受湿肿（脚手面目虚浮） 食毒瓦斯肿（腹肚肾蛊胀急） 伤寒虚气入腹肿 泻痢虚气入腹肿 此
四种所患病不相同，皆由虚得之。受湿，谓脾胃受湿冷，久不克化，气浮，四肢头面皆肿。食毒瓦斯，由脾
胃伤之冷积，毒瓦斯停留胃脘，致虚入腹作肿。伤寒由下之太早，乘虚入腹作肿。泻痢之久，脾气亦虚，是以
致肿。以上宜平调胃气，补脏充实，方可去肿，先服四味理中，无减半干姜，加白术、桑白皮同煎。伤
寒虚肿，加枳实。作喘，加淡豆豉。泻痢虚肿，服正气调胃。胃气既壮，以救生丹利之，其肿即退。再调补
脏腑，用观音散，即平复矣。
气虚肿（亦名气蛊）、血虚肿（亦名血蛊）、荣卫俱虚肿（亦名气血蛊），小儿所患，肿胀一门最为
要急，前人少有究竟，然肿胀之作，皆由荣卫不顺，脏腑怯弱，壅滞三焦，流注百脉，表里俱虚，邪正相乱，
所以致受。四大浮盛，腹肚膨满，多由食毒得之，饮食得之，症伤得之，饥饱得之，积久不化，故成斯病。
病由虚得，或则妄乱通下，因虚致虚，根不得去，疾加已盛，是谓坏证危候，智者怯而为辞，庸者暴以攻击，
二医不同，诚属难治。智者商之，良者审之，疑者塌之（疑其病盛不可利只与塌其气），明者调之
（正荣卫也），先调荣卫之顺，次服分气饮子以散其滞，斯病去矣。
荣卫饮子 调补婴孩气血俱虚，荣卫不顺，四肢、头面、手足俱浮肿以至喘急者，并宜服之。
川当归 熟干地黄（净洗） 人参 白茯苓 川芎 白术 甘草（炙） 白芍药 枳壳（炒、
别制） 黄 （蜜炙） 陈皮
上件等分， 咀。每服二钱匕，水一小盏，煎至半盏，去滓通口，不拘时候。
议曰∶荣者，血温流行于脉，卫者，气顺调和于络，是故荣行脉中，卫行脉外，阴阳相安，循环无止，
自幼至长，不离呼吸，无少滞碍，其脉方调，其气乃顺。呼吸之间，脉不应息，气有违滞，流注经络，
隐伏脏腑，百病皆由兹始，此方最良，虽儿幼小，并可与服，以壮其根，使血荣气卫，顺且和矣，
腑寒脏虚，温且壮矣，
盈亏自然而平，怯弱自然而正，阴阳调均，气脉充实，何病之有。
分气饮子 调理小儿肿胀作喘，气短促急，坐卧不任，四体浮肿，饮食呕逆，神困喜睡。
五味子 桔梗 白茯苓 甘草（炙） 陈橘皮 桑白皮 草果（去壳） 大腹皮 白术
枳壳（去穣、切，炒） 川当归 紫苏 苏子 半夏曲
上，等分， 咀。每服二大钱匕，水一小盏，生姜二小片，枣子半个，煎至半盏，去滓通口，不拘时候。
兼八味理中丸煎服。以上，宜用救生丹通利。
议曰∶清浊无混，邪正不干，上焦得之清凉，下部受之温暖，气滞则少升降，血虚则多流注，虽是乳子，
呼吸一息，其脉之至，徐徐应指，不违其数者，亦同大人流行，但随小大受之短浅而已，若也留滞，其
脉迟数，即太过不及而病生焉。善疗治者，郁则分之，逆则顺之，停则利之，滞则降之，调理之法，先宜顺气，
大抵婴孩气顺即易治，此方分气，与分水谷之分者不同，明者察之。
大效神功救生丹 治小儿气虚喘息，四肢浮肿，肚腹胀急，冲满胁肋，乍热乍寒，或泻或秘，皆由久
停虚积，荣卫不顺，宜用推去其恶毒之气。
雄黄（另研） 朱砂（各一分） 巴豆（二十一粒，去壳） 干姜（二钱）
上件，用米醋一盏，以巴、姜就煮令干，去姜不用，将巴出油，和雄、朱研匀，雪糕搜丸，如麻子大。
每一岁三丸，并用酒浸赤芍药，以少许送下。
[Edema due to Dampness] (manifesting as flaccid swelling of the hands, feet, face, and eyes)
[Edema due to Food Toxicity and Gas] (manifesting as urgent distension and swelling of the abdomen, kidneys, and Gu-type abdominal masses)
[Shanghan] (Cold Damage) causing edema from deficiency qi entering the abdomen.
[Dysentery] causing edema from deficiency qi entering the abdomen.
Although these four conditions differ in their specific pathologies, they all arise from Deficiency (Xu).
"Edema due to Dampness" refers to the Spleen and Stomach being invaded by cold-dampness, leading to long-term failure in transformation and transportation. This causes Qi to float upward, resulting in swelling of the limbs, head, and face.
"Edema due to Food Toxicity and Gas" occurs when the Spleen and Stomach are damaged by cold accumulation; toxic gas remains in the stomach cavity, allowing deficiency pathogens to enter the abdomen and cause swelling.
In [Shanghan], premature purgation allows pathogens to enter the abdomen via deficiency, causing swelling.
Prolonged [Dysentery] weakens Spleen Qi, thereby leading to swelling.
For the above conditions, it is appropriate to harmonize Stomach Qi and tonify the Zang organs to make them full, so that the swelling can be resolved. First, administer Siwei Lizhong Tang (Four-Ingredient Lizhong Decoction), modifying it by removing half the amount of Ganjiang (Dried Ginger), and adding Baizhu (Atractylodis Rhizoma) and Sangbaipi (Morus Albae Cortex) for decoction together. If the edema is due to Shanghan, add Zhishi (Immature Bitter Orange). If accompanied by wheezing, add Dansh douchi (Prepared Soybean). If the edema is due to dysentery, administer Zhengqi Tiaowei San (Zhengqi Harmonizing Stomach Powder). Once Stomach Qi is strengthened, use Jiusheng Dan (Life-Saving Pill) to promote diuresis, at which point the swelling will subside. Subsequently, regulate and tonify the Zang-Fu organs using Guanyin San (Guanyin Powder), and the patient will fully recover.
[Qi Deficiency Edema] (also known as Qi Gu), [Blood Deficiency Edema] (also known as Blood Gu), and [Ying-Wei] Dual Deficiency Edema (also known as Qi-Blood Gu): Among the diseases of swelling in children, this category is the most critical. Predecessors have rarely thoroughly investigated it. However, the formation of swelling is always due to disharmony of Ying and Wei, weakness of the Zang-Fu organs, stagnation in the Triple Burner, flow into the hundred vessels, deficiency in both interior and exterior, and confusion between pathogenic factors and healthy Qi. Thus, susceptibility arises.
Swelling of the four major body parts and abdominal distension are mostly caused by food toxicity, improper diet, pathological injury, or irregular eating habits. Accumulation over time without digestion leads to this disease.
Since the disease originates from deficiency, reckless use of purgatives exacerbates deficiency, making it difficult to remove the root cause. The condition worsens, becoming a "bad syndrome" with critical signs. Wise physicians act cautiously, while mediocre physicians attack aggressively. These differing approaches make treatment difficult. Wise physicians deliberate, good physicians examine carefully, those with doubts employ soothing methods (suspecting the pathogen is strong and avoiding purgation, instead focusing on regulating Qi), and enlightened physicians harmonize (specifically harmonizing Ying and Wei). First, harmonize Ying and Wei to ensure smooth flow, then administer Fenqi Yinzi (Fenqi Decoction) to dissipate stagnation, and the disease will resolve.
Rongwei Yinzi: Used to tonify infants and children with dual Qi and Blood deficiency and disharmonious Ying-Wei, manifesting as generalized edema of the limbs, head, and face, extending to the hands and feet, up to wheezing and urgency. It is suitable for such cases.
Chuan Danggui (Angelicae Sinensis Radix), Shu Dihuang (Rehmanniae Radix Praeparata), Renshen (Ginseng Radix et Rhizoma), Baifuling (Poria), Chuanxiong (Ligustici Chuanxiong Rhizoma), Baizhu (Atractylodis Macrocephalae Rhizoma), Gancao (Licorice Radix et Rhizoma, honey-fried), Baishaoyao (Paeoniae Radix Alba), Zhike (Aurantii Fructus Immaturus, stir-fried, processed separately), Huangqi (Astragali Radix, honey-fried), Chenpi (Citri Reticulatae Pericarpium).
Equal parts of the above ingredients, coarsely crushed. Take two qianbi per dose, decoct with one small lamp of water until half remains, strain, and take orally at any time.
Discussion: Ying refers to blood circulating warmly within the vessels; Wei refers to Qi flowing smoothly and harmoniously within the collaterals. Therefore, Ying circulates inside the vessels, and Wei circulates outside. Yin and Yang remain at peace, cycling endlessly. From childhood to adulthood, this process relies on respiration, without any obstruction, ensuring harmonious pulses and smooth Qi. Between breaths, the pulse should correspond to the respiratory rate. If Qi encounters resistance or stagnation, it flows into the collaterals and hides in the Zang-Fu organs, initiating myriad diseases. This formula is excellent; even for young children, it can be administered to strengthen the root, ensuring that Blood nourishes and Wei protects, achieving smoothness and harmony. Cold in the Fu organs and deficiency in the Zang organs will be warmed and strengthened. Excess and deficiency will naturally balance, weakness will naturally correct, Yin and Yang will harmonize, and Qi and pulses will become substantial. What disease would remain?
Fenqi Yinzi: Regulates pediatric swelling with wheezing, shortness of breath and urgency, restlessness in sitting and lying, generalized edema of the four limbs, vomiting and reflux of food, mental fatigue, and excessive sleepiness.
Wuweizi (Schisandrae Chinensis Fructus), Jiegeng (Platycodonis Radix), Baifuling (Poria), Gancao (Licorice Radix et Rhizoma, honey-fried), Chenjupi (Citri Reticulatae Pericarpium), Sangbaipi (Morus Albae Cortex), Caoguo (Tsaoko Fructus, husked), Dafupi (Arecae Pericarpium), Baizhu (Atractylodis Macrocephalae Rhizoma), Zhike (Aurantii Fructus Immaturus, pith removed, sliced, stir-fried), Chuan Danggui (Angelicae Sinensis Radix), Zisu (Perillae Folium), Suzi (Perillae Fructus), Banxiaqu (Pinelliae Fermentatum).
Equal parts, coarsely crushed. Take two large qianbi per dose, decoct with one small lamp of water, two small slices of fresh ginger, and half a jujube, until half remains. Strain and take orally at any time.
Concurrently decoct and take Bawei Lizhong Wan (Eight-Ingredient Lizhong Pill). For the above conditions, Jiusheng Dan (Life-Saving Pill) is suitable for promoting unblocking and purging.
Discussion: When clear and turbid do not mix, and pathogenic and healthy factors do not interfere, the Upper Jiao receives coolness, and the Lower Jiao receives warmth. Qi stagnation reduces ascending and descending movements; Blood deficiency leads to excessive flow. Although for infants, during each breath, the pulse arrives slowly and responds to the finger without violating rhythm, similar to adults, it merely varies in depth according to size. If stagnation occurs, the pulse becomes slow or rapid, leading to disease due to excess or insufficiency. Skilled healers disperse stagnation, smooth rebellion, promote retention, and descend blockages. The method of regulation first prioritizes smoothing Qi. Generally, if an infant's Qi is smooth, the condition is easy to treat. This formula, named "Separating Qi," differs from formulas that separate water and grain. Enlightened practitioners should observe this carefully.
Da Xiao Shen Gong Jiusheng Dan: Treats pediatric Qi deficiency with wheezing, generalized edema of the four limbs, abdominal distension and urgency, fullness rushing to the hypochondrium, alternating fever and chills, diarrhea or constipation. All result from long-standing accumulation of deficiency, disharmony of Ying and Wei. This formula is suitable to push out toxic Qi.
Xionghuang (Realgar, ground separately), Zhusha (Cinnabar, 1 fen each), Badou (Crotonis Fructus, 21 seeds, husked), Ganjiang (Zingiberis Rhizoma, 2 qian).
Take the above ingredients, boil Badou and Ganjiang in one lamp of rice vinegar until dry. Remove Ganjiang and discard. Extract oil from Badou, mix evenly with Xionghuang and Zhusha. Use snow sugar (or a binding agent) to knead into pills the size of hemp seeds.
Administer three pills per year of age. Send down with a small amount of Chi Shaoyao (Paeoniae Radix Rubra) soaked in wine.