答曰。大肠者传导之官。变化出焉。独受阴阳之浊。化其糟粕。传不洁之道。若三焦不调。
脏腑不和。受热则津液竭燥。肠胃痞涩。大便不通。有寒则腹痛肠鸣。水谷并下。故热则宜
清而通之。寒则宜温而固之。
建中散。治脾胃不和。中脘气滞。宿寒留饮。停积不消。心腹刺痛。胁肋膨胀。呕吐痰涎。
逆噫气。吞酸。肠鸣泄痢。水谷不化。肢体倦怠。不思饮食。
青皮(一本无青皮) 枣子(一斤) 浓朴(一斤) 甘草 半夏(汤泡洗浸五两) 陈皮(八两) 干
姜(炮五两)
以上六味。用水三斗煮。令水尽焙干。
人参(去芦一两) 藿香(一两) 诃子(炮取二两) 白术(一两) 白茯苓(一两) 草豆蔻(去
皮一两)
上为饮子。每服二钱。水二盏。姜三片。煎六分。去渣温服。食前。
四味换肠丸。治便下觉脏腑疼痛。泄痢饮食不美。因多思所致。或寒气积。遂成其痢。(一
名白术止痢丸)
白术(三分) 诃子(炮去复选肉三分) 肉豆蔻(三分) 钟乳粉(一两)
上为细末。入钟乳粉拌面糊为丸。桐子大。每服五十丸。空心熟水送下。止进三两服便效。
热者。服四顺饮子。治大便不通。面赤身热。
大黄 白芍 甘草 当归(各等分)
上为粗散。每服五钱。水盏半。煎一盏。去滓温服。不拘时。
麻仁丸。治肠中受风。津液燥少。往往大便秘。
麻仁(去皮研二两) 枳实(四两麸炒) 白芍(四两) 大黄(四两炮) 浓朴(二两) 杏仁(二
两)
上为细末。蜜丸梧桐子大。米饮下二十丸。未通。加至三十丸。
寒者。理中汤。治肠胃冷热湿。泄泻注下。水谷不分。腹中雷鸣。及伤时气。里寒外热。霍
乱吐痢。手足厥冷。胸脾心疼。逆气结气。并皆治之。
人参 甘草 白术 干姜(炮各二两) 肉豆蔻 砂仁(各二两)
上为饮子。每服三钱。水盏半。煎一盏。去滓热服。食前。
煮朴丸。治脏寒泄痢。
北枣(半斤) 川芎(四两) 生姜(切片四两)
以上三味。水三碗煎干。将生姜浓杵烂。入枣肉一处。再杵令细。以麻油涂手。担如小钱。
慢火焙干。入后药。
苍术(米泔浸) 茴香(炒) 甘草(炙) 官桂(去皮新者) 神曲 麦 (炒净秤) 莪术(煨各
四两) 砂仁 良姜(炒各二两) 肉豆蔻(煨二两) 丁香(一两) 川姜(二两)
上为细末。水煮薄糊为丸。梧桐子大。每服百丸。米饮汤下。不拘时。
豆蔻橘红散。温脾养胃。消谷嗜食。
丁香 木香(一两) 白豆蔻(仁) 人参 白术 浓朴 神曲 干姜(炮) 半夏曲(炒) 陈皮
(去白) 藿香叶(去土) 甘草(炙各半两)
上为细末。每服三钱。水一盏。姜三片。枣一个。煎七分。去滓空心温服。
回答：大肠是负责传导的器官，负责变化并排出糟粕。它单独承受阴阳的浊气，将食物残渣转化为粪便，通过不洁的途径排出体外。如果三焦功能失调，脏腑不和，受热则津液枯竭干燥，导致肠胃痞塞涩滞，大便不通；受寒则腹痛肠鸣，水谷混杂而下。因此，热证适宜用清热通便的方法治疗，寒证适宜用温中固涩的方法治疗。
建中散：治疗脾胃不和，中脘气机阻滞，宿寒停留饮水，积滞不消。症状包括心腹刺痛，胁肋胀满，呕吐痰涎，呃逆嗳气，吞酸，肠鸣泄痢，水谷不化，肢体倦怠，不思饮食。
配方：青皮（有的版本没有青皮），枣子（一斤），浓朴（一斤），甘草，半夏（汤泡洗后浸泡，五两），陈皮（八两），干姜（炮制，五两）。
以上六味药，用水三斗煮，直到水尽然后焙干。
人参（去芦头，一两），藿香（一两），诃子（炮制取肉，二两），白术（一两），白茯苓（一两），草豆蔻（去皮，一两）。
以上药物制成饮子剂型。每次服用二钱，加水二盏，生姜三片，煎至六分，去渣温服，饭前服用。
四味换肠丸：治疗排便时感觉脏腑疼痛，泄痢且饮食不佳，因思虑过多所致，或因寒气积聚而成痢疾。（又名白术止痢丸）
配方：白术（三分），诃子（炮制去壳取肉三分），肉豆蔻（三分），钟乳粉（一两）。
以上药物研为细末，加入钟乳粉，用面糊拌和制成丸剂，如梧桐子大小。每次服用五十丸，空腹时用熟开水送服。最多服用三两服即可见效。
如果是热证，服用四顺饮子：治疗大便不通，面色红赤，身体发热。
以上药物制成粗散剂型。每次服用五钱，加水一盏半，煎至一盏，去渣温服，不拘时间。
配方：麻仁（去皮研碎，二两），枳实（四两，麸炒），白芍（四两），大黄（四两，炮制），浓朴（二两），杏仁（二两）。
以上药物研为细末，用蜂蜜制成丸剂，如梧桐子大小。用米饮送服二十丸，若未通，加至三十丸。
如果是寒证，服用理中汤：治疗肠胃冷热湿邪交织，泄泻注下，水谷不分，腹中雷鸣，以及伤及时气，里寒外热，霍乱吐痢，手足厥冷，胸脾心疼，逆气结气，均能治疗。
配方：人参、甘草、白术、干姜（炮制，各二两），肉豆蔻、砂仁（各二两）。
以上药物制成饮子剂型。每次服用三钱，加水一盏半，煎至一盏，去渣热服，饭前服用。
以上三味药，用水三碗煎干，将生姜捣烂，与枣肉混合在一起，再次捣细。用麻油涂手，捏成小钱大小的丸剂，慢火焙干。加入以下药物：
苍术（米泔水浸泡）、茴香（炒）、甘草（炙）、官桂（去皮的新品）、神曲、麦芽（炒净称重）、莪术（煨，各四两）、砂仁、良姜（炒，各二两）、肉豆蔻（煨，二两）、丁香（一两）、川姜（二两）。
以上药物研为细末，用水煮薄糊制成丸剂，如梧桐子大小。每次服用一百丸，用米饮汤送服，不拘时间。
配方：丁香、木香（一两），白豆蔻（仁），人参，白术，浓朴，神曲，干姜（炮制），半夏曲（炒），陈皮（去白），藿香叶（去土），甘草（炙，各半两）。
Answer: The Large Intestine is the official responsible for conduction, where transformation and excretion occur. It alone receives the turbidity of Yin and Yang, transforms waste into feces, and transmits impurities out of the body. If the San Jiao (Triple Burner) is not harmonious, and the Zang-Fu organs are disordered, heat causes the body fluids to dry up and deplete, leading to stagnation and obstruction in the intestines and stomach, resulting in constipation. Cold causes abdominal pain and borborygmus, with water and grain passing down together. Therefore, heat patterns should be treated by clearing heat and promoting unblocking, while cold patterns should be treated by warming and consolidating.
Jianzhong San (Middle-Jiao Harmonizing Powder): Treats disharmony of the Spleen and Stomach, Qi stagnation in the Zhongwan region, lingering cold and retained fluid, accumulation that fails to digest. Symptoms include stabbing pain in the heart and abdomen, distension and swelling of the hypochondrium, vomiting of phlegm-saliva, belching and eructation, acid regurgitation, borborygmus with diarrhea or dysentery, undigested food and water, limb fatigue, and loss of appetite.
Ingredients: Qingpi (Green Tangerine Peel) [some editions omit this], Zaozi (Jujube Fruit) (one jin), Houpo (Magnolia Bark) (one jin), Gancao (Licorice Root), Banxia (Pinellia Tuber) (soaked in hot water, washed, and steeped; five liang), Chenpi (Aged Tangerine Peel) (eight liang), Ganjiang (Dried Ginger) (processed; five liang).
The above six ingredients are boiled in three dou of water until the water is exhausted, then dried by baking.
Renshen (Ginseng Root) (rhizome removed; one liang), Huoxiang (Patchouli Herb) (one liang), Hezi (Chebula Fruit) (processed, flesh only; two liang), Baizhu (Atractylodes Rhizome) (one liang), Baifuling (Poria) (one liang), Caodoukou (Grass Cardamom Seed) (peeled; one liang).
The above are prepared as a decoction powder (Yinzi). Each dose consists of two qian, boiled with two zhan of water and three slices of ginger until reduced to six parts. Strain and take warm before meals.
Siwei Huan Chang Wan (Four-Ingredient Intestine-Replenishing Pills): Treats pain felt in the Zang-Fu organs during defecation, dysentery with poor dietary intake, caused by excessive thinking, or accumulation of cold qi leading to dysentery. (Also known as Baizhu Zhili Wan / Atractylodes Anti-Dysentery Pills).
Ingredients: Baizhu (Atractylodes Rhizome) (three fen), Hezi (Chebula Fruit) (processed, shell removed, flesh selected; three fen), Roudoukou (Nutmeg Seed) (three fen), Zhongru Fen (Stalactite Powder) (one liang).
The above are ground into fine powder, mixed with Zhongru Fen, and bound with wheat paste to form pills the size of paulownia seeds. Take fifty pills each time, swallowed with warm cooked water on an empty stomach. Effect is usually seen after taking no more than three doses.
For heat patterns, take Sishun Yinzi (Four-Harmonizing Decoction Powder): Treats constipation, red face, and feverish body.
Ingredients: Dahuang (Rhubarb Root), Baishao (White Peony Root), Gancao (Licorice Root), Danggui (Angelica Sinensis Root) (equal parts).
The above are made into a coarse powder. Each dose is five qian, boiled in one and a half zhan of water until reduced to one zhan. Strain and take warm at any time.
Maren Wan (Hemp Seed Pills): Treats wind invading the intestines, causing dryness and scarcity of body fluids, often leading to constipation.
Ingredients: Maren (Hemp Seed) (peeled and pounded; two liang), Zhishi (Immature Bitter Orange) (four liang, stir-fried with bran), Baishao (White Peony Root) (four liang), Dahuang (Rhubarb Root) (four liang, processed), Houpo (Magnolia Bark) (two liang), Xingren (Apricot Seed) (two liang).
The above are ground into fine powder and formed into honey pills the size of paulownia seeds. Take twenty pills with rice drink. If bowel movement is not achieved, increase to thirty pills.
For cold patterns, take Lizhong Tang (Regulate the Middle Decoction): Treats cold, heat, and dampness in the intestines and stomach, profuse watery diarrhea, indistinguishable food and water, borborygmus in the abdomen, as well as injury from seasonal pathogens, interior cold with exterior heat, cholera-like vomiting and dysentery, cold extremities, pain in the chest and spleen/stomach, rebellious Qi, and stagnant Qi. All are treated by this formula.
Ingredients: Renshen (Ginseng Root), Gancao (Licorice Root), Baizhu (Atractylodes Rhizome), Ganjiang (Dried Ginger) (processed, two liang each), Roudoukou (Nutmeg Seed), Sharen (Amomum Fruit) (two liang each).
The above are prepared as a decoction powder. Each dose is three qian, boiled in one and a half zhan of water until reduced to one zhan. Strain and take hot before meals.
Zhu Po Wan (Boiled Magnolia Pills): Treats dysentery caused by visceral cold.
Ingredients: Beizao (Northern Jujube Fruit) (half a jin), Chuanxiong (Sichuan Lovage Rhizome) (four liang), Shengjiang (Fresh Ginger) (sliced; four liang).
The above three ingredients are boiled in three bowls of water until dry. The ginger is pounded thoroughly, mixed with the jujube flesh, and pounded again until fine. Hands are coated with sesame oil, and the mixture is shaped into small coins. They are slowly dried over low fire. Then add the following ingredients:
Cangzhu (Atractylodes Rhizome) (soaked in rice wash water), Huixiang (Fennel Fruit) (stir-fried), Gancao (Licorice Root) (honey-fried), Guanzi Gui (Cinnamon Bark) (new bark, peeled), Shenqu (Medicated Leaven), Maiya (Barley Sprout) (cleaned and stir-fried), Ezhu (Curcuma Rhizome) (roasted, four liang each), Sharen (Amomum Fruit), Liangjiang (Galangal Rhizome) (stir-fried, two liang each), Roudoukou (Nutmeg Seed) (roasted; two liang), Dingxiang (Clove) (one liang), Chuanjiang (Sichuan Ginger) (two liang).
The above are ground into fine powder and bound with thin starch paste made by boiling water to form pills the size of paulownia seeds. Take one hundred pills each time, swallowed with rice drink at any time.
Doukou Juhong San (Cardamom and Exocarpium Citri Reticulatae Powder): Warms the Spleen and nourishes the Stomach, promotes digestion, and stimulates appetite.
Ingredients: Dingxiang (Clove), Muxiang (Aucklandia Root) (one liang), Baidoukou (White Cardamom Seed), Renshen (Ginseng Root), Baizhu (Atractylodes Rhizome), Houpo (Magnolia Bark), Shenqu (Medicated Leaven), Ganjiang (Dried Ginger) (processed), Banxiaqu (Pinellia Medicated Leaven) (stir-fried), Chenpi (Aged Tangerine Peel) (white pith removed), Huoxiangye (Patchouli Leaf) (dust removed), Gancao (Licorice Root) (honey-fried, half a liang each).
The above are ground into fine powder. Each dose is three qian, boiled with one zhan of water, three slices of ginger, and one jujube until reduced to seven parts. Strain and take warm on an empty stomach.