脉浮大者死,及数者死。
身热脉数者死。
肠 下白沫,脉浮者死。如屋漏色者死。尘腐色者死。如鱼脑者死。大孔如竹筒者死。血热者死。
泄泻 脉沉而细疾或微,欲食不下,目睛不了了。又腹满泄、 溏,此阴寒
也。脉数疾,声亮,暴注下迫,渴烦,小便赤涩,水谷消化,此阳热也。虚则无
力,不禁固也,温之。实则圊不便,虚坐努积,下之。
积泄,脾部脉沉弦,宜逐积。
痰积,在太阴分,宜萝卜子吐之。
水恣泄,乃大引饮,热在其上,水多入下,胃经无热不胜,宜五苓。
风泄,久风为飧泄,水谷不化而完出也,肝病传脾,宜泻肝补脾。
脾泄腹胀满,肠鸣,食不化,呕吐,宜理中汤(一云肠鸣食不化脾虚)。
气泻,躁怒不常,伤动其气,肺气乘脾脉弦而逆,宜调气。
惊泄者,心受惊则气乱,心气不通水入。
理中丸 治冷泻、脾泻、虚泄。
白术(土炒) 干姜(炮焦) 甘草(炙) 人参 为末粥丸。
胃风丸 治气虚。
四君子 升麻 芍药
胃补丸 治气虚下溜。
四君子 芍药(炒) 升麻
平胃五苓散 治湿泄、水恣泄、热泄。(此方治一切阳证。)
平胃散 五苓散 白术 芍药 甘草 热加芩 木通
流积丸 治瘀积下流。甚则吐之。
青黛 黄芩 神曲 海石
椒术丸 治湿。
川椒 苍术 肉豆蔻
脾泄丸
白术(二两炒) 神曲(一两半炒) 山楂 半夏(两半) 芍药(酒炒一两) 黄芩(一两半炒)
苍术(五钱) 虚加参、术、甘草,里急后重加槟榔、木香,荷叶煨饭丸。
止泄丸
肉豆寇(五钱) 活石(春一钱,夏二钱,秋一钱半) 寒加炒曲、茱萸,热加连、茯苓,
滑加诃子皮。
温六丸 青龙丸 俱可治
脉象浮大,或兼见数脉的,预后不良(主死)。
身体发热且脉象数的,预后不良(主死)。
大便下白色黏液,脉象浮的,预后不良(主死)。
大便颜色如屋漏之血(色暗红稀薄)的,预后不良(主死)。
大便颜色如尘腐(灰败无光泽)的,预后不良(主死)。
大便状如鱼脑(浑浊如浆)的,预后不良(主死)。
肛门松弛直开如竹筒状的,预后不良(主死)。
伴有血热证的,预后不良(主死)。
泄泻:脉象沉细而疾速,或微弱,想进食但吃不下,眼睛视物模糊不清。又有腹部胀满、大便溏薄,这是阴寒证。脉象数而疾速,声音洪亮,突然剧烈腹泻且肛门急迫窘迫,口渴烦躁,小便赤涩不利,水谷不消化,这是阳热证。虚证则无力固摄,不禁固,宜用温法治疗。实证则排便不畅,虚坐努责(想拉拉不出),宜用下法治疗。
积滞泄泻,脾部脉象沉弦,宜用攻逐积滞的方法。
痰积泄泻,病位在太阴分,宜用萝卜子催吐。
水饮恣意泄泻,是因大量饮水,热邪在上焦,水液多入下焦,胃经无热不能胜水,宜用五苓散。
风泄,久风转为飧泄(完谷不化),水谷不消化而原样排出,是肝病传脾,宜泻肝补脾。
脾泄,腹胀满,肠鸣,食物不消化,呕吐,宜用理中汤(一说肠鸣食不化属脾虚)。
气泄,急躁易怒无常,伤动其气,肺气乘袭脾脏,脉弦而逆乱,宜调气。
惊泄,心受惊吓则气机紊乱,心气不通导致水液代谢失常。
理中丸:治疗冷泻、脾泄、虚泄。
白术(土炒)、干姜(炮至焦黑)、甘草(炙)、人参,研为细末,用米粥泛丸。
胃风丸:治疗气虚。
四君子汤、升麻、芍药。
胃补丸:治疗气虚下陷。
四君子汤、芍药(炒)、升麻。
平胃五苓散:治疗湿泄、水恣泄、热泄。(此方治疗一切阳证。)
平胃散、五苓散、白术、芍药、甘草,热证加黄芩、木通。
流积丸:治疗瘀积下流。严重时宜催吐。
青黛、黄芩、神曲、海浮石。
椒术丸:治疗湿邪。
川椒、苍术、肉豆蔻。
脾泄丸:
白术(二两炒)、神曲(一两半炒)、山楂、半夏(一两半)、芍药(酒炒一两)、黄芩(一两半炒)、苍术(五钱)。虚证加人参、白术、甘草,里急后重加槟榔、木香,荷叶煨饭泛丸。
止泄丸:
肉豆蔻(五钱)、活石(春一钱,夏二钱,秋一钱半)。寒证加炒神曲、吴茱萸,热证加黄连、茯苓,滑脱加诃子皮。
温六丸、青龙丸:均可用于治疗。
If the pulse is floating and large, or rapid, the prognosis is fatal.
If the body is hot and the pulse is rapid, the prognosis is fatal.
If white mucus is discharged from the intestines and the pulse is floating, the prognosis is fatal. If the stool resembles the color of blood from a leaking roof (dark red and thin), it is fatal. If the color resembles dust and decay (dull and lusterless), it is fatal. If the consistency resembles fish brains (turbid and pasty), it is fatal. If the anus opens straight like a bamboo tube, it is fatal. If accompanied by blood-heat syndrome, it is fatal.
Diarrhea: If the pulse is deep, fine, and rapid, or faint; if there is an appetite but inability to eat; and if the eyes are blurry and unable to see clearly clearly. Additionally, abdominal fullness with loose stools indicates a Yin-cold syndrome. If the pulse is rapid and hurried, the voice is loud, there is sudden violent diarrhea with tenesmus (urgent and painful defecation), thirst, irritability, dark and scanty urination, and undigested food in stool, this indicates a Yang-heat syndrome. In deficiency cases, there is weakness and inability to retain stool; warming methods should be used. In excess cases, there is difficulty in defecation despite the urge (tenesmus without passage); purgative methods should be used.
For diarrhea due to accumulation, if the spleen area pulse is deep and wiry, methods to purge accumulation should be used.
For diarrhea due to phlegm accumulation, located in the Taiyin division, vomiting with Radish Seed (Lai Fu Zi) is appropriate.
For diarrhea caused by excessive water intake, where there is excessive drinking, heat is above, and water flows down, while the Stomach channel lacks heat to control the water, Wu Ling San (Five-Ingredient Powder with Poria) is indicated.
For wind-induced diarrhea, chronic wind transforms into Sundiexie (diarrhea with undigested food), where water and grain are not digested and pass out intact; this is Liver disease transmitting to the Spleen; draining the Liver and tonifying the Spleen is appropriate.
For Spleen diarrhea, characterized by abdominal fullness, borborygmus (rumbling in the intestines), indigestion, and vomiting, Li Zhong Tang (Regulate the Middle Decoction) is indicated (some say borborygmus and indigestion belong to Spleen deficiency).
For Qi-induced diarrhea, frequent irritability and anger injure the Qi; Lung Qi attacks the Spleen, resulting in a wiry and rebellious pulse; regulating Qi is appropriate.
For fright-induced diarrhea, fright affects the Heart causing Qi chaos, and Heart Qi obstruction leads to abnormal water metabolism.
Li Zhong Wan (Regulate the Middle Pill): Treats cold diarrhea, Spleen diarrhea, and deficiency diarrhea.
Bai Zhu (Atractylodis Rhizoma, stir-fried with soil), Gan Jiang (Zingiberis Rhizoma, roasted until charred), Gan Cao (Glycyrrhizae Radix et Rhizoma, honey-fried), Ren Shen (Ginseng Radix et Rhizoma). Grind into powder and make pills using congee.
Wei Feng Wan (Stomach Wind Pill): Treats Qi deficiency.
Si Jun Zi Tang (Four Gentlemen Decoction), Sheng Ma (Cimicifugae Rhizoma), Shao Yao (Paeoniae Radix Alba).
Wei Bu Wan (Stomach Tonify Pill): Treats Qi deficiency sinking downward.
Si Jun Zi Tang (Four Gentlemen Decoction), Shao Yao (Paeoniae Radix Alba, stir-fried), Sheng Ma (Cimicifugae Rhizoma).
Ping Wei Wu Ling San (Calm the Stomach and Five-Ling Powder): Treats dampness diarrhea, water-indulgence diarrhea, and heat diarrhea. (This formula treats all Yang syndromes.)
Ping Wei San (Calm the Stomach Powder), Wu Ling San (Five-Ingredient Powder with Poria), Bai Zhu (Atractylodis Rhizoma), Shao Yao (Paeoniae Radix Alba), Gan Cao (Glycyrrhizae Radix et Rhizoma). For heat, add Huang Qin (Scutellariae Radix) and Mu Tong (Akebiae Caulis).
Liu Ji Wan (Flowing Accumulation Pill): Treats stagnant accumulation flowing downward. In severe cases, induce vomiting.
Qing Dai (Indigo Naturalis), Huang Qin (Scutellariae Radix), Shen Qu (Massa Medicata Fermentata), Hai Shi (Floating Lapis Lazuli).
Jiao Shu Wan (Pepper and Atractylodes Pill): Treats dampness.
Chuan Jiao (Zanthoxyli Pericarpium), Cang Zhu (Atractylodis Rhizoma), Rou Dou Kou (Myristicae Semen).
Pi Xie Wan (Spleen Diarrhea Pill):
Bai Zhu (2 liang, stir-fried), Shen Qu (1.5 liang, stir-fried), Shan Zha (Crataegi Fructus), Ban Xia (Pinelliae Rhizoma, 1.5 liang), Shao Yao (Paeoniae Radix Alba, wine-fried, 1 liang), Huang Qin (Scutellariae Radix, stir-fried, 1.5 liang), Cang Zhu (Atractylodis Rhizoma, 5 qian). For deficiency, add Ren Shen (Ginseng Radix et Rhizoma), Bai Zhu (Atractylodis Rhizoma), and Gan Cao (Glycyrrhizae Radix et Rhizoma). For tenesmus, add Bing Lang (Arecae Semen) and Mu Xiang (Vladimiriae Radix). Make pills with lotus leaves and steamed rice.
Zhi Xie Wan (Stop Diarrhea Pill):
Rou Dou Kou (Myristicae Semen, 5 qian), Huo Shi (Live Stone, 1 qian in spring, 2 qian in summer, 1.5 qian in autumn). For cold, add stir-fried Shen Qu (Massa Medicata Fermentata) and Zhu Yu (Evodiae Fructus). For heat, add Lian (Coptidis Rhizoma) and Fu Ling (Poria). For sliding/loose bowels, add He Zi Pi (Terminalia Chebulae Pericarpium).
Wen Liu Wan (Warm Six Pillers) and Qing Long Wan (Green Dragon Pill): Both can be used for treatment.