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Diarrhea and vomiting are more common during the spring, summer, and autumn seasons. They rarely occur in winter. This is because diarrhea and vomiting are caused by deficiency of the Spleen and Stomach, combined with cold or heat pathogens. In winter, Yang Qi resides internally, people consume more warm foods, and drink less liquid, hence the rarity of such diseases. If a patient does fall ill in winter, it must be due to damage from milk or food. If one suffers from diarrhea and vomiting in spring, it is mostly due to Wind; in summer, due to Heat; in autumn, due to Cold. When treating diarrhea and vomiting, one must consider the season, observe the physical signs and symptoms, and examine whether the condition is warm, cool, cold, or hot. Only then will there be no error.

Wind-damage causing diarrhea and vomiting presents with body warmth, alternating chills and fever, frequent yawning, listlessness, and excessive sleepiness. The breath is coarse and hot, stools are yellowish-white, vomit contains undigested milk/food, and there is occasional coughing. The treatment should involve dispersing Wind and tonifying the Lung. If purgatives have already been used, or if there are no indications for purgation, one must strictly avoid using them. This arises from Cold invading the Spleen and Lung, preventing proper transformation. There may also be syndromes involving the Five Zang organs. For dispersing Wind, administer Hua Da Qing Gao (Great Blue Paste). To tonify the Spleen, subsequently administer Yi Huang San (Yellow Benefit Powder). These are formulas used by Qian Yi. The prescriptions are recorded in this collection.

Wind-damage causing diarrhea and vomiting, characterized by fever, excessive sleepiness, ability to suckle, yawning, listlessness, hot breath, incessant drinking, vomiting of phlegm, and yellow watery stools, indicates Stomach deficiency with Heat, thirst, diarrhea, and vomiting. One should generate fluids in the Stomach to quench thirst. Qian Yi prescribed decoction of Atractylodis Macrocephalae Rhizoma (Baizhu) for oral administration, followed by dispersing Wind-Cold, also using Da Qing Gao. It is further stated that: if diarrhea and vomiting lead to lethargy with eyes partially open (exposed pupils), it is Stomach deficiency-Heat; if lethargy occurs with eyes closed, it is Stomach excess-Heat.

Wind-damage causing diarrhea and vomiting, presenting with cool body temperature, foaming at the mouth, greenish-white stools, yawning, restlessness, absence of thirst, frequent belching with long sighs, lethargy, and exposed pupils, indicates chronic wind-invasion leading to weakness and fragility, resulting in diarrhea and vomiting. Treatment should first tonify the Spleen. Qian Yi first used Yi Huang San, then dispersed Wind using Da Qing Gao. These two conditions are more common in spring and winter.

Diarrhea and vomiting with undigested food, where both vomit and feces have a sour, foul odor, indicate food-damage diarrhea and vomiting. Vomiting milk and passing yellow-red stools suggests damage from hot milk/food. Vomiting milk and passing greenish-white stools suggests damage from cold milk/food. Mild purgation is suitable in all cases, followed by harmonizing Stomach Qi. For deficient patients, use mild resolving agents to gradually break down stagnation.

Diarrhea and vomiting occurring within three days after birth, accompanied by high fever, refusal to suckle, and undigested milk or white stools, indicates milk-damage. Mild purgation is appropriate, followed by harmonizing Stomach Qi. Deficient patients should use mild resolving agents to gradually break down stagnation.

Diarrhea and vomiting occurring between three days and ten days after birth, with normal-to-cool body temperature, refusal to suckle, greenish-white stools, and undigested milk, indicates upper excess and lower deficiency. Syndromes involving the Five Zang organs may also appear. One should purge the excess and tonify the deficiency of the Spleen and Stomach.

Diarrhea and vomiting accompanied by organ-specific syndromes: involvement of the Lung presents with exposed pupils during sleep and panting; involvement of the Heart presents with palpitations and desire to drink; involvement of the Spleen presents with fatigue and excessive sleepiness. (Diarrhea and vomiting are fundamentally diseases of the Spleen and Stomach); involvement of the Liver presents with yawning and listlessness; involvement of the Kidney presents with muteness and photophobia.

Previously, Qian Yi treated the five-year-old son of Feng Chengwu, who suffered from diarrhea, vomiting, high fever, and anorexia. Qian Yi observed that the child had fewer black irises than whites, and a pale complexion. Qian Yi said, "This child is prone to illness. A pale complexion indicates timidity of Shen (Spirit); fewer black irises indicate Kidney deficiency. Being inherently timid and deficient, he falls ill often. Even if he grows up, his muscles will likely not be robust, he will be intolerant to cold and heat, and prone to vacuity and excess fluctuations. His Spleen and Stomach will also be weak. He must not indulge in alcohol or sexual desires. Without proper care, he will not reach middle age. His face will lack spiritual luster, resembling that of a woman who has lost blood. Currently, the diarrhea, vomiting, anorexia, and high fever suggest slight food damage. Furthermore, a deficient and timid child should not be purged. Purgation increases deficiency: pathogenic factors entering the Lung cause cough; entering the Heart cause palpitations; entering the Spleen cause fatigue; entering the Kidney worsen deficiency. One should only use medicine to gradually resolve the stagnation, as the food damage is slight. If the damage is severe, purgation is necessary; otherwise, it becomes a mass accumulation (Pi Ji). If solid food stagnation exists internally, purgation is permissible. After purgation, tonifying the Spleen ensures recovery. Treating according to vacuity and excess yields effective results. The formulas used by Qian Yi are recorded in this collection."