Library

Dysentery in the first one or two days, with Yuan Qi (Vital Energy) not yet deficient, can be treated with this formula to purge.
Zhiqiao (Fructus Aurantii, 1.5 qian), Binglang (Arecae Semen, 1 qian), Houpo (Cortex Magnoliae Officinalis, 1 qian), Dahuang (Radix et Rhizoma Rhei, 5-7 qian for robust individuals, 3-4 qian for deficient individuals).
Take 1.5 zhong of water, decoct the first three herbs until reduced to 1 zhong, add Dahuang, boil for two or three boils, take hot. The ideal outcome is rapid purgation (Kuai Li).

After purgation, immediately switch to this formula for regulation.
Danggui (Radix Angelicae Sinensis), Chishao (Radix Paeoniae Rubra), Shengdi (Radix Rehmanniae Preparata, each 0.7 qian), Huanglian (Rhizoma Coptidis, 1 qian), Gancao (Radix Glycyrrhizae, 0.3 qian), Suan Shiliupi (Pericarpium Granati, 0.8 qian), Susu (Pericarpium Papaveris, honey-fried, 0.8 qian), Diyü (Herba Siegesbeckiae, 0.8 qian).
Take 1.5 zhong of water, decoct until reduced to 0.7 zhong, take before meals. One dose will stop dysentery.

For treating red and white dysentery with immediate effect.
Muxiang (Radix Aucklandiae, 1 liang), Huanglian (Rhizoma Coptidis, 4 liang, soaked overnight with 2 liang of Wuzhuyu, stir-fried dry, remove Wuzhuyu).
Grind the above two herbs into fine powder, bind with millet paste into pills the size of paulownia seeds. Take 70 pills per dose, with plain warm water after meals. In the early stage, use a purging method: add Dahuang (2 liang) and Binglang (1 liang) to promote movement. Then, use the base formula with added Roudoukou (Semen Myristicae, fried in egg white, 1.5 liang) to arrest diarrhea. This is called "Two Miracles".

If dysentery is accompanied by aversion to cold, fever, and headache, this is a Exterior Syndrome (Biao Zheng). Use mild sweating and harmonizing methods: decoct Cangzhu (Rhizoma Atractylodis Macrocephalae), Chuanyu (Radix Ligustici Chuanxiong), Chenpi (Pericarpium Citri Reticulatae), Shaoyao (Radix Paeoniae Alba/Lactiflorae), Gancao (Radix Glycyrrhizae), and three slices of Shengjiang (Rhizoma Zingiberis Recens). If there is abdominal pain, tenesmus, and scanty urination, this is an Interior Syndrome (Li Zheng). Use harmonizing middle and dispersing qi methods: decoct fried Zhiqiao (Fructus Aurantii), processed Houpo (Cortex Magnoliae Officinalis), Shaoyao (Radix Paeoniae), Chenpi (Pericarpium Citri Reticulatae), Gancao (Radix Glycyrrhizae), and Huashi (Talcum). If there is abnormal prolapse, purple-black blood in stool, and severe pain, this is a Dead Blood Syndrome (Si Xue Zheng). Treat with Taoren (Semen Persicae) and Huashi (Talcum) to move stasis. If there is thirst, dryness, and burning sensation in the bowel, this is Heat Clamping Syndrome (Jia Re). Add Huangqin (Radix Scutellariae). If there is no thirst, no fever, and preference for warmth, this is Cold Clamping Syndrome (Jia Han). Add Jiang (Shengjiang/Ganjiang) and Gui (Rougui/Guizhi). If prolapse occurs after bloody discharge, this is Qi Stagnation Syndrome (Qi Zhi Zheng). Add one piece of Binglang (Arecae Semen) to the previous prescription. If symptoms are downward stagnation or upward vomiting of food, this is Unresolved Toxic Accumulation with Unbalanced Stomach Qi. Differentiate cold and heat: warm if cold, clear if heat, tonify deficiency with Renshen (Radix Ginseng) and Baizhu (Rhizoma Atractylodis Macrocephalae). Once toxins resolve and accumulation moves, appetite returns. If fatigue, shortness of breath, and anorexia occur, this is Deficiency Clamping Syndrome (Jia Xu Zheng). Add Baizhu (Rhizoma Atractylodis Macrocephalae) and Danggui (Radix Angelicae Sinensis) root ends; add Renshen (Radix Ginseng) for severe cases. For extremely severe cases, use only Chenpi (Pericarpium Citri Reticulatae) to tonify; when deficiency recovers, dysentery stops. If qi flows, blood harmonizes, and accumulation decreases, but there is empty straining (Xu Zuo Nu Ze), this is No-Blood Syndrome (Wu Xue Zheng). Double the dosage of Danggui (Radix Angelicae Sinensis) root ends, combine with raw Shaoyao (Radix Paeoniae) and raw Shengdi (Radix Rehmanniae), assist with Taoren (Semen Persicae), and harmonize with Chenpi (Pericarpium Citri Reticulatae). When blood generates, peace is restored. If prolapse reduces by 70-80%, and foul accumulation is exhausted but feces are not solidified, decoct fried Shaoyao (Radix Paeoniae), fried Baizhu (Rhizoma Atractylodis Macrocephalae), roasted Gancao (Radix Glycyrrhizae), Chenpi (Pericarpium Citri Reticulatae), and Fuling (Sclerotium Poriae) to swallow 30 pills of Guochang Wan (Intestine-Firming Pill). However, Guochang Wan is drying and may retain stagnant qi; thus, drink only the decoction initially and do not rush to use Guochang Wan, as it has damp-draining and intestine-firming properties. If after dysentery, feces are not solid, or pain occurs after eating slightly more porridge or eating when very hungry, do not panic. Decoct equal parts Baizhu (Rhizoma Atractylodis Macrocephalae) and Chenpi (Pericarpium Citri Reticulatae) to restore peace. If long-term dysentery leads to body weakness, qi deficiency, and uncontrolled slipping, use astringents: Kezi (Fructus Chebulae), Roudoukou (Semen Myristicae), Baifan (Alumen), Banxia (Rhizoma Pinelliae); add Muli (Concha Ostreae) for severe cases. Use Chenpi (Pericarpium Citri Reticulatae) as an assistant to prevent pain from excessive astringency. For even worse cases, moxa Tianshu (ST25) and Qihai (CV6).
In the aforementioned formulas, Houpo (Cortex Magnoliae Officinalis) is used specifically to drain stagnant qi. However, Houpo is warm and dispersing; long-term use greatly depletes qi. Remove it once stagnant qi moves. For residual stagnation, use fried Zhiqiao (Fructus Aurantii) and Chenpi (Pericarpium Citri Reticulatae). Zhiqiao also consumes qi; it is milder than Houpo but heavier than Chenpi. Remove it once stagnation recedes. Use only Chenpi (Pericarpium Citri Reticulatae) to harmonize other herbs. Chenpi without peel has both tonifying and draining effects; when assisting Renshen (Radix Ginseng) and Baizhu (Rhizoma Atractylodis Macrocephalae), it acts purely as a tonic. For all dysentery with abdominal pain, Shaoyao (Radix Paeoniae) and Gancao (Radix Glycyrrhizae) must be the Sovereign herbs, with Danggui (Radix Angelicae Sinensis) and Baizhu (Rhizoma Atractylodis Macrocephalae) as Ministers. Add Guizhi (Ramulus Cinnamomi) for cold pain, Huangqin (Radix Scutellariae) for heat pain. Proficient practitioners adjust according to annual qi and seasons, ensuring success every time, rather than rigidly adhering to a single formula!
Fire syndromes have deficiency/excess and light/severe distinctions. Light cases can be descended; severe cases follow their nature to subdue them. Excess fire should be purged; deficiency fire should be tonified. Yin-deficiency fire agitation is difficult to treat; nourish yin and descend fire.