痞者塞也，结者实也，热气蕴于胸膈之间，留饮聚于腹胁之内，于是荣卫不能流行，脏腑不能宣通，由胀满而致痞
结，势使然耳，此实热之症也，时或发为壮热，圣惠甘遂散主之。此药治小儿痞结，虽服汤药时，暂得利而滞实不去，
心下坚胀，按之即啼，内有伏热诸候，并成此疾，宜疏利大便，破结散气，后宜常服进食丸。
圣惠甘遂破结散 治小儿心胸痞结，蕴聚痰水。
甘遂（面裹、煨令黄色、二钱半） 青皮（半两） 黄芩（半两） 川大黄（煨、半两）
上为粗末，每服一钱，水一盏，煎至六分，去滓温和服，量大小加减，得通利则止，后以冷粥补之。
进食丸 治乳食不消，心腹胀满，壮热喘粗，呕吐痰逆，腹鸣泄泻，米谷不化，或下痢赤白，腹痛后重，及食
症、乳癖、 气、痞结并皆治之，小儿胸膈热实，腹内有留饮，致令荣卫痞塞，脏腑之气不得宣通，其病腹内气结胀满
或壮热，凡有此疾，当疏利大便，破结散气，宜常服之。
巴豆霜（一钱） 朱砂（五钱） 枳壳（炒、五钱） 当归（米泔浸一宿、炒） 代赭石（ 、醋淬七次、各三钱）
木香（五钱） 麝（少许）
上为末，面糊为丸如麻子大，一岁儿一丸，温米饮下，更量虚实加减，食后服，治食积发热羸瘦，肚大青筋，疳积
肚疼哺露。
Pi (Pijie, a condition characterized by obstruction and accumulation) refers to blockage; Jie refers to solid accumulation. Heat qi accumulates between the chest and diaphragm, while retained fluids gather within the abdomen and hypochondrium. Consequently, Ying and Wei (Nutritive and Defensive Qi) cannot circulate smoothly, and the Zang-Fu organs cannot function in harmony. Thus, distension and fullness develop into Pi-Jie, which is the natural progression of the disease. This is a syndrome of excess heat. Occasionally, it manifests as high fever. The primary treatment is Gan Sui San from *Taiping Shenghui Fang* (Sanctified惠民 Formulary).
This prescription treats pediatric Pi-Jie. Although administration of decoctions may temporarily promote bowel movement, the internal stagnation and pathogenic solids remain unresolved. Symptoms include hardness and distension in the epigastrium ("Xin Xia"), with crying upon palpation, along with various signs of latent heat within. These factors contribute to this ailment. Treatment should focus on promoting bowel movements, breaking up accumulations, and dispersing stagnant Qi. Subsequently, patients should regularly consume Jin Shi Wan (Appetizing Pill).
**Shenghui Gan Sui Po Jie San** (Gansui Breakup Accumulation Powder from *Shenghui Fang*): Treats pediatric chest and heart Pi-Jie, where phlegm and water accumulate.
Ingredients:
- *Kansui Radix* (Gan Sui) [Radix Kansui]: Wrapped in flour, roasted until yellow, 2.5 qian.
- *Citri Reticulatae Pericarpium Viride* (Qing Pi) [Green Tangerine Peel]: 0.5 liang.
- *Scutellariae Radix* (Huang Qin) [Skullcap Root]: 0.5 liang.
- *Rhei Radix et Rhizoma* (Chuan Dahuang) [Rhubarb Root]: Roasted, 0.5 liang.
Preparation and Administration: Grind the above ingredients into a coarse powder. Take 1 qian per dose, add one cup of water, and boil down to 0.6 cups. Strain the dregs and administer warm. Adjust dosage according to the child's age and size. Stop when bowel movements become free, and follow with cold rice porridge to nourish the stomach.
**Jin Shi Wan** (Appetizing Pill): Treats indigestion of milk and food, epigastric and abdominal distension, high fever with rapid breathing, vomiting of phlegm and reflux, borborygmus with diarrhea, undigested food in stool, or dysentery with red and white discharge, abdominal pain with tenesmus. It also treats food accumulation syndromes, "Ru Pi" (breast lumps), Qi hernia, and Pi-Jie. For children with heat-solid in the chest and diaphragm, and retained fluids in the abdomen causing obstruction of Ying and Wei and dysfunction of Zang-Fu Qi, resulting in abdominal Qi knotting and distension or high fever, this formula is suitable for regular use to promote bowel movements, break accumulations, and disperse Qi.
Ingredients:
- *Crotonis Fructus Preparatum* (Ba Dou Shuang) [Prepared Croton Seed Frost]: 1 qian.
- *Cinnabaris* (Zhu Sha) [Cinnabar]: 5 qian.
- *Aurantii Fructus Immaturus* (Zhi Ke) [Immature Bitter Orange]: Stir-fried, 5 qian.
- *Angelicae Sinensis Radix* (Dang Gui) [Chinese Angelica Root]: Soaked overnight in rice wash water, stir-fried.
- *Haematitum* (Dai Zhe Shi) [Limonite]: Calcined, quenched in vinegar seven times, 3 qian each (for Dai Zhe Shi and another ingredient implied as equal weight, likely referring to specific preparation ratios or combined weight contextually, here listed as 3 qian each for the specified items if multiple, but text says "each 3 qian" for Dai Zhe Shi and potentially others if grouped, strictly translating "Dai Zhe Shi (... , each 3 qian)" implies specific weighting). *Note: Text lists Dai Zhe Shi with processing instructions and "each 3 qian", implying other items might share this or it's a specific ratio. We list as provided.*
- *Costi Rhizoma* (Mu Xiang) [Costus Root]: 5 qian.
- *Moschus* (She) [Musk]: A small amount.
Preparation and Administration: Grind into fine powder and form pills using wheat paste, sized like hemp seeds. One-year-old infants take one pill, administered with warm rice drink. Adjust dosage based on deficiency or excess. Take after meals. Treats food accumulation with fever, emaciation, abdominal distension with visible blue veins, malnutrition (Gan Ji) abdominal pain, and skeletal prominence.