虞抟曰。小儿吐泻泄黄。伤热乳也。吐泻泄青。伤冷乳也。皆用白饼子。下后伤热乳者。玉露散。伤冷乳者。益黄
散。
王汝言曰。小儿吐泻并作。即名霍乱。有心痛而先吐者。有腹痛而先泻者。莫不由中焦而作。上焦主纳而不出。中
焦主腐化水谷而生荣卫。灌溉百骸。下焦分别水谷。主出而不纳。脾居中州。胃为水谷之海。乳哺入胃。脾能克化。然
后水谷传变得宜。岂有吐泻之患。凡小
儿吐泻。皆因六气未完。六淫易侵。兼以调护失宜。乳食不节。遂使脾胃虚弱。清浊相干。蕴作而然。有先泻而后吐者。
乃脾胃虚冷。其候先泻白水。吐亦不多。且气缓而神色慢。额前有汗。六脉沉濡。此为冷也。有先吐而后泻者。乃脾胃
有热。气促唇红。吐来面赤。脉洪而数。渴饮水浆。此为热也。冷热宜辨。
娄全善曰。吐泻昏睡露睛者。胃虚热也。钱氏白术散。吐泻昏睡不露睛者。胃实热也。钱氏玉露散。
张兼善曰。初生吐泻。大便色白。停乳也。紫霜丸。下后用香橘饼。初生月内吐泻。宜朱砂丸。如吐骤。或泻完谷
者。伤风甚也。凡伤风多作吐泻者。风木好侵脾土故也。宜大青膏。
王履曰。婴儿暑月吐泻身热。宜玉露散。或益元散。寒月吐泻身冷。宜益黄散。
钱乙曰。吐泻久。将成慢惊风。宜和胃丸、双金丸。一五岁儿吐泻。壮热。不思乳饮。钱见曰。此见目中黑睛少而
白睛多。面色 白。必多病。夫面色 白者。神怯也。黑睛少者。肾虚也。黑睛属水。本怯而虚。故多病也。纵长成。
必肌肤不壮。不耐寒暑。易虚易实。脾胃亦弱。更不可纵恣酒色。若不保养。不过壮年也。面上常无精神光泽者。如妇
人之失血也。今吐利不食壮热者。伤食也。又虚怯不可下。下之虚入肺则嗽。入心则惊。入脾则泻不止。入肾则益虚。
但以消积磨化之。为微有食积也。
薛己曰。小儿吐泻。手足指冷者。脾气虚寒也。异功散加木香。泻而腹中重坠者。脾气下陷也。补中益气汤。服克
滞药而腹中窄狭者。脾家虚痞也。六君子汤。面黄泻青者。脾虚而肝乘之也。六君加升、柴、木香。多噫泻黄者。六君
加炮姜、升麻。生下半月内吐者。只调其母。儿不胜药也。
Yu Tun stated: When infants experience vomiting and diarrhea with yellow stools, it is due to damage from "hot milk" (overheated or improperly prepared milk). Vomiting and diarrhea with green stools are due to damage from "cold milk." Both conditions should initially be treated with Baibing Zi (White Pill), a formula for purging accumulation. After purgation, if the cause was hot milk, Yulu San (Jade Dew Powder) should be used; if the cause was cold milk, Yihuang San (Yellow Enrichment Powder) should be used.
Wang Ruyan stated: When vomiting and diarrhea occur simultaneously in infants, it is termed Huoluan (Cholera-like disease). Some present with heart pain preceding vomiting, while others have abdominal pain preceding diarrhea; all originate from disorders of the Middle Jiao (Middle Burner). The Upper Jiao governs reception without excretion; the Middle Jiao governs the decomposition and transformation of food and fluids, generating Ying and Wei (Nutritive and Defensive Qi), and irrigating the skeletal system; the Lower Jiao separates clear and turbid fluids, governing excretion without reception. The Spleen resides in the Central Region, and the Stomach is the Sea of Food and Fluids. When milk and food enter the Stomach, the Spleen's transformative function processes them, allowing for proper transmission and transformation of nutrients. How could vomiting and diarrhea occur? Generally, infant vomiting and diarrhea arise because the Six Qi (Six Climatic Factors) are not yet fully established, making the infant susceptible to invasion by the Six Excesses (Pathogenic Factors). Combined with improper care and irregular feeding, this leads to Spleen and Stomach deficiency, where clear and turbid energies interfere with each other, causing stagnation and heat. If diarrhea precedes vomiting, it indicates Spleen and Stomach deficiency-cold. Symptoms include watery diarrhea, mild vomiting, slow breathing, lethargy, sweating on the forehead, and deep, soggy pulses; this is a cold pattern. If vomiting precedes diarrhea, it indicates Spleen and Stomach heat. Symptoms include rapid breathing, red lips, flushed face during vomiting, surging and rapid pulses, and thirst for drinks; this is a heat pattern. Cold and heat patterns must be distinguished carefully.
Lou Quanshan stated: Vomiting and diarrhea accompanied by drowsiness and eyes half-open (exposing the sclera) indicate deficiency-heat in the Stomach, treated with Qian Shi Baizhu San (Dr. Qian's Atractylodes Macrocephala Powder). Vomiting and diarrhea accompanied by drowsiness but with eyes closed indicate excess-heat in the Stomach, treated with Qian Shi Yulu San (Dr. Qian's Jade Dew Powder).
Zhang Jianshan stated: In newborns, vomiting and diarrhea with white stools indicate milk stasis, treated with Zishuang Wan (Cinnabar Frost Pill). After purgation, Xiangju Bing (Fragrant Orange Cake) should be used. For vomiting and diarrhea within the first month of life, Zhusha Wan (Cinnabar Pill) is appropriate. If vomiting is sudden or diarrhea contains undigested food, it indicates severe Wind invasion. Wind pathogens often cause vomiting and diarrhea because Wood (Liver/Gallbladder) tends to invade Earth (Spleen/Stomach); Daqing Gao (Great Blue Ointment) is suitable.
Wang Lü stated: For infants in summer months experiencing vomiting, diarrhea, and fever, Yulu San or Yi Yuan San (Benefit Origin Powder) is appropriate. For those in winter months experiencing vomiting, diarrhea, and cold limbs, Yihuang San is appropriate.
Qian Yi stated: Prolonged vomiting and diarrhea may evolve into Man Jing Feng (Slow Convulsion), treatable with Hewei Wan (Harmonize Stomach Pill) and Shuangjin Wan (Double Gold Pill). Regarding a five-year-old child with vomiting, diarrhea, high fever, and refusal to feed: Qian Yi observed that the child had less black iris and more white sclera, with a pale complexion, indicating frequent illness. A pale complexion suggests weak Shen (Spirit); a small black iris indicates Kidney deficiency. Since the black iris corresponds to Water, being both weak and deficient leads to frequent illness. Even upon adulthood, the muscles will not be robust, sensitivity to cold and heat will persist, the constitution will be prone to both deficiency and excess, and the Spleen and Stomach will remain weak. One must avoid indulgence in alcohol and sexual activity; without proper preservation, one will not reach prime adulthood. A lack of spiritual luster on the face resembles blood loss in women. Current symptoms of vomiting, diarrhea, anorexia, and high fever indicate Food Injury. Furthermore, children with deficiency and timidity should not undergo purgation. If purged, pathogenic factors entering the Lung cause cough; entering the Heart cause palpitations/fright; entering the Spleen cause unceasing diarrhea; entering the Kidney worsen deficiency. Only mild digestion-promoting methods should be used, as there is only slight food stagnation.
Xue Ji stated: Infant vomiting and diarrhea with cold fingers and toes indicate Spleen Qi deficiency-cold, treated with Yigong San (Extraordinary Assistance Powder) added with Muxiang (Vladimiria Root). Diarrhea with a sensation of heaviness and bearing-down in the abdomen indicates Spleen Qi sinking, treated with Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction). Abdominal tightness after taking obstructive/clearing medicines indicates Spleen deficiency bloating, treated with Liujunzi Tang (Six Gentlemen Decoction). Yellow complexion with green stools indicates Spleen deficiency with Liver overacting, treated with Liujunzi Tang plus Shengma (Cimicifuga Rhizome), Chaihu (Bupleurum Root), and Muxiang. Frequent belching with yellow stools is treated with Liujunzi Tang plus Paojiang (Prepared Ginger) and Shengma. Vomiting in infants under half a month old requires treating the mother, as the infant cannot tolerate strong medication.