寒痛中虚脾受寒，尿爪俱白面青看，喜热腹满或下利，理中肢厥加附煎。
【注】寒痛者，多因小儿中气虚弱，复为风冷所乘，则脾经受寒，故不时腹痛。现证
尿白，爪甲白，面多青，喜饮热，或腹满下利。宜理中汤温之。若四肢厥冷，兼属少阴，则加附子。
理中汤（方见不乳）
虫痛不安腹因痛，面色乍青乍赤白，时痛时止吐清涎，安虫理中治最合。
【注】虫痛者，因腹中虫动不安，故腹中作痛。其候面色乍赤乍青乍白，其痛时作时
止，时吐清水。切不可妄用攻下，当以安虫为主，其痛即除。新痛者，钱氏安虫散治之；
痛久不愈者，加减理中汤治之。
钱氏安虫散
胡粉（炒黄） 鹤虱（炒黄） 白矾（枯） 川楝子（去皮尖，各二钱五分）
共为细末，每服一匙，大者五分，米饮调下，痛时服。
加减理中汤（方见虫吐）
内伤乳食外感寒，发热恶寒腹痛兼，恶食呕吐多啼叫，藿香和中可急煎。
【注】小儿内伤乳食，外感寒邪，遂致食寒凝结，腹中作痛。其候无热恶寒，而更兼
腹痛、恶食、呕吐，啼叫不已者，以藿香和中汤治之。
藿香和中汤
藿香 砂仁（研） 羌活 陈皮 苍术（米泔水浸） 浓朴（姜炒） 山楂 甘草（生） 香附
（炙） 白芷 苏叶 川芎
引用生姜，水煎服。
【方歌】藿香和中治腹疼，内伤食滞外寒风，藿砂羌苍陈朴草，山楂香附芷苏芎。
寒痛：中气虚弱，脾脏受寒，小便清白，爪甲苍白，面色发青，喜欢温热，腹部胀满或伴有腹泻，若出现四肢厥冷，则在理中汤基础上加附子煎服。
【注】寒痛，多因小儿中气虚弱，又受到风冷邪气侵袭，导致脾经受寒，所以不时发生腹痛。现症见小便白，爪甲白，面色多呈青色，喜欢喝热饮，或者腹部胀满、腹泻。适宜用理中汤温补。如果四肢厥冷，兼属少阴病证，则加入附子。
理中汤（方剂见“不乳”章节）
虫痛：因腹中虫动不安而致疼痛，面色时而青、时而赤、时而白，疼痛时作时止，有时吐出清稀涎沫，使用安虫理中的方法治疗最为合适。
【注】虫痛，是因为腹中寄生虫扰动不安，所以腹部作痛。其症状表现为面色忽红忽青忽白，疼痛发作有间歇，时常呕吐清水。切不可胡乱使用攻下法，应当以安蛔止痛为主，疼痛自然消除。新发的疼痛，用钱氏安虫散治疗；疼痛日久不愈的，用加减理中汤治疗。
钱氏安虫散
胡粉（炒至黄色） 鹤虱（炒至黄色） 白矾（枯矾） 川楝子（去皮和核，各二钱五分）
共研为细末，每次服用一匙，年龄较大的儿童服用五分，用米汤调服，疼痛时服用。
加减理中汤（方剂见“虫吐”章节）
内伤乳食外感寒：内伤乳食，外感寒邪，发热恶寒并伴有腹痛，厌恶食物、呕吐、哭闹不止，急需煎服藿香和中汤。
【注】小儿内伤乳食，外感寒邪，导致食积与寒邪凝结，在腹部产生疼痛。其症状表现为无热但恶寒，并且兼有腹痛、厌食、呕吐，不停啼哭叫喊的，用藿香和中汤治疗。
藿香和中汤
藿香 砂仁（研磨） 羌活 陈皮 苍术（米泔水浸泡） 浓朴（姜汁炒） 山楂 甘草（生用） 香附（炙烤） 白芷 苏叶 川芎
引用生姜，加水煎服。
【方歌】藿香和中治腹疼，内伤食滞外寒风，藿砂羌苍陈朴草，山楂香附芷苏芎。
Cold Pain: When the middle Qi is deficient and the Spleen is affected by Cold, the urine and nail beds appear white, and the complexion is bluish. The patient prefers warmth; if there is abdominal fullness or diarrhea, Lizhong Tang (Cinnamon Twig, Atractodes, Ginseng, Licorice Decoction) is used. If cold limbs occur, Fuzi (Aconite Root) is added to the decoction.
[Note] Cold pain is mostly caused by the deficiency of the child's Middle Qi, compounded by invasion of Wind-Cold, which chills the Spleen Meridian, causing intermittent abdominal pain. Present symptoms include white urine, pale nails, a predominantly bluish complexion, preference for hot drinks, abdominal fullness, or diarrhea. It is appropriate to warm with Lizhong Tang (Cinnamon Twig, Atractodes, Ginseng, Licorice Decoction). If the four limbs are cold, indicating involvement of the Shaoyin syndrome, Fuzi (Aconite Root) should be added.
Lizhong Tang (See formula in "Refusal to Nurse" chapter)
Worm Pain: Due to restlessness of worms in the abdomen causing pain, the complexion alternates between bluish, reddish, and whitish. The pain comes and goes intermittently, accompanied by vomiting of clear saliva. Treating with methods to calm worms and regulate the middle Jiao is most suitable.
[Note] Worm pain occurs because parasites moving restlessly in the abdomen cause pain. Symptoms include a complexion that fluctuates between red, blue, and white, intermittent pain, and frequent vomiting of clear fluid. One must not recklessly use purgative methods; the primary treatment should focus on calming the worms, after which the pain will subside. For newly onset pain, Qian Shi Anchong San (Dr. Qian's Worm-Calming Powder) is used; for chronic pain that does not resolve, Jiajian Lizhong Tang (Modified Cinnamon Twig, Atractodes, Ginseng, Licorice Decoction) is used.
Qian Shi Anchong San (Dr. Qian's Worm-Calming Powder)
Hu Fen (Lead Carbonate, stir-fried until yellow) Heshi (Chrysanthemum Parthenium Fruit, stir-fried until yellow) Baifan (Alum, calcined) Chuan Lianzi (Sichuan Chinaberry Seed, skin and pit removed, each 2.5 qian)
Grind into fine powder. Take one spoonful per dose (0.5 qian for older children), mixed with rice water, taken during pain episodes.
Jiajian Lizhong Tang (Modified Cinnamon Twig, Atractodes, Ginseng, Licorice Decoction) (See formula in "Vomiting due to Worms" chapter)
Internal Injury from Milk/Food and External Contraction of Cold: Internal injury from milk and food combined with external contraction of Cold leads to fever, aversion to cold, and abdominal pain. With anorexia, vomiting, and incessant crying, Huoxiang Hezhong Tang (Patchouli Harmonizing the Middle Decoction) should be urgently prepared and administered.
[Note] When a child suffers internal injury from milk and food and external contraction of Cold pathogens, food stagnation and Cold condense in the abdomen, causing pain. Symptoms include aversion to cold without fever, accompanied by abdominal pain, food aversion, vomiting, and incessant crying and shouting. This is treated with Huoxiang Hezhong Tang (Patchouli Harmonizing the Middle Decoction).
Huoxiang Hezhong Tang (Patchouli Harmonizing the Middle Decoction)
Huoxiang (Patchouli Herb) Sharen (Amomum Fruit, ground) Qianghuo (Notopterygium Rhizome) Chenpi (Tangerine Peel) Cangzhu (Atractodes Rhizome, soaked in rice wash water) Houpo (Magnolia Bark, stir-fried with ginger juice) Shanzha (Hawthorn Fruit) Gancao (Licorice Root, raw) Xiangfu (Cyperus Rhizome, roasted) Baizhi (Angelica Dahurica Root) Ziyè (Perilla Leaf) Chuanxiong (Ligusticum Rhizome)
Add fresh Ginger as a guiding herb, decoct in water and take orally.
[Formula Song] Huoxiang Hezhong treats abdominal pain, Internal injury from food stagnation and external Wind-Cold, Patchouli, Amomum, Notopterygium, Atractodes, Tangerine Peel, Magnolia Bark, Licorice, Hawthorn, Cyperus, Angelica Dahurica, Perilla, Ligusticum.