海藏云。 病者。因母有妊。儿饮其乳所致。他孕相迫。亦能致此。其状微利。寒热往来。
或发热形瘦腹大。毛发 。情思不悦。令儿断乳。先与龙胆泻肝汤加 蓄。及白饼子下之。后
与异功散、益黄散补之。禀气素虚不胜攻击者。理中加黄连、茯苓、 蓄。或一味 蓄浓煎日服。
以其能利小便也。
小儿疟疾。不越风食乳癖食积痰积。挟惊挟暑。与脾虚胃弱之不同。盖风则多寒。食则多热。
乳癖则泄泻多哭。痰积则呕吐喘鸣。食积则腹胀下血。挟惊则发搐指冷。挟暑则昏睡壮热。脾虚
则倦怠肢冷。胃虚则多渴少食。治法。不离疏风消导豁痰。如小柴胡随证加减。多寒。则加羌活、
桂枝。多热。则加橘皮、枳实。泄泻。则加浓朴、神曲。呕吐。则加橘皮、枳实。下血。则加枳
实、黄连。发搐。则加钩藤、羌活。昏睡。则加茯苓、泽泻。脾虚。则补中益气加桂枝。胃虚。
则六君子加草果。夜发。则加当归。日晏。则加升麻。若痢后疟。疟后痢。与夫三日疟。及久疟
不止。俱补中益气为主。疟母。以小柴胡加鳖甲、桃仁丸服。大抵小儿肌腠疏薄无汗者绝少。即
使无汗。稍加桂枝。有汗。并加芍药。不必用知母、石膏、紫苏、羌活辈也。至于劳疟瘴疟之类。
小儿本无。不复赘及。其有因乳母七情六淫所致者。又当以小柴胡、逍遥散之类。兼治乳母为当。
Zhang Yuansu (styled Haicang) stated: This disease in infants is caused by the fetus drinking the mother's milk during her pregnancy. The pressure from other pregnant women's milk can also induce this condition. The symptoms include mild diarrhea and alternating chills and fever. Alternatively, it may present with fever, emaciation of the body but distension of the abdomen, sparse and brittle hair, and a depressed mood. The treatment involves weaning the infant, first administering Longdan Xiegan Tang (Gentian Liver-Draining Decoction) added with Qumai (Dianthus Herba), along with Baibingzi (White Pill), to purge the pathogen. Subsequently, Yigong San (Extraordinary Power Powder) and Yihuang San (Yellow-Protecting Powder) are used for tonification. For infants with innate deficiency who cannot withstand purgative treatments, Lizhong Tang (Regulate the Middle Decoction) is modified with Huanglian (Coptis Rhizome), Fuling (Poria), and Qumai (Dianthus Herba). Alternatively, Qumai (Dianthus Herba) alone can be decocted strongly for daily consumption, as it promotes diuresis.
Pediatric malaria does not exceed etiologies involving wind, food retention, breast-stasis, phlegm accumulation, as well as complications with fright or summerheat, which differ from cases of Spleen deficiency and Stomach weakness. Generally, wind-induced cases often feature cold signs; food retention cases often feature heat signs. Breast-stasis presents with diarrhea and crying; phlegm accumulation presents with vomiting and wheezing; food retention presents with abdominal distension and bloody stools; complication with fright presents with convulsions and cold fingers; complication with summerheat presents with lethargy and high fever; Spleen deficiency presents with fatigue and cold limbs; Stomach deficiency presents with excessive thirst and poor appetite. The therapeutic methods revolve around dispersing wind, promoting digestion, and resolving phlegm. For instance, Xiaochaihu Tang (Minor Bupleurum Decoction) is used with modifications based on symptoms. If cold signs predominate, add Qianghuo (Notopterygium Rhizome) and Guizhi (Cinnamon Twig); if heat signs predominate, add Chenpi (Tangerine Peel) and Zhishi (Immature Bitter Orange); if diarrhea occurs, add Houpo (Magnolia Bark) and Shenqu (Medicated Leaven); if vomiting occurs, add Chenpi (Tangerine Peel) and Zhishi (Immature Bitter Orange); if bloody stools occur, add Zhishi (Immature Bitter Orange) and Huanglian (Coptis Rhizome); if convulsions occur, add Gouteng (Uncaria Ramulus cum Uncis) and Qianghuo (Notopterygium Rhizome); if lethargy occurs, add Fuling (Poria) and Zexie (Alisma Rhizome); if Spleen deficiency exists, use Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) with Guizhi (Cinnamon Twig); if Stomach deficiency exists, use Liu Junzi Tang (Six Gentlemen Decoction) with Caoguo (Tsaoko Fruit). If attacks occur at night, add Danggui (Angelica Sinensis Radix); if attacks occur in the late afternoon, add Shengma (Cimicifugae Rhizoma). In cases of malaria following dysentery, dysentery following malaria, tertian malaria, or persistent chronic malaria, Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) serves as the primary formula. For Nuomu (Malaria Mother, i.e., splenomegaly due to chronic malaria), Xiaochaihu Tang (Minor Bupleurum Decoction) is modified with Biejia (Trionyx Carapax) and Taoren (Prunus Persica Seed) and administered as pills. Generally, infants rarely have tight skin pores without sweating. Even if there is no sweat, adding a small amount of Guizhi (Cinnamon Twig) suffices; if there is sweat, Shaoyao (Peony Root) should be added concurrently. It is unnecessary to use herbs such as Zhimu (Anemarrhenae Rhizoma), Shigao (Gypsum Fibrosum), Zisu (Perilla Leaf), or Qianghuo (Notopterygium Rhizome). As for Lao Nue (Consumptive Malaria) and Zhang Nue (Miasmic Malaria), these conditions are virtually non-existent in children, so they need not be elaborated upon. If the etiology stems from the wet nurse's emotional disturbances or exogenous pathogens, it is appropriate to treat both the infant and the wet nurse using formulas such as Xiaochaihu Tang (Minor Bupleurum Decoction) or Xiaoyao San (Free and Easy Wanderer Powder).