脾虚食后即作泻，腹满不渴少精神，面黄懒食肌消瘦，参苓白术奏奇勋。
[注]
脾虚泻者，多因脾不健运，
故每逢食后作泻腹满不渴，精神短少，面黄懒食，肌肉消瘦也，
宜用参苓白术散以补脾，其泻自止。
(参苓白术散) 方见脾疳。
%
泻证门
清气下陷失健运，完谷不化飧泻名，补中益气汤升补，久泻肠滑用四神。
[注]
飧泻者，或因春伤风邪，清气下陷，脾失健运，以致完谷不化也，
治者须补养脾土，用补中益气汤升其中气，
若泄泻日久，肠滑不禁者，用四神丸治之。
(补中益气汤) 人参 黄耆蜜炙 当归土炒 白术土炒 炙甘草
陈皮 升麻土炒 柴胡醋炒 引用姜枣水煎服。
(方歌)
飧泻多因清阳陷，补中益气汤最验，参耆归术草陈皮，升麻柴胡功无限。
(四神丸) 补骨脂四两 五味子 肉豆蔻各二两面裹煨 吴茱萸一两水浸炒
以上为细末，生姜枣肉为丸，每服一钱，米饮下。
%
泻证门
脾胃湿盛成水泻，懒食溏泻色多黄，清浊不分溺短涩，胃苓升阳除湿汤。
[注]
水泻者，皆因脾胃湿盛，以致清浊不分，变成水泻之证，
其候小便短涩，懒食溏泻色黄，宜用胃苓汤以除湿，
若泻久不止，则用升阳除湿汤治之，其证自愈。
(胃苓汤) 苍术炒 陈皮 厚朴姜炒 白术土炒 茯苓 炙甘草 肉桂 泽泻 猪苓
姜红枣水煎服。
(方歌)
湿泻胃苓汤堪行，苍术陈皮厚朴同，白术茯苓炙甘草，肉桂泽泻共猪苓。
(升阳除湿汤)
苍术炒 陈皮 防风 神麴炒 麦芽炒 泽泻 炙甘草 升麻 羌活 柴胡
猪苓 引用生姜水煎服。
(方歌)
升阳除湿泻不停，苍术陈皮共防风，神麴麦芽泽甘草，升麻羌活柴猪苓。
%
Spleen deficiency leads to diarrhea immediately after eating, accompanied by abdominal fullness, lack of thirst, and listlessness; the complexion is sallow, appetite is poor, and muscles are emaciated. Shenling Baizhu San (Ginseng, Poria, and Atractylodes Macrocephala Powder) can achieve remarkable efficacy.
[Note]
Spleen-deficiency diarrhea is mostly caused by impaired spleen transportation and transformation functions.
Therefore, diarrhea occurs after every meal, accompanied by abdominal fullness, lack of thirst, insufficient spirit, sallow complexion, poor appetite, and muscle emaciation.
It is appropriate to use Shenling Baizhu San (Ginseng, Poria, and Atractylodes Macrocephala Powder) to tonify the spleen, upon which the diarrhea will naturally cease.
(Shenling Baizhu San) See the "Spleen Gan" chapter for the formula.
%
Diarrhea Syndrome Category
Clear qi sinking results in the loss of normal transportation and transformation; stool containing undigested food is named Sun Diarrhea (undigested food diarrhea). Treatment requires Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) to raise and tonify middle qi. If chronic diarrhea leads to intestinal slipping and incontinence, Sishen Wan (Four Miracles Pill) should be used.
[Note]
Sun Diarrhea (undigested food diarrhea) may occur due to wind pathogens injured in spring, causing clear qi to sink and the spleen to lose its normal transportation and transformation function, resulting in stool containing undigested food.
The practitioner must nourish the spleen earth and use Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) to raise the middle qi.
If diarrhea persists for a long time, leading to intestinal slipping and inability to control defecation, Sishen Wan (Four Miracles Pill) should be used for treatment.
(Buzhong Yiqi Tang [Tonify the Middle and Augment the Qi Decoction]) Renshen (Ginseng Radix), Huangqi (Astragali Radix, honey-fried), Danggui (Angelicae Sinensis Radix, soil-stir-baked), Baizhu (Atractylodis Macrocephalae Rhizoma, soil-stir-baked), Zhigancao (Prepared Licorice Root), Chenpi (Citri Reticulatae Pericarpium), Shengma (Cimicifugae Rhizoma, soil-stir-baked), Chaihu (Bupleuri Radix, vinegar-stir-baked). Add fresh ginger and jujube, decoct with water and take orally.
(Formula Song)
Sun Diarrhea is often due to sinking of clear yang; Buzhong Yiqi Tang is most effective. Ginseng, Astragalus, Angelica, Atractylodes, Licorice, and Citrus peel; Cimicifuga and Bupleurum have boundless merit.
(Sishen Wan [Four Miracles Pill]) Buguzhi (Psoraleae Fructus), four liang; Wuweizi (Schisandrae Chinensis Fructus); Rou Doukou (Myristicae Semen), each two liang, wrapped in flour and roasted; Wuzhuyu (Evodiae Fructus), one liang, soaked in water and stir-fried.
Grind the above into fine powder, make pills using ginger and jujube paste. Take one qian per dose, administered with rice drink.
%
Diarrhea Syndrome Category
Excessive dampness in the spleen and stomach forms Water Diarrhea, characterized by poor appetite, loose stools that are often yellowish, failure to distinguish between clear and turbid qi, and short, scanty, and difficult urination. Weiling Tang (Poria and Magnolia Bark Decoction) or Shengyang Chushi Tang (Raise Yang and Dispel Dampness Decoction) should be used.
[Note]
Water Diarrhea is all caused by excessive dampness in the spleen and stomach, leading to the failure to distinguish between clear and turbid qi, evolving into a syndrome of water diarrhea.
Its manifestations include short, scanty, and difficult urination, poor appetite, loose stools that are yellowish. It is appropriate to use Weiling Tang (Poria and Magnolia Bark Decoction) to dispel dampness.
If diarrhea persists for a long time without stopping, then Shengyang Chushi Tang (Raise Yang and Dispel Dampness Decoction) should be used for treatment, and the syndrome will heal itself.
(Weiling Tang [Poria and Magnolia Bark Decoction]) Cangzhu (Atractylodis Rhizoma, stir-fried), Chenpi (Citri Reticulatae Pericarpium), Houpo (Magnoliae Officinalis Cortex, ginger-stir-fried), Baizhu (Atractylodis Macrocephalae Rhizoma, soil-stir-baked), Fuling (Poria), Zhigancao (Prepared Licorice Root), Rougui (Cinnamomi Cortex), Zexie (Alismatis Rhizoma), Zhuling (Polyporus). Add fresh ginger and jujube, decoct with water and take orally.
(Formula Song)
For damp diarrhea, Weiling Tang is suitable; Atractylodes, Citrus peel, and Magnolia bark together. Atractylodes macrocephala, Poria, and prepared licorice; Cinnamon twig, Alisma, and Polyporus combined.
(Shengyang Chushi Tang [Raise Yang and Dispel Dampness Decoction])
Cangzhu (Atractylodis Rhizoma, stir-fried), Chenpi (Citri Reticulatae Pericarpium), Fangfeng (Saposhnikoviae Radix), Shenqu (Massa Medicata Fermentata, stir-fried), Maiya (Hordei Fructus Germinatus, stir-fried), Zexie (Alismatis Rhizoma), Zhigancao (Prepared Licorice Root), Shengma (Cimicifugae Rhizoma), Qianghuo (Notopterygii Rhizoma et Radix), Chaihu (Bupleuri Radix), Zhuling (Polyporus). Add fresh ginger, decoct with water and take orally.
(Formula Song)
Raise yang and dispel dampness to stop persistent diarrhea; Atractylodes and Citrus peel share with Saposhnikovia. Massa Medicata Fermentata, Hordeum, Alisma, and Licorice; Cimicifuga, Notopterygium, Bupleurum, and Polyporus.