【脉】 脉疾身多动，音声响亮，暴注下迫，此阳也、热也。脉沉细疾，目睛不
了了，饮食不下，鼻准气息，此阴也、寒也。
【因】 湿多成五泄者，胃泄、脾泄、大肠泄、小肠泄、大瘕泄。
【证治】 胃泄，饮食不化、色黄，宜承气汤。
脾泄，腹胀满，泄注食呕吐逆，宜理中汤。一云，肠鸣食不化者，经云脾虚。
大肠泄；食已窘迫，大便色白，肠鸣切痛，宜干姜附子汤。
小肠泄，溲便脓血，小腹痛，宜承气汤。
大瘕泄，里急后重，数圊不得，茎中痛，宜五苓散。
五病治虽不同，其湿一也。有化寒、化热之异故也。虚则无力，不及拈衣而已出，故谓
之不禁故也。温之、热之；实则圊不便，虚坐努责，宜下之。
痰积下流，因太阴分有积痰，肺气不得下流降而瘀，大肠虚而作泄，当治上焦，以萝卜
子等吐之。
水恣泄，乃大引饮，是热在膈上，水多入下，胃经无热不胜。寒泄，大肠满而泄 溏。
风泄，久风为飧泄，乃水谷不化而出也，防风为君。
平胃五苓散 治湿泄、水恣泄、热泄。此方治一切阳证。
平胃散、五苓散、白术。热，加黄连、木通。
补胃丸 治气虚下溜。
四君子、白芍（炒）、升麻。
流积丸 治痰积下流。甚则吐之。
青黛 黄芩 海石 神曲 砂仁
止泻丸 肉豆蔻（五两） 滑石（春一两，夏二两，秋一两半）
寒，加神曲、砂仁、吴茱萸；热，加黄连、茯苓；滑，加诃子（煨）。
温六丸 清六丸
脾泄丸 白术（二两，炒） 白芍（一两，酒炒） 神曲（一两半，炒） 查子 半夏
（一两半） 黄芩（半两，炒） 苍术
虚，加参、术、甘草；里急后重，加槟榔、木香、荷叶煨饭丸。
姜附汤 治寒泄。
椒术丸 治湿泻。
川椒 苍术 肉果。
胃风汤 治风泄。
太平丸 治泄。
黄连
一方与干姜炮各一两，或加诃、归，名驻车丸；一方与茱萸各一两，或加芍药，又名苦
散。
肠鸣，乃湿与热相搏也；或大热亦然；或饮水亦鸣。
许论 泄泻有八。冷泻，脉微，宜暖药。热泻，胃中有热，伤寒多有脉数，宜凉
解之。积泻
，脾脉沉弦，宜逐积。脾泻，同上条。气泄者，躁怒不常，伤动其气，肝气乘脾而泄，脉弦
而逆，宜调气。飧泄者，春伤于风，肝旺受病而传于脾，至季夏土而泄，宜泻肝补土。惊泻
者，因心受惊，惊则气乱，心气不通，水入谷道而泄，心脉散大者，是宜调心利水。病亟气
败而泻者，《素问》云∶门户不要也。
厥逆幽闷，困泻不止，四肢冷，困软不能转侧，下泄不知，脉亡阳，喘者死。
【脉象】 脉象疾速且身体多动，声音响亮，突然发生的剧烈腹泻伴有肛门急迫感，这是阳证、热证。脉象沉细而疾速，眼神昏花不清，饮食难以下咽，鼻准部气息微弱，这是阴证、寒证。
【病因】 湿气重容易形成五种泄泻：胃泄、脾泄、大肠泄、小肠泄、大瘕泄（一种以里急后重为特征的泄泻）。
【证候与治疗】 胃泄，表现为食物不消化、大便色黄，适宜使用承气汤（Chengqi Tang, Purging Decoction）。
脾泄，表现为腹部胀满，腹泻如水并伴有呕吐逆气，适宜使用理中汤（Lizhong Tang, Regulate the Middle Decoction）。另一种说法认为，肠鸣且食物不消化的，经文说是脾虚。
大肠泄：进食后立即感到窘迫急迫，大便颜色发白，肠鸣且疼痛剧烈，适宜使用干姜附子汤（Ganjiang Fuzi Tang, Dried Ginger and Aconite Decoction）。
小肠泄，表现为小便和大便带脓血，小腹部疼痛，适宜使用承气汤。
大瘕泄，表现为腹内急迫、肛门重坠（里急后重），频繁上厕所却排不出多少，尿道疼痛，适宜使用五苓散（Wuling San, Five-Ingredient Powder with Poria）。
这五种病的治疗虽然不同，但其致病因素都是湿邪。只是有的转化为寒，有的转化为热罢了。如果是虚证则无力，甚至来不及提起衣服粪便就流出，所以称为不禁（失禁）。对于虚寒者，应用温法、热法；如果是实证则排便不畅，虽有便意但坐卧不安（虚坐努责），应当用下法。
痰积下流，是因为太阴经有积痰，肺气不能下行降浊而瘀滞，大肠虚弱而导致泄泻，应当治疗上焦，用萝卜子等药物催吐。
水恣泄，是由于大量饮水所致，这是膈上有热，水液过多流入下部，胃经没有热邪而不能制约寒气导致的泄泻。寒泄，是大肠胀满而排泄稀溏。
风泄，久受风邪导致飧泄（完谷不化的泄泻），即水谷不消化而出，以防风（Fangfeng, Saposhnikovia Root）为君药。
平胃五苓散：治疗湿泄、水恣泄、热泄。此方治疗一切阳证。
平胃散（Pingwei San, Calm the Stomach Powder）、五苓散、白术（Baizhu, Atractylodis Macrocephalae Rhizoma）。若有热，加黄连（Huanglian, Coptidis Rhizoma）、木通（Mutong, Akebiae Caulis）。
补胃丸：治疗气虚下陷。
四君子汤（Sijunzi Tang, Four Gentlemen Decoction）、炒白芍（Baishao, Paeoniae Radix Alba）、升麻（Shengma, Cimicifugae Rhizoma）。
流积丸：治疗痰积下流。严重的应当催吐。
青黛（Qingdai, Indigo Naturalis）、黄芩（Huangqin, Scutellariae Radix）、海浮石（Haishi, Spongia）、神曲（Shenqu, Massa Medicata Fermentata）、砂仁（Sharen, Amomi Fructus）。
止泻丸：肉豆蔻（Roudoukou, Myristicae Semen，五两）、滑石（Huashi, Talcum，春季一两，夏季二两，秋季一两半）。
若属寒，加神曲、砂仁、吴茱萸（Wuzhuyu, Evodiae Fructus）；若属热，加黄连、茯苓（Fuling, Poria）；若滑脱不禁，加煨诃子（Hezi, Chebulae Fructus）。
温六丸、清六丸。
脾泄丸：白术（二两，炒）、白芍（一两，酒炒）、神曲（一两半，炒）、山楂子（Zhazhi, Crataegi Fructus）、半夏（Banxia, Pinelliae Rhizoma，一两半）、炒黄芩（半两）、苍术（Cangzhu, Atractylodis Rhizoma）。
若属虚，加人参（Renshen, Ginseng Radix）、白术、甘草（Gancao, Glycyrrhizae Radix et Rhizoma）；若有里急后重，加槟榔（Binglang, Arecae Semen）、木香（Muxiang, Aucklandiae Radix），用荷叶包裹米饭制成丸剂。
姜附汤：治疗寒泄。
椒术丸：治疗湿泻。
川椒（Chuanjiao, Zanthoxyli Pericarpium）、苍术、肉豆蔻（Roudoukou）。
胃风汤：治疗风泄。
太平丸：治疗泄泻。
黄连。
一方与炮干姜各一两，或者加诃子、当归（Danggui, Angelicae Sinensis Radix），名为驻车丸（Zhuche Wan, Stop Traveling Pill）；另一方与吴茱萸各一两，或者加芍药，又名苦散（Kusan, Bitter Powder）。
肠鸣，是湿邪与热邪相互搏结所致；或者大热时也会如此；或者喝水多也会肠鸣。
许论指出：泄泻有八种。冷泻，脉象微弱，适宜用暖药。热泻，胃中有热，伤寒病多见脉数，适宜用凉解法。积泻，脾脉沉弦，适宜消除积滞。脾泻，同上一条。气泄，表现为烦躁易怒无常，伤动其气，肝气乘袭脾土导致泄泻，脉象弦而逆乱，适宜调气。飧泄，春季伤于风邪，肝旺受病传于脾，到了长夏季节土旺之时发生泄泻，适宜泻肝补脾（土）。惊泻，因心受惊吓所致，惊则气乱，心气不通，水液进入谷道而泄泻，心脉散大者，适宜调心利水。病情危重、元气败坏而致的泄泻，《素问》说：“这是门户不能固摄的表现。”
四肢厥冷、幽暗闷乱，困倦泄泻不止，四肢冰冷，困软无法翻身转动，下泄不知控制，脉象显示亡阳，气喘者死。
[Pulse] A rapid pulse accompanied by frequent body movements and a loud voice, along with sudden severe diarrhea and tenesmus (urgent feeling to defecate), indicates Yang syndrome and Heat syndrome. A deep, fine, and rapid pulse, blurred vision, inability to eat or drink, and weak breath at the nose tip indicate Yin syndrome and Cold syndrome.
[Etiology] Excessive dampness easily leads to five types of diarrhea: Wei (Stomach) diarrhea, Pi (Spleen) diarrhea, Dachang (Large Intestine) diarrhea, Xiaochang (Small Intestine) diarrhea, and Dajia diarrhea (a type characterized by tenesmus).
[Syndrome Differentiation and Treatment]
Wei (Stomach) diarrhea is characterized by undigested food in stool and yellowish color; it is suitable for treatment with Chengqi Tang (Purging Decoction).
Pi (Spleen) diarrhea presents with abdominal distension and fullness, watery diarrhea with vomiting and regurgitation; it is suitable for treatment with Lizhong Tang (Regulate the Middle Decoction). Another view states that borborygmus (intestinal rumbling) and undigested food indicate Spleen deficiency according to the classics.
Dachang (Large Intestine) diarrhea involves urgency after eating, white-colored stool, intense borborygmus, and cutting pain; it is suitable for treatment with Ganjiang Fuzi Tang (Dried Ginger and Aconite Decoction).
Xiaochang (Small Intestine) diarrhea presents with pus and blood in urine and stool, and lower abdominal pain; it is suitable for treatment with Chengqi Tang.
Dajia diarrhea is characterized by tenesmus (feeling of incomplete evacuation), frequent attempts to defecate with little output, and pain in the urethra; it is suitable for treatment with Wuling San (Five-Ingredient Powder with Poria).
Although the treatments for these five diseases differ, their pathogenic factor is dampness. The difference lies in whether it transforms into Cold or Heat. In deficiency cases, there is a lack of strength, and stool may leak out before one can lift their clothes, hence termed "incontinence." For deficiency-cold, warming and heating methods should be used. In excess cases, if defecation is difficult but there is straining without passage (false urge), purgative methods should be applied.
Phlegm accumulation flowing downward occurs when phlegm accumulates in the Taiyin channel, preventing Lung Qi from descending and causing stasis, while the Large Intestine becomes deficient leading to diarrhea. The upper Jiao should be treated first by inducing vomiting with seeds of Raphanus sativus (Radish seed) etc.
Water diarrhea results from excessive drinking; this indicates Heat above the diaphragm, where excessive water flows downward because the Stomach channel lacks Heat to counteract the Cold, leading to diarrhea. Cold diarrhea involves fullness in the Large Intestine and loose stools.
Wind diarrhea, caused by prolonged exposure to wind, results in undigested food in stool (canaval diarrhea); Fangfeng (Saposhnikovia Root) is used as the sovereign herb.
Formulas:
Pingwei Wuling San: Treats damp diarrhea, water diarrhea, and heat diarrhea. This formula treats all Yang syndromes.
Pingwei San (Calm the Stomach Powder), Wuling San, and Baizhu (Atractylodis Macrocephalae Rhizoma). If Heat is present, add Huanglian (Coptidis Rhizoma) and Mutong (Akebiae Caulis).
Bugwei Wan: Treats Qi deficiency with sinking.
Sijunzi Tang (Four Gentlemen Decoction), fried Baishao (Paeoniae Radix Alba), and Shengma (Cimicifugae Rhizoma).
Liujie Wan: Treats phlegm accumulation flowing downward. Severe cases require vomiting.
Qingdai (Indigo Naturalis), Huangqin (Scutellariae Radix), Haishi (Spongia), Shenqu (Massa Medicata Fermentata), and Sharen (Amomi Fructus).
Zhixie Wan: Roudoukou (Myristicae Semen, 5 liang), Huashi (Talcum, 1 liang in Spring, 2 liang in Summer, 1.5 liang in Autumn).
If Cold, add Shenqu, Sharen, and Wuzhuyu (Evodiae Fructus); if Heat, add Huanglian and Fuling (Poria); if slippery/incontinent, add roasted Hezi (Chebulae Fructus).
Wenliu Wan, Qingliu Wan.
Pixie Wan: Baizhu (2 liang, fried), Baishao (1 liang, wine-fried), Shenqu (1.5 liang, fried), Zhazhi (Crataegi Fructus), Banxia (Pinelliae Rhizoma, 1.5 liang), fried Huangqin (0.5 liang), Cangzhu (Atractylodis Rhizoma).
If deficiency, add Renshen (Ginseng Radix), Baizhu, and Gancao (Glycyrrhizae Radix et Rhizoma); if tenesmus is present, add Binglang (Arecae Semen) and Muxiang (Aucklandiae Radix), made into pills wrapped in lotus leaves with rice.
Jiangfu Tang: Treats cold diarrhea.
Jiaozhu Wan: Treats damp diarrhea.
Chuanjiao (Zanthoxyli Pericarpium), Cangzhu, and Roudoukou (Myristicae Semen).
Weifeng Tang: Treats wind diarrhea.
Taiping Wan: Treats diarrhea.
Huanglian.
One prescription combines fried Ganjiang (Dried Ginger) and Huanglian in equal amounts (1 liang each), or adds Hezi and Danggui (Angelicae Sinensis Radix), named Zhuche Wan (Stop Traveling Pill). Another prescription combines Huanglian and Wuzhuyu in equal amounts (1 liang each), or adds Shaoyao (Peony Root), also known as Kusan (Bitter Powder).
Borborygmus is caused by the struggle between Dampness and Heat; it can also occur with severe Heat or excessive water intake.
Xu Lun stated that there are eight types of diarrhea:
Cold diarrhea has a faint pulse and is suitable for warming herbs.
Heat diarrhea involves Heat in the Stomach; in Shanghan (Cold Damage) diseases, a rapid pulse is common, and cooling resolution is suitable.
Accumulation diarrhea has a deep and wiry Spleen pulse, and removing accumulation is suitable.
Spleen diarrhea follows the same principles as above.
Qi diarrhea is characterized by irritability and anger, damaging Qi; Liver Qi invades the Spleen causing diarrhea, with a wiry and rebellious pulse, so regulating Qi is suitable.
Canaval diarrhea results from Wind injury in Spring, where hyperactive Liver disease transmits to the Spleen, manifesting as diarrhea in late Summer when Earth is strong; draining the Liver and tonifying Earth is suitable.
Shock diarrhea results from Heart shock; shock causes Qi chaos, Heart Qi obstruction, and water entering the digestive tract causing diarrhea; if the Heart pulse is scattered and large, regulating the Heart and promoting urination is suitable.
Diarrhea due to critical illness and collapse of Qi is described in Suwen as "the gate cannot hold."
Cold limbs, darkness and oppression, continuous exhausting diarrhea, cold limbs, weakness unable to turn over, unconsciousness of defecation, pulse indicating Yang collapse, and panting indicate death.