王海藏先生云∶痘疹初出后,声音洪亮,形病而气不病也。痘疹未发,声音不出,形不病而气病也。疮疹既发,声
音不出,形气俱病也,宜用八风汤,或凉膈散去硝黄主之。窃谓前症若心火上炎,形烁肺金者,宜用人参平肺散。若津
液不足,虚火熏蒸者,宜用六味地黄丸。凡小儿面素白善哭,足热腰痛,或解颅面白,黑睛淡者,出肾虚,痘面青善
怒,或两头赤者,出肝脾虚也。盖邪之所凑,其气必虚,当预为调补。若在乳下,尤当补其母,及慎饮食起居为善。此
余之亲验者也。
一小儿仲冬出痘,呻吟烦躁, 痛作渴,音哑便实。先君谓心肺实热之症,令急与水饮之,遂恣啜始定,大便稍和,
更食梨子数枚得生。夫梨者利也,能令人作渴,今食之而安,乃内有实热而应用也。
一小儿痘愈,而声喑面赤,五心发热,小便赤少,先君谓肾经虚热,用地黄汤、益气汤而愈。其时患是症者,用清
热解毒之药,俱致不起。
一小儿痘愈而声喑面白,两睛多白,两足发热,作泻饮汤,脉浮数,左尺更数而无力,余谓禀肾经阴虚,朝用益气
汤,夕用地黄丸加五味子,两月余声渐出,又服两月余而效。
一小儿出痘声喑,脉息如前,余用前药治之,声渐复清。又饮食过多,泄泻复喑,朝用益气汤,夕用异功散、地黄
丸,声始如旧。
一小儿痘后,声喑半载,以为废人,余询之,但云头晕,其声即喑,脉浮而缓,按之不及一寸,此中气虚不能上接
清阳之气耳,用补中益气汤、地黄丸俱加五味子,不半载,声音渐复。
一男子痘后患喑,恶寒体倦,劳则头晕,余谓元气虚而不能上升,不信,乃服清痰降火之药而殁。
一小儿十四岁,痘后劳而喉喑头晕,脉洪数而无力,恶寒发热,大便欲去而不去,余谓元气下陷也,宜用益气汤,
不悟,乃杂用疏导之药,泄泻不止而殁。
八风散(即八风汤)
藿香(半两,去土) 白芷(一两) 前胡(去芦,一两) 黄 (二两) 甘
草(炙,二两) 人参(二两) 羌活(二两) 防风(三两)
上为末,每服入薄荷少许,煎汤调服。
凉膈散(方见痘疮 裂)
人参平肺散 治心火克肺金而声喑。(方见顶陷心烦)
六味地黄丸 治肾虚声喑。(方见发热属阴阳)
补中益气汤 治中气不足,不能上接清阳之气而喑。
五味异功散(二方见寒战切牙)
王海藏先生曾说:痘疹刚发出后,声音洪亮,这是形体有病而气机未病。痘疹尚未发出时,声音不出,这是形体无病而气机已病。痘疹已经发出,但声音不出,这是形与气都病了,适宜使用八风汤,或者使用凉膈散去掉芒硝、大黄来主治。我认为前述病症如果是心火上炎,灼伤肺金的情况,适宜用人参平肺散。如果是津液不足,虚火熏蒸的情况,适宜用六味地黄丸。凡是小儿面色素白且爱哭,脚热腰痛,或者解颅(囟门迟闭)面色苍白,黑睛颜色淡的,是肾虚所致;痘面发青且易怒,或者头两侧发红的,是肝脾虚弱所致。大概邪气聚集的地方,正气必然虚弱,应当预先进行调补。如果患儿还在吃奶,尤其应当补益其母亲,并且谨慎对待饮食起居才算妥善。这是我亲自验证的经验。
有一个小孩在仲冬时节出痘,呻吟烦躁,疼痛发作并口渴,声音嘶哑,大便干结。我的父亲认为是心肺实热的症状,命令急忙给水给他喝,于是让他大量饮用才安定下来,大便稍微调和,又吃了几个梨子便得以存活。梨的意思是“利”,能让人产生渴感,现在吃了它反而安宁,是因为体内有实热而适用此法。
有一个小孩痘疹痊愈后,声音嘶哑面色发红,五心(两手心、两足心及心胸)发热,小便赤红量少,我的父亲认为是肾经虚热,用地黄汤、益气汤治疗而痊愈。当时患这种症状的人,使用清热解毒的药物,都导致死亡。
有一个小孩痘疹痊愈后声音嘶哑面色苍白,两眼多白眼珠,两脚发热,腹泻,服用汤药后脉象浮数,左尺脉更数且无力,我认为是禀受肾经阴虚,早晨服用益气汤,晚上服用地黄丸加五味子,两个多月后声音逐渐恢复,又服用了两个多月才见效。
有一个小孩出痘后声音嘶哑,脉象如前所述,我用前面的药物治他,声音逐渐恢复清亮。后来因为饮食过多,再次腹泻导致声音嘶哑,早晨服用益气汤,晚上服用异功散、地黄丸,声音才恢复如初。
有一个小孩痘后声音嘶哑半年,被认为已成废人,我询问他,他只说头晕,声音就嘶哑,脉象浮而缓,按之不到一寸,这是中气虚弱不能上接清阳之气,用补中益气汤、地黄丸都加入五味子,不到半年,声音逐渐恢复。
一个男子痘后患失音症,恶寒身体疲倦,劳累则头晕,我认为是元气虚弱不能上升,他不相信,于是服用清痰降火的药物而死。
一个十四岁的小孩,痘后劳累导致喉喑头晕,脉象洪数而无力,恶寒发热,大便想排却排不出,我认为是元气下陷,适宜用益气汤,他不醒悟,于是杂用疏导的药物,腹泻不止而死。
八风散(即八风汤)
藿香(半两,去土) 白芷(一两) 前胡(去芦,一两) 黄芪(二两) 甘草(炙,二两) 人参(二两) 羌活(二两) 防风(三两)
以上研为末,每次服用时加入少许薄荷,煎汤调服。
凉膈散(方剂见痘疮裂章节)
人参平肺散 治疗心火克伐肺金而导致的声音嘶哑。(方剂见顶陷心烦章节)
六味地黄丸 治疗肾虚导致的声音嘶哑。(方剂见发热属阴阳章节)
补中益气汤 治疗中气不足,不能上接清阳之气而导致的声音嘶哑。
五味异功散(两个方剂见寒战切牙章节)
Mr. Wang Haicang stated: After the initial eruption of smallpox and measles, if the voice is resonant, it indicates that the physical form is diseased but the Qi (vital energy) is not. If the voice is absent before the eruption of smallpox and measles, it indicates that the physical form is not diseased but the Qi is. If the eruption has occurred but the voice remains absent, it indicates that both the form and Qi are diseased; in such cases, Bafeng Tang (Eight Winds Decoction) should be used, or Liangge San (Cooling the Diaphragm Powder) with Mangxiao (Mirabilite) and Dahuang (Rhubarb) removed. I believe that for the aforementioned symptoms, if caused by Heart Fire flaming upward and scorching Lung Metal, Ren Shen Ping Fei San (Ginseng Powder to Calm the Lungs) is appropriate. If caused by insufficient body fluids and steaming from deficient fire, Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill) is appropriate. For children who are naturally pale-faced and prone to crying, have hot feet and lower back pain, or present with Jiechu (delayed closure of fontanelles) with a pale face and pale iris, this stems from Kidney Deficiency. If the facial rash is green and accompanied by irritability, or redness on both sides of the head, this stems from Liver and Spleen Deficiency. Generally, where pathogenic factors gather, Qi must be deficient; therefore, preventive regulation and tonification should be undertaken. If the child is still nursing, it is especially important to tonify the mother and to exercise caution regarding diet and daily routine. This is my personally verified experience.
A child developed smallpox in mid-winter, groaning, restless, experiencing painful eruptions and thirst, hoarseness, and constipation. My father considered this a syndrome of Excess Heat in the Heart and Lungs, ordered water to be given urgently, and after copious drinking, the child stabilized. The stool became slightly regular, and after eating several pears, the child survived. The character 'Li' (pear) implies benefit or lubrication; although pears can induce thirst, their consumption brought relief here because internal Excess Heat was present and required this treatment.
A child, after recovering from smallpox, presented with hoarseness, a red face, heat in the five centers (palms, soles, and chest), and scanty dark urine. My father diagnosed this as Deficient Heat in the Kidney Meridian and cured it using Dihuang Tang (Rehmannia Decoction) and Yiqi Tang (Qi-Tonifying Decoction). At that time, patients with similar symptoms treated with Qingre Jiedu (Clearing Heat and Resolving Toxicity) medicines all died.
A child, after recovering from smallpox, presented with hoarseness, a pale face, prominent whites of the eyes, hot feet, and diarrhea. The pulse was floating and rapid; the left Chi position was particularly rapid and forceless. I diagnosed this as congenital Yin Deficiency of the Kidney Meridian. Morning administration of Yiqi Tang and evening administration of Dihuang Wan (Rehmannia Pill) added with Wuweizi (Schisandra Fruit) resulted in gradual recovery of voice over two months, with full efficacy after another two months.
A child presented with hoarseness after smallpox, with a pulse consistent with the previous case. Using the aforementioned medicines, the voice gradually cleared. However, due to excessive food intake, diarrhea recurred leading to hoarseness again. Morning administration of Yiqi Tang and evening administration of Yigong San (Benefiting the Spleen Powder) and Dihuang Wan restored the voice to normal.
A child suffered from hoarseness for half a year after smallpox and was considered incapacitated. Upon inquiry, he reported only dizziness, which triggered hoarseness. The pulse was floating and moderate, and deep pressure failed to reach one cun. This indicated that Middle Qi Deficiency prevented the ascending connection of Clear Yang Qi. Administration of Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) and Dihuang Wan, both added with Wuweizi (Schisandra Fruit), resulted in gradual voice recovery within half a year.
A man suffered from aphonia after smallpox, presenting with aversion to cold, fatigue, and dizziness upon exertion. I diagnosed this as Deficiency of Yuan Qi (Primal Qi) failing to ascend. He did not believe this diagnosis and took medicines to clear phlegm and descend fire, resulting in his death.
A fourteen-year-old child, after smallpox, suffered from labor-induced laryngeal hoarseness and dizziness. The pulse was surging and rapid yet forceless, accompanied by aversion to cold, fever, and tenesmus (urge to defecate without success). I diagnosed this as sinking of Yuan Qi (Primal Qi) and recommended Yiqi Tang (Qi-Tonifying Decoction). He failed to comprehend this, instead using miscellaneous draining and guiding medicines, leading to incessant diarrhea and death.
Bafeng San (i.e., Bafeng Tang / Eight Winds Decoction)
Huoxiang (Agastache Herba, half tael, cleaned of soil) Baizhi (Angelicae Dahuricae Radix, one tael) Qianhu (Peucedani Radix, de-gorged, one tael) Huangqi (Astragali Radix, two taels) Gancao (Licorice Root, roasted, two taels) Renshen (Ginseng Radix, two taels) Qianghuo (Notopterygii Rhizoma et Radix, two taels) Fangfeng (Saposhnikoviae Radix, three taels)
Grind into powder. For each dose, add a small amount of Bohe (Menthae Haplocalycis Herba), decoct with water, and take orally.
Liangge San (Cooling the Diaphragm Powder) (Formula see section on Smallpox Cracking)
Ren Shen Ping Fei San (Ginseng Powder to Calm the Lungs) Treats aphonia caused by Heart Fire suppressing Lung Metal. (Formula see section on Sunken Crown and Restlessness)
Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill) Treats aphonia caused by Kidney Deficiency. (Formula see section on Fever Belonging to Yin and Yang)
Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) Treats aphonia caused by insufficiency of Middle Qi, preventing the ascending connection of Clear Yang Qi.
Wuyi Yigong San (Five-Ingredient Benefiting the Spleen Powder) (Two formulas see section on Cold Shivering and Teeth Chattering)