小儿因湿热凝结于肠胃,以致腹中窘痛,频频下利,尿短色红,舌赤唇焦,喜饮冷水,此里热之证也,热重者,
古法主当归芍药汤(如当归、白芍、木香、黄芩、黄连、肉桂、大黄、生甘草、槟榔等味)。
热轻者,古法主白头翁汤(如白头翁、黄连、黄柏、秦皮等味)。
〔真按〕小儿热痢,其肠胃单纯为无形湿热所凝结,较有形之食滞不同,轻者用白头翁汤,犹嫌味重性寒,
过剂伤胃,但用广木香一钱,川黄连八分,老仓米钱半,引用灯芯五茎。
热重则用川黄连一钱,茵陈蒿钱半,生锦纹五分,尖槟榔一钱,六神曲八分,酒炒白芍八分,茯苓皮二钱,白
归身五分,青子芩一钱,引用鲜荷叶二钱。
小儿本有痢疾,复感时气,身热无汗,遍体疼痛,此系热为邪束,频作呕逆,古法主仓廪汤(如人参、茯苓、
独活、桔梗、
前胡、川芎、炙甘草、枳壳、仓米、柴胡、羌活,引用生姜)。
〔真按〕小儿有痢,兼感时邪,下利在先,感邪在后,专治邪而痢仍不能止,专治痢而邪仍不能退,仓廪
汤散邪而忽于痢,难称完善,法宜表里双解,方用冬桑叶钱半,连翘壳一钱,粉葛根五分,川黄连五分,酒黄芩
八分,小青皮五分,花槟榔八分,油浓朴一钱,滑石块二钱,生甘草三分,引用鲜竹叶五片、灯芯五茎。
小儿因湿热之邪凝结于肠胃,导致腹部拘急疼痛,频繁腹泻,小便短少且颜色发红,舌质红赤、嘴唇焦干,喜欢饮用冷水,这是里热证的表现。热势较重者,古法主要使用当归芍药汤(包含当归、白芍、木香、黄芩、黄连、肉桂、大黄、生甘草、槟榔等药物)。热势较轻者,古法主要使用白头翁汤(包含白头翁、黄连、黄柏、秦皮等药物)。
〔陈守真按语〕小儿患热痢,其肠胃单纯被无形的湿热所凝结,这与有形的食积停滞不同。病情轻者使用白头翁汤,尚且嫌药味厚重、性质寒凉,容易过量损伤胃气,因此仅使用广木香一钱,川黄连八分,老仓米一钱半,以灯芯草五茎为引。热势重者则使用川黄连一钱,茵陈蒿一钱半,生锦纹(大黄)五分,尖槟榔一钱,六神曲八分,酒炒白芍八分,茯苓皮二钱,白归身五分,青子芩一钱,以鲜荷叶二钱为引。
小儿原本患有痢疾,又感受时行疫气,出现身体发热无汗,全身疼痛,这是热邪被外邪束缚所致,频繁发生呕吐逆气。古法主要使用仓廪汤(包含人参、茯苓、独活、桔梗、前胡、川芎、炙甘草、枳壳、仓米、柴胡、羌活,以生姜为引)。
〔陈守真按语〕小儿既有痢疾,又兼感时邪,先有下利,后受外邪侵袭。若专门治疗外邪而痢疾仍不能止,专门治疗痢疾而外邪仍不能退。仓廪汤虽能疏散外邪却忽略了痢疾的治疗,难以称为完善之法。适宜采用表里双解的方法,方剂选用冬桑叶一钱半,连翘壳一钱,粉葛根五分,川黄连五分,酒黄芩八分,小青皮五分,花槟榔八分,油浓朴一钱,滑石块二钱,生甘草三分,以鲜竹叶五片、灯芯草五茎为引。
In infants and children, damp-heat (Shi Re) condenses in the intestines and stomach, causing abdominal urgency and pain, frequent diarrhea, short and red urine, a red tongue with dry lips, and a preference for drinking cold water. This is a syndrome of interior heat (Li Re). For severe heat, ancient methods primarily use Danggui Shaoyao Tang (Angelica Sinensis and White Peony Decoction), which includes herbs such as Danggui (Angelicae Radix Sinensis), Baishao (Paeoniae Radix Alba), Muxiang (Aucklandiae Radix), Huangqin (Scutellariae Radix), Huanglian (Coptidis Rhizoma), Rougui (Cinnamomi Cortex), Dahuang (Rhei Radix et Rhizoma), Sheng Gancao (Glycyrrhizae Radix et Rhizoma Preparata), and Binglang (Arecae Semen), among others. For mild heat, ancient methods primarily use Baitouweng Tang (Baitouweng Decoction), which includes herbs such as Baitouweng (Pulsatillae Radix), Huanglian (Coptidis Rhizoma), Huangbai (Phellodendri Cortex), and Qinpi (Fraxini Cortex), among others.
[Chen Shouzhen's Note] In pediatric heat dysentery (Re Li), the intestines and stomach are simply condensed by formless damp-heat, which differs from tangible food stagnation (Shi Zhi). For mild cases, using Baitouweng Tang is still considered to have heavy flavors and cold nature, risking gastric injury if overdosed. Instead, only Guang Muxiang (Aucklandiae Radix) 1 qian, Chuan Huanglian (Coptidis Rhizoma) 8 fen, Lao Cangmi (Old Rice) 1.5 qian are used, with Dengxin (Junci Medulla) 5 stalks as the guiding herb. For severe heat, Chuan Huanglian (Coptidis Rhizoma) 1 qian, Yinchenshao (Artemisiae Scopariae Herba) 1.5 qian, Sheng Jinwen (Raw Rhei Radix et Rhizoma) 5 fen, Jian Binglang (Arecae Semen Acuminatum) 1 qian, Liushenqu (Massa Medicata Fermentata) 8 fen, Jiuchao Baishao (White Peony Root prepared with wine) 8 fen, Fulingpi (Poria Cum Ligno Cortex) 2 qian, Bai Guishen (Angelicae Radix Sinensis Root Tip) 5 fen, Qing Ziqin (Scutellariae Radix) 1 qian are used, with Xian Heye (Fresh Nelumbinis Folium) 2 qian as the guiding herb.
If an infant or child originally suffering from dysentery (Li Ji) additionally contracts seasonal pathogenic factors (Shi Qi), presenting with fever, absence of sweating, and generalized body pain, this indicates that heat is constrained by external pathogens, leading to frequent vomiting and regurgitation. Ancient methods primarily use Canglin Tang (Granary Decoction), which includes Ren Shen (Ginseng Radix et Rhizoma), Fuling (Poria), Duhuo (Angelicae Pubescentis Radix), Jiegeng (Platycodonis Radix), Qianhu (Peucedani Radix), Chuanxiong (Ligustici Chuanxiong Rhizoma), Zhigancao (Glycyrrhizae Radix et Rhizoma Preparata), Zhiqiao (Aurantii Fructus), Cangmi (Rice), Chaihu (Bupleuri Radix), Qianghuo (Notopterygii Rhizoma et Radix), with Shengjiang (Zingiberis Rhizoma Recens) as the guiding herb.
[Chen Shouzhen's Note] When a child has dysentery complicated by seasonal pathogens, with diarrhea preceding the contraction of pathogens, treating solely the external pathogens fails to stop the diarrhea, while treating solely the dysentery fails to resolve the pathogens. Canglin Tang disperses pathogens but neglects the dysentery, making it imperfect. The appropriate method is to simultaneously release the exterior and purge the interior (Biao Li Shuang Jie). The prescription uses Dong Sangye (Mori Folium) 1.5 qian, Lianqiaoqiao (Forsythiae Fructum) 1 qian, Fen Gegen (Puerariae Radix) 5 fen, Chuan Huanglian (Coptidis Rhizoma) 5 fen, Jiu Huangqin (Scutellariae Radix prepared with wine) 8 fen, Xiao Qingpi (Citri Reticulatae Pericarpium Viride) 5 fen, Hua Binglang (Arecae Semen) 8 fen, You Nongpo (Magnoliae Officinalis Cortex) 1 qian, Huashi (Talcum) 2 qian, Sheng Gancao (Glycyrrhizae Radix et Rhizoma Preparata) 3 fen, with Xian Zhuye (Phyllostachys Viridis Folium) 5 leaves and Dengxin (Junci Medulla) 5 stalks as the guiding herbs.