伏暑痢色如冻，染以水谷，肛垂里急，随食随
痢，完谷不化，此直肠痢也。宜用赤石脂，禹粮石，
炮姜、粳米，共研粉调服，兼补中益气汤，堵截阳
明也。
凡痢初起，必先伤脾，而后及肾，故古人治痢，虽先辨
明暑湿之在气在血，而后施治，必以脾肾两脏为主。今痢色
如冻，而染有水谷，虚寒之状已着。更兼肛垂里急，完谷不
化，此脾肾失固，关闸已撤，的是直肠之险。（内经）云：
肾者胃之关也，开窍于二阴。肾真失固，则胃关不守，致食
入于胃，不及腐化而仍完谷。若非砥柱中流，截堵网关，则
痢何以休。仿仲景少阴下痢之桃化汤，合禹粮石涩肠堵胃，
勿使直下，庶得运化如常，而出纳有度，再兼补中益气以扶
土升阳，得清气上升，庶善会(内经)浊气在上，则生膜
胀，清气在下，则生餐泄之旨矣。再按仲景论泻痢，有寒而
下利清谷者，因釜中无火，不能熟腐五谷，固厉虚寒。又有
热甚而亦完谷不化者，虽云邪热不杀谷，据愚意言之，究系
胃关失守，摄纳无权。予所阅是症，必系身热口干，舌赤少
津，脉数无力，虚热者居多。大抵阴亏阳动，化生内风，纵
横扰乱，清浊混淆，总属虚象，并非邪热。故每用胃关煎加
赤石、禹粮以固涩之，往往收功。更有肢冷脉虚，面惨舌
淡，此属虚寒，用桃化汤加人参、附子以温补之，亦可奏
效。要之完谷直肠之病，虽有阴阳寒热之分，然寒固属虚，
热亦不外乎虚也。若云邪热不杀谷，数廿年阅历以来，未可
准信，故辨及之，以俟明眼定裁。
伏暑引起的痢疾，大便颜色像冻状，混杂着未消化的食物和水谷，肛门下坠且有急迫感，进食后立即腹泻，排出的是完好的谷物，这是直肠痢。适宜使用赤石脂、禹余粮（禹粮石）、炮姜、粳米，共同研磨成粉调服，同时配合服用补中益气汤，以堵塞截断阳明经的邪气。
凡是痢疾初起，必定先损伤脾脏，然后波及肾脏，所以古人治疗痢疾，虽然先辨别暑湿是在气分还是血分，然后施治，但必须以脾肾两脏为主。现在痢疾颜色像冻状，且混杂有水谷，虚寒的症状已经明显。再加上肛门下坠、里急后重、完谷不化，这是脾肾固摄功能失职，关闸已经撤除，确实是直肠痢的危险证候。《内经》说：肾是胃的关口，开窍于前后二阴。肾的真气失于固摄，则胃的关口不能坚守，导致食物进入胃中，来不及腐熟消化就仍然以完谷的形式排出。如果不是像中流砥柱一样，拦截堵塞胃的关口，不让其直泻而下，那么痢疾怎么能停止呢？仿照张仲景治疗少阴病下痢的桃花汤，合用禹余粮涩肠固胃，不要使食物直泻而下，这样或许能使运化功能恢复正常，出入有度，再配合补中益气汤来扶助脾胃、升举阳气，使得清气上升，这样就很好地领会了《内经》中“浊气在上，则生䐜胀；清气在下，则生飧泄”的宗旨。另外考察张仲景论述泻痢，有因寒而下利清谷的，是因为锅釜中没有火，不能煮熟腐化五谷，这固然属于脾胃虚寒。又有因热甚而也出现完谷不化的，虽然说是邪热不能杀谷，据我个人的意见来说，究其根本还是因为胃的关口失守，摄纳没有权力。我所诊察的这种病症，必定伴有身体发热、口干、舌质红赤且津液少、脉数而无力，大多属于虚热。大抵是阴液亏损而阳气妄动，化生内风，纵横扰乱，清浊混淆，总属于虚象，并不是真正的邪热。所以我每每使用胃关煎加入赤石脂、禹余粮来固涩止泻，往往能收到功效。更有四肢冰冷、脉象虚弱、面色惨淡、舌色淡白的，这属于虚寒证，使用桃花汤加入人参、附子来温补，也可以奏效。总之，完谷不化和直肠痢的病证，虽然有阴阳寒热的区别，然而寒证固然属于虚证，热证也不外乎也是虚证。如果说邪热不能杀谷，在我二十多年的阅历以来，认为不可轻信，所以辨析这一点，以等待高明的人裁定。
Dysentery caused by latent summerheat presents with stool resembling jelly, mixed with undigested food and fluids, accompanied by rectal prolapse and tenesmus. Bowel movements occur immediately after eating, passing complete grains without digestion; this is termed "rectal dysentery." It is appropriate to use Chishizhi (Red Halloysite), Yuliangshi (Yuzhang Earth), Pa Jiang (Pounded Ginger), and Jing Mi (Rice Grain), ground together into powder and taken with water, combined with Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) to block and intercept pathogenic factors in the Yangming channel.
Generally, when dysentery first arises, it must first injure the Spleen, and subsequently affect the Kidney. Therefore, ancient physicians, although they first distinguished whether summer-dampness was in the Qi level or Blood level before administering treatment, always focused primarily on the Spleen and Kidney organs. In the present case, the dysenteric stool resembles jelly and is mixed with food and fluids, indicating that deficiency-cold symptoms are already prominent. Furthermore, with rectal prolapse, tenesmus, and undigested food in the stool, this indicates a failure of the Spleen and Kidney to maintain consolidation, and the closure mechanisms have been withdrawn. This is indeed a dangerous condition of rectal dysentery. The *Neijing* states: "The Kidney is the gate of the Stomach, opening into the two yin orifices." If the true Qi of the Kidney fails to consolidate, the gate of the Stomach cannot be guarded, causing food entering the Stomach to fail to undergo proper rotting and ripening, thus being excreted as complete grains. Unless one acts as a pillar in midstream, blocking and intercepting the gastric gate to prevent direct downward flow, how can the dysentery cease? Imitating Zhang Zhongjing's Taohua Tang (Peach Kernel Decoction) for Shaoyin diarrhea, combined with Yuliangshi to astringe the intestines and secure the stomach, preventing direct downward flow, one may hope to restore normal transformation and transportation, ensuring regulated intake and output. Additionally, using Buzhong Yiqi Tang to support the Earth element and raise Yang, allowing clear Qi to ascend, one can properly comprehend the principle from the *Neijing*: "Turbid Qi remaining above leads to abdominal distension; Clear Qi sinking below leads to undigested food diarrhea." Furthermore, examining Zhang Zhongjing's discussion on diarrhea and dysentery, there are cases of cold-induced diarrhea with clear undigested grains, due to the lack of fire in the cauldron, unable to cook and digest the five grains; this undoubtedly belongs to deficiency-cold. There are also cases where severe heat results in undigested food in the stool. Although it is said that "pathogenic heat does not kill grain," in my opinion, fundamentally, this is still due to the loss of control over the gastric gate and the inability to grasp and retain. In the cases I have observed, this syndrome is invariably accompanied by fever, dry mouth, red tongue with scanty fluid, and a rapid yet forceless pulse, predominantly belonging to deficiency-heat. Generally, Yin deficiency with hyperactive Yang generates internal wind, which disrupts freely, confusing clear and turbid Qi; this ultimately belongs to deficiency patterns, not genuine pathogenic heat. Therefore, I often use Weiguan Jian (Stomach Gate Decoction) added with Chishizhi and Yuliangshi to astringe and stop diarrhea, often achieving success. In cases where there are cold limbs, deficient pulse, pale complexion, and pale tongue, this belongs to deficiency-cold; using Taohua Tang added with Renshen (Ginseng) and Fuzi (Prepared Aconite Root) to warm and tonify can also yield effective results. In summary, regarding diseases of undigested food and rectal dysentery, although there are distinctions between Yin/Yang and Cold/Heat, cold certainly belongs to deficiency, and heat also essentially belongs to deficiency. As for the notion that "pathogenic heat does not kill grain," based on my twenty years of clinical experience, I find it unreliable to trust blindly. Hence, I clarify this point, awaiting judgment by those with superior insight.