咳而呕吐，痰食俱出者，伤于胃气。昔人所谓肺病连胃是也。呕血带痰而出者，伤于肺
之络，《金匮》所谓热伤血脉是也。吐食者二陈汤加减治之，吐血者补肺汤主之。
加减二陈汤 半夏（一钱） 杏仁（一钱五分） 茯苓（一钱五分） 炙草（五分） 橘
红（一钱） 竹茹（八分） 生姜（一片） 粳米（一百粒）
上药用清水煎服，加枇杷叶、芦根佳。
补肺阿胶汤
阿胶（一钱五分） 兜铃（五分） 炙草（五分） 牛蒡（一钱） 杏仁（七粒） 糯米（一百粒）
都作一服，甚者加生地黄、藕汁。
戴复庵云∶泻水腹不痛者，湿也。饮食入胃，辄泻之，完谷不化者，气虚也。腹痛泻水
，肠
鸣，痛一阵泻一阵者，火也。或泻或不泻，或多或少者，痰也。腹痛甚而泻，泻后痛减者，
积也。飧泄者，水谷不化而完出，湿兼风也。溏泄者，渐下污积粘垢，湿兼热也。 泄者，
所下澄彻清冷，小便清白，湿兼寒也。濡泄者，体重软弱，泄下多水，湿自甚也。滑泄者，
久下不能禁固，湿胜气脱也。故曰湿多成五泄。
湿泻，一名濡泄，其脉濡细，其症泄水，虚滑，肠鸣，身重，腹不痛。由脾胃有湿，则
水谷
不化，清浊不分。久雨潮溢，或运气湿土司令之时，多有此疾。《内经》所谓湿胜则濡泄。
《左传》所谓雨淫腹疾是也。又水寒之气，入客肠间，亦令人濡泻，经云∶太阳之胜，寒客
下焦，传为濡泄是也。
《本事》芎 丸 治风湿滑泄。
芎 神曲 白术 附子（泡，各等分）
上为细末，面糊丸，如梧子大，每服三五丸，米饮送下。
许叔微云∶左氏述楚子围萧，萧将溃，无社告叔展曰，有麦面乎，有山鞠 乎，意欲令
逃水
中以避，是知芎 能除湿，予常加术、附以制方，治脾湿而泻者，万无不中，此药亦治飧泄
。
刘草窗泻湿汤
生白术（三钱） 白芍（二钱） 陈皮（炒，一钱五分） 防风（一钱） 升麻（五分）
上锉作帖，水煎服。
此用风药以举其气，抑胜其湿也。河间云∶有肠胃燥郁，水液不能宣行于外，反以停湿
而泄
，或燥湿往来而时结时泄者，此又湿泻之变。余见有老人久泄，饮牛乳而泄反止者，此类是
耳。
胃苓汤 治脾湿太过，泄泻不止。
平胃散 五苓散（各等分）
上锉，水煎服。
平胃散治酒泄不已，饮后尤甚，加丁香、缩砂、麦芽、神曲各五钱为末，米饮调二钱，
立愈。
升阳除湿汤（方见飧泄。）
东垣云∶予病脾胃久衰，视听半失，气短精神不足，此由阳气衰弱，不得舒伸，伏匿于
阴中
耳。癸卯岁六七月间，淫雨阴寒，逾月不止，时人多病泄利。一日予体重肢节疼痛，大便泄
下，而小便闭塞。治法诸泄利，小便不利，先分利之。又云∶治湿不利小便，非其治也。噫
！圣人之法，布在方策，其不尽者，可以意求耳。今客邪寒湿之淫，从外而入里，若用淡渗
之剂以除之，是降之又降，复益其阴，而重竭其阳，则阳气愈削而精神愈短矣。故必用升阳
风药，羌活、独活、柴胡、升麻各一钱，防风、葛根半钱，炙甘草半钱，同 咀，水二盅，
煎至一盏，去滓稍热服。大法云∶湿寒之胜，助风以平之。又曰∶下者举之，得阳气升腾而
去矣。又云∶客者除之，是因曲而为之直也。医不达升降浮沉之理，而一概施治，其愈者幸
也。
咳嗽并伴有呕吐，痰液和食物一起吐出的，是胃气受损。这就是古人所说的肺病牵连到胃的情况。呕血且带有痰液而出的，是肺部的络脉受损，即《金匮要略》中所说的热邪损伤血脉的情况。呕吐食物的，用二陈汤加减治疗；呕血的，用补肺汤主治。
加减二陈汤：半夏（一钱）、杏仁（一钱五分）、茯苓（一钱五分）、炙甘草（五分）、橘红（一钱）、竹茹（八分）、生姜（一片）、粳米（一百粒）。
以上药物用清水煎煮服用，加入枇杷叶、芦根效果更好。
补肺阿胶汤：阿胶（一钱五分）、马兜铃（五分）、炙甘草（五分）、牛蒡子（一钱）、杏仁（七粒）、糯米（一百粒）。
以上药物作为一剂服用，病情严重的加生地黄、藕汁。
戴复庵说：泻下清水而腹部不痛的，是湿邪所致。饮食进入胃部后随即泻出，大便中有未消化的食物残渣的，是气虚所致。腹痛伴随泻水，肠鸣音明显，疼痛一阵、腹泻一阵的，是火邪所致。有时腹泻有时不腹泻，腹泻量或多或少的是痰饮所致。腹痛剧烈而后腹泻，腹泻后疼痛减轻的是食积所致。飧泄（完谷不化的泄泻），是水谷不消化而原样排出，是湿邪兼夹风邪。溏泄（大便稀薄粘腻），是逐渐排出污秽粘稠的粪便，是湿邪兼夹热邪。濡泄（澄澈清冷的泄泻），是排出的粪便清澈寒冷，小便清白，是湿邪兼夹寒邪。濡泄（身体沉重软弱，泄下多水），是湿气过盛所致。滑泄（久泻不止，无法固摄），是湿气胜而正气脱失所致。所以说湿气多导致五种泄泻。
湿泻，又称濡泄，其脉象濡细，症状为泻下水样便，虚滑，肠鸣，身体沉重，腹部不痛。这是由于脾胃有湿，导致水谷不能消化，清浊不分。久雨潮湿溢出，或运气中湿土当令的时候，多有此病。《内经》所说的“湿胜则濡泄”，《左传》所说的“雨淫腹疾”就是这种情况。另外，水寒之气侵入肠道之间，也会让人患濡泄，经书说：“太阳之胜，寒邪客于下焦，传变为濡泄”就是这种情况。
《本事方》芎术丸：治疗风湿引起的滑泄。
川芎、神曲、白术、附子（炮制，各等分）。
以上研成细末，用面糊做成丸子，如梧桐子大小，每次服用三五丸，米汤送服。
许叔微说：《左传》记载楚王包围萧国，萧国将领即将溃败时，无社告诉叔展说：“有麦面吗？有山鞠穷吗？”意思是想让叔展逃到水中以躲避灾难，由此可知川芎能除湿，我常在方中加入白术、附子来制约药性，治疗脾湿导致的泄泻，万无一失，此药也能治疗飧泄。
刘草窗泻湿汤：
生白术（三钱）、白芍（二钱）、陈皮（炒，一钱五分）、防风（一钱）、升麻（五分）。
以上切碎成一帖，用水煎煮服用。
此方使用风药来提升气机，抑制胜过体内的湿气。河间说：如果有肠胃燥郁，水液不能宣发运行于体表，反而停滞成湿而导致泄泻，或者燥湿交替出现时而便秘时而泄泻的情况，这又是湿泻的变证。我见过有老人长期泄泻，饮用牛奶后泄泻反而停止的，属于此类情况。
胃苓汤：治疗脾湿过重，泄泻不止。
平胃散、五苓散（各等分）。
以上切碎，用水煎煮服用。
平胃散治疗饮酒导致的泄泻不止，饮酒后尤其严重，加入丁香、缩砂仁、麦芽、神曲各五钱研成末，米汤调服二钱，立即痊愈。
东垣说：我患病脾胃长期衰弱，视力和听力减半丧失，气短精神不足，这是由于阳气衰弱，不能舒展伸张，潜伏隐匿在阴中罢了。癸卯年六七月间，连绵阴雨阴寒，超过一个月不停止，当时许多人患病泄利。有一天我感到身体沉重、肢节疼痛，大便泄下，而小便闭塞。治疗各种泄利的原则是，如果小便不利，先通过利尿的方法处理。又说：治疗湿邪如果不通利小便，就不是正确的治疗方法。唉！圣人的法则，记载在医籍中，其中未尽之意，可以通过心意去探求罢了。如今外来的邪气寒湿之邪，从外部侵入内部，如果使用淡渗利尿的药物来清除它，这是降之又降，反而增加阴气，从而再次耗竭阳气，那么阳气会更加削弱，精神会更加短少。所以必须使用升阳的风药，羌活、独活、柴胡、升麻各一钱，防风、葛根半钱，炙甘草半钱，一同捣碎，用水两盅，煎至一盏，去渣滓稍热服用。大法说：湿寒之胜，借助风药来平息它。又说：下陷的病证用提升法，使阳气升腾而去。又说：外来的邪气用祛除法，这是因势利导将其纠正。医生如果不通达升降浮沉的道理，而一概施治，治愈的只是侥幸罢了。
Cough accompanied by vomiting, with both phlegm and food being expelled, indicates injury to the Stomach Qi. This is what the ancients referred to as Lung disease affecting the Stomach. Hematemesis mixed with phlegm indicates injury to the collaterals of the Lung, which corresponds to "heat injuring the blood vessels" mentioned in the *Jingui Yaolue* (Essential Prescriptions of the Golden Cabinet). For vomiting of food, treat with Erchen Tang (Two-Aged Decoction) modified; for hematemesis, treat primarily with Bufei Tang (Lung-Nourishing Decoction).
Modified Erchen Tang: Banxia (Pinelliae Rhizoma, 1 qian), Xingren (Prunus Armeniaca Seed, 1.5 qian), Fuling (Poria, 1.5 qian), Zhigancao (Prepared Licorice Root, 0.5 qian), Juhong (Citrus Reticulatae Pericarpium Rubrum, 1 qian), Zhuru (Bambusa Textilis Bamboo Shavings, 0.8 fen), Shengjiang (Zingiberis Rhizoma Recens, one slice), Jingmi (Oryza Sativa Germen, 100 grains).
Decoct the above herbs in clear water and take orally. Adding Pipa Ye (Loquat Leaf) and Lugeng (Reed Rhizome) is beneficial.
Bufei Ejiao Tang (Lung-Nourishing Donkey-Hide Gelatin Decoction): Ejiao (Donkey-Hide Gelatin, 1.5 qian), Doulou (Aristolochiae Fructus, 0.5 qian), Zhigancao (Prepared Licorice Root, 0.5 qian), Niubangzi (Arctii Fructus, 1 qian), Xingren (Prunus Armeniaca Seed, seven grains), Nuomi (Glutinous Rice, 100 grains).
Take all ingredients as a single dose. For severe cases, add Shengdihuang (Rehmanniae Radix Recens) and Ouji (Nelumbinis Nuciferae汁).
Dai Fu'an stated: Diarrhea with watery stool but no abdominal pain is caused by Dampness. Food entering the Stomach and immediately being excreted, with undigested food particles in the stool, is caused by Qi Deficiency. Abdominal pain accompanied by watery diarrhea, borborygmus, where pain occurs in bursts followed by diarrhea, is caused by Fire. Intermittent diarrhea with variable amounts is caused by Phlegm. Severe abdominal pain relieved after defecation is caused by Food Retention. Sunxie (diarrhea with undigested food) refers to the complete expulsion of un-digested food and drink, indicating Dampness combined with Wind. Tangxie (loose, sticky stool) refers to the gradual passage of foul, sticky residue, indicating Dampness combined with Heat. Ruxie (clear, cold discharge) refers to clear, cold stools with clear urine, indicating Dampness combined with Cold. Ruxie (heavy body, weakness, profuse watery diarrhea) indicates excessive Dampness. Xiaxie (chronic incontinence of stool) indicates Dampness prevailing with Qi collapse. Therefore, it is said that Dampness often leads to the five types of diarrhea.
Shixie (Dampness Diarrhea), also known as Ruxie, presents with a soggy and fine pulse, symptoms of watery diarrhea, slippery incontinence, borborygmus, heaviness of the body, and absence of abdominal pain. It arises from Dampness in the Spleen and Stomach, leading to failure to transform food and fluids, and confusion between the clear and turbid. This condition frequently occurs during prolonged rainy seasons or when the climatic influence of Wet Earth is dominant. This corresponds to the *Neijing* statement "Excess Dampness leads to Ruxie" and the *Zuo Zhuan* statement "Excessive rain causes abdominal diseases." Additionally, cold-water qi invading the intestines can also cause Ruxie, as stated in the classics: "When Taiyang prevails, cold pathogen lodges in the lower Jiao, transmitting into Ruxie."
*Benshi Fang* Xiongshu Wan treats slippery diarrhea due to Wind-Damp.
Xiong (Ligusticum Chuanxiong Rhizome), Shenqu (Massa Medicata Fermentata), Baizhu (Atractylodis Macrocephalae Rhizoma), Fuzi (Aconiti Lateralis Radix Praeparata, prepared, equal parts).
Grind into fine powder, form pills with wheat paste, size of Sophora japonica seeds. Take 3-5 pills per dose, washed down with rice decoction.
Xu Shumi stated: The *Zuo Zhuan* records that when King Chu besieged Xiao, the Xiao general was about to surrender. Wushe told Shuzhan, "Do you have wheat flour? Do you have Sanjuqiong (Angelica Dahurica)?", implying he wanted Shuzhan to escape into the water to avoid danger. This shows that Xiong can dispel Dampness. I often add Baizhu and Fuzi to this formula to moderate its properties. It effectively treats Spleen-Damp diarrhea without fail, and also treats Sunxie.
Liu Caochuang Xieshi Tang (Draining Dampness Decoction):
Baizhu (Atractylodis Macrocephalae Rhizoma, raw, 3 qian), Baishao (Paeoniae Radix Alba, 2 qian), Chenpi (Citrus Reticulatae Pericarpium, stir-fried, 1.5 qian), Fangfeng (Saposhnikoviae Radix, 1 qian), Shengma (Cimicifugae Rhizoma, 0.5 qian).
Cut into pieces for one dose, decoct in water and take orally.
This formula uses Wind-dispelling herbs to raise Qi and suppress excess Dampness. Hejian stated: If there is dryness and stagnation in the intestines and stomach, body fluids cannot be distributed externally, instead stagnating as Dampness causing diarrhea, or alternating between dryness and Dampness causing intermittent constipation and diarrhea, this is a variation of Dampness Diarrhea. I have observed elderly patients with chronic diarrhea whose symptoms ceased after drinking cow's milk; such cases belong to this category.
Weiling Tang treats persistent diarrhea due to excessive Spleen-Damp.
Pingwei San (Regulate the Stomach Powder), Wuling San (Five-Ingredient Powder with Poria). (Equal parts).
Cut into pieces, decoct in water and take orally.
Pingwei San treats alcohol-induced diarrhea that persists and worsens after drinking. Add Dingxiang (Caryophylli Flos), Suosha (Amomi Fructus Rotundus), Maiya (Hordei Fructus Germinatus), and Shenqu (Massa Medicata Fermentata), each 5 qian, grind into powder. Take 2 qian mixed with rice decoction, and the condition will resolve immediately.
Shengyang Chushi Tang (Raising Yang and Draining Dampness Decoction) (See formula for Sunxie).
Dongyuan stated: I suffered from long-term Spleen and Stomach deficiency, resulting in half-loss of vision and hearing, shortness of breath, and insufficient spirit. This was due to weak Yang Qi that could not extend freely, hiding within Yin. In the sixth and seventh months of the Gui-Mao year, continuous rainy and cold weather lasted over a month. Many people fell ill with diarrhea and dysentery. One day, I felt heavy-bodied and painful in the joints, with loose stools and urinary retention. The treatment principle for various diarrheas and dysenteries is: if urination is difficult, first promote diuresis. It is also said: To treat Dampness, one must not fail to promote urination. Alas! The methods of the sages are recorded in medical texts, but their deeper meanings must be sought through insight. Now, external pathogenic cold-dampness enters from the exterior to the interior. If one uses bland and permeating diuretic agents to eliminate it, this is lowering again and lowering, further increasing Yin and doubly depleting Yang. Consequently, Yang Qi will be further weakened, and spirit more depleted. Therefore, one must use Yang-raising Wind herbs: Qianghuo (Notopterygii Rhizoma et Radix), Duhuo (Angelicae Pubescentis Radix), Chaihu (Bupleuri Radix), Shengma (Cimicifugae Rhizoma), each 1 qian; Fangfeng (Saposhnikoviae Radix), Gegen (Puerariae Lobatae Radix), 0.5 qian; Zhigancao (Prepared Licorice Root), 0.5 qian. Crush together, decoct in two cups of water until one cup remains, strain, and take warm. The great principle states: When Cold-Damp prevails, use Wind herbs to pacify it. It also says: For sinking conditions, lift them; allow Yang Qi to rise and disperse. It also says: Expel the intruding pathogen; this is correcting deviation by following the curve. Physicians who do not understand the principles of ascending, descending, floating, and sinking, and treat uniformly, achieve cures only by luck.