凡小儿饮食停滞中焦不化而发热者必恶食也或噫气作酸或恶闻食臭或欲吐不吐或吐之不
尽或
恶心或气短痞闷或胃口作疼或心下痞满按之则痛此皆停食之候也可辨之矣皆因乳哺不节过餐
生冷坚硬之物脾胃不能克化积滞中脘外为风寒所搏或因夜卧失盖致头疼面黄身热目 微肿腹
痛膨胀足冷肚热喜睡神昏不思饮食或呕或哕口噫酸气大便酸臭此为陈积所伤也若停食或感寒
邪者则左手人迎气口俱大外证头疼恶寒拘急中脘痞闷或吐或呕或痛者以藿香正气散或人参养
胃汤加木香砂仁之类若肉食不化必加棠球子末面食不化者加神曲大麦 生冷肉食果子之类不
化者必加草果砂仁枳实青皮主之如食在胃口上未入于胃乃可吐之不吐则消导之待食下胃变化
糟粕外证已解乃可下其食也宜三物浓朴汤热多者大柴胡汤如无外感但只伤食者以紫霜丸下之
凡治夹食伤寒不可先攻其食且先发散寒邪次可消导之也
藿香正气散
治小儿内伤生冷外感风寒并宜服之
藿香 浓朴 白芷 大腹皮 紫苏 陈皮 半夏 桔梗 甘草 白术 白茯苓
上锉散水一钟姜三片煎至六分温服
人参养胃汤
人参 半夏 陈皮 茯苓 苍术 浓朴 藿香 草果
上水一钟生姜三片枣一枚煎服
三黄枳术丸 治伤肉湿面辛辣味浓之物填塞闷乱不快
枳实(麸炒五钱) 黄连(去须酒浸洗) 大黄(湿纸裹煨) 橘皮 白术(以上各一两) 黄
芩
上为极细末汤浸 饼为丸如绿豆大每服五十丸白汤下临时量所伤多少加减服之
巴豆三棱丸(一名木香见 丸) 治生冷硬物所伤心腹满闷疼痛
巴豆霜(五分) 木香(二钱) 升麻 柴胡(以上各三钱) 草豆蔻(面裹煨熟用仁) 香附
子(炒以上各五钱) 神曲(炒黄色) 石三棱(去皮煨) 京三棱(煨以上各一两)
上为末汤浸 饼为丸如绿豆一倍大每服一二十丸温白汤下量所伤多少加减服之
白术丸 治伤豆粉湿面油腻之物
白矾(枯三分) 黄芩(二钱) 橘皮(三钱) 神曲(炒黄色) 半夏(以上各一两) 枳实(
麸炒黄色一两一钱) 白术(以上各一两)
上为极细末汤浸 饼为丸如绿豆一倍大每服三十五丸白汤下素食多用干姜黄芩汤以泻之
草豆蔻丸 治秋冬伤食之寒冷者胃脘当心而痛上肢两胁咽膈不通
炒盐(五分) 干生姜 青皮 橘皮(以上各二钱) 麦 面(炒黄色) 生黄芩(冬月不用)
夏(汤洗七次) 神曲(炒以上各五钱) 草豆蔻(面裹煨去皮取仁) 白术(以上各一两) 枳实(麸炒二两)
上为极细末汤浸 饼为丸如绿豆大每服五十丸
钱乙说:小儿脉象沉缓,是伤食的表现;右手气口脉紧盛,也是伤食的表现。
凡是小儿饮食停滞在中焦(脾胃),不能消化而发热的,必定厌恶进食。或者嗳气带有酸味,或者厌恶闻到食物的气味,或者有想吐却吐不出来的感觉,或者呕吐不干净,或者恶心,或者气短、胸脘痞闷,或者胃口疼痛,或者心下(胃脘部)痞满,按压时感到疼痛。这些都是停食的症状,可以据此辨别了。这些症状都是因为哺乳喂养没有节制,过量食用生冷坚硬的食物,导致脾胃无法运化,积滞停留在中脘部位;或者是外受风寒邪气侵袭,或者是夜间睡觉没有盖好被子,导致头痛、面色发黄、身体发热、眼睛轻微肿胀、腹痛、腹部膨胀、脚冷肚子热、喜欢睡觉、神志昏沉、不想吃东西,或者呕吐、呃逆、口中嗳出酸气、大便酸臭。这是被陈旧的积食所伤害。如果是停食又感受寒邪的,则左手人迎穴和右手气口脉都大,外部症状有头痛、恶寒、肢体拘急,中脘痞闷,或者呕吐、作呕、疼痛的,用藿香正气散或人参养胃汤,加入木香、砂仁之类的药物。如果是肉食不消化的,必须加棠球子末;面食不消化的,加神曲、大麦;如果是生冷、肉食、果子之类不消化的,必须加草果、砂仁、枳实、青皮来主治。如果食物还在胃口上方,尚未进入胃中,那么可以用催吐法,如果不吐出来,就用消导法。等到食物进入胃中,转化为糟粕,外部症状已经解除后,才可以采用泻下法来排出积食。适宜用三物浓朴汤;热象多的,用大柴胡汤;如果没有外感,只是单纯伤食的,用紫霜丸泻下它。凡是治疗夹带食积的伤寒病,不可先攻伐积食,且必须先发散寒邪,之后才可以消导积食。
藿香正气散
治疗小儿内伤生冷、外感风寒,都适宜服用。
药材:藿香、浓朴、白芷、大腹皮、紫苏、陈皮、半夏、桔梗、甘草、白术、白茯苓。
以上锉成散剂,用水一钟,生姜三片,煎至六分,温服。
人参养胃汤
药材:人参、半夏、陈皮、茯苓、苍术、浓朴、藿香、草果。
以上用水一钟,生姜三片,大枣一枚,煎服。
三黄枳术丸 治疗因损伤肉类、湿面、辛辣味浓之物导致的填塞、闷乱、不快。
药材:枳实(麸炒五钱)、黄连(去须,酒浸洗)、大黄(湿纸包裹煨制)、橘皮、白术(以上各一两)、黄芩。
以上研为极细末,用米汤浸泡面团制成丸药,如绿豆大小。每次服用五十丸,用白开水送下,根据所伤食物的多少临时加减服用。
巴豆三棱丸(一名木香见气丸) 治疗因生冷硬物所伤导致的心腹满闷疼痛。
药材:巴豆霜(五分)、木香(二钱)、升麻、柴胡(以上各三钱)、草豆蔻(面粉包裹煨熟取仁)、香附子(炒,以上各五钱)、神曲(炒至黄色)、京三棱(去皮煨)、莪术(煨,以上各一两)。
以上研为末,用米汤浸泡面团制成丸药,比绿豆大一倍。每次服用一二十丸,用温白开水送下,根据所伤食物的多少加减服用。
白术丸 治疗因损伤豆粉、湿面、油腻之物所致。
药材:白矾(枯矾三分)、黄芩(二钱)、橘皮(三钱)、神曲(炒至黄色)、半夏(以上各一两)、枳实(麸炒至黄色一两一钱)、白术(以上各一两)。
以上研为极细末,用米汤浸泡面团制成丸药,比绿豆大一倍。每次服用三十五丸,用白开水送下。素食多用干姜黄芩汤来泻下。
草豆蔻丸 治疗秋冬季节因寒冷伤食导致的胃脘当心而痛,上肢及两胁、咽膈不通畅。
药材:炒盐(五分)、干生姜、青皮、橘皮(以上各二钱)、麦芽面(炒至黄色)、生黄芩(冬季不用,夏季用沸水洗七次)、神曲(炒,以上各五钱)、草豆蔻(面粉包裹煨制去皮取仁)、白术(以上各一两)、枳实(麸炒二两)。
以上研为极细末,用米汤浸泡面团制成丸药,如绿豆大小。每次服用五十丸。
Qian Yi stated: A deep and slow pulse in children indicates food stagnation (Shang Shi); a tight and excessive pulse at the Qi Kou position on the right hand also indicates food stagnation.
Whenever food stagnates in the Middle Jiao (Middle Burner, referring to the spleen and stomach) and fails to digest, causing fever, the child will necessarily have an aversion to food. Symptoms may include belching with an sour taste, aversion to the smell of food, a sensation of wanting to vomit but being unable to do so, incomplete vomiting, nausea, shortness of breath, chest and epigastric fullness and oppression, pain at the appetite center, or fullness below the heart that is painful upon palpation. These are all signs of retained food and can be identified accordingly. These conditions arise from irregular breastfeeding or feeding, overconsumption of raw, cold, hard, or tough foods, leading to the spleen and stomach's inability to transform and transport, resulting in accumulation and stagnation in the Zhong Wan (Middle Epigastrium). Externally, they may be constrained by wind-cold pathogens, or caused by sleeping uncovered at night, leading to headache, sallow complexion, body heat, slight swelling of the eyes, abdominal pain, abdominal distension, cold feet with a hot abdomen, lethargy, mental confusion, loss of appetite, vomiting, hiccups, sour belching, and sour-smelling stool. This is injury caused by old accumulations. If there is retained food combined with cold pathogen invasion, both the Ren Ying pulse on the left hand and the Qi Kou pulse on the right hand will be large. External symptoms include headache, aversion to cold, and limb stiffness, along with epigastric fullness, vomiting, retching, or pain. In such cases, Huoxiang Zhengqi San (Agastache Powder for Rectifying the Qi) or Renshen Yangwei Tang (Ginseng Decoction for Nourishing the Stomach) should be used, with additions such as Muxiang (Aucklandiae Radix) and Sharen (Amomi Fructus). If meat food is not digested, Tangqiu Zi (Crataegi Fructus) powder must be added; if flour-based foods are not digested, Shenqu (Massa Medicata Fermentata) and Damai (Hordei Fructus Germinatus) should be added; if raw, cold, meat, or fruit foods are not digested, Caoguo (Tsaoko Fructus), Sharen, Zhishi (Aurantii Fructus Immaturus), and Qingpi (Citri Reticulatae Pericarpium Viride) must be added as the main treatment. If the food remains above the stomach opening and has not yet entered the stomach, emesis (inducing vomiting) may be employed; if it does not vomit, resolution and guidance methods should be used. Once the food enters the stomach and transforms into waste, and external symptoms have resolved, purgation (downward draining) may then be used to expel the food. Sanwu Nongpo Tang (Three-Ingredient Magnolia Bark Decoction) is suitable; if heat is predominant, Da Chaihu Tang (Major Bupleurum Decoction) should be used. If there is no external contraction and only food injury exists, Zishuang Wan (Purple Frost Pill) should be used to purge. When treating Taiyang disease complicated by food retention, one must not first attack the food; rather, one must first disperse the cold pathogen, and only then proceed to resolve and guide the food.
Huoxiang Zhengqi San (Agastache Powder for Rectifying the Qi)
Indicated for pediatric internal injury from raw/cold foods and external contraction of wind-cold; suitable for use in both cases.
Ingredients: Huoxiang (Agastetis Herba), Nongpo (Magnoliae Officinalis Cortex), Baizhi (Angelicae Dahuricae Radix), Dafupi (Arecae Pericarpium), Zisu (Perillae Folium), Chenpi (Citri Reticulatae Pericarpium), Banxia (Pinelliae Rhizoma Praeparatum), Jiegeng (Platycodonis Radix), Gancao (Glycyrrhizae Radix et Rhizoma), Baizhu (Atractylodis Macrocephalae Rhizoma), Baifuling (Poria).
These are coarsely powdered. Use one zhong of water and three slices of fresh ginger, decoct until six-tenths remain, and take warm.
Renshen Yangwei Tang (Ginseng Decoction for Nourishing the Stomach)
Ingredients: Renshen (Ginseng Radix), Banxia (Pinelliae Rhizoma Praeparatum), Chenpi (Citri Reticulatae Pericarpium), Fuling (Poria), Cangzhu (Atractylodis Rhizoma), Nongpo (Magnoliae Officinalis Cortex), Huoxiang (Agastetis Herba), Caoguo (Tsaoko Fructus).
Use one zhong of water, three slices of fresh ginger, and one jujube, decoct and take.
Sanhuang Zhizhu Wan (Three-Yellow Aurantium and Atractylodes Pill)
Indicated for injury caused by meat, damp wheat noodles, and strongly flavored spicy foods, leading to stuffiness, oppression, and discomfort.
Ingredients: Zhishi (Aurantii Fructus Immaturus, stir-baked with bran, 5 qian), Huanglian (Coptidis Rhizoma, remove roots, soak in wine and wash), Dahuang (Rhei Radix et Rhizoma, wrapped in wet paper and baked), Ju Pi (Citri Reticulatae Pericarpium), Baizhu (Atractylodis Macrocephalae Rhizoma, each 1 liang above), Huangqin (Scutellariae Radix).
Grind into an extremely fine powder. Moisten with soup/gruel and form pills the size of mung beans. Take 50 pills per dose with plain boiled water, adjusting dosage according to the amount of food injured.
Badou Sanleng Wan (Croton and Curcuma Pill, also known as Muxiang Jianqi Wan)
Indicated for heart and abdominal fullness, oppression, and pain caused by injury from raw, cold, and hard foods.
Ingredients: Badoushuang (Crotonis Fructus Pulvis, 5 fen), Muxiang (Aucklandiae Radix, 2 qian), Shengma (Cimicifugae Rhizoma), Chaihu (Bupleuri Radix, each 3 qian above), Caodoukou (Cardamomi Fructus, wrapped in flour and baked, use kernel), Xiangfu (Cyperi Rhizoma, stir-fried, each 5 qian above), Shenqu (Massa Medicata Fermentata, stir-fried to yellow), Sanleng (Sparganii Rhizoma, peel and bake), Jing Sanleng (Curcumae Rhizoma, bake, each 1 liang above).
Grind into powder. Moisten with soup/gruel and form pills twice the size of mung beans. Take 10-20 pills per dose with warm plain boiled water, adjusting dosage according to the amount of food injured.
Baizhu Wan (Atractylodes Pill)
Indicated for injury caused by bean powder, damp wheat noodles, and greasy foods.
Ingredients: Baijian (Alumen, calcined, 3 fen), Huangqin (Scutellariae Radix, 2 qian), Ju Pi (Citri Reticulatae Pericarpium, 3 qian), Shenqu (Massa Medicata Fermentata, stir-fried to yellow), Banxia (Pinelliae Rhizoma Praeparatum, each 1 liang above), Zhishi (Aurantii Fructus Immaturus, stir-baked with bran to yellow, 1 liang 1 qian), Baizhu (Atractylodis Macrocephalae Rhizoma, each 1 liang above).
Grind into an extremely fine powder. Moisten with soup/gruel and form pills twice the size of mung beans. Take 35 pills per dose with plain boiled water. For injuries from vegetarian foods, use Ganjiang Huangqin Tang (Dry Ginger and Scutellaria Decoction) to purge.
Caodoukou Wan (Cardamom Pill)
Indicated for cold-induced food stagnation in autumn and winter, causing pain in the epigastrium directly below the heart, and obstruction in the upper limbs, hypochondrium, pharynx, and diaphragm.
Ingredients: Chao Yan (Stir-fried salt, 5 fen), Gan Jiang Sheng (Dried Fresh Ginger), Qingpi (Citri Reticulatae Pericarpium Viride), Ju Pi (Citri Reticulatae Pericarpium, each 2 qian above), Mai Ya Mian (Malt Flour, stir-fried to yellow), Sheng Huangqin (Scutellariae Radix, not used in winter; washed seven times in boiling water in summer), Shenqu (Massa Medicata Fermentata, stir-fried, each 5 qian above), Caodoukou (Cardamomi Fructus, wrapped in flour, baked, peel removed, use kernel), Baizhu (Atractylodis Macrocephalae Rhizoma, each 1 liang above), Zhishi (Aurantii Fructus Immaturus, stir-baked with bran, 2 liang).
Grind into an extremely fine powder. Moisten with soup/gruel and form pills the size of mung beans. Take 50 pills per dose.