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Vomiting and diarrhea are diseases of the stomach and intestines. When the disease is in the stomach, vomiting occurs; when it is in the intestines, diarrhea occurs; when both stomach and intestines are affected, vomiting and diarrhea occur alternately. Although the stomach and intestines are demarcated by the pylorus (Yōumén), they are fundamentally connected and continuous structures. Therefore, stomach diseases can sometimes cause diarrhea, and intestinal diseases can sometimes cause vomiting. In terms of these two pathological conditions, the intestines and stomach often involve each other. Furthermore, the Spleen (Pí) is responsible for transporting essence and fluids for the Stomach, and it also distinguishes clear from turbid within the food and drink for the Intestines. Thus, the transformation and transportation functions of both the stomach and intestines are governed by the Spleen. Consequently, the key to vomiting and diarrhea lies primarily in the Spleen. This condition is more severe in children than in adults because children have weak digestive power and fragile stomachs and intestines, making them unable to withstand the damaging effects of vomiting and diarrhea. If the Qi of acquired nutrition (Hòutiān zhī Gǔqì) is injured, the vital mechanism of growth and life may cease. Therefore, pediatricians throughout history have always regarded vomiting and diarrhea as critical syndromes.

Although vomiting and diarrhea can be classified into deficiency and excess patterns, as well as cold and heat patterns, vomiting leads to rebellious Qi, while diarrhea leads to sinking Qi. Prolonged vomiting weakens the Stomach, and prolonged diarrhea injures the Spleen. Regardless of whether the pattern is deficient or excess, cold or heat, the outcome invariably depletes the body's Righteous Qi (Zhèngqì), leading to various complications that affect the entire body. Severe cases may present with simultaneous upper vomiting and lower diarrhea, resulting in sudden collapse of Qi at both the upper and lower levels, with Righteous Qi becoming exhausted. Mild cases may transform into Infantile Convulsions (Jīngfēng) or gradually develop into Infantile Malnutrition Syndrome (Gānzhèng). This is why immediate treatment is essential upon the onset of vomiting and diarrhea in children to prevent complications.

However, regarding pediatric vomiting and diarrhea, slow treatment may lead to more changes, whereas prompt treatment often results in a cure. At the initial stage, one should first differentiate the etiology—whether due to Heat, Cold, Food Retention, or Phlegm—and then observe the predominance of deficiency or excess. In this way, therapeutic methods will hit the mark. If one adheres rigidly to the preconceived notion that "acute vomiting indicates excess, chronic vomiting implies deficiency, acute diarrhea requires purgation, and chronic diarrhea requires astringency," errors may occur. Acute vomiting and diarrhea may sometimes belong to deficiency-cold patterns, while chronic vomiting and diarrhea may occasionally involve retained food or phlegm. Therefore, these cannot be generalized. It depends on the clinician's ability to grasp the major aspects during practice and apply flexible treatment strategies. Hereinafter, we will discuss the three syndromes of vomiting, diarrhea, and combined vomiting and diarrhea separately.