典藏书目

When a disease is in a critical state, only potent and heavy prescriptions can save one or two out of a hundred patients. Current physicians often care too much about their reputation and integrity; they tentatively use light and mild formulas, hoping for accidental success. If the patient survives by luck, they claim it as their merit; if the patient unfortunately dies, they claim it is not their fault. It is feared that those with a sincere heart to save the world should not act this way.

Those who sincerely aim to save the world must generously take life and death as their own responsibility. When cold treatment is indicated, use cold methods decisively; when heat treatment is indicated, use heat methods decisively. When tonification is required, tonify; when purgation is required, purge. Do not hesitate or shrink back, using medicines that are neither cold nor hot, neither tonifying nor purging—like the proverbial "medicines that neither cure the disease nor harm the life." Alas! If they do not cure the disease, how can they avoid harming the life? Is there any logic in this? If one's understanding here is not precise, it is better to leave doubts aside and wait for a more skilled physician. Do not rashly try such approaches in hopes of luck, so as not to betray the original intention of a benevolent person.

Dysentery is caused by the internal invasion of summer-heat and dampness, injuring the Spleen and Stomach. Food and drink fail to transform into essence and micro-nutrients, forming stagnation that seeks to be excreted through the Large Intestine. The *Classic of Internal Medicine* states: "For diseases located below, guide them according to their tendency," allowing the pathogenic factors to exit. If astringent drugs are used to stop the dysentery, the pathogenic qi will inevitably ascend, causing the most severe disaster.

For example, the son of an old man surnamed Yao in the neighborhood, aged twenty, suffered from bloody dysentery (dysentery with pus and blood) and abdominal pain in July, defecating dozens of times a day. A folk remedy was circulated: decoct one qian of Poppy Shell (*Papaveris Pericarpium*) and drink the soup. As soon as it was swallowed, the dysentery indeed stopped, but within half a day, abdominal distension, chest tightness, and shortness of breath occurred, accompanied by alternating chills and fever. Other doctors were consulted and prescribed *Chai Ping Tang* (Bupleurum and Pinellia Decoction). After one dose, the distension worsened, and the eyes became red and protruding. He then sought my treatment. I realized that the latent pathogen had been trapped by the astringent nature of the Poppy Shell, having no outlet, leading first to abdominal distension and chest tightness, then attacking the upper body, causing shortness of breath and protruding eyes. I knew internally that *Chai Ping Tang* was not a formula capable of stabilizing danger and calming chaos. Using *Cheng Qi Tang* (Order the Qi Decoction) to purge might have saved him. However, at that time, both pulses were forceful and pressing against the fingers, the mouth emitted foul odor, the spirit was dull, and the eyes were staring blankly. The intestines and stomach function had already failed. I declined to prescribe a formula. One day later, he died.

It is not only that astringent drugs are inadvisable; even in chronic relapsing dysentery (Xie Xi Li), when using dual tonification of the Spleen and Kidney, failing to add light and clear guiding/digestive herbs will inevitably lead to drawbacks. For instance, the son of Mr. Wang Lichuan, a neighbor, suffered from long-term dysentery that did not heal. Although his father was knowledgeable in medicine, he lacked confidence and went to Suzhou to invite Old Man Gu Yutian. The prescription used the Spleen-Kidney Dual Tonification method by Miao Zhongchun. I happened to pass by his study and saw weighed herbs filling the table. I said to him: "In cases of chronic dysentery developing into relapsing dysentery, the root cause is ultimately summer-heat and dampness damaging the Zang-Fu organs. Although the late-stage treatment uses tonics, herbs like Hawthorn Fruit (*Crataegi Fructus*), Amomum Seed Shell (*Amomi Fructus*), Light Scutellaria (*Scutellariae Radix*), and Black Gardenia (*Gardeniae Fructus*) should not be discarded. Radical tonification may cause drawbacks." The father did not adopt this advice and continued with the original prescription. Gradually, he experienced abdominal distension and reduced appetite. Although changing the formula could still treat the condition, due to his firm belief without doubt, he eventually developed abdominal dropsy (Gu Zhang) and died.

Another case is Qian Hongtai, a scholar-official, who suffered from relapsing dysentery for two years and asked me to arrange medical treatment for him. His physique was robust, and he enjoyed rich, fatty foods and strong wine. Knowing his Yin aspect was not deficient, I prescribed Western Codonopsis (*Codonopsis Radix*), Stir-fried Atractylodes Macrocephala Rhizome (*Atractylodis Macrocephalae Rhizoma*), Poria (*Poria*), Broad-leaved Citrus Peel (*Citri Reticulatae Pericarpium*), Hawthorn Fruit (*Crataegi Fructus*), Amomum Seed Shell (*Amomi Fructus*), Light Scutellaria (*Scutellariae Radix*), Rice Sprout (*Oryzae Germens*), Stir-fried Coix Seed (*Coicis Semen*), and Honey-fried Licorice Root (*Glycyrrhizae Radix et Rhizoma Praeparata cum Melle*). After four doses, there was effective response. With modifications over twenty doses, a pill formula was adopted, resulting in recovery. This also illustrates the necessity of incorporating digestive/guiding methods within tonification.

Furthermore, regarding the use of Bupleurum (*Bupleuri Radix*) and Cimicifuga (*Cimicifugae Rhizoma*) to relieve tenesmus in dysentery: Analysis shows that Cimicifuga and Bupleurum only raise the Qi of the formless aspect and do not obstruct the tangible pathogens. If Platycodon (*Platycodonis Radix*) is used to lift obstructed pathogenic turbidity, it is absolutely contraindicated.