（自利者不因攻下而自利俗名漏底是也六经皆有自利表里寒热治各不同）太阳表
不解。心下有水气。干呕。发热而咳。或渴。或利。或小便不利。少腹满或喘。（小青龙汤）太阳
与阳明合疾。必自下利。（葛根汤）太阳病外症未除。而数下之。遂挟热而利。心下痞硬。表
里不解。（桂枝人参汤）太阳与少阳合病。自利。（黄芩汤若呕者黄芩加半夏生姜汤）太阳少阳
并病。而反下之。成结胸。下利不止。水浆不下。其人心烦。（生姜泻心汤或小陷胸汤）太阳
病。反下之。利遂不止。脉促者。表未解也。喘而汗出。（葛根黄芩黄连汤）太阳病二三日。
不能卧。心下必结。脉微弱者。本有寒也反下之。若利止。必结胸未止者。四日复下之。
此
干噫食臭。胁下有水气。腹中雷鸣下利。（生姜泻心汤）太阳下利。头痛。心下痞。胁下痛
。干呕。短气。汗出。不恶寒此表解里未和也。（十枣汤）十三日过经谵语者。热也。当下之
。若小便利者。大盒饭硬。而反下利。医以丸药下之。非其治也。自利者。脉当微。今反和
者。内实也。（调胃承气汤）下后利不止。身痛者。急当救里。（四逆汤）身痛。便调。急当救
表。（桂枝汤）下利心痞。复下之。利不止。治以理中。利益甚。理中者。理中焦。此利在下
焦。（赤石脂禹余粮汤）过经十余日。欲吐。胸中痛。大便反溏。微满微烦。（调胃承气伤以
上皆太阳）阳明病。潮热。大便溏。胸胁满。（小柴胡汤）无表里症。发热七八日。脉虽浮数
可下。下后脉数不解。而利不止。必便脓。（黄芩汤柏皮汤）阳明少阳合病。必下利。其脉
不滑而数。有宿食也。（大承气汤）脏结如结胸状如故。时时下利。寸脉浮关脉小细沉紧。舌
上胎滑者难治。（以上皆阳明）十三日不解。胸胁满而呕。日晡潮热。微利。此本柴胡症。
下之不利。今反利者。误以丸药下之也。潮热者。实也。（先以柴胡解外复以柴胡加芒硝
此条当属少阳）自利。不渴。属太阴。脏有寒也。（四逆辈）太阴病。脉弱自利。设当行芍药大
黄者。宜减之。以胃弱易动故也。脉浮而缓。手足温者。当发身黄。若小便利者。不发黄。
至七八日。虽暴下利。必自止。以脾家秽腐当去故也。（平胃散加穿山甲以上皆太阴）少阴病
。欲吐不吐。但欲寐。五六日自利而渴者。少阴虚。故引水自救。若小便色白者。下焦虚寒
。（四逆汤）少阴病。下利咽痛。胸满心烦。（猪肤汤）少阴病。四逆。泄利下重。（四逆散）少
阴病。下利六七日。咳而呕渴。心烦不眠。（猪苓汤）少阴病。下利清水。纯青。心下痛。口
干燥（大承气汤急下之）少阴腹痛。小便不利。下利脓血。（桃花汤）少阴病。腹痛小便不利。肢
重而痛。自下利者。此为水气或咳或呕。或小便利者。（真武汤）少阴病。下利清谷。里寒外热
。厥逆脉微。反不恶寒。面赤。或腹痛。或干呕。或咽痛。或利止脉 不出。（通脉四逆汤）少阴
病。下利脉微。与白通汤。利不止。厥逆无脉。干呕烦者。白通加猪胆汁。服汤后。脉暴出
者死。微续者生。少阴病。脉紧至七八日自利。脉微手足反温。脉紧反去者。为欲解也必自
愈。少阴病。脉沉微欲卧。汗出而烦。欲吐自利。烦躁不寐者死。少阴病。利止。眩冒者死
。少阴病。恶寒。身蜷而利。手足逆冷者死。（以上皆少阴）下利欲饮水者。热也。（白头翁
汤）厥阴病。脉浮而迟。表热里寒。下利清谷。（四逆汤）大汗出。热不去。内拘急。四肢疼
。下利。厥逆恶寒。（四逆汤）下利清谷不可攻表。汗出必胀满。（四逆汤）下利。脉沉迟。面
少赤。身微热。下利清谷者。必郁冒汗出而解。下虚必微厥。（四逆汤）发热下利。厥逆。躁
不得卧者死。发热下利。厥不止者死。汗不止者亦死。下利脉反实者死。（以上皆厥阴）
按下利有寒热之分。最宜详辨。凡寒泻者。口不燥渴。脐下多寒。小便清利。脉来沉迟
细软无力。完谷不化。粪色淡白。或淡黄色。或如骛溏。或身虽热。手足逆冷。皆为寒也。凡热
泻者。口必燥渴。脐下多热。小便黄赤。或涩而不利。脉来数大。或浮。或滑。或弦。粪色
焦黄。或热而臭。或粪出声响。得凉药与冷冻饮料则减。得热药与热饮则增。皆为热也。热泻亦
有邪热不杀谷者。与寒泻之完谷不化相似。当以他症。及脉色辨之。身不热。手足温者。属
太阴经。身体四逆。属少阴厥阴二经。身热者。皆属阳明经。然阴利有反发热者。不可因其
热遂以为阳也。未可下而早下之内虚热入名为挟热下痢。
凡胃虚脉弱。热渴自利者。必用四
君子汤。如发热者。四君子加柴胡黄连。若腹满。小便不利。五苓散。合理中汤。呕则加藿
香半夏陈皮生姜。湿则加苍术。胀则加浓朴。腹痛加芍药木香。如脉浮者。表邪未解。小青
龙去麻黄。加芫花。此散表兼治水也。凡下利不可发汗。当先治利。利止则正气复。而邪自解
。盖因利内虚。若误汗之。则内外皆虚。变证危殆。
（自利是指不因攻下治疗而出现的腹泻，俗称“漏底”。六经病证中都有自利的情况，但表里、寒热不同，治疗方法也各不相同。）
太阳病：
表邪未解。心下有停饮。干呕。发热且咳嗽。或口渴。或腹泻。或小便不利。少腹胀满或气喘。（用小青龙汤）
太阳与阳明合病。必然出现自发性腹泻。（用葛根汤）
太阳病外部症状尚未消除，却多次使用攻下法。于是导致挟热腹泻。心下痞塞硬满。表里同病。（用桂枝人参汤）
太阳与少阳合病。出现自发性腹泻。（用黄芩汤；如果伴有呕吐，用黄芩加半夏生姜汤）
太阳与少阳并病，反而误用攻下法。形成结胸证。腹泻不止。水浆难进。病人心中烦乱。（用生姜泻心汤或小陷胸汤）
太阳病，误用攻下法后，腹泻持续不止。脉象急促的，说明表邪未解。气喘且出汗。（用葛根黄芩黄连汤）
太阳病二三天。不能平卧。心下必定痞结。脉象微弱的，原本体内有寒。反而误用攻下法。如果腹泻停止，必然形成结胸；如果腹泻未止，到了第四天再次攻下。这会导致呃逆伴食物腐臭味。胁下有停饮。腹中雷鸣般作响并腹泻。（用生姜泻心汤）
太阳病腹泻。头痛。心下痞。胁下痛。干呕。气短。出汗。不恶寒。这是表证已解，里证未和。（用十枣汤）
病程十三天，超过传经周期出现谵语的，是热证。应当攻下。如果小便通利，大便应当硬结。反而出现腹泻。医生用丸药攻下，这不是正确的治法。自利的病人，脉象应当微弱。现在脉象反而调和有力，说明内有实邪。（用调胃承气汤）
攻下后腹泻不止。身体疼痛的，应当紧急温救里虚。（用四逆汤）
身体疼痛。大便正常。应当紧急解表。（用桂枝汤）
腹泻伴心下痞，再次攻下，腹泻不止。用理中汤治疗，腹泻反而加重。理中汤是调理中焦的，此处的腹泻位于下焦。（用赤石脂禹余粮汤）
病程过十余日。想吐。胸中痛。大便反而稀溏。轻微胀满轻微心烦。（用调胃承气汤——以上皆属太阳病范畴）
阳明病：
潮热。大便稀溏。胸胁满闷。（用小柴胡汤）
没有明显的表证或里实证，发热七八天。脉象虽然浮数，可以攻下。攻下后脉数不解，且腹泻不止。必然排出脓血。（用黄芩汤或黄柏汤）
阳明与少阳合病。必然腹泻。脉象不滑而数，说明有宿食积滞。（用大承气汤）
脏结证，表现像结胸一样。时常腹泻。寸脉浮，关脉小细沉紧。舌苔滑腻的，难以治疗。（以上皆属阳明病范畴）
少阳病：
十三天病邪未解。胸胁满闷且呕吐。傍晚潮热。轻微腹泻。这原本是柴胡汤证。误用攻下法本不应腹泻，现在反而腹泻，是因为误用了丸药攻下。潮热，说明是实证。（先用小柴胡汤解外，再用柴胡加芒硝汤——此条当属少阳病）
太阴病：
自发性腹泻，口不渴，属于太阴病。脏腑有寒。（用四逆汤类方）
太阴病。脉弱自利。假设原本应该使用芍药大黄的情况，应当减量使用。因为胃气虚弱容易受损的缘故。脉象浮而缓，手足温暖的，应当发生身黄。如果小便通利的，不发生身黄。到了七八天，即使突然剧烈腹泻，必然会自行停止。因为脾家内的秽浊腐败之物应当排出的缘故。（用平胃散加穿山甲——以上皆属太阴病）
少阴病：
想吐又吐不出来。只想睡觉。五六天后自发性腹泻且口渴的，是少阴阴虚。所以引水自救。如果小便颜色发白的，说明下焦虚寒。（用四逆汤）
少阴病。腹泻。咽痛。胸满心烦。（用猪肤汤）
少阴病。四肢厥冷。泄泻且肛门重坠感。（用四逆散）
少阴病。腹泻六七天。咳嗽且呕吐口渴。心烦失眠。（用猪苓汤）
少阴病。腹泻排出清水。纯青色。心下疼痛。口干燥。（用大承气汤急下之）
少阴病腹痛。小便不利。腹泻脓血。（用桃花汤）
少阴病。腹痛小便不利。肢体沉重疼痛。自发性腹泻的，这是水气为患。或咳或呕。或者小便通利的。（用真武汤）
少阴病。腹泻完谷不化。内寒外热。四肢厥冷脉微。反而不恶寒。面色发红。或腹痛。或干呕。或咽痛。或腹泻停止但脉搏摸不到。（用通脉四逆汤）
少阴病。腹泻脉微。给予白通汤。腹泻不止。四肢厥冷无脉。干呕心烦的，用白通加猪胆汁汤。服药后，脉搏突然暴出的会死。脉搏逐渐微弱接续的会生还。少阴病。脉紧，到了七八天自发性腹泻。脉微手足反而温暖。脉紧反而消失的，为病情欲解，必然自愈。少阴病。脉沉微想躺卧。出汗且烦躁。想吐自利。烦躁不寐的，预后不良（死证）。少阴病。腹泻停止。头晕目眩的，预后不良（死证）。少阴病。恶寒。身体蜷缩而腹泻。手足逆冷的，预后不良（死证）。（以上皆属少阴病）
厥阴病：
腹泻想喝水的，是热证。（用白头翁汤）
厥阴病。脉浮而迟。表热里寒。腹泻完谷不化。（用四逆汤）
大汗出。热不退。内部拘急。四肢疼痛。腹泻。四肢厥冷恶寒。（用四逆汤）
腹泻完谷不化不可攻表。发汗必然导致胀满。（用四逆汤）
腹泻。脉沉迟。面部少许红润。身体微热。腹泻完谷不化的，必然会出现郁冒出汗而病解。下虚必然轻微厥冷。（用四逆汤）
发热腹泻。四肢厥冷。躁动不得卧的，预后不良（死证）。发热腹泻。四肢厥冷不止的，预后不良（死证）。出汗不止的，也预后不良（死证）。腹泻脉象反实的，预后不良（死证）。（以上皆属厥阴病）
按：腹泻有寒热之分，最应当详细辨别。凡是寒性腹泻，口不燥渴。脐下多寒冷。小便清长通畅。脉象来势沉迟细软无力。大便中有未消化的食物。粪便颜色淡白。或淡黄色。或像鸭粪稀薄。或身体虽然发热，但手足逆冷。这些都是寒证。凡是热性腹泻，口必燥渴。脐下多热感。小便黄赤。或涩滞不通。脉象来势数大。或浮。或滑。或弦。粪便颜色焦黄。或热且臭。或排便时发出声响。服用凉药或冷冻饮料则减轻。服用热药或热饮则加重。这些都是热证。热性腹泻也有因邪热不能消化谷物导致的，与寒性腹泻完谷不化相似。应当通过其他症状及脉色来辨别。身体不热。手足温暖的，属于太阴经。身体四肢逆冷的，属于少阴、厥阴二经。身体发热的，都属于阳明经。然而阴寒腹泻也有反而发热的，不可因为其发热就认为是阳证。如果在未可攻下的情况下过早攻下，导致内虚热入，称为挟热下痢。
凡是胃气虚弱脉弱。发热口渴自发性腹泻的，必须用四君子汤。如果有发热的，四君子汤加柴胡、黄连。如果腹部胀满。小便不利，用五苓散。配合理中汤。呕吐则加藿香、半夏、陈皮、生姜。湿重则加苍术。胀满则加厚朴。腹痛加芍药、木香。如果脉浮的，表邪未解，用小青龙汤去掉麻黄，加芫花。这是发散表邪兼治水饮的方法。凡是腹泻不可发汗。应当先治疗腹泻。腹泻停止则正气恢复，邪气自然解除。因为腹泻导致内部虚弱。如果误用发汗法，则内外皆虚。变证危急。
(Self-purging refers to diarrhea occurring without prior purgative treatment, commonly known as "leaky bottom." Self-purging can occur in all six meridians; however, the patterns of exterior/interior and cold/heat differ, necessitating distinct therapeutic approaches.)
Taiyang Disease:
Exterior pathogen unresolved. Fluid retention in the epigastrium. Dry retching. Fever accompanied by cough. Thirst may or may not be present. Diarrhea may or may not be present. Dysuria. Hypogastric fullness or wheezing. (Xiao Qing Long Tang / Minor Blue Dragon Decoction)
Combined disease of Taiyang and Yangming. Spontaneous diarrhea is inevitable. (Ge Gen Tang / Pueraria Decoction)
Taiyang exterior symptoms remain uneliminated, yet multiple purgations have been applied. This results in diarrhea with heat. Epigastric stiffness and fullness. Exterior and interior both unresolved. (Gui Zhi Ren Shen Tang / Cinnamon Twig and Ginseng Decoction)
Combined disease of Taiyang and Shaoyang. Spontaneous diarrhea. (Huang Qin Tang / Scutellaria Decoction; if vomiting occurs, use Huang Qin Jia Ban Xia Sheng Jiang Tang / Scutellaria Decoction plus Pinellia and Fresh Ginger)
Combined disease of Taiyang and Shaoyang, mistakenly treated with purgation. This forms a Chest Binding (Jie Xiong). Diarrhea persists. Inability to take fluids. The patient is vexed. (Sheng Jiang Xie Xin Tang / Fresh Ginger Drain the Epigastrium Decoction or Xiao Xian Xiong Tang / Minor Sinking into the Chest Decoction)
Taiyang disease, mistakenly purged. Diarrhea persists. A rapid pulse indicates the exterior remains unresolved. Wheezing and sweating. (Ge Gen Huang Qin Huang Lian Tang / Pueraria, Scutellaria, and Coptis Decoction)
On the second or third day of Taiyang disease. Inability to lie down. The epigastrium must be obstructed. A faint pulse indicates pre-existing cold. Mistakenly purged. If diarrhea stops, Chest Binding will surely form; if diarrhea continues, purging again on the fourth day leads to hiccups with the smell of food, fluid retention in the hypochondrium, borborygmus, and diarrhea. (Sheng Jiang Xie Xin Tang / Fresh Ginger Drain the Epigastrium Decoction)
Taiyang diarrhea. Headache. Epigastric obstruction. Hypochondriac pain. Dry retching. Shortness of breath. Sweating. No aversion to cold. This indicates the exterior is resolved but the interior is disharmonious. (Shi Zao Tang / Ten Jujube Decoction)
After thirteen days, exceeding the transmission cycle, delirium indicates heat. Purging is indicated. If urination is free, stool should be hard. Instead, diarrhea occurs. The physician used pill-form purgatives, which was incorrect. In self-purging, the pulse should be faint. Now it appears harmonious, indicating internal excess. (Tiao Wei Cheng Qi Tang / Regulate the Stomach and Direct Downward Decoction)
After purgation, diarrhea persists. Body pain requires urgent rescue of the interior. (Si Ni Tang / Four Reversals Decoction)
Body pain. Normal bowel movement. Urgent resolution of the exterior is required. (Gui Zhi Tang / Cinnamon Twig Decoction)
Diarrhea with epigastric obstruction. Further purgation causes persistent diarrhea. Treatment with Li Zhong Tang / Regulate the Middle Decoction exacerbates the diarrhea. Li Zhong Tang regulates the Middle Jiao; this diarrhea originates from the Lower Jiao. (Chi Shi Zhi Yu Yi Liang Tang / Red Clay and Metastone Decoction)
After more than ten days. Desire to vomit. Chest pain. Stool is loose. Mild fullness and mild vexation. (Tiao Wei Cheng Qi Tang / Regulate the Stomach and Direct Downward Decoction — All above belong to Taiyang)
Yangming Disease:
Tidal fever. Loose stool. Fullness in the chest and hypochondrium. (Xiao Chai Hu Tang / Minor Bupleurum Decoction)
No obvious exterior or interior excess symptoms. Fever for seven to eight days. Although the pulse is floating and rapid, purging may be considered. After purgation, if the rapid pulse persists and diarrhea continues, pus and blood in the stool are inevitable. (Huang Qin Tang / Scutellaria Decoction or Huang Bo Tang / Phellodendron Decoction)
Combined disease of Yangming and Shaoyang. Diarrhea is inevitable. The pulse is not slippery but rapid, indicating retained food stagnation. (Da Cheng Qi Tang / Major Direct Downward Decoction)
Zang Binding presents like Chest Binding. Frequent diarrhea. Floating pulse at the Cun position; small, thin, deep, and tight pulse at the Guan position. Slippery coating on the tongue indicates a difficult-to-treat condition. (All above belong to Yangming)
Shaoyang Disease:
Thirteen days without resolution. Chest and hypochondriac fullness with vomiting. Tidal fever in the late afternoon. Mild diarrhea. This was originally a Chai Hu pattern. Purging should not cause diarrhea; the current diarrhea resulted from mistaken use of pill-form purgatives. Tidal fever indicates excess. (First use Chai Hu Tang / Bupleurum Decoction to resolve the exterior, then use Chai Hu Jia Mang Xiao Tang / Bupleurum Decoction plus Gypsum — This clause belongs to Shaoyang)
Taiyin Disease:
Spontaneous diarrhea without thirst belongs to Taiyin. Cold in the Zang organs. (Si Ni Tang / Four Reversals Decoction or similar formulas)
Taiyin disease. Weak pulse with spontaneous diarrhea. If Peony and Rhubarb were indicated, their dosage should be reduced because the stomach is weak and easily disturbed. A floating and slow pulse with warm hands and feet suggests jaundice will develop. If urination is free, jaundice will not develop. By the seventh or eighth day, even sudden severe diarrhea will stop spontaneously, as the turbid filth of the Spleen is being expelled. (Ping Wei San / Calm the Stomach Powder plus Schizonepetae Herba / Jingjie - *Note: Text says Shan Jian Jia, likely referring to Pangolin Scales or similar, translated as Pangolin Scales based on context of penetrating blockage*) (All above belong to Taiyin)
Shaoyin Disease:
Desire to vomit but unable to. Only desire to sleep. After five to six days, spontaneous diarrhea with thirst indicates Shaoyin Yin deficiency, leading to water intake for self-rescue. If urine is white, it indicates Lower Jiao deficiency-cold. (Si Ni Tang / Four Reversals Decoction)
Shaoyin disease. Diarrhea. Sore throat. Chest fullness and vexation. (Zhu Fu Tang / Pig Skin Decoction)
Shaoyin disease. Cold extremities. Diarrhea with a sensation of heaviness in the anus. (Si Ni San / Four Reversals Powder)
Shaoyin disease. Diarrhea for six to seven days. Cough, vomiting, thirst, vexation, and insomnia. (Zhu Ling Tang / Polyporus Decoction)
Shaoyin disease. Diarrhea of clear water, purely green. Epigastric pain. Dry mouth. (Use Da Cheng Qi Tang / Major Direct Downward Decoction urgently to purge)
Shaoyin abdominal pain. Dysuria. Diarrhea with pus and blood. (Tao Hua Tang / Peach Blossom Decoction)
Shaoyin disease. Abdominal pain, dysuria, heavy and painful limbs, spontaneous diarrhea. This is Water Qi pathology. May include cough or vomiting. Or if urination is free. (Zhen Wu Tang / True Warrior Decoction)
Shaoyin disease. Diarrhea with undigested food. Interior cold with exterior heat. Cold extremities, faint pulse. Paradoxical lack of aversion to cold. Flushed face. Abdominal pain, dry retching, sore throat, or cessation of diarrhea with absent pulse. (Tong Mai Si Ni Tang / Pulse-Returning Four Reversals Decoction)
Shaoyin disease. Diarrhea with faint pulse. Administer Bai Tong Tang / White Pass Decoction. If diarrhea persists, cold extremities, absent pulse, dry retching, and vexation occur. Use Bai Tong Jia Zhu Dan Jiang Tang / White Pass Decoction plus Pig Bile. If the pulse suddenly emerges after ingestion, death ensues. If the pulse gradually returns, life is preserved. Shaoyin disease. Tight pulse. By the seventh or eighth day, spontaneous diarrhea. Faint pulse, warm extremities. Disappearance of the tight pulse indicates impending resolution and spontaneous recovery. Shaoyin disease. Deep and faint pulse, desire to lie down. Sweating, vexation, desire to vomit, spontaneous diarrhea, restlessness, and insomnia indicate death. Shaoyin disease. Cessation of diarrhea with dizziness indicates death. Shaoyin disease. Aversion to cold, curled posture with diarrhea, and cold extremities indicate death. (All above belong to Shaoyin)
Jueyin Disease:
Diarrhea with desire to drink water indicates heat. (Bai Tou Weng Tang / Pulsatilla Decoction)
Jueyin disease. Floating and slow pulse. Exterior heat with interior cold. Diarrhea with undigested food. (Si Ni Tang / Four Reversals Decoction)
Profuse sweating. Heat persists. Internal tension. Limb pain. Diarrhea. Cold extremities and aversion to cold. (Si Ni Tang / Four Reversals Decoction)
Diarrhea with undigested food contraindicates exterior resolution. Sweating will inevitably cause abdominal fullness. (Si Ni Tang / Four Reversals Decoction)
Diarrhea. Deep and slow pulse. Slight facial redness. Mild body heat. Diarrhea with undigested food. This will inevitably lead to Yu Mao (depression and vertigo) with sweating, resulting in resolution. Lower deficiency leads to slight cold extremities. (Si Ni Tang / Four Reversals Decoction)
Fever, diarrhea, cold extremities, and restlessness preventing lying down indicate death. Fever, diarrhea, and persistent cold extremities indicate death. Persistent sweating also indicates death. Diarrhea with a surprisingly solid pulse indicates death. (All above belong to Jueyin)
Commentary:
Diarrhea is divided into cold and heat types, requiring careful differentiation. Cold diarrhea is characterized by no oral dryness/thirst, coldness below the umbilicus, clear and free urination, a deep, slow, fine, soft, and powerless pulse, undigested food in stool, pale or pale-yellow stool, or duck-like loose stool. Even if the body is hot, cold extremities indicate cold. Hot diarrhea is characterized by oral dryness/thirst, heat below the umbilicus, yellow-red or obstructed urination, a rapid, large, floating, slippery, or wiry pulse, dark yellow, hot, or foul-smelling stool, or noisy defecation. Symptoms improve with cool medicines/cold drinks and worsen with hot medicines/hot drinks, indicating heat. Hot diarrhea may also involve failure to digest grain due to pathogenic heat, resembling cold diarrhea's undigested food; differentiation relies on other symptoms and pulse/tongue signs. Body heatlessness and warm extremities indicate Taiyin Meridian involvement. Cold extremities indicate Shaoyin or Jueyin Meridian involvement. Body heat indicates Yangming Meridian involvement. However, Yin-type diarrhea may paradoxically present with fever; one must not assume it is Yang-pattern solely due to heat. Premature purgation when inappropriate leads to interior deficiency and heat invasion, termed "Diarrhea with Heat Clinging" (Jia Re Xia Li).
For patients with weak Stomach Qi, weak pulse, fever, thirst, and spontaneous diarrhea, Si Jun Zi Tang / Four Gentlemen Decoction is mandatory. If fever is present, add Chai Hu / Bupleuri Radix and Huang Lian / Coptidis Rhizoma to Si Jun Zi Tang. If abdominal fullness and dysuria occur, use Wu Ling San / Five-Ingredient Powder with Poria combined with Li Zhong Tang / Regulate the Middle Decoction. For vomiting, add Huo Xiang / Pogostemonis Herba, Ban Xia / Pinelliae Rhizoma, Chen Pi / Citri Reticulatae Pericarpium, and Sheng Jiang / Zingiberis Rhizoma Recens. For dampness, add Cang Zhu / Atractylodis Rhizoma. For fullness, add Hou Po / Magnoliae Officinalis Cortex. For abdominal pain, add Shao Yao / Paeoniae Radix and Mu Xiang / Aucklandiae Radix. If the pulse is floating, indicating unresolved exterior pathogen, use Xiao Qing Long Tang / Minor Blue Dragon Decoction removing Ma Huang / Ephedrae Herba and adding Yuan Hua / Genkwa Flos. This disperses the exterior while managing water retention. Generally, diarrhea contraindicates diaphoresis. One must treat the diarrhea first. Once diarrhea ceases, righteous Qi recovers, and pathogens resolve naturally. Since diarrhea causes interior deficiency, mistaken sweating leads to dual interior-exterior deficiency and critical transformation patterns.