〔曾〕小儿吐泻并作，即名霍乱，有心痛而先吐者，有腹痛而先泻者，莫不由中焦而作。上焦主纳而不出，
中焦主腐化水谷而生荣卫，灌溉百骸，下焦分别水谷，主出而不纳，脾居中州，胃为水谷之海，乳哺入胃，
脾能克化，然后水谷分（脐上一寸有分水穴）传变得宜，岂有吐泻之患。凡小儿吐泻，皆因六气未完，六淫易
侵，兼以调护失宜，乳食不节，遂使脾胃虚弱，清浊相干蕴作而然。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，要须详审。〔娄〕
吐泻昏睡露睛者，胃虚热，钱氏白术散、和中散、主之。吐泻昏睡不露睛者，胃实热，钱氏玉露散、河间
益元散、主之。〔薛〕手足指冷者，脾气虚寒也，用异功散加木香。伤风吐泻者，风木克脾土也，亦用前
药。若饮热乳而泻黄者，湿热壅滞也，用四苓散。如不愈或反甚者，元气复伤也，用白术散。泻而腹中重坠者，脾
气下陷也，用补中益气汤。若服克滞之剂，而腹中窄狭者，脾气虚痞也，用六君子汤。若面黄泻青，脾虚而肝
乘之也，用六君柴胡、升麻、木香。若多噫泻黄，心脾气虚也，用六君炮姜、升麻。生下半月旬日内吐
者，止宜调治其母，恐婴儿脏腑脆弱，不胜药饵故也。
[曾氏观点] 小儿同时出现呕吐和腹泻，就称为霍乱。有的先心痛然后呕吐，有的先腹痛然后腹泻，这些都没有不是从中焦病变引起的。上焦主管受纳而不外泄，中焦主管消化腐熟水谷并生成营卫之气，灌溉全身骨骼，下焦分别清浊水谷，主管排泄而不受纳。脾位于中州（人体中部），胃是水谷之海，乳汁和食物进入胃后，如果脾能正常运化，那么水谷就能分清别浊（脐上一寸有分水穴），传导变化得当，怎么会有呕吐腹泻的祸患呢？大凡小儿吐泻，都是因为六气尚未完善，六淫邪气容易侵袭，加上护理不当，乳食没有节制，致使脾胃虚弱，清气与浊气相互干扰蕴结而造成的。
有先腹泻而后呕吐的，这是脾胃虚冷，其症状是先泻出白水，呕吐也不多，口气缓和而神色倦怠，额头前有汗，六脉沉濡，这属于寒证。
先呕吐而后腹泻的，这是脾胃有热，呼吸急促嘴唇发红，呕吐时面色赤红，脉象洪大而数，口渴想喝水浆，这属于热证。冷热之分，必须详细审察。
[娄氏观点] 吐泻且昏睡、眼睛半睁露睛的，是胃虚热，用钱乙的白术散、和中散来主治。吐泻且昏睡、眼睛紧闭不露睛的，是胃实热，用钱乙的玉露散、刘完素的河间益元散来主治。
[薛氏观点] 手足指头冷的，是脾气虚寒，用异功散加木香。伤风引起的吐泻，是风木克制脾土，也用前面的药方。如果是喝热奶后拉黄便的，是湿热壅滞，用四苓散。如果服药后不见好或者反而加重，是元气再次受损，用白术散。腹泻且腹部有沉重下坠感的，是脾气下陷，用补中益气汤。如果服用消导积滞的药物后，感觉腹部狭窄痞闷的，是脾气虚导致的痞证，用六君子汤。如果面色发黄、大便发青，是脾虚而肝气乘袭，用六君子汤加柴胡、升麻、木香。如果经常打嗝、大便发黄的，是心脾气虚，用六君子汤加炮姜、升麻。出生半个月到十天内的婴儿发生呕吐，只适宜调理母亲的身体，恐怕婴儿脏腑脆弱，承受不住药力所致。
[Zeng's View] When an infant simultaneously experiences vomiting and diarrhea, it is termed Huoluan (Catastrophic Disorder). Some cases involve heart pain preceding vomiting, while others involve abdominal pain preceding diarrhea; none of these arise without pathology in the Middle Jiao (Middle Burner). The Upper Jiao governs reception without discharge, the Middle Jiao governs the decomposition and transformation of food and fluids to generate Ying and Wei (Nutritive and Defensive Qi), irrigating the bones and tissues, and the Lower Jiao separates clear from turbid food and fluids, governing discharge without reception. Spleen resides in the Central Region (Zhongzhou), and Stomach is the Sea of Food and Fluids. After milk and food enter the Stomach, if the Spleen can transform them properly, then food and fluids will be separated into clear and turbid components (there is a Fen Shui Acupoint one cun above the umbilicus), and their transmission and transformation will be appropriate. How could there be the affliction of vomiting and diarrhea? Generally, infant vomiting and diarrhea occur because the Six Qi are not yet fully mature, making the child susceptible to invasion by the Six Excesses (Liu Yin). Coupled with improper care and irregular feeding, this leads to Spleen-Stomach deficiency, where clear and turbid energies interfere with each other and accumulate, resulting in the condition.
In cases where diarrhea precedes vomiting, it indicates Coldness of the Spleen and Stomach. The signs include first passing watery white stool, with little vomiting, slow breath, lethargic expression, sweating on the forehead, and deep, soggy pulses throughout all six positions. This is classified as Cold.
In cases where vomiting precedes diarrhea, it indicates Heat in the Spleen and Stomach. The signs include rapid breathing, red lips, flushed face during vomiting, surging and rapid pulses, and thirst for drinking. This is classified as Heat. The distinction between Cold and Heat must be carefully examined.
[Lou's View] In cases of vomiting and diarrhea accompanied by drowsiness and eyes partially open (exposing the pupils), it is Deficient-Heat of the Stomach, treated with Bai Zhu San (Atractylodes Macrocephala Powder) or He Zhong San (Harmonizing the Center Powder) formulated by Qian Yi. In cases of vomiting and diarrhea accompanied by drowsiness but eyes tightly closed (not exposing the pupils), it is Excess-Heat of the Stomach, treated with Yu Lu San (Jade Dew Powder) or Yi Yuan San (Benefit Primordial Powder) from Liu Wansu.
[Xue's View] Coldness of the fingers and toes indicates Deficient-Cold of the Spleen Qi, treated with Yi Gong San (Extraordinary Merit Powder) added with Mu Xiang (Costus Root). Vomiting and diarrhea caused by Wind-Cold attack indicate Wood overcoming Earth (Liver wind attacking Spleen), also treated with the aforementioned formula. If yellow stool results from drinking hot milk, it indicates Damp-Heat stagnation, treated with Si Ling San (Four Poria Powder). If the condition does not improve or worsens after medication, it indicates further injury to Yuan Qi (Primal Qi), treated with Bai Zhu San. Diarrhea accompanied by a heavy, bearing-down sensation in the abdomen indicates Sinking of Spleen Qi, treated with Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction). If abdominal tightness and fullness occur after taking purgative or stagnation-resolving agents, it indicates Pi Syndrome (fullness obstruction) due to Spleen Qi deficiency, treated with Liu Jun Zi Tang (Six Gentlemen Decoction). Yellow complexion with green stool indicates Spleen deficiency with Liver overacting, treated with Liu Jun Zi Tang added with Chai Hu (Bupleurum Root), Sheng Ma (Cimicifuga Rhizome), and Mu Xiang. Frequent belching with yellow stool indicates Deficiency of Heart and Spleen Qi, treated with Liu Jun Zi Tang added with Pao Jiang (Prepared Ginger) and Sheng Ma. For infants aged half a month to ten days experiencing vomiting, treatment should focus on regulating the mother's body, as the infant's Zang-Fu organs are fragile and may not withstand medicinal dosage.