小儿脾疳,证见面色发黄,肌肉消瘦,身体发热,困倦喜睡,心下痞硬,乳食懒进,睡卧喜冷,好食泥土,
肚腹坚硬疼痛,头大颈细,有时吐泻,口干烦渴,大便腥粘诸状,古方主消疳理脾汤(如芜荑、三棱、莪术、青
皮、陈皮、芦荟、槟榔、使君子肉、生甘草、川黄连、胡黄连、炒麦芽、炒神曲,引用灯芯)。
〔真按〕脾属土,色黄、主肌肉,故脾疳之证必发黄,且有发稀作穗,腹胀脚弱,昼凉夜热,或不思乳食,
或饮食无度之现象,方用蓬莪术二钱,炒青皮五分,广陈皮钱半,煨芦荟五分,西党参二钱,花槟榔五分,使君
子肉五分,川黄连二分,胡黄连四分,炒麦芽一钱,炒山楂钱半,范志曲八分,炙甘草八分,引用旧仓米钱半,
灯芯十五寸。
若将汤剂改作丸剂,除旧仓米不用,以米汤糊丸,如绿豆大,每晨空心再以米汤送下二十丸,如儿小不能吞
丸,即用米汤化十丸服之亦可。
小儿疳泻之证,多缘积热伤脾,以致水谷不分,频频作泻,古法主清热和中汤(如白术、陈皮、浓朴、赤苓、
黄连、神曲、谷芽、使君子、生甘草、白泽泻,引用灯芯)。
〔真按〕久泄不止,胃虚成疳,方用土炒白术二钱,云茯苓
二钱,西党参三钱,姜炒川朴五分,焦谷芽八分,炒黄连五分,使君子肉八分,赤茯苓钱半,生甘草五分,诃子肉
一钱,引用灯芯十五寸,干荷蒂一个。
小儿脾疳,证见面色发黄,肌肉消瘦,身体发热,困倦喜睡,心下痞硬,乳食懒进,睡卧喜冷,好食泥土,肚腹坚硬疼痛,头大颈细,有时吐泻,口干烦渴,大便腥粘诸状,古方主消疳理脾汤(如芜荑、三棱、莪术、青皮、陈皮、芦荟、槟榔、使君子肉、生甘草、川黄连、胡黄连、炒麦芽、炒神曲,引用灯芯)。
【白话翻译】
小儿患脾疳(一种以脾胃虚弱、形体消瘦为主要特征的儿科疾病),症状表现为面色发黄,肌肉消瘦,身体发热,疲倦嗜睡,胃脘部痞塞坚硬,吃奶进食减少,睡觉时喜欢凉爽环境,喜欢吃泥土,腹部坚硬且疼痛,头部较大而颈部细小,有时出现呕吐和腹泻,口干燥且有烦躁口渴感,大便气味腥臭且黏腻。古代方剂主张使用消疳理脾汤(包含芜荑、三棱、莪术、青皮、陈皮、芦荟、槟榔、使君子肉、生甘草、川黄连、胡黄连、炒麦芽、炒神曲,煎药时加入灯芯草作为引经药)。
〔真按〕脾属土,色黄、主肌肉,故脾疳之证必发黄,且有发稀作穗,腹胀脚弱,昼凉夜热,或不思乳食,或饮食无度之现象,方用蓬莪术二钱,炒青皮五分,广陈皮钱半,煨芦荟五分,西党参二钱,花槟榔五分,使君子肉五分,川黄连二分,胡黄连四分,炒麦芽一钱,炒山楂钱半,范志曲八分,炙甘草八分,引用旧仓米钱半,灯芯十五寸。
【白话翻译】
【陈守真按语】脾在五行中属土,其色为黄,主管肌肉,因此脾疳的病症必然会出现面色发黄,并且伴有头发稀疏结成穗状,腹部胀满,下肢软弱无力,白天怕冷晚上发热,或者不想吃奶进食,或者饮食没有节制等现象。处方使用蓬莪术二钱,炒青皮五分,广陈皮一两半(注:原文“钱半”通常指半两或特定计量,此处依古制语境保留单位,现代理解约为1.5钱或根据上下文调整,但翻译需忠实原文单位概念,此处译为“半两”或保留“钱半”并说明,鉴于中医古籍“钱”与“两”换算,1两=10钱,钱半即0.5两=5钱?不,通常“钱”是单位,“半”是数量。若原文写“钱半”,意为0.5钱?还是半两?清代以后多用钱,1两=10钱。若写“钱半”,通常指0.5钱。但看其他药量如“二钱”,这里“钱半”极可能是笔误或特指半两?不,看后文“范志曲八分”,“八分”小于“一钱”。若“钱半”是0.5钱,则剂量很小。若“钱半”是半两(5钱),则剂量较大。结合“广陈皮”常用量,以及“蓬莪术二钱”,此处“钱半”更可能指0.5钱(即5分)或者作者笔误指半两。但在翻译中,我们应忠实于原文的字面意思“钱半”,即0.5钱。*修正:在民国及以前,1两=10钱。若写“钱半”,通常指0.5钱。但有些版本或习惯中,“钱半”也可能被误读。让我们仔细看上下文:“蓬莪术二钱... 广陈皮钱半”。如果钱半是0.5钱,那比黄连(2分)重,比半夏(若有)轻。这是合理的。* 处方具体用量为:蓬莪术二钱,炒青皮五分,广陈皮半钱(0.5钱),煨芦荟五分,西党参二钱,花槟榔五分,使君子肉五分,川黄连二分,胡黄连四分,炒麦芽一钱,炒山楂一两半(注:原文“钱半”对于山楂,若指0.5钱则太少,若指半两则合理。通常山楂用量较大。此处原文前后两个“钱半”,第一个给陈皮,第二个给山楂。考虑到陈皮理气量可小,山楂消食量可大。但为了严谨,翻译时保留“钱半”并标注单位,或根据常规理解为0.5钱/半两。鉴于学术翻译的准确性,我将直译“half a qian”或“0.5 qian”,并在心中备注这可能偏小,但忠实原文。*再次检查:很多古籍中“钱半”确实指0.5钱。*), 范志曲八分,炙甘草八分,煎药时加入旧仓米半钱,灯芯草十五寸作为引经药。
若将汤剂改作丸剂,除旧仓米不用,以米汤糊丸,如绿豆大,每晨空心再以米汤送下二十丸,如儿小不能吞丸,即用米汤化十丸服之亦可。
【白话翻译】
如果将汤剂改为丸剂,不使用旧仓米,而是用米汤将药粉制成丸剂,大小如绿豆。每天早晨空腹时,再用米汤送服二十丸。如果幼儿太小无法吞咽丸剂,也可以用米汤将十丸化开服用,这也是可以的。
小儿疳泻之证,多缘积热伤脾,以致水谷不分,频频作泻,古法主清热和中汤(如白术、陈皮、浓朴、赤苓、黄连、神曲、谷芽、使君子、生甘草、白泽泻,引用灯芯)。
【白话翻译】
小儿患疳泻(因疳积导致的腹泻)的症状,大多是因为积热损伤了脾胃,导致水谷不能正常分别吸收排泄,从而频繁发生腹泻。古代方法主张使用清热和中汤(包含白术、陈皮、厚朴、赤茯苓、黄连、神曲、谷芽、使君子、生甘草、白泽泻,煎药时加入灯芯草作为引经药)。
〔真按〕久泄不止,胃虚成疳,方用土炒白术二钱,云茯苓二钱,西党参三钱,姜炒川朴五分,焦谷芽八分,炒黄连五分,使君子肉八分,赤茯苓钱半,生甘草五分,诃子肉一钱,引用灯芯十五寸,干荷蒂一个。
【白话翻译】
【陈守真按语】长期腹泻不止,会导致胃气虚弱进而形成疳积。处方使用土炒白术二钱,云茯苓二钱,西党参三钱,姜汁炒川厚朴五分,焦谷芽八分,炒黄连五分,使君子肉八分,赤茯苓半钱(0.5钱),生甘草五分,诃子肉一钱,煎药时加入灯芯草十五寸,干荷叶蒂一个作为引经药。
Pediatric Spleen Gan (Spleen-type Malnutrition Syndrome), characterized by yellowish complexion, emaciation of muscles, fever, lethargy and preference for sleep, epigastric fullness and hardness, anorexia, preference for cool sleeping environments, pica (eating dirt), abdominal distension with hardness and pain, macrocephaly with thin neck, occasional vomiting and diarrhea, dry mouth with irritability and thirst, and foul-smelling sticky stools. Ancient formulas advocate Xiaoging Lipi Tang (Cure Gan and Regulate Spleen Decoction) containing *Mume Fructus* (Wuyi), *Sparganium Rhizoma* (Sanleng), *Curcuma Longa Rhizoma* (Ezhu), *Aurantii Fructus Immaturus* (Qingpi), *Aurantii Fructus* (Chenpi), *Aloe* (Luhui), *Areca Seed* (Binglang), *Quisqualis Indica Fruit* (Shijunzi Rou), *Glycyrrhiza Uralensis Radix et Rhizoma* (Sheng Gancao), *Coptis Chinensis Rhizoma* (Chuan Huanglian), *Picrorhiza Scrophulariiflora Rhizome* (Hu Huanglian), *Hordeum Vulgare Sprout* (Chao Maiya), *Crataegus Pinnatifida Fructus* (Chao Shenqu), using *Juncus Effusus* (Dengxin) as a guiding herb.
[Commentary by Chen Shouzhen]: The Spleen belongs to Earth, its color is yellow, and it governs the muscles. Therefore, Spleen Gan must present with yellowish complexion, along with sparse hair forming tufts, abdominal distension, weak legs, chills during the day and fever at night, anorexia, or uncontrolled eating habits. The prescription uses *Curcuma Zedoaria Rhizoma* (Peng Ezhu) 2 qian, fried *Aurantii Fructus Immaturus* (Qingpi) 5 fen, *Aurantii Fructus* (Guang Chenpi) 0.5 qian, roasted *Aloe* (Wei Luhui) 5 fen, *Codonopsis Pilosula Radix* (Xi Dangshen) 2 qian, *Areca Seed* (Hua Binglang) 5 fen, *Quisqualis Indica Fruit* (Shijunzi Rou) 5 fen, *Coptis Chinensis Rhizoma* (Chuan Huanglian) 2 fen, *Picrorhiza Scrophulariiflora Rhizome* (Hu Huanglian) 4 fen, fried *Hordeum Vulgare Sprout* (Chao Maiya) 1 qian, fried *Crataegus Pinnatifida Fructus* (Chao Shanzha) 0.5 qian, *Fanzhi Qu* (Fan Zhi Qu) 8 fen, honey-fried *Glycyrrhiza Uralensis Radix et Rhizoma* (Zhi Gancao) 8 fen, using old warehouse rice 0.5 qian and *Juncus Effusus* (Dengxin) 15 cun as guiding herbs.
If the decoction is changed into pills, excluding the old warehouse rice, use rice gruel to bind the powder into pills the size of mung beans. Take twenty pills every morning on an empty stomach with rice gruel. If the child is too small to swallow pills, ten pills can be dissolved in rice gruel and administered orally.
Pediatric Gan Diarrhea is mostly caused by accumulated heat damaging the Spleen, leading to the failure of separating clear turbid substances from food and water, resulting in frequent diarrhea. Ancient methods advocate Qingre Hezhong Tang (Clear Heat and Harmonize Middle Decoction) containing *Atractylodes Macrocephala Rhizoma* (Baizhu), *Aurantii Fructus* (Chenpi), *Magnolia Officinalis Bark* (N Houpo), *Poria Cocos* (Chi Ling), *Coptis Chinensis Rhizoma* (Huanglian), *Medicated Leaven* (Shenqu), *Setaria Italica Sprout* (Guya), *Quisqualis Indica Fruit* (Shijunzi), *Glycyrrhiza Uralensis Radix et Rhizoma* (Sheng Gancao), *Alisma Orientale Tuber* (Baize Xie), using *Juncus Effusus* (Dengxin) as a guiding herb.
[Commentary by Chen Shouzhen]: Prolonged diarrhea leads to Stomach deficiency and subsequently forms Gan. The prescription uses earth-fried *Atractylodes Macrocephala Rhizoma* (Tu Chao Baizhu) 2 qian, *Poria Cocos* (Yun Fuling) 2 qian, *Codonopsis Pilosula Radix* (Xi Dangshen) 3 qian, ginger-fried *Magnolia Officinalis Bark* (Jiang Chuan Houpo) 5 fen, scorched *Setaria Italica Sprout* (Jiao Guya) 8 fen, fried *Coptis Chinensis Rhizoma* (Chao Huanglian) 5 fen, *Quisqualis Indica Fruit* (Shijunzi Rou) 8 fen, *Poria Cocos* (Chi Fuling) 0.5 qian, *Glycyrrhiza Uralensis Radix et Rhizoma* (Sheng Gancao) 5 fen, *Chebula Retusa Fruit* (Hezi Rou) 1 qian, using *Juncus Effusus* (Dengxin) 15 cun and one dried lotus calyx (Gan Hedi) as guiding herbs.