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Xia Yuzhu stated: The *Neijing* (Inner Canon) mentions, "Stomach deficiency leads to vomiting, Spleen deficiency leads to diarrhea, and simultaneous deficiency of the Stomach and Spleen leads to both vomiting and diarrhea." This statement is extremely erroneous. If diarrhea occurs first followed by vomiting, with a pale complexion, mental fatigue, no fever, no thirst, and slight sweating on the forehead, this indicates Cold-Deficiency of the Spleen and Stomach (Pi Wei Xu Han). It is appropriate to use Lizhong Tang (Regulate the Middle Decoction), Xiao Yi Gong San (Minor Extraordinary Assistance Powder), or Liu Junzi Tang (Six Gentlemen Decoction). If vomiting occurs first followed by diarrhea, with a reddish face, dry lips, irritability, thirst, and dark urine, this indicates Heat in the Spleen and Stomach. Treatment should utilize Wuling San (Five-Ingredient Powder with Poria) added with Zhu Ru (Bamboo Shavings) for decoction and administration. Furthermore, if accumulation stagnation remains in the Spleen, preventing the transformation and transportation of water and grain, leading to vomiting and diarrhea, Xiaodao Erchen Tang (Digestion-Assisting Two-Centuries Decoction) is appropriate.

For vomiting and diarrhea caused by summerheat-dampness during the late summer season, Liuhe Tang (Six-Harmony Decoction) is appropriate.

In my childhood, the daughter of my schoolmate Friend Chen Gongzai suffered from vomiting. At that time, I was suffering from wind-cold. Consequently, a physician specializing in adult internal medicine was summoned who used warming stomach agents, which exacerbated the vomiting. I visited her despite my illness. Her lips were red and lustrous, her exhaled breath was hot to the touch, and her tongue was red-purple. I prescribed one qian of Shu Shigao (Calcined Gypsum) ground into powder, taken with a bowl of tea. The symptoms subsided slightly, and after administering another dose immediately, she recovered instantly. This method is effective for observing the Miao Qiao (facial indicators/childhood diagnostic features) in adults and children; how much more so for infants? Later, she suffered from vomiting again with identical facial and Miao Qiao signs. Using Shigao alone was not very effective. I deduced that there might be Cold Qi in the Lower Yuan (Lower Origin/Kidney-Mingmen area). I used fried salt to moxa-warm the abdomen while continuing to administer Shigao, resulting in recovery. Thus, observing the color of the Miao Qiao has never led me astray.

In the Gui Chou year, upon arriving north at the guild hall, I happened upon Young Master Chen Shi'an's son, whose Spleen diarrhea was about to transform into Man Pi Feng (Slow Spleen Wind/Chronic Spleen Deficiency Convulsion). He entrusted me with his treatment. I asked, "Have you administered Renshen (Ginseng)?" Chen Shi'an replied, "If he takes even one fen of Renshen, he will climb up the wall (indicating agitation or liver wind stirring)." I thought that constitutions might differ between the North and South. However, considering I had just arrived in the capital, I feared being mocked for recklessness. Therefore, I used Liu Junzi Tang (Six Gentlemen Decoction) without Renshen (Ginseng), administered continuously for two doses, but achieved no effect. I then declined further responsibility and referred him to other physicians. After a while, a physician arrived at the hall in a sedan chair. After he left, I requested to see his prescription and found it belonged to the category of digestive-promoting agents. I asked, "Who is that person?" Chen Shi'an said, "This is Dr. Zheng, the pediatrician famous throughout the capital." I said, "When chronic diarrhea is about to transform into Slow Spleen Wind, can one still use digestive-promoting drugs? If used, his life would be uncertain." So I stopped that course. I did not accept Chen Shi'an's words as absolute truth. I insisted on using Liu Junzi Tang (Six Gentlemen Decoction), doubled the dosage of Renshen (Ginseng), and additionally added 5 fen of Fuzi (Prepared Aconite Root). After two doses, he recovered. Chen Shi'an sighed and said, "I have long heard of your skillful hands; today it is indeed true." This serves as a verification of distinguishing colors and examining Miao Qiao, and not believing others' words blindly.