卫气少而寒气乘之也。元气微而饮食伤之也。外乘内伤。酿而成之也。父母以其纯阳耶。故深冬不为裳。
父母以其恶风耶。故盛夏不解衣。父母以其数饥耶。故乳后强食之。父母以其或渴耶。故乳后更饮之。有
为父母愚憨者。又不审其寒暑饮食。故寒而不为暖。暑而不能凉。饮而不至渴。食而不及饥。而小儿幽玄
衔默。抱疾而不能自言。故外乘内伤。因循积渐。酿而成疳也。渴而易饥。能食而瘦。腹胀不利。作HT HT 声。日
远不治。遂生目病。其病生翳。睫闭不能开。眵泪如糊。久而脓流。竟枯两目。何则。为阳气下走也。为阴气反
上也。治法当如阴阳应象大论曰。清阳出上窍。浊阴出下窍。清阳发腠理。浊阴走五脏。清阳行四肢。浊阴
归六腑。各还其原。不反其常。是其治也。当作升阳降阴之剂。茯苓泻湿汤主之。升麻龙胆草饮子主之。此
药非独于目。并治以上数证。然勿缓。缓则危也。为父母者。其慎诸。
茯苓泻湿汤(治小儿易饥而渴。瘦瘠腹胀不利。作HT HT 声。目病生翳。睫闭不开。眵泪如糊。
久而流脓。俗为疳毒眼。)
柴胡(四分) 白术 甘草(炙) 蔓荆子 人参 枳壳(麸炒) 茯苓
薄荷叶(各二分) 前胡 苍术 独活(各三分) 防风 真川芎 羌活(各三分半) 泽泻(一分半)
上锉剂。水一钟半。煎至六分。去滓温服。
上方为小儿寒暑饮食不调。而酿成此证。夫寒暑饮食不节。皆能伤动脾胃。脾胃者。阴阳之会元也。故
清阳下而不升。浊阴上而不降。今以白术、人参。先补脾胃为君。柴胡、甘草、枳壳。辅上药补脾胃为臣。苍
术燥湿。茯苓、泽泻。导浊阴下降为佐。然后以羌活、独活、防风、蔓荆子、前胡、川芎、薄荷诸主风药以胜湿。
引清阳上升为使。此正治神效之法也。
升麻龙胆草饮子(又名消翳散。治小儿疳眼。流脓生翳。湿热为病。疗眼中诸疾之症。)
羌活 黄芩(炒) 龙胆草 青蛤粉(各五分) 蛇蜕 甘草(炙) 谷精草 川郁金(各三分) 麻黄(一分半)
升麻(二分)
上锉剂。作细末亦可。每服二钱。热茶清浓调下。
上方君以升麻。行足阳明胃。足太阴脾也。臣以羌活、麻黄。风以胜湿也。佐以甘草。承和上下。谷精草明
目退翳。蛇蜕主小儿惊疳等疾。使以青蛤粉。治疳止利。川郁金补血破血。龙胆草疗眼中诸疾。黄芩除
上热。目内赤肿。火炒者。为龙胆草。性已苦寒。恐不炒则又过于寒也。
卫气虚弱,寒气便趁机侵袭。元气微弱,饮食不当便会损伤它。外邪侵袭与内伤积滞相互结合,酝酿而成此病。父母认为孩子属纯阳之体,所以在深冬时节不给孩子穿足够的衣服。父母认为孩子怕风,所以在盛夏时节不让孩子脱去衣物。父母担心孩子多次饥饿,所以在哺乳后强行喂食。父母担心孩子口渴,所以在哺乳后继续喂水。有些父母愚笨憨厚,又不仔细审视孩子的寒暑冷暖及饮食情况,所以天冷时不给孩子保暖,天热时不让孩子凉爽,喝水不能解渴,吃饭达不到饱腹。而小儿幽静深沉、沉默寡言,怀抱疾病却不能自己诉说。因此,外邪侵袭与内伤积滞,因循拖延,逐渐积累,最终酿成疳疾(一种以形体消瘦、面色萎黄、毛发稀疏枯焦、饮食异常为主要特征的儿科慢性病)。表现为口渴且容易饥饿,能吃但身体消瘦,腹部胀满且大便不通畅,肠鸣音如“HT HT”声。如果一天天远离治疗,就会引发眼病。这种眼病产生翳膜(角膜混浊),眼睑闭合无法睁开,眼屎和泪水像糊状一样粘稠,时间久了流脓,最终导致双目失明。为什么呢?这是因为阳气下陷走于下部,阴气反而上逆所致。治疗方法应当参照《素问·阴阳应象大论》中的论述:“清阳之气出于上窍,浊阴之气出于下窍;清阳之气发散于腠理,浊阴之气运行于五脏;清阳之气行于四肢,浊阴之气归于六腑。”使各归其位,不违背常道,这就是治疗原则。应当使用升举阳气、降泄阴气的方剂。主用茯苓泻湿汤,或者主用升麻龙胆草饮子。这些药物不仅治疗眼部疾病,同时也能治疗上述几种证候。然而不可迟缓,迟缓则会有危险。作为父母,一定要谨慎对待。
茯苓泻湿汤(治疗小儿容易饥饿且口渴,身体消瘦,腹部胀满且大便不通畅,肠鸣如“HT HT”声,眼部疾病产生翳膜,眼睑闭合无法睁开,眼屎泪水如糊状,时间久了流脓,俗称为疳毒眼。)
柴胡(四分) 白术 甘草(炙) 蔓荆子 人参 枳壳(麸炒) 茯苓
薄荷叶(各二分) 前胡 苍术 独活(各三分) 防风 真川芎 羌活(各三分半) 泽泻(一分半)
以上药材切碎成剂,用水一钟半,煎煮至六分,滤去药渣,温服。
上方是针对小儿寒暑失调、饮食不调而酿成此证。寒暑饮食不节,都能损伤脾胃。脾胃是阴阳汇聚的根本所在。所以清阳之气下陷而不能上升,浊阴之气上逆而不能下降。现在用白术、人参,首先补益脾胃作为君药;柴胡、甘草、枳壳,辅助上述药物补益脾胃作为臣药;苍术燥湿,茯苓、泽泻,引导浊阴之气下降作为佐药;然后用羌活、独活、防风、蔓荆子、前胡、川芎、薄荷等祛风药物来胜湿,引导清阳之气上升作为使药。这正是治疗神效的方法。
升麻龙胆草饮子(又名消翳散,治疗小儿疳眼,流脓生翳,湿热致病,治疗眼中各种疾病的症状。)
羌活 黄芩(炒) 龙胆草 青蛤粉(各五分) 蛇蜕 甘草(炙) 谷精草 川郁金(各三分) 麻黄(一分半)
升麻(二分)
以上药材切碎成剂,也可以做成细末。每次服用二钱,用浓热的茶水调服。
上方以升麻为君药,通行足阳明胃经和足太阴脾经;以羌活、麻黄为臣药,利用风药来胜湿;以甘草为佐药,调和上下;谷精草明目退翳;蛇蜕主治小儿惊疳等疾病;以青蛤粉为使药,治疗疳疾止泻;川郁金补血破血;龙胆草治疗眼中各种疾病;黄芩清除上部热气,治疗目内赤肿。其中龙胆草经过火炒,是因为其性味苦寒,恐怕不炒制的话会过于寒凉。
Wei Qi (Defensive Qi) is deficient, allowing Cold Evil to take advantage. Yuan Qi (Original Qi) is weak, and improper diet causes injury. External invasion combined with internal damage brews into this disease. Parents, considering the child as possessing pure Yang, do not clothe them sufficiently in deep winter. Parents, thinking the child dislikes wind, do not allow them to remove clothes in midsummer. Parents, fearing frequent hunger, force-feed after breastfeeding. Parents, fearing thirst, continue to feed water after breastfeeding. Some parents are foolish and ignorant, failing to examine the child's cold/heat and diet carefully; thus, they do not warm the child when cold, nor cool them when hot; drinking does not quench thirst, eating does not satisfy hunger. Children are quiet and silent, harboring illness but unable to speak of it. Therefore, external invasion and internal damage, following a course of delay and gradual accumulation, brew into Gan Disease (a chronic pediatric condition characterized by emaciation, sallow complexion, sparse/dry hair, and abnormal appetite). Symptoms include thirst and easy hunger, ability to eat yet remaining thin, abdominal distension with difficulty in defecation, and borborygmus sounds like "HT HT". If treatment is delayed day by day, eye diseases arise. This eye disease produces nebulae (corneal opacity), eyelids close and cannot open, discharge and tears become paste-like, and over time pus flows, eventually leading to blindness in both eyes. Why? Because Yang Qi sinks and moves downward, while Yin Qi rebels and moves upward. The treatment method should follow the *Su Wen: Yin Yang Ying Xiang Da Lun*: "Clear Yang emerges from the upper orifices, turbid Yin exits from the lower orifices; Clear Yang disperses through the cou-li (interstices), turbid Yin travels to the Zang organs; Clear Yang circulates in the four limbs, turbid Yin returns to the Fu organs." Let each return to its origin, not reversing their normal state; this is the treatment principle. One should prepare decoctions that raise Yang and descend Yin. Use Fuling Xi Shi Tang (Poria Decoction to Drain Dampness) as the primary formula, or Shengma Longdancao Yinzi (Ephedra and Gentian Decoction) as the primary formula. These medicines treat not only eye diseases but also the aforementioned several syndromes. However, do not delay; delay leads to danger. Parents, please be cautious.
Fuling Xi Shi Tang (Treats pediatric easy hunger and thirst, emaciation, abdominal distension with difficulty in defecation, borborygmus like "HT HT", eye diseases producing nebulae, closed eyelids unable to open, paste-like discharge and tears, pus flowing over time, commonly known as Gan Toxic Eye.)
Chai Hu (Bupleuri Radix, 4 fen) Bai Zhu (Atractylodis Rhizoma, unmeasured) Gan Cao (Glycyrrhizae Radix et Rhizoma, honey-fried, unmeasured) Man Jing Zi (Viticis Fructus, unmeasured) Ren Shen (Ginseng Radix et Rhizoma, unmeasured) Zhi Ke (Aurantii Fructus Immaturus, bran-fried, unmeasured) Fu Ling (Poria, unmeasured)
Bo He Ye (Menthae Haplocalycis Folium, 2 fen each) Qian Hu (Peucedani Radix, unmeasured) Cang Zhu (Atractylodis Rhizoma, 3 fen each) Du Huo (Angelicae Pubescentis Radix, 3 fen each) Fang Feng (Saposhnikoviae Radix, unmeasured) Zhen Chuan Xiong (Ligustici Chuanxiong Rhizoma, 3.5 fen each) Qiang Huo (Notopterygii Rhizoma et Radix, 3.5 fen each) Ze Xie (Alismatis Rhizoma, 1.5 fen)
Cut the above into pieces. Add one and a half zhong of water, decoct until six parts remain, remove dregs, and take warm.
The above formula addresses this syndrome brewed from irregular cold/heat and diet in children. Irregular cold/heat and diet can all injure the Pi Wei (Spleen and Stomach). Pi Wei is the convergence of Yin and Yang. Thus, Clear Yang sinks and fails to rise, Turbid Yin rebels and fails to descend. Now, using Bai Zhu and Ren Shen to first tonify Pi Wei as Jun (Emperor) herbs; Chai Hu, Gan Cao, and Zhi Ke assist the above herbs to tonify Pi Wei as Chen (Minister) herbs; Cang Zhu dries dampness, Fu Ling and Ze Xie guide Turbid Yin downward as Zuo (Assistant) herbs; then use Qiang Huo, Du Huo, Fang Feng, Man Jing Zi, Qian Hu, Chuan Xiong, Bo He, etc., wind-dispelling herbs to overcome dampness and guide Clear Yang upward as Shi (Envoy) herbs. This is indeed a divine and effective method of treatment.
Shengma Longdancao Yinzi (Also known as Xiaoyi San, treats pediatric Gan Eye, pus flow and nebula formation, pathogenic damp-heat, treating various eye diseases.)
Qiang Huo (Notopterygii Rhizoma et Radix, 5 fen each) Huang Qin (Scutellariae Radix, fried, unmeasured) Long Dan Cao (Gentianae Radix, unmeasured) Qing Ge Fen (Concha Meretricis et Cyclinae, 5 fen each) She Tui (Ophichthidis Cutis Cornea, unmeasured) Gan Cao (Glycyrrhizae Radix et Rhizoma, honey-fried, unmeasured) Gu Jing Cao (Evodiae Fructus, unmeasured) Chuan Yu Jin (Curcumae Radix, 3 fen each) Ma Huang (Ephedrae Herba, 1.5 fen)
Sheng Ma (Bupleuri Radix, 2 fen)
Cut the above into pieces, or grind into fine powder. Take two qian per dose, mixed with strong hot tea water.
In the above formula, Sheng Ma is the Jun herb, circulating through the Foot-Yangming Stomach Channel and Foot-Taiyin Spleen Channel; Qiang Huo and Ma Huang are the Chen herbs, using wind herbs to overcome dampness; Gan Cao is the Zuo herb, harmonizing up and down; Gu Jing Brightens the eyes and dispels nebulae; She Tui treats pediatric Jing Gan (convulsive Gan) and other diseases; Qing Ge Fen is the Shi herb, treating Gan to stop diarrhea; Chuan Yu Jin nourishes blood and breaks blood stasis; Long Dan Cao treats various eye diseases; Huang Qin clears upper heat and treats redness and swelling inside the eyes. The Long Dan Cao is fire-fried because its nature is bitter and cold; without frying, it might be excessively cold.