伤寒下利多种数。要识阴阳勿差互。三阳利时身必热。三阴但温无热具。（三阳下利。身热。三阴下利。但温而不热。
此其大概也。）合病自利葛根汤。或用黄芩无致误。（仲景云。太阳阳明合病。必自利。葛根汤主之。桂枝证医反下之。
利不止者。葛根黄芩黄连汤。）自利不渴属太阴。少阴必渴肾虚故。（仲景云。自利不渴属太阴。其脏有寒故也。当温之。
宜四逆辈。又云。自利而渴者。属少阴虚。故引水自救也。）外审证。内凭脉。内外并观斯两得。脉大由来却是虚。脉滑
而数有宿食。（脉经云。大则为虚。仲景云。滑而数者。有宿食也。）协热而利脐下热。（仲景云。太阳证。外证未除。而
数下之。遂协热而利。利下不止。心下痞硬。表里未解者。桂枝人参汤。朱肱云。协热利。脐下必热也。）谵语而利燥屎
结。（仲景云。下利而谵语者。为有燥屎也。属承气汤。）少阴心痛口燥烦。却与利之斯要诀。（仲景云。少阴病。下利。
清水。色青者心下必痛。口干燥者可下之。宜大柴胡汤。六经中惟少阴病难治。有补泻之法。不可不审也。）
虫食下部名曰狐。虫食上部名曰惑。狐则咽干惑声嗄。伤寒变坏成斯疾。面目乍赤乍白黑。但欲睡眠昏默默。更有
虫食脏间。舌上尽白齿无色。（仲景云。狐惑之病。其气如伤寒。嘿嘿但欲卧。目瞑不得眠。起则不安。食于喉咽者为
惑。食于阴者为狐。狐惑之病。并恶饮食。不欲闻食臭。其面乍赤乍黑乍白。食于上部。其声嗄。食于下部其咽干。食
上部者泻心汤主之。食下部者苦参汤淹洗之。食肛外者。烧用雄黄熏之。）上唇有疮蚀其脏。下唇疮甚连肛食。（须频看
上下唇有无疮。有疮则杀人紧急者也。）多因下利而得之。此证杀人为最急。
伤寒病中的下利症状有多种类型，数量繁多。要准确识别其阴阳属性，切勿混淆错误。三阳经发生下利时，身体必然发热；而三阴经发生下利时，身体只是发凉而没有发热。（三阳经下利伴有身热，三阴经下利仅表现为体温偏低而不发热，这是大概的情况。）如果是合病导致的自发性下利，可用葛根汤治疗；或者使用黄芩相关的方剂以免误治。（张仲景说：太阳与阳明合病，必定出现自发性下利，用葛根汤主治。如果是桂枝汤证却误用攻下法，导致下利不止的，应用葛根黄芩黄连汤。）自发性下利且不口渴的，属于太阴病；少阴病下利则必然口渴，这是因为肾气虚的缘故。（张仲景说：自发性下利且不口渴的，属于太阴病，因为脏腑内有寒邪，所以应当温补，适宜使用四逆汤类方剂。又说：自发性下利且口渴的，属于少阴病阴虚，所以患者会引水来自救。）对外要审察外在症状，对内要凭借脉象诊断，内外结合观察才能两全其美。脉象宏大由来是因为正气虚弱；脉象滑利且数，说明体内有宿食积滞。（《脉经》说：脉大表示虚证。张仲景说：脉滑而数的，是有宿食的表现。）协热下利表现为脐下发热。（张仲景说：太阳病证候，表证未除，却多次误用攻下法，于是导致协热下利，下利不止，心下部痞塞硬满，表里之邪均未解除的，用桂枝人参汤治疗。朱肱说：协热下利，脐下必然发热。）谵语并伴有下利，是因为燥屎内结。（张仲景说：下利且出现谵语的，是因为体内有燥屎，属于承气汤证的范畴。）少阴病出现心痛、口干燥且烦躁，此时若给予攻下利导的治疗则是关键诀窍。（张仲景说：少阴病，下利清水，颜色青黑，心下部必然疼痛，口干燥的，可以攻下，适宜用大柴胡汤。六经病中只有少阴病最难治疗，有补法和泻法之分，不可不仔细审察。）
虫类侵蚀下部称为“狐”，虫类侵蚀上部称为“惑”。患“狐”症则咽喉干燥，患“惑”症则声音嘶哑。这是伤寒病情恶化后形成的疾病。患者面目时而发红、时而发白、时而发黑，只想睡觉，神情昏沉沉默。更有甚者，虫类侵蚀内脏之间，导致舌苔全部变白，牙齿色泽暗淡无光。（张仲景说：狐惑病的气象类似伤寒，神情默默只想卧睡，眼睛闭合却无法安眠，起身则心神不安。虫蚀喉咽部位称为“惑”，虫蚀阴部称为“狐”。狐惑病患者都厌恶饮食，不想闻到食物的气味，面色时而红、时而黑、时而白。虫蚀上部的，声音嘶哑；虫蚀下部的，咽喉干燥。虫蚀上部的，用泻心汤主治；虫蚀下部的，用苦参汤浸泡清洗；虫蚀肛门外部的，用烧过的雄黄熏蒸。）上唇有疮疡会侵蚀内脏，下唇疮疡严重则会连及肛门受累。（必须频繁查看上下嘴唇是否有疮疡，如果有疮疡，则是极其紧急致命的病症。）此证多因下利之后感染所致，此病致人死亡的速度最为急迫。
There are many types and numbers of diarrhea (diarrhea) in Taiyang disease (diseases caused by exogenous pathogenic factors). One must distinguish between Yin and Yang to avoid errors. When diarrhea occurs in the Three Yang meridians, the body will necessarily be hot; whereas when it occurs in the Three Yin meridians, the body is merely warm without fever. (Diarrhea in the Three Yang meridians presents with body heat, while diarrhea in the Three Yin meridians presents only with coolness without heat; this is the general rule.) If spontaneous diarrhea occurs due to combined diseases (combined syndromes), Ge Gen Tang (Kudzu Root Decoction) may be used, or Huang Qin (Scutellariae Radix)-based formulas should be employed to prevent mistakes. (Zhang Zhongjing stated: In combined diseases of Taiyang and Yangming, spontaneous diarrhea inevitably occurs, treated with Ge Gen Tang. If a Guizhi Tang syndrome is mistakenly treated with purgation, resulting in unceasing diarrhea, Gegen Huangqin Huanglian Tang [Kudzu Root, Scutellaria, and Coptis Decoction] should be used.) Spontaneous diarrhea without thirst belongs to Taiyin; spontaneous diarrhea with thirst belongs to Shaoyin due to Kidney deficiency. (Zhang Zhongjing stated: Spontaneous diarrhea without thirst belongs to Taiyin, indicating cold in the zang organs, requiring warming treatment with Si Ni Tang-type formulas. He also stated: Spontaneous diarrhea with thirst belongs to Shaoyin deficiency, causing the patient to seek water for self-rescue.) Externally examine the symptoms, internally rely on the pulse; observing both internal and external aspects ensures accuracy. A large pulse indicates underlying deficiency; a slippery and rapid pulse indicates retained food stagnation. (The Mai Jing states: A large pulse signifies deficiency. Zhang Zhongjing stated: A slippery and rapid pulse indicates retained food.) Heat-collateral diarrhea presents with heat below the umbilicus. (Zhang Zhongjing stated: In Taiyang disease, if the exterior syndrome remains unresolved but multiple purgations are applied, heat-collateral diarrhea ensues with unceasing stools, epigastric fullness and hardness, and unresolved interior and exterior pathogens, treated with Guizhi Renshen Tang [Cinnamon Twig and Ginseng Decoction]. Zhu Gong stated: Heat-collateral diarrhea necessarily involves heat below the umbilicus.) Delirium accompanied by diarrhea indicates dry stool accumulation. (Zhang Zhongjing stated: Diarrhea accompanied by delirium indicates the presence of dry fecal masses, belonging to the Chengqi Tang category.) Shaoyin disease presenting with heart pain, dry mouth, and irritability requires careful differentiation before administering purgative methods. (Zhang Zhongjing stated: In Shaoyin disease, diarrhea of clear water with blackish color implies heart pain and dry mouth, which can be treated with purgation using Da Chaihu Tang [Major Bupleurum Decoction]. Among the Six Meridians, Shaoyin disease is the most difficult to treat, involving both tonification and purgation methods that must be carefully examined.)
Parasites eating the lower part are named "Hu" (Fox); parasites eating the upper part are named "Huo" (Charm). Hu manifests as dry throat, while Huo manifests as hoarseness. This disease arises from the deterioration of Taiyang disease. The face alternates between red, white, and black colors. The patient desires sleep, appearing lethargic and silent. Furthermore, if parasites eat within the viscera, the tongue becomes entirely white and the teeth lose their luster. (Zhang Zhongjing stated: The Hu-Huo disease resembles Taiyang disease in its qi presentation; the patient is silent and desires to lie down, cannot sleep with eyes closed, and feels restless upon rising. Parasites eating the throat and pharynx are called Huo; those eating the yin region are called Hu. Patients with Hu-Huo disease dislike food and do not wish to smell food odors. Their faces alternate between red, black, and white. Those with upper part involvement have hoarse voices; those with lower part involvement have dry throats. Upper part involvement is treated with Xie Xin Tang [Drain the Epigastrium Decoction]; lower part involvement is washed with Kushen Tang [Sophora Root Decoction]; involvement outside the anus is fumigated with burnt Xionghuang [Realgar].) Sores on the upper lip erode the viscera; severe sores on the lower lip extend to the anus. (One must frequently check for sores on the upper and lower lips; if present, the condition is urgently fatal.) This condition often arises following diarrhea, and its lethality is the most acute.