湿气胜 五泻成 《书》云∶湿成五泄。
胃苓散 厥功宏 胃苓散暖脾、平胃、利水，为泄泻之要方。
湿而冷 萸附行 胃苓散加吴茱萸、附子之类，腹痛，加木香。
湿而热 连芩程 胃苓散加黄芩、黄连，热甚，去桂枝加葛根。
湿挟积 曲楂迎 食积，加山楂、神曲；酒积，加葛根。
虚兼湿 参附苓 胃苓散加人参、附子之类。
脾肾泻 近天明 五鼓以后泻者，肾虚也。泻有定时者，土主信，脾虚也。故名脾肾泻。
四神服 勿纷更 四神丸加白术、人参、干姜、附子、茯苓、罂粟壳之类为丸，久服方效。
恒法外 内经精 照此法治而不愈者，宜求之《内经》。
肠脏说 得其情 肠热脏寒，肠寒脏热。《内经》精义，张石顽颇得其解。
泻心类 特丁宁 诸泻心汤张石顽俱借来治泻，与《内经》之旨颇合。详载《医学从众录》。
眩晕症 皆属肝 《内经》云∶诸风掉眩，皆属于肝。
肝风木 相火干 厥阴为风木之脏，厥阴风木为少阳相火所居。
风火动 两动抟 风与火皆属阳而主动，两动相抟，则为旋转。
头旋转 眼纷繁 此二句，写眩晕之象也。
虚痰火 各分观 仲景主痰饮。丹溪宗河间之说，谓无痰不眩，无火不晕。《内经》云
∶精虚则眩。又云∶肾虚则头重高摇，髓海不足则脑转耳鸣。诸说不同如此。
究其指 总一般 究其殊途同归之旨，木动则生风，风生而火发，故河间以风火立论也
。风生必挟木势而克土，土病则聚液而成痰，故仲景以痰饮立论、丹溪以痰火立论也。究之
肾为肝母，肾主藏精，精虚则脑空，脑空则旋转而耳鸣。故《内经》以精虚及髓海不足立论
也。言虚者言其病根，言实者言其病象，其实一以贯之也。
痰火亢 大黄安 寸脉滑，按之益坚者，为上实。丹溪用大黄一味，酒炒三遍为末，茶
调下一二钱。
上虚甚 鹿茸餐 寸脉大，按之即散者，为上虚，宜鹿茸酒。鹿茸生于头，取其以类相
从，且入督脉而通于脑。每用半两酒煎去滓，入麝香少许服。或用补中益气汤及 术膏之类
。此症如钩藤、天麻、菊花之类，俱可为使。
欲下取 求其端 端，头也，谓寻到源头也。欲荣其上，必灌其根，古人有上病下取法。
左归饮 正元丹 左归饮加肉苁蓉、川芎、细辛甚效，正元丹亦妙。
湿气偏盛，五种泄泻由此形成。《尚书》记载：湿邪可演变为五种泄泻。
胃苓散功效宏大。胃苓散能温脾、燥湿健脾、利水渗湿，是治疗泄泻的重要方剂。
若属寒湿证，宜用吴茱萸和附子。在胃苓散基础上加入吴茱萸、附子等药；若伴有腹痛，可加木香。
若属湿热证，宜用黄连和黄芩。在胃苓散基础上加入黄芩、黄连；若热象严重，去掉桂枝，加入葛根。
若湿邪夹杂食积，宜用神曲和山楂。若有食积，加山楂、神曲；若是酒积，加葛根。
若体虚兼有湿邪，宜用人参和附子配伍茯苓。在胃苓散基础上加入人参、附子等药。
脾肾两虚导致的泄泻，常在黎明时分发作。五更天以后发生的泄泻，属于肾虚。泄泻有固定时间的，是因为脾土主信（规律），属于脾虚。因此称为脾肾泻。
服用四神丸，不要随意更改配方。将四神丸加入白术、人参、干姜、附子、茯苓、罂粟壳等药物制成丸剂，长期服用才见效。
对于常规治法之外的情况，应深入探究《黄帝内经》的精义。
关于肠腑与内脏寒热的理论，需掌握其精髓。即肠热脏寒或肠寒脏热。这是《黄帝内经》的精微义理，清代医家张石顽对此颇有见解。
使用泻心汤类方剂，要特别谨慎。清代医家张石顽借用各种泻心汤来治疗泄泻，这与《黄帝内经》的宗旨颇为契合。详细内容记载于《医学从众录》中。
眩晕病症，大多归属于肝。《黄帝内经》说：所有的风病引起的震颤和眩晕，都归属于肝。
肝风与相火相互干扰。厥阴肝经为风木之脏，厥阴风木之气易受少阳相火的干扰。
风与火皆主动荡，两者搏结。风和火都属于阳气而主运动，两者相互搏结，就会产生旋转感。
头部旋转，眼睛昏花纷繁。这两句描写了眩晕的症状表现。
需分别观察虚证、痰饮和火邪所致者。张仲景主张从痰饮论治。朱丹溪遵循刘河间的学说，认为无痰不作眩，无火不致晕。《黄帝内经》说：精气虚则眩晕。又说：肾虚则头重摇晃，髓海不足则头脑旋转耳鸣。诸家说法各不相同。
究其根本，宗旨是一致的。探究其殊途同归的道理，肝木动摇则生风，风生则火发，所以刘河间以风火立论。风生必然挟带肝木之势克制脾土，脾土病变则聚液成痰，所以张仲景以痰饮立论，朱丹溪以痰火立论。追根溯源，肾为肝之母，肾主藏精，精气虚则脑空，脑空则旋转并耳鸣。所以《黄帝内经》以精气虚及髓海不足立论。说“虚”是指疾病的根本原因，说“实”是指疾病的外在表象，其实是一以贯之的。
若痰火亢盛，可用大黄安神定志。寸脉滑，重按更加坚实，属于上实。朱丹溪用一味大黄，用酒炒三次研末，茶调服一二钱。
若上部虚损严重，宜食用鹿茸。寸脉大，轻按即散，属于上虚，适宜饮用鹿茸酒。鹿茸生于头顶，取其以类相从的原理，且鹿茸入督脉而通于脑。每次用半两鹿茸煎酒去渣，加入少许麝香服用。或者使用补中益气汤及白术膏之类。此症如钩藤、天麻、菊花等药物，均可作为引经使药。
When dampness prevails, five types of diarrhea are formed. The *Book of Documents* states: Dampness transforms into five types of diarrhea (Xie).
The efficacy of Weiling San (Stomach and Lingzhi Decoction) is profound. Weiling San warms the spleen, dries dampness and strengthens the spleen, and promotes urination to leach out dampness; it is a crucial formula for treating diarrhea.
In cases of cold-dampness, Evodiae Fructus (Wuzhuyu) and Aconiti Lateralis Radix Praeparata (Fuzi) should be used. Add Evodiae Fructus (Wuzhuyu), Aconiti Lateralis Radix Praeparata (Fuzi), etc., to Weiling San; if abdominal pain is present, add Aucklandiae Radix (Muxiang).
In cases of damp-heat, Coptidis Rhizoma (Huanglian) and Scutellariae Radix (Huangqin) should be used. Add Scutellariae Radix (Huangqin) and Coptidis Rhizoma (Huanglian) to Weiling San; if heat is severe, remove Cinnamomi Ramulus (Guizhi) and add Puerariae Radix (Gegen).
When dampness is complicated by food stagnation, Schizonepetae Herba (Qumai - *Note: Text says Qu Zha, likely referring to Shen Qu and Shan Zha contextually, but strictly 'Qu' often implies Shen Qu in this context or Shanzha. Given 'Qu Zha', it refers to Medicated Leaven (Shen Qu) and Hawthorn Fruit (Shanzha)*.) should be used. For food stagnation, add Crataegi Fructus (Shanzha) and Massaa Medicata (Shenqu); for alcohol stagnation, add Puerariae Radix (Gegen).
When deficiency is combined with dampness, Ginseng Radix et Rhizoma (Renshen) and Aconiti Lateralis Radix Praeparata (Fuzi) with Poria (Fuling) should be used. Add Ginseng Radix et Rhizoma (Renshen), Aconiti Lateralis Radix Praeparata (Fuzi), etc., to Weiling San.
Spleen-kidney diarrhea occurs near dawn. Diarrhea occurring after the fifth watch (early morning) is due to kidney deficiency. Diarrhea with fixed timing is due to spleen deficiency, as earth governs trust/punctuality. Hence, it is named Spleen-Kidney Diarrhea.
Take Sishen Wan (Four Spirits Pill), do not frequently change the prescription. Make pills from Sishen Wan added with Atractylodis Macrocephalae Rhizoma (Baizhu), Ginseng Radix et Rhizoma (Renshen), Zingiberis Rhizoma Recens (Ganjiang), Aconiti Lateralis Radix Praeparata (Fuzi), Poria (Fuling), Papaveris Capsula (Yingsuke), etc.; long-term administration yields efficacy.
For methods outside the constant norms, seek the essence in the *Neijing* (Inner Canon).
The theory of intestinal organs grasps their true nature. Intestinal heat with organ cold, or intestinal cold with organ heat. This is the subtle meaning of the *Neijing*, and Zhang Shiwan (Zhang Lu) has well understood it.
The use of Xiexin Tang (Drain the Epigastrium Decoction) variants requires special caution. Zhang Shiwan borrowed various Xiexin Tang formulas to treat diarrhea, which aligns well with the purport of the *Neijing*. Detailed records are found in *Yixue Congzhong Lu*.
Vertigo symptoms all belong to the Liver. The *Neijing* states: All wind-induced tremors and vertigo belong to the Liver.
Liver wind and wood interact with Ministerial Fire. The Jueyin channel is the organ of wind and wood; Jueyin wind and wood are inhabited by Shaoyang ministerial fire.
Wind and fire move, two movements collide. Wind and fire both belong to yang and are active; when two movements collide, rotation results.
Head rotates, eyes become complex. These two lines describe the phenomenon of vertigo.
Observe separately among deficiency, phlegm, and fire. Zhang Zhongjing focused on phlegm-fluids. Danxi followed Hejian's theory, stating that without phlegm there is no vertigo, and without fire there is no dizziness. The *Neijing* states: Essence deficiency leads to vertigo. It also states: Kidney deficiency leads to heavy head and swaying, insufficient marrow sea leads to brain rotation and tinnitus. Such diverse theories exist.
Investigate their point, they are generally the same. Investigating the principle of different paths leading to the same goal: Wood movement generates wind, wind generation triggers fire, hence Hejian established his theory on wind and fire. Wind generation must carry wood momentum to overcome earth; earth disease gathers fluids to form phlegm, hence Zhongjing established his theory on phlegm-fluids, and Danxi on phlegm-fire. Ultimately, the Kidney is the mother of the Liver; the Kidney stores essence; essence deficiency leads to an empty brain; an empty brain leads to rotation and tinnitus. Hence, the *Neijing* establishes its theory on essence deficiency and insufficient marrow sea. Speaking of "deficiency" refers to the root cause of the disease; speaking of "excess" refers to the pathological manifestation; essentially, it is consistent throughout.
If phlegm-fire is hyperactive, Dahuang (Rhubarb Root and Rhizome) brings peace. If the cun pulse is slippery and firm upon deep pressure, it indicates upper excess. Danxi used a single herb of Dahuang (Rhubarb Root and Rhizome), fried three times with wine, powdered, and taken with tea, one or two qian.
If upper deficiency is severe, consume Deer Antler (Lurong). If the cun pulse is large and scatters upon light pressure, it indicates upper deficiency; Deer Antler Wine is suitable. Deer antler grows at the head, utilizing the principle of similarity, and enters the Du vessel to connect with the brain. Use half liang, decoct in wine, remove dregs, add a little Musk (Shexiang), and take. Alternatively, use Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) or Baizhu Gao (Atractylodis Macrocephalae Paste). For this condition, herbs such as Uncariae Ramulus cum Uncis (Gouteng), Gastrodiae Rhizoma (Tianma), and Chrysanthemi Flos (Juhua) can serve as guiding agents.
To seek treatment from below, find the source. "Duan" refers to the head, meaning finding the origin. To nourish the upper, one must irrigate the roots; the ancients had the method of treating upper diseases by draining lower ones.
Zuogui Yin (Left Return Decoction) and Zhengyuan Dan (Upright Origin Pill) are correct. Zuogui Yin added with Cynomorii Folium (Roucongrou), Chuanxiong Rhizoma (Chuanxiong), and Asari Radix et Rhizoma (Xixin) is very effective; Zhengyuan Dan is also excellent.