初生三朝。即用三黄汤解其胎毒。服三四日后。每日投金银花汤。至弥月而止。可保其痘稀。
而少疮疹之患。若遇寒冬之月。或小儿体寒质薄。则专用金银花汤亦可。弥月间声直发搐。
撮口脐风。是胎风也。俗名腹里惊。因其母肝气素郁。儿禀受之。再浴时断脐时。或有进风。得
外风则内风动。此症发之太早。泣不出声。泣而无泪者。皆难治。治法。痰盛者先治痰。火盛者
先清火。或用益黄散治之。视其牙龈有泡。急以绵裹指擦破之。用青黛、冰片。略涂口内为妙。
至三岁以前。形质微弱。无脉可凭。但察其脉之强弱缓急而已。须更审其食指寅卯辰三关。
男左女右。食指近手第一节为寅关。次节为卯关。上节为辰关。凡儿有病。必有脉纹外现。如
现纹在寅关。不过卯关者易治。连卯关者难治。过辰关者更难治。若一条纹。从寅关直透卯
透辰者必死。其纹青色为风。紫为泻利。青紫为肝木乘脾。红则为热。合之唇舌面色。亦可得
其大概也。三岁后六七至为平脉。四五至为寒。九十至为困。脉弦急为气不和。沉缓为伤食。
促结为虚惊。浮为风。沉细为寒。脉乱者不治。
外热与内热不同。外热者。身终日发热。或拘束肢冷。外有清涕咳嗽。头痛鼻塞之象。内则脉
浮而不渴。此外解之症也。不可用凉药。宜荆防散表之。得汗自愈。内热者。如夜热潮热。昼轻
夜重。病最缠绵。或口渴。或腹胀。或盗汗。其症有因伤食停痞。伏燥伏火。阴虚阳虚等异。宜分
别而治。此内解之症也。不可用表药。伤食者。保和丸加地骨皮消之。停痞者。和中丸加鳖甲、
牡蛎消之。伏燥者。贝母栝蒌散润之。伏火者。黄芩芍药汤加山栀、丹皮等清之。阴虚者。蒿皮
四物汤退之。阳虚者。四君子汤养之。此等热久必伤阴。日渐削瘦。成为疳痨。慎勿忽视。
新生儿出生后的前三天,立即使用三黄汤来清除胎毒。服用三四天后,每天给予金银花汤,直到满月时停止。这样可以保证婴儿出痘稀少,从而减少疮疹的隐患。如果遇到寒冬月份,或者小儿体质虚寒、禀赋薄弱,那么专门使用金银花汤也可以。在满月期间,如果声音直硬并发抽搐,撮口(嘴唇收缩如囊口状)和脐风(脐部受风),这是胎风病。俗称“腹里惊”。这是因为母亲肝气素来郁结,胎儿禀受了这种气机;再加上洗澡或断脐时,外界风寒侵入,外风引动内风。此症发病过早,哭泣不出声或哭泣而无眼泪的,都难以治疗。治疗方法:痰湿盛者先治痰,火热盛者先清火。或者使用益黄散治疗。观察其牙龈如果有疱疹,急忙用棉絮包裹手指擦破,再用青黛、冰片稍微涂抹口腔内部为妙。
到了三岁以前,小儿形体质地微弱,没有明显的脉象可以凭依,只需观察脉搏的强弱、缓急即可。必须进一步审察食指上的“虎口三关”脉纹。男左女右,食指靠近手掌的第一节为寅关,中间一节为卯关,最上一节为辰关。凡是小儿有病,必然有脉纹显露在外。如果脉纹只出现在寅关,未超过卯关的,容易治疗;连及卯关的,难治;超过辰关的,更难治。如果有一条脉纹,从寅关直通卯关再透至辰关的,必定死亡。脉纹青色主风证,紫色主泻利,青紫色主肝木乘脾(肝气过旺克制脾胃),红色主热证。结合嘴唇、舌苔和面色,也可以大致判断病情。三岁以后,脉搏一息四到五下为平脉(正常),一到两下为寒证,九到十下为危重之象。脉弦急主气机不和,沉缓主伤食,促脉或结脉主虚惊,浮脉主风邪,沉细主寒邪。脉象紊乱者,无法治疗。
外热与内热是不同的。外热表现为身体整天发热,或者肢体拘紧发冷,外部症状有清涕、咳嗽、头痛、鼻塞等表现。内部则脉象浮而口不渴,这是表证解除了的表现。不可使用凉药,适宜用荆防散发表,出汗后自然痊愈。内热表现为夜间潮热或定时发热,白天轻晚上重,病情最为缠绵。或者口渴,或者腹胀,或者盗汗。这些症状有的因伤食停滞成痞块,有的因伏燥、伏火,有的是阴虚或阳虚等不同情况。应当分别治疗。这属于里证(内解之症)。不可使用解表药。如果是伤食,用保和丸加地骨皮来消导;如果是停痞(积滞痞块),用和中丸加鳖甲、牡蛎来消散;如果是伏燥,用贝母栝蒌散来润燥;如果是伏火,用黄芩芍药汤加山栀、丹皮等来清热;如果是阴虚,用蒿皮四物汤来退热养阴;如果是阳虚,用四君子汤来温补。这类热证日久必伤阴液,日渐消瘦,形成疳痨(慢性消耗性疾病)。千万不要忽视。
Within the first three days after birth, Sanhuang Tang (Three Yellows Decoction) should be administered to resolve fetal toxins. After taking it for three to four days, Jinyinhua Tang (Honeysuckle Decoction) should be given daily until the infant reaches one month of age. This can ensure sparse smallpox eruptions and prevent complications from sores and rashes. If encountered during cold winter months, or if the infant has a cold constitution and weak endowment, using only Jinyinhua Tang is also acceptable. During the first month, if the infant exhibits straight/hard voice accompanied by convulsions, mouth puckering (suo kou), and umbilical wind (qi feng), this is termed Fetal Wind (Tai Feng). Commonly known as "abdominal fright." It arises because the mother's Liver Qi was previously depressed, which the fetus inherited. Additionally, when bathing or cutting the umbilical cord, external wind may invade; external wind stirs internal wind. Since this condition manifests too early, infants who cry without sound or cry without tears are difficult to treat. The treatment principle: if phlegm is abundant, treat the phlegm first; if fire is excessive, clear the fire first. Alternatively, use Yihuang San (Benefit Yellow Powder). Observe if there are blisters on the gums; if so, urgently wipe them open with a finger wrapped in cotton, then apply Qingdai (Indigo Naturalis) and Bingpian (Borneol) slightly inside the mouth, which is optimal.
Before the age of three, the child's physical structure is weak, and pulse diagnosis is unreliable; one should merely observe the strength, weakness, slackness, or urgency of the pulse. One must further examine the three sections of the index finger vein (Yin, Mao, Chen Guan). For boys, check the left hand; for girls, the right hand. The segment closest to the palm is the Yin Guan, the middle segment is the Mao Guan, and the uppermost segment is the Chen Guan. Whenever a child is ill, the vein pattern will necessarily appear externally. If the vein appears only in the Yin Guan and does not reach the Mao Guan, it is easy to treat. If it extends to the Mao Guan, it is difficult to treat. If it passes the Chen Guan, it is even more difficult to treat. If a single vein line penetrates directly from the Yin Guan through the Mao Guan to the Chen Guan, death is certain. A cyan vein indicates Wind; purple indicates diarrhea/dysentery; cyan-purple indicates Liver Wood overacting on Spleen Earth; red indicates Heat. Combined with the lips, tongue, and facial color, one can grasp the general situation. After the age of three, four to five beats per respiration constitute a normal pulse (Ping Mai); one to two beats indicate Cold; nine to ten beats indicate critical condition. A wiry and urgent pulse indicates Disharmony of Qi; a deep and slow pulse indicates Food Stagnation; a rapid or knotted pulse indicates Deficiency Fright; a floating pulse indicates Wind; a deep and thin pulse indicates Cold. A chaotic pulse is untreatable.
External Heat differs from Internal Heat. External Heat presents as constant fever throughout the day, or limb stiffness with cold extremities, accompanied by external symptoms such as clear nasal discharge, cough, headache, and nasal congestion. Internally, the pulse is floating but there is no thirst; this indicates that the exterior syndrome is resolving. Cool/cold-natured medicines should not be used. Instead, Jingfang San (Schizonepeta and Saposhnikovia Powder) should be used to release the exterior; recovery occurs naturally after sweating. Internal Heat presents as tidal fever at night or periodic fever that is mild during the day and severe at night, a condition that is most lingering. Symptoms may include thirst, abdominal distension, or night sweats. These symptoms may stem from different causes such as Food Stagnation forming palpable masses (Ting Pi), latent Dryness, latent Fire, Yin Deficiency, or Yang Deficiency. They must be treated separately. This belongs to Interior Syndromes (Nei Jie Zhi Zheng). Exterior-releasing medicines should not be used. For Food Stagnation, Bahe Wan (Harmonize the Stomach Pill) added with Digupi (Groundcherry Bark) is used to dissipate stagnation. For Ting Pi (Stagnant Masses), Hezhong Wan (Harmonize the Middle Pill) added with Biejia (Turtle Shell) and Muli (Oyster Shell) is used to dissipate masses. For Latent Dryness, Beimu Gualou San (Fritillaria and Trichosanthes Powder) is used to moisten. For Latent Fire, Huangqin Shaoyao Tang (Scutellaria and Peony Decoction) added with Shanzhi (Gardenia) and Danpi (Moutan Cortex) is used to clear heat. For Yin Deficiency, Haopi Siwu Tang (Artemisia Bark and Four Substances Decoction) is used to retreat heat. For Yang Deficiency, Sijunzi Tang (Four Gentlemen Decoction) is used to nourish. Such prolonged heat inevitably damages Yin fluids, leading to gradual emaciation and forming Gan Lao (Infantile Malnutrition and Consumption Disease). Do not neglect this.