痛引腰脊小肠气，加味香苏温散宜，上冲心痛失笑散，有形胡芦巴丸医。
【注】小肠气一证，其受病与疝气等，亦因湿气在内，而寒气又束于外也。发时少腹
胀控睾丸引腰脊，上冲心痛而不肿是也。治宜分别形状∶如引腰而痛者，加味香苏散温
散之；痛而冲心气者，加味失笑散主之；如少腹中有形如卵，上下往来，痛不可忍者，宜胡芦巴丸主之。
加味香苏散
苍术（米泔水浸） 陈皮 川楝肉 甘草 苏叶 香附（醋炒）
引用莲须、葱白，水酒兑煎服。
【方歌】加味香苏散苍术，广陈皮与川楝肉，甘草苏叶香附同，莲须葱白共煎服。
加味失笑散
五灵脂 蒲黄（隔纸炒） 元胡索（醋炒，各等分）
为细末，每服一二钱，水酒调下。
胡芦巴丸
胡芦巴（炒） 川楝子（蒸去皮核焙，各四钱） 川乌（去皮脐） 巴戟肉（各一钱五分） 茴香
（三钱） 吴茱萸（半酒半醋浸一宿焙，二钱五分） 牵牛（炒二钱）
共为细末，酒面糊为丸，如梧桐子大，每服数丸，空心温酒下。
诸淋皆缘寒热湿，下移膀胱溲无时，水道涩滞常作痛，寒热石血随证医。
【注】小儿淋证，或因风寒袭入，或因湿热下移，乘入膀胱，以致水道涩滞，欲出不
出，淋漓不断，甚至窒塞其间，令儿作痛。然必辨其为寒为热，为石为血，分别治之，则
水道宣通，淋自愈矣！
疼痛放射至腰脊的小肠气病，适宜采用加味香苏散进行温散治疗；若疼痛上冲导致心痛，则使用失笑散治疗；若腹部有有形之邪（如疝块），则用胡芦巴丸治疗。
【注】小肠气这一病症，其发病机制与疝气相同，也是由于湿气蕴结于内，寒气束缚于外所致。发作时表现为少腹胀痛并牵引睾丸，进而牵连腰脊，疼痛上冲至心口，但局部不肿胀。治疗应当根据症状形态分别处理：如果是疼痛牵引腰部的，宜用加味香苏散温散寒湿；如果是疼痛上冲心气的，以加味失笑散为主治方剂；如果少腹中有形之物如卵状，上下移动，疼痛难以忍受的，宜用胡芦巴丸主治。
加味香苏散
苍术（用米泔水浸泡） 陈皮 川楝肉 甘草 苏叶 香附（醋炒）
煎服时加入莲须、葱白，用水和酒混合煎煮后服用。
【方歌】加味香苏散由苍术组成，配以广陈皮和川楝肉，甘草、苏叶、香附一同使用，加上莲须、葱白共同煎煮服用。
加味失笑散
五灵脂 蒲黄（隔纸炒） 元胡索（醋炒，各等分）
研磨成细末，每次服用一二钱，用水和酒调服。
胡芦巴丸
胡芦巴（炒） 川楝子（蒸熟去皮去核焙干，各四钱） 川乌（去皮去脐） 巴戟肉（各一钱五分） 茴香（三钱） 吴茱萸（半酒半醋浸泡一夜后焙干，二钱五分） 牵牛（炒，二钱）
共同研磨成细末，用酒和面糊制作成丸药，大小如梧桐子，每次服用数丸，空腹时用温酒送服。
各种淋证都源于寒、热、湿邪，下行移入膀胱，导致小便频急无度，水道涩滞经常疼痛，需根据寒、热、石、血等不同证候进行治疗。
【注】小儿淋证，可能是因为风寒侵袭体内，也可能是因为湿热下移，侵入膀胱，导致水道涩滞，想排尿却排不出，淋漓不断，甚至堵塞其间，使孩子感到疼痛。然而必须辨别是寒证还是热证，是石淋还是血淋，分别进行治疗，这样水道宣通，淋证自然痊愈！
Pain radiating to the lower abdomen, waist, and spine characterizes **Xiaochang Qi** (Intestinal Qi disorder / Hernia); **Jiawei Xiangsu San** (Modified Fragrant Su Powder) is suitable for warming and dispersing; if pain rushes upward causing heart pain, **Shixiao San** (Instant Joy Powder) should be used; if there is a tangible mass in the abdomen, **Huluba Wan** (Fenugreek Pill) is indicated.
[Note] The pathology of Xiaochang Qi is similar to that of hernias (**Shan Qi**), arising from dampness retained internally and cold pathogen binding externally. Upon onset, it presents with distension and pain in the lower abdomen radiating to the testicles and lumbar spine, with pain rushing up to the heart region, but without local swelling. Treatment should be differentiated by symptom presentation: for pain radiating to the waist, use Jiawei Xiangsu San to warm and disperse; for pain rushing up to affect the heart qi, Jiawei Shixiao San is the primary formula; for a tangible mass resembling an egg in the lower abdomen moving up and down with unbearable pain, Huluba Wan is indicated.
**Jiawei Xiangsu San** (Modified Fragrant Su Powder)
*Cangzhu* (Atractylodis Rhizoma, soaked in rice wash water), *Chenpi* (Citri Reticulatae Pericarpium), *Chuanlian Rou* (Toosendan Fructus flesh), *Gancao* (Glycyrrhizae Radix et Rhizoma), *Suye* (Perillae Folium), *Xiangfu* (Cyperii Rhizoma, stir-fried with vinegar).
Decoct with *Lianxu* (Nelumbinis Stamen) and *Congbai* (Allii Fistulosi Bulbus) using water and wine.
[Formula Song] Jiawei Xiangsu San contains Cangzhu, Guang Chenpi, and Chuanlian Rou; Gancao, Suye, and Xiangfu are combined; decoct together with Lianxu and Congbai.
**Jiawei Shixiao San** (Modified Instant Joy Powder)
*Wulingzhi* (Trogopterori Faex), *Puhuang* (Typhae Pollen, stir-fried between papers), *Yuanhusuo* (Corydalis Rhizoma, stir-fried with vinegar, equal parts).
Grind into fine powder. Take 1-2 qian per dose, mixed with water and wine.
**Huluba Wan** (Fenugreek Pill)
*Huluba* (Trigonellae Semen, stir-fried), *Chuanlianzi* (Meliae Fructus, steamed, peeled, pitted, and dried, 4 qian each), *Chuanwu* (Aconiti Radix, peeled and navel removed), *Bajirou* (Morinda Officinalis Radix flesh, 1.5 qian each), *Huixiang* (Foeniculi Fructus, 3 qian), *Wuzhuyu* (Evodiae Fructus, soaked overnight in half wine and half vinegar, then dried, 2.5 qian), *Qianniu* (Pharbitidis Semen, stir-fried, 2 qian).
Grind into fine powder, bind with wine and wheat paste to make pills the size of paulownia seeds. Take several pills per dose, swallowed with warm wine on an empty stomach.
Various types of **Lin Syndrome** (Dysuria / Strangury) originate from cold, heat, and dampness pathogens shifting downward to the bladder, causing frequent and urgent urination without relief. The urinary pathway becomes obstructed and painful; treatment must follow the specific pattern of cold, heat, stone, or blood.
[Note] Pediatric Lin syndrome may result from wind-cold invading the interior or damp-heat shifting downward to invade the bladder, leading to obstruction of the urinary pathway. This causes difficulty in voiding, dribbling continuously, and even complete blockage, resulting in pain. One must differentiate whether the condition is due to cold or heat, or whether it is Stone Lin or Blood Lin, and treat accordingly. Once the urinary pathway is unobstructed, Lin syndrome will resolve spontaneously.