古今治痢，皆曰热则清之，寒则温之，初起热盛则下之，有表症则汗之，小便赤涩则分利之，此五者
举世信用如规矩准绳，不可易。予谓五者惟清热一法无忌，余则犯四大忌，不可用也，今详于后。
一曰忌温补
痢之为病由于湿热蕴积，胶滞于肠胃中而发也。宜清邪热，导滞气，行瘀血，其病即去。若用参术
等温补之药，则热愈热，气愈滞，而血亦凝，久之正气虚，邪气盛，不可疗矣。此投温补之祸为最烈也。
一曰忌大下
痢因邪热胶滞肠胃而成，与沟渠壅塞相似，惟用磨利疏通则愈。若用承气汤大下之，譬如欲
清壅塞之渠，而注狂澜之水，壅塞必不可去，无不岸崩堤塌矣。治痢而大下之，胶滞必不可去，徒伤胃气，损元气而已。
正气伤损，邪气不可除，壮者犹可，弱者危矣。
一曰忌发汗
痢者头痛目眩，身发寒热者，此非外感，乃因毒熏蒸自内达外，虽有表症，实非表邪也。若发汗则正气
既耗，邪气益肆。且风剂燥热愈助热邪，表虚于外，邪炽于内、鲜不毙矣。
一曰忌分利
利小便者，治水泻之良法也。以之治痢则大千矣。痢因邪热交滞，津液枯涩而成。若用五苓等剂分利
其水，则津液愈枯，而涩愈甚，遂至缠绵不己，则分利之为害也。若清热导滞，则痢自愈，
而小便自清，又安用分利为哉。
Throughout history, the treatment of dysentery has always stated that heat is cleared with cooling methods, cold is warmed with warming methods, initial excess heat is purged with downward-draining methods, exterior syndromes are resolved with sweating methods, and red, scanty, or difficult urination is treated with diaphoretic/diuretic methods (promoting urination). These five approaches are universally trusted like compasses and squares, unchangeable. I assert that among these five, only the method of clearing heat has no taboos; the others all violate four major contraindications and should not be used. These are detailed below.
The first is the taboo against warming and tonifying.
Dysentery arises from damp-heat accumulating and stagnating within the intestines and stomach. It should be treated by clearing pathogenic heat, guiding out stagnation, and moving blood stasis, after which the disease will resolve. If warming and tonifying herbs such as Renshen (Ginseng Radix) and Baizhu (Atractylodis Macrocephalae Rhizoma) are used, heat increases, qi stagnates further, and blood coagulates. Over time, righteous qi becomes deficient while pathogenic qi becomes excessive, making it incurable. The disaster caused by administering warming and tonifying agents is the most severe.
The second is the taboo against drastic purgation.
Dysentery results from pathogenic heat adhering and stagnating in the intestines and stomach, resembling a blocked canal. Only by grinding away and unblocking can it heal. If Chengqi Tang (Major Order the Qi Decoction) is used for drastic purgation, it is like attempting to clear a blocked canal by pouring in raging floodwaters; the blockage cannot be removed, resulting inevitably in the collapse of banks and dikes. Treating dysentery with drastic purgation fails to remove the adherent stagnation, merely injuring Stomach qi and depleting Yuan qi (Original qi). With righteous qi damaged, pathogenic qi cannot be eliminated. Those who are robust may survive, but those who are weak face danger.
The third is the taboo against inducing sweating.
When dysentery patients present with headache, vertigo, and alternating chills and fever, this is not an external contraction but rather toxicity steaming outward from within. Although there appear to be exterior signs, they are not truly exterior pathogens. Inducing sweating consumes righteous qi and allows pathogenic qi to spread unchecked. Furthermore, wind-dispelling agents are dry and hot, further assisting pathogenic heat, leaving the exterior deficient and internal pathogenic fire blazing; few escape death.
The fourth is the taboo against promoting urination.
Promoting urination is an excellent method for treating watery diarrhea. Using it for dysentery is a grave error. Dysentery forms due to the intermingling and stagnation of pathogenic heat, leading to the withering and drying of body fluids. If formulas such as Wuling San (Five-Ingredient Powder with Poria) are used to promote urination, body fluids become even more depleted, and dryness/stagnation worsens, leading to lingering, intractable illness. This is the harm caused by promoting urination. If pathogenic heat is cleared and stagnation guided out, dysentery heals spontaneously, and urination clears naturally; why resort to promoting urination?