万密斋治一小儿，周岁，吐泻并作。时天大寒，医用理中、胃苓丸，服之不效。万曰∶此表里有寒邪，未
得发散也。取益黄散与之，其夜得大汗而止。
一女岁半，亦吐泻并作，此伤食也。前有外感风邪，故用益黄散温散其表里之寒。此只伤食，用胃苓丸，
一粒丹，陈壁土汤下，调其脾胃，消其食积，而吐泻俱止。
一儿暴吐泻，上下所出皆乳不化，用理中丸服之效。
一儿暴吐泻，上下所出皆黄水，中有乳片，用二陈汤加黄连姜汁炒，煎服效。或问二病同，而治之异者，
何也？曰∶所出之乳不化者，胃有寒也，故以理中丸急温之。所出乳片不化者，胃有邪热，邪热不杀谷，宜半
夏、黄连以解之，此病同异治法也。
张景岳季子，生于燕地，及白露时甫半周，偶感寒，吐泻大作，即用温胃和脾之药不效，随用理中等剂亦
不效。三日后，加人参三钱及姜、桂、吴茱萸、肉豆蔻之类，亦不效。至四五日，则随乳随吐其半，而泻其
半，腹中已无所留矣。不得已，用人参五六钱，制附、姜、桂各一二钱，下咽即吐，一滴不存，而所下之乳，
洁白无气，犹是乳也。其形气之危，已万无生理。度其寒气犯胃，舍参、姜、桂、附之属，何以为治？既乃悟
其胃虚已极，药之气味略有不投，则随拒而出，且附子味咸，亦能作呕，必其故也。必得甘辣可口之药，庶胃
气可安，乃用胡椒三钱捣碎，煨姜一两，水二钟，煎八分，另用人参二两，水二钟，煎一钟，以茶匙挑合二汤
以配其味。凡用参汤之十，加椒姜汤之一，其味甘而辣，正得可口之宜，遂温至热汤中，徐徐挑与之，经一时
许，皆咽下。自后乳药皆安，但泻仍未止，计半日已尽二两之参矣。参尽后，忽躁扰呻吟，烦剧之甚，家人皆
谓热药内烧所致。因思药果不对，何以初甚相安？此必数日不食，胃气新复，仓廪空虚，饥甚则然也。取粥示
之，果张皇欲得，其状甚急，乃与一小盏，一呷而尽。又欲之，遂与半碗，犹不足，又与半碗，始寂然安卧。
次日，复加制附，得泻止全愈。原其受病之深，用药虽当，气味不投，犹弗获效。至其因饥发躁，使非解悟，
妄用清凉，一剂则全功尽弃，而仍归罪于用参、姜者矣。（叶天士曰∶半岁之婴儿，如此大剂姜、桂等热药，
加之胡椒三钱，人参二两，虽属寒侵，不必如此大剂也。幸而得生，乃粥之功。经云∶五虚者死，粥浆则
生。若竟讲用热药补剂，肠胃何堪消受？景岳将自己三子，以证用热药大补之效，使后人信彼之说。立斋虽
喜用温补，未有若此之甚也。业幼科者，不可执此法以误人。）
薛立斋治一小儿数岁，每停食辄服峻利之剂，后患肚腹膨胀，或呕吐泄泻。先用六君子汤，诸症渐愈。又
用补中益气汤，胃气渐复。
韶州医者刘从周，论小儿吐泻发搐，觉有痰者，但服五苓散入生姜、半夏煎服。吐了痰，泻亦止，惊自退。
（《百乙方》。）
万密斋治疗一个周岁大的小儿，出现呕吐和腹泻同时发作的症状。当时天气非常寒冷，医生使用了理中丸和胃苓丸，但服用后没有效果。万密斋说：“这是表里都有寒邪，没有得到发散。”于是取益黄散给他服用，当天夜里出了大汗，病情就停止了。
另一个半岁大的女孩，也是呕吐和腹泻同时发作，这是伤食（饮食积滞）引起的。之前有外感风邪，所以用益黄散来温散表里的寒邪。这个孩子只是伤食，就用胃苓丸、一粒丹，用陈壁土汤送服，调理脾胃，消除食积，结果呕吐和腹泻都停止了。
还有一个孩子突然剧烈呕吐和腹泻，上下排出的都是未消化的乳汁，使用理中丸服用后见效。
另一个孩子突然剧烈呕吐和腹泻，上下排出的都是黄色水样便，其中含有乳片，使用二陈汤加黄连（用姜汁炒制），煎煮后服用见效。有人问：这两种病症状相同，为什么治疗方法不同？回答说：排出的是未消化的乳汁，说明胃中有寒，所以用理中丸紧急温补。排出的是未消化的乳片，说明胃中有邪热，邪热不能腐熟水谷，适宜用半夏、黄连来解除，这就是同病异治的方法。
张景岳的小儿子，出生在燕地，到白露时节刚满半周岁，偶然感受寒气，呕吐和腹泻大作，立即使用温胃和脾的药物没有效果，随后使用理中等剂量的药物也没有效果。三天后，加入人参三钱以及生姜、肉桂、吴茱萸、肉豆蔻等药，也没有效果。到了第四五天，吃多少吐掉一半，拉出一半，肚子里已经没有任何留存了。不得已，用人参五六钱，制附子、生姜、肉桂各一二钱，喝下去立刻吐出来，一滴也留不住，而拉出的乳汁洁白无气味，还是原来的乳汁。孩子的形体和气机已经非常危险，完全没有生存的希望。推测是寒气侵犯胃部，除了人参、生姜、肉桂、附子这类药物，还能用什么来治疗呢？后来醒悟到他的胃气虚弱到了极点，药物的气味稍微不契合，就会被拒绝吐出，而且附子味道咸，也能引起呕吐，这大概就是原因。必须得到辛辣甘甜可口的药物，才能使胃气安宁，于是用胡椒三钱捣碎，煨姜一两，水两钟，煎至八分，另外用人参二两，水两钟，煎成一钟，用茶匙挑取混合两种药汤以调配味道。凡是十份参汤中加入一份椒姜汤，味道甘甜而辛辣，正符合可口的要求，于是温热后，慢慢喂给他，经过大约一个小时，全部咽下。从此以后，吃奶吃药都安稳了，但是腹泻仍然没有停止，半天时间已经用完了二两人参。人参用完后，忽然烦躁不安呻吟，痛苦非常严重，家人都认为这是热药内烧导致的。心想如果药不对症，为什么刚开始很安稳？这一定是几天没吃东西，胃气刚刚恢复，仓库空虚，极度饥饿才会这样。拿粥给他看，果然慌张想要吃，情况很急，于是给了一小盏，一口喝完。还想吃，就给半碗，还不够，又给半碗，这才安静下来睡觉。第二天，再加制附子，腹泻停止完全痊愈。推究他受病的深度，用药虽然得当，但气味不契合，仍然无法见效。至于因为饥饿引发的烦躁，如果不是理解透彻，胡乱使用清凉药物，一剂药就会让所有努力白费，并且仍然会归罪于使用人参、生姜的人。（叶天士说：半岁的婴儿，如此大剂量的姜、桂等热药，加上胡椒三钱，人参二两，虽然属于寒邪侵袭，不必用如此大剂量。幸好能活下来，是粥的功效。经书说：五虚证者死，喝粥浆则生。如果一味讲究使用热药补剂，肠胃怎么能承受得住？张景岳用自己的三个儿子，来证明使用热药大补的效果，使后人相信他的说法。薛立斋虽然喜欢用温补，也没有像这样严重的。从事儿科的医生，不可固执这种方法而误人。）
薛立斋治疗一个几岁的孩子，每次停食（饮食停滞）就服用峻猛的泻利药物，后来患腹部膨胀，有时呕吐泄泻。先用六君子汤，各种症状逐渐好转。又用补中益气汤，胃气逐渐恢复。
韶州的医生刘从周，论述小儿吐泻并发抽搐，觉得有痰的，只服用五苓散加入生姜、半夏煎煮后服用。吐掉了痰，腹泻也停止，惊厥自然消退。（《百乙方》。）
Wan Mizhai treated a one-year-old infant who presented with simultaneous vomiting and diarrhea. At that time, the weather was extremely cold. The physician prescribed Lizhong Wan (Cinnamon Twig and Atractylodes Macrocephala Pill) and Weiling Wan (Stomach and Five Ling Pill), but there was no effect after administration. Wan said: "This is due to cold pathogens in both the exterior and interior that have not been dispersed." He then administered Yihuang San (Yellow Protecting Powder). That night, the child sweated profusely, and the condition ceased.
Another girl, aged half a year, also presented with simultaneous vomiting and diarrhea, which was caused by food stagnation (accumulation of undigested food). She had previously contracted wind pathogens externally; therefore, Yihuang San was used to warm and disperse the cold in the exterior and interior. This case involved only food stagnation, so Weiling Wan (Stomach and Five Ling Pill) and Yili Dan (One Pill Elixir) were administered with Chenbitu Decoction (Decoction of Old Wall Soil) to regulate the spleen and stomach, eliminate food stagnation, resulting in the cessation of both vomiting and diarrhea.
An infant suffered from sudden severe vomiting and diarrhea, expelling undigested milk through both upper and lower orifices. Lizhong Wan (Cinnamon Twig and Atractylodes Macrocephala Pill) was administered with good effect.
Another infant suffered from sudden severe vomiting and diarrhea, expelling yellow watery stool containing milk curds. Erchen Tang (Two-Cured Decoction) was modified with Huanglian (Rhizoma Coptidis) stir-fried with ginger juice, decocted and administered with good effect. Someone asked: "The two diseases present similarly, yet the treatments differ. Why?" The answer was: "When undigested milk is expelled, it indicates cold in the stomach; thus, Lizhong Wan (Cinnamon Twig and Atractylodes Macrocephala Pill) is used to urgently warm it. When undigested milk curds are expelled, it indicates pathogenic heat in the stomach; pathogenic heat fails to digest grain, so Banxia (Rhizoma Pinelliae) and Huanglian (Rhizoma Coptidis) are suitable to resolve it. This illustrates the principle of treating the same disease with different methods."
Zhang Jingyue's youngest son was born in the Yan region. By the time of Bailu (White Dew solar term), he was just half a year old. He accidentally contracted cold, leading to severe vomiting and diarrhea. Medicines for warming the stomach and harmonizing the spleen were ineffective. Subsequently, Lizhong Wan (Cinnamon Twig and Atractylodes Macrocephala Pill) at standard doses was also ineffective. After three days, Ren Shen (Radix Ginseng) 3 qian, along with Shengjiang (Rhizoma Zingiberis Recens), Rougui (Cortex Cinnamomi), Wuzhuyu (Fructus Evodiae), and Roudoukou (Nucis Arecae Semina) were added, but still without effect. By the fourth or fifth day, he vomited half of whatever milk he drank and defecated the other half; nothing remained in his abdomen. Desperately, Ren Shen (Radix Ginseng) 5-6 qian, Zhi Fuzi (Prepared Radix Aconiti Lateralis), Shengjiang (Rhizoma Zingiberis Recens), and Rougui (Cortex Cinnamomi) 1-2 qian each were given. However, upon swallowing, he vomited immediately, retaining not a drop. The excreted milk was white, odorless, and unchanged. His physical form and qi were critically endangered, with no hope of survival. It was deduced that cold pathogens had invaded the stomach; apart from Ren Shen (Radix Ginseng), Shengjiang (Rhizoma Zingiberis Recens), Rougui (Cortex Cinnamoni), and Fuzi (Radix Aconiti Lateralis), what else could be used? Then it was realized that his stomach qi was extremely deficient; even slight mismatch in the flavor and aroma of medicines would cause rejection and vomiting. Moreover, Fuzi (Radix Aconiti Lateralis) has a salty taste and can induce vomiting, which might be the cause. Medicines with sweet and spicy flavors acceptable to the palate were needed to calm the stomach qi. Thus, Hu Jiao (Piperis Longi Fructus) 3 qian was crushed, and Wei Jiang (Roasted Rhizoma Zingiberis) 1 liang were decocted in 2 zhong of water until reduced to 0.8 zhong. Separately, Ren Shen (Radix Ginseng) 2 liang were decocted in 2 zhong of water until reduced to 1 zhong. These two decoctions were mixed using a tea spoon to balance their flavors. For every ten parts of Ren Shen (Radix Ginseng) decoction, one part of Hu Jiao (Piperis Longi Fructus) and Wei Jiang (Roasted Rhizoma Zingiberis) decoction was added. The mixture was sweet and spicy, perfectly palatable. It was warmed and slowly administered with a tea spoon. After about an hour, all of it was swallowed. Thereafter, milk and medicine were tolerated well, although diarrhea persisted. In half a day, 2 liang of Ren Shen (Radix Ginseng) had been consumed. After the Ren Shen (Radix Ginseng) was exhausted, the child suddenly became restless and moaned, suffering severely. The family believed this was caused by internal burning from hot medicines. Thinking further: if the medicine were incorrect, why was there initial tolerance? This must be due to several days of fasting, new recovery of stomach qi, empty storage organs, and extreme hunger. Porridge was shown to him, and he indeed showed anxiety and desire to eat, urgently so. A small cup was given, which he finished in one sip. He wanted more, so half a bowl was given, which was insufficient. Another half bowl was given, after which he lay down quietly. The next day, Zhi Fuzi (Prepared Radix Aconiti Lateralis) was added, and the diarrhea stopped, leading to full recovery. Analyzing the depth of the disease, although the treatment was appropriate, the mismatch in flavor and aroma prevented efficacy. Regarding the restlessness caused by hunger, if not understood correctly, cooling medicines would have been wrongly used, ruining all efforts in one dose, and blame would still fall on those using Ren Shen (Radix Ginseng) and Shengjiang (Rhizoma Zingiberis Recens). (Ye Tianshi commented: For a six-month-old infant, such large doses of hot medicines like Shengjiang (Rhizoma Zingiberis Recens) and Rougui (Cortex Cinnamomi), plus 3 qian of Hu Jiao (Piperis Longi Fructus) and 2 liang of Ren Shen (Radix Ginseng), though due to cold invasion, need not be so large. Fortunately, survival was achieved thanks to the porridge. The Classics state: Those with five deficiencies die; those who consume porridge and fluids live. If one strictly advocates using hot tonifying medicines, how can the intestines and stomach endure? Zhang Jingyue used his own three sons to demonstrate the efficacy of hot tonifying medicines, causing later generations to believe his theory. Although Xue Lizhai favored warm tonification, he never went to such extremes. Pediatricians should not rigidly adhere to this method and harm patients.)
Xue Lizhai treated a child of several years old who, whenever food stagnation occurred, took harsh purgative medicines. Later, he developed abdominal distension, sometimes accompanied by vomiting and diarrhea. Liujunzi Tang (Six Gentlemen Decoction) was first used, and various symptoms gradually improved. Then, Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) was used, and stomach qi gradually recovered.
Liu Congzhou, a physician from Shaozhou, discussed pediatric vomiting, diarrhea, and convulsions. If phlegm was suspected, only Wuling San (Five Ling Powder) decocted with Shengjiang (Rhizoma Zingiberis Recens) and Banxia (Rhizoma Pinelliae) should be administered. Once phlegm was vomited out, diarrhea would stop, and fright/convulsions would subside naturally. (From *Baibai Fang*.)