小儿腹痛，口中气冷，不思饮食，脾土虚寒也，用调中丸主之。口中气温，大便酸臭，积痛
也，用下积丸治之。面赤壮热，或手足并热，实热也，用泻黄散泻之。面黄微热，或手足并
温，虚热也，用异功散补之。若作渴饮汤，胃气虚热也，用白术散。若痛连两胁，肝木乘脾
也，用四君子汤加柴胡、芍药。若腹痛重坠，脾气下陷也，用补中益气汤加升麻。若手足指
冷，或吃
逆泄泻，寒水侮土也，用六君、炮姜、肉桂；不效，急加附子。若服克滞之药，致腹作痛，
按之不痛，脾气复伤也，用五味异功散。中脘痛者，属脾。少腹痛者，属肾。按之痛者为积
滞；不痛者为里虚。积滞者消之；里虚者补之。
治验
一小儿停食腹痛，发热面赤，或用养胃汤、枳壳、黄连、山楂，反加腹胀，午后发热，按其
腹不痛，此脾虚而克伐伤之也。用六君子汤，数剂而瘥。
一小儿七岁，发热惊悸。用化痰药，反抽搐恶寒，吐痰喘嗽，腹痛少食，用抱龙丸，大便似
痢，寒热往来，殊类风症。余以为脾气复损。用四君子汤少加升麻、柴胡，治之月余而愈。
一小儿肚腹膨痛，食后即泻，手足逆冷，此脾气虚寒也，先用人参理中丸，后用六君子汤而
愈。
一小儿九岁，常患腹痛。至冬月因食生冷之物，其腹仍痛，服理中丸之类辄效。至十六岁，
秋初毕姻后，腹痛又作，唇面黯爪甲青，余先君用八味丸补火随愈；服四两许，痛不再作。
至二十岁，外痛复作，服前丸不应，乃服附子理中汤而止，仍用八味丸而安。
一小儿腹痛吐舌，流涎作渴，饮冷便秘，用清凉饮下之，顿安。余谓∶小儿元气，易虚易实
，病势稍安，不必再药。不信，自用三黄丸一服，果吐泻发搐。余用白术散加钩藤钩，补脾
平肝而愈。
四七气汤 治七气所伤，痰涎结聚，心腹作痛，不能饮食。
半夏（制焙，五两） 人参 辣桂（去皮。各一两） 甘草（半两）
上每服三钱，姜枣水煎。
指迷七气汤 治七情相干，阴阳不升降，气道壅滞，攻冲作痛。
青皮 陈皮 桔梗 蓬术 辣桂 益智仁（各一两） 香附子（一两半） 甘草（炙，三分） 半夏（制，
三分）
上每服三钱，姜枣水煎。
异功散 治小儿诸般病症，角弓反张，胸高脐凸。以透明没药为末，姜汤调下。（方见天钓，
即钱氏异功散）
桔梗枳壳汤 治气壅痞结，腹胁疼痛。
枳壳（炒） 桔梗（各二两） 甘草（炙，半两）
上每服二三钱，姜水煎。
七味白术散 治积痛，和胃气，生津液。（方见积痛）
愚按∶前方若脾胃气虚，作渴饮汤；或因吐泻，津液亏损，烦渴引饮；或脾胃虚弱，腹胀泻
渴，弄舌流涎，手足指冷，并宜服之，以温补脾气，化生津液。（方见积滞）
六君子汤 治脾胃气虚，吐泻不食，肌肉消瘦；或肺金虚，痰嗽喘促恶寒；或肝虚，惊搐眩
晕自汗诸症。并宜服此，以滋化源。（方见内钓）
泻黄散（方见脾脏）
四君子汤（方见内钓）
补中益气汤（方见虚羸）
八味丸（方见肾脏）
附子理中汤
人参理中丸（二方见冷泻，即理中汤）
益黄散（方见脾脏）
调中丸（方见脾胃虚冷）
小儿出现腹痛，口中呼出气息发冷，不想吃东西，这是脾土虚寒所致，应当用调中丸来主治。如果口中气息温热，大便气味酸臭，这是食积引起的疼痛，应当用下积丸来治疗。如果面色发红、高热，或者手脚都发热，这是实热证，应当用泻黄散来清泻热邪。如果面色发黄、微热，或者手脚温度温和，这是虚热证，应当用异功散来补益。如果出现口渴想喝热水，这是胃气虚导致的虚热，应当用白术散。如果腹痛牵连到两侧胁肋部，这是肝木克制脾土所致，应当用四君子汤加入柴胡、芍药。如果腹痛伴有沉重下坠感，这是脾气下陷所致，应当用补中益气汤加入升麻。如果手指脚趾发冷，或者出现呃逆、泄泻，这是寒水反侮脾土所致，应当用六君子汤加炮姜、肉桂；如果无效，紧急情况下加入附子。如果因为服用攻伐积滞的药物，导致腹部疼痛，但按压时不痛，这是脾气再次受损，应当用五味异功散。中脘穴部位疼痛的，病位在脾。少腹部位疼痛的，病位在肾。按压后疼痛加剧的是积滞；按压后不痛的属于里虚。对于积滞，采用消导法治疗；对于里虚，采用补益法治疗。
治验案例：
有一个小孩因停食导致腹痛，发热面赤，有人使用养胃汤、枳壳、黄连、山楂等药，反而加重了腹胀，午后发热，按压腹部并不痛，这是脾虚且被攻伐药物所伤所致。使用六君子汤，服用几剂后痊愈。
有一个七岁的小孩，发热并伴有惊悸。使用化痰药后，反而出现抽搐、恶寒，吐痰喘咳，腹痛食欲减退，使用抱龙丸后，大便似痢疾状，寒热往来，非常像风症。我认为这是脾气再次受损。使用四君子汤少量加入升麻、柴胡，治疗一个多月后痊愈。
有一个小孩肚腹膨大疼痛，吃完饭后就腹泻，手脚逆冷，这是脾气虚寒所致，先用理中丸，后用六君子汤而痊愈。
有一个九岁的小孩，经常患腹痛。到了冬天因为吃了生冷食物，腹部仍然疼痛，服用理中丸之类的药物往往有效。到了十六岁，秋天初婚之后，腹痛又发作，嘴唇面部颜色暗黑，指甲青紫，我的先父使用八味丸温补命门之火，随即痊愈；服用了大约四两，疼痛不再发作。到了二十岁，外感引发的疼痛再次发作，服用之前的药丸没有效果，于是服用附子理中汤才止住，随后仍用八味丸调理而安定。
有一个小孩腹痛伸舌，流口水且口渴，喜欢喝冷水但便秘，使用清凉饮攻下，顿时安宁。我说：小孩子的元气，容易变虚也容易变实，病情稍有好转，不必再用药。家长不信，自行给孩子服用三黄丸一剂，果然导致呕吐、腹泻和抽搐。我使用白术散加入钩藤，补脾平肝而痊愈。
四七气汤：治疗七情之气所伤，痰涎结聚，心腹作痛，不能饮食。
半夏（制焙，五两） 人参 辣桂（去皮。各一两） 甘草（半两）
以上药材每次服用三钱，用生姜、大枣煎水送服。
指迷七气汤：治疗七情相互干扰，阴阳升降失常，气道壅滞，攻冲作痛。
青皮 陈皮 桔梗 蓬术 辣桂 益智仁（各一两） 香附子（一两半） 甘草（炙，三分） 半夏（制，三分）
以上药材每次服用三钱，用生姜、大枣煎水送服。
异功散：治疗小儿各种病症，角弓反张，胸高脐凸。以透明没药研为末，用姜汤调服。（方剂见“天钓”篇，即钱乙的异功散）
桔梗枳壳汤：治疗气机壅滞痞结，腹胁疼痛。
枳壳（炒） 桔梗（各二两） 甘草（炙，半两）
以上药材每次服用二三钱，用姜水煎服。
七味白术散：治疗积滞疼痛，调和胃气，生津液。（方剂见“积痛”篇）
愚按：前方若用于脾胃气虚，口渴想喝热水；或因吐泻导致津液亏损，烦渴引饮；或脾胃虚弱，腹胀腹泻口渴，弄舌流涎，手指脚趾发冷，都适宜服用此方，以温补脾气，化生津液。（方剂见“积滞”篇）
六君子汤：治疗脾胃气虚，呕吐腹泻不进食，肌肉消瘦；或肺金虚，痰嗽喘促恶寒；或肝虚，惊搐眩晕自汗等各种症状。都适宜服用此方，以滋养化源。（方剂见“内钓”篇）
泻黄散（方剂见“脾脏”篇）
四君子汤（方剂见“内钓”篇）
补中益气汤（方剂见“虚羸”篇）
八味丸（方剂见“肾脏”篇）
附子理中汤
人参理中丸（这两个方剂见“冷泻”篇，即理中汤）
益黄散（方剂见“脾脏”篇）
调中丸（方剂见“脾胃虚冷”篇）
Abdominal pain in children, accompanied by cold breath from the mouth and loss of appetite, indicates deficiency-cold of the Spleen Earth. It should be primarily treated with Tiaozhong Wan (Regulate the Middle Pill). If the breath is warm and the stool has a sour, foul odor, it is pain due to food accumulation; it should be treated with Xiaji Wan (Drain Accumulation Pill). If the face is red with high fever, or both hands and feet are hot, it is excess-heat; it should be cleared using Xiehuang San (Drain Yellow Powder). If the face is yellow with slight fever, or both hands and feet are warm, it is deficiency-heat; it should be tonified using Yigong San (Extraordinary Efficacy Powder). If there is thirst and a desire to drink hot water, it is deficiency-heat of the Stomach Qi; use Baizhu San (Atractylodes Macrocephala Powder). If abdominal pain radiates to both hypochondria, it is Liver Wood overacting on Spleen Earth; use Sijunzi Tang (Four Gentlemen Decoction) added with Chai Hu (Bupleuri Radix) and Shaoyao (Paeoniae Radix). If abdominal pain is accompanied by a heavy, bearing-down sensation, it is sinking of Spleen Qi; use Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) added with Shengma (Cimicifugae Rhizoma). If the fingers and toes are cold, or if there is hiccups and diarrhea, it is Cold Water insulting Spleen Earth; use Liujunzi Tang (Six Gentlemen Decoction) with Paojiang (Prepared Zingiberis Rhizoma) and Rougui (Cinnamomi Cortex); if ineffective, urgently add Fuzi (Aconiti Lateralis Radix Praeparata). If abdominal pain occurs after taking drugs that attack stagnation, but pressing the abdomen does not cause pain, this indicates re-injury to Spleen Qi; use Wuwei Yigong San (Five-Ingredient Extraordinary Efficacy Powder). Pain at the Zhongwan point (CV12) belongs to the Spleen. Pain in the lower abdomen belongs to the Kidney. Pain aggravated by pressure indicates stagnation; pain not aggravated by pressure indicates interior deficiency. Stagnation is treated by resolving/dispersing; interior deficiency is treated by tonifying.
Clinical Cases:
One child had abdominal pain due to retained food, with fever and a red face. Someone used Yangwei Tang (Nourish the Stomach Decoction), Zhike (Aurantii Fructus), Huanglian (Coptidis Rhizoma), and Shanzha (Crataegi Fructus), which instead worsened abdominal distension. There was afternoon fever, and pressing the abdomen caused no pain. This indicated Spleen deficiency injured by attacking/draining herbs. Using Liujunzi Tang (Six Gentlemen Decoction), the child recovered after several doses.
One seven-year-old child had fever and palpitations with fright. After using phlegm-resolving drugs, convulsions and aversion to cold developed, along with expectoration, wheezing, cough, abdominal pain, and poor appetite. After using Baolong Wan (Embracing Dragon Pill), the stool resembled dysentery, with alternating chills and fever, resembling wind syndromes. I considered this a further damage to Spleen Qi. Treating with Sijunzi Tang (Four Gentlemen Decoction) with a small addition of Shengma (Cimicifugae Rhizoma) and Chai Hu (Bupleuri Radix), the child recovered after more than a month.
One child had a distended and painful abdomen, diarrhea immediately after eating, and inverted coldness of the hands and feet. This was deficiency-cold of Spleen Qi. First, Renzhi Lizhong Wan (Ginseng Regulate the Middle Pill) was used, followed by Liujunzi Tang (Six Gentlemen Decoction), leading to recovery.
One nine-year-old child frequently suffered from abdominal pain. In winter, after eating raw/cold foods, the abdominal pain persisted, and taking Lizhong Wan (Regulate the Middle Pill) type formulas was effective. At sixteen years old, after early marriage in early autumn, abdominal pain recurred. The lips and face were dark, and the nails were cyanotic. My late father used Bawei Wan (Eight-Ingredient Pill) to tonify Fire (Mingmen), and the condition resolved quickly; after taking about four liang, the pain did not recur. At twenty years old, external pathogen-induced pain recurred. Taking the previous pill was ineffective, so Fuzi Lizhong Tang (Aconite Regulate the Middle Decoction) was taken to stop the pain, followed by stabilization with Bawei Wan (Eight-Ingredient Pill).
One child had abdominal pain with tongue protrusion, drooling, thirst, preference for cold drinks, and constipation. Qingliang Yin (Cooling Drink) was used to purge, resulting in immediate relief. I stated: Children's Yuan Qi (Original Qi) is prone to becoming deficient or excessive. Once the disease trend slightly improves, no further medication is needed. Disbelieving this, the parent self-administered one dose of Sanhuang Wan (Three Yellows Pill), which indeed caused vomiting, diarrhea, and convulsions. I used Baizhu San (Atractylodes Macrocephala Powder) added with Goutenggou (Uncariae Ramulus cum Uncis) to tonify the Spleen and calm the Liver, leading to recovery.
Siqi Qi Tang (Four-Sevens Qi Decoction): Treats injury by the Seven Emotions/Qi, accumulation of phlegm and saliva, pain in the heart and abdomen, and inability to eat.
Banxia (Processed and baked, five liang) Renshen (Ginseng Radix et Rhizoma) Lagui (Cinnamomi Ramulus, peeled. One liang each) Gancao (Licorice Root, half liang)
Take three qian per dose, decoct with ginger and jujube water.
Zhimí Qìqì Tāng (Pointing-to-Mystery Four-Sevens Qi Decoction): Treats interference among the Seven Emotions, failure of Yin and Yang to ascend and descend, obstruction of the Qi mechanism, and attacking pain.
Qingpi (Citri Reticulatae Pericarpium Viride) Chenpi (Citri Reticulatae Pericarpium) Jiegeng (Platycodonis Radix) Pengzhu (Curcumae Rhizoma) Lagui (Cinnamomi Ramulus) Yizhiren (Alpiniae Oxyphyllae Semen) Xiangfuzi (Cyperi Rhizoma, one and a half liang) Gancao (Honey-fried Licorice Root, three fen) Banxia (Processed Pinellia Ternata, three fen)
Take three qian per dose, decoct with ginger and jujube water.
Yigong San (Extraordinary Efficacy Powder): Treats various pediatric conditions, such as opisthotonos (arched back like a bow) and umbilical protrusion. Use transparent Mayao (Myrrha) ground into powder, mixed with ginger water for administration. (Formula see "Tian Diao" chapter, i.e., Qian Yi's Yigong San).
Jiegeng Zhike Tang (Platycodon and Aurantium Decoction): Treats Qi obstruction and痞结 (glomus/knotting), and abdominal/hypochondriac pain.
Zhike (Stir-fried Aurantii Fructus) Jiegeng (Platycodonis Radix, two liang each) Gancao (Honey-fried Licorice Root, half liang)
Take two to three qian per dose, decoct with ginger water.
Qiwei Baizhu San (Seven-Ingredient Atractylodes Macrocephala Powder): Treats accumulation pain, harmonizes Stomach Qi, and generates body fluids. (Formula see "JiTong" chapter).
Commentary: The aforementioned formula is suitable for cases of Spleen-Stomach Qi deficiency with thirst and desire for hot water; or fluid depletion due to vomiting/diarrhea causing irritability and intense thirst; or Spleen-Stomach weakness with abdominal distension, diarrhea, thirst, tongue playing, drooling, and cold fingers/toes. It warms and tonifies Spleen Qi and transforms/fluids. (Formula see "JiZhi" chapter).
Liujunzi Tang (Six Gentlemen Decoction): Treats Spleen-Stomach Qi deficiency with vomiting, diarrhea, anorexia, and emaciation; or Lung Metal deficiency with phlegm-cough, wheezing, and aversion to cold; or Liver deficiency with fright, convulsions, vertigo, and spontaneous sweating. It nourishes the source of transformation. (Formula see "Nei Diao" chapter).
Xiehuang San (Drain Yellow Powder) (Formula see "Pi Zang" chapter).
Sijunzi Tang (Four Gentlemen Decoction) (Formula see "Nei Diao" chapter).
Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) (Formula see "Xu Lei" chapter).
Bawei Wan (Eight-Ingredient Pill) (Formula see "Shen Zang" chapter).
Fuzi Lizhong Tang (Aconite Regulate the Middle Decoction)
Renzhi Lizhong Wan (Ginseng Regulate the Middle Pill) (Both formulas see "Leng Xie" chapter, i.e., Lizhong Tang).
Yihuang San (Enrich Yellow Powder) (Formula see "Pi Zang" chapter).
Tiaozhong Wan (Regulate the Middle Pill) (Formula see "Pi Wei Xu Leng" chapter).