鼻为肺窍,一有风寒停滞,则气道壅塞,津液不收,流为浊涕。若冷结不散,久乃不
闻香臭,辛夷散治之。有风寒挟热者,则鼻干不眠。又有乳母卧时,鼻中出息,吹着儿
囟,亦令鼻塞,不能饮乳,开关散治之。
鼻渊有二症,风入胆中,移热于脑,脑寻窍于鼻而出涕,浓而臭为实热症,当归汤
治之,鼻流不臭清涕,经年不瘥,为肺气虚寒之候,治宜石首鱼脑汤。又有郁火不宣,门
户闭塞,稠粘浊涕,或硬或黄,不嚏则胀闷难忍,嚏则鼻梁疼痛,须加味逍遥散治之。
辛夷散
白芷 川芎 细辛 本 辛夷 木通 升麻 防风 甘草
开关散
香附 川芎 荆芥穗 细辛叶 白僵蚕 皂角(烧存性各等分)
为末,用生葱白同捣成膏,红绢包固,卧时贴囟门上。
当归汤
当归(五钱) 元参(三钱) 辛夷(一钱) 炒栀(八分) 贝母(五分) 柴胡(三分)
石首鱼脑汤
诃子 甘草(各一钱) 荆芥 细辛 人参(各五分) 桔梗(二钱) 石首鱼脑骨(五钱, 存性)
为末,将上件煎好,去渣,入末,再煎一二沸服。
加味逍遥散
当归 白芍 白术 茯苓 甘草 陈皮 柴胡 桔梗 黄芩 白芷 半夏
囟陷者,血气虚弱,不能上冲脑髓,或因泄利下陷,不得平满,总以狗头骨炙黄为
末,入鸡子清调敷之。
囟填者,乳哺不调,致伤寒热,逆气冲填,突然高起,毛发短黄,颤惕自汗,寒气
则牢硬不已,热气则柔软不支,寒者温之,热者凉之,兼调其气,而折其逆,自无不愈。
囟解者,小儿年大,头缝开解不合,由肾气不足,脑髓空虚,如树无根,岂堪培养。
斯时也,惟以六味地黄,加龟板为丸,空心温水服之,外用防风、柏子仁去油为末,乳
汁调涂,或以华阴细辛、肉桂、干姜为末,乳汁调敷,亦多有效。
六味丸
地黄(八两) 山萸肉 山药(各四两) 茯苓 泽泻 丹皮(各三两)
程格思曰∶张仲景原方,有桂、附各一两,名八味丸,钱氏谓小儿稚阳,无补阳之
理,故去桂、附治之。近世俗医,并六味亦不敢与小儿服矣。
The nose is the orifice of the Lung. Once wind-cold pathogens stagnate, the airway becomes congested, body fluids fail to be retained, and flow out as turbid nasal discharge. If cold coagulation does not dissipate, over time one may lose the sense of smell and taste for fragrant and foul odors; Xinyi San (Magnolia Flower Powder) is used to treat this. If wind-cold is accompanied by heat, there will be dryness of the nose and insomnia. Additionally, if a nursing mother exhales through her nose while sleeping, blowing the breath onto the infant's fontanelle (the soft spot on the top of an infant's head), it can also cause nasal congestion, preventing breastfeeding; Kaiguan San (Opening the Lock Powder) is used to treat this.
Bi Yuan (Nasal Sinusitis) presents with two types of symptoms: when wind enters the Gallbladder and transfers heat to the Brain, the Brain seeks the orifice in the nose to discharge fluid; thick and foul-smelling discharge indicates an Excess-Heat syndrome, treated with Danggui Tang (Angelica Decoction). If clear, non-foul-smelling nasal discharge flows for years without healing, it is a sign of Lung Qi Deficiency and Cold; treatment should employ Shishou Yunaotang (Stonehead Fish Brain Decoction). Furthermore, if constrained fire fails to vent and the portals are blocked, resulting in thick, sticky, turbid discharge that is either hard or yellow, obstruction without sneezing causes unbearable distension and fullness, while sneezing causes pain in the nasal bridge; Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder) must be used.
Xinyi San (Magnolia Flower Powder)
Bai Zhi (Angelicae Dahuricae Radix), Chuan Xiong (Chuanxiong Rhizoma), Xi Xin (Asari Radix et Rhizoma), Ben Cao (Ligustici Rhizoma et Radix), Xin Yi (Magnoliae Flos), Mu Tong (Akebiae Caulis), Sheng Ma (Cimicifugae Rhizoma), Fang Feng (Saposhnikoviae Radix), Gan Cao (Glycyrrhizae Radix et Rhizoma).
Kaiguan San (Opening the Lock Powder)
Xiang Fu (Cyperi Rhizoma), Chuan Xiong (Chuanxiong Rhizoma), Jing Jie Sui (Schizonepetae Spica), Xi Xin Ye (Asari Folium), Bai Jiang Can (Bombyx Batryticatus), Zao Jiao (Gleditsiae Fructus) (burned until carbonized but retaining its nature, equal parts).
Grind into fine powder, mash together with raw scallion white stalks to form a paste, wrap securely in red silk, and apply to the fontanelle at bedtime.
Danggui Tang (Angelica Decoction)
Dang Gui (Angelicae Sinensis Radix) (5 qian), Yuan Shen (Scrophulariae Radix) (3 qian), Xin Yi (Magnoliae Flos) (1 qian), Chao Zhi Zi (Gardeniae Fructus, stir-fried) (8 fen), Bei Mu (Fritillariae Thunbergii Bulbus) (5 fen), Chai Hu (Bupleuri Radix) (3 fen).
Shishou Yunaotang (Stonehead Fish Brain Decoction)
He Zi (Terminalia Chebulae Fructus), Gan Cao (Glycyrrhizae Radix et Rhizoma) (each 1 qian), Jing Jie (Schizonepetae Spica), Xi Xin (Asari Radix et Rhizoma), Ren Shen (Ginseng Radix et Rhizoma) (each 5 fen), Jie Geng (Platycodonis Radix) (2 qian), Shishou Yunaogu (Otolithus argenteus brain bone) (5 qian, carbonized).
Grind into fine powder. First decoct the aforementioned herbs, strain off the dregs, add the powder, boil for one or two more boils, and take orally.
Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder)
Dang Gui (Angelicae Sinensis Radix), Bai Shao (Paeoniae Radix Alba), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Fu Ling (Poria), Gan Cao (Glycyrrhizae Radix et Rhizoma), Chen Pi (Citri Reticulatae Pericarpium), Chai Hu (Bupleuri Radix), Jie Geng (Platycodonis Radix), Huang Qin (Scutellariae Radix), Bai Zhi (Angelicae Dahuricae Radix), Ban Xia (Pinelliae Tuber).
Xian (Sunken Fontanelle) results from deficiency of Blood and Qi, unable to ascend to fill the Marrow of the Brain, or due to sinking from diarrhea and dysentery, failing to become level and full. Generally, use roasted dog skull bone ground into powder, mixed with egg white for external application.
Tian (Protruding Fontanelle) is caused by irregular feeding, leading to contraction of Cold Damage Heat, with rebellious Qi rushing and filling, causing sudden protrusion. The hair is short and yellow, trembling and sweating spontaneously. If caused by Cold, it remains hard and unyielding; if caused by Heat, it is soft and unsupported. For Cold, apply warming methods; for Heat, apply cooling methods. Simultaneously regulate the Qi and subdue the rebellion, and recovery will surely follow.
Jie (Splitting/Delayed Closure of Fontanelle) occurs when a child is older, yet the cranial sutures remain open and do not close. This is due to insufficiency of Kidney Qi and emptiness of the Brain Marrow. Like a tree without roots, how can it be nurtured? At this time, only use Liuwei Dihuang Wan (Six-Ingredient Pill with Rehmannia), adding Gui Ban (Testudinis Carapax et Plastrum), formed into pills, taken orally with warm water on an empty stomach. Externally, use Fang Feng (Saposhnikoviae Radix) and Bai Zi Ren (Biota Semen), removing oil and grinding into powder, applied with breast milk. Alternatively, use Hua Yin Xi Xin (Asari Radix et Rhizoma from Huayin), Rou Gui (Cinnamomi Cortex), and Gan Jiang (Zingiberis Rhizoma), ground into powder, applied with breast milk; this is also often effective.
Liuwei Wan (Six-Ingredient Pill)
Di Huang (Rehmanniae Radix) (8 liang), Shan Yu Rou (Corni Fructus), Shan Yao (Dioscoreae Rhizoma) (each 4 liang), Fu Ling (Poria), Ze Xie (Alismatis Rhizoma), Dan Pi (Moutan Cortex) (each 3 liang).
Cheng Gesi said: Zhang Zhongjing's original formula contained Gui Zhi (Cinnamomi Ramulus) and Fu Zi (Aconiti Lateralis Radix Praeparata), each 1 liang, named Bawei Wan (Eight-Ingredient Pill). Qian Yi stated that children possess "tender Yang" and thus there is no rationale for tonifying Yang, so he removed Gui Zhi and Fu Zi to treat pediatric cases. In recent times, worldly physicians dare not even administer Liuwei Dihuang Wan to children.