积热肛肿大便难，努力肛出翻不还，外用蟠龙散消肿，内宜皂刺大黄煎。
【注】小儿积热太盛，以致肛门作肿，大便艰难，努力翻出，肛脱不还，外用蟠龙散
消其肿，内服皂刺大黄汤。其肿一消，肛自收矣。
曾氏蟠龙散
干地蟠龙（略去土，焙，一两） 风化硝（二钱）
上锉研为细末，仍和匀朴硝，每以二钱至三钱，肛门湿润者干涂，干燥者用清油调涂，先用荆芥、生葱煎水，候温
洗浴，轻与拭干，然后敷药。
皂刺大黄汤（方见便血）
肺积痰热病龟胸，胸骨高耸若龟形，气急喘咳体羸瘦，宽气百合酌量行。
【注】龟胸一证，多因小儿饮食不节，痰热炽盛，复为风邪所伤，风热相搏，以致肺
经胀满，攻于胸膈，高如覆杯，现证咳嗽喘急，身体羸瘦。治宜清肺化痰为主。先以宽
气饮开其气道，再以百合丹除其壅滞。肺热清而胀满自除矣。
宽气饮
杏仁（去皮尖炒） 桑白皮（炒） 橘红 苏子（炒） 枳壳（麸炒） 枇杷叶（蜜炙） 麦门冬（去
心） 生甘草 苦葶苈
水煎服。
【方歌】宽气饮治儿龟胸，杏仁桑皮合橘红，苏子枳壳枇杷叶，甘草葶苈麦门冬。
百合丹
百合 天门冬 杏仁（去皮尖，炒） 木通 桑白皮（炒） 甜葶苈 石膏（各五钱） 大黄（三钱）
共为细末，炼蜜为丸如绿豆大，量儿大小服之，临卧滚白水送下。
积热导致肛门肿胀、大便困难，用力排便时肛门脱出无法回纳。外用蟠龙散以消肿，内服皂刺大黄煎剂调理。
【注】小儿体内积热过盛，导致肛门肿胀，大便艰难，因用力努挣致使肛管脱出且不能自行收回。外治使用蟠龙散消除肿胀，内服皂刺大黄汤。一旦肿胀消退，肛门自然就会回缩。
曾氏蟠龙散
干地蟠龙（去除泥土，焙干，一两） 风化硝（二钱）
以上药材切碎研成细末，与朴硝混合均匀。每次取二钱至三钱，若肛门周围湿润则直接干粉涂抹，若干燥则用清油调和后涂抹。先用荆芥、生葱煎水，待温度适宜后清洗患处，轻轻擦干，然后敷药。
皂刺大黄汤（方剂见“便血”章节）
肺中积聚痰热引发龟胸病，胸骨高耸呈现乌龟形状，伴有气急、喘咳及身体消瘦。治疗宜酌情使用宽气饮和百合丹。
【注】龟胸这一病症，多因小儿饮食不节制，导致痰热炽盛，又受风邪侵袭，风热相互搏结，致使肺经胀满，邪气攻冲胸膈，胸部高起如倒扣的杯子。临床表现为咳嗽、气喘急促、身体羸瘦。治疗应以清肺化痰为主。先使用宽气饮开通气道，再使用百合丹消除壅滞。肺热清除后，胀满自然消除。
宽气饮
杏仁（去皮尖，炒制） 桑白皮（炒制） 橘红 苏子（炒制） 枳壳（麸炒） 枇杷叶（蜜炙） 麦门冬（去心） 生甘草 苦葶苈
加水煎煮服用。
【方歌】宽气饮治疗小儿龟胸，杏仁、桑白皮配合橘红，苏子、枳壳、枇杷叶，甘草、葶苈子、麦门冬。
百合丹
百合 天门冬 杏仁（去皮尖，炒制） 木通 桑白皮（炒制） 甜葶苈 石膏（各五钱） 大黄（三钱）
共同研磨成细末，用炼蜜制成如绿豆大小的丸剂，根据患儿年龄大小决定剂量，临睡前用温开水送服。
Heat accumulation causes anal swelling and difficulty in defecation; straining leads to prolapse of the anus that cannot be reduced. Externally apply Panlong San (Dragon Coiling Powder) to reduce swelling, and internally administer Zaoci Dahuang Decoction (Sickle Thorn and Rhubarb Decoction).
[Note] In children, excessive internal heat accumulation causes anal swelling and difficult defecation. Straining results in rectal prolapse that fails to retract spontaneously. Externally use Panlong San (Dragon Coiling Powder) to eliminate swelling, and internally take Zaoci Dahuang Tang (Sickle Thorn and Rhubarb Decoction). Once the swelling subsides, the anus will naturally retract.
Zeng's Panlong San (Dragon Coiling Powder)
Gan Di Panlong (Dried Geum rhizome, cleaned of soil, roasted, 1 liang) Fenghua Xiao (Weathered Natrii Sulfas, 2 qian)
The above herbs are chopped, ground into a fine powder, and mixed evenly with Puxiao (Natrii Sulfas). Use 2 to 3 qian per application. If the perianal area is moist, apply the dry powder directly; if dry, mix with sesame oil for topical application. First, wash the area with a decoction of Jingjie (Schizonepetae Herba) and raw Congbai (Allii Fistulosi Bulbus), wait until warm, gently pat dry, and then apply the medicine.
Zaoci Dahuang Tang (Sickle Thorn and Rhubarb Decoction) (See "Hematochezia" chapter for formula details)
Accumulation of phlegm-heat in the Lung manifests as Turtle Chest (Gui Xiong), where the sternum protrudes resembling a turtle shell. Symptoms include shortness of breath, wheezing cough, and emaciation. Treatment should酌情ly employ Kuanqi Yin (Qi-Widening Drink) and Baihe Dan (Lily Pill).
[Note] Turtle Chest is mostly caused by irregular diet in children, leading to intense phlegm-heat, compounded by wind-pathogen invasion. Wind and heat interact, causing distension in the Lung meridian, attacking the chest and diaphragm, resulting in a chest that protrudes like an inverted cup. Clinical manifestations include cough, rapid breathing, and physical emaciation. The treatment principle is primarily to clear the Lung and resolve phlegm. First, use Kuanqi Yin (Qi-Widening Drink) to open the airways, then use Baihe Dan (Lily Pill) to remove stagnation. Once Lung heat is cleared, distension will naturally resolve.
Kuanqi Yin (Qi-Widening Drink)
Xingren (Apricot Seed, peeled and de-pitted, stir-fried) Sangbaipi (Morus Alba Bark, stir-fried) Juhong (Aged Tangerine Peel) Suzi (Perilla Fruit, stir-fried) Zhike (Bitter Orange Fruit, bran-stir-fried) Pipaye (Loquat Leaf, honey-fried) Maimendong (Ophiopogon Tuber, heart removed) Sheng Gancao (Raw Licorice Root) Ku Tingli (Thladianthae Fructus)
Decoct in water and take orally.
[Formula Song] Kuanqi Yin treats pediatric Turtle Chest, Apricot Seed and Morus Bark combined with Tangerine Peel, Perilla Fruit, Bitter Orange, Loquat Leaf, Licorice, Thladiantha, and Ophiopogon.
Baihe Dan (Lily Pill)
Baihe (Lily Bulb) Tianmendong (Asparagus Tuber) Xingren (Apricot Seed, peeled, de-pitted, stir-fried) Mutong (Akebia Caulis) Sangbaipi (Morus Alba Bark, stir-fried) Tian Tingli (Thladianthae Fructus, sweet variety) Shigao (Gypsum Fibrosum, each 5 qian) Dahuang (Rhubarb Root, 3 qian)
Grind all into a fine powder, bind with refined honey to form pills the size of mung beans. Dosage varies according to the child's age. Take with warm boiled water before bedtime.