仲阳云∶初生下拭掠小儿口中秽恶不尽，咽入喉中，故呕吐，及多生诸病。呕者有声也，吐者吐出乳也。凡小儿乳
哺，不宜过饱，若满则溢，故令呕吐，胃中纳乳，如器之盛物，杯卮之小，不可容巨碗之物，雨骤则沼溢，酒暴则卮翻，
理之必然。乳母无知，但欲速得乳儿长大，更无时度，或儿睡着而更衔乳，岂有厌足，受病之源，自此渐至日深，导其
胃气之虚，慢惊自此而得，可不慎乎，此候但令节乳为上，甚者宜令断乳，先此乳母可服调气之剂，儿服消食丸，化乳
壮胃为上。议曰∶吐乳 乳，此症有数般，有冷有热，当自辨认。若吐自口角出，此是乳多消化不出，满而则溢，此非
病也，常服消乳丸异功散，当令乳母节乳为上。冷吐可服观音散、香朴散，快脾等药。热吐则头额温，有黄涎而渴，小
便赤少，此是热吐，多是伤暑热者有此症，乳母同服香薷散、五苓散。又有风痰吐，乃是伤风不解，吐乳夹痰，若经久
必然生风，仍宜下疏风化痰药，竹茹汤去桂，五苓散、青州白丸子、温胆汤，又当留心调治，紫霜丸亦可服。
杨氏消乳丸 温中快膈止呕吐，消乳食，脉沉者，乃伤食不化故也。
香附（炒、一两） 甘草（炙） 陈皮（各半两） 缩砂仁 神曲（炒） 麦 （炒、各一两）
上为末，泡雪糕丸如黍米大，七岁以上绿豆大三十丸，食后姜汤下。
又治百 内呕吐乳汁或大便青色
上用小妇人乳汁一盏，入丁香十粒，去白陈皮一钱，于器内同煎三十沸，去丁香陈皮，稍热与儿饥时服。
消食丸 治小儿饮食乳哺，取冷过度，冷气积于脾胃。胃为水谷之海，脾气磨而消之，胃气调和，则乳哺消化，
脾伤于冷，则宿食不消，此药宽中快气，消乳食，正颜色。
缩砂仁 陈皮 三棱（煨） 莪术（煨） 神曲（炒） 麦 （炒、各半两） 香附（一两炒）
上为末，面糊丸绿豆大，食后紫苏汤下二十丸。
和剂观音散 治小儿外感风冷，内伤脾胃，呕逆吐泻，不进乳食，久则渐至羸瘦。大抵脾虚则泻，胃虚则吐，
脾胃俱虚，则吐泻不已。此药大能温养脾胃，进美饮食。
石莲肉（去心） 人参 神曲（炒、各三钱） 茯苓（二钱） 甘草（炙） 木香 绵黄 （炙） 白扁豆（炒、
去
皮） 白术（各一钱）
上锉散，每服二钱，水一盏，枣一枚，藿香三叶，煎温服。
异功散 见第十七问。
香朴散 治呕吐泄泻。
藿香 陈皮 浓朴（姜汁炒、各七钱） 半夏（汤泡七次、一两） 甘草（炙、一钱）
上锉散，每服三钱，水一盏，姜五片，枣一枚同煎，如泻甚，加木香、肉豆蔻。
香薷散 治脏腑冷热不调，饮食不节，寒暑风冷之气所伤，致令真邪相干，肠胃虚弱，心腹疼痛，霍乱气逆，
及吐利发热头疼，或呕或泻，或转筋拘急。
香薷（一两） 白扁豆（炒） 浓朴（姜汁制、各半两）
上锉散，每服三钱，水一盏，姜三片，煎服。一方加黄连治泻痢，一方加芎芷、香苏散、治霍乱吐泻，暑月感冒伤
暑之症。
五苓散 见第五十二问。
竹茹汤 治胃受邪热，心烦喜冷，呕吐不止。
葛根（七钱半） 半夏（半两、泡） 甘草（一钱）
上 咀，每服三钱，水一盏，入竹茹、枣少许，生姜五片，煎七分、去滓，取清汁微冷细细服，不拘时，加茯苓三
钱尤妙。
苏合香丸 治传尸骨蒸，诸项劳瘵，顺气化痰，卒暴心痛，鬼魅疟疾，霍乱吐泻，赤白下痢，小儿惊搐。
苏合香油（五钱、入安息膏内） 安息香（一两、另为末、用无灰酒半升、熬膏） 丁香 青木香 白檀香 沉香
荜茇 香附米 诃子（煨、取肉） 乌犀（镑屑） 朱砂（研、水飞、各一两） 薰陆香 片脑（研、各五钱） 麝香
（七钱半）
上为末，用安息香膏入蜜和丸，如芡实大，空心用沸汤化下，小儿一丸老人四丸，酒下。亦可用蜡纸裹一丸弹子大，
用绯绢袋盛，常带之，一切邪不敢近。去脑名麝香苏合香丸，治一切邪及胸膈噎塞，肠中虚鸣，宿食不消，余症并同。
青州白丸子 治一切风痰，小儿惊风。
天南星（生） 白附子（生、各三两） 川乌头（去脐皮） 半夏（生、各七两）
上用井花水浸，次早另换新水，春五日，夏三日，秋七日，冬十日，晒干为细末，以糯米粉煎粥清为丸，如绿豆大。
小儿惊风薄荷汤调下。和苏合香丸服，名苏青丸。
温胆汤 治小儿心经虚怯，夜卧不宁。
枳实 陈皮 茯苓 甘草 半夏（泡、各等分） 竹茹（少许）
上锉散，白水煎，加姜二片，枣一枚，空心服。
紫霜丸 见第三问。
鲁伯嗣引用钱乙（字仲阳）的话说：新生儿出生后，如果清理口腔内的污秽不彻底，使其咽入喉中，就会导致呕吐，并引发多种疾病。所谓“呕”，是指有声音的呕吐；所谓“吐”，是指吐出乳汁。凡是给小儿喂奶，不宜过饱，如果吃得太饱就会溢出，从而导致呕吐。胃容纳乳汁，就像容器盛放物品一样，杯子太小，就不能容纳大碗的东西；雨水骤急则沼泽满溢，酒倒得猛则酒杯翻倒，这是必然的道理。乳母无知，只想让孩子尽快长大，没有节制地哺乳，或者在孩子睡着时还强行喂奶，孩子怎么会有满足的时候呢？这是致病之源，从此逐渐加深，导致胃气虚弱，慢惊风也就由此产生，能不谨慎吗？遇到这种情况，只要节制哺乳就是上策，严重的应当断奶。在此之前，乳母可以服用调理气机的药剂，婴儿服用消食丸，以化解乳汁、强壮胃气为上策。
议论道：吐乳这一症状，有好几种情况，有寒证也有热证，应当自行辨别。如果乳汁从口角流出，这是因为乳汁过多，消化不及，满了自然溢出，这不算病，常服用消乳丸或异功散，主要应让乳母节制哺乳。寒性呕吐可服用观音散、香朴散、快脾散等药物。热性呕吐则表现为额头温热，有黄色涎沫且口渴，小便短赤，这是热吐，多因伤于暑热所致，乳母和婴儿同服香薷散、五苓散。又有风痰引起的呕吐，是由于伤风未愈，呕吐物中夹杂痰液，如果拖延日久必然引动肝风，仍宜使用疏风化痰的药物，如竹茹汤去桂枝，或五苓散、青州白丸子、温胆汤，又当留心调治，紫霜丸也可以服用。
杨氏消乳丸：具有温中、宽胸膈、止呕吐、消乳食的功效。脉象沉者，是伤食不化的缘故。
处方组成：香附（炒制，一两）、甘草（炙制）、陈皮（各半两）、缩砂仁、神曲（炒制）、麦芽（炒制，各一两）。
制法用法：以上药材研为细末，用泡过的雪糕水（注：此处原文可能有误，通常指米泔水或淡盐水，依原文直译）泛丸，大小如黍米。七岁以上儿童如绿豆大，每次三十丸，饭后用姜汤送服。
又方治疗百日内的婴儿呕吐乳汁或大便呈青色：
取小妇人乳汁一盏，加入丁香十粒、去白陈皮一钱，在容器中共同煎煮三十沸，去掉丁香和陈皮，稍加热后，在婴儿饥饿时服用。
消食丸：治疗小儿饮食及哺乳过度受冷，冷气积聚于脾胃。胃是水谷之海，脾气磨碎并消化食物，胃气调和，则乳哺得以消化；若脾被寒气所伤，则宿食不消。此药能宽中理气，消乳食，改善面色。
处方组成：缩砂仁、陈皮、三棱（煨制）、莪术（煨制）、神曲（炒制）、麦芽（炒制，各半两）、香附（一两，炒制）。
制法用法：以上药材研为细末，用面糊泛丸，大小如绿豆，饭后用紫苏汤送服二十丸。
和剂局观音散：治疗小儿外感风寒，内伤脾胃，出现呕逆、吐泻，不能进食乳食，久则逐渐消瘦。大抵脾虚则腹泻，胃虚则呕吐，脾胃俱虚，则吐泻不止。此药能大补温养脾胃，增进食欲。
处方组成：石莲肉（去心）、人参、神曲（炒制，各三钱）、茯苓（二钱）、甘草（炙制）、木香、绵黄芪（炙制）、白扁豆（炒制，去皮）、白术（各一钱）。
制法用法：以上药材切碎成散剂，每次服用二钱，加水一盏，大枣一枚，藿香三叶，煎至温服。
异功散：见第十七问。
香朴散：治疗呕吐泄泻。
处方组成：藿香、陈皮、浓朴（姜汁炒制，各七钱）、半夏（汤泡七次，一两）、甘草（炙制，一钱）。
制法用法：以上药材切碎成散剂，每次服用三钱，加水一盏，生姜五片，大枣一枚，共同煎煮。如果腹泻严重，加木香、肉豆蔻。
香薷散：治疗脏腑冷热不调，饮食不节，受寒暑风冷之气伤害，导致真邪相争，肠胃虚弱，心腹疼痛，霍乱气逆，以及吐利发热头疼，或呕或泻，或转筋拘急。
处方组成：香薷（一两）、白扁豆（炒制）、浓朴（姜汁制，各半两）。
制法用法：以上药材切碎成散剂，每次服用三钱，加水一盏，生姜三片，煎服。另一版本加黄连治疗泻痢；另一版本加川芎、白芷、香苏散，治疗霍乱吐泻及暑月感冒伤暑之症。
五苓散：见第五十二问。
竹茹汤：治疗胃受邪热，心烦喜冷，呕吐不止。
处方组成：葛根（七钱半）、半夏（半两，泡制）、甘草（一钱）。
制法用法：以上药材切碎，每次服用三钱，加水一盏，加入竹茹、少许大枣，生姜五片，煎至七分，去渣，取清汁微冷后细细服用，不拘时间，加茯苓三钱尤其好。
苏合香丸：治疗传尸骨蒸，各种劳瘵，顺气化痰，突发心痛，鬼魅疟疾，霍乱吐泻，赤白下痢，小儿惊搐。
处方组成：苏合香油（五钱，纳入安息香膏内）、安息香（一两，另研为末，用无灰酒半升熬膏）、丁香、青木香、白檀香、沉香、荜茇、香附米、诃子（煨制，取肉）、乌犀（镑屑）、朱砂（研细，水飞，各一两）、薰陆香、片脑（研细，各五钱）、麝香（七钱半）。
制法用法：以上药材研为细末，用安息香膏和蜂蜜混合泛丸，大小如芡实。空腹时用沸水化开服用，小儿一丸，老人四丸，也可用酒送服。也可以用蜡纸包裹一丸如弹子大，用红绢袋盛装，经常佩戴，一切邪气不敢靠近。去掉冰片名为麝香苏合香丸，治疗一切邪气及胸膈噎塞，肠中虚鸣，宿食不消，其余症状相同。
青州白丸子：治疗一切风痰，小儿惊风。
处方组成：天南星（生）、白附子（生，各三两）、川乌头（去脐皮）、半夏（生，各七两）。
制法用法：以上药材用井花水浸泡，次日早晨换上新水，春季五日，夏季三日，秋季七日，冬季十日，晒干后研为细末，用糯米粉煎粥清泛丸，大小如绿豆。小儿惊风可用薄荷汤调下。与苏合香丸同服，名为苏青丸。
温胆汤：治疗小儿心经虚怯，夜间睡眠不安宁。
处方组成：枳实、陈皮、茯苓、甘草、半夏（泡制，各等分）、竹茹（少许）。
制法用法：以上药材切碎成散剂，用水煎煮，加生姜二片，大枣一枚，空腹服用。
紫霜丸：见第三问。
Lu Bosi quotes Qian Yi (courtesy name Zhongyang): After a newborn is born, if the filth in the infant's mouth is not thoroughly cleaned and swallowed into the throat, it will cause vomiting and lead to various diseases. "Ou" (vomiting with sound) refers to vomiting accompanied by noise; "Tu" (spitting up) refers to spitting out milk. When feeding infants, one should not overfill their stomachs. If the stomach is full, it overflows, causing vomiting. The stomach holds milk like a vessel holds objects; a small cup cannot contain the contents of a large bowl. Just as sudden heavy rain causes marshes to overflow and pouring wine too quickly overturns a goblet, this is an inevitable principle. If the nursing mother is ignorant and only desires for the child to grow up quickly without any regulation, or forces the breast into the baby's mouth while the baby is asleep, how can the baby ever feel satisfied? This is the source of disease, gradually deepening day by day, leading to deficiency of Stomach Qi, and slow convulsions arise from this. One must be cautious. In such cases, regulating breastfeeding is the best approach; in severe cases, weaning is necessary. Before that, the nursing mother may take formulas to regulate Qi, and the infant may take Xiaoshi Wan (Digestive Pills), aiming to transform milk and strengthen the Stomach.
Discussion: There are several types of milk-spitting symptoms, including cold and heat patterns, which must be distinguished. If milk flows from the corners of the mouth, it is because there is too much milk and insufficient digestion, leading to overflow when full; this is not a disease. Regularly taking Xiao Ru Wan (Milk-Dissolving Pills) or Yigong San (Extraordinary Efficacy Powder) is recommended, primarily requiring the mother to regulate breastfeeding. For cold-type vomiting, Guanyin San (Guanyin Powder), Xiangpo San (Aucklandia and Magnolia Powder), and Kuaipi San (Spleen-Strengthening Powder) can be taken. For heat-type vomiting, characterized by warmth on the forehead, yellow phlegm, thirst, and scanty dark urine, it is due to heat, often caused by summerheat injury. Both mother and infant should take Xiangru San (Elsholtzia Powder) and Wuling San (Five-Ingredient Powder with Poria). There is also vomiting due to wind-phlegm, resulting from unresolved wind-cold, where vomit contains phlegm. If prolonged, it may generate internal wind; thus, wind-dispelling and phlegm-resolving medicines should be used, such as Zhuru Tang (Bamboo Shavings Decoction) minus Cinnamon Twig, Wuling San, Qingzhou Baizhi Wan (Qingzhou White Pill), and Wendan Tang (Warm the Gallbladder Decoction). Careful treatment is required, and Zishuang Wan (Purple Frost Pill) may also be taken.
Yang Shi Xiao Ru Wan (Yang’s Milk-Dissolving Pill): Warms the middle, opens the chest diaphragm, stops vomiting, and resolves milk food stagnation. A deep pulse indicates food stagnation and failure to digest.
Ingredients: Xiangfu (Cyperi Rhizoma, stir-fried, 1 liang), Gancao (Glycyrrhizae Radix et Rhizoma, honey-fried), Chenpi (Citri Reticulatae Pericarpium, each 0.5 liang), Suosharen (Amomi Fructus), Shenqu (Massae Fermentatae Medicamentosae, stir-fried), Maiya (Hordei Fructus Germinatus, stir-fried, each 1 liang).
Preparation and Administration: Grind the above ingredients into powder. Use soaked snow cream water (note: likely a textual error for rice water or similar) to make pills the size of millet seeds. For children over seven years old, make them the size of mung beans, 30 pills per dose. Take after meals with ginger decoction.
Another prescription treats vomiting of milk or green stools in infants within one hundred days:
Take one cup of breast milk from a young woman, add 10 cloves (Dingxiang), and 1 qian of peeled Chenpi. Simmer together in a vessel for thirty boils. Remove the cloves and Chenpi. Warm slightly and administer to the infant when hungry.
Xiaoshi Wan (Digestive Pills): Treats excessive cold intake during infant feeding, where cold qi accumulates in the Spleen and Stomach. The Stomach is the sea of water and grain; the Spleen grinds and digests it. When Stomach Qi is harmonious, milk and food are digested. If the Spleen is injured by cold, retained food fails to digest. This formula broadens the middle, regulates Qi, resolves milk and food stagnation, and improves complexion.
Ingredients: Suosharen, Chenpi, Sanleng (Sparganii Rhizoma, baked), Ezhu (Curcumae Rhizoma, baked), Shenqu (stir-fried), Maiya (stir-fried, each 0.5 liang), Xiangfu (1 liang, stir-fried).
Preparation and Administration: Grind into powder. Make pills with wheat paste, size of mung beans. Take 20 pills after meals with Perilla decoction.
Heji Ju Guanyin San (Official Pharmacy Guanyin Powder): Treats external wind-cold and internal Spleen-Stomach injury in infants, causing retching, vomiting, diarrhea, inability to feed, and gradual emaciation. Generally, Spleen deficiency leads to diarrhea, Stomach deficiency leads to vomiting; both deficient leads to continuous vomiting and diarrhea. This formula greatly warms and nourishes the Spleen and Stomach and promotes appetite.
Ingredients: Shilianrou (Nelumbinis Semen, heart removed), Renshen (Ginseng Radix et Rhizoma), Shenqu (stir-fried, each 3 qian), Fuling (Poria, 2 qian), Gancao (honey-fried), Muxiang (Aucklandiae Radix), Mian Huangqi (Astragali Radix, honey-fried), Baibian Dou (Phaseoli Semen, stir-fried, peeled), Baizhu (Atractylodis Macrocephalae Rhizoma, each 1 qian).
Preparation and Administration: Cut into pieces for decoction. Take 2 qian per dose with one cup of water, one jujube, and three leaves of Huoxiang. Decoct and take warm.
Yigong San (Extraordinary Efficacy Powder): See Question 17.
Xiangpo San (Aucklandia and Magnolia Powder): Treats vomiting and diarrhea.
Ingredients: Huoxiang (Agastaches Herba), Chenpi, Nongpuo (Magnoliae Officinalis Cortex, stir-fried with ginger juice, each 7 qian), Banxia (Pinelliae Rhizoma, soaked in water seven times, 1 liang), Gancao (honey-fried, 1 qian).
Preparation and Administration: Cut into pieces for decoction. Take 3 qian per dose with one cup of water, five slices of ginger, and one jujube. If diarrhea is severe, add Muxiang and RouDoukou.
Xiangru San (Elsholtzia Powder): Treats disharmony of cold and heat in the zang-fu, irregular diet, and injury from cold, summerheat, wind, and cold qi, causing conflict between healthy and pathogenic qi, weakness of intestines and stomach, abdominal pain, cholera-like reversal of Qi, fever, headache with vomiting/diarrhea, or muscle cramps.
Ingredients: Xiangru (Elsholtziae Herba, 1 liang), Baibian Dou (stir-fried), Nongpuo (prepared with ginger juice, each 0.5 liang).
Preparation and Administration: Cut into pieces for decoction. Take 3 qian per dose with one cup of water and three slices of ginger. Another variant adds Huanglian for dysentery; another adds Xiong, Zhi, and Xiangsu San for cholera-like vomiting/diarrhea and summerheat injury.
Wuling San (Five-Ingredient Powder with Poria): See Question 52.
Zhuru Tang (Bamboo Shavings Decoction): Treats Stomach affected by pathogenic heat, restlessness, preference for cold, and persistent vomiting.
Ingredients: Gegen (Puerariae Lobatae Radix, 7.5 qian), Banxia (soaked, 0.5 liang), Gancao (1 qian).
Preparation and Administration: Cut into pieces. Take 3 qian per dose with one cup of water, add Zhuru (Bambusa Textilis Caulis internodes), a few jujubes, and five slices of fresh ginger. Decoct to 70%, strain, and take the clear liquid slowly while slightly cool, at any time. Adding Fuling (3 qian) is especially good.
Suhe Xiang Wan (Styrax Pill): Treats corpse-transmission bone-steaming, various consumptive diseases, regulates Qi and resolves phlegm, sudden severe chest pain, ghost-malaria, cholera vomiting/diarrhea, red-and-white dysentery, and infantile convulsions.
Ingredients: Suhe Xiang You (Styrax Oil, 5 qian, mixed with Anxi Xiang paste), Anxi Xiang (Liquidambaris Resina, 1 liang, powdered separately, boiled with half sheng of pure wine into paste), Dingxiang (Caryophylli Flos), Qingmuxiang (Lithospermi Radix), Baitanxiang (Santalum Album Lignum), Chenxiang (Aquilariae Lignum Resinatum), Bibo (Piperis Longi Fructus), Xiangfumii (Cyperi Rhizoma), Hezi (Myrobalani Fructus, baked, flesh only), Wu Xi (Rhinocerotis Cornu, shaved), Zhusha (Cinnabaris, ground and washed with water, each 1 liang), Xunluxiang (Boswelliae Resina), Piannao (Borneolum Syntheticum, ground, each 5 qian), Shexiang (Moschus, 7.5 qian).
Preparation and Administration: Grind into powder. Mix with Anxi Xiang paste and honey to make pills the size of water caltrop seeds. Take empty-stomach with boiling water. Infants take one pill, elderly take four, with wine. Alternatively, wrap one pill-sized ball in wax paper, keep in a red silk bag, and wear constantly to ward off evil. Removing Piannao yields Moschus Suhe Xiang Wan, treating all evils, chest oppression, intestinal rumbling, and food stagnation, with other indications same as above.
Qingzhou Baizhi Wan (Qingzhou White Pill): Treats all wind-phlegm and infantile convulsions.
Ingredients: Tian Nanxing (Arisaematis Rhizoma, raw), Baifuzi (Typhonii Rhizoma, raw, each 3 liang), Chuan Wutou (Aconiti Radix Lateralis Preparata, navel and skin removed), Banxia (Pinelliae Rhizoma, raw, each 7 liang).
Preparation and Administration: Soak in well water. Change water the next morning. Spring: 5 days; Summer: 3 days; Autumn: 7 days; Winter: 10 days. Dry and grind into fine powder. Make pills with glutinous rice porridge liquid, size of mung beans. For infantile convulsions, take with mint decoction. Combined with Suhe Xiang Wan, it is named Suqing Wan.
Wendan Tang (Warm the Gallbladder Decoction): Treats infantile Heart channel deficiency and fearfulness, restless sleep at night.
Ingredients: Zhishi (Aurantii Fructus Immaturus), Chenpi, Fuling, Gancao, Banxia (soaked, equal parts), Zhuru (small amount).
Preparation and Administration: Cut into pieces for decoction. Boil in water, add two slices of ginger and one jujube. Take on an empty stomach.
Zishuang Wan (Purple Frost Pill): See Question 3.