伤食发丹者,因脾胃之气未充,乳食过多,不能运化,蕴热于内而达于肌表也。
若因乳食停滞者,先用保和丸消之;大便秘结,量加大黄通之。乳食既消,而丹尚
作者,用清中解郁汤治之。丹邪既去,而乳食不思者,用五味异功散补之。发热作
渴,或饮食少思者,用七味白术散补之。大凡饮食浓味所致者,赤晕或行而缓慢。
若饮烧酒,或误吞信石所致者,遍身赤晕,其行甚速。又有疮疡发 ,周遭有赤晕,
其热消散,或脓出自退,凡此俱忌砭法,皆宜安里为主,不可攻伐。若自吐泻,亦
不可止之,吐泻中有发散之意。因饮烧酒者,饮冷米醋一二杯解之,此神妙之法也。
因母多食炙爆膏粱,或饮烧酒,或服辛热燥药,或郁怒伤肝脾,致儿为患者,当参
胎热毒疮疡治之。
〔曾〕婴孩生后百日之内,半岁以上,忽两眼胞红晕微起,面带青黯色,向夜烦
啼,或脸如胭脂,此伏热在内。亦有脸不红者,始因居胎之时,母受重惊,惊邪伤
胎,递相传袭,形发于外,初发时散生满面,状如水豆,脚微红而不壮,出没休息
无定,次到颈项,赤如朱砂,名为惊丹。用四圣散先洗其目,次百解散加五和汤同
煎,与解惊热丹毒,牛蒡汤、当归散、三解散、黄芩四物汤,皆可为治。如惊丹发
至胸乳间,微有痰喘作搐,急宜宣热拔毒,免致内流,为害不浅,五和汤加升麻、
生干地黄、水姜灯心煎服,则自消除,仍用前数药调治,不生他证。或投万安饮。
黄芩四物汤 治诸疮、丹毒、赤瘤、燥痒。
黄芩(一两) 当归(酒洗) 生干地黄 赤芍药 川芎(四味各半两) 何首乌(去粗皮)
草乌(炮,去皮) 玄参(三味各二钱半) 甘草(六钱) 薄荷(二钱)
上 咀。每服,水一盏,煎七分,无时,温服。
四圣散(初生目不开) 石解散(惊) 五和汤(发热) 牛蒡汤(咽喉) 当归散
三解散(俱发热)
伤食引发的丹毒,是因为小儿脾胃之气尚未充实,乳食摄入过多,无法运化,导致热邪蕴结于体内并外达于肌表。
如果是因乳食停滞引起的,先用保和丸(调和肠胃、消食导滞的方剂)来消除积滞;如果大便秘结,酌情加大黄以通泄大便。待乳食积滞已消,但丹毒仍然发作时,用清中解郁汤治疗。当丹毒之邪已去,但小儿仍不思饮食时,用五味异功散(益气健脾的方剂)进行补益。如果出现发热口渴,或食欲不振的情况,用七味白术散(健脾止泻、生津止渴的方剂)进行补益。一般来说,由饮食肥甘厚味引起的丹毒,其红色晕圈蔓延缓慢。若是饮用烧酒,或误吞信石(砒霜)引起的,则遍身出现红色晕圈,且蔓延速度极快。又有疮疡发作时,周围伴有红色晕圈,若热势消散,或脓液流出后自然消退,凡此情况都忌用砭法(刺破皮肤放血排毒),都应以安固里气为主,不可使用攻伐之法。如果是自发性呕吐腹泻,也不可用药止住,因为吐泻之中蕴含着发散病邪的意思。对于因饮用烧酒引起的,可饮用一两杯冷米醋来解酒毒,这是神妙的方法。如果是因母亲多吃烧烤油腻食物,或饮酒,或服用辛热燥烈药物,或因郁怒损伤肝脾,从而导致患儿发病的,应当参照胎热毒疮疡的方法来治疗。
〔曾氏〕婴儿出生后一百天以内,或半岁以上,忽然两眼眼睑出现微起的红色晕圈,面色带有青黯色,入夜烦躁啼哭,或者脸颊红如胭脂,这是伏热在内。也有脸颊不红的,起初是因为在母体受孕期间,母亲遭受严重惊吓,惊邪伤害胎儿,代代相传袭,表现于外,初发时散布满脸,形状像水痘,根部微红但不壮实,出没无常无定规,随后发展到颈项部,红如朱砂,称为惊丹。先用四圣散清洗眼部,再用百解散加五和汤同煎,用以解除惊热丹毒。牛蒡汤、当归散、三解散、黄芩四物汤,都可以用来治疗。如果惊丹发展至胸乳之间,轻微出现痰喘抽搐,急需宣散热毒、拔除毒素,以免内陷,造成不小危害,可用五和汤加升麻、生干地黄、生姜、灯心草煎服,则自然消除,之后仍用前述几种药物调理,以防产生其他病变。或者投用万安饮。
黄芩四物汤:治疗各种疮疡、丹毒、赤瘤、干燥瘙痒。
黄芩(一两) 当归(酒洗) 生干地黄 赤芍药 川芎(以上四味各半两) 何首乌(去除粗皮) 草乌(炮制,去皮) 玄参(以上三味各二钱半) 甘草(六钱) 薄荷(二钱)
将药材切碎。每次服用,用水一盏,煎至七分,不拘时候,温服。
四圣散(用于初生儿眼睛不开) 石解散(用于惊风) 五和汤(用于发热) 牛蒡汤(用于咽喉疾病) 当归散 三解散(均用于发热)
Dantou (Erysipelas) caused by food stagnation arises because the Qi of the Spleen and Stomach is not yet sufficient. Excessive intake of milk and food cannot be transformed and transported, leading to heat accumulation internally that reaches the muscle and skin surface.
If caused by stagnation of milk and food, first use Baohe Wan (Harmonizing Pill) to eliminate the stagnation; if constipation occurs, add Rhubarb in appropriate amounts to unblock the bowels. Once the food stagnation has cleared but Dantou still manifests, treat with Qingzhong Jieyu Tang (Clear the Middle and Resolve Depression Decoction). After the pathogenic factor of Dantou is removed but the infant still lacks appetite, use Wuwei Yigong San (Five-Ingredient Extraordinary Effort Powder) to tonify. If fever and thirst occur, or there is poor appetite, use Qiwei Baizhu San (Seven-Ingredient Atractylodes Macrocephala Powder) to tonify. Generally, Dantou caused by rich and greasy diet presents with red halos that spread slowly. If caused by drinking distilled spirits or accidentally ingesting arsenic trioxide, red halos appear all over the body and spread very rapidly. In cases where sores and ulcers erupt with surrounding red halos, if the heat dissipates or pus discharges naturally leading to resolution, all such conditions contraindicate Bianfa (pricking therapy for bloodletting); the primary approach should be to stabilize the interior, avoiding purgative or attacking methods. If spontaneous vomiting and diarrhea occur, they should not be stopped, as these symptoms contain the intent of dispersing pathogens. For cases caused by drinking distilled spirits, drinking one or two cups of cold rice vinegar can resolve the toxicity; this is a miraculous method. If the condition results from the mother consuming excessive roasted, fried, or rich foods, drinking alcohol, taking pungent-hot dry drugs, or suffering liver-Spleen injury due to depression and anger, it should be treated according to the principles for fetal heat toxic sores.
[Zeng's experience] Within one hundred days after birth, or beyond six months of age, an infant may suddenly present with slightly raised red halos on both eyelids, a complexion with bluish-dark hues, evening irritability and crying, or cheeks red like rouge; this indicates latent heat within. There are also cases where the cheeks are not red. Initially, during gestation, the mother suffered severe fright; the fright pathogen injured the fetus, transmitting sequentially, manifesting externally. At initial onset, lesions scatter across the face, resembling water poxes, with slightly red but not robust bases, appearing and disappearing irregularly. Subsequently spreading to the neck, becoming red like cinnabar, it is named Jingdan (Fright Erysipelas). First wash the eyes with Sixian San (Four-Saint Powder), then decoct Baixie San (Hundred-Resolution Powder) together with Wuhe Tang (Five-Harmony Decoction) to resolve fright-heat and erysipelas-toxicity. Niubang Tang (Arctium Decoction), Danggui San (Angelica Powder), Sandisai San (Three-Dispersal Powder), and Huangqin Siwu Tang (Scutellaria Four-Substance Decoction) can all be used for treatment. If Jingdan spreads to the chest and breast area, accompanied by slight phlegm-wheeze and convulsions, urgently disperse heat and extract toxins to prevent internal invasion, which would cause significant harm. Use Wuhe Tang added with Cimicifugae Rhizoma (Shengma), dried Rehmanniae Radix (Sheng Dihuang), fresh ginger, and Juncus effusus (Dengxincao) decocted and administered orally, which will lead to natural resolution. Continue regulating with the aforementioned medicines to prevent other complications. Alternatively, administer Wan'an Yin (Ten-Thousand-Peace Drink).
Huangqin Siwu Tang: Treats various sores, erysipelas, red tumors, and dry itching.
Scutellariae Radix (Huangqin, 1 liang) Angelicae Sinensis Radix (Danggui, wine-washed) Prepared Rehmanniae Radix (Sheng Dihuang) Paeoniae Radix Rubra (Chishao) Ligusticum Chuanxiong Rhizoma (Chuanxiong, 0.5 liang each for the four herbs) Polygoni Multiflori Caulis (Heshouwu, coarse skin removed) Aconiti Lateralis Radix Preparata (Caowu, processed, skin removed) Scrophulariae Radix (Xuanshen, 2.5 qian each for the three herbs) Glycyrrhizae Radix et Rhizoma (Gancao, 6 qian) Menthae Haplocalycis Herba (Bohe, 2 qian)
Crush the herbs. For each dose, use one cup of water, decoct until seven-tenths remain, take warm at any time.
Sixian San (for newborns with eyes unable to open) Shijie San (for fright) Wuhe Tang (for fever) Niubang Tang (for throat conditions) Danggui San Sandisai San (all for fever)