乳食不节伤脾胃，羸瘦如柴哺露成，吐食吐虫多烦渴，头骨开张哺热蒸。先用集圣消积滞，继用
肥儿甚有灵；若还腹大青筋现，人参丸服莫从容。
【注】哺露者，因乳食不节，大伤脾胃也。其证羸瘦如柴，吐食吐虫，心烦口渴，头骨
开张，日晡蒸热，先用集圣丸消其积滞，再用肥儿丸调理其脾。若哺露日久，肚大青筋
者，又宜攻补兼施，以人参丸主之。
集圣丸
芦荟（微炒） 五灵脂（炒） 夜明砂（淘洗焙干） 缩砂仁 木香 陈皮 莪术 使君子肉 黄连 川
芎（酒洗炒） 干蟾（炙，各二钱） 当归（一钱五分） 青皮（制，二钱）
上为细末，用雄猪胆二个，取汁和面糊为丸，每服一钱，米饮送下。
肥儿丸（方见脾疳）
人参丸
人参 麦冬（去心） 半夏（姜制） 大黄（微炒） 黄 （炙） 茯苓 柴胡 黄芩 炙甘草 川
芎诃黎勒（煨） 鳖甲（炙）
上为细末，炼蜜为丸，如麻子大，以粥饮下，量儿大小与之。
诸逆上冲成呕吐，乳食伤胃或夹惊，或因痰饮或虫扰，虚实寒热要分明。
【注】呕吐一证，皆诸逆上冲所致也。夫诸逆之因，或以乳食过多，停滞中脘，致伤
胃气，不能健运而上逆也；或于食时触惊，停积不化而上逆也；或痰饮壅盛，阻隔气道；或
蛔虫扰乱，懊 不安而上逆也。总之，上逆之因虽不同，而皆能成呕吐也。但病有虚有
实，有寒有热，治者当于临证时参合兼见之证，审慎以别之，庶不误矣。
Dietary irregularities injure the Spleen and Stomach; emaciation like firewood results from *Bulu* malnutrition. Vomiting food and roundworms brings much irritability and thirst; the fontanelle opens with afternoon tidal fever. First use Jisheng Wan to eliminate stagnation; subsequently Fei'er Wan is very effective. If the abdomen becomes distended with visible blue veins, do not hesitate to administer Renshen Wan.
[Note] *Bulu* malnutrition (pediatric disease characterized by chronic vomiting/diarrhea leading to malnutrition) occurs due to unregulated intake of milk and food, severely injuring the Spleen and Stomach. The manifestations include extreme emaciation, vomiting of food or roundworms, irritability, thirst, open fontanelles, and tidal fever in the late afternoon (Shen hour). Treatment initially employs Jisheng Wan (Jisheng Wan) to resolve food stagnation, followed by Fei'er Wan (Fei'er Wan) to regulate the Spleen. If *Bulu* persists for a long time, resulting in abdominal distension with visible subcutaneous veins, both purgative and tonifying methods should be combined, primarily using Renshen Wan (Renshen Wan).
Jisheng Wan (Jisheng Wan)
Aloe vera (lightly stir-fried), Trogopterus Dung (stir-fried), Bat Guano (washed, roasted, and dried), Amomum fruit, Aucklandia root, Tangerine peel, Curcuma zedoaria, Quisqualis seed pulp, Coptis rhizome, Ligusticum chuanxiong (wine-washed and stir-fried), Dried Bufo (roasted, each 2 qian), Angelica sinensis (1.5 qian), Green tangerine peel (processed, 2 qian).
Grind all ingredients into fine powder. Use bile juice from two male pig gallbladders to mix with wheat flour paste to form pills. Take 1 qian per dose, washed down with rice water.
Fei'er Wan (Formula see Spleen Malnutrition)
Renshen Wan (Renshen Wan)
Ginseng root, Ophiopogon tuber (heart removed), Pinellia tuber (prepared with ginger), Rhubarb rhizome (lightly stir-fried), Astragalus root (roasted), Poria sclerotium, Bupleurum root, Scutellaria root, Roasted licorice root, Ligusticum chuanxiong, Chebula fruit (roasted), Softshell turtle shell (roasted).
Grind all ingredients into fine powder. Mix with refined honey to form pills the size of hemp seeds. Administer with gruel drink, adjusting dosage according to the child's age and size.
Various rebellious Qi rushing upward causes vomiting; milk and food injury to the Stomach may involve fright, or phlegm-fluid retention, or worm disturbance. Deficiency and excess, cold and heat must be clearly distinguished.
[Note] The syndrome of vomiting is caused by various forms of rebellious Qi rushing upward. The causes of this rebellious Qi include: excessive intake of milk and food stagnating in the Zhongwan (epigastrium), injuring Stomach Qi and preventing normal transportation, leading to rebellion; being startled during feeding, causing undigested food to stagnate and rebel; accumulation of phlegm-fluid obstructing the airway; or disturbance by roundworms causing restlessness and rebellion. In summary, although the causes of rebellion differ, they all lead to vomiting. However, diseases manifest as either deficiency or excess, cold or heat. Physicians must carefully differentiate these conditions by integrating accompanying symptoms during clinical practice to avoid errors.