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Xue Lizhai treated the wife of Hu Chengfu, a government official, who suffered from chronic dysentery during pregnancy. After self-medicating with digestive and qi-regulating agents, she experienced abdominal heaviness and sinking, along with fetal restlessness. Subsequent treatment with Ejiao (Donkey-hide Gelatin) and Aiye (Mugwort Leaf) proved ineffective. Xue stated: "Abdominal heaviness and sinking indicate deficiency of Yuan Qi (Original Qi); fetal restlessness indicates severe internal heat." He subsequently used Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) to stabilize the fetus, followed by Liujunzi Tang (Six Gentlemen Decoction) for complete recovery. (Why was the internal heat overlooked? Xue's prescriptions were sometimes unsatisfactory in this manner.)

Sheng Yongjing treated the wife of Chen Jie, who had been pregnant but suffered from dysentery for several months. She had been unconscious for six days, passing stool continuously like water leaking from a roof; her coffin and burial clothes were already prepared. Sheng palpated her pulse and said, "Do not worry." After administering medicine, the dysentery ceased but fetal movement increased, and she delivered a healthy child a few days later. (From *Wujiang County Annals*.)

Sun Wenyuan treated his cousin's daughter, who was seven months pregnant and suffered from bloody dysentery (dysentery characterized by pus and blood in the stool), abdominal pain, and tenesmus. Her constitution was generally weak. The physician prescribed Baishao (White Peony Root) 3 qian, Huangqin (Scutellaria Root) 1.5 qian, Baizhu (Atractylodes Macrocephala Rhizome) and Diyu (Sanguisorba Root) each 0.8 qian, and Gancao (Licorice Root) 0.3 qian. After two doses, she recovered. Later, due to slight overexertion, the dysentery recurred. The physician then used Danggui (Angelica Sinensis Root) 3 qian, Chuanxiong (Ligusticum Chuanxiong Rhizome) 1.5 qian, Zhen Ejiao (Authentic Donkey-hide Gelatin) 2 qian, and Aiye (Mugwort Leaf) 0.3 qian. After one dose, she fully recovered. (This was not dysentery caused by food stagnation, hence the treatment method differed.)

Zhu Danxi treated his eighth aunt, who developed dysentery near term. Her pulse was fine, wiry, and slightly rapid, accompanied by tenesmus and urgency. He used Huashi (Talcum) 3 qian, Baishao (White Peony Root) 2 qian, Zhike (Bitter Orange Fruit, stir-fried) 1.5 qian, Mutong (Akebia Stem) 2 qian, Gancao (Licorice Root) 0.5 qian, Baizhu (Atractylodes Macrocephala Rhizome) 2 qian, Fuling (Poria) 1 qian, and Taoren (Peach Seed) 9 pieces, ground and decocted together.

Ma Yuanyi treated a woman surnamed Zhang, who was eight months pregnant and suffered from dysentery, defecating forty to fifty times day and night. She experienced abdominal pain, rebellious fetal qi, and loss of appetite. Palpation revealed deep and fine pulses at both Guan (Bar) and Chi (Cun) positions, with cold penetrating through the lower body. Ma stated: "Based on symptoms, this appears to be dysentery caused by damp-heat. However, a deep pulse indicates cold, and a fine pulse indicates deficiency. Combined with the profound cold in the lower body, this signifies decline of Fire at the Lower Jiao (Lower Burner) and stagnation of Earth (Spleen/Stomach) in the Middle Jiao. When the Fire of the Five Yangs distributes upward, the Qi of water and grain flows downward smoothly. If Jingye (Body Fluids) and blood vessels are insufficient, the Taiyuan (Fetal Origin) loses nourishment and rebels upward. Pus and blood in stool with a deep pulse, and abdominal pain with a faint pulse, are both dangerous signs. One must discard the symptoms and follow the pulse to save both mother and child." He prescribed Ren Shen (Ginseng Root) 1 liang combined with Fuzi Lizhong Tang (Aconite Decoction to Regulate the Middle) for two doses, after which the pulse became harmonious. A fourth dose was halved, and she recovered after regulation.

The wife of Yu Yuanjing, a friend, was five months pregnant when she developed stagnation-type dysentery with abdominal pain, defecating dozens of times daily. This formula was prescribed for her. Upon drinking just one cup, she felt the medicine reach her abdomen, immediately passed stool, and the pain ceased; the stagnation completely resolved. The formula consisted of: Chuan Huanglian (Coptis Rhizome) 4 qian, Baishao (White Peony Root), Huangqin (Scutellaria Root), Zhike (Bitter Orange Fruit) each 3 qian, Lianrou (Lotus Seed Flesh) 40 grains, Juhong (Citrus Reticulata Peel) and Gange (Kudzu Root) each 1.5 qian, Biandou (Lablab Bean) and Hongqu (Red Yeast Rice) each 2 qian, Shengma (Cimicifuga Rhizome) 0.5 qian, Zhi Cao (Honey-fried Licorice Root) 1 qian, and Wumei Rou (Dark Plum Flesh) 1 piece. (From *Guang Biji*.)

Wei Yuheng stated: Wang Bitang was my neighbor. His wife had suffered from chronic dysentery without medication. Initially, she passed red and white stool, later only red, worsening at night, with abdominal pain and tenesmus. Her father-in-law, a scholar and physician, prescribed Guipi Tang (Restore the Spleen Decoction) combined with Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) and asked for my opinion. I said, "This follows ancient methods, but I fear it may worsen the condition." He did not believe me. After two doses, the frequency of diarrhea indeed increased. I was then summoned to examine her. Her pulse was deep, fine, and rapid. I prescribed Zaoren (Sour Jujube Seed), Shanyao (Chinese Yam), Qizi (Goji Berry), Dihuang (Rehmannia Root), Danggui (Angelica Sinensis Root), Baishao (White Peony Root), Gancao (Licorice Root), and Huangqin (Scutellaria Root). After six doses, she fully recovered. He asked: "You previously stated that Guipi Tang and Buzhong Yiqi Tang would worsen the condition, which proved true. Why?" I replied: "Chronic dysentery leads to Yin depletion. Baizhu (Atractylodes), Shengma (Cimicifuga), and Chaihu (Bupleurum) raise Yang. If Yang rises further, Yin must descend further, which is inevitable." He asked again: "Her abdomen still hurts and tenesmus persists. Why no Xiang (Costus Root) or Sha (Amomum Fruit)?" I replied: "Using them would not cause major harm, but they would not hasten recovery."

A resident of Tangchi, in her twenties, enjoyed fruits and melons during pregnancy. In summer, she developed abdominal pain and dysentery, attributed to fetal qi. By late winter, after delivery, the painful dysentery persisted. An old physician considered postpartum deficiency-cold and chronic dysentery, prescribing Baizhu (Atractylodes Macrocephala Rhizome), Paojiang (Prepared Ginger), Jianlian (Chinese Lotus Seed), Biandou (Lablab Bean), Xiangfu (Cyperus Rhizome), Sharen (Amomum Fruit), Muxiang (Aucklandia Root), and Yuanzhi (Polygala Root), all warming and drying to strengthen the Spleen. The dysentery worsened. Boguzhi (Psoralea Fruit) and Roudoukou (Myristica Seed) were added, causing even more frequent stools. Any porridge consumed was expelled undigested before reaching the toilet. Observing undigested food in the stool, everyone believed the intestines were straight and the diarrhea like a bamboo tube, deeming the prognosis fatal and preparing for burial. My pulse diagnosis revealed a fine, rapid, and choppy pulse, delicate redness on the forehead and cheeks, and dry black tongue coating. I said, "This is dysentery." I predicted that after two doses, red and white stool would appear. I warned him that since previous doctors deemed it a failing deficiency-cold syndrome, seeing red and white stool now might seem hopeless. He replied, "The illness originated from excessive raw/cold food, stagnating in the ileum, transforming into heat over time. Postpartum emptiness allowed stagnation to descend, but dry-heat intercepted it, causing retention, further injuring True Yin, and intensifying internal heat. The current frequency and urgency are 'xie-re xia-li' (dysentery accompanying heat), not 'xu-han xia-tuo' (slippage due to deficiency-cold). Observe her red face indicating Yin deficiency; black tongue indicating internal heat. First tonify Yin, and the diarrhea will slow, revealing the stagnation." I prescribed Shudi (Prepared Rehmannia Root) and Qizi (Goji Berry) each 1 liang, and Zaoren (Sour Jujube Seed) 5 qian. After taking it, facial redness subsided, tongue blackness faded, and food stayed down without urgency. Subsequent doses brought tenesmus and mixed red/white stool. I modified the formula by adding Huangqin (Scutellaria Root), Huanglian (Coptis Rhizome), Danggui (Angelica Sinensis Root), Baishao (White Peony Root), and Gancao (Licorice Root), adjusting as needed. After more than ten doses, she improved significantly. Medication stopped on New Year's Eve. On New Year's Day, upon examination, her diet and routine had normalized. Only slight pale bloody water remained post-defecation, a residual sign of damaged Spleen collaterals. I removed Huangqin and Huanglian, added Wumei (Dark Plum), and prescribed two doses for cure. However, his relative claimed I used tonics too early, causing 'xiuxi li' (lingering dysentery). The previous doctor was a close relative, specifically instructing him to invite me to mock me. I replied, "Would you prefer straight-intestine diarrhea or lingering dysentery?" We parted with laughter.

Ling's cousin's wife was naturally timid and weak. During pregnancy, she nearly developed a consumptive disease, cured by heavy nourishing agents. At ten months, she contracted a seasonal pathogen. The specialist prescribed Jingjie (Schizonepeta Spike), Fangfeng (Saposhnikovia Root), Zhike (Bitter Orange Fruit), and Jiegeng (Platycodon Root) for two doses. Her teacher, Huang Dancheng, strongly opposed this, so she took only the first decoction. Subsequently, she developed dry cough, sore throat, facial redness, dry mouth, night sweats, and fever. After eating several slices of raw pear, she developed diarrhea resembling dysentery, with abdominal pain and tenesmus, occurring ten-plus times daily. Someone remarked: "Xue Lizhai said, 'Li means slippery.' Pears should never be eaten after illness or during pregnancy/postpartum. Now with abdominal pain and dysentery, isn't this injury from cold/raw food?" Pulse diagnosis showed a surging, rapid pulse, with the left Cun position beating forcefully against the finger. I said: "Qian Zhongyang stated that if rash has no other symptoms, use mild medicines. This patient has Yin deficiency with abundant fire; even nourishment might be insufficient. Using aromatic, dispersing drugs to stimulate her caused Fire of the Three Yin to rush upward vacuously. Lung heat became severe, inevitably pressing downward on the Large Intestine causing dysentery. What does the pear have to do with it? Xue Lizhai spoke of general principles. Combining pulse and symptoms, cooling and moistening methods are indicated." Inquiry revealed hot, short urination and bad breath. I prescribed Shengdi (Rehmannia Root), Qizi (Goji Berry), Shashen (Glehnia Root), Maidong (Ophiopogon Tuber), Huanglian (Coptis Rhizome), Louren (Trichosanthes Seed), Xuanshen (Scrophularia Root), and Niubangzi (Arctium Fruit). After two doses, dysentery ceased, and tenesmus disappeared. Suddenly, anal swelling and pain occurred, suspected to be hemorrhoids. I said, "No, this is Lung Fire transmitting downward; the disease is about to resolve." I removed Huanglian and added Huangqin (Scutellaria Root). After several doses, all symptoms resolved.