小儿十指俱热，我按儿额三指俱冷，其候身热，或吐、或泻、或不吐泻，口必恶食，腹
必浮胀拍如鼓声，或作痛是也。推法∶开天门，分阴阳，男女同。男重揉太阳发汗，体弱揉
太阴止之。女反是。推上三关三十，退腑六七下，运八卦重揉艮宫，于大指面旋推补脾，曲
儿小指重揉外劳，于第二指大肠位侧推到虎口，以止泻，不泻不推重按，掐中指一节以止吐
，不吐不掐。于左脚涌泉穴左转揉之止泻，不泻不揉。少顷右转揉之止吐，不吐不揉。女则
右转右揉止泻，左转左揉止吐，推毕即用灯火，脐轮四 ，胸口一 ，用水酒曲一枚，
火煨黄色研末，白汤送下即愈。重则用消导二陈汤加柴胡、紫苏等味煎服。
珩山孝廉方韵皇乃孙，发吐烧热微掣，吐轻热重。余子婿方平阶初业斯道，投天保采
薇汤一剂，不效邀余。一见知为内伤饮食，外挟风邪，用藿香正气散一服即愈。余以汤名曰
天保采薇，取其治外治内之意，用之不当，虽多奚为在。余婿以为症属内伤外感，汤属内
外并治，渠见不为非是。然不知症似社鼠城狐重镇何可轻发，此学人之所宜知而宜慎也。
腹痛，脐以上属火，脐以下属寒，其因不一，有寒痛、热痛、伤食痛、积滞痛，气不和
而痛，脾虚而痛，肝下乘脾而痛，蛔动而痛数种。寒痛则面白，口气冷，大便青色，小便清
利，痛之来也迂缓而不速疾，绵绵不已，痛时以热手按之其痛稍止，肚皮冰冷是也。推法∶
曲儿小指重揉外劳宫，推上三关，揉脐五十，药用干姜、肉桂等分，煎热加木香磨水入服之自
愈。
热痛则面赤，口气热，口渴唇红，大便秘小便赤，时痛时止，痛来迅厉，腹形如常，不
肿不饱，弹之不响，以热手按之其痛愈甚，肚皮滚热，此真热也。推用下六腑，水底捞月。
盖热痛主心脾两热，用灯心、车前、伏龙肝加木香磨水稍许入服。
伤食痛者必恶食，眼胞必浮肿，或泻下酸臭，腹必饱胀，弹如鼓声，或身作热是也。如
气不旺者不宜取泻，只用消导二陈汤。
积滞痛者今日伤、明日伤、逐日伤之而滞于脾胃间，不以饮食得其伤不痛，既有滞而后
以乳食伤碍，故痛也。面色黄，嗳气 ，大便 臭，便后痛减，足冷嗜卧，不思饮食是也。
治宜枳壳、槟榔、木香下之，下后即以小异功散补之。
气不和而痛者，儿下地后或地多湿，儿脐受风，以裹肚束脐过紧，不知儿体渐长束带未
松，则上气不通下气，以故内气不和，故作痛也。审其非寒非热，问其母而脐果有束缚之弊
，则气不和之痛必矣。治以木香磨水服之，随用灯火脐轮六 ，脐下气海一 ，心口窝
一，其痛即止。大儿之气不和者，其候眼胞不肿，面色不黄，饮食如故，腹肿可如鼓声
，摇其头而嗳气是也，宜用木香、陈皮、枳壳、甘草服之。
脾虚痛者，其候面无血气，微黄带微白，大便少而色白，治以补脾开胃为主，用六君子汤
加橘皮。
肝木乘脾痛者，肝木克脾，脾虚不胜其克则肝气无所泄，故乘脾之衰而作痛也。其候
唇白，口中色淡，面多青色，痛则腹连两胁，重按其腹则痛止，起手又痛是也。治用四君子汤
加柴胡、白芍。
蛔痛者，腰曲扑身口流清涎，痛久不歇少顷又痛，或一时或二时而止，或歇半日又痛，
面黄唇白，此蛔痛也。治用使君子去壳，火煨，吃十余粒，少顷又吃，即止。以上婴儿腹痛，口
不能言何以知之，盖儿痛必哭，无故而哭者痛也。哭声雄惨而双眉蹙皱是也。如使君子食之
不止，莫妙于苦楝子树根皮约一、二两许，水煎一茶钟，吃下虫即尽出，但体弱者不可轻用
。
又有一种奇痛，一痛只大叫几声“痛、痛、痛”，即抱胸晕死。余家一女犯此症，先君
在日余见将女面扑地，用冷水一盆以女膝着水上，于委中穴浇水狠拍，粗筋肿起用银针傍筋
打入二针，针出血流，叫一声“痛”即苏，随用冷水滚水各半，连吃一、二碗立愈。记先君曰
此急痧也，与转筋火差似，如平常腹痛从未有，一痛而即死者，急痧之辨紧记在此。
夏禹铸曰∶尝观内经有曰，胃虚则吐，胃热则呕，此说殊属大谬，何也。余屡屡见
吐，吐固有虚，常亦有热；呕固是热，却亦有寒。此余非非议前人，盖见之多而治之效也。
二症各有虚热，不可拘执，惟望面色。唇舌之间红则热，而淡则虚，断无有误。至于泄泻，
出少而缓曰泄，出多而势急曰泻，泄则症轻，泻则重，凡以所泻之色验之，治无不效。
小儿十个手指都发热，我用手按小儿额头，三指接触处都感觉发冷。其表现为身体发热，或者呕吐、或者腹泻、或者不吐不泻，口中必定厌恶食物，腹部必定浮胀，拍打时发出如鼓声般的声响，或者出现疼痛症状。推拿方法：开天门（从眉心向上推至前发际），分阴阳（从眉心向两侧分推），男女通用。男孩重揉太阳穴以发汗，体质虚弱者改为揉太阴（脾经）以止汗。女孩则相反。推上三关（前臂桡侧阳池至曲池连线）三十次，退六腑（前臂尺侧总筋至少海连线）六七下，运八卦并重揉艮宫（手掌面八卦中的艮位，即拇指根部隆起处），在大指面旋推以补脾，弯曲小儿小指重揉外劳宫（手背第2、3掌骨间，与内劳宫相对），沿第二指大肠经侧面向虎口方向推以止泻，若不腹泻则不推；重按中指一节以止吐，若不呕吐则不掐。在左脚涌泉穴左转揉动以止泻，若不腹泻则不揉。片刻后右转揉动以止吐，若不呕吐则不揉。女孩则右转右揉以止泻，左转左揉以止吐。推拿完毕后立即使用灯火灸法，在脐轮四周各灸一壮，胸口正中灸一壮，用水酒曲一枚，用火煨至黄色后研成粉末，用白开水送服即可痊愈。病情较重者，使用消导二陈汤加柴胡、紫苏等药物煎服。
珩山孝廉方韵皇的孙子，出现呕吐、发热且伴有轻微抽搐，呕吐轻而发热重。我的女婿方平阶刚开始从事中医行业，投用天保采薇汤一剂，无效便邀请我去诊治。我一见便知道这是内伤饮食，外挟风邪所致，使用藿香正气散一服即愈。我之所以说汤名叫天保采薇，是取其内外兼治之意，如果用药不当，虽然药名好听又有什么用呢？我的女婿认为病症属于内伤外感，汤剂也属于内外并治，他的看法并非不对。然而他不知道这种病症如同社鼠城狐般顽固深伏，不可轻易攻伐，这是学医之人应当知晓并谨慎对待的。
腹痛，肚脐以上属火，肚脐以下属寒，其原因不一，有寒痛、热痛、伤食痛、积滞痛，气机不和而痛，脾虚而痛，肝木乘脾而痛，蛔虫扰动而痛等多种类型。寒痛则面色苍白，口气冷，大便青色，小便清利，疼痛发作缓慢而不急促，绵绵不断，疼痛时用手热敷按压，疼痛稍缓解，肚皮冰冷即是此症。推拿方法：弯曲小儿小指重揉外劳宫，推上三关，揉脐五十次，药用干姜、肉桂等分，煎热后加入木香磨成的水服用，自然痊愈。
热痛则面红，口气热，口渴唇红，大便秘结小便赤黄，时痛时止，疼痛发作迅猛剧烈，腹部形态如常，不肿不饱，敲击不响，用手热敷按压疼痛加剧，肚皮滚热，这是真热证。推拿采用下六腑，水底捞月手法。因为热痛主因是心脾两热，用灯心草、车前子、伏龙肝加少许木香磨水服用。
伤食痛者必定厌恶食物，眼睑必定浮肿，或者泻下酸臭之物，腹部必定饱胀，敲击如鼓声，或者身体发热即是此症。如果患儿气虚不宜攻泻，只用消导二陈汤。
积滞痛者，今日受伤、明日受伤，每日受损而停滞于脾胃之间，不是饮食造成的损伤不会痛，既有积滞之后，再以乳食阻碍，所以产生疼痛。面色发黄，嗳气，大便恶臭，便后疼痛减轻，脚冷嗜睡，不思饮食即是此症。治疗宜用枳壳、槟榔、木香攻下，攻下后立即用小异功散补益。
气机不和而痛者，婴儿出生后若地面多湿，婴儿肚脐受风，或用裹肚束脐过紧，不知婴儿身体逐渐长大而束带未松，导致上气不通下气，因此内气不和，故而作痛。审察其非寒非热，询问母亲是否脐部有束缚之弊，则必然是气不和之痛。治疗以木香磨水服用，随即用灯火灸脐轮六壮，脐下气海一壮，心口窝一壮，疼痛即止。较大儿童的气不和，其表现为眼睑不肿，面色不黄，饮食如常，腹部肿胀可如鼓声，摇头且嗳气即是此症，宜用木香、陈皮、枳壳、甘草服用。
脾虚痛者，其表现为面色无血色，微黄带微白，大便少而色白，治疗以补脾开胃为主，用六君子汤加橘皮。
肝木乘脾痛者，肝木克脾土，脾虚不能承受肝木的克制，则肝气无处宣泄，因此趁脾之衰弱而作痛。其表现为唇白，口中色泽淡，面色多青，疼痛时腹部牵连两胁，重按腹部则疼痛停止，抬手又痛即是此症。治疗用四君子汤加柴胡、白芍。
蛔虫痛者，腰部弯曲贴近身体，口中流清涎，疼痛长久不停歇，片刻后又痛，或一时或两小时停止，或休息半天又痛，面黄唇白，这是蛔虫痛。治疗用使君子去壳，用火煨熟，吃十余粒，片刻后再吃，疼痛即止。以上婴儿腹痛，口不能言如何得知？大概婴儿疼痛必哭，无故哭泣就是疼痛。哭声雄壮凄惨且双眉紧皱即是此症。如果使用使君子食用后疼痛不止，没有比苦楝子树根皮约一两许，水煎成一茶盅，喝下虫子即尽出更好的方法，但体质虚弱者不可轻易使用。
又有一种奇痛，一痛只大叫几声“痛、痛、痛”，随即抱胸晕死。我家一个女儿患此症，先父在世时我曾见过，将女孩面部扑在地上，用一盆冷水让女孩的膝盖浸在水中，在委中穴浇水狠拍，粗筋肿起后用银针傍着筋打入两针，针刺出血流，叫一声“痛”即苏醒，随即用冷水滚水各半，连吃一二碗立刻痊愈。记得先父说这是急痧，与转筋霍乱相似，如果是平常腹痛从未有过，一痛即死的，急痧的辨别关键记在此处。
夏禹铸说：曾经观看《内经》中有说，胃虚则吐，胃热则呕，这种说法确实是大错特错，为什么呢？我屡屡见到呕吐，呕吐固然有虚证，但也常有热证；呕固然是热证，却也有寒证。这并不是我妄议前人，而是见得多了且治疗效果证实了这一点。这两种症状各有虚热之分，不可拘泥固执，只有观察面色。嘴唇舌头之间红色则为热，淡白则为虚，绝无错误。至于泄泻，排出少而缓慢称为泄，排出多而势急称为泻，泄则症状轻，泻则重，凡是根据所排泄物的颜色来验证，治疗无不有效。
When a child's ten fingers are all hot, and upon my pressing the child's forehead with three fingers, they all feel cold, the presentation involves body heat, or vomiting, or diarrhea, or neither vomiting nor diarrhea. The mouth will certainly show aversion to food, the abdomen will certainly be distended and floating, sounding like a drum when tapped, or presenting pain. Tuina method: Open the Heavenly Gate (pushing from the glabella upward to the anterior hairline), Divide Yin and Yang (pushing from the glabella laterally), applicable to both genders. For boys, heavily rub the Taiyang point to induce sweating; for those with weak constitutions, rub the Taiyin channel to stop sweating. For girls, reverse this. Push up the Three Gates (the radial side of the forearm from Yangchi to Quchi) thirty times, retreat the Six Fu organs (the ulnar side of the forearm from Zongji to Shaohai) six or seven times, circulate the Eight Trigrams and heavily rub the Gen Palace (the eminence at the base of the thumb on the palmar side of the palm), rotate-push on the surface of the thumb to tonify the Spleen, bend the child's little finger and heavily rub the Wailao Gong point (opposite Neilaogong between the 2nd and 3rd metacarpal bones on the dorsum of the hand), push along the lateral side of the second finger towards the Tiger's Mouth to stop diarrhea; if no diarrhea, do not push. Heavily press one segment of the middle finger to stop vomiting; if no vomiting, do not pinch. On the Yongquan point of the left foot, rub in a counter-clockwise direction to stop diarrhea; if no diarrhea, do not rub. After a moment, rub in a clockwise direction to stop vomiting; if no vomiting, do not rub. For girls, reverse clockwise/right-rub to stop diarrhea, and counter-clockwise/left-rub to stop vomiting. Upon completion of pushing, immediately use fire-lighting moxibustion: four applications around the umbilical wheel, one application at the chest center. Take one piece of water-wine qu, roast it over fire until yellow, grind into powder, and deliver with warm water for immediate recovery. For severe cases, use Xiaodao Erchen Tang (Digestive-Resolving Two-Chen Decoction) added with Chaihu (Bupleuri Radix) and Zisu (Perillae Folium), decocted and taken orally.
The grandson of Fang Yunhuang, a Xiaojuan from Hengshan, presented with vomiting, fever, and slight convulsions, where vomiting was mild but fever was severe. My son-in-law, Fang Pingjie, who had just begun practicing medicine, administered one dose of Tianbao Caiwei Tang (Tianbao Collecting Fern Decoction) without effect and invited me. Upon first sight, I knew it was internal injury from diet combined with external wind pathogen. One dose of Huoxiang Zhengqi San (Agarwood Powder to Rectify the Qi) resulted in immediate recovery. I named the decoction Tianbao Caiwei to imply treating both interior and exterior; if used improperly, what good is its name? My son-in-law believed the syndrome belonged to internal injury and external contraction, and the decoction treated both interior and exterior simultaneously; his view was not incorrect. However, he did not know that such syndromes are as entrenched as rats in a shrine or foxes in a city wall, and should not be attacked lightly. This is what scholars of medicine ought to know and exercise caution regarding.
Abdominal pain: above the navel belongs to Fire, below the navel belongs to Cold. Causes vary: there are Cold Pain, Heat Pain, Food Injury Pain, Stagnation Pain, Qi Disharmony Pain, Spleen Deficiency Pain, Liver Overacting on Spleen Pain, and Ascaris Movement Pain. Cold pain presents with pale face, cold breath, green stool, clear urination, slow and gradual onset of pain, continuous lingering pain, relief upon pressing with warm hands, and cold belly skin. Tuina method: Bend the child's little finger and heavily rub Wailao Gong, push up the Three Gates, rub the navel fifty times. Medicinally, use equal parts Ganjiang (Zingiberis Rhizoma) and Rougui (Cinnamomi Cortex), decoct hot, add Muxiang (Aucklandiae Radix) ground in water, and take orally for self-healing.
Heat pain presents with red face, hot breath, thirst, red lips, constipation, and dark urine. Pain comes and goes, onset is sudden and fierce, abdominal shape is normal, not swollen or full, does not sound when tapped, pain worsens upon pressing with warm hands, and the belly skin is scorching hot; this is True Heat. Tuina uses Retreat Six Fu and Water Bottom Scooping Moon techniques. Since Heat pain is primarily due to Heart and Spleen Double Heat, use Dengxincao (Junci Medulla), Cheqiancao (Plantaginis Herba), Fulonggan (Caulis Longanii Preparatus), plus a small amount of Muxiang ground in water for oral administration.
Food Injury pain necessarily involves aversion to food, swollen eyelids, possibly sour-smelling diarrhea, abdominal fullness, drum-like sound upon tapping, or body heat. If Qi is not robust, purging is not suitable; only use Xiaodao Erchen Tang (Digestive-Resolving Two-Chen Decoction).
Stagnation pain results from daily injuries accumulating in the Spleen and Stomach. Without stagnation, dietary injury does not cause pain; once stagnation exists, further obstruction by milk or food causes pain. Presentation includes yellow complexion, belching, foul-smelling stool, pain relief after defecation, cold feet, lethargy, and loss of appetite. Treatment should use Zhike (Aurantii Fructus), Binglang (Arecae Semen), and Muxiang (Aucklandiae Radix) to purge, followed immediately by Xiaoyigong San (Minor Yi-Gong Powder) to tonify.
Qi Disharmony pain: After birth, if the environment is damp, the infant's umbilicus may catch wind. If the swaddling cloth binds the umbilicus too tightly, and the binder is not loosened as the infant grows, Upper Qi cannot descend to Lower Qi, causing internal Qi disharmony and pain. Examine whether it is neither Cold nor Heat; ask the mother if there is binding tightness at the umbilicus. If so, it is definitely Qi Disharmony Pain. Treat with Muxiang ground in water, followed by fire-lighting moxibustion: six applications around the umbilical wheel, one at Qihai (CV6), one at the heart pit. Pain stops immediately. For older children with Qi Disharmony, presentation includes non-swollen eyelids, non-yellow complexion, normal diet, abdominal swelling sounding like a drum, head shaking, and belching. Use Muxiang, Chenpi (Citri Reticulatae Pericarpium), Zhike, and Gancao (Glycyrrhizae Radix et Rhizoma).
Spleen Deficiency pain presents with lack of luster in the face, slightly yellow with whitish tint, scant white stool. Treatment focuses on tonifying Spleen and opening the stomach, using Liujunzi Tang (Six-Gentlemen Decoction) added with Ju pi (Citri Reticulatae Pericarpium).
Liver Wood Overacting on Spleen pain: Liver Wood overacts on Spleen Earth. When Spleen is deficient and cannot withstand the overaction, Liver Qi has no outlet, thus attacking the deficient Spleen to cause pain. Presentation includes white lips, pale oral color, frequent bluish complexion, pain radiating from abdomen to hypochondrium, pain stopping upon heavy pressure but returning upon release. Treat with Sijunzi Tang (Four-Gentlemen Decoction) added with Chaihu (Bupleuri Radix) and Baishao (Paeoniae Radix Alba).
Ascaris pain: Waist bent forward, mouth flowing with clear saliva, pain lasting long without pause then recurring, or stopping after an hour or two, or after half a day. Yellow face, white lips. This is Ascaris pain. Treat with Shijunzi (Quisqualis Fructus), shelled and roasted, eat about ten grains, then eat more after a moment; pain stops. For infants with abdominal pain unable to speak, how to know? Infants cry when in pain; crying without cause indicates pain. Loud, miserable crying with furrowed brows confirms it. If Shijunzi fails, the best remedy is Ku Lian Zi tree root bark, about one to two taels, decocted in water to one teacup volume, taken orally to expel worms completely. However, do not use lightly in weak constitutions.
There is another strange pain: screaming "Pain, Pain, Pain" several times, then clutching chest and fainting. My daughter suffered this. While my father was alive, I saw him lay the girl face down, place her knees in a basin of cold water, pour water on the Weizhong point (BL40) and slap fiercely until thick veins swelled. Insert two silver needles beside the veins, bleeding occurred. She cried "Pain" once and revived. Then drink half cold water and half boiling water, one to two bowls, for immediate recovery. My father said this is Ji Sha (Acute Sha Syndrome), similar to Zhu Jin Huo (Spasm Cholera). Ordinary abdominal pain never kills instantly upon onset; remember this distinction for Ji Sha.
Xia Yuzhu said: I have observed in the *Neijing* that "Stomach deficiency causes vomiting (Tu), Stomach heat causes retching (Ou)." This statement is fundamentally erroneous. Why? I frequently see vomiting; vomiting indeed has deficiency patterns, but also often has heat patterns. Retching is indeed heat, yet can also be cold. I am not criticizing predecessors without reason, but based on extensive observation and effective treatment. Both syndromes have deficiency and heat variations; one must not be dogmatic. Only observe the complexion. Redness of lips and tongue indicates Heat; pallor indicates Deficiency. There will be no error. Regarding diarrhea, small amount and slow flow is Xie (Leakage); large amount and urgent flow is Xie (Flux). Xie is mild, Xie is severe. Verify by the color of the excrement; treatment will invariably be effective.