《巢氏病源》小儿鹤节候∶小儿禀生，血气不足，即肌肉不充，支节柴瘦，骨节皆露，如鹤之脚节也。
《圣惠》论∶夫肾脏者，精神之所舍，元气之所系。若其气强盛，则骨髓满溢，故令肌体充盛之。若气血不
足，脏腑劳伤，真气不守，邪气所侵，则肾气虚弱，骨髓枯竭，不能荣华，故令骨萎羸瘦也。
《外台秘要》疗小儿羸瘦 。常服不妨乳方
甘草（五两，炙）
上一件捣，筛，蜜丸如小豆大。一岁儿服十丸，日三，尽即更合。
《集验方》∶小儿禀气不足，真元怯弱，肢体柴瘦。补其本气，自然气体充盛，肌肤盈溢。宜补肾地黄丸
熟干地黄（八分，焙，秤） 山茱萸 干山药（各四钱） 泽泻 牡丹皮 白茯苓（去皮。各三钱）
上为末，炼蜜和丸如梧桐子大。三岁以下二、三丸，温水空心化下。
《圣惠》论∶夫小儿手拳者，由在胞之时，其母脏腑虚为风冷所乘；儿生之后，肝气不足，致筋脉挛缩，不
得伸展，故令手拳不展也。
《圣惠》治小儿手拳不展，是肝气不足，内伤风邪。宜服薏苡仁散方
薏苡仁（三分） 秦艽（去苗） 防风（去芦头） 酸枣仁（微炒） 甘草（微炙赤，锉。以上各半两） 当
归（锉，微炒） 桂心（各一分）
上件药捣，粗罗为散。每服一钱，以水一小盏，煎至五分，去滓。量儿大小分减，不计时候服之。
《圣惠》治小儿手不展，是风邪滞气所客，令荣卫不通。宜服羚羊角散方
羚羊角屑 羌活 五加皮 白藓皮 桂心（以上各一分） 麻黄（半两，去节、根） 甘草（半分，炙微赤，锉）
上件药捣，粗罗为散。每服一钱，以水一小盏，煎至五分去滓。量儿大小分减，不计时候温服。
《圣惠》又方
麻黄（半两，去节、根） 桂心 赤芍药 羌活 细辛 甘草（炙微赤，锉。以上各一分）
上件药捣，粗罗为散。每服一钱，以水一小盏，煎至五分去滓，不计时候。量儿大小，分减温服。
张涣治小儿受肝气怯弱，致筋脉挛缩，两手伸展无力。宜薏苡丹方。又治手拳不展。
当归（洗，焙干） 秦艽（去苗） 薏苡仁（汤浸，去皮研细） 酸枣仁 防风 羌活
上件各等分捣，罗为细末，炼蜜和如鸡头大。每服一粒至二粒，麝香荆芥汤化下，不计时候。
The *Chao Shi Bing Yuan* (Source of Diseases by Chao Yuanfang) on the syndrome of "Crane Joint" in children: Children with congenital insufficiency have deficient blood and qi, resulting in underdeveloped muscles. Their limbs and joints are emaciated, and bone joints are exposed, resembling the joints of a crane's legs.
The *Sheng Hui Fang* (Prescriptions from the Holy Empress) discusses: The Kidney is the residence of spirit and the root where primordial qi is anchored. If kidney qi is strong, marrow will be full and overflowing, thereby making the body robust and substantial. If blood and qi are insufficient, and viscera are damaged by overwork, true qi fails to remain secure, allowing pathogenic qi to invade. This leads to weak kidney qi and exhausted marrow, which cannot nourish and flourish the body, resulting in skeletal atrophy and emaciation.
The *Wai Tai Mi Yao* (Essential Prescriptions Worth a Thousand Gold) treats emaciation in children with a formula that can be taken regularly without interfering with breastfeeding:
Gancao (Licorice Root, five liang, honey-fried).
Grind the single herb into powder, sift it, and mix with honey to form pills the size of small beans. One-year-old infants take ten pills per dose, three times daily. When finished, prepare more.
The *Ji Yan Fang* (Verified Prescriptions): Children with congenital insufficiency of qi have weak primordial essence and emaciated limbs. By tonifying their source qi, the qi naturally becomes abundant, and the skin and flesh become plump. It is suitable to administer Bushen Dihuang Wan (Kidney-Tonifying Rehmannia Pill):
Shu Gan Dihuang (Prepared Dry Rehmannia Root, eight fen, baked and weighed), Shanzhuyu (Cornus Fruit), Ganshanyao (Dried Dioscorea Rhizome; each four qian), Zexie (Alisma Rhizome), Mudanpi (Moutan Bark), Baifuling (White Poria; peeled, each three qian).
Pulverize the above ingredients into fine powder. Mix with refined honey to form pills the size of paulownia seeds. For children under three years old, administer two or three pills per dose, dissolved in warm water on an empty stomach.
The *Sheng Hui Fang* discusses: The reason for children keeping their hands clenched in fists is that during gestation, the mother's viscera were deficient and invaded by wind-cold. After birth, the child's Liver qi is insufficient, causing tendon and vessel contraction and inability to extend, thus resulting in clenched fists that do not open.
The *Sheng Hui Fang* treats clenched fists in children due to insufficient Liver qi and internal injury from wind pathogens. It is suitable to administer Yiyiren San (Coix Seed Powder):
Yiyiren (Coix Seed, three fen), Qinjiao (Gentiana Macrophylla Root; remove seedlings), Fangfeng (Saposhnikovia Root; remove rhizome head), Suanzaoren (Ziziphus Seed; lightly stir-fried), Gancao (Licorice Root; lightly fried until reddish, crushed; each half liang), Danggui (Angelica Sinensis Root; crushed, lightly stir-fried), Guixin (Cinnamon Twig; each one fen).
Pulverize the above herbs and sieve them into a coarse powder. Take one qian per dose, decoct with one small cup of water until reduced to half a cup, then strain. Adjust the dose according to the child's age and size, and administer at any time.
The *Sheng Hui Fang* treats inability to extend hands in children due to wind pathogens stagnating qi flow, obstructing Ying and Wei circulation. It is suitable to administer Lingyangjiao San (Antelope Horn Powder):
Lingyangjiao Xie (Antelope Horn Shavings), Qianghuo (Notopterygium Rhizome), Wujia Pi (Acanthopanax Bark), Baixianpi (Dictamnus Bark), Guixin (Cinnamon Twig; each one fen), Mahuang (Ephedra Stem, half liang, remove nodes and roots), Gancao (Licorice Root, half fen, honey-fried until slightly reddish, crushed).
Pulverize the above herbs and sieve them into a coarse powder. Take one qian per dose, decoct with one small cup of water until reduced to half a cup, then strain. Adjust the dose according to the child's age and size, and administer warm at any time.
Another prescription from the *Sheng Hui Fang*:
Mahuang (Ephedra Stem, half liang, remove nodes and roots), Guixin (Cinnamon Twig), Chishaoyao (Red Peony Root), Qianghuo (Notopterygium Rhizome), Xixin (Asarum Root), Gancao (Licorice Root; honey-fried until slightly reddish, crushed; each one fen).
Pulverize the above herbs and sieve them into a coarse powder. Take one qian per dose, decoct with one small cup of water until reduced to half a cup, then strain. Adjust the dose according to the child's age and size, and administer warm at any time.
Zhang Huan treats children suffering from weak Liver qi, leading to tendon contraction and weakness in extending both hands. It is suitable to administer Yiyi Dan (Coix Pill). It also treats clenched fists.
Danggui (Angelica Sinensis Root; washed and dried), Qinjiao (Gentiana Macrophylla Root; remove seedlings), Yiyiren (Coix Seed; soaked in hot water, peeled and finely ground), Suanzaoren (Ziziphus Seed), Fangfeng (Saposhnikovia Root), Qianghuo (Notopterygium Rhizome).
Take equal parts of the above, pulverize, and sieve into a fine powder. Mix with refined honey to form pills the size of a cocklebur. Administer one to two pills per dose, dissolved in a decoction of Moschus and Schizonepeta, at any time.