干姜 黄连 黄芩 人参（各三两）
上四味。以水六升。煮取二升。去滓。分温再服。（成注云。辛以散之。甘以缓之。干姜人参之甘辛。以补正气。苦
以泄之。黄连黄芩之苦。以通寒格。）
琥按上成注云。芩连。寒格。其言大谬条辩云。其反佐。更谬之极。愚以上方用干姜之辛热。通寒格而止吐逆也。
芩连之苦寒。泄伏热而坚下利也。人参之甘温。助胃虚而益正气也。且也。干姜人参以调阳。黄连黄芩以和阴。阴阳和
平。而格逆吐下自除矣。
下利。有微热而渴脉弱者。令自愈（此传经热利自愈之证也。阳邪传里而至下利。则热当少衰。故以微热为邪退。
渴则知其非寒利矣。且下利。则津液亡。故渴。凡下利脉宜微小而弱。兹则脉弱。知热邪已退。正气将复之象。故云。
令自愈也。）
下利脉数。有微热。汗出令自愈。设复紧。为未解。（此传经热利。有愈有未解之证也。热利脉数。与脉弱相反。未
可言愈。所喜者。热微汗出。则阳邪还表。胃家之真气复。故令自愈。设脉复紧者。始则寒邪在表而脉紧。兹已传里。
寒化为热。其脉复紧。当是实邪壅塞胸膈而作痛之诊。故为利未解也。）
下利。手足厥冷。无脉者。灸之不温。若脉不还反微喘者。死（此条系真寒证。正文与注见中寒论中）
（重出例）少阴负趺阳者。为顺也。（此条证。已见前少阴篇中）
下利寸脉反浮数。尺中自涩者。必清脓血。（此条乃下利变脓血之候也。热利而得数脉。非反也。得浮脉。则为反矣。
兹者。寸反浮数。此在里之邪热不少敛也。尺中涩者。阴虚也。阳邪乘阴分之虚。则其血必瘀而为脓血。清。圊同厕也。
言如厕。则所下者。皆脓血也。按此条论。仲景无治法。补亡论常器之云。宜桃花汤。误矣愚意云。宜以仲景黄芩汤代
之）下利清谷。不可攻表。汗出必胀满。（此条系真寒直中于里。当是太阴经错简。正文与注详中寒论中。）
下利脉沉弦者。下重也。脉大者。为未止。脉微弱数者。为欲自止。虽发热。不死。（此辩热利之脉也。脉沉弦者。
沉主里。弦主急。故为里急后重。如滞下之证也。脉大者。邪热甚也。脉经云。大则病进。故为利未止也。脉微弱数者。
此阳邪之热已退。真阴之气将复。故为利自止也。下利一候。大忌发热。兹者。脉微弱而带数。所存邪气有限。故虽发
热。不至死耳。按成注云。脉微弱数。为邪气微而阳气复。发热由阳胜。此以热利作寒利解。大谬之极。）
（附例）热利下重者。白头翁汤主之。（条辩云。此申上条而出其治。下重者。厥阴经邪热。下入于大肠之间。肝性
急速。邪热甚。则气滞壅塞。其恶浊之物。急欲出而不得。故下重也。主以白头翁汤者。以泄热而浓肠也。）
Ganjiang, Huanglian, Huangqin, Renshen (each 3 liang)
The above four herbs. Use six sheng of water. Boil to obtain two sheng. Remove the dregs. Divide into two doses and take warm. (Cheng Wuji's annotation states: Pungent flavor disperses, sweet flavor moderates. The pungent and sweet nature of Ganjiang and Renshen is used to tonify healthy qi; bitter flavor drains, the bitter and cold nature of Huanglian and Huangqin is used to unblock cold rejection.)
Hu notes: Cheng Wuji's aforementioned annotation stating that Huangqin and Huanglian are used for cold rejection is grossly incorrect. *Tiaobian* claims this is a counter-assistance method, which is extremely absurd. I believe the upper formula uses the pungent and hot nature of Ganjiang to unblock cold rejection and stop vomiting and reflux; the bitter and cold nature of Huangqin and Huanglian is used to drain latent heat and firm up diarrhea; the sweet and warm nature of Renshen is used to assist stomach deficiency and benefit healthy qi. Moreover, Ganjiang and Renshen regulate Yang, while Huanglian and Huangqin harmonize Yin. When Yin and Yang are in harmony, the rejection, reflux, vomiting, and diarrhea will naturally be eliminated.
Diarrhea accompanied by slight fever, thirst, and a weak pulse indicates spontaneous recovery (This is a syndrome of transmitted-heat diarrhea recovering spontaneously. When Yang pathogen transmits to the interior causing diarrhea, the heat should subside slightly; thus, slight fever indicates the pathogen receding. Thirst indicates this is not cold-type diarrhea. Furthermore, diarrhea causes loss of body fluids, hence thirst. Generally, the pulse in diarrhea should be small, minute, and weak. Here, the weak pulse indicates that heat pathogen has retreated and healthy qi is about to recover, hence it says "will recover spontaneously".)
Diarrhea with a rapid pulse, slight fever, and sweating indicates spontaneous recovery. If the pulse becomes tight again, the disease is not resolved. (This refers to transmitted-heat diarrhea, which may either recover or remain unresolved. Heat diarrhea with a rapid pulse contrasts with a weak pulse, so one cannot claim recovery yet. What is favorable is that slight heat and sweating allow the Yang pathogen to return to the exterior, restoring the true qi of the Stomach, hence spontaneous recovery. If the pulse becomes tight again, initially cold pathogen was on the exterior causing a tight pulse; now it has transmitted to the interior, transforming from cold to heat. A recurrent tight pulse suggests excess pathogen obstructing the chest and diaphragm causing pain, hence the diarrhea is not resolved.)
Diarrhea with cold extremities and no palpable pulse: if moxibustion does not warm the body, and if the pulse does not return but instead slight panting occurs, death ensues. (This clause pertains to True Cold syndrome. The main text and annotations are found in *Zhonghan Lun*.)
(Repeated Example) When Shaoyin pulse is weaker than Fuyang pulse, it is a favorable sign. (This syndrome has already appeared in the previous Shaoyin chapter.)
Diarrhea with an unexpectedly floating and rapid Cun pulse, and a choppy Chi pulse, will certainly result in purulent and bloody stools. (This clause describes the progression of diarrhea into purulent and bloody stools. Heat diarrhea yielding a rapid pulse is not abnormal; yielding a floating pulse is abnormal. Here, the Cun pulse is unexpectedly floating and rapid, indicating that interior heat pathogen is not subsiding. Choppy Chi pulse indicates Yin deficiency. Yang pathogen takes advantage of Yin deficiency, causing blood stasis leading to purulent and bloody stools. "Qing" is synonymous with "Qing" (toilet). Saying "like going to the toilet" implies what is passed down is all purulent and bloody stool. Regarding this clause, Zhang Zhongjing provides no treatment method. *Buwang Lun* states Chang Qizhi's opinion: use Taohua Tang. This is erroneous. My opinion is: use Zhongjing's Huangqin Tang instead.)
Diarrhea with undigested food (clear谷物) prohibits attacking the exterior. Sweating will inevitably cause abdominal distension. (This clause pertains to True Cold directly striking the interior; it should be considered a misplaced text in the Taiyin Jing chapter. Main text and annotations are detailed in *Zhonghan Lun*.)
Diarrhea with a deep and wiry pulse indicates tenesmus. A large pulse indicates the condition has not ceased. A weak, minute, and rapid pulse indicates the condition is about to cease spontaneously; even with fever, there is no danger of death. (This analyzes the pulse of heat diarrhea. Deep and wiry pulse: deep indicates interior, wiry indicates urgency, hence tenesmus, similar to dysentery. Large pulse indicates severe pathogenic heat. *Mai Jing* states: "Large means disease progresses," hence diarrhea has not ceased. Weak, minute, and rapid pulse indicates Yang pathogenic heat has retreated and true Yin qi is recovering, hence diarrhea stops spontaneously. Diarrhea strongly contraindicates fever; here, the pulse is weak, minute, and rapid, meaning residual pathogen is limited, hence even with fever, it is not fatal. Cheng Wuji's annotation states: weak, minute, and rapid pulse means pathogen is slight and Yang qi recovers, fever due to Yang excess; this interprets heat diarrhea as cold diarrhea, which is grossly incorrect.)
(Attached Example) Heat diarrhea with tenesmus (heavy sensation in the anus) is primarily treated with Baitouweng Tang. (*Tiaobian* states: This elaborates on the treatment for the preceding clause. Tenesmus results from Jueyin channel heat pathogen descending into the Large Intestine. The Liver nature is swift and urgent; when heat pathogen is severe, Qi stagnation and obstruction occur, making foul matter urgently desire to exit but unable to do so, hence tenesmus. Primary treatment with Baitouweng Tang is to drain heat and thicken the intestines to stop diarrhea.)