疸有二证 有因天地湿热之气而发之者。有因水谷之湿热而发之者。
小儿之病。多因湿热食积。与大人不同。宜茵陈胃苓丸主之。
胃苓丸（末一两） 茵陈（末五钱） 碾匀。神曲糊丸。灯心煎汤下。
一儿十四岁病疸。面目俱黄。用∶
黄连 黄柏 栀子仁 茵陈 猪苓 泽泻 枳实 浓朴（各二钱） 大黄（一钱） 上为末
。神曲糊丸。陈米汤下。初服二日。吐宿冷黄水二三碗。又二日利三行。五日退。
人以脾胃为本。所当调理。小儿脾常不足。尤不可不调理也。调理之法。不专在医。唯
调乳母。节饮食。慎医药。使脾胃无伤。则根本常固矣。
脾喜温而恶寒。胃喜清而恶热。故用药者。偏寒则伤脾。偏热则伤胃也。制方之法。宜
相济。四气俱备可也。故积温则成热。积凉则成寒。偏热偏寒。食也。食多则饱。饱伤胃。
食少则饥。饥伤脾。故调脾胃。宜节饮食。适寒温也。今之调脾胃者。不知中和之道。偏之
为害。喜补而恶攻。害于攻者大。害于补者岂小小哉。
儿有少食而易饱者。此胃之不受脾之不能消也。宜益胃之阳。养脾之阴。宜钱氏异功散
合小建中汤主之。
人参 白术 茯苓 炙甘草 陈皮 白芍 当归 桂皮（各等分） 木香 砂仁（各减半）
上为末。神曲糊丸。麻子大。米饮下。
儿有多食而易饥者。此脾胃之邪热甚也。宜泻脾胃之火。三黄枳实丸主之。
枳实 白术 黄连 黄芩 大黄（煨各等分） 上共为末。神曲糊丸。麻子大。白汤下。
本县大尹朱云阁公子。常有脾胃病。向是韩医生调治。平时服养脾丸。伤食服保和丸。
日。一旦问余云。闻汝小儿甚精。小官人脾胃久虚。汝可治之。余曰。当攻补兼用。不可偏
补偏攻。韩医云。密斋非所长也。如专补脾胃。则饮食难化。如专消导。则中气易耗。尹不
听曰。汝进一方来。乃进养脾肥儿丸。用∶
人参 白术 甘草 陈皮 枳实 木香 茯苓 砂仁 山药 莲肉 麦芽 神曲 山楂
青
乃相信赐匾。
乳母者。儿之所根据为命者也。如母壮则乳多而子肥。母弱则乳少而子瘠。母安则子安。
母病
食热则乳亦热。母食冷则乳亦冷。故儿伤热乳者则泻黄色。黄芩芍药汤加黄连主之。伤冷乳
则泻青色。理中丸主之。乳多者则绝之。不尔令儿吐乳也。乳少者。宜调其乳母。使乳常足
。不可令儿饥。以他物饲之。为害甚大。调乳母宜加减四物汤。猪蹄汤主之。乳母忌酒面生
冷。次及一切辛热之物。常作猪蹄汤与之甚良。乳母经闭经漏。宜请医治之。恐乳少也。
一小儿食肉早。得脾胃病。或泄痢。腹大而坚。肌肉消瘦。已成疳矣。其母日忧儿病益
深。
半夏曲木香砂仁枳实浓朴神曲麦 面以消积。三棱莪术煨九肋鳖甲醋煮以消癖。黄干蟾烧灰
存性使君子夜明砂以除疳热。共二十三味碾末。粟米糊丸麻子大。每服二十五丸。炒米汤下
。调理而安。
乳食。儿之赖以养命者也。养子歌云。乳多终损胃。食壅即伤脾。甚矣乳食之不可不节
也。
热则伤胃。寒则伤脾。今之养子者。谷肉菜果。顺其自欲。唯恐儿之饥也。儿不知节。必至
饱方足。富贵之儿。脾胃之病。多伤饮食也。贫贱之子无所嗜。而脾胃中和之气不损也。伤
之轻者。损谷自愈。伤之重者。则消导之。宜胃苓保和丸养脾消积丸主之。伤之甚者。则推
去之。审其所伤之物。如伤热食者。宜三化丸三黄枳术丸木香槟榔丸。伤冷物。宜三棱消积
丸丁香脾积丸主之。如脾胃素弱食少。但过食则伤者。补脾进食。肥儿丸要药也。
一富家生子甚弱。结义予为家公。予重其义。朝夕戒其乳母。乳食不可太饱。或煮以烂
粥嚼
。亦无大疾。今气实力壮。饮食多而不伤。寒暑不能侵。南北奔走不为劳。尝语人曰。生我
者父母也。养我者万家公也。
一儿生二月。忽昏睡不乳。予以日计之。非变蒸也。视有二乳母。皆年少气壮者。其乳
必多。更代与之。必伤乳也。戒以今且损之。令饥一日自愈。后宜绝之。只用一乳母可也。次日
果安。父母如其教。亦无伤食之病。
医药者。儿之所以保命者也。无病之时。不可服药。一旦有病。必请专门之良。老诚忠
浓者
之。不可过下亡其阴也。小儿易虚易实。虚则补之。实则泻之。药必对证中病。勿过剂也。
病有可攻者急攻之。不可喜补恶攻。以夭儿命。虽有可攻者。犹不可犯其胃气也。小儿用药
。贵用和平。偏热偏寒之剂。不可多服。如轻粉之去痰。 砂之消积。硫黄之回阳。有毒之
药。皆宜远之。故发散者宜惺惺散。消导者宜保和丸。虚实补泻。按钱氏五脏补泻之方加减
用之。误服热药者。宜大豆卷散主之。误服寒药者。宜益胃散主之。汗下太过者。宜黄 建
中汤主之。
小儿久病。只以补脾胃为主。补其正气。则病自愈。宜养脾丸。加所病之药一二味在内
服之。
或问脾胃补泻之味。予曰。天食人以五气。地食人以五味。五气者。寒热温凉平也。五
味者
以辛补酸泻。气以温补凉泻。心属火。味以咸补苦泻。气以热补寒泻。肺属金。味以酸补辛泻
。气以凉补温泻。肾属水。味以苦补咸泻。气以寒补热泻。是四脏者。各属一季。味则逆之
。气则从之。以补以泻也。至于脾胃属土。寄于四季。无定位。无从逆也。故于五味相济。
四季均平。以中和为主。补泻亦无偏胜也。况脾喜温而恶寒。胃喜清而恶热。偏寒偏热之气
。固不可以专用。而积温成热。积凉成寒。虽温平凉平之药。亦不可以群聚久服也。经云。
治热以寒。温而行之。治寒以热。凉而行之。斯为善矣。
一人自知医。生一男。谓小儿脾不足。作补丸服之。至于有疾。不肯请医。亦自治之。
予曰
害。病必请医。如耕当问农。织当问女之意也。医不三世。不服其药。自非专门之术。而病
之虚实。药之良毒。吾恐必误也。
一儿八岁。形气甚弱。其父责令读书。予见之。谓其父曰。令郎形气弱当怀保之。不可
一于
。用一粒金丹服之。病乃剧。请予。予曰。前与养脾丸肥儿丸服尽乎。曰。未服也。又问曰
。今服者何方也。曰一粒金丹。予辞曰。不可治矣。一粒金丹内有草乌巴豆大毒之药。岂可
常服者乎。此儿脾胃素弱怯。食少而瘦。故以肥儿丸调理。应服而不服。一粒金丹大伤犯胃
气。此不应服而服。伤之重伤。谓之虚。死在旦夕。后果死。
一庸医狂悖。借父祖专门之名。自称得异人之传。妄立方法。变乱绳墨。尝语人曰。吾
人之脏腑。有病而去之。知其所伤之物。而取下之。知其疾之顺逆而预解之。言大而诞。人
皆信之。时有富家杨姓者。生二子。闻其名而交结之。礼意恳至。盖为其子之未出痘也。后
一子出痘。因热以汤蒸汗而死。小子因服附子毒发痈。亦死于医之手。惜哉。
监生胡笃庵咳久不止。汗之不可。下之不可。因于表里之邪俱甚也。自制一方。用苏叶
叶桑白皮末杏霜栝蒌霜桔梗末甘草末各等分。虚者加阿胶。蜜丸。白汤下。或口中噙。五日
而安。后以此方治人屡效。
黄芩芍药汤 治伤热乳而泻黄。
条芩 白芍药（各等分） 甘草（减半） 加黄连（等分） 上水煎服。
加减四物汤 治妇人乳少。
当归身 川芎 生地 麦门冬 桔梗 人参 生甘草（各等分） 上锉水煎服。更用 猪
蹄新汲水煮烂。和汁食之。
三化丸 去胸中宿食菀 之热。
枳实（麸炒） 浓朴（姜汁炒） 大黄（各等分） 上为末。神曲糊丸。麻子大。每服量大小
虚实。温水下。
家传保和丸 补脾胃。进饮食。治一切食积。
白术 陈皮 半夏曲 白茯苓 神曲（各三钱） 枳实（炒） 浓朴（姜汁炒） 香附子（酒
山楂 麦 曲（各二钱半） 黄连（姜汁炒） 连翘（去子） 莱菔子（各二钱） 上为末。荷叶浸
水煮粳米糊丸。麻子大。姜汤下。
三黄枳术丸 治伤肉食面饼。并辛辣肥浓一切热物。
黄芩 黄连（酒炒） 大黄（酒煨） 神曲 陈皮 白术（各一两） 枳实（五钱） 上为末。
荷叶浸水煮粳米糊丸。麻子大。白汤下。
三棱消积丸 治伤生冷一切硬物冷积。
三棱（炮） 莪术（炮） 神曲（各一钱） 青皮 陈皮 小茴香 巴豆（和米炒焦黑去米各
五钱） 益智仁 丁香（各三钱） 上醋面糊为丸。麻子大。量人加减。生姜汤下。
益胃散 治误服寒药过多伤其脾胃者。
陈皮 黄 （蜜炙各七钱） 益智仁 白豆蔻 泽泻 干姜（炒） 砂仁 甘草（炙） 藿香
叶浓
大豆黄卷散 治误服热药。此解之。
贯众 板蓝根 甘草 大豆卷（以无根水浸生卷是也日干各等分） 上为细末。每服五分
。井泉水煎饮。
黄疸有两种证型：有因天地间的湿热之气而引发的；有因饮食水谷的湿热而引发的。
小儿的疾病，多因湿热和食积引起，这与成人不同。适宜用茵陈胃苓丸主治。
胃苓丸（研成末一两）、茵陈（研成末五钱），碾匀混合。用神曲糊制作药丸，灯心草煎汤送服。
有一个十四岁的男孩患黄疸病，面目都发黄。使用以下方剂：
黄连、黄柏、栀子仁、茵陈、猪苓、泽泻、枳实、浓朴（各二钱）、大黄（一钱）。以上药材研成末，用神曲糊制丸，陈米汤送服。初服两天，吐出宿存的冷黄水二三碗；又服两天，腹泻三次；五日黄疸消退。
人应以脾胃为本，应当加以调理。小儿脾常不足，尤其不可不调理。调理的方法，不专在于医生，而在于调护乳母，节制饮食，谨慎用药，使脾胃不受损伤，那么根本就能稳固。
脾喜欢温暖而厌恶寒冷，胃喜欢清凉而厌恶燥热。所以用药的人，如果偏于寒凉就会伤脾，偏于温热就会伤胃。制定方剂的原则，应该相互协调，具备四气即可。因此，积聚温性则成热，积聚凉性则成寒。偏热或偏寒的饮食，吃多了会饱，饱食伤胃；吃得少会饥，饥饿伤脾。所以调理脾胃，应当节制饮食，适应寒温变化。现在的调理脾胃者，不懂中和之道，偏颇之害，喜欢补益而厌恶攻伐，危害于攻伐的大，危害于补益的难道小吗？
儿童有少吃就容易饱的，这是胃不能受纳、脾不能运化的表现。适宜益胃之阳，养脾之阴。适宜用钱氏异功散合小建中汤主治。
人参、白术、茯苓、炙甘草、陈皮、白芍、当归、桂皮（各等分）、木香、砂仁（各减半）。以上药材研成末，用神曲糊制丸，如麻子大，米饮送服。
儿童有多吃却容易饿的，这是脾胃邪热很重的表现。适宜泻脾胃之火，用三黄枳实丸主治。
枳实、白术、黄连、黄芩、大黄（煨，各等分）。以上共研成末，用神曲糊制丸，如麻子大，白开水送服。
本县大尹朱云阁的公子，常有脾胃病，以前是韩医生调理治疗。平时服用养脾丸，伤食时服用保和丸。有一天，他问我：“听说你治小儿病很精妙，我家小官人脾胃久虚，你可以治吗？”我说：“应当攻补兼用，不可偏补或偏攻。”韩医生说：“密斋（万全号）不是他的专长。”如果专补脾胃，则饮食难以消化；如果专消导，则中气容易耗损。朱大尹不听我的劝告，说：“你给我开一方来。”于是进献了养脾肥儿丸，用：
人参、白术、甘草、陈皮、枳实、木香、茯苓、砂仁、山药、莲肉、麦芽、神曲、山楂、青皮。
（此处原文似有缺漏，根据上下文推测为配方组成，后文提到“乃相信赐匾”，意指治愈后致谢。）
乳母，是婴儿赖以生存的根本。如果母亲强壮，则乳汁多且孩子肥胖；母亲虚弱，则乳汁少且孩子消瘦。母亲平安，孩子就平安；母亲生病，孩子也受影响。母亲吃热的食物，乳汁也热；母亲吃冷的食物，乳汁也冷。所以孩子伤了热乳，则泻黄色大便，用黄芩芍药汤加黄连主治。伤了冷乳，则泻青色大便，用理中丸主治。乳汁过多的，应断绝部分乳汁，否则会导致孩子吐乳。乳汁少的，应调理乳母，使乳汁充足，不可让孩子饥饿，用其他东西喂养，危害很大。调理乳母宜用加减四物汤、猪蹄汤主治。乳母忌酒、面食、生冷，以及一切辛热之物。常做猪蹄汤给乳母喝很好。乳母出现经闭或经漏，应请医生治疗，恐怕乳汁减少。
有一个小孩因为过早吃肉，得了脾胃病，有时泄痢，腹部大而坚硬，肌肉消瘦，已经形成疳积了。他的母亲每天担忧孩子的病越来越深。（治疗方法：）半夏曲、木香、砂仁、枳实、浓朴、神曲、麦面以消积滞；三棱、莪术（煨）、九肋鳖甲（醋煮）以消痞块；黄干蟾（烧灰存性）、使君子、夜明砂以除疳热。共二十三味，碾成末，粟米糊制丸，如麻子大。每服二十五丸，炒米汤送服。调理后痊愈。
乳食，是孩子赖以维持生命的物质。《养子歌》说：“乳多终损胃，食壅即伤脾。”乳食不可不节制啊。
热食伤胃，寒食伤脾。现在养育孩子的人，谷物、肉类、蔬菜、水果，顺应孩子的欲望，唯恐孩子饥饿。孩子不知道节制，必须吃饱才满足。富贵人家的孩子，脾胃病多因饮食不当所致。贫贱人家的孩子没有特别嗜好，脾胃中和之气不致受损。受伤轻的，减少饮食即可自愈；受伤重的，则需消导。适宜用胃苓保和丸、养脾消积丸主治。受伤严重的，则需推荡去除。审察所伤之物，如伤热食的，适宜用三化丸、三黄枳术丸、木香槟榔丸；伤冷物的，适宜用三棱消积丸、丁香脾积丸主治。如果脾胃素弱、食量小，只是因过食而受伤的，补脾进食，肥儿丸是关键药物。
一个富家生子非常虚弱，结义我为家公。我重视这份情义，早晚告诫其乳母，乳食不可太饱，或者煮烂粥嚼碎喂。也没有大毛病。如今气实力壮，饮食多而不伤，寒暑不能侵袭，南北奔走不为劳累。曾对人说：“生我的是父母，养我的是万家公。”
有一个两个月大的婴儿，忽然昏睡不吃奶。我按天数推算，不是变蒸期。发现有两个乳母，都是年轻气壮的，她们的乳汁一定很多，交替喂养，必然伤乳。告诫他们现在先减少喂养，让孩子饥饿一天即可自愈，以后应断绝其中一个，只用一个乳母即可。第二天果然安好。父母听从教导，也没有伤食的病。
医药，是孩子用来保命的。无病的时候，不可服药。一旦有病，必须请专门的良医，老诚忠厚的人诊治。不可过度泻下亡其阴液。小儿易虚易实，虚则补之，实则泻之。药必须对症中病，不要过量。病有可攻的，急攻之，不可喜欢补益而厌恶攻伐，以致夭折孩子的生命。虽然有可攻的情况，也不可侵犯其胃气。小儿用药，贵在平和，偏热偏寒的药剂，不可多服。如轻粉去痰，硇砂消积，硫黄回阳，有毒的药物，都应远离。所以发散者宜用惺惺散，消导者宜用保和丸，虚实补泻，按照钱乙五脏补泻的方剂加减使用。误服热药的，宜用大豆卷散主治；误服寒药的，宜用益胃散主治；汗下太过者，宜用黄芪建中汤主治。
小儿久病，只以补脾胃为主，补其正气，则病自愈。宜用养脾丸，加入所患病症的一两味药在内服用。
有人问脾胃补泻的味道，我说：天给人五气，地给人五味。五气，是寒热温凉平。五味，酸、苦、甘、辛、咸。肝属木，味以酸补、辛泻；气以温补、凉泻。心属火，味以咸补、苦泻；气以热补、寒泻。肺属金，味以酸补、辛泻；气以凉补、温泻。肾属水，味以苦补、咸泻；气以寒补、热泻。这四脏，各属一季，味则逆之，气则从之，以补以泻。至于脾胃属土，寄于四季，无固定位置，无从逆顺。所以在五味上相济，四季均平，以中和为主，补泻也不偏胜。况且脾喜温而恶寒，胃喜清而恶热，偏寒偏热之气，固然不可以专用，而且积温成热，积凉成寒，即使是温平凉平的药，也不可以群聚久服。经书说：“治热以寒，温而行之；治寒以热，凉而行之。”这才是好的方法。
一个人自己懂医，生了一个男孩，认为小儿脾不足，做成补丸服用。到了有病时，不肯请医生，也自己治疗。我说：“这是有害的。有病必请医生，如同耕田要问农夫，织布要问织女的意思。医不三世，不服其药，如果不是专门的技术，而病的虚实，药的良毒，我恐怕一定会误事。”
有一个八岁的孩子，形体气息很弱。他的父亲责令他读书。我见到他，对他的父亲说：“令郎形气弱，应当呵护，不可一味逼迫。”（父亲不听，强行施治？）用一粒金丹服用，病情加重。请我去诊治。我说：“之前给的养脾丸、肥儿丸吃尽了吗？”回答说：“没吃。”又问：“现在吃的是什么方？”回答说：“一粒金丹。”我推辞说：“不可治了。一粒金丹内有草乌、巴豆等大毒之药，岂可常服？这个孩子脾胃素弱怯，食少而瘦，所以用肥儿丸调理，应服而不服；一粒金丹大伤犯胃气，此不应服而服。伤之重伤，谓之虚，死在旦夕。”后果然死了。
一个庸医狂妄悖理，借父祖专门之名，自称得异人之传，妄立方法，变乱规矩。曾对人說：“吾人的脏腑，有病就去掉它。知道所伤之物，而下取它。知道疾病的顺逆而预先解除它。”言大而诞，人都相信他。当时有个富家杨姓，生了两个儿子，听说他的名声而结交他，礼节恳切，大概是为了他的孩子还没出痘。后来一个儿子出痘，因热用汤蒸汗而死；小儿子因服附子毒发痈，也死于医之手。可惜啊。
监生胡笃庵咳嗽很久不止，发汗不可，泻下不可，因为表里之邪都很重。自制一方，用苏叶、桑白皮末、杏仁霜、栝蒌霜、桔梗末、甘草末，各等分。体虚者加阿胶，蜜丸，白开水送服，或含在口中。五日而安。后来以此方治人多有效。
黄芩芍药汤 治疗伤热乳而泻黄。
条芩、白芍药（各等分）、甘草（减半），加黄连（等分）。以上用水煎服。
加减四物汤 治疗妇人乳汁少。
当归身、川芎、生地、麦门冬、桔梗、人参、生甘草（各等分）。以上锉碎，用水煎服。更用猪蹄新汲水煮烂，和汁食用。
三化丸 去除胸中宿食郁结之热。
枳实（麸炒）、浓朴（姜汁炒）、大黄（各等分）。以上研成末，神曲糊丸，如麻子大。每服根据大小虚实，温水送服。
家传保和丸 补脾胃，进饮食，治一切食积。
白术、陈皮、半夏曲、白茯苓、神曲（各三钱）、枳实（炒）、浓朴（姜汁炒）、香附子（酒浸）、山楂、麦芽曲（各二钱半）、黄连（姜汁炒）、连翘（去子）、莱菔子（各二钱）。以上研成末，荷叶浸水煮粳米糊丸，如麻子大，姜汤送服。
三黄枳术丸 治疗伤肉食面饼，以及辛辣肥浓一切热物。
黄芩、黄连（酒炒）、大黄（酒煨）、神曲、陈皮、白术（各一两）、枳实（五钱）。以上研成末，荷叶浸水煮粳米糊丸，如麻子大，白开水送服。
三棱消积丸 治疗伤生冷一切硬物冷积。
三棱（炮）、莪术（炮）、神曲（各一钱）、青皮、陈皮、小茴香、巴豆（和米炒焦黑去米各五钱）、益智仁、丁香（各三钱）。以上用醋面糊为丸，如麻子大，根据人数加减，生姜汤送服。
益胃散 治疗误服寒药过多伤其脾胃者。
陈皮、黄芪（蜜炙各七钱）、益智仁、白豆蔻、泽泻、干姜（炒）、砂仁、甘草（炙）、藿香叶、浓朴（各等分，原文此处可能有缺漏或排版问题，依常规推断）。
大豆黄卷散 治疗误服热药。以此解之。
贯众、板蓝根、甘草、大豆卷（以无根水浸生卷是也，日干，各等分）。以上为细末。每服五分，井泉水煎饮。
Jaundice presents in two patterns: one is triggered by the damp-heat qi of heaven and earth; the other is triggered by the damp-heat from food and drink.
Children's diseases are mostly caused by damp-heat and food stagnation, which differs from adults. The appropriate treatment is Yinchen Weiling Wan (Cinnamon Twig and Atractylodes Macrocephala Pill).
Yinchen Weiling Wan (powdered, 1 liang), Yinchen (Artemisiae Scopariae Herba, powdered, 5 qian), mixed evenly. Form pills with a paste made from Shenqu (Medicated Leaven), and administer with a decoction of Dengxincao (Junci Medulla).
A fourteen-year-old boy suffered from jaundice, with yellowing of both the face and eyes. Use the following prescription:
Huanglian (Coptidis Rhizoma), Huangbai (Phellodendri Cortex), Zhizi Ren (Gardeniae Fructus), Yinchen (Artemisiae Scopariae Herba), Zhuling (Polyporus), Zexie (Alismatis Rhizoma), Zhishi (Aurantii Fructus Immaturus), Nongpu (Magnoliae Officinalis Cortex) (each 2 qian), Dahuang (Rhei Radix et Rhizoma, 1 qian). Grind all into powder. Form pills with a paste made from Shenqu (Medicated Leaven), and administer with Chenmi Tang (aged rice water). After taking it for two days initially, he vomited two or three bowls of cold, yellow fluid retained in the stomach. After another two days, he had three bowel movements. The jaundice subsided on the fifth day.
The human body regards the Spleen and Stomach as the root, and they should be regulated. Children have a constant insufficiency of the Spleen, so regulation is especially important. The method of regulation does not rely solely on the physician but involves nursing mothers, regulating diet, and being cautious with medications, ensuring the Spleen and Stomach are not injured, thus keeping the foundation solid.
The Spleen prefers warmth and dislikes cold; the Stomach prefers coolness and dislikes heat. Therefore, if medication is biased towards cold, it injures the Spleen; if biased towards heat, it injures the Stomach. The principle of formulating prescriptions should be mutual coordination, possessing all four Qi properties is acceptable. Thus, accumulation of warm nature becomes heat; accumulation of cool nature becomes cold. Biased hot or cold foods: eating too much leads to fullness, which injures the Stomach; eating too little leads to hunger, which injures the Spleen. Therefore, to regulate the Spleen and Stomach, one should regulate diet and adapt to cold and warmth. Current practitioners of Spleen and Stomach regulation do not understand the Way of Harmony (Zhonghe); the harm of bias is that they prefer tonification and dislike purgation. The harm of purgation is great, but is the harm of tonification not also significant?
Some children eat little but become full easily; this indicates the Stomach cannot receive and the Spleen cannot transform. It is appropriate to benefit the Yang of the Stomach and nourish the Yin of the Spleen. Qian Shi Yigong San (Dr. Qian’s Extraordinary Efficacy Powder) combined with Xiao Jianzhong Tang (Minor Construct the Middle Decoction) is indicated.
Renshen (Ginseng Radix), Baizhu (Atractylodis Macrocephalae Rhizoma), Fuling (Poria), Zhi Gancao (Prepared Licorice Root), Chenpi (Citri Reticulatae Pericarpium), Baishao (Paeoniae Radix Alba), Danggui (Angelicae Sinensis Radix), Guipi (Cinnamomi Cortex) (each equal parts), Muxiang (Aucklandiae Radix), Sharen (Amomi Fructus) (each half dose). Grind all into powder. Form pills with a paste made from Shenqu (Medicated Leaven), size of hemp seeds, administer with Mi Yin (rice drink).
Some children eat much but get hungry easily; this indicates severe pathogenic heat in the Spleen and Stomach. It is appropriate to drain the fire of the Spleen and Stomach using Sanhuang Zhishi Wan (Three Yellows and Aurantium Pill).
Zhishi (Aurantii Fructus Immaturus), Baizhu (Atractylodis Macrocephalae Rhizoma), Huanglian (Coptidis Rhizoma), Huangqin (Scutellariae Radix), Dahuang (Rhei Radix et Rhizoma, roasted) (each equal parts). Grind all into powder. Form pills with a paste made from Shenqu (Medicated Leaven), size of hemp seeds, administer with Bai Tang (plain water).
The son of Zhu Yunge, the Prefect of this county, frequently suffered from Spleen and Stomach diseases, previously treated by Dr. Han. He usually took Yangpi Wan (Spleen-Nourishing Pill) and Baohe Wan (Harmonize the Stomach Pill) for food stagnation. One day he asked me, "I hear you are very skilled in treating children. My young master has long-standing Spleen and Stomach deficiency; can you treat him?" I said, "One must use both purgation and tonification, not bias towards either." Dr. Han said, "Mizhai (Wan Quan's pseudonym) is not his forte." If one exclusively tonifies the Spleen and Stomach, digestion will be difficult; if one exclusively promotes digestion, the Middle Qi will easily be depleted. The Prefect did not listen, saying, "Give me a prescription." So I presented Yangpi Fei'er Wan (Spleen-Nourishing Child-Fattening Pill), using:
Renshen (Ginseng Radix), Baizhu (Atractylodis Macrocephalae Rhizoma), Gancao (Licorice Root), Chenpi (Citri Reticulatae Pericarpium), Zhishi (Aurantii Fructus Immaturus), Muxiang (Aucklandiae Radix), Fuling (Poria), Sharen (Amomi Fructus), Shanyao (Dioscoreae Rhizoma), Lianrou (Nelumbinis Semen), Maiya (Hordei Fructus Germinatus), Shenqu (Medicated Leaven), Shanzha (Crataegi Fructus), Qingpi (Citri Reticulatae Pericarpium Viride).
(He subsequently sent a banner expressing gratitude.)
The nursing mother is the life support for the infant. If the mother is strong, milk is abundant and the child is plump; if the mother is weak, milk is scarce and the child is emaciated. If the mother is safe, the child is safe; if the mother is sick, the child is affected. If the mother eats hot food, the milk becomes hot; if she eats cold food, the milk becomes cold. Therefore, if the child is injured by hot milk, he will pass yellow diarrhea, treated with Huangqin Shaoyao Tang (Scutellaria and Peony Decoction) plus Huanglian (Coptidis Rhizoma). If injured by cold milk, he will pass green diarrhea, treated with Lizhong Wan (Regulate the Middle Pill). If there is excessive milk, it should be reduced; otherwise, it causes the child to vomit milk. If there is insufficient milk, the nursing mother should be regulated to ensure sufficient milk; do not let the child go hungry and feed him other substances, as this causes great harm. Regulating the nursing mother uses Jiajian Siwu Tang (Modified Four Substances Decoction) and Zhuti Tang (Pig Trotter Decoction). Nursing mothers should avoid alcohol, wheat products, raw/cold foods, and all pungent-hot substances. Making pig trotter soup for them regularly is beneficial. If a nursing mother experiences amenorrhea or metrorrhagia, consult a doctor, fearing reduced milk production.
A child who ate meat too early developed Spleen and Stomach disease, sometimes with dysentery, a large and hard abdomen, and emaciation, already forming Gan syndrome (infantile malnutrition). His mother worried daily about his worsening condition. (Treatment:) Banxia Qu (Pinelliae Fermentatum), Muxiang (Aucklandiae Radix), Sharen (Amomi Fructus), Zhishi (Aurantii Fructus Immaturus), Nongpu (Magnoliae Officinalis Cortex), Shenqu (Medicated Leaven), Maimian (Wheat Flour) to eliminate stagnation; Sanleng (Sparganii Rhizoma), Ezhu (Curcumae Rhizoma, roasted), Jiu Lei Biejia (Trionycis Carapax, vinegar-boiled) to eliminate masses; Huang Ganchan (Bufo Skin, calcined), Shijunzi (Quisqualis Fructus), Yemingsha (Felis Splendor) to clear Gan heat. Twenty-three ingredients ground into powder, formed into pills with millet paste, size of hemp seeds. Take 25 pills each time, administered with fried rice water. The child recovered after regulation.
Milk and food are what sustain the child's life. The *Yangzi Ge* (Song of Child-Rearing) says: "Too much milk ultimately damages the Stomach; food congestion injures the Spleen." Indeed, milk and food must be regulated.
Hot food injures the Stomach; cold food injures the Spleen. Those raising children today provide grains, meats, vegetables, and fruits according to the child's desires, fearing hunger. Children do not know moderation and only feel satisfied when full. Children of wealthy families often suffer Spleen and Stomach diseases due to dietary indiscretion. Poor children have few cravings, and their Spleen and Stomach Harmonious Qi is not damaged. Mild injury heals by reducing food intake; severe injury requires digestive promotion. Wei Ling Baohe Wan (Stomach Harmonizing Pill) and Yangpi Xiaoji Wan (Spleen-Nourishing Stagnation-Resolving Pill) are indicated. Severe injury requires pushing out the pathogen. Examine the ingested substance: for hot food injury, use Sanhua Wan (Three Transformations Pill), Sanhuang Zhizhu Wan (Three Yellows and Atractylodes Pill), or Muxiang Binglang Wan (Aucklandia and Betel Nut Pill); for cold food injury, use Sanleng Xiaoji Wan (Sparganium Stagnation-Resolving Pill) or Dingxiang Pi Ji Wan (Clove Spleen Stagnation Pill). For those with inherently weak Spleen and Stomach and small appetite who are injured by overeating, tonify the Spleen and promote appetite; Fei'er Wan (Child-Fattening Pill) is the key medicine.
A wealthy family's newborn was very weak; they swore brotherhood with me as his godfather. Valuing this bond, I advised the nursing mother morning and night that milk and food should not be too abundant, or offered well-cooked porridge chewed by her. There were no major illnesses. Now he is strong in Qi and physical power, eats much without injury, resists cold and heat, and travels north and south without fatigue. He once told people, "My parents gave me birth, but my godfather raised me."
A two-month-old infant suddenly fell into deep sleep and refused to nurse. Calculating by days, it was not Bianzheng (physiological growth fever). I observed two nursing mothers, both young and vigorous, whose milk must have been abundant. Alternating between them likely caused milk injury. I warned them to reduce feeding now, letting the child go hungry for one day to heal naturally, and later to stop one mother, using only one. The next day, the child indeed recovered. The parents followed my advice, and there was no food stagnation illness.
Medicine and drugs are how children preserve life. When healthy, do not take medicine. Once ill, seek a specialized, honest, and reliable physician. Do not excessively purge and lose Yin. Children are prone to deficiency and excess; tonify deficiency, purge excess. Medication must match the syndrome and strike the disease accurately; do not overdose. If the disease allows purgation, purge urgently; do not prefer tonification and dislike purgation, causing premature death. Even if purgation is indicated, do not violate Stomach Qi. Pediatric medication values harmony; preparations biased towards hot or cold should not be taken in excess. Drugs like Qingfen (Calomel) to resolve phlegm, Naosha (Nahcolite) to resolve stagnation, and Liuhuang (Sulfur) to restore Yang are toxic and should be avoided. For dispersing, use Xingxing San (Awakening Powder); for digesting, use Baohe Wan (Harmonize the Stomach Pill). For tonifying or purging deficiency/excess, modify according to Qian Yi’s Five Zang Tonification and Purging formulas. If hot medicine is mistakenly taken, use Dadoujuan San (Soybean Sprout Powder); if cold medicine is mistakenly taken, use Yiwei San (Benefit the Stomach Powder); if sweating and purgation are excessive, use Huangqi Jianzhong Tang (Astragalus and Cinnamon Twig to Construct the Middle Decoction).
For chronic pediatric illness, focus primarily on tonifying the Spleen and Stomach; tonifying righteous Qi leads to natural recovery. Use Yangpi Wan (Spleen-Nourishing Pill) with one or two herbs targeting the specific illness.
When asked about flavors for tonifying and purging the Spleen and Stomach, I said: Heaven provides humans with Five Qi, Earth provides Five Flavors. The Five Qi are Cold, Heat, Warmth, Coolness, and Peace. The Five Flavors are Sour, Bitter, Sweet, Pungent, and Salty. The Liver belongs to Wood; flavor: Sour tonifies, Pungent purges; Qi: Warmth tonifies, Coolness purges. The Heart belongs to Fire; flavor: Salty tonifies, Bitter purges; Qi: Heat tonifies, Cold purges. The Lung belongs to Metal; flavor: Sour tonifies, Pungent purges; Qi: Coolness tonifies, Warmth purges. The Kidney belongs to Water; flavor: Bitter tonifies, Salty purges; Qi: Cold tonifies, Heat purges. These four Zang organs each belong to a season; flavors are contrary, Qi follows, for tonification and purgation. As for the Spleen and Stomach belonging to Earth, residing in all four seasons, having no fixed position, there is no contrariety or following. Thus, harmonize the five flavors, balance the four seasons, prioritize Harmony (Zhonghe), and neither tonification nor purgation should be biased. Moreover, the Spleen prefers warmth and dislikes cold; the Stomach prefers coolness and dislikes heat. Biased cold or hot Qi certainly cannot be used exclusively. Accumulation of warmth becomes heat; accumulation of coolness becomes cold. Even warm, peace, or cool medicines should not be clustered and taken for long periods. The Classics state: "Treat heat with cold, administer warmly; treat cold with heat, administer coolly." This is excellent.
A person knowledgeable in medicine had a son, believing the child had Spleen deficiency, and prepared tonifying pills. When illness occurred, he refused to see a doctor and treated himself. I said, "This is harmful. One must see a doctor when ill, just as one asks a farmer about plowing and a woman about weaving. 'If a physician has not practiced for three generations, do not take his medicine.' Without specialized expertise, regarding the deficiency or excess of disease and the efficacy or toxicity of drugs, I fear mistakes will surely occur."
An eight-year-old child was physically and Qi-deficient. His father forced him to study. I saw him and told his father, "Your son is weak in form and Qi; he should be cherished and protected, not pushed relentlessly." (The father ignored this and used) Yili Jin Dan (One Pill Golden Elixir), causing the illness to worsen. I was called. I said, "Did you finish the Yangpi Wan and Fei'er Wan I prescribed?" He replied, "No." I asked, "What are you taking now?" He said, "Yili Jin Dan." I declined to treat, saying, "It is untreatable. Yili Jin Dan contains Caowu (Aconiti Radix Lateralis Preparata) and Badou (Crotonis Fructus), highly toxic drugs, which cannot be taken regularly. This child has inherently weak and timid Spleen and Stomach, eats little, and is thin, so Fei'er Wan was appropriate for regulation. He should have taken it but didn't; Yili Jin Dan severely injures Stomach Qi, which he shouldn't have taken but did. Injury upon injury leads to deficiency. Death is imminent." He indeed died soon after.
A quack doctor, arrogant and rebellious, claimed inheritance from famous ancestors and received secret transmissions from strange beings. He invented methods and confused standards. He told people, "Human viscera, if diseased, remove them. Knowing the injured substance, purge it. Knowing the disease's progression, preemptively resolve it." His words were grand and absurd, yet people believed him. At that time, a wealthy man surnamed Yang had two sons. Hearing his reputation, he befriended him with great courtesy, likely because his sons had not yet had smallpox. Later, one son contracted smallpox and died from heat induced by steam bathing; the younger son developed carbuncles from Fangzi (Aconite) toxicity and also died at the hands of the physician. Tragic.
Hu Du'an, a Jiansheng (government student), suffered from persistent cough. Sweating was ineffective, purgation was ineffective, because pathogenic factors in both exterior and interior were severe. He self-prescribed a formula: Suzye (Perillae Folium), Sangbaipi (Mori Cortex), Xingren Shuang (Apricot Kernel Frost), Gualou Shuang (Trichosanthis Fructus Frost), Jiegeng Mo (Platycodonis Radix Powder), Gancao Mo (Licorice Powder), each equal parts. For deficiency, add Ejiao (Asini Corii Colla). Form pills with honey, administer with plain water, or hold in the mouth. Recovered in five days. He later used this formula successfully on many others.
Huangqin Shaoyao Tang (Scutellaria and Peony Decoction) treats yellow diarrhea from injured hot milk.
Tiao Qin (Scutellariae Radix), Baishao Yao (Paeoniae Radix Alba) (each equal parts), Gancao (Licorice Root, half dose), plus Huanglian (Coptidis Rhizoma, equal parts). Decoct in water and drink.
Jiajian Siwu Tang (Modified Four Substances Decoction) treats scanty milk in women.
Danggui Shen (Angelicae Sinensis Radix), Chuanxiong (Ligustici Chuanxiong Rhizoma), Shengdi (Rehmanniae Radix), Maidong (Ophiopogonis Tuber), Jiegeng (Platycodonis Radix), Renshen (Ginseng Radix), Sheng Gancao (Raw Licorice Root) (each equal parts). Cut and decoct in water. Also boil fresh pig trotters in clean water until soft, mix the juice, and consume.
Sanhua Wan (Three Transformations Pill) removes heat from stagnant food in the chest.
Zhishi (Aurantii Fructus Immaturus, bran-roasted), Nongpu (Magnoliae Officinalis Cortex, ginger-juice stir-fried), Dahuang (Rhei Radix et Rhizoma) (each equal parts). Grind into powder. Form pills with Shenqu paste, size of hemp seeds. Dosage varies by age and deficiency/excess, administer with warm water.
Family-inherited Baohe Wan (Harmonize the Stomach Pill) tonifies Spleen and Stomach, promotes appetite, treats all food stagnation.
Baizhu (Atractylodis Macrocephalae Rhizoma), Chenpi (Citri Reticulatae Pericarpium), Banxia Qu (Pinelliae Fermentatum), Baifuling (Poria), Shenqu (Medicated Leaven) (each 3 qian), Zhishi (Aurantii Fructus Immaturus, roasted), Nongpu (Magnoliae Officinalis Cortex, ginger-juice stir-fried), Xiangfu Zi (Cyperi Rhizoma, wine-soaked), Shanzha (Crataegi Fructus), Maiqu (Barley Medicated Leaven) (each 2.5 qian), Huanglian (Coptidis Rhizoma, ginger-juice stir-fried), Lianqiao (Forsythiae Fructus, seeds removed), Laifuzi (Raphani Semen) (each 2 qian). Grind into powder. Form pills with rice paste soaked in lotus leaves, size of hemp seeds, administer with ginger water.
Sanhuang Zhizhu Wan (Three Yellows and Atractylodes Pill) treats injury from meat, noodles, pancakes, and all spicy, fatty, rich, and hot substances.
Huangqin (Scutellariae Radix), Huanglian (Coptidis Rhizoma, wine-stir-fried), Dahuang (Rhei Radix et Rhizoma, wine-roasted), Shenqu (Medicated Leaven), Chenpi (Citri Reticulatae Pericarpium), Baizhu (Atractylodis Macrocephalae Rhizoma) (each 1 liang), Zhishi (Aurantii Fructus Immaturus, 5 qian). Grind into powder. Form pills with rice paste soaked in lotus leaves, size of hemp seeds, administer with plain water.
Sanleng Xiaoji Wan (Sparganium Stagnation-Resolving Pill) treats injury from raw/cold foods and all hard, cold accumulations.
Sanleng (Sparganii Rhizoma, processed), Ezhu (Curcumae Rhizoma, processed), Shenqu (Medicated Leaven) (each 1 qian), Qingpi (Citri Reticulatae Pericarpium Viride), Chenpi (Citri Reticulatae Pericarpium), Xiaohuixiang (Foeniculi Fructus), Badou (Crotonis Fructus, stir-fried with rice until black, discard rice, each 5 qian), Yizhiren (Alpiniae Oxyphyllae Fructus), Dingxiang (Caryophylli Flos) (each 3 qian). Form pills with vinegar-paste, size of hemp seeds. Dosage varies by patient. Administer with ginger water.
Yiwei San (Benefit the Stomach Powder) treats Spleen and Stomach injury from excessive mistaken consumption of cold medicines.
Chenpi (Citri Reticulatae Pericarpium), Huangqi (Astragali Radix, honey-roasted, each 7 qian), Yizhiren (Alpiniae Oxyphyllae Fructus), Baidoukou (Amomi Fructus Rotundus), Zexie (Alismatis Rhizoma), Ganjiang (Zingiberis Rhizoma, roasted), Sharen (Amomi Fructus), Zhi Gancao (Prepared Licorice Root), Huoxiang (Agastaches Herba), Nongpu (Magnoliae Officinalis Cortex) (quantities implied equal or balanced).
Dadou Huangjuan San (Soybean Yellow Sprout Powder) treats mistaken consumption of hot medicines. Resolves this.
Guanzhong (Cyatheae Spora), Banlangen (Isatidis Radix), Gancao (Licorice Root), Dadou Juan (Sojae Semen Praeparatum, soaked in rainwater until sprouted, dried in sun, each equal parts). Grind into fine powder. Take 5 fen each time, decoct well-water and drink.