【劳役痢之症】起于大劳之后，下痢纯血，或腰背作楚，胁肋作痛，四肢倦怠，嗜卧减
食，节劳稍缓，劳重即发，此劳役痢症也。
【劳役痢之因】起居不谨，劳役无度，或饥饿不节，负重远行，营伤卫损，则血下溜大
肠，而劳役内伤之症作矣。
【劳役痢之脉】必见虚损，虚数伤血，虚大伤气。虚缓者生，数实者死。
【劳役痢之治】先用当归活血汤，生新去旧，后用当归补血汤，调养气血。气血和平，
用补中益气汤、归脾汤，扶元保本，切不可兜涩太早，又不可误用苦寒。
当归活血汤
当归 红花 桃仁 楂肉 甘草 牡丹皮
血寒加黑炮姜，见黑即止。血热加黑山栀，世人但知见黑即止，当明血寒血热之别。
当归补血汤
当归身 黄
筋脉痛加秦艽、续断。中气弱加人参、白术。气满加陈皮、木香。
补中益气汤 见前节七情内伤痢门。
归脾汤 见前七情痢门。
【饮食内伤痢之症】胸前饱满，不思饮食，腹痛胀满，或泻下飧馊，久久不愈，或下脓
血
【饮食内伤痢之因】胃强脾弱，过食伤脾，损伤肠胃，气凝血泣，停积于中，与损伤之
血，互相胶结，结久不愈，而成赤白之积，此饮食内伤痢也。
【饮食内伤痢之脉】多见滑大，或见弦紧，滑大实积，弦小虚滞。
【饮食内伤痢之治】先用胃苓散，健脾消积，后用四君子汤、异功散等以养脾。切不可
补涩太早，又不可妄用苦寒，必要认真是膏粱积热，方用三黄丸清利之。若系冷食伤脾，则五
积散亦当用也。刘河间云∶食入即泻，胃有宿食，胃满无余地，故即泻也，枳实汤、家秘消
积散治之。酒入即泻，肠胃积热，胃热之甚，见酒性之热，乃寻窍下池也，干葛清胃汤主之
。若饮食伤脾，久利纯血，家秘独圣散。
胃苓散
陈皮（一两） 苍术（一两） 浓朴（五钱） 甘草（二钱） 猪苓（五钱） 白茯苓（一两） 泽
泻（五钱） 白术（一两）
家秘去猪苓、泽泻，加山楂、神曲各一两。
四君子汤
白术 人参 白茯苓 炙甘草
异功散
白术 人参 真广皮 炙甘草 白茯苓
积气未尽加楂肉。腹痛加木香。口渴加干葛。发热加柴胡。
以上三法，治脾虚成积之痢。
三黄丸 治膏粱积热。
大黄 黄芩 黄连
气滞加术、香。
五积散 治寒积泻痢。
苍术 浓朴 陈皮 甘草 干姜 桂心 半夏 枳壳
枳实汤 治肠胃停食。
浓朴 陈皮 麦芽 陈枳实
家秘消积散 治饮食伤脾，积痢不止。
苍术 浓朴 陈皮 甘草 神曲 红曲 山楂 鲜麦芽
甘葛清胃汤
干葛 升麻 甘草 山栀 生地 川黄连 牡丹皮
以上五法，治食伤成积之痢。
家秘独圣散
山楂肉一斤，研细末，滚白汤调服，服完即愈。
[Symptoms of Labor-Induced Dysentery] It originates after severe exertion, presenting with dysentery consisting purely of blood, or soreness and pain in the lower back and waist, pain in the hypochondrium, lassitude of the four limbs, hypersomnia, and reduced appetite. Symptoms may slightly alleviate with moderate rest but flare up when exertion increases; this is the syndrome of labor-induced dysentery.
[Etiology of Labor-Induced Dysentery] Improper daily routine, excessive labor without restraint, irregular eating habits (hunger or overeating), carrying heavy loads while traveling long distances, all damage Ying Qi (Nutritive Qi) and weaken Wei Qi (Defensive Qi). Consequently, blood flows downward into the Large Intestine, giving rise to the syndrome of internal injury due to labor.
[Pulse of Labor-Induced Dysentery] A deficiency pulse must be observed. A deficient and rapid pulse indicates blood injury, while a deficient and large pulse indicates Qi injury. A deficient and slow pulse suggests a favorable prognosis (survival), whereas a rapid and excess pulse suggests an unfavorable prognosis (death).
[Treatment of Labor-Induced Dysentery] First use Danggui Huoxue Tang (Angelica Sinensis Blood-Invigorating Decoction) to generate new blood and eliminate old stasis. Subsequently use Danggui Buxue Tang (Angelica Sinensis Tonifying Blood Decoction) to nourish and regulate Qi and Blood. Once Qi and Blood are harmonious, use Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) and Guipi Tang (Restore the Spleen Decoction) to support the Yuan Qi (Original Qi) and preserve the root. One must absolutely avoid using astringents too early, and must not mistakenly employ bitter-cold herbs.
Danggui Huoxue Tang (Angelica Sinensis Blood-Invigorating Decoction)
Danggui (Angelicae Sinensis Radix), Honghua (Carthami Flos), Taoren (Persicae Semen), Zharenrou (Crataegi Fructus), Gancao (Glycyrrhizae Radix et Rhizoma), Mudanpi (Moutan Cortex).
If the condition is Blood-Cold, add Heipaojiang (Blackened Prepared Ginger Rhizome); stop administration once black stools appear. If the condition is Blood-Heat, add Heishanzhi (Blackened Gardeniae Fructus). People generally know to stop when black stools appear, but one must understand the distinction between Blood-Cold and Blood-Heat.
Danggui Buxue Tang (Angelica Sinensis Tonifying Blood Decoction)
Dangguishen (Body of Angelicae Sinensis Radix), Huangqi (Astragali Radix).
If there is pain in the sinews and vessels, add Qinjiao (Gentianae Macrophyllae Radix) and Xuduan (Dipsaci Radix). If Middle Qi is weak, add Renshen (Ginseng Radix) and Baizhu (Atractylodis Macrocephalae Rhizoma). If there is Qi distension, add Chenpi (Citri Reticulatae Pericarpium) and Muxiang (Aucklandiae Radix).
Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) See previous section on Seven Emotions Internal Injury Dysentery.
Guipi Tang (Restore the Spleen Decoction) See previous Seven Emotions Dysentery section.
[Symptoms of Diet-Induced Internal Injury Dysentery] Fullness in the chest, lack of desire for food, abdominal pain and distension, or diarrhea with undigested food that persists for a long time, or passage of pus and blood.
[Etiology of Diet-Induced Internal Injury Dysentery] Strong Stomach but weak Spleen, overeating damages the Spleen, injuring the intestines and stomach. This causes Qi stagnation and blood stasis, which accumulate in the middle jiao. Combined with injured blood, they adhere together. Prolonged accumulation fails to resolve, forming red and white dysenteric excrement; this is diet-induced internal injury dysentery.
[Pulse of Diet-Induced Internal Injury Dysentery] Mostly slippery and large pulses, or wiry and tight pulses. Slippery and large indicate excess accumulation; wiry and small indicate deficiency and stagnation.
[Treatment of Diet-Induced Internal Injury Dysentery] First use Weiling San (Stomach-Poria Powder) to strengthen the Spleen and dissipate accumulation. Subsequently use Sijunzi Tang (Four Gentlemen Decoction) and Yigong San (Extraordinary Efficacy Powder) to nourish the Spleen. One must absolutely avoid tonifying and astringing too early, and must not recklessly use bitter-cold herbs. Only if it is confirmed as heat from rich foods can Sanhuang Wan (Three Yellows Pill) be used to clear and drain. If it is cold food damaging the Spleen, Wuji San (Five Accumulations Powder) should also be used. Liu Hejian stated: Diarrhea immediately after eating occurs because the Stomach contains retained food, leaving no room; thus, immediate diarrhea ensues. Treat with Zhishi Tang (Immature Bitter Orange Decoction) and Jia Mi Xiaoji San (Secret Formula Accumulation-Dissipating Powder). Diarrhea immediately after drinking wine occurs due to accumulated heat in the intestines and stomach; extreme Stomach Heat meets the hot nature of wine, seeking outlets to discharge downwards. Treat primarily with Gange Qingwei Tang (Pueraria Clearing Stomach Decoction). If diet damages the Spleen causing prolonged dysentery with pure blood, use Jia Mi Dusheng San (Secret Formula Unique Holy Powder).
Weiling San (Stomach-Poria Powder)
Chenpi (Citri Reticulatae Pericarpium, 1 liang), Cangzhu (Atractylodis Rhizoma, 1 liang), Houpo (Magnoliae Officinalis Cortex, 5 qian), Gancao (Glycyrrhizae Radix et Rhizoma, 2 qian), Zhuling (Polyporus, 5 qian), Baifuling (Poria, 1 liang), Zexie (Alismatis Rhizoma, 5 qian), Baizhu (Atractylodis Macrocephalae Rhizoma, 1 liang).
The Secret Formula removes Zhuling and Zexie, adding Zharen (Crataegi Fructus) and Shenqu (Massa Medicata Fermentata), each 1 liang.
Sijunzi Tang (Four Gentlemen Decoction)
Baizhu (Atractylodis Macrocephalae Rhizoma), Renshen (Ginseng Radix), Baifuling (Poria), Zhigancao (Prepared Glycyrrhizae Radix et Rhizoma).
Yigong San (Extraordinary Efficacy Powder)
Baizhu (Atractylodis Macrocephalae Rhizoma), Renshen (Ginseng Radix), Zhen Guangpi (True Tangerine Peel), Zhigancao (Prepared Glycyrrhizae Radix et Rhizoma), Baifuling (Poria).
If Qi accumulation is not fully resolved, add Zharenrou (Crataegi Fructus). For abdominal pain, add Muxiang (Aucklandiae Radix). For thirst, add Gange (Puerariae Lobatae Radix). For fever, add Chaihu (Bupleuri Radix).
The above three methods treat dysentery caused by Spleen deficiency leading to accumulation.
Sanhuang Wan (Three Yellows Pill) Treats heat from rich foods.
Dahuang (Rhei Radix et Rhizoma), Huangqin (Scutellariae Radix), Huanglian (Coptidis Rhizoma).
For Qi stagnation, add Baizhu (Atractylodis Macrocephalae Rhizoma) and Muxiang (Aucklandiae Radix).
Wuji San (Five Accumulations Powder) Treats cold accumulation diarrhea and dysentery.
Cangzhu (Atractylodis Rhizoma), Houpo (Magnoliae Officinalis Cortex), Chenpi (Citri Reticulatae Pericarpium), Gancao (Glycyrrhizae Radix et Rhizoma), Ganjiang (Zingiberis Rhizoma), Guixin (Cinnamomi Ramulus), Banxia (Pinelliae Rhizoma), Zhike (Aurantii Fructus Immaturus).
Zhishi Tang (Immature Bitter Orange Decoction) Treats retained food in intestines and stomach.
Houpo (Magnoliae Officinalis Cortex), Chenpi (Citri Reticulatae Pericarpium), Maiya (Hordei Fructus Germinatus), Chen Zhishi (Immature Bitter Orange Fruit).
Jia Mi Xiaoji San (Secret Formula Accumulation-Dissipating Powder) Treats diet damaging the Spleen, persistent dysenteric accumulation.
Cangzhu (Atractylodis Rhizoma), Houpo (Magnoliae Officinalis Cortex), Chenpi (Citri Reticulatae Pericarpium), Gancao (Glycyrrhizae Radix et Rhizoma), Shenqu (Massa Medicata Fermentata), Hongqu (Red Yeast Rice), Zharen (Crataegi Fructus), Xian Maiya (Fresh Hordei Fructus Germinatus).
Gange Qingwei Tang (Pueraria Clearing Stomach Decoction)
Gange (Puerariae Lobatae Radix), Shengma (Cimicifugae Rhizoma), Gancao (Glycyrrhizae Radix et Rhizoma), Shanzhi (Gardeniae Fructus), Shengdi (Rehmanniae Radix), Chuanhuilian (Coptidis Rhizoma), Mudanpi (Moutan Cortex).
The above five methods treat dysentery caused by food injury leading to accumulation.
Jia Mi Dusheng San (Secret Formula Unique Holy Powder)
1 jin of Zharenrou (Crataegi Fructus), ground into fine powder. Take mixed with boiling water. Cure upon completion of the dose.