秦子曰∶泄泻之症,或泻白,或泻黄,或泻清水,或泻水谷,不杂脓血,名曰泄泻。
若带稠粘之积,则是痢疾,而非泄泻之症矣。今列外感五条,内伤五条,又五更泄泻五条。
【风泻之症】自汗头汗,恶风发热,头痛额疼,泻下水谷,或下清水,此伤风飧泄之症
【风泻之因】风邪入于肠胃之间,则有泄泻之患。经云∶春伤于风,夏必飧泄。此
【风泻之脉】多浮而弦,左关浮弦,风木之邪。大肠脉浮,乃是肠风。右关脉浮,胃风
【风泻之治】左关浮弦,柴胡防风汤,调五苓散。大肠脉弦,风入阳明,干葛防风汤,
下六一散。右关脉弦,风邪入胃,防葛汤,调胃苓散。总之,有表当散表,表既散,当分利
柴胡防风汤
柴胡 防风 荆芥 羌活 川芎 干葛 陈皮 甘草
五苓散
白术 泽泻 猪苓 肉桂 白茯苓
干葛防风汤
干葛 防风 荆芥 羌活 川芎 枳壳 甘草
六一散
滑石 甘草
防风汤
防风 葛根
胃苓散
苍术 浓朴 陈皮 甘草 白术 白茯苓 泽泻 猪苓 肉桂
【寒泻之症】恶寒身痛,不发热,口不渴,小便清白,腹中疼痛,泄泻水谷,此寒邪直
中三阴经之寒泻症也。若恶寒身痛,身反发热,口反渴,此寒伤三阳经之热泻症也。
【寒泻之因】真阳素虚,偶值时令之寒,直中三阴之经,则身不发热,口不发渴,小便
利,腹中疼痛,而中寒下利之症作矣。若肠胃有热,外寒束于皮毛,内热不得发泄,则寒变
【寒泻之脉】右关沉迟,寒中太阴。左尺沉迟,寒中少阴;左关沉迟,寒中厥阴。若身
热脉浮紧,寒伤太阳也。身热脉浮弦,寒伤少阳也。身热脉长,右寸关独大,寒伤阳明也。
【寒泻之治】三阴寒泻,理中汤、四逆汤、真武汤主之。寒伤三阳热泻,应解表,太阳
,羌活汤;阳明,葛根汤;少阳,小柴胡汤。应清热者,葛根黄芩黄连汤、黄芩汤主之。
理中汤 见前。
四逆汤 见前。
真武汤
生姜 白术 附子 白芍药 白茯苓
羌活汤
羌活 防风 川芎 黄芩 苍术 白芷
葛根汤
葛根 桂枝 芍药 甘草 麻黄
有汗去麻黄。无汗面赤,加白芷。寒热加柴胡。里热加黄芩。身痛加羌活。
小柴胡汤
柴胡 黄芩 陈皮 人参 半夏 甘草
葛根黄芩黄连汤
葛根 黄芩 黄连 甘草
黄芩汤
黄芩 大枣 甘草 白芍药
秦子说:泄泻的症状,有的排出白色粪便,有的排出黄色粪便,有的排出清水,有的排出未消化的食物和水的混合物,其中不夹杂脓血,这称为泄泻。
如果大便中带有粘稠的积滞物,那就是痢疾,而不是泄泻的症状了。现在列出外感引起的五条,内伤引起的五条,以及五更泄泻五条。
【风泻的症状】自汗、头部出汗,怕风、发热,头痛、前额疼痛,排泄出未消化的食物和水,或者排泄出清水,这是伤风导致的飧泄(完谷不化)症状。
【风泻的病因】风邪侵入肠胃之间,就会产生泄泻的祸患。医经说:春天被风邪所伤,夏天必定发生飧泄。这是……
【风泻的脉象】脉象多浮而弦,左关脉浮弦,是风木之邪的表现。大肠脉浮,乃是肠风。右关脉浮,是胃风……
【风泻的治疗】左关脉浮弦,用柴胡防风汤,配合调服五苓散。大肠脉弦,风邪侵入阳明经,用干葛防风汤,配合服用六一散。右关脉弦,风邪侵入胃,用防葛汤,配合调服胃苓散。总之,有表证应当解表发散,表证解除后,应当分利水湿。
柴胡防风汤
柴胡 防风 荆芥 羌活 川芎 干葛 陈皮 甘草
五苓散
白术 泽泻 猪苓 肉桂 白茯苓
干葛防风汤
干葛 防风 荆芥 羌活 川芎 枳壳 甘草
六一散
滑石 甘草
防风汤
防风 葛根
胃苓散
苍术 浓朴 陈皮 甘草 白术 白茯苓 泽泻 猪苓 肉桂
【寒泻的症状】怕冷、身体疼痛,不发热,口不渴,小便颜色清亮,腹部疼痛,排泄出未消化的食物和水,这是寒邪直接侵犯三阴经的寒泻症状。如果怕冷、身体疼痛,身体反而发热,口反而口渴,这是寒邪损伤三阳经的热泻症状。
【寒泻的病因】真阳素来虚弱,偶然遇到时令的寒气,直接侵犯三阴经,那么身体就不发热,口也不渴,小便通利,腹部疼痛,于是中寒下利的症状就发作了。如果肠胃内有热,外部的寒气束缚在皮毛,内部的热气不能发泄,则寒邪转化为……
【寒泻的脉象】右关脉沉迟,是寒邪中于太阴经。左尺脉沉迟,是寒邪中于少阴经;左关脉沉迟,是寒邪中于厥阴经。如果身体发热、脉象浮紧,是寒邪伤了太阳经。身体发热、脉象浮弦,是寒邪伤了少阳经。身体发热、脉象长,右寸关脉特别大,是寒邪伤了阳明经。
【寒泻的治疗】三阴经的寒泻,由理中汤、四逆汤、真武汤主治。寒邪损伤三阳经的热泻,应当解表,太阳经用羌活汤;阳明经用葛根汤;少阳经用小柴胡汤。应当清热的,由葛根黄芩黄连汤、黄芩汤主治。
理中汤 见前文。
四逆汤 见前文。
真武汤
生姜 白术 附子 白芍药 白茯苓
羌活汤
羌活 防风 川芎 黄芩 苍术 白芷
葛根汤
葛根 桂枝 芍药 甘草 麻黄
有汗去掉麻黄。无汗且面赤,加白芷。寒热往来加柴胡。里有热加黄芩。身体疼痛加羌活。
小柴胡汤
柴胡 黄芩 陈皮 人参 半夏 甘草
葛根黄芩黄连汤
葛根 黄芩 黄连 甘草
黄芩汤
黄芩 大枣 甘草 白芍药
Qin Zi said: The symptoms of Xie Xie (diarrhea) include discharging white stool, yellow stool, clear water, or undigested food mixed with water, without pus and blood. This is called Xie Xie (diarrhea).
If the stool contains sticky accumulation, it is Li Ji (dysentery), not a symptom of Xie Xie (diarrhea). Now, five categories of exogenous causes, five categories of endogenous injuries, and five categories of Wugeng Xie Xie (predawn diarrhea) are listed.
[Symptoms of Wind-induced Diarrhea] Spontaneous sweating, sweating on the head, aversion to wind, fever, headache, and frontal pain, with discharge of undigested food and water, or clear water. This is the symptom of Sun Fen (diarrhea with undigested food) caused by wind injury.
[Etiology of Wind-induced Diarrhea] When wind pathogen enters between the stomach and intestines, diarrhea occurs. The Classics state: "Injury by wind in spring leads to Sun Fen (diarrhea with undigested food) in summer." This...
[Pulse of Wind-induced Diarrhea] The pulse is mostly floating and wiry. Left Guan (Cun-Guan-Chi at the radial artery) floating and wiry indicates wind-liver wood pathogen. Large intestine pulse floating indicates Chang Feng (intestinal wind). Right Guan pulse floating indicates Wei Feng (stomach wind)...
[Treatment of Wind-induced Diarrhea] If the Left Guan pulse is floating and wiry, use Chai Hu Fang Feng Tang (Bupleurum and Saposhnikovia Decoction), combined with Wu Ling San (Five-Ingredient Powder with Poria). If the large intestine pulse is wiry, wind has entered the Yangming channel; use Gan Ge Fang Feng Tang (Kudzu Root and Saposhnikovia Decoction), combined with Liu Yi San (Six-to-One Powder). If the Right Guan pulse is wiry, wind pathogen has entered the stomach; use Fang Ge Tang (Saposhnikovia and Kudzu Root Decoction), combined with Wei Ling San (Stomach-Poria Powder). In general, if there is an exterior syndrome, resolve the exterior first. Once the exterior is resolved, separate and drain dampness.
Chai Hu Fang Feng Tang (Bupleurum and Saposhnikovia Decoction)
Chai Hu (Bupleuri Radix), Fang Feng (Saposhnikoviae Radix), Jing Jie (Schizonepetae Herba), Qiang Huo (Notopterygii Rhizoma et Radix), Chuan Xiong (Ligustici Chuanxiong Rhizoma), Gan Ge (Puerariae Lobatae Radix), Chen Pi (Citri Reticulatae Pericarpium), Gan Cao (Glycyrrhizae Radix et Rhizoma)
Wu Ling San (Five-Ingredient Powder with Poria)
Bai Zhu (Atractylodis Macrocephalae Rhizoma), Ze Xie (Alismatis Rhizoma), Zhu Ling (Polyporus), Rou Gui (Cinnamomi Cortex), Bai Fu Ling (Poria)
Gan Ge Fang Feng Tang (Kudzu Root and Saposhnikovia Decoction)
Gan Ge (Puerariae Lobatae Radix), Fang Feng (Saposhnikoviae Radix), Jing Jie (Schizonepetae Herba), Qiang Huo (Notopterygii Rhizoma et Radix), Chuan Xiong (Ligustici Chuanxiong Rhizoma), Zhi Ke (Aurantii Fructus), Gan Cao (Glycyrrhizae Radix et Rhizoma)
Liu Yi San (Six-to-One Powder)
Hua Shi (Talcum), Gan Cao (Glycyrrhizae Radix et Rhizoma)
Fang Feng Tang (Saposhnikovia Decoction)
Fang Feng (Saposhnikoviae Radix), Ge Gen (Puerariae Lobatae Radix)
Wei Ling San (Stomach-Poria Powder)
Cang Zhu (Atractylodis Rhizoma), Nong Po (Magnoliae Officinalis Cortex), Chen Pi (Citri Reticulatae Pericarpium), Gan Cao (Glycyrrhizae Radix et Rhizoma), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Bai Fu Ling (Poria), Ze Xie (Alismatis Rhizoma), Zhu Ling (Polyporus), Rou Gui (Cinnamomi Cortex)
[Symptoms of Cold-induced Diarrhea] Aversion to cold, body ache, no fever, no thirst, clear and copious urine, abdominal pain, and discharge of undigested food and water. This is the Cold Diarrhea syndrome where cold pathogen directly invades the Three Yin channels. If there is aversion to cold, body ache, but the body is conversely feverish, and the mouth is conversely thirsty, this is the Heat Diarrhea syndrome where cold pathogen injures the Three Yang channels.
[Etiology of Cold-induced Diarrhea] If True Yang (Zhen Yang) is inherently deficient, and one encounters seasonal cold, which directly invades the Three Yin channels, then the body will not be feverish, nor will there be thirst, urine will be profuse, and abdominal pain will occur, leading to the manifestation of Zhong Han Xia Li (cold invasion causing lower purging). If there is heat in the stomach and intestines, external cold binds the skin and hair, preventing internal heat from venting, then cold transforms into...
[Pulse of Cold-induced Diarrhea] Right Guan pulse deep and slow indicates cold invading Taiyin channel. Left Chi pulse deep and slow indicates cold invading Shaoyin channel; Left Guan pulse deep and slow indicates cold invading Jueyin channel. If the body is feverish and the pulse is floating and tight, cold has injured Taiyang channel. If the body is feverish and the pulse is floating and wiry, cold has injured Shaoyang channel. If the body is feverish and the pulse is long, with only the Right Cun and Guan pulses being particularly large, cold has injured Yangming channel.
[Treatment of Cold-induced Diarrhea] For Three Yin cold diarrhea, Li Zhong Tang (Regulate the Middle Decoction), Si Ni Tang (Reverse the Collapse Decoction), and Zhen Wu Tang (True Warrior Decoction) are primarily used. For heat diarrhea caused by cold injuring the Three Yang channels, one should resolve the exterior: Taiyang channel uses Qiang Huo Tang (Notopterygium Decoction); Yangming channel uses Ge Gen Tang (Kudzu Root Decoction); Shaoyang channel uses Xiao Chai Hu Tang (Minor Bupleurum Decoction). For those requiring clearing of heat, Ge Gen Huang Qin Huang Lian Tang (Kudzu Root, Scutellaria, and Coptis Decoction) and Huang Qin Tang (Scutellaria Decoction) are primarily used.
Li Zhong Tang (Regulate the Middle Decoction) See previous text.
Si Ni Tang (Reverse the Collapse Decoction) See previous text.
Zhen Wu Tang (True Warrior Decoction)
Sheng Jiang (Zingiberis Rhizoma Recens), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Fu Zi (Aconiti Lateralis Radix Praeparata), Bai Shao Yao (Paeoniae Radix Alba), Bai Fu Ling (Poria)
Qiang Huo Tang (Notopterygium Decoction)
Qiang Huo (Notopterygii Rhizoma et Radix), Fang Feng (Saposhnikoviae Radix), Chuan Xiong (Ligustici Chuanxiong Rhizoma), Huang Qin (Scutellariae Radix), Cang Zhu (Atractylodis Rhizoma), Bai Zhi (Angelicae Dahuricae Radix)
Ge Gen Tang (Kudzu Root Decoction)
Ge Gen (Puerariae Lobatae Radix), Gui Zhi (Cinnamomi Ramulus), Shao Yao (Paeoniae Radix), Gan Cao (Glycyrrhizae Radix et Rhizoma), Ma Huang (Ephedrae Herba)
If there is sweating, remove Ma Huang. If there is no sweating and the face is red, add Bai Zhi. If there are alternating chills and fever, add Chai Hu. If there is interior heat, add Huang Qin. If there is body pain, add Qiang Huo.
Xiao Chai Hu Tang (Minor Bupleurum Decoction)
Chai Hu (Bupleuri Radix), Huang Qin (Scutellariae Radix), Chen Pi (Citri Reticulatae Pericarpium), Ren Shen (Ginseng Radix), Ban Xia (Pinelliae Rhizoma), Gan Cao (Glycyrrhizae Radix et Rhizoma)
Ge Gen Huang Qin Huang Lian Tang (Kudzu Root, Scutellaria, and Coptis Decoction)
Ge Gen (Puerariae Lobatae Radix), Huang Qin (Scutellariae Radix), Huang Lian (Coptidis Rhizoma), Gan Cao (Glycyrrhizae Radix et Rhizoma)
Huang Qin Tang (Scutellaria Decoction)
Huang Qin (Scutellariae Radix), Da Zao (Jujubae Fructus), Gan Cao (Glycyrrhizae Radix et Rhizoma), Bai Shao Yao (Paeoniae Radix Alba)