经曰∶新积痛可移者易已，积不痛者难已也。又曰∶胃之大络，名曰虚里。贯膈络肺，出于左乳下，其动应
衣，脉宗气也。结而横，有积矣。陈飞霞曰∶凡饮食之积，其渐积者，不
过以饮食偶伤，必在肠胃之内，故可行可逐治无难也。惟饮食无节，以渐留滞者，多成癖积于左胁膈膜之间，此
阳明宗气所出之道也。若饥饱无论，饮食叠进，以致阳明胃气一有所逆，则阴寒之气得以乘之，而脾不及化，故
余滞未消，并肠外汁沫，抟聚不散，渐成症结矣。然其初起甚微，人多不觉，及其既久，则其根深蒂固，而药饵
难及。今西北小儿多有此疾，而尤以食面之乡为最。正以面性多滞，而留积于皮里膜外，所以不易治也。惟当以
渐消磨，求法治之。幸毋孟浪欲速，妄行攻击，徒致胃气受伤，而积仍未去，以速其危也。
癖者，血膜化水则癖，胁傍时时作病，时热，潮热，或寒热往来似疟，故疟家多有此症。凡疟疾发过之后，
必令其热退极尽，方可饮食。若热未尽而饮食之，则脘中多蓄黄水，日久而成癖积。小儿脏腑和平，脾胃壮实，
则荣卫宣畅，津液流通，纵使多食生浆，不能为病。惟脾胃不胜，乳哺不调，三焦不运，水饮停滞，冷气抟之，
结聚而成癖也。体素弱者，消癖丸；气壮实者，赭石挨癖丸。大约有癖之儿，虚者居多。攻下之药，非可常
用。即不得已而用之，待其略减，用消癖丸缓缓消之。至为良法。
涂蔚生曰∶其动应衣，脉宗气也之衣字，恐系误，待考。又衣字似当作为乎字。
《集成》消癖丸 治癖在胁下，面黄肌瘦，午后发热似疟用之。
人参 白术 陈皮 茯苓 青皮 川朴 枳实 半夏 砂仁 神曲 麦芽 鳖甲（九肋者） 三棱 莪术
广木香 肉桂 炮姜 黄连（姜汁炒）
上为细末，米糊为丸，每服一二钱，量儿大小加减。米汤
下，以癖消药止。
涂蔚生曰∶消癖丸内，有砂仁、神曲、炮姜、肉桂诸热药，必须其癖积，由于寒凝而来者，方为合法。若为
因热而结之癖积，则又须易去其热药，而为知柏芩连之寒药，方能取效也。总之积热宜乎寒下，寒积宜乎热下，
而加以固本之药耳。
《集成》赭石挨癖丸 治腹中癖块，或生寒热，或时作痛，小儿壮实，饮食素强者，方宜用之；脾胃素
虚者，切不可服，惟以前药攻补兼施，久之自愈。
代赭石（火煨醋淬至酥，研末水飞过用） 青皮（醋炒） 莪术 广木香 肉桂（各三钱） 巴豆霜（去油极
净取霜，一钱） 大黄（二钱）
上为细末，醋煮面糊为丸萝卜子大。每服五丸，淡姜汤送下。
《黄帝内经》中说：新形成的积块，疼痛位置可以移动的，容易治愈；积块不痛的，难以治愈。又说：胃的大络，名叫虚里。它贯穿膈肌，联络肺脏，出于左侧乳下，搏动时能震动衣服，这是宗脉之气（反映宗气的盛衰）。如果搏动结聚而横向扩张，说明体内有积块。陈飞霞说：凡是饮食停滞形成的积块，其逐渐积累的过程，不过是因为饮食偶尔受伤所致，必然在肠胃之内，所以可以用行气导滞或攻逐的方法治疗，并不困难。只有那些饮食没有节制，逐渐留滞的，多形成癖积在左胁膈膜之间，这里是阳明经宗气运行的通道。如果饥饱不论，饮食连续进用，导致阳明胃气一旦上逆，阴寒之气就能趁机侵袭，而脾脏来不及运化，所以剩余的停滞物未能消除，并与肠外的津液汁沫结合，凝聚不散，逐渐形成症结。然而这种病初起时非常轻微，人们大多没有察觉，等到时间久了，就根深蒂固，药物很难到达。现在西北地区的儿童多有此病，尤其是以吃面食为主的地区最为严重。正是因为面食的性质多滞涩，且留积在皮里膜外，所以不容易治疗。只应当逐渐消磨，寻求方法治疗。幸好不要鲁莽求快，妄用攻伐攻击的药物，徒然损伤胃气，而积块仍未去除，反而加速了危险。
所谓“癖”，是指血膜化为水饮则成癖，胁肋旁时常疼痛，有时发热，潮热，或者寒热往来像疟疾一样，所以患疟疾的人多有这种症状。凡是疟疾发作过后，必须等热度完全退尽，才可以进食。如果在热度未尽时进食，胃脘中就会蓄积黄水，日久天长就形成癖积。小儿脏腑平和，脾胃壮实，那么营卫宣通畅达，津液流通，即使多吃生冷的浆液食物，也不能致病。只有脾胃不胜任，乳食喂养不调，三焦运行不畅，水饮停滞，冷气凝聚，结聚而成癖积。体质素来虚弱者，服用消癖丸；气力壮实者，服用赭石挨癖丸。大概患有癖积的儿童，虚证居多。攻下的药物，不可以常用。即使不得已而使用，也要等到积块略微减轻后，再用消癖丸缓缓消散。这是很好的方法。
涂蔚生说：“其动应衣，脉宗气也”中的“衣”字，恐怕是误字，有待考证。另外，“衣”字似乎应当作为“乎”字。
《集成》消癖丸：治疗癖积在胁下，面色发黄肌肉消瘦，午后发热像疟疾一样的情况时使用。
人参、白术、陈皮、茯苓、青皮、厚朴、枳实、半夏、砂仁、神曲、麦芽、鳖甲（九肋的）、三棱、莪术、广木香、肉桂、炮姜、黄连（用姜汁炒）
以上药材研为细末，用米糊做成丸药，每次服用一二钱，根据儿童大小增减剂量。用米汤送服，直到癖积消除停药。
涂蔚生说：消癖丸内含有砂仁、神曲、炮姜、肉桂等热性药物，必须是因寒凝导致的癖积，才符合治法。如果是因热邪凝结而成的癖积，就必须去掉这些热药，改用知母、黄柏、黄芩、黄连等寒性药物，才能取得疗效。总之，积热适宜用寒下药，寒积适宜用热下药，并且要加上固本培元的药物。
《集成》赭石挨癖丸：治疗腹中的癖块，或者产生寒热，或者时常疼痛，小儿体质壮实，平时饮食强健的，才适宜使用；脾胃素来虚弱的，千万不可服用，只能用前面的药物攻补兼施，久而久之自然痊愈。
代赭石（用火煨烧，醋淬至酥脆，研末，用水飞法处理）、青皮（醋炒）、莪术、广木香、肉桂（各三钱）、巴豆霜（去油极净取霜，一钱）、大黄（二钱）
以上药材研为细末，用醋煮面糊做成如萝卜子大小的丸药。每次服用五丸，用淡姜汤送下。
The *Huangdi Neijing* (Yellow Emperor's Inner Canon) states: New accumulations that are painful and movable are easy to cure; accumulations that are painless are difficult to cure. It also states: The great collateral of the Stomach is named Xuli (虚里). It penetrates the diaphragm, connects with the Lungs, and emerges below the left breast. Its pulsation can move the clothing, reflecting the Zongqi (宗气, Ancestral Qi). If the pulsation is knotted and horizontal, it indicates the presence of an accumulation. Chen Feixia stated: Regarding accumulations caused by food stagnation, those that accumulate gradually are merely due to occasional dietary injury and must be within the intestines and stomach; thus, they can be treated with methods to promote qi movement or purge, which is not difficult. However, those resulting from unregulated diet and gradual retention often form "Pi" (癖, a type of abdominal mass) between the left hypochondrium and the diaphragm, which is the pathway where the Zongqi of the Yangming meridian emerges. If one eats regardless of hunger or fullness, continuously consuming food, causing the Stomach Qi of Yangming to rebel upwards, Yin-Cold pathogenic factors can take advantage of this. Since the Spleen fails to transform them in time, the remaining stagnation does not dissipate, and combines with the fluid droplets outside the intestines, condensing and gathering without dispersing, gradually forming a fixed mass. However, when it first begins, it is very subtle, and most people do not notice it. After a long time, it becomes deeply rooted and firmly established, making it difficult for medicinal decoctions to reach it. Currently, children in the northwest often suffer from this disease, especially in regions where wheat noodles are the staple food. This is precisely because the nature of noodles is prone to stagnation, and they remain accumulated in the space between the skin and fascia, making them hard to treat. One should only gradually dissolve them and seek appropriate treatments. Fortunately, one must not act rashly or seek quick results, nor recklessly use attacking/purging drugs, which would merely injure the Stomach Qi without removing the accumulation, thereby hastening danger.
"Pǐ" refers to a condition where blood membranes transform into water retention. There is frequent pain in the hypochondriac region, sometimes fever, tidal fever, or alternating chills and fever resembling malaria; therefore, patients with malaria often have this symptom. After a malaria attack subsides, one must wait until the heat has completely dissipated before allowing food intake. If food is consumed while heat remains, yellow fluids will accumulate in the epigastrium, and over time, this forms Pi accumulation. Children with harmonious internal organs and strong Spleen and Stomach function have smooth Ying-Wei (营卫, Nutrient and Defensive Qi) circulation and free flow of body fluids. Even if they consume large amounts of raw/cold liquids, it will not cause disease. Only when the Spleen and Stomach are unable to bear the load, feeding is irregular, and the Sanjiao (三焦, Triple Burner) fails to transport, leading to water-fluid retention and condensation by cold qi, does a Pi accumulation form. For those with constitutionally weak bodies, Xiao Pi Wan (消癖丸, Eliminate Pi Pill) is used; for those with robust qi and strength, Zhe Shi Ai Pi Wan (赭石挨癖丸, Hematite Pi-Attacking Pill) is used. Generally, children with Pi accumulation are mostly deficient. Purging medicines should not be used frequently. Even if used out of necessity, one should wait until the accumulation is slightly reduced, then use Xiao Pi Wan to slowly dissolve it. This is an excellent method.
Tu Weisheng stated: In the phrase "Its pulsation can move the clothing, reflecting the Zongqi," the character "Yi" (clothing) is likely an error and awaits verification. Furthermore, "Yi" might be intended as "Hu" (particle).
*Jicheng* Xiao Pi Wan (Eliminate Pi Pill): Treats Pi located under the hypochondrium, presenting with sallow complexion, emaciation, and afternoon fever resembling malaria.
Ren Shen (Ginseng Radix et Rhizoma), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Chen Pi (Citri Reticulatae Pericarpium), Fu Ling (Poria), Qing Pi (Citri Reticulatae Pericarpium Viride), Chuan Po (Magnoliae Officinalis Cortex), Zhi Shi (Aurantii Fructus Immaturus), Ban Xia (Pinelliae Rhizoma Praeparatum), Sha Ren (Amomi Fructus), Shen Qu (Massa Medicata Fermentata), Mai Ya (Hordei Fructus Germinatus), Bie Jia (Testudinis Carapax et Plastrum - nine-ribbed variety preferred), San Leng (Sparganii Rhizoma), E Zhu (Curcumae Rhizoma), Guang Mu Xiang (Aucklandiae Radix), Rou Gui (Cinnamomi Cortex), Pao Jiang (Zingiberis Rhizoma Preparatum), Huang Lian (Coptidis Rhizoma - stir-fried with ginger juice).
Grind all ingredients into fine powder, mix with rice paste to form pills. Take 1-2 qian per dose, adjusting according to the child's age and size. Administer with rice soup, stopping when the Pi is eliminated.
Tu Weisheng noted: Xiao Pi Wan contains hot herbs such as Sha Ren, Shen Qu, Pao Jiang, and Rou Gui. It is legally indicated only for Pi caused by cold coagulation. If the Pi is formed due to heat, these hot herbs must be removed and replaced with cold herbs like Zhi Mu (Anemarrhenae Rhizoma), Bai Hu (Phellodendri Cortex), Huang Qin (Scutellariae Radix), and Huang Lian to achieve efficacy. In summary, heat accumulations require cold purgatives, cold accumulations require hot purgatives, combined with tonifying herbs to secure the root.
*Jicheng* Zhe Shi Ai Pi Wan (Hematite Pi-Attacking Pill): Treats Pi masses in the abdomen, accompanied by alternating chills and fever or intermittent pain. It is suitable for children who are physically robust and have strong appetites. It must absolutely not be taken by those with constitutionally weak Spleen and Stomach. Instead, use the previous formula combining attack and tonification; with prolonged use, it will heal itself.
Zhe Shi (Hematitum - calcined in fire, quenched in vinegar until brittle, ground to powder, and processed via water flotation), Qing Pi (Citri Reticulatae Pericarpium Viride - stir-fried with vinegar), E Zhu (Curcumae Rhizoma), Guang Mu Xiang (Aucklandiae Radix), Rou Gui (Cinnamomi Cortex) (each 3 qian), Ba Dou Shuang (Crotonis Fructus Frost - oil removed thoroughly, 1 qian), Da Huang (Rhei Radix et Rhizoma) (2 qian).
Grind all ingredients into fine powder, boil wheat paste with vinegar to form pills the size of radish seeds. Take 5 pills per dose, administered with light ginger soup.