兑兄尊堂，年将及耋，本质阴虚，时常头昏，口干耳鸣，心悸，药服滋补相安。秋初患
痢，
后成休息，延至次春，昼夜或十余行，七八行之不等，每便腹痛后重，粪带鲜红，间见白垢
，形疲食少。医治无效，召诊脉如平时，予曰∶体素阴亏，原宜滋养，但痢久脾虚肠滑，滋
药又非所宜。方仿异功散，加首乌、白芍、山药、扁豆、莲肉、老米，剂内俱用人参，数服
痢仍不止。复诊告兑兄曰∶令堂证属休息痢疾，病根在大肠曲折之处，诸药力不能到，即复
人参，亦皆无益。兑兄云∶然则奈何?予曰∶非鸦胆子莫能奏效。特此物本草未收，他书亦
鲜论及，惟幼幼集成载其功能，名为至圣丹。予用治此证，颇多获验。检书与阅，兑兄云∶
据书所言，并先生经验，自必不谬，第恐此药性猛，家慈年迈难胜耳。予曰∶所虑固是。但
每用只三十粒，去壳取仁，不过二三分，且有桂圆肉包裹，兼服补剂，扶持正气，断乎无伤
。盖非此莫达病所，病不能除，正反伤矣。如法制服，三日全瘳。是秋其疾复作，家菡洲兄
为治，多日未瘥，复邀同议。予曰∶上春曾投鸦胆子见功，何不再用?兑兄仍以高年质虚为
忧，予曰∶有病当之不害，亦三服而愈。兑兄虑疾复萌，商用此味，研入调养丸药内，冀刈
病根。予曰∶善后之图固妙，然研末入丸，似不合法，更与菡兄斟酌，仍照原制，每以五粒
与丸药和吞，服之两月，至今三年，其病不发，可见此药之功效如神。
安波按∶久年肠红亦效，可见医贵圆通也。
许兑岩兄的母亲，年纪接近八十岁，体质本质为阴虚，时常出现头晕、口干、耳鸣、心悸的症状，服用滋补药物后身体尚且安适。初秋时患上痢疾，后来演变为休息痢（指痢疾迁延不愈，时发时止），延续到次年春天，每天或夜间排便次数不等，有时十余次，有时七八次，每次排便都伴有腹痛和里急后重感，粪便中带有鲜红色血液，间杂有白色黏液垢浊，形体疲惫，食欲减退。经过治疗无效，邀请我诊脉，脉象与平时一样。我说：患者素体阴亏，原本适宜滋养，但痢疾日久导致脾虚肠滑，滋腻的药物又不适宜使用。处方仿照异功散（由人参、白术、茯苓、甘草、陈皮组成，具有益气健脾、行气化湿功效的方剂），加入何首乌、白芍、山药、扁豆、莲子肉、老米，药方中全部使用人参，服用几剂后痢疾仍然不止。
再次就诊时告诉许兑岩说：令堂的病证属于休息痢疾，病根位于大肠的曲折之处，普通药物的药力无法到达那里，即使是复用人参，也没有益处。许兑岩说：那么该怎么办呢？我说：除了鸦胆子没有别的药能奏效。只是这种药物在《本草纲目》等经典本草著作中未被收录，其他书籍也很少论及，只有《幼幼集成》记载了其功能，名为至圣丹。我用它治疗这个病症，很多都获得了验证。拿出书给他看，许兑岩说：根据书上所说的，以及先生的经验，必定不会出错，只是担心这药性猛烈，家母年迈难以承受。我说：您的顾虑确实有道理。但是每次只使用三十粒，去掉外壳取仁，不过二三分重，而且有桂圆肉包裹，同时服用补益药剂来扶持正气，绝对不会造成伤害。因为如果不是这药不能到达病所，病邪不能去除，反而会对身体造成损害。按照这种方法服用，三天就完全痊愈了。
那年秋天他的病又发作了，家菡洲兄为他治疗，多天没有痊愈，又邀请我一同商议。我说：去年春天曾投用鸦胆子见效，为何不再使用？许兑岩仍然担忧母亲年高体质虚弱，我说：有病在身的人服用此药不会有害，也是服用了三次就好了。许兑岩担心疾病复发，于是购买这种药材，研碎放入调养丸药内，希望铲除病根。我说：善后调理的计划固然巧妙，但是将药研末放入丸药中，似乎不符合用法，再与菡洲兄斟酌，仍然按照原来的制法，每次以五粒与丸药一起吞服，服用两个月，到现在三年，疾病没有再发作，可见此药的功效如神一般。
Brother Xu Duiyan's mother was approaching eighty years of age. Her constitution was fundamentally Yin Deficiency (Yin Xu, a state characterized by a lack of cooling, moistening, and calming substances in the body), presenting with frequent dizziness, dry mouth, tinnitus, and palpitations; she felt comfortable taking nourishing medicines. In early autumn, she contracted dysentery, which later developed into Xiu Xi Li (Resting Dysentery, a chronic form of dysentery characterized by intermittent attacks). This condition persisted until the following spring, with bowel movements occurring ten to seven or eight times a day or night. Each defecation was accompanied by abdominal pain and tenesmus (a feeling of incomplete evacuation), with fresh red blood in the stool and occasional white mucous discharge. She appeared fatigued and had a poor appetite. Previous treatments were ineffective. Upon pulse diagnosis, her pulse was consistent with her usual state. I stated: "Her constitution is inherently Yin deficient, so nourishment is originally indicated. However, due to the prolonged dysentery causing Spleen Qi Deficiency and intestinal laxity, cloying/nourishing herbs are not suitable." The prescription imitated Yi Gong San (Efficacious Powder, a formula for tonifying Qi and strengthening the Spleen), adding He Shou Wu (Polygoni Multiflori Radix Praeparata), Bai Shao (Paeoniae Radix Alba), Shan Yao (Dioscoreae Rhizoma), Bian Dou (Lablab Semen Album), Lian Rou (Nelumbinis Semen), and Lao Mi (Old Rice). All versions of the prescription used Ren Shen (Ginseng Radix). After several doses, the dysentery did not cease.
During the second consultation, I told Brother Xu: "Your mother's condition belongs to Resting Dysentery. The root of the disease lies in the tortuous areas of the Large Intestine, where the efficacy of most herbs cannot reach. Even if you repeat the use of Ren Shen, it will be of no benefit." Brother Xu asked: "Then what should we do?" I replied: "Only Ya Dan Zi (Brucea Fructus) can achieve the desired effect." However, this herb is not recorded in standard Materia Medica texts, and other books rarely discuss it. Only *You You Ji Cheng* (Compendium for Children) records its functions, naming it Zhi Sheng Dan (Supreme Holy Pill). I have used it to treat this condition with much success. I showed him the book. Brother Xu said: "Based on the book and your experience, it must be correct. I only fear that this medicine is too potent for my elderly mother to tolerate." I said: "Your concern is valid. But each time, only thirty seeds are used. Removing the shells and using only the kernels amounts to merely two or three fen (approx. 0.6-0.9 grams). Moreover, they are wrapped in Long Yan Rou (Longan Aril), and combined with tonic preparations to support Zheng Qi (Upright Qi/Healthy Qi), there will definitely be no harm. Without this herb, the pathogen cannot be reached at its location; if the disease is not eliminated, it will cause greater harm." Following this method, she recovered completely in three days.
That autumn, the illness recurred. Brother Jia Han Zhou treated her, but after many days, she had not healed. He invited me to consult together. I said: "Ya Dan Zi was effective last spring; why not use it again?" Brother Xu still worried about his mother's advanced age and deficient constitution. I said: "When one has an illness, taking this medicine does not cause harm. It also resulted in recovery after three doses." Fearing a relapse, Brother Xu purchased this herb, ground it into powder, and mixed it into conditioning pills, hoping to eradicate the root of the disease. I said: "The plan for post-treatment care is ingenious, but grinding the powder into pills seems inconsistent with the proper usage. Please deliberate further with Brother Han Zhou. Continue with the original preparation method: swallow five seeds together with the pills each time." After taking them for two months, and up to three years later, the disease did not recur. This demonstrates the miraculous efficacy of this herb.
An Bo's Note: This case is also effective for long-standing Chang Hong (Intestinal Redness/Bloody Stool). It shows that medical practice values flexibility and adaptability.