泄泻下利，沉小滑弱。实大浮洪，发热则恶。
泻痢见于下部，时时惟出，无论因之内外，总属伤阴耗里之虚证。沉小滑弱，
乃为相宜。（滑乃有余，似乎相反。然喜其有水液，而不因泻痢枯涸耳。大约宜五苓散、平胃散、
东垣升阳除湿汤、理中汤、五味子散、四神丸、七味白术散。痢则芍药汤、香连丸、益元散、败毒散、
东垣芍药黄芩汤、和剂真人养脏汤、金匮桃花汤、白头翁汤、和剂参苓白术散，俱当审寒热虚实
选用之。）若实大浮洪则恶矣。实大与虚反，浮洪与里反。邪盛正衰，不言可喻。再加发热，则阴
气弥伤，而里气弥耗，不至躁亡不已也。
五苓散（见第十七）
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
噫气吞酸，面黄肌瘦，体倦节痛。常自利，常发霍乱、反胃等证。
苍术（去粗皮、米泔浸，五斤） 陈皮（三斤二两，去白） 甘草（锉，炒，三十两） 浓朴（去粗皮、
姜制、炒，三斤二两）
上为细末。每服二钱。水一盏，姜三片，枣二枚，同煎七分，去滓温服。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，辟风寒冷湿不正之气。
东垣升阳除湿汤 治脾胃虚弱，不思饮食，肠鸣腹痛，泄泻无度，小便黄，四肢困弱。
甘草 大麦 面（如胃寒腹鸣者加） 陈皮 猪苓（以上各三分） 泽泻 益智仁 半夏 防风
神曲 升麻 柴胡 羌活（以上各五分） 苍术（一钱）
上 咀，作一服。水三大盏，生姜三片，枣二枚，同煎一盏。去滓，空心服。
理中汤（见第十七）
二神丸 治脾肾虚弱，侵晨五更作泻，全不思食，或食而不化，大便不实神效。
破故纸（四两，炒） 肉豆蔻（二两，生用）
用红枣四十九枚，生姜四两，同煮熟。去姜及皮核，取肉和药丸如梧子。每服五七十丸，空心盐汤下。
五味子散 治肾泄，在侵晨五更作泻，或大便不实，不时去后。
五味子（炒，二两） 吴茱萸（炒，五钱）
为末。每服二钱，白汤调服。为丸更妙。
四神丸 治脾肾虚弱，大便不实，饮食少思。即二神丸、五味子散合丸，空心食前服。
钱氏七味白术散 治中气亏损，津液短少，口舌干渴，或口舌生疮，不喜冷冻饮料，或吐泻后口干，最宜服。
人参 白术 木香 白茯苓 甘草 藿香（各五分） 干葛（一钱）
上，水煎服。
芍药汤 治便血后重。经曰∶溲而便脓血，知气行而血止也。行血，则便脓自愈。调气，则后重自除。
白芍药（二两） 当归 黄连 黄芩（各五钱） 槟榔 木香 甘草（各二钱） 桂（二钱半）
上 咀。每服五钱，水煎服。痢不减，加大黄。
香连丸 治痢疾，并水泻、暑泻，甚效。
黄连（十二两，另用吴茱萸十两为末。二味热水拌和，入瓷器，置热汤中顿一日，同炒至黄
连紫色，去茱用连）
为末。每四两，配木香一两，醋打米糊为丸，如梧子大。每服三十丸，白汤下。
久痢中气下陷，以补中益气汤下。中气虚者，四君子加姜桂汤下。
益元散（一名天水散，一名六一散） 治伤寒表里俱热，烦渴口干，小便不通及霍乱吐泻，下
利肠 ，五淋，及妇人产难，催生下乳。
桂府滑石（腻白者水飞，六两） 粉草（去皮，一两，研烂）
上为极细末。每服三钱，白汤调下，新水亦得。加薄荷末少许，名鸡苏散。加
青黛末少许，名碧玉散，治疗并同。
败毒散（见第三十七）
东垣芍药黄芩汤 治泄痢腹痛，或后重，身热，久不愈，脉洪疾者，及下痢脓血稠粘。
黄芩 白芍药（各一两） 甘草（五钱）
上 咀，每服一两，水一盏半，煎一盏，温服无时。如痛，加桂少许。
和剂真人养脏汤 治大人小儿冷热不调，下痢赤白，或便脓血，有如鱼脑，里急后
重，脐腹 痛，及脱肛坠下，酒毒湿毒，便血，并宜服。
人参 白术 当归（各六钱） 白芍药 木香（各一两六钱） 甘草 肉桂（各八钱） 肉果（
面裹煨，半两） 御米壳（蜜炙，三两六钱） 诃子肉（一两二钱）
上 咀，每服四钱，水一盏半，煎八分，去滓，食前温服。忌酒面生冷腥腻之
物。滑泄夜起，久不瘥者，加附子四片。
金匮桃花汤 治下痢脓血。
赤石脂（一斤，一半锉，一半筛末） 干姜（一两） 粳米（一升）
上先以水七升，煮米姜令熟，去滓，温七合，内石脂末方寸匕。日三服。若一服愈，勿服。
金匮白头翁汤 治热痢脓血。
白头翁（二两） 黄连 黄柏 秦皮（各三两）
上以水七升，煮二升，去滓。温服一升，不愈更服。
和剂参苓白术散 治久泻痢，或大病后调理。消渴者尤宜。
人参 干山药 莲肉（去心） 白扁豆（去皮，姜汁浸，炒，各一斤半） 于白术（二斤） 桔
梗（炒黄色） 砂仁 白茯苓（去皮） 薏苡仁 炙甘草（各一斤）
上为细末，每服二钱，米汤调下，或加姜枣煎服，或枣肉和丸，如桐子大。每
服七十丸，空心米饮下。或炼蜜丸如弹子大，汤化下。
Diarrhea and dysentery present with a deep, small, slippery, or weak pulse. If the pulse is full, large, floating, and forceful, accompanied by fever, the prognosis is ominous.
Diarrhea and dysentery manifest in the lower part of the body, characterized by frequent evacuation. Regardless of whether the etiology is internal or external, these conditions generally belong to deficiency syndromes that damage Yin fluids and deplete interior Qi. A deep, small, slippery, or weak pulse is appropriate. (Although a slippery pulse typically indicates excess, it seems contradictory here. However, its presence is favorable as it suggests the preservation of fluid moisture, indicating that the body fluids have not been dried up due to diarrhea or dysentery.) Generally suitable formulas include Wuling San (Five-Ingredient Poria Decoction), Pingwei San (Calm the Stomach Powder), Li Dongyuan's Shengyang Chushi Tang (Raising Yang and Expelling Dampness Decoction), Lizhong Tang (Regulate the Middle Decoction), Wuweizi San (Schisandra Powder), Sishen Wan (Four Spirits Pill), and Qian's Qiwei Baizhu San (Seven-Ingredient Atractylodes Macrocephala Powder). For dysentery specifically, suitable formulas include Shaoyao Tang (Peony Decoction), Xianglian Wan (Aromatic Coptis Pill), Yiyuan San (Benefit Primordial Powder), Baidu San (Resist Toxins Powder), Li Dongyuan's Shaoyao Huangqin Tang (Peony and Scutellaria Decoction), Renyang Yangzang Tang (Nourish Viscera Decoction) from *Taiping Huimin Heji Jufang*, Taohua Tang (Peach Blossom Decoction) from *Jingui Yaolue*, Baitouweng Tang (Pulsatilla Decoction) from *Jingui Yaolue*, and Shenling Baizhu San (Ginseng, Poria, and Atractylodes Macrocephala Powder) from *Taiping Huimin Heji Jufang*. These should be selected based on an assessment of cold, heat, excess, and deficiency. (Wuling San is detailed in Chapter 17.)
Pingwei San (Calm the Stomach Powder): Treats disharmony of the Spleen and Stomach, loss of appetite, distending pain and stabbing pain in the heart, abdomen, hypochondrium, bitter taste in the mouth, lack of flavor, chest fullness, shortness of breath, vomiting, belching, acid regurgitation, sallow complexion, emaciation, fatigue, and joint pain. It treats spontaneous diarrhea, recurrent cholera-like disorders, and regurgitation.
Ingredients: Cangzhu (Rhizoma Atractylodis Lanceae) (remove coarse skin, soak in rice wash water, 5 jin); Chenpi (Pericarpium Citri Reticulatae) (3 jin 2 liang, remove white pith); Gancao (Radix Glycyrrhizae Preparata) (cut, stir-fried, 30 liang); Houpo (Cortex Magnoliae Officinalis) (remove coarse skin, process with ginger juice, stir-fried, 3 jin 2 liang).
Preparation and Administration: Grind into fine powder. Take 2 qian per dose. Add 1 chalice of water, 3 slices of fresh ginger, and 2 jujubes. Decoct until reduced to 7/10 volume. Strain and take warm. Alternatively, omit ginger and jujube and take hot. Take on an empty stomach before meals. Taking 1 pinch of salt dissolved in boiling water is also acceptable. Regular use regulates Qi, warms the Stomach, resolves retained food, eliminates phlegm-fluids, and wards off pathogenic wind, cold, and dampness.
Li Dongyuan's Shengyang Chushi Tang (Raising Yang and Expelling Dampness Decoction): Treats Spleen-Stomach Qi deficiency, loss of appetite, borborygmus, abdominal pain, unceasing diarrhea, yellow urine, and weakness/heaviness in the four limbs.
Ingredients: Gancao (Radix Glycyrrhizae Preparata); Damai Mian (Farina Hordei Vulgaris) (add if Stomach cold with borborygmus); Chenpi (Pericarpium Citri Reticulatae); Zhuling (Sclerotium Polypori) (each 3 fen); Zexie (Rhizoma Alismatis); Yizhiren (Fructus Alpiniae Oxyphyllae); Banxia (Rhizoma Pinelliae Preparata); Fangfeng (Radix Saposhnikoviae); Shenqu (Massa Medicata Fermentata); Shengma (Rhizoma Cimicifugae); Chaihu (Radix Bupleuri); Qianghuo (Rhizoma Notopterygii) (each 5 fen); Cangzhu (Rhizoma Atractylodis Lanceae) (1 qian).
Preparation and Administration: Cut into pieces. Use one dose. Add 3 large chalices of water, 3 slices of fresh ginger, and 2 jujubes. Decoct until reduced to 1 chalice. Strain and take on an empty stomach.
Lizhong Tang (Regulate the Middle Decoction) (See Chapter 17).
Ershen Wan (Two Spirits Pill): Treats Spleen-Kidney deficiency, morning diarrhea occurring at the fifth watch (5-7 AM), complete anorexia, indigestion, and loose stools. Highly effective.
Ingredients: Poguzhi (Fructus Psoraleae) (4 liang, stir-fried); Roudoukou (Semen Myristicae) (2 liang, raw).
Preparation and Administration: Cook 49 jujubes and 4 liang of fresh ginger together until soft. Remove ginger and jujube pits/skins. Mix the jujube flesh with the powdered herbs to form pills the size of mulberry seeds. Take 50-70 pills per dose on an empty stomach with salted water.
Wuweizi San (Schisandra Powder): Treats Kidney diarrhea (morning diarrhea), occurring at the fifth watch, or loose stools with frequent urgency.
Ingredients: Wuweizi (Fructus Schisandrae Chinensis) (stir-fried, 2 liang); Wuzhuyu (Fructus Evodiae Officinalis) (stir-fried, 5 qian).
Preparation and Administration: Grind into powder. Take 2 qian per dose, mixed with plain boiled water. Forming pills is superior.
Sishen Wan (Four Spirits Pill): Treats Spleen-Kidney deficiency, loose stools, and poor appetite. It is formed by combining Ershen Wan and Wuweizi San. Take on an empty stomach before meals.
Qian's Qiwei Baizhu San (Seven-Ingredient Atractylodes Macrocephala Powder): Treats deficiency of Middle Qi, shortage of body fluids, dry mouth and tongue, oral ulcers, aversion to cold drinks, or dry mouth after vomiting/diarrhea. Most suitable for these conditions.
Ingredients: Renshen (Radix Ginseng); Baizhu (Rhizoma Atractylodis Macrocephalae); Muxiang (Radix Aucklandiae); Baifuling (Poria cum Radix Pini); Gancao (Radix Glycyrrhizae Preparata); Huoxiang (Herba Agastaches); Genge (Radix Puerariae Lobatae) (each 5 fen); Gan Ge (Radix Puerariae Lobatae) (1 qian).
Preparation and Administration: Decoct in water and take.
Shaoyao Tang (Peony Decoction): Treats bloody stool with tenesmus (heaviness in the rectum). The Classics state: "When urination is difficult and pus/blood appear in stool, know that moving Qi stops bleeding." Moving blood heals pus/bloody stool; regulating Qi relieves tenesmus.
Ingredients: Baishaoyao (Radix Paeoniae Lactiflorae) (2 liang); Danggui (Radix Angelicae Sinensis); Huanglian (Rhizoma Coptidis); Huangqin (Radix Scutellariae) (each 5 qian); Binglang (Semen Arecae); Muxiang (Radix Aucklandiae); Gancao (Radix Glycyrrhizae Preparata) (each 2 qian); Guizhi (Ramulus Cinnamomi) (2.5 qian).
Preparation and Administration: Cut into pieces. Take 5 qian per dose, decoct in water. If dysentery persists, add Dahuang (Radix et Rhizoma Rhei).
Xianglian Wan (Aromatic Coptis Pill): Treats dysentery, watery diarrhea, and summerheat diarrhea. Very effective.
Ingredients: Huanglian (Rhizoma Coptidis) (12 liang; separately, grind Wuzhuyu (Fructus Evodiae Officinalis) (10 liang) into powder. Mix the two with hot water, place in a porcelain vessel, set in hot water for one day, then stir-fry together until Huanglian turns purple. Discard Wuzhuyu, keep only Huanglian).
Preparation and Administration: Grind into powder. For every 4 liang of Huanglian, mix with 1 liang of Muxiang (Radix Aucklandiae). Use vinegar and rice paste to form pills the size of mulberry seeds. Take 30 pills per dose with plain boiled water.
For chronic dysentery with sinking of Middle Qi, administer with Buchong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction). For Middle Qi deficiency, administer with Sijunzi Tang (Four Gentlemen Decoction) plus Jiang (Zingiberis Rhizoma) and Guizhi (Ramulus Cinnamomi).
Yiyuan San (Benefit Primordial Powder) (Also known as Tianshui San or Liuyi San): Treats exterior and interior heat from Cold Damage, irritability, thirst, dry mouth, urinary obstruction, cholera-like vomiting/diarrhea, intestinal dysentery, five types of strangury, and difficult labor in women (to induce labor and promote lactation).
Ingredients: Huashi (Talcum) (fine, white, processed by water flotation, 6 liang); Fengancao (Radix Glycyrrhizae Preparata) (peeled, 1 liang, ground).
Preparation and Administration: Grind into extremely fine powder. Take 3 qian per dose, mixed with plain boiled water or new well water. Adding a little Bohe (Herba Menthae) powder creates Jisu San (Chicken Su Powder). Adding a little Qingdai (Indigo Naturalis) powder creates Biyu San (Jade Green Powder). Therapeutic effects are the same.
Baidu San (Resist Toxins Powder) (See Chapter 37).
Li Dongyuan's Shaoyao Huangqin Tang (Peony and Scutellaria Decoction): Treats abdominal pain from diarrhea/dysentery, tenesmus, fever, chronic non-healing cases with rapid/hyperactive pulses, and sticky pus/blood in stool.
Ingredients: Huangqin (Radix Scutellariae); Baishaoyao (Radix Paeoniae Lactiflorae) (each 1 liang); Gancao (Radix Glycyrrhizae Preparata) (5 qian).
Preparation and Administration: Cut into pieces. Take 1 liang per dose. Add 1.5 chalices of water, decoct to 1 chalice. Take warm at any time. If painful, add a small amount of Guizhi (Ramulus Cinnamomi).
Taiping Huimin Heji Jufang's Renyang Yangzang Tang (Nourish Viscera Decoction): Treats adults and children with imbalance of cold and heat, dysentery with red and white discharge, pus/blood in stool resembling fish brains, tenesmus, colic, rectal prolapse, alcohol toxicity, damp-toxin, and bloody stool. Suitable for all these conditions.
Ingredients: Renshen (Radix Ginseng); Baizhu (Rhizoma Atractylodis Macrocephalae); Danggui (Radix Angelicae Sinensis) (each 6 qian); Baishaoyao (Radix Paeoniae Lactiflorae); Muxiang (Radix Aucklandiae) (each 1 liang 6 qian); Gancao (Radix Glycyrrhizae Preparata); Rougui (Cortex Cinnamomi) (each 8 qian); Ranguo (Semen Myristicae) (wrapped in flour, baked, 0.5 liang); Yumike (Pericarpium Papaveris) (honey-fried, 3 liang 6 qian); Hezi Rou (Semen Terminaliae Chebulae) (1 liang 2 qian).
Preparation and Administration: Cut into pieces. Take 4 qian per dose. Add 1.5 chalices of water, decoct to 0.8 volume. Strain and take warm before meals. Avoid alcohol, wheat products, cold/raw, greasy, and fishy foods. For slippery diarrhea with nocturnal onset and chronic non-resolution, add 4 slices of Fuzi (Radix Aconiti Lateralis Preparata).
Jingui Yaolue's Taohua Tang (Peach Blossom Decoction): Treats dysentery with pus and blood.
Ingredients: Chishizhi (Halloysitum Rubrum) (1 jin, half cut, half sifted into powder); Ganjiang (Rhizoma Zingiberis Secati); Jingmi (Semen Oryzae Sativae) (1 sheng).
Preparation and Administration: First, add 7 sheng of water, boil Jingmi and Ganjiang until cooked. Strain. Take 0.7 he of the liquid warm, mixing in 1 fangcun bi (square-inch spoonful) of Chishizhi powder. Take three times daily. If cured after one dose, stop taking it.
Jingui Yaolue's Baitouweng Tang (Pulsatilla Decoction): Treats heat-dysentery with pus and blood.
Ingredients: Baitouweng (Herba Pulsatillae); Huanglian (Rhizoma Coptidis); Huangbai (Cortex Phellodendri); Qinpi (Cortex Fraxini) (each 3 liang).
Preparation and Administration: Add 7 sheng of water, decoct to 2 sheng. Strain. Take 1 sheng warm. If not cured, take again.
Taiping Huimin Heji Jufang's Shenling Baizhu San (Ginseng, Poria, and Atractylodes Macrocephala Powder): Treats chronic diarrhea/dysentery or post-illness recovery. Especially suitable for Xiao Ke (Wasting-Thirst).
Ingredients: Renshen (Radix Ginseng); Shanyao (Rhizoma Dioscoreae Oppositae); Lianrou (Semen Nelumbinis) (remove heart); Bian Dou (Semen Phaseoli Umbellati) (peel, soak in ginger juice, stir-fry, each 1.5 jin); Baizhu (Rhizoma Atractylodis Macrocephalae) (2 jin); Jiegeng (Radix Platycodonis); Sharen (Fructus Amomi); Baifuling (Poria cum Radix Pini); Yiyiren (Semen Coicis); Zhi Gancao (Radix Glycyrrhizae Preparata) (each 1 jin).
Preparation and Administration: Grind into fine powder. Take 2 qian per dose, mixed with rice water. Alternatively, decoct with ginger and jujube, or mix with jujube flesh to form pills the size of paulownia seeds. Take 70 pills per dose on an empty stomach with rice drink. Or, refine honey to form pills the size of quail eggs, dissolve in water, and take.