《惠济论》小儿痢瘥后遍身肿候歌 冷痢日久失医治，遍身浮肿却如吹，脉洪是气化为水，沉实还
因积有之，顺气肿消为上法，气平两日定多尿，莫交食饱还忧滞，此疾元因积损脾。
《惠济论》塌气散
香 白牵牛 甘草（各炒） 木香（各一钱）
上为末。每服半钱，紫苏汤下。
止渴圣效散 治小儿因吐利，气虚津液减耗，生疳烦渴，饮水不休，面肿脚浮，腹大头细，小便利
白，全不吃食。
干葛 白芷（各二两，一两炒黄，一两生用） 细墨（二两，一两火 过，一两生用） 黄丹
（二两，一两炒紫色，
一两生用）
上，同为细末。每服半钱，倒流水调下。
（杨）夫腹痛者，多因邪正交攻，与脏气相击而作也，挟热而痛者必面赤或壮热，四肢烦，手足心热。
见之挟冷而痛者必面色或白或青、手足冷者，见之冷甚而变证则面黯唇口俱黑、爪甲皆青矣。热证四顺清凉
饮（里热）加青皮、枳壳。冷证七气汤加辣桂调苏合香丸。若邪正交攻，冷热不调，桔梗枳壳汤加青皮、
陈皮、木香、当归为妙。若内吊等证，则钓藤散（夜啼）。其余则芍药甘草汤为要药也。实痛有热者，大
柴胡汤（伤寒）主之。心腹痛甚有实热者，大承气汤（伤寒）下之。腹痛，桂枝加芍药。痛甚桂枝加大黄（
二方并见痘疹）。〔薛〕小儿腹痛，口中气冷，不思饮食，脾土虚寒也，用调中丸（不乳食）主之。口中
气温，大便酸臭，积痛也，用下积丸治之。面赤壮热，或手足并热，实热也，用泻黄散（脾）泻之。面黄微热，
或手足并温，虚热也，用异功散（吐泻）补之。若作渴饮汤，胃气虚热也，用白术散（渴）。若痛连两胁，
肝木乘脾也，用
四君子汤（吐泻） 加柴胡、芍药。若腹痛重坠，脾气下陷也，用补中益气汤（虚热）加升麻。若手足指冷，或
吃逆泄泻，寒水侮土也，用六君、炮姜、肉桂，不效，急加附子。若服克滞之药致腹作痛，按之不痛，脾气复伤也，
用五味异功散。中脘痛者属脾。少腹痛者属肾。按之痛者为积滞。不痛者为里虚。积滞者消之，虚者补之。娄氏，
分曲腰干哭无泪者，为盘肠内钓痛。面 白不思食，为胃冷痛。面赤唇焦便黄，为热痛。面黄白，大便醋臭，
为积痛。口淡而沫自出，为虫痛。曾氏，又有脏寒痛，锁肚痛， 瘕痛， 痛，癖痛，吊肾痛，偏坠痛，寒疝痛。
各有治法，今胪列于后∶
《惠济论》中关于小儿痢疾痊愈后全身浮肿的歌诀：冷性痢疾日久若失于医治，会导致遍身浮肿，状如吹气般肿胀；脉象洪大说明是气化失常导致水液停聚，脉象沉实则是因为体内有积滞所致。顺气以消肿是上策，待气机平和两日后，小便通常会增多。此时切勿让患儿吃得过饱，以免担忧食积停滞。此病的根本原因在于积滞损伤了脾脏。
《惠济论》塌气散方：
香附、白牵牛（各炒制）、甘草（各一钱），木香（一钱）。
以上药物研为细末。每次服用半钱，用紫苏汤送服。
止渴圣效散：治疗小儿因呕吐腹泻，导致气虚津液耗损，生出疳积并烦渴不止，饮水不停，面部浮肿脚部肿胀，头大颈细，小便清长色白，完全不吃东西的症状。
干葛、白芷（各二两，其中一两炒至微黄，一两生用），细墨（二两，其中一两火煅过，一两生用），黄丹（二两，其中一两炒至紫色，一两生用）。
以上药物共同研为细末。每次服用半钱，用倒流水调服。
（杨）腹痛这一病症，多因邪气与正气相互交攻，并与脏腑之气相搏击而发作。伴有热痛的，必然面色发红或高热，四肢烦躁，手心脚心发热。见到伴有冷痛的，必然面色发白或发青，手脚冰凉；如果寒气极重出现变证，则面色晦暗，嘴唇和口角发黑，指甲全部发青。对于热证，使用四顺清凉饮（针对里热证）加青皮、枳壳。对于冷证，使用七气汤加辣桂，并调服苏合香丸。如果是邪正交攻，冷热不调，使用桔梗枳壳汤加青皮、陈皮、木香、当归效果最好。如果是内吊等证候，则使用钓藤散（用于夜啼）。其余情况则以芍药甘草汤为主要药物。实证且有热的，以大柴胡汤（见于伤寒论）主治。心腹疼痛剧烈且有实热的，用大承气汤（见于伤寒论）攻下。腹痛可用桂枝加芍药汤。疼痛剧烈的用桂枝加大黄汤（这两方均见于痘疹篇）。〔薛〕小儿腹痛，口中气息寒冷，不想吃东西，这是脾土虚寒，用调中丸（用于不乳食）主治。口中气息温暖，大便酸臭，这是积滞痛，用下积丸治疗。面色红赤壮热，或者手足都热，这是实热，用泻黄散（针对脾经伏火）清泻。面色发黄微热，或者手足都温和，这是虚热，用异功散（用于吐泻后调理）补益。如果口渴想喝热汤，这是胃气虚热，用白术散（用于口渴）治疗。如果疼痛牵连两胁，这是肝木乘脾，用四君子汤（用于吐泻后调理）加柴胡、芍药。如果腹痛沉重下坠，这是脾气下陷，用补中益气汤（用于虚热）加升麻。如果手指脚趾发冷，或者呃逆泄泻，这是寒水侮土，用六君子汤加炮姜、肉桂，如果无效，急忙加入附子。如果因为服用克伐消导的药物导致腹部疼痛，按压时不痛，这是脾气再次受伤，用五味异功散。中脘穴处疼痛属于脾。少腹部疼痛属于肾。按压疼痛的是积滞。不痛的是里虚。有积滞的用消导法，虚弱的用补益法。娄氏认为，分曲身体弯腰哭泣且无泪的，是盘肠内钓痛。面色白不想吃饭，是胃冷痛。面色红赤嘴唇焦裂大便黄，是热痛。面色黄白，大便醋臭，是积痛。口淡且口水自出，是虫痛。曾氏又有脏寒痛、锁肚痛、瘕痛、癖痛、吊肾痛、偏坠痛、寒疝痛。各有治疗方法，现在列举在后面：
Song from *Huiji Lun* on the syndrome of generalized edema after the cure of pediatric dysentery: If cold-type dysentery persists for a long time and is left untreated, it leads to generalized edema, with swelling resembling inflated air; a surging pulse indicates that water retention results from impaired Qi transformation, while a deep and solid pulse suggests the presence of internal accumulation. The best method is to regulate Qi to reduce swelling; once Qi becomes balanced, increased urination will likely occur within two days. One must avoid overfeeding the child to prevent concern about food stagnation. The root cause of this disease lies in damage to the Spleen due to accumulation.
*Taqi San* (Collapse-Qi Powder) from *Huiji Lun*:
Xiangfu (Cyperus Rhizome), Baiqianniu (Pharbitis Seed), Gancao (Licorice Root) (each stir-fried, 1 qian), Muxiang (Aucklandiae Radix, 1 qian).
Grind into fine powder. Take half a qian per dose, administered with Perilla Decoction.
*Zhike Shengxiao San* (Wonderful Effect Powder for Stopping Thirst): Treats pediatric symptoms caused by vomiting and diarrhea leading to Qi deficiency and depletion of body fluids, resulting in malnutrition (Gan syndrome) with irritability and excessive thirst, continuous drinking, facial edema and foot swelling, large head with thin neck, clear white urine, and complete anorexia.
Gegen (Puerariae Radix), Baizhi (Angelicae Dahuricae Radix) (each 2 liang, one liang stir-fried until yellow, one liang raw), Xiemo (Fine Ink Stick, 2 liang, one liang fire-calcined, one liang raw), Huangdan (Lead Tetroxide, 2 liang, one liang stir-fried until purple, one liang raw).
Grind all ingredients together into a fine powder. Take half a qian per dose, mixed with "reverse-flowing water" (water flowing against the current).
(Yang) Abdominal pain often arises from the mutual attack of pathogenic factors and healthy Qi, clashing with the Qi of the Zang organs. Pain accompanied by heat necessarily presents with a red face or high fever, restlessness in the four limbs, and heat in the palms and soles. Pain accompanied by cold necessarily presents with a pale or bluish complexion and cold hands and feet; if the cold is severe and transforms into pathological changes, the face becomes dark, lips and mouth turn black, and fingernails become blue. For heat syndromes, use Six-Direction Cooling Clearing Decoction (for interior heat) with Qingpi (Tangerine Peel) and Zhike (Bitter Orange). For cold syndromes, use Seven-Qi Decoction with Lajia (Spicy Cinnamon Bark), combined with Suhe Xiang Wan (Styrax Pill). If pathogenic and healthy Qi clash, and cold and heat are unbalanced, Jiegeng Zhike Tang (Platycodon and Bitter Orange Decoction) with Qingpi, Chenpi (Aged Tangerine Peel), Muxiang, and Danggui (Angelica Sinensis) is excellent. For internal drawing syndromes, use Diaoteng San (Hookwire Powder) (for night crying). For other cases, Shaoyao Gancao Tang (Peony and Licorice Decoction) is the essential medicine. For excess pain with heat, Da Chaihu Tang (Major Bupleurum Decoction) (from *Shanghan Lun*) is indicated. For severe heart and abdominal pain with excess heat, Dachengqi Tang (Major Order the Qi Decoction) (from *Shanghan Lun*) should be used to purge. For abdominal pain, Guizhi Ji Shaoyao Tang (Cinnamon Twig Plus Peony Decoction) is used. For severe pain, Guizhi Jia Dahuang Tang (Cinnamon Twig Plus Rhubarb Decoction) is used (both formulas appear in the chapter on smallpox/variolae). [Xue] Pediatric abdominal pain with cold breath and loss of appetite indicates deficiency-cold of Spleen Earth, treated with Tiaozhong Wan (Regulate-Middle Pill) (for refusal to nurse). Warm breath and sour-smelling stool indicate accumulation pain, treated with Xiaji Wan (Drain-Accumulation Pill). Red face, high fever, or heat in both hands and feet indicates excess heat, cleared with Xiehuang San (Drain-Yellow Powder) (targeting Spleen). Yellowish face with slight fever or warmth in both hands and feet indicates deficiency heat, supplemented with Yigong San (Extraordinary Merit Powder) (for vomiting and diarrhea). Thirst with desire for hot drinks indicates deficiency-heat of Stomach Qi, treated with Baizhu San (Atractylodes Macrocephala Powder) (for thirst). Pain radiating to both hypochondria indicates Liver Wood invading Spleen, treated with Sijunzi Tang (Four Gentlemen Decoction) (for vomiting and diarrhea) plus Chaihu (Bupleuri Radix) and Shaoyao (Paeoniae Radix). Heavy, bearing-down abdominal pain indicates sinking of Spleen Qi, treated with Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) (for deficiency heat) plus Shengma (Cimicifugae Rhizoma). Cold fingers and toes, or hiccups and diarrhea, indicate Cold Water insulting Earth, treated with Liujun Zi Tang (Six Gentlemen Decoction) plus Paojiang (Prepared Ginger) and Rougui (Cinnamon Bark); if ineffective, add Fuzi (Aconiti Lateralis Radix Preparata) urgently. Abdominal pain caused by taking harsh resolving medicines, which does not hurt upon pressure, indicates further injury to Spleen Qi, treated with Wuwei Yigong San (Five-Ingredient Extraordinary Merit Powder). Pain at Zhongwan (CV12) belongs to the Spleen. Pain in the lower abdomen belongs to the Kidney. Pain upon pressure indicates stagnation; lack of pain indicates interior deficiency. Stagnation is resolved; deficiency is tonified. Lou氏 states that bending the waist and crying without tears indicates Pan Chang Nei Diao pain (Intestinal Coiling Internal Drawing Pain). Pale face and anorexia indicate Stomach cold pain. Red face, cracked lips, and yellow stool indicate heat pain. Yellowish-white face and vinegar-like smelly stool indicate accumulation pain. Pale taste with spontaneous drooling indicates worm pain. Zeng氏 also lists Zang Han Tong (Visceral Cold Pain), Suo Du Tong (Locked Belly Pain), Jia Tong (Mass Pain), Pi Tong (Clump Pain), Diao Shen Tong (Drawing-Kidney Pain), Pian Zhui Tong (Lateral Drooping Pain), and Han Shan Tong (Cold Hernia Pain). Each has its own treatment method, listed below: