滞热丹毒赤游形,伤乳多食滞热生,较之赤游走缓慢,先宜消食次宜清。
【注】此证初发,形若赤游丹,较之赤游丹游走缓慢。因婴儿乳食过多,不能运化,蕴
热于内,达于肌表而生。发热面赤,口酸,舌有黄苔,宜服保和丸,先消食滞。若唇焦便
秘者,宜一捻金服之;丹毒仍作者,宜犀角散服之。其余治法,俱按赤游丹。
保和丸
白茯苓 半夏(制) 山楂肉 神曲(炒,各一两) 陈皮 萝卜子(炒)
连翘(去心,各五钱)
上研细末,粥丸如梧桐子大。每服三十丸,白滚水化下。
【方歌】保和丸用茯苓夏,陈皮萝卜子山
楂,神曲连翘丸水服,能消乳积效堪嘉。
一捻金
人参 大黄 黑丑 白丑 槟榔(各等分)
共为细末,每服一字,蜜水调下。
【方歌】一捻金医食火积,唇焦便秘服通利,大黄黑白丑人参,槟榔为末须加蜜。
犀角散
犀角屑 升麻 防己 山栀(生) 朴硝 黄芩 黄 (各一钱) 牛黄(五分)
上为细末,每服五分,竹叶煎汤调下,量儿加减用之。
【方歌】犀角散消丹毒赤,升麻防己共山栀,硝芩黄 牛黄末,竹叶汤调服无时。
婴儿疮疡乳火成,因食浓味滞火凝,更兼六淫气感受,肿溃治法按疽痈。
【注】凡婴儿生疮疡小疖,多由乳母七情之火,或过周岁能饮食者,由过食干焦浓味,
而生滞火,更兼六淫之气感受,皆能成之。但发表、攻里、托里、消毒等法,及肿溃外治,
俱按痈宜肿疡、溃疡门。婴儿纯阳,火证居多,非峻剂不能胜其病,但肌体脏腑柔脆,应
效即止,不可过剂。
滞热丹毒表现为皮肤红肿,形态类似赤游丹(一种游走性的红色斑片状皮肤病),多因婴儿乳食过量导致食物停滞、郁而化热所致。与赤游丹相比,其病情发展较为缓慢,治疗上应先以消食导滞为主,随后再进行清热处理。
【注】此病初起时,形态若赤游丹,但比赤游丹的游走速度要慢。这是由于婴儿乳食过多,脾胃无法运化,导致内蕴积热,外达肌表而生发此病。症状包括发热、面色红赤、口中酸腐味、舌苔黄腻,适宜服用保和丸,先消除食积。如果出现嘴唇焦裂、大便秘结的情况,适宜服用一捻金;若丹毒症状仍然发作,适宜服用犀角散。其余治疗方法,均参照赤游丹的处理方式。
保和丸
白茯苓、半夏(制)、山楂肉、神曲(炒,各一两)、陈皮、萝卜子(炒)、连翘(去心,各五钱)。
以上药材研成细末,用米粥调和制成如梧桐子大小的药丸。每次服用三十丸,用温开水送服或化开服用。
【方歌】保和丸由茯苓、半夏组成,配以陈皮、萝卜子、山楂、神曲、连翘,用水泛丸服用,消除乳食积滞的效果极佳。
一捻金
人参、大黄、黑丑(牵牛子黑色者)、白丑(牵牛子白色者)、槟榔(各等分)。
共同研磨成细末,每次服用“一字”(约0.3-0.6克),用蜂蜜水调服。
【方歌】一捻金治疗食火积滞,针对嘴唇焦裂、大便秘结者采用通利法,包含大黄、黑白丑、人参,槟榔研末需加蜂蜜。
犀角散
犀角屑、升麻、防己、山栀(生)、朴硝、黄芩、黄连(原文缺字,据方义补)、牛黄(各一钱)、牛黄(五分,此处原文排版似有重复或剂量差异,依原文记录:前六味及黄芩各一钱,牛黄五分)。*注:根据常见古籍版本,通常为犀角、升麻、防己、山栀、朴硝、黄芩、黄连各一钱,牛黄五分。此处依原文文本提取。*
以上研成细末,每次服用五分,用竹叶煎汤调服,根据患儿情况增减用量。
【方歌】犀角散消除丹毒红肿,配伍升麻、防己、山栀,加上朴硝、黄芩、黄连、牛黄研末,用竹叶汤调服,随时可服。
婴儿疮疡多由乳火引起,因食用浓烈味道导致滞火凝结,再加上感受六淫(风、寒、暑、湿、燥、火)邪气,肿胀溃烂的治疗方法参照疽痈(严重的化脓性感染)进行。
【注】凡是婴儿发生疮疡小疖,多由乳母七情(喜、怒、忧、思、悲、恐、惊)之火影响,或者超过周岁能饮食的婴儿,因过食干硬、焦脆、浓烈滋味的食物,产生滞火,再加上感受六淫之气,都能导致发病。但是发表(发散表邪)、攻里(攻下里实)、托里(托毒外出)、消毒等治法,以及肿疡(未溃破)、溃疡(已溃破)的外治方法,都参照痈肿章节中的肿疡、溃疡门进行处理。婴儿属于纯阳之体,火证居多,非峻猛药剂不能战胜疾病,但婴儿肌体和脏腑柔嫩脆弱,见效后应立即停药,不可过度用药。
Stagnant heat carbuncle and erysipelas present with redness and swelling, resembling Chi You Dan (a wandering red plaque-like skin disease). It is mostly caused by excessive milk and food intake in infants, leading to food stagnation and the generation of stagnant heat. Compared to Chi You Dan, its progression is slower; treatment should first focus on resolving food stagnation, followed by clearing heat.
[Note] At the onset, this condition resembles Chi You Dan but moves more slowly than it. It arises because infants consume too much milk and food, which the spleen and stomach cannot transform, causing internal accumulation of heat that reaches the muscle and surface. Symptoms include fever, flushed face, sour breath, and a yellow tongue coating. Bahe Wan (Preservation Harmony Pill) should be taken initially to resolve food stagnation. If lips are scorched and stool is constipated, Yinian Jin (One Pinch of Gold) is suitable; if the erysipelas persists, Xijiao San (Rhinoceros Horn Powder) is appropriate. Other treatments follow those for Chi You Dan.
Bahe Wan (Preservation Harmony Pill)
Bai Fuling (Poria), Banxia (Pinellia Rhizome, processed), Shanzha Rou (Crataegus Fruit Flesh), Shenqu (Medicated Leaven, stir-fried, each 1 liang), Chenpi (Citrus Reticulata Peel), Luobozi (Radish Seed, stir-fried), Lianqiao (Forsythia Fruit, heart removed, each 5 qian).
Grind all into fine powder, mix with congee to form pills the size of paulownia seeds. Take 30 pills per dose, dissolved or swallowed with warm boiled water.
[Formula Song] Bahe Wan contains Poria and Pinellia, along with Citrus Peel, Radish Seed, Hawthorn, Medicated Leaven, and Forsythia; taken as water-habituated pills, it effectively resolves milk and food accumulation with excellent results.
Yinian Jin (One Pinch of Gold)
Renshen (Ginseng Root), Dahuang (Rhubarb Rhizome), Heiqiu (Black Morning Glory Seed), Baiqiu (White Morning Glory Seed), Binglang (Areca Nut, equal parts).
Grind into fine powder. Take one "yi" (approx. 0.3-0.6g) per dose, mixed with honey water.
[Formula Song] Yinian Jin treats food-fire accumulation, indicated for scorched lips and constipation using purgative methods; it contains Rhubarb, Black and White Morning Glory Seeds, Ginseng, and Areca Nut powder added with honey.
Xijiao San (Rhinoceros Horn Powder)
Xijiao Xie (Rhinoceros Horn Chips), Shengma (Cimicifuga Rhizome), Fangji (Stephania Root), Shanzhi (Gardenia Fruit, raw), Puxiao (Mirabilite), Huangqin (Scutellaria Root), Huanglian (Coptis Rhizome - *text implies missing character based on context*), Niuhuang (Calculus Bovis, 1 qian for former, 5 fen for latter - *text lists quantities ambiguously, typically 1 qian for herbs, 5 fen for Niuhuang*).
Grind into fine powder. Take 5 fen per dose, mixed with decoction of Bamboo Leaves (Zhuye), adjusting dosage according to the infant's condition.
[Formula Song] Xijiao San eliminates red erysipelas, combining Cimicifuga, Stephania, and Gardenia; Mirabilite, Scutellaria, Coptis, and Calculus Bovis powder are taken with Bamboo Leaf decoction at any time.
Infant sores and ulcers are formed by milk-fire, resulting from stagnant fire coagulation due to rich flavors, compounded by exposure to the Six Excesses (Wind, Cold, Summerheat, Dampness, Dryness, Fire). Treatment for swelling and suppuration follows the methods for Ju Yong (deep-seated suppurative infections).
[Note] Any infant sore or small boil is often caused by the fire of the Seven Emotions (Joy, Anger, Worry, Thought, Sorrow, Fear, Fright) affecting the nursing mother, or in infants over one year old who can eat solid food, by excessive consumption of dry, fried, and rich flavors generating stagnant fire, combined with exposure to the Six Excesses. However, methods such as releasing the exterior, purging the interior, supporting the interior to expel toxins, and disinfecting, as well as external treatments for swollen stage (Zhong Yang) and ulcerated stage (Kui Yang), all follow the protocols in the Carbuncle chapter under Zhong Yang and Kui Yang sections. Infants possess a "Pure Yang" constitution, making fire syndromes predominant. Only potent drugs can overcome the disease, but their muscles, tissues, and zang-fu organs are tender and fragile; stop medication immediately upon efficacy to avoid overdose.