夏禹铸曰∶丹溪云痢无止法，以通利为主，此言亦不尽然。何也，痢疾有寒有热，白者
虚寒也，红者实热也，治宜调脾为主。若染一二日，遍身壮热，脓血稠粘，里急后重腹痛
者，宜用承气汤，以下之，或用木香槟榔丸。若虚怯者不可下。病久身凉自汗，宜用补中益
气汤。挟热而痢纯血，宜用四顺清凉饮，或黄连芍药汤。挟冷而痢纯白，或乳食不消者，宜
用理中汤。有湿热之毒熏蒸清道上致胃口闭塞而为噤口者，宜用人参、黄连、石莲子。有痢
久胃气虚则不能乳食而为噤口者，宜用理中汤或六君子汤。有积毒之气上冲而呕恶者，宜用
人参败毒汤。有胃气虚寒而呕恶者，宜用附子理中汤。有痢后脾虚不能制水而遍身浮肿者，
宜用六君子汤，外加苍术、浓朴、猪苓、泽泻、黄连、芍药。有痢久脱肛者，经曰肺气
虚寒，由脾虚而金无所养，故大肠虚脱而下陷也。宜补脾温胃，用固肠饮。有积尽而痢久不
愈，乃脾气下陷，宜用补中益气汤，或四君子汤。若初起宜用姜茶散。有夹暑热而痢下赤白相
兼者，用清暑益气汤加香薷饮。
余长男之日五岁时与幼甥同患痢疾，男素脾弱，痢起腹并不痛，痢下纯脓，白色中带蓝
色，口气微冷。不用通利，即以六君子汤服之。甥痢纯红，遍身有风疹，用四顺清凉饮加防
风、柴胡。两药各器同炉煎。姻家误以男药与甥服之，风疹即隐，气喘促，睡鼾。余急以天
保采薇汤与服，疹复出，喘止。仍用前汤数剂愈。此可见脾虚之极不必清利，硬用补剂。热
痢宜清不可用补之，一验也。
夏禹铸说：朱丹溪曾说治疗痢疾没有固定的止法，应以通利为主，这种说法也不完全正确。为什么呢？因为痢疾有寒证和热证之分，大便白色的是虚寒证，大便红色的是实热证，治疗应当以调理脾胃为主。如果患病仅一两天，全身高热，脓血黏稠，伴有里急后重、腹痛等症状，适宜使用承气汤来攻下，或者使用木香槟榔丸。如果是体质虚弱的人，则不可使用攻下法。如果病程较长，身体发凉且自汗，适宜使用补中益气汤。如果夹带热邪而痢下纯血，适宜使用四顺清凉饮，或者黄连芍药汤。如果夹带冷邪而痢下纯白，或者因乳食不消化引起的，适宜使用理中汤。如果有湿热毒气熏蒸上焦，导致胃口闭塞而形成噤口痢的，适宜用人参、黄连、石莲子。如果痢疾日久导致胃气虚弱，不能进食乳食而形成噤口痢的，适宜使用理中汤或六君子汤。如果有积滞毒气上冲引起呕吐恶心的，适宜使用人参败毒汤。如果因胃气虚寒引起呕吐恶心的，适宜使用附子理中汤。如果在痢疾之后脾虚不能制约水液，导致全身浮肿的，适宜使用六君子汤，外加苍术、厚朴、猪苓、泽泻、黄连、芍药。如果痢疾日久出现脱肛的，《内经》认为这是肺气虚寒，由于脾虚导致肺金无所滋养，所以大肠虚脱而下陷。适宜补脾温胃，使用固肠饮。如果积滞已尽但痢疾日久不愈，这是脾气下陷，适宜使用补中益气汤，或者四君子汤。如果是初起阶段，适宜使用姜茶散。如果夹带暑热而痢下赤白相兼的，使用清暑益气汤加香薷饮。
我的长子五岁时，与年幼的外甥一同患上痢疾。我儿子平时脾胃虚弱，发病时腹部并不疼痛，痢下纯为脓液，白色中带蓝色，口气微冷。我没有使用通利之法，而是直接用六君子汤服用。外甥痢下纯红，全身有风疹，我用四顺清凉饮加防风、柴胡。两副药分别装在容器中放在同一个炉子上煎煮。亲戚家误将我儿子的药给外甥服用，结果外甥的风疹立即隐退，气喘急促，睡觉打鼾。我急忙用天保采薇汤给他服用，皮疹重新发出，喘息停止。随后继续使用前方的药物数剂后痊愈。由此可见，脾虚至极不必使用清利之法，强行使用补剂（对于热痢）是错误的；热痢适宜清热，不可使用补法，这是一个验证。
Xia Yuzhu stated: Zhu Danxi said that there is no fixed method to stop dysentery, and treatment should focus on promoting drainage. This statement is not entirely accurate. Why? Because dysentery can be of cold or heat nature; white discharge indicates deficiency-cold, while red discharge indicates excess-heat. Treatment should primarily regulate the Spleen and Stomach. If the disease has been present for only one or two days, accompanied by high fever throughout the body, thick and sticky pus and blood, tenesmus (urgency with painful defecation), and abdominal pain, Chengqi Tang (Cathartic Decoction) should be used to purge, or Muxiang Binglang Wan (Aucklandia and Betel Nut Pill). However, purgatives must not be used in patients with weak constitution. If the illness has persisted for a long time, the body is cool, and spontaneous sweating occurs, Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) is appropriate. If dysentery is complicated by heat with pure blood discharge, Sishun Qingliang Yin (Four-Obedience Cooling Beverage) or Huanglian Shaoyao Tang (Coptis and Peony Decoction) should be used. If complicated by cold with pure white discharge, or due to indigestion of milk and food, Lizhong Tang (Regulate the Middle Decoction) is suitable. If toxic damp-heat steams upward, blocking the throat and causing loss of appetite (Jinkou Li - Dysentery with inability to eat), Ren Shen (Ginseng Radix et Rhizoma), Huanglian (Coptidis Rhizoma), and Shilianzi (Nelumbinis Semen) are indicated. If prolonged dysentery leads to deficient Stomach Qi, resulting in an inability to consume food and drink (Jinkou Li), Lizhong Tang or Liujunzi Tang (Six Gentlemen Decoction) should be used. If accumulated toxins rush upward causing vomiting and nausea, Renshen Baidu Tang (Ginseng Detoxification Decoction) is appropriate. If vomiting and nausea are caused by deficient-cold of the Stomach, Fuzi Lizhong Tang (Aconite Regulate the Middle Decoction) is indicated. If post-dysenteric Spleen deficiency fails to control water metabolism, leading to generalized edema, Liujunzi Tang (Six Gentlemen Decoction) combined with Cangzhu (Atractylodis Rhizoma), Houpo (Magnoliae Officinalis Cortex), Zhuling (Polyporus), Zexie (Alismatis Rhizoma), Huanglian (Coptidis Rhizoma), and Shaoyao (Paeoniae Radix Alba) is suitable. For prolapse of the rectum due to prolonged dysentery, the *Neijing* states this is due to deficient-cold of the Lung Qi; because Spleen deficiency fails to nourish Metal (Lung), the Large Intestine becomes deficient and collapses downward. Treatment should tonify the Spleen and warm the Stomach using Guchang Yin (Intestine-Securing Beverage). If accumulation is exhausted but dysentery persists, it indicates sinking of Spleen Qi; Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) or Sijunzi Tang (Four Gentlemen Decoction) should be used. In the early stage, Jiangcha San (Ginger and Tea Powder) is appropriate. If dysentery with mixed red and white discharge is complicated by summer-heat, Qingshu Yiqi Tang (Clear Summer-heat and Tonify Qi Decoction) added with Xiangru Yin (Elsholtzia Beverage) is indicated.
My eldest son, at five years old, contracted dysentery simultaneously with my young nephew. My son had a constitutionally weak Spleen; upon onset, his abdomen did not hurt, he passed pure pus, white with blue tinges, and his breath was slightly cold. I did not use draining methods but administered Liujunzi Tang (Six Gentlemen Decoction). The nephew passed pure red stool and had wind-rashes all over his body; I prescribed Sishun Qingliang Yin (Four-Obedience Cooling Beverage) added with Fangfeng (Saposhnikoviae Radix) and Chaihu (Bupleuri Radix). The two prescriptions were decocted separately in different vessels on the same stove. A relative mistakenly gave my son’s prescription to the nephew. Consequently, the nephew’s rashes immediately disappeared, but he developed rapid breathing and snoring during sleep. I urgently administered Tianbao Caiwei Tang (Tianbao Vegetable-Picking Decoction). The rashes reappeared, and the wheezing ceased. He recovered after several more doses of the previous formula. This demonstrates that extreme Spleen deficiency does not require clearing and draining; forcibly using tonics [for heat-type dysentery] is incorrect. Heat dysentery requires clearing and should not be treated with tonics; this serves as verification.