泄本属湿，然多因饮食不节，致伤脾胃而作。须看时令，分寒热、新久而施治。治法∶补脾消食、利
小便。亦有升提下陷之气，用风药以胜湿；亦有久泄肠胃虚滑不禁者，宜收涩之。
主方
白术（二钱） 白茯苓 白芍药（炒，各一钱五分） （以上三味乃泄泻必用者）
陈皮（一钱） 甘草（炙，五分）
若伤食泻黄，或食积，加神曲、麦芽、山楂各一钱，黄连（炒）七分。若腹中窄狭，再加
浓朴、枳实以消停滞。
愚按前症若饮食已消而泄泻未止，此脾胃之气伤也，宜用五味异功散；若泄泻而腹中重坠，此脾胃之
气下陷也，宜用补中益气汤；若服克滞之剂而腹中窄狭，此脾气虚痞也，宜用六君子汤；若胁胀少食，善
怒，泻青，此脾虚肝所乘也，宜六君子加柴胡、升麻、木香；若少食体倦，善噫，泄黄，此脾虚色陷也，宜
用六君子加升麻、柴胡。大凡诸症若脾脉弦长者，肝
木乘脾土也，当补脾平肝；若脾脉沉弦者，寒水侮脾土也，当温中补肾。夫黄连、枳实虽消停滞、开痞闷。
若人脾胃充实，暴患实痞，宜暂用之；若人屡患屡服，或脾胃虚痞者而用之，则脾胃反伤而诸症蜂起矣。故
东垣先生云∶脾胃实者，用黄连、枳实泻之；虚者，用白术、陈皮补之。须分病之虚实、人之南北而治之。
后仿此。
若小便赤涩短少，加猪苓、泽泻各一钱，以分利之。夏月加茵陈七分，山栀仁（炒）四分。
愚按前症若津液偏渗于大肠，大便泻而小便少者，宜用此药分利；若阴阳已分而小便短少者，此脾
肺气虚而不能生水也，宜用补中益气汤加麦门、五味；阴火上炎而小便赤少者，此肺气受伤而不能生水也，
用六味地黄丸加麦门、五味；肾经阴虚，阳无所生，而小便短少者，用滋肾丸、肾气丸；肾经阳虚，阴无
所化，而小便短少者，用益气汤、六味丸。若误用渗泄分利，复伤阳气，阴无所生，而小便不利，或目睛
凸出，腹胀如鼓，或腿膝肿硬，或皮肤断裂者，先用滋肾丸、益气汤。每见元气虚而复用泽泻、猪苓之类，
因损真阴，以致前症益甚者，急投金匮加减肾气丸，多有复生者。若反服牵牛、大黄峻剂而通之，是速其
危也。
若口渴引饮，加干姜一钱五分，人参、麦门冬各
一钱，升麻四分，乌梅肉五个。
愚按前症若胃气伤而内亡津液者，用七味白术散；胃气弱而津液少者，用补中益气汤；气血俱虚而
津液少者，用十全大补汤；肾虚津液短少者，用六味地黄丸；肾水不足而虚火上炎者，用加减八味丸。若
肾水不足之人患泄泻，或服分利之剂过多而患口渴者，若不用前药以固其本源，则肺肾复伤，多变小便
不利、肚腹水肿等危症矣。
宪副屠九峰，先泻而口渴，尺脉数而无力，恪用解酒毒、利小便之剂，不应。余曰∶此肾阴亏损，虚火
炽盛，宜急壮水之主，不然必发疽而不能收敛也。不信，别服降火化痰之剂，果患疽而殁。
若夏秋之间湿热大行，暴注水泻，加黄连、苍术、泽泻各一钱，升麻、木通各五分。发热作渴，加干姜、
石膏各一钱。黄胆小便赤，加茵陈一钱，山栀、木通各五分。
愚按东垣云∶若值秋燥行令，湿热少退，体重节痛、口舌干燥，饮食无味，二便不调，不欲饮食，或食
不化，兼洒淅恶寒，凄惨面恶，此肺之脾胃虚而阳气不伸也，用升阳益胃汤治之。前症若湿热内作，脾胃不能
通调而致者，宜用此药分利之；湿热已去，脾胃虚弱而致者，宜用六君子、当归调补之；湿热已去，脾气下
陷而致者，宜用补中益气汤升举之。其黄胆若小便
不利，四肢沉重，渴不欲饮，此湿胜于热，用大茵陈汤；大便自利，茵陈栀子黄连汤；若往来寒热，身黄
者，宜用小柴胡加栀子；若因劳伤形体，饮食失节，而身黄者，用小半夏汤。盖黄胆为内伤不足之症，宜调
补脾胃元气为主，若妄用驱逐，复伤元气，多致不起。
若久泻脾胃虚弱，饮食难化，加黄 （炙）、人参各一钱，神曲、麦芽各一钱二分，木香（煨）、
干姜（炙）各五分。
愚按前症或作呕，或饮食少思，属脾胃虚弱，用四君子加半夏、木香；或兼作呕，或腹作痛，属脾胃
虚寒，用六君子加炮姜、木香。若麦芽善损肾，神曲善化胎消肾，不宜轻用。大抵此症多由泛用消食利水
之剂，损其真阴，元气不能自主持，遂成久泄。若非补中益气汤、四神丸滋其本源，后必胸痞腹胀、小便淋
沥，多致不起。
若久泻肠胃虚滑不禁，加肉豆蔻、诃子皮、赤石脂各一钱，木香（煨）、干姜（炙）各五分。
愚按东垣先生云∶中焦气弱，脾胃受寒冷，大便滑泻，腹中雷鸣，或因误下，末传寒中，复遇时寒、
四肢厥逆，心胃绞痛，冷汗不止，此肾之脾胃虚也，用沉香温胃丸治之。窃谓前症若脾胃虚寒下陷者，用
补中益气汤加木香、肉豆蔻、补骨脂；若脾气虚寒不禁者，用六君子汤加炮姜、肉桂；命门火衰而脾土虚
寒者，用八味丸；若脾肾气血俱虚者，用十全大补
汤送四神丸，若大便滑利，小便闭涩，或肢体渐肿，喘嗽唾痰，为脾肾气血俱虚，宜用十全大补汤送四神
丸；若大便滑利，小便闭涩，或肢体渐肿，喘嗽唾痰，为脾肾亏损，宜用金匮加减肾气丸。
若饮酒便泄，此酒积热泻也，加黄连（炒）、茵陈、干姜各一钱，木香五分。
愚按前症若酒湿未散，脾气未虚，宜用此药分利湿热；若湿热已去，中气被伤，宜用六君子调补中
气，若误服克伐分利之剂，胸膈渐满，小便短小，或腿足与腹渐肿者，急用加减金匮肾气丸调补脾胃，多
有生者。夫酒性大热，乃无形之物，无形元气受伤，当用葛花解醒汤分消其湿，往往反服大热酒症丸，重
泻有形阴血，使阳毒大旺，元气消亡，折人长命。《金匮要略》云∶酒疸下之，久而为黑疸。每见善饮服酒
症丸者，多患疸症，不悟其因，反服分利化痰，以致变症而殁者多矣（详见《奇效方》。）
秀水卜封君，善饮，腹痛，便泄，服分利化痰等剂，不应。其脉滑数，皮肤错甲。余谓此酒毒致肠痈
而溃败也，辞不治。不信，仍服前剂，果便脓而殁。
光禄柴黼庵，善饮，泄泻，腹胀，吐痰，作呕，口干。余谓脾胃气虚，先用六君子加神曲，痰呕已止，
再用补中益气加茯苓、半夏，泻胀亦愈。
旧僚钱可久，素善饮，面赤，痰盛，大便不实。
余以为肠胃湿痰壅滞，用二陈、芩、连、山栀、枳实、干葛、泽泻、升麻一剂，吐痰甚多，大便始实。
此后日以黄连三钱，泡汤饮之而安。
若寒月溏泄，清冷腹痛，伤生冷冻饮料食，加神曲、麦芽（炒）、干姜（炙）各一钱，缩砂、益智、木
香各七分。
愚按前症若脾肾虚寒，宜用四神丸；若脾肾虚脱，用六君、姜、桂，如不应，急补命门火以生脾土。
一儒者，小腹急痛，溏泄清冷，大便欲去不去。余谓此命门火衰而脾土虚寒也，用八味丸月余而愈。
向后饮食失宜，前症仍作，小腹重坠，此脾气下陷也，用补中益气汤而痊。
泄泻本来属于湿邪致病，但多因饮食不节制，导致脾胃受损而引发。治疗时必须结合时令气候，区分寒热属性以及病程的新久来施治。治疗方法：补益脾土、消食导滞、通利小便。也有通过升提下陷之气，使用风药以胜湿；也有久泻导致肠胃虚弱滑脱不禁者，适宜用收涩法治疗。
主方：白术（二钱）、白茯苓、白芍药（炒，各一钱五分）（以上三味是治疗泄泻必用的药物）。陈皮（一钱）、甘草（炙，五分）。
如果因伤食导致大便色黄，或有食积，加神曲、麦芽、山楂各一钱，黄连（炒）七分。如果感觉腹中狭窄紧迫，再加浓朴、枳实以消除停滞。
我按语：前述病症若饮食已消化但泄泻仍未停止，这是脾胃之气受伤，宜用五味异功散；若泄泻且腹中有沉重下坠感，这是脾胃之气下陷，宜用补中益气汤；若服用破气消滞的药物后腹中仍觉痞满狭窄，这是脾气虚导致的痞证，宜用六君子汤；若胁肋胀满、食欲减退、易怒、大便色青，这是脾虚受肝木克制，宜用六君子汤加柴胡、升麻、木香；若食欲减退、身体疲倦、频繁打嗝、大便色黄，这是脾虚清气下陷，宜用六君子汤加升麻、柴胡。大凡上述诸症，若脾脉呈现弦长之象，是肝木乘克脾土，应当补脾平肝；若脾脉呈现沉弦之象，是寒水反侮脾土，应当温中补肾。黄连、枳实虽然能消除停滞、开通痞闷，但如果人体脾胃充实，突发实证痞满，适宜暂时使用；如果人体屡患此病屡服此药，或者脾胃虚弱导致的痞满而使用这些药物，则反而损伤脾胃，导致各种病症蜂拥而起。所以东垣先生说：脾胃实证，用黄连、枳实泻之；虚证，用白术、陈皮补之。必须区分疾病的虚实、人的体质南北差异而治疗。后续仿照此理。
如果小便赤红、涩痛、短少，加猪苓、泽泻各一钱，以分利湿热。夏季加茵陈七分，山栀仁（炒）四分。
我按语：前述病症若津液偏渗于大肠，导致大便泄泻而小便少，适宜用此药分利；若阴阳已分清但小便短少，这是脾肺气虚不能生水，宜用补中益气汤加麦门冬、五味子；若阴火上炎导致小便赤少，这是肺气受伤不能生水，用六味地黄丸加麦门冬、五味子；若肾经阴虚，阳气无所生，导致小便短少，用滋肾丸、肾气丸；若肾经阳虚，阴精无所化，导致小便短少，用益气汤、六味丸。如果误用渗泄分利的药物，再次损伤阳气，阴精无所生，导致小便不利，或眼球突出，腹胀如鼓，或腿膝肿硬，或皮肤破裂，先用滋肾丸、益气汤。常见元气虚弱又复用泽泻、猪苓之类药物，因为损伤真阴，以致前述病症更加严重，急投金匮加减肾气丸，多有起死回生者。如果反而服用牵牛子、大黄等峻猛药物强行通便，这是加速其死亡。
如果口渴想喝水，加干姜一钱五分，人参、麦门冬各一钱，升麻四分，乌梅肉五个。
我按语：前述病症若胃气受伤而内部津液亡失，用七味白术散；胃气弱而津液少，用补中益气汤；气血俱虚而津液少，用十全大补汤；肾虚津液短少，用六味地黄丸；肾水不足而虚火上炎，用加减八味丸。如果肾水不足之人患泄泻，或服用分利药物过多而导致口渴，如果不使用前述药物以固护本源，则肺肾再次受伤，多变为小便不利、肚腹水肿等危重病症。
宪副屠九峰，先出现泄泻而后口渴，尺脉数而无力，严格使用解酒毒、利小便的药物，无效。我说：这是肾阴亏损，虚火炽盛，应当紧急壮水之主（滋阴），否则必然发生疽疮而不能收敛。他不相信，另外服用降火化痰的药物，果然患疽疮而死。
如果在夏秋之间湿热盛行，突然剧烈水样腹泻，加黄连、苍术、泽泻各一钱，升麻、木通各五分。发热伴口渴，加干姜、石膏各一钱。黄疸伴小便赤红，加茵陈一钱，山栀、木通各五分。
我按语：东垣先生说：如果遇到秋燥当令，湿热稍退，身体沉重关节疼痛、口舌干燥、饮食无味、大小便不调、不想饮食、或食物不消化，兼有洒淅恶寒、凄惨面色难看，这是肺之脾胃虚而阳气不能伸展，用升阳益胃汤治疗。前述病症若湿热内作，脾胃不能通调所致，宜用此药分利；湿热已去，脾胃虚弱所致，宜用六君子汤、当归调补；湿热已去，脾气下陷所致，宜用补中益气汤升举。其黄疸若小便不利，四肢沉重，口渴但不想喝水，这是湿胜于热，用大茵陈汤；大便自利，用茵陈栀子黄连汤；若往来寒热，身黄，宜用小柴胡汤加栀子；若因劳伤形体、饮食失节而身黄，用小半夏汤。大概黄疸是内伤不足的病症，适宜以调补脾胃元气为主，如果妄用驱逐之法，再次损伤元气，多导致不治。
如果久泻导致脾胃虚弱，饮食难消化，加黄芪（炙）、人参各一钱，神曲、麦芽各一钱二分，木香（煨）、干姜（炙）各五分。
我按语：前述病症或呕吐，或饮食少思，属于脾胃虚弱，用四君子汤加半夏、木香；或兼呕吐，或腹部疼痛，属于脾胃虚寒，用六君子汤加炮姜、木香。如果麦芽容易损伤肾脏，神曲容易化解胎元并消耗肾气，不宜轻易使用。大抵此症多由泛用消食利水的药物，损伤真阴，元气不能自主持，遂成久泻。如果不是用补中益气汤、四神丸滋养其本源，后来必然胸痞腹胀、小便淋漓，多导致不治。
如果久泻导致肠胃虚弱滑脱不禁，加肉豆蔻、诃子皮、赤石脂各一钱，木香（煨）、干姜（炙）各五分。
我按语：东垣先生说：中焦气弱，脾胃受寒冷，大便滑泻，腹中雷鸣，或因误下，末传寒中，复遇时寒、四肢厥逆，心胃绞痛，冷汗不止，这是肾之脾胃虚，用沉香温胃丸治疗。我认为前述病症若脾胃虚寒下陷，用补中益气汤加木香、肉豆蔻、补骨脂；若脾气虚寒不禁，用六君子汤加炮姜、肉桂；命门火衰而脾土虚寒，用八味丸；若脾肾气血俱虚，用十全大补汤送服四神丸。若大便滑利，小便闭涩，或肢体渐肿，喘嗽唾痰，为脾肾气血俱虚，宜用十全大补汤送服四神丸；若大便滑利，小便闭涩，或肢体渐肿，喘嗽唾痰，为脾肾亏损，宜用金匮加减肾气丸。
如果饮酒后即泄泻，这是酒积热泻，加黄连（炒）、茵陈、干姜各一钱，木香五分。
我按语：前述病症若酒湿未散，脾气未虚，宜用此药分利湿热；若湿热已去，中气被伤，宜用六君子汤调补中气，如果误服克伐分利的药物，胸膈逐渐胀满，小便短小，或腿足与腹部渐肿，急用加减金匮肾气丸调补脾胃，多有生存者。酒性大热，乃无形之物，无形元气受伤，应当用葛花解醒汤分消其湿，往往反而服用大热酒症丸，重泻有形阴血，使阳毒大旺，元气消亡，折损人的寿命。《金匮要略》说：酒疸用下法，久而变为黑疸。常见善于饮酒服用酒症丸的人，多患疸症，不明白其原因，反而服用分利化痰药物，以致变症而死的多矣（详见《奇效方》）。
秀水卜封君，善于饮酒，腹痛，便泄，服用分利化痰等药物，无效。他的脉滑数，皮肤粗糙如错甲。我说这是酒毒导致肠痈而溃败，推辞不治疗。他不相信，仍服用前剂，果然排脓而死。
光禄柴黼庵，善于饮酒，泄泻，腹胀，吐痰，作呕，口干。我说这是脾胃气虚，先用六君子汤加神曲，痰呕已止，再用补中益气汤加茯苓、半夏，泻胀亦愈。
旧僚钱可久，素来善于饮酒，面赤，痰盛，大便不实。我认为这是肠胃湿痰壅滞，用二陈汤、黄芩、黄连、山栀、枳实、干葛、泽泻、升麻一剂，吐痰甚多，大便始实。此后每天用黄连三钱，泡汤饮用而安。
如果在寒冷月份溏泄，清冷腹痛，食用生冷饮料食物，加神曲、麦芽（炒）、干姜（炙）各一钱，缩砂、益智、木香各七分。
我按语：前述病症若脾肾虚寒，宜用四神丸；若脾肾虚脱，用六君子汤加姜、桂，如无效，急补命门火以生脾土。一位儒者，小腹急痛，溏泄清冷，大便欲去不去。我说这是命门火衰而脾土虚寒，用八味丸月余而愈。之后饮食失宜，前症仍发，小腹重坠，这是脾气下陷，用补中益气汤而痊愈。
Diarrhea (Xie Xie) originally belongs to dampness pathogen, but it is mostly caused by irregular diet, which damages the Spleen and Stomach. Treatment must consider the seasonal climate, distinguishing between cold and heat patterns, as well as acute and chronic conditions. Therapeutic methods include: tonifying the Spleen, resolving food stagnation, and promoting urination. There are also cases where Qi sinking requires lifting using wind-dispelling herbs to overcome dampness; for chronic diarrhea with weak intestines and stomach leading to incontinence, astringent methods are appropriate.
Main Formula: Baizhu (Atractylodis Macrocephalae Rhizoma, 2 qian), Bai Fuling (Poria, 1.5 qian), Baishao Yao (Paeoniae Radix Alba, stir-fried, 1.5 qian) (These three are essential for treating diarrhea). Chenpi (Citri Reticulatae Pericarpium, 1 qian), Gancao (Glycyrrhizae Radix et Rhizoma, honey-fried, 0.5 qian).
If diarrhea is yellow due to food injury or food stagnation, add Shenqu (Massa Medicata Fermentata), Maiya (Hordei Fructus Germinatus), and Shanzha (Crataegi Fructus) each 1 qian, and Huanglian (Coptidis Rhizoma, stir-fried) 0.7 fen. If there is a sensation of tightness in the abdomen, add Houpo (Magnoliae Officinalis Cortex) and Zhishi (Aurantii Fructus Immaturus) to resolve stagnation.
My Commentary: In the aforementioned symptoms, if digestion has occurred but diarrhea persists, this indicates injury to Spleen and Stomach Qi; Wuyi Yigong San (Five-Ingredient Powder for Extraordinary Efficacy) should be used. If diarrhea is accompanied by a heavy bearing sensation in the abdomen, this indicates Sinking of Spleen and Stomach Qi; Buzhong Yiqi Tang (Decoction for Supplementing the Middle and Augmenting the Qi) should be used. If abdominal fullness and tightness persist after taking qi-breaking and stagnation-resolving agents, this indicates Pi Man (Spleen Deficiency Fullness); Liu Junzi Tang (Six-Gentlemen Decoction) should be used. If there is hypochondriac distension, poor appetite, irritability, and green stools, this indicates Spleen Deficiency with Liver Overacting; Liu Junzi Tang plus Chaihu (Bupleuri Radix), Shengma (Cimicifugae Rhizoma), and Muxiang (Aucklandiae Radix) should be used. If there is poor appetite, fatigue, frequent belching, and yellow stools, this indicates Sinking of Clear Yang due to Spleen Deficiency; Liu Junzi Tang plus Shengma and Chaihu should be used. Generally, if the Spleen pulse is wiry and long, it indicates Liver Wood overacting on Spleen Earth; tonify the Spleen and pacify the Liver. If the Spleen pulse is deep and wiry, it indicates Cold Water insulting Spleen Earth; warm the Middle and tonify the Kidney. Although Huanglian and Zhishi can resolve stagnation and open fullness, they should only be used temporarily for acute excess fullness in individuals with robust Spleen and Stomach. For recurrent use or in cases of deficiency-type fullness, they will damage the Spleen and Stomach further, causing various symptoms to arise. As Mr. Dongyuan stated: For Spleen/Stomach Excess, use Huanglian and Zhishi to purge; for Deficiency, use Baizhu and Chenpi to tonify. Treatment must distinguish between disease excess/deficiency and regional constitutions. Subsequent cases follow this principle.
If urine is red, scanty, and difficult to pass, add Zhuling (Polyporus, 1 qian) and Zexie (Alismatis Rhizoma, 1 qian) to separate and drain dampness. In summer, add Yinchen (Artemisiae Scopariae Herba, 0.7 fen) and Shanzhiren (Gardeniae Semen, stir-fried, 0.4 fen).
My Commentary: In the aforementioned symptoms, if fluids leak into the Large Intestine causing diarrhea and scanty urine, separation and drainage are appropriate. If Yin and Yang are distinct but urine is scanty, this is Spleen/Lung Qi Deficiency failing to generate fluids; Buzhong Yiqi Tang plus Maidong (Ophiopogonis Radix) and Wuweizi (Schisandrae Fructus) should be used. If Yin Fire flares up causing red, scanty urine, this is Lung Injury failing to generate fluids; Liuwei Dihuang Wan (Six-Ingredient Pill with Rehmannia) plus Maidong and Wuweizi should be used. If Kidney Yin Deficiency leads to lack of Yang generation and scanty urine, Zishen Wan (Kidney-Nourishing Pill) or Shenqi Wan (Kidney-Qi Pill) should be used. If Kidney Yang Deficiency leads to failure to transform Yin and scanty urine, Yiqi Tang (Qi-Supplementing Decoction) or Liuwei Wan should be used. Misuse of draining agents damages Yang, preventing Yin generation, leading to urinary difficulty, proptosis, drum-like abdominal distension, hard swollen legs/knees, or skin fissures. Use Zishen Wan and Yiqi Tang first. I often see patients with deficient Yuan Qi who take Zexie and Zhuling, damaging True Yin and worsening symptoms; urgently administer Jinkui Jiajian Shenqi Wan (Modified Kidney-Qi Pill from the Golden Cabinet), which often results in recovery. Conversely, using harsh purgatives like Qiuniu (Kochiae Semen) or Dahuang (Rhei Radix et Rhizoma) accelerates death.
If thirst with desire to drink occurs, add Ganjiang (Zingiberis Rhizoma, 1.5 qian), Renshen (Ginseng Radix, 1 qian), Maidong (1 qian), Shengma (0.4 fen), and Wumei Rou (Mume Fructus Flesh, 5 pieces).
My Commentary: In the aforementioned symptoms, if Stomach Qi is injured and internal fluids are lost, Qiwei Baizhu San (Seven-Ingredient Atractylodes Powder) should be used. If Stomach Qi is weak with little fluid, Buzhong Yiqi Tang should be used. If both Qi and Blood are deficient with little fluid, Shiquan Dabu Tang (Ten-Ingredient Great Tonifying Decoction) should be used. If Kidney Deficiency causes short fluids, Liuwei Dihuang Wan should be used. If insufficient Kidney Water leads to defying Fire, Jiaban Bawei Wan (Modified Eight-Ingredient Pill) should be used. If a person with insufficient Kidney Water suffers diarrhea or excessive diuretic use leading to thirst, failing to use these drugs to secure the root will injure Lung and Kidney, potentially causing critical conditions like urinary retention and abdominal edema.
Tu Jiufeng, Vice Commissioner, suffered diarrhea followed by thirst, with a rapid and forceless Chi pulse. He strictly used alcohol-detoxifying and diuretic agents without effect. I said: This is Kidney Yin Deficiency with blazing Deficient Fire; urgently nourish Water. Otherwise, carbuncles will develop and fail to heal. He did not believe, took fire-descending and phlegm-resolving agents, and indeed died from carbuncles.
During summer and autumn when damp-heat prevails, sudden violent watery diarrhea warrants adding Huanglian, Cangzhu (Atractylodis Rhizoma), and Zexiei each 1 qian, and Shengma and Mutong (Akebiae Caulis) each 0.5 fen. For fever with thirst, add Ganjiang and Shigao (Gypsum Fibrosum) each 1 qian. For jaundice with red urine, add Yinchen 1 qian, Shanzhi (Gardeniae Fructus) and Mutong each 0.5 fen.
My Commentary: Mr. Dongyuan stated: When autumn dryness rules and damp-heat recedes, with heavy body, joint pain, dry mouth/tongue, loss of taste, bowel/bladder dysfunction, anorexia, indigestion, chills, and aversion to cold, this is Lung/Spleen-Stomach Deficiency with unextended Yang; Shengyang Yizhe Tang (Yang-Raising Stomach-Supplementing Decoction) treats it. For damp-heat internal production causing Spleen/Stomach dysfunction, use separation/drainage. For post-damp-heat Spleen/Stomach weakness, use Liu Junzi Tang and Danggui (Angelicae Sinensis Radix) to tonify. For post-damp-heat Spleen Qi sinking, use Buzhong Yiqi Tang to lift. For jaundice with urinary difficulty, heavy limbs, thirst without desire to drink (Damp > Heat), use Da Yinchen Tang (Great Coix Seed Decoction). For spontaneous loose stools, use Yinchen Zhizi Huanglian Tang. For alternating chills/fever with jaundice, use Xiao Chaihu Tang plus Zhizi. For jaundice due to labor injury and dietary irregularity, use Xiao Banxia Tang (Minor Pinellia Decoction). Jaundice is an insufficiency syndrome; tonify Spleen/Stomach Yuan Qi primarily. Reckless purging damages Qi and often proves fatal.
For chronic diarrhea with Spleen/Stomach weakness and indigestion, add Huangqi (Astragali Radix, honey-fried) and Renshen each 1 qian, Shenqu and Maiya each 1.2 qian, Muxiang (stir-baked) and Ganjiang (honey-fried) each 0.5 fen.
My Commentary: Symptoms of vomiting or poor appetite indicate Spleen/Stomach weakness; Si Junzi Tang plus Banxia (Pinelliae Rhizoma) and Muxiang. Vomiting with abdominal pain indicates Spleen/Stomach Deficiency-Cold; Liu Junzi Tang plus Paojiang (Prepared Ginger) and Muxiang. Maiya damages Kidney; Shenqu transforms fetal essence and consumes Kidney Qi; avoid light use. Chronic diarrhea often results from indiscriminate use of digestive/diuretic agents damaging True Yin, leaving Yuan Qi unable to control, leading to chronic diarrhea. Without Buzhong Yiqi Tang or Sishen Wan to nourish the root, chest fullness, abdominal distension, and dribbling urine may ensue, often proving fatal.
For chronic diarrhea with weak intestines/stomach and incontinence, add Roudoukou (Myristicae Semen), Hezi Pi (Terminaliae Chebulae Pericarpium), and Chishizhi (Halloysit Rubrum) each 1 qian, Muxiang (stir-baked) and Ganjiang (honey-fried) each 0.5 fen.
My Commentary: Mr. Dongyuan stated: Middle Jiao Qi weakness, Cold invading Spleen/Stomach, slippery diarrhea, borborygmus, or misdirected downward transmission leading to Cold, combined with seasonal cold, cold limbs, heart/stomach colic, and cold sweat, indicates Kidney/Spleen-Stomach Deficiency; Chenxiang Wenwei Wan (Agarwood Stomach-Warming Pill) treats it. I hold that for Spleen/Stomach Deficiency-Cold with sinking, use Buzhong Yiqi Tang plus Muxiang, Roudoukou, and Buguzhi (Psoraleae Fructus). For Spleen Qi Deficiency-Cold with incontinence, use Liu Junzi Tang plus Paojiang and Rougui (Cinnamomi Cortex). for Mingmen Fire Decline with Spleen Earth Deficiency-Cold, use Bawei Wan (Eight-Ingredient Pill). For Spleen/Kidney Qi/Blood Dual Deficiency, use Shiquan Dabu Tang delivered with Sishen Wan. For slippery stools, closed urine, gradual swelling, wheezing/cough with sputum indicating Spleen/Kidney Qi/Blood Deficiency, use Shiquan Dabu Tang with Sishen Wan. For slippery stools, closed urine, swelling, wheezing/cough/sputum indicating Spleen/Kidney Loss, use Jinkui Jiajian Shenqi Wan.
For immediate diarrhea after drinking alcohol, this is Alcohol Accumulation Heat Diarrhea; add Huanglian (stir-fried), Yinchen, and Ganjiang each 1 qian, Muxiang 0.5 fen.
My Commentary: If alcohol-damp remains and Spleen Qi is not yet deficient, use these to separate/drain damp-heat. If damp-heat is gone and Middle Qi is injured, use Liu Junzi Tang to tonify Middle Qi. If mistaken use of harsh/diuretic agents causes progressive chest fullness, scanty urine, or leg/abdominal swelling, urgently use Jiaban Jinkui Shenqi Wan to tonify Spleen/Stomach; survival is likely. Alcohol nature is hot and formless; injury to formless Yuan Qi requires Gegua Jiexing Tang (Honeysuckle Flower Awakening-Decoction) to dissipate damp. Often, people mistakenly take large-hot Jiuzheng Wan, purging formless Yin blood, causing Yang toxin to blaze and Yuan Qi to perish, shortening life. *Jinkui Yaolue* states: Purging Wine Jaundice leads to Black Jaundice over time. Many drinkers taking Jiuzheng Wan develop jaundice, misunderstanding the cause, taking diuretics/phlegm-resolvers, and dying from complications (see *Qixiao Fang*).
Bu Fengjun from Xiushui, a heavy drinker, had abdominal pain and diarrhea. Diuretic/phlegm-resolving agents failed. His pulse was slippery and rapid; skin was rough like fish scales. I said this was intestinal abscess ruptured due to alcohol toxicity; declined treatment. He refused, took previous formulas, and died passing pus.
Chai Fu'an, Guanglu, a heavy drinker, had diarrhea, abdominal distension, phlegm expectoration, vomiting, and dry mouth. I diagnosed Spleen/Stomach Qi Deficiency. Used Liu Junzi Tang plus Shenqu; phlegm/vomiting stopped. Then used Buzhong Yiqi Tang plus Fuling and Banxia; diarrhea/distension resolved.
Former colleague Qian Kejiu, a habitual drinker, had red face, profuse phlegm, and loose stools. I diagnosed Phlegm-Damp obstruction in intestines/stomach. Used Erchen Tang, Huangqin (Scutellariae Radix), Huanglian, Shanzhi, Zhishi, Gange (Puerariae Radix), Zexiei, and Shengma. One dose produced much phlegm; stool solidified. Thereafter, he drank water infused with 3 qian Huanglian daily and recovered.
For loose stools in cold months, clear cold abdominal pain, and ingestion of cold drinks/food, add Shenqu, Maiya (stir-fried), and Ganjiang (honey-fried) each 1 qian, Suosha (Amomi Fructus) and Yizhi (Alpiniae Oxyphyllae Fructus) and Muxiang each 0.7 fen.
My Commentary: For Spleen/Kidney Deficiency-Cold, use Sishen Wan. For Spleen/Kidney Collapse, use Liu Junzi Tang plus Jiang and Gui; if ineffective, urgently tonify Mingmen Fire to generate Spleen Earth. A scholar had urgent lower abdominal pain, cold loose stools, and tenesmus. I diagnosed Mingmen Fire Decline with Spleen Earth Deficiency-Cold. Treated with Bawei Wan for over a month; cured. Later, improper diet caused recurrence with heavy bearing in lower abdomen (Spleen Qi Sinking); treated with Buzhong Yiqi Tang; recovered.