寒痛中虚脾受寒，尿爪俱白面青看，喜热腹满或下利，理中肢厥加附煎。
[注]
寒痛者，多因小儿中气虚弱，复为风冷所乘，则脾经受寒，
故不时腹痛，现证尿白爪甲白，面多青，喜饮热，
或腹满下利，宜理中汤温之，
若四肢厥冷，兼属少阴，则加附子。
(理中汤) 方见不乳。
%
腹痛门
虫痛不安腹因痛，面色乍青乍赤白，时痛时止吐清涎，安虫理中治最合。
[注]
虫痛者，因腹中虫动不安，
故腹中作痛，其候面色乍赤乍青乍白，其痛时作时止，时吐清水，
切不可妄用攻下，当以安虫为主，其痛即除，
新痛者，钱氏安虫散治之，痛久不愈者，加减理中汤治之。
(钱氏安虫散) 胡粉炒黄 鹤虱炒黄 白矾枯 川楝子各二钱五分去皮核
以上为细末，每服一大匙，大者五分，米饮调下，痛时服。
(加减理中汤) 方见虫吐。
%
腹痛门
内伤乳食外感寒，发热恶寒腹痛兼，恶食呕吐多啼叫，藿香和中可急煎。
[注]
小儿内伤乳食，外感寒邪，遂致食寒凝结，腹中作痛，
其候发热恶寒，而更兼腹痛恶食，呕吐啼叫不已者，以藿香和中汤治之。
(藿香和中汤) 藿香 砂仁研 羌活 苍术米泔水浸 陈皮 厚朴姜炒
甘草生 山查 香附炙 白芷 苏叶 川芎 引用生姜水煎服。
(方歌)
藿香和中治腹疼，内伤食滞外寒风，藿砂羌苍陈朴草，山查香附芷苏芎。
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Cold Pain: When the middle Qi is deficient and the Spleen is affected by Cold, the urine and nail beds appear white, and the facial complexion is bluish. The patient prefers warmth, experiences abdominal fullness or diarrhea. If cold extremities (Zhi Jue) are present, Aconite Radix Preparata (Fuzi, 附子) should be added to Lizhong Decoction for decoction.
[Note]
Cold pain is mostly caused by the deficiency of Middle Qi in children, compounded by invasion of Wind-Cold pathogens, leading to Cold affecting the Spleen Meridian.
Consequently, intermittent abdominal pain occurs. Clinical manifestations include white urine, pale nails, a predominantly bluish facial complexion, a preference for hot drinks,
or abdominal distension with diarrhea. It is appropriate to treat with Lizhong Decoction (Ginseng, Dried Ginger, Atractylodes Macrocephala Rhizome, and Licorice Root Decoction) to warm the interior.
If cold extremities are accompanied, it indicates involvement of the Shaoyin pattern; therefore, Aconite Radix Preparata (Fuzi, 附子) should be added.
(Lizhong Decoction) See the section on "Refusal to Feed."
Worm Pain: Abdominal pain due to restlessness caused by intestinal worms, with a facial complexion that alternates between bluish, reddish, and whitish. Pain comes and goes intermittently, accompanied by vomiting of clear saliva. Treating with worm-calming agents and warming formulas is most suitable.
[Note]
Worm pain arises from the restless movement of intestinal worms within the abdomen,
causing abdominal pain. Symptoms include a facial complexion that fluctuates between red, blue, and white, intermittent pain, and frequent vomiting of clear fluids.
One must absolutely avoid using purgatives recklessly. The primary treatment should focus on calming the worms; once the worms are calmed, the pain will cease.
For newly onset worm pain, Qian's Worm-Calming Powder (Qianshi Anchong San) should be used. For chronic pain that does not resolve, Modified Lizhong Decoction should be used.
(Qian's Worm-Calming Powder) Lead White (Hufen, 胡粉) stir-fried until yellow, Chrysanthemum Indicum Seed (Heshi, 鹤虱) stir-fried until yellow, Alum (Baifan, 白矾) calcined, Toosendan Fruit (Chuanlianzi, 川楝子) each 2.5 qian (peeled and pitted).
Grind the above ingredients into a fine powder. Take one large spoonful per dose (0.5 qian for older children), mixed with rice water, taken during episodes of pain.
(Modified Lizhong Decoction) See the section on "Vomiting due to Worms."
Internal Injury from Milk/Food and External Contraction of Cold: Internal injury from milk or food combined with external contraction of Cold leads to fever, aversion to cold, and concurrent abdominal pain. Symptoms include anorexia, vomiting, and excessive crying. Huoxiang Hezhong Decoction should be urgently decocted and administered.
[Note]
When children suffer internally from dietary injury (milk/food) and externally from Cold pathogens, food stagnation and Cold condense together, causing abdominal pain.
Clinical signs include fever with aversion to cold, accompanied by abdominal pain, anorexia, vomiting, and incessant crying. This condition is treated with Huoxiang Hezhong Decoction.
(Huoxiang Hezhong Decoction) Pogostemon Herba (Huoxiang, 藿香), Amomum Fructus Rotundus (Sharen, 砂仁) ground, Notopterygium Rhizome (Qianghuo, 羌活), Atractylodes Macrocephala Rhizome (Cangzhu, 苍术) soaked in rice wash water, Citrus Reticulata Pericarpium (Chenpi, 陈皮), Magnolia Officinalis Bark (Houpo, 厚朴) stir-fried with ginger juice, Licorice Root (Gancao, 甘草) raw, Hawthorn Fruit (Shanzha, 山查), Cyperus Rhizome (Xiangfu, 香附) roasted, Angelica Dahurica Root (Baizhi, 白芷), Perilla Leaf (Zisu, 苏叶), Ligusticum Chuanxiong Rhizome (Chuanxiong, 川芎). Decoct with fresh ginger water as a vehicle.
(Prescription Verse)
Huoxiang Hezhong treats abdominal pain, internal food stagnation and external Wind-Cold;
The formula contains Huoxiang, Sharen, Qianghuo, Cangzhu, Chenpi, Houpo, Gancao, Shanzha, Xiangfu, Baizhi, Zisu, and Chuanxiong.