润肠泻下脾约丸

文/卓鹏伟

“金井梧桐秋叶黄，珠帘不卷夜来霜。”秋季，干燥的天气容易影响人体输布津液功能，使胃肠燥热，脾被约束，形成大便不畅或便秘，中医称之为“脾约”。

''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''.

名医慧眼识病因Famous doctor diagnosing disease cause

相传，南宋著名医家许叔微曾遇到一位大便不通，兼有发热、恶风、头疼等伤寒之症的病人。在求医许叔微之前，病人已请来三位医生会诊，一位主张泻热通便，用大承气汤；一位主张调和胃气，用大柴胡汤；一位建议导泻，用蜂蜜。正当三人为便秘和伤寒之症争论不休之时，许叔微来到现场，他通过问诊、切脉得知病人小便次数增多、脉象浮涩，结合其他症状，诊断为脾约证。随后，病人按照许叔微开的药方麻子仁丸抓药服下，当晚排便、出汗，热退病愈。

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，出自中医巨著《伤寒论》，为泻下剂，具有润肠泻热，行气通便之功效，因其主治脾约之症，又称为脾约麻仁丸，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.

行气润肠泄燥热Promoting Qi circulation and moistening the intestines to relieve dryness and heat

麻子仁丸由七味药组成，其中麻子仁润肠通便，为君药；杏仁宣降肺气，白芍养血止痛，共为臣药；枳实、厚朴、大黄组成药方小承气汤，除胃肠燥热，为佐药；蜂蜜甘缓，润肠通便，为使药。全方合用，润肠泄热，行气通便。

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.

在现代临床中，麻子仁丸常用于体虚便秘患者，例如老年人肠燥便秘、习惯性便秘、妇女产后便秘、痔疮术后便秘等。

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.

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

在中医理论中，肺主宣发肃降，正常情况下可使人体津液下行于膀胱大肠，输布周身。若胃肠燥热，肺受煎灼，则津液运行受阻，导致脾约。因此，治疗脾约之症，疏泄脾（胃）土，敛降肺（大肠）金是关键。

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，蕴含了敛降肺金以疏通脾土的五行玄机。杏仁、厚朴均入肺和大肠经，其中杏仁润肺降气，厚朴下气除满。二者通过调节肺金之气，促进津液输布于肠道，再配合小承气汤的疏通和泄热，共同达到润肠通便的效果。

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.

结 语Conclusion

“趺阳脉浮而涩，浮则胃气强，涩则小便数”，麻子仁丸的标准密码是“润肠泻下”四个字，该方通过润肺疏脾，使得腑气通、津液行，达到治愈脾约之功效。特别需要注意的是，麻子仁具有毒性，不可过量、长期服用,否则将损伤人体神经中枢，引起癫痫病和神经衰弱等疾病，孕妇也应慎用。

''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.