Written By Jun Heo (許浚, 1539~1615), translated by Namil Kim, Wung Seok Cha et al. Published by Ministry of Health & Welfare (Korea).
14 Anal Pain from Dysentery 痢疾大孔痛이질로 인한 항문의 통증
① Anal pain from dysentery results from heat flowing downward. Decoct Aucklandiae Radix (木香), Arecae Semen (檳榔), Scutellariae Radix (黃芩), Coptidis Rhizoma (黃連), and Zingiberis Rhizoma (乾薑) (fried) in water and take.
② When the anal area hurts due to dysentery, treatment should be based on warming.
③ When the anal area hurts due to dysentery, the patient should be warmed or cooled. The patient with a cold body and sunken pulse from a chronic disease should be warmed, and the patient with heat in the body with a floating and surging pulse from an acute disease should be cooled.
④ Pain means that heat is flowing downward.
⑤ Incontinence of feces and an opened anus should be treated with spring onion and Zanthoxyli Pericarpium (川椒) powder to block the opening, and sour and astringent herbs like Pericarpium Papaveris (罌粟殼) and Terminaliae Fructus (訶子皮) to close the large intestine.
⑥ Anal pain from dysentery means severe deficiency. Heat a piece of round roof tile of a coin size, soak in the child’s urine, and take out immediately, dry it and wrap it with paper and put on where it is painful. Then take a thick decoction of Ginseng Radix (人參), Angelica Gigantis Radix (當歸), and Citrus Unshius Pericarpium (陳皮).
⑦ Steam with baked Ponciri Fructus Immaturus (枳實) or fried salt. Also, expose to smoke of burned old moxa, yellow beeswax, and Terminaliae Fructus (訶子); it has a dramatic effect.
15 Diarrhea Should Be Induced in Dysentery 痢疾宜下 이질에는 설사시켜야 한다
① On the first and second day of dysentery when source qi is still not deficient, pathogenic qi should be removed. This is the way of “treating “opened” conditions with an “opening” method,” by inducing diarrhea with a Great qi Coordinating Decoction (大承氣湯) or Regulate Stomach and Coordinate Qi Decoction (調胃承氣湯) and then making qi and blood even. After five days, diarrhea should not be induced any more since the qi of the spleen and stomach are deficient by then.
② Previous is a big explanation. The patient with weak qi and blood should not be induced to diarrhea even if it is only for one to two days, while the patient with strong qi and blood can be induced to diarrhea even after ten days.
③ Abdominal bloating in dysentery is a symptom of excess, where diarrhea should be induced.
④ The pulse being rather slippery in dysentery means that unnecessary leftovers should be induced through diarrhea.
⑤ Recurrence of dysentery at the same time of the year it first occurred is because it was not treated completely. It should be induced through diarrhea with a Great qi Coordinating Decoction.
⑥ When Zhongjing (仲景) treated dysentery, he always adjusted an Order the qi Decoction and made the patient to have diarrhea at all cases when the purgation method was adequate. The cold property of Rhei Radix et Rhizoma (大黃) likes to run, so it moves stagnation down by the assistance of the warm property of Magnoliae Cortex (厚朴) and moderation of the sweet taste of Glycyrrhizae Radix (甘草). The intestines become healthier and lighter when cleansed via drinking the decoction, and when accumulation is removed, dysentery will cease. In the Great Peace Imperial Grace Pharmacy’s Formulary (局方), heat medicine is used as the sovereign medicinal and astringent medicine as the assistant medicinal, which can be used in diarrhea of clear and white things. However, the stomach feeling tight and bottom feeling heavy belong to the phrase “bottom feeling heavy is all affiliated to Fire-heat,” which is said in the Classic (經), so how can using astringent and hot medicine not kill a person?
16 Important Secrets in Treating Dysentery 治痢要訣 이질을 치료하는 중요한 비결
➀ When blood circulates well, pus in the feces disappears, and when qi is moderated even, heavy feeling in the bottom disappears.
➁ In the treatment of dysentery, it is said, “Diarrhea should be induced when the bottom is heavy with herbs like Aucklandiae Radix (木香) or Arecae Semen (檳榔) or prescriptions like an Aucklandia and Betel Nut Pill (木香檳榔丸). “
➂ Abdominal pain should be moderated with herbs like Paeoniae Radix (芍藥) and Citrus Unshius Pericarpium (陳皮) or prescriptions like a Peony and Licorice Decoction.
➃ Heaviness of body should be dealt with through the removal of dampness with herbs like Poria Sclerotium (茯苓) and Alismatis Rhizoma (澤瀉) or prescriptions like Five Ingredients Powder with Poria.
➄ A string-like pulse should be dealt with through the removal of wind with Gentianae Macrophyllae Radix (秦芃) and Saposhnikoviae Radix (防風) or Overcome Toxicity Powder.
➅ Sticky blood-pus should be dealt with through the removal with medicine of strong properties like Rhei Radix et Rhizoma (大黃) and Natrii Sulfas (芒硝) or a Rhubarb Decoction.
➆ A cold body and spontaneous sweating should be warmed with Aconiti Lateralis Radix Preparata (附子) and Zingiberis Rhizoma (乾薑) or Starch Solution Powder.
➇ Wind crouched inside should be induced through perspiration by Ephedrae Herba (麻黃), Angelicae Dahuricae Radix (白芷) and Puerariae Radix (葛根), or an Ephedra and Cimicifuga Decoction.
➈ Dysentery which looks like duck droppings should be warmed with Cinnamomi Cortex (桂皮) and Aucklandiae Radix (木香) or a Stewed Aucklandia Pill.”
➉ Also it is said, “Disperse if the pathogen is in the exterior, treat by purgation if the pathogen is in the interior. Make the patient vomit if the pathogen is in the upper energizer, and eliminate all when the pathogen is in the lower energizer. Disperse in the inside if heat is in the exterior of the body; unblock by dividing clear and turbid if urine does not flow out well.”
⑪ Also it is said, “Harmonize exuberancy, unblock the flowing out, and stop the excess.
⑫ In treating dysentery, use Rhei Radix et Rhizoma (大黃) if the feces are black, and Sanguisorbae Radix (地楡) if it is purple. Use Scutellariae Radix (黃芩) when it is red, and Zingiberis Rhizoma (生薑) when is watery. Use Cinnamomi Cortex (桂皮) if it is white, and Crataegi Fructus (山楂) if it is yellow. Use Pericarpium Papaveris (罌粟殼) in water-diarrhea, and Aucklandiae Radix (木香) and Gardeniae Fructus (梔子) for severe pain.
⑬ Early stages of dysentery can be treated immediately by taking Instant Effect Powder (立效散) once. It is also good to remove toxicity with an Guide Qi Aucklandiae Decoction Qi. ⑭ In treating dysentery, heat should be treated with cold medicine, dampness with bitter medicine, and unblocked and dispersed by adding pungent and heat medicine as minister medicinal. This is effective all the time.
⑮ For dysentery, medicine should be prepared with Asini Corii Colla (阿膠珠), Angelica Gigantis Radix (當歸), Citri Unshius Pericarpium Immaturus (靑皮), Poria Sclerotium (茯苓), and Coptidis Rhizoma (黃連). Make into pill by adding Mume Fructus Praeparatum (烏梅) and good quality honey, and it will function to clear dirty things. If accumulation-stagnant disappears by this method, the patient will less frequently go to the bathroom for relieving stools.
⑯ The most important key in treating dysentery is first dispersing wind, resolving stagnation, and opening the stomach. The abrupt use of tonifying medicine like Myristicae Semen (肉豆蔲), Terminaliae Fructus (訶子), and Atractylodis Rhizoma (蒼朮) may hold pathogens, and medicine like Pericarpium Papaveris (罌粟殼), Fossilia Ossis Mastodii (龍骨), and Ostreae Testa (牡蠣) can block the intestines. This will hinder the recovery against the disease. Diarrhea should be induced after abdominal pain and heaviness of the bottom have all subsided.
• Instant Effect Powder 立效散 입효산: It treats abdominal pain and heaviness in the bottom from red-white dysentery and pus-blood dysentery. It soon stops after taking only once. Coptidis Rhizoma (黃連) 4 nyang (fried with Evodiae Fructus (吳茱萸) 2 nyang and water together) and then remove the Evodiae Fructus (吳茱萸) and Aruantii Fructus Immaturus (枳殼) (fried with millet) 2 nyang. Powder these medicines, take 3 don each with yellow alcohol on an empty stomach. As this medicine treats dysentery from accumulated heat and blocked qi, Coptidis Rhizoma (黃連) cools heat and Aruantii Fructus Immaturus (枳殼) punctures the blocked qi.
• Guide Qi Aucklandiae Decoction 木香導氣湯 목향도기탕: It treats abdominal pain, heaviness in the bottom, mixed stools of red and white, fever, and a closed mouth in the early stages of dysentery. Rhei Radix et Rhizoma (大黃) 1.5 don, Paeoniae Radix (芍藥), Mirabilitum (朴硝), Coptidis Rhizoma (黃連) 1.2 don each, Magnoliae Cortex (厚朴), Arecae Semen (檳榔) 1 don each, Angelica Gigantis Radix (當歸) (rootlets), and Poria Sclerotium (茯苓) 8 pun each. Slice these medicines as 1 pack, decoct in water, and take.
17 Common Medicinals for Dysentery 痢疾通治藥 이질을 두루 치료하는 약
① Some symptoms of dysentery are as follows: acute pain around the umbilicus, bleeding of fresh blood, static blood, or purple-black blood. Also, there may be white sticky diarrhea, red and white mixed diarrhea, black bean juice-like diarrhea, color of the brain of fish-like diarrhea, or diarrhea like falling water from the thatched roof all accompanied by abdominal pain, heaviness of bottom, and frequenting the bathroom. Prescriptions like Stewed Aucklandia Paste, Six Spirits Pill, Aucklandia and Coptis Pill, Augmented Aucklandia and Coptis Pill, White Atractylodes Calm Stomach Powder, One in a Hundred Powder, Harmonise the Center Drink, Easy and Simple Broken Lower Bowls Decoction, Stabilize Stomach Powder, and Save and Extend Life Pill are commonly used. ② Dysentery after suffering from malaria is prescribed with a Coptis and Aucklandia Decoction.
• Stewed Aucklandia Paste 水煮木香膏 수자목향고: It treats all kinds of dysentery. Pericarpium Papaveris (罌粟殼) (fried after wetted in honey) 3 nyang, Amomi Fructus (砂仁), Myristicae Semen (肉豆蔲) (baked while buried under an ash Fire), Olibanum (乳香) 7.5 don each, Aucklandiae Radix (木香), Syzygii Flos (丁香), Terminaliae Fructus (訶子), Agastachis Herba (藿香), Angelica Gigantis Radix (當歸), Coptidis Rhizoma (黃連), Magnoliae Cortex (厚朴), Citrus Unshius Pericarpium (陳皮), Citri Unshius Pericarpium Immaturus (靑皮), Paeoniae Radix (芍藥), Glycyrrhizae Radix (甘草) (baked) 5 don each, Ponciri Fructus Immaturus (枳實), and Zingiberis Rhizoma (乾薑) (baked after wrapped with damp paper) 2.5 don each. Powder these medicines, make into paste with honey, and make into pills the size of a bullet. Put 1 glass of water and 1 Zizyphi Fructus (大棗) together, decoct until 70% is left, then remove the Zizyphi Fructus (大棗), and take.
• Six Spirits Pill 六神丸 육신환: This is an important medicine for treating dysentery. Coptidis Rhizoma (黃連), Aucklandiae Radix (木香), Aruantii Fructus Immaturus (枳殼), Poria Sclerotium (茯苓), Massa Medicata Fermentata (神麯) (fried), and Hordei Vulgaris Fructus (麥芽) (fried) all the same quantities. Powder these medicines, make into paste with Massa Medicata Fermentata (神麯) and make into pills the size of a seed of a foxglove tree. Take 50~70 pills at a time. Take with water decocted with Glycyrrhizae Radix (甘草) for red dysentery, water decocted with Zingiberis Rhizoma (乾薑) for white dysentery, and water decocted with Zingiberis Rhizoma (乾薑) and Glycyrrhizae Radix (甘草) for red-white dysentery.
• Augmented Aucklandia and Coptis Pill 加味香連丸 가미향련환: It treats all kinds of dysentery. Coptidis Rhizoma (黃連) (fried) 2 nyang, Evodiae Fructus (吳茱萸) (fried after soaked at water) 1 nyang, Aucklandiae Radix (木香) 1 don, Amomi Fructus (縮砂) Rotundus (白豆蔲) (baked while buried under ash Fire ashes) 1.5 don, and Olibanum (乳香), Myrrha (沒藥) 1 don each. Powder these medicines, make into dough with Mume Fructus Praeparatum (烏梅) with the removed flesh after being soaked in water, and make into pills the size of a seed of a foxglove tree. Take 30 pills at a time with water decoction mentioned above in the Six Spirits Pill.
• White Atractylodes Calm Stomach Powder 白朮安胃散 백출안위산: It treats all diarrhea and dysentery regardless of blood and pus. Pericarpium Papaveris (罌粟殼) (fried after wetted in honey) 2 don, Poria Sclerotium (茯苓), Atractylodis Rhizoma (蒼朮), Plantaginis Semen (車前子) 1 don each, Schisandrae Fructus (五味子), and Mume Fructus Praeparatum (烏梅肉) 5 pun each. Slice these medicines as 1 pack, decoct in water, and take.
• One in a Hundred Powder 百中散 백중산: It treats all kinds of dysentery regardless of the color of stool, red or white. Taking it two or three times will be enough for treatment. Pericarpium Papaveris (罌粟殼) (fried to red after wetted with honey), Magnoliae Cortex (厚朴) (dried after being soaked in Zingiberis Rhizoma (乾薑) juice) 2.5 nyang each. Powder these medicines, mix 2~3don each with porridge, and take on an empty stomach. Avoid raw, cold, or toxic food.
• Harmonise Center Drink 和中飮 화중음: It treats dysentery. It is used in ineffective cases regardless of the color or duration of the disease. However, it must not be taken when there is fever or the patient’s mouth is closed. Pericarpium Papaveris (罌粟殼) (fried after wetted in vinegar) 1.5 don, Citrus Unshius Pericarpium (陳皮), Atractylodis Rhizoma (蒼朮), Poria Sclerotium (茯苓), Paeoniae Radix (赤芍藥) 1 don each, old rice 2 don, Amomi Tsao-ko Fructus (草果仁) 7 pun, Glycyrrhizae Radix (甘草) 3 pun, sugar 3 don, and 1 Mume Fructus Praeparatum (烏梅). Slice these medicines as 1 pack, put 3 pieces of Zingiberis Rhizoma (乾薑), 2 Zizyphi Fructus (大棗), decoct in water, and take.
• Easy and Simple Broken Lower Bowls Decoction 易簡斷下湯 이간단하탕: It treats all kinds of dysentery. It is especially effective for deficient dysentery and continuous dysentery. 14 Pericarpium Papaveris (罌粟殼) (Sliced after the removal of fascis, tip and calyx, and then fried after wetted in vinegar, pounded, and then ground.), Atractylodis Rhizoma (蒼朮), Poria Sclerotium (茯苓) 1 don each, Glycyrrhizae Radix (甘草) (baked) 5 pun, and Amomi Tsao-ko Fructus (草果) (sliced with its skin) 1 pun. For 1 pack, put 7 pieces of Zingiberis Rhizoma (乾薑), Zizyphi Fructus (大棗), and Mume Fructus Praeparatum (烏梅) 7 each in one bowl of water. Decoct until 1 glass remains and take it in two divided amounts.
• Coptis and Aucklandia Decoction 黃連木香湯 황련목향탕: It treats dysentery following malaria. Paeoniae Radix (芍藥) (fried) 2 don, Atractylodis Rhizoma (蒼朮) 1.5 don, Coptidis Rhizoma (黃連) (fried), Aucklandiae Radix (木香), Amomi Fructus (砂仁) (ground), Scutellariae Radix (黃芩) (fried), Citrus Unshius Pericarpium (陳皮), Angelica Gigantis Radix (當歸) (washed with alcohol) 1 don each, and Glycyrrhizae Radix (甘草) 5 pun. Slice these medicines as 1 pack, put 3 pieces of Zingiberis Rhizoma (乾薑), decoct in water together, and take.
• Save and Extend Life Pill 救命延年丸 구명연년환: It treats severe dysentery of both male and female. Coptidis Rhizoma (黃連), Zingiberis Rhizoma (乾薑), Angelica Gigantis Radix (當歸), and Asini Corii Colla (阿膠珠) all the same quantities. Powder these three medicines and make into dough with vinegar decocted with Asini Corii Colla (阿膠). Then make into pills the size of a seed of a foxglove tree. The effect is dramatic when the patient swallows 30~50 pills with porridge.
