Written By Jun Heo (許浚, 1539~1615), translated by Namil Kim, Wung Seok Cha et al. Published by Ministry of Health & Welfare (Korea).
10-14 Accumulation Dysentery 積痢 적리
① Color of feces in accumulation dysentery is as yellow as a fish’s brain and accompanies abdominal swelling and pain and the refusal of food.
② Dysentery does not occur if there is no accumulation.
③ Dysentery results from accumulation and stagnation. Accumulation means that something is piled up, and stagnation means qi is blocked. What is piled up tries to come out but it cannot because qi is blocked. This is why the patient feels a repeated urge to defacate and pulling pain in the abdomen. When theses symptoms occur, the flow should be promoted no matter the color of stool-red or white, and size of pulse-large or small.
④ Damage from food results in diarrhea that smells sour. The existence of accumulation and stagnation can be noticed by the heat coming from the abdomen with whirling pain.
⑤ Damage from accumulation and stagnation can be treated well when the stool is white in color.
⑥ A Preserve Harmony Pill, Reaction Formula, Perilla Disease Formula, or Fresh and Cooked Ingredients Pill should be prescribed for food-accumulation dysentery.
- Reaction Formula 感應元 감응원: It treats red blood and white mucous stools mixed together from red dysentery and chronic dysentery. Myristicae Semen (肉豆蔲) (baked while buried under an ash Fire), Zingiberis Rhizoma (乾薑) (baked after wrapped with damp paper after removal of the skin and being dried), Fulvis Fumi Carbonisatus (百草霜) 2 nyang each, Aucklandiae Radix (木香) 1.5 nyang, Piperis Nigri Fructus (蓽澄茄), Sparganii Rhizoma (三稜) (baked after wrapped with damp paper), Syzygii Flos (丁香) 1 nyang each, 100 Crotonis Semen (巴豆) (remaining powder after removal of the skin, flesh, and membrane and squeezing the oil), 100 Armeniacae Semen (杏仁) (removal of skin, the sharp end, and discarding of those with two seeds. And then frying with bran, grinding, and boiling with alcohol), yellow beeswax 4 nyang, and cooking oil 1 nyang. Powder the seven medicines and add Crotonis Semen (巴豆) and Armeniacae Semen (杏仁) powder. Boil yellow beeswax in oil, mix in the medicine powder to finish the preparation of medicine. Make 10 pills with 1 nyang of this and take one pill each with porridge. Or make into pills the size of mung beans. Swallow 10 pills with boiled water.
- Perilla Disease Formula 蘇感元 소감원: It treats pulling pain in the abdomen from accumulation dysentery. Grind a Musk and Styrax Formula and a Reaction Formula in a ratio of 4 to 6 and make into pills the size of mung beans. Take 30 pills with porridge.
- Fresh and Cooked Ingredients Pill 生熟飮子 생숙음자: It treats all kinds of dysentery in adults and deficient or accumulation dysentery in children. 4 large Pericarpium Papaveris (罌粟殼) (removal of flesh and tip and then use half baked and half raw), Citrus Unshius Pericarpium (陳皮) 2 piece (raw one half and fried one half), Glycyrrhizae Radix (甘草) 2 cun (raw one half and baked one half), 2 Mume Fructus Praeparatum (烏梅) (raw one half and baked under ash Fire half), 2 Jujube (raw one half and baked under an ash Fire half), Zingiberis Rhizoma (乾薑) 2 piece (raw one half and baked under an ash Fire half), Aucklandiae Radix (木香) 1 don (divided in two, fry half and use half in the raw state), 2 large Terminaliae Fructus (訶子) (raw one half and baked under an ash Fire half), 60 black beans (30 raw ones and 30 fried ones), Astragali Radix (黃芪) 2 cun (raw one half and baked one half), Atractylodis Rhizoma (蒼朮) 2 masses (raw one half and baked under an ash Fire half), and Angelica Gigantis Radix (當歸) 2 cun (raw one half and baked under an ash Fire half). Slice these medicines and mix them evenly, put 5 don each in an earthenware bowl of water and boil until half is left, then remove the leftovers, and take it warm. Children should take 1~2 hop. This prescription divides raw ones and cooked ones so it makes cold and heat even. As cold and heat disperse and the intestines and stomach become better and water and food separate naturally, diarrhea and dysentery will cease naturally.
10-15 Chronic Dysentery 久痢 구리
① When 70~80 percent of dysentery is relieved with still loose stools, 30 pills of a Stabilize Yang Pill with water boiled with Paeoniae Radix (芍藥) (fried), Atractylodis Rhizoma (蒼朮) (fried), Glycyrrhizae Radix (甘草) (baked), Citrus Unshius Pericarpium (陳皮), and Poria Sclerotium (茯苓) should be prescribed. However, as this medicine has dry properties, it should be taken only after stagnation is removed.
② When patient is deficient, feels tired, and has continuous diarrhea, herbs like Terminaliae Fructus (訶子), Myristicae Semen (肉豆蔲), Alumen (礬石), and Pinelliae Tuber (半夏) should be considered. In severe cases, Ostreae Testa (牡蠣) should be added with Citrus Unshius Pericarpium (陳皮) as the assistant medicinal. This is because astringent medicines may worsen the condition.
③ When chronic dysentery worsens after taking an Order the Center Decoction (理中湯), it is a sign that the diarrhea results from the lower energizer. A Halloysite and Limonite Decoction is commonly prescribed. Ijung (理中: controlling the middle) means ruling over the middle energizer. A worsened condition results from blocking the lower energizer with this medicine.
④ Prescriptions like a Great Formula for Broken Lower Bowls, Perfect Pill, Person of Integrity Maintain Organs Decoction, Aucklandia Powder, Replete Intestines Powder, Modified Augment Qi Decoction, and Euonymi Cortex Powder should be prescribed for chronic dysentery.
- Aucklandia Powder 木香散 목향산: It treats chronic dysentery and blood dysentery. Glycyrrhizae Radix (甘草) (baked) 1 nyang, Aucklandiae Radix (木香) and Coptidis Rhizoma (黃連) (fried together) 5 don each, and Pericarpium Papaveris (罌粟殼) and Zingiberis Rhizoma (生薑) (fried together) 5 don each. Powder these medicines and put a little Moschus (麝香). Take 2 don each with porridge on an empty stomach.
- Modified Augment Qi Decoction 加減益氣湯 가감익기탕: It treats severe tiredness and weakness from chronic diarrhea. Atractylodis Rhizoma (蒼朮), Paeoniae Radix (芍藥), Citrus Unshius Pericarpium (陳皮) 1 don each, Angelica Gigantis Radix (當歸) 7 pun, Astragali Radix (黃芪), Ginseng Radix (人參), Alismatis Rhizoma (澤瀉), Amomi Fructus (砂仁), Sanguisorbae Radix (地楡) 5 pun each, Cimicifugae Rhizoma (升麻), Aucklandiae Radix (木香), Amomi Fructus (縮砂), Rotundus (白豆蔲), Pericarpium Papaveris (罌粟殼) (fried after wetted in vinegar), and Glycyrrhizae Radix (甘草) (baked) 3 pun each. Slice these medicines as 1 pack, decoct with water, and take it on an empty stomach.
- Euonymi Cortex Powder 樗白皮散 저백피산: It treats chronic dysentery otherswise not treated well. Ailanthi Radicis Cortex (樗根白皮) 1 handful, nonglutinous rice 1 hop, Allii Fistulosi Bulbus (葱白) 1 handful, Glycyrrhizae Radix (甘草) 1 cun, and Sojae Semen Praeparatum (豆豉) 2 hop. Decoct these medicines at 1 doe of water until half is left and take at once.
- Replete Intestines Powder 實腸散 실장산: It treats chronic dysentery including red and white dysentery. This prescription changes the color of the stool to yellow. Dioscoreae Rhizoma (山藥) (fried) 1 nyang, Setariae Semen (黃米) (fried) 1 hop. Powder these medicines, make into paste with hot water with the addition of sugar. It is most effective to take some and gargle with water decocted with rice.
10-16 Epidemic Dysentery 疫痢 역리
① One region or one family showing similar symptoms from infection is epidemic-toxic dysentery. Treatment should be given after considering the harmony of the five circuits and six qi.
② Adults and children of one region showing similar symptoms is called epidemic dysentery. Ginseng Overcome Toxicity Powder with the addition of Citrus Unshius Pericarpium (陳皮) and Paeoniae Radix (芍藥) should be prescribed. Prevention is possible by a Zingiberis Tea Decoction (薑茶湯).
- Zingiberis Tea Decoction 薑茶湯 강다탕: ① It treats abdominal pain from dysentery. Decoct old Zingiberis Rhizoma (乾薑) and a leaf of spring tea in the same quantities and take. ② Zingiberis Rhizoma (乾薑) helps yang and tea helps yin. Moreover, these can also remove summerheat-toxin and alcohol-water toxin. This medicine is widely used for epidemic dysentery, red or white, or cold or heat. ③ Peeled Zingiberis Rhizoma (乾薑) is used for heat dysentery and unpeeled Zingiberis Rhizoma (乾薑) is used for cold dysentery.
10-17 Parasitic Dysentery 蠱疰痢 고주리
① When the patient has bloody feces that look like the liver of the chicken in chronic diarrhea, it is called parasitic dysentery.
② In parasitic dysentery, there is dark red blood like the liver of chicken, thirst, and excruciating pain from the abdomen. This results from taking prescriptions with five kinds of stones. Since the blood is coming out from blood vessels and meridian-collaterals, it should be prescribed with a Madder Pill.
③ An Antelope Horn Formula and Zingiberis Ink Pill should be prescribed for parasitic dysentery.
- Madder Pill 茜根丸 천근환: It treats parasitic dysentery. Zanthoxyli Pericarpium (川椒根), Rhinocertis Cornu (犀角), Cimicifugae Rhizoma (升麻), Sanguisorbae Radix (地楡), Angelica Gigantis Radix (當歸), Coptidis Rhizoma (黃連), Aruantii Fructus Immaturus (枳殼), and Paeoniae Radix (芍藥) all the same quantities. Powder these medicines, make into paste with vinegar, and make into pills the size of a seed of a foxglove tree. Take 50~70 pills with porridge and take.
- Antelope Horn Formula 羚羊角元 영양각원: It treats parasitic dysentery. Coptidis Rhizoma (黃連) 2 nyang, Phellodendri Cortex (黃柏), Antelopis Cornu (羚羊角) (cut and powdered) 1.5 nyang each, and Poria Sclerotium (白茯苓) 1 nyang. Powder these medicines, make into paste with honey, and make into pills the size of a seed of a foxglove tree. Take 50~70 pills with tea.
10-18 Five Colors Dysentery 五色痢 오색리
① Five colors all shown in dysentery result from food accumulation of the spleen-stomach combined with the four qi. It should be treated with a Coptis and Evodia Pill.
② As the spleen and stomach are the seas of water and food, there is nothing that the spleen and stomach cannot accept and because they always accompany the other four viscera, the five colors are mixed in dysentery. The flow should be first of all promoted.
③ Severe dampness-toxin resulting in abdominal pain in dysentery and blood-pus in feces that look like beef juice should be treated with Sanguisorba Powder (地楡散) and a Coptis and Ass Hide Gelatin Decoction.
④ A Secret Formula Maintain Organs Decoction, Loofah Powder, or Miraculously Effective Three Fragrant Substances Powder should be prescribed for five color dysentery.
- Secret Formula Maintain Organs Decoction 秘方養臟湯 비방양장탕: It treats five color dysentery. Pericarpium Papaveris (罌粟殼) (fried after wetted in honey) 1.5 don, Citrus Unshius Pericarpium (陳皮), Aruantii Fructus Immaturus (枳殼), Coptidis Rhizoma (黃輦), Aucklandiae Radix (木香), Mume Fructus Praeparatum (烏梅), Magnoliae Cortex (厚朴), Armeniacae Semen (杏仁), and Glycyrrhizae Radix (甘草) (baked) 7 pun each. Slice these medicines as 1 pack, add 30 black beans, 2 Zizyphi Fructus (大棗), and take. The effect is immediate.
- Loofah Powder 絲瓜散 사과산: It treats bloody stools and abdominal pain in five color dysentery and alcohol dysentery. Powder the ash of one dried Luffae Fructus Retinervus (smooth luffa) that was burned with its skin on. Mix 2 don at a time with alcohol and take on an empty stomach.
- Miraculously Effective Three Fragrant Substances Powder 神效參香散 신효삼향산: It treats five color dysentery, food-refusing dysentery, malnutrition dysentery, parasitic dysentery, and epidemic dysentery. Citrus Unshius Pericarpium (陳皮), Pericarpium Papaveris (罌粟殼) 1.2 nyang each, Myristicae Semen (肉豆蔲), Poria Sclerotium (茯苓) 4 don each, Lablab Semen (白扁豆), Ginseng Radix (人參), and Aucklandiae Radix (木香) 2 don each. Powder these medicines, put 3 don each in porridge, and take on an empty stomach.
11 Eight Dangerous Symptoms in Dysentery 八痢危證 이질의 8가지 위험한 증상
① First is accumulation dysentery from heat. Second is white dysentery from cold. Third is red-white dysentery from cold and heat added together. Fourth is the sour smell from food-accumulation. Fifth is bluish dysentery from infantile convulsions. Sixth is indigestion from spleen deficiency. Seventh is blood mixed from an epidemic. Eighth is malnutrition dysentery, which is a bloating abdomen, and diarrhea due to infantile malnutrition.
② First is the white thing seen in feces from cold dysentery. Second is the red thing seen in feces from heat dysentery. Third is red-white dysentery from uneven cold and heat. Fourth is yellow, white, or all five colors showing in feces from malnutrition dysentery. Fifth is bluish feces without smell from fright diarrhea. Sixth is intermittent dysentery that is of black color much like a fish’s internal organ. Seventh is pus-dysentery that accompanies abdominal bloating, smelly stools, and pain around the anus. Eighth is parasitic dysentery when the patient bleeds pig-like purple-black colored blood.
③ A Minor Parking Pill and Person of Integrity Maintain Organs Decoction are commonly prescribed.
12 Abdominal Pain in Dysentery 痢疾腹痛 이질의 복통
① Abdominal pain in dysentery results from the stagnation of qi from the lung meridian in the large intestine. Patients of excess syndrome should be induced to diarrhea and patients of deficient syndrome should have the stagnant qi dispersed with Platycodonis Radix (桔梗).
② Abdominal pain in dysentery should not be treated with Ginseng Radix (人參) or Astragali Radix (黃芪).
③ Abdominal pain in dysentery should be treated with Paeoniae Radix (芍藥) and Glycyrrhizae Radix (甘草) as the sovereign medicinals and Angelica Gigantis Radix (當歸) and Atractylodis Rhizoma (蒼朮) as assistant medicinals. When the patient hates cold, Cinnamomi Ramulus (桂枝) should be added and when the patient hates heat, Phellodendri Cortex (黃柏) should be added.
④ Worsening pain after eating porridge or meat should be treated with a decoction of Atractylodis Rhizoma (蒼朮) and Citrus Unshius Pericarpium (陳皮). The patient should not eat anything else while taking the decoction.
⑤ When there is blood and pus in dysentery with abdominal pain, a Regulate Stomach and Coordinate Qi Decoction with the addition of Zingiberis Rhizoma (生薑) and Zizyphi Fructus (大棗) should be prescribed. After the diarrhea stops, Augment Base Powder with water decocted with Five Ingredients Powder with Poria should be taken.
⑥ Abdominal pain in dysentery should be treated with an Aucklandia and Coptis Pill, Zingiberis Tea Decoction and Miraculously Effective Gardenia Powder.
- Aucklandia and Coptis Pill 香連丸 향련환: It treats red blood and white sticky stools accompanied by abdominal pain and dysentery. Coptidis Rhizoma (黃輦) 1 nyang (fried with Evodiae Fructus (吳茱萸) together and the Evodiae Fructus (吳茱萸) removed after soaking in water with 5 don of Evodiae Fructus (吳茱萸) for one night), and Aucklandiae Radix (木香) 2.5 don. Powder these medicines, make into a paste with vinegar, and make into pills the size of a seed of a foxglove tree. Take 20~30 pills with porridge on an empty stomach.
- Miraculously Effective Gardenia Powder 神效越桃散 신효월도산: It treats unbearable bloating pain of the abdomen in dysentery. As this is called ‘Yin Yang Ban Chak’, it is yin and yang being out of order. Large Gardeniae Fructus (梔子仁) and Alpiniae Officinari Phizoma (良薑) 3 don each. Powder these medicines, put 2~3 don each in porridge, and take.
13 Tenesmus of Dysentery 痢疾裏急後重 이질의 이급후중
① Igeup (裏急: urgency of the interior) means that the bottom is uncomfortable with pulling pain, and hujung (後重: heaviness of the bottom) is that the large intestine is about to move downward heavily. The reasons for the symptom are varied. That caused by Fire-heat is because Fire property is rapid so it dries things up. That caused by qi stagnation is because qi of the large intestine is blocked so the fluent flow is slowed down. Accumulation-stagnation is because something is conglomerated. Qi deficiency is because qi of the large intestine is unable to ascend as it descended down. Blood deficiency is that the patient struggles in vain. Treatments are as follow. Cool if Fire-heat exists and make qi even if qi-stagnation exists. Remove if accumulation-stagnation exists, raise up qi for qi deficiency, and tonify blood in blood deficiency.
② Houzhong (後重: heaviness of the bottom) results from the large intestine not being able to ascend well when pathogenic qi is pressing it down. Herbs like Rhei Radix et Rhizoma (大黃) and Arecae Semen (檳榔) should be used to remove the pathogen. When there is still Hujung after the pathogen is removed, it is because the large intestine is deficient so it cannot hold the feces from falling out; therefore, the bottom feels heavy. It can be treated with medicines like Pericarpium Papaveris (罌粟殼) which blocks the leaks so as to hold qi.
③ Feeling unordinary heaviness of the bottom with purple-black blood clots in feces and severe pain are signs of static blood. Persicae Semen (桃仁) (ground) and Talcum (滑石) should be used to circulate blood.
④ Aucklandiae Radix (木香) and Arecae Semen (檳榔) should be used for uncomfortable and heavy feelings from hujung to make qi even.
⑤ Since early times in treating tenesmus, qi was made even by only using Aucklandiae Radix (木香) and Arecae Semen (檳榔). Diarrhea was induced to remove accumulation by Rhei Radix et Rhizoma (大黃). It is from Danxi’s Essential Methods that Persicae Semen (桃仁) and Talcum (滑石) was used to remove static blood. The effect was just like beating the drum with a drumstick.
⑥ Blood collapse syndrome is where accumulation is removed as qi flows and blood becomes harmonious, but the patient struggles in vain. Double the amount of body and rootlets of Angelica Gigantis Radix (當歸) and use Rehmanniae Radix Crudus (生地黃), raw Paeoniae Radix (芍藥), and raw Persicae Semen (桃仁) as assistant medicinals and moderate with Citrus Unshius Pericarpium (陳皮), then the blood will form and treat itself. A blood deficiency leads to Igeup (裏急), so Angelica Gigantis Radix (當歸) (the body part) should be used.
⑦ Igeup (裏急) is the uncomfortable feeling in the abdomen. Struggling in the toilet in vain results from a blood deficiency. Hujung (後重) results from deficient qi drooping down.
