(即虚羸之异名也)
〔汤〕小儿鹤节,由禀赋不足,血气不荣,肌肉瘦瘠,则骨节皆露,如鹤之足,皆肾虚不生骨髓之
故。治法宜钱氏地黄丸加鹿茸、牛膝。
〔汤〕消食丸 治宿食不消。又名消乳丸。
砂仁 陈皮(炒) 三棱(炒) 神曲(炒) 麦芽(炒。各半两) 香附(炒。一两)
上末,曲糊丸如麻子大。食后白汤送下,大小加减。
七圣丸
三棱 蓬术 川楝 青皮 陈皮 芫花 杏仁
上件等分,先用醋浸芫花一宿,炒渐干,次入蓬、棱同炒赤色。又入陈、楝等再同炒一处,令微焦,
取出为末。前药如各半两,杏仁亦用半两,汤浸去皮尖,双仁不用,细研,入巴豆二十粒,去油,和匀,
醋糊丸如黍米大。一岁儿常服二丸,临卧温热汤送下,使日间所飧之物,一夜而化,永无疳疾,能使黄瘦
子顿作化生儿。今之小儿可去巴豆,只入杏仁,名七圣丸是也。
〔洁〕枳术丸(方见内伤饮食。)饮食不进,四君子加姜、枣煎。枳实理中丸(方见伤寒。)
〔汤〕痞者,塞也,其病腹内气结,胀满壮热是也。当疏利大便,破结散气,常服进食丸。
〔《圣》〕甘遂散 治小儿痞结,虽服汤药暂利,而滞实不去,心下坚胀,按之辄啼,内有伏热。破结。
甘遂(煨赤) 青皮 黄芩 大黄(炒。各半两)
上 咀,煎,去渣服,量大小加减,以利则止,用之无不效。
〔汤〕户部张侍郎小娘子,患此蕴积结聚已经年矣。其候腹满壮热,大小便闭,不食,诸医皆作虚热潮热,
或作胃寒不食治。然既不食,大小便自然少,又欲作疳热治。百药俱试,而无一中,势已窘迫,招予视之。
问曰∶合服何药?答曰∶当服甘遂、大黄。张惊骇曰∶前诸医者皆用补剂,此女不进食久矣,不宜利动肠胃。
予答曰∶信我者生,逆我者死。张曰∶更有无甘遂而次于此药方者可否?予令即服大承气汤,二服而愈。次
日诊之,尚有余滞积实,其症必过数日而复闭。须服前药,始可除根。数日后果再闭腹满痞结,再投此药,
一服而痊。
〔钱〕小儿急欲乳,不能食,由客风热入儿脐,流入心脾经,即舌浓唇燥,口不能吮乳,当凉心脾。
(这是虚羸病的另一种名称)
〔汤〕小儿鹤节病,是由于先天禀赋不足,导致血气不能滋养身体,肌肉消瘦瘦弱,使得骨节全部显露出来,形状像鹤的脚一样,这都是因为肾虚无法生成骨髓的缘故。治疗方法适宜使用钱乙的地黄丸,加入鹿茸、牛膝。
〔汤〕消食丸,用于治疗宿食不消化。又名消乳丸。
砂仁、陈皮(炒制)、三棱(炒制)、神曲(炒制)、麦芽(炒制,各半两)、香附(炒制,一两)。
以上药物研成细末,用曲糊制作成如麻子大小的丸剂。饭后用白开水送服,根据患者年龄大小调整剂量。
七圣丸
三棱、蓬术、川楝子、青皮、陈皮、芫花、杏仁。
以上药物分量相等,先用醋浸泡芫花一夜,炒至渐干,然后加入蓬术、三棱同炒至赤色。再加入陈皮、川楝子等一同炒,使其微焦,取出研成细末。前面的药物如果各用半两,杏仁也用半两,用水浸泡后去皮尖,双仁者不用,细细研磨,加入巴豆二十粒,去油,混合均匀,用醋糊制成如黍米大小的丸剂。一岁的幼儿常服用二丸,临睡前用温热的汤水送下,使白天所吃的食物在一夜之间消化,永远没有疳疾,能使面色萎黄的瘦弱孩子立刻变成健康的孩子。现在的小儿方可以去掉巴豆,只加入杏仁,这就是所谓的七圣丸。
〔张洁古〕枳术丸(方剂见内伤饮食篇)。饮食不进,可用四君子汤加入生姜、大枣煎服。枳实理中丸(方剂见伤寒篇)。
〔汤〕痞证,就是阻塞的意思,其病症是腹内气机结聚,出现胀满和壮热。应当疏通利导大便,破除结聚、疏散气机,平时可服用进食丸。
〔《太平圣惠方》〕甘遂散,治疗小儿痞结,虽然服用汤药暂时通畅,但积滞实证仍未去除,心下坚硬胀满,按压时患儿就啼哭,体内有伏热。具有破结功效。
甘遂(煨至赤色)、青皮、黄芩、大黄(炒制,各半两)。
以上药物切碎,煎煮,去渣服用,根据患者年龄大小调整剂量,以大便通畅为度,使用此方无不有效。
〔汤〕户部张侍郎的小女儿,患有这种蕴积结聚的病已经一年了。其症状表现为腹部胀满、壮热、大小便闭塞、不能进食,各位医生都将其当作虚热或潮热治疗,或者当作胃寒不食来治疗。然而,既然不能进食,大小便自然减少,又想当作疳热来治疗。各种药物都试过了,但没有一种对症,病情已经十分窘迫,于是邀请我诊治。
我问:“应该服用什么药?”回答说:“应当服用甘遂、大黄。”张侍郎惊恐地说:“之前的各位医生都用补剂,这个女孩很久没吃东西了,不宜使用通利肠胃的药物。”
我回答说:“信任我的能活,违背我的会死。”张侍郎说:“有没有比甘遂次一等且不含甘遂的药方可以吗?”我让他立即服用大承气汤,服用两次后痊愈。第二天诊脉,发现还有余留的积滞结实,其症状必然在几天后会再次闭塞。必须服用之前的药物,才能除根。几天后果然再次出现腹部闭塞胀满痞结,再次投以此药,服用一次就痊愈了。
〔钱乙〕小儿急切想吃奶,但不能吃,这是由于客风热邪侵入婴儿脐部,流入心脾经,导致舌苔厚腻、嘴唇干燥,口不能吮吸乳汁,应当清凉心脾。
(This is another name for Xu Lei disease, characterized by deficiency and emaciation.)
[Tang] Xiao'er Hejie (Crane Joint Disease in Children) arises from congenital insufficiency, where Blood and Qi fail to nourish the body. The muscles become thin and emaciated, causing all bone joints to protrude, resembling the legs of a crane. This is due to Kidney Deficiency failing to generate Marrow. The treatment method should utilize Qian's Dihuang Wan (Rehmannia Pill), added with Lurong (Deer Antler) and Niuxi (Achyranthes Root).
[Tang] Xiaoshi Wan (Digestion-Resolving Pill) treats undigested retained food. It is also known as Xiaoru Wan (Milk-Digesting Pill).
Sharen (Amomum Fruit), Chenpi (Citrus Peel, stir-fried), Sanleng (Sparganium Rhizome, stir-fried), Shenqu (Medicated Leaven, stir-fried), Maiya (Barley Sprout, stir-fried; each half liang), Xiangfu (Cyperus Rhizome, stir-fried; one liang).
Grind the above into powder, form pills using malt paste, sized like hemp seeds. Administer after meals with warm water, adjusting dosage according to age and size.
Qisheng Wan (Seven Sages Pill)
Sanleng (Sparganium Rhizome), Pengzhu (Curcuma Rhizome), Chuanlian (Fructus Toosendan), Qingpi (Young Citrus Peel), Chenpi (Citrus Peel), Yuanhua (Genkwa Flower), Xingren (Apricot Seed).
Take equal parts of the above ingredients. First, soak Yuanhua in vinegar overnight, then stir-fry until gradually dry. Next, add Pengzhu and Sanleng, stir-frying together until reddish. Then add Chenpi and Chuanlian, stir-frying together until slightly scorched. Remove and grind into powder. If the previous herbs are used at half liang each, use half liang of Xingren as well. Soak Xingren in water, remove skin and tips, discard those with two kernels, grind finely, add 20 Baiduo (Croton Seed) kernels (oil removed), mix evenly, and form pills using vinegar paste, sized like millet grains. One-year-old infants commonly take two pills, administered with warm liquid before sleep, so that food consumed during the day is digested overnight, preventing Gan disease (infantile malnutrition) permanently, transforming sallow, emaciated children into healthy ones. Currently, for pediatric use, Baiduo may be omitted, retaining only Xingren; this is called Qisheng Wan.
[Zhang Jiegu] Zhizhu Wan (Formula see Internal Injury Diet section). For loss of appetite, decoct Sizijunzi Tang (Four Gentlemen Decoction) with Shengjiang (Fresh Ginger) and Dazao (Jujube). Zhishi Lizhong Wan (Immature Bitter Orange and Atractylodes Macrocephala Regulating Middle Pill) (Formula see Cold Damage section).
[Tang] Pi Syndrome refers to obstruction. Its pathology involves Qi knotting internally in the abdomen, presenting with distension, fullness, and severe fever. One should unblock and purge the bowels, break up accumulations, and dissipate Qi. Changfu Jinshi Wan (Regularly Take Food Advancing Pill) can be taken regularly.
[Shengji Fang] Gansui San (Kansui Powder) treats pediatric Pi Jie (Pi Knots). Although decoctions provide temporary relief, the stagnant excess pathogen remains. There is hardness and distension below the heart, and crying upon palpation, indicating latent heat within. It has the effect of breaking up knots.
Gansui (baked until red), Qingpi (Young Citrus Peel), Huangqin (Scutellaria Root), Dahuang (Rhubarb Root, stir-fried; each half liang).
Cut the above ingredients, decoct, strain, and administer. Adjust dosage according to age/size. Stop when bowel movement is achieved. This formula is invariably effective.
[Tang] The daughter of Vice Minister Zhang of the Ministry of Revenue suffered from accumulated stagnation and knotting for over a year. Her symptoms included abdominal fullness, severe fever, closure of both large and small intestines (constipation and urinary retention), and inability to eat. All physicians treated it as deficiency heat or tidal fever, or as stomach cold causing anorexia. However, since she could not eat, her bowel and bladder movements were naturally reduced, leading some to treat it as Gan heat. Various medicines were tried without success, and her condition became critical. She invited me to examine her.
I asked, "What medicine should she take?" I answered, "She should take Gansui and Dahuang." Vice Minister Zhang was horrified, saying, "All previous physicians used tonifying agents. This girl has not eaten for a long time; it is inappropriate to use purgatives to disturb the intestines and stomach."
I replied, "Those who trust me will live; those who oppose me will die." Vice Minister Zhang asked, "Is there a formula inferior to Gansui but still effective?" I instructed him to immediately administer Dachengqi Tang (Major Order the Qi Decoction). After two doses, she recovered. On the following day, upon pulse diagnosis, residual stagnation and solid accumulation remained. The symptoms would inevitably recur with closure after several days. Only by taking the previous [Gansui/Dahuang] medicine could the root cause be eliminated. Several days later, indeed, abdominal closure, fullness, and Pi knotting recurred. Upon administering this medicine again, she recovered after one dose.
[Qian Yi] When an infant urgently desires milk but cannot suckle, it is due to exogenous Wind-Heat invading the umbilicus and flowing into the Heart and Spleen meridians. This presents with thick tongue coating and dry lips, making sucking impossible. The treatment should cool the Heart and Spleen.