巢氏云∶尸疰者,是五尸之中一尸疰也,人无问小大,腹内皆有尸虫,尸虫为
性忌恶,多接引外邪共为患害,小儿血气衰弱者,精神亦羸,故尸疰因而为病,其
状沉嘿,不的知病之处,或寒热淋漓,涉引岁月,遂至于死,死又疰易旁人,故名
之为尸疰也。张涣论小儿亦有疰病,与大人所病无异,久后疰易旁人,传染骨肉,
如尸疰蛊毒之类是也。
《外台·张仲景》治大人小儿飞尸
走马汤方
巴豆(去心皮,熬) 杏仁(去皮尖。各二枚)
上二味,取绵缠,捶令极碎,投热汤二合,捻取白汁服之。须臾瘥,未瘥,更
一服,老小量之。通疗鬼击,有尸疰者,常蓄此药,用验。忌野猪肉芦笋。《备急》同。
《圣惠》木香散 治小儿尸疰,心腹满胀疼痛,不可忍。
木香 鬼箭羽 桔梗(去芦头) 当归(锉,微炒) 紫苏茎叶(各半两) 槟榔(三分)
上件药捣,罗为粗散。每服一钱,以水一小盏,入生姜少许,煎至五分,去滓,
不计时候温服,更量儿大小,加减服之。
犀角散 治小儿尸疰及中恶诸病,皆主之。
犀角(屑) 川升麻 木香 川大黄(锉碎,微炒) 桑根白皮(锉) 槟榔(各半两) 麝香(一钱,细研)
桃仁(二七枚,汤浸,去皮尖双仁,麸炒微黄)
上件药捣,细罗为散。每服以温水调下半钱,日四五服,更量儿大小加减服之。
〔张涣〕雌黄丹 治尸疰病。
雌黄 雄黄(各细研) 川大黄(慢火炮黑) 鬼臼(去毛。各一两) 桃仁(三十个,汤浸去皮尖,研) 白头
翁(半两。以上并为细末,次用)
麝香(一分,另研) 巴豆(十粒,去皮心膜,纸裹,压去油)
上件都研匀,以羊脂五两熔,和诸药成膏。服如黍米大三粒至五粒,荆芥汤
冷下,量儿大小加减。
立效汤
川大黄(炮,锉) 干桃柳叶(洗,焙干。各一两) 栀子仁 赤芍药(各半两) 以上捣罗为细末,次用
朱砂(细研水飞,一两) 麝香(别研) 雄黄(别研。各一分)
上件都拌匀。每服一钱蜜汤调下,量儿大小加减。
巢元方说:尸疰(一种具有传染性、迁延日久的慢性消耗性疾病),是五尸中的一种。无论年龄大小,人的腹内都有尸虫。尸虫的性质厌恶外界,常招引外邪共同造成危害。小儿血气衰弱,精神也虚弱,所以容易因尸疰而发病。其症状表现为神情沉默,不能明确指出病痛所在,有时出现寒热往来且淋漓不尽,拖延经年累月,最终导致死亡。死后病气又会传染给旁人,所以称之为尸疰。张涣论述小儿也会患疰病,与成人所患没有不同,时间久了会传染给旁人,波及骨肉,像尸疰、蛊毒之类的疾病就是如此。
《外台秘要》引用张仲景的方子,治疗大人和小孩的飞尸(指病势急骤、游走不定的病症)走马汤方:
巴豆(去除心皮,炒制)、杏仁(去皮尖,各两枚)。
以上两味药,用绵布包裹,捶打至极碎,投入热水二合(约40毫升),揉搓提取白色汁液服用。不久病愈,若未痊愈,再服一次,老人小孩酌情减量。此方通治鬼击(中恶邪之气),有尸疰者,常备此药,使用有效。忌食野猪肉和芦笋。《备急千金要方》记载相同。
《太平圣惠方》木香散,治疗小儿尸疰,心腹胀满疼痛,难以忍受。
木香、鬼箭羽、桔梗(去芦头)、当归(锉碎,微炒)、紫苏茎叶(各半两)、槟榔(三分)。
以上药物捣碎,过筛成粗散。每次服用一钱(约3-5克),用水一小盏(约100毫升),加入少许生姜,煎至五分(约50毫升),去渣,不限时候温服,并根据患儿年龄大小调整剂量。
犀角散,治疗小儿尸疰及中恶(突受秽浊邪气侵袭)等各种病症,均适用。
犀角(锉屑)、川升麻、木香、川大黄(锉碎,微炒)、桑根白皮(锉)、槟榔(各半两)、麝香(一钱,细研)、桃仁(十四枚,热水浸泡,去皮尖双仁,麸炒至微黄)。
以上药物捣碎,细筛成散剂。每次用温水调服半钱(约1.5-2.5克),每日四到五次,并根据患儿年龄大小调整剂量。
〔张涣〕雌黄丹,治疗尸疰病。
雌黄、雄黄(各细研)、川大黄(慢火煨至黑)、鬼臼(去毛,各一两)、桃仁(三十个,热水浸泡去皮尖,研碎)、白头翁(半两。以上均为细末,其次用):
麝香(一分,另研)、巴豆(十粒,去皮心膜,用纸包裹,压榨去油)。
以上全部研磨均匀,用羊脂五两熔化,调和诸药制成膏剂。每次服用如黍米大三粒至五粒,用荆芥汤冷服,根据患儿年龄大小调整剂量。
立效汤
川大黄(炮制,锉碎)、干桃柳叶(洗净,焙干,各一两)、栀子仁、赤芍药(各半两)。以上捣碎过筛成细末,其次用:
朱砂(细研水飞,一两)、麝香(别研)、雄黄(别研,各一分)。
以上全部拌匀。每次服用一钱,用蜜汤调下,根据患儿年龄大小调整剂量。
Chao Yuanfang stated: Shizhu (a contagious, chronic wasting disease with a lingering course) is one of the Five Shi (Five Corpse Diseases). Regardless of age, everyone has "Shi worms" in their abdomen. The nature of these worms is repulsive to external factors and often attracts external pathogenic factors to cause harm together. Children with weak blood and qi also have deficient spirit, thus they are prone to illness due to Shizhu. Its manifestations include a taciturn demeanor, inability to pinpoint the exact location of pain, alternating chills and fever that are persistent and dripping, dragging on for years until death ensues. After death, the pathogenic influence can transmit to others, hence it is called Shizhu. Zhang Huan discussed that children also suffer from Zhu diseases, which are no different from those in adults; after a long time, the disease transmits to others, affecting bones and flesh, such as in cases of Shizhu and Gu Du (Gu Poison).
*Waitai Miyao* cites Zhang Zhongjing's formula for treating Feishi (a condition characterized by rapid, wandering pathology) in adults and children: Zouma Tang (Horse-Galloping Decoction).
Ingredients: Radix Crotonis Fructus (Badou, remove heart and skin, stir-fry); Semen Armeniacae Amarum (Xingren, remove skin and sharp tips, 2 each).
Process: Wrap the two ingredients in cotton cloth, pound them until extremely fine, add 2 he (approx. 40 ml) of hot water, squeeze out the white juice, and administer orally. Recovery occurs shortly; if not recovered, administer another dose. Adjust dosage according to age and constitution for both elderly and young. This formula treats Guiji (attack by evil spirits/ghosts) and is effective for Shizhu; keep this medicine on hand for verification. Avoid eating wild boar meat and reeds (*Ligularia fischeri*). *Beiji Qianjin Yaofang* records the same.
*Tai Ping Sheng Hui Fang*: Muxiang San (Costus Powder), treating pediatric Shizhu with unbearable distension, fullness, and pain in the heart and abdomen.
Ingredients: Radix Aucklandiae (Muxiang); Ramulus Corni Swinhoei (Guijianyu); Radix Platycodonis (Jiegeng, remove rhizome); Radix Angelicae Sinensis (Danggui, sliced, lightly stir-fried); Caulis et Folium Perillae (Zisu Jingye, half liang each); Fructus Arecae (Binglang, 3 qian).
Process: Pound the above herbs, sieve into a coarse powder. Take 1 qian (approx. 3-5 g) per dose, decoct with 1 small zhan (approx. 100 ml) of water and a little fresh ginger until reduced to 5 fen (approx. 50 ml). Strain and take warm at any time. Adjust dosage based on the child's size.
Xijiao San (Rhinoceros Horn Powder), treating pediatric Shizhu and various conditions caused by Zhong'e (sudden attack by turbid evil qi), applicable to all.
Ingredients: Cornu Rhinocerotis (Xijiao, sliced/shredded); Radix Cimicifugae (Chuan Shengma); Radix Aucklandiae (Muxiang); Radix Rhei Preparata (Chuan Dahuang, sliced, lightly stir-fried); Cortex Morus Radicis (Sanggen Baipi, sliced); Fructus Arecae (Binglang, half liang each); Moschus (Shexiang, 1 qian, finely ground); Semen Persicae (Taoren, 14 seeds, soaked in hot water, remove skin and tips, bran-stir-fried until slightly yellow).
Process: Pound the above herbs, sieve finely into a powder. Take half a qian (approx. 1.5-2.5 g) mixed with warm water per dose, 4-5 times daily. Adjust dosage based on the child's size.
[Zhang Huan]: Cihuang Dan (Realgar Orpiment Pill), treating Shizhu disease.
Ingredients: Realgar (Xionghuang) and Orpiment (Cihuang, each finely ground); Radix Rhei Preparata (Chuan Dahuang, slow-fire roasted until black); Rhizoma Typhonii (Guijiao, remove hairs, 1 liang each); Semen Persicae (Taoren, 30 seeds, soaked in hot water, remove skin and tips, ground); Radix Pulsatillae (Baitouweng, half liang). Process the above into fine powders. Then use:
Moschus (Shexiang, 1 fen, ground separately); Radix Crotonis Fructus (Badou, 10 grains, remove skin, heart, and membrane, wrap in paper, press to remove oil).
Process: Grind all ingredients uniformly, melt 5 liang of sheep fat, and mix with the herbal powders to form a paste. Administer 3 to 5 pills the size of millet seeds, taken cold with Jinjie Decoction (Schizonepeta Tea). Adjust dosage based on the child's size.
Lixiao Tang (Instantly Effective Decoction)
Ingredients: Radix Rhei Preparata (Chuan Dahuang, processed, sliced); Dried Leaves of Peach and Willow (Gan Taoliuye, washed, dried, 1 liang each); Semen Gossampini (Zhizi Ren); Radix Paeoniae Rubra (Chishaoyao, half liang each). Process the above into fine powders by pounding and sieving. Then use:
Cinnabar (Zhusha, finely ground and floated in water, 1 liang); Moschus (Shexiang, ground separately); Realgar (Xionghuang, ground separately, 1 fen each).
Process: Mix all ingredients evenly. Take 1 qian per dose, mixed with honey water. Adjust dosage based on the child's size.