热邪内陷因成痢。凭症进剂莫雷同。用心调理起沉痼。勿轻劫涩图霸功。
麻之成痢。乃热邪内陷所致。多见于正收及收后。间有见于初热未出及正出之时者。亦有自
首至尾、而作痢不辄者。又有因久泻而成痢者。当分别治疗。不可混施。若于初热未出与正出之
时、而作痢者。药宜以疏托为君。行滞气为臣为佐。解毒为使。以葛根解肌汤（见第五条）少用葛
根。去赤芍、蝉蜕、木通、甘草。略加青皮、槟榔。再加防风主之。若麻已出透。身热未全退。毒瓦斯
流注而成痢者。以清热导滞汤。去白芍、楂肉、甘草、川浓朴。加生地黄、地骨皮、木通主之。若
麻毒未清。变成赤白痢者。以加减黄芩汤。去白芍、楂肉、甘草。加黑地榆、连翘、牛蒡子主之。如
麻后成痢。赤白腹痛者。以古方黄芩汤加枳壳治之。亦有久泻而成痢者。原因气血已虚。不得已。
用人参、黄连、枯黄芩、干姜煎汤。从权治之。如正收及收后、而下痢白色者。药宜用解毒凉血
行滞气之品。以静远主人黄芩汤、除去人参、木香、甘草。加生地黄、牛蒡子、连翘、防风主之。痢
下脓血者。以白头翁汤。去黄柏、加防风主之。或因食积下滞者。以消食化气为主。用枳壳汤。（见
四十九条）去甘草、加山楂、麦芽、木通、青皮主之。若腹中作胀。时痛时止者。以浓朴汤去干姜、
甘草。加槟榔、山楂主之。夫麻后成痢。乃积热移于大肠。以治麻后痢统方加减主之。（有以三苓
散、见三十七条、加木通枯黄芩治之者、）麻后下痢。而身热腹痛者。以古方黄连解毒汤（见三十
五条）治之。若壮盛之人。内有挟食、积滞、能食者。以三黄丸（见四十八条）利之。若麻后赤痢。
以四物汤（见二十五条）合古方黄连解毒汤（见三十五条）去栀仁。加当归尾、枳壳治之。稍轻
者。以四物汤（见二十五条）加姜汁炒黄连、地榆治之。如麻后白痢。以四物汤（见二十五条）加
陈皮、茯苓、木香。更有加生白术者。须宜酌用。麻后作痢。如兼小便赤涩者。以四物汤（见二十五
条）加车前子、木通治之。麻后痢症。或赤或白者。以四物汤（见二十五条）倍白芍、当归。加大
黄少许。以利泻数次。麻后泄泻成痢者。以四物汤（见二十五条）加地骨皮、酒炒黄芩主之。若麻
前已经泄泻。日久未曾清解。至于麻后变为休息痢。不问赤白。但见里急后重。昼夜无停者。此
余毒在大肠。乃积热移于大肠也。急宜行气养血。切不可妄施涩剂、以图霸功。河间曰。养血而
痢自止。行气则后重自除。诚格言也。宜以河间治久痢方。去人参、白芍药主之。（有用古方黄
芩汤、合天水、与香蔻丸、见六十三条、相间服者。有用静远主人黄芩汤、送下香蔻丸。体虚者、
香蔻丸内、更加人参。肠滑者、香蔻丸内、加榆根白皮治之者。实不若河间治久痢方之为当也。）
如自首至尾。辄痢不辍者。必有风毒留滞于内。宜解毒行滞。而兼疏风实脾之剂。庶几立应。以
清热导滞汤。去当归、淡竹叶。加防风、荆芥治之。（有用四君子汤、加山药吴茱萸治之者。猛而有
理。方并列后。）若痢而兼呕吐。噤口不食。更肠滑不止。或下鲜血。或下紫黯色。或下如痈脓。
或下如屋漏水。或下如鸡肝色。如黑豆汁之类。兼之气喘烦渴、热甚发呃、麻色紫晦者。皆不治
之症。
朱曰 治痢不外数法。曰清热、曰行滞、曰养血、曰凉血。有外感者兼解表。有宿食者兼
消导。至于日久气虚。无妨补气。阴血亏损。亦可养阴。惟麻证则必加以解毒。
清热导滞汤
黄连（酒炒） 槟榔 黄芩（酒炒） 生白芍 枳壳（曲炒） 浓朴（姜汁炒） 陈皮（各七分）
青皮 甘草（各三分） 连翘 牛蒡子（炒研各八分） 楂肉 当归 淡竹叶（各一钱） 灯心五十寸引
。水煎。加犀角末三分、调服。红多者。加红花（二分） 地榆桃仁酒炒（各八分） 闭涩甚者。与里急
后重之极者。加酒炒大黄（八分）
加减黄芩汤
黄芩 黄连 当归 枳壳 槟榔 青皮 泽泻 山楂 槐花 白芍 甘草 灯心引。
古方黄芩汤 治伏气发溢。小肠膀胱三焦胆腑合病自痢。
黄芩（一钱五分） 白芍（六分） 炙甘草（一钱） 大枣二枚引。加半夏（二钱） 名黄芩加半夏
汤。生姜引。
人参黄芩黄连干姜汤 治胃虚客热痞满。
人参 黄芩 黄连 炮干姜（各二钱） 水煎温服。
静远主人黄芩汤
黄芩 黄连 当归 枳壳 槟榔 青皮 川芎 木香 人参 甘草 水煎。调六一散服。
白头翁汤 治热痢下重。
白头翁 黄连 黄柏 秦皮 各等分。水煎温服。不愈再服。
浓朴汤 治脾胃虚作胀。腹中时痛时止。
浓朴（姜汁炒） 陈皮（去白） 茯苓 干姜 炙甘草 水煎服。
治麻后痢统方
黄连（酒炒） 黄芩（酒炒） 麦冬 防风 天花粉 元参 枳壳 牛蒡子 木通 栀仁 滑石
桔梗 赤芍 钩藤钩 甘草 二剂。水煎服。不愈。加猪苓、青皮。
河间治久痢方
当归 白茯苓 黄芩 车前子 陈皮 人参 白芍药 甘草 炮干姜少许为引。水煎服。
四君子汤
人参 白术（土炒） 白茯苓 甘草 红枣、姜引。
〔附〕治麻后痢丹方
西河柳 为末。以砂糖水调服四钱。
〔附〕万氏治麻后痢下鲜血验方
当归尾 生地黄 条子芩 黄连（酒炒） 枳壳（炒） 乌梅肉 人参 白芍 生甘草 水煎服。
Heat pathogen sinking inward causes dysentery. Medication should be prescribed based on symptoms, avoiding uniformity. Attentive management can cure severe ailments; do not lightly use astringents to seek rapid results.
Measles complicated by dysentery is caused by heat pathogen sinking inward. It is mostly seen during the resolution phase and after resolution of measles, occasionally appearing when the initial fever has not yet emerged or during the eruption phase. There are also cases where dysentery persists from beginning to end, and cases where prolonged diarrhea transforms into dysentery. Treatment must be differentiated and cannot be mixed indiscriminately. If dysentery occurs during the initial fever before emergence or during the eruption phase, the medication should prioritize dispersing and pushing out toxins (Chief herb), moving stagnant Qi as Assistant and Adjunct herbs, and detoxifying as Envoy herbs. Use Gegen Jieji Tang (Pueraria Decoction for Unbinding the Muscle Layer) (see Article 5), with a small amount of Puerariae Radix (Gegen), removing Paeoniae Radix Rubra (Chishao), Cicadae Periostracum (Tuiqiao), Akebia Caulis (Mutong), and Glycyrrhizae Radix et Rhizoma (Gancao). Add slightly Qingpi and Arecae Semen (Binglang), plus Saposhnikoviae Radix (Fangfeng) as the main treatment. If measles have fully erupted but body heat has not completely subsided, and toxin flow leads to dysentery, use Qingre Daoshi Tang (Clear Heat and Guide Out Stagnation Decoction), removing Paeoniae Radix Alba (Baishao), Crataegi Fructus (Sharen), Glycyrrhizae Radix et Rhizoma (Gancao), and Magnoliae Officinalis Cortex (Houpo). Add Rehmanniae Radix (Shengdihuang), Lycii Cortex (Digupi), and Akebia Caulis (Mutong) as the main treatment. If measles toxin is not cleared and transforms into red and white dysentery, use Jiajian Huangqin Tang (Modified Scutellaria Decoction), removing Paeoniae Radix Alba (Baishao), Crataegi Fructus (Sharen), and Glycyrrhizae Radix et Rhizoma (Gancao). Add Sanguisorbae Radix (Hei Diyu), Forsythiae Fructus (Lianqiao), and Arctii Fructus (Niubangzi) as the main treatment. If dysentery occurs after measles with red and white stool and abdominal pain, treat with ancient Fang Huangqin Tang (Scutellaria Decoction) added with Aurantii Fructus (Zhike). In cases where prolonged diarrhea turns into dysentery due to deficiency of Qi and Blood, Ren Shen (Ginseng Radix et Rhizoma), Coptidis Rhizoma (Huanglian), dried Scutellariae Radix (Kuhuangqin), and Zingiberis Rhizoma (Ganjiang) are decocted in water for emergency treatment. If white dysentery occurs during or after measles resolution, medications should include those that detoxify, cool blood, and move stagnant Qi. Use Jingyuan Zhuren Huangqin Tang (Master Jingyuan's Scutellaria Decoction), removing Ren Shen (Ginseng Radix et Rhizoma), Aquilariae Lignum Resinatum (Muxiang), and Glycyrrhizae Radix et Rhizoma (Gancao). Add Rehmanniae Radix (Shengdihuang), Arctii Fructus (Niubangzi), Forsythiae Fructus (Lianqiao), and Saposhnikoviae Radix (Fangfeng) as the main treatment. For dysentery with pus and blood, use Baitouweng Tang (Pulsatillae Decoction), removing Phellodendri Cortex (Huangbai), adding Saposhnikoviae Radix (Fangfeng) as the main treatment. If caused by food stagnation leading to lower obstruction, focus on digesting food and transforming Qi, using Zhike Tang (Aurantii Fructus Decoction) (see Article 49). Remove Glycyrrhizae Radix et Rhizoma (Gancao), add Crataegi Fructus (Shanzha), Malto (Maiya), Akebia Caulis (Mutong), and Citri Reticulatae Pericarpium Viride (Qingpi) as the main treatment. If abdominal distension occurs with intermittent pain, use Houpo Tang (Magnoliae Officinalis Decoction) removing Zingiberis Rhizoma (Ganjiang) and Glycyrrhizae Radix et Rhizoma (Gancao), adding Arecae Semen (Binglang) and Crataegi Fructus (Shanzha) as the main treatment. Dysentery after measles is due to accumulated heat transferring to the Large Intestine; treat with Tongfang for Measles Post-Dysentery with modifications (Some use Sanling San (Three-Poria Powder) (see Article 37) added with Akebia Caulis (Mutong) and dried Scutellariae Radix (Kuhuangqin)). For post-measles dysentery with body heat and abdominal pain, treat with ancient Fang Huanglian Jiedu Tang (Coptis Decoction for Clearing Heat and Detoxifying) (see Article 35). For robust individuals with internal food retention and stagnation who can eat, use Sanhuang Wan (Three-Yellows Pill) (see Article 48) to purge. For post-measles red dysentery, combine Siwu Tang (Four-Substance Decoction) (see Article 25) with ancient Fang Huanglian Jiedu Tang (Coptis Decoction for Clearing Heat and Detoxifying) (see Article 35), removing Gardeniae Fructus (Zhiren), adding Angelicae Sinensis Radix (Dangguiwei) and Aurantii Fructus (Zhike). For milder cases, use Siwu Tang (Four-Substance Decoction) (see Article 25) added with Ginger-processed Coptidis Rhizoma (Huanglian) and Sanguisorbae Radix (Diyu). For post-measles white dysentery, use Siwu Tang (Four-Substance Decoction) (see Article 25) added with Citri Reticulatae Pericarpium (Chenpi), Poria (Fuling), and Aquilariae Lignum Resinatum (Muxiang); some add Atractylodis Macrocephalae Rhizoma (Baizhu), which should be used judiciously. For post-measles dysentery accompanied by dark and difficult urination, use Siwu Tang (Four-Substance Decoction) (see Article 25) added with Plantaginis Semen (Cheqianzi) and Akebia Caulis (Mutong). For post-measles dysentery, whether red or white, use Siwu Tang (Four-Substance Decoction) (see Article 25) doubling Paeoniae Radix Alba (Baishao) and Angelicae Sinensis Radix (Danggui), adding a small amount of Rheum Palmatum (Dahuang) to induce defecation several times. For post-measles diarrhea turning into dysentery, use Siwu Tang (Four-Substance Decoction) (see Article 25) added with Lycii Cortex (Digupi) and Wine-processed Scutellariae Radix (Huangqin) as the main treatment. If diarrhea occurred before measles and was not cleared for a long time, leading to chronic intermittent dysentery after measles regardless of color, characterized by tenesmus and constant day-and-night occurrence, this is residual toxin in the Large Intestine, i.e., accumulated heat transferring to the Large Intestine. Urgently promote Qi movement and nourish Blood; absolutely do not recklessly use astringents to seek rapid results. Liu Hejian said: Nourishing Blood stops dysentery naturally; moving Qi relieves tenesmus naturally. This is indeed a golden rule. Use Hejian's Formula for Chronic Dysentery, removing Ren Shen (Ginseng Radix et Rhizoma) and Paeoniae Radix Alba (Baishao) as the main treatment. (Some use ancient Fang Huangqin Tang (Scutellaria Decoction) combined with Tianshui San (Sky-Water Powder) and Xiangkou Wan (Xiangkou Pill) (see Article 63), taken alternately; some use Jingyuan Zhuren Huangqin Tang (Master Jingyuan's Scutellaria Decoction) to wash down Xiangkou Wan; for deficient bodies, add Ren Shen (Ginseng Radix et Rhizoma) to Xiangkou Wan; for slippery intestines, add Ulmi Cortex (Yugenbaipi) to Xiangkou Wan. These are not as appropriate as Hejian's Formula for Chronic Dysentery.) If dysentery persists continuously from beginning to end, wind-toxin must be滞留 internally. Detoxify and move stagnation, combined with formulas that disperse wind and strengthen the Spleen, will yield immediate results. Use Qingre Daoshi Tang (Clear Heat and Guide Out Stagnation Decoction), removing Angelicae Sinensis Radix (Danggui) and Houttuyniae Herba (Danzhuyeqian), adding Saposhnikoviae Radix (Fangfeng) and Schizonepetae Spica (Jingjie) as the main treatment. (Some use Sijunzi Tang (Four-Gentlemen Decoction) added with Dioscoreae Rhizoma (Shanyao) and Evodiae Fructus (Wuzhuyu), which is potent and logical; the formula is listed below.) If dysentery is accompanied by vomiting, inability to eat (Jinkou), continuous intestinal slipping, or passage of fresh blood, purple-dark blood, pus like abscesses, water leaking from a roof, chicken liver-colored stool, or black bean juice-like stool, combined with panting, irritability, thirst, severe heat causing hiccups, and purplish-dull measles color, these are all incurable conditions.
Zhu said: Treating dysentery involves a few methods: clearing heat, moving stagnation, nourishing blood, and cooling blood. If there is an external contraction, combine with releasing the exterior; if there is retained food, combine with digestion. For long-standing Qi deficiency, tonifying Qi is acceptable; for Yin and Blood depletion, nourishing Yin is also possible. However, for measles syndromes, detoxification must always be added.
Qingre Daoshi Tang (Clear Heat and Guide Out Stagnation Decoction)
Coptidis Rhizoma (Huanglian, wine-fried) 1.0g, Arecae Semen (Binglang) 1.0g, Scutellariae Radix (Huangqin, wine-fried) 1.0g, Paeoniae Radix Alba (Baishao, raw) 1.0g, Aurantii Fructus (Zhike, stir-fried with yeast) 1.0g, Magnoliae Officinalis Cortex (Houpo, stir-fried with ginger juice) 1.0g, Citri Reticulatae Pericarpium (Chenpi) 1.0g each.
Citri Reticulatae Pericarpium Viride (Qingpi) 0.5g, Glycyrrhizae Radix et Rhizoma (Gancao) 0.5g each, Forsythiae Fructus (Lianqiao) 1.0g, Arctii Fructus (Niubangzi, stir-fried and ground) 1.0g each, Crataegi Fructus (Sharen) 1.0g, Angelicae Sinensis Radix (Danggui) 1.0g, Houttuyniae Herba (Danzhuyeqian) 1.0g each. Use 50 cun of Juncus Effusus (Dengxin) as guide. Decoct in water, add 0.1g of Rhinocerotis Cornu (Xijiao) powder, mix and take. If redness is predominant, add Carthami Flos (Honghua) 0.1g, Sanguisorbae Radix (Diyu) and Persicae Semen (Taoren) wine-fried 1.0g each. If constipation/severe blockage or extreme tenesmus, add Rheum Palmatum (Dahuang) wine-fried 1.0g.
Jiajian Huangqin Tang (Modified Scutellaria Decoction)
Scutellariae Radix (Huangqin), Coptidis Rhizoma (Huanglian), Angelicae Sinensis Radix (Danggui), Aurantii Fructus (Zhike), Arecae Semen (Binglang), Citri Reticulatae Pericarpium Viride (Qingpi), Alismatis Rhizoma (Zexie), Crataegi Fructus (Shanzha), Sophorae Flavescentis Flos (Huaihua), Paeoniae Radix Alba (Baishao), Glycyrrhizae Radix et Rhizoma (Gancao). Use Juncus Effusus (Dengxin) as guide.
Ancient Fang Huangqin Tang (Scutellaria Decoction) treats Fuqi (Hidden Pathogen) eruption. Small Intestine, Bladder, Sanjiao, and Gallbladder organs combined disease causing spontaneous dysentery.
Scutellariae Radix (Huangqin) 1.5g, Paeoniae Radix Alba (Baishao) 0.6g, Honey-processed Glycyrrhizae Radix et Rhizoma (Zhigancao) 1.0g. Use two Jujubes (Dazao) as guide. Add Pinelliae Rhizoma (Banxia) 2.0g, named Huangqin Banxia Tang (Scutellaria and Pinellia Decoction). Use Fresh Ginger (Shengjiang) as guide.
Renshen Huangqin Huanglian Ganjiang Tang (Ginseng, Scutellaria, Coptis, and Dried Ginger Decoction) treats Stomach deficiency with guest heat causing fullness.
Ren Shen (Ginseng Radix et Rhizoma), Scutellariae Radix (Huangqin), Coptidis Rhizoma (Huanglian), Roasted Zingiberis Rhizoma (Paoganjiang) 2.0g each. Decoct in water, take warm.
Jingyuan Zhuren Huangqin Tang (Master Jingyuan's Scutellaria Decoction)
Scutellariae Radix (Huangqin), Coptidis Rhizoma (Huanglian), Angelicae Sinensis Radix (Danggui), Aurantii Fructus (Zhike), Arecae Semen (Binglang), Citri Reticulatae Pericarpium Viride (Qingpi), Chuanxiong Rhizoma (Chuanxiong), Aquilariae Lignum Resinatum (Muxiang), Ren Shen (Ginseng Radix et Rhizoma), Glycyrrhizae Radix et Rhizoma (Gancao). Decoct in water, mix with Liuyi San (Six-to-One Powder) and take.
Baitouweng Tang (Pulsatillae Decoction) treats Heat dysentery with heaviness in the lower part.
Pulsatillae Radix (Baitouweng), Coptidis Rhizoma (Huanglian), Phellodendri Cortex (Huangbai), Bark of Chinese Privet (Qinpi) in equal parts. Decoct in water, take warm. Repeat if not cured.
Houpo Tang (Magnoliae Officinalis Decoction) treats Spleen and Stomach deficiency causing distension and intermittent abdominal pain.
Magnoliae Officinalis Cortex (Houpo, stir-fried with ginger juice), Citri Reticulatae Pericarpium (Chenpi, pith removed), Poria (Fuling), Zingiberis Rhizoma (Ganjiang), Honey-processed Glycyrrhizae Radix et Rhizoma (Zhigancao). Decoct in water and take.
Tongfang for Measles Post-Dysentery (General Formula for Post-Measles Dysentery)
Coptidis Rhizoma (Huanglian, wine-fried), Scutellariae Radix (Huangqin, wine-fried), Ophiopogonis Tuber (Maidong), Saposhnikoviae Radix (Fangfeng), Trichosanthis Radix (Tianhuafen), Scrophulariae Radix (Yuanshen), Aurantii Fructus (Zhike), Arctii Fructus (Niubangzi), Akebia Caulis (Mutong), Gardeniae Fructus (Zhiren), Talcum (Huashi), Platycodonis Radix (Jiegeng), Paeoniae Radix Rubra (Chishao), Uncaria Rhynchophylla (Goutenggou), Glycyrrhizae Radix et Rhizoma (Gancao). Two doses. Decoct in water and take. If not cured, add Polyporus (Zhuling) and Citri Reticulatae Pericarpium Viride (Qingpi).
Hejian's Formula for Chronic Dysentery
Angelicae Sinensis Radix (Danggui), White Poria (Baifuling), Scutellariae Radix (Huangqin), Plantaginis Semen (Cheqianzi), Citri Reticulatae Pericarpium (Chenpi), Ren Shen (Ginseng Radix et Rhizoma), Paeoniae Radix Alba (Baishaoyao), Glycyrrhizae Radix et Rhizoma (Gancao). Use a little Roasted Zingiberis Rhizoma (Paoganjiang) as guide. Decoct in water and take.
Sijunzi Tang (Four-Gentlemen Decoction)
Ren Shen (Ginseng Radix et Rhizoma), Atractylodis Macrocephalae Rhizoma (Baizhu, earth-fried), White Poria (Baifuling), Glycyrrhizae Radix et Rhizoma (Gancao). Use Red Dates (Hongzao) and Ginger as guide.
[Appendix] Danfang for Treating Post-Measles Dysentery
Salix Westfordiana (Xihe Liu) ground into powder. Mix with sugar water and take 4 qian.
[Appendix] Wan Shi's Verified Formula for Post-Measles Dysentery with Fresh Blood
Angelicae Sinensis Radix Tail (Dangguiwei), Rehmanniae Radix (Shengdihuang), Scutellariae Radix (Tiaoziqing), Coptidis Rhizoma (Huanglian, wine-fried), Aurantii Fructus (Zhike, stir-fried), Pruni Semen Armeniacae Amarum (Wumei Rou), Ren Shen (Ginseng Radix et Rhizoma), Paeoniae Radix Alba (Baishao), Raw Glycyrrhizae Radix et Rhizoma (Shenggancao). Decoct in water and take.