典藏书目

The *Yellow Emperor's Inner Canon* states: "The cold and heat of food and drink, if affected by pathogenic factors, will harm the six fu organs." It also says: "When deficient evil (Xu Xie) invades the human body, if it remains and does not depart, it transmits and lodges in the intestines and stomach. If there is excessive cold, there will be borborygmus (intestinal rumbling) and diarrhea with undigested food; if there is excessive heat, there will be diarrhea." Chen Feixia said: "The root of diarrhea lies invariably in the damage to the Spleen and Stomach. The Stomach is the sea of water and grain, while the Spleen governs transformation and transportation. If the Spleen is healthy and the Stomach harmonious, then water and grain can be decomposed and transformed into Qi and Blood, thereby circulating Ying (Nutrient) and Wei (Defensive) Qi. However, if dietary habits are irregular, and cold and warmth are unregulated, leading to injury of the Spleen and Stomach, then water turns into dampness, and grain turns into stagnation. The essence of Qi cannot be transported and transformed, causing turbid matter to descend, thus resulting in diarrhea. Whenever there is diarrhea with borborygmus but no abdominal pain, it belongs to Dampness, and drying and leaching methods should be used. When food entering the stomach is not retained, or when undigested food appears in the stool, this indicates Qi Deficiency, and warming and tonifying methods should be used. When there is abdominal pain with borborygmus, where pain occurs in bursts followed by diarrhea, this belongs to Fire, and clearing heat and promoting diuresis methods should be used. When diarrhea comes and goes, with varying amounts, this indicates Phlegm accumulation, and resolving phlegm methods should be used. When abdominal pain is severe followed by diarrhea, and pain decreases after defecation, this is Food Stagnation, and resolving methods should be used; for those with strong constitution, purging methods should be used. If Pi Xie (Spleen Diarrhea) has persisted for a long time and the Large Intestine fails to secure, astringent methods should be used; if Yuan Qi (Original Qi) has sunk, lifting methods should be used.

Diarrhea is categorized into five types: Cold, Heat, Deficiency, Excess, and Food Stagnation. However, one must distinguish based on the color of the excrement. Sudden, violent diarrhea with tenesmus belongs to Fire; clear watery stools belong to Cold. Dark yellow indicates Excess-Heat in the Heart, Spleen, and Lung, requiring clearing and resolving methods; pale yellow indicates Deficient-Heat, requiring harmonizing and tonifying methods; green indicates Cold, requiring warming methods; white indicates Spleen Deficiency, requiring tonification. Sauce-colored stool indicates Dampness; sour and rancid odor indicates Food Injury, requiring resolving methods. For diarrhea caused by Spleen Earth Deficiency, characterized by white or undigested food in the stool, or clear watery stools, accompanied by mental fatigue, pale lips and tongue, and warm breath, Lizhong Tang (Regulate the Middle Decoction) or Liu Junzi Tang (Six Gentlemen Decoction) should be used. For diarrhea caused by Heat patterns, characterized by sudden, violent diarrhea (excretion is abundant and rapid), yellow urine, steaming hot breath, irritability, thirst, and poor appetite, Wuling San (Five-Ingredient Powder with Poria) added with Gardenia Seed (Zhi Ren) should be used. For cases of Food Injury and stagnant diarrhea, characterized by belching with sour odor, acid regurgitation, abdominal distension, pain immediately preceding diarrhea, and pain relief after defecation, Baohe Wan (Preserve Harmony Pill) should be used to resolve stagnation. If the food has been digested and pain has ceased, yet diarrhea persists, this indicates that the Clear Yang Qi of the Spleen fails to ascend, and Qi Deficiency with sinking; Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) should be used. For Wind Diarrhea, characterized by thick, sticky green stools, indicating Liver Wood overacting on Spleen Earth, Liu Junzi Tang (Six Gentlemen Decoction) added with Saposhnikovia Root (Fang Feng), Bupleurum Root (Chai Hu), and White Peony Root (Bai Shao) should be used. For Damp Diarrhea, characterized by borborygmus in the abdomen, no abdominal pain, heavy body, and watery diarrhea, or mixed wind-damp causing water and grain to mix, Shengyang Chushi Tang (Raise Yang and Expel Dampness Decoction) should be used. For any severe diarrhea causing thirst, regardless of whether it is new or chronic, Qiwei Baizhu San (Seven-Ingredient Atractylodes Macrocephala Powder) should be used to generate fluids. Baizhu San is considered the sacred medicine for treating diarrhea with thirst. If thirst is severe, it should be taken as tea frequently. Do not consume additional soups or waters simultaneously, otherwise, it will be ineffective. For chronic diarrhea that has not stopped and is about to develop into Gan Syndrome (Infantile Malnutrition), Shenling Baizhu San (Ginseng, Poria, and Atractylodes Macrocephala Powder) added with roasted Myristica Seed (Rou Dou Kou) and Chinese Yam (Huai Shan Yao), ground into powder and taken daily, will naturally stop the diarrhea and generate fluids, preventing the development of Gan Syndrome. Chronic diarrhea often belongs to Deficient-Cold; Shenling Baizhu San added with roasted Myristica Seed made into pills should be taken, which will naturally stop the diarrhea. The *Inner Canon* states: "Death occurs in the Five Deficiencies: First, fine pulse; second, cold skin; third, shortness of breath; fourth, incessant diarrhea; fifth, inability to eat. If all five deficiencies are present, death ensues; if the patient can eat, life is preserved. Incessant diarrhea with poor spirit indicates Spleen Failure. Vomiting and diarrhea with deep red lips indicate Internal Heat. If the complexion does not recede, death ensues; black complexion with panting indicates death; involuntary urination indicates Exhaustion of Kidney Qi.

Zhou Mengjue said: The *Nan Jing* instructs that there are five types of diarrhea: Wei Xie (Stomach Diarrhea) presents with undigested food. Pi Xie (Spleen Diarrhea) presents with abdominal distension and vomiting. Da Chang Xie (Large Intestine Diarrhea) presents with urgency after eating, which can be discussed under Spleen Diarrhea. Xiao Chang Xie (Small Intestine Diarrhea) presents with bloody stool and abdominal pain. Da Jia Xie (Great Mass Diarrhea) presents with frequent trips to the toilet without passage, which should be discussed under the Dysentery category. Thus, diarrhea can be discussed regarding the Spleen and Stomach meridians. If the pulse is rapid and the pathogen comes from outside, it belongs to the Stomach, transforming into Heat. Mild cases use Coptis Rhizome (Huang Lian) and Magnolia Bark (Hou Po), assisted by herbs that promote diuresis and harmonize the Stomach. As for undigested food, this is a severe form of diarrhea; Mangxiao (Mirabilite) and Rhubarb (Da Huang) must be used to purge the pathogen, and the diarrhea will stop. If the pulse is slow and the deficiency arises from within, it belongs to the Spleen, accumulating as Cold. Mild cases use stir-fried Atractylodes Macrocephala Rhizome (Jiao Zhu) to harmonize the middle, assisted by herbs that dry dampness and tonify the Spleen. As for distension, fullness, and vomiting, this is a severe form of diarrhea; Prepared Aconite Root (Fu Pian) and Dried Ginger (Gan Jiang) must be used to warm the Cold, and the diarrhea will be eliminated. The rest is omitted.

Zhongjing's Lizhong Tang (Regulate the Middle Decoction): Ginseng (1 qian), Licorice Root (Gan Cao, 1 qian), Atractylodes Macrocephala Rhizome (Bai Zhu, 1 qian), Dried Ginger (Gan Jiang, 1 qian). If there is throbbing above the navel, indicating Kidney Qi movement, remove Bai Zhu and add Cinnamon Twig (Rou Gui). If vomiting is excessive, remove Bai Zhu and add Fresh Ginger (Sheng Jiang). If palpitations occur, add Poria (Fu Ling). If abdominal fullness occurs, add Prepared Aconite Root (Fu Zi). About half an hour after taking the decoction, drink about one sheng of hot porridge.

Liu Junzi Tang (Six Gentlemen Decoction) (See previous cough formula).

Wuling San (Five-Ingredient Powder with Poria) (See previous cough formula).

Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction): Astragalus Root (Huang Qi, 1 qian), Ginseng (1 qian), Honey-fried Licorice Root (Zhi Cao, 1 qian), Atractylodes Macrocephala Rhizome (Bai Zhu, 1 qian), Angelica Sinensis Root (Dang Gui, 1 qian), Tangerine Peel (Chen Pi, 7 fen), Cimicifuga Rhizome (Sheng Ma, 5 fen), Bupleurum Root (Chai Hu, 1 qian), Fresh Ginger (Sheng Jiang, 1 qian), Jujube (Da Zao, 1 piece).

*Jicheng* Shengjiang Chushi Tang (Raise and Descend to Expel Dampness Decoction): Cimicifuga Rhizome (Sheng Ma, 5 fen), Bupleurum Root (Chai Hu, 1 qian), Medicated Leaven (Shen Qu, 1 qian), Saposhnikovia Root (Fang Feng, 1 qian), Alisma Rhizome (Ze Xie, 1 qian), Polyporus (Zhu Ling, 1 qian), Tangerine Peel (Chen Pi, 7 fen), Atractylodes Lancea Rhizome (Cang Zhu, 1 qian), Honey-fried Licorice Root (Zhi Gan Cao, 1 qian), Fresh Ginger (Sheng Jiang, 1 qian), Jujube (Da Zao, 1 piece). Decoct in water and take orally. If there is Stomach Cold with borborygmus, add Alpinia Oxyphylla Fruit (Yi Zhi Ren) and Pinellia Tuber (Ban Xia), each 1 qian.

*Jicheng* Qiwei Baizhu San (Seven-Ingredient Atractylodes Macrocephala Powder): Ginseng (1 qian), Atractylodes Macrocephala Rhizome (Bai Zhu, 1 qian), Poria (Fu Ling, 1 qian), Costus Root (Guang Mu Xiang, 6 fen), Agastache Leaf (Huo Xiang Ye, 1 qian), Kudzu Root (Fen Ge Gen, 1 qian), Licorice Root (Gan Cao, 1 qian, honey-fried).

Mengjue's Wuling San: Stir-fried Atractylodes Macrocephala Rhizome (Jiao Zhu, 1 qian), Poria (Fu Ling, 1 qian), Cinnamon Twig (Gui Zhi, 1 qian), Coptis Rhizome (Huang Lian, 7 fen), Alisma Rhizome (Ze Xie, 1 qian), Polyporus (Zhu Ling, 1 qian), Plantago Seed (Che Qian Zi, 1 qian), Coix Seed (Yi Yi Ren, 1 qian).

Mengjue's Yinhuang San: Treats severe heat diarrhea. Honeysuckle Flower (Yin Hua, 1 qian), Rhubarb (Da Huang, 1 qian), Mirabilite (Mang Xiao, 1 qian), Honey-fried Licorice Root (Zhi Gan Cao, 1 qian), Fresh Ginger (Sheng Jiang, 1 qian), Jujube (Da Zao, 1 piece).

Mengjue's Wenzhong Tang: Astragalus Root (Huang Qi), Atractylodes Macrocephala Rhizome (Bai Zhu), Poria (Fu Ling), Lotus Seed (Lian Zi Rou), each 1 qian; Processed Pinellia Tuber (Fa Ban Xia, 7 fen); Chebula Fruit (He Zi, 7 fen); Tangerine Peel (Chen Pi, 5 fen); Coix Seed (Yi Mi Ren, 1 qian); Fresh Ginger (Sheng Jiang, 1 qian); Jujube (Da Zao, 1 piece).

Mengjue's Fuzi Lizhong Tang: Treats severe cold diarrhea. Astragalus Root (Huang Qi, 1 qian), Prepared Aconite Root (Fu Pian, 3 fen), Dried Ginger (Gan Jiang, 6 fen), Stir-fried Atractylodes Macrocephala Rhizome (Jiao Zhu, 1 qian), Cinnamon Bark (Rou Gui, 5 fen), Lotus Seed (Lian Zi Rou, 1 qian), Honey-fried Licorice Root (Zhi Gan Cao, 1 qian), Fresh Ginger (Sheng Jiang, 1 qian), Jujube (Da Zao, 1 piece).

Tu Weisheng said: Regarding Chen Feixia's discussion of syndromes and treatments in this section, except for his misunderstanding that Wuling San is not a specific formula for treating Heat-pattern vomiting and diarrhea, and the repetition in wording, it is relatively accurate compared to previous texts. However, he describes undigested food as Deficient-Cold, while Zhou Mengjue describes undigested food as Excess-Heat. Are they contradictory? I say no. Excessive Stomach Heat can also force undigested food to pass directly through, but this situation must also present external heat signs externally, accounting for only about 1-2% of cases. Zhou Mengjue subsequently wrote about Deficient-Cold diarrhea below, intending to detail what others omitted. Furthermore, Kidney Water Deficiency in Shaoyin can also cause diarrhea, which is something physicians must know. In the summer of the 14th year of the Republic of China, I treated an infant with diarrhea in Xinyang. Continuous administration of Ginseng and Atractylodes was ineffective. I reasoned that diarrhea damages Yin, so I used Zhibai Dihuang Tang (Anemarrhena, Phellodendron, and Rehmannia Decoction), which achieved remarkable results. Later, due to my temporary absence, the parents, anxious for the child's recovery, consulted another physician who administered Fuzi Lizhong Tang. The child died after taking it in the evening. This demonstrates that diarrhea is not solely attributed to the Spleen and Stomach. Initially, the fault lies in the Spleen and Stomach, but prolonged diarrhea can affect Kidney Yin. Since Kidney Yin is located inferiorly, and diarrhea flows downward, once Kidney Yin is damaged, it should be nourished. Knowing only to regulate the Spleen is gaining half and losing half. Otherwise, although Ginseng and Atractylodes have been taken several times without major effect, surely there would be some minor effect. The complete lack of efficacy now indicates that the Deficient-Heat of Kidney Yin, suppressed by the tonification of Spleen Earth, forces the Deficient Fire to flare upward, causing the fluids and grains that were about to transform into Jin-Ye (Body Fluids) to continue flowing downward. Initially, the Spleen and Stomach affected the Kidney Yin; ultimately, the Kidney Yin affects the Spleen and Stomach. Such a slight difference requires caution. Additionally, for watery diarrhea, Weiling Tang (Poria and Magnolia Decoction) is highly adoptable.

Weiling Tang: Atractylodes Macrocephala Rhizome (Bai Zhu, 1 qian), Poria (Fu Ling, 1 qian), Polyporus (Zhu Ling, 1 qian), Alisma Rhizome (Ze Xie, 1 qian), Cinnamon Twig (Gui Zhi, 5 fen), Magnolia Bark (Chuan Pu, 6 fen), Tangerine Peel (Chen Pi, 6 fen), Atractylodes Lancea Rhizome (Cang Zhu, 5 fen), Licorice Root (Gan Cao, 1 qian).