〔《大》〕治产后遗尿。取故燕巢中草烧灰，研细，酒调服五分。男子亦治。
又方 白矾（枯） 牡蛎（ ）
上等分为末。酒服方寸匕，日三。男女同治。
〔华〕病患卧，遗屎不觉者死。
〔丹〕痢初得时，一二日间，以利为法，有热先退热。后重者，当利气，木香、槟榔。腹痛，用温散药，
姜、桂之属。下血当凉血、和血，当归、桃仁之属。下痛，发热恶寒，身首俱痛，此为表证，宜微汗和解，用
苍术、川芎、陈皮、芍药、甘草，生姜三片煎。下痢身发热者，有外感，用小柴胡去参。下痢发热，久不止者，
属阴虚，用寒凉药，必兼升散药，并热药用。下痢初发热，必用大承气，下后看症用药。发热不恶寒，脉洪者，
宜大承气。若恶寒者，忌下。下痢腹痛后重，小水短，下积，此为里症，宜和中疏气，用陈皮、芍药、滑石、
枳壳、浓朴之类。
〔洁〕芍药汤 治下血调气。《经》曰 溲而便脓血，知气行而血止也。行血则便自安，调气则后重自除。
芍药（一两） 当归 黄连（各半两） 槟榔 木香（各二钱） 甘草（炙，一钱） 大黄（三钱） 黄芩（五钱）
桂（二钱半）
上粗末。每服半两，水二盏，煎至一盏，食后温服。如血前，则渐加大黄。如清后脏毒，加黄柏半两，同煎服。
〔丹〕一老人，年七十，面白，脉弦数，独胃脉沉滑，因饮白酒作痢，下血淡水脓，腹痛，小便不利，里
急后重。以参、术为君；甘草、滑石、槟榔、木香、苍术为佐；下保和丸二十五丸。第二日前症俱减，独小便
不利，以益元散服之安。
〔河〕益元散 治身发热，下痢赤白，小便不利，荡胃中积聚。（方见泄泻。）
〔丹〕痢初得之，必用调胃承气及大小承气，实者用此下之。下娄男子，五十余，下痢，昼有积淡红色，
夜无积，食自进。先吃小胃丹两服，再与四十丸，次六十丸，去积，却与断下。
〔罗〕玄青丸 治下痢势恶，频并窘痛，或久不愈，诸药不能止，须吐下之，以开除泻热，痞闷积滞，而
使气液宣行者，宜此逐之。兼宣利积热，酒食积，黄瘦中满，水气肿，腹胀。兼疗小儿惊疳、积热、乳癖诸症。
黄连 黄柏 大黄 甘遂 芫花（醋拌，炒） 大戟（各五钱） 轻粉（二钱） 青黛（一两） 牵牛（四两，
取头末，二两）
上为末研匀，水丸，小豆大。初服十丸，每服加十丸，空心日午临卧三服，以快利为度。后常服十五丸，
数日后，得食力。如利尚未痊，再加取利。利后却常服，以意消息，病去为度，后随症止之。小儿丸如黍米
大，退惊疳积热，不须下者，常服十丸。
〔《玄》〕利积丸
黄连（四两） 天水末（八两） 当归（二两） 乳香（一两） 萝卜子（炒，四两） 巴豆（一两，去油，同黄
连一处炒）
上为末，醋糊丸，如桐子大。弱者十五丸，实者二十五丸。治下痢赤白，腹满胀痛里急，上渴引饮，小水
赤涩，此积滞也。宜泄其热，中用清肠丸、导气丸推其积滞，而痢自无矣。凡治积聚之症，轻则温而利之，清肠
丸是也。重者天真散、舟车丸下之。下后，切勿便补之，其或力倦，自觉气少恶食，此为挟虚症，宜加
白术、当归身、尾；甚者，加人参。若又十分重者，止用此药，加陈皮补之，虚回而痢自止矣。
予族叔，年近六十，夏间患滞下病，腹微痛，所下褐色，后重频并，饮食大减，时有微热。察其脉皆弦而
涩，似数稍长，却喜不甚浮大，两手相等。视其神气大减。予曰∶此非滞下，乃忧虑所致，心血亏，脾气弱也。
与参、术为君；归身、陈皮为臣；川芎、炒白芍、茯苓为佐使，如热加黄连为使，与两月而安。
金氏妇，年近四十，秋初尚热，患滞下，腹但隐痛，夜重于昼，全不得睡，食亦稍减，口干不饮，已服治
痢灵砂两帖矣。予视之，两手脉等涩且不匀，神思倦甚，饮食全减。因与四物汤，倍加白术，以陈皮佐之，数
帖而安。
义一侄，患疟间日作，兼痢，脉虚甚，身痛。宜活血补胃，待虚稍回，却又推积。
人参（五分） 白术（一钱半） 苍术 陈皮（各一钱） 白芍药（炒，五分） 川芎（五分） 滑石（炒一钱）
甘草（炙，少许） 桃仁（研，七分）
药后病退，惟脉少弦、身倦，用此方调补。
人参（九分） 苍术（三钱） 半夏（九分） 川芎（一钱） 陈皮（一钱） 木通（二钱半） 甘草（少）
煎服三之一饮之，可淡粥少少塞饥，又静坐养之。
叶先生患滞下，后甚逼迫，正合承气症。但气口虚，形虽实而面黄积白。此必平昔食过饱而胃受伤，宁忍
二三日辛苦。遂与参、术、陈皮、芍药等补药十余帖。至三日后，胃气稍完，与承气二帖而安。苟不先补完胃
气之伤，而遽行承气，恐病安之后，宁免瘦惫乎。
〔世〕治痢，烟蜡丸
黄蜡不拘多少，用银篦挑于真香油灯上烧熏，落下水碗内，凡如此者七次，为丸如萝卜子大，每二十丸。
白痢，甘草汤下；赤痢，乌梅汤下。（本草云∶蜜蜡，主下利脓血，补中。又云∶白蜡，主后重白脓。）
〔葛〕治重下，此即赤白痢。火熬豉令少焦，杵服一合，日三，效无比。又熬豉令焦，水一升，淋取汁，
冷服治淋，日三服，有效。
〔《食》〕治脾胃气虚，下痢久不已，肠滑不进食。用野雉一只，如食法细斫，着陈皮、葱、椒，调和盐
酱，作馄饨熟煮，空心食之。
〔丹〕噤口痢，胃中热甚，大虚大热故也。用人参（二钱）黄连（姜炒，一钱。）浓煎汁，终日细细呷之。
如吐再吃，但一呷下咽，便开。又宜封脐，引热下行，用田螺肉捣碎，罨脐中，入麝香少许。
〔世〕痢疾不纳饮食者，俗谓之噤口痢，以脉症辨之。如脾胃不弱，问而知其头疼心烦，手足温热，未尝
多服凉药者，此乃毒瓦斯上冲心肺，所以呕而不食。宜用败毒散，每服四钱，陈仓米一百粒，姜三片，枣一枚，
水一盏半，煎八分温服。若其脉微弱，或心腹膨胀，手足厥冷，初病则不呕，因服罂粟壳、乌梅苦涩凉药太过，
以致闻食先呕者，此乃脾胃虚弱，用山药一味，锉如小豆大，一半入银瓦铫内炒熟，一半生用，同为末，饭饮
调下。
又方 用石莲槌去壳，留心并肉碾为末，每服二钱，陈米饮调下。此疾盖是毒瓦斯上冲心肺，借此以通心气，便
觉思食，效。
暴注下迫，皆属于热。（全文见诊。）
〔《局》〕香连丸 治下痢赤白，里急后重。
黄连（去芦，二十两，用吴茱萸十两，同炒，令赤，去茱萸不用） 木香（四两八钱，不见火）
上为细末，醋糊丸，如桐子大。每服三十丸，空心饭饮下。
〔钱〕豆蔻香连丸 治泄泻，不问寒热赤白，阴阳不调，腹胀攻痛，可用如神。
黄连（三钱，炒） 肉豆蔻 木香（各一钱）
上为细末，粟米饭丸，米粒大。每服米饮下十丸，至二三十丸，日夜各四五服，食前。
〔杜〕治气痢泻、里急后重神妙方。宣连二两，干姜半两，各为末。每用连二钱，姜半钱，和匀，空心温
酒下。
〔罗〕黄连阿胶丸 治脾胃气冷热不调，下痢赤白，状如鱼脑，里急后重，脐腹疼痛，口燥烦渴，小便不利。
黄连（三两，去须） 茯苓（二两，去皮） 阿胶
上各为末，水调阿胶和药，众手丸如桐子大。每服二十丸，温米饮汤下。
〔仲〕热利下重者，白头翁汤主之。（方见伤寒。）
〔仲〕下痢脓血，里急后重，日夜无度，宜导气汤。
芍药（二钱） 当归（五钱） 大黄 黄芩（各二钱半） 黄连 木香 槟榔（各一钱）
上为细末。每服三钱，水一盏，煎至七分，去渣温服。如未止再服，下后重则止。
〔洁〕大瘕泄者，里急后重，数至圊而不能便，茎中痛，用清凉饮子主之，其泄自止。茎中痛者，属厥阴，
加甘草。里急后重多者，属少阴，加大黄，令急推去旧物，则轻矣。《内经》曰∶因其重而减之。又云∶在下
者，引而竭之。（清凉饮子方见治发热。）
里急后重，数至圊而不得便，皆宜进退大承气汤主之。
进承气法 治太阴症不能食是也。当先补而后泻，乃进药法也。先锉浓朴半两姜制，水一盏，煎至半盏服。
若二三服未已，胃有宿食不消，加枳实二钱，同煎服。二三服泄又未已，如不加食，尚有热毒，又加大黄三钱
推过。泄未止者，为肠胃久有尘垢滑粘，加芒硝半合，垢去尽则安矣。（后重兼无虚症者宜之。若力倦气少，
脉虚不能食者，不宜此法，盖浓朴、枳实大泻元气故也。）
退承气法 治阳明症能食是也。当先泻而后补，乃退药法也。先用大承气五钱，水一盏，根据前法煎至七分，
稍热服。如泻未止，去芒硝，减大黄一半，煎二服。如热气虽已，其人心腹满，又减去大黄，但与枳实浓朴汤，
又煎二三服。如腹胀满退，泄亦自安，后服浓朴汤数服则已。
〔垣〕感应丸 治下痢赤白后重，迟涩。（方见内伤饮食门。）
〔丹〕或曰∶治后重疏通之剂，罗谦甫水煮木香膏、东垣白术安胃散等，方已尽矣。又有用御米壳等固涩
之剂亦可愈，何也？曰∶后重本因邪压大肠坠下，故大肠不能升上而重，是以用大黄、槟榔辈，泻其所压之邪。
今邪已泻，其重仍在者，知大肠虚滑，不能自收而重，是以用御米壳等涩剂，固其滑，收其气，用亦愈也。然
大肠为邪坠下之重，其重至圊后不减；大肠虚滑不收之重，其重至圊后随减，以此辨之，百发百中也。其或下
坠异常，积中有紫黑血，而又痛甚，此为死血症，法当用擂细桃仁、滑石行之。或口渴及大便口燥辣，是名挟
热，即加黄芩。或口不渴，身不热，喜热手熨荡，是名挟寒，即加干姜。
八婶将产患痢，脉细弦而稍数，后重里急。
滑石（三钱，研） 芍药（二钱） 枳壳（炒，钱半） 木通（二钱） 甘草（五分） 白术（二钱） 茯苓（一
钱）
桃仁每帖九枚，研同前。
青田人，肚痢，红紫血，下坠逼迫，不渴不热。
白术 芍药（各一两） 陈皮 枳壳（炒） 归身 滑石（各半两） 甘草（二钱，炙） 桃仁（三十六个）
分八帖，下实肠丸三十粒。
一丈夫因酒多下血，肚疼，后重成痢。
滑石（半两） 连翘 黄芩 木通 芍药 枳壳 白术（各二钱） 甘草（五分） 桃仁（二十一枚） 分四帖服。
后重，积与气坠下，服升消药不愈者，用秦艽、皂角子、煨大黄、当归、桃仁、枳壳、黄连等剂。若大肠
风盛，可作丸服。
自古治里急后重，但用槟榔、木香调气，及大黄下积。至丹溪，始用桃仁、滑石活死血，如鼓应桴，实
发前人之所未发也。
其或下坠在血活之后，此为气滞症，宜前药加槟榔一枚。后重当和气，积与气坠下者，当兼升兼消。（升谓升
麻之类，消谓木香、槟榔之类。）
〔仲〕泄痢下重者，以水五升，煮薤白三升，至二升，去渣，以四逆散方寸匕内汤中，煮取一升半，分温
再服。（东垣云∶薤白泄滞气。）
〔《食》〕主赤白痢下。薤白一握，切煮作粥食。
〔丹〕其或气行、血和、积少，但虚坐努责，此为亡血症。倍用当归身、尾，却以生地黄、生芍药、生桃
仁佐之，复以陈皮和之，血生自安。
〔垣〕虚坐而不得大便，皆因血虚也，血虚则里急，加当归身。凡后重逼迫而得大便者，为有物而然，今
虚坐努责而不得大便，知其血虚也，故用当归为君，生血药佐之。
凡诸用承气等药推积之后，仍后重者，乃阳不升也，药中当加升麻，升其阳其重自去也。
〔垣〕升阳除湿防风汤，治里急后重，数至圊而不能便，或少有白脓，或少血者，慎勿利之。（升阳除湿防风汤
方见下血。）
〔丹〕其或在下则缠滞，在上则呕食，此为毒积未化，胃气未平症。当认其寒则温之，热则清之，虚则用
参、术补之，毒解积下，食自进矣。
治痢方 苍术 白术 茯苓 当归 白芍药 青皮 生地 黄连 滑石 甘草
作一服，水煎。里急后重，加黄连、滑石、桃仁、槟榔。甚者，大黄。呕者，加半夏、姜汁。
〔世〕仲景建中汤 治痢不分赤白久新，但腹中大痛者，神效。其脉弦急，或涩浮大，按之空虚，或举按皆
无力者，亦效。（方见伤寒。）
〔丹〕娄长官，年三十余，奉养浓，夏秋间患滞下，腹大痛。有人教服单煮干姜，与一帖痛定。少顷痛作，
又与又定，由是服干姜三斤。八日后，召予视之，左脉弦大似数，右脉弦而大稍减，亦似数，重取之似紧。予
曰∶此必醉饱后吃寒凉太过，当作虚寒治之。因其多服干姜，遂教与四物汤去地黄加人参、白术、陈皮、酒红
花、茯苓、桃仁，煎生姜汁饮之，一月而安。（丹溪云∶下痢腹痛，用姜、桂温散之法，乃干姜并建中汤加桂
是也。）
〔《圣》〕治冷痢，腹中不能食。肉豆蔻一两，去皮，以醋面裹煨热捣，非时粥饮下二钱匕。
上下痢腹痛，必温散而愈者，盖本于《内经》所谓寒气客于小肠，小肠不得成聚，故腹痛后泄；及所谓
太阳病冬日感寒即泄，当脐而痛之病也。
【《大》】治疗产后遗尿。取旧燕巢中的草烧成灰，研细，用酒调服五分。男子患此病也可用此方。
又一方：白矾（枯矾）、牡蛎。
将以上两味药等分研为末。每次用酒送服一方寸匕，每日三次。男女同治。
【华】病人卧床时，遗屎而不自知者，属死证。
【丹】痢疾初起时，一两天内，以通利大便为法，若有热象先退热。有后重感的，应当行气，用木香、槟榔。腹痛的，用温散药，如姜、桂之类。便血的，当凉血、和血，用当归、桃仁之类。下痢伴身痛、发热恶寒、头身俱痛，这是表证，宜微汗和解，用苍术、川芎、陈皮、芍药、甘草，加生姜三片煎服。下痢身发热的，兼有外感，用小柴胡汤去人参。下痢发热，久不止的，属阴虚，用寒凉药，必须兼用升散药，并配合热性药使用。下痢初起发热，必用大承气汤，攻下后再根据症状用药。发热不恶寒，脉洪大的，宜用大承气汤。若恶寒的，忌用攻下法。下痢腹痛后重，小便短少，下有积滞，此为里证，宜和中疏气，用陈皮、芍药、滑石、枳壳、厚朴之类。
【洁】芍药汤，治疗便血以调气。《内经》说：“小便与大便脓血，知道气行则血止。”行血则大便自安，调气则后重自除。
芍药（一两）、当归、黄连（各半两）、槟榔、木香（各二钱）、甘草（炙，一钱）、大黄（三钱）、黄芩（五钱）、桂枝（二钱半）。
以上为粗末。每次服用半两，加水两盏，煎至一盏，饭后温服。如果血在便前，则逐渐加大黄用量。如果是清厕后脏毒，加黄柏半两，同煎服。
【丹】一位老人，七十岁，面色白，脉弦数，唯独胃脉沉滑，因饮白酒导致痢疾，下血淡如水混脓，腹痛，小便不利，里急后重。以人参、白术为君药；甘草、滑石、槟榔、木香、苍术为佐药；同时服用保和丸二十五丸。第二天前述症状均减轻，唯独小便仍不利，服用益元散后痊愈。
【河】益元散，治疗身体发热，下痢赤白，小便不利，清除胃中积聚。（方剂见泄泻章节。）
【丹】痢疾初得之，必用调胃承气汤及大小承气汤，实证用此攻下。娄姓男子，五十多岁，下痢，白天有淡红色积滞，夜间无积滞，饮食正常。先吃小胃丹两服，再给四十丸，接着六十丸，去除积滞后，再用止痢药。
【罗】玄青丸，治疗下痢势态恶劣，频繁窘迫疼痛，或久不愈，诸药不能止住，须用吐下法，以开除泻热，痞闷积滞，使气液宣通运行，宜用此药驱逐。兼能宣利积热，酒食积滞，黄瘦中满，水气肿，腹胀。兼疗小儿惊疳、积热、乳癖诸症。
黄连、黄柏、大黄、甘遂、芫花（醋拌，炒）、大戟（各五钱）、轻粉（二钱）、青黛（一两）、牵牛子（四两，取头末，二两）。
以上研匀为末，水泛为丸，如梧桐子大。初服十丸，每服增加十丸，空腹、日中、临卧三次服用，以大便通畅为度。之后常服十五丸，数日后，借助食物之力。如果痢疾尚未痊愈，再加量取利。利后却常服，酌情增减，病去为止，随后随症状停药。小儿丸如黍米大，退惊疳积热，不需攻下的，常服十丸。
【《玄》】利积丸
黄连（四两）、天水末（八两，即滑石）、当归（二两）、乳香（一两）、萝卜子（炒，四两）、巴豆（一两，去油，同黄连一处炒）。
以上为末，醋糊丸，如梧桐子大。体弱者十五丸，体实者二十五丸。治疗下痢赤白，腹满胀痛里急，上渴引饮，小便赤涩，此为积滞。宜泄其热，中间用清肠丸、导气丸推其积滞，则痢自无。凡治疗积聚之症，轻则温而利之，清肠丸是也。重者用天真散、舟车丸攻下。攻下后，切勿立即进补，如果感到力倦，自觉气少恶食，此为挟虚症，宜加白术、当归身、尾；甚者，加人参。如果又十分重的，只用此药，加陈皮补之，虚回而痢自止矣。
我的族叔，年近六十，夏季患滞下病，腹部微痛，所下褐色，后重频繁，饮食大减，时有微热。察其脉皆弦而涩，似数稍长，但喜不甚浮大，两手相等。视其神气大减。我说：这不是滞下，乃忧虑所致，心血亏，脾气弱也。给予人参、白术为君药；当归身、陈皮为臣药；川芎、炒白芍、茯苓为佐使药，如有热加黄连为使药，服用两个月而安。
金氏妇，年近四十，秋初尚热，患滞下，腹部仅隐痛，夜间重于白天，完全不得睡，饮食亦稍减，口干但不欲饮，已服治痢灵砂两帖了。我看她，两手脉等涩且不匀，神思倦甚，饮食全减。因此给予四物汤，倍加白术，以陈皮佐之，数帖而安。
义侄，患疟疾间日作，兼痢，脉虚甚，身痛。宜活血补胃，待虚稍回，却又推积。
人参（五分）、白术（一钱半）、苍术、陈皮（各一钱）、白芍药（炒，五分）、川芎（五分）、滑石（炒一钱）、甘草（炙，少许）、桃仁（研，七分）。
药后病退，惟脉少弦、身倦，用此方调补。
人参（九分）、苍术（三钱）、半夏（九分）、川芎（一钱）、陈皮（一钱）、木通（二钱半）、甘草（少许）。
煎服三分之一饮之，可淡粥少少塞饥，又静坐养之。
叶先生患滞下，后重逼迫，正合承气症。但气口虚，形虽实而面黄积白。这必定是平时吃得过饱而胃受伤，宁可忍受二三日辛苦。于是给予人参、白术、陈皮、芍药等补药十余帖。至三日后，胃气稍复，给予承气汤二帖而安。如果不先补完胃气之伤，而遽行承气，恐怕病安之后，岂免瘦惫乎。
【世】治痢，烟蜡丸
黄蜡不拘多少，用银篦挑于真香油灯上烧熏，落下水碗内，凡如此者七次，为丸如萝卜子大，每二十丸。
白痢，甘草汤下；赤痢，乌梅汤下。（本草云：蜜蜡，主下利脓血，补中。又云：白蜡，主后重白脓。）
【葛】治重下，此即赤白痢。火熬豉令少焦，杵服一合，日三，效无比。又熬豉令焦，水一升，淋取汁，冷服治淋，日三服，有效。
【《食》】治疗脾胃气虚，下痢久不已，肠滑不进食。用野雉一只，如食法细斫，着陈皮、葱、椒，调和盐酱，作馄饨熟煮，空心食之。
【丹】噤口痢，胃中热甚，大虚大热故也。用人参（二钱）黄连（姜炒，一钱），浓煎汁，终日细细呷之。如吐再吃，但一呷下咽，便开。又宜封脐，引热下行，用田螺肉捣碎，罨脐中，入麝香少许。
【世】痢疾不纳饮食者，俗谓之噤口痢，以脉症辨之。如脾胃不弱，问而知其头疼心烦，手足温热，未尝多服凉药者，此乃毒瓦斯上冲心肺，所以呕而不食。宜用败毒散，每服四钱，陈仓米一百粒，姜三片，枣一枚，水一盏半，煎八分温服。若其脉微弱，或心腹膨胀，手足厥冷，初病则不呕，因服罂粟壳、乌梅苦涩凉药太过，以致闻食先呕者，此乃脾胃虚弱，用山药一味，锉如小豆大，一半入银瓦铫内炒熟，一半生用，同为末，饭饮调下。
又方：用石莲槌去壳，留心并肉碾为末，每服二钱，陈米饮调下。此疾盖是毒瓦斯上冲心肺，借此以通心气，便觉思食，效。
暴注下迫，皆属于热。（全文见诊法章节。）
【《局》】香连丸，治疗下痢赤白，里急后重。
黄连（去芦，二十两，用吴茱萸十两，同炒，令赤，去茱萸不用）、木香（四两八钱，不见火）。
以上为细末，醋糊丸，如梧桐子大。每次服用三十丸，空腹饭饮下。
【钱】豆蔻香连丸，治疗泄泻，不问寒热赤白，阴阳不调，腹胀攻痛，可用如神。
黄连（三钱，炒）、肉豆蔻、木香（各一钱）。
以上为细末，粟米饭丸，米粒大。每次服用米饮下十丸，至二三十丸，日夜各四五服，食前。
【杜】治疗气痢泻、里急后重神妙方。宣连二两，干姜半两，各为末。每用连二钱，姜半钱，和匀，空腹温酒下。
【罗】黄连阿胶丸，治疗脾胃气冷热不调，下痢赤白，状如鱼脑，里急后重，脐腹疼痛，口燥烦渴，小便不利。
黄连（三两，去须）、茯苓（二两，去皮）、阿胶。
以上各为末，水调阿胶和药，众手丸如梧桐子大。每次服用二十丸，温米饮汤下。
【仲】热利下重者，白头翁汤主之。（方剂见伤寒章节。）
【仲】下痢脓血，里急后重，日夜无度，宜导气汤。
芍药（二钱）、当归（五钱）、大黄、黄芩（各二钱半）、黄连、木香、槟榔（各一钱）。
以上为细末。每次服用三钱，水一盏，煎至七分，去渣温服。如果未止再服，下后重则止。
【洁】大瘕泄者，里急后重，数至圊而不能便，茎中痛，用清凉饮子主之，其泄自止。茎中痛者，属厥阴，加甘草。里急后重多者，属少阴，加大黄，令急推去旧物，则轻矣。《内经》曰：因其重而减之。又云：在下者，引而竭之。（清凉饮子方见治发热章节。）
里急后重，数至圊而不得便，皆宜进退大承气汤主之。
进承气法：治疗太阴症不能食是也。当先补而后泻，乃进药法也。先锉厚朴半两姜制，水一盏，煎至半盏服。如果二三服未已，胃有宿食不消，加枳实二钱，同煎服。二三服泄又未已，如不加食，尚有热毒，又加大黄三钱推过。泄未止者，为肠胃久有尘垢滑粘，加芒硝半合，垢去尽则安矣。（后重兼无虚症者宜之。若力倦气少，脉虚不能食者，不宜此法，盖厚朴、枳实大泻元气故也。）
退承气法：治疗阳明症能食是也。当先泻而后补，乃退药法也。先用大承气五钱，水一盏，根据前法煎至七分，稍热服。如泻未止，去芒硝，减大黄一半，煎二服。如热气虽已，其人心腹满，又减去大黄，但与枳实厚朴汤，又煎二三服。如腹胀满退，泄亦自安，后服厚朴汤数服则已。
【垣】感应丸，治疗下痢赤白后重，迟涩。（方剂见内伤饮食门。）
【丹】有人说：治疗后重疏通之剂，罗谦甫水煮木香膏、东垣白术安胃散等，方已尽矣。又有用御米壳等固涩之剂亦可愈，何也？回答说：后重本因邪压大肠坠下，故大肠不能升上而重，是以用大黄、槟榔辈，泻其所压之邪。今邪已泻，其重仍在者，知大肠虚滑，不能自收而重，是以用御米壳等涩剂，固其滑，收其气，用亦愈也。然大肠为邪坠下之重，其重至圊后不减；大肠虚滑不收之重，其重至圊后随减，以此辨之，百发百中也。其或下坠异常，积中有紫黑血，而又痛甚，此为死血症，法当用擂细桃仁、滑石行之。或口渴及大便口燥辣，是名挟热，即加黄芩。或口不渴，身不热，喜热手熨荡，是名挟寒，即加干姜。
八婶将产患痢，脉细弦而稍数，后重里急。
滑石（三钱，研）、芍药（二钱）、枳壳（炒，钱半）、木通（二钱）、甘草（五分）、白术（二钱）、茯苓（一钱）。
桃仁每帖九枚，研同前。
青田人，肚痢，红紫血，下坠逼迫，不渴不热。
白术、芍药（各一两）、陈皮、枳壳（炒）、归身、滑石（各半两）、甘草（二钱，炙）、桃仁（三十六个）。
分八帖，下实肠丸三十粒。
一丈夫因酒多下血，肚疼，后重成痢。
滑石（半两）、连翘、黄芩、木通、芍药、枳壳、白术（各二钱）、甘草（五分）、桃仁（二十一枚）。分四帖服。
后重，积与气坠下，服升消药不愈者，用秦艽、皂角子、煨大黄、当归、桃仁、枳壳、黄连等剂。若大肠风盛，可作丸服。
自古治里急后重，但用槟榔、木香调气，及大黄下积。至丹溪，始用桃仁、滑石活死血，如鼓应桴，实发前人之所未发也。
其或下坠在血活之后，此为气滞症，宜前药加槟榔一枚。后重当和气，积与气坠下者，当兼升兼消。（升谓升麻之类，消谓木香、槟榔之类。）
【仲】泄痢下重者，以水五升，煮薤白三升，至二升，去渣，以四逆散方寸匕内汤中，煮取一升半，分温再服。（东垣云：薤白泄滞气。）
【《食》】主赤白痢下。薤白一握，切煮作粥食。
【丹】其或气行、血和、积少，但虚坐努责，此为亡血症。倍用当归身、尾，却以生地黄、生芍药、生桃仁佐之，复以陈皮和之，血生自安。
【垣】虚坐而不得大便，皆因血虚也，血虚则里急，加当归身。凡后重逼迫而得大便者，为有物而然，今虚坐努责而不得大便，知其血虚也，故用当归为君，生血药佐之。
凡诸用承气等药推积之后，仍后重者，乃阳不升也，药中当加升麻，升其阳其重自去也。
【垣】升阳除湿防风汤，治疗里急后重，数至圊而不能便，或少有白脓，或少血者，慎勿利之。（升阳除湿防风汤方见下血章节。）
【丹】其或在下则缠滞，在上则呕食，此为毒积未化，胃气未平症。当认其寒则温之，热则清之，虚则用参、术补之，毒解积下，食自进矣。
治痢方：苍术、白术、茯苓、当归、白芍药、青皮、生地、黄连、滑石、甘草。
作一服，水煎。里急后重，加黄连、滑石、桃仁、槟榔。甚者，大黄。呕者，加半夏、姜汁。
【世】仲景建中汤，治疗痢不分赤白久新，但腹中大痛者，神效。其脉弦急，或涩浮大，按之空虚，或举按皆无力者，亦效。（方剂见伤寒章节。）
【丹】娄长官，年三十余，奉养浓，夏秋间患滞下，腹大痛。有人教服单煮干姜，与一帖痛定。少顷痛作，又与又定，由是服干姜三斤。八日后，召予视之，左脉弦大似数，右脉弦而大稍减，亦似数，重取之似紧。我说：这必定是醉饱后吃寒凉太过，当作虚寒治之。因其多服干姜，遂教与四物汤去地黄加人参、白术、陈皮、酒红花、茯苓、桃仁，煎生姜汁饮之，一月而安。（丹溪云：下痢腹痛，用姜、桂温散之法，乃干姜并建中汤加桂是也。）
【《圣》】治疗冷痢，腹中不能食。肉豆蔻一两，去皮，以醋面裹煨热捣，非时粥饮下二钱匕。
上下痢腹痛，必温散而愈者，盖本于《内经》所谓寒气客于小肠，小肠不得成聚，故腹痛后泄；及所谓太阳病冬日感寒即泄，当脐而痛之病也。
[Da] Treats postpartum enuresis. Take grass from an old swallow's nest, burn it to ash, grind finely, and take 5 fen with wine. This method is also effective for men.
Another prescription: Alum (calcined) and Oyster Shell.
Grind the above two ingredients into powder in equal parts. Take one fangcun bi (a measure approx. 2-3 grams) with wine, three times a day. Applicable to both men and women.
[Hua] If a patient defecates involuntarily while lying down without awareness, it is a fatal condition.
[Dan] When dysentery first occurs, within one or two days, the treatment principle is to promote bowel movement. If there is heat, clear the heat first. For tenesmus, regulate qi using Costus Root (Muxiang) and Areca Seed (Binglang). For abdominal pain, use warming and dispersing herbs such as Ginger (Jiang) and Cinnamon Twig (Gui). For bloody stool, cool the blood and harmonize blood using Angelica Sinensis (Danggui) and Peach Kernel (Taoren). If accompanied by body pain, fever, aversion to cold, and headache/body ache, this is a exterior syndrome; induce mild sweating to harmonize, using Atractodes Rhizome (Cangzhu), Ligusticum Rhizome (Chuanxiong), Tangerine Peel (Chenpi), Peony Root (Shaoyao), Licorice Root (Gancao), and three slices of Fresh Ginger (Shengjiang) decocted. If fever accompanies dysentery due to external contraction, use Xiao Chai Hu Tang minus Ginseng. If fever persists for a long time, it belongs to yin deficiency; use cooling herbs combined with ascending and dispersing herbs, along with warm-natured medicines. For initial fever in dysentery, Da Cheng Qi Tang must be used; after purgation, adjust medication based on symptoms. If fever without aversion to cold and a surging pulse, Da Cheng Qi Tang is indicated. If aversion to cold exists, purgation is contraindicated. For abdominal pain, tenesmus, scanty urine, and fecal accumulation, this is an interior syndrome; harmonize the middle and soothe qi using Chenpi, Shaoyao, Talcum (Huashi), Aurantium Fructus (Zhike), and Magnolia Bark (Houpo).
[Jie] Shaoyao Tang treats bloody stool by regulating qi. The Classic states: "When urine and stool contain pus and blood, knowing that qi movement stops bleeding." Moving blood stabilizes the stool; regulating qi eliminates tenesmus.
Peony Root (Shaoyao, 1 liang), Angelica Sinensis (Danggui), Coptis Rhizome (Huanglian, each 0.5 liang), Areca Seed (Binglang), Costus Root (Muxiang, each 2 qian), Roasted Licorice Root (Zhi Gancao, 1 qian), Rhubarb (Dahuang, 3 qian), Scutellaria Root (Huangqin, 5 liang), Cinnamon Twig (Gui, 2.5 qian).
Grind into coarse powder. Take 0.5 liang per dose, add two zhan of water, decoct to one zhan, and take warm after meals. If blood precedes stool, gradually increase Dahuang. For anal toxicity after defecation, add Phellodendron Bark (Huangbai, 0.5 liang) and decoct together.
[Dan] An elderly man, seventy years old, pale complexion, wiry and rapid pulse, but only the stomach pulse was deep and slippery. He developed dysentery from drinking white wine, presenting with bloody stool mixed with watery pus, abdominal pain, difficult urination, tenesmus, and urgency. Use Ren Shen (Ginseng) and Bai Zhu (Atractodes Macrocephala Rhizome) as sovereign drugs; Gan Cao (Licorice), Hu Shi (Talcum), Bing Lang (Areca Seed), Mu Xiang (Costus Root), Cang Zhu (Atractodes Rhizome) as minister/assistant drugs; simultaneously administer Bao He Wan (Preserve Harmony Pill) 25 pills. The next day, previous symptoms decreased, except for difficult urination, which resolved after taking Yi Yuan San (Benefit Element Powder).
[He] Yi Yuan San (Benefit Element Powder) treats body fever, dysentery with red and white discharge, difficult urination, and clears gastric accumulations. (Formula see Diarrhea section.)
[Dan] At the onset of dysentery, Tiao Wei Cheng Qi Tang (Regulate the Stomach Major Order the Qi Decoction) and Da/Xiao Cheng Qi Tangs are necessary for excess patterns. Mr. Lou, over fifty, had dysentery with light red residue during the day and none at night, with normal appetite. First, take Xiao Wei Dan (Small Stomach Pill) twice, then 40 pills, then 60 pills to remove accumulation, followed by anti-dysentery medication.
[Luo] Xuan Qing Wan (Black Green Pill) treats severe dysentery with frequent distress and pain, or chronic cases unresponsive to other drugs. It uses emetic and purgative methods to expel heat, relieve stagnation, and promote qi/fluid circulation. It also clears accumulated heat, food/wine stagnation, jaundice with fullness, edema, and abdominal distension. It treats pediatric convulsive malnutrition, accumulated heat, and breast masses.
Coptis Rhizome (Huanglian), Phellodendron Bark (Huangbai), Rhubarb (Dahuang), Kansui Root (Gansui), Genkwa Flower (Yuanhua - vinegar stir-fried), Great Euphorbia Root (Daji, each 5 qian), Calomel (Qingfen, 2 qian), Indigo Naturalis (Qingdai, 1 liang), Morning Glory Seed (Qianniu, 4 liang, take the finest powder, 2 liang).
Grind uniformly, make water pills size of Sesame seeds. Start with 10 pills, increasing by 10 per dose. Take three times daily (fasting, noon, bedtime) until loose stools occur. Maintain with 15 pills. After several days, rely on dietary strength. If not cured, increase dosage to induce purgation. After purgation, continue maintenance, adjusting according to condition until disease resolves, then stop based on symptoms. For children, make pills size of Millet seeds. For convulsive malnutrition and accumulated heat without need for purgation, take 10 pills regularly.
[Xuan] Li Ji Wan (Remove Accumulation Pill)
Coptis Rhizome (Huanglian, 4 liang), Tianshui Mo (Talcum/Huashi, 8 liang), Angelica Sinensis (Danggui, 2 liang), Frankincense (Ruxiang, 1 liang), Radish Seed (Luobozi - fried, 4 liang), Croton Seed (Badou, 1 liang, oil removed, fried with Huanglian).
Grind to powder, make pills with vinegar paste size of Loranthus Fruit. Weak patients: 15 pills; Strong patients: 25 pills. Treats dysentery with red/white discharge, abdominal fullness/pain/urgency, thirst with desire to drink, and scanty dark urine, indicating accumulation. Clear heat, use Qing Chang Wan (Clear Intestine Pill) and Dao Qi Wan (Guide Qi Pill) to push out accumulation, curing dysentery. For accumulation diseases, mild cases use warming and promoting methods (Qing Chang Wan); severe cases use Tian Zhen San or Zhou Che Wan for purgation. After purgation, do not tonify immediately. If fatigue, shortness of breath, and anorexia occur (deficiency pattern), add Bai Zhu (Atractodes Macrocephala Rhizome) and Dang Gui Shen/Wei (Angelica Sinensis root/shoot); severely, add Ren Shen (Ginseng). If extremely severe, use this formula alone plus Chen Pi (Tangerine Peel) to tonify; once deficiency recovers, dysentery stops.
My clan uncle, nearly sixty, suffered from dysentery in summer with slight abdominal pain, brown discharge, frequent tenesmus, poor appetite, and occasional low-grade fever. Pulses were wiry and choppy, slightly rapid and long, not floating/large, equal in both hands. Spirit was greatly diminished. I said: This is not simple dysentery, but caused by worry, leading to Heart Blood deficiency and Spleen Qi weakness. Prescribe Ren Shen (Ginseng) and Bai Zhu (Atractodes Macrocephala Rhizome) as sovereign; Dang Gui Shen (Angelica Sinensis root) and Chen Pi (Tangerine Peel) as minister; Chuan Xiong (Ligusticum Rhizome), Fried Shaoyao (Peony Root), and Fu Ling (Poria) as assistant/envoy. Add Huanglian (Coptis) if heat present. Took for two months and recovered.
Mrs. Jin, nearly forty, early autumn heat, suffered from dysentery with dull abdominal pain, worse at night, insomnia, reduced appetite, dry mouth without desire to drink. Already took Ling Sha (Spirit Sand) for dysentery for two doses. Pulses were choppy and uneven, spirit exhausted, appetite lost. Prescribed Si Wu Tang (Four Substances Decoction) with doubled Bai Zhu (Atractodes Macrocephala Rhizome) assisted by Chen Pi (Tangerine Peel). Recovered after several doses.
Nephew Yi, suffered from intermittent malaria with dysentery, very deficient pulse, body pain. Promote blood circulation and tonify stomach. Wait for slight recovery, then remove accumulation.
Ren Shen (Ginseng, 5 fen), Bai Zhu (Atractodes Macrocephala Rhizome, 1.5 qian), Cang Zhu (Atractodes Rhizome), Chen Pi (Tangerine Peel, each 1 qian), Fried Shaoyao (Peony Root, 5 fen), Chuan Xiong (Ligusticum Rhizome, 5 fen), Fried Huashi (Talcum, 1 qian), Zhi Gancao (Roasted Licorice, little), Taoren (Peach Kernel, ground, 7 fen).
After medicine, illness receded, but pulse slightly wiry and fatigue remained. Use this formula for regulation and tonification.
Ren Shen (Ginseng, 9 fen), Cang Zhu (Atractodes Rhizome, 3 qian), Ban Xia (Pinellia Tuber, 9 fen), Chuan Xiong (Ligusticum Rhizome, 1 qian), Chen Pi (Tangerine Peel, 1 qian), Mu Tong (Akebia Stem, 2.5 qian), Gancao (Licorice, little).
Decoct, drink one-third. Eat small amounts of thin porridge to alleviate hunger, rest quietly.
Mr. Ye suffered from dysentery with severe tenesmus, fitting Cheng Qi pattern. However, Qi Kou (Radial Artery) was deficient; though physique seemed solid, face was yellow with white patches. Likely caused by overeating damaging the stomach. Endure hardship for 2-3 days. Prescribed tonics like Ren Shen (Ginseng), Bai Zhu (Atractodes Macrocephala Rhizome), Chen Pi (Tangerine Peel), and Shaoyao (Peony Root) for over ten doses. After three days, Stomach Qi recovered slightly, then gave Cheng Qi Decoction for two doses, resulting in recovery. Without first repairing Stomach Qi injury before using Cheng Qi, the patient might become emaciated and exhausted after recovery.
[Shi] Yan La Wan (Smoke Wax Pill) for dysentery.
Yellow Wax (Huang La) any amount. Melt using silver tweezers over pure sesame oil lamp, dripping into water bowl. Repeat seven times. Make pills size of Radish seeds, 20 pills per dose.
For white dysentery, take with Licorice Decoction; for red dysentery, take with Sour Plum Decoction. (Ben Cao states: Beeswax treats dysenteric pus/blood and tonifies middle. White wax treats tenesmus with white pus.)
[Ge] Treats heavy tenesmus (red/white dysentery). Roast Fermented Soybean (Chi) until slightly charred, pound, take one he, three times daily, extremely effective. Alternatively, roast Chi until charred, add one sheng of water, strain juice, take cold, three times daily, effective for strangury.
[Shi] Treats spleen/stomach qi deficiency with chronic dysentery, intestinal slipping, and anorexia. Use one wild pheasant, chop finely, add Chen Pi (Tangerine Peel), Scallion, Pepper, salt, and soy sauce. Make wontons, boil thoroughly, eat on empty stomach.
[Dan] Jin Kou Li (Jaw-Closed Dysentery) is due to extreme heat in the stomach, representing great deficiency and great heat. Use Ren Shen (Ginseng, 2 qian) and Huanglian (Coptis, stir-fried with Ginger, 1 qian). Decoct strongly, sip slowly throughout the day. If vomiting occurs, take again. Once swallowed, appetite opens. Also apply umbilical seal to guide heat downward: mash Field Snail Meat (Tianluo Rou), apply to umbilicus, add little Shexiang (Musk).
[Shi] Dysentery with inability to eat is commonly called Jin Kou Li. Differentiate by pulse and symptoms. If spleen/stomach is not weak, and patient has headache, irritability, warm hands/feet, and hasn't taken much cooling medicine, this is toxic gas rushing to Heart/Lungs causing vomiting/anorexia. Use Bai Du San (Eliminate Toxin Powder), 4 qian per dose, with 100 grains of aged rice, 3 slices Ginger, 1 Jujube, 1.5 zhan water, decoct to 0.8 zhan, take warm. If pulse is weak/faint, or abdominal distension/cold limbs exist, and initially no vomiting but now vomits upon smelling food due to excessive use of Poppy Shell (Yingsuke) and Sour Plum (Wumei) cooling/astringent drugs, this is spleen/stomach deficiency. Use Shan Yao (Chinese Yam) alone, cut size of mung bean, half roasted in silver pot, half raw, grind to powder, take with rice water.
Another prescription: Remove shell from Shi Lian (Stone Lotus), keep heart and flesh, grind to powder. Take 2 qian with aged rice water. This disease is toxic gas rushing to Heart/Lungs; this herb opens Heart Qi, stimulating appetite. Effective.
Sudden violent diarrhea with urgent pressing sensation all belong to heat. (Full text see Diagnosis section.)
[Jú] Xiang Lian Wan (Costus-Coptis Pill) treats dysentery with red/white discharge and tenesmus.
Huanglian (Coptis, remove rhizome, 20 liang, stir-fried with 10 liang Evodia Fruit (Wuzhuyu) until red, discard Wuzhuyu), Muxiang (Costus Root, 4.8 liang, avoid fire).
Grind to fine powder, make pills with vinegar paste size of Loranthus Fruit. Take 30 pills fasting with rice water.
[Qian] Doukou Xiang Lian Wan treats diarrhea regardless of cold/heat/red/white, yin/yang imbalance, abdominal distension/pain. Extremely effective.
Huanglian (Coptis, fried, 3 qian), Rou Doukou (Nutmeg), Muxiang (Costus Root, each 1 qian).
Grind to fine powder, make pills with millet rice size of millet grain. Take 10-30 pills with rice water, 4-5 times day and night before meals.
[Du] Divine Prescription for Qi Dysentery/Diarrhea with Tenesmus. Xuanlian (Coptis, 2 liang), Gan Jiang (Dried Ginger, 0.5 liang), grind separately. Take 2 qian Lian and 0.5 qian Jiang, mix well, take with warm wine fasting.
[Luo] Huanglian Ejiao Wan (Coptis-Agaric Pill) treats spleen/stomach cold/heat imbalance, dysentery with red/white discharge resembling fish brain, tenesmus, umbilical/abdominal pain, dry mouth/thirst, difficult urination.
Huanglian (Coptis, remove roots, 3 liang), Fuling (Poria, peel, 2 liang), Ejiao (Donkey-hide Gelatin).
Grind separately, dissolve Ejiao in water, mix with powders, roll into pills size of Loranthus Fruit. Take 20 pills with warm rice water.
[Zhong] For heat dysentery with tenesmus, Baitouweng Tang (Pulsatilla Decoction) is primary. (Formula see Shanghan section.)
[Zhong] For dysentery with pus/blood, tenesmus, day and night without limit, Dao Qi Tang (Guide Qi Decoction) is suitable.
Shaoyao (Peony Root, 2 qian), Danggui (Angelica Sinensis, 5 liang), Dahuang (Rhubarb), Huangqin (Scutellaria Root, each 2.5 qian), Huanglian (Coptis), Muxiang (Costus Root), Binglang (Areca Seed, each 1 qian).
Grind to fine powder. Take 3 qian, add 1 zhan water, decoct to 0.7 zhan, strain, take warm. If not stopped, take again. Tenesmus stops after purgation.
[Jie] Da Xia Xie (Major Mass Diarrhea) presents with tenesmus, frequent visits to toilet unable to pass stool, penile pain. Qing Liang Yin Zi (Cooling Drink) stops diarrhea. Penile pain indicates Jueyin channel, add Gancao (Licorice). Severe tenesmus indicates Shaoyin channel, add Dahuang (Rhubarb) to urgently push out old matter, relieving severity. Neijing states: Reduce heaviness by subtracting. Also: For lower conditions, drain completely. (Qing Liang Yin Zi formula see Fever Treatment section.)
For tenesmus, frequent visits unable to pass stool, Jin Tui Da Cheng Qi Tang (Advance-Retreat Major Order the Qi Decoction) is suitable.
Advance Cheng Qi Method: Treats Taiyin syndrome with inability to eat. Tonify first, then purge. Slice Houpo (Magnolia Bark, 0.5 liang), ginger-processed, decoct in 1 zhan water to 0.5 zhan. If 2-3 doses fail and food stagnation remains, add Zhishi (Aurantium Fructus, 2 qian), decoct together. If diarrhea continues after 2-3 doses and no food intake, heat toxin remains, add Dahuang (Rhubarb, 3 qian) to push further. If diarrhea persists due to long-term intestinal sludge, add Mangxiao (Mirabilite, 0.5 he). Once sludge is gone, recover. (Suitable for tenesmus without deficiency. Not suitable for fatigue, shortness of breath, deficient pulse, inability to eat, as Houpo/Zhishi greatly deplete yuan qi.)
Retreat Cheng Qi Method: Treats Yangming syndrome with ability to eat. Purge first, then tonify. Use Da Cheng Qi (5 qian), 1 zhan water, decoct to 0.7 zhan, take slightly warm. If diarrhea continues, remove Mangxiao, reduce Dahuang by half, decoct for two doses. If heat clears but abdominal fullness remains, reduce Dahuang further, use only Zhishi/Houpo Tang, decoct 2-3 doses. If fullness subsides and diarrhea settles, finish with Houpo Tang.
[Yuan] Gan Ying Wan (Induction Pill) treats dysentery with red/white discharge, tenesmus, sluggishness. (Formula see Internal Injury/Dietary Stagnation section.)
[Dan] Question: Treatments for tenesmus include Luo Qianfu's Shui Zhu Mu Xiang Gao and Dongyuan's Bai Zhu An Wei San. Are there others? Answer: Tenesmus is originally caused by pathogen pressing down the Large Intestine, preventing it from rising, causing heaviness. Thus, Dahuang/Binglang are used to purge the pressed pathogen. If pathogen is purged but heaviness remains, it indicates Large Intestine deficiency/slippage, unable to contract. Thus, Yumi Ke (Pericarpium Papaveris Rubae) and similar astringents are used to secure slippage and gather qi, also effective. However, heaviness from pathogen pressing does not decrease after defecation; heaviness from deficiency/slippage decreases after defecation. Distinguishing by this ensures accuracy. If abnormal prolapse with purple/black blood in stool and severe pain, this is Dead Blood Syndrome; use ground Taoren (Peach Kernel) and Huashi (Talcum) to move blood. If thirsty and anus burns, it is Heat Clinging, add Huangqin (Scutellaria Root). If not thirsty, body not hot, prefers warm compress, it is Cold Clinging, add Gan Jiang (Dried Ginger).
Aunt Ba, near childbirth, suffered dysentery with fine/wiry/slightly rapid pulse, tenesmus/urgency.
Huashi (Talcum, ground, 3 qian), Shaoyao (Peony Root, 2 qian), Zhike (Aurantium Fructus, fried, 1.5 qian), Mutong (Akebia Stem, 2 qian), Gancao (Licorice, 5 fen), Baizhu (Atractodes Macrocephala Rhizome, 2 qian), Fuling (Poria, 1 qian).
Taoren (Peach Kernel, 9 kernels per dose, ground together).
Person from Qingtian, abdominal dysentery with red/purple blood, oppressive prolapse, no thirst/heat.
Baizhu (Atractodes Macrocephala Rhizome), Shaoyao (Peony Root, each 1 liang), Chenpi (Tangerine Peel), Zhike (Aurantium Fructus, fried), Guishen (Angelica Sinensis root), Huashi (Talcum, each 0.5 liang), Gancao (Licorice, roasted, 2 qian), Taoren (Peach Kernel, 36 kernels).
Divide into 8 doses, take 30 Shichang Wan (Solidify Intestine Pills) with each.
A husband suffered bloody stool, abdominal pain, and tenesmus/dysentery from excessive alcohol.
Huashi (Talcum, 0.5 liang), Lianqiao (Forsythia Fruit), Huangqin (Scutellaria Root), Mutong (Akebia Stem), Shaoyao (Peony Root), Zhike (Aurantium Fructus), Baizhu (Atractodes Macrocephala Rhizome, each 2 qian), Gancao (Licorice, 5 fen), Taoren (Peach Kernel, 21 kernels). Divide into 4 doses.
For tenesmus where accumulation/qi prolapses and ascending/dispersing drugs fail, use Qinjiao (Gentiana Macrophylla Rhizome), Zaojiaoziren (Gleditsia Sinensis Seed), Wei Dahuang (Stir-fried Rhubarb), Danggui (Angelica Sinensis), Taoren (Peach Kernel), Zhike (Aurantium Fructus), Huanglian (Coptis). If Large Intestine Wind is strong, make pills.
Since ancient times, treating tenesmus used Binglang (Areca Seed)/Muxiang (Costus Root) to regulate qi, and Dahuang (Rhubarb) to purge accumulation. Only Danxi started using Taoren (Peach Kernel) and Huashi (Talcum) to activate dead blood, like drum beating responding to stick, truly pioneering previous unknown methods.
If prolapse occurs after blood activation, it is Qi Stagnation syndrome; add one Binglang (Areca Seed) to previous formula. For tenesmus, harmonize qi; for accumulation/qi prolapse, combine ascending and dispersing methods. (Ascending refers to Shengma (Cimicifuga Rhizome); Dispersing refers to Muxiang (Costus Root)/Binglang (Areca Seed)).
[Zhong] For diarrhea/dysentery with heaviness, boil 3 sheng of Xiebai (Allium Macrostemon Bulb) in 5 sheng water to 2 sheng, strain, add Fangcunbi of Si Ni San (Four Reversal Powder) to soup, boil to 1.5 sheng, divide warm, take twice. (Dongyuan says: Xiebai drains stagnant qi.)
[Shi] Mainly for red/white dysentery. Take a handful of Xiebai (Allium Macrostemon Bulb), cut, boil as porridge.
[Dan] If qi moves, blood harmonizes, accumulation is small, but false urgency with straining occurs, this is Blood Loss Syndrome. Double Danggui Shen/Wei (Angelica Sinensis root/shoot), assist with Sheng Dihuang (Rehmannia Glutinosa Root), Sheng Shaoyao (Peony Root), Sheng Taoren (Peach Kernel), harmonize with Chenpi (Tangerine Peel). As blood generates, stability returns.
[Yuan] False urgency without stool passage is due to Blood Deficiency. Blood deficiency causes tenesmus; add Danggui Shen (Angelica Sinensis root). Whenever tenesmus forces stool passage, it is due to physical matter. Now false urgency without stool indicates Blood Deficiency; thus use Danggui as sovereign, assisted by blood-generating herbs.
After using Cheng Qi etc. to purge accumulation, if tenesmus remains, it is Yang not ascending. Add Shengma (Cimicifuga Rhizome) to herbs to ascend Yang, and heaviness will naturally depart.
[Yuan] Sheng Yang Chu Shi Fang Feng Tang (Raise Yang Expel Dampness Saposhnikovia Decoction) treats tenesmus, frequent visits unable to pass stool, slight white pus or blood. Do not use purgatives. (Formula see Bleeding section.)
[Dan] If stagnation is below and vomiting above, this is unresolved toxic accumulation, unstable Stomach Qi. Identify cold to warm, heat to clear, deficiency to tonify with Renshen/Baizhu. Once toxin resolves and accumulation descends, appetite returns.
Dysentery Formula: Cangzhu (Atractodes Rhizome), Baizhu (Atractodes Macrocephala Rhizome), Fuling (Poria), Danggui (Angelica Sinensis), Shaoyao (Peony Root), Qingpi (Green Tangerine Peel), Shengdi (Rehmannia Glutinosa Root), Huanglian (Coptis), Huashi (Talcum), Gancao (Licorice).
One dose, decoct in water. For tenesmus, add Huanglian (Coptis), Huashi (Talcum), Taoren (Peach Kernel), Binglang (Areca Seed). Severe cases, add Dahuang (Rhubarb). For vomiting, add Banxia (Pinellia Tuber), Jiangzhi (Ginger Juice).
[Shi] Zhongjing Jian Zhong Tang (Establish Middle Decoction) treats dysentery regardless of red/white or duration, especially with severe abdominal pain. Extremely effective. Pulse wiry/tight, or choppy/floating/large, empty on pressure, or weak on lift/press, also effective. (Formula see Shanghan section.)
[Dan] Official Lou, over thirty, rich diet, suffered dysentery in summer/autumn with severe abdominal pain. Advised to take boiled Gan Jiang (Dried Ginger), one dose stopped pain. Pain returned shortly, another dose stopped it. Consumed 3 jin of Gan Jiang. Eight days later, left pulse wiry/large/rapid-like, right pulse wiry/large/reduced/rapid-like, deep pressure tight. I said: Likely excessive cold/cool foods after feasting, treat as Deficient Cold. Due to excessive Gan Jiang, prescribe Si Wu Tang (Four Substances Decoction) minus Dihuang, plus Renshen (Ginseng), Baizhu (Atractodes Macrocephala Rhizome), Chenpi (Tangerine Peel), Jiu Honghua (Red Safflower), Fuling (Poria), Taoren (Peach Kernel), decoct with Ginger Juice. Recovered in one month. (Danxi says: For dysentery abdominal pain, use Ginger/Cinnamon warming method, specifically Gan Jiang and Jian Zhong Tang plus Cinnamon.)
[Sheng] Treats Cold Dysentery with inability to eat. Rou Doukou (Nutmeg, 1 liang), peel, wrap in vinegar-flour paste, roast hot, pound, take 2 qian bi with non-mealtime rice water.
Upper/Lower dysentery with abdominal pain must be cured by warming/dispersing, based on Neijing stating: Cold qi invading Small Intestine prevents gathering, causing abdominal pain then diarrhea; and Taiyang syndrome winter cold invasion causing immediate diarrhea and umbilical pain.