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It is said: If there is diarrhea with clear water, the color is red and yellow, or undigested rice and grains are present, there is a strong desire to drink cold water, frequent vomiting and regurgitation, difficulty in urination, symptoms worsen significantly upon exposure to heat, restlessness in the chest and heart, and the pulse is deficient, large, and rapid. This occurs when pathogenic heat enters the Stomach due to deficiency, gathers and seeps into the Lower Jiao (Lower Burner), causing the body fluids to fail to separate into clear and turbid parts, and merging into the Large Intestine. This is called "Xie Re Xia Li" (Diarrhea accompanying fever/heat). First use Wu Ling San (Five-Ingredient Powder with Poria) to promote urination, then use Yu Fen Dan (Jade Powder Pill) and Si Wei E Jiao Wan (Four-Ingredient Donkey-Hide Gelatin Pill).

Ge Fen (Dinosaur Egg Shell Powder) and Liu Huang (Sulfur) in equal proportions.
Grind these two ingredients together into a fine powder, mix with white flour paste to form pills the size of Sophora seeds (Wu Tong Zi). Take 50 pills with warm water.

Huang Lian (Coptis Rhizome), Chi Fu Ling (Red Poria, skin removed, 2 liang), Shao Yao (Peony Root, 3 liang), E Jiao (Donkey-Hide Gelatin, stir-fried until dry, 1 liang).
First grind the first three ingredients into powder. Then boil the E Jiao with good vinegar until it becomes a thin paste. Mix with the powder to form pills the size of Sophora seeds. Take 30 pills with warm water.

The so-called dysentery with red and white discharge was named "Zhi Xia" (Stagnant Downward Flow) by the ancients. Investigating the source of the disease, it is all caused by external contraction of the five pathogenic factors (Wind, Cold, Summer-heat, Dampness, Dryness) and internal injury from raw, hard, or improperly temperature-regulated foods. The manifestations vary: some are red, some are white, some are mixed red and white, some are cold-type, some are heat-type, some are deficiency-type, and some are excess-type. Generally, throughout the four seasons, Stomach Qi is the foundation. No one escapes injury to the Spleen and Stomach without contracting external Wind, Cold, Summer-heat, Dampness, or Dryness. Once the Spleen and Stomach are weakened, and further injured by improper diet, the food cannot be digested, leading to accumulation and stagnation, resulting in Zhi Xia. The ancients said, "No accumulation, no dysentery," which refers to this. The Classics state: "If injured by Wind in Spring, Sun-Xie (diarrhea with undigested food) arises in Summer." Wind tends to injure the Liver. However, in Spring, Liver Wood is vigorous and does not easily accept pathogens; instead, its qi shifts to overact on Spleen Earth. Since the Spleen is subjected to this constraint, if one does not exercise caution in diet and indulges in raw, cold, sticky, or hard foods, the Spleen and Stomach cannot digest them, thus causing accumulation. Furthermore, during Summer and Autumn, if one contracts Summer-heat and Dampness or Wind-Cold again, it triggers dysentery. The symptoms must initially include umbilical and abdominal pain, profuse watery diarrhea, tenesmus (feeling of incomplete defecation), which may or may not be present, with discharge that may be red, white, or mixed, occurring day and night without limit. If such symptoms occur, regardless of whether it is cold, heat, deficiency, or excess, one should first administer Shen Shu San (Divine Efficacy Powder) to disperse Wind-Cold and Cold-Dampness; then administer Wu Ling San (Five-Ingredient Powder with Poria) to separate and drain water and grain; additionally use Jia Ba Ying Xiang Wan (Enhanced Ba Ying Xiang Pill) to warm the Spleen and Stomach and remove accumulation; or Liu Shen Wan (Six-God Pill). There will be no case that does not stabilize. Some say: Although the ancients stated that accumulation leads to dysentery, treatment does not exclusively focus on removing accumulation at first. Is it true that within a year, everyone has accumulation only in Summer and Autumn, but not in Spring and Winter? Actually, when Wind pathogen enters the Stomach, Wood overacts on Earth. If it does not cause sudden severe diarrhea, it becomes dysentery. Shen Shu San is the key formula for this. There is also another prescription where, within a county, transmission occurs among people above and below, with similar clinical presentations. Or within a single family, affecting both elders and children; or transmitted among neighbors; or diseases with the same name but different symptoms; or different symptoms but identical treatments. Some recover with warming agents, others with cooling medicines. Such cases are referred to as Du Yi Li (Toxic Epidemic Dysentery). In treating Toxic Epidemic Dysentery, although one should observe the mutual overcoming relationships of the Five Movements and Six Qi, one must not rigidly adhere to this theory. After all, if the movements and qi overcome each other, how can the toxin be confined to one region or county, affecting only one or two families? If such symptoms exist, first assess deficiency/excess and cold/heat. Initially use Bai Du San (Eliminate Toxin Powder), adding extra Ren Shen (Ginseng), Gan Cao (Licorice), Chen Mi (Aged Rice), Jiang (Ginger), and Zao (Jujube) for decoction. Also consider San Huang Shu Ai Tang (Three Yellows and Cooked Mugwort Decoction), Huang Lian E Jiao Wan (Coptis and Donkey-Hide Gelatin Pill), Wu Ling San (Five-Ingredient Powder with Poria), or Zhu Che Wan (Chariot-Stopping Pill), selecting as appropriate. If dysentery presents with predominantly red discharge, or pure fresh blood, tenesmus, constipation, high fever, heat in the palms and soles, severe restlessness and thirst, distending pain in the abdomen and hypochondrium, dark and scanty urine, and the six pulses are flooding, or tight and rapid, or deep and solid, this is Re Li (Heat Dysentery). It is suitable to use Bai Tou Weng Tang (Pulsatilla Decoction), San Huang Shu Ai Tang (Three Yellows and Cooked Mugwort Decoction), or Wu Ling San (Five-Ingredient Powder with Poria), selecting as appropriate. If Feng Li (Wind Dysentery) involves excessive bleeding, use Wei Feng Tang (Stomach Wind Decoction) added with Mu Xiang (Aucklandia) and Hei Dou (Black Soybean) for decoction. If dysentery occurs in Summer and Autumn, with red, white, or mixed discharge, umbilical and abdominal pain, tenesmus, aversion to cold with fever, chest restlessness, dry thirst with desire to drink, vomiting and nausea, difficulty in urination, and five-palm heat, with weak six pulses, these pulse and symptom patterns indicate the disease was obtained due to latent Summer-heat. One should take Xiang Ru San (Elsholtzia Powder) added with Huang Lian (Coptis), Gan Cao (Licorice), and Dang Gui (Angelica Sinensis), decocted strongly with wine and water, allowed to settle and cool, then taken in one dose. Additionally take Jiu Zheng Huang Lian Wan (Wine-Steamed Coptis Pill), or Xiao Chai Hu Tang (Minor Bupleurum Decoction) added with Ren Shen (Ginseng) for decoction; recovery is certain. (Hanlin Scholar Shen stated: There are many drugs for treating dysentery, but none are as effective as this. Essentially, Xiao Chai Hu Tang can treat Summer-heat toxicity.) If miscellaneous symptoms subside but dysentery persists, use Si Wu Tang (Four Substances Decoction) added with E Jiao (Donkey-Hide Gelatin) and Ai Ye (Mugwort Leaf) for decoction to harmonize Yin and Yang; there will be no case that does not stabilize. If water and grain are not separated and urination is difficult, use Wu Ling San (Five-Ingredient Powder with Poria), administered with decoction of Dan Zhu Ye (Lophatherum Leaf). If thirst and irritability are severe, this is also suitable. If the signs of latent Summer-heat are not understood, and one recklessly administers sulfur, Aconite, Ginger, Cinnamon, and mineral stones based solely on a deficient pulse, causing death, it is deeply lamentable. If dysentery presents with pure white discharge resembling fish brains, cold pain in the umbilical and abdominal regions, occurring day and night without limit, cold limbs, vomiting, inability to eat, preference for warm food and aversion to cold, and faint and thin six pulses, this is due to extreme deficiency-cold of the Zang-Fu organs. One should use Mu Xiang San (Aucklandia Powder) combined with Si Wei Li Zhong Tang (Four-Ingredient Regulate the Middle Decoction) and Zhong Ru Jian Pi Wan (Calcium Carbonate Spleen-Strengthening Pill). In severe cases with cold limbs and imperceptible pulses, one should employ potent tonification alone, combined with moxibustion on Qi Hai (CV6) and Dan Tian (CV8) acupoints, along with stomach-assisting herbs. This reflects the strategy of defense without attack. Suitable formulas include Si Shun Fu Zi Tang (Four-Smooth Aconite Decoction), San Jian Dan (Three Establishments Pill), Bai Dan (White Pill), Jia Wei Shen Fu Tang (Modified Ginseng-Aconite Decoction), and Jiang Fu Tang (Ginger-Aconite Decoction), selecting as appropriate. For elderly and weak individuals, or those with inherent constitutional weakness, this method should be carefully considered for regulation. However, opening the appetite and promoting food intake should be prioritized. Once food enters, the Spleen and Stomach can transform and transport, allowing waste to accumulate. Once waste is formed, the foul matter, blood, and stasis will naturally be eliminated. If chronic dysentery does not heal, with intestinal slipping and incontinence, loose stools persisting, and all other medicines ineffective, only then should astringent herbs for stopping dysentery be applied. One should initially use Long Gu (Fossilized Bones), Rou Dou Kou (Nutmeg), He Zi (Chebula Fruit), Zhong Ru (Calcium Carbonate), and Hu Fen (Lead White). Recently, people often use Ying Su Ke (Poppy Capsule) and Di Yu (Sanguisorba Root), but these substances are too astringent and can damage Stomach Qi. If taken by young, strong, and robust individuals, they may occasionally yield miraculous effects; however, if taken by those with toxic epidemic, summer-heat/dampness conditions, the elderly, or those with constitutional weakness, they will inevitably suffer great harm. If the priority is to astringe the intestines due to constipation, the Wind-Cold, Summer-heat, and Dampness pathogens will not only remain trapped but also cause the Stomach tube to close and become obstructed, leading to anorexia and daily emaciation. Without waste entering the intestines, the pathology cannot be resolved. If such symptoms arise, use Shen Ling Bai Zhu San (Ginseng, Poria, and Atractylodes Macrocephala Powder), Si Jun Zi Tang (Four Gentlemen Decoction), or formulas containing Shi Lian (Lotus Seed Plumule) and Shan Yao (Dioscorea Rhizome); treatment will surely succeed. When administering tonics for dysentery, there must be an intention of warmth and unblocking! Formulas like Si Jun Zi Tang (Four Gentlemen Decoction), Li Zhong Tang (Regulate the Middle Decoction), and Shi Quan Tang (Complete Ten Thousand Things Decoction) added with Mu Xiang (Aucklandia), Bai Dou Kou (Cardamom), Fu Ling (Poria), Guan Gui (Cassia Bark), and Hou Po (Magnolia Bark) can disperse Wind pathogens, separate water passages, open the Stomach tube, relieve entanglement/distress, and unblock constipation. This achieves a balance of attack and defense. Generally, the methods for treating dysentery are: tonify the deficient, purge the excess, astringe the slipping, unblock the closed, push out accumulation, disperse Wind, wash away Summer-heat, dry Dampness, cool Heat, warm Cold, and regulate Cold-Heat combinations. The goal is equilibrium; do not overdo it. This is the general principle. Preface by Yaoyin Laoren (Old Man Medicine Hidden).