吐泻
吐泻初生怎可当，
脾虚则泻，胃虚则吐，脾胃俱虚，吐泻不止，久则变成慢惊与疳。初生恶物未下，但呕黄汁者，木瓜丸∶
木瓜、腻粉、木香、槟榔、麝香各等分，为末，面糊丸小豆大。每一二丸，甘草煎汤下。初生吐泻不止者，朱
砂丸∶朱砂、南星、巴霜各等分，为末，糊丸黍米大。每二丸，薄荷煎汤灌服下之。后以朱沉煎调之∶朱砂二
钱，藿香三钱，滑石五钱，丁香十四粒，为末，用新汲水一盏，麻油滴成花，抄药五分在上，须臾坠下，澄去
水，别用温水下。初生吐泻，壮热不思乳食，大便色白，或不通者，停乳也，先宜紫霜丸下之，后用香橘饼∶
木香、橘皮、青皮各二钱半，浓朴、神曲、麦芽、砂仁各五钱，为末，蜜丸芡实大。每一丸，紫苏煎汤，米汤
任化下；或加肉豆蔻、诃子。一切冷积、泄泻俱效。
治者先分身热凉；寒吐腥臊泻青白，热吐酸臭泻色黄。
初生及稍长婴儿吐泻，以身凉面黄泻青白，吐腥臊者，为内伤寒乳，或外感风寒；以身热面赤泻黄赤，
吐酸臭者，为内伤热食，或外感暑热。古方∶吐泻身凉者，观音散。吐泻身热作渴者，钱氏白术散，吐泻身温，
或乍寒乍热，不思乳食，或食乳难化，大便青白，此上实下虚也，先宜益黄散，后宜四君子汤，随五脏见证加
减。如吐泻肢厥囟陷，加藿香、丁香；脾虚生风多困，加半夏曲、没石子及冬瓜子少许；惊啼螈 ，睡卧不安，
加全蝎，钩藤、白附子；赤白痢，加归、芍、粟米；白痢，加干姜、粟；泄泻，加陈皮、浓朴；伤风，加川芎、
防风、羌活、细辛；发渴，加干葛、枇杷叶及木瓜少许。
挟风必定憎寒热，
伤风多作吐泻，风木好侵脾土故也。外证必憎寒壮热，时有头疼，咳嗽气促。大概热者，宜先服大青膏，
或钩藤散发散，后服益黄散补脾；冷者，先服益黄散补脾，后服大青膏，或钩藤散发散。如吐骤或泻完谷者，
乃伤风甚也，大半夏汤。
被湿腹胀溺不长；
湿多身重腹胀，小水不利，平胃散主之；虚者，异功散。吐泻作渴，溺涩者，五苓散。壮热体重，吐酸
泻浊者，湿兼热也，羌活、黄芩、苍术、甘草等分，水煎温服。
寒多腹痛暑必渴，
寒月吐泻白色不渴者，益黄散；腹痛者，理中丸，肢冷加附子。久不止者，没石子丸∶没石子一个，白
豆蔻五个，诃子二个，木香、黄连各一钱，为末，饭丸麻子大。每十五丸，米饮下。兼治疳痢酿泻。暑月吐
泻色黄引饮者，异功丸，或玉露丸∶石膏、寒水石各一两，甘草五钱，为末，糊丸黄豆大。每一丸，冷水下；
吐不止，姜汤下。久不止者，古连柏丸∶黄连、黄柏各一两，为末，入猪胆汁内煮丸，绿豆大。每二十丸，米饮
下。抑论二证多见于夏秋，如立夏前后，湿热时行，暴吐泻者，苏葛汤；夏至后，吐泻身热，或伤乳食，泻深
黄者，益元散合四苓散，加苍术为末，温水调服；大暑后，吐泻身温，或伤乳食，泻黄白者，食前服益黄散，
食后服益元散；立秋后，吐泻身凉不食，多睡多哕不渴者，频服益黄散，少服益元散；秋分后，吐泻身冷不食，
泻青褐水者，益黄散。
泻臭 乳食必伤。
内伤乳食不化，面黄腹胀，泻如抱坏鸡卵臭者，消乳食丹∶丁香、木香、青皮、肉豆蔻、三棱、莪术各等
分，为末，糊丸麻子大。每五丸，米饮下。小便不清者，胃苓汤加肉豆蔻为
丸，米饮下。腹痛吐乳者，平胃散合苏合香丸，蜜调米饮下。挟痰者，二陈汤加山楂、麦芽、白术、乌梅，热
加黄连，寒加干姜。危甚者，烧针丸∶黄丹一两，或加枯矾等分，为末，枣肉丸芡实大。每服一丸，用针挑于
灯焰上烧存性，乳汁或米泔冷水任化下。此药清镇，专主吐逆及泻，大人亦宜。
内虚失音为肾怯，
吐泻五内俱虚，有失音者，乃肾怯也，肾气丸主之。凡大病后失音者同。
食少气陷损胃阳∶
吐泻久不止者，乃清气下陷，胃口阳虚。饮食少进，四肢无力，升阳益胃汤主之，或异功散；虚渴者，钱
氏白术散。
但食即吐先除积，
内伤乳食，面色青白，发热，四肢逆冷，腹胀，当先用消乳食丹取积消导，宽利胸膈。如呕甚者，只用
白豆蔻、砂仁等分，甘草减半，为末，干糁芽儿口中。凡吃乳、吃物、饮水不下者宜，或烧针丸亦妙。冷气入
胃，呕吐不已者，四君子加白豆蔻、砂仁、肉豆蔻、山药，为末或蜜丸，每一钱，木瓜，紫苏煎汤下。脾胃虚
弱逆痰，含哭饮乳，食物停滞不散，腹满呕吐 乳者，四君子汤加南星、砂仁、丁香、藿香、冬瓜子，姜煎服；
或启脾丸。呕而不止，痰涎在喉有声，将作惊者，二陈汤加丁香，藿香；或抱龙丸主之。因惊气逆而吐者，大
温惊丸。吐而汤水不纳者，五苓散。吐涎痰热者，白玉饼下之；冷者温之。有吐沫，或白绿水者，胃冷也，理
中丸，或半夏、陈粟米等分，姜煎服。吐稠涎及血者，肺热也；久则肺虚，阿胶散加减。吐沫水者，后必虫痛，
安虫丸∶干漆二分，雄黄、巴霜各一钱，为末，糊丸黍米大。每五七丸或二十丸，发时取东行石榴根煎汤；
痛甚，苦楝根或芜荑煎汤下，量儿大小服之。经年吐乳，眼慢粪秽有筋膜者，乃父母交感时吃乳所致，宜益黄
散、五疳保童丸。凡 乳因惊、因积、因气滞、因外感，与治吐同。
泻滑青者慢惊防。
滑者，或出不知，或直射溅流，或谷食不化，或下之如桶 溃，四君子汤加诃子、木香、陈皮、肉豆蔻，
姜煎服，兼进固肠丸，或真人养脏汤，或没石子丸加乳香、肉豆蔻选用。泻青色者，乃夹惊，木克土也，益黄
散、大温惊丸主之。有初起黄变青，或泻药物直过者，尤为寒泻，三五次即困，急用附子理中汤；或肢冷，口
鼻气亦冷，欲作慢惊、慢脾者，观音散加全蝎、天麻、防风、羌活；甚者，用金液丹为末，煎生姜，米饮调灌，
多服乃效。候胃气已生，手足渐暖，螈 犹在者，却用金液丹，合青州白丸子等分服之，兼用异功散、理中丸、
钩藤散、转惊丸调理，虽至危者，往往死中得生。金液丹，真小儿吐之妙剂也。盖小儿吐泻，皆当温补，若
已虚损，尤当速生胃气。惟寻常时行泻证，不可遽投热药，吐泻止，痢作无疑。若患疮泻青，乃毒去无害，不
必服药。
五疳
五疳由积虚而成，
疳者，干也，瘦瘁少血也。五疳病关五脏。二十岁以下曰疳，二十岁以上曰痨。始有乳食太过；或乳母
喜怒房劳后，即与儿乳；或饭粥肉食太早，肥甘不节而成。间有伤寒病后，久吐久泻久渴，痞积疹痘杂证，妄施
吐下，内亡津液而成者。要皆脾胃虚弱，血气枯滞，生积生热生痰，乘脏气之虚，传入为疳。间有热者，亦虚
热耳。故治热不可妄表过凉，治虚不可峻温骤补。
内热中满病初萌；
经曰∶数食肥，令人内热；数食甘，令人中满。言痛之始也。凡婴儿乳食停滞，稍觉饱满，内烦不安，虚
者必须扶胃而兼消导；实者必先疏利而后和胃，不可因循以致积久成疳。又有热满未甚，便施芦荟、胡连、龙
胆苦寒伤胃，反致疳者。
内疳痞结渐黄瘦，外鼻赤烂疮痍生。
疳证初患中满，久则结痞；初患内热，久则外潮。令人肌肤黄瘦，或耳鼻生疮，或遍身生疮，爱吃泥炭土
末、咸酸杂果，食不消化，小便不清，大便反利。大概热疳多见外证，冷疳多见内证。疳证鼻头有疮不着痂，
渐绕耳生疮，宜用白芨、轻粉各二分，乌贼鱼骨三分，为末，先以浆水洗拭，干糁。或鼻下赤烂自揉者，用兰
香叶烧灰二分，铜青半分，轻粉少许，为末，干糁。疳证遍体生疮不歇，乃虫内耗精髓，外蚀皮肤，宜连肚丸∶
黄连七两，水湿透，纳雄猪肚内，用线紧缝，饭上蒸十分烂，取出，和少蒸饭捣丸，小豆大。每二三十丸，
米饮下。仍以川芎、生地、茯苓、茯神与之，调血清心；或芦荟丸、肥儿丸、生犀散选用间服。外以大腹皮、
苦参、白芨煎汤洗，后却用诃子（带皮、核）烧灰，入麝香、轻粉少许，为末敷之。自幼小以至弱冠皆同。
热疳身热大便秘，
疳病初起，人未瘦怯，但脸赤口臭，唇焦烦渴，潮热如火，大便秘涩者为热疳，宜胡连丸∶胡黄连、川黄
连各五钱，辰砂一钱半，为末，入猪胆内系定，虚悬于铫内，用淡浆煮一炊饭久，取出入芦荟末二钱，麝香少
许，粳米饭丸麻子大。每五七丸，茶清下。一方有青黛、蛤蟆灰各二钱。热疳黄瘦，雀目遇夜不见，或生疮者，
五福化毒丹，陈粟米饮下。
冷疳身凉泻不停；
疳病久则目肿，面黧，体瘦，烦渴，多汗，腹胀，滑泻无常，或青或白，或如垢腻者为冷疳，宜二圣丸∶
丁香、丁皮各一钱，木香、浓朴、使君子、陈皮、肉豆蔻各二钱，为末，神曲糊丸麻子大。每七丸，米饮下。
冷热相兼泄且秘，或时便血或潮蒸。
冷热二证交互，非新非久，不内外因者，宜消积和胃，滋血调气，淡薄饮食，久则自然坚牢，如圣丸主之∶
胡黄连、川黄连、芜荑、使君子各一两，麝香五分，为末，用蛤蟆五个捣碎，酒熬成膏，和丸麻子大。每五七
丸或二十丸，人参煎汤下。常服钱氏白术散，以生津液。盖疳本湿热，久则寒湿，全在临时会意。
惊疳面赤盗汗渴，安神退热滋卫荣；
惊疳即心疳。原因心虚血弱，神不守舍，更加乳食不调，心脏积热所致。外证脸赤唇红，口舌生疮，胸膈
烦闷，小便赤涩，五心皆热，盗汗发渴，啮齿惊悸，宜茯神丸∶茯神、芦荟、琥珀、黄连、赤茯苓各三钱，
远志用黑豆水煮去骨，钩藤皮、蛤蟆灰各二钱，菖蒲一钱，麝香少许，为末，粟米糊丸麻子大。每十丸，薄荷
煎汤下。轻者，朱砂安神丸、大温惊丸。
风疳凉血与顺气，摇头揉目便多青。
风疳即肝疳。多因胎风，更加乳食不调，肝脏受热，或乳母外感内伤，邪气未散，遽与乳儿所致。外证
摇头揉目，白膜遮睛，或赤肿眵泪，烂弦痛痒，雀目昏暗，甚至经月眼合，名曰疳眼，汗流合面而卧，肉色青
黄，发立筋青，脑热羸瘦，宜生熟地黄丸，加当归煎服；或黄连肥儿丸，山栀煎汤下。疳眼壮热，体瘦胁痛
便清，一切肝证，风疳丸∶青黛、黄连、天麻、五灵脂、夜明砂、川芎、芦荟各二钱，龙胆草、防风、蝉蜕各一
钱半，全蝎二枚，干蟾头三钱，为末，猪胆汁浸糕丸，麻子大。每十丸，薄荷煎汤下。如胁硬，眼角见黑气者，
难治。
食疳痞胀多溏泄，磨积退黄脾渐宁；
食疳即脾疳。由乳食伤而复伤，脾气孤弱；或乳母恣食生冷肥腻；或酒饭后即与乳儿，久则变为乳癖，
腹胁结块，名曰乳疳。外证黄瘦，腹胀气促，泻臭合睡，食减吃泥，宜益黄散、消乳食丸，或肥儿丸加莪术、
青皮、陈皮。肚大青筋者，小胡连丸∶胡黄连五分（去果积），阿魏一钱半（去肉积），神曲（去食积）、黄
连（去热积）各二钱，麝香一粒，为末，猪胆汁和丸，黍米大。每三十丸，白术煎汤下。
气疳咳血或声哑，退热化痰肺自清。
气疳即肺疳。原因伤寒伤风，汗后劳复，
更加乳食不调，以致肺气受伤。外证鼻下两傍疮痒不痛，或鼻流臭汁，内生 肉，或汁所流处，随即成疮，
名曰疳 。不时咳嗽气逆，寒热唾红，泄泻多啼，揉鼻咬甲，与痨证大同，宜先服清肺汤∶黄芩、当归、麦门
冬、连翘，防风、赤茯苓、桔梗、生地、紫苏、甘草、前胡各五分，桑白皮一钱，水煎服。次服化 丸∶芜荑、
芦荟、青黛、川芎、白芷、胡黄连、川黄连、蛤蟆灰各等分，为末，猎胆汁浸糕丸，麻子大。每二十丸，食后临
卧，杏仁煎汤下。其鼻常用熊胆泡汤，小笔蘸洗。俟前药各进数服，再用青黛、当归、赤小豆、瓜蒂、地榆、
黄连、芦荟各等分，雄黄少许，为末，入鼻敛疮。疳哑不能发声者，用黄连肥儿丸十五粒，苏合香丸一粒，
朱砂、五灵脂各少许，为末，菖蒲煎汤，乘热调服。
肾疳耳焦天柱倒，齿脱手足冷如冰。
肾疳又名急疳，言五疳惟肾为最急也。多因痘后余毒未净，更加乳食不调，甘味入脾而生虫，状似伤寒狐
惑。上蚀齿龈，则口疮出血臭气，甚则齿龈溃烂，齿黑脱落，腮有穴者，名曰走马疳。言阳明热气上奔如马然，
下蚀肠胃，则下痢肛烂，即后疳痢。外证脑热肌削，手足如冰，爪黑面黧，身多疮疥，寒热时作，甚者天柱骨
倒。俱宜肾气丸，加使君子、川楝肉。走马疳并痘毒牙痛者，溺白散，或用白芷五钱，马牙硝一钱，铜青五分，
麝香一字，为末，干敷口角，及擦齿上。妙。
又有诸般难治证，
曰∶疳干、疳渴、疳痨、疳泻、疳痢、疳肿，皆五疳之危证。曰∶蛔疳、脑疳、脊疳、无辜疳、丁奚疳、
哺露疳，皆五疳死证。所以然者，五脏俱病故也。
疳干五脏俱不平；
心疳，舌干多啼；肝疳，干啼，眼不转睛；脾疳，搭口痴眼，口干作渴；肺疳，声焦皮燥，大便干结；
肾疳，身热肢冷，小便干涩。古方通用连胆丸∶黄连五钱猪胆汁浸，栝蒌根、乌梅、莲肉、杏仁各二钱，为末，
Vomiting and Diarrhea
The vomiting and diarrhea in newborn infants are often critical and difficult to bear. Spleen deficiency leads to diarrhea, stomach deficiency leads to vomiting; if both spleen and stomach are deficient, vomiting and diarrhea will persist indefinitely, potentially evolving into slow convulsions (Man Jing Feng) or malnutrition syndromes (Gan Syndrome) over time. If the infant has not passed meconium but only vomits yellow fluid, use Mugua Wan (Papaya Pill): Take equal parts of Fructus Chaenomelis (Mugua), Nifen (Calomel), Radix Aucklandiae (Muxiang), Semen Arecae (Binglang), and Moschus (Shexiang), grind into fine powder, and make pills with wheat paste the size of small beans. Administer one or two pills at a time, washed down with licorice decoction. For those with persistent vomiting and diarrhea after birth, use Zhusha Wan (Cinnabar Pill): Take equal parts of Cinnabar (Zhusha), Rhizoma Arisaematis (Nanxing), and processed Croton Seed (Bashuang), grind into fine powder, and make pills with paste the size of millet grains. Administer two pills at a time,灌fed with mint decoction. Subsequently, regulate with Zhuchen Jian: Take 2 qian of Cinnabar (Zhusha), 3 qian of Patchouli Leaf (Huoxiang), 5 qian of Talcum (Huashi), and 14 buds of Clove (Dingxiang), grind into fine powder. Take one cup of fresh well water, drip sesame oil into it to form flower-like patterns on the surface, scoop up 5 fen of the medicine powder onto the oil flowers, wait for a moment until they sink, clarify by removing the water, and administer separately with warm water. If a newborn has persistent vomiting and diarrhea accompanied by high fever, refusal of milk/food, white-colored stool, or obstruction, this is due to milk stagnation. First, use Zishuang Wan (Purple Frost Pill) to purge, then use Xiangju Bing (Fragrant Orange Cake): Take 2.5 qian each of Radix Aucklandiae (Muxiang), Pericarpium Citri Reticulatae (Jupi), and Pericarpium Citri Reticulatae Viride (Qingpi), and 5 qian each of Cortex Magnoliae Officinalis (Houpo), Massae Fermentatae Medicamentae (Shenqu), Fructus Hordei Germinatus (Maiya), and Fructus Amomi Rotundus (Sharen), grind into fine powder, and make honey pills the size of Euphorbia seed (Qianshi). Administer one pill at a time, dissolved in perilla decoction or rice soup as preferred; nutmeg (Roudoukou) and chebula fruit (Hezi) may be added. This formula is effective for all cold accumulations and diarrhea.
When treating, first distinguish whether the body temperature is hot or cool. Cold-type vomiting has a fishy/foul odor, and stools are greenish-white; heat-type vomiting has a sour/stinky odor, and stools are yellow.
For newborns and slightly older infants with vomiting and diarrhea, if the body is cool, face is yellow, stools are greenish-white, and vomit smells fishy/foul, it indicates internal injury from cold milk/food or external contraction of wind-cold. If the body is hot, face is red, stools are yellowish-red, and vomit is sour/stinky, it indicates internal injury from heat-inducing food or external contraction of summer-heat. Ancient formulas state: For vomiting/diarrhea with a cool body, use Guanyin San (Guanyin Powder); for vomiting/diarrhea with a hot body and thirst, use Qian Shi Baizhu San (Dr. Qian’s Atractylodes Macrocephala Powder); for vomiting/diarrhea with normal body temperature, or alternating chills and fever, refusal of milk, difficulty digesting milk, and greenish-white stools, this is excess above and deficiency below. First use Yihuang San (Yellow Adornment Powder), then Sijunzi Tang (Four Gentlemen Decoction), modifying according to the five zang organ manifestations. If limbs are cold and fontanelle is sunken due to vomiting/diarrhea, add Patchouli Leaf (Huoxiang) and Clove (Dingxiang); if spleen deficiency generates wind with lethargy, add Massae Fermentatae Medicamentae (Banxia Qu), Myrobalan (Meishizi), and a little winter melon seed (Dongguazi); if crying with fright, convulsions, and restlessness, add Scorpio (Quanxie), Uncaria Rhynchophylla (Gouteng), and Rhizoma Typhonii (Baifuzi); for dysentery with red and white discharge, add Angelica Sinensis (Gui) and Paeonia Lactiflora (Shaoyao) and millet (Sumi); for white dysentery, add dried ginger (Ganjiang) and millet (Su); for diarrhea, add Tangerine Peel (Chenpi) and Magnolia Bark (Houpo); for wind-cold, add Ligusticum Chuanxiong (Chuanxiong), Saposhnikovia Root (Fangfeng), Notopterygium Root (Qianghuo), and Asarum Root (Xixin); for thirst, add Kudzu Root (Gegen), Loquat Leaf (Pipaye), and a little papaya (Mugua).
Accompanied by wind, there must be aversion to cold and fever,
Wind-cold frequently causes vomiting and diarrhea because wind wood tends to invade spleen earth. External signs include aversion to cold, high fever, occasional headache, cough, and rapid breathing. Generally, for heat patterns, first take Daqing Gao (Big Green Paste) or Gouteng San (Uncaria Powder) to disperse wind, then take Yihuang San (Yellow Adornment Powder) to tonify the spleen; for cold patterns, first take Yihuang San to tonify the spleen, then take Daqing Gao or Gouteng San to disperse wind. If vomiting occurs suddenly or diarrhea passes undigested grain, it indicates severe wind-cold injury, treat with Banxia Tang (Pinellia Decoction).
Infected by dampness, abdominal distension and short urine;
Excess dampness causes heavy body, abdominal distension, and difficult urination, primarily treated with Pingwei San (Peace the Stomach Powder); for deficiency, use Yigong San (Extraordinary Merit Powder). For vomiting/diarrhea with thirst and astringent urination, use Wuling San (Five Ling Powder). For high fever, heavy body, sour vomiting, and turbid diarrhea, it is dampness combined with heat; take equal parts of Notopterygium Root (Qianghuo), Scutellaria Root (Huangqin), Atractylodes Rhizome (Cangzhu), and Licorice Root (Gancao), decoct in water and take warm.
Cold predominates causing abdominal pain, summer heat inevitably causes thirst,
In cold months, vomiting/diarrhea with white stool and no thirst is treated with Yihuang San (Yellow Adornment Powder); if abdominal pain occurs, use Lizhong Wan (Regulate the Middle Pill), adding Prepared Aconite Root (Fuzi) if limbs are cold. For persistent cases, use Meishizi Wan (Myrobalan Pill): One Myrobalan (Meishizi), five White Cardamom Seeds (Baidoukou), two Chebula Fruits (Hezi), one qian each of Radix Aucklandiae (Muxiang) and Coptis Rhizome (Huanglian), grind into powder, make rice pills the size of hemp seeds. Take fifteen pills at a time with rice drink. It also treats gan-dysentery and lingering diarrhea. In summer months, vomiting/diarrhea with yellow stool and craving drinks is treated with Yigong Wan (Extraordinary Merit Pill) or Yulu Wan (Jade Dew Pill): One liang each of Gypsum Fibrosum (Shigao) and Halloysitum Rubrum (Han Shuishi), five qian of Licorice Root (Gancao), grind into powder, make paste pills the size of soybeans. Take one pill with cold water; if vomiting persists, take with ginger juice. For persistent cases, use Gu Lianbai Wan (Ancient Coptis-Palmate Pill): One liang each of Coptis Rhizome (Huanglian) and Phellodendron Bark (Huangbai), grind into powder, boil in pig bile to make pills the size of mung beans. Take twenty pills at a time with rice drink. In summary, these two conditions are common in summer and autumn. Around Li Xia (Start of Summer), when damp-heat is prevalent and sudden vomiting/diarrhea occurs, use Sugie Tang (Perilla-Kudzu Decoction); after Summer Solstice, for vomiting/diarrhea with fever or milk/food injury resulting in deep yellow stool, use Yi Yuan San (Benefit Origin Powder) combined with Siling San (Four Ling Powder), add Atractylodes Rhizome (Cangzhu), grind to powder, and mix with warm water; after Great Heat, for vomiting/diarrhea with normal temperature or milk/food injury resulting in yellow-white stool, take Yihuang San before meals and Yi Yuan San after meals; after Start of Autumn, for vomiting/diarrhea with cool body, anorexia, excessive sleep, frequent hiccups, and no thirst, frequently take Yihuang San and sparingly take Yi Yuan San; after Autumn Equinox, for vomiting/diarrhea with cold body, anorexia, and green-brown watery stool, use Yihuang San.
Diarrhea with foul odor indicates inevitable damage to milk and food.
Internal injury from indigestion of milk/food presents with yellow face, abdominal distension, and diarrhea smelling like rotten eggs. Treat with Xiaorushi Dan (Digest Milk-Food Pellet): Equal parts of Clove (Dingxiang), Radix Aucklandiae (Muxiang), Pericarpium Citri Reticulatae Viride (Qingpi), Nutmeg (Roudoukou), Rhizoma Sparganii (Sanleng), and Rhizoma Curcumae Longae (Ezhu), grind into powder, make paste pills the size of hemp seeds. Take five pills at a time with rice drink. For unclear urine, use Weiling Tang (Stomach-Ling Decoction) with added Nutmeg (Roudoukou) made into pills, taken with rice drink. For abdominal pain and vomiting milk, use Pingwei San (Peace the Stomach Powder) combined with Suhexiang Wan (Suhexiang Pill), mixed with honey and rice drink. If complicated by phlegm, use Erchen Tang (Two Aged Herbs Decoction) with added Hawthorn Fruit (Shanzha), Fructus Hordei Germinatus (Maiya), Atractylodes Rhizome (Baizhu), and Chinese Olive (Wumei); add Coptis Rhizome (Huanglian) for heat, dried ginger (Ganjiang) for cold. For critical cases, use Shaozhen Wan (Burned Needle Pill): One liang of Red Lead (Huandan), or equal parts of Calcined Alum (Kufan), grind into powder, make date meat pills the size of Euphorbia seed (Qianshi). Take one pill at a time, burn on a lamp flame until charred but retaining nature, and dissolve in breast milk or rice wash water. This clear-and-settle medicine specifically treats vomiting and diarrhea, and is suitable for adults too.
Internal deficiency causing loss of voice is due to kidney weakness,
Vomiting and diarrhea leading to deficiency of all five viscera, resulting in loss of voice, is kidney weakness, primarily treated with Shenqi Wan (Kidney Qi Pill). Loss of voice after any major illness is treated similarly.
Decreased appetite and qi sinking damage stomach yang:
Persistent vomiting and diarrhea indicate sinking of clear qi and deficiency of stomach yang. With decreased food intake and weak limbs, treat with Shengyang Yiewei Tang (Raise Yang Benefit Stomach Decoction), or Yigong San (Extraordinary Merit Powder); for deficiency-thirst, use Qian Shi Baizhu San (Dr. Qian’s Atractylodes Macrocephala Powder).
Vomiting immediately after eating requires first removing accumulation,
Internal injury from milk/food presents with blue-white face, fever, cold limbs, and abdominal distension. First use Xiaorushi Dan (Digest Milk-Food Pellet) to eliminate accumulation and guide out stagnation, opening the chest and diaphragm. For severe vomiting, use equal parts of White Cardamom Seed (Baidoukou) and Amomum Fruit (Sharen), with half dose of Licorice Root (Gancao), grind into powder, and sprinkle dry into the infant's mouth. Suitable for those unable to swallow milk, food, or water; Shaozhen Wan (Burned Needle Pill) is also excellent. For cold qi entering the stomach causing persistent vomiting, use Sijunzi Tang (Four Gentlemen Decoction) with added White Cardamom Seed (Baidoukou), Amomum Fruit (Sharen), Nutmeg (Roudoukou), and Chinese Yam (Shanyao), made into powder or honey pills. Take one qian at a time, washed down with papaya and perilla decoction. For spleen-stomach weakness with rebellious phlegm, crying while drinking milk, stagnant food causing fullness and vomiting, use Sijunzi Tang (Four Gentlemen Decoction) with added Rhizoma Arisaematis (Nanxing), Amomum Fruit (Sharen), Clove (Dingxiang), Patchouli Leaf (Huoxiang), and winter melon seed (Dongguazi), decocted with ginger; or Qipi Wan (Spleen-Opening Pill). For persistent vomiting with phlegm-rattle in the throat, indicating impending convulsions, use Erchen Tang (Two Aged Herbs Decoction) with added Clove (Dingxiang) and Patchouli Leaf (Huoxiang); or Bao Long Wan (Embrace Dragon Pill) as primary treatment. For vomiting due to rebellious qi from fright, use Da Wenjing Wan (Great Warmth-Awakening Pill). For vomiting where fluids cannot be retained, use Wuling San (Five Ling Powder). For vomiting of salty-phlegm-heat, use Baiyu Bing (White Jade Cake) to purge; for cold, warm it. Vomiting foam or white-green water indicates cold stomach, treat with Lizhong Wan (Regulate the Middle Pill), or equal parts of Pinellia Tuber (Banxia) and aged millet (Chen Sumi), decocted with ginger. Vomiting thick saliva and blood indicates lung heat; long-term leads to lung deficiency, modify Ejiao San (Donkey-Hide Gelatin Powder). Vomiting foamy water suggests subsequent worm pain, use Anchong Wan (Settle Worms Pill): Two fen of Dried Resin (Ganqi), one qian each of Realgar (Xionghuang) and processed Croton Seed (Bashuang), grind into powder, make paste pills the size of millet grains. Take five to seven or twenty pills at a time; during attacks, take decoction of east-facing pomegranate root; for severe pain, take decoction of Vitex Root (Kuilgen) or Chrysanthemum Seed (Wuyi), dosing according to the child's size. For chronic milk vomiting with lax eyelids and fecal membranes, caused by parents' dietary habits during conception, use Yihuang San (Yellow Adornment Powder) and Wu Gan Baotong Wan (Five Malnourishment Protect Child Pill). Any milk vomiting due to fright, accumulation, qi stagnation, or external contraction is treated same as vomiting.
Slippery green diarrhea warns of slow convulsions.
Slippery diarrhea involves involuntary passage, splashing flow, undigested food, or bucket-like expulsion. Use Sijunzi Tang (Four Gentlemen Decoction) with added Chebula Fruit (Hezi), Radix Aucklandiae (Muxiang), Tangerine Peel (Chenpi), and Nutmeg (Roudoukou), decocted with ginger; additionally advance Gutang Wan (Intestine-Solidifying Pill), or Zhenren Yangzang Tang (True Person Nourishing Viscera Decoction), or Meishizi Wan (Myrobalan Pill) with added Frankincense (Ruxiang) and Nutmeg (Roudoukou) as selected. Green diarrhea indicates complication with fright, wood overcoming earth, treated with Yihuang San (Yellow Adornment Powder) and Da Wenjing Wan (Great Warmth-Awakening Pill). If starting yellow turning green, or medicines passing through directly, it is especially cold diarrhea; exhaustion occurs after three to five episodes, urgently use Fuzi Lizhong Tang (Prepared Aconite Regulate Middle Decoction); if limbs are cold and breath from mouth/nose is cold, indicating impending slow convulsions or slow spleen syndrome, use Guanyin San (Guanyin Powder) with added Scorpio (Quanxie), Gastrodia Rhizome (Tianma), Saposhnikovia Root (Fangfeng), and Notopterygium Root (Qianghuo); for severe cases, use Jinye Dan (Golden Liquid Pellet) powdered, mixed with ginger decoction and rice drink for灌feeding, taking multiple doses for effect. Once stomach qi recovers and hands/feet warm, but convulsions persist, use Jinye Dan (Golden Liquid Pellet) combined with Qingzhou Baixi Wan (Qingzhou White Pearl Pill) in equal parts, along with Yigong San (Extraordinary Merit Powder), Lizhong Wan (Regulate the Middle Pill), Gouteng San (Uncaria Powder), and Zhuanjing Wan (Turn Awaken Pill) for regulation. Even in critical cases, life is often saved from death. Jinye Dan (Golden Liquid Pellet) is truly a miraculous formula for pediatric vomiting and diarrhea. Generally, pediatric vomiting and diarrhea should be treated with warming and tonifying; if already depleted, rapidly generating stomach qi is crucial. Only for common epidemic diarrhea should hot medicines not be hastily administered, otherwise vomiting/diarrhea stopping will undoubtedly lead to dysentery. If pustular disease accompanies green diarrhea, it indicates toxin expulsion and is harmless; no medicine is needed.
Five Gan Syndromes
The Five Gan syndromes result from accumulation and deficiency.
"Gan" means dry/withered, referring to emaciation and blood deficiency. The Five Gan syndromes involve the five zang organs. Under twenty years old is called Gan; over twenty is called Lao (Consumption). Causes include excessive milk/food intake; or nursing immediately after the mother's anger, joy, or sexual activity; or introducing solid foods too early without节制 of rich/sweet foods. Occasionally, it arises after typhoid fever, prolonged vomiting/diarrhea/thirst,痞accumulation, rash/pox complications, or reckless purging/vomiting causing internal fluid depletion. Ultimately, all stem from spleen-stomach weakness, blood/qi withering and stagnation, generating accumulation, heat, and phlegm, which invade the deficient zang qi to become Gan. Occasional heat patterns are merely deficiency-heat. Thus, treating heat requires avoiding reckless dispersal or excessive cooling; treating deficiency requires avoiding harsh warming or rapid tonification.
Internal heat and middle-fullness mark the initial onset;
The Classics state: Frequent consumption of fatty foods causes internal heat; frequent consumption of sweet foods causes middle-fullness. This describes the beginning of Gan. When infant milk/food stagnates, causing slight fullness and inner irritability, deficiency patterns require supporting the stomach while guiding out stagnation; excess patterns require first draining and then harmonizing the stomach. Do not delay, lest accumulation becomes chronic Gan. Also, applying bitter-cold herbs like Aloe (Luhui), Coptis (Hulian), and Gentian Root (Longdan) for mild heat-fullness damages the stomach,反而 causing Gan.
Internal Gan with痞结 gradually leads to yellow emaciation; externally, red nose and rotting sores appear.
Initial Gan presents with middle-fullness, progressing to痞accumulation; initial internal heat progresses to external tidal fever. This causes yellow-emaciated skin, sores on ears/nose, or widespread sores, craving for mud/charcoal/clay/sour fruits, indigestion, unclear urine, and paradoxical loose stools. Generally, heat Gan shows more external signs, cold Gan shows more internal signs. For Gan sores on the nose tip that do not scab and spread around the ears, use equal parts of Bletilla Rhizome (Baiji) and Calomel (Qingfen), plus three fen of Cuttlefish Bone (Wuzeiyu), grind to powder, wash with grain water first, then apply dry. For red-rotten nose rubbed by self, use two fen of burned Laurel Leaf (Lanxiangye), half fen of Verdigris (Tongqing), and a little Calomel (Qingfen), grind to powder, apply dry. For persistent whole-body sores, worms consume essence internally and erode skin externally; use Liandu Wan (Connected Belly Pill): Seven liang of Coptis Rhizome (Huanglian), soaked in water, placed inside a male pig stomach, sewn tightly, steamed until very soft, removed, mixed with a little steamed rice, pounded into pills the size of small beans. Take twenty to thirty pills at a time with rice drink. Also administer Chuanxiong (Chuanxiong), Rehmannia Root (Shengdi), Poria (Fuling), and Poria with Wood (Fushen) to nourish blood and calm heart; or select Lu Hui Wan (Aloe Pill), Fei'er Wan (Flesh-Enriching Pill), or Sheng Xi San (Fresh Rhino Horn Powder) for intermittent use. Externally, wash with Abutilon Stem (Dafupi), Sophora Root (Kushen), and Bletilla Rhizome (Baiji) decoction, then apply powder of burned Chebula Fruit (Hezi, with peel/core), Musk (Shexiang), and Calomel (Qingfen). This applies from infancy to young adulthood.
Heat Gan features body heat and constipation,
Early Gan without emaciation, but with red face, bad breath, scorched lips, irritability-thirst, tidal fever like fire, and dry constipation is Heat Gan. Use Hulian Wan (Anchored Gold Pill): Five qian each of Coptis Rhizome (Hulian) and Coptis Rhizome (Chuanlian), one and a half qian of Cinnabar (Chensha), grind to powder, tie inside pig gallbladder, suspend in a pot, boil in weak grain water for the duration of cooking a meal, remove, add two qian of Aloe powder (Luhui) and a little Musk (Shexiang), make rice pills the size of hemp seeds. Take five to seven pills with tea infusion. Another formula adds two qian each of Indigo Naturalis (Qingdai) and Toad Ash (Hamahui). For Heat Gan with yellow emaciation, night blindness (Que Mu), or sores, use Wufu Huadu Dan (Five Blessings Detoxifying Pellet), taken with aged millet drink.
Cold Gan features cool body and unceasing diarrhea;
Long-term Gan presents with swollen eyes, dark face, emaciation, irritability-thirst, sweating, abdominal distension, unpredictable slippery diarrhea (green, white, or greasy), indicating Cold Gan. Use Ersheng Wan (Two Sages Pill): One qian each of Clove (Dingxiang) and Clove Skin (Dingpi), two qian each of Radix Aucklandiae (Muxiang), Magnolia Bark (Houpo), Quisqualis Fruit (Shijunzi), Tangerine Peel (Chenpi), and Nutmeg (Roudoukou), grind to powder, make massae fermentatae paste pills the size of hemp seeds. Take seven pills at a time with rice drink.
Mixed cold and heat, diarrhea and constipation, occasional blood in stool or tidal steaming.
When cold and heat patterns interact, neither new nor old, non-internal/non-external causes, treat by eliminating accumulation, harmonizing stomach, nourishing blood, regulating qi, and maintaining bland diet. Over time, health naturally restores. Use Rusheng Wan (Like Sage Pill): One liang each of Coptis Rhizome (Hulian), Coptis Rhizome (Chuanlian), Chrysanthemum Seed (Wuyi), and Quisqualis Fruit (Shijunzi), five fen of Musk (Shexiang), grind to powder, crush five toads, simmer in wine to make paste, mix into pills the size of hemp seeds. Take five to seven or twenty pills with ginseng decoction. Regularly take Qian Shi Baizhu San (Dr. Qian’s Atractylodes Macrocephala Powder) to generate fluids. Gan originates from damp-heat, becoming cold-damp over time; timing and understanding are key.
Fright Gan features red face, night sweats, and thirst; calm spirit, reduce heat, nourish wei and ying;
Fright Gan is Heart Gan. Caused by heart deficiency and blood weakness, spirit not residing, compounded by irregular milk/food and heart heat accumulation. External signs: red face, red lips, mouth/tongue sores, chest oppression, red-astringent urine, heat in five centers, night sweats-thirst, teeth grinding-fright, palpitations. Use Fushen Wan (Poria Spirit Pill): Three qian each of Poria with Wood (Fushen), Aloe (Luhui), Amber (Hupo), Coptis Rhizome (Huanglian), and Red Poria (Chifuling); Polygala Root (Yuanzhi) boiled in black soybeans to remove bone; two qian each of Uncaria Rhynchophylla Stem (Goutengpi) and Toad Ash (Hamahui); one qian of Acorus Rhizome (Changpu); a little Musk (Shexiang). Grind to powder, make millet paste pills the size of hemp seeds. Take ten pills with mint decoction. Mild cases use Zhusha Anshen Wan (Cinnabar Calming Spirit Pill) or Da Wenjing Wan (Great Warmth-Awakening Pill).
Wind Gan cools blood and smooths qi; head shaking, eye rubbing, frequent green stools.
Wind Gan is Liver Gan. Often due to fetal wind, compounded by irregular milk/food, liver heat, or mother's external/internal injury with residual pathogenic qi given to infant. External signs: head shaking, eye rubbing, white membrane covering pupil, red-swollen discharge/tears, sore/itchy eyelids, night blindness, even eyes closed for months (Gan Eye), sweating on face while lying, yellow-green flesh color, erect hair/blue veins, brain heat, emaciation. Use Sheng Shu Dihuang Wan (Raw-Cooked Rehmannia Pill) with added Angelica Sinensis (Danggui) decocted; or Huanglian Fei'er Wan (Coptis Flesh-Enriching Pill) with Gardenia (Shanzhi) decoction. For Gan Eye with high fever, emaciation, hypochondriac pain, clear stools, and all liver signs, use Fenggan Wan (Wind Gan Pill): Two qian each of Indigo Naturalis (Qingdai), Coptis Rhizome (Huanglian), Gastrodia Rhizome (Tianma), Trogopterus Dung (Wulingzhi), Night-shining Sand (Yemingsha), Ligusticum Chuanxiong (Chuanxiong), Aloe (Luhui); one and a half qian each of Gentian Root (Longdancao), Saposhnikovia Root (Fangfeng), Cicada Slough (Chantui); two Scorpios (Quanxie), three qian of Dried Toad Head (Ganchantou). Grind to powder, make cake pills soaked in pig bile, size of hemp seeds. Take ten pills with mint decoction. If hypochondrium is hard and black qi appears at eye corners, prognosis is poor.
Food Gan features痞distension and frequent loose stools; grind accumulation, resolve jaundice, spleen gradually calms;
Food Gan is Spleen Gan. Caused by repeated milk/food injury making spleen qi solitary and weak; or mother consuming raw/cold/rich foods; or nursing immediately after alcohol/meals, eventually becoming milk-pi, abdominal/hypochondriac masses, named Milk Gan. External signs: yellow emaciation, abdominal distension, rapid breathing, smelly diarrhea-sleepiness, reduced appetite-craving mud. Use Yihuang San (Yellow Adornment Powder), Xiaorushi Wan (Digest Milk-Food Pill), or Fei'er Wan (Flesh-Enriching Pill) with added Curcuma Rhizome (Ezhu), Pericarpium Citri Reticulatae Viride (Qingpi), and Tangerine Peel (Chenpi). For large belly with visible blue veins, use Xiao Hulian Wan (Small Anchored Gold Pill): Five fen of Coptis Rhizome (Hulian, remove fruit accumulation), one and a half qian of Ferula Resin (awei, remove meat accumulation), two qian each of Massae Fermentatae Medicamentae (Shenqu, remove food accumulation) and Coptis Rhizome (Huanglian, remove heat accumulation), one grain of Musk (Shexiang). Grind to powder, mix with pig bile into pills the size of millet grains. Take thirty pills at a time with Atractylodes Rhizome (Baizhu) decoction.
Qi Gan features coughing blood or hoarseness; reduce heat, resolve phlegm, lung clears itself.
Qi Gan is Lung Gan. Caused by typhoid/wind-cold, relapse after sweating, compounded by irregular milk/food damaging lung qi. External signs: itchy/painless sores beside nose, or foul nasal discharge, internal polyps, or sores where discharge flows, named Gan Nose. Intermittent cough/rebellious qi, alternating chills/fever, bloody sputum, diarrhea-crying, nose-rubbing/nail-biting, similar to Consumption. First take Qingfei Tang (Clear Lung Decoction): Five fen each of Scutellaria Root (Huangqin), Angelica Sinensis (Danggui), Ophiopogon Tuber (Maimendong), Forsythia Fruit (Lianqiao), Saposhnikovia Root (Fangfeng), Red Poria (Chifuling), Platycodon Root (Jiegeng), Rehmannia Root (Shengdi), Perilla Leaf (Zisu), Licorice Root (Gancao), Peucedanum Root (Qianhu); one qian of Mulberry Root Bark (Sangbaipi). Decoct in water and take. Next take Hua Gan Wan (Resolve Gan Pill): Equal parts of Chrysanthemum Seed (Wuyi), Aloe (Luhui), Indigo Naturalis (Qingdai), Ligusticum Chuanxiong (Chuanxiong), Angelica Dahurica (Baizhi), Coptis Rhizome (Hulian), Coptis Rhizome (Chuanlian), Toad Ash (Hamahui). Grind to powder, make cake pills soaked in wild boar bile, size of hemp seeds. Take twenty pills after meals and before bed with almond decoction. Frequently wash nose with bear bile tea using a small brush. After several doses of previous medicines, use equal parts of Indigo Naturalis (Qingdai), Angelica Sinensis (Danggui), Adzuki Bean (Chixiaodou), Melon Tip (Gua Di), Sanguisorba Root (Diyu), Coptis Rhizome (Huanglian), Aloe (Luhui), and a little Realgar (Xionghuang), grind to powder, insufflate into nose to heal sores. For Gan aphonia unable to speak, use fifteen grains of Huanglian Fei'er Wan (Coptis Flesh-Enriching Pill), one Suhexiang Wan (Suhexiang Pill), a little Cinnabar (Zhusha) and Trogopterus Dung (Wulingzhi), grind to powder, mix with Acorus (Changpu) decoction while hot and take.
Kidney Gan features scorched ears and collapsing pillar bone; tooth loss, cold hands/feet like ice.
Kidney Gan is also called Ji Gan (Urgent Gan), meaning Kidney Gan is the most urgent of the Five Gans. Often due to residual toxins after pox, compounded by irregular milk/food. Sweet flavors enter spleen generating worms, resembling typhoid Huxu syndrome. Upper erosion of gums causes mouth sores, bleeding, foul odor, severe gum ulceration, black/shedding teeth, cheek holes, named Zouma Gan (Running Horse Gan), indicating阳明 heat rushing up like a horse. Lower erosion of intestines/rectum causes dysentery/anal rot, i.e., Posterior Gan Dysentery. External signs: brain heat, muscle wasting, icy hands/feet, black nails, dark face, widespread sores/itch, alternating chills/fever, severe case: collapsing pillar bone (Tian Zhu Gu Dao). All treat with Shenqi Wan (Kidney Qi Pill) added with Quisqualis Fruit (Shijunzi) and Toosendan Fruit (Chuanlianrou). For Running Horse Gan and pox-toothache, use Niobai San (Urine-White Powder), or five qian Angelica Dahurica (Baizhi), one qian Mirabilite (Mayaxiao), five fen Verdigris (Tongqing), one zi of Musk (Shexiang), grind to powder, dry apply to mouth corners and rub on teeth. Excellent.
There are also various difficult-to-treat syndromes,
Named: Gan Dryness, Gan Thirst, Gan Consumption, Gan Diarrhea, Gan Dysentery, Gan Swelling, all critical syndromes of Five Gan. Named: Hookworm Gan, Brain Gan, Spine Gan, Innocent Gan, Dingxi Gan, Bottle-fed Gan, all fatal syndromes of Five Gan. This is because all five zang organs are diseased.
Gan Dryness involves imbalance of all five zang;
Heart Gan: dry tongue, frequent crying; Liver Gan: dry crying, eyes fixed; Spleen Gan: corner-of-mouth sores, dull eyes, dry mouth-thirst; Lung Gan: hoarse voice, dry skin, dry constipation; Kidney Gan: body heat, cold limbs, dry-astringent urine. Ancient general formula uses Liandan Wan (Connected Gall Pill): Five qian Coptis Rhizome (Huanglian) soaked in pig bile, two qian each of Trichosanthes Root (Gualougen), Chebula Fruit (Wumei), Lotus Seed (Lianrou), and Apricot Seed (Xingren), grind to powder,