幼科古主谓之哑科,以其不能言,而不知病之所在也。此特其一端耳。幼科之病,如变
蒸胎
惊之类,与成人异者,不可胜举。非若妇人之与男子异者,只经产数端耳。古人所以另立专
科,其说精详明备。自初生以至成童,其病名不帝以百计。其治法立方,种种各别。又妇人
之与男子病相同者,治亦相同。若小儿与之成人,即病相同者,治亦迥异。如伤食之症,反
有用巴豆、硼砂。其余诸症,多用金石峻厉之药,特分两极少耳。此古人真传也!后世不敢
用,而以草木和平之药治之,往往迁延而死。此医者失传之故。至于调摄之法,病家能知之
者,千不得一。盖小儿纯阳之体,最宜清凉,今人非太暖,即太饱。而其尤害者,则在于有
病之后,而数与之乳。乳之为物,得热则坚韧如棉絮。况儿有病则食乳甚稀,乳久不食,则
愈弃满,一与之吮,则迅疾涌出,较平日之下咽更多。前乳未消,新乳复充,填积胃口,化
为顽痰,痰火相结,诸脉皆闭而死矣。譬如常人平日食饭几何,当病危之时,其食与平时不
减,安有不死者哉?然嘱病家云∶乳不可食。则群相诟曰∶乳犹水也,食之何害?况儿虚如此
,全赖乳养,若复禁乳,则饿死矣。不但不肯信,反将医者诟骂。其余之不当食而食,与当
食而反不与之食,种种失宜,不可枚举。医者岂能坐守之,使事事合节耶?况明理之医,能
知调养之法者,亦百不得一。故小儿之所以难治者,非尽不能言之故也。
Pediatrics was historically referred to as the "Mute Department" (Ya Ke), because infants cannot speak and thus cannot indicate the location of their illness. This is merely one aspect of it. The diseases in pediatrics, such as Bian Zheng (physiological fever in infants) and Tai Jing (fetal fright), differ from those in adults in countless ways. Unlike the differences between women and men, which are limited to menstruation, leukorrhea, pregnancy, and childbirth, the distinctions here are manifold. The ancients established a separate specialty for this reason, with theories that were precise, detailed, clear, and comprehensive. From birth to childhood, disease names numbered in the hundreds. Their treatment methods and prescriptions varied greatly. Furthermore, while women and men share similar treatments when suffering from the same disease, children and adults receive vastly different treatments even if they present with identical symptoms. For instance, in cases of food stagnation (Shang Shi), drugs such as Crotonis Fructus (Badou, 巴豆) and Borax (Pengsha, 硼砂) were sometimes used. For other conditions, heavy and harsh minerals and metals were frequently employed, though in very small dosages. This represents the authentic transmission of the ancients! Later generations dared not use these, opting instead for mild herbal medicines, often resulting in prolonged illness and death. This is due to the loss of medical knowledge. Regarding nursing care, fewer than one in a thousand parents know how to properly manage it. Since children possess a "Pure Yang" constitution (Chun Yang Zhi Ti), they require cool and refreshing care. However, modern caregivers either over-warm or over-feed them. The most harmful practice occurs after illness begins, where milk is administered frequently. Milk, when heated, becomes tough like cotton wadding. Moreover, when a child is ill, milk intake is scant; if left unemptied for long, the breasts become engorged. Upon suckling, the milk flows out rapidly and in greater volume than usual. Before the previous meal has digested, new milk fills the stomach, causing accumulation at the epigastrium, transforming into stubborn phlegm. Phlegm and fire bind together, closing all meridians, leading to death. It is akin to an adult who continues to eat normal amounts during critical illness; survival is impossible. Yet, when physicians instruct parents: "Do not give milk," the crowd curses, saying, "Milk is like water; what harm is there? Besides, the child is so weak and relies entirely on milk for nourishment; if we forbid it, the child will starve." They not only refuse to believe but also insult the physician. Other improper feeding practices—feeding when one should not, or withholding food when one should—are too numerous to list. Can a physician sit by and ensure every detail is managed correctly? Even enlightened physicians who understand nursing principles are rare, less than one in a hundred. Therefore, the difficulty in treating children is not solely due to their inability to speak.