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Zheng stated: Infantile vomiting and diarrhea result from external contraction of wind-cold pathogens or internal injury from milk and food. Alternatively, if the infant is fed while still crying and their breath has not yet regulated, the qi rebels upward and stagnates in the chest and diaphragm, causing vomiting; if the qi rebels downward, it damages the spleen and stomach, causing diarrhea. When both upper and lower qi rebel simultaneously, vomiting and diarrhea occur together. In cases where infants vomit but do not have diarrhea, this is considered a "reverse" syndrome (indicating poor prognosis). If vomiting is accompanied by phlegm inducing convulsions, fewer than one in ten will survive. If infants have diarrhea without vomiting, or present with both symptoms that persist for a long time without resolution, the condition may transform into Yin epilepsy (Yin Xian). Treatment should involve temporarily withholding breast milk: for mild cases, withhold for one day; for severe cases, for three days. During this period, frequent feeding of thin rice gruel is recommended. Medication acts quickly, with an eight or nine out of ten cure rate. Those who disbelieve this advice, arguing that infants rely on milk for life and cannot bear to stop, fail to realize that although milk is essential, if the illness was caused by milk injury, continuing to feed the offending milk is like carrying firewood to save a fire—what use are medicines? Some infants recover without stopping medication because their condition is mild; however, many others deteriorate from mild to severe, leading to premature death. The *Huoyou Xinshu* states: For persistent infantile vomiting and diarrhea, the key is to regulate milk intake and treat gradually with medication to ensure recovery. "Regulate" means to restrict; feed only three or five times a day, ensuring the infant is not overfed each time, which will naturally reduce vomiting. Interspersing thin rice gruel can also harmonize the stomach. It is often observed that practitioners ignorant of this principle seek rapid results through heavy medication, abruptly withholding milk for three to four days. This leads to extreme hunger and deficiency of stomach qi, causing incessant crying and triggering other syndromes. Generally, humans rely on food for life, and infants cannot live without milk; thus, total cessation is inadvisable. However, milk transforms from blood, and blood belongs to Yin with a cold nature. Excessive vomiting weakens the stomach, so regulation is necessary. Physicians must understand this. Nursing mothers should also take herbs to harmonize qi and blood and regulate the spleen and stomach. My opinion is that for older infants capable of eating solid food, complete cessation of milk is preferable until they stabilize. For younger infants unable to eat solids, regulating milk intake is sufficient.

Xue Ji stated: Vomiting is primarily related to the spleen and stomach. As the ancients said, "Spleen deficiency causes Ou (retching), Stomach deficiency causes Tu (vomiting)." Ou is characterized by sound without material expulsion, while Tu involves material expulsion without sound. If the fingertips of the hands and feet are hot, the infant prefers warm drinks, or sleeps with eyes partially open (exposing the eyeballs), these indicate deficiency of Stomach Qi; treat with Yigong San (Extra Efficacy Powder). If fingertips are hot, the infant prefers cold drinks, or sleeps with eyes tightly closed, this indicates Excess Heat in the Stomach Meridian; treat with Xiehuang San (Drain Yellow Powder). If there is thirst, reduced appetite, or reddish urine, this indicates Deficiency Heat in the Stomach Meridian; treat with Qiwei Baizhu San (Seven-Ingredient Atractylodes Macrocephala Powder). Generally, for infants, the nursing mother's diet must be strictly regulated. If the mother suffers from food stagnation, it can cause infantile vomiting and diarrhea, so caution is essential.

Zeng Shirong discussed the origins of vomiting, which are too numerous to list exhaustively. There are Cold Vomiting, Heat Vomiting, Accumulation Vomiting, Wind-Cold Cough-induced Vomiting, and Milk-Injury Vomiting. While the act of vomiting is similar, the accompanying symptoms differ, as detailed below. Cold Vomiting: Undigested milk curds appear; there is much retching but little actual expulsion. The pulse is deep and faint. The face is pale, eyelids droop, and the gaze is dull. Qi is weak, spirit is lethargic, and sweat appears on the forehead. This is caused by wind-cold invading the stomach, consumption of raw/cold foods, or injury from residual old milk. The deficient stomach rejects the contents. Treatment should warm the stomach, dispel wind, and remove cold accumulation. Use Danggui San (Angelica Decoction) decocted with water-boiled ginger and Chenpi (Tangerine Peel). Alternatively, intermittently administer Chonghe Yin (Harmonizing Drink), Lizhong Tang (Regulate the Middle Decoction), Jiangju Tang (Ginger and Tangerine Peel Decoction), or Dingtu Yin (Stop Vomiting Drink). If these are ineffective, use Shenxiang Yin (Ginseng and Costus Root Drink). Heat Vomiting: Red face and lips. Fewer episodes but greater volume of expulsion. Milk curds are digested and yellow. Generalized high fever. Caused by summer-heat in the stomach or consumption of hot-natured foods. Spirit is restless and irritable rather than dull. This is Heat Vomiting. Treat by clearing heat and resolving toxicity using Dashun Yin (Great Smoothness Drink), taken on an empty stomach with warm boiled water. Combine with Wuling San (Five-Ingredient Powder) or Xiaochaihu Tang (Minor Bupleurum Decoction), adding ginger juice and administering slowly. Xiangru San (Elsholtzia Powder) is also indicated. If hot herbs were mistakenly administered, first give Mouton Yin (Mung Bean Drink) to resolve toxicity, then administer anti-emetics. Accumulation Vomiting: Eyelids are puffy, complexion slightly yellow, feet are cold while the abdomen is hot. Symptoms are lighter during the day and heavier at night. In older children, the pulse is deep and slow, indicating cold stagnation in the spleen causing expulsion of yellow, sour fluid or clear phlegm. A real and slippery pulse indicates injury from food stagnation, resulting in expulsion of sour gas or undigested food. In younger infants, it manifests as undigested milk. First, harmonize using Wuling San mixed with ginger juice in warm water, followed by Wuxi Wan (Black Rhinoceros Pill). For the youngest infants, use Sanleng San (Curcuma Decoction) or Huapi Wan (Resolve Masses Pill). Wind-Cold Cough Vomiting: Heat generates wind; wind generates phlegm. Phlegm knots in the chest, obstructing Lung Qi, causing continuous coughing and vomiting up phlegm. This is a Excess syndrome due to severe coughing and phlegm obstruction. Treat by dispelling wind and transforming phlegm. First administer Qingfei Yin (Clear Lungs Drink), then Xiaochaihu Tang. If chronic cough leads to Lung deficiency, where Earth fails to generate Metal (Spleen failing to nourish Lung), presenting with pale face, dry lips, dry cough, and dry retching without phlegm, warming tonification is superior. Use Fuling Nongpu Tang (Poria and Magnolia Bark Decoction), Xingxing San (Awakening Powder), or Ruyi Gao (Ruyi Ointment). Milk-Injury Vomiting: Vomiting occurs immediately after feeding or shortly thereafter. This is due to excessive feeding beyond the capacity of the weak Spleen to transform and transport, akin to overflowing a small vessel. Treatment requires regulating milk intake and administering Sanleng San. Additionally, there is Wind-Phlegm Vomiting, where unresolved wind-cold causes vomiting of milk mixed with phlegm. Prolonged duration risks generating wind; treat with Qingzhou Baiwanzi (Qingzhou White Pills) or Banxia San (Pinellia Powder) to disperse wind and descend phlegm. Toxic Gas Vomiting is described in *Chao Shi Bing Yuan*. Convulsion-Associated Vomiting includes formulas such as Zhang Huan's Sanxiang Dan. Malnutrition-Accumulation Vomiting is described in *Benshi Fang*. For persistent vomiting due to Huoluan (Colic and Diarrhea Syndrome), use two qian of fine powder from Fulonggan (Dragon's House Soil), fried with Luzhimi (Sorghum Rice) until yellow, decocted and taken as a suspension; this stops vomiting immediately. Alternatively, fried white kidney beans (Baibian Dou) decocted in water is effective; fresh young shoots are even better.