成痢症，尚不自觉，又犯房劳，而为骤寒所乘，以故发热身重，不食昏沉，皆少阴肾经外感。少阴受邪，原要
下利清白，此因肠中湿热，已蒸成败浊之形，故色虽变，而下利则同也。与麻黄附子细辛汤一剂，少散外邪。
得汗后，热即微减，再用附子理中汤二剂，热退身轻能食。改用黄连理中汤丸，服至旬日全安。
叶茂卿幼男病痢噤口，发热十余日，呕哕连声不绝，关脉尺脉俱上涌而无根。喻曰∶此非噤口，乃胃气将
绝之症也。噤口痢，虚热在胃，壅遏不宣，治宜补虚清热。此因苦寒所伤，不能容食，惟有清补一法而已。连
投理中汤二剂，不一时，痢下十余行。叶疑药误，喻曰∶吾意先救其胃气之绝，今腹中瘀积，藉药力催之速下，
正为美事，焉可疑之？服二日，人事大转。四日后，止便糟粕，以补中益气调理，旬日而安，可见小儿之痢，
纵啖伤胃者多，内有积热者少，尤不可轻用痢疾门中通套治法也。
一妇人痢疾一月，诸药无功。李诊之曰∶气血两虚，但当大补，痢门药品，一切停废。以十全大补，连投
十剂，兼进补中益气加姜、桂，二十余剂而安。
张兵尊秋间患痢，凡香、连、枳、朴等剂，用之两月而病不衰。李诊之，滑而有力，失下故也。用香、连、
归、芍、陈皮、枳壳，加大黄三钱，下秽物颇多。诊其脉尚有力，仍用前方，出积滞如鱼肠者约数碗，调理十
余日而痊。
毛抚军痢如鱼脑，肠鸣切痛，闻食则呕，所服皆苓、连、木香、菖蒲、藿香、橘红、芍药而已。后有进四
君子汤者，疑而未服。诊得脉虽洪大，按之无力，候至左尺，倍觉濡软，此命门火衰不能生土。亟须参、附，
可以回阳。因问但用参、术可得愈否？李曰∶若无桂、附，虽进参、术无益于病，且脾土太虚，虚则补母，非
补火乎。遂用人参五钱，熟附一钱五分，炮姜一钱，白术三钱，连进三剂，吐止食粥。再以补中益气加姜、附，
四剂后即能视事。
吴又可治张德甫，年二十，患噤口痢，昼夜无度，肢体仅有皮骨，痢虽减，毫无进谷食。以人参二钱煎汤，
入口不一时，身忽浮肿如吹气球，自后饮食渐进，浮肿渐消，肿间已生肌肉矣。
高鼓峰治朱殿臣病痢，日逾百余次，身发热，饮食不进，所用皆槟榔、大黄之属。高曰∶此破气利血药也。
治滞下当调气，不当破气，当和血，不当利血。以当归、白芍、生地、黄芩、木香等数大剂饮之，三日而愈。
冯楚瞻治王姓人，久患重痢。延诊时，当六月，自腹至阴囊，皆重绵浓裹，稍薄则痛甚，其两足心又觉热，
甚则重扇始可，饮食不思，甚危困。脉之，寸强，关尺并弱，曰∶此中气久虚，气不升降，阴阳阻隔，似痢非
痢。误用香连苦寒之剂，以致抑遏阳气于九地之下，而中宫藏阳纳气之所，反已空虚，且久痢阴阳两亡。故足
心之热，阴虚所致；腹中之寒，阳虚所由。中宫之阳，宜温而补；下陷之阳，宜清而升。理难并行，今但先去
其中寒之阻隔，则郁遏下极之火，自能上升。大用附子理中汤加五味子以敛之。（论证甚佳，拟方亦合。但加
五味，似无着落。）二三剂后，腹寒足热俱减六七，乃以归脾汤加肉桂、五味煎汤，送八味丸而愈。
陈秀才患红白痢甚密。诊之，两寸略洪，两尺左关甚弱，舌有黑苔。此肝不能疏泄，肾不能闭藏，宜痢之
重密矣。且真阴亏极于下，真津燥槁于上，水乘火位，故赤舌变黑也。若服黄连，适增其害。乃果有以香连进
者，服后痢更无度。复延冯，与八味汤大料，用人参冲服，渐得轻可。调理月余而安。
杨乘六治沈某病痢，里急后重，日夜百余次，发热口渴，体倦懒言，蜷卧少食，小便不利。或用痢门清热
消滞套药，数剂转甚。脉之，缓大无力，面色嫩白，舌苔微黄，此挟虚感寒，不可以痢疾正治之也。乃用补中
益气加白芍、炮姜，一剂而急重渐缓，痛痢随减。再剂身凉食进，诸症悉愈。
蔡某病痢，脐腹绞痛，里急后重，日夜无度。自知医，所服皆培肾燥脾之剂。（补涩太早，遂成休息。）
幸不误事，但病根不断，每周时或五七次，迁延三载，形肉渐脱，力不能支。杨诊之，脉附骨而紧，左尺尤甚，
面白，舌淡嫩且胖且滑，此寒积在大肠底，诸药不能到，故经年累月，痢无止息也。今脾肾大亏，须服
养荣、八味各
数十帖，待其气血充足，然后以蜡丸巴豆一枚，大如龙眼，空心服，以热水送之，则药到积所乃化，其积自除
矣。如法治之，果不再发。（用蜡丸巴豆以治寒积之痢，亦古人之成法。但前既云所服皆培肾燥脾之剂，
后复云脾肾太虚，须服养荣、八味数十帖，岂三载之培补，犹嫌未至耶。后人医案，其偏驳不醇类如此。）
姚某痢疾，腹痛后重，脓血并见，日夜无度。或用利气凉血清火解毒，一切消克之剂，病不减，而解出断
肠一段，长半尺许。延杨诊，迷病情用药次第，并询断肠之故。思之良久，曰∶决无此事。夫肠者，起自胃之
下口，历幽门阑门，以至肛门，大小相连，若中既断矣，何能自出肛门耶？且肠既出于昨日，则上下断绝已久，
何至今日便中脓血，仍相续不绝耳？盖肠中滑腻稠粘，如脂如膏，粘贴肠上之一层，其形外圆中空，有似乎肠，
而实非肠也。试拨之，必腐矣。果然。诊其脉，细数而弦，按之勒指。舌如镜，而脉无神，此木气太甚，胃气
将绝无救矣。数日果殁。
易思兰治省亭殿下，七月病痢。始服通利，次行和解，又次滋补。月余转甚，每日行数次，肚腹绞痛，但
泄气而便不多，起则腰痛屈曲难伸，胸膈胀满，若有物碍，嗳气连声，四肢厥逆，喘息不定。诊之，两寸沉大，
右寸更有力，右关沉紧，左关弦长而洪。喜两尺沉微，来去一样，曰∶此神劳气滞之病也。以畅中汤进之，制
香附八分，苍术一钱，神曲三钱五分，抚芎七分，黄芩八分，枳壳三分，苏梗五分，甘草三分，姜一片，枣二
个。服后兀兀欲吐，冷气上升，嗳气数十口，即大便去秽污颇多，胸次舒畅，腹中觉饥，自午至酉，止去一次，
四肢不厥，肩背轻快，六脉平复。但心内怔忡，头目昏眩，饮食无味，用六君子汤加香附、砂仁。二剂胃气渐
平，眩晕怔忡，乍止乍作。又以补中益气汤加蔓荆子、茯神、枣仁、黄柏，半月乃全愈。此证脉两寸俱沉，左
寸沉者，心火郁于下，乃神劳也。右寸沉而有力者，肺主气，与大肠为表里，七月肺金当令之时，脉宜浮短，
今不浮而沉。因思则气结，不得循环，失其升降之常，惟走大肠，顺逆气滞而下陷，故作里急后重，有似于痢，
实非痢也。医或谓四肢厥逆，大肠久滑，当用附子温之，或谓内有宿积作痛，当用硝、黄下之，皆非治法。夫
肺脉不浮而沉，是金不得令也。金不得令，则不能制木，故肝脉不弦细而弦洪。不当旺而反旺，木来侮土，脾
气转结于内不能运，故四肢逆而厥冷，所谓热深厥亦深也。热厥者，上不过肘，下不过膝，脉伏有力可验也。
既然热厥，岂可复用附子大热之剂？经曰∶心藏神，多念则神劳；脾藏意，多思则气结。气结故腹痛下痢，若
复加以寒凉之剂，其结愈甚。所以硝、黄亦不可用，惟以辛凉之剂散之。有香附辛温以快肺气，苏梗疏通诸窍，
神曲舒脾气而化脾积，苍术燥湿，引脾气散于四肢，抚芎畅达肝气，黄芩、枳壳荡涤大肠，加甘草以和中，使
气升而循环经络，积去而大肠通快，又何腹痛之不减，而厥逆之不除哉？
张路玉治项鸣先尊堂，下痢血色如苋汁，服消克苦寒芩、连、大黄之类愈甚，不时发热痞闷，六脉瞥瞥
虚大，右关独显弦象，按之则芤。此气虚不能统血之候，与补中益气加炮姜、肉桂，四帖而安。
郭然明之室，患五色痢，日夜数十次，兼带下如崩，误服黄连、大黄十余剂，隔塞不通，口噤不食者半月
余，至夜必大发热燥渴，六脉弦细而疾。此足三阴俱虚之候，与理中加桂、苓、木香、乌梅以调其胃，次与加
减八味汤导其阴火而全安。
某刑部高年久痢，色如苋汁，服芩、连、白芍之类二十余剂，渐加呃逆。六脉弦细如丝，与理中加丁香、
肉桂。疑不服，仍啜前药。数日病愈甚，而骤然索粥，诸医皆以能食为庆。张再诊，则脉至如循刀刃，（真脏脉也。）
此中气告竭，求救于食，除中症也。与伤寒之例同，不可为矣。
褚某尊堂深秋久痢，噤口不食者半月余，但饮开水及瓜汁，啜后必呕胀肠鸣，绞痛不已，烦渴闷乱，至夜
转剧，所下皆脓血，日夜百余次，小水涓滴不通，六脉皆弦细乏力。验其积沫，皆瘀淡色晦。询其所服，皆芩、
连、槟、朴之类。所见诸症俱逆。幸久痢脉弱，尚宜温补，用理中加桂、苓、紫菀调之。服后，小便即通，得
稍寐，数日糜粥渐进，痢亦渐减。更与理中倍参，伏龙肝汤泛丸，调理而痊。
陈进士触热锦旋，抵家即患河鱼腹疾。半月以来，攻克不效，遂噤口，粒米不入，且因都门久食煤火，肩
背发胀，不赤不疼，陷伏不起，发呃神昏。诊之，六脉弦细欲绝，面有戴阳之色，所下瘀晦如烂鱼肠脑。症虽
危，幸脉无旺气，气无喘促，体无躁扰，可进温补。但得补而痈肿 发，便可无虞。遂疏保元汤，每服人参三
钱，黄 二钱，甘草、肉桂各一钱，伏龙肝汤代水煎服。一啜而稀糜稍进，两啜而后重稍轻，三啜而痈毒坟起。
疡医敷治其外，嘱守前方，十余剂而安。
韩晋度春捷锦旋，患腹痛，泄泻下血。或用香连丸，遂饮食艰进，少腹急结，虽小便癃闭，而不喜汤饮，
面色萎黄，日夜去血五十余度。诊之，气口沉细而紧，所下之血，瘀晦如苋菜汁。与理中汤加肉桂二钱，一剂
溺通，小腹即宽。再剂血减食进，四剂泄泻止三四次。去后微有白脓，与补中益气加炮姜，四剂而愈。
张飞畴治朱元臣子，患五色痢，胸膈胀满，粥食不进，服药罔效。另延两医，一用大黄，一用人参，不能
决。求诊之，曰∶用大黄者，因其胀满脉大也；用人参者，因其痢久不食也。痢久不食，大黄断断难施；膈满
作胀，人参亦难遽投。拟伏龙肝为君，专温土脏，用以浓煎代茶，煎焦术、茯苓、甘草、广藿香、木香、炒乌
梅，一剂痢减食进，再剂而止，遂不药调理而安。
柴屿青治解元周让谷，在安抚张西铭京寓时，半年久痢不止。或用参、 、赤茯、粟壳、肉果不效。夜起
六七次，日间不计其数，脓血杂下，已频于殆，始求治。以久痢亡阴，不宜再用赤茯利水，亦非兜涩之所能止，
且久痢寒积在大肠底，现今两脉稍紧，欲用蜡豆丸，众皆不敢。不得已勉用补中益气加茱萸、制川附，一剂而
减。后兼用八味丸而愈。
张三锡治一人患痢，发寒热头痛，左脉浮紧，而右脉滑大，乃内伤挟外感也。先用败毒散加姜、葱，一服
表症悉除。但中脘作胀闷，后重不已，以平胃散加枳壳、木香、槟榔、山楂。二服胀闷移于小腹，投木香槟榔
丸三钱，下粘硬之物而愈。
一妇病痢，自投承气汤二服，不应。诊之，左脉浮而带弦，右三部俱沉，关脉略滑，必郁闷中食所致。病
家云素多恼怒，遂以浓朴、苍术、香附、抚芎舒郁，山楂、槟榔、橘皮、木香理气，白芍调中，三服愈。
一人痢初愈，遂饮烧酒，杂进肉面，胸口胀满，发寒热，右脉弦滑倍常，知饮食酒毒为患也。病后中气未
复，火邪尚存，多食自难传化，烧酒复助其毒，势在不救。今食填胸中，得吐乃有生意，经云在上者，因而越
之是也。不信，自服巴豆丸，药下咽，去血升许而殂。
一人夏月远行饮酒，致下痢皆纯血，日夜无度，心下胀，不食，脉三部俱弦滑而数。先与山楂、枳实、槟
榔、橘红、香、连以和其中，次与木香槟榔丸以导其滞。胀闷已除，下血愈甚，遂以四物用生地、条芩、茱、
连、丹皮，二剂血止一半，再加地榆三服已。
一人下痢胀痛，自服大黄丸，一时痛转甚，手足俱冷，脉沉伏，知寒凉用早也。投炮姜理中汤加浓朴、苍
术、山楂，一服，外用炒盐熨之，下膈周时即定。后用香、连、白芍、浓朴、枳壳等，调理而痊。
一人患痢，二月不愈，秽污在床，六脉弦而弱，投补中益气汤加酒炒白芍，八帖始止，二十帖而痊。
一人病痢，日久不止，四肢俱肿，而脉细小，尚可救。与参苓白术散加肉豆蔻少许，作汤服愈。
一妇病久痢，食时身热，左脉浮数，右脉滑数。询其饮食，虽病未减，至剧始不能食。与仓廪汤先去其热，
后以枳、术、人参、陈皮、楂、曲，又二服，腹中渐宽。后重不止，乃以调中益气汤下木香槟榔丸，二服，下
秽物碗许愈。
陆养愚治一人，因路途感冒，头微痛，身微热，饮食如故。数日后，患水泄，小便赤涩。自服胃苓汤，二
剂泄不止，而反见积。又服芩、连、白芍、木香、槟榔辈，二剂亦不效。诊之，两手浮弦，沉按涩数，此因表
气不舒，致令里气不顺，偶值脾胃不调而作泄也。乃以五积散微加白蔻仁、木香，二剂大汗，而诸症悉愈。
Dysentery develops without the patient's awareness, and upon engaging in sexual activity, they are attacked by sudden cold. Consequently, fever, heaviness of the body, loss of appetite, and lethargy occur; these are all exterior contractions affecting the Shaoyin Kidney Meridian (Shaoyin Ren Jing). When the Shaoyin meridian is affected, one should originally expect clear white diarrhea. However, in this case, damp-heat in the intestines has steamed and transformed into turbid forms, so although the color changes, the nature of the diarrhea remains the same. Administer one dose of Mahuang Fuzi Xixin Tang (Ephedra, Prepared Aconite, and Asarum Decoction) to slightly disperse the exterior pathogen. After sweating, the fever decreases slightly. Then administer two doses of Fuzi Lizhong Tang (Prepared Aconite and Middle-Warming Decoction); the fever subsides, the body feels light, and appetite returns. Switch to Huanglian Lizhong Wan (Coptis and Middle-Warming Pills), taken for ten days until full recovery.
The young son of Ye Maoqing suffered from dysentery with inability to eat (Jinkou Li - Dysentery with Inability to Eat), fever for over ten days, and continuous vomiting and hiccups. The Guan (Hinge) and Chi (Cubit) pulses were both surging upward and rootless. Yu Jia Yan said: This is not Jinkou Li, but a sign that Stomach Qi is about to perish. Jinkou Li is caused by deficient heat in the Stomer causing obstruction and failure to diffuse; treatment should tonify deficiency and clear heat. This illness was caused by damage from bitter-cold herbs, rendering the stomach unable to accept food; only the method of clearing and tonifying is applicable. Continuously administer Lizhong Tang (Middle-Warming Decoction) for two doses. Within no time, more than ten stools are passed. Ye suspected a medication error, but Yu said: My intention was first to rescue the perishing Stomach Qi. Now, the accumulated filth in the abdomen is being urged out quickly by the medicinal power, which is a good thing; why doubt it? After two doses, the patient's mental state improved significantly. Four days later, only undigested food residue was passed. Regulate with Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction), and recovery occurred within ten days. This shows that in children's dysentery, although many cases involve dietary injury to the Stomach, few have internal accumulated heat. One must not lightly use the standard treatments found in the Dysentery chapter.
A woman suffered from dysentery for one month with no effect from various medicines. Li Zhong Zi diagnosed: Both Qi and Blood are deficient; only major tonification is needed. All medicines from the Dysentery chapter should be stopped and discarded. Use Shiquan Dabu Tang (Ten-Tonics Great Tonifying Decoction), administered continuously for ten doses, while simultaneously taking Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) with Ginger and Cinnamon. After more than twenty doses, she recovered.
Zhang Bingzun contracted dysentery in autumn. Medications such as Xianglian Wan (Fragrant and Coptis Pill), Zhi Shi (Immature Bitter Orange), and Hou Po (Magnolia Bark) were used for two months without improvement. Li Zhong Zi diagnosed: The pulse is slippery and forceful, due to failure to purge earlier. Use Xianglian Wan, Dang Gui (Angelica Sinensis), Bai Shao (White Peony Root), Chen Pi (Tangerine Peel), Zhi Ke (Bitter Orange), and add Da Huang (Rhubarb) 3 qian. Much filth was discharged. The pulse remained forceful, so the same formula was continued. Several bowls of fecal matter resembling fish intestines were expelled. After regulating for over ten days, he recovered.
Mao Fujun suffered from dysentery with stool resembling fish brains, loud borborygmus, severe pain, and vomiting upon smelling food. He had taken Fu Ling (Poria), Huang Lian (Coptis), Mu Xiang (Aucklandia), Chang Pu (Acorus), Huo Xiang (Patchouli), Ju Hong (Tangerine Pulp), and Shao Yao (Peony). Later, someone suggested Sizijunzi Tang (Four Gentlemen Decoction), but he doubted and did not take it. The pulse was洪大 (Surging and Large) but empty on pressure. At the Left Chi position, it felt particularly Ru Ruan (Soft and Weak). This indicates Mingmen Fire Deficiency failing to generate Earth. Shen Qu (Ginseng) and Fu Zi (Aconite) are urgently needed to restore Yang. Asked if Shen and Zhu alone could cure him, Li said: Without Gui (Cinnamon) and Fu Zi, even Shen and Zhu would be useless. Moreover, Spleen Earth is too deficient; when deficient, tonify the mother, which means tonifying Fire. Thus, use Ren Shen (Ginseng) 5 qian, Shu Fu Zi (Prepared Aconite) 1.5 qian, Pao Jiang (Roasted Ginger) 1 qian, and Bai Zhu (Atractylodes Macrocephala) 3 qian. After three doses, vomiting stopped, and he could drink congee. Then use Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) with Ginger and Fu Zi. After four doses, he could handle official duties.
Wu Keyou treated Zhang Defu, aged twenty, who suffered from Jinkou Li (Dysentery with Inability to Eat) without day or night limits. His limbs were mere skin and bone. Although dysentery decreased, he could not eat at all. Ren Shen (Ginseng) 2 qian was decocted in water. Upon ingestion, his body suddenly swelled like an inflated balloon. Afterwards, food intake gradually increased, swelling subsided, and muscle grew in the swollen areas.
Gao Gufeng treated Zhu Dianchen with dysentery occurring over a hundred times a day, accompanied by fever and anorexia. Previous medications included Bin Lang (Areca Seed) and Da Huang (Rhubarb). Gao said: These are Qi-breaking and Blood-draining herbs. Treating Zhixia (Dysentery) requires regulating Qi, not breaking it; harmonizing Blood, not draining it. Use Dang Gui (Angelica Sinensis), Bai Shao (White Peony Root), Sheng Di Huang (Rehmannia Root), Huang Qin (Scutellaria), and Mu Xiang (Aucklandia) in large doses. Recovery occurred in three days.
Feng Chuzhan treated a Mr. Wang suffering from chronic severe dysentery. During the June consultation, from abdomen to scrotum, he was wrapped in thick cotton; thinning it caused severe pain. His soles felt hot, requiring fanning for relief. He had no appetite and was critically ill. Pulse: Cun (Inch) strong, Guan and Chi weak. Feng said: This is long-term deficiency of Middle Qi, failure of Qi ascent and descent, and blockage between Yin and Yang. It resembles dysentery but is not. Misuse of bitter-cold herbs like Xianglian Wan suppressed Yang Qi deep below, leaving the Middle Palace empty. Chronic dysentery leads to dual exhaustion of Yin and Yang. Heat in soles is due to Yin deficiency; cold in abdomen is due to Yang deficiency. Middle Yang needs warming and tonifying; sunken Yang needs clearing and ascending. These cannot be done simultaneously. First remove the cold blockage in the middle, allowing the suppressed fire at the bottom to rise naturally. Use a large dose of Fuzi Lizhong Tang (Prepared Aconite and Middle-Warming Decoction) with Wu Wei Zi (Schisandra) to astringe. After two to three doses, abdominal cold and foot heat reduced by 60-70%. Then use Guipi Tang (Restore the Spleen Decoction) with Rou Gui (Cinnamon Bark) and Wu Wei Zi, decocted to deliver Babai Wan (Eight-Ingredient Pill). He recovered.
Scholar Chen suffered from frequent red and white dysentery. Pulse: Two Cun slightly surging, two Chi and Left Guan very weak. Tongue: Black coating. Liver fails to disperse, Kidney fails to store; hence severe dysentery. True Yin is extremely deficient below, true fluids are dry above. Water attacks Fire position, turning red tongue black. Taking Huang Lian would worsen it. Indeed, after taking Xianglian Wan, dysentery became uncontrollable. Feng was consulted again, prescribed Babai Tang (Eight-Ingredient Decoction) in large doses with Ren Shen (Ginseng) taken separately. Gradually improved. Regulated for over a month until recovery.
Yang Chengliu treated Shen Mou with dysentery: Tenesmus, over a hundred times daily, fever, thirst, fatigue, reluctance to speak, curled posture, poor appetite, and difficult urination. Standard heat-clearing and stagnation-resolving drugs made it worse. Pulse: Slow, large, and powerless. Face: Tender white. Tongue: Slightly yellow coating. This is deficiency with cold invasion, not typical dysentery. Prescribe Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) with Bai Shao (White Peony) and Pao Jiang (Roasted Ginger). After one dose, tenesmus eased, pain and dysentery decreased. After two doses, fever subsided, appetite returned, and symptoms resolved.
Cai Mou had dysentery with colic, tenesmus, and frequency. Self-medicating with Kidney-nourishing and Spleen-drying herbs (astringents too early led to chronic intermittent dysentery). Despite no immediate harm, the root cause remained. For three years, episodes occurred 5-7 times weekly, leading to emaciation and weakness. Yang diagnosed: Pulse tight against the bone, especially Left Chi. Face pale, tongue pale, tender, fat, and slippery. Cold accumulation in the lower colon, inaccessible to other drugs. Spleen and Kidney are severely depleted. Must take Yangrong Tang (Nourish Young Decoction) and Babai Wan (Eight-Ingredient Pill) for dozens of doses until Qi and Blood are sufficient. Then take a wax pill containing one Radix Crotonis Tiglii (Ba Dou) seed, size of a longan, taken fasting with warm water. The medicine reaches the accumulation and dissolves it. Treatment followed, recurrence prevented.
Yao Mou had dysentery with abdominal pain, tenesmus, pus and blood, frequent throughout day and night. Qi-regulating, cooling, blood-purifying, and detoxifying drugs failed. He passed a segment of "intestine" half a foot long. Yang Chengliu questioned this impossibility: The intestine connects from stomach to anus; if severed, it couldn't exit. If severed yesterday, pus/blood wouldn't continue today. It was likely a layer of sticky mucus resembling intestine. Pulse: Fine, rapid, wiry, pressing hard. Tongue: Mirror-like, pulse spiritless. Wood Qi excessive, Stomach Qi perishing. Died days later.
Yi Silan treated a Prince in July with dysentery. Initial purgatives, then harmonizers, then tonics failed, worsening condition. Frequent bowel movements, colic, gas without much stool, back pain, chest distension, belching, cold limbs, irregular breathing. Pulse: Cun deep and large, Right Cun forceful, Right Guan deep and tight, Left Guan wiry, long, and surging. Chi deep and faint. Diagnosis: Spirit fatigue and Qi stagnation. Prescribed Changzhong Tang (Unblock Middle Decoction): Zhi Xiang Fu (Processed Aucklandia), Cang Zhu (Atractylodes Lancea), Shen Qu (Medicated Leaven), Fu Xiong (Ligusticum), Huang Qin (Scutellaria), Zhi Ke (Bitter Orange), Su Geng (Perilla Stem), Gan Cao (Licorice), Ginger, Jujube. Vomiting ensued, cold air rose, belching released, much filth passed, chest cleared, hunger returned. Limbs warmed, pulse normalized. Heart palpitations and dizziness remained. Prescribed Liujunzi Tang (Six-Gentlemen Decoction) with Xiang Fu and Sha Ren. Stomach Qi stabilized. Finally, Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) with Man Jing Zi, Fu Shen, Suan Zao Ren, and Huang Bai. Recovered in half a month. Explanation: Deep Cun indicates heart fire depressed (spirit fatigue) and lung Qi blocked (thinking knots Qi). Lung metal not commanding allows liver wood to insult spleen earth, causing cold limbs (deep heat causes deep cold). Not true cold, so Aconite is wrong. Not true excess, so Rhubarb/Niter are wrong. Use acrid-cool herbs to scatter. Xiang Fu moves Lung Qi, Su Geng opens orifices, Shen Qu transforms Spleen accumulation, Cang Zhu dries dampness, Fu Xiong soothes Liver, Huang Qin/Zhi Ke cleanse Large Intestine, Gan Cao harmonizes. Qi ascends, accumulation clears, pain and cold resolve.
Zhang Luzhu treated Mother of Xiang Mingxian with dysentery resembling amaranth juice. Bitter-cold purgatives worsened it. Fever and stuffiness, pulse floating and large but empty, Right Guan wiry and hollow on pressure. Qi deficiency failing to control blood. Prescribed Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) with Pao Jiang and Rou Gui. Recovered in four doses.
Guo Ranming's wife had five-color dysentery, frequent, with leukorrhea like flooding. Mistakenly taking Huang Lian and Da Huang caused blockage, inability to eat, night fevers, and rapid fine wiry pulse. Triple Yin deficiency. Prescribed Lizhong Tang (Middle-Warming Decoction) with Gui Zhi (Cinnamon Twig), Fu Ling (Poria), Mu Xiang, and Wu Mei (Mume Fruit) to regulate Stomach. Then Ji Jian Babai Tang (Modified Eight-Ingredient Decoction) to guide deficient fire. Recovered.
An old Minister had chronic dysentery resembling amaranth juice. Taking Huang Qin, Huang Lian, and Bai Shao caused hiccups. Pulse thread-like. Prescribed Lizhong Tang with Ding Xiang (Clove) and Rou Gui. Doubting, he took previous meds. Condition worsened, suddenly craving porridge. Doctors celebrated ability to eat. Zhang re-diagnosed: Pulse like feeling knife edges (True Organ Pulse). Middle Qi exhausted, seeking food (Chu Zhong syndrome). Same as Shanghan example, incurable.
Chu's mother had late-autumn chronic dysentery, unable to eat for half a month. Only drank water/melon juice, causing vomiting, bloating, pain, thirst, agitation, night worsening, pus/blood discharge, urinary retention, string-tight weak pulse. Filth dark and dull. Took Huang Qin, Huang Lian, Bin Lang, Hou Po. Symptoms adverse. Pulse weak suitable for warming/tonifying. Prescribed Lizhong Tang with Gui Zhi, Fu Ling, Zi Wan (Aster). Urine flowed, sleep improved, diet advanced, dysentery reduced. Further Lizhong Tang with extra Ren Shen, pills made with Fu Long Gan (Dragon's House Soil). Recovered.
Chen Jinshi returned from travel, developed diarrhea. Purgatives failed, leading to Jinkou Li. Shoulders/back swollen from coal smoke, hiccuping, coma. Pulse thread-like, face Dai Yang (floating yang), stool like rotten fish brain. Critical but pulse lacks vigorous energy, no panting/restlessness. Warm tonification indicated. Preserved Yuan Tang (Preserve Origin Decoction): Ren Shen, Huang Qi (Astragalus), Gan Cao, Rou Gui, decocted in Fu Long Gan water. Improved after first dose, tenesmus eased after second, abscesses appeared after third. External treatment plus internal meds led to recovery.
Han Jindu returned victorious, had abdominal pain, bloody diarrhea. Xianglian Wan worsened it. Lower abdominal tension, urinary retention, aversion to drinks, sallow face, heavy bleeding. Pulse: Qi Kou deep, fine, tight. Blood dark like amaranth juice. Prescribed Lizhong Tang with Rou Gui. Urine flowed, abdomen relaxed after one dose. Bleeding reduced, appetite returned after two. Diarrhea stopped after four. White pus appeared, prescribed Buzhong Yiqi Tang with Pao Jiang. Recovered.
Zhang Feichou treated son of Zhu Yuanchen with five-color dysentery, chest distension, anorexia. Two doctors disagreed: one wanted Da Huang (due to distension/large pulse), one Ren Shen (due to chronicity/anorexia). Zhang said: Da Huang contraindicated in chronic anorexia; Ren Shen contraindicated in acute distension. Use Fu Long Gan (Dragon's House Soil) as chief herb to warm Earth. Decoct strongly as tea. Add Pao Zhu, Fu Ling, Gan Cao, Huo Xiang, Mu Xiang, Chao Wu Mei. One dose reduced dysentery/improved appetite; two doses stopped it. Recovered without further meds.
Chai Yuqing treated Zhou Ranggu in Beijing for six-month chronic dysentery. Ren Shen, Huang Qi, Chi Fu Ling, Yu Mi Ke (Poppy Shell), Rou Dou Kou failed. Night wakings 6-7 times, copious pus/blood, near death. Chronic dysentery loses Yin; Chi Fu Ling (draining) inappropriate. Astringents ineffective. Cold accumulation in lower colon, pulses slightly tight. Wanted La Dou Wan (Wax Bean Pill), others afraid. Reluctantly used Buzhong Yiqi Tang with Zhu Yu (Evodia) and Zhi Chuan Fu Zi (Processed Sichuan Aconite). Reduced after one dose. Combined with Babai Wan for recovery.
Zhang Sanxi treated man with dysentery, chills/fever/headache. Left pulse floating/tight, Right pulse slippery/large. Internal injury with exterior contraction. Used Baidu San (Eliminate Toxics Powder) with Ginger/Ginger Stem. Exterior resolved. Epigastric distension/tenesmus remained. Pingwei San (Peace the Stomach Powder) with Zhi Ke, Mu Xiang, Bin Lang, Shan Zha. Distension moved to lower abdomen. Muxiang Binglang Wan (Aucklandia and Areca Pill) discharged sticky/hard matter. Recovered.
Woman with dysentery took Chengqi Tang (Major Order of the Qi Decoction) twice, ineffective. Left pulse floating/wiry, Right三部 (Three Positions) deep, Guan slightly slippery. Caused by depression and food stagnation. History of anger. Use Hou Po, Cang Zhu, Xiang Fu, Fu Xiong to relieve depression; Shan Zha, Bin Lang, Ju Pi, Mu Xiang to regulate Qi; Bai Shao to harmonize middle. Three doses cured.
Man recovered from dysentery, drank liquor, ate meat/noodles. Chest fullness, chills/fever, Right pulse wiry/slippery. Food/alcohol toxicity. Middle Qi not restored, fire pathogen remains. Hard to digest. Liquor aids toxicity. Incurable. Food stuck in chest, need vomiting to survive ("Above, induce vomiting"). Refused, took Ba Dou (Croton) pills. Vomited blood, died.
Man traveled in summer, drank alcohol, pure blood dysentery, frequency, epigastric distension, anorexia, pulses wiry/slippery/rapid. First Shan Zha, Zhi Shi, Bin Lang, Ju Hong, Xiang Lian to harmonize middle. Then Muxiang Binglang Wan to guide stagnation. Distension gone, bleeding worsened. Siwu Tang (Four Substances Decoction) with Sheng Di, Huang Qin, Zhu Yu, Lian Qiao, Dan Pi. Two doses stopped half bleeding. Added Di Yu (Sanguisorba). Three doses cured.
Man with dysentery/pain/swelling took Da Huang pills, pain worsened, cold limbs, deep hidden pulse. Cold herbs used too early. Pao Jiang Lizhong Tang with Hou Po, Cang Zhu, Shan Zha. One dose, external roasted salt compress. Pain settled. Then Xiang Lian, Bai Shao, Hou Po, Zhi Ke to regulate. Recovered.
Man with dysentery for two months, filth on bed, pulses wiry/weak. Buzhong Yiqi Tang with wine-fried Bai Shao. Eight doses stopped, twenty cured.
Man with chronic dysentery, edema, fine/small pulse. Salvageable. Shenling Baizhu San (Ginseng, Poria, and Atractylodes Macrocephala Powder) with Rou Dou Kou (Nutmeg). Soup form cured.
Woman with chronic dysentery, fever when eating, Left pulse floating/rapid, Right pulse slippery/rapid. Anorexia only at peak. Canglin Tang (Granary Decoction) to clear heat first. Then Zhi, Zhu, Ren Shen, Chen Pi, Shan Zha, Shen Qu. Abdomen widened. Tenesmus persisted. Tiaozhong Yiqi Tang with Muxiang Binglang Wan. Discharged filth, cured.
Lu Yangyu treated man with travel cold, mild headache/fever, normal diet. Days later, watery diarrhea, red scanty urine. Weiling Tang (Stomach-Calm Decoction) failed, showed accumulation. Huang Qin, Huang Lian, Bai Shao, Mu Xiang, Bin Lang failed. Pulses floating/wiry, deep/rapid/choppy. Exterior Qi not舒展 (relaxed) causing interior Qi unsmooth, combined with Spleen/Stomach disharmony. Wuji San (Five Accumulations Powder) with Bai Kou Ren, Mu Xiang. Sweated heavily, all symptoms resolved.