仲淳云∶干霍乱者，固猝中邪恶秽污之气，兼有停滞郁于胸腹间，欲吐不得吐，欲泻不得泻，以
致肠胃绞痛异常，胸腹骤胀，遍体紫黑，其死最速。急寻头顶心红发拔去，即用盐水探吐之，大忌米饮
热汤，犯之即死。宜通宜泻，忌塞忌补。
盐水深吐法
用新汲凉水〔二、三大碗。〕入炒盐〔两许。〕恣饮，以鹅翎探喉令吐，不吐再服，如吐未
尽，再吐，三吐乃止。〔经云∶在上者因而越之也。〕若在下者，宜用芒硝。〔所谓引而竭之也。〕如
欲吐下兼行、盐、硝并用。此救急之良
方，有起死回生之功效，干霍乱者，必用之。治干霍乱，用药大法，宜开气通窍，和胃调脾为主，吐
泻止后，半日饥甚，方可少与稀粥。
华陀危病方 治夏月过用水果，填塞至阴，抑遏肝气，霍乱转筋者。〔必验其小便清白，不渴
不热者，方可作寒治之。〕
吴茱萸 木瓜 食盐
此舍时从症之剂也。仲淳治一妇霍乱，用砂仁〔一两。〕盐〔一撮。〕滚汤调冷定。服一剂愈。
云∶伤冷物者，方可加吴茱萸〔钱许。〕慎勿乱投。
霍乱脉宜洪大，不宜迟微，或结或促，或伏或代，皆不可断以死。
霍乱转筋入腹，及遍身转筋者不治。
泄泻一症，《内经》言风，则曰∶春伤于风，夏生飧泄。谓邪气留连既久，则必克制脾土，而为
飧泄。言湿，则
曰∶湿胜则濡泄。谓脾喜燥而恶湿，湿胜则脾伤而为濡泄。言热，则曰∶暴注下迫。皆属于热。热即
火也，言卒暴注泄而后重里急迫痛者，火性急速，而能燥物也。故伤暑之泻，亦必暴注，大孔作痛，皆
火之所为也。又曰∶多热则溏出糜。言热则浊垢下注，故为溏为糜。以糜、秽如泥也。言寒则曰∶诸病
水液，澄澈清冷，皆属于寒。谓水谷不化，而澄澈清冷者。皆得寒水之化。如秋冬寒冷，水必澄清也。又
曰∶多寒则肠鸣飧泄，食不化，言阳气虚而不能消化也。言燥，则曰∶逆秋气则伤肺，冬为飧泄。言肺
伤于燥，发在本经，则冬生咳嗽；移热于腑，则冬为飧泄，皆肺气燥热之所致。此明四时六气，皆能为泄
也。又言饮食不节，起居不时者，下为飧泄。此明饮食劳倦内伤之泄也。又言肝所生病，为飧泄。此明肝
木乘脾之泄也。又言脾虚腹胀肠鸣，飧泄、食不化。又言清气在下，则生飧泄。此明脾虚陷下之泄也。又
言肾脉小甚为洞泄。又言寒入下焦，传为濡泻。此明肾中阳衰之泄也。统而论之，脾土强者，诸邪自不能
干，脾土一衰，诸邪皆得干之而为病。正经所谓∶邪之所凑，其气必虚是也。肾主二便，而司开合，肾
失其职，则开合失常，故肾气虚衰之人，以及久泄不止，下多亡阴，当求责之肾矣。是故以其风也，升
阳以散之；以其湿也，利水以分之。热则清之，寒则温之，燥则濡之。因食因痰者，消之祛之；因虚者
补之益之，肝乘脾者，制之扶之。肾气虚衰者，或壮水之主，使水充而无火迫下注之病；或益火之原，
使火旺而无阳虚失禁之患。故致泻之因不一，而治泄之法亦多，求其大
要，总归重于脾肾二脏，临症之际，圆机灵变，可以胥天下于寿域矣。
升阳除湿汤〔重订。〕治受风飧泄。〔风邪客居肠胃，如顺风扬帆，以故飧已即泄。〕其泄
必完谷不化，〔然亦有因热、因寒、因气虚者。〕洞注有声。又经云∶肝所生病，为飧泄。〔肝木郁于
地中，脾土受制故也。〕亦此主之。〔即逍遥散之义。〕
柴胡〔春为木令，风为木气，此味乃肝胆之主药。〕
升麻 防风〔发散风邪，亦能升举下陷之气。〕炒白芍〔泻土中之木以安脾。〕炒米
仁〔健脾祛风胜湿。〕茯苓〔渗湿，以无湿则不作泻也。〕炙甘草〔益脾，以脾旺则能制湿
也。〕虚者加人参。
此发散升举之剂，经曰∶客者除之。又曰∶下者举之是也。按嘉言云∶风从外入，仍宜领风从肌
表而出，若用补脾刚燥之剂，助风性之劲，则有泄无已矣。又仲淳云∶先用发散升举之，次用黄 四君子
等药，白芍、甘草，制肝实脾，乃始终必用之剂。又谓长夏湿热令行，又岁湿太过，民病多泻，当用风
药。以风能胜湿也。
黄芩汤 治火热作泻，粪色黄褐，肛门燥涩，小便黄赤。
黄芩〔清热。〕白芍 甘草 大枣〔和脾。〕热甚者加黄连。
辰砂益元散〔见暑。〕治伤暑作泻，其泻必暴注，大孔作痛，口渴溺赤。
此二方皆清凉之法。经曰∶热者寒之是也。仲淳云∶此
症桂苓甘露饮亦可去桂加减用之。以方中有石膏、滑石、寒水石清暑热，五苓利湿邪故也。张子和加
参、甘，因其脉虚也。又谓九制黄连，最止热泻，须与人参等分乃可。盖久泻不止，多缘气虚，纯
用苦寒，胃气愈闭。又下多亡阴，必用人参，亦阳生阴长之意。
胃苓汤〔见湿。〕治湿盛作泻，其泻多水，〔凡泻水腹不痛者湿也，泻一阵，痛一阵者，湿
而兼火也。〕小便不利。〔水谷并趋一路故也。〕
此燥脾淡渗，二法同用。经曰∶湿者燥之。故用平胃。又曰∶治湿不利小便，非其治也。故用四
苓。随症分用亦可。如脾胃虚弱者，用白术茯苓汤，〔方只二味。〕加米仁、车前、香、砂之属。
保和丸〔亦可小剂作汤。〕治伤食泄泻。〔腹痛甚而泻，泻后痛减者，食也。〕
山楂〔消肉积。〕麦芽〔消米面菜积。〕神曲〔消糯米食积，各三两。〕卜
子〔消面积。〕橘红〔疏脾胃之滞气，各二两。〕茯苓〔渗脾胃之水湿。三两。〕连
翘仁〔祛脾胃之湿热。〕半夏〔除脾胃之湿痰，各二两。无湿痰者去之。〕加白术〔三两。〕名
大安丸。可加木香、砂仁。如因伤酒作泻，加葛花〔解酒毒。〕猪苓泽泻〔利水湿。〕
苍白二陈汤〔即二陈加二术。〕治湿痰泄泻，〔肥人滑泄责之痰，脉滑不调责之痰，不食不饥责
之痰，昔肥今瘦责之痰。《金质》云∶水走肠间，沥沥有声者，曰痰饮。〕虚者
加人参。
赵以德云∶有积痰在肺，以致大肠之气不固者，宜涌出上焦之痰，而泻自愈。非苍白二陈之所治也。
此二方消之、祛之之法也。食积酒伤痰饮，皆令人泻，随症祛逐，勿使稽留，经所谓实者泻之是也。
枳术丸 消食止泻。又治心下痞满。
白术〔强胃健脾，二两。〕枳实〔消积除痞，一两。〕荷叶〔裨助脾胃，升发阳气，荷
叶包陈米饭，煨干为末，打糊为丸。〕加木香 砂仁〔各一两，〕名香砂枳术丸。
此七补三攻之法，随症加药用之。
归脾汤〔见虚劳。〕治忧思太过，脾气郁结，不能升举，陷入下焦，泄泻。
原方〔补养心脾，〕加砂仁 豆蔻〔开散郁结。〕葛根 荷蒂〔升发阳气。〕
独参膏〔一味熬膏。〕参术膏〔二味，熬膏。〕治气暴脱而虚，顿泻不知人事，口眼俱
闭，呼吸甚微，脉欲绝者，大剂频与之。〔甚至有服参十余斤，而后得愈者。〕
此三方皆补之、益之之法。经云∶虚者补之，是也。
补中益气汤 治劳倦伤脾，〔脾主四肢故
也。〕中气不足，懒于言语，〔脾为后天生气之原中气虚则懒言，以声由气发故也。〕恶食溏泄，〔胃
虚不能胜谷气，故恶食，脾虚不能制土湿，故溏泄。〕日渐瘦弱。〔脾主肌肉也。〕
人参 黄 〔益其气。〕 白术〔各一、二钱。〕甘
萆〔补其中。〕 当归〔脾苦无血，故以养之，土恐太燥，故以泽之。泻者去之亦可。〕橘
红〔一以理脾胃之气，一以行甘温之滞，各七分至钱许。〕 升麻〔提下陷之清气，从右而
旋。〕柴胡〔提下陷之清气，从左而旋。各三、五分。〕
此补之、益之而兼升提之法也。嘉言云∶此方后人谓其升清降浊，殊谬。夫以升清之药，岂有降浊
之能，若阳气未必下陷，反升举其阴气，干犯阳位，为害不小。更有阴气素惯上乾清阳，而胸中之肉
隆耸为 ，胸中之气，漫散为胀者，误施此法，天翻地复矣。夫补其中气，以听中气之自为升降，不用
升、柴，亦无不可，必清气下入腹中为泄，则可多用而升举之，为合法也。若四君、六君、理中、归
脾、桂附理中、连茯理中，皆补脾虚泄泻之圣剂，随宜用之。
理中汤 治中寒骛泄。〔状如鸭粪。〕糟粕不化，澄澈清冷，小便清白。
人参 白术 甘草〔补脾。〕干姜〔温中。〕里寒甚者，可加肉桂。本方加附子，名附子理
中汤，加黄连、茯苓，名连茯理中汤。温补之法，果属虚寒者，投之自效。
四神丸 治肾虚泄泻，其泻多在子后五更，溏而弗甚，累年弗瘳，服补脾胃药不效，是其候也。
破故纸〔温肾，炒，四两。〕肉豆蔻〔固涩，面包煨。〕五味子〔酸收，炒，各二
两。〕吴茱萸〔能暖膀胱，水道即清，大肠自固。他药虽热，不能分解清浊，五
钱。〕可加人参、沉香，甚者加附子、茴香、川椒。
脾肾双补丸 治肾泄。
人参 莲肉〔去心炒黄。〕山药〔炒黄。〕肉果〔补脾，煨。〕补青脂〔盐水
炒。〕五味子〔蜜炙透。〕菟丝子〔制。〕 巴戟天〔去骨甘草汁煮。〕萸肉〔补
肾，各四两。〕橘红 砂仁〔香能醒脾，各二两。〕车前子〔利水与茯苓同功，水道利则清
浊分，而泻止。四两〕〔炼蜜丸，如绿豆大，每服五钱，空心饥时服。〕如虚，而有火者，火盛肺热
者，去人参、肉果、补骨脂、巴戟。
此二方、补脾温肾，酸收固涩，四法同用。经所谓虚者补之，寒者温之，散者收之，滑者涩之，是
也。仲淳治一人。茹素、患内热，每食肠鸣，清晨作泄。以此方去肉果，用白芍代之，外加扁豆六两，
服之而愈。白术虽云健脾除湿，救标则可，多服反能泻脾，以其燥能损津液故耳。仲景有赤石脂、禹
余粮丸，专固下焦之脱，亦可取用。凡治泄泻，多用丸散者，取其实脾土之义也。
喻嘉言验方 治秋伤于燥，咳嗽泄泻。
黄芩 骨皮 甘草〔清肺之热。〕 杏仁 阿胶〔润肺之燥。〕
此润燥清热之剂，亦治泻一法，所谓治病必求其本也。泄泻之脉，缓小者吉，浮大急疾者凶，与痢同看。
脉细皮寒气少，饮食不入，泄利前后者死。下则泄泻，上则吐痰，皆不已，为上下俱脱者死。食方
入口而即出，谓之直肠泄，难治。
顾仲淳说：干霍乱，确实是突然感受了邪恶污秽之气，同时又有饮食停滞郁结在胸腹之间，想吐却吐不出来，想泻却泻不出来，导致肠胃剧烈绞痛，胸腹部突然胀满，全身皮肤呈现紫黑色，死亡速度极快。紧急时寻找头顶心（百会穴区域）的红发拔掉，立即用盐水催吐，绝对禁止饮用米汤或热开水，一旦触犯就会死亡。治疗原则宜疏通、宜泻下，忌堵塞、忌进补。
盐水深吐法
取刚打来的凉水两到三大碗，加入炒过的盐约一两，大量饮用，用鹅毛管探喉催吐，如果不吐再服用，如果呕吐不彻底，继续催吐，直到三次呕吐为止。（《内经》说：病邪在上部的，应当因势利导使其从上而出。）如果病邪在下部，适宜使用芒硝。（这就是所说的引导其从下排出。）如果想要吐下兼施，则盐和芒硝并用。这是急救的良方，有起死回生的功效，干霍乱患者必须使用。治疗干霍乱的用药大法，以开气通窍、调和胃气、调理脾气为主，待吐泻停止后，半天时间如果感到极度饥饿，才可以少量给予稀粥。
华陀危病方 治疗夏季过度食用生冷水果，导致阴寒内盛，压抑肝气，引起霍乱转筋的患者。（必须检查患者小便清白，不口渴、不发热的情况下，才可以作为寒证治疗。）
吴茱萸、木瓜、食盐
这是“舍时从症”（不拘泥于季节气候，而根据具体症状辨证）的方剂。顾仲淳曾治疗一位霍乱妇女，使用砂仁一两、盐一撮，用滚开水调凉后服用。服一剂即愈。他说：如果是损伤冷物引起的，才可以加吴茱萸一钱左右。千万不要乱投药物。
霍乱的脉象宜洪大，不宜迟微，或者出现结脉、促脉、伏脉、代脉，都不能直接断定为死证。
但是，霍乱转筋蔓延至腹部，以及全身转筋的，属于不治之症。
关于泄泻这一病症，《内经》谈到风邪时说：春季伤于风邪，到了夏季就会发生飧泄（完谷不化的腹泻）。意思是邪气留连日久，必然会克制脾土，从而形成飧泄。谈到湿邪时说：湿气胜则发生濡泄（大便稀溏如水）。意思是脾脏喜欢干燥而厌恶湿气，湿气过胜则损伤脾脏而形成濡泄。谈到热邪时说：暴注下迫（急剧的水样腹泻且伴有肛门急迫感），都归属于热。热就是火，所谓卒然暴发、急剧腹泻且伴有里急后重、腹部紧迫疼痛的，是因为火性急速，且具有燥烈特性。所以伤暑导致的腹泻，也必然是暴注，肛门作痛，这都是火热所致。又说：多热则大便溏薄如糜。意思是热邪导致浊垢下注，所以大便呈溏薄或糜烂状，像烂泥一样。谈到寒邪时说：各种水液排泄物，清澈寒冷，都归属于寒。意思是水谷不能消化，排泄物清澈寒冷，都是得到了寒水的性质。就像秋冬寒冷时，水必然澄清一样。又说：多寒则肠鸣飧泄，食物不消化，意思是阳气虚弱而不能消化食物。谈到燥邪时说：违背秋季的气候则损伤肺脏，到了冬季会发生飧泄。意思是肺脏被燥邪所伤，发作在本经则冬季生咳嗽；移热于腑，则冬季发生飧泄，这都是肺气燥热所致。这说明了四时六气都能导致泄泻。又提到饮食不节制、起居无规律的人，会导致下部飧泄。这说明了饮食劳倦内伤导致的泄泻。又提到肝脏所生的疾病，包括飧泄。这说明了肝木乘克脾土导致的泄泻。又提到脾虚腹胀肠鸣，飧泄、食物不消化。又提到清气在下，则发生飧泄。这说明了脾虚下陷导致的泄泻。又提到肾脉细小甚者为洞泄。又提到寒邪侵入下焦，传变为濡泻。这说明了肾中阳气衰微导致的泄泻。统而言之，脾土强健，各种邪气自然不能侵犯；脾土一旦衰弱，各种邪气都能侵犯它而导致疾病。正如经典所说：邪气聚集的地方，正气必定虚弱。肾脏主管二便，并司职开合，肾脏失职，则开合失常，所以对于肾气虚衰的人，以及久泻不止、下利多导致亡阴的情况，应当责之于肾。因此，对于风邪引起的，用升阳散风的方法；对于湿邪引起的，用利水分湿的方法。热邪则清热，寒邪则温中，燥邪则滋润。因食积、痰饮引起的，用消导祛痰的方法；因虚损引起的，用补益的方法；肝木乘脾引起的，用制约扶脾的方法。肾气虚衰的，或者壮水之主（滋补肾阴），使水充足而无火迫下注之病；或者益火之原（温补肾阳），使火旺盛而无阳虚失禁之患。所以导致泄泻的原因不一，治疗泄泻的方法也很多，求其要领，总归重于脾肾两脏，临症时灵活变通，就可以让天下人都达到健康长寿的境界了。
升阳除湿汤（重新修订版） 治疗受风引起的飧泄。（风邪客居肠胃，如同顺风扬帆，所以吃完就拉。）这种泄泻必然完谷不化，（但也有因热、因寒、因气虚引起的。）肠鸣洞注有声。又《内经》说：肝所生病，为飧泄。（肝木郁结在地中，脾土受制所致。）此方也主治这种情况。（即逍遥散的含义。）
柴胡（春季为木令，风为木气，此药是肝胆的主药。）
升麻、防风（发散风邪，也能升举下陷之气。）炒白芍（泻土中之木以安脾。）炒米仁（健脾祛风胜湿。）茯苓（渗湿，没有湿气就不会发生泄泻。）炙甘草（益脾，脾旺就能制湿。）虚者加人参。
这是发散升举的方剂，《内经》说：客邪要清除它。又说：下陷的要提升它。按嘉言的说法：风从外入，仍应引领风邪从肌表而出，如果使用补脾刚燥的药物，助长风性的劲烈，则有泄无已矣。又顾仲淳说：先用发散升举的药，再用黄芪、四君子等药，配合白芍、甘草，制约肝木、充实脾土，这是始终必用的方法。又说长夏湿热盛行，又逢岁运湿太过，民众多病泄泻，当用风药，因为风能胜湿。
黄芩汤 治疗火热引起的泄泻，粪便色黄褐，肛门干燥涩滞，小便黄赤。
黄芩（清热。）白芍、甘草、大枣（和脾。）热甚者加黄连。
辰砂益元散（见暑病章节） 治疗伤暑引起的泄泻，其泄泻必然是暴注，肛门作痛，口渴，小便红赤。
这两个方子都是清凉的方法。《内经》说：热者寒之。顾仲淳说：此症桂苓甘露饮也可以去掉桂枝加减使用。因为方中有石膏、滑石、寒水石清暑热，五苓散利湿邪的缘故。张子和加人参、甘草，是因为患者脉虚的缘故。又说九制黄连最能止热泻，必须与人参等分使用才行。因为久泻不止，多缘于气虚，纯用苦寒药物，胃气会更加闭塞。又下利多亡阴，必须用人参，这也是阳生阴长的意思。
胃苓汤（见湿病章节） 治疗湿盛引起的泄泻，其泄泻多为水样，（凡是泻水且腹部不痛的属湿，泻一阵痛一阵的，是湿兼火邪。）小便不利。（水谷并趋一路的缘故。）
这是燥脾和淡渗两种方法同用。《内经》说：湿者燥之。所以用平胃散。又说：治湿不利小便，不是正确的治疗方法。所以用四苓散。随症状分别使用也可以。如脾胃虚弱者，用白术茯苓汤（方中只有两味药），加米仁、车前子、香附、砂仁之类。
保和丸（也可以小剂量作汤剂） 治疗伤食泄泻。（腹痛剧烈而泻，泻后痛减的，是食积。）
山楂（消肉积。）麦芽（消米面菜积。）神曲（消糯米食积，各三两。）萝卜子（消面食积。）橘红（疏理脾胃滞气，各二两。）茯苓（渗利脾胃水湿，三两。）连翘仁（祛除脾胃湿热。）半夏（祛除脾胃湿痰，各二两。无湿痰者去掉。）加白术（三两。）名为大安丸。可加木香、砂仁。如因饮酒过量致泻，加葛花（解酒毒。）猪苓、泽泻（利水湿。）
苍白二陈汤（即二陈汤加苍术、白术） 治疗湿痰泄泻，（肥胖人滑泄责之于痰，脉滑不调责之于痰，不想吃东西也不觉得饿责之于痰，以前胖现在瘦责之于痰。《金匮要略》说：水走肠间，沥沥有声的，叫痰饮。）虚者加人参。
赵以德说：有积痰在肺，导致大肠之气不固的，应该涌出上焦之痰，而泄泻自愈。这不是苍白二陈汤所能治疗的。
这两个方子是消导、祛痰的方法。食积、酒伤、痰饮，都会让人泄泻，随症祛除，不要使其稽留，这就是《内经》所说的实者泻之。
枳术丸 消食止泻。又治疗心下痞满。
白术（强胃健脾，二两。）枳实（消积除痞，一两。）荷叶（裨助脾胃，升发阳气，用荷叶包陈米饭，煨干研末，打糊为丸。）加木香、砂仁（各一两，）名为香砂枳术丸。
这是七补三攻的方法，随症加药用之。
归脾汤（见虚劳章节） 治疗忧思太过，脾气郁结，不能升举，陷入下焦，导致泄泻。
原方（补养心脾，）加砂仁、豆蔻（开散郁结。）葛根、荷蒂（升发阳气。）
独参膏（一味药熬膏。）参术膏（两味药熬膏。）治疗气暴脱而虚，顿泻不知人事，口眼俱闭，呼吸微弱，脉欲绝者，大剂量频繁给予。（甚至有服用人参十余斤后才痊愈的。）
这三个方子都是补益的方法。《内经》说：虚者补之，是正确的。
补中益气汤 治疗劳倦伤脾，（脾主四肢的缘故。）中气不足，懒于言语，（脾为后天生气之源，中气虚则懒言，因为声音由气发出的缘故。）恶食溏泄，（胃虚不能胜谷气，所以恶食；脾虚不能制土湿，所以溏泄。）日渐瘦弱。（脾主肌肉的缘故。）
人参、黄芪（益其气。）白术（各一、二钱。）甘草（补其中。）当归（脾苦无血，所以用当归滋养它，土恐太燥，所以用当归润泽它。泄泻者去掉亦可。）橘红（一是理脾胃之气，一是行甘温之滞，各七分至一钱许。）升麻（提下陷之清气，从右而旋。）柴胡（提下陷之清气，从左而旋。各三、五分。）
这是补益兼升提的方法。嘉言说：后人认为此方能升清降浊，非常错误。用升清的药物，怎么会有降浊的功能？如果阳气未必下陷，反而升举其阴气，干犯阳位，危害不小。更有阴气素惯上干清阳，而胸中肌肉隆耸成瘿，胸中气漫散成胀的，误用此法，简直是天翻地覆。补其中气，听任中气自行升降，不用升麻、柴胡，也没有不可以，必须是清气下入腹中导致泄泻，才可以多用升举之法，这才是合法。至于四君、六君、理中、归脾、桂附理中、连茯理中，都是补脾虚泄泻的圣剂，随宜使用。
理中汤 治疗中寒骛泄。（状如鸭粪。）糟粕不化，澄澈清冷，小便清白。
人参、白术、甘草（补脾。）干姜（温中。）里寒甚者可加肉桂。本方加附子，名附子理中汤；加黄连、茯苓，名连茯理中汤。温补之法，果属虚寒者，投之自效。
四神丸 治疗肾虚泄泻，其泄泻多在子后五更，溏而不甚，多年不愈，服用补脾胃药无效，就是这种征候。
破故纸（温肾，炒，四两。）肉豆蔻（固涩，面包煨。）五味子（酸收，炒，各二两。）吴茱萸（能暖膀胱，水道即清，大肠自固。其他药虽热，不能分解清浊，五钱。）可加人参、沉香，甚者加附子、茴香、川椒。
脾肾双补丸 治疗肾泄。
人参、莲肉（去心炒黄。）山药（炒黄。）肉果（补脾，煨。）补骨脂（盐水炒。）五味子（蜜炙透。）菟丝子（制。）巴戟天（去骨甘草汁煮。）山萸肉（补肾，各四两。）橘红、砂仁（香能醒脾，各二两。）车前子（利水与茯苓同功，水道利则清浊分，而泻止。四两。）（炼蜜丸，如绿豆大，每服五钱，空心饥时服。）如虚而有火者，火盛肺热者，去人参、肉果、补骨脂、巴戟。
这两个方子，补脾温肾，酸收固涩，四种方法同用。《内经》所说的虚者补之，寒者温之，散者收之，滑者涩之，是正确的。顾仲淳治疗一人，吃素、患内热，每食肠鸣，清晨作泄。以此方去掉肉果，用白芍代替，外加扁豆六两，服用而愈。白术虽然说是健脾除湿，救标则可以，多服反而能泻脾，因为其燥性能损伤津液的缘故。张仲景有赤石脂禹余粮丸，专门固摄下焦之脱，也可以取用。凡治疗泄泻，多用丸散者，取其实脾土的意义。
喻嘉言验方 治疗秋伤于燥，咳嗽泄泻。
黄芩、地骨皮、甘草（清肺之热。）杏仁、阿胶（润肺之燥。）
这是润燥清热的方剂，也是治疗泄泻的一种方法，所谓治病必求其本。泄泻的脉象，缓小者吉，浮大急疾者凶，与痢疾同理看待。脉细、皮寒、气少、饮食不入、泄利前后的，死。下则泄泻，上则吐痰，都不停止的，为上下俱脱者死。食物刚入口就出来，叫做直肠泄，难治。
Gu Zhongchun stated: Gan Huoluan (Dry Cholera) is indeed caused by a sudden contraction of evil, turbid, and filthy qi, combined with food stagnation and depression in the chest and abdomen. The patient desires to vomit but cannot, desires to defecate but cannot, resulting in extreme intestinal and abdominal colic, sudden distension of the chest and abdomen, purple-black discoloration of the entire body, and extremely rapid death. In an emergency, find red hairs at the top of the head (Baihui area), pluck them out, and immediately induce vomiting using salt water. It is strictly forbidden to drink rice soup or hot water; violating this rule leads to death. The treatment principle should be to promote unblocking and purging, while avoiding obstruction and tonification.
Method of Deep Vomiting with Salt Water
Take two to three large bowls of freshly drawn cool water, add about one tael of stir-fried salt, drink it freely, and use a goose feather to stimulate the throat to induce vomiting. If vomiting does not occur, take more. If vomiting is incomplete, continue inducing vomiting until three times. (The *Neijing* states: For pathogens located above, induce their exit from above.) If the pathogen is below, Mangxiao (Natrii Sulfas) is appropriate. (This is referred to as guiding the pathogen to drain from below.) If simultaneous vomiting and purging are desired, use both salt and Mangxiao. This is an excellent emergency prescription with the efficacy of bringing the dead back to life; it must be used for Gan Huoluan. The general principle for treating Gan Huoluan with herbs is to open the qi and unblock orifices, harmonize the stomach, and regulate the spleen. After vomiting and diarrhea cease, if the patient feels extreme hunger after half a day, only then can they be given a small amount of thin porridge.
Hua Tuo's Critical Illness Prescription
Treats cases in summer where excessive consumption of cold fruits causes yin-cold to fill the interior, suppressing Liver Qi, leading to Huoluan with tendon spasms. (One must verify that the urine is clear and white, without thirst or fever, before treating it as a cold syndrome.)
Wuzhuyu (Evodiae Fructus), Mugua (Chaenomelis Fructus), Shiyán (Sodium Chloride).
This is a formula that "abandons the season and follows the symptoms" (ignoring seasonal climate constraints to focus on specific symptoms). Gu Zhongchun once treated a woman with Huoluan using Sandren (Amomi Fructus Rotundus, 1 tael) and salt (a pinch), mixed with boiling water cooled down. One dose resulted in recovery. He stated: Only if caused by injury from cold substances should Wuzhuyu (about 1 qian) be added. Do not administer drugs indiscriminately.
The pulse for Huoluan should be Hongda (Surging and Large); it should not be Chiwei (Slow and Fine). Or it may show Jie (Intermittent), Cu (Rapid Intermittent), Fu (Deep/Hidden), or Dai (Intermittent) pulses; these should not be immediately diagnosed as fatal signs.
However, Huoluan with tendon spasms spreading to the abdomen, or generalized tendon spasms throughout the body, are untreatable.
Regarding the symptom of Xixie (Diarrhea), the *Neijing* discusses Wind: "Injury by wind in spring leads to Sundxie (diarrhea with undigested food) in summer." This means that if pathogenic factors linger for a long time, they will inevitably overcome Spleen Earth, resulting in Sundxie. Regarding Dampness: "Excess dampness leads to Ruxie (loose, watery stool)." This means the Spleen prefers dryness and dislikes dampness; excess dampness injures the Spleen, causing Ruxie. Regarding Heat: "Violent diarrhea with tenesmus all belong to Heat." Heat is Fire. Sudden, violent diarrhea accompanied by tenesmus and urgent abdominal pain occurs because Fire nature is rapid and drying. Therefore, diarrhea caused by Summerheat also presents as violent diarrhea with anal pain, all due to Fire. It is also said: "Excess heat leads to loose, mushy stools." This means heat causes turbid waste to flow downward, resulting in loose or mushy consistency, like mud. Regarding Cold: "All fluid discharges that are clear, cold, and transparent belong to Cold." This means undigested food and fluids are clear and cold, transformed by cold-water properties. Just as water clarifies in the cold seasons of autumn and winter. It is also said: "Excess cold leads to borborygmus and Sundxie with undigested food," meaning Yang Qi deficiency fails to digest food. Regarding Dryness: "Violating Autumn Qi injures the Lung; Sundxie occurs in Winter." This means Lung injury by dryness manifests in its own channel as cough in winter; if heat transfers to the Fu organs, Sundxie occurs in winter, all caused by Lung Qi dryness and heat. This clarifies that the Four Seasons and Six Qi can all cause diarrhea. It is also stated that irregular diet and improper daily routine lead to lower Sundxie, clarifying diarrhea caused by internal injury from diet and fatigue. It is also stated that diseases generated by the Liver include Sundxie, clarifying diarrhea caused by Liver Wood overacting on Spleen Earth. It mentions Spleen deficiency with abdominal distension, borborygmus, Sundxie, and undigested food. It states that when Clear Qi sinks below, Sundxie occurs, clarifying diarrhea caused by Spleen Qi sinking. It mentions that a very fine Kidney pulse indicates Dongxie (profuse diarrhea). It states that Cold entering the Lower Jiao transforms into Ruxie, clarifying diarrhea caused by Kidney Yang decline. Generally speaking, when Spleen Earth is strong, various pathogens cannot invade; when Spleen Earth declines, various pathogens can invade and cause disease. As the classics say: "Where pathogenic factors gather, Qi must be deficient." The Kidneys govern urination and defecation, controlling opening and closing. When Kidney function fails, opening and closing become abnormal. Therefore, for those with Kidney Qi deficiency and chronic persistent diarrhea leading to Yin loss from excessive downward discharge, responsibility lies with the Kidneys. Thus, for Wind-induced cases, use ascending and dispersing methods; for Dampness-induced cases, use diuretic and separating methods. For Heat, clear it; for Cold, warm it; for Dryness, moisten it. For cases due to Food Stagnation or Phlegm, use resolving and dispelling methods; for Deficiency, use tonifying and benefiting methods; for Liver overacting on Spleen, use restraining and supporting methods. For Kidney Qi deficiency, either strengthen the master of Water (nourish Kidney Yin) so that Water is sufficient and no longer forced downward by Fire, or benefit the source of Fire (warm Kidney Yang) so that Fire is vigorous and there is no risk of Yang deficiency incontinence. Therefore, although causes of diarrhea vary and treatments are numerous, the key lies in emphasizing the Spleen and Kidneys. With flexible clinical judgment, one can bring the world to health and longevity.
Shengyang Chushi Tang (Revised)
Treats Sundxie caused by Wind invasion. (Wind pathogens lodge in the intestines and stomach, like sails catching the wind, hence immediate evacuation after eating.) The diarrhea necessarily involves undigested food. (However, it can also be caused by Heat, Cold, or Qi deficiency.) There is loud borborygmus and profuse watery discharge. The *Neijing* also states: Diseases generated by the Liver include Sundxie. (Liver Wood depression in the earth restricts Spleen Earth.) This formula also treats this condition. (Based on the principle of Xiaoyao San.)
Chaihu (Bupleuri Radix): In spring, Wood is dominant, and Wind is the Qi of Wood; this herb is the main medicine for Liver and Gallbladder.
Shengma (Cimicifugae Rhizoma), Fangfeng (Saposhnikoviae Radix): Disperse Wind pathogens and also lift sinking Qi.
Chao Baishao (Stir-fried Paeoniae Radix Alba): Drains Wood within Earth to calm the Spleen.
Chao Yiyiren (Stir-fried Coicis Semen): Strengthens Spleen, dispels Wind, and overcomes Dampness.
Fuling (Poria): Leaches out Dampness; without Dampness, diarrhea does not occur.
Zhi Gancao (Honey-fried Glycyrrhizae Radix et Rhizoma): Benefits the Spleen; when Spleen is robust, it controls Dampness. Add Renshen (Ginseng Radix) for deficiency.
This is a formula for dispersion and lifting. The *Neijing* says: Remove external pathogens. Also: Lift what has sunk. According to Jiayan: Wind enters from outside and should still be led out through the muscle surface. If rigid and drying Spleen-tonifying drugs are used, they assist the forceful nature of Wind, leading to endless diarrhea. Gu Zhongchun also stated: First use dispersing and lifting agents, then use Huangqi (Astragali Radix) and Sijunzi Tang (Four Gentlemen Decoction), along with Baishao and Gancao, to restrain Liver and solidify Spleen. These are essential throughout the treatment. He also stated that during late summer when Damp-Heat prevails, or when annual Dampness is excessive, people often suffer from diarrhea; Wind herbs should be used because Wind can overcome Dampness.
Huangqin Tang (Scutellaria Decoction)
Treats diarrhea caused by Fire-Heat, with yellow-brown feces, dry and astringent anus, and yellow-red urine.
Huangqin (Scutellariae Radix): Clears Heat.
Baishao (Paeoniae Radix Alba), Gancao (Glycyrrhizae Radix et Rhizoma), Dazao (Jujubae Fructus): Harmonizes the Spleen. Add Huanglian (Coptidis Rhizoma) if Heat is severe.
Chensha Yiyuan San (Cinnabar Yi Yuan Powder) (See Summerheat)
Treats diarrhea caused by Summerheat injury. The diarrhea is necessarily violent with anal pain, thirst, and red urine.
Both formulas employ cooling methods. The *Neijing* states: Treat Heat with Cold. Gu Zhongchun said: Gui Ling Ganlu Yin (Cassia Twig, Poria, and Dew Sweetener Drink) can also be used with modifications by removing Guizhi (Cinnamon Twig). This is because the formula contains Shigao (Gypsum Fibrosum), Huashi (Halloysitum Rubrum), and Hanshui Shi (Calcitum) to clear Summerheat-Heat, and Wuling San (Five-Ingredient Powder with Poria) to drain Dampness. Zhang Zihe added Renshen and Gancao because the pulse was deficient. He also stated that Jiuzhi Huanglian (Nine-Processed Coptidis Rhizoma) best stops Heat-diarrhea and must be used in equal parts with Renshen. Because prolonged diarrhea is often due to Qi deficiency, pure use of Bitter-Cold drugs further closes Stomach Qi. Also, excessive downward discharge loses Yin; Renshen must be used, reflecting the principle of Yang generating Yin.
Weiling Tang (Stomach Poria Decoction) (See Dampness)
Treats diarrhea caused by Excess Dampness. The diarrhea is mostly watery. (Watery diarrhea without abdominal pain indicates Dampness; diarrhea alternating with pain indicates Dampness combined with Fire.) Urine is difficult to pass. (Because water and grain follow the same path.)
This uses both Spleen-drying and mild-leaching methods. The *Neijing* states: Treat Dampness with Dryness. Hence, Pingwei San (Regulate the Stomach Powder) is used. It also states: Treating Dampness without promoting urination is incorrect treatment. Hence, Siling San (Four-Ingredient Powder) is used. They can be used separately according to symptoms. For Spleen-Stomach weakness, use Baizhu Fuling Tang (Atractylodes Macrocephala and Poria Decoction, consisting of only two herbs), adding Yiyiren (Coicis Semen), Cheqianzi (Plantaginis Semen), Xiangfu (Cyperi Rhizoma), and Sharen (Amomi Fructus Rotundus).
Baohe Wan (Preserve Harmony Pill) (Can also be made as a small-dose decoction)
Treats diarrhea due to Food Injury. (Severe abdominal pain with diarrhea, pain relieved after defecation, indicates Food Stagnation.)
Shanzha (Crataegi Fructus): Resolves meat accumulation.
Maiya (Hordei Fructus Germinatus): Resolves grain, flour, and vegetable accumulation.
Shenqu (Massa Medicata Fermentata): Resolves sticky rice accumulation. (Each 3 taels.)
Boluozi (Brassicae Semium): Resolves flour accumulation.
Juhong (Citri Reticulatae Pericarpium): Relieves Stagnant Qi in Spleen and Stomach. (Each 2 taels.)
Fuling (Poria): Leaches Water-Dampness in Spleen and Stomach. (3 taels.)
Lianqiaoren (Forcipuliae Semen): Dispels Damp-Heat in Spleen and Stomach.
Banxia (Pinelliae Rhizoma): Eliminates Wet-Phlegm in Spleen and Stomach. (Each 2 taels. Omit if no Wet-Phlegm.)
Add Baizhu (Atractylodis Macrocephalae Rhizoma, 3 taels). Named Da'an Wan (Great Peace Pill). Can add Muxiang (Aucklandiae Radix) and Sharen (Amomi Fructus Rotundus). If diarrhea is caused by alcohol injury, add Geghua (Taphrinae Folium) to resolve alcohol toxicity, and Zhuling (Polyporus) and Zexie (Alismatis Rhizoma) to promote urination and drain Dampness.
Cangbai Erchen Tang (Atractylodes and Cyathula Two-Chen Decoction) (Erchen Tang plus Cangzhu and Baizhu)
Treats diarrhea due to Wet-Phlegm. (Slippery diarrhea in obese individuals is attributed to Phlegm; irregular slippery pulse is attributed to Phlegm; lack of appetite and hunger sensation is attributed to Phlegm; becoming thin after being fat is attributed to Phlegm. *Jinkui Yaolue* states: Water flowing between intestines with gurgling sounds is called Tan-Yin [Phlegm-Fluid].) Add Renshen for deficiency.
Zhao Yi-de stated: If accumulated Phlegm exists in the Lung, causing insecurity of Large Intestine Qi, one should induce the expulsion of Upper Jiao Phlegm, and diarrhea will heal spontaneously. This is not treatable by Cangbai Erchen Tang.
These two formulas employ resolving and dispelling methods. Food stagnation, alcohol injury, and Phlegm-Fluid all cause diarrhea. Dispel them according to symptoms and do not allow them to linger. This is what the *Neijing* refers to as: Treat Excess by Purging.
Zhizhu Wan (Immature Bitter Orange and Atractylodes Pill)
Resolves food and stops diarrhea. Also treats epigastric fullness and stuffiness.
Baizhu (Atractylodis Macrocephalae Rhizoma, 2 taels): Strengthens Stomach and benefits Spleen.
Zhishi (Aurantii Fructus Immaturus, 1 tael): Resolves accumulation and removes fullness.
Heye (Nelumbinis Folium): Assists Spleen and Stomach, raises Yang Qi. Wrap aged rice in Lotus leaf, bake until dry, powder, and make pills with paste.
Add Muxiang (Aucklandiae Radix) and Sharen (Amomi Fructus Rotundus) (each 1 tael). Named Xiangsha Zhizhu Wan.
This is a method of seven parts tonification and three parts attack, used with symptomatic additions.
Guipi Tang (Restore the Spleen Decoction) (See Consumption)
Treats diarrhea caused by excessive worry and thought, leading to Spleen Qi depression, failure to rise, and sinking into the Lower Jiao.
Original Formula (Tonifies Heart and Spleen,) adds Sharen (Amomi Fructus Rotundus) and Doukou (Cardamomi Fructus) to scatter depression. Gegen (Puerariae Radix) and Hedi (Nelumbinis Petiolus) to raise Yang Qi.
Dushen Gao (Single Ginseng Paste) and Renshen Baizhu Gao (Ginseng and Atractylodes Paste)
Treats sudden Qi collapse with deficiency, sudden diarrhea leading to unconsciousness, closed mouth and eyes, faint breathing, and impending pulse disappearance. Administer large doses frequently. (There are even cases of recovery after consuming over ten jin of Ginseng.)
These three formulas employ tonifying and benefiting methods. The *Neijing* states: Treat Deficiency by Tonifying. Correct.
Buzhong Yiqi Tang (Center-Boosting Qi-Enhancing Decoction)
Treats Spleen injury from labor and fatigue. (Spleen governs the four limbs.) Insufficiency of Middle Qi, reluctance to speak. (Spleen is the source of postnatal Qi generation; Middle Qi deficiency leads to reluctance to speak, as voice originates from Qi.) Aversion to food and loose stools. (Stomach deficiency cannot handle grain Qi, hence aversion to food; Spleen deficiency cannot control Earth Dampness, hence loose stools.) Gradual emaciation. (Spleen governs muscles.)
Renshen (Ginseng Radix), Huangqi (Astragali Radix): Benefit Qi.
Baizhu (Atractylodis Macrocephalae Rhizoma): Each 1-2 qian.
Gancao (Glycyrrhizae Radix et Rhizoma): Tonifies the Middle.
Danggui (Angelicae Sinensis Radix): Spleen suffers from Blood deficiency, so use it to nourish; Earth fears excessive dryness, so use it to moisten. Can be omitted in diarrhea.
Juhong (Citri Reticulatae Pericarpium): Regulates Spleen-Stomach Qi and moves the stagnation of Sweet-Warm herbs. Each 7 fen to 1 qian.
Shengma (Cimicifugae Rhizoma): Raises sinking Clear Qi, rotating from the right.
Chaihu (Bupleuri Radix): Raises sinking Clear Qi, rotating from the left. Each 3-5 fen.
This is a method of tonification and elevation. Jiayan stated: Later generations claim this formula raises Clear and descends Turbid, which is profoundly wrong. How can Clear-raising drugs have Turbid-descending functions? If Yang Qi is not necessarily sinking, raising Yin Qi instead invades Yang positions, causing significant harm. Furthermore, in cases where Yin Qi habitually harasses Clear Yang, causing neck lumps (Ying) and abdominal distension from scattered Chest Qi, misapplying this method would be disastrous. Tonifying Middle Qi allows it to regulate its own rising and falling; not using Shengma and Chaihu is also acceptable. However, if Clear Qi sinks into the abdomen causing diarrhea, using lifting methods extensively is correct. Meanwhile, Sijunzi Tang, Liujunzi Tang, Lizhong Tang, Guipi Tang, Guifu Lizhong Tang, and Lianfu Lizhong Tang are all sacred prescriptions for Spleen-deficiency diarrhea; use them appropriately.
Lizhong Tang (Regulate the Middle Decoction)
Treats Ma-xie (duck-like diarrhea) caused by Middle Cold. (Stool resembles duck feces.) Undigested residue, clear and cold, clear urine.
Renshen (Ginseng Radix), Baizhu (Atractylodis Macrocephalae Rhizoma), Gancao (Glycyrrhizae Radix et Rhizoma): Tonify Spleen.
Ganjiang (Zingiberis Rhizoma): Warms the Middle. If interior Cold is severe, add Rougui (Cinnamomi Cortex). Adding Fuzi (Aconiti Lateralis Radix Praeparata) to this formula names Fuzi Lizhong Tang; adding Huanglian (Coptidis Rhizoma) and Fuling (Poria) names Lianfu Lizhong Tang. The warming and tonifying method is effective if the case truly belongs to Deficiency-Cold.
Sishen Wan (Four Spirits Pill)
Treats Kidney-deficiency diarrhea. Diarrhea often occurs between midnight and dawn (Zi-Hou Wugeng), is loose but not severe, persists for years, and does not respond to Spleen-Stomach tonification. This is the characteristic sign.
Poguzhi (Psoraleae Fructus): Warms Kidney, stir-fried, 4 taels.
Roudoukou (Myristicae Semen): Secures astringency, baked in flour.
Wuweizi (Schisandrae Fructus): Sour and astringent, stir-fried, each 2 taels.
Wuzhuyu (Evodiae Fructus): Warms Bladder, clears water passages, and secures Large Intestine. Other hot herbs cannot separate Clear from Turbid. 5 qian.
Can add Renshen (Ginseng Radix) and Chenxiang (Aquilariae Lignum Resinatum). For severe cases, add Fuzi (Aconiti Lateralis Radix Praeparata), Huixiang (Foeniculi Fructus), and Chuanjiao (Zanthoxyli Pericarpium).
Shishen Shuangbu Wan (Spleen-Kidney Dual-Tonifying Pill)
Treats Kidney diarrhea.
Renshen (Ginseng Radix), Lianrou (Nelumbinis Semen, heart removed, stir-fried yellow).
Shanyao (Dioscoreae Rhizoma), stir-fried yellow.
Rouguo (Myristicae Semen), tonifies Spleen, baked.
Buguzhi (Psoraleae Fructus), stir-fried in salt water.
Wuweizi (Schisandrae Fructus), honey-roasted thoroughly.
Tusizi (Cuscutae Semen), processed.
Bajitian (Morindae Radix), bones removed, boiled in Licorice juice.
Yurou (Corni Fructus), tonifies Kidney. (Each 4 taels.)
Juhong (Citri Reticulatae Pericarpium), Sharen (Amomi Fructus Rotundus): Fragrance awakens Spleen. (Each 2 taels.)
Cheqianzi (Plantaginis Semen): Promotes urination with the same effect as Fuling; clearing water passages separates Clear from Turbid, stopping diarrhea. (4 taels.)
Make pills with refined honey, size of mung beans. Take 5 qian per dose on an empty stomach or when hungry. If deficiency with Fire, or excessive Fire and Lung Heat, remove Renshen, Rouguo, Buguzhi, and Bajitian.
These two formulas combine tonifying Spleen, warming Kidney, sour astringency, and securing methods. The *Neijing* states: Treat Deficiency by Tonifying, Cold by Warming, Scattering by Gathering, Slipperiness by Astringing. Correct. Gu Zhongchun treated a person who ate vegetarian food, suffered from internal heat, had borborygmus after every meal, and had morning diarrhea. He used this formula, removing Rouguo and replacing it with Baishao, adding 6 taels of BianDou (Vigna Radiata Semen). The patient recovered. Although Baizhu is said to strengthen Spleen and drain Dampness, it can only rescue the branch; excessive use actually drains Spleen because its dryness damages Body Fluids. Zhang Zhongjing had Chishizhi Yuyuliang Wan (Red Halloysite and Hematitum Pill), specifically for securing Lower Jiao collapse, which can also be used. In treating diarrhea, pills and powders are often used to embody the principle of strengthening Spleen Earth.
Yu Jiayan's Verified Prescription
Treats cough and diarrhea caused by Autumn Dryness injury.
Huangqin (Scutellariae Radix), Gubpi (Moutan Cortex), Gancao (Glycyrrhizae Radix et Rhizoma): Clears Lung Heat.
Xingren (Armeniacae Semen Amarum), Ejiao (Asini Corii Colla): Moistens Lung Dryness.
This is a formula for moistening Dryness and clearing Heat, another method for treating diarrhea, referring to "treating disease requires seeking the root."
The pulse for diarrhea: Huanxiao (Slow and Small) is auspicious; Fudaji (Floating, Large, Rapid, and Urgent) is ominous. View similarly to Dysentery. Pulse Xi (Fine), skin cold, Qi scarce, inability to eat, and diarrhea/urination issues indicate death. Downward diarrhea and upward vomiting of phlegm, both unceasing, indicate total collapse of Upper and Lower Jiao, indicating death. Food exiting immediately upon entry is called Zhichangxie (Rectal Diarrhea), which is difficult to treat.