下痢一症，《内经》谓之肠 。后来论症者，不下数十家。其专主肠胃而言者，固属挂漏；其
主湿热及招凉食冷者，亦不过时痢一门。至分别内伤外感，三阴三阳，虚实寒热，则颇为详明周至
矣。但虚者补之，实者泻之，寒者温之，热者清之，本属定法，岂独痢症为然！愚意尚有吃紧两条
，试申言之。外感各有主病，内伤各有主经，从此分别，更易下手。外感之邪，不外风寒暑湿燥火
。风入肠胃，故为飧泄，内犯于肝。寒气中人，腹痛下痢，内犯于肾。暑湿郁蒸，腹痛下痢，兼有
赤白，内犯于脾。燥气中人，口渴心烦，下痢白滞，内犯于肺。
火邪炽盛，渴饮不止，下痢脓血，频数不休，内犯于心。此外感六淫，与五脏相应者也。至内
伤之症，伤于肝者，胁痛腹痛，作哕下痢。伤于肾者，腹痛腰痛，身冷下痢。伤于脾者，胸满身重
，哕恶食少下痢。伤于肺者，口燥咽干，微咳下痢。伤于心者，烦躁渴饮，下痢不休。此内伤之所
致也。感于风者表解之，感于寒者温通之，感湿热者清利之，感于燥者清润之，感于火者荡涤之，
当各随所主之病以施治。伤肝者解其郁，伤肾者保其阳，伤于脾者运其中，伤于肺者存其津，伤于
心者泄其亢，当各随所主之经以施治。此特就内伤外感两义，缕析言之。其他各症，《痢症汇参》
所已载者，概不复赘。
感风下痢，身热脉微弦者，回风外解汤主之。
回风外解汤（自制）
柴胡（一钱） 薄荷（一钱） 前胡（一钱） 桔梗（一钱） 枳壳（一钱）
葛根（二钱） 豆豉（三钱） 广皮（一钱） 茯苓（二钱） 白术（一钱） 姜皮
（六分） 荷叶（一角）
感寒下痢，腹痛，手足冷，舌白，口不渴，脉沉细者，温中化浊汤主之。甚者加附子。
温中化浊汤（自制）
炮姜（五分） 小茴香（一钱） 乌药（一钱） 木香（五分） 广皮（一钱）
浓朴（一钱） 当归（一钱五分） 茯苓（二钱） 白术（一钱） 佛手干（五分）
感暑湿者，烦渴腹痛，下痢脓血，粉米汤主之。
粉米汤（自制）
花粉（三钱） 苡米（一两） 藿香（一钱） 薄荷（一钱） 黄连（五分酒炒）
黄芩（一钱酒炒） 木香（五分） 木通（一钱酒炒） 当归（一钱五分） 赤苓（一钱酒炒
）荷叶（一角） 绿豆（一撮）
感燥下痢，咽干作渴，腹痛，下痢白滞，金玉保和汤主之。
金玉保和汤（自制）
金石斛（四钱） 玉竹（三钱） 蒌皮（三钱） 黄芩（一钱酒炒） 当归（一钱五分）
茯苓（二钱） 山药（三钱） 广皮（一钱） 枳壳（一钱） 苡仁（四钱）
荷叶（一角） 陈粳米（一撮煎汤代水）
火盛下痢，昼夜不休，作渴腹痛，时下脓血，消炎化毒汤主之。
消炎化毒汤（自制）
黄连（六分） 黄芩（一钱） 大黄（四钱） 银花（二钱） 甘草（五分）
花粉（二钱） 木通（一钱） 青皮（一钱） 当归（一钱五分） 赤芍（一钱）
淡竹叶（二十张）
肝郁下痢，胁痛腹痛，噫气食少，大顺汤主之。
大顺汤（自制）
蒺藜（四钱） 郁金（二钱） 乌药（一钱） 白术（一钱） 广皮（一钱）
浓朴（一钱） 木香（五分） 青皮（一钱） 茯苓（二钱） 枳壳（一钱） 橘
饼（四钱） 煨姜（三片）
肾气虚寒，腹痛下痢，完谷不化，手足俱冷者，立命开阳汤主之。
立命开阳汤（自制）
干河车（二钱切） 破故纸（一钱五分核桃肉拌炒） 益智仁（一钱五分） 制附片（八分） 当归（一
钱五分） 茯苓（二钱） 白术（一钱） 小茴香（一钱） 木香（六分） 乌药（一钱） 煨姜（三片）
脾虚下痢，食少神疲，胸腹时痛者，大中汤主之。
大中汤（自制）
党参（四钱） 制熟附（七分） 茯苓（三钱） 白术（一钱五分） 当归（二钱）
广皮（一钱） 浓朴（一钱） 枳壳（一钱） 乌药（一钱） 木香（五分） 大枣（二枚） 姜（三片）
肺热移于大肠，口燥微咳，下痢白滞者，育金煎主之。
育金煎（自制）
沙参（三钱） 石斛（三钱） 茯苓（三钱） 白术（一钱五分） 山药（三钱）
料豆（三钱） 当归（二钱） 橘红（一钱） 莲子（二十粒打碎去心）
心火下陷，烦扰不安，下痢脓血者，蒲虎汤主之。
蒲虎汤（自制）
生蒲黄（六分） 熟蒲黄（六分） 琥珀（一钱） 丹参（三钱） 茯神（二钱）
当归（二钱） 赤芍（一钱） 黄连（六分） 木香（五分） 灯心（三尺）
Dysentery (dysentery), referred to as "Chang Pi" (intestinal discharge) in the *Neijing* (Classic of Internal Medicine), has been discussed by dozens of later physicians. Those who focus solely on the stomach and intestines inevitably omit certain aspects; those who attribute it mainly to damp-heat or consuming cold food and drinks limit their discussion to seasonal dysentery alone. However, distinguishing between internal injury and external contraction, the Three Yin and Three Yang meridians, deficiency and excess, cold and heat, is quite detailed and comprehensive. Nevertheless, "tonify deficiency, drain excess, warm cold, clear heat" are established principles applicable to all conditions, not just dysentery! I believe there are two critical points worth elaborating. External pathogens have their specific diseases, and internal injuries affect specific meridians; differentiating from this perspective makes treatment easier to initiate. The six external pathogens do not exceed wind, cold, summerheat, dampness, dryness, and fire. Wind entering the stomach and intestines causes stool with undigested food (Sun Xie), affecting the Liver internally. Cold invading the body causes abdominal pain and dysentery, affecting the Kidney internally. Summerheat and dampness stagnating and steaming cause abdominal pain and dysentery, accompanied by red and white pus/blood, affecting the Spleen internally. Dryness invading the body causes thirst, vexation, and dysentery with white sticky discharge, affecting the Lung internally. Fire pathogen blazing intensely causes incessant thirst and drinking, dysentery with pus and blood, frequent and unceasing defecation, affecting the Heart internally. These are the correspondences between the six external pathogens and the five Zang organs. Regarding internal injuries: injury to the Liver presents with hypochondriac and abdominal pain, hiccups, and dysentery. Injury to the Kidney presents with abdominal and lower back pain, cold body, and dysentery. Injury to the Spleen presents with chest fullness, heavy body, hiccups, anorexia, and dysentery. Injury to the Lung presents with dry mouth and throat, slight cough, and dysentery. Injury to the Heart presents with restlessness, thirst, and unceasing dysentery. These are the causes of internal injuries. For wind contraction, resolve the exterior; for cold contraction, warm and unblock; for damp-heat contraction, clear and promote urination/drain dampness; for dryness contraction, clear and moisten; for fire contraction, purge and cleanse. Treatment should follow the specific pathogenic factor. For Liver injury, relieve stagnation; for Kidney injury, preserve Yang Qi; for Spleen injury, transform the Middle Jiao; for Lung injury, preserve fluids; for Heart injury, drain hyperactivity/fire. Treatment should follow the specific meridian involved. This is merely a detailed analysis of the concepts of internal injury and external contraction. Other symptoms already recorded in *Lin Zheng Hui Can* (Comprehensive Reference on Dysentery) will not be repeated.
For dysentery due to wind contraction, with fever and a slightly wiry pulse, Huifeng Waijie Tang (Wind-Resolving Exterior-Resolving Decoction) is the primary formula.
Huifeng Waijie Tang (Self-made)
Chaihu (Bupleuri Radix, 1 qian) Bohe (Menthae Haplocalycis Herba, 1 qian) Qianhu (Peucedani Radix, 1 qian) Jiegeng (Platycodonis Radix, 1 qian) Zhike (Aurantii Fructus Immaturus, 1 qian)
Gegen (Puerariae Lobatae Radix, 2 qian) Douchi (Sojae Semen Praeparatum, 3 qian) Guangpi (Citri Reticulatae Pericarpium, 1 qian) Fuling (Poria, 2 qian) Baizhu (Atractylodis Macrocephalae Rhizoma, 1 qian) Jiangpi (Zingiberis Perispermium, 6 fen) Heye (Nelumbinis Folium, 1 corner)
For dysentery due to cold contraction, with abdominal pain, cold hands and feet, white tongue coating, no thirst, and a deep, fine pulse, Wenzhong Huazhuo Tang (Middle-Warming Turbidity-Transforming Decoction) is the primary formula. Add Fuzi for severe cases.
Wenzhong Huazhuo Tang (Self-made)
Paojiang (Zingiberis Rhizoma Preparatum, 5 fen) Xiaohuixiang (Foeniculi Fructus, 1 qian) Wuyao (Linderae Radix, 1 qian) Muxiang (Aucklandiae Radix, 5 fen) Guangpi (Citri Reticulatae Pericarpium, 1 qian)
Nongpo (Magnoliae Officinalis Cortex, 1 qian) Danggui (Angelicae Sinensis Radix, 1.5 qian) Fuling (Poria, 2 qian) Baizhu (Atractylodis Macrocephalae Rhizoma, 1 qian) Foshougan (Citri Sarcodactylis Fructus, 5 fen)
For contraction of summerheat and dampness, with irritability, thirst, abdominal pain, and dysentery with pus and blood, Fenmi Tang (Powdered Rice Decoction) is the primary formula.
Fenmi Tang (Self-made)
Huafen (Trichosanthis Radix, 3 qian) Yimi (Coicis Semen, 1 liang) Huoxiang (Agastaches Herba, 1 qian) Bohe (Menthae Haplocalycis Herba, 1 qian) Huanglian (Coptidis Rhizoma, 5 fen, wine-fried)
Huangqin (Scutellariae Radix, 1 qian, wine-fried) Muxiang (Aucklandiae Radix, 5 fen) Mutong (Akebiae Caulis, 1 qian, wine-fried) Danggui (Angelicae Sinensis Radix, 1.5 qian) Chiling (Poria cum Rubo, 1 qian, wine-fried) Heye (Nelumbinis Folium, 1 corner) Lvdou (Phaseoli Radiati Semen, 1 pinch)
For dysentery due to dryness contraction, with dry throat, thirst, abdominal pain, and dysentery with white sticky discharge, Jinyu Baohe Tang (Gold-Jade Harmonizing-Decoction) is the primary formula.
Jinyu Baohe Tang (Self-made)
Shihu (Dendrobii Caulis, 4 qian) Yuzhu (Polygonati Odorati Rhizoma, 3 qian) Loupi (Trichosanthis Pericarpium, 3 qian) Huangqin (Scutellariae Radix, 1 qian, wine-fried) Danggui (Angelicae Sinensis Radix, 1.5 qian)
Fuling (Poria, 2 qian) Shanyao (Dioscoreae Rhizoma, 3 qian) Guangpi (Citri Reticulatae Pericarpium, 1 qian) Zhike (Aurantii Fructus Immaturus, 1 qian) Yiren (Coicis Semen, 4 qian)
Heye (Nelumbinis Folium, 1 corner) Chenjingmi (Old Oryzae Sativum Granulum, 1 pinch, decocted in water instead of plain water)
For dysentery due to excessive fire, unceasing day and night, thirst, abdominal pain, and intermittent pus and blood, Xiaoyan Huadu Tang (Anti-inflammatory Detoxifying Decoction) is the primary formula.
Xiaoyan Huadu Tang (Self-made)
Huanglian (Coptidis Rhizoma, 6 fen) Huangqin (Scutellariae Radix, 1 qian) Dahuang (Rhei Radix et Rhizoma, 4 qian) Yinhua (Lonicerae Japonicae Flos, 2 qian) Gancao (Glycyrrhizae Radix et Rhizoma, 5 fen)
Huafen (Trichosanthis Radix, 2 qian) Mutong (Akebiae Caulis, 1 qian) Qingpi (Citri Reticulatae Pericarpium Viride, 1 qian) Danggui (Angelicae Sinensis Radix, 1.5 qian) Chishao (Paeoniae Radix Rubra, 1 qian)
Danzhuye (Lophatheri Herba, 20 leaves)
For dysentery due to Liver Qi stagnation, with hypochondriac and abdominal pain, belching, and poor appetite, Dashun Tang (Great Harmony Decoction) is the primary formula.
Dashun Tang (Self-made)
Jili (Tribuli Fructus, 4 qian) Yujin (Curcumae Radix, 2 qian) Wuyao (Linderae Radix, 1 qian) Baizhu (Atractylodis Macrocephalae Rhizoma, 1 qian) Guangpi (Citri Reticulatae Pericarpium, 1 qian)
Nongpo (Magnoliae Officinalis Cortex, 1 qian) Muxiang (Aucklandiae Radix, 5 fen) Qingpi (Citri Reticulatae Pericarpium Viride, 1 qian) Fuling (Poria, 2 qian) Zhike (Aurantii Fructus Immaturus, 1 qian) Jubing (Citri Reticulatae Fructus Conservatus, 4 qian) Weijiang (Zingiberis Rhizoma Preparatum, 3 slices)
For Kidney Qi deficiency and cold, with abdominal pain and dysentery, undigested food in stool, and cold hands and feet, Liming Kaiyang Tang (Life-Establishing Yang-Opening Decoction) is the primary formula.
Liming Kaiyang Tang (Self-made)
Ganheche (Human Placenta Preparatum, 2 qian, sliced) Poguzhi (Psoraleae Fructus, 1.5 qian, stir-fried with walnut meat) Yizhiren (Alpiniae Oxyphyllae Fructus, 1.5 qian) Zhi fupian (Aconiti Lateralis Radix Preparata, 8 fen) Danggui (Angelicae Sinensis Radix, 1.5 qian) Fuling (Poria, 2 qian) Baizhu (Atractylodis Macrocephalae Rhizoma, 1 qian) Xiaohuixiang (Foeniculi Fructus, 1 qian) Muxiang (Aucklandiae Radix, 6 fen) Wuyao (Linderae Radix, 1 qian) Weijiang (Zingiberis Rhizoma Preparatum, 3 slices)
For Spleen deficiency dysentery, with poor appetite, mental fatigue, and intermittent chest/abdominal pain, Dazhong Tang (Great Central Decoction) is the primary formula.
Dazhong Tang (Self-made)
Dangshen (Codonopsis Radix, 4 qian) Zhishufu (Aconiti Lateralis Radix Preparata, 7 fen) Fuling (Poria, 3 qian) Baizhu (Atractylodis Macrocephalae Rhizoma, 1.5 qian) Danggui (Angelicae Sinensis Radix, 2 qian)
Guangpi (Citri Reticulatae Pericarpium, 1 qian) Nongpo (Magnoliae Officinalis Cortex, 1 qian) Zhike (Aurantii Fructus Immaturus, 1 qian) Wuyao (Linderae Radix, 1 qian) Muxiang (Aucklandiae Radix, 5 fen) Dazao (Ziziphi Jujubae Fructus, 2 pieces) Jiang (Zingiberis Rhizoma Recens, 3 slices)
When Lung Heat transmits to the Large Intestine, causing dry mouth, slight cough, and dysentery with white sticky discharge, Yujin Jian (Metal-Nourishing Decoction) is the primary formula.
Yujin Jian (Self-made)
Shashen (Glehniae Radix, 3 qian) Shihu (Dendrobii Caulis, 3 qian) Fuling (Poria, 3 qian) Baizhu (Atractylodis Macrocephalae Rhizoma, 1.5 qian) Shanyao (Dioscoreae Rhizoma, 3 qian)
Daodou (Sojae Helvolae Semen, 3 qian) Danggui (Angelicae Sinensis Radix, 2 qian) Juhong (Citri Reticulatae Pericarpium Rubrum, 1 qian) Lianzi (Nelumbinis Semen, 20 grains, crushed, heart removed)
When Heart Fire sinks downward, causing restlessness and dysentery with pus and blood, Puhu Tang (Mud-Tiger Decoction) is the primary formula.
Puhu Tang (Self-made)
Shengpuhuang (Typhae Pollen Crude, 6 fen) Shupuhuang (Typhae Pollen Preparatum, 6 fen) Hupo (Electrum, 1 qian) Danshen (Salviae Miltiorrhizae Radix et Rhizoma, 3 qian) Fushen (Poria cum Pararadicodia, 2 qian)
Danggui (Angelicae Sinensis Radix, 2 qian) Chishao (Paeoniae Radix Rubra, 1 qian) Huanglian (Coptidis Rhizoma, 6 fen) Muxiang (Aucklandiae Radix, 5 fen) Dengxin (Junci Medulla, 3 chi)