Library

Dysentery caused by latent summerheat presents with stool resembling jelly, mixed with undigested food and fluids, accompanied by rectal prolapse and tenesmus. Bowel movements occur immediately after eating, passing complete grains without digestion; this is termed "rectal dysentery." It is appropriate to use Chishizhi (Red Halloysite), Yuliangshi (Yuzhang Earth), Pa Jiang (Pounded Ginger), and Jing Mi (Rice Grain), ground together into powder and taken with water, combined with Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) to block and intercept pathogenic factors in the Yangming channel.

Generally, when dysentery first arises, it must first injure the Spleen, and subsequently affect the Kidney. Therefore, ancient physicians, although they first distinguished whether summer-dampness was in the Qi level or Blood level before administering treatment, always focused primarily on the Spleen and Kidney organs. In the present case, the dysenteric stool resembles jelly and is mixed with food and fluids, indicating that deficiency-cold symptoms are already prominent. Furthermore, with rectal prolapse, tenesmus, and undigested food in the stool, this indicates a failure of the Spleen and Kidney to maintain consolidation, and the closure mechanisms have been withdrawn. This is indeed a dangerous condition of rectal dysentery. The *Neijing* states: "The Kidney is the gate of the Stomach, opening into the two yin orifices." If the true Qi of the Kidney fails to consolidate, the gate of the Stomach cannot be guarded, causing food entering the Stomach to fail to undergo proper rotting and ripening, thus being excreted as complete grains. Unless one acts as a pillar in midstream, blocking and intercepting the gastric gate to prevent direct downward flow, how can the dysentery cease? Imitating Zhang Zhongjing's Taohua Tang (Peach Kernel Decoction) for Shaoyin diarrhea, combined with Yuliangshi to astringe the intestines and secure the stomach, preventing direct downward flow, one may hope to restore normal transformation and transportation, ensuring regulated intake and output. Additionally, using Buzhong Yiqi Tang to support the Earth element and raise Yang, allowing clear Qi to ascend, one can properly comprehend the principle from the *Neijing*: "Turbid Qi remaining above leads to abdominal distension; Clear Qi sinking below leads to undigested food diarrhea." Furthermore, examining Zhang Zhongjing's discussion on diarrhea and dysentery, there are cases of cold-induced diarrhea with clear undigested grains, due to the lack of fire in the cauldron, unable to cook and digest the five grains; this undoubtedly belongs to deficiency-cold. There are also cases where severe heat results in undigested food in the stool. Although it is said that "pathogenic heat does not kill grain," in my opinion, fundamentally, this is still due to the loss of control over the gastric gate and the inability to grasp and retain. In the cases I have observed, this syndrome is invariably accompanied by fever, dry mouth, red tongue with scanty fluid, and a rapid yet forceless pulse, predominantly belonging to deficiency-heat. Generally, Yin deficiency with hyperactive Yang generates internal wind, which disrupts freely, confusing clear and turbid Qi; this ultimately belongs to deficiency patterns, not genuine pathogenic heat. Therefore, I often use Weiguan Jian (Stomach Gate Decoction) added with Chishizhi and Yuliangshi to astringe and stop diarrhea, often achieving success. In cases where there are cold limbs, deficient pulse, pale complexion, and pale tongue, this belongs to deficiency-cold; using Taohua Tang added with Renshen (Ginseng) and Fuzi (Prepared Aconite Root) to warm and tonify can also yield effective results. In summary, regarding diseases of undigested food and rectal dysentery, although there are distinctions between Yin/Yang and Cold/Heat, cold certainly belongs to deficiency, and heat also essentially belongs to deficiency. As for the notion that "pathogenic heat does not kill grain," based on my twenty years of clinical experience, I find it unreliable to trust blindly. Hence, I clarify this point, awaiting judgment by those with superior insight.