东垣云∶伤食则恶食，小儿食泻者，因饮食伤脾，脾气不能健运，故乳食不化而出。若嗳臭
吞酸，胸膈胀满，腹痛按之益痛者，虽作泻，而所停滞之物，尚未消也，用保和丸。腹痛按
之不痛者，乳食已消也，用异功散。脾气伤而未复，不思饮食者，用六君子汤；所伤生冷之
物及喜热者，并加木香、干姜。乳食已消，腹痛已止，泻尚未止者，脾失清升之气也，用补
中益气汤。余有别症，当参各门。
治验
一小儿泄泻不食，嗳腐酸气，用平胃散一服而泻止，又用五味异功散而饮食增。后复伤，吐
泻喘嗽，手足指冷，面色黄白，余谓脾虚不能生肺也，用六君、升麻、桔梗而愈。
一小儿伤食作泻发热，服寒凉药，热甚作呕，此胃经虚热也，先用四君子、升麻而呕止，又
用白术散而安。
一小儿乳哺失节，泄泻腹痛，自用药下之，反加痰搐。又服化痰止搐之药，而痰搐益甚，睡
而露睛，手足微冷。余以谓脾胃已虚而重伤之也，用异功散加木香、钩藤钩，母子并服，三
日而痰搐止，五日而泻痛除。
一小儿伤食，泻青发搐，余谓肝木胜脾也，用六君、木香、钩藤钩而愈。后伤食腹痛，别用
消食丸，唇青额黑，泻益甚，此脾气亏损，寒水反来侮土也，用六君、木香、干姜而痊。
一小儿面色痿黄，伤食作泻，面色顿白，气喘痰涌，余谓脾肺气虚下陷，法当升补。彼不信
，别服清气化痰之药，虚症蜂起。余先用补中益气汤一剂，诸症顿退，又用五味异功散而痊
。
一小儿泄泻，两寸脉或短或伏。用补中益气治之顿愈。余见患前症，不服此药而危者多矣，
惜哉！
一小儿饮食后即泻，先用六君、升麻、神曲、山楂而止，又用五味异功散加升麻而痊。后伤
食，吐泻腹痛，用保和丸二服，又用异功散，调补脾气而安。
一小儿伤食，作泻腹胀，四肢浮肿，小便不利，先用五苓散加木香，旬余诸症渐退。又用五
味异功散为主，佐以加减肾气丸。又旬日，二便调和，饮食渐进，浮肿旋消。乃以异功散调
理而愈。
一小儿十三岁，伤食作泻，服克伐之剂，胸腹膨胀，手足并冷，余谓当调补中气，不信，后
见睡而露睛，唇口搐动，乃用六君、木香、钩藤钩，至四剂搐动顿止；又一剂，饮食加进，
以五味异功散加升麻、柴胡，膈宽泻止而愈。
调中汤 治伤乳食泻后，脾胃虚哕吐泻。
人参 茯苓 白术 木香 干姜 藿香 香附（炒，去毛） 缩砂仁 甘草（炙） 丁香（各等分）
上水煎，食前服。
香橘饼 治伤冷积泻。
木香 青皮（各一钱） 陈皮（二钱五分） 浓朴 神曲 麦芽（炒。各半两）
上为末，蜜丸为饼，每服一枚，米饮调下。
保安丸 治伤食泻。
白僵蚕（炮） 青皮（去穣） 陈皮（去白） 三棱（炮） 蓬术（泡） 甘草（炒。各五钱） 砂仁 香附（各
一钱）
上为末，用麦芽米糊丸，绿豆大，每服二三丸，白汤下。
四君子汤
六君子汤
异功散（三方并见内钓）
白术散（方见积痛）
平胃散（方见胃气虚冷）
白饼子（方见发搐）
消食丸（方见呕吐乳）
补中益气汤
保和丸（加白术名保和汤，二方见虚羸）
胃苓散（即五苓散、平胃散合用，姜枣煎服，又名胃苓汤）
金匮加减肾气丸（方见腹胀）
Li Dongyuan stated: Food stagnation leads to aversion to food. In children, diarrhea due to food stagnation occurs because dietary intake damages the spleen and stomach; the spleen qi fails to transport and transform normally, resulting in milk and food failing to digest and being expelled. If there is belching with a foul, rotten odor, acid regurgitation, distension and fullness in the chest and diaphragm, and abdominal pain that worsens upon pressure, although diarrhea is present, the stagnant food has not yet been digested; Bahe Wan (Harmony Preservation Pill) should be used. If abdominal pain does not worsen upon pressure, it indicates that the milk and food have already been digested; Yigong San (Extraordinary Efficacy Powder) should be used. If spleen qi is injured but has not yet recovered, and there is a lack of appetite, Liujunzi Tang (Six Gentlemen Decoction) should be used; if caused by consuming raw or cold foods or if the patient prefers heat, add Muxiang (Aucklandiae Radix) and Ganjiang (Zingiberis Rhizoma). If the milk and food have been digested, abdominal pain has ceased, but diarrhea persists, this is due to the spleen losing its clear yang ascending qi; Buzhong Yiqi Tang (Decoction to Supplement the Middle and Augment the Qi) should be used. For other varying symptoms, refer to the respective sections.
Clinical Cases:
A child presented with diarrhea and anorexia, with belching emitting a foul, sour odor. After one dose of Pingwei San (Calm the Stomach Powder), the diarrhea stopped. Subsequently, Wuyi Yigong San (Five-Gentleman Extraordinary Efficacy Powder) was administered, increasing appetite. Later, re-injury from food occurred, presenting with vomiting, diarrhea, wheezing, coughing, cold fingers and toes, and a sallow-white complexion. I reasoned that spleen deficiency failed to generate lung qi. The case was cured using Liujunzi Tang (Six Gentlemen Decoction) added with Shengma (Cimicifugae Rhizoma) and Jiegeng (Platycodonis Radix).
A child suffered from diarrhea and fever due to food stagnation. After taking cold-natured medicines, the fever intensified and vomiting ensued, indicating deficient heat in the stomach meridian. Si Junzi Tang (Four Gentlemen Decoction) added with Shengma (Cimicifugae Rhizoma) was first used to stop vomiting, followed by Baizhu San (Atractylodis Macrocephalae Powder) to stabilize the condition.
A child had improper breastfeeding habits, leading to diarrhea and abdominal pain. Self-medication with purgatives exacerbated phlegm and convulsions. Subsequent administration of phlegm-resolving and convulsion-stopping medicines worsened the phlegm and convulsions, accompanied by sleeping with eyes half-open (exposed pupils) and slightly cold extremities. I attributed this to severe injury of already deficient spleen and stomach qi. Yigong San (Extraordinary Efficacy Powder) added with Muxiang (Aucklandiae Radix) and Goutenggou (Uncariae Ramulus cum Uncis) was administered to both mother and child. Phlegm and convulsions ceased after three days, and diarrhea and abdominal pain resolved after five days.
A child presented with green stools and convulsions following food-induced diarrhea. I diagnosed liver wood overacting on spleen earth. The case was cured using Liujunzi Tang (Six Gentlemen Decoction), Muxiang (Aucklandiae Radix), and Goutenggou (Uncariae Ramulus cum Uncis). Later, recurrent food stagnation caused abdominal pain. Another prescription, Xiaoshi Wan (Digestive Aid Pill), was used, resulting in cyanotic lips, dark forehead, and worsening diarrhea. This indicated spleen qi depletion with cold water counter-acting to insult spleen earth (water insulting earth). The case was cured using Liujunzi Tang (Six Gentlemen Decoction), Muxiang (Aucklandiae Radix), and Ganjiang (Zingiberis Rhizoma).
A child with a sallow complexion presented with sudden pallor, wheezing, and abundant phlegm following food-induced diarrhea. I diagnosed sinking of spleen and lung qi deficiency, requiring lifting and tonification. The parents disbelieved and administered phlegm-clearing and qi-transforming medicines, causing multiple deficiency syndromes to arise. One dose of Buzhong Yiqi Tang (Decoction to Supplement the Middle and Augment the Qi) immediately alleviated all symptoms, followed by Wuyi Yigong San (Five-Gentleman Extraordinary Efficacy Powder) for recovery.
A child with diarrhea presented with short or hidden pulses at both cun positions. Buzhong Yiqi Tang (Decoction to Supplement the Middle and Augment the Qi) resulted in immediate cure. I observed many cases of prior symptoms becoming critical when this formula was not used; how regrettable!
A child experienced immediate diarrhea after eating. Liujunzi Tang (Six Gentlemen Decoction) added with Shengma (Cimicifugae Rhizoma), Shenqu (Massa Fermentata Medicinalis), and Shanzha (Crataegi Fructus) stopped the diarrhea. Wuyi Yigong San (Five-Gentleman Extraordinary Efficacy Powder) added with Shengma (Cimicifugae Rhizoma) ensured recovery. Later, food stagnation caused vomiting, diarrhea, and abdominal pain. Two doses of Bahe Wan (Harmony Preservation Pill) were given, followed by Yigong San (Extraordinary Efficacy Powder) to regulate and tonify spleen qi, stabilizing the condition.
A child presented with diarrhea, abdominal distension, limb edema, and dysuria due to food stagnation. Wuling San (Five-Ingredient Powder with Poria) added with Muxiang (Aucklandiae Radix) was used initially, with symptoms gradually receding over ten days. Wuyi Yigong San (Five-Gentleman Extraordinary Efficacy Powder) was then used as the main formula, assisted by Jiajian Shenqi Wan (Modified Kidney Qi Pill). After another ten days, bowel and bladder movements harmonized, diet improved, and edema subsided. The case was finally cured with Yigong San (Extraordinary Efficacy Powder) for regulation.
A thirteen-year-old child took purgative medicines for food-induced diarrhea, resulting in abdominal distension and cold extremities. I advised regulating and tonifying middle qi, but the advice was ignored. Later, sleeping with eyes half-open and lip/mouth twitching appeared. Liujunzi Tang (Six Gentlemen Decoction), Muxiang (Aucklandiae Radix), and Goutenggou (Uncariae Ramulus cum Uncis) were administered. Twitching ceased after four doses. After one more dose, diet improved. Wuyi Yigong San (Five-Gentleman Extraordinary Efficacy Powder) added with Shengma (Cimicifugae Rhizoma) and Chaihu (Bupleuri Radix) widened the diaphragm, stopped diarrhea, and cured the case.
Tiaozhong Tang (Regulate the Middle Decoction): Treats post-food-stagnation diarrhea with spleen/stomach deficiency manifesting as hiccups, vomiting, and diarrhea.
Renshen (Ginseng Radix et Rhizoma), Fuling (Poria), Baizhu (Atractylodis Macrocephalae Rhizoma), Muxiang (Aucklandiae Radix), Ganjiang (Zingiberis Rhizoma), Huoxiang (Agastaches Herba), Xiangfu (Cyperi Rhizoma [stir-fried, hairs removed]), Suasharen (Amomi Fructus Rotundus), Gancao (Licorice Root [honey-fried]), Dingxiang (Caryophylli Flos] (equal parts).
Decoct in water and take before meals.
Xiangju Bing (Fragrant Orange Cake): Treats diarrhea due to cold accumulation.
Muxiang (Aucklandiae Radix), Qingpi (Citri Reticulatae Pericarpium Viride) (1 qian each), Chenpi (Citri Reticulatae Pericarpium) (2.5 qian), Houpo (Magnoliae Officinalis Cortex), Shenqu (Massa Fermentata Medicinalis), Maiya (Hordei Fructus Germinatus [stir-fried]) (0.5 liang each).
Grind into powder, form pills with honey into cakes. Take one cake per dose, washed down with rice water.
Baoan Wan (Security Preservation Pill): Treats diarrhea due to food stagnation.
Baijiangcan (Bombyx Batryticatus [pounded]), Qingpi (Citri Reticulatae Pericarpium Viride [de-seeded]), Chenpi (Citri Reticulatae Pericarpium [de-albedo]), Sanleng (Sparganii Rhizoma [pounded]), Pengzhu (Curcumae Aestivae Rhizoma [soaked]), Gancao (Licorice Root [stir-fried]) (5 qian each), Sharen (Amomi Fructus), Xiangfu (Cyperi Rhizoma) (1 qian each).
Grind into powder, make pills with malt starch paste, size of mung beans. Take 2-3 pills per dose, washed down with warm water.
Sijunzi Tang (Four Gentlemen Decoction)
Liujunzi Tang (Six Gentlemen Decoction)
Yigong San (Extraordinary Efficacy Powder) (See Nei Diao section for these three formulas)
Baizhu San (Atractylodis Macrocephalae Powder) (See Jitong section for formula)
Pingwei San (Calm the Stomach Powder) (See Weiqi Xu Leng section for formula)
Baibingzi (White Tablet) (See Facu section for formula)
Xiaoshi Wan (Digestive Aid Pill) (See Oumu section for formula)
Buzhong Yiqi Tang (Decoction to Supplement the Middle and Augment the Qi)
Bahe Wan (Harmony Preservation Pill) (Add Baizhu to name Bahe Tang; see Xu Lei section for both formulas)
Weiling San (Stomach-Ling Powder) (Combination of Wuling San and Pingwei San, decocted with ginger and jujube, also known as Weiling Tang)
Jinkui Jiabian Shenqi Wan (Modified Kidney Qi Pill from Jin Gui Yao Lue) (See Zhangfu section for formula)