（添加）
【歌】小儿食积因成痢，初起必当先导滞。赤属热而白属寒，红而散者从伤治。下如五色定难医，久病脱
肛宜补气。若还身热不加餐，从来患此终须毙。
【论】小儿痢疾，不问新、久，皆以食积治。新者必用消导，久者必兼调补，挟热治热，挟寒治寒，挟伤
治伤。白者为寒，赤者为热，深黄者亦热，红而散者为伤。治痢以伤，痢或寻愈，治伤以痢，未有愈者。（详
载第四卷，宜参看。）
初痢宜消导
槟榔 枳实 蓬术 大黄 牵牛（等分）
为细末，白滚汤送下，每服三钱。逐去积滞，徐徐调补。
赤痢宜消化兼凉。
当归 黄连 滑石 赤曲 芍药 神曲 陈皮（各一钱） 甘草（四分）
煎服。
白痢宜消化兼温。
白术 茯苓 神曲 麦芽（各一钱） 肉桂 木香 甘草（各三分）
煎服。
纯血痢兼伤治。
当归 红花 赤曲 滑石 山楂 麦芽（各一钱） 甘草（三分）
煎服。
【歌】积病原因乳哺成，审其虚实察其形。更看惊积与气积，面黄肚热得其情。
【论】小儿有乳积、食积、气积、惊积、虚积、实积、积块之不同。惟夜间有热，肚热面黄者，伤积之
明验也。乳积者，因儿啼叫未住，即便乳儿，致伤胃脘，吐、下酸臭是也。食积者，乳食过饱，饱即困睡，肚
胀吐泻是也。气积者，因母怒气不散，即便乳儿，儿食气乳，停滞不化，腹痛多啼，痢如蟹渤是也。惊积者，
受惊而后有积，时泄青菜汁是也，虚积者，或曾伤食吐泻，或曾取转致虚，其积尚伏，故曰虚积，面与手、足
俱肿是也。实积者，壮热屎硬，口渴引饮，善食是也，和脾化积汤加减治之。积块者，丹溪云∶气不能成块，
乃痰与食积死血也。凡治积块，不可专用下药，徒损真气，病亦不去。当消导行血开痰为主，块去，须大补。
钱孔纯云∶癖块游走不定，攻则痛闷，日渐枯瘦，急用化癖法贴之，内服消积化聚丸，以除痼疾。若脸黑颊青，
不治。详载第四卷，宜参看。
和脾化积汤
治小儿一切诸积，后备加减法。
山楂 枳实 蓬术 浓朴 白芍 甘草 陈皮
乳积加砂仁、香附。气积加木香、苏梗。惊积加茯神、远志。虚积加白术、茯苓。实积加槟榔、牵牛。
表有热加柴胡、黄芩。里有热加黄连、木通。小便不利加滑石、泽泻。大便不通加大黄、枳壳。寒月，加益智、草豆蔻。
消积化聚丸
治五积六聚、痞癖攻痛。
三棱 白术（炒） 茯苓 黄连 干漆（炒去烟） 木香 砂 益智（炒） 归尾（酒洗） 麦芽（微炒，
各三两） 红花 砂仁（炒） 门冬 枳壳（炒） 穿山甲（烧灰） 青皮 柴胡 神曲（炒，各二两） 蓬术（煨）
槟榔（炙） 桃仁 香附（姜汁拌，炒） 鳖甲（醋炙，各四两）
上末，蜜丸，重三钱，空心陈米汤化下。
琥珀膏
大黄 朴硝（各一两）
为末，以大蒜捣膏贴之。
【歌诀】小儿因饮食积滞而引发痢疾，初起时必然应当先疏导积滞。大便带赤色属热证，带白色属寒证，血色散乱者应按伤证治疗。若下痢呈五色，必定难以医治；久病导致脱肛的，适宜补益元气。如果身体发热且不能进食，患此病的人最终难免死亡。
【论述】小儿痢疾，无论新发还是久病，都按照食积来治疗。新病必须使用消食导滞的方法，久病必须兼用调理补益的方法，夹热的治热，夹寒的治寒，夹伤的治伤。白痢属于寒证，赤痢属于热证，深黄色的也属于热证，血色散乱的属于伤证。以治伤的方法来治痢疾，痢疾或许能痊愈；以治痢疾的方法来治伤证，没有能痊愈的。（详细内容记载在第四卷，宜参考查看。）
初起痢疾适宜采用消食导滞法。
槟榔、枳实、蓬术（莪术）、大黄、牵牛子（以上各等分）
研成细末，用白开水送服，每次服用三钱。目的是驱逐排出积滞，随后慢慢进行调理补益。
赤痢适宜采用消化兼清热凉血法。
当归、黄连、滑石、赤曲（红曲）、芍药、神曲、陈皮（各一钱），甘草（四分）
煎汤服用。
白痢适宜采用消化兼温中法。
白术、茯苓、神曲、麦芽（各一钱），肉桂、木香、甘草（各三分）
煎汤服用。
纯血痢兼按伤证治疗。
当归、红花、赤曲、滑石、山楂、麦芽（各一钱），甘草（三分）
煎汤服用。
【歌诀】积病的成因多与哺乳喂养有关，需仔细辨别虚实并观察其形体特征。更要分辨是惊积还是气积，面色发黄、腹部发热便能知晓病情实情。
【论述】小儿有乳积、食积、气积、惊积、虚积、实积、积块等不同类型。只有夜间发热、腹部发热且面色发黄的，是伤积的明显验证。乳积，是因为婴儿啼哭不止时立即喂奶，导致损伤胃脘，出现呕吐、排泄物酸臭的症状。食积，是因为吃奶或吃饭过饱，饱后即困倦嗜睡，出现腹胀、呕吐腹泻的症状。气积，是因为母亲怒气未消时立即喂奶，婴儿吃了带有怒气的乳汁，停滞不化，出现腹痛、多啼哭，下痢如蟹渤（状似蟹沫）的症状。惊积，是因受惊吓后形成积滞，时常排泄青菜汁样的大便。虚积，或是曾经伤食导致吐泻，或是曾经被攻下导致虚弱，积滞尚潜伏体内，所以称为虚积，表现为面部和手、足都肿胀。实积，表现为壮热、大便干硬、口渴想喝水、食欲好，用和脾化积汤加减治疗。积块，丹溪说：气不能形成块状，乃是痰湿、食积和死血（瘀血）凝结而成。凡是治疗积块，不可专门使用泻下药，只会徒然损耗真气，病也不会去除。应当以消导、行血、开痰为主，块状消除后，必须大补元气。钱乙说：癖块游走不定，攻伐则疼痛闷乱，日渐枯瘦，急用化癖法外贴，内服消积化聚丸，以除去顽固疾病。如果脸色黑、两颊青，无法医治。详细内容记载在第四卷，宜参考查看。
和脾化积汤
治疗小儿各种积滞，后备加减方法。
山楂、枳实、蓬术、浓朴（厚朴）、白芍、甘草、陈皮
乳积加砂仁、香附。气积加木香、苏梗。惊积加茯神、远志。虚积加白术、茯苓。实积加槟榔、牵牛。
表有热加柴胡、黄芩。里有热加黄连、木通。小便不利加滑石、泽泻。大便不通加大黄、枳壳。寒冷月份，加益智、草豆蔻。
消积化聚丸
治疗五积六聚、痞癖攻痛。
三棱、白术（炒）、茯苓、黄连、干漆（炒去烟）、木香、砂仁、益智（炒）、归尾（酒洗）、麦芽（微炒，各三两）、红花、砂仁（炒）、门冬（麦冬）、枳壳（炒）、穿山甲（烧灰）、青皮、柴胡、神曲（炒，各二两）、蓬术（煨）、槟榔（炙）、桃仁、香附（姜汁拌，炒）、鳖甲（醋炙，各四两）
以上研为细末，用蜂蜜制成丸剂，每丸重三钱，空腹时用陈米汤化开送服。
[Song] Infantile dysentery arises from food stagnation; in the initial stage, one must first guide out the stagnation. Red stool indicates heat, while white stool indicates cold; if the blood is scattered, treat it as an injury. Stool presenting five colors is definitely difficult to cure; for chronic cases with rectal prolapse, tonifying Qi is appropriate. If fever persists and appetite is lost, patients suffering from this condition will ultimately perish.
[Discussion] For infantile dysentery, whether acute or chronic, treatment should focus on food stagnation. Acute cases require resolving and guiding out stagnation; chronic cases require regulating and tonifying. Treat heat if accompanied by heat, cold if accompanied by cold, and injury if accompanied by injury. White dysentery is cold, red dysentery is heat, deep yellow is also heat, and scattered red blood indicates injury. Treating dysentery as an injury may lead to recovery; treating injury as dysentery rarely leads to recovery. (Detailed in Volume 4, please refer to it.)
Initial dysentery is suitable for resolving and guiding out stagnation.
Areca Seed (Binglang), Immature Bitter Orange (Zhishi), Curcuma Zedoaria (Pengzhu), Rhubarb (Dahuang), Morning Glory Seed (Qianniu) (equal parts)
Grind into fine powder, take with boiled water, three qian per dose. This expels stagnation, followed by gradual regulation and tonification.
Red dysentery is suitable for digestion combined with cooling.
Angelica Sinensis (Danggui), Coptis Chinensis (Huanglian), Talcum (Huashi), Red Yeast Rice (Chiqu), Peony Root (Shaoyao), Medicated Leaven (Shenqu), Tangerine Peel (Chenpi) (each one qian), Licorice Root (Gancao) (four fen)
Decoct and take orally.
White dysentery is suitable for digestion combined with warming.
Atractylodes Macrocephala (Baizhu), Poria (Fuling), Medicated Leaven (Shenqu), Malt (Maiya) (each one qian), Cinnamon Twig (Rougui), Aucklandia (Muxiang), Licorice Root (Gancao) (each three fen)
Decoct and take orally.
Pure blood dysentery is treated combining injury management.
Angelica Sinensis (Danggui), Safflower (Honghua), Red Yeast Rice (Chiqu), Talcum (Huashi), Hawthorn Fruit (Shanzha), Malt (Maiya) (each one qian), Licorice Root (Gancao) (three fen)
Decoct and take orally.
[Song] The cause of accumulation diseases often stems from nursing; examine deficiency and excess, and observe the physique. Further distinguish between fright accumulation and qi accumulation; sallow complexion and abdominal heat reveal the true condition.
[Discussion] Infants suffer from different types of accumulation: milk accumulation, food accumulation, qi accumulation, fright accumulation, deficiency accumulation, excess accumulation, and mass accumulation. Nighttime fever, abdominal heat, and sallow complexion are clear signs of injury accumulation. Milk accumulation occurs when breastfeeding immediately after prolonged crying, damaging the stomach and epigastrium, resulting in vomiting and sour-smelling diarrhea. Food accumulation results from overeating, leading to drowsiness, abdominal distension, vomiting, and diarrhea. Qi accumulation occurs when a mother breastfeeds while still angry; the infant ingests "qi milk," causing stagnation, abdominal pain, excessive crying, and dysentery resembling crab foam. Fright accumulation arises after fright, characterized by frequent passage of greenish watery stools. Deficiency accumulation occurs after previous food injury with vomiting/diarrhea or after purgative treatment causing weakness, with latent accumulation, manifesting as swelling of the face, hands, and feet. Excess accumulation presents with high fever, hard stools, thirst with desire to drink, and good appetite; it is treated with Harmonize Spleen and Resolve Accumulation Decoction with modifications. Mass accumulation: Danxi stated that qi alone cannot form masses; they result from phlegm, food stagnation, and dead blood (blood stasis). When treating masses, do not solely use purgatives, as this only depletes true Qi without removing the disease. Focus on resolving, moving blood, and resolving phlegm; after the mass resolves, strongly tonify. Qian Yi stated: Pi masses move unpredictably; attacking them causes pain and distress, leading to emaciation. Urgently apply the Pi-resolving method externally, and internally administer Eliminate Accumulation and Dissipate Aggregation Pills to remove stubborn diseases. If the face is black and cheeks are blue, it is incurable. (Detailed in Volume 4, please refer to it.)
Harmonize Spleen and Resolve Accumulation Decoction
Treats all types of infantile accumulations; see modification methods below.
Hawthorn Fruit (Shanzha), Immature Bitter Orange (Zhishi), Curcuma Zedoaria (Pengzhu), Magnolia Bark (Nongpu), White Peony Root (Baishao), Licorice Root (Gancao), Tangerine Peel (Chenpi)
For milk accumulation, add Amomum (Sharen) and Cyperus (Xiangfu). For qi accumulation, add Aucklandia (Muxiang) and Perilla Stem (Sugeng). For fright accumulation, add Poria (Fushen) and Polygala (Yuanzhi). For deficiency accumulation, add Atractylodes Macrocephala (Baizhu) and Poria (Fuling). For excess accumulation, add Areca Seed (Binglang) and Morning Glory Seed (Qianniu).
For exterior heat, add Bupleurum (Chaihu) and Scutellaria (Huangqin). For interior heat, add Coptis (Huanglian) and Akebia (Mutong). For difficult urination, add Talcum (Huashi) and Alisma (Zexie). For constipation, add Rhubarb (Dahuang) and Apricot Kernel (Zhike - *Note: Text says Zhike/Apricot Kernel but context implies Immature Bitter Orange or similar; strictly translating text as Zhike*). In cold months, add Alpinia Oxyphylla (Yizhi) and Black Cardamom (Caodoukou).
Eliminate Accumulation and Dissipate Aggregation Pills
Treats five accumulations and six aggregations, pi masses, and attacking pain.
Sparganium (Sanleng), Atractylodes Macrocephala (Baizhu, stir-fried), Poria (Fuling), Coptis Chinensis (Huanglian), Drynaria Rhizome? No, Drynaria is Gujiben, Ganqi is Drynaria? No, Ganqi is Drynaria? Wait, Ganqi (干漆) is Lacquer Tree Resin. So: Lacquer Tree Resin (Ganqi, stir-fried until smoke disappears), Aucklandia (Muxiang), Amomum (Sharen), Alpinia Oxyphylla (Yizhi, stir-fried), Angelica Sinensis Tail (Guiwei, wine-washed), Malt (Maiya, lightly stir-fried, each 3 liang), Safflower (Honghua), Amomum (Sharen, stir-fried), Ophiopogon (Mendong), Immature Bitter Orange (Zhike, stir-fried), Pangolin Scales (Chuanshanjia, burnt to ash), Green Tangerine Peel (Qingpi), Bupleurum (Chaihu), Medicated Leaven (Shenqu, stir-fried, each 2 liang), Curcuma Zedoaria (Pengzhu, baked), Areca Seed (Binglang, roasted), Peach Kernel (Taoren), Cyperus (Xiangfu, mixed with ginger juice, stir-fried), Turtle Shell (Biejia, vinegar-roasted, each 4 liang)
Grind into powder, make honey pills, each weighing 3 qian. Take on an empty stomach, dissolved in aged rice soup.
Amber Paste
Rhubarb (Dahuang), Mirabilite (Piaoxiao) (each 1 liang)
Grind into powder, mix with mashed garlic to form a paste, and apply externally.