杂痢,谓痢色无定,或水谷,或脓血,或青,或黄,或赤,或白,变杂无常,或杂色相
兼而痢也。挟热则黄赤,热甚则变脓血也;冷则白,冷甚则青黑,皆由饮食不节,冷热不调
,胃气虚,故变易。
休息痢者,胃脘有停饮,因痢积久,或冷气,或热气乘之,气动于饮,则饮动,而肠虚
受之,故为痢也。冷热气调,其饮则静,而痢亦休也。肠胃虚弱,易为冷热,其邪气或动或
静,故其痢乍发乍止,谓之休息痢也。
白滞痢者,肠虚而冷气客之,搏于肠间,津液凝滞成白,故为白滞痢也。
痢如膏者,是由脏腑虚冷,冷气入于大肠成痢,冷气积肠,又虚滑,脂凝如膏也。
此由岁时寒暑不调,则有湿毒之气伤人,随经脉血气,渐至于脏腑。大肠虚者,毒瓦斯乘
之,毒瓦斯挟热,与血相搏,则成血痢也。毒瓦斯侵食于脏腑,如病蛊注之家,痢血杂脓瘀黑,
有片如鸡肝,与血杂下是也。
肠蛊痢者,冷热之气入在肠间,先下赤,后下白,连年不愈,侵伤于脏腑,下血杂白,
如病蛊之状,名为肠蛊痢也。
肠垢者,肠间津汁垢腻也。由热痢蕴积,肠间虚滑,所以因下痢而便肠垢也。
夫四方之气,温凉不同,随方嗜欲,因以成性。若移其旧土,多不习伏。必因饮食以入
肠胃,肠胃不习,便为下痢,故名不伏水土痢也,即水谷痢是也。
Za Li (Miscellaneous Dysentery) refers to dysentery where the color of the discharge is not fixed; it may contain water and undigested food, pus and blood, or be green, yellow, red, or white. The changes are chaotic and irregular, sometimes presenting mixed colors in the dysenteric stool. When accompanied by Heat, the stool appears yellow and red; when Heat is severe, it transforms into pus and blood. When accompanied by Cold, the stool appears white; when Cold is severe, it turns green or black. All these are caused by unregulated diet, imbalance of Cold and Heat, and deficiency of Stomach Qi, leading to alterations in bowel movements.
Xiu Xi Li (Resting Dysentery) occurs due to retained fluids in the epigastrium. After prolonged dysentery, Cold or Heat pathogenic factors invade. The movement of Qi agitates the retained fluids, causing them to move, and the empty intestines are affected, resulting in dysentery. When the Cold and Heat pathogens harmonize, the retained fluids become still, and the dysentery subsides. Due to the weakness of the intestines and stomach, they are susceptible to Cold and Heat. The pathogenic factors fluctuate between activity and stillness, causing the dysentery to flare up and cease intermittently; this is called Resting Dysentery.
Bai Zhi Li (White Stagnant Dysentery) occurs because the intestines are empty and Cold pathogenic factors lodge within, contending in the intestinal space. This causes body fluids to stagnate and turn white, resulting in White Stagnant Dysentery.
Dysentery resembling paste/grease is caused by deficiency and Cold of the Zang-Fu organs. Cold pathogenic factors enter the Large Intestine causing dysentery. The accumulation of Cold in the intestines, combined with intestinal deficiency and slipping, causes lipids to coagulate like grease.
This condition arises from the imbalance of seasonal Cold and Heat, generating Damp-Toxic Qi that harms the human body. Following the meridians and Blood-Qi, it gradually reaches the Zang-Fu organs. If the Large Intestine is deficient, Toxic Qi takes advantage of this deficiency. The Toxic Qi, carrying Heat, contends with Blood, forming Blood Dysentery. The Toxic Qi invades and damages the Zang-Fu organs. Similar to patients suffering from Gu Zhu (Gu Infestation Disease), the dysenteric blood is mixed with pus and dark瘀 (stasis), containing pieces resembling chicken liver, which are discharged mixed with blood.
Chang Gu Li (Intestinal Gu Dysentery) occurs when Cold and Heat pathogenic factors enter the intestines. Initially, red stool is passed, followed by white stool. It persists for years without healing, invading and damaging the Zang-Fu organs. The discharge consists of blood mixed with white substances, resembling the symptoms of Gu disease, hence named Intestinal Gu Dysentery.
Chang Gou (Intestinal Filth) refers to the turbid and sticky nature of fluids in the intestines. It is caused by the accumulation of Heat Dysentery over time, making the intestines deficient and slippery, thus leading to the passage of intestinal filth along with dysentery.
The Qi of the four directions varies in warmth and coolness. People adapt their desires and constitutions according to their local environments. If one moves to a new place, they often fail to adapt ("Fu"). Food and drink enter the stomach and intestines, but the digestive system is unaccustomed to the new environment, leading to diarrhea/dysentery. Therefore, it is called Bu Fu Shui Tu Li (Dysentery due to Non-Adaptation to Local Water and Soil), which is also known as Shui Gu Li (Water and Grain Dysentery).