大吐有真假也既吐矣如何有假有真之分不知吐症而兼他症者多吐为真象则他症为假象吐
为假
象则他症为真象也故亦不可不辨明之耳如伤寒之有吐症也伤寒为真吐乃假象若但止其吐而不
顾其寒则寒症不能愈如翻胃之吐也乃下元之真虚不治其虚而止治其吐则吐愈不可止此吐症之
所以有真假也大约真吐者少而假吐者多真吐者止胃气之病治其胃而即安其症心中泛泛然一时
而来非平昔之素有疾病非火作祟即风作虐耳方用二陈汤加香砂平胃之品一剂便可奏功何治之
易耶以其真吐之病耳若夫假吐之症必观其病情察其虚实看其起居观其口舌之滑燥而后以治伤
寒翻胃等症之药因病而加减之始可奏功以安其吐否则适所以取败也假吐余不立方者正以
病非一端而方难执一耳
大泻之症何以亦分真假其泻果有真假之分哉亦以泻必兼邪挟邪而泻有因虚而泻者实不相
同
故吾又分门而辨论之阴虚而泻乃真泻也补脾阴之气温命门之火前已有方故不再定若挟邪而泻
乃假泻也不可因其泻而用止泻之药其症必腹痛而有一阵一阵之景状者乃邪泻不比正泻之但痛
而不动也邪泻者必后重而里急正泻则不然也以此辨症最为得情上文言泻已定其方然而止言挟
火而泻未尝论及挟邪而泻挟邪而泻者挟风而泻也更有挟毒而泻者此皆假泻不可不知余今立
一方风泻毒泻俱可通治无不神效方名秽逐丹此方逐秽之中而兼去风之药泻火毒而又利其水浊
者仍从大便出而清者则从小便而行真两得之道也然何以知是风泻与毒泻之分风泻者里急浓重
粪门作哔唪之声风泻也下如胶漆乌黑屋漏水之污秽者毒泻也以此分别大约无差又在临症以细
辨之
秽逐丹
大黄（三钱） 车前子（五钱） 当归（五钱） 甘草（二钱） 槟榔（二钱） 枳壳（一钱） 萝卜子（
一钱） 桃仁（二十粒） 栀子（二钱） 柴胡（二钱）水煎服
大吐有真吐和假吐之分。既然已经发生呕吐，怎么会有真假的区别呢？之所以有真与假的区分，是因为不知道有些呕吐症状是兼夹其他病症的。如果呕吐是真象，那么其他伴随的症状就是假象；如果呕吐是假象，那么其他伴随的症状才是真象。因此，也不可不对此加以辨明。
例如伤寒病出现的呕吐症状，伤寒是本（真），呕吐是标（假象）。如果只止住呕吐而不顾及其寒邪，那么寒症就不能痊愈。又如翻胃（反胃）引起的呕吐，这是下元（肾阳/命门）真正的虚损，如果不治疗其虚损而只去止吐，那么呕吐就永远无法停止。这就是呕吐症状之所以有真假之分的缘故。
大概而言，真吐的情况较少，假吐的情况较多。真吐多是胃部本身的疾病，只要治疗胃部就能使症状安宁。这种呕吐心中感到泛泛不适，是一时发作的，并非平素就有宿疾，也不是由火邪作祟或风邪肆虐所致。方剂可用二陈汤加入香砂平胃散的药物，一剂药便可见效，治疗多么容易啊！这是因为它是真吐的病证。
至于假吐的症状，必须观察病人的病情，辨别虚实，查看起居状况，观察口舌的滑润与干燥，然后根据治疗伤寒、翻胃等病症的药物，因病机不同而加减使用，这样才能奏效并平息呕吐。否则，反而会导致失败。对于假吐，我不单独设立固定方剂，正是因为病因不单一，而方剂难以拘泥于一法。
大泻的症状为什么也分真假呢？腹泻果真有真假之分吗？这也是因为腹泻必然兼夹邪气，挟带邪气而泻与因虚而泻，情况绝不相同。所以我又分门别类进行辨析讨论。阴虚导致的腹泻是真泻，此前已有补脾阴、温命门之火的方剂，故不再另行制定。如果是挟带邪气而泻，则是假泻。不能因为腹泻就用止泻药。这种症状必定腹痛，且疼痛呈一阵一阵的特点，这是邪气致泻，不同于正气虚弱之泻只是疼痛而没有阵发性加剧。邪气致泻必定伴有里急后重，而正虚之泻则不是这样。以此辨别病症最为恰当。上文论述腹泻时已确定了方剂，然而只提到了挟火而泻，未曾论及挟邪而泻。挟邪而泻，实际上是挟风而泻，更有挟毒而泻的情况。这些都属于假泻，不可不知。我现在立一方，风泻、毒泻均可通治，无不神效。方名秽逐丹。此方在驱逐秽浊之中兼用祛风药物，既泻火毒，又利水浊，使秽浊仍从大便排出，清者则从小便而行，这是真阴与邪气两得的处理之道。然而如何区分风泻与毒泻呢？风泻表现为里急后重，肛门发出哔唪之声，此为风泻；泻下如胶漆状，颜色乌黑如屋漏水般的污秽物，此为毒泻。以此分别，大约没有差错，又在临症时仔细辨别即可。
秽逐丹
大黄（三钱） 车前子（五钱） 当归（五钱） 甘草（二钱） 槟榔（二钱） 枳壳（一钱） 萝卜子（一钱） 桃仁（二十粒） 栀子（二钱） 柴胡（二钱） 水煎服
There is a distinction between true and false vomiting. Since vomiting has already occurred, how can there be a distinction between true and false? The reason for this distinction lies in the fact that many vomiting cases are accompanied by other symptoms. If the vomiting is the true manifestation (the root cause), then the accompanying symptoms are false manifestations; if the vomiting is a false manifestation, then the accompanying symptoms represent the true condition. Therefore, it is essential to distinguish them clearly.
For instance, in Taiyang disease (Exterior Syndrome of the Taiyang channel) presenting with vomiting, the Taiyang disease is the true condition, while the vomiting is a false manifestation. If one merely stops the vomiting without addressing the cold pathogen, the cold syndrome will not be cured. Similarly, in Fanwei (Regurgitation/Gastric Outlet Obstruction), the vomiting stems from a true deficiency of the Lower Yuan (Kidney Yang/Mingmen Fire). If one treats only the vomiting without addressing the underlying deficiency, the vomiting cannot be stopped. This explains why vomiting symptoms have true and false distinctions.
Generally speaking, true vomiting is rare, whereas false vomiting is common. True vomiting usually results from stomach pathology itself; treating the stomach promptly alleviates the symptoms. In such cases, the patient feels nauseous suddenly, which is not a chronic condition nor caused by fire pathogens or wind pathogens. The formula used is Erchen Tang (Two-Cured Decoction) added with aromatic and sandalwood-type herbs and Pingwei San (Calm the Stomach Powder). One dose can achieve success, making treatment quite easy, as it addresses the true nature of the vomiting.
Regarding false vomiting, one must observe the patient's condition, differentiate deficiency and excess, examine daily habits, and inspect the moisture or dryness of the mouth and tongue. Then, based on formulas for treating Taiyang disease, Fanwei, etc., modifications should be made according to the specific pathology to effectively stop the vomiting. Otherwise, failure may ensue. I do not provide fixed formulas for false vomiting because the causes are diverse, and a single formula cannot apply universally.
Why are diarrhea symptoms also divided into true and false? Does diarrhea truly have such a distinction? This is because diarrhea is invariably accompanied by pathogenic factors. Diarrhea caused by pathogens differs significantly from diarrhea caused by deficiency. Thus, I categorize and discuss them separately. Diarrhea due to Yin deficiency is true diarrhea; previously, formulas for tonifying Spleen Yin and warming Mingmen Fire were provided, so no new formula is established here. However, diarrhea accompanied by pathogens is false diarrhea. One should not use antidiarrheal drugs simply because diarrhea is present. Such cases typically involve abdominal pain that occurs in paroxysms. This "pathogenic diarrhea" differs from "deficiency diarrhea," which involves pain without paroxysmal intensity. Pathogenic diarrhea is characterized by tenesmus (urgent need to defecate with little output), whereas deficiency diarrhea does not present this way. Differentiating based on these signs is most accurate. The previous discussion on diarrhea established formulas but only addressed diarrhea accompanied by fire, neglecting diarrhea accompanied by pathogens. Diarrhea accompanied by pathogens is essentially diarrhea accompanied by wind, and there is also diarrhea accompanied by toxins. These all belong to false diarrhea and must be understood. I now prescribe a formula effective for both wind-diarrhea and toxin-diarrhea, named Hui Zhu Dan (Filth-Expelling Pill). This formula expels filth while simultaneously dispelling wind, clears fire-toxins, and promotes the excretion of turbid fluids through urine, while clearing substances exit via stool. This achieves a balance where both the healthy Qi and pathogens are appropriately managed. How to distinguish between wind-diarrhea and toxin-diarrhea? Wind-diarrhea presents with tenesmus and a buzzing sound in the anus. Toxin-diarrhea presents with stools resembling glue or lacquer, dark black like leaking roof water. Distinguishing by these characteristics is generally accurate, though careful clinical observation is required.
Hui Zhu Dan (Filth-Expelling Pill)
Dahuang (Rhei Radix et Rhizoma) (3 qian) Cheqianzi (Plantaginis Semen) (5 qian) Danggui (Angelicae Sinensis Radix) (5 qian) Gancao (Glycyrrhizae Radix et Rhizoma) (2 qian) Binglang (Arecae Semen) (2 qian) Zhiqiao (Aurantii Fructus Immaturus) (1 qian) Luoboziz (Brassicae Semens) (1 qian) Taoren (Persicae Semen) (20 grains) Zhizi (Gardeniae Fructus) (2 qian) Chaihu (Bupleuri Radix) (2 qian) Decoct in water and take orally.