钱仲阳云∶癖块者，僻于两胁；痞结者，否于中脘。此因乳哺失调，饮食停滞，邪气相搏而成。或乳母六
淫七情所致，古人多用克伐。痞癖既久，饮食减少，脾气必虚，久而不愈，必先以固胃气为主，使养正则积自
除。若欲直攻其结，不唯不能善消，抑且损其脾土。凡脾土亏损，必变症百出矣，当参各类及随儿症而主治之。
若癖块日久，元气脾胃俱虚，宜朝服补中益气汤，夕服千金消癖丸，间与混元丹，兼服治之，获效者多矣。
癖者，生于皮里膜外也。
净腑汤 治小儿一切癖块、发热口干、小便赤、或泄泻。
柴胡 白茯苓（去皮） 猪苓 泽泻 三棱（醋炒） 莪术（醋炒） 山楂（去核。各一钱） 黄芩
白术（去芦） 半夏（姜制） 人参（各八分） 胡黄连 甘草（各三分）
上锉一剂，姜枣煎服。
肥儿丸 治癖如神（方见疳疾。）
千金消癖丸 治小儿癖疾、积块，有殊效。
芦荟 阿魏（另为糊） 青黛 木香 浓朴（姜炒） 槟榔 陈皮（去白穣。各一钱） 麦芽（炒，四钱）
使君子（去壳） 胡黄连 山楂肉
香附（水浸） 三棱（醋炒） 莪术（煨，醋炒。各二钱） 水红花子（微炒） 神曲（炒。各四钱）
人参（去芦） 茯苓（去皮） 白术（去芦。各三钱） 甘草（炙，一钱）
上为末，将阿魏一钱，白水和面打糊为丸，绿豆大。每服四五十丸，米饮、白汤吞下。
益儿饼 治小儿癖疾。
水红花子 使君子（去壳） 山楂肉（各五钱） 白术（去芦，四钱） 槟榔（一钱半） 木香（一钱）
神曲（炒，二钱半）
上为末，入黄蜡、面，水和作煎饼吃。
至宝丸
真阿魏（二钱） 芦荟 天竺黄 胡黄连 雄黄 穿山甲（炒） 沉香 白草乌（泡） 砂 没药
（各二分）
上为极细末，用好酒和成一块，入铜锅内，再入酒半茶钟，熬成膏。勿令火大，恐伤药方，量可丸取出。
丸如豌豆大，每丸黄酒送下。十岁以上，服二丸，临卧时服。待其自然汗出，三日服一次。重者，五七服，
轻者，二三服，热即退、块亦消。须要忌口。如服后热不止，可后服金花丸；如羸弱不进食者，可先服平胃散。
癖疾方
麝香（二分） 全蝎（去毒） 斑蝥（去头、翅、足） 红娘子（去头、尾、足翅，女人用、男子去）
阿魏 蠓虫（去足翅） 血竭 雄黄 砂 芦荟 木香 当归尾（酒浸） 三棱（醋煮） 莪术（醋煮）
香附米（炒） 白豆蔻（去皮） 萝卜子（炒，各一钱）
上为细末，醋糊丸，如梧桐子大。每服三五十丸，或酒、或温水下。壮盛者可服。
癖疾方
芦荟（五分） 阿魏（五分） 急性子（即小桃红子） 水红花子（一钱） 黑
白牵牛（共一钱） 猴（烧灰一钱）
上为细末，每服三分，黄酒送下，三帖全好。
癖疾方
牛黄（四分） 雄胆（四分） 血竭（一钱） 芦荟（四分） 炉甘石（五分） 天竺黄（五钱）
黄蜡（五钱） 净皮硝（一两） 蜂蜜（四两）
上将蜡化开，与蜂蜜一处，滚熟住火，倾入细瓷碗内，凉冷后，将群药为细末，方入蜜蜡内搅匀。每日常
服。先服用箸头蘸吃，后多服不怕，十日全消。忌醋冷油腻之物。
又方
核桃仁（一斤） 槟榔（二十个） 砂（一钱） 大黄（一两）
上三味为细末，入桃仁，水煮一炷香。水滚时，陆续入皮硝半斤，香尽硝亦尽，止食桃仁亦好。
清香散 治癖疾生牙疳、溃烂臭秽。
乳香 没药 孩儿茶 轻粉（炒） 象皮（炒灰） 象牙（焙黄） 红褐（炒灰） 珍珠（焙黄）
海巴（焙干。各等分）
上为细末，搽患处，立时痛止，生肌如神。
桃花散 治癖气上攻，牙腮腐烂。
桃花信一块，桑柴火内烧红，淬入细茶浓卤内。如此七次，去信，将茶卤入雄黄一块，研末入卤内，用鸡
翎频扫患处。止痛生肌，立时见效。
克坚膏 专治小儿癖块、发热羸瘦。
木鳖子 穿山甲 川乌 甘遂 甘草 当归 上各八钱，先用真香油一斤入锅内，将前药熬成灰，滤去渣，
再慢火熬，滴水不散，方下黄丹八两，熬滴水成珠，方下细药入内，再不见火 芦荟 阿魏 硼砂 皮硝
水红花子（各五钱） 砂（三钱） 麝香（一钱）
上为细末，入内搅匀不熬，摊为膏药。贴时，先用皮硝
水洗皮肤，以膏贴癖。二三日后，觉肚内疾作疼，四五日发痒，粪后有脓血之物是其验也。
抓癖膏（李沧溪传） 香油（半斤） 桐油（半斤） 生猪脑子（半斤） 男子血余（灰水洗净，
不拘多少） 桃仁（四两） 白蜡（四钱）
上俱下锅内，文武火熬的脑子尽，用布绢滤去渣，次下飞过黄丹十四两，熬成膏，待温下∶胡黄连、香白
芷、苏木、红花、三棱、莪术（各三钱）、当归尾、 砂（各五钱）、麝香（一钱半）。各为细末，照分两重
罗，入前膏内搅匀收贮。勿令泄气。如有积块，先用皮硝煎水洗患处，令净，次用生姜擦之，方用绢帛摊药贴
上；贴后，用热鞋底炙热熨之五七十遍，觉内热方可。如贴后，癖即消缩如神。
灸法 穴在小儿背脊中，自尾 骨将手揣摸脊骨两傍有血筋发动处两穴。每一穴用铜钱三文压在穴上，
用艾炷安孔中，各灸七壮。此是癖之根，贯血之所。灸之，疮即发，即可见效。灸不着血筋，则疮不发，而不
效矣。
化癖如神散 治痞块积聚。
蟾酥 黄蜡（各二钱） 羚羊角 牛黄（各五分） 麝香（三分） 巴豆肉（一钱） 砂 冰片（各一分）
上为末，丸如菜子大。每用一丸，用扁头针，或患处刺破皮入之，用膏药粘贴。一伏时揭起，其癖化脓血
出尽，服调理脾胃药。
一小儿，患痞癖，服槟榔、蓬术、枳实、黄连之类，痞益甚。余曰∶此脾经血虚痞也，不可克伐。遂用六
君子加当归数剂，胃气渐复，诸症渐愈；乃朝用五味异功散加升麻、柴胡，夕用异功散加当归、芍药而愈。
（方见补益。）
Qian Zhongyang stated: "Pi mass" (lump in the hypochondrium) refers to pathogenic factors lodging obliquely in the bilateral hypochondriac regions; "Pi knot" (epigastric fullness) refers to Qi stagnation obstructing the Zhongwan area. This is caused by improper breastfeeding or feeding, leading to food stagnation and the clashing of pathogenic factors. It may also result from the mother's exposure to the Six Evils (Wind, Cold, Summerheat, Dampness, Dryness, Fire) or emotional disturbances (Joy, Anger, Worry, Overthinking, Sorrow, Fear, Fright). Ancient practitioners often used harsh purgative methods. If Pi or Pi persists for a long time, reducing appetite and inevitably weakening Spleen Qi, prolonged non-resolution requires prioritizing the consolidation of Stomach Qi first. Nourishing the righteous Qi will naturally eliminate the accumulation. Attempting to directly attack the knot will not only fail to dissipate it effectively but also damage the Spleen Earth. Once Spleen Earth is deficient, myriad complications arise; treatment must refer to various categories and address the specific symptoms of the child. If the Pi mass has persisted for a long time, causing deficiency in both Yuan Qi and Spleen/Stomach, it is appropriate to administer Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) in the morning and Qianjin Xiaopi Wan (Thousand-Gold Pill for Dissipating Pi) in the evening, with intermittent use of Hunyuan Dan (Primordial Elixir), yielding many successes.
Pi arises in the tissue between the skin and the fascia.
Jing Fu Tang (Cleanse the Viscera Decoction): Treats all types of Pi masses in children, accompanied by fever, dry mouth, red urine, or diarrhea.
Chai Hu (Bupleuri Radix), Baifuling (Poria Cocos with Peel Removed), Zhuling (Polyporus), Zexie (Alisma Rhizome), Sanleng (Sparganii Rhizoma Vinegar-Processed), Ezhu (Curcumae Rhizoma Vinegar-Processed), Shanzha (Crataegi Fructus Pitted, each 1 qian), Huangqin (Scutellariae Radix), Baizhu (Atractylodis Macrocephalae Rhizoma De-stalked), Banxia (Pinelliae Rhizoma Ginger-Processed), Renshen (Ginseng Radix, each 8 fen), Huhuanglian (Coptidis Rhizoma Alternatives/Huahuanglian), Gancao (Licorice Root, each 3 fen).
Grind these into one dose, decoct with fresh ginger and jujube, and take orally.
Fei'er Wan (Fatten the Child Pill): Highly effective for Pi disease (Formula see section on Gan Disease).
Qianjin Xiaopi Wan (Thousand-Gold Pill for Dissipating Pi): Highly effective for pediatric Pi disease and accumulations.
Luhui (Aloe), Awei (Ferula Resin, prepared separately as paste), Qingdai (Indigo Naturalis), Muxiang (Vladimiriae Radix), Nongpo (Magnoliae Officinalis Cortex Ginger-Processed), Binglang (Arecae Semen), Chenpi (Citri Reticulatae Pericarpium De-white Pith, each 1 qian), Maiya (Hordei Fructus Germinatus Stir-fried, 4 qian), Shijunzi (Quisqualis Fructus Shell Removed), Huhuanglian, Shanzharou (Crataegi Fructus Flesh), Xiangfu (Cyperi Rhizoma Water-Soaked), Sanleng (Sparganii Rhizoma Vinegar-Processed), Ezhu (Curcumae Rhizoma Roasted/Vinegar-Processed, each 2 qian), Shuihonghuazi (Alternantherae Philoxeroides Fruit Lightly Stir-fried), Shenqu (Massa Medicata Fermented Stir-fried, each 4 qian), Renshen (Ginseng Radix De-stalked), Fuling (Poria Cocos Peel Removed), Baizhu (Atractylodis Macrocephalae Rhizoma De-stalked, each 3 qian), Gancao (Licorice Root Honey-Fried, 1 qian).
Grind into fine powder. Take 1 qian of Awei, mix with water and flour to make a paste for pill-making. Size like mung beans. Take 40-50 pills per dose, swallowed with rice water or warm water.
Yi'er Bing (Benefit Child Cake): Treats pediatric Pi disease.
Shuihonghuazi, Shijunzi (Shell Removed), Shanzharou (each 5 qian), Baizhu (De-stalked, 4 qian), Binglang (1.5 qian), Muxiang (1 qian), Shenqu (Stir-fried, 2.5 qian).
Grind into powder, add beeswax and flour, mix with water to make pancakes for consumption.
Zhibao Wan (Treasure-Preserving Pill)
Zhen Awei (Authentic Ferula Resin, 2 qian), Luhui, Tianzhuhuang (Calami Tintinnabuli), Huhuanglian, Xionghuang (Realgar), Chuanshanjia (Manis Squama Stir-fried), Chenxiang (Aquilariae Lignum Resinatum), Baicaowu (Aconiti Kusnezoffii Radix Soaked), Sharen (Amomi Fructus Rotundus), Moyao (Myrrha). (Each 2 fen).
Grind into extremely fine powder. Mix well with good wine into a lump. Place in a copper pot, add half a tea cup of wine, and simmer into an ointment. Do not use high heat to avoid damaging the formula. Remove when ready.
Pill size like pea. Take one pill with yellow wine. For children over ten years old, take two pills at bedtime. Wait for natural sweating. Take once every three days. For severe cases, take 5-7 doses; for mild cases, 2-3 doses. Fever subsides, mass dissipates. Strict dietary restrictions required. If fever persists after taking, follow up with Jinhua Wan (Golden Flower Pill); if emaciated and unable to eat, first take Pingwei San (Regulate the Stomach Powder).
Pi Ji Fang (Prescription for Pi Disease)
Shexiang (Moschus), Quanxie (Scorpio De-toxicated), Banmao (Mylabris Head/Wings/Feet Removed), Hongniangzi (Lytta Head/Tail/Feet/Wings Removed; for females use whole, for males remove head), Awei, Mengchong (Tipula Larva Feet/Wings Removed), Xuexie (Draconis Sanguis), Xionghuang, Sharen, Luhui, Muxiang, Dangguiwei (Angelicae Sinensis Radix Wine-Soaked), Sanleng (Sparganii Rhizoma Vinegar-Boiled), Ezhu (Curcumae Rhizoma Vinegar-Boiled), Xiangfumiao (Cyperi Rhizoma Stir-fried), Baidoukou (Amomi Fructus Peel Removed), Luobozuo (Brassicae Napus Semen Stir-fried, each 1 qian).
Grind into fine powder, make pills with vinegar paste, size like Sophora seeds. Take 30-50 pills per dose, with wine or warm water. Suitable for robust individuals.
Pi Ji Fang
Luhui (5 fen), Awei (5 fen), Jixingzi (Acacia Catharticae Semen/Small Peach Red Seed), Shuihonghuazi (1 qian), Heibai Qianniu (Black and White Pharbitidis Semen Total 1 qian), Houzao (Monkey Gland Ash, 1 qian).
Grind into fine powder. Take 3 fen per dose with yellow wine. Three doses cure completely.
Pi Ji Fang
Niuhuang (Bovis Calculus, 4 fen), Xiongdan (Bear Gallbladder, 4 fen), Xuexie (1 qian), Luhui (4 fen), Luganshi (Calamina, 5 fen), Tianzhuhuang (5 qian), Huangla (Beeswax, 5 qian), Jingpining (Refined Saltpeter, 1 liang), Fengmi (Honey, 4 liang).
Melt wax, mix with honey, boil then remove from fire. Pour into fine porcelain bowl. Cool down. Add powdered herbs, stir evenly into honey-wax mixture. Take daily. Initially apply with chopstick tip; later increase dosage fearlessly. Completely resolves in ten days. Avoid vinegar, cold, and greasy foods.
Another Prescription
Hetaoren (Walnut Kernel, 1 jin), Binglang (Arecae Semen, 20 pieces), Sharen (1 qian), Dahuang (Rhei Radix et Rhizoma, 1 liang).
Grind the above three into fine powder, add Tao Ren (Persicae Semen), boil in water for the time it takes to burn one incense stick. When boiling, gradually add 0.5 liang of Piping Xiao (Saltpeter). When incense burns out, saltpeter dissolves. Eating just the walnut kernels is also acceptable.
Qingxiang San (Clear Fragrance Powder): Treats Pi disease causing dental gangrene, ulceration, and foul odor.
Ruxiang (Olibanum), Moyao (Myrrha), Haiercha (Camelliae Sinensis Tea for Children), Qingfen (Calomelas Stir-fried), Xiangpi (Elephant Skin Charred), Xiangya (Elephant Ivory Roasted Yellow), Honghe (Red Brown Material Charred), Zhenzhu (Pearl Roasted Yellow), Haiba (Morinda Officinalis Root Roasted Dry, equal parts).
Grind into fine powder, apply to affected area. Pain stops immediately, flesh regeneration is miraculous.
Taohua San (Peach Blossom Powder): Treats Pi Qi attacking upwards, causing rotting of teeth and cheeks.
Take one piece of Taohua Xin (Peach Gum/Resin), roast red in mulberry wood fire, quench in strong tea brine. Repeat seven times. Remove Xin. Add one piece of Xionghuang to the tea brine, grind into powder, mix into brine. Use chicken feather to frequently sweep the affected area. Stops pain, regenerates flesh, immediate effect.
Kejian Gao (Hardness-Dissolving Ointment): Specifically treats pediatric Pi masses, fever, and emaciation.
Mubiezi (Strychni Semen), Chuanshanjia, Chuanwu (Aconiti Radix), Gansui (Kansui Radix), Gancao, Danggui. (Each 8 qian). First, put 1 jin of authentic sesame oil in pot, decoct the above herbs until ash, filter dregs. Simmer slowly until a drop does not disperse in water. Then add 8 liang of Huangdan (Litharge). Simmer until drops form pearls. Then add fine herbs: Luhui, Awei, Pengsha (Borax), Piping Xiao, Shuihonghuazi (each 5 qian), Sharen (3 qian), Shexiang (1 qian).
Grind fine herbs into powder, mix into ointment without further heating. Spread as plaster. Before application, wash skin with Piping Xiao water, then apply plaster to Pi mass. After 2-3 days, feel abdominal pain; after 4-5 days, itching occurs; pus and blood in stool indicate efficacy.
Zhua Pi Gao (Scratching Pi Ointment - Passed down by Li Cangxi)
Xiangyou (Sesame Oil, 0.5 jin), Tongyou (Tung Oil, 0.5 jin), Sheng Zhu Naozi (Raw Pig Brain, 0.5 jin), Nanxu Xueyu (Male Hair Ash Washed with Alkaline Water, any amount), Tao Ren (Persicae Semen, 4 liang), Baila (White Beeswax, 4 qian).
Put all in pot, cook with medium-low heat until brain is consumed. Filter through cloth/silk to remove dregs. Add 14 liang of refined Huangdan, cook into ointment. When warm, add: Huhuanglian, Xiangbaizhi (Angelicae Dahuricae Radix), Sumu (Sappan Wood), Honghua (Carthami Flos), Sanleng, Ezhu (each 3 qian), Dangguiwei, Sharen (each 5 qian), Shexiang (1.5 qian). Grind into fine powder, sieve according to weight, mix into previous ointment, store tightly. Do not let air escape. For accumulations, first wash affected area with Piping Xiao decoction, clean thoroughly, then rub with fresh ginger. Apply medicated silk plaster. After application, heat shoe sole and iron/massage the area 50-70 times until internal heat is felt. The Pi mass shrinks miraculously.
Moxibustion Method: Acupoint located on the midline of the child's back. Starting from the coccyx, palpate along both sides of the spine for areas where blood vessels/tendons are active. Two acupoints. Press three copper coins on each point. Place moxa cone in the hole. Moxa 7 cones per point. This is the root of Pi, where blood penetrates. Moxibustion causes sore formation, indicating effectiveness. If moxa does not hit the blood vessel/tendon, no sore forms, and it is ineffective.
Huapi Rushen San (Pi-Dissipating Miraculous Powder): Treats Pi masses and accumulations.
Chansu (Toad Venom), Huangla (Beeswax, each 2 qian), Lingyangjiao (Saiga Antelope Horn), Niuhuang (Bovis Calculus, each 5 fen), Shexiang (3 fen), Badourou (Crotonis Semen Exocarpium, 1 qian), Sharen, Bingpian (Borneolum Syntheticum, each 1 fen).
Grind into powder, make pills size like rapeseed. Use one pill per dose. Pierce skin at affected area with blunt needle or insert directly. Cover with plaster. Remove after one watch (2 hours). Pi transforms into pus/blood discharge. Afterwards, take Spleen/Stomach regulating medicine.
Case: A child suffered from Pi/Pi disease. Took Binglang, Pengzhu, Zhishi, Huanglian, etc., making the condition worse. I said: This is Pi due to Spleen channel Blood deficiency, cannot use purgatives. Used Liu Jun Zi Tang (Six Gentlemen Decoction) plus Dang Gui for several doses. Stomach Qi gradually recovered, symptoms improved. Then used Wu Wei Yi Gong San (Five-Flavor Yi-Gong Powder) plus Sheng Ma, Chai Hu in the morning, and Yi Gong San plus Dang Gui, Shaoyao in the evening. Cured. (Formula see Tonification section)