百会(一穴,在前顶心上中央旋毛中,治久泻下陷脱滑者,灸三壮。)
脾俞(二穴,在十二椎下两旁各开寸半,治泄泻,灸三壮。)
中脘(一穴,在上脘下一寸,灸七壮。)
关元(一穴,在脐下三寸,治泄不止可灸七壮。)
肾俞(二穴,在十四椎下两傍各开一寸半,与脐平,可灸五壮,治洞泻不止。)
大肠俞(一穴,在十六椎两傍各寸半,可灸三壮,治肠鸣腹胀暴泻。)
天枢(二穴,在夹脐中两旁各二寸陷中。)
气海(一穴,在脐下。)
(大便急迫欲出而不通,故曰滞下。泄俗谓之痢下,此反说也,故从古。)
(夫滞下者,古之义;曰痢疾者,今之名。)
《内经》曰∶溲(当有涩字。)而便脓血,(言病机也。)知气行而血止也。(言治法也。)
又曰∶诸下痢皆属于湿。又曰∶下痢稠粘,皆属于火。又曰∶下痢脓血滞下,皆热
证实证也。
《三因》陈氏云∶痢疾有从外感而得者,须分六气之异。外既受伤,肠胃结郁,遂成赤白等
证,当从其气血虚实以调之。有因脏气发动干犯肠胃而得者,须察其何脏相乘,以平治之。有
因饮食失节而得者,则又审其何物所伤以消克之。世之感此疾者,其因诚不越乎是三者,但其受
病之后,肠胃怫郁,脓血稠粘,里急后重。诸方虽有寒热虚实之论,刘河间则以为热,《内经》
亦以热多而寒少。学人当察其脉证,随变而药之,庶万全也。
百会穴(1个穴位,位于前顶穴正中央的旋毛处,治疗久泻导致的下陷脱肛滑脱症状,艾灸3壮。)
脾俞穴(2个穴位,位于第12胸椎棘突下两旁各旁开1.5寸处,治疗泄泻,艾灸3壮。)
中脘穴(1个穴位,位于上脘穴下方1寸处,艾灸7壮。)
关元穴(1个穴位,位于脐下3寸处,治疗泄泻不止可艾灸7壮。)
肾俞穴(2个穴位,位于第14胸椎棘突下两旁各旁开1.5寸处,与肚脐平齐,可艾灸5壮,治疗洞泄不止。)
大肠俞穴(1个穴位,位于第16胸椎棘突下两旁各旁开1.5寸处,可艾灸3壮,治疗肠鸣腹胀暴泻。)
天枢穴(2个穴位,位于夹脐中两旁各2寸的凹陷处。)
气海穴(1个穴位,位于脐下。)
(大便急迫欲出却排出不畅,所以称为“滞下”。民间俗称痢疾为痢下,这是反向说法,因此沿用古称。)
(“滞下”是古代的病名;“痢疾”是现在的名称。)
《黄帝内经》说:小便涩痛且大便脓血。(这是在阐述病机。)可知气行则血止。(这是在阐述治法。)
又说:各种下痢都属于湿邪。又说:下痢稠粘,都属于火邪。又说:下痢脓血、滞下,都是热证实证。
《三因极一病证方论》陈氏说:痢疾有因外感而得的,必须区分六淫之气的差异。外邪既已受伤,肠胃结郁,遂成赤白痢等证,应当根据气血虚实来调理。有因脏腑之气发动干犯肠胃而得的,必须观察是何脏相乘,以平衡治疗。有因饮食失节而得的,则又审查是何物所伤以消导攻伐。世人感染此疾,其病因确实不出这三类,但在患病之后,肠胃怫郁,脓血稠粘,出现里急后重。各方虽有寒热虚实的论述,刘河间则认为属热,《内经》也以热多寒少为主。学者应当察辨脉证,随证变通用药,才能万无一失。
Baihui (GV20, one acupoint, located in the center of the whorl of hair on the vertex, above Qian Ding (GV20), treating chronic diarrhea with sinking and prolapse; moxibustion, 3 cones.)
Pishu (BL20, two acupoints, located 1.5 cun lateral to the lower border of the spinous process of the 12th thoracic vertebra, treating diarrhea; moxibustion, 3 cones.)
Zhongwan (CV12, one acupoint, located 1 cun below Shangwan (CV13); moxibustion, 7 cones.)
Guanyuan (CV4, one acupoint, located 3 cun below the umbilicus, treating persistent diarrhea; moxibustion, 7 cones.)
Shenshu (BL23, two acupoints, located 1.5 cun lateral to the lower border of the spinous process of the 14th thoracic vertebra, level with the umbilicus; moxibustion, 5 cones, treating profuse watery diarrhea that does not cease.)
Dachangshu (BL25, one acupoint, located 1.5 cun lateral to the lower border of the spinous process of the 16th thoracic vertebra; moxibustion, 3 cones, treating borborygmus, abdominal distension, and acute diarrhea.)
Tianshu (ST25, two acupoints, located 2 cun lateral to the umbilicus, in the depression.)
Qihai (CV6, one acupoint, located below the umbilicus.)
(Stool is urgent but difficult to pass, hence termed "Zhi Xia" [Dysentery with obstruction]. Colloquially called "Li Xia" [Dysentery discharge], this is a reverse description, thus the ancient term is retained.)
("Zhi Xia" is the ancient name; "Li Ji" [Dysentery] is the modern name.)
The *Neijing* states: Urination is astringent and stool contains pus and blood. (This explains the pathogenesis.) It indicates that when Qi moves, bleeding stops. (This explains the therapeutic method.)
It also states: All types of dysentery belong to Dampness. It also states: Dysentery with thick and sticky discharge belongs to Fire. It also states: Dysentery with pus and blood, and Zhi Xia, are all Heat Excess syndromes.
Chen from the *San Yin Fang Lun* states: Dysentery can be contracted from external pathogens, requiring differentiation among the Six Qi. Once injured externally, the intestines and stomach become knotted and stagnant, leading to red and white dysentery syndromes; treatment should regulate Qi and Blood based on deficiency and excess. It can arise from internal organ Qi attacking the intestines and stomach; one must observe which organ is overacting and treat to restore balance. It can result from irregular diet; one must examine what food caused injury and use digestion-promoting methods. The causes of this disease in the world indeed do not exceed these three categories. However, after contracting the disease, the intestines and stomach become congested, pus and blood become thick and sticky, and tenesmus occurs. Although various formulas discuss Cold, Heat, Deficiency, and Excess, Liu Hejian considers it Heat, and the *Neijing* also emphasizes more Heat than Cold. Scholars should observe pulse and symptoms and adjust prescriptions accordingly to ensure complete safety.