小儿癖气久不瘥者,灸中脘一穴,章门二穴,各七壮。章门在大横外,直脐,
季胁肋端,侧卧,曲上足,伸下足,举臂取之。中脘在上脘下一寸,脐上四寸,居
心蔽骨与脐之中,从 下取病患四指定穴,并炙脐后脊骨中二七壮,无不验。
洁古论渴有三种一者,实热积于心脾,烦躁大渴引饮,宜白虎汤。谓不因吐
泻大病,忽然而作。二者,因久病,或取转过度,致脾虚引饮,宜白术散。三者,
因患湿热病,热结膀胱,小便不利,大渴引饮,有表里证者,宜五苓散主之。《百
问》云∶小儿唇红如丹,即发渴,红甚焦黑,则危笃,若三焦虚烦作渴者,用三黄
汤。伤寒后唇口焦者,用白虎汤、竹叶汤。泻痢作渴者,用四苓散之类。常治暑积心
脾烦渴引饮者,用白虎汤。下利脾虚作渴,用七味白术散。热结膀胱小便秘,渴者,
用五苓散。上焦虚热者,用四君子汤。膏粱积热者,用清胃散。脾胃积热者,用泻
黄散。中气虚热者,用异功散。肾水虚热者,用六味丸。其余疳证发热,各详本证。
胎禀所致者,当各审其因,若误用寒凉降火,脾胃复伤,则腹胀而为败证矣。
白虎汤(发热)
三黄汤
黄芩 黄连 黄柏(各等分)
上,水煎服。
《圣惠》黄连散 治小儿心肺积热,渴不止,咽喉干痛。
黄连(去须) 射干 川升麻 白茯苓 麦门冬(去心,焙) 玄参 甘草(炙微赤,锉) 桑根白
皮黄芩(各半两)
上件药捣,粗罗为散。每服一钱,以水一小盏,入青竹叶七片,煎五分,去渣,
入蜜半合,更煎一两沸,放温,时时与儿呷之。
麦门冬散 治小儿心肺热壅,口渴不止。
麦门冬(去心) 栀子仁 犀角(屑) 知母 甘草(炙) 黄芩(各半两)
上为散。每服一钱,水一盏,入竹叶七片,煎五分,不计时候服,亦可量儿大
小、分减服。
《圣惠》银饮子 治小儿热渴不止。
银(五两) 石膏 寒水石 蚕蛹茧(各二两)
上件药,以水三升,入银石三味、煎至一升,去银石,次下蛹茧,煎至七合,
去渣,每服半合,不计时候,温温服之,量儿大小加减。
栝蒌根散 治小儿热渴不止,烦闷。
栝蒌根(三分) 黄芩 知母(各半两)
上件药捣,罗为散。每服一钱,以水一小盏,入小麦、粟米一百粒,煎至五分,
去渣,不计时候温服,量儿大小,以意加减。
又方
栝蒌根(三分) 黄芩(半两) 小麦(半合)
上件,以水三盏,煎取一盏,去渣,不计时服,量儿大小加减。
又方
生葛汁 竹沥(各二合)
上件汁相和令匀,不拘时,服半合,量儿大小加减。
〔茅先生〕胡黄连散 治小儿诸渴,及疳渴,解诸般热。
胡黄连 麦门冬 干葛 玄参 甘草(炙) 枇杷叶(炙,去毛)
上各等分,为末。每服一钱,水七分一盏。生姜一片,同煎五分,后放蜜三五
滴同煎,至四分、温服。
对于小儿癖气(腹部积块)长期不愈的情况,可灸中脘穴1个,章门穴2个,每穴各施灸七壮。章门穴位于大横穴外侧,与肚脐相直,在季胁肋骨的末端;取穴时让患儿侧卧,弯曲上方的腿,伸直下方的腿,举起手臂来定位。中脘穴位于上脘穴下方一寸,肚脐上方四寸,处于心蔽骨(剑突)与肚脐的中间位置;取穴时从下往上用患者的四指宽度定穴,并灸脐后脊柱正中第七对穴位(即命门穴附近),这些方法无不灵验。
洁古老人论述口渴有三种类型:第一种是实热积聚在心脾,表现为烦躁、极度口渴且大量饮水,适宜使用白虎汤。这种口渴并非由呕吐、腹泻等大病引起,而是突然发作。第二种是因久病,或过度使用攻下法,导致脾虚而引水自救,适宜使用白术散。第三种是因患湿热病,热邪结聚于膀胱,导致小便不利,出现极度口渴且大量饮水,伴有表证和里证者,适宜以五苓散主治。《百问》中说:小儿嘴唇红如涂丹砂,就会发生口渴;如果红色严重甚至焦黑,则病情危重。如果是三焦虚烦引起的口渴,使用三黄汤。伤寒后嘴唇口角焦裂的,使用白虎汤、竹叶汤。因泻痢引起口渴的,使用四苓散之类。常治暑热积于心脾导致的烦躁口渴、大量饮水的,使用白虎汤。因下利导致脾虚引起的口渴,使用七味白术散。因热结膀胱、小便短少引起的口渴,使用五苓散。上焦虚热的,使用四君子汤。因饮食肥甘厚味积热引起的,使用清胃散。脾胃积热的,使用泻黄散。中气虚热的,使用异功散。肾阴亏虚内热的,使用六味丸。其余疳证发热的,详见各自病症。由胎禀体质因素导致的,应当仔细审察病因,如果误用寒凉降火药物,会再次损伤脾胃,导致腹胀而成为败证。
白虎汤(治疗发热)
三黄汤
黄芩、黄连、黄柏(各等分)
以上药材,加水煎煮后服用。
《圣惠方》黄连散:治疗小儿心肺积热,口渴不止,咽喉干痛。
黄连(去须)、射干、川升麻、白茯苓、麦门冬(去心,焙干)、玄参、甘草(炙至微赤,锉碎)、桑根白皮、黄芩(各半两)。
以上药材捣碎,粗筛为散剂。每次服用一钱,用水一小盏,加入青竹叶七片,煎至五分,去药渣,加入蜂蜜半合,再煎一两沸,放温后,时时让患儿少量饮用。
麦门冬散:治疗小儿心肺热壅,口渴不止。
麦门冬(去心)、栀子仁、犀角(锉屑)、知母、甘草(炙)、黄芩(各半两)。
以上药材制成散剂。每次服用一钱,用水一盏,加入竹叶七片,煎至五分,不限时候服用,也可根据患儿大小减量服用。
《圣惠方》银饮子:治疗小儿热渴不止。
银(五两)、石膏、寒水石、蚕蛹茧(各二两)。
以上药材,用水三升,放入银、石膏、寒水石这三味药,煎至一升,去掉银和石头,接着放入蛹茧,煎至七合,去药渣,每次服用半合,不限时候,温服,根据患儿大小加减剂量。
栝蒌根散:治疗小儿热渴不止,烦闷。
栝蒌根(三分)、黄芩、知母(各半两)。
以上药材捣碎,筛为散剂。每次服用一钱,用水一小盏,加入小麦、粟米一百粒,煎至五分,去药渣,不限时候温服,根据患儿大小酌情加减。
又一方
栝蒌根(三分)、黄芩(半两)、小麦(半合)。
以上药材,用水三盏,煎取一盏,去药渣,不限时候服用,根据患儿大小加减剂量。
又一方
生葛汁、竹沥(各二合)。
以上两种汁液混合均匀,不拘时候,服用半合,根据患儿大小加减剂量。
〔茅先生〕胡黄连散:治疗小儿各种口渴,以及疳渴,解除各种热邪。
胡黄连、麦门冬、干葛、玄参、甘草(炙)、枇杷叶(炙,去毛)。
以上各等分,研为末。每次服用一钱,用水七分一盏,生姜一片,同煎至五分,后放入蜂蜜三五滴同煎,至四分,温服。
For pediatric *pi qi* (abdominal masses) that persist for a long time without healing, moxibustion can be applied to one point of Zhongwan (CV 12) and two points of Zhangmen (LR 13), seven moxa cones (*zhuang*) per point. Zhangmen is located lateral to Dahuang (SP 15), directly aligned with the umbilicus, at the end of the costal margin; it is located by having the patient lie on their side, flexing the upper leg, extending the lower leg, and raising the arm. Zhongwan is located one cun below Shangwan (CV 13), four cun above the umbilicus, midway between the xiphoid process and the umbilicus; the point is located using the patient's four-finger width measure from below, and moxibustion should also be applied to the second pair of vertebrae posterior to the umbilicus in the midline of the spine; these methods are invariably effective.
Jiegu discussed three types of thirst: The first is excess heat accumulating in the Heart and Spleen, characterized by restlessness and extreme thirst with excessive drinking; Baihu Tang (White Tiger Decoction) is suitable. This type arises suddenly and is not caused by severe diseases such as vomiting or diarrhea. The second is due to prolonged illness or excessive use of purgatives, leading to Spleen deficiency and compensatory drinking; Baizhu San (Atractylodes Macrocephala Powder) is suitable. The third is due to damp-heat disease, where heat binds in the Bladder, causing difficult urination, extreme thirst with excessive drinking, and presenting both exterior and interior syndromes; Wuling San (Five-Ingredient Powder with Poria) is the primary treatment. "Baiwen" states: If a child's lips are red like cinnabar, thirst will develop; if the redness becomes severe and scorched black, the condition is critical. For thirst caused by deficiency heat and irritability in the Triple Burner, Sanhuang Tang (Three-Yellow Decoction) is used. For scorching of the lips and mouth after a cold injury, Baihu Tang and Zhuye Tang (Bamboo Leaf Decoction) are used. For thirst caused by dysentery, Siling San (Four-Ingredient Powder) and similar formulas are used. For summer-heat accumulation in the Heart and Spleen causing irritability and thirst with excessive drinking, Baihu Tang is used. For thirst caused by Spleen deficiency following diarrhea, Qiwei Baizhu San (Seven-Ingredient Atractylodes Macrocephala Powder) is used. For thirst caused by heat binding in the Bladder with scanty urine, Wuling San is used. For deficiency heat in the Upper Jiao, Sijunzi Tang (Four-Gentlemen Decoction) is used. For heat accumulation from rich foods, Qingwei San (Stomach-Clearing Powder) is used. For heat accumulation in the Spleen and Stomach, Xiehuang San (Drain-Yellow Powder) is used. For deficiency heat of Middle Qi, Yigong San (Extraordinary Merit Powder) is used. For deficiency heat due to Kidney Yin insufficiency, Liuwei Wan (Six-Ingredient Pill) is used. For fever associated with other *gan* syndromes, refer to the specific syndrome descriptions. For conditions caused by congenital constitution, the etiology must be carefully examined; if cooling and fire-draining herbs are mistakenly used, the Spleen and Stomach will be further damaged, leading to abdominal distension and a deteriorating condition.
Baihu Tang (for fever)
Sanhuang Tang
Huangqin (Scutellariae Radix), Huanglian (Coptidis Rhizoma), Huangbai (Phellodendri Cortex) (equal parts).
Decoct in water and take orally.
Shenghui Fang's Huanglian San: Treats pediatric heat accumulation in the Heart and Lungs, unceasing thirst, and dry, painful throat.
Huanglian (remove roots), Shegan (Belamcandae Rhizoma), Chuan Shengma ( Cimicifugae Rhizoma), Baifuling (Poria), Maimendong (Ophiopogonis Tuber, remove heart, baked), Xuanshen (Scrophulariae Radix), Gancao (Licorice Root, honey-fried until slightly reddish, crushed), Sangbaipipi (Morus Albae Cortex), Huangqin (each half liang).
Crush the ingredients and sieve coarsely into a powder. Take one qian per dose, decoct with one small cup of water and seven leaves of Qingzhuye (Green Bamboo Leaf) until reduced to five fen, strain, add half he of honey, boil for one or two boils, let cool to warm, and give to the child to sip occasionally.
Maimendong San: Treats pediatric heat obstruction in the Heart and Lungs, unceasing thirst.
Maimendong (remove heart), Zhiziren (Gardeniae Semen), Xijiao (Rhinocerotis Cornu, shaved), Zhimu (Anemarrhenae Rhizoma), Gancao (honey-fried), Huangqin (each half liang).
Process into a powder. Take one qian per dose, decoct with one cup of water and seven bamboo leaves until reduced to five fen, take at any time; dosage may be adjusted according to the child's age.
Shenghui Fang's Yin Yinzi: Treats unceasing heat-thirst in children.
Silver (five liang), Shigao (Gypsum Fibrosum), Hanshuishi (Halloysitum Rubrum), Can Yongjian (Silkworm Cocoon) (each two liang).
Decoct the silver, Gypsum, and Halloysite in three sheng of water until reduced to one sheng, remove the silver and stones, then add the silkworm cocoons, decoct until reduced to seven ge, strain. Take half he per dose at any time, warm; adjust dosage according to the child's size.
Gualougen San: Treats unceasing heat-thirst and irritability in children.
Gualougen (Trichosanthis Radix) (three fen), Huangqin, Zhimu (each half liang).
Crush and sieve into a powder. Take one qian per dose, decoct with one small cup of water, one hundred grains of Xiaomai (Triticum aestivum) and Sumi (Setaria italica), until reduced to five fen, strain, take warm at any time; adjust dosage according to the child's size.
Another prescription
Gualougen (three fen), Huangqin (half liang), Xiaomai (half he).
Decoct three cups of water until one cup remains, strain, take at any time; adjust dosage according to the child's size.
Another prescription
Sheng Ge Zhi (Fresh Puerariae Juice), Zhuli (Bambusa Textilis Sap) (each two he).
Mix the juices evenly, take half he at any time; adjust dosage according to the child's size.
[Mao Xiansheng]'s Huhuanglian San: Treats various types of thirst in children, including gan-thirst, and resolves various heat pathogens.
Huhuanglian (Coicis Rhizoma? Note: Typically Coptidis or Picrorhiza, here likely Picrorhizae Rhizoma based on name), Maimendong, Gan Ge (Puerariae Radix), Xuanshen, Gancao (honey-fried), Pipaye (Loquat Leaf, honey-fried, remove hairs).
Equal parts, grind into powder. Take one qian per dose, decoct with seven-tenths of a cup of water and one slice of Shengjiang (Zingiberis Rhizoma Recens) until reduced to five fen, add three to five drops of honey, decoct until reduced to four fen, take warm.