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The Qi of Heaven is unified. The application of this unity manifests as Wind, Fire, Dryness, Dampness, Cold, and Summerheat. Thus, Dampness (Shi) is one aspect of this unified Qi. Through mutual overacting, it produces five transformations: its manifestation in the sky is Rain, on the ground is Mud, in the human body corresponds to the Spleen, and when severe, it leads to Diarrhea (Xie). Therefore, diarrhea caused by Wind combining with Dampness, Summerheat combining with Dampness, Dryness combining with Dampness, Large Intestine Heat combining with Dampness, and Small Intestine Cold combining with Dampness.

Da Jia (Large Mass), if the Stomach pathology persists, transforms into Sun Xie (Diarrhea with undigested food); if Sun Xie persists, it transforms into Dong Xie (Watery diarrhea flowing directly down); if Dong Xie persists, it transforms into Pi Xie Han Zhong (Spleen deficiency with Cold accumulation). This is the transformation of Wind overacting on Dampness. If Pi Xie persists, it transforms into Huo Luan (Acute vomiting and diarrhea); if Huo Luan persists, it transforms into Zhu Xia (Urgent dysentery); if Zhu Xia persists, it transforms into Zhong Gu (Edema and abdominal distension). This is the transformation of Summerheat overacting on Dampness. If Large Intestine diarrhea persists, it transforms into Zhang Man (Abdominal fullness); if Zhang Man persists, it transforms into Chang Ming (Borborygmus); if Chang Ming persists, it transforms into Zhi Man Tang (Hypochondriac fullness with loose stools). This is the transformation of Dryness overacting on Dampness. If Small Intestine diarrhea persists, it transforms into Chang Yong (Intestinal abscess); if Chang Yong persists, it transforms into Zang Du (Toxic sores of the anus/rectum); if Zang Du persists, it transforms into Bleeding from both anterior and posterior orifices. This is the transformation of Heat overacting on Dampness. If Da Jia diarrhea persists, it transforms into Tuo Gang (Rectal prolapse); if Tuo Gang persists, it transforms into Guang Chang Tong (Pain of the rectum); if Guang Chang Tong persists, it transforms into Ru Zhi Chang Feng (Hemorrhoids accompanied by intestinal wind bleeding). This is the transformation of Cold overacting on Dampness. All these twenty-five transformations will not ultimately form disease without Dampness. Moreover, the Spleen and Stomach, both belonging to Earth, jointly govern the Middle Jiao. The Spleen likes moisture but also detests Dampness; this is the origin of Diarrhea.

Regarding pulse diagnosis for Dysentery (Li Ji): a pulse that is fine and small indicates survival, while a floating and large pulse indicates death. For Edema (Shui Zhong), it is the opposite: a floating and large pulse indicates survival, while a deep and fine pulse indicates death. Disease in the Interior presents with a Deep pulse, disease in the Exterior presents with a Floating pulse. Interior syndromes should be treated with Purging methods, Exterior syndromes with Sweating methods. If Dysentery presents with a floating and slippery pulse, and Edema presents with a deep and fine pulse, it means both Exterior and Interior are affected by pathogens, making it untreatable. Regarding Blood in the stool from Zang organs: if both hands' pulses are wiry, it indicates death; if both are slippery and large, it indicates survival; if the blood is warm and the body is hot, it indicates death. Wang Tai Pu stated: "If there is bloody stool accompanied by body heat and warm blood, it is because the blood has escaped outward, as Blood belongs to Fire." Death after seven days occurs because seven is the completed number of Fire.

Sun Xie originates from Wind and can also be cured by Sweating. Or, due to latent fright and terror, the Gallbladder Wood suffers evil, leading to sudden discharge of green water. This refers to Wu Ji (Spleen/Stomach) being attacked by Jia Wood (Liver/Gallbladder). Infants discharging green water, as mentioned in Su Wen under "Infant Wind," follows the same principle. Dong Xie is severe Sun Xie; merely close to Dong Xie, prolonged Dong Xie leads to Cold accumulation in the interior, which can be treated with Warming methods. The treatment principle states: Harmonization is acceptable, Sweating is not. Because pathogen in the Fu organs is easy to treat, but entering the Zang organs makes it hard to attack. Dong Xie with Cold accumulation enters from Fu to Zang, suitable for Harmonization rather than aggressive attack.

The onset of Edema is not sudden. It arises from Dampness pervading the Large Intestine, causing urine to become naturally obstructed. Once Water-Dampness accumulates, swelling doubles daily, presenting with yellow complexion, large abdomen, limbs like mud, and Dampness pervading the whole body. One cannot rely on a single method. One must vent from above and drain from below, release the Exterior and渗利 (leach/drain) the Interior, use Sour astringents and Pungent dispersants, Light leaching agents and Bitter firming agents. Use attacking formulas to rescue severe conditions, and mild formulas to calm residual symptoms. In this way, isolated Jing (Essence) receives Qi, solitary Po (Corporeal Soul) returns to Yang, the physical form can be preserved, stale matter is removed, and the Clean Fu organs are purified.

Do not hastily use Dou Kou (Nutmeg), Wu Mei (Mume Fruit), or Ying Su Ke (Poppy Shell). If the pathological presentation changes, it will surely lead to major errors.

Sometimes Tonification leads to Obstruction, sometimes Obstruction leads to Tonification. Does Obstruction and Tonification limit oneself to only one method? The世俗 (common people) only know that Astringent agents can stop diarrhea, but do not know that Unblocking agents can cause obstruction; this is adherence to fixed prescriptions! Generally, treating Dampness focuses primarily on promoting urination. For various persistent diarrheas, moxibustion at Shui Fen (Water Separation, CV9) is appropriate, as it is where water and grain separate. Moxa 5-7 cones at 1.5 cun above the umbilicus. Abdominal rumbling like thunder is a sign of the Water pathway functioning. Do not use acupuncture for Dampness. Although Nei Jing mentions Mi Ci (Needling the opposite side), it is better to treat it using Zhang Zhongjing's methods for Shang Han (Cold Damage). Diarrhea is also one of the four-season Shang Han diseases. Zhongjing said: "Upper purging and lower draining, exterior sweating and interior attacking, half in the Exterior, half in the Interior, then Harmonization is suitable; if Exterior and Interior signs are both present, follow the syndrome to leach and drain." Although this applies to Shang Han, it is the same for treating Dampness. Still, observe the pulse to see depth, ask age and constitution to see deficiency or excess, and the administered medicine will certainly meet expectations.

Recently, Shan Zhao Xin, Wine Supervisor of Baidi in Shangshui County, suffered from Sun Xie for over a year without cure. Liu Jixian of this county asked me to prescribe medicine for him. I prescribed several taels of Guizhi Mahuang Tang (Cinnamon Twig and Ephedra Decoction), and he was cured after one dose. Therefore, I drew the Diagram of Five Diarrheas, extracting the original intent of Nan Jing and Su Wen. I recorded this text above, had it printed and circulated, sincerely hoping future gentlemen would refer to it. Dai Ren Zhang Zihe narrates the above content, revised and formatted into chapters.