王妪 寒热呕恶，饮食不进，腹痛痢下，日夜五六十次，赤白相杂，里急后重，舌苔腻布，脉象浮紧
而数。感受时气之邪，袭于表分，湿热挟滞，互阻肠胃，噤口痢之重症。先宜解表导滞。
荆芥穗（一钱五分） 青防风（一钱） 淡豆豉（三钱） 薄荷叶（八分） 藿苏梗（各一钱五分）
仙半夏（二钱） 枳实炭（一钱五分） 苦桔梗（一钱） 炒赤芍（一钱五分） 六神曲（三钱） 焦
楂炭（三钱） 生姜（二片） 陈红茶（一钱） 另玉枢丹（开水先冲服，四分）
二诊 得汗，寒热较轻，而痢下如故，腹痛加剧，胸闷泛恶，饮食不进，苔腻不化，脉象紧数。表
邪虽则渐解，而湿热挟滞，胶阻曲肠，浊气上干，阳明通降失司，恙势尚在重途，书云∶无积不成痢。再
宜疏邪导滞，辛开苦降。
炒豆豉（三钱） 薄荷叶（八分） 吴萸（三分） 川雅连（五分，拌炒） 枳实炭（一钱） 仙半夏（二钱）
炒赤芍（一钱五分）
酒炒黄芩（一钱） 肉桂心（三分） 生姜（二片） 青陈皮（各一钱） 六神曲（三钱） 焦楂炭（三钱）
大砂仁（八分） 木香 槟榔丸（包煎，三钱）
三诊 寒热已退，呕恶亦减，佳兆也。而腹痛痢下，依然如故，脘闷不思纳谷，苔腻稍化，脉转弦
滑，湿热滞尚留曲肠，气机窒塞不通。仍宜寒热并用，通行积滞，勿得因年老而姑息也。
仙半夏（二钱） 川连（四分） 酒炒黄芩（一钱五分） 炒赤芍（二钱） 肉桂心（三分） 枳实炭（一钱）
金铃子（二钱） 延胡索（一钱） 六神曲（三钱） 焦楂炭（三钱） 大砂仁（研，八分） 全栝蒌（切，三钱）
生姜（一片） 木香槟榔丸（包煎，四钱）
四诊 痢下甚畅，次数已减，腹痛亦稀，惟脘闷不思纳谷，苔浓腻渐化，脉象濡数，正气虽虚，湿热
滞尚未清澈，脾胃运化无权。今制小其剂，和中化浊，亦去疾务尽之意。
酒炒黄芩（一钱五分） 炒赤芍（一钱五分） 全当归（一钱五分） 金铃子（二钱） 延胡索（一钱）
陈皮（一钱） 春砂壳（八分） 六神曲（三钱） 炒谷麦芽（各三钱） 全栝蒌（切，四钱） 银花炭（三钱）
荠菜花炭（三钱） 香连丸（吞服，一钱）
宣童 发热六天，临晚尤甚，热度至百零四之盛，下痢日夜七八十次之多，速至圊而不能便，腹痛堕胀难
忍，谷食不进，幸无呕吐，而口干欲饮，苔腻黄，脉滑数。时疫伏温，蕴蒸阳明，欲达而不能达，湿滞败浊，
互阻曲肠，欲下而不能下。手足阳明为病，病情猛烈，急议表里双解，通因通用，冀望热清痢减，始有转机之幸。
粉葛根（二钱） 薄荷叶（八分） 金银花（八钱） 连翘壳（四钱） 酒炒黄芩（一钱五分） 炒赤芍（一钱
五分） 青陈皮（各一钱） 全栝蒌（切，四钱） 春砂壳（八分） 苦桔梗（一钱） 六神曲（三钱）
焦楂炭（三钱） 枳实导滞丸（包煎，三钱）
二诊 连投解肌通腑之剂，得汗甚多，发热较轻，白疹隐隐，布于胸膺之间，伏温之邪，有外达之
机，痢下次数虽则不少，而腹痛已减，后重亦松，纳谷无味，口干欲饮，苔黄，脉滑数不静。湿热败浊，
尚在曲肠之间，未得下行也。原法增减，努力前进。
原方去薄荷叶，加清水豆卷（四钱）。
三诊 发热渐退，痢下亦稀，腹痛后重，已减其半。谷食无味，口干不多饮，神疲色萎，苔薄黄，
脉濡滑而数。阴液暗伤，湿热滞尚未清澈，肠胃气机不和。今拟理脾和胃，清化湿浊，更宜薄滋味，节饮
食，恐有食复之弊，虽有虚象，不可骤补。
炒银花（五钱） 炒赤芍（一钱五分） 酒炒黄芩（一钱） 全当归（一钱五分） 陈皮（一钱）
春砂壳（八分） 苦桔梗（一钱） 焦楂炭（三钱） 焦谷麦芽（各三钱） 全栝蒌（切，三钱） 荠菜花炭（三钱）
香连丸（包，一钱二分）
洪左 血痢及旬，日夜十余次，腹疼里急，身热晚甚，口干欲饮，舌前半糙绛，中后腻黄，脉象弦数。此
乃阴液素亏，津乏上承，伏温在营，血渗大肠，肠中湿浊稽留，气机痞塞不通，症非轻浅。姑拟生津达邪，清
营化浊。
鲜石斛（三钱） 淡豆豉（三钱） 金银花（五钱） 连翘壳（三钱） 白头翁（三钱） 北秦皮（二钱）
酒炒黄芩（一钱五分） 炒赤
芍（一钱五分） 焦楂炭（三钱） 全栝蒌（切，四钱） 枳实炭（一钱） 苦桔梗（一钱） 活芦根（去节，一尺）
二诊 昨投药后，诸恙不减，而反烦躁不寐，舌红绛，苔糙黑无津，脉弦数。伏温化热，由阳明而传于
厥少二阴，厥阴为藏血之经，内寄相火，厥阴有热，则血溢沸腾，而下迫大肠，则为血痢；少阴为水火之脏，水
亏火无所济，津液愈伤，神被热扰，则烦躁而不寐也。身热晚甚者，阳明旺于申酉。阳明之温热炽盛也，温已
化热伤阴，少火悉成壮火，大有吸尽西江之势！急拟黄连阿胶汤，滋少阴之阴，白头翁汤，清厥阴之热，银翘、
花粉，解阳明之温。复方图治，犹兵家之总攻击也。勇往前进，以冀弋获。
阿胶珠（二钱） 川雅连（四分） 生甘草（五分） 白头翁（三钱） 鲜石斛（四钱） 连翘壳（三钱）
生赤白芍（各一钱五分） 酒炒黄芩（一钱） 北秦皮（二钱） 金银花（四钱） 粉葛根（一钱五分）
天花粉（三钱） 活芦根（去节，一尺） 生山楂（三钱）
三诊 服药后，已得安静，水火有既济之象，且有微汗，伏温有外解之势，血痢次数亦减，药已中肯，有转
危为安之兆。惟阴液大伤，清津无以上供，齿垢唇燥，舌仍焦糙，口渴不欲饮，热在营分，蒸腾营气上升，故口
渴而不欲饮也。脉弦数不静，守原法而出入一二、冀望
津液来复，邪热退却，由里及表，由营返气，始能入于坦途耳。
原方去葛根，加粉丹皮（一钱五分）、鲜生地（四钱）。
四诊 血痢大减，临晚身热亦去其半，舌黑糙已退，转为光红，唇燥口干，不思纳谷，脉濡数，阴液伤而
难复，邪热退而未净也。仍拟生津清营，以和胃气。
鲜石斛（三钱） 天花粉（三钱） 生甘草（五分） 阿胶珠（二钱） 川雅连（三分） 白头翁（三钱）
酒炒黄芩（一钱） 赤白芍（各一钱五分） 嫩白薇（一钱五分） 炒银花（四钱） 广橘白（一钱） 生熟谷
芽（各三钱） 活芦根（去节，一尺）
五诊 血痢止，潮热亦退，唇燥齿干，睡醒后口舌无津，谷食衰少，神疲萎顿，脉濡数不静。阴液未复，津
无上承，脾胃输化无权，生气受戕，人以胃气为本。今拟甘寒生津，养胃清热，以善其后。
西洋参（一钱五分） 鲜石斛（三钱） 生甘草（五分） 大麦冬（二钱） 炒银花（三钱） 嫩白薇（一钱五分）
广橘白（一钱） 生谷芽（四钱） 抱茯神（三钱） 生扁豆衣（三钱） 淮山药（三钱） 活芦根（去节，一尺）
陶左 夏秋痢下，至冬不止，赤白夹杂，日夜二十余次，腹痛后重，纳谷衰少，面色萎黄，舌苔薄腻，脉
象沉细而迟，此脾脏受寒，不能统血，血渗大肠，肠中湿浊，胶阻不化，延久有胀满之虑。急拟温运太阴，而化
湿浊，勿因久痢骤进兜涩也。更宜节饮食，薄滋味，亦是助药力之一端。
炒潞党参（一钱） 熟附块（一钱五分） 炮姜炭（八分） 清炙草（六分） 生白术（二钱）
全当归（二钱） 炒赤白芍（各一钱五分） 软柴胡（七分） 川桂枝（八分） 焦楂炭（三钱） 大砂仁（研，一钱）
炒焦赤砂糖（三钱）
二诊 投温运太阴，而化湿浊之剂，已服三帖，下痢赤白，已减其半，纳谷衰少，神疲萎顿，脉象沉细，
寒浊虽则渐化，脾胃输运无权。既已获效，更进一筹。
原方去柴胡、桂枝，加炒麦谷芽（各四钱），灶心黄土（四钱）。
吕右 经闭一载，营血早亏，今下痢赤白，已延三月，腹痛后重，纳谷衰少，形瘦骨立，舌光无苔，脉象
濡细。据述未病喜食水果，既病又不节食，脾土大伤，中焦变化之血，渗入大肠，肠中湿浊互阻，积而为痢也。今
拟温运脾胃，以和胃气，寒热并调，去其错杂。
炒潞党参（一钱五分） 熟附块（一钱） 炮姜炭（六分） 生白术（三钱） 清炙草（六分） 全当归
（二钱） 炒赤白芍（各一钱
五分） 肉桂心（饭丸吞服，三分） 焦楂炭（三钱） 大砂仁（研，八分） 阿胶珠（一钱） 戊己丸（包煎，二钱）
炒焦赤砂糖（三钱）
二诊 经治以来，血痢虽则轻减，而余恙如旧。舌边碎痛，恐起口糜之先端。谷食衰少，胃气索然。欲温
中则阴分愈伤，欲滋养则脾胃益困，顾此失彼，棘手之症，难许完璧。专扶中土，以冀土浓火敛之意。
炒潞党（三钱） 生于术（二钱） 清炙草（五分） 炒淮药（三钱） 炮姜炭（六分） 全当归（一钱五分）
赤白芍（炒，各一钱五分） 御米壳（炒，三钱） 炒谷芽（四钱） 驻车丸（包煎，三钱）
滕左 暑湿挟滞，郁于曲肠， 炼成积，气机流行窒塞，腹痛痢下，日夜数十次，赤白相杂，里急后
重，纳少。舌苔腻布，脉象沉紧。先宜通因通用。
炒黑荆芥（一钱） 银花炭（三钱） 炒赤芍（五钱） 全当归（二钱） 苦桔梗（一钱） 青陈皮（各一钱）
全栝蒌（切，三钱） 六神曲（三钱） 焦楂炭（三钱） 炒条芩（八分） 大砂仁（研，八分） 煨姜（二片）
陈红茶（一钱） 枳实导滞丸（三钱，吞服）
罗左 寒暑湿滞，互阻肠胃，腹痛下痢，次数甚多，胸闷泛恶，不能饮食，苔腻脉迟，宜温下法。
熟附块（一钱五分） 制川军（三钱） 枳实炭（一钱五分） 姜
半夏（三钱） 藿香梗（一钱五分） 玉枢丹（先开水冲，四分） 青陈皮（各一钱） 白蔻仁（研，八分）
大砂仁（研，八分） 制川朴（一钱） 焦楂炭（三钱） 生姜（三片）
靳左 痢下纯红，里急后重，腹痛纳少，苔黄，脉濡数。此湿热入营，血渗大肠，肠中滞浊互阻，锻炼而为
红积也。宜清热导滞，调气行血，气调则后重自除，血行则便红自愈。
白头翁（三钱） 北秦皮（二钱） 炒黄芩（一钱五分） 全当归（一钱五分） 酒川连（五分） 炒赤白芍
（各一钱五分） 桃仁泥（包，一钱五分） 杜红花（八分） 焦楂炭（三钱） 全栝蒌（切，四钱） 春砂壳
（八分） 细青皮（一钱）
祁右 痢下匝月，次数虽少，谷食不进，里热口干，加之呃逆口糜，脉小数，舌质红，苔糜腐，痢久伤阴，木
火冲胃，湿热败浊，稽留曲肠，肠膜已腐矣，危状叠见，恐难挽回。勉拟参连开噤意，聊尽人工。
西洋参（一钱五分） 川雅连（五分） 炒黄芩（一钱） 生白芍（一钱五分） 甘草（五分） 陈皮（一钱）
炒竹茹（一钱五分） 清炙枇杷叶（三钱） 柿蒂（十枚） 石莲（三钱） 焦麦芽（一钱五分） 荠菜花炭（三钱）
滋肾通关丸（包煎，一钱五分）
吴左 年五十阴气自半。肠中干燥，喜用西法
灌肠，而转为下痢，色青如蓝，肛门时时堕胀，历五六日，片刻不能安适，谷食减少，舌中剥，边薄腻，脉虚弦，
良由灌肠之时，风邪从肛门而入。风气通于肝，青为肝之色，风淫于肝，肝木乘脾，脾失健运之常，谷食入胃，
不能生化精微，而变为败浊。风气从中鼓荡，驱败浊下注大肠，而为之下痢色青如蓝也。肛门坠胀者，中虚清
气不升，经所谓中气不足，溲便为之变也。宜补中益气，去风化浊之治。
清炙黄 （三钱） 炒防风（一钱） 清炙草（六分） 银柴胡（一钱） 蜜炙升麻（五分） 炒潞党（一钱五分）
全当归（二钱） 炒白芍（一钱五分） 苦桔梗（一钱） 陈皮（一钱） 炒焦赤砂糖（三钱） 山楂肉（三钱）
炒谷麦芽（各三钱）
此方一剂知，三剂已，接服归芍六君汤。
哈左 脾有寒，肠有湿热，痢下赤白，腹痛绵绵，舌薄黄，脉沉细。土虚木来侮之，气机窒塞不通，不通则
痛。徒用攻剂，恐有流弊，今宜温运脾阳，苦化湿热。
银柴胡（八分） 清炙草（五分） 广陈皮（一钱） 酒炒黄芩（一钱五分） 金铃子（二钱） 炒白芍（二钱）
春砂壳（八分） 六神曲（三钱） 肉桂心（三分） 全当归（二钱） 苦桔梗（一钱） 焦楂炭（三钱） 荠
菜花炭（三钱） 香连丸（包，七分）
王右 脾寒肠湿，血痢色紫，腹无痛苦，久而不止，
纳少神疲，脉象沉细，苔薄黄。拟黄土汤加味，温运中阳，而清湿热，以冀火土相生，阳气得以上升，阴血不致
下泄矣。
炮姜炭（三分） 生地炭（三钱） 酒炒黄芩（一钱） 白归身（二钱） 生于术（二钱） 阿胶珠（三钱）
炒赤芍（二钱） 肉桂心（三分） 清炙草（五分） 地榆炭（三钱） 灶心黄土（煎汤代水，一两）
黄左 湿热滞郁于肠胃，气机流行窒塞，腹痛痢下鲜血，里急后重，纳谷减少，苔黄脉数，症势沉重。拟白
**Case 1: Elderly Woman Wang**
An elderly woman named Wang presented with alternating chills and fever (Han Re), vomiting, nausea, inability to eat, abdominal pain, and dysentery occurring 50-60 times a day, with mixed red and white pus and blood in the stool, accompanied by tenesmus (Li Ji Hou Zhong). The tongue coating was thick and greasy, covering the entire surface, and the pulse was floating, tight, and rapid. This condition resulted from contracting epidemic pathogenic factors that attacked the exterior level. Damp-heat combined with food stagnation obstructed the intestines and stomach, constituting a severe case of Jin Kou Li (Dysentery with Inability to Eat). Treatment should initially focus on releasing the exterior and guiding out stagnation.
Prescription: Jing Jie Sui (Schizonepeta Spike) [1.5 qian], Qing Fang Feng (Saposhnikovia Root) [1 qian], Dan Dou Chi (Prepared Soybean) [3 qian], Bo He Ye (Mint Leaf) [0.8 fen], Huo Xiang Geng (Aucklandia Stem) and Zi Su Geng (Perilla Stem) [each 1.5 qian], Xian Ban Xia (Pinellia Tuber) [2 qian], Zhi Shi Tan (Charred Immature Bitter Orange) [1.5 qian], Ku Jie Geng (Platycodon Root) [1 qian], Chao Chi Shao (Fried Red Peony Root) [1.5 qian], Liu Shen Qu (Medicated Leaven) [3 qian], Jiao Zha Tan (Charred Hawthorn Fruit) [3 qian], Sheng Jiang (Fresh Ginger) [2 slices], Chen Hong Cha (Aged Black Tea) [1 qian]. Additionally, Yu Shu Dan (Jade Pivot Pill) [0.4 qian] dissolved in boiling water for administration.
Second Visit: After sweating, the chills and fever subsided slightly, but dysentery persisted, abdominal pain intensified, chest fullness and nausea remained, and appetite was absent. The tongue coating remained greasy, and the pulse was tight and rapid. Although the exterior pathogen was gradually resolving, damp-heat and stagnation were adhering and obstructing the intestines. Turbid qi rose to disturb the Stomach, causing the Yangming Stomach’s descending function to fail. The illness remained critical. As the classics state, "No stagnation, no dysentery." Treatment should again focus on dispersing pathogens and guiding out stagnation using acrid-opening and bitter-descending methods.
Prescription: Chao Dou Chi (Fried Soybean) [3 qian], Bo He Ye (Mint Leaf) [0.8 fen], Wu Zhu Yu (Evodia Fruit) [0.3 fen], Chuan Ya Lian (Coptis Rhizome, stir-fried with Wu Zhu Yu) [0.5 fen], Zhi Shi Tan (Charred Immature Bitter Orange) [1 qian], Xian Ban Xia (Pinellia Tuber) [2 qian], Chao Chi Shao (Fried Red Peony Root) [1.5 qian], Jiu Chao Huang Qin (Alcohol-fried Scutellaria Root) [1 qian], Rou Gui Xin (Cinnamon Bark Heart) [0.3 fen], Sheng Jiang (Fresh Ginger) [2 slices], Qing Chen Pi (Green and Aged Tangerine Peel) [each 1 qian], Liu Shen Qu (Medicated Leaven) [3 qian], Jiao Zha Tan (Charred Hawthorn Fruit) [3 qian], Da Sha Ren (Amomum Fruit) [0.8 fen], Mu Xiang Bing Lang Wan (Costus and Areca Nut Pill) [decocted in bag, 3 qian].
Third Visit: Chills and fever had resolved, and vomiting/nausea decreased, which was a favorable sign. However, abdominal pain and dysentery persisted, with epigastric fullness and loss of appetite. The tongue coating had slightly transformed, and the pulse became wiry and slippery. Damp-heat and stagnation remained obstructing the intestines, blocking Qi mechanism. Treatment should continue with simultaneous use of cold and hot herbs to unblock stagnation; do not be lenient due to the patient's advanced age.
Prescription: Xian Ban Xia (Pinellia Tuber) [2 qian], Chuan Lian (Coptis Rhizome) [0.4 fen], Jiu Chao Huang Qin (Alcohol-fried Scutellaria Root) [1.5 qian], Chao Chi Shao (Fried Red Peony Root) [2 qian], Rou Gui Xin (Cinnamon Bark Heart) [0.3 fen], Zhi Shi Tan (Charred Immature Bitter Orange) [1 qian], Jin Ling Zi (Chinese Melia Fruit) [2 qian], Yan Hu Suo (Corydalis Rhizome) [1 qian], Liu Shen Qu (Medicated Leaven) [3 qian], Jiao Zha Tan (Charred Hawthorn Fruit) [3 qian], Da Sha Ren (Amomum Fruit, powdered) [0.8 fen], Quan Gua Lou (Whole Trichosanthes Fruit) [cut, 3 qian], Sheng Jiang (Fresh Ginger) [1 slice], Mu Xiang Bing Lang Wan (Costus and Areca Nut Pill) [decocted in bag, 4 qian].
Fourth Visit: Dysentery flowed smoothly, frequency decreased, and abdominal pain became sparse. Only epigastric fullness and lack of appetite remained. The thick greasy tongue coating was gradually transforming, and the pulse was soggy and rapid. Although righteous Qi was deficient, damp-heat and stagnation were not yet cleared, and Spleen-Stomach transformation was ineffective. The dosage was reduced to harmonize the middle and transform turbidity, aiming to thoroughly eliminate the disease.
Prescription: Jiu Chao Huang Qin (Alcohol-fried Scutellaria Root) [1.5 qian], Chao Chi Shao (Fried Red Peony Root) [1.5 qian], Quan Dang Gui (Whole Angelica Sinensis) [1.5 qian], Jin Ling Zi (Chinese Melia Fruit) [2 qian], Yan Hu Suo (Corydalis Rhizome) [1 qian], Chen Pi (Tangerine Peel) [1 qian], Chun Sha Ke (Amomum Shell) [0.8 fen], Liu Shen Qu (Medicated Leaven) [3 qian], Chao Gu Mai Ya (Fried Rice and Barley Sprouts) [each 3 qian], Quan Gua Lou (Whole Trichosanthes Fruit) [cut, 4 qian], Yin Hua Tan (Charred Honeysuckle Flower) [3 qian], Ji Cai Hua Tan (Charred Shepherd's Purse Flower) [3 qian], Xiang Lian Wan (Costus and Coptis Pill) [swallowed, 1 qian].
**Case 2: Child Xuan**
Child Xuan had a fever for six days, worsening in the evening, reaching 104°F. Dysentery occurred 70-80 times daily, with urgent need to defecate but difficulty passing stool, unbearable abdominal pain and bearing-down sensation, and inability to eat. Fortunately, there was no vomiting, but there was dry mouth with desire to drink. Tongue coating was greasy and yellow, pulse slippery and rapid. This was latent warm epidemic pathogen steaming in the Yangming channel, unable to vent outward. Damp-stagnation and foul turbidity obstructed the intestines, unable to descend. Disease of the Hand and Foot Yangming channels, with fierce pathology. Urgently discuss simultaneous release of exterior and interior, using "treat obstruction with unblocking" method, hoping for heat clearance and dysentery reduction to bring a turning point.
Prescription: Fen Ge Gen (Kudzu Root) [2 qian], Bo He Ye (Mint Leaf) [0.8 fen], Jin Yin Hua (Honeysuckle Flower) [8 qian], Lian Qiao Qiao (Forsythia Fruit) [4 qian], Jiu Chao Huang Qin (Alcohol-fried Scutellaria Root) [1.5 qian], Chao Chi Shao (Fried Red Peony Root) [1.5 qian], Qing Chen Pi (Green and Aged Tangerine Peel) [each 1 qian], Quan Gua Lou (Whole Trichosanthes Fruit) [cut, 4 qian], Chun Sha Ke (Amomum Shell) [0.8 fen], Ku Jie Geng (Platycodon Root) [1 qian], Liu Shen Qu (Medicated Leaven) [3 qian], Jiao Zha Tan (Charred Hawthorn Fruit) [3 qian], Zhi Shi Dao Zhi Wan (Immature Bitter Orange and Detoxification Pill) [decocted in bag, 3 qian].
Second Visit: After continuous administration of muscle-releasing and bowel-unblocking agents, profuse sweating occurred, fever subsided, and white rashes appeared faintly on the chest. Latent warm pathogen showed signs of external venting. Although dysentery frequency remained high, abdominal pain decreased, and tenesmus relaxed. Appetite was poor, dry mouth with desire to drink, tongue yellow, pulse slippery and rapid/unsettled. Foul damp-heat turbidity remained in the intestines, failing to descend. Modify original prescription and proceed vigorously.
Original prescription minus Bo He Ye (Mint Leaf), add Qing Shui Dou Juan (Clear Water Bean Sprout) [4 qian].
Third Visit: Fever gradually receded, dysentery became thinner, abdominal pain and tenesmus reduced by half. Food tasted bland, dry mouth with little desire to drink, spirit fatigued, complexion sallow, tongue thin yellow coating, pulse soggy-slippery-rapid. Yin fluids secretly damaged, damp-heat stagnation not yet cleared, intestinal-stomach Qi mechanism disordered. Plan to regulate Spleen and Stomach, clear-transform damp-turbidity. Advise light diet and moderation in eating/drinking to prevent relapse due to food. Despite deficiency signs, do not tonify abruptly.
Prescription: Chao Yin Hua (Fried Honeysuckle Flower) [5 qian], Chao Chi Shao (Fried Red Peony Root) [1.5 qian], Jiu Chao Huang Qin (Alcohol-fried Scutellaria Root) [1 qian], Quan Dang Gui (Whole Angelica Sinensis) [1.5 qian], Chen Pi (Tangerine Peel) [1 qian], Chun Sha Ke (Amomum Shell) [0.8 fen], Ku Jie Geng (Platycodon Root) [1 qian], Jiao Zha Tan (Charred Hawthorn Fruit) [3 qian], Jiao Gu Mai Ya (Fried Rice and Barley Sprouts) [each 3 qian], Quan Gua Lou (Whole Trichosanthes Fruit) [cut, 3 qian], Ji Cai Hua Tan (Charred Shepherd's Purse Flower) [3 qian], Xiang Lian Wan (Costus and Coptis Pill) [decocted in bag, 1.2 qian].
**Case 3: Left-side Patient Hong**
Blood dysentery for ten days, 10+ times daily, abdominal pain with tenesmus, body heat worse in evening, dry mouth with desire to drink. Front half of tongue rough and crimson, middle-back greasy yellow, pulse wiry-rapid. Constitutionally deficient in Yin fluids, insufficient Jin fluids to ascend. Latent warm pathogen in Ying level, blood seeping into Large Intestine, damp-turbidity lingering in intestines, Qi mechanism blocked. Condition is not mild. Tentatively plan to generate fluids and expel pathogen, clear Ying level and transform turbidity.
Prescription: Xian Shi Hu (Fresh Dendrobium Stem) [3 qian], Dan Dou Chi (Prepared Soybean) [3 qian], Jin Yin Hua (Honeysuckle Flower) [5 qian], Lian Qiao Qiao (Forsythia Fruit) [3 qian], Bai Tou Weng (Pulsatilla Root) [3 qian], Bei Qin Pi (Ash Bark) [2 qian], Jiu Chao Huang Qin (Alcohol-fried Scutellaria Root) [1.5 qian], Chao Chi Shao (Fried Red Peony Root) [1.5 qian], Jiao Zha Tan (Charred Hawthorn Fruit) [3 qian], Quan Gua Lou (Whole Trichosanthes Fruit) [cut, 4 qian], Zhi Shi Tan (Charred Immature Bitter Orange) [1 qian], Ku Jie Geng (Platycodon Root) [1 qian], Huo Lu Gen (Fresh Reed Rhizome, nodes removed, 1 chi long).
Second Visit: After yesterday's medication, symptoms did not improve; instead, irritability and insomnia worsened. Tongue crimson-red, coating rough black without fluids, pulse wiry-rapid. Latent warm pathogen transformed into heat, transmitting from Yangming to Jueyin and Shaoyin channels. Jueyin stores blood and houses ministerial fire; Jueyin heat causes blood to boil and overflow, pressing down to Large Intestine causing blood dysentery. Shaoyin is the organ of water and fire; water deficiency fails to support fire, fluids further damaged, Spirit disturbed by heat causing irritability and insomnia. Evening fever exacerbates because Yangming is prosperous at Shen-You hours. Yangming warm-heat is blazing; warm pathogen has transformed to heat damaging Yin, Shao Huo becomes Zhuang Huo, threatening to drain all western rivers! Urgently prescribe Huang Lian E Jiao Tang to nourish Shaoyin Yin, Bai Tou Weng Tang to clear Jueyin heat, Yin Qiao San and Tian Hua Fen to resolve Yangming warmth. Compound formula treatment is like a general assault. Advance bravely to hope for victory.
Prescription: E Jiao Zhu (Donkey-hide Gelatin Pearl) [2 qian], Chuan Ya Lian (Coptis Rhizome) [0.4 fen], Sheng Gan Cao (Raw Licorice Root) [0.5 fen], Bai Tou Weng (Pulsatilla Root) [3 qian], Xian Shi Hu (Fresh Dendrobium Stem) [4 qian], Lian Qiao Qiao (Forsythia Fruit) [3 qian], Sheng Chi Bai Shao (Raw Red and White Peony Roots) [each 1.5 qian], Jiu Chao Huang Qin (Alcohol-fried Scutellaria Root) [1 qian], Bei Qin Pi (Ash Bark) [2 qian], Jin Yin Hua (Honeysuckle Flower) [4 qian], Fen Ge Gen (Kudzu Root) [1.5 qian], Tian Hua Fen (Trichosanthes Root) [3 qian], Huo Lu Gen (Fresh Reed Rhizome, nodes removed, 1 chi long), Sheng Shan Zha (Raw Hawthorn Fruit) [3 qian].
Third Visit: After taking medicine, peace returned, indicating successful interaction between Water and Fire. Slight sweating occurred, latent warm pathogen showing signs of external resolution. Blood dysentery frequency decreased. Medication hit the mark, showing signs of turning danger to safety. However, Yin fluids severely damaged, clear fluids unable to ascend. Dental plaque, dry lips, tongue still scorched and rough, thirst without desire to drink. Heat in Ying level steams Ying Qi upward, causing thirst without desire to drink. Pulse wiry-rapid unsettled. Stick to original method with minor adjustments, hoping for fluid recovery, pathogenic heat retreat, transition from interior to exterior, from Ying to Qi, to enter smooth recovery.
Original prescription minus Ge Gen (Kudzu Root), add Fen Dan Pi (Moutan Cortex) [1.5 qian], Xian Sheng Di (Fresh Rehmannia Root) [4 qian].
Fourth Visit: Blood dysentery greatly reduced, evening fever halved. Tongue black-rough coating retreated, turning bare red. Dry lips/mouth, no appetite, pulse soggy-rapid. Yin fluids damaged and hard to recover, pathogenic heat retreated but not cleared. Continue generating fluids, clearing Ying level, harmonizing Stomach Qi.
Prescription: Xian Shi Hu (Fresh Dendrobium Stem) [3 qian], Tian Hua Fen (Trichosanthes Root) [3 qian], Sheng Gan Cao (Raw Licorice Root) [0.5 fen], E Jiao Zhu (Donkey-hide Gelatin Pearl) [2 qian], Chuan Ya Lian (Coptis Rhizome) [0.3 fen], Bai Tou Weng (Pulsatilla Root) [3 qian], Jiu Chao Huang Qin (Alcohol-fried Scutellaria Root) [1 qian], Chi Bai Shao (Red and White Peony Roots) [each 1.5 qian], Nen Bai Wei (Young Sweet Violet Herb) [1.5 qian], Chao Yin Hua (Fried Honeysuckle Flower) [4 qian], Guang Ju Bai (Broad Mandarin Pith) [1 qian], Sheng Shu Gu Ya (Raw and Cooked Rice and Barley Sprouts) [each 3 qian], Huo Lu Gen (Fresh Reed Rhizome, nodes removed, 1 chi long).
Fifth Visit: Blood dysentery stopped, tidal fever receded. Dry lips/teeth, no saliva after waking, reduced food intake, spirit fatigue, pulse soggy-rapid unsettled. Yin fluids not recovered, fluids unable to ascend, Spleen-Stomach transport ineffective, vital Qi injured. Human life relies on Stomach Qi. Now plan sweet-cold method to generate fluids, nourish Stomach and clear heat to conclude treatment.
Prescription: Xi Yang Shen (American Ginseng) [1.5 qian], Xian Shi Hu (Fresh Dendrobium Stem) [3 qian], Sheng Gan Cao (Raw Licorice Root) [0.5 fen], Da Mai Dong (Large Ophiopogon Tuber) [2 qian], Chao Yin Hua (Fried Honeysuckle Flower) [3 qian], Nen Bai Wei (Young Sweet Violet Herb) [1.5 qian], Guang Ju Bai (Broad Mandarin Pith) [1 qian], Sheng Gu Ya (Raw Rice Sprout) [4 qian], Bao Fu Shen (Wrapped Poria with Wood) [3 qian], Sheng Bian Dou Yi (Raw Broad Bean Coat) [3 qian], Huai Shan Yao (Chinese Yam) [3 qian], Huo Lu Gen (Fresh Reed Rhizome, nodes removed, 1 chi long).
**Case 4: Left-side Patient Tao**
Summer-autumn dysentery persisting into winter, mixed red-white, 20+ times daily, abdominal pain with tenesmus, reduced appetite, sallow complexion, thin greasy tongue coating, deep-slow-thin pulse. Spleen affected by cold, unable to control blood, blood seeping into Large Intestine, damp-turbidity in intestines adhering and not transforming. Prolonged duration risks distension. Urgently plan to warm-yun Taiyin and transform damp-turbidity. Do not use astringents abruptly for chronic dysentery. Also advise diet moderation and light flavors to assist medicinal power.
Prescription: Chao Lu Dang Shen (Stir-fried Codonopsis Root) [1 qian], Shu Fu Ku (Cooked Aconite Chunk) [1.5 qian], Pao Jiang Tan (Roasted Ginger Charcoal) [0.8 fen], Qing Zhi Cao (Clear-honey-fried Licorice Root) [0.6 fen], Sheng Bai Zhu (Raw Atractylodes Macrocephala Rhizome) [2 qian], Quan Dang Gui (Whole Angelica Sinensis) [2 qian], Chao Chi Bai Shao (Stir-fried Red and White Peony Roots) [each 1.5 qian], Ruan Chai Hu (Soft Bupleurum Root) [0.7 fen], Chuan Gui Zhi (Cinnamon Twig) [0.8 fen], Jiao Zha Tan (Charred Hawthorn Fruit) [3 qian], Da Sha Ren (Amomum Fruit, powdered) [1 qian], Chao Jiao Chi Sha Tang (Stir-fried Brown Sugar Charcoal) [3 qian].
Second Visit: After three doses of warming-yun Taiyin and transforming damp-turbidity formula, red-white dysentery reduced by half. Reduced appetite, spirit fatigue, deep-thin pulse. Cold-turbidity gradually transforming, but Spleen-Stomach transport ineffective. Since effective, advance further.
Original prescription minus Chai Hu (Bupleurum Root) and Gui Zhi (Cinnamon Twig), add Chao Mai Gu Ya (Stir-fried Wheat and Rice Sprouts) [each 4 qian], Zao Xin Huang Tu (Kitchen Hearth Yellow Earth) [4 qian].
**Case 5: Right-side Patient Lv**
Amenorrhea for one year, Ying-blood already deficient. Now red-white dysentery for three months, abdominal pain with tenesmus, reduced appetite, emaciated, tongue bare without coating, soggy-thin pulse. Reported preference for fruits before illness, and lack of dietary control during illness. Spleen-earth severely damaged, blood transformed in Middle Jiao seeped into Large Intestine, damp-turbidity obstructed intestines, accumulated as dysentery. Plan to warm-yun Spleen-Stomach, harmonize Stomach Qi, adjust cold-hot simultaneously to remove complexity.
Prescription: Chao Lu Dang Shen (Stir-fried Codonopsis Root) [1.5 qian], Shu Fu Ku (Cooked Aconite Chunk) [1 qian], Pao Jiang Tan (Roasted Ginger Charcoal) [0.6 fen], Sheng Bai Zhu (Raw Atractylodes Macrocephala Rhizome) [3 qian], Qing Zhi Cao (Clear-honey-fried Licorice Root) [0.6 fen], Quan Dang Gui (Whole Angelica Sinensis) [2 qian], Chao Chi Bai Shao (Stir-fried Red and White Peony Roots) [each 1.5 qian], Rou Gui Xin (Cinnamon Bark Heart, swallowed in rice pill) [0.3 fen], Jiao Zha Tan (Charred Hawthorn Fruit) [3 qian], Da Sha Ren (Amomum Fruit, powdered) [0.8 fen], E Jiao Zhu (Donkey-hide Gelatin Pearl) [1 qian], Wu Ji Wan (Wu Ji Pill) [decocted in bag, 2 qian], Chao Jiao Chi Sha Tang (Stir-fried Brown Sugar Charcoal) [3 qian].
Second Visit: Since treatment, blood dysentery lightly reduced, but other symptoms remain. Painful ulcers on tongue edges, fearing onset of oral thrush. Reduced food intake, Stomach Qi exhausted. Warming middle damages Yin further; nourishing Yin burdens Spleen-Stomach more. Dilemma, difficult to cure completely. Focus on supporting Central Earth, hoping for earth thickening and fire收敛.
Prescription: Chao Lu Dang (Stir-fried Codonopsis) [3 qian], Sheng Yu Zhu (Raw Atractylodes Macrocephala Rhizome) [2 qian], Qing Zhi Cao (Clear-honey-fried Licorice Root) [0.5 fen], Chao Huai Yao (Stir-fried Chinese Yam) [3 qian], Pao Jiang Tan (Roasted Ginger Charcoal) [0.6 fen], Quan Dang Gui (Whole Angelica Sinensis) [1.5 qian], Chi Bai Shao (Red and White Peony Roots, fried) [each 1.5 qian], Yu Mi Ke (Poppy Shell, fried) [3 qian], Chao Gu Ya (Stir-fried Rice Sprout) [4 qian], Zhu Che Wan (Zhu Che Pill) [decocted in bag, 3 qian].
**Case 6: Left-side Patient Teng**
Summer-dampness with stagnation,郁 in intestines, refined into accumulation, Qi mechanism blocked. Abdominal pain and dysentery dozens of times daily, mixed red-white, tenesmus, reduced intake. Tongue coating greasy, pulse deep-tight. Initially suitable for "treat obstruction with unblocking."
Prescription: Chao Hei Jing Jie (Stir-fried Black Schizonepeta Spike) [1 qian], Yin Hua Tan (Charred Honeysuckle Flower) [3 qian], Chao Chi Shao (Fried Red Peony Root) [5 qian], Quan Dang Gui (Whole Angelica Sinensis) [2 qian], Ku Jie Geng (Platycodon Root) [1 qian], Qing Chen Pi (Green and Aged Tangerine Peel) [each 1 qian], Quan Gua Lou (Whole Trichosanthes Fruit) [cut, 3 qian], Liu Shen Qu (Medicated Leaven) [3 qian], Jiao Zha Tan (Charred Hawthorn Fruit) [3 qian], Chao Tiao Qin (Stir-fried Scutellaria Strip) [0.8 fen], Da Sha Ren (Amomum Fruit, powdered) [0.8 fen], Wei Jiang (Baked Ginger) [2 slices], Chen Hong Cha (Aged Black Tea) [1 qian], Zhi Shi Dao Zhi Wan (Immature Bitter Orange and Detoxification Pill) [swallowed, 3 qian].
**Case 7: Left-side Patient Luo**
Cold-summer-damp-stagnation, mutually obstructing intestines-stomach. Abdominal pain and dysentery, frequent, chest fullness, nausea, inability to eat, greasy coating, slow pulse. Suitable for warm-purgative method.
Prescription: Shu Fu Ku (Cooked Aconite Chunk) [1.5 qian], Zhi Chuan Jun (Processed Rhubarb) [3 qian], Zhi Shi Tan (Charred Immature Bitter Orange) [1.5 qian], Jiang Ban Xia (Ginger-processed Pinellia Tuber) [3 qian], Huo Xiang Geng (Aucklandia Stem) [1.5 qian], Yu Shu Dan (Jade Pivot Pill) [dissolved in boiling water first, 0.4 qian], Qing Chen Pi (Green and Aged Tangerine Peel) [each 1 qian], Bai Kou Ren (White Cardamom Seed, powdered) [0.8 fen], Da Sha Ren (Amomum Fruit, powdered) [0.8 fen], Zhi Chuan Po (Processed Magnolia Bark) [1 qian], Jiao Zha Tan (Charred Hawthorn Fruit) [3 qian], Sheng Jiang (Fresh Ginger) [3 slices].
**Case 8: Left-side Patient Jin**
Pure red dysentery, tenesmus, abdominal pain, reduced intake, yellow coating, soggy-rapid pulse. Damp-heat entered Ying level, blood seeped into Large Intestine, stagnation-turbidity obstructed intestines, refined into red accumulation. Suitable for clearing heat, guiding out stagnation, regulating Qi and moving Blood. Regulated Qi removes tenesmus; moved Blood heals red stool.
Prescription: Bai Tou Weng (Pulsatilla Root) [3 qian], Bei Qin Pi (Ash Bark) [2 qian], Chao Huang Qin (Stir-fried Scutellaria Root) [1.5 qian], Quan Dang Gui (Whole Angelica Sinensis) [1.5 qian], Jiu Chuan Lian (Alcohol-processed Coptis Rhizome) [0.5 fen], Chao Chi Bai Shao (Stir-fried Red and White Peony Roots) [each 1.5 qian], Tao Ren Ni (Peach Kernel Paste, wrapped) [1.5 qian], Du Hong Hua (Safflower) [0.8 fen], Jiao Zha Tan (Charred Hawthorn Fruit) [3 qian], Quan Gua Lou (Whole Trichosanthes Fruit) [cut, 4 qian], Chun Sha Ke (Amomum Shell) [0.8 fen], Xi Qing Pi (Fine Green Tangerine Peel) [1 qian].
**Case 9: Right-side Patient Qi**
Dysentery for a month, few times, inability to eat, internal heat, dry mouth, hiccups, oral thrush, small-rapid pulse, red tongue, rotting coating. Chronic dysentery damaged Yin, Wood-Fire attacking Stomach, damp-heat foul turbidity lingering in intestines, intestinal membrane corroded. Critical signs overlapping, hard to save. Tentatively plan Can Lian Kai Jin idea, doing human effort.
Prescription: Xi Yang Shen (American Ginseng) [1.5 qian], Chuan Ya Lian (Coptis Rhizome) [0.5 fen], Chao Huang Qin (Stir-fried Scutellaria Root) [1 qian], Sheng Bai Shao (Raw White Peony Root) [1.5 qian], Gan Cao (Licorice Root) [0.5 fen], Chen Pi (Tangerine Peel) [1 qian], Chao Zhu Ru (Stir-fried Bamboo Shavings) [1.5 qian], Qing Zhi Pi Pa Ye (Clear-honey-fried Loquat Leaf) [3 qian], Shi Di (Persimmon Calyx) [10 pieces], Shi Lian (Lotus Seed Plumule) [3 qian], Jiao Mai Ya (Charred Malt) [1.5 qian], Ji Cai Hua Tan (Charred Shepherd's Purse Flower) [3 qian], Zi Shen Tong Guan Wan (Nourish Kidney Unblock Passage Pill) [decocted in bag, 1.5 qian].
**Case 10: Left-side Patient Wu**
Age 50, Yin Qi naturally halves. Intestines dry, preferred Western enema method, turned into dysentery, green color like indigo, anal bearing-down constantly, lasting 5-6 days, uncomfortable moments, reduced food intake, peeled center tongue, thin greasy edges, deficient-wiry pulse. Caused by wind pathogen entering anus during enema. Wind Qi connects to Liver, green is Liver color. Wind harassing Liver, Liver Wood overacting on Spleen, Spleen loses normal transport. Food enters Stomach, cannot transform essence, becomes foul turbidity. Wind Qi agitates inside, driving foul turbidity down to Large Intestine, causing green dysentery. Anal bearing-down is Middle Deficiency, Clear Qi not ascending. Classics say: "Middle Qi deficiency, urination and defecation change." Suitable for Bu Zhong Yi Qi, removing wind and transforming turbidity.
Prescription: Qing Zhi Huang Qi (Clear-honey-fried Astragalus Root) [3 qian], Chao Fang Feng (Stir-fried Saposhnikovia Root) [1 qian], Qing Zhi Cao (Clear-honey-fried Licorice Root) [0.6 fen], Yin Chai Hu (Silver Bupleurum Root) [1 qian], Mi Zhi Sheng Ma (Honey-fried Cimicifuga Rhizome) [0.5 fen], Chao Lu Dang (Stir-fried Codonopsis) [1.5 qian], Quan Dang Gui (Whole Angelica Sinensis) [2 qian], Chao Bai Shao (Stir-fried White Peony Root) [1.5 qian], Ku Jie Geng (Platycodon Root) [1 qian], Chen Pi (Tangerine Peel) [1 qian], Chao Jiao Chi Sha Tang (Stir-fried Brown Sugar Charcoal) [3 qian], Shan Zha Rou (Hawthorn Flesh) [3 qian], Chao Gu Mai Ya (Stir-fried Rice and Barley Sprouts) [each 3 qian].
One dose improved, three doses cured. Follow with Gui Shao Liu Jun Tang.
**Case 11: Left-side Patient Ha**
Spleen cold, Intestines damp-heat, red-white dysentery, continuous abdominal pain, thin yellow tongue, deep-thin pulse. Earth deficient, Wood insults it, Qi mechanism blocked, blockage causes pain. Using only purgatives risks side effects. Now suitable to warm-yun Spleen Yang, bitter-transform damp-heat.
Prescription: Yin Chai Hu (Silver Bupleurum Root) [0.8 fen], Qing Zhi Cao (Clear-honey-fried Licorice Root) [0.5 fen], Guang Chen Pi (Broad Tangerine Peel) [1 qian], Jiu Chao Huang Qin (Alcohol-fried Scutellaria Root) [1.5 qian], Jin Ling Zi (Chinese Melia Fruit) [2 qian], Chao Bai Shao (Stir-fried White Peony Root) [2 qian], Chun Sha Ke (Amomum Shell) [0.8 fen], Liu Shen Qu (Medicated Leaven) [3 qian], Rou Gui Xin (Cinnamon Bark Heart) [0.3 fen], Quan Dang Gui (Whole Angelica Sinensis) [2 qian], Ku Jie Geng (Platycodon Root) [1 qian], Jiao Zha Tan (Charred Hawthorn Fruit) [3 qian], Ji Cai Hua Tan (Charred Shepherd's Purse Flower) [3 qian], Xiang Lian Wan (Costus and Coptis Pill) [wrapped, 0.7 fen].
**Case 12: Right-side Patient Wang**
Spleen cold, Intestines damp, purple blood dysentery, no abdominal pain, persistent, reduced intake, spirit fatigue, deep-thin pulse, thin yellow coating. Prescribe Huang Tu Tang modified, warm-yun Middle Yang, clear damp-heat, hoping for Fire-Earth generation, Yang Qi ascending, Yin-Blood not leaking down.
Prescription: Pao Jiang Tan (Roasted Ginger Charcoal) [0.3 fen], Sheng Di Tan (Rehmannia Root Charcoal) [3 qian], Jiu Chao Huang Qin (Alcohol-fried Scutellaria Root) [1 qian], Bai Gui Shen (Angelica Sinensis Root Body) [2 qian], Sheng Yu Zhu (Raw Atractylodes Macrocephala Rhizome) [2 qian], E Jiao Zhu (Donkey-hide Gelatin Pearl) [3 qian], Chao Chi Shao (Stir-fried Red Peony Root) [2 qian], Rou Gui Xin (Cinnamon Bark Heart) [0.3 fen], Qing Zhi Cao (Clear-honey-fried Licorice Root) [0.5 fen], Di Yu Tan (Sanguisorba Root Charcoal) [3 qian], Zao Xin Huang Tu (Kitchen Hearth Yellow Earth, decocted as water substitute) [1 liang].
**Case 13: Left-side Patient Huang**
Damp-heat stagnation郁 in intestines-stomach, Qi mechanism blocked, abdominal pain, bloody dysentery, tenesmus, reduced intake, yellow coating, rapid pulse, serious condition. Prescribe Bai...