《孫真人備急千金要方》Vol. 50

“Formulas for the Spleen: Cold Dysentery, Chapter Eight”

In earlier times, dysentery was often treated very effectively in nobles and dignitaries with the Spleen-Building Pill. Today, for chronic cold-type dysentery that has not resolved, first use the Spleen-Warming Decoction to purge, then take the Spleen-Building Pill to restore and strengthen the body; this treatment never fails to work. Poor households, however, may find it difficult to obtain all these ingredients and may lack the means to recuperate.

Spleen-Warming Decoction: Used to treat chronic dysentery that has not resolved, with both cold and heat, and red and white matter in the stool.

Rhubarb, cassia heart (the inner bark of cinnamon), three liang each; aconite, dried ginger, and ginseng, two liang each.

Pound the five ingredients. Simmer them in seven sheng of water until two and a half sheng remain, and take in three divided doses. (This formula differs slightly from the Spleen-Warming Decoction recorded earlier.)

Spleen-Building Pill: Used to treat wasting and debility, emaciation, heaviness of the body, deficiency-cold of the Spleen and Stomach, indigestion, rumbling and distension in the abdomen, and persistent diarrhea and dysentery.

Calcined stalactite powder, three liang; red halloysite, good-quality fermented grain starter, malted barley, Chinese angelica, coptis, ginseng, asarum, dragon bone, dried ginger, poria, dendrobium, and cassia heart, two liang each; aconite, one liang; Sichuan pepper, six liang.

Grind the fifteen ingredients into a fine powder and mix with white honey to make pills the size of parasol-tree seeds. Take ten pills with wine three times a day, gradually increasing to thirty pills. Those who are weak may take them with a drink instead. This formula can be used by both men and women. (The Collected Proven Formulas omits asarum and dragon bone.)

Modified Spleen-Building Pill: Used to treat debility in men so severe that the five viscera and six bowels are damaged, followed by an invasion of cold. At first, the illness presents as dysentery. If it persists, pus and blood of five colors—red, white, yellow, and black among them—may appear, as though the intestines were rotting, with an extremely foul odor.

Calcined stalactite powder and red halloysite, three liang each; arsenolite (the original note says “in one version, alum is used,” meaning that some editions substitute alum); dried ginger, Chinese dodder, cassia heart, dendrobium, schisandra, alisma, polygala, Chinese taxillus (mistletoe), biota seed, ginseng, white-flowered patrinia, male aconite, Chinese angelica, pomegranate peel, oyster shell, dragon bone, and licorice, two liang each.

Grind the twenty ingredients into a fine powder and mix with honey to make pills. Take twenty pills with wine three times a day, gradually increasing to thirty pills. For abdominal pain, add one liang of Chinese angelica. For dry mouth, add fourteen smoked plums, decoct them to make a medicinal liquid, then put the pills into the liquid and take them. For diarrhea, add two liang of magnolia bark. If there is more red matter in the stool, add two liang of red halloysite; if there is more white matter, add two liang of dragon bone.

Up to forty pills. Both of these prescriptions are highly effective for stopping dysentery.

Zhuche Pills: Used to treat dysentery caused by severe internal Cold, with loose stools containing reddish and whitish mucus resembling fish brains. The bowel movements continue day and night, and the abdominal pain is unbearable.

Six liang of Huanglian, two liang of dried ginger, three liang of Chinese angelica, and three liang of donkey-hide gelatin. Grind the four ingredients into a fine powder. Melt the gelatin in eight ge of strong vinegar, then mix it with the powder and roll the mixture into pills the size of soybeans. Dry the pills before taking them. Adults take thirty pills per dose. Infants under one hundred days old take three pills, and children who have reached one year of age take five pills; adjust the amount for other ages as appropriate. Take three times a day.

Major Peach Blossom Decoction: Used to treat Cold-type white dysentery and abdominal pain.

Three liang each of red halloysite, dried ginger, Chinese angelica, dragon bone, and oyster shell; two liang of aconite; one sheng of white atractylodes; one liang each of licorice and peony; and one and a half liang of ginseng. Coarsely cut the ten ingredients. First decoct the white atractylodes in one dou and two sheng of water until nine sheng remain. Add the other ingredients and continue decocting until three sheng of liquid remain. Divide into three doses. If there is pus in the dysentery, add three liang of magnolia bark. If there is vomiting, add three liang of dried tangerine peel.

Another prescription:

Six liang of dragon bone, three liang of magnolia bark, three liang of Chinese angelica, and five liang of red halloysite. Coarsely cut the four ingredients and decoct them in seven sheng of water until two and a half sheng remain. Divide into three doses. If the condition tends toward Heat, add two and a half liang of Bai Tou Weng and three liang of oyster shell.

Peach Blossom Pills: Used to treat Cold in the lower burner and cramping pain below the navel.

Ten liang each of dried ginger and red halloysite. Grind the two ingredients into powder and use honey to form pills the size of peas. Take ten pills per dose, three times a day, gradually increasing to twenty pills.

Granary Rice Decoction: Used to treat Cold in the lower abdomen, where Cold gathers into a mass and causes Cold-type dysentery with thirty or forty bowel movements day and night.

Half a sheng of granary japonica rice, rinsed and drained; one handful of Chinese chives, with the green parts removed and the rest finely chopped; one sheng of rendered sheep fat; and three sheng of fermented soybeans, decocted in one dou of water until five sheng remain, then left to settle and strained to obtain the liquid. First fry the Chinese chives in the sheep fat until they turn yellow. Add them and the rice to the soybean liquid and decoct until four sheng remain. In the morning, take one sheng warm on an empty stomach. If taking it results in ten or …

If dysentery has continued for a long time, take another sheng of the medicine and stop once the diarrhea has become free-flowing. If it still does not stop, take another dose.

After the diarrhea has become free-flowing, first eat congee made from japonica rice and chi (fermented soybeans). If the illness flares up again, take another dose of the medicine.

This will bring about a cure.

Aconite Decoction: Used to treat sudden-onset diarrhea that continues for days without stopping, as well as chronic dysentery.

Formula: one aconite root, one pomegranate rind, two liang of donkey-hide gelatin, and one liang each of dragon bone, licorice, peony, dried ginger, and coptis, plus half a liang of scutellaria and three he of japonica rice.

Cut the ten ingredients into pieces. Boil them in eight sheng of water until three sheng remain, then take in three portions.

Decoction for Sudden-Onset Diarrhea

Formula: five liang of coptis and one jin of fresh ginger.

Cut the two ingredients into pieces. Boil them in five sheng of water until one sheng remains, and drink it all at once. If the diarrhea has not stopped, prepare and take another dose. The text says this is certain to work.

Formula for Chronic Cold Dysentery with Entirely White Discharges

The text holds that this kind of illness is often caused by lying for a long time in a cold place. When the illness persists without healing, it brings cold into both the spleen and stomach. The patient may have diarrhea fifty or sixty times day and night, along with pain in the upper and lower abdomen. The text classifies white dysentery as a cold pattern and red dysentery as a heat pattern.

Take five sheng of finely ground, high-quality fermented grain starter and lightly toast it until fragrant. Warm clear wine, mix one sheng of it with the starter, and drink the mixture all at once on an empty stomach, three times a day.

At mealtimes, pound one sheng of garlic until soft. Season it with ground ginger and Sichuan pepper, and eat it as usual, but make it thick and do not add salt. Then mix water with two sheng of fermented grain starter to make steamed cakes. Cook them until very soft, remove and drain them, then place them while hot in a garlic mortar and mix them thoroughly with the mashed garlic. Eat the whole amount at once. Afterward, eat a small amount of other food. When hungry, take the starter and wine again as described above. Eat little other food until you recover. The text says that following this method will bring a cure within two days at most.

Formula for Chronic Cold Patterns, or Intermittent Diarrhea with Discomfort from Cold in the Loin and Abdomen

Take three sheng of the finest fresh Sichuan pepper and soak it in vinegar overnight. Then take three sheng of fermented grain starter and mix one sheng of the Sichuan pepper into it thoroughly. Cook the mixture into congee and eat it all at once on an empty stomach. Add scallions, chi, and salt to taste. If you have not recovered, prepare it again and continue until you do. The text says that no more than three sheng of Sichuan pepper are needed for this to take effect. This formula is not only for cold patterns; it can also be used for various forms of deficiency and damage, and for cases of extremely severe cold. The text says that the benefits of taking it over a long period will become clear in time.

Iris Seed Pills: A formula for longstanding accumulation of cold, with diarrhea and white, pus-like discharges.

One sheng of Chinese iris seeds (roasted until cooked), two liang of aconite, two and a half liang each of dried ginger and licorice, five liang each of medicated ferment, malted barley, and donkey-hide gelatin, three liang of Chinese goldthread, and five ge of Sichuan pepper.

Grind the nine ingredients into a fine powder and make pills with honey, each about the size of a parasol-tree seed. Take twenty pills twice a day, continuing until the condition improves. The ingredients may also be made into a powder and taken mixed with wine, one square-inch spoonful at a time (an ancient small measure for medicines, approximately one spoonful); this is also effective.

Magnolia Bark Decoction: A formula for dysentery that has persisted for as long as thirty years

Two liang each of magnolia bark, dried ginger, and donkey-hide gelatin; five liang of Chinese goldthread; and three liang each of mugwort leaves and pomegranate rind.

Cut the six ingredients into small pieces. Boil them in seven sheng of water until two sheng of liquid remain, then divide into two doses.

Four Continuations Pill: A formula for dysentery that has persisted for as long as thirty years, with severe wasting, a sallow complexion, and unremitting intestinal leakage

Also called “Wax-Decoction Pill.”

Five ge of soapberry seeds, roasted until fragrant; three liang of dragon bone; two liang each of aconite and ladybell; and two and a half liang of atractylodes.

Grind the five ingredients into a fine powder. Melt beeswax and use it to form pills about the size of a parasol-tree seed. Take five pills three times a day. A cure usually follows after five or six doses.

Sichuan Pepper and Mugwort Pill: A formula for diarrhea that has persisted for as long as thirty years

Symptoms include being unable to digest any food, with stools that are sometimes green and sometimes yellow; heavy limbs; dizziness and collapse upon standing; extreme emaciation; cold feet; heat and pain in the abdomen; and spasms of the sinews and vessels that come and go. The patient may also need support to walk. The formula also records “coldness of the genitals and infertility” as symptoms.

Three hundred Sichuan peppercorns, two hundred smoked plums, one sheng of prepared mugwort, three liang of dried ginger, and two liang of red halloysite.

Grind the Sichuan pepper, dried ginger, and mugwort into powder and sift it. Place the smoked plums on top of one dou of rice and steam them until the rice is cooked. Remove the plums and take out their pits. Combine the plum flesh with the ginger, pepper, and other powdered ingredients, and pound the mixture three thousand times. Then use honey to make pills about the size of a parasol-tree seed. Take ten pills three times a day; if there is no improvement, gradually increase the dose to twenty pills. One sheng of Chinese goldthread may also be added.

Diarrhea Pill: A formula for dysentery lasting many years, intended to help restore appetite

The original text says that taking it for a long time enables a person to eat, and that keeping it on hand and taking it regularly in summer can prevent cholera.

One sheng each of malted barley and prepared fermented grain; two and a half sheng of smoked plums; and aconite, dried ginger, Chinese goldthread…

The original text breaks off at “Chinese goldthread”; it gives neither the amounts nor the subsequent preparation and dosage instructions.

Three liang each of huangbo and cinnamon bark; half a liang of Sichuan pepper; four liang of Evodia fruit.

Grind the ten ingredients above into a fine powder, mix with honey, and form pills about the size of a parasol tree seed. Take ten pills after meals, three times a day; the dose may be gradually increased to twenty pills each time. Another regimen is to take them three times a day, gradually increasing to forty pills each time.

Qu Nie Wan (a pill made chiefly with malt and fermented grain starter) is used to treat diarrhea that has persisted for decades and resisted treatment. It is also said to aid digestion, regulate the movement of Qi, and nourish those who are weak and emaciated.

One sheng each of malted barley and good-quality fermented grain starter; two liang each of aconite, Chinese angelica, and cinnamon bark; four liang of Evodia fruit; one liang of Sichuan pepper; and four liang each of coptis, black plum flesh, and dried ginger.

Grind the ten ingredients above into a fine powder and use honey to form pills about the size of a parasol tree seed. Take twenty pills after meals, three times a day.

Wu Mei Wan (a pill made chiefly with black plum) is used to treat chronic dysentery. It may also be used when every other medicine has failed, even when the illness has lasted for decades. The formula is said to aid digestion, regulate the movement of Qi, and nourish those who are weak.

Four liang each of black plum flesh, coptis, dried ginger, and Evodia fruit; two liang of cinnamon bark; three liang of Chinese angelica; and one and a half liang of Sichuan pepper.

Grind the seven ingredients above into a fine powder and use honey to form pills about the size of a parasol tree seed. Take ten pills after meals, three times a day.

Another formula: for cold-type dysentery and chronic diarrhea

Three hundred black plums; ten liang each of dried ginger and coptis; four liang each of Chinese angelica and Sichuan pepper; and six liang each of asarum, aconite, cinnamon bark, ginseng, and huangbo. (One alternate account substitutes malt for huangbo.)

Grind the ten ingredients above into a fine powder. First soak the black plums overnight in bitter wine (vinegar), remove the pits, and steam them until cooked. Separately, take five sheng of rice and pound it. Pound the black plums into a paste, mix them with the rice in a dish, add honey, and pound the mixture repeatedly two thousand times. Form pills about the size of a parasol tree seed. Take ten pills before meals, three times a day, gradually increasing the dose to twenty pills.

Seven-Ingredient Powder: for chronic dysentery that does not resolve; said to be notably effective

Eight fen of coptis; two fen each of dragon bone, red halloysite, magnolia bark, and black plum flesh; one fen of licorice; and three fen of donkey-hide gelatin.

Process the ingredients into a powder and sift it. Take it with rice-water. Adults should take two square-inch spoonfuls per dose, twice a day; children should take one qian-spoonful per dose.

The original begins with “the ten ingredients above,” but the listed ingredients and amounts are incomplete, and the wording of the final few dosage entries may reflect copying or punctuation problems. The text is therefore reproduced here according to the available version.

Pig Liver Pills: Used to treat diarrhea and intestinal leakage in which the bowels cannot hold their contents. Food or medicine is passed soon after being swallowed, apparently unchanged.

Take one jin of pig liver and cook it until dry; two liang each of coptis, mume fruit flesh, and donkey-hide gelatin; and seven pieces of lead powder. Grind these five ingredients into a fine powder and mix with honey to make pills the size of wutong seeds. Take twenty pills with wine three times a day. Alternatively, grind the ingredients into powder and take one square-inch spoonful each time. (This is an ancient small spoon used to measure medicinal powder, holding about one spoonful.)

Sheep Fat Decoction: Used to treat various kinds of chronic diarrhea that do not resolve.

Take one piece of sheep fat, two pieces of white wax, one sheng of coptis powder, and seven ge of vinegar. Cook until thick. Add seven ge of honey and cook until five ge remain. Add two liang of mume fruit flesh, and one sheng of ashes made from tangled hair that has been washed in lye to remove dirt and grease. Put all seven ingredients in a copper vessel and cook in a water bath, stirring, to make pills. Take thirty pills the size of wutong seeds three times a day. The text also says they may be made into doses the size of a square-inch spoonful.

Another formula:

Take two liang each of sheep fat, donkey-hide gelatin, and wax, and two sheng of millet. Cook the four ingredients together into a porridge and take it all at once. It is said to bring a cure.

A formula for abdominal emptiness, fullness and discomfort in the chest, and inability to eat after severe diarrhea:

Take one liang each of peony root, licorice, and pinellia; three liang each of magnolia bark, angelica, and cinnamon bark; and five liang of fresh ginger. Cut the seven ingredients into pieces and boil them in eight sheng of water. Reduce the liquid to three sheng and divide it into three doses. Three courses of treatment are said to be most effective.

A formula for fullness and discomfort in the chest during diarrhea, rumbling in the abdomen, or accompanying vomiting:

Take five liang of coptis; two liang each of tangerine peel and licorice; three liang each of dragon bone, fresh ginger, and pinellia; one liang of ginseng; and fifteen jujubes. Cut the eight ingredients into pieces. First bring one dou of water to a boil once, then add the ingredients and simmer until three sheng remain. Divide into four doses. The text says this formula is also suitable for pregnant women.

Dysentery-Ending Decoction: Used for conditions in which retained fluids collect in the chest and below the heart. The formula lists one sheng of pinellia, five liang of fresh ginger, two liang each of poria, licorice, and dragon bone, and one liang of aconite. The text ends here and does not give instructions for preparation or use.

Ginseng and Coptis, three liang each; twelve jujubes.

Chop the nine ingredients listed above. Boil them in eight sheng of water until three sheng of decoction remain. Take in three doses.

Fragrant Perilla Decoction: Treats agitation after purging, when Qi suddenly surges upward.

A handful of fresh perilla; in winter, three liang of perilla seeds. Five liang of fermented black beans.

Boil the two ingredients listed above in five sheng of water until two sheng of decoction remain. Take all at once.

Drain-the-Heart Decoction: Treats sudden, severe diarrhea with fever, dry lips and mouth, retching and vomiting, and a desire to drink water.

Ginseng, licorice, Scutellaria, trichosanthes root, and tangerine peel, one liang each; Coptis, two liang; pinellia, three liang; dried ginger, one and a half liang.

Chop the eight ingredients listed above. Boil them in six sheng of water until two sheng of decoction remain. Take in three doses.

Hu Qia says: This prescription also treats diarrhea in the elderly and children, when food and water pass through undigested, the abdomen rumbles, and there is fullness and blockage below the heart, with dry retching and discomfort. If tangerine peel or trichosanthes root is unavailable, omit it. For cold symptoms, add one aconite tuber; for thirst, add one liang of trichosanthes root; for vomiting, add one liang of tangerine peel; for abdominal pain, add one liang of Chinese angelica. Zhang Zhongjing’s version of the prescription also includes twelve jujubes.

Prescription for sudden exposure to cold in summer, followed by high fever, diarrhea, and thirst: If diarrhea stops after taking a hot decoction, but is followed by generalized swelling and cold symptoms, with a pulse that is deep, fine, small, and rapid, this prescription may be used.

Alisma, one and a half liang; evodia, poria, atractylodes, Chinese angelica, platycodon, rhinoceros horn, green costus root, seaweed, peony, and rhubarb, two liang each.

Chop the eleven ingredients listed above. Boil them in nine sheng of water until three sheng of decoction remain. Take in three doses. Observe the body’s response after taking the medicine. After about five or six days, you may take Maiden-Curd Powder.

Maiden-Curd Powder: Treats weakness and generalized or water swelling after dysentery. The medicine promotes urination, and the swelling then subsides.

One sheng of maiden-curd; dried ginger, asarum, zanthoxylum fruit, aconite, and cassia bark, one liang each.

Grind the six ingredients listed above into a fine powder. Take one fangcunbi (a small spoonful measured with an ancient utensil for dispensing medicinal powder) with wine. If it has no effect, gradually increase the dose to two or three fangcunbi. This prescription is highly effective for women who are weak after childbirth and have abdominal distension.

Prescription for sudden diarrhea from exposure to cold, with pain and distending pressure in the lower abdomen:

Heat a brick, pour plenty of vinegar over it, and cover it with three layers of cloth. Then sit on it; the pain will ease.

Volume Fifty of Sun Zhenren’s Essential Prescriptions Worth a Thousand Gold Pieces for Emergencies (Beiji Qianjin Yaofang).