论泻疾证候 暴泻水泻，此二证秋、夏间多有之，皆因饮食所伤，及食生冷之物，暴泻
不住，须用仔细询问。若噫气吞酸，干呕气臭者，此是伤食也，可先与感应丸一、二服，次
与理中丸、人参豆蔻散、守中金丸、来复丹、温胃丸（以上药性皆温），甚者与附子理中丸、
理中丸、四柱散、已寒丸、温中良姜丸、二姜丸、火轮散、朝真丹、正元散、金液丹、二
气丹（以上药性皆热）、丁香豆蔻散（微热涩固）。须用仔细审实，无伤食者，不可与感应
丸，便用止泻药。吐泻有腹痛者，可与服木香推气丸、沉香丸、丁香丸、感应丸。久病虚弱、
年高及气弱人，脏腑泄泻久不止者，可与人参豆蔻散、浓肠丸、参苓白术散、不换金正气散
、四君子汤之类。
论霍乱吐泻证 霍乱吐泻，有冷热二证。寒多不渴者，可与理中丸、姜附汤、来复丹。
霍乱吐泻，有热烦躁而渴者，可服香薷散、五苓散、嘉禾散、参苓白术散、四君子汤。霍乱
吐泻后，调理脾胃，可与参苓白术散、嘉禾散、五苓散、四君子汤、调气散之类。渴者，与
参苓白术散止之，多服尤佳。出冷汗，手足软者，加金液丹、二气丹、朝真丹。未效者，灸
气海。若吐泻定，热药皆止，只用温药理脾。
论痢疾证候 皆因饮食失调，动伤脾胃，水谷相拌，运化失宜，留而不利，冷热相搏，
遂成痢疾。冷气相搏其色白，热气相搏其色赤，治之法，皆用温药调和脾胃，次随证治之。
大抵人说证，须用仔细询问，有里急后重者，腹痛者或不痛者，频频登厕，一日三、五次
至五、七次无物者。又说大便不通，既里急后重，脐腹痛不止，不问老少、孕妇，皆是痢也
。非无物出，不识此证，只言大便不通，可仔细辨之。病患登厕，才有三、两点物，或赤或
白，或如鱼脑者，此皆痢证也。凡痢下赤白，或纯脓，或 溏，若先脐腹撮痛，遇痛即痢下
，下后痛止者，此为积痢，可与木香推气丸、感应丸，各进两、三服，次随痢颜色治之。下
痢赤白，可与驻车丸、黄连阿胶丸、浓肠丸、胃风汤。下痢白多赤少者，与浓肠丸、驻车丸
、人参豆蔻散。下痢白少赤多者，与黄连阿胶丸、万金丸、金屑丸。下痢纯赤或鲜血者，可
与服黄连阿胶丸、地榆散、万金饮，加麦门冬子煎。纯血痢，须是审问仔细，若下鲜血者，
是有热，遇下痢时，微觉后重者，是有热也。下痢纯白滑泄者，此是冷证，可与丁香豆蔻散
、诃黎勒丸、驻车丸。若下瘀血或紫黑色者，此是虚冷之甚，遇痢下时微滑，当与驻车丸、
浓肠丸、丁香豆蔻散。痢下赤白，连绵日久，愈而复发，腹中时痛，诸药不瘥者，可与木香
推气丸、不二丸、驻车丸、浓肠丸、感应丸。下痢日夜频并虚滑者，可与丁香豆蔻散、四柱
散相兼服。更有一种脾毒下血，与热毒痢一般证候，但不心烦，口不干渴，不喜冷，余者相
似，可与《王氏博济方》内败毒散，以槐花、枯矾二味为末，乌梅煎服。若只下痢，脐腹不
撮痛者，乃无积滞，不须先服感应丸。
论肠风、痔 证 肠风下血，脏毒下血，或秘有热者，可与三黄丸、黄连阿胶丸，浓煎
木香汤吞下。有热者，与鸡苏丸、肠风黑散、金屑丹、万应丸、四物汤，加荆芥并防风煎。
诸痔发作，与钓肠丸。未破者，驱毒散，更用猪胆汁涂之。
论泄泻证候：暴泻和水泻，这两种证候在夏秋季节较为常见，多因饮食损伤，以及食用生冷食物所致。表现为突然剧烈腹泻不止，需要仔细询问病史。如果伴有嗳气吞酸、干呕且气味臭秽，这是伤食（饮食积滞）的表现，可先服用一两服感应丸，随后再服用理中丸、人参豆蔻散、守中金丸、来复丹、温胃丸（以上药物药性均属温热）；病情严重者，可服用附子理中丸、理中丸、四柱散、已寒丸、温中良姜丸、二姜丸、火轮散、朝真丹、正元散、金液丹、二气丹（以上药物药性均属大热）、丁香豆蔻散（药性微热，具有收敛固涩作用）。必须仔细审察确认，若无伤食情况，不可使用感应丸，应直接使用止泻药物。若呕吐腹泻伴有腹痛者，可服用木香推气丸、沉香丸、丁香丸、感应丸。对于久病体虚、年老及气弱之人，脏腑泄泻长期不止者，可服用人参豆蔻散、浓肠丸、参苓白术散、不换金正气散、四君子汤等方剂。
论霍乱吐泻证：霍乱引起的呕吐和腹泻，分为寒证和热证两种。寒证较多且不口渴者，可服用理中丸、姜附汤、来复丹。霍乱吐泻，若伴有热象、烦躁且口渴者，可服用香薷散、五苓散、嘉禾散、参苓白术散、四君子汤。霍乱吐泻后，调理脾胃，可服用参苓白术散、嘉禾散、五苓散、四君子汤、调气散等方剂。若有口渴症状，用参苓白术散治疗以止渴，多服用效果更佳。若出现冷汗、手足软弱无力者，加服金液丹、二气丹、朝真丹。若无效，可艾灸气海穴。若吐泻停止，热性药物均停用，仅用温性药物调理脾脏。
论痢疾证候：皆因饮食失调，损伤脾胃，水谷混杂，运化功能失常，留滞体内而排泄不畅，冷热邪气相互搏结，遂形成痢疾。冷气相搏则大便色白，热气相搏则大便色赤。治疗方法上，均先用温性药物调和脾胃，随后根据具体证候进行治疗。大体上说，诊断此类病症，必须仔细询问：是否有里急后重（腹痛窘迫，时时欲便，肛门重坠，便出不爽）、腹痛或不痛、频繁登厕、一日三至五次甚至五至七次却无物排出的情况。又说大便不通，既然有里急后重、脐腹部疼痛不止，无论老少、孕妇，都是痢疾。并非没有东西排出，若不识别此证，只说是大便不通，需仔细辨别。患者登厕时，仅有两三滴粪便，或红或白，或如鱼脑状，这些都是痢疾的证候。凡痢下赤白相间，或纯为脓液，或稀溏，若先感到脐腹撮痛，遇痛即下痢，下后疼痛停止者，此为积痢，可服用木香推气丸、感应丸，各进两至三服，随后根据痢疾的颜色进行治疗。下痢赤白相间者，可服用驻车丸、黄连阿胶丸、浓肠丸、胃风汤。下痢白多赤少者，服用浓肠丸、驻车丸、人参豆蔻散。下痢白少赤多者，服用黄连阿胶丸、万金丸、金屑丸。下痢纯赤或鲜血者，可服用黄连阿胶丸、地榆散、万金饮，加麦门冬子煎煮服用。纯血痢，须仔细审问，若下鲜血者，是有热邪；在下痢时，微微感觉后重者，也是有热邪。下痢纯白滑泄者，这是冷证，可服用丁香豆蔻散、诃黎勒丸、驻车丸。若下瘀血或紫黑色者，这是虚冷至极，下痢时轻微滑利，应当与驻车丸、浓肠丸、丁香豆蔻散同服。痢下赤白，连绵日久，痊愈后复发，腹中时常疼痛，诸药不效者，可服用木香推气丸、不二丸、驻车丸、浓肠丸、感应丸。下痢日夜频繁且虚滑者，可服用丁香豆蔻散、四柱散交替服用。还有一种脾毒下血，证候与热毒痢相似，但不心烦，口不干渴，不喜欢冷饮，其余症状相似，可服用《王氏博济方》中的败毒散，以槐花、枯矾两味药研为末，用乌梅煎汤送服。若只是下痢，脐腹部没有撮痛感，说明无积滞，不需要先服用感应丸。
论肠风、痔证：肠风下血、脏毒下血，或便秘有热者，可服用三黄丸、黄连阿胶丸，用浓煎的木香汤送服。有热邪者，服用鸡苏丸、肠风黑散、金屑丹、万应丸、四物汤，加荆芥并防风煎煮服用。各种痔疮发作，服用钓肠丸。未破溃者，服用驱毒散，并用猪胆汁涂抹患处。
Discussion on Diarrhea Syndromes: Sudden watery diarrhea and water-like diarrhea are common in summer and autumn, mostly caused by dietary injury and consumption of raw or cold foods. The manifestation is sudden, severe, and incessant diarrhea, requiring careful inquiry into the medical history. If accompanied by belching with acid regurgitation, dry heaving, and foul odor, this indicates food stagnation (accumulation of undigested food). One may first administer one or two doses of Yinggan Wan (Miracle Response Pill), followed by Lizhong Wan (Regulate the Middle Pill), Renshen Doukou San (Ginseng and Cardamom Powder), Shouzhong Jin Wan (Guard the Center Gold Pill), Laifu Dan (Restore Life Elixir), or Wenyi Wan (Warm the Stomach Pill) (all above medicines have warm properties); for severe cases, Fuzi Lizhong Wan (Aconite Regulate the Middle Pill), Lizhong Wan, Sizhu San (Four Pillars Powder), Yihan Wan (Eliminate Cold Pill), Wenzhong Liangjiang Wan (Warm Middle Galangal Pill), Erjiang Wan (Two Gingers Pill), Huolun San (Fire Wheel Powder), Chaozhen Dan (Pay Homage to Truth Elixir), Zhengyuan San (Correct Origin Powder), Jinye Dan (Golden Fluid Elixir), Erqi Dan (Two Qi Elixir) (all above medicines have hot properties), or Dingxiang Doukou San (Clove and Cardamom Powder) (slightly hot with astringent and consolidating effects) may be used. Careful examination is essential; if there is no food stagnation, Yinggan Wan should not be given, and antidiarrheal medicines should be used directly. For vomiting and diarrhea accompanied by abdominal pain, Muxiang Tuiqi Wan (Costus Directing Qi Pill), Chenxiang Wan (Agarwood Pill), Dingxiang Wan (Clove Pill), or Yinggan Wan may be administered. For patients with chronic illness, weakness, advanced age, or deficient qi, who suffer from persistent visceral diarrhea, Renshen Doukou San, Nongchang Wan (Thick Intestine Pill), Shenling Baizhu San (Ginseng, Poria, and Atractylodes Macrocephala Powder), Buhuanjin Zhengqi San (Unchanging Metal Correct Qi Powder), or Sijunzi Tang (Four Gentlemen Decoction) may be prescribed.
Discussion on Cholera-like Vomiting and Diarrhea Syndromes: Vomiting and diarrhea associated with cholera (Huo Luan) present as either cold or heat syndromes. In cases dominated by cold without thirst, Lizhong Wan, Jiangfu Tang (Ginger and Aconite Decoction), or Laifu Dan may be given. For cholera-like vomiting and diarrhea with heat signs, restlessness, and thirst, Xiangru San (Elsholtzia Powder), Wuling San (Five Ling Powder), Jiahe San (Harvest Abundance Powder), Shenling Baizhu San, or Sijunzi Tang may be taken. After cholera-like vomiting and diarrhea, to regulate the spleen and stomach, Shenling Baizhu San, Jiahe San, Wuling San, Sijunzi Tang, or Tiaoqi San (Regulate Qi Powder) may be used. For thirst, Shenling Baizhu San can be used to alleviate it; prolonged use is particularly beneficial. In cases of cold sweat and softness of the hands and feet, add Jinye Dan, Erqi Dan, or Chaozhen Dan. If ineffective, moxa acupuncture may be applied to Qihai (CV-6). Once vomiting and diarrhea cease, hot-natured medicines should be stopped, and only warm-natured medicines should be used to tonify the spleen.
Discussion on Dysentery Syndromes: These arise from dietary irregularity damaging the spleen and stomach, causing mixing of water and grain, dysfunction of transformation and transportation, retention within the body leading to difficult evacuation, and the interplay of cold and heat pathogens, resulting in dysentery. When cold qi interacts, the stool is white; when heat qi interacts, the stool is red. The treatment principle involves first using warm medicines to harmonize the spleen and stomach, followed by syndrome-specific treatment. Generally, diagnosis requires careful inquiry regarding tenesmus (urgent desire to defecate with heavy sensation in the anus), abdominal pain (or lack thereof), frequent visits to the toilet, passing three to five times up to five to seven times daily with little or no output. It is also noted that constipation combined with tenesmus and unceasing periumbilical abdominal pain indicates dysentery in both young and old, including pregnant women. It is not merely "no stool"; failing to recognize this syndrome leads to misdiagnosis as simple constipation, so careful differentiation is needed. When a patient visits the toilet and passes only a few drops of stool, which may be red, white, or resemble fish brains, these are all signs of dysentery. For dysentery with mixed red and white discharge, or pure pus, or loose stools, if preceded by cramping periumbilical pain that ceases after defecation, this is accumulation dysentery. Muxiang Tuiqi Wan and Yinggan Wan may be given, two to three doses each, followed by treatment based on the color of the discharge. For mixed red and white dysentery, Zhuche Wan (Park the Cart Pill), Huanglian Ejiao Wan (Coptis and Donkey-hide Gelatin Pill), Nongchang Wan, or Weifeng Tang (Stomach Wind Decoction) may be used. For dysentery with more white than red discharge, Nongchang Wan, Zhuche Wan, or Renshen Doukou San may be prescribed. For dysentery with less white than red discharge, Huanglian Ejiao Wan, Wanjin Wan (Ten Thousand Gold Pill), or Jinxie Wan (Gold Dust Pill) may be used. For pure red or fresh blood dysentery, Huanglian Ejiao Wan, Diyue San (Sanguisorba Powder), or Wanjin Yin (Ten Thousand Gold Drink) decocted with Maidongzi (Ophiopogon seeds) may be administered. Pure blood dysentery requires careful inquiry; fresh blood indicates heat. A slight sensation of tenesmus during defecation also indicates heat. Pure white slippery discharge indicates a cold syndrome; Dingxiang Doukou San, Helile Wan (Terminalia Pill), or Zhuche Wan may be given. If dark clots or purple-black blood are passed, indicating extreme deficiency-cold, with slight slipperiness during defecation, Zhuche Wan, Nongchang Wan, and Dingxiang Doukou San should be used. For chronic mixed red and white dysentery that recurs, with intermittent abdominal pain and resistance to various medicines, Muxiang Tuiqi Wan, Bu'er Wan (Not Two Pill), Zhuche Wan, Nongchang Wan, or Yinggan Wan may be prescribed. For frequent day-and-night dysentery with deficiency and slipperiness, Dingxiang Doukou San and Sizhu San may be taken alternately. Another type is spleen-toxin bleeding, presenting similarly to heat-toxin dysentery but without mental restlessness, dry mouth/thirst, or aversion to cold drinks; for this, Baidu San (Resist Toxin Powder) from *Wangshi Boji Fang* may be used, with Huaihua (Sophora flower) and Kufan (Alum) ground into powder and taken with Wu Mei (Mume fruit) decoction. If there is only dysentery without periumbilical cramping pain, there is no accumulation, and Yinggan Wan is unnecessary initially.
Discussion on Intestinal Wind and Hemorrhoid Syndromes: For intestinal wind bleeding, organ toxin bleeding, or constipation with heat, Sanhuang Wan (Three Yellow Pill) or Huanglian Ejiao Wan may be taken, swallowed with thickly decocted Muxiang Tang (Costus Decoction). For heat syndromes, Jisu Wan (Chicken Mint Pill), Changfeng Heisan (Intestinal Wind Black Powder), Jinxie Dan, Wanying Wan (Universal Response Pill), or Siwu Tang (Four Substances Decoction) decocted with Jingjie (Schizonepeta) and Fangfeng (Saposhnikovia) may be used. For various hemorrhoid flare-ups, Diaochang Wan (Hook Intestine Pill) may be administered. For unruptured hemorrhoids, Qudu San (Drive Out Toxin Powder) may be used, along with topical application of pig bile.