邹（左） 痢成休息，色赤粘腻。脉濡微滑，苔白心黄。此湿热郁阻大肠屈曲之处。病久邪深，不能一蹴而几也。
炙绵 奎党参 醋炙升麻 诃黎勒 广皮 当归炭 野于术 醋炒柴胡 驻车丸（三钱）
陈（右） 痢成休息，临圊仍痛。脉濡而滑。此湿积伏留大肠屈曲之处。暂为疏通。
炒川连（五分） 于术（一钱五分） 党参（二钱） 枳实（一钱） 湘军（二钱炒） 当归炭（一钱五分）
白芍（一钱五分） 云苓（四钱） 炮姜（三分）
二诊 疏通肠胃，临圊仍然腹痛，脓血稠腻，而大便依然结燥。良以久痢阴伤，脏阴愈亏，则腑阳愈燥。
和阴之中，仍开湿热。
当归炭（二钱） 生地炭（三钱） 火麻仁（三钱） 白芍（甘草汤炒一钱五分） 地榆炭（二钱） 丹皮炭（
二钱） 栝蒌仁（四钱） 阿胶（一钱五分） 上徭桂（三分） 川黄柏（一钱五分） 川连（三分三味研细末米饮
为丸晒干先服）
三诊 养脏之阴，开腑之结，大便减少一次，脓血亦稀。其为脏阴不足，腑阳有余，可无疑义。前法再进一步。
炒阿胶（二钱） 当归炭（二钱） 地榆炭（二钱） 炒槐花（二钱） 火麻仁（三钱） 大生地（四钱）
丹皮炭（二钱） 栝蒌仁（三钱） 白芍（一钱五分甘草二分同炒）
方维卿 投剂之后，合夜甚安，至今午后呃忒又盛，下痢肛门火热滞坠，小溲热痛。脉数左尺坚硬，苔
白质红。痰滞较化，故得胃中之热气暂平。而下焦之火挟热上冲，所以肺胃之气，欲从下降而不能降，
至成彼此鼓激之局。忌款未退仍在危地也。
生熟白芍（各一钱） 广皮（一钱） 砂仁（七分） 炒竹茹（一钱） 滋肾丸（三钱） 生熟木香（各三分）
川连（五分） 吴萸（一分川连同炒） 磨刀豆子（四分）
二诊 宣肺气之痹，原欲行其上而下脘通降也。乃呃忒仍然不止，中脘结痹不舒，沃出痰涎，呃方暂
定。下痢频频。脉数，右关沉糊。良以暑湿热三气郁阻肠胃不化，热迫于下，致湿热之气，俱结于上。胃中
之阳气不通。痢证之忌象频见，敢云治乎。不得已仿附子泻心法。
熟附子（五分） 川连（姜汁炒五分） 木香（五分） 橘皮（一钱） 炙柿蒂（四个） 公丁香（三分）
赤白苓（各二钱） 干姜（五分） 猪苓（二钱） 泽泻（一钱五分） 竹茹（一钱）
三诊 呃逆较疏，仍然不止，下痢较爽，溲略通利。脉象稍稍有神。木邪素旺，暑湿热郁阻肠中，胃府失
于通降，遂失清升浊降之常。仍在险途。
台参须（另煎冲八分） 炒川雅连（四分） 制半夏（三钱） 刀豆子（磨冲三分） 茯苓（四钱） 枳
实（一钱） 炒淡干姜（五分） 橘皮（一钱五分） 竹茹（姜汁炒一钱） 公丁香（三分） 上徭桂（三分）
柿蒂（二枚三味共研细末饭丸药汤送下）
按师常云、维卿之恙，后审知其有停饮，用沉香黑丑二味见功，此法外之法也。下方丁香徭桂黑丑三味，
固以有酸水泛出而用，然治法之神，殆得子和氏三昧者矣。（清儒附注）
四诊 呃忒下痢俱减，神情亦略起色，脉沉略起，然脘中时仍阻塞，并有酸水泛出。良以平素所有之
寒，阻遏中阳，致气血鼓激，胃气逆冲。既稍有转机，不得不竭人力，以希造化。
台参须（另煎六分） 鲜生姜（洗切一钱） 制半夏（三钱） 茯苓（五钱） 煨木香（五分） 公丁香（三
分） 上徭桂（四分） 黑丑（三分后三味研细末饭丸姜汤下）
五诊 呃止两日，而下痢仍然不减，腹痛溲少，糜黄甚臭。脉微数。上寒下热，而又未便苦寒。姑以轻剂扩清火府。
炒红曲（二钱） 砂仁（七分） 猪苓（二钱） 滑石（四钱） 赤白苓（各二钱） 鲜荷叶（一角）
甘草（二分） 广皮（一钱） 木香（五分） 沉香（三分） 血珀（五分二味研细先服）
六诊 胃纳稍起，小溲略通。昨药进后，其痢甚畅，旋即止住有数时之久，至晚又痢不爽。良以湿热之
郁阻者，既开复痹。姑再开通。
广皮 砂仁 木香 薏仁 花槟榔 赤白苓 泽泻 川朴 香连丸（药汁送）
炒枯赤砂糖（四钱） 松萝茶（三钱） 白萝卜汁（半杯冲） 陈关蛰（七钱上四味煎汤代茶）
七诊 胃气渐开，痢亦渐疏，而时有欲痢之意。还是湿热之郁，气机不能开通。再苦辛开通。
赤白苓 木猪苓 木香 砂仁 泽泻 陈皮
生薏仁 滑石块 上徭桂（三分） 炒川连（三分） 炒黄柏（一钱三味研细末米饮糊丸药汁送下）
某 苦辛以合化，淡渗以导湿，亥子之交，小溲即多，且极清利，独后重仍不能除。良以气虚之甚，清阳
之气，沦坠不举，非然者，何以宣通府气，导滞祛湿，并不足以挫其压坠之势，而后重于子后必甚。惟向
有麻瞀昏晕之本病，非方家意会之所及，断不敢言升举耳。其实上越之阳，起于肝木，而沦陷之阳，出
于脾胃，风马牛不相及也。用东垣先生法以觇动静，姑勿过剂，以留余地。
上有 （二钱） 生于术（一钱五分） 炙升麻（三分） 炙草（三分） 白归身（二钱） 大兼参条（一
钱） 炙柴胡（四分） 广皮（七分）
改方加戊己丸。
左 休息痢疾，每因湿热逗留而成，其红赤之物，都缘湿热迫伤营分。然邪郁大肠，安有久而不去，不
腹痛、不后重之理。今并不身热，不腹痛、不后重，其血液时止时来，而脉象常带细数，又安有不发热而
脉数之理。所以然者，以痢伤脾阴，脾为统血之帅，脾阴不能统摄，血液渗溢，其红腻之物，即随时而见。
前用补益藏阴，服之颇适，药既应手，毋庸更张。
当归炭（一钱五分） 人参须（另煎冲七分） 生姜（二钱打汁炒生地渣） 炙草（四分） 茯苓神
（各二钱） 木瓜皮（炒一钱五分） 淮山药（二钱） 白芍（土炒一钱五分） 大生地（四钱打汁
炒生姜渣） 黑大枣（二枚）
荣（右） 交节痢数增多。气虚而湿热留恋，补泻两难，姑用七补三泻，以觇动静。
炙绵 （二钱） 茯苓（四钱） 广木香（五分） 升麻（醋炒四分） 炒于术（一钱五分） 诃黎勒
（三钱） 广皮（一钱） 柴胡（醋炒五分） 党参（二钱） 生熟草（各一分）
二诊 痢数稍减，其为气虚可见。前法再进一步。
炙绵 （三钱） 诃黎勒（二钱煨） 党参（三钱炒） 炮姜（三分） 炒川连（三分） 归身炭（二
钱） 野于术（二钱炒） 泽泻（一钱五分） 真阿胶（一钱五分蛤粉炒） 生熟草（各二分） 茯苓（三钱）
三诊 脉症相安，再守效方出入。
炙上 党参 炒于术 茯苓 驻车丸 菟丝子 柴胡 炙升麻 广皮
四诊 下痢虽减，而有时仍带粘腻。肠胃湿热留恋，脾阳不能升举。前法再进一步。
炙绵 （三钱） 阿胶珠（二钱） 党参（三钱） 炮姜（四分） 诃子肉（煨二钱五分） 炒川连
（四分） 于术炭（二钱） 茯苓（四钱） 炙草（三分） 当归炭（一钱五分）
张（右） 气撑腹痛下痢。湿热化燥伤阴，脉虚喉舌起腐。深入重地，图治为难。
炒川连（三分） 当归须（一钱五分） 川石斛（五钱） 炒松麦冬（一钱五分） 北沙参（五钱） 淡黄芩（酒
炒一钱） 云茯神（三钱） 丹皮炭（一钱五分） 戊己丸（一钱五分二露送下） 野蔷薇露（一两） 白荷花露（
一两）
二诊 糜腐大退，痢亦略疏，而腹仍作痛。湿热稍化，阴液渐能上升，而有形之积，犹然内阻。虽见转机，未
为稳妥。
磨枳实（六分冲） 酒炒淡芩（一钱五分） 炒北沙参（四钱） 川雅连（土炒三分） 川石斛（四钱） 土炒
白芍（一钱五分） 炒范志曲（三钱） 磨槟榔（三分冲） 鲜佛手露（一两冲） 野蔷薇露（一两冲）
左 下痢兜涩太早，以致湿热伤营，便痢紫黑。蒸湿成痰，痰多咳嗽。上下交困，久虚之体，恐不能支。
丹皮炭 南楂炭 炒槐花 前胡 葶苈子 川连炭 延胡索 白桔梗 茯苓 泽泻
二诊 紫黑之血已退，而下痢仍然不止。的是湿热伤营。前法兼益脾肾。
野于术 茯苓 川连炭 破故纸 生熟木香 丹皮炭 广皮 炮姜炭 菟丝子 莲子
某 噤口大势，较前虽减，然临圊依然痛坠，节骱作烧，糜饮入口，辄欲反出上 两腮唇口糜腐满布。
然又并不甚浊。脉数滑。久按少情。此湿热内郁，下则压坠府气，上则熏灼伤阴。有厥脱之虞。拟清燥并
行，甘苦合化法。备请商进。
南沙参（炒黄四钱） 金石斛（三钱） 淡芩（一钱五分） 法半夏（一钱五分盐水炒） 赤白苓（各二钱）
广橘白（一钱） 滑石块（三钱） 川连（五分） 方通（八分） 白荷花露（一两） 佛手露（一两二味温过药）
某 至冬而成下痢，湿热蕴伏之深可知。大肠迂回曲折，湿热在是，不易泄化，欲成休息淹缠之证。可
以治而愈，不可以治而遽愈也。耐心善调为上。
炙绵 当归炭 炙升麻 野于术 西党参 诃黎勒 炙柴胡 广陈皮 驻车丸（二钱）
某 痢久而根未除，赤白互见，后重起沫。脾虚而湿热郁阻肠中。烟体当此，极恶劣也。姑为温脏清腑。
炮姜 焦冬术 生熟木香 范志曲 生熟陈皮 泽泻
川雅连 生熟薏仁 猪茯苓 淡黄芩
章（左） 下痢赤腻，里急后重。苔黄糙 ，脉滞不爽。暑湿热郁阻肠胃。烟体当此，未可与寻常并论。
整砂仁（四枚） 磨木香（四分冲） 陈皮（一钱） 白芍（一钱五分甘草三分煎汤收入） 黄柏
炭（一钱） 川雅连（酒炒五分） 枳实（一钱） 茯苓（三钱） 炮姜（三分）
二诊 下痢已止，而便尚未调。再和中清理湿热，以清邪薮。
上川朴 猪茯苓 南楂炭 生熟谷芽 川雅连 野于术 广陈皮 泽泻
庞（左） 下痢不止，所下皆属紫瘀之色，口燥舌干。脉细数，舌苔灰滞。湿热伤营，清津不司流布。恐元气
难支，虚中生变。
黄柏炭（二钱） 北秦皮（一钱五分） 杭白芍（二钱甘草二分煎汁收入） 橘白（一钱） 当归炭（二钱）
丹皮炭（一钱五分） 川连炭（四分） 炒扁豆衣（三钱） 白头翁（三钱） 炒槐花（二钱）
二诊 下痢大减，血亦太少，然仍赤腻色鲜，口燥舌干。湿热迫伤营分。再参养血和营。
川连炭（五分） 白头翁（三钱） 白芍（一钱五分） 北秦皮（一钱五分） 丹皮炭（二钱） 扁豆衣（三钱）
驻车丸（四钱） 茯苓（三钱）
三诊 下痢已止，然阴分损伤不复，口燥，多梦纷纭。再养血和阴。
阿胶珠（三钱） 丹皮炭（二钱） 甘草（二分） 川雅连（二分） 杭白芍（一钱五分） 金石斛
（三钱） 当归炭（二钱） 茯神（三钱） 炒枣仁（二钱） 生山药（三钱）
左 每至便后，辄下血淋漓。脉形濡滑。湿热郁于大肠。宜苦燥湿，寒胜热。
川连炭（四分） 黄柏炭（二钱） 白茯苓（三钱） 制茅术（一钱五分） 荆芥（一钱） 炒于术
（一钱） 丹皮炭（二钱） 炒防风（一钱） 大红鸡冠花（三钱） 泽泻（一钱五分）
王（左） 休息痢虽愈，肠胃必有留邪，夏湿熏蒸，下痢复发，临圊腹痛，色赤粘腻。舌苔近根霉黑，
肠中尚有留滞。先为疏通。
川朴（一钱） 枳实（一钱） 砂仁（五分） 白芍（一钱五分） 范志曲（二钱炒） 陈皮（一钱）
茯苓（三钱） 木香（五分） 香连丸（六分分二次开水送）
二诊 舌根霉黑已化，下痢较疏，临圊稍爽，赤色亦退。再理气以宣府热。
广木香（五分） 广皮（一钱） 赤白苓（各三钱） 生熟谷芽（各一钱五分） 缩砂仁（五分）
于术（一钱） 生熟薏仁（各二钱） 炒范志曲（一钱五分） 泽泻（一钱五分） 枳壳（一钱）
三诊 下痢已止，大便未实。再培土而参调气。
炒于术（八分） 煨木香（四分） 扁豆衣（三钱） 生熟薏仁（各二钱） 砂仁（五分） 白茯苓（三钱）
广皮（土炒一钱） 炒山药（三钱） 泽泻（一钱五分） 煨生姜（二片）
四诊 大便未实，临圊仍 有声。湿热未能尽澈，气滞因而不宣。再导气理湿。
川朴（八分） 陈皮（土炒一钱） 生熟木香（各三分） 川连（五分） 焦谷芽（三钱） 炮姜（五分）
泽泻（一钱五分） 生熟米仁（各二钱） 砂仁（五分） 茯苓（三钱）
五诊 圊后带红，色虽不鲜，而甚觉粘腻。还是湿热所化。前年曾患休息，脾气藏阴已虚。拟升脾养脏清腑。
奎党参（二钱） 炒于术（一钱五分） 升麻（醋炙三分） 驻车丸（三钱开水送分二服） 炙绵 （二钱）
生熟草（各二分） 柴胡（醋炙三分） 广皮（一钱） 砂仁（五分）
龚（左） 痢经二月有余，从白变赤，腹痛不起于初起之时，而起于从白变赤之后。湿热损伤营分。恐成
休息缠绵之证。
当归炭（二钱） 广木香（三分） 杭白芍（一钱五分） 枳壳（一钱） 白茯苓（三钱） 川
Zou (Left) Dysentery has turned into *xiuxi* dysentery (chronic/recurrent dysentery), with stools being red and sticky. The pulse is soft and slightly slippery, and the tongue coating is white with a yellow center. This indicates damp-heat stagnating and obstructing the convoluted parts of the large intestine. Given the long duration and deep-seated pathogen, a quick cure cannot be expected.
Zhi Mian Huangqi (Honey-fried Astragali Radix) Kui Dangshen (Codonopsis from Kwei) Cu Zhi Shengma (Vinegar-fried Rhizoma Cimicifugae) Helile (Fructus Terminaliae Chebulae) Guangpi (Exocarpium Citri Reticulatae) Danggui Tan (Charred Radix Angelicae Sinensis) Ye Yuzhu (Atractylodis Macrocephalae Rhizoma) Cu Chao Chaihu (Vinegar-fried Bupleuri Radix) Zhuche Wan (Zhuche Pill) (3 qian)
Chen (Right) Dysentery has turned into *xiuxi* dysentery, with pain persisting during defecation. The pulse is soft and slippery. This indicates damp-turbidity accumulating and lingering in the convoluted parts of the large intestine. Temporarily employ a method to unblock and dredge.
Chao Chuanlian (Stir-fried Coptidis Rhizoma) (5 fen) Yuzhu (1 qian 5 fen) Dangshen (2 qian) Zhishi (1 qian) Xiangjun (2 qian, stir-fried) Danggui Tan (1 qian 5 fen)
Baishao (1 qian 5 fen) Yunling (4 qian) Paojiang (3 fen)
Second visit: After unblocking the intestines and stomach, abdominal pain persists during defecation; pus and blood are thick and sticky, and stool remains dry and hard. This is likely due to yin injury from chronic dysentery; as zang-yin becomes more deficient, fu-yang becomes more dry and hot.
While harmonizing yin, continue to open up damp-heat.
Danggui Tan (2 qian) Shengdi Tan (3 qian) Huomaren (3 qian) Baishao (Stir-fried with Licorice decoction, 1 qian 5 fen) Diyu Tan (2 qian) Danpi Tan (2 qian) Gualou Ren (4 qian) Ejiao (1 qian 5 fen) Shangyao Gui (Cinnamon Twig from Shangyu) (3 fen) Chuanhuangbo (1 qian 5 fen) Chuanlian (3 fen, these three ingredients ground into fine powder, made into pills with rice water paste, dried, and taken first).
Third visit: Nourishing the yin of the zang organs and opening the obstruction of the fu organs, bowel movements have decreased by one instance, and pus/blood have become thinner. It is undoubtedly that zang-yin is insufficient and fu-yang is excessive. The previous method should be advanced further.
Chao Ejiao (2 qian) Danggui Tan (2 qian) Diyu Tan (2 qian) Chao Huaihua (2 qian) Huomaren (3 qian) Da Shengdi (4 qian)
Danpi Tan (2 qian) Gualou Ren (3 qian) Baishao (1 qian 5 fen, stir-fried with 2 fen Licorice)
Fang Weiqing: After taking the medicine, he slept peacefully all night, but eructation worsened in the afternoon. Dysentery was accompanied by a burning sensation and tenesmus in the anus, and painful, hot urination. The pulse is rapid, the left chi position is hard, the tongue coating is white, and the tongue body is red. Phlegm-stagnation has slightly resolved, so the heat in the stomach temporarily calmed. However, fire from the lower jiao rushes upward with heat, causing lung and stomach qi to fail to descend, creating a situation where upper and lower forces clash. The cough has not subsided, and the condition remains critical.
Sheng Baishao and Shu Baishao (1 qian each) Guangpi (1 qian) Sharen (7 fen) Chao Zhuru (1 qian) Zishen Wan (Zishen Pill) (3 qian) Sheng Muxiang and Shu Muxiang (3 fen each)
Chuanlian (5 fen) Wuyu (1 fen, stir-fried with Chuanlian) Modouzi (Grind and take, 4 fen)
Second visit: Ventilating the obstruction of lung qi was intended to promote descending function in the lower epigastrium. However, eructation continues, and there is fullness and discomfort in the middle epigastrium. Only after vomiting phlegm-saliva does eructation temporarily stop. Dysentery is frequent. The pulse is rapid, and the right guan position is deep and blurry. This is likely due to summer-heat, dampness, and heat pathogens stagnating in the intestines and stomach, failing to transform. Heat forces downward, causing damp-heat to accumulate in the upper jiao. Yang qi in the stomach is blocked. Contraindicated signs for dysentery appear frequently; how can one claim it is treatable? Reluctantly, I imitate the Fuzi Xiexin Tang method.
Shu Fuzi (5 fen) Chuanlian (Stir-fried with ginger juice, 5 fen) Muxiang (5 fen) Jupi (1 qian) Zhi Shidi (Honeysuckle Calyx, 4 pieces) Gong Dingxiang (Caryophylli Flos, 3 fen)
Chi Ling and Bai Ling (2 qian each) Ganjiang (5 fen) Zhuling (2 qian) Zexie (1 qian 5 fen) Zhuru (1 qian)
Third visit: Eructation intervals have lengthened but has not stopped. Dysentery is smoother, and urination is slightly patent. The pulse shows slight spirit. Liver wood qi is naturally vigorous; summer-heat, dampness, and heat stagnate in the intestines. The stomach fu loses its descending function, disrupting the normal ascent of clear yang and descent of turbid yin. The condition remains dangerous.
Taishen Xu (Decoct separately and add, 8 fen) Chao Chuan Yalian (Stir-fried Coptidis Rhizoma, 4 fen) Zhi Banxia (Prepared Pinellia Tuber, 3 qian) Douzizi (Grind and take, 3 fen) Fuling (4 qian) Zhishi (1 qian) Chao Dan Ganjiang (Stir-fried mild Dried Ginger, 5 fen) Jupi (1 qian 5 fen) Zhuru (Stir-fried with ginger juice, 1 qian) Gong Dingxiang (3 fen) Shangyao Gui (3 fen)
Shidi (2 pieces, these three ground into fine powder, made into rice pills, taken with medicinal soup)
Note: The Master often said that Fang Weiqing’s illness was later found to involve retained fluids (Yin). Using Chenxiang and Heichou proved effective; this is a method beyond standard methods. (Annotation by Qing scholar)
Fourth visit: Eructation and dysentery both decreased, mental state improved slightly, and the pulse rose slightly upon deep pressure. However, the epigastrium remains occasionally blocked, with acid regurgitation. This is likely because inherent cold pathogens obstruct middle yang, causing qi and blood to clash and stomach qi to rebel upward. Since there is slight improvement, we must exert human effort to hope for natural healing.
Taishen Xu (Decoct separately, 6 fen) Xian Shengjiang (Washed and sliced, 1 qian) Zhi Banxia (3 qian) Fuling (5 qian) Wei Muxiang (Baked Aucklandiae Radix, 5 fen) Gong Dingxiang (3 fen)
Shangyao Gui (4 fen) Heichou (Semen Phaseoli Volubilis, 3 fen, last three ground into powder, made into rice pills, taken with ginger soup)
Fifth visit: Eructation stopped for two days, but dysentery persists. Abdominal pain and scanty urine. Stool is mushy, yellow, and foul-smelling. Pulse is slightly rapid. Upper cold and lower heat, yet bitter-cold herbs are inappropriate. Tentatively use a light formula to clear the Fire Fu (Small Intestine).
Chao Hongqu (Stir-fried Red Yeast Rice, 2 qian) Sharen (7 fen) Zhuling (2 qian) Huashi (Talcum, 4 qian) Chi Ling and Bai Ling (2 qian each) Xian Heye (Fresh Lotus Leaf, 1 jiao)
Gancao (2 fen) Guangpi (1 qian) Muxiang (5 fen) Chenxiang (Aquilaria Wood, 3 fen) Xuepo (Blood Amber, 5 fen, these two ground fine and taken first)
Sixth visit: Appetite slightly improved, urination slightly patent. After yesterday's medicine, dysentery flowed freely then stopped for hours, but became unsatisfactory again by evening. Likely because damp-heat obstruction opened but re-obstructed. Tentatively continue to unblock.
Guangpi Sharen Muxiang Yiren (Coix Seed) Huabinglang (Areca Seed) Chi Ling and Bai Ling Zexie Chuanpu (Magnolia Bark) Xianglian Wan (Xianglian Pill, taken with medicinal juice)
Chao Ku Chishatang (Stir-fried Charred Brown Sugar, 4 qian) Songluocha (Songluo Tea, 3 qian) Bailuojiazhi (White Radish Juice, half cup mixed) Chenguandezhe (Aged Eupolyphaga, 7 qian, these four decocted as tea substitute)
Seventh visit: Stomach qi gradually opens, dysentery thins, but there is still an urge to defecate. This is due to damp-heat stagnation preventing qi mechanism from opening. Use bitter and acrid methods to open.
Chi Ling and Bai Ling Mu Zhuling (Wood Polyporus) Muxiang Sharen Zexie Chenpi
Sheng Yiren (Raw Coix Seed) Huashi Shi Kuai (Talc Stone) Shangyao Gui (3 fen) Chao Chuanlian (Stir-fried Coptidis Rhizoma, 3 fen) Chao Huangbo (Stir-fried Phellodendron Bark, 1 qian, these three ground fine, made into pills with rice water paste, taken with medicinal juice)
Certain Patient: Bitter-acrid harmonizes transformation, bland-permeability guides dampness. Between Hai and Zi hours, urination increased significantly and was very clear. However, tenesmus persists. This is due to severe qi deficiency; clear yang sinks and fails to rise. Otherwise, why would ventilating fu qi, guiding stagnation, and dispelling dampness fail to counteract the pressing/heavy sensation, making tenesmus worse after Zi hour? The patient has a pre-existing condition of visual dizziness, which is beyond typical expectations. I dare not suggest lifting methods. Actually, ascending yang originates from Liver Wood, while sinking yang comes from Spleen/Stomach; they are unrelated. Using Li Dongyuan’s method to observe dynamics, tentatively avoid overdosing to leave room for adjustment.
Shangyou (2 qian) Sheng Yuzhu (Raw Atractylodis Macrocephalae Rhizoma, 1 qian 5 fen) Zhi Shengma (Honey-fried Rhizoma Cimicifugae, 3 fen) Zhi Cao (Honey-fried Licorice Root, 3 fen) Baiguishen (Radix Angelicae Sinensis Root Tip, 2 qian) Da Jian Shen Tiao (Codonopsis Stem, 1 qian) Zhi Chaihu (Honey-fried Bupleuri Radix, 4 fen) Guangpi (7 fen)
Change prescription to include Wuji Wan.
Left: *Xiuxi* dysentery usually forms due to lingering damp-heat. The red substance results from damp-heat forcing injury to the Ying level. However, if pathogens stagnate in the large intestine, how can they remain without causing abdominal pain or tenesmus? Currently, there is no fever, abdominal pain, or tenesmus. Blood stops and starts intermittently, and the pulse is fine and rapid. How can there be a rapid pulse without fever? The reason is that dysentery injures Spleen Yin. The Spleen commands blood control; when Spleen Yin cannot control, blood leaks out. The red, sticky substance appears at any time.
The previous method of tonifying Zang Yin was suitable. Since the medicine worked, no changes are needed.
Danggui Tan (1 qian 5 fen) Renshen Xu (Ginseng Rootlet, decoct separately and add, 7 fen) Shengjiang (2 qian, juice used to stir-fry Shengdi residue) Zhi Cao (4 fen) Fuling Shen (Poria with Hostwood, 2 qian each) Mugua Pi (Papaya Peel, stir-fried, 1 qian 5 fen) Huaishanyao (Chinese Yam, 2 qian) Baishao (Earth-fried White Peony Root, 1 qian 5 fen) Da Shengdi (Large Rehmannia Root, 4 qian, juice used to stir-fry Shengjiang residue) Hei Dazao (Black Jujube, 2 pieces)
Rong (Right): Dysentery frequency increases during solar terms. Qi deficiency with lingering damp-heat makes tonification and purgation difficult. Tentatively use 70% tonification and 30% purgation to observe dynamics.
Zhi Mian Huangqi (Honey-fried Astragali Radix) (2 qian) Fuling (4 qian) Guang Muxiang (5 fen) Shengma (Vinegar-fried, 4 fen) Chao Yuzhu (Stir-fried Atractylodis Macrocephalae Rhizoma, 1 qian 5 fen) Helile (3 qian) Guangpi (1 qian) Chaihu (Vinegar-fried, 5 fen) Dangshen (2 qian) Sheng Cao and Shu Cao (Raw and Honey-fried Licorice, 1 fen each)
Second visit: Dysentery frequency slightly decreased, indicating Qi deficiency. Advance the previous method.
Zhi Mian Huangqi (3 qian) Helile (2 qian, baked) Dangshen (3 qian, stir-fried) Paojiang (Roasted Ginger, 3 fen) Chao Chuanlian (Stir-fried Coptidis Rhizoma, 3 fen) Guishen Tan (Charred Angelica Root Tip, 2 qian) Ye Yuzhu (Wild Atractylodis Macrocephalae Rhizoma, 2 qian, stir-fried) Zexie (1 qian 5 fen) Zhen Ejiao (True Donkey-hide Gelatin, 1 qian 5 fen, stir-fried with蛤粉) Sheng Cao and Shu Cao (2 fen each) Fuling (3 qian)
Third visit: Pulse and symptoms are stable. Continue the effective formula with modifications.
Zhi Shangdangshen (Honey-fried Codonopsis) Chao Yuzhu Fuling Zhuche Wan (Zhuche Pill) Tusizi (Cuscutae Semen) Chaihu Zhi Shengma Guangpi
Fourth visit: Dysentery reduced, but sometimes still sticky. Damp-heat lingers in intestines/stomach; Spleen Yang fails to ascend. Advance the previous method.
Zhi Mian Huangqi (3 qian) Ejiao Zhu (Ejiao Pearl, 2 qian) Dangshen (3 qian) Paojiang (4 fen) Hezi Rou (Pericarpium Terminaliae Chebulae, baked, 2 qian 5 fen) Chao Chuanlian (Stir-fried Coptidis Rhizoma, 4 fen) Yuzhu Tan (Charred Atractylodis Macrocephalae Rhizoma, 2 qian) Fuling (4 qian) Zhi Cao (3 fen) Danggui Tan (1 qian 5 fen)
Zhang (Right): Abdominal distension, pain, and dysentery. Damp-heat transforms into dryness, injuring Yin. Pulse is weak, throat and tongue show ulceration. Pathogen has entered deep territory; treatment is difficult.
Chao Chuanlian (Stir-fried Coptidis Rhizoma, 3 fen) Dangguixu (Angelica Rootlets, 1 qian 5 fen) Chuan Shihu (Dendrobii Caulis, 5 qian) Chao Song Maidong (Stir-fried Ophiopogonis Tuber, 1 qian 5 fen) Beishashen (Glehniae Radix, 5 qian) Dan Huangqin (Light Scutellariae Radix, wine-fried, 1 qian) Yun Fushen (Poria with Hostwood, 3 qian) Danpi Tan (1 qian 5 fen) Wuji Wan (Wuji Pill, 1 qian 5 fen, taken with two dews) Ye Qiangwei Lu (Wild Rose Dew, 1 liang) Bai Hehua Lu (White Lotus Flower Dew, 1 liang)
Second visit: Ulcers largely receded, dysentery slightly thinned, but abdomen still hurts. Damp-heat slightly resolved, Yin fluid gradually rising, but有形 accumulation (solid pathogens) still obstructs internally. Although there is improvement, it is not yet secure.
Mo Zhishi (Grind Zhishi, 6 fen, add) Jiu Chao Dan Qin (Wine-stir-fried Light Scutellariae Radix, 1 qian 5 fen) Chao Beishashen (Stir-fried Glehniae Radix, 4 qian) Chuan Yalian (Earth-fried Coptidis Rhizoma, 3 fen) Chuan Shihu (4 qian) Tu Chao Baishao (Earth-stir-fried White Peony Root, 1 qian 5 fen) Chao Fanzhiqu (Stir-fried Medicated Leaven, 3 qian) Mo Binglang (Grind Areca Seed, 3 fen, add) Xian Foshou Lu (Fresh Bergamot Dew, 1 liang, mix) Ye Qiangwei Lu (Wild Rose Dew, 1 liang, mix)
Left: Dysentery was treated with astringents too early, causing damp-heat to injure Ying level, resulting in purple-black bloody stools. Steam-dampness transformed into phlegm, causing much coughing. Upper and lower distress; a chronically deficient constitution may not withstand it.
Danpi Tan Nan Zha Tan (Charred Hawthorn Fruit) Chao Huaihua Qianhu (Peucedani Radix) Tinglizi (Descurainiae/Sisymbrii Semen) Chuanlian Yan (Charred Coptidis Rhizoma) Yanhusuo (Corydalis Rhizoma) Bai Jiegeng (Platycodonis Radix) Fuling Zexie
Second visit: Purple-black blood has receded, but dysentery continues. Indeed, damp-heat injured Ying level. Modify previous method to benefit Spleen and Kidney.
Ye Yuzhu Fuling Chuanlian Yan (Charred Coptidis Rhizoma) Pozhuzi (Psoraleae Fructus) Sheng Shu Muxiang (Raw and Cooked Aucklandiae Radix) Danpi Tan Guangpi Paojiang Tan (Charred Dried Ginger) Tusizi Lianzi (Lotus Seed)
Certain Patient: The severity of Jin Kou Li (Anorexic Dysentery) has decreased compared to before, but defecation still causes pain and heaviness. Joints feel hot. Food entering the mouth causes regurgitation. Ulcers cover cheeks, lips, and mouth.
However, discharge is not very turbid. Pulse is rapid and slippery. Deep pressure lacks spirit. This is damp-heat internal stagnation: downward it presses and obstructs fu qi; upward it scorches and injures Yin. There is risk of collapse. Propose simultaneous clearing-drying and sweet-bitter harmonization method. Prepared for consultation.
Nanshashen (Stir-fried yellow, 4 qian) Jin Shihu (Dendrobii Caulis, 3 qian) Dan Qin (Light Scutellariae Radix, 1 qian 5 fen) Fa Banxia (Prepared Pinellia Tuber, 1 qian 5 fen, salt-water fried) Chi Ling and Bai Ling (2 qian each) Guang Ju Bai (Exocarpium Citri Reticulatae White Part, 1 qian) Huashi Shi Kuai (Talc Stone, 3 qian) Chuanlian (5 fen) Fangtong (8 fen) Bai Hehua Lu (White Lotus Flower Dew, 1 liang) Foshou Lu (Bergamot Dew, 1 liang, these two warmed with medicine)
Certain Patient: Dysentery occurring in winter indicates deep entrapment of damp-heat. The large intestine is convoluted; damp-heat resides here, difficult to drain and transform, leading to chronic *xiuxi* dysentery. It can be cured, but not immediately. Patience and proper care are best.
Zhi Mian Huangqi Danggui Tan Zhi Shengma Ye Yuzhu Xi Dangshen (Western Codonopsis) Helile Zhi Chaihu Guang Chenpi Zhuche Wan (2 qian)
Certain Patient: Chronic dysentery with root cause unresolved; red and white mixed, tenesmus with foam. Spleen deficiency with damp-heat stagnating in intestines. The body is in a very poor state. Tentatively warm the Zang and clear the Fu.
Paojiang Jiao Dongzhu (Burnt Winter Atractylodis Rhizoma) Sheng Shu Muxiang Fanzhiqu Sheng Shu Chenpi (Raw and Cooked Tangerine Peel) Zexie
Chuan Yalian Sheng Shu Yiren (Raw and Cooked Coix Seed) Zhu Fuling (Polyporus and Poria) Dan Huangqin (Light Scutellariae Radix)
Zhang (Left): Dysentery with red, sticky stools, tenesmus. Tongue coating is yellow and rough, pulse is stagnant and unsmooth. Summer-heat, dampness, and heat stagnate in intestines/stomach. The body is in a serious state, not comparable to ordinary cases.
Zheng Sharen (Whole Amomum Fruit, 4 pieces) Mo Muxiang (Grind Aucklandiae Radix, 4 fen, add) Chenpi (1 qian) Baishao (1 qian 5 fen, added to decoction of 3 fen Licorice) Huangbo Tan (Charred Phellodendron Bark, 1 qian) Chuan Yalian (Wine-fried Coptidis Rhizoma, 5 fen) Zhishi (1 qian) Fuling (3 qian) Paojiang (3 fen)
Second visit: Dysentery stopped, but stool not yet regulated. Harmonize middle and clear damp-heat to eliminate pathogen reservoir.
Shang Chuanpu (Upper Magnolia Bark) Zhu Fuling Nan Zha Tan (Charred Hawthorn Fruit) Sheng Shu Guya (Raw and Cooked Sprouted Grain) Chuan Yalian Ye Yuzhu Guang Chenpi Zexie
Pang (Left): Dysentery continues, stools are purple and瘀 (stasis). Dry mouth and tongue. Pulse is fine and rapid, tongue coating is grey and stagnant. Damp-heat injures Ying level, clear fluids fail to circulate. Yuan Qi may not sustain; complications may arise from deficiency.
Huangbo Tan (Charred Phellodendron Bark, 2 qian) Bei Qinpi (Phellodendron Bark from North, 1 qian 5 fen) Hang Baishao (Hangzhou White Peony Root, 2 qian, added to decoction of 2 fen Licorice) Ju Bai (Tangerine Peel White Part, 1 qian) Danggui Tan (2 qian) Danpi Tan (1 qian 5 fen) Chuanlian Yan (Charred Coptidis Rhizoma, 4 fen) Chao Biandou Yi (Stir-fried Vigna Umbellata Seed Coat, 3 qian) Baitouweng (Pulsatillae Radix, 3 qian) Chao Huaihua (Stir-fried Sophorae Flos, 2 qian)
Second visit: Dysentery greatly reduced, blood minimal, but still red, sticky, and bright. Mouth dry, tongue dry. Damp-heat forces injury to Ying level. Reference blood-nourishing and Ying-harmonizing methods.
Chuanlian Yan (Charred Coptidis Rhizoma, 5 fen) Baitouweng (3 qian) Baishao (1 qian 5 fen) Bei Qinpi (1 qian 5 fen) Danpi Tan (2 qian) Biandou Yi (3 qian) Zhuche Wan (4 qian) Fuling (3 qian)
Third visit: Dysentery stopped, but Yin damage not restored. Dry mouth, vivid dreams. Nourish blood and harmonize Yin.
Ejiao Zhu (Ejiao Pearl, 3 qian) Danpi Tan (2 qian) Gancao (2 fen) Chuan Yalian (2 fen) Hang Baishao (1 qian 5 fen) Jin Shihu (Dendrobii Caulis, 3 qian) Danggui Tan (2 qian) Fushen (Poria with Hostwood, 3 qian) Chao Zaoren (Stir-fried Ziziphus Seed, 2 qian) Sheng Shanyao (Raw Chinese Yam, 3 qian)
Left: Bleeding drips continuously after defecation. Pulse is soft and slippery. Damp-heat stagnates in large intestine. Use bitter to dry dampness, cold to overcome heat.
Chuanlian Yan (Charred Coptidis Rhizoma, 4 fen) Huangbo Tan (Charred Phellodendron Bark, 2 qian) Bai Fuling (White Poria, 3 qian) Zhi Maoyu (Prepared Atractylodis Rhizoma, 1 qian 5 fen) Jingjie (Schizonepetae Spica, 1 qian) Chao Yuzhu (Stir-fried Atractylodis Macrocephalae Rhizoma, 1 qian) Danpi Tan (2 qian) Chao Fangfeng (Stir-fried Saposhnikoviae Radix, 1 qian) Dahong Jiguanhua (Red Chicken Comb Flower, 3 qian) Zexie (1 qian 5 fen)
Wang (Left): *Xiuxi* dysentery healed, but pathogens remain in intestines/stomach. Summer dampness steams, causing relapse. Abdominal pain during defecation, red and sticky stools. Tongue coating near root is moldy black, indicating residual stagnation in intestines. First, unblock.
Chuanpu (Magnolia Bark, 1 qian) Zhishi (Immature Bitter Orange, 1 qian) Sharen (7 fen) Baishao (1 qian 5 fen) Fanzhiqu (Medicated Leaven, 2 qian, stir-fried) Chenpi (1 qian) Fuling (3 qian) Muxiang (5 fen) Xianglian Wan (Xianglian Pill, 6 fen, divided twice, taken with boiled water)
Second visit: Moldy black coating on tongue root resolved, dysentery thinner, defecation smoother, red color faded. Regulate qi to vent fu heat.
Guang Muxiang (5 fen) Guangpi (1 qian) Chi Ling and Bai Ling (3 qian each) Sheng Shu Guya (Raw and Cooked Sprouted Grain, 1 qian 5 fen each) Suo Sharen (Amomum Fruit, 5 fen)
Yuzhu (1 qian) Sheng Shu Yiren (Raw and Cooked Coix Seed, 2 qian each) Chao Fanzhiqu (Stir-fried Medicated Leaven, 1 qian 5 fen) Zexie (1 qian 5 fen) Zhike (Aurantii Fructus, 1 qian)
Third visit: Dysentery stopped, stool not firm. Tonify Earth and regulate qi.
Chao Yuzhu (Stir-fried Atractylodis Macrocephalae Rhizoma, 8 fen) Wei Muxiang (Baked Aucklandiae Radix, 4 fen) Biandou Yi (Seed Coat, 3 qian) Sheng Shu Yiren (Raw and Cooked Coix Seed, 2 qian each) Sharen (5 fen) Bai Fuling (White Poria, 3 qian) Guangpi (Earth-fried, 1 qian) Chao Shanyao (Stir-fried Chinese Yam, 3 qian) Zexie (1 qian 5 fen) Wei Shengjiang (Baked Fresh Ginger, 2 slices)
Fourth visit: Stool not firm, sounds heard during defecation. Damp-heat not fully cleared, qi stagnation not vented. Guide qi and resolve dampness.
Chuanpu (8 fen) Chenpi (Earth-fried, 1 qian) Sheng Shu Muxiang (Raw and Cooked Aucklandiae Radix, 3 fen each) Chuanlian (5 fen) Jiao Guya (Burnt Sprouted Grain, 3 qian) Paojiang (5 fen)
Zexie (1 qian 5 fen) Sheng Shu Miren (Raw and Cooked Coix Seed, 2 qian each) Sharen (5 fen) Fuling (3 qian)
Fifth visit: Red streaks after defecation, not bright but sticky. Still due to damp-heat transformation. Previous year had *xiuxi* dysentery; Spleen Qi and Zang Yin already deficient. Propose lifting Spleen, nourishing Zang, clearing Fu.
Kui Dangshen (Codonopsis from Kwei, 2 qian) Chao Yuzhu (Stir-fried Atractylodis Macrocephalae Rhizoma, 1 qian 5 fen) Shengma (Vinegar-fried, 3 fen) Zhuche Wan (Zhuche Pill, 3 qian, taken with boiled water, divided into two doses) Zhi Mian Huangqi (Honey-fried Astragali Radix, 2 qian) Sheng Cao and Shu Cao (Raw and Honey-fried Licorice, 2 fen each) Chaihu (Vinegar-fried, 3 fen) Guangpi (1 qian) Sharen (5 fen)
Gong (Left): Dysentery lasted over two months, changed from white to red. Abdominal pain started not at onset, but after turning red. Damp-heat injured Ying level. Risk of chronic *xiuxi* dysentery.
Danggui Tan (Charred Radix Angelicae Sinensis, 2 qian) Guang Muxiang (5 fen) Hang Baishao (1 qian 5 fen) Zhike (1 qian) Bai Fuling (3 qian) Chuan