此由肠胃虚弱，为风邪所伤，则挟热，热乘于血，则血流渗入肠，与痢相杂下，故为赤
久赤痢者，由体虚热乘于血，血渗肠间，故痢赤。肠胃虚，不平复，其热不退，故经久
不瘥。胃气逆，则变呕哕也。胃虚谷气衰，虫动侵食，则变为 。
血痢者，热毒折于血，血渗入大肠故也。血之随气，循环经络，通行脏腑，常无停积。
毒热气乘之，遇肠虚者，血渗入于肠，肠虚则泄，故为血痢也。身热者死，身寒者生。
诊其关上脉芤，大便去血，暴下血数升也。
此由体虚受热，热折于血，血渗入肠，故成血痢。热不歇，胃虚不复，故痢血久不瘥，
多变呕哕及为湿 。
夫春阳气在表，人运动劳役，腠理则开。血气虚者伤于风，至夏又热气乘之，血性得热
则流散。其遇大肠虚，血渗入焉，与肠间津液相搏，积热蕴结，血化为脓，肠虚则泄，故成
脓血痢也。所以夏月多苦脓血痢，肠胃虚也。
诊其脾脉微涩者，为内溃，多下血脓。又脉悬绝则死，滑大则生。脉微小者生，实急者
死。脉沉细虚迟者生，数疾大而有热者死。
久脓血痢者，热毒乘经络，血渗肠内，则变为脓血痢。热久不歇，肠胃转虚，故痢久不
断，皆变成湿 及呕哕也。
冷痢者，由肠胃虚弱，受于寒气，肠虚则泄，故为冷痢也。凡痢色青、色白、色黑，并
皆为冷痢。色黄、色赤，并是热也。故痢色白，食不消，谓之寒中也。
诊其脉，沉则生，浮则死也。
这是由于肠胃虚弱，受到风邪侵袭，从而夹杂热邪；热邪侵扰血液，导致血液渗入肠道，与痢疾排泄物混杂而下，因此呈现红色。
长期患赤色痢疾的人，是因为体质虚弱，热邪侵扰血液，血液渗入肠间，所以痢下赤色。肠胃功能虚弱，无法恢复平衡，热邪不退，所以经久不愈。胃气上逆，就会转变为呕吐或干哕。胃气虚弱导致谷气衰败，寄生虫躁动侵蚀肠胃，就会转变为“蛊”（指因虫积或腐败食物引起的严重腹部病变）。
血痢，是由于热毒损伤血液，血液渗入大肠所致。血液随着气机运行，循环于经络，通行于脏腑，通常没有停滞积聚。当毒热之气乘虚而入，遇到肠道虚弱时，血液便渗入肠中，肠道虚弱则发生泄泻，所以形成血痢。如果患者身体发热，预后不良（主死）；如果身体发凉，预后良好（主生）。诊察其关部脉象呈芤脉（浮大中空，如按葱管），且大便大量出血，突然腹泻数升鲜血。
这也是因为体质虚弱受热，热邪损伤血液，血液渗入肠道，所以形成血痢。热邪不消退，胃气虚弱不能恢复，所以痢血经久不愈，多容易转变为呕吐、干哕以及湿性蛊病。
春季阳气在体表，人们运动劳役，腠理（皮肤毛孔及肌肉间隙）因而开泄。气血虚弱的人感受风邪，到了夏季又受热气侵袭，血的性质遇热则流动散逸。如果遇到大肠虚弱，血液便渗入其中，与肠间的津液相互搏结，积热蕴结，血液化为脓液，肠道虚弱则泄泻，所以形成脓血痢。因此夏季多有人苦于脓血痢，这是因为肠胃虚弱。诊察脾脉微涩的，为内脏溃败，多下血脓。如果脉象悬绝（无胃气，忽快忽慢或极度微弱），则主死；脉象滑大，则主生。脉象微小者主生，脉象实急者主死。脉象沉细虚迟者主生，脉象数疾（快速）大而有热者主死。
长期患脓血痢的人，是热毒侵入经络，血液渗入肠内，从而变为脓血痢。热邪长久不消退，肠胃更加虚弱，所以痢疾久不断绝，最终都转变为湿性蛊病及呕吐、干哕。
冷痢，是由于肠胃虚弱，受到寒气侵袭，肠道虚弱则泄泻，所以称为冷痢。凡是痢疾颜色青、白、黑，都属于冷痢。颜色黄、赤，都属于热证。所以痢下白色粪便，食物不消化，这被称为寒中（寒气客于中焦）。诊察其脉象，沉脉主生，浮脉主死。
This condition arises from the weakness of the intestines and stomach, which are injured by wind pathogens. Consequently, heat is carried along; when heat attacks the blood, the blood flows and infiltrates into the intestines, mixing with the dysenteric discharge, thus resulting in red dysentery (Chi Li).
In cases of chronic red dysentery, it is due to physical deficiency where heat attacks the blood, causing blood to seep into the intestinal cavity, hence the red stool. The intestines and stomach remain weak and fail to return to equilibrium, while the heat persists, leading to a prolonged course without recovery. If the stomach qi rebels upward, it transforms into vomiting or hiccups. If stomach deficiency leads to a decline in grain qi, parasites may become active and erode the digestive tract, transforming into *Gu* (a severe abdominal disorder caused by parasites or putrefaction).
Blood dysentery occurs because heat-toxins damage the blood, causing it to infiltrate the large intestine. Blood follows qi, circulating through the meridians and passing through the zang-fu organs, normally without stagnation. When toxic heat takes advantage of this, encountering a deficient intestine, the blood infiltrates the bowel. Since a deficient intestine leads to diarrhea, blood dysentery results. If the body is hot, death ensues; if the body is cold, survival is indicated. Upon diagnosis, if the pulse at the Guan position is Khou (floating, large, and empty, like pressing a scallion), accompanied by massive bloody stools and sudden profuse hemorrhage of several sheng, it indicates severe blood loss.
This also stems from physical deficiency receiving heat, where heat damages the blood, causing it to infiltrate the intestines, forming blood dysentery. If the heat does not subside and the stomach remains deficient and unrecovered, the bloody dysentery persists for a long time, often transforming into vomiting, hiccups, and damp-type *Gu*.
In spring, yang qi is on the exterior. When people engage in movement and labor, the couli (pores and interstices) open. Those with deficient qi and blood are injured by wind. By summer, heat qi attacks them. The nature of blood becomes fluid and scattered when heated. If the large intestine is deficient, blood infiltrates it, struggling with the fluids in the intestines. Accumulated heat condenses, transforming blood into pus. A deficient intestine leads to diarrhea, thus forming pus-and-blood dysentery. Therefore, many suffer from pus-and-blood dysentery in summer due to intestinal and stomach weakness. Diagnosing the spleen pulse: if slightly choppy (Se), it indicates internal ulceration with frequent passage of bloody pus. If the pulse is Xuan Jue (suspended and extreme, lacking stomach qi), death ensues; if slippery and large, survival is indicated. A slight and small pulse indicates survival; a solid and urgent pulse indicates death. A deep, fine, deficient, and slow pulse indicates survival; a rapid, large pulse with heat indicates death.
Chronic pus-and-blood dysentery occurs when heat-toxins invade the meridians, and blood infiltrates the intestines, transforming into pus-and-blood dysentery. Prolonged heat that does not subside further weakens the intestines and stomach, causing the dysentery to persist indefinitely, eventually transforming into damp-type *Gu*, vomiting, and hiccups.
Cold dysentery arises from the weakness of the intestines and stomach, which have been invaded by cold qi. A deficient intestine leads to diarrhea, hence it is called cold dysentery. Dysentery with green, white, or black color all belongs to cold dysentery. Yellow and red colors belong to heat syndromes. Therefore, white dysentery with undigested food is termed Han Zhong (cold invading the middle jiao). Diagnosis of the pulse: a deep pulse indicates survival; a floating pulse indicates death.