哮专主乎痰,宜吐法。亦有虚而不可吐者。治哮必须薄滋味专主乎痰,必用大吐,吐药中多用醋,不可全用凉
药,必带表散,此寒包热也。半夏、枳壳炒、桔梗、片黄
芩、炒紫苏、麻黄、杏仁、甘草,天寒加桂。一法小胃丹以二陈汤去甘草,加苍术、黄芩作汤送下,看虚实用之。治
哮积方,用鸡子略损壳勿损膜,浸尿缸中三四日,夜煮吃效,盖鸡子能去风痰也。治哮紫金丹,以精猪肉三十两,
切骰子大,用信一两明者,研极细,拌在肉内,令极匀,分作六分,用纸筋黄泥包之,火烘令干,又用白炭火,于无人
远处 之,以青烟出为度,出火毒放地上一宿,研细,用汤浸蒸饼为丸,如绿豆大,食前茶清下,大人二十丸,小儿十
丸,量虚实与之。一人哮喘,南星、半夏、杏仁、栝蒌仁、香附、橘红、青黛、莱菔子、皂角灰,上末之,曲丸,姜汤
送下。
有湿、有气虚、有火、有痰、有积。世俗类用涩药治痢与泻,若积久而虚者,或可行之;而初得
者,必变他证,为祸不小。殊不知多因于湿,惟分利小水,最是长策。治湿燥湿宜渗泄,四苓散中加苍术、白术,甚
者二术皆炒。气虚用人参、白术、芍药、炒升麻;火宜伐火,利小水用黄芩、木通,入四苓散;痰宜豁痰,用海石、
青黛、黄芩、神曲,作丸服,或用吐法吐之,以升提其清气;食积宜消导之、疏涤之,神曲或大黄等;泄泻水多者,
必用五苓散。止泻方∶肉豆蔻(五两) 滑石(青冬一两二钱半,夏二两半,秋二两) 上用姜汁曲糊丸。又方姜
曲丸∶姜(二两) 陈曲(六两炒),用一二年。陈者、新者、发热不可用,陈麦亦可用茴香半两。治脾泄方,用炒白
术、炒神曲、炒芍药,或汤或散作丸子。尤切当治脾泄,当大补脾气而健运复常。治久病大肠气泄∶熟地黄(五钱)
白芍药(炒) 知母(各三钱) 干
姜(二钱) 炙甘草(一钱) 上末服。泄泻或呕吐,用六一散、生姜汁汤调服。积痰作泄宜下之。青六丸去三焦湿,
治泄泻多与他丸同用,并不单用,若欲治血痢,或产后腹痛,或自痢者,补脾补血药送之。久病气虚,泄泻不止,灸百
会三壮。一老人,奉养太过饮食伤脾,常常泄泻,亦是脾泄∶白术(炒二两) 白芍药(酒炒一两) 神曲(炒二两)
山楂(一两半) 半夏(一两汤浸) 黄芩(炒半两) 上为末,青荷叶烧饭为丸。一老人年七十,面白,脉弦数,独
胃脉沉滑,因饮白酒作痢下血,淡水脓,腹痛,小便不利,里急后重,以人参、白术为君,甘草、滑石、槟榔、木香、
苍术为佐,下保和丸二十五丸。第二日证减,独小便不利,只以益元散服之效。一男子,因辛苦发热,腰脚痛,吐泻交
作,以∶白术(二钱) 人参(一钱) 滑石(二钱) 木通(一钱半) 甘草(半钱) 陈皮(二钱) 柴胡(一钱)
夏月水泻,桂苓甘露饮∶官桂 人参(各五钱) 木香(一分) 茯苓 白术 甘草 泽泻 葛根 石膏 寒水石(以
上各一两) 滑石(二两) 脾胃不和泄泻并伤食用胃苓汤;积聚肚泻胜红丸;肠鸣泄泻久不愈者,诃黎勒丸;泄泻下
积身热水泄者,大柴胡汤;水泻白术、苍术、浓朴、陈皮、炒曲、茯苓、猪苓、泽泻、地榆、甘草,冬月加干姜等分。
治老人水泻∶白术(一两) 苍术(一两) 浓朴(半两) 炒曲(一两) 肉豆蔻(一两) 陈皮(五钱) 炒芍药
(一两) 滑石(一两炒) 甘草(三钱炙) 樗皮(一两炒) 上饭丸,食前米饮下八十粒。一人胸满泄泻不止,当
消食补脾,则泄止;若积病亦有胃壮而泄不止,当下去积则泄止。凡内外之邪,有伤于生化之用,则阴阳失其居处之常,
脏腑失其所司之政,以致肠胃腐熟,而敷化之职不修,所以泻也。一人气脱而虚,顿泻不知人,口眼俱闭,呼吸甚微,
殆欲死者,急灸气海,饮人参膏十余斤而愈。阴虚而肾不
能司禁固之权者,峻补其肾。痰积在肺,致其所合大肠之气不固者,涌出上焦之痰,则肺气降下,而大肠之虚自复
矣。忧思太过,脾气结而不能升举,陷入下焦而泄泻者,开其郁结,补其脾胃,而使谷气升发也。戴云∶凡泻水而
腹不痛者,是湿;饮食入胃不住,完谷不化者,是气虚;肠鸣泻水,痛一阵泻一阵,是火;或泻或不泻,或多或少,是
痰;腹痛甚而泻,泻后痛减者,是食积。治水泻方∶干姜(一钱) 当归(二钱半) 乌梅(三个) 黄柏(一钱
)黄连(二钱) 或云各等分水煎。
哮病专门由痰引起,适宜使用吐法治疗。也有因虚证而不能使用吐法的。治疗哮病必须饮食清淡,专门针对痰邪,一定要用大剂量催吐,催吐药中多加入醋,不能完全使用寒凉药物,必须兼有解表发散的作用,这是寒包热的证型。药材包括半夏、炒枳壳、桔梗、片状黄芩、炒紫苏、麻黄、杏仁、甘草,天气寒冷时加桂枝。另一种方法是用小胃丹,以二陈汤去掉甘草,加入苍术、黄芩煎汤送服,根据虚实情况使用。治疗哮病的积方,用鸡蛋稍微弄破壳但不弄破膜,浸泡在尿缸中三四天,晚上煮熟吃有效,因为鸡蛋能去除风痰。治疗哮病的紫金丹,用精猪肉三十两,切成骰子大小,用好信石一两,研成极细末,拌入肉内,使其非常均匀,分成六份,用纸筋和黄泥包裹,用火烘干,再用白炭火,在无人远处煅烧,以冒出青烟为限度,取出退去火毒后放在地上过夜,研细,用汤浸蒸饼做成丸药,如绿豆大小,饭前茶清送下,成人二十丸,小儿十丸,根据虚实情况给予剂量。有一人哮喘,用南星、半夏、杏仁、瓜蒌仁、香附、橘红、青黛、莱菔子、皂角灰,制成粉末,用曲做成丸药,姜汤送下。
泄泻有湿邪、气虚、火邪、痰邪、食积等原因。世俗人类似乎都用涩药治疗痢疾和泄泻,如果是积滞日久且体虚的,或许可以这样做;但初得的,一定会变成其他证候,危害不小。殊不知多因于湿邪,只有分利小便,才是最好的策略。治疗湿邪燥湿宜渗泄,四苓散中加入苍术、白术,严重的两种白术都炒制。气虚用人参、白术、芍药、炒升麻;火邪宜清火,利小便用黄芩、木通,加入四苓散;痰邪宜豁痰,用海浮石、青黛、黄芩、神曲,做成丸药服用,或者用吐法吐之,以升提清气;食积宜消导、疏涤,用神曲或大黄等;泄泻水多的,一定用五苓散。止泻方:肉豆蔻(五两)滑石(青冬一两二钱半,夏二两半,秋二两),以上用姜汁曲糊做成丸药。又一方姜曲丸:姜(二两)陈曲(六两炒),用一两年以上的陈曲。陈的、新的、发热者不可用,陈麦也可用茴香半两。治疗脾泄方,用炒白术、炒神曲、炒芍药,或汤剂或散剂做成丸药。尤其恰当治疗脾泄,应当大补脾气而健运复常。治疗久病大肠气泄:熟地黄(五钱)白芍药(炒)知母(各三钱)干姜(二钱)炙甘草(一钱),以上研末服用。泄泻或呕吐,用六一散、生姜汁汤调服。积痰作泄宜下之。青六丸去三焦湿,治泄泻多与他丸同用,并不单用,若想治血痢,或产后腹痛,或自痢者,用补脾补血药送服。久病气虚,泄泻不止,灸百会穴三壮。一位老人,奉养太过饮食伤脾,常常泄泻,也是脾泄:白术(炒二两)白芍药(酒炒一两)神曲(炒二两)山楂(一两半)半夏(一两汤浸)黄芩(炒半两),以上为末,青荷叶烧饭为丸。一位老人年七十,面白,脉弦数,唯独胃脉沉滑,因饮白酒作痢下血,淡水脓,腹痛,小便不利,里急后重,以人参、白术为君,甘草、滑石、槟榔、木香、苍术为佐,下保和丸二十五丸。第二日证减,唯独小便不利,只以益元散服之效。一男子,因辛苦发热,腰脚痛,吐泻交作,以:白术(二钱)人参(一钱)滑石(二钱)木通(一钱半)甘草(半钱)陈皮(二钱)柴胡(一钱)。夏月水泻,桂苓甘露饮:官桂 人参(各五钱)木香(一分)茯苓 白术 甘草 泽泻 葛根 石膏 寒水石(以上各一两)滑石(二两)。脾胃不和泄泻并伤食用胃苓汤;积聚肚泻胜红丸;肠鸣泄泻久不愈者,诃黎勒丸;泄泻下积身热水泄者,大柴胡汤;水泻白术、苍术、浓朴、陈皮、炒曲、茯苓、猪苓、泽泻、地榆、甘草,冬月加干姜等分。治疗老人水泻:白术(一两)苍术(一两)浓朴(半两)炒曲(一两)肉豆蔻(一两)陈皮(五钱)炒芍药(一两)滑石(一两炒)甘草(三钱炙)樗皮(一两炒),以上饭丸,食前米饮下八十粒。一人胸满泄泻不止,当消食补脾,则泄止;若积病亦有胃壮而泄不止,当下去积则泄止。凡内外之邪,有伤于生化之用,则阴阳失其居处之常,脏腑失其所司之政,以致肠胃腐熟,而敷化之职不修,所以泻也。一人气脱而虚,顿泻不知人,口眼俱闭,呼吸甚微,殆欲死者,急灸气海,饮人参膏十余斤而愈。阴虚而肾不能司禁固之权者,峻补其肾。痰积在肺,致其所合大肠之气不固者,涌出上焦之痰,则肺气降下,而大肠之虚自复矣。忧思太过,脾气结而不能升举,陷入下焦而泄泻者,开其郁结,补其脾胃,而使谷气升发也。戴云说:凡泻水而腹不痛者,是湿;饮食入胃不住,完谷不化者,是气虚;肠鸣泻水,痛一阵泻一阵,是火;或泻或不泻,或多或少,是痰;腹痛甚而泻,泻后痛减者,是食积。治水泻方:干姜(一钱)当归(二钱半)乌梅(三个)黄柏(一钱)黄连(二钱)或云各等分水煎。
Asthma (Xiao) is primarily caused by phlegm (Tan), and the vomiting method (Tu Fa) is appropriate. There are also cases of deficiency where vomiting cannot be used. In treating asthma, one must adhere to a bland diet and focus specifically on phlegm; a strong emetic must be used. The emetic medicine should contain vinegar, and cold-natured medicines should not be used exclusively; they must include exterior-releasing and dispersing agents, as this represents "cold wrapping heat" (Han Bao Re). The herbs include Banxia (Pinelliae Rhizoma), Chao Zhiqiao (Stir-fried Aurantii Fructus), Jiegeng (Platycodonis Radix), Pian Huangqin (Sliced Scutellariae Radix), Chao Zisu (Stir-fried Perillae Folium), Mahuang (Ephedrae Herba), Xingren (Armeniacae Semen Amarum), Gancao (Glycyrrhizae Radix et Rhizoma); add Guizhi (Cinnamomi Ramulus) in cold weather. Another method uses Xiaowei Dan (Minor Stomach Pill), administered with Erchen Tang (Two-Cured Decoction) from which Gancao has been removed, plus Cangzhu (Atractylodis Rhizoma) and Huangqin (Scutellariae Radix) decocted as soup, used according to deficiency or excess. For an accumulation formula for asthma, use a chicken egg slightly cracked but without breaking the membrane, soak it in a urine jar for three to four days, boil and eat at night for effectiveness, because eggs can remove wind-phlegm. For Zijin Dan (Purple Gold Pill) for asthma, take thirty taels of lean pork, cut into dice-sized pieces, mix with one tael of refined Xinshi (Arsenolite), grind to an extremely fine powder, mix evenly into the meat, divide into six portions, wrap with paper筋 (paper strips) and yellow mud, dry over fire, then calcine over white charcoal fire in a remote place without people until green smoke appears. Remove from fire, let cool on the ground overnight, grind fine, make pills with steamed wheat cake soaked in water, size of mung beans, taken before meals with clear tea water: twenty pills for adults, ten for children, dosed according to deficiency or excess. One case of asthma used Nanxing (Arisaematis Rhizoma), Banxia, Xingren, Gualouren (Trichosanthis Semen), Xiangfu (Cyperi Rhizoma), Juhong (Citri Reticulatae Pericarpium Rubrum), Qingdai (Indigo Naturalis), Laifuzi (Raphani Semen), and Saojiao Hui (Ash of Sesquipedalis Fructus), made into powder, formed into pills with yeast, taken with ginger soup.
Diarrhea (Xiexie) arises from dampness, qi deficiency, fire, phlegm, and food accumulation. Laypeople generally use astringent medicines to treat dysentery and diarrhea; if the condition is chronic and deficient, this might be permissible; but for initial onset, it will likely transform into other syndromes, causing significant harm. It is unknown that it is mostly due to dampness; only by promoting urination to separate dampness is it the best strategy. To treat dampness, drying and leaching is suitable; add Cangzhu and Baizhu (Atractylodis Macrocephalae Rhizoma) to Siling San (Four-Ingredient Powder), stir-frying both if severe. For qi deficiency, use Ren Shen (Ginseng Radix et Rhizoma), Baizhu, Shaoyao (Paeoniae Radix Alba), and Chao Shengma (Stir-fried Cimicifugae Rhizoma); for fire, clear the fire and promote urination using Huangqin and Mutong (Akebiae Caulis) added to Siling San; for phlegm, resolve phlegm using Haishi (Fossilia Calcitae), Qingdai, Huangqin, and Shenqu (Medicated Leaven), made into pills, or use vomiting to raise clear qi; for food accumulation, guide out and drain using Shenqu or Dahuang (Rhei Radix et Rhizoma); for watery diarrhea, Wuling San (Five-Ingredient Powder) is essential. Astringent diarrhea formula: Rou Doukou (Myristicae Semen, five taels) and Huashi (Talcum, one liang two qian half in winter/spring, two taels half in summer, two taels in autumn), made into pills with ginger juice and yeast paste. Another formula, Jiang Qu Wan: Jiang (Ginger, two taels) and Chen Qu (Aged Medicated Leaven, six taels stir-fried, aged one to two years). Old ones, new ones, and those with fever are not used; aged Maike (Wheat Bran) can also be used with Huixiang (Foeniculi Fructus, half a liang). Formula for Pi Xie (Spleen Diarrhea): Chao Baizhu, Chao Shenqu, Chao Shaoyao, made into pills as decoction or powder. Crucially, treating spleen diarrhea requires greatly tonifying spleen qi to restore normal transportation and transformation. For chronic large intestine qi diarrhea: Shu Dihuang (Prepared Rehmanniae Radix, five qian), Chao Shaoyao, Zhimu (Anemarrhenae Rhizoma, each three qian), Ganjiang (Dried Zingiberis Rhizoma, two qian), Zhi Gancao (Honey-fried Glycyrrhizae Radix et Rhizoma, one qian), taken as powder. For diarrhea or vomiting, Liuyi San (Six-to-One Powder) mixed with ginger juice and water. Phlegm accumulation causing diarrhea should be purged. Qingliu Wan removes dampness from the Triple Burner, often used with other pills for diarrhea, rarely alone; for bloody dysentery, postpartum abdominal pain, or spontaneous dysentery, administer with spleen-tonifying and blood-nourishing medicines. For chronic qi deficiency with unceasing diarrhea, moxa Baihui (GV20) three moxibustions. An elderly person, over-indulgent in nourishment damaging the spleen with food, often had diarrhea (spleen diarrhea): Chao Baizhu (two taels), Jiuchao Shaoyao (one tael), Chao Shenqu (two taels), Shanzha (Crataegi Fructus, one tael half), Banxia (one tael soaked in water), Chao Huangqin (half a tael), made into powder, pills with rice cooked in green lotus leaves. A seventy-year-old elderly person, pale face, wiry and rapid pulse, only stomach pulse deep and slippery, developed bloody dysentery with pale pus after drinking white wine, abdominal pain, difficult urination, tenesmus; used Ren Shen and Baizhu as sovereign, Gancao, Huashi, Binglang (Arecae Semen), Muxiang (Vladimiriae Radix), Cangzhu as ministers, followed by Baixiaowan (Harmony-Preserving Pills) twenty-five pills. On the second day symptoms decreased, only difficult urination remained, cured by Yi Yuan San (Benefiting Origin Powder). A man, exhausted and febrile, with waist and leg pain, alternating vomiting and diarrhea, used: Baizhu (two qian), Ren Shen (one qian), Huashi (two qian), Mutong (one qian half), Gancao (half qian), Chenpi (Citri Reticulatae Pericarpium, two qian), Chaihu (Bupleuri Radix, one qian). Summer watery diarrhea: Guiling Ganlu Yin (Cassia Twig, Poria, and Polyscias Decoction): Guigui (Cinnamomi Cortex), Ren Shen (each five qian), Muxiang (one fen), Fuling (Poria), Baizhu, Gancao, Zexie (Alismatis Rhizoma), Gegen (Puerariae Radix), Shigao (Gypsum Fibrosum), Hanshuishi (Halloysitum Rubrum, each one liang above), Huashi (two taels). Spleen-stomach disharmony diarrhea with food injury: Weiling Tang (Poria and Magnolia Decoction); accumulation abdominal diarrhea: Shenghong Wan (Victory Red Pill); chronic borborygmus diarrhea: Helile Wan (Terminalia Pill); diarrhea with accumulation and body heat: Da Chaihu Tang (Major Bupleurum Decoction); watery diarrhea: Baizhu, Cangzhu, Houpo (Magnoliae Officinalis Cortex), Chenpi, Chao Qu, Fuling, Zhuling (Polyporus), Zexie, Diyü (Sanguisorbae Radix), Gancao, equal parts; add Ganjiang in winter. Elderly watery diarrhea: Baizhu (one liang), Cangzhu (one liang), Houpo (half liang), Chao Qu (one liang), Rou Doukou (one liang), Chenpi (five qian), Chao Shaoyao (one liang), Chao Huashi (one liang), Zhi Gancao (three qian), Chu Pi (Swinglea Root Bark, one liang stir-fried), made into rice pills, eighty pills taken before meals with rice drink. One person with chest fullness and unceasing diarrhea should have food resolved and spleen tonified to stop diarrhea; if accumulation disease with strong stomach but unceasing diarrhea, purge accumulation to stop diarrhea. All internal and external pathogens injuring the function of generation and transformation cause yin and yang to lose their normal residence, and organs and bowels to lose their governance, leading to failure of the intestines and stomach to rot and ripen, and failure of distribution and transformation duties, thus causing diarrhea. One person with qi collapse and deficiency, sudden profuse diarrhea losing consciousness, eyes and mouth closed, very faint breathing, nearly dying, urgently moxa Qihai (CV6), drank more than ten jin of Ren Shen Gao (Ginseng Paste) and recovered. For yin deficiency where the kidney cannot control retention, strongly tonify the kidney. For phlegm accumulation in the lungs causing the associated large intestine qi to be insecure, induce vomiting to expel upper jiao phlegm, so lung qi descends and large intestine deficiency restores itself. Excessive worry and thought knotting spleen qi preventing rising, sinking into lower jiao causing diarrhea, open the depression, tonify spleen and stomach, allowing grain qi to rise. Dai Yun said: Diarrhea with water but no abdominal pain is dampness; food entering stomach not staying, undigested grains passing is qi deficiency; borborygmus with watery diarrhea, pain then diarrhea is fire; intermittent diarrhea varying in amount is phlegm; severe abdominal pain with diarrhea, pain relieved after diarrhea is food accumulation. Formula for watery diarrhea: Ganjiang (one qian), Danggui (Angelicae Sinensis Radix, two qian half), Wumei (Mume Fructus, three), Huangbai (Phellodendri Cortex, one qian), Huanglian (Coptidis Rhizoma, two qian), or equal parts decocted in water.