钱仲阳云∶吐泻壮热不食，或乳不消，是伤乳也。宜白饼子下之，后用益黄散和胃。若吐泻
身温不乳，大便青白，此上实下虚也，用益黄散加减治之。大凡吐泻身温，乍凉乍热，气粗
，大便黄白，吐乳不消，此伤风热也，先服大青膏发散，后服益黄散和胃。若吐泻身热多睡
，能乳吐痰，大便黄水，胃虚也，先用白术散生津止渴，后用大青膏、钩藤饮发散风邪。若
夏至后，吐泻身热，或吐乳泻黄，此伤热乳也，用玉露散之类。凡泻乳腹痛，按之而哭者，
食积痛也，用白饼子下之；按之不哭者，脾胃气虚也，用五味异功散补之；手足指冷者，脾
气虚寒也，用异功散加木香；伤风吐泻者，风木克土脾也，亦用前药。若饮热乳而泻黄者，
湿热壅滞也，用四苓散；如不愈，或反甚者，元气复伤也，用白术散。泻而腹中重坠者，脾
气下陷也，用补中益气汤。若服克滞之药，而腹中窄狭者，脾气虚痞也，用六君子汤。若面
黄泻青，脾虚而肝乘之也，用六君、柴胡、升麻、木香。若多噫泻黄，心脾气虚也，用六君、炮姜、
升麻。生下半月、旬日内吐者，止宜调治其母，恐婴儿脏腑脆弱，不胜药饵故也。
治验
一小儿盛暑吐泻，米谷不化。或用黄连香薷饮之类，腹胀作痛，手足指冷，此脾气虚而伏阴
在内也；用五味异功散加木香治之而愈。先君尝云∶凡暑令吐泻，手足指热，作渴饮冷者，
属阳症，宜清凉之剂；手足指冷，作渴饮热者，属阴症，宜温补之剂。故凡病属阴症，误用
寒凉之药，死后手足青黯，甚则遍身皆然，于此可验。
一小儿吐泻乳食，色白不化，露睛气喘，此脾肺不足，形病俱虚也，先用异功散加柴胡、桔
梗顿愈，再用补中益气汤而安。
一小儿吐泻惊悸，困倦腹胀，此心火虚而脾土怯也，用六君、茯神、酸枣仁而愈，又用秘旨
保脾汤乃瘥。
一小儿吐泻，惊搐项强，乃脾伤而肝侮，形气虚而病气实也，用异功散加钩藤钩补脾平肝而
愈。
一小儿吐泻，呵欠顿闷，不语畏明，属脾肺不能生肝肾也，用异功散补脾肺，地黄丸补肝肾
遂痊。
一小儿吐泻，腹胀不乳，此脾胃伤也，先用香砂助胃膏而饮食进；后用六君子汤，而脾胃健
。
一小儿寒热作呕，饮食不入，按其腹则哭，此饮食停滞也，先用大安丸遂安。但唇目抽动，
大便稀黄，此病邪去而脾气虚弱也，用六君子汤以补脾土，钩藤钩以平肝木悉愈。
一小儿白睛多，唇色白，停食吐泻，困睡惊悸，久治不愈。余曰∶惊悸为心血虚怯；困睡为
脾气虚弱；皆禀脾肾不足所致也。用补中益气汤及六味丸加鹿茸而愈。
一小儿未周岁，气短喘急，乳食少进，时或吐乳，乃脾伤而食积也，先用六君、山楂、枳实
渐愈；后吐泻作渴，用胃苓膏以治吐泻，白术散以生胃气而安。
一小儿四岁，每饮食失节，或外惊所忤，即吐泻发搐。服镇惊化痰等药后，患益甚，饮食不
入，药食到口即呕，余用白术一味和土炒黄，用米泔水浓煎，不时灌半匙，尚呕；次日微呕
；又一日不呕，渐加至半杯，月余而愈。
一小儿停食吐泻，身热作渴，泻下红白，或青黄色，服香连丸而愈。甚兼手足指冷，余谓始
为实终为虚也，用补中益气汤加木香、肉果而愈。
一小儿伤食吐泻，大便溏泄，或青绿色，睡而露睛，手足指冷，额黑唇青，此中气虚弱，寒
水侮土也，用五味异功散加升麻、柴胡、木香、附子，一剂而愈。后患吐泻不已，先用胃苓
散，后用异功散而安。
一小儿寒热呕吐，或泻青色，余谓脾虚肝木所乘也，用六君、柴胡、升麻治之而愈。后因惊
寒热，寅卯时益甚，小便频数，久而不愈，此肝火血虚，先以小柴胡汤加白术、茯苓、当归
二剂，顿止，又用地黄丸而愈。
车前子散 治暑月霍乱，吐泻烦闷，引饮不止，小便不利。
白茯苓 猪苓 香薷 车前子（炒） 人参（各等分）
上为末，灯心汤调下。
不换金正气散 治脾胃不和，寒热往来，脏腑虚热，霍乱吐泻。
浓朴（姜制） 藿香 陈皮 半夏 苍术（米泔浸） 甘草（炙。各等分）
上每服二三钱，姜枣水煎服。
二顺散 治中暑霍乱，吐泻烦闷燥渴，小便赤涩，便血肚疼。
猪苓 泽泻 茯苓 白术 甘草（炙） 桂 干姜 杏仁（去皮尖双仁，炒。各一两）
上为末，每服半钱，不拘时，水调下，或水煎服。
又酿乳法 治胃虚吐泻，睡中吐舌，摇头呕乳，额上汗流，惊 面黄，令儿饥饮。
人参 木香 藿香 沉香 陈皮 神曲 麦芽（各等分） 丁香（减半）
上每服四钱，姜十片，紫苏十叶，枣三枚，水煎，每服半盏，令乳母食后，捏去旧乳方服，
卧少时，却与儿乳。
胃苓汤 又名胃苓散，为末蜜丸名胃苓膏。治肠胃受湿，呕吐泄泻。
白术 茯苓 泽泻 浓朴 猪苓 陈皮 甘草（炒。各等分） 桂（少许）
上为末，每服二钱，姜水、灯芯、陈皮煎汤调下。若停食吐泻，小便短少，腹胀作痛，用此
以分利之。更用六君子汤以调补脾胃。
益黄散（方见脾脏）
理中汤（方见咳嗽）
助胃膏（方见热吐，一名香砂助胃）
白饼子（方见发搐）
白术散（方见积痛）
钩藤散（方见慢惊）
玉露散（方见热泻）
五苓散（方见五淋）
香薷饮（方见呕吐）
定命饮子
异功散
六君子汤
四君子汤（三方并见内钓）
大青膏（方见肝脏）
补中益气汤
大安丸（二方见虚羸，即保和丸加白术）
香连丸（方见诸痢）
小柴胡汤（方见痉症）
四苓散（方见五淋，五苓散去桂）
Qian Zhongyang stated: When an infant presents with vomiting, diarrhea, high fever, refusal to eat, or indigestion of milk, this is attributed to injury from nursing (damage caused by improper breastfeeding). It is appropriate to use Baibing Zi (White Pill) to purge the accumulation, followed by Yihuang San (Golden Yellow Powder) to harmonize the stomach. If there is vomiting and diarrhea with a normal body temperature, refusal to nurse, and greenish-white stools, this indicates excess above and deficiency below (pathogenic excess in the upper jiao and righteous deficiency in the lower jiao). Treat with modified Yihuang San. Generally, if vomiting and diarrhea are accompanied by a normal body temperature, alternating chills and fever, coarse breathing, yellowish-white stools, and undigested milk in vomit, this is due to wind-heat injury (injury from wind-heat pathogens). First administer Daqing Gao (Great Blue Ointment) to dissipate the pathogen, then use Yihuang San to harmonize the stomach. If vomiting and diarrhea are accompanied by fever, lethargy, ability to nurse but spitting up phlegm, and yellow watery stools, this is due to stomach deficiency (deficiency of stomach qi). First use Baizhu San (Atractylodes Macrocephala Powder) to generate fluids and quench thirst, then use Daqing Gao and Gouteng Yin (Uncaria Decoction) to dissipate wind pathogens. If after the Summer Solstice, vomiting, diarrhea, fever, or spitting up milk and passing yellow stools occur, this is due to injury from hot milk (damage from consuming overly warm milk). Use formulas such as Yulu San (Jade Dew Powder). For infants with diarrhea, abdominal pain, and crying upon abdominal pressure, this is food stagnation pain; use Baibing Zi to purge. For those who do not cry upon pressure, this is spleen-stomach qi deficiency; use Wuyi Yigong San (Five Agents Extra-ordinary Power Powder) to tonify. For coldness in the fingers of hands and feet, this is spleen qi deficiency-cold; use Yigong San added with Muxiang (Costus Root). For vomiting and diarrhea due to wind injury, where wind wood overacts on earth affecting the spleen, use the aforementioned remedies. If drinking hot milk leads to yellow diarrhea, this is damp-heat congestion (damp-heat pathogens obstructing the middle jiao); use Siling San (Four Porias Powder). If ineffective or if the condition worsens, it indicates further damage to yuan qi (primordial qi); use Baizhu San. For diarrhea with a sensation of heaviness and bearing down in the abdomen, this is sinking of spleen qi (spleen deficiency causing clear yang to fail to ascend); use Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction). If abdominal tightness and discomfort occur after taking purgative/stagnation-resolving drugs, this is spleen qi deficiency with palpable obstruction (qi stagnation due to spleen deficiency); use Liujunzi Tang (Six Gentlemen Decoction). For yellow complexion and green stools, this is spleen deficiency with liver wood encroaching (liver qi overacting on spleen earth); use Liujunzi Tang added with Chaihu (Bupleurum), Shengma (Cimicifuga), and Muxiang. For frequent belching and yellow stools, this is heart-spleen qi deficiency; use Liujunzi Tang added with Paojiang (Prepared Ginger) and Shengma. For infants half a month to ten days old who vomit, only the mother’s constitution should be regulated, as the infant’s zang-fu organs are fragile and may not withstand medicinal potency.
Case Records:
An infant suffered vomiting and diarrhea during midsummer with undigested rice and grains. Someone used Huanglian Xiangru Yin (Coptis and Mosla Decoction) and similar formulas, resulting in abdominal distension, pain, and cold fingers/toes. This indicated spleen qi deficiency with latent yin-cold inside; treat with Wuyi Yigong San added with Muxiang, which cured the case. My father once said: In summer, for vomiting and diarrhea, if the fingers/toes are hot and the patient desires cold drinks, it belongs to yang syndrome, suitable for cooling agents; if the fingers/toes are cold and the patient desires hot drinks, it belongs to yin syndrome, suitable for warming and tonifying agents. Thus, for yin syndrome diseases, misusing cold-cooling medicines can lead to cyanosis of the extremities after death, sometimes spreading to the whole body, which serves as verification.
An infant presented with vomiting and diarrhea of undigested white milk, eyes partially open (exposed pupils), and panting. This indicated insufficiency of spleen and lung, with both form and pathology being deficient. First, Yigong San added with Chaihu and Jiegeng (Platycodon) was administered rapidly, curing the acute symptoms; subsequently, Buzhong Yiqi Tang was used to stabilize the condition.
An infant presented with vomiting, diarrhea, palpitations, fatigue, and abdominal distension. This indicated deficiency of heart fire and timidity of spleen earth. Treatment with Liujunzi Tang added with Fushen (Poria with Hostwood) and Suanzaoren (Ziziphus Seed) resulted in recovery, followed by Mizhi Baopi Tang (Secret Instruction Spleen-Preserving Decoction) for complete cure.
An infant presented with vomiting, diarrhea, convulsions, and neck stiffness. This indicated spleen injury with liver wood counter-rebelling (liver qi invading spleen), with deficiency of form/qi and excess of pathology. Treatment with Yigong San added with Gouteng Gou (Uncaria Hook) to tonify spleen and calm liver resulted in recovery.
An infant presented with vomiting, diarrhea, frequent yawning, sudden drowsiness, mutism, and photophobia. This indicated that spleen and lung failed to nourish liver and kidney. Treatment with Yigong San to tonify spleen-lung and Dihuang Wan (Rehmannia Pill) to tonify liver-kidney led to recovery.
An infant presented with vomiting, diarrhea, abdominal distension, and refusal to nurse, indicating spleen-stomach injury. First, Xiangsha Zhugao (Fragrant Amomum Stomach-Assisting Paste) was used to improve appetite; subsequently, Liujunzi Tang was used to strengthen spleen-stomach function.
An infant presented with alternating chills and fever, vomiting, inability to retain food, and crying upon abdominal pressure, indicating food stagnation. First, Daan Wan (Great Peace Pill) provided immediate relief. However, twitching of lips and eyes with loose yellow stools indicated that pathogens had departed but spleen qi was weak. Treatment with Liujunzi Tang to tonify spleen earth and Gouteng Gou to calm liver wood resulted in full recovery.
An infant presented with prominent sclera, pale lips, food retention with vomiting/diarrhea, lethargy, and palpitations, refractory to long-term treatment. I stated: Palpitations indicate deficiency of heart blood; lethargy indicates weakness of spleen qi; both stem from congenital insufficiency of spleen and kidney. Treatment with Buzhong Yiqi Tang and Liuwei Wan (Six-Ingredient Pill with Rehmannia) added with Lurong (Deer Antler Velvet) resulted in recovery.
An infant under one year old presented with shortness of breath, rapid panting, poor intake of milk/food, and occasional spitting up milk, indicating spleen injury with food stagnation. First, Liujunzi Tang added with Shanzha (Hawthorn) and Zhishi (Immature Bitter Orange) gradually improved the condition; later, when vomiting, diarrhea, and thirst occurred, Weiling Gao was used to treat vomiting/diarrhea, and Baizhu San was used to generate stomach qi, leading to stability.
A four-year-old child experienced vomiting, diarrhea, and convulsions whenever diet was irregular or startled externally. After taking sedative and phlegm-resolving medicines, the condition worsened, with inability to retain food/medicine and immediate vomiting upon ingestion. I used Baizhu (Atractylodes Macrocephala) alone, stir-fried with soil until yellow, decocted strongly in rice wash water, and administered half a spoon occasionally. Vomiting persisted; the next day it was mild; the following day it ceased. The dose was gradually increased to half a cup, and the child recovered within a month.
An infant with food retention presented with vomiting, diarrhea, fever, thirst, and passage of red-white or green-yellow stools. Treatment with Xianglian Wan (Coptis and Alisma Pill) resulted in recovery. If accompanied by cold fingers/toes, I reasoned that the initial stage was excess transforming into deficiency later. Treatment with Buzhong Yiqi Tang added with Muxiang and Rouguo (Myristica) resulted in recovery.
An infant with food-injury vomiting and diarrhea presented with loose stools, possibly green, sleeping with exposed pupils, cold fingers/toes, black forehead, and blue lips. This indicated deficiency of middle qi and cold water rebelling against earth (kidney water overacting on spleen earth). Treatment with Wuyi Yigong San added with Shengma, Chaihu, Muxiang, and Fuzi (Prepared Aconite) cured it in one dose. Later, for persistent vomiting/diarrhea, Weiling San was used first, followed by Yigong San for stabilization.
An infant with chills, fever, vomiting, or green stools was diagnosed as spleen deficiency with liver wood encroachment. Treatment with Liujunzi Tang added with Chaihu and Shengma resulted in recovery. Later, due to fright-induced chills/fever worsening at Yin-Mao hours (3-7 AM), with frequent urination and chronic persistence, this was diagnosed as liver fire and blood deficiency. First, Xiaochaihu Tang (Minor Bupleurum Decoction) added with Baizhu, Fuling (Poria), and Danggui (Angelica Sinensis) for two doses stopped the symptoms immediately; subsequently, Dihuang Wan cured the condition.
Cheqianzi San (Plantago Seed Powder): Treats summer-heat huoluan (acute vomiting and diarrhea), with vomiting, diarrhea, restlessness, excessive thirst, and dysuria.
Ingredients: Baifuling (White Poria), Zhuling (Polyporus), Xiangru (Mosla), Cheqianzi (Plantago Seed, stir-fried), Renshen (Ginseng) in equal parts.
Usage: Powdered, taken with Dengxin Tang (Juncus Decoction).
Buhuanjin Zhengqi San (Unchanging Gold Upright Qi Powder): Treats spleen-stomach disharmony, alternating chills and fever, visceral deficient heat, and huoluan vomiting/diarrhea.
Ingredients: Nongpo (Magnolia Bark, ginger-processed), Huoxiang (Patchouli), Chenpi (Tangerine Peel), Banxia (Pinellia), Cangzhu (Atractylodes Lancea, soaked in rice water), Gancao (Licorice, honey-fried) in equal parts.
Usage: 2-3 qian per dose, decocted with ginger and jujube in water.
Ersun San (Two Smoothness Powder): Treats summer-heat huoluan, with vomiting, diarrhea, restlessness, dry thirst, dark/scanty urine, bloody stool, and abdominal pain.
Ingredients: Zhuling, Zexie (Alisma), Fuling, Baizhu, Gancao (honey-fried), Gui (Cinnamon Twig), Ganjiang (Dried Ginger), Xingren (Apricot Kernel, peeled, double-kernel, stir-fried) each 1 liang.
Usage: Powdered, 0.5 qian per dose, taken with water at any time, or decocted.
Another Method for Nurturing Milk: Treats stomach deficiency with vomiting/diarrhea, tongue protrusion during sleep, head-shaking while vomiting milk, sweating on forehead, fright, and yellow face. Let the infant feed when hungry.
Ingredients: Renshen, Muxiang, Huoxiang, Chenxiang (Agarwood), Chenpi, Shenqu (Medicated Leaven), Maiya (Malt) in equal parts; Dingxiang (Clove) halved.
Usage: 4 qian per dose, with 10 slices of ginger, 10 leaves of Zisu (Perilla), and 3 jujubes. Decoct in water, take half a zhan per dose. The nursing mother should consume this after meals, express and discard old milk, lie down for a while, then nurse the infant.
Weiling Tang (Stomach-Poria Decoction): Also known as Weiling San; powdered and honey-pilled as Weiling Gao. Treats dampness affecting intestines/stomach, vomiting, and diarrhea.
Ingredients: Baizhu, Fuling, Zexie, Nongpo, Zhuling, Chenpi, Gancao (stir-fried) in equal parts; Gui (Cinnamon Twig) a small amount.
Usage: Powdered, 2 qian per dose, taken with decoction of ginger water, Dengxin, and Chenpi. For food retention with vomiting/diarrhea, scanty urine, and abdominal distension/pain, use this to separate turbidity from clarity. Further use Liujunzi Tang to regulate and tonify spleen-stomach.
Yihuang San (See Spleen Organ section)
Lizhong Tang (See Cough section)
Zhugao (See Hot Vomiting section, also named Xiangsha Zhuguo)
Baibing Zi (See Convulsion section)
Baizhu San (See Accumulation Pain section)
Gouteng San (See Slow Convulsion section)
Yulu San (See Hot Diarrhea section)
Wuling San (See Five Stranguries section)
Xiangru Yin (See Vomiting section)
Dingming Yinzi
Yigong San
Liujunzi Tang
Sijunzi Tang (These three formulas are seen in Internal Hook section)
Daqing Gao (See Liver Organ section)
Buzhong Yiqi Tang
Daan Wan (Two formulas seen in Emaciation section, i.e., Baohe Wan added with Baizhu)
Xianglian Wan (See Various Dysentery section)
Xiaochaihu Tang (See Spasm Syndrome section)
Siling San (See Five Stranguries section, Wuling San without Gui)