王损庵云∶痢症不外湿热二字，所受不外阳明一经。阳明为多气多血之府。湿，阴邪也
，湿胜于热，则伤阳明气分，而为白痢；热，阳邪也，热胜于湿，则伤阳明血分，而为赤痢
，湿热俱盛，则为赤白俱见。初病即以芍药汤主之。大意以行血则脓血自愈，调气则后重自
除。真百发百中之奇方也。若发热头痛，脉浮而紧，是风寒郁而不解，内陷而为痢。宜以人
参败毒散，鼓之外出。苟得微汗，其痢自松。若徒用痢门套药，杀人不少。大抵痢症渐久渐
虚，而用药亦宜渐补渐调。四君子汤、六君子汤、四物汤、补中益气汤之类，煎送香连丸，
是薛立斋先生治法，余遵用甚效。
芍药汤（方见《时方》）
治痢初起，腹痛里急后重者。
小便短涩者，加滑石二钱、泽泻钱半；腹痛者，加砂仁一钱；滞涩难出者，加当归、白芍
各钱半；甚者，加大黄一钱；若食积者，加山楂三枚；白痢者，加陈皮、砂仁、茯苓各一钱；
红痢者，加川芎、桃仁各一钱；红白相杂者，加川芎、桃仁以理血，滑石、陈皮、苍术以理
气；如呕吐食不下者，加黑栀、莲子去壳三钱、仓米三钱，入生姜汁一滴，缓缓呷之，以泻
胃口之热湿。
人参败毒散（方见《时方》）
加味平胃散
苍术（二钱） 陈皮 甘草（各一钱） 浓朴（一钱五分） 猪苓 黄芩 泽泻（各一钱五分） 干姜（五
分） 白芍（三钱） 陈仓米（一钱五）
水煎服，色红者去干姜，加当归三钱、黄连一钱。
香连丸（方见《时方》）
张景岳谓痢症是夏月畏热贪凉，过伤生冷，至大火西流，新凉得气，则伏阴内动，应时
而为下痢。初起宜抑扶煎、佐关煎温药以调之导之，久痢用胃关煎，温补命门真火，以扶脾
土，则痢自止。景岳此说虽偏，不可尽信，而阴脏之人，素多寒病，一有不慎，即患此症，不可不知。
余每于此症初起，察其脉迟而细，手足俱冷，腹痛而里急后重者，以干姜二钱、附子一
钱、吴萸一钱、当归三钱、炙甘草一钱、大黄、白芍各一钱五分温通之，久痢每以八味丸与
补中益气汤间服收功。粟壳、诃子、赤石脂、肉豆蔻兜涩之药，不可早服。久痢亦不可废。
又噤口痢，乃胃中湿热之毒，熏蒸清道而上，以致胃口闭塞，而成噤口之证。亦有误服
涩热之药，而邪气停于胃口者，用人参、石莲子等分，煎服强呷，但得一口下咽，虚热即开
。更以二味为末，频频服之。《种福堂》用五谷虫三钱，微炒研末，以米汤送下。
又休息痢，流连年余不愈，愈而又作，是兜涩太早，余邪未净。宜巴豆仁一钱，研去
油净，当归一两、莱菔子五钱炒，同研为末。以冬蜜为丸，如桐子大，每空心以开水送下三
丸至七丸，以竭其余邪，自愈。
张石顽曰∶血色鲜紫浓浓者，属热。若瘀晦稀淡如玛瑙色者，为阳虚不能制阴而下，非
温理其气，则血不清。理气如炉冶分金，最为捷法。设不知此，概行疏利之法，使五液尽随
寒降而下，安望有宁止之日哉！
以伏龙肝二两，取其温暖土脏，煎汤代水。煮参、术、苓、草、姜、桂等药，多取奇效。
五色痢是精气受伤、五液不守之患。宜益火消阴，实脾堤水，兼分理其精气。即噤口不
食者，亦不出此法。
又曰∶丹溪治噤口痢，多用石莲子。今此物真者绝无，余常用藕汁煮熟，稍加糖霜频服
。兼进多年陈米稀糜，调其胃气取效，此即石莲子之意也。
又曰∶休息痢，服补中益气数剂不应，反下鲜紫血块者，此久风成飧泄。风气通于肝，
肝伤不能藏血也。三奇散倍防风，加羌、葛、升麻，其一切利水破气药，皆为切禁。
三奇散
治痢后下重。
枳壳（生） 防风（各一两） 黄 （二两）
为散，每服二钱，米饮下。
伏龙肝汤丸
治胎前下痢，产后不止。
炮黑山楂肉（一两） 熬焦黑糖（二两）
二味一半为丸，一半为末。用伏龙肝二两，煎汤代水。煎末二钱，送前丸二钱。日三，
夜二服，一昼夜令尽。气虚加人参二三钱以驾驭之；虚热加炮姜、肉桂、茯苓、甘草；兼感
风寒加白葱、香豉；膈气不舒，磨沉香汁数匙调服。
羊脂煎（《千金》）
治久痢不痊。
羊脂（一棋子大） 白蜡（二棋子大） 黄连（末一升） 醋（七合，煎，取稠） 蜜（七合煎取五合） 乌梅
肉（二两） 乱发（炭，洗去垢腻烧末，一升）
上七味，合内沙锅中汤上煎之，搅可丸，饮服如桐子大三十丸，日三服。
张石顽曰∶羊脂性滑利，《千金方》用治久痢不瘥，专取滑利，以通虚中留滞也。其
后且有羊脂、阿胶、蜜、蜡、黍米作粥方，深得炎帝本经补中寓泻之意。
王损庵说：痢疾不外乎“湿热”两个字，病位不外乎阳明经。阳明经是多气多血的脏腑。湿，属于阴邪；湿气重于热邪，就会损伤阳明经的气分，从而形成白痢；热，属于阳邪；热邪重于湿气，就会损伤阳明经的血分，从而形成赤痢；如果湿热都旺盛，就会出现红白相间的痢疾。初起病时就用芍药汤为主方。其大意在于：行血则脓血自然痊愈，调气则里急后重自然消除。这真是百发百中的奇方啊。如果有发热、头痛、脉象浮而紧的症状，这是风寒郁结不能解除，内陷而形成痢疾。适宜用人参败毒散，鼓动正气将邪气向外透达。如果能得到微微出汗，痢疾自然缓解。如果仅仅使用治疗痢疾的常规套药，会杀死不少人。大抵痢疾时间越久身体越虚，用药也就应当逐渐补益、逐渐调理。四君子汤、六君子汤、四物汤、补中益气汤之类的方剂，煎好后送服香连丸，这是薛立斋先生的治疗方法，我遵循使用非常有效。
芍药汤（方剂见《时方》）
治疗痢疾初起，腹痛、里急后重的情况。
小便短少涩痛者，加滑石二钱、泽泻一钱半；腹痛者，加砂仁一钱；排便滞涩难出者，加当归、白芍各一钱半；病情严重的，加大黄一钱；如果有食积者，加山楂三枚；白痢者，加陈皮、砂仁、茯苓各一钱；红痢者，加川芎、桃仁各一钱；红白相杂者，加川芎、桃仁来调理血分，加滑石、陈皮、苍术来调理气分；如果出现呕吐、无法进食的情况，加黑栀子、去壳莲子三钱、仓米三钱，滴入一滴生姜汁，缓缓呷饮，以清泻胃口处的热湿。
人参败毒散（方剂见《时方》）
加味平胃散
苍术（二钱） 陈皮 甘草（各一钱） 浓朴（一钱五分） 猪苓 黄芩 泽泻（各一钱五分） 干姜（五分） 白芍（三钱） 陈仓米（一钱五）
用水煎服，大便色红的去掉干姜，加当归三钱、黄连一钱。
香连丸（方剂见《时方》）
张景岳认为：痢疾是因为夏天怕热贪凉，过度食用生冷食物，到了立秋之后，新凉之气到来，体内的伏阴随之而动，应时而发生下痢。初起时适宜用抑扶煎、佐关煎等温性药物来调理引导；久痢用胃关煎，温补命门真火，以扶持脾土，那么痢疾自然停止。张景岳的这个说法虽然有些偏颇，不能完全相信，但是体质为阴寒之人，平时多有寒病，一旦不慎，就会患此症，这一点不可不知道。
我每当遇到这种病症初起，观察到患者脉象迟而细，手脚冰凉，腹痛且伴有里急后重，就用干姜二钱、附子一钱、吴茱萸一钱、当归三钱、炙甘草一钱、大黄、白芍各一钱五分，以温通之法治疗；久痢常用八味丸与补中益气汤交替服用以收效。粟壳、诃子、赤石脂、肉豆蔻等收敛固涩的药物，不可过早服用。久痢也不可废弃不用这些方法。
另外，噤口痢，是由于胃中湿热之毒，熏蒸清道向上，导致胃口闭塞，从而形成噤口证。也有因为误服收敛温热药物，导致邪气停滞在胃口处的，用人参、石莲子等量，煎煮后强行灌服，只要有一口咽下去，虚热就会消散。再用这两味药研成粉末，频繁服用。《种福堂》的方法是用五谷虫三钱，微炒后研末，用米汤送下。
另外，休息痢，缠绵一年多不愈，好了又发作，这是因为收敛固涩太早，余邪未净。适宜用巴豆仁一钱，研磨去油干净，配合当归一两、莱菔子五钱炒制，一同研为粉末。用冬蜜做成丸药，如梧桐子大小，每次空腹用开水送下三丸至七丸，以清除残余邪气，自然痊愈。
张石顽说：血色鲜紫浓稠的，属于热证。如果血色晦暗稀淡像玛瑙色，是阳虚不能制约阴寒而下泄，如果不温理其气，那么血液就不能澄清。理气就像冶炼炉分离金属一样，是最为快捷的方法。假如不知道这个道理，一概使用疏利之法，使五脏津液全部随着寒降之气而下泄，哪里指望有安宁停止的日子呢！
用伏龙肝二两，取其温暖脾脏的作用，煎汤代替水。用来煮人参、白术、茯苓、甘草、干姜、肉桂等药物，往往取得奇特疗效。
五色痢是精气受伤、五脏津液不能固守的祸患。适宜益火消阴，充实脾土堤防水液，同时分别调理精气。即使是噤口不能进食的情况，也不超出这个治法范围。
又说：丹溪治疗噤口痢，多用石莲子。如今真正的石莲子完全没有，我常用藕汁煮熟，稍加糖霜频繁服用。兼进多年陈米的稀粥糜，来调和胃气取效，这就是石莲子的意思。
又说：休息痢，服用补中益气汤几剂没有反应，反而排出鲜紫血块的，这是久风变成了飧泄。风气通于肝，肝受伤不能藏血。用三奇散加倍防风，加羌活、葛根、升麻，那些一切利水破气的药物，都是严格禁忌的。
三奇散
治疗痢疾后肛门重坠感。
枳壳（生） 防风（各一两） 黄芪（二两）
研为散剂，每次服用二钱，用米饮送下。
伏龙肝汤丸
治疗产前下痢，产后不止。
炮黑山楂肉（一两） 熬焦黑糖（二两）
这两味药一半做成丸药，一半做成散末。用伏龙肝二两，煎汤代替水。煎煮散末二钱，送服前面的丸药二钱。白天三次，晚上两次服用，一昼夜服完。气虚加人参二三钱以驾驭药力；虚热加炮姜、肉桂、茯苓、甘草；兼感风寒加白葱、香豉；胸膈气机不畅，磨沉香汁几匙调服。
羊脂煎（出自《千金方》）
治疗久痢不愈。
羊脂（一块棋子的大小） 白蜡（一块棋子的大小） 黄连（末一升） 醋（七合，煎煮取稠状） 蜜（七合煎取五合） 乌梅肉（二两） 乱发（烧成炭，洗去污垢腻物后烧末，一升）
以上七味药，放入沙锅中，加水煎煮，搅拌到可以丸药的程度，用温水送服如梧桐子大小的三十丸，每天三次服用。
张石顽说：羊脂性质滑利，《千金方》用它治疗久痢不愈，专门取其滑利之性，以疏通虚体中的留滞。其后还有用羊脂、阿胶、蜜、蜡、黍米做粥的方子，深得炎帝神农氏《本经》补益中寓含泻除之意。
Wang Sun'an stated: Dysentery is nothing more than "damp-heat," and the pathogenesis involves not beyond the Yangming channel. The Yangming is a residence abundant in Qi and blood. Dampness is a Yin pathogen; when dampness exceeds heat, it injures the Qi aspect of the Yangming, resulting in white dysentery. Heat is a Yang pathogen; when heat exceeds dampness, it injures the Blood aspect of the Yangming, resulting in red dysentery. If both dampness and heat are flourishing, both red and white stools will be observed. In the initial stage, Shaoyao Tang (Peony Decoction) should be used as the primary formula. The general principle is: moving blood allows pus and blood to heal naturally, while regulating Qi eliminates tenesmus spontaneously. This is truly a miraculous formula with hundred percent efficacy. If there are symptoms of fever, headache, and a floating and tight pulse, this indicates wind-cold stagnation failing to resolve, sinking inward to cause dysentery. It is appropriate to use Renshen Baidu San (Ginseng Detoxification Powder) to urge the pathogen outward. If a slight sweat is achieved, the dysentery will naturally loosen. If one merely uses routine drugs for dysentery, many people will die. Generally, as dysentery persists, the body becomes increasingly deficient, and medication should gradually shift towards tonification and regulation. Formulas such as Sijunzi Tang (Four Gentlemen Decoction), Liujunzi Tang (Six Gentlemen Decoction), Siwu Tang (Four Substances Decoction), and Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) should be decocted to administer Xianglian Wan (Fragrant Coptis Pill). This was the treatment method of Mr. Xue Lizhai, which I have followed with great efficacy.
Shaoyao Tang (Formula see *Shifang*)
Treats early-stage dysentery with abdominal pain and tenesmus.
For short and scanty urination with difficulty, add Huashi (Talcum, 2 qian) and Zexie (Alisma Rhizome, 1.5 qian); for abdominal pain, add Sharen (Amomum Fruit, 1 qian); for difficult and obstructive defecation, add Danggui (Angelica Sinensis Root) and Baishao (White Peony Root), each 1.5 qian; for severe cases, add Dahuang (Rhubarb Root, 1 qian); for food stagnation, add Shanzha (Hawthorn Fruit, 3 pieces); for white dysentery, add Chenpi (Aged Tangerine Peel), Sharen, and Fuling (Poria), each 1 qian; for red dysentery, add Chuanxiong (Ligusticum Rhizome) and Taoren (Peach Seed), each 1 qian; for mixed red and white dysentery, add Chuanxiong and Taoren to regulate blood, and Huashi, Chenpi, and Cangzhu (Atractylodes Rhizome) to regulate Qi; for vomiting and inability to eat, add Heizhi (Charred Gardenia Fruit), Quqiao Lianzi (Lotus Seed without shell), 3 qian, and Cangmi (Stored Rice), 3 qian, with one drop of Shengjiang juice (Fresh Ginger Juice), taken slowly by sipping to drain heat-dampness from the stomach opening.
Renshen Baidu San (Formula see *Shifang*)
Modified Pingwei San
Cangzhu (Atractylodes Rhizome, 2 qian) Chenpi (Aged Tangerine Peel) Gancao (Licorice Root, each 1 qian) Houpo (Magnolia Bark, 1.5 qian) Zhuling (Polyporus, Huangqin (Scutellaria Root) Zexie (Alisma Rhizome, each 1.5 qian) Ganjiang (Dried Ginger, 0.5 qian) Baishao (White Peony Root, 3 qian) Chengcangmi (Stored Rice, 1.5 qian)
Decoct in water and take orally. For red-colored stools, remove Ganjiang and add Danggui (Angelica Sinensis Root, 3 qian) and Huanglian (Coptis Rhizome, 1 qian).
Xianglian Wan (Formula see *Shifang*)
Zhang Jingyue stated that dysentery arises from fearing heat and craving coolness in summer, overindulging in cold and raw foods. When autumn arrives and new coolness gains influence, latent Yin moves internally, manifesting seasonally as lower dysentery. In the initial stage, it is suitable to use Wen Yao (warm medicines) such as Yifu Jian (Support and Uplift Decoction) or Zuoguan Jian (Assist the Gate Decoction) to regulate and guide. For chronic dysentery, Weiguan Jian (Stomach Gate Decoction) is used to warm and tonify the True Fire of Mingmen (Gate of Life) to support Spleen Earth, thereby stopping dysentery. Although Zhang Jingyue's theory is somewhat biased and cannot be entirely trusted, individuals with Yin-cold constitutions who often suffer from cold diseases must be cautious, as negligence can lead to this condition.
In my practice, for early-stage cases where the pulse is slow and fine, hands and feet are cold, and there is abdominal pain with tenesmus, I use Ganjiang (Dried Ginger, 2 qian), Fuzi (Prepared Aconite Root, 1 qian), Wuyu (Evodia Fruit, 1 qian), Danggui (Angelica Sinensis Root, 3 qian), Zhigancao (Honey-fried Licorice Root, 1 qian), Dahuang (Rhubarb Root), and Baishao (White Peony Root), each 1.5 qian, to apply warming and unblocking methods. For chronic dysentery, I often alternate Bawei Wan (Eight-Ingredient Pill) and Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) to achieve success. Drugs with astringent properties such as Quke (Poppy Shell), Hezi (Chebula Fruit), Chishizhi (Red Kaolin), and Roudoukou (Nutmeg) should not be used too early. However, they should not be completely abandoned in chronic dysentery either.
Additionally, Jin Kou Li (Dysentery with inability to eat) is caused by toxic heat-dampness in the stomach steaming upwards through the clear pathways, blocking the stomach opening. It may also result from mistakenly taking astringent and hot drugs, causing pathogens to stagnate at the stomach opening. Using equal parts of Renshen (Ginseng Root) and Shilianzi (Stone Lotus Seed), decocted and forcibly administered, if even one mouthful is swallowed, the deficiency-heat will dissipate. Then, these two herbs ground into powder should be taken frequently. *Zhongfutang* recommends using Wuguchong (Grainworms), 3 qian, lightly stir-fried and ground into powder, taken with rice gruel.
Furthermore, Xiuxi Li (Intermittent Dysentery) persists for over a year, recurring after remission, due to premature astringency leaving residual pathogens. It is appropriate to use Badou Ren (Croton Seed Kernel), 1 qian, ground and oil removed, combined with Danggui (Angelica Sinensis Root), 1 liang, and Laifuzi (Radish Seed), 5 qian, stir-fried, then ground together into powder. Formed into pills with winter honey, sized like paulownia seeds, take three to seven pills with boiling water on an empty stomach to exhaust residual pathogens, leading to natural recovery.
Zhang Shiwan stated: Bright purple and thick blood indicates heat. If the blood is dull, thin, and pale like agate, it is due to Yang deficiency failing to control Yin, causing downward discharge. Without warming and regulating Qi, the blood will not clarify. Regulating Qi is like refining gold in a furnace, the most efficient method. If this is ignored and purgative methods are universally applied, causing the fluids of the five zang organs to descend with cold, how can one expect cessation?
Using Fulonggan (Dragon's House Soil), 2 liang, to warm the Spleen organ, decoct in water to replace normal water. Use this water to decoct herbs such as Renshen (Ginseng Root), Baizhu (Atractylodes Macrocephala Rhizome), Fuling (Poria), Gancao (Licorice Root), Ganjiang (Dried Ginger), and Rougui (Cinnamon Bark). This often yields remarkable results.
Wuse Li (Five-Color Dysentery) is a disorder of injured essence and qi, and failure of the five fluids to remain secure. It requires benefiting fire to eliminate yin, strengthening spleen earth to dam water, and separately regulating essence and qi. Even for those unable to eat due to Jin Kou syndrome, this method applies.
He also stated: Danxi treated Jin Kou Li mostly with Shilianzi (Stone Lotus Seed). Today, genuine Shilianzi is extremely rare. I commonly use lotus root juice boiled, with a little sugar added, taken frequently. Consuming congee made from aged rice simultaneously harmonizes Stomach Qi and achieves effect, embodying the intent of Shilianzi.
He further stated: For Xiuxi Li, if Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) fails after several doses, and fresh purple blood clots are passed, this is long-standing wind transforming into Sundxie (Sundigestion/Diarrhea with undigested food). Wind energy connects to the Liver; liver injury leads to failure to store blood. Use Sanqi San (Three Marvels Powder) with doubled Fangfeng (Saposhnikovia Root), plus Qianghuo (Notopterygium Rhizome), Gegen (Kudzu Root), and Shengma (Cimicifuga Rhizome). All diuretic and Qi-breaking drugs are strictly prohibited.
Sanqi San (Three Marvels Powder)
Treats heaviness in the anus after dysentery.
Zhiqiao (Immature Bitter Orange, raw) Fangfeng (Saposhnikovia Root, each 1 liang) Huangqi (Astragalus Root, 2 liang)
Grind into powder. Take 2 qian per dose, with rice drink.
Fulonggan Tang Wan (Dragon's House Soil Decoction and Pill)
Treats dysentery during pregnancy and persistence postpartum.
Paoheshasharen (Roasted Black Hawthorn Flesh, 1 liang) AoJiaohetang (Burnt Brown Sugar, 2 liang)
Half of these two ingredients form pills, half form powder. Use Fulonggan (Dragon's House Soil), 2 liang, decocted in water to replace normal water. Decoct 2 qian of powder, to administer with 2 qian of the aforementioned pills. Take three times during the day and twice at night, finishing within twenty-four hours. For Qi deficiency, add Renshen (Ginseng Root), 2-3 qian, to guide the action; for deficiency-heat, add Paojiang (Roasted Ginger), Rougui (Cinnamon Bark), Fuling (Poria), and Gancao (Licorice Root); for concurrent wind-cold, add Baicong (White Scallion) and Xiangchi (Fermented Soybean); for chest oppression, mix with Chenxiang juice (Agarwood Juice) and take orally.
Yangzhi Jian (Mutton Fat Decoction) (*Qianjin Fang*)
Treats chronic dysentery not healing.
Yangzhi (Mutton Fat, size of a chess piece) Bala (White Beeswax, size of a chess piece) Huanglian (Coptis Rhizome powder, 1 sheng) Cu (Vinegar, 7 he, boiled to thickness) Mi (Honey, 7 he, boiled to 5 he) Wumei Rou (Dark Plum Flesh, 2 liang) Luafa (Human Hair Charcoal, washed clean of grease and burned to powder, 1 sheng)
Combine the above seven ingredients in a clay pot, boil with water, stir until pillable. Take thirty pills the size of paulownia seeds with warm water, three times daily.
Zhang Shiwan stated: Mutton fat has a slippery nature. *Qianjin Fang* uses it for chronic dysentery, specifically utilizing its slipperiness to unblock stagnation in a deficient interior. Later, there were recipes using mutton fat, Ejiao (Donkey-hide Gelatin), honey, wax, and millet to make porridge, deeply understanding the meaning of tonifying the middle while containing draining effects found in the *Shennong Bencao Jing*.