婴儿初生,百日内,觉口冷腹痛,身起寒栗,时发战栗,曲足握拳,昼夜啼哭不
已,或口噤不开,名曰胎寒。其证,在胎时母因腹痛而致产,经云∶胎寒多腹痛。
亦有产妇喜啖甘肥生冷时果,或胎前外感风寒暑湿,治以凉药,内伤胎气,则生后
昏昏多睡,间或 乳泻白,若不早治,必成慢惊、慢脾。凡有此候,宜以冲和饮、
当归散、合和,水煨姜煎服,使之微泄,泄行,进匀气散调补,泄止气匀,神安痛
定,手足舒伸,次用参苓白术散以养胃气,白芍药汤去其寒湿。乳母宜节生冷冻饮料食,
庶易瘥也。又有手足稍冷,唇面微青,额上汗出,罔顾乳食,至夜多啼,颇似前
证,但无口冷寒战,名曰脏寒。其疾夜重日轻,腹痛肠鸣,泄泻清水,间有不泄者,
此证亦在百日内有之,皆因临产在地稍久,冷气侵逼,或以凉水参汤洗儿,或断脐
带短,而又结缚不紧,为寒气所伤如此,宜以白芍药汤及冲和饮加盐炒茴香、茱萸,
水姜煎服,并乳母同服。〔汤〕小儿胎中有寒,生下不能将护,再伤于风,其候面
色青白,四肢逆冷,手足颤动,口噤不开,乃胎寒之故,或寒乘虚入脏,作腹疼盘
肠内吊(治法详寒腹痛条。)
冲和饮 当归散(方见潮热) 白芍药汤(见疝) 匀气散(见疝) 参苓白术散 异功散
薛氏治胎寒用此。
婴儿出生后一百天内,如果感觉口部发冷、腹部疼痛,身体出现寒战发抖,时常发生颤抖,双腿蜷曲、双手握拳,昼夜不停地啼哭,或者牙关紧闭无法张开,这被称为胎寒。其病症成因是:在胎儿时期,母亲因腹痛而早产,正如医经所说:“胎寒多伴有腹痛。”也有因为产妇喜欢食用甘甜、油腻、生冷的水果,或在怀孕前外感风、寒、暑、湿邪气,治疗时使用了寒凉药物,内伤胎气,导致婴儿出生后昏昏欲睡,偶尔吐出乳块或大便呈白色稀便,如果不尽早治疗,必定会演变为慢惊风(一种以抽搐为主要表现的慢性儿科疾病)或慢脾风(一种以脾胃虚衰为主的慢性儿科疾病)。凡是出现这种症状的,适宜使用冲和饮(调和气血的方剂)、当归散(补血调经的方剂),两者合用,加水煨姜煎服,使患儿轻微腹泻;腹泻开始后,改用匀气散(调理气机的方剂)进行调理补益;待腹泻停止、气机调匀、神志安宁、疼痛缓解、手足舒展后,再使用参苓白术散(健脾益气的方剂)来养胃气,并用白芍药汤(调和肝脾、缓急止痛的方剂)去除体内的寒湿之邪。乳母应当节制生冷冰冻的饮食,这样才容易痊愈。
又有另一种情况:手足稍微发冷,嘴唇和面部微微发青,额头出汗,不顾吃奶进食,到了夜晚啼哭较多,颇似前面的证候,但没有口冷和寒战的症状,这称为脏寒。这种疾病夜间重白天轻,伴有腹痛、肠鸣、腹泻清水,间或有不腹泻的情况。此证也发生在出生百日内,都是因为临产时在地上停留时间稍久,冷气侵袭逼迫,或者用凉水参汤给婴儿洗澡,或者断脐带剪得太短,且结扎不紧,被寒气所伤而导致如此。适宜使用白芍药汤以及冲和饮加盐炒小茴香、吴茱萸,用水和生姜煎服,并让乳母同时服用。〔汤〕小儿在胎中就有寒邪,出生后不能妥善护理,再次受风邪伤害,其表现为面色青白,四肢逆冷,手足颤动,牙关紧闭无法张开,这是胎寒的缘故;或者是寒邪乘虚侵入脏腑,引起腹痛、盘肠内吊(指剧烈腹痛,状如肠子向内收缩吊起,治法详见“寒腹痛”条目)。
冲和饮、当归散(方剂见“潮热”条)、白芍药汤(见“疝”条)、匀气散(见“疝”条)、参苓白术散、异功散(薛氏治疗胎寒使用此方)。
In the first hundred days after birth, if the infant feels cold in the mouth and abdominal pain, experiences shivering and trembling of the body, frequently trembles, curls the legs and clenches the fists, cries incessantly day and night, or has a locked jaw that cannot open, this is named Fetal Cold (Tai Han). The etiology involves premature delivery due to maternal abdominal pain during pregnancy; as the classics state: "Fetal cold is often accompanied by abdominal pain." It may also result from the mother's preference for sweet, fatty, raw, or cold fruits, or from external contraction of Wind, Cold, Summerheat, or Dampness prior to conception, treated with cooling herbs that internally injure the fetal Qi. Consequently, the newborn sleeps lethargically, occasionally regurgitates milk curds or passes white loose stools. If not treated early, it will inevitably develop into Slow Convulsion (Man Jing) or Slow Spleen Wind (Man Pi). For such presentations, Chonghe Yin (Harmonizing Decoction) and Danggui San (Angelica Decoction) should be combined and decocted with water-warmed ginger to induce mild diarrhea. Once diarrhea occurs, Yunqi San (Regulating Qi Powder) should be administered to regulate and tonify. After diarrhea ceases, Qi becomes balanced, Spirit is calm, pain subsides, and limbs extend, Shenling Baizhu San (Ginseng, Poria, and Atractylodes Macrocephala Powder) should be used to nourish Stomach Qi, while Baishaoyao Tang (White Peony Decoction) should be employed to dispel Cold-Dampness. The nursing mother should avoid raw, cold, and iced foods and drinks to facilitate recovery.
Another condition presents with slightly cold hands and feet, slightly cyanotic lips and face, sweating on the forehead, refusal to nurse or eat, and increased crying at night, resembling the above syndrome but without cold mouth or chills; this is named Visceral Cold (Zang Han). This disease is heavier at night and lighter during the day, accompanied by abdominal pain, borborygmus, and watery diarrhea, sometimes without diarrhea. This condition also occurs within the first hundred days, caused by prolonged exposure to cold air during labor, washing the infant with cold water ginseng soup, short umbilical cord ligation that is not tight enough, allowing Cold Qi to invade. Bai Shaoyao Tang and Chonghe Yin added with salt-fried Huixiang (Fennel Fruit) and Zhuyu (Evodia Fruit), decocted with water and fresh ginger, are indicated, and the nursing mother should take them concurrently. [Tang] If an infant harbors Cold in the womb and, after birth, fails to receive proper care leading to secondary Wind injury, symptoms include cyanotic-white complexion, cold extremities, tremors of hands and feet, and locked jaw, which are due to Fetal Cold. Alternatively, Cold may enter the Zang organs through deficiency, causing abdominal pain and Pan Chang Nei Diao (intense abdominal pain resembling intestinal retraction; see treatment under "Cold Abdominal Pain").
Chonghe Yin, Danggui San (see "Tidal Fever"), Baishaoyao Tang (see "Hernia"), Yunqi San (see "Hernia"), Shenling Baizhu San, Yigong San (Xue Shi used this formula to treat Fetal Cold).