痰泻者，因痰而致泻也。昔贤云∶脾为生痰之源，肺为贮痰之器。夫痰乃湿气而生，湿由脾弱而起。盖
脾为太阴湿土，得温则健，一被寒湿所侵，遂困顿矣，脾既困顿，焉能掌运用之权衡，则水谷之精微，悉变为
痰。痰气上袭于肺，肺与大肠相为表里，其大肠固者，肺经自病，而为痰嗽；其不固者，则肺病移于大肠，
而成痰泻矣。其脉弦滑之象，胸腹迷闷，头晕恶心，神色不瘁，或时泻，或时不泻是也。宜以化痰顺气法
治之，俾其气顺痰消，痰消则泻自止矣。
（附∶饮泻）
食泻者，即胃泻也。缘于脾为湿困，不能健运，阳明胃腑，失其消化，是以食积太仓，遂成便泻。其
脉气口紧盛，或右关沉滑，其证咽酸嗳臭，胸脘痞闷，恶闻食气，腹痛甚而不泻，得泻则腹痛遂松，当用楂
曲平胃法治之。又有渴能饮水，水下复泻，泻而大渴，名为溢饮滑泻，即《金鉴》中之饮泻，良由水渍于
胃而然，宜用增损胃苓法去浓朴、苍术，加白术、甘草治之。近来之医，饮、食混称者多，岂可不为分别哉！
或问∶先生之书，专为六气而设，今痰泻、食泻，不关六气，亦杂论其中，究系何意？答曰∶痰从湿生，
湿非六气之一乎？食泻即胃泻，胃泄居五泄之一，越人谓湿多成五泄，食泻岂无湿乎？前论飧泄洞泄，皆因伏
气致病，其寒泻因寒，火泻因火，暑泻因暑，湿泻因湿，然痰泻、食泻，虽因痰食，亦难免乎
无湿，而飧、洞寒、火、暑、湿等泻，偶亦有痰食相兼，兼证如文本之搭题，弗宜顾此失彼，医者不可不明。
痰泻，是由于痰湿引起的腹泻。古代贤人曾说：脾是产生痰湿的源头，肺是储存痰湿的器官。痰是由湿气生成的，而湿气源于脾虚。因为脾属于太阴湿土，得到温煦才能健运，一旦受到寒湿侵袭，就会困顿乏力。脾既已困顿，怎能掌管水谷精微运化的权衡？于是水谷的精微物质全部转化为痰。痰气上逆侵犯肺脏，肺与大肠互为表里，如果大肠固摄功能正常，病邪仅在肺经，表现为痰嗽；如果大肠固摄功能不健全，则肺的病邪转移到大肠，形成痰泻。其脉象呈现弦滑之象，伴有胸腹部迷闷、头晕恶心，但神色并未憔悴，时而腹泻，时而不腹泻。应当采用化痰顺气的方法治疗，使气机顺畅、痰湿消除，痰湿消除后腹泻自然停止。
（附注：饮泻）
食泻，就是胃泻。原因是脾被湿气困阻，不能正常运化，阳明胃腑失去消化功能，导致食物积滞在太仓（指胃），从而形成便泻。其脉象在气口部位紧盛，或者右关脉沉滑，症状表现为咽部泛酸、嗳气有臭味，胸脘部痞塞闷胀，厌恶闻到食物的气味，腹痛剧烈但不排便，一旦排便则腹痛随即缓解，应当使用楂曲平胃散进行治疗。又有那种口渴能饮水，但水喝下去后又腹泻，腹泻后更加口渴的情况，称为溢饮滑泻，也就是《医宗金鉴》中提到的饮泻，这完全是由于水液浸渍于胃所致，应当使用增损胃苓汤，去掉厚朴、苍术，加入白术、甘草进行治疗。近来的医生，将饮泻和食泻混为一谈的很多，这怎么可以不加以区分呢！
有人问：先生的著作，专门针对六淫之气而设，如今痰泻、食泻，似乎不直接关联六气，也混杂论述在其中，究竟是何用意？回答说：痰从湿而生，湿难道不是六气之一吗？食泻即胃泻，胃泄居于五泄之一，扁鹊（越人）说湿气多会导致五泄，食泻难道没有湿的因素吗？前文论述飧泄、洞泄，都是因为伏邪致病，寒泻因寒，火泻因火，暑泻因暑，湿泻因湿，然而痰泻、食泻，虽然由痰食引起，但也难免不涉及湿，而飧泄、洞泄、寒泻、火泻、暑泻、湿泻等，偶尔也会有痰食兼夹的情况，兼证就像文章中的搭题一样，不应该顾此失彼，医者不可不明白这个道理。
Tan Xie (Diarrhea due to Phlegm) refers to diarrhea caused by phlegm. Ancient sages stated: "The Spleen is the source of phlegm production, and the Lung is the vessel for storing phlegm." Phlegm arises from dampness, and dampness originates from Spleen deficiency. The Spleen belongs to Taiyin Damp-Soil; it functions well when warmed. Once invaded by cold-dampness, it becomes sluggish and impaired. If the Spleen is impaired, how can it manage the balance of transforming and transporting water and grain? Consequently, the essence and fine nutrients of water and grain are all transformed into phlegm. When phlegm-qi ascends and attacks the Lung, and since the Lung and Large Intestine are exterior-interior partners, if the Large Intestine's consolidation function is intact, the disease remains in the Lung meridian, manifesting as phlegmatic cough; if the consolidation function is not firm, the Lung pathology transfers to the Large Intestine, resulting in Tan Xie (Diarrhea due to Phlegm). The pulse presents a wiry and slippery quality, accompanied by chest and abdominal confusion and stuffiness, dizziness, nausea, yet without emaciation of the spirit or complexion. The patient may experience intermittent diarrhea. Treatment should employ the method of resolving phlegm and smoothing qi. Once qi flows smoothly and phlegm dissipates, the diarrhea will cease spontaneously.
(Attached: Yin Xie - Diarrhea due to Fluid Retention)
Shi Xie (Diarrhea due to Food Stagnation), also known as Wei Xie (Stomach Diarrhea), occurs because the Spleen is constrained by dampness and fails to transport effectively. The Yangming Stomach loses its digestive capacity, leading to food accumulation in the Tai Cang (Great Granary, referring to the Stomach), thereby causing loose stools. The pulse at the Qi Kou position is tight and vigorous, or the Right Guan position is deep and slippery. Symptoms include sour regurgitation, foul belching, chest and epigastric fullness and oppression, aversion to the smell of food, severe abdominal pain that does not relieve with defecation, but relaxes immediately after defecation. One should use Zha Qu Ping Wei San (Hawthorn and Malt Powder to Calm the Stomach) for treatment. There is also a condition where the patient is thirsty and drinks water, but upon drinking, diarrhea ensues, followed by intense thirst again. This is called Yi Yin Hua Xie (Overflowing Fluid Slippery Diarrhea), which corresponds to Yin Xie (Diarrhea due to Fluid Retention) in *Yi Zong Jin Jian* (Golden Mirror of Medicine). It is caused by water soaking the Stomach. Treatment should utilize Zeng Sun Wei Ling Tang (Modified Guizhi Ling Zhu Decoction), removing Hou Po (Magnolia Bark) and Cang Zhu (Atractylodes Rhizome), and adding Bai Zhu (Atractylodes Macrocephala Rhizome) and Gan Cao (Licorice Root). Many recent physicians confuse Yin Xie and Shi Xie; such distinction must not be neglected!
A question was raised: "Your book is specifically designed for the Six Qi (Six Exogenous Pathogens). Now, Tan Xie and Shi Xie do not seem directly related to the Six Qi, yet they are discussed among them. What is the intention?" The answer is: "Phlegm arises from dampness. Is dampness not one of the Six Qi? Shi Xie is Wei Xie, and Wei Xie is one of the Five Xi (Five Types of Diarrhea). Yue Ren (Bian Que) stated that excessive dampness leads to the Five Xi. Does Shi Xie lack dampness? Previously, we discussed Sun Xie (Diarrhea with undigested food) and Dong Xie (Profuse Watery Diarrhea), both caused by latent pathogens. Cold Xie is due to cold, Fire Xie due to fire, Summerheat Xie due to summerheat, and Damp Xie due to dampness. However, although Tan Xie and Shi Xie are caused by phlegm and food, they inevitably involve dampness. Conversely, Sun Xie, Dong Xie, Cold Xie, Fire Xie, Summerheat Xie, and Damp Xie may occasionally have concurrent phlegm and food stagnation. These concurrent syndromes are like supplementary topics in an essay; one should not focus on one aspect while neglecting another. Physicians must understand this clearly."