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In the *Tong Ping Xu Shi Lun* (Discussion on Excess and Deficiency in General) of the *Su Wen*, the Yellow Emperor asked: What is the prognosis for dysentery with bloody stools? Qibo replied: If the body is hot, death ensues; if the body is cold (or normal temperature), life is preserved. The Yellow Emperor asked: What is the prognosis for dysentery with white mucus discharge? Qibo replied: If the pulse is deep (*Chen*), life is preserved; if the pulse is floating (*Fu*), death ensues. The Yellow Emperor asked: What is the prognosis for dysentery with purulent and bloody discharge? Qibo said: If the pulse is suspended and severed (*Xuan Jue*), death ensues; if the pulse is slippery and large (*Hua Da*), life is preserved. The Yellow Emperor asked: Regarding conditions belonging to dysentery, if the body is not hot and the pulse is not suspended and severed, what is the situation? Qibo replied: A slippery and large pulse indicates survival; a suspended and choppy pulse indicates death, which can be predicted according to the timing of organ qi exhaustion.

The *Bai Bing Shi Sheng Pian* (Chapter on the Origin of All Diseases) states: Injury to the Yang collaterals causes blood to overflow externally, resulting in epistaxis (*Nu Xue*); injury to the Yin collaterals causes blood to overflow internally, resulting in bleeding from the lower orifice (*Hou Xue*).

The *Tai Yin Yang Ming Lun* (Discussion on Taiyin and Yangming) states: Irregular diet and improper daily routine cause injury to the Yin meridians. When the Yin meridians are injured, the pathogen enters the Five Zang organs. Entering the Zang organs leads to abdominal fullness and obstruction, manifesting downward as undigested stool diarrhea (*Sun Xie*), and over time evolving into dysentery (*Chang Pi*).

The *Da Qi Lun* (Discussion on Great Anomalies) states: A Spleen pulse that beats outwardly but is deep upon pressure indicates dysentery, which will heal itself after a long period. A Liver pulse that is small and slow indicates dysentery, which is easy to treat. A Kidney pulse that is small, thready, and deep indicates dysentery with bloody discharge; if the blood is warm and the body is hot, death ensues. Pathologies of the Heart and Liver also involve bloody discharge; if both organs are diseased simultaneously, it is treatable. However, if the pulse is small, deep, and choppy accompanied by body heat, death ensues; if heat persists for seven days, death occurs.

The *Lun Ji Zhen Chi Pian* (Chapter on Diagnosing Diseases by Inspecting the Forearm) states: Stool containing red clots with undigested stool diarrhea, a small pulse, and cold hands and feet indicate a difficult-to-treat condition. Undigested stool diarrhea with a small pulse but warm hands and feet indicates that the diarrhea is easily curable. Wind injury in spring generates post-diarrhea and dysentery in summer.

The *Jing Mai Pian* (Chapter on Meridians) states: Diseases generated by the Kidney include dysentery.

The *Yin Yang Bie Lun* (Discussion on Differences between Yin and Yang) states: Dysentery caused by deficiency of both Yin and Yang leads to death.

The *Qi Jue Lun* (Discussion on Qi Reversal) states: Heat transferring from the Kidney to the Spleen transforms into deficiency, leading to dysentery, which results in death.

The *Yu Ji Zhen Cang Lun* (Discussion on the Jade Machine and True Organ Pulses) states: Diarrhea with a large pulse, and blood loss with an excess pulse, are both difficult to treat.

Dysentery (*Li Ji*) is the condition referred to as "Chang Pi" in the *Nei Jing*. Ancient and modern medical texts, due to the blockage and difficulty in defecation associated with this condition, call it "Zhi Xia" (Stagnant Downward). Its symptoms include tenesmus (*Li Ji Hou Zhong*), excretion of foul matter or blood, mixed colors (five colors), predominantly red or purple, with or without pain, with or without vomiting, with or without fever, or with or without aversion to cold. The yin-yang and excess-deficiency nature of this condition must be carefully and thoroughly examined to avoid errors; inaccurate diagnosis leads to grave mistakes. The methods described in the preceding section on diarrhea are fundamentally applicable here and should be consulted and used in conjunction for best results.

1. Dysentery often occurs during the transition between summer and autumn. Traditional methods attribute it to the prevalence of intense heat and the command of Ministerial Fire, where toxic heat accumulates to cause dysentery. This view is widely accepted today. While it seems logical to attribute dysentery to summer heat as a heat syndrome, intense heat is the normal climate. When heat fails to arrive when expected, it becomes a disaster. Conversely, seeking coolness due to heat is a common human behavior; excessive consumption of raw and cold foods causes dysentery. Many prudent individuals who avoid cold and raw foods even during peak summer escape diarrhea and dysentery. Does this mean they alone are unaffected by heat? This indicates that the disease lies in cold pathogens, not summer heat; it lies in human conduct, not celestial timing. Those with strong Stomach qi and robust constitution can consume fruits and cold foods daily without illness because their Yang qi prevails. Others may not fall ill immediately, but as raw/cold intake accumulates, when the autumn coolness arrives (around July/August), latent Yin-cold activates and rises. Thus, Spleen invasion by cold-dampness is most common in the seventh and eighth lunar months, reflecting the decline of Yang and growth of Yin. For those with inherent Spleen-Kidney weakness, illness follows exposure immediately, without needing latent cold or specific seasons, making it very common. Since diarrhea and dysentery arise immediately after swallowing cold/raw food, how can it instantly transform into heat? Why do modern physicians only see the external heat of the season and ignore the internal cold of the viscera? Upon seeing dysentery, they immediately label it "heat toxin" and treat cold-induced pathology with cold-natured herbs. Is this not adding frost to snow? Following this common misconception, countless have died.

Some ask: Are there cases cured by cold-natured herbs? I reply: Yes, for those with strong Stomach and abundant Yang who develop damp-heat, or for those with robust Yuan Qi where evil cannot overcome righteousness, cold treatment or purgative treatment can cure them. However, such cases are extremely rare. For the vast majority—those with weak Stomach and deficient Yang injured by cold—if cold herbs are used or purgatives are recklessly applied, death is inevitable. Most deaths from dysentery today fall into this category. Zhu Danxi stated that diarrhea and dysentery are mostly heat syndromes and rarely cold syndromes. Dai Yuanli claimed that due to toxic heat, when autumn arrives and Yang qi recedes while Fire qi descends, stagnant downward dysentery occurs. These are grossly erroneous statements and should not be believed. I write these vernacular warnings to caution against them.