辽宁张××幼孙，年四岁，得慢脾风证。
病因 秋初恣食瓜果，久则损伤脾胃，消化力减犹不知戒，中秋节后遂成慢脾风证。
证候 食欲大减，强食少许犹不能消化，医者犹投以消食开瘀之剂，脾胃益弱，浸至吐泻交作，间
发抽掣，始求愚为诊视，周身肌肤灼热，其脉则微细欲无，昏睡露睛，神气虚弱。
诊断 此证因脾胃虚寒，不能熟腐水谷消化饮食，所以作吐泻。且所食之物不能融化精微以生气
血，惟多成寒饮，积于胃中溢于膈上，排挤心肺之阳外出，是以周身灼热而脉转微细，
此里有真寒外作假热也。其昏睡露睛者，因眼胞属脾胃，其
脾胃如此虚寒，眼胞必然紧缩，是以虽睡时而眼犹微睁也。其肢体抽掣者，因气血亏损，不能上达于脑
以濡润斡旋其脑髓神经（《内经》谓上气不足则脑为之不满。盖血随气升，气之上升者少，
血之上升亦少。可知观囟门未合之小儿，患此证者，其囟门必然下陷，此实脑为不满之明证，亦即气血不能上达之明征
也），是以神经失其常司而肢体有时抽掣也。此当投以温暖之剂，健补脾胃以消
其寒饮，诸病当自愈。
处方 赤石脂（一两研细） 生怀山药（六钱） 熟怀地黄（六钱） 焦白术（三钱）
乌附子（二钱） 广肉桂（二钱去粗皮后入） 干姜（钱半） 大云苓片（钱半）
炙甘草（二钱） 高丽参（钱半捣为粗末）
药共十味，将前九味煎汤一大盅，分多次徐徐温服，每次皆送服参末少许。
方解 方中重用赤石脂者，为其在上能镇呕吐，在下能止泄泻
也。人参为末送服者，因以治吐泻丸散优于汤剂，盖因丸散之渣滓能留恋于肠胃也。
效果 将药服完一剂，呕吐已止，泻愈强半，抽掣不复作，灼热亦大轻减，遂将干姜减去，白
术改用四钱，再服一剂，其泻亦止。又即原方将附子减半，再加大甘枸杞五钱，服两剂病遂全愈。
帮助 按此证若呕吐过甚者，当先用《福幼编》逐寒荡惊汤开其寒饮，然后能受他药，而此证
呕吐原不甚剧，是以未用。
辽宁张先生的幼孙，年仅四岁，患上了慢脾风证。
病因：初秋时节恣意食用瓜果，日久损伤了脾胃，消化能力减弱却仍不知节制，中秋节后便形成了慢脾风证。
证候：食欲大幅减退，勉强吃下少量食物也无法消化，医生仍然给予消食化瘀的药物，导致脾胃更加虚弱，逐渐发展到呕吐与腹泻同时发作，偶尔出现肢体抽搐，此时才请求我为其诊治。患者周身肌肤灼热，脉象微细几乎摸不到，昏睡且眼睛半睁（露睛），精神气息虚弱。
诊断：此证因脾胃虚寒，不能将水谷熟腐消化，所以发生呕吐和腹泻。而且所吃的食物不能转化为精微物质以生成气血，反而多形成寒饮，积聚在胃中并溢出到膈肌之上，排挤心肺的阳气向外发散，因此周身感觉灼热而脉象转为微细，这是体内有真寒而体表呈现假热的表现。患者昏睡且眼睛半睁，是因为眼睑属于脾胃管辖，脾胃如此虚寒，眼睑必然紧缩，所以即使在睡眠时眼睛也微微张开。肢体抽搐的原因，是由于气血亏损，不能上达于脑部以濡润和调节脑髓神经（《黄帝内经》说“上气不足则脑为之不满”。大概血液随气上升，气上升的少，血液上升的也少。由此可知观察囟门未闭合的小儿，患此证者，其囟门必然下陷，这确实是脑部不满的明显证据，也是气血不能上达的明确征象），因此神经失去正常功能，导致肢体有时抽搐。此时应当投用温补的药物，健运补益脾胃以消除寒饮，各种病症自然会痊愈。
处方：赤石脂（一两研成细粉）、生怀山药（六钱）、熟怀地黄（六钱）、焦白术（三钱）、乌附子（二钱）、广肉桂（二钱，去掉粗皮后放入）、干姜（一钱半）、大云苓片（一钱半）、炙甘草（二钱）、高丽参（一钱半，捣成粗末）。
共十味药，将前九味煎煮成一盅汤剂，分多次慢慢温服，每次服药时都送服少许人参粉末。
方解：方中重用赤石脂，是因为它在上部能镇止呕吐，在下部能止住泄泻。人参制成粉末送服，是因为治疗吐泻时丸散剂优于汤剂，因为丸散的渣滓能在肠胃中停留更久。
效果：将药服完一剂后，呕吐停止，腹泻减轻大半，抽搐不再发作，发热也大大减轻，于是减去干姜，将白术改为四钱，再服用一剂，腹泻也停止了。随后在原方中将附子减半，再加入大甘枸杞五钱，服用两剂后病完全痊愈。
按语：像这种病症如果呕吐过于严重，应当先用《福幼编》中的逐寒荡惊汤来开通寒饮，然后才能接受其他药物，而此证呕吐原本不剧烈，所以没有使用。
The young grandson of Mr. Zhang from Liaoning, aged four, suffered from Slow Spleen Wind (Man Pi Feng).
Etiology: In early autumn, he indulged in eating melons and fruits. Over time, this damaged the Spleen and Stomach, reducing digestive power, yet he did not cease his habits. After the Mid-Autumn Festival, he developed Slow Spleen Wind.
Symptoms: Appetite decreased significantly; even small amounts of forced food could not be digested. Physicians continued to administer formulas for promoting digestion and resolving blood stasis, further weakening the Spleen and Stomach. Gradually, vomiting and diarrhea occurred simultaneously, with occasional limb convulsions. Only then was I consulted for diagnosis. The patient's skin felt hot to the touch, the pulse was faint and thin, nearly imperceptible, he slept deeply with eyes partially open (exposing the pupils), and his spirit and Qi were weak.
Diagnosis: This condition arises from deficiency-cold of the Spleen and Stomach, which fail to properly cook and digest food and fluids, leading to vomiting and diarrhea. Furthermore, ingested food fails to transform into essence to generate Qi and Blood, instead forming cold fluid retention that accumulates in the Stomach and overflows above the diaphragm. This displaces the Yang Qi of the Heart and Lungs outward, causing the sensation of whole-body heat while the pulse becomes faint and thin. This indicates true cold within and false heat on the exterior. The deep sleep with eyes partially open occurs because the eyelids are governed by the Spleen and Stomach; due to their severe deficiency-cold, the eyelids contract tightly, keeping them slightly open even during sleep. The limb convulsions result from Qi and Blood deficiency, preventing them from ascending to the brain to nourish and regulate the brain marrow and nerves (as stated in the *Nei Jing*: "Insufficiency of upper Qi leads to an empty feeling in the brain." Since blood ascends with Qi, less ascending Qi means less ascending blood. Thus, observing infants with unclosed fontanelles suffering from this condition reveals a sunken fontanelle, clear evidence of brain insufficiency and failure of Qi and Blood to ascend). Consequently, the nerves lose their normal function, causing intermittent limb convulsions. Treatment requires warming agents to strengthen and tonify the Spleen and Stomach, dispelling cold fluid retention, after which all symptoms will resolve spontaneously.
Prescription: Red Halloysite (Chishi Zhi) 1 liang, finely ground; Raw Huai Yam (Sheng Huai Shan Yao) 6 qian; Cooked Huai Rehmannia Root (Shu Huai Di Huang) 6 qian; Charred Atractylodes Macrocephala Rhizome (Jiao Bai Zhu) 3 qian; Prepared Aconite Root (Wu Fu Zi) 2 qian; Guang Cinnamon Bark (Guang Rou Gui) 2 qian, coarse bark removed before adding; Dried Ginger (Gan Jiang) 1.5 qian; Large Poria Cocos Sclerotium slices (Da Yun Ling Pian) 1.5 qian; Honey-fried Licorice Root (Zhi Gan Cao) 2 qian; Korean Ginseng (Gao Li Shen) 1.5 qian, crushed into coarse powder.
Ten ingredients in total. Decoct the first nine ingredients in one large cup of water. Take warm in multiple small doses. Each dose should be accompanied by a small amount of ginseng powder.
Formula Analysis: Heavy use of Chishi Zhi is employed because it settles vomiting when acting superiorly and stops diarrhea when acting inferiorly. Administering Ginseng as a powder facilitates treatment of vomiting and diarrhea, as pill and powder formulations are superior to decoctions for these conditions, since the residue of pills/powders adheres longer to the gastrointestinal tract.
Outcome: After completing one dose, vomiting ceased, diarrhea reduced by more than half, convulsions stopped, and fever significantly subsided. Gan Jiang was removed, and Bai Zhu was increased to 4 qian. After another dose, diarrhea also stopped. Subsequently, using the original formula, the dosage of Fu Zi was halved, and 5 qian of Goji Berry (Gou Qi Zi) was added. After two doses, the illness was completely cured.
Note: If vomiting were excessively severe in such cases, one should first use the Formula for Expelling Cold and Dispelling Shock (Zhu Han Dang Jing Tang) from *Fu You Bian* to open up cold fluid retention, allowing tolerance of other medications. However, since vomiting in this case was not severe, it was not used.