泄泻者。胃与大肠之病也。此因饮食不调。脾胃不能运化。小水并于大肠。故令作泻。脉来沉滑。腹中作痛。
宜用胃苓汤加减。以其积滞在胃。气不宣通。稀粪旁流故也。若久泻不止。脉沉细缓。按之无力者。是为脾虚。宜用健
脾丸参苓白术散之类。甚则用八味地黄丸。补命门火以生脾土。此不易之法也。但泄泻之病。虚寒者固有。
而虚热者亦多。如下多亡阴。津液不足。脉来细数无力。甘温毫不可投。宜用脾肾双补汤。此外又有数症。
条分缕析。治之方不误耳。
积泻者。腹痛而泻。泻后痛减。泻去稍宽。偶然而起者。谓之食泻。法当消食分利。若不时举发。定
因脾土虚弱。不能运化。以致食停作泻。初起必先消食。方可用补用温。世人概言脾泻。骤用温补者非也。
大约脉实有力。宜用胃苓汤。脉细无力。宜用半消半补（脉之有力为实无力为虚）
痰泻者。或多或少。或泻或不泻。中焦有痰。饮食入胃。裹结不化。所以作泻。脉滑有热者。宜用枳
朴柴陈汤。脉来弦细无力。宜用香砂六君子汤。
火泻者。腹中痛一阵。泻一阵。后去如汤。后重如滞。此因湿在肠胃之中。火在肠胃之外。宜用清热柴苓汤。甚则
完谷不化者。火性急速。不及传化故也。
冷泻者。鼻吸风寒之气。口食生冷之物。皆能作泻。此暴病也。宜用香砂理中汤。若久泻之后。
脉细皮寒。病涉大虚。宜于前方更加桂附。若加之以不食。危笃难医。至于完谷不化。初起犹为胃寒。
治之可愈。久则胃气已绝。断主于死。
湿泻者。腹中不痛。所泻皆水。（辨证精详）或遍身发肿。身热脉数者。病属于阳。（分别阴阳不
紊）初起宜用分消饮。久以柴苓汤主之。若肢冷脉细。元气大虚。宜用消肿
健脾汤。即金匮肾气丸。亦宜服也。
又有肺燥作泻者。人所不知。秋伤于燥。内热咳嗽。肺中之火无处可宣。传于大肠。故令作泻。宜用清金
润燥汤。润肺兼润其肠。则泄泻自止。若误认脾虚。而用温补。非徒无益。又害其肺也。治者详之。又有脱泻者。水谷
皆下。日有百次。不但糟粕泻尽。并肠中所蓄之黄水。俱已竭尽而无余。所以平人时泄黄水。即是脾坏之候。皆主于死。
不易治也。
加减胃苓汤
苍术 浓朴 陈皮 甘草 赤茯 猪苓 泽泻 山楂 桔梗
平胃而用苍术。取其雄壮上行。发越脾气。脾气一行。则郁结自开。若单用沉降之药。胃反不能开也。但脉来沉缓
者可用。滑数者勿与。以其燥能助火故也。至于猪苓虽能渗湿。脾湿不甚者。服之必伤肾水。不可轻用。若两
肋作胀。因于气郁者。宜加香附青皮之类。
健脾丸
人参（二两） 白术（三两） 白茯（二两） 甘草（一两） 山药（二两） 扁豆（三两） 芡实（三两） 莲
肉（二两） 泽泻（一两） 陈皮（一两） 山楂（三两）
参苓白术散
人参 白术 白茯 甘草 山药 扁豆 苡仁 桔梗 砂仁 莲肉
脾肾双补汤
人参 山药 扁豆 车前子 白茯 白芍 萎蕤 菟丝子 杜仲 山萸 白蔻 石斛
枳朴柴陈汤
柴胡 黄芩 半夏 甘草 陈皮 白茯 枳壳 浓朴 赤芍
香砂六君子汤
人参 白术 白茯 甘草 陈皮 半夏 砂仁 藿香 香附
清热柴苓汤
柴胡 黄芩 半夏 甘草 赤茯 猪苓 泽泻 山栀 赤芍
香砂理中汤
人参 白术 炮姜 甘草 香附 砂仁 藿香
滞多加浓朴。
分消饮
羌活 白芷 柴胡 川芎 枳壳 山楂 陈皮 猪苓 泽泻
热盛加山栀黄芩。
消肿健脾汤
人参 白术 白茯 甘草 车前子 泽泻 浓朴 苡仁 炮姜 附子 陈皮 山药
凡久泻脾虚。以及发肿。俱宜用此。
清金润燥汤
沙参 萎蕤 苡仁 山药 石斛 黄芩 白芍 桔梗 甘草 地骨皮 陈皮 芡实
八仙糕（痢后调理脾胃良方）
白术（四两） 白茯（四两） 山药（八两） 扁豆（八两） 芡实（八两） 莲肉（八
两） 苡仁（四两） 老米粉（二斤） 白糖（二斤）
四神丸
肉果（二两煨熟去油） 补骨脂（四两） 五味（一两） 吴茱萸（水浸炒一两）
姜煮红枣为丸（补命火益脾肾要剂）
泄泻，是胃与大肠的疾病。这通常是因为饮食不规律，导致脾胃无法运化水谷，致使小便并入大肠，从而引起腹泻。脉象表现为沉滑，腹部疼痛。
适宜使用胃苓汤进行加减治疗。这是因为积滞停留在胃中，气机不能宣通，导致稀粪从旁流出。如果是长期腹泻不止，脉象沉细缓弱，按压无力，这是脾虚的表现。适宜使用健脾丸、参苓白术散之类的方剂。病情严重的，可以使用八味地黄丸，通过补益命门之火来生养脾土。这是不可改变的治疗法则。但是泄泻这种病，虽然确有虚寒证型，但虚热证型也很多。如下利过多导致亡阴，津液不足，脉象细数且无力，此时甘温的药物绝对不可投用。适宜使用脾肾双补汤。此外还有几种症状，需要条理分明地分析，治疗才不会出错。
所谓积泻，是指腹痛而腹泻，泻后疼痛减轻，排便后感觉稍宽舒，偶然发作的，称为食泻。治法应当消食导滞、分利湿浊。如果不时发作，必定是因为脾土虚弱，不能运化，导致食物停滞而引起腹泻。初起时必须先消食，然后才能使用补法或温法。世人一概称之为脾泻，骤然使用温补药物，这是错误的。大致而言，脉象实有力的，适宜使用胃苓汤；脉象细无力的，适宜使用半消半补（脉有力为实证，无力为虚证）的方法。
所谓痰泻，腹泻量或多或少，有时泻有时不泻，是因为中焦有痰饮，饮食进入胃中，被痰饮裹结而不能消化，所以引起腹泻。脉象滑且伴有热象的，适宜使用枳朴柴陈汤；脉象弦细无力的，适宜使用香砂六君子汤。
所谓火泻，腹痛一阵，腹泻一阵，大便像开水一样急迫，肛门有重坠感且阻滞不通。这是因为湿气在肠胃之中，火气在肠胃之外。适宜使用清热柴苓汤。如果严重到完谷不化，是因为火性急速，来不及传化所致。
所谓冷泻，鼻吸入风寒之气，口食生冷之物，都能引起腹泻。这是暴发的疾病。适宜使用香砂理中汤。如果在久泻之后，脉象细弱，皮肤寒冷，病情涉及大虚，应当在前方中加入肉桂、附子。如果再加上不能进食，则危重难医。至于完谷不化，初起尚属胃寒，治疗可以痊愈；时间久了则胃气已绝，断定为死证。
所谓湿泻，腹部不痛，所泻出的都是水。（辨证精细详尽）或者全身浮肿，身体发热，脉象数的，病属于阳。（阴阳分辨不乱）初起适宜使用分消饮，日久以柴苓汤为主治。如果四肢冰冷，脉象细弱，元气大虚，适宜使用消肿健脾汤。即金匮肾气丸，也适宜服用。
又有因肺燥引起腹泻的，人们并不知晓。秋季感受燥邪，内热咳嗽，肺中的火热无处宣泄，传导给大肠，所以引起腹泻。适宜使用清金润燥汤，润肺同时滋润肠道，则泄泻自然停止。如果误认为是脾虚，而使用温补药物，不仅无益，反而伤害肺部。医者应仔细辨别。又有脱泻，水谷皆下，每天达上百次，不但糟粕泻尽，连肠中所蓄积的黄水也都竭尽无余。所以普通人时常排泄黄水，就是脾脏败坏的症状，都主死证，难以治疗。
加减胃苓汤
苍术、厚朴、陈皮、甘草、赤茯苓、猪苓、泽泻、山楂、桔梗
平胃散中使用苍术，是取其雄壮上行，发越脾气。脾气一旦运行，郁结自然解开。如果单用沉降的药物，胃反而不能开畅。只有脉象沉缓者可用，滑数者勿用，因为苍术燥性能助火。至于猪苓虽然能渗湿，但脾湿不重的患者，服用必伤肾水，不可轻用。如果两肋作胀，因气郁引起的，适宜加入香附、青皮之类。
健脾丸
人参（二两）、白术（三两）、白茯苓（二两）、甘草（一两）、山药（二两）、扁豆（三两）、芡实（三两）、莲肉（二两）、泽泻（一两）、陈皮（一两）、山楂（三两）
参苓白术散
人参、白术、白茯苓、甘草、山药、扁豆、薏苡仁、桔梗、砂仁、莲肉
脾肾双补汤
人参、山药、扁豆、车前子、白茯苓、白芍、萎蕤、菟丝子、杜仲、山茱萸、白蔻仁、石斛
枳朴柴陈汤
柴胡、黄芩、半夏、甘草、陈皮、白茯苓、枳壳、厚朴、赤芍
香砂六君子汤
人参、白术、白茯苓、甘草、陈皮、半夏、砂仁、藿香、香附
清热柴苓汤
柴胡、黄芩、半夏、甘草、赤茯苓、猪苓、泽泻、山栀、赤芍
香砂理中汤
人参、白术、炮姜、甘草、香附、砂仁、藿香
滞多加厚朴。
分消饮
羌活、白芷、柴胡、川芎、枳壳、山楂、陈皮、猪苓、泽泻
热盛加山栀、黄芩。
消肿健脾汤
人参、白术、白茯苓、甘草、车前子、泽泻、厚朴、薏苡仁、炮姜、附子、陈皮、山药
凡是久泻脾虚，以及出现浮肿，都适宜使用此方。
清金润燥汤
沙参、萎蕤、薏苡仁、山药、石斛、黄芩、白芍、桔梗、甘草、地骨皮、陈皮、芡实
八仙糕（痢疾后调理脾胃的良好方剂）
白术（四两）、白茯苓（四两）、山药（八两）、扁豆（八两）、芡实（八两）、莲肉（八两）、薏苡仁（四两）、老米粉（二斤）、白糖（二斤）
四神丸
肉豆蔻（二两煨熟去油）、补骨脂（四两）、五味子（一两）、吴茱萸（水浸炒一两）
用姜煮红枣为丸（补益命火、益脾肾的重要药剂）
Diarrhea (Xie Xie) is a disease of the Stomach and Large Intestine. This is usually caused by irregular diet, leading to the Spleen and Stomach's inability to transform and transport nutrients, causing urine to merge into the Large Intestine, thus inducing diarrhea. The pulse presents as deep and slippery (Chen Hua), accompanied by abdominal pain.
It is appropriate to use Wei Ling Tang (Stomach-Ling Decoction) with modifications. This is because stagnation remains in the Stomach, and Qi mechanism fails to circulate freely, resulting in loose stools flowing from the sides. If diarrhea persists for a long time, with a deep, fine, and slow pulse that feels weak upon pressure, this indicates Spleen Deficiency (Pi Xu). It is appropriate to use formulas such as Jian Pi Wan (Spleen-Strengthening Pill) or Shen Ling Bai Zhu San (Ginseng, Poria, and Atractylodes Macrocephala Powder). In severe cases, Ba Wei Di Huang Wan (Eight-Ingredient Rehmannia Pill) may be used to tonify Ming Men Fire (Gate of Life Fire) to generate Spleen Earth. This is an unchangeable therapeutic principle. However, regarding diarrhea, while deficiency-cold patterns certainly exist, deficiency-heat patterns are also common. For instance, if excessive purging leads to Yin loss and insufficient body fluids, with a fine, rapid, and weak pulse, sweet-warm herbs must absolutely not be administered. Instead, Pi Shen Shuang Bu Tang (Spleen-Kidney Dual Tonification Decoction) is appropriate. Additionally, there are several other symptom patterns that require detailed analysis to ensure accurate treatment.
The so-called Accumulation Diarrhea (Ji Xie) involves abdominal pain during defecation, where pain decreases after stooling, providing slight relief. Occasional onset characterizes Food Diarrhea (Shi Xie). The treatment method should focus on resolving food stagnation and separating turbidity from clear fluids. If attacks occur frequently, it is undoubtedly due to weak Spleen Earth failing to transform and transport, causing food retention and diarrhea. Initially, food stagnation must be resolved before employing tonifying or warming methods. It is incorrect for people to generally label this as Spleen Diarrhea and abruptly apply warm-tonifying treatments. Generally, if the pulse is forceful and solid, Wei Ling Tang is appropriate; if the pulse is fine and weak, a method of half-resolving and half-tonifying (forceful pulse indicates excess, weak pulse indicates deficiency) is suitable.
The so-called Phlegm Diarrhea (Tan Xie) varies in volume, sometimes occurring, sometimes not. It arises because phlegm-dampness exists in the Middle Jiao; when food enters the Stomach, it is bound by phlegm and fails to digest, causing diarrhea. If the pulse is slippery with heat signs, Zhi Po Chai Chen Tang (Bitter Orange, Magnolia Bark, Bupleurum, and Tangerine Peel Decoction) is appropriate. If the pulse is wiry, fine, and weak, Xiang Sha Liu Jun Zi Tang (Aucklandia, Amomum, and Six Gentlemen Decoction) is appropriate.
The so-called Fire Diarrhea (Huo Xie) involves waves of abdominal pain followed by waves of diarrhea, with stool rushing out like boiling water and a sensation of heaviness and obstruction in the rectum. This is due to dampness within the intestines and stomach, and fire outside them. Qing Re Chai Ling Tang (Heat-Clearing Bupleurum-Poria Decoction) is appropriate. In severe cases where undigested food passes through, it is because the nature of fire is rapid, leaving no time for transformation and transmission.
The so-called Cold Diarrhea (Leng Xie) can be caused by inhaling wind-cold air through the nose or consuming cold/raw foods orally. This is an acute illness. Xiang Sha Li Zhong Tang (Aucklandia, Amomum, and Center-Harmonizing Decoction) is appropriate. After prolonged diarrhea, if the pulse is fine and the skin is cold, indicating severe deficiency, Cinnamon Twig (Gui Zhi) and Aconite Root (Fu Zi) should be added to the previous formula. If anorexia is added, the condition becomes critical and difficult to treat. Regarding undigested food passing through, initial stages suggest Stomach Cold, which can be cured; however, if prolonged, Stomach Qi is exhausted, indicating a fatal prognosis.
The so-called Dampness Diarrhea (Shi Xie) involves no abdominal pain, with watery stools. (Differentiation is precise and detailed.) Or, it may present with generalized edema, fever, and a rapid pulse, indicating a Yang pattern. (Yin and Yang are distinguished without confusion.) Initially, Fen Xiao Yin (Separating and Eliminating Decoction) is appropriate; for chronic cases, Chai Ling Tang (Bupleurum-Poria Decoction) is the primary treatment. If limbs are cold and the pulse is fine, indicating major Yuan Qi deficiency, Xiao Zhong Jian Pi Tang (Edema-Reducing Spleen-Strengthening Decoction) is appropriate. Jin Gui Shen Qi Wan (Kidney Qi Pill from the Golden Cabinet) is also suitable.
There is also diarrhea caused by Lung Dryness (Fei Zao), which is unknown to many. Autumn injury by dryness leads to internal heat and coughing; the fire in the Lung has no outlet for dispersion and transmits to the Large Intestine, causing diarrhea. Qing Jin Run Zao Tang (Clear Metal Moisten Dryness Decoction) is appropriate, moistening both the Lung and the Intestines, thereby stopping diarrhea. Misidentifying this as Spleen Deficiency and using warm-tonifying herbs is not only ineffective but also damages the Lung. Physicians should examine this carefully. There is also Collapse Diarrhea (Tuo Xie), where water and grain pass down excessively, up to a hundred times a day. Not only are residues expelled, but all yellow fluids accumulated in the intestines are completely exhausted. Therefore, frequent passage of yellow fluid in healthy individuals indicates Spleen failure, which is a fatal sign and difficult to treat.
Modified Wei Ling Tang
Cang Zhu (Atractylodis Rhizoma), Hou Po (Magnoliae Officinalis Cortex), Chen Pi (Citri Reticulatae Pericarpium), Gan Cao (Glycyrrhizae Radix et Rhizoma), Chi Fu Ling (Poria cum Rosa), Zhu Ling (Polyporus), Ze Xie (Alismatis Rhizoma), Shan Zha (Crataegi Fructus), Jie Geng (Platycodonis Radix).
Using Cang Zhu in Ping Wei San (Calm the Stomach Powder) leverages its robust, ascending nature to vent Spleen Qi. Once Spleen Qi moves, stagnation naturally resolves. Using only descending herbs would fail to open the Stomach. This is suitable only for a deep-slow pulse; avoid slippery-rapid pulses, as the drying nature aids fire. Although Zhu Ling promotes diuresis, it injures Kidney Water if Spleen Dampness is not significant, so use cautiously. For distension in the hypochondrium due to Qi stagnation, add Xiang Fu (Cyperi Rhizoma) and Qing Pi (Citri Reticulatae Pericarpium Viride).
Jian Pi Wan (Spleen-Strengthening Pill)
Ren Shen (Ginseng Radix et Rhizoma, 2 liang), Bai Zhu (Atractylodis Macrocephalae Rhizoma, 3 liang), Bai Fu Ling (Poria, 2 liang), Gan Cao (Glycyrrhizae Radix et Rhizoma, 1 liang), Shan Yao (Dioscoreae Rhizoma, 2 liang), Bian Dou (Dolichoris Semen, 3 liang), Qian Shi (Euryales Semen, 3 liang), Lian Rou (Nelumbinis Plumula, 2 liang), Ze Xie (Alismatis Rhizoma, 1 liang), Chen Pi (Citri Reticulatae Pericarpium, 1 liang), Shan Zha (Crataegi Fructus, 3 liang).
Shen Ling Bai Zhu San (Ginseng, Poria, and Atractylodes Macrocephala Powder)
Ren Shen, Bai Zhu, Bai Fu Ling, Gan Cao, Shan Yao, Bian Dou, Yi Yi Ren (Coicis Semen), Jie Geng, Sha Ren (Amomi Fructus Rotundus), Lian Rou.
Pi Shen Shuang Bu Tang (Spleen-Kidney Dual Tonification Decoction)
Ren Shen, Shan Yao, Bian Dou, Che Qian Zi (Plantaginis Semen), Bai Fu Ling, Bai Shao (Paeoniae Radix Alba), Wei Rui (Polygonati Odorati Rhizoma), Tu Si Zi (Cuscutae Semen), Du Zhong (Eucommiae Cortex), Shan Yu (Corni Fructus), Bai Kou Ren (Amomi Fructus Rotundus), Shi Hu (Dendrobii Caulis).
Zhi Po Chai Chen Tang (Bitter Orange, Magnolia Bark, Bupleurum, and Tangerine Peel Decoction)
Chai Hu (Bupleuri Radix), Huang Qin (Scutellariae Radix), Ban Xia (Pinelliae Rhizoma), Gan Cao, Chen Pi, Bai Fu Ling, Zhi Ke (Aurantii Fructus Immaturus), Hou Po, Chi Shao (Paeoniae Radix Rubra).
Xiang Sha Liu Jun Zi Tang (Aucklandia, Amomum, and Six Gentlemen Decoction)
Ren Shen, Bai Zhu, Bai Fu Ling, Gan Cao, Chen Pi, Ban Xia, Sha Ren, Huo Xiang (Agastaches Herba), Xiang Fu.
Qing Re Chai Ling Tang (Heat-Clearing Bupleurum-Poria Decoction)
Chai Hu, Huang Qin, Ban Xia, Gan Cao, Chi Fu Ling, Zhu Ling, Ze Xie, Shan Zhi (Gardeniae Fructus), Chi Shao.
Xiang Sha Li Zhong Tang (Aucklandia, Amomum, and Center-Harmonizing Decoction)
Ren Shen, Bai Zhu, Pao Jiang (Zingiberis Rhizoma Preparatum), Gan Cao, Xiang Fu, Sha Ren, Huo Xiang.
Add more Hou Po for severe stagnation.
Fen Xiao Yin (Separating and Eliminating Decoction)
Qiang Huo (Notopterygii Rhizoma et Radix), Bai Zhi (Angelicae Dahuricae Radix), Chai Hu, Chuan Xiong (Chuanxiong Rhizoma), Zhi Ke, Shan Zha, Chen Pi, Zhu Ling, Ze Xiang.
Add Shan Zhi and Huang Qin for intense heat.
Xiao Zhong Jian Pi Tang (Edema-Reducing Spleen-Strengthening Decoction)
Ren Shen, Bai Zhu, Bai Fu Ling, Gan Cao, Che Qian Zi, Ze Xie, Hou Po, Yi Yi Ren, Pao Jiang, Fu Zi (Aconiti Lateralis Radix Preparata), Chen Pi, Shan Yao.
Suitable for all cases of chronic diarrhea with Spleen Deficiency and edema.
Qing Jin Run Zao Tang (Clear Metal Moisten Dryness Decoction)
Sha Shen (Glehniae Radix), Wei Rui, Yi Yi Ren, Shan Yao, Shi Hu, Huang Qin, Bai Shao, Jie Geng, Gan Cao, Di Gu Pi (Lycii Cortex), Chen Pi, Qian Shi.
Ba Xian Gao (Eight Immortals Cake) (Excellent formula for regulating Spleen and Stomach after dysentery)
Bai Zhu (4 liang), Bai Fu Ling (4 liang), Shan Yao (8 liang), Bian Dou (8 liang), Qian Shi (8 liang), Lian Rou (8 liang), Yi Yi Ren (4 liang), Lao Mi Fen (Old Rice Flour, 2 jin), Bai Tang (White Sugar, 2 jin).
Si Shen Wan (Four Miracles Pill)
Rou Dou Kou (Myristicae Semen, 2 liang, baked and oil removed), Bu Gu Zhi (Psoraleae Fructus, 4 liang), Wu Wei Zi (Schisandrae Fructus, 1 liang), Wu Zhu Yu (Evodiae Fructus, 1 liang, soaked in water and stir-fried).
Form pills with red dates boiled in ginger water (Essential agent for tonifying Ming Men Fire and benefiting Spleen and Kidney).