食积痛，面黄腹胀，夜热日凉，宜小黑丸，甚则备急丸。饮食乍伤脾而痛，大便去而痛
止，亦宜用小黑丸、备急丸下之。食得寒则凝，得热则散，更宜行气。有虫宜追虫散，又有痰
痛，痰因气聚而滞，阻碍道路，气不通脉，小便不利，先宜小红丸，后服枳实、朴硝、石碱、半
夏导痰开郁。若痛有常处而不移，是死血，宜归尾、桃仁、蓬术、枳实、青皮、砂仁、红花。腹
鸣作痛，是水欲下而火欲上，宜二陈汤加黄连、山栀。脏寒有水而鸣，宜分三阴部分∶中脘
太阴，脐腹少阴，小腹厥阴。儿只是伤食，食积与虫宜消食止痛，开郁行气，先用小黑丸，备
急尤妙，后用本方。
消食止痛本方
浓朴 苍术 制半夏 香附 枳实 青皮 陈皮 槟榔 砂仁 山楂 甘草 茯苓
痛甚加木香，食积加蓬术、三棱，伤食轻则本方去槟榔，虫加川楝、鹤虱，痰去浓朴、苍
术，加见论中。死血用论中药，可加大黄；水下火上，本方去苍术、槟榔，加论中药；脏寒本方
倍青皮、枳实，加木香、丁香或浓朴、干姜；热痛不宜本方；血虚腹痛白芍药汤治。
脏腑强盛，诸虫不为害，惟虚怯则湿热生虫，虫行求食作痛。上唇有疮，曰惑虫蚀其脏；
下唇有疮，曰狐虫下食其肛。胃热则虫动，动则往来上下，心腹痛，面 白，叫哭仰体扑手，
心神闷乱，吐涎沫或清水，沉沉默默。贯心者，心痛甚死；不贯心亦死。上半月虫头向上，可
投药易治；下半月虫头向下，难治。若病急，先以肥肉汁或糖蜜引转其头，然后用追虫末药。
面黄上有白团印是虫症，好吃布是肺虫，吃桴炭是肝虫，吃盐是肾虫，吃茶叶是心虫，吃酸
物是胆虫，吃土是脾虫，各随本脏施治。脉当沉，若弦，今反洪大是虫；虚小者生，紧急者
死；寸脉沉滑是寸白虫。
陈皮 半夏 枳实 青皮 槟榔 蓬术 鹤虱 芜荑 雷丸 使君子 川楝根（以上虫药可选用）
食积引起的腹痛，表现为面色发黄、腹部胀满，夜间发热而白天凉爽，适宜使用小黑丸，病情严重时使用备急丸。饮食突然损伤脾胃导致疼痛，大便排出后疼痛停止，也适宜用小黑丸或备急丸攻下。食物遇寒则凝结，遇热则消散，更宜配合行气药物。有寄生虫者适宜用追虫散；另有痰饮引起的疼痛，痰因气机郁结而停滞，阻碍经络通道，导致气脉不通、小便不利，先适宜用小红丸，随后服用枳实、朴硝、石碱、半夏以导痰开郁。如果疼痛部位固定不移，这是瘀血所致，适宜用当归尾、桃仁、蓬术、枳实、青皮、砂仁、红花。腹部鸣响并伴有疼痛，是水湿欲下行而火气欲上行所致，适宜用二陈汤加黄连、山栀。脏腑虚寒有水饮内停而肠鸣，应分为三阴经部分辨治：中脘属太阴，脐腹属少阴，小腹属厥阴。小儿只是伤食，食积与虫积宜消食止痛，开郁行气，先用小黑丸，备急丸尤为妙选，之后用本方（消食止痛本方）。
消食止痛本方组成：浓朴、苍术、制半夏、香附、枳实、青皮、陈皮、槟榔、砂仁、山楂、甘草、茯苓。疼痛剧烈加木香；食积重加蓬术、三棱；伤食轻症则本方去槟榔；有虫加川楝、鹤虱；有痰去浓朴、苍术，加前文论述中的药物；瘀血用前述论断中的药物，可加大黄；水在下火在上，本方去苍术、槟榔，加前述论断中的药物；脏寒本方倍量青皮、枳实，加木香、丁香或浓朴、干姜；热痛不宜用本方；血虚腹痛用白芍药汤治疗。
脏腑强盛时，各种寄生虫不会为害，只有身体虚弱怯懦时才生湿热而生虫，虫体蠕动求食引起疼痛。上唇有疮，称为惑虫侵蚀内脏；下唇有疮，称为狐虫向下啃食肛门。胃热则虫动，虫动则上下窜动，引起心腹痛，面色苍白，叫哭仰卧，扑打手脚，心神烦闷混乱，吐涎沫或清水，神情沉默。虫贯入心脏的，心痛剧烈致死；不贯入心脏的也会死。上半月虫头向上，投药容易治愈；下半月虫头向下，难治。若病情紧急，先用肥肉汁或糖蜜引导虫头转向，然后服用追虫散末药。面色黄且上有白色团块印记是虫症，爱吃布的是肺虫，吃炭灰的是肝虫，吃盐的是肾虫，吃茶叶的是心虫，吃酸物的是胆虫，吃土的是脾虫，各随所属的本脏进行治疗。脉象应当沉，若见弦脉，反而洪大则是虫证；脉虚小者生，脉紧急者死；寸脉沉滑是寸白虫（绦虫）。
Pain caused by food stagnation presents with a sallow complexion and abdominal distension, fever at night but coolness during the day. *Xiaohei Wan* (Little Black Pill) is indicated; for severe cases, *Beiji Wan* (Emergency Rescue Pill) is used. If sudden dietary injury to the Spleen and Stomach causes pain that ceases after defecation, *Xiaohei Wan* or *Beiji Wan* should be used to purge. Food coagulates when cold and disperses when hot; thus, Qi-moving methods are particularly suitable. For parasitic infestation, *Zhui Chong San* (Worm-Expelling Powder) is indicated. For pain caused by Phlegm, where Phlegm stagnates due to Qi constraint, obstructing the pathways and causing blocked Qi pulses and difficult urination, first use *Xiaohong Wan* (Little Red Pill), followed by *Zhishi* (Immature Bitter Orange), *Puxiao* (Mirabilite), *Shijian* (Soda Ash), and *Banxia* (Pinellia Tuber) to guide out Phlegm and relieve depression. If pain is fixed in one place and does not move, it is caused by dead blood (stasis); use *Guiwei* (Angelica Sinensis Tail), *Taoren* (Peach Kernel), *Pengzhu* (Curcuma Zedoaria Rhizome), *Zhishi* (Immature Bitter Orange), *Qingpi* (Aurantium Peel), *Sharen* (Amomum Fruit), and *Honghua* (Safflower). Abdominal borborygmus with pain indicates water attempting to descend while fire attempts to ascend; use *Erchen Tang* (Two-Cured Decoction) added with *Huanglian* (Coptis Rhizome) and *Shanzhi* (Gardenia Fruit). Visceral cold with water retention causing borborygmus should be differentiated by the Three Yin meridians: Zhongwan belongs to Taiyin, the umbilical region to Shaoyin, and the lower abdomen to Jueyin. In children, if it is merely food injury, food stagnation and parasites require digestion-promoting and pain-relieving methods, along with opening depression and moving Qi. First use *Xiaohei Wan*; *Beiji Wan* is especially excellent, followed by this formula (Digestion-Promoting and Pain-Relieving Formula).
**Digestion-Promoting and Pain-Relieving Formula:**
Noumu (Magnolia Bark), Cangzhu (Atractylodes Rhizome), Zhibanxia (Prepared Pinellia Tuber), Xiangfu (Cyperi Rhizome), Zhishi (Immature Bitter Orange), Qingpi (Aurantium Peel), Chenpi (Tangerine Peel), Binglang (Areca Seed), Sharen (Amomum Fruit), Shanzha (Hawthorn Fruit), Gancao (Licorice Root), Fuling (Poria).
For severe pain, add Muxiang (Costus Root); for heavy food stagnation, add Pengzhu (Curcuma Zedoaria Rhizome) and Sanleng (Sparganium Rhizome); for mild food injury, remove Binglang from this formula; for parasites, add Chuanliannzi (Toosendan Fruit) and Hese (Chrysanthemum Seed); for phlegm, remove Noumu and Cangzhu, adding herbs discussed in the preceding section. For stasis, use herbs from the previous discussion, optionally adding Dahuang (Rhubarb Rhizome); for water below and fire above, remove Cangzhu and Binglang, adding herbs from the previous discussion; for visceral cold, double Qingpi and Zhishi, adding Muxiang (Costus Root), Dingxiang (Clove) or Noumu (Magnolia Bark), Ganjiang (Dried Ginger); this formula is not suitable for heat pain; for blood-deficiency abdominal pain, Baishao Yao Tang (White Peony Decoction) is used.
When the Zang-Fu organs are strong, various parasites do not cause harm; only when the body is weak and deficient does damp-heat generate worms. Worms move seeking food, causing pain. Sores on the upper lip indicate Huo worms (roundworms) eroding the viscera; sores on the lower lip indicate Hu worms (pinworms) eating the anus. Stomach heat causes worms to move; movement causes them to crawl up and down, resulting in heart and abdominal pain, pale face, crying and screaming, lying supine, flailing hands and feet, mental restlessness and confusion, spitting saliva or clear fluid, and silence. If worms penetrate the Heart, severe heart pain leads to death; even without penetrating the Heart, death may occur. In the first half of the lunar month, worm heads point upward, making treatment easier; in the second half, worm heads point downward, making treatment difficult. If the condition is urgent, first use fatty meat juice or honey to guide the worm head to turn, then administer *Zhui Chong* powder. A sallow face with white circular marks indicates a parasitic syndrome. Craving cloth indicates Lung worms; craving charcoal ash indicates Liver worms; craving salt indicates Kidney worms; craving tea leaves indicates Heart worms; craving sour substances indicates Gallbladder worms; craving soil indicates Spleen worms. Treat each according to its corresponding Zang organ. The pulse should be deep; if wiry, or surprisingly surging and large, it indicates parasites. A deficiency-small pulse suggests survival; an urgent-tight pulse suggests death. A deep-slippery pulse at the Cun position indicates Ascaris lumbricoides (tapeworm/roundworm).
Chenpi (Tangerine Peel), Banxia (Pinellia Tuber), Zhishi (Immature Bitter Orange), Qingpi (Aurantium Peel), Binglang (Areca Seed), Pengzhu (Curcuma Zedoaria Rhizome), Hese (Chrysanthemum Seed), Wuyi (Euodia Fruit), Leiwu (Polyporus Umbrellatus), Shijunzi (Quince Seed), Chuanliangen (Melia Radix) (The above anti-parasitic herbs are optional).