半夏 天南星 枯白矾(各五钱) 枯红矾 鸡冠花(炒) 白附子(各五两) 诃子
肉( )
黑附子(生) 枳壳(各一两) 皮(二枚,炙) 栝蒌(一枚,烧存性) 胡桃仁(十
五枚,烧
存性)
共为末,醋糊作丸。空心温酒下三十丸。
泄泻虚寒脱肛者,此方主之。
湿盛则濡泻,久泻则胃虚,胃虚则脏寒,脏寒则无阳以升举,故令肛肠脱而不上。燥能
去湿,故用半夏、南星。枯能制湿、故用红、白枯矾。温能暖脏,故用黑、白附子。乃若鸡
冠花、刺 皮、枳壳所以驱风。而诃子、栝蒌、胡桃仁之灰,取其涩以固脱也。
熊胆(五分) 孩儿茶(三分) 冰片(一分)
共为细末,乳调涂肛上,热汁下而肛收矣。
热泻脱肛者,用此方涂之良。
热则肛门涩,涩则便不易出,不易出则令人努责,努责之久,则令脱肛。此与寒脱不同
者,此则肛门涩,寒脱则洞泄而不涩也。苦可以胜热,故用熊胆。涩可以固脱,故用儿茶。
辛可以拔邪,故用冰片。
叙曰∶呕有声长、声短之辨,吐有见痰、见食之分,参之以脉证,合之以颜色,问之以
从来,始为无失。毋但曰呕吐小疾而忽之,常见肝实之证,令人呕吐不已而死者。兹考六方,
志
半夏 陈皮(去白) 茯苓 甘草(炙) 山栀子(炒黑) 黄连(炒) 生姜(等分)
胃中有热,膈上有痰,令人呕吐者,此方主之。
有声之谓呕,有物之谓吐。声者,气与火也。物者,痰与涎也。半夏燥痰湿,茯苓渗痰
湿,陈皮利痰气,甘草益脾气,此二陈治痰之旨也。苦可以泻火,故用栀子。辛可以行滞,
故用生姜。
【方剂组成】半夏、天南星、枯白矾(各五钱)、枯红矾、鸡冠花(炒制)、白附子(各五两)、诃子肉、黑附子(生用)、枳壳(各一两)、陈皮(二枚,炙烤)、栝蒌(一枚,烧至保留药性)、胡桃仁(十五枚,烧至保留药性)。
以上药材共同研磨成细末,用醋调制的糊状物作为粘合剂制成丸药。空腹时以温酒送服三十丸。
湿气过盛会导致大便稀溏,长期腹泻会导致胃气虚弱,胃气虚弱则脏腑寒冷,脏腑寒冷则缺乏阳气来升举固摄,从而导致肛肠脱出而无法收回。干燥的药物能够去除湿气,因此使用半夏和天南星。煅烧后的药物能制约湿气,因此使用红矾和白矾的煅制品。温热的药物能温暖脏腑,因此使用黑附子和白附子。至于鸡冠花、刺皮(此处指椿皮或类似祛风药,原文作“刺 皮”,结合语境推测为祛风之品,如椿根皮等,此处依原文直译或泛指祛风药)、枳壳则是为了驱除风邪。而诃子、栝蒌炭、胡桃仁炭,则是取其收敛涩肠的作用以固摄脱出的脏器。
【外用方剂组成】熊胆(五分)、孩儿茶(三分)、冰片(一分)。
以上药材共同研磨成极细的粉末,用乳汁调和后涂抹于肛门处,热性泄泻导致的脱肛即可收回。
热邪会导致肛门涩滞,肛门涩滞则大便不易排出,大便不易排出则使人用力努责,长期用力努责,就会导致脱肛。这与寒性脱肛不同之处在于:热性脱肛肛门涩滞,而寒性脱肛则是洞泄(水样便)且不涩滞。苦味的药物可以胜热,因此使用熊胆。涩味的药物可以固摄脱出,因此使用孩儿茶。辛味的药物可以拔除邪气,因此使用冰片。
【叙曰】关于呕吐,需要辨别声音是长还是短;关于吐物,需要区分是有痰还是食物。结合脉象和证候,综合观察面色,询问病史起因,这样才能不出现失误。不要仅仅认为呕吐是小病而忽视它,常见肝气实盛的病症,会导致人呕吐不止而死亡。这里考察了六个方剂,记录如下:
【方剂组成】半夏、陈皮(去白)、茯苓、甘草(炙烤)、山栀子(炒黑)、黄连(炒制)、生姜(等分)。
有声音称为呕,有物体吐出称为吐。声音,代表气和火;吐出的物体,代表痰和涎。半夏燥化痰湿,茯苓渗利痰湿,陈皮理气化痰,甘草补益脾气,这是二陈汤治疗痰证的宗旨所在。苦味的药物可以泻火,因此使用山栀子。辛味的药物可以行气导滞,因此使用生姜。
[Composition of the Formula] Banxia (Pinelliae Rhizoma), Tiannanxing (Arisaematis Rhizoma), Ku Baifan (Alum, calcined) (each 5 qian), Ku Hongfan (Red Alum, calcined), Jiguanhua (Cristatae Coronari Flos, stir-fried), Baifuzi (Typhonii Rhizoma) (each 5 liang), Hezi Rou (Terminalia Chebulae Fructus pulp), Hei Fuzi (Aconiti Lateralis Radix Praeparata, raw), Zhike (Aurantii Fructus Immaturus) (each 1 liang), Pichen (Citri Reticulatae Pericarpium, 2 pieces, roasted), Gualou (Trichosanthis Fructus, 1 piece, burnt to retain efficacy), Hutaoren (Juglandis Semen) (15 pieces, burnt to retain efficacy).
Grind all ingredients into a fine powder. Use vinegar paste as a binder to form pills. Take 30 pills with warm wine on an empty stomach.
This formula is indicated for prolapse of the rectum due to deficiency-cold resulting from diarrhea.
Excessive dampness leads to loose stools; prolonged diarrhea leads to Spleen-Stomach deficiency; Spleen-Stomach deficiency leads to cold in the Zang organs; cold in the Zang organs results in a lack of Yang Qi to lift and secure, causing the rectum to prolapse and fail to retract. Dryness can eliminate dampness, hence Banxia and Tiannanxing are used. Calcination can control dampness, hence Red Alum and White Alum (calcined) are used. Warmth can暖 (warm) the Zang organs, hence Hei Fuzi and Baifuzi are used. As for Jiguanhua, Cipi (likely referring to Toosendan Fructus or similar wind-dispelling herbs, text says "Ci Pi"), and Zhike, they are used to dispel wind. Hezi, Gualou charred, and Hutaoren charred are used for their astringent properties to secure prolapse.
[External Application Formula Composition] Xiongdan (Ursi Bile), Haiercha (Camelliae Seed Tea), Bingpian (Borneolum Syntheticum).
Grind all ingredients into a very fine powder. Mix with milk and apply to the anus. This will cause the prolapsed rectum caused by hot diarrhea to retract.
This external application is effective for prolapse of the rectum caused by hot diarrhea.
Heat causes stagnation and astringency in the anal region; astringency makes defecation difficult; difficulty in defecation leads to straining; prolonged straining causes prolapse of the rectum. This differs from cold-induced prolapse: heat-induced prolapse involves anal astringency, whereas cold-induced prolapse involves profuse watery diarrhea without astringency. Bitter substances overcome heat, hence Xiongdan is used. Astringent substances secure prolapse, hence Haiercha is used. Acrid substances extract pathogens, hence Bingpian is used.
[Preface] Regarding vomiting, one must distinguish whether the sound is long or short; regarding emesis, one must differentiate between phlegm and food. By integrating pulse and syndrome differentiation, observing complexion, and inquiring about the history of the illness, errors can be avoided. Do not merely consider vomiting a minor ailment and neglect it. It is common to see patients dying from incessant vomiting due to Liver Excess. Here, six formulas are examined and recorded:
[Composition of the Formula] Banxia (Pinelliae Rhizoma), Chenpi (Citri Reticulatae Pericarpium, white pith removed), Fuling (Poria), Gancao (Glycyrrhizae Radix et Rhizoma, roasted), Shanzhizi (Gardeniae Fructus, stir-fried until black), Huanglian (Coptidis Rhizoma, stir-fried), Shengjiang (Zingiberis Rhizoma Recens) (equal parts).
This formula is indicated for vomiting caused by Heat in the Stomach and Phlegm above the Diaphragm.
Vomiting with sound but no substance is called "Ou" (retching); vomiting with substance is called "Tu" (emesis). Sound represents Qi and Fire; substance represents Phlegm and Saliva. Banxia dries Phlegm-Dampness, Fuling leaches out Phlegm-Dampness, Chenpi promotes the movement of Qi to resolve Phlegm, and Gancao tonifies Spleen Qi. These constitute the principle of Erchen Tang in treating Phlegm. Bitter substances purge Fire, hence Shanzhizi is used. Acrid substances promote circulation and remove stagnation, hence Shengjiang is used.