不令下陷为餐泄也。又云∶凡泄则水谷不化，谓之餐泄。是清气在下，乃胃气不升，上古圣人皆以升
浮药扶持胃气，一服而愈，知病在中焦脾胃也。《脉诀》曰∶湿多成五泄。湿者，胃之别名也。病本
在胃，真气弱。真气者，谷气也。不能克化饮食，乃湿盛故也。以此论之，正以脾胃之弱故也。初病
夺食，或绝不食一二日，使胃气日胜，泄不作也。今已成大泄矣，经云∶治湿不利小便，非其治也。
又云∶下焦如渎。又云∶在下者引而竭之。惟此证不宜。此论其病得之于胃气下流，清气不升，阳道
不行，宜升宜举，不宜利小便。《灵枢》云∶头有疾，取之足，谓阳病在阴也。足有疾，取之上，谓
阴病在阳也。中有疾，旁取之。旁者，少阳甲胆是也。中者、脾胃也。脾胃有疾，取之足少阳。甲胆
者，甲风是也，东方春也。胃中谷气者，便是风化也。作一体而认，故曰胃中湿胜而成泄泻，宜助甲
胆风胜以克之，又是升阳助清气上行之法也。又一
说，中焦元气不足，溲便为之变，肠为之苦鸣，亦缘胃气不升，故令甲气上行。又云∶风胜湿也。大
抵此证，本胃气弱，不能化食，夺食则一日而可止。夫夺食之理，为胃弱不能克化，食则为泄，如食
不下何以作泄，更当以药滋养元气令和，候泄止渐与食，胃胜则安矣。若食不化者，于升阳风药内加
炒曲同煎。兼食入顿至心头者，胃之上口也，必口沃沫，或食入反出，皆胃土停寒，其右手关脉中弦，
按之洪缓，是风热湿相合，谷气不行，清气不升，为弦脉之寒所隔，故不下也。曲之热亦能去之。若
反胃者，更加半夏、生姜，入于风药内同煎。夺食少食，欲使胃气强盛也。若药剂大则胃不胜药，泄
亦不止，当渐渐与之。今病既久，已至衰弱，当以常法治之，不可多服饵也。人之肉，如地之土，岂
可人而无肉，故肉消尽则死矣。消瘦之人，有必死者八，《内经》有七，《外经》有一。又病肌肉去
尽，勿治之，天命也。如肌肉不至瘦尽，当急疗之，宜先夺食而益胃气，便与升阳。先助真气，次用
风药胜湿，以助升腾之气，病可已矣。余皆勿论，此治之上法也。（治用升阳除湿汤之类是也。）春
伤于风，夏生餐泄，木在时为春，在人为肝，在天为风。风者、无形之清气也，当春之时，发为温令，
反为寒折，是三春之月行三冬之令也，以是知水为太过矣。水
既太过，金肃愈严，是所胜者乘之而妄行也。所胜者乘之，则木虚明矣。故经曰∶从后来者为虚邪。
木气既虚，火令不及，是所生者受病也，故所不胜者侮之，是以土来木之分，变而为餐泄也。故经曰∶
清气在下，则生餐泄。以其湿令当权，故餐泄之候，发之于夏也。若当春之时，木不发生，温令未显，
止行冬令，是谓伤卫，以其阳气不出地之外也，当以麻黄汤发之。麻黄味苦，味之薄者，乃阴中之阳
也。故从水中补木而泻水，发出津液为汗也。若春木既生，温令已显，阳气出于地之上，寒再至而复
折之，当以轻发之，谓已得少阳之气，不必用麻黄也。春伤于风，夏生餐泄，所以病发于夏者，以木
绝于夏，而土旺于长夏，湿本有下行之体，故餐泄于夏也。不病于春者，以其春时风虽有伤，木实当
权，故餐泄不病于木之时，而发于湿之分也。经曰∶至而不至，是为不及，所胜妄行，所不胜者搏之，
所生者受病，此之谓也。仲景法，下利清谷，里寒外热，汗出而厥者，通脉四逆汤主之。河间法，餐
泄，风冷入中，泄利不止，脉虚而细，日夜数行，口干腹痛不已，白术汤主之。东垣云∶泄利餐泄，
身热，脉弦腹痛而渴，及头痛微汗，宜防风芍药汤。东垣所云∶内动之风也。经云∶春伤于风，夏生
餐泄。又云∶久风为餐泄。又云∶虚邪之中人
也，始于皮肤，留而不去，传舍于络脉；留而不去，传舍于经；留而不去，传舍于输；留而不去，传
舍于伏冲之脉；留而不去，传舍于肠胃。在肠胃之时，贲响腹胀，多寒则肠鸣餐泄，食不化，则非内
动之风也。洁古云∶大渴引饮，多致水谷一时下者，宜灸大椎三五壮，或用车前子、雷丸、白术、茯
苓及五苓散等药渗之。又如久风为餐泄者，则不饮水而谷完出，治法当以宣风散导之，后服苍术防风
汤。餐泄以风为根，风非汗不出。有病此者，腹中雷鸣，泄注水谷不分，小便涩滞，皆以脾胃虚寒故
耳，服豆蔻、乌梅、粟壳、干姜、附子，曾无一效，中脘脐下灸已数千，燥热转甚，津液涸竭，瘦削
无力，饮食减少。延予视之，予以应象论曰，热气在下，水谷不分，化生餐泄，寒气在上，则生 胀，
而气不散何也，阴静而阳动故也。诊其脉两手皆浮大而长，身表微热，用桂枝麻黄汤，以姜枣煎。大
剂连进三服，汗出终日，至旦而愈。次以胃风汤和其脏腑，调养阴阳，食进而愈。经云∶脾虚则腹满
肠鸣，泄食不化。又云∶餐泄取三阴。三阴者，太阴也。宜补中益气汤，以白芍药代当归主之。又云∶
肾脏志，志有余，腹胀餐泄，泻然筋血。又云∶肝足厥阴之脉，所生病者，胸满呕逆，餐泄，视盛、
虚、寒、热、陷下施法。此皆内因无风者也。
不让邪气下陷导致餐泄（因饮食不节引起的腹泻）。又说：凡是腹泻，水谷不能消化，就称为餐泄。这是因为清气在下，是胃气不能上升，上古圣人都是用升浮性质的药物来扶持胃气，服一次药就好了，这说明病位在中焦脾胃。《脉诀》说：湿气多会形成五种泄泻。湿，是胃的别名。病的根本在胃，真气虚弱。真气，就是谷气（水谷精微之气）。不能消化饮食，是因为湿气太盛的缘故。据此讨论，正是因为脾胃虚弱的原因。初发病时剥夺饮食，或者一两天完全不进食，使胃气日渐强盛，腹泻就会停止。现在已经成为严重的腹泻了，医经说：治疗湿证如果不通利小便，就不是正确的治法。又说：下焦的功能像沟渠一样流通。又说：病在下部的，用引导排泄的方法使其枯竭。但这几种说法对于这种证候并不适宜。这个论述指出，此病是由于胃气下流，清气不升，阳道不通畅，应当提升、举托，而不宜通利小便。《灵枢》说：头部有病，取足部的穴位治疗，这叫阳病治阴。足部有病，取上部的穴位治疗，这叫阴病治阳。中部有病，从旁侧取穴治疗。旁侧，指的是少阳胆经。中部，指的是脾胃。脾胃有病，取足少阳胆经的穴位。甲胆，指的是甲风（风木之气），对应东方春季。胃中的谷气，也就是风化（风木之气）的表现。将它们看作一个整体来认识，所以说胃中湿气过胜导致泄泻，应当助长甲胆的风木之气以克制它，这也是升发阳气、帮助清气上升的方法。另一种说法认为，中焦元气不足，大小便就会异常，肠道发出痛苦的鸣响，也是因为胃气不升，导致甲木之气上行。又说：风能胜湿。大抵这种证候，根本在于胃气虚弱，不能消化食物，剥夺饮食一天就可以停止。剥夺饮食的道理，是因为胃弱不能消化，吃了就会腹泻，如果吃不下怎么会产生腹泻呢？更应当用药滋养元气使其调和，等到腹泻停止后逐渐给予食物，胃气强盛了就安好了。如果有食物不消化的情况，在升阳风药中加入炒神曲同煎。兼有食物刚吃下去就觉得冲到心头的，这是胃的上口（贲门）的问题，必然伴有口吐涎沫，或者食物吃进去又反出来，这都是胃土停聚寒邪，右手关脉呈现弦象，重按洪大而缓，这是风热湿相合，谷气不行，清气不升，被弦脉所代表的寒气阻隔，所以食物下不去。神曲的热性也能去除这种寒邪。如果是反胃，再加半夏、生姜，放入风药中同煎。剥夺或少量进食，是为了让胃气强盛。如果药力太大，胃承受不了，腹泻也不会停止，应当逐渐增加药量。现在病已经很久，身体已经衰弱，应当按照常规方法治疗，不可过多服用补益药。人的肌肉，就像大地的土壤，难道人可以没有肌肉吗？所以肌肉消尽就会死亡。消瘦的人，有必死的八种情况，《内经》记载七种，《外经》记载一种。另外，如果肌肉完全消失，就不要治疗了，这是天命。如果肌肉还没有瘦到极点，应当紧急治疗，应当先剥夺饮食以增益胃气，随即使用升阳之法。先扶助真气，其次用风药胜湿，以助升腾之气，病就可以痊愈了。其余的不谈论，这是治疗的上等法则。（治疗使用升阳除湿汤之类的方剂。）春天伤于风邪，夏天产生餐泄。木在季节上对应春，在人体对应肝，在天对应风。风，是无形的清气。正当春季的时候，发作出温热的时令之气，反而被寒气折损，这是三个月的春季行走了三个月冬季的令气，由此可知水气太过了。水气既然太过，金气的肃杀就更严厉，这是所胜者（金克木，此处指金乘木）乘着虚势妄行。所胜者乘着虚势妄行，那么木气就明显虚弱了。所以医经说：从后来者（我生之子反过来克我，或指母病及子后的反向影响，此处语境指五行相乘侮关系中的特定传变）称为虚邪。木气既已虚弱，火令（心火）就不及时，这是所生者（火为木之子）受病了，所以所不胜者（水克火，此处指水侮火或水乘火）欺侮它，于是土气来侵犯木的分野，变化成为餐泄。所以医经说：清气在下，就会产生餐泄。因为湿令当权，所以餐泄的症状，在夏天发作。如果在春天的时候，木气不发生，温热时令不明显，只行冬令，这叫伤卫（卫气），因为阳气不出地之外，应当用麻黄汤发散它。麻黄味苦，气味薄的，属于阴中之阳。所以从水中补木而泻水，发出津液作为汗液。如果春木已经生长，温热时令已经显现，阳气出于地之上，寒气再次到来并折损它，应当用轻度的发散法，说是已经得到了少阳之气，不必用麻黄了。春天伤于风，夏天产生餐泄，之所以病发在夏天，是因为木气绝于夏，而土旺于长夏，湿本来具有下行的性质，所以在夏天发生餐泄。不在春天发病的，是因为春时风虽然有伤，但木气实际上当权，所以餐泄不在木气当令的时候发病，而在湿气当令的时候发作。医经说：时令到了而相应的气机没到，这叫不及，所胜者妄行，所不胜者搏击它，所生者受病，说的就是这个道理。张仲景的法度：下利清谷（大便中有未消化的食物），里寒外热，出汗且四肢厥冷，用通脉四逆汤主治。刘河间的法度：餐泄，风冷侵入体内，腹泻不止，脉象虚而细，日夜多次排便，口干腹痛不停，用白术汤主治。李东垣说：泄利餐泄，身热，脉弦腹痛且口渴，以及头痛微汗，宜用防风芍药汤。李东垣所说的：是内动之风。医经说：春天伤于风，夏天产生餐泄。又说：久风变成餐泄。又说：虚邪中人，始于皮肤，停留不去，传入络脉；停留不去，传入经脉；停留不去，传入输穴；停留不去，传入伏冲之脉；停留不去，传入肠胃。在肠胃的时候，奔响腹胀，多寒则肠鸣餐泄，食物不消化，这就不是内动之风。张洁古说：大渴引饮，多导致水谷一时下行，宜灸大椎穴三壮或五壮，或用車前子、雷丸、白术、茯苓及五苓散等药渗利它。又如久风变成餐泄的，就不饮水而完谷排出，治法应当用宣风散导滞，之后服用苍术防风汤。餐泄以风为根本，风邪非发汗不能外出。有患此病的，腹中雷鸣，泄注如水谷不分，小便涩滞，都是因为脾胃虚寒的缘故，服用豆蔻、乌梅、粟壳、干姜、附子，没有一个有效，中脘和脐下灸了几千壮，燥热反而加重，津液枯竭，消瘦无力，饮食减少。请我去诊治，我用应象理论分析说，热气在下，水谷不分，化生餐泄；寒气在上，则产生胀满，而气不散开，为什么呢？因为阴静而阳动的缘故。诊察他的脉象两手都浮大而长，身体表面微热，用桂枝麻黄汤，用生姜大枣煎煮。大剂量连续进服三剂，整天出汗，到天亮就好了。接着用胃风汤调和脏腑，调养阴阳，进食后痊愈。医经说：脾虚则腹满肠鸣，泄泻食物不消化。又说：餐泄取三阴经穴。三阴，指的是太阴经。宜用补中益气汤，用白芍药代替当归为主药。又说：肾脏主志，志有余，腹胀餐泄，泻然筋血（针刺泻血）。又说：肝足厥阴之脉，所生的病，胸满呕逆，餐泄，视其盛、虚、寒、热、陷下等情况施以针法。这些都是内因而无风邪的情况。
Do not allow the pathogenic factor to sink downward, which would lead to *canxie* (diarrhea caused by dietary indiscretion). It is also stated: Whenever there is diarrhea with undigested food and water in the stool, it is called *canxie*. This occurs because clear Qi fails to ascend due to the failure of Stomach Qi to rise. The sages of antiquity all used ascending and floating herbs to support Stomach Qi, resulting in a cure after a single dose, indicating that the disease location is in the Middle Jiao (Middle Burner) Spleen and Stomach. The *Maijue* (Pulse Classic) states: "Excess dampness leads to five types of diarrhea." Dampness is another name for the Stomach. The root of the disease lies in the Stomach, where True Qi is weak. True Qi refers to Grain Qi (Qi derived from food and drink). The inability to digest food and drink is due to excessive dampness. Based on this discussion, the cause is precisely the weakness of the Spleen and Stomach. In the initial stage, withholding food or fasting completely for one or two days allows Stomach Qi to strengthen day by day, stopping the diarrhea. Now that severe diarrhea has developed, the Classics state: "To treat dampness without promoting urination is not the correct method." It is also said: "The Lower Jiao is like a drainage ditch." And again: "For diseases located below, use methods to drain them thoroughly." However, these principles are not suitable for this specific condition. This argument posits that the disease arises from the sinking of Stomach Qi, failure of clear Qi to ascend, and obstruction of the Yang pathways. Therefore, treatment should focus on ascending and lifting, rather than promoting urination. The *Ling Shu* (Spiritual Pivot) states: "When there is disease in the head, treat the feet; this is treating Yin for Yang disease. When there is disease in the feet, treat the upper body; this is treating Yang for Yin disease. When there is disease in the middle, treat from the sides." The sides refer to the Shaoyang Gallbladder Meridian. The middle refers to the Spleen and Stomach. For Spleen and Stomach diseases, select points from the Foot-Shaoyang Gallbladder Meridian. The "Jia Gallbladder" refers to Jia Wind (Wind-Wood Qi), corresponding to the East and Spring. The Grain Qi in the Stomach is essentially the manifestation of Wind transformation. Recognizing them as a unified whole, it is said that when dampness overcomes the Stomach causing diarrhea, one should assist the Wind-Wood Qi of the Jia Gallbladder to overcome the dampness. This is also a method of raising Yang Qi and assisting the ascent of clear Qi. Another theory suggests that insufficient Yuan Qi in the Middle Jiao leads to abnormalities in urination and defecation, and painful borborygmus in the intestines, also due to the failure of Stomach Qi to ascend, causing Jia Wood Qi to move upward. It is also said: "Wind overcomes dampness." Generally, this condition stems from weak Stomach Qi unable to transform food; withholding food for one day can stop it. The rationale for withholding food is that a weak Stomach cannot digest; eating leads to diarrhea. If one cannot eat, how can diarrhea occur? One should instead use medicine to nourish and harmonize Yuan Qi. Once diarrhea stops, gradually reintroduce food; when Stomach Qi strengthens, health will return. If food remains undigested, add fried Shenqu (Medicated Leaven) to the ascending wind-dispelling herbs for decoction. If food feels like it rushes immediately to the heart upon ingestion, this involves the upper opening of the Stomach (the cardia), often accompanied by drooling or regurgitation. This indicates cold stagnation in Stomach Earth. The pulse at the Guan position of the right hand is wiry, and deep pressure reveals a surging yet slow quality. This represents a combination of wind, heat, and dampness, where Grain Qi fails to move and clear Qi fails to ascend, blocked by the cold represented by the wiry pulse, preventing descent. The warmth of Shenqu can also dispel this. If regurgitation is present, add Banxia (Pinellia Rhizome) and Shengjiang (Fresh Ginger) to the wind-dispelling herbs for decoction. Withholding or reducing food intake aims to strengthen Stomach Qi. If the medicinal dosage is too strong, the Stomach cannot tolerate it, and diarrhea will not cease; thus, the dosage should be increased gradually. Since the illness has persisted for a long time and the patient is now weak, treat according to standard methods, avoiding excessive tonification. Human flesh is like the soil of the earth; can a person exist without flesh? Thus, when flesh is completely consumed, death ensues. There are eight signs of inevitable death in emaciated individuals: seven recorded in the *Nei Jing* (Inner Canon) and one in the *Wai Jing* (Outer Canon). Furthermore, if muscles are completely wasted away, do not treat it; this is destiny. If muscles have not wasted to the extreme, urgent treatment is required. First, withhold food to benefit Stomach Qi, then employ ascending methods. First assist True Qi, then use wind herbs to overcome dampness, thereby aiding the ascending and rising Qi, and the disease can be cured. Other matters are not discussed here; this is the superior method of treatment (using formulas such as Shengyang Chushi Tang). Injury by wind in spring leads to *canxie* in summer. Wood corresponds to spring in seasons, Liver in the human body, and wind in heaven. Wind is formless clear Qi. During spring, warm commands emerge but are suppressed by cold, meaning the three months of spring follow the commands of winter. From this, we know Water Qi is excessive. Since Water is excessive, Metal's肃杀 (astringent/descending) nature becomes stricter; this is the overcoming element taking advantage of deficiency to act recklessly. When the overcoming element acts recklessly, Wood Qi is clearly deficient. Hence, the Classics state: "What comes from behind is called empty evil." With Wood Qi deficient, Fire commands are inadequate; this means the generated element (Fire, child of Wood) suffers disease. Consequently, the non-overcoming element (Water, which controls Fire) insults it. Thus, Earth Qi invades Wood's domain, transforming into *canxie*. Hence, the Classics state: "Clear Qi remaining below generates *canxie*." Because damp commands hold power, *canxie* symptoms manifest in summer. If during spring, Wood Qi does not generate, warm commands do not appear, and only winter commands prevail, this is termed injury to Wei Qi (Defensive Qi), because Yang Qi does not emerge from beneath the earth. In such cases, use Mahuang Tang (Ephedra Decoction) to induce sweating. Mahuang (Ephedrae Herba) is bitter and thin in flavor, representing Yang within Yin. Thus, it supplements Wood by drawing from Water and drains Water, releasing fluids as sweat. If Spring Wood has already grown and warm commands are evident, with Yang Qi emerging above the earth, but cold returns to suppress it, use mild release methods. This implies obtaining Shaoyang Qi, so Mahuang is unnecessary. The reason *canxie* manifests in summer despite spring wind injury is that Wood Qi ends in summer, while Earth prospers in late summer. Dampness naturally tends downward, hence *canxie* occurs in summer. It does not occur in spring because, although wind causes injury, Wood Qi is actually dominant. Thus, *canxie* does not manifest when Wood is in command but when Dampness is in command. The Classics state: "When the season arrives but the corresponding Qi does not, it is called insufficiency. The overcoming element acts recklessly, the non-overcoming element attacks, and the generated element suffers disease." This is what is meant. Zhang Zhongjing's method: For dysentery with undigested food, interior cold with exterior heat, sweating, and cold extremities, use Tongmai Sini Tang (Decoction for Reviving the Pulse). Liu Wan-su's method: For *canxie* with wind-cold invading the interior, unceasing diarrhea, deficient and fine pulse, frequent bowel movements day and night, dry mouth, and persistent abdominal pain, use Baizhu Tang (Atractylodes Macrocephala Decoction). Li Dong-yuan states: For diarrhea and *canxie* with fever, wiry pulse, abdominal pain, thirst, headache, and slight sweating, use Fangfeng Shaoyao Tang (Saposhnikovia and Peony Decoction). Li Dong-yuan refers to this as internally generated wind. The Classics state: "Spring wind injury leads to summer *canxie*." Also: "Chronic wind transforms into *canxie*." Also: "Empty evils entering humans start at the skin; if they remain, they transmit to collaterals; if they remain, to meridians; if they remain, to transport points; if they remain, to the Fu-Chong vessels; if they remain, to the intestines and stomach." During the intestinal and stomach phase, there is rushing noise and abdominal distension. Excess cold causes borborygmus and *canxie*, with undigested food. This is not internally generated wind. Zhang Jie-gu states: Severe thirst with drinking leading to rapid passage of food and water should be treated by moxibustion on Dazhui (GV14) for 3–5 cones, or using Cheqianzi (Plantaginis Semen), Leiwan (Alloplasia Root), Baizhu (Atractylodis Macrocephalae Rhizoma), Fuling (Poria), and Wuling San (Five-Ingredient Powder with Poria) to leach out dampness. Regarding *canxie* caused by chronic wind, where there is no thirst and complete food passes through, the treatment should involve Xuanfeng San (Wind-Releasing Powder) to guide stagnation, followed by Cangzhu Fangfeng Tang (Atractylodes and Saposhnikovia Decoction). *Canxie* takes wind as its root; wind cannot exit without sweating. Patients with this condition have borborygmus, watery diarrhea with indistinguishable food and water, and scanty urine, all due to Spleen-Stomach deficiency-cold. Taking Cardamom, Mume Fruit, Poppy Shell, Dried Ginger, and Aconite yields no effect. Moxa applied to Zhongwan (CV12) and below the umbilicus amounts to thousands of cones, yet dryness and heat worsen, fluids dry up, emaciation and weakness increase, and appetite decreases. Upon examination, I applied the principle of correspondence: "Heat below causes indistinguishable food and water, generating *canxie*; Cold above causes distension, with Qi failing to disperse. Why? Because Yin is still and Yang moves." Palpating the pulse, both hands were floating, large, and long. The body surface had slight heat. I prescribed Guizhi Mahuang Tang (Cinnamon Twig and Ephedra Decoction) decocted with Fresh Ginger and Jujube. Administered in large doses, three consecutive servings resulted in profuse sweating throughout the day, with recovery by dawn. Subsequently, Weifeng Tang (Stomach-Wind Decoction) was used to harmonize the Zang-Fu organs and regulate Yin and Yang. Health returned with food intake. The Classics state: "Spleen deficiency leads to abdominal fullness, borborygmus, and diarrhea of undigested food." Also: "For *canxie*, select the Three Yin meridians." The Three Yin refers to the Taiyin (Spleen/Lung/Kidney Yin channels, specifically Spleen here). Use Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction), substit Danggui (Angelica Sinensis Radix) with Baishao (White Peony Root). Also: "The Kidney houses the Will (Zhi). Excess in Will leads to abdominal distension and *canxie*; bleed the Ranjin blood vessels." Also: "Diseases of the Foot-Jueyin Liver Meridian include chest fullness, vomiting, reverse flow, and *canxie*. Treatment depends on excess, deficiency, cold, heat, or sinking conditions." These are all internal causes without wind pathogens.