崔司空，年逾六旬，患痢赤白，里急后重，此湿热壅滞，用芍药汤内加大黄二钱，一剂减半，
又剂痊愈。惟急重未止，此脾气下陷，用补中益气送香连丸而愈。
罗给事，小腹急痛，大便欲去不去，此脾肾气虚而下陷也，用补中益气送八味丸，二剂而愈。此
等症候，因痢药致损元气，肢体肿胀而殁者，不可枚举。
少宗伯顾东江，停食患痢，腹痛下坠，或用疏导之剂，两足胀肿，食少体倦，烦热作渴，脉洪
数，按之微细。余以六君加姜、桂各二钱，吴茱、五味各一钱，煎熟冷服之即睡，觉而诸症
顿退，再剂全退。此假热而治以假寒也。
太常边华泉，呕吐不食，腹痛后重，自用大黄等药一剂腹痛益甚，自汗发热，昏愦脉大，余
用参、术各一两，炙甘草、炮姜各三钱，升麻一钱，一钟而苏，又用补中益气加炮姜，二剂而
愈。
廷评曲汝为，食后入房，翌午腹痛，去后似痢非痢，次日下皆脓血，烦热作渴，神思昏倦，用
四神丸，一服顿减，又用八味丸料加五味、吴茱、骨脂、肉蔻，二剂痊愈。
判官汪天锡，年六十余。患痢腹痛后重，热渴引冷，饮食不进，用芍药汤内加大黄一两，四剂
稍应，仍用前药，大黄减半，数剂而愈。此等元气，百无一二。
通府薛允 ，下血，服犀角地黄汤等药，其血愈多，形体消瘦，发热少食，里急后重，此脾气
下陷，余用补中益气加炮姜，一剂而愈。
一上舍，患痢后重，自知医，用芍药汤，后重益甚，饮食少思，腹寒肢冷，余以为脾胃亏损，
用六君加木香、炮姜，二剂而愈。
一老人，素以酒乳同饮，去后似痢非痢，胸膈不宽，用痰痢等药不效。余思《本草》云∶酒不
与乳同饮，为得酸则凝结，得苦则行散。遂以茶茗为丸，时用清茶送三、五十丸，不数服而瘥
一老妇，食后，因怒患痢，里急后重，属脾气下陷，与大剂六君加附子、肉蔻、煨木香各一钱
，吴茱五分，骨脂、五味各一钱五分，二剂诸症悉退，惟小腹胀闷，此肝气滞于脾也，与调
中益气加附子、木香五分，四剂而愈。后口内觉咸，此肾虚水泛，与六味地黄丸，二剂顿愈。
先母年八十，仲夏患痢，腹痛，作呕，不食，热渴引汤，手按腹痛稍止，脉鼓指而有力，真气虚
而邪气实也。急用人参五钱，白术、茯苓各三钱，陈皮、升麻、附子、炙甘草各一钱，服之
睡觉索食，脉症顿退，再剂而安。此取症不取脉也，凡暴病，毋论其脉，当从其症。时石阁老
太夫人，其年岁、脉症皆同，彼乃专治其痢，遂致不起。
横金陈梓园，年六十，面带赤色，吐痰口干，或时作泻，癸卯春就诊，谓余曰∶仆之症，或以为
脾经湿热，痰火作泻，率用二陈、黄连、枳实、神曲、麦芽、白术、柴胡之类，不应何也?
余脉之，左关弦紧，肾水不能生肝木也；右关弦大，肝木乘克脾土也。此乃脾肾亏损，不能
生克制化，当滋化源。不信，余谓其甥朱太守阳山曰∶令舅不久当殒于痢。至甲辰夏，果患痢
而殁。
产后痢疾，见《女科撮要》。
崔司空，年龄超过六十岁，患痢疾，大便中带有红色和白色脓血，有急迫想排便但排不出的感觉（里急后重），这是湿热邪气壅滞肠道所致。我用芍药汤（调和气血、清热燥湿的方剂）内加大黄二钱，服用一剂后症状减半，再服一剂即痊愈。只是里急后重的症状仍未完全停止，这是因为脾气下陷，于是用补中益气汤（补益中气、升阳举陷的方剂）送服香连丸（清热化湿、行气止痛的方剂）而治愈。
罗给事，小腹部急痛，大便想排却排不出，这是脾肾气虚导致气机下陷所致。我用补中益气汤送服八味丸（即金匮肾气丸，温补肾阳的方剂），服用两剂后痊愈。这类病症，因为误用治痢药物损伤元气，导致肢体肿胀而死亡的例子，不可胜数。
少宗伯顾东江，因食积停滞患痢疾，腹痛且有下坠感。有人使用疏导攻下的药剂，导致双足肿胀，食欲减退，身体疲倦，伴有烦热和口渴，脉象洪大且数，但重按则感觉微细无力。我用六君子汤（健脾益气、燥湿化痰的方剂）加入干姜、肉桂各二钱，吴茱萸、五味子各一钱，煎好放凉后服用，患者随即入睡，醒来后所有症状顿时消退，再服两剂后症状全部消失。这是假热证，却用假寒（清凉）的方法治疗。
太常边华泉，呕吐不能进食，腹痛且有后重感。自行服用大黄等泻下药一剂，导致腹痛更加严重，出现自汗、发热，神志昏沉模糊，脉象大而无力。我用人参、白术各一两，炙甘草、炮姜各三钱，升麻一钱，煎服一钟（量词，约一碗）后患者苏醒，随后改用补中益气汤加炮姜，服用两剂后痊愈。
廷评曲汝为，进食后行房事，第二天中午腹痛，排便时似痢非痢，次日排出全是脓血，伴有烦热、口渴，精神昏沉疲倦。我使用四神丸（温肾暖脾、固肠止泻的方剂），服用一次后症状立刻减轻，又用八味丸料加上五味子、吴茱萸、补骨脂、肉豆蔻，服用两剂后痊愈。
判官汪天锡，年龄六十多岁。患痢疾，腹痛且有后重感，怕热口渴想喝冷水，饮食不进。我用芍药汤内加大黄一两，服用四剂后稍有见效，仍继续用前面的药方，将大黄剂量减半，经过数剂治疗后痊愈。像这样元气尚存的患者，百人中难有一二。
通府薛允，便血，服用犀角地黄汤（清热凉血解毒的方剂）等药物，出血反而更多，形体消瘦，发热，食欲减少，有里急后重感。这是脾气下陷所致，我用补中益气汤加炮姜，服用一剂后痊愈。
一位上舍生，患痢疾伴有后重感，自己懂医术，使用芍药汤，结果后重感更加严重，食欲减退，腹部寒冷，四肢发冷。我认为这是脾胃亏损所致，使用六君子汤加木香、炮姜，服用两剂后痊愈。
一位老人，平时习惯酒和乳酪同饮，排便时似痢非痢，胸膈部感觉不宽畅。使用治疗痰湿或痢疾的药物无效。我思考《本草》记载：酒不与乳酪同饮，因为遇到酸味会凝结，遇到苦味则会行散。于是用茶末制成丸药，时常让患者用清茶送服三五十丸，没吃几副就好了。
一位老妇人，进食后因生气患痢疾，有里急后重感，属于脾气下陷。给予大剂量的六君子汤，加入附子、肉豆蔻、煨木香各一钱，吴茱萸五分，补骨脂、五味子各一钱五分，服用两剂后所有症状全部消退，只有小腹胀闷，这是肝气郁滞于脾脏所致。给予调中益气汤加附子、木香五分，服用四剂后痊愈。后来口中觉得咸味，这是肾虚水气泛溢所致，给予六味地黄丸（滋补肾阴的方剂），服用两剂后立刻痊愈。
我的母亲八十岁时，仲夏季节患痢疾，腹痛，作呕，不能进食，怕热口渴想喝水，用手按压腹部疼痛稍止，脉象鼓指且有力，这是真气虚弱而邪气实盛的表现。急忙用人参五钱，白术、茯苓各三钱，陈皮、升麻、附子、炙甘草各一钱，服用后患者睡觉醒来便索要食物，脉象和症状顿时消退，再服两剂后安稳。这是依据症状而非脉象来治疗的原则，凡是突发疾病，不论其脉象如何，应当顺从症状表现。当时石阁老太夫人，她的年龄、脉象和症状都相同，但她专门治疗痢疾（攻邪），最终导致死亡。
横金陈梓园，年龄六十岁，面色发红，吐痰口干，有时腹泻。癸卯年春天就诊，他对我说：我的病症，有人认为是脾经湿热、痰火导致的腹泻，我都常规使用二陈汤、黄连、枳实、神曲、麦芽、白术、柴胡之类的药物，为什么没有效果？我诊察他的脉象，左关脉弦紧，说明肾水不能滋养肝木；右关脉弦大，说明肝木克制脾土。这是脾肾亏损，不能正常进行生克制化的关系，应当滋生化之源。他不相信，我对他的外甥朱太守阳山说：您的舅舅不久将会死于痢疾。到了甲辰年夏天，果然患痢疾而死。
产后痢疾，参见《女科撮要》。
Cui Sikong, over sixty years old, suffered from dysentery with red and white pus and blood in the stool, accompanied by tenesmus (urgent desire to defecate with little output). This was due to damp-heat stagnation. I used Shaoyao Decoction (Peony Decoction) with added Rhubarb (Da Huang) 2 qian. After one dose, symptoms halved; after a second dose, he recovered. However, the tenesmus persisted, indicating sinking of Spleen Qi. I administered Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) to deliver Xianglian Wan (Fragrant Coptis Pill), resulting in recovery.
Luo Jishi experienced acute pain in the lower abdomen and difficulty defecating despite the urge. This indicated deficiency and sinking of Qi in the Spleen and Kidney. I used Buzhong Yiqi Tang to deliver Bawei Wan (Eight-Ingredient Pill, i.e., Jin Gui Shen Qi Wan), and he recovered after two doses. Cases where such conditions led to death due to limb swelling caused by damage to Yuan Qi from improper use of dysentery medicines are too numerous to count.
Shao Zongbo Gu Dongjiang suffered from dysentery due to food stagnation, with abdominal pain and a sensation of bearing down. Others used purgative/dredging agents, leading to swollen legs, poor appetite, fatigue, irritability, heat, thirst, and a surging, rapid pulse that felt faint and fine upon deep pressure. I used Liujunzi Tang (Six Gentlemen Decoction) with added Dried Ginger (Jiang) and Cinnamon Twig (Guizhi) 2 qian each, Evodia Fruit (Wuzhuyu) and Schisandra Berry (Wuweizi) 1 qian each. Taken cold after decoction, he slept immediately, and upon waking, all symptoms vanished. Two more doses cleared them completely. This was false heat treated with false cold (cooling method).
Taichang Bian Huaquan suffered from vomiting, inability to eat, abdominal pain, and tenesmus. He self-medicated with Rhubarb (Da Huang) and other purgatives for one dose, worsening abdominal pain, causing spontaneous sweating, fever, confusion, and a large but empty pulse. I used Ginseng (Renshen) and Atractylodes Macrocephala Rhizome (Baizhu) 1 liang each, Roasted Licorice Root (Zhi Gancao) and Fried Ginger (Pao Jiang) 3 qian each, and Cimicifuga Rhizome (Shengma) 1 qian. One cup revived him. Subsequently, Buzhong Yiqi Tang with Fried Ginger was used, and he recovered after two doses.
Tingping Qu Ruwei engaged in sexual intercourse after eating. The next noon, he had abdominal pain. Defecation resembled dysentery but was not true dysentery. The following day, he passed only pus and blood, with irritability, heat, thirst, and mental confusion/fatigue. I used Sishen Wan (Four Spirits Pill); one dose brought immediate relief. Then, Bawei Wan ingredients plus Schisandra Berry (Wuweizi), Evodia Fruit (Wuzhuyu), Psoralea Fruit (Guzhi), and Myristica Seed (Roukou) were used for two doses, resulting in recovery.
Panguan Wang Tianxi, over sixty, suffered from dysentery with abdominal pain and tenesmus, heat, thirst preferring cold drinks, and inability to eat. I used Shaoyao Decoction with added Rhubarb (Da Huang) 1 liang. Four doses showed slight improvement. Continuing the previous prescription with half the amount of Rhubarb, he recovered after several doses. Among such patients, those with sufficient Yuan Qi are rare (one or two in a hundred).
Tongfu Xue Yun suffered from bloody stool. After taking Xijiao Dihuang Tang (Rhino Horn and Rehmannia Decoction) and similar drugs, bleeding increased, body emaciated, fever appeared, appetite decreased, and tenesmus occurred. This was sinking of Spleen Qi. I used Buzhong Yiqi Tang with Fried Ginger (Pao Jiang), and he recovered after one dose.
A Shangsheng suffered from dysentery with tenesmus. Being knowledgeable in medicine himself, he used Shaoyao Decoction, which worsened the tenesmus. Appetite declined, abdomen felt cold, and limbs were cold. I diagnosed this as Spleen and Stomach deficiency/loss, and used Liujunzi Tang with Aucklandia Root (Muxiang) and Fried Ginger (Pao Jiang). He recovered after two doses.
An elderly man habitually drank wine and milk together. His defecation resembled dysentery but was not true dysentery, and his chest and diaphragm felt constricted. Medicines for phlegm-dysentery were ineffective. Recalling the Materia Medica: "Wine should not be drunk with milk; acid causes coagulation, while bitter promotes dispersion." Thus, I made pills using tea leaves, advising him to take 30-50 pills with clear tea occasionally. He recovered after a few doses.
An elderly woman developed dysentery with tenesmus after anger post-meal, attributed to sinking of Spleen Qi. I prescribed a large dose of Liujunzi Tang with added Aconite Root (Fu Zi), Myristica Seed (Roukou), and baked Aucklandia Root (Wei Muxiang) 1 qian each, Evodia Fruit (Wuzhuyu) 0.5 qian, Psoralea Fruit (Guzhi) and Schisandra Berry (Wuweizi) 1.5 qian each. Two doses resolved all symptoms except for lower abdominal distension, indicating Liver Qi stagnation affecting the Spleen. I used Tiaozhong Yiqi Tang with added Aconite Root (Fu Zi) and Aucklandia Root (Muxiang) 0.5 qian. Four doses resulted in recovery. Later, she felt a salty taste in her mouth, indicating Kidney deficiency with water overflowing. I gave Liuwei Dihuang Wan (Six-Ingredient Pill with Rehmannia), and she recovered instantly after two doses.
My mother, aged eighty, suffered from dysentery in midsummer with abdominal pain, vomiting, inability to eat, heat, thirst preferring liquids, and abdominal pain relieved by pressure. Her pulse was forceful and strong at the surface, indicating deficiency of True Qi and excess of pathogenic factors. I urgently prescribed Ginseng (Renshen) 5 qian, Atractylodes Macrocephala Rhizome (Baizhu) and Poria (Fuling) 3 qian each, Tangerine Peel (Chenpi), Cimicifuga Rhizome (Shengma), Aconite Root (Fu Zi), and Roasted Licorice Root (Zhi Gancao) 1 qian each. After ingestion, she slept, woke up asking for food, and both pulse and symptoms subsided. Two more doses ensured stability. This follows the principle of treating based on symptoms rather than pulse; for acute diseases, regardless of the pulse, one should follow the symptoms. At that time, the Lady of Grand Secretary Shi had identical age, pulse, and symptoms, but was treated solely for dysentery (attacking the pathogen), leading to her death.
Chen Ziyuan from Hengjin, aged sixty, had a red complexion, expectorated phlegm, dry mouth, and occasional diarrhea. In spring of the Gui-Mao year, he consulted me, saying: "My condition is sometimes considered damp-heat in the Spleen channel or diarrhea caused by phlegm-fire. I routinely use Erchen Tang, Coptis Rhizome (Huanglian), Immature Bitter Orange (Zhishi), Medicated Leaven (Shenqu), Malt (Maiya), Atractylodes Macrocephala Rhizome (Baizhu), and Bupleurum Root (Chaihu), yet it is ineffective. Why?" I palpated his pulse: the left Guan position was wiry and tight, indicating Kidney Water failing to nourish Liver Wood; the right Guan position was wiry and large, indicating Liver Wood attacking Spleen Earth. This was deficiency of Spleen and Kidney, failing to maintain normal generation and restriction cycles. The source of transformation should be nourished. He did not believe me. I told his nephew, Prefect Zhu Yangshan: "Your uncle will soon perish from dysentery." In summer of the Jia-Chen year, he indeed died of dysentery.
Postpartum dysentery is discussed in *Nuke Cuoyao* (Essentials of Gynecology).