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Cui Sikong, over sixty years old, suffered from dysentery with red and white pus and blood in the stool, accompanied by tenesmus (urgent desire to defecate with little output). This was due to damp-heat stagnation. I used Shaoyao Decoction (Peony Decoction) with added Rhubarb (Da Huang) 2 qian. After one dose, symptoms halved; after a second dose, he recovered. However, the tenesmus persisted, indicating sinking of Spleen Qi. I administered Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) to deliver Xianglian Wan (Fragrant Coptis Pill), resulting in recovery.

Luo Jishi experienced acute pain in the lower abdomen and difficulty defecating despite the urge. This indicated deficiency and sinking of Qi in the Spleen and Kidney. I used Buzhong Yiqi Tang to deliver Bawei Wan (Eight-Ingredient Pill, i.e., Jin Gui Shen Qi Wan), and he recovered after two doses. Cases where such conditions led to death due to limb swelling caused by damage to Yuan Qi from improper use of dysentery medicines are too numerous to count.

Shao Zongbo Gu Dongjiang suffered from dysentery due to food stagnation, with abdominal pain and a sensation of bearing down. Others used purgative/dredging agents, leading to swollen legs, poor appetite, fatigue, irritability, heat, thirst, and a surging, rapid pulse that felt faint and fine upon deep pressure. I used Liujunzi Tang (Six Gentlemen Decoction) with added Dried Ginger (Jiang) and Cinnamon Twig (Guizhi) 2 qian each, Evodia Fruit (Wuzhuyu) and Schisandra Berry (Wuweizi) 1 qian each. Taken cold after decoction, he slept immediately, and upon waking, all symptoms vanished. Two more doses cleared them completely. This was false heat treated with false cold (cooling method).

Taichang Bian Huaquan suffered from vomiting, inability to eat, abdominal pain, and tenesmus. He self-medicated with Rhubarb (Da Huang) and other purgatives for one dose, worsening abdominal pain, causing spontaneous sweating, fever, confusion, and a large but empty pulse. I used Ginseng (Renshen) and Atractylodes Macrocephala Rhizome (Baizhu) 1 liang each, Roasted Licorice Root (Zhi Gancao) and Fried Ginger (Pao Jiang) 3 qian each, and Cimicifuga Rhizome (Shengma) 1 qian. One cup revived him. Subsequently, Buzhong Yiqi Tang with Fried Ginger was used, and he recovered after two doses.

Tingping Qu Ruwei engaged in sexual intercourse after eating. The next noon, he had abdominal pain. Defecation resembled dysentery but was not true dysentery. The following day, he passed only pus and blood, with irritability, heat, thirst, and mental confusion/fatigue. I used Sishen Wan (Four Spirits Pill); one dose brought immediate relief. Then, Bawei Wan ingredients plus Schisandra Berry (Wuweizi), Evodia Fruit (Wuzhuyu), Psoralea Fruit (Guzhi), and Myristica Seed (Roukou) were used for two doses, resulting in recovery.

Panguan Wang Tianxi, over sixty, suffered from dysentery with abdominal pain and tenesmus, heat, thirst preferring cold drinks, and inability to eat. I used Shaoyao Decoction with added Rhubarb (Da Huang) 1 liang. Four doses showed slight improvement. Continuing the previous prescription with half the amount of Rhubarb, he recovered after several doses. Among such patients, those with sufficient Yuan Qi are rare (one or two in a hundred).

Tongfu Xue Yun suffered from bloody stool. After taking Xijiao Dihuang Tang (Rhino Horn and Rehmannia Decoction) and similar drugs, bleeding increased, body emaciated, fever appeared, appetite decreased, and tenesmus occurred. This was sinking of Spleen Qi. I used Buzhong Yiqi Tang with Fried Ginger (Pao Jiang), and he recovered after one dose.

A Shangsheng suffered from dysentery with tenesmus. Being knowledgeable in medicine himself, he used Shaoyao Decoction, which worsened the tenesmus. Appetite declined, abdomen felt cold, and limbs were cold. I diagnosed this as Spleen and Stomach deficiency/loss, and used Liujunzi Tang with Aucklandia Root (Muxiang) and Fried Ginger (Pao Jiang). He recovered after two doses.

An elderly man habitually drank wine and milk together. His defecation resembled dysentery but was not true dysentery, and his chest and diaphragm felt constricted. Medicines for phlegm-dysentery were ineffective. Recalling the Materia Medica: "Wine should not be drunk with milk; acid causes coagulation, while bitter promotes dispersion." Thus, I made pills using tea leaves, advising him to take 30-50 pills with clear tea occasionally. He recovered after a few doses.

An elderly woman developed dysentery with tenesmus after anger post-meal, attributed to sinking of Spleen Qi. I prescribed a large dose of Liujunzi Tang with added Aconite Root (Fu Zi), Myristica Seed (Roukou), and baked Aucklandia Root (Wei Muxiang) 1 qian each, Evodia Fruit (Wuzhuyu) 0.5 qian, Psoralea Fruit (Guzhi) and Schisandra Berry (Wuweizi) 1.5 qian each. Two doses resolved all symptoms except for lower abdominal distension, indicating Liver Qi stagnation affecting the Spleen. I used Tiaozhong Yiqi Tang with added Aconite Root (Fu Zi) and Aucklandia Root (Muxiang) 0.5 qian. Four doses resulted in recovery. Later, she felt a salty taste in her mouth, indicating Kidney deficiency with water overflowing. I gave Liuwei Dihuang Wan (Six-Ingredient Pill with Rehmannia), and she recovered instantly after two doses.

My mother, aged eighty, suffered from dysentery in midsummer with abdominal pain, vomiting, inability to eat, heat, thirst preferring liquids, and abdominal pain relieved by pressure. Her pulse was forceful and strong at the surface, indicating deficiency of True Qi and excess of pathogenic factors. I urgently prescribed Ginseng (Renshen) 5 qian, Atractylodes Macrocephala Rhizome (Baizhu) and Poria (Fuling) 3 qian each, Tangerine Peel (Chenpi), Cimicifuga Rhizome (Shengma), Aconite Root (Fu Zi), and Roasted Licorice Root (Zhi Gancao) 1 qian each. After ingestion, she slept, woke up asking for food, and both pulse and symptoms subsided. Two more doses ensured stability. This follows the principle of treating based on symptoms rather than pulse; for acute diseases, regardless of the pulse, one should follow the symptoms. At that time, the Lady of Grand Secretary Shi had identical age, pulse, and symptoms, but was treated solely for dysentery (attacking the pathogen), leading to her death.

Chen Ziyuan from Hengjin, aged sixty, had a red complexion, expectorated phlegm, dry mouth, and occasional diarrhea. In spring of the Gui-Mao year, he consulted me, saying: "My condition is sometimes considered damp-heat in the Spleen channel or diarrhea caused by phlegm-fire. I routinely use Erchen Tang, Coptis Rhizome (Huanglian), Immature Bitter Orange (Zhishi), Medicated Leaven (Shenqu), Malt (Maiya), Atractylodes Macrocephala Rhizome (Baizhu), and Bupleurum Root (Chaihu), yet it is ineffective. Why?" I palpated his pulse: the left Guan position was wiry and tight, indicating Kidney Water failing to nourish Liver Wood; the right Guan position was wiry and large, indicating Liver Wood attacking Spleen Earth. This was deficiency of Spleen and Kidney, failing to maintain normal generation and restriction cycles. The source of transformation should be nourished. He did not believe me. I told his nephew, Prefect Zhu Yangshan: "Your uncle will soon perish from dysentery." In summer of the Jia-Chen year, he indeed died of dysentery.

Postpartum dysentery is discussed in *Nuke Cuoyao* (Essentials of Gynecology).