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Chi-Bai Li (Dysentery with red and white discharge), known in ancient times as "Zhi Xia" (Stagnant Downward Flow). Investigating its origin, the disease is caused by external contraction of the five pathogenic factors (Wind, Cold, Summer-heat, Dampness, Dryness) and internal injury from consuming raw, hard, cold, or hot food. Its manifestations are diverse.

If Cold pathogen is contracted, leading to Qi stagnation, and Liver Wood overacts on Spleen Earth causing abdominal pain, Leng Ji Wan (Cold Accumulation Pill) can be used to warm the Spleen and remove stagnation; or Liu Shen Wan (Six Gods Pill) can be selected. There is no case where these do not bring relief. Some say: Although the ancients stated "No accumulation, no dysentery," treatment should focus primarily on removing accumulation. But does it mean that within a year, only during Autumn and Summer do people have accumulation, while Spring and Winter they do not? This is incorrect. If Wind pathogen enters the Stomach, and Liver Wood attacks Spleen Earth, failing to transform properly, Shen Shu San (Divine Power Powder) in ancient formulas is the key medicine for treating such conditions.

Furthermore, within a neighborhood or county, diseases may spread upwards and downwards with similar symptoms; or only one family suffers from young to old; or neighbors transmit it to each other. There are cases where the disease name is the same but the syndrome differs, and cases where the syndrome differs but the treatment is the same. Some are cured with warming agents, some with cooling medicines. Such cases belong to toxic epidemic syndromes, i.e., Du Li (Toxic Dysentery). Although this also corresponds to the theory of mutual overcoming among the Five Movements and Six Qi, one must not adhere rigidly to this theory. If it were merely due to the mutual overcoming of toxic epidemic Qi, how could it be limited to just one neighborhood, one county, or even one or two families? For such syndromes, one must first examine deficiency/excess and cold/heat. For deficiency-cold patterns, Bai Du San (Eliminate Toxin Powder) with added Ren Shen (Ginseng Root), Gan Cao (Licorice Root), Chen Mi (Aged Rice), Sheng Jiang (Fresh Ginger), and Da Zao (Jujube) decocted and taken orally can be used. Alternatively, San Huang Shu Ai Tang (Three Yellows Cooked Mugwort Decoction), Huang Lian E Jiao Wan (Coptis Donkey-hide Gelatin Pill), Wu Ling San (Five-Ingredient Powder with Poria), or Zhu Che Wan (Chariot-Stopping Pill) can be selected according to the situation.

If dysentery presents with predominantly red color, or pure fresh blood, accompanied by Tenesmus (urgent need to defecate with little output), inability to pass stool, high fever, heat in the palms and soles, severe irritability and thirst, distending pain in the abdomen and hypochondrium, dark urine, and a surging pulse in all six positions, or tight and rapid, or deep and excess, this is Re Li (Heat Dysentery). Bai Tou Weng Tang (Pulsatilla Decoction), San Huang Shu Ai Tang (Three Yellows Cooked Mugwort Decoction), or Wu Ling San (Five-Ingredient Powder with Poria) should be selected and used appropriately.

If excessive bleeding occurs due to Feng Li (Wind Dysentery), Wei Feng Tang (Stomach Wind Decoction) with Mu Xiang (Aucklandia Root) and Hei Dou (Black Soybean) decocted and taken orally should be used.

If vomiting, nausea, difficult urination, and heat in the five centers (palms, soles, and chest) occur during Summer and Autumn, with weak pulses in all six positions, these pulse and syndrome characteristics are precisely due to Fu Shu (Latent Summer-heat). This disease should be treated with Xiang Ru San (Elsholtzia Powder) added with Huang Lian (Coptis Rhizome), Gan Cao (Licorice Root), and Dang Gui (Angelica Sinensis), decocted strongly with wine and water, taken in one gulp cooled well-water (Jing Hua Shui - well water drawn at dawn), combined with Jiu Zhu Huang Lian Wan (Wine-boiled Coptis Pill) or Xiao Chai Hu Tang (Minor Bupleurum Decoction) added with Ren Shen (Ginseng Root) and decocted. Recovery is certain.

If miscellaneous syndromes recede but dysentery persists, Si Wu Tang (Four Substance Decoction) added with Jiao Ai (Donkey-hide Gelatin and Artemisia Leaf) decocted and taken orally should be used to harmonize Yin and Yang. There is no case where this does not bring relief.

If water and grain are not separated, and urination is difficult, Wu Ling San (Five-Ingredient Powder with Poria) should be used, administered with decoction of Dan Zhu Ye (Lophatherum Herb). It is also suitable for those with severe irritability. If the syndrome of Latent Summer-heat is not understood, and sulfur, Fu Zi (Aconite Root), Gan Jiang (Dried Ginger), Rou Gui (Cinnamon Bark), and Dan Shi (Mineral Drugs) are mistakenly administered based solely on weak pulses, death will surely result. This is deeply lamentable.

If dysentery is purely white, resembling fish brain, with cold pain in the umbilical and abdominal regions, uncontrolled day and night, cold extremities, possibly vomiting, complete loss of appetite, preference for warmth and aversion to cold, and faint, thin pulses, this is due to deficiency-cold of the Zang-Fu organs. Mu Xiang San (Aucklandia Powder) added with Si Wei Li Zhong Tang (Four-Ingredient Regulate the Middle Decoction) and Zhong Ru Jian Pi Wan (Calcium Carbonate Strengthen Spleen Pill) should be used. In severe cases with cold extremities and absent deep pulses, a strong tonifying method should be employed, combined with moxibustion on Qi Hai (CV6) and Dan Tian (CV8) acupoints, further assisted by stomach-nourishing herbs. This represents the strategy of defending without attacking. Si Shun Fu Zi Tang (Four-Obedience Aconite Decoction), San Jian Dan (Three Establishments Elixir), Bai Dan (White Elixir), Jia Wei Shen Fu Tang (Modified Ginseng-Aconite Decoction), and Jiang Fu Tang (Ginger-Aconite Decoction) can all be selected.

For elderly and weak individuals, or those constitutionally frail, this method should also be adopted, adjusted carefully. However, opening the stomach and promoting appetite should come first. If food can enter, the Spleen function will be established. Waste accumulates, forming greasy turbidity, leading to blood stasis. One need not worry about collapse.

If chronic dysentery does not heal, intestinal slipping and continuous diarrhea persist, and various medicines fail, only then should intestinal-astringing and diarrhea-stopping agents be applied. One should also initially use agents like Long Gu (Dragon Bone), Rou Dou Kou (Nutmeg), He Zi (Chebula Fruit), Zhong Ru (Calcium Carbonate), and Hu Fen (Lead White). Modern people often use Ying Su Ke (Poppy Shell) and Di Yu (Sanguisorba Root). However, these substances are too astringent. For young and robust individuals, occasional efficacy may be seen. But for those suffering from epidemic toxins and summer-dampness, the elderly, or the constitutionally frail, taking these will inevitably cause great harm. Because forcibly securing and astringing the intestines traps the Wind, Cold, Summer-heat, and Dampness pathogens inside, preventing their expulsion, leading to closure of the epigastrium and obstruction, anorexia (Jin Kou Li), progressive emaciation, inability to ingest food, and the pathology in the intestines cannot be eliminated. If such a syndrome exists, Shen Ling San (Ginseng and Poria Powder) or Si Jun Zi Tang (Four Gentlemen Decoction) added with Shi Lian (Lotus Seed) and Shan Yao (Dioscorea Rhizome) should be used for treatment. Recovery is certain.

When seeking tonifying medicines for treating dysentery, there is an intention of warming and unblocking within them. For example, Si Jun Zi Tang (Four Gentlemen Decoction) or Li Zhong Shi Quan Tang (Regulate the Middle Complete Decoction) added with Bai Dou Kou (Cardamom), Fu Ling (Poria), Guan Gui (Cinnamon Twig), Cao Guo (Black Cardamom), and Hou Po (Magnolia Bark) can disperse Wind pathogen, separate the Water passages, open the epigastrium, treat entanglement/disturbance, and unblock constipation/astringency. This achieves both attacking and defending strategies perfectly.

Generally, the methods for treating dysentery are: Tonify deficiency, Drain excess, Astringe slipping, Unblock obstruction, Push out accumulation, Disperse Wind, Purge Summer-heat, Dry Dampness, Cool Heat, Warm Cold, Harmonize Heat, aiming for balance. One must not exceed these general principles.

Dysentery is generally caused by Deficiency-Cold of the Spleen and Stomach, weakness of the Zang-Fu organs, inability of diet to harmonize, and failure of water and grain to nourish, resulting in fatigue, reduced appetite, and abdominal pain. During pregnancy, dysentery occurs due to the interplay of Cold and Heat, agitation of Yin and Yang, and weakness of the Zang-Fu organs. Thus, Cold and Heat pathogens attack each other. If they contend in the Blood Sea, dysentery results; if they contend mainly in the Intestines and Stomach, dysentery results. Stasis and pathogens cause urine to be red like mixed dysentery, which can be treated with Long Gu Wan (Dragon Bone Pill).

Formulas:

Hua Xiang San (Fragrant Powder): Treats men, women, and children with unknown Yin-Yang status, where Cold and Heat contend, accumulating into dysentery, either red, white, or mixed, uncontrollable day and night.
Ingredients: Ying Su Ke (Poppy Shell, processed), Chen Pi (Tangerine Peel, pith removed), Fen Cao (Licorice Root, 1 liang each), Hou Po (Magnolia Bark, 0.5 liang), Qing Pi (Green Tangerine Peel), Bai Jiang (White Ginger, 1 fen each).
Usage: Grind all ingredients into fine powder.

Huang Qin Tang (Scutellaria Decoction): Treats dry vomiting and dysentery.
Ingredients: Huang Qin (Scutellaria Root), Ren Shen (Ginseng Root), Gan Jiang (Dried Ginger, 3 liang each), Da Zao (Jujube, 12 pieces), Ban Xia (Pinellia Tuber, 0.5 liang).
Usage: Add 7 sheng of water, simmer gently to obtain 3 sheng. Take warm, divided into four doses.

Si Shun Fu Zi Tang (Four-Obedience Aconite Decoction):
Ingredients: Fu Zi (Aconite Root, raw, skin and umbilicus removed), Bai Jiang (White Ginger, roasted), Gan Cao (Licorice Root), Ren Shen (Ginseng Root, 1 liang each).
Usage: Coarsely crush. Take 4 qian per dose, with 2 zhan of water, decoct until... (text incomplete), take warm. Treats cold extremities.

Jiu Zheng... (Text incomplete, inferred formula): Treats vomiting, diarrhea, and red-white dysentery.
Ingredients: Chen Pi (Tangerine Peel), Huang Lian (Coptis Rhizome, 7.5 qian), Mu Xiang (Aucklandia Root, 5 qian).
Usage: Coarsely cut into two doses. For red dysentery, add 1.5 qian of Wu Dou (Black Soybean); for white dysentery, add 1.5 qian of Gan Jiang (Dried Ginger).

Si Wei E Jiao Wan (Four-Ingredient Donkey-hide Gelatin Pill): Treats Heat Dysentery.
Ingredients: Huang Lian (Coptis Rhizome), Chi Fu Ling (Red Poria, 1-2 liang), Shao Yao (Peony Root, 3 liang), E Jiao (Donkey-hide Gelatin, fried, 1 liang).
Usage: First grind the three ingredients into powder, then use good vinegar to boil into a paste... (text incomplete).

Bai Tou Weng Tang (Pulsatilla Decoction): Treats Heat Dysentery with continuous bloody stools for months that do not heal.
Ingredients: Bai Tou Weng (Pulsatilla Root, 2 liang), Huang Lian (Coptis Rhizome), Huang Bo Pi (Phellodendron Bark), Qin Pi (Ash Bark, 3 liang each).
Usage: Coarsely crush. Take 4 qian per dose, with 1.5 zhan of water, decoct until 0.7 portion remains, take warm.

Ying Su San (Poppy Powder): Treats pre- and post-partum dysentery, regardless of red or white.
Ingredients: Ying Su Ke (Poppy Shell, 10 pieces, white pulp removed), Chen Mu Xiang (Old Aucklandia Root, piece size of small coin), Ju Pi (Tangerine Peel, 1 piece, pulp removed).
Usage: Coarsely cut. Use 1.5 bowls of water... (text incomplete).

Yu Fen Dan (Jade Powder Elixir): Treats Heat Dysentery.
Ingredients: Ge Fen (Clam Shell Ash), Liu Huang (Sulfur, equal parts).
Usage: Grind together finely, mix with wheat flour paste to form pills the size of Sophora seeds. Take 50 pills per dose.

Dou Kou Bing (Cardamom Cake): Treats red-white dysentery, stabbing pain in the umbilical and abdominal regions, chronic non-healing, greatly treats Cold Dysentery.
Ingredients: Ying Su Ke (Poppy Shell, processed, 1 liang), Bai Shao Yao (White Peony Root), Huang Qi (Astragalus Root, 3 qian each), Chen Pi (Tangerine Peel), Qing Pi (Green Tangerine Peel), Mu Xiang (Aucklandia Root), He Zi (Chebula Fruit), Rou Dou Kou (Nutmeg), Ren Shen (Ginseng Root)... (text incomplete).
Usage: ... (text incomplete), take warm when 0.7 portion remains.

Disease of Pulse... (Fragmentary text regarding pulse diagnosis, omitted from formula list).

Tiao Zhong Tang (Regulate the Middle Decoction):
Ingredients: Ge Gen (Kudzu Root), Huang Qin (Scutellaria Root), Shao Yao (Peony Root), Jie Geng (Platycodon Root), Chi Fu Ling (Red Poria), Bai Zhu (Atractylodes Rhizome), Gan Cao (Licorice Root, honey-fried), Ben Cao (Ligusticum Chuanxiong Rhizome, equal parts).
Usage: Coarsely crush. Take 3 qian per dose... (text incomplete).

San Jian Dan (Three Establishments Elixir):
Ingredients: Yang Qi Shi (Pyrite, flown/washed, 0.5 liang), Zhong Ru Fen (Calcium Carbonate Powder, 1 liang), Da Fu Zi (Large Aconite Root, roasted, powdered, 0.5 liang, half used to make paste).
Usage: Use Aconite paste to form pills the size of Sophora seeds... (text incomplete).

Jia Wei Shen Fu Tang (Modified Ginseng-Aconite Decoction):
Ingredients: Da Fu Zi (Large Aconite Root, 2.5 liang, roasted), Ren Shen (Ginseng Root, 3 liang).
Usage: Coarsely crush. Take 4 qian per dose, with 2 zhan of water, 10 slices of Ginger, 15 grains of Ding Xiang (Clove)... (text incomplete).

Xiang Rong Wan (Musk and Velvet Antler Pill): Treats critical dysentery.
Ingredients: She Xiang (Musk, 0.5 qian, separately ground, added at time of use), Lu Rong (Velvet Antler, 1 liang, hair removed, roasted with butter until yellow, ground to powder, mixed with Musk).
Usage: Boil Dendrobium (Deng Xin Cao) and Jujube flesh to form pills the size of Sophora seeds... (text incomplete), take warm.

Pu Huang San (Polygonatum Powder): Treats pre- and post-partum red-white dysentery in women.
Ingredients: Sheng Jiang Zi Ran Zhi (Fresh Ginger Juice, 10 liang for young, 20 liang for old), Ya Zi (Duck, 1, crushed and mixed with ginger juice).
Usage: Simmer until 0.8 portion remains, add Pu Huang (Lygodium Spore)... (text incomplete).

Zi Shen Tang (Purple Ginseng Decoction): Treats dysentery with abdominal pain.
Ingredients: Zi Shen (Purple Ginseng/Bistort Root, 0.5 jin), Gan Cao (Licorice Root, 3 liang).
Usage: Add 5 sheng of water, first decoct Zi Shen to obtain 2 sheng, add Gan Cao, decoct to obtain 1.5 sheng, take warm, divided... (text incomplete).

Formula for stopping persistent dysentery:
Ingredients: Mu Xiang Wan (Aucklandia Pill, boiled in water), 32 aged white plums, burned to ash retaining nature, ground to fine powder.
Usage: Administer with aged rice decoction, 3-5 doses.

He Li Le San (Terminalia Powder): Treats Qi Dysentery.
Ingredients: He Li Le (Terminalia Chebula Fruit, 10 pieces), ground to powder.
Usage: Mix with congee drink and take frequently. *Da Quan Liang Fang* states: Once a woman suffered from continuous diarrhea, resembling dysentery but not quite, resembling blood but not quite... (text incomplete).

Liu Shen Wan (Six Gods Pill): Treats red-white dysentery.
Ingredients: Fu Ling (Poria), Zhi Ke (Aurantii Fructus), Mai Ya (Malt), Mu Xiang (Aucklandia Root, double for white dysentery), Shen Qu (Medicated Leaven, cut to powder reserved for paste), Huang Lian (Coptis Rhizome, equal parts for the six ingredients, double for red dysentery).
Usage: ... (text incomplete, likely processing instructions).

Xiao Hong Wan (Little Red Pill): Treats chronic dysentery with continuous bleeding.
Ingredients: Chi Shi Zhi (Red Halloysite, 1 liang, vinegar-roasted seven times), Gan Jiang (Dried Ginger, 1 liang), Zao (Jujube, 3 liang), Ai Ye (Mugwort Leaf, processed, 1 liang), Chuan Jiao (Sichuan Pepper, 7 qian, stir-fried hot together).
Usage: ... (text incomplete, likely processing instructions).

Long Gu Wan (Dragon Bone Pill): Treats persistent dysentery.
Ingredients: Huang Lian (Coptis Rhizome, slow-fire roasted), Gan Jiang (Dried Ginger, roasted), Dang Gui (Angelica Sinensis, 0.5 liang each, wine-soaked and baked dry), Chi Shi Zhi (Red Halloysite, vinegar... seven times), E Jiao (Donkey-hide Gelatin, 2.5 qian... roasted... Ge... text incomplete).

Treating Jin Kou Li (Anorexic Dysentery):
Ingredients: Shi Lian Rou (Lotus Seed Embryo/Core, any amount), do not roast, remove shell, grind meat and core to fine powder.
Usage: Take 2 qian per dose, administered with aged rice decoction. Appetite will return. If not healed... (text incomplete).

Another Formula:
Ingredients: Gan Shan Yao (Dioscorea Rhizome, any amount), half raw, half roasted yellow, ground to fine powder.
Usage: Administer with rice decoction. This syndrome is due to dysentery toxin rushing up to the Lung (Hua Gai), blocking Heart Qi... (text incomplete).

Treating red-white dysentery and chronic slippery cold diarrhea in nursing mothers. (From *Ben Cao*).
Ingredients: One leaf of Pig Liver (Zhu Zi Gan), thinly sliced. He Zi Mo (Chebula Powder) applied and roasted over slight fire until powder is consumed, up to 0.5 liang.
Usage: Chew finely on an empty stomach, send down with aged rice decoction.