小儿虚症。无论病之新久。邪之有无。但见面色青白。恍惚神疲。口鼻虚冷。嘘气怫郁
。肢
睛。屈体而卧。手足指冷。声音短怯。脉象缓弱虚细。是皆属虚之症。急宜温补脾胃为要。
仍须分别以治之。如气虚者。四君子汤。血虚者。四物汤。气血俱虚者。八珍汤。气虚自汗
者。四君子汤。血虚发躁者。当归补血汤。表虚者。宜固其气。里虚者。宜实其中。阳虚恶
寒者。宜温分肉。阴虚发热者。宜滋肾肝。脾肺气虚者。四君子汤。五味异功散。补中益气
汤。肝肾血虚者。六味丸。加味四物汤。汗后阴虚。阳无所附而热者。四物加参 。汗后阳
虚。阴无所附而热者。四君加芎归。久事表散。而身热不退者。阳气虚也。补中益气汤。过
用攻下。而滑泄不禁者。脾肾虚也。六神散。胃关煎。又虚必生寒。宜详寒论。至于虚热。
亦详见热论。此外虚症尚多。详见各条。宜并玩之。
四物汤 治血虚营弱。一切血病。当以此为主。
熟地黄 当归(各三钱) 川芎(一钱) 白芍药(二钱)
水二钟。煎服。
八珍汤 治气血两虚。调和阴阳。
人参 白术 茯苓(等分) 炙甘草(减半) 熟地 当归(等分) 白芍(减半) 川芎(倍减)
水煎。或加姜枣粳米同煎。
当归补血汤 治血气损伤。或因误攻致虚。肌热口渴。目赤面红。脉大而虚。重按全无
。及病因饥饱劳役者。
黄 (炙一两) 当归(三钱)
水一钟半。煎八分服。
补中益气汤 治劳倦伤脾。中气不足。清阳不升。外感不解。体倦食少。寒热疟痢。气
虚不能摄血等症。
人参 黄 (炙) 白术(炒) 甘草(炙各一钱五分) 当归(一钱) 陈皮(五分) 升麻 柴胡(各三分)
上加姜枣。水煎。空心午前服。
加味四物汤(即前四物汤。加山栀柴胡丹皮。)
六神散 治面青啼哭。口出气冷。或泄泻不乳。腹痛曲腰。四肢厥冷。
人参 白术(炒) 山药(炒各五钱) 白茯苓 白扁豆(炒各一两) 甘草(炙二钱)
上为末。每服二三钱。姜枣水煎。
四君子汤(方见热论)
五味异功散(方见热论)
六味丸(方见热论)
胃关煎(方见寒论)
小儿虚证,无论病程新久,无论有无外邪,只要见到面色青白,神情恍惚、精神疲乏,口鼻感觉虚冷,呼吸急促且伴有郁结感,身体蜷缩而卧,手足指端发冷,声音短促怯弱,脉象缓弱、虚细,这些都是属于虚证的范畴。治疗上急以温补脾胃为关键原则,但仍需根据具体情况分别施治。
如果是气虚,用四君子汤;血虚,用四物汤;气血俱虚,用八珍汤。气虚导致自汗的,用四君子汤;血虚导致烦躁的,用当归补血汤。表虚者,宜固护其卫气;里虚者,宜充实其中焦。阳虚且恶寒的,宜温煦分肉(肌肉间隙);阴虚且发热的,宜滋养肾肝。脾肺气虚的,用四君子汤、五味异功散、补中益气汤。肝肾血虚的,用六味丸、加味四物汤。出汗后出现阴虚,阳气无所依附而发热的,用四物汤加人参;出汗后出现阳虚,阴液无所依附而发热的,用四君子汤加川芎、当归。长期过度使用解表发散药物,而身热不退的,是阳气虚损,用补中益气汤。过度使用攻下药物,导致滑泄不禁的,是脾肾虚损,用六神散、胃关煎。此外,虚证必然伴随寒象,宜详细参考“寒论”;至于虚热,也详见于“热论”。其他虚证还有很多,详见各相关条目,应当一并研读。
四物汤:治疗血虚营血衰弱,一切血病,当以此方为主。
熟地黄、当归(各三钱)、川芎(一钱)、白芍药(二钱)。
用水两钟,煎服。
八珍汤:治疗气血两虚,调和阴阳。
人参、白术、茯苓(等分)、炙甘草(减半)、熟地黄、当归(等分)、白芍(减半)、川芎(倍减,即用量加倍或按特定比例调整,此处依原文直译)。
用水煎煮,或加生姜、大枣、粳米同煎。
当归补血汤:治疗气血损伤,或因误用攻下法导致虚损,表现为肌肤发热、口渴、眼睛红赤、面色红赤,脉象大而虚,重按完全无力。以及因饥饱失调、劳役过度引起的病症。
黄芪(炙一两)、当归(三钱)。
用水一钟半,煎至八分,服用。
补中益气汤:治疗劳倦伤脾,中气不足,清阳不升,外感不解,身体疲倦、食欲减少,寒热往来如疟疾或痢疾,气虚不能摄血等症状。
人参、黄芪(炙)、白术(炒)、甘草(炙,各一钱五分)、当归(一钱)、陈皮(五分)、升麻、柴胡(各三分)。
上加生姜、大枣,水煎。空腹,午前服用。
六神散:治疗面色青紫啼哭,口中呼出冷气,或泄泻、拒乳,腹痛弯腰,四肢厥冷。
人参、白术(炒)、山药(炒,各五钱)、白茯苓、白扁豆(炒,各一两)、甘草(炙,二钱)。
以上研为末,每次服用二三钱,用姜枣水煎服。
Pediatric deficiency syndromes, regardless of whether the disease is new or chronic, and regardless of the presence or absence of pathogenic factors, if one observes a bluish-white complexion, absent-mindedness with mental fatigue, a feeling of cold in the mouth and nose, rapid breathing accompanied by a sense of oppression, a curled-up posture during rest, coldness in the fingertips, a short and timid voice, and a slow, weak, deficient, and fine pulse, these are all classified as deficiency syndromes. The urgent treatment principle is to warm and tonify the Spleen and Stomach. However, treatment must still be differentiated based on specific conditions.
For Qi deficiency, use Si Jun Zi Tang (Four Gentlemen Decoction); for Blood deficiency, use Si Wu Tang (Four Substance Decoction); for combined Qi and Blood deficiency, use Ba Zhen Tang (Eight Treasures Decoction). For Qi deficiency with spontaneous sweating, use Si Jun Zi Tang (Four Gentlemen Decoction); for Blood deficiency with irritability, use Dang Gui Bu Xue Tang (Dong Quai Tonifying Blood Decoction). For exterior deficiency, it is appropriate to consolidate the Wei Qi (Defensive Qi); for interior deficiency, it is appropriate to solidify the Middle Jiao (Middle Burner). For Yang deficiency with aversion to cold, it is appropriate to warm the Fen Rou (muscle spaces); for Yin deficiency with fever, it is appropriate to nourish the Kidney and Liver. For Qi deficiency of the Spleen and Lung, use Si Jun Zi Tang (Four Gentlemen Decoction), Wu Wei Yi Gong San (Five-Ingredient Powder with Extra Efficacy), or Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction). For Blood deficiency of the Liver and Kidney, use Liu Wei Wan (Six-Ingredient Pill) or Jia Wei Si Wu Tang (Modified Four Substance Decoction). After sweating, if Yin deficiency occurs and Yang has no attachment leading to heat, use Si Wu Tang (Four Substance Decoction) added with Ren Shen (Ginseng Root); after sweating, if Yang deficiency occurs and Yin has no attachment leading to heat, use Si Jun Zi Tang (Four Gentlemen Decoction) added with Chuan Xiong (Sichuan Lovage Rhizome) and Dang Gui (Angelica Sinensis). If prolonged and excessive use of diaphoretic (sweat-inducing) methods fails to resolve body heat, this indicates Yang Qi deficiency; use Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction). If excessive use of purgative methods leads to uncontrollable diarrhea, this indicates Spleen and Kidney deficiency; use Liu Shen San (Six Deities Powder) or Wei Guan Jian (Stomach Gate Decoction). Furthermore, deficiency inevitably generates cold; refer to the "Treatise on Cold" for details. As for deficiency heat, refer to the "Treatise on Heat." There are many other deficiency syndromes detailed in various sections; they should be studied together.
Si Wu Tang (Four Substance Decoction): Treats Blood deficiency and Ying Blood (Nutritive Blood) weakness; it is the primary formula for all Blood disorders.
Shu Di Huang (Prepared Rehmannia Root), Dang Gui (Angelica Sinensis Root) (each 3 qian), Chuan Xiong (Ligusticum Wallichii Rhizome) (1 qian), Bai Shao Yao (White Peony Root) (2 qian).
Add two zhong of water, decoct and take orally.
Ba Zhen Tang (Eight Treasures Decoction): Treats dual deficiency of Qi and Blood, harmonizing Yin and Yang.
Ren Shen (Ginseng Root), Bai Zhu (Atractylodes Macrocephala Rhizome), Fu Ling (Poria) (equal parts), Zhi Gan Cao (Honey-fried Licorice Root) (half amount), Shu Di Huang (Prepared Rehmannia Root), Dang Gui (Angelica Sinensis Root) (equal parts), Bai Shao (White Peony Root) (half amount), Chuan Xiong (Ligusticum Wallichii Rhizome) (double amount/reduced proportion as per text).
Decoct with water, or add Sheng Jiang (Fresh Ginger), Da Zao (Jujube), and Jing Mi (Rice) for simultaneous decoction.
Dang Gui Bu Xue Tang (Dong Quai Tonifying Blood Decoction): Treats damage to Qi and Blood, or deficiency caused by erroneous purgation, manifesting as skin heat, thirst, red eyes, and red face. The pulse is large and deficient, disappearing completely upon heavy pressure. It also treats conditions caused by irregular eating or overexertion.
Huang Qi (Astragalus Membranaceus Root) (fired, 1 liang), Dang Gui (Angelica Sinensis Root) (3 qian).
Add one and a half zhong of water, decoct until eight fen remains, and take orally.
Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction): Treats Spleen injury from labor and fatigue, insufficiency of Middle Qi, failure of Clear Yang to ascend, unresolved exterior pathogens, physical fatigue, poor appetite, alternating chills and fever resembling malaria or dysentery, and symptoms where Qi deficiency fails to control blood.
Ren Shen (Ginseng Root), Huang Qi (Astragalus Membranaceus Root) (fired), Bai Zhu (Atractylodes Macrocephala Rhizome) (stir-fried), Zhi Gan Cao (Honey-fried Licorice Root) (each 1.5 qian), Dang Gui (Angelica Sinensis Root) (1 qian), Chen Pi (Citrus Reticulata Pericarp) (0.5 qian), Sheng Ma (Cimicifuga Rhizome), Chai Hu (Bupleurum Root) (each 0.3 fen).
Add Sheng Jiang (Fresh Ginger) and Da Zao (Jujube), decoct with water. Take on an empty stomach before noon.
Jia Wei Si Wu Tang (Modified Four Substance Decoction): Refers to the aforementioned Si Wu Tang (Four Substance Decoction) with added Shan Zhi (Gardenia Fruit), Chai Hu (Bupleurum Root), and Dan Pi (Moutan Cortex).
Liu Shen San (Six Deities Powder): Treats bluish complexion with crying, cold breath exhaled from the mouth, diarrhea with refusal to nurse, abdominal pain with a curved waist, and cold limbs.
Ren Shen (Ginseng Root), Bai Zhu (Atractylodes Macrocephala Rhizome) (stir-fried), Shan Yao (Dioscorea Opposita Rhizome) (stir-fried, each 5 qian), Bai Fu Ling (White Poria), Bai Bian Dou (White Hyacinth Bean) (stir-fried, each 1 liang), Zhi Gan Cao (Honey-fried Licorice Root) (2 qian).
Grind the above into powder. Take 2-3 qian per dose, decoct with Sheng Jiang (Fresh Ginger) and Da Zao (Jujube) water.
Si Jun Zi Tang (Four Gentlemen Decoction) (Formula see "Treatise on Heat")
Wu Wei Yi Gong San (Five-Ingredient Powder with Extra Efficacy) (Formula see "Treatise on Heat")
Liu Wei Wan (Six-Ingredient Pill) (Formula see "Treatise on Heat")
Wei Guan Jian (Stomach Gate Decoction) (Formula see "Treatise on Cold")