消风丸 凡疏通腠理,清解表邪,启发皮毛,流利经络,病之初起者用之。
方见卷二痫证门。
集成金粟丹 凡开关通窍,下气利痰,醒昏定痉,一切危急者用之。
方见卷二咳嗽门。
集成沆瀣丹(音亢械) 凡导滞清热,降火利膈,解胎毒,去积热,通利二便用之。
方见卷二胎疾门。
泻青丸 凡退热平肝,清表里,定痉搐,解烦退热,表里两急者用之。
方见卷四啼哭门。
理中丸 凡脾虚中寒,面青腹痛,寒呕寒泻,四肢厥冷,一切虚寒者用之。
方见卷二乳子伤寒之理中汤,加增分两,炒研蜜丸,即理中丸。
三仙丹 凡饮食过多,有形之物填塞中焦,及痢疾大便不通,一切宜攻下者用之。
方见卷二痢疾门。
太极丸 凡遇年岁疫疠流行,小儿发热昏沉,甚则作搐者,时疫也。宜用此。
方见卷二小儿时疫门。
以上七方,皆宜预为修制,以备急需。凡古方截风定搐之药,无所用之,不必留意。
幼科谓小儿八岁以前无伤寒,不知此语出于何经?夫寒风暑湿燥火,为六气政令,乃阴阳代谢之机,岂伤
人之物?只因人之脏气不足者,各从其类而翕受之,因其偏受而致病,所以谓六淫之邪,其来自天,决无择人
而入之理。今谓小儿八岁以前无伤寒,不知寒邪不伤八岁以前之几乎?抑八岁以前之儿不受寒邪之伤乎?若谓
八岁以前天癸未足,则八岁以后天癸仍未足,则应云十六岁以前无伤寒,又何独以八岁为言哉?夫癸肾内藏真
阳,与膀胱为表里,今癸水真阳未足,则王水清寒,故寒邪之来,各从其类,竟趋太阳寒水之经,以寒召寒,
诚莫能御,所以小儿伤寒为最多。今谓其无伤寒,不几令小儿之病伤寒者,束手待毙,皆死非命乎!非小儿
无伤寒,因其荣血未充,易于生热,治之不当,即变而为痉。幼科指为惊风者,即此是也。然小儿伤寒,贵于
急治,但不宜发表,由其肌肤薄,腠理疏,恐致汗多亡阳。若能于初起之时,即为解肌,祛其表邪从外而出,
则必无变痉之虞矣。
或曰∶伤寒同一病耳,而乳子与小儿治各有异,何也?曰∶乳子筋骨柔脆,不耐伤
寒,初入太阳,即人事昏沉,浑身壮热,筋脉牵强。医不详辨,误认惊风,其祸立至。所以乳子伤寒贵于急治,
故辨证不繁,用方宜简,若迁延时日,则无力耐之矣。是以与小儿之传经论治者,缓急不同。
其证初起,男体重,面黄而带惨色,女面赤而带惨色,喘急恶寒,口中气热,呵欠顿闷,项急者是也。
如恶风寒,心偎藏其身于母怀者,是藏头伏面,此谓表证。可与解肌,桂枝防风汤。
如恶热,出头露面,扬手掷足,烦渴便秘,掀衣气粗,是为里证,略疏通之,小柴胡汤加大黄,中病即止。
如头额冷,手足冷,口中气冷,面色暗淡,大便泻青,此为阴证里虚。当救其里,宜理中汤。
如大热大渴自汗,此表里实热,宜和解,柴胡白虎汤清之。
又有先伤风寒,后伤饮食,或先停饮食,后感风寒,名夹食伤寒。其证壮热头痛,嗳气腹胀,大便酸臭,
留连不解,大柴胡汤下之。体素弱者,猩猩散。
消风丸:凡是疏通腠理(皮肤纹理及汗孔),清解表邪,启发皮毛,流利经络,在疾病初起阶段使用的方剂。
方剂详情见卷二痫证门。
集成金粟丹:凡是开通关窍、通利九窍,降气化痰,苏醒神昏、定止惊厥,适用于一切危急重症的方剂。
方剂详情见卷二咳嗽门。
集成沆瀣丹(读音:亢械):凡是导滞清热,降火利膈,解除胎毒,去除积热,通利大小便的方剂。
方剂详情见卷二胎疾门。
泻青丸:凡是退热平肝,清解表里之热,定止惊厥抽搐,解除烦闷退热,适用于表里俱急的方剂。
方剂详情见卷四啼哭门。
理中丸:凡是脾虚中寒,面色青黄伴腹痛,寒性呕吐、寒性腹泻,四肢厥冷,以及一切虚寒证的方剂。
方剂详情见卷二乳子伤寒之理中汤,增加分量,炒研后以蜂蜜制成丸剂,即为理中丸。
三仙丹:凡是饮食过多,有形之物填塞中焦(脾胃),以及痢疾导致大便不通,一切适宜攻下治疗的方剂。
方剂详情见卷二痢疾门。
太极丸:凡是遇到年份疫病流行,小儿发热昏沉,甚至出现抽搐症状时,属于时行疫病,适宜使用此方。
方剂详情见卷二小儿时疫门。
以上七方,都应当预先制备,以备急需。凡是古方中用于截断风邪、定止抽搐的药物,此处均不适用,不必留意。
儿科医生常说八岁以下的小儿没有伤寒病,不知道这句话出自哪部经典?寒风、暑湿、燥火,作为六气(风、寒、暑、湿、燥、火)的正常政令,是阴阳交替代谢的机制,难道是伤害人体的东西吗?只是因为人的脏气不足,各自顺应同类之气而接受它,因为偏受某种邪气而导致生病,所以说六淫(风、寒、暑、湿、燥、火六种外感病邪)之邪,来自天空,绝对没有挑选人进入的道理。现在说八岁以下的小儿没有伤寒病,难道寒邪不伤害八岁以下的小孩吗?还是说八岁以下的小孩不受寒邪的伤害呢?如果说八岁以下小儿天癸(指肾中精气充盈到一定程度产生的与生殖有关的物质)未足,那么八岁以后天癸也未足,那就应该说十六岁以下没有伤寒病,又何必唯独以八岁来说事呢?夫癸水属肾,内藏真阳,与膀胱互为表里,现在癸水真阳不足,则肾水清寒,所以寒邪来临时,各从其类,径直趋向太阳寒水之经,以寒召寒,确实无法抵御,所以小儿患伤寒病的非常多。现在说他们没有伤寒病,岂不是让患伤寒病的小儿束手待毙,都死于非命吗!并不是小儿没有伤寒病,而是因为他们的营血(运行于脉中的精气)未充盛,容易产生内热,治疗不当,就会转变为痉病(以项背强直、四肢抽搐为主要表现的病证)。儿科医生将其指认为惊风(以抽搐、昏迷为主要特征的儿科常见病),就是这种情况。然而,小儿伤寒贵在紧急治疗,但不宜使用发汗解表的方法,因为其肌肤薄嫩,腠理疏松,恐怕导致出汗过多而亡失阳气。如果能在初起之时,就采用解肌(解除肌表之邪)的方法,祛除表邪从体外排出,那么就一定没有转变为痉病的忧虑了。
有人问:伤寒是同一种病,但婴儿与小儿的治疗各有不同,为什么呢?回答说:婴儿筋骨柔脆,不耐受伤寒,刚侵入太阳经,就会出现人事昏沉,浑身高热,筋脉牵强拘急。医生如果不详细辨别,误认为是惊风,灾祸立刻降临。所以婴儿伤寒贵在紧急治疗,因此辨证不需要太繁杂,用方应该简洁,如果拖延时日,婴儿就没有力气承受了。因此,这与小儿按传经规律论治的方法,缓急是不同的。
其症状初起时,男患儿身体沉重,面色黄而带有惨淡之色;女患儿面色红赤而带有惨淡之色,气喘急促、恶寒,口中气息热,打呵欠且感到郁闷,颈项僵硬,这就是伤寒的症状。
如果恶风寒,喜欢把头藏在母亲怀里,缩头伏面,这称为表证。可以给予解肌治疗,使用桂枝防风汤。
如果恶热,喜欢出头露面,扬手掷足,烦躁口渴,便秘,掀开衣服,呼吸粗重,这是里证,稍微疏通一下,使用小柴胡汤加大黄,见效即止。
如果头额冷,手脚冷,口中气息冷,面色暗淡,大便泻出青色稀便,这是阴证里虚。应当救治其里虚,适宜使用理中汤。
如果出现大热、大渴、自汗,这是表里实热,适宜和解,使用柴胡白虎汤来清解。
又有先伤于风寒,后伤于饮食,或者先停食,后感风寒的,名叫夹食伤寒。其症状为壮热头痛,嗳气腹胀,大便酸臭,病情迁延不解,使用大柴胡汤攻下。体质素来虚弱者,使用猩猩散。
Xiaofeng Wan (Wind-Dispersing Pill): Used at the initial stage of illness to unblock Couli (the pores and interstices of the skin), clear and resolve exterior pathogens, stimulate the skin and hair follicles, and facilitate the flow of meridians.
For the prescription details, see Volume 2, Section on Epilepsy.
Jicheng Jin Su Dan (Integrated Golden Millet Pill): Used for all critical emergencies to open orifices, descend Qi, promote expectoration, awaken from coma, and arrest convulsions.
For the prescription details, see Volume 2, Section on Cough.
Jicheng Hang Xie Dan (Integrated Hengxie Pill) [Pronunciation: Kang Xie]: Used to guide out stagnation, clear heat, descend fire, benefit the diaphragm, resolve fetal toxins, remove accumulated heat, and promote the free flow of urination and defecation.
For the prescription details, see Volume 2, Section on Fetal Diseases.
Xie Qing Wan (Draining Green Pill): Used to reduce fever, calm the Liver, clear heat in both the interior and exterior, arrest convulsions, relieve irritability, and reduce fever, specifically for cases where both exterior and interior conditions are urgent.
For the prescription details, see Volume 4, Section on Crying.
Lizhong Wan (Regulate the Middle Pill): Used for Spleen deficiency with middle Jiao cold, presenting with a bluish-yellow complexion and abdominal pain, cold vomiting, cold diarrhea, cold limbs, and all types of deficiency-cold syndromes.
For the prescription details, see Volume 2, Lizhong Tang for Infant Cold Damage; increase the dosage, grind the herbs, and form pills with honey. This constitutes Lizhong Wan.
Sanxian Dan (Three Immortals Pill): Used for excessive food intake causing tangible matter to block the middle Jiao (Spleen and Stomach), dysentery leading to constipation, and all cases requiring purgative treatment.
For the prescription details, see Volume 2, Section on Dysentery.
Taiji Wan (Supreme Ultimate Pill): Used when epidemic diseases prevail in a given year, and infants present with fever, lethargy, and even convulsions, indicating an epidemic pathogen. This formula is appropriate.
For the prescription details, see Volume 2, Section on Pediatric Epidemic Diseases.
The above seven formulas should all be prepared in advance for emergency use. Medications from ancient formulas used to cut off wind pathogens and arrest convulsions are not applicable here and need not be considered.
Pediatric practitioners often claim that children under eight years old do not suffer from Shanghan (Cold Damage). It is unknown which classic text this statement originates from. Wind, cold, summerheat, dampness, dryness, and fire constitute the Six Qi (Normal Climate Factors), representing the mechanism of yin-yang alternation and metabolism. Are they inherently harmful to humans? Illness arises only because individuals with insufficient Zang-Fu Qi accept pathogens according to their affinity. Due to this biased reception, disease occurs. Thus, it is said that the Six Excesses (Pathogenic Factors) come from heaven and do not selectively enter specific people. To claim that children under eight do not get Shanghan implies either that cold pathogens do not harm those under eight, or that those under eight are immune to cold pathogens. If one argues that Tian Gui (Kidney Essence related to reproduction) is insufficient before age eight, it remains insufficient after age eight as well; thus, it should be stated that no one under sixteen gets Shanghan. Why single out age eight? The Kidney Water (Gui Shui) stores True Yang and has a exterior-interior relationship with the Bladder. When Kidney True Yang is insufficient, the Kidney Water becomes cold and clear. Consequently, cold pathogens follow their affinity and directly attack the Taiyang (Greater Yang) channel of cold water. Inviting cold with cold, defense is indeed impossible, which is why pediatric Shanghan is most common. Claiming they do not get Shanghan would leave these children helpless, leading to premature death! It is not that children do not get Shanghan, but rather that their Ying Blood (Nutritive Blood) is not yet full, making them prone to generating internal heat. Improper treatment can transform the condition into Jing Disease (Spasm Disorder, characterized by stiffness and convulsions). Pediatric practitioners identify this as Jing Feng (Startled Wind), which is precisely this situation. However, pediatric Shanghan requires urgent treatment but forbids aggressive sweating methods (Releasing the Exterior). Because their skin is thin and Couli are loose, excessive sweating may lead to the loss of Yang Qi. If Ji Ji (Muscle Layer) is resolved at the onset to expel exterior pathogens outward, there will be no risk of transformation into Spasm Disorder.
One might ask: Shanghan is the same disease, yet the treatment for infants differs from that for older children. Why? The answer is: Infants have soft and fragile bones and sinews, making them intolerant to Shanghan. Upon entering the Taiyang channel, they quickly exhibit lethargy, high fever throughout the body, and muscle tension. If physicians fail to differentiate carefully and mistakenly diagnose Startled Wind, disaster ensues immediately. Therefore, infant Shanghan requires urgent treatment; differentiation should not be overly complex, and prescriptions should be simple. Delaying treatment exhausts the infant's strength. Hence, the urgency differs from the transmission-based treatment approach used for older children.
Initial symptoms include: In male infants, heavy body, yellowish complexion with a dull hue; in female infants, reddish complexion with a dull hue, panting, aversion to cold, hot breath, yawning with a sense of oppression, and neck stiffness.
If there is aversion to wind and cold, and the child hides their head in the mother's embrace (hiding face and head), this is an Exterior Syndrome. Treat by resolving the muscle layer using Guizhi Fangfeng Tang (Cinnamon Twig and Saposhnikovia Decoction).
If there is aversion to heat, with the child exposing their head and face, throwing hands and feet, irritability, thirst, constipation, lifting clothes, and coarse breathing, this is an Interior Syndrome. Gently unblock using Xiaochaihu Tang (Minor Bupleurum Decoction) with added Dahuang (Rhubarb Root). Stop once the condition improves.
If the forehead and extremities are cold, breath is cold, complexion is dull, and stools are green and watery, this is a Yin Syndrome with Interior Deficiency. Rescue the Interior using Lizhong Tang (Regulate the Middle Decoction).
If there is high fever, extreme thirst, and spontaneous sweating, this is Excess Heat in both Exterior and Interior. Resolve harmoniously using Chaihu Baihu Tang (Bupleurum and White Tiger Decoction) to clear heat.
There is also "Food-Stagnation Shanghan," caused by first contracting wind-cold then suffering from dietary stagnation, or vice versa. Symptoms include high fever, headache, belching, abdominal distension, sour-smelling stools, and lingering illness. Purge using Dachaihu Tang (Major Bupleurum Decoction). For those with constitutionally weak bodies, use Xingxing San (Orangutan Powder).