痢疾多因饮食所伤，湿热相搏。若里急后重，身不发热，饮食如常，此真痢也，为脾气
。先宜疏通，后用黄芩芍药汤调理。若饮食少进，精神短少，四肢倦怠，此内伤似痢也，为
脾气不足，宜升阳为主。
凡痢疾一见表证，必先解表而后治痢，若表不解，则表邪传里，痢必不愈。故发热身痛
，邪
阳明，宜葛根汤。必表邪解而后无传变之患。
凡痢疾有表里，不宜大下解表，解表则里虚不和，大下则表证难退，表里俱不得畅则死
先泻后痢者，脾传肾，脾气下流，湿热乘于肾也；先痢后泻者，肾传脾，肾不受邪，
复返
，里急后重加槟榔、木香，火甚加黄连，积中有紫血，是瘀血也，加红花，倍白芍生血和血
，痢下如绿豆汁色者，湿也，加炒苍术、白术燥湿。凡痢不可用燥药。痢属肾，肾恶燥，燥
痢疾初起，宜先通之，浓朴、大黄、枳实、朴硝。小水不利加栀子，上胀加槟榔，腹痛
赤白痢，里急后重，日夜无度，腹痛，小便赤涩，大承气汤。脉平和者吉，脉微小者易治，
极细无力，气血两虚，调理气血，不可下之。脉洪大身热者难治，主方必先通利，后用黄芩
、白芍、甘草、黄连、槟榔、木香、枳壳。如闭结加大黄、芒硝，小便不利加木通、车前、
灯心，腹痛加川芎，血枯加归身，气滞加杏仁、身凉四肢冷加煨姜、肉桂、吴萸。久不愈，
八珍汤加乌梅、炮姜。寒加桂、附。表热无汗身痛，人参败毒散。
久痢必用制过乳香、没药，行气行血。盖气行则后重自除，血行则便脓自止。再用白芷
以醒脾，人参以补气，甘草、芍药以和中。久痢小腹痛，破故、小茴、杜仲以固肾。痢不止
加续断。久痢腹痛，如湿热为害，里急后重者，用姜汁炒川连。
血痢，红花、苏木、百草霜各三钱，酒调服。里急后重，黑丑烧存性调服，又用皂角灰服，亦效。
赤白痢，肚腹疼痛，里急后重，玉鹤二神丸，当归、川连、枳壳、槟榔各一两，木香二
两，大黄四两，酒糊丸。茶清下七八十丸。
噤口痢，用人参、石莲肉、石菖蒲以开关，牛膝亦可以开关，又方绿色升麻一钱，石莲
肉五钱，人参三钱，神效。
久痢不止，宜涩之。甘草、粟壳各七分，小红枣七枚，灯心七寸，陈酒三杯煎服。或用
五倍子、芽茶等分，枯矾少许，乌梅肉、大蒜捣丸效，或戊己丸，川连、吴萸各五钱、肉桂
痢疾肛门肿胀如痔状，用冰片研乳调搽。
内伤痢疾，阳气下陷，化为燥火，肛门肿胀，必待阳气上升而后邪热可去。补中益气汤
验案
一妇产后痢疾，误服克伐，暂觉宽快，而肛门痛如针刺，脉数无至数，产后见此为难治
。用人参一钱，木香二分，一服减半，后用人参二钱，黄 一钱，升麻、柴胡各五分，甘草
、陈皮、木香各三分，愈。初用人参补肺，肺气充，则大肠之气不至下陷，木香行滞，以散
一小儿八岁，噤口痢。用归身开发上焦，木瓜、牛膝开关达下，炮姜温中，人参补气而效。
一妇痢疾身热，作真痢治，遂烦躁。用附子一钱，白术、炮姜各一钱，甘草五分，愈。
夫身热者，阳浮于外也；烦躁者，阴盛于内而格阳也。附子理中汤回阳于命门，逐阴寒于外
一人病痢腹痛，下之不效，温之不愈，如是一二月，自分必死。诊其脉知有死血，用
乳香、没药二三钱，酒研服，愈。
一女子久痢三月，红白俱止，但鸡鸣腹内作响，作泻七八次，日日如是。此肝气有余，
脾土不足，久痢伤肾。用风能胜湿之药以补脾胃，人参七分，天麻三分。乌梅、阿胶、茯苓
、甘草各五钱，肉苁蓉、黄连、石斛各三钱，木香二钱，北五味一钱，补骨脂、郁金、陈皮
痢疾大多是因为饮食损伤，导致湿热相互搏结。如果出现里急后重（腹痛窘迫，时时欲泻，肛门重坠），身体不发热，饮食正常，这是真性痢疾，属于脾气郁滞。治疗应先宜疏通气机，然后用黄芩芍药汤进行调理。如果饮食减少，精神疲乏，四肢倦怠，这是内伤引起的类似痢疾的症状，属于脾气不足，治疗应以升举阳气为主。
凡是痢疾一旦出现表证（如恶寒、发热等外感症状），必须先解除表邪，然后再治疗痢疾。如果表邪不解，表邪就会传入体内，痢疾必然无法痊愈。因此，如果出现发热、身痛，且病邪涉及阳明经，适宜使用葛根汤。必须等到表邪解除后，才不会有病邪传变的祸患。
凡是痢疾有表证和里证并存的情况，不宜采用峻下法来解表。因为解表会导致里气虚弱不和，峻下则会使表证难以消退，如果表里之气都不通畅，就会导致死亡。
先腹泻后出现痢疾的，是脾脏的病传变到肾脏，脾气下陷流注，湿热之邪乘虚侵入肾脏；先痢疾后出现腹泻的，是肾脏的病传变到脾脏，肾不受邪，病邪又返回脾脏。
对于里急后重严重的，加入槟榔、木香；火毒炽盛的，加入黄连；大便中有紫黑色血块的，是瘀血，加入红花，加倍使用白芍以生血和血；大便像绿豆汁颜色的，是湿邪盛，加入炒苍术、白术以燥湿。但是，凡治痢疾不可滥用燥烈药物。因为痢疾归属于肾，肾厌恶燥热，过于燥热会加重病情。
痢疾初起时，适宜先用通利之法，可用浓朴、大黄、枳实、朴硝。小便不利的，加入栀子；上腹部胀满的，加入槟榔；腹痛剧烈的……（原文此处中断）
赤白痢，伴有里急后重，日夜无度，腹痛，小便赤涩，使用大承气汤。脉象平和者预后良好，脉象微小者容易治疗；脉象极细无力者，是气血两虚，应调理气血，不可使用攻下法。脉象洪大且身体发热的，难治。主方应先通利，后用黄芩、白芍、甘草、黄连、槟榔、木香、枳壳。如果便秘严重加大黄、芒硝；小便不利加木通、车前子、灯心草；腹痛加川芎；血虚加当归身；气滞加杏仁；身体凉、四肢冷加煨姜、肉桂、吴茱萸。久痢不愈，用八珍汤加乌梅、炮姜。寒证加肉桂、附子。表热无汗身痛，用人参败毒散。
久痢必须使用经过炮制的乳香、没药，以行气活血。因为气行则里急后重自然消除，血行则便脓自然停止。再用白芷以醒脾，人参以补气，甘草、芍药以调和脾胃。久痢小腹痛，用补骨脂、小茴香、杜仲以固肾。痢疾不止加续断。久痢腹痛，如果是湿热为害，伴有里急后重的，用姜汁炒黄连。
血痢，用红花、苏木、百草霜各三钱，用酒调服。里急后重，用黑丑烧存性调服，或者用皂角灰服用，也有效。
赤白痢，肚腹疼痛，里急后重，用玉鹤二神丸，由当归、川连、枳壳、槟榔各一两，木香二两，大黄四两组成，用酒糊做成丸剂。用茶清送服七八十丸。
噤口痢（痢疾重症，不能进食），用人参、石莲肉、石菖蒲来开通关窍，牛膝也可以开通关窍。另一个方子是绿色升麻一钱，石莲肉五钱，人参三钱，效果神奇。
久痢不止，应当收敛固涩。用甘草、罂粟壳各七分，小红枣七枚，灯心七寸，陈酒三杯煎服。或者用五倍子、芽茶等分，少许枯矾，乌梅肉、大蒜捣成丸剂，有效。或者用戊己丸，川连、吴茱萸各五钱、肉桂……（原文此处中断）
内伤痢疾，阳气下陷，化为燥火，导致肛门肿胀，必须等待阳气上升，然后邪热才能去除。使用补中益气汤。
验案：
一位产妇产后患痢疾，误服克伐（攻伐消导）药物，暂时觉得宽快，但肛门痛如针刺，脉数而无规律，产后见此脉证为难治。用人参一钱，木香二分，服用一次后症状减半，后来用人参二钱，黄芪一钱，升麻、柴胡各五分，甘草、陈皮、木香各三分，痊愈。起初用人参补肺气，肺气充盛，则大肠之气不至于下陷，木香行气滞，以消散……（原文此处中断）
一个八岁小儿，患噤口痢。用当归身开发上焦，木瓜、牛膝开通关窍达于下焦，炮姜温中，人参补气而见效。
一位妇女患痢疾身热，按真痢治疗，于是出现烦躁。用附子一钱，白术、炮姜各一钱，甘草五分，痊愈。身体发热，是阳气浮越于外；烦躁，是阴寒盛于内而格拒阳气。附子理中汤回阳于命门，驱逐外部的阴寒。
一个人患痢疾腹痛，用攻下法无效，用温法也不愈，如此一两个月，自己认为必死无疑。诊其脉发现体内有死血（瘀血），用乳香、没药二三钱，酒研磨后服用，痊愈。
一个女子久痢三个月，红白便均停止，只是鸡鸣时分腹内作响，腹泻七八次，日日如此。这是肝气有余，脾土不足，久痢伤及肾。用风能胜湿的药物来补益脾胃，人参七分，天麻三分。乌梅、阿胶、茯苓、甘草各五钱，肉苁蓉、黄连、石斛各三钱，木香二钱，北五味子一钱，补骨脂、郁金、陈皮……（原文此处中断）
Dysentery is mostly caused by dietary injury, leading to the interplay of dampness and heat. If there is tenesmus (urgent feeling to defecate with heavy sensation in the anus), no fever, and normal appetite, this is true dysentery, characterized by stagnation of Spleen Qi. Treatment should first focus on unblocking and regulating Qi, followed by regulation using Huangqin Shaoyao Tang (Scutellaria and White Peony Decoction). If food intake is reduced, spirit is fatigued, and limbs are weak, this is a condition resembling dysentery due to internal injury, characterized by deficiency of Spleen Qi. Treatment should primarily focus on raising Yang Qi.
Whenever dysentery presents with exterior symptoms (such as aversion to cold or fever), the exterior pathogen must be resolved first before treating the dysentery. If the exterior pathogen is not resolved, it will transmit inward, and the dysentery will certainly not heal. Therefore, if fever and body pain occur, and the pathogen involves the Yangming channel, Gegen Tang (Kudzu Root Decoction) is appropriate. Only after the exterior pathogen is resolved can one avoid the risk of disease transmission.
In cases where dysentery presents with both exterior and interior signs, drastic purgation should not be used to resolve the exterior. Resolving the exterior may cause interior deficiency and disharmony, while drastic purgation makes it difficult for exterior symptoms to subside. If neither exterior nor interior Qi flows freely, death may ensue.
If diarrhea precedes dysentery, it indicates the transmission of disease from the Spleen to the Kidney, with Spleen Qi sinking and flowing downward, allowing damp-heat pathogens to invade the Kidney. If dysentery precedes diarrhea, it indicates transmission from the Kidney to the Spleen; since the Kidney does not accept the pathogen, the pathogen returns to the Spleen.
For severe tenesmus, add Binglang (Areca Seed) and Muxiang (Aucklandia Root); for intense fire-toxin, add Huanglian (Coptis Rhizome); for purple-black blood clots in stool, indicating blood stasis, add Honghua (Safflower) and double the dosage of Baishao (White Peony Root) to generate and harmonize blood; for stool resembling mung bean juice, indicating excess dampness, add Chao Cangzhu (Fried Atractylodes Rhizome) and Baizhu (Atractododes Macrocephala Rhizome) to dry dampness. However, generally, drying herbs should not be overused in treating dysentery. Dysentery is associated with the Kidney, which dislikes dryness; excessive dryness worsens the condition.
At the onset of dysentery, it is appropriate to first use purgative methods, such as Houpo (Magnolia Bark), Dahuang (Rhubarb Rhizome), Zhishi (Immature Bitter Orange), and Poxiao (Mirabilite). For difficult urination, add Zhizi (Gardenia Fruit); for upper abdominal distension, add Binglang (Areca Seed); for severe abdominal pain... [text cuts off]
For red and white dysentery with tenesmus, frequent bowel movements day and night, abdominal pain, and dark scanty urine, Dachengqi Tang (Major Order the Qi Decoction) is used. A moderate pulse indicates a good prognosis; a minute pulse indicates ease of treatment; an extremely fine and weak pulse indicates dual deficiency of Qi and Blood, requiring regulation of Qi and Blood without purgation. A surging pulse with fever indicates a difficult prognosis. The main formula should first promote free flow, then use Huangqin (Scutellaria Root), Baishao (White Peony Root), Gancao (Licorice Root), Huanglian (Coptis Rhizome), Binglang (Areca Seed), Muxiang (Aucklandia Root), and Zhiqiao (Bitter Orange Peel). For severe constipation, add Dahuang (Rhubarb Rhizome) and Mangxiao (Mirabilite); for difficult urination, add Mutong (Akebia Stem), Cheqianzi (Plantago Seed), and Dengxincao (Juncus Marrow); for abdominal pain, add Chuanxiong (Ligusticum Rhizome); for blood deficiency, add Dangguishen (Angelica Sinensis Root Heart); for Qi stagnation, add Xingren (Apricot Seed); for cool body and cold limbs, add Wei Jiang (Ginger baked in bran), Rougui (Cinnamon Bark), and Wuyu (Evodia Fruit). For chronic non-healing dysentery, Bazhen Tang (Eight Treasures Decoction) is added with Wu Mei (Mume Fruit) and Pao Jiang (Prepared Ginger). For cold patterns, add Rongui (Cinnamon Bark) and Fuzi (Prepared Aconite Root). For exterior heat, no sweat, and body pain, Renshen Baidu San (Ginseng Powder to Overcome Toxins) is used.
Chronic dysentery requires processed Rushxiang (Frankincense) and Moyao (Myrrh) to move Qi and Blood. Since moving Qi eliminates tenesmus and moving Blood stops pus in stool, these are essential. Further, Baizhi (Angelica Dahurica Root) awakens the Spleen, Renshen (Ginseng Root) tonifies Qi, and Gancao (Licorice Root) and Shaoyao (Peony Root) harmonize the Middle Jiao. For chronic dysentery with lower abdominal pain, Buguzhi (Psoralea Fruit), Xiaohuixiang (Fennel Fruit), and Duzhong (Eucommia Bark) are used to secure the Kidney. If dysentery persists, Xu Duan (Dipsacus Root) is added. For chronic dysentery with abdominal pain caused by damp-heat and tenesmus, Huanglian (Coptis Rhizome) fried in ginger juice is used.
For bloody dysentery, Honghua (Safflower), Sumu (Calamus Wood), and Baicaoshuang (Charred Grass Ash) each 3 qian are taken with wine. For tenesmus, Heiqiu (Morning Glory Seed) charred to retain its nature is taken with water, or Soap Pod Ash is also effective.
For red and white dysentery with abdominal pain and tenesmus, Yuhe Ershen Wan (Jade Crane Two Spirits Pill) is used, composed of Danggui (Angelica Sinensis Root), Chuanlian (Coptis Rhizome), Zhiqiao (Bitter Orange Peel), and Binglang (Areca Seed) each 1 liang, Muxiang (Aucklandia Root) 2 liang, and Dahuang (Rhubarb Rhizome) 4 liang. These are made into pills with wine paste and taken with tea infusion, 70-80 pills at a time.
For Jin Kou Li (Dysentery with inability to eat), Renshen (Ginseng Root), Shilianrou (Lotus Seed Flesh), and Shichangpu (Acorus Rhizome) are used to open the orifices. Niuxi (Achyranthes Root) can also open the orifices. Another prescription uses Lvse Shengma (Green Corydalis Rhizome) 1 qian, Shilianrou (Lotus Seed Flesh) 5 qian, and Renshen (Ginseng Root) 3 qian, yielding miraculous effects.
For persistent chronic dysentery, astringents should be used. Gancao (Licorice Root) and Yuke (Poppy Shell) each 7 fen, 7 small red dates, 7 cun of Dengxincao (Juncus Marrow), and 3 cups of aged wine are decocted and taken. Alternatively, Wubeizi (Chinese Gallnut), Yacha (Sprouted Tea Leaves) in equal parts, a little Kufan (Alum), Wu Meirou (Mume Fruit Flesh), and Dasuan (Garlic Clove) are pounded into pills, which is effective. Or use Wuji Wan (Five Extremities Pill), composed of Chuanlian (Coptis Rhizome) and Wuyu (Evodia Fruit) each 5 qian, and Rougui (Cinnamon Bark)... [text cuts off]
For dysentery causing anal swelling resembling hemorrhoids, Bingpian (Borneol) is ground and mixed with milk for external application.
For internal injury dysentery, Yang Qi sinks and transforms into dry fire, causing anal swelling. Only when Yang Qi rises can the pathogenic heat be eliminated. Buzhong Yiqi Tang (Decoction to Tonify the Middle and Augment the Qi) is used.
Case Record:
A postpartum woman suffered from dysentery and mistakenly took purgative/herb-draining medicines. She felt temporarily relieved but experienced needle-like pain in the anus. Her pulse was rapid and irregular, making it difficult to treat in the postpartum state. She was given 1 qian of Renshen (Ginseng Root) and 2 fen of Muxiang (Aucklandia Root). After one dose, symptoms halved. Subsequently, she was given 2 qian of Renshen (Ginseng Root), 1 qian of Huangqi (Astragalus Root), 5 fen of Shengma (Cimicifuga Rhizome) and Chaihu (Bupleurum Root), and 3 fen each of Gancao (Licorice Root), Chenpi (Tangerine Peel), and Muxiang (Aucklandia Root), resulting in recovery. Initially, Renshen tonified Lung Qi; sufficient Lung Qi prevented Large Intestine Qi from sinking, while Muxiang moved stagnation to dissipate... [text cuts off]
An eight-year-old child suffered from Jin Kou Li (Dysentery with inability to eat). Dangguishen (Angelica Sinensis Root Heart) was used to open the Upper Jiao, Mugua (Chaenomeles Fruit) and Niuxi (Achyranthes Root) to open orifices and reach the Lower Jiao, Pao Jiang (Prepared Ginger) to warm the Middle, and Renshen (Ginseng Root) to tonify Qi, resulting in effectiveness.
A woman suffered from dysentery with fever. Treated as true dysentery, she became irritable. She was given 1 qian of Fuzi (Prepared Aconite Root), 1 qian each of Baizhu (Atractododes Macrocephala Rhizome) and Pao Jiang (Prepared Ginger), and 5 fen of Gancao (Licorice Root), resulting in recovery. Fever indicates Yang floating externally; irritability indicates Yin excess internally repelling Yang. Fuzi Lizhong Tang (Aconite Regulate the Middle Decoction) restores Yang to the Mingmen (Gate of Life) and expels external Yin-cold.
A man suffered from dysentery with abdominal pain. Purgatives were ineffective, and warming treatments failed. After one or two months, he believed he would die. His pulse indicated the presence of dead blood (blood stasis). He was given 2-3 qian of Rushxiang (Frankincense) and Moyao (Myrrh), ground in wine and taken, resulting in recovery.
A woman suffered from chronic dysentery for three months. Red and white stools ceased, but her abdomen made noises at dawn, leading to 7-8 bowel movements daily. This indicated excess Liver Qi, insufficient Spleen Earth, and Kidney damage from chronic dysentery. Herbs that use wind to overcome dampness were used to tonify the Spleen and Stomach: Renshen (Ginseng Root) 7 fen, Tianma (Gastrodia Rhizome) 3 fen. Wu Mei (Mume Fruit), Ejiao (Donkey-hide Gelatin), Fuling (Poria), and Gancao (Licorice Root) each 5 qian, Rongrong (Cistanche Stem), Chuanlian (Coptis Rhizome), and Shihu (Dendrobium Stem) each 3 qian, Muxiang (Aucklandia Root) 2 qian, Bei Wuwei Zi (Schisandra Berry) 1 qian, Buguzhi (Psoralea Fruit), Yujin (Curcuma Rhizome), and Chenpi (Tangerine Peel)... [text cuts off]