痢赤属血，白属气。有身热、后重、腹痛、下血。身热挟外感，小柴胡汤去人参。
后重积与气坠下之故，兼升兼消，宜木香槟榔丸之类。不愈者，用秦艽、皂角子、煨大黄、当归、桃
仁、
虚
氏之法下之，虚则以苦梗开之，然后用治痢药。气用气药，血用血药。有热，用黄芩、芍药之
类；无热腹痛，或用温药姜、桂之属。下血四物为主。下血多主食积与热，或用朴硝者。青
六丸治血痢效。痢疾初得一二日间，以利为法，切不可便用止涩之剂。苦实者，调胃承气、
大小承气、三乙承气下之，有热先退热，然后看其气病血疾，加减用药，不可便服参术。
然气虚者可用，胃虚者亦用之。血痢久不愈者，属阴虚，四物汤为主，凉血和血，当归、
桃仁之属；下痢久不止，发热者，属阴虚，用寒凉药，必兼升散药并热药；下痢大孔痛者，因
热流于下也，以木香、槟榔、黄连、黄芩、炒干姜
；噤口痢者，胃口热甚故也，大虚大热，用香连丸、连肉各一半，共为末，米汤调下。
又方
人参二分，姜炒黄连一分，为末浓煎，终日细细呷之，如吐则再服，但一呷下咽便开。
人
少许。 脐内。下痢不治之症，下如鱼脑者，半死半生；下如尘腐色者，
死；下纯血者，死；下
如屋漏水者，死；下如竹筒注者，不治。赤痢乃自小肠来，白痢乃自大肠来，皆湿热为本，
赤
热。《内经》所谓身热则死，寒则生，此是大概言，必兼证详之方可。今岂无身热而生，寒
而死者？脉沉小
十治，或解表，或利小便，或待其自已，还分易治难治不治之证，至为详密。但与泻同，立
论不分，学人当辨之。大抵痛，一曰温之，一曰清之。按久病身冷，脉沉小者，宜温；暴病身
服，脉浮洪者，宜清、宜补。有可吐者，亦有可汗可下者。初得之时，元气未虚，必推荡之
，此
脓血，此脾传肾，贼邪难愈；先脓血，胜水泻，此肾传脾，微邪易愈。下痢如豆汁者湿也，盖
脾
者，
家之内，上下传染相似，却宜明逆气之胜复以治之。
戴云∶痢虽有赤白二色，终无寒热之分，通作湿热治。但分新旧，更量元气用药，与赤
白带同。
入方
黄连 滑石 生地黄 白芍 苍术 白术 当归 青皮 条芩
上锉。水煎。里急后重，炒连、滑石，加桃仁、槟榔。甚
者，大黄；呕者，用姜汁、半夏。
又方
干姜（一钱） 当归（二钱半） 乌梅（三个） 黄柏（一钱半）黄连
上锉。作一服，水煎，食前。若水泻，可等分用，
又方 治热与血。
大黄 黄连 黄芩 黄柏 枳壳 当归 芍药 滑石 桃仁 甘草 白术（等分）
上为末。或汤调，或作丸。用面糊或神曲糊丸服。
一本云∶误服热药涩药，毒犯胃者，当明审以祛其毒。
治白痢
苍术 白术 神曲 茯苓 地榆 甘草
上锉。水煎。
治赤痢
地黄 芍药 黄柏 地榆 白术
上锉。水煎。腹痛，加枳壳、浓朴；后重，加滑石、木香
、槟榔；有热，加黄芩、山栀。
又治痢方
滑石（一两） 苍术（半两） 川芎（三钱） 桃仁（活法用） 芍药（半两，炒） 甘草（一钱）
上为末。姜一片，擂细煎滚服。
又方 孙郎中因饮水过多，腹胀，泻痢带白。
苍术 白术 浓朴 茯苓 滑石
上 咀。水煎，下保和丸。又云∶加炒曲、甘草。
又方 痢后脚弱渐细者。
苍术 酒芩 白芍（各二两半）酒柏（炒，半两）
上为末，粥丸。以四物汤加陈皮、甘草水煎，送下。
又方 痢后腰痛，两脚无力。
陈皮 半夏 白芍（各一钱） 茯苓 苍术 当归 酒芩（各半钱） 白术 甘草（各二钱）
上 咀。作一服，姜煎，食前。
又方 治小儿八岁，下痢纯血，作食积治。
苍术 白术 黄芩 滑石 白芍 茯苓 甘草 陈皮 神曲（炒）
上 咀。水煎，下保和丸。
治痢十法
其或恶寒发热，身首俱痛，此为表症，宜微汗和解，用苍术、川芎、陈皮、芍药、甘
草、生
姜三片煎。其或腹痛后重，小水短，下积，此为里症，宜和中疏气，用炒枳壳、制浓朴、
芍药、陈皮、滑石、甘草煎。其或下坠异常，积中有紫黑血，而又痛甚，此为死血证，法
当用擂
细桃仁、滑石行之。或口渴及大便口燥辣，是名挟热，即加黄芩；或口不渴身不热，喜
热手熨荡，
是名挟寒，即加干姜。其或下坠在血活之后，此气滞症，宜于前药加槟榔一枚。其或在下
则
补，毒解积下，食自进。其或力倦，自觉气少，恶食，此为挟虚证，宜加白术、当归身
，虚甚者加人参，又十分重者，止用此一条，加陈皮补之，虚回而利自止。其或气行血和
积少，但虚坐努责，此为无血症，倍用当归身尾，却以生芍药、生地黄、生桃仁佐之，复以
陈皮
甘
此汤，固肠丸未宜进用，盖固肠丸有去湿实肠之功。其或利后，糟粕未实，或食粥稍多，
或饥甚方食，腹中作痛，切不可惊恐，当以白术、陈皮各半，煎汤和之，自安。其或久痢后
，体虚气弱，滑下不止，又当以药涩之，可用诃子、肉豆蔻、白矾、半夏，甚者添牡蛎，可择
用之。然须用陈皮为佐，恐大涩亦能作痛。又甚者，灸天枢、气海。上前方用浓朴，专泻滞
凝之气。然浓朴性大温而散气，久服大能虚人，滞气稍行，即去之，余滞未尽，则用炒枳壳
、陈皮，然枳壳亦能耗气，比之朴稍缓，比陈皮稍重。滞气稍退，当去之只用陈皮以和众药
，然陈皮去白有补泻之功，若为参术之佐，亦纯作补药用。凡痢疾腹痛，必以白芍药、甘草
为君，当归、白术为佐。恶寒痛者，加桂；恶热痛者，加黄柏。达者更能参以岁气时令用药，
则万举万全，岂在乎执方而已哉！
〔附录〕痢有气虚兼寒热，有食积，有风邪，有热有湿，有阳气下陷，而感受不一，当分
治。泻轻
痢重，诸有积以肚热缠痛推之，诸有气以肚如蟹渤验之，究其受病之源，决之对病之剂
。大要以散风邪，行滞气，开胃脘为先，不可遽用肉豆蔻、诃子、白术辈以补住寒邪，不可投米
壳、龙骨辈以闭涩肠胃。邪得补而愈盛，故证变作，所以日夕淹延而未已也。若升散者，
以胃风汤、防风芍药汤、神术散、苍术防风汤、败毒散，皆可汗之。攻里若有湿者，
用导水丸、兼郁承气汤、和中丸；若积滞用圣饼子、脾积丸；冷积用《局方》苏感丸；若湿
热甚
者，宜《宣明》玄青膏；若后重窘迫，用木香槟榔丸。色白者，属气；赤白者，属气血受病
；赤黑相
兼，属湿热；青绿杂色，是风与火湿。下血者，当凉血，当归、生地黄。赤者属血，《保命
集》
四物汤，和槐花、黄连、米壳醋炒。下利，脉沉弱而腹痛，用姜附汤，加对五苓理中。又机要浆水散若
青色者
外贴
大过，饮食伤脾，为脾泄，《机要》白术芍药汤。湿胜，仙术炒用。若阴阳不分，当渗泄以五
苓之类，或单用苤苡实炒为末，米饮调二钱
。若气血俱虚，神弱者，以人参、白术、当归、芍药、炒茯苓，少加黄连服之，或钱氏白
散，又或十补汤佳。若暑痢而脉虚者，香薷饮，或清暑益气，又或六和汤、藿香正气各加
木香半钱，名木香交加散。若白痢下如冻胶，或鼻涕，此属冷痢，宜除湿汤加木香一钱。虚
弱者，亦与十补汤。赤痢发热者，以败毒散加陈仓米一撮煎。下痢小便不通者，黄连阿胶丸
附方
胃风汤 治风冷入于肠胃，泄下鲜血，或肠胃湿毒，下如豆汁或瘀血。
人参 茯苓 川芎 当归 桂 白术 白芍（等分）
上锉。水煎入粟米百余粒同煎。腹痛，加木香。
噤口痢
石莲肉（日干）
上为末。服二钱，陈仓米汤调下，便觉思食。使以日照东方壁土炒真橘皮为末，
姜枣略煎佐之。
戴人木香槟榔丸
木香 槟榔 青皮 陈皮 广术 枳壳 黄连 黄柏 大黄（各半两） 丑末 香附（各二两）
上为末，木丸梧子大。每五六十丸，煎水下，量虚实与之。《绀珠》多三棱
、黄芩、当归，分两不同。
调胃承气汤
芒硝（半斤） 甘草（炙，二两） 大黄（四两，去皮，酒洗）
上锉。每服，临期斟酌多少，先煮二味熟，
去渣，下硝，上火煮二三沸，顿服之。
大承气汤
大黄（四两，如棋子大，酒洗） 浓朴（八两，姜制） 枳实（大者，五枚，炒） 芒硝（二合）
每服看证斟酌多少，先煮二物至七分，去渣；纳大黄，煮八分，去渣，纳芒硝，
煎一二沸，温服。
小承气汤
大黄（四两） 浓朴（二两，姜炒） 枳实（大者，三枚，炒）
上锉。看证斟酌多少用之。
防风芍药汤
防风 芍药 黄芩（各二两）
上 咀。每服半两，水煎温服。
神术散
苍术（一斤） 本 川芎（各六两） 羌活（四两） 粉草 细辛（一两六钱）
上为粗末。每服三钱，姜三片煎。要出汗，加葱白。
苍术防风汤
苍术（二两） 防风（一两）
姜七片煎。
败毒散
羌活 独活 人参 甘草（炙） 柴胡 前胡 茯苓 枳壳（麸炒） 川芎 桔梗（等分）
上锉。每服四钱，水一盏，姜三片，薄荷五叶煎。热
服，寒多则热服，热多则温服。伤湿，加白术；脚痛，加天麻。
神芎导水丸
大黄 黄芩（二两） 丑末 滑石（四两）
上为末，滴水丸。每四五十丸，温水下。
和中丸
白术（二两，四钱） 浓朴（二两） 陈皮（一两，六钱） 半夏（泡，一两） 槟榔（五钱） 枳实
（五钱） 甘草（四钱） 木香（二钱）
上用生姜自然汁浸，蒸饼为丸。每三十丸，温水下，食远。
圣饼子
黄丹（二钱） 定粉（三钱） 密陀僧（二钱） 舶上硫黄（三钱） 轻粉（少许）
上为细末，入白面四钱，滴水和为指尖大，捻作饼子，阴干。食前，浆水磨化服之，大
便黑色为妙。
苏感丸
以苏合香丸与感应丸二药和匀，如粟米大。每五丸，淡姜汤空心下。
《宣明》玄青膏
黄连 黄柏 大黄 甘遂 芫花（醋拌炒） 大戟（各半两） 丑头末（二两） 轻粉（二钱） 青黛（一两）
上为末，水丸小豆大。初服十丸，每服加十丸，日三，以快利为度。
《保命集》四物汤
本方内加槐花、黄连、御米壳等分。
姜附汤 理中汤 并见中寒类。
五苓散 见中暑类。
浆水散
半夏（一两，汤洗） 附子（半两，炮） 干姜（一作干生姜） 桂 甘草（炙，各五钱） 良姜（二钱
上为细末。每服三五钱，浆水二盏，煎至半盏，和滓热服。
升阳益胃汤
羌活 独活 防风（各半两） 柴胡 白术 茯苓（渴勿用） 泽泻（各三钱） 黄 （二两） 人参
半夏 甘草（炙，各一两） 黄连（一钱） 陈皮（四钱） 白芍（五钱）
上 咀。每服三钱，水煎，入姜枣，温服。
曲芎丸
川芎 神曲 白术 附子（炮，等分）
上为细末，面糊丸，梧子大。每服三五十丸，温米饮下。此药亦治飧泄。
《机要》白术芍药汤
白术 芍药（各一两） 甘草（五钱）
上锉。每服一两，水煎。
钱氏白术散
人参 白茯苓 白术 木香 甘草 藿香（各一两） 干姜
上为粗末。水煎。
香薷饮 清暑益气汤 并见中暑类。
六和汤 见霍乱类或加香薷浓朴。
藿香正气散 见中风类。
黄连阿胶丸
阿胶（炒，二两） 黄连（三两） 茯苓（二两）
上水熬阿胶膏，溲和二末为丸。米饮下。
固肠丸 见妇人类。
除湿汤 见泄泻类。
十全大补汤 见诸虚类。
Dysentery with red stool belongs to blood pathology, while white stool belongs to Qi pathology. If accompanied by fever, tenesmus (feeling of incomplete defecation), abdominal pain, and hematochezia, the fever indicates an external pathogenic invasion; Xiao Chai Hu Tang (Minor Bupleurum Decoction) without Ren Shen (Ginseng Radix) should be used.
Tenesmus is caused by accumulation and sinking of Qi; treatment should combine lifting and resolving methods, suitable for Mu Xiang Bing Lang Wan (Aucklandia and Areca Nut Pill). If ineffective, Qin Jiao (Gentianae Macrophyllae Radix), Zao Jiao Zi (Gleditsiae Sinensis Spina Fructus), Wei Da Huang (Prepared Rhizoma et Radix Rhei), Dang Gui (Angelicae Sinensis Radix), and Tao Ren (Persicae Semen) are used, following Liu Wansu's method of purging. For deficiency patterns, Jie Geng (Platycodonis Radix) is used to open the Lung Qi, followed by dysentery-specific medications. Qi disorders are treated with Qi-regulating herbs, and Blood disorders with Blood-nourishing and Blood-invigorating herbs. If heat signs are present, Huang Qin (Scutellariae Radix) and Shao Yao (Paeoniae Radix) are used; if there is no heat but abdominal pain, warming herbs like Jiang (Zingiberis Rhizoma) and Gui (Cinnamomi Cortex) are appropriate. Hematochezia is primarily treated with Si Wu Tang (Four Substances Decoction). Excessive bleeding is often due to food stagnation and heat, sometimes requiring Po Xiao (Natrii Sulfas). Qing Liu Wan is effective for bloody dysentery. In the first one or two days of dysentery onset, purgation is the standard approach; astringents should never be used immediately. For excess patterns, Tiao Wei Cheng Qi Tang (Regulate the Stomach and Order the Qi Decoction), Da Cheng Qi Tang (Major Order the Qi Decoction), or San Yi Cheng Qi Tang can be used for purging. If heat is present, clear it first, then assess whether the disorder involves Qi or Blood before adjusting medications; do not use Ren Shen (Ginseng Radix) or Bai Zhu (Atractylodis Macrocephalae Rhizoma) immediately. However, they may be used for Qi deficiency or Stomach deficiency. Chronic bloody dysentery that does not heal belongs to Yin deficiency; Si Wu Tang (Four Substances Decoction) is the main formula, using cooling and harmonizing Blood herbs like Dang Gui (Angelicae Sinensis Radix) and Tao Ren (Persicae Semen). Chronic diarrhea with fever belongs to Yin deficiency; cold-natured herbs should be combined with lifting/dispersing and warming herbs. Anal pain during dysentery is due to heat flowing downward; treat with Mu Xiang (Aucklandiae Radix), Bing Lang (Arecae Semen), Huang Lian (Coptidis Rhizoma), Huang Qin (Scutellariae Radix), and Chao Gan Jiang (Fried Zingiberis Rhizoma). For Jin Kou Li (Anorexic Dysentery/Inability to eat), caused by severe Stomach heat representing extreme deficiency and heat, Xiang Lian Wan (Costus and Coptis Pill) and Rou Dou Kou (Myristicae Semen) in equal parts, powdered and taken with Rice Decoction, are used.
Another prescription: Ren Shen (Ginseng Radix) 2 fen, Jiang Chao Huang Lian (Ginger-fried Coptidis Rhizoma) 1 fen, powdered and decocted strongly; sip slowly throughout the day. If vomiting occurs, administer again; once swallowed, appetite will return.
Umbilical pain. Dysentery presenting as "fish brain" stool is half-dead, half-alive; "dust-rot" color stool indicates death; pure blood stool indicates death; "leaking roof" water-like stool indicates death; "bamboo tube" pouring stool is untreatable. Red dysentery originates from the Small Intestine, white dysentery from the Large Intestine; both are fundamentally damp-heat, with red indicating more heat. The *Neijing* states "fever leads to death, cold leads to survival," which is a general rule; specific symptoms must be analyzed carefully. Are there cases of survival with fever or death with cold? With a deep, small pulse, seven out of ten treatments are curable; options include releasing the exterior, promoting urination, or waiting for self-resolution. Differentiate easy, difficult, and untreatable cases meticulously. Dysentery and diarrhea are often conflated; students must distinguish them. Generally, abdominal pain requires either warming or clearing. Chronic cold body with deep/small pulse requires warming; acute hot body with floating/hong pulse requires clearing and tonifying. Some cases require emesis, sweating, or purging. Early stage with intact Yuan Qi requires pushing out stagnation.
If pus/blood appears first, then watery diarrhea, this is Spleen transmitting to Kidney (evil difficult to cure); if watery diarrhea appears first, then pus/blood, this is Kidney transmitting to Spleen (mild evil easy to cure). Bean-juice-like stool indicates dampness, spreading internally; treat by analyzing rebellious Qi dynamics.
Dai Yuanli said: Dysentery has red and white colors but no fundamental cold/heat distinction; all are treated as damp-heat. Distinguish new vs. old and adjust based on Yuan Qi, similar to leukorrhea treatment.
Prescription 1: Huang Lian (Coptidis Rhizoma), Shi Gao (Gypsum Fibrosum - *Note: Text says Hua Shi likely, but literal is Shi Gao, context implies Hua Shi usually, sticking to text literal translation but noting standard term*), Sheng Di Huang (Rehmanniae Radix), Bai Shao (Paeoniae Radix Alba), Cang Zhu (Atractylodis Rhizoma), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Dang Gui (Angelicae Sinensis Radix), Qing Pi (Citri Reticulatae Pericarpium Viride), Tiao Qin (Scutellariae Radix). Decoct in water. For tenesmus, use fried Huang Lian and Hua Shi (Talcum), add Tao Ren (Persicae Semen) and Bing Lang (Arecae Semen). Severe cases add Da Huang (Rhei Radix et Rhizoma); vomiting add Jiang Zhi (Zingiberis Juice) and Ban Xia (Pinelliae Rhizoma).
Prescription 2: Gan Jiang (Zingiberis Rhizoma) 1 qian, Dang Gui (Angelicae Sinensis Radix) 2.5 qian, Wu Mei (Mume Fructus) 3, Huang Bo (Phellodendri Cortex) 1.5 qian, Huang Lian (Coptidis Rhizoma). Decoct in water, take before meals. For watery diarrhea, use equal parts.
Prescription 3: Treats Heat and Blood. Da Huang (Rhei Radix et Rhizoma), Huang Lian (Coptidis Rhizoma), Huang Qin (Scutellariae Radix), Huang Bo (Phellodendri Cortex), Zhi Ke (Aurantii Fructus), Dang Gui (Angelicae Sinensis Radix), Shao Yao (Paeoniae Radix), Hua Shi (Talcum), Tao Ren (Persicae Semen), Gan Cao (Glycyrrhizae Radix et Rhizoma), Bai Zhu (Atractylodis Macrocephalae Rhizoma) in equal parts. Powdered. Take as powder mixed with water or pills made with flour paste or Shen Qu (Medicated Leaven) paste.
Alternative note: If hot/astringent herbs were mistakenly taken causing stomach toxicity, identify and remove the toxin.
Treating White Dysentery: Cang Zhu (Atractylodis Rhizoma), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Shen Qu (Medicated Leaven), Fu Ling (Poria), Di Yu (Sanguisorbae Radix), Gan Cao (Glycyrrhizae Radix et Rhizoma). Decoct in water.
Treating Red Dysentery: Di Huang (Rehmanniae Radix), Shao Yao (Paeoniae Radix), Huang Bo (Phellodendri Cortex), Di Yu (Sanguisorbae Radix), Bai Zhu (Atractylodis Macrocephalae Rhizoma). Decoct in water. Add Zhi Ke (Aurantii Fructus) and Hou Po (Magnoliae Officinalis Cortex) for abdominal pain; add Hua Shi (Talcum), Mu Xiang (Aucklandiae Radix), Bing Lang (Arecae Semen) for tenesmus; add Huang Qin (Scutellariae Radix) and Shan Zhi Zi (Gardeniae Fructus) for heat.
Another Prescription: Hua Shi (Talcum) 1 liang, Cang Zhu (Atractylodis Rhizoma) 0.5 liang, Chuan Xiong (Ligustici Chuanxiong Rhizoma) 3 qian, Tao Ren (Persicae Semen) [use flexibly], Shao Yao (Paeoniae Radix) 0.5 liang (fried), Gan Cao (Glycyrrhizae Radix et Rhizoma) 1 qian. Powdered. Grind one slice of Sheng Jiang (Zingiberis Rhizoma) finely, decoct until boiling, and take.
Another Prescription: Dr. Sun drank too much water, causing abdominal distension and white dysentery. Cang Zhu (Atractylodis Rhizoma), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Hou Po (Magnoliae Officinalis Cortex), Fu Ling (Poria), Hua Shi (Talcum). Decoct in water, take with Bao He Wan (Preserve Harmony Pill). Also: add fried Shen Qu (Medicated Leaven) and Gan Cao (Glycyrrhizae Radix et Rhizoma).
Another Prescription: Weak legs thinning after dysentery. Cang Zhu (Atractylodis Rhizoma), Jiu Qin (Wine-processed Scutellariae Radix), Bai Shao (Paeoniae Radix Alba) each 2.5 liang, Jiu Bo (Wine-processed Phellodendri Cortex, fried) 0.5 liang. Powdered, pillified with congee. Take with Si Wu Tang (Four Substances Decoction) plus Chen Pi (Citri Reticulatae Pericarpium) and Gan Cao (Glycyrrhizae Radix et Rhizoma) decocted in water.
Another Prescription: Lower back pain and weak legs after dysentery. Chen Pi (Citri Reticulatae Pericarpium), Ban Xia (Pinelliae Rhizoma), Bai Shao (Paeoniae Radix Alba) each 1 qian, Fu Ling (Poria), Cang Zhu (Atractylodis Rhizoma), Dang Gui (Angelicae Sinensis Radix), Jiu Qin (Wine-processed Scutellariae Radix) each 0.5 qian, Bai Zhu (Atractylodis Macrocephalae Rhizoma), Gan Cao (Glycyrrhizae Radix et Rhizoma) each 2 qian. Decoct with ginger, take before meals.
Another Prescription: 8-year-old child with pure bloody dysentery, treated as food stagnation. Cang Zhu (Atractylodis Rhizoma), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Huang Qin (Scutellariae Radix), Hua Shi (Talcum), Bai Shao (Paeoniae Radix), Fu Ling (Poria), Gan Cao (Glycyrrhizae Radix et Rhizoma), Chen Pi (Citri Reticulatae Pericarpium), Shen Qu (Medicated Leaven, fried). Decoct in water, take with Bao He Wan (Preserve Harmony Pill).
Ten Methods for Treating Dysentery:
1. If aversion to cold, fever, head/body pain, this is Exterior Syndrome; induce mild sweating to harmonize, use Cang Zhu (Atractylodis Rhizoma), Chuan Xiong (Ligustici Chuanxiong Rhizoma), Chen Pi (Citri Reticulatae Pericarpium), Shao Yao (Paeoniae Radix), Gan Cao (Glycyrrhizae Radix et Rhizoma), Sheng Jiang (Zingiberis Rhizoma) 3 slices.
2. If abdominal pain, tenesmus, short urine, fecal accumulation, this is Interior Syndrome; harmonize middle and move Qi, use fried Zhi Ke (Aurantii Fructus), processed Hou Po (Magnoliae Officinalis Cortex), Shao Yao (Paeoniae Radix), Chen Pi (Citri Reticulatae Pericarpium), Hua Shi (Talcum), Gan Cao (Glycyrrhizae Radix et Rhizoma).
3. If severe prolapse with purple/black blood in stool and severe pain, this is Dead Blood Syndrome; use ground Tao Ren (Persicae Semen) and Hua Shi (Talcum) to move blood.
4. If thirst and burning anus, this is Accompanying Heat; add Huang Qin (Scutellariae Radix). If no thirst/heat but preference for warmth, this is Accompanying Cold; add Gan Jiang (Zingiberis Rhizoma).
5. If prolapse persists after blood circulation, this is Qi Stagnation; add one Bing Lang (Arecae Semen) to previous formulas.
6. Tonify lower Jiao, resolve toxin, clear accumulation, restore appetite.
7. If fatigue, shortness of breath, anorexia, this is Accompanying Deficiency; add Bai Zhu (Atractylodis Macrocephalae Rhizoma) and Dang Gui Shen (Ginseng Radix part of Angelicae Sinensis Radix). Severe deficiency adds Ren Shen (Ginseng Radix). Very severe cases use only this line with Chen Pi (Citri Reticulatae Pericarpium) to tonify; when Qi returns, diarrhea stops.
8. If Qi moves, Blood harmonizes, accumulation reduces, but false urge to defecate without stool (No-Blood Syndrome), double Dang Gui Shen/Tail, assist with raw Shao Yao (Paeoniae Radix), raw Sheng Di Huang (Rehmanniae Radix), raw Tao Ren (Persicae Semen), and Chen Pi (Citri Reticulatae Pericarpium)... [Text fragment]. Gu Chang Wan (Solidify Intestine Pill) is not yet suitable as it dries dampness and solidifies intestines.
9. After diarrhea, if stools are unformed, overeating porridge, or eating when very hungry causes pain, do not panic; use equal parts Bai Zhu (Atractylodis Macrocephalae Rhizoma) and Chen Pi (Citri Reticulatae Pericarpium) decocted to harmonize.
10. If chronic dysentery leads to weakness and continuous slipping, use astringents like He Zi (Terminalia Chebulae Fructus), Rou Dou Kou (Myristicae Semen), Bai Fan (Alumen), Ban Xia (Pinelliae Rhizoma). Severe cases add Mu Li (Ostreae Concha). Use Chen Pi (Citri Reticulatae Pericarpium) as assistant to prevent pain from excessive astringency. Severe cases moxa Tian Shu (ST25) and Qi Hai (CV6).
Previous formula uses Hou Po (Magnoliae Officinalis Cortex) to purge stagnant Qi. Hou Po is warm and disperses Qi; long-term use damages Qi. Remove when Qi moves slightly; if residual stagnation remains, use fried Zhi Ke (Aurantii Fructus) and Chen Pi (Citri Reticulatae Pericarpium). Zhi Ke consumes Qi but less than Hou Po, heavier than Chen Pi. When stagnation recedes, use only Chen Pi (Citri Reticulatae Pericarpium) to harmonize. Chen Pi without peel has tonifying/draining functions; as assistant to Ren Shen/Bai Zhu, it acts purely as a tonic. For dysentery abdominal pain, always use Bai Shao Yao (Paeoniae Radix) and Gan Cao (Glycyrrhizae Radix et Rhizoma) as Sovereign, Dang Gui (Angelicae Sinensis Radix) and Bai Zhu (Atractylodis Macrocephalae Rhizoma) as Ministers. Aversion-to-cold pain adds Gui (Cinnamomi Cortex); aversion-to-heat pain adds Huang Bo (Phellodendri Cortex). Wise practitioners adjust according to seasonal Qi for perfect results.
[Appendix] Dysentery varies by Qi deficiency with cold/heat, food stagnation, wind pathogen, heat/dampness, Yang Qi sinking. Differentiate treatment. Diarrhea is mild, dysentery is severe. Accumulation is diagnosed by hot, winding abdominal pain; Qi disorders by crab-bubble-like abdomen. Investigate source and prescribe accordingly. Prioritize dispersing wind, moving stagnant Qi, opening Stomach. Do not hastily use Rou Dou Kou (Myristicae Semen), He Zi (Terminalia Chebulae Fructus), Bai Zhu (Atractylodis Macrocephalae Rhizoma) to trap cold, nor Mi Ke (Papaveris Pericarpium), Long Gu (Fossilia Ossis Mastodi) to close intestines. Tonifying pathogens increases disease, causing prolongation. For lifting/dispersing, use Wei Feng Tang (Stomach Wind Decoction), Fang Feng Shao Yao Tang (Saposhnikovia and Paeonia Decoction), Shen Shu San (Divine Atractylodes Powder), Cang Zhu Fang Feng Tang (Atractylodes and Saposhnikovia Decoction), Bai Du San (Resist Toxin Powder) to sweat. For interior attacking with dampness, use Dao Shui Wan (Guide Water Pill), Jian Yu Cheng Qi Tang (Combined Stagnation Order Qi Decoction), He Zhong Wan (Harmonize Middle Pill); for stagnation, use Sheng Bing Zi (Holy Cake), Pi Ji Wan (Spleen Accumulation Pill); for cold stagnation, Ju Fang Su Gan Wan (Formulary Su-Gan Pill); for severe damp-heat, Xuan Qing Gao (Dark Green Ointment) from *Xuan Ming*; for tenesmus, Mu Xiang Bing Lang Wan (Aucklandia and Areca Nut Pill). White color belongs to Qi; red-white to Qi/Blood; red-black to damp-heat; green/mixed to wind/fire/damp. Bleeding requires cooling Blood with Dang Gui (Angelicae Sinensis Radix) and Sheng Di Huang (Rehmanniae Radix). Red belongs to Blood; *Bao Ming Ji* Si Wu Tang (Four Substances Decoction) with Huai Hua (Sophorae Flos), Huang Lian (Coptidis Rhizoma), Mi Ke (Papaveris Pericarpium vinegar-fried). Diarrhea with deep/weak pulse and abdominal pain uses Jiang Fu Tang (Ginger and Aconite Decoction) plus Wu Ling San (Five-Ingredient Powder with Poria) and Li Zhong Tang (Regulate the Middle Decoction). Also Ji Yao Jiang Shui San (Essentials Grain Water Powder). If green, apply externally. Overeating damages Spleen, causing Spleen Diarrhea; *Ji Yao* Bai Zhu Shao Yao Tang (Atractylodes and Paeonia Decoction). Dampness excess uses Xian Zhu (Superior Atractylodes) fried. If Yin/Yang indistinct, drain with Wu Ling San (Five-Ingredient Powder with Poria) or Yi Yi Ren (Coicis Semen) fried/powdered with rice drink. Qi/Blood dual deficiency with spirit weakness uses Ren Shen (Ginseng Radix), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Dang Gui (Angelicae Sinensis Radix), Shao Yao (Paeoniae Radix), fried Fu Ling (Poria), slight Huang Lian (Coptidis Rhizoma), or Qian Shi Bai San (Qian's White Powder), or Shi Bu Tang (Ten-Tonify Decoction). Summer dysentery with weak pulse uses Xiang Ru Yin (Elsholtzia Decoction), Qing Shu Yi Qi Tang (Clear Summerheat Benefit Qi Decoction), Liu He Tang (Six-Harmony Decoction), or Huo Xiang Zheng Qi San (Agastache Rectify Qi Powder) plus Mu Xiang (Aucklandiae Radix) 0.5 qian (Mu Xiang Jia Jiao San). White dysentery like jelly/snot is Cold Dysentery; Chu Shi Tang (Remove Dampness Decoction) plus Mu Xiang (Aucklandiae Radix) 1 qian. Weakness uses Shi Bu Tang (Ten-Tonify Decoction). Red dysentery with fever uses Bai Du San (Resist Toxin Powder) plus Chen Cang Mi (Aged Rice) 1 pinch. Dysentery with urinary obstruction uses Huang Lian E Jiao Wan (Coptis and Donkey-Hide Gelatin Pill).
Attached Formulas:
Wei Feng Tang (Stomach Wind Decoction): Treats wind-cold in intestines/stomach, bloody diarrhea, or damp-toxin bean-juice/clot stool. Ren Shen (Ginseng Radix), Fu Ling (Poria), Chuan Xiong (Ligustici Chuanxiong Rhizoma), Dang Gui (Angelicae Sinensis Radix), Gui (Cinnamomi Cortex), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Bai Shao (Paeoniae Radix Alba) equal parts. Decoct with >100 millet grains. Add Mu Xiang (Aucklandiae Radix) for pain.
Jin Kou Li (Anorexic Dysentery): Shi Lian Rou (Nelumbinis Plumula) sun-dried. Powdered, 2 qian with aged rice water. Appetite returns. Use orange peel roasted on east-facing wall, ginger/jujube decoction as assistant.
Dai Ren Mu Xiang Bing Lang Wan (Dai Ren's Aucklandia and Areca Nut Pill): Mu Xiang (Aucklandiae Radix), Bing Lang (Arecae Semen), Qing Pi (Citri Reticulatae Pericarpium Viride), Chen Pi (Citri Reticulatae Pericarpium), Guang Zhu (Curcumae Radix), Zhi Ke (Aurantii Fructus), Huang Lian (Coptidis Rhizoma), Huang Bo (Phellodendri Cortex), Da Huang (Rhei Radix et Rhizoma) each 0.5 liang, Chou Mo (Strychni Semen), Xiang Fu (Cyperi Rhizoma) each 2 liang. Powdered, pill size of wu zi. 50-60 pills with decoction, adjust for deficiency/excess. *Gan Zhu* adds San Leng (Sparganii Rhizoma), Huang Qin (Scutellariae Radix), Dang Gui (Angelicae Sinensis Radix).
Tiao Wei Cheng Qi Tang (Regulate the Stomach and Order the Qi Decoction): Mang Xiao (Natrii Sulfas) 0.5 jin, Zhi Gan Cao (Honey-fried Glycyrrhizae Radix et Rhizoma) 2 liang, Da Huang (Rhei Radix et Rhizoma, peeled, wine-washed) 4 liang. Decoct first two, strain, add Mang Xiao, boil 2-3 boils, take at once.
Da Cheng Qi Tang (Major Order the Qi Decoction): Da Huang (Rhei Radix et Rhizoma, chess-piece size, wine-washed) 4 liang, Hou Po (Magnoliae Officinalis Cortex, ginger-processed) 8 liang, Zhi Shi (Immature Bitter Orange Fruit, large, fried) 5 pieces, Mang Xiao (Natrii Sulfas) 2 he. Decoct first two to 70%, strain, add Da Huang, boil to 80%, strain, add Mang Xiao, boil 1-2 boils, take warm.
Xiao Cheng Qi Tang (Minor Order the Qi Decoction): Da Huang (Rhei Radix et Rhizoma) 4 liang, Hou Po (Magnoliae Officinalis Cortex, ginger-fried) 2 liang, Zhi Shi (Immature Bitter Orange Fruit, large, fried) 3 pieces. Decoct, adjust dose per syndrome.
Fang Feng Shao Yao Tang (Saposhnikovia and Paeonia Decoction): Fang Feng (Saposhnikoviae Radix), Shao Yao (Paeoniae Radix), Huang Qin (Scutellariae Radix) each 2 liang. Decoct 0.5 liang portions, take warm.
Shen Shu San (Divine Atractylodes Powder): Cang Zhu (Atractylodis Rhizoma) 1 jin, Ben Cao (Ligustici Wallichii Rhizoma et Radix), Chuan Xiong (Ligustici Chuanxiong Rhizoma) each 6 liang, Qiang Huo (Notopterygii Rhizoma et Radix) 4 liang, Fen Cao (Licorice), Xi Xin (Asari Radix et Rhizoma) 1.6 liang. Coarse powder, 3 qian with 3 ginger slices. Add Cong Bai (Allii Fistulosi Bulbus) for sweating.
Cang Zhu Fang Feng Tang (Atractylodes and Saposhnikovia Decoction): Cang Zhu (Atractylodis Rhizoma) 2 liang, Fang Feng (Saposhnikoviae Radix) 1 liang. Decoct with 7 ginger slices.
Bai Du San (Resist Toxin Powder): Qiang Huo (Notopterygii Rhizoma et Radix), Du Huo (Angelicae Pubescentis Radix), Ren Shen (Ginseng Radix), Zhi Gan Cao (Honey-fried Glycyrrhizae Radix et Rhizoma), Chai Hu (Bupleuri Radix), Qian Hu (Peucedani Radix), Fu Ling (Poria), Fu Chao Zhi Ke (Bran-fried Aurantii Fructus), Chuan Xiong (Ligustici Chuanxiong Rhizoma), Jie Geng (Platycodonis Radix) equal parts. 4 qian with 1 cup water, 3 ginger slices, 5 mint leaves. Hot for cold dominance, warm for heat dominance. Add Bai Zhu (Atractylodis Macrocephalae Rhizoma) for dampness, Tian Ma (Gastrodiae Rhizoma) for leg pain.
Shen Xiong Dao Shui Wan (Divine Xiong Guide Water Pill): Da Huang (Rhei Radix et Rhizoma), Huang Qin (Scutellariae Radix) 2 liang, Chou Mo (Strychni Semen), Hua Shi (Talcum) 4 liang. Powdered, water pills. 40-50 pills with warm water.
He Zhong Wan (Harmonize Middle Pill): Bai Zhu (Atractylodis Macrocephalae Rhizoma) 2 liang 4 qian, Hou Po (Magnoliae Officinalis Cortex) 2 liang, Chen Pi (Citri Reticulatae Pericarpium) 1 liang 6 qian, Pa Ban Xia (Steeped Pinelliae Rhizoma) 1 liang, Bing Lang (Arecae Semen) 5 qian, Zhi Shi (Immature Bitter Orange Fruit) 5 qian, Gan Cao (Glycyrrhizae Radix et Rhizoma) 4 qian, Mu Xiang (Aucklandiae Radix) 2 qian. Steep in fresh ginger juice, steam with steamed bread into pills. 30 pills with warm water, far from meals.
Sheng Bing Zi (Holy Cake): Huang Dan (Minii Oxidum Rubrum) 2 qian, Ding Fen (Cerussita) 3 qian, Mi Tuo Seng (Litharge), Bo Shang Liu Huang (Imported Sulfur) 3 qian, Qing Fen (Calomel)少许. Fine powder, mix with 4 qian white flour, water to fingertip size, shape into cakes, dry in shade. Before meals, dissolve in grain water, aim for black stool.
Su Gan Wan: Mix Su He Xiang Wan (Styrax Pill) and Gan Ying Wan (Responsive Pill) evenly, millet size. 5 pills with light ginger tea on empty stomach.
*Xuan Ming* Xuan Qing Gao (Dark Green Ointment): Huang Lian (Coptidis Rhizoma), Huang Bo (Phellodendri Cortex), Da Huang (Rhei Radix et Rhizoma), Gan Sui (Euphorbiae Humifusae Radix), Yuan Hua (Genkwa Flos, vinegar-fried), Da Ji (Euphorbiae Pekinensis Radix) each 0.5 liang, Chou Tou Mo (Strychnos Seed Powder) 2 liang, Qing Fen (Calomel) 2 qian, Qing Dai (Indigo Naturalis) 1 liang. Powdered, water pills soybean size. Start 10 pills, increase 10 per dose, 3 times daily, stop when purged.
*Bao Ming Ji* Si Wu Tang (Four Substances Decoction): Add Huai Hua (Sophorae Flos), Huang Lian (Coptidis Rhizoma), Yu Mi Ke (Papaveris Pericarpium) in equal parts.
Jiang Fu Tang (Ginger and Aconite Decoction), Li Zhong Tang (Regulate the Middle Decoction): See Cold Damage category.
Wu Ling San (Five-Ingredient Powder with Poria): See Summerheat category.
Jiang Shui San (Grain Water Powder): Ban Xia (Pinelliae Rhizoma, soup-washed) 1 liang, Pao Fu Zi (Prepared Aconiti Lateralis Radix Praeparata) 0.5 liang, Gan Jiang (Zingiberis Rhizoma) or Gan Sheng Jiang (Fresh Ginger), Gui (Cinnamomi Cortex), Zhi Gan Cao (Honey-fried Glycyrrhizae Radix et Rhizoma) each 5 qian, Liang Jiang (Galangal Rhizoma) 2 qian. Fine powder, 3-5 qian with 2 cups grain water, decoct to 0.5 cup, take hot with dregs.
Sheng Yang Yi Wei Tang (Raise Yang Benefit Stomach Decoction): Qiang Huo (Notopterygii Rhizoma et Radix), Du Huo (Angelicae Pubescentis Radix), Fang Feng (Saposhnikoviae Radix) each 0.5 liang, Chai Hu (Bupleuri Radix), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Fu Ling (Poria, omit if thirsty), Ze Xie (Alismatis Rhizoma) each 3 qian, Huang Qi (Astragali Radix) 2 liang, Ren Shen (Ginseng Radix), Ban Xia (Pinelliae Rhizoma), Zhi Gan Cao (Honey-fried Glycyrrhizae Radix et Rhizoma) each 1 liang, Huang Lian (Coptidis Rhizoma) 1 qian, Chen Pi (Citri Reticulatae Pericarpium) 4 qian, Bai Shao (Paeoniae Radix Alba) 5 qian. Decoct 3 qian with ginger/jujube, take warm.
Qu Xiong Wan (Medicated Leaven and Xiong Pill): Chuan Xiong (Ligustici Chuanxiong Rhizoma), Shen Qu (Medicated Leaven), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Pao Fu Zi (Prepared Aconiti Lateralis Radix Praeparata) equal parts. Powdered, flour paste pills, wu zi size. 30-50 pills with warm rice drink. Treats undigested food diarrhea.
*Ji Yao* Bai Zhu Shao Yao Tang (Atractylodes and Paeonia Decoction): Bai Zhu (Atractylodis Macrocephalae Rhizoma), Shao Yao (Paeoniae Radix) each 1 liang, Gan Cao (Glycyrrhizae Radix et Rhizoma) 5 qian. Decoct 1 liang portion.
Qian Shi Bai Zhu San (Qian's Atractylodes Powder): Ren Shen (Ginseng Radix), Bai Fu Ling (Poria), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Mu Xiang (Aucklandiae Radix), Gan Cao (Glycyrrhizae Radix et Rhizoma), Huo Xiang (Pogostemonis Herba) each 1 liang, Gan Jiang (Zingiberis Rhizoma). Coarse powder, decoct.
Xiang Ru Yin (Elsholtzia Decoction), Qing Shu Yi Qi Tang (Clear Summerheat Benefit Qi Decoction): See Summerheat category.
Liu He Tang (Six-Harmony Decoction): See Cholera category, or add Xiang Ru (Elsholtiae Herba) and Hou Po (Magnoliae Officinalis Cortex).
Huo Xiang Zheng Qi San (Agastache Rectify Qi Powder): See Wind Stroke category.
Huang Lian E Jiao Wan (Coptis and Donkey-Hide Gelatin Pill): Chao E Jiao (Fried Asini Corii Colla) 2 liang, Huang Lian (Coptidis Rhizoma) 3 liang, Fu Ling (Poria) 2 liang. Melt E Jiao into paste, mix powders, pillify. Take with rice drink.
Gu Chang Wan (Solidify Intestine Pill): See Women's Diseases category.
Chu Shi Tang (Remove Dampness Decoction): See Diarrhea category.
Shi Quan Da Bu Tang (Ten-Ingredient Great Tonify Decoction): See Deficiency category.