第十七章．治泄泻方

Herbs for diarrhea

1．益脾饼

1. Yi Pi Bing (Yi here means to help in Chinese; Pi means Spleen, or digestive system; Bing means cake).

治脾胃湿寒，饮食减少，长作泄泻，完谷不化。
This formula is used to solve long term diarrhea, which is due to Cold-Wetness in the Spleen-stomach system. The person has reduced appetite, eats less and has non-digested food in the stool.

白术（四两） 干姜（二两） 鸡内金（二两） 熟枣肉（半斤）
Baizhu 120 gram, Ganjiang 60 gram, Jineijin 60 gram, cooked Chinese Date (no kernel) 125 gram.

上药四味，白术、鸡内金皆用生者，每味各自轧细焙熟（先轧细而后焙者，为其焙之易匀也）。再将干姜轧细，共和枣肉，同捣如泥，作小饼。木炭火上炙干，空心时，当点心，细嚼咽之。曾为友人制此方，和药一料，服之而愈者数人。后屡试此方，无不效验。
Grind the Baizhu and Jineijin into powder. Bake. Grind the Ganjian into powder, mix all of three with the Chinese date, stir the mixture into mud then prepare into small cake. Bake the cake to dry. Eat the cake with empty stomach. Chew slowly. I prepared this cake for one of my friend. It has also been used for several other patients. All are recovered. No failure case at all.

一妇人，年三十许，泄泻数月。用一切治泻诸药皆不效。其脉不凉，亦非完谷不化。遂单用白术、枣肉，如法为饼，服之而愈。此证并不用鸡内金者，因鸡内金虽有助脾胃消食之力，而究与泻者不宜也。
A lady, 30 years of old, had diarrhea for several months. She has tried many ways but no effect at all. Her pulse was not cold. She had no non-digested food in the stool. So, it has been used the Baizhu and Chinese date to cool as cake to eat. She got recovered. In this case the Jineijin was not used, since it is not suitable fro diarrhea, though it helps for digestion.

附录：

Appendix:

直隶青县张××来函：
Letter from Mr. Zhang, Qing city, Zhili province:

胞妹××，年四十余岁，体素瘦弱，久患脾胃湿寒，胃脘时觉疼痛，饮食减少，常作泄泻，完谷不化。因照益脾饼原方，为制一料，服之即愈。为善后计，又服一料，永久祓除病根。

My sister-in-law was 40 years of old. She was slim and thin and weak in the body condition. She got Spleen-Stomach Cold-Wetness condition, felt pain in the stomach from time to time. She ate little, had diarrhea with non-digested food in the stool. I followed the way of the Yi Pi Bing, and gave her to eat. She got recovered. After second preparation, she was cured.

2．扶中汤

2. Fu Zhong Tang (Fu here means to support in Chinese; Zhong means middle part of the body, e.g. the Spleen-Stomach system.)

治泄泻久不止，气血俱虚，身体羸弱，将成劳瘵之候。
This formula is to solve long term diarrhea. The person has Qi and blood deficiency. The body is slim and thin and is to be the exhausting condition.

于术（一两，炒） 生山药（一两） 龙眼肉（一两）
Baizhu 30 gram (fry), Shanyao 30 gram, Longyanrou 30 gram.

小便不利者加椒目（三钱，炒捣）
If the urine is not smooth, add Huajiao (piperales) 9 gram (fry and grind).

龙眼肉，味甘能补脾，气香能醒脾，诚为脾家要药。且心为脾母，龙眼肉色赤入心，又能补益心脏，俾母旺自能荫子也。愚治心虚怔忡，恒俾单购龙眼肉斤许，饭甑蒸熟，徐徐服之，皆大有功效，是能补心之明征。
Herb Longyanrou, for its sweet and fragrant in herbal nature, can wake up the Spleen for digestion. It is really the key herb in the Spleen system. The Heart is the mother of the Spleen. The Longyanrou is red in color, so it goes into the Heart in body, so that it can also nourish the Heart. If the Heart is strong, the mother can help the child (the Spleen). Whenever I treat palpitation, I always use Longyanrou about 250 gram. Steam it over water. Let patient to eat it gradually and from time to time. It works well. It is the clear evidence that it can nourish the heart.

又大便下血者，多因脾虚不能统血，亦可单服龙眼肉而愈，是又补脾之明征也。
The bleeding in stool is usually due to the Spleen weakness condition. In this case, the Longyanrou alone can be eat to solve the bleeding. This is the clear evidence that it can nourish the Spleen.

一妇人，年四十许。初因心中发热，气分不舒，医者投以清火理气之剂，遂泄泻不止。更延他医，投以温补之剂，初服稍轻，久服，则泻仍不止。一日夜四五次，迁延半载，以为无药可治。后愚为诊视，脉虽濡弱，而无弦数之象，知犹可治。但泻久身弱，虚汗淋漓，心中怔忡，饮食减少，踌躇久之，为拟此方，补脾兼补心肾。数剂泻止，而汗则加多。遂于方中加龙骨、牡蛎（皆不用 ）各六钱，两剂汗止，又变为漫肿。盖从前泻时，小便短少，泻止后，小便仍少，水气下无出路，故蒸为汗，汗止又为漫肿也。斯非分利小便，使水下有出路不可。特其平素常觉腰际凉甚，利小便之药，凉者断不可用。遂用此方，加椒目三钱，连服十剂全愈。

A lady, 40 years of old, felt hot in the heart and stagnation in the chest. Doctor gave her Fire-cleansing and Qi-smoothing herbs. She then developed diarrhea. The second doctor gave her warm-nourishing herbs, the condition was improved little bit in the beginning, but after a long time take of the herbal tea, the diarrhea still continued. It could be four to five times per day and night. The condition has been there for several months and it was thought no way to improve. When I saw her, her pulse was ru and weak, but no string or frequent. It was known to be able to solve. But, the body was weak after a long time diseased condition. She had asthenic sweat, palpitation, and reduced diet. I have planned for a long time, and eventually set up this formula to nourish the Spleen and Heart and Kidney. After several doses, the diarrhea stopped but the sweat increased. So, herb Longgu and Muli were added to the formula, 18 gram each. After two doses, the sweat stopped, but the condition became swelling in the body. Previously, when she had diarrhea, she had less urine. After stop of the diarrhea, her urine was still less. The water has no pathway from the urine, so it was steam into sweat. After stop of the sweat, it became swelling. Therefore, to solve the problem, it must be to open the way for water to go through urine. Especially she usually had cold in the lower back. The Cold herbs to smooth the urine should not be used at all. Then use this formula, with addition of Jiaomu 9 gram. After ten doses, the condition was completely solved.

3．薯蓣粥

3. Shuyu Zhou (Shuyu here means herb Shanyao in Chinese; Zhou: soup)

治阴虚劳热，或喘，或嗽，或大便滑泻，小便不利，一切羸弱虚损之证。
This formula is used to solve Yin deficiency with exhausting Fire/Hot, with asthma, or cough, or slippery stool, or hard in urine, all exhausting conditions.

生怀山药（一斤，轧细过罗）
Shanyao (250 gram (grind and filter).

上药一味，每服用药七八钱，或至一两。和凉水调入锅内，置炉上，不住以箸搅之，两三沸即成粥服之。若小儿服，或少调以白糖亦可。
Add the Shanyao powder, 24 gram each time to to 30 gram, into a pot with cold water. Cook with stirring. After two to three boiling, it is ready to eat. For child, it can add some white sugar into the soup.

此粥多服久服间有发闷者，掺以西药百布圣一瓦同服，则无此弊，且更多进饮食。
After a long time drink of the Shanyao soup, the person may feel fullness in the chest or stomach. Drink the western medication Baibushen (?) the same time, there would no such side effect and the person can eat more.

门生吴××，年二十一。羸弱发热，脉象虚数，不能饮食。俾早晚服山药粥，加百布圣，晌午单服玄参三钱，煎汤服。如此数日，食量增加，发热亦愈，自此健壮。
My student, Mr Wu, 21 years of old, got weak and hot. His pulse was asthenic frequent. He could hardly eat. He was asked to drink this Shanyao soup, with the Baibushen. At noon he only took herb Xuanshen 9 gram (cooked as herbal tea to drink). Continuously for several days as such, his appetite increased, and the hot stopped. He body was even more stronger.  

一妇人，年三十余。泄泻数月不止，病势垂危。倩人送信于其父母，其父将往瞻视，询方于愚。言从前屡次延医治疗，百药不效。因授以山药煮粥方，日服三次，两日全愈。又服数日，身亦康健。
A lady, 30 years of old, had continuous diarrhea for several months. She condition is very danger. She asked others send a letter to her parents. Her father came to her and asked herbal formula from me. He said that, she had tried various doctors for help, no any herb worked for her. So, I asked him to prepare Shanyao soup, to let her drink three times a day. After two days, the condition was solved. She continued the drinking for several days, the body was stronger.

一娠妇，日发痫风。其脉无受娠滑象，微似弦而兼数。知阴分亏损，血液短少也。亦俾煮山药粥服之即愈。又服数次，永不再发。
A pregnant woman got epilepsy every day. Her pulse was without pregnant feeling (not slippery pulse), but slightly similar to string and frequent. It was considered to be due to the Yin deficiency, no enough blood. She was asked to drink the Shanyao soup. The condition was solved. After additional several doses, the diarrhea was cured. 

奉天关氏少妇，素有劳疾，因产后暴虚，喘嗽大作。治以此粥，日服两次，服至四五日，喘嗽皆愈。又服数日，其劳疾自此除根。
Mrs. Guan, in Fengtian city, got long time of disease. After childbirth, she became very weak and got asthma and cough. She was asked to drink this soup, twice a day. After four to five days, the cough and asthma were solved. After additional several more days, the problem was completely cure.

奉天郑××之女，年五岁。秋日为风寒所束，心中发热。医者不知用辛凉表散，而纯投以苦寒之药，连服十余剂，致脾胃受伤，大便滑泻，月余不止，而上焦之热益炽。医者皆辞不治，始求愚为诊视，其形状羸弱已甚，脉象细微浮数，表里俱热，时时恶心，不能饮食，昼夜犹泻十余次。治以此粥，俾随便饮之，日四五次，一次不过数羹匙，旬日全愈。
The daughter of Mr. Zhen, in Fengtian city, was five years of old. In an autumn, she was affected by Cold-Wind. She felt hot in the heart. The doctor did not know to use spicy-cooling herbs to disperse the Wind and Cold, but used Cold-bitter herbs. After tens of herbs, her Spleen-Stomach was damaged. She had slippery diarrhea for months without stop. Her Upper Jiao was more Hot. The doctor quitted to continue. I was so asked for help. At that time, the girl was very thin and slim. Her pulse was thin, mild, floating and frequent. She had Fire in both outside and inside, felt nausea from time to time, could not eat. She had diarrhea tens of times every day. I prescribed this herb soup to her to drink four or five times a day and only several spoons each time. After several days, her condition was cure.

农村小儿，于秋夏之交，多得滑泻证。盖农家此时多饮凉水，而小儿尤喜饮之。农家此时多食瓜果，而小儿尤喜食之。生冷之物，皆伤脾胃，脾胃伤，则滑泻随之，此自然之理也。而滑泻之证，在小儿为最难治。盖小儿少阳之体，阴分未足，滑泻不止，尤易伤阴分。往往患此证者，数日即浑身发热，津短燥渴，小便不利，干呕懒食，唯嗜凉物。当此之际，欲滋其阴，而脾胃愈泥，欲健其脾，而真阴愈耗，凉润温补，皆不对证。而小儿又多苦服药，病家又多姑息，以婉随小儿之意，以致迁延岁月，竟成不治者多矣。惟山药脾肾双补，在上能清，在下能固，利小便而止大便，真良药也。且又为寻常服食之物，以之作粥，少加沙糖调和，小儿必喜食之。一日两次煮服，数日必愈。若系哺乳稚子，不能食粥，即食之亦不能多者，但浓煮生山药汁，饮之亦可。愚以此方治小儿多矣。志在救人者，甚勿以为寻常服食之物，而忽之也。

Children in countryside are easy to get such slippery diarrhea at the end of summer and the early autumn. In the farmer, people drink more cold water at this time of the year. This is true especially for children. There are also more fresh fruits and melon at that time. Child is usually eating more. Any non-cook food and cold drink damage the Spleen-Stomach. When the Spleen-Stomach is damaged, there would be such slippery diarrhea. This is natural. The child slippery diarrhea is hard to solve. The child is Shaoyang body, the Yin is not enough yet. The continuous slippery diarrhea is easy to damage the Yin. Usually child with such slippery diarrhea would have hot feeling in the body several days after the diarrhea. The child felt thirsty and dry mouth, and hard in urine, dry nausea and had no appetite but craving for cold thing to eat. At this time, to nourish its boy Yin would prevent the function of the Spleen-Stomach, but to nourish the Spleen-Stomach, the Yin would be exhausted further more. So, neither cooling-wetness or warm-nourishing therapy are suit for the treatment. In addition, it is hard for child to drink bitter herbs. The family is usually following the willing of the child, so that the condition could last for a long time, so as to delaying into a hard-to-solve disease condition. Only the Shanyao, for its ability to nourish both Spleen and Kidney, can clear the upper hot, and fix the lower slippery, to smooth the urine and stop the diarrhea. It is really a fantastic herb. Again, it is actually a regular food. Prepare it as soup, with addition of some sugar, the child is easy to accept it to drink. Drink it twice a day for several days, the condition should be solved. If the sick child is breast milk feeding, could drink soup, or could not drink large amount of the soup each time, prepare it into thick drinks for him to drink. I have saved many sick children with this formula. Doctors’ goal is to save life, don’t neglect it in the healing for its too simple food.

4．薯蓣鸡子黄粥

4. Shuyu Jizihuang soup (Shuyu here means Shanyao, e.g the Chinese yam in Chinese; Jizihuang: egg yolk.)

治泄泻久，而肠滑不固者。

This formula is used for long term slippery diarrhea.

即前薯蓣粥，加熟鸡子黄三枚。
 This formula is the same as the previous Shanyao soup (the Chinese Yam soup) but wityh addition of three egg yolk 

一人，年近五旬。泄泻半载不愈，羸弱已甚。遣人来询方，言屡次延医服药，皆分毫无效。授以薯蓣粥方，数日又来言，服之虽有效验，泻仍不止。遂俾用鸡子数枚煮熟，取其黄捏碎，调粥中服之，两次而愈。盖鸡子黄，有固涩大肠之功，且较鸡子白，易消化也。以后此方用过数次，皆随手奏效。
A man, 50 years of old, had diarrhea for half year more. His body was very thin and weak. He send another person come and aske for prescription. It was said that he had had tried many doctors and herbs, but no effect. I told him this formula. Several days later, it was said that, the formula worked somehow, but the diarehea did not stop completely yet. So, I asked him to cook several chicken eggs. Got the egg yolk. Breaked it and mixed it into the Chinese yam soup to eat. After two days, the diarrhea stopped. The egg yolk has function of stopping diarrhea. It is also easier than the egg white to digest. Later, this formula has been used for several times. All worked.

附录：
Appendix:

直隶青县张××来函：
Letter from Mr.Zhang, Qing city in Zhili province:

河间刘××，年五十余岁。漏疮甚剧，屡治不痊，后兼泄泻不止，盖肠滑不固，故医药无灵。诊其脉甚小弱，渐已成痨。嘱其用薯蓣鸡子黄粥。一剂泻止。三服，精神焕发。十数日后，身体撤消。此后凡遇虚泻久不愈者，用之屡收特效。

Mr. Liu lived in Hejian city and about 50 years of old. He got severe leaking hernia. It was not solved after a long time treatment. Later he got the slippery diarrhea. Since the slippery diarrhea, so none of the medicine worked. His pulse was small and weak. His condition was thought to be in exhausting condition. He was asked to use this Shuyu Jizihuang Tang. After one day, the diarrhea stopped. After three days, his spirit is excellent. After ten days, the body body was stronger. Later, whenever I met such patients with slippery diarrhea and used this formula, all worked.

5．薯蓣苜汤

5. Shyyu Mu Tang (Shyyu means Chinese yam here; Mu means herb Plantain seeds)

 治阴虚肾燥，小便不利，大便滑泻，兼治虚劳有痰作嗽。

This formula is used in Yin deficiency with Kidney Dryness. The person has hard urine and slippery diarrhea. It also works for cough with phlegm in exhausting condition.

生山药（一两，轧细） 生车前子（四钱）
Shanyao 30 gram, Cheqianzi (plantain seed) 12 gram.

上二味，同煮作稠粥服之，一日连服三次，小便自利，大便自固。盖山药能固大便，而阴虚小便不利者服之，又能利小便。车前子能利小便，而性兼滋阴，可为补肾药之佐使（五子衍宗丸中用之），又能助山药以止大便。况二药皆汁浆稠粘，同作粥服之，大能留恋肠胃，是以效也。治虚劳痰嗽者，车前宜减半。盖用车前者，以其能利水，即能利痰，且性兼滋阴，于阴虚有痰者尤宜。而仍不敢多用者，恐水道过利，亦能伤阴分也。
Cook the two ingredients into thick soup to eat, three times a day. The urine would be smooth and the slippery diarrhea should stop. The Shanyao can solidify the stool. In the Yin deficiency with hard urine, it also works to smooth urine. The Cheqianzi can smooth the urine. It can also nourish the Yin, works as a helper in the Kidney-nourishing herbs. It can also help the Shanyao to solidify the stool. The two ingredients are thick in soup, so as able to hold in the intestine to function. To treat cough in exhausting condition, the amount of the Cheqianzi should be reduced to half. The Cheqianzi can conduct the water pass, so can also clear the phlegm. It also works to nourish the Yin, so it is better in the Yin deficiency with phlegm. It should not be used over dose however, for the consideration that over dose may cause over depletion of water, so as to damage the Yin.

按：车前子能利小便，而骤用之亦无显然功效。惟将车前子炒熟（此药须买生者自家经手炒，以微熟为度，过熟则无力），嚼服少许，须臾又服，约六点钟服尽一两，小便必陡然利下，连连不止。此愚实验而得之方也。
Comments: the Cheqianzi can promote urine but sudden use has no such effect. It should be fried (buy the original one, fry by yourself to slight cooked. If over fried, there may have not healing effect).

又：单用车前子两半，煮稠粥，顿服之，治大便滑泻亦甚效验。黄姓媪，大便滑泻，百药不效。或语以此方，一服即愈。然必用生者煮之，始能成粥，若炒熟者，则不能成粥矣。

Again: use the Cheqianzi alone 45 gram, cook as soup to drink all once. It works for the slippery diarrhea too. Mrs. Huang had the slippery diarrhea. None of the herbs worked for her. She heard this formula and tried. After one dose, the diarrhea stopped. However, the original Cheqianzi can be in the soup form after cooking. The fried one cannot.

6．加味天水散

6. Jiawei Tianshui San (Jiawei means with addion of; Tian means sky; Shui means water, San means powder form).

治暑日泄泻不止，肌肤烧热，心中燥渴，小便不利，或兼喘促。小儿尤多此证，用此方更佳。
This formula is for continuous diarrhea in summer. The person feels hot on the skin, dry and thirsty, hard in urine, or has asthma. It is common in child. This formula is more suit.

生山药（一两） 滑石（六钱） 粉甘草（三钱） 作汤服.

Shanyao (Chiese yam) 30 gram, Huashi (talc) 18 gram, Gancao (licorice) 9 gram. Cook as herbal tea to drink.

此久下亡阴，又兼暑热之证也。故方中用天水散以清溽暑之热。而甘草分量，三倍原方（原方滑石六、甘草一，故亦名六一散），其至浓之味，与滑石之至淡者相济，又能清阴虚之热。又重用山药之大滋真阴，大固元气者，以参赞之。真阴足，则小便自利，元气固，则泄泻自止。且其汁浆稠粘，与甘草之甘缓者同用，又能逗留滑石，不至速于淡渗。俾其清凉之性由胃输脾，由脾达肺，水精四布，下通膀胱，则周身之热与上焦之燥渴喘促，有不倏然顿除者乎？
This is a condition, in which the Yin has been damaged due to long time diarrhea, plus the summer Hot attack. The Tianshui San used in the formula to clear the summer Hot. The amount of Gancai is three times of original formula (in original formula, the Huashi is six and the Gancao is one, so it is called Six-one powder). The strong state of the Gancao and the mild taste of the Huashi helps each other, able to clear the Hot in Yin deficiency. Large amount of Shanyao is used to nourish the True Yin and the Yuan Qi. When the True Yin is sufficient, the urine is easier. If the Yuan Qi is sufficient, the diarrhea stops. The thick nature of the Shanyao and the calm nature of the Gancao can hold Huashi longer time in the intestine to function slowly, make the cooling nature of the Huashi, from Stomach to Spleen, from Spleen to the Lung. When the water-humidity disperses all over the body, conducts to the urine bladder, how would the whole body hot and the dryness and thirst in the Upper Jiao not disappear right away?

小儿少阳之体，最不耐热，故易伤暑。而饮食起居，喜贪寒凉，故又易泄泻。泻久则亡阴作热，必愈畏暑气之热，病热循环相因，所以治之甚难也。此方药止三味，而用意周匝，内伤外感，兼治无遗。一两剂后，暑热渐退，即滑石可以渐减，随时斟酌用之，未有不应手奏效者。小儿暑月泻久，虚热上逆，与暑热之气相并，填塞胃口，恒至恶心呕吐，不受饮食。此方不但清暑滋阴，和中止泻，其重坠之性，又能镇胃安冲，使上逆之热与暑气之热，徐徐下行，自小便出，而其恶心呕吐自止。
The child Shaoyang body is difficult to endure the summer Hot so is easy to be attacked by the Hot. In the daily life, the child tends to stay in a cold place and drink and eat cold stuff, so he is easy to get the diarrhea. After a long time diarrhea, the Yin would be damaged to cause the Hot, which makes him more dislike the Hot from weather. The out Hot and the inside Hot work together, so the treatment is difficult. This formula uses only three ingredients, but the meaning is complete. No matter the inside or outside Xie Qi, it can solve all the same time. After one or two doses, the summer Hot disappears gradually, and the amount of Huashi can be reduced accordingly. By this way, there is no case not worked. The long time diarrhea in summer causes asthenic Hot reverse up to combine with the summer Hot, both of which fill up the stomach to cause nausea and reduce appetite. This formula not only clears the Hot and nourishes the Yin, but also calm and harmony the middle part of the body to stop diarrhea. Its heavy nature can also calm and reverse the up-reversed stomach Qi, making the reversed Qi and the summer Hot gradually move down and leave the body through the urine, so that the nausea and vomit stops.

初定此方时，授门人高××录之。翌日，高××还里，遇一孺子，泄泻月余，身热燥渴，嗜饮凉水，强与饮食，即恶心呕吐，多方调治不愈。高××投以此汤，一剂，燥渴与泄泻即愈其半。又服一剂，能进饮食，诸病皆愈。

In the beginning when I set up this formula, I asked my student Mr. Gao cited down. Another day, Mr. Gao turned back his home town. A child had diarrhea in summer for months. His body was hot and thirsty and craved for cold water. If forced to eat, the child would have nausea and vomit. He was sent to try many herbs but none have effects. Mr. Gao used this formula to the child. After one dose, the thirsty and diarrhea reduced to half level. After another dose, the child could eat and the condition was cured.

7．加味四神丸

7. Jiawei Sishen Wan (Si here means number four in Chinese; Shen means angles)

治黎明腹疼泄泻。

This formula is used for diarrhea, stomach pain in early morning.

补骨脂（六两酒炒） 吴茱萸（三两，盐炒） 五味子（四两，炒） 肉豆蔻（四两，面裹煨）花椒（一两微焙） 生硫黄（六钱） 大枣（八十一枚） 生姜（六两，切片）
Buguzhi 180 gram (fry with liquor), Wuzhuyu 90 gram (fry with salt), Wuweizi 120 gram (fry), Roudoukou 120 gram (bake with wheat), Huajiao 30 gram, Liuhuang (brimstone) 18 gram, Chinese date 81 , fresh ginger 180 gram (chop).

先煮姜十余沸，入枣同煮，至烂熟去姜，余药为细末，枣肉为丸，桐子大。
Cook the fresh ginger first for ten boiling. Add Chinese date to cook until the date is ready. Remove the ginger. Prepare other ingredients into powder, mix them with the date mud into pills, each as 1 cm in diameter.

人禀天地之气而生，人身一小天地也。天地之一阳生于子，故人至夜半之时，肾系命门之处，有气息息萌动，即人身之阳气也。至黎明寅时，为三阳之候，人身之阳气，亦应候上升，自下焦而将达中焦。其人或元阳之根柢素虚，当脐之处，或兼有凝寒遮蔽，即互相薄激，致少腹作疼。久之阳气不胜凝寒，上升之机转为下降，大便亦即溏下，此黎明作泻之所由来也。

Human being is born from the sky Qi and the earth Qi. The body is a small universe too. The Yang Qi is born in the Zi shi (middle night), so at the middle night, we could fee kind of shacking on the back, e.g. the movement of the Yang Qi in the body. Upon the early morning, it is the time of the three Yang Qi. The body Yang Qi raises along with the natural Qi circle, from the Lower Jiao up to the Middle Jiao. If the person for a long time is weak in the root of the Yuan Yang, or under the naval, there is Cold-clot block, there would be pain in the lower abdomen. After a while, if the Yangqi cannot combat the sticky Cold, it would return down, the stool would also move down as diarrhea. This is the reason for the diarrhea in the early morning.

夫下焦之阳气少火也，即相火也，其火生于命门，而寄于肝胆。故四神方中，用补骨脂以补命门，吴茱萸以补肝胆，此培火之基也。然泻者关乎下焦，实又关乎中焦，故又用肉豆蔻之辛温者，以暖补脾胃。且其味辛而涩，协同五味之酸收者，又能固涩大肠，摄下焦气化。且姜枣同煎，而丸以枣肉，使辛甘化合，自能引下焦之阳，以达于中焦也。然此药病轻者可愈，病重者服之，间或不愈，以其补火之力犹微也。故又加花椒、硫黄之大补元阳者以助之，而后药力始能胜病也。

The Yang Qi in the Lower Jiao is the Shao Fire, e.g. the Xiang Fire. It borns in the Mingmen (Life gate), but lives in the Liver-Gall Bladder. So, in the Sishen Wan, Buguzhi works to nourish the Mingmen; Wuzhuyu to nourish the Liver-Bladder, to enhance the root for the Fire. However, the diarrhea is related to the Lower Jiao, but also to the Middle Jiao too. So, Roudoutou is used, for its spicy warm, to warm-nourish the Spleen-Stomach. The Roudoutou is spicy and astringent, together with the sour-restraining nature of Wuweizi, it can solidify the large intestine and to enhance the Lower Jiao. When cooked with the ginger and Chinese date, making the spicy-sweet mixture, the mixture can conduct the Yang Qi in the Lower Jiao up to the Middle Jiao. For mild case, this formula works. In severe cases, it may not work so well from time to time, for no enough ability to nourish the Fire. For this reason, add Huajiao and Liuhuang to nourish the Yuan Yang, to make it work in all cases.