小儿滞颐者，涎流出而渍于颐间也。脾之液为涎，由脾胃虚寒，不能收摄耳。治用六君子汤
加木香。凡作渴饮冷者，属实热，宜泻胃火。作渴饮汤者，属虚热，宜补中气。若脾经实热
，而廉泉不能约制者，用牛黄清心丸。脾经虚热，而廉泉不能统摄者，用六君子加木香。胃
经实热，而虫动津液流出者，用泻黄散；虚热用五味异功散。大便秘结，用清凉饮。中气下
陷，用补中益气汤。食积内热，用大安丸。仍参口疮腮肿条互览之。
治验
一小儿滞颐，面色痿黄。余谓当调补中气。不信，用清热之剂，更加弄舌，乃用五味异功散
，渐愈。后因停乳，吐泻复作，先用大安丸，消其宿乳，次用五味异功散，补其中气而痊。
一小儿滞颐，面色赤，手指热，用泻黄散，一服而愈。后因乳母饮酒，其子复患前症，用东
垣清胃散加干葛、神曲、麦芽，母子并服而愈。
一小儿停食腹痛，用疏导之药，痛止，左项筋动，口角涎流，面色痿黄，肢体微肿，先用六
君、柴胡、升麻、山栀四剂，次用异功散加升麻而痊。
一小儿停食腹痛。服峻利之药，吐泻自汗，厥冷滞颐。用六君、升麻、柴胡而愈。
一小儿十一岁，滞颐兼嗳气下气，时常停食，服消导清热之剂，大便不实，小腹重坠，此脾
气下陷也，用六君、升麻、柴胡，饮食渐进，大便渐实，又用四神丸而愈。
一小儿滞颐，面色白或黧，腹痛，手足时冷，脉微细，此肺肾虚寒也，宜先培其脾土，用温
胃散，二服腹痛顿止，又六君子汤，诸症并愈。后停食挟惊，吐泻发搐，滞颐腹痛复作，用
六君加柴胡、钩藤钩，四剂而痊。
一小儿吐舌流涎，余谓心脾有热。用导赤、泻黄二散而愈。后自服清热化痰等药，更加弄舌
，余用异功散加钩藤钩而安，又用六君子汤而愈。
一小儿滞颐，面色白或赤，目札切牙，此禀肝肾气不足，内热而生虚风也。用地黄丸以滋肾
水；异功散以补脾土而安。
一小儿滞颐，面青，手按其腹则叫痛，此夹食与惊也，用异功散加枳实、升麻，二剂而愈。
后又停食，吐泻滞涩发搐，面色青黄，此脾虚而肝木乘之也，用异功散加升麻、柴胡、钩藤
钩而愈。
温胃散 治脾冷涎多，流滞于颐。
丁香（一两） 人参 半夏 肉豆蔻 白术 干姜 甘草（各半两）
上为末，每服一钱，姜水煎。
愚按∶此方治脾胃虚寒，涎流不止，或呕吐腹痛之良剂也。脾气稍温，但服五味异功散。
六君子汤
钱氏异功散
四君子汤
清胃散（四方见内钓）
四顺清凉饮
补中益气汤
大安丸（保和丸加白术，三方见虚羸）
泻黄散（方见脾脏）
牛黄清心丸（方见急惊）
四神丸（方见惊泻）
导赤散（方见心脏）
Pediatric drooling (Zhi Yi) refers to saliva flowing out and soaking the cheeks. The fluid of the Spleen is saliva; this condition arises from deficiency-cold of the Spleen and Stomach, which fails to consolidate and control fluids. Treatment utilizes Liujunzi Tang (Six Gentlemen Decoction) with added Muxiang (Aucklandiae Radix). For those who feel thirsty and desire cold drinks, it belongs to excess-heat syndrome, suitable for purging Stomach fire. For those who feel thirsty and desire hot drinks, it belongs to deficiency-heat syndrome, suitable for tonifying Middle Qi. If there is excess-heat in the Spleen channel, causing the Lianquan acupoint (Ren-23, governing fluid control) to fail in restraint, Niuhuang Qingxin Wan (Calculus Bovis Heart-Clearing Pill) is used. If there is deficiency-heat in the Spleen channel, causing the Lianquan acupoint to fail in controlling fluids, Liujunzi Tang with added Muxiang is used. If there is excess-heat in the Stomach channel, causing worms to move and fluids to flow out, Xiehuang San (Drain Yellow Powder) is used; for deficiency-heat, Wuyi Gong San (Five Virtues Powder) is used. For constipation, Qingliang Yin (Cooling Drink) is used. For sinking of Middle Qi, Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) is used. For food stagnation generating internal heat, Da'an Wan (Great Peace Pill) is used. Refer also to the entries on mouth sores and swollen cheeks for cross-reference.
Case Records:
A child with drooling had a sallow complexion. I stated that the Middle Qi should be regulated and tonified. The family did not believe me and used heat-clearing agents, which resulted in tongue-flicking symptoms. Subsequently, Wuyi Gong San was used, leading to gradual recovery. Later, due to improper weaning, vomiting and diarrhea recurred. Da'an Wan was first used to eliminate retained milk, followed by Wuyi Gong San to tonify the Middle Qi, resulting in full recovery.
A child with drooling had a red face and hot fingers. Xiehuang San was used, resulting in recovery after one dose. Later, because the wet nurse drank alcohol, the child suffered a recurrence of the previous condition. Qingwei San (Clear Stomach Powder) from Dongyuan, with added Gegen (Puerariae Radix), Shenqu (Massa Medicata Fermentata), and Maiya (Hordei Fructus Germinatus), was administered to both mother and child, resulting in recovery.
A child with food stagnation and abdominal pain had pain relieved after using guiding and unblocking medications. However, tendons on the left side of the neck twitched, saliva flowed from the corner of the mouth, the complexion was sallow, and limbs were slightly swollen. Six Junzi Tang, Chaihu (Bupleuri Radix), Shengma (Cimicifugae Rhizoma), and Zhizi (Gardeniae Fructus) were administered for four doses, followed by Yigong San (Yi's Formula) with added Shengma, resulting in recovery.
A child with food stagnation and abdominal pain took harsh purgative medicines, resulting in vomiting, diarrhea, spontaneous sweating, cold extremities, and drooling. Liujunzi Tang, Shengma, and Chaihu were used, resulting in recovery.
An eleven-year-old child suffered from drooling accompanied by belching and flatulence, with frequent food stagnation. After taking digestive and heat-clearing agents, the stool became loose, and there was a heavy sensation in the lower abdomen. This indicated sinking of Spleen Qi. Liujunzi Tang, Shengma, and Chaihu were used; diet gradually increased, and stool became formed. Si Shen Wan (Four Spirits Pill) was then used, resulting in recovery.
A child with drooling had a white or dark complexion, abdominal pain, cold hands and feet, and a faint, fine pulse. This indicated deficiency-cold of the Lung and Kidney. It was appropriate to first cultivate the Earth (Spleen) using Wenwei San (Warm the Stomach Powder). After two doses, abdominal pain ceased immediately. Liujunzi Tang was then used, resolving all symptoms. Later, due to food stagnation complicated by fright, vomiting, diarrhea, and convulsions occurred, with recurrence of drooling and abdominal pain. Liujunzi Tang with added Chaihu and Goutenggou (Uncariae Ramulus cum Uncis) was administered for four doses, resulting in recovery.
A child with tongue protrusion and salivation was diagnosed as having heat in the Heart and Spleen. Daochi San (Guide Out Red Powder) and Xiehuang San were used, resulting in recovery. Later, self-administration of heat-clearing and phlegm-resolving medicines led to more severe tongue-flicking. Yigong San with added Goutenggou was used to calm the condition, followed by Liujunzi Tang, resulting in recovery.
A child with drooling had a white or red face, blinking eyes, and grinding teeth. This indicated insufficient congenital Qi of the Liver and Kidney, with internal heat generating deficient wind. Dihuang Wan (Rehmannia Pill) was used to nourish Kidney Water; Yigong San was used to tonify Spleen Earth, resulting in stabilization.
A child with drooling had a blue complexion and cried in pain when the abdomen was pressed. This indicated complication of food and fright. Yigong San with added Zhishi (Aurantii Fructus Immaturus) and Shengma was administered for two doses, resulting in recovery. Later, food stagnation caused difficult vomiting and diarrhea with convulsions, and a green-yellow complexion. This indicated Spleen deficiency with Liver Wood overacting. Yigong San with added Shengma, Chaihu, and Goutenggou was used, resulting in recovery.
Wenwei San treats cold Spleen with excessive saliva flowing and stagnating in the cheeks.
Dingxiang (Caryophylli Flos, 1 liang) Renshen (Ginseng Radix et Rhizoma) Banxia (Pinelliae Tuber) Roudoukou (Myristicae Semen) Baizhu (Atractylodis Macrocephalae Rhizoma) Ganjiang (Zingiberis Rhizoma) Gancao (Glycyrrhizae Radix et Rhizoma) (each 0.5 liang)
Grind into powder. Take 1 qian per dose, decoct with ginger water.
Commentary: This formula is an excellent remedy for deficiency-cold of the Spleen and Stomach, causing incessant salivation, or vomiting and abdominal pain. Once Spleen Qi warms slightly, only Wuyi Gong San needs to be taken.
Liujunzi Tang (Six Gentlemen Decoction)
Qian Shi Yigong San (Master Qian's Five Virtues Powder)
Sijunzi Tang (Four Gentlemen Decoction)
Qingwei San (Clear Stomach Powder) (See Nei Diao for formulas)
Sishun Qingliang Yin (Four Smooth Cooling Drink)
Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction)
Da'an Wan (Great Peace Pill) (Bahe Wan plus Baizhu; see Xu Lei for three formulas)
Xiehuang San (Drain Yellow Powder) (See Pi Zang)
Niuhuang Qingxin Wan (Calculus Bovis Heart-Clearing Pill) (See Ji Jing)
Si Shen Wan (Four Spirits Pill) (See Jing Xie)
Daochi San (Guide Out Red Powder) (See Xin Zang)