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Wang Sun'an discussed the treatment of dysentery, asserting that one must harmonize Ying (Nutritive Qi) and Wei (Defensive Qi), a principle that is extremely profound. Yu Jiayan's method of "pulling the boat against the current" evolved from this concept. Generally, dysentery may arise from internal injury caused by raw or cold foods, leading to blood stasis in the stomach collaterals; or it may result from external constraint by wind-dampness and summer-heat stagnation causing chaotic blood circulation. Regardless of whether the stool is red or white, damp-heat binds in the Blood level, causing the contractile force of the fascia to relax and the movement of Qi transformation to stagnate. When dampness is excessive, blood stagnates and Qi becomes trapped; when heat is excessive, the membranes swell and blood extravasates. Using blood-breaking herbs to unblock Ying allows no place for pathogenic factors to hide; using diaphoretic herbs to ventilate Wei provides a pathway for pathogenic factors to be excreted. Once the superficial and interior meridians are unblocked, the dysentery should cease. However, if it does not stop, it is because the power of the San Jiao (Triple Burner) fascia has been long steamed by damp-heat, resulting in swelling and relaxation, unable to self-constrain. Thus, saliva and blood overflow downwards continuously without retention. Only by using sour and bitter substances to consolidate and astringe can success be achieved. The *Neijing* states that diarrhea with high fever is fatal. Chen Xiuyuan stated that cases with concurrent exterior syndromes should first be treated by releasing the exterior. Shi Zaizhi noted that epidemic dysentery where water-pathogen invades the Heart, presenting with aversion to cold and fever, is difficult to treat. The use of Xixin (Asari Radix), Baizhi (Angelicae Dahuricae Radix), Rougui (Cinnamomi Cortex), and Fuzi (Aconiti Lateralis Radix Praeparata) all belong to methods of harmonizing Ying and Wei. Whenever dysentery stops but appetite does not recover, it indicates that damp-heat has not been cleared. If diet is normal but defecation feels heavy/tenesmic, it indicates intestinal swelling has not subsided and blood collaterals are bi-obstructed. Prolonged swelling and obstruction lead to Xie Xi Li (Resting Dysentery). Prolonged Resting Dysentery transforms into Chang Wei (Intestinal Atrophy). Resting Dysentery implies incomplete clearing of blood collaterals and failure of membrane strength to restore. Jin Kou Li (Anorexic Dysentery) implies excessive damp-heat causing bi-obstruction and swelling of the stomach collaterals. An old physician treated post-dysentery rectal prolapse using four qian of Shaoyao (Paeoniae Radix Alba) as the sovereign herb, following the aforementioned principles. If the intestinal body is completely atrophic and Qi cannot penetrate, the Right Chi pulse at the deep level feels like small balls under the finger, weak and powerless. As the *Neijing* describes, pressing feels like mud pellets, indicating insufficiency of Da Chang (Large Intestine) Qi. Cases of massive bloody stool or severe, chronic bloody dysentery do occur.

Men and women have different constitutions of Qi and Blood, so their syndrome differentiation and treatment have major differences. Men have robust Qi, and Blood is less prone to stasis. Black tongue and deafness indicate blood collateral bi-obstruction, representing Heat entering the Blood Chamber. Tongue curling and testicular retraction indicate severe blood bi-obstruction where tendons lose nourishment. There are also cases where heat has not yet transformed, but blood collaterals in the hypochondrium are obstructed first. Symptoms include tongue coating fluctuating between yellow and white, inevitably with gray-black hues; urination alternating between retention and free flow; irritability and insomnia, sometimes on one side only. The pulse may be long or short, surging or tight, lacking any fixed pattern. Only a skilled physician capable of aggressively resolving blood stasis can treat this effectively. No disease can heal without the resolution of stasis and the fading of black discoloration. In women, who have abundant Blood, menstruation arriving or ceasing coincidentally with illness often causes contact with pathogens. The Liver and Stomach collaterals are most prone to stasis. Black tongue and delirium are common. However, if ears are not deaf and nipples are not retracted, it is not a critical condition. Even if ears are slightly deaf and there is delirious mania, it is merely a sign of struggle between Pathogenic and Healthy Qi. Only low voice and breath, inability to turn over, are contraindications. Tongue color may be blue, gray, or black, localized to one side or penetrating the whole surface; none of these alone constitute an ominous sign. Therefore, in treating gynecological Shang Han (Cold Damage) and Wen Bing (Warm Diseases), one should harmonize Blood from the outset to prevent complications. Otherwise, after recovery, residual collateral stasis may accumulate into chronic stomach pain or lower back pain. The world generally considers black tongue with prickles as Heat and moist tongue as Cold. However, stasis-induced black tongue, even with Heat, does not produce prickles; smokers' tongues, even with Cold, show dryness and cracking. One must distinguish based on accompanying symptoms. Generally, men's Blood stasis arises from Cold, from Heat, or from excessive use of cold-natured medicines in Warm Diseases which suppress Heat and close collaterals. Women's Blood stasis need not arise from Cold or Heat pathogens interacting with Blood; Blood can spontaneously stagnate. Thus, even after recovery, black tongue discoloration may persist.