病源肠蛊痢者,冷热之气入在肠间,先下赤后下白,连年不愈,侵伤于脏腑,下血杂白
如病蛊之状,名为肠蛊也。(出第十七卷中)
肘后凡病下,应先下白后下赤,若先下赤后下白,为肠蛊方。
牛膝三两捣碎,以酒一升渍经宿,每服一两杯,日二三服,姚同。(出第二卷中)
病源夫春阳气在表,人运动劳役,腠理则开,血气虚者伤于风,至夏又热气乘之,血性
得热则流散也,其遇大肠虚,而血渗入焉,与肠间津液相搏,积热蕴结,血化为脓,肠虚则
泄,故成脓血痢也,所以夏月多苦脓血痢者,肠胃虚也。秋冬诊其脾脉微涩者为内溃,多下
血脓,又脉悬绝则死,滑大则生,脉微小者生,实急者死,脉沉细虚迟者生,数疾大而有热
者死。(出第十七卷中)
肘后疗热病久下痢脓血。柏皮汤方。
黄柏(二两) 栀子(二十枚) 黄连(四两) 阿胶(炙二两)
上四味切,以水六升,煮取二升,分为三服,又一方加乌梅二十枚。(文仲同出第二卷
中)
文仲治热痢,及下黄赤水及黄脓血,四肢烦,皮上冷者方。
黄连(八两) 熟艾(一两) 黄柏(四两) 黄芩(三两)
上四味捣筛为末,以黄腊二两安一升蜜中煮,令消,及暖和药,白饮服六七十丸如小豆
,日二夜一,即验。
又久下痢脓血方。
赤石脂(一升) 乌梅(二十个) 干姜(四片) 粳米(一升)
上四味切,以水七升煮,取令熟药成,服七合,日三。(肘后同并出第三卷中)
删繁疗下焦热,或痢下脓血。赤石脂汤方。
赤石脂(八两) 乌梅(二十枚去核) 栀子(十四枚) 白术 蜀椒(汗) 麻(各
三两) 干姜
(二两) 粟米(一升)
上八味切,以水一斗二升煮米熟,去滓,取七升下诸药,煮取五合服之。(出第四卷中)
备急葛氏云∶若挟热者多下赤脓杂血方。
黄连 灶突中尘(各半两)
上二味末之,酒服方寸匕,日三服。(肘后云以枣膏和分作三丸日服一丸姚氏同出第六
卷中)
古今录验疗肠 溏便脓血,干姜散方。
干姜 黄连 桂心(各一分)
上三味捣筛,服方寸匕,着麋中食,日三,多脓加姜,多血加桂。有验。
又疗中寒下痢脓血,附子散方。
蜀附子(一枚炮) 曲 干姜(各三分)
上三味下筛为散,先食以酒服方寸匕,日二,并疗妇人漏下。忌如前。(并出第三卷中)
【病源】所谓肠蛊痢,是因为寒热之气侵入肠道之间,起初排出赤色粪便,随后排出白色粪便,常年不愈,侵蚀损伤脏腑,排出的血液混杂白色分泌物,如同患蛊毒之状,因此称为肠蛊。(出自第十七卷)
《肘后备急方》指出:凡是患有下痢病症,应当先排白后排赤;如果先排赤后排白,则是肠蛊。治疗肠蛊的方剂如下:
牛膝三两,捣碎,用酒一升浸泡过夜,每次服用一两杯,每日服用二至三次,姚氏(姚僧垣)的方法相同。(出自第二卷)
【病源】春季阳气在体表,人们运动劳作,腠理(皮肤毛孔及肌肉纹理)张开,血气虚弱者易受风邪侵袭,到了夏季,热气又乘虚而入,血液本性遇热则流动散乱,若此时大肠虚弱,血液便渗入其中,与肠道间的津液相互搏结,积热蕴结,血液化为脓液,因肠道虚弱而泄泻,所以形成脓血痢。因此夏季多有人苦于脓血痢,是因为肠胃虚弱所致。在秋冬季节诊察脾脉,若脉象微涩,说明内脏溃败,多伴有下血和脓液;若脉象悬绝(如悬丝般细弱欲断),则预后不良,多致死;若脉象滑大,则预后良好,可生;脉象微小者生,脉象实急者死;脉象沉细虚迟者生,脉象数疾(快速)且大伴有发热者死。(出自第十七卷)
《肘后备急方》治疗热病日久导致下痢脓血。柏皮汤方:
黄柏(二两) 栀子(二十枚) 黄连(四两) 阿胶(炙制二两)
以上四味药切碎,用水六升,煮取二升药液,分三次服用。另一版本方剂加入乌梅二十枚。(文仲的版本相同,出自第二卷)
文仲治疗热痢,以及排出黄色赤水及黄脓血,四肢烦扰不适,皮肤发冷者的方剂:
黄连(八两) 熟艾(一两) 黄柏(四两) 黄芩(三两)
以上四味药捣碎过筛成粉末,将黄蜡二两放入一升蜂蜜中煮化,待温度适宜时调和药粉,用米汤送服六七十丸,大小如小豆,每日两次,夜间一次,即可见效。
又治久痢脓血的方剂:
赤石脂(一升) 乌梅(二十个) 干姜(四片) 粳米(一升)
以上四味药切碎,用水七升煮至药物熟透、药液浓缩,服用七合,每日三次。(《肘后备急方》相同,均出自第三卷)
《删繁方》治疗下焦有热,或痢疾下脓血。赤石脂汤方:
赤石脂(八两) 乌梅(二十枚,去核) 栀子(十四枚) 白术 蜀椒(炒出汗) 麻子仁(各三两) 干姜(二两) 粟米(一升)
以上八味药切碎,用水一斗二升煮粟米至熟,滤去渣滓,取七升药汁,再加入其他药物,煮取五合服用。(出自第四卷)
葛洪《备急千金要方》记载:若夹杂热邪,多排出赤色脓血混合物的方剂:
黄连 灶突中尘(烟囱里的烟灰,各半两)
以上两味药研成粉末,用酒送服一方寸匕,每日三次。(《肘后备急方》说用枣膏调和做成三丸,每日服一丸,姚氏方法相同,出自第六卷)
《古今录验方》治疗肠中溏泄,大便脓血。干姜散方:
干姜 黄连 桂心(各一分)
以上三味药捣碎过筛,服用一方寸匕,随麋肉食物同食,每日三次,脓多者增加干姜用量,血多者增加桂心用量。疗效显著。
又治疗中寒所致下痢脓血。附子散方:
蜀附子(一枚,炮制) 神曲 干姜(各三分)
以上三味药捣碎过筛成散剂,饭前用酒送服一方寸匕,每日两次,同时治疗妇人漏下出血。禁忌事项与前文相同。(均出自第三卷)
[Pathogenesis] The so-called "Chang Gu Li" (Intestinal Gu Dysentery) occurs when cold and hot pathogenic factors enter the intestines. Initially, red stool is passed, followed by white stool. If this condition persists for years without healing, it erodes and damages the Zang-Fu organs. The discharged blood is mixed with white secretions, resembling the appearance of a Gu disease (a traditional concept referring to diseases caused by poisoning or parasites), hence the name "Chang Gu." (From Volume XVII)
The *Zhou Hou Bei Ji Fang* (Emergency Prescriptions Kept Up My Sleeve) states: In cases of dysentery, one should typically pass white stool before red stool; if red stool is passed before white stool, it indicates Chang Gu. The prescription for treating Chang Gu is as follows:
Niuxi (Radix Achyranthis Bidentatae), 3 liang, crushed, soaked in 1 sheng of wine overnight. Take 1-2 cups per dose, administered two to three times daily. Yao’s method is identical. (From Volume II)
[Pathogenesis] In spring, Yang Qi resides on the surface. When people engage in physical activity or labor, the Cou Li (skin pores and interstitial spaces) open. Those with deficient Blood and Qi are susceptible to Wind pathogens. By summer, Heat pathogens invade further. Since Blood tends to flow and scatter when exposed to Heat, if the Large Intestine is weak, Blood may渗 (seep) into it. It interacts with the fluids in the intestines, leading to accumulated Heat and stagnation. The Blood transforms into Pus. Due to intestinal weakness causing diarrhea, Nong Xue Li (Pus-Blood Dysentery) forms. This is why many suffer from pus-blood dysentery in summer: their stomach and intestines are weak. In autumn and winter, if the Spleen pulse is detected as faint and choppy (Wei Se), it indicates internal collapse, often accompanied by bloody and purulent stools. If the pulse is "Xuan Jue" (suspended and severed, indicating extreme deficiency), death is likely. If the pulse is slippery and large (Hua Da), survival is probable. A small and fine pulse indicates life; a solid and urgent pulse indicates death. A deep, fine, empty, and slow pulse indicates life; a rapid, large pulse accompanied by fever indicates death. (From Volume XVII)
The *Zhou Hou Bei Ji Fang* treats prolonged heat diseases resulting in dysentery with pus and blood. Bai Pi Tang (Cortex Phellodendri Decoction):
Huang Bo (Phellodendri Cortex), 2 liang; Zhi Zi (Gardeniae Fructus), 20 pieces; Huang Lian (Coptidis Rhizoma), 4 liang; E Jiao (Colla Corii Asini), 2 liang (roasted).
Cut the four ingredients, add 6 sheng of water, boil to obtain 2 sheng of decoction, and divide into three doses. Another variant adds 20 Wu Mei (Mume Fructus). (Wen Zhong’s version is identical, From Volume II)
Wen Zhong’s prescription for treating heat dysentery, discharge of yellow watery stool and yellow pus-blood, irritability in the four limbs, and coldness of the skin:
Huang Lian (Coptidis Rhizoma), 8 liang; Shu Ai (Artemisiae Argyi Folium, prepared), 1 liang; Huang Bo (Phellodendri Cortex), 4 liang; Huang Qin (Scutellariae Radix), 3 liang.
Grind the four ingredients into powder. Melt 2 liang of Yellow Beeswax in 1 sheng of honey. Mix with the medicine while warm. Take 60-70 pills (size of small beans) with rice water, twice daily and once at night. Effectiveness will be observed.
Another prescription for chronic dysentery with pus and blood:
Chi Shi Zhi (Halloysitum Rubrum), 1 sheng; Wu Mei (Mume Fructus), 20 pieces; Gan Jiang (Zingiberis Rhizoma), 4 slices; Jing Mi (Oryza Sativa Var. Glutinosa), 1 sheng.
Cut the four ingredients, boil in 7 sheng of water until cooked and concentrated. Take 7 he, three times daily. (Identical to *Zhou Hou Bei Ji Fang*, From Volume III)
The *Shan Fan Fang* treats Heat in the Lower Jiao or dysentery with pus and blood. Chi Shi Zhi Tang (Halloysitum Rubrum Decoction):
Chi Shi Zhi (Halloysitum Rubrum), 8 liang; Wu Mei (Mume Fructus), 20 pieces (pitted); Zhi Zi (Gardeniae Fructus), 14 pieces; Bai Zhu (Atractylodis Macrocephalae Rhizoma); Shu Jiao (Zanthoxyli Pericarpium, stir-fried until sweat appears); Ma Ren (Cannabis Semen), each 3 liang; Gan Jiang (Zingiberis Rhizoma), 2 liang; Su Mi (Panicum miliaceum), 1 sheng.
Cut the eight ingredients. Boil the millet in 12 sheng of water until cooked. Strain the residue, retain 7 sheng of liquid, add the remaining herbs, and boil to obtain 5 he. Take orally. (From Volume IV)
Ge Hong’s *Bei Ji Qian Jin Fang* records: For cases complicated by Heat, resulting in frequent discharge of red pus and mixed blood:
Huang Lian (Coptidis Rhizoma); Zao Tu Zhong Chen (Soot from the chimney flue), each half liang.
Grind the two ingredients into powder. Take one fang cun bi (a square-inch measure) with wine, three times daily. (*Zhou Hou Bei Ji Fang* suggests mixing with date paste to form three pills, taking one pill daily. Yao’s method is identical, From Volume VI)
The *Gu Jin Lu Yan Fang* treats loose stools in the intestines with pus and blood. Gan Jiang San (Dried Ginger Powder):
Gan Jiang (Zingiberis Rhizoma); Huang Lian (Coptidis Rhizoma); Gui Xin (Cinnamomi Ramulus), each one fen.
Grind the three ingredients into powder. Take one fang cun bi, consumed with deer meat food, three times daily. Increase Gan Jiang if pus predominates; increase Gui Xin if blood predominates. Effective.
Another prescription for cold-damp dysentery with pus and blood. Fu Zi San (Aconite Powder):
Shu Fu Zi (Aconiti Lateralis Radix Praeparata, roasted), 1 piece; Qu (Medicated Leaven); Gan Jiang (Zingiberis Rhizoma), each three fen.
Grind the three ingredients into powder. Take one fang cun bi with wine before meals, twice daily. Also treats uterine bleeding in women. Taboos are as previously stated. (From Volume III)