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Liver heat punishing the spleen leads to diarrhea, which is referred to in the classics as *sun xie* (diarrhea with undigested food). Other symptoms should include borborygmus (intestinal rumbling), distension and fullness on both sides of the abdomen, sticky mouth with thirst, and dark urine. Treatment should aim to cool the liver and slightly tonify the stomach. Upon pulse diagnosis, the six pulses are lightly wiry; the stomach position exhibits a liver pulse, but not excessively wiry. Although the six pulses are wiry, they need not possess strong "bone force" (firmness), because diarrhea causes qi deficiency and lack of fullness. It is appropriate to use Jingjie San.

Jingjie Sui (Schizonepetae Spica, 1 fen) Fangfeng (Saposhnikoviae Radix) Shaoyao (Paeoniae Radix) Hezi Pi (Arecae Pericarpium) Qianghuo (Notopterygii Rhizoma et Radix) Gancao (Glycyrrhizae Radix et Rhizoma, each 1 fen) Baijili (Tribuli Fructus, 0.5 liang) Nongpo (Magnoliae Officinalis Cortex) Muxiang (Aucklandiae Radix, 3 zhu)

Grind the above into fine powder. At any time, decoct three qianbi (approx. 3-4 grams) of the powder with one cup of water and one jujube. Take the decoction together with the dregs.

Spleen dampness leading to diarrhea is described in the classics as abdominal fullness and loose stools (*tang xie*). Other symptoms include abdominal pain, heaviness of the body, reduced appetite, and in severe cases, flaccidity of the legs, frequent stumbling while walking, and pain in the soles of the feet. It is appropriate to use Xiaozhu Doukou San.

Caodoukou (Alpiniae Katsumadai Semen) Xiaozhu (Zedoary Rhizome / Stir-fried Atractylodis Macrocephalae Rhizome) Hezi Pi (Arecae Pericarpium, each 1 liang) Daxiong (Ligusticum Chuanxiong Rhizoma / Chuanxiong Rhizoma) Chenju Pi (Citri Reticulatae Pericarpium, each 0.5 liang) Gancao (Glycyrrhizae Radix et Rhizoma) Ben (Ligustici Wallichii Rhizoma et Radix / Gaoben, each 8 zhu) Duhuo (Angelicae Pubescentis Radix)

Grind the above into fine powder. On an empty stomach, decoct three qianbi of the powder with one cup of water, two slices of ginger, and two jujubes. Take the decoction (reduced to 80% volume) together with the dregs.

Cold from Kidney Water also generates loose stools, as cold and dampness act together to produce the same pathology. The classics further state that when cold forces the lower jiao, it transforms into *ru xie* (damp diarrhea); when yin qi enters the kidney orifices, it causes uncontrolled diarrhea, and *dong xie* (sudden profuse diarrhea) all belong to diseases generated by earth and water. Symptoms include: heaviness of the body, reduced appetite, abdominal pain, inability to move the limbs, and in severe cases, dysentery-like passage of red and white mucus, soreness and pain in the waist and knees, and inconvenience in the thighs and knees. If the pathology is due to Spleen dampness, the six pulses will be turbid like a leather pulse (tense on the outside, hollow inside), soggy, scattered, and large, feeling like mud under pressure. With added Kidney cold, the pulses become deep, hidden, slow, weak, and powerless upon movement. It is appropriate to treat both the water-cold and warm the Spleen and Kidneys. For warming the Spleen, Xiaozhu Doukou San is suitable; for warming the Kidney organ, Bixie Shengjin Wan is used.

Bixie (Dioscoreae Hypoglaucae Rhizoma) Hezi (Arecae Semen, each 1 liang) Shihu (Dendrobii Caulis) Xuduan (Dipsaci Radix) Peng'e Zhu (Curcumae Longae Rhizoma) Shanzhuyu (Corni Fructus) Xixin (Asari Radix et Rhizoma)

Grind the above into powder, mix with refined honey, and make pills the size of paulownia seeds. On an empty stomach, take 50-70 pills with rice soup.

Another prescription: Bo Shang Liuhuang Wan (see the section on Dysentery).

Excess Lung Metal can also cause borborygmus and loose stools. The Lung governs clear and肃 (descending/clearing) qi; when this flows into the middle jiao, it transforms into cold affecting the middle, leading to loose stools. Furthermore, since the Lung governs the lower abdomen, this disease arises. Other symptoms include: lower abdominal pain, a sense of cold in the center, and hypochondriac pain. The pulse is: six pulses are hair-like (floating and weak) and micro, without being floating. Hair-like indicates a Lung pulse; micro indicates diarrhea and weak qi. In early diarrhea, the original Lung pulse may show bias in one finger position; after one or two days, it changes to a micro pulse, merely lacking the floating quality. The Chi Ze point shows a deep, small, and striking pulse. It is appropriate to warm the Lung using Siwei Shaoyao San.

Wuaizhu (Stir-fried Atractylodis Macrocephalae Rhizoma) Shaoyao (Paeoniae Radix) Jiegeng (Platycodonis Radix) Xiangbaizhi (Angelicae Dahuricae Radix)

Grind the above into equal parts of fine powder. At any time, decoct three qianbi of the powder with one cup of water and three slices of fresh ginger. Add two jujubes, decoct until 80% remains, and take.