论曰伤寒下痢，其种固多端，然皆由表实里虚，寒热湿气，乘虚客搏于肠胃之间。肠胃
随其所伤而下，若寒则青白，热则黄赤，若寒热相杂，则赤白俱下，兼以湿毒，则又下脓血。
如鱼脑如烂肉也，其候不同，有下痢而脉虚者，有下利而脉实者，有湿毒胜而腹痛者，有热
气盛而烦渴者，有津液搏滞而肠垢者。有燥屎结聚而谵语者，其要固在审别虚实治之也。
治伤寒下痢饮水者，有热也，及热痢下重。白头翁汤方
白头翁（半两） 黄柏（去粗皮） 秦皮 黄连（去须各三分）
上四味， 咀如麻豆，每服五钱匕，水一盏半，煎至八分，去滓温服，不拘时候。
治伤寒少阴病，二三日至四五日，腹痛小便不利，下痢不止，便脓血。桃花汤方
赤石脂（四两一半全一半捣末） 糯米（二合半） 干姜（细锉一分）
上三味，以水一升，煎二味并石脂半全者，候米熟去滓，每服取汁一小盏，入石脂末一
钱匕
治伤寒自利不渴者，属太阴，脏寒故也。四逆汤方
甘草（锉一两） 干姜（炮裂三分） 附子（炮裂去皮脐半两）
上三味， 咀如麻豆，每服五钱匕，水一盏半，煎至八分，去滓温服，又治伤寒后，下
痢清谷不止，身疼痛，急当救里者。
治伤寒热病不解，下痢困笃。大青汤方
大青 阿胶（锉炒燥各一两） 赤石脂 山栀子仁 甘草（炙锉各半两）
上五味，粗捣筛，每服五钱匕，水一盏半，入豉一百粒，薤白五寸切，同煎至八分，去
滓温服，不拘时候。
治伤寒下痢不止，腹中微痛。秦皮汤方
秦皮（锉） 黄连（去须锉炒） 阿胶（炒令燥各一两） 白头翁（三分）
上四味，粗捣筛，每服三钱匕，水一盏，煎至七分，去滓食前温服。
治伤寒后血痢，腹痛不可忍。芍药汤方
芍药 当归（切焙） 黄芩（去黑心） 黄连（去须锉炒各三两） 伏龙肝（一两半）
上五味，粗捣筛，每服三钱匕，水一盏，煎至六分，去滓食前温服。
治伤寒后脓血痢，下部疼痛。诃黎勒丸方
诃黎勒（炮去核） 人参（各一两） 白茯苓（去黑皮） 当归（切焙） 木香 白芷
（各三分） 牡丹皮（半两）
上七味，捣罗为末 炼蜜和捣五百下，丸如梧桐子大，每服三十丸，食前米饮下，日再。
治伤寒下痢赤白如烂肉，壮热大肠痛。香豉汤方
豉（半合） 山栀子仁 乌梅肉 甘草（炙各一分） 薤白（五茎）
上五味，锉如麻豆，分二服，每服水一盏半，煎至八分，去滓食前温服。
治伤寒挟热，腹痛下痢。升麻黄连汤方
升麻 黄连（去须锉炒） 当归（切焙） 芍药 桂（去粗皮） 黄柏（去粗皮） 甘
草（炙各半两）
上七味，锉如麻豆，每服三钱匕，水一盏，煎至七分，去滓食前温服。
治伤寒后毒热不解，日晡即壮热腹痛，纯下鲜血。犀角汤方
犀角（镑） 黄连（去须锉炒） 地榆 茜根 黄芩（去黑心各一两） 山栀子仁（半
两）
上六味，锉如麻豆，每服五钱匕，水一盏半，入薤白五寸切，同煎至八分，去滓食前温
服。
治伤寒后热毒攻肠胃，下痢赤白，困绝。龙骨汤方
龙骨 犀角（镑） 当归（切焙） 阿胶（锉炒燥） 黄连（去须锉炒各一两） 人参
（三分）
上六味， 咀如麻豆，每服五钱匕，水一盏半，煎至八分，去滓食前温服。
治湿气热毒，下痢赤白，及下部毒瓦斯，下细虫如布丝，长四五寸，黑头锐尾。雄黄丸方
雄黄（研一分） 丹砂（研） 干姜（炮） 附子（炮裂去皮脐各半两）
上四味，捣研为末，炼蜜和捣五百下。丸如绿豆大，每服十丸，空心米饮下。
治伤寒后下痢脓血。黄柏汤方
黄柏（去粗皮） 阿胶（锉炒燥各半两） 黄连（去须锉炒一两） 山栀子仁（一分）
上四味，锉如麻豆，每服三钱匕，水一盏，煎至六分，去滓食前温服。
治伤寒热痢。黄连当归丸方
黄连（去须锉炒） 当归（切焙各一两） 干姜（炮） 赤石脂（各半两）
上四味，捣罗为末，炼蜜和捣五百下，丸如梧桐子大，每服三十丸，食前米饮下。
治伤寒后下痢赤白。地榆饮方
地榆（三两） 赤石脂（一两）
上二味，粗捣筛，每服三钱匕，水一盏，煎至七分，去滓食前温服，日再。
治伤寒时气后，下痢不止。当归汤方
当归（切焙） 黄连（去须锉炒） 黄柏（去粗皮） 地骨皮（各一两）
上四味，锉如麻豆，每服三钱匕，水一盏，煎至七分，去滓下蜜合，搅匀食前温服。
治伤寒热病后，下痢脓血。龙骨散方
龙骨 黄连（去须炒等分）
上二味，捣罗为散，每服二钱，食前温米饮调下，日再。
治伤寒后气不和，自利无度。诃黎勒饮方
诃黎勒皮（四枚二生二煨） 草豆蔻（四棵二生二煨去皮）
上二味，粗捣筛，每服二钱匕，浆水一盏，煎至六分，去滓空心温服。
治伤寒后脏腑虚冷，下痢白脓腹痛。龙骨丸方
龙骨 干姜（炮） 附子（炮裂去皮脐等分）
上三味，捣罗为末，醋煮面糊和丸，如梧桐子大，每服三十丸，食前米饮下，日再。
治伤寒后一切痢疾，无问冷热腹痛。黄连丸方
黄连（去须炒二两） 木香 吴茱萸（汤洗三遍炒干各一两）
上三味，捣罗为末，面糊和丸，如梧桐子大。每服二十丸，空心食前米饮下。
治伤寒后壮热，下痢不止。牡蛎散方
牡蛎（火 ） 黄连（去须炒各一两） 乌梅肉（焙三分） 龙骨（一两半）
上四味，捣罗为散，每服二钱匕，空心食前米饮调下。
治伤寒后下血，及疮子后下血。千针散方
千针草 地榆 防风（去叉） 生干地黄（焙） 定粉（炒各半两） 硼砂二钱
上六味，捣研为散，每服一钱匕，空心食前米饮调下。
治大人小儿伤寒后，余毒有热，下血不止。贯众散方
贯众（逐叶摘下令净） 黄柏（去粗皮蜜炙等分）
上二味，捣罗为散，每服一钱至二钱匕，煎黑豆汁放温调下。
治伤寒汗后，阳毒入胃，下血频并，疼痛不可忍。胜金散方
郁金（大者五枚捣） 牛黄（研皂子大）
上二味，捣研为散，每服一钱匕，醋浆水一盏，同煎三沸温服。
治伤寒后下血。竹茹汤方
竹茹 芍药 子芩（各半两） 木通（锉三分） 升麻 黑木耳（烧灰各一两半）
上六味，粗捣筛，每服三钱匕，水一盏，煎至六分，去滓入生地黄汁一合，搅匀食前温
服。
治伤寒后挟热下血不止。黄连散方
黄连（去须为末一两）
上一味，鸡子白和饼烧黑，再捣罗为末，每服一钱匕，温酒调下，不拘时候，再服。
治伤寒太阳与少阳合病，自下痢者。黄芩汤方
黄芩（去黑心三分） 芍药 甘草（炙各半两）
上三味， 咀如麻豆，每服五钱匕，水一盏半，入大枣二枚劈破，同煎至八分，去滓温
服。
Discourse states: Dysentery caused by Shanghan (Cold Damage) is indeed diverse in type, but all originate from exterior excess and interior deficiency, where cold, heat, dampness, and qi pathogens take advantage of the deficiency to invade and bind within the intestines and stomach. The intestines and stomach discharge abnormally according to the injury sustained; if cold, the stool is greenish-white; if heat, it is yellow-red; if cold and heat are mixed, both red and white are discharged; combined with damp-toxin, pus and blood are discharged, resembling fish brains or rotting meat. The symptoms vary: some have dysentery with a deficient pulse, some have diarrhea with an excess pulse, some have abdominal pain due to overwhelming damp-toxin, some have restlessness and thirst due to flourishing heat-qi, some have increased intestinal mucus due to stagnation of body fluids, and some have delirium due to accumulation of dry feces. The key to treatment lies in distinguishing between excess and deficiency before treating.
For Shanghan dysentery accompanied by drinking water, indicating heat, and for heat-dysentery with tenesmus (a sensation of incomplete defecation), use Baitouweng Tang (Pulsatilla Decoction):
Baitouweng (Pulsatillae Radix, Ban liang), Huangbai (Phellodendri Cortex, removed coarse bark), Qinpi (Fraxini Cortex), Huanglian (Coptidis Rhizoma, removed stamens, each San fen).
The above four herbs are chopped like hemp seeds. Take Wu qian bi per dose, add Shui yi zhan ban (1.5 cups of water), decoct until Ba fen remains, remove dregs, and take warm at any time.
For Shanghan Shaoyin disease, occurring two to three days up to four to five days, presenting with abdominal pain, difficulty in urination, persistent dysentery, and passage of pus and blood, use Taohua Tang (Peach Kernel Decoction):
Chishizhi (Halloysitum Rubrum, Si liang half whole, half powdered), Nuomi (Oryza Sativa Glutinosa, Er he ban), Ganjiang (Zingiberis Rhizoma, finely cut, Yi fen).
The above three herbs are decocted with Shui yi sheng (1 cup of water). Decoct the two herbs and half of the whole Chishizhi until the rice is cooked, remove dregs, take one Xiao zhan of the liquid per dose, and mix in Yi qian bi of Chishizhi powder.
For spontaneous diarrhea without thirst after Shanghan, belonging to Taiyin syndrome due to internal cold, use Sini Tang (Frigid Extremities Decoction):
Gancao (Glycyrrhizae Radix et Rhizoma, cut, Yi liang), Ganjiang (Zingiberis Rhizoma, processed, San fen), Fuzi (Aconiti Lateralis Radix Praeparata, processed, peeled, and navel removed, Ban liang).
The above three herbs are chopped like hemp seeds. Take Wu qian bi per dose, add Shui yi zhan ban, decoct until Ba fen remains, remove dregs, and take warm. This also treats post-Shanghan cases with persistent passage of undigested food, body pain, requiring urgent rescue of the interior.
For unresolved heat-pathogen in Shanghan with severe dysentery and exhaustion, use Daqing Tang (Isatidis Decoction):
Daqing (Indigo Naturalis), Ejiao (Asini Corii Colla, cut and stir-fried until dry, each Yi liang), Chishizhi (Halloysitum Rubrum), Shanzhizi Ren (Gardeniae Fructus, embryo), Gancao (Glycyrrhizae Radix et Rhizoma, honey-fried and cut, each Ban liang).
The above five herbs are coarsely crushed and sieved. Take Wu qian bi per dose, add Shui yi zhan ban, Shi (Fermented Soybean), Yi bai li, Xiebai (Allii Macrostemonis Bulbus, cut into five-cun pieces), decoct together until Ba fen remains, remove dregs, and take warm at any time.
For persistent dysentery with slight abdominal pain after Shanghan, use Qipi Tang (Fraxini Decoction):
Qipi (Fraxini Cortex, cut), Huanglian (Coptidis Rhizoma, removed stamens, cut and stir-fried), Ejiao (Asini Corii Colla, stir-fried until dry, each Yi liang), Baitouweng (Pulsatillae Radix, San fen).
The above four herbs are coarsely crushed and sieved. Take San qian bi per dose, add Shui yi zhan, decoct until Qi fen remains, remove dregs, and take warm before meals.
For bloody dysentery with unbearable abdominal pain after Shanghan, use Shaoyao Tang (Peony Decoction):
Shaoyao (Paeoniae Radix), Danggui (Angelicae Sinensis Radix, cut and baked), Huangqin (Scutellariae Radix, removed black heart), Huanglian (Coptidis Rhizoma, removed stamens, cut and stir-fried, each San liang), Fulonggan (Caulinis Limonitis, Yi liang ban).
The above five herbs are coarsely crushed and sieved. Take San qian bi per dose, add Shui yi zhan, decoct until Liu fen remains, remove dregs, and take warm before meals.
For purulent and bloody dysentery with lower body pain after Shanghan, use Helile Wan (Terminalia Pill):
Helile (Terminaliae Chebulae Fructus, processed and pitted), Renshen (Ginseng Radix et Rhizoma, each Yi liang), Baifuling (Poria, removed black skin), Danggui (Angelicae Sinensis Radix, cut and baked), Muxiang (Aucklandiae Radix), Baizhi (Angelicae Dahuricae Radix, each San fen), Mudanpi (Moutan Cortex, Ban liang).
The above seven herbs are ground into powder, mixed with refined honey, pounded five hundred times, and formed into pills the size of Sophora seeds. Take thirty pills per dose, with rice drink before meals, twice daily.
For dysentery discharging red and white resembling rotting meat, with high fever and large intestine pain after Shanghan, use Xiangchi Tang (Black Bean Ferment Decoction):
Chi (Fermented Soybean, Ban he), Shanzhizi Ren (Gardeniae Fructus, embryo), Wumei Rou (Mume Fructus pulp), Gancao (Glycyrrhizae Radix et Rhizoma, honey-fried, each Yi fen), Xiebai (Allii Macrostemonis Bulbus, five stalks).
The above five herbs are chopped like hemp seeds, divided into two doses. For each dose, add Shui yi zhan ban, decoct until Ba fen remains, remove dregs, and take warm before meals.
For Shanghan complicated by heat, with abdominal pain and dysentery, use Shengma Huanglian Tang ( Cimicifugae and Coptidis Decoction):
Shengma (Cimicifugae Rhizoma), Huanglian (Coptidis Rhizoma, removed stamens, cut and stir-fried), Danggui (Angelicae Sinensis Radix, cut and baked), Shaoyao (Paeoniae Radix), Gui (Cinnamomi Ramulus, removed coarse bark), Huangbai (Phellodendri Cortex, removed coarse bark), Gancao (Glycyrrhizae Radix et Rhizoma, honey-fried, each Ban liang).
The above seven herbs are chopped like hemp seeds. Take San qian bi per dose, add Shui yi zhan, decoct until Qi fen remains, remove dregs, and take warm before meals.
For unresolved toxic heat after Shanghan, with high fever and abdominal pain at dusk, and pure fresh blood in stool, use Xijiao Tang (Rhinoceros Horn Decoction):
Xijiao (Rhinocerotis Cornu, shaved), Huanglian (Coptidis Rhizoma, removed stamens, cut and stir-fried), Diyü (Sanguisorbae Radix), Qigen (Rubiae Radix), Huangqin (Scutellariae Radix, removed black heart, each Yi liang), Shanzhizi Ren (Gardeniae Fructus, embryo, Ban liang).
The above six herbs are chopped like hemp seeds. Take Wu qian bi per dose, add Shui yi zhan ban, Xiebai (Allii Macrostemonis Bulbus, cut into five-cun pieces), decoct together until Ba fen remains, remove dregs, and take warm before meals.
For heat-toxin attacking the intestines and stomach after Shanghan, causing dysentery with red and white discharge and extreme exhaustion, use Longgu Tang (Dragon Bone Decoction):
Longgu (Dinosaur Bone), Xijiao (Rhinocerotis Cornu, shaved), Danggui (Angelicae Sinensis Radix, cut and baked), Ejiao (Asini Corii Colla, cut and stir-fried until dry), Huanglian (Coptidis Rhizoma, removed stamens, cut and stir-fried, each Yi liang), Renshen (Ginseng Radix et Rhizoma, San fen).
The above six herbs are chopped like hemp seeds. Take Wu qian bi per dose, add Shui yi zhan ban, decoct until Ba fen remains, remove dregs, and take warm before meals.
For dampness-heat-toxin causing dysentery with red and white discharge, and lower body toxic vapors resulting in passing thin worms like threads, four to five cun long, with black heads and sharp tails, use Xionghuang Wan (Realgar Pill):
Xionghuang (Realgar, ground, Yi fen), Dansha (Cinnabar, ground), Ganjiang (Zingiberis Rhizoma, processed), Fuzi (Aconiti Lateralis Radix Praeparata, processed, peeled, and navel removed, each Ban liang).
The above four herbs are pounded and ground into powder, mixed with refined honey, and pounded five hundred times. Form into pills the size of mung beans. Take ten pills per dose, with rice drink on an empty stomach.
For purulent and bloody dysentery after Shanghan, use Huangbai Tang (Phellodendron Decoction):
Huangbai (Phellodendri Cortex, removed coarse bark), Ejiao (Asini Corii Colla, cut and stir-fried until dry, each Ban liang), Huanglian (Coptidis Rhizoma, removed stamens, cut and stir-fried, Yi liang), Shanzhizi Ren (Gardeniae Fructus, embryo, Yi fen).
The above four herbs are chopped like hemp seeds. Take San qian bi per dose, add Shui yi zhan, decoct until Liu fen remains, remove dregs, and take warm before meals.
For heat-dysentery in Shanghan, use Huanglian Danggui Wan (Coptidis and Angelica Pill):
Huanglian (Coptidis Rhizoma, removed stamens, cut and stir-fried), Danggui (Angelicae Sinensis Radix, cut and baked, each Yi liang), Ganjiang (Zingiberis Rhizoma, processed), Chishizhi (Halloysitum Rubrum, each Ban liang).
The above four herbs are ground into powder, mixed with refined honey, pounded five hundred times, and formed into pills the size of Sophora seeds. Take thirty pills per dose, with rice drink before meals.
For dysentery with red and white discharge after Shanghan, use Diyu Yin (Sanguisorba Drink):
Diyu (Sanguisorbae Radix, San liang), Chishizhi (Halloysitum Rubrum, Yi liang).
The above two herbs are coarsely crushed and sieved. Take San qian bi per dose, add Shui yi zhan, decoct until Qi fen remains, remove dregs, and take warm before meals, twice daily.
For persistent dysentery after Shanghan epidemic, use Danggui Tang (Angelica Decoction):
Danggui (Angelicae Sinensis Radix, cut and baked), Huanglian (Coptidis Rhizoma, removed stamens, cut and stir-fried), Huangbai (Phellodendri Cortex, removed coarse bark), Digupi (Lycii Cortex, each Yi liang).
The above four herbs are chopped like hemp seeds. Take San qian bi per dose, add Shui yi zhan, decoct until Qi fen remains, remove dregs, add honey, mix well, and take warm before meals.
For purulent and bloody dysentery after Shanghan heat-pathogen, use Longgu San (Dragon Bone Powder):
Longgu (Dinosaur Bone), Huanglian (Coptidis Rhizoma, removed stamens and fried, equal parts).
The above two herbs are ground into powder. Take Er qian per dose, mixed with warm rice drink before meals, twice daily.
For disharmony of qi and unlimited spontaneous diarrhea after Shanghan, use Helile Yin (Terminalia Drink):
Helile Pi (Terminaliae Chebulae Fructus Pericarpium, four pieces, two raw, two roasted), Caodoukou (Amomi Fructus Rotundus, four pods, two raw, two roasted, peeled).
The above two herbs are coarsely crushed and sieved. Take Er qian bi per dose, add Jiangshui (fermented grain water) Yi zhan, decoct until Liu fen remains, remove dregs, and take warm on an empty stomach.
For deficiency-cold of the viscera and bowels after Shanghan, with dysentery of white pus and abdominal pain, use Longgu Wan (Dragon Bone Pill):
Longgu (Dinosaur Bone), Ganjiang (Zingiberis Rhizoma, processed), Fuzi (Aconiti Lateralis Radix Praeparata, processed, peeled, and navel removed, equal parts).
The above three herbs are ground into powder, mixed with vinegar-boiled wheat paste, and formed into pills the size of Sophora seeds. Take thirty pills per dose, with rice drink before meals, twice daily.
For all types of dysentery after Shanghan, regardless of cold or heat or abdominal pain, use Huanglian Wan (Coptidis Pill):
Huanglian (Coptidis Rhizoma, removed stamens and fried, Liang er), Muxiang (Aucklandiae Radix), Wuzhuyu (Evodiae Fructus, washed in hot water three times and stir-fried dry, each Yi liang).
The above three herbs are ground into powder, mixed with wheat paste, and formed into pills the size of Sophora seeds. Take twenty pills per dose, with rice drink on an empty stomach before meals.
For high fever and persistent dysentery after Shanghan, use Muli San (Oyster Shell Powder):
Muli (Ostreae Concha, fire-calcined), Huanglian (Coptidis Rhizoma, removed stamens and fried, each Yi liang), Wumei Rou (Mume Fructus pulp, baked, San fen), Longgu (Dinosaur Bone, Yi liang ban).
The above four herbs are ground into powder. Take Er qian bi per dose, mixed with rice drink on an empty stomach before meals.
For bleeding after Shanghan, and bleeding after sores/rashes, use Qianzhen San (Thousand Needles Powder):
Qianzhencǎo (unknown herb, likely Centaurii Herba or similar local name), Diyü (Sanguisorbae Radix), Fangfeng (Saposhnikoviae Radix, removed fork-like roots), Shengdihuang (Rehmanniae Radix Recens, baked), Dingfen (Cerussa, fried, each Ban liang), Pengsha (Borax, Er qian).
The above six herbs are pounded and ground into powder. Take Yi qian bi per dose, mixed with rice drink on an empty stomach before meals.
For adults and children with residual toxic heat and persistent bleeding after Shanghan, use Guanzhong San (Cyathulae Powder):
Guanzhong (Cyathulae Rhizoma, leaves picked clean), Huangbai (Phellodendri Cortex, removed coarse bark and honey-fried, equal parts).
The above two herbs are ground into powder. Take Yi qian to Er qian bi per dose, mixed with warm black bean decoction.
For frequent and painful bleeding after sweating in Shanghan, due to Yang-toxin entering the stomach, use Shengjin San (Golden Victory Powder):
Yujin (Curcumae Radix, five large pieces pounded), Niuhuang (Bovis Calculus, ground to the size of a soap nut).
The above two herbs are pounded and ground into powder. Take Yi qian bi per dose, decoct with Cujiangshui (vinegar grain water) Yi zhan for three boils, and take warm.
For bleeding after Shanghan, use Zhuru Tang (Bamboo Shavings Decoction):
Zhuru (Bambusa Textilis Caulis in Succedaneum), Shaoyao (Paeoniae Radix), Zixin (Scutellariae Radix, each Ban liang), Mutong (Akebiae Caulis, cut, San fen), Shengma (Cimicifugae Rhizoma), Heimu'er (Tremella Fuciformis, burned to ash, each Yi liang ban).
The above six herbs are coarsely crushed and sieved. Take San qian bi per dose, add Shui yi zhan, decoct until Liu fen remains, remove dregs, add Shengdihuang汁 (Juice of Rehmanniae Radix Recens) Yi he, mix well, and take warm before meals.
For persistent bleeding complicated by heat after Shanghan, use Huanglian San (Coptidis Powder):
Huanglian (Coptidis Rhizoma, removed stamens and ground into powder, Yi liang).
Take this single herb, mix with egg white to form a cake, burn until black, grind into powder again. Take Yi qian bi per dose, mixed with warm wine, at any time, can be repeated.
For spontaneous dysentery in Shanghan involving simultaneous Taiyang and Shaoyin syndromes, use Huangqin Tang (Scutellaria Decoction):
Huangqin (Scutellariae Radix, removed black heart, San fen), Shaoyao (Paeoniae Radix), Gancao (Glycyrrhizae Radix et Rhizoma, honey-fried, each Ban liang).
The above three herbs are chopped like hemp seeds. Take Wu qian bi per dose, add Shui yi zhan ban, Dazao (Jujubae Fructus, two pieces split open), decoct together until Ba fen remains, remove dregs, and take warm.