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One must not solely employ cold-natured herbs; rather, acrid and warm herbs should be added to the cold-natured ones, such as cold herbs soaked or stir-fried in wine, or Coptidis Rhizoma (Huanglian, 黄连) boiled in wine.
If there is heat, Siwu Tang (Four Substances Decoction) with stir-fried Gardeniae Fructus (Zhizi, 栀子), Cimicifugae Rhizoma (Shengma, 升麻), Gentianae Macrophyllae Radix (Qinjiao, 秦艽), and prepared Eucommiae Cortex (Duzhong, 注：原文为阿胶珠 Ejiao Zhu, Donkey-hide Gelatin Pearl) may be used.
Lower rectal bleeding due to deficiency can be treated with Danggui San (Angelica Powder), which is Siwu Tang (Four Substances Decoction) plus roasted Zingiberis Rhizoma (Ganjiang, 干姜) and Cimicifugae Rhizoma (Shengma, 升麻).
Another prescription: use Baizhi Wupeizi Wan (Angelica Dahurica and Chinese Tallow Tree Galla Pill).
When using blood-stopping herbs, one must not act solely to stop bleeding without addressing the root cause.
If wind-pathogen has sunk downward, lifting and raising methods are appropriate. This is because wind damages the Liver, and the Liver generates blood. If dampness damages the blood, resolving dampness and clearing heat is suitable.
The *Neijing* states that body heat leads to death, while cold leads to survival. This is a general statement; one must examine accompanying symptoms for accurate judgment. Are there not cases today where body heat results in survival and cold results in death?
A pulse that is deep, small, lingering, or faint indicates an easy-to-treat condition.
A pulse that is floating, large, surging, or rapid indicates a difficult-to-cure condition. A slippery pulse is favorable, whereas a wiry pulse is unfavorable.
Zhang Zhongjing’s treatment of dysentery includes five warming methods and ten cooling methods. Some involve releasing the exterior, some promote urination, and some await spontaneous resolution; the distinction between easily treatable and difficult conditions is extremely precise. However, this overlaps with diarrhea, and the legislative principles are not clearly distinguished. Students should differentiate these.
Pain in the anus requires either warming or cooling treatments.
For chronic illness, cold body, spontaneous sweating, and a deep, small pulse, warming is appropriate.
For acute illness, hot body, and a floating, surging pulse, cooling is appropriate.
Some cases may be treated with emesis, some with purgation, and some with diaphoresis.
At the onset, when primordial qi is not yet deficient, pushing out the pathogen is necessary; this is a general method. After a short time, if qi becomes deficient, this method should not be used.
Watery diarrhea preceding pus and blood indicates transmission from Spleen to Kidney; this is a "hostile pathogen" and is difficult to cure.
Pus and blood preceding watery diarrhea indicates transmission from Kidney to Spleen; this is a "mild pathogen" and is easy to cure.
Stool resembling bean juice indicates dampness. Since the Spleen and Stomach are the sea of water and grain, receiving all substances, they often involve the four other zang organs. Thus, like mixed colors, one should first promote unblocking and draining; this follows the principle of "meeting and depriving" (attacking the pathogen at its source). If it is a deficiency pattern, careful examination is also required.
If caused by heat, toxic hot herbs such as Crotonis Fructus (Badou, 巴豆) must not be used. If caused by injury from cold foods, they might be used, but caution is advised.
Additionally, epidemic dysentery, where infection spreads within a region or family with similar symptoms, requires understanding the fluctuations of climate qi (Yunqi) before treating accordingly.