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Dysentery is caused by the accumulation and failure to disperse of turbid qi in the five zang organs. It may result from aversion to cold foods, exposure to cold or heat, irregular eating habits (fasting or overeating), leading to an inability of qi mechanism to circulate freely; it may also arise from excessive consumption of cold/raw foods or binge eating, or from taking too many warm/hot medicines, causing qi stagnation that transforms into dysentery. If diarrhea occurs within two or three days and presents as a cold syndrome, yet blue/green purulent stools (indicating heat) are treated with cooling methods, this is erroneous. Consider skin sores: initially, puncturing them yields blood; only after many days do they suppurate. Why is it said that heat precedes cold?

Wang Shuhe stated: "Excess dampness easily leads to five types of diarrhea, with intestinal sounds like thunder rushing." Ignorant physicians fail to understand that yellow stool appearing after three days indicates heat, while green diarrhea indicates cold. The *Tai Su* states: The five types of diarrhea include loose stool (*tang xie*), undigested food diarrhea (*sun xie*), soft/wet diarrhea (*ru xie*), and slippery diarrhea (*hua xie*). These constitute the five diarrheas. Regarding colors: blue/green corresponds to the image of Liver Wood; red corresponds to Heart Fire; white corresponds to Lung Metal of the West; yellow corresponds to Spleen Earth; and cyan/blue-green corresponds to Kidney Water following beneath Earth Qi. Stool becoming cyan after three days indicates cold; yellow/red indicates heat. Thus, the notion that "three days later" determines the nature is incorrect.

If lower discharge involves extreme heat, frequent episodes with distressing pain, or chronic persistence unresponsive to various medications, purgative methods must be employed to expel damp-heat, obstruction, and accumulated stagnation, thereby allowing qi and fluids to circulate freely. One should use draining methods to simultaneously dissipate and promote the flow of accumulated heat.

**Yiyuan San (Benefit Prime Powder):** Treats fever, vomiting, dysentery, diarrhea, intestinal disorders, bloody/purulent dysentery, urinary retention, and painful dribbling. It promotes urination and primarily treats stone strangury (caused by excessive intake of mineral hot medicines, which condense into sand/stones passed via urine). It clears cold/heat accumulations in the stomach, disperses stagnant qi, unblocks the nine orifices and six fu organs, generates body fluids, removes retained clumps, resolves water retention, quenches thirst, relieves chest fullness, eliminates irritability and restlessness, and alleviates abdominal distension and pain. It tonifies the five zang organs, greatly nourishes Spleen and Kidney qi (note: the Kidney is the storehouse of water, not the primary organ governing water metabolism). It regulates internal injury-induced impotence, calms the soul and stabilizes the spirit, tonifies the five labors and seven injuries, and addresses all deficiencies. It treats epilepsy, palpitations (rapid heartbeat), forgetfulness, irritability, shortness of breath, cough due to organ damage, difficulty swallowing, muscle pain, mouth ulcers, and dental caries. It brightens the eyes and ears, strengthens sinews and bones, unblocks meridians, harmonizes blood and qi, aids digestion of food and water, preserves primordial essence, resolves toxicity from drugs, alcohol, and food, enhances tolerance to labor and hunger/thirst, dissipates heat, and protects against external and internal pathogenic invasions. Long-term use strengthens willpower, lightens the body, rejuvenates complexion, and extends lifespan. It resolves summerheat, cold damage, epidemics, damage from hunger/fullness/labor, emotional disturbances (worry, thought, anger), infectious plagues, residual heat after sweating, and relapse from overexertion. It resolves simultaneous cold damage of exterior and interior, unblocks systemic stagnation, harmonizes qi for recovery, assists lactation and childbirth, treats postpartum qi/blood deficiency, yin deficiency with severe heat, and all heat syndromes. It also treats breast engorgement and mastitis. This is a miraculous immortal medicine. However, pregnant women should not take it, as it causes miscarriage.

Ingredients: Amomum fruit (Sharen), Talcum (Huashi) (each 2 liang); Licorice root (Gancao), honey-fried (4 qian).
Process: Grind into powder. Take 2 qian per dose, mixed with a little honey and warm water (honey is optional). Take three times daily. For those desiring cold drinks, mix with fresh cool water.
For cold damage with fever, mix 4 qian with Scallion White and Fermented Soybean Decoction. (Recipe for decoction: 2 cups water, 5 cun scallion whites, 50 grains fermented soybeans; boil to 1 cup.) Take three doses until effective.
This formula is cold and cooling, resolving depressed heat. Even if the condition is severe and unresolved, taking more of this medicine is harmless, beneficial rather than detrimental. Laypeople dislike its cold nature and consider it a cheap, common substance. Unaware of the principles of creation in the *Su Wen*, they ignore the miraculous efficacy recorded in the *Ben Cao* and rarely use it. Verified by symptoms, it is indeed an immortal medicine for ordinary people and should not be omitted.
In cases of cold damage where sweating is indicated but purgation is contraindicated, or vice versa, accidental ingestion of this medicine may induce sweating and cure the disease, or clear interior heat. For half-exterior/half-interior conditions suitable for harmonization rather than sweating, vomiting, or purging, this medicine often cures or provides slight relief. It resolves constraint. For severe heat, a modified Liangge San is better for harmonization. For those who should not sweat, add 2 fen of Atractylodes macrocephala powder, decocted with scallion whites and fermented soybeans. For pregnant women who should not take the standard formula (due to Talcum, Ephedra, and Cinnamon Twig promoting sweating), use Licorice root (1 liang) and Atractylodes macrocephala (2 liang) ground together. Take 4 qian with 1.5 cups water, plus 5 cun scallion whites and 50 fermented soybeans; decoct to 0.6 cups, strain, and drink warm. Three doses, aiming for mild sweating.
"Biodu San" (Expel Toxin Powder) can be taken by non-pregnant women. "Taibai San" adds 2 liang of Ephedra stem (Mahuang, removed joints) to the base, decocted normally; known as "Shenbai San" (Divine White Powder). Alternatively, Biodu San combined with equal parts Ephedra and Atractylodes is called "Qinglong San" (Green Dragon Powder) in the *Jizhong Fang*. Adding double amounts of Talcum and Atractylodes to Qinglong San makes it an excellent diaphoretic. For cases correctly indicated for sweating, using this results in increased heat, named "Da Biodu San" (Great Expel Toxin Powder). This resolves simultaneous exterior-interior cold damage; combine with decocted Liangge San and 4 qian of Yiyuan San. For lactation, take 4 qian with pork noodle soup or wine, three times daily, accompanied by meat/noodle porridge. For inducing labor, take 3 qian with warm oil water, two to three doses, until delivery. For retained dead fetus, take 5 qian of Yiyuan San mixed with one dose of Sanyi Chengqi Tang; repeat with warm oil water frequently. Both anterior and posterior expulsion of the fetus saves the mother. Dystocia or retained dead fetus is caused by wind-heat dryness/astringency, causing tight stagnation preventing natural dilation. When the medicine's power arrives, heat stagnation opens, facilitating birth. Do not use warm tonics, which generate dryness-heat. Laypeople mistakenly believe postpartum weakness is purely cold-deficiency, ignoring heat signs, and wrongly use hot tonics. They also deny water to thirsty patients, causing harm. Treatment requires assessing zang-fu and six qi excess/deficiency, identifying root and branch, and treating accordingly. While this medicine is commonly effective, laypeople criticize its versatility as reckless. Variants include adding Lead tetroxide (Huangdan) for "Hongyu San" (Red Jade Powder), Indigo naturalis (Qingdai) for "Biyu San" (Jasper Powder), or Mint leaves (Boheye) for "Jisu San" (Chicken Mint Powder). Efficacy remains the same, merely to avoid lay criticism.

**Xuanqing Wan (Black-Green Pill):** Treats severe dysentery with frequent distressing pain, chronic cases unresponsive to other drugs. Requires purgation to clear damp-heat, obstruction, and stagnation, promoting qi/fluid circulation. Also treats accumulated heat from alcohol/food, sallow emaciation, abdominal fullness, edema, and pediatric convulsive malnutrition, heat accumulation, and breast lumps. Contraindicated in diarrhea.
Ingredients: Coptis rhizome (Huanglian), Phellodendron bark (Huangbai), Rhubarb (Dahuang), Kansui root (Gansui), Genkwa flower (Yuanhua - vinegar-soaked, fried), Large Spurge root (Daji) (each 0.5 liang); Morning Glory seed (Qianniu) (4 liang, 1 liang grass powder); Calomel (Qingfen) (2 qian); Indigo naturalis (Qingdai) (2 liang).
Process: Grind all to powder, sprinkle water to make pills size of small beans. Initial dose: 10 pills, increasing by 10 per dose. Take on empty stomach in morning with wine. Stop when bowels move freely. Maintenance: 15-20 pills. Resume eating after several days. For chronic cases, increase dose to achieve purgation. After purgation, resume maintenance dosage based on condition. Pediatric pills: millet/mustard seed size. For persistent pediatric heat/convulsions, take 10 pills regularly.

**Ejiao Meilian Wan (Donkey-hide Gelatin and Smoked Plum Pill):** Treats dysentery regardless of duration or color (red, white, blue, black) or pain.
Ingredients: Donkey-hide gelatin (Ejiao, fried in clean ash until transparent, pounded separately), Smoked plum flesh (Wumei, pitted, fried), Phellodendron bark (Huangbai, chopped, fried), Coptis rhizome (Huanglian), Angelica sinensis root (Danggui, baked), Red Peony root (Chishaoyao), Ginger (Ganjiang, roasted), Red Poria (Chifuling, peeled). Equal parts.
Process: Grind to powder, mix with Ejiao, water-pelletize to wisteria seed size. Take 10 pills with warm rice broth before meals, and 5-6 times at night. Pediatric pills: mung bean size. Avoid greasy/fatty foods.

**Niuhuang Shenjin Wan (Calculus Bovis Divine Gold Pill):** Treats vomiting/diarrhea-dysentery in adults and children, new or old, any color, with or without thirst, with or without difficult urination. Also treats pediatric convulsive malnutrition, heat accumulation, fixed masses, abdominal fullness/hardness/pain, and promotes digestion.
Ingredients: Calomel (Qingfen), Sublimated Arsenic Oxide (Fenshuang), Realgar (Xionghuang), Cinnabar (Zhusha), Arsenolite (Xinpi), Croton seed (Badou, peeled) (each 1 qian); Lead tetroxide (Huangdan), Beeswax (Lazhi) (each 3 qian). Note: Arsenic compounds require careful handling.
Process: Grind Fenshuang first, then add arsenic compound, grind fine. Add Xionghuang, Zhusha, Xinpi, grind again. Add Huangdan powder, mix well. Separate Badou, crush to oil, mix with previous powders. Heat gently, remove heat, soften wax, mix in, roll into pills size of small beans. Adult dose: 1 pill with fresh cool water. Pediatric dose: millet/mustard seed size.
For stopping vomiting/diarrhea-dysentery, mix with Ganlu San (Guiling Ganlu Yin) or Yiyuan San.

**Shaoyao Bapi Wan (Peony and Phellodendron Bark Pill):** Treats all damp-heat malignant dysentery with rising qi and distressing pain, with or without pus/blood.
Ingredients: White Peony root (Shaoyao), Phellodendron bark (Bapi) (each 3 liang); Angelica sinensis root (Danggui), Coptis rhizome (Huanglian) (each 0.5 liang).
Process: Grind to powder, water-pelletize to small bean size. Take 30-40 pills with warm water, anytime, including 5-6 times at night. Avoid greasy/fatty/spicy foods.

**Ersheng Wan (Two Victories Pill):** Treats diarrhea-dysentery with deficiency/exhaustion, new or old.
Ingredients: Salted fermented soybeans (Yanchi), Purple garlic (Zisuan, peeled). Equal parts.
Process: Pound into paste, pelletize to wisteria seed size. Take 3-9 pills with rice broth.
If unresolved, or for bloody/purulent dysentery with abdominal/flank pain, switch to Xingren Wan.

**Xingren Wan (Apricot Kernel Pill):** Treats all bloody/purulent diarrhea-dysentery with abdominal pain and tenesmus.
Ingredients: Apricot kernel (Xingren) (49 pieces), Croton seed (Badou) (49 pieces, peeled).
Process: Char both until carbonized but retaining properties, grind to mud-like consistency, mix with melted wax, pelletize to wisteria seed size. Take 1-2 pills with decocted Rhubarb tea, every other day.

**Baizhu Sheng Sanzi (White Atractylodes Holy Powder):** Treats chronic diarrhea-dysentery unresponsive to treatment, and postpartum dysentery.
Ingredients: Poppy shell (Yumiqiao, 2 liang, honey-fried), Angelica sinensis root (Danggui), Nutmeg (Roudoukou), Cardamom (Suosharen), Pomegranate peel (Shiliupi), Chebula fruit (Hezi), Ginger (Ganjiang, roasted), Tangerine peel (Chenpi, peeled), White Atractylodes rhizome (Baizhu), Licorice root (Gancao), Peony root (Shaoyao) (each 1 liang).
Process: Grind to fine powder. Take 2 qian, decoct with 1 large cup water and Frankincense (Ruxiang), drink with dregs.

**Shengjin Gao (Victory Gold Ointment/Paste):** Treats persistent diarrhea-dysentery with floating/hyperactive stomach pulse, lasting many days. Stops small-volume diarrhea immediately.
Ingredients: Croton peel (Badoupi), Mulberry fruit (Chushi) (charred together).
Process: Grind to powder, mix with melted wax, pelletize to mung bean size. Take 5 pills with decocted Licorice tea.

**Dasheng Zhenjin San (Great Sage True Gold Powder):** Treats all cold-heat loose stools, bloody/purulent dysentery.
Ingredients: Poppy shell (Yumiqiao, 0.5 jin, fried), Licorice root (Gancao, 1 liang, honey-fried), Ginger (Ganjiang, 0.5 liang, roasted), Angelica sinensis root (Danggui, 1 liang), Sour Pomegranate peel (Suan Shiliupi, 1 liang, fried), Tangerine peel (Chenpi, peeled), White Poria (Baifuling, peeled) (each 1 liang).
Process: Grind to powder. Take 2 qian, decoct with 1 cup water (0.5 cup for children) and Frankincense to 0.7 cup volume. Take before meals. Avoid greasy/cold/toxic foods.

**Cheqianzi San (Plantago Seed Powder) (aka Duanni San):** Treats all persistent dysentery.
Ingredients: Plantago seed (Cheqianzi, amount unspecified, fried until fragrant).
Process: Grind to powder. Take 2 qian with rice broth, before meals on empty stomach.

**Xianggu San (Elephant Bone Powder):** Treats Spleen/Stomach deficiency, chest/abdominal fullness, indigestion, belching/acid regurgitation, vomiting after eating, cholera, bloody/purulent diarrhea, heavy limbs, umbilical/abdominal pain with tenesmus, frequent nocturnal urges, loss of appetite.
Ingredients: Elephant bone (Xianggu, 4 liang, fried), Chebula fruit flesh (Hezi, 2 liang), Nutmeg (Roudoukou, 1 liang), Licorice root (Gancao, 2 liang), Ginger (Ganjiang, 0.5 liang).
Process: Grind to powder. Take 3 qian, decoct with 1.5 cups water to 0.8 cup volume. Drink hot with dregs, before meals, three times daily.

**Haige Yufen San (Clam Shell Jade Powder):** Treats bloody dysentery, clearing visceral accumulated heat/toxins.
Ingredients: Clam shell (Haige, amount unspecified).
Process: Grind to powder. Take 2 qian, mix with a little honey, dissolve in cold water. Take anytime.