小儿伤寒初得,浑身发热无汗,多啼哭,只看眼急有如惊风,但用发散退热,莫令发渴,如渴便欲饮水不歇,当发
散,羌活散、三黄散、柴胡散、抱龙丸,或虚烦可用竹叶汤,如嗽,当服洗心散、薄荷散、红绵散,四肢发汗,自然精
神喜悦,感伤寒之重者,当根据仲景之法治之。又有伤寒夹惊,先要发散,次乃退热化痰截惊,乳下婴儿抱龙丸、羌活散
加荆芥防风,三黄散微利,痰热,次用柴胡、黄芩药调理,自然向安,葱白汤亦可服。
羌活散 治伤寒惊热,或中风体硬,可加麻黄、干葛、薏苡仁
羌活 独活 前胡 柴胡 川芎 白茯苓 桔梗 枳壳 人参 地骨皮 天麻(各等分) 甘草(减半)
上锉散,生姜薄荷煎,加蝉蜕治惊热。
柴胡散 见第五十问。
三黄散 治伤风热症。
白术 大黄(蒸) 赤芍药(半两) 黄芩(三钱) 麻黄(去节、一钱) 桂枝(二钱)
上 咀,生姜一片,枣二枚,水一盏,煎七分温服。
抱龙丸 治伤风温疫,身热气粗,痰实壅嗽,常服安神镇惊。亦治疹痘壮热,小儿宜时与服。
胆星(一两) 天竺黄(二钱) 雄黄(二钱) 辰砂(二钱) 麝香(少许) 气喘有痰加杏仁
上为末,煮甘草汁丸如芡实大,薄荷汤化下。
竹叶石膏汤 治伤寒表里俱虚,胸中烦闷,或得汗已解,内无津液,虚羸少气,气逆欲吐,及诸虚烦,伤寒解
后。伤寒未解,切不可服。
石膏(四两) 半夏(六钱) 人参(半两) 甘草(半两) 麦门冬(去心、一两)
上 咀,每服三钱,生姜一片,粳米五十粒,煎米熟为度,去滓温服。呕者加生姜三片,竹叶数片。
洗心散 见第三十七问。
辰砂七宝散 见第三十七问。
薄荷散 见第三十六问。
红绵散 治伤风咳嗽,鼻塞或流清涕。
全蝎(五个、去毒) 麻黄(去节、二钱) 僵蚕(二钱炒) 白芷(二钱) 川芎(二钱) 天麻(二钱) 甘
草(一钱) 苏木(一钱)
上为末,绵少许煎服,有热加荆芥,一方有大黄。
葱白汤 治头疼不止,身疼热渴,小便赤黄,脉浮数无汗。
葛根(半两) 芍药(半两) 知母(半两) 川芎(一两)
上锉散,每服二钱,水一小盏,生姜二片,葱白三枚,煎至七分,去滓热服出汗,如有汗温服。加甘草治小儿夹惊
伤风,并治发疟,头疼加石膏服,呕者加半夏半两。
羌活汤 解利邪气伤风。
羌活(一钱) 人参(一钱) 防风(一钱) 川芎(一钱)
上锉一剂,生姜三片,薄荷七叶,水一盏,加芍药甘草,煎至七分,不拘时服。
小儿初次感受伤寒,全身发热且无汗,经常啼哭,观察其眼神紧急,看起来像惊风一样。此时只需用发散退热的方法治疗,不要让它发展成口渴。如果已经口渴并想不停喝水,应当使用发散法,可选用羌活散、三黄散、柴胡散、抱龙丸;如果是虚烦症状,可以使用竹叶汤(此处原文为竹叶汤,但后文方剂名为竹叶石膏汤,依原文结构处理,通常指代清热生津之剂)。如果有咳嗽,应当服用洗心散、薄荷散、红绵散。四肢微微出汗,精神自然就会喜悦舒畅。感染伤寒较重的,应当按照张仲景的法治疗。
又有伤寒夹惊的情况,首先要发散表邪,然后才能退热、化痰、止惊。对于吃奶的婴儿,可用抱龙丸或羌活散加荆芥、防风,或者用三黄散轻微通便泄热。痰热证,随后用柴胡、黄芩类的药物调理,身体自然会安宁恢复,葱白汤也可以服用。
羌活散:治疗伤寒引起的惊热,或者中风导致的身体僵硬,可以加入麻黄、干葛、薏苡仁。
组成:羌活、独活、前胡、柴胡、川芎、白茯苓、桔梗、枳壳、人参、地骨皮、天麻(各等分),甘草(减半)。
制法与用法:切碎成散剂,用生姜和薄荷煎煮,若治惊热可加蝉蜕。
柴胡散:见第五十问。
三黄散:治疗伤风热症。
组成:白术、大黄(蒸制)、赤芍药(半两)、黄芩(三钱)、麻黄(去节、一钱)、桂枝(二钱)。
制法与用法:切碎,用生姜一片、大枣两枚、水一盏,煎至七分,温服。
抱龙丸:治疗伤风温疫,身体发热气息粗重,痰实壅塞咳嗽,常服可安神镇惊。也治疗疹痘壮热,小儿适宜适时服用。
组成:胆星(一两)、天竺黄(二钱)、雄黄(二钱)、辰砂(二钱)、麝香(少许),气喘有痰者加杏仁。
制法与用法:研为细末,煮甘草汁制成如芡实大小的丸剂,用薄荷汤化开服用。
竹叶石膏汤:治疗伤寒表里俱虚,胸中烦闷,或者发汗后病已解但体内津液不足,身体虚弱气短,气逆想吐,以及各类虚烦,多在伤寒解除后出现。若伤寒未解,切不可服用。
组成:石膏(四两)、半夏(六钱)、人参(半两)、甘草(半两)、麦门冬(去心、一两)。
制法与用法:切碎,每次服用三钱,加生姜一片、粳米五十粒,煎至米熟为止,去渣温服。呕吐者加生姜三片、竹叶数片。
洗心散:见第三十七问。
辰砂七宝散:见第三十七问。
薄荷散:见第三十六问。
红绵散:治疗伤风咳嗽,鼻塞或流清涕。
组成:全蝎(五个、去毒)、麻黄(去节、二钱)、僵蚕(二钱炒)、白芷(二钱)、川芎(二钱)、天麻(二钱)、甘草(一钱)、苏木(一钱)。
制法与用法:研为细末,用少量棉絮包裹煎服,有热者加荆芥,另一版本有大黄。
葱白汤:治疗头痛不止,身体疼痛发热口渴,小便赤黄,脉浮数且无汗。
组成:葛根(半两)、芍药(半两)、知母(半两)、川芎(一两)。
制法与用法:切碎成散剂,每次服用二钱,加水一小盏、生姜两片、葱白三枚,煎至七分,去渣热服以取汗,若有汗则温服。加甘草可治疗小儿夹惊伤风,并治疗疟疾,头痛加石膏服用,呕吐者加半夏半两。
羌活汤:解除邪气伤风。
组成:羌活(一钱)、人参(一钱)、防风(一钱)、川芎(一钱)。
制法与用法:切碎一剂,加生姜三片、薄荷七叶、水一盏,加芍药甘草,煎至七分,不拘时候服用。
When a child first contracts Shanghan (Cold Damage), the whole body becomes feverish without sweat, and the child often cries. Observing their eyes, they appear tense as if suffering from Jingfeng (Convulsions). At this stage, only dispersing methods to reduce fever should be used; do not allow thirst to develop. If the child is already thirsty and desires water incessantly, dispersing methods should still be employed. Formulas such as Qianghuo San (Notopterygium Powder), Sanhuang San (Three Yellows Powder), Chaihu San (Bupleurum Powder), or Baolong Wan (Embrace Dragon Pill) may be used. For deficiency-related vexation, Zhuye Tang (Bamboo Leaf Decoction) can be applied. If there is coughing, Xixin San (Wash Heart Powder), Bohe San (Mint Powder), or Hongmian San (Red Cotton Powder) should be administered. When slight sweating occurs in the four limbs, the spirit naturally becomes joyful and refreshed. For severe cases of Shanghan, treatment should follow the methods of Zhang Zhongjing.
Another condition is Shanghan with夾惊 (Shanghan complicated by Convulsions/Fright). First, disperse the exterior pathogen, then reduce fever, resolve phlegm, and arrest convulsions. For nursing infants, Baolong Wan or Qianghuo San added with Jingjie (Schizonepeta) and Fangfeng (Saposhnikovia) can be used, or Sanhuang San to induce mild purgation for heat. For phlegm-heat syndromes, subsequently regulate with formulas containing Chaihu (Bupleurum) and Huangqin (Scutellaria), and the condition will naturally stabilize. Congbai Tang (Scallion White Decoction) is also acceptable.
Qianghuo San: Treats Shanghan-induced Jingre (Fright-Heat) or wind-stroke causing body stiffness. Mahuang (Ephedra) and Genge (Pueraria) and Yiyiren (Coix Seed) may be added.
Ingredients: Qianghuo (Notopterygii Rhizoma et Radix), Duhuo (Angelicae Pubescentis Radix), Qianhu (Peucedani Radix), Chaihu (Bupleuri Radix), Chuanxiong (Chuanxiong Rhizoma), Baifuling (Poria), Jiegeng (Platycodonis Radix), Zhiqiao (Aurantii Fructus), Renshen (Ginseng Radix et Rhizoma), Digupi (Lycii Cortex), Tianma (Gastrodiae Rhizoma) in equal parts; Gancao (Licorice Radix et Rhizoma) in half amount.
Preparation and Administration: Crush into powder, decoct with Shengjiang (Zingiberis Rhizoma Recens) and Bohe (Menthae Haplocalycis Herba). Add Chanui (Cicadae Periostracum) to treat fright-heat.
Chaihu San: See Question 50.
Sanhuang San: Treats wind-cold transforming into heat syndrome.
Ingredients: Baizhu (Atractylodis Macrocephalae Rhizoma), Dahuang (Rhei Radix et Rhizoma steamed), Chishaoyao (Paeoniae Radix Rubra, 0.5 liang), Huangqin (Scutellariae Radix, 3 qian), Mahuang (Ephedrae Herba, nodes removed, 1 qian), Guizhi (Cinnamomi Ramulus, 2 qian).
Preparation and Administration: Cut into pieces. Decoct with one slice of Shengjiang and two dates in one cup of water until reduced to 70%, take warm.
Baolong Wan: Treats wind-cold-warm epidemic, fever with coarse breathing, phlegm-solidity obstructing cough. Regular use calms the mind and settles fright. Also treats high fever from rash/pox. Suitable for children to take periodically.
Ingredients: Dansheng (Arisaematis Cum Bile, 1 liang), Tianzhuhuang ( Bambusae Spongia), Xionghuang (Realgar, 2 qian), Chencha (Cinnabar, 2 qian), Shexiang (Moschus, a little). Add Xingren (Armeniacae Semen Amarum) if wheezing with phlegm.
Preparation and Administration: Grind into fine powder. Use boiled Licorice juice to make pills the size of Euryale seed. Dissolve in Mint Tea before administration.
Zhuye Shigao Tang: Treats Shanghan with both exterior and interior deficiency, chest vexation, or after sweating when the disease has resolved but internal fluids are depleted, leading to emaciation, shortness of breath, rebellious qi wanting to vomit, and various deficiency vexations, typically occurring after Shanghan resolves. Do not administer if Shanghan has not yet resolved.
Ingredients: Shigao (Gypsum Fibrosum, 4 liang), Banxia (Pinelliae Rhizoma Praeparatum, 6 qian), Renshen (Ginseng Radix et Rhizoma, 0.5 liang), Gancao (Licorice Radix et Rhizoma, 0.5 liang), Maimendong (Ophiopogonis Radix, heart removed, 1 liang).
Preparation and Administration: Cut into pieces. Take 3 qian per dose, add one slice of Shengjiang and 50 grains of Jingmi (Oryza Sativa Glutinosa), decoct until rice is cooked, strain, and take warm. For vomiting, add three slices of Shengjiang and several leaves of Zhuye (Bambusae Folium).
Xixin San: See Question 37.
Chensha Qibao San: See Question 37.
Bohe San: See Question 36.
Hongmian San: Treats wind-cold cough, nasal congestion, or clear runny nose.
Ingredients: Quanxie (Scorpio, five, detoxified), Mahuang (Ephedrae Herba, nodes removed, 2 qian), Jiangcan (Bombyx Batryticatus, stir-fried, 2 qian), Baizhi (Angelicae Dahuricae Radix, 2 qian), Chuanxiong (Chuanxiong Rhizoma, 2 qian), Tianma (Gastrodiae Rhizoma, 2 qian), Gancao (Licorice Radix et Rhizoma, 1 qian), Sumu (Sappan Lignum, 1 qian).
Preparation and Administration: Grind into powder. Wrap in a small amount of cotton and decoct for oral administration. Add Jingjie (Schizonepetae Spica) if heat is present; another version includes Dahuang.
Congbai Tang: Treats persistent headache, body pain with fever and thirst, dark yellow urine, floating rapid pulse without sweat.
Ingredients: Gegen (Puerariae Lobatae Radix, 0.5 liang), Shaoyao (Paeoniae Radix, 0.5 liang), Zhimu (Anemarrhenae Rhizoma, 0.5 liang), Chuanxiong (Chuanxiong Rhizoma, 1 liang).
Preparation and Administration: Crush into powder. Take 2 qian per dose with a small cup of water, two slices of Shengjiang, and three stalks of Congbai (Allii Fistulosi Bulbus). Decoct to 70%, strain, and take hot to induce sweat. If sweat is already present, take warm. Adding Gancao treats wind-cold complicated by fright in children and malaria. Add Shigao for headache; add Banxia (Pinelliae Rhizoma Praeparatum, 0.5 liang) for vomiting.
Qianghuo Tang: Resolves pathogenic factors from wind-cold.
Ingredients: Qianghuo (Notopterygii Rhizoma et Radix, 1 qian), Renshen (Ginseng Radix et Rhizoma, 1 qian), Fangfeng (Saposhnikoviae Radix, 1 qian), Chuanxiong (Chuanxiong Rhizoma, 1 qian).
Preparation and Administration: Cut one dose. Decoct with three slices of Shengjiang, seven leaves of Bohe, one cup of water, plus Shaoyao and Gancao, until reduced to 70%. Take at any time.