〔曾〕论泻之原，有冷泻、热泻、伤食泻、水泻、积泻、惊泻、风泻、脏寒泻、疳积酿泻、种种不同，各分
于后。冷泻，多是白水，泻密而少，腹痛而鸣，眉皱目慢，面带白色，额有汗，多用冲和饮（慢惊）、当归散（潮热）
合和，水煨姜煎服，并守中汤（本条）参苓白术散（不乳食）、益中膏（本条）、沉香槟榔丸（不乳食）治之。热泻，大
便黄色，如
筒吊水，泻过即止，半日复然，心烦口渴，小便黄少，食乳必粗，先用五苓散（惊）或大顺饮（吐），次以钱氏白术
散（渴）主之，香薷散（吐泻）亦佳。伤食泻，乃脾胃素弱，复为生冷果食所伤，故大便不聚而泻，或因乳母餐生冷肥
腻之物，自乳而过，亦能作泻，面唇俱白，泻稀而少，或如坏鸡子，腥臭异常，身形黄瘦，宜先温正胃气，次理积，
而后固脾，冲和饮（慢惊）、当归散（潮热）合和，水煨姜、枣子煎服。理积，儿大者乌犀丸（吐），小者化癖
丸（癖）、三棱散（宿食）、固脾和中散（吐泻）、醒脾散（慢惊）。水泻，谓之洞泄，乃阴阳不顺，水谷不分，
泻黄水而小便少，番次密而无度，是夏秋之际，昼则解衣取凉，夜则失盖感冷，
冷热相激，清浊浑乱，或因母自热中来，乳有热气，遽以哺之，令儿脾胃不和，水谷交杂而下，以 咀五苓散（惊）
加薏苡仁、车前子、半夏，水姜煎服，分正阴阳，或先用大顺饮（吐）、温白汤调下香薷散（吐泻），调中止泻，钱氏白
术
散（渴）、六和汤（吐泻）亦好。积泻，脾气虚弱，乳食入胃，不能运化，积滞日久，再为冷食所伤，传之大肠，
遂成泄泻，留连不止，诸药无效，盖以积在脾胃，积既未除，何由得愈，宜先去积，后止泻，泻止，实脾则病除矣，三
棱散（宿食）、乌犀丸（吐），续用沉香槟榔丸（不乳食）、参苓白术散（慢惊）、和中散（吐泻）、香橘饼（本条）调理。
惊泻，
粪青如苔，稠若胶粘，不可便止，但镇心抑肝，和脾胃，消乳食，斯为治法。先投五苓散（惊），次用三棱散（宿食），
水姜仓米煎服，或三解散（潮热）、神曲生姜煎汤调服，及沉香槟榔丸（不乳食），不惊丹（惊）调治。风泻，慢惊
大病后有之，其粪稀，黄褐色，或夹不消乳食同下，此因脾虚所致，或夹黑褐色者属肾，盖脾虚为
肾水所乘故也，若久不进饮食，再有惊搐，宜疏肾水，去脾风，次补脾，则自愈，庶无复作之患。疏肾水， 咀五苓
散（惊）加黑牵牛，半生半炒，并薏苡仁、水、姜煎服。去脾风，泻黄散（脾）。调脾气，参苓白术散（不乳食）。脏
寒泻，粪如青竹色，不稀不稠，或下青水，未泻时腹痛而鸣，叫哭方泻，多是生来三五月内有此，周岁则无，始因
断脐带短，风冷自外逼内而成，此疾先用冲和饮（慢惊）水葱白煎投，温中解表，次以当归散（潮热）水煨姜煎服，及
投匀气散（疝）理中汤（吐泻）。疳积酿泻，其候面色痿黄，肚胀脚弱，头大项小，发稀且竖，肌肉消瘦，不思饮食，昼
凉
夜热，或腹内有症癖气块，泻则颜色不等，其臭异常，其泻有时，或一月、半月、旬日、一番，自泻自止，名
为疳积酿泻，先以当归散（潮热）加三棱、陈皮，水姜煎服，次投乌犀丸（吐）、沉香槟榔丸（不乳食）及化癖丸（癖）、
芦荟丸（疳
）、没石子丸（本条），儿最小者难下丸子，止投三棱散（宿食）、快膈汤（痞），自然痊愈。若泻或痢色青，甚而
淡黄夹白，寒多热少，此阴邪胜阳，宜用守中汤、胃苓汤（俱本条）与服，扶表救里，方进当归散（潮热）加陈
皮、紫苏、水姜糯米煎服。亦宜和解，理中汤（吐泻），清米饮空心调服，温脾去湿，益气清神。寒盛者，理中汤
内加熟附子水姜枣煎服，次投南星腹皮饮，水姜煎服，和脾胃去阴邪。若泻或泄，色青淡而有沫黄稠，热多寒少，
亦致面黄肌瘦，烦躁不宁，宜以 咀五苓散加薏苡仁、车前子，水姜煎服，解散余邪，仍用茵陈蒿、栀子仁，煎汤
调细末五苓散温服，退黄色，消阳毒，及当归散，水姜枣煎投，或服万安饮（积热）、四神丸。
《养生》治大小老虚之人不拘冷热泄泻。
黄连（去须） 白芍药（并锉如豆） 吴茱萸（各十两）
上三味，釜内慢火炒赤色，放冷，杵罗为细末。每服三钱匕，水一盏半，煎至八九分，去滓，空腹食前
温服，日三四服，小儿量与。或以水浸蒸饼、丸如桐子大。更丸一等如绿豆、黄米大。小儿每服十五丸至二十丸，
温米饮下。若作散，以沸汤或温米饮调下，并可服。病泄痢之人，若不禁生冷鱼肉肥腻，与不服药同。
一方，有木香，无芍药，醋糊丸。
〔茅先生〕香连丸 治泻利。
木香 黄连（茱萸半两，同于铫内炒，令烟起，取出，去茱萸） 肉豆蔻 诃子（炮去核。各半两） 阿胶
（面炒） 朱砂（各一钱）
上为细末。软饭为丸，如桐子大。每服十丸、十四丸，用饭饮吞下。儿小，碎之。
乳香散 治一切泻痢。
乳香（二钱，用荷叶于炭火上炙令半熔，放地上，碗盖，另研） 肉豆蔻 白姜 甘草（炙） 草果子（各一两）
上细锉，用醋面裹，于热灰内煨令赤色，取出去面为末，入乳香末拌匀。每服半钱、一钱，陈米饭饮调下。
[Zeng's discussion] The causes of diarrhea include cold diarrhea, heat diarrhea, food-stagnation diarrhea, water diarrhea, accumulation diarrhea, fright diarrhea, wind diarrhea, visceral-cold diarrhea, and malnutrition-induced diarrhea, among others, which vary greatly. They are described separately below.
Cold diarrhea: Stool is mostly white watery fluid, with frequent but scanty bowel movements, abdominal pain accompanied by borborygmus, furrowed brows, sluggish eyes, pale complexion, and sweating on the forehead. Chonghe Yin (Cure for Slow Convulsion) and Danggui San (Blood Tonic Powder) may be combined and decocted with water-warmed ginger; Shouzhong Tang (Prescription from this section), Shenling Baizhu San (Ginseng, Poria, and Atractylodes Macrocephala Powder), Yizhong Gao (Middle-Boosting Paste), and Chenxiang Binglang Wan (Aucklandia and Betel Nut Pill) can also be used for treatment.
Heat diarrhea: Stool is yellow and flows straight like water pouring from a bamboo tube, stopping immediately after defecation but recurring half a day later. Symptoms include irritability, thirst, and scanty yellow urine. Vomiting often occurs after feeding. Initially, Wuling San (Five-Ingredient Powder with Poria) or Dashun Yin (Great Harmony Drink) may be used for fright or vomiting respectively; subsequently, Qian's Baizhu San (Child's Atractylodes Powder) for thirst is the main prescription, while Xiangru San (Mosla Powder) is also effective for vomiting and diarrhea.
Food-stagnation diarrhea: This results from inherent spleen and stomach weakness compounded by injury from raw, cold fruits and foods, leading to unformed stools and diarrhea. Alternatively, if the nursing mother consumes raw, cold, or greasy foods, these can pass through breast milk and induce diarrhea in the infant. Signs include pale face and lips, thin and scanty stool resembling spoiled eggs with an abnormal fishy odor, yellowish emaciation. Treatment should first warm and regulate stomach qi, then resolve stagnation, and finally secure the spleen. Chonghe Yin and Danggui San may be combined and decocted with water-warmed ginger and jujube. To resolve stagnation, older children may take Wu Xi Wan (Black Rhinoceros Horn Pill) for vomiting, while younger ones may use Huapi Wan (Stagnation-Resolving Pill), Sanleng San (Curcuma Powder), Gupi Hezhong San (Spleen-Securing and Middle-Harmonizing Powder), or Xingpi San (Spleen-Awakening Powder).
Water diarrhea, also known as "drainage diarrhea" (Dongxie), arises from disharmony of yin and yang and failure to separate clear from turbid fluids. It presents with yellow watery stools, scanty urination, and frequent, uncontrolled bowel movements. This often occurs in summer and autumn when one exposes the body to cool air during the day and loses cover at night, causing cold and heat to clash and confuse the clear and turbid qi. It may also result from a mother bringing heat into her breast milk and nursing immediately, disturbing the infant's spleen and stomach, causing water and grain to mix and descend. Treat with crushed Wuling San plus Coicis Semen (Yiyiren), Plantaginis Semen (Cheqianzi), and Pinelliae Rhizoma (Banxia), decocted with water and fresh ginger to harmonize yin and yang. Alternatively, use Dashun Yin followed by Xiangru San taken with Wenbai Tang to regulate the middle and stop diarrhea. Qian's Baizhu San and Liuhe Tang are also suitable.
Accumulation diarrhea: Due to weak spleen qi, ingested milk and food cannot be transformed. Long-standing stagnation, further injured by cold foods, transmits to the large intestine, resulting in persistent diarrhea unresponsive to various medicines. Since the accumulation resides in the spleen and stomach, healing is impossible until it is removed. One must first eliminate the accumulation, then stop the diarrhea, and finally strengthen the spleen to cure the disease. Use Sanleng San or Wu Xi Wan initially, followed by Chenxiang Binglang Wan, Shenling Baizhu San, Hezhong San, or Xiangju Bing for regulation.
Fright diarrhea: Stool is green like moss, thick and sticky. Direct astringency is contraindicated; instead, calm the heart and suppress liver wind, harmonize the spleen and stomach, and digest milk and food. Start with Wuling San, then use Sanleng San decocted with water, fresh ginger, and stored rice. Alternatively, use Sandjie San or Shenqu with fresh ginger decoction, along with Chenxiang Binglang Wan or Bujing Dan.
Wind diarrhea: Often follows severe slow convulsions. Stool is thin, yellow-brown, possibly mixed with undigested milk/food, caused by spleen deficiency. If black-brown, it involves the kidney due to spleen deficiency being overcome by kidney water. If there is prolonged anorexia with convulsions, soothe kidney water, dispel spleen wind, and tonify the spleen to prevent recurrence. Soothe kidney water with crushed Wuling San plus Black Morning Glory Seed (Hei Qianniu, half raw/half fried), Coicis Semen, water, and ginger. Dispel spleen wind with Xiehuang San. Regulate spleen qi with Shenling Baizhu San.
Visceral-cold diarrhea: Stool resembles green bamboo color, neither thin nor thick, or passes green water. Abdominal pain and borborygmus occur before crying leads to defecation. Common in infants aged three to five months, disappearing by one year. Caused by short umbilical cord allowing wind-cold invasion. Treat initially with Chonghe Yin decocted with scallion white to warm the middle and release the exterior, followed by Danggui San with water-warmed ginger, Yunqi San, or Lizhong Tang.
Malnutrition-induced diarrhea: Manifests as sallow complexion, distended abdomen, weak legs, large head with thin neck, sparse upright hair, muscle wasting, anorexia, cool days and hot nights, abdominal masses, variable stool color with abnormal odor, and periodic self-limiting episodes. Treat initially with Danggui San plus Curcuma Zedoaria Rhizoma (Sanleng) and Tangerine Peel (Chenpi) decocted with water and ginger. Follow with Wu Xi Wan, Chenxiang Binglang Wan, Huapi Wan, Lu Hui Wan (Aloe Pill), or Meishi Zi Wan. For very young infants unable to swallow pills, use Sanleng San or Kuai Ge Tang.
If stool is green or pale yellow with white, indicating excess cold and deficient heat (yin pathogen overcoming yang), use Shouzhong Tang or Weiling Tang to support the exterior and rescue the interior. Then administer Danggui San with Chenpi, Perilla Leaf (Zisu), fresh ginger, and glutinous rice. Harmonization with Lizhong Tang taken with clear rice water on an empty stomach warms the spleen, removes dampness, benefits qi, and clears spirit. For severe cold, add Prepared Aconite Root (Shu Fuzi) to Lizhong Tang. Follow with Nanxing Fupi Yin to harmonize the spleen/stomach and remove yin pathogen.
If stool is pale green with yellow froth, indicating excess heat and deficient cold, causing sallow complexion, emaciation, and restlessness, use crushed Wuling San plus Coicis Semen, Plantaginis Semen, water, and ginger to dissipate residual pathogens. Subsequently, use Yinchen Hao and Gardenia Fruit (Zhizi Ren) decoction to mix with Wuling San powder for warm administration to reduce yellowness and clear yang toxicity. Also use Danggui San or Wan'an Yin, or Sishen Wan.
*Yangsheng* treats diarrhea in elderly and weak persons regardless of cold or heat type:
Coptidis Rhizoma (Huanglian, remove stamens), Paeoniae Radix Alba (Baishaoyao, cut like beans), Evodiae Fructus (Wuzhuyu) (each 10 liang).
Stir-fry the three ingredients slowly in a pot until red, cool, pound and sieve into fine powder. Take 3 qianbi per dose with 1.5 cups of water, boil to 80-90%, strain, and take warm before meals, 3-4 times daily. Adjust dosage for children. Alternatively, form pills with steamed dough the size of paulownia seeds, or smaller sizes like mung bean or millet. Children take 15-20 pills with warm rice water. Powder form can be taken with boiling water or warm rice water. Patients must avoid raw, cold, fish, meat, and greasy foods, or medication will be ineffective.
Another formula contains Mugwort Flower Bud (Muxiang) but no Baishaoyao, pillized with vinegar paste.
[Mr. Mao] Xianglian Wan treats dysentery and diarrhea.
Aquilariae Lignum Resinatum (Muxiang), Coptidis Rhizoma (Huanglian - stir-fried with 0.5 liang Evodiae Fructus until smoke rises, then discard Evodia), Myristicae Semen (Roudoukou), Terminalia Chebulae Fructus (Hezi, processed, pitted) (each 0.5 liang), Ecorii Asini Colla (Ejiao, pan-fried with flour), Cinnabaris (Zhusha) (each 1 qian).
Pound into fine powder. Form pills with soft rice, size of paulownia seeds. Take 10-14 pills swallowed with rice water. Crush for small children.
Ruxiang San treats all types of diarrhea and dysentery.
Boswelliae Resina (Ruxiang, 2 qian - roasted on lotus leaf over charcoal until half-melted, placed on ground, covered with bowl, ground separately), Myristicae Semen (Roudoukou), Zingiberis Rhizoma Recens (Baijiang), Glycyrrhizae Radix et Rhizoma (Gancao, honey-fried), Alpiniae Katsumadai Semen (Caoguozhi) (each 1 liang).
Cut finely, wrap in vinegar-dough, bake in hot ashes until red, remove dough, grind to powder, mix with Ruxiang powder. Take 0.5-1 qian with aged rice water.