〔大〕泄泻之证，因肠胃虚冷而邪气乘之。经云∶春伤于风，夏必飧泄。盖风伤肝，
肝木旺而克脾土，属外因也。若七情不平，脏气受伤，属内因也。若饮食生冷伤脾，属不
外内因也。大法寒者温之，热者凉之，滑者涩之，湿者燥之。
〔薛〕前证若生冷所伤，用六君、木香、砂仁。辛热所伤，用二陈、炒连、山栀。面
食所伤，用六君、神曲。米食所伤，用六君、谷 。饮食不时而伤，用四君子汤。饮食过
多而伤，用六君子汤。饮食停滞，人参养胃
汤。脾气虚弱者，六君、升麻、柴胡。脾气虚寒，六君、木香、炮姜。肝木乘脾者，六
君、柴胡、芍药。肝火克脾者，六君、芍药、山栀。中气虚而下陷者，补中益气汤。郁结
伤脾者，济生归脾汤。肾气虚者，五味子散。脾气虚者，二神丸。脾肾虚者，四神丸。命
门火衰者，八味丸。真阳虚败者，固真丸。仍与滞下方参用。侍御沈东江之内，停食腹
痛作泻，以六君加木香、炮姜而愈。后复作，传为肾泄，用四神丸而安。侍御徐南湖子
室，泻属肾经，不信余言，专主渗泄，以致不起。一妇人年逾五十，不食夜饭，五更
作泻二十年矣。后患痢，午前用香连丸，午后用二神丸各二服而痢止，又以二神丸数服
而食夜饭，不月而形体如故。吴江史玄年母，素有血疾，殆将二纪，平居泄泻，饮食
少思，面黄中满，夏月尤甚，治血之药，无虑数百剂，未尝少减。余以为脾肾虚损，用
补中益气汤送二神丸，复用十全大补汤煎送前丸，食进便实，病势顿退。若泥中满忌参、
术，痰痞忌熟地，便泄忌当归，皆致误事。
《补遗》治泻，风证则胃风汤、不换金正气散。寒证则理中汤、四柱散、大已寒丸。暑
则五苓散、香薷散、六和汤。湿则藿香正气、戊己丸。此大概而论，至于通治则有诸方可
检，随证治疗。然男子妇人久泻不止，无逾固肠丸之效验。
香朴丸 治肠胃虚冷泄泻，注下无度，脾虚气闭，不进饮食。
大浓朴（五两） 北 香 白术 陈皮（各三两） 诃子 赤石脂（各一两半）
上为细末，面糊丸如梧桐子大。空心米饮下五十丸。如常服，暖脾胃。
桂香丸 治脏腑虚为风湿寒所搏，冷滑注下不禁，老人虚人危笃，累效。
附子 肉豆蔻（并炮） 白茯苓（各一两） 桂心 木香（炮） 白姜（炮，各半两）
丁香（二钱半）
上为细末，米糊丸如梧桐子大。空心米饮下五十丸。
豆蔻分气饮 治脏腑虚寒，泄泻无度，瘦极，及妇人产后泻，洞泄危笃甚。
藿香叶 草豆蔻仁（炮） 青橘皮（各四两） 甘草 丁香（各半两） 乌梅（五十个）
肉豆蔻（十个，炮）
上 咀，每服四钱，水二盏，糯米一撮，煎七分，去滓温服。
豆蔻丸 治脏寒泄泻不止，服诸药无效。（亦可治男子）
肉豆蔻（面裹煨香，）不以多少，碾细入陈米白饭捣令得所，丸如绿豆大。空心，煮粟米
饮吞下百丸。本家累以此药救人有效。
人参豆蔻散 治久泻不止，服诸药无效，此药屡效。
人参 肉豆蔻 干姜 浓朴 甘草 陈橘皮（各一两） 川芎 桂心 诃子 北 香（各半两）
上为细末，每服三钱，水一小盏，姜三片，枣一枚，煎至六分服。
木香散 治脏腑冷极，及久冷伤脾，口疮，下泄米谷不化，饮食无味，肌肉瘦悴，心
多嗔恚，妇人产后虚冷下泄，及一切水泻冷痢。
木香 破故纸（炒，各一两） 良姜 缩砂仁 浓朴（制，各七钱半） 赤芍药 橘红 桂心
白术（各半两） 吴茱萸（汤泡七次） 胡椒（各二钱半） 肉豆蔻（四枚） 槟榔（一个）
上为散，每服三钱，用不经水猪肝四两许，去筋膜，批为薄片，重重掺药，置一鼎
中，入浆水一碗，醋一茶脚许，盖覆煮肝熟，入盐一钱，葱白三茎细切，生姜弹子许拍破，
同煮水欲尽，空心为一服，冷食之。初服微泻不妨，亦是逐下冷气，少时自止。经年冷
痢滑泻，只是一服。渴即饮粥汤，忌生冷油腻物，如不能食冷物，即添少浆暖服。嘉
兴谢医得此方，病其繁，只用浆水煮猪肝，丸如梧桐子大，粥饮下五十丸亦效。若暴泻痢
只是一服，唯热痢、热泻不宜服。
赵府博宜人病泄泻不止，用附子、木香、
诃子、肉豆蔻、龙骨等药及诸丹服之，皆无效。召余诊之，肝肾脉虚弱，此肝肾虚也。府
博云∶其说见在何经？余曰∶诸方论泄痢，止是言脾胃病，不过讲风冷湿毒之所侵入，及
饮食伤滞，遇肠虚则泄痢。而不知肝肾气虚，亦能为泄痢。古书所载甚明，不可不辨，经
曰∶泄痢前后不止，肾虚也。又曰∶诸厥固泄，皆属于下。下谓下焦肝肾之气也。门户
束要，肝之气也。守司于下，肾之气也。肝气厥而上行，故下焦不能禁固而泄痢。肾为
胃关，门户不要，故仓廪不藏也。若病泄利，其源或出于此，而专以脾胃药治之，则胶固
千里矣。遂用木香散数服而愈。
香连丸 治痢疾并水泻、暑泻腹痛，不问赤白，神效。
黄连（净，二十两） 吴茱萸（去枝梗，十两）
上先将二味，用热水拌和，入瓷器内置热汤顿一日，同炒至黄连紫黄色，去茱用连
为末，每末四两，入木香末一两，淡醋、米饮为丸桐子大。每服二三十丸，滚汤下。久
痢中气下陷者，用补中益气下。中气虚者，用四君子下。中气虚寒者，加姜、桂。
如金丸
好川黄连一斤，分上中下三等拣开，以生姜三斤，先刮下皮，以皮存一处，将姜捣
汁，如前分浸黄连一宿，先用干壁土研细铺锅底，又铺浓绵纸一层，上放黄连炒燥，再
拌再炒，如此九次，方用姜皮同为细末，滴水丸。
防风芍药汤 治飧泄身热，脉弦腹痛及头痛。
防风 芍药（炒） 黄芩（炒，各二钱）
上用水煎服。
渗湿汤 治寒热所伤，身重腰冷如坐水中，或小便秘涩，大便溏泄。此证多因坐卧
湿地，或阴雨所袭而致。
苍术 白术（炒） 甘草（炒，各一两） 干姜（炮） 茯苓（各二两） 陈皮（一两） 丁香（二钱半）
上每服四五钱，枣水煎。
茯苓汤 治湿热泄泻，或饮食伤泻。
白术（炒） 茯苓（各五钱）
上用水煎，食前服。一方有芍药等分，名白术散。
白术芍药汤 治脾经受湿，水泄注下，体重腹满，形体倦怠，不欲饮食，或暴泄无数，
水谷不化。
白术 芍药（各二钱，炒） 甘草（炒，一钱）
上水煎服。
胃苓散 治夏秋之间，脾胃伤冷，水谷不分，泄泻不止。（亦治男子）
五苓散 平胃散
上和合，姜枣煎，空心服妙。
五香散 治食鱼伤泄泻不止，气刺奔冲，及妇人产前产后腹痛血气等疾，用温酒下。产
后败血冲心，用败蒲煎汤下。安胎，以糯米饮调下。孕妇脾泄泻痢，煎陈米饮调下，食前。
乌药 白芷（炒） 枳壳 白术（炒） 良姜（炒）
甘草 莪术（孕者减半）
上等分为细末，每服二钱，温酒调下。
二神丸 （加五味子二两，吴茱萸四两，名四神丸。）治脾肾虚弱，侵晨五更作泻，或全不思
食，或食而不化，大便不实，神效。
破故纸（四两，炒） 肉豆蔻（二两）
上为末，用大红枣四十九枚，生姜四两切碎，同枣用水煮熟，去姜取枣肉和药，丸
桐子大，每服五十丸，空心盐汤下。
五味子散 治肾经虚弱，大便不实，或夜间或五更泄泻。
五味子（炒，二两） 吴茱萸（半两）
上为末，每服二钱，空心米饮调下，其效如神。米糊为丸亦可。
固肠丸
人参（去芦） 苍术（米泔浸一宿） 茯苓 木香（不见火） 诃子肉（煨） 乌梅肉
肉豆蔻（面裹煨） 罂粟壳（去蒂幅）
上各等分为末，面糊丸如梧桐子大。每服四十丸，米饮下。
[Da] The syndrome of diarrhea (Xie Xie) arises from deficiency-cold in the intestines and stomach, allowing pathogenic factors to invade. The Classics state: "If wind is injured in spring, sunken stool diarrhea (Sun Xie) will inevitably occur in summer." This is because wind injures the Liver, causing Liver Wood to flourish and overcome Spleen Earth; this belongs to external causes. If the Seven Emotions (Qi Qing) are unbalanced, injuring the Qi of the Zang organs, this belongs to internal causes. If raw and cold food injures the Spleen and Stomach, this belongs to neither purely internal nor purely external causes. The general treatment principle is: warm what is cold, cool what is hot, astringe what is slipping, and dry what is damp.
[Xue] For the aforementioned syndromes, if injured by raw and cold food, use Liu Jun Zi Tang (Six Gentlemen Decoction) with Mu Xiang and Sha Ren. If injured by pungent-hot food, use Er Chen Tang (Two Aged Decoction) with stir-fried Huang Lian and Shan Zhi. If injured by wheat products, use Liu Jun Zi Tang with Shen Qu. If injured by rice products, use Liu Jun Zi Tang with Gu Ya. If injured by irregular eating habits, use Si Jun Zi Tang (Four Gentlemen Decoction). If injured by overeating, use Liu Jun Zi Tang. If there is food stagnation, use Ren Shen Yang Wei Tang (Ginseng Stomach-Nourishing Decoction). For Spleen Qi deficiency, use Liu Jun Zi Tang with Sheng Ma and Chai Hu. For Spleen Qi deficiency-cold, use Liu Jun Zi Tang with Mu Xiang and Pao Jiang (Charred Ginger). For Liver Wood invading Spleen, use Liu Jun Zi Tang with Chai Hu and Shao Yao. For Liver Fire overcoming Spleen, use Liu Jun Zi Tang with Shao Yao and Shan Zhi. For Middle Qi deficiency with sinking, use Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction). For constraint injuring the Spleen, use Ji Sheng Gui Pi Tang (Ji Sheng Heart-Spleen Decoction). For Kidney Qi deficiency, use Wu Wei Zi San (Schisandra Powder). For Spleen Qi deficiency, use Er Shen Wan (Two Spirits Pill). For Spleen-Kidney deficiency, use Si Shen Wan (Four Spirits Pill). for Ming Men Fire decline, use Ba Wei Wan (Eight-Ingredient Pill). For True Yang deficiency and collapse, use Gu Zhen Wan (Secure the True Pill). These should be used in conjunction with formulas that resolve stagnation. The wife of Censor Shen Dongjiang suffered from abdominal pain and diarrhea due to food stagnation; she was cured using Liu Jun Zi Tang added with Mu Xiang and Pao Jiang. Later it recurred and transformed into Kidney Diarrhea (Shen Xie), which was settled using Si Shen Wan. The daughter-in-law of Censor Xu Nanhu suffered from diarrhea belonging to the Kidney channel; not believing my advice, she exclusively used draining and leaching methods, leading to an untreatable condition. A woman over fifty years old had not eaten dinner and suffered from morning diarrhea (Wu Geng Xie) for twenty years. She later developed dysentery; taking Xiang Lian Wan (Cinnamon-Linked Pill) in the morning and Er Shen Wan in the afternoon, twice each, stopped the dysentery. After several doses of Er Shen Wan, she could eat dinner, and within a month her physique returned to normal. The mother of Shi Xuannian from Wujiang suffered from blood disorders for nearly two decades, accompanied by chronic diarrhea, poor appetite, sallow complexion, and abdominal fullness, worsening in summer. Hundreds of doses of blood-treating herbs were administered without slight relief. I considered this Spleen-Kidney deficiency, using Bu Zhong Yi Qi Tang to deliver Er Shen Wan, followed by Shi Quan Da Bu Tang (Ten Complete Tonifying Decoction) decocted to deliver the previous pill. Her appetite increased, stools became solid, and the disease势头 retreated sharply. Adhering rigidly to "abdominal fullness contraindicates Ren Shen and Bai Zhu, phlegm-fullness contraindicates Shu Di Huang, and loose stools contraindicate Dang Gui" leads to medical errors.
*Supplement* treats diarrhea: Wind syndromes use Wei Feng Tang or Bu Huan Jin Zheng Qi San. Cold syndromes use Li Zhong Tang or Si Zhu San or Da Yi Han Wan. Summerheat syndromes use Wu Ling San or Xiang Ru San or Liu He Tang. Damp syndromes use Huo Xiang Zheng Qi San or Wu Ji Wan. This is a general discussion; for comprehensive treatment, various formulas can be consulted and applied according to the syndrome. However, for chronic diarrhea in men and women that does not cease, no formula is more effective than Gu Chang Wan (Intestine-Securing Pill).
Xiang Po Wan treats intestinal-stomach deficiency-cold diarrhea, profuse watery discharge, Spleen deficiency with Qi obstruction, and inability to eat.
Da Nong Po (Five liang), Bei Xin, Bai Zhu, Chen Pi (Three liang each), He Zi, Chi Shi Zhi (One and a half liang each).
Grind into fine powder, make pills with flour paste the size of paulownia seeds. Take fifty pills on an empty stomach with rice drink. Regular consumption warms the Spleen and Stomach.
Gui Xiang Wan treats deficiency of Zang-Fu organs combated by wind-damp-cold, uncontrollable cold slippery diarrhea, critical conditions in the elderly and deficient persons, with repeated efficacy.
Fu Zi, Rou Dou Kou (both processed), Bai Fu Ling (One liang each), Gui Xin, Mu Xiang (processed), Bai Jiang (processed, half liang each), Ding Xiang (Two and a half qian).
Grind into fine powder, make pills with rice paste the size of paulownia seeds. Take fifty pills on an empty stomach with rice drink.
Dou Kou Fen Qi Yin treats Zang-Fu deficiency-cold, profuse diarrhea, extreme emaciation, and postpartum diarrhea in women, severe洞泄 (Dong Xie).
Huo Xiang Ye, Cao Dou Kou Ren (processed), Qing Ju Pi (Four liang each), Gan Cao, Ding Xiang (Half liang each), Wu Mei (Fifty fruits), Rou Dou Kou (Ten fruits, processed).
Chop, take four qian per dose, add two cups of water and a pinch of glutinous rice, decoct to seven parts, remove dregs, and take warm.
Dou Kou Wan treats organ-cold diarrhea that does not cease, ineffective with other medicines. (Also treats men).
Rou Dou Kou (wrapped in flour and baked until fragrant), quantity as needed. Grind fine, mix with aged white rice porridge, pound appropriately, make pills the size of mung beans. Swallow one hundred pills on an empty stomach with cooked millet drink. My family has repeatedly saved people with this medicine effectively.
Ren Shen Dou Kou San treats chronic diarrhea that does not cease, ineffective with other medicines, this medicine is frequently effective.
Ren Shen, Dou Kou, Gan Jiang, Nong Po, Gan Cao, Chen Ju Pi (One liang each), Chuan Xiong, Gui Xin, He Zi, Bei Xin (Half liang each).
Grind into powder, take three qian per dose, add one small cup of water, three slices of ginger, one date, decoct to six parts, and take.
Mu Xiang San treats extreme cold of Zang-Fu organs, long-term cold injuring the Spleen, mouth ulcers, excretion of undigested grain, tasteless diet, emaciated muscles, frequent irritability, postpartum deficiency-cold lower discharge in women, and all types of watery diarrhea and cold dysentery.
Mu Xiang, Po Gu Zhi (stir-fried, one liang each), Liang Jiang, Suo Sha Ren, Nong Po (processed, seven and a half qian each), Chi Shao Yao, Ju Hong, Gui Xin, Bai Zhu (Half liang each), Wu Zhu Yu (soaked in water seven times), Hu Jiao (Two and a half qian each), Rou Dou Kou (Four pieces), Bing Lang (One piece).
Grind into powder, take three qian per dose. Use about four liang of pig liver that has not been exposed to menstrual blood, remove fascia, slice thinly, layer with medicine powder, place in a pot, add one bowl of fermented rice water, a little vinegar, cover and boil the liver until cooked. Add one qian of salt, three stems of scallion whites finely chopped, one piece of ginger the size of a walnut crushed, boil together until water is almost gone. Take as one dose on an empty stomach, eat cold. Mild diarrhea upon initial intake is acceptable, as it expels cold Qi, stopping shortly after. Chronic cold dysentery and slippery diarrhea lasting years require only one dose. Drink porridge soup when thirsty. Avoid raw, cold, and greasy foods. If unable to eat cold food, add a little fermented rice water to warm it. Doctor Xie from Jiaxing obtained this formula but found it cumbersome; he simply boiled pig liver in fermented rice water, made pills the size of paulownia seeds, and took fifty pills with porridge drink, also effective. For acute diarrhea/dysentery, only one dose is needed. It is unsuitable for heat dysentery and heat diarrhea.
The wife of Bo Yi in the Zhao Mansion suffered from incessant diarrhea. She used Fu Zi, Mu Xiang, He Zi, Rou Dou Kou, Long Gu, etc., and various elixirs, all ineffective. I was summoned to diagnose; the Liver and Kidney pulses were weak, indicating Liver-Kidney deficiency. Bo Yi asked: "In which channel does this theory lie?" I said: "Most discussions on diarrhea and dysentery focus only on Spleen-Stomach diseases, discussing invasion by wind-cold-damp-toxins and dietary stagnation, assuming diarrhea occurs when the intestines are deficient. They do not know that Liver-Kidney Qi deficiency can also cause diarrhea and dysentery. Ancient texts record this clearly; it must not be ignored. The Classics say: 'Diarrhea and dysentery continuing endlessly is Kidney deficiency.' Also: 'All厥 (Jue), obstruction, and diarrhea belong to the Lower Jiao.' Lower refers to the Qi of the Lower Jiao Liver and Kidney. The gate's control relies on Liver Qi; guarding below relies on Kidney Qi. When Liver Qi rebels and moves upward, the Lower Jiao cannot secure and diarrhea/dysentery occurs. The Kidney is the gate of the Stomach; if the gate is not secured, the granaries cannot store. If the source of diarrhea lies here, treating solely with Spleen-Stomach herbs would be a grave error." Thus, using several doses of Mu Xiang San, she was cured.
Xiang Lian Wan treats dysentery, watery diarrhea, summerheat diarrhea with abdominal pain, regardless of red or white, with miraculous efficacy.
Huang Lian (cleaned, Twenty liang), Wu Zhu Yu (remove branches and stalks, Ten liang).
First, mix the two ingredients with hot water, place in a porcelain vessel, set in hot water for one day, stir-fry together until Huang Lian turns purple-yellow. Remove Wu Zhu Yu, keep only Huang Lian, grind into powder. For every four liang of powder, add one liang of Mu Xiang powder. Make pills with light vinegar and rice drink the size of paulownia seeds. Take twenty to thirty pills with boiling water. For chronic dysentery with Middle Qi sinking, take with Bu Zhong Yi Qi Tang. For Middle Qi deficiency, take with Si Jun Zi Tang. For Middle Qi deficiency-cold, add Jiang and Gui.
Ru Jin Wan
Take one jin of high-quality Chuan Huang Lian, sort into upper, middle, and lower grades. Use three jin of fresh ginger, scrape off the skin first, keep the skin aside. Crush ginger to extract juice. Soak the sorted Huang Lian overnight as described above. First, grind dry wall earth fine and spread on the pot bottom, then lay a layer of thick cotton paper. Place Huang Lian on top, stir-fry until dry, mix again, stir-fry again. Repeat nine times. Finally, mix with ginger skin, grind fine, make pills with dripping water.
Fang Feng Shao Yao Tang treats Sun Xie (undigested stool diarrhea) with body heat, wiry pulse, abdominal pain, and headache.
Fang Feng, Shao Yao (stir-fried), Huang Qin (stir-fried, Two qian each).
Decoct in water and take.
Shen Shi Tang treats injury by cold and heat, heavy body and cold waist as if sitting in water, or scanty and difficult urination, loose stools. This syndrome often results from sitting or lying on damp ground or being attacked by rainy weather.
Cang Zhu, Bai Zhu (stir-fried), Gan Cao (stir-fried, One liang each), Gan Jiang (processed), Fu Ling (Two liang each), Chen Pi (One liang), Ding Xiang (Two and a half qian).
Take four to five qian per dose, decoct with jujube water.
Fu Ling Tang treats damp-heat diarrhea or dietary injury diarrhea.
Bai Zhu (stir-fried), Fu Ling (Five qian each).
Decoct in water, take before meals. Another prescription has equal parts of Shao Yao, named Bai Zhu San.
Bai Zhu Shao Yao Tang treats Spleen channel dampness, watery diarrhea, heavy body, abdominal fullness, physical fatigue, loss of appetite, or sudden profuse diarrhea with undigested food and water.
Bai Zhu, Shao Yao (Two qian each, stir-fried), Gan Cao (One qian, stir-fried).
Decoct in water and take.
Wei Ling San treats Spleen-Stomach cold injury between summer and autumn, indistinguishable water and grain, incessant diarrhea. (Also treats men).
Wu Ling San, Ping Wei San.
Mix well, decoct with ginger and jujube, take on an empty stomach for best results.
Wu Xiang San treats diarrhea from fish injury, qi stabbing and rushing, and pre/postpartum abdominal pain and blood-qiu disorders in women, taken with warm wine. For postpartum decaying blood rushing to the heart, take with Bai Pu decoction. For calming the fetus, take with glutinous rice drink. For pregnant women with Spleen diarrhea/dysentery, take with aged rice drink before meals.
Wu Yao, Bai Zi (stir-fried), Zhi Ke, Bai Zhu (stir-fried), Liang Jiang (stir-fried), Gan Cao, E Zhu (halve for pregnancy).
Grind into fine powder, take two qian per dose, mix with warm wine.
Er Shen Wan (Add Wu Wei Zi two liang, Wu Zhu Yu four liang, named Si Shen Wan.) treats Spleen-Kidney weakness, morning diarrhea at Wu Geng time, total lack of appetite, or food not digesting, loose stools, with miraculous efficacy.
Po Gu Zhi (Four liang, stir-fried), Rou Dou Kou (Two liang).
Grind into powder. Use forty-nine large red dates and four liang of chopped ginger. Cook with dates in water until soft. Remove ginger, take date flesh, mix with medicine, make pills the size of paulownia seeds. Take fifty pills on an empty stomach with salt water.
Wu Wei Zi San treats Kidney channel weakness, loose stools, or night/Wu Geng diarrhea.
Wu Wei Zi (stir-fried, Two liang), Wu Zhu Yu (Half liang).
Grind into powder, take two qian per dose on an empty stomach with rice drink. Its effect is miraculous. Making pills with rice paste is also acceptable.
Gu Chang Wan
Ren Shen (remove rhizome), Cang Zhu (soaked in rice wash water overnight), Fu Ling, Mu Xiang (do not expose to fire), He Zi Rou (baked), Wu Mei Rou, Rou Dou Kou (wrapped in flour and baked), Ying Su Qiao (remove stem and sepals).
Grind equal parts into powder, make pills with flour paste the size of paulownia seeds. Take forty pills with rice drink.