（夹实泻并积痢附）
茅先生小儿有积泻候∶面带青黄，眼微黄，上渴，肚膨呕逆，遍身潮热，通下臭秽，此候多因食物过度，伤着脾胃。
所治者，先用青金丹与取下积，（方见积聚门中。）后用匀气散、（方见胃气不和门中。）醒脾散、（另一方，一方见胃气不
和门中，一方见慢脾风门中。）香连丸（方见一切泄泻门中。）相夹调理即愈。
小儿形证论四十八候冷泻有积歌∶
积伤冷泻有多般，方脉唯须仔细看，四体平和无有热，泻终不定为脾间，求医最好休言止，止住之时怕转
难，取积为先方顺气，调和迤逦却求安。
此病冷食在脾，浑身温和无事。若只泻时，用皂角膏取调胃散补之（二方并见积热门中。）
茅先生小儿痢积褊银丸方。
轻粉（研） 粉霜 画粉 白丁香（以上各二钱）
上件一时研，滴鸡子清为丸饼子○此大。一岁一饼，二岁一饼半，三岁二饼以上。随大小加用。仍先用灰
火炮，令饼子黄赤色。饭饮灌下，半夜服之。
《婴孺》治小儿发热，腹内不调，时下利，不消化，颜色渐渐黄方。
浓朴（炙） 黄连（各三分） 人参 龙骨（各四分）
上切，以水一升八合，煮一升二合。分温，渐渐至夜服尽。乳母忌油腻、果子、生冷。
《婴孺》治八岁以上热结痰实，不能食自下方。
大黄（十三分） 柴胡（九分） 升麻 黄芩（各十分） 枳实（六分） 竹叶（切，一升半） 芍药 栀子仁（各
八分） 细辛（二分） 知母（十二分） 生姜（三分）
上以水六升，煮一升八合，为四服。十岁儿为三服。十四、五加柴胡二分、枳实一分、黄芩一分、芍药二
分、栀子仁二分，除细辛加杏仁八分，亦为三服，取二升。
《婴孺》治百日儿结实痰多，自下，大黄汤方
大黄（四分） 升麻（二分） 芍药（三分） 竹叶（切，五合） 甘草（一分） 细辛（半分） 杏仁（二十个，
麸炒，去皮尖）
上切，以水二升，煮六合，为三服。如儿末百日，用药量多少。
《婴孺》治百余日儿结实加壮热，挟实自下汤方。
枳壳 白藓皮（各二分） 大黄（五分） 知母 子芩（各四分） 甘草（一分半） 竹叶（切，五合） 栀子仁
芍药 寒水石 升麻 柴胡（各三分）
上以水二升七合，煮取六合半，为三服。
《婴孺》治四、五岁儿痰结实，自下，竹叶汤方
竹叶（切，一升） 大黄（十三分） 柴胡 栀子仁 芍药（各七分） 升麻 黄芩 知母（各八分） 细辛（一
分半） 枳壳（五分） 杏仁（六分，去皮炒）
上以水五升，煮取一升半。四岁为四服；五、六岁为三服；八、九岁量加之。
《婴孺》治八、九岁至十岁儿痰热结实，不能食自下汤方。
大黄 柴胡（各十二分） 升麻 黄芩 细辛（各十分） 枳壳（六分） 竹叶（切，一升） 芍药 栀子仁 杏
仁（去皮尖。各八分） 知母（三分）
上水六升，煮一升八合，为四服。十岁为三服。
《婴孺》治小儿十二三、十四五结热痰多，壮热，食进少，结实者自下，大黄散方
大黄（十二分） 柴胡 枳壳 升麻 芍药 栀子仁（各十分） 竹叶（一升） 生姜（三分） 知母 杏仁（去
皮尖。各八分）
上以水六升，煮取二升，为四服。十四、五为三服，儿小量之。
《婴孺》治小儿结实，壮热头痛自下，大黄汤方
大黄 柴胡 甘草（炙） 生姜（各十二分） 升麻 知母 黄芩（各七分） 大青（五钱） 石膏（十分） 芍
药枳实（炙。各六分）
上以水四升七合，煮取一升三合，为四服，量大小与之服。
《婴孺》治小儿实不尽下，或黄或青方。
大黄（三分） 细辛（二分半） 甘草（一分） 黄芩（一分半）
上以水二升，煮七合半，为二服。
《吉氏家传》治积痢当归散方
当归 龙骨 甘草（炙） 石榴皮 黄柏皮（各一钱） 诃子（二个，炮，去核）
上为细末。每服半钱，陈米饮下。
《吉氏家传》治积痢芍药散方
芍药 枳壳（去白，炒） 甘草 地榆（洗。各一钱） 黄柏（半两，去粗皮） 川乌头（一个，炮）
上焙干为末。每服半钱，用白梅汤下。
《吉氏家传》治风积、伤积，累用药取不下者，腹胀泻痢频并，及诸积，乳香丸方
乳香 没药 砂（各一块，如皂皂子大） 芥菜子（四十九粒） 巴豆（一粒，生）
上用大枣一枚，湿纸裹重封，灰火煨熟取出，去纸，与枣子支乳钵内，研为膏。若不通丸，入少许飞罗面，
丸如绿豆大。每服七丸，周岁三丸，三岁以上五丸，五更淡姜汤下，取下元物。
(Attached: Diarrhea with Excess and Dysentery with Accumulation)
Mr. Mao discusses the syndrome of pediatric diarrhea due to food accumulation: The complexion presents as cyan-yellow, the eyes are slightly yellow, there is thirst in the upper jiao, abdominal distension accompanied by vomiting and regurgitation, tidal fever over the whole body, and loose stools that are foul-smelling. This syndrome is mostly caused by excessive food intake, which injures the Spleen and Stomach.
The treatment plan first uses Qingjin Dan (Green Golden Pill) to purge the accumulation (formula see section on Accumulation and Distension), followed by regulation using Yunqi San (Qi-Regulating Powder) (formula see section on Disharmony of Stomach Qi), Xingpi San (Spleen-Awakening Powder) (another formula exists; one see section on Disharmony of Stomach Qi, one see section on Slow Spasm Wind), and Xianglian Wan (Cinnamon and Coptis Pill) (formula see section on All Types of Diarrhea). Coordinated regulation will lead to recovery.
Song from "Forty-Eight Syndromes of Pediatric Morphology" regarding Cold Diarrhea with Accumulation:
Accumulation injury and cold diarrhea present in various ways; pulse and syndrome differentiation require careful examination. The four limbs are peaceful without heat; the diarrhea ultimately does not locate solely within the Spleen. When seeking medical help, it is best not to merely stop the diarrhea; forcibly stopping it may cause the condition to transform and become difficult to manage. Removing accumulation should be the priority, followed by regulating Qi; harmony and peace will gradually be sought.
This disease involves cold food stagnating in the Spleen, with the whole body feeling warm and no other issues. If only diarrhea is present, use Zaojiao Gao (Gleditsia Sinensis Ointment) to purge, then tonify with Tiaowei San (Stomach-Regulating Powder) (both formulas see section on Heat Accumulation).
Mr. Mao's Pianyin Wan (Flat Silver Pill) for Pediatric Dysentery with Accumulation.
Qingfen (Calomelas, ground) Fen shuang (Calomelas sublimed) Huafen (Lead carbonate) Baoding (Vermilion Bird Droppings) (each 2 qian)
Grind the above ingredients together at one time, add egg white to form pill cakes. These pills are large. One-year-olds take one cake, two-year-olds take one and a half cakes, three-year-olds take two cakes or more. Increase dosage according to age. Before use, roast them in ash fire until the cakes turn yellow-red. Administer with rice water at midnight.
From *Yingru Shu*: Formula for treating pediatric fever, internal abdominal disharmony, occasional diarrhea, indigestion, and gradually yellowish complexion.
Houpo (Bark of Magnolia officinalis, processed with honey) Huanglian (Rhizoma Coptidis) each 3 fen Renshen (Radix Ginseng) Longgu (Fossilized Mammal Bones) each 4 fen
Cut the herbs, boil in 1.8 sheng of water to reduce to 1.2 sheng. Divide into warm doses, finishing administration by night. The nursing mother must avoid greasy foods, fruits, and raw/cold items.
From *Yingru Shu*: Formula for children over eight years old with heat-binding and phlegm-excess, inability to eat, and spontaneous purging.
Dahuang (Radix et Rhizoma Rhei) 13 fen Chaihu (Radix Bupleuri) 9 fen Shengma (Rhizoma Cimicifugae) Huangqin (Scutellariae Radix) each 10 fen Zhishi (Fructus Aurantii Immaturus) 6 fen Zhuye (Leaf of Bambusa) (cut, 1.5 sheng) Shaoyao (Radix Paeoniae Alba) Zhiziren (Semen Gossypii Herbacei) each 8 fen Xixin (Asari Radix et Rhizoma) 2 fen Zhimu (Rhizoma Anemarrhenae) 12 fen Shengjiang (Zingiberis Rhizoma Recens) 3 fen
Boil the above in 6 sheng of water to obtain 1.8 sheng. Divide into four doses. For ten-year-olds, divide into three doses. For fourteen- and fifteen-year-olds, add Chaihu 2 fen, Zhishi 1 fen, Huangqin 1 fen, Shaoyao 2 fen, Zhiziren 2 fen; remove Xixin and add Xingren (Semen Armeniacae Amarum) 8 fen. Also divide into three doses, obtaining 2 sheng.
From *Yingru Shu*: Dahuang Tang (Major Rhubarb Decoction) for hundred-day infants with excess-solidity and much phlegm, with spontaneous purging.
Dahuang (Radix et Rhizoma Rhei) 4 fen Shengma (Rhizoma Cimicifugae) 2 fen Shaoyao (Radix Paeoniae Alba) 3 fen Zhuye (Leaf of Bambusa) (cut, 5 he) Gancao (Radix Glycyrrhizae) 1 fen Xixin (Asari Radix et Rhizoma) 0.5 fen Xingren (Semen Armeniacae Amarum) (20 pieces, bran-fried, skin and tips removed)
Cut the herbs, boil in 2 sheng of water to obtain 6 he. Divide into three doses. For infants under one hundred days, adjust the dosage accordingly.
From *Yingru Shu*: Decoction for hundred-plus-day infants with excess-solidity plus high fever and挟实 (mixed excess), with spontaneous purging.
Zhike (Pericarpium Citri Reticulatae Viride) Baixianpi (Cortex Dictamni) each 2 fen Dahuang (Radix et Rhizoma Rhei) 5 fen Zhimu (Rhizoma Anemarrhenae) Ziqin (Scutellariae Radix) each 4 fen Gancao (Radix Glycyrrhizae) 1.5 fen Zhuye (Leaf of Bambusa) (cut, 5 he) Zhiziren (Semen Gossypii Herbacei) Shaoyao (Radix Paeoniae Alba) Hanshuishi (Aqua Calcitae) Shengma (Rhizoma Cimicifugae) Chaihu (Radix Bupleuri) each 3 fen
Boil the above in 2.7 sheng of water to obtain 6.5 he. Divide into three doses.
From *Yingru Shu*: Zhuye Tang (Bamboo Leaf Decoction) for four- and five-year-old children with phlegm-excess-solidity and spontaneous purging.
Zhuye (Leaf of Bambusa) (cut, 1 sheng) Dahuang (Radix et Rhizoma Rhei) 13 fen Chaihu (Radix Bupleuri) Zhiziren (Semen Gossypii Herbacei) Shaoyao (Radix Paeoniae Alba) each 7 fen Shengma (Rhizoma Cimicifugae) Huangqin (Scutellariae Radix) Zhimu (Rhizoma Anemarrhenae) each 8 fen Xixin (Asari Radix et Rhizoma) 1.5 fen Zhike (Pericarpium Citri Reticulatae Viride) 5 fen Xingren (Semen Armeniacae Amarum) (6 fen, peeled and fried)
Boil the above in 5 sheng of water to obtain 1.5 sheng. Four-year-olds take four doses; five- and six-year-olds take three doses; eight- and nine-year-olds increase dosage proportionally.
From *Yingru Shu*: Decoction for eight-, nine-, to ten-year-old children with phlegm-heat-excess-solidity, inability to eat, and spontaneous purging.
Dahuang (Radix et Rhizoma Rhei) Chaihu (Radix Bupleuri) each 12 fen Shengma (Rhizoma Cimicifugae) Huangqin (Scutellariae Radix) Xixin (Asari Radix et Rhizoma) each 10 fen Zhike (Pericarpium Citri Reticulatae Viride) 6 fen Zhuye (Leaf of Bambusa) (cut, 1 sheng) Shaoyao (Radix Paeoniae Alba) Zhiziren (Semen Gossypii Herbacei) Xingren (Semen Armeniacae Amarum) (peeled and tips removed, each 8 fen) Zhimu (Rhizoma Anemarrhenae) 3 fen
Boil the above in 6 sheng of water to obtain 1.8 sheng. Divide into four doses. Ten-year-olds take three doses.
From *Yingru Shu*: Dahuang San (Major Rhubarb Powder) for twelve- to thirteen-year-old and fourteen- to fifteen-year-old children with heat-binding, much phlegm, high fever, reduced appetite, and excess-solidity with spontaneous purging.
Dahuang (Radix et Rhizoma Rhei) 12 fen Chaihu (Radix Bupleuri) Zhike (Pericarpium Citri Reticulatae Viride) Shengma (Rhizoma Cimicifugae) Shaoyao (Radix Paeoniae Alba) Zhiziren (Semen Gossypii Herbacei) each 10 fen Zhuye (Leaf of Bambusa) 1 sheng Shengjiang (Zingiberis Rhizoma Recens) 3 fen Zhimu (Rhizoma Anemarrhenae) Xingren (Semen Armeniacae Amarum) (peeled and tips removed, each 8 fen)
Boil the above in 6 sheng of water to obtain 2 sheng. Divide into four doses. Fourteen- and fifteen-year-olds take three doses; smaller children reduce dosage.
From *Yingru Shu*: Dahuang Tang (Major Rhubarb Decoction) for pediatric excess-solidity with high fever and headache, with spontaneous purging.
Dahuang (Radix et Rhizoma Rhei) Chaihu (Radix Bupleuri) Gancao (Radix Glycyrrhizae, processed) Shengjiang (Zingiberis Rhizoma Recens) each 12 fen Shengma (Rhizoma Cimicifugae) Zhimu (Rhizoma Anemarrhenae) Huangqin (Scutellariae Radix) each 7 fen Daqing (Indici Folium) 5 qian Shigao (Gypsum Fibrosum) 10 fen Shaoyao (Radix Paeoniae Alba) Zhishi (Fructus Aurantii Immaturus, processed) each 6 fen
Boil the above in 4.7 sheng of water to obtain 1.3 sheng. Divide into four doses, administering according to the child's size.
From *Yingru Shu*: Formula for pediatric incomplete evacuation of excess, with stool either yellow or green.
Dahuang (Radix et Rhizoma Rhei) 3 fen Xixin (Asari Radix et Rhizoma) 2.5 fen Gancao (Radix Glycyrrhizae) 1 fen Huangqin (Scutellariae Radix) 1.5 fen
Boil the above in 2 sheng of water to obtain 7.5 he. Divide into two doses.
From *Ji Shi Jia Chuan*: Danggui San (Angelica Sinensis Powder) for dysentery with accumulation.
Danggui (Radix Angelicae Sinensis) Longgu (Fossilized Mammal Bones) Gancao (Radix Glycyrrhizae, processed) Shiliupi (Pericarpium Granati) Huangbo (Cortex Phellodendri) each 1 qian Hezi (Fructus Chebulae) (2 pieces, roasted, pitted)
Grind the above into fine powder. Take 0.5 qian per dose, administered with aged rice water.
From *Ji Shi Jia Chuan*: Shaoyao San (Peony Powder) for dysentery with accumulation.
Shaoyao (Radix Paeoniae Alba) Zhike (Pericarpium Citri Reticulatae Viride, white part removed, fried) Gancao (Radix Glycyrrhizae) Diyü (Radix Sanguisorbae) (washed, each 1 qian) Huangbai (Cortex Phellodendri) (0.5 liang, coarse bark removed) Chuan Wutou (Radix Aconiti Lateralis Preparata) (1 piece, processed)
Roast dry and grind into powder. Take 0.5 qian per dose, administered with white plum soup.
From *Ji Shi Jia Chuan*: Ruxiang Wan (Frankincense Pill) for wind-accumulation and food-accumulation where repeated purgative treatments have failed, presenting with abdominal distension, frequent diarrhea and dysentery, and various accumulations.
Ruxiang (Resina Acaciae Cathartae) Moyao (Resina Boswelliae) Sha (Realgar) (each one piece, size of soap pod) Jiecaizi (Semen Sinapis Albæ) (49 grains) Badou (Semen Crotonis) (1 grain, raw)
Wrap one large date in wet paper, seal tightly, and roast in ash fire until cooked. Remove paper, place the date and herbs in a mortar, and grind into a paste. If difficult to pill, add a small amount of refined flour to form pills the size of mung beans. Take seven pills per dose; one-year-olds take three pills, those over three years take five pills. Administer at dawn (fifth watch) with weak ginger soup to expel accumulated matter from the lower origin.