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The *Bai Yi Xuan Fang* records that Jin Kou Li (Forbidden Mouth Dysentery) is caused by toxic qi rushing upward to the Heart and Lungs; treatment should use Shi Lian Rou (Stone Lotus Seed Flesh) to unblock Heart Qi.

Note: If a patient with dysentery can eat, it indicates that Stomach Qi is not yet diseased. However, if damp-heat toxicity of the Spleen and Stomach steams upward through the Qing Dao (clear pathways), causing closure of the stomach opening, this results in the syndrome of Jin Kou Li. Theoretically, one should clear the pathogenic heat from the stomach opening. Yet, the text states "toxic qi rushes upward to the Heart and Lungs," leaving unclear which specific pathogen constitutes this "toxin." Nevertheless, there are cases arising from Spleen and Stomach deficiency, cases caused by mistakenly taking purgative medicines where drug toxicity invades the Stomach, and cases where astringent or hot agents were taken too early, trapping pathogenic qi at the stomach opening. In such instances, one must seek the root cause.

Zhu Danxi stated: "E Ni (Hiccups/Reverse Qi) is the pathological qi rushing upward from below, representing an image of Fire." Ancient prescriptions often attributed this to weak Stomach function, which is inaccurate. It is unknown that so-called "Stomach weakness" actually refers to Yin deficiency, specifically severe deficiency. This syndrome is frequently seen after prolonged dysentery, resulting from Yin deficiency due to chronic diarrhea (see detailed discussion under the chapter on E Ni).

Liu Wansu in the *Yuan Bing Shi* stated: "Diarrhea presenting as white is Cold; Green, Yellow, Red, and Black are all Heat." White corresponds to the color of the Lung. When Cold Water suppresses Fire, it fails to control Metal (Lung), causing Lung Metal to become excessive, hence the white color. Dysentery appearing green indicates Liver Wood Qi becoming excessive because Fire over-controls Metal, failing to restrain Wood, hence the green color. Some claim green dysentery indicates Cold; this is erroneous. Zhang Zhongjing, in the Shaoyin Disease section of the *Shanghan Lun*, mentions that passing clear water with pure green stool indicates interior excess Heat, treated with Da Cheng Qi Tang (Major Order the Qi Decoction) to purge. Similarly, acute convulsive diseases in children with high fever accompanied by dysentery often present with green stool, clearly indicating Heat. Yellow dysentery occurs because excessive Fire leads to deficient Water, allowing Spleen Earth to flourish relatively, hence the yellow color. Red dysentery reflects Heart Fire's color, possibly indicating deep-seated Heat. Regarding black dysentery also being classified as Heat: when Fire and Heat are extremely hyperactive, they may paradoxically assume the transformation of Water (Kidney color) to counteract them, hence the black color. Therefore, in the Yangming Disease section of the *Shanghan Lun* (text omitted), it is prescribed to use Da Cheng Qi Tang for purging; if the stool is not black, it is difficult to treat (or possibly "easy to treat"). All types of dysentery follow this principle.

Note: People generally consider green, white, and black diarrhea/dysentery as Cold syndromes, and yellow and red as Heat syndromes. Observing Hejian's (Liu Wansu's) theory on distinguishing five colors by Zang organs clarifies matters and reveals the errors of common opinion. One might ask: "The *Neijing* observes collateral vessel colors, stating that abundant Cold causes stagnation and coagulation, resulting in blue-black colors; abundant Heat causes liquidity and moisture, resulting in yellow-red colors. It also states: yellow-red indicates much Heat, white indicates Cold. Is secular theory not based on this?" I reply: The *Neijing* discusses the normal colors of meridians: Heart is Red, Lung is White, Liver is Green, Spleen is Yellow, Kidney is Black. The color of Yin collaterals should correspond to the meridian, but the color of Yang collaterals varies with the four seasons and has no fixed color. When encountering cold weather, meridians stagnate, so colors tend to be blue-black; when encountering hot weather, meridians overflow, so colors tend to be yellow-red. This is due to superficial collaterals responding to external climatic cold and heat. Everyone's facial color changes accordingly in winter or summer, or after prolonged sitting or long travel. This is not the case for dysentery colors originating from Zang organs and generated by internal Qi responses. Moreover, dysentery (Zhi Xia) is mostly caused by damp-heat. The *Neijing* states: Lung Heat manifests as white color and hair deterioration; Heart Heat manifests as red color and overflowing collaterals; Liver Heat manifests as greenish color and withered nails; Spleen Heat manifests as yellow color and twitching muscles; Kidney Heat manifests as black color and dry teeth. Although this discusses Wei Syndrome (Atrophy Syndrome), it shows that internal Heat in the five Zang organs can manifest these five colors. The current discussion on the five colors of dysentery shares the same underlying meaning. However, this cannot be equated with superficial collaterals responding to external climatic factors.