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Such cases are rare.

In treating dysentery (Zhi Xia), one must distinguish it from intestinal slipping and spontaneous diarrhea (Chang Da Hua Xie Zi Li). The latter can be treated with astringents; hence, ancient physicians occasionally used Cornus Officinalis Fruit (Shu Yu Pi) and Persimmon Calyx (Xi Ke) to correct the slipping condition. However, if dysentery is fundamentally caused by damp-heat obstruction, the treatment principle should be to promote free flow and drainage, strictly avoiding the use of astringents. The Large Intestine is the Interior-Exterior paired organ of the Lung. If damp-heat stagnates in the Large Intestine, there must also be turbidity and stagnation in the Lung. Therefore, when prescribing, one often benefits the Lung Qi, knowing its nature prefers free flow and unobstructed movement, clearing the Zang organs to reach the Fu organs. If astringents are mistakenly used, damp-heat will have no outlet for excretion, and Lung Qi cannot descend. This not only exacerbates dysentery but allows damp-heat to steaming upward to affect the Lung, leading to symptoms such as distension, qi rebellion, insomnia, and aversion to food.

Yu Jiayan treated severe dysentery where the rectum lost control, using large doses of Si Jun Zi Tang (Four Gentlemen Decoction) mixed with powder of Halloysitum Rubrum (Chi Shi Zhi) and Yuzhuyuan (Yi Yu Liang), administered frequently. The patient subsequently suffered unbearable abdominal pain, illustrating the principle that "free flow prevents pain, pain indicates obstruction." Nevertheless, continuing the medication eventually led to recovery. Later, using Si Jun Zi Tang with doubled Poria Cocos (Fu Ling), full health was restored.

In diarrhea, spontaneous recovery occurs if there is fever with a weak pulse, or if sweating occurs. A pulse that is empty, deep, and choppy indicates a favorable prognosis (Shun); a pulse that is excess, large, and floating indicates death. Warm hands and feet indicate survival; cold limbs (Jue) indicate death. Passing stool resembling house-leak water, fish brains, or pure blood indicates death.

This formula is excellent for both old and new cold accumulations. Although it contains Crotonis Fructus (Ba Dou), it does not cause purging; rather, it eliminates accumulation and stops dysentery.

Aromatic Costus Root (Nan Mu Xiang), Cardamom Seed (Nan Dou Kou), Clove (Ding Xiang) (each 1.5 qian), Ginger (Pao, 1 qian), soot from burning straw (Bai Cao Shuang, 1 qian), Crotonis Fructus (Ba Dou, 70 grains, peeled, heart and membrane removed, ground and oil pressed out), and Apricot Seed (Xing Ren, 140 grains, peeled and tips removed). The first four ingredients are ground into powder. separately, Bai Cao Shuang, Ba Dou, and Xing Ren are ground. The seven ingredients are thoroughly mixed. Six liang of high-quality yellow beeswax is melted into liquid, filtered through heavy silk to remove dregs. One sheng of good wine is added to a clay pot, and the wax is boiled several times. The wine is poured out and cooled; the wax floats to the surface. Four liang of this wax is taken. One qian of clear oil is heated in a small crucible until fragrant and hot. The wax is added and melted together. While hot, the mixture is stirred with the previously prepared medicinal powder. Pills are formed the size of beans. Each dose consists of 39 pills, taken on an empty stomach with ginger decoction. Zhao Yangkui and Li Shizhen both attested to its miraculous efficacy.