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Dysentery caused by latent summerheat, characterized by the passage of red and white pus and blood, with urgent and frequent defecation, abdominal pain relieved after defecation, a yellow tongue coating, and a tight pulse, indicates cold coagulation and qi stagnation. It is appropriate to use herbs such as Danggui (Angelicae Sinensis Radix), Baishao (Paeoniae Radix Alba), Huanglian (Coptidis Rhizoma), Muxiang (Aucklandiae Radix), Shanzha (Crataegi Fructus), Houpo (Magnoliae Officinalis Cortex), Dahuang (Rhei Radix et Rhizoma), and Fuzi (Aconiti Lateralis Radix Praeparata) to warm and unblock while regulating qi.

The previous paragraph discussed heat patterns, whereas this one discusses cold patterns. The fact that abdominal pain is relieved after defecation, accompanied by tenesmus (feeling of incomplete defecation) and urgency occurring day and night without limit, along with a tight pulse and yellow tongue coating, indicates that cold-dampness is sticky and stagnant, fermenting and obstructing, thereby causing dysfunction of the intestines and stomach. Examining the *Neijing* (Classic of Internal Medicine), it states that the five zang organs primarily store essence without draining, while the six fu organs primarily transmit and transform without stagnating. The large intestine and the stomach both belong to the fu organs of the Hand and Foot Yangming meridians, serving as the sea of water and grain, and are primarily responsible for conduction and transformation. Generally, due to the brewing of cold-dampness and the obstruction of the qi pathway, abdominal pain and tenesmus occur, with stool passing in clumps but incompletely. The standard approach should be to promote circulation and resolve stagnation, so that when qi mechanism moves, damp-turbidity is expelled, and the disease can be cured abruptly. Furthermore, according to ancient teachings, sudden onset of metrorrhagia or dysentery should be treated with warming and tonifying methods; chronic metrorrhagia or chronic dysentery should be treated with clearing and purging methods. However, it is not absolute that all sudden cases require only warming/tonifying, nor that all chronic cases require only clearing/purging. The key lies in careful examination during clinical practice and prescribing medication according to specific symptoms, avoiding rigid adherence to a single method. Even in the case of dysentery, which generally requires unblocking, there is a distinction between cold-unblocking and warming-unblocking. If the pulse and symptoms indicate heat and excess, bitter-cold purgatives should originally be used. If the pulse and symptoms indicate cold and deficiency, sweet-warm consolidating tonics should be used. If cold is complicated by excess, one may imitate the *Fuzi Dahuang Tang* (Aconite and Rhubarb Decoction), which warms and unblocks simultaneously. If heat is complicated by deficiency, one may imitate the *Huanglian Ejiao Tang* (Coptis and Donkey-Hide Gelatin Decoction), which clears heat and tonifies simultaneously. If deficiency is complicated by accumulation, one may imitate the *Renshen Shaoyao Tang* (Ginseng and Peony Decoction), which unblocks and tonifies simultaneously. If deficiency is complicated by stagnation, one may imitate Zhang Jingyue's *Tongjie San* (Unblocking and Resolving Powder), which clears and unblocks while supplementing. If these various paragraphs are cross-referenced and carefully contemplated, one can avoid the pitfalls of being dogmatic or lost like asking for directions in the sea. In recent times, the term "accumulation and stagnation" has been used as a general designation for dysentery. In my opinion, "accumulation" refers to excess conditions, where formless qi condenses into tangible solid pathogens; "stagnation" refers to deficiency conditions, where abnormal qi movement condenses into stagnant qi. Therefore, the term "accumulation and stagnation" cannot simply be conflated with excess. I mention this here to seek the opinions of experts, and I trust there will be those capable of distinguishing the nuances.

(1) *Yi* (Should): The original text reads "Yi" (Use). Corrected based on the context of the following sentence.
(2) *Fuzi Dahuang Tang*: From *Jin Gui Yao Lue: Pulse, Symptoms, and Treatment of Abdominal Fullness, Cold Cramps, and Food Stagnation Diseases*. The original text reads: "Dahuang Fuzi Tang".