仲阳云∶积痛口中气温，面色黄白，目无精光，或白睛多及多睡、畏食，或大便酸臭者，当磨积而痛自除，宜消积
丸，甚者白饼子下之。后胃气不和，用白术散、小沉香丸、感应丸治之。又有食积肚痛，有热者，芍药甘草汤加干葛。
吐者，加半夏、生姜，或加枳实亦效。
消积丸 见第四十九问下积丸。
白饼子 见第十四问。
钱氏白术散 治泻渴兼吐泻。
人参（二钱半） 白茯苓（半两） 白术（半两） 藿香叶（半两） 木香（二钱） 甘草（一钱） 干葛（半两、
渴者、加一两）
上锉散，水煎，发热甚渴者去木香，肚痛加白芍药。
小沉香丸 和中顺气，嗜食消痰。
砂仁（煨、四钱） 莪术（煨、四钱） 香附（炒、一两） 甘草（炙、一两半） 沉香（六钱） 甘松（三两六
钱） 益智（炒、一两半） 舶上丁香皮（二两四钱）
上为细末，汤浸蒸饼，丸如梧桐子大，每服三十丸或四十丸，食后温生姜汤下，或嚼破更妙。
芍药甘草汤 治伤寒脉浮、自汗出，小便烦数，微恶寒，脚挛急。拘疼，及治肚腹胸胁大痛。
白芍药（炒一两） 甘草（一两）
上锉散，每服三钱，水二盏，煎至八分，不拘时服。又见四十四问。
小儿有积滞，面目黄肿，肚热胀痛，复睡多困，酷啼不食，或大肠闭涩，小便如油，或便利无禁，粪白酸臭，此皆
积滞也。然有乳积、食积，须当明辨之。吐乳、泻乳，其气酸臭，此由啼叫未已，便用乳儿，停滞不化而得之，是为乳
积。肚硬带热，渴泻或呕，此由饮食无度，多餐过饱，饱后即睡得之，是为食积。腹痛啼叫，利如蟹渤，此由触忤其气，
荣卫不和，淹延日久得之，是为气积。合用木香丸主之，槟榔丸亦可用，大小便闭者，神芎丸妙甚，更用推气丸佳，
冷症下积丸，五珍丸亦可用。
木香丸 见第四十六问。
木香槟榔丸 疏导三焦，宽利胸膈，破痰逐饮，通润大肠。
郁李仁（去皮） 皂角（去皮、醋炙） 半夏曲 枳壳（麸炒） 青皮（去瓤） 杏仁（面炒） 木香（不见火）
槟榔（各一钱）
上为细末，别用皂角四两，用浆一碗，搓揉熬膏，更入熟蜜少许，丸如梧桐子大。每服十丸，小儿服可丸如绿豆大，
食后生姜汤化下。
神芎丸 见第二十问。
推气丸 治三焦痞塞，气不升降，胸膈胀满，大便闭涩，小便赤少。
大黄 陈皮 槟榔 枳实（小者、去瓤） 黄芩 黑牵牛（各等分生用）
上为细末，炼蜜丸如绿豆大，临卧温热水下二三十丸，量虚实加减。
槟榔丸 治小儿疳气腹胀，胸膈痞闷，喘急不安。
青皮（去瓤、同巴豆十粒炒、去巴豆） 萝卜子 香附子（炒） 木香（各一两） 黑牵牛（半两、微炒） 槟榔
（原阙分量）
上为末，生姜自然汁煮，面糊丸黍米大，每服十丸，米饮下。
下积丸 治乳食伤积，心腹胀满，气粗壮热，或泻或呕。
丁香（二十粒） 砂仁（二十个） 使君子（五个） 乌梅（三个） 巴豆（不去油、三粒）
上为末，烂饭丸麻子大，每服三丸，陈皮汤下。
五珍丸 治酒食积通用。
青皮 干姜（烧、存性） 莪术 五灵脂（各一两） 巴豆肉（去油、一钱半）
上为末，粳米饭丸麻子大，每服三五丸，米汤下。
钱乙说：积滞腹痛的孩子口中气息温热，面色黄白，眼神无光彩，或者眼白部分较多且嗜睡、食欲不振，或者大便气味酸臭的，应当使用消导积滞的方法，疼痛自然消除，适宜用消积丸；病情严重的，用白饼子攻下。之后若胃气不和，用白术散、小沉香丸、感应丸来治疗。又有因食积引起的肚痛，有热象的，用芍药甘草汤加干葛。伴有呕吐的，加半夏、生姜，或者加枳实也有效。
消积丸 见第四十九问下积丸。
白饼子 见第十四问。
钱氏白术散 治疗腹泻口渴兼有吐泻。
人参（二钱半） 白茯苓（半两） 白术（半两） 藿香叶（半两） 木香（二钱） 甘草（一钱） 干葛（半两、口渴者加一两）
以上药物切碎成散剂，用水煎煮，发热严重且口渴的去掉木香，肚痛加白芍药。
小沉香丸 调和脾胃顺气，增进食欲消除痰湿。
砂仁（煨制、四钱） 莪术（煨制、四钱） 香附（炒制、一两） 甘草（炙制、一两半） 沉香（六钱） 甘松（三两六钱） 益智仁（炒制、一两半） 舶上丁香皮（二两四钱）
以上药物研为细末，用米汤浸透蒸饼，制成梧桐子大小的丸剂，每次服用三十丸或四十丸，饭后用温生姜汤送服，或者嚼碎后服用更好。
芍药甘草汤 治疗伤寒脉浮、自汗出，小便频数烦闷，轻微恶寒，脚部拘挛急迫。身体拘急疼痛，以及治疗腹部、胸部、胁肋部剧烈疼痛。
白芍药（炒制一两） 甘草（一两）
以上药物切碎成散剂，每次服用三钱，水两盏，煎至八分，不拘时间服用。又见于第四十四问。
小儿有积滞，面目黄肿，肚子发热胀痛，又嗜睡困倦，大声啼哭不进食，或者大肠闭塞不通，小便像油一样浑浊，或者大小便失禁，粪便色白酸臭，这些都是积滞的表现。然而有乳积、食积，必须加以明确辨别。吐奶、拉奶，气味酸臭，这是因为啼哭不止时立即喂奶，乳汁停滞不化而形成的，这叫乳积。肚子硬且带热，口渴腹泻或呕吐，这是因为饮食无节制，多吃过饱，吃饱后立即睡觉而形成的，这叫食积。腹痛啼哭，大便像蟹渤（形容大便性状），这是因为受到惊吓或外邪干扰，营卫不和，拖延日久形成的，这叫气积。合用木香丸主治，槟榔丸也可以使用，大小便闭结的，神芎丸效果很好，再用推气丸更佳，冷症用下积丸，五珍丸也可以使用。
木香丸 见第四十六问。
木香槟榔丸 疏导三焦，宽利胸膈，破除痰饮，通润大肠。
郁李仁（去皮） 皂角（去皮、醋炙） 半夏曲 枳壳（麸炒） 青皮（去瓤） 杏仁（面炒） 木香（不见火） 槟榔（各一钱）
以上药物研为细末，另外取皂角四两，用一碗浆水，搓揉熬成膏状，再加入少许熟蜜，制成梧桐子大小的丸剂。每次服用十丸，小儿服用可做成绿豆大小，饭后用生姜汤化开送服。
神芎丸 见第二十问。
推气丸 治疗三焦痞塞，气机升降失常，胸膈胀满，大便闭涩，小便赤少。
大黄 陈皮 槟榔 枳实（小的、去瓤） 黄芩 黑牵牛（各等分生用）
以上药物研为细末，炼蜜制成绿豆大小的丸剂，临睡前用温热水送服二三十丸，根据虚实情况加减用量。
槟榔丸 治疗小儿疳气腹胀，胸膈痞闷，喘急不安。
青皮（去瓤、同巴豆十粒炒、去巴豆） 萝卜子 香附子（炒） 木香（各一两） 黑牵牛（半两、微炒） 槟榔（原缺分量）
以上药物研为末，用生姜自然汁煮，面粉糊制成黍米大小的丸剂，每次服用十丸，米饮送服。
下积丸 治疗乳食伤积，心腹胀满，气粗身热，或者腹泻或者呕吐。
丁香（二十粒） 砂仁（二十个） 使君子（五个） 乌梅（三个） 巴豆（不去油、三粒）
以上药物研为末，用烂饭制成麻子大小的丸剂，每次服用三丸，陈皮汤送服。
五珍丸 治疗酒食积滞通用。
青皮 干姜（烧、存性） 莪术 五灵脂（各一两） 巴豆肉（去油、一钱半）
以上药物研为末，粳米饭制成麻子大小的丸剂，每次服用三五丸，米汤送服。
Qian Yi stated: In cases of accumulation pain (accumulation and colic), the child's breath is warm, complexion is yellowish-white, eyes lack luster, or there is excessive whiteness in the sclera accompanied by somnolence and anorexia, or stools have a sour odor. One should employ methods to grind down accumulations, after which the pain will naturally subside. Xiaojī Wán (Accumulation-Dissolving Pill) is appropriate; for severe cases, Báibǐng Zǐ (White Cake Pills) can be used to purge. Subsequently, if stomach qi is disharmonious, Báizhú Sǎn (Atractylodes Macrocephala Powder), Xiǎo Chénxiāng Wán (Minor Agarwood Pill), or Gǎnyìng Wán (Responsive Pill) should be used for treatment. For abdominal pain caused by food accumulation with heat signs, Sháoyào Gāncǎo Tāng (Peony and Licorice Decoction) added with Gāngě (Kudzu Root) is indicated. If vomiting occurs, add Bànxià (Pinellia Rhizome) and Shēngjiāng (Fresh Ginger); adding Zhǐshí (Immature Bitter Orange) is also effective.
Xiaojī Wán (Accumulation-Dissolving Pill): See Question 49, Xiaojī Wán below.
Báibǐng Zǐ (White Cake Pills): See Question 14.
Qián shì Báizhú Sǎn (Qian’s Atractylodes Macrocephala Powder): Treats diarrhea with thirst, combined with vomiting and diarrhea.
Rénshēn (Ginseng Radix et Rhizoma, 2.5 qian), Báifúlíng (Poria, 0.5 liang), Báizhú (Atractylodis Macrocephalae Rhizoma, 0.5 liang), Huòxiāng Yè (Agastache Leaf, 0.5 liang), Mùxiāng (Vladimiria Root, 2 qian), Gāncǎo (Licorice Root, 1 qian), Gāngě (Puerariae Lobatae Radix, 0.5 liang; add 1 liang if thirsty).
Crush into powder, decoct in water. If fever is severe and thirst is intense, remove Mùxiāng. Add Báisháoyào (White Peony Root) for abdominal pain.
Xiǎo Chénxiāng Wán (Minor Agarwood Pill): Harmonizes the middle jiao, regulates qi, promotes appetite, and resolves phlegm.
Shārén (Amomi Fructus, roasted, 4 qian), Ézhú (Curcumae Longae Rhizoma, roasted, 4 qian), Xiāngfù (Cyperi Rhizoma, stir-fried, 1 liang), Gāncǎo (Licorice Root, honey-fried, 1.5 liang), Chénxiāng (Aquilariae Lignum Resinatum, 6 qian), Gānsōng (Nardostachyos Radix et Rhizoma, 3.6 liang), Yìzhì (Alpiniae Oxyphyllae Fructus, stir-fried, 1.5 liang), Bóshàng Dīngxiāng Pí (Caryophylli Flos Pericarpium from overseas, 2.4 liang).
Grind into fine powder. Soak steamed leavened bread in herbal decoction, shape into pills the size of Sophora japonica seeds. Take 30–40 pills per dose, administered with warm ginger decoction after meals, or chewed before swallowing for better effect.
Sháoyào Gāncǎo Tāng (Peony and Licorice Decoction): Treats Taiyang disease (Exterior Syndrome of the Bladder Channel) with floating pulse, spontaneous sweating, frequent and uncomfortable urination, slight aversion to cold, and spasmodic cramping of the legs. It also treats general stiffness and pain, as well as severe pain in the abdomen, chest, and hypochondrium.
Báisháoyào (White Peony Root, stir-fried, 1 liang), Gāncǎo (Licorice Root, 1 liang).
Crush into powder. Take 3 qian per dose with two cups of water, decoct until reduced to 80%, take at any time. Also seen in Question 44.
Children with accumulation stagnation present with yellowish and swollen face and eyes, hot and distended painful abdomen, excessive sleepiness, loud crying without eating, constipation, oily turbid urine, or incontinence with white sour-smelling feces. These are all manifestations of accumulation stagnation. However, one must clearly distinguish between milk accumulation and food accumulation. Vomiting milk or passing undigested milk with a sour odor results from feeding immediately while the infant is still crying, causing milk to stagnate and fail to transform; this is called milk accumulation. A hard, hot abdomen with thirst, diarrhea, or vomiting results from overeating or eating too much and sleeping immediately after fullness; this is called food accumulation. Abdominal pain with crying and stools resembling crab excrement results from emotional disturbance or external pathogens leading to disharmony of Ying and Wei (Nutritive and Defensive Qi) over a prolonged period; this is called qi accumulation. Mùxiāng Wán (Aucklandia Pill) is the primary prescription; Bīngláng Wán (Areca Seed Pill) may also be used. For constipation of both large and small bowels, Shénxiōng Wán (Divine Ligusticum Pill) is excellent, followed by Tuīqì Wán (Qi-Pushing Pill). For cold patterns, Xiàjī Wán (Accumulation-Expelling Pill) or Wǔzhēn Wán (Five Treasures Pill) may be used.
Mùxiāng Wán (Aucklandia Pill): See Question 46.
Mùxiāng Bīngláng Wán (Aucklandia and Areca Seed Pill): Unblocks the Sanjiao (Triple Burner), relieves chest and diaphragm oppression, breaks down phlegm and drives out fluid retention, and moistens the large intestine.
Yùlǐrén (Prunus Liitana Seed, peeled), Zàojiǎo (Gleditsiae Sinensis Fructus, peeled and vinegar-fried), Bànxià Qū (Pinellia Fermented Paste), Zhǐqiào (Aurantii Fructus Immaturus, bran-fried), Qīngpí (Citri Reticulatae Pericarpium Viride, pith removed), Xìngrén (Armeniacae Semen Amarum, flour-roasted), Mùxiāng (Vladimiria Root, not exposed to direct fire), Bīngláng (Arecae Semen, each 1 qian).
Grind into fine powder. Separately, take 4 liang of Zàojiǎo (Gleditsiae Sinensis Fructus), rub with one bowl of grain wash, and boil into a paste. Add a little cooked honey, shape into pills the size of Sophora japonica seeds. Take 10 pills per dose; for children, make them the size of mung beans. Dissolve in ginger decoction after meals.
Shénxiōng Wán (Divine Ligusticum Pill): See Question 20.
Tuīqì Wán (Qi-Pushing Pill): Treats obstruction of the Sanjiao (Triple Burner), failure of qi ascending and descending, chest and diaphragm fullness, constipation, and scanty dark urine.
Dàhuáng (Rhei Radix et Rhizoma), Chénpí (Citri Reticulatae Pericarpium), Bīngláng (Arecae Semen), Zhǐshí (Aurantii Fructus Immaturus, small ones, pith removed), Huángqín (Scutellariae Radix), Hēiqiānniú (Pharbitidis Semen, raw, equal parts).
Grind into fine powder, bind with refined honey into pills the size of mung beans. Take 20–30 pills with warm water before bed, adjusting dosage according to deficiency or excess.
Bīngláng Wán (Areca Seed Pill): Treats pediatric gan syndrome (malnutrition) with abdominal distension, chest oppression, panting, and restlessness.
Qīngpí (Citri Reticulatae Pericarpium Viride, pith removed, stir-fried with 10 Bàdòu/Cantharis, then remove Cantharis), Luóbózǐ (Raphani Semen), Xiāngfùzǐ (Cyperi Rhizoma, stir-fried), Mùxiāng (Vladimiria Root, each 1 liang), Hēiqiānniú (Pharbitidis Semen, half liang, lightly stir-fried), Bīngláng (Arecae Semen, original dosage missing).
Grind into powder. Cook with fresh ginger juice and wheat starch paste, shape into pills the size of millet grains. Take 10 pills per dose with rice drink.
Xiàjī Wán (Accumulation-Expelling Pill): Treats injury from milk and food accumulation, epigastric and abdominal fullness, rough breathing and body heat, or diarrhea and vomiting.
Dīngxiāng (Caryophylli Flos, 20 flowers), Shārén (Amomi Fructus, 20 fruits), Shǐjūnzǐ (Quisqualis Indica Fructus, 5 fruits), Wūméi (Mume Fructus, 3 fruits), Bàdòu (Crotonis Fructus, un-oiled, 3 seeds).
Grind into powder, bind with mushy rice into pills the size of sesame seeds. Take 3 pills per dose with Chenpi decoction.
Wǔzhēn Wán (Five Treasures Pill): Generally used for alcohol and food accumulation.
Qīngpí (Citri Reticulatae Pericarpium Viride), Gānjiāng (Zingiberis Rhizoma Recens, burned to retain character), Ézhú (Curcumae Longae Rhizoma), Wǔlíngzhī (Trogopterori Faeces, each 1 liang), Bàdòuròu (Crotonis Fructus flesh, oiled removed, 1.5 qian).
Grind into powder, bind with glutinous rice meal into pills the size of sesame seeds. Take 3–5 pills per dose with rice soup.