杨氏云∶由乳食不调,壅热伤肺所致也,肺主乎气,鼻乃肺所通,其气不和,
则风湿乘虚,客于皮毛,入于血脉,故鼻下两傍,赤痒疮湿,名为鼻疳,其疮不痛,
汁所流处,随即生疮,亦名疳 。外证咳嗽喘逆,壮热恶寒,皮肤粟生,鼻疮流涕,
咽喉不利,颐烂吐红,气胀毛焦,泄痢频并是也。钱氏,主补脾生肺,以益黄散主
之。杨氏,以清肺饮、化 丸、钱氏阿胶散主之。薛氏,用清肺饮以治肺,益气
汤以生金。曾氏,用补肺散。
地黄清肺饮 治肺热疳 ,咳嗽气逆,多啼,壮热恶寒。
桑白皮(炒,半两) 紫苏 北前胡 防风 赤茯苓 黄芩 当归 天门冬(去心) 连翘 桔梗 生地黄 甘草
(炙。各二钱半)
上锉散。每服二钱,井水煎,食后服。次用化 丸。
化 丸
芜荑 芦荟 青黛 川芎 白芷梢 胡黄连 川黄连 虾蟆灰(各等分)
上为末,猪胆汁浸糕糊丸,麻子大。每服二十丸,食后临卧,杏仁煎汤下。其
鼻,常用熊胆泡汤,小笔蘸洗,俟前药各进数服,却用青黛、当归、赤小豆、瓜
蒂、地榆、黄连、芦荟等分,雄黄少许,细末,入鼻敛疮。
补肺散 治久患咳嗽,肺虚气促,有痰恶心。
阿胶(一两半,锉、炒) 白茯苓 马兜铃(去老梗) 糯米(各半两) 杏仁(二十一粒,汤泡,去皮尖) 甘
草(四钱,炙)
上锉。每服二钱,水一盏,煎七分,无时温服。
〔张涣〕麝香丹 治小儿肺疳,皮毛枯燥,咳嗽上气。
胡黄连(一两) 半夏(半两,汤洗七遍) 紫苏子(微炒) 五味子(各一分) 干蟾(一枚,涂酥、炙微黄。
以
上捣罗为细末,次用) 麝香(细研) 芦荟(细研) 朱砂(细研。各一分)
上件一处拌匀,以枣肉和,如黍米大。每服五粒至七粒,米饮下,量儿大小加减。
灵砂丹 因嗽成疳,最宜服之。
人参(半两,去芦) 甜葶苈(研) 五灵脂 胡黄连(各一分。以上捣罗为细末,次用) 辰砂(半两,细研)
麝香(细研) 芦荟(细研) 杏仁(麸炒,去皮尖。各一分)
上件一处拌匀,以粳米饮和,如黍米大。每服十粒,煎人参汤下,量儿大小加减。
五灵脂丹 久嗽恐成疳,常服尤佳。
五灵脂(半两) 蟾头(一枚,涂酥炙微黄) 蝉壳(微炒) 款冬花(各半两。以上捣罗为细末,次用) 青黛
(细
研) 雄黄(细研。各一分)
上件药一处拌匀,糯米饮和,如黍米大。每服十粒,煎人参汤下,不拘时候,量儿大小加减。
《万全方》治小儿肺疳不欲乳食,时复腹痛。胡黄连丸
胡黄连 当归(焙微炒) 诃梨勒皮 木香(各半两) 青橘皮(汤浸,去白穣,焙) 紫苏子 杏仁
(汤浸,去皮尖,麸炒微黄。各一分) 麝香(一钱,研入)
上件捣,罗为末,用粟米饭和丸,绿豆大。每服三丸,以粥饮下,量儿大小加减。
〔张国材〕肺疳方
真珠(七十粒) 辰砂(半钱) 人参 甘草(各二钱) 麝香(半字) 轻粉(五钱匕) 白附子(一个)
上件,先将人参、甘草锉碎炒熟,白附子炮碾末,次研入真珠、辰砂、麝香、
轻粉匀毕。每服半钱或一字,用金银薄荷煎汤调服,日进一服,食后。只三服,其肺疳立愈。
〔庄氏〕第三候,鼻下赤烂,爱揉眼,兼血痢,是肺疳,乃因吃着乘热物或病奶所损
心肺,加之咳嗽,更以服凉冷药过多,便上热下冷,渐渐昏沉,日夜烦哭。
龙脑 朱砂(各一分) 钓藤 玄参(各一两) 胡黄连(炮,半两) 麝香(一钱)
上为末,炼蜜丸,如黄米大。米饮下三丸至五丸。
治小儿头项细,心腹胀满,皮肤干皱,毛发焦黄,鼻下赤烂,口舌生疮,泻痢不止,
日渐羸瘦。
大蟾(一个,去四足,劈开腹、去肚肠,入胡黄连一两,和在内,线缝合,以湿纸三重裹,用泥固济四面,令干,
微
火,出阴气,更用炭三斤,烧令通赤,即焦,候冷,净去泥土,细研如粉) 麝香 熊胆 芦荟(各半两)
上,一处细研如泥,面糊丸,如麻子大。米饮下三丸,乳汁亦得,三岁以上加丸。
理小儿五疳八痢,腹胀羸瘦,头发焦干,口鼻生疮。
黄连 白芜荑(与黄连同炒焦) 夜明砂(用水淘五次,焙。各一两)
上为末, 猪胆汁和丸,如绿豆大。三丸至五丸,不计时候,麦门冬熟水下。
如久患疳气服药无效,或腹胀气促不能饮食,米饮下,取出疳虫,即瘥。(庄氏第八候用此方。)
杨氏说:这是由于乳食不调,导致积热损伤肺脏所致。肺主气,鼻是肺的窍道,肺气不和,则风湿之邪乘虚而入,客居皮毛,深入血脉,所以鼻子下方两侧出现红痒、疮疡湿烂,称为鼻疳。这种疮不痛,流出的汁液所到之处随即又生新疮,也叫做疳(指因疳疾引起的眼部或鼻部病变)。外在症状表现为咳嗽气喘、高热恶寒、皮肤起粟粒状颗粒、鼻疮流涕、咽喉不利、下巴溃烂吐血、腹部胀满毛发枯焦、腹泻痢疾频繁发作等。钱乙主张补脾以生肺金,用益黄散主治。杨氏主张用清肺饮、化虫丸、钱乙的阿胶散主治。薛己用清肺饮治疗肺热,用益气汤来补土生金。曾世铭用补肺散。
地黄清肺饮:治疗肺热疳疾,咳嗽气逆,多啼哭,高热恶寒。
桑白皮(炒,半两) 紫苏 前胡 防风 赤茯苓 黄芩 当归 天门冬(去心) 连翘 桔梗 生地黄 甘草(炙。各二钱半)
以上药材切碎成散剂。每次服用二钱,用井水煎煮,饭后服用。随后使用化虫丸。
化虫丸
芜荑 芦荟 青黛 川芎 白芷梢 胡黄连 川黄连 虾蟆灰(各等分)
以上研为细末,用猪胆汁浸透糕粉制成糊状,搓成如麻子大小的丸药。每次服用二十丸,饭后临睡前,用杏仁煎汤送服。对于鼻疳,常用熊胆泡汤,用小笔蘸取清洗,待上述药物各进服几剂后,再用青黛、当归、赤小豆、瓜蒂、地榆、黄连、芦荟等分,加少许雄黄,研成细末,纳入鼻腔以收敛疮口。
补肺散:治疗久患咳嗽,肺虚气短,有痰恶心。
阿胶(一两半,切碎、炒) 白茯苓 马兜铃(去老梗) 糯米(各半两) 杏仁(二十一粒,热水浸泡,去皮尖) 甘草(四钱,炙)
以上切碎。每次服用二钱,用水一盏,煎至七分,随时温服。
〔张涣〕麝香丹:治疗小儿肺疳,皮毛干枯粗糙,咳嗽气逆。
胡黄连(一两) 半夏(半两,热水洗七遍) 紫苏子(微炒) 五味子(各一分。以上捣碎过筛为细末,备用) 干蟾(一枚,涂酥油、炙至微黄。以上捣碎过筛为细末,备用) 麝香(细研) 芦荟(细研) 朱砂(细研。各一分)
以上拌匀,用枣肉调和,做成如黍米大小的丸药。每次服用五至七粒,米汤送下,根据患儿大小加减剂量。
灵砂丹:因咳嗽而成疳疾,最适宜服用此方。
人参(半两,去芦头) 甜葶苈(研碎) 五灵脂 胡黄连(各一分。以上捣碎过筛为细末,备用) 辰砂(半两,细研) 麝香(细研) 芦荟(细研) 杏仁(麸炒,去皮尖。各一分)
以上拌匀,用粳米汤调和,做成如黍米大小的丸药。每次服用十粒,煎人参汤送下,根据患儿大小加减剂量。
五灵脂丹:久咳恐怕发展成疳疾,常服效果尤佳。
五灵脂(半两) 蟾头(一枚,涂酥油炙至微黄) 蝉蜕(微炒) 款冬花(各半两。以上捣碎过筛为细末,备用) 青黛(细研) 雄黄(细研。各一分)
以上拌匀,用糯米汤调和,做成如黍米大小的丸药。每次服用十粒,煎人参汤送下,不拘时候,根据患儿大小加减剂量。
《万全方》治疗小儿肺疳不想吃奶和食物,时常腹痛。胡黄连丸
胡黄连 当归(焙至微炒) 诃黎勒皮 木香(各半两) 青橘皮(热水浸泡,去白瓤,焙干) 紫苏子 杏仁(热水浸泡,去皮尖,麸炒微黄。各一分) 麝香(一钱,研入)
以上捣碎过筛为末,用粟米饭调和成丸,如绿豆大小。每次服用三丸,用粥饮送下,根据患儿大小加减剂量。
〔张国材〕肺疳方
真珠(七十粒) 辰砂(半钱) 人参 甘草(各二钱) 麝香(半字) 轻粉(五钱匕) 白附子(一个)
以上药材,先将人参、甘草切碎炒熟,白附子炮制后碾成末,再研入真珠、辰砂、麝香、轻粉均匀混合。每次服用半钱或一字量,用金银花、薄荷煎汤调服,每日一服,饭后服用。仅服三剂,肺疳即可痊愈。
〔庄氏〕第三候:鼻子下方红烂,喜欢揉眼睛,兼有血痢,这是肺疳。这是因为进食了过热食物或病态乳汁损伤心肺,加上咳嗽,又过多服用凉冷药物,导致上热下冷,逐渐昏沉,日夜烦躁哭闹。
龙脑 朱砂(各一分) 钩藤 玄参(各一两) 胡黄连(炮制,半两) 麝香(一钱)
以上研为细末,炼蜜为丸,如黄米大小。米汤送下三至五丸。
治疗小儿头颈细小,心腹胀满,皮肤干皱,毛发焦黄,鼻子下方红烂,口舌生疮,泻痢不止,日渐消瘦。
大蟾蜍(一个,去掉四足,劈开腹部,去除内脏,放入胡黄连一两,缝合在内,用湿纸三层包裹,用泥封固四面,晾干,微火烘干阴气,再用炭三斤烧至通红,即焦,冷却后,洗净泥土,细研如粉) 麝香 熊胆 芦荟(各半两)
以上一处细研如泥,面糊为丸,如麻子大小。米汤送下三丸,乳汁也可以,三岁以上增加丸数。
调理小儿五疳八痢,腹胀消瘦,头发焦干,口鼻生疮。
黄连 白芜荑(与黄连同炒焦) 夜明砂(用水淘洗五次,焙干。各一两)
以上研为细末,猪胆汁和丸,如绿豆大小。三至五丸,不计时候,麦门冬熟水送下。
如果久患疳气服药无效,或腹胀气促不能饮食,用米汤送下,可取出疳虫,病即痊愈。(庄氏第八候用此方。)
Yang Shi stated: This is caused by irregular breastfeeding and diet, leading to accumulated heat damaging the Lung. The Lung governs Qi, and the nose is the orifice of the Lung. When Lung Qi is disharmonious, Wind-Dampness pathogens take advantage of the deficiency, lodging in the skin and hair, and entering the blood vessels. Consequently, redness, itching, sores, and dampness appear on both sides below the nose, named Bi Gan (Nose Famine). These sores are painless; where the exudate flows, new sores immediately arise, also referred to as Gan (referring to lesions caused by famine disease). External manifestations include coughing and wheezing, high fever with aversion to cold, skin resembling millet grains, nasal sores with discharge, throat discomfort, ulceration of the chin with vomiting of blood, abdominal distension with dry hair, and frequent diarrhea and dysentery. Qian Yi advocated tonifying the Spleen to generate Lung Metal, treating it primarily with Yihuang San (Benefit Yellow Powder). Yang Shi advocated using Qingfei Yin (Clear the Lung Decoction), Huachong Wan (Eliminate Parasites Pill), and Qian Yi's Ejiao San (Donkey-Hide Gelatin Powder). Xue Ji used Qingfei Yin to treat the Lung, and Yiqi Tang (Qi-Boosting Decoction) to generate Metal (via Earth). Zeng Shiming used Bufei San (Tonify Lung Powder).
Dihuang Qingfei Yin (Rehmannia Clear-Lung Decoction): Treats Lung Heat Gan disease, characterized by coughing, rebellious Qi, frequent crying, high fever, and aversion to cold.
Sangbaipi (Cortex Mori Radicis, stir-fried, half tael) Zisu (Perilla Leaf) Qianhu (Radial Peucedani) Fangfeng (Radial Saposhnikoviae) Chifuling (Poria with Red Coir) Huangqin (Radix Scutellariae) Danggui (Radix Angelicae Sinensis) Tiandongmu (Flos Asparagi, heart removed) Lianqiao (Fructus Forsythiae) Jiegeng (Radix Platycodonis) Shengdihuang (Radix Rehmanniae Preparata) Gancao (Radix Glycyrrhizae, honey-fried. Each two qian and a half)
Crush into coarse powder. Take two qian per dose, decoct well water, and administer after meals. Subsequently use Huachong Wan.
Huachong Wan (Eliminate Parasites Pill)
Wuyi (Fructus Tsooshoos) Lvxun (Aloe) Qingdai (Indigo Naturalis) Chuanxiong (Rhizoma Chuanxiong) Baizhi Shao (Radix Angelicae Dahuricae tip) Huhuanglian (Rhizoma Coptidis Chinensis) Chuanhuilian (Rhizoma Coptidis) Xiama Hui (Ash of Bufo bufo gargarizans. Equal parts)
Grind into fine powder. Soak rice cake paste in pig bile to form pills the size of hemp seeds. Take twenty pills per dose after meals and before sleep, washed down with decoction of apricot kernels. For nasal Gan, commonly soak bear gallbladder in water, dip a small brush to wash. After taking the aforementioned medicines for several doses, then use Qingdai, Danggui, Xiaohongdou (Adzuki Bean), Gudi (Melon Peduncle), Diyü (Radix Sanguisorbae), Huanglian (Rhizoma Coptidis), Lvxun (Aloe) in equal parts, with a little Xionghuang (Realgar), grind into fine powder, and insufflate into the nose to astringe the sores.
Bufei San (Tonify Lung Powder): Treats chronic cough due to Lung deficiency and shortness of breath, with phlegm and nausea.
Ejiao (Colla Corii Asini, one tael and a half, crushed and fried) Baifuling (Poria) Madouling (Fructus Aristolochiae) Nuomi (Oryza Sativa Glutinosa, each half tael) Xingren (Prunus Armeniaca Seed, twenty-one grains, soaked in hot water, skin and tips removed) Gancao (Radix Glycyrrhizae, four qian, honey-fried)
Crush into pieces. Take two qian per dose, with one cup of water, decoct to seven-tenths volume, warm and take at any time.
[Zhang Huan] Shexiang Dan (Musk Pellet): Treats pediatric Lung Gan disease, with dry and rough skin and hair, coughing, and rebellious Qi.
Huhuanglian (Rhizoma Coptidis Chinensis, one tael) Banxia (Rhizoma Pinelliae, half tael, washed seven times in hot water) Zisuzi (Perillae Fructus, slightly stir-fried) Wuweizi (Schisandrae Fructus. Each one fen. Grind and sieve above into fine powder, set aside) Ganchan (Dry Bufo, one unit, coated with butter, roasted until slightly yellow. Grind and sieve above into fine powder, set aside) Shexiang (Moschus, finely ground) Lvxun (Aloe, finely ground) Zhusha (Cinnabar, finely ground. Each one fen)
Mix all ingredients evenly. Combine with jujube flesh to form pills the size of millet seeds. Take five to seven pills per dose, washed down with rice drink, adjusting dosage according to the child's age and size.
Lingsha Dan (Spiritual Mercury Pellet): Most suitable for Gan disease resulting from cough.
Renshen (Ginseng Radix et Rhizoma, half tael, remove rhizome) Tiantingli (Semen Lepidii et Descurainiae, crushed) Wulingzhi (Trogopterori Faeces) Huhuanglian (Rhizoma Coptidis Chinensis. Each one fen. Grind and sieve above into fine powder, set aside) Chensha (Cinnabar, half tael, finely ground) Shexiang (Moschus, finely ground) Lvxun (Aloe, finely ground) Xingren (Prunus Armeniaca Seed, bran-roasted, skin and tips removed. Each one fen)
Mix all ingredients evenly. Combine with japonica rice drink to form pills the size of millet seeds. Take ten pills per dose, washed down with decoction of Renshen, adjusting dosage according to the child's age and size.
Wulingzhi Dan (Trogopterori Faeces Pellet): Long-term cough may develop into Gan disease; regular use is especially beneficial.
Wulingzhi (Trogopterori Faeces, half tael) Chantou (Bufo Head, one unit, coated with butter, roasted until slightly yellow) Chanke (Cicada Slough, slightly stir-fried) Kuandonghua (Flos Farfarae. Each half tael. Grind and sieve above into fine powder, set aside) Qingdai (Indigo Naturalis, finely ground) Xionghuang (Realgar, finely ground. Each one fen)
Mix all ingredients evenly. Combine with glutinous rice drink to form pills the size of millet seeds. Take ten pills per dose, washed down with decoction of Renshen, at any time, adjusting dosage according to the child's age and size.
"Wan Quan Fang" treats pediatric Lung Gan disease with loss of appetite for milk and food, and intermittent abdominal pain. Huhuanglian Wan (Coptis Chinensis Pellet)
Huhuanglian (Rhizoma Coptidis Chinensis) Danggui (Radix Angelicae Sinensis, baked until slightly fried) Helile Pi (Pericarpium Terminaliae Chebulae) Muxiang (Radix Aucklandiae. Each half tael) Qingju Pi (Exocarpium Citri Reticulatae, soaked in hot water, white pith removed, baked) Zisuzi (Perillae Fructus) Xingren (Prunus Armeniaca Seed, soaked in hot water, skin and tips removed, bran-roasted until slightly yellow. Each one fen) Shexiang (Moschus, one qian, ground and added)
Grind and sieve into powder. Combine with millet rice to form pills the size of mung beans. Take three pills per dose, washed down with porridge drink, adjusting dosage according to the child's age and size.
[Zhang Guocai] Lung Gan Formula
Zhenzhu (Pearl, seventy grains) Chensha (Cinnabar, half qian) Renshen (Ginseng Radix et Rhizoma) Gancao (Radix Glycyrrhizae. Each two qian) Shexiang (Moschus, half zi) Qingfen (Calomelas, five qian bi) Baifuzi (Rhizoma Typhonii, one unit)
First, crush and roast Renshen and Gancao until cooked. Roast and grind Baifuzi into powder. Then grind in Zhenzhu, Chensha, Shexiang, and Qingfen evenly. Take half qian or one zi per dose, mix with decoction of Yinchen (Silver Flower) and Bohe (Mentha), administer after meals. Only three doses are needed, and Lung Gan will be cured immediately.
[Zhuang Shi] Third Stage: Redness and ulceration below the nose, preference for rubbing eyes, accompanied by bloody dysentery. This is Lung Gan, caused by consuming overheated food or diseased breast milk damaging the Heart and Lung, compounded by coughing, and excessive intake of cooling/cold medicines, leading to upper heat and lower cold, gradually becoming lethargic, with daily烦躁 (restlessness) and crying.
Longnao (Borneolum Syntheticum) Zhusha (Cinnabar. Each one fen) Gouteng (Uncariae Ramulus cum Uncis) Xuanshen (Radix Scrophulariae. Each one tael) Huhuanglian (Rhizoma Coptidis Chinensis, processed, half tael) Shexiang (Moschus, one qian)
Grind into fine powder. Combine with refined honey to form pills the size of yellow millet. Wash down with rice drink, three to five pills per dose.
Treats pediatric small head and neck, abdominal distension and fullness, dry and wrinkled skin, scorched and yellow hair, redness and ulceration below the nose, sores in mouth and tongue, incessant diarrhea and dysentery, and gradual emaciation.
Da Chan (Large Toad, one unit, remove four feet, split abdomen, remove entrails, insert one tael of Huhuanglian inside, sew with thread, wrap in three layers of wet paper, seal four sides with mud, dry, dry out yin qi over mild fire, then burn with three jin of charcoal until red-hot and charred, cool, clean off mud, grind finely like powder) Shexiang (Moschus) Xiongdan (Ursi Bile) Lvxun (Aloe. Each half tael)
Grind all together finely like mud. Form pills with wheat flour paste, the size of hemp seeds. Wash down with rice drink, three pills per dose; breast milk is also acceptable. Increase pill count for children over three years old.
Regulates pediatric Five Gans and Eight Dysenteries, abdominal distension, emaciation, scorched and dry hair, sores in mouth and nose.
Huanglian (Rhizoma Coptidis) Baiwuyi (Fructus Tsooshoos, stir-fried with Huanglian until scorched) Yemingsha (Guano Vespertilionis, washed five times with water, dried. Each one tael)
Grind into fine powder. Form pills with pig bile, the size of mung beans. Three to five pills per dose, at any time, washed down with prepared water of Ophiopogonis.
If long-standing Gan Qi (Famine Qi) does not respond to medication, or if there is abdominal distension, shortness of breath, and inability to eat, take with rice drink to expel Gan worms, and the illness will heal. (This formula is used in Zhuang Shi's Eighth Stage.)