夫久水谷痢者，由脾胃大肠虚弱，风邪乘之，则泄痢。虚损不复，遂连滞涉引岁月，则
为久痢也。
然痢久则变呕哕。胃弱气逆不下食，故呕逆也。气逆而外冷气乘之，与胃气相折不通，
故哕也。
呕又变为 ，虫动食于五脏也。凡诸虫在人腹内，居肠胃之间。痢则肠胃虚弱，虫
动侵食，若上食于脏，则心闷，齿龈紫黑，唇白齿龈生疮；下食于肛门，则谷道伤
烂而开也。
亦有变为水肿。所以然者，水气入胃，肠虚则泄。大肠金也，脾土也，金土母子也。脾
候身之肌肉，性本克消水谷也。痢由脾弱肠虚，金土气衰，母子俱病，不复相扶，不能克水
，致水气流溢，浸渍肌肉，故变肿也。
亦有不及成肿而五脏伤败，水血并下，而五脏五色随之而出，谓之五液俱下也。凡如此
者多死，而呕、哕、肿、 ，治之时有瘥者。若五液俱下者必死，五脏伤败故也。
凡痢皆由荣卫不足，肠胃虚弱，冷热之气，乘虚入客于肠间，肠虚则泄，故为痢也。然
其痢而赤白者，是热乘于血，血渗肠内则赤也；冷气入肠，搏于肠间，津液凝滞则白也；冷
热相交，故赤白相杂。重者，状如脓涕而血杂之；轻者，白脓上有赤脉薄血，状如鱼脂脑，
世谓之鱼脑痢也。
久赤白痢者，是冷热不调，热乘于血，血渗肠间，与津液相杂而下。甚者肠虚不复，故
赤白连滞，久不瘥也。
凡痢久不瘥，脾胃虚弱，则变呕哕。胃弱气逆，故呕也；气逆而外有冷折之，不通故哕
亦变为 ，虫食人五脏也。三尸九虫，常居人肠胃，肠胃虚则动，上食于五脏，则
心懊而闷，齿龈、唇口并生疮；下食于肠，则肛门伤烂，而谷道开也。轻者可治，重者
所谓久水谷痢，是由于脾胃和大肠虚弱，风邪趁虚侵袭，导致泄泻和痢疾。身体虚损无法恢复，于是病情迁延，跨越岁月，就形成了久痢。
然而，痢疾日久会转变为呕吐和呃逆（哕）。因为胃气虚弱，气机上逆，食物无法下行，所以发生呕吐；气机上逆且外部的冷气乘虚而入，与胃气相互抵触而不通，所以发生呃逆。
呕吐又可能转变为下虫（指排出寄生虫或肠道寄生虫活动引起的症状），这是因为寄生虫在五脏中蠕动并侵蚀脏腑。大凡各种寄生虫生活在人的腹内，居于肠胃之间。患痢疾时肠胃虚弱，寄生虫躁动并侵食人体，如果向上侵蚀内脏，就会出现心中烦闷、齿龈紫黑、嘴唇发白且齿龈生疮的症状；如果向下侵蚀肛门，就会导致肛门损伤溃烂而张开。
也有转变为水肿的情况。之所以这样，是因为水气进入胃部，肠道虚弱则导致泄泻。大肠属金，脾属土，金与土是母子关系。脾主管身体的肌肉，本性具有消化水谷的作用。痢疾由于脾弱肠虚，导致金（大肠）和土（脾）的气机衰弱，母子同病，不再互相扶持，不能制约水湿，致使水气流溢，浸渍肌肉，所以转变为浮肿。
也有来不及形成浮肿，但五脏已经损伤败坏，水和血同时下注，并且五脏对应的五色随之排出的情况，这叫做“五液俱下”。凡是出现这种情况的多为死证，而呕吐、呃逆、浮肿、下虫等症状，治疗时有时可以痊愈。如果是五液俱下，必定死亡，这是因为五脏损伤败坏的缘故。
大凡痢疾都是由营卫之气不足，肠胃虚弱，冷气和热气趁虚侵入肠间，肠道虚弱则泄泻，所以形成痢疾。然而，痢疾中出现赤白相间的，是因为热邪侵袭血液，血液渗入肠内则呈现红色；冷气进入肠道，搏结于肠间，津液凝滞则呈现白色；冷热之气相互交争，所以红白相间。病情重的，状如脓涕混杂血液；病情轻的，白色脓液上有红色的细脉和薄血，状如鱼脑脂，世人称之为“鱼脑痢”。
久赤白痢，是由于冷热不调，热邪侵袭血液，血液渗入肠间，与津液混合而下。严重的，肠道虚弱无法恢复，所以赤白痢疾迁延不断，久久不愈。
大凡痢疾日久不愈，脾胃虚弱，就会转变为呕吐和呃逆。胃气虚弱气机上逆，所以发生呕吐；气机上逆且有外部寒气折损它，不通畅所以发生呃逆；也会转变为下虫，寄生虫侵蚀人的五脏。三尸九虫，常居住在人的肠胃中，肠胃虚弱它们就会躁动，向上侵蚀五脏，就会心中懊恼烦闷，齿龈、唇口都生疮；向下侵蚀肠道，就会肛门损伤溃烂，谷道张开。轻症可以治疗，重症……
The so-called chronic dysentery with watery and undigested food is caused by the weakness of the Spleen, Stomach, and Large Intestine, where Wind Pathogen (Feng Xie) takes advantage of the deficiency to invade, leading to diarrhea and dysentery. When the body's deficiency fails to recover, the condition lingers over years, resulting in chronic dysentery.
However, prolonged dysentery may transform into vomiting and hiccups (Yue). Because the Stomach Qi is weak and rebels upward, preventing food from descending, vomiting occurs. When Qi rebels upward and external Cold Pathogen invades, clashing with Stomach Qi and causing obstruction, hiccups occur.
Vomiting may further transform into the expulsion of parasites (Chong), as parasites move within and erode the Zang Organs. Generally, various parasites reside within the abdomen, dwelling between the intestines and stomach. During dysentery, the intestines and stomach are weak; parasites become active and consume the host's tissues. If they ascend to erode the Zang Organs, symptoms include mental oppression, purplish-black gums, white lips, and sores on the gums. If they descend to erode the anus, the anal canal becomes damaged, ulcerated, and dilated.
There are also cases transforming into edema. The reason is that Water Qi enters the Stomach, and due to intestinal weakness, diarrhea ensues. The Large Intestine corresponds to Metal, and the Spleen to Earth; Metal and Earth share a mother-son relationship. The Spleen governs the muscles of the body and naturally has the function of digesting water and grain. Dysentery results from Spleen weakness and intestinal deficiency, causing the Qi of both Metal and Earth to decline. With both affected and no longer supporting each other, they fail to control Water, leading to the overflow of Water Qi which infiltrates the muscles, thus transforming into swelling.
In some cases, edema does not fully develop before the Five Zang Organs are damaged and failing, causing Water and Blood to flow downward simultaneously, accompanied by the discharge of the five colors corresponding to the Zang Organs, known as "simultaneous discharge of the five fluids." Cases presenting like this often result in death. In contrast, conditions involving vomiting, hiccups, edema, or parasite expulsion may sometimes be cured with treatment. However, simultaneous discharge of the five fluids invariably leads to death due to the failure of the Five Zang Organs.
Generally, all dysentery arises from insufficiency of Ying (Nutritive) and Wei (Defensive) Qi, and weakness of the intestines and stomach. Cold and Heat pathogens invade the intestinal space taking advantage of the deficiency; intestinal weakness leads to diarrhea, forming dysentery. Regarding dysentery with red and white discharge: Heat invading the blood causes blood to seep into the intestines, appearing red; Cold Qi entering the intestines clashes within, causing body fluids to stagnate and appear white. The interaction of Cold and Heat results in mixed red and white discharge. In severe cases, it resembles pus and mucus mixed with blood; in mild cases, there are thin red veins and blood on white pus, resembling fish brain fat, commonly referred to as "Fish Brain Dysentery."
Chronic red and white dysentery is caused by disharmony of Cold and Heat. Heat invades the blood, which seeps into the intestines and mixes with body fluids for downward discharge. In severe cases, the intestines remain weak and fail to recover, causing red and white dysentery to persist chronically without healing.
Generally, when dysentery persists for a long time without healing, Spleen and Stomach weakness leads to vomiting and hiccups. Weak Stomach Qi rebels upward, causing vomiting; when Qi rebels and is constrained by external Cold, causing obstruction, hiccups occur. It may also transform into parasite expulsion, where parasites erode the Zang Organs. The Three Corpses and Nine Worms often reside in the intestines and stomach; when these organs are weak, the parasites become active. Ascending to erode the Zang Organs, they cause mental restlessness and oppression, with sores on the gums, lips, and mouth. Descending to erode the intestines, they cause anal damage and ulceration, opening the anal canal. Mild cases are treatable, while severe cases...