肠交者,其病大小便易位而出,或因大怒,或因醉饱,遂至脏气乖乱,不循常道,
法当宣吐,以开提其气。若脉虚者,尤宜升清降浊,补气淡渗为主,便阑门清利,得司
泌别之职,则愈忌服破气燥热之剂。
治肠胃燥热,大便秘结。
麻仁(二两,另研) 杏仁(五两五钱,去皮、尖,炒) 枳实(麸炒) 浓朴(姜汁
炒) 芍药(各八两) 大黄(一斤) 为末,蜜丸,如桐子大,白汤送下。
约者,约结之约,又约束也。《经》曰∶饮入于胃,游溢精气,上输于脾,脾气散精,上
归于肺,通调水道,下输膀胱,水精四布,五经并行。今胃强脾弱,约束津液不得四布,
但输膀胱,小便数而大便鞭,故曰脾约。麻仁甘平而润,否仁甘温而润,《经》曰∶脾欲缓,
急食甘以缓之。《本草》曰∶润可去枯。是以麻仁为君,杏仁为臣,枳实苦寒,浓朴苦温,
凡破结者,必以苦,故以为佐,芍药酸寒,大黄苦寒,酸苦涌泄为阴,故以为使。丹溪曰∶
既云脾结,血枯火燔,金受邪而津竭必窃脾之母气以自救,金衰则土受木邢,脾失转输,
肺失传化,理宜滋阴降火,金行清化,脾土健旺,律液既润,何秘之有?此方惟
热甚而禀实者可用,热虽甚而虚者,愈致其燥涸之苦矣。
治风结血秘,胃中伏火。
羌活 归尾 大黄(煨,各五钱) 麻仁 桃仁(去皮、尖,各一两) 仁另研如
泥,外为末,蜜丸,桐子大,每早白汤下五十丸,或加煨皂角仁亦妙。盖其性得湿则
滑,滑则燥结自除。
肠交,是指大小便排泄位置互换的病症。这可能是由于大怒或醉酒后饱食所致,导致脏腑之气紊乱,不再遵循正常的生理规律。治疗应当采用催吐法,以升提气机。如果脉象虚弱,尤其适宜采用升清降浊、补气兼用淡渗利湿的方法为主,使阑门(小肠与大肠连接处)功能清晰,恢复其分别清浊的职责,即可痊愈。此时应忌服破气及燥热性质的药物。
治疗肠胃燥热引起的大便秘结。
配方:麻仁二两(单独研碎),杏仁五两五钱(去皮尖,炒制),枳实(麸皮炒),厚朴(姜汁炒),芍药各八两,大黄一斤。将上述药材研为细末,用蜂蜜制成丸剂,大小如梧桐子,用温开水送服。
“约”字,意为约束、限制。《黄帝内经》说:“饮食进入胃中,精气游溢散布,向上输送给脾;脾气散精,向上归于肺;肺通调水道,向下输送至膀胱;水液精微四布全身,五脏经脉并行运行。”如今胃气强盛而脾气虚弱,约束津液使其不能四布全身,只能下输膀胱,导致小便频数而大便干硬,所以称为“脾约”。火麻仁性味甘平而滋润,杏仁性味甘温而滋润,《内经》说:“脾喜缓急,紧急时食用甘味药以缓和之。”《本草》说:“润可以去除枯槁。”因此以火麻仁为君药,杏仁为臣药。枳实苦寒,厚朴苦温,凡是破除结滞的药物,必须用苦味,所以作为佐药。芍药酸寒,大黄苦寒,酸味和苦味具有涌泄作用,属于阴的性质,所以作为使药。朱丹溪说:“既然称为脾结,说明血枯火旺,金(肺)受邪而津液枯竭,必然窃取脾(土)之母气(火生土,此处指代相生关系中的依赖或反向影响,原文意指五行生克失衡导致的自救机制,通常理解为子盗母气或相乘相侮,此处依文意理解为病理上的相互牵连)以自救,金衰则土受木刑(木克土),脾失去转输功能,肺失去传化功能,理应滋阴降火,使金行清化,脾土健旺,津液滋润,哪里还会有便秘呢?此方只适用于热势极盛且体质结实的人。如果热势虽盛但体质虚弱,服用后会更加加重其干燥枯竭的痛苦。”
治疗风邪结滞、血虚秘结以及胃中潜伏之火。
配方:羌活、当归尾、大黄(煨制,各五钱),火麻仁、桃仁(去皮尖,各一两)。将火麻仁单独研成泥状,其余药材研为细末,混合后加蜂蜜制成丸剂,大小如梧桐子。每天早晨用温开水送服五十丸,或者加入煨制的皂角仁也很好。因为它的性质遇湿则滑,滑利则燥结自然消除。
Intestinal Jiao (Chang Jiao) refers to a condition where the excretion of urine and feces is reversed in position. This may be caused by severe anger or overeating after drinking, leading to chaos in the Qi of the Zang-Fu organs and deviation from normal physiological pathways. The treatment method should involve inducing vomiting to raise and lift the Qi. If the pulse is deficient, it is especially appropriate to prioritize raising the clear Yang and descending the turbid Yin, supplemented by tonifying Qi and using bland diuretics to promote urination. When the Lanmen (the junction between the small and large intestines) functions clearly and resumes its duty of separating the clear from the turbid, the patient will recover. One must avoid taking herbs that break Qi or are drying and hot in nature.
This formula treats constipation due to dryness-heat in the stomach and intestines.
Ingredients: Hemp Seed (Hempseed Fructus, 1 liang, ground separately), Apricot Kernel (Armeniacae Semen Amarum, 5 liang 5 qian, peeled and de-cored, stir-fried), Immature Bitter Orange (Aurantii Fructus Immaturus, bran-stir-fried), Magnolia Bark (Magnoliae Officinalis Cortex, ginger juice-stir-fried), Peony Root (Paeoniae Radix Alba, each 8 liang), Rhubarb (Rhei Radix et Rhizoma, 1 jin). Grind all ingredients into fine powder, mix with honey to make pills the size of paulownia seeds, and take with warm water.
The character "Yue" (Yue) means constraint or restriction. The *Classic of Medicine* states: "When food and drink enter the stomach, their essence spreads and overflows, transporting upwards to the Spleen; the Spleen scatters the essence, sending it upwards to the Lung; the Lung regulates the water passages, transporting them downwards to the Bladder; water essence distributes throughout the four directions, and the five meridians run in parallel." Currently, Stomach Qi is strong while Spleen Qi is weak, constraining body fluids so they cannot distribute throughout the body, but instead only transport to the Bladder. This results in frequent urination and hard stools, hence the term "Spleen Constraint" (Pi Yue). Hemp Seed is sweet, neutral, and moistening; Apricot Kernel is sweet, warm, and moistening. The *Classic* says: "The Spleen desires relaxation; when urgent, eat sweet substances to relax it." The *Materia Medica* says: "Moistening can remove dryness." Therefore, Hemp Seed is used as the Sovereign (Jun) herb, and Apricot Kernel as the Minister (Chen) herb. Immature Bitter Orange is bitter and cold, Magnolia Bark is bitter and warm. Generally, herbs that break up accumulations must be bitter, so they serve as Assistant (Zuo) herbs. Peony Root is sour and cold, Rhubarb is bitter and cold. Sour and bitter induce purging and drainage, belonging to Yin, so they serve as Envoy (Shi) herbs. Zhu Danxi said: "Since it is called Spleen Constraint, blood is depleted and fire blazes. Metal (Lung) is affected, and fluids are exhausted, inevitably borrowing from the Mother element of Earth (Spleen) to save itself. When Metal declines, Earth suffers from Wood's punishment (Wood overacts on Earth), the Spleen loses its transforming and transporting function, and the Lung loses its disseminating and descending function. It is appropriate to nourish Yin and descend fire, allowing Metal to clear and transform, making Spleen Earth robust. Once fluids are moist, how can there be constipation?" This formula is only suitable for those with extreme heat and solid constitution. If heat is severe but the constitution is deficient, using this will exacerbate the suffering of dryness and depletion.
This formula treats constipation due to wind accumulation, blood deficiency, and latent fire in the stomach.
Ingredients: Notopterygium Root (Notopterygii Rhizoma et Radix), Tail of Angelica Sinensis (Angelicae Sinensis Radix), Rhubarb (prepared by stir-baking, each 5 qian), Hemp Seed, Peach Kernel (peeled and de-cored, each 1 liang). Grind Hemp Seed separately into a paste, grind other herbs into powder, mix with honey to make pills the size of paulownia seeds. Take 50 pills every morning with warm water. Adding prepared Gleditsia Sinensis Fruit pulp is also excellent. Because its nature becomes slippery when wet, slipperiness naturally eliminates dryness and accumulation.