连炭（五分） 广陈皮（一钱） 生熟草（各二分） 桔梗（一钱）
二诊 腹痛后重俱减，红赤亦退。效方再进一筹。
炒黄芩（一钱） 当归炭（二钱） 白芍（酒炒一钱五分） 泽泻（一钱五分） 白茯苓（三钱） 生甘
草（三分） 丹皮炭（一钱五分） 枳壳（五分） 补中益气丸（一钱五分） 驻车丸（一钱五分二丸开水先服）
郁（左） 久痢不止，临圊腹痛，脓血稠腻，肢面带浮。脾虚肠实，营液损伤。不易图治也。
当归炭（二钱） 杭白芍（一钱五分） 白头翁（二钱） 川连炭（五分） 防风炭（一钱） 生于术（
一钱五分） 白茯苓（三钱） 炮姜炭（三分） 泽泻（一钱五分） 阿胶珠（一钱五分）
二诊 红腻大退，痢数稍减。守效方再望应手。
当归炭（二钱） 煨诃子肉（一钱五分） 炙升麻（四分） 驻车丸（三钱开水先服） 白茯苓（三钱）
杭白芍（酒炒一钱五分） 炙柴胡（四分） 炒于术（一钱五分） 奎党参（三钱） 泽泻（一钱五分）
三诊 休息势稍减轻，临圊仍然作痛。大肠曲折之间，必有留阻。
奎党参（三钱） 枳实炭（七分） 川雅连（五分） 炮姜（三分） 生熟草（各二分） 炒于术（二钱）
当归炭（二钱） 白芍（一钱五分） 锦纹大黄（二钱酒炙成炭后入）
四诊 通因通用，痛痢大减。的属湿热郁阻大肠，屈曲之间不入虎穴，焉得虎子。
炮姜（三分） 当归炭（一钱五分） 生熟草（各二分） 大黄（二钱酒炙成炭） 枳实（一钱）
五诊 下痢大势渐退，而肢面带浮，每至夜卧，气辄上逆。卧则气上，下虚不摄可知。再镇摄其下。
当归炭（二钱） 怀牛膝（三钱） 补骨脂（三钱） 杭白芍（二钱） 炙黑草（四分） 苁蓉（一钱
五分） 白茯苓（三钱） 菟丝子（盐水炒三钱） 紫衣胡桃肉（二枚）
某 感受暑热，热与湿合，阻于肠胃，发为痢疾。乃不为清热，误投姜附，致热伤营分，下血盈盆。其大势
虽得循定，而至今时仍解出瘀块，腹中 痛。胸次窒塞不舒，欲呕难爽。苔色黄薄干腻。此由血去过多，
冲气逆上，而肠胃中湿热仍然未清，补泻两难，为棘手重证。勉拟养肝以平冲气，兼以丸药入下，以坚
阴泄热，为上下分治之法。即请明哲商用。
阿胶珠（二钱） 炒黑豆衣（三钱） 杭白芍（一钱五分） 生熟甘草（各二分） 大天冬（三钱） 炒木
瓜皮（一钱） 炒川贝（一钱五分） 盐水炒竹茹（一钱） 大补阴丸（二钱二次服）
金（左） 红痢后重，肛脱不收。诸医用运气消食磨积之品，不效。宗前贤养阴清热法。
炙生地（三钱） 茯苓（三钱） 炒槐花（二钱） 侧柏炭（二钱） 白芍（酒炒一钱五分） 阿胶珠（
二钱） 杞子（三钱） 炒丹皮（二钱） 当归炭（二钱） 黄柏（一钱五分） 川连（四分） 肉桂（二
分三味研细末饭丸作二次先服）
蒋（左） 痰湿盛极趋入大肠，肠 不止。舌红苔黄。宜运脾理湿泄热。
制半夏（二钱） 生熟薏仁（各二钱） 枳壳（一钱） 丹皮炭（二钱） 台白术（二钱） 白茯苓（三钱）
桔梗（一钱） 防风根（一钱） 香连丸（五分开水送下）
二诊 湿热旁流，势稍减轻。药既应手，宜扩充之。
制半夏（一钱五分） 煨葛根（一钱） 桔梗（一钱） 戊己丸（一钱五分开水先送下） 防风根（一钱炒）
陈广皮（一钱） 枳壳（一钱） 泽泻（一钱五分） 茯苓（三钱） 薏仁（四钱）
三诊 湿热旁流不止，肠红色如猪肝。还是湿热熏蒸之象。再于培土之中，兼清湿热。
炒于术（二钱） 黄柏炭（二钱） 生薏仁（四钱） 川连炭（四分） 制茅术（八分） 炒槐花（二钱）
丹皮炭（二钱） 白茯苓（三钱） 防风炭（一钱） 泽泻（一钱五分） 炙黑大红鸡冠花（三钱）
四诊 肠 不止，肛门下坠。脉象滑大。此湿热不化，大肠府气压坠。拟和营兼清湿热。
当归炭（二钱） 炒槐花（二钱） 杭白芍（一钱五分） 驻车丸（三钱开水先送下） 丹皮炭（二钱） 白茯苓
（三钱） 宋半夏（一钱五分） 淡黄芩（一钱五分） 广橘白（一钱）
卫（左） 向有便血，阴分久亏。复以寒饮伤脾，脾不统摄，肠 日久不止，脏阴愈亏，则腑阳愈燥，所以时
有燥粪杂下。脉象虚弦。养阴之中，参以培脾，兼清湿热。
奎党参（三钱） 炙黑草（三分） 扁豆衣（三钱炒） 酒炒白芍（一钱五分） 生于术（二钱） 白茯苓（三钱）
当归炭（一钱五分） 炒半夏曲（一钱五分） 橘白（一钱） 驻车丸（三钱开水分二次服）
二诊 胃纳渐起，肠 亦减。再扶持中气，除湿升阳。
白茯苓（三钱） 扁豆衣（三钱炒） 生于术（一钱） 小兼条参（另煎冲一钱） 炒山药（三钱）
生熟薏仁（各二钱） 炒谷芽（二钱） 盐水炒橘白（一钱） 泽泻（一钱五分） 建莲子（去心三钱）
三诊 肠 之后，食入饱闷，溲少足肿。良以大肠湿热虽化，而脾土气虚，不能运湿，所以在昔为湿热，
在今为湿寒，在昔为腑实，在今为脏虚。拟脾肾双调法。
盐水炒菟丝子 炒真建曲 炙绵 炒薏仁 盐水炒补骨脂 炒扁豆衣 云茯苓 炙黑草 酒炒杭白芍 奎党
参炒谷芽
土炒于术 土炒怀山药 炒杞子 煨益智 橘白（另煎汤俟诸药汁浓稠然后加入）
后加胡桃肉五两煨姜四两大枣百枚收膏。
[Initial Prescription] Lian Tan (Charred Lotus Root Stalk, 5 fen) Guang Chenpi (Tangerine Peel, 1 qian) Sheng Gancao and Shu Gancao (Raw and Prepared Licorice Root, 2 fen each) Jiegeng (Platycodon Root, 1 qian)
Second Visit: Abdominal pain and tenesmus have both decreased; the redness in the stool has also subsided. The treatment is effective; advance the prescription further.
Chao Huangqin (Fried Scutellaria Root, 1 qian) Danggui Tan (Charred Angelica Sinensis Root, 2 qian) Baishao (White Peony Root, fried with wine, 1.5 qian) Zexie (Alisma Rhizome, 1.5 qian) Bai Fuling (Poria, 3 qian) Sheng Gancao (Raw Licorice Root, 3 fen) Danpi Tan (Charred Moutan Cortex, 1.5 qian) Zhike (Aurantium Fruit, 5 fen) Buzhong Yiqi Wan (Middle-Boosting Qi-Supplementing Pill, 1.5 qian) Zhuche Wan (Zhuche Pill, 1.5 qian, two pills taken first with boiling water)
Patient Yu (Left pulse): Chronic dysentery unceasing; abdominal pain during defecation; thick, sticky pus and blood; edema on limbs and face. Spleen deficiency with intestinal excess; damage to Ying-nutrient fluids. Difficult to treat.
Danggui Tan (Charred Angelica Sinensis Root, 2 qian) Hang Baishao (Hangzhou White Peony Root, 1.5 qian) Baitouweng (Pulsatilla Root, 2 qian) Chuan Lian Tan (Charred Coptis Rhizome, 5 fen) Fangfeng Tan (Charred Saposhnikovia Root, 1 qian) Sheng Baizhu (Raw Atractylodes Macrocephala Rhizome, 1.5 qian) Bai Fuling (Poria, 3 qian) Paojiang Tan (Charred Prepared Ginger, 3 fen) Zexie (Alisma Rhizome, 1.5 qian) Ejiao Zhu (Ejiao Pearls, 1.5 qian)
Second Visit: Pus and sticky discharge greatly reduced; frequency of dysentery slightly decreased. Adhere to the effective formula, hoping for a prompt response.
Danggui Tan (Charred Angelica Sinensis Root, 2 qian) Wei Hezi Rou (Baked Koelreuteria Seed Endocarp, 1.5 qian) Zhi Shengma (Prepared Cimicifuga Rhizome, 4 fen) Zhuche Wan (Zhuche Pill, 3 qian, taken first with boiling water) Bai Fuling (Poria, 3 qian) Hang Baishao (Hangzhou White Peony Root, fried with wine, 1.5 qian) Zhi Chaihu (Prepared Bupleurum Root, 4 fen) Chao Baizhu (Fried Atractylodes Macrocephala Rhizome, 1.5 qian) Kui Dangshen (Kui Codonopsis Root, 3 qian) Zexie (Alisma Rhizome, 1.5 qian)
Third Visit: Intermittent dysentery slightly alleviated, but pain persists during defecation. There must be stagnation and obstruction in the convoluted parts of the Large Intestine.
Kui Dangshen (Kui Codonopsis Root, 3 qian) Zhishi Tan (Charred Aurantium Immature Fruit, 7 fen) Chuan Yalian (Sichuan Elegant Coptis Rhizome, 5 fen) Paojiang (Prepared Ginger, 3 fen) Sheng Gancao and Shu Gancao (Raw and Prepared Licorice Root, 2 fen each) Chao Baizhu (Fried Atractylodes Macrocephala Rhizome, 2 qian) Danggui Tan (Charred Angelica Sinensis Root, 2 qian) Baishao (White Peony Root, 1.5 qian) Jinwen Dahuang (Jinwen Rheum Palmatum Root, 2 qian, fried with wine into charcoal before adding)
Fourth Visit: Using "treat obstruction with unblocking method" (Tong Yin Tong Yong); abdominal pain and dysentery greatly reduced. Indeed, damp-heat is stagnant and obstructing the Large Intestine. Without entering the tiger's den, how can one get the tiger's cub?
Paojiang (Prepared Ginger, 3 fen) Danggui Tan (Charred Angelica Sinensis Root, 1.5 qian) Sheng Gancao and Shu Gancao (Raw and Prepared Licorice Root, 2 fen each) Dahuang (Rheum Palmatum Root, 2 qian, fried with wine into charcoal) Zhishi (Aurantium Immature Fruit, 1 qian)
Fifth Visit: The major trend of dysentery is gradually receding, yet edema remains on limbs and face. Upon lying down at night, Qi rebels upward. Lying down causes Qi to rise, indicating deficiency below failing to secure. Further secure and calm the lower jiao.
Danggui Tan (Charred Angelica Sinensis Root, 2 qian) Huai Niuxi (Huai Achyranthes Root, 3 qian) Buguzhi (Psoralea Fruit, 3 qian) Hang Baishao (Hangzhou White Peony Root, 2 qian) Zhihei Gancao (Charred Black Licorice Root, 4 fen) Rongrong (Cistanche Stem, 1.5 qian) Bai Fuling (Poria, 3 qian) Tiansizi (Cuscuta Seed, salt-fried, 3 qian) Ziyi Hutao Rou (Purple-skinned Walnut Kernel, 2 pieces)
Certain Patient: Contracted summer-heat; heat combined with dampness, obstructing the stomach and intestines, leading to dysentery. Instead of clearing heat, warm herbs like Ginger and Aconite were mistakenly administered, causing heat to injure the Ying-nutrient level, resulting in massive hematochezia filling a basin. Although the general condition has stabilized, blood clots are still passed today, accompanied by abdominal pain. Chest oppression and discomfort, desire to vomit but unable to do so. Tongue coating is thin, yellow, dry, and greasy. This is due to excessive blood loss causing Chong-mai Qi to rebel upward, while damp-heat in the stomach and intestines remains uncleared. Tonification and purgation are both difficult; this is a stubborn, severe case. Tentatively prescribe nourishing Liver to calm Chong-mai Qi, combined with pills descending to nourish Yin and drain heat, employing a method of treating upper and lower separately. Please consult wise practitioners.
Ejiao Zhu (Ejiao Pearls, 2 qian) Chao Heidouyi (Fried Black Soybean Coat, 3 qian) Hang Baishao (Hangzhou White Peony Root, 1.5 qian) Sheng Gancao and Shu Gancao (Raw and Prepared Licorice Root, 2 fen each) Datiantong (Large Asparagus Root, 3 qian) Chao Mugua Pi (Fried Papaya Peel, 1 qian) Chuan Chuanbei (Fried Fritillaria Bulb, 1.5 qian) Yanshui Zhu Ru (Bamboo Shavings fried with salt water, 1 qian) Dabu Yin Wan (Great Yin-Supplementing Pill, 2 qian, taken twice)
Patient Jin (Left pulse): Red dysentery with tenesmus; anal prolapse unable to retract. Physicians used formulas based on Six Qi theory, digestion-promoting, and mass-resolving agents without effect. Follow the ancients' method of nourishing Yin and clearing heat.
Zhi Shengdi (Prepared Rehmannia Root, 3 qian) Fuling (Poria, 3 qian) Chao Huaihua (Fried Sophora Flower, 2 qian) Cebai Tan (Charred Biota Top Leaf, 2 qian) Baishao (White Peony Root, fried with wine, 1.5 qian) Ejiao Zhu (Ejiao Pearls, 2 qian) Qizi (Goji Berry, 3 qian) Chao Danpi (Fried Moutan Cortex, 2 qian) Danggui Tan (Charred Angelica Sinensis Root, 2 qian) Huangbai (Phellodendron Bark, 1.5 qian) Chuan Lian (Sichuan Coptis Rhizome, 4 fen) Rougui (Cinnamon Bark, 2 fen; these three ground into fine powder, made into rice pills, taken first in two doses)
Patient Jiang (Left pulse): Phlegm-dampness extremely abundant, flowing into the Large Intestine, causing continuous bowel sounds and diarrhea. Tongue red, coating yellow. Should move Spleen, regulate dampness, and drain heat.
Zhi Banxia (Prepared Pinellia Tuber, 2 qian) Sheng Yiren and Shu Yiren (Raw and Prepared Coix Seed, 2 qian each) Zhike (Aurantium Fruit, 1 qian) Danpi Tan (Charred Moutan Cortex, 2 qian) Tai Baizhu (Tai Atractylodes Macrocephala Rhizome, 2 qian) Bai Fuling (Poria, 3 qian) Jiegeng (Platycodon Root, 1 qian) Fangfeng Gen (Saposhnikovia Root, 1 qian) Xianglian Wan (Xianglian Pill, 5 fen, taken with boiling water)
Second Visit: Damp-heat leakage slightly alleviated. Since the medicine is effective, expand upon it.
Zhi Banxia (Prepared Pinellia Tuber, 1.5 qian) Wei Gegen (Baked Pueraria Root, 1 qian) Jiegeng (Platycodon Root, 1 qian) Wuji Wan (Wuji Pill, 1.5 qian, taken first with boiling water) Fangfeng Gen (Saposhnikovia Root, 1 qian, fried) Chen Guangpi (Aged Tangerine Peel, 1 qian) Zhike (Aurantium Fruit, 1 qian) Zexie (Alisma Rhizome, 1.5 qian) Fuling (Poria, 3 qian) Yiren (Coix Seed, 4 qian)
Third Visit: Damp-heat leakage continues; intestinal color is red like pig liver. Still indicates damp-heat steaming. In tonifying Earth, simultaneously clear damp-heat.
Chao Baizhu (Fried Atractylodes Macrocephala Rhizome, 2 qian) Huangbai Tan (Charred Phellodendron Bark, 2 qian) Sheng Yiren (Raw Coix Seed, 4 qian) Chuan Lian Tan (Charred Sichuan Coptis Rhizome, 4 fen) Zhi Maoyu (Prepared Atractylodes Lancea Rhizome, 8 fen) Chao Huaihua (Fried Sophora Flower, 2 qian) Danpi Tan (Charred Moutan Cortex, 2 qian) Bai Fuling (Poria, 3 qian) Fangfeng Tan (Charred Saposhnikovia Root, 1 qian) Zexie (Alisma Rhizome, 1.5 qian) Zhihei Dahong Jiguanhua (Charred Black Red Cockcomb Flower, 3 qian)
Fourth Visit: Bowel sounds and diarrhea unceasing; anus feels heavy and sinking. Pulse slippery and large. This is damp-heat not transforming, pressing down the Large Intestine Fu organ. Propose harmonizing Ying-nutrient and simultaneously clearing damp-heat.
Danggui Tan (Charred Angelica Sinensis Root, 2 qian) Chao Huaihua (Fried Sophora Flower, 2 qian) Hang Baishao (Hangzhou White Peony Root, 1.5 qian) Zhuche Wan (Zhuche Pill, 3 qian, taken first with boiling water) Danpi Tan (Charred Moutan Cortex, 2 qian) Bai Fuling (Poria, 3 qian) Song Banxia (Song Pinellia Tuber, 1.5 qian) Dan Huangqin (Light Scutellaria Root, 1.5 qian) Guang Ju Bai (Guang Citrus Albedo, 1 qian)
Patient Wei (Left pulse): Previously had hematochezia; Yin level long depleted. Again injured by cold-fluid damaging Spleen; Spleen fails to control blood; bowel sounds and diarrhea persist for days, depleting Zang-Yin further, thus Fu-Yang becomes drier, hence occasional dry feces mixed with stool. Pulse deficient and wiry. Within nourishing Yin, incorporate tonifying Spleen, and simultaneously clear damp-heat.
Kui Dangshen (Kui Codonopsis Root, 3 qian) Zhihei Gancao (Charred Black Licorice Root, 3 fen) Bian Dou Yi (Lablab Bean Coat, 3 qian, fried) Jiuchao Baishao (White Peony Root fried with wine, 1.5 qian) Sheng Baizhu (Raw Atractylodes Macrocephala Rhizome, 2 qian) Bai Fuling (Poria, 3 qian) Danggui Tan (Charred Angelica Sinensis Root, 1.5 qian) Chao Banxia Qu (Fried Pinellia Fermented Curd, 1.5 qian) Ju Bai (Citrus Albedo, 1 qian) Zhuche Wan (Zhuche Pill, 3 qian, taken with boiling water in two doses)
Second Visit: Appetite gradually rising; bowel sounds and diarrhea decreasing. Further support Middle Qi, remove dampness, and raise Yang.
Bai Fuling (Poria, 3 qian) Bian Dou Yi (Lablab Bean Coat, 3 qian, fried) Sheng Baizhu (Raw Atractylodes Macrocephala Rhizome, 1 qian) Xiao Jian Tiaoshen (Small Joint Strip Ginseng, decocted separately and taken with other medicines, 1 qian) Chao Shanyao (Fried Chinese Yam, 3 qian) Sheng Yiren and Shu Yiren (Raw and Prepared Coix Seed, 2 qian each) Chao Guya (Fried Millet Sprout, 2 qian) Yanshui Ju Bai (Citrus Albedo fried with salt water, 1 qian) Zexie (Alisma Rhizome, 1.5 qian) Jian Lian Zi (Jian Lotus Seed, heart removed, 3 qian)
Third Visit: After bowel sounds and diarrhea, fullness and stuffiness after eating, scanty urination, and foot swelling. The reason is that although damp-heat in the Large Intestine has transformed, Spleen Earth Qi is deficient and cannot transport dampness. Thus, what was damp-heat in the past is now damp-cold; what was Fu-excess in the past is now Zang-deficiency. Propose dual regulation of Spleen and Kidney.
Yanshui Chao Tiansizi (Cuscuta Seed salt-fried) Chao Zhen Jianqu (True Jian Qu fermented cake fried) Zhi Mian Huangqi (Milk Astragalus Root prepared) Chao Yiren (Coix Seed fried) Yanshui Chao Buguzhi (Psoralea Fruit salt-fried) Chao Bian Dou Yi (Lablab Bean Coat fried) Yun Fuling (Cloud Poria) Zhihei Gancao (Licorice Root charred black) Jiuchao Hang Baishao (Hangzhou White Peony Root fried with wine) Kui Dangshen (Codonopsis Root) Chao Guya (Millet Sprout fried)
Tu Chao Baizhu (Earth-fried Atractylodes Macrocephala Rhizome) Tu Chao Huai Shanyao (Chinese Yam earth-fried) Chao Qizi (Goji Berry fried) Wei Yizhi (Ginger-baked Alpinia Oxyphylla Fruit) Ju Bai (Citrus Albedo; decocted separately, added when other medicines are concentrated)
Later add: Wuli Walnut Kernels, Sigli Ginger baked, Baijume Dates, to collect as paste.