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Shen: Summerheat must carry dampness. The injury is in the Qi level. Ancient texts call this "Zhi Xia" (Dysentery with obstruction). This character "Zhi" (obstruction/stagnation) does not refer to food stagnation, but indicates that summerheat and dampness invade internally, obstructing the circulation in the Fu organs, thereby forming a state of stagnation. If one uses methods of digestion/promotion, lifting/raising, or warming/tonifying, the summerheat pathogen will have no exit. The patient presents with chest and epigastric fullness, lack of appetite, inability to eat, persistent sticky sensation, heavy bearing down at the anus, and tenesmus. This indicates that the San Jiao (Triple Burner) is all affected by steaming pathogens, with the upper and lower parts seemingly separated into two distinct zones. Prolonged progression leads to intermittent dysentery, lingering and recurring. This is certainly not a disease that can be cured suddenly within a day or two. (Pattern: Summerheat-Damp-Heat)
Dried Ginger (light), Fresh Ginger, Coptis Rhizome (small), Scutellaria Root (light), Ginseng Radix et Rhizoma, Immature Bitter Orange

Xu: Summer dysentery cases are mostly due to Damp-Heat combined with Food Stagnation. In the initial stage, the pathogen should be dispersed and eliminated. However, the patient has soft, white, and tender skin, indicating a Qi-deficient constitution. Moreover, the patient fears medication; therefore, only small doses should be given, avoiding excess.
Betel Nut Juice, Green Tangerine Peel, Tangerine Peel, Magnolia Bark, Coptis Rhizome, Scutellaria Root, Aucklandia Root, Charred Hawthorn Fruit

Second visit: For Damp-Heat dysentery descending, bitter-pungent-cold herbs must be used. Poppy Shell astringes the intestines and stops diarrhea, which is a established prescription for chronic dysentery. However, since the Heat pathogen is not yet cleared, one should promote circulation/diffusion so that the stagnation can be removed. Because the patient's complexion is pale and Qi is weak, harsh purgatives dare not be used.
Magnolia Bark, Scutellaria Root, Coptis Rhizome, Aucklandia Root Juice, Hawthorn Flesh, Chrysanthemum Flower (stir-fried), Malt

Lu: The Damp-Heat in dysentery stems from latent pathogens from midsummer. If only attacking and resolving methods are used, it severely damages Stomach Qi, failing to eliminate the disease. Now the patient has slight vomiting, lack of appetite, and insomnia. The desire to defecate without passage indicates disharmony of the nine orifices and six Fu organs, ultimately rooted in Stomach disease.
Ginseng Radix et Rhizoma (1 qian), Coptis Rhizome stir-fried with Evodia Fruit (4 fen), Raw Dried Ginger soaked lightly (5 fen), Poria (3 qian), Toosendan Fruit Flesh (1 qian), Raw White Peony Root (1.5 qian)

Certain female patient: Tongue color is grayish-yellow, thirst with little drinking, lack of appetite with nausea, passing red and white sticky discharge, and difficult urination. This is Summerheat-Dampness latent internally, with the Qi mechanism of the San Jiao unable to diffuse and reach. One should use methods to differentiate and regulate Qi and Blood. There is no need to see accumulation and immediately use purgative drugs to scour it away.
Calcined Talcum, Tetrapanax Pith, Polyporus, Poria Cocos Skin, Agastache Stem, Magnolia Bark, Cardamom Seed, New Tangerine Peel

Lu (Family): During menstruation, Summerheat miasma caused Sha Syndrome (plague-like distension). Heart vexation, spontaneous passage of black bloody stasis.
Scutellaria Root (light), Immature Bitter Orange, Coptis Rhizome, Acorus Rhizome, Curcuma Tuber, Tangerine Red Peel

Chen (Elderly woman): Diarrhea and dysentery for two months, limb edema. Advanced age naturally implies deficiency. However, there is chest and epigastric fullness, poor appetite with nausea, and abdominal pain preceding each bowel movement. This is Summerheat-Heat from summer and autumn stagnating in the middle. A deficient body harboring pathogens—how can tonification and astringency remove pathogens and support righteousness? Fear of transformation upon solar term changes makes this clearly a tricky severe case.
Ginseng Radix et Rhizoma, Poria, Coptis Rhizome, Dried Ginger (light), Raw White Peony Root, Immature Bitter Orange

Certain patient: Blue veins protruding above the umbilicus with painful distension indicates injury to the Taiyin Spleen; this was the previous condition. Recently, abdominal pain with white discharge has persisted for twenty days. This is a new contraction of Summer-Dampness from summer and autumn, differing from the old disease. First treat the new disease using the main formula for guiding Qi and dispersing differentiation.
Patchouli Leaf, Magnolia Bark, Broadleaf Citrus Peel, Poria Cocos Skin, Coptis Rhizome, Aucklandia Root, Quince Fruit, Lablab Bean

Certain patient: Chronic Phlegm-Wheezing recurs in early autumn. Coinciding with alternating cold and fever, bloody dysentery, abdominal pain, and vomiting/regurgitation. Pulse is wiry on the right and weak on the left, yellow eyes with photophobia. This must be Summerheat-Dampness condensing and attaching to the interior. Within tonifying deficiency, assist with clearing pathogens; this is the method of unblocking agents.
Ginseng Radix et Rhizoma, Astragalus Root, White Peony Root, Broadleaf Citrus Peel, Stone Lotus Seed, Coptis Rhizome, Hawthorn Flesh, Cassia Seed, Honeysuckle Flower

Wang: Dysentery was anciently called "Zhi Xia" (Obstructive Downward Flow). It is Damp-Heat thinning/biting the stomach and intestines, blocking the Qi level, hence the passage is still unsatisfactory. He-Jian (Liu Wansu) and Dan-Xi (Zhu Zhenheng) both used clearing heat and guiding Qi methods for this reason. (Pattern: Damp-Heat)
Scutellaria Root, Coptis Rhizome, Cassia Seed, Charred Black Hawthorn Fruit, Raw White Peony Root, Stone Lotus Seed, Moutan Cortex, Broadleaf Aucklandia Root Juice

Ni (60 years old): Foul face, white tongue coating. Cold pain and stifling sensation below the heart and in the epigastrium. After defecation, stool remains unsatisfactory. This is dampness from water and grain steaming internally into heat, blocking the Qi pathway, resulting in upper heat and lower cold. If external pathogenic factors were received, having passed the Mu Yuan (Sea of Origin), there would surely be alternating chills and fever.
Scutellaria Root (light), Coptis Rhizome, Light Bamboo Leaf, Betel Nut Juice, White Peony Root, Magnolia Bark, Broadleaf Citrus Peel White

Certain patient: Damp-Warmth causing dysentery with rectal prolapse. Use Wu Ling San (Five-Ingredient Powder with Poria) plus Halloysitum Rubrum (Han Shui Shi).

Jiang: Improper diet causes accumulation in the stomach and intestines, steaming and gathering to form obstructive downward flow. Unresolved for three months. Use clearing and dispersing with tonification.
Ginseng Radix et Rhizoma, Coptis Rhizome, Stir-fried White Peony Root, Stir-fried Hawthorn Fruit, Broadleaf Citrus Peel, Poria, Stir-fried Angelica Sinensis, Chinese Plum

Lu: Damp-Heat accumulates internally, causing epigastric knotting. The constitution has inherent Yang deficiency. Dampness pouring downward causes unsatisfactory spontaneous diarrhea. Consciousness is confused, threatening to transform into Flaccid Spasm (Rou Jing).
Stir-fried Pinellia Tuber, Ginseng Radix et Rhizoma, Immature Bitter Orange, Coptis Rhizome, Dried Ginger, Scutellaria Root, Ginger Juice

Gu: After drinking soup/water, gurgling sounds in the abdomen, spontaneous passage of watery stool. As a habitual drinker, dampness remains internally. Excess dampness accumulates internally, causing gastrointestinal discomfort and coagulation/stagnation. Dong-Yuan's Qing Shu Yi Qi Tang (Clear Summerheat and Boost Qi Decoction) is also designed for Damp-Heat injuring Qi. However, with long-standing Spleen-Stomach disease, the ability to ingest food remains. One should use bitter flavors to firm Yin and aromatic herbs to regulate the Spleen.
Raw Atractylodes Macrocephala Rhizome (4 liang), Stir-fried Black Phellodendron Bark (2 liang), Stir-fried Black Sanguisorba Root (2 liang), Polyporus (1.5 liang), Alisma Rhizome (1.5 liang). Make pills with water, take 3 qian.

Ge (40 years old): Habitual drinker, chronic loose stools. Previously developed carbuncles on the hypochondrium. In spring and summer, palpable masses under the ribs, abdominal fullness/distension. This is long-standing accumulated Damp-Heat. Carbuncle pus passes spontaneously, failing to vent the pathogen. Gastrointestinal Qi is congested, frequent unsatisfactory passage. The method should be to disperse and eliminate to remove Damp-Heat. If purging is too excessive, Spleen and Stomach will be injured. Propose Dan-Xi's Xiao Wen Zhong Wan (Small Warming Middle Pill). Take 2.5 qian in the morning, 2.5 qian at night, total 3 liang.

Certain patient: Tidal fever, spontaneous diarrhea, abdominal pain.
Scutellaria Root, Raw White Peony Root, Immature Bitter Orange, Platycodon Root, Betel Nut Juice, Aucklandia Root Juice

Xu: Able to eat, abdominal pain, dysentery. Simultaneously harmonize Yin.
Ginseng Radix et Rhizoma, Raw White Peony Root, Scutellaria Root, Immature Bitter Orange, Coptis Rhizome, Dried Ginger

Certain patient (16 years old): Internal steaming of Damp-Heat causing red dysentery.
Stir-fried Black Medicated Leaven, Stir-fried Black Hawthorn Fruit, Poria Cocos Skin, Calcined Talcum, New Tangerine Peel, Magnolia Bark, Light Bamboo Leaf, Lablab Bean Leaf

Zhu (38 years old): Ten-year chronic dysentery. Must deduce dietary taboos. For drinkers, dampness stagnates in the intestines. Without the pungency of Wind-dispelling herbs assisted by bitter flavors entering the intestines, how can dampness be overcome and heat expelled? Long-term illness with unchanged diet indicates intestinal pathology.
Cottonworm Fern (Mian Yin Chen), Fragrant Angelica Root, Northern Birch Bark, Poria Cocos Skin, Phellodendron Bark, Patchouli Leaf

Certain patient: Emaciated with Yin deficiency, Damp-Heat dysentery. Mistakenly administered digestive aids, which instead seized fluids. Pathogens not fully cleared, fluids consumed first. Sore throat and choking cough. This means dampness has not ceased, yet upper dryness has appeared.
Coptis Rhizome, Honeysuckle Flower, Tetrapanax Pith, Scutellaria Root, Fritillaria Bulb, Poria Cocos Skin

Certain patient: Damp-Heat obstructing the Qi level internally, abdominal pain and dysentery, yellow eyes, glossy tongue without thirst. Propose clearing the interior and draining Damp-Heat.
Scutellaria Root, Halloysitum Rubrum, Coptis Rhizome, Magnolia Bark, Birch Bark, Curcuma Tuber

Shan (50 years old): Dampness stagnation causing abdominal pain, passage of red discharge like bean juice.
Raw Atractylodes Macrocephala Rhizome (3 qian), Stir-fried Hawthorn Fruit (1.5 qian), Magnolia Bark (1 qian), Red Yeast Rice (1.5 qian), Broadleaf Citrus Peel (1 qian), Polyporus (1 qian)

Certain patient: Summer-Autumn dysentery is indeed Damp-Heat injuring Qi, causing Spleen-Stomach Qi stagnation, tenesmus and unsatisfactory passage. The ancient formula Xiang Lian Wan (Aucklandia and Coptis Pill) takes its clearing of interior heat, but must be assisted by Qi-regulating herbs. It is said that when Qi moves, Damp-Heat accumulation has no place to remain. Zhi Mu (Anemarrhena Rhizome) and Sheng Di Huang (Rehmannia Root) nourish Yin and clear heat, treating fire from Yin deficiency and Yang hyperactivity, which is vastly different from Damp-Heat in dysentery. Nourishing leads to stagnation, dulling Qi and causing blockage, explaining why one desires to pass stool but cannot. Ultimately, the Damp-Heat residual pathogen remains. Gui Fu (Cinnamon Twig and Aconite) are hot and drying, again causing anal bearing down and knife-like pain. Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) is an established method of Dong-Yuan, merely lifting the clear Yang of the Lower Jiao, failing to penetrate directly into the intestines. Using heavy doses of Da Huang (Rhubarb Root) along with Zhi Mu and Sheng Di Huang further injures the Lower Jiao. Texts state that chronic dysentery all belongs to Kidney injury. Lower abdominal pain and bearing down, aversion to cold, clearly indicate Lower Jiao syndrome. Proposing to lift Yang also requires treating from below.
Ginseng Radix et Rhizoma, Poria, Alisma Rhizome, Honey-fried Licorice Root, Saposhnikovia Root, Notopterygium Rhizome, Saussurea Root, Asarum, Fresh Ginger, Jujube

Certain patient: White tongue, thirst but no desire to drink, heat in heart and abdomen, pain with every dysenteric episode, anal bearing down, unsatisfactory passage, slight vomiting with phlegm, altered taste, hollow headache, red cheeks. This is steam from water and grain transforming into Damp-Heat, stagnating in the stomach and intestines, mixing clear and turbid. Suddenly adding irritability and difficulty crying out. The method should be bitter-cold to drain heat, bitter-pungent-aromatic to circulate Qi and permeate-drain dampness. Accumulation is tangible, while Dampness and Heat are inherently intangible.
Coptis Rhizome, Scutellaria Root, Curcuma Tuber, Magnolia Bark, Polyporus, Buckwheat Flower Bud, Birch Bark

Bao: Initial cold limbs (Jue), followed by dysentery with pus and blood, abdominal pain, nausea/vomiting. This is mutual injury of Cold and Heat. (Pattern: Jueyin Latent Heat)
Scutellaria Root (light), Coptis Rhizome, Moutan Cortex, Raw White Peony, Roasted Ginger, Stir-fried Honeysuckle Flower

Chen (Female): Warm pathogen unresolved for ten days, fever with spontaneous diarrhea, consciousness occasionally unclear. This pathogen is latent in Jueyin, fearing transformation into spasm.
Pulsatilla Root, Coptis Rhizome, Scutellaria Root, Northern Birch Bark, Phellodendron Bark, Raw White Peony Root

Second visit: Warm pathogen treated incorrectly with exterior-releasing herbs, seizing fluids. Coma, fearing transformation into spasm/cold limbs.
Stir-fried Rehmannia Root, Donkey-hide Gelatin, Stir-fried Ophiopogon Tuber, Raw White Peony Root, Stir-fried Moutan Cortex, Privet Fruit

Qiu (Elderly woman): Administered moistening agents, pain eased, discharge decreased. Knowing Jueyin dysentery requires softening and unblocking. Blood deficiency with Wind is evident.
Rehmannia Root, Donkey-hide Gelatin, Moutan Cortex, Raw White Peony Root, Honeysuckle Flower, Black Soybean Skin

Certain patient: Heat gradually entering the interior, chest fullness and loose stools. Propose sour-bitter to drain heat.
Scutellaria Root, Coptis Rhizome, Immature Bitter Orange, White Peony Root, Broadleaf Citrus Peel White, Talcum, Licorice Root, Grain Sprout

Cai: Interior deficiency with pathogen sinking,協熱 (Xie Re - accompanying heat) spontaneous diarrhea. Pulse small on left, large on right. Disease persists for nine days without reduction, indicating a severe case. Propose Bai Tou Weng Tang (Pulsatilla Decoction) formula, adding Scutellaria Root and White Peony Root. (Pattern: Accompanying Heat Dysentery)

Pan: Seasonal Summerheat-Dampness enters via mouth and nose. Qi stagnation causes Ying and Wei to lose transport. Must present with fever and no sweat. The pathogen moves from upper to middle, following the Mu Yuan (Sea of Origin), causing gastrointestinal stagnation. Abdominal pain and dysenteric discharge are all transformations of Damp-Heat. Dispersing and eliminating with diuresis is appropriate. If exterior-releasing herbs are used, Yang Qi will be injured.
Poria, Tangerine Peel, Magnolia Bark, Aucklandia Root, Stir-fried Lablab Bean, Stir-fried Hawthorn Fruit

Second visit: Accompanying heat dysentery with sticky bloody water is a transformation of Damp-Heat in the stomach and intestines.
Northern Birch Bark, Pulsatilla Root, Poria, Alisma Rhizome, Stir-fried Honeysuckle Flower, Yi Yuan San (Benefit Element Powder)

Certain patient: Spring-Warmth sinking internally causing dysentery, most prone to collapse (Jue/Tuo).
Coptis Rhizome, Donkey-hide Gelatin, Scutellaria Root (light), Stir-fried Rehmannia Root, Raw White Peony Root, Honey-fried Licorice Root

Wang: Heat toxin lingering and not transforming, tidal fever with dysentery.
Coptis Rhizome, Scutellaria Root, Stir-fried White Peony Root, Poria, Alisma Rhizome, Quince Fruit

Zhang (33 years old): Jiangnan soil is thin, Qi is weak. Summer food accumulation internally, seasonal heat forcing internal gathering. Damp-Heat red dysentery, unresolved into winter, all due to failure to observe dietary restrictions. Should consume bland flavors. (Pattern: Bloody Dysentery)
Raw Atractylodes Macrocephala Rhizome, Magnolia Bark, Southern Hawthorn Fruit, Areca Seed, Melia Root Bark, Sophora Flower, Broadleaf Citrus Peel, Honeysuckle Flower

Second visit: Bloody dysentery for three months, daytime dysentery stopping at night, anus feels like bearing down. Due to Qi sinking, the gate fails to contain.
Ginseng Radix et Rhizoma, Angelica Sinensis, White Peony Root, Cinnamon Twig, Honey-fried Licorice Root, Atractylodes Macrocephala Rhizome, Broadleaf Citrus Peel, Roasted Ginger, Southern Jujube

Certain patient (24 years old): Bloody dysentery for half a year, lower abdominal pain. Liu Wei Di Huang Wan (Six-Ingredient Pill with Rehmannia) plus stir-fried Hawthorn Fruit and stir-fried Corydalis Rhizome.

Certain patient: Bloody accumulation painful dysentery, starting in midsummer, persisting until mid-autumn. Clearly Damp-Heat stagnating in stomach and intestines. Prolonged course, complexion fades, right pulse is large and forceful, which is a major taboo in dysentery. Slightly unblock accumulation, simultaneously harmonize blood.
Wine-stir-fried Rhubarb Root, Coptis Rhizome, Scutellaria Root, Moutan Cortex, Cinnamon Twig, Angelica Sinensis Body, White Peony Root, Raw Licorice Root

Yuan (27 years old): Chronic dysentery, abdominal pain, bloody stool.
Raw Astragalus Membranaceus (3 qian), Raw Atractylodes Macrocephala Rhizome (3 qian), Stir-fried Angelica Sinensis Body (1 qian), Stir-fried Hawthorn Fruit (2 qian), Stir-fried Sanguisorba Root (1.5 qian), Broadleaf Citrus Peel (1 qian), Magnolia Bark (1 qian), Notopterygium Rhizome (5 fen), Saposhnikovia Root (5 fen)

Zhu (39 years old): Dysentery with clotted blood, Qi bearing down in anus, no abdominal pain.
Stir-fried Black Melia Root Bark (1 liang), Raw Atractylodes Macrocephala Rhizome (1 qian), Raw Phellodendron Bark (1 qian), Stir-fried Black Hawthorn Fruit (3 qian), Stir-fried Black Sanguisorba Root (1.5 qian), Stir-fried Charred Honeysuckle Flower (1.5 qian), Red Poria (3 qian), Polyporus (1.5 qian)

Certain patient: Painful dysentery unsatisfactory, already passing blood. Summer-Dampness is not only in the Qi level, and due to overwork and vegetarian diet, attacking/purging should be cautious.
Angelica Sinensis, White Peony Root, Southern Hawthorn Fruit, Magnolia Bark, Areca Seed, Roasted Ginger

Certain patient: Slow pulse, pain above umbilicus, loose stool, short urine. This is Dampness stagnating Spleen-Stomach Yang, causing Qi stagnation and tenesmus. Follow the ancients' intent of guiding dampness and dispersing differentiation. (Pattern: Yang Deficiency with Qi Stagnation)
Raw Atractylodes Macrocephala Rhizome, Broadleaf Citrus Peel, Magnolia Bark, Official Cinnamon, Calcined Talcum, Poria, Polyporus, Alisma Rhizome, Stir-fried Hawthorn Fruit

Zhang (57 years old): Deep-hidden pulse, chronic dysentery with abdominal pain, aversion to cold, poor appetite, weak Qi and intestinal stagnation. Use warming and unblocking methods.
Prepared Aconite Carapax, Raw Atractylodes Macrocephala Rhizome, Raw Rhubarb Root, Poria, Magnolia Bark, Aucklandia Root

Second visit: Warming and purging combined, intestinal stagnation not unblocked, all due to weak Fu Yang. Ancient sages treating dysentery do not leave the two methods of unblocking and astringing.
Angelica Sinensis, Cinnamon Heart, Poria, Magnolia Bark, Southern Hawthorn Fruit, Raw Malt

Wang (62 years old): Usually combines warming and tonifying, indicating a Yang-insufficient constitution. Heard of dysentery for two months, did not restrict diet, causing Spleen-Stomach stagnation and obstruction. Now added nausea/vomiting. The Six Fu organs should be unblocked. The method for treating dysentery is either unblocking or astringing. Rectal/intestinal knotting, in Yang deficiency, use warming herbs to unblock.
Prepared Aconite Carapax, Processed Rhubarb Root, Magnolia Bark, Aucklandia Root, Poria Cocos Skin

Fan (27 years old): Dysentery is called "Zhi Xia" (Obstructive Downward Flow), meaning obstruction must cause pain before passage. Moreover, the disease started from careless eating/drinking, Yang Qi is blocked, accumulation stays. Reviewing previous prescriptions, those promoting unblocking were effective, those retaining tonification made the disease worse. All Six Fu organs use unblocking as their function.
Aconite, Rhubarb Root, Poria, Magnolia Bark, Raw Areca Seed, Broadleaf Citrus Peel

Second visit: Warming and purging already effective, residual stagnation in stomach and intestines, all because Yang does not govern transportation. Again assist with Qi-regulating herbs.
Aconite, Processed Rhubarb Root, Poria, Broadleaf Citrus Peel, Magnolia Bark, Raw Alpinia Oxyphylla Fruit, Aucklandia Root, Polyporus

Li: Dysentery approaching two months, slightly yellow eyes, white tongue, dry mouth, dry red lips, abdominal fullness, soft on pressure. Urine不通 (not flowing) all day. Patient describes anal blockage, straining endlessly, only able to expel drops of sticky accumulation. If there were loose stool, it would surely pour out intestinally and be abundant. Thinking of Summer-Autumn, Summer-Dampness attaches internally causing dysentery. Xuanti (Yellow Emperor) calls it "Zhi Xia", meaning stagnating Qi and Blood, not just food stagnation as one cause. All Six Fu organs belong to Yang, using unblocking as function; all Five Zang organs belong to Yin, storing as substance. First diarrhea then dysentery, Spleen transmitting to Kidney is reverse, i.e., Earth overcoming Water. However, one must investigate the reason for this transmission/overcoming. It is latent pathogen filth not cleared from the middle, thus pouring downward. Protracted duration, righteous Qi becomes deficient due to deficiency. Zhongjing discussed the Three Yin, in the Taiyin chapter, first mentioned abdominal fullness. Spleen is a soft organ, only rigid herbs can diffuse Yang and drive out turbidity. But now the two intestines are blocked, Qi does not circulate. Li Zhong Tang (Regulate the Middle Decoction) methods will hardly unblock the Fu organs. Examining Neijing: treat the excess when there are two deficiencies and one excess, opening one side. However, must warm Yang, assist with guiding Qi and driving out stagnation. To attempt turning the mechanism, there is no other way.
Prepared Aconite, Raw Magnolia Bark, Aucklandia Root, Processed Rhubarb Root, Stir-fried Black Star Anise

Second visit: Lethargy for half a month, Spleen and Kidney exhausted again. Spleen failure does not govern healthy transportation, ingested food turns to phlegm foam. Kidney true essence loses control of receiving Qi, fluid water floats up blocking the throat. All are dysentery injuring turbid obstruction, transforming into distension late transmission. Pulse appears wiry and forceful, indicating no Stomach Qi. Minor recovery turning into disease is most inappropriate. Entering winter is the command for storing Yang. Now Yang gradually dissipates, while Yin fluids are withered. Thirst with little drinking, drinking does not quench thirst. Treating Yang must use rigid herbs, making Yin even more depleted. Turning around, no help can be borrowed. Reluctantly differentiate and regulate Spleen and Kidney. Spleen Yang moving hopes for transportation, Kidney Yang still hoping for storage. King's Way is indeed hard to achieve quick success. Considering substance and function, dangerous herbs should not be used.
Morning: Stir-fried Shen Qi Wan (Kidney Qi Pill). Noon: Shen Ling Bai Zhu San (Ginseng, Poria, and Atractylodes Macrocephala Powder) plus Alpinia Oxyphylla Fruit.

Xu (33 years old): Labor fatigue, coughing, blood loss, still not avoiding cold and heat. Food causes diarrhea and dysentery in abdomen. Disease upon disease, recent infection. Method should treat first, distinguishing new and old diseases. (Pattern: Yang Deficiency)
Magnolia Bark, Alpinia Oxyphylla Fruit, Broadleaf Citrus Peel, Poria Cocos Skin, White Peony Root, Honey-fried Licorice Root, Quince Fruit, Stir-fried Lablab Bean

Second visit: Coughing and dysentery, drug treatments contradict. Treating Lung hinders Spleen, treating Spleen hinders Lung. Now entering winter, treating dysentery is key. Patient says morning meal is comfortable, evening meal causes fullness. Spleen-Stomach Yang Qi is lacking. Do not merely use stagnation-resolving and cold-suppressing methods.
White Peony Root (mixed with Cinnamon Wine), Alpinia Oxyphylla Fruit, Broadleaf Citrus Peel, Poria, Scorched Atractylodes Macrocephala Rhizome, Honey-fried Licorice Root, Grain Sprout, Amomum Villosum Shell

Zhang: After dysentery and diarrhea, pulse right is wiry and large. Stomach deficiency, poor intake. Yang weak, unable to govern transportation. Method should unblock Fu Yang.
Ginseng Radix et Rhizoma, Alpinia Oxyphylla Fruit, Stir-fried Cuscuta Seed Cake, Stir-fried Amomum Villosum Seed Powder, Poria, Broadleaf Citrus Peel White

Lu (26 years old): Abdominal fullness, spontaneous dysentery, pulse soft and small. Disease in Taiyin. Moreover, clear and long urination, not comparable to Fu organ Damp-Heat. Method should warm.
Raw Atractylodes Macrocephala Rhizome, Aconite, Poria, Magnolia Bark, Dried Ginger

Xu (24 years old): Dysentery for one year, already edema and difficult urination. Ancient texts say chronic dysentery must injure Kidney. Last month used Li Yin Jian (Regulate Yin Decoction) without effect. Asked about eating porridge causing acid regurgitation, sallow complexion, soft pulse. Middle Jiao Yang daily exhausts, water-grain dampness not transported. Still use pungent-warm to revive Spleen Yang, assist with separating and draining. Use Wei Ling Tang (Stomach and Poria Decoction), remove Licorice, add Alpinia Oxyphylla Fruit.

Chen: Dysentery accumulation slightly slowed, but various symptoms unchanged. Complexion greenish-dull, four limbs cold. Still in danger. Propose advancing Yi Huang San (Yellow Regulating Powder) method.
Ginseng Radix et Rhizoma, Roasted Alpinia Oxyphylla Fruit, Male Clove, Poria, Broadleaf Citrus Peel, Green Tangerine Peel, Quince Fruit, Stir-fried Winter Rice

Certain patient: Pulse micro and fine, cold limbs, unlimited dysentery. Wu Zhu Yu Tang (Evodia Decoction) can only stop pain, still no food intake. This is Yang failure and Yin turbidity, Fu Qi about to perish. Use Tao Hua Tang (Peach Kernel Decoction).
Red Kaolin, Dried Ginger, White Glutinous Rice

Certain patient: After dysentery, stool is not solid, food not well transported. Color and pulse are both deficiency signs. Clear Yang is lost in the middle, Yin Qi leaks out from below first. First regulate the middle Jiao, then secure Yin.
Ginseng Radix et Rhizoma, Atractylodes Macrocephala Rhizome, Poria, Honey-fried Licorice Root, Broadleaf Citrus Peel, Roasted Ginger, Alpinia Oxyphylla Fruit

Certain patient: Spontaneous diarrhea without thirst belongs to Taiyin. Hiccups come from Stomach having little food intake, Chong Qi rebelling upward, having images of Earth failure. Condition is already critical and severe. Propose Jin Gui Fu Zi Jing Mi Tang (Golden Cabinet Aconite and Rice Decoction).
Ginseng Radix et Rhizoma, Aconite, Dried Ginger, Honey-fried Licorice Root, Glutinous Rice

Certain patient: Vegetarian for years, Earth thin, Qi weak. Added to long dysentery, little food, desire to vomit. Spleen-Stomach Yang is衰竭 (exhausted). From summer to now, half a year not cured. If suddenly swelling occurs, what method to apply?
Ginseng Radix et Rhizoma, Atractylodes Macrocephala Rhizome, Dried Ginger, Roasted Ginger, Clove, Poria

Yuan: Middle and Lower Yang微弱 (weak), vomiting/hiccups and dysentery. Warming middle does not respond. Fear prolonging to collapse. Yang should be unblocked, Yin should be retained. This closes the gate preventing leakage. Spring returns to cold valley, vital energy has grasp. Await Mr. Wang to lead discussion.
Ginseng Radix et Rhizoma, Aconite, Roasted Ginger, Stir-fried Glutinous Rice, Red Kaolin, Raw White Peony Root