Library

Shuigu Dysentery (Water and Grain Dysentery) refers to the passage of feces mixed with pus and blood, accompanied by slight abdominal pain, frequent defecation, poor appetite, fatigue in the four limbs, a fine and slow pulse that is forceless, or a wiry pulse at the Guan position. This is caused by deficiency-cold of the Spleen and Stomach; deficiency leads to failure of normal transportation and transformation, while cold leads to inability to digest food. Treatment should employ the Warm and Cultivate Inferior Supervision Method (Nuan Pei Bei Jian Fa). There are also cases due to Wind-Wood (Liver Qi) overacting on Earth (Spleen), causing Spleen-Earth deficiency and failure of transportation; in such cases, add Bai Shao (White Peony Root) and Fang Feng (Saposhnikovia Root) to the aforementioned method. For cases due to excessive labor leading to exhaustion of Spleen-Yang, add Gu Zhi (Psoralea Fruit) and He Ye (Lotus Leaf). For cases due to lack of fire in the Lower Jiao, failing to ripen and transform substances, add Po Gu Zhi (Psoralea Fruit) and Wu Yu (Evodia Fruit). For cases where middle-Jiao deficiency after dysentery leads to food stagnation, add Chen Pi (Tangerine Peel) and Zha Rou (Hawthorn Flesh). However, dysentery fundamentally involves pathology of the Spleen and Stomach, whether due to excess Wood or deficient Fire; treatment should follow these principles with modifications, ensuring effective results.

Dysentery that recurs repeatedly, stops and starts intermittently, persists for a long time without healing, presents with sallow complexion, and a soggy-slippery pulse is termed Xiuxi Dysentery (Resting Dysentery). It is often caused by using astringents too early, leaving accumulated heat uncleaned; or by failing to regulate diet and abstain from habits, causing intermittent symptoms. It may also result from excessive intake of cold-natured herbs, internal injury to Liver and Spleen, sinking of Yuan Qi (Primal Qi), or Kidney deficiency failing to secure. Each cause requires distinct treatment based on pattern differentiation. The recommended formula is Tiao Zhong Chang Qi Method (Regulate Middle and Unblock Qi Method), which ensures smooth Qi mechanism so that accumulated heat clears naturally, and regulates the Middle Jiao so the Spleen and Stomach recover. If there is dull abdominal pain, add Wu Yu (Evodia Fruit) and Jiang Tan (Charred Ginger) to warm and transform Middle Jiao cold; if red dysentery lingers, assist with Qin Pi (Ash Bark) and Bai Shao (White Peony Root) to clear Liver and Spleen blood-heat; if there is a heavy sensation in the anus, add Sheng Ma (Cimicifuga Rhizome) and Jie Geng (Platycodon Root) to lift sinking Yuan Qi; if there is incontinence due to deficiency and slipperiness, add Gu Zhi (Psoralea Fruit) and Long Gu (Fossilized Bones) to secure Lower Jiao collapse. If any medication fails to produce an effect, carefully differentiate the pulse. If the pulse is deep and solid, even if the disease has lasted long, purgative methods should still be used. Differentiation must be accurate to avoid error.

The *Jin Jian* states: Wuse Dysentery (Five-Color Dysentery) involves the passage of pus and blood of five colors mixed together; if there is a foul odor resembling rotting organs, the prognosis is ominous. This is due to using astringents too early, or incomplete purging of stagnant heat, which accumulates in the intestines and stomach, damaging organ Qi. If all tonifying medicines fail, it indicates that initially either astringents were used too early or purgatives were insufficient. If the pulse is forceful, purgation is still indicated despite the duration of the disease.
The *Yi Tong* states: Patients with Wuse Dysentery suffer from simultaneous damage to the Qi transformation functions of the Zang-Fu organs, hence the presence of five colors. Ancients attributed this to Kidney pathology because the Kidney stores Essence and resides in the deepest, lowest position; if the deep part is diseased, how can the superficial upper parts remain healthy? Once the chamber of Essence is damaged, it cannot fulfill its function of storing and hiding. Zhang Zhongjing noted that when five fluids pour down and umbilical pain occurs, life is in danger. For patients suffering from damage to the essence chamber and loss of control over the five fluids, one must know to benefit Fire to dissipate Yin, strengthen the Spleen to dam Water, and simultaneously regulate Qi, so that accumulated substances lacking Qi transformation are expelled downward, while Essence retaining Qi transformation remains stable. This approach essentially covers the necessary treatment.
Lei Feng’s commentary: These two discussions are indeed key points in the category of dysentery. The former mentions using astringents too early and incomplete clearing of stagnant heat; the latter discusses simultaneous damage to Zang-Fu Qi transformation, attributing it to Kidney pathology. Synthesizing them, this disease has both deficiency and excess patterns requiring differentiated treatment for safety. Early onset indicates Excess; long duration indicates Deficiency. Tenesmus indicates Excess; frequent empty straining indicates Deficiency. A forceful pulse indicates Excess; a weak and forceless pulse indicates Deficiency. Deficiency patterns require tonification, treated with the Tonify Fire to Generate Earth Method; Excess patterns require purgation, treated with the Clear Dysentery and Eliminate Accumulation Method.