泄泻之病，水谷或化或不化，但大便泄水，并无努责后重者是也。脉细、皮寒、少气、
泻利、不食，为
五虚死。泄泻而犯五虚，中土已竭，危候也，参附汤尤不能挽，必加七味白术汤，可以追其
既失之脾阳，而固其元气，试之效捷。用人参附子之类救之，亦有得生者。脉缓、时小结，
或
微下留连者，皆可治。浮大洪数，或紧或弦急，皆难治。脉数疾为热，沉细为寒，虚豁为气
脱，涩
实为积滞，弦而迟者为气泄。心脉止者，为惊泄。湿则泻水，腹不痛。风则米谷不化而完出
。火
则腹痛泻水，肠鸣，痛一阵，泻一阵。痰则或泻或不泻，或多或少。食则腹痛甚而泻，泻后
痛
减。肾虚则五更时便泻，常时则否。寒则腹中冷痛，洞下清水，腹内雷鸣，米饮不化。湿者
燥之，虚者补之，热者清之，寒者温之，有痰者行痰，有积者消积，气陷则升之，气脱则涩
之。主方∶白术，炒二钱，燥湿补脾，白茯苓，去粗皮，分水，白芍，炒，各一
钱五分，止
腹痛，又
能补脾而伐肝。陈皮、去白，一钱，行气。甘草，五分，炙，和中。如的系伤湿者，去
白术以
苍术代之，盖白主收敛，不若苍能发散也，仍加羌活一钱，风能胜湿。猪苓、泽泻各五分，
治湿不利小便，非其治也。
脾虚者加人参一钱，补脾气之要药。木香、砂仁各五分，脾
虚则气
不运，故以药之辛温行气而温中，以腐水谷也。仍服(戊癸丸)，方见脾门。或将前方加莲肉
五
钱，陈糯米一合炒熟俱为末，加白砂糖，每朝空腹以白汤调服，其功尤捷。
肾虚者加破
故纸一钱五分，益肾气，肉豆蔻一钱，止虚泄。二药气味相合，能使脾肾之气交相通而
化水
谷。仍多服戊癸丸。热泻粪色赤黄，弹响作痛，肛门焦痛，粪出谷道如汤之热，烦渴，小便
不
利，宜以赤茯苓代白茯苓，用为君，盖赤火色，取其相入也。热既并入于大肠而作泻，今欲引
归前阴以分其势，故用为君。仍加猪苓、泽泻渗利之药(各五分)以佐之，又加茵陈、山栀仁各
五分，二味俱苦寒，俱能解邪热而利小便。兼进如金丸，方见后。痰泻加半夏曲一钱
五分
，行痰。用陈皮、白茯苓各二钱，治痰以行气为先，而茯苓能利水行津液故也。
虚者加人
参一钱，盖痰气多由脾虚不能运化也。用竹沥、姜汁一盏加入服之。
如体实能食者，不若加
元明粉一钱，就其势从大便去之，却服收涩之剂。食积泻多噫气如败卵臭，宜去白芍药，
加枳实、木香另磨，俱理气之药一钱，砂仁五分，仍看所伤之物而用药。如伤肉食者加
山
楂，伤米食者加神曲，伤面食者加萝卜子，伤酒者加干葛各一钱，伤蟹者加丁香五分，
仍进保和丸，方见伤食。酒积每晨起必泻，本方内加人参、干葛各一钱，白豆蔻仁、吴
茱萸各
五分。寒泻加人参一钱，熟附子、干葛各五分，阳气不足则寒，故用人参补气，姜，
附已
寒。
不能食者进八味丸。元是寒泻，因泻而寒燥引饮，转饮转泻者，去白芍药，加干姜、
黄连、人
参各一钱。干姜治初得之寒，黄连解添加之热，寒何由动，热泻久而虚，故有虚热也，须
用人参补之。此理中汤加黄连也，名连理汤，多有奇效。
有一等盛暑，又复内伤生冷，及热泻暑
泻，诸药不效者，疑似之间，尤宜用此。风泻完谷不化，丹溪以为脾虚，前已列脾虚一条，
若用
补脾药不效，盒饭治风。《素问》云∶久风入中为飧泄。又云∶春伤于风，夏生飧泄。而《
史记·仓公传》又名之为回风。足知完谷不化，(完谷不化乃回风之候，连理汤必佐羌防以
升
之，关窍通而伏风自去。)乃风症也。宜本方内以苍术代白术，加羌活、防风各一钱，(辛
温通关
窍而去风)升麻、柴胡各加五分，又经云∶清气在下，则飧泄。故以二药助甘辛之味引清
气
而上升。仍绝不与食一二日，泄当自止。暑月泄泻与热泻同，仍宜服六和汤，(方见暑门。)
并啖
浸冷西瓜数片。又有一种气泻，肠鸣气走，胸膈痞闷，腹急而痛，泻则腹下宽，须臾又急，
气塞
而不通者，此由中脘停滞，气不流转，水谷不分所致，宜于本方内以苍术代白术、去白芍药
，
以其酸收故去之。加姜制浓朴、(结散气)，大腹皮(主气攻心腹)，各一钱，白蔻仁五分，
(辛温能
下气理中，)仍磨入木香汁服之。(木香治腹中气不转运，又火煨之，能实大肠。)如小便不
利，加猪
苓、泽泻各五分，并调进车前子散。如口渴引饮，加人参、麦冬各一钱，(二药何为能
生津而止
渴，盖脾气上升于肺，肺气下降，乃生津液，而二药能补脾肺故也)。升麻五分，(引清气上
朝于口。
)乌梅肉五个，(酸能止渴。)如久泻气脱加人参一钱，罂粟壳五个，(酸能止渴)。诃子
皮，(二药
俱酸涩，故能敛脱气而止泻)。肉豆蔻各一钱，木香，煨另磨。砂仁各五分，(肉蔻止
泄之要药
，涩以固脱，煨木香实大肠，砂仁理气。)泻久气必下陷，须用升举之药，加升麻、柴胡各
一
钱，羌活、防风各五分，(风药能鼓舞元气上升。)有久泻不止，及泻已愈而隔年及后期
复泻者，有积
故也。宜本方内加三棱(醋煮)，莪术醋煮焙干，二药消积，各一钱。木香、砂仁各五
分，(理
气。)兼进保和丸。凡大便泄，服理中汤，小便不利，大便反泄，不知气化之过，本肺不传
化，以纯
热之药治之，是以转泄，少服则不泻，多服则愈热，所以不分，若以陈皮、青皮之类治之
则可。经曰∶膀胱者，津液之府，气化则能出矣。
《儒门事亲》云；昔闻山东杨先生者，治府主洞泄不已，杨初未对病患，与众人谈日
月星辰缠度，及风云雷雨之变，自辰至未，而病者听之，而忘其圊。杨尝曰∶治洞泄不已之
人，先问其所好之
事。(良医治法变通化裁，出奇制胜，而愈其病。非拘执药饵一法，其用心智能，非庸工所
可揣
度。好棋者与之棋，好乐者与之笛笙不辍)。
按∶兹法匪直可以治泄，即七情虚劳之类亦
宜然
，是故枚生《七发》。楚太子闻吴客之辩，涩然汗出，霍然病已。虽是寓言，实有此理也。
第晓
日风云之变者，世已难其人，而况可求之庸医中乎。可叹!可叹!
《白云集》云；黄子浓者，
江西人
也，精医术。邻郡一富翁病泄泻弥年，礼致子浓诊疗，浃旬莫效。子浓曰∶予未得其说，求
归
一月。读《易》至乾卦天行健，朱子有曰∶天之运旋不息，故阁得地在中间，如人弄碗，只
运
动不住，故空中不坠，少有息则坠矣。因悟向者富翁之病，乃气不能举，为下脱也。又时持
水滴吸水，初以大指按滴上窍，则水满筒，放其按，则水下溜无余。乃豁然悟曰∶吾可以治
翁证矣。即治装往，翁家惊喜，至即为治艾灸百会穴，未三四十壮，泄泻止矣。
一人服内托药，大便大泄，小便秘，或用五苓散则全秘，与陈皮、茯苓气化则效。
一人病虚，服附子热药小便闭，诸药不效，惟得黄连、黄芩则效。
泄泻这种病，表现为水谷有的消化、有的不消化，只是大便稀如水样，并没有排便时用力努挣和肛门坠胀的感觉。如果脉象细弱、皮肤寒冷、气短少气、腹泻不止、不能进食，这属于“五虚”的死证。泄泻如果出现五虚的症状，说明中焦脾胃之气已经竭绝，是危重的征候，即使使用参附汤也难以挽回，必须加用七味白术汤，才能追回已经丧失的脾阳，巩固元气，试用此法见效很快。用人参、附子之类的药物来救治，也有能够存活的。如果脉象缓和、偶尔细小结代，或者轻微下利迁延不愈的，都可以治疗。如果脉象浮大洪数，或者紧促弦急的，都难以治疗。脉数疾表示有热，脉沉细表示有寒，脉虚豁表示气脱，脉涩实表示有积滞，脉弦而迟表示气泄。心脉停止搏动的，是惊悸导致的泄泻。湿邪导致的泄泻是水样便，腹部不痛。风邪导致的泄泻是米谷不化，完谷排出。火邪导致的泄泻是腹痛水泻，肠鸣，痛一阵泻一阵。痰邪导致的泄泻有时泻有时不泻，量或多或少。食积导致的泄泻腹痛剧烈，泻后疼痛减轻。肾虚导致的泄泻在五更时分大便泄泻，平时则没有。寒邪导致的泄泻是腹中冷痛，像洞一样泻出清水，腹内雷鸣，米饮不能消化。湿邪的用燥湿法，虚证的用补益法，热证的用清热法，寒证的用温里法，有痰的用化痰法，有积滞的用消积法，气陷的用升提法，气脱的用固涩法。主方：白术，炒制二钱，燥湿补脾；白茯苓，去掉粗皮，分利水湿；白芍，炒制，各一钱五分，止腹痛，又能补脾而制约肝木。陈皮，去白，一钱，行气。甘草，五分，炙过，调和脾胃。如果是确切的伤湿证，去掉白术用苍术代替，因为白术主收敛，不如苍术能发散，仍加羌活一钱，风能胜湿。猪苓、泽泻各五分，治湿如果不通利小便，就不是正确的治法。脾虚者加人参一钱，这是补脾气的重要药物。木香、砂仁各五分，脾虚则气机不运，所以用这些药的辛温之性来行气温中，以腐熟水谷。仍然服用戊癸丸，方剂见脾门章节。或者将前方加入莲肉五钱，陈糯米一合炒熟，全部研为末，加入白砂糖，每天早晨空腹用白开水调服，功效尤其快捷。肾虚者加破故纸（补骨脂）一钱五分，益肾气，肉豆蔻一钱，止虚性泄泻。这两味药气味相合，能使脾肾之气交通相通从而化生水谷。仍然多服戊癸丸。热泻粪便颜色赤黄，排便弹响作痛，肛门焦痛，粪便排出时如热水般烫人，心烦口渴，小便不利，宜用赤茯苓代替白茯苓作为君药，因为赤色属火，取其同类相入之意。热邪既然并入大肠导致泄泻，现在想要引导热邪从前阴排出以分散其势，所以用赤茯苓作为君药。仍然加猪苓、泽泻等渗利药物（各五分）来辅助，又加茵陈、山栀仁各五分，这两味药都是苦寒之性，都能解除邪热并通利小便。兼服如金丸，方剂见后文。痰泻加半夏曲一钱五分，化痰。用陈皮、白茯苓各二钱，治痰以行气为先，而茯苓能利水行津液。虚证加人参一钱，因为痰气多由脾虚不能运化所致。用竹沥、姜汁一盏加入服用。如果体质壮实能进食的，不如加元明粉一钱，顺随病势从大便排出，然后服用收涩的药物。食积泄泻多有嗳气如败卵臭味，宜去掉白芍药，加枳实、木香另磨，都是理气药各一钱，砂仁五分，仍然根据所伤之物来选择用药。如伤肉食者加山楂，伤米食者加神曲，伤面食者加萝卜子，伤酒者加干葛各一钱，伤蟹者加丁香五分，仍然进服保和丸，方剂见伤食门。酒积每晨起必泄泻，本方内加人参、干葛各一钱，白豆蔻仁、吴茱萸各五分。寒泻加人参一钱，熟附子、干葛各五分，阳气不足则生寒，所以用人参补气，姜、附已能祛寒。不能进食者进服八味丸。原本是寒泻，因腹泻而导致寒燥引饮，越喝越泻的，去掉白芍药，加干姜、黄连、人参各一钱。干姜治疗初得的寒邪，黄连解除添加的热邪，寒邪如何还能发动？热泻日久导致虚弱，所以有虚热，必须用人参补益。这是理中汤加黄连，名叫连理汤，多有奇效。有一种情况是在盛暑时节，又内伤生冷，以及热泻、暑泻，诸药无效的，在疑似之间，尤其适宜用此法。风泻完谷不化，丹溪认为是脾虚，前面已列出脾虚一条，如果使用补脾药无效，就应当治风。《素问》说：久风入中为飧泄。又说：春伤于风，夏生飧泄。而《史记·仓公传》又将其命名为回风。足以知道完谷不化，是回风的征候，连理汤必须佐以羌活、防风来升提，关窍通畅而潜伏的风邪自然去除。这是风症。宜在本方内以苍术代替白术，加羌活、防风各一钱（辛温通关窍而去风），升麻、柴胡各加五分，又经云：清气在下，则飧泄。所以用这两味药帮助甘辛之味，引导清气上升。仍然绝对不给食物一二日，泄泻应当自止。暑月泄泻与热泻相同，仍然宜服用六和汤（方见暑门），并吃浸冷的西瓜几片。又有一种气泻，肠鸣气走，胸膈痞闷，腹部拘急而痛，泻后腹部暂时宽松，片刻后又拘急，气塞不通，这是由于中脘停滞，气机不流转，水谷不分所致，宜于本方内以苍术代替白术、去掉白芍药，因为其酸收的缘故所以去掉。加姜制厚朴（散结气）、大腹皮（主治气攻心腹），各一钱，白蔻仁五分（辛温能下气理中），仍然磨入木香汁服用。（木香治腹中气不转运，又火煨之，能实大肠）。如小便不利，加猪苓、泽泻各五分，并调进车前子散。如口渴引饮，加人参、麦冬各一钱（这两味药为何能生津而止渴，盖因脾气上升于肺，肺气下降，乃生津液，而这两味药能补脾肺的缘故）。升麻五分（引导清气上朝于口）。乌梅肉五个（酸能止渴）。如久泻气脱加人参一钱，罂粟壳五个（酸能止渴）。诃子皮（这两味药俱酸涩，故能敛脱气而止泻）。肉豆蔻各一钱，木香，煨后另磨。砂仁各五分（肉蔻是止泄的要药，涩以固脱，煨木香实大肠，砂仁理气）。泻久气必下陷，须用升举的药物，加升麻、柴胡各一钱，羌活、防风各五分（风药能鼓舞元气上升）。有久泻不止，及泻已愈而隔年及后期复泻者，是有积滞的缘故。宜在本方内加三棱（醋煮），莪术醋煮焙干，这两味药消积，各一钱。木香、砂仁各五分（理气）。兼服保和丸。凡大便泄泻，服用理中汤，小便不利，大便反而泄泻，不知道是气化失常的过错，原本肺不传化，如果用纯热的药物治疗，因此转为泄泻，少服则不泻，多服则更热，所以不分利，如果用陈皮、青皮之类治疗就可以。经曰：膀胱者，津液之府，气化则能出矣。《儒门事亲》说：过去听说山东杨先生，治疗府主的洞泄不止，杨先生起初不对病人诊治，与众人谈论日月星辰的运行度数，以及风云雷雨的变化，从辰时到未时，而病人听他谈话，忘记了上厕所。杨先生曾说：治疗洞泄不止的人，先询问他所喜欢的事情。（良医治疗方法变通化裁，出奇制胜，从而治愈疾病。不是拘执于药饵一种方法，其用心智能，不是庸医所能揣度的。喜好棋艺的人给他下棋，喜好音乐的人让他吹笛笙不停）。按语：这种方法不仅可以直接治疗泄泻，即使是七情虚劳之类的病症也适宜这样，所以枚乘《七发》中楚太子听到吴客的辩论，涩然汗出，霍然病愈。虽然是寓言，确实有此道理。只是懂得风云变化之理的人，世上已经很难找到了，何况能在庸医中寻找呢？可叹！可叹！《白云集》说：黄子浓是江西人，精通医术。邻郡一位富翁患泄泻一年，礼聘子浓诊疗，十天没有效果。子浓说：我没有找到病因，请求回家一个月。读《易经》至乾卦“天行健”，朱熹说：天的运转不息，所以支撑着地在中间，如同人玩碗，只转动不停，所以空中不坠落，稍有停息就会坠落。于是领悟到先前富翁的病，是气不能举托，导致下脱。又当时手持水滴吸水实验，起初以大指按住滴的上窍，则水满筒，放开按住的手，则水下溜无余。于是豁然领悟说：我可以治疗这位老人的病了。立即整理行装前往，翁家惊喜，到了立即为他艾灸百会穴，不到三四十壮，泄泻就停止了。一人服用内托药，大便大泄，小便秘，或用五苓散则完全闭塞，用陈皮、茯苓气化则有效。一人患虚证，服用附子热药后小便闭，诸药无效，只有得到黄连、黄芩才有效。
The disease of diarrhea (Xie Xie) is characterized by food and water being either digested or undigested, with stools flowing like water, but without the sensation of straining (Nu Ze) or tenesmus (Hou Zhong). If the pulse is fine (Xi), skin is cold, there is shortness of breath (Shao Qi), diarrhea (Xie Li), and inability to eat, this constitutes the "Five Deficiencies" (Wu Xu) indicating a fatal prognosis. When diarrhea presents with the Five Deficiencies, it signifies that the Spleen Earth (Zhong Tu) is exhausted, a critical condition; even Shen Fu Tang (Ginseng and Aconite Decoction) may fail to rescue it. One must add Qi Wei Bai Zhu Tang (Seven-Ingredient Atractylodes Macrocephala Decoction) to recover the lost Spleen Yang (Pi Yang) and consolidate Yuan Qi (Primal Qi); clinical trials show rapid efficacy. Using herbs such as Ren Shen (Ginseng) and Fu Zi (Aconite Root) for rescue can also result in survival. If the pulse is slow (Huan) with occasional slight knotted beats (Jie), or if mild diarrhea lingers, these are treatable. If the pulse is floating, large, surging, and rapid (Hong Shu), or tight (Jin) or wiry and urgent (Xian Ji), they are difficult to treat. A rapid (Shu) pulse indicates Heat (Re), a deep and fine (Chen Xi) pulse indicates Cold (Han), a hollow (Xu Huo) pulse indicates Qi Collapse (Qi Tuo), a choppy and excess (Se Shi) pulse indicates Stagnation (Ji Zhi), and a wiry and slow (Xian Chi) pulse indicates Qi Leakage (Qi Xie). Cessation of the Heart pulse indicates Diarrhea due to Fright (Jing Xie). Dampness (Shi) causes watery diarrhea without abdominal pain. Wind (Feng) causes undigested grain to pass completely. Fire (Huo) causes abdominal pain with watery diarrhea, borborygmus (Chang Ming), where pain occurs in bursts followed by diarrhea. Phlegm (Tan) causes intermittent diarrhea with variable amounts. Food stagnation (Shi) causes severe abdominal pain that alleviates after defecation. Kidney Deficiency (Shen Xu) causes diarrhea at dawn (Wu Geng Xie), but not at other times. Cold (Han) causes cold abdominal pain, profuse watery diarrhea ("cave-like" descent), borborygmus, and inability to digest rice or drink. The treatment principles are: Dryness for Dampness, Tonification for Deficiency, Clearing for Heat, Warming for Cold, Moving Phlegm for Phlegm, Resolving Accumulation for Stagnation, Raising for Qi Sinking, and Astringing for Qi Collapse.
Main Formula: Chao Bai Zhu (Stir-fried Rhizoma Atractylodis Macrocephalae), 2 qian, dries dampness and tonifies Spleen; Qu Pi Bai Fu Ling (Poria with coarse skin removed), promotes diuresis; Chao Bai Shao (Stir-fried Radix Paeoniae Alba), 1.5 qian each, stops abdominal pain, tonifies Spleen, and subdues Liver. Qu Bai Chen Pi (Tangerine Peel with white pith removed), 1 qian, moves Qi. Zhi Gan Cao (Honey-fried Radix Glycyrrhizae), 0.5 qian, harmonizes Middle Jiao. For confirmed Dampness injury, replace Bai Zhu with Cang Zhu (Rhizoma Atractylodis), as Bai Zhu is astringent while Cang Zhu disperses; add Qiang Huo (Rhizoma et Radix Notopterygii), 1 qian, as Wind overcomes Dampness. Zhu Ling (Polyporus), Ze Xie (Rhizoma Alismatis), 0.5 qian each; treating Dampness without promoting urination is incorrect. For Spleen Deficiency, add Ren Shen (Radix Ginseng), 1 qian, a key herb for tonifying Spleen Qi. Mu Xiang (Radix Aucklandiae), Sha Ren (Fructus Amomi), 0.5 qian each; since Spleen Deficiency leads to Qi stagnation, these acrid-warm herbs move Qi and warm the Middle to rot and ripen food. Continue taking Wu Gui Wan (Wu-Gui Pill), see Spleen section. Alternatively, add Lian Rou (Lotus Seed), 5 qian, and Chen Nu Mi (Aged Glutinous Rice), 1 he, stir-fried and powdered, mixed with Bai Sha Tang (White Rock Sugar), taken fasting every morning with plain water for superior efficacy.
For Kidney Deficiency, add Po Gu Zhi (Fructus Psoraleae), 1.5 qian, benefits Kidney Qi; Rou Dou Kou (Semen Myristicae), 1 qian, stops deficiency diarrhea. These two harmonize to connect Spleen and Kidney Qi to transform food and water. Continue taking Wu Gui Wan. For Heat Diarrhea, stools are red-yellow, making snapping sounds with pain, anus feels scorched, stool exits hot like boiling water, accompanied by irritability, thirst, and dysuria. Use Chi Fu Ling (Red Poria) instead of Bai Fu Ling as the Sovereign herb, as Red corresponds to Fire, facilitating entry into the channel. Since Heat has entered the Large Intestine causing diarrhea, guiding it out via the anterior opening disperses its force. Add Zhu Ling and Ze Xie (0.5 qian each) as assistants, plus Yin Chen (Herba Artemisiae Scopariae) and Shan Zhi Ren (Semen Gardeniae), 0.5 qian each, both bitter-cold, clearing pathogenic Heat and promoting urination. Also take Ru Jin Wan (Ru-Jin Pill), see later. For Phlegm Diarrhea, add Ban Xia Qu (Massa Medicata Fermentata cum Bello Arisaematis), 1.5 qian, resolves phlegm. Use Chen Pi and Bai Fu Ling, 2 qian each; treating phlegm prioritizes moving Qi, and Poria promotes fluid metabolism. For Deficiency, add Ren Shen, 1 qian, as phlegm-Qi often stems from Spleen Deficiency failing to transform. Take Zhu Li (Bamboo Sap) and Jiang Zhi (Ginger Juice), 1 cup. For robust patients who can eat, adding Yuan Ming Fen (Natrii Sulfas) 1 qian allows expulsion via bowels, followed by astringents.
Food Stagnation Diarrhea features belching smelling like rotten eggs. Remove Bai Shao, add Zhi Shi (Fructus Aurantii Immaturus) and Mu Xiang, ground separately, 1 qian each (Qi-moving herbs), and Sha Ren, 0.5 qian. Select herbs based on the ingested item: Shan Zha (Fructus Crataegi) for meat, Shen Qu (Massa Medicata Fermentata) for grains, Luo Bo Zi (Semen Raphani) for flour, Ge Gen (Radix Puerariae) for alcohol, all 1 qian; Ding Xiang (Flos Caryophylli) 0.5 qian for crab. Continue Bao He Wan (Preserve Harmony Pill), see Food Injury section. Alcohol Accumulation causes morning diarrhea; add Ren Shen and Ge Gen, 1 qian each, Bai Dou Kou Ren (Semen Cardamomi), Wu Zhu Yu (Fructus Evodiae), 0.5 qian each. For Cold Diarrhea, add Ren Shen, 1 qian, Shu Fu Zi (Prepared Radix Aconiti Lateralis Preparata), Ge Gen, 0.5 qian each; insufficient Yang generates Cold, so Ren Shen tonifies Qi, while Ginger and Aconite dispel Cold. For inability to eat, take Ba Wei Wan (Eight-Ingredient Pill). If originally Cold Diarrhea becomes complicated by Cold-Dryness inducing drinking, leading to more diarrhea upon drinking, remove Bai Shao, add Gan Jiang (Rhizoma Zingiberis Recens), Huang Lian (Rhizoma Coptidis), Ren Shen, 1 qian each. Gan Jiang treats initial Cold, Huang Lian resolves added Heat; otherwise, how can Cold persist? Long-standing Heat Diarrhea leads to Deficiency and Deficient Heat, requiring Ren Shen for tonification. This is Li Zhong Tang (Regulate the Middle Decoction) plus Huang Lian, named Lian Li Tang (Coptis and Atractylodes Decoction), showing miraculous effects. It is especially suitable for Summerheat-Damp cases mimicking Heat Diarrhea unresponsive to other drugs.
Wind Diarrhea features undigested food. Danxi attributed it to Spleen Deficiency; if Spleen tonification fails, treat Wind. *Su Wen* states: "Long-standing Wind entering the interior causes Sundry Diarrhea (Sun Xie)." And: "Wind injury in Spring leads to Sundry Diarrhea in Summer." *Shi Ji* calls it Hui Feng (Returning Wind). Undigested food is a sign of Hui Feng; Lian Li Tang must be assisted by Qiang Huo and Fang Feng to raise Qi; once orifices open, latent Wind departs. This is a Wind syndrome. Replace Bai Zhu with Cang Zhu in the base formula, add Qiang Huo and Fang Feng (Radix Saposhnikoviae), 1 qian each (Acrid-Warm opens orifices and expels Wind), Sheng Ma (Rhizoma Cimicifugae) and Chai Hu (Radix Bupleuri), 0.5 qian each. Classics state: "Clear Qi sinking below causes Sundry Diarrhea." These herbs assist Acrid-Sweet flavors to raise Clear Qi. Withhold food for 1-2 days; diarrhea should cease. Summerheat Diarrhea is similar to Heat Diarrhea; take Liu He Tang (Six-Harmony Decoction) and eat chilled Watermelon slices.
Qi Diarrhea features borborygmus, moving Qi, chest oppression, acute abdominal pain relieving temporarily after defecation then returning, with Qi blockage. This stems from Middle Jiao stagnation, failed Qi flow, and failure to separate clear/turbid. Replace Bai Zhu with Cang Zhu, remove Bai Shao (due to sour astringency). Add Zhi Hou Po (Magnolia Bark processed with ginger), Da Fu Pi (Pericarp Arecae), 1 qian each (dissipates knotting Qi, attacks heart/abdominal Qi), Bai Kou Ren (Cardamom Seed), 0.5 qian (Acrid-Warm descends Qi and regulates Middle). Grind in Mu Xiang juice (treats stagnant abdominal Qi; roasted Mu Xiang solidifies Large Intestine). If dysuria, add Zhu Ling and Ze Xiang, 0.5 qian each, and Che Qian Zi San (Plantago Seed Powder). If thirsty, add Ren Shen and Mai Dong (Radix Ophiopogonis), 1 qian each (tonify Spleen/Lung to generate fluids); Sheng Ma, 0.5 qian (guides Clear Qi to mouth); Wu Mei Rou (Pericarpium Mume), 5 pieces (sour stops thirst). For long-term diarrhea with Qi Collapse, add Ren Shen, 1 qian, Ying Su Ke (Pericarpium Papaveris), 5 pieces (astringes collapsing Qi); He Zi Pi (Pericarpium Terminaliae), Rou Dou Kou, Mu Xiang (roasted/ground), Sha Ren, 0.5 qian each (Rou Dou Kou is key for stopping diarrhea/astringing collapse; roasted Mu Xiang solidifies intestine; Sha Ren regulates Qi). Long-term diarrhea sinks Qi; use lifting herbs: Sheng Ma, Chai Hu, 1 qian each; Qiang Huo, Fang Feng, 0.5 qian each (Wind herbs inspire Yuan Qi to rise). For chronic diarrhea or recurrence after remission, there is residual accumulation. Add San Leng (Rhizoma Sparganii) and E Zhu (Rhizoma Curcumae), vinegar-boiled and dried, 1 qian each (resolve accumulation); Mu Xiang, Sha Ren, 0.5 qian each (regulate Qi). Take Bao He Wan.
If taking Li Zhong Tang causes diarrhea despite normal urination, or if dysuria accompanies diarrhea, one ignores the error of failed Qi transformation. Originally, Lung fails to transmit; using pure Heat herbs worsens diarrhea (less dose stops it, more increases Heat). Use Chen Pi and Qing Pi (Exocarpium Citri Reticulatae Viride) instead. Classics: "Bladder is the mansion of fluids; only through Qi transformation can they exit."
*Rumen Shiqin* records: Mr. Yang from Shandong treated a governor's persistent Profuse Diarrhea (Dong Xie). Instead of prescribing immediately, he discussed astronomy and weather from Chen to Wei hours. The patient listened and forgot to defecate. Yang said: Treat Profuse Diarrhea by first asking about the patient's hobbies. (Good doctors adapt treatments creatively, not rigidly relying on herbs; their wisdom surpasses mediocre physicians. Give chess to chess lovers, music to music lovers.) Commentary: This method applies not only to diarrhea but also to Seven Emotions and Consumption. Like Chu Crown Prince curing illness through Wu Guest's debate (*Qi Fa*), though allegorical, it holds truth. Few understand such subtleties today, let alone find them among mediocre doctors. Regrettable!
*Bai Yun Ji*: Huang Zinong, a Jiangxi physician, treated a neighbor's wealthy man with year-long diarrhea. After ten days of ineffectual treatment, he requested leave to study. Reading *I Ching*, Qian Hexagram "Heaven's movement is vigorous," Zhu Xi noted: Heaven's rotation supports Earth like a spinning bowl; if it stops, it falls. Huang realized the patient's Qi failed to lift, causing downward collapse. Observing water dripping: covering the top keeps water in; releasing lets it drain. He cured the old man by moxibustion on Bai Hui (GV20); after 30-40 moxa cones, diarrhea stopped.
Case 1: Internal-pushing herbs caused severe diarrhea and urinary retention. Wu Ling San (Five-Ingredient Powder with Poria) caused complete retention; Chen Pi and Fu Ling restored Qi transformation and efficacy. Case 2: Deficiency patient taking Fu Zi (Heat herbs) developed urinary retention. Other herbs failed; Huang Lian and Huang Qin (Scutellaria Root) were effective.