《庄氏家传》小儿未能语,啼哭不能辨者,当以手候其腹,如有实硬处,即是腹
痛。治之方,研生姜取汁,暖令温,调面成糊,涂纸上,贴脐心,立定。
〔钱〕腹胀,由脾胃虚气攻作也,实者闷乱喘满,可下之,用紫霜丸、白饼子(此言未下而喘者,为实,
故可下,若误下而喘者,为虚气附肺,不可下也。紫霜丸、白饼子二方见癖)。不喘者,虚也,不可下,若误下
之,则脾虚气上,附肺而行。肺与脾子母皆虚,肺主目胞、腮之类,脾主四肢,母气虚甚,即目胞腮肿,
四肢黄色。治之用塌气丸渐消之,未愈,渐加丸数,不可以丁香、木香、橘皮、豆蔻大温散药治之,何以然?
脾虚气未出,故虽腹胀而不喘,可以温散药治之,使上下分消其气,则愈矣。若气虚已出,附肺而行,即脾胃内
弱,每生虚气入于四肢面目矣,小儿易为虚实,脾虚则不受寒温,服寒则生冷,服温则生热,当识此勿误
也。胃久虚热,多生疸病,或引饮不止。脾
虚不能胜肾,随肺气上行于四肢而目肿若水状,肾气漫浮于肺,即大喘也。此当用塌气丸,病愈后面未红者,虚衰未
复故也(此下后喘,故宜塌气丸,若未下而喘,宜下之)。治腹胀者,譬如行兵战冠于林,寇未出林,以兵攻
之,必可获,寇若出林,不可急攻,攻则必有失,当以意渐收之,即顺也(寇未出林,谓虚气未出而不喘,不目胞腮
肿,故可用丁香、木香大温散药上下分消其气而愈也,寇已出林,谓虚气已出,为喘、为目腮肿,须用塌气九渐消之)。
治小儿虚腹胀,先服塌气丸,不愈,腹中有食积结粪,小便黄,时微喘,脉伏而实,时饮水能食者,可下之。
盖脾初虚而后有积,所治宜先补脾,然后下之,后又补脾,即愈也。不可补肺,恐生虚喘。
〔洁古〕腹胀虚实凡久病吐泻之后,虚则其脉微细,肺主目胞及腮,脾主四肢,若色淡黄,目胞腮虚肿,手足
冷,先服塌气丸,后服异功散、和中丸、四君子汤、益黄散之类,用诸温药养真气(异功散、和中丸、四君子汤三方,
并见吐泻)。实则脉洪实,不因吐泻久病后,亦不因痢下,腹胀而喘急闷乱,更有痰有热,及有宿食不化而腹胀者,
宜服白饼子、大黄丸、解毒丸下之,兼须详认大小便,如都不通,先利小便,后利大便。(白饼子方见癖,解毒丸方见喉
痹,
大黄丸方见伤寒)。云岐云∶小儿热结于内,腹胀壮热,
大便赤黄,躁闷烦乱者宜泻青丸。
〔薛〕东垣云∶寒胀多,热胀少,皆主于脾胃。虚者宜用六君子汤。若喘而气短者,脾肺气虚也,用异
功散补之。若服克伐之类而喘胀益甚者,脾肺之气复伤也,用前汤加半夏、升麻。若既下而不喘,则邪气
去而肺气宁也,不必用药。或病久小便不利,或四肢浮肿者,脾肺之气虚,不能通调水道也,用金匮加减肾气
丸主之。或手足逆冷,睡而露睛,脾胃虚寒也,用六君子加炮姜。手足不冷,睡而露睛,脾胃虚弱也,用六
君子汤。若面色青,木克土也,用六君、木香、柴胡,更当调治乳母,节其饮食,恐药饵过剂,复伤胃气
故也。一小儿腹胀,面赤痰喘,大便秘,壮热饮冷。此形病俱实。用紫霜丸一服,诸证益甚,面色顿白,饮
汤不绝。余以为邪气退而真气复伤,故面白而喜汤,用白术散大剂煎汤,令恣饮,良久而睡,翌日顿
安。一小儿伤食腹胀,胸满有痰。余治以异功散而痊。后复伤食腹胀,兼痛,或用药下之,痛胀益甚,而加气
喘。此脾胃伤而致肺虚也。用六君子加桔梗调补而痊。一小儿腹胀恶食,发热恶心,证类外感。余曰此饮食
停滞也。用保和丸一服,诸证
顿退,惟腹胀,用异功散而痊。一小儿伤食腹胀,服克伐之剂,小便涩滞,又服五苓散之类,饮食渐减,小
便不通,四肢顿肿。余朝用《余匮》肾气丸去附子,夕用补中益气汤而安。一小儿腹胀,大便青白,腹左一块,
面色痿黄,齿龈赤烂,食少滞颐。余用异功散调补中气为主,佐以大芜荑汤清疳治热,月余诸证稍愈,仍服异
功散及蚵蟆丸,外贴阿魏膏,两月块消,左胁微痛,用四君子汤、九味芦荟丸、而愈。《百问》云,有疳胀,
气胀,症积胀,锁肚胀,脘膈胀,食膨胀,蛔胀,虚冷积胀。其疳气积胀,宜先与保童兼塌气以去之。其痞癖
气胀、症积胀,宜三棱以消痞。其锁肚胀,宜与珍珠天麻丸以通之。其上膈中脘食伤膨胀,宜三棱、塌气、大
茱连丸以消磨之。其蛔胀,宜下虫丸以化之。其虚冷积胀,宜沉香煎以温之。以上诸证,宜调和胃气,消磨
通利,肿胀必然平复矣。如有热者,必以葶苈、牵牛等辈以治之,推气丸剂亦可用。
按∶《百问》分证虽详,而偏于攻下,若无钱张活法,薛氏补法以主之,鲜不杀人,慎之。
塌气丸
胡椒(一两) 蝎尾(半两)
上为末。糊丸如粟米大。每服五七丸至一二十丸,陈米饮下,无时。一方,有木香一钱。
钱氏、洁古所用塌气丸,乃此二味,不可误用后有牵牛者,慎之。
《本事》调中丸 治小儿久伤脾胃,腹胀。
干姜 橘红 白术 茯苓 木香 砂仁 官桂 良姜(各等分)
上细末,糊丸如麻子大。每服二三十丸,食后,熟水下。
《圣惠》治小儿脾虚腹胀不能乳食。诃梨勒丸
诃梨勒(煨,用皮) 浓朴(去粗皮,涂生姜汁、炙令香熟) 陈橘皮(汤浸,去白,焙。各半两)
干姜(炮裂,锉) 甘草(炙微赤,锉) 木香 白术 人参(去芦头。各一分)
上件药捣,罗为末。炼蜜和丸,如麻子大。每服以粥饮下五丸,日三四服,量儿大小,加减服之。
(张氏)温脾散 治脾胃亏损,腹胁虚胀,乳食不进,困倦无力。
诃子肉 人参(各七钱) 白术 木香 桔梗 茯苓 藿香 陈皮 黄 (各五钱) 甘
草(炙,二钱半)
上,每服二三钱,姜枣水煎。
沉香煎 治脾气冷积。
乳香 沉香 丁香 杏仁(炒) 百草霜 木香(各一钱) 肉豆蔻(一个,煨) 巴豆(十四粒,
出油如霜)
上为末,酒煮蜡和丸,绿豆大。每服三五丸,淡生姜汤送下。应患肚痛不止,服之效。常服,以通为度。
《三因》肥儿丸 治小儿病多因缺乳,吃食太早所致,或因久患脏腑胃虚虫动,日渐
羸瘦,腹大不能行,发竖,发热,无精神。
黄连 神曲(各一两) 麦芽(炒,半两) 木香(二钱) 槟榔(三个,不见火) 使君子肉 豆蔻(面
裹煨。各半两)
上为末,糊为丸,如桐子大。每服三二十丸,量儿加减,熟水吞下。
六神丸 治如前证。
丁香 木香 肉豆蔻(用面裹煨。各五钱) 诃子(煨,去核,半两) 使君子 芦荟(研。各一两)
上为末,以枣肉和丸,如麻子大。每服五丸至七丸,温米饮下,食前。
治小儿疳病或腹大
胡黄连(二钱,去果积) 阿魏(一两半,去肉积) 神曲(二钱,去食积) 黄连(二钱,去热积)
麝香(四粒,通窍)
上为末。每服十二粒,白术汤下。
褐丸子 治疳肿胀。
萝卜子(一两,微炒) 陈皮 青皮 槟榔 五灵脂 蓬术(煨) 黑牵牛(取净末,半生半炒) 赤
茯苓(各半两) 木香(二钱半)
上为末,面糊丸,绿豆大。每服十五丸,紫苏叶或白汤下。
五疳保童丸 治五种疳疾。
五倍子(生) 青黛 夜明砂(布裹洗) 苦楝根皮 芦荟 熊胆(研入) 黄连(去毛) 龙胆草(
生用) 干蟾(酥炙,去皮骨) 麝香(研入) 芜荑(取仁) 蝉蜕(去土。各等分)
上末,用粟米糊为丸,麻子大。一岁儿二十丸,饭饮下,二三服。
幼科有丁奚、哺露、无辜等名,其证腹大、颈小、黄瘦,皆疳胀之异名也,轻
则为此,重则为彼耳。今仍旧别立门于疳后。
杨氏塌气散 治小儿腹胀,气喘、体肿、面浮。
陈米(一合,炒黄) 青皮(去穣,巴豆二十一粒,炒黄色,去巴豆) 甘草(炙。各半两) 黑牵牛(
二钱半,半生半炒) 肉豆蔻(二个,煨香)
上末半钱,米饮调下。加槟榔一个。
塌气丸 治小儿疳气腹胀,喘急并面浮肿。
丁香 胡椒(炒。各五钱) 萝卜子(炒) 白牵牛(各七钱半)
上为末,面糊丸,小豆大。三岁三十丸,米汤下。
塌气散 治小儿腹胀气粗,并疳疾相攻,面目浮肿。
木香(一钱) 青皮(半两) 巴豆(三十粒,同炒豆黄色,去巴豆)
上为末。三岁,半钱,米汤下,食前连进,即效。
分气饮 治小儿肿胀作喘,气短而急。
桔梗 赤茯苓 陈皮 桑白皮(锉) 大腹皮 枳壳(炒) 半夏(曲) 真苏子(微炒) 紫苏
甘草(炙。各二钱) 草果仁(一钱)
上锉散。每服一钱半,姜枣煎服。
三棱煎丸 治婴孩食伤生冷、甜腻、毒热等物,脾胃积滞,久不克化,令儿肚热脚冷,痞癖寒热。及疗
瘕中脘不和,膨胀上膈,气壅心腹,不得宣通,所以作疾。此药温良,但是诸积滞食不化,并宜与服。
京三棱(成块煮) 蓬术(并炮。各半两) 芫花(二钱半,醋浸、炒) 鳖甲(去裙,米醋炙焦,半两) 淡
豆豉(二钱) 巴豆(二十一粒,去壳) 川当归(半两) 杏仁(去皮尖,二钱半,炒令赤)
上,前四味一处以米醋一碗煮令干,仍用炒,起更细锉,焙为末,次入当归末、
杏仁、巴豆、淡豆豉和匀,水煮面糊、为丸麻子大。每服二十丸,姜汤下,大小加减服之。
三棱丸 治小儿停积,腹胁胀满,干哕恶心,全不入食。
三棱(煨) 木香 神曲(炒) 陈皮(去白) 半夏(姜汁制。各一两) 丁香 官桂(各半两)
上为末,曲糊丸,如黄米大。二十丸,乳食后温生姜汤下。
阿魏丸 治小儿食积,腹如蜘蛛状,肚痛,小便白浊。
阿魏(醋浸一宿,研如泥) 黄连(炒) 连翘(各半两) 花碱(研如粉,三钱) 山楂肉(一两) 半夏
(皂角水,浸一宿,一两)
上为末,炒神曲糊丸,如卜子大。每服二十丸,空心米饮下。吃果子多者加胡黄连。米食多者加神曲、
山楂。肉食多者加阿魏。
又阿魏丸
阿魏(一两) 黄连(酒煮,六两)
上为末,醋浸阿魏一宿,研如泥,汤浸蒸饼丸。如元气不足,加人参。
小阿魏丸
山楂肉(三两) 石碱(三钱) 半夏(一两)
上为末,阿魏半两醋浸,糊丸,白汤下。
真珠天麻丸 治急惊风请量用之,以通为度。此方仍治吊肠、锁肚、撮口至妙。丸如麻子大,初生
患者三日三丸,五日五丸,七日七丸。加青黛,名青黛丸。
天南星(炮) 天麻 白附子(炮。各二钱半) 腻粉(半钱) 巴霜(一字) 芜荑(炒) 全蝎 滑石
(各一钱半)
上为末,煮细面糊丸,如麻子大。每服一岁五丸,二岁十丸,大小加减,薄荷汤点茶清送下。
大茱连丸 治小儿饮食过度,胸膈膨胀,上下气不宣通,郁滞迷闷,情思少乐,大则作喘,饮食不
化,作渴烦躁,坐卧不任,肢体倦怠,腹胁疼痛。
蓬术 京三棱(各二钱半,醋煮) 干姜(炮) 青皮 陈皮(去白) 木香 丁香(各三钱) 巴豆(二十
一粒,去膜心出油) 绿细小茱萸(二钱)
上为末,醋糊丸,麻子大。每服七丸至十丸,大者加服,生姜枣子汤下。
下虫丸 治蛔疳诸虫。
苦楝根皮(酒浸,焙) 绿色贯众 木香 桃仁(浸,去皮,焙) 芜荑(焙) 鸡心槟榔(各一钱) 鹤
虱(炒) 轻粉(各半钱) 干虾蟆(炙焦,三钱) 使君子(五十个,煨,取肉用)
上为末,飞面糊丸,麻子大。每服二十丸,天明清肉汁下。内加当归、川连、各二钱半,治脊疳兼疳劳。
遇仙丹 治诸虫,取诸积。
牵牛(三斤) 大腹子(二斤) 锡灰(炙干,为末) 大黄(四两) 雷丸(四两) 青木香 鹤虱 干漆
(各二两) 皂角(四条)
上,后三味煎水,用粟米煮粥,初用牵牛末,次用大腹末,三用锡灰,四用
大黄,五用雷丸,六用青木香和剂,丸如梧桐子大。每服五七九丸,用姜汤熟水送下。此药专治男子妇人
积虫气块,五劳七伤,赤白痢疾,便血注下,皮黄水肿,十般气,十一般恶虫。又进饮食除病,悦颜色,不与
他药相反,四季可服。细末三四钱,量大小加减,服时不吃晚饭,三更用茶清下,次早桶子内虫积及粒
米尽,方可洗面,温粥补之,伤寒孕妇,不可服。
东垣治胀,不犯上下二焦,用《素问》中满者写之于内之法。实者,分气消积。虚者,升阳滋血。治者
当师其意而活用之,胜前所用排击诸方远矣。
中满分消丸
黄连 枳实 浓朴(各五钱) 干姜 姜黄 猪苓 砂仁 泽泻 茯苓(各三分) 陈皮
白术(各一分) 半夏(四分) 黄芩(一两二钱) 甘草(一分)
上为细末,蒸饼为丸,如黍米大。每服三十丸,温酒送下。
消痞丸 快利之剂。
黄连(半两) 枳实 黄芩 甘草 人参(各三钱) 浓朴(七分) 干姜(四分) 橘皮(一钱) 姜黄(五分)
*Zhuang's Family Collection*: For infants who cannot yet speak and whose crying cannot be distinguished, one should palpate the abdomen with the hand. If there is a solid or hard area, it indicates abdominal pain (Abdominal Pain). The treatment method is to crush fresh ginger (Zingiberis Rhizoma Recens) and extract the juice, warm it until lukewarm, mix with flour to form a paste, apply it on paper, and stick it to the center of the umbilicus (Shenque, CV8); the pain will stop immediately.
[Qian Yi] Abdominal distension (Abdominal Distension) arises from deficiency of the Spleen and Stomach with Qi attacking and flaring up. In excess patterns, there is chest oppression, restlessness, wheezing, and fullness; purgation can be used, employing Zishuang Wan (Purple Frost Pill) or Baibing Zi (White Cake Pill) (This refers to wheezing present before purgation, indicating an excess pattern, thus purgation is suitable; if wheezing occurs after mistaken purgation, it indicates deficient Qi attaching to the Lung, and purgation is contraindicated. See "Pi" section for formulas). If there is no wheezing, it is a deficiency pattern, and purgation is contraindicated. Mistaken purgation causes Spleen Qi to become deficient and ascend, attaching to the Lung. Since the Lung and Spleen are in a mother-son relationship, both become deficient. The Lung governs the eyelids and cheeks, while the Spleen governs the four limbs. When maternal Qi (Spleen Qi) is severely deficient, swelling of the eyelids and cheeks occurs, and the limbs turn yellow. Treatment involves using Taqi Wan (Collapse Qi Pill) to gradually resolve the condition. If not cured, gradually increase the dosage. Do not use strongly warming and dispersing herbs such as Dingxiang (Caryophylli Flos), Muxiang (Aucklandiae Radix), Chuanpiao (Tangerine Peel), and Doukou (Cardamomi Fructus). Why? Because Spleen Qi is deficient but has not yet escaped outward; thus, although there is abdominal distension, there is no wheezing. In this case, warming and dispersing herbs can be used to distribute and eliminate Qi from above and below, leading to recovery. However, if Qi deficiency has already escaped outward and attached to the Lung, meaning internal Spleen and Stomach weakness generates deficient Qi entering the limbs and face, infants are prone to mixed deficiency and excess. Spleen deficiency cannot tolerate cold or heat; administering cold herbs generates cold, while administering warm herbs generates heat. One must recognize this to avoid errors. Long-term Stomach deficiency with heat often leads to jaundice (Jaundice) or excessive thirst. Spleen deficiency fails to control the Kidney; following Lung Qi upward to the limbs causes eyelid swelling resembling water retention. Kidney Qi floats diffusely into the Lung, causing severe wheezing. This requires Taqi Wan. If the face remains pale after recovery, it indicates that deficiency and decline have not yet restored (This refers to wheezing after purgation, hence Taqi Wan is appropriate; if wheezing precedes purgation, purgation is indicated). Treating abdominal distension is like warfare in a forest: if the enemy has not left the forest, attacking them yields victory; if they have emerged, do not attack hastily, for attack may lead to loss. One should gradually subdue them with strategy, which is顺应 (following the natural course) (Enemy not out of forest: deficient Qi has not escaped, no wheezing or facial swelling, so warming/dispersing herbs can be used; Enemy out of forest: deficient Qi has escaped, presenting as wheezing or facial swelling, requiring Taqi Wan to gradually resolve). For pediatric deficiency-type abdominal distension, first administer Taqi Wan. If unresolved, and there is food accumulation and fecal impaction in the abdomen, yellow urine, occasional mild wheezing, deep and solid pulse, occasional desire to drink and eat, purgation may be used. Since the Spleen was initially deficient and then developed accumulation, treatment should first tonify the Spleen, then purge, then tonify the Spleen again for recovery. Do not tonify the Lung, lest it generate deficient wheezing.
[Jiegu (Li Dongyuan)] Regarding excess and deficiency in abdominal distension, especially after prolonged vomiting and diarrhea: deficiency presents with a faint and fine pulse. The Lung governs the eyelids and cheeks; the Spleen governs the limbs. If the complexion is pale yellow, eyelids and cheeks are vacuously swollen, and hands and feet are cold, first administer Taqi Wan, followed by Yigong San (Heterogeneous Powder), Hezhong Wan (Harmonize Middle Pill), Sijunzi Tang (Four Gentlemen Decoction), or Yihuang San (Yellow-Protecting Powder), using various warming herbs to nourish True Qi (See "Vomiting and Diarrhea" for these three formulas). Excess presents with a surging and solid pulse, not necessarily following prolonged vomiting/diarrhea or dysentery. With abdominal distension, rapid wheezing, chest oppression, restlessness, phlegm, heat, and undigested food causing distension, administer Baibing Zi, Dahuang Wan (Rhubarb Pill), or Jiedu Wan (Detoxification Pill) to purge. Carefully distinguish urinary and bowel status; if neither is unobstructed, promote urination first, then bowel movement (See "Pi" for Baibing Zi, "Sore Throat" for Jiedu Wan, "Cold Damage" for Dahuang Wan). Yunqi stated: For children with internal heat binding, abdominal distension, high fever, red-yellow stool, and restless agitation, Xieqing Wan (Drain Green Pill) is suitable.
[Xue Ji] Dongyuan stated: Cold distension is common; heat distension is rare. Both are governed by the Spleen and Stomach. Deficiency patterns suit Liujunzi Tang (Six Gentlemen Decoction). If wheezing and shortness of breath occur, indicating Spleen-Lung Qi deficiency, use Yigong San to tonify. If purgative or harsh drugs worsen wheezing and distension, it indicates further injury to Spleen-Lung Qi; add Banxia (Pinelliae Rhizoma) and Shengma (Cimicifugae Rhizoma) to the previous formula. If purged without subsequent wheezing, pathogenic factors are expelled and Lung Qi is calm; no medication is needed. If long-standing illness causes oliguria or limb edema, it indicates Spleen-Lung Qi deficiency failing to regulate water passages; use Jin Gui Ji Jian Shenqi Wan (Modified Kidney Qi Pill from Golden Cabinet) as the main treatment. If hands and feet are cold and eyes open during sleep, it indicates Spleen-Stomach deficiency-cold; use Liujunzi Tang plus Paojiang (Prepared Ginger). If hands and feet are not cold but eyes open during sleep, it indicates Spleen-Stomach weakness; use Liujunzi Tang. If the complexion is green, Wood overacts on Earth; use Liujunzi Tang, Muxiang, and Chaihu (Bupleuri Radix). Additionally, regulate the nursing mother's diet to prevent excessive medication from damaging Stomach Qi. A child with abdominal distension, red face, phlegm-wheezing, constipation, high fever, and craving cold drinks presented with both form and disease being excess. One dose of Zishuang Wan exacerbated symptoms, turning the face suddenly white with continuous desire for warm drinks. I reasoned that pathogenic factors receded but True Qi was injured, hence the white face and preference for warmth. Administered a large dose of Baizhu San (Atractylodis Macrocephalae Powder) decoction for free drinking; after some time sleeping, the child recovered fully the next day. A child with food-stagnation abdominal distension and chest fullness with phlegm was cured with Yigong San. Later, recurrent food stagnation caused distension and pain; purgation worsened pain and distension, adding wheezing. This indicated Spleen-Stomach injury leading to Lung deficiency. Cured with Liujunzi Tang plus Jiegeng (Platycodonis Radix). A child with abdominal distension, aversion to food, fever, nausea, resembling exterior syndrome, was diagnosed with food stagnation. One dose of Baohe Wan (Preserve Harmony Pill) resolved most symptoms, leaving only distension, cured with Yigong San. A child with food-stagnation distension took harsh drugs, causing difficult urination; Wuling San (Five-Poria Powder) was added, reducing appetite but stopping urination and causing sudden limb edema. Morning administration of Jin Gui Shenqi Wan minus Fuzi (Aconiti Lateralis Radix Preparata), evening administration of Buzhong Yiqi Tang (Tonify the Middle and Augment Qi Decoction) brought relief. A child with abdominal distension, blue-white stool, a mass on the left abdomen, sallow complexion, red/rotten gums, and poor intake with drooling was treated primarily with Yigong San to regulate Middle Qi, assisted by Dayuwanyi Tang (Great Wormwood Decoction) to clear malnutrition heat. After a month, symptoms improved slightly; continued Yigong San and Emawang Wan (Toad Pill), externally applied Awei Gao (Styrax Plaster). After two months, the mass disappeared, with slight left hypochondriac pain, cured with Sijunzi Tang and Jiwei Lvhui Wan (Nine-Ingredient Aloe Pill). *Baiwen* states: There are malnutrition distension, Qi distension, mass distension, locked-belly distension, epigastric distension, food-distension, roundworm distension, and deficiency-cold accumulation distension. For malnutrition-Qi accumulation distension, first use Baotong and Taqi to remove it. For pi-mass Qi distension and mass distension, use Sanleng (Sparganii Rhizoma) to dissipate masses. For locked-belly distension, use Zhenzhu Tianma Wan (Pearl Gastrodia Pill) to unblock. For upper epigastric food-injury distension, use Sanleng, Taqi, and Dajulian Wan (Large Zanthoxyli-Coptis Pill) to digest. For roundworm distension, use Xiachong Wan (Expel Worm Pill) to dissolve. For deficiency-cold accumulation distension, use Chenxiang Jian (Aquilaria Decoction) to warm. All these conditions require harmonizing Stomach Qi, digesting, and promoting unobstructed flow; swelling will surely subside. If heat is present, treat with Tingli (Descurainiae Semen) and Qianniu (Pharbitidis Semen); Tuiqi Wan (Push Qi Pill) is also usable.
Note: Although *Baiwen* categorizes syndromes in detail, it leans towards purgation. Without the flexible methods of Qian Yi and Zhang Huan, and the tonifying methods of Xue Ji, few cases avoid fatality. Be cautious.
**Taqi Wan (Collapse Qi Pill)**
HuJiao (Piperis Longi Fructus) (1 liang), Xiewei (Scorpio) (0.5 liang).
Grind into powder. Form pills with paste the size of millet seeds. Take 5-7 to 10-20 pills at any time, washed down with aged rice water. Another prescription adds Muxiang (1 qian).
The Taqi Wan used by Qian Shi and Jiegu consists of these two ingredients. Do not mistakenly use versions containing Qianniu later added. Be cautious.
**Ben Shi Fang Tiao Zhong Wan (Regulate Middle Pill from Essential Prescriptions)**
Treats long-term Spleen-Stomach injury in children causing abdominal distension.
Ganjiang (Dried Ginger), Juhong (Tangerine Red Peel), Baizhu (Atractylodis Macrocephalae Rhizoma), Fuling (Poria), Muxiang, Sharen (Amomi Fructus), Guanzi Gui (Cinnamomi Cortex), Liangjiang (Alpiniae Officinarum Rhizoma) (Equal parts).
Grind finely. Form pills with paste the size of hemp seeds. Take 20-30 pills after meals, washed down with cooked water.
**Sheng Hui Fang He Li Le Wan (Myrobalan Pill)**
Treats pediatric Spleen deficiency abdominal distension preventing breastfeeding/eating.
Helile (Myrobalani Fructus) (roasted, use peel), Houpo (Magnoliae Officinalis Cortex) (scraped, coated with ginger juice, roasted until fragrant), Chenpi (Tangerine Peel) (soaked in water, scraped, dried) (0.5 liang each).
Ganjiang (Roasted, chopped), Gancao (Licorice Root) (roasted reddish, chopped), Muxiang, Baizhu, Renshen (Ginseng Radix) (remove rhizome) (0.1 liang each).
Pound and sieve into powder. Mix with refined honey to form pills the size of hemp seeds. Take 5 pills with gruel water, 3-4 times daily, adjusting dosage according to age.
**(Zhang Shi) Wen Pi San (Warm Spleen Powder)**
Treats Spleen-Stomach damage, vacuous distension of abdomen/hypochondrium, inability to take milk/food, fatigue, and weakness.
Hezi Rou (Arecae Seed Flesh), Renshen (7 qian each). Baizhu, Muxiang, Jiegeng, Fuling, Huoxiang (Agastaches Herba), Chenpi, Huangqi (Astragali Radix) (5 qian each). Gancao (Roasted) (2.5 qian).
Take 2-3 qian per dose, decoct with ginger and jujube water.
**Chenxiang Jian (Aquilaria Decoction)**
Treats Spleen Qi cold accumulation.
Ruxiang (Olibanum), Chenxiang (Aquilaria Lignum), Dingxiang, Xingren (Pruni Armeniaci Semen) (stir-fried), Baicaoshuang (Fuligo Cinereus), Muxiang (1 qian each). Roudoukou (Myristicae Semen) (one, roasted), Badou (Crotonis Fructus) (14 grains, expressed oil like frost).
Grind into powder. Boil in wine, mix with wax to form pills the size of mung beans. Take 3-5 pills, washed down with light ginger soup. Effective for persistent abdominal pain. For regular use, aim for unobstruction.
**San Yin Fang Fei Er Wan (Fat Child Pill)**
Treats pediatric diseases often caused by lack of breast milk, early weaning, or long-term organ/Stomach deficiency with worm activity, leading to emaciation, large abdomen unable to walk, standing hair, fever, and lethargy.
Huanglian (Coptidis Rhizoma), Shenqu (Massae Fermentatae Medicatae) (1 liang each). Maiya (Hordei Fructus Germinatus) (stir-fried, 0.5 liang). Muxiang (2 qian). Binglang (Arecae Semen) (three, not exposed to fire), Shijunzi Rou (Quisqualis Fruit Flesh), Doukou (Cardamomi Fructus) (wrapped in dough, roasted) (0.5 liang each).
Grind into powder. Form pills with paste the size of paulownia seeds. Take 30-20 pills, adjust by age, swallow with cooked water.
**Liushen Wan (Six Gods Pill)**
Treats conditions as above.
Dingxiang, Muxiang, Roudoukou (wrapped in dough, roasted) (5 qian each). Hezi (Myrobalani Fructus) (roasted, pitted, 0.5 liang). Shijunzi, Lvhui (Aloe) (ground) (1 liang each).
Grind into powder. Mix with jujube flesh to form pills the size of hemp seeds. Take 5-7 pills before meals, washed down with warm rice water.
**Treating Pediatric Malnutrition Disease or Large Abdomen**
Huhuanglian (Picrorhizae Rhizoma) (2 qian, removes fruit accumulation), Awei (Styrax Resina) (1.5 liang, removes meat accumulation), Shenqu (2 qian, removes food accumulation), Huanglian (2 qian, removes heat accumulation). Shexiang (Musk) (4 grains, opens orifices).
Grind into powder. Take 12 pills, washed down with Baizhu Tang.
**He Wan (Brown Pill)**
Treats malnutrition edema/swelling.
Luobozi (Brassicae Semens) (1 liang, lightly stir-fried), Chenpi, Qingpi (Green Tangerine Peel), Binglang, Wulingzhi (Trogopterori Faeces), Pengzhu (Curcumae Rhizoma) (roasted), Hei Qianniu (Black Pharbitidis Semen) (clean powder, half raw half fried), Chi Fuling (Red Poria) (0.5 liang each). Muxiang (2.5 qian).
Grind into powder. Form pills with flour paste the size of mung beans. Take 15 pills, washed down with Perilla leaf water or plain hot water.
**Wu Gan Bao Tong Wan (Five Malnourishments Protect Child Pill)**
Treats five types of malnutrition diseases.
Wubeizi (Galla Chinensis) (raw), Qingdai (Indigo Naturalis), Yeming Sha (Nyctibi Pedem), Kuluan Genpi (Toosendan Cortex), Lvhui, Xiongdan (Ursi Fel) (ground), Huanglian (deprived of fibers), Longdancao (Gentianae Radix) (raw), Ganchan (Dry Bufo Skin) (fried in lard, skin/bone removed), Shexiang (ground), Wuyi (Terminaliae Emblicae Fructus) (kernel), Chantui (Cicadae Periostracum) (cleaned) (Equal parts).
Grind into powder. Form pills with millet paste the size of hemp seeds. One-year-old child takes 20 pills with rice water, 2-3 doses.
In pediatrics, names such as Dingxi, Bulu, and Wugu exist. Their symptoms include large abdomen, small neck, yellow thinness; these are all alternative names for malnutrition distension. Mild cases present as one, severe cases as another. Now, separate sections are established after Malnutrition.
**Yang Shi Taqi San (Collapse Qi Powder)**
Treats pediatric abdominal distension, wheezing, body swelling, and facial edema.
Chenmi (Aged Rice) (1 he, stir-fried yellow), Qingpi (Remove albedo, stir-fry with 21 Badou grains until yellow, remove Badou), Gancao (Roasted) (0.5 liang each). Hei Qianniu (2.5 qian, half raw half fried). Roudoukou (two, roasted fragrant).
Grind into powder. Take half a qian, mixed with rice water. Add one Binglang.
**Taqi Wan (Collapse Qi Pill)**
Treats pediatric malnutrition-Qi abdominal distension, rapid wheezing, and facial edema.
Dingxiang, HuJiao (Piper Longum) (stir-fried) (5 qian each). Luobozi (Radish Seed) (stir-fried), Bai Qianniu (White Pharbitidis Semen) (7.5 qian each).
Grind into powder. Form pills with flour paste the size of adzuki beans. Three-year-old child takes 30 pills, washed down with rice soup.
**Taqi San (Collapse Qi Powder)**
Treats pediatric abdominal distension with coarse breathing, attacking malnutrition diseases, and facial/ocular edema.
Muxiang (1 qian), Qingpi (0.5 liang). Badou (30 grains, stir-fry together until bean-yellow, remove Badou).
Grind into powder. For three-year-olds, take half a qian, washed down with rice soup before meals, continuous administration yields immediate effect.
**Fenqi Yin (Separate Qi Decoction)**
Treats pediatric swelling with wheezing, shortness of breath, and urgency.
Jiegeng, Chi Fuling, Chenpi, Sangbaipi (Morus Cortex Radicis) (chopped), Dafupi (Arecae Pericarpium), Zhike (Aurantii Fructus Immaturus) (stir-fried), Banxia (Pinelliae Rhizoma) (fermented), Zhen Suzi (Perillae Fructus) (lightly stir-fried), Zisu (Perillae Folium), Gancao (Roasted) (2 qian each). Caoguoren (Tsaoko Cardamomi Semen) (1 qian).
Cut into pieces. Take 1.5 qian per dose, decoct with ginger and jujube.
**Sanleng Jian Wan (Sparganium Decoction Pill)**
Treats infants injuring spleen/stomach with cold/raw, sweet/greasy, toxic/hot foods, causing Spleen-Stomach stagnation, long-term indigestion, leading to warm belly/cold feet, pi-mass alternating cold/heat. Also treats abdominal masses, middle epigastric disharmony, upper diaphragm distension, Qi congestion in heart/abdomen, lack of free flow, causing disease. This medicine is warm and mild; suitable for all accumulations and undigested food.
Jingsanleng (Sparganii Rhizoma) (boiled in chunks), Pengzhu (Curcumae Rhizoma) (processed) (0.5 liang each). Yuanhua (Genkwa Flos) (2.5 qian, soaked in vinegar, stir-fried), Biejia (Testudinis Carapax et Plastrum) (remove skirt, roast scorched with rice vinegar, 0.5 liang), Danshidouchi (Sojae Semen Praeparatum) (2 qian), Badou (21 grains, shelled), Chuang Danggui (Angelicae Sinensis Radix) (0.5 liang), Xingren (Pruni Semen) (remove skin/point, 2.5 qian, stir-fried red).
Boil the first four ingredients in one bowl of rice vinegar until dry, stir-fry again, chop finely, roast into powder. Then add Danggui powder, Xingren, Badou, Danshidouchi, mix evenly. Boil in water with flour paste to form pills the size of hemp seeds. Take 20 pills, washed down with ginger soup, adjust by age.
**Sanleng Wan (Sparganium Pill)**
Treats pediatric stagnation, abdominal/hypochondriac fullness, dry retching, nausea, complete anorexia.
Sanleng (Sparganii Rhizoma) (roasted), Muxiang, Shenqu (stir-fried), Chenpi (scraped), Banxia (prepared with ginger juice) (1 liang each). Dingxiang, Guanzi Gui (Cinnamomi Cortex) (0.5 liang each).
Grind into powder. Form pills with fermented dough paste the size of broomcorn millet. Take 20 pills, washed down with warm ginger soup after milk/food.
**Awei Wan (Styrax Pill)**
Treats pediatric food accumulation, abdomen shaped like a spider, abdominal pain, cloudy white urine.
Awei (Soaked in vinegar overnight, ground to paste), Huanglian (stir-fried), Lianqiao (Forsythiae Fructus) (0.5 liang each). Hua Jian (Flower Alkali) (ground to powder, 3 qian), Shanzha Rou (Crataegi Fructus Flesh) (1 liang), Banxia (Soaked in soap pod water overnight, 1 liang).
Grind into powder. Stir-fry Shenqu, mix with paste to form pills the size of radish seeds. Take 20 pills on empty stomach with rice water. Increase Huhuanglian if fruit intake is high. Increase Shenqu/Shanzha if rice intake is high. Increase Awei if meat intake is high.
**Another Awei Wan**
Awei (1 liang), Huanglian (Coptidis Rhizoma) (wine-boiled, 6 liang).
Grind into powder. Soak Awei in vinegar overnight, grind to paste. Form pills with steamed bread dough soaked in water. If Yuan Qi is insufficient, add Renshen.
**Xiao Awei Wan (Small Styrax Pill)**
Shanzha Rou (3 liang), Shi Jian (Stone Alkali) (3 qian), Banxia (1 liang).
Grind into powder. Soak 0.5 liang Awei in vinegar, form pills with paste, wash down with plain hot water.
**Zhenzhu Tianma Wan (Pearl Gastrodia Pill)**
Treats acute convulsive wind; use according to severity, aiming for unobstruction. This formula is also excellent for diaochang (twisted intestine), suodu (locked belly), cuokou (mouth drawing). Pills the size of hemp seeds. Newborn patients: 3 pills on day 3, 5 pills on day 5, 7 pills on day 7. Add Qingdai to name Qingdai Wan.
Tian Nan Xing (Arisaematis Rhizoma) (processed), Tianma (Gastrodiae Rhizoma), Baifuzi (Typhonii Rhizoma) (processed) (2.5 qian each). Nifen (Calomel), Bashuang (Croton Oil) (one character/wedge), Wuyi (stir-fried), Quanxie (Scorpio), Huashi (Talcum) (1.5 qian each).
Grind into powder. Boil fine flour paste to form pills the size of hemp seeds. Take 5 pills for one year old, 10 for two years old, adjust by age. Wash down with mint soup and tea infusion.
**Dajulian Wan (Large Zanthoxyli-Coptis Pill)**
Treats pediatric overeating, chest/diaphragm distension, lack of upper/lower Qi flow, depression/confusion, low mood, severe wheezing, indigestion, thirst/restlessness, inability to sit/lie comfortably, limb fatigue, abdominal/hypochondriac pain.
Pengzhu, Jingsanleng (Sparganii Rhizoma) (2.5 qian each, vinegar-boiled). Ganjiang (Roasted), Qingpi, Chenpi (scraped), Muxiang, Dingxiang (3 qian each). Badou (21 grains, remove membrane/core, express oil), Lv Xiao Zhuyu (Green Small Zanthoxyli Fructus) (2 qian).
Grind into powder. Form pills with vinegar paste the size of hemp seeds. Take 7-10 pills, more for older children, washed down with ginger-jujube soup.
**Xia Chong Wan (Expel Worm Pill)**
Treats roundworm malnutrition and various worms.
Kuluan Genpi (Toosendan Cortex) (wine-soaked, dried), Lü Se Guan Zhong (Cyatheae Rhizoma), Muxiang, Taoren (Persicae Semen) (soaked, skinned, dried), Wuyi (dried), Jixin Binglang (Arecae Semen) (1 qian each). Helie (Chrysanthemi Indici Flos) (stir-fried), Qingfen (Calomel) (0.5 qian each). Gan Xia Ma (Bufo) (roasted scorched, 3 qian). Shijunzi (Quisqualis Fructus) (50 count, roasted, flesh used).
Grind into powder. Form pills with sifted flour paste the size of hemp seeds. Take 20 pills with clear meat juice in the morning. Add Danggui and Chuanlian (Coptidis Rhizoma) (2.5 qian each) to treat spinal malnutrition and malnutrition consumption.
**Yuxian Dan (Immortal Meeting Pill)**
Treats various worms, removes various accumulations.
Qianniu (Pharbitidis Semen) (3 jin), Dafuzi (Arecae Pericarpium) (2 jin), Xi Hui (Tin Ash) (roasted dry, powdered), Dahuang (Rhei Radix et Rhizoma) (4 liang), Leiwan (Polyporii Umbilici) (4 liang), Qingmuxiang (Pseudostellariae Radix), Helie, Ganqi (Dammar Resina) (2 liang each). Zhaojiao (Gleditsiae Sinensis Spina) (4 strips).
Decoct the last three ingredients in water. Use millet to cook porridge. First add Qianniu powder, second Dafu powder, third Tin Ash, fourth Dahuang, fifth Leiwan, sixth Qingmuxiang. Mix and form pills the size of tung tree seeds. Take 5-7-9 pills, washed down with ginger soup and cooked water. This medicine specifically treats men and women with accumulated worms, Qi masses, five labors, seven injuries, red/white dysentery, hematochezia, yellow skin edema, ten types of Qi disorders, ten types of evil worms. It promotes appetite, removes disease, brightens complexion, does not conflict with other medicines, and can be taken in all seasons. Grind to fine powder, take 3-4 qian, adjust by age. Do not eat dinner when taking; at midnight, wash down with tea infusion. Next morning, check bucket for worm accumulation and grain residue; only then wash face and replenish with warm porridge. Contraindicated in cold damage and pregnancy.
Dongyuan’s treatment of distension does not violate the Upper and Lower Jiao, employing the *Suwen* method of draining interior fullness. For excess, separate Qi and dissipate accumulation. For deficiency, raise Yang and nourish Blood. Practitioners should learn its intent and apply flexibly, far surpassing previous aggressive formulas.
**Zhongman Fenxiao Wan (Middle Fullness Dividing and Eliminating Pill)**
Huanglian, Zhishi (Aurantii Fructus Immaturus), Houpo (5 qian each). Ganjiang, Jianghuang (Curcumae Longae Rhizoma), Zhuling (Polyporus), Sharen, Zexie (Alismatis Rhizoma), Fuling (0.3 liang each). Chenpi, Baizhu (0.1 liang each). Banxia (0.4 liang). Huangqin (Scutellariae Radix) (1.2 liang). Gancao (0.1 liang).
Grind to fine powder. Form pills with steamed bread dough the size of broomcorn millet. Take 30 pills, washed down with warm wine.
**Xiao Pi Wan (Eliminate Mass Pill)**
A rapidly acting purgative agent.
Huanglian (0.5 liang), Zhishi, Huangqin, Gancao, Renshen (3 qian each). Houpo (0.7 liang). Ganjiang (0.4 liang). Juapi (Tangerine Peel) (1 qian). Jianghuang (0.5 liang).