总括
小儿泄泻一证,多因脾被湿侵,土不胜水而成。然致病之原各异,医者认之须清。或伤乳停食不化,或感受寒冷暑
热之气,或惊邪外触,或脏受寒冷,或脾虚作泻,更有飧泻水泻之证。致疾之因不同,而调治之法亦异,或分消,或温
补,治宜精细辨之。
伤乳食泻
小儿因乳食过饱,损伤脾胃,乳食不化,故频泻酸胀,噫臭,腹热胀满疼痛,口渴恶食,小便赤涩。须用保安丸消
其滞,次用平胃散和其脾,庶积消而泻止,奏神功矣。
中寒泻
小儿中寒泻者,因过食生冷油腻。肠鸣腹胀,时复疼痛,所泄皆澄彻清冷,面色淡白,四肢逆冷,懒进饮食。温中
理中汤主之,止泻诃子散堪行也。
火泻
火泻者,皆因脏腑积热,或外伤暑气。故泻时暴注下迫,肚腹疼痛,心烦口渴,泻多黄水,小便赤色。先用玉露散
清其热,再用四苓散利其水,庶可收功矣。
惊泻
惊泻者,因气弱受惊,致成泄泻。其候夜卧不安,昼则惕惊,粪稠若胶,并带青色如苔也。治宜镇心抑肝,先以镇
惊散定其惊,次以养脾丸服之理其脾,则通灵可望也。
脏寒泻
小儿断脐失护,风冷乘入,传于大肠,遂成寒泻之证。其候粪色清白,腹痛肠鸣。先散其寒,用和气饮极效;后用
温补,以调中汤再灵也。
脾虚泻
脾虚泻者,多因脾不健运。故每逢食后即作泻,腹满不渴,短少精神,面黄懒食,肌肉消瘦也。宜用参苓白术散治
之,必奏奇效也。
飧泻
小儿或因春伤风邪,清气下陷,脾失健运,以致完谷不化者,乃飧泻之名也。治者须补养脾土,先用补中益气汤,
升其中气。若泄泻日久,肠滑不禁者,用四神丸治之。
水泻
小儿脾胃湿盛,致成水泻。懒食溏泻,便色多黄,清浊不分,溺来短涩。宜用胃苓汤以除湿;若泻久不止,则用升
阳除湿汤治之自愈。
总括
小儿泄泻这一病症,多因脾脏被湿邪侵袭,导致土(脾)不能克制水(肾/湿),从而形成。然而致病的根源各不相同,医生必须辨识清楚。有的因乳食停滞不化,有的因感受寒冷或暑热之气,有的因惊邪外触,有的因脏腑受寒,有的是脾虚导致的泄泻,更有飧泻和水泻的证型。致病原因不同,调理治疗的方法也各异,有的采用分消法,有的采用温补法,治疗应当精细辨别。
伤乳食泻
小儿因为乳食过饱,损伤了脾胃,乳食无法消化,所以频繁腹泻且伴有酸胀感,打嗝有臭味,腹部发热、胀满疼痛,口渴且厌恶进食,小便赤红涩痛。需要使用保安丸来消除积滞,接着使用平胃散来调和脾脏,这样积滞消除而泄泻停止,就能取得神奇的功效了。
中寒泻
小儿患中寒泻,是因为过多食用生冷油腻食物。肠鸣腹胀,时常反复疼痛,排泄物清澈冷凉,面色淡白,四肢逆冷,懒于进食。以温中的理中汤为主治方剂,止泻的诃子散也可以使用。
火泻
火泻,都是因为脏腑内有积热,或者外伤暑气。所以腹泻时急迫暴注,肚腹疼痛,心烦口渴,排泄大量黄水,小便颜色赤红。先用玉露散清除其热,再用四苓散利水渗湿,这样才能收效。
惊泻
惊泻,是因为气弱受到惊吓,导致形成泄泻。其表现为夜间睡眠不安,白天则惊恐惕惧,粪便稠厚如胶,并带有青色如同苔藓一样。治疗应当镇心安神、抑制肝风,先用镇惊散安定其惊悸,再用养脾丸服用以调理脾脏,那么痊愈的希望就很大了。
脏寒泻
小儿断脐时护理不当,风冷之邪乘虚而入,传入大肠,遂成寒泻证型。其表现为粪便颜色清白,腹痛肠鸣。先散其寒,使用和气饮效果极佳;后用温补之法,以调中汤再次发挥灵验作用。
脾虚泻
脾虚泻,多因脾脏运化功能不健。所以每逢进食后即发生泄泻,腹部胀满但不口渴,精神短少,面色萎黄懒食,肌肉消瘦。宜用参苓白术散治疗它,必定能奏出奇效。
飧泻
小儿或因春季受伤风邪,清气下陷,脾失健运,以致完谷不化的,这就是飧泻的名称。治疗者必须补养脾土,先用补中益气汤,提升其中气。如果泄泻日久,肠道滑脱不禁的,用四神丸治疗。
水泻
小儿脾胃湿气盛,导致形成水泻。懒食,大便溏薄,便色多黄,清浊不分,尿量少且涩滞。宜用胃苓汤来除湿;如果泄泻长久不止,则用升阳除湿汤治疗即可自愈。
General Overview
The syndrome of infantile diarrhea (Xie Xie) is mostly caused by the Spleen being invaded by Dampness, resulting in Earth failing to control Water. However, the origins of disease vary, and physicians must clearly identify them. Some cases arise from milk and food stagnation with indigestion; some from exposure to cold or summer-heat pathogens; some from external startling evils; some from cold affecting the Zang organs; some are diarrhea due to Spleen deficiency; and there are also syndromes of undigested stool diarrhea (Sun Xie) and watery diarrhea (Shui Xie). Since the causes of disease differ, the methods of regulation and treatment also vary: some employ dispersion and elimination, while others use warming and tonification. Treatment requires careful differentiation.
Diarrhea Due to Milk and Food Injury
Infantile diarrhea due to milk and food injury occurs when excessive intake damages the Spleen and Stomach, causing milk and food to fail to digest. Consequently, there is frequent diarrhea accompanied by sour distension, foul belching, abdominal heat, fullness, pain, thirst, aversion to food, and dark, scanty, painful urination. One must use Bao'an Wan to eliminate stagnation, followed by Pingwei San to harmonize the Spleen. Thus, the accumulation will dissipate, diarrhea will cease, and miraculous results will be achieved.
Middle-Jiao Cold Diarrhea
Infantile middle-jiao cold diarrhea is caused by overconsumption of raw, cold, and greasy foods. Symptoms include borborygmus, abdominal distension, recurrent pain, clear and cold stools, pale complexion, cold limbs, and anorexia. The primary formula for warming the Middle Jiao is Lizhong Tang, and Hexie Zi San can also be used to stop diarrhea.
Fire Diarrhea
Fire diarrhea is caused by accumulated heat in the Zang-Fu organs or external invasion of summer-heat. Symptoms include sudden, urgent diarrhea with a sense of urgency, abdominal pain, restlessness, thirst, passage of large amounts of yellow water, and red urine. First, Yulu San should be used to clear the heat, followed by Siling San to promote diuresis, so that recovery can be achieved.
Startling Diarrhea
Startling diarrhea is caused by Qi deficiency leading to fright, resulting in diarrhea. Manifestations include restless sleep at night, daytime startle and fear, thick feces resembling glue, and greenish color like moss. Treatment should focus on calming the Heart and subduing the Liver. First, use Zhenjing San to settle the fright, then administer Yangpi Wan to regulate the Spleen, thereby offering hope for complete recovery.
Visceral Cold Diarrhea
In infants, improper care during umbilical cord separation allows wind-cold to enter and transmit to the Large Intestine, forming visceral cold diarrhea. Symptoms include white and clear stools, abdominal pain, and borborygmus. To disperse the cold first, Heqi Yin is extremely effective; subsequently, to apply warming tonification, Tiaozhong Ling is again efficacious.
Spleen Deficiency Diarrhea
Spleen deficiency diarrhea is mostly due to impaired Spleen transportation and transformation. Thus, diarrhea occurs after every meal, accompanied by abdominal fullness without thirst, low spirit, sallow complexion, anorexia, and emaciation. Shenling Baizhu San should be used for treatment, which will surely yield remarkable effects.
Undigested Stool Diarrhea (Sun Xie)
If an infant contracts wind-pathogens in spring, causing clear Yang to sink and the Spleen to lose its transportation function, resulting in the passage of undigested food, this is named Sun Xie. The practitioner must nourish and tonify the Spleen Earth. First, use Buzhong Yiqi Tang to raise the Middle Qi. If diarrhea persists for a long time with intestinal slipping and incontinence, use Sishen Wan for treatment.
Watery Diarrhea (Shui Xie)
Watery diarrhea in infants is caused by excess dampness in the Spleen and Stomach. Symptoms include anorexia, loose stools, predominantly yellow stool color, indistinct clear and turbid separation, and short, scanty, difficult urination. Weiping Tang should be used to remove dampness; if diarrhea persists for a long time, Shengyang Chushi Tang should be used for treatment, leading to spontaneous recovery.