茅先生小儿疳肿塌气丸气肿、水肿不用此药。
川巴豆壳（用醋煮，黑色为度） 青橘皮（去白） 萝卜子（等分）
上为末，醋面糊为丸如此○大。每服五丸至七丸中庸，赤小豆煎汤下。
长沙医者郑愈传治小儿上气喘促，头腹虚肿，时时作声，四肢无力，常有冷热疳气，虚肿。大黄散方
大黄（半两，煨） 川芎 甘草 黑牵牛 犀角（末） 朴硝（各一分）
上件为末。每服二钱，水二盏，煎至三分，入生姜三片同煎，如虚肿入少许蜜，如不肿不用蜜。
吉氏治疳气肿满
陈米（半两，巴豆二十一粒，炒焦） 木香（二钱） 陈橘皮 樟柳根（焙。各一分） 萝卜子（轻炒，钱半）
末，半钱，赤小豆汤温调下。
汉东王先生《家宝》治小儿久患疳疾，体虚，久不进饮食，患来日久。诸候退，只是天柱骨倒，医者不识，谓
之五软候。须进金灵散、生筋散（方并见本门）。
汉东王先生《家宝》生筋散方
木鳖子（三个） 蓖麻子（三十个）
上各取肉，同研。每用一钱许，津唾调贴，急抱揩项上，令热贴之。
《吉氏家传》贴头起项膏 治小儿疳热胆冷，头项软倒方。
川乌（末） 肉桂（末） 芸苔子 天南星 蓖麻子（各一钱） 黄丹（炒，一钱匕）
上大蒜一颗，煨熟去皮，乳钵内研和药细。每用一钱，入米醋和匀，贴项上一日许。
《吉氏家传》野狼毒丸 治小儿胆热肝风，天柱倒折，宜服此药。更用前起头贴项药。
野狼毒（酒浸，焙） 白附子 大附子（炙） 天麻 防风 羌活（以上各一分） 朱砂 地龙（去土。各一钱） 麝
香（一分）
上为细末，法酒煮糊为丸如此○大。每服七丸至十五丸。用黑豆薄荷汤，入酒一滴吞下。
《形证论》他病天柱骨倒歌∶
天柱才倒非心脾，吐泻失调至 羸。大患伤寒无汗脉（《凤髓》∶却被伤寒无浮脉），定因妙药疗他迟。无此卒然生此
患，又兼不辩四肢肥。身软难堪头似石，面红唇赤脸如绯。此病多因伤肾热（《凤髓》胆热），后来因（作伏） 热病（作
又）相随。肝受热风天柱倒，但将凉药与维持。贴须性热筋方缓，立见温和请莫疑。吐泻项软唯调气，伤寒柱倒不须医。
《石壁经》云∶或伤寒，或吐或泻，乘虚邪毒透入肝脉，热邪所浸，致筋软长，或手足软，或项颈软，须凉
膈。若吐泻，先调胃气，贴项，并服凉肝胆药，勿太热，亦恐过冷。
汉东王先生金灵散
直白僵蚕去丝炒，末，薄荷酒调服一钱，日三，更须生筋散贴。
《形证论》贴项药。
川乌头 白芷 地龙 五灵脂 赤小豆等分，末，姜汁，酒调贴项上，更服竹茹散
竹茹散
菊花（三钱） 黄芩 人参（各一钱） 大黄（半两） 甘草（一钱）
末，竹叶汤下。
《玉诀》贴项药。
草乌头、赤小豆等分。末，姜汁调，摊帛上贴，经宿项立起。
茅先生小儿疳肿塌气丸：适用于气肿、水肿者禁用此药。
川巴豆壳（用醋煮，至变黑为止） 青橘皮（去除白色部分） 萝卜子（三者等分）
以上研为细末，用醋调面糊制成如梧桐子大小的丸剂。每次服用五丸至七丸，用赤小豆煎汤送服。
长沙医生郑愈传的大黄散方：治疗小儿上气喘促，头腹部虚肿，时常发出声音，四肢无力，常有冷热疳气引起的虚肿。
大黄（半两，煨制） 川芎 甘草 黑牵牛 犀角（研末） 朴硝（各一分）
以上药材研为细末。每次服用二钱，加水两盏，煎至剩余三分，加入生姜三片同煎；若为虚肿则加入少许蜂蜜，若不肿则不加蜂蜜。
吉氏治疗疳气肿满的方法：
陈米（半两，与二十一粒巴豆一起炒焦） 木香（二钱） 陈橘皮 樟柳根（焙干。各一分） 萝卜子（轻炒，一钱半）
研为细末，每次取半钱，用赤小豆汤温服调下。
汉东王先生《家宝》记载：治疗小儿长期患疳疾，身体虚弱，长期不能进食，患病时间已久。其他症状消退后，仅出现天柱骨倒斜，医生不认识，称之为五软候。必须服用金灵散、生筋散（方剂均见本门类）。
汉东王先生《家宝》中的生筋散方：
木鳖子（三个） 蓖麻子（三十个）
以上分别取肉，共同研磨。每次取约一钱，用唾液调和贴敷，迅速抱住并擦拭颈部，使其发热贴敷。
《吉氏家传》中的贴头起项膏：治疗小儿疳热胆冷，头项软弱倒斜的方剂。
川乌（研末） 肉桂（研末） 芸苔子 天南星 蓖麻子（各一钱） 黄丹（炒制，一钱匕）
以上取大蒜一颗，煨熟去皮，在乳钵中研磨并与药物混合均匀。每次取一钱，加入米醋调和均匀，贴敷于颈部一日左右。
《吉氏家传》中的野狼毒丸：治疗小儿胆热肝风，天柱骨倒折，宜服用此药。同时使用前文提到的起头贴项药。
野狼毒（酒浸，焙干） 白附子 大附子（炙烤） 天麻 防风 羌活（以上各一分） 朱砂 地龙（去土。各一钱） 麝香（一分）
以上研为细末，用法制酒煮面糊制成如梧桐子大小的丸剂。每次服用七丸至十五丸。用黑豆薄荷汤，滴入一滴酒吞服。
《形证论》中关于他病导致天柱骨倒的歌诀：
天柱骨倒并非心脾之病，而是吐泻失调导致极度消瘦。若患伤寒无汗且脉象异常（《凤髓》注：却是伤寒无浮脉），定因用药迟缓所致。若无此情况突然发生此患，又兼四肢不肥壮。身体软弱难支头部沉重如石，面色红唇赤脸颊绯红。此病多因伤肾热（《凤髓》注：胆热），后来因伏热病相随。肝受热风导致天柱倒，只需将凉药给予维持。贴敷需用性热之药筋才能舒缓，立即见效温和请莫怀疑。吐泻导致项软唯需调气，伤寒导致柱倒不需特殊医治。
《石壁经》云：或患伤寒，或呕吐或腹泻，乘虚邪毒透入肝脉，热邪浸淫，导致筋脉松弛伸长，或手足软弱，或项颈软弱，须用凉膈法。若为吐泻，先调理胃气，贴敷颈部，并服用凉肝胆药，不要太热，也恐过冷。
汉东王先生的金灵散：
直白僵蚕（去丝炒制，研末），用薄荷酒调服一钱，每日三次，还需配合生筋散贴敷。
《形证论》中的贴项药：
川乌头 白芷 地龙 五灵脂 赤小豆（等分），研末，用姜汁、酒调和贴敷颈部，同时服用竹茹散。
竹茹散方：
菊花（三钱） 黄芩 人参（各一钱） 大黄（半两） 甘草（一钱）
研为细末，用竹叶汤送服。
《玉诀》中的贴项药：
草乌头、赤小豆（等分）。研末，用姜汁调和，摊在帛上贴敷，经过一夜颈部立刻挺起。
Mao Xiansheng's Erlian Zhongta Qi Wan (Infantile Malnutrition Swelling Collapsing Qi Pill): Contraindicated for patients with Qi swelling or Water swelling.
Cassia obtusifolia Seed Shell (Fried in vinegar until black) Qingju Pi (Green Tangerine Peel, pith removed) Radish Seed (Equal parts)
Grind the above into fine powder, mix with vinegar and wheat paste to form pills the size of a wax gourd seed. Administer 5 to 7 pills per dose, taken with decoction of Adzuki Bean.
Da Huang San (Rhubarb Powder) by Zheng Yuchuan, a physician from Changsha: Treats infantile asthma with rapid breathing, flaccid swelling of the head and abdomen, frequent sounds, weakness of the four limbs, and recurring cold-heat malnutrition qi causing flaccid swelling.
Rhubarb Root and Rhizome (Half tael, stir-baked) Ligusticum Chuanxiong Rhizome Licorice Root Black Morning Glory Seed Rhinoceros Horn (Powdered) Mirabilite (Each one fen)
Grind the above ingredients into fine powder. Take two qian per dose, add two zhan of water, boil down to three parts, add three slices of fresh ginger and boil together. If there is flaccid swelling, add a small amount of honey; if no swelling, do not add honey.
Ji Shi's treatment for malnutrition qi swelling and fullness:
Aged Rice (Half tael, fried scorched with twenty-one Cassia obtusifolia Seeds) Costus Root Two-qian Aged Tangerine Peel Cinnamomum Camphora Root (Dried. Each one fen) Radish Seed (Lightly fried, one-and-a-half qian)
Grind into fine powder. Take half a qian, mix with warm Adzuki Bean decoction and take orally.
Wang Xiansheng from Handong's *Jiabao* (Family Treasure): Treats infants suffering from long-term malnutrition disease, physical weakness, inability to eat for a long time, and prolonged illness duration. After other symptoms subside, only the Tianzhu bone (nuchal rigidity/collapse) remains collapsed. Physicians unfamiliar with this condition call it the "Five Soft" syndrome. Must administer Jinling San (Golden Spirit Powder) and Shengjin San (Tendon-Generating Powder) (formulas see this section).
Shengjin San (Tendon-Generating Powder) from Wang Xiansheng's *Jiabao*:
Mumie Fruit (Three seeds) Castor Seed (Thirty seeds)
Extract the flesh from each, grind together. Apply approximately one qian externally, mixed with saliva, to the nape of the neck. Hold tightly and rub the neck area to generate heat upon application.
*Tie Tou Qi Xiang Gao* (Paste Head to Raise Neck Ointment) from *Ji Shi Jiachuan* (Ji Family Transmission): Treats infantile malnutrition heat with gallbladder cold, resulting in soft and collapsed head and neck.
Aconitum Carmichaelii Lateral Root (Powdered) Cinnamon Bark Rape Seed Arisaema Cum Bile Castor Seed (Each one qian) Red Lead (Stir-fried, one qian bi)
Take one clove of garlic, bake until cooked, peel, and grind in a mortar with the medicines until fine. Apply one qian per dose, mixed with rice vinegar, to the neck for about one day.
Ye Langdu Wan (Wild Wolf Poison Pill) from *Ji Shi Jiachuan*: Treats infantile gallbladder heat and liver wind, causing collapse of the Tianzhu bone. This medicine should be taken. Also use the previous neck-pasting ointment.
Euphorbia Fissurata Root (Soaked in wine, dried) Hyacinth Bean Tubers Prepared Aconite Root Gastrodia Elata Rhizome Saposhnikovia Divaricata Root Notopterygium Root (Each one fen above) Cinnabar Earthworm (Cleaned of soil. Each one qian) Musk (One fen)
Grind into fine powder, make pills using prepared wine and wheat paste, sized like wax gourd seeds. Take 7 to 15 pills per dose. Swallow with decoction of Black Soybean and Mint, adding one drop of wine.
Song on Tianzhu Bone Collapse due to Other Diseases from *Xingzheng Lun*:
Tianzhu collapse is not due to Heart or Spleen, but vomiting and diarrhea imbalance leading to emaciation. Severe Shanghan (Cold Damage) without sweating and abnormal pulse (Note from *Fengsui*: instead of floating pulse), determined by delayed treatment with effective medicine. Without these, sudden onset implies lack of limb fat. Body soft, head heavy as stone, face red, lips crimson, cheeks scarlet. This disease often stems from Kidney Heat (Note from *Fengsui*: Gallbladder Heat), followed by latent heat diseases. Liver receiving heat-wind causes Tianzhu collapse, maintain with cooling medicines. Paste must be hot-natured for tendons to relax, immediate mild effect, do not doubt. Vomiting/diarrhea neck softness requires Qi regulation; Shanghan column collapse needs no special treatment.
*Shibi Jing* states: Whether Shanghan, vomiting, or diarrhea, pathogenic toxins enter the Liver meridian due to deficiency, heat pathogens soak the tendons, causing them to become soft and elongated, or hands/feet soft, or neck soft. Must use Liangge method. If vomiting/diarrhea, first regulate Stomach Qi, paste neck, and take cooling Liver/Gallbladder medicines. Do not be too hot, nor too cold.
Jinling San (Golden Spirit Powder) by Wang Xiansheng from Handong:
Bombyx Batryticatus (Remove silk, stir-fry, powder), take one qian mixed with Mint Wine, three times daily. Also apply Shengjin San externally.
Neck-Pasting Medicine from *Xingzheng Lun*:
Aconitum Carmichaelii Root Angelica Dahurica Root Pheretima Aspergillum Trogopterus Dung Vigna Angularis Seed (Equal parts), powder, mix with Ginger Juice and Wine, paste on neck. Also take Zhuru San.
Zhuru San (Bamboo Shavings Powder):
Chrysanthemum Flower Scutellaria Baicalensis Ginseng Root (Each one qian) Rhubarb Root (Half tael) Licorice Root (One qian)
Powder, take with Bamboo Leaf decoction.
Neck-Pasting Medicine from *Yujue*:
Aconitum Kusnezoffii Root and Vigna Angularis Seed (Equal parts). Powder, mix with Ginger Juice, spread on cloth, paste on neck. Overnight, the neck will stand upright.