呕逆吐痢者，由肠胃虚，邪气并之，脏腑之气自相乘克也。《脉经》云∶心乘肝则吐痢
。心，火也；肝，木也；火木，子母也。火乘于木，子扶母也，此为二脏偏实也。大肠，金
也；胃，土也；金土，母子也。大肠虚则金气衰微，不能扶土，致令胃气虚弱，此两腑偏虚
也。木性克土，火性克金，是为火木相扶，心肝俱盛；而金畏于火，土畏于木，则为肠胃皆
弱。肠虚弱则泄痢，胃虚弱则呕吐，故呕逆而复吐痢也。
诊其关上脉数，其人吐。跗阳脉微而涩，微则下痢，涩即吐逆也。
春伤于风，邪气留连，因饮食不节，肠胃虚弱，邪气乘之，则变为痢。痢则腑脏俱虚，
水气相并，上乘于心，心气不宣畅，痞满在内，故令痢而兼烦者也。
夫水谷之精，化为血气津液，以养脏腑。脏腑虚，受风邪，邪入于肠胃，故痢。痢则津
液空竭，腑脏虚燥，故痢而兼渴也。渴而引饮，则痢不止，翻益水气，脾胃已虚，不能克消
水，水气流溢，浸渍肌肉，则变肿也。
凡痢，口里生疮，则肠间亦有疮也。所以知者，犹如伤寒热病，胃烂身则发疮也。此由
挟热痢，脏虚热气内结，则疮生肠间；热气上冲，则疮生口里。然肠间、口里生疮，皆胃之
虚热也。胃虚谷气弱，则九虫、三尸发动，则变成 。
痢兼肿者，是痢久脾虚，水气在于肌肉之所为也。脾与胃合，俱象土，脾候身之肌肉，
胃为水谷之海，而以脾气克消水谷也。风邪在内，肠胃虚弱，则水谷变为痢也。膀胱与肾合
，俱象水，膀胱为津液之腑。小肠与心合，俱象火，而津液之水行于小肠，下为小便也。土
性本克水，今因痢，脾胃虚弱，土气衰微，不能克制于水，致令水得妄行，不流于小肠而浸
渍脏腑，散流皮肤，与气相搏，腠理壅闭，故痢而肿也。
Vomiting, hiccups, vomiting with diarrhea, and dysentery are caused by the deficiency of the stomach and intestines, where pathogenic factors invade and cause the qi of the zang-fu organs to mutually overcome each other. The *Mai Jing* (Pulse Classic) states: "When Heart qi overcomes Liver qi, vomiting and diarrhea occur." The Heart belongs to Fire; the Liver belongs to Wood; Fire and Wood have a mother-son relationship. When Fire overcomes Wood, it is the son assisting the mother, indicating that both organs are in a state of excess. The Large Intestine belongs to Metal; the Stomach belongs to Earth; Metal and Earth have a mother-son relationship. When the Large Intestine is deficient, Metal qi becomes weak and fails to support Earth, causing Stomach qi to become weak, indicating that both fu organs are in a state of deficiency. Wood nature overcomes Earth, and Fire nature overcomes Metal. This means Fire and Wood support each other, making the Heart and Liver abundant; while Metal fears Fire and Earth fears Wood, resulting in weakness of both the stomach and intestines. Weakness of the intestines leads to diarrhea and dysentery, while weakness of the stomach leads to vomiting. Therefore, hiccups occur accompanied by vomiting, diarrhea, and dysentery.
Palpating the Guan position pulse as rapid indicates vomiting. If the Fuyang pulse is faint and choppy, a faint pulse indicates dysentery, and a choppy pulse indicates vomiting and hiccups.
If wind pathogen is injured in spring, and the pathogen lingers, combined with irregular diet leading to weakness of the stomach and intestines, the pathogen takes advantage of this weakness to transform into dysentery. In dysentery, the zang-fu organs are all deficient, and Water qi merges with it, ascending to overwhelm the Heart. The Heart qi cannot circulate freely, causing stagnation and fullness internally, thus leading to dysentery complicated by irritability.
The essence of food and drink transforms into blood, qi, and body fluids to nourish the zang-fu organs. When the zang-fu organs are deficient and affected by wind pathogen, the pathogen enters the stomach and intestines, causing dysentery. Dysentery depletes body fluids, leaving the zang-fu organs deficient and dry, thus causing dysentery complicated by thirst. Thirst leads to drinking water, which prevents the dysentery from stopping, further increasing Water qi. Since the Spleen and Stomach are already weak and cannot transform and transport the water, the water flows溢出 (overflows), infiltrates the muscles, and transforms into edema.
In cases of dysentery, if sores appear in the mouth, there are also sores in the intestines. We know this because, similar to how in cold damage febrile diseases, rotting of the stomach manifests as sores on the body. This is due to heat-complicated dysentery, where internal deficiency heat knots together, causing sores in the intestines; when heat qi rushes upward, sores appear in the mouth. However, sores in both the intestines and the mouth are due to deficiency-heat of the Stomach. When Stomach deficiency leads to weak grain qi, the Nine Worms and Three Corpses are activated, transforming into [parasitic accumulation/infantile malnutrition].
Dysentery complicated by edema is caused by long-standing dysentery leading to Spleen deficiency, with Water qi residing in the muscles. The Spleen and Stomach combine and both symbolize Earth; the Spleen governs the muscles of the body, and the Stomach is the sea of water and grain, relying on Spleen qi to transform and transport water and grain. With wind pathogen inside and weakness of the stomach and intestines, water and grain transform into dysentery. The Bladder and Kidney combine and both symbolize Water; the Bladder is the fu organ of body fluids. The Small Intestine and Heart combine and both symbolize Fire; body fluid water travels through the Small Intestine and exits downward as urine. The nature of Earth is to overcome Water. Now, due to dysentery, the Spleen and Stomach are weak, Earth qi is declining, and it cannot overcome Water, causing Water qi to act recklessly. Instead of flowing into the Small Intestine, it infiltrates the zang-fu organs, scatters and flows in the skin, combats with Qi, obstructs the couli (pores/skin texture), thus resulting in dysentery complicated by edema.