立斋治一小儿。每饮食失节。或外惊所忤。即吐泻发搐。服镇惊化痰等药而愈。后发搐
益甚。饮食不进。虽参、术之剂。到口即呕。乃用白术和土炒黄。以米泔煎数沸。不时灌半
匙。仍呕。次日灌之。微呕。渐加至二三匙。递加至半杯。不呕。乃浓煎服而愈。
景岳治其季子。甫半岁。受寒。吐泻大作。用温胃和脾之药不效。用理中汤。三日后加
人参三钱。及姜、桂、吴茱萸、肉果。亦不效。至四五日。则随乳随吐。吐其半而泻其半。
腹中毫无所留。乃用人参六钱。制附子、姜、桂等各一二钱。下咽即吐。一滴不存。而所下
之乳。则白洁无气。仍犹乳也。斯证形气之危。万无生理矣。因思寒气犯胃而吐泻不止。若
舍参、姜、桂、附之属。尚何术焉。再四思之。谓胃虚已极。而药之气味。略有不投。必拒
而不纳。矧附子味咸。亦能致呕。惟得甘辣可口之药。庶乎胃气可安。尚有生意。乃用胡椒
三钱捣碎。加煨姜一两。水煎。又令煎人参二两。以参汤之十。入椒姜汤之一。茶匙挑与。
竟咽而不吐。徐徐服之。乳药皆安矣。四鼓服起。至次日未时服完。忽然躁扰呻吟。烦剧之
甚。家人疑热药太过。烧断肚肠。相与抱泣。景岳云。若药果有难堪。何自四鼓至午前皆相
安。而此时遽变若此。其必数日不食。胃气新复。而仓廪空虚。饥甚则然也。取粥以示之。
则张皇欲得。因与食之。竟至半碗。而寂然安卧矣。次日复加制附。始泻止全愈。此因饥发
躁。设用清凉一解。则全功尽弃。而初时用参数钱。毫无所效。倘不知药未及病。改用苦寒
亦必即死。旁观者。仍归罪于用参也。
薛立斋治疗一名小儿。每当饮食不节制，或者受到外界惊吓干扰，就会出现呕吐、腹泻并伴随抽搐的症状。服用镇惊化痰等药物后痊愈。后来抽搐症状日益加重，饮食无法进服，即使是人参、白术这类补益药剂，入口即吐。于是采用白术与灶心土同炒至黄色，用米泔水煎煮数沸，不时地灌入半匙药汁。患儿仍然呕吐。第二天再次灌服，出现轻微呕吐。逐渐增加剂量至二三匙，递增至半杯，此时不再呕吐，改用浓煎的药液服用而痊愈。
张景岳治疗他的小儿子。刚满半岁，感受寒邪，呕吐和腹泻剧烈发作。使用温胃健脾的药物无效。改用理中汤。三天后加入人参三钱，以及干姜、肉桂、吴茱萸、肉豆蔻。依然无效。到了第四五天，吃多少吐多少，吐出的一半是未消化的乳汁，拉出的一半也是未消化的乳汁。腹中毫无留存。于是用人参六钱，制附子、干姜、肉桂等各一二钱。药液咽下即吐，一滴也存留不住。而且所下的乳汁，洁白清澈无气味，看起来还像新鲜的乳汁一样。这种证候，形体和元气都已极度危险，万无生机了。考虑到寒气侵犯胃部导致吐泻不止，如果舍弃人参、干姜、肉桂、附子这一类药物，还有什么办法呢？反复思考后认为，胃气虚弱已至极点，而药物的气味略有不相投合，必然会被拒绝而不纳受。况且附子味咸，也能引起呕吐。只有得到甘甜辛辣且可口的药物，或许能使胃气安宁，尚存一线生机。于是使用胡椒三钱捣碎，加入煨姜一两，用水煎煮。又令另煎人参二两，将人参汤的十分之一，混入胡椒姜汤的九分之一（注：原文“以参汤之十，入椒姜汤之一”通常理解为比例调配，此处依文意译为混合服用策略，或指取少量参汤调入姜椒汤中，结合上下文“茶匙挑与”，实为调和口味），用茶匙喂服。竟然能咽下而不呕吐。慢慢地服用，乳汁和药物都安定了。凌晨四鼓开始服药，到次日未时服完。突然烦躁不安、呻吟，痛苦非常严重。家人怀疑热药太过，烧断了肚肠，互相抱着哭泣。张景岳说：“如果药物真的难以承受，为什么从四鼓到午前都相安无事，而此时突然变成这样？这一定是因为几天没吃东西，胃气刚刚恢复，而肠胃空虚，饥饿所致。”拿来粥给他们看，孩子慌张地想要吃。于是给他喂食，竟然吃了半碗，然后安静地躺卧下来。第二天再加用制附子，最终腹泻停止，完全痊愈。这是因为饥饿引发的烦躁，如果使用清凉药物解表，则全部疗效尽弃。而且初时用人参仅几钱，毫无效果，倘若不知道是药力未达到病所，改用苦寒药物，也必定立即死亡。旁观的人，仍然归罪于使用人参。
Xue Lizhai treated a pediatric patient. Whenever there was dietary indiscretion or external fright, the child would suffer from vomiting, diarrhea, and convulsions. The condition resolved after administering medications for calming fright and resolving phlegm. Later, the convulsions worsened significantly, and the child refused food. Even tonifying formulas containing Ren Shen (Ginseng Radix) and Bai Zhu (Atractylodis Macrocephalae Rhizoma) were vomited immediately upon ingestion. Therefore, he used Bai Zhu (Atractylodis Macrocephalae Rhizoma) stir-fried with kitchen soil until yellow, decocted in rice washing water for a few boils, and administered half a spoonful intermittently. Vomiting persisted. On the next day, upon re-administration, mild vomiting occurred. The dosage was gradually increased to two or three spoonfuls, then up to half a cup, at which point vomiting ceased. A concentrated decoction was then administered, leading to recovery.
Zhang Jingyue treated his youngest son, who was only six months old. After contracting cold, the infant suffered from severe vomiting and diarrhea. Medications for warming the stomach and harmonizing the spleen were ineffective. Li Zhong Tang (Regulate the Middle Decoction) was prescribed. Three days later, Ren Shen (Ginseng Radix) 3 qian was added, along with Gan Jiang (Zingiberis Rhizoma), Rou Gui (Cinnamomi Cortex), Wu Zhu Yu (Evodiae Fructus), and Rou Dou Kou (Myristicae Semen). This also proved ineffective. By the fourth or fifth day, every feed resulted in immediate regurgitation; half of the milk was vomited out, and the other half was passed as diarrhea. Nothing remained in the abdomen. Consequently, Ren Shen (Ginseng Radix) 6 qian, Zhi Fu Zi (Prepared Aconiti Lateralis Radix), Gan Jiang (Zingiberis Rhizoma), and Rou Gui (Cinnamomi Cortex) each 1-2 qian were used. However, the medicine was vomited immediately upon swallowing, not a single drop retained. Moreover, the excreted milk appeared white, clear, and odorless, resembling fresh milk. Given the critical state of the child's form and vital energy, survival seemed impossible. Considering that cold pathogen invading the stomach caused persistent vomiting and diarrhea, what method could be employed if one abandoned agents like Ren Shen (Ginseng Radix), Gan Jiang (Zingiberis Rhizoma), Rou Gui (Cinnamomi Cortex), and Fu Zi (Aconiti Radix)? After repeated deliberation, it was concluded that the Stomach Qi deficiency was extreme, and the flavor and aroma of the medicines were slightly incompatible, causing rejection. Furthermore, Fu Zi (Aconiti Radix) has a salty taste, which can induce vomiting. Only by using sweet and pungent medicines that are palatable could the Stomach Qi potentially stabilize, offering a chance of life. Thus, Hu Jiao (Piperis Longi Fructus) 3 qian was crushed, combined with Wei Jiang (Zingiberis Rhizoma Recens Praeparatum) 1 liang, and decocted in water. Separately, Ren Shen (Ginseng Radix) 2 liang was decocted. A mixture of the Ren Shen (Ginseng Radix) decoction and the Hu Jiao (Piperis Longi Fructus)-Wei Jiang (Zingiberis Rhizoma Recens Praeparatum) decoction was administered via tea spoon. The infant swallowed it without vomiting. Slowly, both milk and medicine were tolerated. Treatment began at the fourth watch (around 1-3 AM) and finished by Wei hour (1-3 PM) the next day. Suddenly, the child became restless and moaned intensely, suffering greatly. The family suspected the hot medicines had burned through the intestines and wept together. Zhang Jingyue said, "If the medicine were truly intolerable, why was there peace from the fourth watch until noon? Why this sudden change now? It must be due to several days of fasting; the Stomach Qi is newly restored, but the Granary House (Stomach/Intestines) is empty. Extreme hunger causes this." He showed them congee. The child eagerly desired it. They fed the child, who consumed half a bowl and then lay down quietly. On the next day, Zhi Fu Zi (Prepared Aconiti Lateralis Radix) was added again, leading to complete cessation of diarrhea and full recovery. This agitation was caused by hunger. Had cooling herbs been used to resolve it, all previous efforts would have been wasted. Initially, using only a few qian of Ren Shen (Ginseng Radix) yielded no effect. If one did not realize that the dosage was insufficient to reach the disease site and instead switched to bitter-cold herbs, death would have ensued immediately. Bystanders still blamed the use of Ren Shen (Ginseng Radix).