董浔阳素有酒积，因而患痢。虽奉养丰而禀赋浓，而清凉消导过多，今痢已少瘥，而大便犹滞，小便短数
黄赤，身时热，上壅头面，鼻塞耳聋，眼昏口燥。脉之，浮大而数，按之而驶。或谓芩、连、滑石，但可清下
焦之火，当以凉膈散清上焦以佐之。且谓脉尚洪盛，未可议补。陆曰∶公平日脉顶指洪盛，以今日较之，已弱
极矣。凡九窍不利，由于阳气上盛而致，则当清泻。若由于肠胃之所生，则当补敛。今泻痢久，数用清凉消导
之剂，肠胃有不虚乎？夫中焦气血不足，多致虚火上炎下迫，用人参、白术补气为君，当归、白芍养血为佐，
五味、麦冬、枣仁敛耗散之气以为臣，甘草、茯苓缓以渗之以为使。待上焦既清，而后提其下陷之阳，则便实
溺清而通畅矣。服二剂之后，再以补中益气加减，服之全愈。
陆肖愚治吴南邱，八月间，醉饱后御内，明日患痢，昼夜百余次，赤白相间，其状如烂肉，腹中温温作痛，
四肢厥冷。脉之，缓大无力，两尺脉尤弱。谓此症即宜补塞，先书人参、肉果二味，其子大骇，谓无积不成痢，
岂有隔一二日间，即用补塞者？不得已，姑与调气养荣汤服之。病无进退，更医遂投以芩、连、槟榔、木香
等药，腹痛如 ，足厥如冰，冷汗气促，食入即从大便而出，色尚未变。再亟诊，身体不能转侧，大便如流，
犹幸脉与神气未变，因用大料人参附子理中汤加肉桂、肉果服之。一剂痛减，数剂足温，泄泻少止，后用人参至
二斤始起，须发尽落。
鞠二府九月间赤痢腹痛，里急后重。或用芩、连、槟榔、白芍、滑石，一剂痛觉增，二剂痛更甚。乃谓
医曰∶通则不痛，汝为我用大黄下之。医唯唯。幸其公子力争不可。诊之，面赤戴阳，唇若涂朱，舌白滑无苔，
所下有瘀血如豆大者数十枚，如淡黄而溏，其脉浮按微数而大，沉按迟而无力。曰∶此痛乃寒也，当以温热解
之。盖脉无热象，大而无力者为虚寒，痢赤为热，色晦而便溏者为虚寒。用白芍五钱，醇酒炒数次，姜炭二钱，
炙甘草、桂、附各一钱，木香五分，枣二枚，一剂痛减，能即卧，二剂痛止。改加升麻、参、 ，数剂，而后
重泻痢并除矣。
朱丹溪治青田人，下痢红紫血，下坠逼迫，不渴不热，用白术、白芍各一两，陈皮、枳壳、归身、滑石各
半两，甘草炙二钱，桃仁三十六个，分八帖，下实肠丸三十粒。
许叔向曰∶陈侍郎经中，庚戌秋，过仪真求诊，初不觉有疾，及诊视，肝脉沉弦附骨，重取则牢。予曰∶
病在左胁有血积，必发痛。陈曰∶诚如是。前某守九江，被召，冒暑泛长江，暨抵行朝，积血一块大如杯，旬
日如碗大，痛发则不可忍，故急请公视以归耳，奈何？予曰∶积痢不强止，故积血结于脐胁下，非抵当丸不可。
渠疑而不肯服，次年竟以此终。
郑奠壹治江南臬司多公，患噤口痢，粒米不进，令服牛乳，久之而瘥。
陆祖愚诊吴翔高，年近七旬，秋初患痢，起于醉饱房劳。诊之，容颜黯滞，六脉弦紧，此形症不足，脉候
有余。明是阳亢阴微，须用参、附挽回，否则不出三日。满座哄然，医者从而和之，乃投以鼎串之药，烧热草
头，令病患闻吸，以开胃气。次早痢果减六七，渐进薄粥，谈笑吟诗，大有起色，阅二日而讣音至矣。
陈三农治一妇，久痢不止，口干发热，饮食不进，犹服香、连等药，完谷不化。尚谓邪热不杀谷，欲进芩、
连，数日不食，势正危迫。诊之，脉大而数，按之极微。询之，小便仍利，腹痛喜手按。此火衰不能生土，内
真寒而外假热也。小便利，则不热可知；腹喜按，则虚寒立辨。亟进附子理中汤，待冷与服，一剂而痛止，连
服数剂而愈。
抚州铜客，病痢甚危，悬五十金酬医。太学生倪士实授一方，用当归末、阿魏丸，调白汤送下，三服而愈。
（《续金陵琐事》。）
胡竹亭授一治痢方，用黄花地丁草，捣取自然汁一酒杯，加蜂蜜少许，服之神验。
薛立斋治崔司空，年逾六旬，患痢赤白，里急后重。此湿热壅滞，用芍药汤，内加大黄二钱，一剂减半，
又剂全愈。惟急重未止，此脾气下陷，用补中益气送香连丸而愈。
马元仪治一人，年逾古稀，下痢脓血，调治半年不愈。脉之，左见弦涩，右关尺微濡，按之则几微欲绝，
此脾肾俱虚之候也。脾主转输，肾主二阴，二脏不治，将何恃为健运蛰藏之本耶？病久年高，所喜发言清越，
神气明爽，虽危可治。用人参三两，熟附三钱，服后三四时许，觉周身肌肉胀不可忍。疑药之过，急召诊，则
右关尺俱透，按之有根。曰∶脉透者，气充于内也；肌胀者，气达于表也。前方少减附子，连进五剂，痢减半，
粪微溏。再服，症减七八，但小便少，微渴。与五苓散减桂加参，小便如泉。再以补中益气，调理两月而安。
（系纯用阳药之过。后之口微渴，亦由于此。得茯苓、猪苓等引参力下降，故小便即利。病虽愈，非正治也。）
凌伯尹患痢，两月不止，百治益甚。诊之，右关尺虚而结滞，胸中有块突起如拳，水浆不得下咽。（是噤
口矣。）曰∶此症屡经误治，邪未得除，而胃气已伤，客邪乘虚结于心下，与痰饮相搏而成痞。水不得下咽者，
土虚不能胜水，且以寒饮内格而不入也。与半夏泻心汤，二剂结块渐平，再剂而症减七八，渐进粥饮。盖外邪
挟内饮相结，其留连胶固，有非一表一里所能尽者。攻之则正愈伤，补之则痞益甚，然舍此则治法何从而施？
乃用人参、大枣以安胃气之虚，而加炮姜、半夏、黄芩、黄连以涤痰治邪，而成倾痞之用，正如良吏治民，
威惠兼着，而治功成矣。
包瑞溪学宪，传治血痢痛甚方∶白芷酒炒五钱，（此一味仲淳加入者。）枳壳、槐花同炒，去槐花，五
钱，升麻醋炒七分，真川连姜汁炒五钱，滑石末三钱，乳香、没药各七分五厘，山楂肉三钱，甘草五分，试之
神效。（《广笔记》。）
黄聚川年兄太夫人，年八十余，偶患痢，胸膈胀，绝粒数日。予以升麻、人参、黄连、莲肉，方投之，参
用至一两，诸子骇甚。再问，予曰∶迟则不救。一剂啜粥，再剂腹中响，一泄痢即止。今年九十余尚健也。（同上。）
陈赤石督学，因校士过劳感冒，遂滞下纯血，医皆难之。陈刺史曰∶此非缪仲淳莫能疗也。使者旁午得之
吴门，一日夜驰之武林。诊知其所由，遂用人参五钱，升麻七分，炙甘草、红曲各钱半，乌梅二枚，川连三钱，
白芍二钱，莲肉二十粒，煎调滑石末五钱，二剂而愈。督学曰∶痢止矣，心摇摇不能阅卷，奈何？仲淳曰∶此
劳心太过，暑因客之耳。加竹叶、干葛、枣仁，一剂遂平。（同上。）
庚子秋，华氏妹归宁忽痢，日夜几百行，身热发呕，一呕数十声不绝。吴医争欲下之，且曰∶补即死矣。
时仲淳以先王母病，留湖滨，怜其促治后事甚亟。曰∶既以知危，何不以药试之？服如金丸，（一味黄连，姜汁和丸。
）因思饮，予固守仲淳前方，以人参、炒白芍、扁豆、升麻、滑石、炙草、橘红，煎下如金丸，二剂势稍定，更
数服愈。华水部至今感服。（同上。）
一少年贵介，暑月中出外，饮食失宜，兼以暑热，遂患滞下，途次无药，病偶自止，归家腹痛不已，遍尝
诸医之药，药入口，痛愈甚，亦不思饮。仲淳视之曰∶此湿热耳。其父曰∶医亦以湿热治之而转剧。问投何药？
曰∶苍术、黄连、浓朴、枳壳、陈皮等。仲淳曰∶误也。术性温而燥，善闭气，故滞下家忌之。郎君阴虚人也，
尤非所宜。更以滑石一两为细末，丹皮汁煮之，别以白芍酒炒五钱，炙草二钱，炒黑干姜五分，水煎调服。根据
方服之，须臾小便如注，痛立止。（同上。）
秦公藩病痢，医误投涩药，一剂痢止。湿热无自而出，遍攻肢体骨节间，以致项强、目赤，肩、臂、腕、
膝、足胫俱发肿，痛甚不能转侧。仲淳疏方寄之，用白芍、石斛、牛膝、木瓜、黄柏、苡仁、炙草、车前、茯
苓，痛虽止，尚不能转侧。更用蒺藜、菊花、首乌、胡麻、黄柏、炙草，复逾年愈。其始病时，一医稍投参、
术，痛极欲死。此系本症阴虚有火，又加湿热，暑湿交攻，故现此症，名痢风。阴虚有火，故不受补，又不宜
燥，惟微寒清平之剂调之，久之自愈。（同上。）
姚公远幼子病痢，医误下之，遂下纯血，喘，身热不思食。缪以人参四五钱、石莲子、白芍、升麻、橘红、
甘草、滑石、僵蚕、白扁豆。（同上。）
立斋治一小儿患痢，骤用涩药，致大肠经分作痛，与扁豆、滑石末、炙甘草投之，一剂喘平血止，又数剂
痢止。嘱曰∶儿百日不出痘则生，以下多元气未复故也。未几，即毒流于隧道之中，以四物汤加桃仁、酒芩、
红花、升麻、枳壳、陈皮、甘草，治渐愈。因年幼胃弱，竟至不起。又一患者，亦用涩药，环跳穴作痛，与前
药，去升麻、陈皮、甘草，加苍术、黄柏、柴胡、青皮、生姜，十余剂，少可。更刺委中出黑血而愈。如手蘸
热水拍腿上，有泡起，挑去亦可，不若刺穴尤速效也。（委中在膝腕中央，横纹中动脉便是。）
仲淳之弟稚端，幼病痢，日夜数十次，用人参三钱，吴茱萸汤泡七次一钱，川黄连姜汁炒一钱，后二味饭
上蒸，煎服。如受，以药一匙，间米汤一匙，渐渐饮之。如头疼发热，加寒水石六钱，干葛一钱，别调六一散四
钱，冷水服，数剂即愈。
虞元静房中人，方孕五月，患滞下腹痛，日下数次，用川黄连四钱，白芍三钱，黄芩三钱，白扁豆二钱，
莲子四十粒，橘红一钱五分，枳壳三钱，红曲二钱，干葛一钱五分，升麻五分，炙甘草一钱，乌梅一枚。甫饮
一钟，即觉药行，即解一次，痛亦随止，滞下全愈。
韩户部左臂患一紫泡，根畔赤肿，脉大而芤，谓芤主失血，或积血。韩曰∶血痢未瘳，以芍药汤二剂，更
以人参败毒散二剂，疮痢并愈。
沈明生治吴君一媳，患痢四十余日，食少倦怠。原医以日久困惫，当从补治，无复可疑。延诊，谓其染患
以来，膏粱未尝一日去口，则旧积未除，新积复起，形虽虚而症固实也，日虽久而积固新也，治法应与初症同。
先进导滞丸二服，嗣用补消兼进。仍嘱其清虚调养，后果全愈。由此观之，国中末三法，有难尽拘，而望闻
切之外，不可废问。且吴俗有饱不死痢疾一语，恣啖肥甘，惟恐弗及，何异藉寇兵而资盗粮耶？蔓延日久，
驯致证实形虚，欲补形则碍其证，欲攻实则虑其虚。始也求其多食，而终至于不能食，良可悯也。因志之，
以戒夫世之患痢而不慎口腹者。
章素文母，秋间患滞下，脉与症本皆轻浅，乃过于慎重，泥高年不可寒凉之说，更医至再，亦惟将顺主人，
致令绵延不已。最后延诊，力矫前非，竟以黄连主治得瘥。时有童鸣佩，章石交也，亦久痢，亟以沈荐，且言
治此恙者，莫过于沈，而沈之善用，亦莫过于黄连一味耳。即诊即告，曰∶是诊非附子弗痊。章讶之，谓童利
下之色，与夫作痛溺涩，日期近远，颇与前症相类，何用药水火如是？曰∶辨症不多岐，但须一矢破的。童之
滞下并证，皆似乎热，而询其每欲圊时，必先腰痛，一语而得病根矣。夫腰为肾主，二便乃胃家北门锁钥之
司也。虚则不能闭藏，是以每欲更衣，辄先作痛，非与腹部之痛随利减者可同日而语。向皆用寒凉荡涤主治，
疾何瘥？于是先以理中、补中相合为剂，嗣以八味丸益火之原，果得奏续。嗟夫，症同治异，孰谓可概施一法
也哉。（雄按∶腰痛固为肾虚之证据，然须辨别阴阳，不可概以桂、附为主药也。今秋，王雨苍室，患此两
旬，延余视之，腰痛腹坠，溲少口干，烦躁
面红，知饥不寐，脉至弦数左甚，而痢不赤白，略无粪色相兼，及至更衣，又极艰涩，且无痢色相杂。温补宣
通，皆无小效。稍佐升清，胸即痞塞。询其月事，因痢愆期。余谓能食便坚，腑气无滞，阴虚肝旺，管液旁
流。与苁蓉、杞子、乌 、鲍鱼、阿胶、秦皮、黄柏、柏子仁、白头翁、银花，投剂
即减。继加熟地、归身、龟板、鹿角而愈。）
吴有声云∶壬寅秋，予病痢而剧，郡治逾月，气息奄奄，色毁骨瘠，望者却走。明生先生至，诊视之则曰∶
是何中暑之深也？家人疑之，谓予安坐书斋，足不出户，奚暑之乘？先生决之于指，断之于心，遂投以凉剂，
一服即有效，不数日而全愈。盖予夏间曾制地黄，以酒渍之，每日必出诸酒，而曝之烈日之中，至夕，仍返而
渍之于酒。如是者，几一月。予愚甚，以为地黄之精神，尽在酒也，取而饮之，而不知炎威之毒，渐蓄于酒者，
早已入余之肺肠，此家人所不知，即予亦未悟，迨病愈而推之始得，而先生独知其中暑之深，则其视病，可不
谓神焉者哉。
聂久吾曰∶痢为险恶之症，生死攸关，然古今治法，多罕十全。予以经验既多，渐悟病机，乃自制此方，
所向辄效，遂刊布广施，全活甚众。第服者藻须地道，尤不可任意加减耳。方用川黄连、条芩、生白芍、山楂
Dong Xunyang had a history of alcohol accumulation, which led to dysentery. Although his lifestyle was abundant and his constitution robust, due to excessive use of cooling and resolving agents, although the dysentery had slightly improved, his stool remained obstructed, urination was scanty and frequent with yellow-red color, body temperature occasionally rose with heat congesting upwards to the head and face causing nasal congestion, deafness, blurred vision, and dry mouth. Palpation revealed a floating, large, and rapid pulse, which became hurried upon deep pressure. Some suggested using Scutellariae Radix (Huangqin), Coptidis Rhizoma (Huanglian), and Talcum (Huashi), arguing that these could only clear fire in the Lower Jiao, and recommended adding Lianpo San (Cooling the Diaphragm Powder) to clear the Upper Jiao as an adjunct. They also argued that since the pulse was still surging, tonification should not be considered. Lu said: "Your usual pulse is forceful and surging against the fingers; compared to today, it has become extremely weak. Any obstruction of the nine orifices caused by excess Yang above should be cleared and purged. However, if it arises from intestinal and stomach deficiency, it should be tonified and astringed. Now, after prolonged diarrhea and dysentery, and repeated use of cooling and resolving agents, can the intestines and stomach remain non-deficient? Deficiency of Qi and Blood in the Middle Jiao often leads to deficient Fire flaming upward and pressing downward. Use Ginseng Radix et Rhizoma (Renshen) and Atractylodis Macrocephalae Rhizoma (Baizhu) to tonify Qi as the sovereign drug; Angelicae Sinensis Radix (Danggui) and Paeoniae Radix Alba (Baishao) to nourish Blood as the minister drugs; Schisandrae Fructus (Wuweizi), Ophiopogonis Radix (Maidong), and Ziziphi Spinosae Semen (Zaoren) to gather scattered Qi as the assistant drugs; Glycyrrhizae Radix et Rhizoma (Gancao) and Poria (Fuling) to moderate and leach out dampness as the envoy drugs. Once the Upper Jiao is cleared, then lift the sunken Yang, and the stool will solidify, urine will clear, and flow will be smooth. After two doses, modify Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) and continue taking it until full recovery.
Lu Xiaoyu treated Wu Nanqiu. In August, after drunkenness and overeating followed by sexual intercourse, he developed dysentery the next day, occurring more than a hundred times day and night, with red and white mixture resembling rotten meat, dull abdominal pain, and cold limbs. Palpation revealed a slow, large, and powerless pulse, especially weak at both Chi positions. He stated that this condition required tonification and consolidation, prescribing first Ginseng Radix et Rhizoma (Renshen) and Myristicae Semen (Rougu). His son was greatly alarmed, arguing that dysentery cannot exist without accumulation, questioning how one could use tonification and consolidation within a day or two. Reluctantly, they administered Tiao Qi Yang Rong Tang (Regulate Qi and Nourish Blood Decoction). The condition neither improved nor worsened. A subsequent doctor prescribed Scutellariae Radix (Huangqin), Coptidis Rhizoma (Huanglian), Arecae Semen (Binglang), and Aucklandiae Radix (Muxiang). Abdominal pain became severe like knife-cutting, feet were ice-cold, cold sweat appeared with shortness of breath, and ingested food passed directly through the bowels unchanged in color. Upon urgent re-examination, the patient could not turn their body, and stool flowed like water. Fortunately, the pulse and spirit remained unchanged. Therefore, a large dose of Fuzi Lizhong Tang (Aconite Decoction to Warm the Middle) plus Cinnamomi Cortex (Rougui) and Myristicae Semen (Rougu) was administered. Pain decreased after one dose, feet warmed after several doses, and diarrhea slightly stopped. Later, consuming two jin of Ginseng Radix et Rhizoma (Renshen) allowed him to rise, though all hair and beard fell out.
Ju Erfu suffered from red dysentery with abdominal pain and tenesmus in September. Someone used Scutellariae Radix (Huangqin), Coptidis Rhizoma (Huanglian), Arecae Semen (Binglang), Paeoniae Radix Alba (Baishao), and Talcum (Huashi). Pain increased after one dose and worsened after two. He told the doctor, "If there is free flow, there is no pain. Use Rhei Radix et Rhizoma (Dahuang) to purge me." The doctor agreed. Fortunately, his son strongly opposed it. Examination showed facial flushing resembling Dai Yang syndrome, lips painted red like cinnabar, white slippery tongue coating without moss, and passage of dozens of bean-sized blood clots. Stool was pale yellow and loose. Pulse was superficially slight rapid and large, but deep slow and powerless. He said: "This pain is due to Cold; it should be resolved with warmth. The pulse shows no heat signs; large and powerless indicates Deficient Cold. Red dysentery appears hot, but dark color and loose stool indicate Deficient Cold. Use 5 qian of Paeoniae Radix Alba (Baishao) stir-fried several times with pure wine, 2 qian of Ginger Charcoal (Jiantan), 1 qian each of Glycyrrhizae Radix et Rhizoma (Gancao), Cinnamomi Ramulus (Guizhi), and Aconiti Lateralis Radix Praeparata (Fuzi), 0.5 fen of Aucklandiae Radix (Muxiang), and two dates. Pain decreased after one dose, allowing immediate lying down; pain ceased after two doses. Add Shengma (Cimicifugae Rhizoma), Renshen (Ginseng), [missing character], and after several doses, tenesmus and dysentery were eliminated.
Zhu Danxi treated a man from Qingtian who passed red-purple bloody stools with severe bearing-down sensation, without thirst or fever. He used Baizhu (Atractylodis Macrocephalae Rhizoma) and Baishao (Paeoniae Radix Alba) 1 liang each, Chenpi (Citri Reticulatae Pericarpium) and Zhike (Aurantii Fructus) 0.5 liang each, Danggui Shen (Angelicae Sinensis Radix) and Huashi (Talcum) 0.5 liang each, Gancao (Glycyrrhizae Radix et Rhizoma) 2 qian roasted, and 36 Tao Ren (Persicae Semen). Divided into eight doses, taken with thirty pills of Shichang Wan (Solidify Intestine Pill).
Xu Shuxiang said: Minister Chen Jingzhong visited Yizhen for treatment in autumn of Gengxu year. Initially unaware of illness, upon examination, Liver pulse was deep, wiry, felt to the bone, and firm upon heavy pressure. I said: "There is blood stasis in the left hypochondrium, which must cause pain." Chen replied: "Indeed. Previously, while serving as Prefect of Jiujiang, summoned to court, I traveled across the Yangtze River in summer heat. Upon arriving at the imperial capital, a blood mass accumulated, size of a cup initially, growing to bowl-size in ten days. Pain was unbearable when it flared, hence I urgently requested your consultation. What should be done?" I said: "Dysentery not forcibly stopped leads to blood stasis knotting below the navel and hypochondrium. Only Didang Wan (Eliminate Stagnation Pill) will suffice." He doubted and refused to take it, and died of this condition the following year.
Zheng Dianyi treated Du Gong, Judicial Commissioner of Jiangnan, suffering from Jin Kou Li (Throat-Closing Dysentery), unable to eat even a grain of rice. He instructed him to drink cow's milk, and after a long time, he recovered.
Lu Zuyu diagnosed Wu Xianggao, nearly seventy years old, who contracted dysentery in early autumn due to drunkenness, overeating, and sexual fatigue. Examination showed dull complexion, six pulses wiry and tight. This indicated insufficient form and symptoms but excessive pulse signs, clearly Yang hyperactivity and Yin deficiency. It required Renshen (Ginseng) and Fuzi (Prepared Aconite Root) to rescue, otherwise death within three days. The room erupted in laughter, doctors concurred, and they administered Ding Chuan Zhi Yao (Tripod Strangulation Medicine), heating grass heads for the patient to inhale to open stomach Qi. Next morning, dysentery reduced by 60-70%, thin porridge was gradually accepted, conversation and poetry recited, showing great improvement. Two days later, news of death arrived.
Chen Sansan treated a woman with chronic dysentery, dry mouth, fever, inability to eat, yet still taking Xianglian (Magnolia Bark and Coptis) herbs, passing undigested food. Shang claimed that pathogenic heat fails to digest grains and wanted to add Huangqin (Scutellaria) and Huanglian (Coptis). After days of no food, the situation was critical. Pulse was large and rapid but extremely faint on deep pressure. Urination was normal, abdominal pain favored pressure. This indicated Fire deficiency failing to generate Earth, internal True Cold with external False Heat. Normal urination proves absence of heat; preference for pressure confirms Deficient Cold. Urgently administer Fuzi Lizhong Tang (Aconite Decoction to Warm the Middle), cooled before ingestion. Pain stopped after one dose, cured after several doses.
A copper merchant from Fuzhou suffered critically from dysentery, offering fifty taels of silver to the physician. Student Ni Shishi prescribed a formula: Danggui Wei (Angelica Sinensis Powder) and Awei Wan (Ferula Pill), taken with plain water. Cured after three doses. (From *Xu Jinling Suoshi*).
Hu Zhuting transmitted a dysentery formula: Dandelion (Huanghua Diding Cao) juice, one wine cup, mixed with a little honey. Divine efficacy.
Xue Lizhai treated Vice Minister Cui, over sixty years old, with red and white dysentery and tenesmus. This was Damp-Heat stagnation. Used Shaoyao Tang (Peony Decoction) with added 2 qian of Dahuang (Rhubarb). Halved after one dose, fully cured after another. Tenesmus persisted, indicating Spleen Qi sinking. Cured by sending Xianglian Wan (Magnolia and Coptis Pill) with Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction).
Ma Yuanyi treated a man over seventy with pus and blood in stool, untreated for half a year. Left pulse wiry and choppy; Right Guan and Chi pulses slight and soggy, barely perceptible on pressure. This indicated Spleen and Kidney deficiency. Spleen governs transformation and transportation; Kidneys govern the two lower orifices. If these two organs are not treated, what supports the foundation of movement and storage? Though old and ill, his voice was clear and spirit bright, so it was treatable. Used 3 liang of Renshen (Ginseng) and 3 qian of Shu Fuzi (Prepared Aconite). After 3-4 hours, whole-body muscle swelling became unbearable. Suspecting overdose, urgent consultation revealed Right Guan and Chi pulses emerged with root. He said: Pulse emergence indicates Qi filling internally; muscle swelling indicates Qi reaching the exterior. Reduced Fuzi dosage in previous formula, continued for five doses. Dysentery halved, stool slightly loose. Continued, symptoms reduced by 70-80%, but scanty urine and slight thirst. Used Wuling San (Five-Ling Powder) minus Guizhi (Cinnamon Twig) plus Renshen. Urine flowed like a spring. Then used Bu Zhong Yi Qi Tang for two months until stable. (Note: This was due to excessive use of Yang-warming drugs. Subsequent slight thirst resulted from this. Fuling and Zhu Ling guided Renshen's power downward, thus promoting urination. Though cured, this was not standard treatment.)
Ling Boyin suffered dysentery for two months, worsening with various treatments. Right Guan and Chi pulses were deficient and knotted; a lump protruded in the chest like a fist, preventing swallowing of fluids. (This is Jin Kou Li). He said: Repeated misdiagnosis failed to remove pathogens but damaged Stomach Qi. Exogenous pathogens took advantage of deficiency to knot in the epigastrium, battling with phlegm-fluids to form Pi (Glomus). Inability to swallow water is because Earth deficiency cannot control Water, and Cold fluids repel entry internally. Prescribed Banxia Xiexin Tang (Pinellia Decoction to Drain the Epigastrium). Lump flattened after two doses, symptoms reduced by 70-80% after another two, gradually accepting porridge. Exogenous pathogens combined with internal fluids are stubborn, not resolvable by simple exterior-releasing or interior-purging methods. Purging harms Zheng Qi; tonifying worsens Pi. However, abandoning this approach leaves no treatment method. Thus, Renshen and Dazao (Jujube) were used to stabilize deficient Stomach Qi, while Pao Jiang (Roasted Ginger), Banxia (Pinellia), Huangqin (Scutellaria), and Huanglian (Coptis) were added to resolve phlegm and eliminate pathogens, achieving the effect of dispersing Pi. Like a good official governing people, combining authority and benevolence, success was achieved.
Bao Ruixueyuan transmitted a formula for severe pain in bloody dysentery: Bai Zhi (Angelicae Dahuricae Radix) 5 qian wine-fried (added by Zhongchun); Zhike (Aurantii Fructus) and Huai Hua (Sophorae Flos) stir-fried together, Huai Hua removed, 5 qian; Shengma (Cimicifugae Rhizoma) 0.7 fen vinegar-fried; Zhen Chuan Lian (Coptidis Rhizoma) 5 qian ginger-juice fried; Huashi (Talcum) powder 3 qian; Rushi (Dragon's Blood) and Moyao (Myrrha) 0.75 fen each; Shan Zha (Crataegi Fructus) 3 qian; Gancao (Licorice) 0.5 fen. Tested with divine efficacy. (From *Guang Biji*).
Elder Lady Huang Ju'chuan, over eighty, accidentally contracted dysentery with chest oppression, fasting for days. I prescribed Shengma (Cimicifugae Rhizoma), Renshen (Ginseng), Huanglian (Coptis), and Lian Rou (Nelumbinis Semen). Renshen dosage reached 1 liang, shocking her sons. When asked again, I said: "Delay means no salvation." One dose of porridge, second dose abdominal rumbling, one bowel movement stopped dysentery. She is healthy at ninety-plus. (Same source).
Chen Chishi, Education Commissioner, caught cold from overwork during exam supervision, resulting in pure bloody dysentery. Doctors found it difficult. Prefect Chen said: "Only Miao Zhongchun can treat this." Messengers found him in Wu Men, traveling overnight to Wu Lin. Diagnosis identified the cause. Prescribed Renshen 5 qian, Shengma 0.7 fen, Zhi Gancao (Roasted Licorice) and Hong Qu (Red Yeast Rice) 1.5 qian each, Wumei (Mume Fruit) 2 pieces, Chuan Lian 3 qian, Baishao 2 qian, Lian Rou 20 grains. Decocted, mixed with 5 qian Huashi powder. Cured in two doses. Commissioner said: Dysentery stopped, but heart feels unsettled, unable to review papers. Zhongchun said: This is excessive mental labor, Summer-Heat invading. Added Zhuye (Bambusa Leaf), Ge Gen (Puerariae Radix), and Suan Zaoren (Ziziphi Spinosae Seed). Stable after one dose. (Same source).
Autumn of Gengzi year, Sister Hua returned home suddenly with dysentery, hundreds of times day and night, fever, vomiting dozens of times continuously. Wu doctors wanted to purge, saying "tonification equals death." At that time, Zhongchun stayed by the lake due to elder grandmother's illness, pitying her urgent need to settle affairs. He said: "Since danger is known, why not try medicine?" Administered Ru Jin Wan (Like Gold Pill - single herb Coptis rolled in ginger juice). Patient desired drink. I adhered to Zhongchun's previous formula: Renshen, Chao Baishao (Stir-fried Peony), Bian Dou (Lablab Bean), Shengma, Huashi, Zhi Gancao, Juhong (Tangerine Peel). Decocted, taken with Ru Jin Wan. Situation stabilized after two doses, cured after several more. Hu Shuibu remains grateful. (Same source).
A young nobleman went out in mid-summer, improper diet combined with summer heat led to dysentery. No medicine available en route, illness temporarily stopped. Returned home with persistent abdominal pain. Tried many doctors' prescriptions; pain worsened upon ingestion, no desire for water. Zhongchun examined and said: "This is Damp-Heat." Father said: "Doctors also treated as Damp-Heat, but condition worsened." Asked what medicines were used: Cang Zhu (Atractylodis Rhizoma), Huanglian (Coptis), Houpo (Magnolia Bark), Zhike, Chenpi. Zhongchun said: "Wrong. Cang Zhu is warm and drying, tends to close Qi, contraindicated in dysentery. The young master is Yin-deficient, especially unsuitable." Further prescribed 1 liang of Huashi (Talcum) powdered fine, boiled in Mudan Pi (Moutan Bark) juice. Separately, 5 qian Baishao wine-fried, 2 qian Zhi Gancao, 0.5 fen Chao Hei Gan Jiang (Charred Dried Ginger). Decocted and taken. Shortly after urination flowed heavily, pain stopped instantly. (Same source).
Qin Gongfan suffered dysentery. Doctor mistakenly used astringents, stopping dysentery after one dose. Damp-Heat had no exit, attacking limbs and joints, causing stiff neck, red eyes, swelling of shoulders, arms, wrists, knees, calves, severe pain preventing turning. Zhongchun sent a prescription: Baishao, Shihu (Dendrobium), Niuxi (Achyranthes), Mugua (Chaenomelis Fructus), Huangbai (Phellodendron), Yiyi Ren (Coix Seed), Zhi Gancao, Che Qian (Plantago), Fuling. Pain stopped but mobility remained impaired. Further prescribed Jili (Tribulus), Juhua (Chrysanthemum), Shouwu (Polygonum), Huma (Sesamum), Huangbai, Zhi Gancao. Recovered after over a year. Initially, a doctor gave Renshen and Baizhu, causing extreme pain almost leading to death. This case involved underlying Yin deficiency with Fire, compounded by Damp-Heat and Summer-Damp attack, named Li Feng (Dysentery Wind). Yin deficiency with Fire rejects tonification and drying; only mild cold and clearing formulas work over time. (Same source).
Yao Gongyuan's young son had dysentery. Doctor mistakenly purged, resulting in pure blood, panting, fever, anorexia. Miao used Renshen 4-5 qian, Shi Lian Zi (Stone Lotus Seed), Baishao, Shengma, Juhong, Gancao, Huashi, Jiangcan (Silkworm), Bai Biandou (White Lablab Bean). (Same source).
Lizhai treated a child with dysentery. Sudden use of astringents caused pain in Large Intestine meridian. Given Biandou, Huashi powder, Zhi Gancao. Panting and bleeding stopped after one dose, dysentery stopped after several. Advised: Child survives if pox does not appear within 100 days, due to unrecovered Yuan Qi. Soon, toxin flowed into tunnels. Treated with Siwu Tang (Four Substances Decoction) plus Taoren (Peach Kernel), Jiu Qin (Wine-fried Scutellaria), Honghua (Safflower), Shengma, Zhike, Chenpi, Gancao. Gradually improved. Due to young age and weak stomach, ultimately unsuccessful. Another patient used astringents, causing pain at Huantiao acupoint. Given previous formula minus Shengma, Chenpi, Gancao, plus Cang Zhu, Huangbai, Chaihu (Bupleurum), Qingpi (Aurantii Fructus Immaturus), Shengjiang (Fresh Ginger). Improved after ten-plus doses. Pricking Weizhong (BL40) released black blood, curing the condition. Blistering skin with hot water and picking blisters works too, but acupuncture is faster. (Weizhong is at the center of the popliteal crease, where the artery beats.)
Zhongchun's younger brother Zhiduan, childhood dysentery, dozens of times daily. Used Renshen 3 qian, Wuzhuyu (Evodia) 1 qian soaked seven times in Wuzhuyu Tang, Chuan Lian 1 qian ginger-juice fried. Last two steamed over rice, decocted and taken. If intolerant, give one spoon of medicine, interval with one spoon of rice gruel, slowly drinking. If headache/fever, add Hanshui Shi (Halloysit Rubra) 6 qian, Ge Gen 1 qian, mix separately with Liuyi San (Six-to-One Powder) 4 qian, taken cold. Cured in several doses.
Yu Yuanjing's concubine, five months pregnant, suffered dysentery with abdominal pain, defecating several times daily. Used Chuan Lian 4 qian, Baishao 3 qian, Huangqin 3 qian, Bai Biandou 2 qian, Lianzi 40 grains, Juhong 1.5 fen, Zhike 3 qian, Hong Qu 2 qian, Ge Gen 1.5 fen, Shengma 0.5 fen, Zhi Gancao 1 qian, Wumei 1 piece. After one cup, felt medicine moving, immediately passed stool, pain stopped, dysentery cured.
Han Hubu had a purple blister on left arm, red swelling at base, pulse large and Kou (hollow). Kou indicates blood loss or stasis. Han said: Bloody dysentery not healed. Used Shaoyao Tang two doses, then Baidu San (Resist Toxicity Powder) two doses. Both sore and dysentery cured.
Shen Mingsheng treated daughter-in-law of Mr. Wu, dysentery for forty days, poor appetite, fatigue. Original doctor thought chronic exhaustion required tonification. Shen examined and said: Since infection, rich foods never left mouth, old accumulation not removed, new accumulation arising. Form is deficient but symptoms are excess. Days are long but accumulation is fresh. Treatment should match initial presentation. First administered Daozhi Wan (Guide Stagnation Pill) twice, then combined tonification and resolution. Advised light diet. Fully recovered. Thus, the last three methods cannot be rigidly applied; besides observation, listening, palpation, inquiry is indispensable. Wu custom says "full belly prevents dying of dysentery," indulging in rich foods is like arming the enemy and feeding thieves. Prolonged spread leads to excess symptoms with deficient form. Tonifying hinders symptoms; purging worries deficiency. Started seeking much food, ended unable to eat. Pitiful. Recorded to warn those with dysentery who neglect diet.
Mother of Zhang Suwen, autumn dysentery, pulse and symptoms originally mild. Over-cautious, adhering to "elderly should not use cold" theory, changed doctors repeatedly, merely pleasing the host, prolonging illness. Finally consulted Shen, correcting past errors, cured primarily with Huanglian (Coptis). Tong Mingpei, Zhang's friend, also had chronic dysentery, urgently recommended Shen, saying Shen excels with Huanglian. Shen examined and told Zhang: "This requires Fuzi (Aconite) for cure." Zhang surprised, noting Tong's discharge color, pain, urinary difficulty, and duration similar to previous case, why such different hot/cold medicines? Shen said: Differentiation is key, hitting the target accurately. Tong's dysentery seemed hot, but asking revealed lower back pain always preceded urge to defecate. This revealed the root. Waist belongs to Kidney; urination/defecation are gates of Stomach/Kidney. Deficiency fails to secure closure, hence pain precedes defecation, unlike abdominal pain relieved by defecation. Past treatments used cold/purging, how could disease heal? First combined Lizhong Tang (Middle-Warming Decoction) and Bu Zhong Yi Qi Tang, then Bayi Wan (Eight-Ingredient Pill) to benefit Fire origin. Success achieved. Alas, same symptoms, different treatments, who says one method fits all? (Xiong Note: Lower back pain is evidence of Kidney deficiency, but Yin/Yang must be distinguished, not blindly using Guizhi/Fuzi. This autumn, Wang Yu Cang's wife suffered this for twenty days. Consulted me. Lower back pain, abdominal heaviness, scanty urine, dry mouth, irritability, red face, hungry but insomnia, pulse wiry-rapid stronger on left, dysentery not red-white, no fecal color mixed, difficult defecation, no dysentery color mixed. Warm-tonifying and unblocking ineffective. Slight lifting-clearing caused chest oppression. Menstruation delayed due to dysentery. I reasoned: Eating well, hard stool, no Fu organ stagnation, indicates Yin deficiency with Liver hyperactivity, fluid leaking sideways. Prescribed Congrong (Cynomorium), Gouqi (Goji), Wu Mei, Abalone, Ejiao (Donkey-hide Gelatin), Qinpi (Fraxinus Bark), Huangbai, Baizi Ren (Biota Seed), Baitouweng (Pulsatilla), Yinhua (Honeysuckle). Symptoms reduced immediately. Added Shudi (Rehmannia), Guishen (Angelica Root), Guiban (Turtle Shell), Lujiao (Deer Antler). Cured.)
Wu You sheng said: Autumn of Renyin year, I suffered severe dysentery. County treatment lasted over a month, breath faint, emaciated, observers fled. Mr. Ming Sheng arrived, examined and said: "How deep is this Summer-Heat invasion?" Family doubted, saying I sat in study, never went out, how could Summer-Heat invade? Master decided by finger, judged by heart, administered cooling agent. Effective after one dose, cured in few days. I made Dihuang (Rehmannia) in summer, soaked in wine, taking it out daily to expose to scorching sun, returning to wine at dusk. This continued for nearly a month. Foolishly thought Dihuang's spirit was in the wine, drank it, unaware heat toxicity accumulated in wine entered my lungs/intestines. Family didn't know, I didn't realize until cured deduction. Master alone knew depth of Summer-Heat invasion. Is his diagnosis not divine?
Nie Jiuwu said: Dysentery is dangerous, life-or-death. Ancient and modern treatments rarely perfect. With much experience, I gradually understood pathology, self-formulated this prescription, always effective, published widely, saving many lives. Patients must use authentic materials, especially do not arbitrarily modify. Formula uses Chuan Huanglian (Coptis), Tiao Huangqin (Scutellaria), Sheng Baishao (Peony), Shan Zha (Crataegus)...