【歌】湿蒸热瘀而成痢，后重里急由气滞。下迫窘痛火为殃，未虚芍药并承气。下后虽宽痢不清，香连化
滞应须继。若还久病补兼升，虚坐努责和血是。表里有热内疏之，小水不通可分利。身寒呕逆脉细微，水液澄
彻制温剂。豆汁鱼脑半死生，尘腐纯血皆难治。噤口多因胃不升，若然不禁须兜
住。
【论】痢者，古名滞下，以其积滞不行故也。盖人日受饮食之积留滞于内，湿蒸热瘀，伏而不作，偶或
调摄失宜，复感酷热之毒，至秋，阳气始收，火气下降，蒸发蓄积，而滞下之病作矣。故湿热之积干于血分则
赤，干于气分则白，赤白兼下者，气血俱病也。豆汁色者，湿胜也。如五色之相染，五脏俱病也。纯红者，热
毒入深也。鱼脑色者，脾虚不运，陈积脱滑下凝也。如鼻冻胶者，脏腑虚冷脱滑也。如白脓者，虚坐努责而出，
气受热邪瘀结也。如屋漏水，枣腐色者，元气惫弱之盛也。后重里急，至圊不能便，下迫窘痛，大肠经滞不通，
湿热内盛也。初病元气未虚，里急甚者下之。下后余积未清，不可骤补，宜化滞清热荡涤之，直候积尽，方可
调补气血。今人不问新久便兜涩，为患匪轻。善治者，审其冷、热、虚、实、气、血之证，而行汗、吐、下、
清、温、补、兜、涩之法可也。
达按∶痢之作也，非一朝一夕之故，其所由来者渐矣。盖平素饮食不节，将息失宜，油腻生冷恣供口腹，
醉之以酒，劳之以色，游行冒暑，奔驰忍饥，尘事关心，冗言生恼，七情六欲日夜交攻，以致气血俱伤，饮食
停积，湿热熏蒸，化为秽浊。足太阴脾经之病传于手阳明大肠经，大肠为肺之腑，肺主清化，脾土受病则不能
生金，而肺失清化之令，脏不受病而病其腑，故大肠受之。大肠于五行为金，于时令为秋，故痢多发于秋也。
痢之初作时，须先服大剂消血化积之药，浮动其根，次服下剂，荡涤肠垢，旋为调补，以收全功。然又必分在
气在血∶白者伤于气；赤者伤于血；赤白混杂者，气血俱伤。若无赤白，惟见黄色稠浊者，以食积治。后重者，
以火治。杂下散血者，以伤治。凡初痢皆属于热，宜凉解。
久痢不愈，则变为寒，宜温补。肛肠下者，宜补气兼升。经年累月，时愈时发者，名休息痢，宜调胃气，服大
补之剂，此治痢之大要也。凡痢∶身不热者轻；身热者重；能食者轻；不能食者重；绝不食者死；发呕者死；
直肠自下者死；久痢忽大下结粪者死；小儿出痘后，即发痢者死；妇人新产，即发痢者死。
【脉】涩则无血，厥寒为甚，尺微无阴，下痢逆冷。又曰∶无积不痢，脉宜滑大，浮弦急死，沉细无害。
热盛内实
初病后重里急，下迫窘痛，芍药汤。下后痢止，热甚而渴，便赤者，黄芩汤。腹痛不通快，里急，香连化
滞汤、三黄丸。
芍药汤
治痢初起，腹痛，里急后重，数至圊，不能便。
芍药 当归（各钱五分） 黄连 黄芩（各钱二分） 肉桂（四分） 槟榔（一钱） 木香（六分）
甘草（四分） 大黄（量人虚实，临时斟酌）
加浓朴（一钱） 枳壳（一钱） 青皮（五分）
上，水煎，温服。
如后重，小便涩，加炒滑石一钱五分。如腹痛甚，加砂仁一钱，再加当归、木香各五分。食积加山楂、枳
实各一钱。红痢加川芎、桃仁泥各一钱。白痢加茯苓、陈皮、砂仁各八分。红白相杂加川芎、桃仁以理血；滑
石、陈皮、苍术以理气。如呕吐，食不下，加软石膏、炒山栀各一钱，陈皮八分，入姜汁缓缓呷之，以泻胃口
之热。如色赤、黑相杂，此湿胜也，小便必赤涩短少，加木通、泽泻、茯苓各一钱，炒山栀仁五分以分利之。
如血痢，加川芎、桃仁、生地、炒槐花各一钱，去大黄、槟榔、肉桂。有一样寒痢，去大黄、黄芩，加
干姜、缩砂、浓朴各五分以温之。孕妇不用大黄，加山栀二钱，倍加芩、连、枳壳。
黄芩汤
治协热下利（一名黄芩芍药汤。）
黄芩（炒，二钱） 芍药（炒，一钱半） 甘草（一钱）
水煎，温服。
香连化滞汤
治积滞不行，里急后重，频上圊而去少。
即芍药汤去大黄、桂，加青皮、枳实、滑石、陈皮。
挟风邪
外挟风邪，宜汗之，苍术防风汤。恶寒发热，身首痛，神术汤。风邪乘虚入于肠胃，下清血，胃风汤。（方见泄泻。）
苍术防风汤
苍术（三钱，泔制） 防风（一钱五分）
加黄连 木香（各五分） 浓朴 陈皮 枳壳（各一钱） 甘草（四分）
上，生姜七片，煎服。
如头痛身疼，发热，加川芎、羌活、柴胡、黄芩各一钱。腹痛加当归、炒芍药、砂仁各一钱。里急后重加
槟榔一钱。
神术散
治四时瘟疫，头疼项强，发热憎寒，身体疼痛。伤寒鼻塞声重，咳嗽头昏。
本 羌活 甘草 白芷 细辛 苍术 川芎
上，姜、葱煎服。
秘方
治疫痢，一人有病，他人即传染者是也。
用苍术一两，水三钟，煎至二钟，去苍术，入防风、白术、芍药、羌活、人中黄各一钱，煎至一钟，温服。
挟寒
挟寒者，所下清冷，不渴，小便清白，手足冷，无热证，脉沉迟，理中汤。过食生冷，及服寒凉药多，本
方加附子。病久，所下若鼻涕、冻胶，脉迟弱，形体虚怯，四肢倦怠，除湿汤。
理中汤
祛寒，止呕逆泄利，定心腹冷痛，温脾固胃。
人参 甘草（炙） 白术 干姜（炮，等分）
上，水、姜煎。
加附子名附子理中汤。
除湿汤
浓朴（姜汁拌炒） 苍术（米泔浸，炒） 半夏（各一钱） 藿香叶（三分） 陈皮 茯苓 白术（各五分）
姜、枣水煎，温服。
食积痢
下痢腹痛，饮食不化，胀满，保和丸。原有食积，腹胀里急，香连化滞汤。急痛，枳术丸加黄连、木通、
神曲、麦芽、芍药、木香、槟榔。
保和丸（方见伤食。）
枳术丸（方见脾胃。）
虚弱痢
久病气血虚，神不足，钱氏白术散。久病便清血，胃风汤。倦怠食不进，卫生汤。脾气陷下，虚坐努责不
出，补中益气汤。
钱氏白术散（方见泄泻。）
异功散
即四君子加陈皮。
卫生汤
即异功散加山药、薏苡仁、泽泻、黄连（等分。）
补中益气汤（方见内伤。）
王节斋治久痢方
红痢久，胃弱血虚，或下后未愈，用四物汤加阿胶、陈皮、白术、芩、连、甘草。
白痢久，胃弱气虚，或下后未愈，用四君子汤加黄 、陈皮、缩砂、木香、干姜等分，芩、连减半煎服。
气血俱虚而痢者，用四物汤加人参、白术、陈皮、黄连、黄芩、阿胶以补之，而痢自止。气下陷加升麻。
滑脱
久病滑泻不禁，气虚欲脱，诃子散。元气脱弱，大孔如竹筒，直出无禁，真人养脏汤或可十全一、二也。
诃子散
治泄痢久不止。
木香（五钱） 甘草（炙） 黄连（各三钱） 诃子（一两，半生半熟）
末之，煎芍药白术汤调服二钱。
真人养脏汤
治久痢不止，滑泄不禁。
人参 当归 白芍 甘草（各四分） 肉果 诃子（各三分） 木香（七分） 肉桂（三分） 白术
（二分） 粟壳（去蒂、盖，蜜炙，一钱）
脏寒加附子。
噤口痢
噤口痢者，大虚大热，以人参、姜炒黄连煎汤时时哈之，更以田螺捣 脐中。或以石莲子煎汤频饮之。此
病得之热毒瓦斯侵胃口，犹有可治之理，至于胃弱气陷，绝不思食者，则难治也。
治噤口痢秘方
一用香连丸、石莲肉二味等分，为末，米饮调下。
一用干山药一斤，略炒，煮汤，时时呷之。
一用石莲肉晒干为末，陈仓米煎汤调下二钱，便觉思食。仍以日照东壁土炒真橘皮为末，姜、枣煎服。
一用木鳖子为末，和面作饼，贴脐中。
【歌诀】湿热蒸腾、热邪瘀结而形成痢疾，后重里急是由于气机阻滞。肛门下迫窘迫疼痛是火邪为患，若正气未虚，可用芍药汤配合承气汤治疗。攻下之后虽然症状缓解但痢疾未清，应当继用香连化滞汤。若是久病，则需补益兼以升提，出现虚坐努责时应调和血液。表里俱热者宜内疏清热，小便不通者可分利小便。身体寒冷、呕吐逆气、脉象细微，且排泄物清澈透明者，应使用温性药剂。如豆汁色、鱼脑色属半死半生之候，如尘腐色、纯血色皆难治愈。噤口痢多因胃气不升所致，若饮食不禁须用兜涩法固摄。
【论述】痢疾，古称“滞下”，是因为体内积滞不行所致。大概人们每日摄入的饮食积滞留在体内，湿热蒸腾、热邪瘀结，潜伏而不发作；偶然间调护失当，又感受酷热毒邪，到了秋季，阳气开始收敛，火气下降，蒸发蓄积的邪气，于是滞下之病就发作了。所以，湿热之邪侵犯血分则便下赤色，侵犯气分则便下白色，赤白相兼而下者，是气血都受病了。像豆汁颜色的，是湿邪偏胜。像五色混杂相染的，是五脏都受病了。纯红色的，是热毒深入。像鱼脑颜色的，是脾虚不能运化，陈旧的积滞脱滑下行凝结而成。像鼻冻胶（鼻涕状）的，是脏腑虚冷导致脱滑。像白脓样的，是虚坐努责而出，气受热邪瘀结所致。像屋漏水、枣腐色的，是元气极度衰弱。后重里急，想上厕所却排不出，肛门下迫窘迫疼痛，是大肠经气机阻滞不通，湿热内盛所致。初发病时元气尚未虚弱，里急严重的应当攻下。攻下后余留的积滞未清，不可立即进补，宜用化滞、清热、荡涤的方法，直到积滞排尽，才可以调理补益气血。现在的人不分新病久病就用兜涩止泻之法，造成的危害不小。善于治疗的人，审察其寒、热、虚、实、气、血的证候，而行汗、吐、下、清、温、补、兜、涩等治法即可。
达按：痢疾的发生，不是一朝一夕的缘故，它的由来是逐渐积累的。大概平时饮食不节制，调养失当，恣意食用油腻生冷之物，醉酒纵欲，冒暑游行，奔驰忍饥，尘事挂心，冗杂言语生恼，七情六欲日夜交攻，以致气血俱伤，饮食停积，湿热熏蒸，化为秽浊之气。足太阴脾经的病传变到手阳明大肠经，大肠是肺的腑，肺主清肃化降，脾土受病则不能生金（肺气），导致肺失去清肃化降的职能，脏虽未直接受病但影响了其腑，所以大肠受病。大肠在五行中属金，在时令中对应秋季，所以痢疾多发于秋季。痢疾刚发作时，必须先服用大剂量消血化积的药物，浮动其病根，其次服用攻下药，荡涤肠道垢腻，随即进行调补，以收全功。然而又必须分辨病在气分还是血分：白色的损伤气分；红色的损伤血分；赤白混杂的，气血都受伤。如果没有赤白，只见黄色稠浊的，按食积治疗。后重的，用火法治之（指清热或行气）。杂下散血的，按伤血治疗。凡是初起痢疾都属于热，宜用凉解法。久痢不愈，则变为寒证，宜用温补法。直肠脱出的，宜补气兼升提。经年累月，时好时发的，名叫休息痢，宜调理胃气，服用大补剂，这是治疗痢疾的大要。凡痢疾：身体不发热的轻；发热的重；能进食的轻；不能进食的重；完全不能进食的死；发生呕吐的死；直肠自下（脱肛）的死；久痢突然大便排出硬结粪块的死；小儿出痘疹后立即发痢的死；妇女新产后立即发痢的死。
【脉诊】脉涩表示无血，厥冷寒甚，尺脉微弱表示无阴，下痢伴四肢逆冷。又说：无积滞不成痢，脉象宜滑大，浮弦急者死，沉细者无害。
热盛内实证：初病后重里急，肛门下迫窘痛，用芍药汤。攻下后痢止，热甚口渴，小便赤者，用黄芩汤。腹痛不通快，里急，用香连化滞汤、三黄丸。
芍药汤
治疗痢疾初起，腹痛，里急后重，频繁去厕所却不能排便。
芍药、当归（各五分），黄连、黄芩（各二分），肉桂（四分），槟榔（一钱），木香（六分），甘草（四分），大黄（根据病人虚实情况，临时斟酌用量）。
加浓朴（一钱）、枳壳（一钱）、青皮（五分）。
以上药物，水煎，温服。
如果后重明显，小便涩滞，加炒滑石一钱五分。如果腹痛严重，加砂仁一钱，再加当归、木香各五分。有食积加山楂、枳实各一钱。红痢加川芎、桃仁泥各一钱。白痢加茯苓、陈皮、砂仁各八分。红白相杂加川芎、桃仁以理血；滑石、陈皮、苍术以理气。如果有呕吐，吃不下东西，加软石膏、炒山栀各一钱，陈皮八分，加入姜汁慢慢呷服，以泻胃口之热。如果血色赤黑相杂，这是湿胜的表现，小便必定赤涩短少，加木通、泽泻、茯苓各一钱，炒山栀仁五分以分利小便。如果是血痢，加川芎、桃仁、生地、炒槐花各一钱，去掉大黄、槟榔、肉桂。有一种寒痢，去掉大黄、黄芩，加干姜、缩砂、浓朴各五分以温中之。孕妇不用大黄，加山栀二钱，加倍黄芩、黄连、枳壳。
黄芩汤
治疗协热下利（又名黄芩芍药汤）。
黄芩（炒，二钱）、芍药（炒，一钱半）、甘草（一钱）。
水煎，温服。
香连化滞汤
治疗积滞不行，里急后重，频繁去厕所但排便量少。
即芍药汤去掉大黄、肉桂，加青皮、枳实、滑石、陈皮。
挟风邪证
外感风邪，宜用发汗法，用苍术防风汤。恶寒发热，头身疼痛，用神术汤。风邪乘虚侵入肠胃，下注清血，用胃风汤。（方剂见泄泻章节。）
苍术防风汤
苍术（三钱，泔水制过）、防风（一钱五分）。
加黄连、木香（各五分）、浓朴、陈皮、枳壳（各一钱）、甘草（四分）。
以上药物，生姜七片，煎服。
如果头痛身疼，发热，加川芎、羌活、柴胡、黄芩各一钱。腹痛加当归、炒芍药、砂仁各一钱。里急后重加槟榔一钱。
神术散
治疗四时瘟疫，头疼项强，发热憎寒，身体疼痛。伤寒鼻塞声重，咳嗽头昏。
本（此处疑为“本”字误或特定草药，原文如此）、羌活、甘草、白芷、细辛、苍术、川芎。
以上药物，生姜、葱白煎服。
秘方
治疗疫痢，一人有病，他人即被传染的情况。
用苍术一两，水三钟，煎至二钟，去掉苍术，入防风、白术、芍药、羌活、人中黄各一钱，煎至一钟，温服。
挟寒证
挟寒者，所下排泄物清冷，口不渴，小便清白，手足冷，无热证，脉沉迟，用理中汤。过食生冷，及服用寒凉药过多，本方加附子。病久，所下排泄物像鼻涕、冻胶，脉迟弱，形体虚怯，四肢倦怠，用除湿汤。
理中汤
祛寒，止呕逆泄利，定心腹冷痛，温脾固胃。
人参、甘草（炙）、白术、干姜（炮，等分）。
以上药物，水、生姜煎服。
加附子名为附子理中汤。
除湿汤
浓朴（姜汁拌炒）、苍术（米泔水浸，炒）、半夏（各一钱）、藿香叶（三分）、陈皮、茯苓、白术（各五分）。
生姜、大枣水煎，温服。
食积痢
下痢腹痛，饮食不化，胀满，用保和丸。原有食积，腹胀里急，用香连化滞汤。急痛，用枳术丸加黄连、木通、神曲、麦芽、芍药、木香、槟榔。
保和丸（方剂见伤食章节。）
枳术丸（方剂见脾胃章节。）
虚弱痢
久病气血虚，精神不足，用钱氏白术散。久病便下清血，用胃风汤。倦怠食欲不振，用卫生汤。脾气下陷，虚坐努责不出，用补中益气汤。
钱氏白术散（方剂见泄泻章节。）
王节斋治疗久痢方
红痢日久，胃弱血虚，或攻下后未愈，用四物汤加阿胶、陈皮、白术、黄芩、黄连、甘草。
白痢日久，胃弱气虚，或攻下后未愈，用四君子汤加黄芪、陈皮、缩砂、木香、干姜等分，黄芩、黄连减半煎服。
气血俱虚而患痢疾的，用四物汤加人参、白术、陈皮、黄连、黄芩、阿胶以补之，痢疾自然停止。气下陷加升麻。
滑脱证
久病滑泻不禁，气虚欲脱，用诃子散。元气脱弱，肛门如竹筒直出无法控制，真人养脏汤或许能救一二。
诃子散
治疗泄痢久不止。
木香（五钱）、甘草（炙）、黄连（各三钱）、诃子（一两，半生半熟）。
研末，用芍药白术汤调服二钱。
真人养脏汤
治疗久痢不止，滑泄不禁。
人参、当归、白芍、甘草（各四分）、肉果、诃子（各三分）、木香（七分）、肉桂（三分）、白术（二分）、粟壳（去蒂、盖，蜜炙，一钱）。
脏寒加附子。
噤口痢
噤口痢者，属大虚大热，用人参、姜炒黄连煎汤时时哈气吸入，更用田螺捣烂敷脐中。或用石莲子煎汤频饮。此病得之于热毒瓦斯侵胃口，还有可治的道理，至于胃弱气陷，完全不想吃东西的，则难治。
治疗噤口痢秘方
一用香连丸、石莲肉两味等分，研末，米饮调下。
一用干山药一斤，略炒，煮汤，时时呷服。
一用石莲肉晒干为末，陈仓米煎汤调下二钱，便觉得思食。仍以日照东壁土炒真橘皮为末，姜、枣煎服。
一用木鳖子为末，和面作饼，贴于脐中。
[Song] Dysentery arises from the steaming of dampness and the stasis of heat; tenesmus (feeling of incomplete defecation) and urgency are caused by qi stagnation. The urgent, painful pressure in the anus is a disaster of fire; if deficiency has not yet occurred, Shaoyao Tang (Peony Decoction) combined with Chengqi Tang (Order the Qi Decoction) should be used. After purgation, although relief is gained, if the dysentery is not cleared, Xianglian Zhizhi Tang (Costus and Coptis Decoction to Transform Stagnation) must follow. If it is a chronic disease, tonification combined with lifting is needed; for false tenesmus (xu zuo nu ze), harmonizing blood is appropriate. For heat in both exterior and interior, internal clearing and dispersing is indicated; for obstruction of urination, separating and promoting diuresis may be used. For cold body, vomiting, and reversal, with a fine and minute pulse, and clear urine, warming agents should be controlled. Colors like bean juice or fish brain indicate a half-dead, half-living state; dust-rotten color or pure blood are all difficult to treat. Jin Kou Li (Dysentery with inability to eat) is mostly due to the failure of stomach qi to ascend; if food intake cannot be retained, astringent methods must be employed to secure it.
[Dissertation] Dysentery was formerly known as "Zhi Xia" (Stagnant Downward Flow) because of the retention and non-movement of accumulated stagnation. Generally, dietary accumulation remains stagnant within the body day after day; dampness steams and heat stasis lurks without manifesting. Occasionally, improper care leads to contracting severe heat toxins. By autumn, when yang qi begins to收 (gather) and fire qi descends, it evaporates the accumulated pathogens, causing the disease of Zhi Xia to arise. Thus, when damp-heat affects the blood level, red stool appears; when it affects the qi level, white stool appears; when red and white appear together, both qi and blood are diseased. A color resembling bean juice indicates excess dampness. A color mixing five hues indicates that all five zang organs are diseased. Pure red indicates deep penetration of heat toxin. A color resembling fish brain indicates spleen deficiency failing to transport, with old accumulation slipping down and coagulating. A texture resembling nasal mucus indicates deficiency-cold of the zang-fu leading to slippage. White pus indicates false tenesmus resulting from qi constrained by heat toxin. A color resembling leaking roof water or rotting dates indicates extreme exhaustion of yuan qi. Tenesmus and urgency, where one rushes to the toilet but cannot pass stool, accompanied by urgent, painful pressure, indicate blockage in the Large Intestine meridian with excess damp-heat internally. In early onset, when yuan qi is not yet deficient, severe urgency requires purgation. After purgation, if residual stagnation remains, sudden tonification is forbidden; instead, methods to transform stagnation, clear heat, and purge should be used until the stagnation is exhausted, only then can qi and blood be regulated and tonified. Nowadays, people indiscriminately use astringent methods regardless of whether the disease is new or chronic, causing significant harm. A skilled practitioner examines the patterns of cold, heat, deficiency, excess, qi, and blood, and applies sweating, vomiting, purging, clearing, warming, tonifying, securing, and astringing methods accordingly.
Commentary Da: The occurrence of dysentery is not a matter of a single day or night; its origin is gradual. Usually, irregular diet and improper lifestyle lead to indulgence in greasy, raw, and cold foods, intoxication with alcohol, sexual exhaustion, exposure to summer heat, rushing while fasting, mental stress from worldly affairs, and irritation from trivial matters. The interplay of seven emotions and six desires attacks day and night, injuring both qi and blood, causing food stagnation. Damp-heat steams and transforms into turbid filth. The disease of the Foot-Taiyin Spleen Meridian transmits to the Hand-Yangming Large Intestine Meridian. The Large Intestine is the fu organ of the Lung; the Lung governs clear transformation. When Spleen earth is diseased, it cannot generate Metal (Lung qi), causing the Lung to lose its function of clear transformation. Although the zang organ itself may not be directly diseased, its fu organ suffers, so the Large Intestine is affected. The Large Intestine corresponds to Metal in the Five Elements and to Autumn in the seasons; therefore, dysentery often occurs in Autumn. At the initial stage of dysentery, large doses of blood-resolving and stagnation-transforming medicines should be taken first to loosen the root, followed by purgatives to cleanse intestinal filth, and then regulation and tonification to achieve complete recovery. One must distinguish between involvement of qi or blood: white involves qi injury; red involves blood injury; mixed red and white involves both. If there is no red or white, but only thick turbid yellow, treat as food stagnation. For tenesmus, treat with fire-related methods (clearing heat or moving qi). For scattered blood discharge, treat as blood injury. All initial dysentery belongs to heat and should be treated with cooling and resolving methods. Chronic dysentery that does not heal turns into cold and should be treated with warming and tonifying methods. Rectal prolapse requires tonifying qi and lifting. Dysentery lasting years, recurring intermittently, is called Resting Dysentery (Xiu Xi Li); it requires regulating stomach qi and taking major tonics. This is the general principle of treating dysentery. Regarding prognosis: dysentery without fever is mild; with fever is severe. Ability to eat is mild; inability to eat is severe. Complete refusal to eat is fatal. Vomiting is fatal. Rectal prolapse is fatal. Sudden passage of hard feces after chronic dysentery is fatal. Dysentery appearing immediately after smallpox in children is fatal. Dysentery appearing immediately after childbirth in women is fatal.
[Pulse Diagnosis] A choppy pulse indicates lack of blood; severe cold and reversal indicate severity. A faint pulse at the Chi position indicates yin deficiency, with dysentery and cold limbs. It is also said: Without stagnation, there is no dysentery; the pulse should be slippery and large. Floating, wiry, and rapid pulses indicate death; sinking and fine pulses are harmless.
Heat Excess with Internal Fullness: Initial tenesmus, urgency, and painful pressure are treated with Shaoyao Tang (Peony Decoction). After purgation, if dysentery stops but heat is severe with thirst and red urine, Huangqin Tang (Scutellaria Decoction) is used. Abdominal pain with incomplete relief and urgency are treated with Xianglian Zhizhi Tang (Costus and Coptis Decoction to Transform Stagnation) and Sanhuang Wan (Three Yellows Pill).
Shaoyao Tang (Peony Decoction)
Treats early-stage dysentery with abdominal pain, tenesmus, frequent urges to defecate with inability to pass stool.
Shaoyao (Radix Paeoniae Alba), Danggui (Radix Angelicae Sinensis) (each 0.5 qian); Huanglian (Rhizoma Coptidis), Huangqin (Radix Scutellariae) (each 0.2 qian); Rougui (Cortex Cinnamomi) (0.4 qian); Binglang (Semen Arecae) (1 qian); Muxiang (Radix Aucklandiae) (0.6 qian); Gancao (Radix Glycyrrhizae) (0.4 qian); Dahuang (Radix et Rhizoma Rhei) (dose adjusted according to patient's deficiency or excess).
Add Houpo (Cortex Magnoliae Officinalis) (1 qian), Zhiqiao (Fructus Aurantii) (1 qian), Qingpi (Pericarpium Citri Reticulatae Viride) (0.5 qian).
Decoct in water and take warm.
If tenesmus is prominent and urination is obstructed, add Chao Huashi (Folium Talcum, stir-baked) (1.5 qian). If abdominal pain is severe, add Sharen (Fructus Amomi Rotundus) (1 qian), plus Danggui and Muxiang (each 0.5 qian). For food stagnation, add Shanzha (Fructus Crataegi) and Zhishi (Fructus Aurantii Immaturus) (each 1 qian). For red dysentery, add Chuanxiong (Rhizoma Chuanxiong) and Taoren (Semen Persicae, paste) (each 1 qian). For white dysentery, add Fuling (Sclerotium Poriae cocos), Chenpi (Pericarpium Citri Reticulatae), and Sharen (each 0.8 qian). For mixed red and white, add Chuanxiong and Taoren to regulate blood; Huashi, Chenpi, and Cangzhu (Rhizoma Atractylodis Lanceae) to regulate qi. If vomiting occurs and food cannot be taken, add Ruanshigao (Gypsum Fibrosum) and Chao Shanzhi (Fructus Gardeniae, stir-baked) (each 1 qian), Chenpi (0.8 qian), mixed with ginger juice and sipped slowly to clear heat in the stomach opening. If blood is mixed with black, indicating excess dampness, and urination is red, scanty, and obstructed, add Mutong (Caulis Akebiae Trifoliatae), Zexie (Rhizoma Alismatis), and Fuling (each 1 qian), and Chao Shanzhiren (Semen Gardeniae, stir-baked) (0.5 qian) to promote diuresis. For bloody dysentery, add Chuanxiong, Taoren, Shengdi (Radix Rehmanniae Preparata), and Chao Huaihua (Flos Sophorae Immaturus, stir-baked) (each 1 qian); remove Dahuang, Binglang, and Rougui. For a type of cold dysentery, remove Dahuang and Huangqin, add Ganjiang (Rhizoma Zingiberis Preparatum), Suisha (Fructus Amomi Rotundus), and Houpo (each 0.5 qian) to warm. Pregnant women should not use Dahuang; add Shanzhi (2 qian) and double Huangqin, Huanglian, and Zhiqiao.
Huangqin Tang (Scutellaria Decoction)
Treats dysentery with concurrent heat (also known as Huangqin Shaoyao Tang).
Huangqin (Radix Scutellariae, stir-baked) (2 qian), Shaoyao (Radix Paeoniae Alba, stir-baked) (1.5 qian), Gancao (Radix Glycyrrhizae) (1 qian).
Decoct in water and take warm.
Xianglian Zhizhi Tang (Costus and Coptis Decoction to Transform Stagnation)
Treats stagnation with tenesmus and frequent urges to defecate with little output.
It is Shaoyao Tang minus Dahuang and Rougui, plus Qingpi, Zhishi, Huashi, and Chenpi.
Accompanied by Wind Pathogen
When externally complicated by wind pathogen, sweating method is suitable; use Cangzhu Fangfeng Tang (Atractylodes and Saposhnikovia Decoction). For aversion to cold, fever, headache, and body pain, use Shenzhu Tang (Divine Power Decoction). When wind pathogen enters the intestines and stomach through deficiency, causing bloody diarrhea, use Weifeng Tang (Wind-Stopping Decoction). (Formula see Diarrhea section.)
Cangzhu Fangfeng Tang
Cangzhu (Rhizoma Atractylodis Macrocephalae) (3 qian, processed with rice wash water), Fangfeng (Radix Saposhnikoviae) (1.5 qian).
Add Huanglian, Muxiang (each 0.5 qian); Houpo, Chenpi, Zhiqiao (each 1 qian); Gancao (0.4 qian).
Decoct with 7 slices of fresh ginger and take.
For headache, body pain, and fever, add Chuanxiong, Qianghuo (Rhizoma Notopterygii), Chaihu (Radix Bupleuri), and Huangqin (each 1 qian). For abdominal pain, add Danggui, Chao Shaoyao, and Sharen (each 1 qian). For tenesmus, add Binglang (1 qian).
Shenzhu San (Divine Power Powder)
Treats epidemics in all four seasons, headache, stiff neck, fever with aversion to cold, body pain. Also treats common cold with nasal congestion, heavy voice, cough, and dizziness.
Ben (Root), Qianghuo, Gancao, Baizhi (Radix Angelicae Dahuricae), Xixin (Herba Asari), Cangzhu, Chuanxiong.
Decoct with ginger and green onion and take.
Secret Formula
Treats epidemic dysentery, which is contagious from one person to another.
Use Cangzhu (1 liang), water 3 zhong, decoct to 2 zhong, remove Cangzhu, add Fangfeng, Baizhu (Rhizoma Atractylodis Macrocephalae), Shaoyao, Qianghuo, Renzhonghuang (Human Middle Yellow) (each 1 qian), decoct to 1 zhong, take warm.
Accompanied by Cold
When accompanied by cold, the discharge is clear and cold, no thirst, clear and white urine, cold hands and feet, no heat signs, pulse is deep and slow; use Lizhong Tang (Regulate the Middle Decoction). If caused by excessive consumption of raw/cold foods or overuse of cold-cooling medicines, add Fuzi (Radix Aconiti Lateralis Preparata) to this formula. For chronic illness, with discharge resembling mucus or jelly, slow and weak pulse, emaciated and weak physique, and tired limbs, use Chushi Tang (Remove Dampness Decoction).
Lizhong Tang (Regulate the Middle Decoction)
Expels cold, stops vomiting and diarrhea, settles cold pain in heart and abdomen, warms spleen and secures stomach.
Renshen (Radix Ginseng), Gancao (Radix Glycyrrhizae, honey-fried), Baizhu, Ganjiang (Rhizoma Zingiberis Preparatum, roasted, equal parts).
Decoct with water and ginger.
Adding Fuzai makes it Fuzi Lizhong Tang (Aconite Regulate the Middle Decoction).
Chushi Tang (Remove Dampness Decoction)
Houpo (stir-fried with ginger juice), Cangzhu (soaked in rice wash water, stir-fried), Banxia (Rhizoma Pinelliae Preparata) (each 1 qian); Huoxiangye (Leaf Pogostemonis Cablin) (0.3 qian); Chenpi, Fuling, Baizhu (each 0.5 qian).
Decoct with ginger and jujube in water and take warm.
Food Stagnation Dysentery
Dysentery with abdominal pain, undigested food, and fullness; use Baohe Wan (Preserve Harmony Pill). Pre-existing food stagnation with abdominal distension and urgency; use Xianglian Zhizhi Tang. Acute pain; use Zhizhu Wan (Immature Bitter Orange and Atractylodes Pill) added with Huanglian, Mutong, Shenqu (Massa Medicata Fermentata), Maiya (Fructus Hordei Germinatus), Shaoyao, Muxiang, and Binglang.
Baohe Wan (See Food Injury section.)
Zhizhu Wan (See Spleen and Stomach section.)
Deficiency Dysentery
Chronic illness with qi and blood deficiency and lack of spirit; use Qian Shi Baizhu San (Master Qian's Atractylodes Powder). Chronic illness with clear bloody stool; use Weifeng Tang. Fatigue and poor appetite; use Weisheng Tang (Health-Preserving Decoction). Sinking of spleen qi with false tenesmus; use Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction).
Qian Shi Baizhu San (See Diarrhea section.)
Yigong San (Extraordinary Efficacy Powder)
Is Si Junzi Tang (Four Gentlemen Decoction) plus Chenpi.
Weisheng Tang (Health-Preserving Decoction)
Is Yigong San plus Shanyao (Rhizoma Dioscoreae), Yiyiren (Semen Coicis), Zexie, and Huanglian (equal parts).
Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) (See Internal Injury section.)
Wang Jiezhai's Formula for Chronic Dysentery
For chronic red dysentery with weak stomach and blood deficiency, or unresolved after purgation: Use Siwu Tang (Four Substances Decoction) plus Ejiao (Colla Corii Asini), Chenpi, Baizhu, Huangqin, Huanglian, and Gancao.
For chronic white dysentery with weak stomach and qi deficiency, or unresolved after purgation: Use Si Junzi Tang plus Huangqi (Radix Astragali), Chenpi, Suisha, Muxiang, and Ganjiang (equal parts); reduce Huangqin and Huanglian by half for decoction.
For dysentery with both qi and blood deficiency: Use Siwu Tang plus Renshen, Baizhu, Chenpi, Huanglian, Huangqin, and Ejiao to tonify, and the dysentery will stop naturally. Add Shengma (Rhizoma Cimicifugae) if qi sinks.
Slippage Syndrome
Chronic slippage and uncontrollable diarrhea due to qi deficiency approaching collapse; use Hezi San (Myrobalan Powder). Extreme depletion of yuan qi with anus like a bamboo tube, direct uncontrolled expulsion; Zhenren Yangzang Tang (True Man Nourishing the Viscera Decoction) might save one or two cases.
Hezi San (Myrobalan Powder)
Treats chronic diarrhea and dysentery that does not stop.
Muxiang (5 qian), Gancao (honey-fried), Huanglian (each 3 qian), Hezi (Myrobalan) (1 liang, half raw, half cooked).
Grind into powder, mix with Shaoyao Baizhu Tang (Peony and Atractylodes Decoction), and take 2 qian.
Zhenren Yangzang Tang (True Man Nourishing the Viscera Decoction)
Treats chronic dysentery not stopping and uncontrollable slippage.
Renshen, Danggui, Baishao (Radix Paeoniae Rubra), Gancao (each 0.4 qian); Rouguo (Nucis Arecae Katechu), Hezi (each 0.3 qian); Muxiang (0.7 qian); Rougui (0.3 qian); Baizhu (0.2 qian); Susuke (Pericarpium Papaveris, removed of stem and cap, honey-fried) (1 qian).
Add Fuzi for cold viscera.
Jin Kou Li (Dysentery with Inability to Eat)
Jin Kou Li is characterized by extreme deficiency and extreme heat. Decoct Renshen and Huanglian stir-fried with ginger in water, and inhale the steam frequently. Also apply mashed fresh water snail to the umbilicus. Or frequently drink decoction of Shilianzi (Fructus Nelumbinis). This disease results from heat toxin invading the stomach opening, so there is still hope for treatment. However, if it is due to weak stomach and sinking qi with complete loss of appetite, it is difficult to treat.
Secret Formulas for Treating Jin Kou Li
1. Equal parts of Xianglian Wan (Costus and Coptis Pill) and Shilianrou (Mesocarp of Fructus Nelumbinis), ground into powder, taken with rice water.
2. Dry Shanyao (1 jin), slightly roasted, boiled in water, sipped frequently.
3. Shilianrou dried and powdered, taken with decoction of aged warehouse rice (2 qian), inducing appetite. Then, use orange peel stir-fried on the east-facing wall exposed to sun, ground into powder, decocted with ginger and jujube.
4. Mumiezi (Semen Momordicae) ground into powder, mixed with flour to make cakes, applied to the umbilicus.