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Touxie (Vomiting and Diarrhea) is a syndrome characterized by sudden onset and gastrointestinal disturbance. "Huo" refers to vomiting, and "Luan" refers to diarrhea. Some patients experience heart pain followed by vomiting, while others experience abdominal pain followed by diarrhea; none of these arise without originating from the Middle Jiao (Middle Burner, primarily referring to the Spleen and Stomach). The Upper Jiao governs reception and does not allow leakage outwards; the Middle Jiao governs the digestion and transformation of food and fluids, thereby generating Ying and Wei (Nutritive and Defensive Qi), irrigating the bones and body; the Lower Jiao separates the clear and turbid aspects of food and fluids, governing excretion rather than reception. These three constitute the fundamental pattern of the human body, representing daily physiological functions. Therefore, the Spleen resides in the Central Earth (Middle Jiao), and the Stomach is the Sea of Food and Fluids. When food enters the Stomach, the Spleen can transform and digest it. Then, at one cun above the umbilicus (known as the Fen Shui Acupoint), the clear and turbid are separated, and transmission and reception are appropriate, thus preventing the disaster of vomiting and diarrhea.

Whenever infants suffer from incessant upper vomiting and continuous lower diarrhea, it is because their congenital essence (Six Qi, here referring to the foundational energies of tendons, bones, flesh, blood, etc.) is not yet complete, making them susceptible to invasion by the Six Excesses (Six Yin Pathogens: Wind, Fire, Summer-heat, Dampness, Dryness, Cold). Additionally, improper nursing and irregular feeding lead to Spleen and Stomach deficiency, causing Clear and Turbid Qi to interfere with each other, stagnate, and generate pathology.

If diarrhea occurs first followed by vomiting, this indicates Spleen and Stomach Deficiency-Cold. The symptoms include initially passing white water or white mucus, with mild vomiting, slow breath, lethargic expression, sweating on the forehead, and deep, soggy pulses throughout all six positions. This is classified as Cold.

If vomiting occurs first followed by diarrhea, this indicates Heat in the Spleen and Stomach. Symptoms include rapid breathing, red lips, flushed face during vomiting, surging and rapid pulses, thirst for drinking, and desire for fluids. This is classified as Heat. The distinction between Cold and Heat must be carefully examined.

Children of several years old may also suffer from this syndrome. It often begins in summer and autumn. During the day, they stay near extremely hot places and expose themselves to cool air after removing clothes; at night, they sleep in drafty areas without adequate covering, contracting cold. This causes an struggle between Yin and Yang, with cold qi striking the Middle Jiao, named Huoluan (Chaos/Vomiting-Diarrhea Syndrome). The *Huoren Shu* (Book of Living Persons) uses Xiangru San (Elsholtzia Powder) for treatment, as it can separate food and fluids and regulate the ascending and descending of Yin and Yang. It further states: For cases with more heat and desire to drink water, use Wuling San (Five-Ingredient Powder with Poria); for cases with more cold and no desire to drink water, use Lizhong Wan (Regulate the Middle Pill). A detailed examination of treatment methods reveals that the aim is indeed to calm the Middle Jiao.

In cases where Spleen Meridian accumulation/stagnation remains unresolved, and the child is injured again by diet, resulting in alternating vomiting and diarrhea, it is appropriate to use Sanleng San (Sparganium Powder) to resolve accumulation and Shouwei San (Stomach-Guarding Powder) to harmonize the Stomach, ensuring recovery.

Qian Zhongyang discussed: Vomiting milk with yellow stool indicates injury from Hot Milk; vomiting milk with green stool indicates injury from Cold Milk. Both conditions should be treated with purgative methods. However, upon detailed analysis of this principle, which represents the method of "attacking and seizing" (forcing downward), it is preferable to treat heat-injury with Wuling San to guide rebellious Qi downward, and cold-injury with Lizhong Tang (Regulate the Middle Decoction) to warm the Middle Jiao, leading to natural recovery.

Furthermore, in midsummer or early autumn, if children are exposed to wind at night, drink water when thirsty, and overconsume raw and cold fruits, the stomach and intestines are stimulated, leading to sudden violent vomiting and diarrhea. This may progress to numbness of the hands and feet, tendon spasms, and pain. During pain, the spirit and consciousness become unsettled. Treating this as a Convulsion Syndrome (Jing Zheng) would be a mistake.

It is said that tendons contract and shorten when encountering cold. The Yangming Meridian nourishes the Zong Jin (Major Tendons) and belongs to the Stomach and Large Intestine. Due to internal injury from consuming raw, cold drinks and foods, combined with external contraction of Wind Pathogen, vomiting and diarrhea occur alternately. The Stomach Qi is inherently deficient and cannot nourish the Zong Jin, leading to tendon spasms. The signs of this syndrome include warm breath, pale/dull complexion, and deep, slow pulses. Pressing below the knees and wrists reveals tendon contraction pulling against the skin, which confirms the diagnosis. Treatment involves Lizhong Tang, added with half raw and half processed Fuzi (Aconite Lateral Root), decocted with water and fresh ginger, taken warm on an empty stomach. Further adjustments should be made based on deficiency/excess and cold/heat patterns.