痞者塞也，结者实也，热气蕴于胸膈之间，留饮聚于腹胁之内，于是荣卫不能流行，脏腑不能宣通，由胀满而致痞
结，势使然耳，此实热之症也，时或发为壮热，圣惠甘遂散主之。此药治小儿痞结，虽服汤药时，暂得利而滞实不去，
心下坚胀，按之即啼，内有伏热诸候，并成此疾，宜疏利大便，破结散气，后宜常服进食丸。
圣惠甘遂破结散 治小儿心胸痞结，蕴聚痰水。
甘遂（面裹、煨令黄色、二钱半） 青皮（半两） 黄芩（半两） 川大黄（煨、半两）
上为粗末，每服一钱，水一盏，煎至六分，去滓温和服，量大小加减，得通利则止，后以冷粥补之。
进食丸 治乳食不消，心腹胀满，壮热喘粗，呕吐痰逆，腹鸣泄泻，米谷不化，或下痢赤白，腹痛后重，及食
症、乳癖、 气、痞结并皆治之，小儿胸膈热实，腹内有留饮，致令荣卫痞塞，脏腑之气不得宣通，其病腹内气结胀满
或壮热，凡有此疾，当疏利大便，破结散气，宜常服之。
巴豆霜（一钱） 朱砂（五钱） 枳壳（炒、五钱） 当归（米泔浸一宿、炒） 代赭石（ 、醋淬七次、各三钱）
木香（五钱） 麝（少许）
上为末，面糊为丸如麻子大，一岁儿一丸，温米饮下，更量虚实加减，食后服，治食积发热羸瘦，肚大青筋，疳积
肚疼哺露。
痞，是指气机阻塞不通；结，是指邪气积聚结实。热气蕴结在胸膈之间，停饮聚集在腹胁之内，导致营卫之气不能正常运行，脏腑之气无法宣通，从而由胀满发展为痞结，这是病情发展的必然结果，属于实热证候。有时发作时会出现高热，治疗以《圣惠方》的甘遂散为主方。
此药用于治疗小儿痞结症。虽然服用汤药后，暂时能通便得利，但体内的积滞和实邪并未去除，表现为心下（胃脘部）坚硬胀满，按压时患儿会啼哭，体内有潜伏的热邪等各种症状，最终形成此疾。应当疏通利导大便，破除结聚、疏散气机，之后宜常服用进食丸。
《圣惠方》甘遂破结散：主治小儿心胸痞结，痰水蕴结聚集。
药材及用量：甘遂（用面粉包裹，煨至黄色，二钱半）、青皮（半两）、黄芩（半两）、川大黄（煨制，半两）。
制法与用法：将上述药物捣成粗末，每次服用一钱，加水一盏，煎煮至六分，滤去药渣，温服。根据患儿年龄大小酌情加减剂量，待大便通畅后即停药，随后喝冷粥以养胃气。
进食丸：主治乳食不消化，心腹胀满，高热喘促气粗，呕吐痰逆，肠鸣泄泻，米谷不化，或下痢赤白相间，腹痛且里急后重，以及食积症、乳癖、气疝、痞结等病症均能治疗。对于小儿胸膈热实，腹内有停饮，导致营卫痞塞，脏腑之气不得宣通，出现腹内气结胀满或高热的情况，凡有此疾，都应当疏通利导大便，破除结聚、疏散气机，适宜常服此药。
药材及用量：巴豆霜（一钱）、朱砂（五钱）、枳壳（炒制，五钱）、当归（用米泔水浸泡一夜，炒制）、代赭石（煅烧，醋淬七次，各三钱）、木香（五钱）、麝香（少许）。
制法与用法：将上述药物研为细末，用面糊制成如麻子大小的丸剂。一岁的婴儿服用一丸，用温热的米饮送服。再根据患儿的虚实情况酌情加减剂量，饭后服用。主治食积发热、身体消瘦羸弱、腹部膨大且可见青筋暴露、疳积腹痛、形体消瘦露骨等症状。
Pi (Pijie, a condition characterized by obstruction and accumulation) refers to blockage; Jie refers to solid accumulation. Heat qi accumulates between the chest and diaphragm, while retained fluids gather within the abdomen and hypochondrium. Consequently, Ying and Wei (Nutritive and Defensive Qi) cannot circulate smoothly, and the Zang-Fu organs cannot function in harmony. Thus, distension and fullness develop into Pi-Jie, which is the natural progression of the disease. This is a syndrome of excess heat. Occasionally, it manifests as high fever. The primary treatment is Gan Sui San from *Taiping Shenghui Fang* (Sanctified惠民 Formulary).
This prescription treats pediatric Pi-Jie. Although administration of decoctions may temporarily promote bowel movement, the internal stagnation and pathogenic solids remain unresolved. Symptoms include hardness and distension in the epigastrium ("Xin Xia"), with crying upon palpation, along with various signs of latent heat within. These factors contribute to this ailment. Treatment should focus on promoting bowel movements, breaking up accumulations, and dispersing stagnant Qi. Subsequently, patients should regularly consume Jin Shi Wan (Appetizing Pill).
**Shenghui Gan Sui Po Jie San** (Gansui Breakup Accumulation Powder from *Shenghui Fang*): Treats pediatric chest and heart Pi-Jie, where phlegm and water accumulate.
Ingredients:
- *Kansui Radix* (Gan Sui) [Radix Kansui]: Wrapped in flour, roasted until yellow, 2.5 qian.
- *Citri Reticulatae Pericarpium Viride* (Qing Pi) [Green Tangerine Peel]: 0.5 liang.
- *Scutellariae Radix* (Huang Qin) [Skullcap Root]: 0.5 liang.
- *Rhei Radix et Rhizoma* (Chuan Dahuang) [Rhubarb Root]: Roasted, 0.5 liang.
Preparation and Administration: Grind the above ingredients into a coarse powder. Take 1 qian per dose, add one cup of water, and boil down to 0.6 cups. Strain the dregs and administer warm. Adjust dosage according to the child's age and size. Stop when bowel movements become free, and follow with cold rice porridge to nourish the stomach.
**Jin Shi Wan** (Appetizing Pill): Treats indigestion of milk and food, epigastric and abdominal distension, high fever with rapid breathing, vomiting of phlegm and reflux, borborygmus with diarrhea, undigested food in stool, or dysentery with red and white discharge, abdominal pain with tenesmus. It also treats food accumulation syndromes, "Ru Pi" (breast lumps), Qi hernia, and Pi-Jie. For children with heat-solid in the chest and diaphragm, and retained fluids in the abdomen causing obstruction of Ying and Wei and dysfunction of Zang-Fu Qi, resulting in abdominal Qi knotting and distension or high fever, this formula is suitable for regular use to promote bowel movements, break accumulations, and disperse Qi.
Ingredients:
- *Crotonis Fructus Preparatum* (Ba Dou Shuang) [Prepared Croton Seed Frost]: 1 qian.
- *Cinnabaris* (Zhu Sha) [Cinnabar]: 5 qian.
- *Aurantii Fructus Immaturus* (Zhi Ke) [Immature Bitter Orange]: Stir-fried, 5 qian.
- *Angelicae Sinensis Radix* (Dang Gui) [Chinese Angelica Root]: Soaked overnight in rice wash water, stir-fried.
- *Haematitum* (Dai Zhe Shi) [Limonite]: Calcined, quenched in vinegar seven times, 3 qian each (for Dai Zhe Shi and another ingredient implied as equal weight, likely referring to specific preparation ratios or combined weight contextually, here listed as 3 qian each for the specified items if multiple, but text says "each 3 qian" for Dai Zhe Shi and potentially others if grouped, strictly translating "Dai Zhe Shi (... , each 3 qian)" implies specific weighting). *Note: Text lists Dai Zhe Shi with processing instructions and "each 3 qian", implying other items might share this or it's a specific ratio. We list as provided.*
- *Costi Rhizoma* (Mu Xiang) [Costus Root]: 5 qian.
- *Moschus* (She) [Musk]: A small amount.
Preparation and Administration: Grind into fine powder and form pills using wheat paste, sized like hemp seeds. One-year-old infants take one pill, administered with warm rice drink. Adjust dosage based on deficiency or excess. Take after meals. Treats food accumulation with fever, emaciation, abdominal distension with visible blue veins, malnutrition (Gan Ji) abdominal pain, and skeletal prominence.