心主惊,实则叫哭发热,饮水而搐;虚则困卧,悸动不安。肝主风,实则目直大叫,呵欠项急顿闷;虚则切牙呵欠,
气热则外生风。气温则内生风。脾主困,实则困睡,身热饮水;虚则吐泻生风。肺主喘,实则闷乱喘促,有饮水者,有
不饮水者;虚则哽气长出气。肾主虚,无实也。惟痘疮实则黑陷,更当别虚实证。假如肺病,又见肝证,切牙多呵欠者,
易治,肝虚不能胜肺故也。若目直大叫哭,项急顿闷者,难治。盖肺久病虚冷,肝强实而反胜肺也。视病之新久虚实,
虚则补母,实则泻子。
肝病∶哭叫目直,呵欠顿闷项急。心病∶多叫哭惊悸,手足动摇,发热饮水。脾病∶困睡泄泻,不思饮食。肺病∶
闷乱,哽气长出,气喘气急。肾病∶目无精光,畏明,体骨重。治疗之法∶大抵肝病以疏风理气为先,心病以抑火镇惊
为急,脾病当温中消导,肺病宜降气清痰,肾则补助真元,斯得其治法之大要也。
肝外主感风,呵欠顿闷,口中气热,当发散,大青膏主之。若能食饮水不止,当大黄丸微下,余不可下。肝热手寻
衣领,及乱捻物。泻青丸主之。壮热饮水,喘闷,泻白散主之。肝病胜肺,肝病秋见。肝强胜肺,肺怯不能胜肝,当补
脾。治肝益脾者,母令子实故也。补脾,益黄散;治肝,泻青丸。肝有风,目连眨不搐,得心热则搐。治肝,泻青丸;
治心,导赤散主之。肝有热,目直视不搐,治同上法。肝有风,其身反张,强直不搐,心不受热也,当补肾治肝。补肾,
地黄丸;治肝,泻青丸主之。凡病或新或久,皆引肝风之动,而动止于头目,目属肝,风入于目,上下左右,如风吹,
不轻不重,儿不能任,故目连眨也。若热入于目,牵其筋脉,两 俱紧,不能转视,故目直也。若得心热则搐,以其子
母俱有实热,风火相搏故也。肝病见秋木旺,肝强胜肺也,宜补肺泻肝,轻者肝病退,重者唇白而死。
大青膏 治伤风痰热发搐,百日左右并二三岁亦可服。
天麻(一钱) 白附子(一钱) 蝎尾(半钱) 朱砂(一字) 青黛(一钱) 天竺黄(一字) 麝香(一字)
乌蛇(酒浸,取肉焙干,半钱)
上为末,生蜜为丸,如芡实大,月中儿粳米大,同牛黄膏、薄荷汤化下,五岁以上,同甘露散服之。
大黄丸 治小儿无辜疳疾,急疳壮热,疳劳骨蒸,头发作穗,身上生疮,瘰 核块,多要 煎,食物不成肌肤,
腹大颈细。
大黄(三钱) 木香(半两)
上为末,米醋一升相和,置铜罐中,下于铛内,浮水上,炭火煮,用竹篦子搅药,候可丸即丸,入稠糊丸如小豆大,
二岁二十丸,米汤下,加减与之,当下青脓为效。一方治无辜疳疾,肚大,或时泻痢,冷热不调,漏芦为末,每服一钱;
猪肝一两,盐少许煮,空心服之。
大黄丸(钱氏方) 治风热里实,口中气热,大小便秘赤,饮水不止,有下证者宜服之。
黑牵牛(半生半炒,五钱) 川芎(半两) 甘草(一钱,炙) 大黄(一两,酒洗过,蒸熟,切片,曝干)
上为细末,稀糊和丸如麻子大,二岁每服十丸,温蜜水下,乳后服,以溏利为度,未利加丸数再服,量大小加减用
之。
泻青丸 治小儿赤眼多泪,睛疼心躁,并消热翳,急惊发搐。
当归 川芎 防风 龙胆草 大黄 羌活 山栀仁(各等分,一方加甘草、赤芍药。)
上为末,炼蜜丸如芡实大,每服一丸,沙糖汤下。
泻白散 治小儿痰壅咳嗽,宽气进食。
地骨皮 桑白皮(炒,各一两) 甘草(炙,一钱)
上锉散,入粳米一撮,水二小盏,煎七分,食前服。
益黄散 治小儿吐泻,脾虚不食,米谷不化,困倦力少,滑肠夜起,并疳虚盗汗,并治涎唾不收,颔下常湿,
名曰滞颐。
陈皮(去白,一两) 丁香(二钱,一方用木香) 诃子(炮,去核) 青皮(去瓤) 甘草(炙,各五钱)
上为末,每服二钱,水一盏,煎三分,食前服。
导赤散 治小儿心惊,内虚邪热。
生地黄 生甘草 木通(各等分)
上锉散,竹叶七片,再加黄芩、赤芍药、羌活、灯心各等分,水一盏,煎三分,食前服。
地黄丸 治肾疳脑热肌削,手足如冰,滑泄肚痛。
熟地黄 山茱萸(去核) 干山药(各四钱) 泽泻 牡丹皮 白茯苓(去皮,各三钱)
上为末,炼蜜和丸,如梧桐子大,三岁以下,一、二丸至三丸,温水空心化下,行迟鹤膝加鹿茸、牛膝、五加皮。
Background Information:
Book Title: Ying Tong Bai Wen (A Hundred Questions for Infants and Children)
Author: Lu Bosi
Dynasty: Ming Dynasty
Chapter: Question 6 on the Five Zang Organs' Dominance (No Formulas) / Question 7 on Five Zang Organ Diseases (No Formulas) / Question 8 on the Liver
Category: Gynecology and Pediatrics
Translation:
The Heart governs fright. In excess conditions, there is crying and wailing, fever, and convulsions when drinking water; in deficiency conditions, there is lethargy, palpitations, and restlessness. The Liver governs wind. In excess conditions, there is staring eyes, loud crying, yawning, neck stiffness, and sudden chest oppression; in deficiency conditions, there is teeth grinding and yawning. Heat in Qi generates external wind. Warmth in Qi generates internal wind. The Spleen governs lassitude. In excess conditions, there is drowsiness, body heat, and thirst; in deficiency conditions, there is vomiting, diarrhea, and generation of wind (convulsions). The Lung governs panting. In excess conditions, there is chest stuffiness, confusion, and rapid breathing; some patients desire water, while others do not; in deficiency conditions, there is choking sensation and long sighing. The Kidney governs deficiency and has no excess conditions. Only in cases of smallpox/chickenpox (Dou Chuang), black depression indicates an excess condition, requiring differentiation between excess and deficiency patterns. For instance, if a patient has a Lung disease but also presents Liver symptoms such as teeth grinding and frequent yawning, it is easy to treat because the Liver is deficient and cannot overcome the Lung. If there are staring eyes, loud crying, neck stiffness, and sudden chest oppression, it is difficult to treat. This is because the Lung has been diseased for a long time leading to deficiency and cold, while the Liver is strong and excessive, counter-overcoming the Lung. Depending on whether the disease is new or old, and whether it is excess or deficiency, deficiency should be treated by tonifying the mother organ, and excess by purging the child organ.
Liver Disease: Crying, staring eyes, yawning, sudden chest oppression, neck stiffness. Heart Disease: Frequent crying, fright, palpitations, trembling of hands and feet, fever, thirst. Spleen Disease: Drowsiness, diarrhea, loss of appetite. Lung Disease: Chest stuffiness, confusion, choking sensation, long sighing, panting, rapid breathing. Kidney Disease: Lackluster eyes, photophobia, heaviness of the body and bones. General Treatment Principles: Generally, Liver diseases should prioritize dispersing wind and regulating Qi; Heart diseases urgently require clearing fire and calming fright; Spleen diseases should be warmed in the middle and aided in digestion; Lung diseases should benefit from descending Qi and clearing phlegm; Kidney diseases require supplementing the primordial Yuan Qi. These constitute the main principles of treatment.
External invasion of Wind by the Liver manifests as yawning, sudden chest oppression, and hot breath in the mouth; it should be treated with dispersing methods, primarily using Da Qing Gao (Great Blue Ointment). If the patient can eat but drinks excessively, Da Huang Wan (Rhubarb Pill) should be used to gently purge; other conditions should not be purged. Liver Heat manifests as hands seeking the collar and randomly rubbing objects; this is treated with Xie Qing Wan (Drain the Green Pill). High fever with thirst, panting, and chest oppression are treated with Xie Bai San (Drain the White Powder). When Liver disease overcomes the Lung, it is seen in Autumn. When the Liver is strong and overcomes the Lung, and the Lung is weak and cannot overcome the Liver, the Spleen should be tonified. Treating the Liver to benefit the Spleen follows the principle that "the mother makes the child full." Tonify the Spleen with Yi Huang San (Benefit the Yellow Powder); treat the Liver with Xie Qing Wan. If the Liver has Wind, the eyes blink frequently without convulsions; if the Heart becomes hot, convulsions occur. Treat the Liver with Xie Qing Wan; treat the Heart with Dao Chi San (Guide Out the Red Powder). If the Liver has Heat, the eyes stare straight without convulsions; treat according to the above method. If the Liver has Wind, the body arches backward, stiff without convulsions, indicating the Heart does not receive heat; tonify the Kidney and treat the Liver. Tonify the Kidney with Di Huang Wan (Rehmannia Pill); treat the Liver with Xie Qing Wan. Any disease, whether new or old, can induce the movement of Liver Wind, which stops at the head and eyes. The eyes belong to the Liver. When Wind enters the eyes, blowing up, down, left, and right, neither lightly nor heavily, the infant cannot bear it, causing frequent blinking. If Heat enters the eyes, pulling the sinews, both eyelids become tight, preventing eye movement, causing staring. If the Heart receives heat, convulsions occur because both mother and child organs have excess heat, and wind and fire struggle against each other. Liver disease appearing in Autumn when Wood energy is prosperous indicates the Liver is strong and overcomes the Lung; one should tonify the Lung and purge the Liver. Mild cases see the Liver disease recede; severe cases result in white lips and death.
Da Qing Gao (Great Blue Ointment): Treats convulsions caused by wind-cold and phlegm-heat. Suitable for infants around 100 days old and children aged two to three years.
Ingredients: Tian Ma (Gastrodiae Rhizoma, 1 qian), Bai Fu Zi (Typhonii Rhizoma Praeparatum, 1 qian), Xie Wei (Scorpio, 0.5 qian), Zhu Sha (Cinnabar, 1 zi), Qing Dai (Indigo Naturalis, 1 qian), Tian Zhu Huang (Bambusae Concretio Silicea, 1 zi), She Xiang (Moschus, 1 zi), Wu She (Zaocys, soaked in wine, meat taken and dried, 0.5 qian).
Preparation: Grind into powder, form pills with raw honey, size of Euryale Seed. For one-month-old infants, size of Rice Grain. Dissolve with Niu Huang Gao (Calculus Bovis Ointment) and Bo He Tang (Mentha Decoction). For children over five years, take with Gan Lu San (Sweet Dew Powder).
Da Huang Wan (Rhubarb Pill): Treats infantile malnutrition (Gan Ji) due to innocent causes, acute Gan fever, bone-steaming Gan consumption, hair matted like tufts, skin sores, scrofula nodules, frequent need for decoctions, food failing to nourish muscles, large abdomen with thin neck.
Ingredients: Da Huang (Rhei Radix et Rhizoma, 3 qian), Mu Xiang (Aucklandiae Radix, 0.5 liang).
Preparation: Grind into powder, mix with 1 sheng of rice vinegar. Place in a copper jar inside a pan floating on water. Boil over charcoal fire, stirring with a bamboo spatula. When ready, form pills. Add thick paste to make pills size of Adzuki Bean. Two-year-olds take 20 pills with rice soup. Adjust dosage. Effect indicated by passage of green pus-like stool. Another prescription for innocent Gan Ji with large abdomen, intermittent dysentery, and cold-heat imbalance: Lou Lu (Euphorbiae Humifusae Radix) powder, 1 qian per dose; Pig liver 1 liang, boiled with little salt, taken on an empty stomach.
Da Huang Wan (Qian's Formula): Treats interior excess due to wind-heat, hot breath, constipation with red urine, incessant thirst, where purgation indications exist.
Ingredients: Hei Qian Niu (Pharbitidis Semen, half raw half fried, 5 qian), Chuan Xiong (Ligustici Chuanxiong Rhizoma, 0.5 liang), Gan Cao (Glycyrrhizae Radix et Rhizoma, 1 qian, roasted), Da Huang (Rhei Radix et Rhizoma, 1 liang, washed with wine, steamed, sliced, dried).
Preparation: Grind into fine powder, mix with thin paste to form pills size of Sesame Seed. Two-year-olds take 10 pills with warm honey water after milk feeding. Stop when stools become loose. If no effect, increase dose. Adjust based on age/size.
Xie Qing Wan (Drain the Green Pill): Treats pediatric red eyes with excessive tearing, eye pain, irritability, clears heat nebula, and emergency childhood convulsions.
Ingredients: Dang Gui (Angelicae Sinensis Radix), Chuan Xiong (Ligustici Chuanxiong Rhizoma), Fang Feng (Saposhnikoviae Radix), Long Dan Cao (Gentianae Radix), Da Huang (Rhei Radix et Rhizoma), Qiang Huo (Notopterygii Rhizoma et Radix), Shan Zhi Ren (Gardeniae Semen, equal parts). Alternative adds Gan Cao and Chi Shao Yao.
Preparation: Grind into powder, form pills with refined honey size of Euryale Seed. Take one pill with sugar water.
Xie Bai San (Drain the White Powder): Treats pediatric cough with abundant phlegm, regulates Qi and promotes appetite.
Ingredients: Di Gu Pi (Lycii Cortex), Sang Bai Pi (Mori Cortex, fried, 1 liang each), Gan Cao (Glycyrrhizae Radix et Rhizoma, 1 qian, roasted).
Preparation: Cut into pieces. Add a pinch of Jing Mi (Oryza Sativa Germ). Boil in two small cups of water until reduced to 70%. Take before meals.
Yi Huang San (Benefit the Yellow Powder): Treats pediatric vomiting and diarrhea, Spleen deficiency with anorexia, undigested food, fatigue, loose stools with nocturnal urination, Gan deficiency night sweats, and inability to retain saliva causing wet chin (Zhi Yi).
Ingredients: Chen Pi (Citri Reticulatae Pericarpium, pith removed, 1 liang), Ding Xiang (Caryophylli Flos, 2 qian, alternative Mu Xiang), He Zi (Chebulae Fructus, processed, pitted), Qing Pi (Citri Reticulatae Pericarpium Viride, pith removed), Gan Cao (Glycyrrhizae Radix et Rhizoma, roasted, 5 qian each).
Preparation: Grind into powder. Take 2 qian with one cup of water, boil to 30%. Take before meals.
Dao Chi San (Guide Out the Red Powder): Treats pediatric fright and internal deficiency with pathogenic heat.
Ingredients: Sheng Di Huang (Rehmanniae Radix), Sheng Gan Cao (Glycyrrhizae Radix et Rhizoma), Mu Tong (Akebiae Caulis, equal parts).
Preparation: Cut into pieces. Add seven leaves of Zhu Ye (Bambusae Folium). Add Huang Qin (Scutellariae Radix), Chi Shao Yao (Paeoniae Radix Rubra), Qiang Huo (Notopterygii Rhizoma et Radix), Deng Xin Cao (Junci Medullia, equal parts). Boil one cup of water to 30%. Take before meals.
Di Huang Wan (Rehmannia Pill): Treats Kidney Gan Ji with brain heat and muscle wasting, ice-cold hands and feet, loose stools, and abdominal pain.
Ingredients: Shu Di Huang (Rehmanniae Radix Preparata), Shan Zhu Yu (Corni Fructus, pitted), Gan Shan Yao (Dioscoreae Rhizoma, 4 qian each), Ze Xie (Alismatis Rhizoma), Mu Dan Pi (Moutan Cortex), Bai Fu Ling (Poria, peeled, 3 qian each).
Preparation: Grind into powder, mix with refined honey to form pills size of Sophora Seed. Children under three years take 1-3 pills dissolved in warm water on an empty stomach. For delayed walking or crural deformity (Cruris Oxina), add Lu Rong (Cervi Cornu Pantotrichum), Niu Xi (Achyranthis Bidentatae Radix), and Wu Jia Pi (Acanthopanacis Cortex).