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Preface: It is common knowledge that initial dysentery should be treated with purgation; it is also common knowledge that chronic dysentery should be treated with tonification. However, regarding cases where two Yang meridians combine to cause dysentery, if Taiyang and Yangming combined disease presents with spontaneous diarrhea/dysentery, sweating (diaphoresis) is appropriate; if Taiyang and Shaoyang combined disease presents with spontaneous diarrhea/dysentery, harmonization is appropriate; if Yangming and Shaoyang combined disease presents with spontaneous diarrhea/dysentery, attacking the interior (purging) is appropriate. Only those who have mastered the key principles of Cold Damage (Shanghan) are qualified to discuss this. The following ten formulas are examined here, mostly based on hearsay and observation.

Bai Shao Yao (White Peony Root, 2 qian), Dang Gui Wei (Tail of Angelica Sinensis), Huang Lian (Coptis Rhizome), Huang Qin (Scutellaria Root) (each 1 qian), Mu Xiang (Aucklandia Root, not roasted over fire), Gui Xin (Cinnamon Heart), Bing Lang (Areca Seed), Gan Cao (Licorice Root) (each 5 fen), Da Huang (Rhubarb Root and Rhizome, 7 fen), Mang Xiao (Mirabilite, 1 qian).
This formula is indicated for dysentery presenting with pus and blood in the stool, accompanied by tenesmus (urgent desire to defecate with a feeling of incomplete evacuation).
Dysentery is also known as "Zhi Xia" (stagnant discharge). Dysentery is generally attributed to Damp-Heat. Heat injuring Qi leads to white discharge; Heat injuring Blood leads to red discharge; Heat damaging the Large Intestine causes dryness and obstruction in the Large Intestine, resulting in tenesmus. He-Jian (Liu Wansu) stated: "Moving blood heals pus and blood naturally," therefore Dang Gui and Bai Shao are used to move blood; Mang Xiao and Da Huang are used to purge accumulation. "Harmonizing Qi eliminates tenesmus," therefore Mu Xiang, Bing Lang, and Gan Cao are used to harmonize Qi. Bitter flavors can firm the intestines, and cold natured herbs overcome heat; thus Huang Qin and Huang Lian are used to thicken the intestinal fluids and clear heat. By borrowing its qi, there are no contraindications; thus, the acrid-hot nature of Gui Xin is borrowed as a counter-agent (anti-toxin or guiding agent to prevent rejection).

Tao Ren (Peach Kernel, 25 pieces, skin and tip removed), Gui Zhi (Cinnamon Twig, 7 fen, stir-fried), Da Huang (Rhubarb Root and Rhizome, 5 qian, soaked in wine), Mang Xiao (Mirabilite, 5 qian), Gan Cao (Licorice Root, 2 qian).
This formula is indicated for early-stage dysentery in patients with robust constitution. If purgation was missed in the initial stage and astringent drugs were instead used, causing pathogenic heat to accumulate internally and blood circulation to stagnate, leading to severe abdominal pain resembling death, this formula should be urgently employed.
The *Nei Jing* (Inner Canon) states: "Use unblocking methods for unblocking symptoms" (Tong Yin Tong Yong); it also states: "For acute conditions, use draining methods." Therefore, Da Huang and Mang Xiao are used for their salty-cold nature to cleanse pathogenic heat; Tao Ren is used for its bitter nature to expel stagnant blood; Gan Cao is used for its sweet nature to harmonize Stomach Qi. As for Gui Zhi, which is an acrid-hot substance, why is it used? The Classics state: "For mild conditions, treat contrary to the disease; for severe conditions, treat according to the disease" (Cong Zhi). Therefore, it is used to guide Da Huang and Mang Xiao directly to the nest of stasis and heat, acting as vanguard troops.