小儿与大人无异,初感畏寒,宜散邪消化乳食。如热邪传里,婴儿亦舌上白苔,扬手掷足,
怕热不恶寒,可与白虎汤。大便闭结,小便短赤,承气汤下之。若手足凉,口气冷,头额冷汗,
面色黑暗,大便泻青,此为阴证。须用温里之药,治方与大人相同,但药剂之分两轻少耳。凡天
行痘疹时,从痘疹门用药,微感风寒,宜抱龙丸、惺惺散治之。如遇变蒸之期,但宜调护,不药
可也。
小儿身热汗出,口渴吐泻,霍乱等证,治宜辰砂五苓散(五苓散加辰砂。)治伏暑吐泻、渴
烦,六和半夏汤。霍乱痰嗽,六一散加辰砂。一切暑热证(三方见大人门)。
阴雨地湿,坐卧感受,或溺污衣被,皆能致之。脉见沉缓,身体烦痛,发热恶风而多汗,小
便不利,大便溏泄,日久则手垂足肿,入脏则喑哑不言。治宜疏利小便,其湿自除,兼健脾土。
不宜发汗及峻攻之。
主方 白术(五分) 苍术(五分) 猪苓(五分) 泽泻(五分) 干姜(炮,五分)
车前(五分) 赤茯苓 木通(各一钱) 上加灯心十茎,水煎服。
寒湿去木通,加浓朴、甘草。呕加陈皮、半夏、藿香。肿胀加大腹皮。
小儿纯阳,脏腑易热。阴阳气迁,熏蒸于外,致身热也。肝热则眼肿、翳瘴;心热则舌疮、
溺赤;肺热则鼻衄、便秘 脾热则唇燥流涎;胃热则口臭作渴;肾热则耳疮脓出。若夫五脏蕴热
,面赤烦躁,痰涎壅盛。大抵小儿为病,多因热极生风,风生惊,故有热即当清之,此拔本塞源者
也。然小儿发热,更有多种。患潮热者,发歇有时;惊热者,颠叫恍惚;夜热者,夕发旦止;邪
热者,昼夜热盛;实热者,壮盛壅滞;虚热者,气血俱虚;食热者,乳食致伤;疳热者,肚大形
瘦;烦热者,身躁心烦,积热者,颊赤口疮;风热者,汗出恶风;客热者,去来不定,癖热者,
腹中有块;痰热者,涎嗽喘急,脉浮沉皆数,治宜随证用方。幼科虽另门类,方药亦可与大方参
用。
主方 (泻肝火,治目赤。)
防风 当归 川芎 羌活 薄荷 大黄(酒煮) 龙胆草 栀子 甘草(等分) 水煎或为
末,茶调下。
心热,导赤散;脾热,泻黄散。胃火加石膏;肺热,泻白散加芩、天粉、防风、茯苓;肾热
耳脓,通圣散(四方并见火门。)潮热、壮热、夜热,宜后方。
又方(治三种热) 柴胡 骨皮 知母 麦门冬 半夏 赤茯苓 黄芩 甘草(等分)
加姜、枣,水煎服。灯心可加。
惊热,从惊风治;邪热,从伤寒治。实热,凉膈散(方见火门),虚热,四物汤加黄芩、黄连、
人参、黄 、甘草水煎。食热,从伤食治;疳热,从疳证治;风热,从伤风治。客热,甘露饮子
(方见火门),烦热,生地、木通、当归、栀子、黄芩、甘草,水煎。积热,保和丸(方见脾胃;
)痰热,抱龙丸(方见惊风。)小柴胡汤(往来寒热) 白虎汤(治发热渴) 参苏饮(方见
伤风寒门)
小儿的生理病理特点与成人没有本质区别。初感外邪时出现畏寒症状,治疗宜采用发散邪气、消食导滞的方法。如果热邪传入体内,婴儿也会出现舌苔发白的情况,表现为扬手掷足(烦躁不安),怕热而不恶寒,此时可以使用白虎汤。若大便闭结不通,小便短少色赤,可用承气汤攻下通便。如果出现手足冰凉,口气冷,头额出冷汗,面色晦暗发黑,大便泻下青色稀便,这属于阴证。必须使用温里散寒的药物,治疗方案与成人相同,只是药剂的分量要轻且少。凡是遇到天行痘疹流行的时候,应从痘疹门的相关方药中选择用药;若是轻微感受风寒,宜用抱龙丸或惺惺散治疗。如果遇到变蒸期(婴幼儿生长发育过程中的正常生理现象),只需注意调护即可,不需要服药。
小儿身体发热、出汗、口渴、呕吐腹泻,出现霍乱等证候,治疗宜用辰砂五苓散(在五苓散基础上加入辰砂)。治疗伏暑引起的吐泻、口渴心烦,用六和半夏汤。霍乱伴有痰嗽,用六一散加辰砂。(以上三方详见成人篇)。
阴雨天气地面潮湿,坐卧感受湿气,或者尿液弄脏衣被,都能导致湿邪致病。脉象呈现沉缓,身体烦痛,发热恶风且多汗,小便不利,大便溏泄,日久则出现手脚下垂肿胀,病入脏腑则声音嘶哑不能言语。治疗宜疏利小便,湿气自然消除,同时兼以健脾土。不宜使用发汗及峻猛攻下的方法。
主方:白术(五分)、苍术(五分)、猪苓(五分)、泽泻(五分)、干姜(炮制,五分)、车前子(五分)、赤茯苓、木通(各一钱)。上加灯心草十茎,水煎服。
若寒湿重去木通,加浓朴、甘草。呕吐加陈皮、半夏、藿香。肿胀加大腹皮。
小儿属纯阳之体,脏腑容易生热。阴阳之气运行变化,熏蒸于体表,导致身体发热。肝热则眼睛肿胀、生翳障;心热则舌生疮疡、小便色赤;肺热则鼻出血、便秘;脾热则嘴唇干燥、流涎;胃热则口臭、作渴;肾热则耳部生疮流脓。如果是五脏蕴藏热邪,见面色红赤、烦躁不安、痰涎壅盛。大抵小儿患病,多因热极生风,风生惊厥,所以有热就要及时清解,这是拔除病根、堵塞源头的治法。然而小儿发热还有多种类型:患潮热的,发热间歇有时;患惊热的,尖叫恍惚;患夜热的,傍晚发作早晨停止;患邪热的,昼夜发热旺盛;患实热的,壮盛壅滞;患虚热的,气血俱虚;患食热的,因乳食损伤所致;患疳热的,肚子大形体瘦弱;患烦热的,身体躁动心烦;患积热的,脸颊红赤口舌生疮;患风热的,出汗恶风;患客热的,发热来去不定;患癖热的,腹中有肿块;患痰热的,涎多咳嗽气喘急促,脉象浮沉皆数,治疗宜随证选用方剂。儿科虽另立门类,但方药也可以与成人通用参考。
主方(泻肝火,治疗目赤。):防风、当归、川芎、羌活、薄荷、大黄(酒煮)、龙胆草、栀子、甘草(等分)。水煎或研为末,茶调下。
心热,用导赤散;脾热,用泻黄散。胃火加石膏;肺热,用泻白散加黄芩、天花粉、防风、茯苓;肾热耳流脓,用通圣散。(以上四方并见火门篇)。潮热、壮热、夜热,宜用后方。
又一方(治疗三种热):柴胡、地骨皮、知母、麦门冬、半夏、赤茯苓、黄芩、甘草(等分)。加生姜、大枣,水煎服。灯心草可加。
惊热,从惊风证治疗;邪热,从伤寒证治疗。实热,用凉膈散(方见火门),虚热,用四物汤加黄芩、黄连、人参、黄芪、甘草水煎。食热,从伤食证治疗;疳热,从疳证治疗;风热,从伤风证治疗。客热,用甘露饮子(方见火门),烦热,用地黄、木通、当归、栀子、黄芩、甘草水煎。积热,用保和丸(方见脾胃门);痰热,用抱龙丸(方见惊风门)。小柴胡汤(治疗往来寒热)、白虎汤(治疗发热口渴)、参苏饮(方见伤风寒门)。
Pediatric physiological and pathological characteristics are not essentially different from adults. When initially contracting external pathogens and presenting with aversion to cold, the treatment should focus on dispersing pathogens and resolving food stagnation. If heat pathogens transmit inward, infants may also present with a white tongue coating, manifesting as restless waving of hands and feet (restlessness), aversion to heat without aversion to cold; in such cases, Baihu Tang (White Tiger Decoction) can be administered. If accompanied by constipation and short, dark urine, Chengqi Tang (Chengqi Decoction) should be used to purge accumulation. If the extremities are cold, breath is cold, forehead sweats coldly, complexion is dark and dull, and stool is green and loose, this indicates a Yin syndrome (Cold Syndrome). Warm interior-dispersing herbs must be used; the treatment protocol is the same as for adults, but the dosage should be lighter and smaller. During epidemics of smallpox or chickenpox, medications from the Smallpox/Chickenpox section should be selected; for mild wind-cold contraction, Baolong Wan (Dragon-Holding Pill) or Xingxing San (Xingxing Powder) are appropriate. During the period of Bianzheng (a normal physiological developmental phase in infants), only nursing care is needed, and medication is unnecessary.
For pediatric fever with sweating, thirst, vomiting, and diarrhea, presenting as Huoluan (Cholera-like syndrome), Chenwu Wuling San (Cinnabar-Wu Ling San / Five-Ingredient Powder with Poria) [Wu Ling San added with Cinnabar] is indicated. For vomiting and diarrhea caused by latent summerheat with thirst and irritability, Liuhe Banxia Tang (Six-Harmony Pinellia Decoction) is used. For Huoluan with phlegm and cough, Liuyi San (Six-to-One Powder) added with Cinnabar is applied. (The above three formulas are detailed in the Adult section).
Dampness resulting from rainy weather and humid ground, sitting or lying in dampness, or soiling clothes and bedding with urine, can all lead to pathogenic dampness. The pulse appears deep and slow; symptoms include bodily restlessness and pain, fever with aversion to wind and profuse sweating, difficult urination, and loose stools. If prolonged, it leads to drooping hands and swollen feet; if entering the Zang organs, it causes aphonia and inability to speak. Treatment should focus on promoting diuresis to eliminate dampness naturally, while simultaneously strengthening the Spleen Earth. Sweating-inducing methods and harsh purgatives are contraindicated.
Main Formula: Baizhu (Atractylodis Rhizoma, 5 fen), Cangzhu (Atractylodis Rhizoma, 5 fen), Zhuling (Polyporus, 5 fen), Zexie (Alismatis Rhizoma, 5 fen), Ganjiang (Zingiberis Rhizoma Preparatum, 5 fen), Cheqian (Plantaginis Semen, 5 fen), Chifuling (Poria with Red Sandalwood), Mutong (Akebiae Caulis, 1 qian each). Add ten stems of Dengxincao (Junci Medulla), decoct in water and take orally.
If cold-dampness is heavy, remove Mutong and add Houpo (Magnoliae Officinalis Cortex) and Gancao (Glycyrrhizae Radix et Rhizoma). For vomiting, add Chenpi (Citri Reticulatae Pericarpium), Banxia (Pinelliae Rhizoma), and Huoxiang (Agastaches Herba). For swelling, add Fupi (Arecae Pericarpium).
Children possess a "Pure Yang" constitution, making their Zang-Fu organs prone to heat. The migration of Yin and Yang Qi steams outward, causing body heat. Liver heat causes eye swelling and nebulae; Heart heat causes tongue ulcers and dark urine; Lung heat causes epistaxis and constipation; Spleen heat causes dry lips and salivation; Stomach heat causes halitosis and thirst; Kidney heat causes otitis with pus discharge. If the five Zang organs harbor heat, symptoms include red face, irritability, and abundant phlegm-saliva. Generally, pediatric diseases often arise from extreme heat generating wind, and wind generating convulsions; therefore, heat must be cleared promptly, which is a method of eliminating the root cause. However, there are various types of pediatric fever: Tidal fever (Chaore) occurs at specific intervals; Convulsive fever (Jingre) presents with screaming and trance-like states; Night fever (Yere) starts in the evening and stops in the morning; Pathogenic fever (Xiere) is intense day and night; Excess fever (Shire) is vigorous and obstructed; Deficiency fever (Xure) involves deficiency of both Qi and Blood; Food fever (Shire) results from dietary injury; Malnutrition fever (Ganre) features a distended abdomen and emaciation; Irritable fever (Fanre) involves physical restlessness and mental agitation; Accumulated heat (Jire) manifests as red cheeks and oral ulcers; Wind-heat (Fengre) presents with sweating and aversion to wind; Guest heat (Kere) comes and goes irregularly; Mass fever (Pi re) involves abdominal masses; Phlegm-heat (Tanre) presents with excessive saliva, cough, wheezing, and rapid pulses at all depths. Treatment should follow the pattern differentiation. Although Pediatrics is a separate category, its formulas can be referenced alongside adult prescriptions.
Main Formula (Clearing Liver Fire, treating red eyes): Fangfeng (Saposhnikoviae Radix), Danggui (Angelicae Sinensis Radix), Chuanxiong (Ligustici Chuanxiong Rhizoma), Qianghuo (Notopterygii Rhizoma et Radix), Bohe (Menthae Haplocalycis Herba), Dahuang (Rhei Radix et Rhizoma prepared with wine), Longdancao (Gentianae Radix), Zhizi (Gardeniae Fructus), Gancao (Glycyrrhizae Radix et Rhizoma) in equal parts. Decoct in water or grind into powder, taken with tea.
Heart heat: Daochi San (Guide Out the Red Powder); Spleen heat: Xiehuang San (Drain Yellow Powder). Stomach fire: add Shigao (Gypsum Fibrosum). Lung heat: Xiebai San (Drain White Powder) added with Huangqin (Scutellariae Radix), Tianfen (Tianhua Fen / Trichosanthis Radix), Fangfeng, and Fuling. Kidney heat with ear pus: Tongsheng San (Unimpeded Salvation Powder). (The above four formulas are found in the Fire section). For tidal fever, robust fever, and night fever, use the subsequent formula.
Another Formula (Treating three types of heat): Chaihu (Bupleuri Radix), Goubi (Phellodendri Cortex / Gu Pi), Zhimu (Anemarrhenae Rhizoma), Maimendong (Ophiopogonis Radix), Banxia (Pinelliae Rhizoma), Chifuling, Huangqin, Gancao in equal parts. Add Jiang (Zingiberis Rhizoma) and Zao (Jujubae Fructus), decoct in water. Dengxincao can be added.
Convulsive fever: treat according to Convulsion patterns; Pathogenic fever: treat according to Cold Damage patterns. Excess fever: Liangge San (Cool the Diaphragm Powder, see Fire section); Deficiency fever: Siwu Tang (Four Substances Decoction) added with Huangqin, Huanglian (Coptidis Rhizoma), Renshen (Ginseng Radix et Rhizoma), Huangqi (Astragali Radix), and Gancao, decocted. Food fever: treat according to Food Injury patterns; Malnutrition fever: treat according to Gan Syndrome patterns; Wind-heat: treat according to Wind-Cold Injury patterns. Guest heat: Ganlu Yinzi (Sweet Dew Drink, see Fire section); Irritable fever: Dihuang (Rehmanniae Radix), Mutong, Danggui, Zhizi, Huangqin, Gancao, decocted. Accumulated heat: Baohe Wan (Preserve Harmony Pill, see Spleen/Stomach section); Phlegm-heat: Baolong Wan (see Convulsion section). Xiaochaihu Tang (for alternating chills and fever), Baihu Tang (for fever and thirst), Shenru Yin (see Wind-Cold Injury section).