王肯堂曰。乳积者。其候但是吐下乳来。有酸臭气。因啼叫未已。遽与乳吃。停滞不化而得。兼面青黄。发热作渴。
多睡口疮。渐渐黄瘦。腹内结块不散。茅先生用丁香散开胃后。用牛黄丸取下乳积。后用匀气散。常服健脾散。即愈。
食积者。肚硬而热。或泻或呕。因饮食过饱。饱后即睡而得。茅先生用牛黄丸取积。后用匀气散调理。常服万灵丸即
愈。气积者。面色黄白。不进食。腹痛啼叫。利如蟹渤。此因营卫不和。日久而得。茅先生用万灵丸、匀气散、醒脾散
相夹调理。惊积者。时时泄清水如米泔。是受伤而复有积。烦闷啾唧。常以生嗔。先解散。用百解散。后理积。乌犀丸、
三棱散、醒脾散。宁惊化积。壮气和胃。仍节冷乳。自愈。热积者。大便不通。风毒疮疖。喉闭 腮。咽中涎响。茅先
生用夺命散吐下热涎。后用匀气散、醒脾散调理。常服镇心丸、天竺黄散、愈。
钱乙曰。积痛。口中气温。面色黄白。目无睛光。或白睛多。及多睡畏食。或大便酸臭者。当磨积而痛自除。宜下
积丸。甚者白饼子下之。后和胃气。用白术散。又有食积肚痛。有热者。芍药甘草汤。加葛根。吐者。加生姜、半夏。
或加枳实。亦效。其有积而潮热寒热。心腹胀满疼痛者。良方妙香丸。
李杲曰。凡小儿失乳。以食饷之。未有食肠。不能克化。致成食积。腹胀而痛。利色无常。日久瘦弱。
鳌按。有寒积腹痛者。由日渐受寒。兼吃冷物凉饮。寒邪结于脾经。遂致作痛。始犹数日一发。继则一二日发
。或日日发。发则面青白。吐清水。喜人手按。或将物抵住。方得稍可。宜用棉子仁八两炒令烟尽。加入枳壳炒、
乌药炒各一两。木香生研五钱。神曲糊丸。空心淡姜汤下。数日当下白物。渐愈。
王肯堂说：乳积的症状，仅仅是吐出未消化的乳汁，带有酸臭味。因为婴儿啼哭不止，就急忙喂奶，导致乳汁停滞不化而致病。兼见面色青黄，发热口渴，多睡且生口疮，逐渐变得面黄肌瘦，腹部有结块不散。茅先生先用丁香散开胃，再用牛黄丸攻下乳积，后用匀气散调理，常服健脾散，即可痊愈。
食积的症状，肚子硬且热，或者腹泻或者呕吐。因为饮食过饱，吃饱后立即睡觉而致病。茅先生用牛黄丸攻下积滞，后用匀气散调理，常服万灵丸即可痊愈。
气积的症状，面色黄白，不想进食，腹痛啼叫，大便像蟹渤（一种小蟹）一样稀薄。这是因为营卫不和，日久形成的。茅先生用万灵丸、匀气散、醒脾散交替调理。
惊积的症状，时常排泄清水状如米泔水，这是受伤后又有积滞。表现为烦闷、低声呻吟，经常容易发怒生气。先使用百解散进行疏散解表，后处理积滞，用乌犀丸、三棱散、醒脾散。使惊恐平息、积滞化解，强壮正气和调胃气，同时节制生冷乳汁，自然痊愈。
热积的症状，大便秘结不通，伴有风毒疮疖，喉闭腮肿，咽喉中有痰鸣声。茅先生用夺命散催吐并攻下热涎，后用匀气散、醒脾散调理，常服镇心丸、天竺黄散，即可痊愈。
钱乙说：积痛的症状，口中气息温热，面色黄白，眼睛缺乏神采，或者眼白较多，以及多睡、畏食，或者大便酸臭的，应当磨消积滞，疼痛自然消除。宜用下积丸。严重的用白饼子攻下。之后调和胃气，用白术散。又有因食积引起的肚痛，有热象的，用芍药甘草汤加葛根；呕吐的，加生姜、半夏；或者加枳实，也有效。那些有积滞且出现潮热寒热往来，心腹胀满疼痛的，用良方妙香丸。
李杲说：凡是小儿断奶后，用食物喂养，由于肠胃尚未成熟，不能消化，导致形成食积。腹胀且痛，大便颜色无常，日久身体瘦弱。
沈金鳌按语：有寒积腹痛的情况，是由于日渐受寒，兼吃冷物凉饮，寒邪凝结于脾经，从而导致疼痛。起初还是几天发作一次，后来变成一两天发作，或者每天发作。发作时面色青白，吐出清水，喜欢让人手按压，或者用物体抵住腹部，才能稍微缓解。适宜用棉子仁八两炒至烟尽，加入炒枳壳一两、炒乌药一两，生研木香五钱，用神曲糊制成丸剂，空腹时用淡姜汤送服。数日后应排出白色物质，逐渐痊愈。
Weng Kentang stated: For milk accumulation (Ru Ji), the symptoms are merely vomiting undigested milk with a sour, foul odor. It arises because the infant cries incessantly and is fed immediately, causing the milk to stagnate and fail to digest. Accompanying signs include a cyan-yellow complexion, fever with thirst, excessive sleepiness accompanied by mouth sores, gradual emaciation and yellowish pallor, and palpable masses in the abdomen that do not dissipate. Master Mao first used Dingxiang San (Clove Powder) to open the stomach, then employed Niuhuang Wan (Calculus Bovis Pill) to purge the milk accumulation, followed by Yunqi San (Regulating Qi Powder) for regulation, and regular administration of Jianpi San (Spleen-Strengthening Powder), leading to recovery.
For food accumulation (Shi Ji), the abdomen is hard and hot, presenting with either diarrhea or vomiting. It results from overeating followed by immediate sleep. Master Mao used Niuhuang Wan (Calculus Bovis Pill) to remove the accumulation, followed by Yunqi San (Regulating Qi Powder) for regulation, and regular administration of Wanling Wan (Myriad Efficacy Pill), leading to recovery.
For qi accumulation (Qi Ji), the complexion is yellowish-white, appetite is poor, there is abdominal pain with crying, and stool is thin like "Xiebo" (a type of small crab). This arises from disharmony between Ying (Nutritive Qi) and Wei (Defensive Qi) over a long period. Master Mao alternated the use of Wanling Wan (Myriad Efficacy Pill), Yunqi San (Regulating Qi Powder), and Xingpi San (Spleen-Awakening Powder) for regulation.
For fright accumulation (Jing Ji), there is frequent passage of clear water resembling rice washings, indicating injury compounded by accumulation. Symptoms include irritability, whimpering, and frequent anger. First, use Baijie San (Hundred Resolutions Powder) to disperse; subsequently, treat the accumulation using Wuxi Wan (Black Rhinoceros Horn Pill), Sanleng San (Curcuma Zedoaria Powder), and Xingpi San (Spleen-Awakening Powder). This calms fright, resolves accumulation, strengthens vital energy, harmonizes the stomach, and requires moderation of cold milk for spontaneous recovery.
For heat accumulation (Re Ji), there is constipation, wind-toxin sores and boils, throat closure with swollen cheeks, and rattling phlegm in the throat. Master Mao used Duoming San (Life-Snatching Powder) to induce vomiting and purge hot phlegm, followed by Yunqi San (Regulating Qi Powder) and Xingpi San (Spleen-Awakening Powder) for regulation, and regular administration of Zhenxin Wan (Heart-Calming Pill) and Tianzhuhuang San (Bamboo Stone Powder), leading to recovery.
Qian Yi stated: For colic due to accumulation (Ji Tong), the breath from the mouth is warm, the complexion is yellowish-white, the eyes lack luster, or the sclera is prominent, accompanied by excessive sleepiness, aversion to eating, or sour-smelling stool. One should grind away the accumulation, and the pain will naturally cease. Xiaji Wan (Accumulation-Expelling Pill) is appropriate. In severe cases, Baixingzi (White Cake Pill) may be used to purge. Afterwards, harmonize the stomach qi using Baizhu San (Atractylodes Macrocephala Powder). For colic due to food accumulation with heat, use Shaoyao Gancao Tang (Peony and Licorice Decoction) added with Gegen (Pueraria Root). If vomiting occurs, add Shengjiang (Fresh Ginger) and Banxia (Pinellia Tuber); adding Zhishi (Immature Bitter Orange) is also effective. For cases with accumulation presenting with tidal fever and alternating chills and heat, along with epigastric and abdominal distension and pain, Liangfang Miaoxiang Wan (Excellent Formula Wonderful Fragrance Pill) is indicated.
Li Gao stated: Whenever infants lose breast milk and are fed solid food, their intestines and stomach are immature and unable to digest it, leading to food accumulation. This causes abdominal distension and pain, variable stool color, and eventual emaciation over time.
Shen Jin'ao noted: There are cases of abdominal pain due to cold accumulation. These result from gradual exposure to cold and consumption of cold foods and drinks, causing cold pathogens to knot in the Spleen meridian, leading to pain. Initially, attacks occur every few days; later, they occur every one or two days, or daily. During an attack, the face appears cyan and pale, clear fluid is vomited, and the patient desires manual pressure or objects pressed against the abdomen for slight relief. The suitable prescription uses 8 liang of Cottonseed Kernel (Mianziren) stir-fried until smoke ceases, added with 1 liang of stir-fried Zhike (Bitter Orange) and 1 liang of stir-fried Wuyao (Lindera Root), and 5 qian of raw-ground Muxiang (Aucklandia Root). Form into pills with Shenqu (Medicated Leaven) paste, and take on an empty stomach with light ginger soup. Within several days, white matter should be expelled, leading to gradual recovery.