(东垣) 治肠胃有伏火,大便秘涩。全不思食,风结血结。(风结即风秘,由风搏
脏,传于大肠。或素有风病者,亦多秘。气秘,由气不升降。血秘,由亡血血虚,津液不
热秘,由大肠热结。冷秘,由冷气横于肠胃,凝阴固结,津液不通,非燥粪也。仲景曰
浮而数,能食。不大便者,此为实,名曰阳结。脉沉而迟,不能食。身体重,大便反硬
曰阴结。李东垣曰∶实秘热秘,即阳结也,宜散之。虚秘冷秘,即阴结也,宜温之。)
大黄 归尾 羌活(五钱) 桃仁(研) 大麻仁(去壳一两)蜜丸。一方有防风。风
湿加秦艽皂
归尾桃仁,润燥活血,羌活搜风散邪,大黄破结通幽,麻仁滑肠利窍。血和风疏,肠胃
得润
用枳
是也
加防风皂角仁,蜜丸,名活血润燥丸,治同。(皂角得湿则滑,湿滑则燥结自除)去羌
活,加
等分蜜丸
治妇人血虚经滞,不能流畅而痛极者,当以水济水。若江河一决,而积垢皆去,宜
汤,随证加减主之。此用补为泻之神剂也。
当归(三五钱或一两) 泽泻(一钱五分) 肉桂(一二三钱) 熟地(二三钱或五七
钱。或不用
可。如气滞而
如小腹不暖而
弥佳。如气虚
(丹溪) 治胃脘有死血,干燥枯槁,食下作痛,翻胃便秘。(胃脘有死血者,嗜
辛,躁暴多怒,积久而成瘀热也。枯槁者,血聚则肝气燥,燥热故槁也。瘀血阻碍,故
作痛,翻胃而吐出也。瘀血不去,则新血不生,故肠枯而便秘。膈噎翻胃,多因气血两
胃槁胃冷而成。饮可下而食不下,槁在吸门,即喉间之会厌也。食下胃脘痛,须臾吐出
在贲门,胃之上口也,此上焦名噎。食下良久吐出,槁在幽门,胃之下口也,此中焦名
朝食暮吐,槁在阑门,小肠下口也,此下焦名翻胃。又有寒痰,瘀血,食积,壅塞胃口
或补,或消,或润,宜随病施治。)
韭菜汁 牛乳 等分。时时呷之。有痰阻者,加姜汁。一方去牛乳,加陈酒,治血膈尤
捷。
矣。
呕,
朱
乳
不如少服药,饮牛乳,加韭汁,或姜汁,或陈酒为佳。)
(李东垣)治疗肠胃中有潜伏的火邪,导致大便秘结涩滞。完全不想吃东西,属于风秘或血秘。(所谓风秘,即由风邪搏结脏腑,传至大肠所致。或者素来患有风病的人,也大多出现便秘。气秘,是由于气机升降失常。血秘,是由于失血或血虚,津液不足。热秘,是由大肠热结引起。冷秘,是由于冷气横亘于肠胃之间,阴寒凝滞固结,津液不通,并非燥屎内结。张仲景说:脉象浮而数,能进食,不大便的,这是实证,称为阳结。脉象沉而迟,不能进食,身体沉重,大便反而硬的,称为阴结。李东垣说:实秘和热秘,就是阳结,适宜用发散的方法治疗。虚秘和冷秘,就是阴结,适宜用温补的方法治疗。)
大黄、当归尾、羌活(各五钱)、桃仁(研碎)、大麻仁(去壳一两),炼蜜为丸。另一配方中有防风。风湿加秦艽、皂角仁。
当归尾、桃仁,滋润干燥并活血;羌活搜剔风邪并驱散外邪;大黄破除结滞并通利幽隐之处;麻仁润滑肠道并通利窍道。血行顺畅则风邪疏散,肠胃得以滋润,就是这个道理。
加入防风、皂角仁,炼蜜为丸,名为活血润燥丸,主治相同。(皂角遇湿则滑,湿滑则燥结自然消除)。去掉羌活,加入枳实等分,炼蜜为丸。
治疗妇人血虚导致经血停滞,不能流畅运行而疼痛剧烈的情况,应当以水济水(比喻以血补血,滋润枯竭)。就像江河决堤一样,积聚的污垢都会被冲走,适宜使用决津煎汤剂,根据证候加减主方。这是“以补为泻”的神奇方剂。
当归(三五钱或一两)、泽泻(一钱五分)、肉桂(一二三钱)、熟地黄(二三钱或五七钱,或者不用肉桂也可以)。如果气滞而胀满,加枳壳;如果小腹不温暖,加吴茱萸更佳。如果气虚,加人参等分,炼蜜为丸。
(朱丹溪)治疗胃脘部有死血(瘀血),导致干枯槁涩,食物下咽后作痛,翻胃便秘。(胃脘有死血的原因,是嗜食辛辣,性情急躁暴怒,积久形成瘀热。枯槁的原因,是血液聚积导致肝气燥,燥热故而成枯槁。瘀血阻碍气机,所以作痛,翻胃而吐出。瘀血不去,则新血不生,所以肠道干枯而便秘。膈噎翻胃,多因气血两亏、胃中干枯或胃冷而成。饮水可下但食物不下,干枯部位在吸门,即喉间的会厌。食物下咽后胃脘痛,须臾间吐出,干枯部位在贲门,即胃的上口,这在上焦称为噎。食物下咽良久后吐出,干枯部位在幽门,即胃的下口,这在中焦称为反胃。朝食暮吐,干枯部位在阑门,即小肠的下口,这在下焦称为翻胃。又有寒痰、瘀血、食积,壅塞胃口,或补益,或消导,或润燥,适宜随病情施治。)
(Li Dongyuan) Treats latent fire in the intestines and stomach, causing constipation with dryness and difficulty. Complete loss of appetite, due to Wind Constipation or Blood Constipation. (Wind Constipation refers to constipation caused by wind pathogens combing with internal organs and transmitting to the large intestine. Those who have a history of wind diseases often suffer from constipation. Qi Constipation is due to dysfunction of qi ascending and descending. Blood Constipation is due to blood loss or blood deficiency, leading to insufficient body fluids. Heat Constipation is caused by heat accumulation in the large intestine. Cold Constipation is due to cold qi obstructing the intestines and stomach, causing yin cold to coagulate and bind, blocking body fluids; it is not dry feces. Zhang Zhongjing said: A pulse that is floating and rapid, with the ability to eat but no bowel movement, is an excess syndrome called Yang Jie (Yang Binding). A pulse that is deep and slow, inability to eat, heavy body, and hard stool is Yin Jie (Yin Binding). Li Dongyuan said: Excess Constipation and Heat Constipation are equivalent to Yang Jie, suitable for dispersing treatment. Deficiency Constipation and Cold Constipation are equivalent to Yin Jie, suitable for warming treatment.)
Da Huang (Rhei Radix et Rhizoma), Dang Gui Wei (Angelicae Sinensis Radix caudex), Qiang Huo (Notopterygii Rhizoma et Radix) (each 5 qian), Tao Ren (Persicae Semen, crushed), Da Ma Ren (Cannabis Fructus, shelled) (1 liang), honey pills. Another prescription includes Fang Feng (Saposhnikoviae Radix). For wind-dampness, add Qin Jiao (Gentianae Macrophyllae Radix) and Zao Jiao Ren (Ziziphi Spinosae Semen).
Dang Gui Wei and Tao Ren moisten dryness and invigorate blood; Qiang Huo searches out wind and dispels evil pathogens; Da Huang breaks up accumulations and unblocks the obscure passages; Ma Ren lubricates the intestines and benefits the orifices. When blood flows smoothly and wind is dispersed, the intestines and stomach become moist; this is the principle.
Add Fang Feng and Zao Jiao Ren, make into honey pills, named Huo Xue Run Zao Wan (Invigorate Blood and Moisten Dryness Pill), treating the same condition. (Zao Jiao becomes slippery when wet; slipperiness removes dryness and binding naturally). Remove Qiang Huo, add Zhi Shi (Aurantii Fructus Immaturus) in equal parts, make into honey pills.
Treats women with blood deficiency causing stagnant menstruation, unable to flow smoothly, resulting in severe pain. One should "use water to aid water" (metaphorically using blood to nourish blood and moisten dryness). Just as a river bursting its banks washes away accumulated filth, it is appropriate to use Jue Jin Jian Decoction, modified according to symptoms. This is a miraculous agent of "tonifying to purge."
Dang Gui (3-5 qian or 1 liang), Ze Xie (Alismatis Rhizoma) (1.5 qian), Rou Gui (Cinnamomi Cortex) (1-3 qian), Shu Di Huang (Rehmanniae Radix Preparata) (2-3 qian or 5-7 qian, or Rou Gui may be omitted if suitable). If there is qi stagnation with distension, add Zhi Ke (Aurantii Fructus); if the lower abdomen is not warm, add Wu Zhu Yu (Evodiae Fructus) for better effect. If there is qi deficiency, add Ren Shen (Ginseng Radix et Rhizoma) in equal parts, make into honey pills.
(Zhu Danxi) Treats dead blood (blood stasis) in the epigastrium, causing dryness and withering, pain upon eating, regurgitation, and constipation. (Dead blood in the epigastrium arises from indulgence in spicy foods, irritability, and anger, accumulating over time to form stasis-heat. Withering occurs because blood pooling causes Liver qi to become dry; dryness and heat lead to withering. Stasis blocks qi mechanism, causing pain and regurgitation. If stasis is not removed, new blood cannot be generated, leading to dry intestines and constipation. Ge Ye Fan Wei (Diaphragmatic obstruction and regurgitation) is mostly due to dual deficiency of qi and blood, gastric withering, or cold stomach. Drinking can go down but food cannot; withering is at Xi Men (the epiglottis). Food enters the epigastrium, causes pain, and is vomited shortly after; withering is at Ben Men (the upper opening of the stomach), known as Ge (dysphagia) in the Upper Jiao. Food enters, is vomited after a long time; withering is at You Men (the lower opening of the stomach), known as Fan Wei (regurgitation) in the Middle Jiao. Morning food vomited in the evening; withering is at Lan Men (the lower opening of the small intestine), known as Fan Wei in the Lower Jiao. There are also cases of cold phlegm, blood stasis, and food retention obstructing the stomach opening. Treatment should follow tonification, digestion, or moistening methods according to the disease.)
Jiu Cai Zhi (Allium Tuberosum Juice) and Niu Nai (Bovis Lac) in equal parts. Sip frequently. If there is phlegm obstruction, add Jiang Zhi (Zingiberis Rhizoma Juice). Another prescription removes Niu Nai and adds Chen Jiu (Chenpi-infused wine), which is particularly effective for treating Xue Ge (Blood Diaphragm).
(Vomit... Cinnabar... Bovine milk... It is better to take less medicine and drink Bovine milk, adding Jiu Cai Zhi, or Jiang Zhi, or Chen Jiu, which is best.)