（第六）
脾居中州，胃为水谷之海。乳哺入胃，脾能克化，然后水谷分其清浊，传变得宜则无
吐泻之患。凡小儿上吐不止，下泻不住，皆因内外伤侵，兼以调护失常，乳食不节，遂使脾
胃虚弱，清浊相干，蕴作而成。有先泻而后吐者，乃脾胃虚冷。其候先泻白水，吐亦不多，
口气缓而神色慢，额前有汗，六脉沉濡，此为冷也。先吐而后泻者，乃脾胃有热，气促唇红，
吐来面赤，脉洪而数，渴饮水浆，此为热也。冷热之分，须要详审。
伤风吐泻，身温，乍寒乍热，多气粗，大便黄白色，呕吐乳食，完谷不消，时咳嗽，
更五脏兼见证，宜先服钩藤散，后用益黄散、香朴散主之。及有吐泻，身热，多睡，能食乳，
饮水不止，吐痰，大便黄水，皆为胃虚热渴泻也。当生胃中津液，以止其渴，后服发散止渴，
多服白术散、钩藤散。吐泻身凉，吐沫青白色，闷乱不渴，气肿露睛，当补脾，宜加减四君
子汤、藿香散、银白散主之。夏月伤暑吐泻，手足厥冷者，理中汤、藿香正气散、五顺散、
车前子散、不换金正气散可选而用之。如吐泻之证有风搐欲成慢候，可看慢脾方论治之。
《内经》云∶脉浮者霍乱。刘宗浓云∶霍乱脉来浮洪者可治；微而迟，气少不语者难治。
《脉诀》云∶小儿乳后辄呕逆，更兼脉乱无忧虑。
（第六）
脾位于身体中部，胃是受纳水谷的容器。乳汁和食物进入胃后，依靠脾的运化功能进行消化，随后水谷被分为清浊两部分，如果传导变化适宜，就不会出现呕吐和腹泻的祸患。凡是小儿上吐不止、下泻不停，都是因为内外邪气侵袭，加上护理不当，乳食没有节制，从而导致脾胃虚弱，清气与浊气相互干扰，郁结蕴蒸而发病。有先腹泻而后呕吐的，这是脾胃虚寒的表现。其症状是先泻出白水，呕吐也不剧烈，口气缓和且神色倦怠，额头前有汗出，六脉沉而濡软，这属于寒证。先呕吐而后腹泻的，这是脾胃有热的表现，气息急促、嘴唇发红，呕吐时面色潮红，脉象洪大而数，口渴想喝水浆，这属于热证。区分寒证和热证，必须仔细审察。
伤风引起的吐泻，身体温和，忽冷忽热，呼吸粗重，大便呈黄白色，呕吐未消化的乳食，完谷不化，时常咳嗽，并兼见五脏的其他证候，适宜先服用钩藤散，之后用益黄散、香朴散主治。还有出现吐泻、身体发热、嗜睡、能吃乳、饮水不止、呕吐痰液、大便呈黄水状的情况，这都是因为胃虚热盛导致的口渴和腹泻。应当滋生胃中的津液以止渴，之后服用发散解表、止渴的药物，多服用白术散、钩藤散。吐泻时身体发凉，呕吐物为青白色泡沫，胸闷烦乱且不口渴，气肿且眼睛半睁（露睛），应当补益脾气，适宜用加减四君子汤、藿香散、银白散主治。夏季因伤暑引起的吐泻，手足厥冷的，可选用理中汤、藿香正气散、五顺散、车前子散、不换金正气散进行治疗。如果吐泻的症状伴有风搐，快要发展成慢惊风的证候，可以参考慢脾风的方论来治疗。
《内经》说：脉象浮的，是霍乱。刘宗浓说：霍乱脉象浮洪的，可以治愈；脉象微细而迟，气短少言的，难以治愈。《脉诀》说：小儿哺乳后随即呕吐逆气，只要脉象不乱，就不用担忧。
(6)
The Spleen resides in the central region (Zhongzhou), and the Stomach is the sea of water and grain. When milk and food enter the Stomach, the Spleen's transformation and transportation function digests them. Subsequently, the water and grain are separated into clear and turbid parts; if the transmission and transformation are appropriate, there will be no worry of vomiting and diarrhea. Whenever a child suffers from incessant upper vomiting and continuous lower diarrhea, it is due to invasion by internal and external pathogenic factors, combined with improper care and irregular intake of milk and food. This leads to weakness of the Spleen and Stomach, where clear and turbid qi interfere with each other, accumulating and transforming into disease. Cases where diarrhea precedes vomiting indicate deficiency-cold of the Spleen and Stomach. The manifestations include first passing watery stool, followed by mild vomiting, slow breath and lethargic expression, sweating on the forehead, and deep, soggy pulses in all six positions; this is a cold pattern. Cases where vomiting precedes diarrhea indicate heat in the Spleen and Stomach. The manifestations include rapid breathing, red lips, flushed face during vomiting, surging and rapid pulses, thirst for drinking fluids; this is a heat pattern. Distinguishing between cold and heat patterns requires careful examination.
For vomiting and diarrhea caused by Wind-Cold, with warm body temperature, alternating chills and fever, coarse breathing, yellowish-white stools, vomiting of undigested milk and food, complete retention of undigested food particles, occasional coughing, and accompanying syndromes of the five Zang organs, it is advisable to first administer Gouteng San (Uncaria Decoction), followed by Yihuang San (Benefit Yellow Decoction) and Xiangpo San (Aromatic Magnolia Bark Decoction). In cases of vomiting and diarrhea accompanied by fever, excessive sleepiness, ability to suckle, incessant drinking, vomiting of phlegm, and yellow watery stools, these are symptoms of Stomach deficiency-heat leading to thirst and diarrhea. One should generate fluids in the Stomach to quench thirst, then administer dispersing and thirst-quenching formulas, primarily Baizhu San (Atractylodes Macrocephala Decoction) and Gouteng San (Uncaria Decoction). If the body is cool during vomiting and diarrhea, with vomiting of bluish-white froth, chest oppression, restlessness without thirst, edema, and eyes half-open (exposed pupils), the Spleen should be tonified. Suitable formulas include Jiajian Sijunzi Tang (Modified Four Gentlemen Decoction), Huoxiang San (Agastache Powder), and Yinbai San (Silver White Powder). For summerheat-induced vomiting and diarrhea with cold extremities, one may select Lizhong Tang (Regulate the Middle Decoction), Huoxiang Zhengqi San (Agastache Rectify Qi Powder), Wushun San (Five Smoothness Powder), Cheqianzi San (Plantago Seed Powder), or Buhuanjin Zhengqi San (Gold-Unchanging Rectify Qi Powder). If the symptoms of vomiting and diarrhea involve wind-tremors that threaten to develop into Slow Convulsion (Man Jing Feng), refer to the treatise on Slow Spleen Syndrome for treatment.
The *Neijing* states: "When the pulse is floating, it indicates Huoluan (Cholera-like syndrome)." Liu Zongnong stated: "In Huoluan, if the pulse is floating and surging, it is curable; if the pulse is faint and delayed, with shortness of breath and inability to speak, it is difficult to cure." The *Maijue* (Pulse Classic) states: "If an infant vomits immediately after breastfeeding, as long as the pulse is not chaotic, there is no need to worry."