夫小儿吐泻。因六气未完。故六淫易侵。兼以调护失常。乳食不节。遂使脾胃虚弱。清
浊相
干。蕴作而然。大概有冷有热有食积三者之不同也。盖冷者脾胃虚寒。水谷不化。小便白而
大便青。或如糟粕。手足厥冷。或吐或泻。宜助胃膏主之。如上之症。或兼有外感风寒。内
伤生冷。身热。乍凉乍热。作吐泻者。宜藿香正气散主之。热者脾胃有湿。大便黄而小便赤
口干烦渴。四肢温暖。或吐或泻。宜甘露散主之。如上之候。有兼中暑受热作吐泻者。宜
茹苓汤主之。或益元散亦可。食积者。因伤食过多。积滞脾胃。则腹胀发热。若吐如酸 气
或泻如败卵臭。宜万亿丸微利即愈。利后不愈。乃脾胃虚弱。仍助胃膏主之。凡吐泻初起
者。即服烧针丸镇固之即效。大抵吐泻之症。多因乳食以伤脾胃。乳食伤胃。则为呕吐。乳
食伤脾。则为泄泻。吐泻不止。渐到日深。致其脾气之虚。慢惊之候。自此而得。可不慎乎
小儿泻不定。精神好者。脾败也。吐泻唇深红者。内热故也。不退必死。
而黑气喘者不治。大渴不定。止之又渴。肾败也。
遗泻不觉者死。
烧针丸 治吐泻如神。
黄丹（水飞过） 朱砂 白矾（火 各等分）
上为末。枣肉为丸如黄豆大。每服三四丸。戳针尖上。放灯焰上烧过存性至烂。凉米泔
水调
服。泻者食前。吐者无时。外用绿豆粉。以鸡子清和作膏。以涂脚心。如泻涂囟门上。止则
去之。
一治脾胃虚弱。吐泻不食。凡虚寒症。先服此以正胃气。
五味异功散
人参 白术（去芦） 茯苓（去皮） 陈皮 甘草
上锉。姜、枣煎服。
一论小儿吐泻。脾胃虚弱。饮食不进。腹胁胀满。肠鸣吐泻。虚寒等症。
助胃膏
人参 白术（炒） 白茯苓（去皮） 丁香 木香 砂仁 白豆蔻 肉豆蔻 官桂 藿香
甘草（各一钱） 陈皮（五分） 山药（四钱）
上为细末。炼蜜为丸。如弹子大。每服一丸。米汤化下。兼治 乳便青。或时夜啼。胎
寒腹痛。
一论四时不正之气。寒疫时气。山崖瘴气。雨湿蒸气。或中寒腹痛。冒风吐泻。中湿身
重。
泄泻。脾胃不和。或饮食停滞。复感外寒。头疼憎寒。呕逆恶心。肋膈闷。或发寒热无汗。
藿香正气散
藿香（一钱） 紫苏（八分） 陈皮 浓朴（姜炒） 白术（去芦炒） 茯苓（去皮） 桔梗 大
腹皮 白芷 甘草（炙各五分） 半夏（姜汁炒五分）
上锉一剂。姜、枣煎服。
一论小儿夏秋之月。霍乱吐泻。身热口渴。
加减茹苓汤
猪苓（七分） 赤茯苓（去皮一钱） 泽泻（七分） 白术（去芦五分） 黄连（五分） 竹茹（
一钱） 干葛（七分） 天花粉（二钱） 甘草（五分）
上锉。生姜煎服。如热极。加石膏、知母。泻极。加升麻。腹痛。加炒白芍一钱。肉桂
三分。寒痛亦加。
一论小儿五种泄泻。赤白痢疾。宜用
铁门拴
文蛤（一两炒黄色） 白矾（一钱半生半枯） 黄丹（二钱）
上为末。用黄蜡一两。化开为丸。如绿豆大。大人每服十五丸。小儿五七丸。用茶一钱
姜二钱煎汤下。
一小儿水泻痢疾。用蜜三匙。枯矾末三钱。萝卜汁调服。微汗。忌醋。
一论小儿脾胃久虚。呕吐泄泻。频频不止。津液枯竭。发热烦渴多燥。但欲饮。乳食不
进。羸困失治。变成慢惊风痫。不问阴阳虚实。并宜服之。
七味白术散
人参 白术（去芦炒） 白茯苓（去皮） 藿香 木香 干姜 甘草
上锉。姜、枣煎服。如小儿频频泻痢。将成慢惊。加山药、扁豆、肉豆蔻各一钱。姜汁
一钱
煎服。若慢惊已作。加细辛、天麻各一钱。全蝎二个。白附子八分。若小儿冬月吐泻。皆是
胃寒胃虚所致。加丁香两粒。若胃虚不能食。而大渴不止者。不可用淡渗之药。但胃元气少
故也。以白术散补之。如不能食而渴者。倍用干葛。加天花粉。如能食而渴者。白虎汤加人
参。
一论小儿呕吐不止。宜
金枣丸
木香 半夏 南星（汤泡透姜汁炒各三钱） 丁香 陈皮（各二钱） 砂仁 藿香（各五钱）
人参（一钱半）
上为细末。姜汁打糊和成锭。辰砂为衣。淡姜汤送下。
一论小儿久泻久痢不止。及满口生疮。白烂如泥。痛哭不已。诸医罔效。用
巴豆（去壳一个） 瓜子仁（七个）
共捣一处如泥。津调。贴在两眉间。手巾包。待成泡。揭去即愈。
一论小儿泄泻。用巴豆汁末为膏。贴在囟门上。烧线香一炷。火尽即去巴豆。立效。
一小儿泄泻不止。用山药炒为末。不拘多少。入粥。同粥食之。立止。
一小儿久泻兼脱肛。小腹重坠。四肢浮肿。面色痿黄。时或兼青。诸药到口即呕吐。审
乳母忧
郁伤脾。大便不实。先用补中益气汤。后用五味异功散及四神丸调治其母。不两月而子母俱
痊。
一小儿伤食呕吐。服克伐之药。呕中见血。用清热凉血之药。又大便下血。唇色白而或
青。
问其故于余。余曰。此脾土亏损。肝木所乘而然也。令空心用补中益气汤。食远用异功散
以调补中气。使涎血各归其源而愈。
一小儿吐泻不止。或攻伐过多。四肢发厥。虚风不省人事。用此四肢温暖。神识渐省
益阳散
天南星为末。每服三钱。入京枣二枚同煎。温服。
一治小儿吐不定。五倍子两个。一生一熟。甘草一握。用湿纸包。炮过。同为末。每服
半钱。用米泔水调下。
Pediatric vomiting and diarrhea are caused by the incomplete maturation of the Six Qi (Six Atmospheric Influences), making the child susceptible to invasion by the Six Excesses (Six Pathogenic Factors). Coupled with improper care and irregular feeding, this leads to Spleen-Stomach deficiency, where Clear and Turbid energies interfere with each other and accumulate, resulting in the disease. Generally, there are three types: Cold, Heat, and Food Stagnation.
The Cold type involves Spleen-Stomach Deficiency-Cold, where water and grain fail to digest. The urine is clear/white, and the stool is green or resembles dregs. There may be cold extremities, alternating vomiting and diarrhea. It should be treated primarily with Zhuwei Gao (Stomach-Assisting Paste). If these symptoms are accompanied by external contraction of Wind-Cold and internal injury from raw/cold foods, presenting with fever, alternating chills and heat, and vomiting/diarrhea, Huoxiang Zhengqi San (Agastache Powder for Regulating the Qi) should be used.
The Heat type involves Dampness in the Spleen-Stomach. The stool is yellow, urine is red, with dry mouth, irritability, and thirst. Extremities are warm, with vomiting or diarrhea. Ganlu San (Sweet Dew Powder) is indicated. If these conditions are complicated by Summerheat-Heat causing vomiting/diarrhea, Ruling Tang (Radix Scutellariae and Poria Decoction) is indicated, or Yiyuan San (Benefit Origin Powder) may also be used.
The Food Stagnation type results from excessive eating, causing stagnation in the Spleen-Stomach, leading to abdominal distension and fever. If vomit has a sour odor or stool smells like rotting eggs, Wan Yi Tai Pill (Ten Thousand Billions Pill) should be used to induce mild purgation for cure. If not cured after purgation, it indicates Spleen-Stomach deficiency, and Zhuwei Gao (Stomach-Assisting Paste) should still be used. For initial onset of vomiting/diarrhea, administering Shaozhen Wan (Burned Needle Pill) immediately for stabilization is effective. Generally, vomiting/diarrhea stems from food damaging the Spleen-Stomach. Damage to the Stomach causes vomiting; damage to the Spleen causes diarrhea. Persistent vomiting/diarrhea deepens over time, depleting Spleen Qi, leading to Slow Convulsion (Man Jing). One must be cautious.
If pediatric diarrhea is uncertain but the spirit is good, it indicates Spleen Failure. Deep red lips during vomiting/diarrhea indicate Internal Heat; if unrelieved, death ensues. Black complexion with panting breath indicates an incurable condition. Extreme thirst that returns after stopping indicates Kidney Failure. Involuntary urination/stooling without awareness indicates death.
Shaozhen Wan (Burned Needle Pill): Treats vomiting/diarrhea miraculously.
Huangdan (Lead Oxide, water-washed), Zhusha (Cinnabar), Baifan (Alum, fire-calcined), equal parts.
Grind into powder, form pills with jujube flesh the size of soybeans. Take 3-4 pills per dose, place on a needle tip, burn over lamp flame until charred but retaining efficacy, cool, and mix with cold rice wash water. Take before meals for diarrhea, anytime for vomiting. Externally, mix Mung Bean Powder with egg white into a paste, apply to soles. For diarrhea, apply to Fontanelle (Baihui area); remove when stopped.
One prescription treats Spleen-Stomach deficiency with vomiting/diarrhea and anorexia. For Deficiency-Cold patterns, take this first to rectify Stomach Qi.
Wuwei Yigong San (Five-Ingredient Extraordinary Merit Powder): Renshen (Ginseng Root), Baizhu (Atractylodis Rhizoma, remove rhizome), Fuling (Poria, remove bark), Chenpi (Citrus Peel), Gancao (Licorice Root).
Cut into pieces, decoct with ginger and jujube.
Another discussion on pediatric vomiting/diarrhea due to Spleen-Stomach deficiency, anorexia, abdominal/hypochondriac fullness, borborygmus, vomiting/diarrhea, and Deficiency-Cold.
Zhuwei Gao (Stomach-Assisting Paste): Renshen (Ginseng Root), Baizhu (Atractylodis Rhizoma, stir-fried), Baifuling (Poria, remove bark), Dingxiang (Caryophylli Flos), Muxiang (Aucklandiae Radix), Sharen (Amomi Fructus), Baidoukou (Tsaoko Fructus), Roudoukou (Myristicae Semen), Guigui (Cinnamon Twig), Huoxiang (Patchouli Herba), Gancao (Licorice Root) [1 qian each], Chenpi (Citrus Peel) [0.5 qian], Shanyao (Dioscoreae Rhizoma) [4 qian].
Grind into fine powder, make pills with refined honey the size of a bullet. Take one pill per dose, dissolve in rice soup. Also treats green milk stool, nocturnal crying, fetal cold abdominal pain.
Another discussion on abnormal Qi of the four seasons, cold epidemics, mountain miasma, rain-damp vapor, or cold-abdominal pain, wind-capture vomiting/diarrhea, dampness-heavy body, diarrhea, Spleen-Stomach disharmony, food stagnation, re-contracted external cold, headache, aversion to cold, nausea/vomiting, chest/diaphragm oppression, or fever/chills without sweat.
Huoxiang Zhengqi San (Agastache Powder for Regulating the Qi): Huoxiang (Patchouli Herba) [1 qian], Zisu (Perillae Folium) [0.8 fen], Chenpi (Citrus Peel), Nongpu (Magnoliae Officinalis Cortex, ginger-fried), Baizhu (Atractylodis Rhizoma, remove rhizome and stir-fry), Fuling (Poria, remove bark), Jiegeng (Platycodonis Radix), Dafupi (Arecae Pericarpium), Baizhi (Angelicae Dahuricae Radix), Gancao (Licorice Root, honey-fried) [0.5 fen each], Banxia (Pinelliae Rhizoma, ginger-juice fried) [0.5 fen].
Cut one dose, decoct with ginger and jujube.
Another discussion on pediatric summer-autumn Cholera vomiting/diarrhea with fever and thirst.
Jiajian Ruling Tang (Modified Radix Scutellariae and Poria Decoction): Zhuling (Polyporus) [0.7 fen], Chifuling (Poria with Red Core, remove bark) [1 qian], Zexie (Alismatis Rhizoma) [0.7 fen], Baizhu (Atractylodis Rhizoma, remove rhizome) [0.5 fen], Huanglian (Coptidis Rhizoma) [0.5 fen], Zhuru (Bambusae Caulis in Taeniam) [1 qian], Qange (Puerariae Radix) [0.7 fen], Tianhuafen (Trichosanthis Radix) [2 qian], Gancao (Licorice Root) [0.5 fen].
Cut, decoct with fresh ginger. If extreme heat, add Shigao (Gypsum Fibrosum) and Zhimu (Anemarrhenae Rhizoma). If extreme diarrhea, add Shengma (Cimicifugae Rhizoma). If abdominal pain, add Chao Baishao (Paeoniae Radix Alba, stir-fried) [1 qian] and Rougui (Cinnamomi Cortex) [0.3 fen]. Add for cold pain as well.
Another discussion on five types of pediatric diarrhea and dysentery (red and white), use Tieshuanshun (Iron Gate Latch).
Wenge (Clam Shell, stir-fried yellow) [1 liang], Baifan (Alum, half raw half calcined) [1.5 qian], Huangdan (Lead Oxide) [2 qian].
Grind into powder, melt 1 liang of beeswax to form pills the size of mung beans. Adults take 15 pills, children 5-7 pills, taken with tea (1 qian) and ginger (2 qian) decoction.
One prescription for pediatric watery diarrhea/dysentery: Mix 3 spoons of honey, 3 qian of calcined alum powder, and radish juice. Take orally. Mild sweating expected. Avoid vinegar.
Another discussion on long-term Spleen-Stomach deficiency in children with frequent vomiting/diarrhea, exhaustion of fluids, fever, irritability, thirst, dryness, desire to drink, anorexia, emaciation, and neglect leading to Slow Convulsion Epilepsy. Regardless of Yin/Yang or Deficiency/Excess, this formula is suitable.
Qiwei Baizhu San (Seven-Ingredient Atractylodes Macrocephala Powder): Renshen (Ginseng Root), Baizhu (Atractylodis Rhizoma, remove rhizome and stir-fry), Baifuling (Poria, remove bark), Huoxiang (Patchouli Herba), Muxiang (Aucklandiae Radix), Jiang (Zingiberis Rhizoma Recens), Gancao (Licorice Root).
Cut, decoct with ginger and jujube. If frequent diarrhea/dysentery approaching Slow Convulsion, add Shanyao (Dioscoreae Rhizoma), Bian Dou (Vigna Seed), and Roudoukou (Myristicae Semen) [1 qian each], and Ginger Juice [1 qian]. If Slow Convulsion has occurred, add Xixin (Asari Radix et Rhizoma), Tianma (Gastrodiae Rhizoma) [1 qian each], Quanxie (Scorpio) [2 units], and Baifuzi (Aconiti Kusnezoffii Rhizoma) [0.8 fen]. If winter vomiting/diarrhea due to Stomach Cold/Deficiency, add Dingxiang (Caryophylli Flos) [2 grains]. If Stomach Deficiency prevents eating with extreme thirst, avoid diuretic/damp-draining herbs as Stomach Yuan Qi is low. Tonify with Baizhu San. If unable to eat but thirsty, double Qange (Puerariae Radix) and add Tianhuafen (Trichosanthis Radix). If able to eat but thirsty, use Baihu Tang (White Tiger Decoction) plus Renshen (Ginseng Root).
Another discussion on persistent pediatric vomiting, use Jinzao Wan (Golden Date Pill).
Muxiang (Aucklandiae Radix), Banxia (Pinelliae Rhizoma), Nanxing (Arisaematis Rhizoma, soaked in water, fried with ginger juice) [3 qian each], Dingxiang (Caryophylli Flos), Chenpi (Citrus Peel) [2 qian each], Sharen (Amomi Fructus), Huoxiang (Patchouli Herba) [5 qian each], Renshen (Ginseng Root) [1.5 qian].
Grind into fine powder, make paste with ginger juice, form ingots, coat with Zhensha (Cinnabar), take with light ginger soup.
Another discussion on prolonged pediatric diarrhea/dysentery, mouth ulcers white and rotten like mud, incessant crying, ineffective treatments. Use Badou (Crotonis Fructus, shelled) [1 unit], Guazi Ren (Cucurbitae Semen) [7 units].
Pound together into paste, mix with saliva, apply between eyebrows, cover with handkerchief. When blister forms, remove to cure.
Another discussion on pediatric diarrhea: Apply Badou juice/paste to Fontanelle. Burn incense stick length of time, remove Badou when ash falls. Immediate effect.
One prescription for persistent pediatric diarrhea: Stir-fry Shanyao (Dioscoreae Rhizoma) into powder, amount unspecified, mix into congee and eat. Immediate stop.
One case of prolonged pediatric diarrhea with rectal prolapse, heavy lower abdomen, edema of limbs, sallow complexion sometimes bluish. Vomiting upon taking medicine. Diagnosis: Wet nurse's melancholy injured Spleen, loose stools. First treat with Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction), then treat the mother with Wuwei Yigong San (Five-Ingredient Extraordinary Merit Powder) and Sishen Wan (Four Miracles Pill). Within two months, both mother and child recovered.
One case of pediatric food-injury vomiting. After using harsh draining medicines, blood appeared in vomit. Using heat-clearing/blood-cooling medicines led to bloody stools, pale/bluish lips. Inquiry revealed: Spleen Earth deficiency, Liver Wood overacting. Prescribed empty-stomach Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) and post-meal Yigong San (Extraordinary Merit Powder) to regulate middle Qi, allowing phlegm and blood to return to their sources. Cure.
One case of persistent pediatric vomiting/diarrhea, or excessive purging, cold extremities, false wind, unconsciousness. Use this to warm extremities and restore consciousness.
Yiyang San (Benefit Yang Powder): Nanxing (Arisaematis Rhizoma) powder. Take 3 qian per dose, decoct with 2 jujubes, take warm.
One prescription for uncertain pediatric vomiting: Wubeizi (Terminaliae Fructus) [2 units, one raw one cooked], Gancao (Licorice Root) [one handful]. Wrap in wet paper, process. Grind into powder. Take 0.5 qian per dose, mix with rice wash water.