Chronic diarrhea is a very difficult condition to treat. Because of its mixed causes, it is necessary to identify the nuances and understand the changes in order to achieve satisfactory results. The author’s treatment experience is described below. 1, spleen deficiency and stagnation, spleen transport is better than spleen supplementation “the essence of diarrhea, all from the spleen and stomach”. The stomach is responsible for accepting and maturing, and the spleen is responsible for transporting and transforming. The cause of prolonged diarrhea is mostly due to the failure of the spleen to transport and transform, and the water and grain do not return to the correct transformation, the water is brewed as wet, the grain is stagnant, wet and stagnant, the clear and turbid are not separated, and go to the large intestine, due to diarrhea causes deficiency, because the deficiency is easy to diarrhea, mutual cause and effect, very easy to cause the complex situation of spleen deficiency with stagnation, deficiency in the real. However, the sign of stagnation is easily covered up by the sign of spleen deficiency, making people negligent, and the evidence must be carefully examined. The key to identifying stagnation is whether the evidence is accompanied by post-eating gastric distension, diarrhea, poor appetite, greasy coating, etc. The treatment of spleen transportation is better than spleen supplementation because if spleen supplementation is used, it is afraid that it will help stagnation, but if spleen transportation is performed, there is no such worry and it can rebuild the function of spleen and stomach. The formula of Drunken Country Jade Crumb, which is composed of Atractylodes macrocephala, Houpu, Chenpi, Licorice, Gynostemma, Sharen and Clove, is suitable for treating this type of prolonged diarrhea. Among them, Atractylodes macrocephala is the main medicine to transport the spleen. Prof. Yan Dexin, the master of this formula, once said that “one flavor of Atractylodes macrocephala is more effective than four kings”. Based on this formula, it can be used in clinical practice with Zedoary and Plantain. He treated a patient surnamed Wang, female, 64 years old. She had a history of chronic diarrhea for 4 years, with loose stools, sometimes with indigestible matter, bloating and diarrhea after every meal, but without food, the diarrhea was slightly slowed down, with little food, lethargy and fatigue, and suffering. The barium enema showed chronic colitis. The former doctor had used the methods of clearing damp-heat, warming the spleen and kidney, and astringent intestines to stop diarrhea. With Similac and other western drugs. Long treatment did not see significant results, 6-7 times daily stool. The texture is loose and thin, and the tongue is light with slightly thick coating. It was identified as spleen deficiency with stagnation and abnormal transportation. The proposed method is to transport the spleen and eliminate the conductive method, the drunken country yu crumb formula to increase the loss: atractylodes 20g, Chuan Park 15g, sand 3g (after the next), Chen Pi 9g, chicken naijin 15g, sandalwood (each) 3g, zedoary 10g, plantain 30g, wheat sprout 30g, Liu Yi San 12g (packet decoction), lotus leaf 10g. 1 week of medication, the number of stools decreased, 2 to 3 times a day, the quality of soft and loose, gastric distension and pain is reduced, the grain is slightly more than before. The stomach distension and pain were reduced, and the food intake was slightly higher than before. After 7 more doses, the stools were soft and formed, 1 to 2 times daily. The symptoms disappeared after 2 weeks of continuous treatment. Later, Ling Gui Zhu Gan and Xiang Sha Liu Jun Wan were used for post-treatment, and the medicine was stopped in 2 weeks. 2, spleen and yin deficiency, the choice of medicine still need to think smartly The problem of diarrhea is blamed on the spleen and kidney. It is a common method to strengthen the spleen and stop diarrhea, and to warm the kidney and fix the lower part of the body. In people with prolonged diarrhea, there is certainly a deficiency of the spleen’s qi and yang, but it is not uncommon to have prolonged diarrhea, or to use too much aromatic and dry products, or to share too much profit, which injures the spleen’s yin, resulting in biochemical decline. The characteristics of the symptoms are: frequent bowel movements, diarrhea, loose stools with small amount, red tongue with vivid coating, and sunken and weak pulse. Treatment should be based on the correction of spleen-yin deficiency, and should not be confined to the usual method. The selection of medicine must be thoughtful, because if the method of benefitting the spleen and warming the kidneys is followed, the delusion of using fragrant and dry products such as ginger, sophora, tonic bone fat, Xian Ling spleen, etc., will certainly make the spleen yin more damaged; if cold medicine is used to nourish yin or nourishing thick taste, it is also afraid of aggravating diarrhea or hindering spleen movement. The author’s clinical experience, the ingenious point of its use of drugs are three: First, away from the dull tonic; second, nourishing Yin and astringent intestines used together; third, “sweet and flat moisten astringent” as the criteria for selecting drugs, less adjuvant light spirit circulation generation such as Chen Pi, sand, Dai Dai Hua class. The principle of treatment is to support the spleen and nurture yin, astringent intestines to stop diarrhea. The formula is such as Mai Men Dong Tang, Ginseng and Bai Zhu San, with the addition of Bai Shao, Wu Mei, Mu Gua, Hao Zi and other sour and astringent substances as appropriate. He treated a patient surnamed Cheng, male, 70 years old. He had a history of “chronic colitis” for more than 8 years, with diarrhea 5-6 times a day and loose stools with low volume, which had not been treated by many doctors. Recently, the tendency of diarrhea was aggravated and the stool was frequent and urgent, so he was hospitalized in our department. He was treated with potassium supplementation because of the low blood potassium level, but the diarrhea was aggravated after each infusion, so he stopped using the supplementation. He was poor in appetite, thin in shape, dry in mouth, with a reddish tongue and a sunken and weak pulse. He was identified as having a deficiency of spleen and yin, and a derangement of transportation and transformation. We proposed to use Mai Men Dong Tang combined with Ginseng and Bai Zhu San to increase the loss: 15g of Mai Men Dong, 15g of Bai Shao, 30g of Yam, 15g of Bei Sha Shen, 30g of Prince Ginseng, 15g of Bai Zhu, 15g of Dendrobium, 10g of Wu Wei Zi, 15g of Umei, 10g of Chestnut, 15g of Pomegranate Peel, 10g of Chen Pi, 3g of Dai Dai Hua. 1 week of medication, the stool was reduced to 3-5 times a day, and the dry mouth was alleviated. The above formula was supplemented with 15g of malt and 15g of Shen Qu, and 7 more doses were taken, the bowel movement was reduced and the stool was once a day, but the texture was slightly loose. Later, he took Ginseng and Atractylodes macrocephala as the basis and added and subtracted with the evidence for 3 weeks, and the tongue became lighter and all symptoms disappeared. No recurrence was seen during the follow-up period of 3 months. 3, deficiency in both evil, careful use of astringent and astringent treatment of prolonged diarrhea, astringent and astringent products, is commonly used drugs. I think the use of caution is needed. Because long diarrhea persistent disease, although the majority of deficiency evidence, but deficiency in the real, with food accumulation, gas stagnation, dampness, blood stasis and other standard real evil, is not uncommon. If you use astringent genera, it is easy to make the evil stay and help stagnant evil congestion, which affects the efficacy of treatment. Clinical experience shows that if a person with prolonged diarrhea is accompanied by abdominal distension, abdominal pain, mucous jelly in the stool, thick and greasy tongue coating, and dark tongue with petechiae, astringent products should be used with caution. In such patients, on the basis of transporting the spleen, it is advisable to remove congestion and restore the spleen’s movement. If there are no obvious signs of concurrent evil, astringent and astringent products such as Qinpi, Tsubaki root bark, pomegranate bark, Wu Mei, Wu Bei Zi, etc., are also the proper way of treatment. However, when examining the evidence, do not use astringent products to avoid aggravating the disease and increasing the patient’s pain. A patient surnamed Zhang, female, 52 years old, was treated. He had a history of chronic diarrhea for more than 6 years, treated with Chinese and Western drugs for many years, but did not see significant results, stool 7 to 8 times a day, with less abdominal distension and pain. The former medical treatment with the method of regulating qi and strengthening the spleen, astringent and astringent method did not cure the diarrhea, but the abdominal distension increased. The evidence of recurrent diarrhea, less abdominal distension, thin stools, sometimes with indigestible material, thin and greasy tongue coating, small slippery pulse. The evidence belongs to the spleen deficiency and stagnation. Because of stagnation, the previous doctor was negligent and used astringent products early, so that there is no way out of the stagnation, but increased congestion. It is advisable to use the method of transporting the spleen and guiding stagnation, the sparing formula is as follows: Atractylodes macrocephala 15g, Chuan Park 15g, Chen Pi 10g, Chicken Neijin 15g, Shen Qu 15g, Big Belly Skin 30g, Cumin 3g, Wu Yao 10g, Zelig 10g, Grain and wheat sprouts (each) 15g, Poria 15g. 1 week of medication, abdominal distension is reduced, grain intake increased, tongue coating gradually, diarrhea decreased. The medicine is used for 3 weeks, all symptoms if lost. Follow up 3 months, no recurrence.