曹氏云。蛔者九虫之一。因脏腑虚弱及伤甘肥生冷。致蛔不安。动则腹中攻痛。或作或止。
口吐涎水。贯心则死。钱仲阳云。吐水不心痛者胃冷也。吐沫心痛者虫痛也。与痫相似。但目不
斜。手不搐耳。化虫丸。田氏云。虫痛啼哭。俯仰坐卧不安。自按心痛。时时大叫。面色青黄。
唇色兼白。目无精光。口吐涎沫也。若因胃冷即吐。理中汤加炒川椒、乌梅。或送乌梅丸尤妙。
若中气虚而虫不安者。但补脾胃自安。冬月吐虫。多是胃气虚寒。白术散加丁香、乌梅。
小儿阴肿疝气。多属肝肾气虚。为风邪所伤。血气相搏而成。六味丸加茴香、川楝子。若坐
卧湿地所致者。五苓散换苍术加蝎尾、柴胡、山栀、车前。不时寒热者。小柴胡去参加桂、苓、
川楝、蝎尾。若因啼哭不止。动于阴器。结聚不散。而睾丸肿大者。桂枝汤加细辛、当归、木香、
蝎尾。啼叫气逆。水道不行而致者。沉香降气散加青皮、蝎梢、柴胡。小腹作痛。小便涩滞者。
龙胆泻肝汤加延胡索、肉桂。
五脏六腑之精气。皆上注于目。而黑睛为肝之窍。瞳神又为肾之精华。小儿目无精光。及白
睛多黑精少者。肝肾俱不足也。地黄丸加鹿茸。昼视通明。夜视罔见者。所禀阳气衰弱。遇夜阴
盛则阳愈衰。故不能视也。冲和养胃汤、煮肝散。疳眼者。因肝火湿热上冲。脾气有亏。不能上
升清气。故生白翳。睫闭不开。眵泪如糊。久而脓流。遂至损目。益气聪明汤、决明鸡肝散。目
闭不开者。因乳食失节。或过服寒凉之药。使阳气下陷。不能升举。补中益气汤。眼连札者。肝
经风热也。柴胡清肝散。若目札面青。食少体倦。肝木克脾土也。五味异功散加白芍、柴胡、生
姜。实者。去参换赤芍加羌活、蝎梢。若生下目黄壮热。大小便秘结。乳食不思。面赤眼闭者。
皆由在胎时。感母热毒所致。儿服泻黄散。母服地黄丸。若乳母膏粱积热。致儿目黄者。母服清
胃散。若肢体面目爪甲皆黄。小便如屋尘色者。难治。余参眼目本门治之。
小儿误跌。或打着头脑受惊。肝系受风。致瞳神不正。名曰通睛。宜石南散吹鼻。内服牛黄平肝镇惊药。
曹氏说:蛔虫是九种寄生虫之一。由于脏腑虚弱以及饮食过量甘肥生冷之物,导致蛔虫不安定。蛔虫扰动时,腹部出现攻冲性疼痛,疼痛时作时止。口中吐出涎水。如果蛔虫上窜穿过心脏,则会导致死亡。钱仲阳说:呕吐清水但不心痛的是胃寒;呕吐涎沫且心痛的是虫痛。这种症状与痫证相似,但区别在于患者眼睛不斜视,手脚不抽搐。可用化虫丸治疗。
田氏说:因虫痛而啼哭的孩子,身体俯仰坐卧都不安稳,自己按压心胸部,不时大声呼叫,面色青黄相间,嘴唇颜色发白,眼神没有光彩,口吐涎沫。如果是因胃寒引起的呕吐,可用理中汤加入炒川椒、乌梅。或者送服乌梅丸效果更好。如果是中气虚弱导致蛔虫不安的,只需补益脾胃,蛔虫自然安定。冬季呕吐蛔虫,多是胃气虚寒所致,可用白术散加入丁香、乌梅。
小儿阴囊肿大及疝气,多属于肝肾气虚,受到风邪侵袭,气血相互搏结而形成。可用六味地黄丸加入小茴香、川楝子治疗。如果是因久坐湿地导致的,可用五苓散替换苍术,并加入全蝎尾、柴胡、山栀、车前子。如果伴有间歇性的恶寒发热,可用小柴胡汤加入桂枝、茯苓、川楝子、全蝎尾。如果是因哭闹不止,导致气机扰动阴器,结聚不散,从而睾丸肿大的,可用桂枝汤加入细辛、当归、木香、全蝎尾。如果啼叫导致气机上逆,水道不通畅而引发的,可用沉香降气散加入青皮、蝎梢、柴胡。如果小腹疼痛,小便涩滞不畅的,可用龙胆泻肝汤加入延胡索、肉桂。
五脏六腑的精气,都向上灌注于眼睛。黑睛(角膜)是肝的外窍,瞳神(瞳孔)又是肾精的精华所在。小儿眼睛没有光彩,以及白睛多而黑睛少的,说明肝肾都不足。可用地黄丸加入鹿茸治疗。白天视力清晰,晚上看不见东西的,是因为禀赋阳气衰弱,遇到夜晚阴气盛时,阳气更加衰弱,所以不能视物。可用冲和养胃汤、煮肝散治疗。疳积眼病,是因为肝火湿热上冲,脾气亏损,不能上升清气,所以生成白翳(角膜混浊)。眼睑闭合不开,眼屎眼泪像糊状,时间久了流脓,最终导致失明。可用益气聪明汤、决明鸡肝散治疗。眼睛闭合不开的,是因为乳食无节制,或者过服寒凉药物,使阳气下陷,不能升举。可用补中益气汤治疗。眼睛频繁眨动的,是肝经风热所致。可用柴胡清肝散治疗。如果眼睛频眨且面色发青,食欲少,身体疲倦,这是肝木克制脾土的表现。可用五味异功散加入白芍、柴胡、生姜。实证者,去掉人参换为赤芍,并加入羌活、蝎梢。如果出生后眼睛发黄、壮热,大小便便秘结,不吃奶,面红眼闭的,都是由在母胎时感受母体热毒所致。婴儿服用泻黄散,母亲服用地黄丸。如果是乳母食用膏粱厚味积热,导致婴儿眼睛发黄的,母亲服用清胃散。如果肢体、面目、爪甲都发黄,小便像屋尘颜色的,难以治疗。其余情况参考眼科专篇治疗。
Cao stated: Ascaris (roundworm) is one of the nine types of parasites. Due to weakness of the Zang-Fu organs and excessive consumption of sweet, fatty, cold, and raw foods, the ascaris becomes restless. When disturbed, it causes attacking pain in the abdomen, which comes and goes intermittently. The patient may vomit saliva. If the worm ascends through the heart, death ensues. Qian Zhongyang stated: Vomiting clear fluid without heart pain indicates Cold of the Stomach; vomiting froth with heart pain indicates Worm Pain. This condition resembles Epilepsy (Xian), but differs in that the eyes do not deviate and the hands and feet do not convulse. Huachong Wan can be used for treatment.
Tian stated: Children crying due to worm pain are restless in flexion, extension, sitting, and lying down. They press their own epigastrium, cry out loudly at times, have a greenish-yellow complexion, pale lips, lackluster eyes, and vomit froth. If vomiting occurs due to Stomach Cold, Lizhong Tang added with stir-fried Sichuan Pepper (Chuanjiao) and Sour Plum (Wumei) should be used. Alternatively, administering Wumei Wan is particularly effective. If Middle Qi deficiency causes the worms to be restless, simply tonifying the Spleen and Stomach will calm them. Vomiting worms in winter is mostly due to Deficiency-Cold of Stomach Qi; Baizhu San added with Clove (Dingxiang) and Sour Plum (Wumei) is indicated.
Pediatric scrotal swelling and hernia often belong to Deficiency of Liver and Kidney Qi, caused by invasion of Wind pathogen, resulting from the struggle between Blood and Qi. Liuwei Dihuang Wan added with Fennel (Huixiang) and Toosendan Fruit (Chuanlianzi) is suitable. If caused by sitting on damp ground, Wuling San with Atractylodis Rhizoma (Cangzhu) replacing Poria (Fuling), added with Scorpion Tail (Xiewei), Bupleurum Root (Chaihu), Gardenia Fruit (Shanzhi), and Plantago Seed (Cheqianzi) should be used. If accompanied by intermittent chills and fever, Xiaochaihu Tang added with Cinnamon Twig (Guizhi), Poria (Fuling), Toosendan Fruit (Chuanlianzi), and Scorpion Tail (Xiewei) is appropriate. If caused by incessant crying, disturbing the Yin organ, leading to stagnation and swelling of the testicles, Guizhi Tang added with Asarum (Xixin), Angelica Sinensis (Danggui), Aucklandia Root (Muxiang), and Scorpion Tail (Xiewei) should be used. If crying leads to rebellious Qi and obstruction of the water passages, Chenxiang Jiangqi San added with Green Tangerine Peel (Qingpi), Scorpion Tip (Xieshao), and Bupleurum Root (Chaihu) is indicated. If lower abdominal pain and dysuria occur, Longdan Xiegan Tang added with Corydalis Rhizome (Yanhusuo) and Cinnamon Bark (Rougui) should be used.
The essence of the Five Zang and Six Fu organs all ascend to nourish the eyes. The black cornea is the opening of the Liver, and the pupil is the essence of the Kidney. Lackluster eyes in children, or having more white sclera than black iris, indicate insufficiency of both Liver and Kidney. Dihuang Wan added with Deer Antler (Lurong) is indicated. Clear vision during the day but blindness at night indicates weak congenital Yang Qi. When Yin is abundant at night, Yang becomes even weaker, thus causing inability to see. Chonghe Yangwei Tang and Zhugan San are indicated. Gan eye disease (trachoma-like conditions associated with malnutrition) is caused by Liver Fire and Damp-Heat rushing upward, combined with Spleen Qi deficiency failing to ascend clear Yang, leading to the formation of leukoma (white opacity). Eyelids remain closed, discharge is like paste, and pus flows over time, eventually damaging vision. Yiqi Congming Tang and Jueming Jigan San are indicated. Eyes closed and unable to open are caused by irregular diet or excessive use of cold-cooling medicines, causing Yang Qi to sink and fail to rise. Buzhong Yiqi Tang is indicated. Frequent blinking of the eyes is due to Wind-Heat in the Liver Meridian. Chaihu Qinggan San is indicated. If blinking is accompanied by a cyan complexion, poor appetite, and fatigue, it indicates Liver Wood overacting on Spleen Earth. Wuwei Yigong San added with White Peony Root (Baishao), Bupleurum Root (Chaihu), and Fresh Ginger (Shengjiang) is indicated. For excess patterns, remove Ginseng, replace with Red Peony Root (Chishao), and add Notopterygium Root (Qianghuo) and Scorpion Tip (Xieshao). Jaundice, high fever, constipation of urine and stool, anorexia, red face, and closed eyes appearing after birth are all caused by maternal Heat-Toxin transmitted during gestation. The infant should take Xieh Huang San, and the mother Dihuang Wan. If the wet nurse's accumulation of heat from rich food causes infant jaundice, the mother should take Qingwei San. If the limbs, face, eyes, and nails are all yellow, and urine is colored like house dust, the prognosis is difficult. Refer to the Ophthalmology section for other treatments.
If a child accidentally falls or suffers head trauma with fright, causing the Liver system to be affected by Wind, leading to misalignment of the pupil, it is called Tongjing (strabismus). Shinan San should be blown into the nose, and Niuhuang Pinggan Zhenjing medicine should be taken internally.