治热痢下重腹疼，及患痢之人，从前曾有鸦片之嗜好者。
生山药（一两） 白头翁（四钱） 秦皮（三钱） 生地榆（三钱） 生杭芍（四钱） 甘草（二钱） 旱三七（三
钱，
轧细） 鸭蛋子（六十粒，去皮拣成实者）
上药共八味，先将三七、鸭蛋子，用白蔗糖水送服一半，再将余煎汤服。其相去之时间，宜至点半钟。所
余一半，至煎汤药渣时，仍如此服法。
《伤寒论》治厥阴热痢下重者，有白头翁汤。其方，以白头翁为主，而以秦皮、黄连、黄柏佐之。
愚用此方，而又为之通变者，因其方中尽却病之药，而无扶正之药，于证之兼虚者不宜。且连、柏并用，
恐其苦寒之性妨碍脾胃，过侵下焦也。矧《伤寒论》白头翁汤，原治时气中初得之痢，如此通变之，至痢久而
肠中腐烂者，服之亦可旋愈也。
奉天王××，年四十许。己未孟秋，自郑州病归，先泻后痢，腹疼重坠，赤白稠粘，一日夜十余次。先入奉
天东人所设医院中，东人甚畏此证，处以隔离所，医治旬日无效。遂出院归寓，求为延医。其脉弦而有力，知
其下久阴虚，肝胆又蕴有实热也。投以此汤，一剂痢愈。仍变为泻，日四五次，自言腹中凉甚。愚因其疾原先
泻，此时痢愈又泻，且恒以温水袋自熨其腹，疑其下焦或有伏寒，遂少投以温补之药。才服一剂，又变为痢，
下坠腹疼如故，惟次数少减。知其病原无寒，不受温补。仍改用通变白头翁汤。一剂痢又愈，一日犹泻数次。
继用生山药一两，龙眼、莲子各六钱，生杭芍三钱，甘草、茯苓各二钱，又少加酒曲、麦芽、白蔻消食之品，
调补旬日全愈。
奉天李××，年近四旬。因有事，连夜废寝。陡然腹疼，继而泄泻，兼下痢。其痢赤多于白，上焦有热，不
能饮食。其脉弦而浮，按之不实。先投以三宝粥方，腹疼与泻痢皆见轻，仍不能饮食。继用通变白头翁汤方，
连服两剂，痢愈可进饮食，腹疼泄泻犹未全愈。后仍用三宝粥方，去鸭蛋子，日服两次，数日病全愈。
治疗热痢伴有肛门重坠感及腹痛，以及患有痢疾且此前有鸦片嗜好的人。
生山药（一两） 白头翁（四钱） 秦皮（三钱） 生地榆（三钱） 生杭芍（四钱） 甘草（二钱） 旱三七（三钱，研细） 鸭蛋子（六十粒，去皮并挑选饱满者）
以上八味药，先将三七和鸭蛋子用白蔗糖水送服一半，再将剩余的药物煎汤服用。两次服药的时间间隔，宜为半小时。剩下的一半药物，在煎煮药渣时，仍按此法服用。
《伤寒论》治疗厥阴病热痢伴有肛门重坠感的，有白头翁汤。该方以白头翁为主药，以秦皮、黄连、黄柏为辅佐药。
我使用此方，又对其进行通变调整的原因，是因为原方中全是祛邪治病的药物，而没有扶正固本的药物，对于兼有虚证的病人不宜使用。况且黄连、黄柏并用，恐怕其苦寒之性会妨碍脾胃，过度损伤下焦。何况《伤寒论》中的白头翁汤，原本治疗的是时行疫病初期所患的痢疾，经过这样通变调整后，即使是痢疾日久、肠中腐烂的情况，服用后也可迅速痊愈。
奉天王××，年龄四十岁左右。己未年孟秋时节，从郑州带病归来，先出现腹泻，后转为痢疾，腹痛且有重坠感，大便赤白相间、稠厚粘腻，一昼夜十多次。起初入住由奉天当地人设立的医院，日本医生非常畏惧此证，将其安置在隔离室，医治十天无效。于是出院回到住所，请求我为其诊治。其脉象弦而有力，可知其因久泻导致下焦阴虚，肝胆又蕴积有实热。投以此汤，一剂后痢疾痊愈。随后转变为腹泻，每天四五次，患者自述腹中非常凉。我因其疾病原先就是腹泻，此时痢疾痊愈后又转为腹泻，且经常用温水袋熨烫腹部，怀疑其下焦可能有伏寒，于是少量投予温补的药物。才服用一剂，又转变为痢疾，下坠感和腹痛如故，只是次数略有减少。得知其病因并无寒邪，不耐受温补。仍改用通变白头翁汤。一剂后痢疾又愈，一天仍有数次腹泻。继而生用山药一两，龙眼肉、莲子各六钱，生杭芍三钱，甘草、茯苓各二钱，又稍加酒曲、麦芽、白蔻等消食导滞之品，调补十日完全痊愈。
奉天李××，年龄近四十岁。因为有事，连夜废寝忘食。突然腹痛，继而发生泄泻，兼有下痢。其痢疾赤多白少，上焦有热，不能进食。其脉象弦而浮，按之不实。先投以三宝粥方，腹痛与泄痢均见减轻，但仍不能进食。继用通变白头翁汤方，连续服用两剂，痢疾痊愈，可以进食，但腹痛泄泻仍未完全痊愈。后来仍用三宝粥方，去掉鸭蛋子，每日服用两次，数日后病完全痊愈。
Treats heat-dysentery accompanied by a sensation of heaviness and tenesmus in the anus, abdominal pain, as well as patients suffering from dysentery who previously had an addiction to opium.
Raw Dioscoreae Rhizoma (Shanyao) (1 liang), Pulsatillae Radix (Baitouweng) (4 qian), Phellodendri Cortex Chinensis (Qinpi) (3 qian), Raw Sanguisorbae Radix (Diyu) (3 qian), Raw Paeoniae Radix Alba (Hangshao) (4 qian), Glycyrrhizae Radix et Rhizoma (Gancao) (2 qian), Panacis Japonicis Radix (Zhangsanqi) (3 qian, finely ground), Strychni Semen (Yadanzi) (60 grains, peeled and selected for plumpness).
The above eight herbs: first, administer half of the Zhangsanqi and Yadanzi orally with water sweetened with white sugar; then decoct the remaining herbs into a soup and drink it. The time interval between these two administrations should be half an hour. For the remaining half portion, when decocting the medicinal dregs, use this same method of administration.
In *Shanghan Lun* (Treatise on Cold Damage Diseases), Baitouweng Tang (Pulsatilla Decoction) is used to treat Jueyin heat-dysentery with tenesmus. This formula uses Pulsatillae Radix as the principal herb, assisted by Phellodendri Cortex Chinensis, Coptidis Rhizoma (Huanglian), and Phellodendri Cortex (Huangbai).
I utilize this formula but modify it because the original formula consists entirely of herbs that expel pathogens and lacks herbs that support healthy qi (Zhengqi), making it unsuitable for cases complicated by deficiency. Moreover, the combined use of Huanglian and Huangbai may hinder the spleen and stomach due to their bitter-cold nature, excessively invading the lower jiao (Lower Burner). Furthermore, the Baitouweng Tang in *Shanghan Lun* originally treats dysentery occurring at the initial stage of seasonal epidemic diseases. With such modifications, even in cases where dysentery has persisted for a long time causing putrefaction in the intestines, taking this modified formula can lead to rapid recovery.
Patient Wang XX from Fengtian, approximately forty years old. In early autumn of the Jiwei year, he returned from Zhengzhou ill. He initially experienced diarrhea which progressed to dysentery, characterized by abdominal pain and a heavy, bearing-down sensation. His stool was thick, sticky, and mixed with red blood and white mucus, occurring more than ten times a day and night. Initially admitted to a hospital established by Fengtian locals, Japanese physicians were wary of this condition and placed him in isolation. After ten days of ineffective treatment, he was discharged and returned to his residence, seeking my medical attention. His pulse was wiry and forceful, indicating yin deficiency in the lower jiao due to prolonged diarrhea, and excess heat accumulating in the liver and gallbladder. I administered this modified formula; after one dose, the dysentery ceased. It then transformed into diarrhea, occurring four or five times daily, with the patient reporting significant coldness in the abdomen. Given that his illness began with diarrhea, followed by dysentery and now back to diarrhea, and noting his frequent use of warm compresses on his abdomen, I suspected latent cold in the lower jiao. Consequently, I prescribed a small amount of warming and tonifying herbs. After just one dose, the condition reverted to dysentery, with tenesmus and abdominal pain returning as before, though the frequency decreased slightly. Realizing the root cause was not cold and that the patient could not tolerate warming tonification, I switched back to the Modified Baitouweng Tang. After one dose, the dysentery resolved again, although diarrhea persisted several times a day. Subsequently, I prescribed Raw Dioscoreae Rhizoma (1 liang), Longan Aril (Longyanrou) and Nelumbinis Semen (Lianzi) (each 6 qian), Raw Paeoniae Radix Alba (3 qian), Glycyrrhizae Radix et Rhizoma and Poria (Fuling) (each 2 qian), along with small amounts of Jiuxqu (Wine Qu), Maiya (Hordeum Germinatum), and Baikou (Amomi Fructus Rotundus) to aid digestion. After ten days of regulation and tonification, he fully recovered.
Patient Li XX from Fengtian, nearly forty years old. Due to urgent matters, he stayed up all night neglecting sleep and meals. Suddenly, he experienced abdominal pain, followed by diarrhea and dysentery. His dysentery contained more red blood than white mucus, accompanied by heat in the upper jiao and inability to eat. His pulse was wiry and floating, feeling empty upon pressure. I first administered Sanbao Zhou (Three Treasures Porridge); the abdominal pain and diarrhea/dysentery improved, but he still could not eat. Then I used the Modified Baitouweng Tang formula. After two consecutive doses, the dysentery resolved, and he could eat, though abdominal pain and diarrhea had not completely ceased. Later, I resumed using Sanbao Zhou, omitting Strychni Semen, administered twice daily. After several days, he fully recovered.