《秘旨》云∶小儿便如米泔，或溺停，少顷变作泔浊者，此脾胃湿热也。若大便泔白色，或
如鱼冻，或带红黄黑者，此湿热积滞也。宜理脾清滞，去湿热，节饮食。若忽然变青，此是
变蒸也，不必用药。若久而不愈，用补脾制肝。若心膈伏热，则成疳矣。大抵多因乳哺失节
，脾气有伤，元气下陷，或乳母饮食七情所致。小便如疳，或大便泔白者，用四味肥儿丸。
积滞黄黑者，用四君子汤加黄连、木香。色青日久不复，或兼泄泻，或腹痛者，用六君子汤
加木香、芍药。若小便小利，大便褐色，发黄脱落，鼻下疮痍，用栀子茯苓汤。乳食少思，
胸腹膨胀，大便频数，用四味肥儿丸。仍审乳母饮食七情主之。
治验
一小儿每食停滞，大便色白而频，先用大安丸、异功散，少加炒黑黄连，一二服后，小水澄
久如泔，发热体倦，用四味肥儿丸而愈。
一小儿患前症，停食发热，先用大安丸而愈。后患腹胀，午时发热，用五味异功散而瘥。
一小儿患前症，兼自痢，用异功散加升麻、柴胡而愈。但日晡微热倦怠，用补中益气汤、四
味肥儿丸而愈。
一小儿患前症，服驱逐之剂，手足并冷，作渴少食，此脾气复伤也，用六君、升麻、柴胡而
泻止；又四味肥儿丸而愈。
四君子汤
六君子汤
加味逍遥散
五味异功散（四方见内钓）
龙胆泻肝汤（方见疝气）
补中益气汤
大安丸（保和丸加白术，二方见虚羸）
四味肥儿丸（方见寒吐）
栀子茯苓汤（即大芜荑汤，方见疳症）
补中益气汤（方剂见“虚羸”章节）
白术散（方剂见“积滞”章节）
《秘旨》记载：小儿大便像米泔水，或者小便静止片刻后变成浑浊的米泔状，这是脾胃湿热所致。如果大便是米泔白色，或者像鱼冻一样，或者带有红、黄、黑色，这是湿热积滞所致。适宜采用健脾理气、清除积滞、去除湿热的方法，并节制饮食。如果突然变为青色，这是“变蒸”现象，不需要用药。如果病情迁延不愈，应采用补脾抑肝的方法。如果心膈有伏热，则会发展成疳症。大体上多因哺乳喂养不当，损伤脾气，导致元气下陷，或者是由于乳母的饮食和七情（喜、怒、忧、思、悲、恐、惊）变化所引起。小便像疳症表现，或者大便呈米泔白色的，使用四味肥儿丸。积滞表现为黄黑色的，使用四君子汤加黄连、木香。颜色青且日久不愈，或者兼有泄泻、腹痛的，使用六君子汤加木香、芍药。如果小便短少不利，大便褐色，身体发黄消瘦脱落，鼻下有疮痍，使用栀子茯苓汤。乳食减少不思饮食，胸腹部膨胀，大便次数频繁，使用四味肥儿丸。仍需审察乳母的饮食和七情因素进行调理。
治疗验案
有一个小孩每次进食都停滞，大便色白且频繁，先用大安丸、异功散，稍加炒黑的黄连，服用一二剂后，小便澄清久置如米泔水，伴有发热、身体疲倦，用四味肥儿丸治愈。
有一个小孩患上述病症，停食发热，先用大安丸治愈。后来出现腹胀，午时发热，用五味异功散痊愈。
有一个小孩患上述病症，兼有自发性痢疾，用异功散加升麻、柴胡治愈。但傍晚时分有轻微发热和倦怠，用补中益气汤、四味肥儿丸治愈。
有一个小孩患上述病症，服用驱逐邪气的药剂后，手足冰冷，口渴少食，这是脾气再次受损，用六君子汤加升麻、柴胡使腹泻停止；再用四味肥儿丸治愈。
四君子汤
六君子汤
加味逍遥散
五味异功散（以上四方见“内钓”章节）
龙胆泻肝汤（方剂见“疝气”章节）
补中益气汤
大安丸（由保和丸加白术组成，以上二方见“虚羸”章节）
四味肥儿丸（方剂见“寒吐”章节）
栀子茯苓汤（即大芜荑汤，方剂见“疳症”章节）
Bu Zhong Yi Qi Tang (Formula see "Xu Lei")
Bai Zhu San (Formula see "Ji Zhi")
The *Mi Zhi* states: If a child's stool resembles rice wash water, or if urine becomes turbid like rice wash water after standing for a short while, this is due to damp-heat in the Spleen and Stomach. If the stool is rice-wash white, or resembles fish jelly, or contains red, yellow, or black colors, this is due to damp-heat and food stagnation. It is appropriate to regulate the Spleen, clear stagnation, remove damp-heat, and control diet. If it suddenly turns green, this is a phenomenon of "Bian Zheng" (physiological growth fever in infants), and no medication is needed. If it persists without healing, tonify the Spleen and subdue the Liver. If there is latent heat in the Heart and Diaphragm, it will develop into Gan Syndrome (Pediatric Malnutrition). Generally, this is mostly caused by irregular breastfeeding or feeding, which injures Spleen Qi, causing Yuan Qi (Original Qi) to sink, or resulting from the mother's diet and emotional fluctuations (Seven Emotions). For cases where urine resembles Gan syndrome manifestations, or stool is rice-wash white, use Si Wei Fei Er Wan. For stagnation presenting as yellow or black, use Si Jun Zi Tang added with Huang Lian and Mu Xiang. For green color persisting for a long time, accompanied by diarrhea or abdominal pain, use Liu Jun Zi Tang added with Mu Xiang and Shao Yao. For cases with scanty and difficult urination, brown stool, yellowish complexion with emaciation, and sores under the nose, use Zhi Zi Fu Ling Tang. For poor appetite, chest and abdominal distension, and frequent stools, use Si Wei Fei Er Wan. One must also examine the nursing mother's diet and emotional state to guide treatment.
Clinical Cases
A child experienced food stagnation after every meal, with white and frequent stools. Initially, Da An Wan and Yi Gong San were used, with a small amount of stir-fried black Huang Lian added. After one or two doses, the urine became clear but turned turbid like rice wash water upon standing, accompanied by fever and fatigue. The condition was cured using Si Wei Fei Er Wan.
A child suffered from the aforementioned symptoms, with food stagnation and fever. Initially, Da An Wan cured the acute phase. Later, abdominal distension and afternoon fever occurred, which were resolved using Wu Wei Yi Gong San.
A child suffered from the aforementioned symptoms, accompanied by spontaneous dysentery. The condition was cured using Yi Gong San added with Sheng Ma and Chai Hu. However, mild fever and fatigue persisted in the late afternoon, which were cured using Bu Zhong Yi Qi Tang and Si Wei Fei Er Wan.
A child suffered from the aforementioned symptoms. After taking purgative agents, the hands and feet became cold, thirst increased, and food intake decreased. This indicated a recurrence of Spleen Qi injury. The diarrhea stopped using Liu Jun Zi Tang added with Sheng Ma and Chai Hu; subsequently, the condition was cured with Si Wei Fei Er Wan.
Si Jun Zi Tang (Four Gentlemen Decoction)
Liu Jun Zi Tang (Six Gentlemen Decoction)
Jia Wei Xiao Yao San (Modified Free and Easy Wanderer Powder)
Wu Wei Yi Gong San (Five-Agent Yi Gong Powder) (See "Nei Diao" for these four formulas)
Long Dan Xie Gan Tang (Gentian Liver-Draining Decoction) (Formula see "Shan Qi")
Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction)
Da An Wan (Great Peace Pill) (Composed of Bao He Wan added with Bai Zhu; see "Xu Lei" for these two formulas)
Si Wei Fei Er Wan (Four-Ingredient Child-Nourishing Pill) (Formula see "Han Tu")
Zhi Zi Fu Ling Tang (Gardenia and Poria Decoction) (Also known as Da Wu Yi Tang; Formula see "Gan Zheng")