泄泻之症，水谷或化或不化，腹痛或不痛，并无努责，亦无脓血，及里急
后重，惟觉困倦耳，故与痢疾异。饮食入胃下小肠，得气营运则清浊以分，水渗膀
胱，谷趋大肠，二便调矣。何泄之有？若气不运化，水谷不分，归并大肠一路，则
泻矣。而气之所以不运，则六淫七情种种之邪，皆得而滞之，略具如下。
或因于风。经曰∶春伤于风，夏为飧泄。言春时伤于风寒，由皮肤而经络，传
入肠胃，腹胀肠鸣，（风气往来肠胃间，冲击作响也。）因而飧泄也。（泄出原食不化。）
此风非汗不出，
始为寒气，久则郁热。又肝木之气，亦名为风。春时肝气宜升，为邪所伤，郁而下
陷，郁久成热，热久蒸化为湿，遂至飧泄，此宜升清除湿。二证皆肠鸣，（肝风内煽亦鸣
响。）脉弦，泄时或闭而不下，下多白沫，辟辟有声，其气不甚臭秽，以完谷不化也。
夏以久言，勿泥。（或谓春木当令，虽不能升，亦不肯下趋，但郁成热，至夏热
盛蒸湿，如云蒸而雨降，故至
夏乃泄，亦通。）
或因于寒。盖寒则气凝，无以营运水谷，故泄也。寒气攻刺，腹中绵绵作痛，
肠鸣，暴下无声，水谷不化，所下清冷，如鸭屎之溏，（大便如水，中有少粪也。）小便白，
脉沉迟，身冷。脉细，（心虚。）皮寒，（肺虚。）气少，（肝虚。）前后泄利，（肾虚。）饮食不入，
（脾虚。）为五虚，难治，用参术补剂早救之，迟则不能挽矣。
或因于热。盖火性急迫，逼其水谷下注，往往不及传化即出。勿因其完谷不化，
误作虚寒。其脉洪数，小便赤涩，腹中痛刺，痛一阵泻一阵，口燥渴，粪出辟辟有
声，肛门热痛。热泻固由火性急迫，亦有热气壅滞不行，不但寒不能运也，所下多
垢粘，色黄赤，腹中闷痛。
或因于暑。与热泻同理。证则面垢，多汗，烦渴。
或因于湿。湿盛而小便不利，水走肠间，漉漉有声，腹不痛，脉沉缓，体重软
弱。治湿宜利小便。若气虚下陷而利之，是降而又降也，当升其阳，所谓下者举之
也。升阳用风药，风药又能胜湿。
或因于食。盖伤食则脾滞，不能营运水谷，故泄，噫气如败卵臭，腹中绞痛，
痛一阵泻一阵，下过稍宽，少顷又痛，所下臭秽粘腻，（前食既滞，则后食继停，陈陈相因，久
而乃出，故臭秽。）色黄。
或伤于酒。每天明时泻一二次。（酒质湿，夜气阴寒，不能久摄，故至明必泻。）
或因于饮。渴而饮，饮而泻，泻而复渴，复饮复泻也。
或因于痰。痰滞气不行，故水谷不分，腹中隐隐微痛，或觉冷，下如稠饮，时
泻时不泻，或多或少，不食不饥，昔肥今瘦，脉滑。
有脾虚不能受食，食毕即肠鸣腹满，必泻出所食方快，不食则无事，名脾泻。
每天明时泻一二次，名肾泻。（肾火虚寒也。）
有肝气滞。两肋痛而泻者，名肝泄。
有患口舌糜烂而泻者，乃心脾二经之热，心开窍于舌，脾开窍于口，其热上攻
故糜烂。若移其热于胃与小肠，则运化失职，故泄也，名口糜泄。
久泻不已名滑泻，又名洞泄。大孔如竹筒，饮食入口，直出无禁，气将脱矣，
饮食不进则无救矣。
治法∶风泻，升阳益胃汤（见恶寒）。寒泻，理中汤（见中寒）、浆水散。
热泻，益元散（见
伤暑）加芩、连、灯心、竹叶。止泻汤去白术，加黄连、滑石、扁豆。热止在上膈，
渴而引饮，水入胃中，胃本无热，不能行水，致泻，灸第一椎下陷中，五苓散（见伤湿）。
亦可。暑泻，青六丸、（见痢。）玉龙丸。湿泻，胃苓汤、五苓散、升阳除湿汤吞戊己丸、
止泻汤。寒湿加姜、桂，热湿加黄连、葛根。食泻，平胃散（见伤饮食）加枳实。审其
曾伤何物，仍烧此物存性，调服三五钱。形气实者下之。酒泻，理中汤（见中寒）加干葛，
吞酒煮黄连丸（见伤暑），或葛花解酲汤（见伤饮食）。饮泻，实者神佑丸（见肿胀），
虚者春泽汤（见伤
湿）、白术调中汤。痰泻，止泻汤加半夏、海粉。实者吐之下之，虚者六君子汤。（见气。）
脾泻，快脾丸。肾泻，四神丸，早晚二服。肝泄，止泻汤加柴胡、青皮。若因肝
气不敛，致脾气散而不运，加白芍。口糜泄，其证上发则下止，下泄则上愈。当口
糜发时，用泻心导赤散，滚汤淬服。若当泄泻时，则早晚用参苓白术散，糯米汤服。
若小便少，利不止，乃水走大肠，用茯苓、车前子各等分，煎汤代茶。若服寒凉药，
口疮不效，则为虚火上泛，理中汤加肉桂，大倍茯苓，降阳利水，阳降则口糜愈，
水利则泄泻止。久泄，八柱散，或四君子（见气）加肉果、升麻。仲景云∶下利不止，以
理中与之益甚，理中者理中焦，此利在下焦，赤石脂禹余粮汤丸主之。泻久不止，
多变为痢，（详痢门。）实者以浓朴枳实汤预防之，虚寒者四神丸。收涩之剂，固肠丸、
诃子散皆治热泻，扶脾丸、桃花丸、诃子丸、赤石脂禹余粮汤皆治寒滑。泄泻久不
止，不可离甘草、芍药，为脾病也。不可离白术，为湿也。忌枳壳。为能宽肠也。
忌当归，为能滑肠也。（用补中益气者白芍代之。）泻已愈，至明年此月复发者，有积也。热
积大承气汤，（见大便不通。）虚者保和丸（见伤饮食）加三棱、蓬术之属。寒积备急
丸。（见伤饮食。）
理中（见中寒）加茯苓、黄连，名连理汤，寒热杂合而泻者最宜。（如暑泻兼内伤生冷，或
热邪已解，而泻
仍不止，疑似之证，皆可服之。）凡泻，津液既去，口必渴，小便多赤涩，
未可便作热论。（必
初起即渴，即赤涩，乃为热。）阴阳已分，泻已止，而小便少者，此肺气虚不能生水，补中
益气汤（见气）加麦冬、五味。或肾阴虚而水自涸，六味丸（见虚损）加麦冬、
五味。或肾阳
虚而阴无以化，八味丸。（见虚损。）若再行渗利，则小便益不行，而水入不消，肿胀之
证反作矣。泻脉必沉，宜细小，不宜大数实。下泄，上吐痰，皆不已，为上下俱脱，
死。腹大胀，手足厥，利不止，形脱，死。
泄泻的症状，表现为大便中的水谷有的能消化、有的不能消化，腹痛或不痛，没有排便时的用力努责感，也没有脓血，更没有里急后重（想拉拉不出，拉完还想拉的感觉），只感到身体困倦乏力，因此与痢疾不同。饮食进入胃中下行至小肠，依靠气的运化作用使清浊分离，水分渗入膀胱，谷物残渣趋向大肠，这样大小便就正常了。怎么会发生泄泻呢？如果气不能运化，导致水谷不分，全部归并到大肠这一路，就会发生泄泻。而气之所以不能运化，是因为六淫（风、寒、暑、湿、燥、火六种外感病邪）和七情（喜、怒、忧、思、悲、恐、惊七种情志变化）等各种邪气，都能阻碍气的运行，大致情况如下。
有时是因为风邪。医经说：春天伤于风邪，夏天就会发生飧泄（指大便中有未消化的食物）。意思是春天时受风寒侵袭，由皮肤经络传入肠胃，导致腹胀肠鸣（风气在肠胃间往来冲击发出声响），因而发生飧泄（排出的原食未消化）。这种风邪必须通过发汗才能排出。起初是寒气，久了则郁结化为热。另外，肝木之气也称为风。春季肝气应当升发，若被邪气所伤，郁结而下陷，郁久化热，热久蒸腾化为湿，最终导致飧泄，这种情况适宜用升阳除湿的方法治疗。这两种证候都有肠鸣（肝风内动也会引起鸣响）、脉弦的表现，泄泻时有时闭塞不下，或者排出很多白沫，腹部辟辟有声，气味不是很臭秽，因为食物完谷不化。这里说的“夏以久言”，不要拘泥于字面意思。（有人说是因为春季木气当令，虽然不能升发，但也不肯下趋，只是郁结成热，到了夏季热盛蒸腾湿气，像云蒸雨降一样，所以到夏天才发生泄泻，这种解释也通顺。）
有时是因为寒邪。寒邪会使气机凝滞，无法运化水谷，所以发生泄泻。寒气攻刺，腹中绵绵作痛，肠鸣，突然腹泻且无声响，水谷不化，排泄物清冷，像鸭屎样的稀溏（大便如水，其中夹杂少量粪便），小便清白，脉象沉迟，身体寒冷。如果脉细（心气虚），皮肤寒冷（肺气虚），气短少言（肝气虚），前后二阴泄利不止（肾气虚），饮食不进（脾气虚），这称为五虚，难以治疗，应用人参、白术等补益剂尽早救治，晚了就无法挽回了。
有时是因为热邪。火的性质急迫，逼迫水谷向下注泄，往往来不及传化就排出了。不要因为食物完谷不化，就误认为是虚寒证。其脉象洪数，小便赤涩，腹中刺痛，痛一阵泻一阵，口干燥渴，粪便排出时辟辟有声，肛门热痛。热泻固然由火性急迫引起，也有热气壅滞不行的情况，不仅仅是寒气不能运化所致，排泄物多垢腻粘滞，颜色黄赤，腹中闷痛。
有时是因为暑邪。与热泻原理相同。症状则是面色垢浊，多汗，烦躁口渴。
有时是因为湿邪。湿邪盛则小便不利，水液走窜肠间，漉漉有声，腹部不痛，脉象沉缓，身体沉重软弱。治疗湿邪宜利小便。如果是气虚下陷导致的泄泻而使用利小便的方法，这是降了又降，应当升举阳气，这就是所说的“下者举之”（对于下陷的病情要用升提的方法治疗）。升阳可以用风药，风药又能胜湿。
有时是因为饮食积滞。伤了饮食则脾脏停滞，不能运化水谷，所以发生泄泻，嗳气有败卵臭味，腹中绞痛，痛一阵泻一阵，泻过后稍觉宽松，一会儿又痛，排泄物臭秽粘腻（前面的食物既已停滞，后面的食物接着停聚，陈陈相因，久了才排出，所以臭秽），颜色黄。
有时是因为饮酒过度。每天黎明时分泻一两次。（酒质属湿，夜间气息阴寒，不能长久摄纳，所以到黎明必然泄泻。）
有时是因为饮水过多。口渴而饮水，饮了就泻，泻了又渴，反复饮水反复泄泻。
有时是因为痰饮。痰饮停滞导致气机不行，所以水谷不分，腹中隐隐微痛，或感觉冷，排泄物像稠厚的饮邪，时而泄泻时而不停，或多或少，不想吃东西也不觉得饿，以前肥胖现在消瘦，脉滑。
有脾虚不能承受食物，吃完即肠鸣腹满，必须把吃的东西泻出来才舒服，不吃则没事，这叫脾泻。
有患口舌糜烂且泄泻的，这是心脾二经的热邪，心开窍于舌，脾开窍于口，热邪上攻所以糜烂。如果热邪移于胃和小肠，则运化功能失职，所以泄泻，这叫口糜泄。
久泻不止叫滑泻，也叫洞泄。肛门像竹筒一样，饮食入口，直接流出不受控制，元气将脱竭了，如果饮食不进就没有救药了。
治疗方法：风泻，用升阳益胃汤（见恶寒章节）。寒泻，用理中汤（见中寒章节）、浆水散。热泻，用益元散（见伤暑章节）加黄芩、黄连、灯心草、竹叶。止泻汤去掉白术，加黄连、滑石、扁豆。如果热邪止在上膈，口渴引饮，水入胃中，胃本无热，不能行水导致泄泻，可灸第一椎骨下的凹陷处，也可用五苓散（见伤湿章节）。暑泻，用青六丸（见痢疾章节）、玉龙丸。湿泻，用胃苓汤、五苓散、升阳除湿汤吞服戊己丸、止泻汤。寒湿加生姜、肉桂，热湿加黄连、葛根。食泻，用平胃散（见伤饮食章节）加枳实。审察曾损伤何种食物，仍将该食物烧存性，调服三五钱。形体气实者用攻下法。酒泻，用理中汤（见中寒章节）加干葛，吞服酒煮黄连丸（见伤暑章节），或用葛花解酲汤（见伤饮食章节）。饮泻，实证用神佑丸（见肿胀章节），虚证用春泽汤（见伤湿章节）、白术调中汤。痰泻，用止泻汤加半夏、海粉。实证用吐法和下法，虚证用六君子汤（见气章节）。脾泻，用快脾丸。肾泻，用四神丸，早晚各服一次。肝泄，用止泻汤加柴胡、青皮。如果是因肝气不收敛，导致脾气散漫而不能运化，加白芍。口糜泄，其证上部发作则下部停止，下部泄泻则上部痊愈。应当在口糜发作时，用泻心导赤散，用滚开水冲泡服用。如果在泄泻时，则早晚用参苓白术散，糯米汤送服。如果小便少，利水不止，是水走大肠，用茯苓、车前子各等分，煎汤代茶。如果服用寒凉药，口疮无效，则为虚火上泛，用理中汤加肉桂，大剂量增加茯苓，以降阳利水，阳气下降则口糜痊愈，水利则泄泻停止。久泄，用八柱散，或四君子汤（见气章节）加肉果、升麻。张仲景说：下利不止，如果用理中汤反而加重，理中汤是调理中焦的，此利在下焦，应用赤石脂禹余粮汤丸主治。泻久不止，多变为痢疾（详见痢疾门）。实证用浓朴枳实汤预防，虚寒者用四神丸。收涩之剂，固肠丸、诃子散都治热泻；扶脾丸、桃花丸、诃子丸、赤石脂禹余粮汤都治寒滑。泄泻久不止，不可离开甘草、芍药，因为这是脾的病。不可离开白术，因为这是湿的病。忌用枳壳，因为它能宽肠。忌用当归，因为它能滑肠。（如果使用补中益气汤，可用白芍代替当归。）泄泻已愈，到明年这个月复发的，是有积滞。热积用大承气汤（见大便不通章节），虚者用保和丸（见伤饮食章节）加三棱、蓬术之类。寒积用备急丸（见伤饮食章节）。
理中汤（见中寒章节）加茯苓、黄连，名叫连理汤，寒热错杂而致的泄泻最适合服用。（如暑泻兼内伤生冷，或热邪已解，而泄泻仍不止，疑似的证候，都可以服用。）凡是泄泻，津液既然流失，口必渴，小便多赤涩，不可以立即当作热证论治。（必须是初起就渴，小便就赤涩，才是热证。）阴阳已分清，泄泻已止，而小便少的，这是肺气虚不能生水，用补中益气汤（见气章节）加麦冬、五味子。或者是肾阴虚而水自枯竭，用六味丸（见虚损章节）加麦冬、五味子。或者是肾阳虚而阴无以化生，用八味丸（见虚损章节）。如果再行渗利之法，则小便更加不行，而水入不消，肿胀的病证反而会发作。泄泻的脉象必沉，宜细小，不宜大数实。下泄上吐痰，都不停止，为上下俱脱，死证。腹部大胀，手足厥冷，利不止，形体脱失，死证。
Symptoms of diarrhea include stool containing water and undigested food, abdominal pain or no pain, without tenesmus (the feeling of incomplete defecation), pus, blood, or the sensation of urgency with little output. The patient only feels fatigue and lethargy; thus, it differs from dysentery. When food and drink enter the stomach and move down to the small intestine, the movement of Qi separates the clear from the turbid. Water seeps into the bladder, while grain residues tend toward the large intestine, resulting in normal urination and defecation. How does diarrhea occur? If Qi fails to transform and transport, causing water and grain to mix indistinguishably and all flow into the large intestine, diarrhea ensues. The reason for Qi's failure to move is that various pathogens from the Six Excesses (Wind, Cold, Summerheat, Dampness, Dryness, Fire) and Seven Emotions can stagnate Qi. The details are as follows.
Sometimes it is due to Wind. The classics state: "Injury by Wind in Spring leads to unformed stools (Sun-xie) in Summer." This means that in Spring, Wind-Cold invades from the skin and meridians, transmitting to the intestines and stomach, causing abdominal distension and borborygmus (sound caused by wind moving between the intestines), leading to Sun-xie (stool containing undigested original food). This type of Wind pathogen must be expelled through sweating. Initially, it is Cold, but over time, it stagnates and transforms into Heat. Additionally, the Qi of the Liver Wood is also called Wind. In Spring, Liver Qi should ascend; if injured by pathogens, it stagnates and sinks. Prolonged stagnation generates Heat, which steams and transforms into Dampness, eventually causing Sun-xie. This condition requires ascending Yang and resolving Dampness. Both syndromes present with borborygmus (also caused by internal stirring of Liver Wind), a wiry pulse, and during defecation, there may be obstruction with no output, or copious white foam with popping sounds. The odor is not particularly foul because the food is undigested. The phrase "Summer implies duration" should not be taken literally. (Some argue that when Wood Qi is dominant in Spring, although it cannot ascend, it refuses to descend, merely stagnating into Heat. By Summer, intense Heat steams Dampness like clouds producing rain, hence diarrhea occurs in Summer. This explanation is also valid.)
Sometimes it is due to Cold. Cold causes Qi to congeal, unable to transport water and grain, resulting in diarrhea. Cold pathogen attacks, causing continuous abdominal pain, borborygmus, sudden silent diarrhea, undigested food, cold watery stool resembling duck feces (stool like water with little solid matter), clear urine, a deep and slow pulse, and cold body. If the pulse is fine (Heart deficiency), skin is cold (Lung deficiency), breath is short (Liver deficiency), both bowels and urethra discharge profusely (Kidney deficiency), and food intake is absent (Spleen deficiency), this is called the Five Deficiencies. It is difficult to treat and requires early rescue with tonifying decoctions containing Ginseng and Atractylodes Macrocephala; delay makes recovery impossible.
Sometimes it is due to Heat. Fire has an urgent nature, forcing water and grain downward before they can be transformed. Do not mistake undigested food for deficiency-cold. The pulse is surging and rapid, urine is red and scanty, abdominal stabbing pain occurs with each episode of diarrhea, dry mouth and thirst are present, stool makes popping sounds upon exit, and the anus feels hot and painful. Diarrhea due to heat is indeed caused by the urgency of fire, but it can also result from stagnation of Heat Qi, not just the inability of Cold to transport. Stool is often dirty, sticky, yellow-red in color, with stifling abdominal pain.
Sometimes it is due to Summerheat. The principle is the same as heat diarrhea. Symptoms include a greasy complexion, profuse sweating, irritability, and thirst.
Sometimes it is due to Dampness. Excessive Dampness leads to difficult urination; water flows into the intestines making gurgling sounds, without abdominal pain. The pulse is deep and moderate, and the body feels heavy and weak. Treatment for Dampness should promote urination. If diarrhea is caused by Qi deficiency and sinking, using diuretics is lowering again after lowering; one should instead raise the Yang, as stated: "For sinking conditions, lift them." To raise Yang, use Wind herbs, which also overcome Dampness.
Sometimes it is due to Food Stagnation. Injury to food causes Spleen stagnation, preventing the transport of water and grain, leading to diarrhea. Belching smells like rotten eggs, there is colicky abdominal pain, pain followed by diarrhea, relief after passing stool, then pain returns shortly. Stool is foul, sticky, and yellow (previous food stagnates, subsequent food stops, accumulating over time before being expelled, hence the foul smell).
Sometimes it is due to Alcohol. Diarrhea occurs once or twice every dawn. (Alcohol is damp in nature; night Qi is Yin and cold, unable to retain it long, so diarrhea inevitably occurs at dawn.)
Sometimes it is due to Drinking Water. Thirst leads to drinking, drinking leads to diarrhea, diarrhea leads back to thirst, repeating the cycle.
Sometimes it is due to Phlegm. Phlegm stagnation blocks Qi movement, causing water and grain to mix indistinguishably. There is dull, slight abdominal pain or a feeling of cold. Stool resembles thick fluid, intermittent diarrhea varying in amount, loss of appetite without hunger, emaciation despite previous obesity, and a slippery pulse.
If the Spleen is deficient and cannot accept food, borborygmus and abdominal fullness occur immediately after eating, relieved only by vomiting up the food. Without eating, there is no issue; this is called Spleen Diarrhea.
Diarrhea occurring once or twice at dawn is called Kidney Diarrhea (due to Kidney Fire deficiency and cold).
If Liver Qi is stagnant, accompanied by hypochondriac pain and diarrhea, it is called Liver Diarrhea.
If oral and tongue ulceration accompanies diarrhea, it is Heat in the Heart and Spleen meridians. The Heart opens into the tongue, and the Spleen opens into the mouth; Heat attacking upward causes ulceration. If Heat transfers to the Stomach and Small Intestine, transport and transformation fail, causing diarrhea, called Mouth Ulcer Diarrhea.
Chronic diarrhea that does not stop is called Slippery Diarrhea or Hole Diarrhea. The anus is like a bamboo tube; food enters and exits directly without control, indicating impending Qi collapse. If food intake ceases, there is no cure.
Treatment methods: For Wind Diarrhea, use Shengyang Yijie Decoction (see Chills). For Cold Diarrhea, use Lizhong Decoction (see Middle Cold) or Jiangshui San. For Heat Diarrhea, use Yiyuan San (see Summerheat Injury) added with Scutellaria Baicalensis Root, Coptis Chinensis Rhizome, Juncus Effusus Stem, and Bamboo Leaf. Remove Atractylodes Macrocephala Rhizome from Zhixie Tang, add Coptis Chinensis Rhizome, Talcum, and Dolichos Lablab Seed. If Heat stops in the upper chest, causing thirst and excessive drinking, but the Stomach lacks Heat to process water, leading to diarrhea, moxa the depression below the first thoracic vertebra; Wuling San (see Dampness Injury) is also suitable. For Summerheat Diarrhea, use Qingliu Wan (see Dysentery) or Yulong Wan. For Dampness Diarrhea, use Weiling Tang, Wuling San, or swallow Wuji Wan with Shengyang Chushi Tang or Zhixie Tang. Add Ginger and Cinnamon Twig for Cold-Damp; add Coptis Chinensis Rhizome and Pueraria Lobata Root for Heat-Damp. For Food Diarrhea, use Pingwei San (see Food Injury) added with Immature Bitter Orange. Identify the ingested substance, burn it to charcoal, and administer 3-5 qian. If constitution is strong, use purgatives. For Alcohol Diarrhea, use Lizhong Decoction (see Middle Cold) added with Kudzu Root, swallow Wine-processed Coptis Chinensis Rhizome Pills (see Summerheat Injury), or Gehua Jieying Tang (see Food Injury). For Water Drinking Diarrhea, use Shenyao Wan (see Swelling) for excess patterns, or Chunze Tang (see Dampness Injury) and Baizhu Tiaozhong Tang for deficiency patterns. For Phlegm Diarrhea, use Zhixie Tang added with Pinellia Ternata Tuber and Sea Powder. For excess, induce vomiting or purge; for deficiency, use Liujunzi Tang (see Qi). For Spleen Diarrhea, use Kuaipi Wan. For Kidney Diarrhea, use Sishen Wan, taken morning and evening. For Liver Diarrhea, use Zhixie Tang added with Bupleurum Root and Green Tangerina Peel. If Liver Qi fails to consolidate, causing Spleen Qi to scatter and fail to transport, add White Peony Root. For Mouth Ulcer Diarrhea, symptoms on top cease when diarrhea starts, and vice versa. During mouth ulcers, use Xiexin Daochi San brewed in boiling water. During diarrhea, use Shenling Baizhu San taken with rice gruel morning and evening. If urine is scanty and diuresis continues, water flows to the large intestine; use equal parts Poria and Plantago Seed boiled as tea. If cold-natured drugs fail to heal mouth ulcers, it indicates floating deficiency Fire; use Lizhong Decoction added with Cinnamon Bark and significantly increased Poria to descend Yang and promote urination. Descending Yang heals mouth ulcers; promoting urination stops diarrhea. For chronic diarrhea, use Bazhu San or Sijunzi Tang (see Qi) added with Myristica Seed and Cimicifuga Rhizome. Zhang Zhongjing said: "Unremitting diarrhea worsens with Lizhong Decoction because Lizhong regulates the Middle Jiao, whereas this diarrhea is in the Lower Jiao; treat with Red Stone Lapis and Hematite Decoction/Pill." Chronic unremitting diarrhea often transforms into dysentery (see Dysentery section). Use Magnolia Bark and Immature Bitter Orange Decoction to prevent in excess patterns; Sishen Wan for deficiency-cold. Astringents such as Guchang Wan and Chebulae Fructus Powder treat heat diarrhea; Fupi Wan, Taohua Wan, Chebulae Pill, and Red Stone Lapis and Hematite Decoction treat cold slipperiness. Chronic diarrhea离不开 Licorice Root and White Peony Root because it is a Spleen disease. It离不开 Atractylodes Macrocephala Rhizome because it is a Dampness disease. Avoid Aurantium Imperiale Fruit because it relaxes the intestines. Avoid Angelica Sinensis Root because it lubricates the intestines (use White Peony Root if using Buzhong Yiqi Tang). If diarrhea recurs next year in the same month, there is accumulation. For heat accumulation, use Dachengqi Tang (see Constipation); for deficiency, use Baohe Wan (see Food Injury) added with Curcuma Zedoaria Rhizome and Curcuma Phaeocaulis Rhizome. For cold accumulation, use Beiji Wan (see Food Injury).
Lizhong Decoction (see Middle Cold) added with Poria and Coptis Chinensis Rhizome is named Lianli Tang, most suitable for mixed cold-heat diarrhea (e.g., summerheat injury combined with internal damage from cold/raw food, or unresolved diarrhea after heat pathogen clears). In all diarrhea, after fluids are lost, thirst and red/scanty urine occur; do not immediately diagnose as heat. (It must be thirst and red/scanty urine from onset to be heat.) After Yin-Yang differentiation and cessation of diarrhea, if urine remains scanty, it is Lung Qi deficiency failing to generate water; use Buzhong Yiqi Tang (see Qi) added with Ophiopogon Japonicus Root and Schisandra Berry. Or Kidney Yin deficiency causing water depletion; use Liuwei Wan (see Deficiency Damage) added with Ophiopogon Japonicus Root and Schisandra Berry. Or Kidney Yang deficiency failing to transform Yin; use Bawei Wan (see Deficiency Damage). Further diuresis will worsen urine retention, cause water intoxication, and trigger swelling. Diarrhea pulse must be deep, preferably fine/small, not large/rapid/excess. Downward diarrhea with upward vomiting of phlegm, unceasing, indicates collapse of both upper and lower, a death sign. Abdominal distension, cold extremities, unremitting diarrhea, and physical emaciation indicate death.