积热红肿大使难，努力肛出翻不还，外用蟠龙散消肿，内宜皂刺大黄煎。
[注]
小儿积热太盛，以致肛门作肿大便艰难，努力翻出，肛脱不还，
外用蟠龙散消其肿，内服皂刺大黄汤，其肿一消，肛自收矣。
(皂刺大黄汤) 方见便血。
(曹氏蟠龙散) 干地蟠龙一两略去土焙 风化朴硝二钱 以上锉税为细末，
仍和匀朴硝，每以二钱至三钱，肛门湿润者干涂，干燥者用清油调涂，
先用荆芥生葱煎水，候温洗浴轻与拭干，然后敷药。
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杂证门
肺积痰热病龟胸，胸骨高耸若龟形，气急喘咳体羸瘦，宽气百合酌量行。
[注]
龟胸一证，多因小儿饮食不节痰热炽盛，复为风邪所伤，
风热相搏，以致肺经胀满，攻于胸膈，高如覆杯，
现证咳嗽喘急，身体羸瘦，
治宜清肺化痰为主，先以宽气饮开其气道,
再以百合丹除其壅滞，肺热清而胀满自除矣。
(宽气散) 杏仁去皮尖炒 桑白皮炒 橘红 苏子炒 枳壳麸炒 枇杷叶蜜炙
麦冬去心 生甘草 苦葶苈 水煎服。
(方歌)
宽气饮治儿龟胸，杏仁桑皮合橘红，苏子枳壳枇杷叶，甘草葶苈麦门冬。
(百合丹)百合 天门冬 杏仁炒去皮尖 木通 桑白皮炒 甜葶苈
石膏各五钱 大黄三钱 以上为细末，炼蜜丸如菉豆大，
量儿大小服之，临卧滚白水迭下。
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杂证门
积热导致红肿，大便困难；用力排便时肛门脱出且无法回纳。外用蟠龙散以消肿，内服皂刺大黄煎剂。
[注]
小儿体内积热过盛，导致肛门肿胀、大便艰难，用力努挣致使肛管脱出而不能收回。
外用蟠龙散消除肿胀，内服皂刺大黄汤，待肿胀消退后，肛门自然收缩复位。
（皂刺大黄汤）方剂见“便血”篇。
（曹氏蟠龙散）干地蟠龙一两（略去泥土，焙干），风化朴硝二钱。以上药材锉碎为细末，再与朴硝混合均匀。每次取二钱至三钱，若肛门周围湿润则干涂药粉，若干燥则用清油调匀后涂抹。先用荆芥和生葱煎水，待温度适宜时清洗患处，轻轻拭干后，再敷上药物。
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杂证门
肺中积聚痰热引发龟胸病，胸骨高耸呈龟背状，气促喘咳，身体消瘦。治疗宜酌情使用宽气饮和百合丹。
[注]
龟胸这一病症，多因小儿饮食不节制，导致痰热炽盛，又受风邪侵袭。
风热相互搏结，致使肺经胀满，邪气攻冲胸膈，胸部隆起如同倒扣的杯子。
临床表现为咳嗽、气喘急促，身体羸弱消瘦。
治疗应以清肺化痰为主，先使用宽气饮开通气道，
再使用百合丹消除壅滞，肺热清除后，胀满症状自然消除。
（宽气散）杏仁（去皮尖，炒），桑白皮（炒），橘红，苏子（炒），枳壳（麸炒），枇杷叶（蜜炙），麦冬（去心），生甘草，苦葶苈。水煎服。
（方歌）
宽气饮治疗小儿龟胸，包含杏仁、桑白皮与橘红，苏子、枳壳、枇杷叶，以及甘草、葶苈子和麦门冬。
（百合丹）百合，天门冬，杏仁（炒，去皮尖），木通，桑白皮（炒），甜葶苈，石膏各五钱，大黄三钱。以上药材研为细末，用炼蜜制成如绿豆大小的丸剂，根据患儿年龄大小服用，临睡前用温开水送服。
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杂证门
Accumulated heat causes redness and swelling, with difficulty in defecation; straining leads to prolapse of the anus that cannot be reduced. Externally apply Panlong San (Panlong Powder) to reduce swelling, internally administer Zaoci Dahuang Decoction (Sickle Thorn and Rhubarb Decoction).
[Note]
In children, excessive accumulation of heat causes swelling of the anal region and difficult defecation. Straining results in prolapse of the rectum that fails to retract.
Externally apply Panlong San (Panlong Powder) to eliminate swelling, and internally take Zaoci Dahuang Tang (Sickle Thorn and Rhubarb Decoction). Once the swelling subsides, the anus will naturally retract.
(Zaoci Dahuang Tang [Sickle Thorn and Rhubarb Decoction]) See the section on "Hematochezia" for the formula.
(Cao's Panlong San [Panlong Powder]): Gan Di Panlong (Dry Radix Bungean Peony) 1 liang (approx. 37.5g), remove soil residue and dry-roast; Fenghua Puxiao (Effloresced Mirabilite) 2 qian (approx. 7.5g). Crush the above herbs into a fine powder, mix evenly with the Mirabilite. Use 2–3 qian (approx. 7.5–11.25g) per application. If the perianal area is moist, apply the powder dry; if dry, mix with clear sesame oil for topical application. First, decoct Jingjie (Schizonepetae Herba) and raw Congbai (Allii Fistulosi Bulbus) in water. After the water cools to a warm temperature, wash the affected area, gently pat dry, and then apply the medication.
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Miscellaneous Diseases Section
Accumulation of phlegm-heat in the Lung manifests as Turtle Chest disease, characterized by a high sternum resembling a turtle shell, shortness of breath, wheezing cough, and emaciation. Treatment should appropriately utilize Kuanqi Yin (Qi-Widening Drink) and Baihe Dan (Lily Pill).
[Note]
Turtle Chest is mostly caused by irregular diet in children leading to flourishing phlegm-heat, compounded by invasion of wind-pathogen.
Wind and heat interact, causing fullness in the Lung meridian, attacking the chest and diaphragm, resulting in a protrusion like an inverted cup.
Clinical manifestations include cough, rapid breathing, and emaciated body.
Treatment should focus on clearing Lung heat and resolving phlegm. First, use Kuanqi Yin (Qi-Widening Drink) to open the airways,
then use Baihe Dan (Lily Pill) to remove stagnation. Once Lung heat is cleared, the fullness will naturally resolve.
(Kuanqi San [Qi-Widening Powder]: Xingren (Apricot Seed, peeled and de-husked, stir-fried), Sangbaipi (Morus Alba Bark, stir-fried), Juhong (Citrus Reticulata Pericarpium), Su Zi (Perilla Fruit, stir-fried), Zhike (Aurantii Fructus, bran-fried), Pipaye (Loquat Leaf, honey-fried), Maidong (Ophiopogon Root, heart removed), Sheng Gancao (Raw Licorice Root), Ku Tingli (Thladianthae Fructus, bitter). Decoct in water and take orally.)
(Verse for Formula:)
Kuanqi Yin treats pediatric Turtle Chest, combining Apricot Seed, Morus Alba Bark, and Citrus Reticulata Pericarpium; Perilla Fruit, Aurantii Fructus, Loquat Leaf, Licorice Root, Thladianthae Fructus, and Ophiopogon Root.
(Baihe Dan [Lily Pill]: Baihe (Lilii Bulbus), Tianmendong (Asparagi Radix), Xingren (Apricot Seed, stir-fried, peeled and de-husked), Mutong (Akebiae Caulis), Sangbaipi (Morus Alba Bark, stir-fried), Tian Tingli (Thladianthae Fructus, sweet), Shigao (Gypsum Fibrosum) each 5 qian (approx. 18.75g); Dahuang (Rhei Radix et Rhizoma) 3 qian (approx. 11.25g). Grind the above into a fine powder, bind with refined honey into pills the size of mung beans. Administer according to the child's age, swallowing with warm boiled water before bedtime.)
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Miscellaneous Diseases Section