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Dysentery, known in ancient times as "Zhi Xia" (Stagnant Downward Discharge). Loose stools constitute diarrhea (Xie Xie), while the discharge of pus and blood constitutes dysentery (Li). Red color indicates a blood-level pathology originating from the Small Intestine; white color indicates a Qi-level pathology originating from the Large Intestine; both are attributed to Damp-Heat. "Ji" refers to Food Stagnation, while "Zhi" refers to Qi Stagnation. When pathogenic matter desires to exit but is obstructed by Qi stagnation, it causes a sensation of bearing down, thus resulting in tenesmus (Li Ji Hou Zhong) characterized by urgent abdominal pain followed by incomplete evacuation. Liu Hejian discussed that harmonizing the Blood leads to natural ease of defecation, and regulating Qi eliminates tenesmus; this method is excellent. Zhang Zhongjing typically employed Chengqi Tang (Cathartic Decoction) to purge via the bowels, modifying the formula according to the severity of the illness. For pediatric patients, Xiaohei Wan (Little Black Pill) is used first to purge, followed by Qinlian Shaoyao Tang (Scutellaria and Coptis Peony Decoction). One must still adjust the assistant and guide herbs based on whether the pathology is in the Blood or Qi. Astringent medicines should not be used to stop dysentery unless the condition has persisted for a long time leading to deficiency.

Qinlian Shaoyao Tang (Scutellaria and Coptis Peony Decoction)
Ingredients: Shaoyao (Paeoniae Radix), Fuling (Poria), Chenpi (Citri Reticulatae Pericarpium), Houpo (Magnoliae Officinalis Cortex), Gancao (Glycyrrhizae Radix et Rhizoma), Huanglian (Coptidis Rhizoma), Huangqin (Scutellariae Radix), Zhiqiao (Aurantii Fructus Immaturus), Binglang (Arecae Semen), Shanzha (Crataegi Fructus), Mutong (Akebiae Caulis).
If there is bleeding, add Danggui (Angelicae Sinensis Radix) or Shengdihuang (Rehmanniae Radix); if the blood is dark purple, add Taoren (Persicae Semen) and Danggui shao (the tail of Angelicae Sinensis Radix); if there is abdominal pain, add Sharen (Amomi Fructus); if severe, add a small amount of Muxiang (Aucklandiae Radix), though this is unsuitable for bloody dysentery. If suffering from Jinkou Li (Throat-Closing Dysentery, inability to eat), add Rougui (Cinnamomi Cortex) or Wumei (Mume Fructus); if tenesmus is severe, add Shengma (Cimicifugae Rhizoma) and Chaihu (Bupleuri Radix); these may also be added if dysentery persists for a long time, to prevent the sinking of Yuan Qi (Primary Qi). If the stool resembles green grass juice, this is due to Wind-Toxin; add Fangfeng (Saposhnikoviae Radix) or Gange (Puerariae Lobatae Radix, i.e., Gegen). If abdominal pain is severe, add Ruxiang (Olibanum) and Moyao (Myrrha), which also treat Phlegm-Blood stasis. For chronic dysentery, add Diyü (Sanguisorbae Radix) and Puhuang (Typhae Pollen). If abdominal pain occurs due to Lung Metal Qi stagnating in the Large Intestine, use Kushen (Sophorae Flavescentis Radix) and Jiegeng (Platycodonis Radix). If the discharge resembles bean curd dregs, dampness is severe; add Fangfeng, or Jiuzhi Cangzhu (Atractylodis Rhizoma processed nine times). Huashi (Talcum) can also promote diuresis to drain dampness and may be added if urine volume is low. Once stagnation is cleared, use Baizhu (Atractylodis Macrocephalae Rhizoma) to strengthen the Spleen and regulate Qi. If hiccups occur, use Shidi (Diospyri Fructus), Pipaye (Eriobotryae Folium, de-haired and honey-fried), and Dingxiang (Syzygii Flos); if chronic and deficient, add Hezi (Terminalia Chebulae Fructus) and Roudoukou (Myristicae Semen). If fatigue, shortness of breath, and anorexia occur, this indicates accompanying deficiency; use Danggui (body and tail), Baizhu, and Chenpi. If extremely deficient, add Renshen (Ginseng Radix et Rhizoma) to tonify deficiency; once Qi recovers, dysentery will cease naturally. If bloody dysentery persists for a long time, it belongs to Yin Cold (Yin Lu), treated primarily with Siwu Tang (Four Substances Decoction). If dysentery does not heal after a long time due to Spleen Qi sinking, use Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) with doubled Shengma and Chaihu. If dysentery persists and later transforms into malaria, presenting with body edema, sallow complexion, abdominal pain, or foul-smelling watery diarrhea, and dull eyesight, use Yu Jia Dahei Wan (Master Yu's Large Black Pill) and Muxiang Bing (Aucklandia Cake) alternately. The previous formula should be decocted with Renshen, Baizhu, Muxiang, and Roudoukou.
For children aged seven or eight who pass pure blood, do not treat as Food Stagnation. Add Danggui or Shengdihuang, Diyü, Puhuang (vinegar-fried), Jingjie (Schizonepetae Herba), and Wumei to the previous formula to astringe blood. If the blood is dark purple, first use Dangguiwei (the tail of Angelicae Sinensis Radix) and Taoren to invigorate blood circulation. If both Qi and Blood are deficient and spirit is weak, administer Renshen, Baizhu, Danggui, Baishao (Paeoniae Radix Alba), Fushen (Poria cum Radix), and Huanglian, alternating with Dahei Wan and Muxiang Bing. If malaria transforms into dysentery, indicating pathogenic factors have penetrated deeply from the exterior into the Five Zang Organs, this condition is difficult to treat. For Jinkou Li caused by severe Stomach Heat, use one qian of Huanglian and three fen of Renshen, decocted in water to be sipped throughout the day; if vomiting occurs, take another sip, and upon swallowing, vitality returns. Alternatively, crush fresh snails, add Moshe (Moschus), grind together, apply to the umbilicus, and bind tightly to draw heat downward. For Xiuxi Li (Intermittent Dysentery), which stops and recurs, treat as a deficiency pattern. Cases where stool resembles dust/rotten matter, like leaking roof water, passing pure blood, anus straight as a bamboo tube, lips vermilion red, stool resembling fish brain, accompanied by fever and a large pulse, are all untreatable. This is a general discussion.

Dahei Wan (Also known as Baohe Wan)
Ingredients: Chao Xiangfu (Cyperi Rhizoma, stir-fried, 1 liang), Chao Houpo (stir-fried, 1 liang), Cu Qingpi (Citri Reticulatae Pericarpium Viride, vinegar-fried, 1 liang), Chenpi (1 liang), Shijunzi (Quisqualis Fructus, 1 liang), Binglang (1 liang), Cu Sanleng (Sparganii Rhizoma, vinegar-fried, 1 liang), Chao Gancao (stir-fried, 5 qian), Chao Shenqu (Medicated Leaven, stir-fried, 5 qian), Jiangzhi Huanglian (Coptidis Rhizoma, ginger-juice fried, 5 qian), Chao Maiya (Hordei Fructus Germinatus, stir-fried, 5 qian), Tu Baizhu (Atractylodis Macrocephalae Rhizoma, earth-fried, 1 liang), Cu Pengzhu (Curcumae Rhizoma, vinegar-fried, 1 liang), Shanzha (1.5 liang).
Make into honey pills, size of a longan seed. Take one pill per dose, swallowed with rice soup on an empty stomach.

Muxiang Bing (Aucklandia Cake)
Ingredients: Muxiang (1 qian), Chao Chenpi (stir-fried, 2 liang), Chao Shenqu (stir-fried, 1 liang), Chao Maiya (stir-fried, 1 liang), Wei Roudoukou (roasted Myristicae Semen, 1 liang), Renshen (0.5 liang), Houpo (0.5 liang), Wei Hezi Rou (roasted Terminalia Chebulae Fructus flesh, 1 liang), Chao Biandou (Vigna Cochinchinensis Seed, stir-fried, 1 liang), Chao Gancao (stir-fried, 0.5 liang).
Make into honey pills, size of a longan seed. Take one pill per dose, swallowed with rice drink on an empty stomach.