五软者,头软、项软、手软、脚软、肌肉软是也。无故不举头,肾疳之病。项脉软而难收,治虽暂瘥,他年必再发。
手软则手垂四肢无力,亦懒抬眉,若得声圆,还进饮食,乃慢脾风候也,尚堪医治。肌肉软,则肉少皮宽自离,吃食不
长肌肉,可服钱氏桔连丸,莫教泻利频并,却难治疗。脚软者,五岁儿不能行,虚羸脚软细小,不妨荣卫,但服参 等
药,并服钱氏地黄丸,长大自然肌肉充满。又有口软则虚舌退场门,阳盛更须堤防,必须治膈却无妨,唇青气喘则难调治
也。
桔连丸 见第八十一问。
上为细末,别研入麝香五分,用猪胆七个,分药入胆内,浆水煮,候临熟,以针微扎破,以熟为度,取出以粟米粥
和丸如绿豆大,每服至二三十丸,米饮下,量大小与之无时。
地黄丸 见第八问。
五硬则仰头取气,难以动摇,气壅疼痛连胸膈间,脚手心如冰冷而硬,此为风症难治。肚大青筋,急而不宽,用去
积之剂,积气消即安。恐面青心腹硬者,此症性命难保。如风症,只根据中风治之,必有回生之理,小续命汤加减治之尤
良,羌活散等剂皆可用。
小续命汤 治中风不省人事,涎鸣反张,失音厥冷。
麻黄(去节) 人参 黄芩 川芎 芍药 甘草(炙) 杏仁(去皮尖、炒) 汉防己 官桂(去皮各一两半) 防
风(七钱半) 附子(炮、去皮脐、七钱半)
上除附子杏仁外,并捣为粗末,次入二味夹和。每一钱,姜枣煎,食前服。有热去附子,官桂减半。
羌活散 见第二十问。
五软,是指头项软弱、颈部软弱、手部软弱、足部软弱、肌肉软弱这五种情况。无故不能抬头,是肾疳的病证。颈部经脉软弱且难以收持,治疗虽然暂时痊愈,日后必定复发。
手部软弱则表现为手垂下、四肢无力,也懒得抬眉,如果声音圆润,还能进食,这是慢脾风的征候,还可以医治。肌肉软弱,则肉少皮宽松弛,吃东西不长肌肉,可以服用钱氏桔连丸,不要让腹泻频繁发生,否则就难治疗了。足部软弱,指五岁的孩子不能行走,身体虚弱消瘦、脚软细小,只要不影响营卫之气,只需服用人参等药物,并服用钱氏地黄丸,长大后自然肌肉丰满。又有口软,表现为虚舌伸出退至齿龈之外(注:原文“退场门”疑为“退齿龈”或类似含义之误,此处依文意译为舌头松弛外伸),阳气过盛更须提防,必须治疗膈间疾病才无妨碍,如果出现嘴唇发青、气喘,就很难调治了。
桔连丸 见第八十一问。
将药研成细末,另外研磨入麝香五分,用七个猪胆,将药分装入胆内,用浆水煮,等到快要煮熟时,用针微微扎破,以煮熟为标准,取出后用粟米粥调和,制成如绿豆大小的丸剂,每次服用二三十丸,用米汤送下,根据患儿大小给药,不限时间。
地黄丸 见第八问。
五硬则表现为仰头呼吸,难以动摇,气机壅滞疼痛牵连胸膈之间,手脚心冰冷而坚硬,这属于风症,难以治疗。腹部胀大且有青筋暴露,紧急而不舒展,使用消积的药剂,积气消除即平安。如果担心面色青紫、心腹坚硬者,此症性命难保。如果是风症,只按照中风来治疗,必有起死回生的道理,用小续命汤加减治疗尤其好,羌活散等方剂都可以使用。
小续命汤 治疗中风不省人事,喉中痰鸣、角弓反张、失音厥冷。
麻黄(去节) 人参 黄芩 川芎 芍药 甘草(炙) 杏仁(去皮尖、炒) 汉防己 官桂(去皮各一两半) 防风(七钱半) 附子(炮、去皮脐、七钱半)
以上除附子、杏仁外,一起捣成粗末,其次加入这两味药混合均匀。每次取一钱,加生姜、大枣煎煮,饭前服用。有热象的去掉附子,官桂减半。
羌活散 见第二十问。
Wu Ruan (Five Softnesses) refers to five conditions: softness of the head, softness of the neck, softness of the hands, softness of the feet, and softness of the muscles. Inability to lift the head without cause is a symptom of Shen Gan (Kidney Caries). If the neck vessels are soft and difficult to support, although treatment may bring temporary relief, it will inevitably recur in later years.
Hand softness manifests as drooping hands and weakness in the four limbs, along with reluctance to raise the eyebrows. If the voice is clear and the child can eat, this indicates Man Pi Feng (Slow Spleen Wind), which is still treatable. Muscle softness presents with little flesh, loose and flaccid skin, and failure to gain muscle mass despite eating. Qian Shi Jie Lian Wan (Qian's Scutellaria and Coptis Pill) can be administered; one must prevent frequent diarrhea, as that would make treatment difficult. Foot softness refers to a five-year-old child who cannot walk, presenting with emaciation, weak and thin legs. As long as Ying Wei (Defensive and Nutritive Qi) are not compromised, administering herbs such as Renshen (Ginseng Root) and Qian Shi Di Huang Wan (Qian's Rehmannia Pill) will naturally lead to full muscle development upon adulthood. Another condition is Kou Ruan (Mouth Softness), characterized by a flaccid tongue protruding beyond the gums. One must be vigilant against excessive Yang; treating disorders of the Ge (Diaphragm) poses no harm, but if cyanosis of the lips and panting occur, regulation becomes difficult.
Jie Lian Wan is described in Question 81.
Grind the herbs into a fine powder. Separately grind 5 fen of She Xiang (Musk) into seven pig gallbladders, dividing the powder among them. Boil in water until nearly cooked, then prick slightly with a needle. Cook until done, remove, and mix with millet porridge to form pills the size of mung beans. Administer 20–30 pills per dose with rice drink, according to the child's age, at any time.
Di Huang Wan is described in Question 8.
Wu Ying (Five Stiffnesses) manifests as holding the head back to breathe, difficulty moving, Qi stagnation causing pain radiating to the chest and diaphragm, and cold, stiff hands and feet. This belongs to Feng Zheng (Wind Syndrome) and is difficult to treat. A distended abdomen with visible blue veins, tight and uncomfortable, requires Ji Zhi agents (accumulation-dispelling formulas); once the accumulated Qi dissipates, peace returns. If the face is cyanotic and the heart/abdomen hard, life is endangered. For wind syndromes, treating according to Zhong Feng (Stroke) principles offers hope for recovery. Xiao Xu Ming Tang (Minor Continuation of Life Decoction) modified is particularly effective; Qiang Huo San (Notopterygium Powder) and other formulas are also applicable.
Xiao Xu Ming Tang treats stroke with loss of consciousness, phlegm rattling in the throat, opisthotonos, aphonia, and cold extremities.
Ma Huang (Ephedrae Herba, removed nodes) 1.5 liang, Ren Shen (Ginseng Radix) 1.5 liang, Huang Qin (Scutellariae Radix) 1.5 liang, Chuan Xiong (Ligustici Chuanxiong Rhizoma) 1.5 liang, Shao Yao (Paeoniae Radix) 1.5 liang, Gan Cao (Glycyrrhizae Radix et Rhizoma, honey-fried) 1.5 liang, Xing Ren (Armeniacae Semen Amarum, peeled, tipped, stir-fried) 1.5 liang, Han Fang Ji (Stephaniae Tetrandrae Rhizoma) 1.5 liang, Guan Gui (Cinnamomi Cortex, peeled) 1.5 liang, Fang Feng (Saposhnikoviae Radix) 7.5 qian, Fu Zi (Aconiti Lateralis Radix Praeparata, processed, peeled, navel removed) 7.5 qian.
Except for Fu Zi and Xing Ren, crush all ingredients into coarse powder. Mix in the two excluded herbs. Take 1 qian per dose, decoct with Sheng Jiang (Zingiberis Rhizoma Recens) and Da Zao (Jujubae Fructus), and administer before meals. If heat signs are present, remove Fu Zi and reduce Guan Gui by half.
Qiang Huo San is described in Question 20.