汤氏云∶小儿热泻者，大便黄而赤，或有沫，乃脏中有积，或因乳母好饮酒，或嗜热物，或生下伤湿蕴热。医者不
明，但用豆蔻、诃子等药，服之如水浇石，既不识其症，故不辨其冷热，用药又不得法，焉得取效矣。此症当以小便赤
少，口干烦躁为验，治法当用钱氏白术散去木香用之，五苓散去桂亦可服。其热甚者，四逆散、大柴胡汤去大黄，服之
殊验也，更用黄连丸等剂亦佳，调中汤去大黄加黄连、枳壳。如夹热而泻，太阳与少阳合病，自下利者，与黄芩汤，
呕者加半夏也。又有夹热泻利，而小便秘涩赤甚者，四顺清凉饮主之。
钱氏白术散 见第四十八问。
大柴胡汤 见第二十九问。
五苓散 见第五十二问。
黄连丸 见第七十九问。
四逆散 见第六十五问。
调中汤 见第五十二问。
黄芩汤 治下利而头痛胸满，口苦咽干，或往来寒热而呕，其脉浮大而弦，专治协热而利者。
黄芩（一两半，炒） 白芍药（炒、一两） 甘草（炙、一两）
上 咀，每服三钱，枣子一个，水一盏，煎至七分，去滓温服。呕者加制半夏，生姜汁。
四顺清凉饮 见第四十四问。
汤氏云∶凡此泻，不宜便补，先用消食药，或用紫霜丸取其积尽，然后可补。经云∶食泻重，当取疳，虚用补虚。
治食泻与香橘饼子，加减观音散、调中汤散以意加减。凡伤食泻，不可即止，宜节饮食，当用进食丸取下食积令尽，次
以钱氏加减益黄散，只一服可止，此乃切要治法，然后异功散、四君子汤调理，必取全安。有腹中雷鸣下利者，生姜泻
心汤主之。如冷积酿泻，用香朴散止之。白术散以和气调胃，调中散、保安丸能止伤食泻，感应丸、沉香煎、三棱丸皆
可服。
紫霜丸 见第三问。
香橘饼 治伤冷泻利。
木香 青皮（炒） 陈皮（各一钱） 川浓朴（姜汁炒） 神曲（炒） 麦芽（炒、各半两）
上为末，蜜丸为饼，紫苏米饮调下。
全蝎观音散 止吐泻、截虚风。
黄 （蜜炙） 人参（去芦） 木香 大粉草（炙） 石莲（去心） 扁豆（炒黄、各一两） 白芷（七钱） 白
茯苓（去皮、一两） 全蝎（七钱） 羌活（八钱） 防风（八钱、去芦） 天麻（八钱）
上锉散，每服三钱，水一盏，煎至七分服，加姜枣煎。
调中散 治伤食泻，凡此泻不宜便补，先用食药，或紫霜丸取
其积尽，然后可补。经云∶食泻重、当取疳，虚用补虚，良医明妙理，何虑疾难除。
人参（去芦） 白茯苓 白术（炒） 木香 干姜（炮） 藿香叶 香附子（炒、去毛） 砂仁（炒） 甘草（炙）
丁香（各一两）
上为末，每服一钱，姜枣汤下，肚痛白汤，大小以意加减。
进食丸 见第四十七问。
异功散 见第十七问。
四君子汤 见第十六问。
益黄散 见第八问。
生姜泻心汤 治伤寒、汗出解后，胃中不和，心下痞硬，胁下有水气，腹中雷鸣下利者。
黄连（半炒） 甘草（半炙） 人参 干姜（炮） 黄芩（炒、各一两半） 半夏（汤泡、洗、一两）
上锉散，每服三钱，水一盏，生姜三片，枣一枚，煎七分，去滓温服。
香朴散 见第六十问。
白术散 见第四十八问钱氏白术散。
保安丸 治小儿酿泻、伤食泻。
香附子（一两） 白姜（炮） 青皮（去瓤） 陈皮（去白） 三棱（炮） 莪术（炮） 甘草（炙、各半两） 砂
仁（一两）
上为末，麦 面糊丸绿豆大，每服三丸，白汤下。
沉香煎 见第八十四问。
三棱丸 见第八十四问。
杏霜丸 治小儿食积作泻，并痢症。
杏仁（三两、去皮尖、麸炒） 巴豆（一两、去壳油、炒焦、却入杏仁同炒） 黄蜡（二两、酒煮绵滤） 百草霜
（为末二两、用油六钱、炒匀）
上将杏仁巴豆研极细，却入百草霜令匀，溶蜡和丸如绿豆大。赤痢甘草汤，白痢生姜汤，先进三、四服，腹胀者十
余服，效验如神。
汤氏说：小儿热泻的症状，是大便颜色黄中带红，有时伴有泡沫。这是由于脏腑内有积滞，或者因为乳母喜欢饮酒，或嗜食热性食物，又或者是婴儿出生时感受湿邪蕴结化热所致。医生如果不明白这些道理，仅仅使用豆蔻、诃子等收敛止泻的药物，服用后就像冷水浇在烧红的石头上一样（毫无效果，甚至加重病情）。这既不认识病症，也不辨别寒热，用药方法又不恰当，怎么能取得疗效呢？这种病症应当以小便短赤、口干烦躁作为验证标准。治疗方法应当使用钱乙的白术散，去掉木香来服用；或者使用五苓散，去掉桂枝也可以服用。如果热势很重的，可以使用四逆散、大柴胡汤去掉大黄，服用后效果显著；另外使用黄连丸等方剂也很好，或者用调中汤去掉大黄，加入黄连、枳壳。如果是夹有热邪而腹泻，属于太阳经与少阳经合病，出现自发性下利的，给予黄芩汤治疗，如果有呕吐症状的，加入半夏。又有夹带热邪的泻痢，且小便涩痛、颜色深红的，以四顺清凉饮为主治方。
钱氏白术散 见第四十八问。
大柴胡汤 见第二十九问。
五苓散 见第五十二问。
黄连丸 见第七十九问。
四逆散 见第六十五问。
调中汤 见第五十二问。
黄芩汤 治疗下利并伴有头痛、胸满、口苦咽干，或者往来寒热且呕吐，脉象浮大而弦，专门治疗协热下利者。
黄芩（一两半，炒） 白芍药（炒、一两） 甘草（炙、一两）
以上药物切碎，每次服用三钱，加枣子一个，水一盏，煎煮至七分，去渣温服。呕吐者加入制半夏和生姜汁。
四顺清凉饮 见第四十四问。
汤氏说：凡是这类腹泻，不适宜立即进补，应先使用消食药，或者用紫霜丸攻取使积滞排尽，然后才可以进补。医经说：食积导致的腹泻较重，应当按疳积论治，虚证则用补虚法。治疗食泻可以用香橘饼子，加减观音散、调中汤散等，根据具体情况灵活加减。凡是伤食引起的腹泻，不可以立即止泻，应当节制饮食，宜用进食丸攻下食积使其排尽，其次使用钱氏加减益黄散，只需一服即可止泻，这是关键的治法，然后再用异功散、四君子汤进行调理，必定能完全康复。如果有腹中肠鸣、下利的情况，以生姜泻心汤主治。如果是冷积酿成的腹泻，用香朴散来止住。白术散可以调和气机、调理胃气，调中散、保安丸能够止住伤食泻，感应丸、沉香煎、三棱丸都可以服用。
紫霜丸 见第三问。
香橘饼 治疗伤冷引起的泻痢。
木香 青皮（炒） 陈皮（各一钱） 川浓朴（姜汁炒） 神曲（炒） 麦芽（炒、各半两）
以上研为细末，用蜂蜜制成丸剂做成饼状，用紫苏米饮送服。
全蝎观音散 止吐泻、截断虚风。
黄芪（蜜炙） 人参（去芦头） 木香 大粉草（炙） 石莲（去心） 扁豆（炒黄、各一两） 白芷（七钱） 白茯苓（去皮、一两） 全蝎（七钱） 羌活（八钱） 防风（八钱、去芦头） 天麻（八钱）
以上锉成散剂，每次服用三钱，水一盏，煎煮至七分服用，加生姜、大枣同煎。
调中散 治疗伤食泻，凡是这类腹泻不适宜立即进补，先用消食药，或用紫霜丸攻取其积滞排尽，然后才可以进补。医经说：食积腹泻重，应当按疳积论治，虚证用补虚法，良医通晓妙理，何必担忧疾病难除。
人参（去芦头） 白茯苓 白术（炒） 木香 干姜（炮制） 藿香叶 香附子（炒、去毛） 砂仁（炒） 甘草（炙） 丁香（各一两）
以上研为细末，每次服用一钱，用姜枣汤送服，腹痛者用白开水送服，用量大小根据情况灵活加减。
进食丸 见第四十七问。
异功散 见第十七问。
四君子汤 见第十六问。
益黄散 见第八问。
生姜泻心汤 治疗伤寒，发汗解表后，胃中不和，心下部痞塞硬满，胁下有停饮，腹中肠鸣下利者。
黄连（半炒） 甘草（半炙） 人参 干姜（炮制） 黄芩（炒、各一两半） 半夏（汤泡、洗、一两）
以上锉成散剂，每次服用三钱，水一盏，生姜三片，枣一枚，煎煮至七分，去渣温服。
香朴散 见第六十问。
白术散 见第四十八问钱氏白术散。
保安丸 治疗小儿酿泻、伤食泻。
香附子（一两） 白姜（炮制） 青皮（去瓤） 陈皮（去白） 三棱（炮制） 莪术（炮制） 甘草（炙、各半两） 砂仁（一两）
以上研为细末，用麦面糊制成绿豆大小的丸剂，每次服用三丸，用白开水送服。
沉香煎 见第八十四问。
三棱丸 见第八十四问。
杏霜丸 治疗小儿食积引起的腹泻，以及痢疾症状。
杏仁（三两、去皮尖、麸炒） 巴豆（一两、去壳油、炒焦、再放入杏仁中同炒） 黄蜡（二两、酒煮绵滤） 百草霜（研为细末二两、用油六钱、炒匀）
先将杏仁、巴豆研磨极细，再放入百草霜混合均匀，熔化蜡液和丸如绿豆大小。赤痢用甘草汤送服，白痢用生姜汤送服，先服用三四丸，腹胀者服用十余丸，效果灵验如神。
Mr. Tang said: The symptoms of pediatric heat diarrhea (Heat Diarrhea) involve stools that are yellow with a reddish tint, sometimes accompanied by froth. This is caused by accumulation within the zang-fu organs, or because the nursing mother enjoys drinking alcohol, consumes hot-natured foods, or the infant contracted dampness at birth which accumulated and transformed into heat. If physicians do not understand this, and merely use astringent herbs such as Tsaoko Fructus (Doukou) and Chebulae Fructus (Hezi), the effect is like pouring cold water on a red-hot stone—completely ineffective. Since they fail to recognize the syndrome and distinguish between cold and heat, their medication methods are inappropriate; how can they expect efficacy? For this syndrome, one should verify it by observing scanty dark urine, dry mouth, and irritability. The treatment method should employ Qian's Baizhu San (Atractylodes Macrocephala Powder), removing Xiangru (Costus Root), for administration; alternatively, Wuling San (Five-Ingredient Poria Pill) without Guizhi (Cinnamon Twig) may also be used. If the heat is severe, Sini San (Frigid Extremities Powder) or Daxiehu Tang (Major Bupleurum Decoction) with Dahuang (Rhubarb) removed may be used, yielding remarkable results. Additionally, Huanglian Wan (Coptis Pill) and other preparations are excellent, or one may use Tiaozhong Tang (Middle-Regulating Decoction) removing Dahuang and adding Huanglian (Coptis Rhizome) and Zhike (Aurantii Fructus). If diarrhea occurs with concurrent heat, representing a combined disease of Taiyang (Greater Yang) and Shaoyang (Lesser Yang) presenting with spontaneous diarrhea, Huangqin Tang (Scutellaria Decoction) should be administered; if vomiting is present, Banxia (Pinellia Tuber) should be added. In cases of heat-complicated diarrhea and dysentery where urination is difficult and deeply red, Sishun Qingliang Yin (Four-Obedient Clearing and Cooling Drink) is the primary formula.
Qian's Baizhu San (Atractylodes Macrocephala Powder): See Question 48.
Daxiehu Tang (Major Bupleurum Decoction): See Question 29.
Wuling San (Five-Ingredient Poria Pill): See Question 52.
Huanglian Wan (Coptis Pill): See Question 79.
Sini San (Frigid Extremities Powder): See Question 65.
Tiaozhong Tang (Middle-Regulating Decoction): See Question 52.
Huangqin Tang (Scutellaria Decoction): Treats diarrhea accompanied by headache, chest fullness, bitter taste in the mouth, dry throat, alternating chills and fever, and vomiting, with a floating, large, and wiry pulse. It specifically treats diarrhea complicated by heat.
Huangqin (Scutellariae Radix, 1.5 liang, stir-fried); Baishaoyao (Paeoniae Radix Alba, stir-fried, 1 liang); Gancao (Glycyrrhizae Radix et Rhizoma, honey-fried, 1 liang).
Chop the above ingredients. Take 3 qian per dose, with one jujube and one cup of water, decoct until 0.7 cup remains, remove dregs, and take warm. Add Zhi Banxia (Prepared Pinellia Tuber) and Shengjiang Zhi (Ginger Juice) if vomiting occurs.
Sishun Qingliang Yin (Four-Obedient Clearing and Cooling Drink): See Question 44.
Mr. Tang said: For all such diarrheas, tonification should not be applied immediately. First, use food-resolving medicines, or use Zishuang Wan (Purple Frost Pill) to clear the accumulation completely before proceeding with tonification. The classics state: For heavy food-induced diarrhea, treat it as malnutrition (Gan Syndrome); for deficiency, use tonification methods. To treat food-induced diarrhea, use Xiangju Bingzi (Fragrant Orange Cake), Jiajian Guanyin San (Modified Guanyin Powder), or Tiaozhong Tang San (Middle-Regulating Powder), adjusting according to circumstances. For diarrhea caused by food injury, stopping it immediately is inadvisable; dietary restriction is necessary. One should use Jinshi Wan (Food-Advancing Pill) to purge the food accumulation completely, followed by Qian's Jiajian Yihuang San (Modified Yellow-Hiding Powder), which typically stops the diarrhea after just one dose. This is a crucial treatment method. Thereafter, use Yigong San (Beneficial Work Powder) and Sijunzi Tang (Four Gentlemen Decoction) for regulation, ensuring complete recovery. In cases of borborygmus (abdominal rumbling) with diarrhea, Shengjiang Xiexin Tang (Ginger Heart-Purgation Decoction) is indicated. For diarrhea caused by cold accumulation, use Xiangpo San (Costus and Magnolia Bark Powder) to stop it. Baizhu San (Atractylodes Macrocephala Powder) harmonizes qi and regulates the stomach; Tiaozhong San (Middle-Regulating Powder) and Bao'an Wan (Security Pill) can stop food-induced diarrhea; Yinggan Wan (Responsive Pill), Chenxiang Jian (Agarwood Decoction), and Sanleng Wan (Sparganii Pill) are also suitable.
Zishuang Wan (Purple Frost Pill): See Question 3.
Xiangju Bing (Fragrant Orange Cake): Treats diarrhea and dysentery caused by cold injury.
Muxiang (Costi Radix); Qingpi (Citri Reticulatae Pericarpium Viride, stir-fried); Chenpi (Citri Reticulatae Pericarpium, each 1 qian); Chuan Nanzhou (Magnoliae Officinalis Cortex, stir-fried with ginger juice); Shenqu (Massa Medicata Fermentata, stir-fried); Maiya (Hordei Fructus Germinatus, stir-fried, each half liang).
Grind into powder, form pills into cakes using honey, and administer with Zi Su Mi Yin (Perilla Seed Rice Drink).
Quanxie Guanyin San (Scorpion Guanyin Powder): Stops vomiting and diarrhea, intercepts deficiency wind.
Huangqi (Astragali Radix, honey-fried); Renshen (Ginseng Radix, de-radicle); Muxiang (Costi Radix); Da Fugcao (Glycyrrhizae Radix et Rhizoma, honey-fried); Shilian (Nelumbinis Semen, de-heart); Bian Dou (Dolichoris Lablab Semen, stir-fried until yellow, each 1 liang); Baizhi (Angelicae Dahuricae Radix, 7 qian); Baifuling (Poria, peeled, 1 liang); Quanxie (Scorpio, 7 qian); Qianghuo (Notopterygii Rhizoma et Radix, 8 qian); Fangfeng (Saposhnikoviae Radix, 8 qian, de-radicle); Tianma (Gastrodiae Rhizoma, 8 qian).
Cut into pieces to make a powder. Take 3 qian per dose, with one cup of water, decoct until 0.7 cup remains. Add fresh ginger and jujube during decoction.
Tiaozhong San (Middle-Regulating Powder): Treats food-induced diarrhea. As mentioned, tonification should not be applied immediately to such diarrheas; first use food-resolving medicines, or Zishuang Wan to clear accumulation completely before tonifying. The classics state: Heavy food-induced diarrhea should be treated as Gan Syndrome; deficiency requires tonification. A skilled physician understands these profound principles; why worry about the difficulty of curing the disease?
Renshen (Ginseng Radix, de-radicle); Baifuling (Poria); Baizhu (Atractylodis Macrocephalae Rhizoma, stir-fried); Muxiang (Costi Radix); Ganjiang (Zingiberis Rhizoma, processed); Huoxiangye (Pogostemonis Herba); Xiangfuzi (Cyperi Rhizoma, stir-fried, de-hair); Sharen (Amomi Fructus, stir-fried); Gancao (Glycyrrhizae Radix et Rhizoma, honey-fried); Dingxiang (Caryophylli Flos, each 1 liang).
Grind into powder. Take 1 qian per dose, with Ginger-Jujube Decoction. For abdominal pain, use plain boiled water. Adjust dosage based on the patient's condition.
Jinshi Wan (Food-Advancing Pill): See Question 47.
Yigong San (Beneficial Work Powder): See Question 17.
Sijunzi Tang (Four Gentlemen Decoction): See Question 16.
Yihuang San (Yellow-Hiding Powder): See Question 8.
Shengjiang Xiexin Tang (Ginger Heart-Purgation Decoction): Treats post-Shanghan (Cold Damage) conditions where sweating has resolved the exterior, but the stomach is disharmonious, leading to epigastric stiffness and fullness, fluid retention under the hypochondrium, borborygmus, and diarrhea.
Huanglian (Coptidis Rhizoma, half stir-fried); Gancao (Glycyrrhizae Radix et Rhizoma, half honey-fried); Renshen (Ginseng Radix); Ganjiang (Zingiberis Rhizoma, processed); Huangqin (Scutellariae Radix, stir-fried, each 1.5 liang); Banxia (Pinelliae Rhizoma, soaked in water, washed, 1 liang).
Cut into pieces to make a powder. Take 3 qian per dose, with one cup of water, three slices of fresh ginger, and one jujube. Decoct until 0.7 cup remains, remove dregs, and take warm.
Xiangpo San (Costus and Magnolia Bark Powder): See Question 60.
Baizhu San (Atractylodes Macrocephala Powder): See Question 48, Qian's Baizhu San.
Bao'an Wan (Security Pill): Treats pediatric fermented diarrhea and food-induced diarrhea.
Xiangfuzi (Cyperi Rhizoma, 1 liang); Baijiang (Zingiberis Rhizoma, processed); Qingpi (Citri Reticulatae Pericarpium Viride, de-pith); Chenpi (Citri Reticulatae Pericarpium, de-albedo); Sanleng (Sparganii Rhizoma, processed); Ezhu (Curcumae Longae Rhizoma, processed); Gancao (Glycyrrhizae Radix et Rhizoma, honey-fried, each half liang); Sharen (Amomi Fructus, 1 liang).
Grind into powder, form pills using wheat flour paste to the size of mung beans. Take 3 pills per dose with plain boiled water.
Chenxiang Jian (Agarwood Decoction): See Question 84.
Sanleng Wan (Sparganii Pill): See Question 84.
Xingshuang Wan (Apricot Frost Pill): Treats pediatric diarrhea caused by food accumulation, as well as dysentery syndromes.
Xingren (Armeniacae Semen Amarum, 3 liang, de-skin and tip, stir-fried with bran); Badou (Crotonis Fructus, 1 liang, de-shell and oil, stir-fried until scorched, then stir-fried together with apricot kernels); Huangla (Beeswax, 2 liang, boiled in wine and filtered through silk); Baicaoshuang (Fuliginis Stipitis Pulvis, 2 liang ground powder, stir-fried evenly with 6 qian of oil).
First, grind the apricot kernels and croton seeds extremely finely, then mix in the fuliginis powder evenly. Melt the beeswax and form pills the size of mung beans. For bloody dysentery, administer with Licorice Decoction; for white dysentery, administer with Ginger Decoction. Initially take 3-4 pills; for abdominal distension, take over ten doses. The efficacy is miraculous.