小儿但见上窜及摇头切牙,即是心热,黄连、甘草。目连闪,肝热,柴胡、防风、
甘草。若左腮红,是肝风,与钱氏泻青丸。〔右〕腮红,肺热,与泻白散。额上红者,是心热,
与黄连一味。鼻上红,是脾热,与钱氏泻黄散。颏上红者,肾热,知母、黄柏皆二制,甘草炙。
凡〔治〕小儿病,药味与大人同,只剂料等差少。如见腮、目胞赤,〔呵〕
欠,嚏喷,惊悸,耳尖、手足梢冷,即是疮疹。三日后其证不减,亦不见疮苗,即以柴
胡、升麻、甘草,〔加〕生姜煎,慎不可投以寒凉利脏腑之剂,使疮不能出,其祸不
可〔测〕。
凡养小儿,酒肉油腻生硬冷物及生水等,不可食,自无〔疳〕癖二证、惊风搐者,
与破伤风同。
潮热者,黄连、黄芩、生甘草。辰戌时发,加羌活;午间发,黄连;未间发,石
膏;申时发,柴胡;酉时,升麻;夜间,当归根。若有寒者,加黄 、人参、白术。
咳嗽有声无痰者,生姜、杏仁、升麻、五味子、防风、桔梗、甘草。无声有痰者,
半夏、白术、五味子、防风、枳壳、甘草,冬月须加麻黄、陈皮少许。有声有痰者,白
术与半夏、五味子、防风。久不愈者,枳壳、阿胶。痰有五证,风、气、热、寒、温
也,详见《活法机要》中。
肝 虚以陈皮、生姜之类补之,经曰∶虚则补其母,水能生木,肾乃肝之母。肾,
水也,若补其肾,熟地黄、黄柏是也。如无他证,钱氏地黄丸主之。实则白芍药泻之,
如无他证,钱氏泻青丸主之。实则泻其子,心乃肝之子,以甘草泻心。
心 虚则炒盐补之,虚则补其母,木能生火,肝乃心之母。肝、木也;心、火也。
以生姜泻肝。如无他证,钱氏安神丸是也。实则甘草泻之,如无他证,以钱氏方中重则
泻心汤,轻则导赤散。
脾 虚则甘草、大枣之类补之,实则以枳壳泻之。如无他证,虚则以钱氏益黄散,
实则泻黄散。心乃脾之母,以炒盐补之;肺乃脾之子,以桑白皮泻肺。
肺 虚则五味子补之,实则桑白皮泻之。如无他证,实则用钱氏泻白散,虚则用阿
胶散。虚则以甘草补土,补其母也;实则泻子,泽泻泻其肾水。
肾 虚则熟地黄、黄柏补之,泻以泽泻之咸。肾本无实,本不可泻,钱氏止有补肾
地黄丸,无泻肾之药。肺乃肾之母,金生水,补之故也。补则以五味子。
以上五脏,《内经·藏气法时论》中备言之,欲究其详,精看本论。
小儿只要出现头向上仰、摇头和咬牙的症状,就是心热证,用黄连、甘草治疗。眼睛频繁眨动,是肝热证,用柴胡、防风、甘草治疗。如果左腮发红,是肝风证,给予钱乙的泻青丸。右腮发红,是肺热证,给予泻白散。额头发红,是心热证,单用一味黄连。鼻梁发红,是脾热证,给予钱乙的泻黄散。下巴发红,是肾热证,知母和黄柏都经过炮制,甘草用炙过的。
凡是治疗小儿疾病,药味与成人相同,只是剂量稍小一些。如见到面颊、眼睑发红,呵欠,打喷嚏,惊悸,耳尖和手脚末端发冷,这就是疮疹(天花或麻疹等出疹性疾病)。三天后症状不减,也没有看到皮疹苗头,就用柴胡、升麻、甘草,加生姜煎服,千万不可投用寒凉通利脏腑的药物,以免导致疹毒不能透发,其后果不堪设想。
凡是养育小儿,酒、肉、油腻、生冷坚硬食物以及生水等,都不可以吃,这样自然就不会患疳积、癖块两种病证,也不会发生惊风抽搐,这与破伤风的病因类似。
潮热者,用黄连、黄芩、生甘草。如果在辰时或戌时发作,加羌活;午间发作,用黄连;未时发作,用石膏;申时发作,用柴胡;酉时发作,用升麻;夜间发作,用当归根。如果有寒象,加黄芩、人参、白术。
咳嗽有声但无痰者,用生姜、杏仁、升麻、五味子、防风、桔梗、甘草。无声但有痰者,用半夏、白术、五味子、防风、枳壳、甘草,冬季须加少许麻黄、陈皮。有声且有痰者,用白术配半夏、五味子、防风。久治不愈者,加枳壳、阿胶。痰有五种证型:风痰、气痰、热痰、寒痰、湿痰,详见《活法机要》一书。
肝虚证,用陈皮、生姜之类补益,医经说:“虚则补其母”,水能生木,肾乃肝之母。肾属水,若补肾,用熟地黄、黄柏。如果没有其他兼证,以钱乙的地黄丸为主方。肝实证,用白芍药泻之,如果没有其他兼证,以钱乙的泻青丸为主方。实则泻其子,心乃肝之子,用甘草泻心火。
心虚证,用炒盐补益,虚则补其母,木能生火,肝乃心之母。肝属木,心属火。用生姜泻肝木。如果没有其他兼证,以钱乙的安神丸为主方。心实证,用甘草泻之,如果没有其他兼证,重证用钱乙方中的泻心汤,轻证用导赤散。
脾虚证,用甘草、大枣之类补益,实证用枳壳泻之。如果没有其他兼证,虚证用钱乙的益黄散,实证用泻黄散。心乃脾之母,用炒盐补心;肺乃脾之子,用桑白皮泻肺。
肺虚证,用五味子补益,实证用桑白皮泻之。如果没有其他兼证,实证用钱乙的泻白散,虚证用阿胶散。虚证时用甘草补土(脾),这是补其母的方法;实证时泻其子,用泽泻泻肾水。
肾虚证,用熟地黄、黄柏补益,泻法用泽泻的咸味。肾本无实证,本来不可泻,钱乙只有补肾的地黄丸,没有泻肾的药。肺乃肾之母,金生水,所以补肺即是补肾。补法用五味子。
以上五脏的补泻,《内经·藏气法时论》中已有详尽论述,想要探究详情,请精读该篇原文。
If a child exhibits upward tilting of the head, shaking of the head, and grinding of teeth, it indicates Heart Heat (Xin Re), treated with Huanglian (Coptidis Rhizoma) and Gancao (Glycyrrhizae Radix et Rhizoma). Frequent blinking of the eyes indicates Liver Heat (Gan Re), treated with Chaihu (Bupleuri Radix), Fangfeng (Saposhnikoviae Radix), and Gancao (Glycyrrhizae Radix et Rhizoma). If the left cheek is red, it indicates Liver Wind (Gan Feng), treated with Qian's Xieqing Wan (Drain the Green Pill by Qian Yi). If the right cheek is red, it indicates Lung Heat (Fei Re), treated with Xiebai San (Drain the White Powder). Redness on the forehead indicates Heart Heat (Xin Re), treated with a single herb of Huanglian (Coptidis Rhizoma). Redness on the nose indicates Spleen Heat (Pi Re), treated with Qian's Xiehuan San (Drain the Yellow Powder by Qian Yi). Redness on the chin indicates Kidney Heat (Shen Re), treated with processed Zhimu (Anemarrhenae Rhizoma) and Huangbai (Phellodendri Cortex), along with roasted Gancao (Glycyrrhizae Radix et Rhizoma).
In treating pediatric diseases, the herbal ingredients are the same as for adults, but the dosages are slightly reduced. For instance, if one observes redness in the cheeks and eyelids, yawning, sneezing, palpitations, coldness at the ear tips and extremities, this indicates Chuangzhen (exanthematous disease such as smallpox or measles). If after three days the symptoms persist without the appearance of rash buds, administer Chaihu (Bupleuri Radix), Shengma (Cimicifugae Rhizoma), and Gancao (Glycyrrhizae Radix et Rhizoma) decocted with Shengjiang (Zingiberis Rhizoma Recens). One must strictly avoid administering cold-natured purgatives that drain the zang-fu organs, as this may prevent the eruption of the rash, leading to unpredictable and disastrous consequences.
When raising children, alcohol, meat, greasy foods, raw/hard/cold items, and unboiled water should not be consumed. This prevents the onset of Ganji (infantile malnutrition) and Pikuai (abdominal masses), as well as Jingfeng (convulsive disorders), which share etiologies similar to Poshangfeng (tetanus).
For tidal fever, use Huanglian (Coptidis Rhizoma), Huangqin (Scutellariae Radix), and raw Gancao (Glycyrrhizae Radix et Rhizoma). If it occurs during Chen (7-9 AM) or Xu (7-9 PM) hours, add Qianghuo (Notopterygii Rhizoma et Radix); if during Wu (11 AM-1 PM), use Huanglian (Coptidis Rhizoma); if during Wei (1-3 PM), use Shigao (Gypsum Fibrosum); if during Shen (3-5 PM), use Chaihu (Bupleuri Radix); if during You (5-7 PM), use Shengma (Cimicifugae Rhizoma); if at night, use Danggui (Angelicae Sinensis Radix). If there are signs of cold, add Huangqin (Scutellariae Radix), Renshen (Ginseng Radix et Rhizoma), and Baizhu (Atractylodis Macrocephalae Rhizoma).
For cough with sound but no phlegm, use Shengjiang (Zingiberis Rhizoma Recens), Xingren (Armeniacae Semen Amarum), Shengma (Cimicifugae Rhizoma), Wubeizi (Schisandrae Fructus), Fangfeng (Saposhnikoviae Radix), Jiegeng (Platycodonis Radix), and Gancao (Glycyrrhizae Radix et Rhizoma). For cough with no sound but with phlegm, use Banxia (Pinelliae Rhizoma), Baizhu (Atractylodis Macrocephalae Rhizoma), Wubeizi (Schisandrae Fructus), Fangfeng (Saposhnikoviae Radix), Zhike (Aurantii Fructus Immaturus), and Gancao (Glycyrrhizae Radix et Rhizoma); in winter, add a small amount of Mahuang (Ephedrae Herba) and Chenpi (Citri Reticulatae Pericarpium). For cough with both sound and phlegm, use Baizhu (Atractylodis Macrocephalae Rhizoma) combined with Banxia (Pinelliae Rhizoma), Wubeizi (Schisandrae Fructus), and Fangfeng (Saposhnikoviae Radix). For chronic cases that do not resolve, add Zhike (Aurantii Fructus Immaturus) and Ejiao (Asini Corii Colla). There are five types of phlegm: Wind-phlegm, Qi-phlegm, Heat-phlegm, Cold-phlegm, and Damp-phlegm; see *Huofa Jiyao* for details.
For Liver Deficiency (Gan Xu), tonify with Chenpi (Citri Reticulatae Pericarpium) and Shengjiang (Zingiberis Rhizoma Recens). The classics state: "Tonify the mother when deficient." Water generates Wood, so the Kidney is the mother of the Liver. Since the Kidney belongs to Water, tonifying it involves using Shudihuang (Rehmanniae Radix Preparata) and Huangbai (Phellodendri Cortex). If there are no other syndromes, Qian's Dihuang Wan (Rehmannia Pill) is the primary formula. For Liver Excess (Gan Shi), drain with Shaoyao (Paeoniae Radix Alba). If there are no other syndromes, Qian's Xieqing Wan (Drain the Green Pill) is the primary formula. "Drain the son when excessive"; the Heart is the son of the Liver, so drain the Heart with Gancao (Glycyrrhizae Radix et Rhizoma).
For Heart Deficiency (Xin Xu), tonify with roasted salt. "Tonify the mother when deficient"; Wood generates Fire, so the Liver is the mother of the Heart. The Liver belongs to Wood; the Heart belongs to Fire. Drain the Liver with Shengjiang (Zingiberis Rhizoma Recens). If there are no other syndromes, Qian's Anshen Wan (Calming Spirit Pill) is the primary formula. For Heart Excess (Xin Shi), drain with Gancao (Glycyrrhizae Radix et Rhizoma). If there are no other syndromes, for severe cases use Xixin Tang (Drain the Heart Decoction) from Qian's formulas, and for mild cases use Daochi San (Guide Out the Red Powder).
For Spleen Deficiency (Pi Xu), tonify with Gancao (Glycyrrhizae Radix et Rhizoma) and Dazao (Jujubae Fructus); for excess, drain with Zhike (Aurantii Fructus Immaturus). If there are no other syndromes, for deficiency use Yihuang San (Benefit the Yellow Powder) by Qian, and for excess use Xiehuan San (Drain the Yellow Powder). The Heart is the mother of the Spleen, tonify it with roasted salt; the Lung is the son of the Spleen, drain it with Sangbaipi (Mori Cortex).
For Lung Deficiency (Fei Xu), tonify with Wubeizi (Schisandrae Fructus); for excess, drain with Sangbaipi (Mori Cortex). If there are no other syndromes, for excess use Xiebai San (Drain the White Powder) by Qian, and for deficiency use Ejiao San (Donkey-hide Gelatin Powder). For deficiency, tonify Earth (Spleen) with Gancao (Glycyrrhizae Radix et Rhizoma), which is tonifying the mother; for excess, drain the son by draining Kidney Water with Zexie (Alismatis Rhizoma).
For Kidney Deficiency (Shen Xu), tonify with Shudihuang (Rehmanniae Radix Preparata) and Huangbai (Phellodendri Cortex); drain using the salty nature of Zexie (Alismatis Rhizoma). The Kidney fundamentally has no excess patterns and should not be drained; Qian only provided Dihuang Wan (Rehmannia Pill) for tonifying the Kidney, with no herbs for draining it. The Lung is the mother of the Kidney; Metal generates Water, so tonifying the Lung serves to tonify the Kidney. The method for tonification is using Wubeizi (Schisandrae Fructus).
The above methods for tonifying and draining the Five Zang organs are fully discussed in the *Neijing* chapter "Zangqi Fashi Lun" (Treatise on the Laws of Time for Organ Qi). To investigate in detail, carefully study the original text of that chapter.