经曰∶水谷之寒热，感则害人六腑。又曰∶虚邪之中人也，留而不去，传舍于肠胃，多寒则肠鸣飧泄，食
不化，多热则溏如糜。夫泄泻之本，无不由于脾胃。盖胃为水谷之海，而脾主运化，使脾健胃和，则水谷腐化，
而为气血以行荣卫。若饮食失节，寒温不调，以致脾胃受伤，则水反为湿，谷反为滞，精华之气，不能输化，乃
致合污下降，而泄泻作矣。
凡泄泻肠鸣腹不痛者，是湿，宜燥渗之；
饮食入胃不住，或完谷不化者，是气虚，宜温补之；腹痛肠鸣泻水，痛一阵、泻一阵者，是火，宜清利之；时泻
时止，或多或少，是痰积，宜豁之；腹痛甚而泻，泻后痛减者，为食积，宜消之，体实者下之；如脾泄已久，
大肠不禁者，宜涩之，元气下陷者升提之。
泄泻有五∶寒、热、虚、实、食积也。但宜分别所泻之色。凡暴注下迫，属火；水液清澄，属寒；老黄色属
心脾肺实热，宜清解；淡黄色属虚热，宜调补；青色属寒，宜温；白色属脾虚，宜补；酱色属湿气，宜燥湿，
馊酸气属伤食，宜消。
脾土虚寒作泻，所下白色，或谷食不化，或水液澄清。其候神疲，唇口舌俱白色，口气温热，宜理中汤或
六君子汤。
热证作泻，泻时暴注下迫，谓其出物多而迅速也，便黄溺赤，口气蒸手，烦渴少食，宜五苓散加栀仁。
有伤食及滞泻者，其候口嗳酸气，吞酸腹胀，一痛即泻，一泻痛减，保和丸消之。
如食已消，痛已止，而犹泄泻不止者，乃脾失清升之气，气虚下陷，补中益气汤。
有风泻，泻而色青稠粘，乃肝木乘脾，宜六君子汤加防风、柴胡、白芍。
有湿泻，腹内肠鸣，肚不痛，身体重而泻水，或兼风者，水谷混杂，宜升阳除湿汤。
凡大泻作渴者，其病不论新久，皆用七味白术散生其津液。凡痢疾作渴亦然。盖白术散为渴泻之圣药。倘
渴甚者，以之当茶水，不时服之，不可再以汤水，兼之则不效矣。
久泻不止，多属虚寒。宜参苓白术散，加肉豆蔻煨熟为丸，服之自止。
久泻未止，将成疳者，参苓白术散加肉豆蔻煨，倍加怀山药，共为末。每日服之，则泄泻自止，津液自生，
不致成疳矣。
经曰∶五虚者死，一脉细，二皮寒，三少气，四泄泻不止，五饮食不入。五虚悉具者死，能食者生。
凡泻不止精神好者，脾败也；吐泻而唇
深红者，内热也；色若不退者死，面黑气喘者死。遗屎不禁者，肾气绝也。
《黄帝内经》说：饮食中的寒热之邪，侵入人体就会伤害六腑。又说：虚邪贼风侵袭人体，如果停留不去，传变并停留在肠胃之间，寒气多则出现肠鸣、完谷不化的泄泻；热气多则大便稀薄如粥状。大凡泄泻的根本原因，没有不是由于脾胃受损引起的。因为胃是受纳水谷的脏腑（水谷之海），脾主运化水谷精微，如果脾气健运、胃气和降，那么水谷就能被腐熟消化，转化为气血以运行于营卫之中。如果饮食没有节制，寒温失调，导致脾胃受伤，那么水液就会变成湿浊，谷物就会停滞不化，精华之气不能正常输布转化，于是混杂污秽之物下降，泄泻就发生了。
凡是泄泻伴有肠鸣但腹部不痛的，属于湿邪，适宜用燥湿渗利的方法治疗；
食物进入胃中无法停留，或者大便中有未消化的食物残渣的，属于气虚，适宜用温补的方法治疗；腹痛伴肠鸣、泻下如水，疼痛一阵、腹泻一阵的，属于火邪，适宜用清热利湿的方法治疗；时断时续地腹泻，或多或少，属于痰积，适宜用豁痰的方法治疗；腹痛剧烈且伴随腹泻，排便后疼痛减轻的，属于食积，适宜用消导的方法治疗，体质壮实者可用攻下法；如果是脾虚泄泻日久，大肠固摄无力的，适宜用涩肠止泻的方法，元气下陷的应当升提阳气。
泄泻分为五种：寒、热、虚、实、食积。但应当分别观察排泄物的颜色。凡是突然发作、急迫向下的泄泻，属于火邪；排泄物清亮澄澈的，属于寒邪；老黄色的属于心、脾、肺的实热证，适宜清热解表；淡黄色的属于虚热证，适宜调理补益；青色的属于寒邪，适宜温里；白色的属于脾虚，适宜补益；酱色的属于湿气，适宜燥湿；有馊酸气味的属于伤食，适宜消食导滞。
脾土虚寒导致的泄泻，排泄物呈白色，或者食物不消化，或者水液清亮澄澈。其症状表现为精神疲倦，嘴唇、口唇和舌头都呈现白色，口气温热，适宜使用理中汤或六君子汤。
热证导致的泄泻，排便时突然发作、急迫向下（指出物多而迅速），小便黄赤，呼气烫手，心烦口渴、食欲减退，适宜使用五苓散加栀子仁。
有伤食及停滞性泄泻的，其症状表现为口中嗳出酸气，吞酸腹胀，一痛即泻，泻后疼痛减轻，适宜使用保和丸消食导滞。
如果食物已消化，疼痛已停止，但仍然泄泻不止的，这是脾失清阳上升之气，气虚下陷，适宜使用补中益气汤。
有风邪导致的泄泻，大便青色稠粘，这是肝木乘克脾土，适宜使用六君子汤加防风、柴胡、白芍。
有湿邪导致的泄泻，腹内肠鸣，肚子不痛，身体沉重且泻下清水，或者兼夹风邪的，水谷混杂，适宜使用升阳除湿汤。
凡是严重腹泻且感到口渴的，无论病程新久，都使用七味白术散来生津液。凡是痢疾导致口渴的情况也是如此。因为白术散是治疗渴泻的圣药。如果口渴严重的，将其当作茶水，随时服用，不要再额外饮用汤水，否则效果不佳。
久泻不止，多属于虚寒证。适宜使用参苓白术散，加入煨熟的肉豆蔻制成丸剂服用，泄泻自然停止。
久泻未止，即将发展成疳证的，使用参苓白术散加入煨熟的肉豆蔻，加倍加入怀山药，共同研为细末。每日服用，则泄泻自止，津液自生，就不会发展成疳证了。
《黄帝内经》说：五虚证预后不良，可能致死，具体表现为：一脉象细微，二皮肤寒冷，三气息微弱，四泄泻不止，五饮食不入。如果五虚症状全部具备则死亡，如果能进食则有生机。
凡是腹泻不止但精神尚好的，是脾脏败坏的表现；呕吐腹泻且嘴唇深红色的，是内热炽盛；面色如果不退黑则死，面色发黑且气喘的则死。大便失禁的，是肾气衰竭的表现。
The *Yellow Emperor's Inner Classic* states: Cold and heat from food and drink, when invading the body, harm the Six Fu organs. It also states: When deficient evil (pathogenic factors) invades a person, if it remains and does not depart, it transmits and lodges in the intestines and stomach. If there is excess cold, it causes borborygmus (intestinal rumbling) and diarrhea with undigested food; if there is excess heat, it causes loose stools resembling porridge. The root of diarrhea lies invariably in the Spleen and Stomach. The Stomach is the sea of water and grain, while the Spleen governs transportation and transformation. If the Spleen is healthy and the Stomach harmonious, water and grain are decomposed and transformed into Qi and Blood to nourish Ying and Wei (Nutritive and Defensive levels). However, if dietary habits are irregular or cold and heat are unbalanced, causing injury to the Spleen and Stomach, then water transforms into dampness, and grain becomes stagnant. The essence of Qi cannot be transported and transformed, leading to the downward movement of impure substances, thereby resulting in diarrhea.
In cases where diarrhea is accompanied by borborygmus but no abdominal pain, it is due to Dampness, and treatment should focus on drying and leaching out dampness.
If food entering the stomach cannot be retained, or if undigested food appears in the stool, it is due to Qi deficiency, and treatment should focus on warming and tonifying.
If there is abdominal pain with borborygmus and watery diarrhea, where pain occurs in bursts followed by diarrhea, it is due to Fire, and treatment should focus on clearing heat and promoting urination.
If diarrhea comes and goes intermittently, varying in amount, it is due to Phlegm accumulation, and treatment should focus on resolving phlegm.
If abdominal pain is severe and diarrhea follows, with pain relief after defecation, it is due to Food stagnation, and treatment should focus on digesting food; for those with strong constitution, purgation may be used.
If Spleen-deficiency diarrhea has persisted for a long time, leading to intestinal incontinence, treatment should focus on astringing the intestines; if Yuan Qi (Original Qi) has sunk, it should be lifted and raised.
Diarrhea is categorized into five types: Cold, Heat, Deficiency, Excess, and Food stagnation. One must distinguish based on the color of the excrement. Sudden onset with urgent tenesmus belongs to Fire; clear and transparent fluid belongs to Cold; dark yellow belongs to Excess-Heat of the Heart, Spleen, and Lungs, requiring clearing and resolving; pale yellow belongs to Deficient-Heat, requiring regulation and tonification; green belongs to Cold, requiring warming; white belongs to Spleen deficiency, requiring tonification; sauce-colored belongs to Dampness, requiring drying dampness; sour and rancid odor belongs to Food injury, requiring digestion.
When Spleen Earth deficiency and cold cause diarrhea, the excrement is white, or contains undigested food, or is clear fluid. Symptoms include mental fatigue, white lips, mouth, and tongue, and warm breath. Treatment should use Lizhong Tang (Regulate the Middle Decoction) or Liujunzi Tang (Six Gentlemen Decoction).
In diarrhea caused by Heat syndrome, the onset is sudden and urgent (indicating large volume and rapid expulsion), with yellow urine and hot breath, irritability, thirst, and poor appetite. Treatment should use Wuling San (Five-Ingredient Powder with Poria) added with Zhiren (Gardenia Seed).
In cases of Food injury and stagnant diarrhea, symptoms include sour belching, acid regurgitation, abdominal distension, pain immediately preceding diarrhea, and pain relief after defecation. Treatment should use Baohe Wan (Preserve Harmony Pill) to digest food.
If the food has been digested and pain has ceased, but diarrhea continues, this indicates that the Spleen has lost its clear ascending Qi, and Qi deficiency has led to sinking. Treatment should use Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction).
In Wind-induced diarrhea, the stool is green, thick, and sticky, indicating Liver Wood overacting on Spleen Earth. Treatment should use Liujunzi Tang (Six Gentlemen Decoction) added with Fangfeng (Saposhnikovia Root), Chaihu (Bupleurum Root), and Baishao (White Peony Root).
In Damp-induced diarrhea, there is borborygmus in the abdomen, no abdominal pain, heavy body, and watery diarrhea, or mixed water and grain if wind is also involved. Treatment should use Shengyang Chushi Tang (Raise Yang and Expel Dampness Decoction).
For any severe diarrhea accompanied by thirst, regardless of whether the disease is new or chronic, Qiwei Baizhu San (Seven-Ingredient Atractylodes Macrocephala Powder) should be used to generate fluids. The same applies to thirst caused by Dysentery. This powder is considered the supreme remedy for thirsty diarrhea. If thirst is severe, it should be taken as tea frequently, without additional soup or water, otherwise efficacy will be lost.
Chronic diarrhea that does not stop often belongs to Deficiency-Cold. Treatment should use Shenling Baizhu San (Ginseng, Poria, and Atractylodes Macrocephala Powder) added with roasted Roudoukou (Nutmeg), made into pills, which will naturally stop the diarrhea.
If chronic diarrhea persists and is about to develop into Gan syndrome (Infantile Malnutrition), use Shenling Baizhu San added with roasted Roudoukou (Nutmeg), doubling the amount of Huai Shanyao (Chinese Yam), and grind them together into powder. Daily administration will stop the diarrhea, generate fluids, and prevent the development of Gan syndrome.
The *Inner Classic* states: Death results from the Five Deficiencies. These are: one, fine pulse; two, cold skin; three, shortness of breath; four, unremitting diarrhea; five, inability to eat. If all five deficiencies are present, death ensues; if the patient can eat, life is possible.
If diarrhea is unremitting but spirit is good, it indicates Spleen failure; if vomiting and diarrhea are accompanied by deep red lips, it indicates internal heat; if the complexion does not fade, death occurs; if the face is black and there is panting, death occurs. Incontinence of feces indicates the exhaustion of Kidney Qi.