答曰。春伤于风。邪气运留。遇肠胃虚弱。风邪因时伤之。肠虚则泄。故为水谷之痢也。或
肠虚受热气者。下痢则赤。受冷气者。下痢则白。冷热相交。其痢如鱼脑鼻涕。相杂连滞不
已者。谓之滞痢也。
香连丸。治泄痢不止。
木香 黄连 吴茱萸 白芍(各等分)
上为细末。面糊丸。桐子大。每服二十丸。浓煎米饮汤下。空心日三服。妊娠下痢不止。
黄柏 干姜 赤石脂(各二两) 酸榴皮(一具)
上为粗末。每服五钱。水盏半。煎六分。去滓食前温服。
赤石脂散。治肠胃虚弱。水谷不化。冷热不调。下痢赤白。肠滑腹痛。肢体困倦。饮食减少
。
赤石脂 甘草(各二两) 肉豆蔻仁(十两) 砂仁(五两)
上为细末。每服二钱。温粟米饮汤下。食前。
归连丸。治一切下痢。无以新久。及冷热脓血。肠滑里急。日夜无度。脐腹绞痛不可忍。
阿胶(捣碎炒如珠三两以醋四升煮成膏) 黄连 当归(各三两) 干姜(二两) 木香(一两五
钱)
上共为末。用阿胶膏丸。桐子大。每服三十丸食前米饮下。
当归芍药散。治妊娠腹中绞痛。心下急胀。及产血晕。内虚气乏。崩中久痢。常服通畅血脉
。不生痈疡。消痰。养胃。明目。益津。
白芍(八两) 当归 白茯苓 白术(各二两) 泽泻 川芎(各四两)
上为细末。每服二钱。温酒调下。食前。元和纪用。经云。本六气经纬。能补虚劳。养真阳
。退邪热。缓中。和神志。润泽颜色。散邪寒温瘴时疫。安期先生赐君少久饵之药。后仲景
增减为妇人怀妊腹痛本方。用芍药四两。泽泻茯苓川芎一两。当归白术二两。亦可以蜜丸服
。又方等分。每服三钱。温酒米饮任下。
鸡黄散。治怀妊下痢。赤白绞刺疼痛。
鸡子(一个乌者为妙就头作一窍倾出清留黄以黄丹一钱入前鸡子内打令黄匀以浓纸裹盐泥固
济煨取出焙干)
上为末。每服二钱。米饮调下。一服愈者是男。二服愈者是女。
严氏第九问。妊娠下痢赤白者何。曰。盖因冷物停脾。辛酸损胃。冷热不调。胎气不安。凝
滞下痢频频。时有时无。或赤或白。肠鸣后重。谷道疼痛。急服黄连丸。不问冷热二证。皆
可服之。
蒙姜黄连丸。
干姜(炮) 黄连 川芎 砂仁(微炒) 阿胶(蛤粉炒各一两) 白术(一两) 乳香(三钱另研)
枳壳(半两)
上为细末。同盐梅三个取肉。入少醋糊用杵匀。丸如桐子大。每服四十丸。白痢干姜汤下。
赤痢甘草汤。赤白痢干姜甘草汤下。
答：春季感受风邪，邪气留滞体内。若遇到肠胃虚弱之时，风邪便趁机侵袭。肠道虚弱则导致泄泻，因此出现夹杂未消化食物和水的痢疾。如果肠道虚弱又受到热邪侵袭，下痢时大便呈红色；受到寒邪侵袭，下痢时大便呈白色。若冷热邪气交杂，痢疾性状如同鱼脑或鼻涕，混杂粘连、持续不止的，称为“滞痢”。
香连丸：治疗泄泻痢疾不止。
配方：木香、黄连、吴茱萸、白芍（各等分）。
制法与用法：将上述药材研为细末，用面糊制成丸剂，大小如梧桐子。每次服用二十丸，用浓煎的米汤送服。空腹时每日服用三次。
若孕妇下痢不止：
配方：黄柏、干姜、赤石脂（各二两）、酸榴皮（一个）。
制法与用法：将上述药材研为粗末。每次服用五钱，加水一盏半，煎至六分满，去渣后于饭前温服。
赤石脂散：治疗肠胃虚弱，水谷不化，冷热不调，下痢赤白，肠滑腹痛，肢体困倦，饮食减少。
配方：赤石脂、甘草（各二两）、肉豆蔻仁（十两）、砂仁（五两）。
制法与用法：将上述药材研为细末。每次服用二钱，用温热的粟米汤送服，饭前服用。
归连丸：治疗各种下痢，无论新久，以及冷热引起的脓血便，肠滑里急后重，日夜无度，脐腹绞痛难以忍受。
配方：阿胶（捣碎炒至如珠状三两，用四升醋煮成膏）、黄连、当归（各三两）、干姜（二两）、木香（一两五钱）。
制法与用法：将除阿胶外的药材研为细末，加入阿胶膏制成丸剂，大小如梧桐子。每次服用三十丸，饭前用米汤送服。
当归芍药散：治疗妊娠期间腹中绞痛，心下急胀，以及产后血晕，内虚气乏，崩漏日久痢疾。常服可通畅血脉，不生痈疡，消痰，养胃，明目，生津液。
配方：白芍（八两）、当归、白茯苓、白术（各二两）、泽泻、川芎（各四两）。
制法与用法：将上述药材研为细末。每次服用二钱，用温酒调服，饭前服用。
《元和纪用经》记载：此方本源于六气经纬理论，能补虚劳，养真阳，退邪热，缓急和中，调和神志，润泽面色，驱散邪寒及温疫时气。安期先生将此药赐予君主长期服用。后来张仲景在此基础上增减，改为治疗妇人怀孕腹痛的本方，使用芍药四两，泽泻、茯苓、川芎各一两，当归、白术各二两，也可以用蜜丸服用。另有方子各药等分，每次服用三钱，用温酒或米汤任其送服。
鸡黄散：治疗怀孕期间下痢，赤白相兼，绞刺疼痛。
配方：鸡蛋（一个，以乌骨鸡所产为佳，在头部开一个小孔，倒出蛋清保留蛋黄，将一钱红丹放入蛋黄内搅匀，用厚纸包裹并用盐泥密封固定，煨烤取出后焙干）。
制法与用法：将上述药物研为细末。每次服用二钱，用米汤调服。服用一次痊愈者为男胎，服用两次痊愈者为女胎。
严氏第九问：妊娠期间下痢赤白是什么原因？
答：大概是因为生冷食物停滞于脾，辛酸之物损伤胃气，导致冷热不调，胎气不安，凝滞而成下痢，频频发作，时有时无，大便或赤或白，伴有肠鸣和后重感，肛门疼痛。应紧急服用黄连丸，不论属于冷证还是热证，均可服用。
蒙姜黄连丸：
配方：干姜（炮制）、黄连、川芎、砂仁（微炒）、阿胶（蛤粉炒）、白术（各一两）、乳香（三钱，另研）、枳壳（半两）。
制法与用法：将上述药材研为细末，同三个盐梅取肉，加入少量醋糊，用杵捣匀，制成如梧桐子大小的丸剂。每次服用四十丸。白痢用干姜汤送服，赤痢用甘草汤送服，赤白痢用干姜甘草汤送服。
Answer: In spring, one is injured by wind pathogen, and the pathogenic qi remains stagnant. When encountering weak spleen and stomach, the wind pathogen takes this opportunity to attack. If the intestines are weak, diarrhea occurs, resulting in dysentery containing undigested food and water. If the intestines are weak and affected by heat pathogen, the dysenteric stool will be red; if affected by cold pathogen, the dysenteric stool will be white. When cold and heat pathogens interact, the dysentery resembles fish brains or mucus, mixed and sticky, persisting without cessation, which is called "Zhi Li" (Stagnant Dysentery).
Xianglian Wan (Coptis and Aucklandia Pill): Treats persistent diarrhea and dysentery.
Ingredients: Mugwort Wood (Aucklandiae Radix), Coptis Rhizome (Coptidis Rhizoma), Evodia Fruit (Evodiae Fructus), White Peony Root (Paeoniae Radix Alba) (equal parts).
Preparation and Administration: Grind the above ingredients into fine powder, make pills with wheat paste, size of Sophora fruit. Take 20 pills each time, administered with thickly boiled rice decoction. Take on an empty stomach, three times a day.
For pregnant women with persistent dysentery:
Ingredients: Phellodendron Bark (Phellodendri Chinensis Cortex), Dried Ginger (Zingiberis Rhizoma), Halloysitum Rubrum (Halloysiti Rubrum), Pomegranate Rind (Granati Pericarpium) (one piece).
Preparation and Administration: Grind the above ingredients into coarse powder. Take 5 qian each time, add 1.5 cups of water, boil down to 0.6 cup, remove dregs, and take warm before meals.
Chishizhi San (Halloysitum Rubrum Powder): Treats weak spleen and stomach, inability to digest food and water, imbalance of cold and heat, bloody and purulent dysentery, slippery intestines with abdominal pain, limb fatigue, and decreased appetite.
Ingredients: Halloysitum Rubrum (Halloysiti Rubrum), Licorice Root (Glycyrrhizae Radix et Rhizoma) (each 2 liang), Nutmeg Seed (Myristicae Semen), Amomum Fruit (Amomi Fructus) (10 liang and 5 liang respectively).
Preparation and Administration: Grind the above ingredients into fine powder. Take 2 qian each time, administered with warm millet decoction, before meals.
Guilian Wan (Angelica and Coptis Pill): Treats all types of dysentery, regardless of new or old onset, as well as pus and blood caused by cold or heat, slippery intestines with tenesmus, occurring day and night without limit, unbearable colic in the umbilical and abdominal regions.
Ingredients: Donkey-hide Gelatin (Colla Corii Asini) (3 liang, crushed, fried until bead-like, boiled with 4 sheng of vinegar into a paste), Coptis Rhizome (Coptidis Rhizoma), Angelica Sinensis Root (Angelicae Sinensis Radix) (each 3 liang), Dried Ginger (Zingiberis Rhizoma) (2 liang), Aucklandia Root (Aucklandiae Radix) (1.5 liang).
Preparation and Administration: Grind the non-gelatin ingredients into powder, mix with donkey-hide gelatin paste to form pills, size of Sophora fruit. Take 30 pills each time, administered with rice decoction before meals.
Danggui Shaoyao San (Angelica and White Peony Powder): Treats colic during pregnancy, urgency and distension in the epigastrium, postpartum blood faintness, internal deficiency and Qi exhaustion, prolonged metrorrhagia and chronic dysentery. Regular use can unblock blood vessels, prevent carbuncles, resolve phlegm, nourish the stomach, brighten the eyes, and generate body fluids.
Ingredients: White Peony Root (Paeoniae Radix Alba) (8 liang), Angelica Sinensis Root (Angelicae Sinensis Radix), Poria (Poria), Atractylodes Macrocephala Rhizome (Atractylodis Macrocephalae Rhizoma) (each 2 liang), Alisma Tuber (Alismatis Rhizoma), Szechwan Lovage Rhizome (Ligustici Chuanxiong Rhizoma) (each 4 liang).
Preparation and Administration: Grind the above ingredients into fine powder. Take 2 qian each time, mixed with warm wine, before meals.
The *He Yuan Ji Yong Jing* states: This formula originates from the theory of the Six Qi, capable of tonifying deficiency and fatigue, nourishing true Yang, clearing pathogenic heat, relieving spasms and harmonizing the middle, calming the spirit, moistening the complexion, and dispersing pathogenic cold and epidemic fevers. Master Anqi presented this medicine to the ruler for long-term consumption. Later, Zhang Zhongjing modified it based on this original formula to treat abdominal pain during pregnancy in women, using 4 liang of White Peony Root, 1 liang each of Alisma Tuber, Poria, and Szechwan Lovage Rhizome, and 2 liang each of Angelica Sinensis Root and Atractylodes Macrocephala Rhizome. It can also be taken as honey pills. Another variation uses equal parts of all ingredients, taking 3 qian each time, administered with warm wine or rice decoction at will.
Jihuang San (Chicken Yolk Powder): Treats dysentery during pregnancy with mixed red and white stools and stabbing pain.
Ingredients: Chicken Egg (one, preferably from a black-boned chicken, make a small hole at the head, pour out the white keeping the yolk, add 1 qian of Red Lead Oxide to the yolk, beat until uniform, wrap in thick paper, seal with salt mud, roast, take out, and dry).
Preparation and Administration: Grind the above ingredient into powder. Take 2 qian each time, administered with rice decoction. If cured after one dose, it indicates a male fetus; if cured after two doses, it indicates a female fetus.
Question 9 from Yan Shi: What is the cause of bloody and purulent dysentery during pregnancy?
Answer: It is generally due to cold foods stagnating in the spleen, sour and pungent substances damaging the stomach, leading to an imbalance of cold and heat, unsettling the fetal qi, causing stagnation and frequent dysentery that comes and goes, with stools being either red or white, accompanied by borborygmus, tenesmus, and anal pain. One should urgently take Huanglian Wan. Regardless of whether it is a cold syndrome or heat syndrome, it can be taken.
Meng Jiang Huanglian Wan (Mongolian Ginger and Coptis Pill):
Ingredients: Dried Ginger (Zingiberis Rhizoma) (processed), Coptis Rhizome (Coptidis Rhizoma), Szechwan Lovage Rhizome (Ligustici Chuanxiong Rhizoma), Amomum Fruit (Amomi Fructus) (lightly stir-fried), Donkey-hide Gelatin (Colla Corii Asini) (fried with frog shell powder), Atractylodes Macrocephala Rhizome (Atractylodis Macrocephalae Rhizoma) (each 1 liang), Frankincense Resin (Boswelliae Resina) (3 qian, separately ground), Bitter Orange (Aurantii Fructus) (0.5 liang).
Preparation and Administration: Grind the above ingredients into fine powder, combine with the flesh of three salted plums, add a little vinegar paste, pound evenly, and form pills size of Sophora fruit. Take 40 pills each time. For white dysentery, administer with Dried Ginger Decoction; for red dysentery, administer with Licorice Decoction; for mixed red and white dysentery, administer with Dried Ginger and Licorice Decoction.