《巢氏病源》小儿遗尿候∶遗尿者,此由膀胱有冷不能约于水故也。足太阴为膀胱之经,足少阴为肾之经,
此二经为表里。肾主水,肾气下通于阴。小便者,水液之余也。膀胱为津液之腑,既冷气衰弱不能约水,故遗尿也。
《千金》治小儿遗尿方。
瞿麦 龙胆 皂荚 桂心 石韦(各半两) 鸡肠草 人参(各一两) 车前子(一两六铢)
上八味末之,蜜丸,每食后服如小豆大五丸,日三,加至六七丸。
《千金》又方
上以小豆叶捣汁服。
《千金》又方
上烧鸡肠末之,浆水服方寸匕,日三。一云面北斗服。
《外台》∶《千金》疗失禁不觉尿出方。
上以豆酱和灶突墨,如大豆许,内尿孔中佳。
《圣惠》治小儿遗尿不可禁止。鸡 散方
鸡 (六具,炙令黄) 桑螵蛸(三分微炒) 甘草(一分,炙微赤,锉) 黄 牡蛎(烧为粉。各半两)
上件药捣,粗罗为散。每服二钱,以水二小盏,煎至六分去滓,量儿大小分减温服。
《圣惠》治小儿遗尿、体瘦、心烦不欲食。牡蛎散方
牡蛎粉 桑螵蛸(微炒) 龙骨(各三分) 甘草(七分,炙微赤,锉) 麦门冬(去心焙) 鸡肠草 黄 白
茯苓(各半两)
上件药捣,粗罗为散。每服一钱,以水一小盏,入生姜少许,枣二枚,煎至六分去滓,量儿大小分减温服。
《圣惠》治小儿遗尿足寒,宜服白术散方
白术 土瓜根(各半两) 牡蛎粉(三分)
上件药捣,粗罗为散。每服一钱,以水一小盏,入生姜少许,枣二枚,煎至六分去滓,量儿大小分减温服。
《婴孺》治小儿遗尿方。
上杵小豆末,取乳汁调服之。
《婴孺》又方
瞿麦 龙胆 石韦 皂荚(炙) 桂心(各二分) 鸡肠草 人参(各三分) 车前子(五分) 桑螵蛸(炙,十
分) 肉鸡肠(自死者,十二分)
上为末,蜜丸如小豆大。服五丸,日三,至六、七丸,食前。
《千金》灸法∶遗尿灸脐下二寸半,随年壮。又灸大敦三壮亦治。
《巢氏病源》中关于小儿遗尿的论述:遗尿,是由于膀胱有寒邪,不能约束尿液所致。足太阴脾经与膀胱相表里(注:此处原文表述有误,通常足太阳膀胱经与足少阴肾经为表里,但此处依原文翻译),足少阴肾经是肾脏的经脉,这两条经脉互为表里关系。肾主水液代谢,肾气向下通达于前阴。小便,是水液代谢后的剩余部分。膀胱是贮存津液的腑,既然寒气导致脏腑功能衰弱,无法约束尿液,所以出现遗尿。
《千金方》治疗小儿遗尿的方剂。
瞿麦、龙胆、皂荚、桂心、石韦(各半两)、鸡肠草、人参(各一两)、车前子(一两六铢)。
以上八味药研成细末,用蜂蜜制成丸药,每次饭后服用如小豆大小的五丸,每日三次,剂量可逐渐增加至六七丸。
《千金方》又一方。
将鸡肠烧成炭后研末,用浆水送服一方寸匕,每日三次。另一种说法是面向北斗星方向服用。
《外台秘要》记载:《千金方》治疗小便失禁、不知不觉尿出的方剂。
用豆酱调和灶膛口的烟墨(灶突墨),取如大豆大小的量,纳入尿道口内为佳。
《太平圣惠方》治疗小儿遗尿、无法控制尿意的鸡散方。
鸡(六具,炙烤至黄色)、桑螵蛸(三分,微炒)、甘草(一分,炙至微红,切碎)、黄芪、牡蛎(烧成粉,各半两)。
以上药物捣碎,粗筛成散剂。每次服用二钱,用水两小盏,煎煮至六分,去渣,根据患儿年龄大小调整剂量,温服。
《太平圣惠方》治疗小儿遗尿、身体消瘦、心烦不想吃饭的牡蛎散方。
牡蛎粉、桑螵蛸(微炒)、龙骨(各三分)、甘草(七分,炙至微红,切碎)、麦门冬(去心焙干)、鸡肠草、黄芪、白茯苓(各半两)。
以上药物捣碎,粗筛成散剂。每次服用一钱,用水一小盏,加入少许生姜、大枣两枚,煎煮至六分,去渣,根据患儿年龄大小调整剂量,温服。
《太平圣惠方》治疗小儿遗尿且脚冷的,宜服用白术散方。
白术、土瓜根(各半两)、牡蛎粉(三分)。
以上药物捣碎,粗筛成散剂。每次服用一钱,用水一小盏,加入少许生姜、大枣两枚,煎煮至六分,去渣,根据患儿年龄大小调整剂量,温服。
《婴孺方》又一方。
瞿麦、龙胆、石韦、皂荚(炙)、桂心(各二分)、鸡肠草、人参(各三分)、车前子(五分)、桑螵蛸(炙,十分)、肉鸡肠(自然死亡的,十二分)。
以上药物研成细末,用蜂蜜制成如小豆大小的丸药。每次服用五丸,每日三次,增至六、七丸,饭前服用。
According to *Chao Shi Bing Yuan* (Source of Diseases by Master Chao) regarding the syndrome of pediatric enuresis: Enuresis is caused by cold in the Bladder, which fails to restrain water. The Foot-Taiyin Splein Meridian is associated with the Bladder, and the Foot-Shaoyin Kidney Meridian is the meridian of the Kidney; these two meridians have a exterior-interior relationship. The Kidney governs water metabolism, and Kidney Qi extends downward to the external genitalia. Urine is the residual part of fluid metabolism. The Bladder is the fu-organ of body fluids; since cold qi weakens its function, failing to restrain urine, enuresis occurs.
*Qianjin Fang* (Prescriptions Worth a Thousand Gold) treats pediatric enuresis with the following formula:
*Epimedii Herba* (Qumai), *Gentianae Radix* (Longdan), *Gleditsiae Fructus* (Zaojia), *Cinnamomi Ramulus* (Guixin), *Pyri Folium* (Shiwei) (each 0.5 liang); *Polygoni avicularis Herba* (Jichangcao), *Ginseng Radix et Rhizoma* (Renshen) (each 1 liang); *Plantaginis Semen* (Cheqianzi) (1 liang 6 zhu).
Grind the above eight herbs into powder, mix with honey to make pills the size of small beans. Take five pills after each meal, three times a day, increasing gradually to six or seven pills.
Another prescription from *Qianjin Fang*:
Crush the leaves of *Vigna angularis* (Xiaodouye) to extract juice and take it orally.
Another prescription from *Qianjin Fang*:
Burn chicken intestines to ash, grind into powder, and take one fangcun bi (a measure for powder) with jiangshui (fermented grain liquid), three times a day. Another method states to take it facing the Big Dipper.
*Waitai Miyao* (Secret Prescriptions from the Imperial Cabinet) records a prescription from *Qianjin Fang* for urinary incontinence where urination occurs unconsciously:
Mix bean paste with soot from the chimney flue (Zaotu Mo), form a pill the size of a large bean, and insert it into the urethral orifice. This is considered optimal.
*Tai Ping Sheng Hui Fang* (Holy惠民 Formulas of the Taiping Era) treats pediatric enuresis with uncontrollable urge using Ji San Powder:
Chicken (six units, roasted until yellow); *Mantis Ootheca* (Sangpiaoxiao) (3 fen, lightly stir-fried); *Licorice Root* (Gancao) (1 fen, roasted until slightly red, chopped); *Astragali Radix* (Huangqi); *Ostreae Concha* (Muli) (calcined into powder, each 0.5 liang).
Pulverize the above ingredients and sieve coarsely to make a powder. Take 2 qian per dose, decoct with two small cups of water until reduced to 0.6 cup, strain, and administer warm in adjusted doses according to the child's age and size.
*Tai Ping Sheng Hui Fang* treats pediatric enuresis accompanied by emaciation, irritability, and anorexia using Muli San Powder:
*Ostreae Concha* powder; *Mantis Ootheca* (Sangpiaoxiao) (lightly stir-fried); *Fossilized Bones* (Longgu) (each 3 fen); *Licorice Root* (Gancao) (7 fen, roasted until slightly red, chopped); *Ophiopogonis Tuber* (Mendong) (decored and baked); *Polygoni avicularis Herba* (Jichangcao); *Astragali Radix* (Huangqi); *Poria* (Fuling) (each 0.5 liang).
Pulverize the above ingredients and sieve coarsely to make a powder. Take 1 qian per dose, decoct with one small cup of water, add a little fresh ginger and two dates, reduce to 0.6 cup, strain, and administer warm in adjusted doses according to the child's age and size.
*Tai Ping Sheng Hui Fang* treats pediatric enuresis with cold feet, recommending Baizhu San Powder:
*Atractylodis Macrocephalae Rhizoma* (Baizhu); *Trichosanthes Thunbergiana Radix* (Tugua Gen) (each 0.5 liang); *Ostreae Concha* powder (3 fen).
Pulverize the above ingredients and sieve coarsely to make a powder. Take 1 qian per dose, decoct with one small cup of water, add a little fresh ginger and two dates, reduce to 0.6 cup, strain, and administer warm in adjusted doses according to the child's age and size.
*Yingru Fang* treats pediatric enuresis:
Grind *Vigna angularis* seeds into powder, mix with milk, and take orally.
Another prescription from *Yingru Fang*:
*Epimedii Herba* (Qumai), *Gentianae Radix* (Longdan), *Pyri Folium* (Shiwei), *Gleditsiae Fructus* (Zaojia, roasted), *Cinnamomi Ramulus* (Guixin) (each 2 fen); *Polygoni avicularis Herba* (Jichangcao), *Ginseng Radix et Rhizoma* (Renshen) (each 3 fen); *Plantaginis Semen* (Cheqianzi) (5 fen); *Mantis Ootheca* (Sangpiaoxiao, roasted, 10 fen); Chicken intestine (from naturally dead chickens, 12 fen).
Grind into powder, mix with honey to make pills the size of small beans. Take five pills, three times a day, increasing to six or seven pills, taken before meals.
Moxibustion method from *Qianjin Fang*: For enuresis, moxa-burn the point 2.5 cun below the umbilicus, with the number of moxa cones (zhuang) corresponding to the child's age. Additionally, moxa-burning the Dazhun (LR1) point for three cones also treats this condition.