3.水浆不入痢不止, 气少脉细皮肤寒, 纯血噤口呕脏气, 身热脉大
命难全.
【注】下痢不止, 水浆不入, 气少脉细, 皮肤寒, 死于阳绝也. 下痢
纯血, 噤口, 呕逆脏气, 身热脉大, 死于阴绝也.
仓廪汤 大黄黄连汤
4.初痢表热宜仓廪, 里热冲心大黄连, 寒痢理中诃蔻缩, 附白桂赤
不须言.
【注】初痢有表证发热者, 不宜攻之, 法当先解其外, 用仓廪汤汗之
.里热盛, 上冲心作呕噤口者, 法当先攻其里, 用大黄, 黄连, 好酒
煎服攻之. 寒痢宜用理中汤, 加诃子, 肉蔻, 缩砂. 白多者加附子,
赤多者加肉桂也.
芍药汤
5.初痢内外无大热, 芩连枳木芍归榔, 桂草尿涩滑石倍, 痢数窘痛
入大黄.
【注】初痢外无表热, 内热不盛, 宜用芍药汤. 即黄芩, 黄连, 枳实
,木香, 芍药, 当归, 槟榔, 甘草, 肉桂少许也. 小便涩赤加滑石.
下痢次数无度, 下坠痛甚, 入大黄也.
香连和胃汤 参连开噤汤 贴脐法
6.痢疾下后调气血, 宜用香连和胃汤, 黄芩芍药香连草, 陈皮白术
缩砂当, 赤虚更加椿榆炒, 白虚参苓共炒姜, 噤口参连石莲子, 贴脐
王瓜藤散良.
【注】痢疾攻后病势大减, 宜调气血, 用香连和胃汤, 即黄芩, 芍药
,木香, 黄连, 甘草, 陈皮, 白术, 当归, 缩砂也. 赤痢下血多虚者
,当涩之, 加炒椿根白皮, 炒地榆. 白痢日久气虚者, 加人参, 茯苓
,炒干姜以补之. 实而噤口堪下者, 以大黄黄连汤下之. 不堪下者,
内以人参, 黄连, 石莲子煎汤, 徐徐服之, 下咽即好. 外以贴脐王瓜
藤散, 即王瓜藤, 茎, 叶经霜者, 烧灰香油调, 纳脐中, 即有效也.
真人养脏汤
7.久痢寒热乌梅治, 寒虚滑痢养脏汤, 参术肉蔻归诃桂, 芍药罂粟
草木香.
【注】久痢脏有寒热不分者, 宜用乌梅丸调和之. 寒虚滑脱者, 宜用
养脏汤温补之, 即人参, 白术, 肉蔻, 当归, 诃子, 肉桂, 芍药, 罂
粟壳, 甘草, 木香也.
香连平胃散 胃风汤
8.水谷调中益气治, 湿痢香连平胃方, 虚湿风痢胃风治, 桂粟八珍
减地黄.
【注】水壳痢者, 乃脾胃虚, 腐化不及, 宜调中益气汤. 湿痢宜木香
,黄连, 合平胃散方. 湿而虚者, 宜用胃风汤, 即肉桂, 粟米, 八珍
汤减地黄也.
3. 痢疾患者若无法进食进水，且腹泻不止，气息微弱、脉象细弱、皮肤发凉，这是阳气衰竭的危候；若排出纯血，伴有口噤不开（牙关紧闭）、呕吐出脏腑之气、身体发热且脉象洪大，这是阴气衰竭的危候，性命难保。
【注】下痢不止，不能进食进水，气息微弱脉象细弱，皮肤寒冷，是由于阳气衰竭而死。下痢纯血，口噤不开，呕吐逆出脏腑之气，身体发热脉象洪大，是由于阴气衰竭而死。
仓廪汤、大黄黄连汤
4. 初起患痢疾且有表证发热的，适宜用仓廪汤；里热炽盛上冲于心导致呕吐、口噤不开的，适宜用大黄黄连汤。寒性痢疾宜用理中汤加诃子、肉豆蔻收敛固涩；白痢多加附子，赤痢多加肉桂，这些都不必多言。
【注】初起痢疾有表证发热的，不宜攻下，治法应当先解表，用仓廪汤发汗。里热盛，上冲于心导致呕吐、口噤不开的，治法应当先攻里，用大黄、黄连，用好酒煎服以攻逐邪气。寒性痢疾适宜用理中汤，加诃子、肉豆蔻、缩砂仁。白痢多者加附子，赤痢多者加肉桂。
芍药汤
5. 初起患痢疾，内外均无大热，可用黄芩、黄连、枳实、木香、芍药、当归、槟榔、甘草治疗，若小便涩痛则加倍使用滑石，若痢疾次数频繁、窘迫疼痛严重，则加入大黄。
【注】初起痢疾外无表热，内热不盛，适宜用芍药汤。即由黄芩、黄连、枳实、木香、芍药、当归、槟榔、甘草及少许肉桂组成。小便涩赤者加滑石。下痢次数无度，下坠疼痛严重者，加入大黄。
香连和胃汤、参连开噤汤、贴脐法
6. 痢疾经过攻下治疗后，病情大势已减，适宜调理气血，使用香连和胃汤。该方由黄芩、芍药、木香、黄连、甘草、陈皮、白术、缩砂仁、当归组成。赤痢下血多且属虚证的，应当收敛固涩，加炒椿根白皮、炒地榆。白痢日久且气虚的，加人参、茯苓、炒干姜以补益。实证且口噤不开但可攻下的，用大黄黄连汤攻下。不可攻下的，内服人参、黄连、石莲子煎汤，徐徐服用，咽下即见效。外用贴脐王瓜藤散，即用经霜的王瓜藤、茎、叶烧成灰，用香油调和，敷于脐中，即有效。
真人养脏汤
7. 久痢寒热错杂者，用乌梅丸治疗；寒性虚证滑脱不禁者，用养脏汤温补。该方由人参、白术、肉豆蔻、当归、诃子、肉桂、芍药、罂粟壳、甘草、木香组成。
香连平胃散、胃风汤
8. 水谷痢因脾胃虚弱、腐熟运化不及所致，宜用调中益气汤治疗；湿痢用香连平胃散治疗；虚湿兼风邪之痢用胃风汤治疗，该方由肉桂、粟米、八珍汤减去地黄组成。
3. If a patient with dysentery cannot take food or fluids, and the diarrhea persists, accompanied by faint breath, fine pulse, and cold skin, this indicates the exhaustion of Yang Qi (Yang energy), a critical condition leading to death. If the stool consists of pure blood, accompanied by trismus (lockjaw), vomiting of visceral qi, fever, and a large pulse, this indicates the exhaustion of Yin Qi (Yin substance/fluids), also a fatal condition.
[Canglin Decoction (Granary Decoction), Dahuang Huanglian Tang (Rhubarb and Coptis Decoction)]
Note: Persistent dysentery, inability to ingest food or fluids, faint breath, fine pulse, and cold skin result from the exhaustion of Yang Qi. Dysentery with pure blood, trismus, vomiting of visceral qi, fever, and a large pulse result from the exhaustion of Yin Qi.
4. For early-stage dysentery presenting with exterior heat, Canglin Decoction is appropriate. For interior heat blazing upward to the heart causing vomiting and trismus, Dahuang Huanglian Tang is appropriate. For cold-type dysentery, Lizhong Tang (Regulate the Middle Decoction) should be used with Hezi (Chebulae Fructus) and Roudoukou (Myristicae Semen) for astringency. For white-dominant dysentery, add Fuzi (Aconiti Lateralis Radix Praeparata); for red-dominant dysentery, add Rougui (Cinnamomi Cortex). These principles need no further elaboration.
Note: Early dysentery with exterior symptoms and fever should not be purged; the method is to first release the exterior using Canglin Decoction to induce sweating. When interior heat is severe and rushes upward to the heart causing vomiting and trismus, the method is to first purge the interior using Dahuang (Rhei Radix et Rhizoma) and Huanglian (Coptidis Rhizoma), decocted in good wine to attack the pathogen. Cold dysentery is suitable for Lizhong Tang, added with Hezi, Roudoukou, and Suosharen (Amomi Fructus Rotundus). Add Fuzi for predominant white discharge; add Rougui for predominant red discharge.
Shaoyao Tang (Peony Decoction)
5. For early-stage dysentery without significant exterior or interior heat, use Huangqin (Scutellariae Radix), Huanglian, Zhishi (Aurantii Fructus Immaturus), Muxiang (Aucklandiae Radix), Shaoyao (Paeoniae Radix), Danggui (Angelicae Sinensis Radix), Binglang (Arecae Semen), and Gancao (Glycyrrhizae Radix et Rhizoma). If urination is astringent and painful, double the dosage of Huashi (Talcum). If the frequency of dysentery is excessive and there is severe tenesmus and pain, add Dahuang.
Note: Early dysentery without exterior heat and with mild interior heat is suitable for Shaoyao Tang. This formula consists of Huangqin, Huanglian, Zhishi, Muxiang, Shaoyao, Danggui, Binglang, Gancao, and a small amount of Rougui. Add Huashi for astringent, red urine. Add Dahuang for uncontrolled frequency of dysentery and severe tenesmus/pain.
Xianglian Hewei Tang (Costus and Coptis Stomach-Harmonizing Decoction), Shenlian Kailing Tang (Ginseng and Coptis Opening-Throat Decoction), Umbilical Patching Method
6. After purgative treatment for dysentery, when the disease trend has significantly subsided, it is appropriate to regulate Qi and Blood using Xianglian Hewei Tang. This formula contains Huangqin, Shaoyao, Muxiang, Huanglian, Gancao, Chenpi (Citri Reticulatae Pericarpium), Baizhu (Atractylodis Macrocephalae Rhizoma), Suosharen, and Danggui. For red dysentery with excessive bleeding and deficiency, astringents such as Chonggenbaipi (Toosendanii Cortex) and Diyuyu (Sanguisorbae Radix), both stir-fried, should be added. For long-standing white dysentery with Qi deficiency, add Renshen (Ginseng Radix et Rhizoma), Fuling (Poria), and Chao Jiang (Zingiberis Rhizoma Praeparatum) to tonify. For excess patterns with trismus that can tolerate purging, use Dahuang Huanglian Tang to purge. For those who cannot tolerate purging, internally administer a decoction of Renshen, Huanglian, and Shilianzi (Nelumbinis Nuculus) slowly; improvement occurs upon swallowing. Externally apply Wangguateng San (Trichosanthes Vine Powder) to the umbilicus: burn the frost-exposed vines, stems, and leaves of Wanggua Teng (Trichosanthis Caulis) to ash, mix with sesame oil, and apply to the umbilicus; this is effective.
Zhren Yangzang Tang (True Person Spleen-Nourishing Decoction)
7. For chronic dysentery with mixed cold and heat, Wumei Wan (Mume Pill) is used to harmonize. For cold-deficiency patterns with slippery incontinence, Yangzang Tang is used to warm and tonify. This formula consists of Renshen, Baizhu, Roudoukou, Danggui, Hezi, Rougui, Shaoyao, Yingsuqiao (Papaveris Pericarpium), Gancao, and Muxiang.
Xianglian Pingwei San (Costus and Coptis Stomach-Calming Powder), Weifeng Tang (Stomach Wind Decoction)
8. For water-and-grain dysentery caused by Spleen-Stomach deficiency and inadequate transformation, Tiaozhong Yiqi Tang (Regulate Middle and Boost Qi Decoction) is indicated. For dampness dysentery, Xianglian Pingwei Fang (Costus and Coptis Formula for Calming the Stomach) is used. For deficiency-dampness wind dysentery, Weifeng Tang is used, which consists of Rougui, Sumi (Panicum miliaceum), and Bazhen Tang (Eight Treasure Decoction) minus Dihuang (Rehmanniae Radix).