小儿痢证，多因外受暑湿，内伤生冷而成，伤于气者色多白，以肺于大肠为表里也。伤于血者色多赤，以心
与小肠为表里也。里急者腹窘痛也，后重者频下坠也。古今方书以其闭滞不利，故又谓之滞下。其证里急后重，
或垢或血，或见五色，或多红紫，或痛或不痛，或呕或不呕，或为发热，或为恶寒。此证之阴阳虚实，最宜详审，
庶不差误，仍宜脉证合参。凡身热作渴，脉数有力而能食者为热，身凉不渴，脉沉无力而不能食者为寒。凡痢能
食者易治，不能食者难治。痛久不止，脾胃受伤，中气下陷，则为脱肛。热毒上逆，食入便吐，不思饮食，则为
噤口。久痢阴伤，肾气虚败，两膝红肿，则为鹤膝。失治痢转五色，则五脏俱败，或如烟尘水，或如屋漏水，或
肛门如竹筒，如鱼胶，胸高气促，心烦、坐卧不安，大渴引水，面容似朱，皆不可治。故治痢须分寒痢、热痢、
时痢、噤口痢、休息痢、血痢各名目，不可混而言之曰痢也，因作痢解。
小儿因寒冷伤胃，久痢不已，或脏气本虚，复为风冷所乘，伤于脾胃，故痢时肠鸣切痛，面唇青白，口虽甚
渴，最喜热饮，
此里寒虚之证也，寒痢初起，古法主理中汤（如人参、白术、干姜、炙甘草）。
寒痢已久，古人主真人养脏汤（如人参、土炒白术、煨木香、土炒当归、炒白芍、肉桂、炙甘草、蜜炙罂粟
壳、诃子肉面煨去核、煨肉果，引用乌梅）。
〔真按〕痢之初起，实热实积，皆易知而易治，惟体虚冷积成痢，人多不以为意，此由阴性迟缓，慎毋养
虎贻患。方用广陈皮钱半，酒炒赤芍一钱，陈松萝茶炒麦芽八分，当归身八分，煨木香一钱，炒白芍八分，煨肉
果五分，炒蔻仁五分，炙甘草五分，引用北干姜三片。
小儿痢疾证候，多因外感暑湿之邪，内伤生冷饮食所致。损伤气分的，大便颜色多为白色，因为肺与大肠互为表里。损伤血分的，大便颜色多为红色，因为心与小肠互为表里。“里急”是指腹部窘迫疼痛，“后重”是指频繁有下坠感。古今医书因其肠道闭塞阻滞、排便不畅，所以又称之为“滞下”。其症状表现为里急后重，大便或夹杂脓垢，或带血液，或呈现五色杂下，或红紫较多，或腹痛或不痛，或呕吐或不呕吐，或发热或恶寒。此证的阴阳虚实属性，最需详细审察，以免误诊，仍应将脉象与症状结合参考。凡是身体发热、口渴、脉象数而有力且能进食的属于热证；身体发凉、不渴、脉象沉而无力且不能进食的属于寒证。凡患痢疾能进食的容易治疗，不能进食的难以治疗。腹痛日久不止，损伤脾胃，中气下陷，就会导致脱肛。热毒上逆，食物入口即吐，不思饮食，就称为“噤口痢”。久痢导致阴液亏损，肾气虚衰败坏，出现两膝红肿，就称为“鹤膝风”。若失治导致痢疾转为五色杂下，则五脏功能俱败，大便或像烟尘水样，或像屋顶漏下的雨水，或肛门松弛如竹筒，或排出物如鱼胶状，伴有胸高气促、心烦、坐卧不安、极度口渴想喝水、面容红润如涂朱砂等症状，都属于不可治愈的危重症。因此，治疗痢疾必须区分寒痢、热痢、时行痢、噤口痢、休息痢、血痢等不同名目，不可笼统地统称为痢疾，于是撰写了这篇《痢解》。
小儿因寒冷损伤胃气，久痢不愈，或者脏腑之气本已虚弱，又遭受风冷侵袭，损伤脾胃，所以在痢疾发作时肠鸣音明显且剧烈疼痛，面色和嘴唇青白，虽然非常口渴，但最喜欢喝热饮，这是里寒虚损的证候。寒痢初起时，古法主张使用理中汤（包含人参、白术、干姜、炙甘草）。寒痢病程已久时，古人主张使用真人养脏汤（包含人参、土炒白术、煨木香、土炒当归、炒白芍、肉桂、炙甘草、蜜炙罂粟壳、诃子肉面煨去核、煨肉豆蔻，煎药时引用乌梅）。
〔陈守真按语〕痢疾初起时，实热和实积都容易知晓且容易治疗，只有体质虚弱、冷积成痢的情况，人们往往不以为意，这是因为阴性病证发展迟缓，务必不要纵容病邪留下后患。方剂使用广陈皮一钱半，酒炒赤芍一钱，陈松萝茶炒麦芽八分，当归身八分，煨木香一钱，炒白芍八分，煨肉豆蔻五分，炒白豆蔻仁五分，炙甘草五分，煎药时引用北干姜三片。
Pediatric dysentery syndromes are mostly caused by external contraction of summerheat-dampness and internal injury from raw or cold food. Injury to the Qi results in white-colored stool, as the Lung and Large Intestine are exterior-interiorly related. Injury to the Blood results in red-colored stool, as the Heart and Small Intestine are exterior-interiorly related. "Tenesmus" (Li Ji) refers to urgent abdominal pain and discomfort; "heaviness in the rectum" (Hou Zhong) refers to frequent defecation with a bearing-down sensation. Ancient and modern medical texts refer to this condition as "Zhi Xia" (Stagnant Downward Flow) due to intestinal blockage and difficulty in defecation. The symptoms include tenesmus and heaviness in the rectum, with stool containing pus or blood, presenting five colors, or being predominantly red-purple; it may be painful or painless, accompanied by vomiting or not, fever or chills. The Yin-Yang and Deficiency-Excess nature of this syndrome must be carefully examined to avoid errors, integrating pulse diagnosis with symptom assessment. Fever, thirst, a rapid and forceful pulse, and ability to eat indicate Heat; cool body temperature, absence of thirst, a deep and weak pulse, and inability to eat indicate Cold. Dysentery patients who can eat are easy to treat; those who cannot eat are difficult to treat. Prolonged pain damages the Spleen and Stomach, causing Central Qi to sink, leading to rectal prolapse. Upward reversal of heat-toxin causes immediate vomiting after eating and loss of appetite, known as "Jin Kou Li" (Clamped-Mouth Dysentery). Chronic dysentery injuring Yin and failing Kidney Qi leads to redness and swelling of both knees, known as "He Xi Feng" (Crane-Knee Wind). Untreated dysentery turning into five-color discharge indicates failure of all five Zang organs; stool may resemble smoke-dust water or roof-leak water, the anus may become loose like a bamboo tube, or discharge may resemble fish glue. Accompanied by chest fullness, shortness of breath, irritability, restlessness, extreme thirst, and a ruddy face resembling cinnabar, these are incurable conditions. Therefore, treating dysentery requires distinguishing between Cold Dysentery, Heat Dysentery, Seasonal Dysentery, Clamped-Mouth Dysentery, Resting Dysentery, and Bloody Dysentery, rather than lumping them all under the general term "Dysentery." Hence, this explanation on Dysentery is composed.
Children suffering from stomach injury due to cold, with chronic dysentery that does not resolve, or those with originally deficient organ Qi attacked by wind-cold, damaging the Spleen and Stomach, will experience borborygmus and severe cutting pain during dysentery episodes, bluish-white complexion and lips, and although extremely thirsty, they strongly prefer hot drinks. This is a pattern of Interior Cold and Deficiency. For early-stage Cold Dysentery, ancient methods primarily recommend Lizhong Tang (Cinnamon Twig and Atractylodes Decoction), containing Renshen (Ginseng Radix), Baizhu (Atractylodis Macrocephalae Rhizoma), Ganjiang (Zingiberis Rhizoma), and Zhigancao (Prepared Licorice Root). For long-standing Cold Dysentery, ancient methods recommend Zhenren Yangzang Tang (True Man's Nourishing the Viscera Decoction), containing Renshen (Ginseng Radix), Tu Chao Baizhu (Earth-fried Atractylodis Macrocephalae Rhizoma), Wei Muxiang (Baked Aucklandiae Radix), Tu Chao Danggui (Earth-fried Angelicae Sinensis Radix), Chao Baishao (Fried White Peony Root), Rougui (Cinnamon Bark), Zhigancao (Prepared Licorice Root), Mi Zhi Yingsuke (Honey-fried Poppy Shell), Hezi Rou Mian Wei Qu He (Areca Seed Flesh Baked in Flour with Core Removed), and Wei Rouguo (Baked Myristica Seed), using Wumei (Mume Fruit) as a guide.
[Chen Shouzhen's Note:] At the onset of dysentery, Excess-Heat and Excess-Stagnation are easy to identify and treat. However, cases where deficiency constitution and cold-stagnation form dysentery are often overlooked because Yin-patterns develop slowly. One must not nurture the tiger only to invite disaster. The prescription uses Guang Chenpi (Broad-Leaved Tangerine Peel) 1.5 qian, Jiu Chao Chishao (Wine-fried Red Peony Root) 1 qian, Chen Songluo Cha Chao Maiya (Aged Songluo Tea-fried Barley Sprout) 8 fen, Danggui Shen (Body of Angelicae Sinensis Radix) 8 fen, Wei Muxiang (Baked Aucklandiae Radix) 1 qian, Chao Baishao (Fried White Peony Root) 8 fen, Wei Rouguo (Baked Myristica Seed) 5 fen, Chao Kourén (Fried Cardamomi Fructus Rotundus) 5 fen, Zhigancao (Prepared Licorice Root) 5 fen, using Bei Ganjiang (Northern Dried Ginger) 3 slices as a guide.