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Euodiae Fructus (Mufangji), Raw Atractylodis Rhizoma (Sheng Baizhu), Coix Seed (Yiren), Papaveris Fructus (Mugua), Cinnamomi Ramulus (Guizhi Mu), Alismatis Rhizoma (Zexie).

Patient Ma (41 years old): Consumed much alcohol and little grain. The Middle Qi has been deficient for a long time, leading to morning diarrhea and coldness in the lower body. This indicates the exhaustion of both Kidney Yang and Spleen Yang. Although feeling hungry, the appetite is low. The treatment principle should be to regulate and warm Yang. Patients accustomed to drinking alcohol generally do not tolerate sweet, greasy, or nourishing-yin herbs. (Syndrome differentiation: Spleen-Kidney Yang Deficiency)

Poria (Fuling), Rubi Fructus (Fupenzi), Alpiniae Oxyphyllae Fructus (Sheng Yizhi), Fried Cuscutae Semen (Chao Tusibing), Psoraleae Fructus (Buguzhi), Euryales Semen (Qianshi).

Patient Zhu (40 years old): Internal obstruction by dampness from alcohol, leading to Spleen-Kidney Yang Deficiency. Use Hei Di Huang Wan (Black Earth Pill), prepared by boiling steamed buns in water and mixing with the powder to form pills.

Patient Xu (59 years old): Morning diarrhea originates in the Kidney; there is a mass in the lower abdomen, which also belongs to Yin pathogenic factors. If rich meat or strong-flavored foods are consumed, the disease will flare up immediately due to accumulated depletion of Yang Qi. It is proposed to use Si Shen Wan (Four Spirits Pill).

Patient Xi (54 years old): After recovering from Yin Malaria, dietary indiscretion led to weakened Clear Yang and loss of Spleen-Stomach transportation function, causing Qi stagnation in the intestines and stomach, resulting in profuse watery diarrhea. There is slight swelling on the dorsum of the foot, raising concern about abdominal distension resembling a drum. In summer, when the Spleen and Stomach govern, a bland diet is especially suitable. Medication should prioritize unblocking Yang. For daily maintenance, treat both Spleen and Kidney. Use Wei Ling Tang (Stomach-Ling Decoction) removing Baizhu and Gancao, followed by Hei Di Huang Wan removing Wuweizi.

Patient Zhu (41 years old): Chronic diarrhea inevitably damages the Kidneys. Reduced appetite and indigestion indicate that Yang Qi is not functioning. Ba Wei Shen Qi Wan (Eight-Ingredient Rehmannia Pill) draws Yang from Yin and yields only slight effect. It is proposed to use a method to raise Yang.
Deer Antler (Lurong), Ginseng Radix et Rhizoma (Renshen), Actinidiae Radix (Yangqishi), Poria (Fuling), Prepared Aconiti Lateralis Radix (Pao Fuzi), Dried Ginger (Dan Jiang).
Re-examination: Chronic diarrhea must be treated primarily from the Spleen and Kidney. However, if there is pain with sticky stools and short, difficult urination, warming and tonifying are ineffective. It is proposed to unblock the Fu organs' Qi.
Magnoliae Officinalis Cortex (Houpo), Citri Reticulatae Pericarpium (Guangpi), Poria (Fuling), Polyporus (Zhuling), Alismatis Rhizoma (Zexie), Coptidis Rhizoma (Chuanlian), Prepared Aucklandiae Radix (Wei Muxiang), Fried Crataegi Fructus (Chao Shanzha), Fried Massae Fermentatae Medicinalis (Chao Shenqu).

Monk (55 years old): Five-year history of Jia diarrhea (diarrhea associated with masses), reduced appetite, and borborygmus belong to Spleen-Kidney Yang Decline. Recent mild abdominal pain combined with Qi stagnation requires regulating Qi. Use Chen Wuzhe's San Shen Wan (Three Divine Pills).

Unknown Patient: Pulling sensation from the back radiating to the hypochondrium, morning diarrhea. Use Ling Gui Zhu Gan Tang (Poria, Cinnamon Twig, Atractylodes, and Licorice Decoction) removing Gancao, adding Deer Horn (Lujiao), Fresh Ginger (Shengjiang), and Jujube (Dazao).

Patient Gong (52 years old): Pulse at both Guan positions is slow and weak; Chi pulse moves downward. Before eating in the morning, there is mental restlessness and difficulty digesting food. This is because Spleen Yang is weak, causing dampness accumulation in the Middle Jiao and impaired transportation; Kidney Yin is depleted, leading to loss of consolidation and Jia diarrhea. Therefore, the Middle Jiao needs rotation and transportation, while the Lower Jiao needs sealing and storing. This is the fundamental principle of medicine. It is proposed to take Zhi Zhong Tang (Regulate Middle Decoction) in the morning and Si Shen Wan in the evening.

Gao Shi: Abdominal distension during menstruation, soreness and heaviness in the umbilicus and spine. Diarrhea has persisted since autumn, with epigastric fullness interfering with eating. Ji Sheng Wan was ineffective.
Deer Horn Glue (Lujiao Shuang), Fried Cuscutae Semen (Chao Tusibing), Raw Eucommiae Cortex (Sheng Duzhong), Dried Cynomorii Herba (Dan Congrong), Poria (Fuling), Astragali Complanati Semen (Shayuan), Scorched Angelicae Sinensis Radix (Jiao Guishen), Charred Foeniculum Vulgare Fructus (Chaohei Xiaohui).

Chen Shi: Having given birth fifteen times, the Yuan Qi in the lower body lacks consolidation, leading to morning diarrhea. Since ancient times, treating Kidney Yang requires nourishment from below so that Spleen Yang can transform and transport. Wang Shi considers postprandial indigestion as a lack of Yang. All greasy and heavy foods should be avoided. Take Si Shen Wan in the morning and Lizhong Tang removing Baizhu and Gancao, adding Yizhi, Mugua, and Sharen in the evening.

Zhang Shi (Elderly Woman): Diarrhea, Spleen-Kidney Deficiency, abdominal distension after eating.
Ginseng Radix et Rhizoma (Renshen), Fried Cuscutae Semen (Chao Tusizi), Fried Dry Ginger (Chao Huang Ganjiang), Poria (Fuling), Prepared Alpiniae Oxyphyllae Fructus (Wei Yizhi), Papaveris Fructus (Mugua).

Unknown Patient: Diarrhea for fifty days, borborygmus, thirst with desire to drink, difficult urination, aversion to cold, physical fatigue, sweating upon waking from sleep. Use the method of warming the Middle and calming Liver Wind.
Ginseng Radix et Rhizoma (Renshen), Pedalium Fruit (Huluba), Prepared Ginger (Pao Jiang), Poria (Fuling), Terminalia Chebula Retzii Pericarpium (Hezi Pi), Aconiti Lateralis Radix Preparata (Fuzi), Poppy Shell (Suke).

Unknown Patient: Spleen-Kidney failing to consolidate, Dawn Diarrhea (Wu Geng Xie).
Morinda Officinalis Root (Baji), Cuscutae Semen (Tusizi), Schisandrae Chinensis Fructus (Wuweizi), Psoraleae Fructus (Buguzhi), Euryales Semen (Qianshi), Nelumbinis Plumula (Jianlian), Dioscoreae Rhizoma (Shanyao), Honey-fried Glycyrrhizae Radix et Rhizoma (Zhicao).

Unknown Patient: Chronic diarrhea, deficiency pulse.
Ginseng Radix et Rhizoma (Renshen), Schisandrae Chinensis Fructus (Wuweizi), Halloysitum Rubrum (Yuyuliangshi).

Zhang Shi: Poor recovery postpartum, abdominal pain with Jia diarrhea.
Fried Cuscutae Semen (Chao Tusibing), Deer Horn Glue (Lujiao Shuang), Raw Eucommiae Cortex (Sheng Duzhong), Mild Psoraleae Fructus (Dan Buguzhi), Charred Foeniculum Vulgare Fructus (Chaohei Xiaohui), Fried Lycii Fructus (Chao Qizi), Poria (Fuling).

Gu Shi: Reviewing the pathology, this is damage from overwork, affecting the Three Yin meridians and the extraordinary vessels. However, Qi rises in the abdomen causing stomach pain, and tangible pathogens cause movement, indicating deficiency in Chong and Ren meridians. Tonifying statically causes stagnation; cooling and moistening causes slipping. Fistulas, chronic diarrhea, and alternating chills and fever are most critical. First, consolidate and secure the Lower Jiao.
Ginseng Radix et Rhizoma (Renshen), Fried Cuscutae Semen (Chao Tusibing), Euryales Semen (Qianshi), Lotus Seed (Hulian), Poria Cum Radix Pini (Fushen), Halloysitum Rubrum (Chishizhi).

Unknown Patient: Kidney Deficiency with Jia diarrhea.
Fragrant Fried Cuscutae Semen (Chaoxiang Tusizi), Raw Eucommiae Cortex (Sheng Duzhong), Charred Fried Psoraleae Fructus (Chaojiao Buguzhi), Fennel (Huixiang), Cloud Poria (Yun Fuling).
Re-examination: Yang is weak, borborygmus occurs after midnight. The previous formula stopped the Jia diarrhea.
Ginseng Radix et Rhizoma (Renshen), Fried Cuscutae Semen (Chao Tusizi), Fried Psoraleae Fructus (Chao Buguzhi), Lotus Seed Meat (Hulianrou), Euryales Semen (Qianshi), Poria (Fuling).

Gu Shi: Spleen-Kidney Jia diarrhea, abdominal distension, limb edema. Long-term illness leads to severe deficiency. It is proposed to unblock and tonify the Yang of the Middle and Lower Jiao.
Ginseng Radix et Rhizoma (Renshen), Prepared Aconiti Radix (Chuan Shu Fu), Poria (Fuling), Alismatis Rhizoma (Zexie), Fried Dry Ginger (Chao Huang Ganjiang).

Unknown Patient: Kidney Deficiency with Jia diarrhea, due to Lower Jiao failure to consolidate. Purely acrid-hot herbs may damage Yin fluids, as the Kidney dislikes dryness. Take Zhen Ling Dan (Shaking Spirit Pill) twenty pills in the morning. In the evening, take Shen Ling Bai Zhu San (Ginseng, Poria, and Atractylodes Macrocephala Powder) two qian mixed with rice water. Take both medicines for twelve days.

Gao Shi: Fine and sinking pulse, elderly with chronic cough, abdominal pain and diarrhea, emaciated spirit and physique. This injury is difficult to recover from and cannot be cured by attacking drugs. Propose the Sweet-Slow method.
(Hollow Middle Abdominal Pain)
Honey-fried Glycyrrhizae Radix et Rhizoma (Zhigancao), Fried Paeoniae Radix Alba (Chaobaishao), Fried Maltose (Chao Yitang), Poria Cum Radix Pini (Fushen), Southern Jujube (Nanzao).

Wang Shi: Diarrhea from overeating, Stomach injury with Qi sinking, fluids unable to ascend and moisten. Tongue is dry and slightly thirsty when lying down. Diet should be bland for regulation. Use Harmonizing Middle agents; taking two or three doses can bring relief. (Food Injury)
Ginseng Radix et Rhizoma (Renshen), Kudzu Root (Gegen), Raw Hordei Fructus Germinatus (Sheng Guya), Honey-fried Glycyrrhizae Radix et Rhizoma (Zhigancao), Citri Reticulatae Pericarpium (Guangpi), Lotus Leaf Stem (Heyetidi).

Diarrhea is a type of pouring-down syndrome. The Classics state: "Excess dampness forms five types of diarrhea." These are Sun diarrhea, Tang diarrhea, Wu diarrhea, Ru diarrhea, and Hua diarrhea. Sun diarrhea with undigested food is dampness combined with Wind. Tang diarrhea with foul intestinal mucus is dampness combined with Heat. Wu diarrhea (clear watery stool) is dampness combined with Cold. Ru diarrhea with heavy and weak body is dampness prevailing. Hua diarrhea with inability to control prolonged discharge is dampness excess leading to Qi collapse. Therefore, Wei Feng Tang treats Sun diarrhea with blood; Qing Liu Wan treats hot Tang diarrhea with intestinal mucus.
If stool is clear and urine white with hard objects inside, select Lizhong Tang or Zhi Zhong Tang. For Hua diarrhea with faint pulse and Qi collapse, or uncontrollable pouring diarrhea, urgently administer Si Zhu Yin or Liu Zhu Yin. Only Ru diarrhea has deficiency and excess patterns, treated with either Wei Ling Tang or Shu Fu Tang. As for Spleen diarrhea, Stomach diarrhea, Kidney diarrhea, Large Intestine diarrhea, Small Intestine diarrhea, Da Jia diarrhea, Phlegm diarrhea, Depression diarrhea, Alcohol-injury diarrhea, and Food-injury diarrhea, ancient formulas and methods are detailed. Acute cases treat the branch, adapting to time and symptoms, which is natural. Chronic cases treat the root. Is it sufficient to only know how to dry Spleen and leach out dampness?
The Spleen is like Kun Earth, fundamentally still yet possessing Qian's strength, generating all things and serving them. It follows Water and Fire, manifesting as Cold and Heat. Observing diarrhea with coordinated heat, less than one or two in ten cases are from Water-Cold diarrhea, eight or nine in ten. Speaking of the obvious, treatment focuses on the Spleen; deducing the reason, one must seek it in Water and Fire. Human Water and Fire are like a balance; if one wins, the other loses. Fire winning means Water losing; Water winning means Fire losing. The five diarrheas involve much dampness; dampness and water share the same qi. When Water is abundant, Fire is deficient. Thus, Shaoyang is the pivot of the Three Yang, housing Ministerial Fire, fanning the Stomach with wind-fire to cook grains; Shaoyin is the pivot of the Three Yin, housing Dragon Fire, steaming the zang-fu to transport waste. Stomach reception and Spleen transport rely on Fire's operation. However, without Thunder hiding and Dragon submerging, how can there be no dryness or dampness? If the trend is like fire blazing upwards, but Earth is stable and Water is safe, preventing overflow, there will be no worry of Clear Qi sinking below. Thus I say: Treating the five diarrheas involves clearing the source by balancing Water and Fire, and blocking the flow by reinforcing Earth.
Observing Ye Tianshi's case records, the combination of flavors is fresh and elegant. His therapeutic techniques follow rules. He raises what sinks, consolidates what slips, warms what is cold, clears what is hot. Stringent pulse treats Wind; soggy pulse leaches Dampness. In short, he excels at differentiating syndromes and prescribing formulas, ensuring efficacy. This is reading the ancients without being bound by them, selecting formulas without being attached to them. The subtlety of modification is rare. My friend Wu Zi Yiwen, formerly a student of Ye Tianshi, said that the Master understood human nature and current affairs well, making him a hero of his time. Hence, through this minor art, he gained great fame. It is also heard that in his spare time, he liked reading the Han Dynasties histories, so his words were always high and ancient. It is a pity that we cannot see his complete case records, causing sighs and unforgettable regret. (Commentary by Jiang Shiyu)

Xu's Commentary: The method of treating diarrhea is merely clarifying, descending turbidity, promoting urination, and unblocking Qi. The formulas in the cases are balanced and appropriate, with seven or eight repetitions. What is the compiler's intention? All diarrheas involve phlegm, dampness, cold, and wind, causing disharmony in the intestines. The cases blindly use tonifying and astringent herbs; formulas with Renshen and Wuweizi account for half. For pure deficiency without pathogenic factors, they may be effective. But if the righteous Qi is deficient yet pathogenic factors remain, this condition will never heal. Many were misled at that time. This elder was famous then; those seeking his diagnosis likely had severe and chronic illnesses, hence many tonifying and astringent herbs in the cases, and few herbs for clarifying and descending turbidity.