张子和治一小儿,寐而不寤。诸医作睡惊治之,或欲以艾火灸之,或以大惊丸及水银饼子治之。其父曰∶
此子平日无疾,何骤有惊乎?以问张。诊其两手脉皆平和,曰∶若惊风之脉,当洪大而强。令则平和,非惊风
也。乃窃讯其乳母,尔三日前曾饮醉酒否?遽然笑曰∶夫人以煮酒见饷,酒味甚美,三饮一罂而睡。陈酒
味甘而恋膈,酒气满乳,儿亦醉也。乃锉甘草、葛花、砂仁、贯仲,煎汁饮之,立醒。
万密斋治本县胡正衢子,二月,发热不乳。万视之,虽似变蒸,非变蒸也。时乳母皆肥健者,必因伤乳发
热也。令损之,次日热退而安。
李立之治一婴儿,忽患喑求治。立之令以衿里小儿,乘高投之地,儿不觉大惊,发声能言。问之,曰∶此
乳搐心也,非药石所能疗,其术之高,大率类此。(《杭州府志》。!^
一小儿吐乳便黄,身有微热。万曰∶此伤热乳也,吐作腥气,今已成积。母曰∶未食热物。乃密语其父曰∶
必伤交你得之矣。问何为交你?曰∶父母交感之后,以乳哺儿,此淫火之邪,忤儿脾胃正气也。不治之,必成
癖矣。盖淫火者,肝火也,病则发搐。癖者,脾病也,积不消则为癖矣。宜泻肝补脾,乃与泻火,胃苓丸服之
而愈。
御史陈公忽小儿,闭目,口不出声,手足俱软,急延医治之。独盂友荆一见便云∶公子无病,乃饮酒乳过
多沉醉耳。浓煎六安茶,饮数匙便醒。御史抚掌大笑曰∶得之矣,可谓良医。
王三峰子二岁,多病。万视之曰∶此乳少病也。王曰∶儿乳极多。万不应,遂行。既而其母验其乳媪,果
无乳也。询之,夜则嚼饭以哺之,或啖以粑果,夜则贮水以饮之。复求治。曰∶欲使即换乳母,则儿认惯不可
换也。若不使有乳妇人哺之,则疾终难治也。不若仍与旧母养之,择一少壮有乳者,夜则相伴,以乳哺之,久
而惯熟,自相亲矣。王曰∶有乳无乳,治法异乎?曰∶有乳之疳,得之伤乳,乃饱病也,宜集胜丸。无乳之疳,
得之失乳,乃饥病也,宜肥儿丸。调理一月而安。
陆养愚治姚明水儿,甫一岁,其母无乳,乃以糕饼枣柿哺之,遂患疳积痢,上则口舌腐烂,下则脓血相杂。
治疗半载,肉削如柴,饮食少进。医谓上疳下痢,睡不闭目,肛门如竹筒,指纹已过命关,不可为矣。诊之,
形脱而神在,以一指按其脉,上浮数而微,下沉微而数。其肛似外脱,而非竹筒也。此上越者不降,下陷者不
升,若升其元阳,降其邪火,犹可生也。先与补中益气汤二钱,以提其不足之阳,又浓煎生脉散,俟冷,时时
以匙挑灌之,间以孩儿茶、冰片、青黛、人中白吹之,二日而安,旬日全安。
薛立斋治一小儿,目睛缓视,大便臭秽,乃乳伤脾胃所致。用四君子加木香、藿香,治之而安。
张子和治疗一个小孩,睡觉时无法唤醒。其他医生将其当作惊风来治疗,有的想用艾火灸治,有的想用“大惊丸”和“水银饼子”来治疗。孩子的父亲说:“这个孩子平时没有病,为什么突然会有惊风呢?”于是去询问张子和。张子和诊察他两手脉象都平和,说:“如果是惊风的脉象,应当洪大且强劲。现在脉象平和,不是惊风。”于是私下讯问他的乳母:“你三天前曾经喝醉酒吗?”乳母突然笑着说:“夫人用煮好的酒招待我,酒味很美,我喝了满满一罐就睡了。陈年的酒味甘且滞留在胸膈,酒气充满乳汁,孩子也醉了。”于是切碎甘草、葛花、砂仁、贯众,煎汁给孩子喝,孩子立刻醒来。
万密斋治疗本县胡正衢的儿子,二月时发热且不吸吮母乳。万密斋观察后认为,虽然看似变蒸(婴幼儿生长发育过程中的一种生理现象),但不是变蒸。当时乳母都很肥壮健康,一定是因为伤乳导致发热。让母亲减少喂奶次数,第二天热退而平安。
李立之治疗一个婴儿,突然患失音症求治。李立之让人抱着孩子在高处扔向地面,孩子不觉受到极大惊吓,发出声音并能说话。问他原因,他说:“这是乳搐心(因哺乳不当导致的心神受扰),不是药物能治疗的,其医术高明之处,大致类似这样。(出自《杭州府志》)
一个小孩吐奶后大便发黄,身体有轻微发热。万密斋说:“这是伤热乳(食用过热食物或受热后哺乳导致的病症),呕吐物有腥气,现在已经形成积滞。”母亲说:“没吃过热的东西。”万密斋悄悄对父亲说:“一定是你们行房事后给孩子喂奶导致的。”问什么是行房事后喂奶?他说:“父母交合之后,立即用乳汁喂养孩子,这是淫火之邪,冲犯孩子的脾胃正气。如果不治疗,一定会形成癖块(腹部结块)。所谓淫火,就是肝火,发病时会抽搐;癖块,是脾病,积滞不消就会形成癖块。”应该泻肝补脾,于是给予泻火胃苓丸服用而痊愈。
御史陈公的小儿子,闭着眼睛,口中不出声,手足都软弱无力,急忙请医生治疗。只有孟友荆一见便说:“公子没有病,是因为饮酒过量导致乳汁过多,孩子沉醉了。”浓煎六安茶,喂几匙就醒了。御史拍掌大笑说:“得法了,真是好医生。”
王三峰的二儿子两岁,多病。万密斋看后说:“这是缺乳导致的病。”王三峰说:“孩子吃奶非常多。”万密斋不再回应,随即离开。后来他的母亲检查乳母,果然没有乳汁。询问得知,晚上则嚼饭来喂养,或者给吃糕饼果子,晚上则储存水来饮用。再次请求治疗。万密斋说:“如果想立即更换乳母,孩子已经习惯旧乳母,不可更换。如果不让有乳汁的妇人哺育,那么疾病终究难治。不如仍然由旧乳母抚养,选择一位年轻力壮且有乳汁的妇人,晚上陪伴在旁,用乳汁哺育孩子,久而久之习惯了,自然亲近了。”王三峰问:“有乳汁和无乳汁的病,治疗方法不同吗?”万密斋说:“有乳汁的疳积,是由于伤乳引起的,属于饱食之病,适宜用集胜丸。无乳汁的疳积,是由于失乳引起的,属于饥饿之病,适宜用肥儿丸。”调理一个月后平安。
陆养愚治疗姚明水的儿子,刚满一岁,母亲没有乳汁,就用糕饼枣柿喂养,于是患上疳积痢疾,上则口舌腐烂,下则脓血混杂。治疗半年,肌肉消瘦如柴,饮食很少进食。医生说这是上疳下痢,睡觉眼睛不闭,肛门像竹筒一样直,指纹已过命关,无法救治了。陆养愚诊察后,发现形体脱失但神气尚存,用手指按脉,浮取数而微,沉取微而数。他的肛门似外脱,而不是竹筒状。这是上越者不降,下陷者不升,如果能升提元阳,降泄邪火,还可以存活。先给予补中益气汤二钱,以提举不足的阳气,又浓煎生脉散,等冷却后,时时用勺子挑灌,间或用孩儿茶、冰片、青黛、人中白吹入患处,两天后安定,十天完全康复。
Zi Hezi treated a child who was asleep and could not be awakened. Other physicians treated it as infantile convulsion (Jing Feng), some wishing to use moxibustion with moxa cones, others prescribing Dajing Wan (Great Alarm Pill) or Mercury Pills. The father said, "This child has been healthy normally, why would he suddenly have convulsions?" He asked Zi Hezi for advice. Zi Hezi palpated the pulses of both hands and found them peaceful and regular, saying, "If it were convulsions, the pulse should be surging, large, and strong. Since the pulse is now peaceful, it is not convulsions." He then privately questioned the wet nurse, asking, "Did you drink alcohol to intoxication three days ago?" She suddenly laughed and replied, "The lady offered me boiled wine; the taste was very fine, I drank a whole jar and fell asleep. Old wine has a sweet taste and lingers in the chest and diaphragm; its qi filled the breast milk, and the child also became intoxicated." He then chopped Glycyrrhizae Radix et Rhizoma (Gancao), Puerariae Flos (Ge Hua), Amomi Fructus Rotundus (Sharen), and Dryopteridis Rhizoma (Guanzhong), decocted them in water, and gave the juice to drink. The child woke up immediately.
Wan Muzhai treated the son of Hu Zhengqu from his county. In February, the child had fever and refused breastfeeding. Wan observed him and noted that although it resembled Bian Zheng (a physiological phenomenon in infants involving low-grade fever during growth), it was not Bian Zheng. At that time, the wet nurses were all robust and healthy, so it must be heat caused by damaged milk. He advised reducing the frequency of feeding. The next day, the fever subsided and the child was at peace.
Li Lizhi treated an infant who suddenly lost his voice and sought treatment. Li instructed someone to hold the child high and drop him onto the ground. The child was greatly startled without realizing danger, cried out, and could speak again. When asked about the method, he said, "This is Ru Chu Xin (heart disturbance due to improper lactation), which cannot be cured by medicine. The skill involved is roughly of this nature." (From *Hangzhou Fu Zhi*)
A child vomited milk and had yellow stool, with a slight fever. Wan said, "This is Shang Re Ru (heat damage from milk), characterized by fishy-smelling vomit, which has now formed accumulation." The mother said, "He did not eat hot food." Wan whispered to the father, "It must be due to intercourse followed by breastfeeding." Asked what intercourse followed by breastfeeding meant, he explained, "After parents engage in sexual union, if the child is fed immediately, the 'lustful fire' pathogen offends the righteous qi of the child's spleen and stomach. If untreated, it will certainly form Pi Kuai (abdominal masses). Lustful fire refers to liver fire, which causes convulsions when manifesting; Pi Kuai is a spleen disease where unresolved accumulation forms masses." The treatment should drain the liver and tonify the spleen. He prescribed Xiehuo Weiling Wan (Fire-Draining Weiling Pill), and the child recovered.
The young son of Censor Chen closed his eyes, made no sound, and his limbs were soft and weak. They urgently summoned a physician. Only Meng Youjing looked at him and said, "The young master has no illness; he is merely intoxicated from excessive alcohol-laden milk." Strongly decocted Lu'an Tea was given, a few spoonfuls of which revived him. The Censor clapped his hands and laughed heartily, saying, "I have found the solution; truly a good physician."
Wang Sanfeng's second son was two years old and suffered from frequent illnesses. Wan observed him and said, "This is a disease caused by insufficient milk." Wang said, "The child drinks a great deal of milk." Wan did not respond and left. Later, the mother inspected the wet nurse and indeed found there was no milk. Inquiry revealed that at night, chewed rice was fed, or cakes and fruits were given, and water was stored for drinking at night. They sought treatment again. Wan said, "If you wish to change the wet nurse immediately, the child is accustomed to the current one and cannot be changed. If no woman with milk nurses him, the illness will ultimately be difficult to cure. It is better to keep the original wet nurse but select a young, vigorous woman with milk to accompany her at night to breastfeed the child. Over time, the child will become accustomed and naturally attached." Wang asked, "Are the treatments different for diseases caused by having milk versus not having milk?" Wan replied, "Pi Ji (infantile malnutrition) with milk results from damaging the milk, belonging to overeating disorders, suitable for Jisheng Wan. Pi Ji without milk results from loss of milk, belonging to hunger disorders, suitable for Fei'er Wan." After one month of regulation, the child was well.
Lu Yangyu treated the son of Ming Yaoshui, who was just one year old. His mother had no milk, so he was fed cakes, pastries, dates, and persimmons, leading to Pi Ji Li (malnutrition with dysentery). Upper symptoms included rotting of the mouth and tongue; lower symptoms included pus and blood mixed in stool. Treatment lasted half a year, resulting in emaciation like firewood and poor appetite. Physicians stated this was upper Pi and lower dysentery, with eyes open during sleep, anus resembling a bamboo tube, and the fingerprint extending beyond the Life Gate, declaring it incurable. Lu palpated and found that while the form was depleted, the spirit remained. Palpating the pulse with one finger, the superficial layer was rapid and faint, while the deep layer was faint and rapid. The anus appeared prolapsed but was not tubular. This indicated that the ascending yang failed to descend, and the sinking yin failed to rise. If the primordial yang could be raised and evil fire descended, survival was possible. First, Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) 2 qian was given to lift the deficient yang. Then, Sheng Mai San (Generate the Pulse Powder) was strongly decocted, cooled, and administered drop by drop with a spoon. Intermittently, Hai'er Cha (Child's Tea), Bing Pian (Borneol), Qing Dai (Indigo Naturalis), and Renzhong Bai (Calcined Human Excrement) were insufflated into the lesions. Within two days, the condition stabilized; within ten days, full recovery was achieved.
Xue Lizhai treated a child whose eyeballs moved slowly and whose stool had a foul odor. This was caused by milk damaging the spleen and stomach. Si Jun Zi Tang (Four Gentlemen Decoction) was modified with Mu Xiang (Aucklandiae Radix) and Huo Xiang (Pogostemonis Herba), and the child recovered.