一、泄泻之暴病者，或为饮食所伤，或为时气所犯，无不由于口腹，必各有所因，宜察
其因而治之。如因食生冷寒滞者，宜抑扶煎、和胃饮之属以温之。因湿滞者，宜平胃散、胃
苓汤，或白术芍药散以燥之痢之。因食滞而胀痛有余者，宜大、小和中饮之属以平之。因气
滞而痛泻之甚者，宜排气饮，或平胃散之属以调之。因食滞而固结不散，或胃气之强实者，
宜神佑丸、赤金豆、百顺丸之属以行之。凡初感者，病气未深，脏气未败，但略去其所病之
滞，则胃气自安，不难愈也。
一、凡脾气稍弱，阳气素不强者，一有所伤，未免即致泄泻，此虽为初病，盒饭调理元
气，自非强盛偶伤者之比。如因泻而神气困倦者，宜养中煎，或温胃饮，或圣术煎，或四君
子汤，或五君子煎。如微寒兼滞而不虚者，宜佐关煎。若脾虚而微滞者，宜五味异功散。若
脾虚而微寒微滞者，宜六味异功煎，或温胃饮。若因饮食不调，忽而溏泻，以渐而甚，或见
微痛，但所下酸臭，而颜色淡黄，便是脾虚胃寒不化之证，即宜用五德丸，再甚者，即宜用
胃关煎，切勿疑也。
一、凡兼真阴不足而为泄泻者，则或多脐下之痛，或于寅卯时为甚，或食入已久，反多
不化，而为呕恶溏泻，或泻不甚臭而多见完谷等证。盖因丹田不暖，所以尾闾不固，阴中少
火，所以中焦易寒，此其咎在下焦，故曰真阴不足也，本与中焦无涉，故非分利所及也，惟
胃关煎一剂，乃为最上之乘。且人之患此者最多，勿谓其为新病而不可用也，勿谓其为年少
而未宜用也，觉有是证，即宜是药，剂少功多，攸利非小。但知者见其先，昧者见其后，见
其后，恐见之迟矣，所以贵见先也。
一、肾泄证，即前所谓真阴不足证也，每于五更之初，或天将明时，即洞泄数次，有经
月连年弗止者，或暂愈而复作者，或有痛者，或有不痛者，其故何也？盖肾为胃关，开窍于
二阴，所以二便之开闭，皆肾脏之所主，今肾中阳气不足，则命门火衰，而阴寒独盛，故于
子丑五更之后，当阳气未复，阴气盛极之时，即令人洞泄不止也。古方有椒附丸、五味子散
，皆治此之良方；若必欲阳生于阴，而肾气充固，则又惟八味地黄丸为宜。然余尝用此，则
似犹未尽善，故特制胃关煎、一气丹、九气丹、复阳丹之属，斯得其济者多矣，或五味子丸
亦佳；其有未甚者，则加五德丸、四神丸，皆其最宜者也。
一、凡脾泄久泄证，大都与前治脾弱之法不相远，但新泻者可治标，久泻者不可治标，
且久泻无火，多因脾肾之虚寒也。若止因脾虚者，惟四君子汤、参术汤、参苓白术散之属为
宜。若脾胃兼寒者，宜五君子煎、黄芽丸、五德丸。若脾气虚寒兼滞闷者，宜六味异功煎、
温胃饮、圣术煎。若脾气虚寒之甚，而饮食减少，神疲气倦，宜参附汤、术附汤、十全大补
汤。若病在下焦，肾气虚而微热者，宜六味地黄汤；微寒者，宜八味地黄汤，或胃关煎。若
脾虚溏泄，久不能愈，或小儿脾泄不止者，止用敦阜糕、粘米固肠糕，亦易见效。若脾胃寒
湿而溏泄不止者，苍术丸亦佳。若久泻元气下陷，大肠虚滑不收者，须于补剂中加乌梅、五
味子、粟壳之属以固之。
一、大泻如倾，元气渐脱者，宜速用四味回阳饮，或六味回阳饮主之。凡暴泻如此者，
无不即效；若久泻至此，犹恐无及，盖五夺之中，惟泻最急，是不可见之不早也。倘药未及
效，仍宜速灸气海，以挽回下焦之阳气。仍须多服人参膏。
一、酒泻证，饮酒之人多有之，但酒有阴阳二性，人有阴阳二脏，而人多不能辨也。夫
酒性本热，酒质则寒，人但知酒有湿热，而不知酒有寒湿也。故凡因酒而生湿热者，因其性
也，以 汁不滋阴，而悍气生热也；因酒而生寒湿者，因其质也，以性去质不去，而水留为
寒也。何以辨之？常见人有阳强气充而善饮者，亦每多泄泻，若一日不泻，反云热闷，盖其
随饮随泻，则虽泻不致伤气，而得泻反以去湿，此其先天禀浓，胃气过人者也，最不易得，
亦不多见。此而病者，是为阳证，不过宜清宜利，如四苓散、大厘清饮，或酒蒸黄连丸之类
，去其湿热而病可愈也。若阳虚之人，则与此大异。盖脾虚不能胜湿，而湿胜即能生寒，阳
气因寒，所以日败，胃气因湿，所以日虚，其证则形容渐羸，饮食渐减，或脉息见弦细，或
口体常怯寒，或脐腹常有隐疼，或眩晕常多困倦，或不安于五鼓，或加甚于秋冬，但无热证
可据，而常多飧泄者，则总属虚寒也。凡若此者，若不速培阳气，必致渐衰，而日以危矣。
余于四旬之外，亦尝病此数年，其势已窘，因遍求治法，见朱丹溪曰∶因伤于酒，每晨
起必泻者，宜理中汤加葛根，或吞酒蒸黄连丸。王节斋曰∶饮酒便泄者，此酒积热泻也，宜
加黄连、茵陈、干姜、木香之属。薛立斋曰∶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，宜用六君调补中气。又曰∶酒性大热，乃无形之物，无形元气受伤
，当用葛花解酲汤分消其湿。凡此诸论，若已尽之。然朱、王二家之说，则不分寒热，皆用
黄连，是但知酒之有热，而不知酒之有寒，乌足凭也，惟薛氏之说，虽亦云酒性大热，而所
重在脾，诚若善矣。余因效之，初服葛花解酲汤，不效，继服六君子、补中益气汤，又不效
，再服理中以至八味，俱不效。斯时也，计穷力竭，若无再生之望矣，因潜思熟计，料非峻
补命门，终无益也。乃自制胃关煎、右归丸、一气丹等方以治其病，仍绝口不饮以杜其源，
调理年余，竟得全愈，自后始明、性质之理，多得济人。向使己无确见，执信湿热之说，而妄
用黄连、干葛清凉分利之剂，则焉望其有今日？即或自用稍迟，则既甚亦难挽矣。
矧今人之病此者最多，而是阴是阳，不可不辨。凡阳盛者，脾强胃健，而气不易夺者也
，故治本无难，而泄亦无虑；阳衰者，脾肾既伤，则脱气最易，故宜防其无及，不可不为深
虑也。若必以酒为热，则其为古法所误者，诚不少矣。
一、气泄证，凡遇怒气便作泄泻者，必先以怒时挟食，致伤脾胃。故但有所犯，即随触
而发，此肝脾二脏之病也，盖以肝木克土，脾气受伤而然。使脾气本强，即见肝邪，未必能
入，今既易伤，则脾气非强可知矣。故治此者，当补脾之虚而顺肝之气，此固大法也，但虚
实有微甚，则治疗宜分轻重耳。如禀壮气实，年少而因气泄泻者，可先用平胃散，或胃苓汤
。若肝气未平而作胀满者，宜解肝煎先顺其气。若脾气稍弱者，宜二术煎，或粘米固肠糕，
或消食导气饮。若脾气稍寒者，宜抑扶煎、吴茱萸散，或苍术丸。若脾弱居多者，宜温胃饮
、圣术煎，或六味异功煎。若既畏此证为患，则必须切戒气怒。
一、风泄证，亦当辨其风寒风热而治之。热者，如伤寒外感热
二、之属是也，宜以伤寒门
自利条诸法治之；寒者，以风寒在胃，而脾土受伤，如《内经》所云春伤于风，夏生飧泄之
属是也，宜以前温胃理中之法治之。
一、突然发作的泄泻病，有的是因为饮食损伤，有的是因为外感时邪所致，没有不是由于口腹之欲引起的，必定各有其病因，应当审察病因后进行治疗。如果是因食用生冷导致寒邪停滞，适宜用抑扶煎、和胃饮等方剂来温中散寒。如果是因湿邪停滞，适宜用平胃散、胃苓汤或白术芍药散来燥湿止泻。如果是因食积停滞且胀满疼痛明显，适宜用大和中饮、小和中饮等方剂来消导积滞。如果是因气机阻滞且腹痛腹泻严重，适宜用排气饮或平胃散等方剂来调理气机。如果是因食积停滞而结聚不散，或者胃气强盛实热者，适宜用神佑丸、赤金豆、百顺丸等方剂来攻逐积滞。凡是初感外邪的，病邪尚未深入，脏腑之气未败，只要略微去除致病的气血食滞，胃气自然安宁，不难痊愈。
二、凡是脾气稍弱，阳气素来不强的人，一旦受到损伤，难免立即导致泄泻，这虽然属于初病，但应当调理元气，这与体质强壮偶受损伤的情况不同。如果因为腹泻而导致精神困倦，适宜用养中煎，或温胃饮，或圣术煎，或四君子汤，或五君子煎。如果有轻微寒邪兼有积滞但不虚弱的，适宜用佐关煎。如果是脾虚而有轻微积滞的，适宜用五味异功散。如果是脾虚而有轻微寒邪和轻微积滞的，适宜用六味异功煎，或温胃饮。如果是因为饮食不调，忽然出现稀便泄泻，逐渐加重，或者见到轻微疼痛，但排出的粪便酸臭，颜色淡黄，这就是脾虚胃寒不能运化消化的证候，就应当立即使用五德丸，再严重的，就应当使用胃关煎，切勿犹豫。
三、凡是兼有真阴不足而导致的泄泻，那么往往会有脐下疼痛，或者在寅时卯时（凌晨3-7点）症状加重，或者食物吃下去很久，反而多不消化，而出现呕吐恶心、稀便泄泻，或者泄泻气味不重但多见完谷不化等症状。这是因为丹田不温暖，所以尾闾关不固摄，阴中少火不足，所以中焦容易寒冷，这个病根在下焦，所以称为真阴不足，本来与中焦脾胃没有直接关系，所以不是分利小便的方法所能治好的，只有胃关煎这一剂方，才是最好的选择。而且患此病的人最多，不要认为这是新病就不敢用此药，也不要认为患者年轻就不宜用此药，觉得有这些证候，就应当用这些药物，剂量少而功效多，利益不小。但明智的人能预见在先，愚昧的人只能看到后果，等到看到后果，恐怕发现得太迟了，所以贵在能预见在先。
四、肾泄证，就是前面所说的真阴不足证，经常在五更天刚开始，或者天将亮的时候，就发生几次剧烈泄泻，有的持续数月连年不停，或者暂时痊愈后又复发，有的伴有疼痛，有的不痛，这是什么原因呢？盖因肾为胃之关窍，开窍于前后二阴，所以大小便的开闭，都由肾脏所主宰，现在肾中阳气不足，则命门火衰，而阴寒独盛，所以在子丑时及五更之后，当阳气尚未恢复，阴气极盛的时候，就会让人洞泄不止。古方中有椒附丸、五味子散，都是治疗此病的良方；如果一定要让阳生于阴，使肾气充盛坚固，那么又只有八味地黄丸比较合适。然而我曾用过此方，似乎还不够完善，所以特别配制了胃关煎、一气丹、九气丹、复阳丹等方剂，因此得到救治的人很多，或者五味子丸也很好；病情较轻的，可以加用五德丸、四神丸，这些都是最适宜的。
五、凡是脾泄久泄证，大多与前文治疗脾弱的方法相差不远，但新发泄泻可以治标，久泻则不可只治标，而且久泻无火，多因脾肾的虚寒所致。如果只是脾虚，适宜用四君子汤、参术汤、参苓白术散等方剂。如果脾胃兼有寒邪，适宜用五君子煎、黄芽丸、五德丸。如果脾气虚寒兼有积滞闷胀，适宜用六味异功煎、温胃饮、圣术煎。如果脾气虚寒非常严重，且饮食减少，精神疲乏气息倦怠，适宜用参附汤、术附汤、十全大补汤。如果病位在下焦，肾气虚而有微热的，适宜用六味地黄汤；微寒的，适宜用八味地黄汤，或胃关煎。如果是脾虚溏泄，久治不愈，或者小儿脾泄不止的，只用敦阜糕、粘米固肠糕，也容易见效。如果是脾胃寒湿导致溏泄不止的，苍术丸也很好。如果久泻导致元气下陷，大肠虚滑不能固摄，必须在补益剂中加入乌梅、五味子、罂粟壳等药物来固涩收敛。
六、大泻如注，元气逐渐脱失的，应当迅速使用四味回阳饮，或六味回阳饮主治。凡是暴发性泄泻达到这种程度的，没有不立即见效的；如果是久泻发展到这种地步，还担心来不及救治，因为在五种夺损之中，唯独泄泻最为急迫，这是不能不早发现的。如果药物未能及时见效，仍应迅速艾灸气海穴，以挽回下焦的阳气。仍然需要多服人参膏。
七、酒泻证，饮酒的人多有此病，但酒有阴阳两种性质，人有阴阳两种脏腑，而人们大多不能辨别。酒的性质本热，但酒的质地则寒，人们只知道酒有湿热，却不知道酒也有寒湿。所以凡是因酒而生湿热的，是因其性质，因为酒汁不滋阴，而其悍烈之气生热；因酒而生寒湿的，是因其质地，因为酒性散发而质地留存，水液停留成为寒邪。如何辨别呢？常见有人阳气强盛气血充沛而善于饮酒的，也常常多泄泻，如果一天不泻，反而说热闷，这是因为随饮随泻，虽然泻但不致伤气，而且得泻反而去除了湿气，这是他们先天禀赋浓厚，胃气超过常人的表现，最不容易得到，也不多见。这类患者，属于阳证，不过适宜清热利湿，如四苓散、大厘清饮，或酒蒸黄连丸之类，去除湿热而病可愈。如果是阳虚的人，则与此大不相同。盖因脾虚不能胜湿，而湿胜就能生寒，阳气因寒而日渐败坏，胃气因湿而日渐虚弱，其证候则是形体逐渐消瘦，饮食逐渐减少，或者脉象见弦细，或者口鼻身体常怕冷，或者脐腹部常有隐痛，或者眩晕常多困倦，或者在五更天不安宁，或者在秋冬季节加重，只要没有热证依据，而经常有多食不化泄泻的，则总属虚寒。凡是这种情况，如果不迅速培补阳气，必然导致日渐衰弱，而一天比一天危险。我在四十岁以后，也曾患此病数年，形势已经窘迫，于是遍求治疗方法，看到朱丹溪说：因伤于酒，每晨起必泻的，适宜理中汤加葛根，或吞服酒蒸黄连丸。王节斋说：饮酒便泄的，这是酒积热泻，适宜加黄连、茵陈、干姜、木香等药物。薛立斋说：如果酒湿未散，脾气未虚，适宜用此药分利湿热。如果湿热已去，中气被伤，适宜用六君子汤调补中气。又说：酒性大热，乃无形之物，无形元气受伤，应当用葛花解酲汤分消其湿。以上诸家论述，似乎都已讲尽。然而朱、王两家的说法，不分寒热，都用黄连，是只知道酒有热，而不知道酒有寒，哪里值得凭借呢？只有薛氏的说法，虽然也说酒性大热，但重在脾脏，确实很好。我效法他的方法，起初服用葛花解酲汤，无效，继而又服六君子汤、补中益气汤，又无效，再服理中汤以至八味地黄丸，都无效。此时，计谋穷尽力量衰竭，好像没有再生的希望了，于是潜心深思熟虑，料定非峻补命门，最终无益。于是自制胃关煎、右归丸、一气丹等方剂来治疗我的病，仍然绝口不饮酒以杜绝病源，调理了一年多，竟然完全痊愈，从此才明白酒性质之理，多得以此救人。假使当时没有确切的见解，执着相信湿热的说法，而妄用黄连、干葛清凉分利的药剂，哪里能指望有今天？即使自己用药稍晚，那么病情既已严重也难以挽回了。何况现在患此病的人最多，是阴证还是阳证，不可不辨别。凡是阳盛的，脾强胃健，而气不易被夺走的，所以治疗本来不难，而泄泻也不必担忧；阳衰的，脾肾既已受伤，则脱气最容易，所以应当防止来不及救治，不可不为深虑。如果一定认为酒是热的，那么被古法误害的人，确实不少了。
八、气泄证，凡是遇到怒气就发作泄泻的，必定是在发怒时夹杂进食，导致损伤脾胃。所以只要有所触犯，就随即触发而发病，这是肝脾两脏的疾病，盖因肝木克伐脾土，脾气受伤所致。假如脾气本来强盛，即使见到肝邪侵犯，未必能侵入，现在既然容易受伤，则脾气不强可知了。所以治疗此病，应当补脾之虚而顺肝之气，这固然是大法，但虚实有轻重程度不同，则治疗应当区分轻重。比如禀赋壮实气盛，年少而因气泄泻的，可以先用平胃散，或胃苓汤。如果肝气未平而作胀满的，适宜用解肝煎先顺其气。如果脾气稍弱的，适宜用二术煎，或粘米固肠糕，或消食导气饮。如果脾气稍寒的，适宜用抑扶煎、吴茱萸散，或苍术丸。如果脾弱占多数的，适宜用温胃饮、圣术煎，或六味异功煎。如果既畏惧此证为患，则必须切戒生气发怒。
九、风泄证，也应当辨别风寒和风热而治疗。热证的，如伤寒外感热邪之类的，适宜用伤寒门自利条中的诸法治疗；寒证的，以风寒在胃，而脾土受伤，如《内经》所说春伤于风，夏生飧泄之类的，适宜用前文温胃理中的法治之。
1. Sudden onset of diarrhea may be caused by dietary injury or invasion by seasonal pathogens, all stemming from oral intake, each with specific causes that must be identified for treatment. If caused by consumption of cold and raw foods leading to cold stagnation, Yi Fu Decoction (Support and Suppress Decoction) or He Wei Yin (Stomach Harmonizing Drink) should be used to warm the middle. If caused by dampness stagnation, Ping Wei San (Calm the Stomach Powder), Wei Ling Tang (Stomach and Intestine Decoction), or Bai Zhu Shao Yao San (Atractylodes Macrocephala and Peony Powder) should be used to dry dampness and stop diarrhea. If caused by food stagnation with excess distension and pain, Da Zhong He Yin (Great Middle Harmonizing Drink) or Xiao Zhong He Yin (Small Middle Harmonizing Drink) should be used to resolve stagnation. If caused by qi stagnation with severe abdominal pain and diarrhea, Pai Qi Yin (Expel Qi Drink) or Ping Wei San should be used to regulate qi. If food stagnation is firmly bound and unresolved, or if stomach qi is strong and excessive, Shen You Wan (Divine Protection Pill), Chi Jin Dou (Red Gold Bean), or Bai Shun Wan (Hundred Smooth Pills) should be used to purge accumulation. In early stages, when pathogenic factors are not deep and organ qi is not depleted, merely removing the stagnation will restore stomach qi, making recovery easy.
2. Individuals with slightly weak spleen qi and inherently deficient yang, upon any injury, are prone to immediate diarrhea. Although this is an initial illness, it requires tonifying primordial qi, differing from those with strong constitutions who suffer occasional injuries. If diarrhea leads to mental fatigue and lethargy, Yang Zhong Jian (Nourish the Middle Decoction), Wen Wei Yin (Warm the Stomach Drink), Sheng Zhu Jian (Sage Atractylodes Decoction), Si Jun Zi Tang (Four Gentlemen Decoction), or Wu Jun Zi Jian (Five Gentlemen Decoction) are suitable. For mild cold combined with stagnation without deficiency, Zuo Guan Jian (Assist the Gate Decoction) is appropriate. For spleen deficiency with slight stagnation, Wu Wei Yi Gong San (Five Ingredients Extraordinary Efficacy Powder) is indicated. For spleen deficiency with slight cold and stagnation, Liu Wei Yi Gong Jian (Six Ingredients Extraordinary Efficacy Decoction) or Wen Wei Yin is suitable. If irregular diet causes sudden loose stools that gradually worsen, accompanied by mild pain, sour/foul odor, and pale yellow color, this indicates spleen deficiency and stomach cold failing to transform food; Wude Wan (Five Virtues Pill) should be used immediately. For more severe cases, Weiguan Jian (Stomach Gate Decoction) is required without hesitation.
3. Diarrhea associated with insufficiency of True Yin often presents with pain below the umbilicus, worsening during Yin and Mao hours (3:00–7:00 AM), delayed digestion after eating, vomiting, nausea, loose stools, or undigested food in stool despite lack of foul odor. This is due to a warming failure in the Dantian and insecurity of the Tailgate gate, with insufficient fire within yin leading to cold in the middle jiao. The root lies in the lower jiao, termed "insufficiency of True Yin," unrelated to the middle jiao, thus diuretic methods are ineffective. Weiguan Jian is the superior choice. Many suffer from this; do not dismiss it as a new disease unsuitable for treatment, nor assume young patients cannot use it. Recognize the syndrome and apply the formula; small doses yield great benefits. Wise practitioners anticipate symptoms early, while the ignorant react late, highlighting the value of foresight.
4. Kidney Diarrhea refers to the aforementioned insufficiency of True Yin. It typically occurs at dawn (Wu Geng time) or just before daybreak, causing profuse diarrhea several times daily, persisting for months or years, recurring after temporary remission, with or without pain. Why? The Kidneys act as the gate for the Stomach, opening into the two yin passages, governing bowel and bladder control. Insufficient kidney yang leads to decline of Mingmen Fire and dominance of yin-cold. After Zi and Chou hours (11 PM–3 AM) and during Wu Geng time, when yang qi has not recovered and yin-cold is at its peak, profuse diarrhea ensues. Ancient formulas like Jiao Fu Wan (Pepper and Aconite Pill) and Wu Wei Zi San (Schisandra Powder) are effective. To generate yang from yin and solidify kidney qi, Ba Wei Di Huang Wan (Eight-Ingredient Rehmannia Pill) is suitable. However, I found it imperfect, so I formulated Weiguan Jian, Yi Qi Dan (One Qi Elixir), Jiu Qi Dan (Nine Qi Elixir), and Fu Yang Dan (Restore Yang Elixir), which have saved many lives. Wu Wei Zi Wan (Schisandra Pill) is also good; for milder cases, add Wude Wan or Si Shen Wan.
5. Chronic Spleen Diarrhea largely follows methods for treating weak spleen, but acute diarrhea can address symptoms (biao), whereas chronic diarrhea requires addressing the root, as chronic diarrhea lacks heat and stems from spleen-kidney deficiency-cold. For pure spleen deficiency, Si Jun Zi Tang, Shen Zhu Tang (Ginseng and Atractylodes Decoction), or Shen Ling Bai Zhu San (Ginseng, Poria, and Atractylodes Powder) are suitable. For spleen-stomach cold, Wu Jun Zi Jian, Huang Ya Wan (Yellow Sprout Pill), or Wude Wan are appropriate. For spleen qi deficiency-cold with stagnation and fullness, Liu Wei Yi Gong Jian, Wen Wei Yin, or Sheng Zhu Jian are indicated. For severe spleen qi deficiency-cold with reduced appetite, fatigue, and lethargy, Shen Fu Tang (Ginseng and Aconite Decoction), Shu Fu Tang (Atractylodes and Aconite Decoction), or Shi Quan Da Bu Tang (Ten Complete Tonifying Decoction) are needed. For lower jiao pathology with kidney qi deficiency and slight heat, Liu Wei Di Huang Tang (Six-Ingredient Rehmannia Decoction) is used; for slight cold, Ba Wei Di Huang Tang or Weiguan Jian. For chronic spleen deficiency loose stools unresponsive to treatment, or persistent pediatric spleen diarrhea, Dun Fu Gao (Dun Fu Cake) or Nian Mi Gu Chang Gao (Glutinous Rice Intestinal-Solidifying Cake) show quick results. For spleen-stomach cold-dampness causing persistent loose stools, Cang Zhu Wan (Atractylodes Lancea Pill) is excellent. For chronic diarrhea with sinking yuan qi and lax large intestine, add Mei Zi (Mume Fruit), Wu Wei Zi (Schisandra Berry), or Yu Ke (Poppy Shell) to tonifying formulas to astringe.
6. Profuse diarrhea resembling a torrent with gradual loss of yuan qi requires immediate administration of Si Wei Hui Yang Yin (Four-Ingredient Return to Yang Drink) or Liu Wei Hui Yang Yin (Six-Ingredient Return to Yang Drink). Acute cases respond quickly; chronic cases reaching this stage are difficult to save, as diarrhea is the most urgent among the five types of depletion. Early detection is crucial. If medication fails, moxa Qihai (Sea of Qi, CV6) urgently to restore lower jiao yang qi, and administer Ren Shen Gao (Ginseng Paste) frequently.
7. Alcohol Diarrhea is common among drinkers, yet wine possesses both yin and yang natures, and humans have yin and yang organs, often unrecognized. Wine’s nature is hot, but its substance is cold. People know of wine’s damp-heat but ignore its cold-dampness. Damp-heat arises from wine’s nature (fierce qi generating heat); cold-dampness arises from its substance (water retention after the nature dissipates). Differentiation: Strong individuals with robust constitution who drink heavily may experience frequent diarrhea; if they don’t defecate, they feel hot and stifled. Frequent defecation removes dampness without damaging qi, indicating strong innate constitution and superior stomach qi—a rare type. This is a Yang syndrome, treated with clearing and draining methods like Si Ling San (Four Poria Powder), Da Li Qing Yin (Great Clarity Clearing Drink), or Jiu Zheng Huang Lian Wan (Wine-Steamed Coptis Pill) to remove damp-heat. Conversely, Yang-deficient individuals differ greatly. Spleen deficiency fails to overcome dampness, leading to cold generation, further damaging yang and stomach qi. Symptoms include emaciation, reduced appetite, wiry-thin pulse, aversion to cold, dull abdominal pain, dizziness, lethargy, restlessness at dawn, and worsening in autumn/winter. Without heat signs but with frequent undigested stool, it is total deficiency-cold. Failure to rapidly tonify yang leads to decline and danger. I suffered this for years past age forty. Seeking cures, I reviewed Zhu Danxi (Li Zhong Tang plus Ge Gen, or Jiu Zheng Huang Lian Wan), Wang Jiezhai (add Huang Lian, Yin Chen, Gan Jiang, Mu Xiang for alcohol-heat), and Xue Lizhai (Si Jun Zi Tang for damaged middle qi after damp-heat clears; Ge Hua Jie Cheng Tang for无形 yuan qi damage). While Zhu and Wang ignored cold, using Huang Lian indiscriminately, Xue focused on the spleen. I tried Ge Hua Jie Cheng Tang, Liu Jun Zi Tang, Bu Zhong Yi Qi Tang, Li Zhong Tang, and Ba Wei Di Huang Wan, all ineffective. Despairing, I realized only vigorous tonification of Mingmen would help. I created Weiguan Jian, You Gui Wan (Right Restoration Pill), and Yi Qi Dan, abstained from alcohol, and recovered after a year of regulation, gaining insight into wine’s nature. Had I stuck to damp-heat theories and used cooling/diuretic agents, recovery would be impossible. Now, distinguishing yin/yang is vital. Yang-excess individuals have strong spleen/stomach and resist qi loss; Yang-deficient individuals risk rapid qi collapse, requiring deep caution. Assuming wine is purely hot has misled many.
8. Qi Diarrhea occurs upon anger, usually triggered by eating while angry, injuring spleen and stomach. It recurs upon emotional trigger, involving Liver and Spleen, as Liver Wood overacts on Earth. If spleen qi were strong, Liver pathogen couldn’t invade; susceptibility proves spleen weakness. Treatment must tonify spleen deficiency and soothe Liver qi. Severity dictates approach. For robust youth with Qi Diarrhea, start with Ping Wei San or Wei Ling Tang. For uncalmed Liver qi with distension, Jie Gan Jian (Resolve Liver Decoction) to smooth qi first. For slightly weak spleen, Er Zhu Jian (Two Atractylodes Decoction), Nian Mi Gu Chang Gao, or Xiao Shi Dao Qi Yin (Digest Food and Guide Qi Drink). For slightly cold spleen, Yi Fu Jian, Wu Zhu Yu San (Evodia Powder), or Cang Zhu Wan. For predominant spleen weakness, Wen Wei Yin, Sheng Zhu Jian, or Liu Wei Yi Gong Jian. Prevention requires strict avoidance of anger.
9. Wind Diarrhea requires differentiation between Wind-Cold and Wind-Heat. Heat types, such as external contraction heat in Shang Han (Cold Damage), are treated per the Self-Diarrhea section in Shang Han chapters. Cold types, where wind-cold affects the stomach and injures Spleen Earth (as stated in Nei Jing: Spring wind injury leads to Summer undigested stool), are treated with warming the stomach and regulating the middle methods described previously.