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Qian Yi stated: Heat pain is characterized by incessant crying, with red face and scorched lips during nocturnal episodes, and dark yellow urine. It should be treated with Sanhuang Wan (Three-Yellow Pill [clearing interior heat]), administered with Renshen Tang (Ginseng Decoction).

The *Yingru* text treats infantile abdominal pain where the child cannot breastfeed due to severe pain. Formula for Fuling Wan (Poria Pill):
Fuling (Poria) and Huanglian (Coptidis Rhizoma), each 1 liang.
Grind into powder, form pills the size of soybeans using honey. Administer with water, adjusting dosage according to the child's condition.

Qian Yi stated: Accumulation pain presents with warm breath, a sallow-white complexion, dull eyes, or excessive scleral exposure, lethargy, anorexia, or sour-smelling stools. One should eliminate accumulation; Xiaojie Wan (Accumulation-Resolving Pill) is appropriate. For severe cases, Baixiazi (White Cake Pill) may be used to purge, followed by harmonizing the stomach with Baizhu San (Atractylodes Macrocephala Powder). (Formulas for Xiaojie Wan and Baixiazi are found under the "Pi Ji" section; formula for Baizhu San is found under the "Xiao Ke" section.)

Zeng Shirong stated: Accumulation pain involves dull abdominal pain, sallow complexion, and anorexia. Older children may exhale sour, fermented odors from the mouth. First treat the accumulation, then regulate the spleen and stomach; the pain will cease naturally. Differentiation between deficiency and excess is required for harmonizing treatment; see the "Pi Ji" section below for methods.

Tang Shi Sanleng San (Sanleng Powder of Master Tang): Treats abdominal pain caused by qi accumulation.
Sharen (Amomi Fructus), Gancao (Glycyrrhizae Radix et Rhizoma), Yizhi (Alpiniae Oxymelae Fructus, stir-fried, husked), Sanleng (Sparganii Rhizoma), Pengzhu (Curcumae Rhizoma), Qingpi (Citri Reticulatae Pericarpium Viride, stir-fried), in equal proportions.
Grind into powder. Take with boiling water.

Zhu Danxi stated: Food-stagnation abdominal pain requires herbs such as Zisu (Perillae Folium) and Laifuzi (Raphani Semen). Chu Yushi treated a child who developed abdominal pain from eating zongzi (sticky rice dumplings) by administering pills made of equal parts Huanglian (Coptidis Rhizoma) and Baijiu Yao (Fermented Rice Ball).

Worm pain presents with a pale face, epigastric and abdominal pain, drooling and clear fluid from the mouth, and periodic pain attacks. Tian Shi stated: Worm pain manifests as crying, rolling over, restlessness, self-palpation of the heart and abdomen, frequent loud screaming, abnormal facial coloration (blue, yellow, white), lackluster eyes, and salivation. This is worm pain. Qian Yi stated: Accumulation pain, food-stagnation pain, and deficiency pain are largely similar, except that worm pain is characterized by a bland taste and spontaneous salivation. Treatment should follow the specific syndrome. Worm pain resembles epilepsy (Xian Zheng); infants are inherently timid, so coldness and deficiency in the stomach cause worms to move, inducing heart pain, which slightly resembles epilepsy but differs by the absence of eye deviation and hand convulsions. An Chong San (Calming Worms Powder) is the primary formula. Zeng Shi stated: Ascaris-induced pain presents with spitting of clear fluid and saliva, or expulsion of worms, with unbearable pain. This disease results from early consumption of sweet, fatty, and meaty foods, causing stomach coldness that activates worms. The expelled worms may be alive or dead. In young children, this causes severe suffering and danger. Initially, Lizhong Tang (Regulate the Middle Decoction [for vomiting and diarrhea]) with Wumei (Mume Fructus) decocted in water should be given to warm the stomach and prevent rebellion. Subsequently, Lushui Wan (Aloe Pill [for malnutrition]), Shijunzi Wan (Quinine Seed Pill), or Huachong Yin (Worm-Dissolving Drink) may be used. In older children presenting with a pale-yellow complexion, increased meat consumption, emaciation, and intermittent abdominal pain, blood flukes and ascarides may be mixed within. Ersheng Wan (Two-Sage Pill) should be used to purge them. Extreme cold or heat affecting the stomach can also activate worms, causing mild or no pain, followed by sudden expulsion. The method should prioritize calming the worms. Aggressive worm-expelling methods damage stomach qi and are inadvisable. For activation due to cold, use Lizhong Tang with Wumei decocted in water. For activation due to heat, use Juzai Wuling San (Modified Five-Ingredient Poria Powder) with Wumei and Shengjiang (Zingiberis Rhizoma Recens) decocted in water.

Case: A five-year-old girl of the Xin family suffered from worm pain. Various physicians treated her with Badou (Crotonis Fructus), Ganqi (Dammar Resina), and Naosha (Natrii Sulfas) without effect. By the fifth day, she cried frequently, rolled over, was restless in sleep, pressed her heart and abdomen, screamed loudly, displayed fluctuating facial colors (blue, yellow, white, black), had dull eyes, pale lips, and salivated. On the sixth day, her chest was elevated, and lying down became increasingly uncomfortable. Qian Yi was summoned. After careful examination, he prescribed three doses of Wuyi San (Meliosma Powder). Seeing that the blue hue in her eyes persisted, he exclaimed in alarm, "This illness is critical. If diarrhea ensues, it will be a adverse sign." The next day, Mrs. Xin told Qian Yi, "Indeed, she had diarrhea at the third watch last night." Qian Yi examined the stool basin, noting the feces resembled medicinal juice. Stirring it with a stick, he saw pill fragments. Qian Yi said, "This child has thick muscles and should present with excess patterns, but now the signs indicate deficiency; it is untreatable." Mrs. Xin asked why. Qian Yi replied, "Spleen deficiency and stomach cold activate worms. Now the eyes are blue, indicating Liver wood overacting on Spleen earth. Coupled with diarrhea, we know her qi is extremely depleted. The pills passing with the stool indicate the collapse of Stomach and Spleen qi. Furthermore, the physical state does not match the disease pattern; thus, I know it is a fatal case." Five days later, she fell into deep coma, and died seven days after onset.

Qian Yi An Chong San (Calming Worms Powder): Treats infantile worm pain.
Hufen (Cerussita, stir-fried until yellow), Leshe (Chrysanthemi Indici Flos, stir-fried), Chuanlianzi (Toosendan Fructus, peeled and seeded), Baifan (Alumen, calcined, 2 qian 5 fen).
Grind into fine powder. Each dose: one zi (approx. 0.3g); for older children, 5 fen. Mix with rice drink and take. Administer during pain episodes.

For severe pain caused by moving worms that is unbearable: Use Ganqi (Dammar Resina) 0.5 liang, Binglang (Arecae Semen) 1 piece (raw), and Yaolao (fired clay from kilns) 1 piece. Grind all three into fine powder. Take with hot wine on an empty stomach. After some time, worms will be expelled, and recovery will be immediate. (Note: Yaolao is likely fired mud from kilns.)

Another prescription: Use Ganqi (Dammar Resina) 1 liang, crush it, and stir-fry until smoke ceases. Mix with fresh well water and raw Sesame Oil (Sesami Oleum). Take on an empty stomach.

Qian Yi An Chong Wan (Calming Worms Pill): Treats deficiency in the Upper and Middle Jiao, stomach cold activating worms, and pain.
Ganqi (Dammar Resina, stir-fried until smoke ceases, 2 fen), Xionghuang (Realgar, 1 fen), Badoushuang (Crotonis Fructus Frost, 1 qian).
Grind into fine powder, make pills the size of millet seeds using paste. Dosage depends on the child's age. Take with decoction of Shiliugen (Punica Granati Radix Cortex from eastward-growing trees), or Kuanlien Gen (Meliae Radix Cortex), or Wuyi Tang (Meliosma Decoction). Dose: 5–7 pills up to 20–30 pills. Administer during attacks.

Wuyi San (Meliosma Powder): Indications same as above. Whenever a child cries loudly during pain, and the philtrum, nose tip, and lips turn black simultaneously, the pulse should be deep, weak, and wiry. If the pulse is instead large, it indicates a worm syndrome.
Baiwuyi (Meliosmae Fructus), Ganqi (Dammar Resina, stir-fried), in equal proportions.
Grind into fine powder. Each dose: one zi, 5 fen, or 1 qian. Mix with rice drink. Administer during attacks.

Shijunzi Wan (Quinine Seed Pill): Treats pain caused by various intestinal parasites and spitting of clear fluid.
Shijunrou (Canarii Semen, thinly sliced, dried on roof tiles), Binglang (Arecae Semen), Suan Shiliu Genpi (Punica Granati Radix Cortex, preferably from eastward-growing trees, washed clean, cut, and dried), Dahuang (Rhei Radix et Rhizoma, half raw, half processed), each 7 qian 5 fen.
Process: Cut and dry Binglang without overheating. Roast the other three ingredients again. Grind all together into powder. Make pills using sugar-water wheat paste, size of hemp seeds.
Each dose: 30–50 pills. Take on an empty stomach with lean pork broth; chicken broth is also acceptable.

Huachong Yin (Worm-Dissolving Drink): Dissolves worm toxins causing abdominal pain.
Binglang (Arecae Semen), Suan Shiliu Genpi (Punica Granati Radix Cortex, washed and dried, each 1 liang), Hongdan (Minii Preparatum, calcined), Leiwan (Waniliae Semen), Guanzhong (Cyrtomii Rhizoma, best if shaped like a chicken head), Shijunrou (Canarii Semen, thinly sliced and dried, each 2 qian 5 fen), Gancao (Glycyrrhizae Radix et Rhizoma, honey-fried), Zhike (Aurantii Fructus, pith removed, bran-fried until slightly yellow), Dahuang (Rhei Radix et Rhizoma, each 5 qian).
Grind into fine powder. Fry one egg in clear oil until crisp like a spring pancake. Let cool. Place 1 qian of powder on the egg, spread evenly, and roll up. Eat on an empty stomach. For small children, make pills with glutinous rice flour paste, size of millet grains. Each dose: 15–30 pills. Take on an empty stomach with lean pork broth; chicken broth is also acceptable.

Ersheng Wan (Two-Sage Pill): Treats various intestinal parasites, promotes digestion, expels water, directs qi downward, and dispels wind.
Binglang (Arecae Semen, 1 liang), Badou (Crotonis Fructus, 15 seeds, husked and cored, select large ones retaining oil).
Process: Cut and dry Binglang into powder. Crush Badou finely in a mortar. Mix thoroughly with Binglang powder. Make pills with wheat paste, size of mung beans. Each dose: 77–99 pills. Take with warm tea on an empty stomach at the fifth watch (early morning). Single dose only. Once worms are fully expelled, resume diet with thin congee to restore comfort.