遗风庞 便痢未除，脉弦急，气不和，舌浓黄滑，潮热。姑宜清暑和中。（八月十四号
戊申初三日。）
焦六曲（四钱） 青蒿子（钱半） 大腹皮（三钱） 藿香梗（二钱） 六一散（三钱） 扁豆衣
（三钱） 省头草（二钱） 通草（钱半） 川朴（一钱） 炒麦芽（三钱） 仙半夏（钱半）
清煎三帖。
介按∶暑湿痢由于湿热郁滞肠胃，每至午后潮热，治以清暑渗湿，最为适当。
后马周 肠 久累，脉弦，舌滑，头晕而疼。宜黄连阿胶汤治之。（二月十二日。）
炒川连（八分） 炒白芍（钱半） 白头翁（钱半） 北秦皮（钱半） 赤茯苓（四钱） 枳壳（
钱半）
青木香（八分） 草决明（三钱，即青葙子） 炒驴胶（钱半） 荆芥炭（钱半） 通草（钱半）
（引）荷叶（一角）
一帖。
介按∶古之所谓肠 下血，即今之所谓赤痢也。兹以热入厥阴而为下痢，肝阳上越而为
头晕，治以黄连阿胶合白头翁汤，借清肝热而滋阴。
某 休息下痢，脉弦濡，跗浮脘闷，此湿热蕴蓄，宜和中清利。（三月十七日。）
秦艽（钱半） 藿梗（二钱） 炒枳壳（钱半） 猪苓（钱半） 浓朴（一钱） 原滑石（四钱）
青木香（七分） 泽泻（三钱） 大腹皮（三钱） 冬瓜皮（三钱） 新会皮（钱半）
清煎三帖。
又 休息下痢，圊而不爽，脉涩滞，胃钝，湿热犹存，舌微白。宜和中清利（三月二十
日。）
藿梗（二钱） 左金丸（八分） 川楝子（三钱） 大腹皮（三钱） 滑石（四钱） 炒枳壳（钱
半） 赤苓（三钱） 石莲子（三钱） 浓朴（一钱） 广木香（七分） 新会皮（钱半）
清煎三帖。
介按∶休息痢疾，多由病患贪食油腻，或由医者早投滋阴，以致湿热留恋，滞而不去。
兹因
湿热久蓄，伤及脾脏中气，中气一伤，则脾不能为胃行其津液，津液郁滞，则不能下润于大
肠，所以圊而不爽。初方从藿朴胃苓汤加减，次则参用平肝和胃。此后尚须参用补气之品，
庶奏桴鼓之应。
Patient Pang: Dysentery has not yet resolved; the pulse is wiry and rapid, qi mechanism is disharmonious, tongue coating is thick yellow and slippery, with tidal fever. Tentatively suitable to clear summerheat and harmonize the middle jiao. (August 14th, Lunar Calendar: Year of Wushen, 3rd day of the 3rd month.)
Prescription: Jiaoliuqu (Scorched Medicated Leaven) (4 qian), Qinghaozi (Artemisiae Annuae Fructus) (1.5 qian), Dafupi (Arecae Pericarpium) (3 qian), Huoxianggeng (Agastaches Rhizoma et Radix) (2 qian), Liuyisan (Six-to-One Powder) (3 qian), Biandouyi (Dolichoris Semen Testa) (3 qian), Shengtoucao (Perillae Folium) (2 qian), Tongcao (Tetrapanacis Medulla) (1.5 qian), Chuanpu (Magnoliae Officinalis Cortex) (1 qian), Chao Maiya (Fomentari Fructus Germinatus) (3 qian), Xian Banxia (Pinelliae Rhizoma Praeparatum) (1.5 qian).
Decoct in water, three doses.
Commentary by Shao Jie: Summerheat-damp dysentery arises from damp-heat stagnating in the intestines and stomach, often presenting with afternoon tidal fever. Treatment with clearing summerheat and leaching out dampness is most appropriate.
Patient Ma: Chronic intestinal wind disease, pulse is wiry, tongue coating is slippery, dizziness accompanied by pain. Suitable to treat with Huanglian Ejiao Tang (Coptis and Donkey-Hide Gelatin Decoction). (February 12th.)
Prescription: Chao Chuanlian (Stir-fried Coptidis Rhizoma) (8 fen), Chao Baishao (Stir-fried Paeoniae Radix Alba) (1.5 qian), Baitouweng (Pulsatillae Radix) (1.5 qian), Bei Qinpi (Fraxini Cortex) (1.5 qian), Chi Fuling (Poria with Red Hostwood) (4 qian), Zhiqiao (Aurantii Fructus) (1.5 qian), Qingmuxiang (Illicijii Fructus Aromaticus) (8 fen), Caojueming (Semen Cassiae, i.e., Qiangxiangzi) (3 qian), Chao Lujiao (Stir-fried Asini Corii Colla) (1.5 qian), Jingjie Tan (Carbized Schizonepetae Spica) (1.5 qian), Tongcai (Tetrapanacis Medulla) (1.5 qian, as guide herb), Heluye (Nelumbinis Folium) one corner.
One dose.
Commentary by Shao Jie: What ancient texts refer to as "intestinal wind with blood discharge" corresponds to what is now called red dysentery. Here, heat enters the Jueyin meridian causing dysentery, and Liver Yang floats upward causing dizziness. Treatment employs a combination of Huanglian Ejiao Tang and Baitouweng Tang to clear Liver heat and nourish Yin.
Certain patient: Resting dysentery, pulse is wiry and soggy, dorsum of foot is swollen, epigastric stuffiness. This indicates damp-heat accumulation and storage; suitable to harmonize the middle and clear/drain damp-heat. (March 17th.)
Prescription: Qinjiao (Gentianae Radix) (1.5 qian), Huogeng (Zingiberis Rhizoma Recens) (2 qian), Chao Zhiqiao (Stir-fried Aurantii Fructus) (1.5 qian), Zhuling (Polyporus) (1.5 qian), Nongpu (Magnoliae Officinalis Cortex) (1 qian), Yuanshishi (Raw Talcum) (4 qian), Qingmuxiang (Illicijii Fructus Aromaticus) (7 fen), Zexie (Alismatis Rhizoma) (3 qian), Dafupi (Arecae Pericarpium) (3 qian), Dongguapi (Benincasae Exocarpium) (3 qian), Xinhuiqi (Citri Reticulatae Pericarpium) (1.5 qian).
Decoct in water, three doses.
Follow-up: Resting dysentery, defecation is unsatisfactory, pulse is choppy and stagnant, stomach qi is dull/stagnant, damp-heat still remains, tongue coating is slightly white. Suitable to harmonize the middle and clear/drain damp-heat. (March 20th.)
Prescription: Huogeng (Zingiberis Rhizoma Recens) (2 qian), Zuojin Wan (Left Metal Pill) (8 fen), Chuanlianzi (Toosendan Fructus) (3 qian), Dafupi (Arecae Pericarpium) (3 qian), Shishi (Talcum) (4 qian), Chao Zhiqiao (Stir-fried Aurantii Fructus) (1.5 qian), Chi Ling (Poria with Red Hostwood) (3 qian), Shilianzi (Nelumbinis Nuciferae Semen) (3 qian), Nongpu (Magnoliae Officinalis Cortex) (1 qian), Guangmuxiang (Aucklandiae Radix) (7 fen), Xinhuiqi (Citri Reticulatae Pericarpium) (1.5 qian).
Decoct in water, three doses.
Commentary by Shao Jie: Resting dysentery often results from patients overindulging in greasy foods, or from physicians administering yin-nourishing herbs too early, causing damp-heat to linger and remain stagnant. In this case, long-standing damp-heat accumulation has damaged the Middle Qi of the Spleen. Once Middle Qi is injured, the Spleen cannot transport fluids for the Stomach; fluid stagnation prevents downward moistening of the Large Intestine, hence the unsatisfactory defecation. The initial prescription was modified from Huopo Weiling Tang (Agastache and Magnolia Bark and Poria Decoction); the second visit incorporated methods to soothe the Liver and harmonize the Stomach. Subsequently, Qi-tonifying herbs should be included to achieve rapid and effective results (like a drumstick striking a drum).