羸瘦不生肌肤 胃 （灸一壮。）
〔田〕小儿疳瘦。于胸下骨尖上灸三壮，次于脊下端尾翠骨尾上灸三壮。
小儿疳瘦脱肛，体瘦渴饮，形容瘦悴，诸方不瘥者。取尾翠骨上三寸骨陷中灸三壮。
小儿身羸瘦，贲豚腹肿，四肢懈惰，肩背不举。章门二穴各灸七壮。
汤氏云∶小儿鹤节，由禀赋不足，血气不荣，肌肉瘦瘠，则骨节皆露，如鹤之
足，皆肾虚不生骨髓之故。治法宜钱氏地黄丸加鹿茸、牛膝。
地黄丸 治头囟不合，体瘦骨露，有如鹤膝，皆肾虚不足。并治肾疳天柱倾倒。肾主骨也。
熟地黄（洗，焙，八钱） 泽泻（洗，二钱） 牡丹皮（去心） 白茯苓（各三钱） 山茱萸肉 牛膝 鹿
茸（酥炙） 山药（各四钱）
为末，蜜丸梧子大。三岁以下三二丸，温水空心化下。
巢氏云∶小儿丁奚病者，由哺食过度，而脾胃尚弱，不能磨消故也。哺食不消，
则水谷之精减损，无以荣其气血，致肌肉消瘠，其病腹大、颈小、黄瘦是也，若
久不瘥，则变成谷 。伤饱哺露病一名丁奚，三种大体相似，轻重立名也。《真
珠囊》凡小儿或因吐而泻，久不瘥，或病退不能行，膝大，肠红，号曰丁奚。七
岁以下号鼓棰风。十五以下名鹤膝风。盖此并是风冷伤于肾所致，肾主骨故也。
庄氏，疳胀、丁奚辨证云∶小儿腹大，如有青筋见，即曰疳胀也。如无青筋，乃
名丁奚。是因过饱伤食而得之。〔曾〕丁奚者，亦久积成疳之证，皆因饮食过伤于
脾胃，脾胃虚，不能磨化饮食，饮食渐减，无以生其气血，面白色惨，潮热往来，
腹大而多青筋，手足如筒，颅囟开解，颈项小而身黄瘦。先投万应丸（通治五疳），次参
苓白术散（不乳食）早晨一服，与养胃气，及醍醐散进食，食后下乌犀丸（积）三粒至五粒，
助脾化食，此即用迎夺之法。间投醒脾散（慢惊）、沉香槟榔丸、木香莪术丸（宿食），次第
调理。有渴泻腹痛，千金膏自好。若脾气稍和，饮食渐进，再以化癖丸（积）、快活丸
常服。或用乌犀丸略下二三行，匀气散（疝）止补。有寒热往来，柴胡饮（疳热）主之。腹胀，
投南星腹皮散（水肿）。有余热，麦芽、柳枝煎汤，调三解散（潮热）。有虫，下使君子丸（腹痛）。
斯疾得之非一朝一夕，然施治之法，亦须渐渐令其平复，欲求速效，则难矣。凡鸡
酒羊面鱼 甘甜生冷毒物，宜忌之。
十全丹 治丁奚、哺露，神效。
槟榔 枳壳（麸炒） 青皮 陈皮 三棱（炒） 蓬术（炒） 砂仁（各半两） 丁香 木香（各一分） 香附（一
两）
上为末，神曲糊丸如黍米大。空心食前，米饮下百丸。一方，去香附、砂仁、
丁香、三棱、枳壳，加五灵脂、白蔻、使君子、芦荟、虾蟆、川芎。
醍醐散 治吐泻后调和脾胃，消进饮食，及丁奚哺露虚热烦渴，气逆心恶。
陈皮（去白） 缩砂仁 浓朴（去粗皮。锉碎，姜汁浸一宿，慢火焙干） 麦芽（洗净，焙干） 乌梅（和核。各
五钱） 良姜（锉，东壁土炒） 干葛 乌药（各二钱半） 草果仁（炮，二钱） 甘草（炙，三钱）
上碎。每服二钱，水一盏，姜二片，枣一枚，盐少许，煎七分。空心温服。
快活丸 治丁奚疳证，皮肤瘦削，骨露如柴，肚大青筋，小便白浊，睡卧烦躁，神
气昏沉，常服健脾化积，进食肥肌。
蒸饼（一两，去顶剜空，入青矾半钱重，仍以碎饼屑紧塞，上用水纸封定，灰火中炮透，取出候冷用之）
上件锉焙为末，别以肥枣用米泔水浸经一宿，饭上蒸少时，去皮核，用乳钵烂
杵如糊，同前饼末，亭分再杵匀，丸麻仁大。每服三十丸至五十丸，温米清汤，
无时送下，儿小者亦以米汤化服。其蒸饼不拘个数，大约以一两入青矾半钱重为
定，下常如前法制半斤作一料。后人切勿以见方不重药为误，余尝屡试屡验，其
饼如南馒头样者是也。
《圣惠》赤芍药丸 治小儿丁奚，虽食不生肌肉，腹大食不消化。
赤芍药 川大黄（微炒） 鳖甲（醋涂，炙令黄，去裙 。各三分） 桂心 赤茯苓 柴胡（去苗）
上件药捣，罗为末，炼蜜和丸如麻子大。每服，煎蜜汤下五丸，日三服。
《婴孺》芍药丸 治小儿百病，有寒热，大腹，食不消化，不生肌肉，痿痹。
芍药 茯苓 大黄（各五分） 柴胡（四分） 鳖甲（三分炙） 桂心（二分） 人参（一分，一方二分）
上为末，蜜丸。三岁以下服三小豆大，不知加之，七八岁三桐子大，不知加之。
苦腹坚大者，加鳖甲一分。渴者，加栝蒌二分。病甚者服二十日效，已试大良。
一方，有杏仁二两，人参三分。
张涣大麝香丹 治小儿羸瘦，腹大见青筋，及丁奚等病。
麝香（研） 朱砂（细研水飞） 粉霜（研。各半两） 五灵脂 肉豆蔻仁 干蟾（涂酥炙。各一两） 夜明
砂白矾灰（各半两） 干地龙（炒，一分） 干蜣螂（七个，去翅，炙令黄熟）
上件捣，罗为末，与朱砂等同研匀细，炼蜜和如黍米大。每服三粒至五粒，温
水下，量儿大小加减服之。
初虞世治小儿腹如蜘蛛，四肢瘦者。用黑骨鸡子，破顶，入蜘蛛一枚于内，以湿纸
糊窍，用文武火煨熟，去蜘蛛，食其鸡子。累效，必数枚方愈。
《肘后方》捣生薤根，以猪脂煎，稍稍服。或熟炙鼠肉哺之。亦治哺露。
Emaciation and failure of muscles to grow (Moxibustion, one Zhuang.)
Tian said: In pediatric malnutrition (Gan) with emaciation. Moxibustion three Zhuang on the tip of the lower sternum bone, then three Zhuang above the tail vertebra at the lower end of the spine.
For pediatric malnutrition (Gan) with emaciation accompanied by rectal prolapse, emaciated body with thirst and desire to drink, haggard appearance, and ineffective treatment with various prescriptions. Moxibustion three Zhuang in the bony depression three cun above the tail vertebra.
Pediatric extreme emaciation, Qi rushing upward like a pig (Ben Tun), abdominal swelling, flaccidity and weakness of the four limbs, inability to lift shoulders and back. Moxibustion seven Zhuang on each Zhangmen point (LR13).
Tang said: Pediatric Crane Joint disease is due to congenital insufficiency, where blood and Qi fail to nourish, leading to emaciated muscles and exposed joints resembling crane legs. This is caused by Kidney deficiency failing to generate marrow. The treatment method should use Qian's Dihuang Wan (Rehmannia Pill) added with Deer Antler (Lurong) and Achyranthes Root (Niuxi).
Dihuang Wan (Rehmannia Pill): Treats fontanelles that do not close, emaciated body with exposed bones resembling crane knees, all due to Kidney Qi insufficiency. Also treats Tianzhu collapse (weakness of the neck) caused by Kidney Gan. The Kidney governs the bones.
Prepared Rehmannia Root (Shu Dihuang) (washed, dried, 8 qian) Alisma Rhizome (Zexie) (washed, 2 qian) Moutan Bark (Mudanpi) (core removed) Poria (Baifuling) (each 3 qian) Cornus Fruit (Shanzhuyu) Acanthopanax Root (Niuxi) Deer Antler (Lurong) (prepared with butter) Chinese Yam (Shanyao) (each 4 qian)
Pulverized into fine powder, formed into pills the size of wutong seeds with honey. For children under three years old, administer two or three pills, dissolved in warm water on an empty stomach.
Chao Yu-fang said: Pediatric Ding Xi disease arises from overfeeding while the Spleen and Stomach are still weak, unable to grind and digest food. Undigested food reduces the essence of water and grain, failing to nourish blood and Qi, resulting in emaciated muscles. The manifestations are a large abdomen, small neck, and yellowish emaciation. If prolonged without cure, it may transform into Gu Dan (grain jaundice/severe malnutrition). Shang Bao (food injury) and Bu Lu (nursing exposure) diseases are also named Ding Xi; these three conditions are similar in nature but named according to severity. Zhenzhu Nang states: Whenever a child suffers from vomiting followed by diarrhea that persists, or cannot walk after illness subsides, with swollen knees and bloody stools (Chang Hong), it is called Ding Xi. Under seven years old, it is called Guzhuifeng. Under fifteen years old, it is called Hexifeng. Generally, these are caused by wind-cold injuring the Kidney, as the Kidney governs the bones.
Zhuang's differentiation between Gan Zhang (Malnutrition Distension) and Ding Xi states: When a child has a distended abdomen with visible green veins, it is called Gan Zhang. Without green veins, it is called Ding Xi. This results from overeating causing food stagnation. Zeng stated: Ding Xi is also a syndrome of Gan accumulated over time, caused by dietary excess damaging the Spleen and Stomach. Spleen-Stomach deficiency fails to transform food, leading to reduced intake and inability to generate blood and Qi. Symptoms include pale face, alternating tidal fever, large abdomen with many green veins, limbs like tubes (edematous or wasted), open fontanelles, small neck, and yellowish emaciation. First administer Wanying Wan (Universal Pill for Five Gans), then Shenling Baizhu San (for poor feeding) once in the morning to nourish Stomach Qi, along with Tiguh San to promote eating. After meals, administer Wuxi Wan (for stagnation) 3-5 pills to assist Spleen digestion. This is the method of "Ying Duo" (attacking and capturing). Intermittently administer Xingpi San (for slow convulsion), Chenxiang Binglang Wan, and Muxiang Ezhu Wan (for retained food), regulating in sequence. For thirst, diarrhea, and abdominal pain, use Qianjin Gao. If Spleen Qi harmonizes slightly and diet gradually increases, regularly take Huapi Wan (for masses) and Kuaohuo Wan. Or occasionally use Wuxi Wan to induce slight bowel movements (2-3 times), stop tonification/aeration with Yunqi San (for hernia). For alternating chills and fever, use Chaihu Yin (for Gan heat). For abdominal distension, use Nanxing Fupi San (for edema). For residual heat, decoct malt and willow branches, mix with Sansan Jie San (for tidal fever). For intestinal parasites, administer Shijunzi Wan (for abdominal pain). This disease does not arise overnight; treatment must gradually restore balance. Seeking rapid effect is difficult. Avoid chicken, alcohol, mutton, noodles, fish, sweet, cold, raw, and toxic foods.
Shiquan Dan (Ten Complete Pills): Treats Ding Xi and Bu Lu with miraculous efficacy.
Areca Seed (Binglang) Immature Bitter Orange (Zhike) (bran-fried) Green Tangerine Peel (Qingpi) Tangerine Peel (Chenpi) Burreed Tuber (Sanleng) (fried) Curcuma Zedoaria (Pengzhu) (fried) Amomum Fruit (Sharen) (each half liang) Clove (Dingxiang) Costus Root (Muxiang) (each 1 fen) Cyperus Rhizome (Xiangfu) (1 liang)
Pulverized into powder, formed into pills the size of millet grains using Qu paste. Administer 100 pills before meals on an empty stomach with rice drink. Another prescription removes Xiangfu, Sharen, Dingxiang, Sanleng, Zhike, adding Dysderma (Wulingzhi), White Cardamom (Baiko), Quinine Fruit (Shijunzi), Aloe (Luhui), Toad (Hamax), and Ligusticum Chuanxiong (Chuanxiong).
Tiguh San (Tiger Brain Powder): Harmonizes Spleen and Stomach after vomiting and diarrhea, promotes food intake, and treats deficient heat, irritability, thirst, rebellious Qi, and nausea caused by Ding Xi and Bu Lu.
Tangerine Peel (Chenpi) (white part removed) Amomum Fruit (Suasharen) Magnolia Bark (Noupu) (bark removed, chopped, soaked in ginger juice overnight, dried over slow fire) Malt (Maiya) (washed, dried) Smoked Plum (Wumei) (with core, each 5 qian) Galangal (Liangjiang) (chopped, stir-fried with eastern wall soil) Kudzu Root (Gange) Cinnamon Twig (Wuyao) (each 2.5 qian) Tsaoko Fruit Kernel (Caoguoren) (processed, 2 qian) Licorice Root (Gancao) (roasted, 3 qian)
Chop ingredients finely. Take 2 qian per dose, add one cup of water, two slices of ginger, one jujube, and a pinch of salt. Decoct to 70%. Take warm on an empty stomach.
Kuaohuo Wan (Happy Life Pill): Treats Ding Xi Gan syndrome, emaciated skin, exposed bones like firewood, large abdomen with green veins, turbid white urine, restless sleep, lethargy. Regularly taken to invigorate Spleen, resolve stagnation, promote appetite, and build muscle.
Steamed Wheat Cake (Zhengbing) (1 liang, top removed and hollowed, insert 0.5 qian Vitriol Qingfan, seal tightly with cake crumbs, cover with wet paper, roast thoroughly in ash fire, cool before use)
Crush and dry the above ingredients into powder. Soak fleshy jujubes in rice wash water overnight, steam briefly, remove skin and pits, pound into paste in a mortar. Mix with the cake powder, knead evenly, form into pills the size of hemp seeds. Take 30-50 pills at any time with warm clear rice soup; infants can be given dissolved in rice milk. The amount of steamed cake is flexible, but standardize on 1 liang cake with 0.5 qian Qingfan. Remaining ingredients processed similarly to make half a jin per batch. Do not mistake this formula for being ineffective due to light dosage; I have tested it repeatedly with success. The cake should resemble southern mantou.
Shenghui Fang Chishao Yao Wan (Red Peony Pill): Treats pediatric Ding Xi where food intake does not generate muscle, abdominal distension, and indigestion.
Red Peony Root (Chishaoyao) Rhubarb (Chuang Dahuang) (lightly fried) Turtle Shell (Biejia) (coated with vinegar, roasted yellow, skirt removed, each 3 fen) Cassia Twig (Guixin) Red Poria (Chifuling) Bupleurum Root (Chaihu) (roots removed)
Pound and sieve into powder, mix with refined honey to form pills the size of hemp seeds. Take 5 pills per dose with honey water decoction, three times daily.
Yingru Shu Shaoyao Wan (Peony Pill): Treats hundred diseases in children, including chills/fever, large abdomen, indigestion, lack of muscle growth, and flaccidity/numbness.
Peony Root (Shaoyao) Poria (Fuling) Rhubarb (Dahuang) (each 5 fen) Bupleurum Root (Chaihu) (4 fen) Turtle Shell (Biejia) (3 fen roasted) Cassia Twig (Guixin) (2 fen) Ginseng Root (Renshen) (1 fen, another version 2 fen)
Pulverize into powder, form honey pills. Children under three take three pills the size of small beans, increasing if ineffective. Children aged seven-eight take three pills the size of paulownia seeds, increasing if ineffective. For hard, distended abdomen, add 1 fen Biejia. For thirst, add 2 fen Trichosanthes Root (Gualou). Severe cases show improvement after 20 days of administration; tested and highly effective.
Another version includes 2 liang Apricot Seeds (Xingren) and 3 fen Renshen.
Zhang Huan's Damochexiang Dan (Large Musk Pill): Treats pediatric emaciation, abdominal distension with visible green veins, and Ding Xi.
Musk (Shexiang) (ground) Cinnabar (Zhusha) (fine ground, water-floted) Lead Subacetate (Fenshuang) (ground, each half liang) Dysderma (Wulingzhi) Nutmeg Kernel (Roudoukouren) Dried Toad (Ganchan) (coated with butter, roasted, each 1 liang) Night Flying Sand (Yemingcha) Alum Ash (Baifanhui) (each half liang) Earthworm (Gan Dilong) (fried, 1 fen) Dung Beetle (Gan Danglang) (seven, wings removed, roasted until yellow)
Pound and sieve into powder, mix uniformly with Zhusha. Form into pills the size of millet grains with refined honey. Take 3-5 pills per dose with warm water, adjusting dosage based on child's size.
Chu Yushi treated pediatric spider-like abdomen with emaciated limbs using black-bone chicken eggs. Break the top, insert one spider inside, seal holes with wet paper, roast over mild fire until cooked. Remove spider, eat the egg. Repeatedly effective; several eggs required for cure.
Zhouhou Fang: Pound fresh Scallion Bulbs (Xiegen), fry in lard, take small amounts. Or cook and roast rat meat to feed. Also treats Bu Lu disease.