《千金》∶小儿之病与大人不殊,唯用药有多少为异。其惊痫、客忤、解颅、不行等八、九篇,合为一卷。
自余下痢等方,并散在诸篇中,可披而得也。
葛稚川《肘后方》载鹿鸣山续古序云∶观夫古方药品分两,灸穴分寸不类者,盖古今人体大小或异,脏腑
血脉亦有差焉,请以意酌量。药品分两,古序已明,取所服多少配之。或一分为两,或一铢为两,以盏当升可
也。如中卷末紫丸方,代赭、赤石脂各一两,巴豆四十粒,杏仁五十枚。小儿服一麻子,百日者一小豆且多矣。
若两用二铢四 ,巴豆四粒,杏仁五枚,可疗十数小儿,此其类也。灸之分寸,取其人左、右中指中节可也。
其使有毒野狼虎性药,乃急救性命者也。或遇发毒,急掘地作小坑,以水令满、熟搅稍澄,饮水自解,名为地浆。
特加是说于品题之后尔。
《外台秘要》∶凡人有少病,若似不如平常,则须早道。若隐忍不疗,小儿、女子益以滋甚。
《婴童宝鉴》云∶夫人禀阴阳二气,生疾病于三焦,然冠壮易明,童幼难治。黄帝云∶吾不能察其幼小者,
为别是一家调理耳。此不在《黄帝图经》之论也。(黄帝与岐伯撰《素问》,只说大人十二经脉,即不说小儿。
黄帝云∶吾不察其少小,赖国有巫方,虽以不经可知天寿之要。)又云∶小儿如水中之泡,草头之露者,以表用
药,无令造次焉。为小儿脏腑娇嫩,血气懦
弱,肌体不密,精神未备,故称不易医也。或云∶初生者曰婴儿,三岁者曰小儿,十岁者曰童子。大小各异,
且不可概而用药也。必明消息形候,审定生死,察病患之浅深,知药性之寒温,乃一世之良工矣。
《千金方》记载:小儿的疾病与成人没有本质区别,只是用药剂量的多少有所不同。其中关于惊痫、客忤、解颅、不能行走等八九篇内容,合并为一卷。其余如痢疾等方剂,都分散在各篇章中,查阅即可找到。
葛洪(字稚川)在《肘后备急方》所载的鹿鸣山续古序中说:观察古代方剂的药品分量、艾灸穴位的分寸标准不一致,大概是因为古今人体大小或有差异,脏腑血脉也有不同,请凭心意酌情衡量。药品的分量,古序已经说明,根据服用量的多少进行配比即可。或者将一分折算为两分,或者将一铢折算为两分,用盏代替升来计算也是可以的。例如中卷末尾的紫丸方,代赭石、赤石脂各一两,巴豆四十粒,杏仁五十枚。小儿服用一粒麻子大小的药量,百日大的婴儿服用一粒小豆大小的药量就已经很多了。如果改为用二铢和四铢,巴豆四粒,杏仁五枚,就可以治疗十几个小儿,这就是其中的类推方法。艾灸的分寸,取患者左右手中指中间一节作为标准即可。那些使用具有毒性、像野狼猛虎一样猛烈性质的药物,是为了急救性命。如果遇到毒发,急忙挖掘一个小坑,注满水,充分搅拌后稍作澄清,饮用此水可自行解毒,这种水称为“地浆”。特意在此品题之后加上这一说法罢了。
《外台秘要》记载:凡是人有一点小病,如果觉得身体状态不如平常,就必须尽早告知医生。如果隐忍不治疗,小儿和女子的病情会更加严重。
《婴童宝鉴》说:人禀受阴阳二气而生,疾病产生于三焦,然而成年人容易诊断,婴幼儿难以治疗。黄帝说:我不能详细察知幼小者的情况,因为他们是另一套调理体系。这不在《黄帝图经》的论述范围内。(黄帝与岐伯撰写《素问》,只讲述成人十二经脉,并不讲述小儿。黄帝说:我不察知年少者,依靠国家有巫医方术,虽然看似不经传,但可知晓天年寿数的要领。)又说:小儿就像水中的泡沫、草叶上的露珠,因此在使用表证药物时,不可草率行事。因为小儿脏腑娇嫩,血气虚弱,肌体结构不紧密,精神尚未完备,所以称其不易医治。有人说:刚出生的叫婴儿,三岁的叫小儿,十岁的叫童子。大小各不相同,况且不能一概而论地使用药物。必须明了调护形体征候,审定生死预后,察看病患病的深浅程度,知晓药性的寒热温凉,才是一世的良医。
*Qianjin Fang* (Thousand Gold Formulas) records: The diseases of children are not different from those of adults, with the only exception being the dosage of medication. The eight or nine chapters concerning *jingxian* (convulsions and epilepsy), *ketu* (sudden fright/illness caused by unexpected visitors), *jielu* (separation of cranial sutures), inability to walk, etc., are combined into one volume. Other formulas, such as those for dysentery, are scattered among various chapters and can be found by consulting them.
Ge Hong (courtesy name Zhichuan), in the "Continued Ancient Preface" recorded in *Zhouhou Beiji Fang* (Handbook of Prescriptions for Emergencies), states: Observing that the dosages of medicinal ingredients and the measurements for acupuncture/moxibustion points in ancient prescriptions differ, this is likely because human bodies have varied in size across eras, and the viscera and blood vessels also differ. Therefore, please judge and adjust according to your own understanding. The dosages of medicinal ingredients have already been clarified in the ancient preface; simply match them according to the amount taken. One might convert one *fen* to two *fen*, or one *zhu* to two *zhu*; using a cup (*zhan*) instead of a *sheng* (a unit of volume) is acceptable. For example, in the *Ziwan* (Purple Pill) formula at the end of the middle volume, *Daizhe Shi* (Hematite) and *Chishizhi* (Red Halloysite) are each used in amounts of one *liang*, *Badou* (Croton Seed) forty grains, and *Xingren* (Apricot Seed) fifty pieces. A child taking an amount the size of a hemp seed, or a hundred-day-old infant taking an amount the size of a small bean, would receive a sufficient dose. If converted to two *zhu* and four *zhu*, with four grains of *Badou* and five pieces of *Xingren*, it could treat more than ten children; this illustrates such proportional reasoning. For moxibustion measurements, one may use the middle joint of the left or right middle finger of the patient as the standard. Medicines with toxic properties, akin to wild wolves and tigers, are used only for emergency life-saving measures. In cases of sudden poisoning, one should hastily dig a small pit, fill it with water, stir thoroughly, allow it to settle slightly, and drink this water to detoxify oneself; this water is called *Di Jiang* (Earth Slurry). This specific explanation is added after the title commentary.
*Waitai Miyao* (Essential Prescriptions Worth a Thousand Pieces of Gold) records: Whenever a person feels slightly unwell or notices their condition deviating from the norm, they must report it early. If endured silently without treatment, the condition will worsen significantly, especially in children and women.
*Tongying Baojian* (Precious Mirror for Infants and Children) states: Humans are endowed with Yin and Yang Qi, and diseases arise in the Sanjiao (Triple Burner). However, adult conditions are easier to diagnose, while pediatric conditions are harder to treat. Huangdi (Yellow Emperor) said: "I cannot fully examine the young, as they belong to a separate category requiring distinct management." This is not discussed in the *Huangdi Tu Jing* (Yellow Emperor's Atlas Classic). (Huangdi and Qibo wrote the *Suwen* (Basic Questions), discussing only the twelve meridians of adults, not children. Huangdi said: "I do not examine the young; relying on state-sponsored shamanic methods, though seemingly unorthodox, reveals the essentials of lifespan.") It further states: "Children are like bubbles in water or dew on grass blades; therefore, when using exterior-releasing medications, one must not act rashly." This is because children's viscera are delicate, their Blood and Qi are weak, their body tissues are not dense, and their Spirit has not yet fully developed, hence they are difficult to treat. Some say: Those just born are called *Ying'er* (infants), three-year-olds are called *Xiao'er* (children), and ten-year-olds are called *Tongzi* (boys/children). Their sizes vary greatly, and one cannot apply medications indiscriminately. One must clearly understand how to care for and observe physical signs, determine prognosis, inspect the depth of the illness, and know the cold and warm nature of medicines, to become a master physician of one's generation.