二分，当归、人参、白术、熟甘草各五分。（以上三方，有胎妇人服之，去红花、桃仁、槟榔。）以上方法随
用辄效，间有不效者，必其初投参、术等补剂太早，补塞邪热在内，久而正气已虚，邪气犹盛，欲补而涩之则助
邪，欲清而疏之则愈滑，遂至不救，虽有奇方，无如之何，则初投温补之祸也。予尝治一公子、一仕官，皆投
补剂而后不可救者，故表而出之以戒后。（《奇效医述》）（《集验良方》引倪涵初第三方稍异。）
驻车丸，治大冷洞痢肠滑，下赤白如鱼脑，日夜无节度，腹痛不可堪忍者方。
黄连（六两） 干姜（二两） 当归 阿胶（各三两）
上四味，末之，以大酢八合烊胶和之，并手丸如大豆许，干之，大人饮服三十丸，小儿百日以还三丸，期年
者五丸，余以意加减，日三服。（《千金》）古方驻车丸治痢，人皆知之，须是一帖作一服浓煎，陈米饮下，一
时一服，三服不愈，五服定愈，毋可疑者。（《选奇方后集》）《外台》文仲隐居效验方，主下部绞痛，重下，
下赤白方，于本方去阿胶，加黄柏（各二两），捣筛，煮取乌梅汁服方寸匕，日三。（《苏沈》名四神散，皆炒。
《圣济》曰∶大凡泄痢，宜食酸苦，盖酸收苦坚故也。）
治卒大下痢热，唇干口燥，呕逆引饮，泻心汤方。
人参 甘草 黄芩 橘皮 栝蒌根（各一两） 黄连（二两） 半夏（三两） 干姜（一两半）
上八味 咀，以水六升，煮取二升，分二服。（《千金》）
治赤白痢，香连丸方。
黄连（去须炒） 木香（各二两）
上二味捣罗为末，以面糊和丸，如梧桐子大，每服五十丸，空心陈米饮下，日再。（《圣济》）其久冷人，
即用煨熟大蒜为丸。此方本出李绛《兵部手集方》，婴孺用之亦效。（《本草图经》）大香连丸，木香（不见
火，四两八钱八分）、黄连（去芦须，二十两，用吴茱萸十两同炒令赤，去茱萸不用）。
上件为细末，醋糊为丸，如梧桐子大，每服二十丸，饭饮吞下，空心食前日进三二服。（《和剂》）（《济
生续方》曰∶治阴阳相搏，冷热不调，或泻或痢。按∶此方诸家增味不一，今不繁载。）
戊己丸，治脾受湿气，泄痢不止，米谷迟化，脐腹刺痛。
吴茱萸（去梗炒） 黄连（去须） 白芍药（各五两）
上为细末，面糊为丸，如梧桐子大，每服二十丸，浓煎米饮下，空心日三服。（《和剂》）（按∶此方原出
《苏沈》，名芍药散，水煎服。）《鸡峰》若下痢赤黄，日夜数十行，手足不厥，胸中痞闷，时觉微寒，服温
药而增极，其脉沉实而大，此由湿热之气，蕴于肠胃，复因饮食，积而不化，聚而不运，水谷并注而下，先宜
此三味黄连丸（即本方），不瘥者，与杏子元（系用杏仁、巴豆二味）。《元和纪用经》二气黄金丸，调冷热，
断赤白下痢变入恶证，若鱼烂黑汁，肠中切痛，枯瘦不能食，于本方去芍药，加当归（各等分），炼蜜加米膏
少许和丸。一方，以木香代当归。《卫生家宝》如神散，治肠胃气虚，冷热不调，下痢赤白，状如鱼脑，里急
后重，于本方加当归，等分为末。
噤口痢者，胃口热甚故也，大虚大热，用香连丸，莲肉各一半，共为末，米汤调下。又方，人参二分，姜
炒黄连一分，为末浓煎，终日呷之，吐则再服，但一呷下咽便妙，不可用温热药甘味。（《丹溪》）（宜与前
噤口痢条相参。）
诸下痢之后，小便利而腹中虚痛不可忍者，此谓阴阳交错，不和之甚也，当服神效越桃散。
大栀子（三钱） 高良姜（三钱）
上和均，每服三钱，米饮或酒调下，其痛立效。（《保命集》）
荡涤方法 痢发于秋，是暑月湿热所致，其理甚着；但所以致郁热者，多因暑热酷烈，过饮冰水生冷，
热为寒郁，久而为沉寒积冷者亦有之，不可泥定是热，当辨症切脉，真知其有热积，方可用大黄。若系寒积而
用大黄，不惟不愈，反增痛极而危矣。大凡下热痢用大黄，下寒痢用巴豆，有是病则服是药，详按古人成法，
不容毫发差谬。（《医贯》）
其病初得一二日，皆宜荡涤邪秽，消溶渣滓，以通利为先，次辨冷热虚实，以调理而扶脾助胃，为上策也。
其通利之法有二∶积滞胜宜用丸，丸者缓也，缓以消之，除其积也；邪毒胜宜用汤，汤者荡也，荡而荡之，去
其毒也。当用丸而用汤，毒去而积不除；当用汤而用丸，积除而毒不行。治失其宜，故病皆难愈也。（《医经会
解》）
盖暑毒与食物相搏，结在下脘，则升降出入不得循其正，糟粕欲行不得行，而火复迫之，则将脏腑脂膏逼
迫而下，故取大黄驱热毒、下糟粕、清肠脏也。（《金匮翼》）
如便脓血相杂而脉浮大，慎不可以大黄下之，下之必死，谓气下竭而阳无所收也。（《保命集》）
下痢，舌黄燥不渴，胸中实，身热腹胀，并身热谵语者，腹有燥粪，大柴胡汤下之。（《全婴方论》）
小承气汤，治下痢赤黄，但烦饮冷，小便不利，得热则极，心烦躁喜渴，先服一二服荡之，须审是实热方
可。（《得效》）
桃仁承气汤，痢疾初起质实者，此方主之。若初间失下，反用固涩之药，以致邪热内蓄，血不得行，腹痛欲
死者，急以此方主之。（《医方考》）（按∶程星海有本方加牡丹皮、红花、槟榔、木通、滑石治验。）
六一顺气汤，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。（《医鉴》）（按∶
此陶节庵方，宜参《伤寒广要·阳明病》。）
芍药汤，下血调气。经曰∶溲而便脓血，气行而血止，行血而便脓自愈，调气则后重自除。
芍药（一两） 当归 黄连（各半两） 槟榔（二钱） 木香（二钱） 甘草（二钱炙） 大黄（三钱）
黄芩（半两） 官桂（一钱半）
上 咀，每服半两，水二盏，煎至一盏，食后温服。如血痢，则渐加大黄。如汗后藏毒，加黄柏半两，根据前
服。（《保命集》）又治下痢脓血，里急后重，日夜无度，导气汤，于本方去官桂、甘草（《奇效》加枳壳）。
《医方考》芍药汤，加芒硝，痢疾便脓血里急后重者主之。《明医杂着》痢疾主方，于本方去当归、大黄、官桂，
加枳壳（《回春》芍药汤，即此方有当归）。若呕吐食不得下，加软石膏（一钱半）、陈皮（一钱）、山栀仁
（炒五分），入生姜汁，缓呷之，以泻胃口之热。
太阴传于少阴，是为贼邪，先以浓朴枳实汤防其传变。
浓朴（一两） 枳实（一两） 诃子（一两半生半熟） 木香（半两） 黄连（二钱） 甘草（三钱炙）
大黄（二钱）
上为末，每服三五钱，水一盏半，煎至一盏，去滓温服。（《保命集》）
大黄汤，治泄痢久不愈，脓血稠粘，里急后重，日夜无度，久不愈者。（《医鉴》将军饮，即此方，其主治
更曰∶及愈而又发，止而复作，名曰休息痢。）
大黄（一两）
上细锉，好酒二大盏，同浸半日许，同煎至一盏半，去大黄，将酒分为二服，顿服之，痢止一服，如未止
再服，以利为度。（同上）
大黄丸，痢初起，壮实者可用，胃弱者禁施。
川大黄（切片蜜蒸一斤） 白芍药（酒浸切片炒六两） 甘草（炙三两） 槟榔（四两） 木香（切片不
见火为末一两） 枳壳（炒四两）
细末，炼蜜同水煎木香和捣为丸，如绿豆大，白莱菔汤吞三钱，重者五钱，以行两三次腹中爽快为度。胃气
虚极之人勿轻用之，积滞重而元气虚者以人参汤吞，孕妇以人参缩砂汤吞，行后另用人参丸补之。（《广笔记》）
四味香连丸，黄连炒十两，大黄酒煨四两，木香二两，槟榔一两，为末，糊丸如绿豆大，每七十丸，空心米
饮下。治痢初起，不问赤白，每日二服，有积自行，无积自止。（《入门》）
神妙散，治赤白痢疾。（按∶散当作丸。）
大黄 人参 枳壳 火麻子（各等分）
上为末，面糊为丸，如梧桐子大，每服三十丸，白汤下。（《经验良方》）（按∶此本《近效》加减麻仁丸，
今去诃子，加枳壳，宜参大便不通。）
朱孔阳年二十五岁，形体清瘦，素享安逸，夏月因构讼奔走日中，暑湿合内郁之火而成痢疾，昼夜一二百次，不
能起床，以粗纸铺于褥上，频频易置，但饮水而不进食，其病甚厉，肛门如火烙，扬手掷足，躁扰无奈。余诊
其脉，弦紧劲急，不为指挠。谓曰∶此症一团毒火，蕴结在肠胃之内，其势如焚，救焚须在顷刻，若二三日外，
肠胃朽腐矣。于是以大黄四两，黄连、甘草各二两，入大砂锅内煎，随滚随服。服下人事稍宁片时，少顷仍前
躁扰。一昼夜服至二十余碗，大黄俱已煎化，黄连、甘草俱煎至无汁。次日病者再求前药。余诊毕，见脉势稍
柔，知病可愈，但用急法，不用急药，遂改用生地黄、麦门冬各四两另研生汁，而以天花粉、牡丹皮、赤芍药、
甘草各一两煎成和汁大碗咽之。以其来势暴烈，一身津液从之奔竭，待下利止然后生津养血，则枯槁一时难回；
今脉势已减，则火邪俱退，不治痢而痢自止，岂可泥润滞之药而不急用乎。服此药果然下痢尽止，但遗些少气
沫耳。第三日思食豆腐浆，第四日略进陈仓米清汁，缓缓调至旬余方能消谷，亦见胃气之存留一线者，不可少
此焦头烂额之客耳。（《寓意草》）
治下久赤白连年不止，及霍乱脾胃冷实不消，温脾汤方。
大黄（四两） 人参 甘草 干姜（各二两） 附子（大者一枚）
上五味 咀，以水八升，煮取二升半，分三服，临熟下大黄。与后温脾汤小异，须大转泻者当用此方神效。
（《千金》）又温脾汤，治积久冷热赤白痢者，于本方去甘草，加桂心（大黄、桂心各三两，余各一两），以
水七升，煮取二升半，分三服。（按∶此方宜与《泄泻门》、《腹痛门》及《伤寒广要·太阴病》中所举互参。）
《外台》许仁则，前件诸痢（按∶前论有水痢、谷痢、血痢、脓痢、脓血相和痢、肠僻痢），患无新旧，如
药疗之， 差还发，此即纵以新药止
之，终存其根本。由肠胃中冷热不调，病根固结，必须汤药涤之，以泄病势，痢后更以药物补助之。有此候者，
宜根据后附子等六味汤以利之，于本方加细辛（大黄五两，余各三两）。此汤当得快利，利中有恶物如鱼脑状，或
如桃李，但异于常利，勿怪之。
治积痢，灵砂丹。（并论证）
砂（一分） 朱砂（一分并研极细）
上另用黄蜡半两，巴豆三七粒，去壳皮膜，同于银石器内重汤煮一伏时，候巴豆紫色为度，去二七粒，止将
一七粒与前来二味同再研极匀，再溶蜡匮药，每旋丸绿豆大，每服三丸至五丸，水泻生姜汤下，白痢艾汤，赤白
痢乌梅汤，服时须极空腹，服毕一时，方可吃食，临卧尤佳，次食淡粥一日。疟疾乳香汤服，不发日晚间服。
此药不动气，服之泻者止，痢者断，疼者愈，有积者内化，亦不动脏腑。大凡痢有沉积者，不先去其积，虽得
暂安，后必为害。尝记陈侍郎泾仲，庚戌秋过仪真求诊，初不觉有疾，及诊视，则肝脉沉弦，附骨取则牢。予曰∶
病在左胁有血积，必发痛。陈曰∶诚如是。前此守九江被召，冒暑涉长江，暨抵行朝，血痢已数日矣，急欲登对，
医者以刚剂燥之，虽得止，数日脐下一块大如杯，不旬日如碗大，发则不可忍，故急请官祠以归。为之奈何？
予曰∶积痢不可强止，故血结于脐胁下，非抵当丸不可。渠疑而不肯服，次年竟以此终。（《本事》）（按∶此
方亦出《鸡峰方》，名至圣缠金丹，朱砂、 砂各一两，巴豆七个，黄蜡十枣大，熔蜡煮巴豆焦色，去巴豆不
用。）
感应丸，治大便频并，后重迟涩，久痢赤白，脓血相杂，米谷不消，愈而复发。（《和剂》）赤白痢疾，脐
腹痛者，多由肠胃间积滞所致，先以此药微利，次方断下。
（《易简》）（《续易简》曰∶若夫赤痢而服此，岂不败乃事哉。）
苏感丸，治积痢不进饮，神效。
苏合香丸 感应丸
上二味和合丸，如绿豆大，每服二三十丸，姜汤吞下。（《朱氏》）
治白痢，针头丸。
巴豆十个（去壳醋浸一宿去油） 杏仁十个（文武火炮存性） 百草霜（二钱炒） 黄蜡（栗子大一块）
上以蜡和成剂，丸如芥子大，每服三丸，水泻井水下，黑痢乌梅汤下，白痢干姜汤下，赤痢甘草汤下。
（《卫生家宝》）（按∶《圣济》治水泻不止黑神丸与本方同，以糯米粥和丸。）
二色丸，治诸般赤白痢，神。
吴茱萸（拣去枝梗二两） 黄连（去须二两） 巴豆（四十九个去皮）
上同于铫子内炒令黄赤色，去巴豆不用，只将上面二味各自为末，面糊和丸，如萝卜子大，看大小紧慢，
加减丸数。（《小儿总微论》）
经验痢疾四宝丹。（此方施之已久，无不应验，不欲自秘，以公于人，宝之宝之。）
公丁香（一钱） 胡黄连（三钱） 巴豆霜（一钱，治巴豆霜法，巴豆不拘多少，去壳，纸包裹置新瓦上，
又复瓦盖，炭火下 炼去油，烟尽力度，存性。）
两分，当归、人参、白术、熟甘草各五分。（以上三个方剂，有孕妇服用时，去掉红花、桃仁、槟榔。）以上方法随用随效，间或有无效的，一定是因为起初过早投用参、术等补益药，导致邪热被补塞在体内，时间久了正气已虚，邪气仍然强盛，想要补益收敛则会助长邪气，想要清热疏通则会导致腹泻更加滑脱，最终导致无法救治，虽然有奇方，也无能为力，这是起初误用温补药的祸害。我曾经治疗一位公子、一位官员，都是用了补益药之后变得不可救治的，所以列举出来以警示后人。（《奇效医述》）（《集验良方》引用的倪涵初第三个方剂稍有不同。）
驻车丸，治疗大寒导致的洞泄痢疾、肠道滑脱，大便下赤白脓血像鱼脑一样，日夜没有节制，腹痛难以忍受的方剂。
黄连（六两） 干姜（二两） 当归 阿胶（各三两）
以上四味药，研成末，用米醋八合烊化阿胶调和，用手搓成如大豆大小的丸子，晒干，成人每次饮服三十丸，婴儿百日以上三丸，一周岁五丸，其余根据情况加减，每日三次服用。（《千金方》）古方驻车丸治痢疾，人们都知道，必须是一帖药作一次服用，浓煎，陈米汤送下，一时辰服一次，三次不愈，五次定能痊愈，不要怀疑。（《选奇方后集》）《外台秘要》文仲隐居效验方，主治下部绞痛，重痢，下赤白脓血的方剂，在本方中去掉阿胶，加入黄柏（各二两），捣碎过筛，煮取乌梅汁送服一方寸匕，每日三次。（《苏沈良方》称为四神散，都是炒过的。《圣济总录》说：大凡泄痢，适宜吃酸苦味的食物，因为酸能收敛，苦能坚阴的缘故。）
治疗突然发生的大热痢疾，嘴唇干燥口燥，呕吐逆气引水自救，泻心汤方。
人参 甘草 黄芩 橘皮 栝蒌根（各一两） 黄连（二两） 半夏（三两） 干姜（一两半）
以上八味药，切碎，用水六升，煮取二升，分两次服用。（《千金方》）
治疗赤白痢疾，香连丸方。
黄连（去须炒） 木香（各二两）
以上两味药捣罗成末，用面糊和丸，如梧桐子大小，每次服用五十丸，空腹时用陈米汤送下，每日两次。（《圣济总录》）如果是久冷体质的人，就用煨熟的大蒜为丸。此方原本出自李绛《兵部手集方》，婴幼儿使用也有效。（《本草图经》）大香连丸，木香（不见火，四两八钱八分）、黄连（去芦须，二十两，用吴茱萸十两同炒至变红，去掉茱萸不用）。
以上药材为细末，醋糊为丸，如梧桐子大小，每次服用二十丸，饭后用米汤吞下，空腹食前每日进二三服。（《太平惠民和剂局方》）（《济生续方》说：治疗阴阳相搏，冷热不调，或泻或痢。按：此方各家增味不一，现在不繁琐记载。）
戊己丸，治疗脾受湿气，泄痢不止，米谷消化迟缓，脐腹刺痛。
吴茱萸（去梗炒） 黄连（去须） 白芍药（各五两）
以上为细末，面糊为丸，如梧桐子大小，每次服用二十丸，浓煎米汤送下，空腹每日三次服用。（《太平惠民和剂局方》）（按：此方原出《苏沈良方》，名芍药散，水煎服。）《鸡峰普济方》若下痢赤黄，日夜数十行，手足不厥冷，胸中痞闷，时常觉得微寒，服用温药而症状加重，其脉沉实而大，这是由于湿热之气，蕴结于肠胃，又因饮食，积滞不化，聚而不运，水谷并注而下，先宜用这三味组成的黄连丸（即本方），如果不愈，给予杏子元（系用杏仁、巴豆两味）。《元和纪用经》二气黄金丸，调理冷热，断绝赤白下痢变入恶证，如果像鱼烂黑汁，肠中剧烈疼痛，枯瘦不能进食，在本方中去掉芍药，加入当归（各等分），炼蜜加少许米膏和丸。另一法，用木香代替当归。《卫生家宝》如神散，治疗肠胃气虚，冷热不调，下痢赤白，状如鱼脑，里急后重，在本方中加入当归，等分为末。
噤口痢，是因为胃口热甚所致，属于大虚大热，用香连丸，莲肉各一半，共为末，米汤调下。又一法，人参二分，姜炒黄连一分，为末浓煎，终日小口呷之，吐了就再服，只要有一口咽下去就妙，不可用温热药甘味。（《丹溪心法》）（宜与前噤口痢条相参考。）
各种下痢之后，小便通利而腹中虚痛难以忍受的，这叫做阴阳交错，不和得很严重，应当服用神效越桃散。
大栀子（三钱） 高良姜（三钱）
以上和匀，每次服用三钱，米饮或酒调下，疼痛立即见效。（《保命集》）
荡涤方法 痢疾发于秋季，是暑月湿热所致，道理很明显；但是导致郁热的，多因暑热酷烈，过量饮用冰水生冷，热被寒郁遏，时间久了成为沉寒积冷的也有，不能拘泥认定是热，应当辨证切脉，真正知道有热积，才可以用大黄。如果是寒积而用大黄，不仅不愈，反而增加剧痛而危险。大凡下热痢用大黄，下寒痢用巴豆，有病则服对应的药，详细按照古人成法，不容毫发差错。（《医贯》）
病初得一二日，都适宜荡涤邪秽，消溶渣滓，以通利为先，其次辨别冷热虚实，以调理而扶脾助胃，为上策。
通利的方法有两种：积滞胜宜用丸，丸者缓也，缓以消之，除去积滞；邪毒胜宜用汤，汤者荡也，荡而荡之，去除毒素。当用丸而用汤，毒去而积不除；当用汤而用丸，积除而毒不行。治疗失当，所以病都难愈。（《医经会解》）
大概暑毒与食物相搏，结在下脘，则升降出入不得循其正道，糟粕欲行不得行，而火又迫之，则将脏腑脂膏逼迫而下，所以取大黄驱热毒、下糟粕、清肠脏。（《金匮翼》）
如果便脓血相杂而脉浮大，千万不要用大黄攻下，下之必死，这是因为气下竭而阳无所收。（《保命集》）
下痢，舌苔黄燥不渴，胸中实，身热腹胀，并身热谵语的，腹中有燥粪，大柴胡汤下之。（《全婴方论》）
小承气汤，治疗下痢赤黄，只是烦躁想喝冷饮，小便不利，得热则极，心烦躁喜渴，先服一二服荡涤，必须审察是实热才可以。（《得效方》）
桃仁承气汤，痢疾初起体质实者，此方主之。如果初起失于攻下，反用固涩的药，以致邪热内蓄，血不得行，腹痛欲死的，急以此方主之。（《医方考》）（按：程星海有本方加牡丹皮、红花、槟榔、木通、滑石治验。）
六一顺气汤，治疗痢疾不问赤白相杂，肚痛里急后重，浑身发热，口干烦渴，用此通利即止。（《医鉴》）（按：此陶节庵方，宜参《伤寒广要·阳明病》。）
芍药汤，下血调气。经上说：溲而便脓血，气行而血止，行血而便脓自愈，调气则后重自除。
芍药（一两） 当归 黄连（各半两） 槟榔（二钱） 木香（二钱） 甘草（二钱炙） 大黄（三钱）
黄芩（半两） 官桂（一钱半）
以上切碎，每次半两，水二盏，煎至一盏，食后温服。如果是血痢，则逐渐加大黄。如果是汗后藏毒，加黄柏半两，根据前面方法服用。（《保命集》）又治疗下痢脓血，里急后重，日夜无度，导气汤，在本方中去掉官桂、甘草（《奇效良方》加枳壳）。《医方考》芍药汤，加芒硝，痢疾便脓血里急后重者主之。《明医杂着》痢疾主方，在本方中去掉当归、大黄、官桂，加枳壳（《回春》芍药汤，即此方有当归）。如果呕吐食不得下，加软石膏（一钱半）、陈皮（一钱）、山栀仁（炒五分），入生姜汁，缓呷之，以泻胃口之热。
太阴传于少阴，是为贼邪，先用浓朴枳实汤防止其传变。
浓朴（一两） 枳实（一两） 诃子（一两半生半熟） 木香（半两） 黄连（二钱） 甘草（三钱炙）
大黄（二钱）
以上为末，每次三五钱，水一盏半，煎至一盏，去滓温服。（《保命集》）
大黄汤，治疗泄痢久不愈，脓血稠粘，里急后重，日夜无度，久不愈者。（《医鉴》将军饮，即此方，其主治更说：及愈而又发，止而复作，名叫休息痢。）
大黄（一两）
以上细锉，好酒二大盏，同浸半日许，同煎至一盏半，去大黄，将酒分为二服，顿服之，痢止一服，如未止再服，以利为度。（同上）
大黄丸，痢初起，壮实者可用，胃弱者禁施。
川大黄（切片蜜蒸一斤） 白芍药（酒浸切片炒六两） 甘草（炙三两） 槟榔（四两） 木香（切片不见火为末一两） 枳壳（炒四两）
细末，炼蜜同水煎木香和捣为丸，如绿豆大，白莱菔汤吞三钱，重者五钱，以行两三次腹中爽快为度。胃气虚极之人勿轻用之，积滞重而元气虚者以人参汤吞，孕妇以人参缩砂汤吞，行后另用人参丸补之。（《广笔记》）
四味香连丸，黄连炒十两，大黄黄酒煨四两，木香二两，槟榔一两，为末，糊丸如绿豆大，每次七十丸，空腹米饮下。治疗痢初起，不问赤白，每日二服，有积自行，无积自止。（《医学入门》）
神妙散，治疗赤白痢疾。（按：散当作丸。）
大黄 人参 枳壳 火麻子（各等分）
以上为末，面糊为丸，如梧桐子大小，每次服用三十丸，白开水下。（《经验良方》）（按：此本《近效方》加减麻仁丸，今去掉诃子，加枳壳，宜参大便不通。）
朱孔阳年二十五岁，形体清瘦，素享安逸，夏月因构讼奔走日中，暑湿合内郁之火而成痢疾，昼夜一二百次，不能起床，以粗纸铺于褥上，频频易置，但饮水而不进食，其病甚厉，肛门如火烙，扬手掷足，躁扰无奈。我诊其脉，弦紧劲急，不为指挠。对他说：此症一团毒火，蕴结在肠胃之内，其势如焚，救焚须在顷刻，若二三日外，肠胃朽腐了。于是用大黄四两，黄连、甘草各二两，入大砂锅内煎，随滚随服。服下人事稍宁片时，少顷仍前躁扰。一昼夜服至二十余碗，大黄俱已煎化，黄连、甘草俱煎至无汁。次日病者再求前药。我诊毕，见脉势稍柔，知病可愈，但用急法，不用急药，遂改用生地黄、麦门冬各四两另研生汁，而以天花粉、牡丹皮、赤芍药、甘草各一两煎成和汁大碗咽之。以其来势暴烈，一身津液从之奔竭，待下利止然后生津养血，则枯槁一时难回；今脉势已减，则火邪俱退，不治痢而痢自止，岂可泥润滞之药而不急用乎。服此药果然下痢尽止，但遗些少气沫耳。第三日思食豆腐浆，第四日略进陈仓米清汁，缓缓调至旬余方能消谷，亦见胃气之存留一线者，不可少此焦头烂额之客耳。（《寓意草》）
治疗下久赤白连年不止，及霍乱脾胃冷实不消，温脾汤方。
大黄（四两） 人参 甘草 干姜（各二两） 附子（大者一枚）
以上五味药切碎，用水八升，煮取二升半，分三次服用，临熟下大黄。与后温脾汤小异，须大转泻者当用此方神效。（《千金方》）又温脾汤，治疗积久冷热赤白痢者，在本方中去掉甘草，加桂心（大黄、桂心各三两，余各一两），用水七升，煮取二升半，分三次服用。（按：此方宜与《泄泻门》、《腹痛门》及《伤寒广要·太阴病》中所举互参。）
《外台秘要》许仁则，前件诸痢（按：前论有水痢、谷痢、血痢、脓痢、脓血相和痢、肠僻痢），患无新旧，如药疗之，差还发，此即纵以新药止之，终存其根本。由肠胃中冷热不调，病根固结，必须汤药涤之，以泄病势，痢后更以药物补助之。有此候者，宜根据后附子等六味汤以利之，在本方加细辛（大黄五两，余各三两）。此汤当得快利，利中有恶物如鱼脑状，或如桃李，但异于常利，勿怪之。
治疗积痢，灵砂丹。（并论证）
砂（一分） 朱砂（一分并研极细）
以上另用黄蜡半两，巴豆三七粒，去壳皮膜，同于银石器内重汤煮一伏时，候巴豆紫色为度，去二七粒，止将一七粒与前来二味同再研极匀，再溶蜡匮药，每旋丸绿豆大，每次服三丸至五丸，水泻生姜汤下，白痢艾汤，赤白痢乌梅汤，服时须极空腹，服毕一时，方可吃食，临卧尤佳，次食淡粥一日。疟疾乳香汤服，不发日晚间服。
此药不动气，服之泻者止，痢者断，疼者愈，有积者内化，亦不动脏腑。大凡痢有沉积者，不先去其积，虽得暂安，后必为害。曾经记得陈侍郎泾仲，庚戌秋过仪真求诊，初不觉有疾，及诊视，则肝脉沉弦，附骨取则牢。我说：病在左胁有血积，必发痛。陈说：诚如是。此前守九江被召，冒暑涉长江，暨抵行朝，血痢已数日矣，急欲登对，医者以刚剂燥之，虽得止，数日脐下一块大如杯，不旬日如碗大，发则不可忍，故急请官祠以归。为之奈何？我说：积痢不可强止，故血结于脐胁下，非抵当丸不可。他疑而不肯服，次年竟以此终。（《本事方》）（按：此方亦出《鸡峰方》，名至圣缠金丹，朱砂、 砂各一两，巴豆七个，黄蜡十枣大，熔蜡煮巴豆焦色，去巴豆不用。）
感应丸，治疗大便频并，后重迟涩，久痢赤白，脓血相杂，米谷不消，愈而复发。（《太平惠民和剂局方》）赤白痢疾，脐腹痛者，多由肠胃间积滞所致，先以此药微利，次方断下。
（《易简方》）（《续易简方》说：如果赤痢而服此，岂不败乃事哉。）
苏感丸，治疗积痢不进饮，神效。
苏合香丸 感应丸
以上两味和合丸，如绿豆大，每次服二三十丸，姜汤吞下。（《朱氏集验方》）
治疗白痢，针头丸。
巴豆十个（去壳醋浸一宿去油） 杏仁十个（文武火炮存性） 百草霜（二钱炒） 黄蜡（栗子大一块）
以上以蜡和成剂，丸如芥子大，每次服三丸，水泻井水下，黑痢乌梅汤下，白痢干姜汤下，赤痢甘草汤下。
（《卫生家宝方》）（按：《圣济总录》治水泻不止黑神丸与本方同，以糯米粥和丸。）
二色丸，治疗诸般赤白痢，神。
吴茱萸（拣去枝梗二两） 黄连（去须二两） 巴豆（四十九个去皮）
以上同于铫子内炒令黄赤色，去巴豆不用，只将上面二味各自为末，面糊和丸，如萝卜子大，看大小紧慢，加减丸数。（《小儿总微论》）
经验痢疾四宝丹。（此方施之已久，无不应验，不欲自秘，以公于人，宝之宝之。）
公丁香（一钱） 胡黄连（三钱） 巴豆霜（一钱，治巴豆霜法，巴豆不拘多少，去壳，纸包裹置新瓦上，又复瓦盖，炭火下 炼去油，烟尽力度，存性。）
Two fen, Danggui (Angelicae Sinensis Radix), Renshen (Ginseng Radix), Baizhu (Atractylodis Macrocephalae Rhizoma), and Shu Gancao (Prepared Licorice Root) each five fen. (For the above three formulas, if taken by pregnant women, remove Honghua (Carthami Flos), Taoren (Persicae Semen), and Binglang (Arecae Semen).) The above methods are effective upon use; occasionally there are cases of ineffectiveness, which is necessarily because tonifying agents such as Renshen and Baizhu were administered too early at the beginning, causing pathogenic heat to be blocked inside. Over time, the righteous qi has become deficient while the pathogenic qi remains strong. Attempting to tonify and astringe will aid the pathogen, while attempting to clear and drain will cause further diarrhea, leading to an untreatable condition. Even with miraculous formulas, nothing can be done; this is the disaster of initially using warm-tonifying methods. I once treated a young nobleman and an official, both of whom became untreatable after receiving tonifying medicines. Therefore, I list them to warn future practitioners. (From *Qixiao Yishu*) (The third formula cited from Ni Hanchu in *Jiyan Liangfang* differs slightly.)
Chuzha Wan (Resting Carriage Pill), treats severe cold-induced dysentery with intestinal slippage, passing red and white pus resembling fish brains, without day or night restraint, accompanied by unbearable abdominal pain.
Huanglian (Coptidis Rhizoma) (six liang), Ganjiang (Zingiberis Rhizoma) (two liang), Danggui (Angelicae Sinensis Radix), Ejiao (Donkey-hide Gelatin) (each three liang).
The above four ingredients are powdered. Melt Ejiao in eight he of dark vinegar, mix with the powder, and hand-roll into pills the size of soybeans. Dry them. Adults take thirty pills with water; infants over one hundred days take three pills; those one year old take five pills. Adjust the rest according to circumstances. Take three times daily. (From *Qianjin Fang*) People know that the ancient Chuzha Wan treats dysentery. It must be decocted thickly as one dose, taken with aged rice water, one dose per shichen (two hours). If not cured after three doses, it will certainly be cured after five doses. Do not doubt. (From *Xuanqi Fang Houji*) The Wai Tai Mi Yao Wen Zhong Yinju Xiaoyan Fang mainly treats lower abdominal colic, heavy dysentery, and passage of red and white discharge. Remove Ejiao from this base formula and add Huangbai (Phellodendri Cortex) (each two liang). Pound and sieve, decoct in Wu Mei juice (Mume Fructus), and take one cunbi (square inch measure). Take three times daily. (Known as Sishen San in *Su Shen Li Fang*, all fried. *Shengji Zonglu* states: Generally for diarrhea and dysentery, sour and bitter foods are suitable, because sour astringes and bitter hardens.)
Treat sudden severe hot dysentery with dry lips and mouth, vomiting, thirst, and drinking water. Xie Xin Tang (Drain the Epigastrium Decoction) formula.
Renshen (Ginseng Radix), Gancao (Licorice Root), Huangqin (Scutellariae Radix), Ju Pi (Citri Reticulatae Pericarpium), Gualou Gen (Trichosanthis Radix) (each one liang), Huanglian (Coptidis Rhizoma) (two liang), Banxia (Pinelliae Rhizoma) (three liang), Ganjiang (Zingiberis Rhizoma) (one and a half liang).
The above eight ingredients are cut. Decoct in six sheng of water to obtain two sheng. Divide into two doses. (From *Qianjin Fang*)
Treat red and white dysentery. Xianglian Wan (Costus and Coptis Pill) formula.
Huanglian (Coptidis Rhizoma, remove stamens and stir-fry), Muxiang (Aucklandiae Radix) (each two liang).
Pound and sieve the above two ingredients into powder. Mix with flour paste to form pills the size of Sophora seeds. Take fifty pills each time with aged rice water on an empty stomach, twice daily. (From *Shengji Zonglu*) For those with chronic cold constitution, use roasted garlic instead. This formula originally comes from Li Jiang's *Bingbu Shouji Fang* and is also effective for infants. (From *Bencao Tujing*) Daxianglian Wan (Great Costus and Coptis Pill): Muxiang (Aucklandiae Radix, do not expose to fire, four liang eight qian eight fen), Huanglian (Coptidis Rhizoma, remove rhizome and stamens, twenty liang, stir-fry together with ten liang of Wuzhuyu (Evodiae Fructus) until red, then discard Wuzhuyu).
Powder the above ingredients finely. Form pills with vinegar paste, size of Sophora seeds. Take twenty pills each time, swallowed with rice water before meals, two or three times daily on an empty stomach. (From *Heji Jufang*) (*Jisheng Xufang* states: Treats interplay of yin and yang, imbalance of cold and heat, resulting in diarrhea or dysentery. Note: Various schools add different ingredients to this formula; they are not listed here for brevity.)
Wuji Wan (Wu Ji Pill), treats spleen affected by dampness, continuous diarrhea and dysentery, slow digestion of rice and grain, stabbing pain in the umbilical and abdominal region.
Wuzhuyu (Evodiae Fructus, remove stems and stir-fry), Huanglian (Coptidis Rhizoma, remove stamens), Shaoyao (Paeoniae Radix Alba) (each five liang).
Powder finely. Form pills with flour paste, size of Sophora seeds. Take twenty pills each time with thick rice water on an empty stomach, three times daily. (From *Heji Jufang*) (Note: This formula originally appears in *Su Shen Li Fang* under the name Shaoyao San, decocted in water.) *Jifeng Puji Fang*: If dysentery presents with red-yellow stool, dozens of times a day, without cold limbs, chest oppression, occasional slight chills, and worsening with warm medicines, with a deep, solid, and large pulse, this is due to damp-heat accumulating in the intestines and stomach, compounded by dietary accumulation failing to transform and transport, causing water and grain to rush downward. First, use these three ingredients to make Huanglian Wan (i.e., this formula). If not improved, give Xingzi Yuan (made of Xingren (Armeniacae Semen) and Badou (Crotonis Semen)). *Yuanhe Jiyong Jing* Erqi Huangjin Wan (Two Qi Golden Pill) regulates cold and heat, stops red-white dysentery turning into malignant conditions, such as black fluid like rotting fish, severe intestinal pain, emaciation, and inability to eat. Remove Shaoyao from this base formula and add Danggui (Angelicae Sinensis Radix) (equal parts). Mix with refined honey and a little rice paste to form pills. Another method replaces Danggui with Muxiang. *Weisheng Jiabao* Rushen San (Miracle Powder) treats gastrointestinal qi deficiency, cold-heat imbalance, red-white dysentery resembling fish brains, tenesmus. Add Danggui to this base formula, powder equally.
Jinkouli (Closed-Mouth Dysentery) is caused by excessive heat in the stomach opening, representing extreme deficiency and heat. Use Xianglian Wan, with Lianrou (Nelumbinis Semen) in equal halves, powdered together, mixed with rice soup and taken. Another method: Two fen of Renshen, one fen of Huanglian stir-fried with ginger, powdered and decocted thickly. Sip throughout the day. If vomiting occurs, take again. It is beneficial as soon as one sip goes down. Do not use warm-hot or sweet medicines. (From *Danxi Xinfa*) (Refer to the section on Closed-Mouth Dysentery earlier.)
After various dysenteries, if urination is clear but abdominal deficiency pain is unbearable, this is called severe yin-yang disarray and disharmony. One should take Shenxiao Yue Tao San (Divine Effect Peach Dispersing Powder).
Da Zhizi (Gardeniae Fructus, three qian), Gaoliangjiang (Alpiniae Officinarum Rhizoma) (three qian).
Mix evenly. Take three qian each time with rice drink or wine. Pain relieves immediately. (From *Baoming Ji*)
Drying and Purging Methods: Dysentery occurring in autumn is caused by summer heat and dampness; the principle is clear. However, the reason for郁热 (stagnant heat) is often due to intense summer heat, excessive consumption of ice water and raw/cold foods, where heat is constrained by cold. Over time, this can become deep cold and accumulated cold. One cannot rigidly assume it is only heat. One must differentiate symptoms and palpate the pulse to truly confirm heat accumulation before using Dahuang (Rhei Radix et Rhizoma). If it is cold accumulation and Dahuang is used, not only will it not heal, but it will increase severe pain and danger. Generally, for hot dysentery, use Dahuang; for cold dysentery, use Badou (Crotonis Semen). Take the medicine corresponding to the disease. Carefully follow ancient established methods; not a hair's breadth of error is allowed. (From *Yiguan*)
In the first one or two days of the disease, it is appropriate to purge pathogenic filth and dissolve residues, prioritizing unblocking and draining. Then differentiate cold, heat, excess, and deficiency, regulating to support the spleen and assist the stomach, which is the best strategy.
There are two methods of unblocking and draining: When stagnation is dominant, use pills; pills act slowly to dissolve stagnation and remove accumulation. When pathogenic toxins are dominant, use decoctions; decoctions sweep away toxins. Using decoctions when pills are needed removes toxins but leaves accumulation; using pills when decoctions are needed removes accumulation but fails to eliminate toxins. Improper treatment makes the disease difficult to cure. (From *Yijing Huijie*)
Generally, summer toxins contend with food, knotting in the lower epigastrium. Ascending and descending, exiting and entering cannot follow their proper paths. Waste products want to move but cannot, and fire forces them, driving the fatty tissues of the zang-fu organs downward. Therefore, Dahuang is taken to drive out heat toxins, purge waste, and clear the intestines and stomach. (From *Jingui Yi*)
If pus and blood are passed mixed with a floating and large pulse, absolutely do not purge with Dahuang; purging will lead to death, as qi exhausts downward and yang has no anchor. (From *Baoming Ji*)
In dysentery, if the tongue coating is yellow and dry without thirst, the chest feels full, there is body heat and abdominal distension, along with body heat and delirious speech, there is dry feces in the abdomen. Purge with Da Chaihu Tang (Major Bupleurum Decoction). (From *Quanying Fanglun*)
Xiao Chengqi Tang (Minor Order the Qi Decoction) treats dysentery with red-yellow stool, only irritability and desire for cold drinks, difficulty urinating, worsening with heat, heart irritability, and thirst. Take one or two doses first to purge. Must confirm it is excess heat before using. (From *Defang*)
Taoren Chengqi Tang (Peach Kernel Order the Qi Decoction) is indicated for dysentery in its initial stage in patients with substantial constitution. If purging was missed initially and astringents were wrongly used, causing pathogenic heat to accumulate internally and blood to fail to circulate, resulting in unbearable abdominal pain, urgently use this formula. (From *Yifang Kao*) (Note: Cheng Xinghai has a verified case adding Mudanpi (Moutan Cortex), Honghua (Carthami Flos), Binglang (Arecae Semen), Mutong (Akebiae Caulis), and Huashi (Talcum) to this formula.)
Liuyi Shunqi Tang (Six-One Smooth Qi Decoction) treats dysentery regardless of red-white mixture, abdominal pain, tenesmus, whole-body fever, dry mouth, and irritability/thirst. Unblocking and draining with this stops the condition. (From *Yijian*) (Note: This is Tao Jian'an's formula; refer to *Shanghan Guangyao · Yangming Disease*.)
Shaoyao Tang (Peony Decoction) stops bleeding and regulates qi. The Classics state: When urine is accompanied by pus and blood, moving qi stops bleeding; moving blood heals pus and blood; regulating qi eliminates tenesmus.
Shaoyao (Paeoniae Radix Alba) (one liang), Danggui (Angelicae Sinensis Radix), Huanglian (Coptidis Rhizoma) (each half liang), Binglang (Arecae Semen) (two qian), Muxiang (Aucklandiae Radix) (two qian), Gancao (Licorice Root, prepared) (two qian), Dahuang (Rhei Radix et Rhizoma) (three qian), Huangqin (Scutellariae Radix) (half liang), Guigui (Cinnamomi Ramulus) (one and a half qian).
Cut. Take half liang each time, decoct in two zhan of water to one zhan. Take warm after meals. For bloody dysentery, gradually increase Dahuang. For post-sweat internal toxicity, add Huangbai (Phellodendri Cortex) half liang, take as previously directed. (From *Baoming Ji*) Also treats dysentery with pus and blood, tenesmus, day and night without limit. Daoqi Tang (Guide Qi Decoction) removes Guigui and Gancao from this base formula (*Qixiao* adds Zhike (Aurantii Fructus)). *Yifang Kao* Shaoyao Tang adds Mangxiao (Natrii Sulfas) for dysentery with pus/blood and tenesmus. *Mingyi Zazhu* main formula for dysentery removes Danggui, Dahuang, and Guigui from this base formula, adding Zhike (*Huichun* Shaoyao Tang includes Danggui). If vomiting prevents eating, add Ruangushao (Gypsum Fibrosum) (one and a half qian), Chenpi (Citri Reticulatae Pericarpium) (one qian), Shanzhiren (Gardeniae Semen, fried) (five fen), add fresh ginger juice, sip slowly to clear stomach heat.
Taiyin transmitting to Shaoyin is called "Thief Evil." First use Nongpo Zhishi Tang (Magnolia Bark and Immature Bitter Orange Decoction) to prevent transmission.
Nongpo (Magnoliae Officinalis Cortex) (one liang), Zhishi (Aurantii Fructus Immaturus) (one liang), Hezi (Terminalia Chebulae Fructus, half raw half cooked) (one and a half liang), Muxiang (Aucklandiae Radix) (half liang), Huanglian (Coptidis Rhizoma) (two qian), Gancao (Licorice Root, prepared) (three qian), Dahuang (Rhei Radix et Rhizoma) (two qian).
Powder. Take three to five qian each time, decoct in one and a half sheng of water to one sheng. Strain and take warm. (From *Baoming Ji*)
Dahuang Tang (Rhubarb Decoction) treats persistent diarrhea/dysentery not healing, thick sticky pus and blood, tenesmus, day and night without limit, long-standing non-healing. (From *Yijian*). General Yin (General Drink) is this formula; its indication further states: Recurrence after healing, stopping and starting again, named Xiuxi Li (Resting Dysentery).
Dahuang (Rhei Radix et Rhizoma) (one liang).
Finely chop. Soak in two large zhan of good wine for half a day. Decoct together to one and a half sheng. Remove Dahuang. Divide the wine into two doses. Take in one go. If dysentery stops, one dose suffices; if not, take again. Stop when purged. (Same source)
Dahuang Wan (Rhubarb Pill) can be used for dysentery in its initial stage in robust individuals; contraindicated for weak stomachs.
Chuan Dahuang (Rhei Radix et Rhizoma, sliced and steamed with honey, one jin), Baishao (Paeoniae Radix Alba, soaked in wine, sliced, fried, six liang), Gancao (Licorice Root, prepared, three liang), Binglang (Arecae Semen, four liang), Muxiang (Aucklandiae Radix, sliced, not exposed to fire, powdered, one liang), Zhike (Aurantii Fructus, fried, four liang).
Powder finely. Refine honey, decoct Muxiang in water, mix and pound into pills the size of mung beans. Swallow three qian with white radish soup; five qian for severe cases. Continue until bowels move two or three times and the abdomen feels comfortable. Do not use lightly in those with extremely deficient stomach qi. For heavy stagnation with deficient yuan qi, swallow with Renshen Tang. For pregnant women, swallow with Renshen Suisha Tang. After evacuation, supplement with Renshen Wan separately. (From *Guang Biji*)
Siwei Xianglian Wan (Four-Ingredient Costus and Coptis Pill): Huanglian (Coptidis Rhizoma, fried, ten liang), Dahuang (Rhei Radix et Rhizoma, wine-steamed, four liang), Muxiang (Aucklandiae Radix, two liang), Binglang (Arecae Semen, one liang). Powder, form pills with paste, size of mung beans. Take seventy pills each time with rice water on an empty stomach. Treats initial dysentery, regardless of red/white. Take twice daily. Stool moves naturally if there is accumulation; stops naturally if none. (From *Rumen*)
Shenmiao San (Divine Wonder Powder), treats red-white dysentery. (Note: San should be Wan/Pill.)
Dahuang (Rhei Radix et Rhizoma), Renshen (Ginseng Radix), Zhike (Aurantii Fructus), Huomazi (Hemp Seed) (equal parts).
Powder. Form pills with flour paste, size of Sophora seeds. Take thirty pills each time with plain boiled water. (From *Jingyan Liangfang*) (Note: This is based on *Jinxiao* modified Mahuan Wan, removing Hezi and adding Zhike; refer to constipation.)
Zhu Kongyang, age 25, thin and slender, accustomed to comfort. In summer, due to litigation running in the sun, summer-dampness combined with internal stagnant fire caused dysentery. One to two hundred times day and night, unable to get out of bed. Placed coarse paper on the mattress, changing frequently. Only drank water, did not eat. The illness was severe, anus felt like burning iron, waving hands and throwing feet, restless and unbearable. I palpated his pulse: wiry, tight, forceful, and urgent, resisting finger pressure. I said: This condition is a mass of toxic fire accumulating in the intestines and stomach, burning fiercely. Saving from fire requires immediate action; otherwise, in two or three days, the intestines and stomach will rot. Thus, I used four liang of Dahuang, two liang each of Huanglian and Gancao, decocted in a large clay pot, taken as it boiled. After taking, consciousness calmed briefly, then restlessness returned. Over one day and night, more than twenty bowls were consumed; Dahuang melted completely, Huanglian and Gancao lost all juice. The next day, the patient sought the previous medicine again. After palpation, seeing the pulse force soften, I knew the disease could be cured. But use urgent methods, not urgent medicines. I switched to Sheng Dihuang (Rehmanniae Radix Recens) and Maidong (Ophiopogonis Radix) each four liang, crushed separately for fresh juice. Decoct Tianhuafen (Trichosanthis Radix), Mudanpi (Moutan Cortex), Chi Shao (Paeoniae Radix Rubra), and Gancao (Licorice Root) each one liang, mix with the fresh juice, and drink a large bowl. Because the onset was violent, exhausting all body fluids, waiting until diarrhea stops to nourish fluids and blood would make recovery from emaciation difficult at that moment. Now that the pulse force has decreased, fire pathogens have retreated. Not treating dysentery directly causes it to stop itself. How can one cling to cloying/stagnating medicines and not use them urgently? Taking this medicine indeed stopped all dysentery, leaving only a small amount of qi foam. On the third day, craving tofu milk; on the fourth day, slightly consuming clear juice of aged rice. Slowly regulated for over ten days before digesting grain. This shows the remaining thread of stomach qi; one cannot lack this "burnt-head guest" (referring to the harsh but necessary treatment). (From *Yuyi Cao*)
Treat long-term red-white dysentery lasting years, and cholera with cold-solid spleen/stomach failing to digest. Wenyi Tang (Warm the Spleen Decoction) formula.
Dahuang (Rhei Radix et Rhizoma) (four liang), Renshen (Ginseng Radix), Gancao (Licorice Root), Ganjiang (Zingiberis Rhizoma) (each two liang), Fuzi (Aconiti Lateralis Radix Praeparata, one large piece).
The above five ingredients cut. Decoct in eight sheng of water to obtain two and a half sheng. Divide into three doses. Add Dahuang near the end of decoction. Slightly different from the following Wenyi Tang; for those requiring strong purgation, this formula is miraculous. (From *Qianjin Fang*) Another Wenyi Tang treats long-standing cold-heat red-white dysentery. Remove Gancao from this base formula, add Guixin (Cinnamomi Ramulus) (Dahuang and Guixin each three liang, others one liang). Decoct in seven sheng of water to obtain two and a half sheng. Divide into three doses. (Note: Refer to *Xiexie Men*, *Futong Men*, and *Shanghan Guangyao · Taiyin Disease* for cross-reference.)
*Waitai Mi Yao* Xu Renze: Regarding the aforementioned dysenteries (water, grain, blood, pus, pus-blood mixed, intestinal deviation), regardless of new or old, if treated with medicine and recurs after improvement, even if new medicine stops it temporarily, the root remains. Due to cold-heat imbalance in intestines/stomach, disease root is firmly knotted. Must use decoctions to purge and relieve disease momentum, then supplement with medicine after dysentery. For such cases, use the following Fuzi six-ingredient decoction to promote drainage, adding Xixin (Asari Radix et Rhizoma) to this base formula (Dahuang five liang, others three liang). This decoction should produce rapid drainage; discharge containing foul matter like fish brains or plums/apricots, differing from normal dysentery, should not surprise you.
Treat accumulated dysentery. Lingsha Dan (Cinnabar and Orpiment Pill). (With discussion)
Lingsha (Realgar and Cinnabar, one fen each, ground extremely fine).
Separately use half liang of beeswax, seven to nine grains of Badou (Crotonis Semen), remove shell/skin/membrane. Boil in a silver/ceramic vessel in double boiler for one fushi (four hours) until Badou turns purple. Remove seven grains, keep one seven-grain portion. Grind uniformly with the two powders. Melt wax to seal medicine. Roll into pills size of mung beans. Take three to five pills each time. For watery diarrhea, take with ginger soup; for white dysentery, mugwort soup; for red-white dysentery, mume soup. Must take on extreme empty stomach. Eat only after one hour. Best taken before sleep. Follow with light congee for one day. For malaria, take with Ruxiang Tang (Frankincense Decoction); take in evening when not attacking.
This medicine does not disturb qi. Diarrhea stops, dysentery ceases, pain heals, accumulation dissolves internally, without disturbing zang-fu organs. Generally, for dysentery with sediment, if accumulation is not removed first, temporary relief leads to later harm. I remember Vice Minister Chen Jingzhong visiting Yizhen for diagnosis in autumn of Gengxu year. Initially unaware of illness, upon examination, liver pulse was deep and wiry, firm when pressed to bone. I said: Blood accumulation in left hypochondrium will cause pain. Chen agreed. Previously guarding Jiujiang, summoned, traveled across Yangtze in summer heat. Upon arrival, bloody dysentery had lasted days. Urgently wanted to attend court. Doctor used harsh/dry medicines. Although stopped, a lump appeared below navel, cup-sized in days, bowl-sized in ten days. Unbearable when attacking, so urgently requested retirement. What to do? I said: Accumulated dysentery cannot be forcibly stopped. Blood knots below navel/hypochondrium. Only Didang Wan (Shoulder-to-Shoulder Pill) works. He doubted and refused. Died of it the next year. (From *Benshi Fang*) (Note: This formula also appears in *Jifeng Fang* as Zhisheng Chanjin Dan. Cinnabar and Realgar each one liang, seven Badou, beeswax size of ten dates. Melt wax, boil Badou until scorched, discard Badou.)
Ganying Wan (Induction Pill) treats frequent bowel movements, late/sluggish tenesmus, long-standing red-white dysentery, mixed pus/blood, undigested grain, recurrence after healing. (From *Heji Jufang*) Red-white dysentery with umbilical/abdominal pain is mostly caused by intestinal/stomach accumulation. First use this medicine to mildly purge, then stop dysentery. (From *Yijian Fang*) (*Xu Yijian Fang* says: If red dysentery takes this, will it not ruin matters?)
Sugan Wan (Storax Induction Pill) treats accumulated dysentery with inability to drink, miraculous effect.
Suhe Xiang Wan (Styrax Induction Pill), Ganying Wan (Induction Pill).
Mix the above two into pills, size of mung beans. Take twenty to thirty pills, swallowed with ginger soup. (From *Zhushi Jiyan Fang*)
Treat white dysentery. Zhentou Wan (Needle Head Pill).
Badou (Crotonis Semen) ten (remove shell, soak in vinegar overnight, remove oil), Xingren (Armeniacae Semen) ten (fire-roast preserving nature), Baicaoshuang (Soot from Chimney, two qian, fried), Huangla (Beeswax, size of chestnut).
Form agent with wax. Roll into pills size of mustard seeds. Take three pills each time. For watery diarrhea, well water; for black dysentery, mume soup; for white dysentery, dried ginger soup; for red dysentery, licorice soup. (From *Weisheng Jiabao Fang*) (Note: *Shengji Zonglu* Heishen Wan for unceasing watery diarrhea is same as this, formed with glutinous rice porridge.)
Erse Wan (Two-Color Pill) treats various red-white dysentery, miraculous.
Wuzhuyu (Evodiae Fructus, remove branches/stems, two liang), Huanglian (Coptidis Rhizoma, remove stamens, two liang), Badou (Crotonis Semen, forty-nine, peeled).
Stir-fry together in a crucible until yellow-red. Discard Badou. Powder the two ingredients separately. Form pills with flour paste, size of radish seeds. Adjust pill count based on severity/tightness. (From *Xiao'er Zongweilun*)
Experience Dysentery Four Treasures Pill. (Used for long time, always effective, not keeping secret, sharing publicly, treasure it.)
Gong Dingxiang (Eugeniae Caryophyllatus Flos, one qian), Hu Huanglian (Picrorhizae Rhizoma, three qian), Badoushuang (Crotonis Semen Frost, one qian. Method: Badou any amount, remove shell, wrap in paper, place on new tile, cover with another tile, roast over charcoal until oil gone, smoke ends, preserve nature.)