〔钱〕小儿初生三日内吐泻壮热，不思乳食，大便乳食不消或白色，是伤寒，当下
之并和胃，下用白饼子（癖），和胃用益黄散（脾）主之。
儿生三日以上至十日，吐泻身温凉，不思乳食，大便青白色，乳食不消，此上实下虚也。更有五脏兼见证，
肺，睡露睛喘气。心，惊悸饮水。脾，困倦饶睡。肝，呵欠烦闷。肾，不语畏明。当先视儿兼藏证，先泻其所实
者，而补其虚，如脾虚，益黄散主之，此二证多病于秋夏也。
五月夏至后，吐泻身壮热者，此热也，盖小儿脏腑十分中九分热也。或因伤热乳食不消，泻深黄色。玉露散主之。
玉露散方（一名甘露散）
寒水石（半两，软而微青黑，中有细纹者） 生甘草（一钱） 石膏（半两，坚白而有墙壁，手不可析者，如
无，以方解石代之，坚白似石膏，敲之段段皆方者是）
上，同为细末。每服一字或五分一钱，食后温汤调下。（海藏云∶非肾热相火大盛者，不宜服此）
六月大暑后，吐泻身大温而似热，脏腑中六分热、四分冷也，吐呕乳食不消，
泻黄白色，似渴或食乳或不食乳，食前少服益黄散，食后多服玉露散。广亲宫五太
尉，病吐泻不止，米谷不化。众医用温药，一日而加喘、吐不定。钱氏曰，当以凉药治之，所以然者，谓伤热在
内也，用石膏汤三服并服之。众医皆言吐泻多而米谷又不化，当补脾，何以用凉药。王信。众医皆用补脾丁香
散三服。钱医后至，曰不可服此，三日后必腹满身热，饮水吐逆。三日外，果如所言。所以然者，谓六月
热甚，伏入腹中，而令引饮，热伤脾胃，即大吐泻也，医又行温药，使上焦亦热，故喘而引饮，三日当甚。众师不能
治。复召钱至，见其热证，以白虎汤（发热）三服，更以白饼子下之，一日减药二分，二日三日又与白虎汤各二服，
四日用石膏汤一服，及旋合麦门冬、黄芩、脑子、牛黄、天竺黄、茯苓，以朱砂为衣，服五丸，竹叶汤化下，热退而安。
七月立秋后，吐泻身温，脏腑中三分热、七分冷也，不能食乳，多似睡，闷乱，哽气长出气，睡露睛，唇白多哕，
欲
大便，不渴。食前多服益黄散，食后少服玉露散。广亲宫七太尉七岁，病吐泻，是时七月，其证全不食而昏睡，睡觉
而闷乱，哽气干呕，大便或有或无，不渴。众医作惊治之，疑睡故也。钱曰，先补脾，后退热，
与使君子丸（疳）补脾，石膏汤退热，次日又以水银硫黄末研和，以姜水调下一字。钱
曰凡吐泻，五月内九分下，而一分补，八月内九分补、而一分下，此者是脾虚泻，医妄治之，至于虚损，下之即死，
即当补脾，若以使君子丸，恐缓，已又留温胃益脾药治之。医者李生曰，何食而哕？钱曰脾虚津少即呕逆。曰何泻
青褐水？曰肠胃至虚，冷极故也。钱治而愈。
八月秋分后，吐泻身冷无阳也，不能食乳，干呕哕，泻青褐水，当补脾，益黄散主之，不可下也。
〔田〕凡小儿盛暑吐泻，邪热在下焦则泻，在上焦则吐，亡津必渴，用玉露散，虽吐，时时与啜之，过三日必愈。
如身热脉大，小便黄，用五苓、益元各半，热汤调，温服之。如身凉脉细，小便青，早晨益黄散，午后玉露散。如过
四五日困弱，宜异功散、和中散、开胃丸。
〔洁〕如有风而泻，用防风、羌活（谓吐泻，兼肝病风搐拘急也。有热而泻，用黄连、黄芩、大黄（谓吐泻，兼
心病身热也）。有寒而泻，用附子（谓吐泻，兼肾病身冷，或足胫寒而逆也）。有湿而泻，用白术、茯苓（谓吐泻，
兼本脏脾病多睡体重昏倦也）。有肺病而泻用芍药、桂心，定喘麦冬、人参，甚者多槟榔，大便不通加大黄（谓
吐泻，兼肺病喘嗽也）。更详看病新旧，新则止之，
久则有肠风之患，宜推陈致新，法当宣风散（痘发热）导过后，用入脏君臣药调之，宜益黄散。
〔曾〕有小儿盛夏初秋，遇夜乘风，渴而饮水，过餐生冷果物，攻激肠胃，遂乃暴吐暴泻，传作手足俱痹，
筋挛而痛，痛则神志不宁，以惊证治之，误矣。所谓筋遇寒则引缩，又以阳明养宗筋，属胃与大肠，因内伤生冷
饮食，外感风邪，吐泻交作，胃气因虚，不能养其宗筋，亦致挛急，此证口气温，面色惨，脉沉缓，再以手
按两膝腕下，见筋缩而引于皮间，是其候也。治以理中汤加附子半生半炮，水姜熟煎，空心温服，更详虚实冷热，
为治可也。有数岁小儿忽患吐泻，始自夏秋昼近极热之地，解衣乘凉，夜卧当风之所致，盖先感热，后感冷，阴
阳相搏，气射中焦，名为霍乱。《活人书》用香薷散调治，以其能分别水谷，升降阴阳。又曰∶热多欲饮
水者五苓散，寒多不饮水者理中丸。详此治法，得非欲平中焦乎。〔薛〕凡暑令吐泻，手足指热，作渴饮冷者，
属阳证，宜清凉之剂。手足指冷，作渴饮热者，属阴证，宜温补之剂。凡病属阴证误用寒凉者，死则手足青黯，
或遍身皆然。
香薷饮 治夏秋脏腑冷热不调，饮食不节，吐痢心腹疼痛，发热烦闷。
香薷（三两） 白扁豆 浓朴（各一两半） 生甘草（二两）
上锉。每服二钱，水一盏，煎服。
车前子散 治暑月霍乱吐泻，烦闷引饮不止，小便不利。
白茯苓 猪苓 香薷 车前子（炒） 人参（各等分）
上为末。灯心汤调下。
不换金正气散 治脾胃不和，寒热往来，脏腑虚热，霍乱吐泻。
浓朴（姜制） 藿香 陈皮 半夏 苍术（米泔浸） 甘草（炙。各等分）
上每服二三钱，姜枣水煎服。
二顺散 治中暑霍乱吐泻，烦闷燥渴，小便赤涩，便血肚疼。
猪苓 泽泻 茯苓 白术 甘草（炙） 官桂 干姜 杏仁（各一两，去皮尖双仁，炒）
上为末。每服半钱，不拘时，水调下，或水煎服。
六和汤 治心脾不和，气不升降，霍乱吐泻，咳嗽胸满，头目疼痛，嗜卧倦怠，并
阴阳不分，冒暑伏热，烦闷成痢，中酒作渴，心逆畏食。
人参（去芦） 缩砂仁 甘草（炙） 杏仁（泡去皮尖） 半夏（汤煮透，锉，焙
干。各一两） 白扁豆（炒熟，锉
去壳，一斤，碎切，烂杵，拌匀，酿、经一宿，焙干） 藿香 赤茯苓（去皮） 木瓜（各二两） 香藿 浓朴
（去粗皮，姜制，慢火焙干。各四两）
上，每服二钱，水一盏，姜二片，枣一枚，煎七分，无时温服。或入盐半字同煎。
[Qian Yi] When infants within three days after birth present with vomiting, diarrhea, and high fever, refusal of milk/food, and stools containing undigested milk or appearing white, this is a Cold Damage (Shanghan) syndrome. It should be treated with purgation to harmonize the Stomach Qi. For purgation, use Baibing Zi (White Pill) to treat accumulations; for harmonizing the Stomach, use Yihuang San (Yellow-Protecting Powder) to treat Spleen disorders.
For infants aged three days to ten days after birth, presenting with vomiting, diarrhea, normal or slightly cool body temperature, refusal of milk/food, and stools that are greenish-white with undigested milk, this indicates Excess above and Deficiency below. Additionally, there may be concurrent manifestations of the Five Zang organs: Lung involvement presents as sleeping with eyes half-open and panting; Heart involvement presents as palpitations and thirst; Spleen involvement presents as lethargy and excessive sleepiness; Liver involvement presents as yawning and irritability; Kidney involvement presents as muteness and photophobia. One must first observe the concurrent organ syndromes, first draining the Excess and then tonifying the Deficiency. For example, for Spleen Deficiency, Yihuang San is indicated. These two types of syndromes commonly occur in autumn and summer.
After the Summer Solstice in May, when vomiting, diarrhea, and high fever occur, this is a Heat syndrome, because infants possess nine parts Heat out of ten in their internal organs. If caused by damage from heat-inducing milk/food leading to indigestion, resulting in deep yellow loose stools, Yulu San (Jade Dew Powder) is indicated.
Formula for Yulu San (also known as Ganlu San):
Hanshuishi (Halloysitum, half tael, soft with slight bluish-black color and fine grain), Sheng Gancao (Raw Glycyrrhizae Radix et Rhizoma, one qian), Shigao (Gypsum Fibrosum, half tael, hard, white, and fibrous, difficult to break by hand; if unavailable, Fangjieshi [Alumen] may substitute, which should be hard, white like Gypsum, and fracture into square pieces).
Grind all ingredients into fine powder. Administer one zi or five fen to one qian per dose, mixed with warm water after meals. (Haizang stated: This is not suitable unless there is excessive Fire of the Ministerial Heat due to Kidney Heat.)
After the Great Heat in June, when vomiting, diarrhea, and a body temperature that is relatively high but seemingly febrile occur, indicating six parts Heat and four parts Cold in the internal organs, with vomiting of undigested milk, yellowish-white loose stools, thirst with variable desire for milk, administer small doses of Yihuang San before meals and larger doses of Yulu San after meals. The Fifth Taivwei of Guangqin Palace suffered from incessant vomiting and diarrhea with undigested rice and grain. Physicians used warming medicines, causing worsening wheezing and uncertain vomiting within one day. Qian Yi said it should be treated with cooling medicines because Heat was injured internally. Use Shigao Tang (Gypsum Decoction) for three doses. The physicians argued that severe vomiting and diarrhea with undigested food require Spleen tonification, questioning the use of cooling medicines. Wang Xin agreed. The physicians then administered Dingxi San (Clove Powder) for Spleen tonification for three doses. Qian Yi’s physician arrived later and said, "Do not take this; in three days, abdominal distension, body heat, thirst, and vomiting/regurgitation will occur." Three days later, it happened exactly as predicted. This occurred because the intense heat of June penetrated the abdomen, inducing thirst; Heat damaged the Spleen and Stomach, causing severe vomiting and diarrhea. The physicians' use of warming medicines heated the Upper Jiao, causing wheezing and thirst, which would worsen in three days. The senior teachers could not cure it. Qian Yi was summoned again, observed the Heat syndrome, administered Baihu Tang (White Tiger Decoction) for three doses, followed by Baibing Zi for purgation. On the first day, reduce the dosage by two fen; on the second and third days, administer Baihu Tang twice each. On the fourth day, administer Shigao Tang once, and prepare a decoction of Maidong (Ophiopogonis Radix), Huangqin (Scutellariae Radix), Bingpian (Borneolum Syntheticum), Niuhuang (Calculus Bovis), Tianzhuhuang (Spatholobi Caulis), and Fuling (Poria), coated with Zhusha (Cinnabaris), taken as five pills, washed down with Zhuyeqin Tang (Bamboo Leaf Decoction). The heat subsided, and he recovered.
After the Beginning of Autumn in July, when vomiting, diarrhea, and normal body temperature occur, indicating three parts Heat and seven parts Cold in the internal organs, inability to suckle, excessive sleepiness, irritability, sighing with long exhalations, sleeping with eyes half-open, white lips with frequent hiccups, urge to defecate without thirst, administer large doses of Yihuang San before meals and small doses of Yulu San after meals. The Seventh Taivwei of Guangqin Palace, aged seven, suffered from vomiting and diarrhea in July. His symptoms included complete anorexia and lethargy, irritability upon waking, sighing and dry retching, intermittent stools, and no thirst. Physicians treated it as Wind-Phlegm disturbing the mind, suspecting the sleepiness. Qian Yi said, "First tonify the Spleen, then clear Heat." He prescribed Shijunzi Wan (Quisqualis Pill) to tonify the Spleen and Shigao Tang to clear Heat. The next day, he ground Mercury and Sulfur together, mixed with ginger water, and administered one zi. Qian Yi stated that for vomiting and diarrhea, in May, treat nine parts with purgation and one part with tonification; in August, treat nine parts with tonification and one part with purgation. This case was Spleen-Deficiency Diarrhea, wrongly treated by physicians, leading to deficiency damage. Further purgation would cause death; thus, Spleen tonification is required. Using Shijunzi Wan might be too slow, so warming and Spleen-strengthening medicines were retained. Physician Li Sheng asked, "What causes hiccups?" Qian Yi replied, "Spleen Deficiency and scanty fluids cause vomiting and regurgitation." Asked, "Why greenish-brown watery stools?" Answered, "Extreme deficiency of the Intestines and Stomach, and extreme Cold." Qian Yi cured him.
After the Autumn Equinox in August, when vomiting, diarrhea, cold body, and lack of Yang Qi occur, with inability to suckle, dry retching, hiccups, and greenish-brown watery stools, one should tonify the Spleen using Yihuang San. Purgation is contraindicated.
[Tian Shi] In general, for infants suffering from vomiting and diarrhea during the peak of summer, if pathogenic Heat is in the Lower Jiao, it causes diarrhea; if in the Upper Jiao, it causes vomiting. Loss of Body Fluids inevitably leads to thirst. Use Yulu San. Even if vomiting occurs, offer it frequently in small sips; recovery is certain after three days. If the body is hot with a large pulse and yellow urine, mix Wuling San (Five-Ingredient Powder with Poria) and Yiyuan San (Benefiting Origin Powder) equally, mix with hot water, and take warm. If the body is cool with a thin pulse and blue-green urine, administer Yihuang San in the morning and Yulu San in the afternoon. If weakness persists after four or five days, use Yigong San (Extra Power Powder), Hezhong San (Harmonize the Middle Powder), or Kaiwei Wan (Open the Stomach Pill).
[Zhang Congzheng] If diarrhea is caused by Wind, use Fangfeng (Saposhnikoviae Radix) and Qianghuo (Notopterygii Rhizoma et Radix) (indicating vomiting/diarrhea accompanied by Liver Wind spasms and rigidity). If caused by Heat, use Huanglian (Coptidis Rhizoma), Huangqin (Scutellariae Radix), and Dahuang (Rhei Radix et Rhizoma) (indicating vomiting/diarrhea accompanied by Heart Heat and body fever). If caused by Cold, use Fuzi (Aconiti Lateralis Radix Praeparata) (indicating vomiting/diarrhea accompanied by Kidney Cold, body chill, or cold/reversal of lower legs). If caused by Dampness, use Baizhu (Atractylodis Macrocephalae Rhizoma) and Fuling (Poria) (indicating vomiting/diarrhea accompanied by Spleen disease with excessive sleep, heavy body, and lethargy). If diarrhea is due to Lung disease, use Shaoyao (Paeoniae Radix Alba) and Guixin (Cinnamomi Ramulus); for wheezing, use Maidong (Ophiopogonis Radix) and Renshen (Ginseng Radix); for severe cases, add more Binglang (Arecae Semen); if stool is obstructed, add Dahuang. Also, carefully distinguish between new and chronic conditions. New conditions should be stopped immediately; chronic conditions risk Changfeng (Intestinal Wind), requiring the removal of stale matter and promotion of new growth. The method is to use Xuanfeng San (Wind-Dispersing Powder) for guidance, followed by Jun-Chen medicines entering the Zang organs, preferably Yihuang San.
[Zeng Shirong] An infant in mid-summer to early autumn, exposed to wind at night, drank water due to thirst, and overconsumed raw/cold fruits, irritating the intestines and stomach, resulting in sudden vomiting and diarrhea. This transmitted to numbness of hands and feet, tendon contraction, and pain. During pain, the spirit and consciousness were unsettled. Treating this as a Wind-Phlegm disorder was erroneous. Tendons contract when exposed to Cold. The Yangming channel nourishes the Zongjin (Major Tendons), belonging to the Stomach and Large Intestine. Internal injury from raw/cold food and external invasion of Wind-Cold caused alternating vomiting and diarrhea. Stomach Qi became deficient, failing to nourish the Zongjin, leading to contraction. Signs include warm breath, pale complexion, and a deep-slow pulse. Pressing below the knees and wrists reveals tendons contracting and pulling against the skin. Treat with Lizhong Tang (Regulate the Middle Decoction) plus Fuzi (half raw, half processed), decocted with water and fresh ginger, taken warm on an empty stomach. Adjust treatment based on deficiency/excess and cold/heat. Another child of several years suddenly developed vomiting and diarrhea after playing near extreme heat in summer/autumn, removing clothes to cool off, and sleeping in the wind at night. This was initial Heat exposure followed by Cold exposure, with Yin and Yang struggling, Qi penetrating the Middle Jiao, named Huoluan (Cholera-like disorder). *Huoren Shu* recommends Xiangru San (Elsholtzia Decoction) to regulate water/grain separation and Yin/Yang ascent/descent. It states: For Heat-dominant cases with thirst, use Wuling San; for Cold-dominant cases without thirst, use Lizhong Wan. Analyzing these methods aims to pacify the Middle Jiao.
[Xue Ji] Generally, for vomiting and diarrhea during the heat season, if fingers/hands are hot and the patient is thirsty for cold drinks, it belongs to Yang Syndromes; use cooling agents. If fingers/hands are cold and the patient is thirsty for hot drinks, it belongs to Yin Syndromes; use warming and tonifying agents. If Yin Syndrome patients are mistakenly treated with cold/cooling medicines, death results with cyanotic/dark limbs or whole-body discoloration.
Xiangru Yin (Elshuetia Infusion): Treats disharmony of cold/heat in internal organs during summer/autumn, irregular diet, vomiting/dysentery with abdominal pain, fever, and irritability.
Xiangru (Elsholtziae Herba, 3 liang), Baidou (Phaseoli Semen Album), Houpo (Magnoliae Officinalis Cortex, 1.5 liang each), Sheng Gancao (Raw Glycyrrhizae Radix et Rhizoma, 2 liang).
Cut into pieces. Take 2 qian per dose, decoct in one cup of water.
Cheqianzi San (Plantaginis Seed Powder): Treats cholera-like vomiting/diarrhea in summer months, persistent irritability and thirst, and dysuria.
Baifuling (Poria), Zhuling (Polyporus), Xiangru (Elsholtziae Herba), Cheqianzi (Plantaginis Semen, stir-fried), Renshen (Ginseng Radix) (equal parts).
Grind into powder. Take with Dengxin Tang (Junci Medulla Decoction).
Buhuanjin Zhengqi San (Unchanging Gold Upright Qi Powder): Treats Spleen-Stomach disharmony, alternating chills and fever, deficiency-heat in internal organs, and cholera-like vomiting/diarrhea.
Houpo (Magnoliae Officinalis Cortex, ginger-processed), Huoxiang (Agastaches Herba), Chenpi (Citri Reticulatae Pericarpium), Banxia (Pinelliae Rhizoma), Cangzhu (Atractylodis Rhizoma, soaked in rice wash water), Gancao (Glycyrrhizae Radix et Rhizoma, honey-roasted) (equal parts).
Take 2-3 qian per dose, decoct with ginger and jujube.
Ershun San (Two-Harmonies Powder): Treats cholera-like vomiting/diarrhea from summer-heat stroke, irritability, dry thirst, red/scanty urine, bloody stool, and abdominal pain.
Zhuling (Polyporus), Zexie (Alismatis Rhizoma), Fuling (Poria), Baizhu (Atractylodis Macrocephalae Rhizoma), Gancao (Glycyrrhizae Radix et Rhizoma, honey-roasted), Guigui (Cinnamomi Cortex), Ganjiang (Zingiberis Rhizoma), Xingren (Armeniacae Semen Amarum, peeled and double-kernel, stir-fried) (1 liang each).
Grind into powder. Take half a qian per dose at any time, mixed with water, or decocted in water.
Liuhe Tang (Six-Harmonies Decoction): Treats Heart-Spleen disharmony, failure of Qi ascent/descent, cholera-like vomiting/diarrhea, cough with chest fullness, headache/eye pain, drowsiness/fatigue, confusion of Yin/Yang, summer-heat retention, irritability progressing to dysentery, alcohol-induced thirst, heart rebellion, and aversion to food.
Renshen (Ginseng Radix, remove rhizome), Suozhenren (Amomi Fructus Rotundus), Gancao (Glycyrrhizae Radix et Rhizoma, honey-roasted), Xingren (Armeniacae Semen Amarum, soaked, peeled, remove kernel) (1 liang each). Baidou (Phaseoli Semen Album, stir-fried, husked, 1 jin, crushed, mixed, fermented overnight, dried). Huoxiang (Agastaches Herba), Chifuling (Poria with Red Skin, peeled), Mugua (Chaenomelis Fructus) (2 liang each). Xianghuo (Agastaches Herba), Houpo (Magnoliae Officinalis Cortex, ginger-processed, slow-fire dried) (4 liang each).
Take 2 qian per dose, with one cup of water, two slices of ginger, and one jujube. Decoct to 70%, take warm at any time. Alternatively, add half a zi of salt during decoction.