久冷痢者，由肠虚而寒积，故冷痢久不断也。而廪丘公说云∶诸下悉寒也。凡人肠中大
便，有寒则常鸭溏，有热则傧硬。人见病身体发热而下，便谓热下，非也。平常恒自将
节，饮食衣被调适，其人无宿寒者，大便自调。强人适发越，薄衣冷冻饮料食，表有热不觉里冷
，而胃内潜冷，冷即下也。今始发热而下，当与理中汤加大附子一枚，连服三四剂，重覆
令微汗出，微汗出则热除，不复思冷，胃气温暖，下与发热俱瘳矣。
宿寒之家，其人常自患冷。蹑湿地，若足踏冻地，或衣被薄，皆发。风下最恶，何谓风
下？当风吹腰腹，冷气彻里而暴下者，难治也。
久痢，胃虚气逆则变呕；呕而气逆，遇冷折之，气逆不通则变哕。亦变湿 也，胃
虚虫动故也。
此由肠胃虚弱，风邪挟热乘之，肠虚则泄，故为热痢也，其色黄。若热甚，黄而赤也。
此由肠虚热积，其痢连滞，故久不瘥也。痢久，胃气虚则变呕；呕而气逆，遇冷折之，
气不通则变哕。亦变湿 也，胃虚虫动故也。
夫冷热痢者，由肠胃虚弱，宿有寒，而为寒热所伤，冷热相乘，其痢乍黄乍白是也。若
热搏于血，血渗肠间，则变为血痢也。而冷伏肠内，搏津液，则变凝白，则成白滞，亦变赤
白痢也。其汤熨针石，别有正方，补养宣导，今附于后。
《养生方·导引法》云∶泄下有寒者，微引气，以息内腹，徐吹息。以鼻引气，气足复
前即愈。其有热者，微呼以去之。
久冷痢，是由于肠道虚弱导致寒邪积聚，因此冷痢迁延不愈。廪丘公曾说：“所有的下利都属于寒证。”一般人的大便，如果有寒邪则常呈鸭溏状（稀薄如鸭粪），有热邪则干燥坚硬。人们看到病人身体发热且伴有下利，就认为是热性下利，这是错误的。如果平时能自我节制，饮食衣物调适得当，体内没有宿寒的人，大便自然正常。强壮之人如果过度发散（如剧烈运动或出汗），穿着单薄并食用冷冻饮料食物，体表虽有热感却不觉内部寒冷，而胃内潜藏寒气，寒气下行就会导致下利。此时刚开始出现发热和下利，应当给予理中汤（温中散寒方剂）加一枚附子（乌头科植物旁生的侧根），连续服用三四剂，加盖厚被使其微微出汗，微汗出后热邪去除，不再思慕冷饮，胃气温暖，下利与发热同时痊愈。
有宿寒体质的人，常常自感寒冷。踩湿地、脚踩冻地，或者衣被单薄，都会诱发此病。风邪引起的下利最为恶劣，什么是风下？当腰腹部受风吹，冷气深入体内导致突然暴发性下利时，属于难治之症。
久痢患者，若胃虚气逆则会转变为呕吐；呕吐且气逆，若遇寒邪遏制，气机不通畅则会转变为呃逆（打嗝）。也会转变为湿痢，这是因为胃虚虫动所致。
这种热痢是由肠胃虚弱，风邪挟带热邪侵袭所致，肠道虚弱则泄泻，所以称为热痢，其排泄物颜色为黄色。如果热势严重，排泄物呈黄中带赤色。
这是由于肠道虚弱且有热邪积聚，痢疾连绵不断，所以久久不能痊愈。痢疾日久，胃气虚弱则转变为呕吐；呕吐且气逆，遇冷邪遏制，气机不通畅则转变为呃逆。也会转变为湿痢，这是因为胃虚虫动所致。
冷热痢，是由于肠胃虚弱，体内素有寒邪，又受到寒热邪气的伤害，寒热相互搏结，导致痢疾发作时颜色忽黄忽白。如果热邪搏结于血分，血液渗入肠间，则转变为血痢。如果寒邪潜伏在肠内，搏结津液，则变为凝滞的白色物质，形成白滞，也转变为赤白痢。至于汤熨（热敷）、针石等疗法，另有专门的方剂，补养和导引等方法，现附在后面。
《养生方·导引法》说：对于泄下有寒者，轻微引导气息，用呼吸充盈腹部，缓慢呼气。用鼻子吸气，气息充足后再重复前面的动作即可痊愈。对于有热者，轻微呼气以排出热邪。
Chronic cold dysentery arises from intestinal deficiency with accumulation of cold, thus the cold dysentery persists for a long time. Mr. Linqiu stated: "All forms of lower purging belong to cold syndromes." Generally, in the human body's stool, if there is cold, it often appears as duck-dung loose stool (thin and watery like duck feces); if there is heat, it becomes dry and hard. When people see a patient with fever accompanied by diarrhea, they assume it is heat-type diarrhea, which is incorrect. If one maintains self-restraint in daily life, adjusts diet and clothing appropriately, and has no chronic cold in the body, the stool will naturally be regular. A robust person who overexerts themselves (e.g., through excessive sweating or exercise), wears thin clothes, and consumes frozen beverages and food may feel heat on the exterior while being unaware of the cold within; this latent cold in the stomach leads downward, causing diarrhea. At this initial stage of fever and diarrhea, one should administer Lizhong Tang (Spleen-Warming Decoction) with one added Fuzi (Aconite Lateral Root), taken continuously for three to four doses. Covering heavily to induce slight perspiration, the heat will dissipate upon slight sweating, the craving for cold drinks will cease, the stomach qi will become warm, and both the diarrhea and fever will heal simultaneously.
Those with a constitution of chronic cold often complain of feeling cold. Stepping on wet ground, treading on frozen earth, or wearing thin bedding can all trigger this condition. Diarrhea caused by wind pathogen is the most severe. What is "wind diarrhea"? It refers to cases where wind blows on the waist and abdomen, allowing cold qi to penetrate deeply into the interior and cause sudden, violent diarrhea; these are difficult to treat.
In chronic dysentery, if the stomach is deficient and qi rebels upward, it transforms into vomiting; if vomiting occurs with rebellious qi, and this is constrained by cold, leading to obstruction of qi flow, it transforms into hiccups. It may also transform into damp dysentery, due to stomach deficiency causing parasites to move.
This type of heat dysentery arises from gastrointestinal weakness, where wind pathogen carrying heat invades the body. Intestinal deficiency leads to diarrhea, hence it is called heat dysentery, and the excrement color is yellow. If the heat is severe, the excrement is yellow mixed with red.
This results from intestinal deficiency with heat accumulation, causing the dysentery to persist continuously, thus failing to heal for a long time. In prolonged dysentery, stomach qi deficiency leads to vomiting; if vomiting is accompanied by rebellious qi and constrained by cold, resulting in blocked qi flow, it transforms into hiccups. It may also transform into damp dysentery, due to stomach deficiency causing parasites to move.
Cold-heat dysentery arises from gastrointestinal weakness and pre-existing internal cold, which is then injured by cold and heat pathogens. The interplay of cold and heat causes the dysentery to fluctuate between yellow and white colors. If heat binds with blood, causing blood to seep into the intestines, it transforms into bloody dysentery. If cold lingers in the intestines, binding with body fluids, it transforms into coagulated white matter, forming white stagnation, and also transforms into red-and-white dysentery. Regarding therapies such as hot compresses (Tangwen) and acupuncture/stone therapy, there are separate specific formulas. Nourishing and guiding exercises are attached below.
The *Health Preservation Formulas · Daoyin Methods* states: For diarrhea with cold, gently guide the qi, fill the abdomen with breath, and exhale slowly. Inhale through the nose; when the qi is sufficient, repeat the previous actions until recovery. For those with heat, gently exhale to expel the heat.