钱仲阳云∶泻痢黄赤黑，皆热也。泻痢青白，米谷不化，皆冷也。东垣云∶白者湿热伤于气
分，赤者湿热伤于血分，赤白相杂，气血俱伤也。海藏用四君、芎、归，治虚弱之痢；四君
、干姜，治虚寒之痢。余尝治手足指热饮冷者为实热，用香连丸。手足指冷冻饮料热者为虚寒，
用异功散送香连丸。若兼体重肢痛，湿热伤脾也，用升阳益胃汤。小便不利，阴阳不分也，
用五苓散。若湿热退而久痢不愈者，脾气下陷也，用补中益气汤倍加升麻、柴胡。泻痢兼呕
，或腹中作痛者，脾胃虚寒也，用异功散加炮姜、木香。或变而为疟者，肝克脾也，用六君、升麻、
柴胡、钩藤钩。若积滞已去，痢仍不止者，脾气虚也，用四君子送下香连丸。若因乳母膏粱
浓味，六淫七情，致儿为患者，当各推其因，仍兼治其母，并参冷热泻及积滞腹痛等症览之
治验
一小儿下痢赤白，里急后重，腹时痛，用香连丸而痊。后伤食复变痢，欲呕少食，用五味异
功散加木香三分、黄连二分，吴茱萸一分，数剂而愈。
一小儿患痢，口干发热，用白术散煎与恣饮，时以白术散送香连丸而安。
一小儿久痢，里急后重，欲去不去，手足并冷，此胃气虚寒下陷也，用补中益气汤加木香、
补骨脂，倍加升麻、柴胡而愈。
一小儿久痢作渴，发热饮汤，用白术散为主，佐以人参二两，黄连一两炒黑，为丸，时服数
粒，尽剂而痊。
一小儿作泻不乳，服克伐之剂，变痢腹痛后重，余用补中益气汤送香连丸，又用香砂助胃膏
、六君子汤而愈。
一小儿伤乳食，不时呕吐，杂用消导之剂，变痢不止，先用六君、木香渐愈；后用七味白术
散而痊。
一小儿伤乳食，吐泻变赤痢，后重腹痛，先用香连丸而愈。又乳食过多腹痛，先用保和丸一
服，痛止，又用五味异功散加木香二剂而愈。
一小儿下痢腹痛，阴冷，小便短少，用五味异功散加肉豆蔻顿愈。复作呕吐咽酸，或用巴豆
之药连泻五次，饮食顿减，手足并冷，余用五味异功散加木香、干姜，饮食少进，倍用干姜
，又四剂，手足温而痢亦痊。
一小儿痢后腹胀作呕，大便不实，小便不利，诸药不应，余先用五味异功散加木香、肉果数
服，二便少调，又数剂，诸症少愈；用八味丸补命门之火，腹胀渐消；用金匮加减肾气丸，
诸症顿退；又用四君、升麻、柴胡而痊安。
一小儿患痢，喘嗽不已，此肺气虚也，用六君子加木香为末，每服钱许，以人参、陈米、姜
汤调服即睡，乳食少进，又二服，而喘嗽顿安，乃用四君子汤而痊。
石莲散 治小儿噤口痢，呕逆不食。
莲肉（炒去心）
为末，每服一钱，米饮调，一方山药末，米饮调下。
胃风汤 治风冷客于肠胃，乳食不化，泄泻肠鸣，腹满而痛，或下如豆汁或瘀血，日夜无度
。
白芍药 白术 肉桂 人参 当归 川芎 茯苓
上为末，每服二钱，入粟米水煎，空心热服。
香连丸
黄连（十两，用吴茱萸五两水拌湿，入瓷器顿滚汤中半日，炒焦黑） 木香（二两）
上为末，丸如赤豆大。每服二三丸，白汤下。
地榆饮 治冷热痢，腹痛下痢，赤白频并。
地榆（三分） 甘草 赤芍药（炒） 枳壳（各二分）
上水煎服。
黄连解毒汤 治时疾三日汗已解，若烦闷干呕，口燥呻吟，发热不卧。
黄连（炒，三钱） 黄柏（炒，半两） 栀子（炒，四两） 黄芩（炒，二钱）
上每服二三钱，水煎，未效再服，亦治热痢。
汤氏异功散 止渴消暑生津。
泽泻 猪苓（去皮，三钱） 陈皮（二钱半） 白术 茯苓 人参（各五钱） 辰砂（一钱）
上为末，蜜丸芡实大，每服一丸，灯心竹叶汤化下。
升阳益胃汤
黄 （二钱） 半夏 人参 甘草（炙。各一钱） 独活 防风 白芍药 羌活（各五钱） 陈皮 茯苓
柴胡 泽泻（各三分） 白术 黄连（炒，一钱）
上水二钟，姜三片，枣二枚，煎四分，食远服。
五苓散（方见五淋）
愚按∶前症若津液偏渗于大肠，大便泻而小便少者，宜用此药分利。若阴阳已分而小便短少
者，此脾肺虚而不能生也，宜用补中益气汤加麦门、五味。虚火上炎而小便赤少者，此肺气
受伤，而不能生水也，用六味地黄丸料加麦门冬、五味。不可概以小便不利，而用渗泄之剂也。
四君子汤
六君子汤
异功散（三方见内钓）
补中益气汤
保和丸（二方见虚羸）
香砂助胃膏（方见热吐）
白术散（方见积痛）
八味丸（方见肾脏，即六味丸加肉桂、五味子）
金匮加减肾气丸（方见腹胀）
Qian Zhongyang stated: Diarrhea and dysentery with yellow, red, or black stools all indicate Heat syndromes. Diarrhea and dysentery with green or white stools, containing undigested rice and grain, all indicate Cold syndromes. Li Dongyuan stated: White stools indicate Damp-Heat injuring the Qi level (Qi Fen); red stools indicate Damp-Heat injuring the Blood level (Xue Fen); mixed red and white stools indicate injury to both Qi and Blood. Zhang Yuansu (Hai Zang) used Si Jun Zi Tang (Four Gentlemen Decoction) plus Chuanxiong Rhizoma (Chuanxiong) and Angelicae Sinensis Radix (Danggui) to treat deficiency-type dysentery; and Si Jun Zi Tang plus Dried Ginger (Ganjiang) to treat deficiency-Cold type dysentery.
I once treated a case where the child's fingers were hot and desired cold drinks, indicating Excess Heat syndrome, for which I used Xiang Lian Wan (Fragrant Coptis Pill). In another case where the fingers were frozen cold and desired hot drinks, indicating Deficiency-Cold syndrome, I used Yi Gong San (Extraordinary Efficacy Powder) to administer Xiang Lian Wan. If accompanied by heavy body and limb pain, this indicates Damp-Heat injuring the Spleen, for which Sheng Yang Yi Wei Tang (Raise Yang and Benefit Stomach Decoction) is used. If urination is difficult, this indicates Yin and Yang are not distinct, for which Wu Ling San (Five-Ingredient Powder with Poria) is used. If Damp-Heat subsides but chronic dysentery persists, this indicates Spleen Qi sinking, for which Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) is used with added Sheng Ma (Cimicifugae Rhizoma) and Chai Hu (Bupleuri Radix). If diarrhea/dysentery is accompanied by vomiting or abdominal pain, this indicates Spleen-Stomach Deficiency-Cold, for which Yi Gong San is used with added Pao Jiang (Prepared Ginger) and Mu Xiang (Aucklandiae Radix). If the condition transforms into malaria, this indicates Liver Wood overacting on Spleen Earth, for which Liu Jun Zi Tang (Six-Gentleman Decoction) is used with added Sheng Ma, Chai Hu, and Gou Teng Uncaria (Uncariae Ramulus cum Uncis). If stagnation has been cleared but dysentery continues, this indicates Spleen Qi deficiency, for which Si Jun Zi Tang is used to administer Xiang Lian Wan.
If the disease in children is caused by the nursing mother consuming rich, greasy foods, or by external Six Evils and internal Seven Emotions, one must investigate the specific cause and treat the mother concurrently, referring to the treatment experiences of Cold/Hot diarrhea and abdominal pain due to stagnation.
Case 1: A child presented with red and white dysentery, tenesmus (feeling of incomplete defecation), and intermittent abdominal pain. Treated with Xiang Lian Wan, he recovered. Later, food stagnation recurred causing dysentery again, with desire to vomit and poor appetite. Treated with Wu Wei Yi Gong San (Five-Ingredient Extraordinary Efficacy Powder) plus Mu Xiang (3 fen), Huang Lian (2 fen), and Wu Zhu Yu (1 fen), he recovered after several doses.
Case 2: A child suffered from dysentery with dry mouth and fever. Baizhu San (Atractylodis Macrocephalae Powder) was decocted for him to drink freely, and occasionally administered with Xiang Lian Wan, leading to stabilization.
Case 3: A child had chronic dysentery with tenesmus, feeling the urge to defecate but unable to do so, and cold hands and feet. This indicated Stomach Qi deficiency-Cold with sinking. Treated with Bu Zhong Yi Qi Tang plus Mu Xiang and Gutierrezae Songorae Radix (Buguzhi), with doubled Sheng Ma and Chai Hu, he recovered.
Case 4: A child had chronic dysentery with thirst, fever, and desire for hot drinks. Baizhu San was used as the main formula, assisted by Ren Shen (Codonopsis/Ginseng, 2 liang) and Huang Lian (Coptidis Rhizoma, 1 liang, stir-fried until black), made into pills. Taking a few pills at a time, he recovered after finishing one dose.
Case 5: A child had diarrhea and refused breastfeeding. After taking harsh purgatives, the condition transformed into dysentery with abdominal pain and tenesmus. I used Bu Zhong Yi Qi Tang to administer Xiang Lian Wan, followed by Xiang Sha Zhu Wei Gao (Fragrant Sandalwood Stomach-Nourishing Paste) and Liu Jun Zi Tang, resulting in recovery.
Case 6: A child injured by milk and food vomited frequently. After indiscriminate use of digestive aids, the condition transformed into persistent dysentery. Initially treated with Liu Jun Zi Tang plus Mu Xiang for gradual improvement; subsequently treated with Qi Wei Bai Zhu San (Seven-Ingredient Atractylodis Powder) for recovery.
Case 7: A child injured by milk and food had vomiting and diarrhea transforming into red dysentery with tenesmus and abdominal pain. Initially treated with Xiang Lian Wan for recovery. Later, abdominal pain due to excessive milk/food intake was treated with Bao He Wan (Preserve Harmony Pill) for one dose to stop pain, followed by Wu Wei Yi Gong San plus Mu Xiang for two doses for full recovery.
Case 8: A child had dysentery with abdominal pain, cold yin area, and scanty urine. Treated with Wu Wei Yi Gong San plus Rou Dou Kou (Myristicae Semen) for immediate relief. Subsequently, vomiting and acid regurgitation occurred. Another practitioner used Ban Dou (Croton Seed) causing five purges, leading to reduced diet and cold limbs. I treated with Wu Wei Yi Gong San plus Mu Xiang and Gan Jiang (Zingiberis Rhizoma). Diet slightly improved. Doubling Gan Jiang and administering for four doses, limbs warmed and dysentery resolved.
Case 9: A child had abdominal distension and vomiting after dysentery, loose stools, and difficult urination, unresponsive to various medicines. I first used Wu Wei Yi Gong San plus Mu Xiang and Rou Guo (Myristicae Arillus) for several doses; bowel movements and urination slightly regulated. After more doses, symptoms improved. Then Ba Wei Wan (Eight-Ingredient Pill) was used to tonify Ming Men Fire (Gate of Life Fire), reducing distension. Jin Gui Jia Jian Shen Qi Wan (Modified Kidney Qi Pill from Golden Cabinet) was used, retreating all symptoms. Finally, Si Jun Zi Tang plus Sheng Ma and Chai Hu led to complete recovery.
Case 10: A child suffered from dysentery with incessant wheezing and coughing, indicating Lung Qi deficiency. Liu Jun Zi Tang plus Mu Xiang was powdered. One qian was taken each time,調服 (mixed and taken) with Ren Shen, aged rice, and Ginger Decoction, inducing sleep. Milk and food intake increased slightly. After two more doses, wheezing and coughing ceased. Subsequently, Si Jun Zi Tang led to recovery.
Shi Lian San (Lotus Seed Powder): Treats pediatric Jing Kou Li (Jaw-closed Dysentery), characterized by vomiting, regurgitation, and inability to eat.
Lian Rou (Lotus Seed Meat, stir-fried and heart removed)
Powdered. Take one qian per dose, mixed with rice water. Alternatively, Shan Yao (Dioscoreae Rhizoma) powder mixed with rice water may be used.
Wei Feng Tang (Stomach Wind Decoction): Treats Wind-Cold invading the intestines and stomach, causing indigestion of milk/food, diarrhea with borborygmus, abdominal fullness and pain, or passage of bean-jelly-like substance or blood clots, day and night without limit.
Bai Shao Yao (Paeoniae Radix Alba), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Rou Gui (Cinnamomi Cortex), Ren Shen (Ginseng Radix et Rhizoma), Dang Gui (Angelicae Sinensis Radix), Chuan Xiong (Chuanxiong Rhizoma), Fu Ling (Poria)
Powdered. Take two qian per dose, decocted with millet water, taken warm on an empty stomach.
Xiang Lian Wan (Fragrant Coptis Pill):
Huang Lian (Coptidis Rhizoma, 10 liang, moistened with water mixed with 5 liang Wu Zhu Yu, boiled in a porcelain vessel in boiling water for half a day, stir-fried until charred black), Mu Xiang (Aucklandiae Radix, 2 liang)
Powdered, formed into pills the size of adzuki beans. Take 2-3 pills per dose with plain warm water.
Di Yu Yin (Sanguisorba Decoction): Treats Cold-Heat dysentery, abdominal pain with dysentery, frequent mixing of red and white stools.
Di Yu (Sanguisorbae Radix, 3 fen), Gan Cao (Licorice Root), Chi Shao Yao (Paeoniae Radix Rubra, stir-fried), Zhi Ke (Aurantii Fructus, 2 fen each)
Decocted in water and taken.
Huang Lian Jie Du Tang (Coptis Decoction for Resolving Toxicity): Treats epidemic diseases where sweat has cleared after three days, but restlessness, dry retching, dry mouth, groaning, fever, and inability to lie down persist.
Huang Lian (Coptidis Rhizoma, stir-fried, 3 qian), Huang Bo (Phellodendri Cortex, stir-fried, 0.5 liang), Zhi Zi (Gardeniae Fructus, stir-fried, 4 liang), Huang Qin (Scutellariae Radix, stir-fried, 2 qian)
Take 2-3 qian per dose, decocted in water. Repeat if ineffective. Also treats Heat dysentery.
Tang Shi Yi Gong San (Dr. Tang's Extraordinary Efficacy Powder): Stops thirst, clears summerheat, generates fluids.
Ze Xie (Alismatis Rhizoma), Zhu Ling (Polyporus, peeled, 3 qian), Chen Pi (Citri Reticulatae Pericarpium, 2.5 qian), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Fu Ling (Poria), Ren Shen (Ginseng Radix et Rhizoma, 5 qian each), Chen Sha (Cinnabar, 1 qian)
Powdered, honey-pilled the size of euryale seed. Take one pill per dose, dissolved in Deng Xin Cao (Junci Medullae) and Zhu Ye (Bambusae Folium) decoction.
Sheng Yang Yi Wei Tang (Raise Yang and Benefit Stomach Decoction):
Huang Qi (Astragali Radix, 2 qian), Ban Xia (Pinelliae Rhizoma), Ren Shen (Ginseng Radix et Rhizoma), Gan Cao (Licorice Root, prepared, 1 qian each), Du Huo (Angelicae Pubescentis Radix), Fang Feng (Saposhnikoviae Radix), Bai Shao Yao (Paeoniae Radix Alba), Qiang Huo (Notopterygii Rhizoma et Radix, 5 qian each), Chen Pi (Citri Reticulatae Pericarpium), Fu Ling (Poria), Chai Hu (Bupleuri Radix), Ze Xie (Alismatis Rhizoma, 3 fen each), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Huang Lian (Coptidis Rhizoma, stir-fried, 1 qian)
Decoct with 2 zhong of water, 3 slices of ginger, and 2 jujubes. Reduce to 0.4 zhong. Take long after meals.
Wu Ling San (Five-Ingredient Powder with Poria) (Formula see "Wu Lin" section)
Commentary: For the aforementioned conditions, if body fluids leak excessively into the large intestine causing diarrhea and scanty urine, this formula for separating and draining is appropriate. If Yin and Yang are already distinct but urine is scanty, this indicates Spleen-Lung deficiency failing to generate fluids; Bu Zhong Yi Qi Tang plus Mai Men Dong (Ophiopogonis Radix) and Wu Wei Zi (Schisandrae Fructus) is appropriate. If deficient fire flares upward causing red, scanty urine, this indicates Lung Qi injury failing to generate water; Liu Wei Di Huang Wan (Six-Ingredient Pill with Rehmannia) material plus Mai Men Dong and Wu Wei Zi is appropriate. One should not indiscriminately use diuretic/drainage agents simply because urination is difficult.
Si Jun Zi Tang (Four Gentlemen Decoction)
Liu Jun Zi Tang (Six-Gentleman Decoction)
Yi Gong San (Extraordinary Efficacy Powder) (See "Nei Diao" section for these three formulas)
Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction)
Bao He Wan (Preserve Harmony Pill) (See "Xu Lei" section for these two formulas)
Xiang Sha Zhu Wei Gao (Fragrant Sandalwood Stomach-Nourishing Paste) (See "Re Tu" section for formula)
Bai Zhu San (Atractylodis Macrocephalae Powder) (See "Ji Tong" section for formula)
Ba Wei Wan (Eight-Ingredient Pill) (See "Shen Zang" section for formula, i.e., Liu Wei Wan plus Rou Gui and Wu Wei Zi)
Jin Gui Jia Jian Shen Qi Wan (Modified Kidney Qi Pill from Golden Cabinet) (See "Fu Zhang" section for formula)