面 白色弱，腹痛不思食。当补脾，益黄散主之。若下利者，调中丸主之。
口中气温，面黄白，目无精光，或白睛多，及多睡，畏食，或大便酸臭者。当磨积，
宜消积丸；甚者，当白饼子下之。后和胃。
（虚实腹痛附）
面 白，心腹痛，口中沫及清水出，发痛有时，安虫散主之。小儿本怯者，多此病。
积痛、食痛、虚痛，大同小异。惟虫痛者，当口淡而沫自出，治之随其证。
小儿本怯，故胃虚冷，则虫动而心痛，与痫略相似，但目不斜，手不搐也。安虫散主之
不食，但饮乳是也。当渐用白饼子下之。
小儿病癖，由乳食不消，伏在腹中，乍凉乍热，饮水或喘嗽，与潮热相类，不早治，必
成疳。以其有癖，则令儿不食，致脾胃虚而热发，故引饮水过多，即荡涤肠胃，亡失津液，脾胃
不能传化水谷，其脉沉细，益不食，脾胃虚衰，四肢不举，诸邪遂生，鲜不瘦而成疳矣。余
见疳门。
（肿附）
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。不喘者虚也，不
可下。若误下，则脾气虚，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，即目胞腮肿也。色黄者，属脾也。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，腹胀而不喘，可以散药治之。使上
下分消其气，则愈也。若虚气已出，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，随肺之气上行于四肢，若水状；肾气浸浮于肺，即大
喘也。此当服塌气丸。病愈后面未红者，虚衰未复故也。
治腹胀者，譬如行兵战寇于林。寇未出林，以兵攻之，必可获；寇若出林，不可急攻，
攻必有失，当以意渐收之，即顺也。
治虚腹胀，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。盖脾初虚而后结有积。所治宜先补脾，后下之，下后又补脾，即愈也。补肺
恐生虚喘。
面色苍白且无光泽，口中气息寒冷，不想进食，呕吐清水。应当补益脾脏，以益黄散为主方治疗。
面色白而色泽虚弱，腹痛不想进食。应当补益脾脏，以益黄散为主方治疗。如果伴有腹泻，则以调中丸为主方治疗。
口中气息温热，面色黄白，眼睛缺乏神采，或者眼白部分较多，以及嗜睡，畏惧进食，或者大便气味酸臭的。应当消磨积滞，宜用消积丸；病情严重的，应当用白饼子攻下。之后再调和胃气。
（虚实腹痛附）
面色苍白，心腹部疼痛，口中流出唾液及清水，疼痛发作有定时，以安虫散为主方治疗。小儿原本体质怯弱者，多患此病。积滞痛、食积痛、虚痛，大体相同而细节略有差异。只有虫痛者，表现为口淡且口水自出，治疗需根据具体证候进行。
小儿原本体质怯弱，因此胃气虚冷，导致虫动而引起心痛，与痫证略微相似，但眼睛不斜视，手脚不抽搐。以安虫散为主方治疗。
口唇频繁撮动，应当调理气机，以益黄散为主方治疗。
脾胃寒冷，因此不能消化食物。应当补益脾脏，以益黄散为主方治疗。
小儿患有癖积，是由于乳食不消化，潜伏在腹中，时而发凉时而发热，饮水或出现喘咳，与潮热症状类似，如果不尽早治疗，必定发展为疳证。因为有癖积，导致小儿不肯进食，致使脾胃虚弱而生内热，所以引水过多，进而荡涤肠胃，丧失津液，脾胃不能传输化生水谷，脉象沉细，更加不肯进食，脾胃虚衰，四肢无力抬举，各种邪气随之产生，很少有不消瘦而发展成疳证的。我在疳门章节中有详细论述。
（肿胀附）
腹胀是由脾胃虚弱，气机攻冲所致。实证表现为胸闷烦乱、气喘胀满，可以攻下，使用紫霜丸或白饼子。如果不喘则是虚证，不可以攻下。如果误用攻下法，则脾气更虚，虚气上犯于肺并随肺气运行，肺与脾母子两脏皆虚。肺主眼睑腮部等部位，脾主四肢，母气（脾）极度虚弱，就会导致眼睑和腮部肿胀。面色发黄，属于脾病。治疗时使用塌气丸逐渐消除。未痊愈时逐渐增加丸药数量，不可用丁香、木香、橘皮、豆蔻等大温散药物来治疗。为什么这样呢？脾虚气机未出，腹胀但不喘，可以用散剂治疗。使上下分消其气，即可痊愈。如果虚气已经外出，依附于肺而运行，即脾胃内部虚弱，经常产生虚气，进入四肢面目了。
小儿容易虚实夹杂，脾虚既不耐寒也不耐温，服用寒凉药则生生冷之疾，服用温燥药则生热，应当认清这一点以免误治。胃长期虚热，多生黄疸病，或者引水不止。脾虚不能制约肾，随肺气上行至四肢，像水湿状；肾气浸淫上浮于肺，即大喘。这应当服用塌气丸。病愈后面色未红润的，是因为虚衰尚未恢复的缘故。
治疗腹胀，譬如在林林中行兵作战对付寇贼。寇贼未走出树林，用兵力攻打，必定能抓获；寇贼若已走出树林，不可急于攻打，攻打必有损失，应当凭心意逐渐收服，这就顺理成章了。
治疗虚性腹胀，先服用塌气丸；若未痊愈，腹中有食积结粪，小便黄，时常轻微气喘，脉象沉伏而实，时常饮水，能进食的，可以攻下。这是因为脾初虚而后结聚有积滞。所治宜先补脾，后攻下，攻下后再补脾，即可痊愈。补肺恐怕会产生虚喘。
The complexion is pale and lusterless, the breath from the mouth is cold, there is no desire to eat, and water is vomited. The Spleen should be tonified, with Yihuang San (Benefiting Yellow Powder) as the primary formula.
The complexion is white but weak in luster, accompanied by abdominal pain and loss of appetite. The Spleen should be tonified, with Yihuang San (Benefiting Yellow Powder) as the primary formula. If diarrhea occurs, Tiaozhong Wan (Regulating Middle Pill) should be used as the primary formula.
If the breath from the mouth is warm, the complexion is yellowish-white, the eyes lack luster, or the whites of the eyes are prominent, along with excessive sleepiness, aversion to eating, or sour-smelling stool, stagnation should be dispersed. Xiaojie Wan (Eliminating Stagnation Pill) is appropriate; for severe cases, Baibing Zi (White Cake Pills) should be used to purge. Afterwards, the Stomach Qi should be harmonized.
(Attached: Deficiency-Excess Abdominal Pain)
The complexion is pale, with heart and abdominal pain, saliva and clear fluid flowing from the mouth, and pain occurring at specific times. Anchong San (Calming Parasites Powder) is the primary formula. Children who are naturally timid often suffer from this disease. Pain due to accumulation, food stagnation, and deficiency are largely similar with minor differences. Only parasitic pain presents with a bland taste in the mouth and spontaneous salivation; treatment should follow the specific syndrome.
Children are naturally timid; thus, when Stomach Qi is deficient and cold, parasites move causing heart pain, which is slightly similar to epilepsy, but without deviation of the eyes or twitching of the hands. Anchong San (Calming Parasites Powder) is the primary formula.
Frequent puckering of the lips indicates a need to regulate Qi, with Yihuang San (Benefiting Yellow Powder) as the primary formula.
Coldness in the Spleen and Stomach prevents digestion. The Spleen should be tonified, with Yihuang San (Benefiting Yellow Powder) as the primary formula.
Not eating, but only drinking milk, is the condition described. Baibing Zi (White Cake Pills) should be gradually used to purge.
Pediatric pi accumulation arises from undigested milk and food lying latent in the abdomen, alternating between cold and heat, drinking water, or wheezing and coughing, resembling tidal fever. If not treated early, it will inevitably develop into gan syndrome. Because of the pi accumulation, the child refuses to eat, leading to Spleen and Stomach deficiency and internal heat generation, causing excessive water intake. This purges the intestines and stomach, depleting body fluids. The Spleen and Stomach fail to transport and transform water and grain; the pulse is deep and fine. With further refusal to eat, Spleen and Stomach deficiency worsens, limbs become immobile, various pathogens arise, and few escape becoming emaciated and developing gan syndrome. I have discussed this in the Gan Syndrome section.
(Attached: Swelling)
Abdominal distension is caused by Spleen and Stomach deficiency and attacking Qi. In excess patterns, there is chest oppression, restlessness, wheezing, and fullness, which can be purged using Zishuang Wan (Purple Frost Pill) or Baibing Zi (White Cake Pills). If there is no wheezing, it is a deficiency pattern, and purging is contraindicated. If mistakenly purged, Spleen Qi becomes deficient, and deficient Qi ascends to attach to the Lung and follows its movement. Both Lung and Spleen, being mother and child organs, become deficient. The Lung governs the eyelids and cheeks; the Spleen governs the four limbs. When maternal Qi (Spleen) is extremely deficient, eyelid and cheek swelling occur. A yellow complexion belongs to the Spleen. Treatment uses Taqi Wan (Settling Qi Pill) to gradually resolve it. If not cured, gradually increase the number of pills. Do not treat with strongly warming and dispersing herbs such as Dingxiang (Caryophylli Flos), Muxiang (Aucklandiae Radix), Chuanpiao (Tangerine Peel), and Doukou (Cardamomi Fructus). Why? When Spleen deficiency exists and Qi has not yet escaped, causing abdominal distension without wheezing, powder formulations can be used to disperse Qi. By dispersing Qi from above and below, recovery occurs. If deficient Qi has already escaped and attached to the Lung, internal Spleen and Stomach weakness persists, generating frequent deficient Qi that enters the limbs and face.
Children are prone to deficiency-excess complexities. Spleen deficiency cannot tolerate either cold or warmth; administering cold herbs generates cold conditions, while administering warm herbs generates heat. One must recognize this to avoid error. Long-term Stomach deficiency heat often leads to jaundice or incessant thirst. Spleen deficiency fails to control the Kidney; following Lung Qi, it ascends to the four limbs like water; Kidney Qi infiltrates and floats up to the Lung, causing severe wheezing. This requires Taqi Wan (Settling Qi Pill). If the complexion remains unrosy after cure, it is because deficiency has not yet recovered.
Treating abdominal distension is like waging war against bandits in a forest. If the bandits have not left the forest, attacking them with troops will surely capture them; if they have left the forest, one must not attack hastily, as an attack will result in losses. One should gradually subdue them with strategy, which is favorable.
To treat deficiency-type abdominal distension, first administer Taqi Wan (Settling Qi Pill). If not cured, and there is food accumulation and fecal impaction in the abdomen, yellow urine, occasional mild wheezing, a deep and forceful pulse, frequent thirst, and ability to eat, purging may be used. This is because the Spleen was initially deficient and later developed accumulation. Treatment should first tonify the Spleen, then purge, and then tonify the Spleen again for recovery. Tonifying the Lung may induce deficiency wheezing.