下痢，水谷不入，里急后重，是泄泻也。
〔世〕胃苓汤一名对金饮子，治脾湿太过，泄泻不止。
平胃散 五苓散（各等分） 上锉，水煎服极效。
〔罗〕《内经》曰∶湿胜则濡泄。《甲乙经》云∶寒气客于下焦，传为濡泄。夫脾者，五脏之至阴，其性恶寒湿。
令寒湿之气内客于脾，故不能裨助胃气，腐熟水谷，致清浊不分，水入肠间，虚莫能制，故洞泄如水，随气
而下，谓之濡泄。法当除湿利小便也。治之以对金饮子。
平胃散（五钱） 五苓散（二钱半） 草豆蔻（面裹煨熟，半两）
上相和作四服。水一盏半，生姜三片，枣二枚，煎至一盏，去渣温服，食前。
〔垣〕加减平胃散 治脾胃不和，不思饮食，心腹、胁肋胀满刺痛，口苦无味，胸满短气，呕哕恶心，噫气吞酸，
面色痿黄，肌体瘦弱，怠惰嗜卧，体重节痛，常多自痢，或发霍乱及五噎、八噫、膈气、反胃等症。
浓朴（去皮，姜制炒，三两二钱） 苍术（去粗皮，米泔浸，五两） 陈皮（三两二钱） 甘草（锉，炒，二两）
上为细末。每服二钱，水一盏，生姜三片，枣二枚，同煎至七分，去渣温服。或去姜、枣带热服，空心食
前。入盐一捻，沸汤点服亦得。常服调气暖胃，化宿食，消痰饮，辟风寒冷湿四时非常之气。如小便赤涩，
加白茯苓、泽泻。如米谷不化，饮食伤多，加枳实。如胃中气不快，心下痞气，加枳壳、木香。如脾胃困弱，
不思饮食，加人参、黄 。如心下痞闷、腹胀者，加浓朴，甘草减半。如遇夏，加炒黄芩。如遇雨水湿润时，
加茯苓、泽泻。如有痰涎，加半夏、陈皮。凡加时，除苍术、浓朴，根据例加之，如一服五钱，有痰用半夏一
两。如嗽，饮食减少，脉弦细，加归身、黄 。如脉洪大缓，加黄芩、黄连。如大便硬，加大黄三钱，芒硝
二钱。先嚼麸炒桃仁烂，以药送下。
〔海〕加减平胃散例∶
若泄泻脾湿，加茯苓、丁香、白术，为调胃散。一法，加藿香、半夏。若加干姜，为浓朴汤。若温疫
时气二毒，伤寒头痛壮热，加连须葱白五寸、豆豉三十粒，煎二三服，取微汗出愈。若五劳七伤，脚手心热，烦
躁不安，百节酸疼，加柴胡。若痰嗽疟痢，加姜制半夏。若小肠气痛，加茴香。若水气肿满，加桑白皮。若
妇人赤白带下，加黄 。若酒伤，加丁香。若饮冷伤，加高良姜。若滑脱泄泻，加肉豆蔻。若风痰四肢沉困，
加荆芥。若腿膝冷痛，加牛膝。若浑身虚肿拘急，加地骨皮。若腿膝湿痹，加菟丝子。若白痢，加吴茱萸。
若赤痢，加黄连。若头风，加 本。若转筋霍乱，加樟木皮。若七邪六极，耳鸣，梦泄，盗汗，四肢沉重，
腿膝痿，妇人宫脏久冷，月事不调者，加桂枝。若胃寒呕吐多，加生姜。一法，加茯苓、丁香各三两。若气
不舒快，中脘痞塞，加砂仁、香附三两，生姜煎服。若与五苓散相半，为对金饮子。若与六一散相合，为黄
白散。若与钱氏异功散相合，为调胃散。若饮食进退，加神曲、麦芽。冬月加吴茱萸、川椒、干姜、桂，
为吴茱萸汤。若加 本、桔梗，为和解散，治伤寒吐利。若加藿香、半夏为不换金正气散。若疟疾寒热
者，加柴胡。若小肠气痛者，加苦楝、茴香。
〔丹〕或曰∶平胃散之温和，可以补养胃气，吾子以为何如？予曰∶苍术性燥气烈，行湿解表，甚为有功。
浓朴性温散气，非胀满实急者不用，承气用之可见矣。虽有陈皮、甘草之甘缓甘辛，亦是决烈耗散之剂，实无
补土之利。经谓土气太过曰敦阜，亦能为病。况胃为水谷之海，多气多血，故因其病也用之，以泻有余之气，
使之平耳。又须察其挟寒气、得寒物者，而后投之。胃气和平，便须却药。谓之和平者，初非补之之谓，岂可
以为补剂而常用之乎？或曰∶谓胃承气亦治胃病。谓之调者，似举平胃之平意义相近，何用药之相远也？予曰∶
调胃承气治热，中下二焦药也。经云∶热淫于内，治之咸寒，佐以苦甘。功在乎导利而行之以缓。平胃散止治湿，
上焦药也。经曰∶湿上甚而热，治以苦温，佐以甘辛。以汗为故而止。或曰∶治湿不利小便，非其治也，此非
仲景法耶？何子言之悖也？予曰∶淡渗治湿，因有湿在中下二焦。今湿在上，宜以微汗而解，不欲汗多，故不
用麻黄、葛根辈耳。五苓散治泄泻水多者。（方见伤寒。）
泻湿，四苓散加苍术、白术，甚者二术必用炒。
白术（三分，加至两半） 泽泻（一两） 茯苓 猪苓 苍术（各五钱）
〔《本》〕治水泻，用草乌半生、半烧灰存性为末，醋丸。空心井花水下七丸。
〔河〕益元散 治身热泄泻，小便不利。
滑石（六两） 甘草（炙，一两）
上为末。每服三钱，蜜汤调下，日三服。如解寒发汗，煎葱白豆豉汤调下四钱，并三服，以效为度。
〔丹〕参萸丸 治湿热滞气者，湿热甚者用为向导，上可治吞酸，下可治自利。
六一散（七两，即益元散） 吴茱萸（二两，煮过）
一方去茱萸，加干姜一两，名温六丸。
〔《本》〕欧阳文忠公，尝得暴下，国医不能愈。人云市人有此药，三文一帖，甚效。夫人买进之，一服
而愈。后召卖药者问其方，但用车前子一味为末，米饮下二钱匕。（此药利水道。）
〔丹〕黄芩、木通入四苓散煎服，治火多泄泻。水煮金花丸，治泄不止，干呕。（方见干呕而利门。）
〔世〕木香和中丸 腹痛泄泻，脉滑者，神效。累验。（方见治虚实法。）
〔《仲》〕下利脉迟而滑者，实也。利未欲止，急下之，宜大承气汤。（方见伤寒。）下利脉反滑者，当
有所去，下乃愈，宜大承气汤。下利脉中坚者，当下之。下利后三部皆平，按之心下坚者，宜大承气急下之。
病者脉伏，
其人欲自利，利反快，虽利心下续坚满，此为留饮欲去故也，甘遂半夏汤主之。
甘遂（大者，三枚） 半夏（十二枚，以水一升，煮取半升，去渣） 芍药（五枚） 甘草（指大一枚，炙）
上四味，以水二升，煮取半升，去渣；以蜜半升和药汁煎。取八合，顿服之。
〔丹〕仁七侄之子，肚泄有积，与小胃丹二十粒，作二次吞之。（小胃丹方见内伤饮食。）积热作泄，亦
宜下之。
〔《保》〕治寒积痢，男妇小儿各不同。或赤白，或清痢如水，不后重者寒也。经曰∶澄澈清冷，皆属于寒。
此为虚寒，中有积也。宜附子、巴豆辈下之，见利则愈，空心服。
〔仲〕下痢气者，当利其小便。
〔洁〕治太阴脾经受湿，水泻注下，体重微满，困弱无力，不欲饮食，暴泄无数，水谷不化，先宜白术芍药汤。
白术 芍药（各一两） 甘草（五钱，俱用炒黄，效速。）
上细末。每一两，水二盏，煎至盏半，温服。
如腹痛甚者，宜苍术芍药汤主之。
苍术 芍药（各一两） 黄芩（半两）
上锉。每一两，入淡桂半钱，水盏半，煎至一盏，温服。
如脉弦头痛者，宜苍术防风汤主之。
苍术 防风（各二两） 上锉，同前法煎服。
如下血，宜苍术地榆汤主之。（方见滞下。）
以上症，如心下痞，每服加枳实一钱。如小便不利，每服加茯苓二钱。如腹痛渐已，泄下渐少，宜诃子散
止之。（方见后。）
〔丹〕气虚泄泻，人参、白术、炒芍药、升麻主之。
〔垣〕异功散 治脾胃虚冷，肠鸣腹痛自利，不思饮食。（方见小儿吐泻。人参、白术、茯苓、甘草、陈皮各等
分，为末，每五钱，姜、枣煎服。）
〔丹〕女人肚泄，左手脉弱，此自来欠血，面带黄多年，当作虚湿治之。
滑石（六钱） 白术（半两） 陈皮 当归（各三钱） 浓朴 木通 芍药（各一钱） 甘草（炙，五分）
分六帖，姜一片，煎。
四八官患泄，小便赤少，食少倦怠，脉弱。此受湿为病，当补脾凉肺。
白术 滑石（各一两） 黄芩 人参 芍药（各五钱） 木通 陈皮（各三钱） 干姜（一钱）
甘草（炙，一钱） 分八帖煎服。
五儿腹泄，此受寒凉为病。
白术 苍术（各二钱） 干姜 茯苓 浓朴（各一钱） 甘草（三分）
上为末。每服二钱，白汤调下。
一丈夫腹泻，胸痞不渴。
半夏（一钱） 苍术 白术 青皮（各二钱） 木通 紫苏（各一钱） 良姜（半钱） 甘草（少许）
分三帖，姜三片，水二盏，煎服。
辉五孺人，瘰 已好，止是食少乏力，肚泄自汗。
牡蛎（一钱半） 白术（二钱） 干姜（三钱） 陈皮（五分） 黄 （二分） 当归（一分） 白水煎服。
贾宅女人，六十八岁，腹泄，面黄乏力，脉浮大而数，此有热积。
滑石 白术（炒。各一两） 茯苓 神曲（炒） 陈皮（各五钱） 黄连 黄芩 干姜（各一钱）
上为末，粥为丸。山楂汤食前下五十粒。
一丈夫病热退未尽，食太早，口渴倦甚，腹泄，心烦，脚冷。
人参 滑石 柴胡 白术 陈皮（各一钱） 木通（一钱半） 甘草（五分）
分四帖，煎七分，下保和十五丸。
上九方，丹溪、东垣治泄泻之法，大率皆用白术、滑石补脾行湿，其余随症加减。第一二方专治泄也，
第三方治泄之挟热也；第四五六方治泄之挟寒也；第七八方治泄之挟饮食积也。
〔垣〕予病脾胃久衰，视听半失，此阴盛乘阳，加之气短，精神不足，此由弦脉令虚多言之过也。皆阳气
衰弱，不得舒伸，伏匿于阴中耳。癸卯岁六七月间，淫雨阴寒，逾月不止，致人多病泄痢，湿多成五泄故也。
一日予体重，肢节疼痛，大便泄并下者三，而小便闭塞。思其治法，按《内经·标本论》大小不利，无问标
本，先利小便。又云∶在下者引而竭之，亦是先利小便也。又云∶诸泄利小便不利，先分别之；又云∶治湿不
利小便，非其治也，皆言当利小便。必用淡味渗泄之剂以利之，是其法也。噫！圣人之法，虽布在方册，其不
尽者可以意求耳。今客邪寒湿之淫，从外而入里，以暴加之，若从以上法度，用淡渗之剂以除之，病虽即已，
是降之又降，是复益其阴而重竭其阳，则阳气愈削而精神愈短矣。是阴重强，阳重衰，反助其邪之谓也，故必
用升阳风药即瘥。以羌活、独活、柴胡、升麻各一钱，防风根半钱，炙甘草半钱，同 咀，水二钟，煎至一盏，
去渣，稍热服。大法云∶湿寒之胜，助风以平之。又曰∶下者举之，得阳气升腾而去矣。又法云∶客者除之，
是因曲而为之直也。夫圣人之法，可以类推，举一而知百者也。若不达升降浮沉之理，而一概施治，其愈者幸
也。
升阳除湿汤 治脾胃虚弱，不思饮食，泄泻无度，小便黄，四肢困弱，自下而上，引而去之。
升麻 柴胡 羌活 防风（各半钱） 苍术 甘草（炙，三分） 神曲 泽泻 猪苓 陈皮（各五分） 麦 （三
分）
上 咀，水二盏煎，去渣，空心服。如胃寒肠鸣，加益智、半夏各五分，姜、枣同煎，非肠鸣不用。
人参升胃汤 治一日大便三四次，溏而不多，有时泄泻腹鸣，小便黄。
黄 （二钱） 甘草（炙，一分） 升麻（六分） 柴胡 陈皮 归身 益智（各二钱） 红花（少许） 人参（六
分）
上锉，作二服，水二盏，煎至一盏，去渣稍热，食前服。
〔丹〕止泻，姜曲丸
神曲（六两） 茴香（半两） 生姜（二两）
上为丸。每服五七十丸。
痰积泄泻。
海石 青黛 黄芩 神曲
上为丸。每服三五十丸。病少者，必用吐法吐之方愈。
上积滞泄泻，腹必耕痛方泄者是也。或肚腹满，按之坚者亦是也。受病泄者，宜神曲之类消导之；病
深而顽者，必用滞下门后重多热条，进退承气之类，下之方安。
〔丹〕固肠丸
樗皮（四两） 滑石（二两）
上为末，粥丸。（丹溪云∶固肠丸性燥，若滞气未尽者，不可遽用。）
〔《保》〕诃子散 治泄久，腹痛渐已，泻下渐少，宜此药止之。
诃子（一两，半生半熟） 木香（半两） 甘草（二钱） 黄连（三钱）
上为细末。每服二钱，以白术芍药汤调下。如止之不已，宜因其归而送之，于诃子散内加浓朴一两，竭其
邪气也。虚滑久而不止者，多传变为痢。太阴传少阴，是为鬼邪，先以浓朴枳实汤防其传变。
浓朴 枳实（各一两） 诃子（一两，半生半熟） 木香（半两） 黄连（二钱） 甘草（炙，二钱） 大
黄（三钱）
上为细末。每服三钱或五钱，水一盏半，煎至一盏，去渣温服。（以上皆治热滑泻。）
〔丹〕补脾丸
白术（半两） 白芍药（二钱）
上为细末，饭丸。冬月去芍药，加肉豆蔻、泽泻服之。又不止者，于内加飞矾一钱半。气痢，诃黎勒散主之。
诃黎勒（十枚，煨）
上一味为散，粥饮和，顿服。（林亿云∶疑非仲景方也。）
〔垣〕扶脾丸 治脾胃虚寒，腹中痛，溏泄无度，饮食不化。
白术 茯苓 甘草（炙） 诃子皮 乌梅肉（各二钱） 红豆 干姜 肉桂（各半钱） 麦 神曲（炒。各四钱）
陈皮（一钱） 半夏（二钱）
Diarrhea, characterized by dysentery, inability to retain food and water, abdominal urgency, and tenesmus (a feeling of incomplete defecation), is referred to as diarrhea.
[Shi] Weiling Tang (Guizhi Tang combined with Pingwei San, also known as Duojin Yinzi) treats diarrhea that does not stop due to excessive dampness in the spleen.
Pingwei San (Cinnamon Twig Decoction combined with Wuling San, equal parts) The above herbs are chopped, decocted in water, and taken orally; it is extremely effective.
[Luo] The *Huangdi Neijing* (Yellow Emperor's Inner Canon) states: "When dampness prevails, it leads to Ru Xie (damp diarrhea)." The *Jia Yi Jing* says: "When cold qi invades the lower jiao, it transforms into Ru Xie." The spleen is the most yin organ among the five zang organs, and its nature dislikes cold and dampness.
Now, when cold and damp qi internally invade the spleen, it cannot assist stomach qi in rotting and ripening food and water, leading to a failure to distinguish clear from turbid. Water enters the intestines, and due to deficiency, it cannot be controlled, resulting in Dong Xie (profuse watery diarrhea) flowing down with the qi, called Ru Xie. The treatment method should be to remove dampness and promote urination. Treat with Duojin Yinzi.
Pingwei San (5 qian) Wuling San (2.5 qian) Caodoukou (wrapped in flour and baked until cooked, 0.5 liang)
Mix the above herbs into four doses. For each dose, use 1.5 cups of water, three slices of fresh ginger, and two jujubes. Decoct until one cup remains, strain, and take warm before meals.
[Yuan] Jiajian Pingwei San (Modified Cinnamon Twig Decoction) treats disharmony between the spleen and stomach, loss of appetite, distending and stabbing pain in the heart, abdomen, and hypochondrium, bitter taste in the mouth, lack of flavor, chest fullness, shortness of breath, vomiting, hiccups, nausea, belching, and acid regurgitation, sallow complexion, emaciation, lethargy, desire to lie down, heavy body, joint pain, frequent spontaneous dysentery, or occurrence of cholera, Wu Ye (five blockages), Ba Yi (eight belches), Ge Qi (food impaction), Fan Wei (regurgitation), and other syndromes.
Nanxiong (peeled, processed with ginger and stir-fried, 3.2 liang) Cangzhu (remove coarse skin, soak in rice washing water, 5 liang) Chenpi (3.2 liang) Gancao (chopped, stir-fried, 2 liang)
Grind the above herbs into fine powder. Take 2 qian per dose with one cup of water, three slices of fresh ginger, and two jujubes. Decoct until 0.7 cup remains, strain, and take warm. Alternatively, omit ginger and jujube and take hot, on an empty stomach or before meals. Adding a pinch of salt and taking with boiling water is also acceptable. Long-term use regulates qi, warms the stomach, resolves retained food, eliminates phlegm-fluids, and wards off abnormal qi of wind, cold, dryness, and dampness across the four seasons. If urine is red and difficult to pass, add Baifuling (Poria) and Zexie (Alisma). If rice and grain are undigested due to excessive dietary injury, add Zhishi (Immature Bitter Orange). If stomach qi is stagnant with epigastric stuffiness, add Zhike (Bitter Orange) and Muxiang (Aucklandia). If spleen and stomach are weak and fatigued with loss of appetite, add Renshen (Ginseng) and Huangqi (Astragalus). If there is epigastric stuffiness and abdominal distension, add Nanxiong, and reduce Gancao by half. In summer, add Chao Huangqin (Stir-fried Scutellaria). During rainy and humid periods, add Fuling (Poria) and Zexie (Alisma). If there is phlegm-saliva, add Banxia (Pinellia) and Chenpi (Tangerine Peel). When adding herbs, except for Cangzhu and Nanxiong, follow the examples: e.g., if one dose is 5 qian and there is phlegm, use 1 liang of Banxia. If there is cough, reduced appetite, and a wiry-thin pulse, add Guishen (Angelica Sinensis root body) and Huangqi (Astragalus). If the pulse is surging-large and slow, add Huangqin (Scutellaria) and Huanglian (Coptis). If stool is hard, add Dahuang (Rhubarb) 3 qian and Mangxiao (Mirabilite) 2 qian. Chew bran-fried Taoren (Peach Kernel) thoroughly first, then swallow with the medicine.
[Hai] Examples of modifying Pingwei San:
If diarrhea is due to spleen dampness, add Fuling (Poria), Dingxiang (Clove), and Baizhu (Atractylodes), called Tiaowei San. Another method adds Huoxiang (Patchouli) and Banxia (Pinellia). If Ganjiang (Dried Ginger) is added, it becomes Nanxiong Tang. For epidemic toxic qi and two poisons, or cold-damage with headache and high fever, add 5 cun of scallion white with roots and 30 grains of Douchi (Fermented Soybean); decoct and take 2-3 doses until mild sweating occurs for cure. For five labors and seven injuries, heat in palms and soles, restlessness, and generalized joint soreness, add Chaihu (Bupleurum). For phlegm-cough, malaria, and dysentery, add Banxia processed with ginger. For Xiao Chang Qi (small intestine qi pain), add Huixiang (Fennel). For fluid retention and edema, add Sangbaipi (Mulberry Root Bark). For women with red and white leukorrhea, add Huangqi (Astragalus). For alcohol injury, add Dingxiang (Clove). For cold drink injury, add Gaoliangjiang (Galangal). For slipping and uncontrolled diarrhea, add Roudoukou (Nutmeg). For wind-phlegm causing heaviness and fatigue in limbs, add Jingjie (Schizonepeta). For cold pain in legs and knees, add Niuxi (Achyranthes). For generalized edema and spasms, add Digupi (Groundsel Root Bark). For damp bi syndrome in legs and knees, add Tusizi (Cuscuta). For white dysentery, add Wuzhuyu (Evodia). For red dysentery, add Huanglian (Coptis). For head wind, add Gaben (Ligusticum). For muscle cramps and cholera, add Zhangmupi (Camphor Tree Bark). For seven evils and six extremes, tinnitus, nocturnal emission, night sweats, heavy limbs, leg/knee weakness, chronic cold uterus, and irregular menstruation, add Guizhi (Cinnamon Twig). For frequent vomiting due to stomach cold, add Shengjiang (Fresh Ginger). Another method adds Fuling (Poria) and Dingxiang (Clove), each 3 liang. If qi is not free and middle jiao is blocked, add Sharen (Amomum) and Xiangfu (Cyperus), each 3 liang, decoct with ginger. If mixed equally with Wuling San, it is called Duojin Yinzi. If combined with Liuyi San, it is called Huangbai San. If combined with Qian Shi Yigong San, it is called Tiaowei San. If diet fluctuates, add Shenqu (Medicated Leaven) and Maiya (Sprouted Barley). In winter, add Wuzhuyu, Chuanjiao, Ganjiang, and Gui, forming Wuzhuyu Tang. If Gaben and Jiegeng are added, it is called Hejie San, treating cold-damage with vomiting and diarrhea. If Huoxiang and Banxia are added, it is called Bu Huan Jin Zhengqi San. For malaria with alternating chills and fever, add Chaihu. For small intestine qi pain, add Kulian and Huixiang.
[Dan] Someone asked: "Pingwei San is mild and can nourish stomach qi. What do you think?" I said: "Cangzhu is drying and potent, effective for moving dampness and releasing the exterior. Nanxiong is warm and disperses qi; it is not used unless there is fullness and urgency, as seen in Chengqi Tang. Although Chenpi and Gancao are sweet and mild, this formula is still fierce and dissipating, lacking benefit for tonifying earth. The classics say excessive earth qi is called Dunfu, which can also cause disease. Moreover, the stomach is the sea of water and grain, abundant in qi and blood, so it is used according to the disease to drain excess qi and restore balance. One must observe if cold qi or cold substances are involved before administering. Once stomach qi is balanced, medication should be stopped. 'Peaceful' here does not mean tonification; how can it be considered a tonic for long-term use?" Someone asked: "Wei Chengqi Tang also treats stomach diseases. 'Tiao' (regulate) seems similar to 'Ping' (peace/level) in Pingwei San. Why is the medication so different?" I said: "Tiaowei Chengqi Tang treats heat; it acts on the middle and lower jiao. The classics say: 'Heat rampant inside, treat with salty-cold, assist with bitter-sweet.' Its function is to guide and drain gently. Pingwei San only treats dampness; it acts on the upper jiao. The classics say: 'Dampness severe above with heat, treat with bitter-warm, assist with sweet-pungent.' Cure is indicated by sweating." Someone asked: "Treating dampness without promoting urination is not correct treatment, isn't this contrary to Zhongjing's method? Why do you speak against it?" I said: "Acrid-leaching treats dampness because dampness is in the middle and lower jiao. Now dampness is in the upper jiao; it should be resolved via slight sweating. We do not want profuse sweating, hence we do not use Mahuang (Ephedra) or Gegen (Kudzu Root)." Wuling San treats diarrhea with excessive water. (Formula see Shanghan section.)
To drain dampness, Siling San plus Cangzhu and Baizhu; in severe cases, both must be stir-fried.
Baizhu (3 fen, up to 1.5 liang) Zexie (1 liang) Fuling Zhu Ling Cangzhu (each 5 qian)
[Ben] To treat watery diarrhea, use Caowu (Aconitum carmichaelii): half raw, half calcined to ash but retaining properties, ground to powder, made into pills with vinegar. Take 7 pills on an empty stomach well water.
[He] Yiyuan San treats body heat with diarrhea and difficulty urinating.
Huashi (Talcum) (6 liang) Gancao (roasted, 1 liang)
Grind into powder. Take 3 qian per dose, mixed with honey water, three times daily. To resolve cold and induce sweating, mix with Congbai Douchi Tang (Scallion and Fermented Soybean Decoction), 4 qian per dose, three times total, until effective.
[Dan] Shanyu Wan treats damp-heat with stagnant qi. For severe damp-heat, it serves as a guide: upward treats acid regurgitation, downward treats spontaneous diarrhea.
Liuyi San (7 liang, i.e., Yiyuan San) Wuzhuyu (2 liang, boiled)
Another prescription removes Wuzhuyu and adds Ganjiang (Dried Ginger) 1 liang, named Wenliu Wan.
[Ben] Ouyang Xiu once suffered from sudden severe diarrhea, which imperial physicians could not cure. Someone said a market vendor had this medicine, costing three wen per packet, very effective. His wife bought it, and one dose cured him. Later, he summoned the vendor to ask for the formula. It was simply Cheqianzi (Plantago Seed) ground to powder, taken with rice drink, 2 qian bi. (This herb promotes water passage.)
[Dan] Huangqin (Scutellaria) and Mutong (Akebia) added to Siling San decocted and taken, treats diarrhea due to excessive fire. Boiled Jinhua Wan treats persistent diarrhea and dry heaving. (Formula see Dry Heaving and Diarrhea section.)
[Shi] Muxiang Hezhong Wan is miraculous for abdominal pain and diarrhea with a slippery pulse. Repeatedly verified. (Formula see Treating Deficiency-Excess methods.)
[Zhong] Dysentery with a slow and slippery pulse indicates excess. If diarrhea has not ceased, urgently purge with Dachengqi Tang. (Formula see Shanghan section.) Dysentery with a surprisingly slippery pulse indicates something needs to be removed; purging will lead to recovery, suitable for Dachengqi Tang. Dysentery with a firm pulse in the middle requires purging. After dysentery, if all three pulses are normal but palpation reveals hardness below the heart, urgently purge with Dachengqi Tang. If the patient has a hidden pulse, desires spontaneous diarrhea, feels relief after passing stool, yet continues to have hardness below the heart, this is residual fluid attempting to exit; Gansui Banxia Tang governs.
Gansui (large, 3 pieces) Banxia (12 pieces, decocted in 1 sheng water to 0.5 sheng, strained) Shaoyao (5 pieces) Gancao (finger-sized, 1 piece, roasted)
Decoct the four ingredients in 2 sheng water to 0.5 sheng, strain. Mix with 0.5 sheng honey and decoct the medicine juice. Take 0.8 he in one dose.
[Dan] Renqi's nephew's son had abdominal diarrhea with accumulation. Given Xiaoweidan (Small Stomach Pill) 20 pills, swallowed in two doses. (Xiaoweidan formula see Internal Injury Diet section.) Accumulated heat causing diarrhea should also be purged.
[Bao] Treating cold accumulation dysentery differs for men, women, and children. It may be red-white, or clear like water without tenesmus, indicating cold. The classics say: "Clear and cold belongs to cold." This is deficiency-cold with accumulation. Use Fuzi (Aconite) and Badou (Croton) to purge; cure upon seeing diarrhea, taken on an empty stomach.
[Zhong] For dysentery with qi sensation, promote urination.
[Jie] Treating Taiyin spleen channel dampness, watery diarrhea pouring down, heavy body with slight fullness, weakness, loss of appetite, sudden profuse diarrhea with undigested food/water, first use Baizhu Shaoyao Tang.
Baizhu Shaoyao (each 1 liang) Gancao (5 qian, all stir-fried yellow for faster effect)
Grind to fine powder. For every 1 liang, use 2 cups of water, decoct to 1.5 cups, take warm.
If abdominal pain is severe, use Cangzhu Shaoyao Tang.
Cangzhu Shaoyao (each 1 liang) Huangqin (0.5 liang)
Chop. For every 1 liang, add Dan Gui (Light Cinnamon) 0.5 qian, 1.5 cups water, decoct to 1 cup, take warm.
If pulse is wiry with headache, use Cangzhu Fangfeng Tang.
Cangzhu Fangfeng (each 2 liang) Chop, decoct as above.
If bloody stool, use Cangzhu Diyutang. (Formula see Dysentery section.)
For the above symptoms, if epigastric stuffiness, add Zhishi 1 qian per dose. If urination is difficult, add Fuling 2 qian per dose. If abdominal pain subsides and diarrhea decreases, use Hezi San to stop it. (Formula see later.)
[Dan] For qi-deficiency diarrhea, use Renshen (Ginseng), Baizhu (Atractylodes), stir-fried Shaoyao (Peony), and Shengma (Cimicifuga).
[Yuan] Yigong San treats spleen-stomach deficiency-cold, borborygmus, abdominal pain, spontaneous diarrhea, and loss of appetite. (Formula see Infant Vomiting/Diarrhea. Renshen, Baizhu, Fuling, Gancao, Chenpi equal parts, powder, 5 qian per dose, decoct with ginger/jujube.)
[Dan] Woman with abdominal diarrhea, weak left hand pulse, chronic blood deficiency, sallow complexion for years, treat as deficiency-dampness.
Huashi (6 qian) Baizhu (0.5 liang) Chenpi Danggui (each 3 qian) Nanxiong Mutong Shaoyao (each 1 qian) Gancao (roasted, 5 fen)
Divide into 6 packets, decoct with one slice of ginger.
Official Si Ba suffered diarrhea, red/scanty urine, poor appetite, fatigue, weak pulse. This is disease from dampness, tonify spleen and cool lung.
Baizhu Huashi (each 1 liang) Huangqin Renshen Shaoyao (each 5 qian) Mutong Chenpi (each 3 qian) Ganjiang (1 qian) Gancao (roasted, 1 qian) Divide into 8 packets, decoct and take.
Child Wu had abdominal diarrhea from cold-dampness.
Baizhu Cangzhu (each 2 qian) Ganjiang Fuling Nanxiong (each 1 qian) Gancao (3 fen)
Grind to powder. Take 2 qian per dose with plain water.
One man had diarrhea, chest stuffiness, no thirst.
Banxia (1 qian) Cangzhu Baizhu Qingpi (each 2 qian) Mutong Zisu (each 1 qian) Liangjiang (0.5 qian) Gancao (little)
Divide into 3 packets, decoct with 3 slices ginger, 2 cups water.
Lady Hui Wu had scrofula cured, now poor appetite, fatigue, abdominal diarrhea, spontaneous sweating.
Muli (1.5 qian) Baizhu (2 qian) Ganjiang (3 qian) Chenpi (5 fen) Huangqi (2 fen) Danggui (1 fen) Decoct with plain water.
Woman in Jia household, 68 years old, abdominal diarrhea, sallow face, fatigue, floating-large-rapid pulse, indicates heat accumulation.
Huashi Baizhu (stir-fried, each 1 liang) Fuling Shenqu (stir-fried) Chenpi (each 5 qian) Huanglian Huangqin Ganjiang (each 1 qian)
Grind to powder, make pills with congee. Take 50 pills before meals with Hawthorn soup.
One man had incomplete resolution of heat illness, ate too early, thirsty, very fatigued, abdominal diarrhea, irritability, cold feet.
Renshen Huashi Chaihu Baizhu Chenpi (each 1 qian) Mutong (1.5 qian) Gancao (5 fen)
Divide into 4 packets, decoct to 0.7 portion, take 15 Baohe Pills.
The above nine formulas, Danxi and Dongyuan's methods for treating diarrhea, generally use Baizhu and Huashi to tonify spleen and move dampness, with other additions based on symptoms. Formulas 1-2 specifically treat diarrhea; Formula 3 treats diarrhea with heat; Formulas 4-6 treat diarrhea with cold; Formulas 7-8 treat diarrhea with food accumulation.
[Yuan] I suffered from long-term spleen-stomach decline, partial loss of vision and hearing, due to yin flourishing attacking yang, compounded by shortness of breath and insufficient spirit, caused by over-talking due to xu (deficiency) indicated by wiry pulse. All are due to weak yang qi unable to extend, hiding within yin. In the sixth and seventh months of the Gui Mao year, continuous rain and cold lasted over a month, causing many people to suffer diarrhea and dysentery; dampness often forms the five types of diarrhea.
One day I felt heavy body and joint pain, had three episodes of diarrhea, and urinary obstruction. Considering treatment, according to *Neijing·Biao Ben Lun*, for difficulty in urination or defecation, regardless of biao/ben, first promote urination. Also: "Those below, draw out and exhaust," also means first promote urination. Also: "For various diarrheas with urinary difficulty, first differentiate"; also: "Treating dampness without promoting urination is incorrect," all stating one should promote urination. Must use acrid-leaching agents to promote it, this is the method. Alas! Sage methods are in books, but未尽 (unwritten) aspects can be sought through intuition. Now, pathogenic cold-dampness invades from outside to inside violently. If following the above method using acrid-leaching agents to remove it, although the disease might cease, it is lowering again and again, re-enriching yin and exhausting yang, further weakening yang and spirit. This makes yin strong and yang weak, assisting evil. Thus, one must use ascending wind herbs for immediate cure. Use Qianghuo, Duhuo, Chaihu, Shengma each 1 qian, Fangfenggen 0.5 qian, roasted Gancao 0.5 qian, chop together, decoct in 2 zhong water to 1 cup, strain, take slightly hot. Great method says: "For damp-cold victory, assist with wind to pacify." Also: "Those below, lift them; obtain yang qi ascending to depart." Also: "Remove guests; straighten the crooked." Sage methods can be inferred; know one to understand hundreds. Without understanding ascending-descending-floating-sinking principles, applying uniform treatment, recovery is merely luck.
Shengyang Chushi Tang treats spleen-stomach weakness, loss of appetite, unlimited diarrhea, yellow urine, weak limbs, drawing away from bottom to top.
Shengma Chaihu Qianghuo Fangfeng (each 0.5 qian) Cangzhu Gancao (roasted, 3 fen) Shenqu Zexie Zhuling Chenpi (each 5 fen) Maidong (3 fen)
Chop, decoct in 2 cups water, strain, take on empty stomach. If stomach cold with borborygmus, add Yizhi and Banxia each 0.5 qian, decoct with ginger/jujube; not for non-borborygmus cases.
Renshen Shengwei Tang treats bowel movement 3-4 times daily, loose but not much, occasional diarrhea with borborygmus, yellow urine.
Huangqi (2 qian) Gancao (roasted, 1 fen) Shengma (6 fen) Chaihu Chenpi Guishen Yizhi (each 2 qian) Honghua (little) Renshen (6 fen)
Chop, make 2 doses, decoct in 2 cups water to 1 cup, strain, take slightly hot before meals.
[Dan] Stop diarrhea, Jiangqu Wan
Shenqu (6 liang) Huixiang (0.5 liang) Shengjiang (2 liang)
Make pills. Take 50-70 pills per dose.
Phlegm accumulation diarrhea.
Haishi Qingdai Huangqin Shenqu
Make pills. Take 30-50 pills per dose. For mild cases, vomiting method is necessary for cure.
Upper accumulation diarrhea, where abdominal pain precedes diarrhea, is indicated. Or abdominal fullness with hardness on pressure is also indicated. For disease-caused diarrhea, use Shenqu-like herbs to digest; for deep and stubborn disease, use Houzhong (tenesmus) and Heat sections, Jin Tui Chengqi-like herbs to purge for safety.
[Dan] Guchang Wan
Chupi (4 liang) Huashi (2 liang)
Grind to powder, make pills with congee. (Danxi says: Guchang Wan is drying; if stagnant qi is not exhausted, do not use hastily.)
[Bao] Hezi San treats prolonged diarrhea, subsiding abdominal pain, decreasing stool volume, use this to stop.
Hezi (1 liang, half raw half cooked) Muxiang (0.5 liang) Gancao (2 qian) Huanglian (3 qian)
Grind to fine powder. Take 2 qian per dose, mixed with Baizhu Shaoyao Tang. If stopping fails, follow the path and send it out; add Nanxiong 1 liang to Hezi San to exhaust evil qi. Deficient slipping lasting long often transforms into dysentery. Taiyin transmitting to Shaoyin is called Ghost Evil; first use Nanxiong Zhishi Tang to prevent transmission.
Nanxiong Zhishi (each 1 liang) Hezi (1 liang, half raw half cooked) Muxiang (0.5 liang) Huanglian (2 qian) Gancao (roasted, 2 qian) Dahuang (3 qian)
Grind to fine powder. Take 3 or 5 qian per dose, decoct in 1.5 cups water to 1 cup, strain, take warm. (Above all treat heat-slipping diarrhea.)
[Dan] Bupi Wan
Baizhu (0.5 liang) Baishaoyao (2 qian)
Grind to powder, make pills with steamed bun. In winter remove Shaoyao, add Roudoukou and Zexie. If still not stopping, add Feifan (Calcined Alum) 1.5 qian. For qi dysentery, Helile San governs.
Helile (10 pieces, baked)
Grind the single ingredient to powder, mix with rice drink, take in one dose. (Lin Yi says: Suspect not Zhongjing's formula.)
[Yuan] Fupi Wan treats spleen-stomach deficiency-cold, abdominal pain, unlimited loose diarrhea, undigested food.
Baizhu Fuling Gancao (roasted) Hezipi Wumeirou (each 2 qian) Hongdou Ganjiang Rougui (each 0.5 qian) Maidong Shenqu (stir-fried, each 4 qian) Chenpi (1 qian) Banxia (2 qian)