〔丹溪〕治小儿赤鼻
雄黄 黄丹（各等分） 用无根水调敷。
或用菖蒲半叶，酒蒸，为末调服，解食毒。（无根水者，天落雨水，用碗盛之者是也。）
〔薛氏〕云，鼻色赤，乃脾胃实热也，用泻黄散。微赤，乃脾经虚热也，用异功散
加升麻、柴胡。色深黄，用《济生》犀角地黄汤，后用杨氏地黄散。淡白色，用六君子汤。
〔杨氏〕地黄散 治荣中有热，肺壅鼻衄。
生地黄 赤芍药 当归身 川芎（各等分）
上，每服二三钱，水煎熟，入蒲黄少许。春夏衄，入地黄汁、蒲黄各少许。秋
冬衄，用车前子汁少许。
〔钱〕肺热胀满，攻于胸膈。即成龟胸。又，乳母多食五辛亦成。〔张〕乳母乳
儿，常捏去宿乳，夏常洗乳净，捏去热乳，若令儿饮热乳，损伤肺气，胸高胀满，
令儿胸高如龟，乃名龟胸。〔曾〕此候因风痰停饮，聚积心胸，再感风热，肺为诸
脏华盖，居于膈上，水气泛溢，则肺为之浮，日久凝而为痰，停滞心胸，兼以风热
内发，其外证唇红面赤，咳嗽喘促，致胸骨高如覆掌，名曰龟胸。治法，宽肺化痰
利膈，以除肺经痰饮，先用五苓散和宽气饮入姜汁葱汤调服，次清肺饮、雄黄散、
碧玉丸、如意膏为治。若投前药，愈而复作传变，目睛直视，痰涎上涌，兼以
发搐，则难治矣。〔薛〕龟胸、龟背，多因小儿元气未充，腠理不密，风邪所乘，
或痰饮郁结，风热交攻而致，法当调补血气为主，而以清热消痰佐之。若因乳母膏
粱浓味者，当以清胃散治其母，子亦服少许。
《圣惠》大黄丸 治龟胸，肺热壅滞，心膈满闷。
川大黄（七钱半，微炒） 天门冬（焙） 百合 杏仁（麸炒微黄） 木通 桑白皮 甜葶苈（隔纸炙紫）
川朴硝（各五钱）
上为细末，蜜丸如绿豆大。不时，温水研五丸，量儿大小加减。《幼科类萃》
去朴硝，加百合、石膏。
〔张〕百合丹（即大黄丸加减）
百合（一两） 川朴硝 杏仁（汤浸，去皮尖） 桑根白皮 木通 川大黄 天门冬（去心。各半两）
上，为极细末，炼蜜和如黍米大。每服十粒，米饮送下，量儿大小加减。
〔曾〕五苓散（见惊） 宽气饮（见惊） 清肺饮（见咳嗽） 雄黄散（见惊） 碧玉丸
（见咳嗽） 如圣膏（见喘）
〔丹〕治小儿龟胸方
苍术 黄柏（酒炒） 芍药（酒炒） 陈皮 防风 山楂 威灵仙 加当归。又，利后、加生地黄。
上为末，炼蜜丸。食后温水下。
外治法
龟尿摩胸骨上，瘥。
〔灸法〕
田氏取两乳前各一寸五分上两行，三骨罅间，六处各三壮，炷如麦，春夏从下灸
上，秋冬从上灸下。庄氏取九家灰一斗，盛簸箕中，令儿合面印胸迹，于龟胸、
从上当中及两边，令三姓人同下火，各于灰上灸三壮，弃灰河流或水中。
[Danxi] Treatment for infantile red nose:
Take Xionghuang (Realgar) and Huangdan (Lead Oxide) in equal parts, mix with Wugen Shui (Rainwater collected from the sky), and apply externally.
Alternatively, use half a leaf of Changpu (Acori Tatarinowii Rhizoma), steam it with wine, grind into powder, and take orally to resolve food toxicity. (Wugen Shui refers to rainwater collected in a bowl.)
[Xue Ji] stated that a red nasal color indicates excess heat in the Spleen and Stomach; use Xiehuang San (Spleen-Draining Powder). If slightly red, it indicates deficiency heat in the Spleen Meridian; use Yigong San (Extraordinary Efficacy Powder) augmented with Shengma (Cimicifugae Rhizoma) and Chaihu (Bupleuri Radix). If the color is deep yellow, use Xijiao Dihuang Tang (Rhinoceros Horn and Rehmannia Decoction) from *Jisheng Fang*, followed by Yangshi Dihuang San (Yang's Rehmannia Powder). If pale white, use Liujunzi Tang (Six Gentlemen Decoction).
[Yangshi] Dihuang San (Rehmannia Powder): Treats heat in the Ying (Nutritive) level and Lung congestion causing epistaxis (nosebleed).
Shengdihuang (Rehmanniae Radix Recens), Chishaoyao (Paeoniae Radix Rubra), Dangguishen (Angelicae Sinensis Radix Corpus), Chuanxiong (Ligustici Chuanxiong Rhizoma) in equal parts.
Grind the above ingredients. Take 2-3 qian per dose, decoct with water until cooked, and add a small amount of Puhuang (Typhae Pollen). For epistaxis in Spring and Summer, add a little Dihuajiang (Rehmanniae Juice) and Puhuang. For epistaxis in Autumn and Winter, add a little Cheqianzijiang (Plantaginis Semen Juice).
[Qian Yi] posited that Lung heat causing distension and fullness attacking the chest and diaphragm results in Guixiong (Turtle Chest). Additionally, if the nursing mother consumes excessive "Five Pungent Spices" (Wuxin), this condition may also arise.
[Zhang Huan] noted that during breastfeeding, residual old milk should often be squeezed out. In summer, breasts should be washed clean, and hot milk squeezed out. If an infant drinks hot milk, it damages Lung Qi, leading to high and distended chest, making the infant's chest protrude like a turtle shell, which is named Guixiong (Turtle Chest).
[Zeng Shirong] believed this syndrome arises from Wind-Phlegm stagnating as fluid accumulation in the heart and chest, compounded by external Wind-Heat. The Lung, being the canopy of the five Zang organs, resides above the diaphragm. When Water-Qi overflows, the Lung floats; over time, it condenses into Phlegm, stagnating in the heart and chest. Combined with internal Wind-Heat eruption, external signs include red lips, ruddy face, coughing, and panting, resulting in the sternum protruding like an inverted palm, named Guixiong (Turtle Chest). The treatment method involves widening Lung Qi, resolving Phlegm, and unblocking the diaphragm to eliminate Phlegm-fluid in the Lung Meridian. First, administer Wuling San (Five-Ingredient Powder with Poria) combined with Kuanqi Yin (Qi-Widening Drink) mixed with Ginger Juice and Scallion Decoction. Subsequently, treat with Qingfei Yin (Lung-Clearing Drink), Xionghuang San (Realgar Powder), Biyu Wan (Jasper Pill), and Ruyi Gao (Ruyi Ointment). If previous medications fail and the condition recurs with transmission, presenting with fixed gaze, surging phlegm-saliva, and convulsions, it becomes difficult to treat.
[Xue Ji] held that Guixiong (Turtle Chest) and Beigui (Turtle Back) are mostly due to infants' incomplete Yuan Qi (Primordial Qi) and loose Couli (interstitial spaces), allowing Wind-Evil to invade, or due to Phlegm-fluid stagnation and combined attack of Wind-Heat. The method should primarily regulate and tonify Blood and Qi, assisted by clearing Heat and resolving Phlegm. If caused by the nursing mother consuming rich, greasy foods, treat the mother with Qingwei San (Stomach-Clearing Powder), and the infant should take a small amount.
*Shenghui Fang* Dahuang Wan (Rhubarb Pill): Treats Guixiong (Turtle Chest), Lung heat stagnation, and chest/diaphragm fullness.
Chuan Dahuang (Rhei Radix et Rhizoma, 7.5 qian, lightly stir-fried), Tianmendong (Asparagi Radix, baked), Baihe (Lilii Bulbus), Xingren (Armeniacae Semen Amarum, bran-stir-fried until slightly yellow), Mutong (Akebiae Caulis), Sangbaipi (Mori Cortex), Tinglizi (Descurainiae Semen seu Lepidii Semen, roasted purple between papers), Chuan Pu Xiao (Natrii Sulfas, 5 qian each).
Grind into fine powder, mix with honey to form pills the size of mung beans. At any time, dissolve five pills in warm water for administration, adjusting dosage according to the child's age and size. *Youke Leicui* removes Pu Xiao and adds Baihe and Shigao.
[Zhang Huan] Baihe Dan (Lily Pill - a modification of Dahuang Wan):
Baihe (Lilii Bulbus, 1 liang), Chuan Pu Xiao (Natrii Sulfas), Xingren (Armeniacae Semen Amarum, soaked in water, skin and tip removed), Sanggenbaiti (Mori Cortex), Mutong (Akebiae Caulis), Chuan Dahuang (Rhei Radix et Rhizoma), Tianmendong (Asparagi Radix, core removed, 0.5 liang each).
Grind into extremely fine powder, mix with refined honey to form pills the size of millet seeds. Take ten pills per dose, delivered with rice drink, adjusting dosage according to the child's size.
[Zeng Shirong] Wuling San (Five-Ingredient Powder with Poria - see Epilepsy chapter), Kuanqi Yin (Qi-Widening Drink - see Epilepsy chapter), Qingfei Yin (Lung-Clearing Drink - see Cough chapter), Xionghuang San (Realgar Powder - see Epilepsy chapter), Biyu Wan (Jasper Pill - see Cough chapter), Rusheng Gao (Rusheng Ointment - see Asthma chapter).
[Danxi] Prescription for treating infantile Guixiong (Turtle Chest):
Cangzhu (Atractylodis Rhizoma), Huangbai (Phellodendri Cortex, wine-fried), Shaoyao (Paeoniae Radix, wine-fried), Chenpi (Citri Reticulatae Pericarpium), Fangfeng (Saposhnikoviae Radix), Shanzha (Crataegi Fructus), Weilingxian (Smilacis Glabrae Rhizoma), plus Danggui (Angelicae Sinensis Radix). Furthermore, after purgation, add Shengdihuang (Rehmanniae Radix Recens).
Grind into powder, mix with refined honey to form pills. Take with warm water after meals.
External Treatment Method:
Rub the sternum with Guiyao (Turtle Urine); it will heal.
[Moxibustion Method]
Tian Shi selected two rows of points, one cun five fen anterior to both nipples, located in the gaps between three bones, totaling six sites. Apply three moxa cones at each site, cone size like a wheat grain. In Spring and Summer, moxa from bottom to top; in Autumn and Winter, from top to bottom.
Zhuang Shi took one dou of ash from nine different families, placed it in a winnowing basket, and had the infant press their face onto the chest to leave a mark. On the Guixiong area, directly above the center and on both sides, have three people of different surnames light fire simultaneously. Moxa three cones on the ash, then discard the ash into a river or water.