《良方》妙香丸 治小儿虚中积，潮发寒热，心腹胀满疼痛。
辰砂（一两） 牛黄 生龙脑 麝香（各二钱半） 金箔（十四片） 粉霜 腻粉（各一钱） 黄蜡（二两）
巴豆（肥者，一百二十粒）
上，丸如弹子大。量虚实加减，龙脑浆水下，夜半后服。脏虚即以龙脑米饮下，
每服三丸如小豆，欲药势缓，即按令扁。疾坚者加至十丸，皆以针刺作数孔，以
行药力。小儿取积，丸如绿豆，治小儿吐逆尤效。此药最下胸中烦及虚积。
《婴孺》治小儿自下后得寒热，血结成癖气在左胁下，或寒饮，或冷食积聚气动，胸
心留热，不下食饮，暗瘦。宜先服少饮子散气下食，后服紫双丸去宿积，自充溢
也。
饮子方
柴胡 茯苓 人参 白术 鳖甲（醋涂，炙香熟。各半两）
上，切如豆大，水二升，煮五合。空心分温三四服。相去如人行一二里久再服，食粥将息。
茅先生论小儿生下五个月日上至七岁，有结癖在腹成块，如梅核大来去，或似
卵大，常叫疼痛者。亦分数类，在左胁下痛者名 气，在右胁下痛者名癖气，下蓬
莪术散、夹建脾饮（不乳食）与服即愈，如见面黑，眼直视，泻黑血，鼻口冷，手足冷，不
进食者死。钱氏论小儿病癖，由乳食不消，伏在腹中，乍凉乍热，饮水或喘嗽，与
潮热相类，不早治，必成疳。以其有癖，故令儿不食，致脾胃虚而热发，故引饮过
多，即荡涤肠胃，亡失津液，胃不能传化水谷，其脉沉细，益不食，脾胃虚衰，四
肢不举，诸邪遂生，鲜不瘦而成疳矣。论癖为潮热云∶曹宣德子三岁，面黄时发寒
热，不欲食，而饮水及乳不止。众医以为潮热，用牛黄丸、麝香丸不愈，及以止
渴干葛散服之反吐。钱曰当下白饼子（见前），后补脾，乃以消积丸磨之（见前），此乃癖也，
后果愈。何以故？不食但饮水者，食伏于管内不能消，致令发寒。服止渴药吐者，
以药冲脾故也，下之即愈。仁斋曰∶癖者，血膜包水，侧僻于胁旁，时时作痛也。
惟癖，为能发潮，为能生寒热，故疟家中脘，多蓄黄水，日久而复结癖，寒热不已，
有是疾者以此。小儿脏腑和平，荣卫调畅，则津液自然流通，纵使多饮水浆，不能
为病，惟乳哺失调，三焦关隔，以致水饮停滞肠胃，不能宣通，如冷气搏之，则结
聚而成癖，轻者用积滞木香丸。重者用取癖丸。曾氏曰∶婴儿始生，禀赋未完，失
于襁褓之不谨，乳哺之不节，外为六淫侵袭，内因五脏气虚，冷积久停于脾，不能
克化，结成癖，鬼突于胁下，或左或右，俗曰龟KT ，其疾皆因积滞蕴作，致有寒热，
或腹肚疼痛，或昼凉夜热。治疗之法，气实者，亦须温正胃气，后用乌犀丸或水晶
丹下之，如过二三次，即以稀粥略止，候所作形证消尽，方投补益之剂。气虚者，
先与调脾胃，固真元，神色稍正，饮食进多，如前法下之。若太虚甚，用三棱散、
化癖丸、渐消之，顺适阴阳，以平为期。然先补后泻，行迎夺之法，则取去陈寒冷
积，若面黄唇白，发竖肌瘦，乃为虚极，不可轻下，但徐徐用药消化调理为上。若
儿小者，更令乳母常服藿香饮，使药从乳过，亦少助也。
〔茅先生〕蓬莪术散 主小儿 气，一切气疾。
蓬莪术 青橘皮 益智（各半两） 木香（二钱半） 糯米（一两）
上为末。每服一大钱，用陈米饮调下，日进四服。
《圣惠》鳖甲散
用鳖甲（一枚，涂醋炙令黄，去裙 ）
上捣，细罗为末。每服一钱，以童子小便一小盏煎至五分，量儿大小，分减服
之，日三服，神效。
化癖丸（曾氏） 主癖结气块在胁之间，日久不化，乍寒乍热，腑脏不调，米谷不消，哽
气喘促，胸腹满闷。及理丁奚哺露。
南木香 陈皮（去白） 莪术（炮，锉） 三棱（炮，锉） 青皮（巴豆九粒、去皮膜心，微炒，去巴豆） 枳壳
（去穣，麸炒） 槟榔（七味各半两） 白术 丁香（二味各二钱） 细辛（烧，存性，四钱）
上除木香、槟榔、丁香不过火，余七味焙，同前三味为末，曲糊丸作麻仁
大。每服十五丸至二十一丸，清米汤、空心下。有寒热往来，以柴胡饮间服，忌
油腻生冷。
木香丸 治吐乳泻乳，其气酸臭，由啼叫不已，以乳与儿，停滞不化，是为乳积。
肚硬热渴吐泻，由饮食无度，过饱即睡，是为食积。腹痛啼叫，利如蟹渤，由触
忤其气，荣卫不和，淹延日久，是为气积，疟后肚内结癖成块。
木香 蓬术 砂仁 青皮（去白） 朱砂（研细） 代赭石（研。各二钱） 大丁香 川巴豆肉（纸
压去油。各一钱）
上为细末，和匀，飞白面糊为丸，麻子大。每服二三丸，乳伤，乳汁下，食伤，米饮下。
取癖丸 峻剂，非实积危甚不用。
甘遂（微炒） 芫花（炒） 牵牛（半炒半生，研取末） 辣桂 蓬术 青皮（去穣） 木香 桃仁（浸，去
皮，炒） 五灵脂（各二钱）
上为细末，入去油巴豆一钱研和，十分细飞面糊丸麻子大。每服一二丸，姜
蜜煎汤灌下，泄后，冷粥补，仍和胃。
挨癖丸 治乳癖谷 ，腹中块痛。
木香 青皮（去穣） 蓬术 代赭石（火 ，醋淬，细研） 生地黄（各三钱） 巴豆（压，去油尽，一钱）
上为细末，醋面糊丸麻子大。每服二丸，食后，擦姜泡汤下。
《外台·必效》疗大人小儿癖方
上，取车下李仁，微汤退去皮及双仁，与干面相半，捣之为饼，如犹干，和淡
水如常搜面，大小一如病患手掌，为两饼，微炙使黄，勿令至熟。空肚食一枚，
当快利，如不利，更食一枚，或饮热粥汁即利，以快利为度。至午后利不止，即
以醋饭止之。利后当虚，病未尽者，量力一二日更尽一服，以病尽为限。小儿亦
以意量之。不得食酪及牛马肉，无不效。但病重者，李仁与面相半。轻者，以意
减之。后服者，亦任量力。频试瘥，神效。
《圣惠》前胡丸 治小儿癖气，腹痛。
前胡 桔梗（各去芦） 赤芍药 赤茯苓 枳壳 川大黄 当归 郁李仁（去皮，微炒。各
半两） 鳖甲（一两，炙令黄）
上件捣，罗为末，炼蜜和丸，如绿豆大。三岁儿，每服空心以粥饮化破五丸服，
量儿大小加减。
《婴孺》治小儿闪癖，身体壮热，频服冷药，冷气漫心成癖，下焦又冷，肠结大便难方
茯苓 川芎 鳖甲（炙） 枳壳（炙） 芍药（各二分） 柴胡（四分）
上锉，以水一大升三合。煎至三合。空心为二服，去如人行五六里再服。忌苋子。
〔朱氏〕知母丸 治小儿腹痛不调，兼癖气。
知母（六分） 鳖甲（炙，四分） 牡蛎 枳壳（麸炒。各三分） 大黄（十二分，纸裹，煨熟）
上件为末，蜜丸如绿豆大。米饮下五丸，大人以意分减服。
治七八岁儿多睡或时壮热，日加羸瘦，身虽不痛，有时痢脓，呕逆不食，是癖气之
候，其疾似疟疾，人多不识此患方
柴胡 黄芩（各一分） 枳壳（炒，两片） 甘草 知母 芍药（各二分） 大诃梨勒（煨，取皮，一个，
小者用二个）
上件为末，水一盏，煎服。
The Miaoxiang Wan (Marvelous Fragrance Pill) from *Liangfang* treats pediatric deficiency-type accumulation, characterized by periodic alternating chills and fever, abdominal distension, fullness, and pain.
Ingredients: Cinnabar (Shachen, 1 liang), Calculus Bovis (Niuhuang), Borneolum Syntheticum (Sheng Longnao), Moschus (Shexiang) (each 2.5 qian), Folium Auratum (Jinbo, 14 pieces), Fen Shuang, Nifen (each 1 qian), Cera Flava (Huangla, 2 liang), Fructus Crotonis Tiglii (Badou, selecting plump ones, 120 grains).
Preparation and Administration: Grind the above ingredients and form pills the size of a marble. Adjust the dosage according to the child's deficiency or excess condition. Administer with Borneol solution water at midnight. If the zang organs are deficient, administer with Borneol rice infusion. Each dose consists of three pills, sized like small beans; to缓 (slow down) the drug's potency, press the pill flat. For stubborn diseases, increase to ten pills. All pills should be pricked with a needle to create several holes to facilitate the release of medicinal power. When used for pediatric accumulation, make pills the size of mung beans; this is especially effective for treating pediatric vomiting and regurgitation. This medicine is most effective in clearing chest烦 (restlessness/heat) and deficiency-type accumulation.
*Yingru Ji* records: Treating children who develop chills and fever after purgation; this is blood coagulating into a mass (Pi Qi) located under the left hypochondrium; or it may be due to cold fluid retention or cold food accumulation causing qi movement, with residual heat in the chest and heart, inability to eat or drink, and hidden emaciation (dark and thin appearance). It is appropriate to first take a small amount of Shaoyinzi San to move qi and promote digestion, followed by Zishuang Wan to remove old accumulation, allowing the body to gradually fill out and recover.
Shaoyinzi Formula Ingredients: Radix Bupleuri (Chaihu), Poria (Fuling), Radix Ginseng (Renshen), Rhizoma Atractylodis Macrocephalae (Baizhu), Testudo Carapax et Plastrum (Biejia - coated with vinegar and roasted until fragrant and cooked through. Each 0.5 liang).
Preparation and Administration: Cut the herbs into bean-sized pieces. Boil in 2 sheng of water until reduced to 5 he. Take warm in 3-4 divided doses on an empty stomach. Wait the time it takes a person to walk 1-2 li before taking the next dose. Consume porridge afterwards for dietary care.
Mr. Mao discusses: Children between five months and seven years of age may have masses forming in the abdomen due to accumulated Pi (masses), moving back and forth like a plum pit, or as large as an egg, often crying out in pain. These are classified into types: pain under the left hypochondrium is named "Qi" (qi stagnation/mass), while pain under the right hypochondrium is named "Pi Qi". Administer Peng'ezhu San and Jia Jianpi Yin (for those refusing milk/food) together, which will lead to recovery. If the face turns black, eyes stare straight ahead, stool contains black blood, nose and mouth feel cold, hands and feet are cold, and there is no desire to eat, the prognosis is fatal.
Qian Yi discusses pediatric Pi disease, caused by undigested milk and food lying latent in the abdomen, presenting with intermittent chills and fever, drinking water or wheezing/coughing, resembling tidal fever. If not treated early, it will inevitably develop into Gan syndrome (malnutrition/wasting). Because of the Pi mass, the child refuses to eat, leading to spleen and stomach deficiency and the emergence of heat. This causes excessive thirst, scouring the intestines and stomach, depleting body fluids. The stomach fails to transport and transform food and fluids. The pulse is deep and fine. With continued refusal to eat, spleen and stomach deficiency worsens, limbs become weak and unable to lift, various pathogens arise, and few escape becoming emaciated and developing Gan syndrome.
Regarding Pi as tidal fever: Cao Xuande's son, aged three, had a yellow complexion and periodic chills and fever, refused food, but continuously drank water and milk. Other physicians considered it tidal fever and used Niuhuang Wan and Shexiang Wan without success. Later, Zhike Gansan was administered, causing vomiting. Qian Yi stated that Baibing Zi (see previous text) should be used to purge, followed by tonifying the spleen, and then using Xiaoji Wan to grind away the accumulation (see previous text). This was indeed Pi disease, and the child recovered. Why? Refusing food but drinking only water indicates food is trapped in the gastrointestinal tract and cannot digest, causing chills. Vomiting after taking thirst-quenching medicines is due to the medicine attacking the spleen; purging resolves it.
Ren Zhai states: Pi disease involves blood membranes wrapping water, situated laterally beside the hypochondrium, causing intermittent pain. Only Pi disease can induce tidal fever and generate chills and fever. In malaria patients, fluid often accumulates in the epigastrium; over time, it may condense into Pi, causing persistent chills and fever. Those with this condition should use this method. When a child's zang-fu organs are harmonious and Ying-Wei (nutritive and defensive qi) flow smoothly, body fluids circulate naturally. Even if they drink plenty of fluids, it does not cause disease. However, improper breastfeeding/dietary management leads to Sanjiao obstruction, causing fluid retention in the intestines and stomach, preventing free circulation. If attacked by cold qi, it condenses into Pi. Mild cases use Jizhi Muxiang Wan; severe cases use Qu Pi Wan.
Zeng Shi states: Infants are born with incomplete constitution. Negligence in swaddling care and unregulated feeding, combined with external invasion by the Six Excesses and internal deficiency of the Five Zang qi, cause cold accumulation to linger in the spleen, failing to transform. This forms Pi, with ghost qi protruding under the hypochondrium, either left or right, commonly known as Gui Zhu (turtle infestation). These diseases result from accumulation stagnation fermenting, causing chills and fever, abdominal pain, or daytime coolness and nighttime fever. Treatment: For excess qi, first warm and regulate stomach qi, then use Wuxi Wan or Shuijing Dan to purge. After two or three doses, stop with thin porridge. Wait until all formed symptoms disappear before administering tonics. For deficiency qi, first regulate spleen and stomach, consolidate true yuan. Once spirit/color improves and food intake increases, purge as previously described. If extremely deficient, use Sanleng San or Huapi Wan to gradually eliminate, regulating yin and yang until balance is achieved. Tonifying before purging follows the method of welcoming and seizing, removing old cold accumulation. If the face is yellow, lips white, hair stands up, and muscles are wasted, this is extreme deficiency; do not purge lightly. Slowly using medicine to digest and regulate is superior. For young children, the nursing mother should frequently take Huoxiang Yin so the medicine passes through breast milk, providing slight assistance.
[Mr. Mao] Peng'ezhu San: Mainly treats pediatric Qi Pi and all qi disorders.
Ingredients: Rhizoma Curcumae (Peng'ezhu), Pericarpium Citri Reticulatae Viride (Qingju Pi), Fructus Alpiniae Oxyphyllae (Yizhi) (each 0.5 liang), Radix Aucklandiae (Muxiang, 2.5 qian), Glutinous Rice (Nuomi, 1 liang).
Preparation and Administration: Grind into powder. Take one Da Qian per dose, mixed with aged rice infusion. Take four times daily.
*Shenghui Fang* Biejia San:
Use Testudo Carapax et Plastrum (Biejia, one piece, coated with vinegar, roasted until yellow, remove skirt edge).
Preparation and Administration: Crush, sift finely into powder. Take one Qian per dose, decoct with one small cup of urine from an uncircumcised boy until reduced to five Fen. Adjust dosage based on child's size, divide and take. Three times daily, miraculous effect.
Huapi Wan (Zeng Shi): Mainly treats Pi accumulation and qi masses in the hypochondrium, persisting for a long time without resolving, alternating chills and fever, disharmony of fu-zang, indigestion of rice and grain, choking, asthma, shortness of breath, chest and abdominal fullness. Also treats Dingxi Bulu (a type of pediatric gan syndrome).
Ingredients: Radix Aucklandiae (Nanmuxiang), Pericarpium Citri Reticulatae (Chenpi - remove white pith), Rhizoma Curcumae (Ezhu - processed, crushed), Rhizoma Sparganii (Sanleng - processed, crushed), Pericarpium Citri Reticulatae Qingpi (Qingpi - with 9 grains of Badou, remove skin/core, lightly stir-fry, remove Badou), Fructus Aurantii (Zhike - remove pulp, stir-fry with bran), Semen Arecae (Binglang) (these seven each 0.5 liang), Rhizoma Atractylodis Macrocephalae (Baizhu), Flos Caryophylli (Dingxiang) (these two each 2 qian), Radix Asari (Xixin) (burned, retain character, 4 qian).
Preparation and Administration: Except for Nanmuxiang, Binglang, and Dingxiang which are not overheated, bake the other seven herbs. Grind together with the first three into powder. Form pills with yeast paste to the size of hemp seeds. Take 15-21 pills per dose on an empty stomach with clear rice soup. If there are alternating chills and fever, take alternately with Chaihu Yin. Avoid greasy and raw/cold foods.
Muxiang Wan: Treats vomiting/regurgitating milk and diarrhea of milk, with sour/foul odor, caused by incessant crying where milk is given, leading to stagnation and failure to digest; this is Milk Accumulation. Hard, hot, thirsty belly with vomiting/diarrhea, caused by unregulated diet, sleeping immediately after overeating; this is Food Accumulation. Abdominal pain with crying, stool like crab excrement, caused by disturbing qi, disharmony of Ying-Wei, lingering for a long time; this is Qi Accumulation. Masses forming in the abdomen after malaria.
Ingredients: Radix Aucklandiae (Muxiang), Rhizoma Curcumae (Pengshu), Fructus Amomi (Sharen), Pericarpium Citri Reticulatae Qingpi (Qingpi - remove white pith), Cinnabar (Zhusha - finely ground), Haematitum (Daizheshi - ground. Each 2 qian), Large Clove (Dadingxiang), Semen Crotonis Tiglii (Chuan Badou Rou - pressed on paper to remove oil. Each 1 qian).
Preparation and Administration: Grind into fine powder, mix evenly. Form pills with refined white flour paste to the size of hemp seeds. Take 2-3 pills per dose. For milk injury, take with breast milk; for food injury, take with rice infusion.
Qu Pi Wan: A harsh agent, not used unless there is severe excess accumulation.
Ingredients: Radix Kansui (Gansui - lightly stir-fried), Flos Genkwaniae (Yuanhua - stir-fried), Semen Pharbitidis (Qianniu - half stir-fried, half raw, grind to take powder), Cinnamomum Cassia Bark (Lagui), Rhizoma Curcumae (Pengshu), Pericarpium Citri Reticulatae Qingpi (Qingpi - remove pulp), Radix Aucklandiae (Muxiang), Semen Persicae (Taoren - soaked, peel removed, stir-fried), Resina Trogopterori (Wulingzhi) (each 2 qian).
Preparation and Administration: Grind into fine powder. Add 1 qian of oil-free Badou and grind together. Mix very finely with refined flour paste to form pills the size of hemp seeds. Take 1-2 pills per dose,灌 (administer) with ginger-honey decoction. After diarrhea, replenish with cold congee to harmonize the stomach.
Ai Pi Wan: Treats milk Pi and grain masses, abdominal mass pain.
Ingredients: Radix Aucklandiae (Muxiang), Pericarpium Citri Reticulatae Qingpi (Qingpi - remove pulp), Rhizoma Curcumae (Pengshu), Haematitum (Daizheshi - calcined, quenched in vinegar, finely ground), Radix Rehmanniae Preparata/Shengdihuang (Sheng Dihuang - note: text says Sheng, usually prepared for such formulas but stick to text) (each 3 qian), Semen Crotonis Tiglii (Badou - pressed, oil completely removed, 1 qian).
Preparation and Administration: Grind into fine powder. Form pills with vinegar-flour paste to the size of hemp seeds. Take 2 pills per dose after meals, with ginger-rubbed decoction.
*Waitai Mi Yao · Bixiao Fang* treats adult and pediatric Pi:
Take Prunus salicina kernels (Che Xia Li Ren) found under carts. Blanch in hot water to remove skin and double kernels. Mix equally with dry wheat flour. Pound into cakes. If too dry, add plain water and knead like dough. Make two cakes, each the size of the patient's palm. Lightly roast until yellow, do not cook thoroughly. Eat one cake on an empty stomach. There should be rapid bowel movement. If no movement, eat another. Drinking hot porridge juice may induce movement. Stop when rapid movement is achieved. If diarrhea continues past noon, stop with vinegar-cooked rice. Post-diarrhea, the body will be deficient. If disease remains, take another dose in 1-2 days according to strength, until disease is gone. Adjust for children accordingly. Do not consume dairy or beef/horse meat. Effective for all. For severe disease, equal parts kernel and flour. For mild disease, reduce according to judgment. Subsequent doses also depend on strength. Frequent trials show miraculous effects.
*Shenghui Fang* Qianhu Wan: Treats pediatric Pi Qi, abdominal pain.
Ingredients: Radix Peucedani (Qianhu), Radix Platycodi (Jiegeng - remove rhizome), Radix Paeoniae Rubra (Chishaoyao), Polyporus (Chifuling), Fructus Aurantii (Zhike), Radix Rheomi Palmati (Chuan Dahuang), Radix Angelicae Sinensis (Danggui), Semen Pruni Armeniacae (Yuli Ren - remove skin, lightly stir-fried. Each 0.5 liang), Testudo Carapax et Plastrum (Biejia, 1 liang, roasted until yellow).
Preparation and Administration: Crush and sift into powder. Mix with refined honey to form pills the size of mung beans. For three-year-olds, take 5 pills dissolved in porridge infusion on an empty stomach. Adjust dosage based on child's size.
*Yingru Ji* treats pediatric Shan Pi (flash Pi), high fever, frequent use of cold medicines causing cold qi to overflow into the heart forming Pi, lower jiao cold, intestinal constipation and difficult defecation.
Ingredients: Poria (Fuling), Radix Ligustici Chuanxiong (Chuanxiong), Testudo Carapax et Plastrum (Biejia - roasted), Fructus Aurantii (Zhike - roasted), Radix Paeoniae Alba/Bicolor (Shaoyao) (each 2 fen), Radix Bupleuri (Chaihu, 4 fen).
Preparation and Administration: Chop. Decoct in 1 sheng 3 he of water until reduced to 3 he. Take in two doses on an empty stomach. Wait the time it takes a person to walk 5-6 li before taking again. Avoid Amaranth seeds.
[Mr. Zhu] Zhimu Wan: Treats pediatric abdominal pain and irregularity, combined with Pi Qi.
Ingredients: Radix Anemarrhenae (Zhimu, 6 fen), Testudo Carapax et Plastrum (Biejia - roasted, 4 fen), Concha Ostreae (Muli), Fructus Aurantii (Zhike - stir-fried with bran. Each 3 fen), Radix Rheomi Palmati (Dahuang, 12 fen, wrapped in paper, baked until cooked).
Preparation and Administration: Grind into powder. Form honey pills the size of mung beans. Take 5 pills with rice infusion. Adults adjust dosage accordingly.
Treats 7-8 year olds who sleep excessively or have intermittent high fever, progressively wasting away. Body may not hurt, but sometimes has dysentery with pus, vomiting, regurgitation, and refusal to eat. These are signs of Pi Qi. This disease resembles malaria, often unrecognized by people.
Formula: Radix Bupleuri (Chaihu), Radix Scutellariae (Huangqin) (each 1 fen), Fructus Aurantii (Zhike - stir-fried, 2 slices), Radix Glycyrrhizae (Gancao), Radix Anemarrhenae (Zhimu), Radix Paeoniae (Shaoyao) (each 2 fen), Fructus Terminaliae Chebulae (Da Helile - roasted, use peel, one piece; small ones use two).
Preparation and Administration: Grind into powder. Decoct in one cup of water and take.