小儿诸疾皆由乳食无度过伤于饱伤以致不能克化留而成积初得之时不问乳积食积气积并以木香
丸消积丸之类其惊积以辰砂膏或青龙丸量轻重而疏导之仍以调气和胃取愈大凡小儿肚腹或热
或胀或硬皆由内实法当疏利下之故东垣云食者有形之物伤之则宜损其谷其次莫若消导丁香栏
饭丸枳术丸之类主之稍重而攻化三棱消积丸木香见 丸之类主之尤重则或吐或下瓜蒂散备急
丸之类主之以平为期盖脾已伤又以药伤使营运之气减削食愈难消故至真要大论云大毒治病十
去其六小毒治病十去其七常毒治病十去其八无毒治病十去其九肉果菜食之物必无使过之伤其
正也凡人以胃气为本惟治病亦然小儿胃气有虚有实虚则呕吐不食之证实则痞满内热之证虚
者益之实者损之欲得其平则可矣胃虚用木香丁皮浓朴肉豆蔻等剂胃实用北桔梗枳壳柴胡大黄
等剂若夫胃中停寒则干姜官桂丁香又不可阙贵在酌量但以小小分剂与之夫是为之平胃心者脾
之母进食不止于和脾盖火能生土当以心药入于脾胃药之中庶几两得古人进食方剂多用益智者
此也
下积丸 治小儿乳食伤积心腹胀满气粗肚热或泻或吐
丁香 缩砂（各十二个） 使君子（五个焙） 乌梅肉（焙） 川巴豆
上为末研细和匀烂饭丸麻子大每三十丸橘皮汤送下
木香丸 治小儿乳积食积气积
木香 蓬术 缩砂仁 青皮（去白） 朱砂（研细） 代赭石（研各二钱） 大丁香（一钱）
川巴豆肉（纸压去油一钱）
上为细末和匀飞白面糊丸麻子大风干每服二三丸乳伤乳汁下食伤米饮下后与大异香散或
和剂异香散亦得气积橘皮汤下后与和剂流气饮
五珍丸 治小儿食积
青皮（不去白炒焦黄） 干姜（炮带生存性） 北五灵脂 蓬莪术（各一两）
上为末夹和称药末一两肥巴豆肉以石压去油称一钱研拌和粳米饭糊丸麻子大每服三五丸
米汤下饥饱时服
丁香烂饭丸 治小儿饮食所伤
丁香皮 甘草（炙各一钱） 砂仁 益智仁（炮） 甘松（各三钱） 丁香 京三棱（炮） 木
香广术（炮各一钱） 香附子（半两）
上为细末汤浸 饼为丸如绿豆大每服五七丸白汤下
木香见 丸 治伤冷硬物心腹满闷疼痛
巴豆霜（半钱） 荆三棱（一两煨） 神曲（炒一两） 香附子（一钱） 石三棱（半两煨） 升
麻（三钱） 柴胡（二钱） 草豆蔻（煨半两）
上为末汤浸 饼丸如麻子大每服十五丸白汤下量所伤多少服之
三棱消积丸 治伤生冷硬物不能克化心腹满痛
丁皮 益智（各三钱） 陈皮 青皮（各五钱） 茴香（炒半两） 炒曲 广术（炮） 京三棱
（焙各七钱） 巴豆（和米炒去米五钱）
上为细末醋糊丸如麻子大每服十丸温姜汤下食前看虚实加减服
枳实导滞丸 治伤湿冷之物不得施化而作痞满闷乱不安
茯苓 黄芩 白术 黄连（各三钱） 泽泻（二钱） 大黄（一两） 枳实（炒） 神曲（各五
钱）
上为细末汤浸 饼为丸如绿豆大每服十丸白汤送下
青龙丸 治小儿惊积有热
青黛 茯神 芦荟 南星（炮各一钱） 麝（少许） 轻粉 巴豆（一字） 全蝎（三个焙）
上先将巴豆研如泥次入诸药令极细丸如粟米大朱砂为衣每服一丸薄荷汤送下
辰砂膏
辰砂（三钱） 硼砂 马牙硝（各一钱半） 玄明粉（二钱） 全蝎 真珠（末各一钱） 麝（
一字）
上为末和毕用油单包起自然成膏每服一豆许治诸惊用
朱银丸 治胎风壮热痰盛反眼口噤取下胎中蕴受之毒亦治惊
水银（一钱蒸枣研如泥） 白附子（一钱半） 全蝎（一钱） 南星 朱砂（一钱） 天浆子
牛黄 芦荟（各半钱） 铅霜（半钱和水银研） 脑（一字） 麝（一字） 直僵蚕（炒七个）
上为末粟米糊丸如芥子大每一丸薄荷汤下
小儿的各种疾病，大多是因为哺乳和饮食没有节制，过度饱食导致脾胃受损，无法消化食物，停滞而成积滞。在初起阶段，无论是乳积、食积还是气积，都应当使用木香丸、消积丸之类的药物来消除积滞；对于惊积，则根据病情的轻重，选用辰砂膏或青龙丸进行疏导治疗，同时配合调理气机、和胃的方法以求痊愈。
大凡小儿腹部出现发热、胀满或坚硬的情况，都是由体内实邪所致，治法应当采用疏通利下的方法。所以李东垣说：食物是有形的物质，损伤了它，适宜通过损耗谷物（即消食导滞）来治疗，其次不如采用消导之法，如丁香烂饭丸、枳术丸等方剂主治。病情稍重的，用攻下化积的三棱消积丸、木香见[注：原文此处可能有缺字或异体字，通常指木香丸类]等方剂主治。病情特别严重的，或者采用催吐，或者采用泻下，如瓜蒂散、备急丸等方剂主治，以病情平复为度。这是因为脾脏已经受伤，如果再用药损伤，会使营运之气减少削弱，食物更加难以消化。所以《素问·至真要大论》中说：用大毒性的药物治疗疾病，病去十分之六就应停药；用小毒性的药物，病去十分之七停药；用常毒性的药物，病去十分之八停药；用无毒性的药物，病去十分之九停药。肉类、水果、蔬菜等食物，也绝不能过量食用而损伤正气。
大凡人的身体以胃气为本，治病也是如此。小儿的胃气有虚证和实证之分：虚证表现为呕吐、不能进食；实证表现为痞闷胀满、内热。虚证应当补益，实证应当攻损，达到平衡就可以了。胃虚者，使用木香、丁皮、浓朴、肉豆蔻等药剂；胃实者，使用北桔梗、枳壳、柴胡、大黄等药剂。如果胃中有停寒，那么干姜、官桂、丁香也不可缺少，关键在于斟酌剂量，只给少量的药量。这就是所谓的“平胃心”（调和脾胃），因为脾之母是心，进食不仅在于调和脾脏，盖因火能生土，应当在入脾胃的药中加入清心之药，这样两全其美。古人进食方剂中多用益智仁，就是这个道理。
下积丸：治疗小儿乳食伤积引起的心腹胀满、呼吸气粗、肚腹发热，或者腹泻、呕吐。
配方：丁香、缩砂（各十二个）、使君子（五个，焙干）、乌梅肉（焙干）、川巴豆。
制法与用法：上药研成细末，混合均匀，用烂饭做丸，如麻子大小。每次服用三十丸，橘皮汤送服。
木香丸：治疗小儿乳积、食积、气积。
配方：木香、蓬术、缩砂仁、青皮（去白）、朱砂（研细）、代赭石（研，各二钱）、大丁香（一钱）、川巴豆肉（用纸压去油，一钱）。
制法与用法：上药研成细末，混合均匀，用飞白面糊做丸，如麻子大小，风干。每次服用二三丸。若是乳汁损伤，用乳汁送服；若是食物损伤，用米饮送服。服药后给予大异香散，或者和剂异香散也可以。若是气积，用橘皮汤送服，服药后给予和剂流气饮。
五珍丸：治疗小儿食积。
配方：青皮（不去白，炒至焦黄）、干姜（炮制，保留辛散之性）、北五灵脂、蓬莪术（各一两）。
制法与用法：上药研成细末，称取药末一两，加入肥巴豆肉（用石压去油，称一钱），研磨拌匀，用粳米饭糊做丸，如麻子大小。每次服用三五丸，米汤送服，饥饱时服用。
丁香烂饭丸：治疗小儿饮食所伤。
配方：丁香皮、甘草（炙，各一钱）、砂仁、益智仁（炮制）、甘松（各三钱）、丁香、京三棱（炮制）、木香、广术（炮制，各一钱）、香附子（半两）。
制法与用法：上药研成细末，用水浸泡过的饼粉做丸，如绿豆大小。每次服用五到七丸，白开水送服。
木香见[注：疑为“木香丸”或特定名]丸：治疗因伤冷硬物引起的心腹满闷疼痛。
配方：巴豆霜（半钱）、荆三棱（一两，煨）、神曲（炒，一两）、香附子（一钱）、石三棱（半两，煨）、升麻（三钱）、柴胡（二钱）、草豆蔻（煨，半两）。
制法与用法：上药研成细末，用水浸泡过的饼粉做丸，如麻子大小。每次服用十五丸，白开水送服，根据所伤食物的多少调整剂量服用。
三棱消积丸：治疗因伤生冷硬物导致无法消化，引起的心腹满痛。
配方：丁皮、益智（各三钱）、陈皮、青皮（各五钱）、茴香（炒，半两）、炒曲、广术（炮制）、京三棱（焙，各七钱）、巴豆（与米同炒，去米，五钱）。
制法与用法：上药研成细末，用醋糊做丸，如麻子大小。每次服用十丸，温姜汤送服，饭前服用，根据虚实情况加减剂量。
枳实导滞丸：治疗因伤湿冷之物，导致无法正常运化，产生痞闷胀满、烦乱不安。
配方：茯苓、黄芩、白术、黄连（各三钱）、泽泻（二钱）、大黄（一两）、枳实（炒）、神曲（各五钱）。
制法与用法：上药研成细末，用水浸泡过的饼粉做丸，如绿豆大小。每次服用十丸，白开水送服。
青龙丸：治疗小儿惊积伴有热象。
配方：青黛、茯神、芦荟、南星（炮制，各一钱）、麝香（少许）、轻粉、巴豆（一字）、全蝎（三个，焙干）。
制法与用法：先将巴豆研成泥状，再加入其他药物，令其极细，做成如粟米大小的丸剂，用朱砂为衣。每次服用一丸，薄荷汤送服。
辰砂膏：
配方：辰砂（三钱）、硼砂、马牙硝（各一钱半）、玄明粉（二钱）、全蝎、真珠（研末，各一钱）、麝香（一字）。
制法与用法：上药研成细末，混合均匀，用油纸包起来，自然形成膏状。每次服用如豆粒大小，用于治疗各种惊证。
朱银丸：治疗胎风壮热、痰盛、反眼、口噤，旨在排出胎中蕴受的毒素，也治疗惊风。
配方：水银（一钱，蒸枣研如泥）、白附子（一钱半）、全蝎（一钱）、南星、朱砂（一钱）、天浆子、牛黄、芦荟（各半钱）、铅霜（半钱，与水银同研）、脑（一字）、麝香（一字）、直僵蚕（炒，七个）。
制法与用法：上药研成细末，用粟米糊做丸，如芥子大小。每一丸用薄荷汤送服。
Various diseases in children are mostly caused by unregulated breastfeeding and dieting. Excessive fullness damages the spleen and stomach, leading to an inability to digest food, which stagnates and forms accumulation (Ji). At the initial stage, regardless of whether it is milk accumulation, food accumulation, or qi accumulation, formulas such as Muxiang Wan (Wood Fragrance Pill) and Xiaoji Wan (Eliminate Accumulation Pill) should be used to eliminate the accumulation. For fright accumulation (Jing Ji), based on the severity, Chen Sha Gao (Cinnabar Paste) or Qinglong Wan (Azure Dragon Pill) should be selected for guidance and drainage. Treatment should also include regulating Qi and harmonizing the Stomach to achieve recovery.
Generally, if a child's abdomen presents with heat, distension, or hardness, it is due to internal excess. The treatment method should be to dredge and purge downwards. Therefore, Li Dongyuan stated: Food is a tangible substance; when injured, it is appropriate to reduce the grain intake (digestive enzymes/action). Secondly, it is better to use digestion-promoting methods, such as Dingxiang Lanfan Wan (Clove Rice Pill) or Zhizhu Wan (Immature Bitter Orange and Atractylodes Pill). For slightly more severe cases, aggressive transformation formulas like Sanling Xiaoji Wan (Curcuma Longa Accumulation-Eliminating Pill) or Muxiang Jian [Note: Textual variant] Wan are indicated. For particularly severe cases, either emesis or purgation is used, such as Gouti San (Seed of Melon Trichosanthes Powder) or Beijie Wan (Urgent Rescue Pill), aiming for equilibrium. This is because the Spleen is already injured; further medication injury would deplete the transporting and transforming Qi, making food even harder to digest. Thus, the *Suwen: Zhi Zhen Yao Da Lun* states: When treating disease with highly toxic substances, stop when six-tenths of the disease is gone; with moderately toxic substances, stop at seven-tenths; with commonly toxic substances, stop at eight-tenths; with non-toxic substances, stop at nine-tenths. Meat, fruit, and vegetable foods must not be overconsumed to avoid damaging healthy Qi.
The human body relies on Stomach Qi as its foundation, and this applies equally to treating diseases. Children's Stomach Qi can be deficient or excessive. Deficiency manifests as vomiting and anorexia; excess manifests as epigastric stuffiness, fullness, and internal heat. Deficiency should be tonified, and excess should be reduced, to achieve balance. For Stomach deficiency, formulas containing Muxiang (Aucklandiae Radix), Dingpi (Cortex Cinnamomi), Houpo (Magnoliae Officinalis Cortex), and Roudoukou (Myristicae Semen) are used. For Stomach excess, formulas containing Beiju Geng (Platycodonis Radix), Zhike (Aurantii Fructus Immaturus), Chaihu (Bupleuri Radix), and Dahuang (Rhei Radix et Rhizoma) are used. If there is cold retention in the Stomach, Ganjiang (Zingiberis Rhizoma), Guigui (Cinnamomi Ramulus), and Dingxiang (Eugeniae Flos) cannot be omitted. The key lies in dosage adjustment, administering only small doses. This is referred to as "Ping Wei Xin" (Calming the Stomach and Heart); since the Mother of the Spleen is the Heart, nourishment is not just about harmonizing the Spleen. Fire generates Earth, so heart-calming herbs should be incorporated into Stomach and Spleen formulas to benefit both. This is why ancient formulas for promoting appetite often used Yizhiren (Alpinia Oxyphylla Fructus).
Xiaji Wan (Lower Accumulation Pill): Treats pediatric milk/food accumulation causing epigastric and abdominal distension/fullness, coarse breathing, abdominal heat, diarrhea, or vomiting.
Ingredients: Dingxiang (Eugeniae Flos), Suosha (Amomi Fructus Rotundus) (12 each), Shijunzi (Quisqualis Fructus) (5, roasted), Wumei Rou (Semen Pruni Mume) (roasted), Chuandabao (Crotonis Fructus).
Preparation and Administration: Grind all ingredients into a fine powder, mix evenly, and make pills using cooked rice, sized like hemp seeds. Take 30 pills per dose, washed down with Jupi Tang (Tangerine Peel Decoction).
Muxiang Wan (Wood Fragrance Pill): Treats pediatric milk accumulation, food accumulation, and qi accumulation.
Ingredients: Muxiang (Aucklandiae Radix), Pengzhu (Curcumae Phaeocaulis Rhizoma), Suosharen (Amomi Fructus Rotundus), Qingpi (Citri Reticulatae Pericarpium Viride - white pith removed), Zhusha (Cinnabaris - finely ground), Daizheshi (Haematitum - finely ground, 2 qian each), Dadingxiang (Eugeniae Flos) (1 qian), Chuandabaorou (Crotonis Fructus flesh - oil pressed out via paper, 1 qian).
Preparation and Administration: Grind into fine powder, mix evenly, and make pills using refined white wheat flour paste, sized like hemp seeds, dried in the wind. Take 2-3 pills per dose. For milk injury, wash down with breast milk; for food injury, wash down with rice drink. Afterward, administer Dayixiang San (Great Heterogeneous Fragrance Powder) or Heji Yixiang San (Harmonized Formula Heterogeneous Fragrance Powder). For qi accumulation, wash down with Jupi Tang; afterward, administer Heji Liuqi Yin (Harmonized Formula Flowing Qi Decoction).
Wuzhen Wan (Five Treasures Pill): Treats pediatric food accumulation.
Ingredients: Qingpi (Citri Reticulatae Pericarpium Viride - white pith retained, stir-fried until scorched yellow), Ganjiang (Zingiberis Rhizoma - processed, retaining pungency), Beiwulingzhi (Trogopteri Dung), Peng'ezhu (Curcumae Phaeocaulis Rhizoma) (1 liang each).
Preparation and Administration: Grind into powder. Weigh 1 liang of herb powder, add Fei Dabaorou (Crotonis Fructus flesh - oil pressed out with stone, weighed 1 qian), grind and mix well. Make pills using glutinous rice paste, sized like hemp seeds. Take 3-5 pills per dose, washed down with rice soup, taken during times of hunger or fullness.
Dingxiang Lanfan Wan (Clove Rice Pill): Treats injuries from dietary intake.
Ingredients: Dingxiangpi (Cortex Cinnamomi), Gancao (Glycyrrhizae Radix et Rhizoma - honey-fried, 1 qian each), Sharen (Amomi Fructus), Yizhiren (Alpinia Oxyphylla Fructus - processed), Gansong (Nardostachyos Radix et Rhizoma) (3 qian each), Dingxiang (Eugeniae Flos), Jingsanleng (Curcumae Radix - processed), Muxiang (Aucklandiae Radix), Guangzhu (Curcumae Longae Rhizoma - processed, 1 qian each), Xiangfuzi (Cyperi Rhizoma) (0.5 liang).
Preparation and Administration: Grind into fine powder. Soak in water, mix with biscuit dough to make pills sized like mung beans. Take 5-7 pills per dose, washed down with plain boiled water.
Muxiang Jian [Variant] Wan: Treats epigastric and abdominal fullness and pain caused by ingesting cold, hard objects.
Ingredients: Babao Shuang (Crotonis Fructus Frost) (0.5 qian), Jingsanleng (Curcumae Radix - 1 liang, calcined), Shenqu (Massa Medicata Fermentata - stir-fried, 1 liang), Xiangfuzi (Cyperi Rhizoma) (1 qian), Shisanleng (Curcumae Radix - 0.5 liang, calcined), Shengma (Cimicifugae Rhizoma) (3 qian), Chaihu (Bupleuri Radix) (2 qian), Caodoukou (Alpiniae Katsumadai Semen - calcined, 0.5 liang).
Preparation and Administration: Grind into powder. Soak in water, mix with biscuit dough to make pills sized like hemp seeds. Take 15 pills per dose, washed down with plain boiled water. Adjust dosage according to the amount of ingested food.
Sanling Xiaoji Wan (Curcuma Longa Accumulation-Eliminating Pill): Treats inability to digest cold, raw, hard objects, causing epigastric and abdominal fullness and pain.
Ingredients: Dingpi (Cortex Cinnamomi), Yizhi (Alpiniae Oxyphylla Fructus) (3 qian each), Chenpi (Citri Reticulatae Pericarpium), Qingpi (Citri Reticulatae Pericarpium Viride) (5 qian each), Huixiang (Foeniculi Fructus - stir-fried, 0.5 liang), Chaoqu (Stir-fried Massa Medicata Fermentata), Guangzhu (Curcumae Longae Rhizoma - processed), Jingsanleng (Curcumae Radix - baked, 7 qian each), Babao (Crotonis Fructus - stir-fried with rice, remove rice, 5 qian).
Preparation and Administration: Grind into fine powder. Make pills using vinegar paste, sized like hemp seeds. Take 10 pills per dose, washed down with warm ginger soup. Take before meals. Adjust dosage based on deficiency or excess.
Zhishi Daozhi Wan (Immature Bitter Orange Guiding Away Stagnation Pill): Treats stuffiness, fullness, and restlessness caused by damage from damp-cold substances that fail to transform and diffuse.
Ingredients: Fuling (Poria), Huangqin (Scutellariae Radix), Baizhu (Atractylodis Macrocephalae Rhizoma), Huanglian (Coptidis Rhizoma) (3 qian each), Zexie (Alismatis Rhizoma) (2 qian), Dahuang (Rhei Radix et Rhizoma) (1 liang), Zhishi (Aurantii Fructus Immaturus - stir-fried), Shenqu (Massa Medicata Fermentata) (5 qian each).
Preparation and Administration: Grind into fine powder. Soak in water, mix with biscuit dough to make pills sized like mung beans. Take 10 pills per dose, washed down with plain boiled water.
Qinglong Wan (Azure Dragon Pill): Treats pediatric fright accumulation with heat.
Ingredients: Qingdai (Indigo Naturalis), Fushen (Poria with Hostwood), Lvhui (Aloe), Nanxing (Arisaematis Rhizoma - processed, 1 qian each), Shexiang (Moschus) (small amount), Qingfen (Calomelas), Babao (Crotonis Fructus) (one character weight), Quanxie (Scorpio - 3, roasted).
Preparation and Administration: First grind Babao into a paste. Add other drugs and grind until extremely fine. Make pills sized like millet grains, coated with Zhusha (Cinnabaris). Take 1 pill per dose, washed down with Bohe Tang (Mint Decoction).
Chensha Gao (Cinnabar Paste):
Ingredients: Chensha (Cinnabaris) (3 qian), Pengsha (Borax), Mayaxiao (Mirabilite) (1.5 qian each), Xuanmingfen (Thenardite) (2 qian), Quanxie (Scorpio), Zhenzhu (Pearl - powdered, 1 qian each), Shexiang (Moschus) (one character weight).
Preparation and Administration: Grind into fine powder, mix thoroughly, and wrap in oiled paper to naturally form a paste. Take a bean-sized amount per dose. Used to treat various fright conditions.
Zhuyin Wan (Vermilion Silver Pill): Treats fetal wind with high fever, profuse phlegm, eyes rolling back, and jaw lock. It aims to expel toxins retained in the fetus and also treats fright convulsions.
Ingredients: Shuiyin (Mercurius) (1 qian, steamed with jujube and ground to paste), Baifuzi (Typhonii Rhizoma) (1.5 qian), Quanxie (Scorpio) (1 qian), Nanxing (Arisaematis Rhizoma), Zhusha (Cinnabaris) (1 qian), Tianjiangzi (Passiflorae Semen), Niuhuang (Bovis Calculus), Lvhui (Aloe) (0.5 qian each), Qianshuang (Plumbum Subacetatum) (0.5 qian, ground with Shuiyin), Nao (Camphora) (one character weight), Shexiang (Moschus) (one character weight), Zhijiangcan (Bombyx Batryticatus - stir-fried, 7).
Preparation and Administration: Grind into fine powder. Make pills using millet paste, sized like mustard seeds. Take one pill per dose, washed down with Bohe Tang (Mint Decoction).