治婴孩小儿惊热风痰四证结聚于胸臆之间令儿昏困沉重关窍不通诸脉气闭所以默默欲食
不食欲起不起倦伏不知其症候者但不经吐利宜与服之立见苏省大效疏风散良方
锦纹大黄(紧实者三两重) 鸡心槟榔(二重) 旧陈橘皮(去白二两) 朴硝(一两) 黑牵
牛(一分半熟)
上五味为末每二岁儿服半两匕三岁一两匕先用生蜜调就次煎薄荷汤点与服不拘时候
议曰风痰在上即吐在下即泻(诸鬲上下也)一服之间决定安乐未可便投他药恐相致误常人
只和用脑子麝香参苓术附(香附子)无担负之药似此四症如何和顺调理
议曰五疳八痢本经所载详明然究竟疳在五脏五病故有五名及其顺逆相传变动脏腑则病不
循症
候而作者岂可以五疳为数八痢为拘疳者始自于疳痢者起自于痢疳以饮食不节过伤脾胃痢即脾
胃虚弱而受积毒治疳之药理脾胃温中补气消疳煞虫治痢之药理肠胃去湿调中滋血和气为上
治婴孩小儿食肉太早伤及脾胃水谷不分积滞不化疾作疳气等候宜服大效使君槟榔良方
肉豆蔻(两个炮) 槟榔(一个生) 宣连 胡黄连 陈皮 青皮 川楝子肉(炒) 芜荑(
炒去皮) 神曲 麦芽(并炒) 木香 夜明砂(炒去土) 芦荟 川芎(各一两重) 麝(一字)
上为末 猪胆汁薄荷为丸如麻子大每服三五十丸温饭饮下
议曰积是疳之母所以有积不治乃成疳候又有治积不下其积存而脏虚成疳尤重大抵小儿患
疳泄
泻无时不作风候者何惟疳泻名热泻其脏腑转动有限所以不成风候虽泻不风亦转它症作渴虚热
燥烦下痢肿满喘急皆疳候虚症古云疳虚用补虚是知疳之为疾不可更利动脏腑发作之初名曰疳
气腹大胀急名曰疳虚泻痢频并名曰疳积五心虚烦名曰疳热毛焦发穗肚大青筋好吃异物名曰疳
极(受病传脏已极)热发往来形体枯槁面无神彩肉无血色名曰疳劳手足细小项长骨露尻臀无肉
肚胀脐突名曰丁奚食加呕哕头骨分开作汤引饮虫从口出名曰哺露此皆疳候
又因多食生冷疳粘肥腻积滞中脘不化久亦成
疳治疳之法量候轻
重理其脏腑和其中脘顺其三焦使胃气温而纳食益脾丸壮以消化则脏腑自然调贴令气脉与血脉
相参肚筋力与骨力俱健神清气爽疳消虫化渐次安愈若以药攻之五脏疏却肠胃下去积毒取出虫
子虽曰医疗即非治法盖小儿脏腑虚则生虫虚则积滞虚则疳羸虚则胀满何更利下若更转动肠胃
致虚由虚成疳疳虚症候乃作无辜之孩难救矣
治疗婴幼儿惊风、热病、风痰、食积这四类病症结聚在胸膈之间,导致孩子昏沉困倦、身体沉重、关窍不通、诸脉气机闭塞。所以孩子表现为沉默不语、想吃又吃不下、想活动却无力起身、疲倦嗜卧。如果不了解这些症候,只要没有经过呕吐或腹泻,就适宜服用此方,能立即见效苏醒。大效疏风散是良方。
锦纹大黄(质地紧实的三两重) 鸡心槟榔(二两重) 旧陈橘皮(去白二两) 朴硝(一两) 黑牵牛子(一分半,炒熟)
以上五味药研为细末。每两岁幼儿服用半汤匙,三岁幼儿服用一汤匙。先用生蜂蜜调匀,再煎薄荷汤冲服。不限时间。
按语说:风痰在上部则引起呕吐,在下部则引起腹泻(涉及上中下三焦)。服用一次之后决定能恢复安乐,不可立刻投用其他药物,恐怕相互干扰导致误治。普通人只混合使用冰片、麝香、参苓术附(香附子)等没有攻伐负担的药物,像这四种病症,怎么能调和顺理地治疗呢?
按语说:五疳八痢在经典医籍中有详细记载。然而究其根本,疳疾源于五脏的五种病变,所以有五种名称。及其顺逆相传,变动脏腑,那么疾病就不遵循固定的症候表现,岂可以“五疳”和“八痢”的数量来拘泥限制?疳疾起始于饮食不节导致的疳证,痢疾起始于脾胃虚弱而受积毒。治疗疳疾的道理在于调理脾胃、温中补气、消除疳虫;治疗痢疾的道理在于调理肠胃、去除湿气、调和中焦、滋养血液、和气为上策。
治疗婴幼儿因过早食用肉类损伤脾胃,导致水谷不分、积滞不化,发作出疳气症候时,适宜服用大效使君槟榔丸。
肉豆蔻(两个,炮制) 槟榔(一个,生用) 宣连(黄连) 胡黄连 陈皮 青皮 川楝子肉(炒) 芜荑(炒,去皮) 神曲 麦芽(均炒) 木香 夜明砂(炒,去土) 芦荟 川芎(各一两重) 麝香(一字量)
以上药物研为细末,用猪胆汁和薄荷汁泛丸,如麻子大小。每次服用三五十丸,用温热的米饮送下。
按语说:积滞是疳疾的母亲,所以有积滞而不治疗,最终会形成疳疾症候。又有治疗积滞不能下行,积滞留存而脏腑虚弱,从而形成疳疾,这种情况尤为严重。大致上小儿患疳疾,泄泻无时不伴有风象吗?并非如此,只有疳泻才称为热泻,因为脏腑转动有限,所以不成风象。虽然泄泻但不伴风象,也会转为其他症候:作渴、虚热、燥烦、下痢、肿满、喘急,这些都是疳疾的虚症候。古语说:“疳虚用补”,这是知道疳疾这种病不可更用利下之法扰动脏腑。发作之初名为“疳气”;腹部胀大紧急名为“疳虚”;泄泻痢疾频繁并见名为“疳积”;五心烦热烦躁名为“疳热”;毛发焦枯发穗、肚大青筋、好吃异物名为“疳极”(病情传遍脏腑已到极点);寒热往来、形体枯槁、面无神采、肌肉无血色名为“疳劳”;手足细小、项长骨露、尻臀无肉、肚胀脐突名为“丁奚”;进食即呕哕、头骨分开如汤引、饮水、虫从口出名为“哺露”。这些都是疳疾的症候。
又因多吃生冷、黏腻肥甘之物,积滞在中脘不消化,久而久之也成疳疾。治疗疳疾的方法,要衡量病情的轻重,调理其脏腑,调和其中脘,理顺其三焦,使胃气温和而纳食增加,健脾丸以助消化,则脏腑自然调顺,令气脉与血脉相参,肚腹筋力与骨骼力量俱健,神清气爽,疳消虫化,逐渐安愈。如果用药强行攻伐,五脏疏泄,肠胃下去积毒,取出虫子,虽说是医疗,其实不是正确的治法。盖因小儿脏腑虚弱则生虫,虚弱则积滞,虚弱则疳瘦羸弱,虚弱则胀满,哪里还能再用利下之法?如果更扰动肠胃,致使由虚而成疳,疳虚症候乃作,无辜的孩子就难以救治了。
To treat infants and young children suffering from the accumulation of four syndromes: **Jing Feng** (Convulsive Wind), **Re Bing** (Heat Disease), **Feng Tan** (Wind-Phlegm), and **Shi Ji** (Food Retention) in the chest and diaphragm. This causes the child to be drowsy, heavy, with blocked orifices and closed qi mechanisms in all pulses. Consequently, the child remains silent, desires food but cannot eat, wishes to rise but lacks strength, and is fatigued and prone to lying down. Those who do not understand these symptom patterns should administer this prescription if there has been no vomiting or diarrhea; it will immediately restore consciousness. **Da Xiao Shu Feng San** (Great Efficacy Wind-Dispersing Powder) is an excellent formula.
* Jin Wen Da Huang (Rhubarb Root and Rhizome, *Rhei Radix et Rhizoma*) - 3 liang, firm texture
* Ji Xin Bing Lang (Betel Nut, *Arecae Semen*) - 2 liang
* Jiu Chen Ju Pi (Tangerine Peel, *Citri Reticulatae Pericarpium*) - 2 liang, white pith removed
* Po Xiao (Mirabilite, *Natrii Sulfas*) - 1 liang
* Hei Qian Niu (Black Morning Glory Seed, *Pharbitidis Semen*) - 1.5 fen, cooked
Grind the above five herbs into powder. For a two-year-old child, administer half a spoonful; for a three-year-old, one spoonful. First, mix with raw honey, then decoct Mint Water (*Bohe Tang*, *Menthae Haplocalycis Herba*) to wash down the powder. Administer at any time.
Commentary: Wind-phlegm located in the upper jiao causes vomiting; located in the lower jiao causes diarrhea. After one dose, peace and comfort are determined. Do not hastily administer other medicines, as they may interfere and cause errors. Ordinary people merely mix substances like Borneol (*Naozi*), Musk (*Shexiang*), Cyperus (*Xiang Fu*), Ginseng (*Ren Shen*), Poria (*Fu Ling*), Atractylodes (*Bai Zhu*), and Prepared Aconite (*Fu Zi*), which lack purgative properties. How can such a mixture properly regulate these four syndromes?
Commentary: The Five Kan (Chronic Malnutrition Syndromes) and Eight Dysenteries are detailed in classic texts. However, fundamentally, Kan arises from pathologies in the five Zang organs, hence its five names. As it transmits according to shun/ni (favorable/unfavorable) patterns and affects the Zang-Fu, the disease does not strictly follow fixed symptom patterns. One cannot rigidly adhere to the numbers "Five Kan" and "Eight Dysenteries." Kan originates from dietary irregularities leading to Kan-Dysentery; Dysentery originates from Spleen-Stomach weakness accepting accumulated toxins. The principle of treating Kan is to regulate the Spleen and Stomach, warm the middle, tonify Qi, and eliminate Kan-worms. The principle of treating Dysentery is to regulate the intestines and stomach, remove dampness, harmonize the middle, nourish blood, and harmonize Qi.
When infants and young children consume meat too early, damaging the Spleen and Stomach, causing indistinguishable water and grain, retention of stagnation, and failure to transform, resulting in Kan-Qi symptoms, **Da Xiao Shi Jun Bing Lang Wan** (Great Efficacy Quinquina Betel Pill) is appropriate.
* Rou Dou Kou (Nutmeg, *Myristicae Semen*) - 2 pieces, processed
* Bing Lang (Betel Nut, *Arecae Semen*) - 1 piece, raw
* Xuan Lian (Coptis Rhizome, *Coptidis Rhizoma*)
* Hu Huang Lian (Picrorhiza Root, *Picrorhizae Rhizoma*)
* Chen Pi (Tangerine Peel, *Citri Reticulatae Pericarpium*)
* Qing Pi (Green Tangerine Peel, *Citri Reticulatae Pericarpium Viride*)
* Chuan Li Zi Rou (Fructus Toosendan, *Toosendan Fructus*) - stir-fried
* Wu Yi (Alpinia Oxyphylla Fruit, *Alpiniae Oxyphyllae Fructus*) - stir-fried, peel removed
* Shen Qu (Massa Medicata Fermentata, *Medicated Leaven*)
* Mai Ya (Sprouted Hordeum Grain, *Hordei Fructus Germinatus*) - both stir-fried
* Mu Xiang (Aucklandia Root, *Aucklandiae Radix*)
* Ye Ming Sha (Bat Guano, *Vespertilionis Faeces*) - stir-fried, soil removed
* Lu Hui (Aloe, *Aloes*)
* Chuan Xiong (Sichuan Lovage Rhizome, *Ligustici Chuanxiong Rhizoma*) - each 1 liang
* She Xiang (Musk, *Moschus*) - 1 zi
Grind the above into powder. Form pills using Pig Bile (*Zhu Dan*) and Mint juice, sized like hemp seeds. Take 30-50 pills per dose, washed down with warm rice water.
Commentary: Retention is the mother of Kan; thus, untreated retention eventually becomes Kan syndrome. If treatment fails to move the retention, it remains while the Zang become deficient, forming Kan, which is particularly serious. Generally, when children suffer from Kan, does diarrhea always present with wind signs? No. Only Kan-diarrhea is termed Heat Diarrhea because the movement of Zang-Fu is limited, so it does not generate wind. Although there is diarrhea without wind, it may transform into other symptoms: thirst, deficiency heat, dryness and irritability, dysentery, swelling and fullness, panting and urgency—all are Kan deficiency symptoms. Ancient texts state: "Kan deficiency requires tonification," indicating that Kan disease must not be treated with purgatives that disturb the Zang-Fu. At the onset, it is called Kan-Qi; abdominal distension and urgency is called Kan-Xu; frequent diarrhea and dysentery is called Kan-Ji; five-palm heat and vexation is called Kan-Re; brittle hair, prominent abdominal veins, and pica is called Kan-Ji (pathology has reached the extreme); alternating fever and chills, emaciation, dull complexion, and loss of muscle color is called Kan-Lao; small hands and feet, long neck, exposed bones, flat buttocks, abdominal distension, and protruding umbilicus is called Ding Xi; vomiting upon eating, separated cranial sutures, drinking water, and worms emerging from the mouth is called Bu Lu. These are all Kan symptoms.
Furthermore, excessive consumption of cold, raw, sticky, fatty, and greasy foods leads to retention in the Zhong Wan (Middle Jiao) that fails to digest, eventually becoming Kan over time. The method for treating Kan involves assessing severity, regulating the Zang-Fu, harmonizing the Zhong Wan, and smoothing the San Jiao (Triple Burner). This warms the Stomach Qi to increase appetite, strengthens the Spleen via pills to aid digestion, thereby naturally adjusting the Zang-Fu. It ensures Qi and Blood meridians interact, abdominal tendon strength and bone strength are robust, spirit is clear, Kan dissipates, worms dissolve, and recovery occurs gradually. If one uses drugs to attack, the Five Zang become dispersed, the intestines and stomach purge retained toxins, and worms are expelled. Although this appears medical, it is not the correct treatment. Because children's Zang-Fu are deficient: deficiency generates worms, deficiency causes retention, deficiency leads to Kan emaciation, deficiency causes distension. How can purgatives be used further? If the intestines and stomach are further disturbed, deficiency leads to Kan, Kan-deficiency symptoms arise, and innocent children become difficult to save.