小儿肺疳,证见面白气逆,咳嗽,毛发焦枯,皮上生粟,肌肤干燥,憎寒发热,常流清涕,鼻颊生疮诸病状,
古法主生地清肺饮以疏解之(如炒桑皮、生地黄、天冬、前胡、桔梗、苏叶、防风、黄芩、生甘草、当归、连翘、
赤苓,引用生姜、红枣),继用甘露饮清之(如生地黄、熟地黄、天冬、麦冬、炒枳壳、桔梗、黄芩、蜜炙枇杷叶、
茵陈蒿、石斛,引用红枣肉)。
日久肺虚者,主补肺散(如白茯苓、蛤粉、炒阿胶、糯米、马兜铃、炙甘草、炒杏仁),水煎服。
〔真按〕肺属金,色白主皮毛,故有面白焦枯诸现象,甚至鼻下赤烂,手足枯细,口中腥臭,亦系此证中
所应有,古方疏解之法,参以防风、当归、姜、枣,未免过当,但用蜜炙桑皮钱半,苦桔梗一钱,炙苏叶八分,
软前胡五分,生熟地黄各一钱,川石斛钱半,寸麦冬一钱,生甘草三分,引用鲜枇杷叶一大片,去毛净。
日久肺虚,本方加东阿胶钱半,生熟白芍各六分,改用白粳米一撮为引。
小儿患肾疳者,初必有解颅、鹤膝、齿迟、行迟、肾气不足等证,更因甘肥失节,夕则渐成肾疳。证见面色
黧黑,齿龈出血,口中气臭,足冷如冰,腹痛泄泻,啼哭不已诸现象,古法主先用金蟾丸治其疳(如 干虾膜五
个,胡黄连,川黄连各三钱,鹤虱二钱,煨肉豆蔻、苦楝根、桑白皮、雷丸、生芦荟、芜荑各三钱,共为末,面
糊为丸,绿豆大,雄黄为衣),每服十五丸,米汤化下。
继以九味地黄丸调补之(如熟地、茱萸肉各五钱,赤苓、泽泻、牡丹皮、炒山药、当归、川楝子、使君子肉
各三钱,共为细末,炼白蜜为丸,如芡实大,用滚白水研化,食前服)。
若禀赋不足者,古法主调元散(如人参、茯苓、土白术、炒山药、川芎、当归、熟地黄、茯神、炙黄 、炙
甘草、炒白芍,引用姜枣)。
〔真按〕肾属水,色黑主骨,初由先天不足,或肾气亏损,始得此证,或有两耳内外生疮之现象,金蟾丸剂
过于猛烈,小儿气力不支,调补又嫌太晚,只可消中带补,方用熟地三钱,茯苓三钱,山药三钱,山萸肉二钱,
丹皮二钱,泽泻二钱,干蟾蜍钱半,使君子肉钱半,蓬莪术二钱,川黄连八分,高丽参须三钱。引用炒粳米一撮。
禀赋不足,加炙黄 二钱,高丽参须倍用之。
小儿肺疳,症状表现为面色苍白、气机上逆、咳嗽、毛发焦枯、皮肤上出现粟粒状皮疹、肌肤干燥、怕冷发热、经常流清鼻涕、鼻部和脸颊生疮等病症。
古代医法主要使用生地清肺饮来疏解(药物包括:炒桑白皮、生地黄、天冬、前胡、桔梗、苏叶、防风、黄芩、生甘草、当归、连翘、赤茯苓,煎药时加入生姜、红枣作为引经药),随后使用甘露饮进行清热(药物包括:生地黄、熟地黄、天冬、麦冬、炒枳壳、桔梗、黄芩、蜜炙枇杷叶、茵陈蒿、石斛,煎药时加入红枣肉)。
若病程日久导致肺气虚弱者,主要使用补肺散(药物包括:白茯苓、蛤粉、炒阿胶、糯米、马兜铃、炙甘草、炒杏仁),用水煎服。
〔陈守真按语〕肺在五行中属金,其色为白,主司皮毛,因此会出现面色苍白、毛发焦枯等现象,甚至鼻下红肿溃烂、手足枯细、口中散发腥臭味,也属于此证候中应有的表现。古方中的疏解之法,参用了防风、当归、姜、枣,未免过于温燥或不当。我只使用蜜炙桑白皮半钱,苦桔梗一钱,炙苏叶八分,软前胡五分,生地黄和熟地黄各一钱,川石斛半钱,寸麦冬一钱,生甘草三分,引用鲜枇杷叶一大片(去毛洗净)。
若病程日久导致肺气虚弱,本方中加入东阿胶半钱,生地黄、熟地黄、白芍各六分,改用白粳米一撮作为引经药。
小儿患肾疳者,初期必然出现解颅(囟门迟闭)、鹤膝(膝关节肿大如鹤膝)、齿迟(出牙晚)、行迟(走路晚)、肾气不足等症状,再加上饮食甘肥无节制,到了晚上逐渐演变成肾疳。症状表现为面色黧黑、齿龈出血、口中气味臭秽、双脚冰冷如冰、腹痛泄泻、啼哭不止等现象。古代医法主张先用金蟾丸治疗疳积(药物包括:干虾蟆五个,胡黄连、川黄连各三钱,鹤虱二钱,煨肉豆蔻、苦楝根、桑白皮、雷丸、生芦荟、芜荑各三钱,共研为末,用面糊制成丸剂,大小如绿豆,以雄黄为衣),每次服用十五丸,用米汤化开送服。
随后使用九味地黄丸进行调补(药物包括:熟地黄、山茱萸肉各五钱,赤茯苓、泽泻、牡丹皮、炒山药、当归、川楝子、使君子肉各三钱,共研为细末,用炼过的白蜜制成丸剂,大小如芡实,用滚开水研化,饭前服用)。
若是先天禀赋不足者,古代医法主张使用调元散(药物包括:人参、茯苓、土白术、炒山药、川芎、当归、熟地黄、茯神、炙黄芪、炙甘草、炒白芍,煎药时加入生姜、大枣作为引经药)。
〔陈守真按语〕肾在五行中属水,其色为黑,主司骨骼,初期由先天不足,或肾气亏损,才得此证;或者伴有两耳内外生疮的现象。金蟾丸药性过于猛烈,小儿体力难以承受,而随后的调补又嫌太晚,只能采取消积与补益兼顾的方法。方剂组成如下:熟地黄三钱,茯苓三钱,山药三钱,山茱萸肉二钱,牡丹皮二钱,泽泻二钱,干蟾蜍半钱,使君子肉半钱,蓬莪术二钱,川黄连八分,高丽参须三钱。引用炒粳米一撮。
Pediatric lung gan (Lung Malnutrition Syndrome) presents with symptoms such as a pale complexion, rebellious qi, coughing, scorched and brittle hair, millet-grain-like eruptions on the skin, dryness of the flesh and skin, aversion to cold accompanied by fever, frequent flow of clear nasal discharge, and sores on the nose and cheeks.
Ancient methods primarily employed Shengdi Qingfei Yin (Rehmannia Root Decoction for Clearing the Lung) to disperse and resolve the pathogen (ingredients include: fried Mulberry Bark [Morus Albae Cortex], Raw Rehmannia Root [Rehmanniae Radix], Asparagus Tuber [Asparagi Radix], Peucedanum Root [Peucedani Radix], Platycodon Root [Platycodonis Radix], Perilla Leaf [Perillae Folium], Saposhnikovia Root [Saposhnikoviae Radix], Scutellaria Root [Scutellariae Radix], Raw Licorice Root [Glycyrrhizae Radix et Rhizoma], Angelica Sinensis Root [Angelicae Sinensis Radix], Forsythia Fruit [Forsythiae Fructus], Red Poria [Poria cum Rosa], with Fresh Ginger [Zingiberis Rhizoma Recens] and Jujube [Zizyphi Fructus] used as guides). Subsequently, Ganlu Yin (Sweet Dew Decoction) was used to clear heat (ingredients include: Raw Rehmannia Root, Prepared Rehmannia Root [Rehmanniae Radix Preparata], Asparagus Tuber, Ophiopogon Tuber [Ophiopogonis Radix], Fried Aurantium Fruit [Aurantii Fructus], Platycodon Root, Scutellaria Root, Honey-fried Loquat Leaf [Eriobotryae Folium], Capillaris Herb [Capillaris Herba], Dendrobium Stem [Dendrobii Caulis], with Jujube pulp used as a guide).
For cases where prolonged illness leads to Lung Qi deficiency, Bufe San (Powder for Tonifying the Lung) is primarily used (ingredients include: White Poria [Poria], Araneus Powder [Araneus], Fried Donkey-hide Gelatin [Colla Corii Asini], Glutinous Rice [Oryza Sativa Glutinosa], Aristolochia Root [Aristolochiae Radix], Honey-fried Licorice Root, Fried Apricot Seed [Armeniacae Semen Amarum]), decocted in water for oral administration.
[Chen Shouzhen’s Note]: The Lung belongs to Metal in the Five Elements, its color is white, and it governs the skin and hair; therefore, phenomena such as a pale face and scorched/brittle hair occur. Even redness and ulceration under the nose, thin and withered hands and feet, and a fishy odor in the mouth are manifestations expected within this syndrome. The ancient dispersal methods, which incorporated Fangfeng [Saposhnikoviae Radix], Danggui [Angelicae Sinensis Radix], Ginger [Zingiberis Rhizoma], and Jujube [Zizyphi Fructus], were somewhat excessive or inappropriate. I only use Honey-fried Mulberry Bark (Ban Qian), Bitter Platycodon Root (1 Qian), Honey-fried Perilla Leaf (8 Fen), Soft Peucedanum Root (5 Fen), Raw and Prepared Rehmannia Roots (each 1 Qian), Sichuan Dendrobium Stem (Ban Qian), Cun Ophiopogon Tuber (1 Qian), Raw Licorice Root (3 Fen), using one large fresh Loquat Leaf (cleaned and de-hair) as a guide.
If prolonged illness results in Lung Qi deficiency, add Dong E'jiao (Donkey-hide Gelatin) (Ban Qian), Raw and Prepared White Peony Root (each 6 Fen) to the above formula, and change the guide to a pinch of White Japonica Rice (Bai Jing Mi).
Children suffering from Kidney Gan initially must exhibit signs such as Jie Lu (delayed closure of fontanelles), He Xi (crural swelling resembling a crane's knee), Chi Chi (delayed teething), Xing Chi (delayed walking), and insufficient Kidney Qi. Furthermore, due to unregulated consumption of sweet and fatty foods, Kidney Gan gradually develops by evening. Symptoms present as a dark/blackish complexion, bleeding gums, foul breath, cold feet like ice, abdominal pain with diarrhea, and incessant crying. Ancient methods advocate first treating the malnutrition with Jin Chan Wan (Toad Pill) (ingredients include: five dried Toads [Bufo bufo gargarizans), Coptis Rhizome [Coptidis Rhizoma], Chuan Lian Zi [Meliae Fructus], each 3 Qian; Nidus Vespae [Vespa Nidus], 2 Qian; baked Nutmeg [Myristicae Semen], bark of Melia Azedarach [Meliae Cortex], Mulberry Bark [Morus Albae Cortex], Omphalia Lapponica [Omphaliae Spora], Raw Aloe [Aloe], and Coir of Areca Seed [Arecae Pericarpium], each 3 Qian. These are ground into powder, formed into pills with wheat paste, sized like mung beans, and coated with Realgar]. Each dose consists of fifteen pills, dissolved and taken with rice soup.
Subsequently, Jiwei Dihuang Wan (Nine-Ingredient Rehmannia Pill) is used for regulation and tonification (ingredients include: Prepared Rehmannia Root, Cornus Fruit [Corni Fructus], each 5 Qian; Red Poria, Alisma Rhizome [Alismatis Rhizoma], Moutan Bark [Moutan Cortex], Fried Chinese Yam [Dioscoreae Rhizoma], Angelica Sinensis Root, Chuan Lian Zi [Meliae Fructus], Seed of Quisqualis [Quisqualis Semen], each 3 Qian. These are ground into fine powder, formed into pills with refined white honey, sized like Euryale Seeds [Euryales Semen], and taken before meals after dissolving in boiling water).
For those with congenital insufficiency, ancient methods advocate using Tiaoyuan San (Decoction for Regulating the Origin) (ingredients include: Ginseng [Panacis Ginseng Radix], Poria [Poria], Earth-processed Atractylodes Macrocephala Rhizome [Atractylodis Macrocephalae Rhizoma], Fried Chinese Yam, Szechwan Lovage Rhizome [Ligustici Chuanxiong Rhizoma], Angelica Sinensis Root, Prepared Rehmannia Root, Spirit of Poria [Poria cum Pinia], Honey-fried Astragalus Root [Astragali Radix], Honey-fried Licorice Root, Fried White Peony Root [Paeoniae Radix Alba], with Ginger [Zingiberis Rhizoma] and Jujube [Zizyphi Fructus] used as guides).
[Chen Shouzhen’s Note]: The Kidney belongs to Water in the Five Elements, its color is black, and it governs the bones. This syndrome originates initially from congenital insufficiency or depletion of Kidney Qi. It may also present with sores inside and outside both ears. Jin Chan Wan is too harsh; children lack the physical strength to withstand it, and subsequent tonification is considered too late. One should employ a method that combines resolving accumulation with tonification. The prescription is: Prepared Rehmannia Root (3 Qian), Poria (3 Qian), Chinese Yam (3 Qian), Cornus Fruit (2 Qian), Moutan Cortex (2 Qian), Alisma Rhizome (2 Qian), Dried Toad (Ban Qian), Quisqualis Seed (Ban Qian), Curcuma Zedoina Rhizome [Curcumae Zedoinae Rhizoma] (2 Qian), Coptis Rhizome (8 Fen), Korean Ginseng Stamen [Panacis Ginseng Radix Stamen] (3 Qian). Use a pinch of fried Japonica Rice as a guide.
For congenital insufficiency, add Honey-fried Astragalus Root (2 Qian) and double the dosage of Korean Ginseng Stamen.