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The *Jingui Yaolu* (Essentials of the Golden Cabinet) states: When tenesmus (urgency and pain in defecation) is present, purgatives should be used; when abdominal pain occurs, harmonization is indicated; when the body feels heavy, dampness should be eliminated; when the pulse is wiry (Xian), wind should be expelled; when pus and blood are thick and sticky, heavy-dosed formulas should be employed to exhaust (clear) them; when the body is cold with spontaneous sweating, toxic drugs (referring to potent or harsh herbs) should be used for warming. If wind pathogens have retreated inward, diaphoresis (sweating method) is appropriate; if there is fright-induced diarrhea, warming is required. It further states: Pathogens in the exterior should be dispersed; those in the interior should be purged; those above should be induced to vomit; those below should be exhausted (drained). For heat on the body surface, internal clearing/detoxification is needed; for astringent urine, water passages should be separated and drained. It also says: When pathogenic factors are excess, they should be weakened; when healthy qi departs, it should be supported; when pathogens arrive, their advance should be halted. The Art of War states: Avoid the enemy's sharp spirit, strike when they are tired and returning. This is what is meant.

The *Yifang Mizang* (Secret Treasury of Medical Formulas) states: Suppose cold damage or dietary injury leads to distension and fullness, transmitting into undigested stool diarrhea (Sun Xie); warm-tonic formulas should be used to resolve stagnation. If pus and blood result from damaging hot-damp substances, bitter-cold formulas should be used for internal clearing. For wind pathogens sinking downward, yang should be lifted; for excessive internal dampness, water passages should be separated. For urgency (Li Ji), purgation is indicated; for tenesmus (Hou Zhong), Qi should be regulated; for abdominal pain, harmonization is needed. For sudden profuse diarrhea with borborygmus, weakness so severe one cannot lift clothes, and a wiry-thin-weak pulse, warming and astringing are required. For thick, sticky pus and blood, straining at stool without ability to pass, and a surging-strong pulse, cold-purgative methods should be used.

According to this classification, treatments for wind-cold, damp-heat, exterior-interior, warm-tonic, and cold-purge are very appropriate. Students should study them carefully. However, the meanings of urgency, tenesmus, and abdominal pain are not detailed here; these will be discussed separately below.

The *Jingui Yaolu* states: When the Taiyin channel is invaded by dampness, resulting in watery diarrhea, flaccid incontinence, heaviness, slight fullness, and poor appetite, it may eventually transform into dysentery with pus and blood. Transmission from the Spleen channel to the Kidney channel is called "Thief Evil" (Zei Xie), making it difficult to cure. If diarrhea precedes flaccidity, it is called "Minor Evil" (Wei Xie), making it easier to recover. These are all caused by Spleen Earth being affected by dampness. Additionally, Wind-Cold syndromes are discussed under the section on diarrhea and dysentery.

Discussion on how Wind, Cold, Summer-Heat, and Dampness can all cause dysentery.

Chen Wuzhuo states: The syndrome of Zhi Xia (Dysentery/Obstructed Downward Flow) is recorded in the *Neijing* as blood overflow, blood leakage, and bloody stools flowing down. Ancient formulas treat clear pus and blood; modern times call it Li Ji (Dysentery), but it is essentially the same. It mostly arises from Stomach-Spleen disharmony, overeating, accumulation in the intestines and stomach that cannot be digested, combined with interference from Wind, Cold, Summer-Heat, and Dampness. Injury by Heat results in red stools; injury by Cold results in white stools; injury by Wind results in pure clear blood; injury by Dampness results in stools like bean dregs. If Cold and Heat mix, red and white stools appear together. Treatment should first use unblocking and draining medicines to cleanse the Zang-Fu organs.

Yan Shi states: Use drugs like Radix Crotonis Tiglii (Badou) to push out accumulated heat, then differentiate between Cold, Heat, Wind, and Dampness syndromes to prescribe medication. For Heat with red color, clear it; for Cold with white color, warm it. For Wind injury with clear blood discharge, expel the pathogen; for Dampness injury with bean-dreg-like discharge, separate and drain dampness; for mixed Cold and Heat, regulate with warm and cool properties. One must first regulate Stomach Qi and absolutely avoid abruptly using Poppy Shell (Yingsu) or Chinese Olive (Hezi) to stop and astringe, which would trap stagnation and lead to critical danger.

Commentary: The theory of distinguishing Cold and Heat by red and white colors is discussed in detail by Liu Hejian. He states that Wind causing clear blood is because Wind favors injuring the Liver, and the Liver governs Blood, hence clear blood indicates Wind. Dampness causing bean-soup-like discharge is because Dampness favors injuring the Spleen; the Spleen and Stomach are the sea of the five grains, receiving everything, and often involve the four other Zang organs. The color of bean dregs resembles the mixing of the five colors, hence bean-soup discharge indicates Dampness. He also states treatment should first unblock and drain, which is the meaning of "meeting and seizing" (attacking the pathogen directly). If deficiency exists, it must be examined carefully; only if there is actual stagnation in the intestines and stomach should unblocking be used. However, Yan Shi claims Radix Crotonis Tiglii (Badou) is suitable for cold injuries but harmful for heat injuries. He also mentions expelling Wind, but does not specify the method or herbs for "expulsion." If pathogens should be expelled, why only Wind? Why not Cold, Damp, or Heat? This point remains unclear.