脾胃俱虚，吐泻并作，伤食为多，四时俱有。或有春因于风，佐以防风、天麻；夏因于
暑，佐以香薷、扁豆；秋因于凉，本方皆温剂，不必药佐。昏睡露睛，胃家虚热，睡不露睛，胃
家实热，无论虚热实热，先用小黑丸微利之。亦有身大热而吐泻，皆伤风症，宜治风。不因
吐泻而感之，伤食吐泻，乳食不化，或吐与泻皆酸臭，宜消食平胃汤。
消食平胃汤
藿香 浓朴 苍术 半夏 香附 陈皮 山楂 神曲 茯苓
泻色黄赤属热，加姜炒黄连，青白属冷，只用本方，甚则加木香、丁香、肉桂、干姜、肉
蔻等。腹痛加砂仁，身热加柴胡。伤食重，枳实、青皮、槟榔可渐加。身凉吐沫，泻青白，呵
欠，烦闷不渴，哕气，常见露睛，此病久荏苒，因成吐泻，急宜补脾。量加人参、白术、干姜、
肉桂、附子、木香、丁香等。
身热或不热，眼眶陷，舌上有刺，唇燥饮水，泻焦黄臭，清胃止渴汤。
清胃止渴汤
人参 莲肉 柴胡 黄连 杏仁 陈皮 甘草 石膏 山栀 贝母 茯苓
若眼眶勿陷，且勿用人参，只用白术；眼眶已陷，断要用参。腹痛加砂仁，久渴而虚亦
须加山药、白术。不止加肉蔻、诃子。冷泻色青白，面 白凄惨，去黄连加附子、木香、苍
术，甚则丁香、肉桂亦可用。此症手足厥冷为逆，急与人参、附子温其胃，不变慢惊。伤食泻
粪色白，水谷不化，酸臭，去黄连加苍术、香附。泻而浮肿，小便涩少不行，是小肠渗入脾
胃，宜利水汤。
利水汤
苍术（白术也可） 滑石 猪苓 泽泻 浓朴 陈皮 甘草 山楂 茯苓皮 赤芍药 车前子
用升麻、柴胡提其气，木香、天麻醒其脾，防风燥其湿。上吐清汁，下泻完谷，面白腹痛，
手麻脚转筋，大叫哭，食乳即返，此因湿痰流注四肢，宜除湿化痰汤。若唇口干燥，司空黄色，勿用
此方，亦用利水汤加天麻。
小儿吐乳或痰泻黄沫，唇深红，额汗自时出，若阴囊吊缩，牙龈黑色，女儿阴肿，勿必用医药。
Spleen and Stomach deficiency with simultaneous vomiting and diarrhea, mostly caused by food stagnation, can occur in all seasons. If due to wind in spring, add Fangfeng (Radix Saposhnikoviae) and Tianma (Rhizoma Gastrodiae); if due to summerheat in summer, add Xiangru (Herba Elsholtziae) and Biandou (Semen Dolichoris); if due to coolness in autumn, no additional herbs are needed as the base formula consists of warm agents. Drowsiness with eyes half-open indicates deficient heat in the Stomach; sleeping with eyes closed indicates excess heat in the Stomach. Regardless of deficient or excess heat, first administer Xiaohei Wan (Little Black Pill) to induce mild purgation. There are also cases of high fever accompanied by vomiting and diarrhea, which belong to wind-injury syndromes and should be treated by resolving wind. If not contracted through vomiting and diarrhea but due to food stagnation causing vomiting and diarrhea, with undigested milk and food, or sour-smelling vomit and stool, Xiaoshi Pingwei Tang (Digestive Food and Regulate Stomach Decoction) is indicated.
Xiaoshi Pingwei Tang (Digestive Food and Regulate Stomach Decoction)
Huoxiang (Herba Agastaches), Houpo (Cortex Magnoliae Officinalis), Cangzhu (Rhizoma Atractylodis Lanceae), Banxia (Rhizoma Pinelliae Preparatum), Xiangfu (Rhizoma Cyperi), Chenpi (Pericarpium Citri Reticulatae), Shanzha (Fructus Crataegi), Shenqu (Massa Medicata Fermentata), Fuling (Poria).
Yellow-red stool color indicates heat; add Huanglian (Rhizoma Coptidis) stir-fried with ginger. Green-white stool color indicates cold; use only the base formula, adding Muxiang (Radix Aucklandiae), Dingxiang (Flos Caryophylli), Rougui (Cortex Cinnamomi), Ganjiang (Rhizoma Zingiberis Preparatum), and Roucou (Semen Myristicae) for severe cases. Add Renkou (Fructus Amomi Rotundus) for abdominal pain; add Chaihu (Radix Bupleuri) for fever. For severe food stagnation, gradually increase Zhishi (Fructus Aurantii Immaturus), Qingpi (Pericarpium Citri Reticulatae Viride), and Binglang (Semen Arecae). Cold body, foamy vomiting, green-white stool, yawning, irritability without thirst, belching, and frequent eye-opening indicate a chronic condition evolving into vomiting and diarrhea; urgently tonify the Spleen. Appropriately add Renshen (Radix Ginseng), Baizhu (Rhizoma Atractylodis Macrocephalae), Ganjiang, Rougui, Fuzi (Radix Aconiti Lateralis Preparata), Muxiang, and Dingxiang.
If feverish or not, with sunken eye orbits, prickles on the tongue, dry lips desiring water, and foul yellow-brown stool, use Qingwei Zhike Tang (Clear Stomach and Quench Thirst Decoction).
Qingwei Zhike Tang (Clear Stomach and Quench Thirst Decoction)
Renshen, Lianrou (Semen Nelumbinis), Chaihu, Huanglian, Xingren (Semen Armeniacae Amarum), Chenpi, Gancao (Radix Glycyrrhizae), Shigao (Gypsum Fibrosum), Shanzhi (Fructus Gardeniae), Beimu (Bulbus Fritillariae Cirrhosae), Fuling.
If eye orbits are not sunken, do not use Renshen, use only Baizhu; if sunken, Renshen is essential. Add Renkou for abdominal pain; add Shanyao (Rhizoma Dioscoreae) and Baizhu for prolonged thirst with deficiency. If diarrhea persists, add Roucou and Hezi (Fructus Terminaliae Chebulae). Cold diarrhea with green-white stool and pale, miserable complexion: remove Huanglian, add Fuzi, Muxiang, and Cangzhu; Dingxiang and Rougui may be used in severe cases. Extremity coldness in this syndrome is an adverse sign; urgently administer Renshen and Fuzi to warm the Stomach to prevent transformation into slow convulsions. White stool from food stagnation, undigested food, sour smell: remove Huanglian, add Cangzhu and Xiangfu. Diarrhea with edema and scanty urine indicates fluid infiltration from the Small Intestine into Spleen and Stomach; use Li Shui Tang (Promote Water Metabolism Decoction).
Li Shui Tang (Promote Water Metabolism Decoction)
Cangzhu (Baizhu may also be used), Huashi (Talcum), Zhuling (Polyporus), Zexie (Rhizoma Alismatis), Houpo, Chenpi, Gancao, Shanzha, Fulingpi (Exocarpium Citri Grandis), Chi Shaoyao (Radix Paeoniae Rubra), Cheqianzi (Semen Plantaginis).
Use Shengma (Rhizoma Cimicifugae) and Chaihu to lift Qi; Muxiang and Tianma to awaken the Spleen; Fangfeng to dry dampness. Upper vomiting of clear fluid, lower diarrhea of undigested food, pale face, abdominal pain, numb hands and feet, muscle twitching, loud crying, and regurgitation after feeding indicate damp-phlegm flowing into the four limbs; use Chushi Huatan Tang (Remove Dampness and Resolve Phlegm Decoction). If lips and mouth are dry and skin has a sallow hue, do not use this formula; instead, use Li Shui Tang plus Tianma.
Infants vomiting milk or having phlegm-diarrhea with yellow foam, deep red lips, spontaneous sweating on the forehead, retracted scrotum, black gums, or swollen vulva in girls require immediate medical treatment.