小儿因饮食不节，积滞不化所致。故食入即痛，其候喜饮凉水，恶食腹满，吐酸便秘，古法主小承气汤以下
之〔如大黄、枳实（麸炒），浓朴（姜炒），引用生姜〕。
若下后仍痛者，古法主香砂平胃散以消导之〔如苍术、陈皮、浓朴、炙甘草、缩砂、香附（醋炒）、南山楂、
炒神曲、炒麦芽、炒枳壳、炒白芍，引用生姜〕。
〔真按〕小儿因伤食而腹痛，只要消食兼微下之为得。方用川浓朴八分，山楂炭钱半，五谷虫一钱，范志曲一
钱，炒麦芽一钱，广陈皮钱半，炒枳壳一钱，玄明粉一钱，炙甘草五分，引用生姜二薄片。
小儿因中气虚弱，复为风冷所乘，则脾经受寒，故不时腹痛。现证尿白，爪甲白，面多青，喜饮热，或腹满下
痢，古法主理中汤（方见不乳）。若四肢厥冷，则加附子。
〔真按〕小儿因气弱受寒而腹痛，用参尚须斟酌，必先去寒止痛，再为调补气分，尤臻稳妥。方用北干姜一
钱，煨木香八分，广陈皮钱半，炙甘草五分，姜炒浓朴八分，引用生姜一片，俟痛止，再以五味异功散加干姜为
引，调补其脾。
小儿因腹中虫动不安，故作痛。其候面色乍赤、乍青、乍白，其痛时作时止，时吐清水。切不可妄用攻下，
古法主钱氏安虫散〔如炒胡粉、鹤虱、枯白矾、川楝子（去皮核）各二钱五分。共为细末〕。每服一匙，大者五
分，米饮调下，痛时服。痛久不愈者，古法主加减理中汤（方见虫吐）。
〔真按〕小儿因腹中积化为虫，虫动则腹痛，发则肿聚一块。其虫为蛔虫，长至一尺，则贯胃伤心，祸不旋
踵。当虫痛时，但少与花椒汤服之，其虫闻椒则伏，痛亦立止。
若欲除虫，则宜用化虫丸，方用芜荑、雷丸各二钱，槟榔、木香、炒白术、陈皮、神曲各钱半，雄黄三钱，
使君子肉三钱，共为末，水为丸，如绿豆大，以米汤送下。量儿大小强弱与之。
虫已下尽，复用异功散加山药、芡实，以养脾，可免虫类再生之患。
小儿腹痛因饮食不节制，导致食物积滞无法消化所致。因此进食后立即疼痛，其表现为喜欢饮用凉水，厌恶进食且腹部胀满，呕吐酸水，大便秘结，古法主张用小承气汤来通下攻积（方中包含大黄、麸炒枳实、姜炒浓朴，煎服时加入生姜作为药引）。
如果经过泻下治疗后疼痛仍未缓解，古法主张用香砂平胃散来消除积滞并引导排出（方中包含苍术、陈皮、浓朴、炙甘草、缩砂仁、醋炒香附、南山楂、炒神曲、炒麦芽、炒枳壳、炒白芍，煎服时加入生姜作为药引）。
〔陈守真按语〕小儿因伤食引起腹痛，治疗关键在于消食导滞兼以轻微通便，这样最为得当。处方使用川浓朴八分，山楂炭一钱半，五谷虫一钱，范志曲一钱，炒麦芽一钱，广陈皮一钱半，炒枳壳一钱，玄明粉一钱，炙甘草五分，煎服时加入两片生姜作为药引。
小儿因中气虚弱，又受到风冷邪气侵袭，导致脾经受寒，所以不时出现腹痛。临床表现为小便浑浊发白，指甲苍白，面色多呈青色，喜欢喝热水，或者腹部胀满伴有腹泻痢疾，古法主张用理中汤治疗（该方剂见“不乳”章节）。如果出现四肢厥冷症状，则在方中加入附子。
〔陈守真按语〕小儿因气虚受寒引起腹痛，使用人参尚需斟酌，必须先去寒止痛，然后再调理补气，这样尤为稳妥。处方使用北干姜一钱，煨木香八分，广陈皮一钱半，炙甘草五分，姜炒浓朴八分，煎服时加入一片生姜作为药引，等到疼痛停止后，再用五味异功散加干姜作为药引，来调补脾胃。
小儿因腹中寄生虫蠕动不安，从而引发疼痛。其表现为面色时而发红、时而发青、时而发白，疼痛时作时止，时常呕吐清水。切不可胡乱使用攻下药物，古法主张用钱氏安虫散（方中包含炒胡粉、鹤虱、枯白矾、去皮核的川楝子各二钱五分，共研为细末）。每次服用一匙，年龄较大的儿童服用五分，用米汤调服，在疼痛发作时服用。如果疼痛日久不愈，古法主张用加减理中汤治疗（该方剂见“虫吐”章节）。
〔陈守真按语〕小儿因腹中积滞化为虫，虫体蠕动则引起腹痛，发作时腹部可摸到肿聚的一块。这种虫是蛔虫，长达一尺，若贯穿胃部伤害心脏，灾祸将立刻降临。当虫痛发作时，只需少量给予花椒汤服用，虫子闻到花椒的气味就会伏卧不动，疼痛也会立即停止。
如果想要彻底驱虫，则适宜使用化虫丸，方中包含芜荑、雷丸各二钱，槟榔、木香、炒白术、陈皮、神曲各一钱半，雄黄三钱，使君子肉三钱，共研为粉末，用水泛丸，制成绿豆大小的丸剂，用米汤送服。根据儿童的年龄大小和体质强弱决定剂量。
Abdominal pain in children is caused by irregular diet leading to food accumulation and indigestion. Consequently, pain occurs immediately after eating. The manifestations include a preference for drinking cold water, aversion to food with abdominal distension, vomiting of sour fluid, and constipation. Ancient methods advocate using Xiaochengqi Tang (Minor Order the Qi Decoction) to purge accumulation [ingredients include Rhizoma Rhei Preparata (Dahuang), Fructus Aurantii (Zhishi, stir-fried with bran), Caulis Magnoliae Officinalis (Nanpiao, stir-fried with ginger juice), with Fresh Ginger (Shengjiang) as an adjuvant].
If pain persists after purgation, ancient methods advocate using Xiangsha Pingwei San (Aucklandia and Amomum Powder to Stabilize the Stomach) to resolve stagnation and guide it out [ingredients include Rhizoma Atractylodis Macrocephalae (Cangzhu), Pericarpium Citri Reticulatae (Chenpi), Caulis Magnoliae Officinalis (Nanpiao), Radix Glycyrrhizae Preparata (Zhigancao), Fructus Amomi Rotundus (Suosha), Rhizoma Cyperi Preparata (Xiangfu, stir-fried with vinegar), Crataegi Fructus (Nanshan Zha), Massae Fermentatae Medicinales Stir-fried (Chao Shenqu), Hordei Fructus Germinatus Stir-fried (Chao Maiya), Fructus Aurantii Preparatus (Chao Zhike), Radix Paeoniae Alba Stir-fried (Chao Baishao), with Fresh Ginger (Shengjiang) as an adjuvant].
[Commentary by Chen Shouzhen] For abdominal pain in children due to food injury, the key lies in resolving food stagnation combined with mild purgation. The prescription uses Caulis Magnoliae Officinalis (Chuan Nanpiao) 8 fen, Crataegi Fructus Carbonized (Shanzha Tan) 1.5 qian, Larva Chironomidae (Wuguchong) 1 qian, Massae Fermentatae Medicinales (Fanzhi Qu) 1 qian, Hordei Fructus Germinatus Stir-fried (Chao Maiya) 1 qian, Pericarpium Citri Reticulatae (Guang Chenpi) 1.5 qian, Fructus Aurantii Preparatus (Chao Zhike) 1 qian, Natrii Sulfas Exsiccatus (Xuanmingfen) 1 qian, Radix Glycyrrhizae Preparata (Zhigancao) 5 fen, with two thin slices of Fresh Ginger (Shengjiang) as an adjuvant.
Children with deficient middle qi, when invaded by wind-cold, suffer from cold in the Spleen meridian, resulting in intermittent abdominal pain. Clinical signs include cloudy white urine, pale fingernails, a bluish complexion, a preference for hot drinks, or abdominal distension with dysentery. Ancient methods advocate using Lizhong Tang (Regulate the Middle Decoction) [see "Refusal to Nurse" chapter]. If there is coldness in the four limbs, add Radix Aconiti Lateralis Preparata (Fuzi).
[Commentary by Chen Shouzhen] For abdominal pain in children due to qi deficiency and cold invasion, the use of Radix Ginseng (Renshen) requires careful consideration. One must first dispel cold and stop pain, then regulate and tonify qi, which is more prudent. The prescription uses Dried Ginger (Beiganjiang) 1 qian, Rhizoma Aucklandiae Calcined (Weimuxiang) 8 fen, Pericarpium Citri Reticulatae (Guang Chenpi) 1.5 qian, Radix Glycyrrhizae Preparata (Zhigancao) 5 fen, Caulis Magnoliae Officinalis Stir-fried with Ginger (Jiangchao Nanpiao) 8 fen, with one slice of Fresh Ginger (Shengjiang) as an adjuvant. Once the pain subsides, use Weiyi Yigong San (Five-Ingredient Decoction for Extraordinary Efficacy) with Dried Ginger (Ganjiang) as an adjuvant to tonify the Spleen.
Abdominal pain in children is caused by restless movement of intestinal parasites. Manifestations include a complexion that alternates between red, blue, and white; pain that comes and goes intermittently; and frequent vomiting of clear fluid. Aggressive purgatives must never be used recklessly. Ancient methods advocate using Qianshi Anchong San (Dr. Qian's Parasite-Calming Powder) [ingredients include Calx Ostreae Stir-fried (Chao Hufen), Herba Pedicularis (Heshi), Alum Calcined (Ku Baifan), Fructus Toosendan Prepared (Chuannianzi, peel and seed removed) each 2.5 qian. Grind into fine powder]. Take one spoonful per dose (0.5 qian for older children), mixed with rice water, taken during pain episodes. For chronic pain, ancient methods advocate using Jiajian Lizhong Tang (Modified Regulate the Middle Decoction) [see "Parasitic Vomiting" chapter].
[Commentary by Chen Shouzhen] Abdominal stagnation in children can transform into parasites; their movement causes abdominal pain, presenting as a palpable mass during attacks. These are Ascarids (Huichong), which can grow up to one chi long. If they penetrate the stomach and damage the Heart, disaster will follow swiftly. During acute parasitic pain, administer a small amount of Sichuan Pepper Soup (Huajiao Tang); the parasites will subside upon smelling the pepper, and pain will cease immediately.
To eliminate parasites, Huachong Wan (Parasite-Dissolving Pill) is suitable. The formula contains Fructus Tsojo (Wuyi), Polyporus Umbellatus (Leiyuan) each 2 qian, Semen Arecae (Binglang), Rhizoma Aucklandiae (Muxiang), Rhizoma Atractylodis Macrocephalae Stir-fried (Chao Baizhu), Pericarpium Citri Reticulatae (Chenpi), Massae Fermentatae Medicinales (Shenqu) each 1.5 qian, Realgar (Xionghuang) 3 qian, Semen Quintinae (Shijunzi Rou) 3 qian. Grind into powder, make pills with water, size of mung beans, and swallow with rice soup. Adjust dosage according to the child's age and strength.
After all parasites have been expelled, resume Yigong San (Extraordinary Efficacy Decoction) added with Rhizoma Dioscoreae (Shanyao) and Semen Euryales (Qianshi) to nourish the Spleen, preventing the recurrence of parasitic infestation.