泻色白者。冷泻也。此由小儿肠胃虚弱。因解脱风冷干之。或因食寒饮冷。入于肠胃。冷气相搏。为下痢
也。其色白面白。或腹痛者。并宜调中。若又伤风冷。前后重沓。冷甚则泻不止。而为泄注也。
泻色赤者。热泻也。此由小儿肠胃本挟虚热。而风冷乘之。入于肠胃之间。热气相搏。而为痢下。故其色赤
也。宜微下之。以导其热。后调其气。
泻色乍赤乍白。或水或谷者。此冷热泻也。由小儿肠胃先因有冷。而复伤热。或先有其热。而复伤冷。肠胃
宿虚。冷热交攻。而为痢下。宜调其冷热。和养其气。
泻色黄赤红黑者。皆热也。赤黑者有毒。并微下之。然后调气。
泻色青。发热有时。睡卧不安者。此惊泻也。小儿粪黄。脾胃土之本色也。色青者。肝木为风。肝木来刑脾
土。宜早治之。不尔。则变
脾风。而发螈 。则难治也。所谓粪青者。须才便下。便色青是也。若初下时黄。良久乃青者非也。小儿安者皆
然。不可认为青粪也。若泻青色白。谷不化者。此谓冷也。宜温补脾胃。发散风冷。
泻酿下色赤白。腹大。上青筋见。发稀饶啼。或吃泥土。时有蛔虫。此疳泻也。宜止泻退疳。(治方具于疳
门之下)。
泻多日。唇口及粪色皆白。粪颇多者。久因成冷。脾胃衰困。恐变脾风发痫。宜以药防备而温养。
补助脾胃。
泻于暑热时多患者。谓时热及饮食皆冷故也。不伤于热。必伤于冷。若伤热伏暑而泻者。则心藏烦热。必小
便不利。清浊不分。泻色赤黄。宜利小便。解暑热。若小便快而泻者。冷泻也。色必青白。谷不化。宜温脾胃止
泻。
泻者不可急以热药止之。多变为痢而下脓血也。当审察冷热证候。详度缓急施治也。
泻下颜色发白的,属于冷泻。这是由于小儿肠胃虚弱,因受风寒侵袭,或因进食寒凉饮食,寒气进入肠胃,冷气相互搏结,导致下痢。其粪便色白、面色苍白,或伴有腹痛的,都适宜调理中焦。如果又感受风冷,前后症状重叠,寒气极盛则腹泻不止,演变为泄注(水样直下)。
泻下颜色发红的,属于热泻。这是由于小儿肠胃本自挟带虚热,风冷之邪乘虚而入,侵入肠胃之间,热气相互搏结,导致痢疾下血,所以粪便颜色发红。适宜轻微通下,以引导热邪外出,随后调理气机。
泻下颜色忽红忽白,或夹杂水液或未消化食物的,属于冷热错杂泻。这是由于小儿肠胃先前已有寒气,又复感热邪;或者先前有热,又复感寒气。肠胃宿有虚弱,冷热之气交相攻击,导致下痢。适宜调和冷热,和养正气。
泻下颜色黄、赤、红、黑的,都属于热证。其中赤色和黑色的含有毒邪,都适宜轻微通下,然后调理气机。
泻下颜色发青,发热有定时,睡眠不安稳的,属于惊泻。小儿正常的粪便是黄色的,这是脾胃土的本色。粪便发青,是因为肝木受风邪影响,肝木克制脾土。应当尽早治疗,否则就会转变为脾风,并引发抽搐(瘛疭),那就难以治疗了。所谓粪青,是指刚排出时就是青色。如果初排时是黄色,过很久才变青的,则不是这种情况。正常的小儿大便都是如此,不能误认为是病态的青粪。如果泻下青色且白色,食物不消化的,这称为冷泻。适宜温补脾胃,发散风冷。
泻下赤白脓血,腹部胀大,上部青筋显露,头发稀疏且多啼哭,或有吃泥土癖好,时有蛔虫排出的,属于疳泻。适宜止泻并消除疳积。(具体治疗方剂详见疳门之下)。
腹泻多日,嘴唇和口角以及粪便颜色皆白,粪便量多的,是因为久病导致成寒,脾胃衰败困顿,恐怕会转变为脾风并发癫痫。适宜用药防备并温养,补助脾胃。
在暑热季节多发的腹泻,是因为时令炎热及饮食皆偏冷的缘故。如果不伤于热,必定伤于冷。如果是伤于热邪、伏暑而导致的腹泻,则心藏烦热,必然小便不利,清浊不分,泻下颜色赤黄,适宜利小便,解除暑热。如果小便通畅而腹泻的,属于冷泻,颜色必为青白,食物不消化,适宜温脾胃止泻。
Stools that are white in color indicate cold diarrhea (Leng Xie). This is caused by the weakness of the infant's intestines and stomach, followed by invasion of wind-cold, or by consuming cold food and drinks. The cold qi enters the intestines and stomach, where cold qi clashes with each other, resulting in dysentery. If the stool and complexion are white, or if there is abdominal pain, regulating the middle jiao (Middle Burner) is appropriate. If wind-cold is additionally contracted, causing symptoms to overlap, severe cold leads to unceasing diarrhea, evolving into profuse watery discharge (Xie Zhu).
Stools that are red in color indicate heat diarrhea (Re Xie). This occurs because the infant's intestines and stomach originally harbor deficient heat, which is exploited by wind-cold invading between the intestines and stomach. Heat qi clashes, leading to bloody dysentery, hence the red color. Mild purgation is suitable to guide out the heat, followed by regulation of qi.
Stools that fluctuate between red and white, or contain water or undigested food, indicate mixed cold-heat diarrhea (Leng Re Xie). This arises when the infant's intestines and stomach previously had cold and were subsequently injured by heat, or previously had heat and were subsequently injured by cold. Due to chronic deficiency in the intestines and stomach, cold and heat attack each other, causing dysentery. It is appropriate to harmonize cold and heat, and nourish the qi.
Stools that are yellow, red, crimson, or black all indicate heat syndromes. Red and black colors imply toxicity; mild purgation is suitable for these, followed by qi regulation.
Stools that are green, accompanied by periodic fever and restless sleep, indicate fright diarrhea (Jing Xie). Normal infant stool is yellow, reflecting the natural color of Spleen-Stomach Earth. Green stool indicates Liver Wood affected by wind, where Liver Wood overacts on Spleen Earth. Early treatment is essential; otherwise, it may transform into Spleen Wind (Pi Feng) and manifest as convulsions (Chi Zong), which becomes difficult to treat. "Green stool" specifically refers to stool that is green immediately upon passage. If stool is initially yellow and turns green only after a long time, it is not pathological green stool. Normal infants exhibit this pattern. However, if the stool is greenish-white and contains undigested food, it is classified as cold. Warming and tonifying the Spleen and Stomach, and dispersing wind-cold are indicated.
Dysentery with mixed red and white pus and blood, distended abdomen, visible superficial veins on the upper body, sparse hair, frequent crying, pica (eating dirt), and occasional expulsion of roundworms indicate malnutrition diarrhea (Gan Xie). Stopping diarrhea and resolving malnutrition are indicated. (See formulas under the Gan section).
Prolonged diarrhea lasting many days, with white lips, mouth corners, and stools, and large volume of stool, results from chronic cold damaging the Spleen and Stomach. There is a risk of transforming into Spleen Wind and epilepsy. Medication should be used to prevent this and to warm and nourish, supplementing the Spleen and Stomach.
Diarrhea occurring frequently during hot summer weather is due to seasonal heat and cold dietary habits. One either suffers from heat or from cold. If injured by heat and latent summer-heat, causing diarrhea, the Heart organ will feel vexed and hot, urination will be obstructed, clear and turbid fluids will mix, and stool will be red-yellow. Promoting urination and resolving summer-heat are indicated. If urination is smooth but diarrhea persists, it is cold diarrhea; the stool will be greenish-white and undigested. Warming the Spleen and Stomach to stop diarrhea is indicated.
For diarrhea, one must not hastily use hot herbs to stop it, as this often transforms into dysentery with pus and blood. One must carefully examine cold and heat patterns and determine the urgency before treating.