〔钱〕伤寒吐泻,身温乍凉乍热,睡多气粗,大便黄白色,呕吐乳食不消,时咳嗽,更有五脏兼见证,当煎入
脏君臣药,先服大青膏,后服益黄散。如先曾下,或无下证慎不可下,此乃脾肺受寒,不能入脾也。(洁古云,身温
吐泻咳嗽,是风木入于脾,母虚,其子亦弱,法当煎槟榔豆蔻汤下大青膏,后服益黄散。)
伤风吐泻,身热多睡,能食乳,饮水不止,吐痰,大便黄水,此为胃虚热渴吐泻也,当生胃中津液,以止其
渴,止后,用发散药。止渴多服白术散,发散大青膏主之。(洁古云,吐泻身热而渴、小便少者,五苓散主之,
身热而呕者,当服白术散,后煎槟榔木香汤下大青膏。)
伤风吐泻,身凉吐沫,泻青白色,闷乱不渴,哽气长出气,睡露睛,此伤风荏
苒轻怯,因成吐泻,当补脾,后发散。补脾益黄散,发散大青膏主之。此二证多病于春冬也。(洁古云,身凉吐泻,
不渴者、则知为寒,煎附子桂枝汤、下大青膏)
大青膏
天麻(末,一分) 白附子(末,生,一钱半) 蝎尾(去毒,生,半钱) 朱砂(研,一字匕) 青黛(一钱,
研) 麝香(一字匕) 乌蛇稍肉(酒浸,焙干,取末,半钱) 天竺黄(一字匕,研)
上,同再研细,生蜜和成膏。每服半皂子大至一皂子大,月中儿粳米大,同牛黄膏、温薄荷水,化一处服之,
五岁以上,同甘露散服之。
小儿伤于风冷,病吐泻,医谓脾虚,以温补之,不已,复以凉药治之,又不能散,谓之本伤风,医者乱攻之,
因脾气积虚,内不能散,外不能解,至十余日,其证多睡露睛身温,风在脾胃,故大便不聚而为泻,当去脾间风,
风退则痢止,宣风散主之。后用使君子丸补其胃。亦有诸吐痢久不瘥者,则脾虚生风,而成慢惊矣。
〔海〕吐泻过多,脾胃虚乏,欲生风候者。四君子加白附子减半,生姜煎服。
守胃散 治阴阳不和,吐泻不止,预防风证,常调脾胃,进饮食。
人参(去芦) 白术 白茯苓(去皮) 山药(去黑皮) 干葛 扁豆(炒,去壳) 南星(锉碎,瓦器盛,东壁
土同酷煮少时,滤干,切片,焙)甘草 藿香(去梗) 防风(去芦) 天麻(各半两)
上锉。每服二钱,水一钟,姜二片,冬瓜子仁五十粒掐碎,煎七分,空心温服。
如泻不止,入沉香、白豆蔻同煎。
钓藤饮 治吐利,脾胃气虚生风。
钓藤钩(二钱) 蝉壳 天麻 防风 蝎尾(去毒) 人参(各半两) 麻黄 僵蚕(炒) 甘草(
炙) 川芎(各二钱五分) 麝香(五分)
上为末。水煎服。虚寒,加附子一钱。
【钱乙】小儿患伤寒出现呕吐腹泻,身体温度时而温暖、时而忽冷忽热,嗜睡且呼吸粗重,大便呈黄白色,呕吐未消化的乳食,时常咳嗽,同时伴有五脏兼夹的症状。治疗时应当将“脏君臣药”煎煮后服用,先服用大青膏,随后服用益黄散。如果此前已经使用过泻下法,或者没有需要泻下的证候,务必不可再次使用泻下法。这是因为脾肺受寒,导致脾气不能正常运化。(张洁古说:身体温暖、呕吐腹泻并伴有咳嗽,这是风木之邪侵入脾土,母脏虚弱,子脏也随之衰弱,治法应当煎煮槟榔豆蔻汤送服大青膏,随后服用益黄散。)
小儿患伤风出现呕吐腹泻,身体发热,嗜睡,食欲尚可(能进食乳食),饮水不止,呕吐痰液,大便呈黄色水样,这属于胃虚热盛导致的口渴和吐泻。治疗应当滋生胃中的津液以止渴,口渴停止后,再使用发散表邪的药物。止渴多服用白术散,发散表邪以大青膏为主治。(张洁古说:呕吐腹泻、身体发热且口渴、小便量少者,用五苓散主治;身体发热且呕吐者,应当服用白术散,随后煎煮槟榔木香汤送服大青膏。)
小儿患伤风出现呕吐腹泻,身体发凉,口吐涎沫,大便呈青色或白色,胸闷烦乱且不口渴,频繁打嗝并长出气,睡觉时眼睛半睁(露睛),这是伤风迁延日久导致正气怯弱,进而形成吐泻。治疗应当先补脾,随后解表发散。补脾用益黄散,解表发散用大青膏主治。这两种证候多在春冬季节发病。(张洁古说:身体发凉、呕吐腹泻且不口渴的,可知为寒证,应煎煮附子桂枝汤送服大青膏。)
大青膏
天麻(研末,一分) 白附子(生用,研末,一钱半) 蝎尾(去毒,生用,半钱) 朱砂(研细,一字匕量) 青黛(一钱,研细) 麝香(一字匕量) 乌蛇梢肉(酒浸,焙干,取末,半钱) 天竺黄(一字匕量,研细)
以上药物共同再次研成细末,用生蜂蜜调和制成膏剂。每次服用半个皂荚子大小至一个皂荚子大小,月龄小的婴儿如粳米大小,与牛黄膏一同,用温薄荷水化开混合服用,五岁以上儿童,与甘露散一同服用。
小儿因感受风冷而患病,出现呕吐腹泻,医生认为是脾虚,采用温补法治疗,但病情未愈,又改用凉药治疗,又不能疏散病邪,这种情况称为“本伤风”。医者胡乱攻伐,导致脾气积滞虚弱,内不能消散,外不能解除,经过十余日,症状表现为多睡、露睛、身体微温,风邪滞留于脾胃,因此大便不成形而致泻。治疗应当祛除脾间的风邪,风邪退去则痢疾/腹泻停止,用宣风散主治。之后用使君子丸来补益胃气。也有各种呕吐腹泻久治不愈的,则是脾虚生风,演变为慢惊风。
【海藏】小儿呕吐腹泻过多,导致脾胃虚弱匮乏,即将出现动风征象者。用四君子汤加入白附子(用量减半),加生姜煎服。
守胃散 治疗阴阳不和,呕吐腹泻不止,预防风证,经常调理脾胃,增进饮食。
人参(去芦头) 白术 白茯苓(去皮) 山药(去黑皮) 干葛 扁豆(炒,去壳) 南星(切碎,置于瓦器中,与东壁土同醋煮片刻,滤干,切片,焙干) 甘草 藿香(去梗) 防风(去芦头) 天麻(各半两)
以上药物切碎。每次服用二钱,加水一钟,生姜两片,冬瓜子仁五十粒捏碎,煎至七分,空腹温服。
如果腹泻不止,加入沉香、白豆蔻一同煎煮。
钓藤饮 治疗吐利,因脾胃气虚而生风。
钓藤钩(二钱) 蝉壳 天麻 防风 蝎尾(去毒) 人参(各半两) 麻黄 僵蚕(炒) 甘草(炙) 川芎(各二钱五分) 麝香(五分)
以上药物研为末。用水煎服。若属虚寒证,加附子一钱。
[Qian Yi] When an infant suffers from Shanghan (Cold Damage) presenting with vomiting and diarrhea, body temperature fluctuating between warm and suddenly cold, excessive sleepiness with coarse breathing, yellowish-white stools, vomiting of undigested milk and food, occasional coughing, along with concurrent syndromes involving the five Zang organs, one should decoct the "Zang Jun Chen Medicines" for administration. First administer Daqing Gao (Great Cyan Pill), followed by Yihuang San (Yellow-Protecting Powder). If purgatives have been used previously, or if there are no indications for purgation, one must strictly avoid using purgatives again. This condition arises from Cold invading the Spleen and Lungs, impairing the Spleen's ability to transform and transport. (Jiegu said: Body warmth with vomiting, diarrhea, and coughing indicates Wind-Wood invading the Spleen; when the Mother organ is deficient, the Child organ is also weak. The method should involve decocting Binglang Doukou Tang (Areca Seed and Cardamom Decoction) to swallow Daqing Gao, followed by Yihuang San.)
When an infant suffers from Shangfeng (Wind Injury) presenting with vomiting and diarrhea, body heat, excessive sleepiness, ability to feed on milk, incessant thirst for water, vomiting of phlegm, and yellow watery stools, this constitutes Stomach deficiency with Heat causing thirst, vomiting, and diarrhea. Treatment should first generate fluids in the Stomach to quench thirst. After thirst is controlled, use dispersing herbs to release the exterior. For quenching thirst, Baizhu San (Atractylodes Macrocephala Powder) is taken frequently; for dispersing the exterior, Daqing Gao is the primary treatment. (Jiegu said: For vomiting, diarrhea, body heat, thirst, and scanty urine, Wuling San (Five-Aliquots Powder) is indicated; for body heat with vomiting, Baizhu San should be taken, followed by Banglang Muxiang Tang (Areca Seed and Costus Root Decoction) to swallow Daqing Gao.)
When an infant suffers from Shangfeng presenting with vomiting and diarrhea, cool body temperature, foaming at the mouth, green or white stools, chest stuffiness and restlessness without thirst, frequent belching with long sighs, and sleeping with eyes partially open (exposing the eyeballs), this is due to prolonged Wind injury leading to frailty and weakness, resulting in vomiting and diarrhea. Treatment should first tonify the Spleen, then disperse the exterior. Tonifying the Spleen uses Yihuang San; dispersing the exterior uses Daqing Gao. These two syndromes often occur in Spring and Winter. (Jiegu said: For cool body temperature with vomiting, diarrhea, and absence of thirst, it is known as Cold; decoct Fuzi Guizhi Tang (Aconite and Cinnamon Twig Decoction) to swallow Daqing Gao.)
Daqing Gao (Great Cyan Pill)
Tianma (Gastrodiae Rhizoma, powdered, 1 fen) Baifuzi (Typhonii Rhizoma, raw, powdered, 1.5 qian) Xiewei (Buthus cauda, de-toxicated, raw, 0.5 qian) Zhusha (Cinnabaris, ground, 1 yizi bi) Qingdai (Indigo Naturalis, 1 qian, ground) Shexiang (Moscus, 1 yizi bi) Wushe shao rou (Daboia sinensis tail meat, soaked in wine, baked dry, powdered, 0.5 qian) Tianzhuhuang (Calami Tuber, 1 yizi bi, ground)
All ingredients are finely ground together again, mixed with raw honey to form a paste. Each dose is half the size of a soap bean to the size of a soap bean. For infants of one month old, the dose is the size of a rice grain. It is taken mixed with Niuhuang Gao (Calculus Bovis Paste) and dissolved in warm Bohe Shui (Mentha Water). For children over five years old, it is taken with Ganlu San (Sweet Dew Powder).
When an infant contracts Wind-Cold, resulting in vomiting and diarrhea, physicians may attribute it to Spleen deficiency and treat with warming tonification. If ineffective, they may switch to cooling medicines, which fail to disperse the pathogen. This is termed "Ben Shangfeng" (Original Wind Injury). Physicians' chaotic aggressive treatments cause Spleen Qi to become accumulated and deficient; internally unable to disperse and externally unable to resolve, after more than ten days, symptoms include excessive sleepiness, exposed eyes during sleep, and mild body warmth. Wind remains in the Spleen and Stomach, causing loose stools and diarrhea. Treatment should remove Wind from the Spleen; once Wind recedes, dysentery/diarrhea stops. Xuanfeng San (Dispel Wind Powder) is indicated. Subsequently, Shijunzi Wan (Quisqualis Pill) is used to tonify the Stomach. In cases where various vomiting and dysentery persist for a long time without healing, Spleen deficiency generates Wind, evolving into Man Jing Feng (Slow Convulsion).
[Hai Zang] When excessive vomiting and diarrhea lead to Spleen and Stomach deficiency and exhaustion, approaching a state of generating Wind manifestations. Si Jun Zi Tang (Four Gentlemen Decoction) with added Baifuzi (dosage halved), decocted with Shengjiang (Fresh Ginger) for administration.
Shouwei San (Stomach-Guarding Powder) Treats disharmony of Yin and Yang, incessant vomiting and diarrhea, prevents Wind syndromes, regularly regulates the Spleen and Stomach, and promotes appetite.
Renshen (Panax Ginseng, remove rhizome) Baizhu (Atractodis Rhizoma) Baifuling (Poria, remove skin) Shanyao (Dioscoreae Rhizoma, remove black skin) Gange (Puerariae Radix) Biandou (Dolichoris Semen, stir-fried, remove shell) Nanting (Pinelliae Rhizoma, chopped, placed in earthenware vessel, boiled briefly with Dongbi Tu (East Wall Soil) and Cu (Vinegar), filtered, dried, sliced, baked) Gancao (Glycyrrhizae Radix et Rhizoma) Huoxiang (Agastaches Herba, remove stem) Fangfeng (Saposhnikoviae Radix, remove rhizome) Tianma (Gastrodiae Rhizoma) (each 0.5 liang)
All ingredients are chopped. Each dose is 2 qian, decocted with 1 zhong of water, 2 slices of Ginger, and 50 crushed Donggua Zirén (Benincasae Semen) until reduced to 0.7 parts. Take warm on an empty stomach.
If diarrhea does not stop, add Chenxiang (Aquilariae Lignum Resinatum) and Baidoukou (Amomi Fructus Rotundus) and decoct together.
Diaoteng Yin (Uncaria Decoction) Treats vomiting and diarrhea caused by Wind generated from Spleen and Stomach Qi deficiency.
Diaotenggou (Uncariae Ramulus cum Uncis) Chanqiao (Cicadae Periostracum) Tianma (Gastrodiae Rhizoma) Fangfeng (Saposhnikoviae Radix) Xiewei (Buthus cauda, de-toxicated) Renshen (Panax Ginseng) (each 0.5 liang) Mahuang (Ephedrae Herba) Jiangcan (Bombyx Batryticatus, stir-fried) Gancao (Glycyrrhizae Radix et Rhizoma, honey-fried) Chuanxiong (Ligustici Chuanxiong Rhizoma) (each 2.5 qian) Shexiang (Moscus) (0.5 fen)
All ingredients are powdered. Decoct in water and take orally. For deficiency-cold patterns, add Fuzi (Aconiti Lateralis Radix Praeparata) 1 qian.