某 春痢入冬。痢止。腹痛食少。童年那有淫欲之扰。此系寒热不和。脾胃受伤也。六君子汤
加肉桂。
某 脉沉微。下痢红紫黑。舌胎粉白。并不渴饮。此太阴脾营虚寒也。仿理阴煎。（脾营虚寒）
当归头 白芍 炮姜 炙草 茯苓 益智
唐（氏） 下痢四十余日。形寒腹痛。
炒当归 生白芍 肉桂 炒山楂 青皮 茯苓
沈 议堵截阳明一法。（阳明不阖）
人参 炒白粳米 炮姜 赤石脂
某（六四） 高年下痢。痰多舌干。脉右空大。神困音低。乃脾肾两亏。二气交虚。有年致此。恐非宜。（脾肾兼虚）
人参（一钱半） 菟丝子（一钱半） 赤石脂（三钱） 炮姜（一钱半） 茯苓（三钱） 木瓜（一钱）
王（五十） 久痢久泻为肾病。下泻久而阴伤气坠。四神丸治脾肾晨泄。辛温香燥皆刚。佐入五味酸
柔。不过稍制其雄烈。此肛坠尻酸。乃肾液内少而气陷矣。腥油肉食须忌。
熟地 禹余粮石 五味子
蒋（五一） 久痢用辛甘温而效。是脾阳久伤。治由东垣法极是。述食血腥。滑必便溏。四肢忽有肉疹。
营卫内应脾胃。气血未得充复。五旬外。下亦怯。用脾肾两补。
人参 山药 茯苓 湖莲 芡实 补骨脂 苁蓉 萸肉 五味 巴戟 菟丝 覆盆子
某 下痢腹痛舌干。肛坠。痢伤阴也。（痢伤阴液）
熟地炭 炒归身 炒白芍 炒楂肉 茯苓 炙草
某 滞浊下行痛缓。议养阴通腑。
生地 阿胶 丹皮 山栀 猪苓 泽泻
孙 脉左数。下利。腹不甚痛。暮夜微热。所伏暑热。乘阴虚下陷。是清热理脾不效。当摄阴升阳。
熟地炭 当归炭 山楂炭 炒黑麦芽 炙黑甘草 防风根
炒黑升麻。
又 照方去山楂麦芽加人参焦白芍。
又 泻痢久必阴损液耗。此口渴微咳。非实火客邪。与甘酸化阴。
人参 山药 炙草 炒乌梅 木瓜 炒湖莲肉
蔡 脉右数。左细数。面垢舌燥。白苔点点。肌肤甲错。左胁动气。伏暑当秋凉而发。初病如疟。当
从苦辛寒法。里邪炽烈。变为下痢。胃津被劫。阴液大耗。昔贤于热病液涸。急以救阴为务。苟
胃关得苏。渐以冀安。否则犯喻氏所指。客邪内陷。液枯致危之戒矣。复脉汤去姜桂麻。
又 酸甘化阴法。
人参 生地 乌梅 炙草 麦冬 木瓜
鲍 痢久。阴液消亡。无以上承。必唇燥舌干。奈胃关不和。善噫难饥。此由阴腻柔剂所致。择其
不腻滞者调之。
人参 炙草 炒白芍 炒乌梅肉 炒麦冬 茯神
周（五十） 痢后气坠。都主阴伤。但嗔怒不已。木犯土。致病留连。摄阴之中。聊佐和肝。
熟地 茯苓 炒山楂 炒乌梅 木瓜
某 阴液涸。则小水不通。胃气逆。则厌食欲呕。此皆痢之款症也。治以中下二焦为主。议理阴
煎。
熟地 白芍 附子 五味 炮姜 茯苓
吴（三十） 痢久阴伤腹痛。肛门坠胀。秋病入冬不愈。已属休息症。和阴剂中。仍有升降。仿东垣法。
炒熟地 炒当归 炒白芍 炙草 生山楂 生谷芽
陈（三七） 泻痢久则伤肾。多见下焦沉坠。先伤在阴。刚药不效。（久痢伤肾下焦不摄）
人参 鹿茸 菟丝子 茯苓 舶茴香 制补骨脂 砂仁
张（五一） 晨泄痢血属肾病。无痛坠等因。用黑地黄丸。
范 泻痢起于长夏。医谓时令湿热。胃苓汤。芩芍法。固非谬讹。因高年肾阳肝阴先亏。使客气
内扰阻遏。中流乏砥柱坐镇。致狂澜滔天耳。病经两旬不减。重阴无阳。验诸神识尚清。其外
邪为少。而内损为多八脉无权。下无收摄。漏卮不已。理必生阳泄。下焦冷。此皆阴阳二气微
绝治病则夯。治本为宜。非置之不理。实究天人而已。
人参（二钱） 鹿茸（二钱） 炒黑当归（三钱） 生杜仲（三钱） 生沙苑（一钱） 茯苓（三钱）
李（五十） 自痢五六年。即周身痛痹。盖肠胃病。致经络筋骨 篱疏撤。阳失卫。药难效灵。书此代煎。
冬于术 苁蓉 熟附子 河水煎。
吴（四九） 治痢大法。无过通塞二义。夏秋湿热固多。初痢不痛。已非湿热。色滞者。肠中陈腐也。至今
痛而痢。痢后复痛。按之痛减属虚。小雪不愈。阳不来复。久痢治肾。然非滋腻。先用苓姜术桂
汤。
某（氏） 治痢古法。不越通涩。经停有瘕。腹浮肿。八脉之病。医惑于见痢。认为脾胃症。议用济生肾
气丸。
朱（五七） 痢久肛坠。是下焦肾虚。失于收纳。治脾胃药无功。
熟地炭 炒归身 赤石脂 五味子 炒楂肉
周（四六） 痢久必伤肾阴。八脉不固。肠腻自滑而下。但执健脾无用。病不在中。纳谷运迟。下焦坎阳
亦衰。用三神丸。
五味子 补骨脂 肉果
某 痢久阴阳两伤。少腹肛坠。连两腰胯脊髀酸痛。由脏腑络伤。已及奇经。前议轻剂升阳颇
投。仍从下治。
人参 鹿茸 附子 炒当归 茴香 菟丝子 杜仲
周 转方柔药相安。显然久痢伤及肾阴。当用理阴煎。兼用禹粮石脂丸。以摄固肠中。
熟地炭 归身炭 人参 炙甘草 五味子 炒楂肉
兼服禹粮赤石脂丸。
金（氏） 脉数劲。下痢腹鸣痛。后坠。卧则气冲。咳嗽吐粘涎。产后过月。显是下损至中。
纳谷日少。形神日衰。势已延成蓐劳。难期速功。
熟地炭 人参 茯神 炒山药 建莲 赤石脂
某（氏） 休息痢。经二年。明是下焦阴阳皆虚。不能收摄。经期不来。小腹抚摩有形上行。似乎
瘕。其实气结。若不急进温补。恐滋扰肿胀之累也。
人参 附子 茯苓 炙草 五味 白芍
某 气虚下陷。门户不藏。（气虚下陷）
人参 黄 广皮 炙草 归身 炒白芍 防风 升麻
某 痢经五十日来。小愈再发。独见后重下坠。此为气陷。则门户不藏。亦胃弱内风乘袭。议陷
者举之。
人参 归身 白芍 炙草 升麻 荷叶
石 疟邪热气。内陷变痢。延已三月。脾胃气衰。面浮肚膨。仍有里急欲坠之象。中虚伏邪。进以
和解。（疟变痢）
黄芩 柴胡 人参 丹皮 炒当归 白芍 谷芽 炒山楂
蔡 神气索然。腹中动气。舌红嗌干。寒热日迟。平素积劳致虚。邪伏厥阴。脉促细坚。温清难用。
勉议复脉汤。存阴勿涸。希图援救。复脉汤。
又 两投复脉色脉略转。所言平素积虚。不但疟邪内陷阳结于上则胸痞。阴走于下则频利。
非徒开泄攻邪也。救逆汤去姜。
又 奔脉动气。皆是阳虚浊泛。当和营理阳。
人参 茯苓 归身 炙草 桂心 牡蛎 煨姜 大枣
又 冲气填塞。邪陷下痢。势非轻小。用泻心法。
人参 淡干姜 熟附子 川连 黄芩 枳实
又 人参 淡干姜 生地 炒桃仁
张 气衰热伏。腹痛下痢。脘中痞闷。不欲纳食。由疟变痢。经邪入腑。斯病势已重。清理湿热以
开痞。延久必须扶正。
淡黄芩 川连 人参 生白芍 干姜 枳实
某 邪陷疟后变痢。伤及厥阴。症见气上撞心。饥不能食。干呕腹痛。全是肝病。肝为至阴之脏。
相火内寄。仲景治法。不用纯刚燥热之药。以肝为刚脏故也。今正交土旺。土木为仇。五日内
未为稳当。
人参 炒当归 炒白芍 炒乌梅肉 茯苓 淡吴萸 生香附汁 真北秦皮
孙 下痢无积。肛坠。肠间汨汨有声。此属肠风。当用摄固。（肠风）
熟地炭 萸肉炭 炒归身 炒杞子 川断 北味肉
煎药送赤石脂丸三钱。
某 当年久痢。用三神丸得效。是脾肾两因。兼理气分之滞。体质阳虚。遇冷病加。今病起长
夏。小水不通。必系夏热阻其宣化。久则气血凝着而为肠红。先与桂苓甘露饮。分消其湿。
于术 茯苓 猪苓 泽泻 滑石 桂心
包（噤口痢）
川连 人参 黄芩 白芍 草决明 炒山楂 炒银花
又 噤口痢。乃热气自下上冲。而犯胃口。肠中传导皆逆阻似闭。腹痛在下尤甚。香连梅芍。仅
宣中焦。未能泄下热燔燎。若不急清。阴液同归于尽。姑明其理。以俟高明备采。白头翁汤。
又 脉左细。数右弦。干呕不能纳谷。腹痛里急后重。痢积不爽。此暑湿深入着腑。势属噤口痢
疾。症非轻渺。议用苦寒清解热毒。必痛缓胃开。方免昏厥之变。
川连 干姜 黄芩 银花 炒山楂 白芍 木香汁
又 下午病剧。乃阴气消亡之征。若但阴柔。恐生生不至。疏补胃药。正宜进商。
生地 阿胶 人参 生白芍 炒山楂 炒银花
矫 初起无寒热。即泻痢呕恶不食。乃噤口痢重病。夫暑邪之伤。由口鼻吸气而入。邪与水谷
交混。蒸变湿热。酿为积滞脓血。肠胃气窒。欲解不能通爽。遂致里结后重。香连苦辛。理气导
湿清热。初用颇是。皆缘劳碌之人。非膏粱温养之质。淡薄积劳。中气易伤。四十日来。积少痛
缓。医称病解。而食不下咽。不知饥饱。诊得脉弦。形衰。舌白。不渴饮水。日泻数行。全属胃倒气
夺。中宫损极。下关不摄。谷不能咽。焉能承受汤药。药味气劣。胃衰必恶。久痢久泻。务在能食。
古人非醒脾胃。即安肾摄纳。再询粉浆下咽。或呛或噎。议以上脘宜通其清阳。下焦当固摄
其滑脱。仿古方中参苓白术散末。当以米饮日服二次。间以不腻滑之物。食些少勿多。以示
胃之所喜为补。必得胃气渐醒。方有转危为安。
人参（二钱） 焦术（一钱半） 茯苓（一钱半） 炙草（五分） 炒扁豆（二钱） 苡仁（一钱半）
桔梗（一钱） 砂仁（七分炒） 炮姜炭（一钱） 肉豆蔻（一钱）
上药研细。秤准分两。每次用香粳米饮汤调服一钱五分。上药须日进二次。
鲍 舌心黄。边白。渴饮。水浆停胃脘。干呕微微冷呃。自痢稀水。小便不利。诊脉坚劲不和。八旬
又二。暑湿热邪内着。必脾胃气醒。始可磨耐。以高年不敢过清过消。用清暑益气方法。
川连 黄芩 石莲子 煨干葛 青皮 人参 茯苓 浓朴 猪苓 泽泻
又 口中干燥。小水全无。泉源已竭。阴液无以上承。痢症噤口。都是湿热壅于胃口。下元衰惫。
冲脉气震高突。此攻病保真。理难捉摸矣。
川连 黄芩 草决明 石莲子 乌梅 白芍
痢症。古名滞下。惟夏秋暑湿挟积者居多。其次则风淫火迫寒侵也。推之燥气。独不为患。
考前法。悉有定例。不必再述。至于暑者。有阴暑阳暑之源。其邪必兼乎湿。夫阴暑由于人
之阳气先亏。加以贪凉喜冷。郁折生阳。故主于温。阳暑由于天之热伏。阻气化浊。则重于
清。而医之下手工夫。于此须细心认定。但邪之来也。似水之流。脏腑间。一有罅隙。则乘虚
而着。故有在气在血之分。伤脏伤腑之异。若表之邪郁。而气机下流不息者。喻氏论人参
败毒散。里之积壅。而寒热交粘者。洁古立芍药汤。在气分。有苦辛调气。与辛甘益气等法。
在血分。有酸苦行血。及咸柔养血诸方。若表症急。从乎三阳。有桂枝汤。葛根芩连汤。小柴
胡汤。里势实。专究脾胃。有小承气汤。温脾汤。总之。治腑以三焦见症为凭。治脏以足三阴
为要领。辨得虚实之情形。酌以或通或涩之法。则临症权宜。庶乎不错矣。但是症不治
之条甚多。最难愈者。莫如休息痢。攻补之法非一。予亦不赘。最危险者。莫如噤口痢。却有
两端。若因暑湿邪充。格拒三焦者。气机皆逆传而闭。上下之势。浑如两截。若治不得其要。
则邪无出路。正立消亡。此丹溪立法最高。后世都宗其旨。先生又借用半夏泻心汤。减去
守中之品。取补以运之。辛以开之。苦以降之。与病情尤为允协。所以先生之见长。是集之
奥妙。每每在此。又因脾肾之阳素虚。阴邪从中而下者。先伤太阴。继伤少阴。关闸大开。痛
泄无度。戊癸少化火之。机命阳无蒸变之力。此不饥不食。为呕为胀。理宜然矣。与邪多积
热之候相比。绝然不同。参之仲景理中汤。肾气丸。及景岳理阴煎。胃关煎等法可也。吾乡
姚颐真先生。化出快捷方式良法。以大剂苁蓉。配入参归姜附桂制白芍之类治之。靡不应
手而愈。想苁蓉之性。温能达下。咸可利胃。质之柔润。以补阳中之阴。较地黄阿胶尤胜。与
之肠膏竭尽。络脉结涩而痛者。堪称神品。自此推展。用治甚多。若曰某方某药。但治某症。
不知活用。反称杜撰。则禁绝后人灵活之心。无从施发矣。（邵新甫）
徐评 夏秋之痢。总由湿热积滞。与伤寒传入三阴之痢不同。案中合法者亦甚多。一遇老年
及久痢。即混入阴经治法。并参附乌梅五味等。全不对症。随笔乱书。并与案中之论。亦自己相
背。想是习气使然。抑此中实无定见也。后人竟用温补。以为本之此老。杀人无算。触目伤怀。
**Case 1**
A patient suffered from dysentery starting in spring and extending into winter. After the dysentery ceased, abdominal pain and poor appetite occurred. Children do not have the disturbance of sexual indulgence. This is due to disharmony of cold and heat, damaging the Spleen and Stomach. Use Liu Jun Zi Tang (Six Gentlemen Decoction) with added Rou Gui (Cinnamon Twig).
**Case 2**
Pulse is deep and minute. Dysenteric discharge is red, purple, and black. Tongue coating is powdery white. There is no thirst or desire to drink. This is Tai Yin Spleen Ying (Nutritive Qi) deficiency-cold. Imitate Li Yin Jian (Replenish Yin Decoction). (Spleen Ying deficiency-cold)
Dang Gui Tou (Angelica Sinensis Root Head), Bai Shao (White Peony Root), Pao Jiang (Prepared Ginger), Zhi Cao (Honey-fried Licorice), Fu Ling (Poria), Yi Zhi Ren (Alpinia Oxyphylla Fruit).
**Case 3**
Patient Tang has had dysentery for over forty days. The body feels cold, and there is abdominal pain.
Chao Dang Gui (Stir-fried Angelica Sinensis), Sheng Bai Shao (Raw White Peony Root), Rou Gui (Cinnamon Twig), Chao Shan Zha (Stir-fried Hawthorn Fruit), Qing Pi (Green Tangerine Peel), Fu Ling (Poria).
**Case 4**
Patient Shen discusses a method of "blocking and intercepting" the Yang Ming channel. (Yang Ming does not close/consolidate)
Ren Shen (Ginseng), Chao Bai Jing Mi (Stir-fried White Rice Grain), Pao Jiang (Prepared Ginger), Chi Shi Zhi (Red Halloysite).
**Case 5**
Patient (64 years old), elderly with dysentery, excessive phlegm, dry tongue. Right pulse is empty and large. Spirit is fatigued, voice is low. This is deficiency of both Spleen and Kidney, with mutual deficiency of Yin and Qi. Due to advanced age causing this, it is feared to be difficult to treat. (Spleen and Kidney dual deficiency)
Ren Shen (Ginseng) (1.5 qian), Tu Si Zi (Cuscuta Seed) (1.5 qian), Chi Shi Zhi (Red Halloysite) (3 qian), Pao Jiang (Prepared Ginger) (1.5 qian), Fu Ling (Poria) (3 qian), Mu Gua (Chaenomeles Fruit) (1 qian).
**Case 6**
Patient Wang (50 years old), long-term dysentery and diarrhea belong to Kidney disease. Long-term diarrhea leads to Yin injury and Qi sinking. Si Shen Wan (Four Spirits Pill) treats Spleen-Kidney morning diarrhea; its properties are acrid, warm, aromatic, and drying, all being rigid. Adding Wu Wei Zi (Schisandra Berry)'s sour softness merely serves to slightly restrain its vigorous nature. Here, anal prolapse and soreness of the sacrum indicate that Kidney fluids are internally insufficient and Qi is sinking. Greasy, oily, and meat foods must be avoided.
Shu Di Huang (Prepared Rehmannia Root), Yu Yu Liang Shi (Yuzhuyu Litharge), Wu Wei Zi (Schisandra Berry).
**Case 7**
Patient Jiang (51 years old), long-term dysentery treated with acrid-sweet-warm methods was effective, indicating long-term damage to Spleen Yang. Treating according to Dong Yuan's (Li Dongyuan) method is very correct. Describing eating blood/meat causes slippery loose stools. Sudden flesh rashes on limbs. Ying and Wei internally correspond to Spleen and Stomach; Qi and Blood have not yet recovered. Over fifty, lower body is also weak. Use Spleen and Kidney dual tonification.
Ren Shen (Ginseng), Shan Yao (Chinese Yam), Fu Ling (Poria), Hu Lian (Lake Lotus Seed), Qian Shi (Euryale Seed), Bu Gu Zhi (Psoralea Fruit), Cong Rong (Cistanche Stem), Yu Rou (Cornus Fruit), Wu Wei Zi (Schisandra Berry), Ba Ji Tian (Morinda Root), Tu Si Zi (Cuscuta Seed), Fu Pen Zi (Raspberry).
**Case 8**
Patient, dysentery with abdominal pain, dry tongue, anal prolapse. This is dysentery injuring Yin fluids. (Dysentery injures Yin fluids)
Shu Di Tan (Charred Prepared Rehmannia), Chao Gui Shen (Stir-fried Angelica Sinensis Body), Chao Bai Shao (Stir-fried White Peony Root), Chao Zha Rou (Stir-fried Hawthorn Flesh), Fu Ling (Poria), Zhi Cao (Honey-fried Licorice).
**Case 9**
Patient, stagnation and turbidity move downward, pain relieves. Discuss nourishing Yin and unblocking the Fu organs.
Sheng Di Huang (Raw Rehmannia Root), E Jiao (Donkey-hide Gelatin), Dan Pi (Moutan Bark), Shan Zhi (Gardenia Fruit), Zhu Ling (Polyporus), Ze Xie (Alisma Rhizome).
**Case 10**
Patient Sun, Left pulse is rapid. Lower purging. Abdomen not very painful. Slight fever at night. Latent summer-heat, taking advantage of Yin deficiency to sink downward. Clearing heat and regulating Spleen was ineffective. Should collect Yin and raise Yang.
Shu Di Tan (Charred Prepared Rehmannia), Dang Gui Tan (Charred Angelica Sinensis), Shan Zha Tan (Charred Hawthorn), Chao Hei Mai Ya (Stir-fried Black Malt), Zhi Hei Gan Cao (Honey-fried Black Licorice), Fang Feng Gen (Saposhnikovia Root).
Chao Hei Sheng Ma (Stir-fried Black Cimicifuga Rhizome).
Second visit: Remove Shan Zha and Mai Ya from the formula, add Ren Shen and Jiao Bai Shao (Scorched White Peony Root).
Third visit: Long-term diarrhea and dysentery inevitably damage Yin and consume fluids. Thirst and slight cough here are not due to excess fire or pathogenic factors. Use Sweet-Sour to transform Yin method.
Ren Shen (Ginseng), Shan Yao (Chinese Yam), Zhi Cao (Honey-fried Licorice), Chao Wu Mei (Stir-fried Mume Fruit), Mu Gua (Chaenomeles Fruit), Chao Hu Lian Rou (Stir-fried Lake Lotus Endosperm).
**Case 11**
Patient Cai, Right pulse is rapid. Left pulse is fine and rapid. Face is greasy, tongue is dry, white coating spots. Skin is rough like armor plates. Moving Qi in left hypochondrium. Latent summer-heat erupts in autumn coolness. Initial illness resembles malaria. Should follow Bitter-Acid-Cold method. Internal pathogens are fierce, transforming into dysentery. Stomach fluids are robbed, Yin fluids largely consumed. Former sages, when fluids dried up in heat diseases, urgently prioritized saving Yin. If Guan (Gate/Stomach) revives, gradually hope for peace. Otherwise, one violates Yu Shi's warning: pathogenic factors sink inward, fluid depletion leads to danger. Use Fu Mai Tang (Restore the Pulse Decoction) removing Jiang (Ginger), Gui (Cinnamon), Ma (Ephedra).
Second visit: Sour-Sweet to transform Yin method.
Ren Shen (Ginseng), Sheng Di Huang (Raw Rehmannia), Wu Mei (Mume Fruit), Zhi Cao (Honey-fried Licorice), Mai Dong (Ophiopogon Tuber), Mu Gua (Chaenomeles Fruit).
**Case 12**
Patient Bao, dysentery long-standing, Yin fluids exhausted, unable to ascend. Lips and tongue must be dry. However, Stomach Gate is disharmonious, prone to belching, hungry but hard to eat. This is caused by Yin-nourishing greasy agents. Select non-greasy ones to regulate.
Ren Shen (Ginseng), Zhi Cao (Honey-fried Licorice), Chao Bai Shao (Stir-fried White Peony Root), Chao Wu Mei Rou (Stir-fried Mume Flesh), Chao Mai Dong (Stir-fried Ophiopogon Tuber), Fu Shen (Poria with Hostwood).
**Case 13**
Patient Zhou (50 years old), post-dysentery Qi sinking is mainly due to Yin injury. But anger persists, Wood invades Earth, causing lingering disease. While collecting Yin, briefly assist in harmonizing Liver.
Shu Di Huang (Prepared Rehmannia), Fu Ling (Poria), Chao Shan Zha (Stir-fried Hawthorn), Chao Wu Mei (Stir-fried Mume), Mu Gua (Chaenomeles Fruit).
**Case 14**
Patient, Yin fluids dried up, so Xiao Shui (urination) is blocked. Stomach Qi rebels, so aversion to food and vomiting occur. These are common symptoms of dysentery. Treatment focuses on Middle and Lower Jiao. Discuss Li Yin Jian (Replenish Yin Decoction).
Shu Di Huang (Prepared Rehmannia), Bai Shao (White Peony Root), Fu Zi (Aconite Root), Wu Wei Zi (Schisandra Berry), Pao Jiang (Prepared Ginger), Fu Ling (Poria).
**Case 15**
Patient Wu (30 years old), long dysentery injures Yin, abdominal pain, anal distension. Autumn illness entering winter without cure, already belongs to Rest Dysentery. In Yin-harmonizing agents, there is still ascending and descending. Imitate Dong Yuan's method.
Chao Shu Di (Stir-fried Prepared Rehmannia), Chao Dang Gui (Stir-fried Angelica Sinensis), Chao Bai Shao (Stir-fried White Peony Root), Zhi Cao (Honey-fried Licorice), Sheng Shan Zha (Raw Hawthorn), Sheng Gu Ya (Raw Barley Sprout).
**Case 16**
Patient Chen (37 years old), long diarrhea/dysentery injures Kidney. Often shows Lower Jiao heaviness/sinking. First injures Yin, rigid medicines are ineffective. (Long dysentery injures Kidney, Lower Jiao fails to secure)
Ren Shen (Ginseng), Lu Rong (Deer Antler Velvet), Tu Si Zi (Cuscuta Seed), Fu Ling (Poria), Bo Hui Xiang (Fennel), Zhi Bu Gu Zhi (Processed Psoralea Fruit), Sha Ren (Amomum Fruit).
**Case 17**
Patient Zhang (51 years old), morning diarrhea/dysentery blood belongs to Kidney disease. No pain or prolapse etc. Use Hei Di Huang Wan (Black Rehmannia Pill).
**Case 18**
Patient Fan, diarrhea/dysentery started in Late Summer. Doctor said seasonal damp-heat, used Wei Ling Tang (Stomach-Perturbing Decoction), Qin-Shao method. Certainly not wrong. Because high age, Kidney Yang and Liver Yin were first deficient, allowing guest pathogens to disturb internally and obstruct. Middle lacks a pillar to stabilize, causing raging waves. Disease unchanged after twenty days, heavy Yin without Yang. Verifying spirit is clear, external pathogens are few, internal damage is much. Eight Extraordinary Vessels lack power, Lower Jiao has no retention, leaking endlessly. Logic dictates generating Yang and draining Lower Jiao cold. These are subtle/extinct Yin and Yang Qi. Treating disease is clumsy, treating root is suitable. Not ignoring it, but investigating Heaven and Man.
Ren Shen (2 qian), Lu Rong (Deer Antler Velvet) (2 qian), Chao Hei Dang Gui (Stir-fried Black Angelica Sinensis) (3 qian), Sheng Du Zhong (Raw Eucommia Bark) (3 qian), Sheng Sha Yuan (Raw Astragalus Complanatus/Astragalus Membranaceus seed area? Note: Sha Yuan usually refers to Astragalus complanatus seed) (1 qian), Fu Ling (Poria) (3 qian).
**Case 19**
Patient Li (50 years old), self-dysentery for 5-6 years, then whole body pain/bi. Because intestinal/stomach disease causes meridians/collaterals/bones/muscles to loosen, Yang loses protection, medicine is hard to be effective. Write this for decoction.
Dong Yu Zhu (Winter Atractylodes), Cong Rong (Cistanche), Shu Fu Zi (Prepared Aconite), decocted in river water.
**Case 20**
Patient Wu (49 years old), general rule for treating dysentery is only Tong (Unblocking) and Sai (Stopping). Summer/Autumn damp-heat is many. Initial dysentery without pain is not damp-heat. Color stagnant is old filth in intestines. Until now pain and dysentery, pain after dysentery, pressing reduces pain belongs to Deficiency. Xiaoxue (Light Snow solar term) not cured, Yang does not return. Long dysentery treats Kidney, but not with cloying/nourishing. First use Ling Jiang Zhu Gui Tang (Poria, Ginger, Atractylodes, Cinnamon Decoction).
**Case 21**
Patient, ancient methods for treating dysentery do not exceed Tong/Sai. Menstruation stopped with mass, abdomen swollen. Disease of Eight Extraordinary Vessels. Doctor confused by seeing dysentery, considers it Spleen/Stomach disease. Discuss using Ji Sheng Shen Qi Wan (Kidney Qi Pill from Preserving Life).
**Case 22**
Patient Zhu (57 years old), long dysentery anal prolapse is Lower Jiao Kidney deficiency, failing to receive/store. Treating Spleen/Stomach medicine is useless.
Shu Di Tan (Charred Prepared Rehmannia), Chao Gui Shen (Stir-fried Angelica Sinensis Body), Chi Shi Zhi (Red Halloysite), Wu Wei Zi (Schisandra Berry), Chao Zha Rou (Stir-fried Hawthorn Flesh).
**Case 23**
Patient Zhou (46 years old), long dysentery inevitably injures Kidney Yin, Eight Extraordinary Vessels not secure, intestinal grease naturally slides down. Only执 (holding onto) Jian Pi (Strengthening Spleen) is useless. Disease is not in Middle. Food intake and transport are slow, Lower Jiao Kan Yang is also declining. Use San Shen Wan (Three Gods Pill).
Wu Wei Zi (Schisandra Berry), Bu Gu Zhi (Psoralea Fruit), Rou Dou Kou (Nutmeg).
**Case 24**
Patient, long dysentery damages both Yin and Yang, lower abdomen and anal prolapse, connecting two loins/hips/spine/thighs sore/aching. From Zang-Fu collaterals injured, reaching Odd Meridians. Previous discussion of light agents raising Yang was quite appropriate, still treat from below.
Ren Shen (Ginseng), Lu Rong (Deer Antler Velvet), Fu Zi (Aconite Root), Chao Dang Gui (Stir-fried Angelica Sinensis), Hui Xiang (Fennel), Tu Si Zi (Cuscuta Seed), Du Zhong (Eucommia Bark).
**Case 25**
Zhou, changing formula to soft medicines for peace. Obviously long dysentery injured Kidney Yin. Should use Li Yin Jian (Replenish Yin Decoction). Concurrently use Yu Liang Shi Zhi Wan (Litharge-Halloysite Pill) to secure/intestines.
Shu Di Tan (Charred Prepared Rehmannia), Gui Shen Tan (Charred Angelica Sinensis Body), Ren Shen (Ginseng), Zhi Gan Cao (Honey-fried Licorice), Wu Wei Zi (Schisandra Berry), Chao Zha Rou (Stir-fried Hawthorn Flesh).
Concurrently take Yu Liang Chi Shi Zhi Wan.
**Case 26**
Patient Jin, pulse is rapid and forceful. Dysentery with abdominal barking/pain, tenesmus. Lying down causes Qi rushing. Coughing with sticky saliva. Postparture past month. Clearly Lower Damage reaching Middle.
Food intake decreases daily, form/spirit declines daily. Condition has extended into Ru Lao (Postpartum Consumption). Hard to expect quick results.
Shu Di Tan (Charred Prepared Rehmannia), Ren Shen (Ginseng), Fu Shen (Poria with Hostwood), Chao Shan Yao (Stir-fried Chinese Yam), Jian Lian (Lotus Seed), Chi Shi Zhi (Red Halloysite).
**Case 27**
Patient, Rest Dysentery, passed two years. Clearly Lower Jiao Yin and Yang both deficient, unable to retain. Menstruation does not come. Lower abdomen palpable mass moving upward, seems like Mass (Jia), actually Qi knot. If not urgently advancing Warm Tonification, fear swelling/distension burden.
Ren Shen (Ginseng), Fu Zi (Aconite Root), Fu Ling (Poria), Zhi Cao (Honey-fried Licorice), Wu Wei Zi (Schisandra Berry), Bai Shao (White Peony Root).
**Case 28**
Patient, Qi deficiency sinking, Gate/Portal not storing. (Qi deficiency sinking)
Ren Shen (Ginseng), Huang Qi (Astragalus Root), Guang Pi (Tangerine Peel), Zhi Cao (Honey-fried Licorice), Gui Shen (Angelica Sinensis Body), Chao Bai Shao (Stir-fried White Peony Root), Fang Feng (Saposhnikovia Root), Sheng Ma (Cimicifuga Rhizome).
**Case 29**
Patient, dysentery passed fifty days, slightly better then relapsed. Only sees tenesmus/prolapse. This is Qi sinking, so Gate/Portal not storing. Also Stomach weak, internal Wind attacking. Discuss "Raise what has sunk" method.
Ren Shen (Ginseng), Gui Shen (Angelica Sinensis Body), Bai Shao (White Peony Root), Zhi Cao (Honey-fried Licorice), Sheng Ma (Cimicifuga Rhizome), He Ye (Lotus Leaf).
**Case 30**
Patient Shi, Malaria pathogen heat Qi, sinks inward transforming into dysentery. Extended three months. Spleen/Stomach Qi decline, face swollen belly distended. Still has urgency/prolapse sensation. Middle deficiency latent pathogen, advance with Harmonize. (Malaria transforms to Dysentery)
Huang Qin (Scutellaria Root), Chai Hu (Bupleurum Root), Ren Shen (Ginseng), Dan Pi (Moutan Bark), Chao Dang Gui (Stir-fried Angelica Sinensis), Bai Shao (White Peony Root), Gu Ya (Barley Sprout), Chao Shan Zha (Stir-fried Hawthorn).
**Case 31**
Patient Cai, spirit exhausted, moving Qi in abdomen, red tongue, dry throat, chills/fever delayed day by day. Usually accumulation/labor causes deficiency. Pathogen hides in Jue Yin. Pulse is hurried, fine, firm. Warm/Clear hard to use. Tentatively discuss Fu Mai Tang (Restore the Pulse Decoction). Preserve Yin, do not let it dry up. Hope for rescue. Fu Mai Tang.
Second visit: Two doses of Fu Mai Tang, color/pulse slightly turned. Said usual accumulation deficiency, not only Malaria pathogen sinking inward Yang knots upper causing chest fullness, Yin walks lower causing frequent purging. Not merely opening/draining attacking pathogen. Jiu Ni Tang (Rescue Collapse Decoction) remove Jiang (Ginger).
Third visit: Running pulse/moving Qi, all are Yang deficiency turbid flooding. Should harmonize Ying and regulate Yang.
Ren Shen (Ginseng), Fu Ling (Poria), Gui Shen (Angelica Sinensis Body), Zhi Cao (Honey-fried Licorice), Gui Xin (Cinnamon Heart), Mu Li (Oyster Shell), Wei Jiang (Roasted Ginger), Da Zao (Jujube).
Fourth visit: Chong Qi fills/seals, pathogen sinks causing dysentery, condition is not light/small. Use Xie Xin Fa (Drain Epigastrium Method).
Ren Shen (Ginseng), Dan Gan Jiang (Pale Dried Ginger), Shu Fu Zi (Prepared Aconite), Chuan Lian (Coptis Rhizome), Huang Qin (Scutellaria Root), Zhi Shi (Immature Bitter Orange).
Fifth visit: Ren Shen (Ginseng), Dan Gan Jiang (Pale Dried Ginger), Sheng Di Huang (Raw Rehmannia), Chao Tao Ren (Stir-fried Peach Kernel).
**Case 32**
Patient Zhang, Qi decline heat hiding, abdominal pain dysentery, epigastric fullness, no desire to eat. From Malaria transforming to Dysentery, meridian pathogen enters Fu. This disease condition is already heavy. Clear/drain damp-heat to open fullness. Extended long time must support Zheng (Righteous Qi).
Dan Huang Qin (Pale Scutellaria Root), Chuan Lian (Coptis Rhizome), Ren Shen (Ginseng), Sheng Bai Shao (Raw White Peony Root), Gan Jiang (Dried Ginger), Zhi Shi (Immature Bitter Orange).
**Case 33**
Patient, pathogen sinks after Malaria transforming to dysentery, injures Jue Yin. Symptoms see Qi hitting heart, hungry cannot eat, dry heaving abdominal pain. All Liver disease. Liver is extreme Yin organ, Minister Fire resides internally. Zhong Jing's (Zhang Zhongjing) treatment method does not use pure rigid/drying-hot medicines, because Liver is rigid organ. Now just meeting Earth prosperous time, Wood/Earth are enemies. Five days inside not yet stable.
Ren Shen (Ginseng), Chao Dang Gui (Stir-fried Angelica Sinensis), Chao Bai Shao (Stir-fried White Peony Root), Chao Wu Mei Rou (Stir-fried Mume Flesh), Fu Ling (Poria), Dan Wu Yu (Evodia Fruit), Sheng Xiang Fu Zhi (Fresh Cyperus Juice), Zhen Bei Qin Pi (True Fraxinus Bark).
**Case 34**
Patient Sun, dysentery without residue, anal prolapse, intestines gurgling sound. This belongs to Chang Feng (Intestinal Wind). Should use Securing/Consolidating. (Intestinal Wind)
Shu Di Tan (Charred Prepared Rehmannia), Yu Rou Tan (Charred Cornus Fruit), Chao Gui Shen (Stir-fried Angelica Sinensis Body), Chao Qi Zi (Stir-fried Goji Berry), Chuan Duan (Dipsacus Root), Bei Wei Rou (Schisandra Berry).
Decoct medicine to send Chi Shi Zhi Wan (Red Halloysite Pill) 3 qian.
**Case 35**
Patient, previous year long dysentery, used San Shen Wan (Three Gods Pill) got effect. Is Spleen/Kidney dual cause, concurrently regulates Qi branch stagnation. Constitution Yang deficiency, meets cold disease adds. Now disease starts Late Summer, Xiao Shui (urination) blocked, must be Summer Heat blocking transformation. Long time then Qi/Blood congeal becoming Chang Hong (Intestinal Redness/Bleeding). First give Gui Ling Gan Lu Yin (Cinnamon-Poria Sweet Dew Drink) to separate/drain dampness.
Yu Zhu (Atractylodes Macrocephala), Fu Ling (Poria), Zhu Ling (Polyporus), Ze Xie (Alisma Rhizome), Hua Shi (Talcum), Gui Xin (Cinnamon Heart).
**Case 36**
Patient Bao (Jin Kou Li - Mouth-Locked Dysentery):
Chuan Lian (Coptis Rhizome), Ren Shen (Ginseng), Huang Qin (Scutellaria Root), Bai Shao (White Peony Root), Cao Jue Ming (Apocynum Seed?), Chao Shan Zha (Stir-fried Hawthorn), Chao Yin Hua (Stir-fried Honeysuckle Flower).
Second visit: Jin Kou Li (Mouth-Locked Dysentery), is Heat Qi rising from below upwards, offending Stomach Gate. Intestine transmission all reversed/obstructed like closure. Abdominal pain lower especially severe. Xiang Lian Mei Shao (Aromatic-Link-Mume-Peony), only宣 (disperse) Middle Jiao, failed to drain lower heat burning. If not urgently clearing, Yin fluids perish together. Briefly clarify principle, wait for experts to collect. Bai Tou Weng Tang (Pulsatilla Decoction).
Third visit: Pulse Left fine, Number Right stringy. Dry heaving cannot accept grain. Abdominal pain urgency/tenesmus, dysentery residue not smooth. This Summer-Damp deeply penetrates attaching to Fu, condition belongs to Jin Kou Li (Mouth-Locked Dysentery), symptom not trivial. Discuss using Bitter-Cold to clear/resolve heat toxin. Must pain relieve Stomach open, then avoid fainting change.
Chuan Lian (Coptis Rhizome), Gan Jiang (Dried Ginger), Huang Qin (Scutellaria Root), Yin Hua (Honeysuckle Flower), Chao Shan Zha (Stir-fried Hawthorn), Bai Shao (White Peony Root), Mu Xiang Zhi (Aucklandia Juice).
Fourth visit: Afternoon disease severe, is Yin Qi consumption sign. If only Yin-soft, fear life generation not arrive. Scatter/Tonify Stomach medicine, right to advance Shang (Merchant/Metal?).
Sheng Di Huang (Raw Rehmannia), E Jiao (Donkey-hide Gelatin), Ren Shen (Ginseng), Sheng Bai Shao (Raw White Peony Root), Chao Shan Zha (Stir-fried Hawthorn), Chao Yin Hua (Stir-fried Honeysuckle Flower).
**Case 37**
Patient Jiao, initial no chills/fever, immediately diarrhea/dysentery vomiting/nausea no eating, is Jin Kou Li (Mouth-Locked Dysentery) heavy disease. Summer pathogen injury, from mouth/nose inhaling Qi enters, pathogen mixes with food/water, steams/transforms damp-heat, brews into residue pus-blood, intestinal-stomach Qi blocks, wants resolve cannot pass smoothly, thus leading to interior knotting tenesmus. Xiang Lian bitter-acrid, regulates Qi guides damp clears heat, initial use quite correct. All because laborious person, not rich/greasy nourished constitution, bland accumulation labor, Middle Qi easily injured. Forty days passed, residue less pain relieves, doctor calls disease resolved, but food cannot swallow, know not hunger/fullness, diagnose pulse stringy, form decline, tongue white, no thirst drinking, daily diarrhea several times, all belongs to Stomach reversal Qi snatching, Middle Palace damage extreme, Lower Gate not securing, grain cannot swallow, how can bear soup medicine? Medicine taste Qi inferior, Stomach decline must dislike. Long dysentery long diarrhea, must be able to eat. Ancients either wake Spleen/Stomach, or calm Kidney secure/grasp. Again ask powder paste swallowing, or choke or block. Discuss Upper Jiao should pass its Clear Yang, Lower Jiao should secure its sliding escape. Imitate ancient formula Zhong Jing Bai Zhu San end, should use rice drink daily serve twice, between non-greasy smooth things, eat little not much, show Stomach likes as tonification, must get Stomach Qi gradually wake, then have turn danger to peace.
Ren Shen (2 qian), Jiao Zhu (Scorched Atractylodes) (1.5 qian), Fu Ling (Poria) (1.5 qian), Zhi Cao (Honey-fried Licorice) (0.5 qian), Chao Bian Dou (Stir-fried Lablab Bean) (2 qian), Yi Ren (Coix Seed) (1.5 qian).
Jie Geng (Platycodon Root) (1 qian), Sha Ren (Amomum Fruit) (0.7 qian stir-fried), Pao Jiang Tan (Charred Prepared Ginger) (1 qian), Rou Dou Kou (Nutmeg) (1 qian).
Above medicines grind fine, weigh accurate points. Each time use Fragrant Rice Drink Soup mix serve 1.5 qian. Above medicines must daily enter twice.
**Case 38**
Patient Bao, tongue center yellow, edge white, thirst drinking, water/paste stops Stomach House, dry heaving slight cold hiccups, self-dysentery thin water, urination not beneficial. Diagnose pulse firm-forceful not harmonious, eighty-two years. Summer-Heat-Damp pathogen internally attaches, must Spleen-Stomach Qi wake, then can endure. Because high age dare not over-clear over-drain, use Qing Shu Yi Qi method.
Chuan Lian (Coptis Rhizome), Huang Qin (Scutellaria Root), Shi Lian Zi (Stone Lotus Seed), Wei Gan Ge (Roasted Kudzu Root), Qing Pi (Green Tangerine Peel), Ren Shen (Ginseng), Fu Ling (Poria), Nong Po (Magnolia Bark), Zhu Ling (Polyporus), Ze Xie (Alisma Rhizome).
Second visit: Mouth dry, Xiao Shui (urination) completely none, spring source already exhausted, Yin fluids unable to ascend. Dysentery symptom Jin Kou (Mouth-Locked), all are Damp-Heat congesting Stomach Gate, Lower Origin decline fatigue, Chong Mai Qi shakes high protrusion, this attack disease protect True, principle hard to grasp.
Chuan Lian (Coptis Rhizome), Huang Qin (Scutellaria Root), Cao Jue Ming (Apocynum Seed?), Shi Lian Zi (Stone Lotus Seed), Wu Mei (Mume Fruit), Bai Shao (White Peony Root).
Dysentery symptom, ancient name Zhi Xia (Stagnant Down), only Summer/Autumn Summer-Damp carrying residue mostly. Next then Wind淫 Fire force Cold invade. Push Dryness Qi, alone not harm. Examine former methods, all have fixed examples, need not repeat. As for Summer, has Yin Summer Yang Summer source, its pathogen must combine with Damp. Yin Summer because person's Yang Qi first deficient, plus greedy cool like cold, depressed fold generates Yang, so main on Warm. Yang Summer because Heaven's Heat hides, blocks Qi transformation turbid, then heavy on Clear. And Doctor's manual skill, here must carefully identify. But pathogen comes, like water flows, Zang-Fu between, once has gap, then takes advantage of deficiency and attaches, so has in Qi in Blood division, injures Zang injures Fu difference. If exterior pathogen depression, and Qi mechanism flows down incessantly, Yu Shi discusses Ren Shen Bai Du San (Ginseng Detoxication Powder). Interior residue congestion, and cold/heat stick together, Jie Gu Li Shao Yao Tang (Peony Decoction). In Qi branch, has Bitter-Acid regulate Qi, and Acrid-Sweet benefit Qi etc methods. In Blood branch, has Sour-Bitter move Blood, and Salty-Soft nourish Blood various formulas. If exterior symptom urgent, follow Three Yang, has Gui Zhi Tang (Cinnamon Twig Decoction), Ge Gen Qin Lian Tang (Kudzu-Skullcap-Honeysuckle Decoction), Xiao Chai Hu Tang (Minor Bupleurum Decoction). Interior situation solid, specifically investigate Spleen/Stomach, has Xiao Cheng Qi Tang (Minor Order the Qi Decoction), Wen Pi Tang (Warm Spleen Decoction). Generally, treat Fu rely on Three Jiao visible symptoms as proof, treat Zang rely on Foot Three Yin as key. Differentiate get Xu/Shi situation, consider with or Tong (unblock) or Sai (stop) method, then clinical discretion, probably not wrong. But this symptom not treat items very many, hardest to cure, nothing like Rest Dysentery, Gong/Bu (Attack/Tonify) methods not one, I also not add. Most dangerous, nothing like Jin Kou Li (Mouth-Locked Dysentery), yet has two ends. If because Summer-Damp pathogen fill, reject Three Jiao, Qi mechanism all reverse transmit and close, Upper/Lower situation,浑如 (totally like) two sections. If treat not get its key, then pathogen no exit, Zheng (Righteous Qi) immediately consumes. This Dan Xi legislation highest, later generations all respect its intent. Mr. again borrows Ban Xia Xie Xin Tang (Pinellia Drain Epigastrium Decoction), reduce Shou Zhong (Guard Middle) products, take tonify to move it, Acrid to open it, Bitter to descend it, with disease condition especially appropriate. So Mr.'s view long, is collection's mystery, often here. Again because Spleen/Kidney Yang usually deficient, Yin pathogen from middle downward, first injures Tai Yin, next injures Shao Yin, gate opens wide, pain diarrhea unlimited, Wu-Gui (Earth-Water) little transform fire mechanism, Ming Yang no steam-transform power, this not hungry not eat, vomit distend, principle should be so. Compare with pathogen much accumulate heat condition, absolutely different. Refer to Zhong Jing Li Zhong Tang (Regulate Middle Decoction), Shen Qi Wan (Kidney Qi Pill), and Jing Yue Li Yin Jian (Replenish Yin Decoction), Wei Guan Jian (Stomach Gate Decoction) etc methods can. My hometown Yao Yi Zhen Mr., transforms out fast good method, with large dose Cong Rong (Cistanche), match enter Ren Gui Jiang Fu Gui Zhi Bai Shao etc treat it, none not handle hand and cure. Think Cong Rong nature, Warm can reach down, Salty can benefit Stomach, substance soft-moist, to tonify Yang inside Yin, compared Di Huang E Jiao even superior, with it intestine paste exhausted, collaterals vessels knotted-seize and pain, worthy call divine product. Since then expand, use treat very many. If say certain formula certain medicine, only treat certain symptom, know not live use, opposite call fabrication, then forbid cut later generation flexible heart, from nowhere exert. (Shao Xin Fu comment)
Xu Comment: Summer/Autumn dysentery, total by Damp-Heat residue stagnation, with Shang Han (Cold Damage) transmit Three Yin dysentery different. Case matches law also very many. Once meet old age and long dysentery, immediately mix enter Yin Meridian treatment method, and Shen Fu Wu Mei Wu Wei Zi etc, all not against symptom, random book write, and with case middle theory, also self-oppose. Think is habit makes so, or this middle really no fixed view. Later people竟然 (actually) use Warm Tonification, think base of this old man, kill people countless, touch eye hurt heart.