Library

The *Huoren Shu* (Book of Vitality) states: "Absence of Yang leads to Jue (cold extremities); absence of Yin leads to vomiting." It further states that for Shaoyin disease with diarrhea and a faint pulse, Baotong Tang (White Connect Decoction) should be administered. If the diarrhea persists, accompanied by cold extremities, absent pulse, and dry heaving, Baotong Jia Zhuzhi Dan Tang (Baotong Decoction plus Pig Bile Decoction) is the primary treatment. It also states: "For dry heaving caused by cold phlegm in the diaphragm, emesis should not be induced; instead, urgent warming is required, preferably using Sini Tang (Frigid Extremities Decoction)." Liu Shouzhen (Liu Wansu) stated: "Vomiting is a manifestation of Fire Qi flaming upward; thus, severe Stomach Heat causes vomiting." He further stated: "Vomiting sour fluid is the flavor of Liver Wood. This occurs when excessive Fire restricts Lung Metal, preventing it from subduing Liver Wood, causing Liver Wood to become increasingly hyperactive, leading to sour regurgitation and a preference for sour foods during eating. Some claim sourness belongs to Cold, but this is incorrect. Consider wine: its bitter nature is hot, nourishing Heart Fire. Drinking it causes ruddy complexion, coarse breathing, surging and rapid pulse, slurred speech or delirium, singing, laughing or crying, manic anger or joy, mental confusion and forgetfulness, irritability, thirst, and vomiting—all are signs of Heat. The vomit will inevitably be sour, clearly indicating retained Heat." The *Suwen·Zhi Zhen Yao Da Lun* (Plain Questions: The Most Important Questions of Truth) states: "All types of vomiting and sour regurgitation, sudden diarrhea with tenesmus, belong to Heat." (The commentary notes: "Obstruction with vomiting, reverse qi, and belching, where food cannot enter, is due to Fire.")

The *Huoren Shu* states: "There are many types of diarrhea in Shanghan (Cold Damage); one must distinguish between Yin and Yang to avoid errors. Generally, regarding the various types of Shanghan diarrhea, one must examine the pulse and external symptoms. A large pulse with diarrhea indicates deficiency. A faint pulse suggests the condition will stop spontaneously. When Cold Toxin enters the Stomach, there is cold below the umbilicus, abdominal fullness, and stools that are yellowish-white, green, black, or contain undigested food. When Damp-Toxic Qi is severe, diarrhea with abdominal pain occurs, and stools resemble pus and blood or rotten meat juice. For cases caused by Cold Toxin entering the Stomach, treatments include Sini Tang (Frigid Extremities Decoction), Lizhong Tang (Regulate the Middle Decoction), Baotong Tang (White Connect Decoction) with added Fuzi (Prepared Aconite Root), etc. For damp-toxic diarrhea with pus and blood, Taohua Tang (Peach Blossom Decoction) and Diyü Tang (Sanguisorba Decoction) are indicated. Liu Shouzhen stated: "Diarrhea with pus and blood is like grains, meats, fruits, and vegetables in the world; when Damp-Heat is severe, they naturally rot and disintegrate into water. Similarly, food in the abdomen, upon receiving pathogenic Damp-Heat, naturally transforms into pus and blood. The red color is due to Heat belonging to Heart Fire; the yellow turbidity is due to Dampness belonging to Spleen Earth; the dry stagnation appearing white is due to belonging to Lung Metal. Severe Damp-Heat in the intestines and stomach forms constrained Heat. Dampness primarily causes obstruction because Qi rebellion prevents free circulation, thereby forming intestinal Dampness. Dampness and Heat combine. Water and Fire, Yin and Yang, Cold and Heat are like the weights on a balance beam; if one side is high, the other is low; if one is prosperous, the other declines. How can Cold and Heat both flourish in the intestines simultaneously to cause the same diarrhea? Such fallacies are widely circulated in the world, similar to how Heat generates sores and ulcers." The *Suwen·Da Qi Lun* (Plain Questions: Great Anomalies) states: "Intestinal bleeding is due to insufficiency of Shaoyin Qi, where binding allows Yang Qi to invade; Heat in the Lower Jiao results in lower bleeding." The *Suwen·Yin Yang Bie Lun* (Plain Questions: Differentiation of Yin and Yang) states: "In Yin Binding, bleeding of one sheng [unit], [since Yin governs Blood]; two sheng for second binding; three sheng for third binding." (Commentary: "Two sheng is called second binding; three sheng is called third binding.") The *Suwen·Zhi Zhen Yao Da Lun* (Plain Questions: The Most Important Questions of Truth) states: "Severe internal Heat binding causes incessant diarrhea. Heat should be treated with Cold medicines; binding must be removed. Using Cold purgatives disperses the binding and stops the diarrhea; this is the method of 'treating obstruction with unblocking agents' (Tong Yin Tong Yong)."