《痘疹方》云∶痘疹吐泻，盖因脾胃不和，饮食不调，烦渴，呕吐泄泻，并用白术散。然疮疹皆赖脾土，脾土实则
易出易靥，万物得土气，温暖而生，吐泻则伤脾土，遂有更变之症。夏月中暑烦渴泻，或腹痛，或欠筋，用五苓散加藿
香。伤食吐泻，用小异功散。手足并冷者，用益黄散、豆蔻丸。顶陷灰白，用木香散。疮正出而吐泻者，或见血者，俱
为逆症，难治。窃谓前症虽因脾胃不和，然邪实上焦则宜吐，邪实下焦则宜泻。如吐泻嗳腐吞酸，皆宜宣发，但微甚不
同耳。张翼之云∶若痘疹吐泻少食为里虚，陷伏倒靥灰白为表虚，二者俱见为表里俱虚，合用十二味异功散救之，甚至
姜、附、灵砂亦可用。若止里虚，去官桂。止表虚，减肉豆蔻。若能食便秘倒靥为里实，忌补，当用钱氏及丹溪法下之。
皆为能食为里实，里实而补，则结痈毒。红活绽凸为表实，表实而补，则溃烂不结痂。凡痘见 ，便忌葛根汤，恐发表
虚也。如有更变，当随症治之。
一小儿痘初出，忽吐泻，饮乳不歇，属脾胃虚弱，用人参白术散，作大剂，母子并服；又用五味异功散为末，时以
乳调服，吐泻止而靥。
一小儿出痘作泻，手足并冷，用十二味异功散稍愈；又用五味异功散加姜、桂一剂而止，又去姜加木香一剂；再用
参四圣散而靥。
一小儿痘疮愈而作泻不食，此脾气内虚，先用五味异功散而泻止，食进后又伤食吐泻发搐，仍以五味异功散加天
麻、柴胡而愈。
一小儿痘后作泻，腹中疼痛，手足并冷，此脾气虚也，用五味异功散加干姜一剂，乃去姜，又数剂而痛止；又用六
君子汤加柴胡而泻止。
益黄散 治疮疹，因烦渴饮水过多，而伤脾胃吐泻。
丁香 诃子（煨） 青皮 陈皮 木香（各等分）
上为末，每服一钱，水煎。
橘皮汤 治呕吐不止，饮食不入。
陈皮 生姜（各一钱） 人参（五分）
上水煎，作三四次服之。
生气散 治脾胃气虚吐泻，肚腹膨胀，饮食不化，或腹痛不止。
丁香 甘草（各五分） 白术 青皮 木香 人参（各七分）
上水煎，徐徐服。
五苓散（方见小便不利）
五味异功散（方见寒战切牙）
对金饮 治饮食吐泻（方见不靥闷乱）
豆蔻丸（方见泄泻切牙）
十一味木香散
十二味异功散（二方见顶陷灰白）
人参白术散（方见发热属阴阳）
参 四圣散（方见腹胀气促）
六君子汤（方见不靥闷乱）
《痘疹方》记载：痘疹出现呕吐和腹泻，大概是因为脾胃功能不和，饮食调节不当，导致烦渴、呕吐和泄泻，这些情况都使用白术散治疗。然而，疮疹的生长都依赖于脾土，脾土充实则容易发出且容易结痂愈合，就像万物得到土气温暖才能生长一样；呕吐和腹泻会损伤脾土，于是产生各种变证。夏季中暑引起的烦渴泄泻，或者腹痛，或者筋脉拘挛，使用五苓散加藿香。伤食引起的吐泻，使用小异功散。手足发冷的，使用益黄散、豆蔻丸。痘顶凹陷、颜色灰白的，使用木香散。痘疮正在发出时出现吐泻的，或者见血的，都属于逆症，难以治疗。我认为上述病症虽然因脾胃不和引起，但如果邪气实于上焦则适宜用吐法，邪气实于下焦则适宜用泻法。如吐泻伴有嗳腐吞酸，都适宜宣发，只是程度轻重不同罢了。张翼之说：如果痘疹吐泻且食欲减少属于里虚，痘陷伏倒靥、颜色灰白属于表虚，两者同时出现属于表里俱虚，合用十二味异功散来救治，甚至姜、附子、灵砂也可以使用。如果只是里虚，去掉官桂。如果只是表虚，减少肉豆蔻的量。如果能进食但便秘、痘陷属于里实，忌用补法，应当采用钱乙及朱丹溪的方法用泻下法治疗。凡是能进食的属于里实，里实而误用补法，则会结成痈毒。痘色红活绽凸属于表实，表实而误用补法，则会溃烂不结痂。凡是见到痘疹，就忌讳使用葛根汤，恐怕发表会导致正气虚弱。如果有其他变化，应当根据症状进行治疗。
一个小孩痘疮刚发出，忽然出现吐泻，喝奶不停，属于脾胃虚弱，用人参白术散，制成大剂量，母子一起服用；又用五味异功散研成末，时常以乳汁调服，吐泻停止并结痂愈合。
一个小孩出痘腹泻，手足发冷，用十二味异功散稍有好转；又用五味异功散加生姜、肉桂一剂后停止，后又去掉生姜加木香一剂；再用参四圣散使痘疮结痂愈合。
一个小孩痘疮痊愈后却出现腹泻且不进食，这是脾气内虚，先用五味异功散使腹泻停止，进食后再次伤食导致吐泻抽搐，仍以五味异功散加天麻、柴胡而治愈。
一个小孩痘后出现腹泻，腹中疼痛，手足发冷，这是脾气虚，用五味异功散加干姜一剂，然后去掉干姜，又服数剂后疼痛停止；又用六君子汤加柴胡使腹泻停止。
益黄散 治疗疮疹，因烦渴饮水过多，而损伤脾胃导致的吐泻。
丁香 诃子（煨） 青皮 陈皮 木香（各等分）
以上研为末，每次服用一钱，水煎服。
橘皮汤 治疗呕吐不止，饮食无法进入。
陈皮 生姜（各一钱） 人参（五分）
以上水煎，分三四次服用。
生气散 治疗脾胃气虚引起的吐泻，肚腹膨胀，饮食不化，或腹痛不止。
丁香 甘草（各五分） 白术 青皮 木香 人参（各七分）
以上水煎，慢慢服用。
五苓散（方剂见小便不利条）
五味异功散（方剂见寒战切牙条）
对金饮 治疗饮食引起的吐泻（方剂见不靥闷乱条）
豆蔻丸（方剂见泄泻切牙条）
十一味木香散
十二味异功散（二方剂见顶陷灰白条）
人参白术散（方剂见发热属阴阳条）
参四圣散（方剂见腹胀气促条）
六君子汤（方剂见不靥闷乱条）
The *Douzhen Fang* (Formulas for Smallpox and Measles) states: Vomiting and diarrhea in smallpox and measles are generally caused by disharmony of the Spleen and Stomach and improper dietary regulation, leading to irritability, thirst, vomiting, and diarrhea; all these conditions should be treated with Baizhu San (Atractylodes Macrocephala Powder). However, sores and rashes rely on the Earth element of the Spleen. When the Spleen Earth is solid, it is easy for lesions to erupt and heal, just as all things grow when warmed by the Earth's Qi. Vomiting and diarrhea damage the Spleen Earth, thereby causing various complications. In summer, heatstroke-induced irritability, thirst, and diarrhea, or abdominal pain, or muscle spasms, should be treated with Wuling San (Five-Ingredient Poria Decoction) added with Huoxiang (Patchouli). Food-stagnation-induced vomiting and diarrhea should be treated with Xiaoyigong San (Minor Yi Gong Decoction). Coldness of both hands and feet should be treated with Yihuang San (Benefit Yellow Decoction) and Doukou Wan (Cardamom Pill). Sunken lesions with grayish-white color should be treated with Muxiang San (Costus Root Powder). Vomiting and diarrhea occurring while lesions are erupting, or those presenting with blood, are all considered adverse syndromes and are difficult to treat. I believe that although the aforementioned symptoms are due to Spleen and Stomach disharmony, if pathogenic factors are excess in the Upper Jiao, emesis is indicated; if pathogenic factors are excess in the Lower Jiao, purgation is indicated. For vomiting and diarrhea accompanied by belching with a rotten smell and acid regurgitation, venting/dispersing methods are appropriate, differing only in severity. Zhang Yizhi said: If smallpox/measles presents with vomiting, diarrhea, and reduced appetite, it indicates Interior Deficiency; sunken, inverted, grayish-white lesions indicate Exterior Deficiency. If both are present, it indicates simultaneous Exterior and Interior Deficiency, requiring Shierwei Yigong San (Twelve-Ingredient Yi Gong Decoction) for rescue; even Jiang (Ginger), Fuzi (Prepared Aconite Root), and Lingsha (Cinnabar) may be used. If only Interior Deficiency exists, remove Guigui (Cassia Bark); if only Exterior Deficiency exists, reduce the dosage of Roudoukou (Nutmeg). If the patient can eat but has constipation and sunken lesions, this indicates Interior Excess; tonification is contraindicated, and one should adopt the methods of Qian Yi and Zhu Danxi using purgatives. Generally, ability to eat indicates Interior Excess; tonifying Interior Excess will lead to carbuncle formation. Red, vibrant, and protruding lesions indicate Exterior Excess; tonifying Exterior Excess will lead to ulceration without scabbing. Once smallpox/measles lesions appear, Gegen Tang (Kudzu Root Decoction) is contraindicated, as releasing the exterior may weaken Zheng Qi (Upright Qi). If other changes occur, treatment should follow the specific symptoms.
A child whose smallpox had just begun to erupt suddenly developed vomiting and diarrhea and drank milk incessantly. This was attributed to Spleen and Stomach deficiency. Ren Shen Baizhu San (Ginseng and Atractylodes Macrocephala Powder) was prescribed in a large dose, taken by both mother and child. Additionally, Wuwei Yigong San (Five-Ingredient Yi Gong Powder) was administered as a powder mixed with breast milk intermittently. The vomiting and diarrhea ceased, and the lesions healed.
A child developing smallpox suffered from diarrhea and coldness of both hands and feet. Shierwei Yigong San (Twelve-Ingredient Yi Gong Decoction) was used, resulting in slight improvement. Subsequently, Wuwei Yigong San (Five-Ingredient Yi Gong Decoction) added with Jiang (Ginger) and Rougui (Cinnamon Bark) for one dose stopped the symptoms. Ginger was then removed, and Muxiang (Costus Root) was added for another dose. Finally, Can Sisheng San (Ginseng and Four-Sage Powder) was used to promote healing.
A child who had recovered from smallpox developed diarrhea and loss of appetite. This was diagnosed as internal deficiency of Spleen Qi. Wuwei Yigong San (Five-Ingredient Yi Gong Decoction) was first used to stop the diarrhea. After appetite returned, food stagnation led to vomiting, diarrhea, and convulsions. Treatment with Wuwei Yigong San (Five-Ingredient Yi Gong Decoction) added with Tianma (Gastrodia Rhizome) and Chaihu (Bupleurum Root) resulted in recovery.
A child developed diarrhea after smallpox, accompanied by abdominal pain and coldness of both hands and feet. This was identified as Spleen Qi deficiency. Wuwei Yigong San (Five-Ingredient Yi Gong Decoction) added with Ganjiang (Dried Ginger) was administered for one dose. Ginger was then removed, and several more doses were given until the pain ceased. Liu Junzi Tang (Six-Gentleman Decoction) added with Chaihu (Bupleurum Root) was then used to stop the diarrhea.
Yihuang San (Benefit Yellow Decoction): Treats sores and rashes where excessive drinking due to irritability and thirst damages the Spleen and Stomach, causing vomiting and diarrhea.
Dingxiang (Caryophylli Flos), Hezi (Arecae Semen Preparatum, roasted), Qingpi (Aurantii Fructus Immaturus Pericarpium), Chenpi (Aurantii Fructus Ripen Pericarpium), Muxiang (Aucklandiae Radix) (equal parts).
Grind into powder. Take one qian per dose, decocted in water.
Jupi Tang (Tangerine Peel Decoction): Treats persistent vomiting and inability to retain food.
Chenpi (Aurantii Fructus Ripen Pericarpium), Shengjiang (Zingiberis Rhizoma Recens) (each one qian), Renshen (Ginseng Radix et Rhizoma) (five fen).
Decoct in water and take in three to four divided doses.
Shengqi San (Vitalizing Qi Powder): Treats vomiting and diarrhea due to Spleen and Stomach Qi deficiency, abdominal distension, indigestion, or unceasing abdominal pain.
Dingxiang (Caryophylli Flos), Gancao (Glycyrrhizae Radix et Rhizoma) (each five fen), Baizhu (Atractylodis Macrocephalae Rhizoma), Qingpi (Aurantii Fructus Immaturus Pericarpium), Muxiang (Aucklandiae Radix), Renshen (Ginseng Radix et Rhizoma) (each seven fen).
Decoct in water and take slowly.
Wuling San (Five-Ingredient Poria Decoction) (See formula under "Urination Difficulty").
Wuwei Yigong San (Five-Ingredient Yi Gong Decoction) (See formula under "Chills and Teeth Grinding").
Duijin Yin (Metal-Matching Drink): Treats vomiting and diarrhea due to diet (See formula under "Failure to Heal and Confusion").
Doukou Wan (Cardamom Pill) (See formula under "Diarrhea and Teeth Grinding").
Shiyiwei Muxiang San (Eleven-Ingredient Costus Root Powder).
Shierwei Yigong San (Twelve-Ingredient Yi Gong Decoction) (Both formulas see under "Sunken Lesions with Grayish-White Color").
Renshen Baizhu San (Ginseng and Atractylodes Macrocephala Powder) (See formula under "Fever Attributed to Yin and Yang").
Can Sisheng San (Ginseng and Four-Sage Powder) (See formula under "Abdominal Distension and Shortness of Breath").
Liu Junzi Tang (Six-Gentleman Decoction) (See formula under "Failure to Heal and Confusion").