《针经》云∶春伤于风，夏生后泄肠 。注家谓春令伤乎风邪，风木内干，损其胃气，则上升清阳之气，
反内陷而为飧泄，久则传太阴而为肠 ，此分明因风而致，故谓之风痢也。夫风痢之证，先作泄而后作痢，脉
象每见沉小而弦，腹微痛而有后重，似肠风而下清血，此由春令之伏气，至夏而发，是属木胜，土亏之候。
如体素寒者，宜用培中泻木法加木香、苍术治之；体素热者，宜本法去吴萸、炮姜，加芩、连、煨葛治之；
如胸闷溺赤者，必夹湿也，宜佐赤苓、泽泻治之；吞酸嗳腐者，必夹食也，宜佐山楂、浓朴治之。
或问曰∶古云∶先泻后痢，为脾传肾。今风痢亦先泻后痢，究竟系脾传肾否？曰∶否也。昔贤谓先泻
后痢，为土克水之证。此言先泻后痢者，由风木克胃，胃传脾之证，自是两途，当辨治之。又问曰∶尝见痢
疾发于秋令者多，夏令者少。今言至夏而发，得无谬乎？曰∶诸痢多发于秋令，或发于夏秋之
交，惟风痢独发于夏，盖由春时之伏气，从内而发。经曰∶春伤于风、夏生后泄肠 ，此之谓也。
前言风痢，是论春时伏气，至夏而发，其余之痢则不然。今先以寒痢论之，其病虽发于夏秋之交，其实
受寒较受暑为多。景岳云∶炎热者，天之常令，当热不热，必反为灾。因热贪凉，人之常事，过食生冷，所
以致痢，每见人之慎疾者，虽经盛暑，不犯寒凉，终无泻痢之患。可见寒痢之证，实因炎热贪凉，过食生冷，冷
则凝滞，中州之阳，不能运化，清气不升，脾气下陷，以致腹痛后重，痢下白色，稀而清腥，脉迟苔白者，当
去其寒，兼扶脾土，则痢自止，宜用暖培卑监法佐以楂炭、木香治之。然而寒痢亦有赤色者，不可不别，总之
以脉迟苔白为据。倘脉数苔黄者便为热痢，温热之品，又不可施。医者总当以脉舌分其寒热，慎弗忽诸。
王海藏曰∶寒毒内伤，复用寒凉，非其治也。况血为寒所凝，浸入大肠间而便下，得温乃行，所以用热
药，其血自止。经曰∶治病必求其本。此之谓也。胃既得温，其血不凝而自行，各守其乡矣。
程曦曰∶尝见今之治痢，不分属热属寒，开口便言湿热，动手便用寒凉，盖因未究脉象，未审舌苔之
故耳。凡辨病之寒热虚实，表里阴阳，皆当于脉舌中细细求之，庶几无误。
《针经》说：春季感受风邪，到了夏季就会发生后泄和肠澼。注释家认为，在春季被风邪所伤，风木之气内犯，损伤了胃气，导致本应上升的清阳之气，反而下陷而形成飧泄（完谷不化的腹泻），时间久了传变到太阴脾经，就形成肠澼（痢疾）。这分明是因风邪引起的，所以称为风痢。
风痢的症状，是先出现腹泻，然后才转为痢疾，脉象通常表现为沉小而弦，腹部轻微疼痛且有里急后重感，看起来像肠风证但排出的是清稀带血的便液。这是由春季潜伏的风邪，到了夏季发作所致，属于木气过盛、土气亏虚的证候。
如果患者体质素来偏寒，适宜使用培中泻木法，并加入木香、苍术进行治疗；如果患者体质素来偏热，适宜在本方中去掉吴茱萸、炮姜，加入黄芩、黄连、煨葛根进行治疗；如果出现胸闷、小便赤涩的情况，说明必定夹有湿邪，适宜辅助使用赤茯苓、泽泻进行治疗；如果出现吞酸、嗳出腐臭食物的情况，说明必定夹有食积，适宜辅助使用山楂、厚朴进行治疗。
有人问道：古书说：“先腹泻后痢疾，是脾病传肾。”现在风痢也是先腹泻后痢疾，究竟是不是脾传肾呢？回答说：不是。以前的贤者说先腹泻后痢疾，是土克水的证候。这里所说的先腹泻后痢疾，是由风木克制胃气，胃病传脾的证候，这是两条不同的路径，应当辨别治疗。又问道：我常看到痢疾多发生在秋季，发生在夏季的较少。现在说风痢在夏季发作，难道没有错误吗？回答说：各种痢疾多发生在秋季，或者发生在夏秋之交，只有风痢独自在夏季发作，这是因为春季潜伏的病气，从体内发作出来。医经说：“春季感受风邪，夏季发生后泄肠澼”，说的就是这个道理。
前面论述的风痢，是讨论春季伏邪至夏季发作的情况，其他的痢疾则不是这样。现在先以寒痢来论述，这种病虽然发生在夏秋之交，但实际上受寒比受暑更多。张景岳说：炎热是天的正常时令，当热而不热，必然成为灾害。因为贪热而贪凉，是人的常情，过度食用生冷食物，是导致痢疾的原因。常见那些谨慎防病的人，即使在盛夏，也不触犯寒凉之物，最终没有腹泻痢疾的祸患。可见寒痢这个证候，实在是因为天气炎热而贪凉，过度食用生冷，寒气凝滞，中焦脾胃之阳气不能运化，清气不升，脾气下陷，导致腹痛、里急后重，痢下白色，质地稀薄且气味清腥，脉象迟缓、舌苔白腻的，应当去除寒邪，兼以扶持脾土，那么痢疾自然停止，适宜使用暖培卑监法，佐以山楂炭、木香进行治疗。然而寒痢也有排出红色血液的，不可不加以辨别，总之以脉象迟、舌苔白为依据。如果脉象数、舌苔黄的，就是热痢，温热性质的药物，就不可以使用了。医生总应当通过脉象和舌苔来分辨寒热，千万不要忽视这些细节。
王海藏说：寒毒内伤，如果再使用寒凉药物，就不是正确的治疗方法。况且血液被寒邪凝滞，渗入大肠之间而随大便排出，得到温暖才能运行，所以使用热药，出血自然会停止。医经说：“治病必须探求根本”，说的就是这个道理。胃得到温暖，血液不再凝滞而自行运行，各守其位了。
程曦说：我曾见到现在的医生治疗痢疾，不分属于热证还是寒证，开口就说湿热，动手就用寒凉药物，大概是因为没有深入研究脉象，没有审察舌苔的缘故罢了。凡是辨别疾病的寒热虚实、表里阴阳，都应当在脉象和舌苔中仔细寻求，这样才能几乎没有错误。
The *Zhen Jing* (Needle Classic) states: "If wind is injured in spring, post-diarrhea and Chang Pi (dysentery with intestinal discharge) will arise in summer." Commentators explain that being injured by wind pathogenic factors during the spring season causes Wind-Wood to internally interfere, damaging Stomach Qi. Consequently, the clear Yang Qi that should ascend instead sinks inward, resulting in Sun Xie (diarrhea with undigested food). If prolonged, it transmits to the Taiyin Spleen channel, forming Chang Pi. This is clearly caused by wind, hence it is called Feng Li (Wind Dysentery).
The syndrome of Feng Li presents initially as diarrhea, which later transforms into dysentery. The pulse is typically deep, small, and wiry. There is mild abdominal pain accompanied by tenesmus (a feeling of incomplete defecation). It resembles Chang Feng (Intestinal Wind) but discharges clear blood. This arises from latent pathogens contracted in spring, manifesting in summer, representing a pattern of Wood excess and Earth deficiency.
For patients with a constitution inherently prone to cold, the Pei Zhong Xie Mu method (Nourish the Middle and Drain Wood method) should be used, augmented with Muxiang (Aucklandiae Radix) and Cangzhu (Atractylodis Rhizoma). For patients with a constitution inherently prone to heat, the same base method should be used, but removing Wuyu (Evodiae Fructus) and Paojiang (Prepared Zingiberis Rhizoma), and adding Huangqin (Scutellariae Radix), Lianzi (Coptidis Rhizoma), and Wei Gegen (Prepared Puerariae Radix). If chest tightness and dark urine are present, dampness must be夹杂 (intermixed); thus, Chifuling (Poria Cocos with Red Coir) and Zexie (Alismatis Rhizoma) should be added. If acid regurgitation and belching of putrid food occur, food stagnation must be intermixed; thus, Shanzha (Crataegi Fructus) and Houpo (Magnoliae Officinalis Cortex) should be added.
One might ask: Ancient texts state, "Diarrhea preceding dysentery indicates the transmission of disease from the Spleen to the Kidney." Since Feng Li also begins with diarrhea followed by dysentery, does this constitute Spleen transmitting to Kidney? The answer is no. Former sages stated that diarrhea preceding dysentery is a pattern of Earth overcoming Water. Here, diarrhea preceding dysentery results from Wind Wood overcoming Stomach Qi, with Stomach disease transmitting to the Spleen. These are two distinct pathways and must be differentiated and treated accordingly. Another question arises: I often observe that dysentery occurs mostly in autumn and rarely in summer. Is it not erroneous to say it manifests in summer? The response is: Various types of dysentery mostly occur in autumn or at the transition between summer and autumn. Only Feng Li uniquely manifests in summer because the latent pathogen from spring erupts from within. As the Classics state: "Injured by wind in spring, post-diarrhea and Chang Pi arise in summer," this is precisely what is meant.
The aforementioned discussion on Feng Li concerns latent pathogens from spring manifesting in summer; other types of dysentery are different. Now, let us discuss Cold Dysentery (Han Li). Although this disease occurs at the transition between summer and autumn, injury from cold is more common than injury from summer-heat. Zhang Jingyue stated: "Heat and warmth are the normal commands of Heaven; if it is hot when it should not be, disaster ensues." It is human nature to seek coolness due to heat. Overconsumption of raw and cold foods leads to dysentery. We often see those who are cautious about illness; even during intense summer heat, they avoid cold and cooling substances, ultimately escaping the affliction of diarrhea and dysentery. Thus, the syndrome of Cold Dysentery is truly caused by seeking coolness in the heat and overeating raw/cold items. Cold causes stagnation; the Yang Qi of the Middle Jiao cannot transform and transport; clear Qi fails to ascend; Spleen Qi sinks downward. This results in abdominal pain, tenesmus, and the passage of white, thin, clear, and fishy-smelling stool. In cases with a slow pulse and white tongue coating, one should dispel cold and simultaneously support Spleen Earth, whereupon the dysentery will cease naturally. The Nuan Pei Bei Jian method (Warm and Nourish the Inferior Monitor method) should be used, assisted by Zhaka Tan (Charred Crataegi Fructus) and Muxiang. However, Cold Dysentery can also present with red blood; this must not be overlooked. Ultimately, the basis for differentiation is a slow pulse and white tongue coating. If the pulse is rapid and the tongue coating yellow, it is Heat Dysentery, and warming agents must not be applied. Physicians must always differentiate cold and heat through pulse and tongue diagnosis, and must not neglect these details.
Wang Haizang stated: "Internal injury from cold toxins, compounded by the use of cold-cooling therapies, is incorrect treatment." Moreover, blood congealed by cold seeps into the large intestine and is discharged; it moves only when warmed. Therefore, using hot medicines stops the bleeding naturally. The Classics state: "Treating disease requires seeking its root," which refers to this principle. Once the Stomach is warmed, the blood ceases to congeal and flows freely, each element remaining in its proper place.
Cheng Xi stated: "I have observed that contemporary physicians treating dysentery do not distinguish between heat and cold patterns. They immediately speak of damp-heat and immediately apply cold-cooling herbs. This is likely because they have not investigated the pulse image nor examined the tongue coating. When differentiating the cold/heat, deficiency/excess, exterior/interior, and Yin/Yang of a disease, one must carefully seek answers within the pulse and tongue coating, thereby avoiding error."