泄泻形衰脉实大，五虚哕逆手足寒，大孔直出无禁止，下泻上嗽命多难。
【注】五虚，谓脉细，皮寒，气少，水浆不入，大便不禁也。大孔，谓肛门大孔不禁也。
参苓白术散
湿泻胃苓厘清浊，寒泻理中附子添，飧泻升阳益胃治，倍加芍药减黄连，脾泻参苓
白术散，扁豆四君莲肉攒，意苡山药缩砂桔，肾泻二神四神丸。
【注】参苓白术散，即扁豆，人参、白术、茯苓，炙草、莲肉、薏苡仁、山药、缩砂、桔
梗也。二神丸，即补骨脂、肉豆蔻，本方加吴茱萸、五味子，名四神丸。
青六散 芍药芩连葛根汤 八柱散
食泻实下虚消导，饮泻实者神 斟，虚者春泽甘露饮，痰泻实攻虚六君，火泻草芍
芩连葛，暑泻红曲六一匀，滑泻八柱理中附，粟壳乌梅诃蔻寻。
【注】食泻形气实者，宜大承，化滞等药下之，形气虚者，宜枳术、平胃等消导之。神
斟，谓虽当用神 丸逐饮，然亦斟酌不可过也。春泽，谓春泽汤也。甘露饮，谓五苓
甘露饮也。芍药芩连葛根汤，即甘草、芍药、黄芩、黄连、葛根也。青六散，即六一散加
红曲也。八柱散，附子理中汤加罂粟壳、乌梅、诃子、肉蔻也。
泻心导赤散 茯苓车前子饮 苓桂理中汤
口糜泄泻虽云热，上下相移亦必虚，心脾开窍于舌口，小肠胃病化职失，糜发生地
通连草，泻下参苓白术宜，尿少茯苓车前饮，火虚苓桂理中医。
【注】口疮糜烂泄泻一证，古经未载，以理推之，虽云属热，然其上发口糜下泻即止，
泄泻方止，口糜即生，观其上、下相移之情状，亦必纯实热之所为也。心之窍开于舌，脾
之窍开于口，心脾之热，故上发口舌疮赤糜烂。胃主消化水谷，小肠主盛受消化，心脾
之热下移小肠胃腑，则运化之职失矣，故下注泄泻也。口糜发时，晚用泻心导赤散，滚
汤淬服之，即生地、木通、黄连、甘草梢也。下泄泻时，早晚用参苓白术散、糯米汤服之。
若小便甚少，下利不止，则为水走大肠，宜用茯苓、车前子二味各等分，煎汤时时代饮，
利水导热。若服寒凉药口疮不效，则为虚火上泛，宜用理中汤加肉桂大倍茯苓，降阳利
水。降阳而口糜自消，水利泄泻自止，可并愈也。
If a patient with diarrhea (Xie Xie) presents with physical emaciation but a full and large pulse, or exhibits the "Five Deficiencies" (Wu Xu) accompanied by hiccups/regurgitation (Hui Ni) and cold hands and feet, or suffers from uncontrolled rectal prolapse/diarrhea (Da Kong), or has persistent lower diarrhea combined with upper cough, these are mostly fatal conditions.
[Note] The "Five Deficiencies" refer to five symptoms: fine pulse (Mai Xi), cold skin (Pi Han), shortness of breath/lack of Qi (Qi Shao), inability to take in food and fluids (Shui Jiang Bu Ru), and involuntary defecation (Da Bian Bu Jin). "Da Kong" refers to the anus losing its control function.
For dampness-induced diarrhea, use Weiling Tang (Gastrodia and Poria Decoction) to clarify turbidity. For cold-induced diarrhea, add Aconite Root (Fuzi) to Lizhong Tang (Regulate the Middle Decoction). For undigested food diarrhea (Sun Xie), use Shengyang Yiwang Tang (Raise Yang and Benefit Stomach Decoction); increase the dosage of White Peony Root (Shaoyao) and decrease Coptis Rhizome (Huanglian). For spleen deficiency-induced diarrhea, use Shenling Baizhu San (Ginseng, Poria, and Atractylodes Macrocephala Powder), composed of Coix Seed (Bian Dou), Sijunzi Tang (Four Gentlemen Decoction), Lotus Seed (Lian Rou), plus Coix Seed (Yiyi Ren), Chinese Yam (Shanyao), Amomum Fruit (Suosha), and Platycodon Root (Jiegeng). For kidney deficiency-induced diarrhea, use Ershen Wan (Two Spirits Pill) or Sishen Wan (Four Spirits Pill).
[Note] Shenling Baizhu San consists of Coix Seed, Ginseng Root (Renshen), Atractylodes Macrocephala Rhizome (Baizhu), Poria (Fuling), Honey-fried Licorice Root (Zhigancao), Lotus Seed, Coix Seed, Chinese Yam, Amomum Fruit, and Platycodon Root. Ershen Wan consists of Psoralea Fruit (Buguzhi) and Myristica Seed (Roudoukou). Adding Evodia Fruit (Wuzhuyu) and Schisandra Berry (Wuweizi) to this formula creates Sishen Wan.
Qingliu San, Shaoyao Qinlian Gegen Tang (White Peony, Coptis, and Kudzu Decoction), Bazhu San.
For food stagnation-induced diarrhea, if the constitution is strong, use purgative and resolving methods such as Dachengqi Tang (Major Order the Qi Decoction) or Huazhi Tang; if the constitution is weak, use Zhizhu Wan (Immature Bitter Orange and Atractylodes Pill) or Pingwei San (Calm the Stomach Powder) for digestion promotion. For fluid retention-induced diarrhea, for excess patterns use Shenzhen Wan (dose cautiously), and for deficiency patterns use Chunze Tang or Ganlu Yin. For phlegm-dampness-induced diarrhea, attack excess patterns and tonify deficiency patterns using Liujunzi Tang (Six Gentlemen Decoction). For fire-induced diarrhea, use Shaoyao Qinlian Gegen Tang (composed of Licorice Root, White Peony Root, Scutellaria Root, Coptis Rhizome, and Kudzu Root). For summerheat-induced diarrhea, use Hongqu (Red Yeast Rice) combined with Liuyi San (Six-to-One Powder). For slippery/uncontrollable diarrhea, use Bazhu San, which includes Lizhong Tang plus Poppy Shell (Yangsuhke), Mume Fruit (Wumei), Chebula Fruit (Hezi), and Myristica Seed (Roudoukou).
[Note] For food stagnation diarrhea with strong Qi and form, use Dachengqi Tang or Huazhi Tang to purge; for weak Qi and form, use Zhizhu Wan or Pingwei San to resolve stagnation. "Shenzhen" implies that while Shenzhen Wan should be used to expel fluid retention, the dosage must be carefully considered and not excessive. "Chunze" refers to Chunze Tang. "Ganlu Yin" refers to Wuling Ganlu Yin. Shaoyao Qinlian Gegen Tang consists of Licorice Root, White Peony Root, Scutellaria Root, Coptis Rhizome, and Kudzu Root. Qingliu San is Liuyi San added with Hongqu. Bazhu San is Fuzi Lizhong Tang added with Poppy Shell, Mume Fruit, Chebula Fruit, and Myristica Seed.
Xiexin Daochi San, Fuling Cheqianzi Yin, Linggui Lizhong Tang.
Mouth ulcers/erosion accompanied by diarrhea, although attributed to heat, involves deficiency when pathology shifts between upper and lower parts. The Heart and Spleen open into the tongue and mouth respectively. When the Small Intestine and Stomach fail in their functions, erosion occurs. Treat the upper part with Xiexin Daochi San (composed of Rehmannia Root, Akebia Stem, Coptis Rhizome, and Licorice Root tip); treat the lower diarrhea with Shenling Baizhu San. If urine output is low, use Fuling Cheqianzi Yin (Poria and Plantago Seed Drink). For fire-deficiency patterns, use Linggui Lizhong Tang.
[Note] This syndrome of mouth ulcers/erosion with diarrhea is not recorded in ancient classics. By reasoning, although it belongs to heat, the alternating nature of upper mouth erosion and lower diarrhea suggests it is purely due to excess heat. The Heart opens into the tongue, and the Spleen opens into the mouth; heat from the Heart and Spleen flares upward, causing red sores and erosion on the tongue and mouth. The Stomach governs the digestion of water and grain, and the Small Intestine governs reception and digestion. Heat from the Heart and Spleen shifts downward to the Small Intestine and Stomach, causing loss of transportation and transformation functions, leading to downward pouring diarrhea. During mouth erosion episodes, take Xiexin Daochi San at night, brewed with boiling water (Rehmannia Root, Akebia Stem, Coptis Rhizome, Licorice Root tip). During lower diarrhea, take Shenling Baizhu San morning and evening with glutinous rice soup. If urine is very scanty and diarrhea persists, water flows into the Large Intestine; use equal parts of Poria and Plantago Seed, decocted and drunk frequently to promote urination and guide out heat. If cold-natured medicines fail to heal mouth ulcers, it indicates deficient fire floating upward; use Lizhong Tang added with Cinnamon Bark (Rougui), doubling the amount of Poria, to descend Yang and promote urination. Descending Yang resolves mouth erosion, and promoting urination stops diarrhea, allowing both to heal simultaneously.