(附∶交肠)
经曰∶诸转反戾,水液混浊,皆属于热。又曰∶脾胃湿热下流,渗入膀胱,故便溲白或赤而
混浊。盖缘思虑过节,房欲无度,致心肾气虚,君相不能管摄,阴阳不能降升,上下乖睽,清浊
混淆,伤气分者白,伤血分者赤。又有肥人因湿痰流注,稠粘如糊,宜燥脾土。弱人因伤精漩白
,光彩如膏,宜益下元。少年患者,溺时痛似刀割,管口精浊干凝,多缘欲事中阻,淫火不泄。治宜分利清火为主,
赤兼清心调气,白兼补肾培元。两尺脉洪数,便浊。
主方 (便浊,大痛) 赤茯苓 泽泻 猪苓 木通 黄柏(盐炒) 瞿麦 车前子 淡
竹叶 蓄(各八分) 滑石(研细,钱半) 甘草(三分) 上加灯心二十枝,水煎,空心服
。
火盛加栀子、条黄芩、车前草(捣绞汁。)
厘清饮 治赤、白浊。
益智 川萆 (赤者) 石菖蒲 车前子 赤茯苓 猪苓 泽泻 白术 枳壳 陈皮(各八
分) 升麻 甘草梢(各三分)
上加灯心、水酒各半,煎,空心服。首帖加麻黄(八分),减升麻。如热甚作痛加炒黄柏(
二钱),煎成,调青黛(七分)、滑石末(二钱),去枳、陈、智。不通加木通、淡竹叶、 蓄
、石苇等。变虚寒加炮姜、肉桂(三分)。
日久服凉药过多,真元耗损,肾虚有寒,频数无度,光彩如膏。益智、萆 、菖蒲、乌药、
茯苓等分,水煎,入盐一分,空心服。
珍珠粉丸 治白浊遗精。
黄柏(盐炒为末) 蛤粉( ,另研。各四两) 珍珠(五钱,水飞,如无,用真青黛)。
水丸,桐子大,每二钱灯心汤下。
水陆二仙丹 治赤、白浊及遗精。
芡实肉(研末) 金樱子(刮刺去子)
捣绞汁,熬膏,和芡丸,每服二钱,空心白汤下。
白龙丸 治白浊滑精。
龙骨 牡蛎( 。各一两) 鹿角霜(二两)
为末,山药末调糊丸,桐子大。五十丸,空心酒下。
妙灵丸 治赤、白浊,遗精。
白茯苓 菟丝子(煮饼) 龙骨( 。各五钱) 益智仁 石莲肉 桑螵蛸(各三钱半)
上末,山药末调糊,丸桐子大,每服五十丸,空心,人参枣仁汤下,白汤亦可。
清心莲子饮 赤浊淋沥、涩痛,遗精、口苦咽干渴,妇人带下(方见淋门)。
二陈汤 (方见痰门)
肥人湿痰下流加白术一钱、升麻、柴胡各五分。湿痰兼气血虚加苍、白术、参、归、地黄、
栀、柏、牛膝。
六味地黄丸 (方见虚损)
瘦人虚热便浊加芍、知、麦、柏、参、术、草、膝、 蓄。
六一散 (方见暑门) 浊痛。
每三钱,车前草捣汁,调匀,灯心汤送下。
简便方 白浊遗精。
白盐入瓷罐,盖, 通红,地上放冷,每两入茯苓、山药末(各一两)。
枣肉和蜜丸,如梧桐子大。每服三十丸,空心枣汤下。
又 茯苓(二两) 猪苓(一两) 水一碗,煮干去猪,用茯苓为末,腊丸弹大,每丸嚼细
,灯心枣汤下。或韭子研末酒下;或陈皮、冬瓜仁研末,米汤下。
(附注:交肠病)
《内经》说:各种筋脉拘挛翻转、小便浑浊,都属于热证。又说:脾胃湿热下注,渗入膀胱,所以大小便排出物呈白色或红色且浑浊。这大概是因为思虑过度、房事不节,导致心肾气虚,君火与相火不能统摄,阴阳之气升降失常,上下乖离,清浊混淆。损伤气分的表现为白色,损伤血分的表现为红色。又有肥胖之人因湿痰流注,质地稠粘如糊状,宜用燥脾土的方法治疗。体弱之人因耗伤精气而尿液清白,光泽如膏脂,宜补益下元。少年患者,排尿时疼痛如刀割,尿道口精浊干燥凝结,多因行房中途受阻,淫火不得宣泄所致。治疗应以分利湿热、清泻火邪为主,赤浊兼以清心调气,白浊兼以补肾培元。两尺脉象洪数,为便浊之征。
主方(用于便浊,疼痛剧烈者):赤茯苓、泽泻、猪苓、木通、黄柏(盐炒)、瞿麦、车前子、淡竹叶、萹蓄(各八分),滑石(研细,一钱半),甘草(三分)。上加灯心草二十枝,水煎,空腹服用。
若火盛,加栀子、条芩、车前草(捣汁)。
厘清饮:治疗赤浊、白浊。
益智仁、川萆薢(治赤浊)、石菖蒲、车前子、赤茯苓、猪苓、泽泻、白术、枳壳、陈皮(各八分),升麻、甘草梢(各三分)。
上加灯心草、水酒各半,煎服,空腹服用。第一帖加麻黄(八分),减去升麻。如果热甚疼痛,加炒黄柏(二钱),煎好后,调入青黛(七分)、滑石末(二钱),去掉枳壳、陈皮、益智仁。若小便不通,加木通、淡竹叶、萹蓄、石苇等。若变为虚寒证,加炮姜、肉桂(三分)。
若日久服用凉药过多,真元耗损,肾虚有寒,尿频无度,尿色光彩如膏脂。用益智仁、萆薢、菖蒲、乌药、茯苓等分,水煎,入盐一分,空腹服用。
珍珠粉丸:治疗白浊、遗精。
黄柏(盐炒为末)、蛤粉(煅,另研,各四两)、珍珠(五钱,水飞,若无,可用真青黛代替)。
制成水丸,梧桐子大,每次二钱,灯心草汤送下。
水陆二仙丹:治疗赤浊、白浊及遗精。
芡实肉(研末)、金樱子(刮去刺并去除种子)。
捣绞取汁,熬成膏,和芡实末制成丸剂,每次服二钱,空腹白开水送下。
白龙丸:治疗白浊、滑精。
龙骨、牡蛎(煅,各一两)、鹿角霜(二两)。
研为末,用山药末调糊制成丸剂,梧桐子大。每次五十丸,空腹黄酒送下。
妙灵丸:治疗赤浊、白浊、遗精。
白茯苓、菟丝子(煮饼制)、龙骨(煅,各五钱)、益智仁、石莲肉、桑螵蛸(各三钱半)。
研为末,用山药末调糊,制成梧桐子大的丸剂,每次服五十丸,空腹,用人参枣仁汤送下,白开水亦可。
清心莲子饮:治疗赤浊淋沥、涩痛,遗精、口苦咽干渴,妇人带下(方见淋门)。
二陈汤(方见痰门)
肥胖之人湿痰下流,加白术一钱、升麻、柴胡各五分。湿痰兼气血虚,加苍术、白术、人参、当归、地黄、栀子、黄柏、牛膝。
六味地黄丸(方见虚损)
瘦人虚热便浊,加芍药、知母、麦冬、黄柏、人参、白术、甘草、牛膝、萹蓄。
六一散(方见暑门):治疗浊痛。
每次三钱,用车前草捣汁调匀,灯心草汤送下。
简便方:治疗白浊、遗精。
白盐放入瓷罐,盖好,烧至通红,放在地上冷却,每两盐加入茯苓、山药末(各一两)。
用枣肉和蜜制成丸剂,梧桐子大。每次服三十丸,空腹枣汤送下。
又方:茯苓(二两)、猪苓(一两),用水一碗,煮干后去掉猪苓,将茯苓研为末,制成腊丸,弹子大。每次嚼细一丸,灯心草枣汤送下。或用韭子研末,酒送下;或用陈皮、冬瓜仁研末,米汤送下。
(Attachment: Jiao Chang Disease)
The *Neijing* states: Various conditions involving tendon spasms, convulsions, and turbid urine all belong to Heat. It further states: Damp-Heat in the Spleen and Stomach flows downward, infiltrating the Bladder, causing urine or feces to be white or red and turbid. This is generally due to excessive mental exertion and immoderate sexual activity, leading to Qi deficiency of the Heart and Kidney, failure of the Ministerial Fire (Xiang Huo) and Sovereign Fire (Jun Huo) to control and regulate, dysfunction of Yin and Yang ascending and descending, separation of upper and lower parts, and confusion of Clear and Turbid substances. Injury to the Qi level manifests as white discharge; injury to the Blood level manifests as red discharge. Additionally, obese individuals may suffer from Damp-Phlegm flowing into the channels, with a thick and sticky consistency like paste; treatment should focus on drying Spleen Earth. Frail individuals may have clear urine resembling cream due to Essence depletion; treatment should focus on tonifying the Lower Yuan. Young patients experiencing pain like knife-cutting during urination, with dry condensation of essence-turbidity at the urethral orifice, often result from interrupted coitus and unvented Lust-Fire. Treatment should primarily focus on separating and draining Dampness and clearing Fire. For red turbidity, clear the Heart and regulate Qi; for white turbidity, tonify the Kidney and cultivate the Yuan. A surging and rapid pulse at both Chi positions indicates Bian Zhuo (Turbid Urine).
Main Formula (for Bian Zhuo with severe pain): Chi Fu Ling (Red Poria), Ze Xie (Alisma Rhizome), Zhu Ling (Polyporus), Mu Tong (Akebia Caulis), Huang Bo (Phellodendron Bark, salt-fried), Qu Mai (Dianthus Herb), Che Qian Zi (Plantago Seed), Dan Zhu Ye (Lophatherum Leaf), Pian Xu (Persicaria Herb) (each 0.8 fen), Hua Shi (Talcum, finely ground, 1.5 qian), Gan Cao (Licorice Root) (0.3 fen). Add twenty stalks of Deng Xin Cao (Juncus Medulla), decoct in water, take on an empty stomach.
If Fire is excessive, add Zhi Zi (Gardenia Fruit), Tiao Huang Qin (Scutellaria Root), and Che Qian Cao (Plantago Herb, crushed for juice).
Li Qing Yin (Clearing and Separating Decoction): Treats Red and White Turbidity.
Yi Zhi Ren (Alpinia Oxyphylla Fruit), Chuan Bi Xie (Dioscorea Hypoglauca Rhizome [for red turbidity]), Shi Chang Pu (Acorus Rhizome), Che Qian Zi (Plantago Seed), Chi Fu Ling (Red Poria), Zhu Ling (Polyporus), Ze Xie (Alisma Rhizome), Bai Zhu (Atractylodes Macrocephala Rhizome), Zhi Ke (Bitter Orange Fruit), Chen Pi (Citrus Reticulata Peel) (each 0.8 fen), Sheng Ma (Cimicifuga Rhizome), Gan Cao Gao (Licorice Root Tip) (each 0.3 fen).
Add Deng Xin Cao (Juncus Medulla), half water and half wine, decoct, take on an empty stomach. On the first dose, add Ma Huang (Ephedra Herb, 0.8 fen) and reduce Sheng Ma. If heat causes severe pain, add Chao Huang Bo (Salt-fried Phellodendron Bark, 2 qian); after decoction, mix in Qing Dai (Indigo Naturalis, 0.7 fen) and Hua Shi powder (Talcum, 2 qian), removing Zhi Ke, Chen Pi, and Yi Zhi Ren. If urinary obstruction occurs, add Mu Tong (Akebia Caulis), Dan Zhu Ye (Lophatherum Leaf), Pian Xu (Persicaria Herb), Shi Wei (Pyrrosia Leaf), etc. If it transforms into a Deficiency-Cold pattern, add Pao Jiang (Prepared Ginger) and Rou Gui (Cinnamon Bark, 0.3 fen).
If long-term use of cooling medicines has depleted True Yuan, resulting in Kidney Deficiency with Cold, frequent urination without limit, and urine shining like cream: Use equal parts of Yi Zhi Ren (Alpinia Oxyphylla Fruit), Bi Xie (Dioscorea Hypoglauca Rhizome), Chang Pu (Acorus Rhizome), Wu Yao (Lindera Root), and Fu Ling (Poria). Decoct in water, add one fen of salt, take on an empty stomach.
Zhen Zhu Fen Wan (Pearl Powder Pill): Treats White Turbidity and Spermatorrhea.
Huang Bo (Phellodendron Bark, salt-fried and powdered), Ge Fen (Clam Shell Powder, calcined, separately ground) (each 4 liang), Zhen Zhu (Pearl, 5 qian, water-pulverized; if unavailable, use genuine Qing Dai/Indigo Naturalis).
Make water pills, size of Sophora seeds. Take 2 qian per dose, washed down with Deng Xin Cao (Juncus Medulla) decoction.
Shui Lu Er Xian Dan (Water and Land Two Immortals Elixir): Treats Red and White Turbidity and Spermatorrhea.
Qian Shi Rou (Euryale Seed Flesh, powdered), Jin Ying Zi (Cherokee Rose Hip, scraped of thorns and seeds removed).
Crush and extract juice, boil into a paste, mix with Qian Shi powder to make pills. Take 2 qian per dose, washed down with plain warm water on an empty stomach.
Bai Long Wan (White Dragon Pill): Treats White Turbidity and Slippery Sperm.
Long Gu (Fossilized Bone, calcined), Mu Li (Oyster Shell, calcened) (each 1 liang), Lu Jiao Shuang (Deer Horn Glue Frost, 2 liang).
Grind into powder, mix with Shan Yao (Dioscorea Oppolata Rhizome) powder and paste to make pills, size of Sophora seeds. Take 50 pills per dose, washed down with yellow wine on an empty stomach.
Miao Ling Wan (Miraculous Spirit Pill): Treats Red and White Turbidity, Spermatorrhea.
Bai Fu Ling (White Poria), Tu Si Zi (Cuscuta Seed, boiled with bean cake), Long Gu (Fossilized Bone, calcined) (each 5 qian), Yi Zhi Ren (Alpinia Oxyphylla Fruit), Shi Lian Rou (Lotus Plumule), Sang Piao Xiao (Mantis Egg-case) (each 3.5 qian).
Grind into powder, mix with Shan Yao (Dioscorea Oppolata Rhizome) powder and paste to make pills, size of Sophora seeds. Take 50 pills per dose on an empty stomach, washed down with Ren Shen (Ginseng Root) and Suan Zao Ren (Ziziphus Seed) decoction; plain warm water is also acceptable.
Qing Xin Lian Zi Yin (Heart-Clearing Lotus Seed Decoction): Treats red turbidity with dribbling and painful dysuria, spermatorrhea, bitter taste in mouth, dry throat and thirst, and leukorrhea in women (Formula seen in Lin Men chapter).
Er Chen Tang (Two-Cured Decoction) (Formula seen in Tan Men chapter).
For obese individuals with Damp-Phlegm flowing downward, add Bai Zhu (Atractylodes Macrocephala Rhizome, 1 qian), Sheng Ma (Cimicifuga Rhizome, 0.5 fen), and Chai Hu (Bupleurum Root, 0.5 fen). For Damp-Phlegm combined with Qi and Blood deficiency, add Cang Zhu (Atractylodes Lancea Rhizome), Bai Zhu (Atractylodes Macrocephala Rhizome), Ren Shen (Ginseng Root), Dang Gui (Angelica Sinensis Root), Di Huang (Rehmannia Root), Zhi Zi (Gardenia Fruit), Huang Bo (Phellodendron Bark), and Niu Xi (Achyranthes Root).
Liu Wei Di Huang Wan (Six-Ingredient Rehmannia Pill) (Formula seen in Xu Sun chapter).
For thin individuals with Deficiency-Heat causing turbid urine, add Shao Yao (Peony Root), Zhi Mu (Anemarrhena Rhizome), Mai Dong (Ophiopogon Tuber), Huang Bo (Phellodendron Bark), Ren Shen (Ginseng Root), Bai Zhu (Atractylodes Macrocephala Rhizome), Gan Cao (Licorice Root), Niu Xi (Achyranthes Root), and Pian Xu (Persicaria Herb).
Liu Yi San (Six-to-One Powder) (Formula seen in Shu Men chapter): Treats turbid pain.
Take 3 qian per dose, mix evenly with Che Qian Cao (Plantago Herb) juice, wash down with Deng Xin Cao (Juncus Medulla) decoction.
Simple Prescription: Treats White Turbidity and Spermatorrhea.
Put Bai Yan (White Salt) in a porcelain jar, cover tightly, heat until red-hot, place on the ground to cool. For every 1 liang of salt, add Fu Ling (Poria) and Shan Yao (Dioscorea Oppolata Rhizome) powder (each 1 liang).
Mix with jujube flesh and honey to make pills, size of Sophora seeds. Take 30 pills per dose, washed down with jujube decoction on an empty stomach.
Another prescription: Fu Ling (Poria, 2 liang), Zhu Ling (Polyporus, 1 liang). Decoct in one bowl of water until dry, remove Zhu Ling (Polyporus), grind Fu Ling (Poria) into powder, make wax pills, size of a bullet. Chew one pill thoroughly per dose, wash down with Deng Xin Cao (Juncus Medulla) and jujube decoction. Alternatively, chew Jiu Zi (Asparagus Seed) powder with wine; or chew Chen Pi (Citrus Reticulata Peel) and Dong Gua Ren (Winter Melon Seed) powder with rice soup.