小儿之体最嫩,服药分两较大人当用药一钱者,只可二三分,以次加减。如药味过大,
树皮草根,船小何能重载?反损真气。至老人与体虚者,纵药可合机,亦宜小其剂数。以其
气质本衰,无能抵御药力,宣达脏腑,充贯脉络,易使气壅胸塞,呕恶神伤,未收本病之效,
先发变端。合机之药尚如此,不合病之大剂,其不至误人,果谁信哉?故分两不可不慎。且
古之一两,乃今时七分六厘,简编久载。古人禀赋强实,每用一药,不过数分,每服一方尚
分数次,而今运会日下,人身较于古时倍见孱弱,无如医者漫喜大剂浪投,不辨症之虚实,
不究分两之重轻。任情率意,恬不自悔,病家昧于不知,罹其夭札者,不一而足,何啻暗中
以刃杀人?惜未经人发明者,良足致慨,倘病阴寒,非大温剂,不足以回其阳。大时热,非大
凉药,不足以救其阴。骤脱症,非重用参 ,不足以接其元阳。与夫壮实之辈,非轻剂所能胜
其病,又非可一例论也。
龟背症起于小儿,筋骨脆弱,加以先天不足,或病后失调,或跌伤碰损,大人肾虚腰痛,
每成此症。由脊骨第一节数至第十四节下,两傍各一寸五分为肾俞穴,入之两腰,乃肾经发
源,即在此一点,先天生命所系,阴阳之变化出焉。今十四节椎骨肿凸如梅,痛连肾俞,使
腰屈而不能直,久则肿大,伛偻不治。乘初起用长尺许宽五寸布膏药,再掺观音救苦膏末
药(方见《青囊集》)于上,外贴肿处连两腰眼,半月一换,内服方看体质虚实,轻者半年,重者
一载屡效。此法亦可治鸡胸痰。
小儿的体质最为娇嫩,服药的分量比成人应当使用一钱的药量相比,只能使用二三分,并在此基础上逐渐增减。如果药味过重,就像小船承载不了重载一样,反而损伤真气。至于老人和体质虚弱的人,即使药物对症,也应当减小剂量。因为他们的体质本来衰弱,无法抵御药力,使药气宣达脏腑、充贯脉络,容易导致气机壅滞、胸膈痞塞、呕吐恶心、精神受损,还没收到治疗本病的疗效,就先引发了变证。对症的药物尚且如此,不对症的大剂量用药,如果不误人,谁会相信呢?所以药量的分量不可不谨慎。况且古代的一两,相当于现在的七分六厘,这在古籍中早有记载。古人禀赋强实,每用一味药,不过数分,每次服用一方剂还要分几次服下;而当今世运日下,人体较之古时更加孱弱,无奈医生们却喜欢盲目投以大剂量,不辨别病症的虚实,不考究分量的轻重。任性随意,恬不知悔,病人家属愚昧无知,遭受夭折或重病伤害的,不计其数,这何止是暗中用刀杀人?可惜这一观点未曾被人阐明,实在令人感慨。如果是阴寒病症,非大温热的药剂不足以回阳;如果是大热病症,非大寒凉的药剂不足以救阴;如果是骤然脱证,非重用参类药材不足以接续元阳。以及那些身体壮实的人,非轻剂所能胜任其病,这些又不可以一概而论。
龟背症起于小儿,筋骨脆弱,加上先天不足,或者病后调养不当,或者跌打损伤碰伤,大人肾虚腰痛,也容易形成此症。从脊骨第一节数到第十四节下方,两旁各一寸五分处为肾俞穴,深入两腰,这是肾经的发源之处,即在此关键点,先天生命所系,阴阳的变化由此产生。如今十四节椎骨肿凸如梅子状,疼痛牵连肾俞,使得腰部弯曲而不能挺直,时间久了则肿大,驼背畸形难以治愈。趁着初起时用长约一尺、宽五寸的布制膏药,再掺入观音救苦膏的药末(方剂见《青囊集》)在上面,外贴于肿胀处连同两腰眼,半个月更换一次,内服方剂需根据体质虚实而定,轻者半年,重者一年,屡见疗效。此法也可以治疗鸡胸痰。
The constitution of infants and children is the most tender; when prescribing, the dosage should be much smaller than that for adults. For instance, where an adult might take one qian (approx. 3.73g) of a herb, an infant should only take two or three fen (approx. 0.6-1.1g), with adjustments made gradually. If the dosage is too heavy, it is like a small boat trying to carry a heavy load; it will instead damage the True Qi (Zhen Qi). As for the elderly and those with weak constitutions, even if the medication is appropriate to the syndrome, the dosage should still be reduced. This is because their inherent vitality is declining and they lack the capacity to withstand the medicinal force, allowing the medicine to circulate through the Zang-Fu organs and meridians without causing Qi stagnation in the chest, abdominal fullness, nausea, vomiting, and spiritual depletion. Before the intended therapeutic effect on the primary disease is achieved, adverse changes may arise. If even appropriate medications require such caution, who would believe that inappropriate large-dose prescriptions do not harm patients? Therefore, dosage must be handled with extreme care. Moreover, one tael (liang) in ancient times was equivalent to seven fen six li (approx. 28.4g) in modern times, a fact long recorded in texts. Ancients had strong constitutions; each herb used was merely a few fen, and each prescription was taken in divided doses over several servings. However, as the era declines, human bodies are significantly more frail than in ancient times. Regrettably, physicians often blindly administer large doses without distinguishing between deficiency and excess syndromes, nor considering the weight of the dosage. Acting arbitrarily and without remorse, while patients' families remain ignorant, many suffer premature death or severe illness. Is this not akin to killing people in the dark with a blade? It is lamentable that this point has not been sufficiently elucidated. Nevertheless, for Yin-Cold syndromes, only large warming formulas can restore Yang; for intense Heat syndromes, only large cooling herbs can save Yin; for sudden collapse syndromes, high doses of Ginseng (Renshen) are required to reconnect Yuan Yang. Conversely, robust individuals may not respond to light dosages. These exceptions cannot be generalized.
The "Turtle Back" deformity originates in childhood due to fragile bones and tendons, congenital insufficiency, improper post-illness care, or trauma from falls and impacts. In adults, Kidney Deficiency lower back pain can also lead to this condition. Counting from the first vertebra down to below the fourteenth, the Shenshu (BL-23) acupoints are located one cun five fen lateral to the spine, extending into the loins. This area is the source of the Kidney Meridian, the nexus of congenital life, and the origin of Yin-Yang transformations. Currently, the fourteen thoracic vertebrae become swollen and convex like plums, with pain radiating to Shenshu, causing the waist to bend and preventing straightening. Over time, swelling increases, leading to kyphosis that becomes incurable. During the early stages, apply a cloth plaster approximately one chi (approx. 33cm) long and five cun wide. Sprinkle the powder of Guanyin Jiuku Gao (Guanyin's Saving and Suffering Relieving Plaster, formula see *Qingnang Ji*) onto the plaster, and apply externally to the swollen area and both lumbar regions. Replace every half month. Internal herbal formulas should be selected based on constitutional deficiency or excess. Mild cases may take six months, severe cases one year, with frequent efficacy observed. This method can also treat pigeon chest phlegm.