痢出于积滞。积,物积也;滞,气滞也。物积欲出,气滞而不与之出,所以下坠里急,
乍起乍止,日夜凡百余度。病家所请,莫不求其止,孰知物积气滞致有如是之证耶?继人但
见有上项证候,不论色之赤白,脉之大小,一皆以通利。行之物积,用巴豆、大黄辈;气滞
用枳壳、桔梗、青皮、莪术辈;二者兼济,必能收功,其间佐以黄连阿胶丸效验尤着。盖痢
疾多因伤暑、伏热、酒面、炙爆酝酿而成,其阿胶尤大肠之要药,有热毒留滞则能疏导,无
热毒留滞则能安平。市肆或无丸子,即以炒阿胶、当归、青皮、赤茯苓、黄连作剂,入乌梅、
浓蜜同煎,最能荡涤恶秽,积滞既去,遍数自疏,嗣是却以木香、茯苓、缩砂、白豆蔻、陈
皮、甘草调之,自然喜食,食则糟粕入于大肠,然后真人养脏汤、易简断下汤,可止则止矣。
诸热痢、血痢,及痢后大肠里痛,用萝卜截碎研细,滤清汁一小盏,蜜水相半一盏,同
煎。
又法 热痢,旧年白梅并好茶、蜜水各半煎服。冷痢,生姜汁、蜜水各半煎服。仍兼木
香、生肉豆蔻为佐。蜜最治痢。
姜能助阳,茶能助阴,二者皆能消散,又且调平阴阳,况于暑毒、酒食毒皆能解之也。
不问赤白冷热通用之。老生姜切如豆许,与茶叶等分,用新水煎服。东坡医文潞公作效。
痢疾源于积滞。所谓“积”,是指食物停滞;所谓“滞”,是指气机阻滞。食物积滞想要排出,但气机阻滞阻碍其排出,因此出现下坠感、肛门急迫(里急后重),症状时发时止,一天一夜多达百余次。患者所求的,无不是希望停止腹泻,殊不知正是食物积滞和气机阻滞导致了这样的证候。后世医生只见有上述证候,不论大便颜色是赤是白,脉象是大是小,一律使用通利攻下的药物。对于食物积滞,使用巴豆、大黄之类;对于气机阻滞,使用枳壳、桔梗、青皮、莪术之类;两者兼用,必定能取得疗效,其中辅以黄连阿胶丸(Huanglian Ejiao Wan, Coptis and Donkey-hide Gelatin Pill)效果尤为显著。大概痢疾多因伤暑、伏热、饮酒面食、炙烤爆炒食物酝酿而成,阿胶尤其是对大肠的关键药物,若有热毒留滞则能疏导,若无热毒留滞则能安宁平复。市场上若没有现成的丸子,就用炒阿胶、当归、青皮、赤茯苓、黄连制成汤剂,加入乌梅、浓蜜同煎,最能荡涤污秽恶浊之物,积滞既去,排便次数自然减少,此后再用木香、茯苓、缩砂仁、白豆蔻、陈皮、甘草来调理,自然食欲恢复,进食后糟粕进入大肠,然后使用真人养脏汤(Zhenren Yangzang Tang, True Person's Nourishing Viscera Decoction)、易简断下汤(Yijian Duansha Tang, Simple Decoction to Stop Dysentery),可以止泻就止泻了。
各种热痢、血痢,以及痢疾后大肠内部疼痛,用萝卜切碎研细,滤取澄清汁液一小盏,蜂蜜水各半盏,一同煎煮。
另一种方法:治疗热痢,用旧年的白梅和好茶、蜂蜜水各半煎服。治疗冷痢,用生姜汁、蜂蜜水各半煎服。同时辅以木香、生肉豆蔻作为佐药。蜂蜜最擅长治疗痢疾。
生姜能助长阳气,茶叶能助长阴气,两者都能消散邪气,并且调和阴阳,何况对暑毒、酒食毒都能解除。无论赤白痢、冷痢热痢都通用此法。老生姜切成如豆子大小,与茶叶等量,用新汲的水煎服。苏东坡为文潞公写的医案证明有效。
Dysentery arises from accumulation and stagnation. "Accumulation" refers to food retention; "stagnation" refers to Qi stagnation. Food accumulation desires to be expelled, but Qi stagnation prevents its expulsion, thus resulting in tenesmus (a feeling of incomplete defecation with urgency), symptoms that come and go intermittently, occurring more than a hundred times a day and night. What patients seek is nothing but relief from diarrhea, yet they do not realize that it is precisely food accumulation and Qi stagnation that cause such manifestations. Later physicians, seeing only the aforementioned symptoms, regardless of whether the stool color is red or white, or whether the pulse is large or small, uniformly employ purgative and draining agents. For food accumulation, substances like Radix Euphorbiae Hussonis (Badou, 巴豆) and Radix et Rhizoma Rhei (Dahuang, 大黄) are used; for Qi stagnation, Fructus Aurantii (Zhike, 枳壳), Flos Platycodonis (Jiegeng, 桔梗), Pericarpium Citri Reticulatae (Qingpi, 青皮), and Rhizoma Curcumae (Ezhu, 莪术) are employed; using both together will surely achieve success, among which supplementing with Huanglian Ejiao Wan (Coptis and Donkey-hide Gelatin Pill) yields particularly remarkable results. Generally, dysentery is often caused by summerheat injury, latent heat, consumption of alcohol and wheat products, and foods prepared by roasting or frying. Ejiao (Colla Corii Asini, Donkey-hide Gelatin) is especially a crucial herb for the Large Intestine; if heat-toxins are retained, it can guide their discharge; if no heat-toxins are retained, it can pacify and stabilize. If pills are unavailable in the market, one may prepare a decoction using fried Ejiao, Radix Angelicae Sinensis (Danggui, 当归), Pericarpium Citri Reticulatae (Qingpi, 青皮), Poria (Chifuling, 赤茯苓), and Rhizoma Coptidis (Huanglian, 黄连), adding Fructus Mume (Wumei, 乌梅) and thick honey to boil together. This can thoroughly cleanse foul and turbid matter. Once accumulation and stagnation are removed, the frequency of defecation naturally decreases. Subsequently, regulating with Aucklandiae Radix (Muxiang, 木香), Poria (Fuling, 茯苓), Amomi Fructus Rotundus (Suosha, 缩砂), Alpiniae Katsumadai Semen (Baidoukou, 白豆蔻), Pericarpium Citri Reticulatae (Chenpi, 陈皮), and Radix Glycyrrhizae (Gancao, 甘草) will naturally restore appetite. After eating, residue enters the Large Intestine, after which Zhenren Yangzang Tang (True Person's Nourishing Viscera Decoction) and Yijian Duansha Tang (Simple Decoction to Stop Dysentery) can be used to stop diarrhea when appropriate.
For various heat-type dysentery, bloody dysentery, and pain inside the Large Intestine following dysentery, chop radishes into pieces, grind them finely, filter to obtain a clear juice of one small cup, mix with half a cup of honey water, and boil together.
Another method: For heat-type dysentery, boil equal parts of old-year white plums, good tea leaves, and honey water. For cold-type dysentery, boil equal parts of ginger juice and honey water. Supplement with Aucklandiae Radix (Muxiang, 木香) and Semen Myristicae Crassum (Sheng Rou Doukou, 生肉豆蔻). Honey is most effective in treating dysentery.
Ginger can assist Yang energy, while tea can assist Yin energy; both can dissipate pathogens and harmonize Yin and Yang. Moreover, they can resolve summerheat toxins and toxins from alcohol and food. This method is universally applicable regardless of whether the dysentery is red or white, cold or hot. Cut old ginger into pieces the size of beans, use an equal amount of tea leaves, and decoct with fresh water. Su Dongpo recorded this as effective in his medical text for Lord Wen Lu.