分在气、在血治，赤属血，白属气。身热、后重、腹痛。身热者，挟外邪，法当解表，不恶寒用小柴胡去参；
后重，积与气郁坠在下之故，兼升兼消；腹痛者，是肺金之气郁在大肠之间，以苦梗发之，然后用治痢药。气用气药，
血用血药。下痢腹痛人实者，宜用刘氏之法下之，然后随气血用治痢之药。下血多主食积与热，当凉血活血，当归、
桃仁、黄芩之类，或有用朴硝者。青六丸治血痢效，以六一散一料炒红曲半两，能活血，以饭为丸。腹痛者，宜温
散药，如姜桂之属以和之。如有热，用黄芩、芍药之类。壮者与初病者。宜下之；虚弱衰老者，宜升之。一痢初得
之时，一二日间，法当利，大小调胃承气汤下之，看其气血而用药。气病用参术，血病用四物汤为主，有热先退热。后
重者，当和气，木香、槟榔之类。因积作后重者，保和丸主之。五日后不可下，脾胃虚故也。保和丸方∶山楂肉（三
两） 神曲（二两） 陈皮 半夏 茯苓（以上各一两） 连翘（五钱） 莱菔子（五钱） 上炒七味为末，粥丸，姜
汤下，或加白术二两。下痢初发热，必用大承气汤下之，后随证用药。下痢久不止发
热者，属阴虚，用寒凉药，必兼升药热药用。一本云∶血久
不止，发热者，属阴虚，四物为主。下痢后，身发热者，有外感。初下腹痛，不可用参术，虽气虚胃虚者，皆不可
用。下血有风邪下陷，宜升提之，盖风伤肝，肝主血故也。有湿伤血，宜行湿清热。后重者，积与气坠下，当
和气，兼升兼消，木香、槟榔之类。不愈，用皂角子煨大黄、当归、桃仁、黄连、枳壳作丸，盖后重大肠风盛故也。下
痢病，有半死半生者，二下如鱼脑者，半死半生；身热脉大者，半死半生。有不治证者五∶下血者死；下如尘腐色
者死；下如屋漏水者死；下痢唇如朱砂红者死；下痢如竹筒者不可治。夫痢而能食，胃未病也。若脾胃湿热之毒，熏蒸
清道而上，以致胃口闭塞，遂成禁口证。一方治禁口痢，香莲丸与莲肉各半，研末，半汤调下。治禁口痢，脐中用
田螺人麝香少许，捣烂盒之，以引其热就下，热去则欲食也。治痢方∶苍术、白术、条芩、当归、白芍药、生地
黄、青皮、黄连、滑石、甘草，作一服，白水煎，里急后重，炒连、滑石，加桃仁、槟榔，甚者加大黄，呕者加半夏
姜煎。又方∶干姜（一钱） 当归（二钱半） 乌梅（三个） 黄柏（一钱半） 黄连（二钱） 上作一服，白水煎。
孙郎中因饮食过多，腹膨满，痢带白色，用苍术、白术、浓朴、甘草、茯苓、滑石，煎下保和丸三十粒。又方有炒曲。
痢后脚弱渐细∶苍术（二两） 酒芍药（二两半） 龟板（三两） 酒柏（半两） 上末之，粥丸，以四
物汤加陈皮、甘草煎汤吞之。痢后腰痛，两脚无力∶陈皮 半夏 白芍药（以上各一钱） 茯苓 苍术 当归 酒芩（以
上各半钱） 白术（一钱） 甘草（二钱） 上作一服，姜三片煎，食前服。一人泄泻，辛苦劳役，下利白积，滑
石末炒陈皮、芍药、白术、茯苓、甘草，上煎，食前服。一妇人痢后，血少肚痛，以
川芎、当归、陈皮、芍药，上煎，调六一散服。一方治久
痢∶罂粟壳（半两） 樗白皮（一钱） 黑豆（二十一粒） 上同煎，食前服。痢时气发热，苍术、浓朴、赤芍药、
当归、黄芩、黄柏、地榆、粟壳、枳壳、槟榔、木香、甘草、干姜，鲜血痢加黄连，小便不通加滑石、车前子，痢下
血水奈何？加阿胶。治痢丸子，侧柏叶、黄连、黄柏、黄芩、当归、芍药、粟壳、生地黄、地榆、枳壳、香附、木
香、槟榔，米糊丸，下七八十丸。有食有积、腹痛加莪术、三棱、缩砂。饮酒之人脏毒，如血痢状，乃平日饮酒之过，
遂成此病，先宜戒酒而药可愈∶苍术（一钱） 赤芍药（二钱） 炒槐花（一钱半） 地榆（二钱） 枳壳（一钱） 炙
甘草（三分） 黄连（炒五分） 干葛（二钱） 当归（五分） 上作一帖，清水煎，食前顿服，愈。又方∶樗皮
（二两） 神曲（炒五钱） 白芍药（一两） 滑石（炒一两） 枳壳（五钱） 上为末，烂饭丸，桐子大，米饮下
七十丸。久下痢数月不能起床，饮食不进，惫弱之甚以∶人参（五分） 白术（一钱） 黄 （五分） 当归（六分）
芍药（一钱） 炙甘草（三分） 粟壳（三钱） 实地榆（五分） 木香（三分） 缩砂（五分） 陈皮（一钱） 升
麻（三分） 白豆蔻仁（三分） 泽泻（五分） 上作一帖。有热加黄芩，脉细，四体恶寒加干姜或煨肉豆蔻、川附
数片，服数帖渐自进食。湿热下痢，小便涩少，烦渴能食，脉洪大缓，腹痛后重，夜多痢下，桂苓甘露饮送保和丸
三十丸。一作胃苓汤送下。湿多热少，脾胃不和，食少腹痛，后重，夜多利下，胃苓汤送保和丸三十丸。一作桂苓甘
露饮送下。气虚面色黄白，或体肢倦懒之人，频并痛，后重不食，脉细弱，或有汗出，黄 建中汤吞保和丸三十丸。
湿热不渴者，建中汤如苍术、茯苓，吞保和丸。脾胃不和，食少腹胀痛，后重痢下，脉弦紧，平胃散加芍药、官
桂、葛根，或白术茯苓汤送保和丸。下痢白积，黄芩芍药汤加白术、陈皮、甘草、滑石、桃仁。下痢赤积，身热，
益元散加木通、炒芍药、炒陈皮、白术、煎，送下保和丸。一老人因饮白酒，作痢下，淡血水脓，腹痛，小便不通，里
急后重，人参、白术、滑石、苍术、槟榔、木香、甘草，上煎下保和丸二十五丸。第二日前证俱减，惟小便不利，用益
无散。仲景治痢，凡言可下，率用承气汤，大黄之寒，其性善走，佐以浓朴之温，善行滞气，缓以甘草之甘，饮以汤
液，灌涤肠胃，滋润轻快，无所留碍，积行即止。刘河间发明滞下证，尤为切要。有曰∶行血则便自愈，调气则后重
自除，此实盲者之日月，聋者之雷霆也。一人患利不进饮食，四君子加芎、归、药、陈皮、炒曲、黄连、砂仁、半
夏、生姜煎服。东易胡兄年四十余，患痢病已百日，百药治不效。时九月初，其六脉急促，沉弦细弱，左手为甚，日
夜数十行，视瘀物甚少，惟下清滞，有紫黑血丝，食全不进，此非痢，当作瘀血治之。间瘀血何由而致？如饱后急
走，极力叫骂，殴打 扑，多受疼痛，一怒不泄，补塞太过，火酒火肉，皆能致之。盖此人去年枉受杖责，经涉两
年，有此瘀血，服药后，得瘀血则生矣。遂以乳香、没药、桃仁、滑石，佐以木香、槟榔，以曲糊为丸，米汤下百余
粒，夜半又不动，又根据前法下二百粒，至天明大下秽物，如烂鱼肠，约一二升，困顿终日，渐与粥而安。一人患痢后
甚逼迫。一人患痢，善食易饥已见《医要》，世俗类用涩药治痢与泻，若积久而虚者，或可行之，而初得者，必变他
证，为祸不小。殊不知多因湿，惟分利小水，最是长策。《内经》谓∶下体热，却死；寒、即生。此大概言之耳，必兼
证详之方可。今岂无身热而生寒、而死者乎？脉沉小流连或微者，易治；浮洪大数者，难治。脉宜滑大，不宜弦
急。仲景治痢，可温者五法；可下者十法；或解表或利小
便或待其自己区分易治、难治极密，但与泻同，立论不分，学人当辨之。大孔痛，一曰温之，一曰清之。按久病身
冷，自汗，脉沉小者，宜温；暴病，或身热，脉浮洪者，宜清；身冷自汗，用温药；有可吐者，有可汗者，有可下者。
初得时，元气未虚，必推荡之，此通因通用法，稍久，气虚则不可也。赤痢乃小肠来，白痢自大肠来，皆湿热为本，
赤白带，赤白浊同。先水泄，后脓血，此脾传肾，贼邪难愈；先脓血，后水泻，此肾经传脾，是谓微邪易愈。下如
豆汁者，湿也，盖脾胃为水谷之海，无物不受，常兼四脏，故如□□之相染，当先通利，此迎而夺□□义如虚，宜审
之。因热而作不可用巴豆等药，如伤冷物者，或可用，宜谨之。又有时疫作痢，一方一家之内，上下相传染者相
似，此却宜用运气之胜伏以治之。禁口痢，此胃口热结，用黄连多加人参，湿煎呷之，如吐了又呷；当开以降之。人
不知此，多用温药甘味，以火济火，以滞益滞也。亦有误服热药，毒瓦斯犯胃，当推明而祛其毒。
痢疾的治疗需区分病位在气分还是血分，便血多属血分病变，便白多属气分病变。若伴有身热、里急后重、腹痛等症状：身热者，为兼夹外邪，治法应当解表，若不恶寒，可用小柴胡汤去人参；里急后重，是由于积滞与气机郁结下坠所致，治疗需兼顾升提与消导；腹痛者，是肺金之气郁结在大肠之间，需用桔梗宣发肺气，然后再用治疗痢疾的药物。气分病用理气药，血分病用活血药。下痢且腹痛，体质壮实者，适宜采用刘河间的攻下法进行泻下，随后再根据气血情况使用治疗痢疾的药物。便血多因食积与热邪引起，应当凉血活血，选用当归、桃仁、黄芩等药物，有时也可使用朴硝。青六丸治疗血痢效果显著，配方为将六一散一料与炒红曲半两混合，能活血，以米饭为丸服用。腹痛者，适宜用温散药物，如生姜、肉桂之类来调和。若有热象，使用黄芩、芍药等药物。体质壮实及初患病者，宜用攻下法；体弱衰老者，宜用升提法。痢疾初起的一两天内，治法应当通利，用大小调胃承气汤泻下，观察其气血状况再用药。气分病用人参、白术，血分病以四物汤为主，若有热先退热。里急后重者，应当调和气机，用木香、槟榔等药物。因积滞导致后重的，以保和丸为主方。发病五日后不可再用攻下法，因为脾胃已虚。保和丸方剂组成：山楂肉三两，神曲二两，陈皮、半夏、茯苓各一两，连翘五钱，莱菔子五钱。以上七味炒制后研为细末，用米粥泛丸，姜汤送服，也可加白术二两。下痢初起发热，必须用大承气汤泻下，随后随证用药。下痢日久不止且发热者，属于阴虚，使用寒凉药物时，必须兼用升提药和温热药。另一版本说：便血日久不止且发热者，属于阴虚，以四物汤为主。下痢后身体发热者，是有外感。初起腹痛，不可用人参、白术，即使是气虚、胃虚者，也都不可用。便血若因风邪下陷，宜用升提法，因为风邪伤肝，肝主藏血。若因湿邪伤血，宜行湿清热。里急后重者，因积滞与气机下坠，当调和气机，兼用升提与消导，用木香、槟榔等药物。若无效，用皂角子煨大黄、当归、桃仁、黄连、枳壳制成丸剂，这是因为大肠风盛导致后重。痢疾病中，有半死半生预后的情况：大便像鱼脑一样者，半死半生；身体发热、脉象洪大者，半死半生。有五种不治之证：下血者死；大便像尘土腐色者死；大便像屋漏水者死；下痢嘴唇像朱砂红者死；下痢像竹筒一样通畅无阻者不可治。痢疾若能进食，说明胃气未败。若是脾胃湿热之毒，熏蒸清道而上，导致胃口闭塞，遂成禁口痢。一方治疗禁口痢，用香连丸与莲子肉各半量，研为细末，一半用汤水调服。治疗禁口痢，可在脐中放田螺并加少许麝香，捣烂敷贴，以引热下行，热去则欲进食。治疗痢疾的方剂：苍术、白术、黄芩、当归、白芍药、生地黄、青皮、黄连、滑石、甘草，作一剂，白水煎服，若有里急后重，用炒黄连、滑石，加桃仁、槟榔，严重者加大黄，呕吐者加半夏姜汁煎服。又一方：干姜一钱，当归二钱半，乌梅三个，黄柏一钱半，黄连二钱，作一剂，白水煎服。孙郎中因饮食过多，腹部膨满，下痢带白色，用苍术、白术、厚朴、甘草、茯苓、滑石煎服，并送服保和丸三十粒。另一方中有炒神曲。痢疾后脚部软弱逐渐变细：苍术二两，酒浸芍药二两半，龟板三两，酒浸黄柏半两。研为细末，米粥泛丸，用四物汤加陈皮、甘草煎汤吞服。痢疾后腰痛，两脚无力：陈皮、半夏、白芍药各一钱，茯苓、苍术、当归、酒黄芩各半钱，白术一钱，甘草二钱。作一剂，加生姜三片煎服，饭前服用。一人泄泻，因辛苦劳役，下利白积，用滑石末、炒陈皮、芍药、白术、茯苓、甘草煎服，饭前服用。一妇人痢疾后，血少肚痛，用川芎、当归、陈皮、芍药煎服，调入六一散服用。一方治疗久痢：罂粟壳半两，樗白皮一钱，黑豆二十一粒。一同煎服，饭前服用。痢疾时气分发热，用苍术、厚朴、赤芍药、当归、黄芩、黄柏、地榆、粟壳、枳壳、槟榔、木香、甘草、干姜，鲜血痢加黄连，小便不通加滑石、车前子，痢下血水怎么办？加阿胶。治疗痢疾的丸子：侧柏叶、黄连、黄柏、黄芩、当归、芍药、粟壳、生地黄、地榆、枳壳、香附、木香、槟榔，米糊泛丸，每次服七八十丸。有食积、腹痛加莪术、三棱、缩砂。饮酒之人患脏毒，症状如血痢，这是平日饮酒过度所致，应先戒酒然后用药可愈：苍术一钱，赤芍药二钱，炒槐花一钱半，地榆二钱，枳壳一钱，炙甘草三分，黄连炒五分，干葛二钱，当归五分。作一帖，清水煎，饭前顿服，痊愈。又一方：樗皮二两，神曲炒五钱，白芍药一两，滑石炒一两，枳壳五钱。研为细末，烂饭泛丸，梧桐子大，米饮送下七十丸。久痢数月不能起床，饮食不进，极度疲惫虚弱：人参五分，白术一钱，黄芪五分，当归六分，芍药一钱，炙甘草三分，粟壳三钱，实地榆五分，木香三分，缩砂五分，陈皮一钱，升麻三分，白豆蔻仁三分，泽泻五分。作一帖。有热加黄芩，脉细，四肢恶寒加干姜或煨肉豆蔻、川附子数片，服数帖后逐渐能进食。湿热下痢，小便涩少，烦渴能食，脉洪大缓，腹痛后重，夜间多痢下，用桂苓甘露饮送服保和丸三十丸。一作胃苓汤送服。湿多热少，脾胃不和，食少腹痛，后重，夜间多痢下，用胃苓汤送服保和丸三十丸。一作桂苓甘露饮送服。气虚面色黄白，或肢体疲倦懒惰之人，频繁腹痛，后重不食，脉细弱，或有汗出，用黄芪建中汤吞服保和丸三十丸。湿热但不口渴者，用建中汤加苍术、茯苓，吞服保和丸。脾胃不和，食少腹胀痛，后重痢下，脉弦紧，用平胃散加芍药、官桂、葛根，或用白术茯苓汤送服保和丸。下痢白积，用黄芩芍药汤加白术、陈皮、甘草、滑石、桃仁。下痢赤积，身热，用益元散加木通、炒芍药、炒陈皮、白术煎服，送下保和丸。一老人因饮白酒，患痢下，淡血水脓，腹痛，小便不通，里急后重，用人参、白术、滑石、苍术、槟榔、木香、甘草煎服，送下保和丸二十五丸。第二天前证均减轻，惟小便不利，用益元散。张仲景治疗痢疾，凡是说可以攻下的，通常用承气汤，大黄性寒，善于走窜，佐以厚朴之温，善于行滞气，缓以甘草之甘，用汤液灌涤肠胃，滋润轻快，无所留碍，积滞去除即止。刘河间阐发滞下证，尤为切要。他说：行血则便自愈，调气则后重自除，这真是对盲人而言如见日月，对聋人而言如闻雷霆。一人患痢疾不进饮食，用四君子汤加川芎、当归、白芍、陈皮、炒神曲、黄连、砂仁、半夏、生姜煎服。东易胡兄年四十余岁，患痢疾已百日，百药治疗无效。当时九月初，其六脉急促，沉弦细弱，左手更甚，日夜数十次，视瘀物甚少，只下清稀滞浊之物，有紫黑血丝，食物完全不进，这不是痢疾，当作瘀血治疗。问瘀血从何而来？如饱饭后急走，极力叫骂，殴打扑跌，多受疼痛，一怒不泄，补塞太过，火酒火肉，皆能致之。大概此人去年枉受杖责，经过两年，有此瘀血，服药后，排出瘀血则生机复现。遂用乳香、没药、桃仁、滑石，佐以木香、槟榔，以曲糊为丸，米汤送下百余粒，半夜仍未动，又按前法下二百粒，至天明大下秽物，如烂鱼肠，约一二升，困顿终日，渐给粥而安。一人患痢后甚逼迫。一人患痢，善食易饥已见《医要》，世俗常用涩药治疗痢疾与腹泻，若积久体虚者，或许可行，但初得病者，必变他证，为祸不小。殊不知多因湿，只有分利小水，才是最上策。《内经》说：下体热则死，寒则生。这是大概而言，必须兼证详查方可。如今难道没有身热而生寒而死的情况吗？脉沉小流连或微者，易治；浮洪大数者，难治。脉宜滑大，不宜弦急。张仲景治痢，可温者五法；可下者十法；或解表或利小便或待其自己区分，易治、难治极密，但与泻同，立论不分，学人当辨之。肛门痛，一说温之，一说清之。按久病身冷，自汗，脉沉小者，宜温；暴病，或身热，脉浮洪者，宜清；身冷自汗，用温药；有可吐者，有可汗者，有可下者。初得时，元气未虚，必推荡之，此通因通用法，稍久，气虚则不可也。赤痢乃小肠来，白痢自大肠来，皆湿热为本，赤白带，赤白浊同。先水泄，后脓血，此脾传肾，贼邪难愈；先脓血，后水泻，此肾经传脾，是谓微邪易愈。下如豆汁者，湿也，盖脾胃为水谷之海，无物不受，常兼四脏，故如□□之相染，当先通利，此迎而夺□□义如虚，宜审之。因热而作不可用巴豆等药，如伤冷物者，或可用，宜谨之。又有时疫作痢，一方一家之内，上下相传染者相似，此却宜用运气之胜伏以治之。禁口痢，此胃口热结，用黄连多加人参，湿煎呷之，如吐了又呷；当开以降之。人不知此，多用温药甘味，以火济火，以滞益滞也。亦有误服热药，毒瓦斯犯胃，当推明而祛其毒。
Treatment of dysentery requires distinguishing whether the pathology is in the Qi level or the Blood level. Bloody stool generally belongs to the Blood level, while white discharge generally belongs to the Qi level. Symptoms include fever, tenesmus (feeling of incomplete defecation), and abdominal pain. Fever indicates an external pathogen complication; the treatment method should be to release the exterior. If there is no aversion to cold, Xiaochaihu Tang (Minor Bupleurum Decoction) without Ginseng can be used. Tenesmus is caused by accumulation and Qi stagnation sinking downward; treatment must combine lifting and resolving methods. Abdominal pain is due to Lung Metal Qi stagnating between the large intestine; Jiegeng (Platycodon Root) should be used to disperse it, followed by dysentery-specific medications. Qi-level diseases are treated with Qi-regulating herbs, and Blood-level diseases with Blood-activating herbs. For dysentery with abdominal pain in robust patients, Liu Hejian's purgative method is appropriate, followed by dysentery medication based on Qi and Blood status. Bloody stool is mostly caused by food retention and heat; cooling blood and activating blood methods should be used, such as Danggui (Angelica Sinensis), Taoren (Peach Kernel), Huangqin (Scutellaria Root), etc., sometimes using Poxiao (Mirabilite). Qingliu Wan (Green Six Pill) is effective for bloody dysentery; it consists of one portion of Liuyi San (Six-to-One Powder) stir-fried with half a tael of Hongqu (Red Yeast Rice), which activates blood, formed into pills with rice paste. For abdominal pain, warm-dispersing herbs like Shengjiang (Fresh Ginger) and Rougui (Cinnamon Bark) are suitable for harmonization. If heat is present, Huangqin and Shaoyao (Peony Root) are used. Robust patients and those in the early stage of illness should be purged; weak and elderly patients should have their Qi lifted. In the first one or two days of initial dysentery, the treatment should be unblocking; Da Diao Wei Chengqi Tang (Major Regulate the Stomach and Intestines Cathartic Decoction) or Xiao Diao Wei Chengqi Tang is used for purging, and medication is adjusted according to Qi and Blood conditions. Qi-level diseases use Renshen (Ginseng) and Baizhu (Atractylodes Macrocephala); Blood-level diseases use Siwu Tang (Four Substances Decoction) as the main formula, clearing heat first if present. For tenesmus, Qi should be harmonized using Muxiang (Vladimiria Root) and Binglang (Areca Seed). If caused by accumulation, Baohe Wan (Preserve Harmony Pill) is the primary formula. After five days, purging is contraindicated due to Spleen and Stomach deficiency. Baohe Wan formula: Shan Zha (Hawthorn Fruit) 3 taels, Shenqu (Medicated Leaven) 2 taels, Chenpi (Tangerine Peel), Banxia (Pinellia Tuber), Fuling (Poria) each 1 tael, Lianqiao (Forsythia Fruit) 5 qian, Laifuzi (Radish Seed) 5 qian. The seven ingredients are stir-fried, ground into powder, formed into pills with congee, and taken with Ginger Decoction; Baizhu 2 taels may be added. Initial dysentery with fever requires Da Chengqi Tang (Major Cathartic Decoction) for purging, followed by symptom-based medication. Chronic dysentery with persistent fever belongs to Yin deficiency; cold-natured medicines should be combined with lifting and warming agents. Another version states that chronic bloody dysentery with fever belongs to Yin deficiency, primarily treated with Siwu Tang. Post-dysentery fever indicates an external contraction. Initial abdominal pain should not be treated with Renshen or Baizhu, even in cases of Qi or Stomach deficiency. Bloody stool due to Wind pathogen sinking should be lifted, as Wind injures the Liver, which governs Blood. If injured by Dampness affecting Blood, Dampness-draining and Heat-clearing methods are indicated. For tenesmus caused by accumulation and Qi sinking, harmonize Qi with lifting and resolving agents like Muxiang and Binglang. If ineffective, use Suojiangzi (Gleditsia Sinensis Seed) roasted with Dahuang (Rhubarb Root), Danggui, Taoren, Huanglian (Coptis Rhizome), Zhike (Aurantium Fructus) as pills, as severe Large Intestine Wind causes tenesmus. Dysentery has semi-dead/semi-living prognoses: stool resembling fish brain indicates semi-dead/semi-living; fever and large pulse indicate semi-dead/semi-living. There are five untreatable signs: death from bloody stool; death from stool resembling dust/rotten color; death from stool resembling leaking roof water; death from lips red as cinnabar during dysentery; untreatable if stool flows freely like a bamboo tube. Ability to eat during dysentery indicates the Stomach is not diseased. If Spleen-Stomach Damp-Heat toxin steams upward, blocking the appetite, it becomes Jin Kou Li (Forbidden Mouth Dysentery). One formula for Jin Kou Li uses Xianglian Wan (Fragrant Coptis Pill) and Lianrou (Lotus Seed Flesh) in equal parts, ground to powder, half mixed with decoction for ingestion. To treat Jin Kou Li, apply Tianluo (Snail) mixed with Moshi (Musk) to the umbilicus to draw heat downward; when heat leaves, appetite returns. Dysentery formula: Cangzhu (Atractylodes Lancea), Baizhu, Tiao Qin (Scutellaria Root), Danggui, Baishaoyao (White Peony Root), Sheng Dihuang (Rehmannia Root), Qingpi (Green Tangerine Peel), Huanglian, Huashi (Talcum), Gancao (Licorice Root). One dose, boiled in plain water. For tenesmus, use stir-fried Huanglian and Huashi, add Taoren and Binglang; severe cases add Dahuang. For vomiting, add Banxia with Ginger juice. Another formula: Ganjiang (Dried Ginger) 1 qian, Danggui 2.5 qian, Wumei (Dark Plum) 3 pieces, Huangbai (Phellodendron Bark) 1.5 qian, Huanglian 2 qian. One dose, boiled in plain water. Sun Langzhong had abdominal distension and white dysentery due to overeating; treated with Cangzhu, Baizhu, Houpo (Magnolia Bark), Gancao, Fuling, Huashi decocted, followed by 30 Baohe Wan pills. Another formula includes stir-fried Shenqu. Weakness and thinning legs after dysentery: Cangzhu 2 liang, Jiushaoyao (Wine-treated Peony) 2.5 liang, Guiban (Tortoise Shell) 3 liang, Jiubai (Wine-treated Phellodendron) 0.5 liang. Ground to powder, pillified with congee, swallowed with Siwu Tang plus Chenpi and Gancao decoction. Lower back pain and leg weakness after dysentery: Chenpi, Banxia, Baishaoyao each 1 qian, Fuling, Cangzhu, Danggui, Jiuhuangqin (Wine-treated Scutellaria) each 0.5 qian, Baizhu 1 qian, Gancao 2 qian. One dose, boiled with 3 slices of Ginger, taken before meals. A patient with diarrhea due to hard labor had white dysenteric stool; treated with Huashi powder, stir-fried Chenpi, Shaoyao, Baizhu, Fuling, Gancao decocted, taken before meals. A woman with post-dysentery abdominal pain and low blood was treated with Chuanxiong (Sichuan Lovage Rhizome), Danggui, Chenpi, Shaoyao decocted, mixed with Liuyi San. One formula for chronic dysentery: Yingsuke (Poppy Shell) 0.5 liang, Chubai pi (Tree-of-Heaven Bark) 1 qian, Heidou (Black Soybean) 21 grains. Boiled together, taken before meals. Dysentery with Qi-level fever: Cangzhu, Houpo, Chishaoyao (Red Peony), Danggui, Huangqin, Huangbai, Diyu (Sanguisorba Root), Sushe (Poppy Shell), Zhike, Binglang, Muxiang, Gancao, Ganjiang. Add Huanglian for fresh bloody dysentery; add Huashi and Cheqianzi (Plantago Seed) for urinary obstruction. For bloody watery stool, add Ejiao (Donkey-hide Gelatin). Dysentery pills: Ce Baiye (Biota Top), Huanglian, Huangbai, Huangqin, Danggui, Shaoyao, Sushe, Sheng Dihuang, Diyu, Zhike, Xiangfu (Cyperus Rhizome), Muxiang, Binglang. Pillified with rice paste, take 70-80 pills. Add Ezhu (Curcuma Zedoaria), Sanleng (Sparganium Rhizome), Suosha (Amomum Fruit) for food retention and abdominal pain. Visceral toxin in drinkers resembles bloody dysentery, caused by habitual alcohol excess; abstain from alcohol and medicate. Formula: Cangzhu 1 qian, Chishaoyao 2 qian, Chao Huaihua (Stir-fried Sophora Flower) 1.5 qian, Diyu 2 qian, Zhike 1 qian, Zhigancao (Honey-fried Licorice) 0.3 qian, Chao Huanglian (Stir-fried Coptis) 0.5 fen, Gange (Kudzu Root) 2 qian, Danggui 0.5 fen. One dose, boiled in clear water, taken in one go before meals. Another formula: Chupi (Tree-of-Heaven Bark) 2 liang, Shenqu (stir-fried) 5 qian, Baishaoyao 1 liang, Chao Huashi (Stir-fried Talc) 1 liang, Zhike 5 qian. Ground to powder, pillified with soft rice, size of paulownia seeds, take 70 pills with rice drink. Chronic dysentery for months, unable to rise, no intake, extreme weakness: Renshen 0.5 fen, Baizhu 1 qian, Huangqi (Astragalus Root) 0.5 fen, Danggui 0.6 fen, Shaoyao 1 qian, Zhigancao 0.3 fen, Sushe 3 qian, Shidiyu (Wild Sanguisorba) 0.5 fen, Muxiang 0.3 fen, Suosha 0.5 fen, Chenpi 1 qian, Shengma (Cimicifuga Rhizome) 0.3 fen, Bairdoukou Ren (Cardamom Seed) 0.3 fen, Zexie (Alisma Rhizome) 0.5 fen. One dose. Add Huangqin for heat; if pulse is fine and limbs fear cold, add Ganjiang or Wei Roudoukou (Roasted Nutmeg), Chuan Fu (Aconite Root) slices. After several doses, eating gradually resumes. Damp-heat dysentery with scanty/astringent urine, irritability/thirst, good appetite, large/slow pulse, abdominal pain/tenesmus, frequent night stools: Gui Ling Gan Lu Yin (Cassia-Agaricus Sweet Dew Decoction) to swallow 30 Baohe Wan pills. Alternatively, Wei Ling Tang (Stomach-Cinnamon Decoction). Damp > Heat, Spleen-Stomach disharmony, poor appetite/abdominal pain/tenesmus, frequent night stools: Wei Ling Tang to swallow 30 Baohe Wan pills. Alternatively, Gui Ling Gan Lu Yin. Qi deficiency with yellow-white complexion or lethargy, frequent pain/tenesmus/no appetite, fine/weak pulse, sweating: Huangqi Jianzhong Tang (Astragalus Build the Middle Decoction) to swallow 30 Baohe Wan pills. Damp-heat without thirst: Jianzhong Tang plus Cangzhu, Fuling, swallow Baohe Wan. Spleen-Stomach disharmony, poor appetite/bloating/pain/tenesmus/dysentery, string-tight pulse: Pingwei San (Calm the Stomach Powder) plus Shaoyao, Guigui (Cinnamon Twig), Gegen (Kudzu Root), or Baizhu Fuling Tang to swallow Baohe Wan. White dysenteric stool: Huangqin Shaoyao Tang (Scutellaria-Peony Decoction) plus Baizhu, Chenpi, Gancao, Huashi, Taoren. Red dysenteric stool with fever: Yi Yuan San (Benefit Origin Powder) plus Mutong (Akebia Stem), Chao Shaoyao, Chao Chenpi, Baizhu decocted, swallow Baohe Wan. An elderly man drinking white wine developed dysentery with pale bloody pus, abdominal pain, urinary obstruction, tenesmus: Renshen, Baizhu, Huashi, Cangzhu, Binglang, Muxiang, Gancao decocted, swallow 25 Baohe Wan pills. Next day symptoms reduced except urinary difficulty; use Yi Yuan San. Zhang Zhongjing treats dysentery saying "purge" usually with Chengqi Tangs. Dahuang is cold and mobile; assisted by Houpo's warmth to move stagnant Qi; moderated by Gancao's sweetness; liquid form cleans intestines, moistens and lightens, leaving no obstruction; stops once accumulation moves. Liu Hejian elucidated "Zhi Xia" (stagnant down-flow) syndrome crucially: "Moving blood heals stool; regulating Qi removes tenesmus." This is like sun/moon to the blind, thunder to the deaf. A patient with dysentery refusing food: Sizijun Zi Tang (Four Gentlemen Decoction) plus Chuanxiong, Danggui, Shaoyao, Chenpi, Chao Shenqu, Huanglian, Sharen (Amomum Fruit), Banxia, Shengjiang decocted. Dongyi Hu brother, 40+, had dysentery for 100 days, all medicines failed. Early September, six pulses rapid, deep/string/fine/weak, left hand worse, dozens of times daily, little excrement seen, only clear turbid fluid with purple-black blood threads, no food intake. This is not dysentery but Blood Stasis. Cause? Running after full meals, shouting, beating/falling, pain, anger not vented, excessive tonification/blocking, spicy wine/meat. Last year he suffered beatings; two years later this stasis appeared. Medication induced stasis expulsion. Formula: Ruxiang (Frankincense), Moyao (Myrrh), Taoren, Huashi, assisted by Muxiang, Binglang, pillified with leaven paste, take 100+ pills with rice soup. Midnight no movement; repeat 200 pills. By dawn, expelled foul matter like rotten fish intestines, 1-2 sheng. Exhausted all day, recovered with porridge. One patient felt intense pressure after dysentery. One patient ate well/easily hungry (see Medical Essentials). Laypeople often use astringents for dysentery/diarrhea; acceptable only for chronic deficiency, but dangerous for acute cases. It is mostly due to Dampness; promoting urination is the best strategy. *Neijing* says: lower body heat leads to death; cold leads to survival. Generally true, but must consider combined symptoms. Are there cases of heat turning to cold/death? Deep/small/lingering/micro pulses are easy to treat; floating/huge/fast pulses are difficult. Pulses should be slippery/large, not string/tight. Zhang Zhongjing: 5 warming methods, 10 purging methods for dysentery; releasing exterior or promoting urination or waiting for self-resolution. Easy/difficult differentiation is precise but similar to diarrhea; students must distinguish. Anal pain: warm or clear. Long illness/cold limbs/sweating/deep/small pulse: warm. Acute illness/fever/floating/huge pulse: clear. Cold/sweating: warm herbs. Some can be vomited, some sweated, some purged. Initially, Yuan Qi not deficient, must purge (tong yin tong yong - treating obstruction with unblocking); later, Qi deficiency makes this impossible. Red dysentery comes from Small Intestine; white from Large Intestine; both rooted in Damp-Heat. Red/white leukorrhea and turbidity are similar. Watery diarrhea then pus/blood: Spleen transmitting to Kidney (Thief Evil), hard to cure. Pus/blood then watery diarrhea: Kidney transmitting to Spleen (Minor Evil), easy to cure. Stool like bean curd juice indicates Dampness. Spleen/Stomach is the sea of water/grain, receiving everything, often involving four Zang organs, so infection spreads like [missing characters]. Must first unblock; this follows the principle of "meeting and robbing" [missing characters] like deficiency, examine carefully. Heat-induced: do not use Radix Crotonis (Badou) etc.; cold injury may use them cautiously. Epidemic dysentery infecting families similarly: treat using Yunqi (Six Qi) victory/subjugation theory. Jin Kou Li (Forbidden Mouth Dysentery) is heat knotting the stomach opening; use more Huanglian plus Renshen, decoct thickly and sip; if vomited, sip again; must open to descend. People don't know this, using warm/sweet herbs adds fire to fire and stagnation to stagnation. Mistaken hot medicine causing toxic gas to invade stomach: identify and remove toxicity.