凡泄泻之病，多由水谷不分，故以痢水为上策。然痢水之法，法有不同，如湿胜无寒而
泻者，宜四苓散、小厘清饮之类主之，但欲分其清浊也。如湿挟微寒而泻者，宜五苓散、胃
苓汤之类主之，以微温而痢之也。如湿热在脾，热渴喜冷而泻者，宜大厘清饮、茵陈饮、益
元散之类主之，去其湿热而痢之也。
一、泄泻之病，多见小水不利，水谷分则泻自止，故曰∶治泻不利小水，非其治也。然
小水不利，其因非一，而有可利者，有不可利者，宜详辨之。如湿胜作泻而小水不利者，以
一时水土相乱，并归大肠而然也。有热胜作泻而小水不利者，以火乘阴分，水道闭涩而然也
。有寒泻而小水不利者，以小肠之火受伤，气化无权而然也。有脾虚作泻而小水不利者，以
土不制水，清浊不分而然也。有命门火衰作泻而小水不利者，以真阴亏损，元精枯涸而然也
。凡此皆小水不利之候。然惟暴注新病者可痢，形气强壮者可痢，酒湿过度，口腹不慎者可
利，实热闭涩者可痢，小腹胀满，水道痛急者可痢。又若病久者不可痢，阴不足者不可痢，
脉证多寒者不可痢，形虚气弱者不可痢，口干非渴而不喜冷者不可痢。盖虚寒之泻，本非水
有余，实因火不足；本非水不痢，实因气不行。夫病不因水，而痢则亡阴，泻以火虚，而痢
复伤气，倘不察其所病之本，则未有不愈痢愈虚，而速其危者矣。
In cases of diarrhea, the pathology often stems from the failure to separate clear and turbid substances within the ingested food and fluids. Therefore, promoting urination is considered the superior therapeutic strategy. However, the methods for promoting urination vary according to the specific syndrome. For diarrhea caused by dampness predominance without cold signs, formulas such as Siling San (Four-Ingredient Powder) or Xiaoli Qingyin (Minor Clearing Decoction) are appropriate, aiming to separate clear from turbid. For diarrhea accompanied by slight cold due to dampness, formulas such as Wuling San (Five-Ingredient Powder) or Weiling Tang (Stomach-Lining Decoction) are suitable, utilizing mild warming properties to promote urination. For diarrhea associated with damp-heat in the spleen, characterized by thirst and a preference for cold drinks, formulas such as Dali Qingyin (Major Clearing Decoction), Yincheng Yin (Artemisia Capillaris Drink), or Yiyuan San (Benefit-Origin Powder) are indicated, aiming to eliminate damp-heat through diuresis.
1. Diarrhea frequently presents with difficult or scanty urination. Once the separation of water and grain is restored, the diarrhea naturally ceases. Hence, it is stated: "Treating diarrhea without promoting urination is not the correct approach." However, the causes of difficult urination are diverse; some conditions allow for diuresis, while others contraindicate it, necessitating careful differentiation.
Diarrhea with difficult urination due to dampness predominance arises from the chaotic mixing of water and earth qi, which converges into the large intestine.
Diarrhea with difficult urination due to heat predominance arises from fire invading the yin aspect, causing obstruction and涩滞 (astringency/stagnation) in the water passages.
Cold-type diarrhea with difficult urination arises from injury to the fire of the small intestine, resulting in powerless qi transformation.
Spleen-deficiency type diarrhea with difficult urination arises from earth failing to control water, leading to the confusion of clear and turbid.
Mingmen fire decline type diarrhea with difficult urination arises from depletion of true yin and exhaustion of primordial essence.
These are all manifestations of difficult urination. However, diuresis is only indicated for acute onset and new diseases, patients with strong constitution and qi, those suffering from excessive alcohol intake or dietary indiscretion, cases of excess heat with closure and stagnation, and instances where the lower abdomen is distended with painful and urgent urinary difficulty.
Conversely, diuresis is contraindicated for chronic diseases, patients with insufficient yin, cases presenting predominantly with cold pulse and symptoms, patients with weak physique and deficient qi, and those with dry mouth but no thirst who do not prefer cold drinks. This is because diarrhea of deficiency-cold nature is not due to an excess of water, but rather a deficiency of fire (yang); it is not that the water passages are blocked, but that qi movement is impaired. If the disease is not caused by water retention, forcing diuresis will deplete yin. If diarrhea is caused by fire (yang) deficiency, further diuresis will damage qi. If the root cause of the disease is not investigated, the result will inevitably be that the more one promotes urination, the weaker the patient becomes, thereby accelerating critical danger.