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The *Jiyao* (Essential Principles) states: When the Taiyin meridian is invaded by dampness, it leads to watery diarrhea characterized by loose and slippery stools, heaviness of the body, slight fullness, loss of taste for food, and if prolonged, may transform into dysentery with pus and blood. Transmission of pathogenic factors from the Spleen meridian to the Kidney meridian is called "Zei Xie" (Robber Evil), making it difficult to cure. If urination becomes frequent first followed by slippery diarrhea, it is called "Wei Xie" (Minor Evil), which is easy to recover from. These are all caused by the Spleen Earth being affected by dampness.

Dysentery involving the Jueyin meridian that does not stop, with a deep and slow pulse, cold extremities, and pus and blood in nasal discharge and saliva, is difficult to treat. It is suitable to use Mahuang Tang (Ephedra Decoction) or Xiao Xuming Tang (Minor Continue Life Decoction) to induce sweating and resolve the exterior. This is because there is an exterior pathogen contracting inward; one should dissipate the exterior pathogen to achieve recovery.

Sudden profuse diarrhea without sound, cold body, spontaneous sweating, clear and abundant urination, involuntary defecation, weak breathing, and vomiting require immediate treatment with heavy warming medicines, such as Jiangshui San (Fermented Grain Water Powder).

Zihe said: Acute violent diarrhea with continuous watery stool is described in the *Neijing* (Inner Canon) as "Zhuxia" (Pouring Down), meaning watery diarrhea. Severe and rapid cases belong to Fire pathogen. One should use Shuitiao Guiling Ganlu Yin (Water-Adjusted Cinnamon Twig, Poria, and Sweet Dew Drink), Wuling San (Five-Ingredient Powder with Poria), or Yiyuan San (Benefit Origin Powder). Alternatively, decoct with long-flowing water and take after cooling. Liangge San (Cooling Chest Powder) and Tongsheng San (Unimpeded Generation Powder) can also treat this condition. One must strictly avoid suddenly using astringent and warm substances like Ying Susu Ke (Poppy Shell), Ganjiang (Dried Ginger), and Doukou (Cardamom). Even if diarrhea stops, other diseases will arise. One should only differentiate Yin and Yang and promote water pathways.

Commentary: The above discussions differentiate syndromes of Cold, Heat, Wind, Dampness, and Fire to clarify that the Six Excesses (Liu Yin) can all cause diarrhea and pouring down. Treatment should be differentiated according to the specific pathogenic factor involved.

The *Jiyao* states: The Spleen and Stomach share the transformation of Damp-Earth, primarily responsible for rotting and ripening food and drink. When Stomach Qi is harmonious, nutrients from ingested food are transported to the Spleen Earth, return to the Lung, circulate through the hundred vessels, and thereby form Ying (Nutrient) and Wei (Defensive) Qi. If diet is irregular or daily routine is untimely, damaging Stomach Qi, the ascending essence instead descends, resulting in Sunxie (diarrhea with undigested food). Over time, Taiyin disease transforms into Shaoyin disease, leading to Changpi (intestinal dysentery).

The *Jiyao* states: In Spring, one should keep the body relaxed; relaxation allows Liver Wood Qi to flourish. Conversely, excessive stillness follows the Metal command of Autumn, where Metal controls Wood. Among the Five Viscera, at Summer Solstice, Fire Qi is prosperous while Metal recedes, leaving Wood Qi dominant and damaging Spleen Earth. Mild cases present as Sunxie, Mai Xie (pulse-related diarrhea), and undigested food in stool; severe cases present with dysentery containing pus and blood, thick and sticky. The *Liangfang* cites the classic saying: "Injured by Wind in Spring, Sunxie occurs in Summer." This is because Wind pathogen easily injures the Liver. In Spring, when Wood Qi is vigorous, Wind cannot directly invade the Liver but instead transfers its qi to attack Spleen Earth. Since Spleen Earth is controlled, it fails to transport and transform, leading to accumulation. Between Summer and Autumn, upon re-exposure to Summer Heat, Dampness, Wind, and Cold, these factors activate to form dysentery.