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Background Information:
Book Title: Huoyou Kouyi (Oral Discussions on Pediatric Care)
Author: Zeng Shirong
Dynasty: Yuan Dynasty
Chapter: E Wan / Xie Xie Zheng Hou Fang Yi / Chang San
Category: Comprehensive

Treatment for pediatric cases of Wugu Gan (a chronic consumptive disease characterized by emaciation, abdominal distension, and fever) resulting in deficiency heat of the Triple Burner (San Jiao), manifesting as incessant thirst, frequent dysentery without day or night restraint, restlessness, dry heaving, and immediate vomiting after eating. In such severe conditions, if conventional Ganji medicines fail to stop water and food stagnation, relieve thirst and irritability, improve dysentery, or restore appetite, this prescription should be used. With administration, the condition stabilizes: deficiency heat dissipates after one dose, thirst and irritability cease after two doses, and dysentery stops after three doses. Within three doses, all symptoms are expected to resolve effectively. This is the miraculous secret honey-coated E Wan prescription.

One toad, taken alive in summer; specifically those found in ditches with large bellies, unable to jump or croak, and covered in pimple-like growths.
Obtain a scoop of dung beetles and place them in a bucket. Pour feces around the edges to dry them out, thereby retaining the beetles. Then, kill the toad and place it atop the beetles, allowing the beetles to consume the toad over two days.
Wrap the mixture in a new cloth bag, tie it securely with thin hemp rope, and suspend it in a fast-flowing stream overnight. The next day, retrieve the residue, dry it on tiles, grind it into powder, mix uniformly with musk, and form pills the size of hemp seeds using steamed dough moistened with rice decoction. For younger children, administer twenty pills per dose; for older children, thirty pills. Take with warm rice wine or decoct Ophiopogon japonicus seeds (with hearts removed) and take the decoction on an empty stomach. Administer twice daily. The efficacy is divine. Preparation should be done with utmost sincerity.

Discussion: When pediatric diarrhea is caused by food accumulation, if initial treatment with tonifying herbs fails to stop the diarrhea, it is necessary to purge the accumulation. Only after the accumulation is expelled will the diarrhea naturally cease. For purging, Xiao Chenxiang Jian Wan (Minor Amber Decoction Pills) is suitable to regulate accumulation within deficiency-cold; it should be administered frequently. Alternatively, use Xiao Taqi Wan (Minor Qi-Sinking Pills); if there is still no relief, administer Sanling Jian (Three Rhizomes Decoction). Strictly avoid using Xuanzhuan Yao (strong purgative/laxative agents), lest they cause excessive scouring and damage healthy qi. Once the accumulation has been cleared, administer drugs that harmonize the Stomach and warm the Spleen, such as Ji Ji Dan. This is the method for treating accumulation-type diarrhea. Sudden onset diarrhea in summer is due to coldness of the viscera and slippery, deficient intestines leading to rapid evacuation; Qisheng Dan should be given. If incontinence persists, proceed to Chang San (Intestine Powder); subsequently, administer both Qisheng Dan and Ji Ji Dan. For Dongli (profuse watery diarrhea) with irregular, alarming attacks, immediately administer Chang Weizi (Intestine Un-Child Pill - *note: likely a variant name or typo in source, retained as is*); subsequently, administer Zhufu Tang (Aconite and Atractylodes Decoction) to slightly slow the progression of the pathology, ensuring a favorable prognosis. The principles of treating diarrhea cannot be ignored while waiting; laypersons may lack knowledge, but physicians must exercise caution.

For infants and young children suffering from persistent diarrhea due to deficiency-cold of the intestines and stomach and long-standing coldness of the viscera, this is the effective prescription for Chang San (Intestine Powder).
Zhen Qianfen (Lead Carbonate, half liang, stir-fried), Baishi Zhi (White Halloysite, two qian), Bai Fan (Alum, two qian), Bai Longgu (White Fossilized Bone, one qian).
Grind all ingredients into powder. Each dose is half a qianbi (approx. 1.5-2g); for adults/older children, one qian (approx. 3g). Mix with warm rice wine for ingestion. Alternatively, form small pills using a thin paste; frequent administration yields better results.