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The Spleen resides in the central region of the body. When milk and food enter the Stomach, the Spleen governs transportation and transformation, separating the clear from the turbid. If dietary habits are irregular, damaging the Spleen and Stomach, their ability to transport and transform is impaired, leading to the interference of clear and turbid Qi. This may be accompanied by external pathogens, resulting in vomiting and diarrhea.

If diarrhea precedes vomiting, it indicates Cold deficiency of the Spleen and Stomach. The patient will necessarily desire warm water, vomit little, and present with weak breath, mental fatigue, sweating on the forehead, abdominal pain, and a deep and soggy pulse throughout all positions.

If vomiting precedes diarrhea, it indicates Heat in the Spleen and Stomach. The patient presents with rapid breathing, red lips, flushed face, a flooding pulse, thirst desiring water or cold rice soup, and possibly vomiting phlegm.

Some cases involve vomiting and diarrhea due to Wind injury accompanied by coughing; some occur during summer months due to Summerheat injury causing irritability and thirst; some involve latent Summerheat leading to cold extremities. Generally, after the Summer Solstice, Heat patterns predominate; after Major Heat, Heat and Cold are equal; after Start of Autumn, Cold patterns gradually increase.

Main Formula: Prepared Atractylodis Rhizoma (Cangzhu), Magnoliae Officinalis Cortex (Houpo), Citri Reticulatae Pericarpium (Chenpi), Glycyrrhizae Radix et Rhizoma (Gancao) [raw for Heat, roasted for Cold], Pinelliae Rhizoma (Banxia), Agastaches Herba (Huoxiang), Poria (Fuling).

For Heat patterns, add Atractylodis Macrocephalae Rhizoma (Baizhu), Polyporus (Zhuling), and Alisma Rhizoma (Zexie); remove Cangzhu. For Cold deficiency with cold extremities, add Dried Zingiberis Rhizoma (Ganjiang), Baizhu, and Cinnamomi Ramulus (Guizhi); remove Cangzhu. For deficiency, add Ginseng Radix et Rhizoma (Renshen). For Summerheat, add Elsholtziae Herba (Xiangru), Phaseoli Semen (Bian Dou), and Talcum (Huashi). For Wind-Cold, add Perillae Folium (Zisu) and Angelicae Dahuricae Radix (Baizhi). For Food stagnation, add Malt (Maiya) and Medicated Leaven (Shenqu). Add Zingiberis Rhizoma Recens (Jiang) and Jujubae Fructus (Zao), decoct in water. (For Gan Huoluan [Dry Cholera], administer light salt water; pain stops after vomiting or diarrhea occurs.)

Pediatric Huoluan is often caused by consuming raw, cold, or greasy, hard-to-digest foods in summer, or through breast milk if the nursing mother indulges excessively. Treatment must first employ purgative agents to guide out stagnation, followed by regulation. The formula is the same as for adults, differing only in dosage strength. It is erroneous to claim that one dares not use Rhubarb (Dahuang) for children and instead uses astringent drugs to block the condition, which endangers the child's life. One should simply use half the adult dosage.

Infants under one year old who cry incessantly without cause suffer from abdominal pain. A pale face and blue lips with clear, white loose stools indicate Cold. Apply warm cotton-wrapped heat to the abdomen, and the nursing mother should drink more Ginger Decoction. A red face and red lips, with constipation and intensified crying when warmed, indicate Heat; do not forcibly apply warmth. Children over one year old mostly suffer from Food stagnation. A fine and small pulse indicates a favorable prognosis; a full and large pulse indicates an unfavorable prognosis.

Main Formula: Cangzhu, Houpo, Chenpi, Fuling, Huoxiang, Banxia, Gancao, decocted with Jiang and Zao.

For Cold, add Pao Ganjiang and Rougui. For Heat, add Bai Shao and Huang Qin; remove Huoxiang. If stool is blocked, add a small amount of Dahuang. For Food stagnation, add Shanzha and Maiya.