火泻,完谷不化,饮食下喉即吐,日夜有泄数十次,甚至百次者,人皆知其热也。然而热之生也,何故?生
于肾中之水衰,不能制火,使胃土关门不能守于上下,所以直进而直出也。论其势之急迫,似乎宜治其标。然治其
标,而不能使火之骤降,必须急补肾中之水,使火有可居之地,而后不至于上腾,方用∶
熟地(三两) 山萸(一两) 白芍(三两) 茯苓(一两) 车前子(一两) 甘草(一两) 肉桂(三分)
水煎服。
此方乃补肾之药,非止泻之品,然而止泻之妙,捷如桴鼓。〔盖肾水一生,肾火即降,顷刻应验,非好为奇
谈,而乃据实理也。若正作胃虚有火治之,未尝无功,不若此方之捷也。〕
有一日泻五、六十行者,倾肠而出,完谷不化,粪门肿痛,如火之热,苟无以救之,必致立亡。方用截泻汤∶
薏仁(二两) 白芍(二两) 山药(一两) 车前子(一两) 茯苓(五钱) 泽膝(二钱) 黄连(五钱)
人参(三钱) 甘草(二钱) 肉桂(三分)
水煎服。
水泻,〔乃脾气不温,〕方用∶
白术(一两) 车前子(五钱)
水煎服。
此方补肾健脾,利水去湿,治泻神效。〔白术、车前子,利腰脐而消水气。然而白术亦能健脾,脾健水湿自能
分消,不必借重车前子。车前子能通窍而安脏气,亦不止分消水湿巳也。脏安则水湿之气自消,各有专能,又能分
助,所以奏功如神耳。〕
火泻,表现为大便中夹杂未消化的食物,饮食刚入口即呕吐,白天黑夜腹泻数十次,甚至达到上百次,人们都知道这是热证。然而,热邪的产生,原因何在?是因为肾中的阴水衰退,不能制约阳气之火,导致胃土(脾胃)的关门功能失调,无法固摄于上下,所以食物直进直出。从病势的急迫来看,似乎适宜治疗其标症。但是,如果只治标,而不能使火热之邪迅速下降,就必须紧急补肾中的阴水,使火有所依附和栖息的地方,然后才不至于向上冲腾。方剂用:熟地黄(三两)、山茱萸(一两)、白芍(三两)、茯苓(一两)、车前子(一两)、甘草(一两)、肉桂(三分)。用水煎服。
这个方子是补肾的药物,并非专门的止泻药,然而其止泻的效果,灵敏得如同敲鼓应声一样迅速。(大概是因为肾水一旦滋生,肾火就会随即下降,顷刻间就能见效,这并不是故意追求奇谈怪论,而是依据真实的医理。如果是按照胃虚有火来治疗,并非没有功效,但不如这个方子快捷。)
有一类情况是一天腹泻五六十次,肠道内容物倾泻而出,大便中夹杂未消化的食物,肛门肿痛,感觉像火烧一样热,如果没有办法救治,必定会导致立即死亡。方剂用截泻汤:薏苡仁(二两)、白芍(二两)、山药(一两)、车前子(一两)、茯苓(五钱)、泽泻(二钱)、黄连(五钱)、人参(三钱)、甘草(二钱)、肉桂(三分)。用水煎服。
水泻,(是由于脾气不温暖,)方剂用:白术(一两)、车前子(五钱)。用水煎服。
这个方子能补肾健脾,利水祛湿,治疗腹泻效果神奇。(白术、车前子,能疏通腰脐部位并消除水气。然而白术也能健脾,脾脏健运则水湿自然能够分化解散,不必过分依赖车前子。车前子能通利窍道并安定脏腑之气,也不仅仅只是分消水湿罢了。脏腑安宁则水湿之气自然消散,它们各有专长,又能互相辅助,所以奏效如神一般。)
Fire diarrhea (Huo Xie), characterized by undigested food in the stool, vomiting immediately after swallowing food, and defecating dozens or even hundreds of times a day and night, is generally known to be a heat syndrome. However, what is the cause of this heat? It arises from the deficiency of water (Yin) in the Kidney, which fails to control fire (Yang). This causes the "gate" function of the Stomach Earth (Spleen and Stomach) to fail in guarding the upper and lower openings, resulting in food passing directly through. Given the urgency of the condition, it might seem appropriate to treat the branch (symptoms). However, treating only the branch without rapidly descending the fire requires urgently tonifying the water in the Kidney, providing a residence for the fire so that it does not flare upward. The prescription is as follows: Shu Di Huang (Prepared Rehmannia Root, 3 liang), Shan Yu (Cornus Fruit, 1 liang), Bai Shao (White Peony Root, 3 liang), Fu Ling (Poria, 1 liang), Che Qian Zi (Plantago Seed, 1 liang), Gan Cao (Licorice Root, 1 liang), Rou Gui (Cinnamon Bark, 3 fen). Decoct in water and take orally.
This prescription consists of herbs that tonify the Kidney, not specifically anti-diarrheal agents, yet its effect in stopping diarrhea is as swift as a drumbeat. [This is because once Kidney Water is generated, Kidney Fire descends immediately; the effect is instantaneous. This is not merely seeking novelty but is based on true principles. If treated as Stomach deficiency with fire, there may be some efficacy, but it is not as rapid as this prescription.]
In cases where one experiences fifty to sixty episodes of diarrhea per day, with intestinal contents pouring out, undigested food in the stool, painful and swollen anus, and a burning sensation like fire, failure to provide rescue will lead to immediate death. The prescription Jie Xie Tang (Diarrhea-Cutting Decoction) is used: Yi Ren (Coix Seed, 2 liang), Bai Shao (White Peony Root, 2 liang), Shan Yao (Chinese Yam, 1 liang), Che Qian Zi (Plantago Seed, 1 liang), Fu Ling (Poria, 5 qian), Ze Xie (Alisma Rhizome, 2 qian), Huang Lian (Coptis Rhizome, 5 qian), Ren Shen (Ginseng Root, 3 qian), Gan Cao (Licorice Root, 2 qian), Rou Gui (Cinnamon Bark, 3 fen). Decoct in water and take orally.
Water diarrhea (Shui Xie), [caused by the Spleen Qi lacking warmth], is treated with: Bai Zhu (Atractylodes Macrocephala Rhizome, 1 liang), Che Qian Zi (Plantago Seed, 5 qian). Decoct in water and take orally.
This prescription tonifies the Kidney and strengthens the Spleen, promotes urination to remove dampness, and is miraculously effective for treating diarrhea. [Bai Zhu and Che Qian Zi unblock the waist and umbilical region and dissipate water qi. However, Bai Zhu also strengthens the Spleen; when the Spleen is healthy, water and dampness are naturally separated and eliminated, reducing reliance on Che Qian Zi. Che Qian Zi can open orifices and stabilize organ qi, doing more than just dissipating water dampness. When organs are stable, water dampness naturally dissipates. Each herb has its specific function and they assist each other, thus achieving miraculous results.]