高××,年三十六岁,得大便下血证。
病因 冷时出外办事,寝于寒凉屋中,床衾又甚寒凉遂得斯证。
证候 每日下血数次,或全是血,或兼有大便,或多或少,其下时多在夜间,每觉腹中作疼,即
须入厕,夜间恒苦不寐,其脉迟而芤,两尺尤不堪重按,病已二年余,服温补下元药则
稍轻,然终不能除根,久之,则身体渐觉羸弱。
诊断 此下焦虚寒太甚,其气化不能固摄而血下陷也。视其从前所服诸方,皆系草木之品,其
质轻浮,温暖之力究难下达,当以矿质之品温暖兼收涩者投之。
处方 生硫黄(半斤色纯黄者) 赤石脂(半斤纯系粉末者)
将二味共轧细过罗,先空心服七八分,日服两次,品验渐渐加多,以服后移时微觉腹中温暖为度。
效果 后服至每次二钱,腹中始觉温暖,血下亦渐少。服至旬
余,身体渐壮,夜睡安然,可无入厕。服至月余,则病根祓除矣。
方解 按硫黄之性,温暖下达,诚为温补下焦第一良药,而生用之尤佳,惟其性能润大便(本草谓
其能使大便润、小便长,西医以为轻泻药药),于大便滑泻者不宜,故辅以赤石脂之粘腻收涩,自有益而无弊矣。
崔童,年十三岁,得大便下血证。
病因 仲夏天热,赛球竞走,劳力过度,又兼受热,遂患大便下血。
证候 每日大便,必然下血,便时腹中作疼,或轻或剧,若疼剧时,则血之下者必多,已年
余矣。饮食减少,身体羸弱,面目黄白无血色,脉搏六至,左部弦而微硬,右部濡而无力。
诊断 此证当因脾虚不能统血,是以其血下陷至其腹,所以作疼,其肠中必有损伤溃烂处也。当
用药健补其脾胃,兼调养其肠中溃烂。
处方 生怀山药(一两) 龙眼肉(一两) 金银花(四钱) 甘草(三钱) 广三
七(二钱半轧细末) 鸦胆子(八十粒去皮拣其仁之成实者)
共药六味,将前四味煎汤,送服三七、鸦胆子各一半,至煎渣再服时,仍送服其余一半。
效果 将药如法服两次,下血病即除根矣。
高某某,三十六岁,患大便下血证。
病因 寒冷时节外出办事,睡在寒凉的房屋中,床铺和被褥也非常寒冷,因此得了这个病。
证候 每天排便数次出血,有时全是血,有时夹杂在大便中,血量或多或少。出血多在夜间发生,每次感觉腹部疼痛时,就必须上厕所。夜间常常痛苦得无法入睡。脉象迟而芤(浮大中空,如按葱管),两尺部尤其不堪重按。患病已两年多,服用温补下元(肾与命门)的药物后症状稍轻,但始终不能除根,久而久之,身体逐渐感到虚弱消瘦。
诊断 这是下焦虚寒太严重,气化功能不能固摄血液,导致血液下陷所致。查看他之前服用的各方剂,都是草木类的药材,质地轻浮,温暖的药力终究难以下达至下焦,应当用矿物类的药材,兼具温暖与收涩作用的药物来治疗。
处方 生硫黄(半斤,颜色纯黄的) 赤石脂(半斤,纯系粉末状的)
将这两味药共同碾碎过筛,先空腹服用七八分,每天服用两次,根据药效体验逐渐增加剂量,以服药后过了一会儿微微感到腹部温暖为限度。
效果 后来服用至每次二钱,腹部才开始觉得温暖,出血也逐渐减少。服用十多天后,身体逐渐强壮,夜间睡眠安稳,可以不用起夜上厕所。服用一个多月后,病根就被彻底清除了。
方解 按照硫黄的药性,能够温暖并下达至下焦,确实是温补下焦的第一良药,而生用效果更好。只是它的性能能润通大便(《本草》记载它能使大便润滑、小便增多,西医认为它是轻泻药),对于大便滑泄不禁者不宜单独使用,所以辅以赤石脂的粘腻收涩之性,自然有益而无弊端了。
崔童,十三岁,患大便下血证。
病因 仲夏天气炎热,参加球赛竞走,劳动过度,又兼受热邪,于是患上大便下血。
证候 每天大便时必然出血,排便时腹部疼痛,或轻或重。如果疼痛剧烈时,流出的血必然较多。这种情况已经持续一年多了。饮食减少,身体虚弱消瘦,面色黄白无血色,脉搏每分钟六至(较快),左脉弦而微硬,右脉濡而无力。
诊断 此证应当是因为脾虚不能统摄血液,所以血液下陷至腹部,因此产生疼痛,肠道中必定有损伤溃烂的地方。应当用药健运补益脾胃,同时调养肠道中的溃烂。
处方 生怀山药(一两) 龙眼肉(一两) 金银花(四钱) 甘草(三钱) 广三七(二钱半,碾成细末) 鸦胆子(八十粒,去皮,挑选其中仁饱满成熟的)
共六味药,将前四味煎汤,送服三七和鸦胆子各一半的量;等到煎煮药渣再服用时,仍然送服剩余的一半。
效果 按照这种方法服药两次,下血的病根就彻底消除了。
Gao XX, aged thirty-six, suffered from hematochezia (bleeding from the rectum).
Etiology During cold weather, he went out for business and slept in a cold house; the bed and bedding were also very cold, which led to this condition.
Symptoms He experienced bleeding several times daily during defecation. Sometimes the stool consisted entirely of blood, sometimes it was mixed with feces, varying in amount. The bleeding mostly occurred at night. Whenever he felt abdominal pain, he had to rush to the toilet. He often suffered from insomnia at night. His pulse was slow and Kou (floating, large, and hollow, feeling like pressing on a green onion stalk), especially at both Chi positions (corresponding to the Kidney and Mingmen), where pressure was intolerable. The illness had persisted for over two years. Taking herbs that warm and tonify the Lower Yuan (Kidney and Mingmen) provided slight relief, but the root cause could not be eradicated. Over time, his body gradually became weak and emaciated.
Diagnosis This is due to severe deficiency-cold in the Lower Jiao (Lower Burner), where Qi transformation fails to secure and hold blood, causing blood to sink downward. Reviewing the previous prescriptions he took, they all consisted of herbal materials (plant-based drugs), which have light and floating qualities, making their warming power difficult to reach the Lower Jiao. It is necessary to use mineral substances that possess both warming and astringent properties.
Prescription Raw Sulfur (Ban Huang, half a jin, pure yellow in color) Chih-shih (Hematitum, half a jin, pure powder form)
Grind these two ingredients together into a fine powder and sieve them. Initially, take seven or eight fen on an empty stomach, twice daily. Gradually increase the dosage based on therapeutic response, stopping when a slight warmth is felt in the abdomen some time after ingestion.
Effect After increasing the dose to two qian per administration, warmth was finally felt in the abdomen, and bleeding gradually decreased. After more than ten days of treatment, his physical strength improved, nighttime sleep became peaceful, and nocturia ceased. After one month of treatment, the root of the disease was completely eliminated.
Formula Analysis According to the nature of Sulfur, it warms and descends to the Lower Jiao, truly being the best herb for warming and tonifying the Lower Jiao, especially when used raw. However, its property moistens the intestines to promote bowel movements (as recorded in Materia Medica: it moistens stools and increases urine volume; Western medicine considers it a mild laxative), so it is unsuitable for patients with loose stools or incontinence. Therefore, it is supplemented with Chih-shih (Hematitum), which has sticky and astringent properties, ensuring benefit without adverse effects.
Cui Tong, aged thirteen, suffered from hematochezia.
Etiology In mid-summer, during hot weather, he participated in ball games and running races, exerting himself excessively while exposed to heat, leading to hematochezia.
Symptoms Every bowel movement was accompanied by bleeding, along with abdominal pain during defecation, ranging from mild to severe. When the pain was intense, the amount of blood loss was necessarily greater. This condition had persisted for over a year. His appetite decreased, and his body became weak and emaciated. His complexion was sallow and pale without luster. His pulse rate was six beats per breath cycle (rapid). The left pulse was Wiry (Xian) and slightly hard, while the right pulse was Soft (Ru) and forceless.
Diagnosis This condition is likely caused by Spleen deficiency failing to control blood, causing blood to sink into the abdomen, resulting in pain. There must be damage and ulceration in the intestines. Treatment should focus on strengthening and tonifying the Spleen and Stomach, while simultaneously nourishing and healing the intestinal ulcers.
Prescription Sheng Huai Shan Yao (Raw Dioscoreae Hypoglaucae Rhizoma, one liang) Long Yan Rou (Longan Aril, one liang) Yin Hua (Flos Lonicerae Japonicae, four qian) Gan Cao (Radix Glycyrrhizae, three qian) Guang San Qi (Panax Notoginseng Radix et Rhizoma, two qian half, ground into fine powder) Ya Dan Zi (Fructus Bruceae, eighty grains, peeled, selecting only mature kernels)
These six ingredients are prepared as follows: Decoct the first four ingredients to make a decoction. Use this decoction to swallow half of the powdered San Qi and Ya Dan Zi. When the dregs are decocted for the second dose, use that decoction to swallow the remaining half of the powders.
Effect After taking the medicine according to this method for two doses, the hematochezia was completely cured.