【因】外感证一起。即直肠洞泻。不因攻下而自利者。世俗通称为漏底伤寒。然有
协风、协寒、协热、协食之别。必先其所因而明辨之。
【证】协风自利者。初起头痛怕风。自汗腹疼。肠鸣飧泄。完谷不化。舌苔白薄而
润。或淡白而嫩滑。协寒自利者。初起恶寒蜷卧。身虽发热而手足厥冷。或吐清水。大
便色青。完谷不变。形如 溏。小便清白。脐下必冷。腹多胀满。舌苔白嫩而滑。或灰
滑而淡白。协热自利者。一起即身发壮热。背微恶寒。面垢齿燥。口干渴饮。大便虽亦
有完谷不化。而状如垢腻。色多黄赤黑。且皆热臭。气暖如汤。后重而滞。溺色黄赤。
或涩或闭。脐下必热。舌苔黄腻而糙。中后截浓腐垢腻。协食自利者。初起虽微恶风寒
。而身热口燥。渴饮而呕。胸脘硬痛。嗳腐吞酸。傍流粪水。热臭难闻。矢气亦臭。舌
苔黄而垢腻。浓腐堆起。中后愈浓。或如豆腐渣炒黄满布。
【脉】左弦浮。右沉濡者。乃外风搏动肠风。《内经》所谓清气在下。则生飧泄是
也。沉迟无力。甚则沉微似伏者。《伤寒论》所谓胃中虚冷。水谷不别故也。数而有力
。甚则洪弦而实者。王太仆谓大热内结。淫泻不止。陶节庵所云热邪不杀谷是也。弦长
而滑。或滑数而实者。《伤寒论》所谓下利有宿食也。若下利谵语者。肠中必有燥粪也
。
【治】协风自利。初与刘氏肠风汤加味。（生晒术、炒白芍各钱半、炒广皮、煨
防风、焦麦芽各一钱、煨葛根、川芎各八分）疏表建中以止泻。继与补中益气汤去
当归。加煨木香。带壳春砂（各八分）调中益气以善后。
协寒自利。轻则胃苓汤。温胃利水以止泻。重则附子理中汤。热壮脾阳以住泄。终与白
术和中汤。温和脾胃以善后。协热自利。先与葛根芩连汤加味。（生葛根、青子芩各
钱半、小川连八分、拌炒广木香六分、滑石三钱、清炙草六分）。清中解表以泄热。继
与加味白头翁汤。清热坚肠以止利。终与三黄熟艾汤。（条芩一钱、川连六分、川柏四
分、熟艾二分、猪苓、泽泻、生白芍各钱半、乌梅肉二分、灯心两小帚。）酸苦泄热
。芳淡利湿以善后。协食自利先与枳实导滞汤。消积下滞以廓清胃肠。继与芩连二陈汤
。苦降辛通以整肃余热。终与麦门冬汤。加鲜石斛、蔗浆。清养津液以调和胃气。总之
证既自利。当先其所因以治利。利止内实。正气得复。邪气自解。往往微汗出而愈。盖
下利为内虚里急。仲景所谓里急者即当救里也。若不救里。专发其汗以治表。则内
外俱虚。变证蜂起。轻则气上逆而为呕哕。重则气内虚而成痞满。虚则误汗亡阳而转脱
。实则误汗助火而转闭。临证者慎之。
【秀按】漏底伤寒。始见于陶氏《六书》。乃田野间俗名耳。陶氏谓伤寒自利。多
责于热。杂病自利。多责于寒。亦不尽然。又谓伤寒三阳下利。身必热。太阴下利。手
足温。少阴厥阴下利。身凉无热。此亦言其大概耳。总以审察病机。色脉合参为首要。
俞君明辨病因。别风寒热食四端。对证发药。分际自清。庶不致草率误人矣。虽然。凡
病一起即下利。甚至洞泄不止。如俗称漏底者。虽由外感。必夹内伤。死证甚多。约计
之则有六。（一）下利谵语。两目直视。（二）下利厥逆。烦躁不眠。（三）下利发热
。厥逆自汗。（四）下利清谷。肢厥无脉。灸之不温。脉终不出。（五）下利一日十数
行。脉反实。（六）下利脉弦。大热不止。此六者。虽对证施治。竭力挽救。效者甚鲜
。不效者多。虽医圣如仲景。《伤寒论》具在。善用其方者。亦未必方方奏效也。食古
不化者。其亦深长思哉。
【荣斋按】“漏底伤寒”是伤寒症中的一个证候，不是伤寒外另有所谓漏底伤寒。
这个名称，深入在一般医
家和病患的心目中，成为习俗的、可怕的一个病名。上海丁仲英先生把它的病状、病理
和治法，简单介绍出来，他说∶“有人于此。初起一二日。身发大热。至三四日。热甚
而为焦渴烦躁。至五六日。躁甚而至于四肢忽然厥冷。甚则过于肘膝。厥甚。则神情烦
躁者。至此转为呆钝。当此之时。设大便忽尔泄泻如注。甚则纯下清水。按其脉。轻举
不可得。重手按之。始觉指下跃跃大动。参其证情。似为三阴虚寒之证。然无初起发热
之理。无以名之。乃巧立漏底伤寒之名。证情如此。无经验之医家。必以为非救逆回阳。
不足以挽回。于是以参苓 术补其虚。附桂萸姜温其阳。恐其厥之不回。利之不止。而
卒至厥冷不回。利下不止。以至撤手长逝。医家病家。卒不致悟。遂委为此症之难治。
故一闻漏底寒伤。莫不惊惶相告。以为九死一生。回春无计矣。不知所谓漏底伤寒者。
大多为热结旁流之证。《内经》曰。暴注下迫。皆属于热是也。《伤寒论》云。下利谵
语。有燥屎也。宜小承气汤。（大黄、川朴、枳实）又云。少阴病下利清水。心下必痛
。口干燥者。可下之。宜大承气汤。（大黄、芒硝、浓朴、枳实）此明示人为热结旁流
。急当用下法。去其实热。病可转机。热结旁流之原因为肠受，疾病之影响。失其蠕动
作用。粪积不下。久则腐解。其毒素、上冲于巅。扰乱清明之府。成为厥逆之象。腐解
之后。夺路而出。成为下利。故其治法。宜用承气。下其燥粪。若投以温中回汤等法。
无异火上加油。变生顷刻。”这篇文本，丁先生发表在一九三三年《新闻报医药副刊》
中，针对当时所谓“漏底伤寒无治法”或用“温补法治漏底伤寒”的错误任务法，予以
有力的抨击。强调指出“漏底伤寒”是“热结旁流”，治宜“急下”。这种去火抽薪的
疗法，足补俞氏所不及。
【病因】外感病证初起，即出现直肠洞泄（指大便稀薄如水，直下无度）。并非因使用攻下药物而导致的自发性腹泻者，世俗通称为“漏底伤寒”。然而，其中有协风、协寒、协热、协食的区别。必须先查明其致病原因并加以明辨。
【症状】
协风自利者：初起时头痛、怕风，自汗出，腹痛，肠鸣，完谷不化（指大便中含有未消化的食物），舌苔白薄而润泽，或淡白且嫩滑。
协寒自利者：初起时恶寒，蜷缩而卧，身体虽然发热但手足厥冷，或呕吐清水，大便颜色青，完谷不变，形状如溏便，小便清白，脐下部位必定发冷，腹部多胀满，舌苔白嫩而滑，或灰滑且淡白。
协热自利者：病一起即身体发出壮热，背部轻微恶寒，面部污垢，牙齿干燥，口干渴饮，大便虽然也有完谷不化的情况，但性状如垢腻之物，颜色多为黄、赤、黑，且皆带有热臭气，气味暖热如汤，伴有后重感和滞涩感，尿液颜色黄赤，或排尿涩痛或闭塞，脐下部位必定发热，舌苔黄腻而粗糙，中后部厚腻腐垢堆积。
协食自利者：初起时虽轻微恶风寒，但身体发热，口燥，口渴饮水且伴有呕吐，胸脘部硬痛，嗳气有腐臭味，吞酸，旁流粪水，热臭难闻，矢气（放屁）亦臭，舌苔黄而垢腻，厚腐堆起，中后部更浓，或如豆腐渣炒黄般满布舌面。
【脉象】
左手脉弦浮，右手脉沉濡者，乃外风搏动肠风所致，《内经》所谓“清气在下，则生飧泄”即是此理。
脉沉迟无力，甚至沉微似伏者，《伤寒论》所谓“胃中虚冷，水谷不别”的缘故。
脉数而有力，甚至洪大、弦而实者，王太仆谓“大热内结，淫泻不止”，陶节庵所云“热邪不杀谷”即是此理。
脉弦长而滑，或滑数而实者，《伤寒论》所谓“下利有宿食”也。若下利伴谵语者，肠中必有燥屎。
【治法】
协风自利：初起给予刘氏肠风汤加味。（生晒术、炒白芍各钱半、炒广皮、煨防风、焦麦芽各一钱、煨葛根、川芎各八分）以疏表建中而止泻。继予补中益气汤去当归，加煨木香、带壳春砂仁（各八分），以调中益气善后。
协寒自利：轻症用胃苓汤，温胃利水以止泻；重症用附子理中汤，热壮脾阳以止泄。终予白术和中汤，温和脾胃以善后。
协热自利：先予葛根芩连汤加味。（生葛根、青子芩各钱半、小川连八分、拌炒广木香六分、滑石三钱、清炙草六分）以清中解表而泄热。继予加味白头翁汤，清热坚肠以止利。终予三黄熟艾汤。（条芩一钱、川连六分、川柏四分、熟艾二分、猪苓、泽泻、生白芍各钱半、乌梅肉二分、灯心两小帚）以酸苦泄热，芳淡利湿以善后。
协食自利：先予枳实导滞汤，消积下滞以廓清胃肠。继予芩连二陈汤，苦降辛通以整肃余热。终予麦门冬汤，加鲜石斛、蔗浆，清养津液以调和胃气。
总之，证候既见自利，应当先审察其病因以治疗下利。待下利停止，内实之邪得解，正气恢复，邪气自然解除，往往通过微微出汗而痊愈。盖因下利属于内虚里急，仲景所谓“里急者即当救里也”。若不救里，专事发汗以治表，则内外俱虚，变证蜂起。轻则气上逆而为呕哕，重则气内虚而成痞满。虚证误汗则亡阳而转脱，实证误汗则助火而转闭。临证者务必谨慎。
【秀按】
“漏底伤寒”始见于陶氏《六书》，乃是田野间的俗名。陶氏认为伤寒自利，多归责于热；杂病自利，多归责于寒。这也不尽然。他又说伤寒三阳下利，身体必定发热；太阴下利，手足温暖；少阴、厥阴下利，身体凉而无热。这也是只说了大概情况。总之以审察病机、色脉合参为首要任务。俞君明辨病因，区分风、寒、热、食四端，对证用药，分寸自然清晰，这样才不会草率误人。虽然如此，凡病初起即下利，甚至洞泄不止，如俗称的漏底者，虽由外感引起，必夹杂内伤，死证甚多。约计有六种死证：（一）下利伴谵语，两眼直视；（二）下利伴四肢厥逆，烦躁不眠；（三）下利伴发热，四肢厥逆且自汗；（四）下利排出清谷，四肢厥冷无脉，艾灸后不温，脉搏始终不出；（五）下利一日十数次，脉象反而实大；（六）下利脉弦，大热不止。这六种情况，即使对证施治，竭力挽救，见效的很少，不见效的多。即使是医圣如张仲景，《伤寒论》具在，善于运用方剂的人，也未必能方方奏效。食古不化者，应深思之。
【荣斋按】
“漏底伤寒”是伤寒症中的一个证候，不是伤寒之外另有所谓的“漏底伤寒”。这个名称深入一般医家和病患的心目中，成为习俗的、可怕的一个病名。上海丁仲英先生将它的病状、病理和治法简单介绍出来，他说：“有人于此，初起一二日，身体发出大热，至三四日，热甚而为焦渴烦躁，至五六日，躁甚而至于四肢忽然厥冷，甚至超过肘膝。厥冷严重，则神情烦躁转为呆钝。当此之时，假如大便忽然泄泻如注，甚至纯下清水。按其脉象，轻举不可得，重手按之，始觉指下跃跃大动。参究其证情，似乎为三阴虚寒之证。然而没有初起发热的道理，无法命名，于是巧立‘漏底伤寒’之名。证情如此，无经验之医家，必以为非救逆回阳不足以挽回，于是用人参、茯苓、白术补其虚，附子、肉桂、山茱萸、干姜温其阳。恐怕厥冷不回，下利不止，最终导致厥冷不回，下利不止，以至撒手长逝。医家病家，最终未能醒悟，遂委托此为病症难治。故一听到漏底寒伤，无不惊慌相告，以为九死一生，回春无计了。不知所谓的‘漏底伤寒’，大多为‘热结旁流’之证。《内经》曰：‘暴注下迫，皆属于热’是也。《伤寒论》云：‘下利谵语，有燥屎也。宜小承气汤。（大黄、川朴、枳实）’又云：‘少阴病下利清水，心下必痛，口干燥者，可下之。宜大承气汤。（大黄、芒硝、浓朴、枳实）’此明示人为热结旁流，急当用下法，去其实热，病可转机。热结旁流的原因为肠道受疾病之影响，失其蠕动作用，粪积不下，久则腐解，其毒素上冲于巅顶，扰乱清明之府，成为厥逆之象。腐解之后，夺路而出，成为下利。故其治法，宜用承气汤类，下其燥粪。若投以温中回阳等法，无异火上加油，变生顷刻。”这篇文本，丁先生发表在一九三三年《新闻报医药副刊》中，针对当时所谓“漏底伤寒无治法”或用“温补法治漏底伤寒”的错误治疗方法，予以有力的抨击。强调指出“漏底伤寒”是“热结旁流”，治宜“急下”。这种去火抽薪的疗法，足补俞氏所不及。
[Pathogenesis] When an exterior contraction syndrome begins, it is immediately accompanied by rectal torrential diarrhea (referring to thin, watery stools flowing down uncontrollably). This spontaneous diarrhea, which does not result from the administration of purgatives, is commonly known in secular terms as "Lou Di Shang Han" (Leaky Bottom Cold Damage). However, there are distinctions among those associated with Wind, Cold, Heat, and Food Stagnation. One must first ascertain the etiology and distinguish them clearly.
[Symptoms]
In cases of self-diarrhea associated with Wind: At the onset, there is headache, aversion to wind, spontaneous sweating, abdominal pain, borborygmus, undigested food in the stool, a white and thin but moist tongue coating, or a pale white and tender-smooth coating.
In cases of self-diarrhea associated with Cold: At the onset, there is aversion to cold, curling up while lying, fever in the body but cold extremities, or vomiting of clear fluid, green-colored stools, undigested food unchanged in form resembling loose stools, clear and white urine, coldness below the umbilicus, frequent abdominal distension, a white, tender, and slippery tongue coating, or a gray-slippery and pale-white coating.
In cases of self-diarrhea associated with Heat: From the beginning, there is high fever, slight aversion to cold on the back, dirty complexion, dry teeth, dry mouth with thirst and desire to drink. Although undigested food may also appear in the stool, the consistency resembles foul residue, and the color is often yellow, red, or black. All possess a hot, foul odor, feeling warm like soup, accompanied by tenesmus and stagnation. Urine is yellow-red, either painful and difficult or obstructed. There is heat below the umbilicus, a yellow-greasy and rough tongue coating, with thick, foul, greasy accumulation in the middle and posterior parts.
In cases of self-diarrhea associated with Food: At the onset, although there is slight aversion to wind and cold, there is body heat, dry mouth, thirst with desire to drink accompanied by vomiting, hardness and pain in the chest and epigastrium, belching with rotten odor, acid regurgitation, leakage of fecal water, unbearable hot foul odor, and foul-smelling flatulence. The tongue coating is yellow and greasy, thickly accumulated, becoming denser in the middle and posterior parts, or spreading like fried tofu dregs covering the entire surface.
[Pulse]
If the left pulse is wiry and floating, and the right pulse is deep and soggy, it indicates external wind stirring intestinal wind. This corresponds to the *Nei Jing* saying, "When clear qi descends, sunken diarrhea occurs."
If the pulse is deep, slow, and weak, or even deep, minute, and seemingly hidden, it corresponds to the *Shang Han Lun* saying, "Cold deficiency in the stomach causes failure to separate water and grain."
If the pulse is rapid and forceful, or even surging, wiry, and solid, Wang Taipu stated, "Internal binding of great heat causes incessant profuse diarrhea." This aligns with Tao Jie'an's statement that "heat pathogen fails to digest food."
If the pulse is wiry, long, and slippery, or slippery, rapid, and solid, it corresponds to the *Shang Han Lun* saying, "Diarrhea with retained food." If diarrhea is accompanied by delirium, there must be dry feces in the intestines.
[Treatment]
For self-diarrhea associated with Wind: Initially administer Liu Shi Chang Feng Tang (Intestinal Wind Decoction) with modifications (Raw processed Atractylodis Macrocephalae Rhizoma, stir-fried Paeoniae Radix Alba each 1.5 qian; stir-fried Citri Reticulatae Pericarpium, baked Saposhnikoviae Radix, scorched Malto each 1 qian; baked Puerariae Radix, Chuanxiong each 0.8 fen). This disperses the exterior and strengthens the middle to stop diarrhea. Subsequently administer Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) removing Dang Gui, adding baked Xiang Ru (Costus Root) and unpeeled Amomi Fructus Rotundus (each 0.8 fen) to regulate the middle and augment Qi for recovery.
For self-diarrhea associated with Cold: For mild cases, use Wei Ling Tang (Stomach and Five Decoction) to warm the stomach and promote diuresis to stop diarrhea. For severe cases, use Fu Zi Li Zhong Tang (Aconite Regulate the Middle Decoction) to heat and strengthen Spleen Yang to stop diarrhea. Finally, use Bai Zhu He Zhong Tang (Atractylodes Harmonize the Middle Decoction) to mildly warm the Spleen and Stomach for recovery.
For self-diarrhea associated with Heat: Initially administer Ge Gen Qin Lian Tang (Kudzu, Scutellaria, and Coptis Decoction) with modifications (Raw Puerariae Radix, Qing Zi Qin (Scutellaria Baicalensis) each 1.5 qian; Xiao Chuan Lian (Coptidis Rhizoma) 0.8 fen; stir-fried Guang Mu Xiang (Costus Root) 0.6 fen; Talcum 3 qian; Clear roasted Licorice 0.6 fen). This clears the interior, releases the exterior, and drains heat. Subsequently administer Jia Wei Bai Tou Weng Tang (Modified Pulsatilla Decoction) to clear heat and firm the intestines to stop dysentery. Finally, use San Huang Shu Ai Tang (Three Yellows and Prepared Mugwort Decoction) (Tiao Qin (Scutellaria) 1 qian; Chuan Lian (Coptidis Rhizoma) 0.6 fen; Chuan Bo (Phellodendri Cortex) 0.4 fen; Prepared Artemisiae Argyi Folium 0.2 fen; Polyporus, Alisma, Raw Paeoniae Radix Alba each 1.5 qian; Olibanum flesh 0.2 fen; two small bundles of Juncus effusus heartwood). This uses sour and bitter flavors to drain heat, and aromatic and bland flavors to promote dampness drainage for recovery.
For self-diarrhea associated with Food: Initially administer Zhi Shi Dao Zhi Tang (Immature Bitter Orange Guide Out Stasis Decoction) to eliminate accumulation and descend stagnation to clear the gastrointestinal tract. Subsequently administer Qin Lian Er Chen Tang (Scutellaria, Coptis, and Two-Chen Decoction) using bitter descent and pungent unblocking to rectify residual heat. Finally, use Mai Men Dong Tang (Ophiopogon Decoction) with fresh Dendrobii Caulis and sugarcane juice to clear and nourish fluids and harmonize Stomach Qi.
In summary, when the syndrome presents with spontaneous diarrhea, one must first examine the etiology to treat the diarrhea. Once the diarrhea stops, internal excess is resolved, righteous Qi recovers, and pathogenic factors naturally dissipate, often resulting in recovery through slight sweating. Since diarrhea involves internal deficiency and urgency, Zhang Zhongjing stated that "internal urgency requires saving the interior." If one fails to save the interior and solely induces sweating to treat the exterior, both interior and exterior become deficient, leading to numerous complications. Mildly, Qi rebels upward causing vomiting and hiccups; severely, internal Qi deficiency leads to fullness and obstruction. In deficiency patterns, mistaken sweating causes loss of Yang and collapse; in excess patterns, mistaken sweating aids fire and leads to closure. Clinicians must exercise caution.
[Xiu's Commentary]
"Lou Di Shang Han" first appeared in Tao's *Liu Shu*, being merely a rural colloquialism. Tao believed that spontaneous diarrhea in Shang Han is mostly attributed to Heat, while in miscellaneous diseases, it is mostly attributed to Cold. This is not entirely accurate. He also stated that in Yangming, Taiyang, and Shaoyang Shang Han with diarrhea, the body must be hot; in Taiyin diarrhea, hands and feet are warm; in Shaoyin and Jueyin diarrhea, the body is cool without heat. This only describes general situations. Ultimately, examining the disease mechanism and combining inspection of complexion with pulse diagnosis is paramount. Mr. Yu clearly distinguishes the etiology, separating Wind, Cold, Heat, and Food, prescribing medicines according to syndromes, ensuring clear boundaries, thus avoiding careless errors. Nevertheless, any disease starting with diarrhea, even torrential diarrhea unceasing as commonly called "leaky bottom," though caused by exterior contraction, must involve internal injury, with many fatal cases. Approximately six types exist: (1) Diarrhea with delirium and fixed gaze; (2) Diarrhea with cold extremities, irritability, and insomnia; (3) Diarrhea with fever, cold extremities, and spontaneous sweating; (4) Diarrhea with clear undigested grains, cold extremities, absent pulse, no warmth after moxibustion, and pulse never returning; (5) Diarrhea occurring ten or more times a day, yet the pulse is surprisingly solid; (6) Diarrhea with a wiry pulse and unceasing high fever. In these six cases, even with correct treatment and desperate efforts to rescue, few recover, and many fail. Even if the Medical Sage Zhang Zhongjing were present, with the *Shang Han Lun* available, those skilled in using formulas might not achieve success with every prescription. Those who rigidly adhere to ancient texts should reflect deeply.
[Rongzhai's Commentary]
"Lou Di Shang Han" is a syndrome within Shang Han diseases, not a separate entity outside of Shang Han. This name has penetrated the minds of ordinary physicians and patients, becoming a customary and terrifying disease name. Mr. Ding Zhongying of Shanghai briefly introduced its symptoms, pathology, and treatment, stating: "Consider a person who, in the first one or two days of onset, develops high fever. By the third or fourth day, the heat becomes intense, causing parched thirst, irritability, and restlessness. By the fifth or sixth day, restlessness intensifies until the limbs suddenly become cold, extending beyond the elbows and knees. With severe cold extremities, mental agitation turns into dullness. At this time, if the bowels suddenly loosen with profuse diarrhea, even passing only clear water, and the pulse cannot be felt with light pressure but throbs vigorously under heavy pressure. Considering the symptoms, it seems to be a Shaoyin, Taiyin, or Jueyin deficiency-cold pattern. However, there is no rationale for initial fever, so it is arbitrarily named 'Lou Di Shang Han.' Given such symptoms, inexperienced physicians will surely believe that only rescuing deviation and restoring Yang can save the patient. Thus, they use Ginseng, Poria, and Atractylodes to tonify deficiency, and Aconite, Cinnamon, Cornus, and Ginger to warm Yang. Fearing that cold extremities will not return and diarrhea will not stop, the patient ultimately suffers from irreversible cold extremities and unceasing diarrhea, leading to death. Physicians and patients fail to realize this, attributing it to the difficulty of treating this condition. Hence, hearing 'Lou Di Cold Damage' causes panic, believing it is nine deaths to one life with no hope of recovery. They do not know that so-called 'Lou Di Shang Han' is mostly 'Heat Binding with Side Flow.' The *Nei Jing* states: 'Sudden violent diarrhea and straining belong to Heat.' The *Shang Han Lun* says: 'Diarrhea with delirium indicates dry feces; use Xiao Cheng Qi Tang (Rhubarb, Magnolia Bark, Immature Bitter Orange).' It also says: 'Shaoyin disease with diarrhea of clear water, pain in the epigastrium, and dry mouth/throat can be purged; use Da Cheng Qi Tang (Rhubarb, Mirabilite, Magnolia Bark, Immature Bitter Orange).' This explicitly indicates that for heat binding with side flow, urgent purgation is required to remove excess heat, allowing the disease to turn. The cause of heat binding with side flow is that the intestines, affected by disease, lose their peristaltic function. Feces accumulate and do not pass; over time, they rot and decompose. Their toxins rush upward to the head, disturbing the clear orifices, creating an image of cold extremities. After decomposition, they break out along another route, becoming diarrhea. Therefore, the treatment should use Cheng Qi formulas to purge dry feces. If warming and restoring Yang methods are used, it is like adding oil to fire, causing changes instantly." This text was published by Mr. Ding in the Medical Supplement of the *Xin Wen Bao* in 1933, powerfully criticizing the erroneous treatment methods of the time, such as claiming "no treatment for Lou Di Shang Han" or using "warming and tonifying methods." He emphasized that "Lou Di Shang Han" is "Heat Binding with Side Flow" and should be treated with "urgent purgation." This method of removing fire by drawing away the firewood sufficiently supplements what Mr. Yu missed.