一痢疾无外症恶症。但见里急后重便脓血者。三日内。俱宜
芍药汤。（六十）
一痢疾腹中撮痛。或下血片。及噤口恶痢。诸药不效者。宜
斗门秘传方。（七十）
一痢疾不论新久。以陈米汤送下香连丸三钱。一日三服。极验。至于久痢。以四君子汤
六君子汤补中益气汤十全大补汤送下。法本薛氏多效。
一久痢诸药不效。审其为虚脱不禁无余邪者。宜
真人养脏汤。（七十五）
一久痢流连不愈。愈而又作。名为休息痢。是堵涩太早。余邪未尽。宜羊脂四钱。白蜡
三钱。黄连末三钱。白蜜八钱。乌梅肉炒研末二钱。血余灰三钱。煎搅为丸丸如桐子大。以
米饮送下三十丸。日三服。此孙真人法也。○又有服补中益气汤。不应。反下鲜紫血块者。
此久风成食泄。风气通于肝。肝伤不能藏血也。宜玉屏风散。去白术。倍防风。加羌活葛根
升麻主之。宜
玉屏风散。（六十七）
一洞泄寒中。注下水谷。赤痢白痢。食已即出。
食物不消者。宜
圣济附子丸。（七十）
（修园新订）
程山龄云。时疫之症。须知有来路两条。去路五条。何谓来路两条。疫有在天者。在人
者。如春应温而反寒。夏应热而反凉。秋应凉而反热。冬应寒而反温。非其时而有其气。自
人受之。皆从经络而入。或为头痛发热咳嗽。或颈肿发？大头风之类。斯在天之疫也。若一
人之病。染及一室。一室之病。染及一乡。以及阖邑。病气秽气。互相传染。其气从口鼻而
入。其见症。憎寒壮热。胸膈饱闷。○吐黄涎。乃在人之疫以气相感。与天无涉。所谓来路
两条者此也。夫在天之疫。邪从经络入。寒多者。治以辛温。宜五积散。热多者。治以辛凉。
宜九味羌活汤。审其气虚不能作汗者。宜人参败毒散。热甚格邪。不作汗者。宜防风通圣散。
若发颐及大头症。是风火相乘而为毒。宜防风通圣散。加牛蒡子金银花桔梗贝母栝蒌仁之类。
俾邪从经络入者。仍从经络出。此以发汗为去路也。在人之疫。邪从口鼻入。或香苏饮。
加玉竹川芎忍冬。或神术散。加葛根葱头。或藿香正气散之类。俾其从口鼻入者。仍从口鼻
出。此以解秽为去路也。至于经络口鼻所受之邪。传于阳明之经。则为自汗大渴大热斑黄等
症。宜甘露饮。生其津液。以为胜邪回生之本。甚者必用人参白虎汤。以清阳明散漫之热。
此以清火为去路也。如入于胃腑。则为谵语发狂。大便实小腹拒按等症。宜三一承气汤下之
。或内有实热外有实邪者。宜防风通圣以两解。此方。疫症第一良方用之得法。不论新久。
头头是道。此以攻下为去路也。复有虚人患疫。或病久变虚。或误治变虚。须用四物汤四君
子汤补中益气汤等加减。此以补养托邪为去路也。要之疫症必从大汗而解。人壮者。不战而
汗。人虚者。必战栗而后大汗。汗未彻者。俟七日后而又作汗。以上五法。该于发汗一法之
中。散邪。是发汗正法。而秽浊之气袭经络。不以辛香解之。则汗不出。火邪内燔。血干津
涸。非清火。则阴气不滋而汗不出。胃气壅塞不攻。其实。则浊气不解。而汗不出。汗由液
化其出自阳。其源自阴。非补养阴阳。则气血不充。而汗不出。此发汗一法。为治疫大关头
。有汗则生无汗则死。若治之失法。或涸其汗源。或强逼使汗皆枉其死也。可不慎哉
未汗。宜阳脉。忌阴脉。 已汗。宜阴脉。忌阳脉。
痢疾如果没有外感表证和危重恶症，只要见到里急后重、排泄脓血症状的，在三日内，都适宜使用芍药汤。
痢疾如果伴有腹部拘急疼痛，或者排出片状血液，以及出现噤口痢（无法进食）等严重痢疾，服用各种药物无效时，适宜使用斗门秘传方。
痢疾无论新发还是久病，用陈米汤送服香连丸三钱，每日三次服用，效果极佳。至于久痢，可用四君子汤、六君子汤、补中益气汤、十全大补汤送服，这种方法源自薛氏，多有效验。
久痢服用各种药物无效，仔细辨证确认为虚脱不禁且无其余邪滞留者，适宜使用真人养脏汤。
久痢迁延不愈，好了又发作，称为休息痢，这是因为过早使用收敛固涩药物，导致余邪未尽。适宜用羊脂四钱、白蜡三钱、黄连末三钱、白蜜八钱、乌梅肉炒研成末二钱、血余灰三钱，煎煮搅拌制成如梧桐子大小的丸药，用米饮送下三十丸，每日三次服用。这是孙思邈的方法。○又有服用补中益气汤无效的，反而排出鲜紫色血块的，这是久风导致的食泄，风气通于肝，肝受伤不能藏血。适宜使用玉屏风散，去掉白术，加倍防风，加入羌活、葛根、升麻为主治方。适宜使用玉屏风散。
洞泄寒中（寒邪直中脾胃导致的严重腹泻），水谷直下，赤白痢疾，食物吃下后立即吐出或排出，食物不消化者，适宜使用圣济附子丸。
（修园新订）
程山龄说：时疫的症状，必须知道有两条来路，五条去路。什么叫来路两条？疫病有的来自天时，有的来自人际传染。比如春天应该温暖却反常寒冷，夏天应该炎热却反常凉爽，秋天应该凉爽却反常炎热，冬天应该寒冷却反常温暖，非其时而有其气，人受到这种气候影响，病邪都从经络侵入，表现为头痛、发热、咳嗽，或者颈部肿胀引发大头风之类，这是来自天时的疫病。如果一个人的病，传染给一屋子人，一屋子人的病，传染给一个乡，甚至全县，病气和秽气互相传染，病邪从口鼻侵入，出现的症状是憎寒壮热（极度怕冷同时高热）、胸膈饱闷、吐黄涎，这是人际间的疫病，以气相感应，与天时无关。所谓来路两条就是说的这个意思。来自天时的疫病，邪气从经络进入，寒邪多的，用辛温法治疗，适宜五积散；热邪多的，用辛凉法治疗，适宜九味羌活汤；审察其气虚不能作汗的，适宜人参败毒散；热势极盛格拒邪气，不能作汗的，适宜防风通圣散。如果出现发颐（腮腺炎类疾病）及大头症，这是风火相乘化为毒邪，适宜防风通散，加入牛蒡子、金银花、桔梗、贝母、瓜蒌仁之类，使从经络侵入的邪气，仍从经络排出，这是以发汗为去路。人际间的疫病，邪气从口鼻进入，或用香苏饮加玉竹、川芎、忍冬，或用神术散加葛根、葱头，或用藿香正气散之类，使其从口鼻侵入的邪气，仍从口鼻排出，这是以解秽为去路。至于从经络和口鼻受受的邪气，传入阳明经，就会出现自汗、大渴、大热、斑疹发黄等症状，适宜甘露饮，滋生津液，作为战胜邪气、挽救生命的基础。严重的必须用人参白虎汤，以清除阳明经散漫的热邪，这是以清火为去路。如果邪气进入胃腑，就会出现谵语、发狂、大便干结、小腹拒按等症状，适宜三一承气汤攻下。或者内有实热外有实邪的，适宜防风通圣散两解表里。这个方子是治疗疫症的第一良方，用法得当，不论新病久病，条理清晰。这是以攻下为去路。又有体虚之人患疫，或者病久转为虚证，或者误治转为虚证，需要用四物汤、四君子汤、补中益气汤等加减治疗，这是以补养托邪为去路。总之，疫症必须通过大汗才能解除。身体强壮的人，不战栗而直接出汗；身体虚弱的人，必须经过战栗之后才出大汗。汗出不彻底的，等待七日后又会再次出汗。以上五种方法，都包含在发汗这一法之中。疏散邪气，是发汗的正法；而秽浊之气侵袭经络，不用辛香药解之，则汗不出；火邪内燔，血干津涸，不清火，则阴气不滋而生不出汗；胃气壅塞不通，不攻其实，则浊气不解而生不出汗；汗由体液转化而来，出自阳分，源自阴分，不补养阴阳，则气血不充而生不出汗。这发汗一法，是治疗疫症的关键大关头，有汗则生，无汗则死。如果治疗失当，要么枯竭其汗源，要么强行逼迫出汗，都会导致枉死。能不谨慎吗？未出汗时，宜见阳脉，忌见阴脉；已出汗后，宜见阴脉，忌见阳脉。
Dysentery without exterior symptoms or severe malignant signs: whenever there are tenesmus and passage of pus and blood, within three days, Shaoyao Decoction (Shaoyao Tang) is suitable.
For dysentery accompanied by cramping abdominal pain, passage of bloody clots, or anorexic dysentery (Jinkou Li), where various medicines have failed, the Doumen Secret Formula (Doumen Mitruan Fang) is suitable.
For dysentery regardless of whether it is new or chronic, Xianglian Pill (Xianglian Wan) taken with old rice soup, three qian per dose, three times a day, is highly effective. For chronic dysentery, it can be administered with Sijunzi Decoction (Sijunzi Tang), Liujunzi Decoction (Liujunzi Tang), Buzhong Yiqi Decoction (Buzhong Yiqi Tang), or Shiquan Dabu Decoction (Shiquan Dabu Tang). This method originates from Dr. Xue and is often effective.
For chronic dysentery unresponsive to various medicines, if carefully diagnosed as deficiency collapse with incontinence and no remaining pathogenic factors, Zhenren Yangzang Decoction (Zhenren Yangzang Tang) is suitable.
For chronic dysentery lingering and recurring, known as Resting Dysentery (Xiuxi Li), caused by premature use of astringents leaving residual pathogens, use four qian of Mutton Fat (Yangzhi), three qian of White Beeswax (Baila), three qian of Coptis Powder (Huanglian Mo), eight qian of White Honey (Baimi), two qian of Stir-fried and Ground Smoked Plum Flesh (Wumei Rou), and three qian of Ashed Human Hair (Xuyuhui). Boil and stir into pills the size of Torreya seeds, taken with rice drink, thirty pills per dose, three times a day. This is the method of Sun Simiao. ○ In cases where Buzhong Yiqi Decoction fails and fresh purple bloody clots are passed, this is food retention diarrhea caused by long-standing wind; wind energy connects to the Liver, and liver injury leads to failure to store blood. Yupingfeng San (Yupingfeng San) is suitable, removing Atractylodes Macrocephala Rhizome (Baizhu), doubling Saposhnikovia Root (Fangfeng), and adding Notopterygium Rhizome (Qianghuo), Pueraria Root (Gegen), and Cimicifuga Rhizome (Shengma) as the main treatment. Yupingfeng San is suitable.
For Dongxie Cold Middle (severe diarrhea due to cold invading the spleen/stomach), with water and undigested food passing directly, red and white dysentery, immediate expulsion after eating, and indigestion, Shengji Fuzi Wan (Shengji Fuzi Wan) is suitable.
(Revised by Xiuyuan)
Cheng Shanling stated: Regarding epidemic diseases, one must understand there are two sources (lai lu) and five exit routes (qu lu). What are the two sources? Epidemics come from Heaven (natural climate) or from Humans (human-to-human transmission). For example, spring should be warm but is cold; summer should be hot but is cool; autumn should be cool but is hot; winter should be cold but is warm. When the season does not match the qi, humans contract it, and the pathogen enters via the meridians, manifesting as headache, fever, cough, or neck swelling leading to Big Head Wind (Datou Feng). This is an epidemic from Heaven. If one person's illness infects a room, a room infects a village, and a village infects a county, the disease qi and turbid qi transmit mutually. The pathogen enters via the mouth and nose, manifesting as aversion to cold with high fever, chest fullness, and vomiting of yellow saliva. This is a human epidemic, transmitted by qi resonance, unrelated to Heaven. These are the two sources. For epidemics from Heaven, the pathogen enters via meridians. If cold predominates, treat with acrid-warm methods; Wuji San (Wuji San) is suitable. If heat predominates, treat with acrid-cool methods; Jiwei Qianghuo Tang (Jiwei Qianghuo Tang) is suitable. If qi deficiency prevents sweating, Renshen Baidu San (Renshen Baidu San) is suitable. If extreme heat repels the pathogen preventing sweating, Fangfeng Tongsheng San (Fangfeng Tongsheng San) is suitable. For conditions like Parotitis (Fayi) and Big Head Syndrome, caused by wind-fire combining into toxicity, Fangfeng Tongsheng San added with Arnebia Root/Lithospermum Root (Niubangzi), Honeysuckle Flower (Jinyinhua), Platycodon Root (Jiegeng), Trichosanthes Seed (Gualou Ren), etc., is used so that pathogens entering via meridians exit via meridians. This is using sweating as an exit route. For human epidemics, the pathogen enters via mouth/nose. Use Xiangsu Yin (Xiangsu Yin) added with Polygonatum Odoratum Rhizome (Yuzhu), Ligusticum Chuanxiong Rhizome (Chuanxiong), Lonicera Japonica Flower/Bud (Renjendu), or Shenzhu San (Shenzhu San) added with Pueraria Root (Gegen) and Scallion Stalk (Congtou), or Huoxiang Zhengqi San (Huoxiang Zhengqi San), so that pathogens entering via mouth/nose exit via mouth/nose. This is using resolving turbidity as an exit route. As for pathogens received via meridians and mouth/nose transmitting to the Yangming Meridian, symptoms include spontaneous sweating, great thirst, high fever, macules, and jaundice. Ganlu Yin (Ganlu Yin) is suitable to generate fluids as the basis for overcoming pathogens and restoring life. Severe cases require Renshen Baihu Tang (Renshen Baihu Tang) to clear scattered heat in Yangming. This is using clearing fire as an exit route. If entering the Stomach Fu, symptoms include delirium, mania, constipation, and lower abdominal tenderness. Sanyi Chengqi Tang (Sanyi Chengqi Tang) is suitable for purgation. If there is interior excess heat and exterior excess pathogen, Fangfeng Tongsheng San is suitable to resolve both. This formula is the premier good prescription for epidemics; when used correctly, it is logical for both new and chronic cases. This is using purgation as an exit route. For deficient persons suffering from epidemics, or those becoming deficient due to prolonged illness or mis-treatment, Siwu Tang (Siwu Tang), Sijunzi Tang (Sijunzi Tang), Buzhong Yiqi Tang (Buzhong Yiqi Tang), etc., should be modified. This is using nourishment to support and expel pathogens as an exit route. Essentially, epidemics must resolve through heavy sweating. Robust persons sweat without shivering; deficient persons must shiver before heavy sweating. If sweating is incomplete, wait seven days for another bout of sweating. The above five methods are contained within the sweating method. Dispersing pathogens is the correct sweating method. However, if turbid qi attacks meridians and is not resolved with acrid-aromatics, sweat will not occur. If fire evil burns internally, drying blood and fluids, clearing fire is required to nourish yin and produce sweat. If stomach qi is obstructed and excess is not purged, turbid qi will not resolve and sweat will not occur. Sweat transforms from fluids, originating from yang but sourced from yin. Without nourishing yin and yang, qi and blood will not be sufficient, and sweat will not occur. Thus, the sweating method is the critical juncture in treating epidemics: sweating means life, no sweating means death. Improper treatment either depletes the source of sweat or forces sweat, leading to wrongful death. One must be cautious. Before sweating, yang pulse is suitable, yin pulse is contraindicated. After sweating, yin pulse is suitable, yang pulse is contraindicated.