经云∶胃伤则吐。小儿热吐者，因多食甘甜炙 之物；或乳母膏粱浓味，胃经积热；或夏间
暑气内伏于胃所致。若肌肉 动，烦热作渴者，暑伤胃气也，先用香薷饮，次用竹茹汤。若
吐乳色黄不能受纳者，胃经有热也，先用泻黄散，次用人参安胃散。若吐出酸秽者，乳食内
停也，用保和丸。吐乳不消者，胃气弱也，用异功散。吐而少食，腹痛欲按者，脾气虚也，
用六君子加木香。凡诸症当验其手足，热则胃热，冷则胃寒，热用泻黄散，寒用理中汤，不
热不寒，异功散调之。
治验
一小儿夏月吐乳，手指发热，作渴饮冷，口吐涎水，余谓胃气热，廉泉开而涎出也，用泻
黄散而愈。后复呕吐，另用克滞之剂，口渴饮汤，流涎不已，余谓胃气虚寒，不能摄涎也，
用理中丸而愈。
一小儿七岁，呕吐不食，面白指冷，此胃气虚寒也，用理中汤；呕吐顿愈，又用六君子汤而
痊。后伤食腹痛，发热呕吐流涎，先用保和丸一服，而痛呕愈；再用四君、山栀而涎止。
一小儿食凉粉，而呕吐酸物，头痛发热，此内伤兼外感也，用人参养胃汤末二钱，姜汤调服
，诸症皆愈；惟吐酸涎，用大安丸一服而止。
一小儿伤食发热，呕吐酸物，手指常冷，此胃气虚寒，阴盛隔阳于外，虚热所致也，用保和
丸末二钱，浓姜汤调服而吐止，再用六君子汤加山栀而安。
一小儿呕吐作渴，暑月或用玉露饮子之类而愈。又伤食吐酸，余先用保和丸一服，吐止，次
用五味异功散，饮食渐进，又用四君子汤而痊。
一小儿暑月患吐泻，服香薷饮、五苓散之类而止，但手足并冷，睡而露睛，饮食不入，肠鸣
作呕，欲用清凉之剂。余曰∶此始为热，终为寒也，当舍时从症。用人参理中丸，以姜汤化
二服，病势始定；次用助胃膏渐安；又用六君子汤，调理而愈。
一小儿饮食多即吐，余用五味异功散愈之。又腹痛呕吐，先服大安丸，仍用异功散而愈。后
症复作，另投祛逐之剂，吐泻不食，腹中痛甚，以手按之则止，此脾气复伤也，先用补中益
气汤加茯苓、半夏一剂，又用六君子、升麻、柴胡二剂，饮食顿进。后食生冷，挟惊吐泻，手足并冷
，唇口搐动，用六君、钩藤钩、柴胡而愈。
一小儿吐酸，作渴饮冷，腹痛发热，用人参养胃汤加黄连一剂，吐热稍定；又用保和丸一服
，腹痛顿止。后伤食复吐，腹胀大便不通，用紫霜丸下之寻愈。又感冒咳嗽腹胀，另服下药
，发热作吐，腹胀，手足并冷，睡而露睛，发搐，用六君、钩藤钩而安，又用四君加当归、
川芎而愈。后患吐泻，手足并冷，用助胃膏顿痊。
一小儿呕吐发热，用泻黄散而愈。后因乳母饮酒，腹胀吐泻，用葛花解醒汤，子母服之渐愈
，大便日去五七次，用五味异功散加升麻二剂，日去三次，乃用四君、肉豆蔻而痊。
一小儿吐酸发热，用保和丸渐愈，又用四君、山楂、神曲而安。后因饮食过多，呕吐复作，
另用下积丸，更加作泻腹胀，手足发搐。余以为肝木侮脾，用五味异功散加柴胡、钩藤钩而
搐止，又用六君子汤，饮食渐进而痊。
一小儿夏间呕吐腹痛，大便不通，服大黄药而愈。又伤食患吐发热，服泻黄散等药，呕吐腹
痛，按之即止，面色青黄，手足并冷，此脾胃复伤而虚寒也，用异功散加木香愈之。后又伤
食，腹胀作痛，或用消食丸，吐泻并作，小腹重坠，午后益甚，余朝用补中益气汤，夕用六
君子加木香而愈。
一小儿呕吐，发热腹痛，面赤手热，口干饮汤，按其腹不痛，此脾胃气虚也，用异功散加木
香、干姜一剂而愈。后伤食，吐而咽酸，腹中作痛，按之益甚，此饮食内停也，用保和丸二
服而痊。
葛花解醒汤 治乳母酒醉后，乳儿遗热为患。
白豆蔻 砂仁 葛花（各五钱） 干生姜 白术 泽泻 神曲（炒黄。各二钱） 白茯苓 陈皮 人
参猪苓 木香（五分） 青皮（三分）
上为末，每服二钱，白汤调服。
愚按∶前汤先哲不得已而用之，盖醉酒耗气，又复辛散，重损真阴，折人长命，可不慎哉！
助胃膏 治脾胃虚寒吐泻等症。
人参 白术 白茯苓 甘草（炙） 丁香（各五钱） 砂仁（四十个） 木香（三钱） 白豆蔻（十四个） 干山
药（一两） 肉豆蔻（四个，煨）
上为末，蜜丸，芡实大。每服十丸，米汤化下。
香薷散（方见热吐）
竹茹汤
五苓散（二方并见五淋）
玉露散
补中益气汤
大安丸
保和丸（四方见虚羸）
六君子汤
四君子汤（二方见天钓）
泻黄散
人参安胃散（二方见脾脏）
理中丸（方见冷泻）
人参养胃汤（方见疟症）
《黄帝内经》说：胃气受损就会发生呕吐。小儿热性呕吐，是因为过多食用甘甜、烤炙的食物；或者乳母食用肥美厚味的食物，导致胃经积热；或者是夏季暑气内伏于胃所致。如果肌肉跳动，烦躁发热且口渴，这是暑邪损伤了胃气，应当先用香薷饮，再用竹茹汤。如果吐出的乳汁颜色发黄且不能受纳，这是胃经有热，应当先用泻黄散，再用人参安胃散。如果吐出酸腐秽浊之物，这是乳食停滞在体内，使用保和丸。吐出乳汁且不消化，这是胃气虚弱，使用异功散。呕吐且进食少，腹痛且喜欢按压，这是脾气虚弱，使用六君子汤加木香。凡是这些症状，都应当检查患儿的手足，手足热则是胃热，用泻黄散；手足冷则是胃寒，用理中汤；不热也不冷，用异功散调理。
治验记录：
有一个小儿在夏季呕吐乳汁，手指发热，口渴想喝冷水，口吐涎水，我认为这是胃气热，廉泉穴开泄导致涎水流出，使用泻黄散而痊愈。后来再次呕吐，另用了消食导滞的药物，口渴想喝热水，流涎不止，我认为这是胃气虚寒，不能摄纳涎水，使用理中丸而痊愈。
有一个七岁的小儿，呕吐不想吃东西，面色苍白，手指发冷，这是胃气虚寒，使用理中汤；呕吐立刻停止，又用六君子汤而康复。后来因伤食导致腹痛，发热呕吐并流涎，先用保和丸一服，疼痛和呕吐就停止了；再用四君子汤加山栀，涎水就止住了。
有一个小儿吃了凉粉，出现呕吐酸物、头痛发热，这是内伤饮食兼外感邪气，用人参养胃汤粉末二钱，姜汤调服，各种症状都好了；只有吐酸涎，用大安丸一服就止住了。
有一个小儿因伤食发热，呕吐酸物，手指经常发冷，这是胃气虚寒，阴盛格阳于外，导致的虚热，使用保和丸粉末二钱，浓姜汤调服，呕吐就停止了，再用六君子汤加山栀而安定。
有一个小儿呕吐且口渴，在暑月可能用玉露饮子之类的药物而痊愈。又有伤食吐酸的情况，我先用保和丸一服，呕吐停止，接着用五味异功散，饮食逐渐增加，又用四君子汤而康复。
有一个小儿在暑月患呕吐腹泻，服用香薷饮、五苓散等药物后停止，但手脚都冷，睡觉时眼睛半睁（露睛），饮食不进，肠鸣作呕，想要用清凉的药物。我说：这开始是热证，最终转为寒证，应当舍弃季节因素而从症状论治。用人参理中丸，用姜汤化开服用两剂，病势才稳定；接着用助胃膏逐渐好转；又用六君子汤，调理后痊愈。
有一个小儿吃多了就吐，我用五味异功散治愈了他。又有腹痛呕吐，先服大安丸，仍用异功散而痊愈。后来症状复发，另投祛逐邪气的药物，导致吐泻不吃东西，腹中剧痛，用手按压则疼痛停止，这是脾气再次受伤，先用补中益气汤加茯苓、半夏一剂，又用六君子汤加升麻、柴胡两剂，饮食立刻增进。后来吃了生冷食物，挟带惊风导致吐泻，手脚都冷，嘴唇口角抽动，用六君子汤加钩藤、柴胡而痊愈。
有一个小儿吐酸，口渴喝冷水，腹痛发热，用人参养胃汤加黄连一剂，呕吐热象稍定；又用保和丸一服，腹痛立刻停止。后来伤食再次呕吐，腹胀大便不通，用紫霜丸攻下，不久痊愈。又感冒咳嗽腹胀，另服下药，发热作吐，腹胀，手脚都冷，睡觉露睛，抽搐，用六君子汤加钩藤而安定，又用四君子汤加当归、川芎而痊愈。后来患吐泻，手脚都冷，用助胃膏立刻康复。
有一个小儿呕吐发热，用泻黄散而痊愈。后来因为乳母饮酒，小儿腹胀吐泻，用葛花解醒汤，母子同服逐渐痊愈，每天大便去五到七次，用五味异功散加升麻两剂，每天去三次，于是用四君子汤加肉豆蔻而康复。
有一个小儿吐酸发热，用保和丸逐渐痊愈，又用四君子汤加山楂、神曲而安定。后来因为饮食过多，呕吐复发，另用下积丸，更加严重地导致腹泻腹胀，手脚抽搐。我认为这是肝木侮脾，用五味异功散加柴胡、钩藤，抽搐停止，又用六君子汤，饮食逐渐增加而康复。
有一个小儿在夏季呕吐腹痛，大便不通，服用大黄药而痊愈。又因伤食患呕吐发热，服用泻黄散等药，呕吐腹痛，按压即止，面色青黄，手脚都冷，这是脾胃再次受伤而虚寒，用异功散加木香治愈他。后来又伤食，腹胀作痛，或用消食丸，吐泻并作，小腹重坠，午后更严重，我早晨用补中益气汤，晚上用六君子汤加木香而痊愈。
有一个小儿呕吐，发热腹痛，面赤手热，口干想喝热水，按腹部不痛，这是脾胃气虚，用异功散加木香、干姜一剂而痊愈。后来伤食，吐而咽酸，腹中作痛，按压更甚，这是饮食停滞在体内，用保和丸两服而康复。
葛花解醒汤：治疗乳母醉酒后进乳，遗热给婴儿造成的病患。
白豆蔻、砂仁、葛花（各五钱）、干生姜、白术、泽泻、神曲（炒黄，各二钱）、白茯苓、陈皮、人参、猪苓、木香（五分）、青皮（三分）。
以上研为末，每次服二钱，白开水调服。
我按语：前面的方剂是先哲不得已而使用的，大概是因为醉酒耗气，又加上辛散之品，严重损伤真阴，折损人的寿命，能不谨慎吗！
助胃膏：治疗脾胃虚寒引起的呕吐腹泻等症状。
人参、白术、白茯苓、甘草（炙）、丁香（各五钱）、砂仁（四十个）、木香（三钱）、白豆蔻（十四个）、干山药（一两）、肉豆蔻（四个，煨）。
以上研为末，蜂蜜制丸，如芡实大小。每次服十丸，米汤化下。
香薷散（方见热吐）
竹茹汤
五苓散（二方并见五淋）
玉露散
补中益气汤
大安丸
保和丸（四方见虚羸）
六君子汤
四君子汤（二方见天钓）
泻黄散
人参安胃散（二方见脾脏）
理中丸（方见冷泻）
人参养胃汤（方见疟症）
The *Classic of Medicine* (Huangdi Neijing) states: "When the Stomach is injured, vomiting occurs." Pediatric heat-type vomiting is caused by excessive consumption of sweet and roasted foods; or by the wet nurse consuming rich and greasy foods, leading to accumulated heat in the Stomach meridian; or due to summer-heat qi lying dormant within the Stomach during summer. If muscle twitching, irritability, fever, and thirst occur, this indicates summer-heat damaging Stomach Qi; initially use Xiangru Yin (Elsholtzia Decoction), followed by Zhuru Tang (Bamboo Shavings Decoction). If the vomited milk is yellow and cannot be retained, this indicates heat in the Stomach meridian; initially use Xiehuang San (Drain the Yellow Powder), followed by Renshen Anwei San (Ginseng Stomach-Calming Powder). If sour and foul matter is vomited, this indicates retention of milk and food internally; use Baohe Wan (Harmonize the Stomach Pill). If vomited milk is not digested, this indicates weak Stomach Qi; use Yigong San (Extraordinary Assistance Powder). If vomiting occurs with little food intake, abdominal pain that prefers pressure, this indicates Spleen Qi deficiency; use Liujunzi Tang (Six Gentlemen Decoction) added with Muxiang (Aucklandiae Radix). For all these symptoms, examine the hands and feet: if hot, it is Stomach heat, treated with Xiehuang San; if cold, it is Stomach cold, treated with Lizhong Tang (Regulate the Middle Decoction); if neither hot nor cold, regulate with Yigong San.
Clinical Cases:
One infant vomited milk in summer, with hot fingers, thirst desiring cold drinks, and salivation. I diagnosed this as heat in Stomach Qi causing the opening of Lianquan (Conduction Spring acupoint) and salivation; cured with Xiehuang San. Later, vomiting recurred, and another agent for stagnation was used. The child became thirsty for warm drinks and salivated incessantly. I diagnosed this as deficiency-cold of Stomach Qi failing to control saliva; cured with Lizhong Wan (Regulate the Middle Pill).
One seven-year-old child vomited and refused food, with a pale face and cold fingers, indicating deficiency-cold of Stomach Qi. Treated with Lizhong Tang; vomiting ceased immediately. Then treated with Liujunzi Tang for recovery. Later, due to food injury causing abdominal pain, fever, vomiting, and salivation, initially one dose of Baohe Wan stopped the pain and vomiting; then Sizijunzi Tang (Four Gentlemen Decoction) added with Shanzhi (Gardeniae Fructus) stopped the salivation.
One child ate cold jelly, resulting in vomiting of sour substances, headache, and fever. This indicated internal injury combined with external contraction. Treated with two qian of Renshen Yangwei Tang (Ginseng Nourishing Stomach Decoction) powder, mixed with ginger decoction; all symptoms resolved. Only the vomiting of sour saliva remained, which stopped after one dose of Da'an Wan (Great Peace Pill).
One child had food-injury fever, vomiting of sour substances, and frequently cold fingers. This indicated deficiency-cold of Stomach Qi, with excess Yin repelling Yang to the exterior, causing deficient heat. Treated with two qian of Baohe Wan powder, mixed with strong ginger decoction; vomiting stopped. Then stabilized with Liujunzi Tang added with Shanzhi.
One child vomited and felt thirsty; in summer, cured with agents like Yulu Yinzi (Jade Dew Drink). Another case of food-injury vomiting of sour substances: initially one dose of Baohe Wan stopped vomiting; then Wuweiyigong San (Five-Ingredient Extraordinary Assistance Powder) allowed gradual dietary intake; finally cured with Sizijunzi Tang.
One child suffered from vomiting and diarrhea in summer. After taking Xiangru Yin and Wuling San (Five-Ingredient Poria Decoction), symptoms stopped, but hands and feet were cold, eyes opened while sleeping (exposing pupils), no food intake, borborygmus, and vomiting. One wished to use cooling agents. I said: "This started as heat but ended as cold. Discard the season and treat according to symptoms." Used Renshen Lizhong Wan, dissolved in ginger decoction, two doses; condition stabilized. Then gradually improved with Zhuwei Gao (Stomach-Assisting Paste); finally cured with Liujunzi Tang.
One child vomited when eating too much; cured with Wuweiyigong San. Another case of abdominal pain and vomiting: first took Da'an Wan, then Yigong San for recovery. Later, symptoms recurred, and dispersing agents were given, leading to vomiting, diarrhea, anorexia, severe abdominal pain relieved by pressure. This indicated re-injury of Spleen Qi. First, one dose of Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) added with Fuling (Poria) and Banxia (Pinelliae Rhizoma); then two doses of Liujunzi Tang added with Shengma (Cimicifugae Rhizoma) and Chaihu (Bupleuri Radix); diet improved abruptly. Later, after eating raw/cold food, complicated by fright-induced vomiting and diarrhea, cold hands and feet, and lip/mouth twitching; cured with Liujunzi Tang added with Goutenggou (Uncariae Ramulus cum Uncis) and Chaihu.
One child vomited sour substances, thirstily drank cold water, had abdominal pain and fever. One dose of Renshen Yangwei Tang added with Huanglian (Coptidis Rhizoma) slightly settled the heat and vomiting; one dose of Baohe Wan stopped abdominal pain immediately. Later, recurrent vomiting due to food injury, abdominal distension, and constipation; treated with Zishuang Wan (Purple Frost Pill) to purge; recovered soon. Subsequently, caught a cold with cough and abdominal distension; took purgatives, leading to fever, vomiting, abdominal distension, cold hands and feet, exposed pupils while sleeping, and convulsions. Stabilized with Liujunzi Tang added with Goutenggou; cured with Sizijunzi Tang added with Danggui (Angelicae Sinensis Radix) and Chuanxiong (Ligustici Chuanxiong Rhizoma). Later suffered from vomiting and diarrhea with cold hands and feet; instantly recovered with Zhuwei Gao.
One child vomited and had fever; cured with Xiehuang San. Later, because the wet nurse drank alcohol, the child had abdominal distension, vomiting, and diarrhea. Gehua Jiexing Tang (Kudzu Flower Awakening Intoxication Decoction) was taken by both mother and child; gradually improved. Bowel movements went 5-7 times daily; two doses of Wuweiyigong San added with Shengma reduced this to three times daily; finally cured with Sizijunzi Tang added with Roudoukou (Myristicae Semen).
One child vomited sour substances and had fever; gradually improved with Baohe Wan, then stabilized with Sizijunzi Tang added with Shanzha (Crataegi Fructus) and Shenqu (Medicated Leaven). Later, due to overeating, vomiting recurred. Another stasis-purging pill was used, worsening diarrhea and abdominal distension, with hand/foot convulsions. I diagnosed this as Liver Wood insulting Spleen Earth. Convulsions stopped with Wuweiyigong San added with Chaihu and Goutenggou; diet gradually improved and recovered with Liujunzi Tang.
One child had summer vomiting and abdominal pain, with constipation; cured with Dahuang (Rhei Radix et Rhizoma) medicine. Later, food-injury fever and vomiting occurred; took Xiehuang San etc., resulting in vomiting and abdominal pain relieved by pressure, green-yellow complexion, and cold hands/feet. This indicated re-injury of Spleen and Stomach leading to deficiency-cold; cured with Yigong San added with Muxiang. Later, food injury caused abdominal distension and pain; took Xiaoshi Wan (Digestive Pills), resulting in simultaneous vomiting and diarrhea, heavy bearing sensation in lower abdomen, worse in afternoon. Morning treatment with Buzhong Yiqi Tang, evening with Liujunzi Tang added with Muxiang; cured.
One child vomited, had fever and abdominal pain, red face, hot hands, dry mouth desiring warm drinks, but no pain upon abdominal palpation. This indicated Spleen-Stomach Qi deficiency; cured with one dose of Yigong San added with Muxiang and Ganjiang (Zingiberis Rhizoma). Later, food injury led to vomiting with sour throat, abdominal pain worsening on pressure. This indicated food retention internally; cured with two doses of Baohe Wan.
Gehua Jiexing Tang: Treats ailments caused by heat transmitted to the infant via breast milk after the wet nurse's intoxication.
Baiddoukou (Cardamomi Albi Fructus), Sharen (Amomi Fructus), Gehua (Puerariae Flos) (each 5 qian), Ganshengjiang (Dry Ginger), Baizhu (Atractylodis Macrocephalae Rhizoma), Zexie (Alismatis Rhizoma), Shenqu (Medicated Leaven, stir-fried until yellow) (each 2 qian), BaiFuling (Poria), Chenpi (Citri Reticulatae Pericarpium), Renshen (Ginseng Radix et Rhizoma), Zhuling (Polypori Umbellati mycelia), Muxiang (Aucklandiae Radix) (0.5 qian), Qingpi (Citri Reticulatae Pericarpium Viride) (0.3 qian).
Grind into powder. Take 2 qian each time, mixed with white boiled water.
My Commentary: The aforementioned formulas were used by sages out of necessity. Alcohol consumption depletes Qi, and the pungent-dispersing nature further damages True Yin, shortening lifespan. How can one not be cautious!
Zhuwei Gao: Treats vomiting and diarrhea due to Spleen-Stomach deficiency-cold.
Renshen (Ginseng Radix et Rhizoma), Baizhu (Atractylodis Macrocephalae Rhizoma), BaiFuling (Poria), Gancao (Licorice Radix et Rhizoma, honey-fried), Dingxiang (Caryophylli Flos) (each 5 qian), Sharen (Amomi Fructus) (40 units), Muxiang (Aucklandiae Radix) (3 qian), Baiddoukou (Cardamomi Albi Fructus) (14 units), Ganshanyao (Dioscoreae Rhizoma, dried) (1 liang), Roudoukou (Myristicae Semen, baked) (4 units).
Grind into powder, make pills with honey, size of Euryale Seed. Take 10 pills each time, dissolved in rice soup.
Xiangru San (Formula seen in Heat Vomiting)
Zhuru Tang
Wuling San (Two formulas seen in Five Types of Dysuria)
Yulu San
Buzhong Yiqi Tang
Da'an Wan
Baohe Wan (Four formulas seen in Emaciation)
Liujunzi Tang
Sizijunzi Tang (Two formulas seen in Heavenly Fishing/Convulsions)
Xiehuang San
Renshen Anwei San (Two formulas seen in Spleen Organ)
Lizhong Wan (Formula seen in Cold Diarrhea)
Renshen Yangwei Tang (Formula seen in Malaria)