小儿八痢者。乃饥饱劳役。风寒暑湿。因触冒天地八风之邪而得。故以痢命名也。大抵
多由
脾胃不和。饮食过度。停积于脾胃。不能克化。又为风寒暑湿干之。故为此疾。伤热则赤。
伤冷则白。伤风则纯下清血。伤湿则下如豆汁。冷热交并。赤白兼下。若下迫后重。里急窘
迫。急痛者。火性急速。而能燥物。故也。或夏末秋初。忽有暴折于盛热无所发。故客搏肌
肤之中。发于外则为疟。发于内则为痢。内外俱发则为疟痢。凡痢病久则令肿满。下焦偏冷
上焦偏结。则为上实下虚。若脾胃湿热之毒。熏蒸清道而上。以致胃口闭塞而噤口痢疾。
又有一方一家之内。上下传染。长幼相似。是疫毒痢也。当先推其岁运。以平其外。察其郁
结。以调其内。审其所伤。别其虚实冷热以治之。条然明白。不致妄投也。
凡小儿下痢。如豆腐色者死。下如屋漏水者死。
下痢日久。大孔如孔者死。下痢如竹筒注水者死。
又小儿赤白同下。久而不禁。小便赤涩。腹痛。时发热。唇红舌胎。气促心烦。坐卧不
安。狂渴饮水。谷道倾陷。复面容似妆。饮食全不进者。并不治。
清热化滞汤 治痢主方。
黄连（吴茱黄煎汤拌炒） 白芍药 陈皮 白茯苓（去皮） 枳壳（去穣炒） 黄芩 甘草
上锉一剂。用生姜一片。水煎。空心。温服。初起积热正炽。加大黄、芒硝。血痢。加
酒炒
黄芩、当归、地榆。白痢。加浓朴、枳壳。赤白并下。加川芎、归尾、桃仁、红花滑石、陈
皮
、干姜炒黑。白痢久虚。加白术、黄 、白茯苓。去芩、连、枳壳。赤痢久虚。下后未愈。
去芩、连、。加当归、白芍、白术、川芎、阿胶珠。里急后重。加木香、槟榔。腹痛。加白
芍、川芎、玄胡索、枳壳。小便赤少。加木通、猪苓、泽泻。下如豆汁。加白术、苍术、防
风。食积。加山楂、枳实、麦芽、神曲。久痢气血两虚者。加人参、黄 、当归、川芎、升
麻、肉蔻。下后二便流利。惟后重不去者。气陷于下也。以升麻提之。
一论小儿痢疾属热居多。用黄连、黄芩、大黄、甘草煎服。赤痢。加桃仁、红花。白痢
加滑石末同煎。
开板丹
黄丹（飞过一两） 黄蜡（一两） 乳香（一钱） 没药（一钱） 杏仁（去皮尖八个） 巴豆（
去油八个）
上将四味为细末。将黄蜡熔开。后将末药同蜡拌匀。调冷成块。丸如黄豆大。每服一丸
空心服。红痢。冷甘草汤下。白痢。冷干姜汤下。水泻。冷米汤下。忌生冷油腻。
一治休息痢及疳泻。日久不能安。用鸡子一枚打破。用黄蜡一块。如指大。铫内熔。以
鸡子拌和。炒熟。空心食之。
一治小儿痢疾方。用鸡子一个。冷水下锅。煮二三沸取出。去白用黄。研碎。以生姜汁
半小钟和匀。与小儿服。不用茶。神效。
一治小儿患痢脱肛。色赤或痛。以补中益气汤送香连丸而愈。后伤食作泻。脱肛不入。
仍以益气汤服之。更以蓖麻仁研涂顶门。
一治小儿久痢里急后重。欲去不去。手足并冷。皆胃气虚寒下陷也。以补中益气汤加木
香、补骨脂。倍加升麻、柴胡。
一治红痢及噤口。用田螺捣烂填脐中。顷刻奏效。
一治痢不拘赤白。白萝卜汁、蜜各等分。调匀。服三四匙。即效。
一治小儿噤口痢。用甜梨一个。挖空。入蜜填满。纸包火煨熟吃立止。
一治噤口痢。汤饮米谷不下者。石莲子去壳并内红皮及心。为细末。每服量儿大小。或
五分。或一钱、二三钱。用陈仓米汤调下。如呕。加生姜汁一二匙。
一治血痢。用苦参炒为末。每服三分或五分。米汤调下。
一治白痢。用肉豆蔻。面包煨乳香一粒。共为末。每服二三分。米汤调下。
一治久痢不止。用陈萝卜煎汤。一服立止。
一方。用苋菜煎汤服效。
一治泻久久不止。不肯服药。用肉豆蔻煨去油。为末三钱。麦面四两同和。切面入葱。
盐煮如常食之。
小儿八痢，是由于饥饱不均、过度劳役，以及感受风、寒、暑、湿等邪气，因触犯天地间“八风”之邪而致病，因此以“痢”命名。大抵多由脾胃功能不和，饮食过量，导致食物停滞积聚在脾胃之中，无法消化运化，又受到风寒暑湿的干扰，从而引发此病。损伤热邪则大便带血呈红色；损伤冷邪则大便色白；损伤风邪则纯下清稀血液；损伤湿邪则大便如豆汁样。若冷热邪气交杂，则赤白脓血并下。如果出现肛门坠胀、里急后重（腹痛窘迫，急于排便但排便不畅）、剧烈疼痛等症状，是因为火性急速且能燥伤津液所致。或者在夏末秋初之际，突然遭遇盛热之气郁结不得发散，邪气客居于肌肤之间，发于体表则为疟疾，发于体内则为痢疾，内外同时发作则为疟痢。凡是痢疾病程长久，会导致身体肿胀胀满。若下焦偏冷而上焦偏热郁结，则形成上实下虚的证候。若是脾胃湿热之毒，熏蒸向上侵犯清窍，导致胃口闭塞，则发展为噤口痢疾。还有一种情况是一方一家之内，上下相互传染，长幼症状相似，这是疫毒痢。治疗时应当先推算当年的岁运气候，以调和外部邪气；观察体内的郁结状况，以调理内部脏腑；审察所受的病因，辨别虚实、冷热的性质来进行治疗，这样条理清晰明白，就不会盲目用药了。
凡是小儿患痢疾，如果大便颜色像豆腐渣一样的是死证；大便像屋漏雨水滴落的是死证；痢疾日久，肛门松弛如孔洞张开的是死证；大便像竹筒倒水一样直泻不止的是死证。
另外，小儿赤白脓血同下，病程长久不能控制，小便赤涩短少，腹痛，时常发热，嘴唇红，舌苔厚腻，气促心烦，坐卧不安，极度口渴想喝水，肛门脱出（谷道倾陷），面色红润如化妆一般（真寒假热之象），完全不能进食的，都属于不治之症。
清热化滞汤：治疗痢疾的主方。
组成：黄连（用吴茱萸煎汤拌炒）、白芍药、陈皮、白茯苓（去皮）、枳壳（去瓤炒制）、黄芩、甘草。
用法：将上述药材锉碎为一剂，用生姜一片，加水煎煮，空腹温服。
加减法：初起积热正盛时，加大黄、芒硝；血痢，加酒炒黄芩、当归、地榆；白痢，加浓朴、枳壳；赤白脓血并下，加川芎、当归尾、桃仁、红花、滑石、陈皮、干姜（炒黑）；白痢日久体虚，加白术、黄芪、白茯苓，去掉黄芩、黄连、枳壳；赤痢日久体虚，便后未愈，去掉黄芩、黄连，加当归、白芍、白术、川芎、阿胶珠；里急后重，加木香、槟榔；腹痛，加白芍、川芎、玄胡索、枳壳；小便赤少，加木通、猪苓、泽泻；大便如豆汁样，加白术、苍术、防风；食积，加山楂、枳实、麦芽、神曲；久痢气血两虚者，加人参、黄芪、当归、川芎、升麻、肉豆蔻；便后二便通畅，唯独后重不除的，是气陷于下，用升麻提升清气。
论述：小儿痢疾大多属热证，可用黄连、黄芩、大黄、甘草煎服。赤痢，加桃仁、红花；白痢加滑石末同煎。
开板丹：
组成：黄丹（飞过一两）、黄蜡（一两）、乳香（一钱）、没药（一钱）、杏仁（去皮尖八个）、巴豆（去油八个）。
用法：将前四味药研为细末，将黄蜡熔化，然后将药末与蜡拌匀，冷却成块，制成如黄豆大小的丸剂。每次服用一丸，空腹服。红痢用冷甘草汤送服，白痢用冷干姜汤送服，水泻用冷米汤送服。忌食生冷油腻。
一方：治疗休息痢及疳泻，日久不能安宁。用鸡蛋一枚打破，取一块如手指大的黄蜡，在锅中熔化，用鸡蛋液搅拌混合，炒熟，空腹食用。
一方：治疗小儿痢疾。用鸡蛋一个，冷水下锅，煮二三沸后取出，去掉蛋白只用蛋黄，研碎，用生姜汁半小钟调和均匀，给小儿服用，不服茶，效果神奇。
一方：治疗小儿患痢疾导致脱肛，颜色发红或疼痛。用补中益气汤送服香连丸即可痊愈。后来因伤食导致腹泻，脱肛不能回纳，仍以补中益气汤服用，再用蓖麻仁研碎涂抹头顶百会穴。
一方：治疗小儿久痢里急后重，欲便不便，手足冰冷，这都是胃气虚寒下陷所致。用补中益气汤加木香、补骨脂，加倍使用升麻、柴胡。
一方：治疗痢疾不分赤白。用白萝卜汁、蜂蜜各等分，调匀，服用三四匙，立即见效。
一方：治疗小儿噤口痢。用甜梨一个，挖空，填入蜂蜜至满，用纸包裹在火上煨熟吃，立止。
一方：治疗噤口痢，汤水饮食米谷均不能下咽者。用石莲子去壳连同里面的红皮及心，研为细末。每次根据患儿大小，服用五分、一钱或二三钱，用陈仓米汤调服。如果呕吐，加生姜汁一二匙。
一方：治疗血痢。用苦参炒为末，每次服用三分或五分，米汤调服。
一方：治疗白痢。用肉豆蔻，面包煨熟，加入一粒乳香，共研为末，每次服用二三分，米汤调服。
一方：治疗久痢不止。用陈年萝卜煎汤，服用一次立即停止。
另一方：用苋菜煎汤服用有效。
一方：治疗泄泻久久不止，不肯服药。用肉豆蔻煨去油，研为末三钱，与麦面四两混合，切面条加入葱、盐，按常法煮熟食用。
The "Eight Dysenteries" in children arise from irregular eating and drinking, excessive labor, and exposure to wind, cold, summer-heat, and dampness. It is caused by encountering the pathogenic factors of the "Eight Winds" from heaven and earth, hence named "Dysentery." Generally, it stems from disharmony of the Spleen and Stomach, overeating leading to food stagnation and accumulation in the Spleen and Stomach, inability to digest and transform, compounded by interference from wind, cold, summer-heat, and dampness. Injury by heat pathogens results in red stool; injury by cold pathogens results in white stool; injury by wind pathogens results in pure clear blood discharge; injury by damp pathogens results in stool resembling bean juice. If cold and heat pathogens mix, red and white pus and blood are discharged together. Symptoms such as tenesmus (urgent pain with a feeling of incomplete evacuation) and severe pain occur because fire pathogens are rapid and drying. Alternatively, at the end of summer or beginning of autumn, sudden oppression by intense heat without release causes pathogens to lodge in the skin and muscles. Manifesting externally, it becomes Malaria (a disease characterized by alternating chills and fever); manifesting internally, it becomes Dysentery; manifesting both internally and externally, it becomes Malaria-Dysentery. Long-standing dysentery leads to swelling and fullness. If the Lower Jiao is cold while the Upper Jiao is constrained and hot, it forms a pattern of Excess above and Deficiency below. If toxic damp-heat from the Spleen and Stomach steams upward, obstructing the stomach opening, it develops into Anorexic Dysentery (dysentery accompanied by inability to eat). Another scenario involves transmission within a household, where elders and children share similar symptoms, known as Epidemic Toxic Dysentery. Treatment should first consider the annual climate运气 (Yunqi) to harmonize external pathogens, observe internal constraints to regulate internal organs, examine the cause of injury, and differentiate deficiency/excess and cold/heat for treatment. This approach ensures clarity and prevents blind medication.
In pediatric dysentery, if the stool resembles tofu dregs, it is a fatal sign. If the stool drips like water leaking from a roof, it is fatal. If dysentery persists long-term and the anus remains open like a hole, it is fatal. If the stool flows straight out like water pouring from a bamboo tube, it is fatal.
Additionally, if a child discharges red and white pus and blood continuously for a long time, with scanty dark urine, abdominal pain, intermittent fever, red lips, thick tongue coating, shortness of breath, irritability, restlessness, extreme thirst, rectal prolapse (described as "valley gate collapse"), a flushed face resembling makeup (false heat), and complete anorexia, these are incurable conditions.
Qingre Huazhi Tang (Clear Heat and Resolve Stagnation Decoction): The main formula for treating dysentery.
Ingredients: Huanglian (Coptidis Rhizoma, stir-fried with Evodiae Fructus decoction), Baishao (Paeoniae Radix Alba), Chenpi (Citri Reticulatae Pericarpium), Baifuling (Poria, peeled), Zhike (Aurantii Fructus, pith removed and stir-fried), Huangqin (Scutellariae Radix), Gancao (Glycyrrhizae Radix et Rhizoma).
Usage: Coarsely crush one dose. Add one slice of Shengjiang (Zingiberis Rhizoma Recens), decoct in water, and take warm on an empty stomach.
Modifications: For initial excess heat, add Dahuang (Rhei Radix et Rhizoma) and Mangxiao (Natrii Sulfas). For bloody dysentery, add Jiuhuangqin (Scutellariae Radix stir-fried with wine), Danggui (Angelicae Sinensis Radix), and Diyü (Sanguisorbae Radix). For white dysentery, add Houpo (Magnoliae Officinalis Cortex) and Zhike. For mixed red and white discharge, add Chuanxiong (Ligustici Chuanxiong Rhizoma), Guiwei (Angelicae Sinensis Radix tail), Taoren (Persicae Semen), Honghua (Carthami Flos), Huashi (Talcum), Chenpi, and Jiangtanhei (Zingiberis Rhizoma carbonized). For chronic white dysentery with deficiency, add Baizhu (Atractylodis Macrocephalae Rhizoma), Huangqi (Astragali Radix), and Baifuling; remove Huangqin, Huanglian, and Zhike. For chronic red dysentery with deficiency and persistent symptoms after defecation, remove Huangqin and Huanglian; add Danggui, Baishao, Baizhu, Chuanxiong, and Ejiaozhu (Colla Corii Asini processed). For tenesmus, add Muxiang (Aucklandiae Radix) and Binglang (Arecae Semen). For abdominal pain, add Baishao, Chuanxiong, Yuanhusuo (Corydalis Rhizoma), and Zhike. For scanty dark urine, add Mutong (Akebiae Caulis), Zhuling (Polyporus), and Zexie (Alismatis Rhizoma). For stool resembling bean juice, add Baizhu, Cangzhu (Atractylodis Rhizoma), and Fangfeng (Saposhnikoviae Radix). For food stagnation, add Shanzha (Crataegi Fructus), Zhishi (Aurantii Fructus Immaturus), Maiya (Hordei Fructus Germinatus), and Shenqu (Massa Medicata Fermentata). For long-term dysentery causing Qi and Blood deficiency, add Renshen (Ginseng Radix et Rhizoma), Huangqi, Danggui, Chuanxiong, Shengma (Cimicifugae Rhizoma), and Roukou (Myristicae Semen). If bowel movements are free but tenesmus persists, it indicates sinking Qi; use Shengma to lift Qi.
Discussion: Pediatric dysentery is mostly due to heat. Use Huanglian, Huangqin, Dahuang, and Gancao decocted and taken orally. For red dysentery, add Taoren and Honghua. For white dysentery, add Huashi powder during decoction.
Kaiban Dan (Open Board Pill):
Ingredients: Huangdan (Mineral Lead Oxide, purified, 1 liang), Huangla (Beeswax, 1 liang), Ruxiang (Boswelliae Resin, 1 qian), Moyao (Commiphora Resin, 1 qian), Xingren (Pruni Armeniaci Semen, 8 pieces, skin and tips removed), Badou (Crotonis Fructus, 8 pieces, oil removed).
Usage: Grind the first four ingredients into fine powder. Melt the beeswax, mix with the powder, cool into blocks, and form pills the size of soybeans. Take one pill on an empty stomach. For red dysentery, swallow with cold Licorice decoction; for white dysentery, with cold Ginger decoction; for watery diarrhea, with cold Rice decoction. Avoid raw, cold, and greasy foods.
One prescription for lingering dysentery and malnutrition-related diarrhea that does not resolve: Break one egg. Take a piece of beeswax the size of a finger, melt it in a pot, mix with the egg, stir-fry until cooked, and eat on an empty stomach.
One prescription for pediatric dysentery: Boil one egg in cold water for two or three boils, remove, discard the white, keep the yolk, grind it, mix with half a small cup of fresh ginger juice, and administer to the child. Do not give tea. This is highly effective.
One prescription for pediatric dysentery with rectal prolapse, redness, or pain: Administer Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) to deliver Xianglian Wan (Fragrant Coptis Pill). If subsequent food stagnation causes diarrhea and irreducible prolapse, continue with Yiqi Tang and apply crushed Ricinus communis seed (Bimaren) to the Baihui acupoint (GV20) on the vertex.
One prescription for long-term pediatric dysentery with tenesmus, inability to pass stool, and cold extremities, indicating Spleen-Stomach Qi deficiency and cold sinking: Use Buzhong Yiqi Tang plus Muxiang and Buguzhi (Psoraleae Fructus), doubling the dosage of Shengma and Chaihu (Bupleuri Radix).
One prescription for red dysentery and anorexic dysentery: Apply crushed freshwater snail (Tianluo) to the umbilicus for immediate effect.
One prescription for dysentery regardless of color: Mix equal parts of White Radish Juice (Baikeliu Zhi) and Honey, stir well, and take 3-4 spoons for immediate relief.
One prescription for pediatric anorexic dysentery: Hollow out one sweet pear, fill with honey, wrap in paper, roast over fire, and eat for immediate cessation.
One prescription for anorexic dysentery where liquids and solids cannot be swallowed: Remove the shell of Shilianzi (Nelumbinis Plumula), including the red skin and heart, grind into powder. Dosage depends on age: 0.5 qian, 1 qian, or 2-3 qian. Mix with aged rice decoction. If vomiting occurs, add 1-2 spoons of ginger juice.
One prescription for bloody dysentery: Stir-fry Kushen (Sophorae Flavescentis Radix) into powder. Take 0.3 or 0.5 qian mixed with rice decoction.
One prescription for white dysentery: Use Doukou (Myristicae Semen) baked in flour, combined with one grain of Ruxiang, ground into powder. Take 0.2-0.3 qian mixed with rice decoction.
One prescription for intractable long-term dysentery: Decoct old radish and drink; one dose stops the dysentery immediately.
Another prescription: Decoct Amaranthus leaves (Xiancai) and drink; effective.
One prescription for chronic diarrhea resistant to medication: Bake Doukou to remove oil, grind into 3 qian of powder. Mix with 4 liang of wheat flour. Cut into noodles, add green onion and salt, cook normally, and eat.