典藏书目

The *Huangdi Neijing* (Yellow Emperor's Inner Canon) states: In dysentery with bloody stools, if the body is hot, the prognosis is poor (death); if the body temperature is normal or low, the prognosis is good (survival). In dysentery with white mucus, a deep pulse (Chen Mai) indicates a good prognosis, while a floating pulse (Fu Mai) indicates a poor prognosis. Zhang Zhongjing stated: In dysentery, if the pulse is slippery and rapid (Hua Shuo), it indicates retained food stagnation, and purgative therapy should be applied. The *Mai Jue* (Pulse Classic) states: In dysentery accompanied by intestinal urgency and pain, if a floating and large pulse appears, it signifies the depletion of vital qi and impending death (returning to the spring path).

The "Eight Dysenteries" in children arise from irregular eating and drinking, overexertion, and exposure to wind, fright, summerheat, and dampness, having touched the evil qi of the eight directions of heaven and earth; hence the name. Generally, this disease stems from disharmony of the Spleen and Stomach, excessive intake of food that accumulates in the Spleen and Stomach and cannot be transformed and transported, compounded by invasion of wind-cold, summerheat, and dampness. Injury by heat leads to red pus and blood in stool; injury by cold leads to white mucus; injury by wind leads to pure clear blood; injury by dampness leads to stool resembling bean dregs. If cold and heat mix, red and white discharge occurs together. If there is tenesmus (Li Ji Hou Zhong), abdominal urgency and distress, and acute pain, this is due to the fiery nature being rapid and drying. Alternatively, at the end of summer or beginning of autumn, sudden cold may suppress intense heat. With nowhere for the pathogen to dissipate, it lodges in the skin and muscles. Manifesting externally, it becomes Malaria (Nüe); manifesting internally, it becomes Dysentery (Li); manifesting both internally and externally, it becomes Malaria-Dysentery. Chronic dysentery can lead to abdominal distension and fullness. Cold in the Lower Jiao combined with heat accumulation in the Upper Jiao results in excess above and deficiency below. If toxic damp-heat from the Spleen and Stomach steams upward, invading the clear pathways, causing closure of the stomach opening, it results in "Forbidden Mouth Dysentery" (Jin Kou Li), where the patient cannot eat. Another type is Epidemic Toxic Dysentery (Yi Du Li), where infection spreads within a household, affecting all ages similarly. Treatment requires first analyzing the annual climate cycle to balance external pathogens, observing stagnation to regulate internal conditions, examining the cause of injury, and distinguishing deficiency/excess and cold/heat to guide therapy, ensuring clarity and avoiding erroneous prescriptions.

*Bing Ji Shi Yao* (Essentials of Pathogenesis) states: Tenesmus is suitable for purgation; abdominal pain is suitable for harmonization; heaviness of the body is suitable for removing dampness; a wiry pulse is suitable for dispelling wind; thick and sticky pus and blood require heavy agents to exhaust them; cold body with spontaneous sweating requires toxic drugs to warm; internal contraction of wind evil requires diaphoresis; duck-dung-like loose stools require warming. It also states: Pathogens on the exterior are treated by dispersing; those in the interior by purging; those high up by emesis; those low down by exhausting. External heat is treated by internal clearing; urinary difficulty by separating and draining. Furthermore: Excess is drained; deficiency is guided; arrival (of pathogen) is stopped; departure (of pathogen) is sent away. As military strategy says: Avoid their sharp energy, strike when they are retreating and exhausted. This is what is meant. *Lan Shi Mi Zang* (Secrets of the Cabinet of the Orchid Chamber) states: If injury from cold food causes distension progressing to undigested stool (Sun Xie), warm and acrid agents should be used to digest and guide out. If injury from damp-heat food results in pus and blood, bitter and cold agents should be used to clear internally. Wind evil sinking downward requires lifting and raising; internal dominance of dampness requires separation and drainage. Urgency requires purging; tenesmus requires regulating Qi; abdominal pain requires harmonizing; torrential diarrhea with borborygmus, weakness, inability to lift clothes, and a fine, weak pulse requires warming. Thick, sticky pus and blood, inability to defecate despite urge, and a surging, forceful pulse require cold purgation.

Regarding dietary injury, indulging in pungent-hot or cold foods damages the intestines and stomach. Once damaged, they fail to transform and transport, leading to accumulation and stagnation, resulting in dysentery. The *Neijing* states: "Irregular diet and improper daily routine injure the Yin. When Yin is injured, it enters the five zang organs. Fullness and blockage in the zang organs do not result in undigested stool, but over time become Chang Pi (intestinal disorder/dysentery)." This is exactly what is described. Treatment methods should first resolve food toxicity, possibly using purgation, and then regulate according to cold, heat, warmth, and coolness.