《巢氏病源》小儿头身喜汗出候∶小儿有血气未实者,肤腠则疏。若浓衣温卧,腑脏生热,蒸发腠理,津液
泄越,故令头身喜汗也。
钱乙云∶喜汗者,浓衣卧而额汗出也。止汗散主之。(方见本门。)又六阳虚汗上至头、下至项,不过胸也,不须
治之。
《婴童宝鉴》∶小儿汗出喜惊,舌上白者,衣浓伤热也。
《玉诀》治小儿血热,若病夜间有汗,皆因抱损,抱得胸膛热传与脾,脾传气、气传血。血家既热,内被淳
阳气抱却升,即化而为汗。头发者,血之余,血为根,发为苗。血家既热,头发作穗;血家既热,浑身黄瘦;
血家既热,夜间汗出,此病也,不为盗汗。宜凉胃散。(方见本门。)
《形证论》∶小儿多盗汗,睡起即成迹。医者谓骨蒸,用柴胡药非是,宜服饮心气药即瘥者。心之液为汗,
小儿缘惊,心气不收,故多汗。
《婴童宝鉴》小儿衣浓伤温歌∶
衣浓伤温损令儿,热蒸津液透肤皮,致令身体并头上,汗出如珠滴湿衣。
《千金》治少小头汗出,二物茯苓粉散方。《圣惠》同,亦治盗汗。
茯苓 牡蛎(各四两)
上治下筛,以粉八两,合捣为散。有热辄以粉汗,即自止。
《外台》治心藏热之所感有汗。宜服犀角饮子方
犀角(三分) 茯苓(四分) 麦门冬(六分) 甘草(二分,炙) 白术(一分)
上五味切,以水九合,煎取四合,分再服即定。又加龙齿四分佳。
钱乙止汗散方
上用故蒲扇灰。如无扇,只将故蒲烧灰、研细。每服一、二钱,温酒调下,无时。
《玉诀》治小儿多汗。凉胃散方
青黛 马牙硝 大黄(蒸。各半两) 甘草(炙,一分)
上为末。每服半字,蛤粉水下。
《王氏手集》香粉散 治理虚疏病,常多汗。每用少许扑有汗处,频使不妨。
牡蛎(火 通赤研为粉。一两) 甘松(半两,细研)
《巢氏病源》中关于小儿头部和身体容易出汗的论述:小儿如果气血尚未充实,皮肤腠理就会疏松。如果穿着厚衣服、睡在温暖的地方,脏腑产生内热,热气蒸发腠理,导致津液外泄,所以会出现头部和身体容易出汗的情况。
钱乙说:所谓“喜汗”,是指因为穿得太多、睡得太暖而导致额头出汗。这种情况可以用止汗散来治疗。(方剂见本门。)另外,如果是六阳经虚导致的汗出,汗液上至头顶、下至后颈,但不过胸部,这种情况不需要治疗。
《婴童宝鉴》记载:小儿容易出汗且受惊,舌苔发白的,是因为穿衣过厚导致体内受热。
《玉诀》治疗小儿血热,如果夜间有汗,都是因为被大人怀抱损伤所致。怀抱使胸膛发热,热邪传给脾,脾传气,气传血。血分既已受热,内部受到淳阳之气的影响而升腾,就化为汗水。头发是血的余绪,血为根本,发为枝叶。血分受热,头发会变得干枯如穗;血分受热,全身会发黄消瘦;血分受热,夜间出汗,这是病态,不属于盗汗。宜用凉胃散治疗。(方剂见本门。)
《形证论》记载:小儿多盗汗,睡醒后枕头上留有汗迹。医生认为是骨蒸(一种消耗性热病),使用柴胡类药物是不对的,应该服用调理心气的药物即可痊愈。心的体液是汗,小儿因为受惊,心气不能收敛,所以容易多汗。
《婴童宝鉴》中关于小儿穿衣过厚导致温热的歌诀:
穿衣过厚损害小儿,热气蒸腾津液透达皮肤,导致身体和头部,出汗如珠滴落湿透衣物。
《千金方》治疗婴幼儿头部出汗的二物茯苓粉散方。《圣惠方》相同,也治疗盗汗。
茯苓、牡蛎(各四两)
将上述药材捣碎并过筛,取八两米粉混合捣匀制成散剂。如果有热象,就用此粉扑洒在出汗处,汗自会停止。
《外台秘要》治疗因心脏受热感受邪气而出汗。宜服用犀角饮子方。
犀角(三分)、茯苓(四分)、麦门冬(六分)、甘草(二分,炙烤)、白术(一分)
将以上五味药切碎,用水九合煎煮,取汁四合,分两次服用即可安定。如果再增加龙齿四分效果更好。
钱乙的止汗散方
使用旧的蒲扇灰。如果没有扇子,只需将旧蒲草烧成灰、研细。每次服用一、二钱,用温酒调服,不限时间。
《玉诀》治疗小儿多汗的凉胃散方
青黛、马牙硝、大黄(蒸制,各半两)、甘草(炙烤,一分)
将上述药材研为末。每次服用半字量,用蛤粉水送服。
《王氏手集》香粉散,用于治疗虚疏病症,经常多汗。每次取少许扑在有汗的地方,频繁使用也无妨。
牡蛎(火煅至通红,研磨成粉,一两)、甘松(半两,细研)
According to *Chao Shi Bing Yuan* (Pathogenesis of Diseases by Master Chao) regarding the syndrome of infants and children prone to sweating on the head and body: Infants and children whose blood and qi are not yet solid have loose skin pores (Cou Li). If they wear thick clothes or sleep in warm conditions, internal heat generates within the Zang-Fu organs. This heat steams the pores, causing body fluids (Jin Ye) to leak out, thus resulting in a tendency for the head and body to sweat easily.
Qian Yi stated: "Prone sweating" refers to sweating on the forehead caused by wearing too many clothes and sleeping in warmth. It should be treated with Zhi Han San (Stop Sweat Powder) (See formula in this section). Furthermore, if sweating is due to deficiency of the Six Yang channels, extending from the top of the head down to the neck but not reaching the chest, no treatment is necessary.
*Ying Tong Bao Jian* (Precious Mirror for Infants and Children) records: If an infant sweats easily and startles easily, with a white coating on the tongue, it is due to overheating from excessive clothing.
*Yu Jue* (Jade Instructions) treats blood-heat in infants. If there is night sweating, it is often caused by being held too tightly. The heat from the holder's chest transmits to the Spleen; the Spleen transmits to Qi; Qi transmits to Blood. Once the Blood aspect becomes hot, it is influenced by pure Yang Qi rising internally, transforming into sweat. Hair is considered the surplus of Blood; Blood is the root, and hair is the sprout. When Blood is hot, hair becomes dry and tufted; when Blood is hot, the whole body becomes yellow and emaciated; when Blood is hot, night sweating occurs. This is a pathological condition, distinct from spontaneous sweating during sleep (Dao Han). One should use Liang Wei San (Cool Stomach Powder) (See formula in this section).
*Xing Zheng Lun* (Treatise on Forms and Syndromes) records: Infants often suffer from Dao Han (night sweating), leaving wet marks upon waking. Physicians who diagnose this as Gu Zheng (Bone Steaming, a consumptive fever) and prescribe Chai Hu (Bupleurum) formulas are incorrect. Instead, one should administer medicines that regulate Heart Qi, which will lead to recovery. The fluid of the Heart is sweat. Due to fright, the Heart Qi fails to consolidate, leading to excessive sweating.
From *Ying Tong Bao Jian*, a song regarding infants suffering from warmth due to excessive clothing:
Excessive clothing harms the child,
Heat steams fluids through the skin.
This causes the body and head
To sweat like beads, soaking the clothes.
*Qian Jin Fang* (Essential Prescriptions Worth a Thousand Gold) provides the Er Wu Fu Ling Fen San (Two-Ingredient Poria Powder) for treating head sweating in young children. *Sheng Hui Fang* (Holy Benefit Formulary) has the same formula and also treats Dao Han.
Fu Ling (Poria), Mu Li (Oyster Shell) (each 4 liang).
Process and sift these ingredients. Mix with 8 liang of rice flour and pound into a powder. Apply this powder to sweaty areas when heat is present, and sweating will stop spontaneously.
*Wai Tai Mi Yao* (Secret Essentials of the Outer Palace) treats sweating caused by Heat affecting the Heart Zang. One should take Xi Jiao Yin Zi (Rhinoceros Horn Drink).
Xi Jiao (Rhinoceros Horn), Fu Ling (Poria), Mai Men Dong (Ophiopogon Tuber), Gan Cao (Licorice Root, roasted), Bai Zhu (Atractylodes Rhizome).
Cut the five herbs. Decoct in 9 he of water until 4 he remains. Divide into two doses. Adding Long Chi (Dragon Teeth) 4 fen is beneficial.
Qian Yi’s Zhi Han San (Stop Sweat Powder):
Use ash from old cattail fans. If unavailable, burn old cattail leaves to ash and grind finely. Take 1–2 qian per dose, mixed with warm wine, at any time.
*Yu Jue*’s Liang Wei San (Cool Stomach Powder) for treating excessive sweating in infants:
Qing Dai (Indigo Naturalis), Ma Ya Xiao (Niter), Da Huang (Rhubarb Root and Rhizome, steamed) (each half liang), Gan Cao (Licorice Root, roasted) (1 fen).
Grind into powder. Take half zi per dose, washed down with water containing Ge Fen (Clam Shell Powder).
*Wang Shi Shou Ji* (Wang’s Hand Collection) Xiang Fen San (Fragrant Powder) treats deficiency-type looseness with frequent sweating. Apply a small amount to sweaty areas frequently; this is safe.
Mu Li (Oyster Shell, calcined until red-hot and ground to powder) (1 liang), Gan Song (Nardostachys Radix) (half liang, finely ground).