剂以代汤。须臾饮尽。予见其渴甚。再加制过天花粉二剂。其夜渴止。泻亦微止。次日又进
一剂。渴泻俱止。三日热亦渐退。四日公又问余曰。小姐病未安柰何。余告曰。初来时曾许
三日止渴。五日止泻。十日退热。今日来五日渴泻俱止。热亦渐退。耕当问农。织当问女。
小姐贵体。余以身任之。唯足下宽量数日可也。公称谢。再用白术散减干葛加陈皮。调治半
月而效。公大喜。给札付冠带儒医匾。白金一十两。此万历元年九月初四日也。本县大尹唐
百峰行之。
痢不问赤白。皆从积治。湿热者。食积之所生也。痢初得之。其法宜下。积不去。
止也。如吐泄后痢者。其积已下。不可再下。复伤胃气。可下者。木香导滞丸主之。不可下
。宜去积。保和丸主之。
陈皮（五钱） 枳壳（炒三钱） 黄连（姜汁炒五钱） 神曲 山楂肉 麦 （各三钱） 莱服
子（炒三钱） 槟榔（三钱） 上为末。水糊丸。麻子大。白汤下。
木香导滞丸
枳实（炒） 浓朴（姜汁炒） 槟榔（各五钱） 黄连 黄芩 黄柏 大黄（各七钱半） 木香
（二钱五分） 黑牵牛（半生半炒取头末二钱半） 上为末。酒糊丸。小豆大。白汤下。
祖训只用香连丸。
黄连（一两。净锉，用吴茱萸半两。水拌湿同炒。去萸不用。） 木香（五钱） 石莲肉（
一钱） 上为末。酒糊丸。麻子大。陈仓米煎汤下。此家传十三方也。
予教诸子。治痢只用保和丸香连丸同服。万无一失。
郧阳抚台都御史孙小姐。自五月病痢。至七月未愈。差荆襄承差取郧阳医官治之不效。
差王加宜取予。予往。病亟矣。用人参白茯苓甘草当归白芍黄苓车前子陈皮各等分。炒干姜
少许。煎服略差。五日大安。公晚饮间。问予云。诸医皆用木香黄连。今汝不用。所用皆非
治痢之药。而效者何也。余曰。此乃河间黄芩芍药汤方也。所谓调其气则后重除。养其血而
痢止之法也。台云。小女前年在湖广病泄。今年在此病痢。皆五六月间。幸遇汝之良医而安
。然小女之遇汝。尔之遇我。非偶然。余叩首谢。
本县祝道士长子。七岁病痢。半年不愈。求予治之。予与一方。用人参白术茯苓甘草陈
药黄 桔梗木香黄连诃子肉豆蔻车前子干姜炒泽泻神曲当归麦芽白芍为末。水面丸。米饮下
。一月安。名和中丸。
一女十岁患痢。久不止。脉洪数。或曰。下痢脉宜小。今脉洪数恐难治。予曰无妨。玉
曰。欲识童男并童女。决在寸关并尺里。自然紧数甚分明。都缘未散精华气。此童女脉宜如
是。胃气当强。不久自愈。果数日痢渐止。
本县张大尹。有公子半岁。病赤白痢甚苦。用黄连一钱。木香五分。石莲肉五分。陈皮
七分。干姜炒二分。为末。神曲丸。黍米大。陈米饮下。
痢疾渴者。七味白术散去干葛。加炒干姜黄连阿胶乌梅主之。
痢苦噤口者。宜参苓白术散加石菖蒲为末。陈仓米汤下。
痢疾脱肛者。只止其痢。痢止肛自不下矣。
泻后变痢后重者。胃气之下陷也。赤白者。肠垢之下溜也。水谷尽而肠胃败。故死。
痢后变泻。后重止者。湿热之气去也。赤白止者。陈腐之物尽也。肠胃通而水谷行。故
凡下痢鲜血者。黑如屋漏水者。气促者。大孔如竹筒者。呕哕不食者。足趺肿者。身
热脉大者。渴欲饮水者。只大渴者。面娇面青者。皆死证也。
初病痢者。腹中急痛。大便窘迫。小便赤涩。身热饮水。宜急下之。轻者三黄枳术丸。
木香槟榔丸。去其陈垢其痢自止。此时邪气未动。正气未伤。故宜下之。若喜补恶攻。使邪
气日强。正气日弱。不下之则积热不除。下之则脾胃俱弱。酿成大病。医之过也。
初病泄泻。渐变痢者。此时宿垢已去。不可再下。如有腹痛里急后重之证。乃未尽之余
邪也。宜去积止痢。去积保和去滞丸。止痢香连丸。
痢久不止者。名休息痢。家传和中丸。
或问。赤痢为热。白痢为寒何如。曰。原病式论之详矣。痢下赤白。皆湿热也。赤者自
来。小肠者心之腑。心属火故其色赤。白者自大肠来。大肠者肺之腑也。肺属金故其色白。
赤者属热。白者属湿。湿亦热也。经云。湿盛而热也。若初痢下鲜血者。非赤也。此风热之
毒。宜剪红丸主之。如痢下瘀血。或如豆汁者。此湿气下血也。宜胃风汤主之。
或问。河间云。行气则后重除。养血则痢止。此千古不易之法也。今幼科治痢之方。不
法何也。曰。痢者。素云肠 。难云大瘕泄。古云滞下。肠 者。因于饱食也。大瘕泄者。
食症也。滞下者。积滞之物下出也。故云无积不成痢。治法以攻积为先务也。积不去则气不
行。去积所以行其气。而不里急后重也。热则伤血。痢久则伤血。去热止泄。所以养其血也
。法虽不同。意则合也。
或问。丹溪云。先泻后变痢者脾传肾也难治。先痢后变泻者肾传脾也易治。何以言之。
脾主湿。湿胜则濡泻。泻者脾之病也。泻久不止。又变成痢。痢下后重肾病也。如痢非真痢
也。故后重者。胃气之下陷也。脓血者。肠垢之下溜也。真气败而谷气绝。是谓难治。肾恶
湿。小儿久坐湿地则伤肾。里急后重。便脓血者。肾之病也。痢久不止。忽变成泻。湿去而
脾病在也。故里不急痛者。湿热之毒除也。便无脓血者。陈 之秽尽也。肠胃通而水谷行。
故易治。
或问。痢疾身凉脉静者生。身热脉躁者死。其然乎。曰。初病时。邪气方盛。身热脉躁
。不可呼为死证也。邪气盛则实。可急下之。邪去脉自衰身自凉也。痢久而身热脉躁。则不
可治也。脉静身凉。久痢之后。真气已虚之脉也。身宜温。不可太凉。脉宜静不可太弱。经
云。泻痢五虚者死。脉细一也。皮寒二也。少气三也。泄痢不止四也。饮食不入五也。此脉
静身凉之言。不可执着也。
痢久不能食。或有食入即吐者名噤口痢。即经所谓五虚者死。古方虽多。无甚效者。大
痢日久。津液已竭。脾胃虚弱。不能食也。宜以补脾为主。白术散去干葛加炒干姜主之。能
食者生矣。不能食者死。
痢久脱肛者。气血虚也。素云下陷者虚也。难云出者为虚。古方多用涩剂。如 皮木贼
。此治其标也。当用河间行气养血之法。痢止后重除。肛肠自不脱出矣。加减八珍丸主之。
有痢下赤白青黑者。名野鸡痢。用阿胶梅连丸主之。
有痢两膝肿大者。名曰鹤膝风。加味地黄丸主之。
保和去滞丸 治痢疾。有积胃弱。不可重下。
陈皮（五钱） 半夏曲 白茯苓 枳实（麸炒） 浓朴（姜汁炒） 槟榔（各五钱） 莱菔子（
炒二钱半） 木香 上为末。神曲糊丸。麻子大。陈米汤下。
三黄枳朴丸 治湿热成痢。并有食积者。
黄连 黄芩 黄柏（皆酒炒各三钱） 大黄（酒煨五钱） 枳实（麸炒） 浓朴（姜汁炒） 槟
榔（各二钱） 上为末。酒糊丸。麻子大。姜汤下。
胃风汤 八珍汤去地黄甘草。加桂等分。入粟米同煎。本方去桂。加连等分。吴茱萸减
半。同炒为末。酒糊丸。可治远近血痢。
阿胶梅连丸 治痢无分久新。赤白青黑疼痛证。
阿胶（草灰炒成珠） 赤茯苓 乌梅（去核炒） 赤芍 黄柏（炒） 黄连（炒） 干姜（炒）
当归（各等分） 上为末。入阿胶和匀水丸。麻子大。陈米饮下。
家传和中丸 专治休息痢。
人参 甘草 当归身 川芎 车前子（略炒） 猪苓 泽泻 神曲 黄连（炒各三钱） 麦
面
三钱） 上为末。酒糊丸。麻子大。陈米饮下。
加味地黄丸 治痢后鹤膝风。
地黄丸加牛膝。虎胫骨酥炙。白茯苓。共为末。蜜丸服。
加味八珍丸 治久痢脱肛。
八珍汤去川芎白术加黄连（炒） 阿胶（上炒各三分） 木香（三分之二减半） 上共为末。
水丸麻子大。炒米汤下。多服佳。
剪红丸 治痢血神效。
当归身 黄连（炒） 槐角子（炒） 侧柏叶（炒） 荆芥穗 枳壳（炒各等分） 上为末。酒
煮面糊丸。麻子大。陈米汤下。
用汤剂代替煎药。片刻间饮尽。我看见她口渴非常严重，又加了经过炮制的天花粉两剂。当晚口渴停止，腹泻也稍微减轻。第二天又服用一剂，口渴和腹泻都停止了。三天后发热也逐渐消退。第四天，那位父亲又来问我：“小姐的病还没有痊愈，该怎么办？”我告诉他：“刚来时我曾承诺三天止渴，五天止泻，十天退热。今天已经是第五天，口渴和腹泻都已停止，发热也在逐渐消退。耕种的事要问农民，织布的事要问女子。小姐的贵体，我来承担责任，请您宽限几天即可。”他道谢。随后使用白术散减去干葛，加入陈皮，调理半个月后见效。他非常高兴，赠送了写有“儒医”字样的匾额和十两白银。这是万历元年九月初四日的事情。本县县令唐百峰执行此事。
痢疾不论赤白，都要从积滞论治。湿热痢是由食积产生的。痢疾初起，治法应当攻下。如果积滞不去，痢疾不会停止。如果是呕吐腹泻之后出现的痢疾，说明积滞已经下行，不可再次攻下，否则会进一步损伤胃气。可以攻下的，用木香导滞丸主治；不可以攻下的，宜消除积滞，用保和丸主治。
陈皮（五钱） 枳壳（炒三钱） 黄连（姜汁炒五钱） 神曲 山楂肉 麦芽（各三钱） 莱菔子（炒三钱） 槟榔（三钱） 以上药物研为细末，用水糊制作丸剂，如麻子大小，温开水送服。
木香导滞丸
枳实（炒） 厚朴（姜汁炒） 槟榔（各五钱） 黄连 黄芩 黄柏 大黄（各七钱半） 木香（二钱五分） 黑牵牛（半生半炒取头末二钱半） 以上药物研为细末，用酒糊制作丸剂，如小豆大小，温开水送服。
家传祖训只用香连丸。
黄连（一两，净锉，用吴茱萸半两，水拌湿同炒，去萸不用。） 木香（五钱） 石莲肉（一钱） 以上药物研为细末，用酒糊制作丸剂，如麻子大小，陈仓米煎汤送服。这是家传的十三方之一。
我教导我的儿子们，治疗痢疾只用保和丸和香连丸同时服用，万无一失。
郧阳抚台都御史孙小姐，从五月患痢疾，到七月未愈。派遣荆襄承差取郧阳医官治疗无效，又派遣王加宜来请我。我去诊治时，病情已经很危急了。用人参、白茯苓、甘草、当归、白芍、黄芩、车前子、陈皮各等分，加少许炒干姜，煎服后症状略有好转，五天后大安。那天晚上他在饮酒时问我：“其他医生都用木香和黄连，现在你不用，所用都不是治疗痢疾的药，为什么有效呢？”我说：“这是河间氏的黄芩芍药汤方。所谓调其气则后重除，养其血而痢止的方法。”他说：“小女前年在湖广患泄泻，今年在这里患痢疾，都是在五六月间，幸遇良医而痊愈。然而小女遇到您，您遇到我，并非偶然。”我叩首致谢。
本县祝道士的长子，七岁患痢疾，半年不愈，求我治疗。我给他一方，用人参、白术、茯苓、甘草、陈皮、诃子肉、木香、黄连、肉豆蔻、车前子、干姜、炒泽泻、神曲、当归、麦芽、白芍，研为细末，用水面制作丸剂，米饮送服。一个月后痊愈，名为和中丸。
一个十岁的女孩患痢疾，久治不愈，脉象洪数。有人说：“下痢脉象宜小，现在脉象洪数恐怕难治。”我说：“无妨。古人说：‘欲识童男并童女，决在寸关并尺里。自然紧数甚分明。都缘未散精华气。’这个女童的脉象应该如此。胃气应当强盛，不久会自愈。”果然几天后痢疾逐渐停止。
本县张大尹的公子，半岁大，患赤白痢非常痛苦。用黄连一钱，木香五分，石莲肉五分，陈皮七分，干姜炒二分，研为细末，用神曲制作丸剂，如黍米大小，陈米饮送服。
痢疾伴口渴的，用七味白术散去干葛，加炒干姜、黄连、阿胶、乌梅主治。
痢疾伴噤口不食的，宜用参苓白术散加石菖蒲研为细末，陈仓米汤送服。
痢疾伴脱肛的，只需止住痢疾，痢止后肛门自然不再脱出。
泄泻后转变为痢疾伴里急后重的，是胃气下陷的表现。大便带赤白的，是肠垢下溜的表现。如果水谷精微耗尽而肠胃败坏，就会死亡。
痢疾后转变为泄泻，里急后重停止的，是湿热之气已去除的表现。赤白停止的，是陈旧腐败之物已排尽的表现。肠胃通畅而水谷运行正常，所以……（原文此处似有缺漏，意为病愈）。
凡是下痢鲜血的，大便黑如屋漏水的，呼吸急促的，肛门直开如竹筒的，呕吐呃逆不能进食的，足背浮肿的，身体发热脉大的，极度口渴想喝水的，面色娇嫩或发青的，都是死证。
初患痢疾的，腹中急痛，大便窘迫，小便赤涩，身体发热想喝水，应当紧急攻下。轻症用三黄枳术丸、木香槟榔丸，去除体内的陈旧污秽，痢疾自然会停止。此时邪气未动，正气未伤，所以适宜攻下。如果喜欢补益厌恶攻伐，使邪气日益强盛，正气日益虚弱，不攻下则积热不除，攻下则脾胃俱弱，酿成大病，这是医生的过错。
初患泄泻，逐渐转变为痢疾的，此时宿垢已去，不可再攻下。如果有腹痛、里急后重的症状，这是未尽的余邪。宜消除积滞止痢，消除积滞用保和去滞丸，止痢用香连丸。
痢疾久治不愈的，名为休息痢。家传和中丸。
有人问：“赤痢为热，白痢为寒，对吗？”我说：“《原病式》论述得很详细了。痢下赤白，都是湿热所致。红色来自小肠，小肠是心的腑，心属火，所以颜色红。白色来自大肠，大肠是肺的腑，肺属金，所以颜色白。红色属热，白色属湿，湿中也含有热。经书说：‘湿盛则……热也。’如果初痢下鲜血，不是普通的赤痢，这是风热毒邪，宜用剪红丸主治。如果痢下瘀血，或像豆汁一样，这是湿气下注导致的出血，宜用胃风汤主治。
有人问：“河间氏说：行气则后重除，养血则痢止，这是千古不变的方法。现在儿科治疗痢疾的方剂，为什么不遵循这个方法呢？”我说：“痢疾，《素问》称为肠澼，《难经》称为大瘕泄，古称滞下。肠澼，是因为饱食引起的。大瘕泄，是食积症。滞下，是积滞之物排出。所以说‘无积不成痢’。治法以攻积为先务。积滞不去则气机不行，去除积滞所以能行气，从而消除里急后重。热邪会伤血，痢疾日久也会伤血，清除热邪止住泄利，所以能养血。方法虽然不同，用意则是相合的。
有人问：“丹溪说：先泄泻后变为痢疾的是脾传肾，难治；先痢疾后变为泄泻的是肾传脾，易治。为什么呢？”我说：“脾主湿，湿胜则濡泻。泄泻是脾的病。泄泻久治不愈，又变成痢疾，痢疾伴后重是肾的病。如果痢疾不是真正的痢疾，那么后重是胃气下陷的表现。脓血是肠垢下溜的表现。真气败坏而谷气断绝，这叫做难治。肾恶湿，小儿久坐湿地则伤肾。里急后重，便脓血，是肾的病。痢疾久治不愈，忽然变成泄泻，湿气去除而脾病仍在。所以没有里急后重疼痛，是湿热毒邪已除。没有脓血，是陈旧秽物已尽。肠胃通畅而水谷运行，所以易治。
有人问：“痢疾身凉脉静者生，身热脉躁者死，是这样吗？”我说：“初病时，邪气正盛，身热脉躁，不能称之为死证。邪气盛则实证，可以紧急攻下。邪去脉自衰，身自凉。痢疾日久且身热脉躁，则不可治了。脉静身凉，是久痢之后真气已虚的脉象。身体应温暖，不可太凉。脉象宜静，不可太弱。经书说：‘泻痢五虚者死。’脉细是一虚，皮寒是二虚，少气是三虚，泄痢不止是四虚，饮食不入是五虚。对于‘脉静身凉’这句话，不可执着理解。
痢疾日久不能进食，或者有食入即吐的，名为噤口痢。就是经书所说的‘五虚者死’。古方虽多，没有特别有效的。痢疾日久，津液已竭，脾胃虚弱，不能进食。宜以补脾为主，用白术散去干葛加炒干姜主治。能进食的就活，不能进食的就死。
痢疾日久脱肛的，是气血虚弱。《素问》说下陷者是虚，《难经》说出者为虚。古方多用涩剂，如罂粟皮、木贼等，这是治标的方法。应当用河间氏行气养血的方法。痢止后重除，肛肠自然不脱出。用加减八珍丸主治。
有痢下赤白青黑的，名为野鸡痢。用阿胶梅连丸主治。
有痢疾伴两膝肿大的，名为鹤膝风。用加味地黄丸主治。
保和去滞丸 治疗痢疾，有积滞且胃弱，不可重下。
陈皮（五钱） 半夏曲 白茯苓 枳实（麸炒） 厚朴（姜汁炒） 槟榔（各五钱） 莱菔子（炒二钱半） 木香 以上药物研为细末，用神曲糊制作丸剂，如麻子大小，陈米汤送服。
三黄枳朴丸 治疗湿热成痢，并有食积者。
黄连 黄芩 黄柏（皆酒炒各三钱） 大黄（酒煨五钱） 枳实（麸炒） 厚朴（姜汁炒） 槟榔（各二钱） 以上药物研为细末，用酒糊制作丸剂，如麻子大小，姜汤送服。
胃风汤 八珍汤去地黄甘草，加桂枝等分，入粟米同煎。本方去桂枝，加黄连等分，吴茱萸减半，同炒为细末，酒糊丸，可治远近血痢。
阿胶梅连丸 治疗痢疾不分新旧，赤白青黑疼痛证。
阿胶（草灰炒成珠） 赤茯苓 乌梅（去核炒） 赤芍 黄柏（炒） 黄连（炒） 干姜（炒） 当归（各等分） 以上药物研为细末，加入阿胶和匀，用水制作丸剂，如麻子大小，陈米饮送服。
家传和中丸 专治休息痢。
人参 甘草 当归身 川芎 车前子（略炒） 猪苓 泽泻 神曲 黄连（炒各三钱） 麦冬（三钱） 以上药物研为细末，用酒糊制作丸剂，如麻子大小，陈米饮送服。
加味地黄丸 治疗痢后鹤膝风。
地黄丸加牛膝、虎胫骨酥炙、白茯苓，共为细末，蜜丸服用。
加味八珍丸 治疗久痢脱肛。
八珍汤去川芎白术加黄连（炒）、阿胶（上炒各三分）、木香（三分之二减半） 以上共为细末，水丸如麻子大小，炒米汤送服，多服为佳。
剪红丸 治疗痢血神效。
当归身 黄连（炒） 槐角子（炒） 侧柏叶（炒） 荆芥穗 枳壳（炒各等分） 以上药物研为细末，酒煮面糊制作丸剂，如麻子大小，陈米汤送服。
Use decoctions instead of boiling. Drink it all up in a moment. I saw that she was extremely thirsty, so I added two doses of processed *Tianhuafen* (Trichosanthis Radix). That night, her thirst stopped, and the diarrhea also slightly subsided. The next day, another dose was administered, and both the thirst and diarrhea ceased. After three days, the fever gradually receded. On the fourth day, the father asked me again, "Miss's illness is not yet resolved; what should we do?" I told him, "When she first came, I promised to stop the thirst in three days, the diarrhea in five days, and the fever in ten days. Today is already the fifth day; the thirst and diarrhea have stopped, and the fever is gradually receding. As for farming, ask the farmer; as for weaving, ask the woman. I take responsibility for Miss's health; please just allow us a few more days." He expressed his gratitude. Then, *Baizhu San* (Atractylodes Macrocephala Powder) with *Gan Ge* (Kudzu Root) removed and *Chenpi* (Citrus Reticulata Peel) added was used for调理 (regulation/treatment), showing efficacy after half a month. He was overjoyed, presenting a plaque inscribed with "Confucian Physician" and ten taels of silver. This occurred on the fourth day of the ninth month in the first year of Wanli. The county magistrate, Tang Baifeng, executed this matter.
Regardless of whether dysentery presents with red or white discharge, treatment must address accumulation (*Ji*). Damp-heat dysentery arises from food stagnation. In the initial stage of dysentery, the method should be purgative. If the accumulation is not expelled, the dysentery will not cease. If dysentery occurs after vomiting and diarrhea, the accumulation has already been evacuated; do not purge again, as this would further damage Stomach Qi. For cases suitable for purging, *Muxiang Daozhi Wan* (Costus Root Pill for Guiding Stagnation) is indicated. For cases unsuitable for purging, eliminating accumulation with *Baohe Wan* (Preserve Harmony Pill) is appropriate.
*Chenpi* (5 qian), *Zhi Qiao* (Stir-fried, 3 qian), *Huanglian* (Stir-fried with Ginger Juice, 5 qian), *Shenqu* (Medicated Leaven), *Shanzha Rou* (Hawthorn Flesh), *Ma Ya* (Malt) (each 3 qian), *Laifu Zi* (Stir-fried, 3 qian), *Binglang* (Areca Seed, 3 qian). Grind into fine powder, make pills with water paste, size of hemp seeds, administer with warm water.
*Muxiang Daozhi Wan* (Costus Root Pill for Guiding Stagnation)
*Zhishi* (Stir-fried), *Houpo* (Stir-fried with Ginger Juice), *Binglang* (each 5 qian), *Huanglian*, *Huangqin*, *Huangbai*, *Dahuang* (each 7.5 qian), *Muxiang* (2.5 qian), *Hei Qianniu* (Half raw, half stir-fried, take the finest powder, 2.5 qian). Grind into fine powder, make pills with wine paste, size of adzuki beans, administer with warm water.
The ancestral instruction uses only *Xianglian Wan* (Coptis and Costus Pill).
*Huanglian* (1 liang, cleaned and cut, stir-fried with half a liang of *Wuzhuyu* moistened with water, discard *Wuzhuyu*), *Muxiang* (5 qian), *Shilian Rou* (Stone Lotus Flesh, 1 qian). Grind into fine powder, make pills with wine paste, size of hemp seeds, administer with decoction of aged rice grains. This is one of the thirteen family prescriptions.
I teach my sons to treat dysentery by administering *Baohe Wan* and *Xianglian Wan* together; there is no failure.
Miss Sun, daughter of the Censor-in-Chief of Yunyang, suffered from dysentery from May until July without recovery. A messenger from Jingxiang was sent to Yunyang physicians without effect, then Wang Jiayi was sent to summon me. Upon my arrival, the condition was critical. I prescribed equal parts of *Renshen* (Ginseng), *Baifuling* (Poria), *Gancao* (Licorice), *Danggui* (Angelica Sinensis), *Baishao* (White Peony), *Huangqin* (Scutellaria), *Cheqianzi* (Plantago Seed), *Chenpi*, with a small amount of stir-fried *Ganjiang* (Dried Ginger). After decocting and administering, symptoms improved slightly, and after five days, she was greatly relieved. That evening, while drinking, he asked me, "All other doctors use *Muxiang* and *Huanglian*. You do not use them, yet your remedies are not typical for dysentery, yet they are effective. Why?" I replied, "This is the formula of Huangqin Shaoyao Tang (Scutellaria and White Peony Decoction) from He Jian. It follows the principle: regulating Qi eliminates tenesmus; nourishing Blood stops dysentery." He said, "My daughter had diarrhea in Huguang last year and dysentery here this year, both in May and June. Fortunately, I met you, a good physician. However, my daughter meeting you, and you meeting me, is not accidental." I bowed in gratitude.
The eldest son of Daoist Zhu in our county suffered from dysentery at age seven, lasting half a year without cure. Seeking my treatment, I prescribed a formula containing *Renshen*, *Baizhu* (Atractylodes Macrocephala), *Fuling* (Poria), *Gancao*, *Chenpi*, *Hezi Rou* (Chebulic Myrobalan Flesh), *Muxiang*, *Huanglian*, *Roudoukou* (Nutmeg), *Cheqianzi*, *Ganjiang*, stir-fried *Zexie* (Alisma), *Shenqu*, *Danggui*, *Maiya* (Barley Sprout), *Baishao*. Grind into powder, make pills with flour water, administer with rice drink. She recovered in one month. It was named *Hezhong Wan* (Harmonize Middle Pill).
A ten-year-old girl suffered from persistent dysentery. Her pulse was flooding and rapid. Someone said, "In dysentery, the pulse should be small. A flooding and rapid pulse now suggests difficult treatment." I said, "No harm. As the ancients said: 'To identify young boys and girls, decide by the Cun, Guan, and Chi positions. Naturally tight and rapid, very clear. All due to undispersed essence and Qi.' This fits the girl's pulse. Stomach Qi should be strong; she will recover soon." Indeed, after a few days, the dysentery gradually ceased.
The young master of Grand Magistrate Zhang in our county, half a year old, suffered severely from red and white dysentery. Use *Huanglian* (1 qian), *Muxiang* (5 fen), *Shilian Rou* (5 fen), *Chenpi* (7 fen), stir-fried *Ganjiang* (2 fen). Grind into powder, make pills with *Shenqu*, size of millet grains, administer with aged rice drink.
For dysentery accompanied by thirst, use *Qiwei Baizhu San* (Seven-Ingredient Atractylodes Powder) removing *Gan Ge*, adding stir-fried *Ganjiang*, *Huanglian*, *Ejiao* (Donkey-hide Gelatin), and *Wumei* (Mume Fruit).
For dysentery complicated by an inability to eat (Jinkou Li), use *Shenling Baizhu San* (Ginseng, Poria, and Atractylodes Powder) with *Shichangpu* (Acorus Tatarinowii Rhizome) ground into powder, administered with aged rice grain decoction.
For dysentery complicated by rectal prolapse, simply stop the dysentery; once the dysentery stops, the prolapse will naturally retract.
After diarrhea transforms into dysentery with tenesmus, it indicates sinking of Stomach Qi. Red and white discharge indicates slipping of intestinal mucus. When fluids and谷物 (grains/nutrients) are exhausted and intestines/stomach fail, death ensues.
After dysentery transforms into diarrhea, cessation of tenesmus indicates removal of damp-heat Qi. Cessation of red/white discharge indicates expulsion of stale/filthy matter. Intestines and stomach become unobstructed, and fluids/grains circulate, thus... [text implies recovery].
Any case of passing bright red blood, black stool like roof leak water, shortness of breath, anus open straight like a bamboo tube, vomiting/reflux with inability to eat, swelling of the dorsum of the feet, body heat with large pulse, extreme thirst desiring water, delicate or greenish face, are all signs of death.
In early dysentery, with urgent abdominal pain, urgent defecation, dark/scanty urination, body heat, and desire for water, urgent purging is indicated. For mild cases, *Sanhuang Zhizhu Wan* (Three Yellows and Immature Bitter Orange Pill) or *Muxiang Binglang Wan* (Costus Root and Areca Seed Pill) can remove old filth, and the dysentery will stop itself. At this time, pathogenic Qi has not moved deeply, and Healthy Qi is not yet damaged, so purging is appropriate. If one prefers tonification and fears attack, Pathogenic Qi grows stronger daily, while Healthy Qi grows weaker daily. Not purging leaves accumulated heat unchecked; purging weakens Spleen and Stomach, brewing major illness. This is the physician's fault.
If early diarrhea gradually transforms into dysentery, the old filth has already been cleared; do not purge again. If symptoms of abdominal pain and tenesmus remain, these are residual pathogens not fully cleared. Eliminate accumulation and stop dysentery: use *Baohe Quzhi Wan* (Preserve Harmony and Remove Stagnation Pill) to eliminate accumulation, and *Xianglian Wan* to stop dysentery.
For chronic, non-resolving dysentery, named Xie Xi Li (Resting Dysentery), use the family-prescribed *Hezhong Wan*.
Someone asked, "Is red dysentery heat and white dysentery cold?" I said, "*Yuan Bing Shi* discusses this in detail. Red and white discharge in dysentery are both due to damp-heat. Red comes from the Small Intestine, which is the Fu organ of the Heart; Heart belongs to Fire, hence its color is red. White comes from the Large Intestine, which is the Fu organ of the Lung; Lung belongs to Metal, hence its color is white. Red belongs to Heat; White belongs to Dampness, but Dampness also contains Heat. The Classics state: 'Excess Dampness leads to... Heat.' If early dysentery passes bright red blood, it is not ordinary red dysentery; this is Wind-Heat toxin, treated with *Jianhong Wan* (Cut Red Pill). If dysentery passes clotted blood or looks like bean juice, this is Dampness causing bleeding, treated with *Weifeng Tang* (Stomach Wind Decoction).
Someone asked, "He Jian said: Regulating Qi eliminates tenesmus; nourishing Blood stops dysentery. This is an eternal method. Why do pediatric dysentery formulas not follow this?" I said, "Dysentery is called Chang Pi in *Su Wen*, Da Jia Xie in *Nan Jing*, and Zhi Xia in ancient texts. Chang Pi arises from overeating. Da Jia Xie is a food stagnation syndrome. Zhi Xia means discharge of stagnant material. Thus, 'No accumulation, no dysentery.' Treatment prioritizes attacking accumulation. If accumulation is not removed, Qi cannot move; removing accumulation allows Qi to move, relieving tenesmus. Heat injures Blood; chronic dysentery injures Blood; clearing Heat and stopping diarrhea nourishes Blood. Although methods differ, the intent aligns."
Someone asked, "Dan Xi said: Diarrhea transforming into dysentery is Spleen transmitting to Kidney, difficult to treat. Dysentery transforming into diarrhea is Kidney transmitting to Spleen, easy to treat. Why?" I said, "Spleen governs Dampness; excess Dampness causes loose stools. Diarrhea is a Spleen disease. Chronic diarrhea transforming into dysentery with tenesmus involves the Kidney. If the dysentery is not true dysentery, tenesmus indicates sinking of Stomach Qi. Pus and blood indicate slipping of intestinal mucus. True Qi fails, Grain Qi ends; this is termed difficult to treat. Kidney dislikes Dampness; children sitting long on wet ground injure the Kidney. Tenesmus and pus/blood are Kidney diseases. Chronic dysentery suddenly transforming into diarrhea indicates Dampness is gone, but Spleen disease remains. Hence, no tenesmus/pain means damp-heat toxin is removed. No pus/blood means stale filth is exhausted. Intestines/stomach unobstructed, fluids/grains circulate; thus, easy to treat."
Someone asked, "Body cool and pulse quiet in dysentery indicates life; body hot and pulse restless indicates death. Is this true?" I said, "In early illness, Pathogenic Qi is flourishing; body heat and restless pulse cannot be called death signs. Flourishing Pathogenic Qi indicates Excess; urgent purging is possible. Once Pathogen is gone, pulse declines, body cools. Chronic dysentery with body heat and restless pulse is untreatable. Pulse quiet and body cool after chronic dysentery reflects deficiency of True Qi. Body should be warm, not too cool. Pulse should be quiet, not too weak. Classics say: 'Five Deficiencies in diarrhea/dysentery lead to death.' Pulse thin is one; cold skin is two; shortness of breath is three; unceasing diarrhea/dysentery is four; inability to eat is five. One must not rigidly interpret 'pulse quiet and body cool'."
Chronic dysentery with inability to eat, or vomiting immediately after eating, is named Jinkou Li (Locked Mouth Dysentery), corresponding to the Classic's "Five Deficiencies lead to death." Although many ancient formulas exist, none are highly effective. Chronic dysentery depletes Jin Ye (Body Fluids); Spleen/Stomach are weak, unable to digest. Prioritize tonifying Spleen: use *Baizhu San* removing *Gan Ge*, adding stir-fried *Ganjiang*. Ability to eat indicates life; inability indicates death.
Chronic dysentery with rectal prolapse indicates Qi and Blood deficiency. *Su Wen* states sinking is deficiency; *Nan Jing* states protrusion is deficiency. Ancient formulas often use astringents like Ying Su Pi (Poppy Shell) and Mu Zei (Equisetum); this treats the branch. One should use He Jian's method of regulating Qi and nourishing Blood. Once dysentery stops and tenesmus ceases, the anal canal naturally does not prolapse. Use *Jiaban Bazhen Wan* (Modified Eight Treasures Pill).
Dysentery with red, white, green, or black discharge is named Ye Ji Li (Pheasant Dysentery). Treat with *Ejiao Meilian Wan* (Donkey-hide Gelatin and Mume-Coptis Pill).
Dysentery with swollen knees is named He Xi Feng (Crane Knee Wind). Treat with *Jiawei Dihuang Wan* (Modified Rehmannia Pill).
*Baohe Quzhi Wan* treats dysentery with accumulation and weak Stomach; heavy purging is contraindicated.
*Chenpi* (5 qian), *Banxia Qu* (Pinellia Medicated Leaven), *Baifuling*, *Zhishi* (Bran-stir-fried), *Houpo* (Ginger-juice stir-fried), *Binglang* (each 5 qian), *Laifu Zi* (Stir-fried, 2.5 qian), *Muxiang*. Grind into powder, make pills with *Shenqu* paste, size of hemp seeds, administer with aged rice soup.
*Sanhuang Zhipo Wan* (Three Yellows, Immature Bitter Orange, and Magnolia Bark Pill) treats damp-heat dysentery with food accumulation.
*Huanglian*, *Huangqin*, *Huangbai* (all wine-stir-fried, each 3 qian), *Dahuang* (wine-baked, 5 qian), *Zhishi* (bran-stir-fried), *Houpo* (ginger-juice stir-fried), *Binglang* (each 2 qian). Grind into powder, make pills with wine paste, size of hemp seeds, administer with ginger soup.
*Weifeng Tang*: *Bazhen Tang* (Eight Treasures Decoction) minus *Dihuang* and *Gancao*, add *Guizhi* (Cinnamon Twig) in equal parts, decoct with millet. To modify: remove *Guizhi*, add *Huanglian* in equal parts, reduce *Wuzhuyu* by half, stir-fry together, grind to powder, make pills with wine paste. Treats recent or remote bloody dysentery.
*Ejiao Meilian Wan* treats dysentery regardless of duration, with red/white/green/black discharge and pain.
*Ejiao* (stir-fried with grass ash until bubbling), *Chifuling* (Red Poria), *Wumei* (pitted, stir-fried), *Chishao* (Red Peony), *Huangbai* (stir-fried), *Huanglian* (stir-fried), *Ganjiang* (stir-fried), *Danggui* (equal parts). Grind into powder, mix with *Ejiao*, make water pills, size of hemp seeds, administer with aged rice drink.
Family-preserved *Hezhong Wan*: Specifically treats Resting Dysentery.
*Renshen*, *Gancao*, *Danggui Shen* (Angelica Body), *Chuanxiong*, *Cheqianzi* (slightly stir-fried), *Zhuling* (Polyporus), *Zexie*, *Shenqu*, *Huanglian* (stir-fried, each 3 qian), *Maidong* (Ophiopogon, 3 qian). Grind into powder, make pills with wine paste, size of hemp seeds, administer with aged rice drink.
*Jiawei Dihuang Wan*: Treats Crane Knee Wind after dysentery.
*Dihuang Wan* (Rehmannia Pill) plus *Niuxi* (Achyranthes), *Hu Jing Gu* (Tiger Tibia Bone, prepared with酥/suet), *Baifuling*. Grind to powder, make honey pills.
*Jiaban Bazhen Wan*: Treats chronic dysentery with rectal prolapse.
*Bazhen Tang* minus *Chuanxiong* and *Baizhu*, add *Huanglian* (stir-fried), *Ejiao* (stir-fried, each 3 fen), *Muxiang* (reduce by two-thirds). Grind to powder, make water pills size of hemp seeds, administer with stir-fried rice soup. Take more for better results.
*Jianhong Wan*: Divine efficacy for dysenteric blood.
*Danggui Shen*, *Huanglian* (stir-fried), *Huaijiao Zi* (Styphnolobium Seed, stir-fried), *Ce Bai Ye* (Biota Leaf, stir-fried), *Jingjie Sui* (Schizonepeta Flower Spike), *Zhi Qiao* (stir-fried, equal parts). Grind to powder, make pills with wine-boiled wheat paste, size of hemp seeds, administer with aged rice soup.