典藏书目

3. In cases of diarrhea (Xie Xie), if the patient's physical condition is emaciated yet the pulse is large and excess (Shi Da), or if the "Five Deficiencies" (Wu Xu) syndrome occurs accompanied by hiccups/reverse flow of Qi (Yue Ni) and cold hands and feet, along with uncontrolled expulsion of feces from the anus (Da Kong) and simultaneous lower diarrhea and upper cough, such conditions are mostly critical and difficult to cure.
[Note] The "Five Deficiencies" refer to a fine pulse (Mai Xi), cold skin (Pi Han), shortness of breath/lack of Qi (Qi Shao), inability to take in food and fluids (Shui Jiang Bu Ru), and involuntary defecation (Da Bian Bu Jin). "Da Kong" refers to the anus being loose and unable to retain feces.

Ginseng, Poria, and Atractylodes Macrocephala Powder (Shen Ling Bai Zhu San)

4. For diarrhea caused by dampness, use Wei Ling Tang to separate clear from turbid; for diarrhea caused by cold, use Li Zhong Tang with added Fu Zi (Aconite Lateral Root); for undigested stool diarrhea (Sun Xie), use Sheng Yang Yi Wei Tang, doubling the dosage of Bai Shao (White Peony Root) and reducing Huang Lian (Coptis Rhizome); for spleen deficiency diarrhea, use Shen Ling Bai Zhu San, which consists of Dou Bian (Lablab Bean), Si Jun Zi Tang (Four Gentlemen Decoction: Ren Shen, Bai Zhu, Fu Ling, Zhi Gan Cao), Lian Rou (Lotus Seed Flesh), Yi Yi Ren (Coix Seed), Shan Yao (Dioscorea Rhizome), Suo Sha Ren (Amomum Fruit), and Jie Geng (Platycodon Root); for kidney deficiency diarrhea, use Er Shen Wan or Si Shen Wan.
[Note] Shen Ling Bai Zhu San consists of Dou Bian, Ren Shen, Bai Zhu, Fu Ling, Zhi Gan Cao, Lian Rou, Yi Yi Ren, Shan Yao, Suo Sha Ren, and Jie Geng. Er Shen Wan consists of Bu Gu Zhi (Psoralea Fruit) and Rou Dou Kou (Nutmeg). Adding Wu Zhu Yu (Evodia Fruit) and Wu Wei Zi (Schisandra Berry) to this formula creates Si Shen Wan.

Qingliu San (Qingliu San) Peony, Scutellaria, Coptis, and Kudzu Root Decoction (Shao Yao Qin Lian Ge Gen Tang) Bazhu San (Bazhu San)

5. For diarrhea due to food stagnation, apply purgative and digestive methods for excess patterns and digestive methods for deficiency patterns; for diarrhea due to excessive fluid intake, cautiously use Shen You Wan to drain fluid for excess patterns, and use Chun Ze Tang or Gan Lu Yin for deficiency patterns; for diarrhea due to phlegm-fluid retention, apply attacking methods for excess patterns and Liu Jun Zi Tang for deficiency patterns; for fire-induced diarrhea, use a formula containing Gan Cao, Shao Yao, Huang Qin, Huang Lian, and Ge Gen; for summerheat-induced diarrhea, evenly mix Hong Qu (Red Yeast Rice) with Liu Yi San; for slippery/uncontrollable diarrhea, use Bazhu San or Li Zhong Tang with added Fu Zi, and seek收敛 (astringent) herbs such as Yu Ke (Poppy Shell), Wu Mei (Mume Fruit), He Zi (Chebula Fruit), and Rou Kou (Nutmeg).
[Note] For food stagnation diarrhea with robust constitution and Qi, it is appropriate to use Da Cheng Qi Tang or Hua Zhi Tang to purge; for those with deficient constitution and Qi, use Zhi Zhu Wan or Ping Wei San to digest. "Shen You Zhen" implies that although Shen You Wan should be used to drain fluid retention, the dosage must be carefully considered and not excessive. "Chun Ze" refers to Chun Ze Tang. "Gan Lu Yin" refers to Wu Ling Gan Lu Yin. Shao Yao Qin Lian Ge Gen Tang consists of Gan Cao, Shao Yao, Huang Qin, Huang Lian, and Ge Gen. Qingliu San is Liu Yi San added with Hong Qu. Bazhu San is Fu Zi Li Zhong Tang added with Ying Su Ke, Wu Mei, He Zi, and Rou Dou Kou.

Xixin Daochi San (Xixin Daochi San) Poria and Plantago Seed Drink (Fu Ling Che Qian Zi Yin) Poria, Cinnamon Twig, and Li Zhong Decoction (Ling Gui Li Zhong Tang)

6. Mouth ulcers and erosion accompanied by diarrhea, although described as heat syndromes, involve deficiency when symptoms shift between upper and lower parts. The heart opens into the tongue, and the spleen opens into the mouth. Pathologies of the stomach and small intestine lead to loss of their functional roles, resulting in erosion. For upper mouth erosion, use Di Huang, Tong Cao, Huang Lian, and Gan Cao; for lower diarrhea, Shen Ling Bai Zhu San is suitable. For scanty urine, use Fu Ling Che Qian Zi Yin. For fire-deficiency patterns, treat with Ling Gui Li Zhong Tang.
[Note] The syndrome of mouth ulcers/erosion with diarrhea is not recorded in ancient classics. By reasoning, although it is attributed to heat, the alternating occurrence of upper mouth erosion and lower diarrhea suggests that pure excess heat is likely involved. The heart's orifice opens to the tongue, and the spleen's orifice opens to the mouth. Heat from the heart and spleen causes upper mouth and tongue sores, redness, and erosion. The stomach governs the digestion of water and grain, and the small intestine governs reception and digestion. When heart-spleen heat shifts downward to the stomach and intestines, the function of transportation and transformation is lost, leading to downward pouring and diarrhea. During mouth erosion episodes, administer Xixin Daochi San at night, steeped in boiling water; this formula contains Di Huang, Mu Tong, Huang Lian, and Gan Cao Shao (tip of Licorice Root). During lower diarrhea episodes, administer Shen Ling Bai Zhu San morning and evening, taken with glutinous rice decoction. If urine is very scanty and dysentery does not cease, it indicates water flowing into the large intestine; use equal parts of Fu Ling and Che Qian Zi, decocted as tea to be drunk frequently, to promote urination and guide out heat. If cold-cooling herbs are ineffective for mouth ulcers, it indicates floating deficiency fire; use Li Zhong Tang with added Rou Gui (Cinnamon Bark) and double the amount of Fu Ling to descend Yang and promote urination. Descending Yang eliminates mouth erosion naturally, and promoting urination stops diarrhea naturally, allowing both to heal simultaneously.