七宝散 治小儿温壮伏热,伤寒烦躁,面赤气喘,夜热晓凉。此药凉心脏,消风热。
川大黄(蒸) 赤芍药 甘草(炙) 川当归(各二钱半) 麻黄 白术 荆芥穗(各二钱)
上为末。一岁一钱,水半盏,葱白一寸,薄荷一叶,煎至三分,不拘时温服。
双解饮子(即通圣散合六一散,方见伤寒太阳病发热条。)
白虎汤 治伤寒或吐或下后七八日邪毒不解,热结在里,表里俱热,时时恶风,大
渴舌上干燥而烦,欲饮数升者,宜服之。又治夏月中暑,汗出恶风寒,身热而渴。
知母(三两) 甘草(一两,炙) 石膏(八两,另研) 糯米(三合)
上每服二三钱,水煎,至米熟为度。
小柴胡汤 治伤寒温热,身热恶风,头痛项强,四肢烦疼,往来寒热,胁痛耳聋,
呕哕痰实,中暑、疟疾,并服之。(方见伤寒少阳病。)
愚按∶前方,若肝胆经风热,肝火瘰 ,寒热往来,日晡发热潮热不欲饮食。
或怒火口苦,耳聋咳嗽。或胁痛 满,小便不利。或泄泻吐酸苦水。或肢体搐动,
唇目抽掣。及乳母有前证,致儿为患者,并宜服之。
余热者,谓寒邪未尽传经之遗热也。仁斋曰∶伤寒汗下后而热又来,乃表里俱
虚,气不归元,阳浮于外,不可再用凉药,盖热去则寒起,古人戒之,法当和胃气,
使阳气收敛归内,其热自止,宜以参苓白术散主之。〔曾〕有小儿热证用表里药后,
其热俱退,既退,复热者何也。疗病至此,难以概举,或再解表攻里,或施凉剂,
热见愈甚,以阴阳辨之,何者为是,推其原乃表里俱虚而阳浮于外,阴伏于内,所
以又发热,宜用温平之药和其里,则体热自除,投钱氏白术散去木香,加扁豆,水
煎,及黄 六一汤、安神散,自然平复。若日久汗多烦渴,食减,脉微缓,喜饮热,
可服真武汤,虽附子性温,取其收敛阳气,内有芍药性寒,一寒一温,停分得宜,
用之无不验矣。〔薛〕汗后血虚而热益甚者,六神散加粳米。汗后气虚而恶寒发热
者,补中益气汤。汗后阴虚,阳无所附而热者,用四物汤加参 。汗后阳虚,阴无
所附而热者,用四君汤加芎归。
实脾散 治小儿余热不除。
川芎 茯苓 甘草 白术
上锉散。用水煎,食远服。
参苓白术散 主脾胃虚弱,饮食不进,多困少气,中满痞,噫呕吐逆,此药不寒不
热,性味和平,常服,调脾悦色,顺正去邪。
人参(去芦) 白茯苓(去皮) 粉草 白术 白扁豆(如前制) 山药(去黑皮)
缩砂仁 薏苡仁 桔梗(锉、炒。各一两) 莲子肉(去心)
上,锉、焙为末。每服半钱至一钱,用枣汤、空心调服,或温米汤亦可。
安神散 治吐泻诸病后心虚烦闷,触物易惊,气郁生涎,涎与气搏,睡不得宁,预
防变生他证。
人参 白茯苓 半夏(制) 甘草(炙) 陈皮(去白) 枳实(制。各五钱)
上锉。每服二钱,水一盏,姜二片,枣一枚,竹茹小团,煎七分,无时温服。
有微热渴,入麦门冬去心同煎。
《简易》凝神散 治小儿经汗下热去复作,收敛胃气,清凉肌表,神效。
人参 白术 白茯苓 山药(炒。各一两) 扁豆 粳米 知母 生地黄 甘草(各半两)
淡竹叶 地骨皮 麦门冬(各一分)
细末。每二钱,水小盏,姜二片,枣一枚煎,无时。
钱氏白术散(见渴) 黄 六一汤(见自汗) 真武汤(见自汗) 六神散(见夜啼)
七宝散:治疗小儿温热壮热、伏留之热,伤寒引起的烦躁不安,面色发红、气喘,夜间发热而清晨凉爽。此药能清心火,消散风热。
川大黄(蒸制) 赤芍药 甘草(炙制) 川当归(各二钱半) 麻黄 白术 荆芥穗(各二钱)
以上药物研为细末。一岁的患儿服用一钱,加水半盏,葱白一寸,薄荷一叶,煎煮至剩余三分之一的药液,不拘泥于特定时间温服。
双解饮子:即通圣散与六一散的合方,方剂详情见“伤寒太阳病发热”条下。
白虎汤:治疗伤寒或经过催吐、泻下治疗后七八天,邪毒仍未解除,热邪结聚在体内,表现为表里俱热,时常怕风,极度口渴,舌面干燥且心烦,想要饮用数升水的情况,适宜服用此方。又用于治疗夏季中暑,出现汗出、怕风怕冷,身体发热且口渴的症状。
知母(三两) 甘草(一两,炙制) 石膏(八两,另研成粉) 糯米(三合)
每次服用二三钱,加水煎煮,直到米煮熟为止。
小柴胡汤:治疗伤寒温热病,身体发热、怕风,头痛、项部僵硬,四肢烦痛,寒热往来(忽冷忽热),胁肋疼痛、耳聋,呕吐哕逆、痰涎壅盛,以及中暑、疟疾等症,均可服用。(方剂详情见“伤寒少阳病”条下。)
我按语:前方(指小柴胡汤),若用于肝胆经的风热证,肝火导致的瘰疬,寒热往来,下午申时发热如潮,不想饮食;或者因愤怒导致口苦、耳聋、咳嗽;或者胁肋疼痛、腹部胀满,小便不利;或者泄泻、吐出酸苦水;或者肢体抽搐抽动,嘴唇和眼睛痉挛抽搐。以及乳母有上述症状,导致婴儿患病的,都适宜服用此方。
余热:是指寒邪未尽,传变经络后遗留的热邪。仁斋说:伤寒经过发汗、攻下治疗后,热势再次出现,这是因为表里俱虚,气不能归元,阳气浮越于外,不可再用凉药,因为热去则寒起,古人对此有戒律。治疗方法应当调和胃气,使阳气收敛回归体内,其热自止,适宜以参苓白术散为主治方。〔曾〕氏提出:有小儿热证在使用了表里双解药后,热势全部消退,但消退后又重新发热,这是什么原因?治疗疾病到了这种地步,难以一概而论,如果再次解表攻里,或使用凉剂,热势反而加重。用阴阳理论辨析,如何判断正确?推究其根源,乃是表里俱虚而阳气浮越于外,阴气潜伏于内,所以再次发热。适宜使用温平的药物调和里气,则体表热自除。投予钱乙的白术散去木香,加扁豆,水煎服,以及黄芪六一汤、安神散,自然能够平复。如果日久汗多、烦渴,食欲减退,脉象微缓,喜欢喝热水,可以服用真武汤,虽然附子性温,是取其收敛阳气的作用,内有芍药性寒,一寒一温,比例得当,使用无不灵验。〔薛〕氏指出:发汗后血虚而热势更甚的,用六神散加粳米。发汗后气虚而恶寒发热的,用补中益气汤。发汗后阴虚,阳气无所依附而发热的,用四物汤加人参。发汗后阳虚,阴气无所依附而发热的,用四君汤加川芎、当归。
实脾散:治疗小儿余热不除。
川芎 茯苓 甘草 白术
以上切碎成散剂。用水煎煮,饭后服用。
参苓白术散:主治脾胃虚弱,饮食不进,疲倦乏力、气短,胸腹痞满,嗳气呕吐逆气。此药不寒不热,性味平和,常服可调理脾胃、悦泽面色,顺应正气、祛除邪气。
人参(去芦头) 白茯苓(去皮) 粉草 白术 白扁豆(如前法炮制) 山药(去黑皮) 缩砂仁 薏苡仁 桔梗(切碎、炒制。各一两) 莲子肉(去心)
以上切碎、焙干研为细末。每次服用半钱至一钱,用枣汤或空腹调服,或用温米汤送服亦可。
安神散:治疗吐泻诸病之后,心虚烦闷,接触事物容易受惊,气郁生涎,涎与气搏结,睡眠不得安宁,预防变生其他证候。
人参 白茯苓 半夏(炮制) 甘草(炙制) 陈皮(去白) 枳实(炮制。各五钱)
以上切碎。每次服用二钱,加水一盏,生姜两片,大枣一枚,竹茹一小团,煎至七分,不拘时间温服。
若有轻微发热口渴,加入去心的麦门冬同煎。
《简易》凝神散:治疗小儿经过发汗、攻下后热势退去又复发,能收敛胃气,清凉肌表,效果神奇。
人参 白术 白茯苓 山药(炒制。各一两) 扁豆 粳米 知母 生地黄 甘草(各半两) 淡竹叶 地骨皮 麦门冬(各一分)
研为细末。每次二钱,加水小盏,生姜两片,大枣一枚煎煮,不拘时间服用。
Qibao San (Seven-Treasure Powder): Treats pediatric warm-heat with robust fever, latent heat, restlessness caused by Shanghan (Cold Damage), flushed face, asthma, and night fever with morning coolness. This medicine cools the Heart fire and dissipates wind-heat.
Rhizoma et Radix Rhei (Dahuang, 大黄) (steamed) Radix Paeoniae Rubra (Chishaoyao, 赤芍药) Radix Glycyrrhizae Preparata (Gancao, 甘草) (roasted) Radix Angelicae Sinensis Chuanxiong (Chuan Danggui, 川当归) (2.5 qian each) Herba Ephedrae (Mahuang, 麻黄) Rhizoma Atractylodis Macrocephalae (Baizhu, 白术) Flos Schizonepetae (Jingjie Sui, 荆芥穗) (2 qian each)
Grind the above into powder. For a one-year-old infant, administer 1 qian with half a cup of water, 1 cun of scallion white, and 1 leaf of Mentha haplocalyx (Bohe, 薄荷). Decoct until one-third remains. Take warm at any time.
Shuangjie Yinzi (Double-Resolution Drink): Equivalent to Tongsheng San combined with Liuyi San. See the section on "Fever in Taiyang Disease of Shanghan" for the formula details.
Baihu Tang (White Tiger Decoction): Treats cases where, after seven or eight days of Shanghan or following emesis/purgation, pathogenic toxins remain unresolved, heat is knotted internally, presenting with heat in both exterior and interior, occasional aversion to wind, severe thirst, dry tongue with irritability, and desire to drink several liters of water; this decoction is suitable. It also treats summerheat-stroke in summer, characterized by sweating, aversion to wind and cold, body heat, and thirst.
Radix Anemarrhenae (Zhimu, 知母) (3 liang) Radix Glycyrrhizae Preparata (Gancao, 甘草) (1 liang, roasted) Gypsum Fibrosum (Shigao, 石膏) (8 liang, separately ground) Oryza Sativa (Nuomi, 糯米) (3 he)
For each dose of 2-3 qian, decoct in water until the rice is cooked.
Xiaochaihu Tang (Minor Bupleurum Decoction): Treats Shanghan warm-heat diseases, body heat with aversion to wind, headache and neck stiffness, painful limbs, alternating chills and fever, hypochondriac pain, deafness, vomiting and hiccups with phlegm-rheum, summerheat-stroke, and malaria. (See the section on "Shaoyang Disease of Shanghan" for the formula details.)
My commentary: The aforementioned formula (referring to Xiaochaihu Tang) is indicated for wind-heat in the Liver and Gallbladder meridians, scrofula due to Liver fire, alternating chills and fever, tidal fever in the afternoon (Shen hour) with anorexia; anger-induced bitter taste, deafness, and cough; hypochondriac pain and abdominal fullness with dysuria; diarrhea and vomiting of sour/bitter fluids; limb twitching, lip and eye spasms. It is also suitable if the nursing mother has these symptoms causing illness in the infant.
Residual Heat refers to lingering heat remaining after pathogenic cold has not fully transmitted through the meridians. Renzhai stated: After Shanghan is treated with sweating or purging, if heat returns, it is due to deficiency in both exterior and interior, Qi failing to return to its origin, and Yang floating outward. Cool medicines should not be used again, as removing heat may invite cold; ancients warned against this. The method should harmonize Stomach Qi, causing Yang to converge inward, so the heat stops naturally. Shenling Baizhu San is appropriate. [Zeng] asked: In pediatric heat conditions, after using exterior-interior resolving medicines, heat subsides completely but returns later. Why? Treating such cases cannot be generalized. If one again resolves the exterior and attacks the interior, or uses cool agents, heat may worsen. Analyzing via Yin-Yang theory: investigating the root reveals deficiency in both exterior and interior, with Yang floating outward and Yin hiding inward, causing recurrent fever. Warm-neutral medicines should be used to harmonize the interior, eliminating body heat. Administer Qian Yi's Baizhu San without Xiangru, adding Phaseolus vulgaris (Bian Dou, 扁豆), decocted in water, along with Huangqi Liuyi Tang and Anshen San, and recovery will occur naturally. If prolonged sweating, irritability, thirst, reduced appetite, faint/slow pulse, and preference for hot drinks persist, Zhenwu Tang can be taken. Although Fuzi is warm, it is used here to converge Yang; within it, Shaoyao is cold. With proper balance of cold and warm, efficacy is assured. [Xue] noted: For heat worsening due to blood deficiency after sweating, use Liushen San plus Oryza Sativa (Jingmi, 粳米). For aversion to wind and fever due to Qi deficiency after sweating, use Buzhong Yiqi Tang. For heat due to Yin deficiency with Yang lacking attachment after sweating, use Siwu Tang plus Renshen. For heat due to Yang deficiency with Yin lacking attachment after sweating, use Sijunzi Tang plus Chuanxiong and Danggui.
Shipi San (Solidify the Spleen Powder): Treats persistent residual heat in children.
Radix Ligustici Chuanxiong (Chuanxiong, 川芎) Poria (Fuling, 茯苓) Radix Glycyrrhizae (Gancao, 甘草) Rhizoma Atractylodis Macrocephalae (Baizhu, 白术)
Cut into pieces. Decoct in water and take after meals.
Shenling Baizhu San (Ginseng, Poria, and Atractylodes Macrocephala Powder): Governs Spleen-Stomach weakness, anorexia, fatigue, shortness of breath, epigastric fullness and stuffiness, belching, vomiting, and regurgitation. This medicine is neither cold nor hot, with a balanced nature and flavor. Regular consumption regulates the Spleen, enhances complexion, supports righteous Qi, and expels pathogenic factors.
Radix Ginseng (Renshen, 人参) (de-gorged) Poria (Baifuling, 白茯苓) (de-barked) Radix Glycyrrhizae (Fengcao, 粉草) Rhizoma Atractylodis Macrocephalae (Baizhu, 白术) Semen Phaseoli Mungonis (Baidiandou, 白扁豆) (prepared as before) Rhizoma Dioscoreae (Shanyao, 山药) (de-blackened skin) Fructus Amomi Villoso (Suosharen, 缩砂仁) Semen Coicis (Yiyiren, 薏苡仁) Radix Platycodonis (Jiegeng, 桔梗) (cut, fried. 1 liang each) Semen Nelumbinis (Lianziren, 莲子肉) (de-heart)
Cut, roast, and grind into powder. Take 0.5 to 1 qian per dose, mixed with Jujube Decoction on an empty stomach, or with warm rice soup.
Anshen San (Calming the Spirit Powder): Treats mental restlessness and irritability due to Heart deficiency after various vomiting/diarrhea diseases, susceptibility to fright upon touching objects, Qi stagnation generating phlegm-rheum, struggle between phlegm and Qi, restless sleep, and prevents transformation into other syndromes.
Radix Ginseng (Renshen, 人参) Poria (Baifuling, 白茯苓) Rhizoma Pinelliae Praeparatum (Banxia, 半夏) (prepared) Radix Glycyrrhizae Preparata (Gancao, 甘草) (roasted) Pericarpium Citri Reticulatae (Chenpi, 陈皮) (de-white) Fructus Aurantii Immaturus (Zhishi, 枳实) (prepared. 5 qian each)
Cut. Take 2 qian per dose with 1 cup of water, 2 slices of Zingiberis Recens (Jiang, 姜), 1 Jujubae Fructus (Zao, 枣), and a small ball of Bambusae Caulis in Taeniam (Zhuru, 竹茹). Decoct to 70%, take warm at any time.
If mild heat and thirst are present, add Ophiopogonis Radix (Maimendong, 麦门冬) (de-heart) and decoct together.
Jianyi Shenningsan (Simplifying Miracle Calming Spirit Powder): Treats recurrent heat in children after sweating/purging, converges Stomach Qi, cools the muscle surface, with miraculous effects.
Radix Ginseng (Renshen, 人参) Rhizoma Atractylodis Macrocephalae (Baizhu, 白术) Poria (Baifuling, 白茯苓) Rhizoma Dioscoreae (Shanyao, 山药) (fried. 1 liang each) Semen Phaseoli Mungonis (Biandou, 扁豆) Oryza Sativa (Jingmi, 粳米) Radix Anemarrhenae (Zhimu, 知母) Radix Rehmanniae Preparata (Shengdihuang, 生地黄) Radix Glycyrrhizae (Gancao, 甘草) (0.5 liang each) Folium Phyllostachidis Dispar (Danzhuye, 淡竹叶) Cortex Lycii (Digupi, 地骨皮) Radix Ophiopogonis (Maimendong, 麦门冬) (1 fen)
Grind into fine powder. Take 2 qian with a small cup of water, 2 slices of ginger, 1 jujube, decoct, take at any time.
Qian Shi Baizhu San (see "Thirst") Huangqi Liuyi Tang (see "Spontaneous Sweating") Zhenwu Tang (see "Spontaneous Sweating") Liushen San (see "Night Crying")