《汉东王先生家宝》小儿积病,可医者九。面上虚肿是积。积者是脾之所系,
脾主身之肌肉,故应面,故知是脾积,其脾系土,土无正形,故早晚浮肿不定,多
则早浮,其睡则脾不磨,上面作肿,若病后,此证则是虚中积,宜用调脾消积行气
等药。面合地卧是积。何以合地,其受积在脾,是冷积,何以知之,其脾好土,故
知在脾,其冷者属阴,故知伤冷硬食得之,宜下热积气药耳。腹胀是积。其积在
肺,何以知之,其肺主于气,才当受积,其气便冷,腹胀满气急,故知在肺,如腹
胀,先宜调气后转,转后更宜调气。小便如油是积。其积在小肠,何以知之,其积
受于脾,脾当传心,心不受触,则入小肠,小肠是心之府,故知在小肠,则节其水
道,小便如米泔油相似也。发黄是积。是积气伤心,心主血脉,荫遍身毛发,被积
气所干,则发黄,故知是积伤心,宜下空心散及取积药,此人必时复发热也。赤白
痢是积。其积在肺,受传大肠,及有外伤冷而得,何以知之,其肺主西方庚辛金,
其色白,后赤则是外邪,故知肺传大肠,则为赤白痢也,宜取后调气。两眼黄赤、
睛青、是积。其积在肝,何以知之,肝主东方甲乙木,色青,却被积气所干,即黄
赤,睛青者,眼属五脏,肝是其主,肝若受积,故令眼睛青,是肝受积。若传
胆,其人口苦,不要吃物,宜凉药退之。遍身虚肿是积。其积不在脏,只在腑,何
以知之,为其积曾取,后被药发动,即不在脏,故出皮肤之间为肿也,只宜下取虚
中积药,然后补之。多泻白粪是积。是受冷积在脾,何以知之,脾主化,受冷积在
脾,冷滑而泻白粪,故知在脾,宜先转,后热药补之。积病不可医者六。喘急是
肺积,肺主气,其喘急则肺绝,其人当面白,全无血色,故不可医也。面黑是肾
积,其人面黑者,是肾绝也,人当不辨好恶,眼直无光,只得一日而死也。吐热气
是荣积,其不医者,是血绝不可治也,血主心,心不能管,故出热气不止耳。手脚
心生疮是卫积,卫者气也,胃气不生,故手足生疮,若卫绝,则气不回,只得半日
也。恶心吐干呕是胃积,何以不医,胃主化食,其胃热则恶吐,故不治,其人必食
乳不化,不食亦干吐呕,面色青黄无血色也。泻久住又泻是积,咬脾烂。何以知
其脾烂,其人当泻白粪,为食不消,住了,却放粪赤黑而死,即知脾烂不可治。
《宝鉴》论小儿五积,为脏气不行,蓄积一处不动,故曰积。夫心为伏梁,在脐
上,上攻其心,下攻胃口。脾为痞气,在胃口上横之。肝为肥气,在脐之左边。肺
为息贲,在脐之右畔。肾为贲豚,在脐下。各有变动,非食之所成,乃气积也,脏
属阴,故在一处而不动也。聚谓六腑之气留聚也,腑属阳,阳气运转不停,故其聚
不定一处,发而腹痛。积聚之候,皆面黄瘦劣, 不生肌肉,发立或肌体浮肿,
腹急多困,多为水气。
《真珠囊》虚中积候,凡惊中虚积者,谓因惊取,复惊发动是也,所下粪青秽。
凡虚中有积者,因伤食而泻又吐,如此渐虚,其病未瘥,故曰虚积也。又虚中之
积,有积而频频取转,却取转不着,致其积尚伏,故亦曰虚中积。若惊积取下,则
粪随惊青。如是食积,即粪成块子。凡疳中虚积者,因疳病转泻,虚而疳不退,故
虚中尔,所取下粪里白色也。
〔曾〕凡婴孩所患积证,皆因乳哺不节,过餐生冷坚硬之物,脾胃不能克化,积
停中脘,外为风寒所袭。或因夜卧失盖。致头疼面黄身热,眼胞微肿,腹痛膨胀,
足冷肚热,喜睡神昏,饮食不思,或呕或哕,口噫酸气,大便 臭,此为陈积所伤。
如觉一二日,先以百伤饮(外感)发表,次当归散(潮热)水姜煎服,温动积滞,方下乌犀丸、
六圣丸,重与宽利,后用匀气散(疝)调补。〔汤〕凡有积滞,须辨虚实,况孩儿虚瘦
长短黑白,南北古今不同,不可一概论也。予今之法,实者,可服进食丸。虚而微
白芨疳瘦者,宜服肥儿丸(即三因肥儿丸见腹胀条)。〔薛〕初患元气未损之时,或腹胀作痛,
大小便不利者,先用白饼子或木香槟榔丸下之。下后以白术散或五味异功散和之,
渴加干葛,吐加半夏。下而热不退,或作呕作泻,饮食不思,此脾胃俱伤也,用六
君子汤。手足指冷,喜饮热汤,此脾胃虚寒也,前方加炮姜、木香。面色黄白,目
无精光,脾肺俱虚也,用四君子加柴胡、升麻。腹痛泄利下垂,或小便不利者,用
四逆散。发热晡热,或泻未已,脾气下陷也;潮热口渴,大便不调,欲变疳证也;
并用补中益气汤,佐以肥儿丸。经云∶邪之所凑,其气必虚,留而不去,其病乃实。
必以调脾为主,而以消导佐之。古人所谓养正积自除。正此意也。
《千金》紫双丸 治小儿身热头痛,食饮不消,腹中胀满。或小腹绞痛,大小便不
利。或重下数起,小儿无异疾,惟饮食过度,不知自止,哺乳失节。或惊悸寒热。
惟此丸治之,不瘥,更可重服。小儿欲下,是其蒸候,哺食减少,气息不快,夜
啼不眠,是腹内不调,悉宜用此丸,不用他药,数用神验,千金不传方。(臣亿等详
序例中凡云服紫丸者,即前变蒸篇中四味者是也,云服紫丸不下者,服赤丸,赤丸瘥驶,病重当用之,方中并无赤丸,
而此用朱砂者,又力紧于紫丸,疑此即赤丸也。)
巴豆(去皮) 蕤核仁(去皮。各十八铢) 甘草(炙,五铢) 牡蛎(火 赤) 黄蜡(各八铢) 甘遂 朱砂
(各二铢) 麦门冬(去心,十铢)
上八味,以汤熟洗巴豆,研,新布绞去油,别捣甘草、甘遂、牡蛎、麦门冬,
下筛讫。研蕤核仁令极熟,乃内散,更捣二千杵,药燥不能相丸,更入少蜜足之。
半岁儿服如荏子一双,一岁二岁儿服如半麻子一双,三四岁者服如麻子二丸,五
六岁者服如麻子大二丸,七岁八岁服如小豆二丸,九岁十岁微大于小豆二丸,常
以鸡鸣时服之。至日出时不下者,投粥饮数合即下。丸皆双出也。下甚者,饮以
冷粥即止。
〔茅先生〕青金丹 小儿诸积病悉主之。
滑石(末) 白丁香(罗过) 天南星(各二钱匕) 青黛(罗过,平钱满挑二钱) 轻粉(重二钱) 水银(秤
二钱,先以锡二钱于铜铫内熔化,便下水银拌和匀,倾出于地,冷用) 川巴豆(去皮心膜,七十二个,无缺损者,井
华水浸
一宿,悬当风处,吹干,烂研)
上前件药同拌合,用软饭为丸,如小绿豆大。巴豆不出油。根据形证用汤使下。
伤寒后取积,淡煎葱汤吞下。取疳虫,用牛肉炙汁下。惊风肚中紧硬,面青黑,
金银薄荷葱汤吞下。因伤,看肚中及腹皮上微热肚胀,夜间作热,似疳又不是疳,
面青黄色,眼微黄,此腹中有积,用皂角子二七粒,灰火煨过,用水一盏、煎至
半盏下。有积作泻,鱼 汤下。气积炒 香汤下。凡下此药,周岁十四丸,三岁
十八丸,七岁二十四丸,量大小加减。下须是四更初下,至天明通下。积来尽时,
可根据形证候,下药补之。临吃此药,恐先吐下些小涎来,亦不妨。
万灵丸 主小儿诸积,根据形证用之。
木香 黄连 蓬莪术(各半分) 陈橘皮 青橘皮(各去瓤,一分) 槟榔(一钱半重者一枚)
上为末,每匕药一钱,用巴豆一粒去心膜用醋煮,巴豆一枚煮药令巴豆紫色,
用杏仁一枚去皮尖灯火上 留性,二味都研,用醋面糊为丸,如小绿豆大。每服
五丸七丸十丸,薄荷姜汤吞下。
〔钱乙〕消积丸
丁香(九枚) 缩砂仁(十二枚) 乌梅肉(三个,焙) 巴豆(二枚,去皮油心膜)
上为细末,面糊丸,黍米大。三岁以上三五丸,以下三二丸,温水下,无时。
紫霜丸 消积聚。
巴豆(去油心膜) 杏仁(去皮尖。各二十一个) 代赭石(一钱,研细水飞)
上为细末,饭丸如粟米大。每服三五丸至十丸,煎皂角仁汤下,无时,儿小者减之。
真珠丸 取小儿虚中,一切积聚、惊涎、宿食、乳癖,治大小便涩滞,疗腹胀,行滞气。
木香 白丁香(真者) 丁香(末) 轻粉(各半钱,留少许为衣) 白滑石(末,二钱) 巴豆(十四粒,水浸
一宿,研极腻)
上为末,研匀,湿纸裹,烧粟米饭丸麻子大。一岁一丸,八九岁以上至十五
岁服八丸。炮皂子煎汤放冷下。挟风热难动者,先服凉药一服。乳癖者,减丸数,隔日、临卧一服。
消坚丸 消乳癖及下交奶,又治痰热膈实,取积。
砂(末) 巴豆霜 轻粉(各一钱) 黄明胶(末,五钱) 细墨(少许) 水银沙子(两皂子大)
上,同研细末,少入面糊为丸,如麻子大。倒流水下,一岁儿服一丸,食后。
白饼子 治小儿腹中有癖,不食,但饮乳是也。
滑石 轻粉 半夏(汤洗,焙干) 南星(各一钱,为末) 巴豆(二十四粒,去皮膜,水一升煮,水尽为度)
上研匀,巴豆后入,众药以糯米饭为丸,如小绿豆大,捏作饼子。儿三岁以上
三五饼,三岁以下一二饼,葱白汤下,临卧服。
〔张涣〕万灵丹 治小儿脾胃久不和,挟积,服温热药皆不效,此药神妙。
肉桂 川黄连 蓬莪术(各一两) 肉豆蔻仁 槟榔 陈橘皮(去白,焙干) 木香 丁香(各
半两。以上捣罗为细末,次用) 巴豆(去皮心膜) 杏仁(麸炒,去皮尖。二件并灯上烧灰存性。各二七个)
上件同再捣拌匀,滴水丸黍米大。每服,未周 一粒,二三岁二粒,三四岁三
粒,五七岁五粒,十岁以上七粒,用生姜汤放冷下,乳食后。久积或乳癖,并宜常服。
剪红丸 磨癖积,杀诸虫,进饮食,神效。男女老幼皆可服。孕妇勿服。
干漆(炒烟尽) 紫芫花(醋拌,炒。各一钱) 巴豆(七粒,去皮膜心,不去油) 斑蝥(七枚,去头足翅,炒,
研时、
塞两鼻孔)
上为丸,醋糊丸梧桐子大。用红砂包,红线缚定,剪切来每服一丸,同后药服之。
南木香 雷丸 三棱(生) 莪术(生) 百部(微炒。各半两) 贝母 槟榔 大黄(生。各一两) 使
君子肉(四十九枚,半生半炒) 牵牛(生半斤,取头末三两半)
为细末用 皂角十锭捶碎,山茵陈(一两),苦楝根皮(二两),水四五碗,砂锅内慢火
煎至一小碗,将前末搜为丸梧子大,日干。小儿粟米大。每服二钱半重。各随
后证,改汤使引下,五更初服。忌荤腥生硬油腻物,此方与诸方甚异,毋忽。小
儿 喘急咳嗽,桑白皮汤下。取寸白虫,煎石榴根汤下。香港脚肿不可行,木
瓜汤或蜜水下。取蛔虫苗虫,沙糖水下。小儿一切诸证,蜜水或沙糖水下。酒
痢酒积,百药煎汤下。妇人血脉不行,淡醋红花汤送下。妇人血蛊,葱白汤下。
肠风下血,煎山栀子汤下。大小便不通,淡醋汤下。食积气块诸证,用温蜜水、温茶汤下。
真方五色丸子 治小儿一切所伤,痰涎壅塞,胸膈不利,乳食不消,变生癖积,胁
肋片硬,按之疼痛,及治一切急慢惊风发搐,痰涎壅塞。
青丸子∶青黛(别研) 南星(姜制。各半两) 巴霜(半钱)
红丸子∶朱砂(水飞) 半夏(姜制。各半两) 巴霜(半钱)
黄丸子∶大黄(煨) 郁金(各半两) 巴霜(半钱)
白丸子∶白附子(生) 寒水石( 。各半两) 巴霜(半钱)
黑丸子∶五灵脂(炒) 全蝎(炒。各半两) 巴霜(半钱)
上前五色药,各另研为细末,入巴霜半钱同匀,面糊丸粟米大。一岁服五丸,
乳汁送下,量大小加减。或姜汤下。急惊,金银薄荷汤。慢惊,生姜全蝎汤。
下积丸 治乳食伤积,心腹胀满,气粗壮热,或泻或呕。
丁香(二十粒) 缩砂仁(二十枚) 使君子肉(五枚) 乌梅 巴豆肉(不去油。各三枚)
上为末,烂饭丸麻子大。每服三丸,陈皮汤下。
五珍丸 治酒食积,通用。
青皮 干姜(烧,存性) 蓬术 五灵脂(各一两) 巴豆肉(去半油,一钱)
上为细末,粳米饭丸麻子大。每服三五丸,米汤下。
《局方》进食丸 治乳食不化,心胸胀满,疳积肚疼。
木香(炮) 枳壳(去白,炒) 当归 代赭石(各五钱) 朱砂(另研,三钱) 巴豆(去油膜,一钱) 麝香
(另研,五分)
上为细末,面糊丸,如黍米大。一岁二丸,量儿大小加减,米饮送下。
六圣丸(曾氏) 治诸积和胃,大能主气浓肠,消疳快膈。
莪术(炮,锉) 净黄连 陈皮(去白) 白姜(炮。各五钱) 南木香(二钱半)
上除木香不见火,余四味锉焙,同木香为末,每一钱重,巴豆三粒去壳膜心,
存油,碎切,入乳钵细研,同前药再研匀,醋煮面糊丸麻仁大。每服十五粒至
二十五粒或三十五粒,五更空心淡姜汤下。利三五行,匀气散止补(方见疝)。常服助
脾化积,进食消疳,临睡以净汤或汤酒下三粒及五粒。每次止丸药末三钱,净巴
豆九粒为则,不可多合,久则味散。
《汉东王先生家宝》指出,小儿积病可治愈的有九种情况。面部虚浮肿胀是积证。积证与脾脏有关,脾主司全身的肌肉,所以反映在面部,因此知道这是脾积。脾属土,土没有固定的形态,所以早晚浮肿不定,通常早晨浮肿明显。睡觉时脾不运化,导致面部浮肿。如果是病后出现此证,属于虚中夹积,适宜使用调脾、消积、行气等药物。面部紧贴地面仰卧是积证。为什么紧贴地面?因为积滞在于脾,属于冷积。如何知道?脾喜土性,所以知病在脾;寒冷属于阴邪,所以知道是因为受了生冷坚硬的食物所致,适宜服用泻下热积气的药物。腹部胀满是积证。积滞在于肺,如何知道?肺主气,刚受到积滞影响,气便变冷,导致腹胀满、气急,所以知道病在肺。如出现腹胀,先宜调理气机,待气机转动后再继续调理。小便像油一样是积证。积滞在于小肠,如何知道?积滞受于脾,脾传于心,心不受邪则传入小肠,小肠是心的腑,所以知道病在小肠,这就节制了水道,小便就像米泔水混着油一样。身体发黄是积证。这是积气伤及心脏,心主血脉,荫护全身毛发,被积气干扰,就会发黄,所以知道是积气伤心,适宜服用空心散及取积药,这种人必定时常发热。赤白痢疾是积证。积滞在于肺,受传于大肠,加上外感寒邪而得。如何知道?肺主西方庚辛金,其色白,大便带红则是外邪所致,所以知道是肺传大肠,形成赤白痢,适宜通过通利大便来调理气机。两眼黄赤、眼珠发青是积证。积滞在于肝,如何知道?肝主东方甲乙木,色青,却被积气干扰,即现黄赤;眼珠发青,因为眼睛归属五脏,肝是其主宰,肝若受积,所以令眼睛发青,这是肝受积。如果传至胆,人口苦,不想吃东西,适宜用凉药退治。遍身虚肿是积证。积不在脏,只在腑,如何知道?因为积曾经过攻下治疗,后被药物发动,就不在脏,而出现在皮肤之间成为浮肿,只适宜服用攻取虚中积的药,然后进行补益。多排泄白色粪便为积证。这是受了冷积在脾,如何知道?脾主运化,受冷积在脾,因冷滑而排泄白色粪便,所以知道病在脾,适宜先转导积滞,后用热药补益。
积病不可治愈的有六种。喘促急促是肺积,肺主气,喘促急促则肺气绝,病人面色苍白,全无血色,所以不可治愈。面色发黑是肾积,病人面色黑的,是肾气绝的表现,人应当不能辨别好坏,眼睛直视无光,只能活一天就死了。吐出热气是营血之积,之所以不可治,是因为血绝不可治,血由心主,心不能统摄,所以吐出热气不止。手脚心生疮疡是卫气之积,卫就是气,胃气不生,所以手足生疮,如果卫气绝,则气不回返,只能活半天。恶心干呕是胃积,为什么不治?胃主消化食物,胃热则恶吐,所以不治,此人必定吃乳不消化,不吃也干吐,面色青黄无血色。腹泻久停后又泻是积证,咬烂脾脏。如何知道脾烂?此人当排泄白色粪便,因为食物不消化,停了之后,却排出赤黑色粪便而死,就知道脾烂不可治。
《宝鉴》论述小儿五积,是因为脏气运行不畅,蓄积在一处不动,所以叫积。心积称为伏梁,在脐上,上攻心,下攻胃口。脾积称为痞气,在胃口上方横结。肝积称为肥气,在脐的左边。肺积称为息贲,在脐的右边。肾积称为贲豚,在脐下。各有变动,不是由饮食造成的,而是气积。脏属阴,所以在某一处不动。聚是指六腑之气留聚,腑属阳,阳气运转不停,所以其聚不定在一处,发作时腹痛。积聚的症状,都是面色黄瘦,不长肌肉,头发竖起或肌体浮肿,腹部拘急多困倦,多为水气。
《真珠囊》论虚中积候,凡是惊悸引起的虚积,是说因为惊吓而得,又因再次惊吓而发动,所下的粪便青秽。凡是虚中有积的,因为伤食而泻又吐,这样逐渐虚弱,病未痊愈,所以叫虚积。又有虚中之积,有积而频繁攻下转导,却转导不掉,致使积滞仍潜伏,所以也叫虚中积。如果是惊积攻下,则粪便随惊而青。如果是食积,则粪便成块状。凡是疳病中的虚积,因为疳病转泻,虚而疳不退,所以虚中,所下的粪便里有白色物质。
〔曾氏〕凡是婴孩患的积证,都是因为乳哺不节,过食生冷坚硬之物,脾胃不能克化,积滞停在脘腹,外受风寒侵袭。或者夜间睡觉失盖。导致头疼面黄身热,眼睑微肿,腹痛膨胀,脚冷肚热,喜欢睡觉神志昏沉,饮食不思,或呕吐或呃逆,口出酸气,大便臭,这是陈年积滞所伤。如果发觉一两天,先用百伤饮(用于外感)发表,再用当归散(用于潮热)加生姜煎服,温动积滞,然后服用乌犀丸、六圣丸,重剂宽利,后用匀气散(用于疝)调补。〔汤氏〕凡是有积滞,必须辨别虚实,何况孩子体质强弱、高矮、黑白、南北古今不同,不可一概而论。我现在的治法,实证的可服用进食丸。虚而轻微消瘦的,适宜服用肥儿丸(即三因方中的肥儿丸,见腹胀条)。〔薛氏〕初患病元气未损之时,如果腹胀作痛,大小便不利的,先用白饼子或木香槟榔丸攻下。下后以白术散或五味异功散调和,口渴加干葛,呕吐加半夏。攻下后热不退,或作呕作泻,饮食不思,这是脾胃俱伤,用六君子汤。手足指冷,喜欢喝热汤,这是脾胃虚寒,前方加炮姜、木香。面色黄白,目无精光,是脾肺俱虚,用四君子汤加柴胡、升麻。腹痛泄利下垂,或小便不利的,用四逆散。发热晡热,或泻未止,是脾气下陷;潮热口渴,大便不调,欲变为疳证的,并用补中益气汤,佐以肥儿丸。经云:邪之所凑,其气必虚,留而不去,其病乃实。必须以调脾为主,而以消导为辅。古人所谓养正积自除,就是这个意思。
《千金方》紫双丸 治疗小儿身热头痛,饮食不消,腹中胀满。或小腹绞痛,大小便不利。或多次排便,小儿无异疾,只是饮食过度,不知自止,哺乳失节。或惊悸寒热。只有此丸能治,如果不愈,可再服。小儿欲下积,是其蒸腾之候,哺食减少,气息不快,夜啼不眠,是腹内不调,都适宜用此丸,不用其他药,多次使用神验,千金不传方。(臣亿等详序例中凡是说服紫丸的,就是前变蒸篇中的四味药,说服紫丸不下的,服赤丸,赤丸疗效更速,病重当用之,方中并无赤丸,而此处用朱砂的,又力紧于紫丸,怀疑这就是赤丸。)
巴豆(去皮) 蕤核仁(去皮。各十八铢) 甘草(炙,五铢) 牡蛎(火煅至赤) 黄蜡(各八铢) 甘遂 朱砂(各二铢) 麦门冬(去心,十铢)
以上八味药,用开水烫熟洗巴豆,研碎,用新布绞去油,另外捣碎甘草、甘遂、牡蛎、麦门冬,过筛后。研蕤核仁令极细,然后加入药散,再捣两千杵,药燥不能成丸,再加入少许蜂蜜足够成丸。半岁婴儿服用如芝麻粒大的一对,一至两岁婴儿服用如半粒芝麻大的一对,三至四岁者服用如芝麻粒大的两丸,五至六岁者服用如芝麻粒大的两丸,七至八岁服用如小豆大的两丸,九至十岁略大于小豆大的两丸,常在鸡鸣时服用。到日出时不下的,灌入数合粥饮即可下。丸药皆成对排出。下得多,饮冷粥即止。
〔茅先生〕青金丹 主治小儿各种积病。
滑石(末) 白丁香(筛选过) 天南星(各二钱匕) 青黛(筛选过,平钱满挑二钱) 轻粉(重二钱) 水银(秤二钱,先用锡二钱在铜锅内熔化,立即下水银拌和匀,倾出在地上,冷却后用) 川巴豆(去皮心膜,七十二个,无缺损者,井华水浸泡一夜,悬挂在通风处,吹干,烂研)
将上述药物同拌合,用软饭为丸,如小绿豆大。巴豆不出油。根据形证用汤使送下。伤寒后取积,淡煎葱汤吞下。取疳虫,用牛肉炙汁送下。惊风肚中紧硬,面青黑,金银薄荷葱汤吞下。因伤,看肚中及腹皮上微热肚胀,夜间发热,似疳又不是疳,面青黄色,眼微黄,这是腹中有积,用皂角子十四粒,灰火煨过,用水一盏、煎至半盏送下。有积作泻,鱼汤下。气积炒茴香汤下。凡服此药,周岁十四丸,三岁十八丸,七岁二十四丸,量大小加减。下须是在四更初服,至天明通下。积来尽时,可根据形证候,下药补之。临吃此药,恐先吐下些小涎液,也不妨碍。
万灵丸 主治小儿各种积,根据形证使用。
木香 黄连 蓬莪术(各半分) 陈橘皮 青橘皮(各去瓤,一分) 槟榔(一钱半重者一枚)
以上为末,每匕药一钱,用巴豆一粒去心膜用醋煮,巴豆一枚煮药令巴豆紫色,用杏仁一枚去皮尖灯火上烧留性,二味都研,用醋面糊为丸,如小绿豆大。每服五丸七丸十丸,薄荷姜汤吞下。
〔钱乙〕消积丸
丁香(九枚) 缩砂仁(十二枚) 乌梅肉(三个,焙) 巴豆(二枚,去皮油心膜)
以上为细末,面糊丸,黍米大。三岁以上三五丸,以下三二丸,温水送下,无固定时间。
紫霜丸 消积聚。
巴豆(去油心膜) 杏仁(去皮尖。各二十一个) 代赭石(一钱,研细水飞)
以上为细末,饭丸如粟米大。每服三五丸至十丸,煎皂角仁汤送下,无固定时间,幼儿减量。
真珠丸 取小儿虚中,一切积聚、惊涎、宿食、乳癖,治大小便涩滞,疗腹胀,行滞气。
木香 白丁香(真者) 丁香(末) 轻粉(各半钱,留少许为衣) 白滑石(末,二钱) 巴豆(十四粒,水浸一夜,研极腻)
以上为末,研匀,湿纸裹,烧粟米饭丸麻子大。一岁一丸,八九岁以上至十五岁服八丸。炮皂子煎汤放冷送下。挟风热难动者,先服凉药一服。乳癖者,减丸数,隔日、临卧一服。
消坚丸 消乳癖及下交奶,又治痰热膈实,取积。
砂(末) 巴豆霜 轻粉(各一钱) 黄明胶(末,五钱) 细墨(少许) 水银沙子(两皂子大)
以上同研细末,少入面糊为丸,如麻子大。倒流水送下,一岁儿服一丸,食后。
白饼子 治疗小儿腹中有癖,不食,只饮乳。
滑石 轻粉 半夏(汤洗,焙干) 南星(各一钱,为末) 巴豆(二十四粒,去皮膜,水一升煮,水尽为度)
以上研匀,巴豆后入,众药以糯米饭为丸,如小绿豆大,捏作饼子。儿三岁以上三五饼,三岁以下一二饼,葱白汤送下,临卧服。
〔张涣〕万灵丹 治疗小儿脾胃久不和,挟积,服温热药皆不效,此药神妙。
肉桂 川黄连 蓬莪术(各一两) 肉豆蔻仁 槟榔 陈橘皮(去白,焙干) 木香 丁香(各半两。以上捣罗为细末,次用) 巴豆(去皮心膜) 杏仁(麸炒,去皮尖。二件并灯上烧灰存性。各二七个)
以上同再捣拌匀,滴水丸黍米大。每服,未满周岁一粒,二三岁二粒,三四岁三粒,五七岁五粒,十岁以上七粒,用生姜汤放冷送下,乳食后。久积或乳癖,并宜常服。
剪红丸 磨癖积,杀诸虫,进饮食,神效。男女老幼皆可服。孕妇勿服。
干漆(炒烟尽) 紫芫花(醋拌,炒。各一钱) 巴豆(七粒,去皮膜心,不去油) 斑蝥(七枚,去头足翅,炒,研时塞两鼻孔)
以上为丸,醋糊丸梧桐子大。用红砂包,红线缚定,剪切来每服一丸,同后药服之。
南木香 雷丸 三棱(生) 莪术(生) 百部(微炒。各半两) 贝母 槟榔 大黄(生。各一两) 使君子肉(四十九枚,半生半炒) 牵牛(生半斤,取头末三两半)
为细末用皂角十锭捶碎,山茵陈(一两),苦楝根皮(二两),水四五碗,砂锅内慢火煎至一小碗,将前末搜为丸梧子大,日干。小儿粟米大。每服二钱半重。各随后证,改汤使引下,五更初服。忌荤腥生硬油腻物,此方与诸方甚异,毋忽。小儿喘急咳嗽,桑白皮汤下。取寸白虫,煎石榴根汤下。香港脚肿不可行,木瓜汤或蜜水下。取蛔虫苗虫,沙糖水下。小儿一切诸证,蜜水或沙糖水下。酒痢酒积,百药煎汤下。妇人血脉不行,淡醋红花汤送下。妇人血蛊,葱白汤下。肠风下血,煎山栀子汤下。大小便不通,淡醋汤下。食积气块诸证,用温蜜水、温茶汤下。
真方五色丸子 治疗小儿一切所伤,痰涎壅塞,胸膈不利,乳食不消,变生癖积,胁肋片硬,按之疼痛,及治一切急慢惊风发搐,痰涎壅塞。
青丸子∶青黛(别研) 南星(姜制。各半两) 巴霜(半钱)
红丸子∶朱砂(水飞) 半夏(姜制。各半两) 巴霜(半钱)
黄丸子∶大黄(煨) 郁金(各半两) 巴霜(半钱)
白丸子∶白附子(生) 寒水石(煅。各半两) 巴霜(半钱)
黑丸子∶五灵脂(炒) 全蝎(炒。各半两) 巴霜(半钱)
上前五色药,各另研为细末,入巴霜半钱同匀,面糊丸粟米大。一岁服五丸,乳汁送下,量大小加减。或姜汤下。急惊,金银薄荷汤。慢惊,生姜全蝎汤。
下积丸 治疗乳食伤积,心腹胀满,气粗壮热,或泻或呕。
丁香(二十粒) 缩砂仁(二十枚) 使君子肉(五枚) 乌梅 巴豆肉(不去油。各三枚)
以上为末,烂饭丸麻子大。每服三丸,陈皮汤送下。
五珍丸 治疗酒食积,通用。
青皮 干姜(烧,存性) 蓬术 五灵脂(各一两) 巴豆肉(去半油,一钱)
以上为细末,粳米饭丸麻子大。每服三五丸,米汤送下。
《局方》进食丸 治疗乳食不化,心胸胀满,疳积肚疼。
木香(炮) 枳壳(去白,炒) 当归 代赭石(各五钱) 朱砂(另研,三钱) 巴豆(去油膜,一钱) 麝香(另研,五分)
以上为细末,面糊丸,如黍米大。一岁二丸,量儿大小加减,米饮送下。
六圣丸(曾氏) 治疗诸积和胃,大能主气浓肠,消疳快膈。
莪术(炮,锉) 净黄连 陈皮(去白) 白姜(炮。各五钱) 南木香(二钱半)
以上除木香不见火,余四味锉焙,同木香为末,每一钱重,巴豆三粒去壳膜心,存油,碎切,入乳钵细研,同前药再研匀,醋煮面糊丸麻仁大。每服十五粒至二十五粒或三十五粒,五更空心淡姜汤送下。利三五行,匀气散止补(方见疝)。常服助脾化积,进食消疳,临睡以净汤或汤酒送下三粒及五粒。每次止丸药末三钱,净巴豆九粒为则,不可多合,久则味散。
According to "Han Dong Wang Xiansheng Jiabao," there are nine types of pediatric accumulation (Ji, a condition characterized by the stagnation and accumulation of food or pathogenic factors) that can be cured. Facial edema indicates accumulation. Accumulation is related to the Spleen; since the Spleen governs the muscles of the body, it manifests on the face, thus indicating Spleen accumulation. The Spleen corresponds to Earth, which has no fixed form, so morning and evening edema varies; typically, swelling is more pronounced in the morning. During sleep, the Spleen fails to transform, leading to facial swelling. If this occurs after an illness, it is deficiency with accumulation, suitable for herbs that regulate the Spleen, resolve accumulation, and promote Qi movement. Lying face down with the face pressed against the ground indicates accumulation. Why? Because the accumulation is in the Spleen, specifically cold accumulation. How do we know? The Spleen favors the Earth element; cold belongs to Yin, so it is known to result from consuming cold, hard foods. It is suitable to take herbs that purge heat and move Qi. Abdominal distension indicates accumulation. The accumulation is in the Lung. How do we know? The Lung governs Qi; upon receiving accumulation, the Qi becomes cold, causing abdominal distension and shortness of breath, thus indicating the pathology is in the Lung. For abdominal distension, one should first regulate Qi, and after Qi moves, continue regulation. Urine resembling oil indicates accumulation. The accumulation is in the Small Intestine. How do we know? Accumulation originates in the Spleen, transmits to the Heart; if the Heart does not accept the pathogen, it enters the Small Intestine. The Small Intestine is the Fu organ of the Heart, so the pathology is in the Small Intestine, restricting water pathways, resulting in urine like rice wash mixed with oil. Yellowing of the skin indicates accumulation. This is accumulation Qi injuring the Heart. The Heart governs blood vessels and nourishes hair and skin; when disturbed by accumulation Qi, yellowing occurs, indicating Heart injury by accumulation. It is suitable to use Kongxin San and herbs to remove accumulation; such patients likely experience intermittent fever. Red and white dysentery indicates accumulation. The accumulation is in the Lung, transmitted to the Large Intestine, combined with external cold invasion. How do we know? The Lung governs Metal (Geng-Xin), whose color is white; red stool indicates external pathogens, so Lung transmission to the Large Intestine causes red and white dysentery. It is suitable to regulate Qi through purgation. Yellow-red eyes with blue pupils indicate accumulation. The accumulation is in the Liver. How do we know? The Liver governs Wood (Jia-Yi), whose color is green; when disturbed by accumulation Qi, it appears yellow-red. Blue pupils occur because the eyes belong to the Zang organs, governed by the Liver; Liver accumulation causes blue pupils. If transmitted to the Gallbladder, the patient experiences bitter taste and anorexia, suitable for cooling herbs. Generalized edema indicates accumulation. The accumulation is not in the Zang but in the Fu organs. How do we know? After previous purgation, medication triggered the accumulation to manifest between the skin as swelling. It is suitable to take herbs for deficiency-with-accumulation, followed by tonification. Frequent passage of white stool indicates accumulation. Cold accumulation in the Spleen. How do we know? The Spleen governs transformation; cold accumulation causes slippery white stool, indicating Spleen pathology. One should first move the accumulation, then tonify with warm herbs.
There are six types of accumulation that cannot be cured. Rapid panting indicates Lung accumulation. The Lung governs Qi; rapid panting signifies Lung exhaustion. The face is pale without blood color, so it is incurable. Black complexion indicates Kidney accumulation. A black face signifies Kidney exhaustion; the patient cannot distinguish good from bad, stares blankly without light in the eyes, and will die within a day. Vomiting hot air indicates Ying (Nutritive) accumulation. It is incurable because blood exhaustion is untreatable. Blood is governed by the Heart; if the Heart cannot control it, hot air is continuously vomited. Sores on palms and soles indicate Wei (Defensive) accumulation. Wei is Qi; if Stomach Qi does not generate, sores appear on hands and feet. If Wei Qi exhausts, Qi does not return, and death occurs within half a day. Nausea and dry retching indicate Stomach accumulation. Why incurable? The Stomach digests food; Stomach heat causes vomiting. The patient cannot digest milk, vomits dryly even without eating, and has a cyan-yellow, bloodless complexion. Chronic diarrhea that stops and resumes indicates accumulation rotting the Spleen. How do we know the Spleen is rotten? The patient passes white stool due to undigested food; after stopping, they pass dark red-black stool and die, indicating incurable Spleen rot.
"Baojian" discusses five pediatric accumulations caused by stagnant Zang Qi accumulating in one place. Heart accumulation is called Fuliang, located above the umbilicus, attacking upward to the Heart and downward to the stomach opening. Spleen accumulation is called Piqi, located horizontally above the stomach opening. Liver accumulation is called Feiqi, located to the left of the umbilicus. Lung accumulation is called Xiben, located to the right of the umbilicus. Kidney accumulation is called Benteng, located below the umbilicus. Each has variations; these are not formed by food but by Qi accumulation. Zang organs are Yin, so they remain stationary in one place. Ju refers to the retention of Qi in the Six Fu organs. Fu organs are Yang; Yang Qi moves constantly, so Ju does not stay in one place and presents with abdominal pain upon onset. Signs of accumulation include sallow thin complexion, lack of muscle growth, erect hair or swollen body, abdominal tightness, fatigue, often due to Water Qi.
"Zhenzhu Nang" describes deficiency-with-accumulation. Startle-induced deficiency accumulation arises from fright and is reactivated by further fright, passing green foul stool. Deficiency-with-accumulation from food injury involves diarrhea and vomiting, leading to gradual weakness without recovery. Another type involves frequent purging that fails to remove the accumulation, leaving it latent. If startle accumulation is purged, stool turns green with fright. Food accumulation forms clumps in stool. Deficiency-with-accumulation in Gan disease arises from chronic diarrhea where deficiency persists despite Gan disease, passing white material in stool.
[Zeng] Pediatric accumulation results from irregular feeding, overconsumption of cold/raw/hard foods, failing digestion, stagnation in the Middle Jiao, and external Wind-Cold attack or uncovered sleeping at night. Symptoms include headache, sallow face, fever, slightly swollen eyelids, abdominal pain/distension, cold feet/hot belly, lethargy/confusion, anorexia, vomiting/hiccups, sour belching, and foul stool, indicating old accumulation. If detected early, use Baishang Yin to release the exterior, then Danggui San with ginger to warm and move stagnation, followed by Wuxi Wan and Liusheng Wan for strong purgation, and finally Yunqi San to regulate and tonify. [Tang] Accumulation must be differentiated as excess or deficiency, considering individual constitution differences. Excess cases may use Jinshi Wan. Deficient, slightly emaciated cases should use Fei'er Wan. [Xue] In early stages before Yuan Qi damage, with abdominal distension/pain and urinary/fecal difficulty, use Baibing Zi or Muxiang Binglang Wan to purge. Post-purge, harmonize with Baizhu San or Wuwei Yigong San; add Gegen for thirst, Banxia for vomiting. If heat persists post-purge with vomiting/diarrhea/anorexia, Spleen and Stomach are injured; use Liujunzi Tang. Cold extremities preferring hot drinks indicate Spleen-Stomach deficiency-cold; add Paojiang and Muxiang to the previous formula. Sallow-white face with dull eyes indicates Spleen-Lung deficiency; use Sijunzi Tang plus Chaihu and Shengma. Abdominal pain with prolapse or urinary difficulty uses Sini San. Afternoon fever or persistent diarrhea indicates Spleen Qi sinking; tidal fever/thirst with irregular stool suggests impending Gan syndrome; both use Buzhong Yiqi Tang assisted by Fei'er Wan. As stated: "Where evil gathers, Qi is deficient; remaining unchecked, the disease becomes excess." Regulation of the Spleen is primary, with digestion assistance secondary. "Nourish the Righteous, and Accumulation removes itself."
"Qianjin Fang" Zishuang Wan treats pediatric fever/headache, indigestion, abdominal distension, lower abdominal colic, urinary/fecal difficulty, or frequent defecation without other diseases, caused by overeating or irregular nursing/startle/fever. It is effective for steaming patterns, reduced appetite, restless breathing, night crying, and internal imbalance. Use only this pill.
Ricinus Communis Seed (Shelled) Prunus Persica Kernel (Shelled, each 18 zhu) Glycyrrhiza uralensis Root (Roasted, 5 zhu) Ostrea Shell (Calcined red) Beeswax (each 8 zhu) Kansui Root Cinnabar (each 2 zhu) Ophiopogon japonicus Tuber (Dehearted, 10 zhu)
Boil Ricinus seed, grind, squeeze oil out with new cloth. Grind Glycyrrhiza, Kansui, Ostrea, Ophiopogon separately, sieve. Grind Prunus kernel finely, mix with powder, pound 2000 times. Add honey if too dry. Half-year-old: size of sesame pair. 1-2 years: half sesame pair. 3-4 years: two sesame-sized pills. 5-6 years: two sesame-sized pills. 7-8 years: two mung bean-sized pills. 9-10 years: slightly larger than mung bean pair. Take at dawn. If not passed by sunrise, drink porridge to induce. Pills pass in pairs. If severe purging, drink cold porridge to stop.
[Mao Xiansheng] Qingjin Dan treats all pediatric accumulations.
Talcum Powder White Dinosaur Egg Powder (Sieved) Pinellia ternata Rhizome (each 2 qianbi) Indigo Naturalis (Sieved, level spoon 2 qian) Calomel (2 qian) Mercury (2 qian, melted Tin in copper pot, mix with Mercury, pour on ground, cool) Sichuan Ricinus Seed (Shelled/decored, 72 seeds, soaked overnight in well water, dried in wind, ground)
Mix with soft rice paste into small mung bean-sized pills. Ricinus must not exude oil. Administer based on syndrome. Post-typhoid accumulation: scallion decoction. Gan worm removal: beef juice. Startle wind with tight abdomen/blue-black face: silver-mint-scallion decoction. Injury with mild belly heat/bloating/night fever/sallow-blue face/yellow eyes: roast 14 Gleditsia sinensis pods in ash, decoct in 1 cup water to 0.5 cup. Diarrhea from accumulation: fish soup. Qi accumulation: roasted fennel soup. Dosage: 1 year=14 pills, 3 years=18, 7 years=24. Adjust by size. Take at 3-5 AM, pass by dawn. Tonify after accumulation clears. May vomit saliva initially, which is acceptable.
Wanling Wan treats all pediatric accumulations based on syndrome.
Costus Root Coptis chinensis Rhizome Curcuma phaeocaulis Rhizome (each 0.5 fen) Tangerine Peel Green Tangerine Peel (each de-seeded, 1 fen) Areca Seed (one weighing 1.5 qian)
Powder. 1 qian herb per dose. Boil 1 Ricinus seed in vinegar until purple. Burn 1 Almond kernel (de-skinned/de-coreced) to retain char. Grind both, mix with vinegar-flour paste into mung bean-sized pills. Dose: 5-10 pills with mint-ginger tea.
[Qian Yi] Xiaoji Pill
Clove Cardamom Fruit Dried Plum Flesh Ricinus Seed (2 seeds, shelled/oiled/decored)
Fine powder, flour paste, millet-sized pills. >3 years: 3-5 pills; <3 years: 2-3 pills. Warm water, anytime.
Zishuang Wan resolves accumulation.
Ricinus Seed (Oiled/decored) Almond Kernel (De-skinned/de-coreced, each 21) Hematite (1 qian, fine powder/water-floated)
Fine powder, rice paste, millet-sized pills. Dose: 3-10 pills. Decoction of Gleditsia sinensis kernel, anytime. Reduce for infants.
Zhenzhu Pill treats pediatric deficiency-with-accumulation, all accumulations, startle-phlegm, retained food/milk, urinary/fecal obstruction, abdominal distension, moving stagnant Qi.
Costus Root White Dinosaur Egg Powder Clove Powder Calomel (each 0.5 qian, reserve some for coating) White Talcum Powder Ricinus Seed (14 seeds, soaked overnight, ground smooth)
Powder, mix, wrap in wet paper, cook with millet rice into hemp seed-sized pills. 1 year: 1 pill. 8-15 years: 8 pills. Cool decoction of roasted Gleditsia pod. For wind-heat difficult to move, take cooling medicine first. For milk lump, reduce dose, every other day at bedtime.
Xiaojian Pill resolves milk lumps, lowers breast milk, treats phlegm-heat chest fullness, removes accumulation.
Borax Ricinus Frost Calomel (each 1 qian) Yellow Beef Hide Gel Fine Ink Mercury Sand (size of 2 Gleditsia pods)
Fine powder, little flour paste, hemp seed-sized pills. Reverse flowing water. 1 year: 1 pill post-meal.
Baibing Zi treats pediatric abdominal masses, anorexia, only drinking milk.
Talcum Powder Calomel Pinellia ternata Rhizome (Washed/dried) Pinellia ternata Rhizome (each 1 qian, powder) Ricinus Seed (24 seeds, shelled, boiled in 1升 water until dry)
Grind together, add Ricinus last. Rice paste, mung bean-sized, shaped as cakes. >3 years: 3-5 cakes; <3 years: 1-2 cakes. Scallion white decoction, bedtime.
[Zhang Huan] Wanling Dan treats long-term Spleen-Stomach disharmony with accumulation unresponsive to warm herbs.
Cinnamon Bark Coptis chinensis Rhizome Curcuma phaeocaulis Rhizome (each 1 liang) Myristica fragrans Seed Areca Seed Tangerine Peel (De-albedo, dried) Costus Root Clove (each 0.5 liang. Powder these first.) Ricinus Seed Almond Kernel (Bran-roasted, de-skinned/de-coreced. Charred on lamp, retain nature. Each 27)
Pound/mix, drop-water pills, millet-sized. <1 year: 1 pill. 2-3 years: 2 pills. 3-4 years: 3 pills. 5-7 years: 5 pills. >10 years: 7 pills. Cool ginger tea, post-nursing/feeding. Long-term accumulation/milk lumps: regular use.
Jianhong Pill grinds masses, kills worms, promotes appetite, highly effective. Safe for all except pregnant women.
Dry Lacquer (Charred smoke-free) Genkwa Flower (Vinegar-mixed, fried. Each 1 qian) Ricinus Seed (7 seeds, shelled/decored, keep oil) Mylabris (7 insects, head/legs/wings removed, fried, stuff nostrils during grinding)
Vinegar-flour paste, wu-tong seed-sized. Wrap in red sand, tie with red thread. Cut to dose. Take with following herbs:
Southern Costus Root Polyporus Umbellatus Rhizoma Samare Trichosanthes Radix Curcuma longa Rhizome Stemona Root Fritillaria Thunbergii Bulb Areca Seed Rhubarb Root and Rhizome (Raw. Each 1 liang) Quisqualis Indica Fruit (49 nuts, half raw/half fried) Morning Glory Seed (Raw 0.5 jin, take top powder 3.5 liang)
Powder. Crush 10 soap pods. Add Artemisia capillaris (1 liang), Toosendan Root Bark (2 liang). Decoct in 4-5 bowls water to 1 bowl. Mix powder into pills, wu-tong sized, sun-dry. Infant: millet sized. Dose: 2.5 qian. Modify vehicle by syndrome. Take at 3-5 AM. Avoid meat/spicy/greasy. Different from other formulas. Asthma/cough: Morus alba Leaf decoction. Tapeworm: Pomegranate root decoction. Podagra/swelling: Chaenomelis Fructus decoction or honey water. Roundworms: Rock sugar water. All syndromes: Honey/Rock sugar water. Wine dysentery/accumulation: Pentapetala oxyphylla decoction. Amenorrhea: Light vinegar Safflower decoction. Blood蛊: Scallion white decoction. Intestinal wind bleeding: Gardenia decoction. Constipation: Light vinegar water. Food/Qi mass: Warm honey/tea water.
Zhenfang Wuse Wanzi treats all pediatric injuries, phlegm-fluid congestion, chest discomfort, indigestion, mass formation, rib hardness/pain, acute/chronic startle wind convulsions, phlegm congestion.
Green Pill: Indigo Naturalis (Separate grind) Pinellia ternata Rhizome (Ginger-processed. Each 0.5 liang) Ricinus Frost (0.5 qian)
Red Pill: Cinnabar (Water-floated) Pinellia ternata Rhizome (Ginger-processed. Each 0.5 liang) Ricinus Frost (0.5 qian)
Yellow Pill: Rhubarb Root and Rhizome (Roasted) Turmeric Tuber (Each 0.5 liang) Ricinus Frost (0.5 qian)
White Pill: Aconitum carmichaelii Lateral Root (Raw) Halloysitum Rubrum (Calcined. Each 0.5 liang) Ricinus Frost (0.5 qian)
Black Pill: Trogopterus Dung (Fried) Scorpio (Fried. Each 0.5 liang) Ricinus Frost (0.5 qian)
Grind each color separately, mix with Ricinus frost, flour paste, millet-sized. 1 year: 5 pills, milk. Adjust by size. Or ginger tea. Acute startle: Silver-mint tea. Chronic startle: Ginger-Scorpio tea.
Xiaji Pill treats food injury accumulation, heart/abdominal fullness, thick hot Qi, diarrhea/vomiting.
Clove Cardamom Fruit Quisqualis Indica Fruit Dried Plum Ricinus Meat (Keep oil. Each 3)
Powder, mashed rice paste, hemp seed-sized. Dose: 3 pills, Tangerine peel tea.
Wuzhen Pill treats wine/food accumulation, general use.
Green Tangerine Peel Dried Ginger (Burned, retain nature) Curcuma Phosphor Five-Ling Zhi (Each 1 liang) Ricinus Meat (Remove half oil, 1 qian)
Fine powder, glutinous rice paste, hemp seed-sized. Dose: 3-5 pills, rice water.
"Ju Fang" Jinshi Wan treats milk/food indigestion, chest/heart fullness, Gan accumulation abdominal pain.
Costus Root (Fried) Aurantium aurantioides Fruit (De-albedo, fried) Angelica Sinensis Root Hematite (Each 5 qian) Cinnabar (Separate grind, 3 qian) Ricinus Seed (De-oil/de-membrane, 1 qian) Moschus (Separate grind, 0.5 fen)
Fine powder, flour paste, millet-sized. 1 year: 2 pills. Adjust by size. Rice drink.
Liusheng Wan (Zeng Shi) harmonizes Stomach for all accumulations, regulates Qi, thickens intestines, resolves Gan, opens diaphragm.
Curcuma phaeocaulis Rhizome (Fried, cut) Purified Coptis chinensis Rhizome Tangerine Peel (De-albedo) White Ginger (Fried. Each 5 qian) Southern Costus Root (2.5 qian)
Exclude Costus from fire. Chop/dry others, powder with Costus. Per 1 qian powder, add 3 Ricinus seeds (shell/membrane removed, keep oil, crushed, ground in mortar), mix with powder, vinegar-boiled flour paste, hemp seed-sized. Dose: 15-35 pills. 3-5 AM empty stomach, light ginger tea. Purge 3-5 times, stop with Yunqi San (see Gan). Regular use aids Spleen, transforms accumulation, promotes appetite, resolves Gan. Bedtime: 3-5 pills clean water/wine. Limit: 3 qian powder max, 9 pure Ricinus seeds max. Do not make large batches; flavor dissipates over time.