病源夫水谷之精，化为血气津液，以养藏腑，藏腑虚受风邪，邪入于肠胃故痢，痢则津
液空
水，
必效疗痢兼渴方。
麦门冬（三两去心） 乌梅（二大枚）
上二味，以水一大升者，煮取强半，绞去滓，待冷，细细咽之，即定，仍含之。（出第
二卷中）
古今录验疗热渴痢方。
冬瓜（一枚）
上一味，以黄土浓一尺，火炮，稳约以水烂去土净洗，绞取服之。
许仁则云，此病有数种，有水痢，有谷痢，有血痢，有脓痢，有脓血相和痢者，有肠
痢，其水痢者，本由脾气热，消谷作水，谷气不得消，便生此痢，谷痢者，由脾气冷，谷气
不消
相和
色
又水痢之候，心腹甚痛，食无妨，但食后即痢，食皆化尽，唯变作水谷无期度，多食多
下，少食少下，有此伏者，宜依后黄芩等五味散服之方。
黄芩 黄连 黄柏（各五两） 黄 （四两） 龙骨（六两）
上药捣筛为散，以饮下之，初服一方寸匕，日二服，稍稍加至二三匕，服差乃止。
又谷痢之候，痢无期度，食不消化，腹痛，每过冷便发，有此疾候者，宜依后附子等五
味散主之方。
附子（炮） 细辛 白术（各五两） 干姜（四两） 神曲（一升）
上药捣筛为散，以饮下之，初服一方寸匕，日再服，稍稍加至二三匕良。
又血痢之候，小腹绞痛，无期度食，不住如水，但兼血而下，有此患者。宜依后方。
犀角五味散方。
生犀角（末五两） 阿胶（炙四两） 黄柏（四两） 艾叶 干姜（各三两一作干蓝）
上药捣筛为散，以饮下之，初服一方寸匕，日再服，稍稍加至二三匕良。
又脓痢之候，腹亦刺痛，食亦不大稀，但大便兼脓，遇冷而剧，有此候者，宜依后神曲
等五味散服之良。
曲末（一升） 干姜（六两） 丁香 豆蔻（各四两） 高良姜（五两）
上药捣筛为散，以饮下之，初服一方寸匕，日再服，稍稍加至二三匕良。
又脓血相和痢候，食不甚稀，每出脓血，与食相兼，腹亦小痛，有此候者，宜依后黄
等五味散服之方。
黄 （六两） 赤石脂（八两） 浓朴（五两炙） 干姜 艾叶（炙各二两）
上药捣筛为散，以饮下之，初服一方寸匕，日再服，稍稍加至二三匕良。
又肠 痢候，食稀或稠，便但似脓，每便极滑，痢有常期，有如此者，宜依后豆蔻子等
八味散服之方。
豆蔻子 丁香（各三两） 细辛 附子（炮） 干姜（各四两） 人参 黄 （各五两）
赤石
脂（六两）
上药捣筛为散，以饮下之，初服一方寸匕，日再，稍稍加至二三匕良。
又前件诸痢，患无新旧，如药疗之， 差还发，此即纵以新药止之。终存其根，本由肠
胃中冷热不调，病根固结，必须汤药涤之，以泄病势，痢后更以药物补助之，有此候者，宜
依后附子等六味汤以利之。后服高良姜十味散以补之方。
附子（炮） 细辛 甘草（炙） 人参（各二两） 干姜（三两） 大黄（五两）
上药切，以水七升煮取二升四合，去滓，分温三服，服如人行十里久，一服此汤，当得
快利
姜等
高良姜 细辛 黄 白术 苦参（各五两） 丁香（二两） 人参 干姜（各四两） 豆
蔻
子（三两） 赤石脂（六两）
上药捣筛为散，以饮下之，初服一方寸匕，日再服之，稍稍加至二三匕。（并出上卷中）
【病机分析】水谷的精微物质，转化为血、气、津液，用以滋养脏腑。若脏腑虚弱而感受风邪，邪气侵入肠胃，就会导致痢疾。患痢疾则津液枯竭，导致口渴。
《必效方》治疗痢疾兼有口渴的方剂：
麦门冬（三两，去心） 乌梅（两枚大的）
以上两味药，用水一升，煮取半升多，过滤去渣滓，待药液冷却后，细细咽下，症状即可平息，服药时让药液在口中含漱片刻。（出自第二卷中）
《古今录验》治疗热渴痢的方剂：
冬瓜（一枚）
以上一味药，用厚约一尺的黄泥土包裹，用火煨烤至熟透，剥去泥土洗净，绞取汁液服用。
许仁则认为，此病有多种类型，有水痢、谷痢、血痢、脓痢、脓血相杂痢、肠滑痢等。其中水痢，原本是由于脾气热盛，消化谷物过快变成水液，谷气不能正常运化，从而产生这种痢疾；谷痢，则是由于脾气虚冷，谷物之气不能消化……（原文此处有缺漏/错简，推测为脾气冷导致谷不消）。又如水痢的症状，心腹部非常疼痛，饮食不受影响，只是进食后立即腹泻，食物完全消化，唯独变为无定时度的水样便，多吃就多泻，少吃就少泻，有此伏邪者，适宜按照后面黄芩等五味散的方法服用。
黄芩 黄连 黄柏（各五两） 黄芩（四两，原文“黄”疑为黄芩或黄芪，结合语境及后世校勘多为黄芩或黄芪，此处依原文保留“黄”，但在实体提取中需注意，通常此类清热燥湿方多用黄芩，然前文已有黄芩，此处可能指黄芪或笔误，按原文提取为“黄”） 龙骨（六两）
以上药物捣碎过筛制成散剂，用饮送服。初次服用一方寸匕，每日两次，逐渐增加至二三匕，痊愈后停药。
又有谷痢的症状，腹泻无定时，食物不消化，腹痛，每次受冷就会发作，有此病症者，适宜按照后面附子等五味散的主治方剂。
附子（炮制） 细辛 白术（各五两） 干姜（四两） 神曲（一升）
以上药物捣碎过筛制成散剂，用饮送服。初次服用一方寸匕，每日两次，逐渐增加至二三匕，效果良好。
又有血痢的症状，小腹绞痛，无定时，排泄物不停如水状，但夹杂血液而下，有此患者，适宜按照后面的方剂。
犀角五味散方：
生犀角（研末五两） 阿胶（炙四两） 黄柏（四两） 艾叶 干姜（各三两，一作干蓝）
以上药物捣碎过筛制成散剂，用饮送服。初次服用一方寸匕，每日两次，逐渐增加至二三匕，效果良好。
又有脓痢的症状，腹部也刺痛，饮食不太稀薄，但大便夹杂脓液，遇冷则病情加重，有此症状者，适宜按照后面神曲等五味散服用，效果良好。
神曲末（一升） 干姜（六两） 丁香 豆蔻（各四两） 高良姜（五两）
以上药物捣碎过筛制成散剂，用饮送服。初次服用一方寸匕，每日两次，逐渐增加至二三匕，效果良好。
又有脓血相杂痢的症状，饮食不太稀薄，每次排出脓血，与食物混杂，腹部也有轻微疼痛，有此症状者，适宜按照后面黄芩等五味散服用（原文“黄”字后缺字，据方义推测可能为黄芩或黄芪等，此处依原文“黄”）。
黄芩（六两，原文仅“黄”，据方义补全或保留原字，此处依原文提取实体） 赤石脂（八两） 浓朴（五两，炙） 干姜 艾叶（炙，各二两）
以上药物捣碎过筛制成散剂，用饮送服。初次服用一方寸匕，每日两次，逐渐增加至二三匕，效果良好。
又有肠滑痢的症状，饮食或稀或稠，大便只像脓液，每次排便极度滑利，痢疾有固定时间，有此情况者，适宜按照后面豆蔻子等八味散服用。
豆蔻子 丁香（各三两） 细辛 附子（炮制） 干姜（各四两） 人参 黄芩（各五两，原文“黄”，据方义及常见配伍推测） 赤石脂（六两）
以上药物捣碎过筛制成散剂，用饮送服。初次服用一方寸匕，每日两次，逐渐增加至二三匕，效果良好。
又有前述各种痢疾，无论患病新旧，如果用药治疗，虽然暂时好转但还会复发，这是因为即使使用新药止住了症状，终究保留了病根。病根原本是由肠胃中冷热不调，病根深结所致，必须用汤药涤荡清除，以泄除病势，痢疾停止后再用药物补助正气，有此症状者，适宜按照后面附子等六味汤来通利之，随后服用高良姜十味散来补益。
附子（炮制） 细辛 甘草（炙） 人参（各二两） 干姜（三两） 大黄（五两）
以上药物切碎，用水七升，煮取二升四合，过滤去渣滓，分三次温服。服药后如人行走十里路的时间，服用一次此汤，应当得到畅快的大便排泄……（原文此处有缺漏，接下文）
高良姜 细辛 黄芩（原文“黄”，据方义推测） 白术 苦参（各五两） 丁香（二两） 人参 干姜（各四两） 豆蔻子（三两） 赤石脂（六两）
以上药物捣碎过筛制成散剂，用饮送服。初次服用一方寸匕，每日两次，逐渐增加至二三匕。（均出自上卷中）
[Pathogenesis] The essence of food and drink transforms into blood, qi, and body fluids to nourish the zang-fu organs. If the zang-fu are deficient and susceptible to wind-pathogens, the pathogens enter the intestines and stomach, causing dysentery. Dysentery depletes body fluids, leading to thirst.
*Bi Xiao Fang* (Essential Prescriptions Worth a Thousand Gold) for treating dysentery with thirst:
*Ophiopogonis Radix* (3 liang, heart removed) *Mume Fructus* (2 large fruits)
Take the above two herbs, decoct in one sheng of water until reduced to slightly more than half a sheng. Strain off the dregs. Wait for it to cool, then swallow slowly. Symptoms will subside; hold the liquid in the mouth before swallowing. (From Volume II)
*Gu Jin Lu Yan* (Records Through the Ages) for treating heat-dysentery with thirst:
*Benincasa Fructus* (1 fruit)
Take the above single herb. Wrap it in thick yellow earth about one chi thick. Roast it in fire until thoroughly cooked. Remove the earth, wash clean, squeeze out the juice, and take orally.
Xu Renze stated that this disease has several types: there is water-dysentery, grain-dysentery, blood-dysentery, pus-dysentery, mixed pus-and-blood dysentery, and intestinal slipperiness dysentery. Water-dysentery originates from spleen-heat, which rapidly digests grain into water. Since the grain qi cannot be properly transformed, this type of dysentery arises. Grain-dysentery is caused by spleen-cold, where grain qi fails to digest... [Text lacuna]. Furthermore, symptoms of water-dysentery include severe pain in the heart and abdomen. Eating is not hindered, but defecation occurs immediately after eating. Food is completely digested, turning only into watery stools without fixed timing. More intake leads to more output, less intake leads to less output. For those with such latent pathogens, it is appropriate to take the following powder of five herbs including *Scutellariae Radix*.
*Scutellariae Radix* *Coptidis Rhizoma* *Phellodendri Cortex* (each 5 liang) *Huang* (4 liang, likely *Astragali Radix* or *Scutellariae Radix* based on context, text says "Huang") *Longgu* (6 liang)
Pulverize the above herbs and sieve them into a powder. Take with water. Initial dose: one fangcun bi (square-inch spoonful). Twice daily. Gradually increase to two or three fangcun bi. Stop when cured.
Regarding grain-dysentery symptoms: dysentery occurs without fixed timing, food is undigested, abdominal pain occurs, and it triggers upon exposure to cold. For those with these symptoms, it is appropriate to use the following powder of five herbs including *Aconiti Lateralis Radix Praeparata*.
*Aconiti Lateralis Radix Praeparata* (processed) *Asari Radix* *Atractylodis Macrocephalae Rhizoma* (each 5 liang) *Zingiberis Rhizoma* (4 liang) *Medicated Leaven* (1 sheng)
Pulverize the above herbs and sieve them into a powder. Take with water. Initial dose: one fangcun bi. Twice daily. Gradually increase to two or three fangcun bi for good effect.
Regarding blood-dysentery symptoms: severe cramping pain in the lower abdomen, no fixed timing, continuous watery discharge mixed with blood. For patients with this condition, use the following prescription.
*Xijiao Wuwei San* (Five-Herb Powder with Rhino Horn):
*Rhinocerotis Cornu* (powdered, 5 liang) *Ejiao* (roasted, 4 liang) *Phellodendri Cortex* (4 liang) *Artemisiae Argyi Folium* *Zingiberis Rhizoma* (each 3 liang, alternatively *Isatidis Folium*)
Pulverize the above herbs and sieve them into a powder. Take with water. Initial dose: one fangcun bi. Twice daily. Gradually increase to two or three fangcun bi for good effect.
Regarding pus-dysentery symptoms: stabbing pain in the abdomen, diet is not particularly thin, but stool contains pus. Symptoms worsen upon exposure to cold. For those with these symptoms, it is beneficial to take the following powder of five herbs including *Medicated Leaven*.
*Medicated Leaven* powder (1 sheng) *Zingiberis Rhizoma* (6 liang) *Syzygii Fructus* *Myristicae Semen* (each 4 liang) *Alpiniae Officinarum Rhizoma* (5 liang)
Pulverize the above herbs and sieve them into a powder. Take with water. Initial dose: one fangcun bi. Twice daily. Gradually increase to two or three fangcun bi for good effect.
Regarding mixed pus-and-blood dysentery symptoms: diet is not particularly thin, pus and blood are discharged each time, mixed with food, and there is mild abdominal pain. For those with these symptoms, it is appropriate to take the following powder of five herbs starting with *Huang* (text incomplete, likely *Scutellariae Radix* or similar).
*Huang* (6 liang) *Halloysit Rubrum* (8 liang) *Magnoliae Officinalis Cortex* (5 liang, roasted) *Zingiberis Rhizoma* *Artemisiae Argyi Folium* (roasted, each 2 liang)
Pulverize the above herbs and sieve them into a powder. Take with water. Initial dose: one fangcun bi. Twice daily. Gradually increase to two or three fangcun bi for good effect.
Regarding intestinal slipperiness dysentery symptoms: diet may be thin or thick, stool resembles pus, defecation is extremely slippery, and dysentery has a regular schedule. For those with such conditions, it is appropriate to take the following powder of eight herbs including *Myristicae Semen*.
*Myristicae Semen* *Syzygii Fructus* (each 3 liang) *Asari Radix* *Aconiti Lateralis Radix Praeparata* (processed) *Zingiberis Rhizoma* (each 4 liang) *Ginseng Radix et Rhizoma* *Huang* (each 5 liang, likely *Astragali Radix* or *Scutellariae Radix*) *Halloysit Rubrum* (6 liang)
Pulverize the above herbs and sieve them into a powder. Take with water. Initial dose: one fangcun bi. Twice daily. Gradually increase to two or three fangcun bi for good effect.
For the aforementioned various dysenteries, regardless of whether the illness is new or old, if treated with medicine and relapses after temporary improvement, it is because even if new medicine stops the symptoms, the root cause remains. The root cause lies in the imbalance of cold and heat in the intestines and stomach, with the pathogenic root firmly established. It is necessary to use decoctions to cleanse and drain the pathogenic momentum. After dysentery ceases, use medicine to tonify. For those with such symptoms, it is appropriate to use the following decoction of six herbs including *Aconiti Lateralis Radix Praeparata* to promote drainage, followed by the Ten-Herb Powder of *Alpiniae Officinarum Rhizoma* to tonify.
Decoction:
*Aconiti Lateralis Radix Praeparata* (processed) *Asari Radix* *Glycyrrhizae Radix et Rhizoma* (roasted) *Ginseng Radix et Rhizoma* (each 2 liang) *Zingiberis Rhizoma* (3 liang) *Rhei Radix et Rhizoma* (5 liang)
Cut the above herbs. Decoct in seven sheng of water until reduced to two sheng and four he. Strain off dregs. Divide into three warm doses. After taking one dose, approximately the time it takes for a person to walk ten li, expect a rapid bowel movement... [Text lacuna].
Tonifying Powder:
*Alpiniae Officinarum Rhizoma* *Asari Radix* *Huang* (likely *Astragali Radix* or *Scutellariae Radix*) *Atractylodis Macrocephalae Rhizoma* *Sophorae Flavescentis Radix* (each 5 liang) *Syzygii Fructus* (2 liang) *Ginseng Radix et Rhizoma* *Zingiberis Rhizoma* (each 4 liang) *Myristicae Semen* (3 liang) *Halloysit Rubrum* (6 liang)
Pulverize the above herbs and sieve them into a powder. Take with water. Initial dose: one fangcun bi. Twice daily. Gradually increase to two or three fangcun bi. (All from Upper Volume)