《巢氏病源》小儿痞结候∶痞者塞也。小儿胸膈热实，腹内有留饮，致令荣卫痞塞，不得宣通，其病腹内气
结胀满，或时壮热是也。
《婴童宝鉴》小儿痞结歌∶
胸中热兼实，荣卫不通彻，脏腑岂能和，经中号痞结。气满腹肚胀，时时变寒热，何必问神祗，此是分明诀。
《葛氏肘后》若患腹中痞结，常壮热者方。
大黄（炙使烟出） 龟甲（炙令黄） 茯苓（各三分）
上捣为末，蜜丸。服如大豆一枚，日三。看儿大小增减。
《千金》鳖甲丸 治少小腹中结坚，胁下有疹，手足烦热方。
鳖甲（醋炙香熟） 芍药 大黄（各三十铢） 茯苓 柴胡 干姜（炮 各二十四铢） 桂
心（六铢） 虫 蛴螬（各二十枚）
上件末之，蜜和。服如梧子大七丸，渐渐加之，以知为度。
《千金》治小儿痞气，胁下、腹中有积聚，坚痛。鳖头丸方
鳖头（一枚） 虻虫 桃仁 虫（各十八铢） 甘皮（半两）
上五味末之，蜜丸。服如小豆大二丸，日三。大便不利加大黄十八铢，以知为度。《圣惠》方同，但用大黄无甘皮。
《千金》治小儿心下痞，淡癖结聚，腹大胀满，身体壮热，不欲哺乳。芫花丸方
芫花 黄芩（各一两） 大黄（二两半。《婴孺》用十铢） 雄黄（二两半。《婴孺》用十铢）
上四味末之，蜜和，更捣一千杵，三岁儿至一岁以下，服如粟米大一丸。欲服丸，内儿喉中，令母与乳。
若长服消病者，当以意消息与服之，与乳哺相避。
陈藏器治小儿痞满方
上用三白草捣，绞汁服，令人吐逆。除胸膈热疾，亦主疟及小儿痞满。按此草初生无白，入夏叶端半白如
粉，农人候之莳田，三叶草白便秀，故谓之三白。
陈藏器又方
上用甜藤叶捣，敷小儿腹，除痞满闪癖。
《圣惠》治小儿腹内痞结，壮热羸瘦，多啼。宜服前胡散方
前胡（去芦头） 川大黄（锉碎，微炒。各三分） 枳壳（微炒，微黄） 赤茯苓 犀角（
屑） 郁李仁（汤浸，去皮，微炒） 鳖甲（涂醋炙令黄，去裙 。各半两）
上件药捣，粗罗为散。每服一钱，以水一小盏，煎至五分，去滓，看儿大小分减温服，微利为度。
《圣惠》治小儿腹内痞结，身体壮热，中焦壅闷，肠胃不利，柴胡散方
柴胡（去苗） 赤茯苓 芎 鳖甲（涂醋炙令黄，去裙 ） 枳壳（麸炒微黄，去瓤） 赤勺药 桃
仁（汤浸去皮、尖、双仁。麸炒微黄） 槟榔（各半两） 甘草（一分，炙微赤，锉）
上件药捣，粗罗为散。每服一钱，以水一小盏，煎至五分，去滓温服，日三服。更量儿大小加减服之。
《圣惠》治小儿腹内痞结，壮热憎寒，大小便不利。大腹皮散方
大腹皮（锉） 陈橘皮（汤浸，去白瓤，焙） 桔梗（去芦头） 鳖甲（涂醋炙令黄，去
裙。各三分） 人参（去芦头） 赤芍药 川大黄（锉碎，微炒） 木通（锉。各半两） 甘草（一分，炙微赤，锉）
上件药捣，粗罗为散。每服一钱，以水一小盏，煎至五分，去滓。看儿大小分减温服之。
《圣惠》治小儿腹内痞结，壮热不能乳食，心胸烦壅。宜服槟榔散方
槟榔 川大黄（锉碎，微炒。各半两） 枳壳（麸炒微黄，去瓤） 人参 柴胡（各去芦头） 知母 赤
芍药 地骨皮 甘草（炙微赤，锉。各一分）
上件药捣，粗罗为散。每服一钱，以清水一小盏，煎至五分，去滓。放温，量儿大小分减服之。
《圣惠》治小儿腹内痞结，虽服汤得利，而滞实不去，心下坚满，按之辄啼，内有伏热诸候，集成此疾，宜服破
痞除热甘遂散方
甘遂（一分，煨令微黄） 青橘皮（汤浸，去白瓤，焙） 黄芩 川大黄（锉碎，微炒。各半两）
上件药捣，粗罗为散。每服一钱，以水一小盏，煎至五分，去滓。量儿大小分减温服，以利即止。
《圣惠》治小儿腹内痞结，多惊。牛黄丸方
牛黄 麝香（各细研） 甘遂（煨令微黄） 川椒（去目及开口者，微炒去汗。各一分） 巴豆霜（半分） 蜈
蚣（一枚，去足，炙令黄） 蚱蝉（七枚，微炙） 川芒硝 真珠（末） 雄黄（细研。各半两）
上件药捣，罗为末，都研令匀。用炼成蜜一合，入白腊一两，合煎令熔，和丸如麻子大。每服以粥饮下二
丸，以利为度，如未利，再服。看儿大小以意加减。
《圣惠》治小儿腹内痞结妨闷。硝石丸方
硝石 柴胡（去苗） 川大黄（锉碎，微炒） 黄芩（各半两） 细辛（洗，去苗、土） 当
归（锉，微炒） 茯神 赤芍药 甘遂（煨令微黄） 木
香甜葶苈（隔纸炒令紫色。各一分） 巴豆（十枚。去皮、心，纸裹压去油）
上件药捣，罗为末，都研令匀，炼蜜和丸如绿豆大。每服一岁儿一丸，二岁二丸，三岁三丸，四、五岁儿
可服五丸。并空心以粥饮下，以得快利为度，若未利，明旦再服之。更量儿虚实以意加减。
《圣惠》治小儿腹内痞结，乳食不消，心腹刺痛。甘遂丸方
甘遂（煨令微黄） 真珠（末。各一分） 黄芩 赤芍药 杏仁（汤浸，去皮尖、双仁，麸炒微黄） 巴
豆霜（各半两）
上件药捣，罗为末∶入杏仁、巴豆霜同研令匀，炼蜜和丸如麻子大。二、三岁儿空腹，以温水下二丸，以
利为效，未利再服。更随儿大小以意加减。
太医局进食丸 治乳食不消，心腹胀满，壮热喘粗，呕吐痰逆，肠鸣泄泻，水谷全出。或下痢赤白，腹痛后重，
及食 ，乳癖， 气，痞结，并皆治之。
代赭（醋 ，研） 当归（去芦头，锉，微炒） 朱砂（细研水飞） 枳壳（麸炒微黄，去瓤） 木香（各半
两） 麝香（细研，一分） 巴豆霜（半分）
上件药捣，罗为末，入研药匀，面糊为丸如麻子大。每一岁儿服一丸，温米饮下。更量虚实加减服之，食
后。
《婴孺》鳖甲足丸 治少小里急、胁下支坚方。
鳖头、足（一具，酒二斤，浸一宿，炙干） 蛴螬（四十个，炙） 虻虫（二合。去头、足、羽） 蚱
蝉蜣螂（各炙二十个） 干姜 人参（各三两） 云母（炼） 芎（各二两） 桂心（一两） 牛黄（一分）
上为末，炼蜜为丸如小豆大。二丸，日再。
《婴孺》治小儿八痞，曾青丸 一、当心下坚痛，大如小杯，名蒸痞，曾青主之。二、如板起于胁下，抢心，
名蛇痞，龙骨主之。三、夹脐如手，名鱼痞，龟甲主之。四、绕脐腹雷鸣，名寒痞，干姜主之。五、当心如杯，
不可摇动，名虫痞，牡丹主之。六、心下如盘，名气痞，鳖甲主之。七、生于寒热，腰背痛状如疟，名血痞，
虫主之。八、脓出腹中痛，名风痞，蜚蠊主之。
曾青 干姜 虫 紫石英 牡丹皮（去心） 桂心（各二分） 大黄 龙骨（各五分） 蜀漆（七
分） 龟甲（亦云鳖甲） 真珠 蜚蠊（各三分） 细辛（六分） 附子（炮，四分）
上十四味为末，视上所说，根据病所主，皆倍药分，和以蜜，未食服桐子大四丸。此是五、六岁儿所服，若
小儿，以意量之。日三服，丸子大小，量儿与之。服之当微烦，勿怪。腹中诸病皆出，神效。忌猪、鱼、菜
物。据上八说，疑别有鳖甲并用也。
《婴孺》治小儿先得寒热，腹坚牢强痞，不能饮食，不生肌肉，时苦壮热。鸡骨丸方
芎 当归 紫菀 大黄（蒸，三升米下） 茯苓（各三分） 杏仁（去皮炒） 桂心（各四分） 杜
衡白芷 石膏（各二分） 半夏（一分，洗）
黄雌鸡（一个，破腹，勿令中水，去肉取两胁翼及胫骨，干之，炙令黄色）
上为末，蜜为丸如小豆大。每服二丸，日进三服，稍稍加之，神效。
《婴孺》治小儿患腹中痞结，常壮热方。
大黄（炙烟出） 鳖甲（炙黄） 茯苓（等分）
上为末，蜜丸大豆大。饮下，日三。小儿加减之。
《婴孺》治小儿胁下有痞，手足烦热。五参丸方
人参 苦参 丹参 沙参 元参 防风（各一两） 干姜 附子（各半两，炮）
虫（五个，炙） 大黄（四两，蒸三升米下） 蜀椒（一合，去汗） 巴豆（二十个，去皮、心，炒） 葶苈（一合，
炒）
上为末，别研巴豆，入匀，杵万下，蜜丸如小豆大。一岁儿一丸，日再，稍加丸数。
《婴孺》治小儿胁下积气，羸瘦骨立，圊便不节。大鳖头足丸方
鳖头、足（一具，酒浸一宿。炙令黄） 干漆（二分，炒） 紫芝 芍药 人参 栝蒌根（各三
分） 甘草（四分）
上为末，蜜和丸如胡豆大。一丸，日进三服。鳖截之，去颔、下段足，取腕前。
《婴孺》治小儿痞气，胁下胀满，腹中积聚、坚痛。鳖头丸方
鳖头（一个） 虻虫 虫 桃仁（炒。各三分）
上为末，蜜丸如小豆大。二丸，日进三服，以知为度。如不利，加大黄三分。
《婴孺》治小儿服汤已得大利，温壮已折，而滞实不去，心下坚，痞满不可按，辄啼，内有伏热诸候，集成此疾。
宜服破痞除热。甘遂汤方
甘遂 甘草（炙。各二分） 黄芩 大黄（各四分）
上以水二升，破鸡子二个和，取白投水中搅，令沫上，吹去之，内药煮九合。为二服。
《吉氏家传》取小儿痞方。
白丁香 紫丁香（各四十九粒） 舶上硫黄 密陀僧（各一块，皂皂子大） 五倍子（一个，
枣大） 黄鹰条（末，炒一钱） 麝（少许）
上末。如小儿瘦者，粟米饮下半钱；肥者大米饮下。并第七椎下两边灸之，须齐下火。疳、蛔虫自出如麸
片相似，效。
《巢氏病源》中关于小儿痞结的论述：痞，意为阻塞。小儿因胸膈部位热邪壅盛且实证，腹内有停饮（水液代谢障碍形成的病理产物），导致营卫之气痞塞阻滞，不能宣通畅达，其病症表现为腹内气机结聚、胀满，有时伴有高热。
《婴童宝鉴》中关于小儿痞结的歌诀：
胸中热邪兼有实邪，营卫之气不通彻，脏腑功能怎能调和？在经络中称为痞结。气机壅滞导致腹部胀满，时常出现寒热交替的症状，何必去问神鬼，这是明确的诊断口诀。
《葛氏肘后》治疗若患腹中痞结，经常发高热的方剂。
大黄（炙至烟出） 龟甲（炙至黄色） 茯苓（各三分）
以上药物捣碎成末，用蜂蜜制成丸药。每次服用如大豆大小的一粒，每日三次。根据患儿年龄大小酌情增减剂量。
《千金方》鳖甲丸，治疗少腹及小腹部结块坚硬，胁下有疹块，手足烦热的方剂。
鳖甲（醋炙至香熟） 芍药 大黄（各三十铢） 茯苓 柴胡 干姜（炮制，各二十四铢） 桂心（六铢） 䗪虫 蛴螬（各二十枚）
以上药物研成细末，用蜂蜜调和。每次服用如梧桐子大小的七丸，逐渐增加剂量，以见效为度。
《千金方》治疗小儿痞气，胁下、腹中有积聚物，坚硬疼痛。鳖头丸方
鳖头（一枚） 虻虫 桃仁 䗪虫（各十八铢） 甘皮（半两）
以上五味药研成细末，用蜂蜜制成丸药。每次服用如小豆大小的两丸，每日三次。若大便不通畅，加大黄十八铢，以见效为度。《圣惠方》与此相同，只是不用甘皮而用大黄。
《千金方》治疗小儿心下痞闷，淡癖结聚，腹部胀大，身体高热，不想吃奶。芫花丸方
芫花 黄芩（各一两） 大黄（二两半。《婴孺书》用十铢） 雄黄（二两半。《婴孺书》用十铢）
以上四味药研成细末，用蜂蜜调和，再捣一千杵。三岁至一岁以下的幼儿，每次服用如粟米大小的一丸。欲服药时，将药丸放入婴儿喉中，让母亲同时喂奶。
若长期服用以消除疾病，应当斟酌情况给药，并与哺乳时间错开。
陈藏器治疗小儿痞满的方剂
上述药物用三白草捣碎，绞取汁液服用，能引起呕吐。可清除胸膈的热疾，也主治疟疾及小儿痞满。按此草初生时无白色，入夏后叶端一半变白如粉，农民观察它来安排插秧，三片叶子变白便抽穗开花，所以叫三白草。
陈藏器又一方
上述药物用甜藤叶捣碎，敷于小儿腹部，可消除痞满和闪癖。
《圣惠方》治疗小儿腹内痞结，高热消瘦，多啼哭。宜服前胡散方
前胡（去芦头） 川大黄（锉碎，微炒。各三分） 枳壳（微炒，微黄） 赤茯苓 犀角（屑） 郁李仁（汤浸，去皮，微炒） 鳖甲（涂醋炙令黄，去裙襕。各半两）
以上药物捣碎，粗筛为散剂。每次服用一钱，用水一小盏，煎至五分，去渣，根据患儿年龄大小分次减量温服，以轻微腹泻为度。
《圣惠方》治疗小儿腹内痞结，身体高热，中焦壅闷，肠胃不利，柴胡散方
柴胡（去苗） 赤茯苓 川芎 鳖甲（涂醋炙令黄，去裙襕） 枳壳（麸炒微黄，去瓤） 赤芍药 桃仁（汤浸去皮、尖、双仁。麸炒微黄） 槟榔（各半两） 甘草（一分，炙微赤，锉）
以上药物捣碎，粗筛为散剂。每次服用一钱，用水一小盏，煎至五分，去渣温服，每日三次。再根据患儿年龄大小加减剂量服用。
《圣惠方》治疗小儿腹内痞结，高热恶寒，大小便不利。大腹皮散方
大腹皮（锉） 陈橘皮（汤浸，去白瓤，焙） 桔梗（去芦头） 鳖甲（涂醋炙令黄，去裙襕。各三分） 人参（去芦头） 赤芍药 川大黄（锉碎，微炒） 木通（锉。各半两） 甘草（一分，炙微赤，锉）
以上药物捣碎，粗筛为散剂。每次服用一钱，用水一小盏，煎至五分，去渣。根据患儿年龄大小分次减量温服。
《圣惠方》治疗小儿腹内痞结，高热不能进食，心胸烦闷壅塞。宜服槟榔散方
槟榔 川大黄（锉碎，微炒。各半两） 枳壳（麸炒微黄，去瓤） 人参 柴胡（各去芦头） 知母 赤芍药 地骨皮 甘草（炙微赤，锉。各一分）
以上药物捣碎，粗筛为散剂。每次服用一钱，用清水一小盏，煎至五分，去渣。放温，根据患儿年龄大小分次减量服用。
《圣惠方》治疗小儿腹内痞结，虽服汤药已得腹泻，但积滞实邪未去，心下坚硬胀满，按压就啼哭，内有伏热等各种症状，集成此疾，宜服破痞除热甘遂散方
甘遂（一分，煨令微黄） 青橘皮（汤浸，去白瓤，焙） 黄芩 川大黄（锉碎，微炒。各半两）
以上药物捣碎，粗筛为散剂。每次服用一钱，用水一小盏，煎至五分，去渣。根据患儿年龄大小分次减量温服，一旦腹泻即停止服用。
《圣惠方》治疗小儿腹内痞结，易受惊吓。牛黄丸方
牛黄 麝香（各细研） 甘遂（煨令微黄） 川椒（去目及开口者，微炒去汗。各一分） 巴豆霜（半分） 蜈蚣（一枚，去足，炙令黄） 蚱蝉（七枚，微炙） 川芒硝 真珠（末） 雄黄（细研。各半两）
以上药物捣碎，过筛成末，全部研磨均匀。用炼成的蜜一合，加入白蜡一两，合煎至熔化，调和制成如麻子大小的丸药。每次用米粥送服两丸，以腹泻为度，若未腹泻，再服用。根据患儿年龄大小斟酌加减。
《圣惠方》治疗小儿腹内痞结妨碍闷乱。硝石丸方
硝石 柴胡（去苗） 川大黄（锉碎，微炒） 黄芩（各半两） 细辛（洗，去苗、土） 当归（锉，微炒） 茯神 赤芍药 甘遂（煨令微黄） 木香 甜葶苈（隔纸炒令紫色。各一分） 巴豆（十枚。去皮、心，纸裹压去油）
以上药物捣碎，过筛成末，全部研磨均匀，用炼蜜调和制成如绿豆大小的丸药。每次服用：一岁儿一丸，二岁二丸，三岁三丸，四、五岁儿可服五丸。均空腹用米粥送服，以得快利为度，若未腹泻，次日早晨再服。再根据患儿虚实情况斟酌加减。
《圣惠方》治疗小儿腹内痞结，乳食不消，心腹刺痛。甘遂丸方
甘遂（煨令微黄） 真珠（末。各一分） 黄芩 赤芍药 杏仁（汤浸，去皮尖、双仁，麸炒微黄） 巴豆霜（各半两）
以上药物捣碎，过筛成末：加入杏仁、巴豆霜同研均匀，用炼蜜调和制成如麻子大小的丸药。二、三岁儿空腹，用温水送服两丸，以腹泻为效，未腹泻再服。再随患儿年龄大小斟酌加减。
太医局进食丸，治疗乳食不消，心腹胀满，高热喘促粗重，呕吐痰逆，肠鸣泄泻，水谷全出。或下痢赤白，腹痛里急后重，以及食积，乳癖，疳气，痞结，都一并治疗。
代赭石（醋淬，研） 当归（去芦头，锉，微炒） 朱砂（细研水飞） 枳壳（麸炒微黄，去瓤） 木香（各半两） 麝香（细研，一分） 巴豆霜（半分）
以上药物捣碎，过筛成末，加入研好的药拌匀，用面糊制成如麻子大小的丸药。每一岁儿服一丸，用温米汤送服。再根据虚实情况加减服用，饭后服用。
《婴孺书》鳖甲足丸，治疗婴幼儿里急、胁下支撑坚硬。
鳖头、足（一具，酒二斤，浸泡一夜，炙干） 蛴螬（四十个，炙） 虻虫（二合。去头、足、翅） 蚱蝉 蜣螂（各炙二十个） 干姜 人参（各三两） 云母（炼） 川芎（各二两） 桂心（一两） 牛黄（一分）
以上药物研成细末，用炼蜜制成如小豆大小的丸药。每次两丸，每日两次。
《婴孺书》治疗小儿八种痞气，曾青丸
一、当心下坚硬疼痛，大如小杯，名为蒸痞，由曾青主治。二、如板状突起于胁下，冲犯心脏，名为蛇痞，由龙骨主治。三、夹脐部如手掌大小，名为鱼痞，由龟甲主治。四、绕脐腹部雷鸣作响，名为寒痞，由干姜主治。五、当心口如杯子状，不可摇动，名为虫痞，由牡丹主治。六、心下如盘状，名为气痞，由鳖甲主治。七、生于寒热之间，腰背痛状如疟疾，名为血痞，由䗪虫主治。八、脓出腹中痛，名为风痞，由蜚蠊主治。
曾青 干姜 䗪虫 紫石英 牡丹皮（去心） 桂心（各二分） 大黄 龙骨（各五分） 蜀漆（七分） 龟甲（亦云鳖甲） 真珠 蜚蠊（各三分） 细辛（六分） 附子（炮，四分）
以上十四味药研成细末，根据上述所说，依据病情主要症状，都将药量加倍，用蜂蜜调和，未进食时服用如梧桐子大小的四丸。这是五、六岁儿童所服的剂量，若是更小的幼儿，根据情况斟酌。每日三次，丸子大小，根据患儿年龄给予。服药后应当轻微烦躁，不要奇怪。腹中各种病邪皆会排出，效果神奇。忌食猪、鱼、菜类食物。据以上八种说法，怀疑另有鳖甲并用。
《婴孺书》治疗小儿先得寒热，腹部坚硬强直痞结，不能饮食，不长肌肉，时常苦于高热。鸡骨丸方
川芎 当归 紫菀 大黄（蒸，三升米下） 茯苓（各三分） 杏仁（去皮炒） 桂心（各四分） 杜衡 白芷 石膏（各二分） 半夏（一分，洗）
黄雌鸡（一个，剖开腹部，勿令进水，去掉肉取两胁翼及胫骨，晒干，炙至黄色）
以上药物研成细末，用蜂蜜制成如小豆大小的丸药。每次服用两丸，每日进服三次，逐渐增加剂量，效果神奇。
《婴孺书》治疗小儿患腹中痞结，经常高热方。
大黄（炙烟出） 鳖甲（炙黄） 茯苓（等分）
以上药物研成细末，用蜂蜜制成如大豆大小的丸药。饮水送服，每日三次。根据小儿年龄加减剂量。
《婴孺书》治疗小儿胁下有痞，手足烦热。五参丸方
人参 苦参 丹参 沙参 玄参 防风（各一两） 干姜 附子（各半两，炮制）
䗪虫（五个，炙） 大黄（四两，蒸三升米下） 蜀椒（一合，去汗） 巴豆（二十个，去皮、心，炒） 葶苈（一合，炒）
以上药物研成细末，另外单独研巴豆，混合均匀，捣一万杵，用蜂蜜制成如小豆大小的丸药。一岁儿一丸，每日两次，逐渐增加丸数。
《婴孺书》治疗小儿胁下积气，消瘦骨立，排便不节制。大鳖头足丸方
鳖头、足（一具，酒浸泡一夜。炙令黄） 干漆（二分，炒） 紫芝 芍药 人参 栝蒌根（各三分） 甘草（四分）
以上药物研成细末，用蜂蜜调和制成如胡豆大小的丸药。每次一丸，每日进服三次。鳖截断，去掉下巴和下段脚，取腕关节前部。
《婴孺书》治疗小儿痞气，胁下胀满，腹中积聚、坚硬疼痛。鳖头丸方
鳖头（一个） 虻虫 䗪虫 桃仁（炒。各三分）
以上药物研成细末，用蜂蜜制成如小豆大小的丸药。每次两丸，每日进服三次，以见效为度。若不腹泻，加大黄三分。
《婴孺书》治疗小儿服汤药已得大利，温热已退，但积滞实邪未去，心下坚硬，痞满不可按压，动辄啼哭，内有伏热等各种症状，集成此疾。宜服破痞除热甘遂汤方
甘遂 甘草（炙。各二分） 黄芩 大黄（各四分）
以上用水二升，打破鸡蛋两个混合，取蛋清投入水中搅拌，令泡沫浮起，吹去之，放入药物煮至九合。分为两次服用。
《吉氏家传》治疗小儿痞方的方法。
白丁香 紫丁香（各四十九粒） 舶上硫黄 密陀僧（各一块，皂荚子大） 五倍子（一个，枣大） 黄鹰条（末，炒一钱） 麝（少许）
以上药物研成细末。如果小儿瘦弱，用粟米饮送服半钱；肥胖的用大米饮送服。并在第七椎下两边施灸，必须同时点火。疳积、蛔虫自然排出如麸片相似，有效。
According to *Chao Shi Bing Yuan* (Source of Diseases by Chao Yuanfang) regarding the syndrome of pediatric Pi Jie (abdominal mass/blockage): "Pi" means obstruction. In children, due to heat excess and solid pathogenic factors in the chest and diaphragm, with retained fluids (pathological fluid accumulation) in the abdomen, Ying and Wei Qi (nutritive and defensive energies) become blocked and cannot circulate freely. The disease manifests as qi stagnation and distension in the abdomen, sometimes accompanied by high fever.
The song from *Ying Tong Bao Jian* (Precious Mirror for Infants and Children) on pediatric Pi Jie:
Heat and excess in the chest, Ying and Wei Qi not flowing thoroughly, how can Zang and Fu organs harmonize? It is called Pi Jie in the meridians. Qi fullness causes abdominal distension, frequent changes between cold and heat. Why ask spirits and gods? This is a clear diagnostic formula.
From *Ge Shi Zhou Hou* (Emergency Prescriptions in the Elbow Sleeve by Ge Hong), a prescription for abdominal Pi Jie with frequent high fever.
Da Huang (Rhei Radix et Rhizoma, processed until smoke appears) Gui Jia (Testudinis Carapax et Plastrum, processed until yellow) Fu Ling (Poria, each 3 fen).
Grind the above into powder, mix with honey to make pills. Administer one pill the size of a soybean, three times a day. Adjust dosage according to the child's age.
*Bian Jia Wan* (Soft-shelled Turtle Pill) from *Qian Jin* (Essential Prescriptions Worth a Thousand Gold), treating hard masses in the lower abdomen, nodules under the hypochondrium, and vexing heat in the hands and feet.
Bian Jia (Testudinis Carapax et Plastrum, vinegar-processed until fragrant) Shao Yao (Paeoniae Radix) Da Huang (Rhei Radix et Rhizoma, each 30 zhu) Fu Ling (Poria) Chai Hu (Bupleuri Radix) Gan Jiang (Zingiberis Rhizoma, processed, each 24 zhu) Gui Xin (Cinnamomi Ramulus, 6 zhu) E Chong (Asiatic Ground Beetle, 20 pieces) Qi Cao (Melandryi Larva, 20 pieces).
Grind the above ingredients into powder, mix with honey. Administer seven pills the size of a sterculia seed, gradually increasing the dose until efficacy is achieved.
*Bian Tou Wan* (Soft-shelled Turtle Head Pill) from *Qian Jin*, treating pediatric Pi Qi (abdominal mass), accumulations in the hypochondrium and abdomen, with hardness and pain.
Bian Tou (Head of Soft-shelled Turtle, 1 piece) Meng Chong (Bloodsucking Fly, 18 zhu) Tao Ren (Persicae Semen, 18 zhu) E Chong (Asiatic Ground Beetle, 18 zhu) Gan Pi (Citri Reticulatae Pericarpium, half liang).
Grind the above five herbs into powder, mix with honey to make pills. Administer two pills the size of a mung bean, three times a day. If bowel movement is difficult, add Da Huang (Rhei Radix et Rhizoma) 18 zhu, stop when efficacy is achieved. The prescription in *Sheng Hui Fang* is the same but uses Da Huang instead of Gan Pi.
*Yuan Hua Wan* (Genkwa Flower Pill) from *Qian Jin*, treating pediatric subcardiac Pi (stagnation), Dan Pi (pale accumulation), abdominal distension, high fever, and refusal to nurse.
Yuan Hua (Flos Genkwa, 1 liang) Huang Qin (Scutellariae Radix, 1 liang) Da Huang (Rhei Radix et Rhizoma, 2.5 liang; *Ying Ru* uses 10 zhu) Xiong Huang (Realgar, 2.5 liang; *Ying Ru* uses 10 zhu).
Grind the above four herbs into powder, mix with honey, and pound for one thousand strokes. For children aged one to three years, administer one pill the size of a millet grain. To administer, place the pill in the infant's throat while the mother nurses.
For long-term use to eliminate disease, adjust the dosage carefully and avoid administering simultaneously with nursing.
Chen Cangqi's prescription for pediatric Pi Man (fullness/blockage):
Crush San Bai Cao (Three-white Herb) and extract the juice for oral administration, which induces vomiting. It clears heat disorders in the chest and diaphragm and also treats malaria and pediatric Pi Man. Note: This herb is white when it first grows; in summer, half of the leaf tip turns white like powder. Farmers observe this to time their rice transplanting. When the three leaves turn white, it flowers, hence the name "San Bai" (Three Whites).
Another prescription by Chen Cangqi:
Crush Tian Teng Ye (Sweet Vine Leaf) and apply topically to the child's abdomen to remove Pi Man and Shan Pi (flash accumulation).
*Qian Hu San* (Peucedani Radix Powder) from *Sheng Hui Fang*, treating pediatric intra-abdominal Pi Jie, high fever, emaciation, and excessive crying.
Qian Hu (Peucedani Radix, remove rhizome) Chuan Da Huang (Rhei Radix et Rhizoma, crushed, slightly stir-fried, each 3 fen) Zhi Ke (Aurantii Fructus, slightly stir-fried, slightly yellow) Chi Fu Ling (Red Poria) Xi Jiao (Rhinocerotis Cornu, shaved) Yu Li Ren (Prunus Lavidiana Seed, soaked in water, peeled, slightly stir-fried) Bian Jia (Testudinis Carapax et Plastrum, coated with vinegar, processed until yellow, remove skirt-like edges, each half liang).
Grind the above medicines, sieve coarsely to make a powder. Take one qian per dose, decoct with one small cup of water until reduced to half a cup, strain, and administer warm in divided doses adjusted for the child's age, stopping when mild diarrhea occurs.
*Chai Hu San* (Bupleuri Radix Powder) from *Sheng Hui Fang*, treating pediatric intra-abdominal Pi Jie, high fever, middle jiao congestion, and intestinal/colonic dysfunction.
Chai Hu (Bupleuri Radix, remove sprouts) Chi Fu Ling (Red Poria) Xiong (Ligustici Chuanxiong Rhizoma) Bian Jia (Testudinis Carapax et Plastrum, coated with vinegar, processed until yellow, remove skirt-like edges) Zhi Ke (Aurantii Fructus, bran-stir-fried until slightly yellow, remove pith) Chi Shao Yao (Red Paeoniae Radix) Tao Ren (Persicae Semen, soaked in water, peeled, remove tips and double kernels, bran-stir-fried until slightly yellow) Bing Lang (Arecae Semen, each half liang) Gan Cao (Glycyrrhizae Radix et Rhizoma, 1 fen, roasted until slightly red, crushed).
Grind the above medicines, sieve coarsely to make a powder. Take one qian per dose, decoct with one small cup of water until reduced to half a cup, strain, and administer warm, three times a day. Adjust dosage according to the child's age.
*Da Fu Pi San* (Arecae Pericarpium Powder) from *Sheng Hui Fang*, treating pediatric intra-abdominal Pi Jie, high fever with aversion to cold, and difficulty in urination and defecation.
Da Fu Pi (Arecae Pericarpium, crushed) Chen Ju Pi (Citri Reticulatae Pericarpium, soaked in water, remove white pith, dried) Jie Geng (Platycodonis Radix, remove rhizome) Bian Jia (Testudinis Carapax et Plastrum, coated with vinegar, processed until yellow, remove skirt-like edges, each 3 fen) Ren Shen (Ginseng Radix, remove rhizome) Chi Shao Yao (Red Paeoniae Radix) Chuan Da Huang (Rhei Radix et Rhizoma, crushed, slightly stir-fried) Mu Tong (Akebiae Caulis, crushed, each half liang) Gan Cao (Glycyrrhizae Radix et Rhizoma, 1 fen, roasted until slightly red, crushed).
Grind the above medicines, sieve coarsely to make a powder. Take one qian per dose, decoct with one small cup of water until reduced to half a cup, strain, and administer warm in divided doses adjusted for the child's age.
*Bing Lang San* (Arecae Semen Powder) from *Sheng Hui Fang*, treating pediatric intra-abdominal Pi Jie, high fever, inability to eat/drink, and mental restlessness/congestion.
Bing Lang (Arecae Semen) Chuan Da Huang (Rhei Radix et Rhizoma, crushed, slightly stir-fried, each half liang) Zhi Ke (Aurantii Fructus, bran-stir-fried until slightly yellow, remove pith) Ren Shen (Ginseng Radix) Chai Hu (Bupleuri Radix, remove rhizomes, each) Zhi Mu (Anemarrhenae Rhizoma) Chi Shao Yao (Red Paeoniae Radix) Di Gu Pi (Lycii Cortex) Gan Cao (Glycyrrhizae Radix et Rhizoma, roasted until slightly red, crushed, each 1 fen).
Grind the above medicines, sieve coarsely to make a powder. Take one qian per dose, decoct with one small cup of clear water until reduced to half a cup, strain, let cool to warm, and administer in divided doses adjusted for the child's age.
*Gan Sui San* (Kansui Root Powder for Breaking Pi and Removing Heat) from *Sheng Hui Fang*, treating pediatric intra-abdominal Pi Jie where, although decoctions induce diarrhea, stagnation and excess remain, with hardness/fullness below the heart, crying upon pressure, and internal latent heat symptoms.
Gan Sui (Kansui Radix, 1 fen, baked until slightly yellow) Qing Ju Pi (Green Citri Reticulatae Pericarpium, soaked in water, remove white pith, dried) Huang Qin (Scutellariae Radix) Chuan Da Huang (Rhei Radix et Rhizoma, crushed, slightly stir-fried, each half liang).
Grind the above medicines, sieve coarsely to make a powder. Take one qian per dose, decoct with one small cup of water until reduced to half a cup, strain, and administer warm in divided doses adjusted for the child's age. Stop once diarrhea occurs.
*Niu Huang Wan* (Calculus Bovis Pill) from *Sheng Hui Fang*, treating pediatric intra-abdominal Pi Jie with frequent fright.
Niu Huang (Calculus Bovis) She Xiang (Moschi Moschiferi Secretio, each finely ground) Gan Sui (Kansui Radix, baked until slightly yellow) Chuan Jiao (Sichuan Pepper, remove eyes and open ones, slightly stir-fried to remove sweat, each 1 fen) Ba Dou Shuang (Crotonis Fructus Paste, half fen) Wu Gong (Scolopendra, 1 piece, remove feet, bake until yellow) Zha Chan (Tettigidae, 7 pieces, slightly baked) Chuan Mang Xiao (Mirabilitum) Zhen Zhu (Margarita, powdered) Xiong Huang (Realgar, finely ground, each half liang).
Grind the above medicines, sieve into powder, and grind all together until uniform. Use one he of refined honey and one liang of white beeswax, melt together, and mix to form pills the size of sesame seeds. Administer two pills per dose with porridge drink, stopping when diarrhea occurs. If no diarrhea, administer again. Adjust dosage according to the child's age.
*Xiao Shi Wan* (Niter Pill) from *Sheng Hui Fang*, treating pediatric intra-abdominal Pi Jie causing oppression and stuffiness.
Xiao Shi (Natrii Sulfas) Chai Hu (Bupleuri Radix, remove sprouts) Chuan Da Huang (Rhei Radix et Rhizoma, crushed, slightly stir-fried) Huang Qin (Scutellariae Radix, each half liang) Xi Xin (Asari Radix et Rhizoma, washed, remove sprouts and soil) Dang Gui (Angelicae Sinensis Radix, crushed, slightly stir-fried) Fu Shen (Poria with Hostwood) Chi Shao Yao (Red Paeoniae Radix) Gan Sui (Kansui Radix, baked until slightly yellow) Mu Xiang (Aucklandiae Radix) Tian Ting Li (Descurainiae Semen Lepidii seu Sisymbrii, stir-fried between papers until purple, each 1 fen) Ba Dou (Crotonis Fructus, 10 pieces, peel, remove heart, wrap in paper and press to remove oil).
Grind the above medicines, sieve into powder, and grind all together until uniform. Mix with refined honey to form pills the size of mung beans. Dosage: one-year-old takes one pill, two-year-old takes two, three-year-old takes three, four- to five-year-olds take five. All taken on an empty stomach with porridge drink, aiming for rapid purgation. If no purgation, administer again the next morning. Adjust based on the child's deficiency or excess.
*Gan Sui Wan* (Kansui Root Pill) from *Sheng Hui Fang*, treating pediatric intra-abdominal Pi Jie, indigestion of milk/food, and stabbing pain in the heart and abdomen.
Gan Sui (Kansui Radix, baked until slightly yellow) Zhen Zhu (Margarita, powdered, each 1 fen) Huang Qin (Scutellariae Radix) Chi Shao Yao (Red Paeoniae Radix) Xing Ren (Armeniacae Semen Amarum, soaked in water, peel, remove tips and double kernels, bran-stir-fried until slightly yellow) Ba Dou Shuang (Crotonis Fructus Paste, each half liang).
Grind the above medicines, sieve into powder: add Xing Ren and Ba Dou Shuang, grind together until uniform. Mix with refined honey to form pills the size of sesame seeds. Two- to three-year-olds take two pills on an empty stomach with warm water, aiming for purgation. If no purgation, administer again. Adjust based on the child's age.
*Jin Shi Wan* (Food-Advancing Pill) from the Imperial Medical Bureau, treating indigestion, cardiac/abdominal distension, high fever with coarse breathing, vomiting of phlegm, borborygmus with diarrhea, complete expulsion of food/water, dysentery with red and white discharge, abdominal pain with tenesmus, food retention, milk accumulation, gan qi (pediatric wasting disorder), and Pi Jie.
Dai Zhe Shi (Hematitum, quenched in vinegar, ground) Dang Gui (Angelicae Sinensis Radix, remove rhizome, crush, slightly stir-fried) Zhu Sha (Cinnabar, finely ground and floated in water) Zhi Ke (Aurantii Fructus, bran-stir-fried until slightly yellow, remove pith) Mu Xiang (Aucklandiae Radix, each half liang) She Xiang (Moschi Moschiferi Secretio, finely ground, 1 fen) Ba Dou Shuang (Crotonis Fructus Paste, half fen).
Grind the above medicines, sieve into powder, mix with ground ingredients evenly. Form pills the size of sesame seeds using wheat paste. One-year-old takes one pill, administered with warm rice drink. Adjust dosage based on deficiency/excess. Take after meals.
*Bian Jia Zu Wan* (Soft-shelled Turtle Foot Pill) from *Ying Ru*, treating infants with urgency and hard support under the hypochondrium.
Bian Tou Zu (Head and Feet of Soft-shelled Turtle, one set, soaked in two jin of wine overnight, baked dry) Qi Cao (Melandryi Larva, 40 pieces, baked) Meng Chong (Bloodsucking Fly, 2 he, remove head, feet, wings) Zha Chan (Tettigidae) Qiang Lang (Scarabaeus, each 20 pieces, baked) Gan Jiang (Zingiberis Rhizoma) Ren Shen (Ginseng Radix, each 3 liang) Yun Mu (Muscovite) Xiong (Ligustici Chuanxiong Rhizoma, each 2 liang) Gui Xin (Cinnamomi Ramulus, 1 liang) Niu Huang (Calculus Bovis, 1 fen).
Grind into powder, mix with refined honey to form pills the size of small beans. Two pills, twice a day.
*Zeng Qing Wan* (Azurite Pill) from *Ying Ru*, treating eight types of pediatric Pi:
1. Hardness and pain below the heart, size of a small cup, named Zheng Pi (Steaming Pi), treated by Zeng Qing.
2. Plate-like protrusion under the hypochondrium, rushing to the heart, named She Pi (Snake Pi), treated by Long Gu.
3. Like a hand beside the navel, named Yu Pi (Fish Pi), treated by Gui Jia.
4. Borborygmus around the navel, named Han Pi (Cold Pi), treated by Gan Jiang.
5. Cup-shaped at the heart, immovable, named Chong Pi (Insect Pi), treated by Mu Dan Pi.
6. Plate-shaped below the heart, named Qi Pi (Qi Pi), treated by Bian Jia.
7. Arising from alternating cold and heat, backache resembling malaria, named Xue Pi (Blood Pi), treated by E Chong.
8. Pus discharge with abdominal pain, named Feng Pi (Wind Pi), treated by Fei Lian.
Zeng Qing (Azurite) Gan Jiang (Zingiberis Rhizoma) E Chong (Asiatic Ground Beetle) Zi Shi Ying (Fluorite) Mu Dan Pi (Moutan Cortex, remove heart) Gui Xin (Cinnamomi Ramulus, each 2 fen) Da Huang (Rhei Radix et Rhizoma) Long Gu (Fossilia Ossis Mastodi, each 5 fen) Shu Qi (Polygalae Radix, 7 fen) Gui Jia (Testudinis Carapax et Plastrum, also said to be Bian Jia) Zhen Zhu (Margarita) Fei Lian (Blatta Orientalis, each 3 fen) Xi Xin (Asari Radix et Rhizoma, 6 fen) Fu Zi (Aconiti Lateralis Radix Praeparata, processed, 4 fen).
Grind the above fourteen herbs into powder. Based on the specific condition described, double the dosage of the primary herb for that condition. Mix with honey and take four pills the size of sterculia seeds before meals. This is the dose for five- to six-year-olds; adjust for younger children. Take three times a day. Pill size should be adjusted for the child. Mild irritability may occur after administration; do not be alarmed. All abdominal pathogens will be expelled with miraculous effect. Avoid pork, fish, and vegetables. Regarding the above eight descriptions, it is suspected that Bian Jia is also used concurrently.
*Ji Gu Wan* (Chicken Bone Pill) from *Ying Ru*, treating pediatric initial alternating cold and heat, hard and rigid abdominal Pi, inability to eat, failure to gain muscle, and frequent high fever.
Xiong (Ligustici Chuanxiong Rhizoma) Dang Gui (Angelicae Sinensis Radix) Zi Wan (Asteris Radix) Da Huang (Rhei Radix et Rhizoma, steamed over three sheng of rice) Fu Ling (Poria, each 3 fen) Xing Ren (Persicae Semen, peeled and fried) Gui Xin (Cinnamomi Ramulus, each 4 fen) Du Heng (Metapris Radix) Bai Zhi (Angelicae Dahuricae Radix) Shi Gao (Gypsum Fibrosum, each 2 fen) Ban Xia (Pinelliae Rhizoma, 1 fen, washed) Huang Ci Ji (Hen, female yellow chicken, 1 piece, cut open belly, prevent water entry, remove meat, keep two wing bones and shin bones, dry, bake until yellow).
Grind into powder, mix with honey to form pills the size of small beans. Take two pills per dose, three times a day, gradually increasing the dose. Miraculous effect.
Prescription from *Ying Ru* for pediatric intra-abdominal Pi Jie with frequent high fever.
Da Huang (Rhei Radix et Rhizoma, processed until smoke appears) Bian Jia (Testudinis Carapax et Plastrum, baked until yellow) Fu Ling (Poria, equal parts).
Grind into powder, mix with honey to form pills the size of soybeans. Take with water, three times a day. Adjust dosage according to the child's age.
*Wu Shen Wan* (Five Ginseng Pills) from *Ying Ru*, treating pediatric Pi under the hypochondrium with vexing heat in hands and feet.
Ren Shen (Ginseng Radix) Ku Shen (Sophorae Flavescentis Radix) Dan Shen (Salviae Miltiorrhizae Radix) Sha Shen (Glehniae Radix or Adenophorae Radix) Yuan Shen (Scrophulariae Radix) Fang Feng (Saposhnikoviae Radix, each 1 liang) Gan Jiang (Zingiberis Rhizoma) Fu Zi (Aconiti Lateralis Radix Praeparata, each half liang, processed) E Chong (Asiatic Ground Beetle, 5 pieces, baked) Da Huang (Rhei Radix et Rhizoma, 4 liang, steamed over three sheng of rice) Shu Jiao (Sichuan Pepper, 1 he, remove sweat) Ba Dou (Crotonis Fructus, 20 pieces, peel, remove heart, fry) Ting Li (Descurainiae Semen Lepidii seu Sisymbrii, 1 he, fry).
Grind into powder. Separate Ba Dou, grind separately, mix evenly, pound ten thousand times. Mix with honey to form pills the size of small beans. One-year-old takes one pill, twice a day, gradually increasing the number of pills.
*Da Bian Tou Zu Wan* (Large Soft-shelled Turtle Head and Foot Pill) from *Ying Ru*, treating pediatric accumulation of Qi under the hypochondrium, emaciation with visible bones, and uncontrolled defecation.
Bian Tou Zu (Head and Feet of Soft-shelled Turtle, one set, soaked in wine overnight, baked until yellow) Gan Qi (Dryobalanops Resina) Zi Zhi (Ganoderma) Shao Yao (Paeoniae Radix) Ren Shen (Ginseng Radix) Gua Lou Gen (Trichosanthis Radix, each 3 fen) Gan Cao (Glycyrrhizae Radix et Rhizoma, 4 fen).
Grind into powder, mix with honey to form pills the size of broad beans. One pill, three times a day. Cut the turtle, remove the jaw and lower leg segments, take the part before the wrist.
*Bian Tou Wan* (Soft-shelled Turtle Head Pill) from *Ying Ru*, treating pediatric Pi Qi, distension under the hypochondrium, abdominal accumulations, and hard pain.
Bian Tou (Head of Soft-shelled Turtle, 1 piece) Meng Chong (Bloodsucking Fly) E Chong (Asiatic Ground Beetle) Tao Ren (Persicae Semen, fried, each 3 fen).
Grind into powder, mix with honey to form pills the size of small beans. Two pills, three times a day, stop when efficacy is achieved. If no purgation, add Da Huang (Rhei Radix et Rhizoma) 3 fen.
*Gan Sui Tang* (Kansui Decoction for Breaking Pi and Removing Heat) from *Ying Ru*, treating pediatric cases where decoctions have induced severe purgation and fever has subsided, but stagnation remains, with hardness below the heart, unbearable fullness, crying upon touch, and internal latent heat symptoms.
Gan Sui (Kansui Radix) Gan Cao (Glycyrrhizae Radix et Rhizoma, roasted, each 2 fen) Huang Qin (Scutellariae Radix) Da Huang (Rhei Radix et Rhizoma, each 4 fen).
Take two sheng of water, break two eggs and mix. Take the egg white, throw into water, stir to create foam, blow away the foam. Add herbs and boil until nine he remain. Divide into two doses.
Method from *Ji Shi Jia Chuan* for taking pediatric Pi prescriptions.
Bai Ding Xiang (Stercus Columbae) Zi Ding Xiang (Stercus Columbae, each 49 grains) Bo Shang Liu Huang (Native Sulfur) Mi Duo Seng (Litharge, each one piece the size of a soap pod) Wu Bei Zi (Galla Chinensis, one piece the size of a date) Huang Ying Tiao (Powdered Hawk Barley?, stir-fried 1 qian) She (Moschi Moschiferi Secretio, a little).
Grind into powder. For thin children, take half a qian with millet drink; for fat children, take with rice drink. Also moxa both sides below the seventh vertebra, applying fire simultaneously. Pinworms and roundworms will exit like bran flakes. Effective.