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Dysentery, anciently known as "Zhi Xia" (Stagnant Downward Flow), is mostly caused by external contraction of summer-heat and dampness, and internal injury from raw and cold foods. When the Qi is injured, the stool color tends to be white, because the Lung and Large Intestine are exterior-interior related. When the Blood is injured, the stool color tends to be red, because the Heart and Small Intestine are exterior-interior related. "Li Ji" (Tenesmus/Urge) refers to abdominal urgency and pain. "Hou Zhong" (Heaviness in the rectum) refers to frequent bearing-down sensations. In summary, without stagnation, dysentery cannot form; internal treatment should primarily employ methods to promote circulation and unblocking.

Hot Dysentery: Caused by steaming and condensation of damp-heat in the stomach and intestines, leading to abdominal pain, anal bearing-down sensation, short urine, red tongue, dry lips, irritability, thirst with a sense of urgency, passage of fresh red dysenteric stools, and a surging and slippery pulse. This is generally due to summer-heat and dampness stagnation; internal treatment should use methods to clear fire and guide out stagnation.

Massage techniques: Push San Guan (Three Gates) (200 times), Retreat Liu Fu (Six Palaces) (100 times), Clear Xin Jing (Heart Meridian) (100 times), Divide Yin and Yang (200 times), Push Da Chang (Large Intestine) (80 times), Push Pi Tu (Spleen Earth) (200 times), Move Ba Gua (Eight Trigrams) (80 times), Push Shen Shui (Kidney Water) (80 times), Rub Qi (Navel) and Gui Wei (Turtle Tail) (100 times each).

Cold Dysentery: Caused by irregular consumption of raw and cold foods, leading to Spleen failure in transformation and transportation, resulting in passage of white purulent stools, loud borborygmus with severe pain, blue-white complexion and lips, thirst preferring hot drinks, and a string-taut and weak pulse. Internal treatment should warm and regulate the Spleen and Stomach, assisted by methods to move Qi.

Massage techniques: Divide Yin and Yang (200 times), Push San Guan (200 times), Retreat Liu Fu (80 times), Move Ba Gua (80 times), Push Pi Tu (100 times), Push Da Chang (100 times), Tian Men Ru Hu Kou (Heaven's Gate Entering Tiger's Mouth) (80 times), Rub Qi and Gui Wei (100 times each), Yun Shui Ru Tu (Move Water into Earth) (100 times), Ban Men Tui Xiang Heng Wen (Push Ban Men towards Transverse Crease) (50 times), Push Wei Zhong and Hou Cheng Shan (50 times each). For all pushing techniques, use ginger and scallion water, and apply moxibustion on Shen Que (CV8). (See Volume 2, page 26.)

Red and White Dysentery: Caused by imbalance of cold and heat. Internal treatment primarily uses Zhu Che Wan (Chariot-Stopping Pill) and Lian Li Tang (Licorice-Linked Decoction).

Massage techniques: Divide Yin and Yang (200 times), Push San Guan (100 times), Retreat Liu Fu (100 times), Push Pi Tu (100 times), Move Ba Gua (50 times), Push Da Chang (200 times), Ban Men Tui Xiang Heng Wen (50 times), Mo Qi, Yao Yan, and Gui Wei (120 times each), Push Wei Zhong and Hou Cheng Shan (50 times each). Use ginger and scallion water for all pushing techniques.

Jin Kou Li (Mouth-Closing Dysentery): Caused by heat-toxin rushing to the Stomach, reversing and obstructing intestinal transmission, resembling closure, accompanied by fever, red tongue, and red lips. Internal treatment primarily focuses on clearing and resolving heat-toxin.

Massage techniques: Divide Yin and Yang (200 times), Push San Guan (100 times), Retreat Liu Fu (100 times), Push Pi Tu (100 times), Push Da Chang (200 times), Ban Men Tui Xiang Heng Wen (50 times), Mo Qi, Yao Yan, and Gui Wei (120 times each), Push Wei Zhong and Hou Cheng Shan (50 times each).

Commentary: Dysentery must involve stagnation of damp-heat, obstruction and reversal of Qi mechanism, preventing free flow, leading to tenesmus, heaviness in the rectum, and dark, astringent urine. Bitter-cold herbs should be used to dry dampness and purge heat, assisted by acrid-warm herbs to open depression and move Qi. Therefore, regulating blood heals pus in stools naturally, and regulating Qi eliminates heaviness in the rectum naturally. However, treatment must be divided into early, middle, and late stages. In early dysentery, if physical strength and Qi are still strong, with distension, fullness, hardness, and pain, it is urgent to remove stagnation; once stagnation is removed, dysentery stops. This is the method of "using unblocking to treat unblocking." If there is irritability and heat, preference for cold, solid pulse, abdominal fullness, and pure passage of fresh red blood, it indicates excess damp-heat internally, requiring urgent clearing and draining. After prolonged illness causing injury, either Yin or Yang may be damaged. Injury to Yin involves loss of essence, blood, and fluids through dysentery, presenting with irritability, heat, and thirst; clear-moistening and nourishing Yin methods are suitable. Injury to Yang involves decline of Spleen and Kidney original Yang due to dysentery, presenting with slipping/diarrhea and cold extremities; warming and tonifying to restore Yang is suitable. In general, acute diseases are mostly excess, chronic diseases are mostly deficiency, slipping/diarrhea is mostly cold, and astringency/stagnation is mostly heat. Referencing pulse and symptoms, combined with newness or duration of disease, one approaches the truth; do not rely solely on massage therapy. (Ti Li Zi)