脉诀云。痢疾脉沉细者生。洪大者死。此言久病也。初起之时。元气未虚。谷气尚强。其脉未有不滑而大者。
惟久病之后。元气已虚。谷食又少。故脉宜沉细。不宜洪大也。夫痢疾之起。由于暑食伤脾。不能运化。并于血
分。作成
痢疾。其色红者。从食中之热化。其色白者。从食中之冷化。不可以赤为热。而白为寒也。治之当分表里。丹溪曰。恶
寒发热。身首俱痛。是为在表。在表则当散暑。邪入里。必由皮肉而及筋骨。由筋骨而入肠胃。今寒热身痛。表
邪未净也。若但清胃化滞。不及其表。则表间之邪。势必尽从里出。何日可解。柴胡化滞汤。诚表里两解之良剂也。
（治挟表痢大有捷效屡试屡验喻氏逆流挽舟法即此方加减）古方用人参败毒散。责之太阳。而不责少阳。未免求之
太远矣。至于后重窘迫。腹痛急坠。是为在里。在里则当下。宜用朴黄丸下之。然欲用下药。必在两三日之
间。元气未虚。脉犹有力。方可用下。若日久痢多。脉来无力。虽有后重。气虚下陷。与初起者不同。不可妄下。
至于外无头疼身痛。内无里急后重者。宜用芩芍调中汤。黄芩能敛大肠之气。白芍能敛大肠之血。痢疾便红。非此
不愈。然患痢之人。多由饮食不节。旧积未尽。新谷又多。往往然也。若见胸中不宽。芩芍未可骤用。恐其收敛饮食。
愈加其痢。通调之后。合当大补元气。但痢家气虚者固有。而阴亏者亦多。下多亡阴。脏腑虚燥。大渴欲饮。脉
来细数。宜用芍药健脾汤。但止其汤。其痢自愈。若是阳虚。脉必洪大无力。宜用芩芍补中汤。或用资生丸。补
而不愈。方可再行兜涩。不可骤用粟壳等药。恐积滞不尽。而成胀满。病愈甚也。（每成休息痢皆由兜涩早耳）
虽然。肾有胃关。未可久痢而胃不损者。凡四君归脾十全补中。皆补脾虚。未尝不善。若病在火衰。土位无母。
设非桂附大补命门。以复肾中之阳。以救脾家之母。饮食何由而进。门户何由而闭。真元何由而复耶。若畏热不前。仅
以参术补土。未见
痢之能愈也。此皆治热痢之法。而沉寒者亦有。不可泥定是热。平日元气虚弱。口食生冷凉物。以致胃寒下痢。
脉来沉细无力。四肢厥冷。可为辨也。宜用理中化滞汤。不但冷痢如此。即热症变冷者亦往往有之。李东垣云。
久痢不止。（着眼久痢二字）各症不减。或反加重。竟作虚治。用补中汤。加炮姜一升一补。虚回而痢自止。如
小腹重坠切痛奔豚。加肉桂破故纸诚确论也。痢家虽不禁食。只宜清淡柔烂。少吃为妥。生冷面食俱不相宜。
浓味尤当禁之。至于五色兼下者。如鱼脑髓者。或下烟尘屋漏水者。大孔如竹筒。唇似朱涂者。皆难治之症也。
又有热毒痢者。水谷倾囊而出。一昼夜间八九十行。此则肠胃为热毒所挠。宜从里治。里急后重者。宜用大黄
黄连甘草大剂下之。若无里急后重。宜用芩芍调中汤。加黄连肉桂。盖暑邪据于肠胃。凉药入口。隔拒而不纳。
少加肉桂。引凉药直达热所。有如向导之兵。人所不知者也。若脉来沉细无力。八九十行者。又为气虚下陷。非前法所
可治也。
下痢噤口者。胃中湿热之毒。熏蒸清道而上。以致胃口闭寒。不欲饮食。古方仓禀汤。散其内中热毒。非散表也。
后以仓连人参汤。频频与之。服之不应者。多主于死。初起胸中不宽。不欲饮食者。胃中有痰有食。非噤口也。
又有血痢者。纯红散血。不与粪杂。故为血痢。若有血又有粪者。谓之便血。非血痢也。此因饮食伤脾。中州郁结。
不能摄血。所以血从大孔而下。亦用芩芍调中汤。若脉来细数。胸中如故者。宜用柴胡四物汤。加地榆乌梅之
类。勿以血痢为拘耳。
丹溪云。先水泻而后便脓血者。脾传肾也。为贼邪治之难愈。先脓血而后水泻者。肾传脾也。为微邪治之易痊。论
虽如此。又当看其轻重。先泻后痢。固为难治。若下痢不甚。岂难治乎。先痢后泻。固为易治。若泻多不止。岂易痊乎。
世有痢兼疟者。当以治痢为主。不必治疟。若疟后变痢发泄已尽。必无暑热之毒。宜以资生丸调理。其有恣意饮食。
酿成痢疾者。又不拘于此例也。
柴胡化滞汤
柴胡 黄芩 甘草 丹参 当归 枳壳 浓朴 山楂 木香 槟榔
柴芩甘草。用之以治暑也。枳朴山楂。用之以消食也。河间曰。行血则便脓自愈。故用丹参当归。调气则后重自除。
故用木香槟榔。此方不但初病宜用。即久痢身热者。亦宜用之。金匮云。下痢脉反弦。身热汗出者自愈。夫久
痢之脉。深入阴分。沉细微弱矣。忽然而转弦脉。全是少阳生发之气。用此逆流挽舟。邪从外散。
宁不愈乎。若脉沉细滑。表里无热者。脾气郁结。加藿香一钱。更有殊功。
朴黄丸
大黄（四两酒煮） 浓朴（二两姜汁炒）
芩芍调中汤
枳壳 浓朴 山楂 黄岑 白芍 丹参 桔梗 槟榔 泽泻
热盛加酒炒黄连。
芍药健脾汤
山药 扁豆 石斛 萎蕤 沙参 白芍 陈皮 白茯 山楂 神曲 花粉
连芍补中汤
人参 白术 甘草 黄 陈皮 升麻 柴胡 白芍 黄连
久痢宜忌当归。以其润下故也。去升柴加阿胶地榆尤妙。
资生丸
人参（三两） 白术（二两） 甘草（一两） 白茯（两半） 山楂（二两） 神曲（二两） 麦芽（两半） 陈
皮（两半） 桔梗（五钱） 山药（两半） 扁豆（三两） 苡仁（三两） 藿香（五钱） 芡
实（两半） 泽泻（五钱） 黄连（三钱五分） 白蔻（三钱五分）
蜜丸弹子大。
理中化滞汤
人参 白术 炮姜 甘草 砂仁 浓朴 藿香 陈皮
寒甚加肉桂。
仓廪汤
人参 白茯 甘草 羌活 独活 柴胡 前胡 川芎 枳壳 桔梗 陈仓米 石莲肉
本方不用人参。服之无效。脉沉者。宜加藿香。
仓连人参汤
黄连（七钱） 陈仓米（三钱） 人参（五钱）
脉洪实者。去人参名仓连煎。
外治法
用大田螺一枚。捣烂如泥。入射一厘。纳入脐中。引热下行。胃即开矣。（此法曾经试之效捷）
香连丸
木香（一两） 黄连（二两）
《脉诀》中说：痢疾患者若脉象沉细，预后良好；若脉象洪大，则预后不良。这是针对久病而言的。在疾病初起时，人体元气尚未虚弱，谷气（饮食水谷之气）尚且强盛，其脉象没有不呈现滑而大的特征的。
只有在久病之后，元气已经虚弱，饮食摄入又少，所以脉象适宜沉细，而不宜洪大。
痢疾的发生，是由于暑湿和饮食损伤了脾胃，导致脾胃不能正常运化，病邪并入血分，从而形成痢疾。大便颜色发红的，是由食物中的热邪转化而来；颜色发白的，是由食物中的寒邪转化而来。不能简单地认为红色就是热证，白色就是寒证。治疗时应当区分表证和里证。朱丹溪说：如果伴有恶寒发热、头身疼痛，说明病邪在表。病邪在表，就应当疏散暑邪。邪气侵入体内，必然由皮肉进而波及筋骨，再由筋骨进入肠胃。现在出现寒热交替、身体疼痛，说明表邪尚未清除。如果仅仅清胃化滞，不顾及表邪，那么表间的邪气势必全部转入里部，何时才能解除呢？柴胡化滞汤，确实是能够表里双解的良好方剂。（治疗兼有表证的痢疾大有捷效，屡试屡验。喻嘉言的“逆流挽舟法”即是在此方基础上加减而成。）古方用人参败毒散，将其责之于太阳经，而不责之于少阳经，未免求之过远了。至于肛门重坠窘迫、腹痛急坠，这是病邪在里。病邪在里，就应当使用下法。适宜使用朴黄丸来攻下。然而想要使用下药，必须在发病两三天之间，此时元气未虚，脉象仍然有力，才可以攻下。如果日久痢疾频繁，脉象无力，即使有肛门重坠感，也是因气虚下陷所致，与初起者不同，不可妄用攻下法。
如果外无头痛身痛，内无里急后重，适宜使用芩芍调中汤。黄芩能收敛大肠之气，白芍能收敛大肠之血。痢疾便血，不用此方难以痊愈。然而患痢疾的人，多因饮食不节制，旧有的积滞未尽，新的饮食又多，往往如此。如果见到胸中不畅快，芩芍调中汤不可贸然使用，恐怕其收敛作用会留滞饮食，加重痢疾。待通调之后，应当大补元气。但是，痢疾患者气虚的固然有，阴虚亏损的也很多。下利过多会导致亡阴，脏腑虚燥，大渴欲饮，脉象细数，适宜使用芍药健脾汤。只要服用此汤，痢疾自然痊愈。如果是阳虚，脉象必定洪大无力，适宜使用芩芍补中汤，或者使用资生丸。如果补益后仍未痊愈，才可以再行收涩止泻，不可骤然使用罂粟壳等药物，恐怕积滞未尽，反而导致胀满，使病情更加严重。（每有转为休息痢的，都是因为过早使用收涩药所致。）
虽然如此，肾为胃之关，久痢之人，胃不可能不受损。凡是四君子汤、归脾汤、十全大补汤、补中益气汤，都是补脾虚的，并非不好。但如果病机在于火衰，土位无母（肾阳不足无法温煦脾土），如果不是用桂枝、附子大补命门之火，以恢复肾中之阳，来救助脾脏之母（火生土），饮食如何能进？门户如何能闭合？真元如何能恢复呢？如果畏惧热药而不敢前进，仅用人参、白术补土，未见痢疾能痊愈的。这些都是治疗热痢的方法，但也有沉寒证，不可固执地认为是热证。平日元气虚弱，口食生冷凉物，导致胃寒下痢，脉象沉细无力，四肢厥冷，可以据此辨别。适宜使用理中化滞汤。不仅仅是冷痢如此，即使是热症转变为冷症的，也往往有这种情况。李东垣说：久痢不止（着重指出“久痢”二字），各种症状不减，或反而加重，竟当作虚证治疗，使用补中益气汤，加炮姜一两一钱进行补益，虚证回阳而痢疾自止。如小腹重坠切痛、奔豚气发作，加肉桂、破故纸，这确实是确切的论述。痢疾患者虽然不禁食，只宜清淡柔烂的食物，少吃为宜。生冷面食都不相宜，浓味尤其应当禁止。至于五色痢并见，如排出鱼脑髓样物质，或排出烟尘屋漏水样的物质，肛门松弛如竹筒，嘴唇红如涂朱砂，都是难治的病症。
又有热毒痢，水谷倾囊而出，一昼夜间排便八九十次，这是因为肠胃被热毒扰乱，应当从里治。如果有里急后重，适宜使用大黄、黄连、甘草的大剂量方剂攻下。如果没有里急后重，适宜使用芩芍调中汤，加入黄连、肉桂。因为暑邪占据肠胃，凉药入口，会被格拒而不纳受，少量加入肉桂，引导凉药直达热所，如同向导之兵，这是人们所不知道的。如果脉象沉细无力，一天排便八九十次，又是气虚下陷，不是前法所能治疗的。
下痢出现噤口（不能进食）的情况，是胃中湿热之毒熏蒸清道而上，导致胃口闭寒，不欲饮食。古方仓廪汤，是散发其中的热毒，并非发散表邪。随后用仓连人参汤，频频给予服用。服药后无效的，大多主死。初起时胸中不畅快，不欲饮食的，是胃中有痰有食，不属于噤口痢。
又有血痢，纯红色的血液散出，不与粪便混杂，所以称为血痢。如果有血又有粪的，称为便血，不是血痢。这是由于饮食损伤脾胃，中焦郁结，不能摄血，所以血液从肛门而下。也使用芩芍调中汤。如果脉象细数，胸中情况如故（指无明显表证或里实热），适宜使用柴胡四物汤，加入地榆、乌梅之类。不要拘泥于血痢的名称。
朱丹溪说：先水泻而后便脓血的，是脾传肾，称为贼邪，治疗难愈。先脓血而后水泻的，是肾传脾，称为微邪，治疗易痊。理论虽然如此，又应当看其轻重程度。先泻后痢，固然是难治，但如果下痢不严重，难道难治吗？先痢后泻，固然是易治，但如果泻下不止，难道易愈吗？世间有痢疾兼夹疟疾的，应当以治痢为主，不必治疟。如果是疟疾后变为痢疾，发泄已尽，必无暑热之毒，适宜用资生丸调理。那些恣意饮食，酿成痢疾的，又不拘泥于此例。
柴胡化滞汤
柴胡、黄芩、甘草、丹参、当归、枳壳、厚朴、山楂、木香、槟榔。
柴胡、黄芩、甘草，用来治疗暑邪。枳壳、厚朴、山楂，用来消食。刘河间说：行血则便脓自愈，所以用丹参、当归。调气则后重自除，所以用木香、槟榔。此方不仅初病适宜使用，即使是久痢身热的，也适宜使用。《金匮要略》说：下痢脉反弦，身热汗出的会自愈。久痢的脉象，深入阴分，表现为沉细微弱。忽然转为弦脉，全是少阳生发之气。使用此方逆流挽舟，邪气从外表散出，难道不会痊愈吗？如果脉象沉细滑，表里无热，脾气郁结，加藿香一钱，更有特殊功效。
芩芍调中汤
枳壳、厚朴、山楂、黄芩、白芍、丹参、桔梗、槟榔、泽泻。
热盛加酒炒黄连。
芍药健脾汤
山药、扁豆、石斛、萎蕤、沙参、白芍、陈皮、白茯苓、山楂、神曲、花粉。
连芍补中汤（原文作“连芍补中汤”，结合上下文及方名规律，此处应为补中益气汤加减，但依原文提取）
人参、白术、甘草、黄芪、陈皮、升麻、柴胡、白芍、黄连。
久痢宜忌用当归，因为其润下的缘故。去掉升麻、柴胡，加入阿胶、地榆尤为妙。
资生丸
人参（三两）、白术（二两）、甘草（一两）、白茯苓（一两半）、山楂（二两）、神曲（二两）、麦芽（一两半）、陈皮（一两半）、桔梗（五钱）、山药（一两半）、扁豆（三两）、薏苡仁（三两）、藿香（五钱）、芡实（一两半）、泽泻（五钱）、黄连（三钱五分）、白蔻（三钱五分）。
蜜丸，弹子大小。
理中化滞汤
人参、白术、炮姜、甘草、砂仁、厚朴、藿香、陈皮。
寒甚加肉桂。
仓廪汤
人参、白茯苓、甘草、羌活、独活、柴胡、前胡、川芎、枳壳、桔梗、陈仓米、石莲肉。
本方不用人参，服用无效。脉沉者，适宜加藿香。
仓连人参汤
黄连（七钱）、陈仓米（三钱）、人参（五钱）。
脉洪实者，去人参，名为仓连煎。
The *Mai Jue* (Pulse Classic) states: In dysentery, if the pulse is deep and fine, prognosis is good; if the pulse is surging and large, prognosis is poor. This refers to chronic cases. At the onset of the disease, the Yuan Qi (Original Qi) has not yet become deficient, and the Gu Qi (Grain Qi/Nutritional Energy) is still strong, so the pulse invariably presents as slippery and large.
Only after a long illness, when the Yuan Qi has become deficient and food intake is reduced, should the pulse be deep and fine, rather than surging and large.
The onset of dysentery results from summerheat and dietary injury to the Spleen and Stomach, impairing their transportation and transformation functions, allowing pathogenic factors to merge into the Blood level, thereby forming dysentery. Stools that are red in color result from the transformation of heat within the food stagnation; those that are white result from the transformation of cold within the food stagnation. One cannot simply equate red with Heat syndrome and white with Cold syndrome. Treatment must distinguish between Exterior and Interior patterns. Zhu Danxi stated: If accompanied by aversion to cold, fever, and pain in the head and body, the pathogen is in the Exterior. When the pathogen is in the Exterior, one should disperse summerheat. Pathogens entering the Interior necessarily move from skin and flesh to sinews and bones, and then from sinews and bones into the Intestines and Stomach. The current presence of alternating chills and fever, along with body pain, indicates that Exterior pathogens have not been cleared. If one merely clears the Stomach and resolves stagnation without addressing the Exterior, the pathogens in the Exterior will inevitably all shift to the Interior, and how can the condition ever resolve? Chai Hu Hua Zhi Tang (Bupleurum Decoction to Resolve Stagnation) is indeed an excellent formula for resolving both Exterior and Interior simultaneously. (It yields rapid and reliable effects in treating dysentery complicated by Exterior symptoms. Yu Jia Yan's "Reverse Flow Pulling the Boat" method is based on modifications of this formula.) Ancient formulas used Renshen Baidu San (Ginseng Powder to Overcome Toxins), attributing it to the Taiyang (Greater Yang) channel while neglecting the Shaoyang (Lesser Yang) channel, which is somewhat seeking too far away. As for tenesmus (heavy sensation in the rectum) and abdominal pain with urgent bearing down, this indicates the pathogen is in the Interior. When the pathogen is in the Interior, purgative methods should be employed. Puhuang Wan (Magnolia Bark and Rhubarb Pill) is suitable for purgation. However, to use purgatives, it must be within two or three days of onset, when the Yuan Qi is not yet deficient and the pulse is still forceful, before purgation can be applied. If the dysentery has persisted for a long time with frequent stools and a weak pulse, even if there is tenesmus, it is due to Qi deficiency with sinking, which differs from the initial stage, and reckless purgation must be avoided.
If there are no exterior symptoms such as headache and body pain, and no interior symptoms such as tenesmus, Qín Sháo Tiáo Zhōng Tang (Scutellaria and Peony Decoction to Regulate the Middle) is appropriate. Huang Qin (Scutellaria Root) can consolidate the Qi of the Large Intestine, and Bai Shao (White Peony Root) can consolidate the Blood of the Large Intestine. Dysentery with bloody stools cannot heal without this formula. However, patients with dysentery often suffer from irregular diet, where old stagnation remains and new food intake is excessive. If the chest feels uncomfortable, Qín Sháo Tiáo Zhōng Tang should not be used abruptly, as its astringent properties may retain food and worsen the dysentery. After regulating and unblocking, one should strongly tonify the Yuan Qi. Nevertheless, while Qi deficiency is common in dysentery patients, Yin deficiency is also frequent. Excessive purging leads to loss of Yin, causing deficiency and dryness of the Zang-Fu organs, intense thirst with desire to drink, and a fine and rapid pulse. In such cases, Shao Yao Jian Pi Tang (Peony Decoction to Strengthen the Spleen) is suitable. Merely taking this decoction will allow the dysentery to heal spontaneously. If it is Yang deficiency, the pulse will likely be surging, large, and forceless. In such cases, Qin Shao Bu Zhong Tang (Scutellaria and Peony Decoction to Tonify the Middle) or Zi Sheng Wan (Life-Nourishing Pill) should be used. If tonification fails to cure the condition, astringent methods can then be employed. One must not abruptly use drugs like Yingsuke (Poppy Shell), lest residual stagnation cause distension and fullness, worsening the disease. (Cases turning into chronic intermittent dysentery are often due to premature use of astringents.)
Although, the Kidney serves as the gate of the Stomach; in prolonged dysentery, the Stomach cannot remain undamaged. Formulas such as Si Jun Zi Tang (Four Gentlemen Decoction), Gui Pi Tang (Restore the Spleen Decoction), Shi Quan Da Bu Tang (Comprehensive Great Tonifying Decoction), and Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) all tonify Spleen deficiency and are not ineffective. However, if the pathology lies in Fire deficiency, with Earth lacking its Mother (Kidney Yang failing to warm Spleen Earth), unless Gui Zhi (Cinnamon Twig) and Fu Zi (Aconite Root) are used to strongly tonify the Ming Men (Gate of Life) and restore Kidney Yang to rescue the Spleen (Mother of Earth), how can food intake resume? How can the anal sphincter close? How can the True Yuan be restored? If one fears heat and hesitates to proceed, using only Renshen (Ginseng) and Bai Zhu (Atractylodes Macrocephala Root) to tonify Earth, dysentery is rarely cured. These are methods for treating Heat-type dysentery, but Cold-type dysentery also exists. One must not rigidly assume it is always Heat. Patients with平日里 weak Yuan Qi who consume raw, cold, or cool foods may develop Stomach Cold leading to dysentery, characterized by a deep, fine, and forceless pulse and cold limbs. This can be differentiated. Li Zhong Hua Zhi Tang (Regulating Middle Decoction to Resolve Stagnation) is suitable. This applies not only to Cold dysentery but also to cases where Heat syndromes transform into Cold. Li Dongyuan stated: For persistent dysentery (emphasizing the term "persistent"), if various symptoms do not decrease or instead worsen, treat it as a deficiency syndrome using Bu Zhong Yi Qi Tang, adding Pao Jiang (Prepared Ginger) 1 sheng 1 qian to tonify. Once deficiency returns, the dysentery stops spontaneously. For heavy bearing down and cutting pain in the lower abdomen, or Ben Tun (Rushing Pig) qi attacks, add Rou Gui (Cinnamon Bark) and Po Gu Zhi (Psoralea Fruit); this is indeed an accurate discussion. Dysentery patients need not strictly restrict diet, but should only consume light, soft, and well-cooked foods, eating small amounts. Raw, cold, and wheat-based foods are unsuitable, and rich flavors are especially prohibited. Regarding Wu Se Li (Five-Color Dysentery), such as discharging substances resembling fish brain marrow, or smoke/dust-like water leaking from a house, with an anus relaxed like a bamboo tube and lips painted red like cinnabar, these are all difficult-to-treat conditions.
There is also Re Du Li (Heat-Toxin Dysentery), where food and fluids are expelled entirely, with bowel movements occurring 80–90 times a day. This occurs because the Intestines and Stomach are disturbed by heat toxins, requiring treatment from the Interior. If there is tenesmus, a large dose of Da Huang (Rhubarb Root), Huang Lian (Goldthread Rhizome), and Gan Cao (Licorice Root) should be used to purge. If there is no tenesmus, Qín Sháo Tiáo Zhōng Tang with added Huang Lian and Rou Gui is suitable. Because summerheat pathogens occupy the Intestines and Stomach, cold medicines may be rejected upon entry. Adding a small amount of Rou Gui guides the cold medicine directly to the site of heat, acting like a vanguard soldier, a concept unknown to many. If the pulse is deep, fine, and forceless, with 80–90 bowel movements per day, it indicates Qi deficiency with sinking, which is not treatable by the previous methods.
In dysentery presenting with Jin Kou (Closed Mouth/Anorexia), damp-heat toxins in the Stomach steam upward through the clear pathways, causing closure and coldness at the stomach opening, leading to loss of appetite. The ancient formula Cang Lin Tang (Granary Decoction) disperses internal heat toxins, not Exterior pathogens. Subsequently, Cang Lian Ren Shen Tang (Granary, Goldthread, and Ginseng Decoction) should be given frequently. If there is no response to medication, death is mostly indicated. Initial discomfort in the chest and loss of appetite due to phlegm and food retention in the Stomach do not constitute Jin Kou dysentery.
There is also Xue Li (Bloody Dysentery), characterized by pure red blood discharged separately, not mixed with feces. If blood is present along with feces, it is called Bian Xue (Blood in Stool), not Bloody Dysentery. This results from dietary injury to the Spleen, causing stagnation in the Middle Jiao, preventing the containment of blood, so blood flows out from the anus. Qín Sháo Tiáo Zhōng Tang is also used here. If the pulse is fine and rapid, and the chest condition remains unchanged (no obvious exterior or interior excess heat), Chai Hu Si Wu Tang (Bupleurum Four Substance Decoction) with added Di Yu (Sanguisorba Root) and Wu Mei (Mume Fruit) is suitable. Do not be constrained by the label of "Bloody Dysentery."
Zhu Danxi said: Water diarrhea followed by pus and blood indicates transmission from Spleen to Kidney, termed Zei Xie (Robber Evil), which is difficult to cure. Pus and blood followed by water diarrhea indicates transmission from Kidney to Spleen, termed Wei Xie (Minor Evil), which is easy to cure. Although this theory holds, severity must be assessed. Diarrhea preceding dysentery is indeed difficult to treat, but if the dysentery is mild, is it truly difficult? Dysentery preceding diarrhea is indeed easy to treat, but if diarrhea persists excessively, is it truly curable easily? In cases where dysentery is combined with malaria, treatment should focus primarily on dysentery, not malaria. If dysentery develops after malaria, having exhausted the pathogenic factors, there is likely no remaining summerheat toxin, and Zi Sheng Wan is suitable for regulation. Cases caused by indulgent eating leading to dysentery do not adhere to this example.
Chai Hu Hua Zhi Tang (Bupleurum Decoction to Resolve Stagnation)
Chai Hu (Bupleurum Root), Huang Qin (Scutellaria Root), Gan Cao (Licorice Root), Dan Shen (Salvia Miltiorrhiza Root), Dang Gui (Angelica Sinensis Root), Zhi Ke (Aurantium Fructus Immaturus), Hou Po (Magnolia Bark), Shan Zha (Hawthorn Fruit), Mu Xiang (Costus Root), Bing Lang (Areca Seed).
Chai Hu, Huang Qin, and Gan Cao are used to treat summerheat. Zhi Ke, Hou Po, and Shan Zha are used to digest food. Liu Hejian stated: Promoting Blood circulation heals pus and blood in stool spontaneously, hence Dan Shen and Dang Gui are used. Regulating Qi eliminates tenesmus spontaneously, hence Mu Xiang and Bing Lang are used. This formula is suitable not only for early-stage disease but also for chronic dysentery with body heat. The *Jin Gui Yao Lue* states: Dysentery with a string-like (Xian) pulse, accompanied by fever and sweating, will heal spontaneously. The pulse in chronic dysentery, having penetrated the Yin level, is typically deep, fine, and weak. A sudden shift to a string-like pulse indicates the generating Qi of Shaoyang. Using this formula to "pull the boat against the current" allows pathogens to scatter from the Exterior. Will it not heal? If the pulse is deep, fine, and slippery, with no heat in the Exterior or Interior, and Spleen Qi stagnation, add Huo Xiang (Patchouli Herb) 1 qian for special efficacy.
Pu Huang Wan (Magnolia Bark and Rhubarb Pill)
Da Huang (Rhubarb Root, 4 liang, boiled in wine), Hou Po (Magnolia Bark, 2 liang, stir-fried with ginger juice).
Qin Shao Tiao Zhong Tang (Scutellaria and Peony Decoction to Regulate the Middle)
Zhi Ke, Hou Po, Shan Zha, Huang Qin, Bai Shao, Dan Shen, Jie Geng (Platycodon Root), Bing Lang, Ze Xie (Alisma Rhizome).
Add Jiu Chao Huang Lian (Wine-fried Goldthread Rhizome) for severe heat.
Shao Yao Jian Pi Tang (Peony Decoction to Strengthen the Spleen)
Shan Yao (Chinese Yam Rhizome), Bian Dou (Lablab Bean), Shi Hu (Dendrobium Stem), Wei Ru (Polygonatum Odoratum Rhizome), Sha Shen (Glehnia Root), Bai Shao, Chen Pi (Tangerine Peel), Bai Fu Ling (Poria), Shan Zha, Shen Qu (Medicated Leaven), Hua Fen (Trichosanthes Root).
Lian Shao Bu Zhong Tang (Goldthread and Peony Decoction to Tonify the Middle)
Renshen (Ginseng Root), Bai Zhu (Atractylodes Macrocephala Rhizome), Gan Cao (Licorice Root), Huang Qi (Astragalus Root), Chen Pi, Sheng Ma (Cimicifuga Rhizome), Chai Hu, Bai Shao, Huang Lian.
For chronic dysentery, avoid Dang Gui due to its lubricating and downward-moving nature. Removing Sheng Ma and Chai Hu, and adding E Jiao (Donkey-Hide Gelatin) and Di Yu is particularly effective.
Zi Sheng Wan (Life-Nourishing Pill)
Renshen (3 liang), Bai Zhu (2 liang), Gan Cao (1 liang), Bai Fu Ling (1.5 liang), Shan Zha (2 liang), Shen Qu (2 liang), Mai Ya (Malt, 1.5 liang), Chen Pi (1.5 liang), Jie Geng (5 qian), Shan Yao (1.5 liang), Bian Dou (3 liang), Yi Yi Ren (Coix Seed, 3 liang), Huo Xiang (5 qian), Qian Shi (Euryale Seed, 1.5 liang), Ze Xie (5 qian), Huang Lian (3.5 qian), Bai Kou (White Cardamom Seed, 3.5 qian).
Pill size of a bullet, made with honey.
Li Zhong Hua Zhi Tang (Regulating Middle Decoction to Resolve Stagnation)
Renshen, Bai Zhu, Pao Jiang (Prepared Ginger), Gan Cao, Sha Ren (Amomum Fruit), Hou Po, Huo Xiang, Chen Pi.
Add Rou Gui (Cinnamon Bark) for severe cold.
Cang Lin Tang (Granary Decoction)
Renshen, Bai Fu Ling, Gan Cao, Qiang Huo (Notopterygium Rhizome), Du Huo (Angelica Pubescens Root), Chai Hu, Qian Hu (Peucedani Radix), Chuan Xiong (Ligusticum Chuanxiong Rhizome), Zhi Ke, Jie Geng, Chen Cang Mi (Aged Rice), Shi Lian Rou (Lotus Seed Embryo).
This formula is ineffective without Renshen. For deep pulses, add Huo Xiang.
Cang Lian Ren Shen Tang (Granary, Goldthread, and Ginseng Decoction)
Huang Lian (7 qian), Chen Cang Mi (3 qian), Renshen (5 qian).
For surging and solid pulses, remove Renshen, naming it Cang Lian Jian (Granary and Goldthread Decoction).
External Treatment Method
Use one large river snail, mash into a paste, add 1 li of She Xiang (Musk), apply to the umbilicus to guide heat downward, opening the Stomach. (This method has been tested and yields rapid results.)
Xiang Lian Wan (Costus and Goldthread Pill)
Mu Xiang (1 liang), Huang Lian (2 liang).