協熱利简体协热利

xié rè lì

Heat-joined diarrhea · xie re li

Also rendered: Heat-joined diarrhea (Literal) · Cooperative heat diarrhea (Mitchell) · Diarrhea from heat driven inward (Clinical)

Pathology

Reviewed · 2026-10-31

At a glance

Pinyin: xié rè lì
Simplified: 协热利
Literal: 協 xié is to bring into accord, to join forces — 《說文》 defines it as the concord of many. 熱 rè is heat, here the heat of the exterior that has not been resolved. 利 lì is the loose passage of the bowels, what the chapters more often call 下利. The three together name a diarrhea in which unresolved exterior heat has joined with the interior: not heat alone, and not simple vacuity, but the two bound into one.
Shuowen: **《說文》：「協，衆之同和也。」** 後世注家多以「協」通「挾」，謂表熱挾裏而下。**底本第七篇兩見俱作「恊」**（行332、334），篇八又作「協熱而便膿血」，同字異寫，經文不改；詞目取通行形「協」，引文仍存底本字面。**六至十篇「恊熱利」二見**，皆在第七篇；「協熱」又見第八篇行619，義同而證異（便膿血而非下利）。

In brief

Diarrhea produced when exterior heat, left unresolved, is driven inward by a mistaken purge and joins with the interior. The chapter reaches it twice: once when a taiyang patient who cannot lie down is purged and the looseness does not stop, and once in the pulse sequence, where a deep and slippery pulse foretells it. The point of the term is that the heat is not simply inside — it is heat that has been brought in and made common with the interior, so that clearing the interior alone will not do and releasing the exterior alone will not do either. A related line in the yang brightness chapter speaks of heat joined and purulent blood in the stool, the same mechanism with a different outcome.

Senses in the classical corpus

誤下成利此作恊熱利也

本有寒分，反下之；利止者作結胸，利不止者再下，表熱遂挾裏虛而下，故名協熱利

There was cold within to begin with, and the physician purged. If the looseness stops a knotted chest forms; if it does not stop and the purge is repeated, exterior heat is carried into the interior vacuity and the bowels run. That is why it is called heat-joined diarrhea.

太陽病二三日，不能卧，但欲起，心下必結，脉微弱者，此本有寒分也，反下之，若利止，必作結胸。未止者，四日復下之，此作恊熱利也。 — 辨太陽病脉證并治下第七

脈沉滑脉沉滑者，恊熱利

結胸、咽痛、脅急、頭痛、嘔、協熱利、下血七證，俱以脉定之；沉滑主裏有熱而水穀下趨

The chapter runs through seven outcomes — knotted chest, sore throat, cramped flanks, headache, vomiting, heat-joined diarrhea, blood below — and settles each by the pulse. Deep and slippery means heat within with grain and water moving downward.

脉沉緊者，必欲嘔；脉沉滑者，恊熱利；脉浮滑者，必下血。 — 辨太陽病脉證并治下第七

Occurrences in the classics

Passages where the term does real work, with the original, pinyin and English on the same line.

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2 passages

辨太陽病脉證并治下第七·辨太陽病脉證并治下第七 Read in context →

太陽病二三日，不能卧，但欲起，心下必結，脉微弱者，此本有寒分也，反下之，若利止，必作結胸。未止者，四日復下之，此作恊熱利也。太阳病二三日，不能卧，但欲起，心下必结，脉微弱者，此本有寒分也，反下之，若利止，必作结胸。未止者，四日复下之，此作协热利也。

tài yáng bìng èr sān rì bù néng wò dàn yù qǐ xīn xià bì jié mài wēi ruò zhě cǐ běn yǒu hán fèn yě fǎn xià zhī ruò lì zhǐ bì zuò jié xiōng wèi zhǐ zhě sì rì fù xià zhī cǐ zuò xié rè lì yě

In taiyang disease of two or three days, the patient cannot lie down and wants to sit up; there must be binding below the heart. With a faint, weak pulse, he had cold in him from the start. If he is wrongly purged and the diarrhoea stops, chest binding will follow; if it does not stop, and he is purged again on the fourth day, this makes heat-assisted diarrhoea.

一誤下而兩變：利止成結胸，利不止成協熱利，同源而異趨。

辨太陽病脉證并治下第七·辨太陽病脉證并治下第七 Read in context →

太陽病，下之，其脉促，不結胸者，此爲欲解也。脉浮者，必結胸也；脉緊者，必咽痛；脉弦者，必兩脅拘急；脉細數者，頭痛未止；脉沉緊者，必欲嘔；脉沉滑者，恊熱利；脉浮滑者，必下血。太阳病，下之，其脉促，不结胸者，此为欲解也。脉浮者，必结胸也；脉紧者，必咽痛；脉弦者，必两胁拘急；脉细数者，头痛未止；脉沉紧者，必欲呕；脉沉滑者，协热利；脉浮滑者，必下血。

tài yáng bìng xià zhī qí mài cù bù jié xiōng zhě cǐ wéi yù jiě yě mài fú zhě bì jié xiōng yě mài jǐn zhě bì yàn tòng mài xián zhě bì liǎng xié jū jí mài xì shuò zhě tóu tòng wèi zhǐ mài chén jǐn zhě bì yù ǒu mài chén huá zhě xié rè lì mài fú huá zhě bì xià xuè

In taiyang disease after purgation, a hurried pulse without chest binding means the disease is about to resolve. A floating pulse means chest binding; a tense pulse, sore throat; a string-like pulse, cramping of both flanks; a fine, rapid pulse, headache that does not stop; a deep, tense pulse, a wish to vomit; a deep, slippery pulse, heat-assisted diarrhoea; a floating, slippery pulse, bleeding.

七證以脉定，沉滑獨主協熱利，可見其病在裏而熱未嘗不在表。

Compounds built on this term

協熱利

xié rè lì

heat-joined diarrhea

辨太陽病脉證并治下第七

協熱

xié rè

heat joined in

辨陽明病脉證并治第八

下利

xià lì

looseness of the bowels

辨太陽病脉證并治下第七

結胸

jié xiōng

knotted chest

辨太陽病脉證并治下第七

How it has been translated

Every rendering below is a decision about which reader is being addressed. There is no neutral option.

This site	heat-joined diarrhea	keeps 協 as a joining, not a mere 'with'
Literal	accordant-heat diarrhea	exact and unreadable
Clinical	diarrhea from heat driven inward	explains the mechanism, loses the graph

Entry status

Review pending — who reviews this?

2026-10-31

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