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7. Dysentery occurring after childbirth is called "postpartum dysentery" (Chan Zi Li). It is often caused by dietary intake of raw and cold foods, or interference from summer-heat or cold pathogens. If symptoms include tenesmus (Li Ji Hou Zhong - urgent need to defecate with a feeling of incomplete evacuation and heaviness in the anus), it belongs to an excess (Shi Zheng) syndrome; if the disease persists for a long time leading to incontinence or chronic diarrhea without control (Hua Tuo), it belongs to a deficiency (Xu Zheng) category. Dysentery that is red-yellow, thick, and sticky mostly indicates a heat syndrome; dysentery that is clear, thin, and watery like duck feces definitely indicates a cold syndrome. Treatment should be adjusted according to methods such as clearing heat, warming cold, harmonizing, tonifying, and astringing. The conditions of excess vs. deficiency, and acute vs. chronic onset, must be carefully differentiated and analyzed.

[Annotation] Postpartum dysentery, named Chan Zi Li, is mostly caused by irregular diet, craving for raw and cold foods, or careless living habits leading to exposure to wind-cold or summer-heat. If there is abdominal pain accompanied by tenesmus, it belongs to an excess syndrome; if the disease has lasted for a long time presenting with deficiency-cold and incontinence, it belongs to a deficiency syndrome. Yellow-red and thick/sticky dysentery color mostly belongs to heat syndrome; clear, thin, and watery dysentery resembling duck feces belongs to cold syndrome. The treatment principles are: clear heat for heat syndromes, warm interior for cold syndromes, harmonize for mixed cold-heat patterns, tonify for deficiency syndromes, and drain/excess for excess syndromes. One must carefully analyze the nuances between excess/deficiency and new/chronic diseases.

Huailian Siwu Decoction Shaoyao Tang Zhenren Yangzang Tang

8. Huailian Siwu Decoction is effective for heat dysentery; Shaoyao Tang is used for mixed cold-heat and excess conditions. Shaoyao Tang consists of Bai Shao (Radix Paeoniae Alba), Huang Qin (Scutellariae Radix), Huang Lian (Coptidis Rhizoma), Dang Gui (Angelicae Sinensis Radix), Mu Xiang (Aucklandiae Radix), and Gan Cao (Glycyrrhizae Radix et Rhizoma); Zhi Ke (Aurantii Fructus), Rou Gui (Cinnamomi Cortex), and Bing Lang (Arecae Semen) are used to promote qi movement and guide stagnation downward; Sheng Da Huang (Rhei Radix et Rhizoma) is added for severe pain to purge heat and unblock the bowels. For deficiency-cold with incontinence, Ren Shen (Ginseng Radix), Bai Zhu (Atractylodis Macrocephalae Rhizoma), and Rou Gui are used for warming and tonifying, combined with Bai Shao, He Zi (Terminalia Chebulae Fructus), Rou Dou Kou (Myristicae Semen), and Guang Mu Xiang for astringing and stopping diarrhea. Adding Gan Cao and Ying Su Qiao (Papaveris Capsicum) constitutes Zhenren Yangzang Tang. If the condition persists for a long time, Shiquan Dabu Tang may be used.

[Annotation] Since heat syndromes require clearing, heat dysentery is suitable for Huailian Siwu Decoction, which is Siwu Tang plus Huai Hua (Sophorae Flos) and Huang Lian, to clear heat and strengthen the intestines. For mixed cold-heat patterns requiring harmonization, Shaoyao Tang is suitable, composed of Bai Shao Yao, Huang Qin, Huang Lian, Dang Gui, Mu Xiang, Gan Cao, Rou Gui, and Bing Lang. "Zhuì" (descending/purging) implies increasing the dosage of Bing Lang to enhance the guiding of stagnation; "Tòng" (pain) implies adding Sheng Da Huang to relieve pain. If deficiency-cold with incontinence occurs, warming, tonifying, and astringing methods are appropriate, using Zhenren Yangzang Tang, composed of Ren Shen, Bai Zhu, Bai Shao Yao, Rou Gui, Rou Dou Kou, He Zi, Mu Xiang, Gan Cao, and Ying Su Qiao decocted together. If the disease persists for a long time causing severe deficiency of qi and blood, Shiquan Dabu Tang is suitable for tonification.

Siwu Tang Shiquan Dabu Tang Formulas are found in the first volume.

Renshen Baidu San Xianglian Wan Jiawei Siwu Tang

9. For dysentery accompanied by exterior syndromes, Renshen Baidu San is used, consisting of Qiang Huo, Du Huo, Zhi Ke, Jie Geng, Chai Hu, Qian Hu, Ren Shen, Fu Ling, Chuan Xiong, and Gan Cao, with Sheng Jiang (Zingiberis Rhizoma Recens) and Cong Bai (Allii Fistulosii Bulbus) as guides. For dysentery caused by summer-heat and dampness, Xianglian Wan is used. If stagnant blood infiltrates the large intestine forming bloody dysentery, Siwu Tang can be modified by adding E Jiao (Colla Corii Asini), Di Yu (Sanguisorbae Radix), Xue Yu Tan (Spuma Sanguinis Humanis), etc.

[Annotation] For dysentery caused by external contraction of wind-cold, Renshen Baidu San is suitable, composed of Qiang Huo, Du Huo, Zhi Ke, Jie Geng, Chai Hu, Qian Hu, Ren Shen, Fu Ling, Chuan Xiong, and Gan Cao, with Sheng Jiang and Cong Bai as guides. If dysentery is caused by summer-heat and dampness, Xianglian Wan is suitable, composed of Huang Lian and Mu Xiang made into pills. If stagnant blood infiltrates the large intestine resulting in bloody dysentery, Siwu Tang added with E Jiao, Di Yu, Xue Yu Tan, and Wu Zei Gu (Sepiae Endoconcha) is suitable for administration.

Siwu Tang formula is found in the first volume.