王肯堂曰。乳积者。其候但是吐下乳来。有酸臭气。因啼叫未已。遽与乳吃。停滞不化而得。兼面青黄。发热作渴。
多睡口疮。渐渐黄瘦。腹内结块不散。茅先生用丁香散开胃后。用牛黄丸取下乳积。后用匀气散。常服健脾散。即愈。
食积者。肚硬而热。或泻或呕。因饮食过饱。饱后即睡而得。茅先生用牛黄丸取积。后用匀气散调理。常服万灵丸即
愈。气积者。面色黄白。不进食。腹痛啼叫。利如蟹渤。此因营卫不和。日久而得。茅先生用万灵丸、匀气散、醒脾散
相夹调理。惊积者。时时泄清水如米泔。是受伤而复有积。烦闷啾唧。常以生嗔。先解散。用百解散。后理积。乌犀丸、
三棱散、醒脾散。宁惊化积。壮气和胃。仍节冷乳。自愈。热积者。大便不通。风毒疮疖。喉闭 腮。咽中涎响。茅先
生用夺命散吐下热涎。后用匀气散、醒脾散调理。常服镇心丸、天竺黄散、愈。
钱乙曰。积痛。口中气温。面色黄白。目无睛光。或白睛多。及多睡畏食。或大便酸臭者。当磨积而痛自除。宜下
积丸。甚者白饼子下之。后和胃气。用白术散。又有食积肚痛。有热者。芍药甘草汤。加葛根。吐者。加生姜、半夏。
或加枳实。亦效。其有积而潮热寒热。心腹胀满疼痛者。良方妙香丸。
李杲曰。凡小儿失乳。以食饷之。未有食肠。不能克化。致成食积。腹胀而痛。利色无常。日久瘦弱。
鳌按。有寒积腹痛者。由日渐受寒。兼吃冷物凉饮。寒邪结于脾经。遂致作痛。始犹数日一发。继则一二日发
。或日日发。发则面青白。吐清水。喜人手按。或将物抵住。方得稍可。宜用棉子仁八两炒令烟尽。加入枳壳炒、
乌药炒各一两。木香生研五钱。神曲糊丸。空心淡姜汤下。数日当下白物。渐愈。
Weng Kentang stated: For milk accumulation (Ru Ji), the symptoms are merely vomiting undigested milk with a sour, foul odor. It arises because the infant cries incessantly and is fed immediately, causing the milk to stagnate and fail to digest. Accompanying signs include a cyan-yellow complexion, fever with thirst, excessive sleepiness accompanied by mouth sores, gradual emaciation and yellowish pallor, and palpable masses in the abdomen that do not dissipate. Master Mao first used Dingxiang San (Clove Powder) to open the stomach, then employed Niuhuang Wan (Calculus Bovis Pill) to purge the milk accumulation, followed by Yunqi San (Regulating Qi Powder) for regulation, and regular administration of Jianpi San (Spleen-Strengthening Powder), leading to recovery.
For food accumulation (Shi Ji), the abdomen is hard and hot, presenting with either diarrhea or vomiting. It results from overeating followed by immediate sleep. Master Mao used Niuhuang Wan (Calculus Bovis Pill) to remove the accumulation, followed by Yunqi San (Regulating Qi Powder) for regulation, and regular administration of Wanling Wan (Myriad Efficacy Pill), leading to recovery.
For qi accumulation (Qi Ji), the complexion is yellowish-white, appetite is poor, there is abdominal pain with crying, and stool is thin like "Xiebo" (a type of small crab). This arises from disharmony between Ying (Nutritive Qi) and Wei (Defensive Qi) over a long period. Master Mao alternated the use of Wanling Wan (Myriad Efficacy Pill), Yunqi San (Regulating Qi Powder), and Xingpi San (Spleen-Awakening Powder) for regulation.
For fright accumulation (Jing Ji), there is frequent passage of clear water resembling rice washings, indicating injury compounded by accumulation. Symptoms include irritability, whimpering, and frequent anger. First, use Baijie San (Hundred Resolutions Powder) to disperse; subsequently, treat the accumulation using Wuxi Wan (Black Rhinoceros Horn Pill), Sanleng San (Curcuma Zedoaria Powder), and Xingpi San (Spleen-Awakening Powder). This calms fright, resolves accumulation, strengthens vital energy, harmonizes the stomach, and requires moderation of cold milk for spontaneous recovery.
For heat accumulation (Re Ji), there is constipation, wind-toxin sores and boils, throat closure with swollen cheeks, and rattling phlegm in the throat. Master Mao used Duoming San (Life-Snatching Powder) to induce vomiting and purge hot phlegm, followed by Yunqi San (Regulating Qi Powder) and Xingpi San (Spleen-Awakening Powder) for regulation, and regular administration of Zhenxin Wan (Heart-Calming Pill) and Tianzhuhuang San (Bamboo Stone Powder), leading to recovery.
Qian Yi stated: For colic due to accumulation (Ji Tong), the breath from the mouth is warm, the complexion is yellowish-white, the eyes lack luster, or the sclera is prominent, accompanied by excessive sleepiness, aversion to eating, or sour-smelling stool. One should grind away the accumulation, and the pain will naturally cease. Xiaji Wan (Accumulation-Expelling Pill) is appropriate. In severe cases, Baixingzi (White Cake Pill) may be used to purge. Afterwards, harmonize the stomach qi using Baizhu San (Atractylodes Macrocephala Powder). For colic due to food accumulation with heat, use Shaoyao Gancao Tang (Peony and Licorice Decoction) added with Gegen (Pueraria Root). If vomiting occurs, add Shengjiang (Fresh Ginger) and Banxia (Pinellia Tuber); adding Zhishi (Immature Bitter Orange) is also effective. For cases with accumulation presenting with tidal fever and alternating chills and heat, along with epigastric and abdominal distension and pain, Liangfang Miaoxiang Wan (Excellent Formula Wonderful Fragrance Pill) is indicated.
Li Gao stated: Whenever infants lose breast milk and are fed solid food, their intestines and stomach are immature and unable to digest it, leading to food accumulation. This causes abdominal distension and pain, variable stool color, and eventual emaciation over time.
Shen Jin'ao noted: There are cases of abdominal pain due to cold accumulation. These result from gradual exposure to cold and consumption of cold foods and drinks, causing cold pathogens to knot in the Spleen meridian, leading to pain. Initially, attacks occur every few days; later, they occur every one or two days, or daily. During an attack, the face appears cyan and pale, clear fluid is vomited, and the patient desires manual pressure or objects pressed against the abdomen for slight relief. The suitable prescription uses 8 liang of Cottonseed Kernel (Mianziren) stir-fried until smoke ceases, added with 1 liang of stir-fried Zhike (Bitter Orange) and 1 liang of stir-fried Wuyao (Lindera Root), and 5 qian of raw-ground Muxiang (Aucklandia Root). Form into pills with Shenqu (Medicated Leaven) paste, and take on an empty stomach with light ginger soup. Within several days, white matter should be expelled, leading to gradual recovery.