黄疸不必分五样,总是湿热。
凡小儿身皮目皆黄者,黄病。身痛背强,大小便涩,一身面
目指爪俱皆黄,小便如屋漏尘水色,着物皆黄,渴者,难治,此
黄疸也。其症多得于大病之后,以茯苓渗湿汤主之。
如小儿生下百日及半年,不因病后身微黄者,胃热也,加减
泻黄散主之。
如面黄腹大,吐食而渴者,脾疳也,集圣丸主之。
又有自生而身黄者,胎疸也,地黄汤主之。若淡黄兼白者,
胃怯,白术散主之。
如夏月身体蒸热,胸膈烦满,皮肤似橘。白晴亦黄,筋骨痿
弱,不能行立着,脾胃郁热也,加减泻黄散主之。
通治黄疸,茵陈五苓散尤稳。
如吐泻黄疸,三棱汤主之。
白茯苓,泽泻、茵陈、猪苓、黄苓、黄连、栀子、
防己,白术、苍术、陈皮、枳壳,水煎,徐徐温服。
黄连、茵陈各五钱,黄柏、黄苓各三钱,茯苓、栀子
各三钱,泽泻二钱,水煎服。
三棱、莪术、青皮、陈皮、神曲、麦芽、甘草、黄连
白术、茯苓,伤食吐泻加山楂,时气吐泻加滑石,发热
吐泻加薄荷,水煎服。
祖传治黄疸:以胃苓丸一料,加茵陈末五钱,同为丸。用竹
叶、灯心、车前子,煎汤吞服。
凡发黄大渴不止,面黑,鼻气冷。寸口无脉者,不可治。
汗者心之所藏,在内为血,在外为汗。
小儿气血嫩弱,肤腠未密,若厚衣太暖,薰蒸脏腑。脏腑生
热,热搏于心,故液不能自藏。而额汗出也。额属心木位(23),
宜收敛心气,团参汤主之,此虚汗也。
如大病后,气血尚弱。液溢自汗,或潮热,或寒热,发过之
后,身凉自汗,日久令人黄瘦,失治,则变为骨蒸疳痨,黄?固真
汤主之。
如睡中汗出。不睡则无汗,乃睡浓也。醒觉则止,而不复出
汗,亦是心虚,此盗汗也。宜敛心气,团参汤主之。
如睡中遍身汗出,醒觉时久不干,此积症盗汗、脾冷所致,
益黄散主之。
如病困,睡中身体汗流,此因阳虚所致,黄?固真汤主之。
如脾虚泄泻,自汗后遍身冷,又汗出有时,遇泄则无,未泄
则有,此为大虚证,急当补脾,宜理中汤加熟附子,待泄止,又
以黄?固真汤主之。
凡自汗,上至胸,下至脐,此胃气虚也,当补胃,四君子汤
加黄?治之。
如肺虚自汗,其症右脸色胱白,脉按之无力,盖因久咳嗽连
声不已,以致肺气上壅,故令汗出。以四君子汤加麦冬,此益母救
子之义也。
如慢惊自汗,遍身俱有,其冷如冰,此危症也,大补汤加熟
附子一片治之。
如伤风作热自汗着,宜救表解肌,以柴葛解肌汤主之。
如无时冷汗出,发根如头珠,面颜上减减然,此为惊风,宜抱
龙丸、四君子汤,加麻黄根治之。
凡小儿自汗,上至头,下至项,谓之六阳虚汗,不须治之自
愈。
凡小儿伤寒汗出,至颈而止者,此欲发黄,茵陈汤主之。
凡诸汗症,服前药不止者,俱加牡蛎、蛤粉,或止汗散调
之。如有实热在内,烦躁汗出不止,三黄丸下之。
凡是小儿全身皮肤和眼目都发黄的情况,称为黄病(黄疸)。如果伴有身体疼痛、背部僵硬、大小便涩滞不畅,全身及面目指甲都发黄,小便颜色像屋顶漏下的含有灰尘的水,沾染物体后都会变黄,且伴有口渴症状的,属于难治之症,这就是黄疸。这种病症多在大病之后发生,治疗应以茯苓渗湿汤为主方。
如果是刚出生百日或半岁的婴儿,并非因为大病之后而身体微微发黄,这是胃热所致,治疗应以加减泻黄散为主方。
如果面色发黄且腹部胀大,呕吐食物并伴有口渴,这是脾疳(脾胃虚弱导致的疳积),治疗应以集圣丸为主方。
又有从出生起身体就发黄的,称为胎疸(胎黄),治疗应以地黄汤为主方。如果黄色淡白兼有白色,这是胃气虚弱,治疗应以白术散为主方。
如果在夏季身体蒸腾发热,胸膈烦闷胀满,皮肤颜色像橘子皮一样黄,眼白也发黄,筋骨痿软无力,不能站立行走,这是脾胃郁热所致,治疗应以加减泻黄散为主方。
【茯苓渗湿汤组成】白茯苓、泽泻、茵陈、猪苓、黄芩、黄连、栀子、防己、白术、苍术、陈皮、枳壳,水煎,慢慢温服。
【加减泻黄散组成】黄连、茵陈各五钱,黄柏、黄芩各三钱,茯苓、栀子各三钱,泽泻二钱,水煎服。
【三棱汤组成】三棱、莪术、青皮、陈皮、神曲、麦芽、甘草、黄连、白术、茯苓。若因伤食导致吐泻加山楂;若因时气(流行性疫病)导致吐泻加滑石;若发热伴吐泻加薄荷,水煎服。
祖传治疗黄疸的方法:用一料胃苓丸,加入五钱茵陈末,混合制成丸药。用竹叶、灯心草、车前子煎汤送服。
凡是出现发黄、大渴不止、面色发黑、鼻息冰冷、寸口脉摸不到的情况,属于不可治愈的死证。
汗是心所藏之物,在体内为血,在体外为汗。
小儿气血娇嫩柔弱,肌肤腠理不致密,如果穿衣过厚太暖,熏蒸脏腑。脏腑产生热气,热邪搏结于心,导致津液不能自行固藏,从而额头出汗。额头属于心经部位,应当收敛心气,治疗应以团参汤为主方,这属于虚汗。
如果在大病之后,气血仍然虚弱,津液外溢导致自汗,或者出现潮热,或者寒热往来,发作过后身体凉爽但仍自汗,日久会导致身体发黄消瘦,若失治误治,则会转变为骨蒸疳痨(一种慢性消耗性疾病),治疗应以黄芪固真汤为主方。
如果在睡觉中出汗,不睡时不出汗,这是盗汗。醒来后停止,不再出汗,这也是心气虚弱所致,应当收敛心气,治疗应以团参汤为主方。
如果在睡觉中全身出汗,醒来很久后汗仍未干,这是积滞症引起的盗汗,由脾冷所致,治疗应以益黄散为主方。
如果病情危重,睡觉中身体汗流浃背,这是因为阳虚所致,治疗应以黄芪固真汤为主方。
如果脾虚泄泻,自汗后全身发冷,又有时出汗,遇到泄泻时不出汗,未泄泻时有汗,这是大虚证,应当紧急补脾,宜用理中汤加熟附子,待泄泻停止后,再以黄芪固真汤为主方。
凡是自汗,从上至胸部,下至肚脐,这是胃气虚弱,应当补胃,治疗应以四君子汤加黄芪。
如果是肺虚自汗,症状表现为右脸色苍白,脉象按之无力,大概是因为久咳不止,导致肺气上逆壅塞,所以引起出汗。治疗以四君子汤加麦冬,这是“培土生金”(益母救子)的道理。
如果是慢惊风引起的自汗,全身都有,手脚冰凉如冰,这是危重症,治疗以大补汤加一片熟附子。
如果是伤风发热引起的自汗,应当解表肌表,治疗应以柴葛解肌汤为主方。
如果无定时出冷汗,发根像珍珠滴落,面部逐渐消瘦,这是惊风,治疗应以抱龙丸、四君子汤,加麻黄根。
凡是小儿自汗,上至头部,下至颈部,称为六阳虚汗,不需要治疗,自愈。
Jaundice need not be divided into five types; its root cause is always damp-heat.
When a child's entire skin and eyes appear yellow, it is termed Huang Bing (Jaundice). If accompanied by body pain, stiffness of the back, difficult and scanty urination and defecation, yellowing of the whole body including face, eyes, and nails, urine resembling water with sediment leaking from a roof that stains objects yellow, and thirst, this is considered a difficult-to-treat case of Jaundice. This condition often occurs after a severe illness and should be primarily treated with Fuling Shen Shi Tang (Poria Decoction for Leaching Out Dampness).
If an infant born one hundred days or half a year old presents with slight yellowing of the body not caused by a prior severe illness, this is due to Stomach Heat and should be primarily treated with Jiajian Xie Huang San (Modified Powder to Drain Spleen Heat).
If the face is yellow with abdominal distension, vomiting of food, and thirst, this is Pi Gan (Spleen-related Infantile Malnutrition) and should be primarily treated with Ji Sheng Wan (Accumulation-Sage Pill).
Those who are yellow from birth suffer from Tai Dan (Fetal Jaundice) and should be primarily treated with Dihuang Tang (Rehmannia Decoction). If the yellow color is pale and mixed with white, this indicates Weakness of the Stomach Qi and should be primarily treated with Baizhu San (Atractylodes Macrocephala Powder).
If during summer the body feels steaming hot, the chest and diaphragm feel vexed and full, the skin resembles the color of an orange peel, the sclera is yellow, and the sinews and bones are weak making standing and walking difficult, this is due to Depressed Heat in the Spleen and Stomach and should be primarily treated with Jiajian Xie Huang San (Modified Powder to Drain Spleen Heat).
For general treatment of Jaundice, Yinchen Wuling San (Artemisia Capillaris Five-Ingredient Powder) is particularly stable and effective.
For Jaundice accompanied by vomiting and diarrhea, Sanleng Tang (Curcuma Zedoaria Decoction) should be primarily used.
[Composition of Fuling Shen Shi Tang]: Bai Fuling (Poria), Zexie (Alisma), Yinchen (Artemisiae Scopariae Herba), Zhuling (Polyporus), Huangqin (Scutellariae Radix), Huanglian (Coptidis Rhizoma), Zhizi (Gardeniae Fructus), Fangji (Stephaniae Tetrandrae Radix), Baizhu (Atractylodis Macrocephalae Rhizoma), Cangzhu (Atractylodis Rhizoma), Chenpi (Citri Reticulatae Pericarpium), Zhike (Aurantii Fructus Immaturus). Decoct in water and take warm slowly.
[Composition of Jiajian Xie Huang San]: Huanglian (Coptidis Rhizoma) and Yinchen (Artemisiae Scopariae Herba) each 5 qian; Huangbo (Phellodendri Cortex) and Huangqin (Scutellariae Radix) each 3 qian; Fuling (Poria) and Zhizi (Gardeniae Fructus) each 3 qian; Zexie (Alisma) 2 qian. Decoct in water and take.
[Composition of Sanleng Tang]: Sanleng (Sparganii Rhizoma), Ezhu (Curcumae Rhizoma), Qingpi (Citri Reticulatae Pericarpium Viride), Chenpi (Citri Reticulatae Pericarpium), Shenqu (Massa Medicata Fermentata), Maiya (Hordei Fructus Germinatus), Gancao (Glycyrrhizae Radix et Rhizoma), Huanglian (Coptidis Rhizoma), Baizhu (Atractylodis Macrocephalae Rhizoma), Fuling (Poria). For vomiting and diarrhea due to food stagnation, add Shanzha (Crataegi Fructus); for vomiting and diarrhea due to seasonal pathogens, add Huashi (Talcum); for fever with vomiting and diarrhea, add Bohe (Menthae Haplocalycis Herba). Decoct in water and take.
Ancestral prescription for treating Jaundice: Take one dose of Weiling Wan (Poria and Atractylodes Macrocephala Pill), add 5 qian of Yinchen powder, and mix to form pills. Swallow with decoction made from Zhuye (Bambusae Folium), Dengxincao (Junci Medullae), and Cheqianzi (Plantaginis Semen).
If jaundice is accompanied by unrelenting extreme thirst, blackening of the face, cold breath from the nose, and absence of pulse at the Cun Kou (Radial Artery), the condition is incurable.
Sweat is stored by the Heart; internally it is Blood, externally it is Sweat.
Children have tender and weak Qi and Blood, and their skin pores are not dense. If dressed too warmly, it steams the Zang-Fu organs. Heat generated within the Zang-Fu organs combats with the Heart, causing fluids to fail to remain contained, resulting in sweating on the forehead. The forehead belongs to the Heart region; therefore, Heart Qi should be astringed. The primary treatment is Tuanshen Tang (Ginseng Pill), which addresses Deficient Sweating.
After a severe illness, if Qi and Blood remain weak, fluids overflow causing spontaneous sweating, tidal fever, or alternating chills and fever. After the episode passes, the body cools but spontaneous sweating continues. Prolonged neglect leads to yellowing and emaciation; if untreated, it transforms into Gu Zheng Gan Lao (Bone-steaming Infantile Malnutrition and Consumption). The primary treatment is Huangqi Guzhen Tang (Astragalus Stabilizing True Decoction).
Sweating only during sleep, without sweating when awake, is Dao Han (Night Sweating). It stops upon waking. This is also due to Heart Deficiency; Heart Qi should be astringed, primarily treated with Tuanshen Tang (Ginseng Pill).
If sweating covers the whole body during sleep and remains wet long after waking, this is Dao Han caused by accumulation disorders and Cold Spleen. The primary treatment is Yihuang San (Yellow-Protecting Powder).
If the patient is critically ill and sweats profusely during sleep, this is due to Yang Deficiency. The primary treatment is Huangqi Guzhen Tang (Astragalus Stabilizing True Decoction).
If there is Spleen Deficiency with diarrhea, followed by spontaneous sweating and whole-body coldness, with sweating occurring intermittently (absent during diarrhea, present when not), this is a Major Deficiency Syndrome. Urgent tonification of the Spleen is required using Lizhong Tang (Regulate the Middle Decoction) plus Shu Fuzi (Prepared Aconite Root). Once diarrhea stops, resume treatment with Huangqi Guzhen Tang (Astragalus Stabilizing True Decoction).
If spontaneous sweating extends from the chest to the navel, this indicates Deficiency of Stomach Qi. The Stomach should be tonified using Sijunzi Tang (Four Gentlemen Decoction) plus Huangqi (Astragali Radix).
If spontaneous sweating is due to Lung Deficiency, symptoms include a pale complexion on the right cheek and a pulse that feels powerless upon pressure. This is likely caused by prolonged coughing leading to upward congestion of Lung Qi, inducing sweating. Treat with Sijunzi Tang (Four Gentlemen Decoction) plus Maidong (Ophiopogonis Tuber), following the principle of "Tonifying the Mother to Save the Child" (Earth generating Metal).
If spontaneous sweating accompanies Slow Convulsion, covering the whole body with cold limbs like ice, this is a critical condition. Treat with Dabu Tang (Great Tonifying Decoction) plus one slice of Shu Fuzi (Prepared Aconite Root).
If spontaneous sweating occurs with wind-cold induced fever, the exterior should be released and muscles relaxed using Chaige Jieji Tang (Bupleurum and Kudzu Decoction to Release the Muscles).
If cold sweat occurs unpredictably, with hair roots beading like pearls and gradual facial wasting, this indicates Jing Feng (Wind Agitation/Convulsion). Treat with Baolong Wan (Embracing Dragon Pill) and Sijunzi Tang (Four Gentlemen Decoction), adding Mahuanggen (Ephedrae Radix et Rhizoma).
If a child's spontaneous sweating extends from the head to the neck, it is called Liuyang Xu Han (Six-Yang Deficient Sweating) and requires no treatment as it will resolve spontaneously.
If a child with Shanghan (Cold Damage) sweats only up to the neck, this indicates impending Jaundice. Treat with Yinchen Tang (Artemisia Capillaris Decoction).
For all types of sweating syndromes where previous medications fail to stop sweating, add Muli (Ostreae Concha) and Hafan (Concha Meretricis et Cyprinis) or use Zhi Hansan (Stop-Sweating Powder) for administration. If there is excess heat internally causing restlessness and unceasing sweating, purge it using Sanhuang Wan (Three-Yellow Pill).