经云∶中气不足，溲便为变。人之二便，全藉中气为之转输，故不失其常度。肾气虚则
关门
不固，脾气虚则仓廪失藏，便泻溲数之病生焉。方定补中益气汤，升举脾元，四神丸固摄肾
气。二药合投，并行不悖。加枸兔佐蔻萸之功，增莲芡辅参术之力，方则脾肾分施，病则溲
便并治矣。
安波按∶肾开窍于二阴，肾气虚则失其司，脾气弱则运失其旋，故以脾肾双补治。然
此公大约多年，或久泻溲数。如新泻溺短，则大相径庭矣。
痢疾古名滞下，然此滞字，非单指饮食停滞之谓，言其暑湿内侵，腑气阻遏而为滞耳。
长夏
感受暑邪，伏于肠胃，新秋患痢，腹痛后重，赤白稠粘，日夜频次。考古贤治痢，不外通涩
两法。大都初痢宜通，久痢宜涩。夫暑湿邪热，客于营卫则生疮疖，入于肠胃则为泻痢。痢
之红白，如疖之脓血，脓血不净疖不收，红白不净痢不止。证在初起，治贵乎通。经曰∶通
因通用。然此通字，亦非专指攻下之谓，言其气机流行而无壅滞，乃为通耳。丹溪以河间发
明滞下证治，和血则便脓自愈，调气则后重自除二语，实盲者之日月，聋者之雷霆。特其方
法，每用芩连槟枳，苦寒攻伐，藜藿洵属合宜，膏粱恐难胜任。敝郡汪氏蕴谷书称，痢疾即
时疫，浊邪中下，名曰滞。亦杂气之所乘，故多传染于人。其自定黄金汤一方，药虽平淡无
奇，然于逐邪解毒之义，颇为切当。谷食不减，胃气尚强，约期二候，可以奏功。
安波按∶黄金汤者，用黄土、金银花、扁豆肉、扁豆花、茯苓、谷芽、黑豆、甘草、
生白芍、五谷虫、生姜也。余治噤口痢甚效，已验之数人矣。
《黄帝内经》说：中气不足，大小便就会发生异常。人的二便，完全依赖中气的转输作用，因此才能保持正常规律。肾气虚弱则关门不固，脾气虚弱则仓廪失守，便泻、小便频数等疾病由此产生。方定采用补中益气汤，以升举脾元之气；四神丸，以固摄肾气。两药合用，并行不悖。加入枸杞、兔丝子（此处原文“枸兔”疑为枸杞、菟丝子之简称或笔误，依语境解）辅助白豆蔻、山茱萸的功效，增加莲子、芡实辅助人参、白术的力量，处方则脾肾分治，病症则二便并调。
安波按语：肾开窍于前后二阴，肾气虚弱则失去其主管功能，脾气虚弱则运化失去其旋转之力，因此采用脾肾双补的方法治疗。然而这位患者大概患病多年，或是长期腹泻、小便频数。如果是新近发生的腹泻、尿短赤，那就大相径庭了。
痢疾古称滞下，但这个“滞”字，并非单指饮食停滞的意思，而是指暑湿内侵，腑气被阻遏而形成的滞涩状态。长夏季节感受暑邪，潜伏于肠胃，到了初秋患痢疾，出现腹痛、里急后重，大便赤白稠粘，日夜次数频繁。考察古代贤人治疗痢疾，不外乎通法和涩法两种。大多初起痢疾宜用通法，久痢宜用涩法。暑湿邪热，客居于营卫之间则生疮疖，进入肠胃则为泻痢。痢疾中的红白脓血，如同疖肿的脓血，脓血排不净疖肿就不愈合，红白不净痢疾就不停止。证候在初起阶段，治疗贵在通利。经书说：通因通用。然而这个“通”字，也并非专指攻下的意思，而是指气机流行而没有壅滞，这才是真正的“通”。丹溪认为河间先生阐明了滞下的证治，指出调和血脉则便脓自愈，调理气机则里急后重自除这两句话，实在是如日月般光明，如雷霆般震撼。只是他的方法，每用黄芩、黄连、槟榔、枳实等苦寒攻伐之品，对于粗茶淡饭的平民固然合适，但对于饮食膏粱厚味的人恐怕难以胜任。我郡汪蕴谷先生称，痢疾即时疫，浊邪侵犯下部，名为滞。也是杂气所乘袭，所以多传染于人。他自己制定的黄金汤一方，药物虽然平淡无奇，但在驱逐邪毒解毒的意义方面，颇为恰当。如果谷食不减，胃气尚强，大约经过两周时间，可以奏效。
安波按语：黄金汤，是用黄土、金银花、扁豆肉、扁豆花、茯苓、谷芽、黑豆、甘草、生白芍、五谷虫、生姜组成的。我治疗噤口痢非常有效，已经验证过几个人了。
The *Huangdi Neijing* (Yellow Emperor's Inner Canon) states: "Deficiency of Zhong Qi (Middle Jiao Qi) leads to abnormalities in urination and defecation." The body's excretion of urine and feces relies entirely on the transportation and transformation function of Zhong Qi, thereby maintaining normal physiological patterns. When Kidney Qi is deficient, the "gate" fails to secure retention; when Spleen Qi is deficient, the "granary" fails to store, giving rise to diseases such as diarrhea and frequent urination. Fang Ding prescribed Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) to raise Spleen Yuan Qi, and Sishen Wan (Four Spirits Pill) to consolidate Kidney Qi. The two prescriptions are used concurrently without conflict. Added Gouqi (Lycium Fruit) and Tusi (Cuscuta Seed) [Note: Text says 'Gou Tu', interpreted as Gouqi and Tusizi] assist the efficacy of Doukou (Amomum Fruit) and Yuyu (Cornus Fruit); Lianzi (Lotus Seed) and Qianshi (Euryale Seed) augment the power of Renshen (Ginseng) and Baizhu (Atractylodes Macrocephala Rhizome). Thus, the prescription treats the Spleen and Kidney separately, while the disease addresses both urination and defecation simultaneously.
An Bo comments: The Kidney opens into the two yin orifices (anterior and posterior). When Kidney Qi is deficient, it loses its controlling function; when Spleen Qi is weak, its transportation loses its rotational force. Therefore, a method of tonifying both Spleen and Kidney is employed. However, this patient likely suffered for many years, with chronic diarrhea and frequent urination. If the diarrhea and short, red urine were recent in onset, the condition would be vastly different.
Dysentery was anciently known as "Zhi Xia" (Stagnant Downward Flow). However, the character "Zhi" (Stagnation) here does not solely refer to food stagnation, but rather indicates that Summer-heat and Dampness invade internally, obstructing the Qi mechanism of the Fu organs, leading to stagnation. Contracting Summer-heat pathogens during late summer, which lie latent in the intestines and stomach, results in dysentery in early autumn, characterized by abdominal pain, tenesmus (feeling of incomplete defecation), sticky discharge of red and white pus/blood, and frequent bowel movements day and night. Examining how ancient sages treated dysentery, they did not exceed two methods: Purging (Tong) and Astringing (Se). Generally, initial dysentery should be treated with purging, while chronic dysentery should be treated with astringing. Summer-heat and Dampness pathogens lodging in Ying and Wei (Nutritive and Defensive levels) cause sores and boils; entering the intestines and stomach causes diarrhea and dysentery. The red and white discharge in dysentery is like the pus and blood in boils; if pus and blood are not cleared, the boil will not heal; if red and white discharge is not cleared, dysentery will not cease. In the initial stage of the syndrome, treatment values purging. The Classics state: "Use purging to treat purging-type syndromes" (Tong Yin Tong Yong). However, this "purging" does not exclusively refer to cathartic methods, but signifies the free flow of Qi mechanism without obstruction. Danxi noted that Hejian elucidated the syndrome and treatment of Zhi Xia, stating that harmonizing blood heals bloody stool spontaneously, and regulating Qi eliminates tenesmus spontaneously. These two statements are truly illuminating as the sun and moon, and shocking as thunder. Yet his methods often use Huangqin (Scutellaria Root), Huanglian (Coptis Rhizome), Binglang (Areca Seed), and Zhishi (Immature Bitter Orange), which are bitter-cold and attacking. While suitable for those eating simple coarse foods, they may be too harsh for those consuming rich, fatty foods. Mr. Wang Yungu from my prefecture stated that dysentery is an epidemic pestilence; turbid pathogens attack the lower jiao, named "Zhi". It is also caused by miscellaneous qi, hence it is often contagious. His self-formulated Huangjin Tang (Golden Yellow Decoction), although composed of plain and unremarkable herbs, is quite appropriate in its principle of expelling pathogens and detoxifying. If appetite for grain food remains unchanged and Stomach Qi is still strong,功效 can be achieved within approximately two weeks (14 days).
An Bo comments: Huangjin Tang consists of Huangtu (Yellow Earth), Jinyinhua (Lonicera Flower), Bian Dou Rou (Flesh of Lablab Bean), Bian Dou Hua (Lablab Bean Flower), Fuling (Poria), Guya (Sprouted Grain), Heidou (Black Soybean), Gancao (Licorice Root), Sheng Baishao (Raw White Peony Root), Wugu Chong (Insect Excrement), and Shengjiang (Fresh Ginger). I have found it very effective in treating Jin Kou Li (Dysentery with inability to eat/drink), having verified its efficacy on several patients.