论泻之原，有冷泻、热泻。伤食泻、水泻、积泻、惊泻、风泻、脏寒泻、疳积酿泻，
种种不同，各分于后。冷泻多是白水，泻密而少，腹痛而鸣，眉皱目慢，面带白色，额
有汗多，此为冷泻。冲和饮。当归散，合和水煨姜煎服，并守中汤、参苓白术散、益中
膏、沉香槟榔丸治之。热泻大梗黄色，如筒吊水，泻过即止，半日复然心烦口渴，小便
黄少，食乳必粗，此为热泻。先用五苓散或大顺饮，次以钱氏白术散主之，香薷散亦佳。
伤食泻，乃脾胃素弱，复为生冷果食所伤，故大便不聚而泻，或因乳母餐生冷肥腻之物，自
乳而过，亦能作泻，面唇俱白，泻稀而少，或如坏鸡子，腥臭异常，身形黄瘦，名伤食泻。
宜先温正胃气，次理积而后固脾，冲和饮、当归散，合和水、煨姜、枣子煎服。理积，儿
大者乌犀丸，小者化癖丸、三棱散、固脾和中散、醒脾散。水泻谓之洞泄，乃阴阳不顺，
水谷不分，泻黄水而小便少，番次密而无度，是夏秋之际，昼则解衣取凉，夜则失盖感冷，
冷热相激，清浊浑乱，或因母自热中来，乳有热气，遽以哺之，令儿脾胃不和，水谷交
杂而下，以 咀五苓散加薏苡仁、车前子、半夏，水姜煎服。分正阴阳，或先用大顺饮，温
白汤调下。香薷散调中止补，钱氏白术散、六和汤亦好。积泻，脾气虚弱，乳食入胃，不
能运化，积滞日久，再为冷食所伤，传之大肠，遂成泄泻，留连不止，诸药不效。盖以
积在脾胄，积既未除，何由得愈？宜先去积，后止泻，泻止实脾，则病除矣，三棱散、乌
犀丸，续用沉香槟榔丸、参苓白术散、和中散、香橘饼调理。惊泻，粪青如苔，稠若胶
粘，不可便止，但镇心抑肝，和脾胃，消乳食，斯为治法。先投五苓散，次用三棱散，水
姜、粳米煎服，或三解散，煨神曲、生姜煎汤调服，及沉香槟榔丸、不惊丹调治。风泻，
慢惊大病后有之。其粪稀黄褐色，或夹不消乳食同下，此因脾虚所致，或夹褐黑色者属
肾。盖脾虚为肾水所乘故也。若久不进饮食，再有惊搐，宜疏肾水，去脾风，次补脾则自
愈，庶无复作之患。疏肾水， 咀五苓散加黑牵牛半生半炒，并薏苡仁，水、姜煎服。去
脾风，泻黄散。调脾气，参苓白术散。脏寒泻，粪如青竹色，下稀不稠，或下青水，未
泻时腹痛而鸣，叫哭方泻，多是生来三五月内有此，周岁则无。始因断脐带短，风冷自
外逼内而成，此疾先用冲和饮，水葱白煎投，温中解表，次以当归散，水、煨姜煎服，及
投匀气散。理中汤。疳积酿泻，其候面色痿黄，肚胀脚弱，头大项小，发稀且竖，肌肉
消瘦，不思饮食，昼凉夜热，或腹内有症癖气块，泻则颜色不等，其臭异常，其泻有时，
或一月半月旬日一番，自泻自止，名为疳积酿泻。先以当归散加三棱。陈皮，水、姜煎
服，次投乌犀丸、沉香槟榔丸及化癖丸、芦荟丸、没石子丸。儿最小者，难下丸子，止
投三棱散、快膈汤，自然痊愈。若泻或痢，色青甚而淡黄夹白，寒多热少，此阴邪胜阳，宜
用守中汤、胃苓汤与服，扶表救里，方进当归散加陈皮、紫苏，水、姜、糯米煎服。亦
宜和解，理中汤、清米饮，空心调服，温脾去湿，益气清神。寒盛者。理中汤内加熟附
子，水姜、枣煎服，次投南星腹皮饮，水、姜煎服，和脾胃，去阴邪，若泻或泄，色青淡
而有沫粪稠，热多寒少，亦致面黄肌瘦，烦躁不宁，宜以 咀五苓散加薏苡仁、车前子，
水姜煎服。解散余邪，仍用茵陈蒿、栀子仁煎汤，调细末五苓散温服，退黄色，消阳毒，
及当归散，水、姜、枣煎投，或服万安饮、四神散。
论述泄泻的成因，有冷泻、热泻之分。还有伤食泻、水泻、积泻、惊泻、风泻、脏寒泻、疳积酿泻等，种种情况各不相同，分别叙述如下。
冷泻多排出白色稀水，排便次数密而量少，腹部疼痛且肠鸣，眉头紧皱，眼神迟缓，面色苍白，额头出汗较多，这称为冷泻。可用冲和饮治疗。当归散，配合和水及煨姜煎服；也可用守中汤、参苓白术散、益中膏、沉香槟榔丸来治疗。
热泻大便呈深黄色，如筒状吊水般直下，泻后随即停止，半天后又复发，伴有心烦口渴，小便黄少，吃奶时必然急躁粗鲁，这称为热泻。先用五苓散或大顺饮，随后以钱氏白术散为主治方，香薷散也很好。
伤食泻，是因为脾胃素来虚弱，又受到生冷瓜果食物的伤害，所以大便不成形而泄泻；或者因为乳母吃了生冷肥腻的食物，通过乳汁传给孩子，也能引起泄泻。患儿面唇俱白，大便稀薄量少，有时像坏鸡蛋一样，气味腥臭异常，身体发黄消瘦，名为伤食泻。应当先温补调和胃气，再消理积滞，最后固护脾气。可用冲和饮、当归散，配合和水、煨姜、枣子煎服。若要消理积滞，年龄较大的幼儿可用乌犀丸，年幼的可用化癖丸、三棱散、固脾和中散、醒脾散。
水泻被称为洞泄，是由于阴阳不调，水谷不分，排出黄色水样便且小便减少，腹泻频繁无度。这是在夏秋之际，白天脱衣取凉，晚上失去覆盖感受寒冷，冷热相互激荡，清浊之气混乱所致；或者因为母亲从炎热环境中来，乳汁带有热气，立即哺乳，导致小儿脾胃不和，水谷混杂而下。可用咀碎的五苓散加薏苡仁、车前子、半夏，用水和生姜煎服。以此分调阴阳，或者先用大顺饮，用温开水送服。香薷散可调理中焦并补益，钱氏白术散、六和汤也很好。
积泻，因脾气虚弱，乳食进入胃中，不能运化，积滞日久，再次受到冷食伤害，传导至大肠，遂成泄泻，迁延不止，各种药物无效。这是因为积滞在脾胃，积滞未除，怎么能痊愈呢？应当先去积滞，后止泄泻，泻止后充实脾气，病就能消除了。可用三棱散、乌犀丸，接着使用沉香槟榔丸、参苓白术散、和中散、香橘饼进行调理。
惊泻，粪便青色如苔藓，稠厚若胶粘，不可强行止泻，只需镇心安神、抑制肝风，调和脾胃，消导乳食，这才是治疗方法。先投予五苓散，随后用三棱散，加水、生姜、粳米煎服；或者用三解散，加煨神曲、生姜煎汤调服，以及沉香槟榔丸、不惊丹进行治疗。
风泻，多见于慢惊大病之后。其粪便稀薄呈黄褐色，或夹杂未消化的乳食一同排出，这是因脾虚所致；如果夹杂褐黑色，则属于肾。这是因为脾虚被肾水所乘（克制）的缘故。如果长时间不进饮食，又有惊厥抽搐，应当疏利肾水，祛除脾风，然后补脾，自然痊愈，这样才没有复发的隐患。疏利肾水，可用咀碎的五苓散加黑牵牛（半生用半炒用），并加薏苡仁，用水、生姜煎服。祛除脾风，用泻黄散。调理脾气，用参苓白术散。
脏寒泻，粪便颜色如青竹色，下利稀薄不稠，或者排出青色水液，未泻之前腹痛肠鸣，叫哭之后才泻出，多是出生后三到五个月内出现这种情况，满周岁就没有了。起初是因为断脐带过短，风冷之邪从外部逼迫入内而成。此疾先用冲和饮，用水葱白煎煮投服，以温中解表；随后用当归散，用水、煨姜煎服，以及投用匀气散、理中汤。
疳积酿泻，其症状表现为面色萎黄，肚子胀大，脚部软弱，头大项小，头发稀疏且竖立，肌肉消瘦，不思饮食，白天发凉晚上发热，或者腹内有症癖气块，泻下时颜色不等，气味异常，泄泻有定时，或者一月半月、旬日一次，自行泄泻自行停止，名为疳积酿泻。先用当归散加三棱、陈皮，用水、生姜煎服；随后投用乌犀丸、沉香槟榔丸以及化癖丸、芦荟丸、没石子丸。幼儿最小的，难以吞咽丸子，只投用三棱散、快膈汤，自然痊愈。
如果泄泻或痢疾，颜色青甚而淡黄夹白，寒多热少，这是阴邪胜过阳邪，宜用守中汤、胃苓汤服用，扶正体表，救里，然后进服当归散加陈皮、紫苏，用水、生姜、糯米煎服。也宜和解，用理中汤、清米饮，空腹调服，以温脾去湿，益气清神。寒盛者，在理中汤内加熟附子，用水、生姜、枣子煎服；随后投用南星腹皮饮，用水、生姜煎服，以和脾胃，去阴邪。如果泄泻或泄，颜色青淡而有泡沫，粪质稠厚，热多寒少，也会导致面黄肌瘦，烦躁不宁，宜用咀碎的五苓散加薏苡仁、车前子，用水、生姜煎服。以解散余邪，仍用茵陈蒿、栀子仁煎汤，调细末五苓散温服，以退黄色，消阳毒，以及当归散，用水、生姜、枣子煎服投用，或者服用万安饮、四神散。
The etiology of diarrhea includes cold diarrhea and heat diarrhea. There are also food-stagnation diarrhea, watery diarrhea, accumulation diarrhea, fright-induced diarrhea, wind-induced diarrhea, visceral-cold diarrhea, and malnutrition-accumulation brewing diarrhea. These conditions vary greatly and are described separately below.
Cold diarrhea typically presents with white watery stools, frequent but scanty bowel movements, abdominal pain accompanied by borborygmus, furrowed eyebrows, sluggish gaze, a pale complexion, and excessive sweating on the forehead. This is termed cold diarrhea. It can be treated with Chonghe Yin (Harmonizing Decoction). Danggui San (Angelica Powder) should be taken combined with He Shui (Harmonizing Water) and roasted ginger decocted together; alternatively, it can be treated with Shouzhong Tang (Decoction to Guard the Center), Shenling Baizhu San (Ginseng, Poria, and Atractylodes Macrocephala Powder), Yizhong Gao (Paste to Benefit the Center), or Chenxiang Binglang Wan (Aquilaria and Areca Nut Pill).
Heat diarrhea presents with dark yellow stools flowing straight down like water from a tube, stopping immediately after defecation, only to recur half a day later. It is accompanied by mental restlessness, thirst, and scanty yellow urine. The infant feeds eagerly and roughly. This is termed heat diarrhea. Initially, Wuling San (Five-Ingredient Poria Powder) or Dashun Yin (Great Smoothness Decoction) should be used, followed primarily by Qian Shi Baizhu San (Dr. Qian’s Atractylodes Powder); Xiangru San (Elsholtzia Powder) is also excellent.
Food-stagnation diarrhea occurs due to pre-existing weakness of the spleen and stomach, compounded by injury from raw, cold fruits and foods, resulting in unformed stools and diarrhea. Alternatively, if the nursing mother consumes raw, cold, fatty, or greasy foods, these qualities may transmit through breast milk, causing diarrhea in the infant. The child exhibits a pale face and lips, thin and scanty stools, sometimes resembling spoiled eggs with an exceptionally fishy and foul odor, along with a sallow, emaciated body. This is named food-stagnation diarrhea. Treatment should first warm and regulate stomach qi, then resolve stagnation, and finally secure the spleen. Chonghe Yin and Danggui San, decocted with He Shui, roasted ginger, and dates, are indicated. To resolve stagnation, older children may use Wuxi Wan (Rhino Horn Pill), while younger children may use Huapi Wan (Stasis-Resolving Pill), Sanleng San (Curcuma Powder), Gu Pi He Zhong San (Spleen-Securing and Middle-Harmonizing Powder), or Xing Pi San (Spleen-Awakening Powder).
Watery diarrhea is called Dongxie (Cavity Leakage Diarrhea). It results from disharmony of yin and yang and the failure to differentiate water and grain, presenting with yellow watery stools and scanty urination. Bowel movements are frequent and uncontrolled. This often occurs in summer and autumn when one exposes the body to cool air during the day and loses cover at night, allowing cold to invade. The clash of cold and heat confuses the clear and turbid qi. Alternatively, if the mother comes from a hot environment and breastfeeds immediately while her milk carries excess heat, it disrupts the infant’s spleen and stomach harmony, causing water and grain to mix and descend. Crushed Wuling San (Five-Ingredient Poria Powder) added with Yiyiren (Coix Seed), Cheqianzi (Plantago Seed), and Banxia (Pinellia Tuber), decocted with water and ginger, is prescribed to balance yin and yang. Alternatively, Dashun Yin (Great Smoothness Decoction) may be taken first with warm water. Xiangru San (Elsholtzia Powder) regulates the middle jiao and tonifies; Qian Shi Baizhu San (Dr. Qian’s Atractylodes Powder) and Liuhe Tang (Six-Harmonies Decoction) are also suitable.
Accumulation diarrhea arises from spleen qi deficiency, where ingested milk and food fail to transform and transport. Stagnation persists for a long time, and subsequent injury from cold foods transmits to the large intestine, resulting in persistent diarrhea that resists various treatments. Since the accumulation resides in the spleen and stomach, how can recovery occur without removing it? One must first eliminate the accumulation, then stop the diarrhea, and finally strengthen the spleen once the diarrhea ceases, leading to cure. Sanleng San (Curcuma Powder) and Wuxi Wan (Rhino Horn Pill) are used initially, followed by Chenxiang Binglang Wan (Aquilaria and Areca Nut Pill), Shenling Baizhu San (Ginseng, Poria, and Atractylodes Macrocephala Powder), Hezhong San (Middle-Harmonizing Powder), and Xiangju Bing (Fragrant Tangerine Peel Cake) for regulation.
Fright-induced diarrhea presents with green, moss-like, thick, and sticky stools. Forced cessation of diarrhea is contraindicated; instead, the treatment involves calming the heart and suppressing liver wind, harmonizing the spleen and stomach, and digesting milk and food. Initially, Wuling San (Five-Ingredient Poria Powder) is administered, followed by Sanleng San (Curcuma Powder) decocted with water, ginger, and Jingmi (Japonica Rice). Alternatively, Sanjie San (Three-Resolving Powder) mixed with roasted Shenqu (Medicated Leaven) and ginger decoction, or Chenxiang Binglang Wan (Aquilaria and Areca Nut Pill) and Bu Jing Dan (Non-Frightening Elixir) may be used.
Wind-induced diarrhea often follows severe cases of slow convulsions. The stool is thin and yellow-brown, possibly containing undigested milk and food, caused by spleen deficiency. If brownish-black particles are present, it relates to the kidney, as spleen deficiency allows kidney water to overact. If the child refuses food for a long time and experiences convulsions again, one should drain kidney water, dispel spleen wind, and then tonify the spleen for natural recovery, preventing recurrence. To drain kidney water, crushed Wuling San (Five-Ingredient Poria Powder) added with Hei Qianniu (Black Morning Glory Seed, half raw and half stir-fried) and Yiyiren (Coix Seed), decocted with water and ginger, is used. To dispel spleen wind, Xiehuang San (Draining Yellow Powder) is prescribed. To regulate spleen qi, Shenling Baizhu San (Ginseng, Poria, and Atractylodes Macrocephala Powder) is used.
Visceral-cold diarrhea presents with stools colored like green bamboo, thin and non-viscous, or discharging green water. Abdominal pain and borborygmus occur before defecation, followed by crying and then diarrhea. This condition typically appears within three to five months after birth and resolves by one year of age. It originates from a short umbilical cord stump, allowing wind and cold to invade from the exterior. Initially, Chonghe Yin (Harmonizing Decoction) is decocted with Shuicongbai (Water Scallion White) to warm the interior and release the exterior. Subsequently, Danggui San (Angelica Powder) decocted with water and roasted ginger, along with Yunqi San (Qi-Balancing Powder) and Lizhong Tang (Regulate the Middle Decoction), are administered.
Malnutrition-accumulation brewing diarrhea presents with a sallow complexion, distended abdomen, weak legs, a large head with a thin neck, sparse and erect hair, muscle emaciation, anorexia, daytime chilliness with nighttime fever, and possible abdominal masses. Stools vary in color and have an abnormal odor, occurring periodically (e.g., every ten days to a month), starting and stopping spontaneously. This is named malnutrition-accumulation brewing diarrhea. Initially, Danggui San (Angelica Powder) added with Sanleng (Curcuma) and Chenpi (Tangerine Peel), decocted with water and ginger, is given. Subsequently, Wuxi Wan (Rhino Horn Pill), Chenxiang Binglang Wan (Aquilaria and Areca Nut Pill), Huapi Wan (Stasis-Resolving Pill), Lushui Wan (Aloe Pill), and Moshizi Wan (Myrobalan Pill) are administered. For very young infants unable to swallow pills, only Sanleng San (Curcuma Powder) and Kuai Ge Tang (Rapid Epigastric Decoction) are used, leading to natural recovery.
If diarrhea or dysentery presents with colors ranging from deep green to pale yellow with white, indicating more cold than heat (yin pathogen overcoming yang), Shouzhong Tang (Decoction to Guard the Center) and Weiling Tang (Stomach and Poria Decoction) should be taken to support the exterior and rescue the interior. Then, Danggui San (Angelica Powder) added with Chenpi (Tangerine Peel) and Zisu (Perilla Leaf), decocted with water, ginger, and Nuomi (Glutinous Rice), is administered. Harmonization is also appropriate; Lizhong Tang (Regulate the Middle Decoction) and Qing Mi Yin (Clear Rice Drink) taken on an empty stomach warm the spleen, remove dampness, boost qi, and clarify the spirit. In cases of severe cold, Shu Fuzi (Prepared Aconite Root) is added to Lizhong Tang (Regulate the Middle Decoction), decocted with water, ginger, and dates. Subsequently, Nanxing Fupi Yin (Arisaema and Tangerine Peel Drink) decocted with water and ginger harmonizes the spleen and stomach and removes yin pathogens. If diarrhea is pale green with foam and thick consistency, indicating more heat than cold, leading to sallow complexion, emaciation, and irritability, crushed Wuling San (Five-Ingredient Poria Powder) added with Yiyiren (Coix Seed) and Cheqianzi (Plantago Seed), decocted with water and ginger, is used to dissipate residual pathogens. Still, Yinchenhao (Artemisia Capillaris Herb) and Zhiziren (Gardenia Seed) decoction is used to mix with fine powder of Wuling San (Five-Ingredient Poria Powder) for warm administration to reduce yellowness and clear yang toxicity. Additionally, Danggui San (Angelica Powder) decocted with water, ginger, and dates, or Wan’an Yin (Ten-Thousand Peace Drink) and Sishen San (Four-Essence Powder) may be taken.