Written By Jun Heo (許浚, 1539~1615), translated by Namil Kim, Wung Seok Cha et al. Published by Ministry of Health & Welfare (Korea).
10-5 Pus-blood Dysentery 膿血痢 농혈리
① Agitation and pus followed by blood in the feces cannot be treated without Coptidis Rhizoma (黃連). This means blood of the upper energizer.
② An aversion to cold, sunken pulse, lower back pain, and pain in the lower abdomen cannot be removed without Scutellariae Radix (黃芩). This is the blood of the middle energizer.
③ An aversion to cold, sunken pulse, and pus followed by blood in feces cannot be treated without Sanguisorbae Radix (地楡). This is the blood of the lower energizer.
④ Sticky blood-pus, tight feeling in the abdomen, and heaviness of the bottom all pertain to Fire. In the Inner Classic (內經), it is said, “If there is blood-pus in the stool with difficulty in urination, blood-pus will cease when qi flows.” Existence of blood-pus in the stool with difficulty in urination is the cause of the disease, and the flowing of qi is the treatment. This is why it is said, “Pus of the stool is naturally cured if blood flows and heaviness of the bottom naturally is removed when qi is controled.” A Peony Decoction is usually prescribed.
⑤ Pus-blood in the stool with difficulty in urination should have the inducing of diarrhea with heavy medicine like a Rhubarb Decoction, and moderated with light medicine like a Scutellaria and Peony Decoction.
⑥ Sticky blood-pus pertains to Fire. Dampness of greater yin conducts diarrhea and that of lesser yin conducts dysentery. As fluid collapses due to diarrhea, the Fire gets more dried; the kidneys hate dryness. Because the kidneys are located at the blood aspect of the lower energizer, if it is attacked by a pathogen, blood-pus appears in stools. This is why diarrhea belongs to the spleen and why dysentery belongs to the kidneys.
⑦ If it is purple-black colored by accumulated heat, it means the existence of static blood. When there is abdominal pain and heaviness at the bottom, there should be the inducing of diarrhea by a Peach Pit Order Qi Decoction. In dysentery, there is always static blood and that static blood is severe if the color is black.
⑧ A Peach Blossom Decoction, Guide Qi Decoction, Coptis and Ass Hide Gelatin Decoction, Guide Out Stagnation Decoction, Sanguisorba Powder, Resolve Toxicity Golden Flower Powder, Peony and Phellodendron Bark Pill, Halloysite Pill, or Ginseng Powder should be prescribed for pus-blood dysentery.
- Peony Decoction 芍藥湯 작약탕: It treats dribbling urine and blood-pus in stools. When the flow of blood is promoted, the pus of the stool will be relieved; when qi is moderated, the heaviness of the bottom will be relieved by itself. This is how this prescription works. Paeoniae Radix (芍藥) 2 don, Coptidis Rhizoma (黃連), Scutellariae Radix (黃芩) (thin and filled), Angelica Gigantis Radix (當歸) (Rootlets) 1 don each, Rhei Radix et Rhizoma (大黃) 7 pun, Aucklandiae Radix (木香), Arecae Semen (檳榔), Cinnamomi Cortex (桂心), and Glycyrrhizae Radix (甘草) 5 pun each. Slice these medicines as 1 pack, decoct in water, and take.
- Rhubarb Decoction 大黃湯 대황탕: It treats heat dysentery with symptoms of sticky blood-pus, tightening abdominal pain, heaviness of the bottom, and continuous diarrhea. Slice Rhei Radix et Rhizoma (大黃) 1 nyang and soak in 2 glasses of good alcohol for a day. Boil until it becomes one and a half glasses and throw the leftovers away. Divide this into two and have the patient take both of them successively until he/she has diarrhea. Then take a Peony Decoction so the patient can be harmonized. This is the prescription that washes pathogen-heat. Boiling in alcohol leads the effect of the prescription up to the top of head and out to the skin and hair.
- Scutellaria and Peony Decoction 黃芩芍藥湯 황금작약탕: ① It treats dysentery with symptoms of blood-pus, bodily fever, abdominal pain, and a surging and rapid pulse. Scutellariae Radix (黃芩), Paeoniae Radix (芍藥) 2 don each, and Glycyrrhizae Radix (甘草) 1 don. Slice these medicines as 1 pack, decoct with water, and take. Add Cinnamomi Cortex (桂心) 3 pun for severe abdominal pain. ② This is also called a Scutellaria Decoction.
- Guide Qi Decoction 導氣湯 도기탕: It treats dysentery with symptoms of blood-pus, abdominal pain, and heaviness of the bottom. Angelica Gigantis Radix (當歸) 2.5 don, Rhei Radix et Rhizoma (大黃), Scutellariae Radix (黃芩), Paeoniae Radix (芍藥) 1 don each, Coptidis Rhizoma (黃連), Aucklandiae Radix (木香), and Arecae Semen (檳榔) 5 pun each. Slice these medicines as 1 pack, decoct with water, and take.
- Coptis and Ass Hide Gelatin Decoction 黃連阿膠湯 황련아교탕: It treats blood-pus that looks like meat juice in dysentery from heat toxins. Coptidis Rhizoma (黃連), Asini Corii Colla (阿膠珠), Phellodendri Cortex (黃柏), and Gardeniae Fructus (梔子) 1.25 don each. Slice these medicines as 1 pack, decoct in water, and take.
- Guide Out Stagnation Decoction 導滯湯 도체탕: It treats dysentery with symptoms of blood-pus, tightening abdominal pain, heaviness of the bottom, thirst, and continuous diarrhea. Paeoniae Radix (芍藥) 2 don, Angelica Gigantis Radix (當歸), Scutellariae Radix (黃芩), Coptidis Rhizoma (黃連) 1 don each, Rhei Radix et Rhizoma (大黃) 7 pun, Cinnamomi Cortex (桂心), Aucklandiae Radix (木香), Arecae Semen (檳榔), and Glycyrrhizae Radix (甘草) 3 pun each. Slice these medicines as 1 pack, decoct in water, and take on an empty stomach.
- Sanguisorba Powder 地楡散 지유산: It treats blood-pus in dysentery from heat toxins. Sanguisorbae Radix (地楡), Rhinocertis Cornu (犀角), Coptidis Rhizoma (黃連) (fried), Puerariae Radix (葛根), Scutellariae Radix (黃芩) 1 don each, and Gardeniae Fructus (梔子) 5 pun. Slice these medicines as 1 pack, add 5 stems of Allii Macrostemi Bulbus (薤白), decoct together, and take.
- Resolve Toxicity Golden Flower Powder 解毒金花散 해독금화산: It treats pus-blood dysentery caused by heat toxins. Coptidis Rhizoma (黃連), Phellodendri Cortex (黃柏) 2 don each, Atractylodis Rhizoma (蒼朮), Scutellariae Radix (黃芩), Poria Sclerotium (茯苓), and Paeoniae Radix (赤芍藥) 1 don each. Slice these medicines as 1 pack, decoct with water, and take.
- Peony and Phellodendron Bark Pill 芍藥柏皮丸 작약백피환: It treats blood-pus occurring due to malignant dysentery caused by dampness-heat. Paeoniae Radix (芍藥), Phellodendri Cortex (黃柏皮) 1 nyang each, Angelica Gigantis Radix (當歸), and Coptidis Rhizoma (黃連) 5 don each. Powder these medicines, make into dough with water, and make into pills the size of adzuki beans. Take 30~40 pills with warm water.
- Halloysite Pill 赤石脂丸 적석지환: It treats blood-pus and abdominal pain in dysentery. Halloysitum Rubrum (赤石脂), Zingiberis Rhizoma (乾薑) 1 nyang each, Coptidis Rhizoma (黃連), and Angelica Gigantis Radix (當歸) 2 nyang each. Powder these medicines, make into paste with honey, and make into pills the size of a seed of a foxglove tree. Take 30~50 pills with porridge on an empty stomach.
- Ginseng Powder 人參散 인삼산: It treats dysentery accompanied by heat from alcohol-toxins with the symptoms of blood-pus and abdominal pain. Ailanthi Radicis Cortex (樗根白皮) and Ginseng Radix (人參) 1 nyang each. Powder these medicines 2 don each, take it by mixing with porridge on an empty stomach. Patients must do away with alcohol, flour, chicken, pork, fish, fruits, and vegetables.
10-6 Food-denying Dysentery 噤口痢 금구리
① Not being able to eat from dysentery is called food-denying dysentery. Hot hands and feet are signs that toxins are attacking the heart and lungs. Take 5 don of Overcome Toxicity Powder decocted with 1 don of Nelumbinis Semen (蓮肉), 100 grains of old rice, 3 pieces of Zingiberis Rhizoma (乾薑), and 2 Zizyphi Fructus (大棗). When the patient nauseates on hearing of food from overtaking a bitter-astringent or cold medicine, slice Dioscoreae Rhizoma (山藥) to a size of adzuki beans, parch half of them in a silver or gold vessel, grind the other half, mix with a thin gruel of rice, and take. Effects will show immediately.
② Food-denying dysentery results from an excess of heat at the entrance of the stomach. A Ginseng and Lotus Seeds Decoction should be prescribed with navel-compressing therapy. Warm medicines and sweet medicines should not be wrongly prescribed, since these add Fire to Fire and block what is already blocked.
③ A patient with dysentery clenching one’s teeth and refusing food-drink results from spleen-deficiency. Prescribed Ginseng, Poria, and White Atractylodes Powder with the removal of Dioscoreae Rhizoma (山藥) and the addition of Acori Gramineri Rhizoma (石菖蒲) (powdered). Grind and take 2 don at a time with gruel or take a decoction with the addition of Ginseng Radix (人參), Poria Sclerotium (茯苓), and Nelumbinis Semen (石蓮子) added with Acori Gramineri Rhizoma (石菖蒲). Then the chest will be opened and the patient will naturally feel an appetite.
④ When Pericarpium Papaveris (罌粟殼) is prescribed too early in treating dysentery, it will block the pathway to the heart and the patient will clench the teeth and refuse food. The patient should take warm gruel made by Pericarpium Papaveris (罌粟).
⑤ A Granary Decoction, Relieve Sullenness Powder, Lotus Powder, Resolve Muteness Pill, or Umbilicus Paste should be prescribed for food-denying dysentery.
