脉
下利之脉，宜微小，不宜浮洪；宜滑大，不宜弦急；宜身凉，不宜身热。经所谓；身凉脉细者生，身热
脉大者死。是亦大概言之耳，不可一途而论也。叔和云∶下痢微小却为主，脉大浮洪无瘥日。
证
夫痢乃湿、热、食积三者，下青、黄、赤、白、黑五色也。湿热伤血分则赤，伤气分则白，气血俱伤，则
赤白相兼。黄者食积，黑者湿胜也。其症脐腹 痛，或下鲜血，或下瘀血，或下紫黑血，
或下白脓，或赤白相杂，或下如豆汁，或如鱼脑髓，或如屋漏水，里急后重，频欲登厕，昼夜无度。
治
治法行气和血，开郁散结。泻脾胃之湿热，消脏腑之积滞。经云∶热积气滞而为痢，其初只宜立效散，一
服即愈。或木香导气汤，以推其邪，以彻其毒，皆良法也。痢稍久者不可下，胃虚故
也。调中理气汤，加味香连丸之类，择便用之。痢多属热，亦有虚与寒者。虚者补之，寒者温之，以神效参
香散主之。盖痢之初，邪毒正盛，宜推荡之，不可用粟壳、诃子收涩之药；则淹缠不已。痢之稍久，真气下
陷，宜收涩之。不可用巴豆、牵牛通利之剂，用之则必致杀人。又有下痢噤口而不食者，亦有二也。有脾虚，
有脾热。脾虚者，参苓白术散，脾热，参连汤，或仓连煎之类。大凡下痢纯红者，如尘腐色者，如屋漏水者，
大孔开如竹筒者，唇如朱红者，俱死症也。如鱼脑髓者，身热脉大者，俱半死半生。
方
木香导气汤 治痢疾初起，腹痛，红白相杂，里急后重，发热
噤口，不拘老幼，先与一服甚效。
大黄（一钱五分） 槟榔（一钱二分） 浓朴（一钱二分） 白芍药（一钱二分） 黄连
（一钱二分） 归尾（八分） 茯苓（八分） 朴硝（一钱二分） 木香（五分） 小便赤加滑
石（一钱五分） 木通（一钱）
上锉一剂，水二钟，煎至八分，滤去渣，空心热服。
闸板丹（张小庵传）〔批〕（按此方治痢，以推其邪而彻其毒也） 治痢初起，以此丹推荡其邪毒。
黄丹（一两，水飞） 黄蜡（一两） 乳香（一钱） 没药（一钱） 杏仁（八个，去皮尖）
巴豆（八个，去油）
上将五味为末，将黄蜡熔化，后将药末同蜡拌匀，搅冷成块。
每服一丸，如黄豆大，空心服。红痢，冷甘草汤下；白痢，冷干姜汤下；水泻，冷米汤下。
立效散（云林制）〔批〕（按此方治热积气滞而为痢者，以黄连清热，枳壳破气，清
平之剂） 治痢，腹中疠痛，赤白相兼，即止。
黄连（四两，酒洗，吴茱萸二两，同炒，去茱萸用） 枳壳（二两，麸炒）
上为末，每服三钱，空心酒送下。泄泻，米汤下。噤口痢，陈仓米汤下。
调中理气汤 丹溪云∶调气则后重自除。此也。
苍术（米泔浸，炒） 片术（炒，各一钱） 陈皮（八分） 浓朴（姜炒，七分） 枳壳
（一钱） 白芍（炒，一钱） 槟榔（一钱） 木香（八分）
上锉一剂，水二盏，煎一盏，滤去渣，空心温服。如赤痢，
浓朴、芍药俱不必炒，再加黄连、条芩各一钱五分。白痢只根据本方。
加味香连丸〔批〕（按此方治痢，调理之剂） 此方治痢之总司。
黄连（二两，炒） 吴茱萸（滚水泡，炒，二两） 木香（一钱） 白豆蔻（带壳面裹
火煨，一钱五分） 秘方加乳香、没药（各一钱）
上为细末，用乌梅二两，滚水泡去核，捣和为丸如梧桐子大。每服三十丸。白痢，干姜汤下；血痢，甘
草汤下；赤白相兼，二味泡汤下，白泻，米汤下。
仓廪散 治赤白痢疾，发热不退。凡下痢有积、有暑，如用药不效，即是肠胃有风邪热也。此方甚效。
即人参败毒散加黄连、陈仓米、姜、枣煎服。噤口痢，加石莲肉七枚。痢后手足
痛，加槟榔、木瓜。不早治，则成鹤膝风。
六一顺气散〔批〕（按此方治内外两感发热痢疾及时行疫痢之剂） 治痢不问
赤白相杂，肚痛，里急后重，浑身发热，口干烦渴，用此通利即止。（方见伤寒门）
纳脐膏（何晴岳传） 治噤口痢，危急之证，用之立愈。
黄瓜藤（不拘多少，连茎叶经霜者，晒干烧灰存性，出火毒）
上用香油调，纳脐中，即效。
点眼膏（黄宾） 治一切赤白痢，及噤口危急之证。
初胎粪（炙干，一钱） 雄黄（五分） 黄连（四分） 片脑（少许）
上为极细末，水调，点两 ，神效。
仓连煎（刘太府传） 治噤口痢，不拘赤白。
陈仓米（赤痢用三钱，白痢用七钱，赤白相兼用五钱） 黄连（赤痢用七钱，白痢用
三钱，赤白相兼用五钱）
上锉，水一钟，煎至七分，露一宵，空心温服。
凡下痢噤口不食者，虽曰脾虚，盖因热毒闭塞，心胸胃口所致。用参苓白术散，加石菖蒲一钱，木
香少许，共为末，陈米饮调下。再服仓连煎，尤妙。噤口痢，诸药不效者，粪缸中蛆，不拘多
少，洗净，瓦上焙干为末。每服一、二匙，米饮调服，即能思食。
噤口痢，多是胃口热甚，用黄连一两，人参五钱，煎汤。终日呷之，如吐，再强饮。但得一呷下咽，
便好。一方加石莲肉三钱，水煎服，立效。外以田螺捣烂，入麝香少许，合脐上，引热下行故
也。又方用秤锤烧红，用好醋浇之，令病患吸其烟，神效。按前诸方，皆治噤口不食之剂。凡医者用药，不
必拘其赤白，饮食即吐，诸物不纳，皆是毒瓦斯熏蒸，胃口热甚，切不可认胃寒噤口，而用辛热之药。宜
以前方选用，或木香导气汤去大黄煎熟入韭汁，陈仓米饮各一盏于内同服，即愈。
加减益气汤 治痢日久不愈，不能起床虚弱症。
黄 （五分） 人参（五分） 白术（一钱） 陈皮（一钱） 当归（七分） 白芍药（一钱）
升麻（三分） 甘草（炙，三分） 泽泻（五分） 砂仁（五分） 木香（三分） 白豆蔻（三分）
地榆（五分） 御米壳（醋炒，三分）
上锉一剂，水二盏，煎至八分，滤去渣，空心温服。
神效参香散〔批〕（按此方治痢久不愈，元气虚弱，滑脱下陷，止涩之剂） 治
脏气怯弱，冷热不调，积而成痢。或下鲜血，或如豆汁，或如鱼脑，或下瘀血，或下紫黑血，或赤白相杂，
里急后重，日夜频数无度。
罂粟壳（去带穣，醋炙，一两） 陈皮（一两） 白茯苓（去皮，四钱） 肉豆蔻（面
裹煨，四钱） 人参（二钱） 白扁豆（二钱） 木香（二钱）
上共七味为末，赤痢每九分，加制黄连末一分；白痢每九分，加制茱萸末一分；赤白相杂，每服八分，
加黄连茱萸末各一分；青色、黄色，无加减，每用一钱，俱用米汤调下。忌生冷、油腻、炙
爆。制黄连、茱萸法∶二味等分，不锉碎，以老酒浸一宿，同一处炒燥，分出。各为极细末，另包，听前用。
姜茶汤 治痢疾腹痛，不问赤白冷热。盖姜能助阳，茶能助
阴，二者皆能清散。又且调平阴阳，况于暑毒酒食毒，皆能解之也。
老生姜（细切，二钱） 细茶叶（三钱）
上用新汲水煎服。一方加连根韭菜一握，三味同捣汁，酒调服。
三白汤（杜守玄传） 治痢不拘赤白。
白砂糖（一两） 鸡子清（一个） 烧酒（一钟半） 煎八分温服。
仙梅丸（桑双冈传） 治痢疾发热发渴。
细茶 乌梅（水洗，剥去核，晒干，各一两）
上为末，生姜捣作丸，弹子大。每一丸，冷水送下。
椿鸡丸（桑环川传） 治久痢不止。
雪里炭一只，吊死。去肠毛，入黄连一两，椿根白皮一两于肚内，好酒 熟，去药食鸡，神效。
舒凫饮（刘桐川传） 治白痢如鱼冻色，久不愈者。白鸭一只，杀取血，以滚酒和饮之，立止。
将军饮 治痢脓血稠粘，里急后重，昼夜无度，不问新久，及愈而又发，止而复作，名曰休息痢。
绵纹大黄（锉，一两）
上以好酒二钟，浸半日，煎至七分，去渣，分作二次服，以利
为度。按前诸方，治痢简易，故附方末，以备选用。
脉象
下利（痢疾）的脉象，适宜微小，不适宜浮洪；适宜滑大，不适宜弦急；适宜身体凉爽，不适宜身体发热。医经所说：身体凉爽、脉象细弱的可以生存，身体发热、脉象粗大的会死亡。这也是一般性的说法，不能一概而论。王叔和说：下痢脉象微小为主，若脉象大且浮洪，则没有痊愈的日子。
证候
痢疾是由于湿、热、食积三者结合，导致排出青、黄、赤、白、黑五色粪便。湿热损伤血分则便赤，损伤气分则便白，气血俱伤，则赤白相兼。黄色代表食积，黑色代表湿气胜。其症状为脐腹部疼痛，或排出鲜血，或排出瘀血，或排出紫黑色血，或排出白色脓液，或赤白相间，或排出如豆汁样物质，或如鱼脑髓样物质，或如屋漏水样物质，伴有里急后重（腹痛窘迫，时时欲便，肛门重坠，便出不爽），频繁想要上厕所，昼夜无度。
治法
治疗方法在于行气和血，开郁散结。泻除脾胃的湿热，消除脏腑的积滞。医经云：热积气滞而导致的痢疾，初期只宜用立效散，服用一次即可痊愈。或者使用木香导气汤，以推荡邪气，彻底清除毒素，都是良法。痢疾时间稍久者不可攻下，因为胃气虚弱的原因。可使用调中理气汤、加味香连丸之类，酌情选用。痢疾多属热证，也有虚证和寒证。虚证用补法，寒证用温法，以神效参香散为主方。大概痢疾初起时，邪毒正盛，宜用推荡之法，不可使用粟壳、诃子等收涩药物；否则病情缠绵不已。痢疾时间稍久，真气下陷，宜用收涩之法。不可使用巴豆、牵牛等通利之剂，使用则必致人死亡。又有下痢出现噤口痢（痢疾患者恶心呕吐，不能进食）而不进食的情况，也有两种原因。有脾虚，有脾热。脾虚者，用参苓白术散；脾热者，用参连汤，或仓连煎之类。大凡下痢纯红色者，如尘腐色者，如屋漏水者，肛门张开如竹筒者，嘴唇如朱红色者，都属于死症。如排出鱼脑髓样物质者，身体发热脉象大者，都属于半死半生。
方剂
木香导气汤 治疗痢疾初起，腹痛，红白相杂，里急后重，发热，噤口，不拘老少，先服用一剂非常有效。
大黄（一钱五分） 槟榔（一钱二分） 厚朴（一钱二分） 白芍药（一钱二分） 黄连（一钱二分） 归尾（八分） 茯苓（八分） 朴硝（一钱二分） 木香（五分） 小便赤加滑石（一钱五分） 木通（一钱）
以上药材锉成粗末为一剂，用水二钟，煎至八分，滤去药渣，空腹热服。
闸板丹（张小庵传授）〔批注〕（按此方治疗痢疾，旨在推荡邪气并清除毒素） 治疗痢疾初起，以此丹推荡邪毒。
黄丹（一两，水飞处理） 黄蜡（一两） 乳香（一钱） 没药（一钱） 杏仁（八个，去皮尖）
巴豆（八个，去油）
以上五味药材研为细末，将黄蜡熔化，后将药末与蜡拌匀，冷却凝固成块。
每次服用一丸，如黄豆大小，空腹服用。红痢，用冷甘草汤送服；白痢，用冷干姜汤送服；水泻，用冷米汤送服。
立效散（云林制作）〔批注〕（按此方治疗热积气滞而致的痢疾，以黄连清热，枳壳破气，为清平之剂） 治疗痢疾，腹中疠痛，赤白相兼，立即停止。
黄连（四两，酒洗，与吴茱萸二两同炒，去茱萸只用黄连） 枳壳（二两，麸炒）
以上研为细末，每次服用三钱，空腹用酒送服。泄泻，用米汤送服。噤口痢，用陈仓米汤送服。
调中理气汤 朱丹溪说：调气则后重自除。就是这个道理。
苍术（米泔水浸泡，炒） 白术（炒，各一钱） 陈皮（八分） 厚朴（姜炒，七分） 枳壳（一钱） 白芍（炒，一钱） 槟榔（一钱） 木香（八分）
以上锉成粗末为一剂，用水二盏，煎至一盏，滤去药渣，空腹温服。如果是赤痢，厚朴、芍药都不必炒，再加黄连、黄芩各一钱五分。白痢只根据本方原方使用。
加味香连丸〔批注〕（按此方治疗痢疾，为调理之剂） 此方是治疗痢疾的总纲方。
黄连（二两，炒） 吴茱萸（滚水泡，炒，二两） 木香（一钱） 白豆蔻（带壳面裹火煨，一钱五分） 秘方加乳香、没药（各一钱）
以上研为细末，用乌梅二两，滚水泡去核，捣烂混合制成梧桐子大小的丸药。每次服用三十丸。白痢，用干姜汤送服；血痢，用甘草汤送服；赤白相兼，用这两种药泡的水送服；白泻，用米汤送服。
仓廪散 治疗赤白痢疾，发热不退。凡是下痢有积滞、有暑邪，如果用药无效，就是肠胃有风邪热毒。此方非常有效。即人参败毒散加黄连、陈仓米、姜、枣煎服。噤口痢，加石莲肉七枚。痢后手足痛，加槟榔、木瓜。如果不早治疗，则会形成鹤膝风。
六一顺气散〔批注〕（按此方治疗内外两感发热痢疾及时行疫痢的药剂） 治疗痢疾不问赤白相杂，肚痛，里急后重，浑身发热，口干烦渴，用此方通利即可停止。（方剂见伤寒门）
纳脐膏（何晴岳传授） 治疗噤口痢，危急之证，使用后立即痊愈。
黄瓜藤（不拘多少，连茎叶经霜者，晒干烧灰存性，去除火毒）
以上用香油调和，纳入肚脐中，立即见效。
点眼膏（黄宾传授） 治疗一切赤白痢，及噤口危急之证。
初胎粪（炙干，一钱） 雄黄（五分） 黄连（四分） 冰片（少许）
以上研为极细末，用水调和，点入两眼，神效。
仓连煎（刘太府传授） 治疗噤口痢，不拘赤白。
陈仓米（赤痢用三钱，白痢用七钱，赤白相兼用五钱） 黄连（赤痢用七钱，白痢用三钱，赤白相兼用五钱）
以上锉碎，用水一钟，煎至七分，露天放置一夜，空腹温服。
凡是下痢出现噤口不食者，虽然说是脾虚，其实是因为热毒闭塞，心胸胃口所致。用参苓白术散，加石菖蒲一钱，木香少许，共为细末，用陈米饮调服。再服用仓连煎，尤其妙。噤口痢，诸药无效者，取粪缸中的蛆，不拘多少，洗净，在瓦上焙干研为细末。每次服用一、二匙，用米饮调服，就能产生食欲。
噤口痢，多是胃口热甚，用黄连一两，人参五钱，煎汤。整天小口啜饮，如果吐出，再强行喂饮。只要有一口咽下去，就会好转。另一方法加石莲肉三钱，水煎服，立即见效。外用田螺捣烂，入麝香少许，敷于脐上，以引热下行。又一方用秤锤烧红，用好醋浇之，让病患吸入其烟雾，神效。按前述各方，都是治疗噤口不食的药剂。凡医者用药，不必拘泥于赤白，饮食即吐，诸物不纳，都是毒瓦斯熏蒸，胃口热甚，切不可误认为胃寒噤口，而使用辛热药物。宜以前方选用，或者用木香导气汤去掉大黄，煎熟后加入韭汁、陈仓米饮各一盏在内同服，即可痊愈。
加减益气汤 治疗痢疾日久不愈，不能起床的虚弱症状。
黄芪（五分） 人参（五分） 白术（一钱） 陈皮（一钱） 当归（七分） 白芍药（一钱）
升麻（三分） 甘草（炙，三分） 泽泻（五分） 砂仁（五分） 木香（三分） 白豆蔻（三分）
地榆（五分） 罂粟壳（醋炒，三分）
以上锉成粗末为一剂，用水二盏，煎至八分，滤去药渣，空腹温服。
神效参香散〔批注〕（按此方治疗痢疾久不愈，元气虚弱，滑脱下陷，为止涩之剂） 治疗脏气怯弱，冷热不调，积而成痢。或下鲜血，或如豆汁，或如鱼脑，或下瘀血，或下紫黑血，或赤白相杂，里急后重，日夜频数无度。
罂粟壳（去带穣，醋炙，一两） 陈皮（一两） 白茯苓（去皮，四钱） 肉豆蔻（面裹煨，四钱） 人参（二钱） 白扁豆（二钱） 木香（二钱）
以上共七味研为细末，赤痢每九分，加制黄连末一分；白痢每九分，加制吴茱萸末一分；赤白相杂，每服八分，加黄连、吴茱萸末各一分；青色、黄色，无加减，每用一钱，俱用米汤调下。忌生冷、油腻、炙爆食物。制黄连、吴茱萸法：二味等分，不锉碎，以老酒浸一宿，同一处炒燥，分出。各为极细末，另包，听凭前方使用。
姜茶汤 治疗痢疾腹痛，不问赤白冷热。盖姜能助阳，茶能助阴，二者皆能清散。又能调平阴阳，况且对于暑毒、酒食毒，都能解之也。
老生姜（细切，二钱） 细茶叶（三钱）
以上用新汲水煎服。另一方加连根韭菜一握，三味同捣汁，酒调服。
三白汤（杜守玄传授） 治疗痢疾不拘赤白。
白砂糖（一两） 鸡蛋清（一个） 烧酒（一钟半） 煎至八分温服。
仙梅丸（桑双冈传授） 治疗痢疾发热发渴。
细茶 乌梅（水洗，剥去核，晒干，各一两）
以上研为细末，生姜捣烂作丸，弹子大小。每一丸，冷水送下。
椿鸡丸（桑环川传授） 治疗久痢不止。
雪里炭一只，吊死。去肠毛，入黄连一两，椿根白皮一两于肚内，好酒煮熟，去药食鸡，神效。
舒凫饮（刘桐川传授） 治疗白痢如鱼冻色，久不愈者。白鸭一只，杀取血，以滚酒和饮之，立即停止。
将军饮 治疗痢脓血稠粘，里急后重，昼夜无度，不问新久，及愈而又发，止而复作，名曰休息痢。
绵纹大黄（锉，一两）
以上用好酒二钟，浸泡半天，煎至七分，去渣，分作二次服，以利尽为度。按前述各方，治疗痢疾简易，故附于方剂末尾，以备选用。
Pulse
For dysentery (Li Ji), the pulse should be fine and small, not floating and surging; it should be slippery and large, not wiry and rapid; the body temperature should be cool, not hot. The classics state: "Those with a cool body and fine pulse survive; those with a hot body and large pulse die." This is a general statement and cannot be applied rigidly. Wang Shuhe said: "In dysentery, a fine and small pulse is primary; if the pulse is large, floating, and surging, there will be no days of recovery."
Symptoms
Dysentery arises from the combination of dampness, heat, and food stagnation, resulting in the discharge of feces in five colors: green, yellow, red, white, and black. If damp-heat injures the blood level, the stool is red; if it injures the qi level, the stool is white; if both qi and blood are injured, red and white are mixed. Yellow indicates food stagnation, and black indicates excessive dampness. Symptoms include pain in the umbilical and abdominal regions, or the passage of fresh blood, stagnant blood, purple-black blood, white pus, or a mixture of red and white. Stools may resemble bean juice, fish brain matter, or leaking roof water. There is tenesmus (urgent desire to defecate with a feeling of incomplete evacuation), frequent urges to use the toilet, day and night without limit.
Treatment Principles
The treatment method involves regulating qi and nourishing blood, resolving depression and dissipating nodules. It aims to drain damp-heat from the spleen and stomach and eliminate stagnation in the zang-fu organs. The classics say: "Dysentery caused by heat accumulation and qi stagnation should initially be treated with Li Xiao San (Instant Efficacy Powder); one dose brings cure." Alternatively, Mu Xiang Dao Qi Tang (Aucklandia Qi-Moving Decoction) can be used to push out pathogens and thoroughly eliminate toxins, both being excellent methods. For dysentery that has persisted for some time, purgatives should not be used because the stomach qi is deficient. Tiao Zhong Li Qi Tang (Regulate Middle Regulate Qi Decoction) or Jia Wei Xiang Lian Wan (Modified Aucklandia and Coptis Pills) should be selected as appropriate. Dysentery mostly belongs to heat patterns, but there are also deficiency and cold patterns. Deficiency is treated by tonification, cold by warming, primarily using Shen Xiao Shen Xiang San (Divine Efficacy Ginseng and Aucklandia Powder). Generally, at the onset of dysentery, pathogenic toxins are vigorous, so pushing/discharging methods are suitable; astringents like Yumi Qiao (Poppy Shell) and He Zi (Chebula Fruit) should not be used, otherwise the condition will linger. When dysentery persists, true qi sinks downward, so astringents are appropriate. Purgatives like Badou (Croton Seed) and Qianniu (Morning Glory Seed) must not be used, as they can lead to death. Another presentation is Jin Kou Li (Jin Kou Dysentery), where the patient cannot eat due to nausea/vomiting. This has two causes: spleen deficiency and spleen heat. For spleen deficiency, Shen Ling Bai Zhu San (Ginseng, Poria, and Atractylodes Macrocephala Powder) is used; for spleen heat, Shen Lian Tang (Ginseng and Coptis Decoction) or Cang Lian Jian (Coix Seed and Coptis Decoction) are used. Generally, pure red stools, dust-like rotten color, leaking roof water appearance, anus opening like a bamboo tube, and lips like vermilion indicate fatal conditions. Discharge resembling fish brain matter, accompanied by fever and a large pulse, indicates a critical condition with a fifty-fifty chance of survival.
Formulas
Mu Xiang Dao Qi Tang (Aucklandia Qi-Moving Decoction): Treats early-stage dysentery with abdominal pain, mixed red and white stools, tenesmus, fever, and Jin Kou symptoms. Effective for all ages, especially the first dose.
Da Huang (Rhubarb Root and Rhizome, 1.5 qian), Bing Lang (Areca Nut, 1.2 qian), Hou Po (Magnolia Bark, 1.2 qian), Bai Shao Yao (White Peony Root, 1.2 qian), Huang Lian (Coptis Rhizome, 1.2 qian), Gui Wei (Angelica Sinensis Tail, 0.8 qian), Fu Ling (Poria, 0.8 qian), Po Xiao (Mirabilite, 1.2 qian), Mu Xiang (Aucklandia Root, 0.5 qian). Add Hua Shi (Talcum, 1.5 qian) and Mu Tong (Akebia Stem, 1 qian) if urine is red.
Crush ingredients into coarse powder for one dose. Boil in two zhong of water until reduced to eight fen. Strain and take warm on an empty stomach.
Zha Ban Dan (Gate Board Pill, transmitted by Zhang Xiao'an) [Commentary]: This formula pushes out pathogens and eliminates toxins in early dysentery.
Huang Dan (Lead Monoxide, 1 liang, prepared by water levigation), Huang La (Yellow Beeswax, 1 liang), Ru Xiang (Frankincense, 1 qian), Mo Yao (Myrrh, 1 qian), Xing Ren (Apricot Seed, 8 pieces, skin and tip removed), Ba Dou (Croton Seed, 8 pieces, oil removed).
Grind the five herbs into fine powder. Melt the beeswax, mix with the powder, stir, and cool into blocks.
Take one pill per dose, size of a soybean, on an empty stomach. For red dysentery, take with cold Licorice Decoction; for white dysentery, with cold Dried Ginger Decoction; for watery diarrhea, with cold Rice Decoction.
Li Xiao San (Instant Efficacy Powder, made by Yunlin) [Commentary]: Treats dysentery due to heat accumulation and qi stagnation; Huang Lian clears heat, Zhi Ke breaks qi stagnation; a clear and peaceful formula.
Huang Lian (Coptis Rhizome, 4 liang, washed with wine, stir-fried with 2 liang Wu Zhu Yu, discard Wu Zhu Yu), Zhi Ke (Bitter Orange, 2 liang, stir-fried with bran).
Grind into fine powder. Take 3 qian per dose, taken with wine on an empty stomach. For diarrhea, take with rice water. For Jin Kou dysentery, take with aged grain water.
Tiao Zhong Li Qi Tang (Regulate Middle Regulate Qi Decoction): Zhu Danxi said, "Regulating qi removes tenesmus naturally."
Cang Zhu (Atractylodes Lancea, soaked in rice wash water, stir-fried), Pian Zhu (Atractylodes Macrocephala, stir-fried, each 1 qian), Chen Pi (Tangerine Peel, 0.8 qian), Hou Po (Magnolia Bark, stir-fried with ginger, 0.7 qian), Zhi Ke (Bitter Orange, 1 qian), Bai Shao (White Peony Root, stir-fried, 1 qian), Bing Lang (Areca Nut, 1 qian), Mu Xiang (Aucklandia Root, 0.8 qian).
Crush into coarse powder for one dose. Boil in two zhan of water until reduced to one zhan. Strain and take warm on an empty stomach. For red dysentery, do not stir-fry Hou Po and Shao Yao; add Huang Lian (Coptis Rhizome) and Huang Qin (Scutellaria Root) each 1.5 qian. For white dysentery, use the base formula as is.
Jia Wei Xiang Lian Wan (Modified Aucklandia and Coptis Pills) [Commentary]: A regulatory formula for dysentery, serving as the master prescription.
Huang Lian (Coptis Rhizome, 2 liang, stir-fried), Wu Zhu Yu (Evodia Fruit, soaked in boiling water, stir-fried, 2 liang), Mu Xiang (Aucklandia Root, 1 qian), Bai Dou Kou (White Cardamom, wrapped in flour shell and fire-roasted, 1.5 qian). Secret recipe adds Ru Xiang (Frankincense) and Mo Yao (Myrrh) each 1 qian.
Grind into fine powder. Soak 2 liang Wumei (Mume Fruit) in boiling water, remove pits, mash, and mix with powder to form pills the size of paulownia seeds. Take 30 pills per dose. For white dysentery, take with Dried Ginger Decoction; for bloody dysentery, with Licorice Decoction; for mixed red and white, with decoctions of either; for white diarrhea, with rice water.
Cang Lin San (Granary Powder): Treats red and white dysentery with persistent fever. If dysentery with stagnation or summerheat fails to respond to medication, it indicates wind-heat pathogen in the intestines and stomach. This formula is very effective. It is Ren Shen Bai Du San (Ginseng and Imperata Decoction) plus Huang Lian (Coptis Rhizome), Chen Cang Mi (Aged Grain), Jiang (Ginger), and Zao (Jujube) boiled together. For Jin Kou dysentery, add 7 Shi Lian Rou (Stone Lotus Flesh). For post-dysentery hand and foot pain, add Bing Lang (Areca Nut) and Mu Gua (Chaenomeles Fruit). If not treated early, it may develop into Crane Knee Wind (Knee Joint Tuberculosis/Arthritis).
Liu Yi Shun Qi San (Six-One Smooth Qi Powder) [Commentary]: A formula for dysentery with fever due to internal and external pathogen interaction, and epidemic dysentery.
Treats dysentery regardless of red or white mixing, abdominal pain, tenesmus, whole-body fever, dry mouth, and irritability. Use this formula to promote free flow and stop symptoms. (Formula see in Shang Han Men/Treatise on Cold Damage section).
Na Qi Gao (Umbilical Application Paste, transmitted by He Qingyue): Treats critical Jin Kou dysentery, effective immediately.
Hua Gua Teng (Cucumber Vine, any amount, including stems and leaves after frost, dried, burned to ash retaining nature, remove fire toxicity).
Mix with sesame oil and apply to the umbilicus. Effective immediately.
Dian Yan Gao (Eye Drop Ointment, by Huang Bin): Treats all types of red and white dysentery and critical Jin Kou conditions.
Chu Tai Fen (First Feces of Newborn, dried by roasting, 1 qian), Xiong Huang (Realgar, 0.5 qian), Huang Lian (Coptis Rhizome, 0.4 qian), Pian Nao (Borneol, a little).
Grind into extremely fine powder. Mix with water and apply to both eyes. Divine efficacy.
Cang Lian Jian (Coix and Coptis Decoction, transmitted by Liu Taifu): Treats Jin Kou dysentery, regardless of red or white.
Chen Cang Mi (Aged Grain, 3 qian for red, 7 qian for white, 5 qian for mixed), Huang Lian (Coptis Rhizome, 7 qian for red, 3 qian for white, 5 qian for mixed).
Crush ingredients. Boil in one zhong of water until reduced to seven fen. Leave exposed overnight. Take warm on an empty stomach.
Regarding Jin Kou dysentery (inability to eat due to vomiting/nausea in dysentery patients): Although often attributed to spleen deficiency, it is actually caused by heat-toxin blockage affecting the chest, heart, and stomach. Use Shen Ling Bai Zhu San (Ginseng, Poria, and Atractylodes Macrocephala Powder) plus Shi Chang Pu (Acorus Rhizome, 1 qian) and Mu Xiang (Aucklandia Root, a little), ground into powder, taken with aged rice water. Follow with Cang Lian Jian (Coix and Coptis Decoction) for best results. For Jin Kou dysentery unresponsive to other medicines, take maggots from a manure pit, wash clean, dry on tiles, grind into powder. Take 1-2 spoons per dose with rice water to stimulate appetite.
Jin Kou dysentery is mostly due to severe stomach heat. Use Huang Lian (Coptis Rhizome, 1 liang) and Ren Shen (Ginseng Root, 5 qian) boiled in water. Sip throughout the day. If vomited, force-feed again. As long as one sip goes down, improvement occurs. Another method adds Shi Lian Rou (Stone Lotus Flesh, 3 qian), boiled in water, effective immediately. Externally, mash a field snail, add a little She Xiang (Musk), and apply to the umbilicus to draw heat downward. Another method: heat a hammer until red, pour good vinegar on it, and let the patient inhale the smoke. Divine efficacy. All preceding formulas treat inability to eat in dysentery. Physicians should not rigidly distinguish between red and white; if food is vomited immediately and nothing is retained, it is due to toxic fumes steaming upward and severe stomach heat. Do not mistake it for cold-stomach Jin Kou and use acrid-hot drugs. Select from previous formulas, or use Mu Xiang Dao Qi Tang (Aucklandia Qi-Moving Decoction) removing Da Huang (Rhubarb), boil well, add Jiu Zhi (Chinese Chive Juice) and Chen Cang Mi Yin (Aged Grain Drink) each one zhan, take together, and recover.
Jia Jian Yi Qi Tang (Modified Tonify Qi Decoction): Treats weakness and inability to rise from bed due to prolonged dysentery.
Huang Qi (Astragalus Root, 0.5 qian), Ren Shen (Ginseng Root, 0.5 qian), Bai Zhu (Atractylodes Macrocephala, 1 qian), Chen Pi (Tangerine Peel, 1 qian), Dang Gui (Angelica Sinensis, 0.7 qian), Bai Shao Yao (White Peony Root, 1 qian), Sheng Ma (Cimicifuga Rhizome, 0.3 qian), Gan Cao (Licorice Root, roasted, 0.3 qian), Ze Xie (Alisma Rhizome, 0.5 qian), Sha Ren (Amomum Fruit, 0.5 qian), Mu Xiang (Aucklandia Root, 0.3 qian), Bai Dou Kou (White Cardamom, 0.3 qian), Di Yu (Sanguisorba Root, 0.5 qian), Yu Mi Qiao (Poppy Shell, vinegar-roasted, 0.3 qian).
Crush into coarse powder for one dose. Boil in two zhan of water until reduced to eight fen. Strain and take warm on an empty stomach.
Shen Xiao Shen Xiang San (Divine Efficacy Ginseng and Aucklandia Powder) [Commentary]: Treats chronic dysentery with deficient yuan qi, sliding collapse, and sinking; an astringent formula.
Treats weak zang-fu qi, imbalance of cold and heat, accumulating into dysentery. Discharges may include fresh blood, bean juice, fish brain, stagnant blood, purple-black blood, or mixed red and white. Tenesmus and frequent bowel movements day and night.
Ying Su Qiao (Poppy Shell, remove pith, vinegar-roasted, 1 liang), Chen Pi (Tangerine Peel, 1 liang), Bai Fu Ling (Poria, peeled, 4 qian), Rou Dou Kou (Nutmeg, baked in flour, 4 qian), Ren Shen (Ginseng Root, 2 qian), Bai Bian Dou (White Hyacinth Bean, 2 qian), Mu Xiang (Aucklandia Root, 2 qian).
Grind seven ingredients into fine powder. For red dysentery, take 0.9 qian plus 0.1 qian processed Huang Lian powder; for white dysentery, take 0.9 qian plus 0.1 qian processed Wu Zhu Yu powder; for mixed red and white, take 0.8 qian plus 0.1 qian each of Huang Lian and Wu Zhu Yu powder; for green/yellow, no addition, take 1 qian. Take all with rice water. Avoid raw/cold, greasy, and fried foods. Processing Huang Lian and Wu Zhu Yu: Equal parts, do not crush, soak in old wine overnight, stir-fry together until dry, separate, grind separately into fine powder, store separately for use in the above formulas.
Jiang Cha Tang (Ginger and Tea Decoction): Treats dysentery abdominal pain, regardless of red/white or cold/heat. Ginger assists yang, tea assists yin; both clear and disperse. They balance yin and yang and resolve summerheat, alcohol, and food toxins.
Lao Sheng Jiang (Old Ginger, finely cut, 2 qian), Xi Cha Ye (Fine Tea Leaves, 3 qian).
Boil in fresh well water. Another method adds a handful of connected-root Chinese Chives, mash all three into juice, take with wine.
San Bai Tang (Three Whites Decoction, transmitted by Du Shouxuan): Treats dysentery regardless of red or white.
Bai Sha Tang (White Sugar, 1 liang), Ji Zi Qing (Egg White, 1), Shao Jiu (Baijiu/Liquor, 1.5 zhong). Boil to eight fen, take warm.
Xian Mei Wan (Immortal Plum Pill, transmitted by Sang Shuanggang): Treats dysentery with fever and thirst.
Xi Cha (Fine Tea), Wu Mei (Mume Fruit, washed, pitted, dried, each 1 liang).
Grind into powder. Form pills with mashed ginger, size of a bullet. Take one pill with cold water.
Chun Ji Wan (Toon Chicken Pill, transmitted by Sang Huanchuan): Treats chronic dysentery not stopping.
One chicken fed charcoal from snow-covered fields, strangled. Remove intestines and feathers. Insert Huang Lian (Coptis Rhizome, 1 liang) and Chun Gen Bai Pi (Toona Root Bark, 1 liang) into the stomach. Cook well in good liquor. Remove medicine, eat chicken. Divine efficacy.
Shu Fu Yin (Swan Drinking Decoction, transmitted by Liu Tongchuan): Treats white dysentery resembling fish jelly, chronic.
One white duck, slaughter and collect blood. Mix with boiling liquor and drink. Stops immediately.
Jiang Jun Yin (General's Drink): Treats dysentery with thick sticky pus and blood, tenesmus, day and night without limit. Applies to new or old cases, recurring after remission, known as Resting Dysentery (Xiu Xi Li).
Mian Wen Da Huang (Woven-pattern Rhubarb Root, crushed, 1 liang).
Soak in two zhong of good liquor for half a day. Boil to seven fen. Strain. Divide into two doses. Stop when bowels move freely. The preceding formulas are simple for treating dysentery, so they are appended at the end for selection.