〔薛〕小儿食积者，因脾胃虚寒，乳食不化，久而成积，其证至夜发热，天明复
凉，腹痛膨胀，呕吐吞酸，足冷肚热，喜睡神昏，大便酸臭是也。有前证而兼寒热
者，名曰食积寒热，若食在胃之上口者吐之，胃之下口者消之，腹痛痞胀，按之益痛
者下之，下后仍痛按之则止者补之。夹食伤寒者，先散之用参苏饮。热甚便秘者，
先利之用大柴胡汤。如无外感，但只伤食，不至于甚，保和丸调之。盖脾为至阴之
脏也，故凡脾病者，至夜必热，热而兼寒，则又见所胜者侮所不胜矣。食未消者，
消之则寒热自止。食既消者，补之则寒热自痊。若手足并冷喜热饮食，此中州虚寒
也，宜温之。大便欲去不去，脾气下陷也，宜升之。若夜间或侵晨泄泻者，脾肾俱
虚也，用四神丸（泻）。手足并热作渴饮水者，脾胃实热也，用泻黄散（脾）。大便秘结用
大柴胡汤（潮热）。手足虽热，口不作渴、大便不实者，用白术散（渴）。仍参腹痛腹胀，积
痛积滞治之。
〔曾〕有食饱伤脾，脾气稍虚，物难消化，留而成积，积败为痢，腹肚微痛，先
调胃气，次理积，却止痢，则病根自除。和中散（吐泻）理虚养胃。三棱散（见前）、乌犀丸（积）
助脾化积。沉香槟榔丸（积）、守中汤（泻）进食止痢。仍忌生冷粘腻等物，不致复作。
《千金》治小儿食不知饥饱方
用鼠屎二七枚，烧为末。服之。
【薛己】小儿出现食积，是因为脾胃虚寒，乳食无法消化，久而久之形成积滞。其症状表现为夜间发热，天亮后恢复凉爽，腹痛且腹部胀满，呕吐并伴有吞酸感，脚部发冷而肚腹发热，喜欢睡觉且精神昏沉，大便气味酸臭。如果有上述症状并兼有寒热交替的，称为“食积寒热”。如果食物停滞在胃的上口，应采用催吐法；如果食物停滞在胃的下口，应采用消导法；如果腹痛痞胀，按压时疼痛加剧的，应采用泻下法；如果泻下后仍然疼痛，但按压时疼痛缓解的，应采用补益法。如果是夹带饮食停滞的伤寒病，先用参苏饮来发散表邪。如果热势严重且大便秘结的，先用大柴胡汤来通利攻下。如果没有外感病邪，仅仅是伤食，且病情不严重的，用保和丸来调理。因为脾是至阴之脏，所以凡是脾病的人，到了夜晚必然发热。如果发热兼有恶寒，这是脾土受侮的表现（即所胜者侮所不胜）。食物未消化的，通过消导治疗，寒热症状自然停止；食物已经消化后的，通过补益治疗，寒热症状自然痊愈。如果手脚都发冷且喜欢热饮食，这是中焦脾胃虚寒，应当温补。如果大便想排却排不出，这是脾气下陷，应当升提。如果在夜间或清晨发生泄泻，这是脾肾两虚，使用四神丸。如果手脚都发热且口渴饮水，这是脾胃实热，使用泻黄散。大便秘结使用大柴胡汤。如果手脚虽然发热，但口不渴、大便不成形，使用白术散。同时还需参考腹痛腹胀的症状，按照积痛、积滞的方法治疗。
【曾氏】有因吃得太饱损伤脾气的情况，脾气稍微虚弱，食物难以消化，停留而形成积滞，积滞败坏进而导致痢疾，腹部轻微疼痛。此时应先调理胃气，其次处理积滞，最后止住痢疾，这样病根自然除去。使用中焦调和散治疗吐泻以调理虚损、养护胃气。使用三棱散、乌犀丸来辅助脾脏化解积滞。使用沉香槟榔丸、守中汤来促进进食并止住痢疾。同时忌食生冷、黏腻等食物，以免疾病复发。《千金方》治疗小儿不知饥饱的方子：用鼠屎十四枚，烧成粉末。服用即可。
[Xue Ji] When children suffer from food stagnation (Food Stagnation), it is due to deficiency-cold of the Spleen and Stomach, where milk and food fail to digest. Over time, this forms a mass. The symptoms include fever at night with cooling by dawn, abdominal pain and distension, vomiting with acid regurgitation, cold feet but a hot abdomen, a preference for sleep accompanied by mental confusion, and sour-smelling stools. If these symptoms are accompanied by alternating chills and fever, it is named "Food Stagnation with Chills and Fever" (Food Stagnation Chills-Fever). If food is lodged in the upper orifice of the stomach, induce vomiting; if lodged in the lower orifice, promote digestion; if there is abdominal pain and fullness that worsens upon pressure, apply purgation; if pain persists after purgation but subsides upon pressure, apply tonification. For Taiyang disease (Exterior Syndrome) complicated by food stagnation, first use Shen Su Yin (Ginseng and Perilla Decoction) to release the exterior. If heat is severe with constipation, first use Da Chai Hu Tang (Major Bupleurum Decoction) to purge and unblock. If there is no external pathogen, only food injury, and the condition is not severe, regulate with Bao He Wan (Preserve Harmony Pill). Since the Spleen is an organ of extreme Yin, patients with Spleen disease inevitably experience fever at night. If fever is accompanied by chills, it indicates that the conquered element insults the conqueror (a pathological interaction among the Five Elements). If food remains undigested, resolving it will stop the chills and fever; if food has already been digested, tonifying will cure the chills and fever. If both hands and feet are cold and the patient desires hot drinks, this is deficiency-cold of the Middle Jiao (Middle Burner); warm it. If there is a sensation of defecation without passage, this is sinking of Spleen Qi; raise it. If diarrhea occurs at night or early morning, this is deficiency of both Spleen and Kidney; use Si Shen Wan (Four Spirits Pill). If both hands and feet are hot with thirst and desire to drink, this is excess-heat of the Spleen and Stomach; use Xie Huang San (Drain the Yellow Powder). For dry stool constipation, use Da Chai Hu Tang. If hands and feet are hot but there is no thirst and stools are loose, use Bai Zhu San (Atractylodes Macrocephala Powder). Additionally, consider abdominal pain and distension, treating them according to methods for accumulation pain and stagnation.
[Zeng Shi] There are cases where overeating damages the Spleen, causing slight Spleen Qi deficiency, making food difficult to digest. It remains and forms stagnation, which deteriorates into dysentery (Dysentery), with mild abdominal pain. First, regulate the Stomach Qi, then resolve the stagnation, and finally stop the dysentery, so the root of the disease is eliminated. Use He Zhong San (Harmonize the Middle Powder) for vomiting and diarrhea to tonify deficiency and nourish the Stomach. Use San Leng San (Burreed Rhizome Powder) and Wu Xi Wan (Black Rhinoceros Horn Pill) to assist the Spleen in transforming stagnation. Use Chen Xiang Bing Lang Wan (Aquilaria and Areca Nut Pill) and Shou Zhong Tang (Maintain the Center Decoction) to promote appetite and stop dysentery. Avoid raw, cold, sticky, and greasy foods to prevent recurrence. *Qian Jin Fang* (Essential Prescriptions Worth a Thousand Gold) treats children who do not know hunger or satiety: Use fourteen rat feces pellets, burn them into powder, and administer.