〔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〕小儿同时出现呕吐和腹泻，就称为霍乱。有的先心痛而后呕吐，有的先腹痛而后腹泻，这些都没有不是从中焦病变引起的。上焦主管受纳而不排泄，中焦主管消化水谷并生成营卫之气，灌溉全身骨骼肢体，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），胃是水谷汇聚的海港，乳汁和食物进入胃中，脾能够运化分解，然后水谷得以分流（脐上一寸处有分水穴），转化传输得当，怎么会有呕吐和腹泻的祸患呢？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混杂而引发此病。
有的先腹泻而后呕吐，这是脾胃虚冷。其表现为先排出白色稀水样便，呕吐也不剧烈，口气缓和且神色倦怠，额头前有汗出，六脉沉而濡软，这属于寒证。
先呕吐而后腹泻的，这是脾胃有热。表现为呼吸急促、嘴唇发红，呕吐时面色潮红，脉象洪大而数，口渴想喝水浆，这属于热证。区分寒证和热证，必须详细审察。
〔娄〕呕吐腹泻且昏睡、眼睛半睁露睛的，是胃虚热，用钱乙的白术散、和中散来主治。呕吐腹泻且昏睡、眼睛紧闭不露睛的，是胃实热，用钱乙的玉露散、刘河间的益元散来主治。
〔薛〕手足指头发冷的，是脾气虚寒，用异功散加木香。因伤风引起吐泻的，是风木之邪克制脾土，也用前面的药物。如果是喝热奶后拉黄色稀便的，是湿热壅滞，用四苓散。如果服药后不见好转或反而加重，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。如果服用消积导滞的药物后，感觉腹部狭窄不适的，是脾气虚导致的痞满，用六君子汤。如果面色发黄、大便发青，是脾虚而肝木乘袭脾土，用六君子汤加柴胡、升麻、木香。如果经常打嗝且大便发黄，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，承受不了药力所致。
[Zeng] When infants simultaneously present with vomiting and diarrhea, it is named Huoluan (Cholera-like disease). Some cases involve heart pain preceding vomiting, while others involve abdominal pain preceding diarrhea; none of these arise without originating from the Middle Jiao (Middle Burner). The Upper Jiao governs reception but not excretion. The Middle Jiao governs the decomposition and transformation of food and fluids, generating Ying (Nutritive Qi) and Wei (Defensive Qi), and irrigating the entire body. The Lower Jiao separates clear and turbid fluids, governing excretion but not reception. Spleen resides in the Central Region (Zhongzhou), and Stomach is the Sea of Food and Fluids. Once milk and food enter the Stomach, if the Spleen can transform and transport them, then the separation and transmission of food and fluids proceed appropriately (there is a Fen Shui point one cun above the umbilicus); how could there be afflictions of vomiting and diarrhea? Generally, infant vomiting and diarrhea occur because the Six Qi are not yet fully established, 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, causing the condition.
If diarrhea precedes vomiting, it indicates Spleen-Stomach deficiency-cold. The signs include first passing white watery stools, with little vomiting, slow breath, lethargic expression, sweating on the forehead, and deep, soggy pulses throughout. This is cold.
If vomiting precedes diarrhea, it indicates Spleen-Stomach heat. Signs include rapid breathing, red lips, flushed face during vomiting, surging and rapid pulses, and thirst for drinking water or liquids. This is heat. Distinguishing between cold and heat requires careful examination.
[Lou] For vomiting and diarrhea accompanied by drowsiness and eyes partially open (exposing the pupils), it is Stomach deficiency-heat; treat with Qianyi's Baizhu San (Atractylodes Macrocephala Powder) and Hezhong San (Harmonizing Middle Powder). For vomiting and diarrhea accompanied by drowsiness with eyes tightly closed, it is Stomach excess-heat; treat with Qianyi's Yulu San (Jade Dew Powder) and Liu Hejian's Yi Yuan San (Benefit Primordial Powder).
[Xue] Coldness in the fingers and toes indicates Spleen Qi deficiency-cold; use Yigong San (Extraordinary Efficacy Powder) added with Muxiang (Costus Root). Vomiting and diarrhea due to Wind-Cold invasion indicate Wood attacking Earth (Liver wind overacting on Spleen); also use the aforementioned formulas. If yellow diarrhea occurs after drinking hot milk, it indicates damp-heat stagnation; use Siling San (Four-Poria Powder). If the condition does not improve or worsens after medication, it indicates further injury to Yuan Qi (Primal Qi); use Baizhu San. A sensation of heavy dragging in the abdomen during diarrhea indicates Spleen Qi sinking; use Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction). If abdominal tightness/discomfort arises after taking resolving and purgative agents, it indicates Spleen Qi deficiency with palpable fullness (Pi); use Liujunzi Tang (Six-Gentlemen Decoction). Yellow complexion with greenish stools indicates Spleen deficiency with Liver overacting; use Liujunzi Tang added with Chaihu (Bupleurum Root), Shengma (Cimicifugae Rhizoma), and Muxiang. Frequent belching with yellow stools indicates Heart and Spleen Qi deficiency; use Liujunzi Tang added with Paojiang (Prepared Ginger) and Shengma. Infants under half a month to ten days old who vomit should only have their mothers treated, as the infant’s Zang-Fu organs are fragile and cannot withstand medicinal herbs.