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医宗金鉴十五卷
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Zong Jin Jian>>
Chapter 15
辨可下病脉证篇
Conditions indicating the use of
bowel-cleansing therapy
01
大法秋宜下。
Autumn is the best season in which a
bowel-cleansing therapy can be used.[1]
02
凡可下者，用汤胜丸散，中病便止，不必尽剂也。
In the bowel-cleansing, herbs in the form
of herbal tea are better than the pills or powder. Once the
bowel-cleansing solves the clinic Fullness condition in the
abdomen, stop to drink the remaining herbs.
03
下利，三部脉皆平，按之心下硬者，急下之，宜大承气汤。
If a person has diarrhea, but his pulse is
normal in the Chun, Guan and Chi positions, and his upper
stomach feels hard when press, use bowel-cleansing therapy as
soon as possible.
[2]
04
下利，脉迟而滑者，内实也，利未欲止，当下之，宜大承气汤。
If a person has diarrhea, and his pulse is
slow and slippery, it indicates a Fullness condition inside that
causes the diarrhea. Use Da Chengqi Tang to remove the fullness
condition to stop the diarrhea.
05
问曰：人病有宿食，何以别之？师曰：寸口脉浮而大，按之反涩，尺中亦大[3]而涩，故知有宿食，当下之，宜大承气汤。
Asked: how to know if a person has hosting
food in the abdomen? Master: the person has floating and big
pulse in the Chun position, which feels harsh when pressed deep
however. The pulse feels big and harsh in the Chi position as
well. For such hosting food condition, use Da Chengqi Tang.
06
下利不欲食者，以有宿食故也，当下之，宜大承气汤。
If a person has an acute diarrhea and
dislike to eat, it means the digestive system is damaged by the
improper diet. If a person has chronic diarrhea and has little
appetite, it is the damage in the Spleen system. He should feel
fullness in the stomach after eating. If a person has an acute
diarrhea and has no appetite, it means he has hosting food in
the abdomen, so need Da Chengqi Tang to remove the hosting food
from the abdomen.
07
下利差，至其年月日时复发者，以病不尽故也，当下之，宜大承气汤。
If a person has chronic diarrhea and it
stops for a while, now after one full year, his diarrhea comes
back again with the same clinic conditions, it means he has
hosting stool in the abdomen. For the treatment, use Da Chengqi
Tang.
08
下利脉反滑，当有所去，下乃愈，宜大承气汤。
(continue the paragraph above) If he has
the new diarrhea again and the pulse is slippery, and his
general condition is pretty strong, diet is relatively normal,
it indicates that he has hosting stool in the abdomen that needs
to cleanse. Use Da Chengqi Tang.
09
病腹中满痛者，此为实也，当下之，宜大承气汤。
If a person feels fullness, hard and pain
in the abdomen, it is a Fullness condition. Use bowel-cleansing
therapy, Da Chengqi Tang.
[4]
10
伤寒後脉沉，沉者内实也，下之解，宜大柴胡汤。
After a Shanghan disease, if the person has
a deep pulse, the deep pulse means an inside Fullness condition.
Use Da Chaihu Tang.
11
脉双弦而迟者，必心下硬，脉大而紧者，阳中有阴也，可下之，宜大承气汤。
If the person has string pulse in the Guan
position of both wrists, he will have hardness feeling in the
upper stomach. If the pulse is big and tight, suggesting a
relatively strong Yang condition. Use Da Chengqi Tang.
[1] In nature, the Qi in the fall is
descending. It is a time to hold, to harvest, and to
collect. The nature of bowel-cleansing therapy is also
to descend the stool. It matches the movement of the Qi
in the nature.
[2] When a person has diarrhea, his
pulse should be weak and he should has Jue condition.
Now, his pulse is normal, calm, gentle, suggesting that
there is Fullness condition inside of the abdomen.
Therefore a bowel-cleansing therapy is needed.
[3] In original version, it is “weak”.
[4] If the person feels pain but no
fullness, it is a weak condition, not the fullness
condition. If the person has such fullness condition
(fullness, hardness, and pain in abdomen), the
bowel-cleansing therapy should be used, even if he is in
Taiyin, Shaoyin or Jueyin stages.
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