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Dysentery is a condition whose essence does not change with the passage of time, yet its name varies according to the era. The records transmitted in ancient medical texts have their origins and cannot but use ancient standards to regulate contemporary treatment. *Suwen* (Plain Questions) refers to it as "Changpi" (Intestinal discharge); *Nanjing* (Classic of Difficult Issues) calls it "Liji Houzhong" (Tenesmus and urgency); the Han Dynasty termed it "Zhixia" (Stagnant downward flow); the Jin Dynasty called it "Qiuzao" (Autumn dryness); and by the Tang Dynasty, it was named "Li" (Dysentery). Interpreting the meaning from these names: bloody stool is "Pi", severe pain is "Ji" (Urgency), obstruction is "Zhi" (Stagnation), wrinkling/cracking is "Zao" (Dryness), and difficulty in defecation is "Li" (Dysentery). The manifestations of dysentery are already revealed in its nomenclature. Throughout history, physicians have elaborated on this, akin to morning bells and evening drums, prompting deep reflection. How can one treat this disease rashly, instead of guarding against it like the thief-prevention metaphor in *Zhuangzi*: "To prepare for thieves who pry boxes and open chests, one must tighten ropes and secure locks, which worldly wisdom considers smart. Yet when a great thief arrives, he carries the chest and runs away, worrying only that the ropes and locks were not secure enough." (Note: Jiong means to lock/close), thereby leaving the patient to die?!

At this time, summer heat recedes, Metal Qi (autumnal dryness) begins, and Earth Qi resides within (Earth prospers in all four seasons; the fifth and sixth months represent the middle of heaven and earth, centered on Wei Earth). Heat, Dryness, and Dampness converge simultaneously, and these three pathogens combine to cause disease. In epidemic dysentery, pathogens enter via the skin and hair, causing slight aversion to cold and abdominal pain; red and white pus/blood appears only after residual food is expelled. Where wind pathogens pass, if they spread through one family, the whole family falls ill; if they spread through a region, the whole region falls ill. In contagious cases, pathogens enter via the mouth and nose, without aversion to cold, with abdominal pain; red and white pus/blood appears immediately upon expelling residual food. Where Qi touches, if it infects one person, one person falls ill; if it infects a locality, the locality falls ill. At such times, sighing while touching pillows and mats, regardless of gender; or suffering pain like falling into a latrine pit (as recorded in *Zuo Zhuan*: Duke Jing of Jin fell ill, attempted to eat wheat, went to the toilet, fell into the pit, and died), unable to predict life or death. Weather fluctuates between cloudy and clear, foul odors fill the room; lights flicker on and off, groans last until the fifth watch. Those indulging in rich foods need not be discussed. Pity the poor scholars suffering disaster, whose friends return home, making it hard to invite grain reserves (*Shangshu: Fei Shi*: "On Jiaxu day, prepare your rations"); people cover their noses, only hearing military code calls (*Zuo Zhuan*: During the meeting between Wu and Lu, King Wu did not provide grain to soldiers;大夫 Shen Shuyi begged for grain from Lu;大夫 Gongsun Youshan replied: "No fine grain, but coarse grain exists. If you climb Shoushan Mountain and call 'Geng Gui', help will come." Du Yu's commentary: Military rules forbid openly distributing grain, so coded language is used. Geng belongs to West, governing grain; Gui belongs to North, governing water). Those gathered in their hometowns can still support each other. Most painful is the traveler far from home, where old friends do not come (Du Fu's poem: "Old rain comes, new rain does not come"), who pities the lonely stranger in a foreign land (Wen Tianxiang's poem: "Speaking of fear at Konghuang Beach, sighing over loneliness in Lingding Ocean"); hearing rumors, everyone avoids, caring not if the guest has left home. Scholars examine gains and losses of past and present, verifying their own moral cultivation, thus achieving profound diagnostic insight. Originally, the heart of compassion should naturally be used to save all beings.

Yu Jiayan said: "In the initial stage, use acrid-cool herbs to release the exterior; subsequently, use bitter-cold herbs to clear the interior." Liu Hejian said: "Regulating Qi eliminates tenesmus; moving Blood stops pus and blood." For early-stage epidemic dysentery, I follow Yu Jiayan’s approach, unblocking meridians and driving out pathogens using Baidu San (Ginseng Radix et Rhizoma, Notopterygii Rhizoma et Radix, Angelicae Pubescentis Radix, Bupleuri Radix, Peucedani Radix, Chuanxiong Rhizoma, Aurantii Fructus Immaturus, Platycodonis Radix, Poria, Glycyrrhizae Radix et Rhizoma Preparata), strengthening strategies like those of senior statesmen; for early-stage contagious dysentery, I follow Liu Hejian’s approach, harmonizing Ying and Wei and guiding out stagnation using Shaoyao Tang (Paeoniae Radix Rubra, Angelicae Sinensis Radix Caulis, Scutellariae Radix, Coptidis Rhizoma, Rheum Palmati Radix et Rhizoma, Aquari Fructus, Arecae Semen, Cinnamomi Cortex, Glycyrrhizae Radix et Rhizoma Preparata), ensuring auspicious outcomes for great persons. As the condition resolves, stagnation transforms into Heat; palpating the pulse reveals no exception to being Rapid (Shu). Therefore, Xianglian Wan (Coptidis Rhizoma 20 liang, Evodiae Fructus 10 liang stir-fried together, Aucklandiae Radix 4.8 liang, not processed by fire, ground into powder, pillified with vinegar paste) serves as the general formula for treating dysentery. However, it is contraindicated in exterior stages because pathogens have not entered the interior; it is difficult to use in chronic cases to avoid severely damaging vital Qi. Zhao Yangkui previously used Liuwei Dihuang Tang to treat Cold Damage, considered his innovation. Since excessive diarrhea damages Yin, I once used Liuwei Tang to treat dysentery, which is my innovation. If the pulse is Deficient with spontaneous sweating, and red/white discharge is nearly exhausted, Zhenren Yangzang Tang (Papaveris Pericarpium, Terminalia Chebula Retzii Fructus, Myristicae Semen, Aquari Fructus, Cinnamomi Cortex, Ginseng Radix et Rhizoma, Atractodis Macrocephalae Rhizoma, Angelicae Sinensis Radix, Paeoniae Radix Alba, Glycyrrhizae Radix et Rhizoma. Add Aconiti Lateralis Radix Preparata if cold is severe; one variation lacks Angelicae Sinensis Radix) and Hezi San (Papaveris Pericarpium, Terminalia Chebula Retzii Fructus, Zingiberis Rhizoma Recens, Citri Reticulatae Pericarpium, ground into powder, taken on an empty stomach) can be used with discretion. Dysentery, whether red or white, originates from Heat; recovery after taking acrid-hot herbs (Aconiti Lateralis Radix Preparata, Cinnamomi Cortex, Zingiberis Rhizoma Recens, Fried Atractodis Macrocephalae Rhizoma, Amomi Fructus, Glycyrrhizae Radix et Rhizoma Preparata) employs the method of "following treatment" (treating symptoms that mimic the disease nature). Human constitutions vary, having Cold or Heat tendencies; pathogenic Heat often transforms according to the host's constitution. Acrid-hot herbs can resolve stagnation and knots, promoting Qi and Blood circulation, suitable for those whose Cold transforms into Heat. If mistakenly used for those whose Heat transforms into Heat, the disaster would be incalculable! Those intending to save the world, if they encounter dysentery where Cold transforms into Heat and achieve great results with warm-tonifying methods, must not rigidly adhere to this as a standard rule.