency, and rapid indicates Yang movement. When deficiency and movement clash, solitary Yang cannot stand alone, leading to cold and emaciation of the skin and body. Morning loose stools indicate Kidney Cold. Cheng Qi Tang should be administered.
In Shaoyin disease, if symptoms persist from day 2-3 to day 4-5, with abdominal pain, difficulty in urination, heavy and painful limbs, and spontaneous diarrhea, this indicates Water Qi (Fluid Retention). Zhen Wu Tang should be administered.
If a patient has reversal of both Yin and Yang, isolated and weak Spleen Qi, downward flow of Qi from the Five Viscera, failure of the Lower Jiao to close, resulting in complete digestion in stool or diarrhea, and if there is throbbing pain in the abdomen, Shen Fu Bai Zhu San should be administered.
Shen Fu Bai Zhu San Formula
Ren Shen (Panacis Ginseng Radix), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Fu Ling (Poria), Shan Yao (Dioscoreae Rhizoma), Suo Sha (Amomi Fructus Rotundus), Chen Pi (Citri Reticulatae Pericarpium), Gan Jiang (Zingiberis Rhizoma), Lian Rou (Nelumbinis Plumula) (each 3 qian); Huo Xiang (Agastaches Herba), Bai Bian Dou (Dolichoris Semen), Yi Yi Ren (Coicis Semen), Gan Cao (Glycyrrhizae Radix et Rhizoma) (each half dose)
Grind the above twelve herbs into powder. Mix evenly with maltose syrup and take.
Dysentery prohibits reckless purging. If purged recklessly, turbid stasis will not decrease, and blood will surely be exhausted.
In dysentery, frequently inspect the mouth. If teeth are scorched black, this is Zou Ma Gan (Rapid Gangrene of the Gums). For dysentery toxins, epidemic heat, or carbuncle-rash toxins, Qiao Hua Jian should be taken.
Qiao Hua Jian Formula
Qiao Hua (Flower of Forsythia, 5 qian) Bai Tang (White Sugar, 5 qian)
Add two sheng of water. Decoct Qiao Hua. Strain off dregs. Add sugar and take.
If dysentery heat does not subside, with irritability, thirst, drowsiness, and a string-taut, rapid pulse, this is the beginning of Fa Jing (Onset of Convulsions).
Patients with loose stools must reduce their diet. If they eat recklessly, it will be difficult to treat.
After dysentery, if blood is dry and exhausted, leg muscles are significantly wasted, and if there is contraction and pain, this is He Xi Feng (Crane Knee Wind).
In dysentery, if there is tenesmus and straining, it will inevitably lead to rectal prolapse due to Lower Jiao deficiency.
If dysentery persists for many days, blood is dry and exhausted, and the pulse is fine and rapid, it transforms into Gan Xie (Gan Diarrhea).
If a patient has a deep and slow pulse, slight facial redness, slight body heat, and diarrhea with undigested food, they will likely experience Yu Mao (dizziness and confusion). Sweating will resolve it. The person will have slight fever. This is because of Dai Yang (floating Yang on the face) and Lower Jiao deficiency.
If the body is emaciated, Spleen and Stomach are weak, food intake is reduced, and suffering from diarrhea, Bai Zhu Gao should be taken.
Bai Zhu Gao Formula
Bai Zhu (Atractylodis Macrocephalae Rhizoma, roasted, 1 jin) Fu Ling (Poria, 4 liang) Chen Pi (Citri Reticulatae Pericarpium, 4 liang)
Add one dou of water. Simmer to obtain three sheng of liquid. Filter out residue. Add another eight sheng of water. Simmer to obtain two sheng. Mash the residue. Add another five sheng of water. Simmer to obtain one sheng. Combine all liquids. Simmer again to two sheng. Add four liang of honey. Simmer until thick, testing by dripping to form beads. Take pill-sized doses, 2-3 times daily.
For patients with diarrhea, if they usually eat little but now eat more, it indicates recovery is near.
Dysentery requires regulating Qi and invigorating Blood as the key. Regulated Qi reduces urgency; invigorated Blood heals diarrhea spontaneously.
Dysentery recurring monthly for several months is called Xiu Xi Li (Resting Dysentery).
If a patient has diarrhea with a floating and slow pulse, this is Exterior Heat and Interior Cold. The stool will contain undigested food. Si Ni Tang should be taken.
In Shaoyin disease, presenting with diarrhea of undigested food, Interior Cold with Exterior Heat, cold extremities, and a faint pulse nearly imperceptible, Tong Mai Si Ni Tang should be administered. Add Ren Shen (Panacis Ginseng Radix), 3 fen.
If the anterior and posterior orifices exchange positions in excretion, it is called Jiao Chang (Crossed Intestines). This is caused by disordered Zang-Fu organs.
If dysentery stool resembles fish brain or leaking roof water, with red eyes and dry lips, this is exhaustion of Qi and Blood.
If dysentery persists for over ten days, with spontaneous bleeding, faint pulse, shortness of breath, more exhaling than inhaling, the prognosis is fatal.
In diarrhea, if hands and feet are cold and pulseless, apply moxibustion. If warmth does not return, or pulse does not recover, and slight panting occurs, the prognosis is fatal.
In sudden profuse diarrhea, if pulse disappears and hands/feet are cold, but pulse occasionally returns and hands/feet become warm, the prognosis is favorable (survival). If pulse does not return, the prognosis is fatal.
In dysentery, if the body is emaciated and pulse is weak, but the patient can still eat, the prognosis is favorable. If unable to eat, the prognosis is fatal.
If the body is cold, pulse is faint, thirsty, with diarrhea of undigested food, shortness of breath, and irritability, the prognosis is fatal.
In dysentery persisting for many days, with vomiting, hiccuping, slight swelling of the dorsum of the foot, or spitting roundworms, the prognosis is fatal.
Question: What causes difficulty in defecation?
Answer: Spleen Excess causes difficulty in defecation; Spleen Deficiency causes loose stools. If neither loose nor difficult, the person is healthy.
If there is tidal fever with difficulty in defecation, delirium, or blurred vision, this is Pathogenic Heat in the Interior. Da Cheng Qi Tang should be administered.
If a patient has not had a bowel movement for six or seven days, with headache and fever, Da Cheng Qi Tang should be administered.
If a child has a distended, hard, and full chest and abdomen with difficulty in defecation, this is caused by Ru Pi (Milk Accumulation). Bai Hua Tang should be administered.
If the body is emaciated, skin is dry, Large Intestine blood is dry, and stool is hard, use Bo Dan Hua. Bo Dan Hua (1 jin) and White Sugar (1 jin) are pounded into a paste, stored in a pot with a tight lid. Take a size similar to a plum pit.
Yang Pulse: Floating and Choppy. Floating indicates strong Stomach Qi; Choppy indicates frequent urination. Floating and Choppy interacting causes difficulty in defecation. This is Pi Yue (Spleen Constriction). Ma Ren Wan should be administered.
Ma Ren Wan Formula
Ma Zi Ren (Cannabis Fructus, 4 qian) Shao Yao (Paeoniae Radix Alba, 4 qian) Da Huang (Rhei Radix et Rhizoma, 8 qian) Hou Po (Magnoliae Officinalis Cortex, 2 qian) Zhi Shi (Aurantii Fructus Immaturus, 1 qian) Xing Ren (Armeniacae Semen Amarum, 4 qian)
Make the above six herbs into powder. Form pills with refined honey, sized like wu-tong seeds. Take 10 pills with water, three times daily. Gradually increase dosage until harmony is achieved.
In Yangming disease, with spontaneous sweating, or after sweating with free urination, this indicates internal exhaustion of Body Fluids. Although the stool is hard, do not purge. Wait for the patient's natural desire to defecate. Mi Jian Dao (Honey Suppository) should be used to facilitate passage.
Mi Jian Dao Formula
Mi (Honey, 7 he)
Place the single herb in a copper vessel. Simmer gently over low fire until slightly condensed like maltose. Stir to prevent burning. When moldable, shape into suppositories by hand while hot, pointed at the head, about two cun long. Insert into the anus while warm (hardens when cool). Hold tightly with hand. Remove when urge to defecate arises.
For patients with emaciation, dry blood, and hard stool, use hot water in a basin, sit on it while hot, and the anus will moisten and open shortly.
For patients with Qi deficiency, emaciation, dry intestinal blood, and hard stool, Zhu Chang Wan should be administered.
Zhu Chang Wan Formula
Ba Dou (Crotonis Fructus, 4 qian) Liu Huang (Sulfur, 2 qian) Bing Lang (Arecae Semen, 2 qian) Gan Song (Nardostachyos Radix et Rhizoma, 2 qian) Tie Luo (Ferrum Limatura, 4 qian) Da Huang (Rhei Radix et Rhizoma, 4 qian)
Grind the above six herbs into powder. Form pills with wine paste, sized like Zhi Shi. Separately, boil Shu Jiao (Zanthoxyli Pericarpium), 2 qian, in two sheng of water to obtain one sheng. Strain. Wash palms with this liquid. Wipe clean and apply Sesame Oil. Hold one pill. Male: left hand. Female: right hand. Stop when bowel movement occurs. If no movement, hold a new one. Or hold in both hands. If movement occurs but cannot be controlled, wash palms frequently with cold water to stop it.
Question: What is meant by difficulty in urination?
Answer: The Bladder relies on Qi transformation. Whether Cold, Heat, Excess, or Deficiency, if Qi does not move, transformation fails, resulting in difficulty in urination.
If a patient has a rapid pulse, fever, thirst, and astringent urination, this is Guest Heat in the Bladder. If the pulse is choppy and the body is slightly swollen, this is Wind-Dampness.
If the abdomen is hard, pulse is deep, and urination is difficult, this is caused by Pi Kuai (Accumulations/Masses).
If the pulse is floating, with slight fever, wasting-thirst, and difficulty in urination, Wu Ling San (Five-Ingredient Powder with Poria) should be administered.
If there is body swelling, scanty urine, Water Qi in the skin, and tremulous movements in the limbs, Fang Ji Fu Ling Tang should be administered.
Fang Ji Fu Ling Tang Formula
Fang Ji (Stephaniae Tetrandrae Radix, 1 qian) Huang Qi (Astragali Radix, 1 qian) Gui Zhi (Cinnamomi Ramulus, 3 fen) Fu Ling (Poria, 1 qian) Gan Cao (Glycyrrhizae Radix et Rhizoma, 3 fen)
Take the above five herbs. Add two sheng of water. Decoct to obtain one sheng. Divide into three warm doses.
In Wind-Dampness, if the pulse is floating, body is heavy, sweating with aversion to wind, and urine is scanty, Fang Ji Huang Qi Tang should be administered.
Fang Ji Huang Qi Tang Formula
Fang Ji (Stephaniae Tetrandrae Radix, 1 qian) Gan Cao (Glycyrrhizae Radix et Rhizoma, 3 fen) Bai Zhu (Atractylodis Macrocephalae Rhizoma, 3 fen) Huang Qi (Astragali Radix, 5 fen)
Cut into hemp-seed size. Take 2.7 qian per dose. Add one slice of Sheng Jiang (Zingiberis Rhizoma Recens) and one Da Zao (Jujubae Fructus). Add one and a half cups of water. Decoct to eight parts. Strain. Divide into warm doses.
In Feng Shui (Wind Edema), with aversion to wind, whole-body swelling, floating pulse, no thirst, continuous sweating, and no significant heat, Yi Bi Tang should be administered.
Yi Bi Tang Formula
Ma Huang (Ephedrae Herba, 1 qian) Shi Gao (Gypsum Fibrosum, 1 qian) Sheng Jiang (Zingiberis Rhizoma Recens, 3 fen) Da Zao (Jujubae Fructus, 2 pieces) Gan Cao (Glycyrrhizae Radix et Rhizoma, 2 fen)
Take the above five herbs. Add two sheng of water. First decoct Ma Huang, remove foam. Add other herbs. Decoct to obtain one sheng. Divide into three warm doses.
If the body is heavy, sweating only from the waist up, no sweating below,弛缓 pain in the waist and hips, sensation of something in the skin, severe cases unable to eat, body pain, heaviness, irritability, and difficulty in urination, Gui Zhi Jia Huang Qi Tang should be administered.
If urination is astringent, painful, and spraying sideways, this is Bladder Heat. Hua Shi Tang should be administered.
Hua Shi Tang Formula
Hua Shi (Talcum, 1 qian) Mang Xiao (Natrii Sulfas, 3 fen) Bai Shi (Platycladi Semen, 5 fen) Fu Ling (Poria, 1 qian) Gan Cao (Glycyrrhizae Radix et Rhizoma, 3 fen) Sheng Jiang (Zingiberis Rhizoma Recens, 3 fen)
Take the above six herbs. Add two sheng of water. Decoct to obtain one sheng. Strain. Divide into warm doses.
If the abdomen is hard and full, legs and feet are cramped, and urination is difficult, this is Pao Bi (Bladder Obstruction).
If urethral obstruction causes abdominal fullness and shortness of breath, Ting Li Ma Huang Tang should be administered.
Ting Li Ma Huang Tang Formula
Ting Li (Descurainiae Semen seu Lepidii Semen, 1 qian) Fu Ling (Poria, 2 qian) Dou Huang Juan (Sojae Semen Praeparatum, 3 qian) Ma Xi (Portulacae Herba, 2 qian) Gan Cao (Glycyrrhizae Radix et Rhizoma, 3 fen)
Take the above five herbs. Add two sheng of water. Decoct to obtain one sheng. Strain. Divide into warm doses.
If Yuan Yang (Primal Yang) is depleted, and the Bladder lacks transformative function, leading to abdominal distension and difficulty in urination, using diuretics (Dan Shen) is a mistake. It worsens the condition. With shortness of breath and distress, Zhe Shui Tang should be administered.
Zhe Shui Tang Formula
Sang Bai Pi (Mori Cortex, 1 qian) Wu Zhu Yu (Evodiae Fructus, 5 fen) Zhi Shi (Aurantii Fructus Immaturus, 7 fen) Bing Lang (Arecae Semen, 1 qian) Fu Ling (Poria, 1 qian) Suo Sha (Amomi Fructus Rotundus, 5 fen) Xiang Fu (Cyperi Rhizoma, 5 fen) Fu Zi (Aconiti Lateralis Radix Preparata, 3 fen) Sheng Jiang (Zingiberis Rhizoma Recens, 3 fen) Mai Ya (Hordei Fructus Germinatus, 2 qian)
Take the above ten herbs. Add two sheng of water. First decoct Mai Ya until volume reduces by five he. Add other herbs. Decoct to obtain one sheng. Strain. Divide into warm doses.
If the patient has massive chest and abdominal fullness, unresolved binding heat, or jiao ni (foot disease) with palpitations, Jiang Qi San should be administered.
Jiang Qi San Formula
Tian Luo (Vivipara Chinensis Shell, shell removed, charred black, 1 liang) She Xiang (Moschus, 3 fen)
Grind evenly. Take 7 qian per dose with white boiled water.
When swelling subsides slightly but the dorsum of the foot remains swollen, Fu Zi Jian should be used.
Fu Zi Jian Formula
Fu Zi (Aconiti Lateralis Radix Preparata, 4 qian) Zhang Nao (Borneolum, 4 qian)
Add five sheng of wine. Decoct to obtain three sheng. Warm and frequently apply as a compress, 5-6 times daily.
If the bladder is twisted causing difficulty in urination, use Yin Yang Moxibustion Method.
For Gan Xia (Gan Mass) with abdominal distension and difficulty in urination, give Hei San.
Hei San Formula
Ha Ma (Bufo Toad Skin, 1 liang) Suo Sha (Amomi Fructus Rotundus, 1 liang)
Charcoal-roast the above two herbs, preserving their nature. Grind and sieve. Take with ginger tea.
If the patient has lower abdominal cramping and moving Qi in the chest and heart, this is Yuan Zang (Kidney) Deficiency. Urine will resemble rice water. Po Gu Tang should be administered.
Po Gu Tang Formula
Po Gu Zhi (Psoraleae Fructus, 1 qian) Lu Jiao Shuang (Cervi Cornus Degelatinati Corneum, 5 fen) Fu Ling (Poria, 1 qian) Lian Rui (Nelumbinis Plumula, 3 fen) Hong Qu (Monascus Fermented Rice, 5 fen) Gan Cao (Glycyrrhizae Radix et Rhizoma, 3 fen)
Take the above six herbs. Add two sheng of water. Decoct to obtain one sheng. Strain. Divide into warm doses.
If the patient has massive chest and abdominal swelling, hard as stone, even if Qi and Body are weak, it must be broken first. "Having pathology means no harm." This is a "Hegemonic" (forceful) treatment. Tao Hua Jian should be used to break it.