(附痔漏肠痈)
血清而色鲜者为肠风。浊而黯者为脓毒。或在粪前。或在粪后。并宜米饮汤调枳壳散。
下酒
煮黄连丸。或枳壳散。或乌梅丸。此乃因登圊粪中有血。却与泻血不同。或用小乌沉汤和黑
神散。米饮调下。粪前后有血皆可用。色瘀尤甚捷。
脏毒者。蕴积毒瓦斯。久而始见。肠风者。邪气外入。随感随见。此三因方五痔脏毒肠风
辨之
甚详。脏毒肠风之血。出于肠脏间。五痔之血。出于粪门蚀孔处。治各不同。无择翁乌连汤
治脉痔外无形。而所下血一线如箭。或点滴下不能已。此由脉窍中来也。其方已录千里镜
血色清鲜者。以瓦松烧灰研细。米饮调服。宜
减桂五苓饮。加茅花半钱。吞荆梅花丸。仍以侧柏叶同姜烂捣。冷水解下。侵些米饮佳。
如血色淡浊者。胃风汤。吞蒜连丸。或乌荆丸。或棕灰散。仍以米饮调香附末。或三灰
散。
或久而不已。面色痿黄。渐成虚惫。下元衰弱者。宜黄 四君子汤。下断红丸。或十全
大补汤
或黄 饮。诸般肠风脏毒。并宜生银杏四十九个。去壳膜烂研。入百药煎末。丸如弹子大
每两三丸空心细嚼米饮下。痔漏证状颇多。自属外科。不复繁引。既血自内出。不可全仗
外敷。宜只HT 散。吞钓肠丸。痔正发而血多者。亦宜自里托之。宜千金内补散。减桂之半。
加鳖头血尤妙。
肠痈即肠中生痈也。腹中 痛。其始发热恶寒。证状难辨。因下脓血。乃觉。或小腹痛
满。或小便涩滞。或脓从脐出。宜千金内补散。太乙膏。
(附痔疮、漏管、肠痈)
血色清稀且颜色鲜红的是肠风。
血色浑浊且颜色暗黑的是脏毒。
出血可能在排便之前,也可能在排便之后。
均适宜用米汤送服枳壳散。
用酒送服煮黄连丸。或者服用枳壳散。或者服用乌梅丸。这是因为登厕时大便中有血,但这与泻血不同。也可以使用小乌沉汤和黑神散,用米汤调服。无论排便前还是排便后出血均可使用。如果血色瘀滞,效果尤其迅速显著。
脏毒是由于毒气蕴积日久才显现出来;肠风则是邪气从外部侵入,感邪后立即显现。《三因方》中关于五痔、脏毒、肠风的辨析非常详尽。脏毒和肠风的出血,来源于肠道脏腑之间;而五痔的出血,来源于肛门蚀孔处。治疗方法各不相同。无择翁的乌连汤治疗脉痔,其特点是外部没有明显形态,但排出的血液像箭一样一线射出,或点滴不止。这是由脉窍中流出的缘故。该方剂已收录于千里镜中。
血色清澈鲜红的,将瓦松烧成灰研细,用米汤调服。适宜服用减桂五苓饮,加入半钱茅花,吞服荆梅花丸。仍以侧柏叶同生姜捣烂,用冷水送下,稍加些米汤更好。
如果血色淡浊,服用胃风汤,吞服蒜连丸。或者乌荆丸。或者棕灰散。仍以米汤调服香附末。或者三灰散。
如果病久不愈,面色萎黄,逐渐形成虚弱疲惫,下元衰弱者,适宜服用黄芪四君子汤。或者服用断红丸。或者十全大补汤。或者黄芪饮。各种肠风、脏毒,都适宜生银杏四十九个,去掉壳和膜捣烂,加入百药煎末,制成如弹子大小的丸药。每次两三丸,空腹细细咀嚼后用米汤送下。痔疮和漏管的证状很多,自然属于外科范畴,不再繁琐引用。既然血液是从内部流出,不能全仗外敷药物。适宜只服用HT散(注:原文可能有误,推测为某种内服散剂),吞服钓肠丸。痔疮刚发作且出血多的,也适宜从内部托毒外出。适宜服用千金内补散,减去一半桂枝,加入鳖头血尤为奇妙。
肠痈就是肠道中产生痈肿。腹部疼痛。起初发热恶寒,证状难以辨别,直到排出脓血,才察觉。或者小腹胀满。或者小便涩滞不畅。或者脓液从肚脐流出。适宜服用千金内补散。太乙膏。
(Attached: Hemorrhoids, Fistula, Intestinal Abscess)
Blood that is clear and bright red is Changfeng (Intestinal Wind).
Blood that is turbid and dark is Zangdu (Visceral Toxin).
Bleeding may occur before defecation or after defecation.
It is suitable to take Zhike San (Bitter Orange Powder) mixed with rice water in all cases.
Take Zhuhuanglian Wan (Boiled Coptis Pill) with wine. Or take Zhike San (Bitter Orange Powder). Or take Wumei Wan (Mume Pill). This occurs because there is blood in the stool when using the toilet, but this is different from Xieyue (Draining Blood). Alternatively, Xiaowuchen Tang (Minor Black and Sinking Decoction) and Heishen San (Black Divine Powder) can be used, taken with rice water. It can be used whether bleeding occurs before or after defecation. If the blood color is stasis, the effect is particularly rapid and effective.
Zangdu (Visceral Toxin) manifests only after toxins have accumulated for a long time; Changfeng (Intestinal Wind) is caused by pathogenic factors entering from the exterior, manifesting immediately upon infection. The differentiation of Five Hemorrhoids, Zangdu, and Changfeng in *San Yin Fang* (Formulas of Three Causes) is very detailed. The blood from Zangdu and Changfeng originates between the intestinal organs, whereas the blood from the Five Hemorrhoids originates from the erosion at the anal opening. The treatments differ. Wu Lian Tang (Wu Lian Decoction) by Wuzeweng treats Mai Zhi (Vessel Hemorrhoid), characterized by no external visible form, but the discharged blood shoots out like an arrow or drips incessantly. This flows from the vessel orifices. This prescription has been recorded in *Qianli Jing*.
For blood that is clear and fresh, burn Aspidistra elatior (Wasong) to ash, grind it finely, and take it with rice water. Jian Gui Wu Ling Yin (Cinnamon-Reduced Five-Agents Decoction) is suitable, add half a qian of Maohua (Catkin), and swallow Jingmeihua Wan (Prunus Mume Flower Pill). Still, crush Platycladi Cacumen (Ce Bai Ye, 侧柏叶) with ginger, mix well, and take with cold water; adding some rice water is better.
If the blood color is pale and turbid, take Weifeng Tang (Stomach Wind Decoction), swallow Suanlian Wan (Garlic-Coptis Pill). Or Wu Jing Wan (Evodia-Jingjie Pill). Or Zonghui San (Brown Ash Powder). Still, take Xiangfu Mo (Cyperi Rhizoma Powder) mixed with rice water. Or Sanhui San (Three Ashes Powder).
If the condition persists for a long time without healing, the complexion becomes sallow, gradually becoming weak and exhausted, with deficiency and weakness of the Lower Yuan, Huangqi Sijunzi Tang (Astragalus Four Gentlemen Decoction) is suitable. Or Duanhong Wan (Stop Red Pill). Or Shiquan Dabu Tang (Ten Complete Great Tonifying Decoction). Or Huangqi Yin (Astragalus Drink). For various Changfeng and Zangdu, it is suitable to use forty-nine raw Ginkgo nuts (Yinxing), remove the shell and membrane, crush them, add Banyaoye Jie (Myrobalan Extract) powder, and make pills the size of bullet seeds. Take two or three pills each time, chew them slowly on an empty stomach, and swallow with rice water. There are many symptoms of hemorrhoids and fistulas, which naturally belong to Surgery, so they will not be cited extensively here. Since the blood comes from inside, one cannot rely entirely on external applications. It is suitable to only take HT San (Note: Text likely erroneous, implies internal powder), swallow Diaochang Wan (Hook Intestine Pill). When hemorrhoids first erupt and bleeding is heavy, it is also suitable to support from within. Qianjin Neibu San (Thousand Gold Internal Support Powder) is suitable, reduce Guizhi (Cinnamon Twig) by half, adding blood from a softshell turtle head is especially excellent.
Changyong (Intestinal Abscess) refers to an abscess forming in the intestine. Abdominal pain occurs. Initially, there is fever and aversion to cold, making symptoms difficult to distinguish; it is only noticed after pus and blood are discharged. Or there is lower abdominal fullness. Or dysuria. Or pus discharges from the umbilicus. Qianjin Neibu San (Thousand Gold Internal Support Powder) and Taiyi Gao (Great One Ointment) are suitable.