论曰凡下痢不止，或时气之余，为水湿所乘，客于肠胃，令九虫皆动。侵蚀腑脏。故为
湿之病，所谓 者，虫动于匿而难知故也。谓其虫因湿而动，故名湿 ，其证上则蚀唇口
，下则蚀肛门，上唇生疮。是虫蚀五脏。令人心烦懊 ，下唇生疮。是虫蚀下部。令人肛门
伤烂，若胃虚气逆，则变为呕哕，甚即腑脏被伤，齿上下龈皆生疮，齿色黯黑。是其候也。
下痢出瘀血者，不可治。
治湿 痢不止，芫荑丸方
芜荑仁（微炒） 吴茱萸（汤洗焙炒） 干姜（炮各半两） 枳壳（去瓤麸炒） 黄连
（去须炒各三分）
上五味，捣罗为末，煮浆水饭和丸，如梧桐子大，每服二十丸，空心日午米饮下。
治湿 痢不止，芜荑黄连丸方
芜荑仁（微炒半两） 黄连（去须炒一两）
上二味。捣罗为末，炼蜜和丸，如梧桐子大，每服五丸，空心食前暖米饭下。加至七丸
治疳 蚀下部。苦参汤方
苦参 青葙子（各一两） 甘草（炙锉） 熊胆（研各半两）
上四味，除熊胆外，粗捣筛，每服四钱匕，水一盏半，煎至八分，去滓入胆半分搅和。
空心顿服，日午再煎服之。
治疳湿 痢，虫蚀下部。参连汤方
苦参（一两半） 黄连（去须炒二两） 阿胶（炙令燥一两）
上三味。粗捣筛，每服五钱匕，水一盏半，煎至八分，去滓空心温服，日晚再服。
治疳湿 蚀口齿，及下部。青葙子散方
青葙子 苦参 甘草（生锉各一两）
上三味。捣罗为散，每服一钱匕。食前暖生地黄汁调下。
治疳湿 下部疮烂。黄连汤方
黄连（去须四两） 熟艾（炒二两） 苦参 槐白皮（各三两）
上四味细锉，如麻豆大，每服五钱匕，水二盏，煎至八分。去滓温服，重者不过三剂。
治疳 蚀人下部。通见五脏。痢下脓血，举体不安，遍身疼痛，面无颜色，手足虚肿。
苦参散方
苦参 矾石（熬令汁尽） 青葙子（各半两） 藜芦（一分）
上四味，捣罗为散，每用二钱匕。置竹筒中，吹下部，日三二度，小儿只一钱匕。
治疳 下部上攻，移热杀虫，猪胆煎方
猪胆（一枚） 米醋（五合）
上二味。煎醋令百沸。入胆汁更三五沸，满口饮之，虫死即瘥。
治疳 无问所在，皆治之方。
上取死虾蟆，烧灰研末，以油和涂疮上。
治疳蚀赤血痢久不瘥。用之即瘥方
虾蟆（一枚五月五日采烧灰研） 金银土锅 人屎灰（一方云发灰各五两） 麝香（研
一分） 银末
上五味捣研为末，每用少许，敷疮上即瘥，痢者吹入下部。
治疳 蚀下部生疮，脓血杂下。身面有浮气。雄黄散方
雄黄（研） 青葙子（各二两） 苦参（三两） 矾石（熬令汁枯） 雌黄（研） 藜
芦铁衣（各一两） 麝香
上八味，捣研为散，每和酸枣大。以竹管送内下部中。日一，小儿以大豆许。此方能救
死。
治疳湿 ，下赤黑血，肛门虫蚀赤烂，日夜疼痛，熏黄散方
雄黄（研） 丹砂（研） 食盐（研） 青黛（研） 丁香 矾石（熬令汁枯研） 铁
衣栀子仁 麝香（研各一分） 莨菪子 细辛（去苗叶） 土瓜根 干姜（炮） 甜葶苈
（纸上炒） 菖蒲 虾蟆（烧灰研） 蜀椒（去目及闭口炒出汗） 故靴底（烧灰研各一钱）
天灵盖（枯腐者一分炙）
上一十九味，捣研为散，每用一钱匕，以绵裹内下部中，日再易，有疮即敷其上。
治疳湿 ，洗熨下部。丁香散方
丁香（一分） 麝香（研一钱） 犀角（镑） 甘草（锉各三分）
上四味。捣研为散，以盐椒各三合，豉二合，水三升，都煎至一升，去滓乘热。用绵蘸，
洗熨下部，冷即再暖用。
Commentary states: Whenever dysentery persists without cessation, or is due to residual pathogens from seasonal epidemic diseases, it is invaded by water-dampness. This pathogen lodges in the intestines and stomach, causing the "Nine Worms" (parasitic worms) to become active. They erode the fu organs and zang organs. Thus, a dampness disease arises. The condition referred to as "Gu" (a severe pathological state caused by worm accumulation or damp-heat) gets its name because the worms move in hidden places and are difficult to detect. It is said that these worms become active due to dampness, hence the name Damp-Gu. The symptoms manifest as erosion of the lips and mouth superiorly, and erosion of the anus inferiorly; sores appear on the upper lip, indicating that worms are eroding the five zang organs, causing mental restlessness and vexation. Sores appear on the lower lip, indicating that worms are eroding the lower part, causing injury and ulceration of the anus. If the stomach qi is deficient and rebellious, it transforms into vomiting and hiccups. In severe cases, the fu organs are damaged, sores appear on both the upper and lower gums, and the teeth turn dark black. These are the signs. If bloody stool with clots is passed during dysentery, it is incurable.
Formula for Yuan Yi Pill to treat persistent Damp-Gu dysentery:
Myrobalan Kernel (Myrobalanus chebula Retz., slightly stir-fried), 0.5 liang; Evodia Fruit (Evodiae Fructus, washed with decoction, dried, and stir-fried), 0.5 liang; Dried Ginger (Zingiberis Rhizoma Praeparatum, processed), 0.5 liang; Aurantium Fructus (Aurantii Fructus, pith removed, stir-fried with bran), 0.5 liang; Coptis Rhizome (Coptidis Rhizoma, mustards removed, stir-fried), 3 qian.
The above five herbs are crushed, sifted into powder, mixed with fermented rice water and cooked rice to form pills the size of paulownia seeds. Take 20 pills per dose, orally with rice beverage on an empty stomach and at noon.
Formula for Yuan Yi Huanglian Pill to treat persistent Damp-Gu dysentery:
Myrobalan Kernel (Myrobalanus chebula Retz., slightly stir-fried), 0.5 liang; Coptis Rhizome (Coptidis Rhizoma, mustards removed, stir-fried), 1 liang.
The above two herbs are crushed, sifted into powder, mixed with refined honey to form pills the size of paulownia seeds. Take 5 pills per dose, orally before meals on an empty stomach with warm cooked rice. Dosage may be increased to 7 pills.
Decoction of Sophora Root to treat Gan syndrome with Damp-Gu erosion of the lower part:
Sophora Root (Sophorae Flavescentis Radix), 1 liang; Celosia Seed (Celosiae Semen), 1 liang; Licorice Root (Glycyrrhizae Radix et Rhizoma, roasted and cut), Bear Bile (Ursi Fel, ground), 0.5 liang.
For the above four herbs, except Bear Bile, coarsely crush and sieve. Take 4 qian bi per dose, add 1.5 sheng of water, decoct until 0.8 sheng remains, strain, and mix in 0.5 fen of Bear Bile. Take orally in one dose on an empty stomach, and decoct again for a second dose at noon.
Decoction of Ginseng and Coptis to treat Gan syndrome with Damp-Gu dysentery and worm erosion of the lower part:
Sophora Root (Sophorae Flavescentis Radix), 1.5 liang; Coptis Rhizome (Coptidis Rhizoma, mustards removed, stir-fried), 2 liang; Donkey-hide Gelatin (Asini Corii Colla, roasted until dry), 1 liang.
The above three herbs are coarsely crushed and sieved. Take 5 qian bi per dose, add 1.5 sheng of water, decoct until 0.8 sheng remains, strain, and take warm on an empty stomach. Take another dose in the evening.
Powder of Celosia Seed to treat Gan syndrome with Damp-Gu erosion of the mouth, teeth, and lower part:
Celosia Seed (Celosiae Semen), 1 liang; Sophora Root (Sophorae Flavescentis Radix), 1 liang; Licorice Root (Glycyrrhizae Radix et Rhizoma, raw and cut), 1 liang.
The above three herbs are crushed and sifted into powder. Take 1 qian bi per dose, mix with warm juice of fresh Rehmannia Root (Rehmanniae Radix) before meals.
Decoction of Coptis to treat Gan syndrome with Damp-Gu ulceration of the lower part:
Coptis Rhizome (Coptidis Rhizoma, mustards removed), 4 liang; Prepared Mugwort Leaf (Artemisiae Argyi Folium, stir-fried), 2 liang; Sophora Root (Sophorae Flavescentis Radix), 3 liang; Bark of Huai Tree (Meliae Cortex), 3 liang.
The above four herbs are finely cut to the size of hemp seeds. Take 5 qian bi per dose, add 2 sheng of water, decoct until 0.8 sheng remains, strain, and take warm. For severe cases, no more than three doses are needed.
Powder of Sophora Root to treat Gan syndrome where Gu toxin erodes the lower part, affecting the five zang organs. Symptoms include dysenteric discharge of pus and blood, general discomfort, body-wide pain, pallor, and edema of hands and feet:
Sophora Root (Sophorae Flavescentis Radix), 0.5 liang; Alum (Alumen, boiled until liquid is gone), 0.5 liang; Celosia Seed (Celosiae Semen), 0.5 liang; Veratrum Rhizome (Veratri Rhizoma), 1 qian.
The above four herbs are crushed and sifted into powder. Use 2 qian bi each time, place in a bamboo tube, and insufflate into the lower affected area. Apply 2-3 times daily. For children, use only 1 qian bi.
Decoction of Pig Gallbladder to treat Gan syndrome where Gu toxin attacks upward from the lower part, transferring heat to kill worms:
Pig Gallbladder (Suis Vesica Biliaris), 1 piece; Rice Vinegar (Acetum Orizae), 5 he.
Boil the vinegar until it boils vigorously multiple times. Add the gallbladder juice and boil for 3-5 more cycles. Drink enough to fill the mouth. The worms will die and the condition will heal.
General formula to treat Gan syndrome Gu regardless of location:
Take a dead toad, burn it to ash, grind into powder, mix with oil, and apply topically to the sores.
Effective formula for Gan syndrome erosion causing chronic bloody dysentery that does not heal:
Toad (collected on the fifth day of the fifth lunar month, burned to ash and ground), 5 liang; Yinjin Tu Guo (specific mineral/earth material, 5 liang); Ash of Human Feces (another version uses hair ash), 5 liang; Moschus (Moschi Fermentum, ground), 1 qian; Silver Powder.
Grind the above five ingredients into powder. Apply a small amount topically to sores for healing. For dysentery, insufflate into the lower part.
Powder of Realgar to treat Gan syndrome Gu erosion causing sores in the lower part with mixed pus and blood, and facial/body edema:
Realgar (Arsenici Sulfidum, ground), Celosia Seed (Celosiae Semen), 2 liang each; Sophora Root (Sophorae Flavescentis Radix), 3 liang; Alum (Alumen, boiled until dry), Female Realgar (Arsenici Trisulfidi, ground), Lirui Tieyi (Iron rust from Li Lu processing?), 1 liang each; Moschus (Moschi Fermentum).
Crush and grind the above eight ingredients into powder. Mix with a dose equivalent to a sour jujube seed, insert into the lower part using a bamboo tube. Once daily. For children, use a dose the size of a soybean. This formula can save dying patients.
Fumigation Powder Xunhuang to treat Gan syndrome Damp-Gu, passage of red-black blood, red and rotten erosion of the anus by worms, and day-and-night pain:
Realgar (Arsenici Sulfidum, ground), Cinnabar (Mercurii Sulfidum Rubrum, ground), Salt (Natrii Chloridum, ground), Indigo Naturalis (Indici Folium, ground), Clove (Eugeniae Flos), Alum (Alumen, boiled until dry and ground), Iron Rust (Ferrum Oxidatum), Gardenia Fruit (Gardeniae Fructus), Moschus (Moschi Fermentum, ground, 1 qian each), Henbane Seed (Hyoscyami Semen), Asarum Root (Asari Radix et Rhizoma, stems and leaves removed), Trichosanthes Root (Trichosanthis Radix), Dried Ginger (Zingiberis Rhizoma Praeparatum), Sweet Descurainia Seed (Descurainiae Semen Praeparatum, stir-fried on paper), Acorus Tatarinowii Rhizome (Acori Tatarinowii Rhizoma), Toad Ash (Bufo Venenum, burned to ash and ground), Sichuan Pepper (Zanthoxyli Pericarpium, eyes and closed-mouth ones removed, stir-fried to release moisture), Old Boot Sole (burned to ash and ground, 1 qian each), Tianlinggai (Skull bone of human, decomposed, roasted, 1 qian).
Grind the above nineteen ingredients into powder. Use 1 qian bi per dose, wrap in cotton, insert into the lower part. Change twice daily. If there are sores, apply the powder on top.
Powder Dingxiang for washing and compressing the lower part in Gan syndrome Damp-Gu:
Cloves (Eugeniae Flos), 1 qian; Moschus (Moschi Fermentum, ground), 1 qian; Rhino Horn (Rhinocerotis Cornu, sliced); Licorice Root (Glycyrrhizae Radix et Rhizoma, cut), 3 qian.
Crush and grind the above four ingredients into powder. With salt and Sichuan pepper (3 he each) and fermented soybeans (2 he), add 3 sheng of water. Decoct until 1 sheng remains. Strain while hot. Dip cotton in the liquid to wash and compress the lower part. Reheat when cool.