钱乙曰。百日内发搐。真者不过两三次必死。假者频发不为重。真者内生惊痫。假者外伤风冷。盖血气未实。不能
胜任。乃发搐也。欲知假者。口中气出热。治之可发散。大青膏主之。
王汝言曰。小儿未盈月。惊搐似中风。欲死者。用辰砂以新汲水浓磨汁。涂五心。最效。
曾氏曰。胎痫者。因未产前。腹中被惊。或母食酸咸过多。或为七情所汨。致伤胎气。儿生百日内有者是也。发时。
心不宁。面微黄。气逆痰作。目上视。身反张。啼声不出。先用参苏饮。次用琥珀抱龙丸。轻者可愈。重者难全。
李 曰。胎惊痫风者。乃孕妇嗜欲。忿怒惊扑。或伤风邪。儿初生下。即呕吐搐掣。口眼 斜。声啼气短。腮缩囟
开。或颊赤。或面青。噤口切牙。眼合涎潮。筋骨拘挛。身腰强直。脐腹肿起。与噤口撮口同症。视其眉间气色。红赤
者生。青黑者死。辰砂膏最妙。
王肯堂曰。胎惊者。初生月内。壮热吐 。心神不宁。手足抽掣。身体强直。眼目反张。是胎惊。皆由妊妇调摄乖
常。饮酒嗜欲。忿怒惊扑。母有所触。胎必感之。或外挟风邪。有伤于胎。故子乘母气。生下即病也。其候月内壮热。
眼翻握拳。噤口切牙。强直涎潮。呕吐搐掣。惊啼。腮缩囟开。或颊赤。或面青。但胎惊眼合。不可误作慢脾。妄用温
药。其有搭眼噤口之类。亦此一种之所发也。虎口指纹曲入里者可治。反出外者不治。先宜解散风邪。利惊化痰开气。
及贴囟法。甚则以朱银丸利之。若面青拳搐。保命丹、钩藤散、全蝎散之类。大抵芽儿脏腑脆弱。不可辄用铅粉镇坠之
剂。如遇此候。急用猪乳细磨牛黄麝香各少许调。抹入口中。仍服导赤散以泻肝之子。即愈矣。胎风者。小儿初生。其
身有如汤泼火伤者。此皆乳母过食膏粱所致。其母宜服清胃散。及逍遥散。以清气血。儿亦时饮数滴。有身无皮肤而不
赤者。由产母脾气不足也。粳米粉敷之。 赤发热者。产母胃火炽也。石膏敷之。经谓脾主肌肉。肺主皮毛。故知病脾
肺也。未盈月而撮口握拳。腰软如随者。此肝肾之中邪胜正弱也。三日内必不治。如男指向里。女指向外。尚可治。宜
全蝎散、钩藤散。眉红者不可治。胎黄者。小儿生下。遍身面目皆黄。状如金色。壮热。大便不通。小便如栀汁。乳食
不思。啼哭不止。此胎黄之候。皆因母受湿热而传于胎也。凡有此症。母子皆宜服地黄汤、地黄饮子。有生下百日。及
半周。不因病后身微黄者。胃热也。若自生而身黄者。胎疸也。经云诸疸皆热。色深黄者是也。犀角散。若淡黄兼白者。
胃怯也。白术散。
钱乙说:婴儿在出生百日内出现抽搐,如果是真病,发作不过两三次就会死亡;如果是假病,虽然频繁发作但病情不重。真病是内生的惊痫,假病是外感风冷。这是因为婴儿气血尚未充实,不能胜任外界刺激,从而引发抽搐。想要辨别是否为假病,可以观察口中呼出的气息是否发热,如果是,治疗时可采用发散法,以大青膏为主方。
王汝言说:小儿未满月,出现惊厥抽搐类似中风症状,甚至濒临死亡,可用辰砂用新汲取的井水浓磨成汁,涂抹在手心、脚心等五心部位,效果最好。
曾氏说:胎痫,是因为母亲在怀孕前腹部受到惊吓,或者食用过多酸咸食物,或者被七情(喜、怒、忧、思、悲、恐、惊)扰乱,导致胎气受伤。婴儿出生后百日内发病的属于此类。发作时,心中不安,面色微黄,气逆痰涌,眼睛上视,身体向后反张,啼哭不出声。先用参苏饮治疗,再用琥珀抱龙丸。轻症可以痊愈,重症难以保全。
李姓医家说:胎惊痫风,是由于孕妇嗜欲无度、愤怒惊恐或跌扑损伤,或者感受风邪,婴儿刚出生就出现呕吐、抽搐掣动,口眼歪斜,啼哭声低气短,腮部收缩、囟门开放,或者脸颊发红,或者面色发青,牙关紧闭切齿,眼睛闭合且涎水如潮,筋骨拘挛,腰身强直,脐腹部肿胀隆起。这些症状与噤口撮口症相似。观察患儿眉间的气色,红赤色的预后良好,青黑色的预后不良。辰砂膏最为有效。
王肯堂说:胎惊,是在出生一个月内,出现高热、呕吐、心神不宁、手足抽搐、身体强直、眼睛上翻、身体反张等症状,这就是胎惊。这都是因为孕妇调养失当,饮酒、嗜欲、愤怒、惊恐或跌扑,母亲受到触动,胎儿必然感应到。或者外感风邪,损伤胎气,所以孩子承袭母体之气,出生后立刻发病。其症状表现为满月内高热,眼睛上翻握拳,牙关紧闭切齿,身体强直涎水多,呕吐抽搐,惊叫啼哭,腮缩囟开,或者脸颊红,或者面色青。但是胎惊的特点是眼睛闭合,不可误认为是慢脾风而妄用温补药物。那些伴有眼合、噤口等症状的,也是由这一类病因引发的。虎口指纹弯曲向内的可以治疗,向外延伸的无法治疗。起初宜疏散风邪,利惊化痰、开理气机,以及使用贴囟法。严重时可用朱银丸通利。如果面色青、手握拳抽搐,可用保命丹、钩藤散、全蝎散之类。大抵新生儿脏腑脆弱,不可轻易使用铅粉等镇坠的药物。如果遇到这种情况,急用猪乳汁细细磨牛黄、麝香各少许调和,抹入口中,再服用导赤散以泻肝之子(心火),即可痊愈。
胎风,是指小儿刚出生,身体就像被热水泼过或被火烧伤一样。这都是因为乳母过度食用油腻厚味食物所致。乳母宜服用清胃散和逍遥散,以清气血,婴儿也可偶尔饮用几滴。如果身体没有皮肤且不红,是由于产母脾气不足,可用粳米粉外敷。如果发红发热,是产母胃火炽盛,可用石膏外敷。经书说脾主肌肉,肺主皮毛,所以知道病在脾肺。未满月就出现撮口握拳,腰部软如垂下的样子,这是肝肾中邪气胜而正气弱的表现,三日内必死无疑。如果男婴手指向内,女婴手指向外,还可以治疗,宜用全蝎散、钩藤散。眉毛发红者不可治。
胎黄,是指小儿出生后,全身面目都发黄,状如金色,高热,大便不通,小便像栀子汁一样黄,不吃奶食,啼哭不止。这是胎黄的征候,都是因为母亲受湿热之邪传给胎儿所致。凡是有这种症状的,母子都宜服用地黄汤、地黄饮子。有出生后百日及半岁,不是因为病后身体微黄的,是胃热。如果是生下来就身体黄的,是胎疸。经书说各种黄疸都属于热证,颜色深黄的就是。可用犀角散。如果淡黄兼白,是胃气虚弱,可用白术散。
Qian Yi stated: If convulsions occur in infants within one hundred days after birth, if it is a true disease, death will ensue after no more than two or three episodes; if it is a false disease, although frequent, the condition is not severe. True disease arises from internal fright and epilepsy (Jing Xian), while false disease results from external contraction of wind-cold. This occurs because the infant's Qi and Blood are not yet solidified and cannot withstand the stimuli, leading to convulsions. To identify a false disease, observe whether the breath exhaled from the mouth is hot; if so, treatment should employ dispersing methods, with Da Qing Gao (Great Blue Paste) as the primary formula.
Wang Ruyan stated: For infants under one month old who exhibit convulsions resembling stroke (Zhong Feng) and are near death, grind Chen Sha (Cinnabar) thickly with fresh well water into a juice, and apply it to the five centers (palms and soles). This is most effective.
Zeng Shi stated: Tai Xian (Fetal Epilepsy) is caused by fright suffered by the abdomen before birth, excessive consumption of sour and salty foods by the mother, or disturbance by the Seven Emotions, which injures the fetal Qi. It manifests within one hundred days after birth. During an episode, the heart feels restless, the complexion is slightly yellow, Qi rebels with phlegm rising, eyes roll upward, the body arches backward, and crying is silent. First treat with Shen Su Yin (Ginseng and Perilla Decoction), followed by Hu Po Bao Long Wan (Amber Dragon-Embracing Pill). Mild cases can be cured, but severe cases are difficult to save.
Li stated: Tai Jing Xian Feng (Fetal Fright, Epilepsy, and Wind) results from the pregnant woman's excessive desires, anger, fright, or falls, or contraction of wind pathogens. Immediately after birth, the infant exhibits vomiting, convulsive twitching, deviation of the mouth and eyes, shortness of breath in crying, retracted cheeks, open fontanelle, red cheeks, or cyanotic face, locked jaw with teeth grinding, closed eyes with tidal saliva, tendon and bone spasms, stiff waist and back, and swollen umbilical abdomen. These symptoms are similar to Jin Kou (Locked Mouth) and Cuo Kou (Pinched Mouth). Observe the color between the eyebrows: red indicates survival, while blue-black indicates death. Chen Sha Gao (Cinnabar Paste) is best.
Wang Kentang stated: Tai Jing (Fetal Fright) occurs within the first month after birth, characterized by high fever, vomiting, restlessness of the heart-mind, twitching of hands and feet, body stiffness, upward rolling of eyes, and opisthotonos. This is all due to improper care during pregnancy, such as drinking alcohol, indulging desires, anger, fright, or trauma. The mother's shock affects the fetus. Alternatively, external wind pathogens may injure the fetus. Thus, the child inherits the maternal Qi and falls ill immediately after birth. Symptoms include high fever within the month, eyes rolling up with clenched fists, locked jaw, stiffness, salivation, vomiting, convulsions, frightened crying, retracted cheeks, open fontanelle, red cheeks, or cyanotic face. However, Tai Jing is characterized by closed eyes and must not be mistaken for Man Pi Feng (Slow Spleen Wind) treated with warm herbs. Conditions involving eye closure and locked mouth also stem from this category. If the fingerprint on the tiger's mouth curves inward, it is treatable; if it extends outward, it is untreatable. Initially, disperse wind pathogens, benefit from calming fright, resolve phlegm, and regulate Qi, along with applying treatments to the fontanelle. In severe cases, use Zhu Yin Wan (Vermilion Silver Pill) to purge. If the face is cyanotic with clenched-hand convulsions, use Bao Ming Dan (Life-Preserving Pill), Gou Teng San (Uncaria Powder), or Quan Xie San (Scorpion Powder). Generally, newborns have fragile Zang-Fu organs and should not be given heavy sedatives containing lead powder. In such emergencies, grind Ni Huang (Calculus Bovis) and She Xiang (Musk) slightly in pig milk and apply to the mouth, then administer Dao Chi San (Guide Out Red Powder) to drain the son of the Liver (Heart Fire), which leads to recovery.
Tai Feng (Fetal Wind) refers to the newborn's skin appearing as if scalded by boiling water or burned by fire. This is caused by the wet nurse consuming excessive rich and greasy foods. The wet nurse should take Qing Wei San (Clear Stomach Powder) and Xiao Yao San (Free and Easy Wanderer Powder) to clear Qi and Blood, and the infant may occasionally drink a few drops. If the body lacks skin and is not red, it is due to the mother's deficiency of Spleen Qi; apply rice flour externally. If red and febrile, it is due to the mother's blazing Stomach Fire; apply gypsum externally. The Classics state that the Spleen governs muscles and the Lungs govern skin and hair; thus, the disease lies in the Spleen and Lungs. If within one month there is locked mouth and clenched fists, with a limp waist like a hanging thing, it indicates pathogenic factors overcoming righteous Qi in the Liver and Kidneys, which is fatal within three days. If male infants' fingers point inward and female infants' fingers point outward, it is still treatable; use Quan Xie San or Gou Teng San. Those with red eyebrows are untreatable.
Tai Huang (Fetal Jaundice) refers to the newborn having a yellow complexion over the entire body and face, resembling gold color, accompanied by high fever, constipation, urine as yellow as gardenia juice, refusal of milk/food, and incessant crying. This is the sign of Tai Huang, caused by the transmission of damp-heat from the mother to the fetus. For such symptoms, both mother and infant should take Di Huang Tang (Rehmannia Decoction) or Di Huang Yin Zi (Rehmannia Elixir). If an infant remains slightly yellow at one hundred days or half a year without prior illness, it is Stomach Heat. If yellow from birth, it is Tai Dan (Fetal Jaundice). The Classics state that all jaundices are heat conditions, indicated by deep yellow color; use Xi Jiao San (Rhinoceros Horn Powder). If pale yellow mixed with white, it is Spleen Qi Deficiency; use Bai Zhu San (Atractylodes Macrocephala Powder).