湿痰脾湿懒饮食,倦怠嗜卧面色黄,痰多枳桔二陈剂,饮多桂苓甘术汤。
【注】湿痰者,因小儿过食生冷、油腻之物,有伤脾胃,遂致脾土虚湿,不能运化而
成湿痰,滑而易出。脾虚不运,故懒食;脾主四肢,故倦怠嗜卧;脾属土,故面色多黄。
痰多者,宜用枳桔二陈汤加苍术、白术,除湿化痰;饮盛者,须用桂苓甘术汤,扶阳散
饮。调治合宜,而痰自化矣。
枳桔二陈汤(方见 乳)
桂苓术甘汤
茯苓 桂枝 甘草(生) 白术(土炒)
引用生姜,水煎服。
【方歌】桂苓甘术湿痰饮,除湿利饮更扶阳,茯苓桂枝生甘草,白术土炒引生姜。
诸疝厥阴任脉病,外因风寒邪聚凝,内因湿热为寒郁,证皆牵睾引腹疼。胎疝多因禀赋
病,总审热纵寒痛疼,血左不移气右动,湿则坠重虚坠轻。
【注】厥阴环阴器,入少腹;任脉起于中极之下,以上毛际,循腹里上关元,故诸病
疝莫不属之也。小儿病此,多因先天不足,本脏虚弱。复因外感风邪,内食生冷,寒邪凝
结而成者有之。或因湿热郁于中,复被寒邪束于外,邪气乘虚并于血队,流入厥阴,厥
阴属肝,其性急速,故牵引睾丸,少腹绞痛也,又有胎疝一证,多因孕妇啼泣过伤,动
于阴气,结聚不散,令儿生下即成此证者。大抵热则多纵,寒则多痛;在血分者不移,在
气分者多动;湿肿坠则重,虚肿坠则轻。因证施治,自切中病情矣。
湿痰证表现为脾虚湿盛、食欲不振,身体疲倦乏力、喜欢躺卧,面色萎黄,痰液较多。治疗痰多者,宜用枳桔二陈汤;治疗水饮内停者,宜用桂苓甘术汤。
【注】所谓湿痰,是因为小儿过量食用生冷、油腻食物,损伤脾胃,导致脾土虚弱湿困,不能正常运化水湿而形成湿痰,其质地滑利而易于咳出。脾虚导致运化无力,所以食欲减退;脾主四肢肌肉,所以感到疲倦、嗜睡;脾在五行中属土,对应黄色,所以面色多呈黄色。若痰多,适宜使用枳桔二陈汤加入苍术、白术,以除湿化痰;若水饮邪气旺盛,必须使用桂苓甘术汤,以扶助阳气、消散水饮。只要调理得当,痰饮自然化解。
枳桔二陈汤(方剂见“乳”部)
桂苓甘术汤
组成:茯苓、桂枝、甘草(生用)、白术(土炒)。
用法:加生姜为引,用水煎服。
【方歌】桂苓甘术汤主治湿痰与水饮,能除湿利水并扶助阳气,方中含茯苓、桂枝、生甘草及土炒白术,引用生姜煎服。
各种疝气病属于厥阴肝经和任脉的病变,外因是风寒邪气凝聚,内因是湿热被寒邪郁遏,症状都表现为牵引睾丸疼痛并牵连腹部疼痛。胎疝多因先天禀赋不足所致,总体原则是审察热证则多见弛纵,寒证则多见疼痛;病在血分者位置固定不移,病在气分者疼痛游走不定;湿邪所致者坠胀感沉重,虚证所致者坠胀感较轻。根据具体证候施治,就能切中病情。
【注】厥阴肝经环绕生殖器,进入少腹;任脉起于中极穴之下,向上经过毛际,沿腹腔内部上行至关元穴,所以各种疝气病无不归属于这两条经脉。小儿患此病,多因先天不足,本脏虚弱。再加上外感风邪,内食生冷,导致寒邪凝结而成;或者因湿热郁结于体内,又被寒邪束缚于体表,邪气乘虚侵入血分,流入厥阴经。厥阴经属肝,肝性急速,所以牵引睾丸,引起少腹绞痛。此外还有胎疝这一证型,多因孕妇啼哭过度伤及阴气,导致气机结聚不散,致使婴儿出生后即形成此证。大抵而言,热证多表现为弛纵,寒证多表现为疼痛;病在血分者痛处固定不移,病在气分者疼痛游走不定;湿邪导致的肿胀下坠感觉沉重,虚证导致的肿胀下坠感觉轻微。根据证候进行治疗,自然能切中病情。
Damp-phlegm syndrome manifests as spleen deficiency with dampness, leading to poor appetite, fatigue, a preference for lying down, and a sallow complexion. For cases with abundant phlegm, Zhijie Erchen Tang (Bitter Orange, Platycodon, and Two-Old Decoction) is indicated; for cases with fluid retention, Guiling Gan Zhu Tang (Cinnamon Twig, Poria, Licorice, and Atractylodes Macrocephala Decoction) is indicated.
[Note] Damp-phlegm arises when children overconsume raw, cold, or greasy foods, damaging the Spleen and Stomach. This leads to Spleen-earth deficiency and dampness, impairing transportation and transformation, thereby forming damp-phlegm, which is slippery and easy to expectorate. Due to Spleen deficiency and impaired transport, there is anorexia; since the Spleen governs the four limbs, there is fatigue and lethargy; as the Spleen corresponds to Earth in the Five Phases, the complexion tends to be yellow. If phlegm is abundant, Zhijie Erchen Tang added with Cangzhu (Atractylodis Rhizoma) and Baizhu (Atractylodis Macrocephalae Rhizoma) should be used to resolve dampness and transform phlegm; if fluid retention is severe, Guiling Gan Zhu Tang must be used to support Yang and dissipate fluids. With appropriate regulation, the phlegm and fluids will naturally resolve.
Zhijie Erchen Tang (Formula see "Infant Care" section)
Guiling Gan Zhu Tang
Ingredients: Fuling (Poria), Guizhi (Cinnamomi Ramulus), Gancao (Licorizae Radix et Rhizoma, raw), Baizhu (Atractylodis Macrocephalae Rhizoma, stir-fried with earth).
Administration: Add Shengjiang (Zingiberis Rhizoma Recens) as a guide, decoct in water, and take orally.
[Formula Song] Guiling Gan Zhu Tang treats damp-phlegm and fluid retention, resolving dampness, promoting diuresis, and supporting Yang; it contains Fuling, Guizhi, raw Gancao, and earth-stir-fried Baizhu, guided by Shengjiang.
Various hernia diseases belong to the Jueyin Liver Meridian and Ren Mai (Conception Vessel). Externally, they are caused by the aggregation of Wind-Cold pathogens; internally, by Damp-Heat constrained by Cold. The symptoms all involve pain radiating from the testicles to the abdomen. Congenital hernia (Tai Shan) is mostly due to innate constitution defects. Generally, Heat patterns manifest as flaccidity/relaxation, while Cold patterns manifest as pain; Blood-level pathology remains fixed, whereas Qi-level pathology moves; Dampness causes heavy bearing-down sensation, while Deficiency causes light bearing-down sensation.
[Note] The Jueyin meridian circles the genitalia and enters the lower abdomen; the Ren Mai originates below Zhongji (CV3), ascends above the pubic hair, and follows the interior of the abdomen to Guan Yuan (CV4). Therefore, all hernia diseases belong to these meridians. Children suffering from this condition often have innate insufficiency and weakness of the Zang-Fu organs. This may be compounded by external contraction of Wind pathogens and internal consumption of raw/cold foods, causing Cold pathogen coagulation; or by Damp-Heat stagnating internally while Cold binds externally, allowing pathogens to invade the Blood aspect and flow into the Jueyin meridian. Since Jueyin belongs to the Liver, and the Liver's nature is swift and urgent, it causes traction on the testicles and colicky pain in the lower abdomen. There is also the condition of congenital hernia, often caused by excessive weeping by the pregnant woman, disturbing Yin Qi, leading to qi stagnation and accumulation, resulting in the infant being born with this condition. Broadly speaking, Heat causes flaccidity, Cold causes pain; Blood-level pathology is fixed, Qi-level pathology moves; Dampness causes heavy swelling and bearing-down, Deficiency causes light swelling and bearing-down. Treating according to the specific syndrome will accurately address the disease.