治婴孩小儿食伤生冷粘腻热毒等物脾胃积滞久不克化令儿肚热脚冷痞癖寒热及疗 瘕中
脘不和膨胀上膈气壅心腹不得宣通所以作疾此药温良但是诸积滞食不化并宜与服三棱煎丸方
京三棱 蓬莪术（并炮各半两） 羌花（一分） 鳖甲（去裙米醋炙令焦半两） 淡豆豉（二
两重） 巴豆（二十一粒去壳） 川当归（半两） 杏仁（去皮尖一分令炒赤）
上前六味一处以米醋一碗煮令干仍就炒起更细截焙为末次入当归末又入杏仁巴淡豆和匀
水煮面糊为丸麻子大每服二十丸生姜汤下大小加减服之
议曰此方亦名消痞丸又名化积丸其药破气行血和脾开胃应痞癖 瘕诸积气滞并皆疗之噫
调理
婴孩之法预究脾胃之源脾胃者乃饮食之脏腑也古云人无根株饮食为命然饮食之物有所宜则谷
气消血脉匀则肌肤壮精神爽有所不利则肠胃虚肢体瘦面目黄疾病作是以药固脏腑其胃气和即
谷食自然留之其脾胃壮即谷食自然磨之若饮食迟化即气弱饮食不化即气虚小儿服此初安脏腑
次益肌肤三焦既顺百脉俱调效验至良医痞第一
议曰此一症候儿在胞胎中无恙只由初生七日内有患触受而成急如水火其作延久渐见加重
以至肚上青筋撮口不乳其候甚速得名胀急其
儿感
乱者速便下药以通为度方通便安功效至圣无可疑者儿已获安吻乳如法渐次气肚肉重欢悦可爱
宜服真珠天麻丸（方在前急惊证内）
治疗婴幼儿因食用生冷、粘腻或热毒等食物，导致脾胃积滞，长期无法消化，从而引起腹部发热、脚部发冷、痞块癖气、寒热往来，以及治疗腹中瘕聚（腹内结块）、脘腹不和、腹胀膨胀、上膈气机壅塞、心腹之气不得宣通而引发的疾病。此药性温良，凡是各种积滞食积不化者，均适宜服用三棱煎丸方。
【处方】
京三棱、蓬莪术（均炮制，各半两）、羌花（一分）、鳖甲（去除裙边，用米醋炙至焦黄，半两）、淡豆豉（二两重）、巴豆（二十一粒，去壳）、川当归（半两）、杏仁（去皮尖，一分，炒至赤色）。
【制法与用法】
将前六味药材放在一起，用一碗米醋煮至药液干涸，随即取出炒干，再细细切碎焙干研为细末。接着加入当归末，再加入杏仁、巴豆和淡豆豉，混合均匀。用水煮面糊作为粘合剂，制成如麻子大小的丸剂。每次服用二十丸，用生姜汤送服，根据患儿年龄大小酌情加减剂量。
曾世荣评议说：此方又名消痞丸，又名化积丸。其药物具有破气行血、调和脾胃、开胃的功效，对于痞块、癖气、瘕聚等各种积气和气滞病症均有疗效。
【调理论述】
调理婴幼儿的方法，在于预先探究脾胃的根源。脾胃是受纳饮食的脏腑。古人云：“人若无根株，饮食即为生命。”然而，饮食之物若适宜，则谷气得以消化，血脉调和，肌肤壮实，精神清爽；若饮食不适宜，则肠胃虚弱，肢体消瘦，面目发黄，疾病发作。因此，用药固护脏腑，使胃气调和，则谷物食物自然能够留存；使脾胃强壮，则谷物食物自然能够磨化。如果饮食消化迟缓，说明气弱；饮食不化，说明气虚。小儿服用此药后，首先安固脏腑，其次滋养肌肤，三焦既已顺畅，百脉俱调，疗效极佳，堪称医治痞证的第一妙方。
【胀急症候评议】
曾世荣评议说：这一症候，婴儿在母胎中本是健康的，只因为出生后的七天内受到外邪触动而致病，病情急迫如同水火之急。随着时间推移，症状逐渐加重，直至出现肚上青筋暴露、撮口（口唇紧缩）、不能吸乳等症状，病势发展迅速，故得名“胀急”。
【乱证处理】
若婴儿感受邪气导致神志昏乱，应迅速给予下药，以通便为度。大便通畅则身体安宁，功效显著，确属至圣之法，无可怀疑。婴儿获得安宁后，若能按法吮乳，则气顺、肚子变软、肌肉渐丰，变得欢快可爱。此时适宜服用真珠天麻丸（方剂见前文急惊风证章节）。
To treat infants and young children who have suffered from food injury due to consuming cold, raw, sticky, greasy, or heat-toxic substances. This leads to accumulation and stagnation in the Spleen and Stomach, which fail to digest over a long period. Symptoms include abdominal heat with cold feet, fixed masses (Pipi), alternating chills and fever, as well as treating abdominal Jia masses (abdominal lumps), disharmony of the epigastrium, abdominal distension and swelling, Qi congestion in the upper diaphragm, and obstruction of Qi in the heart and abdomen, thereby causing disease. This medicine is warm and mild; it is suitable for all cases of accumulated stagnation and undigested food. The formula for Sanleng Jian Wan is as follows:
[Formula]
Jingsanleng (Rhizoma Sparganii), Peng'ezhu (Rhizoma Curcumae) (both processed, each 0.5 liang), Qianghua (1 fen), Biejia (Tartaric Testudinis Carapax et Plastrum) (remove the skirt, roast with rice vinegar until charred, 0.5 liang), Dandouchi (Folium Sojae Praeparatum) (2 liang weight), Badou (Semen Crotonis) (21 grains, remove shell), Chuan Danggui (Radix Angelicae Sinensis) (0.5 liang), Xingren (Semen Armeniacae Amarum) (remove skin and tips, 1 fen, stir-fry until red).
[Preparation and Administration]
Place the first six herbs together and boil them in one bowl of rice vinegar until the liquid is dry. Then stir-fry them until dry, finely cut, bake, and grind into powder. Next, add the powdered Danggui, followed by Xingren, Badou, and Dandouchi, mixing evenly. Use water-boiled wheat paste as a binder to form pills the size of hemp seeds. Administer 20 pills per dose, taken down with Ginger Decoction (Shengjiang Tang). Adjust the dosage according to the child's age and condition.
Zeng Shirong commented: This formula is also known as Xiaopi Wan (Mass-Dispersing Pill) and Huaji Wan (Accumulation-Dissolving Pill). Its ingredients break Qi stagnation, promote blood circulation, harmonize the Spleen, and open the stomach. It treats various conditions involving Pi masses, Pipi, Jia accumulations, Qi stagnation, and food retention.
[Dietary Regulation Discussion]
The method for regulating infants lies in investigating the root of the Spleen and Stomach beforehand. The Spleen and Stomach are the Zang-Fu organs responsible for receiving and digesting food. As the ancients said, "If humans lack roots, food becomes their life." However, if dietary items are appropriate, Gu Qi (Grain Qi) is digested, blood vessels are harmonious, muscles and skin are strong, and spirit is refreshed. If dietary items are inappropriate, the intestines and stomach become deficient, limbs emaciate, face and eyes turn yellow, and diseases arise. Therefore, using medicine to consolidate the Zang-Fu organs harmonizes Stomach Qi, allowing grain and food to be retained naturally; strengthening the Spleen and Stomach allows grain and food to be ground and digested naturally. If digestion of food is slow, it indicates weak Qi; if food does not digest, it indicates Qi deficiency. After infants take this medicine, the Zang-Fu organs are first stabilized, then muscles and skin are nourished. Once the Triple Burner (Sanjiao) is smooth, all meridians are regulated. The curative effect is excellent, making it the premier prescription for treating Pi disorders.
[Commentary on Distension Emergency Syndrome]
Zeng Shirong commented: In this syndrome, the infant was healthy in the womb. The illness arises only from external pathogenic invasion within the first seven days after birth, progressing rapidly like fire or water. As time passes, symptoms gradually worsen, leading to visible green veins on the abdomen, mouth closure (Cuokou), and inability to suckle. The progression is rapid, hence the name "Distension Emergency" (Zhangji).
[Management of Chaotic Syndrome]
If the infant suffers from chaotic symptoms due to pathogenic infection, administer purgative medicines promptly, aiming for bowel evacuation as the goal. Once the bowels are unblocked, the body calms, demonstrating significant efficacy. This is a supreme method, beyond doubt. Once the infant is calm and able to suckle properly, Qi will flow smoothly, the abdomen will soften, flesh will increase, and the child will become joyful and lovable. At this stage, it is appropriate to administer Zhenzhu Tianma Wan (Pearl and Gastrodia Pill) (formula found in the preceding section on Acute Convulsion Syndrome).