Diarrhea, with all three pulses being even, and upon palpation, the area below the heart feels hard, drastic purgation should be applied, and it is appropriate to use Major Purgative Decoction.

bubble_chart Note

• In cases of diarrhea with hardness below the heart, it is a symptom of various Heart-Draining Decoction syndromes.
• If the pulses at the inch, bar, and cubit positions are even and strong, although there is diarrhea, it is still appropriate to attack the hardness.

bubble_chart Collected Annotations

• Fang You-zhi said: "All three pulses being even indicates that the blood and qi are harmonious. The hardness below the heart is substantial, hence the application of drastic purgation."
• Zhang Xi-ju said: "The classic text states: If there is spontaneous diarrhea, the pulse should be faint and weak. Now, if it is instead harmonious, this indicates internal substantiality, and purgation is appropriate."