引翁年将花甲，秋季患痢，缠绵日久，清利过剂，肛如竹筒，直下无度，卧床不起，诊
脉细
濡，望色憔悴，知为脾肾两亏，元气下夺，所幸尚能纳谷，胃气未败。仿胃关煎，调石脂余
粮末，与服两日，其痢稍减。再加桑螵蛸，晚间参服四神丸，治疗匝月始。
安波按∶痢者利也，不可以通利治痢之常药，以医老人久痢之不固。其法不一，医师
胸有成竹耳。
予弟倚兰，服贾庐江。戊辰冬，予自中州回，道经彼地，羁留信宿，有王策勋先生者，
与予
弟善，抱其幼孙，恳为延医。视其体热面黄，肢细腹大，发焦目暗，颈起结核，予曰∶此乃
疳疾。疳者干也，小儿肠胃柔脆，乳食失调，运化不及，停积发热，热久津干，故名曰疳。
又谓之丁奚哺露。丁奚者，言奚童枯瘠如丁，哺露者，言愈哺而骨愈露。但是疾，每多生虫
，虫 日滋，侵蚀脏腑，非寻常药饵所能去病。古方有布袋丸，治此证多验。药用人参、白
术
、茯苓、使君子肉各一两，芦荟、夜明沙、芜荑、甘草各五钱，共为末，蒸饼糊丸，每粒约
重三钱，日用一丸，以夏布袋盛之。另切精猪肉二两，同煮汁服，肉亦可食。如法制就，服
完一料而愈。
安波按∶布袋丸名亦奇，方亦奇，故治亦奇。沈姓幼童五龄者，余之内戚也，患腹膨
形黑
，善食作泻，虽骨支床已半载矣，余宗是丸服半料，沉 霍然。盖意布袋者，今人之胃，如
物之袋，病久致疳，虫蚀已空，故其胃必虚，津液必涸，赖以猪肉汁充养胃阴，而从药得以
各司其司，同心共济，以奏凯歌也。
[Background Information]
Book: *Cheng Xingxuan's Medical Cases* | Author: Cheng Xingxuan | Dynasty: Qing | Chapter: Old Man Cao Yinquan's Bamboo-Tube Dysentery / Mr. Wang Cexun's Young Grandson's Gan Disease | Category: Medical Discussion
[Original Text to Process]
Old Man Cao Yinquan was approaching sixty years of age when he contracted dysentery (a disease characterized by abdominal pain, tenesmus, and passage of bloody or purulent stool) in autumn. The condition lingered for a long time. Due to the excessive use of clearing-heat and draining-dampness medications, his anus became lax like a bamboo tube, with uncontrolled direct diarrhea, leaving him bedridden. His pulse was fine and soggy (Xì Rú), and his complexion was haggard. It was determined that this was a deficiency of both Spleen and Kidney, with Yuan Qi (Primordial Qi) sinking and escaping. Fortunately, he could still take food, indicating that Stomach Qi had not yet collapsed. I modeled the prescription after Wei Guan Jian (Stomach-Guarding Decoction), compounded with Yu Liang Shi Zhi San (Powder of Yu Yu Liang and Chi Shi Zhi), and administered it. After two days, the dysentery slightly decreased. Then, Sang Piao Xiao (Mantis Egg-case) was added, and Si Shen Wan (Four Spirits Pill) was taken in the evening. The treatment lasted a month before he recovered.
An Bo’s Commentary: Dysentery (Li) implies discharge. One cannot use the usual purgative or draining herbs intended for treating dysentery to manage the non-retention caused by chronic dysentery in the elderly. The methods vary; the key lies in the physician having a clear strategy in mind.
My younger brother, Yi Lan, was engaged in commerce in Lujiang. In the winter of the Wuchen year, upon returning from Zhongzhou, I passed through that area and stayed for two nights. There was a Mr. Wang Cexun who was on good terms with my brother. He brought his young grandson and earnestly requested I arrange medical care. Observing the child’s body heat, yellowish complexion, thin limbs, distended abdomen, dry and brittle hair, dim eyes, and cervical tubercles (swollen lymph nodes), I said: This is Gan disease (a chronic wasting syndrome in children characterized by spleen-stomach damage, emaciation, sallow complexion, dry hair, and abnormal diet). "Gan" means dryness. Children’s intestines and stomach are tender and fragile. If milk and food intake are irregular, transportation and transformation fail, leading to stagnation and heat accumulation. Prolonged heat dries up body fluids, hence the name Gan. It is also called Ding Xi Bu Lu. "Ding Xi" refers to a skinny servant boy looking as lean as a peg; "Bu Lu" means the more one feeds him, the more his bones protrude. However, this disease often involves parasites. As parasites multiply daily, they erode the Zang-Fu organs, and ordinary medicines cannot eliminate the pathogen. An ancient formula, Bu Dai Wan (Cloth-Bag Pill), is effective for this condition. The ingredients are Ren Shen (Ginseng Root), Bai Zhu (Atractylodes Rhizome), Fu Ling (Poria), and Shi Jun Zi Rou (Quisqualis Seed Flesh), each at one tael; Lu Hui (Aloe), Ye Ming Sha (Trogopterus Dung), Wu Yi (Chaulmoogra Seed), and Gan Cao (Licorice Root), each at five qian. These are ground into powder, mixed with steamed bread paste to form pills, each weighing approximately three qian. One pill is taken daily, stored in a cloth bag. Additionally, cut two liang of lean pork, boil it together to extract the juice for administration; the meat may also be eaten. Following this method, completing one course resulted in a cure.
An Bo’s Commentary: Bu Dai Wan has a peculiar name, a peculiar formula, and thus a peculiar efficacy. A five-year-old child surnamed Shen, who is my relative, suffered from abdominal distension, darkened emaciation, voracious appetite but diarrhea. Although his bones were supporting his bed for half a year, I followed this pill, administering half a course, and Shen recovered instantly. My interpretation is that the "cloth bag" represents the modern human stomach, like a sack holding items. Chronic illness leads to Gan disease, where parasites have hollowed out the interior, so the Stomach must be deficient, and body fluids depleted. Relying on pork juice to nourish Stomach Yin allows the medicinal herbs to perform their respective functions, working in concert to achieve victory.