脾实生痰滑泄，肾虚气弱多溏，遗精失禁便不藏，温涩相投切当。涩治之法，其理不出
温补
温补于下。但下虚滑泄之证，非独健理坤位，亦宜固守坎宫。盖肾为胃关，关门紧固，则二
便分调，自无不藏之患矣。（王胥山曰∶大便滑泄，亦有因脾湿生痰所致者，宜以二陈治之
。若下元虚弱者，舍温补更无别法矣，故分别言之。慎斋以温补为涩字符机注脚，盖以脾肾
两固则二便均调，启闭有节，自无 溏峻泻关门不禁之患。涩治之要，莫尚于此，与世医之
专用芡实，金樱子、粟壳之类为涩药者，相去远矣。）
痢疾泄痛用通因，验色分明辨久新，寒则当温热当下，有余不足妙如神。通治之法，不
出于泻利二端。若泻利后重逼急，而痛太甚，速去无度，或滞不行，或身热色赤，此等理宜急下
。如不痛者，此乃积也，所有不通旁流之物，俱宜下之，所谓通因通用之法也。若用止药，
则泻愈甚而病愈增矣！至于痢久色白，或兼红色，气息腥秽，身冷脉弱，下泄无度，腹痛喜
按，切忌芩、连、栀、秦、寒凉之剂，急用桂、附、干姜温补为要。若泻久而 溏者，亦宜
加参、苓、山药之类温之。古云诸积诸痛，喜温而恶寒者，斯言信矣。人有贵贱，贵虚而贱
实，尤宜识此。（王胥山曰∶贵者多虚，贱者多实，凡病皆宜识此，不独泻利一证，慎斋特
于此条发其例耳，夫富贵之人多劳其心，又耽嗜好，故有病者，其正气多虚。贫贱之人，只
是劳力，但于风雨寒暑燥湿不能避忌，故其病也，多本邪实，此人事之固然也。若贵者之先
天充实，或者培养得宜，而贱者于劳力之外，兼复劳心，又或纵欲无度，则虚实之形必自相
反，不可执一而论。）
脾脏实证会生痰并导致滑泄，肾脏虚亏、气机虚弱则多出现大便溏薄、遗精及小便失禁等无法固摄的症状，此时采用温补与收敛相结合的方法最为恰当。治疗“涩”证（指滑脱不禁之证）的原则，其机理不出于在下焦进行温补。然而，对于下元虚损导致的滑泄病症，不仅应当健脾（健理坤位），也应当固护肾气（固守坎宫）。因为肾是胃的关口，如果关门紧固，那么大小便就能分别调节自然就不会有无法固摄的隐患了。（王胥山说：大便滑泄，也有因脾湿生痰所致的，适宜用二陈汤治疗。如果是下元虚弱的人，除了温补之外没有别的办法，所以要分别说明。慎斋将温补作为“涩”字的注脚，大概是因为脾肾两脏坚固，则大小便均能调节，启闭有度，自然没有大便溏泻、急迫且关门不紧的隐患。治疗“涩”证的要点，没有比这更重要的了，这与世医专门使用芡实、金樱子、罂粟壳之类的药物作为涩药相比，相差甚远了。）
痢疾伴有腹痛时，应采用“通因通用”的治疗方法，通过观察粪便颜色来明确辨别病程的久暂。属寒证当用温热法，属实证当下法，运用得当妙如神明。治疗“通”证（指通利之法）的原则，不外乎泻法和利法两端。如果在泻利之后仍有里急后重、紧迫感，且疼痛剧烈，或者排泄物无节制地排出，或者积滞不行，或者身体发热、面色红赤，这些情况理应紧急攻下。如果不痛，这是积滞所致，所有不通畅而旁流溢出的物质，都应当攻下，这就是所谓的“通因通用”法则。如果使用止泻药，那么腹泻会更严重，病情也会加重！至于痢疾日久，粪便色白，或兼带红色，气息腥臭，身体寒冷，脉象微弱，下泄无度，腹痛喜欢按压，切忌使用黄芩、黄连、栀子、秦艽等寒凉药剂，应当紧急使用肉桂、附子、干姜进行温补为要。如果腹泻日久且大便溏薄，也应当加入人参、茯苓、山药等药物进行温补。古话说各种积滞和疼痛，喜欢温暖而厌恶寒冷，这话是可信的。人有贵贱之分，贵者多虚而贱者多实，尤其应当认识这一点。（王胥山说：贵人大多体虚，贱人大多邪实，凡是疾病都应当认识到这一点，不仅仅局限于泻利这一病症，慎斋特别在此条中阐发这个例子罢了。富贵之人多用心劳神，又沉溺于嗜好，所以生病时，正气多虚。贫贱之人只是从事体力劳动，但在风雨寒暑燥湿等方面不能避免禁忌，所以他们患病，多为本邪实盛，这是人事的必然规律。如果贵者的先天体质充实，或者调养得当，而贱者在体力劳动之外，又兼用心劳神，或者纵欲无度，那么虚实的情况必定相反，不可固执一端而论。）
Spleen excess generates phlegm and causes slippery diarrhea; Kidney deficiency with weak Qi leads to frequent loose stools, spermatorrhea, and incontinence of urine or feces due to failure of consolidation. The combination of warming and astringent methods is most appropriate. The principle of treating "astringency" (conditions characterized by sliding and uncontrollable discharge) does not go beyond warming and tonifying the lower jiao. However, for conditions of lower yuan deficiency causing slippery diarrhea, it is not only necessary to strengthen the spleen (Jian Li Kun Wei), but also to consolidate the Kidney (Gu Shou Kan Gong). Since the Kidney serves as the gate of the Stomach, if the gate is tightly secured, urination and defecation will be regulated separately, naturally avoiding the hazard of inability to retain fluids and solids. (Wang Xushan said: Slippery stool can also be caused by Spleen dampness generating phlegm, which should be treated with Er Chen Tang. For those with deficiency of the lower origin, there is no method other than warming and tonifying, hence the distinction. Shen Zhai uses warming and tonifying as the footnote for the character "astringent," implying that when both Spleen and Kidney are solidified, urination and defecation are regulated, opening and closing are controlled, thus avoiding hazards such as loose stool, urgent diarrhea, and an unguarded gate. The key to treating "astringency" lies here, far removed from worldly physicians who specifically use herbs like Euryale Semen (Qianshi), Rosa Laevigata Fruit (Jinyingzi), and Poppy Capsule (Suhua) as astringents.)
For dysentery accompanied by abdominal pain, the method of "treating obstruction with unblocking agents" (Tong Yin Tong Yong) should be used. Clearly distinguish between recent and chronic cases by observing the color. If cold, apply warming methods; if excess, apply purgative methods. Applied skillfully, they work like magic. The principles of treating "unblocking" (methods involving purgation or drainage) do not exceed two aspects: purgation and drainage. If after diarrhea or dysentery there is still tenesmus and urgency, with severe pain, or if excretion is excessive without restraint, or if stagnation prevents passage, or if there is fever and redness of the body/face, these situations require immediate purgation. If there is no pain, this indicates accumulation; all substances that are blocked yet leaking out laterally should be purged. This is the so-called "treat obstruction with unblocking agents" method. If astringent medicines are used, diarrhea will worsen and the disease will increase! As for chronic dysentery where the stool is white, or mixed with red, with a fishy odor, cold body, weak pulse, uncontrolled downward discharge, and abdominal pain relieved by pressure, one must strictly avoid cold-cooling agents such as Scutellaria Root (Huangqin), Coptis Rhizome (Huanglian), Gardenia Fruit (Zhizi), and Gentiana Macrophylla Root (Qinjiao). Urgently using Cinnamon Twig (Guizhi), Aconite Root (Fuzi), and Dried Ginger (Ganjiang) for warming and tonifying is essential. If diarrhea persists for a long time with loose stools, adding Ginseng Radix et Rhizoma (Renshen), Poria (Fuling), and Chinese Yam Rhizome (Shanyao) for warming is also appropriate. The ancients said that various accumulations and pains prefer warmth and dislike cold; this statement is credible. People differ in status; the noble tend toward deficiency while the humble tend toward excess. This point deserves special recognition. (Wang Xushan said: Nobles are mostly deficient, while commoners are mostly excess. This applies to all diseases, not just diarrhea and dysentery. Shen Zhai specifically illustrates this example in this section. Rich people often strain their minds and indulge in desires, so when ill, their righteous Qi is mostly deficient. Poor people engage mainly in physical labor but cannot avoid exposure to wind, rain, cold, heat, dryness, and dampness, so their illnesses are mostly rooted in pathogenic excess. This is the natural course of human affairs. However, if nobles have strong congenital constitution or proper nurturing, and commoners, besides physical labor, also strain their minds or indulge in lust without limit, then the forms of deficiency and excess will necessarily reverse. One cannot argue rigidly based on a single standard.)