典藏书目

Tang Rongchuan stated: "Jinkou Li" (Dysentery with inability to eat) refers to a condition where the patient suffers from dysentery and cannot eat. This is caused by pathogenic fire and turbid qi attacking, damaging the Stomach Qi, which fails to diffuse. Most medical texts follow Zhu Danxi's view and use Shilian Tang (Lotus Seed Decoction). *Yizong Jinjian* (Golden Mirror of Medical Tradition) states that excessive internal heat rushes upward to the Heart, causing vomiting. For Jinkou Li, Dahuang Huanglian Tang (Rhubarb and Coptis Decoction) should be used, decocted in high-quality yellow wine to attack the pathogen.

I believe that the reason the intestines and stomach can accept food is that the Stomach contains fluids (Jin Ye), maintaining a clear, harmonious, moist, and nourishing state, thereby generating appetite. Western medicine, though sometimes rigid in its observations, has credible aspects. They state that when food enters the Stomach, Stomach fluids are immediately secreted to mix with it, digesting the food into a mushy consistency. If one were to constantly probe for Stomach fluids to stir rice, it would turn into mush almost instantly. Based on this, the desire to eat is entirely dependent on Stomach fluids. Observe a dog desiring meat; saliva flows from its mouth. This fluid is the root of the desire to eat. Similarly, human Stomach fluids drive the emotion of wanting to eat. Currently, the Stomach is occupied by pathogenic heat and turbid qi. Its clear and harmonious fluids are transformed into turbid stagnation. When flowing downward into the Large Intestine, it becomes dysentery; when stagnating in the Stomach, it rejects food intake.

Although Zhu Danxi's Shilian Tang aims to clear fire and tonify the Stomach, "Shilian" refers to lotus seeds with black shells. Modern physicians use "Shilianzi," but it is unclear what substance this actually is, so it must not be used. Even if using lotus seeds, their nature is astringent. Dysentery requires slippery methods to remove adherent pathogens; astringency is contraindicated. Moreover, turbid stagnation in the Stomach cannot be resolved without cleansing and transforming it. This formula, while addressing cold and heat, fails to cleanse the stagnation or transform the turbidity; thus, it is not a life-saving prescription. Using Qingwen Baidu Yin (Plague-Dispersing Toxin-Resolving Decoction), Zhuye Shigao Tang (Bamboo Leaf and Gypsum Decoction), Renshen Baihu Tang (Ginseng White Tiger Decoction), or Maidong Yangrong Tang (Ophiopogon Nourishing Harmony Decoction) with appropriate modifications can cleanse the Stomach and transform fluids, serving as an excellent method to open the Stomach and promote eating. Regarding vomiting and loss of appetite, *Yizong Jinjian* uses Dahuang and Huanglian with good wine, relying on their rapid and potent action to counteract rebellion. While treating rebellion is indeed correct, it neglects the generation of Stomach fluids, failing to address the root of eating.

My opinion is that Dachaihu Tang (Minor Bupleurum Decoction) should be used, supplemented with Shigao (Gypsum), Huafen (Trichosanthes Root), and Renshen (Ginseng). This approach attacks rebellion and generates fluids simultaneously, benefiting both the Stomach opening and food intake. There has never been such a discussion on treating Jinkou Li before. I have now realized the practical principle and am shouting loudly for these patients. I originally intended to serve the country through literature, but now consider myself incapable; perhaps by elucidating this path, I may offer some benefit to the people.

Supplementary discussion: Generally, for Jinkou Li, characterized by upper obstruction (inability to eat) and lower dysentery, the treatment method should focus on harmonizing the Middle Jiao. Comparing this with Huoluan (Cholera-like disorder) makes it clear: Huoluan involves upper vomiting and lower diarrhea, and must be cured by harmonizing the Middle Jiao. Therefore, Jinkou Li, with upper obstruction and lower dysentery, must also be cured by harmonizing the Middle Jiao. However, Huoluan arises from Cold invading the Middle and represents a syndrome of collapse of both upper and lower aspects, so the treatment primarily uses Lizhong Tang (Regulate the Middle Decoction) to warm. Jinkou Li, with upper obstruction and lower stagnation, indicates Heat in the Middle. Heat knots in the Middle, blocking the upper and lower openings. The method of harmonizing the Middle should reverse the approach of Lizhong Tang and other warming herbs, instead using cold/cool herbs. Shengjiang Xiexin Tang (Ginger Heart-Draining Decoction) with Ganjiang (Dried Ginger) removed is suitable; Renshen Baihu Tang is also excellent.

Shilian Tang Formula: Renshen (1 qian), Huangqin (1 qian), Huanglian (1 qian), Shilian (1 qian, i.e., lotus seed with black shell).

Zhuye Shigao Tang: Danshuye (1 qian), Shigao (1 qian), Renshen (1 qian), Gancao (1 qian), Cundong (1 qian), Banxia (0.7 qian), Shengjiang (1 qian), Jingmi (1 qian).

Tu Weisheng stated: Shengjiang and Banxia are both acrid and drying; they should be used cautiously in this condition. Even with the cooling properties of Shigao and Cundong, there is still a fear of consuming body fluids, as this condition is essentially a type of Heat syndrome.

Qingwen Baidu San: Shigao (1 qian), Zhimu (1 qian), Shengdi (1 qian), Xijiao (0.5 qian), Huanglian (1 qian), Zhizi (1 qian), Jiegeng (1 qian), Huangqin (1 qian), Chishao (1 qian), Xuanshen (1 qian), Lianqiao (1 qian), Danpi (1 qian), Gancao (1 qian), Zhuye (1 qian).

Dachaihu Tang: Chaihu (1 qian), Huangqin (1 qian), Renshen (1 qian), Banxia (0.7 qian), Dahuang (1 qian), Zhishi (0.7 qian), Shengjiang (1 qian), Dazao (1 piece).

Renshen Baihu Tang: See previous Warm Disease formulas.

Maidong Yangrong Tang: Renshen (1 qian), Zhimu (1 qian), Cundong (1 qian), Gancao (1 qian), Wuweizi (1 qian), Danggui (1 qian), Baishao (1 qian), Chenpi (0.6 qian), Huangqi (1 qian), Shengdi (1 qian).