论曰。脏腑泻痢。其证多种。大抵从风湿热论。是知寒少而热多。寒则不能久也。故曰暴泻非阳。久泻非
阴。论曰。春宜缓形。形缓动则肝木乃荣。反静密则是行秋令。金能制木。风气内藏。夏至则火盛而金去。
独火木旺。而脾土损矣。轻则飧泄身热脉洪。谷不能化。重则下痢脓血稠粘。皆属于火。经曰。溲而便脓血。
知气行而血止也。宜大黄汤下之。是为重剂。黄芩芍药汤为之轻剂。是实则泻其子。木能自虚而脾土实矣。故
经曰。春伤于风。夏生飧绁。此逆四时之气。人所自为也。有自太阴脾经受湿而为水泄。虚滑微满身重。不知
谷味。假令春。宜益黄散补之。夏宜泻之。法云。宜补宜泻宜和宜止。假令和则芍药汤是也。止则诃子汤是也。
久则防变而为脓血也。脾传肾。谓之贼邪。故难愈。若先痢而后滑。谓之微邪。故易痊。此皆脾土受湿。天行
为也。虽圣智不能逃。口食味。鼻食气。从鼻而入。留积于脾而为水泻。有厥阴经动。下痢不止。其脉沉而迟。
手足厥逆。涕唾脓血。此为难治。宜麻黄汤小续命汗之。法曰。谓有表邪缩于内。当散表邪而愈。有暴下无声。
身冷自汗。小便清利。大便不禁。气难布息。脉微呕吐。急以重药温之。浆水散是也。故法云。后重则宜下。
腹痛则宜和。身重则除湿。脉弦则去风。血脓稠粘。以重药竭之。身冷自汗。以毒药温之。风邪内缩。宜汗之则
愈。 溏为痢。当温之。又云。在表者发之。在里者下之。在上者涌之。在下者竭之。身表热者内疏之。小便涩
者分利之。又曰。盛者和之。去者送之。过者止之。兵法云。避其来锐。击其惰归。此之谓也。凡病泄而恶风
寒。是太阴传少阴。土来克水也。用除湿白术茯苓安脾。芍药桂黄连破血也。火邪不能胜水也。太阴经不能传
少阴。而反火邪上乘肺经。而痢必白脓也。加黄连当归之类。又里急后重。脉大而洪实。为里热而甚蔽。是有物
结坠也。若脉浮大甚。不宜下。虽里急后重。而脉沉细弱者。谓寒邪在内而气散也。可温养而自愈。里急后重
闭者。大肠经气不宣通也。宜加槟榔木香宣通其气。如痢或泄而呕者。胃中气不和也。上焦不和。治以生姜橘
皮。中焦不和。治以芍药当归桂茯苓。下焦不和。寒治以轻热甚以重热药□□□□□大便虚秘涩久不愈。恐太
阴传少阴。多传变为痢。太阴传少阴是为贼邪。先以枳实浓朴汤。以防其变。若四肢懒倦。小便少或不利。大
便走沉困饮食减。宜调胃去湿。白术芍药茯苓三味。水煎服。以白术之甘。能入胃而除脾胃之湿。芍药之酸涩。
除胃中之湿热。四肢困。茯苓之淡泄。能通水道走湿。此三味。泄痢须用此。如发热恶寒。腹不痛。加黄芩为
主。如未见脓而恶寒。乃太阴欲传少阴也。加黄连为主。桂枝佐之。如腹痛甚者。加当归倍芍药。如见血。
加黄连为主。桂当归佐之。如躁烦或先便白脓后血。或发热。或恶寒。非黄芩不止。此上部血也。
如恶寒脉沉。或腰痛。或血痢下痛。非黄连不能止。此中部血也。
如恶寒脉沉。先血后便。非地榆不能止。此下部血也。
如便脓血相杂。而脉浮大。慎不可以大黄下之。下之必死。谓气下竭而阳无所收也。凡阴阳不和。惟可以分
阴阳药治之。又云。暴泄非阳。久泄非阴。大便完谷下。有寒有热者。脉疾身
多动。音声响亮。暴注下迫。此阳也。寒者脉沉而细疾。身不动作。目睛不了了。饮食不下。鼻准气息者。姜
附汤主之。若身重四肢不举。术附汤主之。
黄芩芍药汤 治泄痢腹痛。或后重身热。久而不愈。脉洪疾者。及下痢脓血稠粘。
黄芩 芍药（各一两） 甘草（五钱）
上为粗末。每服半两。水一盏半。煎至一盏。滤清温服无时。如痛则加桂少许。
大黄汤 治泄痢久不愈。脓血稠粘。里急后重。日夜无度。久不愈者。
大黄（一两）
上细 。好酒二大盏。同浸半日许。再同煎至一盏半。去大黄不用。将酒分为二服。顿服之。痢止一服。
如未止再服。以利为度。服芍药汤和之。痢止再服黄芩汤和之。以彻其毒也。
芍药汤 下血调气。经曰。溲而便脓血。气行而血止。行血则便脓自愈。调气则后重自除。
芍药（一两） 当归 黄连（各半两） 槟榔（二钱） 木香（二钱） 甘草（二钱炙） 大黄（三钱）
黄芩（半两） 官桂（一钱半）
上 咀。每服半两。水二盏。煎至一盏。食后温服。如血痢则渐加大黄。如汗后脏毒。加黄柏半两。根据前
服。
白术黄 汤 服前药。痢虽已除。犹宜此药和之。
白术（一两） 黄 （七钱） 甘草（三钱）
上 咀。均作三服。水一盏半煎至一盏。去滓温清服之。
防风芍药汤 治泄痢飧泄身热脉弦。腹痛而渴。及头痛微汗。
防风 芍药 黄芩（各一两）
上 咀。每服半两。或一两。水三盏。煎至一盏。滤清温服。
治太阴脾经受湿。水泄注下。体微重微满。困弱无力。不欲饮食。暴泄无数。水谷不化。先宜白术芍药汤
和之。身重暴下。是大势来。亦宜和之。
白术芍药汤
白术（一两） 芍药（一两） 甘草（五钱）
上 。每服一两。水二盏。煎至一盏。滤清温服。如痛甚者。宜
苍术芍药汤
苍术（二两） 芍药（一两） 黄芩（半两）
上 。每服一两。加淡味桂半钱。水一盏半。煎至一盏。温服清。如脉弦头微痛者。宜
苍术防风汤
苍术 防风（各二两） 上使
上 。同前煎服。如下血者。宜
苍术地榆汤
苍术（二两） 地榆（一两） 下使
上 。同前煎服。
以上证。如心下痞。每服加枳实一钱。如小便不利。各加茯苓二钱。如腹痛渐已。泻下微少。宜诃子散止
之。法云。大势已去。而宜止之。
诃子散
诃子（一两半生半熟） 木香（半两） 黄连（三钱） 甘草（三钱）
上为细末。每服二钱。以白术芍药汤调下。如止之不已。宜归而送之也。诃子散加浓朴一两。竭其邪气也。
虚滑久不愈者。多传变为痢疾。太阴传于少阴。是为贼邪。先以浓朴枳实汤。防其传变。
浓朴枳实汤
浓朴（一两） 枳实（一两） 诃子（一两半生半熟） 木香（半两） 黄连（二钱） 甘草（三钱炙）
大黄（二钱）
上为细末。每服三五钱。水一盏半。煎至一盏。去滓温服。
浆水散 治暴泄如水。周身汗出。一身尽冷。脉微而弱。气少而不能语。其甚者加吐。此谓急病。治
之宜以此。
半夏（二两汤洗） 附子（半两炮） 干姜（五钱） 良姜（二钱半） 桂枝（五钱） 甘草（五钱炙）
上为细末。每服三五钱。浆水二盏。煎至一盏。和滓热服。甚者三四服。微者三服。大肠经动下痢为 溏。
大肠不能禁固。卒然而下。成水泄。青色。其中或有硬物。欲起而又下。欲了而不了。小便多清。此寒也。
宜温之。春夏桂枝汤。秋冬白术汤。
桂枝汤
桂枝 白术 芍药（各半两） 甘草（二钱炙）
上 。每服半两。水一盏。煎至七分。去滓取清。宜温服之。
白术汤
白术 芍药（各三钱） 干姜（半两炮） 甘草（二钱炙）
上 为粗末。如前服之。甚则去干姜。加附子三钱。辛能发也。
治厥阴动为泻痢者。寸脉沉而迟。手足厥逆。下部脉不至。咽喉不利。或涕唾脓血。泻痢不止者。为难治。
宜升麻汤或小续命汤以发之。法云。谓表邪缩于内。故下痢不止。当散表邪于四肢。布于络脉。外无其邪。则
脏腑自安矣。
诸水积入胃。名曰溢饮。滑泄。渴能饮水。水下复泻而又渴。此无药证。当灸大椎。
诸泻痢久不止。或暴下者。皆太阴守病。故不可离于芍药。若不受湿。不能下痢。故须用白术。是以圣人
立法。若四时下痢。于芍药白术内。春加防风。夏加黄芩。秋加浓朴。冬加桂附。
然更详外证寒热处之。如里急后重。须加大黄。如身困倦。须加白术。如通身自汗。逆冷气息微。加桂附以温
之。如或后重脓血稠粘。虽在盛冬。于温药内亦加大黄。
诸下痢之后。小便利而腹中虚痛不可忍者。此谓阴阳交错。不和之甚也。当服神效越桃散。
大栀子（三钱） 高良姜（三钱）
上和匀。每服三钱。米饮或酒调下。其痛立效。
治大便后下血。腹中不痛。谓之湿毒下血。宜服黄连汤。
黄连（去须） 当归（各半两） 甘草（二钱炙）
上 咀。每服五钱。水一盏。煎至七分。食后温服。
治大便后下血。腹中痛者。谓热毒下血。当服芍药黄连汤。
芍药 当归 黄连（各半两） 大黄（一钱） 桂（淡味半钱） 甘草（二钱炙）
上 咀。每半两同前煎服。如痛甚者。调木香槟榔末一钱服之。
治久病肠风。痛痒不任。大便下血。宜服地榆汤。
苍术（去皮四两） 地榆（二两）
上 咀。每服一两。水一盏。煎至七分。食前多服除根。
治湿泻茯苓汤。
白术（一两） 茯苓（去皮七钱半）
上 咀。水煎一两。食前服。食入而泻。谓胃中有宿谷也。当加枳实五钱。酒入而泻。湿热泻也。加黄芩
五钱。
治寒积痢。男子小儿妇人皆不问赤白。或清痢如水。不后重者寒也。经云。澄彻清冷。皆属于寒。皆为虚。
寒中有积也。宜附子巴豆之类下之。见痢则愈。空心服。
治泻痢久不止。脏腑虚滑。谷不化。用苍术汤。下桃花丸。
苍术（二两） 防风（一两）
上 为细末。用水一碗。煎至一大盏。绞清汁。下桃花丸八十丸立愈。如小便涩少。以五苓散下桃花丸。
或赤石脂丸。小便利则愈矣。
大阳为协热痢。凉膈散主之。
阳明为痼瘕。进退大承气汤主之。珍珠囊中有。
少阳风气自动。其脉弦。大柴胡汤主之。
太阴湿胜濡泻。不可利而可温。四逆汤主之。
少阴蛰封不禁固。可涩。赤石脂丸干姜汤主之。
厥阴风泄。以风治风。小续命汤消风散主之。
治下痢脓血。里急后重。日夜无度。导气汤。
芍药（一两） 当归（五钱） 大黄 黄芩（各二钱半） 黄连 木香（各一钱） 槟榔（一钱）
上为末。每服三五钱。水一盏。煎至七分。去滓温服。如未止再服。不后重则止。
杂例
溲而便脓血者。大肠泄也。脉五至之上洪者。宜以七宣丸。如脉平者。立秋至春分。宜香连丸。春分至立
秋。宜芍药柏皮丸。四季通用。宜加减平胃散七宣丸之类。后宜服此药。去其余邪。兼平胃气。
芍药柏皮丸
芍药 黄柏（各等分）
上为细末。醋糊为丸。如桐子大。每服五七十丸。至二百丸。温水下。食前服。
加减平胃散
白术 浓朴 陈皮（各一两） 甘草（七钱） 槟榔（三钱） 木香（三钱） 桃仁 黄连 人参 阿胶
（各半两） 白茯苓（去皮半两）
上为细末。同平胃散煎服。
血多加桃仁。泄加黄连。小便涩加茯苓。
气不下后重。加槟榔木香。
腹痛加芍药甘草。脓加阿胶。湿加白术。脉洪加大黄。
四时以胃气为本。久下血痢。则脾虚损。而血不流于四肢。入于胃中。为血痢宜滋养脾胃则愈。
夫五泄者之病。其治法各不同者。外证各异也。
胃泄者。饮食不化。色黄。承气汤下。
脾泄者。腹胀满泄注。食即呕吐逆。建中及理中汤。
大肠泄者。食已窘迫。大便色白。肠鸣切痛。干姜及附子汤。
小肠泄者。溲便脓血。少腹痛。承气汤。
大瘕泄者。里急后重。数至圊而不能便。足少阴是也。茎中痛。急利小便。此五泄之病也。胃小肠大瘕三
证。皆清凉饮子主之。其泄自止。后厥阴少阴二证。另有治法。厥阴证加甘草。谓主茎中痛。是肝也。内经曰。
肝苦急。急食甘以缓之。少阴经证。多里急后重。故加大黄。令急推过。物去则轻矣。内经曰。因其重而减之。
又曰。在下者引而竭之。又有太阴阳明二经证。当进退大承气汤主之。太阴证不能食也。当先补而后泻之。乃
进药法也。先煎浓朴半两。俱根据本方加制。水一盏半。煎至一半服之。若三两服后未已。谓有宿食不消。又加
枳实二钱。同煎服。三两服泄又未已。如稍加食。尚有热毒。又加大黄三钱。推过泄止住药。如泄未止。谓肠
胃有久尘垢滑粘。加芒硝半合。宿垢去尽。则愈矣。
阳明证。能食是也。当先泻而后补。谓退药法也。先用大承气汤五钱。水一盏。根据前法煎至七分。稍热服。
如泄未止。去芒硝。后稍热退。减大黄一半煎两服。如热气虽已。其人心腹满。
又减去大黄。枳实浓朴汤。又煎三两服。如是腹胀满退。泄亦自愈。后服浓朴汤数服则已。
又寒热水泄之例于后。
泄者一也。总包五法。谓之六义。曰六解。难经有伤寒五泄。叔和云。湿多成五泄。仲景解四经泄利。有
不可汗。有不可下者。可吐可灸者。仲景随经自言之。假令渴引饮者。是热在膈上。水多入。则下膈入胃中。
胃经本无热。不胜其水。名曰水恣。故使米谷一时下。此证当灸大椎三五壮立已。乃泻督也。如用药。乃使车
前子擂丸。白术茯苓之类。可选用之。五苓散亦可。
论述说：脏腑引起的泄泻和痢疾，症状表现多种多样。大体上应从风、湿、热来辨证论治。由此可知，寒证较少而热证较多。寒邪致病往往不能持久。所以说，暴发性泄泻多属阳证，久泄多非纯阴证。
论述又说：春季养生宜舒展形体，形体舒缓运动则肝木之气得以荣养。如果反而保持静止密闭的状态，则是行秋季的肃杀之令。金气能克制木气，风气内藏。到了夏至，火气旺盛而金气退去，只剩下火和木气旺盛，从而损伤脾土。轻症表现为完谷不化的飧泄、身体发热、脉象洪大，食物不能消化；重症表现为下痢脓血、质地稠粘，这些都属于火邪。《内经》说：小便涩痛且大便脓血，说明气机运行通畅则血自止。适宜用大黄汤攻下，这是重剂。黄芩芍药汤是轻剂。这是“实则泻其子”的原则，肝木（子）虚弱则脾土（母）自然充实。所以《内经》说：春季伤于风邪，夏季发生飧泄。这是违背四时气候规律，是人自己造成的。有的因太阴脾经受湿邪侵袭而致水泄，表现为虚滑、轻微的身体困重、不知谷味。假如在春季，适宜用益黄散补益；夏季适宜清泻。医法说：该补、该泻、该调和、该收敛止泻。假如属于调和之法，芍药汤就是代表。假如属于收敛止泻之法，诃子汤就是代表。久病则防止病变为脓血痢。脾传肾，称为贼邪，所以难愈。如果先下痢而后出现滑脱不禁，称为微邪，所以容易痊愈。这些都是脾土受湿邪影响，属于天行疫气所致。即使是圣智之人也不能逃脱。口尝味道，鼻嗅气味，邪气从鼻而入，留积于脾而导致水泄。如果有厥阴经动乱，导致下痢不止，脉象沉迟，手足厥冷，鼻涕唾液中带脓血，这属于难治之症。适宜用麻黄汤或小续命汤发汗解表。医法说：因为表邪内陷，应当发散表邪即可痊愈。如果有暴注下泄无声，身体寒冷，自汗，小便清利，大便失禁，气息短促难以布息，脉象微弱，伴有呕吐，急需用重药温补。浆水散就是此类方剂。所以医法说：里急后重适宜攻下，腹痛适宜调和，身体沉重适宜祛湿，脉弦适宜祛风，脓血稠粘适宜用重药竭除邪气，身体寒冷自汗适宜用毒药温补，风邪内陷适宜发汗则愈，便溏为痢疾，应当温补。又说：病在表者用发汗法，病在里者用攻下法，病在上者用涌吐法，病在下者用竭除法。体表发热者用内疏法，小便涩滞者用分利法。又说：邪气盛者用调和法，正气去者用送扶法，过度者用止涩法。兵法说：避开敌人锐气，攻击敌人懈怠归来之时。说的就是这个道理。凡是患泄泻而恶风寒的，这是太阴传给少阴，土克水。用除湿白术茯苓安脾，芍药桂黄连破血。火邪不能胜水。如果太阴经不能传给少阴，反而火邪上乘肺经，那么痢疾必见白脓。加黄连、当归之类。又有里急后重，脉象大而洪实，为里热甚盛，是有实物结聚坠胀感。如果脉象浮大严重，不宜攻下。虽然里急后重，但脉象沉细弱，称为寒邪在内而气散，可以温养而自愈。里急后重闭塞不通的，是大肠经气机不宣通，适宜加槟榔、木香宣通气机。如痢疾或泄泻伴有呕吐，是胃中气机不和。上焦不和，用生姜、橘皮治疗；中焦不和，用芍药、当归、桂枝、茯苓治疗；下焦不和，寒证用轻热药，热甚用重热药……大便虚秘涩滞久不愈，恐怕太阴传给少阴，多传变为痢疾。太阴传给少阴称为贼邪。先用枳实浓朴汤，以防其传变。如果四肢懒倦，小便少或不畅，大便沉重困顿，饮食减少，适宜调理脾胃、祛除湿邪。用白术、芍药、茯苓三味药，水煎服。利用白术的甘味，能入胃而除去脾胃之湿；芍药的酸涩，能除去胃中之湿热；茯苓的淡渗，能通利水道走泄湿气。这三味药，治疗泄痢必须使用。如发热恶寒，腹部不痛，加黄芩为主药。如未见脓血而恶寒，是太阴欲传给少阴，加黄连为主药，桂枝辅助。如腹痛严重的，加当归，倍用芍药。如见血，加黄连为主药，桂枝、当归辅助。如烦躁烦闷，或先排白脓后排血，或发热，或恶寒，不用黄芩不能止住。这是上部出血。如恶寒脉沉，或腰痛，或血痢下腹痛，不用黄连不能止住。这是中部出血。如恶寒脉沉，先血后便，不用地榆不能止住。这是下部出血。如便脓血混杂，而脉象浮大，千万不可以大黄攻下。攻下必死。这是因为气下竭而阳气无所依附收摄。凡阴阳不和，只可以用分阴阳的药物来治疗。又说：暴泄非阳，久泄非阴。大便中有未消化的食物排出，有寒证也有热证。脉数急、身体多动、声音响亮、暴注下迫的，属于阳证。寒证则脉沉细而疾，身体不动，眼神恍惚不清，饮食不下，鼻准部气息微弱，用姜附汤主治。如果身体沉重、四肢不能抬起，用术附汤主治。
黄芩芍药汤：治疗泄痢腹痛，或里急后重、身热，久治不愈，脉象洪数者。以及下痢脓血稠粘。
黄芩、芍药（各一两），甘草（五钱）。
以上捣成粗末，每次服用半两，加水一盏半，煎至一盏，滤去渣滓，随时温服。如果疼痛，加少许桂枝。
大黄汤：治疗泄痢久治不愈，脓血稠粘，里急后重，日夜无度，久治不愈者。
大黄（一两）。
以上切碎，用好酒两大盏，共同浸泡约半天，再同煎至一盏半，去掉大黄不用，将酒分为两次服用，一次性服下。痢止则停服一剂。如未止再服，以痢止为度。服芍药汤调和，痢止后再服黄芩汤调和，以清除余毒。
芍药汤：治疗下血、调气。《内经》说：小便涩痛且大便脓血，气行则血止。行血则便脓自愈，调气则后重自除。
芍药（一两），当归、黄连（各半两），槟榔（二钱），木香（二钱），甘草（二钱，炙），大黄（三钱），黄芩（半两），官桂（一钱半）。
以上锉碎，每次服用半两，加水二盏，煎至一盏，饭后温服。如果是血痢，逐渐加大黄用量。如果是汗后脏毒，加黄柏半两，根据前方服用。
白术黄耆汤：服用前面的药物后，痢疾虽已去除，仍适宜用此药调和。
白术（一两），黄耆（七钱），甘草（三钱）。
以上锉碎，均作三服，加水一盏半，煎至一盏，去渣滓，温服或凉服。
防风芍药汤：治疗泄痢、飧泄、身热、脉弦、腹痛而渴，以及头痛、微汗。
防风、芍药、黄芩（各一两）。
以上锉碎，每次服用半两或一两，加水三盏，煎至一盏，滤去渣滓，温服。
治疗太阴脾经受湿，水泄注下，身体微重微满，困弱无力，不欲饮食，暴泄无数，水谷不化。先宜用白术芍药汤调和。身体沉重暴下，是大势所趋，也宜调和。
白术芍药汤：白术（一两），芍药（一两），甘草（五钱）。
以上捣碎，每次服用一两，加水二盏，煎至一盏，滤去渣滓，温服。如果疼痛严重，宜用苍术芍药汤。
苍术芍药汤：苍术（二两），芍药（一两），黄芩（半两）。
以上捣碎，每次服用一两，加淡味桂半钱，加水一盏半，煎至一盏，温服清汁。如果脉弦头微痛，宜用苍术防风汤。
苍术防风汤：苍术、防风（各二两）。
以上捣碎，同前法煎服。如下血的，宜用苍术地榆汤。
苍术地榆汤：苍术（二两），地榆（一两）。
以上捣碎，同前法煎服。
以上证候，如果心下痞满，每服加枳实一钱。如果小便不利，各加茯苓二钱。如果腹痛渐减，泻下微少，宜用诃子散止泻。医法说：大势已去，则宜止之。
诃子散：诃子（一两，半生半熟），木香（半两），黄连（三钱），甘草（三钱）。
以上为细末，每次服用二钱，用白术芍药汤调下。如果止泻无效，宜归而送之（即收敛的同时兼以疏导）。诃子散加浓朴一两，以竭除邪气。
虚滑久治不愈者，多传变为痢疾。太阴传给少阴，称为贼邪。先用浓朴枳实汤，防止其传变。
浓朴枳实汤：浓朴（一两），枳实（一两），诃子（一两半，半生半熟），木香（半两），黄连（二钱），甘草（三钱，炙），大黄（二钱）。
以上为细末，每次服用三五钱，加水一盏半，煎至一盏，去渣滓，温服。
浆水散：治疗暴泄如水，周身汗出，一身尽冷，脉微而弱，气少而不能语。严重的伴有呕吐。这称为急病，治疗适宜用此方。
半夏（二两，汤洗），附子（半两，炮），干姜（五钱），良姜（二钱半），桂枝（五钱），甘草（五钱，炙）。
以上为细末，每次服用三五钱，用浆水二盏，煎至一盏，连渣热服。严重的服三四次，轻微的服三次。大肠经动乱下痢为溏泄。大肠不能固摄，突然下泄，成为水泄，青色，其中或有硬物，想起身却又腹泻，想结束却结束不了，小便多清利，这是寒证。适宜温补。春夏用桂枝汤，秋冬用白术汤。
桂枝汤：桂枝、白术、芍药（各半两），甘草（二钱，炙）。
以上捣碎，每次服用半两，加水一盏，煎至七分，去渣取清汁，适宜温服。
白术汤：白术、芍药（各三钱），干姜（半两，炮），甘草（二钱，炙）。
以上为粗末，按前法服用。严重的去掉干姜，加附子三钱。辛味能发散。
治疗厥阴经动乱导致的泄痢，寸脉沉迟，手足厥逆，下部脉不至，咽喉不利，或鼻涕唾液中带脓血，泄痢不止的，为难治。适宜用升麻汤或小续命汤发汗解表。医法说：因为表邪内陷，所以下痢不止。应当发散表邪于四肢，布于络脉，外无邪气，则脏腑自然安宁。
各种水饮积聚入胃，称为溢饮。滑泄，口渴能饮水，水入复泻而又渴，这是无药可治的证候，应当灸大椎穴。
各种泄痢久不止，或暴下的，都是太阴守病，所以不可离开芍药。如果不受湿，就不能下痢，所以须用白术。因此圣人立法，如果在四季时下痢，在芍药、白术内，春季加防风，夏季加黄芩，秋季加浓朴，冬季加桂附。
然而更需详细辨别外证的寒热来处理。如里急后重，须加大黄。如身体困倦，须加白术。如通身自汗，逆冷气息微弱，加桂附以温补。如果后重脓血稠粘，即使在盛冬，在温药内也加大黄。
各种下痢之后，小便利而腹中虚痛不可忍受的，这称为阴阳交错，不和之极。应当服用神效越桃散。
大栀子（三钱），高良姜（三钱）。
以上和匀，每次服用三钱，米饮或酒调下，疼痛立即见效。
治疗大便后下血，腹中不痛，称为湿毒下血。适宜服用黄连汤。
黄连（去须）、当归（各半两），甘草（二钱，炙）。
以上锉碎，每次服用五钱，加水一盏，煎至七分，饭后温服。
治疗大便后下血，腹中痛的，称为热毒下血。当服用芍药黄连汤。
芍药、当归、黄连（各半两），大黄（一钱），桂（淡味半钱），甘草（二钱，炙）。
以上锉碎，每次半两同前法煎服。如果疼痛严重，调木香槟榔末一钱服用。
治疗久病肠风，痛痒难忍，大便下血，适宜服用地榆汤。
苍术（去皮四两），地榆（二两）。
以上锉碎，每次服用一两，加水一盏，煎至七分，饭前多服以除根。
治疗湿泻茯苓汤：
白术（一两），茯苓（去皮七钱半）。
以上锉碎，水煎一两，饭前服。食入而泻，称为胃中有宿谷，应当加枳实五钱。酒入而泻，是湿热泻，加黄芩五钱。
治疗寒积痢，男子、小儿、妇人都不问赤白，或清痢如水，不里急后重的，是寒证。《内经》说：澄彻清冷，皆属于寒。皆为虚证。寒中有积。适宜用附子、巴豆之类攻下。见到痢疾排出则愈。空腹服用。
治疗泄痢久不止，脏腑虚滑，谷不化，用苍术汤，送服桃花丸。
苍术（二两），防风（一两）。
以上为细末，用水一碗，煎至一大盏，绞取清汁，送服桃花丸八十丸，立愈。如果小便涩少，用五苓散送服桃花丸，或用赤石脂丸。小便利则愈。
太阳经协热痢，用凉膈散主治。
阳明经痼瘕，进退大承气汤主治。珍珠囊中有记载。
少阳经风气自动，其脉弦，用大柴胡汤主治。
太阴经湿胜濡泻，不可利而可温，用四逆汤主治。
少阴经蛰封不禁固，可涩，用赤石脂丸、干姜汤主治。
厥阴经风泄，以风治风，用小续命汤、消风散主治。
治疗下痢脓血，里急后重，日夜无度，用导气汤。
芍药（一两），当归（五钱），大黄、黄芩（各二钱半），黄连、木香（各一钱），槟榔（一钱）。
以上为末，每次服用三五钱，加水一盏，煎至七分，去渣滓，温服。如未止再服，不后重则止。
杂例：
小便涩痛且大便脓血的，是大肠泄。脉象五至之上且洪大的，适宜用七宣丸。如脉平者，立秋至春分，适宜用香连丸；春分至立秋，适宜用芍药柏皮丸；四季通用，适宜用加减平胃散、七宣丸之类。痢后宜服此药，去除其余邪，兼平胃气。
芍药柏皮丸：芍药、黄柏（各等分）。
以上为细末，醋糊为丸，如梧桐子大，每次服用五七十丸，至二百丸，温水送下，饭前服。
加减平胃散：白术、浓朴、陈皮（各一两），甘草（七钱），槟榔（三钱），木香（三钱），桃仁、黄连、人参、阿胶（各半两），白茯苓（去皮半两）。
以上为细末，同平胃散煎服。
血多加桃仁，泄加黄连，小便涩加茯苓。
气不下后重，加槟榔、木香。
腹痛加芍药、甘草，脓加阿胶，湿加白术，脉洪加大黄。
四时以胃气为本，久下血痢，则脾虚损，而血不流于四肢，入于胃中，为血痢，适宜滋养脾胃则愈。
夫五泄之病，其治法各不同，是因为外证各异。
胃泄者，饮食不化，色黄，用承气汤攻下。
脾泄者，腹胀满泄注，食即呕吐逆，用建中汤及理中汤。
大肠泄者，食已窘迫，大便色白，肠鸣切痛，用干姜及附子汤。
小肠泄者，溲便脓血，少腹痛，用承气汤。
大瘕泄者，里急后重，数至圊而不能便，足少阴是也。茎中痛，急利小便。此五泄之病也。胃、小肠、大瘕三证，皆清凉饮子主治，其泄自止。后厥阴、少阴二证，另有治法。厥阴证加甘草，谓主茎中痛，是肝也。《内经》说：肝苦急，急食甘以缓之。少阴经证，多里急后重，故加大黄，令急推过，物去则轻矣。《内经》说：因其重而减之，又曰：在下者引而竭之。又有太阴、阳明二经证，当进退大承气汤主治。太阴证不能食也，当先补而后泻之，乃进药法也。先煎浓朴半两，俱根据本方加制，水一盏半，煎至一半服之。若三两服后未已，谓有宿食不消，又加枳实二钱，同煎服。三两服泄又未已，如稍加食，尚有热毒，又加大黄三钱，推过泄止住药。如泄未止，谓肠胃有久尘垢滑粘，加芒硝半合，宿垢去尽，则愈矣。
阳明证，能食是也。当先泻而后补，谓退药法也。先用大承气汤五钱，水一盏，根据前法煎至七分，稍热服。如泄未止，去芒硝，后稍热退，减大黄一半煎两服。如热气虽已，其人心腹满，又减去大黄，枳实浓朴汤，又煎三两服。如是腹胀满退，泄亦自愈，后服浓朴汤数服则已。
又有寒热水泄之例于后。
泄者一也，总包五法，谓之六义，曰六解。《难经》有伤寒五泄，叔和云：湿多成五泄。仲景解四经泄利，有不可汗，有不可下者，可吐可灸者。仲景随经自言之。假令渴引饮者，是热在膈上，水多入，则下膈入胃中，胃经本无热，不胜其水，名曰水恣，故使米谷一时下。此证当灸大椎三五壮立已，乃泻督也。如用药，乃使车前子擂丸，白术茯苓之类，可选用之。五苓散亦可。
It is discussed that diarrhea and dysentery caused by the zang-fu organs present various symptoms. Generally, they should be differentiated based on wind, dampness, and heat. Thus, it is known that cold patterns are few while heat patterns are many. Cold pathogens cannot persist for long. Therefore, it is said: acute diarrhea is not purely yang, and chronic diarrhea is not purely yin.
It is also discussed: In spring, one should keep the body relaxed; when the body moves freely, the liver wood qi flourishes. Conversely, remaining still and closed corresponds to the autumnal command. Metal restricts wood, causing wind qi to hide within. By summer solstice, fire qi becomes prosperous and metal recedes, leaving only fire and wood flourishing, which damages spleen earth. Mild cases manifest as undigested stool (sun-xie), fever, and a surging pulse, with food failing to digest; severe cases manifest as dysentery with pus and blood, thick and sticky, all belonging to fire. The Classics state: "When urination is painful accompanied by pus and blood in stool, it indicates that if qi moves, blood stops." It is appropriate to use Dahuang Tang (Rhubarb Decoction) to purge, which is a heavy agent. Huangqin Shaoyao Tang (Scutellaria and Peony Decoction) is a light agent. This follows the principle of "purging the son when excess," where weakening liver wood (son) allows spleen earth (mother) to become solid. Thus, the Classics say: "Injury by wind in spring leads to sun-xie in summer." This violates the qi of the four seasons and is self-inflicted. Some suffer from water diarrhea due to dampness invading the Taiyin Spleen meridian, presenting with flaccid sliding, slight heaviness, and loss of taste for grain. If occurring in spring, Yihuang San (Benefit Yellow Powder) is suitable for tonification; in summer, purging is suitable. The method states: "Appropriate to tonify, appropriate to purge, appropriate to harmonize, appropriate to astringe." For harmonization, Shaoyao Tang (Peony Decoction) is used. For astringing, Hezi Tang (Myrobalan Decoction) is used. Prolonged illness risks transforming into pus-blood dysentery. Transmission from Spleen to Kidney is called "robber pathogen" (zei-xie) and is difficult to cure. If dysentery precedes sliding incontinence, it is called "minor pathogen" and is easy to recover. These are all due to spleen earth being affected by dampness, resulting from epidemic influences. Even sages and wise men cannot escape them. Mouth tastes flavors, nose smells qi; pathogens enter through the nose, accumulate in the spleen, and cause water diarrhea. If Jueyin meridian is disturbed, leading to incessant dysentery, with a deep and slow pulse, cold extremities, and pus-blood in nasal discharge and saliva, this is difficult to treat. Mahuang Tang (Ephedra Decoction) or Xiao Xuming Tang (Minor Continue Life Decoction) should be used to induce sweating. The method states: "Because exterior pathogens have retreated inward, disperse the exterior pathogens to achieve cure." If there is sudden silent profuse diarrhea, cold body, spontaneous sweating, clear and free urination, involuntary defecation, shortness of breath, weak pulse, and vomiting, urgent heavy warming agents are needed. Jiangshui San (Fermented Rice Water Powder) is indicated. Thus, the method states: "Tenesmus requires purging; abdominal pain requires harmonizing; body heaviness requires dispelling dampness; wiry pulse requires expelling wind; thick sticky pus-blood requires exhausting with heavy agents; cold body with spontaneous sweating requires warming with toxic agents; internal contraction of wind pathogens requires sweating to cure; loose stools as dysentery require warming." It is also said: "Exterior conditions require releasing; interior conditions require purging; upper conditions require inducing vomiting; lower conditions require exhausting." "Body surface heat requires internal dispersing; astringent urination requires separating and benefiting." It is also said: "Abundance requires harmonizing; departure requires escorting; excess requires stopping." Military strategy says: "Avoid their sharp onset, strike their fatigue and return." This applies here. Any disease of diarrhea with aversion to wind and cold indicates transmission from Taiyin to Shaoyin, where earth overcomes water. Use Chushi Baizhu Fuling Anpi (Damp-Dispel Atractylodes and Poria to Calm Spleen); Shaoyao, Guizhi, Huanglian, and Huangqin break blood stasis. Fire pathogens cannot overcome water. If Taiyin cannot transmit to Shaoyin but fire pathogens ascend to invade Lung meridian, dysentery will necessarily show white pus. Add Huanglian and Danggui. Tenesmus with a large, surging, and full pulse indicates severe interior heat and obstruction, suggesting material accumulation. If the pulse is floating and large severely, do not purge. Although there is tenesmus, if the pulse is deep, fine, and weak, it indicates interior cold and scattered qi; it can heal with warming and nourishing. Closure with tenesmus indicates non-circulation of Large Intestine meridian qi; add Binglang (Areca Seed) and Muxiang (Aucklandia Root) to circulate qi. If dysentery or diarrhea is accompanied by vomiting, stomach qi is disharmonious. Upper jiao disharmony is treated with Shengjiang (Fresh Ginger) and JuPi (Tangerine Peel); middle jiao disharmony with Shaoyao, Danggui, Guizhi, and Fuling; lower jiao disharmony uses mild heat herbs for cold and heavy heat herbs for severe heat... Chronic constipation with deficiency may indicate transmission from Taiyin to Shaoyin, often transforming into dysentery. Taiyin transmitting to Shaoyin is robber pathogen. Use Zhishi Nongpo Tang (Immature Bitter Orange and Magnolia Bark Decoction) first to prevent transmission. If limbs are lazy and fatigued, urine is scanty or obstructed, stool feels heavy and tired, and appetite decreases, regulate stomach and dispel dampness using Baizhu, Shaoyao, and Fuling decocted in water. Baizhu's sweetness enters the stomach and dispels spleen-stomach dampness; Shaoyao's sour astringency dispels stomach damp-heat; Fuling's bland leaching promotes water pathways and drains dampness. These three herbs are essential for treating diarrhea and dysentery. If fever and aversion to cold occur without abdominal pain, add Huangqin as the chief herb. If aversion to cold occurs without visible pus, Taiyin is about to transmit to Shaoyin; add Huanglian as chief, assisted by Guizhi. If abdominal pain is severe, add Danggui and double Shaoyao. If blood appears, add Huanglian as chief, assisted by Guizhi and Danggui. If restlessness, or white pus followed by blood, or fever, or aversion to cold occurs, only Huangqin can stop it; this is upper jiao bleeding. If aversion to cold with deep pulse, or lower back pain, or painful bloody dysentery occurs, only Huanglian can stop it; this is middle jiao bleeding. If aversion to cold with deep pulse, and blood before stool, only Diyü (Sanguisorba Root) can stop it; this is lower jiao bleeding. If pus and blood are mixed with a floating-large pulse, absolutely do not use Dahuang to purge; purging will cause death because qi exhausts downward and yang has no anchor. For yin-yang disharmony, only yin-yang separating herbs should be used. It is also said: Acute diarrhea is not yang; chronic diarrhea is not yin. Stool containing undigested food can be cold or heat. Rapid pulse, frequent movement, loud voice, sudden violent diarrhea with urgency belongs to yang. Cold pattern presents with deep, fine, rapid pulse, immobility, blurred vision, inability to eat, and weak breath at the nose tip; Jiangfu Tang (Ginger and Aconite Decoction) is primary. If body heaviness and inability to lift limbs occur, Shufu Tang (Atractylodes and Aconite Decoction) is primary.
Huangqin Shaoyao Tang: Treats diarrhea/dysentery with abdominal pain, tenesmus, fever, chronic non-healing, surging-rapid pulse, and thick sticky pus-blood dysentery.
Huangqin (Scutellariae Radix), Shaoyao (Paeoniae Radix) (1 liang each), Gancao (Licorice Root) (5 qian).
Grind into coarse powder. Take 0.5 liang per dose, add 1.5 cups of water, boil to 1 cup, filter, and take warm at any time. If painful, add a little Guizhi (Cinnamon Twig).
Dahuang Tang: Treats chronic non-healing diarrhea/dysentery with thick sticky pus-blood, tenesmus, day and night without limit.
Dahuang (Rhei Radix et Rhizoma) (1 liang).
Cut finely. Soak in 2 large cups of good wine for half a day. Boil together to 1.5 cups. Remove Dahuang. Divide wine into two doses and take at once. Stop if dysentery ceases. If not, repeat until stopped. Follow with Shaoyao Tang to harmonize, then Huangqin Tang to clear toxins.
Shaoyao Tang: Stops bleeding and regulates qi. The Classics state: "Painful urination with pus-blood in stool; when qi moves, blood stops." Moving blood heals pus-blood; regulating qi removes tenesmus.
Shaoyao (1 liang), Danggui (Angelicae Sinensis Radix), Huanglian (Coptidis Rhizoma) (0.5 liang each), Binglang (Arecae Semen), Muxiang (Aucklandiae Radix), Gancao (2 qian, honey-fried), Dahuang (3 qian), Huangqin (0.5 liang), Guanzhi (Cinnamomi Ramulus) (1.5 qian).
Chop. Take 0.5 liang per dose, add 2 cups water, boil to 1 cup, take warm after meals. For bloody dysentery, gradually increase Dahuang. For post-sweat intestinal toxin, add Huangbai (Phellodendri Cortex) 0.5 liang.
Baizhu Huangqi Tang: After taking previous medicines, if dysentery is cleared, use this to harmonize.
Baizhu (Atractodis Macrocephalae Rhizoma) (1 liang), Huangqi (Astragali Membranacei Radix) (7 qian), Gancao (3 qian).
Chop. Divide into three doses. Add 1.5 cups water, boil to 1 cup, remove dregs, take warm or cool.
Fangfeng Shaoyao Tang: Treats diarrhea/dysentery, sun-xie, fever, wiry pulse, abdominal pain with thirst, headache, and slight sweating.
Fangfeng (Saposhnikoviae Radix), Shaoyao, Huangqin (1 liang each).
Chop. Take 0.5 or 1 liang per dose, add 3 cups water, boil to 1 cup, filter, take warm.
For Taiyin Spleen dampness causing water diarrhea, slight heaviness/fullness, weakness, anorexia, sudden profuse diarrhea with undigested food: First use Baizhu Shaoyao Tang to harmonize. For heavy body and sudden diarrhea, also harmonize.
Baizhu Shaoyao Tang: Baizhu (1 liang), Shaoyao (1 liang), Gancao (5 qian).
Crush. Take 1 liang per dose, add 2 cups water, boil to 1 cup, filter, take warm. If pain is severe, use Cangzhu Shaoyao Tang.
Cangzhu Shaoyao Tang: Cangzhu (Atractodis Rhizoma) (2 liang), Shaoyao (1 liang), Huangqin (0.5 liang).
Crush. Take 1 liang per dose, add Danwei Gui (Cinnamon) 0.5 qian, add 1.5 cups water, boil to 1 cup, take warm clear liquid. If wiry pulse and slight headache, use Cangzhu Fangfeng Tang.
Cangzhu Fangfeng Tang: Cangzhu, Fangfeng (2 liang each).
Crush. Decoct as above. For bloody stool, use Cangzhu Diyü Tang.
Cangzhu Diyü Tang: Cangzhu (2 liang), Diyü (1 liang).
Crush. Decoct as above.
For these syndromes: If epigastric痞 (fullness/stuffiness), add Zhishi (Immature Bitter Orange) 1 qian per dose. If difficult urination, add Fuling (Poria) 2 qian per dose. If abdominal pain subsides and diarrhea lessens, use Hezi San (Myrobalan Powder) to stop. Method: When major pathogenic force has passed, stop it.
Hezi San: Hezi (Myrobalani Fructus, half raw half roasted) (1.5 liang), Muxiang (0.5 liang), Huanglian (3 qian), Gancao (3 qian).
Make fine powder. Take 2 qian per dose, mix with Baizhu Shaoyao Tang. If stopping fails, use "return and send" method. Add Nongpo (Magnoliae Officinalis Cortex) 1 liang to Hezi San to exhaust evil qi.
For chronic flaccid sliding non-healing, likely transforming into dysentery via Taiyin to Shaoyin (robber pathogen). First use Nongpo Zhishi Tang to prevent transmission.
Nongpo Zhishi Tang: Nongpo (1 liang), Zhishi (Immature Bitter Orange) (1 liang), Hezi (1.5 liang, half raw half roasted), Muxiang (0.5 liang), Huanglian (2 qian), Gancao (3 qian, honey-fried), Dahuang (2 qian).
Make fine powder. Take 3-5 qian per dose, add 1.5 cups water, boil to 1 cup, remove dregs, take warm.
Jiangshui San: Treats sudden watery diarrhea, whole-body sweating, cold body, weak pulse, shortness of breath, inability to speak. Severe cases include vomiting. This is an emergency.
Banxia (Pinelliae Rhizoma, washed in boiling water) (2 liang), Fuzi (Aconiti Lateralis Radix Praeparata, processed) (0.5 liang), Ganjiang (Zingiberis Rhizoma) (5 qian), Liangjiang (Galangal Rhizome) (2.5 qian), Guizhi (5 qian), Gancao (5 qian, honey-fried).
Make fine powder. Take 3-5 qian per dose, add 2 cups fermented rice water (Jiangshui), boil to 1 cup, take hot with dregs. Severe cases: 3-4 doses; mild: 3 doses.
Large Intestine meridian disturbance causes loose stools. Inability to control leads to sudden water diarrhea, green color, possibly hard objects, urge to rise but continue defecating, incomplete feeling, clear abundant urine. This is cold; warm it. Spring/Summer: Guizhi Tang. Autumn/Winter: Baizhu Tang.
Guizhi Tang: Guizhi, Baizhu, Shaoyao (0.5 liang each), Gancao (2 qian, honey-fried).
Crush. Take 0.5 liang per dose, add 1 cup water, boil to 0.7 cup, filter, take warm.
Baizhu Tang: Baizhu, Shaoyao (3 qian each), Ganjiang (0.5 liang, processed), Gancao (2 qian, honey-fried).
Make coarse powder. Decoct as above. For severe cases, remove Ganjiang, add Fuzi 3 qian. Pungent herbs disperse.
For Jueyin disturbance causing diarrhea/dysentery: Cun pulse deep and slow, cold extremities, lower pulses absent, throat discomfort, pus-blood in saliva, incessant diarrhea/dysentery. Difficult to treat. Use Shengma Tang (Cimicifugae Rhizoma Decoction) or Xiao Xuming Tang to release exterior. Method: Exterior pathogens contracted inward cause incessant dysentery. Disperse exterior pathogens to limbs and collaterals; without external pathogens, zang-fu settle.
Water accumulation in stomach is called Yi Yin (Overflowing Drink). Sliding diarrhea, thirst, drinking leads to more diarrhea and thirst. No medicine fits; moxa Dazhui (GV14).
Chronic or sudden diarrhea/dysentery are Taiyin diseases. Do not depart from Shaoyao. Without dampness, no dysentery; thus use Baizhu. Sage's law: For seasonal dysentery, add Fangfeng in spring, Huangqin in summer, Nongpo in autumn, Guizhi/Fuzi in winter to Shaoyao/Baizhu base.
Detail exterior cold/heat: Tenesmus needs Dahuang. Body fatigue needs Baizhu. Whole body sweating, cold extremities, weak breath needs Guizhi/Fuzi to warm. Thick sticky pus-blood tenesmus needs Dahuang even in deep winter with warming herbs.
After dysentery, clear urination with unbearable empty abdominal pain indicates extreme yin-yang disorder. Use Shenxiao Yetao San (Divine Effect Peach Kernel Powder).
Da Zhizi (Gardeniae Fructus) (3 qian), Gaoliangjiang (Alpiniae Officinarum Rhizoma) (3 qian).
Mix well. Take 3 qian per dose with rice drink or wine. Pain stops immediately.
Post-defecation bleeding without abdominal pain is Wet Toxin Bleeding. Use Huanglian Tang.
Huanglian (deveined), Danggui (0.5 liang each), Gancao (2 qian, honey-fried).
Chop. Take 5 qian per dose, add 1 cup water, boil to 0.7 cup, take warm after meal.
Post-defecation bleeding with abdominal pain is Heat Toxin Bleeding. Use Shaoyao Huanglian Tang.
Shaoyao, Danggui, Huanglian (0.5 liang each), Dahuang (1 qian), Gui (pungent 0.5 qian), Gancao (2 qian, honey-fried).
Chop. Take 0.5 liang per dose as above. If pain severe, mix with Muxiang Binglang powder 1 qian.
Chronic Changfeng (Intestinal Wind) with intolerable pain/itching and bloody stool: Use Diyü Tang.
Cangzhu (peeled, 4 liang), Diyü (2 liang).
Chop. Take 1 liang per dose, add 1 cup water, boil to 0.7 cup. Take frequently before meals to eradicate root.
Shixie Fuling Tang (Damp Diarrhea Poria Decoction):
Baizhu (1 liang), Fuling (peeled, 7.5 qian).
Chop. Decoct 1 liang in water, take before meal. Diarrhea after eating indicates retained food; add Zhishi 5 qian. Diarrhea after alcohol indicates damp-heat; add Huangqin 5 qian.
Cold Accumulation Dysentery: Regardless of red/white, clear watery stool without tenesmus is cold. Classics: "Clear and cold belongs to cold." All deficiency. Cold with accumulation. Use Fuzi/Badou (Croton Seed) to purge. Cure upon seeing dysentery. Take on empty stomach.
Chronic non-healing diarrhea/dysentery with viscera flaccidity and undigested food: Use Cangzhu Tang to administer Taohua Wan (Peach Blossom Pill).
Cangzhu (2 liang), Fangfeng (1 liang).
Make fine powder. Decoct 1 bowl water to 1 large cup, strain juice. Administer 80 Taohua Wan pills for immediate cure. If urine is scanty/astringent, use Wuling San (Five-Poria Powder) or Chishizhi Wan (Red Kaolin Pill) to administer Taohua Wan. Cure when urine flows freely.
Taiyang協熱痢 (Collateral Heat Dysentery): Liangge San (Cool Chest Powder) primarily.
Yangming Gujia (Stubborn Mass): Jin Tui Dachengqi Tang (Advance-Retreat Major Order the Qi Decoction) primarily. Recorded in Zhenzhu Nang.
Shaoyang Wind Movement: Wiry pulse. Dachaihu Tang (Major Bupleurum Decoction) primarily.
Taiyin Damp Excess Ru Xie (Moist Diarrhea): Do not drain, warm instead. Sini Tang (Reverse the Yang Decoction) primarily.
Shaoyin Seal Failure Incontinence: Astringe. Chishizhi Wan (Red Kaolin Pill) or Ganjiang Tang (Dried Ginger Decoction) primarily.
Jueyin Wind Diarrhea: Treat wind with wind. Xiao Xuming Tang (Minor Continue Life Decoction) or Xiaofeng San (Wind-Expelling Powder) primarily.
Pus-blood dysentery, tenesmus, day/night unlimited: Daoqi Tang (Qi-Conducting Decoction).
Shaoyao (1 liang), Danggui (5 qian), Dahuang, Huangqin (2.5 qian each), Huanglian, Muxiang (1 qian each), Binglang (1 qian).
Make powder. Take 3-5 qian per dose, add 1 cup water, boil to 0.7 cup, filter, take warm. Repeat if necessary. Stop when tenesmus ceases.
Miscellaneous Examples:
Painful urination with pus-blood is Large Intestine Xie. Pulse >5 beats/cycle and surging: Qixuan Wan (Seven-Regulating Pill). Normal pulse: Lidong-Chunfen period: Xianglian Wan (Cinnamon-Coptis Pill); Chunfen-Lidong period: Shaoyao Bapi Wan (Peony-Bark Pill); Four Seasons: Jiajian Pingwei San (Modified Stomach-Regulating Powder) or Qixuan Wan. Post-dysentery: Use these to clear residual evil and regulate stomach qi.
Shaoyao Bapi Wan: Shaoyao, Huangbai (Phellodendri Cortex) (equal parts).
Make powder, pill with vinegar paste, size of tung seed. Take 50-70 pills, up to 200, with warm water, before meals.
Jiajian Pingwei San: Baizhu, Nongpo, Chenpi (Tangerine Peel) (1 liang each), Gancao (7 qian), Binglang, Muxiang (3 qian each), Taoren (Peach Kernel), Huanglian, Renshen (Ginseng), Ejiao (Donkey-Hide Glue) (0.5 liang each), Baifuling (White Poria, peeled) (0.5 liang).
Make powder. Decoct with Pingwei San.
Add Taoren for much blood; Huanglian for diarrhea; Fuling for astringent urine; Binglang/Muxiang for qi stagnation/tenesmus; Shaoyao/Gancao for abdominal pain; Ejiao for pus; Baizhu for dampness; Dahuang for surging pulse.
Four seasons rely on Stomach Qi. Chronic bloody dysentery damages Spleen, blood fails to flow to limbs, enters stomach. Nourish Spleen/Stomach to cure.
The five types of Xie (Diarrhea/Dysentery) have different treatments due to distinct exterior signs.
Stomach Xie: Undigested food, yellow color. Chengqi Tang purges.
Spleen Xie: Abdominal distension/fullness, pouring diarrhea, vomiting after eating. Jianzhong Tang and Lizhong Tang.
Large Intestine Xie: Urgency after eating, white stool, borborygmus and cutting pain. Ganjiang and Fuzi Tang.
Small Intestine Xie: Painful urination with pus-blood, lower abdominal pain. Chengqi Tang.
Da Jia Xie: Tenesmus, frequent visits to toilet unable to pass stool, Foot-Shaoyin meridian. Penile pain, urgently benefit urination. These are the five Xie. Stomach, Small Intestine, Da Jia three syndromes are treated with Qingliang Yin Zi (Cooling Drink), stopping diarrhea. Jueyin and Shaoyin have separate methods. Jueyin adds Gancao for penile pain (Liver). Classics: "Liver suffers from tension, eat sweet to relax." Shaoyin often has tenesmus, add Dahuang to push out quickly. Classics: "Reduce what is heavy," "Draw out what is below." Taiyin and Yangming syndromes use Jin Tui Dachengqi Tang. Taiyin cannot eat; tonify then purge (advance method). Decoct Nongpo 0.5 liang first, follow formula, add 1.5 cups water, boil to half, take. If 3 doses fail, retained food remains; add Zhishi 2 qian, decoct together. If 3 more doses fail and slight food intake shows heat toxin, add Dahuang 3 qian to push out. If still not stopping, long-standing sticky filth remains; add Mangxiao (Mirabilite) 0.5 he. Clean filth cures.
Yangming syndrome: Can eat. Purge then tonify (retreat method). First Dachengqi Tang 5 qian, 1 cup water, boil to 0.7 cup, take slightly warm. If not stopping, remove Mangxiao. As heat retreats, halve Dahuang, divide into 2 doses. If heat gone but chest/abdomen full, reduce Dahuang further, use Zhishi Nongpo Tang, decoct 3 doses. If distension resolves, diarrhea heals. Follow with Nongpo Tang several doses.
Examples of Cold/Hot/Water Diarrhea follow.
Diarrhea is one, encompassing five methods, six meanings, called Six Solutions. Nan Jing mentions Five Xie in Cold Damage. Shuhe says: "Dampness forms Five Xie." Zhang Zhongjing explains Four Meridian diarrhea/dysentery: some cannot sweat, some cannot purge, some can vomit, some can moxa. Zhongjing speaks according to meridians. Thirst indicating drinking suggests heat above diaphragm; water enters stomach, stomach lacks heat, cannot handle water, called "Water Indulgence," causing instant passage of grain. Moxa Dazhui 3-5 cones to cure, draining Du meridian. Medicinally, use Cheqianzi Lei Wan (Plantago Seed Paste Pill), Baizhu/Fuling, or Wuling San.