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Long-standing diarrhea that fails to heal can be treated with Baoyuan Tang (Preserve the Origin Decoction) added with Atractylodis Macrocephalae Rhizoma (Baizhu), Poria (Fuling), and Pine Flower Pollen (Songhua) decocted for administration, or added with Aconiti Lateralis Radix Praeparata (Fuzi). For all types of diarrhea, Sijunzi Tang (Four Gentlemen Decoction) is suitable. Acute diarrhea due to food stagnation is treated with Weiling Tang (Gastrointestinal Regulation Decoction); summer diarrhea caused by damp-heat with difficulty in urination is treated with Wuling San (Five-Ingredient Powder with Poria); diarrhea of green watery stool with tenesmus is treated with Xianglian Wan (Coptis and Aucklandia Pill); chronic diarrhea is treated with Sijunzi Tang added with Angelicae Dahuricae Radix (Baizhi) and Scutellariae Radix (Huangqin); if vomiting occurs, add Zingiberis Rhizoma Praeparatum (Paojiang) and remove Baizhi; chronic diarrhea with abdominal fullness and oppression is treated with Buzhong Yiqi Tang (Decoction to Supplement the Middle and Augment the Qi) with Dangguishen (Radix Angelicae Sinensis Stem) removed and Fuzi added; if there is body heat, add Notopterygii Rhizoma et Radix (Qianghuo) and Saposhnikoviae Radix (Fangfeng), as wind can overcome dampness. Diarrhea occurring every morning is treated with Shenshen Wan (Four Miracles Pill); Kidney-type diarrhea (Wu Geng Xie) is treated with Schisandrae Fructus (Wuweizi) two liang and Evodiae Fructus (Wuyu) five qian, ground into powder and taken with aged rice water, combined with moxibustion on Qihai (CV6). Chronic diarrhea with spontaneous sweating, tidal fever, and aversion to cold is treated with Jianzhong Tang (Decoction to Establish the Middle) added with Ginseng Radix et Rhizoma (Renshen) and Fuling. Tidal fever cannot be cured without tonification. Morning chronic diarrhea with spontaneous sweating, tidal fever, and nocturnal emission... [text gap] ... other diarrheas are treated with Wuling San. If accompanied by abdominal distension and pain, administer salt water to induce vomiting; if accompanied by body heat and spontaneous sweating, take with hot water; if passing hot water, take with cold water; if thirsty, take with Ginseng decoction. Diarrhea accompanied by fever and fatigue should be treated by nourishing blood within the Qi level, using Baoyuan Tang or Sijunzi Tang added with Paeoniae Radix Alba (Baishao) and Songhua. Chronic diarrhea damages the Kidney; for adults and children alike, regardless of vomiting or diarrhea, tonifying the Spleen is appropriate. Even if there are other miscellaneous syndromes, they need not be treated initially; afterwards, Shenling Baizhu San (Poria, Atractylodes Macrocephala and Licorice Powder) added with Aucklandiae Radix (Muxiang), Amomi Fructus Rotundus (Sharen), and Cardamomi Fructus (Doukou) is used for regulation. Chronic diarrhea may involve constrained fire; add a small amount of Coptidis Rhizoma (Huanglian). For children with accumulation, Sijunzi Tang is added; nothing surpasses this method.

For all diarrheas, Sijunzi Tang is suitable. Add Songhua for heat, Paojiang for cold, Ge Gen (Kudzu Root) and Wuweizi for thirst, Baizhi and Huangqi (Astragalus Root) for exterior heat and exterior deficiency. Diarrhea with white bubbles and audible sounds indicates damp-heat in the Small Intestine, treated with Pingwei San (Regulate the Stomach Powder) added with Paojiang. Ordinary loose stools are effectively treated by decocting Hongmi (Red Rice) and Heidou (Black Soybean) after frying.

For severe vomiting and diarrhea where food and water cannot be retained, and grains are undigested, these belong to Cold syndromes, treated with Lizhong Tang (Decocton to Regulate the Middle). Restlessness, thirst, yellow stool like porridge, and sour foul odor belong to Heat syndromes, treated with Shaozhen Wan (Burned Needle Pill). In cases of no Qi deficiency but Cold in the Zang organs causing diarrhea, use Rou Dou Kou (Nutmeg) four liang, Muxiang one liang, Fuling four liang, Paojiang one liang, and Fuzi one liang, ground into powder and made into pills with ginger juice, taken with Nelumbinis Plumula (Lianxin) decoction, 50-60 pills at a time. Spleen-type diarrhea refers to morning diarrhea; if diarrhea occurs with sound during Yin-Mao hours (3-7 AM), it is called Liver-type diarrhea; if diarrhea occurs at midnight (Zi hour, 11 PM-1 AM), it is called Kidney-type diarrhea, as the Kidney governs the two orifices. Use Eucommiae Cortex (Duzhong) one liang and Shengjiang (Fresh Ginger) one liang, stir-fried together until dry, plus Wuweizi and Rou Dou Kou one liang each, Psoraleae Fructus (Buguzhi) one liang, and Wuyu two qian, ground into powder. Make pills with dates boiled in ginger water. For Kidney deficiency causing diarrhea, use Shudi (Prepared Rehmannia Root) and Shengjiang one liang each, boiled together, pounded into cakes, dried, then mixed with Dioscoreae Rhizoma (Shanyao) and Fuling one liang each, made into pills. For Spleen diarrhea, use Baizhu one jin sliced, and Dazao (Jujube) eight liang, layering Baizhu and Dazao in a jar, boiling until soft, pounding into cakes, drying, then mixing with Songhua four liang, stir-fried until yellow, and made into pills with rice paste.

Case Records
One patient felt abdominal relief when defecating at night, but bloating occurred if he did not. The Heart pulse was surging, the Liver pulse floating, and the Kidney pulse tight. This indicates the Heart is not governing properly, and Ministerial Fire acts on its behalf; Kidney Water is stirred by Liver Wood, so the diarrhea originates in the Kidney. Tonifying the Kidney is inferior to tonifying the Spleen; warming the Spleen also solidifies the Kidney. Use Euryales Semen (Qianshi), Shanyao, and Fuling each one qian, Renshen five fen, Shudi four fen, and Yizhiren (Alpinia Oxyphylla Fruit) three fen, decocted for administration. For pills, use Wuweizi two liang and Wuyu four qian, made into pills with date flesh, taken with warm water, 30 pills per dose.

One person, fond of drinking, suffered from morning diarrhea after alcohol intoxication, with abdominal and leg pain, and joint pain, indicating internal damp-heat. Use Baizhu, Fuling, Polyporus (Zhuling), Qianghuo, Bei Wuweizi, Ze Xie, and Qin Jiao. One prescription stops it immediately; taking it upon recurrence cures it.

One person suffered from diarrhea and cholera-like symptoms for three years since spring. Each episode resolved with Lizhong Tang. After stopping medication, chest pain felt like knife-cutting; slight dietary indiscretion led to pain for three to four days and diarrhea resembling red yeast rice meat soup. Blood-nourishing medicines were used. Half a year later, abdominal pain lasted six days; Sijunzi Tang added with Fuzi, Paojiang, and Baishao was used, combined with moxibustion on Qihai (CV6), leading to recovery.

One person had six pulses that were deep and Yin, weak and unclear upon heavy pressure, indicating Kidney deficiency. Epigastric pain followed by diarrhea, with pain episodes triggering diarrhea episodes, indicates deficient fire floating upward from the Kidney-Spleen. Tonifying the Spleen depletes Kidney Water; nourishing Yin causes Water to insult Earth. The treatment method is to warm the Kidney, which thereby warms the Spleen. Having not conceived a child for thirty years, Kidney Cold is evident. The Kidney governs bones; shin pain is a sign of Kidney deficiency. Use Dihuang Tang (Rehmannia Decoction) and Buzhong Yiqi Tang with modifications. For pills: Shanyao and Fuling two liang each, Buguzhi, Huixiang (Fennel), Shudi, Duzhong, and Bei Wuweizi one liang each, Renshen seven qian, Chen Huo Rou Gu Hui (Ash of Charred Meat Bone) one liang, and Wuyu five fen.

One person suffered from chronic Spleen diarrhea due to Heat in the Kidney. Use Baizhu eight liang, Fuling five liang, and Yuan Mi (Regular Rice) five he, placed inside a pig stomach, cooked until soft, pounded into cakes, dried, ground into powder, and made into pills with rice paste, coated with Chenxiang (Agarwood) three qian.

One person with diarrhea had a slightly surging Heart pulse and deficient Liver-Kidney pulses. Treating only diarrhea risks Earth insulting Water. Use Baizhi three qian to raise Stomach Qi; Wuweizi stops diarrhea and harmonizes Earth and Water. Made into pills with rice paste, taken with clear rice water before noon, 50 pills.

Pediatric diarrhea unceasing, unresponsive to Sijunzi Tang modifications, indicates internal constrained damp-heat. Treat by regulating the Spleen and cooling the Kidney. Baizhu one qian, Songhua five fen, ground into powder and taken with white sugar. Alternatively, boil Baizhu one liang, stir-fry Hongqu (Red Yeast Rice) one liang, mix with Chen Huo Rou Gu Hui one liang, grind to fine powder, and take with white sugar.

One person had pain around the navel, triggering diarrhea upon pain, indicating Spleen deficiency with Kidney Water invading upward and Cold in the Kidney. Warming the Kidney calms the Water; raising Stomach Qi strengthens Earth, stopping pain and thus stopping diarrhea. Use Baizhi seven qian, Bei Wuweizi, Lurong (Deer Antler), Renshen, and Paojiang one liang each, made into pills with Yuan Mi paste, taken with warm water.

A child suffered diarrhea, over-treated with purgatives, resulting in whole-body heat and preference for lying on cold ground. This is due to Kidney deficiency causing diarrhea, leading to Liver Fire rising and Dryness in the Stomach.

A woman had a weak Mingmen pulse, attributed to lack of Fire. Diarrhea imminent at cockcrow, with abdominal rumbling and fullness, indicates Kidney deficiency failing to grasp Qi. Use Buguzhi four liang to tonify Mingmen, made into pills with date flesh to benefit Qi and thicken the intestines.

A woman with diarrhea had spiritless Chi pulses on both sides, indicating Kidney Dryness and failure to close. A doctor used Fuling and Yizhiren, causing dizziness. Instead, use Congrong (Cistanche) three qian to moisten, Bei Wuweizi eight fen to secure, Renshen one qian to benefit Qi, Dangguishen eight fen to nourish Blood, Baishao and Gancao (Licorice) to harmonize the Middle, and Paojiang two fen to calm the Kidney. Two prescriptions showed effect; ten prescriptions cured it. Pills use the same formula doubled, made with honey. (Zhang Dongfu said: "Kidney Dryness and failure to close" is an excellent phrase. All things, when moist, are firm and seamless; when dry, they crack and show flaws. The Kidney opens into the two lower orifices; when the Kidney is depleted and dry, the orifices open and fail to close. This is truly profound truth.)

Zhang Dongfu said: Due to Shenzhai's words on "Kidney Dryness and failure to close," I reflected that Seminal Wetness (Huajing) shares similar principles. The Kidney belongs to Water; Water deficiency leads to Dryness. Dry Water cannot nourish the Liver. Without Water nourishment, Wood becomes dry and generates Fire. Having lost its function of sealing and storing, the Kidney opens instead of closing; the Liver then indulges its dispersing nature, leading to leakage. The more leakage, the drier it becomes; the drier it becomes, the more it opens. Thus, for seminal emission/leakage, after extreme severity or long duration, merely clearing Fire is useless, and merely astringing is useless. One must use Moistening herbs to moisten the Kidney, so that Dryness and failure to close can reunite. Moreover, the Liver gets nourished, and Fire does not blaze, preventing erratic dispersal. The prescription principle should focus on moistening the Kidney, while simultaneously using herbs to clear and tonify the Liver, which would be especially effective... [text gap]. Regarding Seminal Wetness, in its early stages caused by thoughts/desires, the primary treatment should be clearing the Heart, assisting with clearing Liver Fire, and supporting with tonifying Kidney Water; astringent herbs are unnecessary. After long duration, Kidney Water must be deficient and dry; the main treatment should be tonifying Kidney and Liver, secondary clearing Liver Fire, tertiary clearing Heart Fire, with astringents used adjunctively, but not as the sovereign herb. If severe uncontrollable leakage occurs, and the "Jade Gate" does not close, temporarily using astringents as sovereign herbs, combined with heavily tonifying Kidney and Liver, slightly assisted by Fire-clearing agents, is logically appropriate. Furthermore, lifting herbs must be added to ensure thoroughness and rapid efficacy. These discussions on emission syndromes refer mainly to excessive desire and Kidney deficiency types. Cases caused by damp-heat, phlegm, etc., cannot generally be treated solely based on Kidney Dryness... [text incomplete]