夫泻症不同，溏泄滑利，洞五泻是也。溏者，似泻非泻，精粕不聚，其色似脓。泄
者，无时而作，泻出不知利者，直射溅溜，气从中脘滑者，水谷直过肠胃不化。洞者，
顿然下之，如桶散溃不留，当以脉候参详，而虚实迥别矣。寒泻者，其色必白；热泻
者，色必黄赤，或粪沫射出而远，火性迅速，元阳直走，毋轻视也。然有久寒之后，
因虚而生火者，有因热极而伤寒者，有因实而致虚者，有因虚不运化而似实者，有因伤
后频伤，色白似寒者，有因伤久燥涩色黄，津液耗亡作渴而似热者，有因木来克土色青
似惊者。更泄症所属有五，有胃泄、脾泄、大肠泄、小肠泄、大瘕泄者。胃泄者，饮食
不化，其色必黄；脾泄者，腹胀满而泄注，食即吐逆；大肠泄者，今已窘迫，大便色
白，肠鸣切痛；小肠泄者，泄短而便脓血，少腹必痛；大瘕泄者，数至圊而不能便，茎
中亦痛。更有食积泻者，积聚停饮，痞膈中满，胁肋疼痛，昼凉夜热，厥口吐酸。脉实
者，先利而后补，虚者，先补而后利，如春月伤风咳嗽而泄泻者，是表里俱虚，木旺而
土亏也。冬月受寒而泄泻者，不治，即成慢脾也。中湿而泄泻者，必肠鸣肚痛，手足俱
寒，宜宣利其水可也。然泄泻、疟痢，同乎一原，皆由暑月脾伤所致。饮食为痰，充于
胸膈则为疟。饮食为积胶于肠胃则为痢，饮食始伤即泻为轻，停滞既久乃发疟痢为重。
又见水泻而腹不痛，肌肉虚浮，身体重着者，是湿如完谷不化者为气虚。如腹痛肠
鸣，卒痛一阵，水泻一阵者，是火如昏闷疾多，时泻时止，或多或少者为痰。如痛甚而
泻，泻后而腹痛减者为食积。如面垢烦躁渴饮水浆，背寒自汗，头热呕吐者为伤暑。然
泻本属湿，或饮食伤脾，治法不外乎渗湿消导分利补脾数法而已。然尤宜分寒热新久，
如泻久而元气下陷者，宜升提之；肠胃虚滑不禁者，宜收涩之。利水不可施于久病之
后；收涩不可投于初起之时。面赤褐泻者，暖剂宜禁。泻久作渴者，凉剂忌投。盖暴泻
非阴，久泻非阳。渴者，当致不渴方愈，谓其邪热去，脾气复，津液生也。不渴者，当
致微渴才痊，谓其积滞去，阴阳和也。如泻进止时发者，可发散脾间湿气，后与扶脾可
也。若交寅时而泻者，谓之晨泻，宜为温补肾阳。盖肾开窍于二阴，而失闭藏之职也。
故有脾虚、肝虚、肾虚，谓之三虚。有因湿、因火、因痰、因虚、因暑、因积、因
风、因冷谓之八症。若吐乳泻黄，是伤热乳也。吐乳泻青者，是伤冷乳也。粪如臭鸡子
而肚膨，手纹紫色而身热者，是疳泻也。粪青夜啼，或时惊悸者，是惊泻也。初泻微
黄，良久则色青者，为脏冷也。便青而夹白脓，稠粘如涎者，是赤肠寒。久则令见腹痛
鸣啼，面白形青，渐成阴痫。总脾者，一身之祖，百脉之源，病则十二经皆病矣。
腹泻的病症各不相同。溏泄滑利，指的是洞泻。所谓“溏”，是似泻非泻，精微与糟粕不能聚拢，颜色像脓一样；所谓“泄”，是不分时间发作，泻出时不知节制；所谓“利”，是直射溅流，气从中脘部滑过，水谷直接通过肠胃而不消化；所谓“洞”，是突然向下排泄，如同桶散溃败不留痕迹。应当结合脉象来详细参详，虚实差别就很大了。寒性腹泻，大便颜色必定发白；热性腹泻，大便颜色必定黄赤，或者粪沫喷射而出且射程较远，因为火性迅速，元阳直走，不可轻视。然而也有久寒之后，因虚而生火的；有因热极而感受寒邪的；有因实证导致虚证的；有因虚证运化无力而看似实证的；有因多次受伤后，颜色发白看似寒证的；有因受伤日久燥涩、颜色发黄、津液耗亡导致口渴而看似热证的；有因肝木克伐脾土、颜色发青看似惊风的。
此外，腹泻病症归属有五类：胃泄、脾泄、大肠泄、小肠泄、大瘕泄。胃泄，饮食不消化，大便颜色必黄；脾泄，腹胀满且泄注，进食后即呕吐逆乱；大肠泄，感到窘迫急迫，大便色白，肠鸣切痛；小肠泄，排便短促且便中有脓血，小腹部必定疼痛；大瘕泄，频繁去厕所却不能排便，尿道中也疼痛。更有食积泻，表现为积聚停饮，胸膈痞闷胀满，胁肋疼痛，白天凉晚上热，口吐酸水。脉象实的，先通利而后补益；脉象虚的，先补益而后通利。如春季伤风咳嗽而兼腹泻的，是表里俱虚，肝木旺而脾土亏。冬季受寒而腹泻的，难以治愈，即使治疗也会演变成慢脾风。中湿而腹泻的，必定肠鸣肚痛，手足都寒冷，适宜宣通利水的方法。
然而腹泻、疟疾、痢疾，根源相同，都是由暑月脾脏受伤所致。饮食化为痰，充满胸膈则为疟疾；饮食化为积滞胶结于肠胃则为痢疾；饮食刚受伤即腹泻为轻症，停滞既久才发作疟痢为重症。又见水样腹泻而腹部不痛，肌肉虚浮，身体沉重着的，这是湿气重；完谷不化的，这是气虚。如腹痛肠鸣，突然痛一阵、水泻一阵的，这是火邪；如昏闷疾多，时泻时止，或多或少的是痰邪。如痛甚而泻，泻后腹痛减轻的是食积。如面色垢腻烦躁、渴欲饮水浆，背部恶寒自汗，头部发热呕吐的是伤暑。
总之，腹泻本属湿邪，或因饮食伤脾，治法不外乎渗湿、消导、分利、补脾这几法而已。但尤其应当区分寒热和新久。如腹泻日久元气下陷的，宜升提；肠胃虚滑不禁的，宜收涩。利水之法不可用于久病之后；收涩之法不可投于初起之时。面赤褐色腹泻的，温热药剂宜禁用。腹泻日久作渴的，寒凉药剂忌投用。大概暴泻不属于阴证，久泻不属于阳证。口渴的，应当使其不再口渴才算痊愈，这是因为邪热去除，脾气恢复，津液生成。不渴的，应当使其微微口渴才算痊愈，这是因为积滞去除，阴阳调和。如腹泻进止不时发作的，可发散脾间湿气，随后给予扶脾调理即可。若在寅时（凌晨3-5点）腹泻的，称为晨泻，宜温补肾阳。因为肾开窍于二阴，失去了闭藏的职责。所以有脾虚、肝虚、肾虚，称为三虚。有因湿、因火、因痰、因虚、因暑、因积、因风、因冷，称为八症。若吐乳且泻黄色粪便，是伤热乳。吐乳且泻青色粪便，是伤冷乳。粪便像臭鸡蛋味且肚子膨隆，手纹紫色且身热的，是疳泻。粪便青色夜间啼哭，或时常惊悸的，是惊泻。初泻微黄，良久则变青色的，为脏冷。大便青色夹杂白色脓液，稠粘如涎沫的，是大肠寒。久了会导致腹痛鸣啼，面白形青，逐渐形成阴痫。脾胃总括一身，是身体的根本，百脉的源头，生病则十二经都会受影响。
Diarrheal syndromes vary. "Tang" (loose stool) and slippery flow refer to "Dong" diarrhea (sudden, profuse diarrhea). "Tang" implies a state resembling diarrhea but not fully so, where essence and dregs fail to consolidate, with a color resembling pus; "Xie" (leakage) occurs without specific timing, with uncontrolled discharge; "Li" (profuse flow) involves direct splashing streams, where Qi slides through the Zhongwan area, allowing food and water to pass directly through the intestines and stomach without digestion; "Dong" refers to sudden downward expulsion, like a bucket bursting and scattering without retention. One must carefully examine the pulse to distinguish clearly between deficiency and excess patterns. Cold diarrhea presents with white-colored stools; heat diarrhea presents with yellow or reddish stools, or fecal foam ejected forcefully at a distance, as fire nature is rapid and primal Yang rushes forth, which should not be taken lightly. However, there are cases of fire generated from deficiency after prolonged cold, cases of cold contracted due to extreme heat, cases of deficiency resulting from excess, cases of apparent excess due to failure of transformation in deficiency, cases of white color resembling cold after repeated injuries, cases of yellow color resembling heat due to prolonged injury causing dryness, fluid depletion, and thirst, and cases of green color resembling fright due to Liver Wood overacting on Spleen Earth.
Furthermore, diarrhea syndromes are categorized into five types: Stomach Xie, Spleen Xie, Large Intestine Xie, Small Intestine Xie, and Da Jia Xie. Stomach Xie features undigested food and yellow stools; Spleen Xie features abdominal distension and fullness with pouring diarrhea, vomiting and regurgitation immediately after eating; Large Intestine Xie features urgency and distress, white stools, intestinal borborygmi, and cutting pain; Small Intestine Xie features short, frequent passages with pus and blood, and lower abdominal pain; Da Jia Xie features frequent trips to the toilet with inability to defecate, and pain in the urethra. There is also Food Stagnation Diarrhea, characterized by accumulation of retained fluids, chest and diaphragm stuffiness and fullness, hypochondriac pain, coolness by day and fever by night, and acid regurgitation. If the pulse is Excess, tonify after purging; if Deficient, purge after tonifying. For example, spring wind-cold cough accompanied by diarrhea indicates both exterior and interior deficiency, with hyperactive Liver Wood and deficient Spleen Earth. Winter cold-induced diarrhea is difficult to treat and may develop into Slow Spleen Wind. Dampness-induced diarrhea features borborygmi, abdominal pain, and cold hands and feet, suitable for promoting urination to drain dampness.
However, diarrhea, malaria, and dysentery share the same origin, caused by Spleen injury during the hot summer months. When food transforms into Phlegm and fills the chest and diaphragm, it becomes Malaria; when food forms stagnation and adheres to the intestines and stomach, it becomes Dysentery. Initial injury leading to diarrhea is mild; prolonged stagnation leading to malaria or dysentery is severe. Water diarrhea without abdominal pain, flaccid muscles, and heavy body indicates Dampness; undigested food indicates Qi Deficiency. Abdominal pain with borborygmi, sudden pain followed by watery diarrhea, indicates Fire; mental cloudiness with frequent symptoms, intermittent diarrhea varying in amount, indicates Phlegm. Severe pain with diarrhea that relieves pain afterward indicates Food Stagnation. Greasy complexion, irritability, thirst for drinks, cold back with spontaneous sweating, hot head, and vomiting indicate Summerheat Injury.
Generally, diarrhea belongs to Dampness, often caused by dietary injury to the Spleen. Treatment methods do not exceed draining dampness, resolving stagnation, separating clear from turbid, and tonifying the Spleen. It is crucial to differentiate cold/heat and new/chronic. For chronic diarrhea with sinking Yuan Qi, lifting methods are appropriate; for loose intestines and uncontrollable leakage, astringent methods are appropriate. Diuretics should not be used after long-term illness; astringents should not be used at the onset. Reddish-brown facial complexion with diarrhea contraindicates warm agents; chronic diarrhea with thirst contraindicates cooling agents. Acute diarrhea is typically not Yin-pattern; chronic diarrhea is typically not Yang-pattern. Thirst should resolve for cure, indicating elimination of pathogenic heat, restoration of Spleen Qi, and generation of fluids. Absence of thirst should lead to slight thirst for recovery, indicating elimination of stagnation and harmony of Yin and Yang. Intermittent diarrhea can be treated by dispersing Spleen dampness, followed by supporting the Spleen. Diarrhea occurring at Yin hour (3-5 AM) is called Morning Diarrhea, suitable for warming and tonifying Kidney Yang, as the Kidney opens into the two yin orifices and fails in its storing function. Thus, there are three deficiencies: Spleen, Liver, and Kidney. There are eight syndromes: caused by Dampness, Fire, Phlegm, Deficiency, Summerheat, Stagnation, Wind, and Cold. Vomiting milk with yellow diarrhea indicates Heat Milk Injury; vomiting milk with green diarrhea indicates Cold Milk Injury. Feces smelling like rotten eggs with abdominal distension, purple finger veins, and fever indicate Gan Diarrhea (malnutrition diarrhea). Green feces with night crying or occasional palpitations indicate Fright Diarrhea. Initially yellow stool turning green after a while indicates Cold Viscera. Green stool mixed with white pus, thick and sticky like saliva, indicates Cold Large Intestine. Prolonged cases may lead to abdominal pain, crying, pale face, bluish complexion, gradually forming Yin Epilepsy. The Spleen and Stomach are the ancestors of the whole body and the source of all meridians; disease here affects all twelve meridians.