阳气不营成五硬，仰头取气难摇动，手足强直冷如冰，气壅胸膈牵连痛。小续命汤最为良，乌药顺
气散极应，若遇肝木乘脾经，加味六君妙无竟。
【注】五硬者，仰头取气，难以动摇，气壅疼痛，连胸膈间，手心、足心冰凉而硬。皆
由阳气不营于四末，最为难治。重者以小续命汤疏其风，轻者以乌药顺气散调其气。若
肝木乘脾，食少气弱者，加味六君子汤治之。内外交治，而证自日瘥矣。
小续命汤
人参 麻黄 川芎 黄芩 芍药 甘草（炙） 防风 官桂（去皮） 附子（泡去皮脐） 杏仁（炒
去皮尖） 汉防己
引用姜、枣，水煎服。
【方歌】小续命汤治五硬，人参麻黄川芎共，黄芩芍药草防风，官桂附子防己杏。
乌药顺气散
麻黄 白芷 川芎 桔梗 枳壳（炒） 僵蚕（炒） 乌药 炮姜 甘草（生） 橘红
引用葱白，水煎服。
【方歌】乌药顺气五硬轻，麻黄白芷合川芎，桔梗枳壳僵蚕炒，乌药炮姜草橘红。
加味六君子汤
人参 白术 炮姜 陈皮 半夏（制） 茯苓 炙甘草 肉桂 升麻（蜜炙） 柴胡（醋炒）
【方歌】加味六君虚五硬，人参白术共炮姜，陈半茯苓炙甘草，升麻柴胡肉桂良。
小儿禀来气血虚，筋骨软弱步难移，牙齿不生发疏薄，身坐不稳语言迟。加味地黄为主治，补中
益气继相医，邪乘心气菖蒲好，血虚发迟苣胜宜。
【注】小儿五迟之证，多因父母气血虚弱，先天有亏，致儿生下筋骨软弱，行步艰难，齿
不速长，坐不能稳，要皆肾气不足之故。先用加味地黄丸滋养其血，再以补中益气汤调
养其气。又足少阴为肾之经，其华在发，若少阴之血气不足，即不能上荣于发，苣胜丹
主之。又有惊邪乘入心气，至四五岁尚不能言者，菖蒲丸主之。
加味六味地黄丸
熟地黄（一两） 山萸肉（一两） 怀山药（炒） 茯苓（各八钱） 泽泻 牡丹皮（各五
钱） 鹿茸（炙三钱） 五加皮（五钱） 麝香
共为细末，炼蜜丸如梧桐子大，大儿每服二钱，小儿一钱五分，盐汤送下。
补中益气汤（方见飧泻）
菖蒲丸
人参 石菖蒲 麦门冬（去心） 远志（去心） 川芎 当归（酒洗） 乳香 朱砂（水飞，各一钱）
共为细末，炼白蜜为丸，如黍米大，食远用米汤送下。
苣胜丹
当归 生地黄（洗焙） 白芍药（炒，各一两） 苣胜子（碾，二两） 胡粉（碾，三钱）
同研匀，炼蜜为丸，如黍米大，每服十粒，煎黑豆汤下。
阳气不能温煦四肢，导致五硬证，表现为头向后仰以助呼吸，身体难以转动，手足僵硬冰冷如冰，气机壅滞于胸膈并引发牵连性疼痛。小续命汤疗效最佳，乌药顺气散效果极佳；若遇到肝木乘克脾经的情况，使用加味六君子汤妙不可言。
【注】所谓五硬，是指头向后仰以助呼吸，身体难以转动，气机壅滞疼痛，牵连至胸膈部位，手心、足心冰凉且坚硬。这都是由于阳气不能温养四肢末端所致，属于最难治疗的病症。重症用小续命汤疏散风邪，轻症用乌药顺气散调理气机。若是肝木乘克脾土，出现食欲减退、气虚体弱的情况，用加味六君子汤治疗。内外同治，病症自然日渐痊愈。
小续命汤
人参 麻黄 川芎 黄芩 芍药 甘草（炙） 防风 官桂（去皮） 附子（泡去皮脐） 杏仁（炒去皮尖） 汉防己
引用生姜、大枣，水煎服。
【方歌】小续命汤治五硬，人参麻黄川芎共，黄芩芍药草防风，官桂附子防己杏。
乌药顺气散
麻黄 白芷 川芎 桔梗 枳壳（炒） 僵蚕（炒） 乌药 炮姜 甘草（生） 橘红
引用葱白，水煎服。
【方歌】乌药顺气五硬轻，麻黄白芷合川芎，桔梗枳壳僵蚕炒，乌药炮姜草橘红。
加味六君子汤
人参 白术 炮姜 陈皮 半夏（制） 茯苓 炙甘草 肉桂 升麻（蜜炙） 柴胡（醋炒）
【方歌】加味六君虚五硬，人参白术共炮姜，陈半茯苓炙甘草，升麻柴胡肉桂良。
小儿先天禀赋气血虚弱，筋骨软弱，行走困难，牙齿不生，头发稀疏单薄，身体坐不稳，语言发育迟缓。治疗以加味地黄丸为主，继以补中益气汤辅助治疗；若邪气乘袭心气，石菖蒲为好药；血虚导致的发迟，苣胜丹适宜。
【注】小儿五迟的证候，多因父母气血虚弱，先天不足，导致婴儿出生后筋骨软弱，行走艰难，牙齿生长缓慢，坐立不稳，这都是肾气不足的缘故。先用加味六味地黄丸滋养其血，再用补中益气汤调养其气。另外，足少阴肾经，其荣华表现在头发上，如果少阴经的血气不足，就不能上荣于头发，用苣胜丹主治。又有惊邪侵入心气，导致四五岁还不能说话的情况，用菖蒲丸主治。
加味六味地黄丸
熟地黄（一两） 山萸肉（一两） 怀山药（炒） 茯苓（各八钱） 泽泻 牡丹皮（各五钱） 鹿茸（炙三钱） 五加皮（五钱） 麝香
共研为细末，炼蜜制成梧桐子大小的丸剂，大儿童每次服用二钱，小儿童一钱五分，盐汤送下。
补中益气汤（方见飧泄篇）
菖蒲丸
人参 石菖蒲 麦门冬（去心） 远志（去心） 川芎 当归（酒洗） 乳香 朱砂（水飞，各一钱）
共研为细末，炼白蜜制成黍米大小的丸剂，饭后用米汤送下。
苣胜丹
当归 生地黄（洗焙） 白芍药（炒，各一两） 苣胜子（碾，二两） 胡粉（碾，三钱）
一同研匀，炼蜜制成黍米大小的丸剂，每次服用十粒，黑豆汤送下。
Yang Qi fails to nourish the extremities, resulting in the syndrome of Five Stiffnesses (Wu Ying), characterized by the head tilting backward to facilitate breathing, difficulty in moving the body, stiffness and coldness of the hands and feet like ice, and qi stagnation in the chest and diaphragm causing radiating pain. Xiao Xuming Tang (Minor Continuation Life Decoction) is the most effective; Wuyao Shunqi San (Aucklandia Regulating Qi Powder) yields excellent results. If Liver Wood overacts on Spleen Earth, Jiawei Liujunzi Tang (Modified Six Gentlemen Decoction) is extraordinarily beneficial.
[Note] The syndrome of Five Stiffnesses refers to the head tilting backward for breath, inability to move freely, qi stagnation with pain radiating to the chest and diaphragm, and cold, hard palms and soles. This is caused by Yang Qi failing to warm and nourish the four extremities, making it a difficult-to-treat condition. Severe cases are treated with Xiao Xuming Tang to disperse wind; mild cases are treated with Wuyao Shunqi San to regulate qi. In cases where Liver Wood overacts on Spleen Earth, presenting with poor appetite and qi deficiency, Jiawei Liujunzi Tang is used. Treating both internally and externally will lead to gradual recovery.
Xiao Xuming Tang (Minor Continuation Life Decoction)
Ren Shen (Ginseng Radix et Rhizoma), Ma Huang (Ephedrae Herba), Chuan Xiong (Ligustici Chuanxiong Rhizoma), Huang Qin (Scutellariae Radix), Shao Yao (Paeoniae Radix), Gan Cao (Glycyrrhizae Radix et Rhizoma - honey-fried), Fang Feng (Saposhnikoviae Radix), Guan Gui (Cinnamomi Ramulus - bark removed), Fu Zi (Aconiti Lateralis Radix Praeparata - soaked, skin and umbilicus removed), Xing Ren (Armeniacae Semen Amarum - fried, skin and tips removed), Han Fang Ji (Stephaniae Tetrandrae Radix).
Add fresh ginger and jujube, decoct in water and take orally.
[Prescription Verse] Xiao Xuming Tang treats Five Stiffnesses, Ginseng, Ephedra, and Ligusticum together, Scutellaria, Paeonia, Licorice, and Saposhnikovia, Cinnamon Twig, Aconite, Stephania, and Apricot Seed.
Wuyao Shunqi San (Aucklandia Regulating Qi Powder)
Ma Huang (Ephedrae Herba), Bai Zhi (Angelicae Dahuricae Radix), Chuan Xiong (Ligustici Chuanxiong Rhizoma), Jie Geng (Platycodonis Radix), Zhi Ke (Aurantii Fructus Immaturus - fried), Jiang Can (Bombyx Batryticatus - fried), Wu Yao (Tsoao Radix), Pao Jiang (Zingiberis Rhizoma Praeparatum), Gan Cao (Glycyrrhizae Radix et Rhizoma - raw), Ju Hong (Citri Reticulatae Pericarpium).
Add scallion white, decoct in water and take orally.
[Prescription Verse] Wuyao Shunqi San for mild Five Stiffnesses, Ephedra, Angelica, and Ligusticum combine, Platycodon, Aurantium, fried Bombyx, Aucklandia, prepared Ginger, Licorice, and Citrus peel.
Jiawei Liujunzi Tang (Modified Six Gentlemen Decoction)
Ren Shen (Ginseng Radix et Rhizoma), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Pao Jiang (Zingiberis Rhizoma Praeparatum), Chen Pi (Citri Reticulatae Pericarpium), Ban Xia (Pinelliae Rhizoma Praeparatum), Fu Ling (Poria), Zhi Gan Cao (Glycyrrhizae Radix et Rhizoma - honey-fried), Rou Gui (Cinnamomi Cortex), Sheng Ma (Cimicifugae Rhizoma - honey-fried), Chai Hu (Bupleuri Radix - vinegar-fried).
[Prescription Verse] Modified Six Gentlemen for deficient Five Stiffnesses, Ginseng, Atractylodes, and prepared Ginger, Tangerine Peel, Pinellia, Poria, honey-fried Licorice, Cimicifuga, Bupleurum, and Cinnamon Bark are good.
Children born with congenital deficiency of Qi and Blood, weak bones and tendons, difficulty walking, failure of teeth eruption, sparse and thin hair, inability to sit steadily, and delayed speech. Treatment primarily uses Jiawei Dihuang Wan (Modified Rehmannia Pill), followed by Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction). If pathogenic factors invade Heart Qi, Shi Chang Pu (Acori Tatarinowii Rhizoma) is beneficial; for hair delay due to Blood deficiency, Qusheng Dan (Qusheng Pill) is suitable.
[Note] The syndrome of Five Delays in children is mostly due to parents' deficiency of Qi and Blood and congenital insufficiency, leading to weak bones and tendons, difficult walking, slow tooth growth, and unstable sitting after birth. All these stem from insufficient Kidney Qi. First, use Jiawei Liuwei Dihuang Wan (Modified Six-Ingredient Rehmannia Pill) to nourish Blood, then use Buzhong Yiqi Tang to regulate Qi. Furthermore, the Foot-Shaoyin Kidney Meridian manifests in the hair; if the Qi and Blood of Shaoyin are insufficient, they cannot nourish the hair upward, which is treated with Qusheng Dan. Additionally, if fright pathogens invade Heart Qi, causing an inability to speak at age four or five, Changpu Wan (Acorus Pill) is indicated.
Jiawei Liuwei Dihuang Wan (Modified Six-Ingredient Rehmannia Pill)
Shu Di Huang (Rehmanniae Radix Praeparata - 1 liang), Shan Yu Rou (Corni Fructus - 1 liang), Huai Shan Yao (Dioscoreae Hypoglaucae Rhizoma - fried), Fu Ling (Poria - each 8 qian), Ze Xie (Alismatis Rhizoma), Mu Dan Pi (Moutan Cortex - each 5 qian), Lu Rong (Cervi Cornu Degelatinatum - roasted, 3 qian), Wu Jia Pi (Acanthopanacis Cortex, 5 qian), She Xiang (Moschus).
Grind into fine powder, mix with refined honey to form pills the size of paulownia seeds. Older children take 2 qian per dose, younger children 1.5 qian, taken with salt water.
Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) (See section on Unformed Stool)
Changpu Wan (Acorus Pill)
Ren Shen (Ginseng Radix et Rhizoma), Shi Chang Pu (Acori Tatarinowii Rhizoma), Mai Men Dong (Ophiopogonis Radix - heart removed), Yuan Zhi (Polygalae Radix - heart removed), Chuan Xiong (Ligustici Chuanxiong Rhizoma), Dang Gui (Angelicae Sinensis Radix - wine-washed), Ru Xiang (Olibanum), Zhu Sha (Cinnabaris - water-ground, each 1 qian).
Grind into fine powder, mix with refined white honey to form pills the size of millet seeds. Take after meals with rice water.
Qusheng Dan (Qusheng Pill)
Dang Gui (Angelicae Sinensis Radix), Sheng Di Huang (Rehmanniae Radix - washed and dried), Bai Shao Yao (Paeoniae Radix Alba - fried, each 1 liang), Qusheng Zi (unknown seed, ground, 2 liang), Hu Fen (Lead Carbonate, ground, 3 qian).
Grind uniformly, mix with refined honey to form pills the size of millet seeds. Take ten pills per dose, with black bean decoction.