方见伤寒门。
张子和曰∶飧泄以风为根,风非汗不出,有病此者,腹中雷鸣,水谷不分,小便滞涩,服
涩药温药不效,炙中脘脐下数十,燥热转甚,津液枯竭,延予视之,脉浮大而
长,身表微热,用桂枝麻黄汤加姜枣煎,连进三大剂,汗出终日至旦而愈。次以胃风汤,和其脏腑,
食迸而安。《经》曰∶春伤于风,夏必飧泄。故可汗而愈。按∶风属木,脾属土,木克土故泄也。
治脾肾虚寒,大便大实,饮食不思。
肉果(面煨) 五味子(各二两) 补骨脂(四两) 吴茱萸(水浸,一两)
为末,生姜八两,红枣一百枚,煮熟,取枣肉去皮,和丸桐子大,每服四钱,空心米饮下。
治脏腑虚寒,腹痛泄泻,大效。
吴茱萸(炒,二两) 赤石脂 干姜(各一两五钱) 缩砂仁 艾叶(炒) 肉豆蔻 附
子(制,各一两) 共为细末,面糊丸,每服三钱,米饮送下。
破故纸(炒,四两) 肉豆蔻(生,二两)
为末,以枣四十九个,生姜四两,同煮烂,去姜取枣肉和丸,每服五十丸,盐汤下。
治泄泻久重,其人甚虚。
椒红(炒) 附子(炒,各五钱) 山萸肉(二两) 桑螵蛸(炙) 鹿茸(酒蒸) 龙
骨(各三钱) 为末酒糊丸,每服五十丸,空心米饮下。
治肝经受寒,面色青惨,厥而泄利。
当归(炒) 浓朴(制,各二两) 官桂(三两) 良姜(五两) 每服三钱,水煎服。
《经》曰∶肾司闭藏,肝司疏泄,肝肾气虚为病泄泻,何也?盖肾者,所处在下,大小二便之
门户,而肝者,又为门户约束之具,肝肾气实,则能闭、能束,故不泄泻。肝肾气虚,则闭束失职,故
泄泻也。又肝者,脾之贼,肝经正虚邪盛,木能克土,亦作泄泻。此当归浓朴汤所以实肝而止也。
该方剂记载于伤寒门。
张子和说:飧泄(完谷不化的腹泻)以风邪为根本,风邪非通过发汗不能排出,患有此病的人,腹中肠鸣如雷,水谷不分,小便涩滞不畅,服用收敛药和温补药无效,在中脘穴及脐下施灸数十壮后,燥热感反而加重,津液枯竭,于是来找我诊治。诊见脉象浮大而长,体表微热,使用桂枝麻黄汤加生姜、大枣煎服,连续服用三剂,出汗直至第二天早晨才痊愈。随后用胃风汤调和脏腑,饮食得以安宁。《黄帝内经》说:春季感受风邪,夏季必然发生飧泄。因此可以通过发汗法治愈。按语:风属木,脾属土,木克土所以导致泄泻。
治疗脾肾阳虚寒盛,大便极度干结坚硬,不思饮食。
肉豆蔻(面粉煨制) 五味子(各二两) 补骨脂(四两) 吴茱萸(用水浸泡,一两)
研为细末,生姜八两,红枣一百枚,煮熟,取出枣肉并去皮,与药末混合制成梧桐子大小的丸药,每次服用四钱,空腹时用米汤送服。
治疗脏腑虚寒引起的腹痛泄泻,效果显著。
吴茱萸(炒制,二两) 赤石脂 干姜(各一两五钱) 缩砂仁 艾叶(炒制) 肉豆蔻 附子(炮制,各一两)
共研为细末,用面糊制作丸药,每次服用三钱,用米汤送服。
破故纸(即补骨脂,炒制,四两) 肉豆蔻(生用,二两)
研为细末,用枣子四十九个,生姜四两,一同煮烂,去掉生姜,取枣肉与药末混合制成丸药,每次服用五十丸,用盐汤送服。
治疗久重泄泻,患者身体非常虚弱。
椒红(花椒去籽后的红色部分,炒制) 附子(炒制,各五钱) 山茱萸肉(二两) 桑螵蛸(炙制) 鹿茸(酒蒸制) 龙骨(各三钱)
研为细末,用酒糊制作丸药,每次服用五十丸,空腹时用米汤送服。
治疗肝经受寒,面色青暗惨白,四肢厥冷且伴有泄利。
当归(炒制) 厚朴(炮制,各二两) 官桂(三两) 高良姜(五两)
每次服用三钱,加水煎服。
《黄帝内经》说:肾主管闭藏,肝主管疏泄,肝肾气虚导致泄泻,为什么呢?大概肾位于下部,是大小便的门户,而肝则是约束这个门户的工具。肝肾之气充实,就能闭藏和约束,所以不会泄泻。肝肾之气虚弱,则闭藏约束功能失职,所以发生泄泻。另外,肝是脾的“贼”(克制者),肝经正气虚弱而邪气强盛,木能克土,也会造成泄泻。这就是当归浓朴汤能够补益肝脏从而止泻的原因。
The formula is recorded in the *Shanghan* (Cold Damage) section.
Zhang Hezi stated: Wind is the root of *sunxie* (diarrhea with undigested food). Wind pathogens cannot be expelled without sweating. Patients suffering from this condition experience borborygmus (rumbling in the abdomen), indistinguishable water and grain in stools, and scanty or difficult urination. When astringent and warming medicines fail to produce results, and moxibustion applied to the Zhongwan (CV12) and areas below the umbilicus for dozens of moxa cones exacerbates dryness and heat while depleting body fluids, they seek my consultation. The pulse is floating, large, and long; there is slight surface heat. I prescribed Guizhi Mahuang Tang (Cinnamon Twig and Ephedra Decoction) with added fresh ginger and jujube, decocted and administered. After three consecutive doses, profuse sweating occurred until dawn, leading to recovery. Subsequently, Weifeng Tang (Stomach Wind Decoction) was used to harmonize the zang-fu organs, allowing diet and rest to normalize. The *Classic* states: "Wind injury in spring leads to sunxie in summer." Therefore, it can be cured by inducing sweating. Commentary: Wind belongs to Wood, and Spleen belongs to Earth; Wood overacting on Earth causes diarrhea.
For treating spleen and kidney yang deficiency with cold, severe constipation (hard stool), and loss of appetite.
Rou Dou Kou (Nutmeg, prepared by baking in flour) and Wu Wei Zi (Schisandra Berry) each two liang; Bu Gu Zhi (Psoralea Fruit) four liang; Wu Zhu Yu (Evodia Fruit), soaked in water, one liang.
Grind into fine powder. Take eight liang of fresh ginger and one hundred red dates, boil until cooked. Remove the date flesh, peel it, and mix with the powder to make pills the size of paulownia seeds. Take four qian per dose, swallowed with rice gruel on an empty stomach.
For treating abdominal pain and diarrhea due to visceral deficiency-cold, with excellent efficacy.
Wu Zhu Yu (Evodia Fruit, stir-fried) two liang; Chi Shi Zhi (Red Halloysite) and Gan Jiang (Dried Ginger) each one tael five qian; Suo Sha Ren (Amomum Fruit); Ai Ye (Mugwort Leaf, stir-fried); Rou Dou Kou (Nutmeg); Fu Zi (Prepared Aconite Root) each one tael.
Grind into fine powder, bind with wheat paste to form pills. Take three qian per dose, swallowed with rice gruel.
Po Gu Zhi (Psoralea Fruit, stir-fried) four liang; Rou Dou Kou (Nutmeg, raw) two liang.
Grind into fine powder. Boil forty-nine jujubes and four liang of fresh ginger until soft. Remove the ginger, take the jujube flesh, and mix with the powder to form pills. Take fifty pills per dose, swallowed with salted water.
For treating chronic and severe diarrhea where the patient is extremely deficient.
Jiao Hong (Pericarpium Zanthoxyli, stir-fried) and Fu Zi (Prepared Aconite Root, stir-fried) each five qian; Shan Yu Rou (Cornus Fruit) two liang; Sang Piao Xiao (Mantis Egg-case, roasted); Lu Rong (Deer Antler, steamed in wine); Long Gu (Fossilized Bones, calcined) each three qian.
Grind into fine powder, bind with wine paste to form pills. Take fifty pills per dose, swallowed with rice gruel on an empty stomach.
For treating cold invasion of the Liver Meridian, presenting with a dark cyan complexion, cold limbs (jue), and diarrhea.
Dang Gui (Angelica Sinensis Root, stir-fried) and Hou Po (Magnolia Bark, processed) each two liang; Guan Gui (Cinnamon Bark) three liang; Liang Jiang (Galangal Rhizome) five liang.
Take three qian per dose, decocted in water and taken orally.
The *Classic* states: The Kidney governs closure and storage, while the Liver governs dispersion and flow. Why does liver-kidney qi deficiency cause diarrhea? The Kidney resides in the lower part of the body and serves as the gatekeeper for urine and feces. The Liver acts as the mechanism that controls this gate. When liver and kidney qi is sufficient, it can close and constrain, preventing diarrhea. When liver and kidney qi is deficient, the function of closure and constraint fails, resulting in diarrhea. Furthermore, the Liver is the "thief" (overactor) of the Spleen. When the Liver meridian has righteous qi deficiency and pathogenic excess, Wood overacts on Earth, also causing diarrhea. This explains why Danggui Nongpo Tang (Angelica and Magnolia Decoction) tonifies the Liver to stop diarrhea.