虚热病后荣卫弱,神倦气乏用补中,呕渴竹叶石膏治,面赤尿白厥自通。
[注]
虚热者,因小儿病后气血虚弱,荣卫尚未调匀之故,
其证神倦气乏,宜用补中益气汤治之,
若兼口渴引饮而呕者,宜用竹叶石膏汤治之,
又有阴盛格阳,外浮发热者,其面色虽赤,
然小便必清白,四肢必厥逆,宜用白通汤收敛阳气,热退自愈。
(补中益气汤) 方见飧泄。
(竹叶石膏汤) 竹叶 石膏煆 人参 麦冬去心 甘草生 半夏姜制 粳米
引用生姜水煎服
(方歌)
病后虚弱烦渴呕,皆因气弱胃津亡,竹叶石膏参麦草,半夏粳米共生姜。
(白通汤) 干姜 附子制 葱 水煎服。
(方歌)虚热原于阴格阳,真寒假热白通汤,散寒姜附葱白茎,厥回热退自然康。
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发热门
实热积热午潮热,腹胀尿红大便难,烦渴口疮腮颊赤,凉膈大柴效通仙。
[注]
小儿有余积热,以致午后潮热,蒸蒸有汗,肚腹胀满小便赤,大便难,
烦渴啼叫,口舌生疮,腮颊红赤,脉洪数有力,
法宜清热通利,时时热者,凉膈散主之,
午后潮热者,大柴胡汤主之。
(凉膈散)方见急惊风
(大柴胡汤)方见伤寒
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小儿养生食与乳,撙节失宜积滞成,停乳伤食宜分晰,因证调治保安宁。
[注]
夫乳与食,小儿资以养生者也,胃主纳受,脾主运化,乳贵有时,
食贵有节,可免积滞之患,
若父母过爱,乳食无度,则宿滞不消而病成矣,
医者当别其停乳伤食之异,临证斟酌而施治焉。
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积滞门
乳滞
婴儿乳滞睡不安,多啼口热吐惊烦,肚胀腹热便酸臭,慎攻宜用消乳丸。
[注]
乳滞之儿,其候睡卧不宁,不时啼叫,口中气热,频吐乳片,
肚腹胀热,大便酸臭也,但脏腑娇嫩,不可过攻,
惟宜调和脾胃为上,以消乳丸消导之。
(消乳丸) 方见伤乳吐。
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积滞门
虚热:疾病痊愈后,营卫之气虚弱,出现精神疲倦、气力不足的症状,应当使用补中益气汤进行调理。如果伴有呕吐、口渴的症状,则使用竹叶石膏汤治疗;若见面色发红、小便清长、四肢厥冷且自然通畅的情况,说明是阴寒内盛格拒阳气于外导致的假热,此时应使用白通汤收敛浮越的阳气,待热退后身体自然康复。
[注]
所谓虚热,是因为小儿在病后气血虚弱,营卫之气尚未调和均匀的缘故。
其症状表现为精神疲倦、气力匮乏,适宜使用补中益气汤治疗。
如果兼有口渴想喝水并且伴有呕吐的情况,适宜使用竹叶石膏汤治疗。
还有一种情况是阴寒过盛格拒阳气,导致阳气外浮而发热,虽然面色发红,
但是小便必定清亮白色,四肢必定出现厥逆(寒冷),适宜使用白通汤来收敛阳气,热退后自愈。
(补中益气汤) 方剂见飧泄篇。
(竹叶石膏汤) 组成:竹叶、煅石膏、人参、去心麦冬、生甘草、姜制半夏、粳米。
引用生姜水煎服。
(方歌)
病后虚弱烦渴呕,皆因气弱胃津亡,竹叶石膏参麦草,半夏粳米共生姜。
(白通汤) 组成:干姜、制附子、葱白。水煎服。
(方歌) 虚热原于阴格阳,真寒假热白通汤,散寒姜附葱白茎,厥回热退自然康。
发热门
实热:积滞产生的实热表现为午后潮热,腹部胀满,小便红赤,大便困难,烦躁口渴,口舌生疮,腮颊发红,使用凉膈散或大柴胡汤效果显著,如同神仙般灵验。
[注]
小儿体内有余留的积热,导致午后出现如潮水般定时发作的热象,身体蒸蒸发热并有汗出,肚腹胀满,小便颜色深赤,大便排泄困难,
烦躁口渴、啼哭叫喊,口舌生出疮疡,腮颊部位红赤,脉象洪大而数且有力,
治法应当清热并通利二便,如果是时时发热者,主用凉膈散;
如果是午后潮热者,主用大柴胡汤。
(凉膈散) 方剂见急惊风篇。
(大柴胡汤) 方剂见伤寒篇。
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小儿养生要注意饮食与哺乳,如果节制失当就会形成积滞,需要区分是停乳还是伤食,根据具体证候调治以保平安。
[注]
乳汁和食物,是小儿赖以生存养生的物质基础,胃负责受纳,脾负责运化,哺乳贵在按时,
进食贵在有节制,这样可以避免积滞带来的病患。
如果父母过分溺爱,导致乳食无度,那么宿存的停滞之物无法消化而生病。
医生应当辨别是停乳还是伤食的不同,临证时斟酌情况施治。
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积滞门
乳滞:婴儿因乳汁停滞导致睡眠不安,经常啼哭,口中热气,呕吐物带有惊恐烦躁之象,肚子胀、腹部热,大便酸臭,谨慎使用攻下法,适宜使用消乳丸。
[注]
乳汁停滞的婴儿,其表现是睡卧不宁静,不时啼叫,口中气息热,频繁吐出乳片,
肚腹胀热,大便气味酸臭。但脏腑娇嫩,不可过度攻伐,
只宜调和脾胃为上策,使用消乳丸进行消导治疗。
(消乳丸) 方剂见伤乳吐篇。
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积滞门
Xu Re (Deficient Heat): After the recovery from illness, when Ying and Wei (Nutritive and Defensive Qi) are weak, manifesting as mental fatigue and lack of energy, Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) should be used. If accompanied by vomiting and thirst, Zhu Ye Shi Gao Tang (Bamboo Leaf and Gypsum Decoction) is indicated. In cases where the face is red, urine is clear, and limbs are cold yet naturally unobstructed, it indicates false heat caused by Yin excess repelling Yang to the exterior; Bai Tong Tang (White Connecting Decoction) should be used to consolidate floating Yang, after which the heat will subside and health will return naturally.
[Note]
Xu Re (Deficient Heat) occurs due to deficiency of Qi and Blood after illness in children, where Ying and Wei (Nutritive and Defensive Qi) have not yet harmonized.
The symptoms include mental fatigue and lack of energy, for which Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) is appropriate.
If accompanied by excessive thirst with drinking and vomiting, Zhu Ye Shi Gao Tang (Bamboo Leaf and Gypsum Decoction) is appropriate.
Another scenario involves Yin excess repelling Yang, causing Yang to float outward and generate heat; although the complexion may be red,
the urine must be clear and white, and the limbs must be cold (Jue Ni), for which Bai Tong Tang (White Connecting Decoction) is used to consolidate Yang, leading to natural recovery as the heat subsides.
(Bu Zhong Yi Qi Tang) Formula see section on Sundry Diarrhea.
(Zhu Ye Shi Gao Tang) Ingredients: Zhu Ye (Bamboo Leaf), Shi Gao Calcined (Calcined Gypsum), Ren Shen (Ginseng Root), Mai Dong (Ophiopogon Tuber), Gan Cao Raw (Licorice Root), Ban Xia Ginger-processed (Pinellia Rhizome), Jing Mi (Rice).
Decoct with Sheng Jiang (Fresh Ginger) and water.
(Formula Song)
Post-illness weakness, vexation, thirst, and vomiting, all stem from weak Qi and loss of Stomach fluids; Bamboo leaf, gypsum, ginseng, licorice, ophiopogon, pinellia, rice, and fresh ginger together.
(Bai Tong Tang) Ingredients: Gan Jiang (Dried Ginger), Fu Zi Processed (Prepared Aconite Root), Cong Bai (Scallion White). Decoct with water.
(Formula Song) Xu Re originates from Yin repelling Yang, true cold and false heat treated with Bai Tong Tang; Dispel cold with ginger, aconite, and scallion stalks, when Jue returns and heat retreats, health naturally restores.
Fa Re Men (Fever Chapter)
Shi Re (Excess Heat): Accumulated excess heat manifests as tidal fever in the afternoon, abdominal distension, reddish urine, and difficult defecation, along with vexation, thirst, mouth sores, and red cheeks. Liang Ge San (Cool the Diaphragm Powder) or Da Chai Hu Tang (Major Bupleurum Decoction) yield effective results, akin to divine efficacy.
[Note]
Children with residual accumulated excess heat may experience tidal fever in the afternoon, steaming heat with sweating, abdominal fullness, dark red urine, and difficult stool.
They may exhibit vexation, thirst, crying, mouth and tongue ulcers, red cheeks, and a洪 (Surging) and Shuo (Rapid) pulse that is forceful.
The treatment principle is to clear heat and promote free flow; for constant fever, Liang Ge San (Cool the Diaphragm Powder) is the primary formula.
For tidal fever in the afternoon, Da Chai Hu Tang (Major Bupleurum Decoction) is the primary formula.
(Liang Ge San) Formula see section on Acute Convulsive Wind.
(Da Chai Hu Tang) Formula see section on Cold Damage.
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Pediatric health preservation requires attention to diet and breastfeeding; improper regulation leads to accumulation and stagnation. One must distinguish between milk retention and food injury, treating according to the specific syndrome to ensure peace and safety.
[Note]
Milk and food are the substances that sustain pediatric life. The Stomach governs reception, and the Spleen governs transformation and transportation. Breastfeeding should be timed appropriately,
and eating should be moderate, to avoid the hazards of accumulation and stagnation.
If parents overindulge their affection, leading to unregulated intake of milk and food, retained stagnation fails to digest and disease arises.
Physicians must differentiate between milk retention and food injury, exercising judgment in clinical practice to administer treatment.
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Ji Zhi Men (Accumulation and Stagnation Chapter)
Ru Zhi (Milk Stagnation): Infants with milk stagnation suffer from restless sleep, frequent crying, hot breath, vomiting with signs of fright and vexation, abdominal distension, abdominal heat, and sour-smelling stools. Aggressive purgation should be avoided; Xiao Ru Wan (Milk-Dissolving Pill) is appropriate.
[Note]
Infants with milk stagnation present with restless sleep, intermittent crying, hot breath, frequent regurgitation of undigested milk curds,
abdominal distension and heat, and sour-smelling stools. However, since the Zang-Fu organs are delicate, aggressive purgation must not be used excessively.
The best approach is to harmonize the Spleen and Stomach, using Xiao Ru Wan (Milk-Dissolving Pill) for digestion and guidance.
(Xiao Ru Wan) Formula see section on Milk-Injury Vomiting.
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Ji Zhi Men (Accumulation and Stagnation Chapter)