(胃口热甚故也。)
黄连多加人参煮汤,终日呷之,如吐了再吃,开以降之。人不知此,多用温药甘味。此以火济火,以滞益滞,哀哉。
一方∶脐中用田螺, 之以引下其热。
亦有误服热药涩药之毒犯胃者,当明审以祛其毒。痢方亦作丸∶
大黄 黄连 黄芩 黄柏 枳壳 当归 白芍药 滑石 甘草 桃仁 白术(各等分)
上为末,神曲糊丸。
孙郎中因饮水过多,腹胀泻痢带白。
苍术、白术、浓朴、茯苓、滑石
上煎,下保和丸。
小儿八岁下痢纯血,以食积治。
苍术 白术 黄芩 白芍 滑石 茯苓 甘草 陈皮 炒曲 上煎,下保和丸。
又下痢法∶热不止者属阴虚,用寒凉药兼升药(药热)。
(湿、气虚、火、痰、食积。)
戴云∶凡泻水腹不痛者,是湿也。饮食入胃不住,或完谷不化者,是气虚也。腹痛泻水,腹鸣,痛一阵
泻一阵,是火也。或泻,时或不泻,或多或少,是痰也。腹痛甚而泻,泻后痛减者,是食积也。
湿,燥湿兼渗泄之。四苓散加苍术、白术。甚者,二术炒。
气虚,人参、白术、芍药(炒)、升麻。
火,宜伐火,利小水。黄芩、木通入四苓散。
痰积,宜豁之。海石、青黛、黄芩、神曲、蛤粉。或用吐法。
食积,宜消导疏涤之。神曲、大黄。
以上诸药皆作丸子服之。
凡泄泻水多者,仍用五苓散治之。
世俗类用涩药治痢与泻。若积久而虚者,或可行之;而初得之者,恐必变他疾,为祸不小矣。殊不知多
因于湿,惟分利小水,最为上策。
止泻方
肉豆蔻(五钱) 滑石(春冬一两二钱) 半夏(二两半,秋二两)
又方姜曲丸
陈曲(六两,炒) 陈麦(亦可) 茴香(五钱) 生姜(一两)
上炒白术、炒曲、炒芍药,或丸、或散、或汤,作丸妙。
(这是因为胃中热邪炽盛所致。)
黄连用量稍多,加入人参煎煮成汤剂,整天小口啜饮,如果发生呕吐则再次服用,以此起到降逆止呕的作用。世人不懂这个道理,往往过多使用温性且味甘的药物。这如同用火焰去助长火势,用滋腻之品加重气机阻滞,实在令人悲哀。
另一个方子:将田螺置于脐中,用以引导热邪下行。
也有因误服热性或收敛固涩药物的毒性侵犯胃部者,应当仔细审察以祛除其毒。治疗痢疾的方剂也可制成丸剂:
大黄、黄连、黄芩、黄柏、枳壳、当归、白芍药、滑石、甘草、桃仁、白术(各等分)
以上药物研为细末,用神曲糊作为粘合剂制成丸剂。
孙郎中因为饮水过多,出现腹胀、腹泻和痢疾,大便带有白色黏液。
苍术、白术、厚朴、茯苓、滑石
以上药物煎煮汤剂,送服保和丸。
八岁小儿患痢疾,排出纯血,按照食积进行治疗。
苍术、白术、黄芩、白芍、滑石、茯苓、甘草、陈皮、炒神曲
以上药物煎煮汤剂,送服保和丸。
另外关于治疗痢疾的方法:如果热邪不止,属于阴虚,应使用寒凉药物配合升提药物(此处指具有升提作用的药物,原文可能有误或特指某类药)。
(涉及湿、气虚、火、痰、食积等因素。)
戴云说:凡是泻下清水而腹部不痛的,是湿邪所致。饮食进入胃中无法停留,或者完谷不化(食物未经消化即排出),是气虚所致。腹痛伴随泻下清水,肠鸣音亢进,痛一阵泻一阵,是火邪所致。时而腹泻,时而不泻,或多或少,是痰浊所致。腹痛剧烈而后腹泻,腹泻后疼痛减轻,是食积所致。
对于湿邪,应采用燥湿兼渗泄的方法。使用四苓散加苍术、白术。病情严重者,苍术和白术需炒制。
对于气虚,用人参、白术、芍药(炒)、升麻。
对于火邪,宜清泻火邪,通利小便。使用黄芩、木通加入四苓散中。
对于痰积,宜豁痰。使用海浮石、青黛、黄芩、神曲、蛤粉。或者采用催吐法。
对于食积,宜消食导滞、疏通涤荡。使用神曲、大黄。
以上各种药物均制成丸剂服用。
凡是泄泻水量较多者,仍使用五苓散治疗。
世俗之人通常使用收敛固涩药物治疗痢疾和泄泻。如果是病程长久且体质虚弱者,或许可以施行;但对于初患病者,恐怕必然引发其他疾病,造成的祸害不小了。殊不知多数情况是由于湿邪引起,只有分利小便,才是最好的策略。
止泻方
肉豆蔻(五钱)、滑石(春冬季一两二钱)、半夏(二两半,秋季二两)
另一个方子:姜曲丸
陈年神曲(六两,炒制)、陈年小麦(也可以)、茴香(五钱)、生姜(一两)
以上与炒白术、炒神曲、炒芍药一起,可制成丸剂、散剂或汤剂,制成丸剂效果更佳。
(This is due to excessive heat in the stomach.)
Use a larger dose of Huanglian (Coptidis Rhizoma), add Renshen (Ginseng Radix et Rhizoma), and decoct into a soup. Sip it throughout the day. If vomiting occurs, take it again to descend rebellious Qi and stop vomiting. People do not understand this principle and often overuse warm and sweet-flavored medicines. This is like using fire to fuel fire, and using cloying substances to increase stagnation; how lamentable.
Another prescription: Place Tianluo (Viverricula indica or similar snail) on the umbilicus to guide the heat downward.
There are also cases where the toxicity from mistakenly taking hot or astringent medicines invades the stomach; one must carefully examine and dispel the toxicity. The dysentery prescription can also be made into pills:
Dahuang (Rhei Radix et Rhizoma), Huanglian (Coptidis Rhizoma), Huangqin (Scutellariae Radix), Huangbai (Phellodendri Cortex), Zhike (Aurantii Fructus Immaturus), Danggui (Angelicae Sinensis Radix), Baishao (Paeoniae Radix Alba), Huashi (Talcum), Gancao (Glycyrrhizae Radix et Rhizoma), Taoren (Persicae Semen), Baizhu (Atractylodis Macrocephalae Rhizoma) (equal parts).
Grind the above into powder, use Shenqu (Massa Medicata Fermentata) paste as a binder to make pills.
Director Sun drank too much water, resulting in abdominal distension, diarrhea, and dysentery with white discharge.
Cangzhu (Atractylodis Rhizoma), Baizhu (Atractylodis Macrocephalae Rhizoma), Houpo (Magnoliae Officinalis Cortex), Fuling (Poria), Huashi (Talcum).
Decoct the above, and administer Baohe Wan (Harmonize the Stomach Pill).
An eight-year-old child suffered from dysentery passing pure blood, treated as food stagnation.
Cangzhu (Atractylodis Rhizoma), Baizhu (Atractylodis Macrocephalae Rhizoma), Huangqin (Scutellariae Radix), Baishao (Paeoniae Radix Alba), Huashi (Talcum), Fuling (Poria), Gancao (Glycyrrhizae Radix et Rhizoma), Chenpi (Citri Reticulatae Pericarpium), Chaoqu (Stir-fried Massa Medicata Fermentata).
Decoct the above, and administer Baohe Wan (Harmonize the Stomach Pill).
Another method for treating dysentery: If heat persists, it belongs to Yin deficiency; use cold-cooling medicines combined with ascending medicines (note: original text implies specific ascending herbs, possibly referring to their nature or action).
(Involve dampness, Qi deficiency, fire, phlegm, and food stagnation.)
Dai Yun said: Whenever there is watery diarrhea without abdominal pain, it is due to dampness. When food enters the stomach but cannot stay, or passes through undigested (complete grain digestion failure), it is due to Qi deficiency. Abdominal pain accompanied by watery diarrhea, borborygmus, pain followed by a bout of diarrhea, is due to fire. Diarrhea that comes and goes, varying in amount, is due to phlegm. Severe abdominal pain followed by diarrhea, with pain relief after defecation, is due to food stagnation.
For dampness, employ drying dampness and promoting diuresis. Use Siling San (Four-Ingredient Powder for Dampness) plus Cangzhu (Atractylodis Rhizoma) and Baizhu (Atractylodis Macrocephalae Rhizoma). For severe cases, stir-fry both Atractylodes species.
For Qi deficiency, use Renshen (Ginseng Radix et Rhizoma), Baizhu (Atractylodis Macrocephalae Rhizoma), Shaoyao (Paeoniae Radix, stir-fried), Shengma (Cimicifugae Rhizoma).
For fire, it is appropriate to purge fire and promote urination. Add Huangqin (Scutellariae Radix) and Mutong (Akebiae Caulis) to Siling San (Four-Ingredient Powder for Dampness).
For phlegm accumulation, it is appropriate to resolve phlegm. Use Haishi (Fossilia Calcitae), Qingdai (Indigo Naturalis), Huangqin (Scutellariae Radix), Shenqu (Massa Medicata Fermentata), Gafen (Concha Meretricis et Cyclinae). Alternatively, use emesis therapy.
For food stagnation, it is appropriate to digest, guide out, and clear. Use Shenqu (Massa Medicata Fermentata) and Dahuang (Rhei Radix et Rhizoma).
All the above medicines should be taken as pills.
For those with profuse watery diarrhea, continue to use Wuling San (Five-Ingredient Powder for Resolving Fluids) to treat it.
The secular world generally uses astringent medicines to treat dysentery and diarrhea. If the condition has persisted for a long time and involves deficiency, this might be permissible; but for those who have just contracted the disease, it is feared that other illnesses will inevitably develop, causing significant harm. They fail to realize that most cases are caused by dampness; only by separating and promoting urination is it the best strategy.
Diarrhea-stopping Prescription
Roudoukou (Nucis Arecae Semina Preparatum, 5 qian), Huashi (Talcum, 1 liang 2 qian in spring/winter), Banxia (Pinelliae Rhizoma, 2.5 liang, 2 liang in autumn).
Another Prescription: Jiangqu Wan (Ginger and Fermented Grain Pill)
Chenqu (Old Massa Medicata Fermentata, 6 liang, stir-fried), Chenmai (Old Tritici Fructus, optional), Huixiang (Foeniculi Fructus, 5 qian), Shengjiang (Zingiberis Rhizoma Recens, 1 liang).
Stir-fry Baizhu (Atractylodis Macrocephalae Rhizoma), stir-fry Shenqu (Massa Medicata Fermentata), stir-fry Shaoyao (Paeoniae Radix). These can be made into pills, powders, or decoctions; making them into pills is excellent.