总括
痰者，因水谷所化之津液，不能四布，留于胸中而成者也。多因饮食无节，或乳食过食浓味，脾胃不能运化而生。
若阴气素盛，则化而为饮；阳气素盛，则化而为痰。如稠粘黄色，涩滞难出，为之燥痰；清稀色白，滑而易出，乃湿寒
也。二者或宜清润，或宜通利，治各不同。
燥痰
燥痰者，乃肺燥滞涩难出，痰因火动也。火盛则痰多燥粘，故气逆喘咳，夜卧不宁，面红口干，小便黄赤。轻者，
用清气化痰丸清之；重者，用苏葶滚痰丸平之。
湿痰
湿痰者，因小儿过食生冷油腻之物，有伤脾胃，遂致脾土虚湿，不能运化，而成湿痰。滑而易出；脾虚不运，故懒
饮食；脾主四肢，故倦怠嗜卧；脾属土，故面色多黄。如痰多者，用枳桔二陈之剂加苍术、白术除湿化痰。饮盛者，用
桂苓甘术汤扶阳散饮。调治合宜，而痰自化矣。
总括
厥阴之脉环阴器，入小腹。任脉起于中极之下，以上毛际，循腹里，上关元。故诸疝莫不属之厥阴任脉为病也。小
儿病此，多因先天不足，本脏虚弱，复因外感风寒，内食生冷，以致寒邪积聚凝结而成者有之。或因湿热郁于中，复为
寒邪束于外，邪气乘虚，并于血队，流入厥阴。厥阴属肝，其性急速，故其见证，皆牵引睾丸，小腹绞痛也。又有胎疝
一证，多因孕妇啼泣过伤，动于阴气，结聚不散，令儿生下，即成此证者，乃禀赋为病也。总审大抵热则多纵，寒则痛
临。血分者，在左不移，气分者，在右多动，湿肿坠则重，虚肿坠则轻也。因证而治，自中病情矣。
寒疝
小儿平日过食生冷，或卧湿地，以致寒湿内蓄，阴结于内，气滞不行，为日已久深，复为风冷所束，水气所侵。故
发时囊冷结硬，牵引小腹作痛，而成寒疝。初得之兼表者，以乌头桂枝汤主之；寒甚者，金茱丸治之如神也。
湿热感寒疝
小儿平素浓味过度，致生湿热。湿热之气下行，流入囊中，复触风寒，而疝气成矣。发时囊纵红肿，常常刺痛，当
以乌头栀子汤服之即宁也。
胎疝
胎疝者，多因孕妇啼哭过伤，气结不散，蕴于胞中，令儿生下胞硬，疼痛无时。轻者用十味苍柏散治之，重者用金
铃散或川楝丸最宜。
阴肿
阴器者，乃诸筋之总会也。因邪客于少阴厥阴之经，湿热之气，与风冷之气相搏，气不得通，故阴囊肿大者，乃邪
气凝结也。总之，风盛多痒，湿盛多坠，热盛多疼。如外肾肤囊肿大，痒痛坠下，此风湿袭于下也，宜疏风五苓散主之。
如外肾肤囊肿痛光亮，此因心火移热于小肠故也，宜用加味五苓散，或导赤散主之。更有偏坠一证，或左或右，睾丸作
肿者，此因食积不化，湿气下行故也，宜加味守效丸服之最灵。
小肠气
小肠气一证，其受病与疝气等，亦因湿气在内，而寒气又束于外也。发时小腹胀控，睾丸痛引腰脊，上冲心痛而不
肿是也。治宜分别形状，如引腰而痛者，宜加味香苏散温散之为宜；如上冲心气而痛者，加味失笑散主之；如小腹中有
形如卵，上下往来，痛不可忍者，宜胡芦巴丸医之。
General Overview
Phlegm (Tan, 痰) is formed when the body fluids (Jinye, 津液) derived from food and drink fail to distribute normally throughout the body and stagnate in the chest. It often arises from irregular diet or excessive consumption of rich and greasy foods by infants and children, leading to the spleen and stomach's inability to transport and transform.
If yin qi is inherently abundant, it transforms into fluid retention (Yin, 饮); if yang qi is inherently abundant, it transforms into phlegm. Phlegm that is thick, sticky, yellow, and difficult to expectorate is called dry phlegm (Zao Tan, 燥痰); phlegm that is clear, thin, white, slippery, and easy to expectorate indicates cold-dampness (Shi Han, 湿寒). The treatments for these two types differ: one may require clearing and moistening methods, while the other requires draining and promoting methods.
Dry Phlegm
Dry phlegm results from lung dryness causing stagnation and difficulty in expectoration, with phlegm stirred up by fire. Excessive fire leads to abundant, dry, and sticky phlegm, causing rebellious qi, wheezing, coughing, restless sleep at night, red face, dry mouth, and dark yellow urine. For mild cases, Qingqi Huatan Wan (Clear Qi and Resolve Phlegm Pill) is used to clear heat; for severe cases, Su Ting Gun Tan Wan (Perilla and Lepidium Pill to Roll Down Phlegm) is used to calm phlegm-fire.
Damp Phlegm
Damp phlegm occurs when infants and children overconsume raw, cold, or greasy foods, damaging the spleen and stomach. This leads to deficiency and dampness in the spleen earth, impairing transportation and transformation, resulting in damp phlegm. The phlegm is slippery and easy to expectorate. Due to spleen deficiency and impaired transport, there is poor appetite. Since the spleen governs the four limbs, fatigue and a desire to lie down occur. As the spleen belongs to earth, the complexion is often yellow. For excessive phlegm, Zhiji Erchen Decoction (Erchen Decoction with Zhi Ke and Jie Geng) added with Cang Zhu and Bai Zhu is used to remove dampness and resolve phlegm. For predominant fluid retention, Guiling Gan Shu Tang (Cinnamon Twig, Poria, Licorice, and Atractylodes Macrocephala Decoction) is used to support yang and dissipate fluid retention. With appropriate regulation, the phlegm will naturally dissolve.
General Overview on Hernia
The Jueyin meridian circles the external genitalia and enters the lower abdomen. The Ren Mai (Conception Vessel) originates below the Zhongji point, ascends above the pubic hairline, follows the interior of the abdomen, and reaches the Guanyuan point. Therefore, all hernias are attributed to diseases of the Jueyin meridian and the Ren Mai. In infants and children, this condition often stems from congenital insufficiency and weakness of the zang organs, compounded by external contraction of wind-cold and internal injury from raw/cold foods, leading to the accumulation and coagulation of cold pathogens. Alternatively, damp-heat may stagnate in the middle jiao, constrained externally by cold pathogens, allowing evil qi to enter through deficiencies, merge with the blood level, and flow into the Jueyin meridian. Jueyin corresponds to the liver, which has a rapid nature; thus, symptoms include traction pain in the testicles and colicky pain in the lower abdomen. There is also a condition called fetal hernia (Tai Shan, 胎疝), often caused by excessive crying and emotional distress in the pregnant mother, disturbing yin qi and causing stagnation. This results in the infant presenting with this condition immediately after birth, due to inherited predisposition. Generally, heat patterns manifest as flaccidity and prolapse, while cold patterns manifest as pain. Blood-level involvement is fixed on the left; qi-level involvement moves frequently on the right. Damp-induced swelling and prolapse feel heavy; deficiency-induced swelling and prolapse feel light. Treating according to the syndrome ensures accurate therapy.
Cold Hernia
Infants and children who overconsume raw/cold foods or sleep on damp ground accumulate cold-dampness internally. Yin cold coagulates inside, causing qi stagnation. Over time, deep-seated cold is further constrained by wind-cold and invaded by water qi. Upon onset, the scrotum becomes cold, hard, and knotted, with pain radiating to the lower abdomen, forming cold hernia. If accompanied by exterior symptoms upon initial onset, Wutou Guizhi Tang (Aconite and Cinnamon Twig Decoction) is indicated. For severe cold, Jin Zhu Wan (Gold and Galangal Pill) is highly effective.
Damp-Heat Hernia Complicated by Cold
Excessive consumption of rich foods generates damp-heat. Damp-heat qi descends into the scrotum. When exposed to wind-cold, hernia forms. Upon onset, the scrotum is flaccid, red, swollen, and suffers frequent stabbing pain. Wutou Zhizi Tang (Aconite and Gardenia Decoction) should be administered to bring relief.
Fetal Hernia
Fetal hernia is often caused by excessive crying in the pregnant mother, leading to qi stagnation and accumulation in the uterus. After birth, the infant presents with a hard, painful scrotum without fixed timing. For mild cases, Shiwei Cangbai San (Ten-Ingredient Cang Zhu and Coptis Powder) is used. For severe cases, Jinling San (Golden Bell Powder) or Chuanlian Wan (Toosendan Pill) are most suitable.
Scrotal Swelling
The external genitalia are the convergence point of all sinews. Evil pathogens invade the Shaoyin and Jueyin meridians. Damp-heat qi contends with wind-cold qi, blocking qi flow, resulting in scrotal swelling due to pathogen coagulation. In summary, excess wind causes itching; excess dampness causes heaviness/prolapse; excess heat causes pain. If the scrotal skin is swollen, itchy, painful, and heavy, it indicates wind-damp attacking the lower part; Shufeng Wuling San (Wind-Dispersing Five-Ingredient Poria Powder) is indicated. If the scrotal skin is swollen, painful, and shiny, it indicates heart fire transferring heat to the small intestine; Jiawei Wuling San (Modified Five-Ingredient Poria Powder) or Daochi San (Directing Red Powder) are indicated. Another condition is unilateral descent (Pianzhui, 偏坠), where one testicle swells, either left or right, due to undigested food accumulation and descending dampness; Jiawei Shouxiao Wan (Modified Efficacious Pill) is most effective.
Small Intestine Qi
Small intestine qi shares similar etiology with hernia: internal dampness constrained by external cold. Onset involves lower abdominal distension and pain radiating to the testicles, waist, and spine, with qi rushing upward causing heart pain but no swelling. Treatment depends on the presentation: for pain radiating to the waist, Jiawei Xiangsu San (Modified Fragrant Perilla Powder) for warming and dispersing; for qi rushing to the heart causing pain, Jiawei Shixiao San (Modified Heartbreak-Away Powder) is indicated; for a palpable egg-shaped mass in the lower abdomen moving up and down with unbearable pain, Huluba Wan (Trigonella Fenugreek Pill) is used.