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Tan Xie (Diarrhea due to Phlegm) refers to diarrhea caused by phlegm. Ancient sages stated: "The Spleen is the source of phlegm production, and the Lung is the vessel for storing phlegm." Phlegm arises from dampness, and dampness originates from Spleen deficiency. The Spleen belongs to Taiyin Damp-Soil; it functions well when warmed. Once invaded by cold-dampness, it becomes sluggish and impaired. If the Spleen is impaired, how can it manage the balance of transforming and transporting water and grain? Consequently, the essence and fine nutrients of water and grain are all transformed into phlegm. When phlegm-qi ascends and attacks the Lung, and since the Lung and Large Intestine are exterior-interior partners, if the Large Intestine's consolidation function is intact, the disease remains in the Lung meridian, manifesting as phlegmatic cough; if the consolidation function is not firm, the Lung pathology transfers to the Large Intestine, resulting in Tan Xie (Diarrhea due to Phlegm). The pulse presents a wiry and slippery quality, accompanied by chest and abdominal confusion and stuffiness, dizziness, nausea, yet without emaciation of the spirit or complexion. The patient may experience intermittent diarrhea. Treatment should employ the method of resolving phlegm and smoothing qi. Once qi flows smoothly and phlegm dissipates, the diarrhea will cease spontaneously.

(Attached: Yin Xie - Diarrhea due to Fluid Retention)
Shi Xie (Diarrhea due to Food Stagnation), also known as Wei Xie (Stomach Diarrhea), occurs because the Spleen is constrained by dampness and fails to transport effectively. The Yangming Stomach loses its digestive capacity, leading to food accumulation in the Tai Cang (Great Granary, referring to the Stomach), thereby causing loose stools. The pulse at the Qi Kou position is tight and vigorous, or the Right Guan position is deep and slippery. Symptoms include sour regurgitation, foul belching, chest and epigastric fullness and oppression, aversion to the smell of food, severe abdominal pain that does not relieve with defecation, but relaxes immediately after defecation. One should use Zha Qu Ping Wei San (Hawthorn and Malt Powder to Calm the Stomach) for treatment. There is also a condition where the patient is thirsty and drinks water, but upon drinking, diarrhea ensues, followed by intense thirst again. This is called Yi Yin Hua Xie (Overflowing Fluid Slippery Diarrhea), which corresponds to Yin Xie (Diarrhea due to Fluid Retention) in *Yi Zong Jin Jian* (Golden Mirror of Medicine). It is caused by water soaking the Stomach. Treatment should utilize Zeng Sun Wei Ling Tang (Modified Guizhi Ling Zhu Decoction), removing Hou Po (Magnolia Bark) and Cang Zhu (Atractylodes Rhizome), and adding Bai Zhu (Atractylodes Macrocephala Rhizome) and Gan Cao (Licorice Root). Many recent physicians confuse Yin Xie and Shi Xie; such distinction must not be neglected!

A question was raised: "Your book is specifically designed for the Six Qi (Six Exogenous Pathogens). Now, Tan Xie and Shi Xie do not seem directly related to the Six Qi, yet they are discussed among them. What is the intention?" The answer is: "Phlegm arises from dampness. Is dampness not one of the Six Qi? Shi Xie is Wei Xie, and Wei Xie is one of the Five Xi (Five Types of Diarrhea). Yue Ren (Bian Que) stated that excessive dampness leads to the Five Xi. Does Shi Xie lack dampness? Previously, we discussed Sun Xie (Diarrhea with undigested food) and Dong Xie (Profuse Watery Diarrhea), both caused by latent pathogens. Cold Xie is due to cold, Fire Xie due to fire, Summerheat Xie due to summerheat, and Damp Xie due to dampness. However, although Tan Xie and Shi Xie are caused by phlegm and food, they inevitably involve dampness. Conversely, Sun Xie, Dong Xie, Cold Xie, Fire Xie, Summerheat Xie, and Damp Xie may occasionally have concurrent phlegm and food stagnation. These concurrent syndromes are like supplementary topics in an essay; one should not focus on one aspect while neglecting another. Physicians must understand this clearly."