Library

Pediatric dysentery progressing to "Jinkou Li" (dysentery with inability to eat) presents with a large pulse, fever, inability to ingest food, red tongue body, red lips, and a preference for cold drinks. This syndrome is caused by fire-toxin attacking the stomach. Ancient methods advocate using Shenlian Kaijin San (Ginseng and Coptis Decoction to Open the Stuck Throat), composed of equal parts of Renshen (Ginseng Root), Jiangchao Chuanlian (Coptis Rhizome fried with ginger juice), and Lianziren (Lotus Seed Endosperm), ground into fine powder and taken with rice water.

[Commentary] Jinkou Li is due to stomach deficiency with rebellious qi rushing upward, causing vomiting and inability to swallow food or drink; it mostly belongs to deficiency and exhaustion patterns. One must not solely attribute it to fire-toxin attacking the stomach while neglecting the underlying deficiency. The prescription uses Xiyangshen (American Ginseng Root) 1.5 qian, Jiangzhi Chao Huanglian (Coptis Rhizome fried with ginger juice) 8 fen, Shichangpu (Acori Tatarinowii Rhizoma) 7 fen, Shilianzi (Stone Lotus Seed) 1 qian, Jingshenshen (Salvia Miltiorrhiza Root) 2 qian, Baifuling (Poria) 2 qian, Dongguaren (Winter Melon Seed, shelled) 1.5 qian, with Lao Cangmi (Old Stored Rice) 1 zhua and Xian Hedi (Fresh Lotus Petiole Base) 1 as guides.

Pediatric Xiexi Li (chronic intermittent dysentery) occurs because cold accumulation was not purged urgently in time. Over time, the accumulation descends gradually until it reaches the junction of the lower end of the large intestine and the upper end of the rectum. This area has small twists and hidden spaces, being the deepest part of the intestinal organs where medicinal power is difficult to reach. Symptoms fluctuate between mild and severe, remission and recurrence; stools vary between red and white, hard and loose, without consistency. Ancient formulas used Badou (Croton Seed) pills for purgation, but this is unsuitable for prolonged illness with depleted spirit/qi. Instead, Yadanzi (Chaulmoogra Seed/Baccaurea Ramiflora Seed - *Note: Context implies Chaulmoogra or similar antiparasitic seed, often identified as Bruguiera sexangula or similar in modern TCM context for dysentery, here translated descriptively based on text*) 24 grains are recommended. The seeds resemble Yi Zhizi (Yi Zhi Ren) but are smaller, with a grayish-brown shell. Gently crack the shell with a small hammer; the kernel is white, oily, and rice-sized. Do not use cracked kernels; use only whole kernels. Wrap three seeds tightly in Longyanrou (Longan Aril). Swallow one packet with rice water on an empty stomach, then cover with a meal to suppress the drug's action. Continue swallowing eight packets in total.

If a child first suffers from dysentery and later transforms into diarrhea, it indicates the transmission of pathogenic factors from the Kidney to the Spleen. This is considered a minor pathogen and is easy to treat. It represents blood-level pathology transmitting to the qi level; treatment should focus on regulating qi, slightly adding blood-nourishing herbs. One must not rely solely on astringents, lest the toxin remain and transform back into dysentery. The formula uses Xidangshen (Codonopsis Root) 1 qian, Sheng Baizhu (Atractylodes Macrocephala Rhizoma, raw) 1.5 qian, Baifuling (Poria) 2 qian, Dangguishen (Angelica Sinensis Root Body) 7 fen, Hangbaishao (White Peony Root) 1 qian, Zhigancao (Licorice Root, honey-fried) 5 fen, with Shengjiang (Fresh Ginger) 1 slice and Gan Hedi (Dried Lotus Petiole Base) 1 as guides.

If a child first suffers from diarrhea and later transforms into dysentery, it indicates the transmission from the Spleen to the Kidney. This is considered a "robber pathogen" and is difficult to treat. It represents qi-level pathology transmitting to the blood level; treatment should focus on nourishing blood, further adding qi-regulating herbs. One must not mistakenly use purgatives, which would damage stomach qi. The formula uses Bai Guishen (Angelica Sinensis Root Body) 1 qian, Hangbaishao (White Peony Root) 1 qian, Huai Shengdi (Rehmannia Glutinosa Root, prepared) 1.5 qian, Bai Yunling (Poria) 1.5 qian, Zheng Yalian (Coptis Rhizome) 1 qian, Nan Muxiang (Vladimiria Root) 8 fen, Jian Binglang (Areca Seed) 5 fen, Chao Diyü (Sanguisorba Officinalis Root, fried) 8 fen, with Liuyisan (Six-Ingredient Powder) 2 qian as a guide.

When wind-cold pathogens lodge in the intestines and stomach, resulting in the passage of bright red blood; or when intestinal-stomach damp-toxin causes discharge resembling bean curd dregs, or passage of stasis-blood, the formula uses Chuan Huanglian (Coptis Rhizome) 8 fen, Dong Ejiao (Donkey-Hide Gelatin) 1.5 qian, Bai Yunling (Poria) 1.5 qian, Dangguishen (Angelica Sinensis Root Body) 8 fen, Guang Muxiang (Costus Root) 6 fen, with Jiu Cangmi (Old Stored Rice) 1 zhua as a guide.

In cases of pediatric sinking of stomach qi, where tenesmus persists, excessive straining may cause prolapse of the rectum. The method should involve nourishing blood and regulating qi, adding lifting herbs. Then the dysentery will cease naturally, and the anus will retract. The formula uses Lv Shengma (Ephedra-like Bupleurum/Cimicifuga - *Note: Luoshengma is Cimicifuga, Lvshengma often refers to specific grade or type, here translated as Cimicifuga Rhizoma* ) 5 fen, Chao Dangshen (Codonopsis Root, fried) 1.5 qian, Baifuling (Poria) 2 qian, Jingjie Sui (Schizonepeta Spike) 5 fen, Bai Guishen (Angelica Sinensis Root Body) 8 fen, Chao Baishao (White Peony Root, fried) 8 fen, Zhen Guangpi (Tangerine Peel) 1 qian, Zhigancao (Licorice Root, honey-fried) 5 fen, with Fei Wumei (Smoked Plum) 1 grain as a guide.

Externally, use Wubeizi (Chinese Gall) 3 qian, Bai Mangxiao (Mirabilite) 6 fen, Jingjie Sui (Schizonepeta Spike) 1 qian. Decoct for fumigation and washing. Then apply powdered Wubeizi externally. Support the prolapsed tissue with soft cloth to facilitate natural retraction.