论曰下焦者在脐下，当膀胱上口，主分别清浊，出而不内以传导也，又下焦如渎。司决
壅泄，其气实而有热，则津液内燥，传导不利，由是有气逆、便难、胃胀、呕哕之证。
治下焦热结，大小便不通。柴胡汤方
柴胡（去苗） 黄芩（去黑心） 陈橘皮（汤浸去白焙） 栀子仁 石膏（碎） 羚羊
角（镑）
生干地黄（焙各一两） 芒硝（半两）
上八味，粗捣筛，每服三钱匕，水一盏，煎至七分，去滓温服，日二夜一。
治下焦热结，呕吐不止，心腹满闷。香豉汤方
豉（炒） 生干地黄（焙） 白术（锉各二两） 甘草（炙一两） 石膏（碎三两） 赤
茯苓（去
上六味，粗捣罗，每服四钱匕，水一盏半，竹叶十片，煎至一盏，去滓温服。日二夜一
治下焦热结气逆，呕吐不禁，名曰走哺。人参汤方
人参 栀子仁 葳蕤 黄芩（去黑心） 知母（切焙各一两） 赤茯苓（去黑皮） 白
术
上九味。粗捣筛，每服三钱匕，水一盏，生姜三片，煎至七分，去滓温服，日二夜一。
治下焦受病，大肠菀热，伏瘕深固。茵陈蒿丸方
茵陈蒿（五两） 茹（三两） 威灵仙（去土） 太一余粮（ ） 柴胡（去苗各二
两） 黄芩
上九味，捣罗为末，炼蜜丸如梧桐子大，每服二十丸，木香汤下，以知为度。
治下焦受热，大便难，及多疮疡。石长生丸方
石长生（五两） 升麻（三分） 鸡舌香 水银粉 硝石（别研各二两） 石膏（碎） 葛
根（
上九味，捣罗为末，炼蜜和丸，如绿豆大，每服十丸，早晚食前温米饮下，渐加至二十
丸，以知为度。
治下焦肠胃伏热，妇人胎热产难。酸浆丸方
酸浆实（五两） 苋实（三两） 马蔺子（炒焦） 大盐（别研） 榆白皮（锉各二两）
柴胡（
去苗） 黄芩（去黑心） 栝蒌根（锉） 茹（各一两）
上九味，捣罗为末，炼蜜丸如梧桐子大，不计时候，用木香汤吞下二十丸，至三十丸。
以知为度。
治下焦蕴热。结成毒痢，血如鹅鸭肝。升麻汤方
升麻 紫草（去苗） 黄芩（去黑心） 桔梗（炒各三分） 犀角（镑） 地榆（去苗）
荷根（
上九味，粗捣筛，每服三钱匕，水一盏半，煎至一盏，去滓温服，日三夜一。
治下焦蕴热痢下脓血，烦痛 闷。赤石脂汤方
赤石脂 乌梅（炒各一两） 栀子仁（三分） 白术（一两半） 干姜（炮半两） 升
麻（一两）
上七味，粗捣筛，每服三钱匕，水一盏半，煎至一盏，去滓不拘时候温服。
治下焦蕴热毒，变赤血痢，脐腹 痛不可忍。香豉汤方
豉（微炒二两） 栀子仁 黄柏（去粗皮锉） 地榆（锉） 白术 茜根（锉各一两）
上六味，粗捣筛，每服三钱匕，水一盏半，同煎至一盏，去滓温服，日二夜一。
治下焦热结。五味子丸方
五味子（五两） 天门冬（去心焙三两） 白芍药 防己 车前子（各二两） 槟榔（锉）
牵
上九味，捣研为末，炼蜜和丸，如梧桐子大，每服十五丸，食后木香汤下，稍增至三十
丸，以知为度。
论述说：下焦位于脐部下方，正当膀胱上口的位置，主要功能是分别清浊之气，排出废物而不纳入体内，以完成传导作用，正如古人所说“下焦如同沟渠”。如果下焦气机壅实且伴有热邪，就会导致体内津液干燥，传导功能不利，从而出现气逆、排便困难、胃脘胀满、呕吐呃逆等症状。
治疗下焦热结导致的大小便不通。柴胡汤方：
柴胡（去苗）、黄芩（去黑心）、陈橘皮（用热水浸泡后去掉白色部分并焙干）、栀子仁、石膏（捣碎）、羚羊角（镑成薄片）、生干地黄（焙干，以上各一两）、芒硝（半两）。
以上八味药，粗捣筛过，每次服用三钱匕，加水一盏，煎煮至七分水量，滤去药渣，温服，每日两次，夜间一次。
治疗下焦热结，呕吐不止，心腹部胀满闷痛。香豉汤方：
豉（炒制）、生干地黄（焙干）、白术（锉碎，以上各二两）、甘草（炙制，一两）、石膏（捣碎，三两）、赤茯苓（去掉黑色外皮，一两）。
以上六味药，粗捣罗过，每次服用四钱匕，加水一盏半，竹叶十片，煎煮至一盏水量，滤去药渣，温服，每日两次，夜间一次。
治疗下焦受病导致气逆，呕吐无法控制，这种病症名叫“走哺”。人参汤方：
人参、栀子仁、葳蕤、黄芩（去黑心）、知母（切后焙干，以上各一两）、赤茯苓（去掉黑皮）、白术（一两）。
以上九味药，粗捣筛过，每次服用三钱匕，加水一盏，生姜三片，煎煮至七分水量，滤去药渣，温服，每日两次，夜间一次。
治疗下焦患病，大肠郁积热邪，形成深固的伏瘕（腹内结块）。茵陈蒿丸方：
茵陈蒿（五两）、茹（三两，注：原文此处疑为“茜根”或类似药材，依原文保留“茹”）、威灵仙（去土）、太一余粮（打碎，二两）、柴胡（去苗，二两）、黄芩（二两）。
以上九味药，捣罗成粉末，用炼蜜制成梧桐子大小的丸剂，每次服用二十丸，用木香汤送下，以见效为度。
治疗下焦受热，大便困难，以及多发疮疡。石长生丸方：
石长生（五两）、升麻（三分）、鸡舌香、水银粉、硝石（单独研磨，以上各二两）、石膏（捣碎）、葛根（二两）。
以上九味药，捣罗成粉末，用炼蜜调和制成绿豆大小的丸剂，每次服用十丸，早晚饭前用温米饮送下，逐渐增加至二十丸，以见效为度。
治疗下焦肠胃潜伏热邪，妇人胎热导致难产。酸浆丸方：
酸浆实（五两）、苋实（三两）、马蔺子（炒焦）、大盐（单独研磨）、榆白皮（锉碎，以上各二两）、柴胡（去苗）、黄芩（去黑心）、栝蒌根（锉碎）、茹（以上各一两）。
以上九味药，捣罗成粉末，用炼蜜制成梧桐子大小的丸剂，不限时候，用木香汤吞服二十丸，最多至三十丸，以见效为度。
治疗下焦蕴藏热邪，结成毒痢，大便血色如鹅鸭肝。升麻汤方：
升麻、紫草（去苗）、黄芩（去黑心）、桔梗（炒制，以上各三分）、犀角（镑成薄片）、地榆（去苗）、荷根（一两）。
以上九味药，粗捣筛过，每次服用三钱匕，加水一盏半，煎煮至一盏水量，滤去药渣，温服，每日三次，夜间一次。
治疗下焦蕴热导致的痢疾下脓血，心烦疼痛闷乱。赤石脂汤方：
赤石脂、乌梅（炒制，以上各一两）、栀子仁（三分）、白术（一两半）、干姜（炮制，半两）、升麻（一两）。
以上七味药，粗捣筛过，每次服用三钱匕，加水一盏半，煎煮至一盏水量，滤去药渣，不拘时候温服。
治疗下焦蕴热毒，变为赤血痢，脐腹部疼痛难以忍受。香豉汤方：
豉（微炒，二两）、栀子仁、黄柏（去掉粗皮锉碎）、地榆（锉碎）、白术、茜根（锉碎，以上各一两）。
以上六味药，粗捣筛过，每次服用三钱匕，加水一盏半，共同煎煮至一盏水量，滤去药渣，温服，每日两次，夜间一次。
治疗下焦热结。五味子丸方：
五味子（五两）、天门冬（去心焙干，三两）、白芍药、防己、车前子（以上各二两）、槟榔（锉碎）、牵牛子（一两）。
以上九味药，捣研成粉末，用炼蜜调和制成梧桐子大小的丸剂，每次服用十五丸，饭后用木香汤送下，稍增至三十丸，以见效为度。
Discourse states: The Lower Jiao (Lower Burner) is located below the umbilicus, at the opening of the bladder. Its primary function is to separate the clear from the turbid, expelling waste without reabsorption, thereby facilitating conduction and transformation. As the ancients said, "The Lower Jiao is like a drainage ditch." It governs the resolution of obstructions and the discharge of fluids. If the Qi in the Lower Jiao becomes full and hot, it causes internal dryness of body fluids and impedes conduction, leading to symptoms such as rebellious Qi, difficult defecation, abdominal distension, vomiting, and hiccups.
Treatment for heat accumulation in the Lower Jiao resulting in obstruction of both urination and defecation. Chaihu Tang (Bupleurum Decoction):
Chai Hu (Radix Bupleuri, stems removed), Huang Qin (Radix Scutellariae, blackened parts removed), Chen Pi (Pericarpium Citri Reticulatae, soaked in water, white pith removed, dried), Zhi Zi Fructus Gardeniae), Shi Gao (Gypsum Fibrosum, crushed), Ling Yang Jiao (Cornu Saigae Tataricae, shaved into flakes), Sheng Di Huang (Radix Rehmanniae Preparata, dried; each 1 liang), Mang Xiao (Natrii Sulfas, 0.5 liang).
The above eight ingredients are coarsely pounded and sifted. Each dose consists of 3 qian bi (approx. 9-10g), boiled with 1 sheng (approx. 200ml) of water until reduced to 0.7 sheng. Strain and take warm. Administer twice daily and once at night.
Treatment for heat accumulation in the Lower Jiao causing incessant vomiting and fullness/stuffiness in the heart and abdomen. Xiang Chi Tang (Fermented Soybean Decoction):
Chi (Fermented Soybean, fried), Sheng Di Huang (Radix Rehmanniae Preparata, dried), Bai Zhu (Rhizoma Atractylodis Macrocephalae, sliced; each 2 liang), Gan Cao (Radix Glycyrrhizae, honey-fried, 1 liang), Shi Gao (Gypsum Fibrosum, crushed, 3 liang), Chi Fu Ling (Poria Cocos with Red Skin, black skin removed, 1 liang).
The above six ingredients are coarsely pounded and sieved. Each dose consists of 4 qian bi, boiled with 1.5 sheng of water and 10 slices of Zhu Ye (Phyllostachys Viridis Leaf) until reduced to 1 sheng. Strain and take warm. Administer twice daily and once at night.
Treatment for rebellious Qi due to disease in the Lower Jiao, with uncontrollable vomiting, a condition named "Zou Bu" (Running Feeding). Ren Shen Tang (Ginseng Decoction):
Ren Shen (Radix Ginseng), Zhi Zi (Fructus Gardeniae), Wei Rui (Rhizoma Polygonati Odorati), Huang Qin (Radix Scutellariae, blackened parts removed), Zhi Mu (Rhizoma Anemarrhenae, sliced and dried; each 1 liang), Chi Fu Ling (Poria Cocos with Red Skin, black skin removed), Bai Zhu (Rhizoma Atractylodis Macrocephalae, 1 liang).
The above nine ingredients are coarsely pounded and sifted. Each dose consists of 3 qian bi, boiled with 1 sheng of water and 3 slices of Sheng Jiang (Rhizoma Zingiberis Recens) until reduced to 0.7 sheng. Strain and take warm. Administer twice daily and once at night.
Treatment for disease in the Lower Jiao where the Large Intestine harbors stagnant heat, forming deep-seated Fu Xia (abdominal masses). Yin Chen Hao Wan (Artemisiae Scopariae Pill):
Yin Chen Hao (Herba Artemisiae Scopariae, 5 liang), Ru (Root of Rubia or similar, 3 liang - *Note: Text says 'Ru', likely referring to Qian Cao Gen or similar red-dyeing root*), Wei Ling Xian (Radix Saposhnikoviae, soil removed), Tai Yi Yu Liang (Kaolin, crushed, 2 liang), Chai Hu (Radix Bupleuri, stems removed, 2 liang), Huang Qin (Radix Scutellariae, 2 liang).
The above nine ingredients are pounded into powder, mixed with refined honey, and formed into pills the size of Sophora seeds. Each dose is 20 pills, taken with Mu Xiang Tang (Aucklandia Decoction), adjusted until efficacy is achieved.
Treatment for heat in the Lower Jiao causing difficult defecation and multiple sores/ulcers. Shi Chang Sheng Wan (Lithospermum Pill):
Shi Chang Sheng (Radix Lithospermi, 5 liang), Sheng Ma (Rhizoma Cimicifugae, 3 fen), Ji She Xiang (Styrax, 2 liang), Shui Yin Fen (Calomelas, 2 liang), Xiao Shi (Natrii Nitras, separately ground, 2 liang), Shi Gao (Gypsum Fibrosum, crushed, 2 liang), Ge Gen (Puerariae Radix, 2 liang).
The above nine ingredients are pounded into powder, mixed with refined honey, and formed into pills the size of mung beans. Each dose is 10 pills, taken with warm rice drink before morning and evening meals. Gradually increase to 20 pills, adjusted until efficacy is achieved.
Treatment for latent heat in the intestines and stomach of the Lower Jiao, and fetal heat in women causing difficult labor. Suan Jiang Wan (Physalis Pill):
Suan Jiang Shi (Fructus Physalis Alkekengi, 5 liang), Xian Shi (Seed Amaranthi, 3 liang), Ma Lin Zi (Seed Liriopis, stir-fried until charred), Da Yan (Halitum, separately ground), Yu Bai Pi (Cortex Ulmi, sliced; each 2 liang), Chai Hu (Radix Bupleuri, stems removed), Huang Qin (Radix Scutellariae, blackened parts removed), Gua Lou Gen (Radix Trichosanthis, sliced), Ru (Root of Rubia or similar; each 1 liang).
The above nine ingredients are pounded into powder, mixed with refined honey, and formed into pills the size of Sophora seeds. Take 20 to 30 pills with Mu Xiang Tang (Aucklandia Decoction) at any time, adjusted until efficacy is achieved.
Treatment for heat accumulation in the Lower Jiao turning into toxic dysentery, with stool resembling goose or duck liver. Sheng Ma Tang (Cimicifuga Decoction):
Sheng Ma (Rhizoma Cimicifugae), Zi Cao (Radix Arnebiae, stems removed), Huang Qin (Radix Scutellariae, blackened parts removed), Jie Geng (Radix Platycodonis, fried; each 3 fen), Xi Jiao (Cornu Rhinocerotis, shaved into flakes), Di Yu (Radix Sanguisorbae), He Gen (Rhizoma Nelumbinis, 1 liang).
The above nine ingredients are coarsely pounded and sifted. Each dose consists of 3 qian bi, boiled with 1.5 sheng of water until reduced to 1 sheng. Strain and take warm. Administer three times daily and once at night.
Treatment for dysentery with pus and blood due to heat accumulation in the Lower Jiao, accompanied by irritability and pain. Chi Shi Zhi Tang (Hematitum Decoction):
Chi Shi Zhi (Hematitum, fried), Wu Mei (Fructus Mume, fried; each 1 liang), Zhi Zi (Fructus Gardeniae, 3 fen), Bai Zhu (Rhizoma Atractylodis Macrocephalae, 1.5 liang), Gan Jiang (Rhizoma Zingiberis Preparatum, processed, 0.5 liang), Sheng Ma (Rhizoma Cimicifugae, 1 liang).
The above seven ingredients are coarsely pounded and sifted. Each dose consists of 3 qian bi, boiled with 1.5 sheng of water until reduced to 1 sheng. Strain and take warm at any time.
Treatment for toxic heat in the Lower Jiao transforming into bloody dysentery, with unbearable pain in the navel and abdomen. Xiang Chi Tang (Fermented Soybean Decoction):
Chi (Fermented Soybean, slightly fried, 2 liang), Zhi Zi (Fructus Gardeniae), Huang Bo (Cortex Phellodendri, coarse bark removed, sliced), Di Yu (Radix Sanguisorbae, sliced), Bai Zhu (Rhizoma Atractylodis Macrocephalae), Qian Gen (Radix Rubiae, sliced; each 1 liang).
The above six ingredients are coarsely pounded and sifted. Each dose consists of 3 qian bi, boiled with 1.5 sheng of water until reduced to 1 sheng. Strain and take warm. Administer twice daily and once at night.
Treatment for heat accumulation in the Lower Jiao. Wu Wei Zi Wan (Schisandra Pill):
Wu Wei Zi (Fructus Schisandrae, 5 liang), Tian Men Dong (Radix Asparagi, core removed, dried, 3 liang), Bai Shao Yao (Radix Paeoniae Alba), Fang Ji (Radix Stephaniae Tetrandrae), Che Qian Zi (Seed Plantaginis; each 2 liang), Bing Lang (Areca Seed, sliced), Qian Niu Zi (Seed Pharbitidis, 1 liang).
The above nine ingredients are pounded and ground into powder, mixed with refined honey, and formed into pills the size of Sophora seeds. Each dose is 15 pills, taken after meals with Mu Xiang Tang (Aucklandia Decoction). Gradually increase to 30 pills, adjusted until efficacy is achieved.