夏禹铸曰∶内经有曰，胃虚则吐，脾虚作泻，脾胃俱虚吐泻兼作，此言极谬。若先
泻后吐，面白神疲，不热不渴，额有微汗乃脾胃虚寒也，宜理中汤或小异功散，或六君子汤
。若先吐后泻，面赤唇燥，烦渴溺赤，乃脾胃有热也，治宜五苓散加竹茹煎服。又有积滞在
脾，不能运化水谷而吐泻者，宜用消导二陈汤。
有长夏夹暑吐泻者，宜用六和汤。
余髫年砚席友陈公载嫒患吐症，适余抱风寒，因延大方脉用温胃剂吐益甚。带疾往视，
口唇红丽，气出蒸手，舌色红紫，用熟石膏一钱研碎，以茶一碗送下，稍止，随加一服，立
愈。在大人苗窍尚验，况婴儿乎。后又患吐，色窍俱同，仍用石膏却不甚应，揣之下元或有
寒气，用炒盐熨腹，仍服石膏即愈。可见苗窍颜色从不一误。
余于岁癸丑北上到会馆，适陈是庵幼郎脾泻将慢，付余治，问曰∶曾服参否。是庵曰∶
如服一分便爬上了壁。余心以为南北或亦有异。转思初到都门，恐孟浪来诮，以六君子汤去
人参连服二剂，了无一效，辞接别医。良久一医拥舆至馆。去后余请所发剂视之，剂属消导
。因问∶彼何人斯。是庵曰∶此名震京都之郑小儿科也。余曰∶久泻将慢尚可再用消导之药
，用之命不可知矣。乃止。余便不以是庵之言为正，硬用六君子汤，倍加人参，且外加附子
五分，两服即愈。是庵叹曰∶素闻妙手，今果然矣。此辨色审窍勿以人言为信之一验也。
夏禹铸说：《内经》中提到：“胃虚则呕吐，脾虚则泄泻，脾胃俱虚则吐泻并作”，这种说法极其错误。如果是先泄泻后呕吐，面色苍白、精神疲乏，不发热也不口渴，额头有微汗，这是脾胃虚寒证，适宜使用理中汤或小异功散，或者六君子汤。如果是先呕吐后泄泻，面色红赤、嘴唇干燥，心烦口渴、小便短赤，这是脾胃有热证，治疗适宜用五苓散加竹茹煎服。又有因积滞停留在脾，不能运化水谷而导致吐泻的，适宜使用消导二陈汤。
我童年时砚席（同窗）朋友陈公载的女儿患有呕吐症，当时我正抱着风寒病，于是请了擅长大人内科的大夫使用温胃药物，结果呕吐更加严重。我带病前去诊视，见其口唇红润美丽，呼出的热气烫手，舌色红紫，便用熟石膏一钱研碎，用一碗茶送服，症状稍止，随即再加服一剂，立刻痊愈。在大人及小儿苗窍（面部特征）诊断上尚且有效，何况是婴儿呢？后来她又患呕吐，面色和苗窍特征都相同，仍然使用石膏却不太见效，推测可能是下元（肾与命门区域）有寒气，便用炒热的盐熨烫腹部，同时继续服用石膏，于是痊愈。可见观察苗窍颜色从未出过错。
我在癸丑年北上到达会馆时，恰逢陈是庵的小儿子脾泻即将转为慢惊风（慢脾风），委托我治疗。我问：“曾经服用人参吗？”陈是庵说：“如果服下一分人参，孩子就会爬到墙上（形容烦躁不安或动风之象）。”我心里想南北方体质或许也有差异。转念想到初到京城，恐怕鲁莽行事会被嘲笑，于是用六君子汤去掉人参，连续服用两剂，毫无效果，便辞谢并转请其他医生诊治。过了一会儿，一位医生坐着轿子来到会馆。那位医生走后，我请求查看他开的药方，发现药方属于消导类。于是问：“那是什么人？”陈是庵说：“这就是名震京都的郑氏儿科医生。”我说：“久泻即将转为慢脾风，还可以再用消导的药物吗？用了的话性命难保。”于是制止了他。我不再相信陈是庵的话，坚持使用六君子汤，加倍加入人参，并且外加附子五分，服用两剂即痊愈。陈是庵感叹道：“素闻您医术高明，今天果然如此。”这是辨别面色审察苗窍、不要轻信他人言语的一个验证案例。
Xia Yuzhu stated: The *Neijing* (Inner Canon) mentions, "Stomach deficiency leads to vomiting, Spleen deficiency leads to diarrhea, and simultaneous deficiency of the Stomach and Spleen leads to both vomiting and diarrhea." This statement is extremely erroneous. If diarrhea occurs first followed by vomiting, with a pale complexion, mental fatigue, no fever, no thirst, and slight sweating on the forehead, this indicates Cold-Deficiency of the Spleen and Stomach (Pi Wei Xu Han). It is appropriate to use Lizhong Tang (Regulate the Middle Decoction), Xiao Yi Gong San (Minor Extraordinary Assistance Powder), or Liu Junzi Tang (Six Gentlemen Decoction). If vomiting occurs first followed by diarrhea, with a reddish face, dry lips, irritability, thirst, and dark urine, this indicates Heat in the Spleen and Stomach. Treatment should utilize Wuling San (Five-Ingredient Powder with Poria) added with Zhu Ru (Bamboo Shavings) for decoction and administration. Furthermore, if accumulation stagnation remains in the Spleen, preventing the transformation and transportation of water and grain, leading to vomiting and diarrhea, Xiaodao Erchen Tang (Digestion-Assisting Two-Centuries Decoction) is appropriate.
For vomiting and diarrhea caused by summerheat-dampness during the late summer season, Liuhe Tang (Six-Harmony Decoction) is appropriate.
In my childhood, the daughter of my schoolmate Friend Chen Gongzai suffered from vomiting. At that time, I was suffering from wind-cold. Consequently, a physician specializing in adult internal medicine was summoned who used warming stomach agents, which exacerbated the vomiting. I visited her despite my illness. Her lips were red and lustrous, her exhaled breath was hot to the touch, and her tongue was red-purple. I prescribed one qian of Shu Shigao (Calcined Gypsum) ground into powder, taken with a bowl of tea. The symptoms subsided slightly, and after administering another dose immediately, she recovered instantly. This method is effective for observing the Miao Qiao (facial indicators/childhood diagnostic features) in adults and children; how much more so for infants? Later, she suffered from vomiting again with identical facial and Miao Qiao signs. Using Shigao alone was not very effective. I deduced that there might be Cold Qi in the Lower Yuan (Lower Origin/Kidney-Mingmen area). I used fried salt to moxa-warm the abdomen while continuing to administer Shigao, resulting in recovery. Thus, observing the color of the Miao Qiao has never led me astray.
In the Gui Chou year, upon arriving north at the guild hall, I happened upon Young Master Chen Shi'an's son, whose Spleen diarrhea was about to transform into Man Pi Feng (Slow Spleen Wind/Chronic Spleen Deficiency Convulsion). He entrusted me with his treatment. I asked, "Have you administered Renshen (Ginseng)?" Chen Shi'an replied, "If he takes even one fen of Renshen, he will climb up the wall (indicating agitation or liver wind stirring)." I thought that constitutions might differ between the North and South. However, considering I had just arrived in the capital, I feared being mocked for recklessness. Therefore, I used Liu Junzi Tang (Six Gentlemen Decoction) without Renshen (Ginseng), administered continuously for two doses, but achieved no effect. I then declined further responsibility and referred him to other physicians. After a while, a physician arrived at the hall in a sedan chair. After he left, I requested to see his prescription and found it belonged to the category of digestive-promoting agents. I asked, "Who is that person?" Chen Shi'an said, "This is Dr. Zheng, the pediatrician famous throughout the capital." I said, "When chronic diarrhea is about to transform into Slow Spleen Wind, can one still use digestive-promoting drugs? If used, his life would be uncertain." So I stopped that course. I did not accept Chen Shi'an's words as absolute truth. I insisted on using Liu Junzi Tang (Six Gentlemen Decoction), doubled the dosage of Renshen (Ginseng), and additionally added 5 fen of Fuzi (Prepared Aconite Root). After two doses, he recovered. Chen Shi'an sighed and said, "I have long heard of your skillful hands; today it is indeed true." This serves as a verification of distinguishing colors and examining Miao Qiao, and not believing others' words blindly.