痢疾暑湿生冷成，伤气为白伤血红，后重里急腹窘痛，寒热时痢噤口名。
【注】痢之为证，多因外受暑湿，内伤生冷而成。伤于气者色多白，以肺与大肠为表
里也。伤于血者色多赤，以心与小肠为表里也。里急者，腹窘痛也；后重者，频下坠也。
又有寒痢、热痢、时痢、噤口痢之别，医者须详察之。
寒伤久痢脏虚寒，肠鸣切痛实难堪，面唇青白喜饮热，理中养脏效通仙。
【注】寒痢者，寒冷伤胃，久痢不已，或脏气本虚，复为风冷所乘，伤于肠胃。故痢
时肠鸣切痛，面唇青白，口虽渴喜饮热。此里寒虚之证也。初宜理中汤，久则真人养脏
汤治之。寒得温散而证愈矣。
理中汤（方见不乳）
真人养脏汤
人参 白术（土炒） 木香（煨） 肉桂 当归
（土炒） 白芍（炒） 罂粟壳（蜜炙） 诃子肉（面煨去核） 肉果（煨） 甘草（炙）
引用乌梅，水煎服。
【方歌】寒痢须用养脏汤，人参白术广木香，归芍肉桂炙甘草，粟壳诃子肉果良。
痢初实热腹窘痛，下痢无度尿短红，舌赤唇焦喜饮冷，芍药白头香连灵。
【注】热痢者，皆因湿热凝结于肠胃，以致腹中窘痛，频频下痢，尿短色红，舌赤唇
焦，喜饮冷水，此里热之证也。重则当归芍药汤主之，轻则白头翁汤主之，或香连丸主之。
当归芍药汤
当归 白芍 木香 黄芩 黄连 肉桂 大黄 槟榔 甘草（生）
水煎服。
【方歌】热痢当归芍药汤，里急后重服最良，归芍木香芩连桂，大黄甘草共槟榔。
白头翁汤
黄连 黄柏 秦皮 白头翁
水煎服。
【方歌】白头翁汤治热痢，腹中窘痛溺短赤，连柏秦皮白头翁，煎服之后痢自愈。
香连丸
木香 川黄连（各等分）
为细末醋糊为丸如桐子大，量儿大小用之，空心米饮下。
痢疾多由暑湿之邪与生冷饮食共同作用而成。损伤气分则大便色白，损伤血分则大便色红。伴有肛门坠胀、腹部急迫疼痛的症状称为“后重里急”。若兼见寒热往来或不能进食，则分别称为时行痢或噤口痢。
【注】痢疾这一病症，多因外感暑湿之气，内伤生冷食物所致。病在气分的，大便颜色多为白色，因为肺与大肠互为表里。病在血分的，大便颜色多为红色，因为心与小肠互为表里。“里急”是指腹部拘急疼痛；“后重”是指频繁有便意但排便不畅、肛门下坠。此外，还有寒痢、热痢、时行痢、噤口痢的区别，医生必须详细诊察辨别。
寒邪导致的久痢属于脏腑虚寒证，表现为肠鸣、剧烈腹痛难以忍受，面色和嘴唇青白，喜欢喝热水，理中汤和真人养脏汤疗效显著，如同通仙之药。
【注】寒痢，是由于寒冷损伤胃气，导致久痢不愈；或者脏腑之气原本虚弱，又受风冷侵袭，损伤了肠胃。因此痢疾发作时肠鸣音明显且腹痛剧烈，面色和嘴唇呈现青白色，虽然口渴但喜欢喝热水。这是里寒虚证的表現。初期适宜使用理中汤，日久则用真人养脏汤治疗。寒邪得到温散，病症即可痊愈。
理中汤（方剂见“不乳”章节）
真人养脏汤
人参 白术（土炒） 木香（煨制） 肉桂 当归（土炒） 白芍（炒制） 罂粟壳（蜜炙） 诃子肉（面煨去核） 肉豆蔻（煨制） 甘草（炙制）
引用乌梅，加水煎服。
【方歌】寒痢须用养脏汤，人参白术广木香，归芍肉桂炙甘草，粟壳诃子肉果良。
痢疾初起属实热证，腹部拘急疼痛，腹泻次数极多，小便短少且色红，舌质红赤、嘴唇焦干，喜欢喝冷水，可用芍药白头香连灵方治疗。
【注】热痢，都是因为湿热凝结在肠胃，导致腹部拘急疼痛，频繁腹泻，小便短少色红，舌质红赤嘴唇焦干，喜欢喝冷水，这是里热证的表现。病情重的用当归芍药汤主治，病情轻的用白头翁汤主治，或者用香连丸主治。
当归芍药汤
当归 白芍 木香 黄芩 黄连 肉桂 大黄 槟榔 甘草（生用）
加水煎服。
【方歌】热痢当归芍药汤，里急后重服最良，归芍木香芩连桂，大黄甘草共槟榔。
Dysentery is often caused by the combined action of summer-heat and dampness pathogens along with raw and cold food. Injury to the Qi level results in white-colored stool, while injury to the Blood level results in red-colored stool. Symptoms characterized by tenesmus (urgent need to defecate) and abdominal distress are termed "houzhong liji" (posterior heaviness and internal urgency). If accompanied by alternating chills and fever or an inability to eat, it is respectively referred to as epidemic dysentery or jin Kou dysentery (dysentery with inability to swallow).
[Note] The syndrome of dysentery is mostly caused by external contraction of summer-heat and dampness, and internal damage from raw and cold foods. When the pathogen affects the Qi level, the stool color tends to be white, because the Lung and Large Intestine are exterior-interiorly related. When the pathogen affects the Blood level, the stool color tends to be red, because the Heart and Small Intestine are exterior-interiorly related. "Li ji" refers to abdominal cramping pain; "Hou zhong" refers to frequent urge to defecate with a sensation of bearing down. Furthermore, there are distinctions among cold dysentery, heat dysentery, epidemic dysentery, and jin Kou dysentery; physicians must examine them in detail.
Cold-induced chronic dysentery belongs to the deficiency-cold syndrome of the zang-fu organs, manifesting as borborygmus (intestinal rumbling), severe abdominal pain that is hard to endure, cyanotic and pale face and lips, and a preference for drinking hot water. Lizhong Tang (Regulate the Middle Decoction) and Zhenren Yangzang Tang (Genuine Human Nourish Viscera Decoction) are highly effective, akin to celestial elixirs.
[Note] Cold dysentery occurs when cold damages the Stomach qi, leading to chronic dysentery that does not heal; or when the organ qi is originally deficient, compounded by invasion of wind-cold, damaging the intestines and stomach. Therefore, during dysentery episodes, there is prominent borborygmus and severe cutting abdominal pain, the face and lips appear cyanotic and pale, and although thirsty, the patient prefers hot drinks. This is a syndrome of interior cold and deficiency. Initially, Lizhong Tang is suitable; for prolonged cases, Zhenren Yangzang Tang is used to treat it. Once the cold is dispersed by warmth, the syndrome resolves.
Lizhong Tang (Formula see chapter on "Non-nursing")
Zhenren Yangzang Tang (Genuine Human Nourish Viscera Decoction)
Ren Shen (Ginseng Radix), Bai Zhu (Atractylodis Rhizoma, stir-fried with soil), Mu Xiang (Vladimiriae Radix, baked), Rou Gui (Cinnamomi Cortex), Dang Gui (Angelicae Sinensis Radix, stir-fried with soil), Bai Shao (Paeoniae Radix Alba, stir-fried), Ying Su Ke (Papaveris Pericarpium, honey-fried), He Zi Rou (Terminalia Chebulae Fructus, flour-baked, pitted), Rou Dou Kou (Myristicae Semen, baked), Gan Cao (Licorice Radix et Rhizoma, honey-fried).
Add W Mei (Mume Fructus) as a guide, decoct with water, and take orally.
[Prescription Song] For cold dysentery, use Yangzang Tang,
Ren Shen, Bai Zhu, and Guang Mu Xiang.
Dang Gui, Bai Shao, Rou Gui, and honey-fried Gan Cao,
Ying Su Ke, He Zi, and Rou Dou Kou are excellent.
Initial dysentery presenting as excess-heat involves abdominal distress and pain, profuse diarrhea, short and red urine, a red tongue and scorched lips, and a preference for drinking cold water. Shaoyao Baitou Xianglian Ling formula may be used.
[Note] Heat dysentery is caused by the coagulation of damp-heat in the intestines and stomach, resulting in abdominal distress and pain, frequent diarrhea, short and red urine, a red tongue with scorched lips, and a preference for drinking cold water. This is a syndrome of interior heat. In severe cases, Danggui Shaoyao Tang (Angelica and Peony Decoction) is the primary treatment; in mild cases, Baitouweng Tang (Pulsatillae Decoction) is used, or Xianglian Wan (Mu Xiang and Coptis Pill).
Danggui Shaoyao Tang (Angelica and Peony Decoction)
Dang Gui (Angelicae Sinensis Radix), Bai Shao (Paeoniae Radix Alba), Mu Xiang (Vladimiriae Radix), Huang Qin (Scutellariae Radix), Huang Lian (Coptidis Rhizoma), Rou Gui (Cinnamomi Cortex), Da Huang (Rhei Radix et Rhizoma), Bing Lang (Arecae Semen), Gan Cao (Licorice Radix et Rhizoma, raw).
Decoct with water and take orally.
[Prescription Song] For heat dysentery, use Danggui Shaoyao Tang,
Most effective for tenesmus and posterior heaviness.
Dang Gui, Bai Shao, Mu Xiang, Huang Qin, Huang Lian, and Rou Gui,
Da Huang, Gan Cao, together with Bing Lang.
Baitouweng Tang (Pulsatillae Decoction)
Huang Lian (Coptidis Rhizoma), Huang Bo (Phellodendri Cortex), Qin Pi (Fraxini Cortex), Baitouweng (Pulsatillae Radix).
Decoct with water and take orally.
[Prescription Song] Baitouweng Tang treats heat dysentery,
Abdominal distress and pain with short, red urine.
Huang Lian, Huang Bo, Qin Pi, and Baitouweng,
After decoction and ingestion, the dysentery heals itself.
Xianglian Wan (Mu Xiang and Coptis Pill)
Mu Xiang (Vladimiriae Radix), Chuan Huang Lian (Coptidis Rhizoma) (equal parts).
Grind into fine powder, form pills using vinegar paste, sized like paulownia seeds. Use according to the child's age, taken on an empty stomach with rice water.