潤腸瀉下脾約丸

文/卓鵬偉

“金井梧桐秋葉黃，珠簾不卷夜來霜。”秋季，干燥的天氣容易影響人體輸布津液功能，使胃腸燥熱，脾被約束，形成大便不暢或便秘，中醫稱之為“脾約”。

''Autumn leaves of the sycamore next to the golden well are yellow and frost flies into the room at night because the curtains are not rolled up''. In the fall, the dry weather easily affects the body's ability to transmit fluids and makes the stomach and intestines hot and dry. As a result, the spleen was restrained to work so there will be constipation, which is called ''Spleen Contraction''.

名醫慧眼識病因Famous doctor diagnosing disease cause

相傳，南宋著名醫家許叔微曾遇到一位大便不通，兼有發熱、惡風、頭疼等傷寒之癥的病人。在求醫許叔微之前，病人已請來三位醫生會診，一位主張瀉熱通便，用大承氣湯；一位主張調和胃氣，用大柴胡湯；一位建議導瀉，用蜂蜜。正當三人為便秘和傷寒之癥爭論不休之時，許叔微來到現場，他通過問診、切脈得知病人小便次數增多、脈象浮澀，結合其他癥狀，診斷為脾約證。隨后，病人按照許叔微開的藥方麻子仁丸抓藥服下，當晚排便、出汗，熱退病愈。

According to legend, Xu Shuwei, a famous doctor of the Southern Song Dynasty, once encountered a patient who suffered from constipation and had fever; intolerance to wind; headache and other symptoms of typhoid fever. Before seeking treatment from Xu Shuwei, the patient had already invited three doctors for consultation, one of whom advocated diarrhea and laxatives, using Da Cheng Qi Tang; one advocated harmonizing stomachqi, using Da Chai Hu Tang; and one suggested diarrhea,using honey. Just as the three men were arguing about constipation and typhoid fever, Xu Shuwei came to the scene. Through questioning and pulsetaking, he learned that the patient's frequency of urination had increased, and his pulse was floating and uneven. Combined with other symptoms,the disease was diagnosed as Spleen Contraction Syndrome. Afterwards, the patient took the medicine according to Xu Shuwei's prescription of Fructus Cannabis Pills. At night he had a bowel movement, sweated, and recovered from the fever.麻子仁丸，出自中醫巨著《傷寒論》，為瀉下劑，具有潤腸瀉熱，行氣通便之功效，因其主治脾約之癥，又稱為脾約麻仁丸，沿用至今已有1 800余年。

Fructus Cannabis Pills, from the Chinese medicine masterpiece "Treatise on Exogenous Febrile Diseases", is type of laxative, with efficacy of moistening the intestines; relieving heat; promoting circulation ofqiand relieving constipation. Because of its main treatment of the spleen contraction syndrome, it is also known as Pi Yue Ma Ren Wan.The prescription has been used for more than 1,800 years.

行氣潤腸泄燥熱Promoting Qi circulation and moistening the intestines to relieve dryness and heat

麻子仁丸由七味藥組成，其中麻子仁潤腸通便，為君藥；杏仁宣降肺氣，白芍養血止痛，共為臣藥；枳實、厚樸、大黃組成藥方小承氣湯，除胃腸燥熱，為佐藥；蜂蜜甘緩，潤腸通便，為使藥。全方合用，潤腸泄熱，行氣通便。

Fructus Cannabis Pills is composed of seven medicines. Fructus Cannabis, the monarch medicine, moisten the intestines and relax the bowels. Amygdalus Communis Vas disperses lung-qiwhile Cynanchum Otophyllum Schneid nourishes blood and relieves pain. The two are regarded as the minister medicines. Xiao Cheng Qi Tang is composed of Aurantii Immaturus Fructus;Magnoliae Officinalis Cortex and Rhei Radix etRhizoma, which can remove dryness and heat from stomach and intestines and are regarded as the assistant medicines. Honey is sweet and gentle and is used as the laxative, which is regarded as the guide medicine. This prescription, when used in combination, moistens the intestines and drains heat,promotes circulation ofqiand relieves constipation.

在現代臨床中，麻子仁丸常用于體虛便秘患者，例如老年人腸燥便秘、習慣性便秘、婦女產后便秘、痔瘡術后便秘等。

In modern clinical practice, Fructus Cannabis Pills is commonly used in patients with constipation due to physical weakness, such as constipation in the elderly with dry bowel;habitual constipation;women's post-partum constipation; constipation after hemorrhoidal surgeryand so on.

肅降肺金疏脾土Dispersing and descending lung-gold to dispel spleen-earth

在中醫理論中，肺主宣發肅降，正常情況下可使人體津液下行于膀胱大腸，輸布周身。若胃腸燥熱，肺受煎灼，則津液運行受阻，導致脾約。因此，治療脾約之癥，疏泄脾（胃）土，斂降肺（大腸）金是關鍵。

In TCM theory, the lungs govern dispersing and descending. Under normal circumstances the lungs make the human body fluid flow into the bladder,large intestine and all over the body. If the stomach and intestines are dry and hot, the lungs will be burned and the flow of fluids will be blocked, which will cause spleen contraction. Therefore, the key to treating the spleen contraction is to drain the spleenearth (stomach) and make the lung-gold (large intestine) descend.

麻子仁丸的配伍，蘊含了斂降肺金以疏通脾土的五行玄機。杏仁、厚樸均入肺和大腸經，其中杏仁潤肺降氣，厚樸下氣除滿。二者通過調節肺金之氣，促進津液輸布于腸道，再配合小承氣湯的疏通和泄熱，共同達到潤腸通便的效果。

The formula of Fructus Cannabis Pills contains the five elements of astringency to lower the lung-gold in order to dredge the spleen-earth. Amygdalus Communis Vas and Magnoliae Officinalis Cortex both enter the meridians of the lung and large intestine meridians. Amygdalus Communis Vas moisturizes the lung and lowersqiwhile Magnoliae Officinalis Cortex lowersqito remove bloating. By regulating theqiof lung-gold, they promote the transmission of fluid to the intestines,and together with Xiao Cheng Qi Tang's functions of dredging and draining heat. All of them work together to achieve the effect of moistening the intestines and relieving constipation.

結 語Conclusion

“趺陽脈浮而澀，浮則胃氣強，澀則小便數”，麻子仁丸的標準密碼是“潤腸瀉下”四個字，該方通過潤肺疏脾，使得腑氣通、津液行，達到治愈脾約之功效。特別需要注意的是，麻子仁具有毒性，不可過量、長期服用,否則將損傷人體神經中樞，引起癲癇病和神經衰弱等疾病，孕婦也應慎用。

''Anterior Tibial Pulse is in the status of floating or uneven. If the pulse floats the lung-qiis strong, if the pulse is uneven , there will be frequent micturition.''The standard code for Fructus Cannabis Pills are moistening the intestines and relieving constipation''.The prescription is used to moisten the lung and harmonize the spleen to disperseqiand make fluids flow smoothly in the body to achieve the effect of curing the spleen contraction. Special attention should be paid to the fact that Fructus Cannabis Pills is toxic and never to overdose and long-term use, otherwise it will damage the human nerve center, causing epilepsy, neurasthenia and other diseases, pregnant women should also be used with caution.