万密斋治教谕熊文村子，二岁病呕吐，更数医不效，食故入口即吐出。万视之曰∶病可治也。问用何方？
曰∶理中汤。曰∶服多剂矣，不效奈何？曰∶如在《内经》乃阴盛格阳之病，寒因热用，伏其所主，先其所因
则效矣。乃作一剂，取 猪胆汁、童便各半，和药炒干，煎而服之，（即仲景白通汤入人尿、猪胆汁之法。）
吐立止。后称渴，以汤饮之，复作吐。万曰∶凡呕家多渴者，胃脘之津液干也，当得一二时吐止，胃气回，津
液生，渴自止矣。令将前药渣再煎服之，仍禁其饮食，半日而安。熊问同是理中汤，前用之不效，今用之而效，
何也？曰∶公子胃寒而吐，当以热药治之。乃寒盛于中，投之热剂，两情不得，故不效也。今以理中为治寒之
主，用猪胆汁之苦寒，小便之咸寒为佐，以从其格拒之寒，药下于咽，而寒相得入于胃，阴体渐弱，阳性乃发。
其始则同，其终则异，故曰∶伏其所主，先其所因也。此轩岐之秘旨，启元子之奥义，张长沙之良法也。后王
民肃子，半载呕吐不纳乳，昏睡仰卧而努其身，有作慢风之候，亦以理中末三分，用水一杯，煎至半杯，入胆
汁、童便各一匙搅匀，徐徐灌之而瘥。
郑氏女患呕吐，万视其症，乃伤食吐乳也。家人云无，乃用理中汤去甘草加丁香、藿香，不效。又作胆汁
童便法，亦不效。四日后，吐出饭半碗。询其家人曰∶此儿数日不食，何得有此？始吾言伤食，语固云无，故
治不见效。遂取脾积丸投之，取下恶粪如靛，乃五日前所食鸡子黄也。所吐之饭，即其时所食也。壅塞肠胃，
格拒饮食，所以作吐，下之即愈。
一儿自盈月后，常吐乳，父母忧之，诸医不能止。一日问万，万曰∶呕吐者，非常有之病也。今常吐乳，
非病也。然小儿赖乳以生，频吐非所宜也。其间有母气壮乳多，纵儿饱足，饱则伤胃，所食之乳涌而出，此名
溢乳，如瓶之注水，满而溢也，宜损节之，更服肥儿丸。儿之初生，筋骨软弱，为乳母者，常怀抱护持可也，
不然则左右倾侧，其乳流出，此名 乳，如瓶之侧，其水流出也，能紧护持，则不吐也。有胃弱也，不能受乳
以变之，吐出无时，所吐不多，此名哺露，如瓶之漏，不能容受也，当补其脾胃，助其变化可也，亦以肥儿丸
主治自愈。（通达之论，养子者宜知之。）
龚子才治小儿伤食呕吐。服克伐之药，呕中见血。用清热凉血之药，又大便下血，唇色白而或青。问其故。
龚曰∶此脾土亏损，肝木所乘而然也。今空心用补中益气汤，食后用异功散，以调补中气，使涎血各归其原而愈。
薛立斋治一小儿，每饮食失节，或外经所忤，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，用米泔煎数沸，不时灌半匙，仍呕。次日灌之，微呕。再日灌
之，欲呕。此后每服二三匙，渐加至半杯，不呕，乃浓煎服而愈。（叶天士∶观立斋治吐泻者，以脾胃为主，
并不参入归、地，此乃认清门路之治，非张景岳所能及也。）
一小儿停食，服通利之剂作呕，腹胀，此脾胃复伤也，用补中益气汤而愈。
万密斋治一儿，初生即吐。或欲用钱氏木瓜丸，曰∶不可，小儿初生，胃气甚微，或有乳多过饱而吐者，
当缓缓与之。或因浴时客寒犯胃而吐者，当用乳汁一杯，用姜葱同煎，少与服之。或因恶露泄水，停在腹中而
吐者，宜以炙草煎汤而吐去之。奈何用木瓜丸，以铁粉、槟榔之重剂，犯其胃中初生中和之气耶？故常语人曰∶
钱氏小儿方，非先生亲笔，乃门人附会之说也。
《大还》治一小儿，生方九日，即呕吐腹胀。作脾气虚寒，用半夏、陈皮、姜汁、卜子、丁香、藿香、砂仁
各少许，煎饮半酒盏而愈。
万密斋诊治教谕熊文村的儿子，两岁时患呕吐病，经过多位医生治疗均无效，食物刚入口就吐出来。万密斋诊视后说：“这病可以治愈。”问用什么方子？
回答说：“理中汤。”对方说：“已经服用了多剂，没有效果，怎么办？”万密斋说：“如果在《内经》的理论框架下，这是阴盛格阳的病证，应当采用寒因热用的方法，伏藏其主导的病机，先解决其病因，就能见效。”于是配制一剂药，取猪胆汁和童便各一半，与药物混合炒干，煎煮后服用（即张仲景白通汤中加入人尿、猪胆汁的方法），呕吐立刻停止。后来孩子感到口渴，喂以汤水，又再次发生呕吐。万密斋说：“凡是呕吐的病人大多会口渴，这是因为胃脘的津液干燥所致，应当等待一两个时辰，待呕吐停止，胃气恢复，津液生成，口渴自然就会停止。”命令将之前的药渣再煎服下，同时禁止饮食，半天后病情安定。熊先生问同样是理中汤，之前使用无效，现在使用却有效，为什么呢？万密斋说：“公子胃寒而呕吐，本应用热药治疗。但是寒邪盛于中焦，投入热性药剂，寒热两种性质相互排斥，所以无效。现在用理中汤作为治疗寒邪的主药，用猪胆汁的苦寒、小便的咸寒作为佐使，以顺从其格拒寒邪的特性，药液咽下后，寒性得以相合进入胃中，阴寒之体逐渐减弱，阳气才得以发挥效用。开始时性质相同，最终结果不同，所以说：‘伏其所主，先其所因’。这是黄帝岐伯的隐秘旨意，启元子的深奥义理，张仲景的良好法则。”后来王民肃的儿子，半年来呕吐不能进食乳汁，昏睡仰卧并用力伸展身体，有慢惊风的征兆，也用理中汤研末三分，用水一杯，煎至半杯，加入胆汁、童便各一匙搅匀，慢慢灌服而痊愈。
郑氏的女儿患呕吐，万密斋诊视其症状，认为是伤食导致的吐乳。家人说没有，于是用理中汤去掉甘草，加丁香、藿香，无效。又采用胆汁童便法，也无效。四天后，吐出半碗饭。询问家人说：“这孩子几天没吃东西，怎么会有这个？”起初我说伤食，家人坚持说没有，所以治疗不见效。于是取脾积丸投服，排出如靛蓝色的恶臭粪便，是五天前吃的鸡蛋黄。所吐出的饭，就是当时吃的食物。肠胃壅塞，格拒饮食，所以导致呕吐，通下后即愈。
一个婴儿满月后，经常吐奶，父母为此担忧，各位医生不能止住。一天去问万密斋，万密斋说：“呕吐是非常见之病。现在经常吐奶，不是病。然而小儿依靠乳汁生存，频繁吐奶是不适宜的。其中有母亲体质壮实、乳汁过多，任凭婴儿吃饱，饱则伤胃，所食的乳汁涌出而出，这叫溢乳，像瓶子注水，满了就溢出来，应当节制喂养，另外服用肥儿丸。婴儿初生，筋骨软弱，做乳母的应当经常怀抱护持，不然左右倾斜，乳汁流出，这叫乳漏，像瓶子侧放，水流出来一样，能紧紧护持，就不会吐了。有胃弱的情况，不能受纳乳汁进行转化，随时吐出，吐得不多，这叫哺露，像瓶子漏水，不能容纳，应当补益脾胃，帮助其运化即可，也以肥儿丸主治自愈。（通达的言论，养育子女的人应该知道。）”
龚子才诊治小儿伤食呕吐。服用克伐性质的药物后，呕吐中带血。用清热凉血的药物后，大便又下血，嘴唇颜色白或青。询问原因。龚子才说：“这是脾土亏损，肝木乘虚侵袭所致。现在空腹服用补中益气汤，饭后服用异功散，以调补中气，使涎血各自回归本源而痊愈。”
薛立斋诊治一个小孩，每次饮食不节制，或外感邪气干扰，就出现吐泻发搐，服用镇惊化痰等药后痊愈。后来发搐更加严重，饮食不进，即使是人参、白术的药剂，到口就呕，于是用白术和土炒黄，用米泔水煎煮几沸，不时灌入半匙，仍然呕吐。第二天灌服，轻微呕吐。再第二天灌服，想吐但不吐出来。此后每次服用二三匙，逐渐增加到半杯，不再呕吐，于是浓煎服用而痊愈。（叶天士评论：看薛立斋治疗吐泻，以脾胃为主，并不参入当归、地黄，这是认清门路的治法，不是张景岳所能达到的境界。）
一个小孩停食，服用通利药物后作呕，腹胀，这是脾胃再次受伤，用补中益气汤而痊愈。
万密斋诊治一个婴儿，出生后即呕吐。有人想用钱乙的木瓜丸，万密斋说：“不行，小儿初生，胃气很微弱，或者有乳汁过多过饱而呕吐的，应当缓缓给予。或者因为洗澡时客寒犯胃而呕吐的，应当用乳汁一杯，加姜葱同煎，少量服用。或者因为恶露泄水，停在腹中而呕吐的，宜用炙甘草煎汤催吐去除。为什么要用木瓜丸，以铁粉、槟榔的重剂，侵犯其胃中初生的中和之气呢？”所以他常对人说：“钱乙的小儿方，如果不是先生亲笔，乃是门人附会的说法。”
《大还》诊治一个小孩，出生刚九天，就呕吐腹胀。诊断为脾气虚寒，用半夏、陈皮、姜汁、莱菔子、丁香、藿香、砂仁各少许，煎饮半酒盏而痊愈。
Wan Mizhai treated the son of Jiaoyu Xiong Wenzicun, who was two years old and suffering from vomiting. After seeing several physicians without effect, food was vomited immediately upon entering the mouth. Wan examined him and said, "The disease is curable." When asked which prescription to use, he replied, "Lizhong Tang (Cinnamon Twig and Ginger Decoction)." The father said, "We have taken many doses with no effect; what should we do?" Wan explained, "According to the *Neijing* (Classic of Internal Medicine), this is a condition of Yin excess repelling Yang. One must employ 'treating heat with cold' methods, subdue the dominant pathogen, and address the root cause first to achieve efficacy." He then prepared one dose, mixing half pig bile and half child's urine with the herbs, stir-frying them until dry, decocting, and administering orally. (This follows Zhang Zhongjing's method in Baitong Tang adding human urine and pig bile.) The vomiting stopped immediately. Later, the child felt thirsty, and after drinking water, vomiting recurred. Wan said, "Patients with vomiting often feel thirsty due to dryness of the stomach fluids. Wait one or two hours; once vomiting ceases, stomach Qi returns, fluids are generated, and thirst will naturally stop." He ordered the dregs of the previous medicine to be decocted again and administered, while forbidding food intake. Half a day later, the child stabilized. Mr. Xiong asked, "Why did Lizhong Tang fail previously but succeed now?" Wan replied, "Your son has cold in the stomach causing vomiting, which requires hot medicines. However, since cold is abundant in the middle jiao, introducing hot agents causes mutual rejection between the cold pathogen and the hot medicine, hence the failure. Now, using Lizhong Tang as the main treatment for cold, we add the bitter-cold pig bile and salty-cold child's urine as assistants to accommodate the rejecting cold. When the medicine is swallowed, its cold nature harmonizes with the pathogenic cold, allowing it to enter the stomach. The Yin cold gradually weakens, and Yang Qi can then function. Though they start similarly, they end differently; thus, it is said: 'Subdue the dominant pathogen, address the root cause.' This is the secret principle of Huangdi and Qibo, the profound meaning of Qiyuanzi, and the excellent method of Zhang Changsha (Zhongjing). Later, Wang Minsu's son suffered from vomiting and inability to take milk for six months, sleeping drowsily on his back and straining his body, showing signs of slow wind syndrome. He was also treated with three fen of Lizhong Tang powder, decocted in one cup of water until half remained, mixed with one spoonful each of bile and child's urine, stirred well, and slowly灌fed, resulting in recovery.
Zheng's daughter suffered from vomiting. Wan diagnosed it as vomiting of milk due to food stagnation. Her family denied any dietary indiscretion. Wan used Lizhong Tang minus Gancao (Licorice Root), adding Dingxiang (Clove) and Huoxiang (Patchouli), but it failed. He then tried the bile and child's urine method, which also failed. Four days later, she vomited half a bowl of rice. Wan asked her family, "This child hasn't eaten for days; how could there be this?" Initially, I mentioned food stagnation, but your insistence that there was none caused the treatment to fail. He then administered Piji Wan (Spleen Accumulation Pill), which expelled foul stools resembling indigo dye—specifically, egg yolks eaten five days prior. The vomited rice was also from that time. The intestines and stomach were blocked, rejecting food and drink, causing vomiting. Once purged, the disease resolved.
Another infant frequently vomited milk after one month of age, worrying his parents despite various physicians' attempts to stop it. One day, he consulted Wan, who said, "Vomiting is an acute illness. Frequent milk vomiting is not a disease per se. However, infants rely on milk for life, so frequent vomiting is undesirable. There are cases where the mother has strong constitution and abundant milk; if allowed to feed until full, the stomach is injured by overfilling, causing milk to surge out. This is called 'overflowing milk,' like filling a bottle until it spills. Feeding should be moderated, and Fei'er Wan (Child-Nourishing Pill) should be taken. Newborns have soft bones and tendons; nurses should hold and protect them constantly. Otherwise, tilting left or right causes milk to flow out, known as 'milk leakage,' like water flowing from a tilted bottle. Firm holding prevents vomiting. In cases of weak stomach unable to transform milk, vomiting occurs at any time with small amounts, called 'nursing dew,' like a leaking bottle unable to hold content. The spleen and stomach should be tonified to aid transformation; Fei'er Wan is also indicated for self-healing. (This is a penetrating discussion; those raising children should know this.)"
Gong Zicai treated a child with vomiting due to food stagnation. After taking harsh draining medicines, blood appeared in the vomit. Using cooling and blood-cooling medicines led to bloody stools, with white or bluish lips. Asked for the cause, Gong said, "This is due to deficiency of Spleen Earth being invaded by Liver Wood. Empty-stomach administration of Buzhong Yiqi Tang (Tonify the Middle and Augment Qi Decoction) followed by Yigong San (Extraordinary Power Powder) after meals will regulate and tonify Middle Qi, allowing phlegm and blood to return to their origins, leading to recovery."
Xue Lizhai treated a child who, upon dietary irregularity or external pathogenic interference, experienced vomiting, diarrhea, and convulsions, recovering after taking calming fright and resolving phlegm medicines. Later, convulsions worsened, appetite vanished, and even Ren Shen (Ginseng Root) and Bai Zhu (Atractylodes Rhizome) formulas caused immediate vomiting. He used Bai Zhu stir-fried with soil until yellow, decocted in rice wash water for a few boils, and administered half a spoonful occasionally. Vomiting persisted. The next day, slight vomiting occurred. On the third day, the urge to vomit arose but did not manifest. Subsequently, 2-3 spoonfuls were given, gradually increasing to half a cup without vomiting, after which a concentrated decoction was taken, resulting in recovery. (Ye Tianshi commented: Observing Xue Lizhai's treatment of vomiting and diarrhea focuses on the Spleen and Stomach, without incorporating Dang Gui (Angelica Sinensis Root) or Di Huang (Rehmannia Root). This is a treatment recognizing the correct pathway, surpassing what Zhang Jingyue could achieve.)
Another child developed vomiting and abdominal distension after taking purgative medicines for food retention, indicating further injury to the Spleen and Stomach. Recovery was achieved with Buzhong Yiqi Tang.
Wan Mizhai treated a newborn who vomited immediately after birth. Someone suggested Qian Yi's Mugua Wan (Papaya Pill), but Wan said, "No. Newborns have very weak Stomach Qi. If vomiting occurs due to excessive milk feeding, it should be fed slowly. If caused by external cold invading the stomach during bathing, boil one cup of milk with ginger and scallion and administer sparingly. If caused by lochia fluid retained in the abdomen, induce vomiting by drinking decocted Zhi Cao (Prepared Licorice Root) soup. Why use Mugua Wan with heavy agents like Tie Fen (Iron Powder) and Bing Lang (Areca Seed) to violate the neutral Qi of the newborn's stomach?" He often told people, "Qian Yi's pediatric prescriptions, if not personally written by him, are likely apocryphal additions by disciples."
*Dahuan* treated a nine-day-old infant with vomiting and abdominal distension. Diagnosed as Spleen Qi deficiency and cold, a decoction of Ban Xia (Pinellia Tuber), Chen Pi (Tangerine Peel), Jiang Zhi (Ginger Juice), Bo Zi (Radish Seed), Ding Xiang (Clove), Huo Xiang (Patchouli), and Sha Ren (Amomum Fruit) in small quantities, drunk from half a wine cup, resulted in recovery.