大瘕小肠大肠泻，肠癖滞下古痢名，外因风暑湿蒸气，内因不谨饮食生。白痢伤气
赤伤血，寒虚微痛热窘疼，实坠粪前虚坠后，湿热寒虚初久称。
【注】大瘕泻者，里急后重，数至圊而不能便，茎中痛也。小肠泻者，溲涩而便脓血，
少腹痛也。大肠泻者，食已窘迫，大便色白，肠鸣切痛也。肠癖者，饮食不节，起居不时，
阴受之，则入五脏， 胀闭塞，下为飧泻，久为肠癖，腹痛下血也。滞下者，积汁垢腻，与
湿热滞于肠中，因而下也。此皆古痢之名也。然痢之为病，里急后重，下利脓血，小便赤
涩。里急者，腹痛积滞也。后重者，下坠气滞也。小便赤涩者，湿热郁滞也。皆因外受
风暑湿蒸之气，内伤生冷冻饮料食过度而生也。白痢自大肠来。大肠与肺为表里，肺主气，故
属伤气也。赤痢自小肠来，小肠与心为表里，心主血，故属伤血也。寒闭痛甚，寒开痛微，
痢开病减，故痛微也。虚者少气，气无壅滞，故亦痛微也。热者多实，性急不得舒通，故
窘痛甚也。后坠下迫肛门，粪出坠止，为粪前坠，乃滞也，故曰实坠。粪出更坠，为粪
后坠，非滞也，故曰虚坠。初痢多属湿热，久痢多属寒虚也。
噤口痢 水谷痢 风痢 休息痢 热痢 寒痢 湿痢 五色痢
噤口饮食俱不纳，水谷糟粕杂血脓，风痢坠重圊清血，休息时作复时停，热痢鱼脑
稠粘秽，寒痢稀趺白清腥，湿痢黑豆汁混浊，五色相杂脏气凶。
【注】噤口痢者，下利不食，或呕不能食也。水谷痢者，糟粕脓血杂下也，风痢者，似
肠风下清血而有坠痛也。休息痢者，时发作时停止也。五色痢者，五色脓血相杂而下也，
若有脏腐尸臭之气则凶。
Da Jia Xie (Great Mass Diarrhea), Xiao Chang Xie (Small Intestine Diarrhea), and Da Chang Xie (Large Intestine Diarrhea), along with Chang Pi (Intestinal Dysentery) and Zhi Xia (Stagnant Downward Discharge), are ancient names for Li Ji (Dysentery). The external etiology involves Wind, Summerheat, Dampness, and Zheng (Damp-Heat Miasma); the internal etiology arises from imprudent diet. White dysentery injures Qi; red dysentery injures Blood. Cold and Deficiency patterns present with mild pain, while Heat patterns present with urgent and severe pain. Excess patterns manifest as tenesmus before defecation, whereas Deficiency patterns manifest as tenesmus after defecation. Early-stage dysentery mostly belongs to Damp-Heat, while chronic dysentery mostly belongs to Cold and Deficiency.
[Note] Da Jia Xie is characterized by Li Ji Hou Zhong (tenesmus: urgent abdominal pain with a constant desire to defecate but difficult passage and a heavy sensation in the anus), frequent trips to the toilet with inability to pass stool, and pain in the urethra. Xiao Chang Xie presents with painful and scanty urination accompanied by pus and blood in the stool, and pain in the lower abdomen. Da Chang Xie presents with immediate abdominal urgency after eating, white-colored stool, borborygmus, and cutting abdominal pain. Chang Pi results from irregular diet and lifestyle, where pathogenic factors enter through the Yin meridians, transmit to the Five Zang organs, causing abdominal distension and obstruction, progressing downward to Sun Xie (diarrhea with undigested food), and eventually becoming Chang Pi, characterized by abdominal pain and hematochezia. Zhi Xia refers to the downward discharge of stagnant, greasy fluids mixed with Damp-Heat obstructing the intestines. These are all ancient names for dysentery. However, the disease of Li Ji is characterized by Li Ji Hou Zhong, passage of pus and blood in the stool, and dark, scanty, and painful urination. "Li Ji" refers to abdominal pain due to stagnation; "Hou Zhong" refers to the sensation of heaviness and Qi stagnation; dark and painful urination indicates Damp-Heat stagnation. All these arise from external contraction of Wind, Summerheat, Dampness, and Damp-Heat miasma, combined with internal injury from excessive consumption of cold, frozen drinks, and foods. White dysentery originates from the Large Intestine. The Large Intestine and Lung are exterior-interiorly related; the Lung governs Qi, thus it belongs to Qi injury. Red dysentery originates from the Small Intestine. The Small Intestine and Heart are exterior-interiorly related; the Heart governs Blood, thus it belongs to Blood injury. When Cold obstructs, pain is severe; when Cold dissipates, pain is mild. When the dysentery opens (passes), the condition alleviates, so pain is mild. In Deficiency patterns, there is shortness of Qi and no Qi stagnation, so pain is also mild. In Heat patterns, there is often Excess; the nature is impatient and lacks smooth flow, so urgent and severe pain occurs. Tenesmus pressing on the anus, which stops after stool passage, is called "tenesmus before stool," indicating stagnation, hence termed "Excess tenesmus." Tenesmus that persists after stool passage is called "tenesmus after stool," indicating no stagnation, hence termed "Deficiency tenesmus." Early dysentery mostly belongs to Damp-Heat, while chronic dysentery mostly belongs to Cold and Deficiency.
Jin Kou Li (Anorexic Dysentery), Shui Gu Li (Food and Water Dysentery), Feng Li (Wind Dysentery), Xiu Xi Li (Intermittent Dysentery), Re Li (Heat Dysentery), Han Li (Cold Dysentery), Shi Li (Damp Dysentery), Wu Se Li (Five-Color Dysentery):
Jin Kou Li manifests as complete inability to ingest food or water; Shui Gu Li manifests as the mixed passage of fecal matter, pus, and blood; Feng Li manifests with severe tenesmus and passage of clear blood; Xiu Xi Li manifests as intermittent episodes of onset and remission; Re Li manifests with stool resembling fish brains—thick, sticky, and foul; Han Li manifests with thin, white, clear, and fishy-smooth stool; Shi Li manifests with turbid stool resembling black bean juice; Wu Se Li manifests with five colors mixed together, indicating a dire prognosis due to the decline of Zang organ Qi.
[Note] Jin Kou Li refers to diarrhea accompanied by an inability to eat, or vomiting preventing intake. Shui Gu Li refers to the mixed passage of fecal matter, pus, and blood. Feng Li resembles Chang Feng (Wind affecting the intestines) with clear blood passage and tenesmus pain. Xiu Xi Li is characterized by periodic attacks and remissions. Wu Se Li refers to the mixed passage of pus and blood in five colors; if accompanied by a smell of rotting viscera or corpse-like odor, the prognosis is dire.