（第三）
丁奚哺露者，皆因脾胃久虚，不能克化水谷，以荣气血，故肌肉消瘦，肾气不足，渐
致肉枯骨露。亦有胎中受病于母，手足极细，项小骨高，腹大脐突，或生谷瘕，是为丁奚。
若往来蒸热，颅囟分开，吐乳吐虫，烦渴呕哕，是为哺露。此盖疳证之极而因其形以名之也。
十全丹 治小儿丁奚哺露。
青皮 陈皮 莪术（炮） 川芎 五灵脂 白豆蔻 槟榔 芦荟 木香 使君子 虾蟆（各
二钱。炙）
上为末，猪胆汁浸膏糊丸，麻子大。每服二十丸，米饮下。
大芦荟丸 治前证。（方见疳门。）
（第四）
呕者，有声也。吐者，吐出乳食也。凡小儿乳哺不宜过饱，若满则溢，故令呕吐。乳母无
知，但欲速得儿长，更无时度，或儿睡着而强乳，自此受病之源，渐至日深，遂成呕吐。甚者，
宜渐断乳。先令乳母服调气之剂，儿服消食丸，化乳壮胃为上。盖吐乳呕乳证有数般，有冷吐，
有热吐，当辨审之。若吐自口角出，此是乳多不能消化，满而则溢，此非病也，当服消乳丸。
热吐则头额温或有黄涎，五心热，小便赤少或唇干而烦渴，多是暑月伤暑成此证。乳母服香薷
散、五苓散；儿服香薷汤、五苓散。冷吐则清涎夹乳吐出，小便清而多。由乳母当风取凉解脱，
致令风冷之气入乳，令乳变败。儿饮之则冷气入胃，故呕吐也。乳母宜捏去旧宿乳，服理中汤
快气助胃之剂，次用酿乳法，茯苓半夏汤、加减观音散快胃之药。又有风痰吐者，乃是伤风不解，
吐乳夹痰，久必生风，宜服青州白丸子、半夏散疏风化痰之剂。
(Third)
Dingxi Bulu (Dingxi and Bulu syndromes) are all caused by long-term deficiency of the Spleen and Stomach, which fails to transform and transport food and fluids, thereby failing to nourish Qi and Blood. Consequently, muscles emaciate, Kidney Qi becomes insufficient, and gradually flesh withers while bones protrude. Some cases arise from disease contracted in the womb from the mother, presenting with extremely thin limbs, a slender neck with prominent bones, a distended abdomen with an everted umbilicus, or the formation of Gu Jia (Grain Accumulation/Mass). This is termed Dingxi. If accompanied by alternating steaming fever, separation of the cranial fontanelles, vomiting milk or worms, irritability, thirst, retching, and hiccups, this is termed Bulu. These represent the extreme stage of Gan Syndrome (Infantile Malnutrition), named according to their physical manifestations.
Shiquan Dan (Ten Complete Pills) treats Dingxi Bulu in children.
Qingpi (Green Tangerine Peel), Chenpi (Aged Tangerine Peel), Ezhu (Curcuma Rhizome, processed), Chuanxiong (Sichuan Lovage Rhizome), Wulingzhi (Trogopterus Dung), Baidoukou (White Cardamom Seed), Binglang (Areca Seed), Lushui (Aloe), Muxiang (Vladimiria Root), Shijunzi (Quisqualis Fruit), Xama (Toad, each two qian, roasted).
Grind the above into powder, soak in pig bile to make a paste for pill coating, size of hemp seeds. Take twenty pills per dose, swallowed with rice water.
Da Lushui Wan (Large Aloe Pill) treats the aforementioned syndrome. (Formula see Gan Men chapter.)
(Fourth)
Ou (Retching) refers to having sound; Tu (Vomiting) refers to expelling milk and food. In infants, breastfeeding should not be excessive. If overfed, it overflows, causing vomiting. Ignorant nurses, eager for rapid growth without regard for timing or quantity, may force-feed sleeping infants. This becomes the source of disease, deepening over time until vomiting ensues. In severe cases, weaning should be gradual. First, the nurse should take Qi-regulating formulas, and the infant should take Xiaoshi Wan (Digestion-Resolving Pills) to resolve milk stasis and strengthen the Stomach, which is the superior approach. There are several types of milk-vomiting syndromes: Cold Vomiting and Heat Vomiting, which must be carefully differentiated. If milk flows from the corner of the mouth, it is due to excess milk that cannot be digested and overflows; this is not a disease, and Xiaoru Wan (Milk-Resolving Pills) should be taken. Heat Vomiting presents with warmth on the forehead or yellow phlegm, heat in the Five Centers (palms, soles, and chest), scanty dark urine, dry lips, and irritability/thirst. It is often caused by Summerheat injury during summer months. The nurse takes Xiangru San (Elsholtzia Powder) and Wuling San (Five-Ingredient Powder with Poria); the infant takes Xiangru Tang (Elsholtia Decoction) and Wuling San. Cold Vomiting presents with clear saliva mixed with milk, and clear, frequent urination. This results from the nurse exposing herself to wind and cooling off by undressing, allowing Wind-Cold Qi to enter the breast milk, causing it to spoil. When the infant drinks this, Cold Qi enters the Stomach, causing vomiting. The nurse should discard old retained milk, take Lizhong Tang (Regulate the Middle Decoction) and other Qi-moving, Stomach-strengthening agents, and subsequently employ the "Nurturing Milk" method using Fuling Banxia Tang (Poria and Pinellia Decoction) or Jiaguan Yin Zi (Modified Guanyin Powder) to benefit the Stomach. Another type is Wind-Phlegm Vomiting, caused by unresolved Wind-Cold where vomited milk contains phlegm. Over time, this generates internal Wind. Qingzhou Baiwan Zi (Qingzhou White Pills) and Banxia San (Pinellia Powder) should be taken to dispel Wind and resolve Phlegm.