经云∶饮食不节，起居不时，阴受之，则入五脏。下为肠泄，久为肠 。陈飞霞曰∶小儿此病初起，两眉皱而
多啼，由腹痛也。烦躁不安，由里急后重也。数至圊而不能，或赤白相兼，或单红单白，是其候也。周梦觉曰∶痢
有不与世相递嬗，而名则因时而变易。方策所传，其来有自，不容不据古以准今。《素问》谓之肠 ，《难经》谓
之里急后重，汉谓之滞下，晋谓之秋燥，至唐方谓之痢。即其名而绎其义，便血曰 ，痛甚日急，壅甚曰滞，皱
裂，曰燥不利曰痢，痢之情形，已显示于称名之表。历代以来，扬榷指陈，扬榷，犹言大概也。不啻以暮鼓晨钟，
发人深省。治是症者，顾可孟浪从事，翻欲缄滕扃 而置之死地乎。当此暑炎方退，金飙初起，土间其中，热湿燥
汇于一时，三气凑而为病。有时行者，从皮毛入，微恶寒腹痛，泄尽宿食，方转红白。风之所过，行于一家，则病一
家；行于一境，则病一境。有传染者，从口鼻入，不恶寒腹痛，随泄宿食，即转红白。气之所触，染于一人则病一人，
染于一方则病一方。于斯时也，抚枕席而兴嗟，何分男女，如厕坑而抱痛，莫测死生。天气阴晴，诟闻一室；灯光
明灭，呻彻五更。饮膏粱者无论已，可怜寒土当灾，朋尽返回，难邀甲戌之峙，人皆掩鼻，从传庚癸之呼。聚桑梓者犹
可也，最苦旅人远适，今雨不来，谁恤零丁异地；闻风争避，那管客子离乡。儒者考古今之得失，证一己之功
修，于是证而参上乘焉。本来恻隐之心，自应以之普度也。喻嘉
言∶初用辛凉以解表，次用苦寒以清里。刘河间曰∶调气则后重自除，行血则脓血自除。余于痢之时行初起者，而宗
嘉言焉，疏经络而趋邪，败毒散克壮元老之猷。于痢之传染初起者，而宗河间焉，和营卫而导滞，芍药汤允占丈
人之吉。及其归宿，郁则为热，试诊其脉，未有不数者，所以香连丸，为治痢之总方。顾在表忌用者，邪犹未入于里
也。久病难用者，恐重伤其生气也。昔赵养葵以六味地黄汤治伤寒，人讥为赵氏之创见，而下多伤阴。余尝以六味
地黄汤治痢，此又余之创见也。如果脉虚自汗，赤白将尽，真人养脏汤、诃子散，俱可酌而用之。夫痢不分赤白，
既出于热，反服辛热而愈者，此乃从治之法。盖人之禀赋有寒有热，邪热之中人，每从其类而化。辛热药能开郁解结，
使气血得以宣通，特宜于以寒化热之人。若遇以热化热，而误用之，其祸有不可胜言矣。存心济世者，倘遇以寒化热
之痢，用温补而大获其效，慎勿执以为例。
人参败毒散
人参（一钱） 羌活（五分） 独活（五分） 柴胡（一钱） 前胡（一钱） 川芎（五分） 枳壳（一钱）
桔梗（一钱） 茯苓（一钱） 甘草（一钱）
芍药汤
芍药（一钱） 当归（一钱） 黄芩（一钱） 黄连（一钱） 大黄（一钱） 木香（六分） 槟榔（七分）
肉桂（五分） 炙甘草（一钱）
香连丸
黄连（二钱） 吴萸（一钱上二味同炒，去吴芋，加木香五分，不见火，共研细末，醋糊为丸）
真人养脏汤
粟壳（一钱） 诃子（一钱） 肉豆蔻（一钱） 木香（六分） 甘草（一钱） 肉桂（五分） 人参（一钱）
白术（一钱） 当归（一钱） 白芍（一钱）
诃子散
粟壳（一钱） 诃子（一钱） 干姜（七分） 陈皮（一钱） 上共为细末，空心服。
桂附汤
附子（三分） 肉桂（三分） 干姜（六分） 焦术（一钱） 砂仁（五分） 炙甘草（一钱）
涂蔚生曰∶痢虽只分红白，与红白相兼者三种，而寒热虚实之症，亦无不尽在其中。唐容川曰∶肠胃之中，
除却糟粕，只微有脂膏水液而已。脂膏属血分，水液属气分。病气分，则水混而为白痢。病血分，则血扰而为赤痢。
气血交病，则赤白相半。由何处酿成真脓，而从大便泄出哉。有之，则毒聚肠胃，将肠胃脂膏血肉，蒸化为脓，或下
如烂瓜，或如屋漏水，此腐肠溃胃之危候，与痈之腐烂无异，此非寻常治痢之法所能克也。是容川已将痢之发生原由，
揭示其大概矣。而治之之法，有谓宜发汗者；有谓宜清凉者，有谓宜寒热合治者，有谓由于夏月贪凉，过食生
冷，至秋伏阴内动，应时而痢，宜温暖者；有谓时痢宜泻，久痢宜补者；有谓宜收涩者；有谓初痢忌用芩连者，
有谓宜燥湿者；有谓宜消导者。以上之主张，既不一致，而彼此之互相攻讦，亦因以起矣。余以患痢五年，深恨
大医之难延，名医之炎凉，时医之误我，于是引咎自奋，弃儒就医。偏于痢症一门，三致意焉。迨其痢自治愈，
稍有心得，始知诸家之所主张，均有至理，而亦即有所偏也。吾人如欲长于治痢，必须知诸家之有所长，与诸家
之所短。而取其所长，舍其所短，互相参考补用。聚群众之精华，成一己之利器，方能有中而不偏，有济而无偾也。
夫痢之所以宜发汗者，以寒邪从皮毛而入，循外之周身油膜，以入内之肠胃油膜。肠胃之气化，既受阴凝下降
而为白痢。吾人即急当升提开发，使邪之由外而入者，仍由外而出，此葛根、柴胡等药之在所必用也；若有里急
后重，欲便不便者，而木香、槟榔、枳壳、当归、白芍等在所必用，有寒热风者，而防风、天麻、白头翁等在所必用。
此即先贤所谓逆流挽舟之法，以及理气则后重自除也。
痢之所以宜清凉者，以内部之火热，既扰伤经络之阴血，使下降而为赤痢。则吾人之欲热退痢止，亦惟在清凉
之一途，故知柏芩连归芍等味，在所必用。其兼有由于外之风热者，而天麻、白头翁、僵蚕、桑寄生等在所必用。
其兼有里急后重者，而木香、槟榔、枳壳、浓朴等味在所必用。其兼有日久血虚者，而生地、阿胶、龟胶等味亦
在所必用。此即先贤之所谓清热解毒以及调血则便脓自愈也。若唐容川所谓血色黑暗，脉迟，手足冷者，属虚寒，
黄土汤主之。此系红痢之变症，亦犹白痢之亦间有可少用芩连者也。
痢之所以宜寒热合用者，以寒邪既伤六腑之气，而火热又伤其六脏之血，使寒热参杂，赤白间下，则惟有寒
热合用之一途，此葛柴荆防归芍芩连香枳姜枣之在所必用也。唐容川谓此寒热合用，必有寒热兼见之实症，不得笼
统言之，而混用寒热杂方也。即如仲景乌梅丸所治之症，消渴气上冲心，心中疼热，饥不欲食，此热症之实据也。
食即吐蛔，下之痢不止，此即寒症之实据也。惟其有腑热脏寒之实据，故用乌梅丸，兼寒热治之。又如仲景生姜泻
心汤所治之症云∶心下痞硬，干噫食臭，此火症也；胁下有水气，腹中雷鸣，此水病也；惟其有此火在胃中，水在肠
间之实据，故用生姜泻心汤治之。大便初头硬，后半溏者，此胃中有寒，肠中有热也，陈修园拟用理中汤加大黄，
此皆寒热兼见之实据。医者必辨症如是之严，而后用药处方，不失铢黍。此等精细注脚，询可谓不易多得者也。
痢之所以宜温暖者，以生冷虽伤内部生阳之气，而将值夏令，犹可借吸入之天阳，以调剂其阴凝寒滞。迨至时迁
势移，向者温暖之空气，一变而为清凉之空气，则吾人向日阴凝寒滞之脏腑，其气血自不得不随寒冷之凝结，一
发而为痢下矣。吾人欲其痢止，则不得不从温暖，此茯苓、白术、苡仁、陈皮、木香、甘草生姜、大枣等味之所必用也。
痢之所以时痢宜泻，久痢宜补，宜收涩者，此盖谓寒热既初伤其气血，使气血之原质，变为赤白痢下。其势
方炽，不得不从事推荡。俾已成之痢，尽行推下，减其积垢，即所以减其邪势；减其邪势，即所以止其痢候，此枳
壳、槟榔、木香、陈皮、芒硝、大黄，之在所必用也。然此必须毫无外感，而后可用，否则亦须加解外诸药。若
夫久痢不止，气血下陷，则魂魄将随之而脱，魂魄既脱，其死亡也，可立而待。故治之之法，惟宜滋补。有热者，
清燥救肺汤主之；有寒者，八珍汤加升麻主之。仲景之桃花汤，乌梅丸，皆是涩以止脱之义。慎勿谓涩，则邪气
固结于内，而不敢用收涩之药也。
痢之所以忌用芩连者，此盖谓寒凉足以伤胃；胃伤，则生化之源顿绝。然必有伏阴在内，寒邪凝滞之实据，方可
忌用芩连。若火结肠胃，下迫至甚，腹痛如锥，则芩连硝黄又为此症得力之猛将也。
痢之所以宜燥湿者，以湿之有伤气血，无异寒热之伤气血。吾人欲其去痢止，则惟有燥之之一法。然湿有寒热，
而痢又宜以寒热为转移，此茯苓、白术、车前、苡仁、泽泻等类，有时与姜附同用，而有时又须与芩连同用者也。
痢之所以宜消导者，此盖时痢宜泻之义。以痢多食积，必须消其食积，而后可冀痢止，此枳壳、浓朴、大黄、
山楂、神曲、麦芽、莱菔子，之所必用也。然容川解曰∶痢症之里急，为急欲下便，是肝木之疏泄。后重为欲便
不得，是肺气之敛，而于止奔迫，解郁闭一方，而肝肺并治者，拟用白头翁汤，加石膏、知母、杏仁、桔梗、枳
壳、槟榔、柴胡、麦芽、当归、白芍等治之，轻则，用小柴胡加当归、白芍、杏仁、枳壳、槟榔、麦芽、花粉，
调和肝肺，则肺气不迫注，肝气得开利矣。又云∶肝气欲泄而下注，肺气欲收而不开，故痢多发于秋。秋金肺气闭
而不开，肝气决裂而不遏，是以迫痛，治宜甘桔汤加白芍，以桔梗开
提肺气，以白芍平治肝木，本此意以为加减，则鳖甲、龙胆草、青皮、秦皮、芦荟、皆平肝之药，当归、生地、桃
仁、五灵脂、元胡索，皆治肝经血分之药，黄芩、麦冬、桑皮、知母皆清肺之药，枳壳、贝母、杏仁、陈皮，皆
肺经调气之药。随宜致用，变化在人，乌有不治之痢哉。
容川此节证论，虽仅足为时痢之方针，而临症择而用之，亦无不效，若桴鼓者矣。
黄土汤方
灶心土（二钱） 甘草（一钱） 白术（一钱） 熟地（一钱） 黄芩（一钱） 附子（炮，五分） 阿胶（一钱）
仲景乌梅丸方
乌梅（一钱） 细辛（六分） 干姜（五分） 黄芩（一钱） 黄连（一钱） 当归（一钱） 附子（五分）
川椒（一钱） 桂枝（七分） 党参（一钱） 黄柏（一钱）
仲景生姜泻心汤方
生姜（一钱） 甘草（一钱） 人参（一钱） 干姜（五分） 黄芩（一钱） 半夏（六分） 黄连（一钱）
大枣（一钱）
清燥救肺汤方（见前咳嗽方内）
知柏地黄汤方（见前咳嗽方内）
八珍汤方
当归（一钱） 白芍（一钱） 熟地（一钱） 川芎（五分） 白术（一钱） 茯苓（一钱） 党参（一钱）
甘草（一钱）
仲景桃花汤方
赤石脂（一钱） 干姜（五钱） 粳米（一钱）
仲景白头翁汤方
白头翁（一钱） 黄连（一钱） 黄柏（一钱） 秦皮（一钱）
仲景小柴胡汤方（见前咳嗽方内）
仲景甘桔汤方
甘草（二钱） 桔梗（一钱）
《黄帝内经》说：饮食没有节制，起居没有规律，阴气受到邪气侵袭，病邪就会传入五脏。向下表现为肠道泄泻，日久则发展为痢疾。陈飞霞说：小儿患此病初起时，双眉紧皱且多啼哭，这是因为腹痛的缘故。烦躁不安，是因为有里急后重的感觉。频繁去厕所却排不出大便，或者大便中赤白相兼，或者只有红色或只有白色，这就是痢疾的征候。周梦觉说：痢疾有一种情况是不随时代更替而改变其本质，但名称却因时而异。医书典籍所传，由来已久，不能不依据古法来衡量今病。《素问》称之为“肠澼”，《难经》称之为“里急后重”，汉代称之为“滞下”，晋代称之为“秋燥”，到了唐代方剂书中才称为“痢”。从名称推究其含义，便血称为“澼”，疼痛剧烈称为“急”，壅滞严重称为“滞”，皱裂不通称为“燥”，不利称为“痢”，痢疾的情形，已经显示在名称的表面。历代以来，概括指陈，概括，就是大概的意思。这不仅仅是像暮鼓晨钟一样，发人深省。治疗这种病症，难道可以轻率从事，反而想要缄口不言、置之死地吗？当暑热刚退，秋风初起之时，湿气夹杂其中，热、湿、燥三气汇聚于一时，三种邪气凑合而成病。有时是时行疫气，从皮毛侵入，轻微恶寒腹痛，排泄完宿食后，大便才转为红白相间。风邪所过之处，流行于一家，则一家患病；流行于一境，则一境患病。有的是传染性的，从口鼻侵入，不恶寒腹痛，随着排泄宿食，立即转为红白相间。气邪所触，感染一人则一人患病，感染一方则一方患病。在这个时候，抚摸着枕席而叹息，不分男女老少，如同蹲在厕所坑边抱着痛苦，无法预测生死。天气阴晴变化，令人厌恶听闻于室内；灯光明灭不定，呻吟声彻夜直到五更。那些享用膏粱厚味的人不必说了，可怜贫寒之人遭遇灾祸，朋友都返回家乡，难以邀请甲戌年（指特定年份或比喻艰难时刻）的支撑，人们都掩着鼻子，听从传递庚癸（指军中乞粮的隐语，此处借指求助无门或病情危急）的呼喊。聚集在故乡的人还可以，最痛苦的是旅客远行他乡，如今老朋友不来，谁怜悯孤零异地的人；听到风声争相躲避，哪管客子离乡之苦。儒者考证古今的得失，验证自身的功修，于是考证并参悟高深的医术。本来恻隐之心，自然应该用来普度众生。喻嘉言说：初起时用辛凉药物以解表，次用苦寒药物以清里。刘河间说：调气则后重自然消除，行血则脓血自然清除。我对于痢疾的时行初起者，遵循喻嘉言的方法，疏通经络以驱除邪气，用人参败毒散来增强疗效。对于痢疾的传染初起者，遵循刘河间的方法，调和营卫以导滞，用芍药汤确实能取得良好的效果。等到病情归宿，郁结则化为热，试诊其脉象，没有不是数脉的，所以香连丸，成为治疗痢疾的总方。但是在表证阶段忌用攻下，因为邪气尚未入里。久病难用攻伐，恐怕会重伤人体的生气。过去赵养葵用六味地黄汤治疗伤寒，被人讥笑为赵氏的创见，认为这样容易损伤阴液。我曾经用六味地黄汤治疗痢疾，这又是我的创见。如果脉象虚弱自汗，赤白痢将尽，真人养脏汤、诃子散，都可以酌情使用。痢疾不分赤白，既然出于热证，反而服用辛热药物而痊愈的，这是反治法。因为人的禀赋有寒有热，邪热中人，往往从其体质属性而转化。辛热药物能开郁解结，使气血得以宣通，特别适合以寒化热体质的人。如果遇到以热化热的情况，而误用辛热药，其祸害不可胜言。存心济世的人，倘若遇到以寒化热的痢疾，用温补法大获其效，千万不要固执地以此为常规。
人参败毒散
人参（一钱） 羌活（五分） 独活（五分） 柴胡（一钱） 前胡（一钱） 川芎（五分） 枳壳（一钱）
桔梗（一钱） 茯苓（一钱） 甘草（一钱）
芍药汤
芍药（一钱） 当归（一钱） 黄芩（一钱） 黄连（一钱） 大黄（一钱） 木香（六分） 槟榔（七分）
肉桂（五分） 炙甘草（一钱）
香连丸
黄连（二钱） 吴茱萸（一钱，上两味同炒，去吴茱萸，加木香五分，不经过火炒，共研细末，醋糊为丸）
真人养脏汤
罂粟壳（一钱） 诃子（一钱） 肉豆蔻（一钱） 木香（六分） 甘草（一钱） 肉桂（五分） 人参（一钱）
白术（一钱） 当归（一钱） 白芍（一钱）
诃子散
罂粟壳（一钱） 诃子（一钱） 干姜（七分） 陈皮（一钱） 以上共为细末，空腹服用。
桂附汤
附子（三分） 肉桂（三分） 干姜（六分） 焦白术（一钱） 砂仁（五分） 炙甘草（一钱）
涂蔚生说：痢疾虽然只分红痢、白痢和红白相兼这三种，但寒热虚实的症状，也没有不完全包含在内的。唐容川说：肠胃之中，除了糟粕，只有微量的脂膏和水液而已。脂膏属于血分，水液属于气分。病在气分，则水混浊而成为白痢。病在血分，则血液受扰而成为赤痢。气血同时患病，则赤白各半。由何处酿成真脓，而从大便泄出呢？有的话，则是毒聚肠胃，将肠胃的脂膏血肉，蒸化为脓，或者下如烂瓜，或者如屋漏水，这是腐肠溃胃的危重征候，与痈疽腐烂无异，这不是寻常治疗痢疾的方法所能克服的。唐容川已经将痢疾发生的缘由，揭示其大概了。而治疗方法，有人说宜发汗；有人说宜清凉；有人说宜寒热合治；有人说由于夏季贪凉，过食生冷，到秋季伏阴内动，应时而发痢疾，宜温暖；有人说时痢宜泻，久痢宜补；有人说宜收涩；有人说初痢忌用黄芩、黄连；有人说宜燥湿；有人说宜消导。以上的主张，既不一致，彼此之间的互相攻击也就因此产生了。我患痢疾五年，深深怨恨大医难请，名医势利，时医误我，于是引咎自责，奋发图强，弃儒从医。专注于痢疾一门，三次用心钻研。等到自己的痢疾自愈，稍有心得，才知道各家主张，均有至理，但也各有偏颇。我们如果想擅长治疗痢疾，必须知道各家的长处和各家的短处。取其长处，舍其短处，互相参考补充使用。聚集众人的精华，成就自己的利器，才能做到准确而不偏颇，有益而无失败。
所谓痢疾宜发汗的原因，是因为寒邪从皮毛而入，沿着体表的油膜，进入体内的肠胃油膜。肠胃的气化功能，既受阴凝下降的影响而成为白痢。我们应当紧急升提开发，使由外而入的邪气，仍由外而出，这就是葛根、柴胡等药物在所必用的原因；如果有里急后重，想排便却排不出的情况，那么木香、槟榔、枳壳、当归、白芍等药物就在所必用；有寒热风邪的，那么防风、天麻、白头翁等药物就在所必用。这就是先贤所说的“逆流挽舟”之法，以及理气则后重自然消除的道理。
所谓痢疾宜清凉的原因，是因为内部的火热，既扰乱损伤经络的阴血，使其下降而成为赤痢。那么我们想要热退痢止，也只有通过清凉这一途径，所以知母、黄柏、黄芩、黄连、当归、白芍等味道，就在所必用。其兼有外部风热的，那么天麻、白头翁、僵蚕、桑寄生等药物就在所必用。其兼有里急后重的，那么木香、槟榔、枳壳、厚朴等味道就在所必用。其兼有日久血虚的，那么生地、阿胶、龟胶等药物也在所必用。这就是先贤所谓的清热解毒以及调血则便脓自愈的道理。如果唐容川所说血色黑暗，脉迟，手足冷者，属于虚寒，用黄土汤主治。这是红痢的变症，也就像白痢中间也有可少量使用黄芩、黄连的情况一样。
所谓痢疾宜寒热合用的原因，是因为寒邪既伤了六腑之气，而火热又伤了六脏之血，使寒热参杂，赤白间下，那么只有寒热合用这一条路，这就是葛根、柴胡、荆芥、防风、当归、白芍、黄芩、黄连、木香、枳壳、生姜、大枣等药物在所必用的原因。唐容川说这种寒热合用，必须有寒热兼见的实证，不能笼统地说，而混用寒热杂方。就像张仲景乌梅丸所治疗的病症，消渴，气上冲心，心中疼热，饥饿但不想吃东西，这是热证的实据。吃东西就吐蛔虫，攻下则痢不止，这是寒证的实据。正因为有腑热脏寒的实据，所以用乌梅丸，兼用寒热治疗。又如张仲景生姜泻心汤所治疗的病症说：心下痞硬，干噫食臭，这是火症；胁下有水气，腹中雷鸣，这是水病；正因为有此火在胃中，水在肠间的实据，所以用生姜泻心汤治疗。大便开头硬，后半稀溏，这是胃中有寒，肠中有热，陈修园拟用理中汤加大黄，这都是寒热兼见的实据。医生必须辨证如此严格，然后用药处方，才不会失之毫厘。这些精细的注脚，真可以说是难得一遇的。
所谓痢疾宜温暖的原因，是因为生冷虽然伤了内部生阳之气，但正值夏令，还可以借助吸入的天阳，来调剂其阴凝寒滞。等到时过境迁，先前温暖的空气，一变而为清凉的空气，那么我们往日阴凝寒滞的脏腑，其气血自然不得不随着寒冷的凝结，一发而成为痢下了。我们想要其痢止，则不得不从温暖入手，这就是茯苓、白术、薏苡仁、陈皮、木香、甘草、生姜、大枣等药物之所必用的原因。
所谓时痢宜泻，久痢宜补，宜收涩的原因，这大概是说寒热既初伤其气血，使气血的原质，变为赤白痢下。其势头正盛，不得不从事推荡。使已成之痢，尽行推下，减少积垢，也就是减少邪势；减少邪势，也就是停止痢疾的症状，这就是枳壳、槟榔、木香、陈皮、芒硝、大黄等药物在所必用的原因。然而这必须毫无外感，之后才可使用，否则也必须加入解表诸药。至于久痢不止，气血下陷，则魂魄将随之而脱，魂魄既脱，其死亡，可以立刻等待。所以治疗的方法，惟宜滋补。有热的，用清燥救肺汤主治；有寒的，用八珍汤加升麻主治。张仲景的桃花汤、乌梅丸，都是涩以止脱的意义。千万不要认为涩，则邪气固结于内，而不敢用收涩的药物。
所谓痢疾忌用黄芩、黄连的原因，这大概是说寒凉足以伤胃；胃受伤，则生化之源顿绝。然而必须有伏阴在内，寒邪凝滞的实据，才可以忌用黄芩、黄连。如果火结肠胃，下迫至极，腹痛如锥刺，那么黄芩、黄连、芒硝、大黄又为此症的得力猛将。
所谓痢疾宜燥湿的原因，是因为湿邪伤害气血，无异于寒热伤害气血。我们想要去痢止，则只有燥湿这一种方法。然而湿有寒热之分，而痢疾又宜以寒热为转移，这就是茯苓、白术、车前子、薏苡仁、泽泻等类药物，有时与姜、附同用，而有时又须与黄芩、黄连同用的原因。
所谓痢疾宜消导的原因，这大概是时痢宜泻的意思。因为痢疾多有食积，必须消其食积，然后才可希望痢止，这就是枳壳、厚朴、大黄、山楂、神曲、麦芽、莱菔子等药物之所必用的原因。然而唐容川解释说：痢疾的里急，是急于想下便，这是肝木的疏泄功能；后重是想便不得，这是肺气的收敛功能，而在止奔迫、解郁闭的一方，而肝肺并治的，拟用白头翁汤，加石膏、知母、杏仁、桔梗、枳壳、槟榔、柴胡、麦芽、当归、白芍等治疗，轻症，用小柴胡汤加当归、白芍、杏仁、枳壳、槟榔、麦芽、天花粉，调和肝肺，则肺气不迫注，肝气得开利矣。又说：肝气欲泄而下注，肺气欲收而不开，所以痢疾多发于秋季。秋季金肺气闭而不开，肝气决裂而不遏，是以迫痛，治疗宜用甘桔汤加白芍，以桔梗开提肺气，以白芍平治肝木，本着这个意思进行加减，那么鳖甲、龙胆草、青皮、秦皮、芦荟，都是平肝的药物，当归、生地、桃仁、五灵脂、元胡索，都是治肝经血分的药物，黄芩、麦冬、桑白皮、知母都是清肺的药物，枳壳、贝母、杏仁、陈皮，都是肺经调气的药物。随意致用，变化在人，哪有治不好的痢疾呢。
唐容川这一节的论证，虽然仅足以作为时痢的方针，但临症选择使用，也无不有效，像击鼓应响一样迅速。
黄土汤方
灶心土（二钱） 甘草（一钱） 白术（一钱） 熟地黄（一钱） 黄芩（一钱） 附子（炮，五分） 阿胶（一钱）
张仲景乌梅丸方
乌梅（一钱） 细辛（六分） 干姜（五分） 黄芩（一钱） 黄连（一钱） 当归（一钱） 附子（五分）
川椒（一钱） 桂枝（七分） 党参（一钱） 黄柏（一钱）
张仲景生姜泻心汤方
生姜（一钱） 甘草（一钱） 人参（一钱） 干姜（五分） 黄芩（一钱） 半夏（六分） 黄连（一钱）
大枣（一钱）
八珍汤方
当归（一钱） 白芍（一钱） 熟地黄（一钱） 川芎（五分） 白术（一钱） 茯苓（一钱） 党参（一钱）
甘草（一钱）
The *Yellow Emperor's Inner Canon* states: If diet is unregulated and daily routines are irregular, Yin is affected by pathogens, which then enter the Five Zang organs. Downward, it manifests as intestinal diarrhea; if prolonged, it develops into dysentery (intestinal disorder with tenesmus). Chen Feixia stated: When children first contract this disease, their eyebrows knit tightly and they cry frequently due to abdominal pain. Restlessness and unease stem from tenesmus (a feeling of incomplete defecation accompanied by straining). Frequent trips to the toilet with inability to pass stool, or stools mixed with red and white discharge, or purely red or purely white, are the signs of dysentery. Zhou Mengjue said: Dysentery has a nature that does not change with the times, but its name varies according to the era. The transmitted medical texts have ancient origins and cannot fail to use ancient methods to gauge modern diseases. The *Suwen* calls it "Chang Pi" (intestinal discharge), the *Nanjing* calls it "tenesmus," the Han dynasty called it "Zhi Xia" (stagnant downward flow), the Jin dynasty called it "Qiu Zao" (autumn dryness), and by the Tang dynasty, formulas referred to it as "Li" (dysentery). Analyzing the meaning through the name: blood in stool is called "Pi," severe pain is called "Ji" (urgent), severe obstruction is called "Zhi" (stagnant), cracking is called "Zao" (dry), and difficulty in passage is called "Li." The condition of dysentery is already revealed on the surface of its name. Throughout history, generalizations have been made, serving like evening drums and morning bells to awaken deep reflection. Can one treat this syndrome carelessly, choosing instead to remain silent and leave it to die? When summer heat recedes and autumn wind begins, dampness intermingles, and heat, dampness, and dryness converge simultaneously, these three pathogenic factors combine to cause disease. Sometimes it is an epidemic qi entering from the skin and hair, causing slight aversion to cold and abdominal pain; after expelling retained food, the stool turns red and white. Wherever the wind pathogen passes, if it spreads in one family, the whole family falls ill; if it spreads in one region, the whole region falls ill. Some cases are contagious, entering via the mouth and nose, without aversion to cold or abdominal pain; immediately after expelling retained food, the stool turns red and white. Wherever the qi pathogen touches, infecting one person causes illness in that person, infecting one area causes illness in that area. At such times, sighing over pillows and mats, regardless of gender; squatting in latrines embracing pain, unable to predict life or death. Weather changes bring disgust within the room; flickering lights accompany groans until the fifth watch. Those who enjoy rich foods need not be mentioned; pity the poor suffering disaster, friends returning home, unable to rely on support in difficult times, people holding their noses, hearing cries for help. Those gathered in their hometowns may cope, but travelers far from home suffer most; old friends do not come, who pities the lonely stranger? Hearing rumors, everyone avoids, caring little for the traveler leaving home. Scholars examine gains and losses of past and present, verifying personal cultivation, thus researching and mastering superior medical arts. Originally, compassion should be used to save all beings. Yu Jiayan said: Initially use acrid-cool herbs to release the exterior, then use bitter-cold herbs to clear the interior. Liu Hejian said: Regulating Qi eliminates tenesmus; moving Blood clears pus and blood. For early-stage epidemic dysentery, I follow Yu Jiayan’s method, unblocking meridians to drive out pathogens, using Renshen Baidu San (Ginseng Decoction to Overcome Toxins) to enhance efficacy. For early-stage contagious dysentery, I follow Liu Hejian’s method, harmonizing Ying and Wei to guide stagnation, using Shaoyao Tang (Peony Decoction) to achieve good results. As the disease progresses, stagnation transforms into heat; pulse diagnosis invariably shows a rapid pulse. Thus, Xianglian Wan (Coptis and Acorus Pill) becomes the general formula for treating dysentery. However, when the pathogen is in the exterior, purgatives are contraindicated as the pathogen has not entered the interior. In chronic cases, harsh treatments are difficult to use for fear of damaging vital Qi. Zhao Yangkui once used Liuwei Dihuang Tang (Six-Ingredient Pill with Rehmannia) to treat Cold Damage, mocked as a novel approach that might injure Yin. I once used Liuwei Dihuang Tang to treat dysentery, another innovation of mine. If the pulse is deficient with spontaneous sweating, and red/white discharge is nearly exhausted, Zhenren Yangzang Tang (True Man’s Nourishing Viscera Decoction) and Hezi San (Myrobalan Powder) can be used酌情ly. Dysentery, whether red or white, arises from heat; yet recovery occurs after taking acrid-hot herbs—this is contrary treatment (treating symptoms that mimic the root cause). Human constitutions vary in cold and heat; pathogenic heat often transforms according to the patient's constitution. Acrid-hot herbs can resolve stagnation and unblock knots, allowing Qi and Blood to circulate freely, suitable for those whose pathology transforms from cold to heat. If one mistakenly uses them for heat-transforming-into-heat cases, the consequences are dire. Practitioners intending to save lives, if they encounter dysentery transforming from cold to heat and achieve great success with warming tonification, must not rigidly apply this as a standard rule.
Renshen Baidu San (Ginseng Decoction to Overcome Toxins)
Renshen (Ginseng Radix et Rhizoma) (1 qian), Qianghuo (Notopterygii Rhizoma et Radix) (5 fen), Duhuo (Angelicae Pubescentis Radix) (5 fen), Chaihu (Bupleuri Radix) (1 qian), Qianhu (Peucedani Radix) (1 qian), Chuanxiong (Ligustici Chuanxiong Rhizoma) (5 fen), Zhike (Aurantii Fructus Immaturus) (1 qian), Jiegeng (Platycodonis Radix) (1 qian), Fuling (Poria) (1 qian), Gancao (Glycyrrhizae Radix et Rhizoma) (1 qian).
Shaoyao Tang (Peony Decoction)
Shaoyao (Paeoniae Radix Alba/Rubra) (1 qian), Danggui (Angelicae Sinensis Radix) (1 qian), Huangqin (Scutellariae Radix) (1 qian), Huanglian (Coptidis Rhizoma) (1 qian), Dahuang (Rhei Radix et Rhizoma) (1 qian), Muxiang (Aucklandiae Radix) (6 fen), Binglang (Arecae Semen) (7 fen), Rougui (Cinnamomi Cortex) (5 fen), Zhigancao (Prepared Glycyrrhizae Radix et Rhizoma) (1 qian).
Xianglian Wan (Coptis and Acorus Pill)
Huanglian (Coptidis Rhizoma) (2 qian), Wuyu (Evodiae Fructus) (1 qian). Stir-fry the two together, remove Evodiae Fructus, add Muxiang (Aucklandiae Radix) (5 fen), do not roast, grind into fine powder, bind with vinegar paste into pills.
Zhenren Yangzang Tang (True Man’s Nourishing Viscera Decoction)
Yangsuke (Papaveris Pericarpium) (1 qian), Hezi (Myrobalani Fructus) (1 qian), Roudoukou (Myristicae Semen) (1 qian), Muxiang (Aucklandiae Radix) (6 fen), Gancao (Glycyrrhizae Radix et Rhizoma) (1 qian), Rougui (Cinnamomi Cortex) (5 fen), Renshen (Ginseng Radix et Rhizoma) (1 qian), Baizhu (Atractylodis Macrocephalae Rhizoma) (1 qian), Danggui (Angelicae Sinensis Radix) (1 qian), Baishao (Paeoniae Radix Alba) (1 qian).
Hezi San (Myrobalan Powder)
Yangsuke (Papaveris Pericarpium) (1 qian), Hezi (Myrobalani Fructus) (1 qian), Ganjiang (Zingiberis Rhizoma) (7 fen), Chenpi (Citri Reticulatae Pericarpium) (1 qian). Grind all into fine powder, take on an empty stomach.
Guifu Tang (Cinnamon and Aconite Decoction)
Fuzi (Aconiti Lateralis Radix Praeparata) (3 fen), Rougui (Cinnamomi Cortex) (3 fen), Ganjiang (Zingiberis Rhizoma) (6 fen), Jiaozhu (Fried Atractylodis Rhizoma) (1 qian), Sharen (Amomi Fructus) (5 fen), Zhigancao (Prepared Glycyrrhizae Radix et Rhizoma) (1 qian).
Tu Weisheng said: Although dysentery presents only as red, white, or mixed, all syndromes of cold, heat, deficiency, and excess are contained within. Tang Rongchuan said: Within the intestines and stomach, apart from waste, there is only a small amount of fat/grease and fluids. Fat/grease belongs to the Blood aspect; fluids belong to the Qi aspect. Disease in the Qi aspect causes turbid fluids leading to white dysentery. Disease in the Blood aspect causes disturbed blood leading to red dysentery. Simultaneous disease in Qi and Blood results in equal parts red and white. How is true pus formed and discharged via the large intestine? It occurs when toxins accumulate in the intestines and stomach, steaming the fat/grease and flesh into pus, discharging like rotten melon or leaking roof water. This is a critical sign of rotting intestines and ulcerating stomach, no different from abscess rupture, beyond the reach of ordinary dysentery treatments. Tang Rongchuan has revealed the general origin of dysentery. Treatment methods vary: some advocate diaphoresis; some advocate cooling; some advocate combined cold and heat treatment; some attribute it to summer cold/raw food consumption leading to latent Yin activation in autumn, requiring warmth; some say acute dysentery requires purging, chronic requires tonifying; some advocate astringency; some say avoid Huangqin/Huanglian in early dysentery; some advocate drying dampness; some advocate resolving accumulation. These inconsistent views lead to mutual criticism. Having suffered from dysentery for five years, deeply resenting the difficulty of finding good doctors, the fickleness of famous physicians, and the errors of contemporary practitioners, I blamed myself, strove hard, abandoned Confucian studies for medicine, and focused intensely on dysentery. After my own recovery and gaining insights, I realized each school has merit but also bias. To master dysentery treatment, one must know the strengths and weaknesses of each school, adopt strengths, discard weaknesses, and cross-reference. Gathering collective essence creates a personal weapon, ensuring accuracy and benefit without failure.
Dysentery warrants diaphoresis because cold pathogens enter via skin/hair, traveling along superficial membranes to intestinal membranes. Intestinal Qi transformation is inhibited by Yin condensation descending, causing white dysentery. We must urgently lift and open, allowing external pathogens to exit externally. Hence Gegen (Puerariae Radix) and Chaihu (Bupleuri Radix) are essential. For tenesmus and incomplete defecation, Muxiang (Aucklandiae Radix), Binglang (Arecae Semen), Zhike (Aurantii Fructus Immaturus), Danggui (Angelicae Sinensis Radix), and Baishao (Paeoniae Radix Alba) are essential. For cold-wind-heat pathogens, Fangfeng (Saposhnikoviae Radix), Tianma (Gastrodiae Rhizoma), and Baitouweng (Pulsatillae Radix) are essential. This is the "pulling the boat upstream" method and regulating Qi to relieve tenesmus.
Dysentery warrants cooling because internal fire disturbs and damages meridian Yin-Blood, descending as red dysentery. To stop heat and dysentery, cooling is necessary. Hence Zhimu (Anemarrhenae Rhizoma), Huangbai (Phellodendri Cortex), Huangqin (Scutellariae Radix), Huanglian (Coptidis Rhizoma), Danggui (Angelicae Sinensis Radix), and Baishao (Paeoniae Radix Alba) are essential. For concurrent external wind-heat, Tianma (Gastrodiae Rhizoma), Baitouweng (Pulsatillae Radix), Jiangcan (Bombyx Batryticatus), and Sangjisheng (Taxilli Herba) are essential. For concurrent tenesmus, Muxiang (Aucklandiae Radix), Binglang (Arecae Semen), Zhike (Aurantii Fructus Immaturus), and Houpo (Magnoliae Officinalis Cortex) are essential. For chronic blood deficiency, Shengdi (Rehmanniae Radix), Ejiao (Asini Corii Colla), and Guijiao (Testudinis Carapacis et Plastratis Colla) are essential. This is clearing heat-toxin and regulating Blood to heal pus. If Tang Rongchuan describes dark blood, slow pulse, cold limbs as deficiency-cold, use Huangtu Tang (Yellow Earth Decoction). This is a variant of red dysentery, similar to occasional mild use of Huangqin/Huanglian in white dysentery.
Dysentery warrants combined cold and heat treatment because cold damages Six Fu Qi, while heat damages Six Zang Blood, mixing cold and heat with alternating red/white discharge. Hence Gegen (Puerariae Radix), Chaihu (Bupleuri Radix), Jingjie (Schizonepetae Spica), Fangfeng (Saposhnikoviae Radix), Danggui (Angelicae Sinensis Radix), Baishao (Paeoniae Radix Alba), Huangqin (Scutellariae Radix), Huanglian (Coptidis Rhizoma), Muxiang (Aucklandiae Radix), Zhike (Aurantii Fructus Immaturus), Shengjiang (Zingiberis Rhizoma Recens), and Dazao (Jujubae Fructus) are essential. Tang Rongchuan states this requires real evidence of mixed cold-heat, not vague mixing of formulas. Zhang Zhongjing’s Wumei Wan (Mume Pill) treats thirst, Qi rushing up to the heart, heart pain/heat, hunger without desire to eat (heat evidence); vomiting worms after eating, diarrhea after purging (cold evidence). Due to Fu-heat and Zang-cold, Wumei Wan treats both. Zhang Zhongjing’s Shengjiang Xiexin Tang (Fresh Ginger Drain the Epigastrium Decoction) treats epigastric fullness/stiffness, belching with food odor (fire); fluid under costal margin, borborygmus (water). Due to fire in stomach and water in intestines, Shengjiang Xiexin Tang is used. Hard initial stool followed by loose stool indicates stomach cold and intestinal heat. Chen Xiuyuan proposes Lizhong Tang plus Dahuang. These are real mixed cold-heat evidence. Physicians must differentiate strictly to prescribe accurately. Such detailed annotations are rare.
Dysentery warrants warming because raw/cold food damages internal Yang Qi. During summer, heavenly Yang can adjust Yin-cold stagnation. As seasons change to cool air, previously stagnant viscera’s Qi/Blood condenses, triggering dysentery. To stop dysentery, warming is necessary. Hence Fuling (Poria), Baizhu (Atractylodis Macrocephalae Rhizoma), Yiyiren (Coicis Semen), Chenpi (Citri Reticulatae Pericarpium), Muxiang (Aucklandiae Radix), Gancao (Glycyrrhizae Radix et Rhizoma), Shengjiang (Zingiberis Rhizoma Recens), and Dazao (Jujubae Fructus) are essential.
Acute dysentery warrants purging, chronic warrants tonifying/astringing. Initially, cold-heat damage Qi/Blood, turning them into red/white discharge. With strong momentum, purging is needed to expel accumulated pathogens, reducing evil force to stop dysentery. Hence Zhike (Aurantii Fructus Immaturus), Binglang (Arecae Semen), Muxiang (Aucklandiae Radix), Chenpi (Citri Reticulatae Pericarpium), Mangxiao (Natrii Sulfas), and Dahuang (Rhei Radix et Rhizoma) are essential. This requires no exterior pathogen; otherwise, exterior-releasing herbs must be added. Chronic dysentery with Qi/Blood sinking leads to soul loss and imminent death. Treatment must tonify. With heat, Qingzao Jiufei Tang (Clear Dryness Rescue Lung Decoction) is used; with cold, Bazhen Tang (Eight-Treasure Decoction) plus Shengma (Cimicifugae Rhizoma) is used. Zhang Zhongjing’s Taohua Tang (Peach Blossom Decoction) and Wumei Wan (Mume Pill) use astringents to prevent collapse. Do not fear astringents locking pathogens inside.
Dysentery forbids Huangqin/Huanglian because cold-natured herbs damage Stomach Qi, cutting off the source of generation. This applies only if latent Yin and cold stagnation exist. If fire binds intestines/stomach, severe lower pressure, and stabbing abdominal pain occur, Huangqin, Huanglian, Mangxiao, and Dahuang become powerful agents.
Dysentery warrants drying dampness because dampness harms Qi/Blood like cold/heat. To stop dysentery, drying is necessary. Dampness has cold/heat aspects, and dysentery shifts accordingly. Hence Fuling (Poria), Baizhu (Atractylodis Macrocephalae Rhizoma), Cheqian (Plantaginis Semen), Yiyiren (Coicis Semen), Zexie (Alismatis Rhizoma) may be used with Jiang/Fu or Huangqin/Huanglian depending on the case.
Dysentery warrants resolving accumulation because acute dysentery often involves food retention. Resolving food helps stop dysentery. Hence Zhike (Aurantii Fructus Immaturus), Houpo (Magnoliae Officinalis Cortex), Dahuang (Rhei Radix et Rhizoma), Shanzha (Crataegi Fructus), Shenqu (Massa Medicata Fermentata), Maiya (Hordei Fructus Germinatus), and Laifuzi (Radish Seed) are essential. Tang Rongchuan explains: Tenesmus is liver Wood’s draining function; heaviness is lung Metal’s contracting function. To stop urgency and resolve depression, treat Liver and Lung together. Use Baitouweng Tang plus Shigao (Gypsum Fibrosum), Zhimu (Anemarrhenae Rhizoma), Xingren (Armeniacae Semen Amarum), Jiegeng (Platycodonis Radix), Zhike (Aurantii Fructus Immaturus), Binglang (Arecae Semen), Chaihu (Bupleuri Radix), Maiya (Hordei Fructus Germinatus), Danggui (Angelicae Sinensis Radix), Baishao (Paeoniae Radix Alba). Mild cases use Xiao Chaihu Tang plus Danggui, Baishao, Xingren, Zhike, Binglang, Maiya, Huafen (Trichosanthis Radix) to harmonize Liver/Lung. Liver Qi drains downward, Lung Qi contracts but fails to open, so dysentery often starts in Autumn. Autumn Lung Metal closes, Liver Qi ruptures, causing pain. Treat with Ganjie Tang plus Baishao. Jiegeng lifts Lung Qi; Baishao soothes Liver Wood. Add Biejia (Trionycis Carapax), Longdancao (Gentianae Radix), Qingpi (Citri Reticulatae Pericarpium Viride), Qinpi (Fraxini Cortex), Lvhui (Aloe), all soothing Liver. Danggui, Shengdi, Taoren (Persicae Semen), Wulingzhi (Trogopterori Faeces), Yuanhusuo (Corydalis Rhizoma) treat Liver Blood. Huangqin, Maidong (Ophiopogonis Radix), Sangbaipi (Mori Cortex), Zhimu clear Lung. Zhike, Beimu (Fritillariae Bulbus), Xingren, Chenpi regulate Lung Qi. Apply flexibly; no dysentery will be incurable.
Tang Rongchuan’s argument serves as a guideline for acute dysentery. Clinical application yields effective results like drum responses.
Huangtu Tang (Yellow Earth Decoction)
Zaoxintu (Caulis Trapa Positionis) (2 qian), Gancao (Glycyrrhizae Radix et Rhizoma) (1 qian), Baizhu (Atractylodis Macrocephalae Rhizoma) (1 qian), Shudi (Rehmanniae Radix Preparata) (1 qian), Huangqin (Scutellariae Radix) (1 qian), Fuzi (Aconiti Lateralis Radix Praeparata, processed) (5 fen), Ejiao (Asini Corii Colla) (1 qian).
Zhang Zhongjing’s Wumei Wan (Mume Pill)
Wumei (Mume Fructus) (1 qian), Xixin (Asari Radix et Rhizoma) (6 fen), Ganjiang (Zingiberis Rhizoma) (5 fen), Huangqin (Scutellariae Radix) (1 qian), Huanglian (Coptidis Rhizoma) (1 qian), Danggui (Angelicae Sinensis Radix) (1 qian), Fuzi (Aconiti Lateralis Radix Praeparata) (5 fen), Chuanjiao (Zanthoxyli Pericarpium) (1 qian), Guizhi (Cinnamomi Ramulus) (7 fen), Dangshen (Codonopsis Radix) (1 qian), Huangbai (Phellodendri Cortex) (1 qian).
Zhang Zhongjing’s Shengjiang Xiexin Tang (Fresh Ginger Drain the Epigastrium Decoction)
Shengjiang (Zingiberis Rhizoma Recens) (1 qian), Gancao (Glycyrrhizae Radix et Rhizoma) (1 qian), Renshen (Ginseng Radix et Rhizoma) (1 qian), Ganjiang (Zingiberis Rhizoma) (5 fen), Huangqin (Scutellariae Radix) (1 qian), Banxia (Pinelliae Rhizoma) (6 fen), Huanglian (Coptidis Rhizoma) (1 qian), Dazao (Jujubae Fructus) (1 qian).
Qingzao Jiufei Tang (Clear Dryness Rescue Lung Decoction) (See previous Cough formulas)
Zhibai Dihuang Tang (Anemarrhena, Phellodendron and Rehmannia Pill) (See previous Cough formulas)
Bazhen Tang (Eight-Treasure Decoction)
Danggui (Angelicae Sinensis Radix) (1 qian), Baishao (Paeoniae Radix Alba) (1 qian), Shudi (Rehmanniae Radix Preparata) (1 qian), Chuanxiong (Ligustici Chuanxiong Rhizoma) (5 fen), Baizhu (Atractylodis Macrocephalae Rhizoma) (1 qian), Fuling (Poria) (1 qian), Dangshen (Codonopsis Radix) (1 qian), Gancao (Glycyrrhizae Radix et Rhizoma) (1 qian).
Zhang Zhongjing’s Taohua Tang (Peach Blossom Decoction)
Chishizhi (Halloysit Rubrum) (1 qian), Ganjiang (Zingiberis Rhizoma) (5 qian), Jingmi (Oryza Sativa Germen) (1 qian).
Zhang Zhongjing’s Baitouweng Tang (Pulsatilla Decoction)
Baitouweng (Pulsatillae Radix) (1 qian), Huanglian (Coptidis Rhizoma) (1 qian), Huangbai (Phellodendri Cortex) (1 qian), Qinpi (Fraxini Cortex) (1 qian).
Zhang Zhongjing’s Xiao Chaihu Tang (Minor Bupleurum Decoction) (See previous Cough formulas)
Zhang Zhongjing’s Ganjie Tang (Licorice and Platycodon Decoction)
Gancao (Glycyrrhizae Radix et Rhizoma) (2 qian), Jiegeng (Platycodonis Radix) (1 qian).