一因伤寒之后余毒不解成潮热宜服脱甲散兼小柴胡汤
二因痞气有块阴阳不均成潮热先服梨浆饮次三棱煎丸
三因 积食伤冷滞脾胃不和成潮热先服脱甲次拓气下之后调胃
四因阴阳不和脏腑虚怯成潮热或胃暑湿脾疟成潮热单服煨姜散
五因疮疹后余毒不解成潮热宜服大连翘饮子更与助胃气
议曰潮热谓热来之有期或百一发或两日一发或三日一发不越三日先寒后热正定来者易治
乱日者难理疾起脾
胃即是疟候同出而异名只有单热潮发之作疳长作劳若症积伤冷积滞痞气皆脚冷浑身热若有虫
积其肚亦热如火凡儿有患脚冷肚热者便与下之须量热轻重分数而利有虫多者取之少则安之取
虫宜在于春旺冬实之时其或儿壮虫盛不拘此说
凡小儿患痢之时未热久则气虚其脏腑虚极作热此属恶候才见痢候作热此儿脏腑虚弱同
于虚
热主治其或三焦热引饮不歇四肢浮肿者理宜温补脏腑散除湿气喘则难治凡痢热疳热吐泻热并
不可发散退热不任寒凉药但理其病源调其脏腑和其荣卫主其胃气令进饮食次与痢药服之参酌
赤白多少脓血相杂里急后重用行血浓肠胃和中脘温脏腑其热自然退愈凡儿患痢不问轻重悉禁
荤腥冷热炙爆腌藏应毒之物若恣口腹愈而复作若也求安须用戒绝之矣
议曰幼幼患痢悉由积毒而受虚热而发三焦不和五脏蕴伏冷热相攻阴阳反逆是以作疾肠胃
言正患之时不热稍愈其体温壮众莫能知此等皆由劳其形役其气食其毒触其脏余毒不化所以作
热隐伏于百脉经络之间与由归本若更逐抑何得而安所用正气谓胃智者默而唯然疳痢之热安自
内和若和则上下气相承表里相顺使饮食以自然而然行坐以快乐而乐是谓和矣其或感眉垂首桎
腹操脐撼体拘挛焦唇烦躁皆由不和也所欲和者食饲粳粟药饵参苓葱汤涤卧避风湿仍常以肛调
胃散与服虽疾无加惟热必愈能禁能戒且安且乐而已
1. For tidal fever (tidal fever) resulting from residual pathogens not cleared after a cold damage disease, it is appropriate to administer Tuojia San (Exfoliation Powder) combined with Xiaochaihu Tang (Minor Bupleurum Decoction).
2. For tidal fever caused by imbalance of Yin and Yang due to the presence of Pi Qi (abdominal masses), first administer Lijiang Yin (Pear Syrup Drink), followed by Sanleng Jian Wan (Curcuma Pill).
3. For tidal fever caused by food accumulation and cold stagnation in the Spleen and Stomach leading to disharmony, first administer Tuojia San, then use Tuoqi Xia (Qi-moving purgatives), and subsequently regulate Stomach Qi.
4. For tidal fever caused by disharmony of Yin and Yang and deficiency/cowardice of the Zang-Fu organs, or for tidal fever caused by Stomach affected by Summer-heat and Dampness, or Spleen affected by Malaria, administer Wei Jiang San (Baked Ginger Powder) alone.
5. For tidal fever resulting from residual pathogens not cleared after Chu Zhen (exanthematous diseases such as smallpox or measles), it is appropriate to administer Da Lianqiao Yin Zi (Large Forsythia Decoction) while simultaneously assisting Stomach Qi.
Discussion states: Tidal fever refers to fever that occurs at regular intervals, either once a day, every two days, or every three days, never exceeding three days. It typically presents with initial chills followed by heat. This type of regular tidal fever is easy to treat; however, if the timing is chaotic, it is difficult to manage. The disease originates in the Spleen and Stomach and manifests as a Malaria pattern; although the name differs, the origin is similar. Only those presenting with isolated high fever without chills belong to the category where Gan accumulation (nutritional deficiency syndrome) progresses into Lao consumption (consumptive disease). If caused by Zheng accumulation, cold injury, food stagnation, or Pi Qi, symptoms usually include cold feet and a hot body. If caused by intestinal parasites, the abdomen may feel hot like fire. For any child presenting with cold feet and a hot abdomen upon illness, purgative methods should be employed. One must assess the severity of the heat to determine dosage and degree of purgation. If there are many parasites, expel them; if few, calm them. Parasite expulsion is best conducted during the prosperous times of Spring or Winter. However, if the child is robust and the parasite infestation is severe, these general rules do not apply.
Whenever children suffer from Dysentery, initially there is no fever. Over time, Qi becomes deficient, leading to extreme deficiency of the Zang-Fu organs and generating internal heat. This is considered an adverse prognosis. If fever appears immediately upon the onset of dysentery symptoms, it indicates that the child's Zang-Fu organs are weak, similar to the treatment principle for Deficiency Heat. If caused by excessive heat in the Triple Burner leading to incessant thirst and edema of the four limbs, one should warm and tonify the Zang-Fu organs and dissipate dampness. If panting occurs, it is difficult to treat. For fever associated with dysentery, Gan accumulation, or vomiting and diarrhea, dispersing methods or antipyretics should not be used, nor should cold-natured drugs be tolerated. Instead, one should address the root cause, harmonize the Zang-Fu organs, harmonize Ying and Wei (Nutritive and Defensive Qi), protect Stomach Qi, promote appetite, and then administer dysentery-specific medications. Depending on whether the stool contains red blood, white mucus, or pus mixed with blood, and accompanied by tenesmus, employ methods to invigorate blood, thicken the intestines and stomach, harmonize the Middle Jiao, and warm the Zang-Fu organs. The fever will naturally subside, and recovery will ensue. Regardless of severity, all children with dysentery must strictly avoid meat, raw/cold foods, roasted/fried items, pickled/preserved foods, and toxic substances. Indulging in diet will cause relapse after improvement. To seek peace and health, these dietary restrictions must be strictly observed.
Discussion states: Pediatric dysentery is entirely caused by the invasion of accumulated toxins and triggered by deficiency heat. Disharmony of the Triple Burner, latent cold and heat in the Five Zang organs clashing against each other, and reversal of Yin and Yang lead to disease. During the acute phase of intestinal and stomach pathology, if there is no fever, but the body temperature rises slightly upon apparent improvement, this phenomenon is often misunderstood by laypeople. These situations arise from physical fatigue, Qi depletion, ingestion of toxins, and irritation of the viscera, causing residual pathogens to fail to transform, thus generating heat that hides within the hundred vessels and meridians. This aligns with the principle of returning to the root; further suppression cannot bring peace. True "Zheng Qi" (Upright Qi) implies that the Stomach Qi is wise and silently complies with nature. How can the heat of Gan-dysentery settle on its own? Only through internal harmony, where Qi flows continuously between upper and lower parts, and interior and exterior are smooth, allowing food and drink to process naturally, and movement and rest to be joyful. This state is called "Harmony." Signs of disharmony include drooping brows, abdominal stiffness, grasping the navel, body tremors and spasms, dry lips, and irritability. To achieve harmony, diet should consist of rice and millet, medicinals such as Ginseng and Poria, and Scallion Soup for cleansing. Rest in bed and avoid wind and dampness. Continuously administer Gangtiaowei San (Intestine-Stomach Harmonizing Powder). Even if the disease persists, it will not worsen, and the fever will surely heal. By observing these prohibitions and regulations, one can achieve peace and joy.