小儿肥疳恣食,寒暑不适,生冷油腻伤脾,糖面炙爆助火,因循积渐,酿成疳疾。
渴而易饥,善食而瘦,发竖下泄,腹胀鼻干,久久不治。脾弱肝强,化源既绝,肾阴
自亏,木失所养,肝火自燎其窍,这成目眚,多生翳膜,睫闭不开,眵泪如糊,乃中
州弱而清阳不升,肝火盛而浊阴不降所致,治当升清降浊,以白术、人参先补脾胃为
君,柴胡、枳壳疏肝抑气为臣,苍术、茯苓、泽泻渗湿降浊为佐,羌活、蔓荆、升
麻、川芎、薄荷诸风药,既散风火,且借上达之性,以为使,疳与目疾咸获其效矣。
魃病者,儿将过岁,母复有妊,儿饮其魃乳,(又谓爱乳。)以成斯症。或有母患他病,
儿饮其乳,以类母病者有焉。盖母之血气若调,乳则长养,精神血气一病,乳则反生他
病,母既妊娠,精华下荫,气则壅而为热,血则郁而为恶,小儿神气未全,易于感动,
其候寒热时作,微微下痢,毛发 ,意殊不悦,甚至面色痿黄,腹胀青筋,泻青多
吐,日渐 羸,乳食不进,竟成疳状。又有谓受妊之时,或因大实大虚,饥饱劳役,大
暑大寒,风雨雷电,及阴阳不等,犯禁亦成。此候俗以孕在胎中,因儿饮乳,其魄识
嫉,而致儿病,故谓之胎妒。
蒸热之病,多起于足阳明,其始也,火上冲而能啖,火消烁而善饥,盖胃为气血之
海,气血不足,邪火杀谷,水谷之精不足济之,渐成口秽烦躁,夜热朝凉,毛焦口渴,
气促盗汗,形如鹄立,谓之消瘅。若大便日有十余,肢瘦腹大,频食多饥,谓之食并。
再失调治,邪火不退,相传相受,耗烁精滋,五脏俱困。如传诸肝,则多怒善恐,颊
痛转筋,遇卯酉时则较重;传诸脾则神怠肉肿,足冷肠鸣,辰戌丑未时则较重;传诸
肺,则咳逆膈胀,背楚恶寒,遇午后则较重;传诸心,则五心燔灼,唇鲜口苦,当午
则较重;传诸肾,则虫食膂髓,宣露柴骨,遇阴分则较重。此皆邪火为害,而耗伤精
血,致病者也。若至年大,情窦既开,损伤精血而成骨蒸者,此又是精枯受伤,致成骨
蒸者也。当于精血根本处求之。
小儿肥疳(因饮食不节导致的小儿营养不良证),由于恣意进食,加之寒暑失调,生冷油腻之物损伤脾胃,糖类、面食及油炸爆炒食物助长内火,若不及时纠正,积滞渐久,酿成疳疾。
表现为口渴且容易饥饿,食欲旺盛但身体消瘦,头发竖立,大便泄泻,腹部胀满,鼻干,若长久不治,会导致脾弱肝强。由于化源(脾胃生化之源)断绝,肾阴自然亏损,肝木失去滋养,肝火自行灼烧眼窍,从而形成目病(疳眼),多生翳膜,眼睑闭合难开,眼屎泪水如糊状。这是中焦虚弱而清阳之气不能上升,肝火旺盛而浊阴之气不能下降所致。治疗应当升清降浊,以白术、人参先补益脾胃作为君药,柴胡、枳壳疏肝理气作为臣药,苍术、茯苓、泽泻渗湿降浊作为佐药,羌活、蔓荆子、升麻、川芎、薄荷等风药,既疏散风火,又借助其上行通达的特性,作为使药,这样疳疾与眼疾都能获得疗效。
魃病(又称爱乳病),是指孩子即将过周岁时,母亲再次怀孕,孩子饮用了母亲的“魃乳”(即孕期乳汁),从而形成此症。也有母亲患有其他疾病,孩子饮用其乳汁,因而患上类似母亲疾病的状况。大概母亲的血气调和,乳汁就能滋养孩子;一旦母亲的精神血气生病,乳汁反而滋生他病。母亲既然怀孕,精华向下荫蔽,气则壅滞化为热,血则郁结化为恶。小儿神气尚未完全,容易受感应,其症状表现为寒热交替发作,轻微下痢,毛发干枯,神情特别不愉快,甚至面色萎黄,腹部胀满且有青筋暴露,腹泻青色便且多呕吐,日渐消瘦,乳食不进,最终形成疳状。又有说法认为,受孕之时,或因大实大虚、饥饱劳役、大暑大寒、风雨雷电,以及阴阳不调,触犯禁忌也会造成此病。这种候症俗称为“胎妒”,认为是胎儿在胎中时,因孩子饮乳,其魄识嫉妒,而导致孩子生病。
骨蒸(一种慢性消耗性发热病症)之病,多起于足阳明胃经。起初,火上冲而能进食,火消烁而善饥。因为胃是气血的海,气血不足,邪火杀谷(加速消化但无法吸收营养),水谷的精微不足以补充,逐渐形成口秽烦躁,夜热朝凉,毛发焦枯口渴,气促盗汗,形体瘦削如鹤站立,称为消瘅。如果大便每天十多次,四肢瘦削腹部胀大,频繁进食却多饥饿,称为食并。如果再失调治,邪火不退,相传相受,耗伤精滋,五脏俱困。如果传变至肝,则易怒善恐,脸颊疼痛转筋,在卯酉时(早晨5-7点,下午5-7点)较重;传变至脾,则精神倦怠肌肉浮肿,脚冷肠鸣,在辰戌丑未时(早晨7-9点,晚上7-9点,凌晨1-3点,下午1-3点)较重;传变至肺,则咳嗽气逆胸膈胀满,背部酸痛恶寒,在午后较重;传变至心,则五心烦热,嘴唇鲜红口苦,在午时(中午11-13点)较重;传变至肾,则虫蚀脊髓,骨骼显露如柴,在阴分(夜间或阴盛之时)较重。这些都是邪火为害,耗伤精血,导致疾病的。如果到了年纪较大,情窦初开,损伤精血而成骨蒸者,这又是精枯受伤,导致成为骨蒸的病证。应当在精血根本处寻求治疗方法。
Pediatric Fei Gan (a syndrome of malnutrition in children due to improper diet), caused by excessive eating, combined with disharmony of cold and heat. Raw, cold, greasy, and oily foods damage the Spleen and Stomach, while sugar, wheat products, and fried or roasted foods assist internal fire. If neglected over time, accumulation gradually brews into Gan disease (pediatric malnutrition syndrome).
Symptoms include thirst with easy hunger, a good appetite but emaciation, upright hair, diarrhea, abdominal distension, and dry nose. If left untreated for a long time, it leads to weak Spleen and strong Liver. With the source of transformation (Spleen-Stomach metabolic origin) cut off, Kidney Yin naturally depletes, and Liver Wood loses nourishment. Liver Fire burns its own orifices, resulting in eye diseases (Gan eyes), often forming pterygium-like membranes, eyelids closing tightly, and discharge resembling paste. This is caused by weakness in the Middle Jiao preventing Clear Yang from ascending, and excess Liver Fire preventing Turbid Yin from descending. Treatment should raise the Clear and descend the Turbid. Use Baizhu (Atractylodis Macrocephalae Rhizoma) and Renshen (Ginseng Radix et Rhizoma) to first tonify the Spleen and Stomach as Sovereign herbs; Chaihu (Bupleuri Radix) and Zhike (Aurantii Fructus Immaturus) to soothe the Liver and regulate Qi as Minister herbs; Cangzhu (Atractylodis Rhizoma) and Fuling (Poria) and Zexie (Alismatis Rhizoma) to leach out dampness and descend turbidity as Assistant herbs; Qianghuo (Notopterygii Rhizoma et Radix), Manjingzi (Viticis Semen), Shengma (Cimicifugae Rhizoma), Chuanxiong (Ligustici Chuanxiong Rhizoma), and Bohe (Menthae Haplocalycis Herba), various wind-dispelling herbs, which both disperse wind-fire and utilize their ascending nature as Envoy herbs. In this way, both Gan disease and eye ailments will achieve efficacy.
Ba disease (also known as Ai Ru disease) occurs when a child approaching one year of age drinks the mother's "Ba milk" (lactation during pregnancy) after the mother becomes pregnant again, leading to this condition. Alternatively, if the mother suffers from other illnesses and the child drinks her milk, the child may contract symptoms similar to the mother's illness. Generally, if the mother's blood and Qi are harmonious, the milk nourishes; if the mother's spirit, blood, and Qi are diseased, the milk generates other diseases. When pregnant, the essence descends to nourish the fetus; Qi stagnates and transforms into heat, while Blood stasis transforms into evil. The child's divine Qi is not yet complete and is easily affected. Symptoms include alternating chills and fever, mild diarrhea, dry hair, distinct unhappiness, sallow complexion, abdominal distension with visible blue veins, green diarrhea with frequent vomiting, progressive emaciation, refusal of milk and food, eventually resembling Gan syndrome. Another view suggests that conception conditions—such as extreme excess or deficiency, irregular eating, labor, extreme heat or cold, wind, rain, thunder, lightning, or imbalance of Yin and Yang, or violating taboos—can also cause this. This condition is colloquially called "Tai Du" (Fetal Jealousy), believing that the fetus in the womb, jealous of the child drinking milk, causes the illness through its soul/spirit recognition.
Gu Zheng (bone-steaming fever) usually originates from the Foot-Yangming Stomach Meridian. Initially, fire rushes upward allowing eating, and fire consumes causing hunger. Since the Stomach is the sea of Qi and Blood, insufficient Qi and Blood allow pathogenic fire to digest food rapidly without absorption. Water and grain essences fail to replenish, gradually leading to foul breath, irritability, night fever and morning coolness, scorched hair and thirst, shortness of breath, and night sweats. The body becomes emaciated like a standing crane, termed Xiao Dan (wasting-thirst). If there are more than ten bowel movements daily, thin limbs and large abdomen, frequent eating but constant hunger, it is called Shi Bing (food accumulation). If treatment remains unadjusted, pathogenic fire persists, transmitting and affecting each other, consuming essence and nourishment, distressing the Five Zang organs. Transmission to the Liver causes anger and fear, cheek pain, and tendon spasms, worsening at Mao-You hours (5-7 AM, 5-7 PM). Transmission to the Spleen causes mental fatigue, muscle swelling, cold feet, and borborygmus, worsening at Chen-Xu-Chou-Wei hours (7-9 AM, 7-9 PM, 1-3 AM, 1-3 PM). Transmission to the Lung causes cough, reverse Qi, chest fullness, back soreness, and aversion to cold, worsening in the afternoon. Transmission to the Heart causes five-palm burning, bright red lips, and bitter taste, worsening at Wu hour (11 AM-1 PM). Transmission to the Kidney causes worms eating the spinal marrow, exposed skeletal structure, worsening during Yin phases (night or Yin-dominant times). All these are harms of pathogenic fire consuming essence and blood. For older children whose emotional desires open and damage essence and blood, resulting in Gu Zheng, this is due to essence depletion and injury. One must seek the root in essence and blood.