论曰肾者、胃之关。开窍于二阴,水谷入胃。输于下焦。机关在肾,小儿脾肾禀受不足
者,关闭不利,水液不能下输,致水聚于胃而生诸病,土不胜水,水液妄行。乘于肌肉,流
溢皮肤,故为肿满,然有水肿,有风肿,皮薄如熟李者,水肿也,虚肿如吹者风肿也,治各
有法,宜根据证调之。
治小儿水肿腹大,诸疗不瘥。泽漆丸方
泽漆叶 葶苈(纸上炒各半两) 甘遂(炒) 黄芩(去黑心) 郁李仁(汤浸去皮尖
炒研)
芍药 猪苓(去黑皮) 杏仁(汤浸去皮尖双仁炒研) 车前子(各三分) 鳖甲(去裙
醋炙)
柴胡(去苗各半两)
上一十一味,捣研为末。炼蜜和捣三五百杵,丸如绿豆大,五六岁儿,每服五丸,温水
下,更看儿大小增减。
治小儿肿满结实,诸治不瘥。甘遂丸方
甘遂(炒) 葶苈(纸上炒) 车前子 猪苓(去黑皮) 杏仁(汤浸去皮尖双仁炒研)
芍药
(各三分) 泽漆叶 黄芩(去黑心) 鳖甲(去(裙 醋炙各半两)
上九味,捣研为末,炼蜜和丸。如绿豆大,五六岁儿每服五丸,竹叶汤下,以利为度,
更量儿大小增减。
治小儿肿满。构皮汤方
构木白皮(切五合即楮也) 赤小豆(四合) 赤茯苓(去黑皮一两半)
上三味, 咀如麻豆大,五六岁儿每服一钱匕,水七分,煎至四分,去滓温服,日再
,更量儿大小增减。
治小儿通体肿满,腹胀气喘。郁李仁汤方
郁李仁(汤浸去皮尖炒捣研) 大黄(煨锉) 柴胡(去苗各一两半) 芍药 猪苓(去
黑心) 泽泻(各一两) 赤茯苓(去黑皮) 黄芩(去黑皮各一两一分) 麻黄(去根节
一分) 升麻
杏仁(汤浸去皮尖双仁炒研) 鳖甲(去裙 醋炙各三分)
上一十二味,粗捣筛。五六岁儿每用二钱匕,水一盏,煎至五分,去滓分温二服,日再
,以利为度,更量儿大小增减。
治小儿水气肿满。猪苓汤方
猪苓(去黑皮) 海蛤 防己 白术 葶苈子(纸上炒) 朴硝(各一分) 桑根白皮
(锉)
赤茯苓(去黑皮各半两)
上八味,粗捣筛。五六岁儿每服一钱匕,水七分,煎至四分,去滓温服,日再,以瘥为
度,更量儿大小增减。
治小儿水气。甘遂散方
甘遂(炒) 大黄(锉炒) 牵牛子(炒各三分) 葶苈(纸上炒一分) 槟榔(煨锉
半两)
上五味,捣罗为散。每服一字匕,熟水调下。以利为度,更量儿大小增减。
治小儿肿满,服药不退。葶苈煎方
葶苈(纸上炒三分) 防己(一两半) 泽漆叶 郁李仁(去皮尖炒各一两一分) 赤
茯苓(
去黑皮) 泽泻 杏仁(汤浸去皮尖双仁炒研如膏各三两) 柴胡(去苗二两)
上八味,将七味粗捣筛。以水一斗,煎至二升半,去滓入杏仁膏,及白蜜一斤,慢火煎
如稀饧,二岁儿每服半钱匕,温水调下,渐加之,更随儿大小加减。
治小儿水气。槟榔散方
槟榔(煨熟锉) 大黄(锉炒各三分) 葶苈(纸上炒) 牵牛子(炒各半两)
上四味,捣罗为散,三四岁儿每服半钱匕,熟水调下,以利为效,更随儿大小增减。
论述说:肾,是胃的关口。肾开窍于前阴和后阴,水谷进入胃中后,向下输送到下焦。其调控机关在肾,小儿如果先天禀赋不足,脾肾功能虚弱,导致关门开合不利,水液不能正常向下输布,致使水湿停滞于胃并引发各种疾病。土(脾)不能克制水(肾),水液就会妄行,侵袭肌肉,泛滥于皮肤,从而形成肿胀和胀满。然而,水肿和风肿有所不同:皮肤薄嫩如同熟透的李子的是水肿;身体虚浮肿胀如同吹起的气球的是风肿。两者的治疗方法各不相同,应当根据具体证候进行调理。
治疗小儿水肿、腹部膨大,经过多种疗法无效者。泽漆丸方
泽漆叶、葶苈子(在纸上炒,各半两)、甘遂(炒制)、黄芩(去除黑心部分)、郁李仁(用热水浸泡,去皮尖,炒制后捣碎研细)、芍药、猪苓(去除黑色外皮)、杏仁(用热水浸泡,去皮尖,保留双仁,炒制后捣碎研细)、车前子、鳖甲(去除裙边,用醋炙烤)、柴胡(去除苗茎,各半两)。
以上十一味药,捣碎研成细末。用炼蜜调和,捣击三五百下,制成如绿豆大小的丸剂。五至六岁的儿童,每次服用五丸,温开水送服,并根据患儿年龄大小酌情增减剂量。
治疗小儿肿胀胀满、腹部坚实,经过多种治疗无效者。甘遂丸方
甘遂(炒制)、葶苈子(在纸上炒制)、车前子、猪苓(去除黑色外皮)、杏仁(用热水浸泡,去皮尖,保留双仁,炒制后捣碎研细)、芍药(各三分)、泽漆叶、黄芩(去除黑心部分)、鳖甲(去除裙边,用醋炙烤,各半两)。
以上九味药,捣碎研成细末,用炼蜜调和制成丸剂,大小如绿豆。五至六岁的儿童,每次服用五丸,用竹叶汤送服,以大便通畅为度,并根据患儿年龄大小酌情增减剂量。
治疗小儿肿胀胀满。构皮汤方
构树白皮(切碎五合,即楮树皮)、赤小豆(四合)、赤茯苓(去除黑色外皮一两半)。
以上三味药,切碎如麻豆大小。五至六岁的儿童,每次服用一钱匕,加水七分,煎煮至四分,去渣后温服,每日两次,并根据患儿年龄大小酌情增减剂量。
治疗小儿全身肿胀胀满,腹部胀大且气喘。郁李仁汤方
郁李仁(用热水浸泡,去皮尖,炒制后捣碎研细)、大黄(煨制后锉碎)、柴胡(去除苗茎,各一两半)、芍药、猪苓(去除黑心部分)、泽泻(各一两)、赤茯苓(去除黑色外皮)、黄芩(去除黑色外皮,各一两一分)、麻黄(去除根节,一分)、升麻、杏仁(用热水浸泡,去皮尖,保留双仁,炒制后捣碎研细)、鳖甲(去除裙边,用醋炙烤,各三分)。
以上十二味药,粗捣后过筛。五至六岁的儿童,每次取二钱匕,加水一盏,煎煮至五分,去渣后分两次温服,每日两次,以大便通畅为度,并根据患儿年龄大小酌情增减剂量。
治疗小儿水气肿胀胀满。猪苓汤方
猪苓(去除黑色外皮)、海蛤、防己、白术、葶苈子(在纸上炒制)、朴硝(各一分)、桑根白皮(锉碎)、赤茯苓(去除黑色外皮,各半两)。
以上八味药,粗捣后过筛。五至六岁的儿童,每次服用一钱匕,加水七分,煎煮至四分,去渣后温服,每日两次,以病愈为度,并根据患儿年龄大小酌情增减剂量。
治疗小儿水气。甘遂散方
甘遂(炒制)、大黄(锉碎后炒制)、牵牛子(炒制,各三分)、葶苈子(在纸上炒制,一分)、槟榔(煨制后锉碎,半两)。
以上五味药,捣碎筛选成散剂。每次服用一字匕,用熟水调服,以大便通畅为度,并根据患儿年龄大小酌情增减剂量。
治疗小儿肿胀胀满,服药后症状未消退。葶苈煎方
葶苈子(在纸上炒制,三分)、防己(一两半)、泽漆叶、郁李仁(去皮尖炒制,各一两一分)、赤茯苓(去除黑色外皮)、泽泻、杏仁(用热水浸泡,去皮尖,保留双仁,炒制后捣碎如膏状,各三两)、柴胡(去除苗茎,二两)。
以上八味药,将其中七味药粗捣后过筛。用水一斗,煎煮至二升半,去渣后加入杏仁膏及一斤白蜜,用慢火煎至像稀糖一样的稠度。两岁的儿童,每次服用半钱匕,用温水调服,逐渐增加剂量,并根据患儿年龄大小酌情增减。
治疗小儿水气。槟榔散方
槟榔(煨熟后锉碎)、大黄(锉碎后炒制,各三分)、葶苈子(在纸上炒制)、牵牛子(炒制,各半两)。
以上四味药,捣碎筛选成散剂。三至四岁的儿童,每次服用半钱匕,用熟水调服,以大便通畅为效验,并根据患儿年龄大小酌情增减剂量。
Discourse states: The Kidney is the gate of the Stomach. It opens into the two yin orifices (the anterior and posterior openings). After food and water enter the Stomach, they are transported to the Lower Jiao (Lower Burner). The mechanism of control lies in the Kidney. In children who have insufficient congenital endowment of the Spleen and Kidney, the opening and closing functions are impaired. Consequently, body fluids cannot be transported downward, leading to the accumulation of water-dampness in the Stomach and the generation of various diseases. When Earth (Spleen) fails to overcome Water (Kidney), water fluids act recklessly, invading the muscles and overflowing into the skin, resulting in swelling and distension. However, there is a distinction between edema and wind-swelling: skin that is thin and tender like a ripe plum indicates edema; a body that is vacuously swollen like an inflated balloon indicates wind-swelling. Their treatment methods differ, and one should regulate according to the specific syndrome.
Formula for Zeqi Wan (Ze Qi Pill) to treat pediatric edema with abdominal distension unresponsive to various therapies:
Folium Phytolaccae (Zeqie Ye), Semen Lepidii et Descurainiae (Tingli, stir-fried on paper, each 0.5 liang), Radix Euphorbiae Lathyridis (Gansui, stir-fried), Radix Scutellariae (Huangqin, remove black heart), Semen Pruni (Yuliren, soaked in hot water, peel and remove tips, stir-fried and ground), Radix Paeoniae Alba (Shaoyao), Polyporus (Zhuling, remove black skin), Semen Armeniacae Amarum (Xingren, soaked in hot water, peel and remove tips, keep double kernels, stir-fried and ground), Fructus Plantaginis (Cheqianzi), Carapax et Plastrum Testudinis (Biejia, remove skirt, vinegar-processed), Radix Bupleuri (Chaihu, remove sprouts, each 0.5 liang).
The above eleven ingredients are crushed and ground into powder. Mix with refined honey and pound three to five hundred times until uniform. Form pills the size of mung beans. For children aged five to six, administer five pills per dose with warm water, adjusting the dosage according to the child's size.
Formula for Gansui Wan (Gansui Pill) to treat pediatric swelling and firm distension unresponsive to various treatments:
Radix Euphorbiae Lathyridis (Gansui, stir-fried), Semen Lepidii et Descurainiae (Tingli, stir-fried on paper), Fructus Plantaginis (Cheqianzi), Polyporus (Zhuling, remove black skin), Semen Armeniacae Amarum (Xingren, soaked in hot water, peel and remove tips, keep double kernels, stir-fried and ground), Radix Paeoniae Alba (Shaoyao) (each 3 fen), Folium Phytolaccae (Zeqie Ye), Radix Scutellariae (Huangqin, remove black heart), Carapax et Plastrum Testudinis (Biejia, remove skirt, vinegar-processed, each 0.5 liang).
The above nine ingredients are crushed and ground into powder. Mix with refined honey to form pills the size of mung beans. For children aged five to six, administer five pills per dose with decoction of bamboo leaves, stopping when bowel movement occurs, and adjust the dosage according to the child's size.
Formula for Goupi Tang (Goupi Decoction) to treat pediatric swelling and distension:
Cortex Morus Australis (Goumu Baipi, i.e., Cortex Broussonetiae, cut into pieces, 5 he), Semen Phaseoli Angularis Rubrum (Chixiaodou, 4 he), Poria Cocos cum Rubra Cortice (Chifuling, remove black skin, 1.5 liang).
The above three ingredients are cut into pieces the size of hemp seeds. For children aged five to six, administer one qianbi per dose with seven parts water, decoct until four parts remain, strain, and take warm. Administer twice daily, adjusting the dosage according to the child's size.
Formula for Yuliren Tang (Yuliren Decoction) to treat pediatric generalized swelling and distension with abdominal fullness and asthma:
Semen Pruni (Yuliren, soaked in hot water, peel and remove tips, stir-fried and ground), Radix et Rhizoma Rhei (Dahuang, baked and chopped), Radix Bupleuri (Chaihu, remove sprouts, each 1.5 liang), Radix Paeoniae Alba (Shaoyao), Polyporus (Zhuling, remove black heart), Radix Alismatis (Zexie, each 1 liang), Poria Cocos cum Rubra Cortice (Chifuling, remove black skin), Radix Scutellariae (Huangqin, remove black skin, each 1 liang 1 fen), Herba Ephedrae (Mahuang, remove root and joints, 1 fen), Rhizoma Cimicifugae (Shengma), Semen Armeniacae Amarum (Xingren, soaked in hot water, peel and remove tips, keep double kernels, stir-fried and ground), Carapax et Plastrum Testudinis (Biejia, remove skirt, vinegar-processed, each 3 fen).
The above twelve ingredients are coarsely crushed and sieved. For children aged five to six, use two qianbi per dose with one cup of water, decoct until half remains, strain, and divide into two warm doses. Administer twice daily, stopping when bowel movement occurs, and adjust the dosage according to the child's size.
Formula for Zhuling Tang (Zhuling Decoction) to treat pediatric water-qi swelling and distension:
Polyporus (Zhuling, remove black skin), Concha Meretricis et Cyclinae (Hai Ge), Radix Stephaniae Tetrandrae (Fangji), Rhizoma Atractylodis Macrocephalae (Baizhu), Semen Lepidii et Descurainiae (Tinglizi, stir-fried on paper), Natrii Sulfas (Puxiao) (each 1 fen), Cortex Morus Radicis (Sanggen Baipi, chopped), Poria Cocos cum Rubra Cortice (Chifuling, remove black skin, each 0.5 liang).
The above eight ingredients are coarsely crushed and sieved. For children aged five to six, administer one qianbi per dose with seven parts water, decoct until four parts remain, strain, and take warm. Administer twice daily, stopping when cured, and adjust the dosage according to the child's size.
Formula for Gansui San (Gansui Powder) to treat pediatric water-qi:
Radix Euphorbiae Lathyridis (Gansui, stir-fried), Radix et Rhizoma Rhei (Dahuang, chopped and stir-fried), Semen Pharbitidis (Qianniuzi, stir-fried, each 3 fen), Semen Lepidii et Descurainiae (Tingli, stir-fried on paper, 1 fen), Fructus Arecae (Binglang, baked and chopped, 0.5 liang).
The above five ingredients are crushed and sifted into powder. Administer one zibi per dose mixed with boiled water, stopping when bowel movement occurs, and adjust the dosage according to the child's size.
Formula for Tingli Jian (Tingli Electuary) to treat pediatric swelling and distension unrelieved by medication:
Semen Lepidii et Descurainiae (Tingli, stir-fried on paper, 3 fen), Radix Stephaniae Tetrandrae (Fangji, 1.5 liang), Folium Phytolaccae (Zeqie Ye), Semen Pruni (Yuliren, peel and remove tips, stir-fried, each 1 liang 1 fen), Poria Cocos cum Rubra Cortice (Chifuling, remove black skin), Radix Alismatis (Zexie), Semen Armeniacae Amarum (Xingren, soaked in hot water, peel and remove tips, keep double kernels, stir-fried and ground into paste, each 3 liang), Radix Bupleuri (Chaihu, remove sprouts, 2 liang).
The above eight ingredients: coarsely crush and sieve seven of them. Decoct with ten dou of water until two and a half sheng remain. Strain, add the almond paste and one jin of white honey, and slowly simmer until it resembles thin syrup. For two-year-old children, administer half a qianbi per dose mixed with warm water, gradually increasing the amount, and adjust according to the child's size.
Formula for Binglang San (Binglang Powder) to treat pediatric water-qi:
Fructus Arecae (Binglang, baked熟 and chopped), Radix et Rhizoma Rhei (Dahuang, chopped and stir-fried, each 3 fen), Semen Lepidii et Descurainiae (Tingli, stir-fried on paper), Semen Pharbitidis (Qianniuzi, stir-fried, each 0.5 liang).
The above four ingredients are crushed and sifted into powder. For children aged three to four, administer half a qianbi per dose mixed with boiled water, taking effect when bowel movement occurs, and adjust the dosage according to the child's size.