金魁官，九月间患五色痢，日下数十行，七、八日来，口噤不纳，腹痛呻吟，危在旦夕矣。孟英视之，曰∶
暑挟食耳，误服热药矣，攻补皆不可施也，轻清取之可即愈焉。以∶北沙参 黄连 鲜莲子 栀子 黄芩 枇杷
叶石斛 扁豆 银花 桔梗 山楂 神曲 滑石为方，覆杯即安。孟英尝曰∶莲子最补胃气而镇虚逆，若反胃
由于胃虚而气冲不纳者，是皆热邪伤其胃中清和之气，故以黄连苦
泄其邪，即仗莲子甘镇其胃。鲜莲子清香不浑，镇胃之功独胜。
附录∶孟英玉芝丸 猪肚一具，治净，以连子去心入肚内，水煎糜烂，收干捣为丸服，凡胃气薄弱者，常
服玉芝丸，令人肥健。
朱某，患痢于越，表散、荡涤、滋腻等药备尝之矣。势濒于危，始返杭乞孟英诊之，神气昏沉，耳聋脘闷，口
干身热，环脐硬痛异常，昼夜下五色者数十行，小溲涩痛，四肢抽搐，时时晕厥。曰∶此暑热之邪，失于清解，表散
荡涤，正气伤残，而邪乃传入厥阴，再以滋腻之品，补而锢之，遂成牢不可拔之势。正虚邪实，危险极矣。与∶白
头翁汤加山栀、黄芩、银花、白芍、楝实、苁蓉、石斛、桑叶、羚羊角、橘叶、牡蛎、海 、鳖甲、鸡内金等药，大
剂频灌，一帖而抽厥减半，四帖而抽厥始熄。旬日后，便色始正，溲渐清长，粥食渐进。半月后，脐间之硬始得尽
消。改用养阴调理，逾月而康。
朱念民，患泄泻。自谓春寒偶薄而饮烧酒，次日转为滞下。左腹起一痞块，痢时绞痛异常。孟英曰∶阴虚木燥，
侮胃为泻，误饮火酒，怒木愈张，非寒也。亟屏辛温之物，用白头翁汤加（黄）芩、（川）楝、栀（子）、（
黄）连、海 、银花、草决明、枳 子、绿豆皮，十余剂而愈。
汪左泉，患滞下，日夜数十行，而即日须补岁考遗材，浼孟英商速愈之策。孟英切脉弦滑，黄苔满布。
曰∶易事耳。重用（黄芩） （黄）连 佐以（山）楂 （浓）朴 服青麟丸四钱，投匕而痊。
陈昼三，病滞下，某进通因通用法，痛泄无度，呕恶不纳，汗出息微，脉弱眩晕。孟英曰∶近多伏暑之痢，
此独非其证也。元将脱矣。急投大剂温补，脉候渐安。一月后，甫得健复。
高若舟之庶母，年逾花甲，体丰善泻，张某向用参、术取效。今秋患白痢，张谓寒湿滞中，仍与理中（
汤）加减，病遂日增。因疑老年火衰，蒸变无权，前药中复加附子。白痢病果减，而腹胀且痛，不食不溺、哕逆发
热、势已危殆。始迓孟英视之。脉沉而滑数梗梗。曰∶暑热未清，得毋补药早投乎？与（黄）芩 （黄）连 杏
（仁） （浓）朴 橘（红） （神）曲 （白）芍 滑（石） （川）楝 银花 海蛇 鸡内金之类，一剂溺行
痛减，而痢下仍白。其女为屠西园之室，乃云∶向服补药，白痢已止，今服凉药，白痢复作，盖病本久寒，
凉药不可再用矣。孟英曰∶言颇近理，使他医闻之，必改温补。但病机隐伏，测识匪易，前此之止，非邪净而止之
止，乃血得补而不行之止。邪气止而不行，是以痛胀欲死。夫强止其痢，遽截其疟，犹之乎新产后妄涩其恶露也。
世人但知其恶露之宜通。而不知间有不可妄通者，但知疟、痢之当止，而不知邪未去而强止之，其害较不止为尤甚也。
今邪未清涤，而以温补药壅塞其流行之道，以致邪不能出，逆而上冲，哕不能食，此痢症之所畏。吾以通降凉润之剂，
搜邪扫浊，惟恐其去之不速，胡反以白痢复作为忧？岂欲留此垢滞于腹中，冀得化脂膏而填空隙，何若是之宝惜而
不愿其去耶？幸若舟深信，竟从孟英议。寻愈。
戚妪，病痢，某医以其高年，用“舍病顾虚”之法为治，渐至少腹结块，攻痛异常，大渴无溺，杳不知饥，
昼夜百余行，五色并见，呼号欲绝。孟英诊之，脉至沉滑而数。因谓曰∶纵然暑湿深受，见症奚至是耶？此必温补
所酿也。夫痢疾古称滞下，明指“欲下而滞塞不通”。顾名思义，岂可以守补之品更滞其气？燥烈之药再助其虐？
现少腹聚气如瘕，痢症初起，因于停滞者有之。今见于七八日之后，且时欲冲逆，按之不硬，则显非停滞之可拟，
实为药剂之误投。察前诸方，果是参、术、姜、萸、附、桂、粟壳、故纸、川椒、乌梅等一派与病刺谬之药。是但知
年老元虚，不闻邪实则实？幸未呕哕，尚可希冀一二。遂与∶苁蓉 (川）楝 （白）芍 （黄）芩 （黄）连 橘（
皮） （石）斛 （山）楂 （神）曲 延胡 绿（萼）梅 鳖甲 鸡（内）金 鼠矢 海 ，出入互用，数帖渐安。
十八涧徐有堂室，病痢，医作寒湿治，广服温补之药，痢出觉冷，遂谓沉寒。改投燥热。半月后，发热无溺，
口渴不饥，腹痛且胀，巅痛不眠。翁嘉顺嘱其求诊于孟英，察脉弦细，沉取甚数，舌绛无津，肌肉尽削。是暑热胶锢，
阴气受烁。与∶北沙参 肉苁蓉 （黄）芩 （石）斛 楝（实） （白）芍 银花 桑叶 丹皮 阿胶合白头
翁汤为剂，次日各恙皆减。痢出反热，有堂不解，问（何以）故？孟英曰∶热证误投热药，热结而大便不行者有之；
或热势奔迫，而泄泻如火者有之；若误服热药而痢出反冷者，殊不多见也。无怪医者指为久伏之沉寒。吾以脉证参
之，显为暑热。然暑热之邪，本无形质，其为滞下也，必挟身中有形之垢浊。故治之之道，最忌补涩壅滞之品。
设误用之，则邪得补而
愈炽，浊被壅而愈塞，耗其真液之灌溉，阻其正气之流行，液耗则出艰，气阻则觉冷。大凡有形之邪，皆能
阻气机之周流。如痰盛于中，胸头觉冷。积滞于腑，脐下欲熨之类。皆非真冷，人不易识。吾曾治愈多人矣。徐极
叹服，仍议育阴涤热，病果渐瘳。
管氏妇，自去秋患赤痢，多医罔效，延至暮春。孟英诊脉弦数，苔黄，渴饮，腹胀而坠，五热夜甚。用白头
翁汤合金铃子散，加∶（黄）芩、（白）芍、栀（子）、（石）斛，吞驻车丸，浃旬而愈。
朱浚宣令堂，患滞下，医闻白色，而予升提温补。旬日后，肢冷自汗，液脱肛坠，群医束手，虑其虚脱。因浼
濮树堂乞诊于孟英，曰∶药误耳。与大剂行气蠲痰清肺之药，果渐吐痰而痢愈。
又其令弟，同时患此。五色并见，神昏肢搐，大渴茎肿，腹痛夜热，危险异常。孟英察脉细数，与白头翁汤加
犀角、生地、银花、石斛、楝实、延胡、（黄）芩、（黄）连、滑石、丹皮、木通、甘草梢等药，三帖后，热退神清，
溺行搐止。乃去犀角、甘草梢、丹皮、滑石、木通，加砂仁拌炒熟地、山楂炭，服之渐安，半月而愈。
盛犀林广文之仆，患血痢。自秋徂冬，半年罔效。孟英察脉细弱，而口干、腰膝酸痛。予∶鹿角霜 苁蓉
枸杞 杜仲 菟丝 续断 血余 木瓜（赤） 石脂 砂仁末炒熟地黄，十余剂而痊。
丙午春，高汉芳，患滞下。色酱，日数十行。年已七十七岁。自去秋以来，渐形疲惫，即服补药，驯致见痢，
黄某径用温补，势乃剧。延孟英诊之，右脉弦细芤迟，口渴溲涩，时时面赤自汗，乃吸受暑邪，误作虚（寒）
治。幸其所禀极坚，尚能转痢。一误再误，邪愈盛而正反虚矣。以白头翁汤加（人）参、（白）术、银花、（黄）
芩、（白）芍、楝（实）、（石）斛、延胡，二剂即减，五剂而安。继予调补，竟得霍然。后三载，以他疾终。
叶昼三侄女适朱氏，上年四月分娩，七月患赤痢，其家谓产后之病，不敢服药，延至今春，肌消膝软，见食
欲呕，昼三迓孟英诊之，左细软，右滑数，伏暑为病，幸未误药。与∶沙参 陈仓米 （当）归 （白）芍 续
断木瓜 扁豆 （黄）连 （石）斛 石莲 荷蒂 柿蒂 枇杷叶 橘皮为方，送驻车丸而愈。
孙心言，以七十之年患滞下，胡某知为暑热，以青麟丸下之，治颇不谬。继则连投（苍）术、（浓）朴、（法）
夏、葛（根）等药。渐至咽痛口糜，呃忒噤口。诸医进补，其势孔亟。伊芳婿童秋门迓孟英诊之，右脉滑数上溢，
身热面赤，溲涩无眠，体浓痰多，时欲出汗。在痢疾门中，固为危候。第以脉证参之，岂是阳虚欲脱？实由升散温
燥之剂，燥烁其阴，肺胃之气，窒塞而不能下行也。与大剂整肃之药，一剂知，二剂已。随以生津药溉之，痢亦寻愈。
庄芝阶舍人之外孙汪震官，春前陡患赤痢。孟英诊之，脉滑数而沉，面赤苔黄，手足冷过肘膝，当脐硬痛，
小溲涩少。伏热为病也。与大剂∶（黄）芩 （黄）连 （山）栀 楝（实） 滑石 丹皮 砂仁 延胡 楂（肉
）（神）曲 银花 草决明等药，两服，手足渐温，而脚背红肿起 如蒲桃（葡萄）大一、二十枚。四服后，
腹痛减，苔退而渴。于原方去楂（肉）、（神）曲、砂仁，加白头翁、赤芍、海 。
旬日后，痢色转白，而 溃黄水而平。谷食遂安，改用养胃阴清余热之法而愈。
闻孟英治此证，每剂银花辄用至两许，尚须半月而瘳。设病在他家，焉能如此恪信？苟遇别手，断无如
此重剂，况在冬春之交。诚古所未有之痢案，后人恐难企及。
一叟，患滞下，色白不粘，不饥不渴，腹微痛而不胀。孟英切脉，迟微。进大剂真武汤加人参而愈。
吴尔纯，八月下旬患滞下，腹痛异常，伊芳外祖许仲廉，延孟英往诊，形瘦脉数而弦，口渴音微，溺涩，乃阴分
极虚，肝阳炽盛，伏暑为痢。治法不但与寒例迥异，即与他人之伏暑成痢者，亦当分别用药也。与白头翁汤加知母、
花粉、银花、丹皮、金铃、延胡、沙参、（黄）芩、（黄）连服之。
次日复视，痢减音开。而右腹疼痛拒按。为加∶冬瓜子、乌药、鼠矢，三剂而消，滞下亦愈。惟薄暮火升，
面赤自汗，重加介类潜阳而痊。
徐氏妇，怀妊患痢，医投温补，胸腹痛极，昏厥、咽糜，水饮碍下。孟英诊之，脉洪数，舌绛燥。亟吹锡类散，
灌以∶犀角 石膏 元参 知母 花粉 竹沥 麦冬 银花 栀子 石斛 旋复 青蒿 白薇等，大剂投之，神气
渐清。旬日后，各恙始平。继去犀角，加生地，服二月痊愈。
谢再华请孟英治乍浦人滞下证，昼夜百余行，不饥不渴，而欲呕腹痛，上及于心胸。切其脉，颇平和，是寒湿
也。与时行暑湿痢大相迳庭，投∶（干）姜 （肉）桂 （吴）萸 （浓）朴之剂，数服霍然。
王瘦石夫人，患滞下，腹痛微呕，不饥口苦，溲短耳鸣。孟英诊曰∶脉见细弱之形，肌无华泽之色，汛不行而
早断，舌紫黯以无津，是素质阴亏，情怀悒郁，二阳默炽，五液潜消，虽吸暑邪，莫投套药。与∶白头翁汤加雪羹、
银花、栀子、楝实，数剂而减。继去雪羹，加生地、苁蓉、柿饼、藕汁而安。改授∶甘（草） （小）麦 大枣
加西洋参 生地 苁蓉 竹茹 （当）归 芍（药） 葡萄干，而以藕汤煎服，调养体质以痊。
王苇塘，患滞下，医投枳（实）、（浓）朴、槟（榔）、楂（肉）之药，数服后，肢冷自汗，杳不进谷，脘闷
腹痛，小溲牵疼。举家惶惶。孟英视脉，细涩，舌绛无津。是高年阴亏，伏暑伤液，况平昔茹素，胃汁不充，加以
燥热之药，津何以堪。因与∶沙参 银花 苁蓉 白芍 石斛 木瓜 甘草 楝实 扁豆花 鲜稻根，数剂。痛闷
渐去，汗止肢温。乃加生地、阿胶、麦冬、柿饼、葡萄干等以滋之，居然而痢止餐加，惟舌色至匝月始津润复常，
阴液之难充也如此。
沈缓斋令堂，患滞下色白，医予温运，病势日剧，腹胀昏瞀，汤饮不下。孟英诊为伏暑。用∶（黄）芩
（黄）连 滑（石） （浓）朴等药，沈疑高年，且素患脘痛，岂可辄用苦寒？孟英再四剖陈，始服半剂，病果大
减，不数帖即愈。按此等证甚多，奈执迷不悟者，虽剀切言之，不能解其惑，亦可哀也已。
曹泳之二尹，将赴代理昌化任，而疟痢并作，寒少热多，滞下五色。迎孟英视之，面垢苔黄，干呕口渴，痛胀
溺赤，汗出神疲，脉至洪数不清，与大剂∶（黄）芩 （黄）连 滑（石） （浓）朴 知母 花粉 银花
石膏 连翘 竹茹等药，投匕即减，三服而起。
金魁官，在九月间患上了五色痢（痢疾的一种，大便中夹杂红、白、黄、青、黑五色脓血），每天排便几十次。七八天来，牙关紧闭无法进食，腹痛呻吟，生命垂危。王孟英诊视后说：“这是暑邪夹带食积，误服了热性药物。此时攻下或补益都不适宜，用轻清之剂治疗即可痊愈。”处方：北沙参、黄连、鲜莲子、栀子、黄芩、枇杷叶、石斛、扁豆、银花、桔梗、山楂、神曲、滑石。服药后很快见效。
王孟英曾说道：“莲子最能补益胃气并镇降虚逆之气。如果是由于胃虚导致气冲不纳的反胃症，这都属于热邪损伤了胃中的清和之气，所以用黄连的苦寒来泄除邪热，依靠莲子的甘平来镇定胃气。鲜莲子清香纯正，镇胃的功效尤为显著。”
附录：王孟英的玉芝丸方。猪肚一个，洗净，将去心的莲子放入肚内，加水煎煮至糜烂，收干捣碎制成丸药服用。凡是胃气薄弱的人，常服玉芝丸，能使人身体肥壮强健。
朱某，在越地患痢疾，表散、荡涤、滋腻等药物都尝试过了。病情危急，才返回杭州请求王孟英诊治。患者神志昏沉，耳聋，脘腹闷胀，口干身热，脐周硬痛异常，昼夜排出五色痢几十次，小便涩痛，四肢抽搐，时常晕厥。王孟英说：“这是暑热之邪，失于清解。经过表散和荡涤，正气受损，邪气传入厥阴经，又用了滋腻的药物，使邪气被封闭固结，于是形成了难以拔除的局面。正虚邪实，非常危险。”给予白头翁汤加山栀、黄芩、银花、白芍、楝实、肉苁蓉、石斛、桑叶、羚羊角、橘叶、牡蛎、海蛇、鳖甲、鸡内金等药，大剂量频繁灌服。一帖后抽搐晕厥减半，四帖后抽搐晕厥停止。十天后，大便颜色开始恢复正常，小便逐渐清长，粥食逐渐增加。半个月后，脐间的硬块才完全消退。改用养阴调理的方法，一个月后康复。
朱念民，患泄泻。自述因春寒偶尔喝了一点烧酒，第二天转为痢疾。左腹部出现痞块，痢疾发作时绞痛异常。王孟英说：“阴虚肝木燥热，克制脾胃导致泄泻，误饮火酒，使肝木更加亢盛，这不是寒证。必须立即停用辛温之物，用白头翁汤加黄芩、川楝子、栀子、黄连、海蛇、银花、草决明、枳棋子、绿豆皮，十余剂而愈。”
汪左泉，患痢疾，日夜几十次，但当天必须参加岁考遗材补录，恳请王孟英商量速愈之策。王孟英切脉见弦滑，舌苔满布黄色。说：“容易治。”重用黄芩、黄连，佐以山楂、厚朴，服用青麟丸四钱，投药即痊愈。
陈昼三，患痢疾。某医生采用“通因通用”法，导致疼痛泄泻无度，呕吐恶心不能进食，出汗气息微弱，脉弱眩晕。王孟英说：“近来多是伏暑引起的痢疾，但这并非其证候。元气即将脱失。急需投以大剂温补药物，脉象逐渐平稳。一个月后才得以恢复健康。”
高若舟的庶母，年过六十，体型丰满易腹泻，张某以前常用人参、白术取得疗效。今年秋天患白痢，张某认为是寒湿阻滞中焦，仍用理中汤加减，病情反而日益加重。因为怀疑老年人火力衰弱，蒸化无权，在前药中又加了附子。白痢病果然减轻，但腹胀且痛，不吃不尿，呃逆发热，形势已经危急。这才迎接王孟英诊视。脉象沉而滑数有力。说：“暑热未清，是不是过早投用了补药？”给予黄芩、黄连、杏仁、厚朴、橘红、神曲、白芍、滑石、川楝子、银花、海蛇、鸡内金之类药物。一剂后小便通畅，疼痛减轻，但痢下仍为白色。他的女儿是屠西园的妻子，就说：“之前服用补药，白痢已止，现在服用凉药，白痢又发作，大概是病本属久寒，凉药不可再用。”王孟英说：“这话听起来颇有道理，换其他医生听到，一定会改为温补。但病机隐伏，难以推测。之前的停止，不是邪气干净后的自然停止，而是血液得到补益后不再运行的停止。邪气停滞不行，所以疼痛胀满欲死。强行止住痢疾，突然截断疟疾，就像新产后妄行收敛恶露一样。世人只知道恶露应当通利，却不知道间或有不可妄通的；只知道疟疾、痢疾应当止住，却不知道邪气未去而强行止住，其危害比不止更严重。现在邪气未清，却用温补药壅塞其流行之道，导致邪气不能外出，反而上冲，呃逆不能进食，这是痢症所忌讳的。我用通降凉润的药剂，搜剔邪气扫荡浊气，惟恐它去除得不快，怎么反而担忧白痢复发？难道想留这些垢滞在腹中，希望它们化为脂膏填补空隙吗？为何如此珍视而不愿其去除呢？幸好若舟深信，竟听从了王孟英的建议。不久痊愈。”
戚家老妇，患痢疾，某医生因为她年事已高，用“舍病顾虚”的方法治疗，逐渐导致少腹结块，攻痛异常，大渴无尿，不知饥饿，昼夜一百多次，五色并见，呼号欲绝。王孟英诊视，脉象沉滑而数。因而对她说：“纵然深受暑湿，症状怎么会这样？这一定是温补所酿成的。痢疾古称滞下，明确指‘想要排泄而滞塞不通’。顾名思义，怎么能用守补的药物更阻滞气机？用燥烈药物再助长邪虐？现在少腹聚气如瘕，痢疾初起，因于停滞的情况有之。现在见于七八日之后，且时时欲冲逆，按之不硬，则明显不是停滞所能比拟的，实在是药剂误投所致。观察前面的诸方，果然是人参、白术、生姜、山茱萸、附子、肉桂、粟壳、故纸、川椒、乌梅等一派与病情相悖的药物。只是知道年老元气虚弱，没听说邪实则实证？幸好没有呕吐呃逆，还可以希冀一二。”于是给予：肉苁蓉、川楝子、白芍、黄芩、黄连、陈皮、石斛、山楂、神曲、延胡索、绿萼梅、鳖甲、鸡内金、鼠矢、海蛇，出入互用，几帖后逐渐安定。
十八涧徐有堂的妻子，患痢疾，医生当作寒湿治疗，广泛服用温补药物，痢出感觉冷，于是说是沉寒。改投燥热药物。半月后，发热无尿，口渴不饥，腹痛且胀，头顶痛不眠。翁嘉顺嘱咐她向王孟英求诊。察脉弦细，沉取甚数，舌绛无津，肌肉尽削。这是暑热胶固，阴气受灼。给予：北沙参、肉苁蓉、黄芩、石斛、楝实、白芍、银花、桑叶、丹皮、阿胶合白头翁汤为剂，次日各症皆减。痢出反觉热，徐有堂不解，问为什么？王孟英说：“热证误投热药，热结而大便不行的情况有；或者热势奔迫，泄泻如火的情况有；如果误服热药而痢出反冷的，确实不多见。难怪医生指为久伏的沉寒。我综合脉证来看，显为暑热。然而暑热之邪，本来无形质，它成为滞下，必定挟带体内有形的垢浊。所以治疗之道，最忌补涩壅滞的药物。假如误用，则邪气得补而更炽盛，浊气被壅而更堵塞，耗损真液的灌溉，阻碍正气的流行，液耗则排出艰难，气阻则感觉冷。大凡有形的邪气，都能阻碍气机的周流。如痰盛于中，胸头感觉冷；积滞于腑，脐下想要熨烫之类。都不是真冷，人不易识别。我曾治愈多人。徐有堂极叹服，仍议育阴涤热，病果渐愈。”
管氏妇人，自去年秋天患赤痢，多位医生无效，拖延到暮春。王孟英诊脉弦数，苔黄，渴饮，腹胀而坠，五心烦热夜间加重。用白头翁汤合金铃子散，加黄芩、白芍、栀子、石斛，吞服驻车丸，十天而愈。
朱浚宣的母亲，患痢疾，医生听说大便白色，就予升提温补。旬日后，肢冷自汗，液脱肛坠，群医束手，担心虚脱。于是请濮树堂向王孟英求诊。王孟英说：“药误罢了。”给予大剂行气蠲痰清肺的药物，果然逐渐吐痰而痢愈。
又是他的弟弟，同时患此病。五色并见，神昏肢搐，大渴茎肿，腹痛夜热，危险异常。王孟英察脉细数，给予白头翁汤加犀角、生地、银花、石斛、楝实、延胡索、黄芩、黄连、滑石、丹皮、木通、甘草梢等药，三帖后，热退神清，小便通畅抽搐停止。于是去掉犀角、甘草梢、丹皮、滑石、木通，加砂仁拌炒熟地、山楂炭，服用后逐渐安定，半月而愈。
盛犀林广文的仆人，患血痢。从秋到冬，半年无效。王孟英察脉细弱，而口干、腰膝酸痛。给予：鹿角霜、肉苁蓉、枸杞、杜仲、菟丝子、续断、血余炭、木瓜、赤石脂、砂仁末炒熟地黄，十余剂而痊愈。
丙午年春天，高汉芳，患痢疾。色酱，日数十行。年已七十七岁。自去年秋天以来，渐渐疲惫，就服用补药，逐渐导致见痢，黄某直接用温补，病情加剧。请王孟英诊视，右脉弦细芤迟，口渴溲涩，时时面赤自汗，乃是吸受暑邪，误作虚寒治疗。幸而他禀赋极坚，尚能转痢。一误再误，邪气更盛而正气更虚。以白头翁汤加人参、白术、银花、黄芩、白芍、楝实、石斛、延胡索，二剂即减，五剂而安。继予调补，竟得霍然痊愈。三年后，因他病去世。
叶昼三的侄女嫁给朱家，上年四月分娩，七月患赤痢，家人认为是产后病，不敢服药，拖延至今春，肌消膝软，见食物欲呕，叶昼三迎王孟英诊视，左脉细软，右脉滑数，伏暑为病，幸好未误药。给予：沙参、陈仓米、当归、白芍、续断、木瓜、扁豆、黄连、石斛、石莲、荷蒂、柿蒂、枇杷叶、橘皮为方，送服驻车丸而愈。
孙心言，七十岁患痢疾，胡某知道是暑热，用青麟丸下之，治疗颇不错。接着连续投用苍术、厚朴、法夏、葛根等药。渐渐至咽痛口糜，呃逆噤口。诸医进补，病情危急。他的女婿童秋门迎王孟英诊视，右脉滑数上溢，身热面赤，溲涩无眠，体胖痰多，时欲出汗。在痢疾门中，固为危候。但以脉证参之，难道是阳虚欲脱？实在由升散温燥之剂，燥烁其阴，肺胃之气，窒塞而不能下行也。给予大剂整肃之药，一剂知，二剂已。随后以生津药灌溉之，痢亦寻愈。
庄芝阶舍人的外孙汪震官，春节前突然患赤痢。王孟英诊视，脉滑数而沉，面赤苔黄，手足冷过肘膝，当脐硬痛，小溲涩少。伏热为病也。给予大剂：黄芩、黄连、山栀、楝实、滑石、丹皮、砂仁、延胡索、楂肉、神曲、银花、草决明等药，两服，手足渐温，而脚背红肿起疱如葡萄大一二十枚。四服后，腹痛减，苔退而渴。于原方去楂肉、神曲、砂仁，加白头翁、赤芍、海蛇。
旬日后，痢色转白，而疱溃黄水而平。谷食遂安，改用养胃阴清余热之法而愈。
听说王孟英治此证，每剂银花辄用至一两许，尚须半月而瘳。设病在他家，焉能如此恪信？苟遇别手，断无如此重剂，况在冬春之交。诚古所未有之痢案，后人恐难企及。
一老叟，患痢疾，色白不粘，不饥不渴，腹微痛而不胀。王孟英切脉，迟微。进大剂真武汤加人参而愈。
吴尔纯，八月下旬患痢疾，腹痛异常，他的外祖许仲廉，延王孟英往诊，形瘦脉数而弦，口渴音微，溺涩，乃阴分极虚，肝阳炽盛，伏暑为痢。治法不但与寒例迥异，即与他人之伏暑成痢者，亦当分别用药也。给予白头翁汤加知母、花粉、银花、丹皮、金铃、延胡索、沙参、黄芩、黄连服之。
次日复视，痢减音开。而右腹疼痛拒按。为加：冬瓜子、乌药、鼠矢，三剂而消，滞下亦愈。惟薄暮火升，面赤自汗，重加介类潜阳而痊。
徐氏妇人，怀妊患痢，医投温补，胸腹痛极，昏厥、咽糜，水饮碍下。王孟英诊之，脉洪数，舌绛燥。亟吹锡类散，灌以：犀角、石膏、元参、知母、花粉、竹沥、麦冬、银花、栀子、石斛、旋复花、青蒿、白薇等，大剂投之，神气渐清。旬日后，各恙始平。继去犀角，加生地，服二月痊愈。
谢再华请王孟英治乍浦人滞下证，昼夜百余行，不饥不渴，而欲呕腹痛，上及于心胸。切其脉，颇平和，是寒湿也。与时行暑湿痢大相迳庭，投：干姜、肉桂、吴萸、厚朴之剂，数服霍然。
王瘦石夫人，患痢疾，腹痛微呕，不饥口苦，溲短耳鸣。王孟英诊曰：脉见细弱之形，肌无华泽之色，月经不行而早断，舌紫黯以无津，是素质阴亏，情怀悒郁，二阳默炽，五液潜消，虽吸暑邪，莫投套药。给予：白头翁汤加雪羹、银花、栀子、楝实，数剂而减。继去雪羹，加生地、苁蓉、柿饼、藕汁而安。改授：甘草、小麦、大枣加西洋参、生地、苁蓉、竹茹、当归、芍药、葡萄干，而以藕汤煎服，调养体质以痊。
王苇塘，患痢疾，医生投枳实、厚朴、槟榔、楂肉之药，数服后，肢冷自汗，杳不进谷，脘闷腹痛，小溲牵疼。举家惶惶。王孟英视脉，细涩，舌绛无津。是高年阴亏，伏暑伤液，况平昔茹素，胃汁不充，加以燥热之药，津何以堪。因给予：沙参、银花、苁蓉、白芍、石斛、木瓜、甘草、楝实、扁豆花、鲜稻根，数剂。痛闷渐去，汗止肢温。乃加生地、阿胶、麦冬、柿饼、葡萄干等以滋之，居然而痢止餐加，惟舌色至匝月始津润复常，阴液之难充也如此。
沈缓斋的母亲，患痢疾色白，医生予温运，病势日剧，腹胀昏瞀，汤饮不下。王孟英诊为伏暑。用：黄芩、黄连、滑石、厚朴等药，沈疑高年，且素患脘痛，岂可辄用苦寒？王孟英再四剖陈，始服半剂，病果大减，不数帖即愈。按此等证甚多，奈执迷不悟者，虽剀切言之，不能解其惑，亦可哀也已。
曹泳之二尹，将赴代理昌化任，而疟痢并作，寒少热多，滞下五色。迎王孟英视之，面垢苔黄，干呕口渴，痛胀溺赤，汗出神疲，脉至洪数不清，与大剂：黄芩、黄连、滑石、厚朴、知母、花粉、银花、石膏、连翘、竹茹等药，投匕即减，三服而起。
Jin Kuiguan, in September, contracted Wuse Dysentery (dysentery characterized by stool containing pus and blood of five colors: red, white, yellow, green, and black), defecating dozens of times a day. For seven or eight days, his jaw was locked and he could not take food; abdominal pain accompanied by groaning indicated that his life was in imminent danger. Wang Mengying examined him and said: "This is Summerheat combined with Food Stagnation, caused by the mistaken administration of hot-natured medicines. Neither purgatives nor tonics are suitable at this time; a light and clear formula will bring about a cure." The prescription consisted of Bei Sha Shen (Glehniae Radix), Huang Lian (Coptidis Rhizoma), Xian Lian Zi (Fresh Nelumbinis Semen), Zhi Zi (Gardeniae Fructus), Huang Qin (Scutellariae Radix), Pi Pa Ye (Loquat Leaf), Shi Hu (Dendrobii Caulis), Bian Dou (Lablab Album), Yin Hua (Lonicerae Flos), Jie Geng (Platycodonis Radix), Shan Zha (Crataegi Fructus), Shen Qu (Massa Medicata Fermentata), and Hua Shi (Talcum). He recovered quickly after taking the medicine.
Wang Mengying once remarked: "Lian Zi (Nelumbinis Semen) is most effective in tonifying Stomach Qi and subduing deficiency-type rebellious Qi. In cases of Fan Wei (Rebellious Vomiting/Regurgitation) due to Stomach deficiency with Qi rushing upward and failing to descend, this is invariably because Heat Evil has damaged the clear and harmonious Qi within the Stomach. Therefore, Huang Lian's bitter cold nature is used to drain the pathogenic heat, while Lian Zi's sweet and calming property stabilizes the Stomach. Fresh Lian Zi, with its pure and fragrant quality, possesses a superior ability to calm the Stomach."
Appendix: Wang Mengying's Yuzhi Wan (Jade Mushroom Pill). Take one pig stomach, clean it thoroughly, place heart-free Lian Zi inside, boil with water until soft and mushy, dry it, and grind into pills for oral administration. Those with weak Stomach Qi who take Yuzhi Wan regularly will become robust and healthy.
Zhu Mou suffered from dysentery in Yue. He had tried various treatments including diaphoretic, purgative, and cloying/nourishing herbs without success. His condition became critical before he returned to Hangzhou to seek Wang Mengying's consultation. He presented with dull spirit, deafness, epigastric oppression, dry mouth, fever, severe hardness and pain around the umbilicus, defecating dozens of times daily with mixed-color dysenteric stools, painful and difficult urination, limb convulsions, and frequent syncope. Wang Mengying stated: "This is Summerheat-Heat Evil that failed to be cleared and resolved. Diaphoresis and purgation have damaged the Healthy Qi, allowing the pathogen to penetrate into the Jueyin channel. Subsequent use of cloying tonics has trapped the pathogen, creating an intractable situation. With deficiency of Healthy Qi and excess of Pathogenic Evil, the prognosis is extremely dangerous." He prescribed Baitouweng Tang (Pulsatilla Decoction) modified with Shan Zhi Zi (Gardeniae Fructus), Huang Qin (Scutellariae Radix), Yin Hua (Lonicerae Flos), Bai Shao (Paeoniae Radix Alba), Lian Shi (Meliae Fructus), Rou Cong Rong (Cynomorii Herba), Shi Hu (Dendrobii Caulis), Sang Ye (Mori Folium), Ling Yang Jiao (Capricornu Saigae Tataricae), Ju Ye (Citri Reticulatae Folium), Mu Li (Concha Ostreae), Hai She (Hydrophiidae Corpus), Bie Jia (Carapax et Plastrum Testudinis), and Ji Nei Jin (Galli Gigerii Endothelium Corneum). Large doses were administered frequently. After one dose, convulsions and syncope halved; after four doses, they ceased. Ten days later, stool color normalized, urination became clear and abundant, and congee intake increased. Half a month later, the hardness around the umbilicus completely resolved. Treatment shifted to nourishing Yin, and he recovered fully after one month.
Zhu Nianmin suffered from diarrhea. He claimed that drinking burning wine due to spring chill led to dysentery the next day. A mass formed in the left abdomen, causing severe colic during dysenteric episodes. Wang Mengying diagnosed: "Yin deficiency with Liver Wood dryness attacking the Stomach causes diarrhea. The mistaken consumption of fire-wine exacerbated Liver Qi stagnation. This is not a Cold pattern. Immediately discontinue acrid-warm substances. Prescribe Baitouweng Tang modified with Huang Qin (Scutellariae Radix), Chuan Lian Zi (Meliae Fructus), Zhi Zi (Gardeniae Fructus), Huang Lian (Coptidis Rhizoma), Hai She (Hydrophiidae Corpus), Yin Hua (Lonicerae Flos), Cao Jue Ming (Cassiae Semen), Zhi Ju Zi (Araliae Fructus), and Lu Dou Pi (Phaseoli Radiati Pericarpium). He recovered after more than ten doses."
Wang Zuoquan suffered from dysentery, defecating dozens of times day and night. However, he needed to attend a supplementary examination for official selection and urgently requested Wang Mengying's advice for a rapid cure. Wang palpated the pulse as wiry and slippery, with a thick yellow coating covering the tongue. He said: "An easy matter." He heavily utilized Huang Qin (Scutellariae Radix) and Huang Lian (Coptidis Rhizoma), assisted by Shan Zha (Crataegi Fructus) and Hou Po (Magnoliae Officinalis Cortex), and administered Qing Lin Wan (Green Unicorn Pill) 4 qian. Recovery was immediate upon administration.
Chen Zhou San suffered from dysentery. A certain physician applied the method of "treating obstruction with unblocking agents" (Tong Yin Tong Yong), resulting in uncontrollable painful diarrhea, vomiting, inability to retain food, sweating, faint breath, weak pulse, and dizziness. Wang Mengying said: "Most recent cases involve hidden Summerheat dysentery, but this does not fit that pattern. The Primordial Qi is on the verge of collapse. Urgently administer large doses of warming and tonifying herbs." The pulse stabilized gradually. Full recovery took one month.
The concubine of Gao Ruozhou, over sixty years old, was corpulent and prone to diarrhea. Physician Zhang previously achieved efficacy using Ren Shen (Ginseng Radix) and Bai Zhu (Atractylodis Macrocephalae Rhizoma). In autumn, she developed white dysentery. Zhang attributed it to Cold-Damp obstructing the Middle Jiao and continued prescribing modified Lizhong Tang (Middle-Warming Decoction), causing the illness to worsen. Suspecting kidney-fire decline and lack of transformation power, Zhang added Fu Zi (Aconiti Lateralis Radix Praeparata). Although the white dysentery temporarily improved, abdominal distension and pain ensued, along with anorexia, anuria, hiccups, fever, and critical condition. Wang Mengying was then consulted. The pulse was deep, slippery, rapid, and forceful. He said: "Summerheat-Heat has not cleared. Was tonification administered too early?" He prescribed Huang Qin (Scutellariae Radix), Huang Lian (Coptidis Rhizoma), Xing Ren (Armeniacae Semen Amarum), Hou Po (Magnoliae Officinalis Cortex), Ju Hong (Citri Reticulatae Pericarpium), Shen Qu (Massa Medicata Fermentata), Bai Shao (Paeoniae Radix Alba), Hua Shi (Talcum), Chuan Lian Zi (Meliae Fructus), Yin Hua (Lonicerae Flos), Hai She (Hydrophiidae Corpus), and Ji Nei Jin (Galli Gigerii Endothelium Corneum). After one dose, urination resumed and pain decreased, though the dysentery remained white. His daughter, married to Tu Xiyuan, argued: "Previous tonics stopped the white dysentery; now cooling herbs have brought it back. The root cause must be chronic Cold; cooling herbs should not be used." Wang Mengying replied: "Your words sound plausible. Other physicians would likely switch to warming tonics. However, the disease mechanism is subtle and hard to discern. The previous cessation was not due to the elimination of pathogens, but rather the stopping of bleeding due to excessive tonification. Pathogenic stagnation causes severe pain and distension. Forcibly stopping dysentery or malaria is akin to incorrectly astringing lochia postpartum. People know lochia should be expelled, yet sometimes forcing it is harmful; they know malaria and dysentery should stop, but forcibly stopping them before pathogen clearance is far more dangerous than letting them continue. Now, with uncleared pathogens, warm tonics block their exit, causing rebellion upward, leading to hiccups and anorexia—this is what dysentery fears. I use descending, cooling, and moistening agents to search out and sweep away pathogens and turbidity, wishing only for their rapid removal. Why worry about the recurrence of white dysentery? Do you wish to keep this filth in the abdomen, hoping it transforms into fat to fill voids? Why cherish it so much and resist its expulsion?" Fortunately, Gao Ruozhou trusted Wang Mengying completely and followed his advice. He recovered soon after.
An elderly woman from the Qiqi family suffered from dysentery. A physician, citing her advanced age, employed the strategy of "abandoning the disease to protect the deficiency." This led to a mass in the lower abdomen with severe pain, extreme thirst, anuria, anorexia, and over a hundred bowel movements daily with mixed colors, leaving her wailing in despair. Wang Mengying found the pulse deep, slippery, and rapid. He told her: "Even if severely affected by Summerheat-Damp, how could symptoms reach this extent? This must be the result of warming tonics. Dysentery is anciently called 'Zhi Xia' (Stagnant Downward Flow), explicitly referring to 'the desire to defecate but being blocked.' By its name, how can astringent tonics further stagnate Qi? How can drying-hot drugs exacerbate the pathogen? Currently, Qi gathers in the lower abdomen like a mass. While initial dysentery can be due to stagnation, appearing after seven or eight days with upward rushing sensations and non-hard palpation indicates medication error, not simple stagnation. Reviewing previous prescriptions reveals a list of herbs contrary to the pathology: Ren Shen (Ginseng Radix), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Sheng Jiang (Zingiberis Rhizoma Recens), Yu Zhu (Polygonati Odorati Rhizoma), Fu Zi (Aconiti Lateralis Radix Praeparata), Gui Zhi (Cinnamomi Ramulus), Su Ke (Myrobalani Fructus), Gu Zhi (Psoraleae Fructus), Chuan Jiao (Zanthoxyli Pericarpium), and Wu Mei (Mume Fructus). You only knew of the elderly patient's deficiency, ignoring the reality of pathogenic excess. Fortunately, there is no vomiting or hiccups, offering some hope." He prescribed Rou Cong Rong (Cynomorii Herba), Chuan Lian Zi (Meliae Fructus), Bai Shao (Paeoniae Radix Alba), Huang Qin (Scutellariae Radix), Huang Lian (Coptidis Rhizoma), Chen Pi (Citri Reticulatae Pericarpium), Shi Hu (Dendrobii Caulis), Shan Zha (Crataegi Fructus), Shen Qu (Massa Medicata Fermentata), Yan Hu Suo (Corydalis Rhizoma), Lv E Mei (Prunus mume var. viridis calyx), Bie Jia (Carapax et Plastrum Testudinis), Ji Nei Jin (Galli Gigerii Endothelium Corneum), Shu Shi (Musca Domestica), and Hai She (Hydrophiidae Corpus), alternating as needed. After several doses, she gradually stabilized.
Xu Youtang's wife in Shibajian suffered from dysentery. Physicians treated it as Cold-Damp, administering extensive warming tonics. The stool felt cold, leading to a diagnosis of deep-seated Cold. Hot-drying drugs were then given. Half a month later, she developed fever, anuria, thirst, anorexia, abdominal pain and distension, vertex headache, and insomnia. Weng Jiajun advised seeking Wang Mengying. Pulse was wiry and thin, very rapid on deep pressure; tongue was crimson without moisture; muscles were wasted. This indicated Summerheat-Heat adhering and Yin fluid being scorched. Prescription: Bei Sha Shen (Glehniae Radix), Rou Cong Rong (Cynomorii Herba), Huang Qin (Scutellariae Radix), Shi Hu (Dendrobii Caulis), Lian Shi (Meliae Fructus), Bai Shao (Paeoniae Radix Alba), Yin Hua (Lonicerae Flos), Sang Ye (Mori Folium), Dan Pi (Moutan Cortex), E Jiao (Colla Corii Asini), combined with Baitouweng Tang (Pulsatilla Decoction). Symptoms reduced significantly the next day. Xu Youtang was puzzled why the dysentery felt hot despite previous complaints of cold. Wang Mengying explained: "In Heat patterns mistakenly treated with hot drugs, heat consolidation causing constipation occurs; or heat urgency causing fiery diarrhea occurs. But dysentery feeling cold after hot drugs is rare. No wonder doctors diagnose deep latent Cold. Combining pulse and symptoms, this is clearly Summerheat-Heat. Summerheat-Heat is formless, but when manifesting as dysentery, it carries有形 (formable) filth from the body. Thus, treatment strictly forbids astringent, tonifying, and cloying herbs. Misuse leads to pathogens strengthening via tonification and turbidity blocking via cloying, depleting true fluids and obstructing Healthy Qi flow. Fluid depletion makes excretion difficult; Qi obstruction creates a sensation of cold. Generally, formable pathogens obstruct Qi circulation. For example, phlegm abundance causes chest coldness; intestinal accumulation causes desire for warmth below the navel. These are not true Cold, yet people fail to recognize them. I have cured many such cases." Xu was deeply convinced. Treatment continued with nourishing Yin and clearing Heat, leading to gradual recovery.
Lady Guan suffered from red dysentery since last autumn. Multiple physicians failed. By late spring, Wang Mengying found a wiry and rapid pulse, yellow coating, thirst, abdominal distension with bearing-down sensation, and worse five-palm heat at night. He prescribed Baitouweng Tang (Pulsatilla Decoction) combined with Jinlingzi San (Melia and Cyperus Powder), adding Huang Qin (Scutellariae Radix), Bai Shao (Paeoniae Radix Alba), Zhi Zi (Gardeniae Fructus), and Shi Hu (Dendrobii Caulis), with Zhuche Wan (Stop Dysentery Pill) taken orally. She recovered in ten days.
Madam Zhu Junxuan (mother of Zhu Junxuan) suffered from dysentery. Physicians, noting white stool, used lifting and warming tonics. After ten days, she developed cold limbs, spontaneous sweating, fluid depletion, and rectal prolapse. Physicians were helpless, fearing collapse. Pu Shutang consulted Wang Mengying, who said: "Medication error." He prescribed large doses of Qi-moving, phlegm-resolving, and Lung-clearing herbs. She expectorated phlegm and the dysentery healed.
Her brother-in-law simultaneously suffered from the same condition. Mixed-color stool, unconsciousness, limb convulsions, extreme thirst, penile swelling, abdominal pain, and night fever indicated extreme danger. Pulse was fine and rapid. Wang prescribed Baitouweng Tang (Pulsatilla Decoction) modified with Xi Jiao (Rhinocerotis Cornu - *Note: Use substitutes in modern practice*), Sheng Di Huang (Rehmanniae Radix), Yin Hua (Lonicerae Flos), Shi Hu (Dendrobii Caulis), Lian Shi (Meliae Fructus), Yan Hu Suo (Corydalis Rhizoma), Huang Qin (Scutellariae Radix), Huang Lian (Coptidis Rhizoma), Hua Shi (Talcum), Dan Pi (Moutan Cortex), Mu Tong (Akebiae Caulis), and Gan Cao Shao (Paeoniae Radix Rubra cum Glycyrrhiza). After three doses, fever subsided, consciousness returned, urination normalized, and convulsions stopped. Xi Jiao, Gan Cao Shao, Dan Pi, Hua Shi, and Mu Tong were removed. Sha Ren (Amomi Fructus Rotundus) stir-fried with Shu Di Huang (Rehmanniae Radix Praeparata) and Shan Zha Tan (Crataegi Fructus Carbonized) were added. Gradual stability followed, with full recovery in half a month.
The servant of Sheng Xilin Guangwen suffered from bloody dysentery. From autumn to winter, six months passed without effect. Pulse was fine and weak; dry mouth, soreness, and pain in waist and knees were present. Prescription: Lu Jiao Shuang (Cornu Cervi Pantotrichum Preparatum), Rou Cong Rong (Cynomorii Herba), Gou Qi Zi (Lycii Fructus), Du Zhong (Eucommiae Cortex), Tu Si Zi (Cuscutae Semen), Xu Duan (Dipsaci Radix), Xue Yu Tan (Sanguinis Capillaris Carbonized), Mu Gua (Chaenomelis Fructus), Chi Shi Zhi (Halloysit Rubrum), and Sha Ren Mo stir-fried with Shu Di Huang (Rehmanniae Radix Praeparata). Recovery occurred after more than ten doses.
In the spring of Bingwu year, Gao Hanfang, aged 77, suffered from dysentery with sauce-colored stool, dozens of times daily. Since last autumn, he had been fatigued and self-medicated with tonics, which precipitated the dysentery. Physician Huang used warming tonics, worsening the condition. Wang Mengying found the right pulse wiry, thin, hollow, and slow; thirst, difficult urination, facial flushing, and spontaneous sweating occurred frequently. This was Summerheat invasion mistakenly treated as deficiency-Cold. Fortunately, his strong constitution allowed some recovery. Double errors made pathogens stronger and Healthy Qi weaker. Baitouweng Tang (Pulsatilla Decoction) modified with Ren Shen (Ginseng Radix), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Yin Hua (Lonicerae Flos), Huang Qin (Scutellariae Radix), Bai Shao (Paeoniae Radix Alba), Lian Shi (Meliae Fructus), Shi Hu (Dendrobii Caulis), and Yan Hu Suo (Corydalis Rhizoma) reduced symptoms in two doses and stabilized in five. Follow-up tonification led to complete recovery. He died of another illness three years later.
Ye Zhou San's niece, married to the Zhu family, gave birth in April last year. In July, she developed red dysentery. Family members, fearing postpartum complications, refused medication. By this spring, she had muscle wasting, knee weakness, and nausea upon seeing food. Ye Zhou San consulted Wang Mengying. Left pulse was fine and soft; right pulse was slippery and rapid. Diagnosis: Hidden Summerheat. Fortunately, no erroneous medication had been given. Prescription: Sha Shen (Glehniae Radix), Chen Cang Mi (Aged Rice), Dang Gui (Angelicae Sinensis Radix), Bai Shao (Paeoniae Radix Alba), Xu Duan (Dipsaci Radix), Mu Gua (Chaenomelis Fructus), Bian Dou (Lablab Album), Huang Lian (Coptidis Rhizoma), Shi Hu (Dendrobii Caulis), Shi Lian Zi (Nelumbinis Plumula), He Di (Nelumbinis Petiolus), Shi Di (Diospyroi Fructus Calyx), Pi Pa Ye (Loquat Leaf), and Ju Pi (Citri Reticulatae Pericarpium), with Zhuche Wan (Stop Dysentery Pill) taken orally. She recovered.
Sun Xin Yan, aged 70, suffered from dysentery. Hu recognized Summerheat and used Qing Lin Wan (Green Unicorn Pill) for purgation, which was appropriate. However, subsequent continuous use of Cang Zhu (Atractylodis Rhizoma), Hou Po (Magnoliae Officinalis Cortex), Fa Ban Xia (Pinelliae Rhizoma Preparatum), and Ge Gen (Puerariae Lobatae Radix) led to sore throat, oral ulcers, hiccups, and inability to open the mouth. Physicians attempted tonification, worsening the critical condition. His son-in-law, Tong Qiumen, consulted Wang Mengying. Right pulse was slippery, rapid, and overflowing; body heat, facial redness, difficult urination, insomnia, obesity, and excessive phlegm were present. Sweating occurred intermittently. Although critical in dysentery, pulse and symptoms did not indicate Yang deficiency collapse. Rather, ascending, dispersing, warming, and drying herbs had scorched Yin, obstructing Lung and Stomach Qi descent. Large doses of regulating herbs worked in one dose to improve and two to resolve. Subsequent Yin-nourishing herbs aided dysentery recovery.
Wang Zhenguan, grandson of Zhuang Zhijie, suddenly developed red dysentery before spring. Pulse was slippery, rapid, and deep; face red, tongue yellow coating, hands and feet colder than elbows and knees, hardness and pain at umbilicus, scanty painful urination. Diagnosis: Hidden Heat. Large dose of Huang Qin (Scutellariae Radix), Huang Lian (Coptidis Rhizoma), Shan Zhi Zi (Gardeniae Fructus), Lian Shi (Meliae Fructus), Hua Shi (Talcum), Dan Pi (Moutan Cortex), Sha Ren (Amomi Fructus Rotundus), Yan Hu Suo (Corydalis Rhizoma), Zha Rou (Crataegi Fructus Core), Shen Qu (Massa Medicata Fermentata), Yin Hua (Lonicerae Flos), and Cao Jue Ming (Cassiae Semen). After two doses, extremities warmed, but bullae the size of grapes appeared on the dorsum of feet (10-20 units). After four doses, abdominal pain decreased, coating receded, and thirst emerged. Zha Rou, Shen Qu, and Sha Ren were removed from the original formula; Baitouweng (Pulsatilla), Chi Shao (Paeoniae Radix Rubra), and Hai She (Hydrophiidae Corpus) were added. Ten days later, stool turned white, bullae ruptured with yellow fluid and flattened. Appetite stabilized. Treatment shifted to nourishing Stomach Yin and clearing residual Heat, leading to recovery. It is reported Wang Mengying used up to one liang of Yin Hua (Lonicerae Flos) per dose for this case, requiring half a month for cure. Such trust and heavy dosage in early spring is unprecedented and hard to replicate.
An old man suffered from dysentery with white, non-sticky stool, no hunger/thirst, mild abdominal pain without distension. Pulse was slow and minute. Large dose of Zhen Wu Tang (True Warrior Decoction) modified with Ren Shen (Ginseng Radix) cured him.
Wu Erchun, in late August, suffered from dysentery with severe abdominal pain. His maternal grandfather, Xu Zhonglian, invited Wang Mengying. Patient was emaciated, pulse rapid and wiry, thirsty with hoarse voice, difficult urination. Diagnosis: Extreme Yin deficiency with blazing Liver Yang, Hidden Summerheat dysentery. Treatment differed from Cold patterns and typical Summerheat dysentery. Baitouweng Tang (Pulsatilla Decoction) modified with Zhi Mu (Anemarrhenae Rhizoma), Hua Fen (Trichosanthis Radix), Yin Hua (Lonicerae Flos), Dan Pi (Moutan Cortex), Jin Ling Zi (Meliae Fructus), Yan Hu Suo (Corydalis Rhizoma), Sha Shen (Glehniae Radix), Huang Qin (Scutellariae Radix), and Huang Lian (Coptidis Rhizoma) was administered.
Next day, dysentery reduced, voice improved. Right abdominal pain persisted, refusing pressure. Dong Gua Zi (Benincasae Semen), Wu Yao (Linderae Radix), and Shu Shi (Musca Domestica) were added. Mass resolved in three doses, dysentery healed. Evening rising fire, facial redness, and sweating required additional shell-type minerals to anchor Yang for full recovery.
Mrs. Xu, pregnant, suffered from dysentery. Physicians used warming tonics, causing severe chest/abdominal pain, syncope, pharyngeal ulceration, and difficulty swallowing liquids. Wang Mengying found pulse flooding and rapid, tongue crimson and dry. He urgently applied Xi Lei San (Tin Category Powder) and administered large doses of Xi Jiao (Rhinocerotis Cornu - *Note: Use substitutes*), Shi Gao (Gypsum Fibrosum), Yuan Shen (Scrophulariae Radix), Zhi Mu (Anemarrhenae Rhizoma), Hua Fen (Trichosanthis Radix), Zhu Li (Bambusae Succus), Mai Dong (Ophiopogonis Radix), Yin Hua (Lonicerae Flos), Zhi Zi (Gardeniae Fructus), Shi Hu (Dendrobii Caulis), Xuan Fu Hua (Inulae Flos), Qing Hao (Artemisiae Annuae Herba), and Bai Wei (Cynanchi Atrati Radix). Spirit gradually clarified. After ten days, all symptoms平息 (subsided). Xi Jiao was removed, Sheng Di Huang (Rehmanniae Radix) added. Two months of treatment led to recovery.
Xie Zaihua requested Wang Mengying to treat a resident of Zhapu with dysentery, over a hundred times daily, no hunger/thirst, but nausea, abdominal pain extending to chest/heart. Pulse was relatively peaceful, indicating Cold-Damp, distinct from epidemic Summerheat-Damp dysentery. Gan Jiang (Zingiberis Rhizoma), Rou Gui (Cinnamomi Cortex), Wu Zhu Yu (Evodiae Fructus), and Hou Po (Magnoliae Officinalis Cortex) were administered. Rapid recovery occurred after several doses.
Mrs. Wang Shoushi suffered from dysentery with mild abdominal pain, slight nausea, anorexia, bitter taste, short urination, and tinnitus. Wang Mengying diagnosed: Fine and weak pulse, lackluster skin, early menopause, purple-dark tongue without moisture. Constitution: Yin deficiency, depressed mood, silent blazing of Yangming channels, latent consumption of Five Fluids. Although Summerheat was absorbed, standard formulas should not be used. Baitouweng Tang (Pulsatilla Decoction) modified with Xue Geng (Snow Soup - usually Snow Fungus and Winter Melon), Yin Hua (Lonicerae Flos), Zhi Zi (Gardeniae Fructus), and Lian Shi (Meliae Fructus) reduced symptoms in several doses. Xue Geng was removed; Sheng Di Huang (Rehmanniae Radix), Rou Cong Rong (Cynomorii Herba), Shi Bing (Persimmon Cake), and Ou Zhi (Lotus Root Juice) were added for stability. Maintenance formula: Gan Cao (Glycyrrhizae Radix), Xiao Mai (Tritici Fructus), Da Zao (Jujubae Fructus) plus Xi Yang Shen (American Ginseng), Sheng Di Huang (Rehmanniae Radix), Rou Cong Rong (Cynomorii Herba), Zhu Ru (Bambusae Caulis in Taenia), Dang Gui (Angelicae Sinensis Radix), Shao Yao (Paeoniae Radix), and Grape Kernels, decocted in Lotus Root Soup. Body constitution was regulated for recovery.
Wang Weitang suffered from dysentery. Physicians used Zhi Shi (Aurantii Fructus), Hou Po (Magnoliae Officinalis Cortex), Bing Lang (Arecae Semen), and Zha Rou (Crataegi Fructus Core). After several doses, cold limbs, spontaneous sweating, anorexia, epigastric oppression, abdominal pain, and painful urination ensued. Family panicked. Wang Mengying found fine and choppy pulse, crimson tongue without moisture. Diagnosis: Elderly Yin deficiency, Summerheat damaging fluids. Vegetarian diet meant insufficient Stomach juices; drying-hot herbs depleted remaining fluids. Prescription: Sha Shen (Glehniae Radix), Yin Hua (Lonicerae Flos), Rou Cong Rong (Cynomorii Herba), Bai Shao (Paeoniae Radix Alba), Shi Hu (Dendrobii Caulis), Mu Gua (Chaenomelis Fructus), Gan Cao (Glycyrrhizae Radix), Lian Shi (Meliae Fructus), Bian Dou Hua (Lablab Flower), and Xian Dao Gen (Fresh Oryza Sativa Root). Pain and oppression gradually ceased, sweating stopped, limbs warmed. Sheng Di Huang (Rehmanniae Radix), E Jiao (Colla Corii Asini), Mai Dong (Ophiopogonis Radix), Shi Bing (Persimmon Cake), and Grape Kernels were added to nourish. Dysentery stopped, appetite increased. Only tongue moisture returned to normal after a month, illustrating the difficulty of replenishing Yin fluids.
Madam Shen Huanzhai suffered from white dysentery. Physicians used warming-moving methods, worsening the condition to abdominal distension, confusion, and inability to swallow liquids. Wang Mengying diagnosed Hidden Summerheat. Huang Qin (Scutellariae Radix), Huang Lian (Coptidis Rhizoma), Hua Shi (Talcum), and Hou Po (Magnoliae Officinalis Cortex) were prescribed. Shen doubted the use of bitter-cold herbs for an elderly patient with chronic epigastric pain. Wang Mengying explained repeatedly. Half a dose was taken, symptoms greatly reduced, and recovery occurred in few doses. Many such cases exist, but stubborn patients remain unconvinced despite earnest explanation, which is lamentable.
Cao Yongzhi, Second Magistrate, preparing for acting role in Changhua, suffered from simultaneous malaria and dysentery, less chills more fever, mixed-color dysentery. Face dirty, yellow coating, dry retching, thirst, painful distension, red urine, sweating, fatigue. Pulse flooding and indistinct. Large dose of Huang Qin (Scutellariae Radix), Huang Lian (Coptidis Rhizoma), Hua Shi (Talcum), Hou Po (Magnoliae Officinalis Cortex), Zhi Mu (Anemarrhenae Rhizoma), Hua Fen (Trichosanthis Radix), Yin Hua (Lonicerae Flos), Shi Gao (Gypsum Fibrosum), Lian Qiao (Forsythiae Fructus), and Zhu Ru (Bambusae Caulis in Taenia) was administered. Symptoms reduced immediately, recovery in three doses.