治小儿变蒸发热不解。并挟伤寒、温壮汗后热不歇,及腹中有痰 ,哺乳不进,乳则吐
食痫先寒热方∶
代赭石 赤石脂(各一两) 巴豆(三十枚,去心皮,熬) 杏仁(五十枚,去皮尖,
熬)
上四味,末之,巴豆、杏仁别捣为膏,和更捣二千杵,当自相得。若硬入少蜜同捣,密
器中收之三十日。儿服如麻子一丸,与少乳汁令下。食顷后与少乳,勿令多。至日中,当小
下热除。若未全除。明旦更与一丸。百日儿服如小豆一丸。以此准量增减。夏月多热,喜令
发疹。二三十日辄一服佳。此丸无所不治,难下,不虚人。
治小儿变蒸中挟时行温病,或非变蒸时而得时行方∶
麻黄(去节) 桔仁(去皮尖,熬,各半两) 大黄(一分)
上三味,捣为散。一月儿服小豆大一枚。以乳汁和服,抱令得汗。汗出,温粉粉之,勿
使
相儿命长短法∶
儿生枕骨不成者,能言而死。
膝骨不成者,能倨而死。
掌骨不成者,能扶伏而死。
踵骨不成者,能行而死。
膑骨不成者,能立而死。
生身不收者死。
鱼口者死。
股间无生肉者死。
颐下破者死。
阴不起者死。
囊下白者死,赤者死。
相法甚博,略述十数条而已。
儿初生额上有旋毛者,早贵,妨父母。
儿初生阴大而与身色同者,成人。
儿初生叫声连延相属者,寿;声绝而复扬急者,不寿。
儿初生汗血者,多厄不寿。
儿初生目视不正,数动者,大非佳人。
儿初生自开目者,不成人。
儿初生通身软弱,如无骨者,不成人。
儿初生发稀少者,强不听人。
儿初生脐小者,不寿。
儿初生早坐、早行、早语、早齿生,皆恶性,非佳人。
儿初生头四破者,不成人。
儿初生砂毛不周匝者,不成人。
啼声散,不成人。
啼声深,不成人。
汗不流,不成人。
小便凝如脂膏,不成人。
常摇手足者,不成人。
无此状候者,皆成人也。
儿初生脐中无血者,好。
卵下缝通达而黑者,寿。
鲜白长大者,寿。
论曰∶儿三岁以上、十岁以下,观其性气高下,即可知其夭寿大略。儿小时识悟通敏过
人者多夭,则项托颜回之流是也。小儿骨法成就,威仪回转迟舒,稍费人精神雕琢者寿。其
预知人意回旋敏速者亦夭,则杨修、孔融之流是也。由此观之,夭寿大略可知也。亦由梅花
早发,不睹岁寒;甘菊晚荣,终于年事。是知晚成者,寿之兆也。
凡小儿之痫有三种∶有风痫,有惊痫,有食痫。然风痫,惊痫时时有尔。十人之中未
有一二是食痫者。凡是先寒后热发痫者,皆是食痫也。惊痫当按图灸之,风痫当与豚心汤下
之,食痫当下乃愈。紫丸佳。
凡小儿所以得风者,缘衣暖汗出,风因而入也。风痫者,初得之时,先屈指如数乃发作
。此风痫也。惊痫者,起于惊怖,先啼乃发作,此惊痫也。惊痫微者急持之,勿复更惊之,
或自止也。其先不哺乳吐,而变热后发痫,此食痫也。早下之则瘥。四味紫丸逐 饮最良。
去病速而不虚人,赤丸瘥快。病重者当用之。小儿衣甚寒薄,则腹中乳食不消,其大便皆酢
臭。此欲为癖之渐也。便将紫丸以微消之。服法先从少起,常令大便稀,勿使大下也。稀后
便渐减之。矢不酢臭乃止药。惊痫但灸及摩生膏,不可下也。惊痫心气不定,下之内虚,益
令甚尔。惊痫甚者,特为难治。故养小儿常当慎惊,勿令闻大声。抱持之间,当安徐勿令怖
也。又天雷时,须塞其耳。但作余小声以乱之也。
凡小儿微惊者,以长血脉。但不欲大惊。大惊乃灸惊脉。
小儿有热,不欲哺乳。卧不安,又数惊,此痫之初也。服紫丸便愈。不瘥,更服之。儿
立夏后有病,治之慎勿妄灸。不欲吐下,但以除热汤浴之,除热散粉之,除热赤膏摩之。又
脐中以膏涂之,令儿在凉处,勿禁水浆,常以新水饮之,儿眠时小惊者。一月辄一以紫丸下
之,减其盛气,令儿不病痫也。
小儿气盛有病,但下之,必无所损。若不时下,则将成病。痼难治矣。
凡下,四味紫丸最善。难下不损人,足以去疾尔。若四味紫丸不时下者,当以赤丸下之
。赤丸不下,当更倍之。若已下而余热不尽,当按方作龙胆汤稍稍服之,并摩赤膏。
凡小儿冬月下无所畏,夏月下难瘥。然有病者不可不下,下后腹中当小胀满,故当节哺
乳数日,不可妄下。又乳哺小儿,常令多少有常剂。儿渐大,当稍稍增之。若减少者,此腹
中已有小不调也,便微服药停哺,但与乳。甚者十许日,微者五六日止哺。自当如常。若不
肯哺而欲乳者,此是有癖,为疾重要,当下之。无不瘥者,不下则致寒热,或反吐而发痫,
或更致下痢。此皆病重,不早下之所为也,为难治。但先治其轻时,儿不耗损而病速愈。
凡小儿屎黄而臭者,此腹中有伏热。宜微将服龙胆汤。若白而酢者,此挟寒不消也,当
服紫丸。微者少与药令内消,甚者小增。令小下。皆须节乳哺数日,令胃气平和。若不节乳
哺,则病易复。复下之,则伤其胃气,令腹胀满。再三下之尚可,过此伤矣。
凡小儿有癖,其脉大必发痫。此为食痫,下之便愈。当候掌中与三指脉,不可令起而不
时下。致于发痫,则难治也。若早下之,此脉终不起也;脉在掌中尚可早治,若至指则病增
也。
凡小儿腹中有疾生则身寒热,寒热则血脉动,血脉动则心不定,心不定则易惊,惊则痫
发速也。
龙胆汤治小儿出腹血脉盛实。寒热温壮四肢惊掣。发热大吐 者,若已能进哺中食实不
消。壮热及变蒸不解。中客人鬼气并诸惊痫方悉主之。十岁以下小儿皆服之。小儿龙胆汤第
一,此是出腹婴儿方。若日月长大者。以次依此为例。若必知客忤及魅气者。可加人参当归,
各
龙胆 钩藤 柴胡(去苗) 黄芩 桔梗 芍药 茯神 甘草(炙,各一分) 蜣螂(二
枚,
炙) 大黄(一两)
上一十味, 咀,以水二升煮取五合为一剂也。取之如后节度。药有虚实,虚药宜足数
合水也。儿生一日至七日分一合,为三服。儿生八日至十五日分一合半,为三服。儿生十六
日至二十日分二合,为三服。儿生二十日至三十日分三合,为三服。儿生三十日至四十日尽,
以五
治少小心腹热,除热丹参赤膏方∶
凡参 雷丸 芒硝 戎盐 大黄(各三两)
上五味,切,以苦酒半升浸四种一宿以成。炼猪脂一斤,煎三上三下,去滓,纳芒硝。
膏成,以摩心下。冬夏可用一方,但丹参雷丸。
治少小新生肌肤幼弱,喜为风邪所中,身体壮热,或中大风,手足惊掣,五物甘草生摩
膏方∶
甘草(炙) 防风(各一两 二十铢) 雷丸(二两半) 桔梗(二十铢)
上五味,切,以不中水猪肪一斤微火煎为膏,去滓,取弹丸大一枚,炙手以摩儿百过。
寒者更热,热者更寒。小儿无病早起,常以膏摩囟上及手足心,甚辟风寒。
Treats infantile fever due to Bianzheng (a physiological developmental process in infants) that does not resolve. Also treats cases complicated by Shanghan (Cold Damage) or Wenbing (Warm Disease) with high fever, where heat persists after sweating, accompanied by phlegm-fluid retention in the abdomen, difficulty in nursing, and vomiting upon feeding, specifically for Shixian (Food-induced Epilepsy) presenting with initial chills followed by fever:
Hematitum (Dai Zhe Shi), Red Kaolin (Chi Shi Zhi) (each 1 liang); Crotonis Fructus (Ba Dou) (30 seeds, remove heart and skin, stir-fry); Armeniacae Semen Amarum (Xing Ren) (50 seeds, remove skin and tip, stir-fry).
The above four herbs are ground into fine powder. The Ba Dou and Xing Ren are separately pounded into a paste, then mixed together and pounded two thousand times until they fully integrate. If the mixture is too hard, add a small amount of honey and pound together. Store in a sealed container for thirty days. For infants, administer one pill the size of a hemp seed, washed down with a small amount of breast milk. After a short while, give a little more milk, but do not overfeed. By noon, there should be mild diarrhea, and the heat will be eliminated. If the heat is not completely resolved, administer another pill the next morning. For infants under one hundred days old, administer a pill the size of a mung bean. Adjust dosage accordingly. In summer, when heat is prevalent and rashes are prone to occur, it is advisable to administer this once every twenty to thirty days. This pill is effective for various conditions; it is potent and difficult to swallow but does not damage healthy Qi.
Treats infantile Bianzheng complicated by epidemic warm diseases, or epidemic diseases contracted outside of the Bianzheng period:
Ephedrae Herba (Ma Huang) (remove joints); Platycodonis Radix (Jie Geng) (remove skin and tip, stir-fry, each 0.5 liang); Rhei Radix et Rhizoma (Da Huang) (1 fen).
The above three herbs are crushed and ground into a powder. For one-month-old infants, administer a dose the size of a mung bean. Mix with breast milk for administration. Hold the infant tightly to induce sweating. After sweating occurs, apply warm powder to the body to prevent wind invasion.
Methods for assessing an infant's lifespan:
If the occipital bone is undeveloped at birth, death will occur when the child learns to speak.
If the knee bones are undeveloped, death will occur when the child learns to squat.
If the metacarpal bones are undeveloped, death will occur when the child learns to crawl.
If the calcaneus (heel bone) is undeveloped, death will occur when the child learns to walk.
If the patella (kneecap) is undeveloped, death will occur when the child learns to stand.
Infants whose bodies cannot maintain normal posture die.
Infants with "fish-mouth" anus (fissured like a fish mouth) die.
Infants without flesh between the thighs die.
Infants with broken chins die.
Infants whose scrotum cannot elevate die.
Infants with white skin under the scrotum die; those with red skin also die.
The art of physiognomy is extensive; only a dozen items are briefly listed here.
Infants born with a whorl of hair on the forehead are predicted to achieve early nobility but may harm their parents.
Infants born with large genitalia matching the body color will reach adulthood.
Infants with continuous, unbroken crying sounds at birth will live long; those whose cries stop and then resume abruptly will have short lives.
Infants born bleeding will face many disasters and have short lives.
Infants born with misaligned gaze and frequent blinking are not virtuous.
Infants born opening their eyes spontaneously will not reach adulthood.
Infants born with total body weakness, as if lacking bones, will not reach adulthood.
Infants born with sparse hair will have strong-willed and disobedient personalities.
Infants born with small umbilical openings will have short lives.
Infants who sit, walk, speak, or grow teeth early all possess malignant traits and are not ideal children.
Infants born with four cracks on the head will not reach adulthood.
Infants born with incomplete distribution of lanugo (fine hair) will not reach adulthood.
Infants with scattered crying sounds will not reach adulthood.
Infants with deep crying sounds will not reach adulthood.
Infants who do not sweat will not reach adulthood.
Infants with urine congealed like fat/gel will not reach adulthood.
Infants who constantly shake their hands and feet will not reach adulthood.
Those without these signs will all reach adulthood.
Infants born without blood in the umbilicus are auspicious.
Infants with open, blackened scrotal seams will live long.
Infants with fresh, white, and large genitalia will live long.
Discussion: For children aged three to ten, observing their temperament and spirit can roughly predict whether they will die young or live long. Children who are exceptionally smart and perceptive in their youth often die young, such as Xiang Tuo and Yan Hui. Children with well-developed bones and dignified, slow movements, requiring careful nurturing, tend to live long. Those who are overly quick to anticipate others' thoughts and react swiftly also tend to die young, such as Yang Xiu and Kong Rong. Thus, the general trend of longevity or premature death can be understood. This is akin to plum blossoms blooming early, missing the harsh winter, while chrysanthemums bloom late, completing their annual cycle. Therefore, late bloomers are a sign of longevity.
There are three types of epilepsy in children: Fengxian (Wind Epilepsy), Jingxian (Fright Epilepsy), and Shixian (Food Epilepsy). However, Wind and Fright Epilepsies occur frequently. Among ten people, rarely one or two have Food Epilepsy. Any epilepsy preceded by chills and followed by fever is classified as Food Epilepsy. Fright Epilepsy should be treated with acupuncture/moxibustion according to diagrams; Wind Epilepsy should be treated with Zhu Xin Tang (Pig Heart Decoction); Food Epilepsy must be resolved through purgation. Zi Wan (Purple Pill) is excellent.
Children contract wind pathogens because clothing is too warm, causing sweating, which allows wind to enter. Wind Epilepsy begins with fingers flexing as if counting before onset. Fright Epilepsy starts with fright, followed by crying before onset. Mild Fright Epilepsy can be stopped by holding the child firmly and avoiding further fright. Vomiting without nursing followed by fever and epilepsy indicates Food Epilepsy; early purgation leads to recovery. Si Wei Zi Wan (Four-Ingredient Purple Pill) is best for expelling fluid retention. It removes disease quickly without damaging healthy Qi; Chi Wan (Red Pill) acts fast and is used for severe cases. If clothing is too thin and cold, food stagnates, causing sour-smelling stools, indicating the onset of Pi Ji (accumulation masses). Use Zi Wan mildly. Start with small doses to keep stools loose, avoiding severe diarrhea. Reduce dosage as stools normalize. Stop medication when stools are no longer sour-smelling. Fright Epilepsy requires only moxibustion and application of Sheng Mo Gao (Raw Massage Paste); purgation is contraindicated as it causes internal deficiency and worsens the condition. Severe Fright Epilepsy is difficult to treat. Caregivers should protect children from loud noises and sudden frights. During thunderstorms, plug the child's ears and use soft voices to distract them.
For mild fright, regulate the blood vessels; avoid severe fright. Severe fright requires moxibustion on Jing Mai (Fright Vessels).
Heat in children causes refusal to nurse, restlessness, and frequent fright, marking the early stage of epilepsy. Zi Wan cures this. If ineffective, repeat. After Li Xia (Start of Summer), avoid blind moxibustion. Do not induce vomiting or purgation; instead, bathe with Chu Re Tang (Heat-Removing Decoction), dust with Chu Re San (Heat-Removing Powder), and massage with Chu Re Chi Gao (Heat-Removing Red Paste). Apply ointment to the umbilicus. Keep the child in a cool place, allow free drinking of fresh water. For infants with slight fright during sleep, administer Zi Wan monthly to reduce excessive Qi and prevent epilepsy.
Excessive Qi in children with illness requires purgation to prevent harm. Delayed purgation leads to chronic, difficult-to-treat conditions.
Si Wei Zi Wan is best for purgation. It is potent but non-damaging. If Zi Wan is unavailable, use Chi Wan. Double the dose if necessary. If residual heat remains after purgation, administer Long Dan Tang slowly and massage with Chi Gao.
Winter purgation is safe; summer purgation is harder to recover from. Purging causes mild abdominal fullness; thus, limit nursing for a few days. Avoid blind purgation. Maintain regular nursing amounts, increasing as the child grows. Reduced intake indicates minor abdominal imbalance; medicate lightly and pause nursing. Severe cases require pausing nursing for ten days; mild cases for five to six days. Normalcy returns naturally. Refusal to eat but desire for milk indicates Pi Ji (masses); purgation is required. Failure to purge leads to alternating chills/fever, vomiting, epilepsy, or dysentery. These are severe conditions resulting from delayed treatment. Early intervention prevents damage and ensures rapid recovery.
Yellow, foul-smelling stool indicates latent heat; administer Long Dan Tang mildly. White, sour stool indicates cold stagnation; administer Zi Wan. Mild cases require small doses to dissolve internally; severe cases require slight purgation. Limit nursing for a few days to restore Stomach Qi. Failure to limit nursing leads to recurrence. Repeated purgation damages Stomach Qi and causes abdominal fullness. Moderate purgation is acceptable; excessive purgation causes injury.
Pi Ji with a large pulse predicts epilepsy (Food Epilepsy); purgation cures it. Monitor pulses in the palm and three finger positions. Do not wait for the pulse to rise before purging, as this makes treatment difficult. Early purgation prevents pulse elevation. Pulses in the palm allow early treatment; pulses reaching the fingertips indicate worsening disease.
Abdominal pathology causes chills and fever, moving blood vessels, unsettling the Heart, leading to fright and rapid epilepsy onset.
Long Dan Tang treats excess blood and Qi in newborns. It addresses chills, fever, limb convulsions, high fever, vomiting, food stagnation, persistent heat, and epidemic qi/fright epilepsy. Suitable for children under ten. This is the primary formula for newborns; adjust dosages for older children. If Guest Worry (Ke Wu) or demonic qi is suspected, add Ginseng Radix et Rhizoma (Ren Shen) and Angelicae Sinensis Radix (Dang Gui), each [amount omitted in source].
Gentianae Radix (Long Dan), Uncariae Ramulus cum Uncis (Gou Teng), Bupleuri Radix (Chai Hu) (remove roots), Scutellariae Radix (Huang Qin), Platycodonis Radix (Jie Geng), Paeoniae Radix Alba (Bai Shao), Polyporus (Fu Ling), Glycyrrhizae Radix et Rhizoma (Gan Cao) (stir-fried, each 1 fen), Silphii Laricis Insectum (Liang Lang) (2 insects, stir-fried), Rhei Radix et Rhizoma (Da Huang) (1 liang).
The above ten herbs are chopped. Boil in 2 sheng of water to obtain 5 he as one dose. Follow subsequent instructions. Dosage depends on deficiency/excess. For infants 1-7 days old, divide 1 he into three doses. For 8-15 days, divide 1.5 he into three doses. For 16-20 days, divide 2 he into three doses. For 20-30 days, divide 3 he into three doses. For 30-40 days, use 5 [dose omitted in source].
Treats minor abdominal heat, Chu Re Dan Shen Chi Gao (Heat-Removing Danshen Red Paste):
Danshen (Dan Shen), Polyporus Umbellatus (Lei Wan), Natrii Sulfas (Mang Xiao), Sal Rhois (Rong Yan), Rhei Radix et Rhizoma (Da Huang) (each 3 liang).
Chop the five herbs. Soak four of them (excluding Mang Xiao) in half a sheng of Ku Jiu (bitter wine/vinegar) overnight. Melt 1 jin of lard, boil three times up and down, strain, and add Mang Xiao. Once the paste is ready, massage the epigastrium. In winter and summer, a simpler formula using only Danshen and Lei Wan can be used.
Treats newborns with tender skin susceptible to wind pathogens, presenting with high fever, severe wind strike, or limb convulsions, Wu Wu Gan Cao Sheng Mo Gao (Five-Ingredient Raw Massage Paste):
Glycyrrhizae Radix et Rhizoma (Gan Cao) (stir-fried), Saposhnikoviae Radix (Fang Feng) (each 1 liang 20 zhu), Polyporus Umbellatus (Lei Wan) (2.5 liang), Platycodonis Radix (Jie Geng) (20 zhu).
Chop the five herbs. Simmer in 1 jin of pure pork fat over low heat to make a paste. Strain. Take a pill the size of a quail egg, warm the hands, and massage the infant one hundred times.
For cold conditions, generate heat; for heat conditions, generate cold. For healthy infants, massage the fontanelle and palms/soles with this paste regularly to ward off wind and cold.