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Xia Yuzhu stated: Zhu Danxi said that there is no fixed method to stop dysentery, and treatment should focus on promoting drainage. This statement is not entirely accurate. Why? Because dysentery can be of cold or heat nature; white discharge indicates deficiency-cold, while red discharge indicates excess-heat. Treatment should primarily regulate the Spleen and Stomach. If the disease has been present for only one or two days, accompanied by high fever throughout the body, thick and sticky pus and blood, tenesmus (urgency with painful defecation), and abdominal pain, Chengqi Tang (Cathartic Decoction) should be used to purge, or Muxiang Binglang Wan (Aucklandia and Betel Nut Pill). However, purgatives must not be used in patients with weak constitution. If the illness has persisted for a long time, the body is cool, and spontaneous sweating occurs, Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) is appropriate. If dysentery is complicated by heat with pure blood discharge, Sishun Qingliang Yin (Four-Obedience Cooling Beverage) or Huanglian Shaoyao Tang (Coptis and Peony Decoction) should be used. If complicated by cold with pure white discharge, or due to indigestion of milk and food, Lizhong Tang (Regulate the Middle Decoction) is suitable. If toxic damp-heat steams upward, blocking the throat and causing loss of appetite (Jinkou Li - Dysentery with inability to eat), Ren Shen (Ginseng Radix et Rhizoma), Huanglian (Coptidis Rhizoma), and Shilianzi (Nelumbinis Semen) are indicated. If prolonged dysentery leads to deficient Stomach Qi, resulting in an inability to consume food and drink (Jinkou Li), Lizhong Tang or Liujunzi Tang (Six Gentlemen Decoction) should be used. If accumulated toxins rush upward causing vomiting and nausea, Renshen Baidu Tang (Ginseng Detoxification Decoction) is appropriate. If vomiting and nausea are caused by deficient-cold of the Stomach, Fuzi Lizhong Tang (Aconite Regulate the Middle Decoction) is indicated. If post-dysenteric Spleen deficiency fails to control water metabolism, leading to generalized edema, Liujunzi Tang (Six Gentlemen Decoction) combined with Cangzhu (Atractylodis Rhizoma), Houpo (Magnoliae Officinalis Cortex), Zhuling (Polyporus), Zexie (Alismatis Rhizoma), Huanglian (Coptidis Rhizoma), and Shaoyao (Paeoniae Radix Alba) is suitable. For prolapse of the rectum due to prolonged dysentery, the *Neijing* states this is due to deficient-cold of the Lung Qi; because Spleen deficiency fails to nourish Metal (Lung), the Large Intestine becomes deficient and collapses downward. Treatment should tonify the Spleen and warm the Stomach using Guchang Yin (Intestine-Securing Beverage). If accumulation is exhausted but dysentery persists, it indicates sinking of Spleen Qi; Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) or Sijunzi Tang (Four Gentlemen Decoction) should be used. In the early stage, Jiangcha San (Ginger and Tea Powder) is appropriate. If dysentery with mixed red and white discharge is complicated by summer-heat, Qingshu Yiqi Tang (Clear Summer-heat and Tonify Qi Decoction) added with Xiangru Yin (Elsholtzia Beverage) is indicated.

My eldest son, at five years old, contracted dysentery simultaneously with my young nephew. My son had a constitutionally weak Spleen; upon onset, his abdomen did not hurt, he passed pure pus, white with blue tinges, and his breath was slightly cold. I did not use draining methods but administered Liujunzi Tang (Six Gentlemen Decoction). The nephew passed pure red stool and had wind-rashes all over his body; I prescribed Sishun Qingliang Yin (Four-Obedience Cooling Beverage) added with Fangfeng (Saposhnikoviae Radix) and Chaihu (Bupleuri Radix). The two prescriptions were decocted separately in different vessels on the same stove. A relative mistakenly gave my son’s prescription to the nephew. Consequently, the nephew’s rashes immediately disappeared, but he developed rapid breathing and snoring during sleep. I urgently administered Tianbao Caiwei Tang (Tianbao Vegetable-Picking Decoction). The rashes reappeared, and the wheezing ceased. He recovered after several more doses of the previous formula. This demonstrates that extreme Spleen deficiency does not require clearing and draining; forcibly using tonics [for heat-type dysentery] is incorrect. Heat dysentery requires clearing and should not be treated with tonics; this serves as verification.