痢亦夏秋为多，他时间有也。其因亦由夏月爱啖瓜桃生冷，内受暑邪，外感风凉，伏邪
欲泄
，为斑为疹为疟者有之，至迫入大肠，则病痢矣。其白者在气分，黄痢伤脾，赤痢在血分，
赤白黄紫并见者，为五色痢，当分治之。前人以白属寒，赤属热，非也。分气血则可，分寒
热则未当。治白痢疏气消导，或加清利湿热，或用丁香温脾。治黄痢补脾，如炒白术、茯苓
之类，加清导利疏之品。治赤痢以黄连、黄芩、白
芍为主药，随症加减。下痢兼身热头疼恶风者，加表药。若疟当兼和解，惟初起赤痢作呕不
纳
者，为噤口痢，最重，因兼胃病也。前人有用对金散，予治此症，每加半夏、炒竹茹、银花
露、莲肉之类，亦多效者。后重里急，见风洒淅，加防风、葛根、升麻、柴胡，以升提清阳
。赤痢必用之药，除主药之外，如楂肉、浓朴、白头翁、银花、陈皮、木香、苦参，初起随
症选用。至于用过清热逐秽，调气不愈者，宜和血之品，如生地炭、归身炭、丹皮之类。下
如豆汁者，兼挟湿也，宜用茅术、浓朴、茯苓、泽泻、猪芩之类。下如鱼脑者，属脾肾虚寒
，参附汤亦可酌用；如屋漏水者，湿毒为多。二种近于败症，久而不愈，延为休息者，补脾
为主，兼可补肾，所谓久不愈，责诸肾。然而必佐以枯芩、楂肉、砂仁壳之类，缓缓调补，
切
不可峻用双补，多致腹胀。盖休息一症，脾肾虽虚，亦有留邪未尽，故宜佐淡清轻消，方为
无弊。凡泻变痢，为脾传肾转重；痢变泻，为肾传脾转轻。赤痢初起体实者，用桃仁承气下
之，取效最速。切忌用涩药，贻害非细。丹溪云∶“调气则后重自除，和血则便脓自愈。”
予亦
有所得，乃曰∶调气则后重自除，凉血则便脓自愈；升阳则后重自除，升清则浊降，和血
则便脓自愈。一转移间，有先后之分，尤为允治。
痢疾在夏季和秋季较为多见，其他季节偶尔也有发生。其病因多因夏季喜爱食用瓜果桃类等生冷食物，体内感受暑邪，外部又受风凉侵袭，伏留的邪气想要排出，有的表现为斑疹疟疾等症，若邪气深入大肠，就会形成痢疾。白痢病位在气分，黄痢损伤脾脏，赤痢病位在血分，赤、白、黄、紫各色并见的，称为五色痢，应当分别治疗。前人认为白痢属寒证，赤痢属热证，这种观点是不对的。区分气血是可以的，但区分寒热则不恰当。治疗白痢应疏理气机、消食导滞，或者加入清利湿热的药物，也可以使用丁香温补脾脏。治疗黄痢应补益脾气，如炒白术、茯苓之类，再加入清热导滞、利湿疏利的药物。治疗赤痢以黄连、黄芩、白芍为主药，根据症状加减。下痢兼有身体发热、头痛、怕风的，加入解表药物。如果是疟疾，应当兼用和解法；只有初起时赤痢伴有呕吐、不能进食的，称为噤口痢，病情最重，因为兼有胃部的病变。前人有用对金散治疗的，我治疗此症，常加入半夏、炒竹茹、银花露、莲肉之类，也多有效验。出现里急后重，遇风感到寒冷战栗的，加入防风、葛根、升麻、柴胡，以升提清阳之气。治疗赤痢必须用的药物，除了主药之外，如山楂肉、厚朴、白头翁、金银花、陈皮、木香、苦参，初起时根据症状选用。至于使用过清热逐秽、调气方法后仍不愈的，宜用和血药物，如生地炭、当归身炭、丹皮之类。大便像豆汁样的，是兼夹湿邪，宜用苍术、厚朴、茯苓、泽泻、猪苓之类。大便像鱼脑样的，属于脾肾虚寒，参附汤也可以酌情使用；像屋漏水样的，多是湿毒所致。这两种情况接近败症，久治不愈，拖延成休息痢的，以补脾为主，兼可补肾，所谓久治不愈，责任在于肾。然而必须佐以枯黄芩、山楂肉、砂仁壳之类，缓缓调补，切不可峻猛使用双补之法，否则多导致腹胀。因为休息痢这一病症，虽然脾肾虚弱，但也有残留邪气未尽，所以宜佐以清淡轻灵的消导药物，这样才没有弊端。凡是泄泻转变为痢疾的，是脾病传肾，病情转重；痢疾转变为泄泻的，是肾病传脾，病情转轻。赤痢初起体质壮实的，用桃仁承气汤攻下，取效最快。切忌使用收敛固涩的药物，贻害不小。朱丹溪说：“调气则后重自除，和血则便脓自愈。”我也有心得，于是说道：调气则后重自除，凉血则便脓自愈；升阳则后重自除，升清则浊降，和血则便脓自愈。在一念转移之间，就有先后之分，更为允当适宜的治疗原则。
Dysentery is more common in summer and autumn, though it occasionally occurs at other times. Its etiology often stems from consuming raw and cold foods such as melons and peaches during summer, leading to internal invasion by summerheat pathogen and external contraction of wind-cold. The latent pathogen seeks expulsion; some manifest as macules, rashes, or malaria, but if the pathogen forces its way into the large intestine, dysentery ensues. White dysentery involves the Qi level; yellow dysentery injures the Spleen; red dysentery involves the Blood level. When red, white, yellow, and purple colors appear together, it is called Five-Color Dysentery (Wu Se Li), which requires differentiated treatment. Previous practitioners believed that white indicates Cold and red indicates Heat, which is incorrect. Differentiating between Qi and Blood is acceptable, but differentiating strictly by Cold and Heat is inappropriate. Treatment for white dysentery should focus on regulating Qi and promoting digestion, possibly adding herbs to clear damp-heat, or using Ding Xiang (Caryophylli Flos) to warm the Spleen. Treatment for yellow dysentery should tonify the Spleen, using herbs like Chao Bai Zhu (Stir-fried Atractylodis Rhizoma) and Fu Ling (Poria), combined with agents that clear heat, promote drainage, and regulate flow. Treatment for red dysentery takes Huang Lian (Coptidis Rhizoma), Huang Qin (Scutellariae Radix), and Bai Shao (Paeoniae Radix Alba) as principal medicines, modified according to symptoms. If dysentery is accompanied by fever, headache, and aversion to wind, add exterior-releasing drugs. If associated with malaria, harmonizing methods should be used concurrently. However, if red dysentery initially presents with vomiting and inability to swallow, it is termed Jin Kou Li (Jaw-Closed Dysentery), which is the most severe due to concurrent Stomach pathology. Previous practitioners used Dui Jin San; I treat this condition by adding Ban Xia (Pinelliae Rhizoma), Chao Zhu Ru (Stir-fried Bambusae Caulis in Taenia), Yin Hua Lu (Silver Flower Dew), and Lian Rou (Nelumbinis Semen), which proves effective in many cases. For tenesmus and feeling chilly upon exposure to wind, add Fang Feng (Saposhnikoviae Radix), Ge Gen (Puerariae Lobatae Radix), Sheng Ma (Cimicifugae Rhizoma), and Chai Hu (Bupleuri Radix) to raise and lift the Clear Yang. Besides the principal medicines, essential herbs for red dysentery include Zha Rou (Crataegi Fructus), Hou Po (Magnoliae Officinalis Cortex), Bai Tou Weng (Pulsatillae Radix), Yin Hua (Lonicerae Japonicae Flos), Chen Pi (Citri Reticulatae Pericarpium), Mu Xiang (Aucklandiae Radix), and Ku Shen (Sophorae Flavescentis Radix), selected based on initial symptoms. If clearing heat and purging turbidity along with regulating Qi fails, blood-nourishing agents such as Sheng Di Tan (Carbonized Rehmanniae Radix), Gui Shen Tan (Carbonized Angelicae Sinensis Radix), and Dan Pi (Moutan Cortex) should be used. Stool resembling bean juice indicates concurrent dampness, treated with Cang Zhu (Atractylodis Rhizoma), Hou Po (Magnoliae Officinalis Cortex), Fu Ling (Poria), Ze Xie (Alismatis Rhizoma), and Zhu Ling (Polyporus). Stool resembling fish brain indicates Spleen-Kidney deficiency-cold, where Shen Fu Tang (Ginseng and Aconite Decoction) may be considered appropriately. Stool resembling leaking roof water suggests abundant damp-toxin. Both conditions approach critical failure; if prolonged without cure, they develop into Xiu Xi Li (Resting Dysentery). Treatment primarily tonifies the Spleen and secondarily the Kidney, adhering to the principle that chronic dysentery implicates the Kidney. However, one must adjunctively use Ku Huang Qin (Scutellariae Radix dried/stemmed), Zha Rou (Crataegi Fructus), and Sha Ren Qiao (Amomi Fructus Shell) for slow tonification. One must absolutely avoid harsh dual-tonification, as it often causes abdominal distension. In Resting Dysentery, although Spleen and Kidney are deficient, residual pathogens remain; thus, light, clear, and resolving agents are necessary to avoid harm. Generally, diarrhea transforming into dysentery indicates Spleen transmitting to Kidney, worsening the condition; dysentery transforming into diarrhea indicates Kidney transmitting to Spleen, lightening the condition. For red dysentery in patients with strong constitution at onset, Tao Ren Cheng Qi Tang (Peach Kernel and Magnolia Decoction) should be used for purgation, yielding rapid results. Astringent drugs must be strictly avoided to prevent serious harm. Zhu Danxi stated: "Regulating Qi eliminates tenesmus; harmonizing Blood heals pus in stool." I have gained insights and propose: Regulating Qi eliminates tenesmus; cooling Blood heals pus in stool; raising Yang eliminates tenesmus; raising the Clear causes Turbid to descend; harmonizing Blood heals pus in stool. Within a moment of conceptual shift, there is a distinction of priority, making this an even more appropriate therapeutic principle.