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This condition arises from the weakness of the intestines and stomach, which are injured by wind pathogens. Consequently, heat is carried along; when heat attacks the blood, the blood flows and infiltrates into the intestines, mixing with the dysenteric discharge, thus resulting in red dysentery (Chi Li).

In cases of chronic red dysentery, it is due to physical deficiency where heat attacks the blood, causing blood to seep into the intestinal cavity, hence the red stool. The intestines and stomach remain weak and fail to return to equilibrium, while the heat persists, leading to a prolonged course without recovery. If the stomach qi rebels upward, it transforms into vomiting or hiccups. If stomach deficiency leads to a decline in grain qi, parasites may become active and erode the digestive tract, transforming into *Gu* (a severe abdominal disorder caused by parasites or putrefaction).

Blood dysentery occurs because heat-toxins damage the blood, causing it to infiltrate the large intestine. Blood follows qi, circulating through the meridians and passing through the zang-fu organs, normally without stagnation. When toxic heat takes advantage of this, encountering a deficient intestine, the blood infiltrates the bowel. Since a deficient intestine leads to diarrhea, blood dysentery results. If the body is hot, death ensues; if the body is cold, survival is indicated. Upon diagnosis, if the pulse at the Guan position is Khou (floating, large, and empty, like pressing a scallion), accompanied by massive bloody stools and sudden profuse hemorrhage of several sheng, it indicates severe blood loss.

This also stems from physical deficiency receiving heat, where heat damages the blood, causing it to infiltrate the intestines, forming blood dysentery. If the heat does not subside and the stomach remains deficient and unrecovered, the bloody dysentery persists for a long time, often transforming into vomiting, hiccups, and damp-type *Gu*.

In spring, yang qi is on the exterior. When people engage in movement and labor, the couli (pores and interstices) open. Those with deficient qi and blood are injured by wind. By summer, heat qi attacks them. The nature of blood becomes fluid and scattered when heated. If the large intestine is deficient, blood infiltrates it, struggling with the fluids in the intestines. Accumulated heat condenses, transforming blood into pus. A deficient intestine leads to diarrhea, thus forming pus-and-blood dysentery. Therefore, many suffer from pus-and-blood dysentery in summer due to intestinal and stomach weakness. Diagnosing the spleen pulse: if slightly choppy (Se), it indicates internal ulceration with frequent passage of bloody pus. If the pulse is Xuan Jue (suspended and extreme, lacking stomach qi), death ensues; if slippery and large, survival is indicated. A slight and small pulse indicates survival; a solid and urgent pulse indicates death. A deep, fine, deficient, and slow pulse indicates survival; a rapid, large pulse with heat indicates death.

Chronic pus-and-blood dysentery occurs when heat-toxins invade the meridians, and blood infiltrates the intestines, transforming into pus-and-blood dysentery. Prolonged heat that does not subside further weakens the intestines and stomach, causing the dysentery to persist indefinitely, eventually transforming into damp-type *Gu*, vomiting, and hiccups.

Cold dysentery arises from the weakness of the intestines and stomach, which have been invaded by cold qi. A deficient intestine leads to diarrhea, hence it is called cold dysentery. Dysentery with green, white, or black color all belongs to cold dysentery. Yellow and red colors belong to heat syndromes. Therefore, white dysentery with undigested food is termed Han Zhong (cold invading the middle jiao). Diagnosis of the pulse: a deep pulse indicates survival; a floating pulse indicates death.