仲景白头翁汤治热痢重下者
白头翁(二两) 黄连(三两) 黄柏(三两) 秦皮(三两)
上四味以水七升煮取二升去渣服一升不愈再服
按此治痢在下焦肾虚有热也经云肾欲坚故用纯苦之剂以坚之出太阴例药也以其下痢属太
阴故也
机要黄芩芍药汤治泄痢腹痛或后重身热久不愈脉洪疾及下痢脓血稠粘
黄芩 芍药(各二两) 甘草(五钱)
上咀每服半两水一盏半煎一盏温服
按此手足太阴经之药也仲景用芍药甘草汤以复其阴酸以收之甘以缓之酸甘相合以补阴血
也芍药白者补赤者泻出太阳芍药甘草例
大黄汤治泄痢久不愈脓血稠粘里急后重日夜无度
大黄(一两)
上细锉好酒二大盏同浸半日许再同煎至一盏半去大黄将酒分为二服顿服之痢止一服如未
止再服取利为度后服芍药汤以和之利止再服黄芩芍药汤彻其毒也
按此乃阳明调荡涤邪热之药用酒煎者欲其上至顶颠外彻皮毛也
芍药汤下血调气经曰溲而便脓血知气行而血止也行血则便自愈调气则后重除
芍药(一两) 当归 黄连(各半两) 槟榔 木香(各二钱) 桂(二钱半) 大黄(三钱)
黄芩(半两) 甘草(二钱炙)
上咀每服半两水煎食后温服清如利不减加大黄
按此行血调气不热之药也大凡用药之杂与品味之多者难以细分经络当观其大体如何此则
太阳桂枝例药也
白术黄芩汤服前药痢虽除更宜此调和
白术(一两) 黄芩(七钱) 甘草(三钱)
上咀匀作三服水煎服清
按此去湿热和中活血之药也
钱氏芍药柏皮丸
芍药 黄柏(各等分)
上为末水丸
守真芍药柏皮丸治一切湿热恶痢
芍药 黄柏(各一两) 黄连(半两) 当归(半两)
上为末水丸如小豆大
按此二方补阴降火下焦之药也出太阳例
局方黄连阿胶丸治冷热不调赤白下痢
阿胶(炒二两) 黄连(三两) 茯苓(二两)
上水熬阿胶膏溲和二末为丸米饮服
按此补虚退热除湿之药也出太阳例海藏云以上苦寒之剂元病不经内伤冷物者宜察亦当审
人之虚实及以脉别之
张仲景的白头翁汤用于治疗热毒痢疾且下痢严重的情况。
白头翁（二两） 黄连（三两） 黄柏（三两） 秦皮（三两）
以上四味药，用七升水煎煮，取药液二升，去渣滓，每次服用一升；若未痊愈，再服一次。
按语：此方治疗的是位于下焦、因肾虚有热所致的痢疾。《内经》说“肾欲坚”，所以使用纯苦味的药物来坚固肾气。此方出自太阴病的用药法则，因为下痢属于太阴病范畴。
《医学启源》中的黄芩芍药汤用于治疗泄泻痢疾伴有腹痛，或里急后重、身体发热、久治不愈、脉象洪数疾速，以及下痢脓血、质地稠粘的情况。
黄芩 芍药（各二两） 甘草（五钱）
将药物切碎，每次服用半两，用水一盏半煎煮至一盏，温服。
按语：这是手足太阴经的药物组合。张仲景使用芍药甘草汤来恢复阴液，酸味以收敛，甘味以缓急，酸甘相合以补益阴血。其中白芍用于补益，赤芍用于泻实，这出自太阳病中芍药甘草汤的范例。
大黄汤用于治疗泄泻痢疾久治不愈，脓血稠粘，里急后重，日夜无度。
大黄（一两）
将大黄细切，用好酒两大盏浸泡约半天，再共同煎煮至一盏半，去掉大黄渣，将药酒分为两份服用，一次性服完。若痢疾停止，则停服；若未停止，继续服用，以大便通畅为度。之后服用芍药汤以调和肠胃，痢止后再服用黄芩芍药汤以清除余毒。
按语：这是阳明经调理荡涤邪热的药物。使用酒煎是为了使药力上达头顶，外彻皮毛。
芍药汤具有行血调气的功效。《内经》说：“小便及大便排出脓血，说明气机运行而血自止。”行血则便脓自愈，调气则里急后重消除。
芍药（一两） 当归 黄连（各半两） 槟榔 木香（各二钱） 桂枝（二钱半） 大黄（三钱）
黄芩（半两） 甘草（二钱，炙）
将药物切碎，每次服用半两，用水煎煮，饭后温服。如果痢疾不减，加大黄用量。
按语：这是行血调气且不偏于寒热的药物。大凡用药杂乱、品味众多的方剂，难以细分所属经络，应当观察其大体性质。此方属于太阳病桂枝汤的范例药物。
白术黄芩汤：在服用前述药物后，虽然痢疾已除，但仍宜服用此方以调和脾胃。
白术（一两） 黄芩（七钱） 甘草（三钱）
将药物切碎，均匀分为三服，用水煎服。
按语：这是去除湿热、中和脾胃、活血的药物。
钱乙的芍药柏皮丸
芍药 黄柏（各等分）
以上药物研为末，用水泛丸。
张从正（守真）的芍药柏皮丸用于治疗一切湿热引起的恶痢。
芍药 黄柏（各一两） 黄连（半两） 当归（半两）
以上药物研为末，用水泛丸如小豆大小。
按语：这两个方剂都是补阴降火、作用于下焦的药物，出自太阳病的用药范例。
《局方》中的黄连阿胶丸用于治疗冷热不调引起的赤白下痢。
阿胶（炒二两） 黄连（三两） 茯苓（二两）
以上药物用水熬化阿胶成膏，用来拌和另外两种药的粉末，制成丸剂，用米饮送服。
按语：这是补虚退热、除湿的药物，出自太阳病的用药范例。李东垣（海藏）说：以上这些苦寒性质的方剂，适用于原发病并非因内伤冷物所致者，应当审察病人的虚实状况，并通过脉象加以辨别。
Zhang Zhongjing's Baitouweng Tang (Bupleurum Decoction) is used to treat severe dysentery caused by heat-toxin.
Baitouweng (2 liang), Huanglian (3 liang), Huangbai (3 liang), Qinpi (3 liang).
The above four herbs are boiled in seven sheng of water until two sheng remain. The dregs are removed, and one sheng is taken orally. If not cured, take another dose.
Commentary: This formula treats dysentery located in the lower jiao (Lower Burner), caused by kidney deficiency with heat. The *Classic of Internal Medicine* states "the kidney desires firmness," hence pure bitter agents are used to consolidate it. This follows the herbal principles of the Taiyin (Great Yin) pattern, as dysentery belongs to the Taiyin category.
Huangqin Shaoyao Tang (Scutellaria and Peony Decoction) from *Jiyao* is used to treat diarrhea and dysentery accompanied by abdominal pain, tenesmus (feeling of incomplete defecation), fever, chronic non-healing conditions, rapid and surging pulse, and passage of thick, sticky pus and blood.
Huangqin, Shaoyao (each 2 liang), Gancao (5 qian).
Crush the herbs. Take half a liang per dose, boil in one and a half sheng of water until one sheng remains, and take warm.
Commentary: These are herbs for the Hand and Foot Taiyin meridians. Zhang Zhongjing uses Shaoyao Gancao Tang (Peony and Licorice Decoction) to restore yin. Sour flavors astringe, sweet flavors moderate; sour and sweet combined nourish yin blood. White peony tonifies, red peony purges. This derives from the Shaoyao Gancao Tang example in the Taiyang (Greater Yang) pattern.
Dahuang Tang (Rhubarb Decoction) is used for chronic diarrhea and dysentery that does not heal, characterized by thick, sticky pus and blood, tenesmus, and frequent episodes day and night.
Dahuang (1 liang).
Finely cut Dahuang, soak in two large zhan of good wine for about half a day. Boil together until one and a half zhan remains. Remove Dahuang, divide the medicinal wine into two doses, and take all at once. If dysentery stops, stop taking it; if not, continue taking until bowel movements are regulated. Afterwards, take Shaoyao Tang to harmonize. Once dysentery stops, take Huangqin Shaoyao Tang again to eliminate residual pathogens.
Commentary: This is an agent for the Yangming (Yang Brightness) meridian to regulate and purge pathogenic heat. Wine decoction is used to guide the medicinal power upward to the vertex and outward to the skin and hair.
Shaoyao Tang moves blood and regulates qi. The *Classic of Internal Medicine* states: "Passage of pus and blood in urine and stool indicates that when qi moves, blood stops." Moving blood heals dysentery; regulating qi eliminates tenesmus.
Shaoyao (1 liang), Danggui, Huanglian (each half liang), Binglang, Muxiang (each 2 qian), Guizhi (2.5 qian), Dahuang (3 qian), Huangqin (half liang), Gancao (2 qian, honey-fried).
Crush the herbs. Take half a liang per dose, boil in water, and take warm after meals. If dysentery persists, increase the amount of Dahuang.
Commentary: This is an agent that moves blood, regulates qi, and is not overly hot or cold. Generally, complex formulas with many ingredients are difficult to assign to specific meridians; one must observe the general nature. This formula follows the Gui Zhi Tang (Cinnamon Twig Decoction) example of the Taiyang pattern.
Baizhu Huangqin Tang (Atractylodes Macrocephala and Scutellaria Decoction): After taking the previous medicines, even if dysentery has ceased, this formula is suitable for harmonizing.
Baizhu (1 liang), Huangqin (7 qian), Gancao (3 qian).
Crush the herbs, divide equally into three doses, boil in water, and take.
Commentary: This is an agent that removes damp-heat, harmonizes the middle jiao, and invigorates blood.
Qian Shi's Shaoyao Bapi Wan (Peony and Phellodendron Pills)
Shaoyao, Huangbai (equal parts).
Grind into powder and make pills with water.
Shouzhen's Shaoyao Bapi Wan treats all types of severe dysentery caused by damp-heat.
Shaoyao, Huangbai (each 1 liang), Huanglian (half liang), Danggui (half liang).
Grind into powder and make small bean-sized pills with water.
Commentary: These two formulas are agents that tonify yin, descend fire, and act on the lower jiao, deriving from the Taiyang pattern examples.
Ju Fang's Huanglian Ejiao Wan (Coptis and Donkey-hide Gelatin Pills) treats red and white dysentery caused by imbalance of cold and heat.
Ejiao (stir-fried 2 liang), Huanglian (3 liang), Fuling (2 liang).
Boil Ejiao in water to make a paste, mix with the powders of the other two herbs, make pills, and swallow with rice water.
Commentary: This is an agent that tonifies deficiency, reduces fever, and removes dampness, deriving from the Taiyang pattern examples. Haizang (Li Dongyuan) stated: Among these bitter-cold agents, they are suitable for cases where the original disease was not caused by internal injury from cold foods. One must examine the patient's deficiency or excess and differentiate via pulse diagnosis.