浮肿治法,开鬼门者,发汗也,洁净府者,利小便也。
凡小儿面目遍身浮肿者,或因胎禀虚弱,卒冒风湿,或因疟
疾汗后,不曾禁风,皆成此症。轻者用胃苓丸治之,重者可用加
减胃苓汤治之。
凡小儿浮肿,又加喘急者。此脾传肺也,当专治脾而兼治
肺,日服加减胃苓汤,夜服葶苈丸。如先喘急而后面目浮肿者,
此肺传脾也,当专治肺而兼治脾,日服葶苈丸,夜服胃苓汤加麻
黄、杏仁。如先浮肿而后腹胀者,此表邪传里也,只以加减胃苓
汤主之。
凡浮肿,不可妄用汗下,更不宜阑大戬、甘遂、牵牛之类,
以伤元气。
陈皮、苍术、厚朴(姜汁炒)、甘草、猪苓、赤茯
苓、泽泻、木通、白术、官桂、滑石,防己、五加皮、
生姜皮。因喘而致者,加麻黄、杏仁,桑白皮。腹胀
者,加大腹皮、木香、槟榔、苏梗,去甘草。气虚者,
加人参,灯心引,顺取长流水煎,温服。
浴法
于午时煎葱百沸汤,避风处浴之。盖覆,喀取微
汗,日日根据此诀行甚效。
祖传治浮肿:只用胃苓丸,用长流水,五加皮、灯心煎汤
吞,外用浴法。
凡浮肿气促,面黑,脉微细,不饮食着,不治
西 江 月
小儿病患浮肿,或因胎气赢虚,卒冒风湿外邪欺,以致泽身
肿起;又或诸病汗下,脾虚又被风吹,遂尔浮肿堪忧虑(21),症
别轻重用剂。
轻用胃苓丸子,重则加减堪行,再用浴法保安宁,此法古今
永定。不可太施汗下。太补亦不宜行,能根据方法救孩婴,方可称为
司命。
大抵浮肿治法,鬼门净府须知,木通防己五加皮,苏叶车前
滑石。渗湿四苓饮子,补脾平胃须宜,灯心长流水煎之,每日清晨
早吃。
要识浮肿死症,气促面黑须扰,脉微细小不堪谋,饮食不飧
难救。脐翻粪如羊屎,泰山倒了难扶,忽生大喘肺经虚,纵有灵
丹何救。
浮肿的治疗原则,所谓“开鬼门”,就是发汗;所谓“洁净府”,就是利小便。
凡是小儿出现面目及全身浮肿的,可能是因为先天禀赋虚弱,突然遭受风湿侵袭;也可能是因为患疟疾出汗后,没有注意避风,从而形成这种病症。病情较轻的用胃苓丸治疗,病情较重的可用加减胃苓汤治疗。
凡是小儿浮肿,又伴有气喘急促的,这是脾病传变至肺,应当专门治疗脾脏并兼治肺脏,白天服用加减胃苓汤,晚上服用葶苈丸。如果是先出现气喘急促而后出现面目浮肿的,这是肺病传变至脾,应当专门治疗肺脏并兼治脾脏,白天服用葶苈丸,晚上服用胃苓汤并加入麻黄、杏仁。如果是先出现浮肿而后出现腹胀的,这是表邪传入里部,只用加减胃苓汤主治。
凡是浮肿,不可胡乱使用发汗或攻下法,更不宜使用大戟、甘遂、牵牛子等峻猛药物,以免损伤元气。
(方药组成:)陈皮、苍术、厚朴(用姜汁炒)、甘草、猪苓、赤茯苓、泽泻、木通、白术、官桂、滑石、防己、五加皮、生姜皮。因气喘而致病的,加入麻黄、杏仁、桑白皮。出现腹胀的,加入大腹皮、木香、槟榔、苏梗,去掉甘草。气虚的,加入人参,以灯心草为引,用顺取的长流水煎煮,温服。
浴法:在午时煎煮葱白百沸汤,在避风处洗浴。覆盖身体,使其微微出汗,每天按照这个方法执行,非常有效。
祖传治疗浮肿的方法:只用胃苓丸,用长流水加上五加皮、灯心草煎汤吞服,外用浴法。
凡是浮肿伴有气促、面色黑、脉象微细、不能进食的,属于不治之症。
西江月词曰:
小儿患病出现浮肿,可能是因为胎气虚弱,突然遭受风湿外邪侵袭,导致全身肿胀;又或者经过各种疾病的治疗后发汗或攻下,脾虚又受到风吹,于是出现令人担忧的浮肿症状,需辨别轻重来选择药剂。
病情轻的用胃苓丸,病情重的则使用加减方,再配合浴法使身体安宁,此法是古今永远确定的准则。不可过度使用发汗或攻下法,过度进补也不适宜,若能遵循方法救治婴儿,才可称为良医。
大抵治疗浮肿的原则,必须知晓“开鬼门”和“洁净府”的道理,常用木通、防己、五加皮、苏叶、车前子、滑石等药。通过渗湿的四苓饮来调理,补脾平胃也须适宜,用灯心草和长流水煎煮,每日清晨尽早服用。
要识别浮肿的死症,若见气促面黑且烦躁不安,脉象微细难以诊治,饮食不进难以挽救。若见脐部突出如翻出,粪便像羊屎一样干结,如同泰山倒塌难以扶持;或者突然发生严重气喘,说明肺经已虚,即使有灵丹妙药也无法救治。
The treatment principle for edema: "Opening the ghost gate" refers to inducing sweating; "Purifying the clean mansion" refers to promoting urination.
In cases where infants present with edema of the face, eyes, and entire body, it may be due to weak congenital endowment followed by sudden exposure to wind-dampness, or it may result from failure to avoid wind after sweating during malaria, leading to this condition. For mild cases, Weiling Wan (Gastrodia and Atractylodes Macrocephala Pill) is used; for severe cases, Jiajian Weiling Tang (Modified Gastrodia and Atractylodes Macrocephala Decoction) is indicated.
When infantile edema is accompanied by panting and rapid breathing, this indicates the transmission of disease from the Spleen to the Lung. Treatment should focus primarily on the Spleen while simultaneously addressing the Lung. Administer Jiajian Weiling Tang (Modified Gastrodia and Atractylodes Macrocephala Decoction) during the day and Tingli Wan (Descurainia Seed Pill) at night. If panting and rapid breathing precede the facial edema, this indicates transmission from the Lung to the Spleen. Treatment should focus primarily on the Lung while simultaneously addressing the Spleen. Administer Tingli Wan (Descurainia Seed Pill) during the day and Weiling Tang (Gastrodia and Atractylodes Macrocephala Decoction) added with Mahuang (Ephedrae Herba) and Xingren (Armeniacae Semen) at night. If edema precedes abdominal distension, this indicates the transmission of exterior pathogenic factors into the interior; treat solely with Jiajian Weiling Tang (Modified Gastrodia and Atractylodes Macrocephala Decoction).
In cases of edema, do not recklessly use diaphoretic or purgative methods. Furthermore, harsh drugs such as Daji (Kansui Radix), Gansui (Spurge Root), and Qianniu (Pharbitidis Semen) should be avoided to prevent damage to Yuanqi (Original Qi).
(Ingredients:) Chenpi (Citri Reticulatae Pericarpium), Cangzhu (Atractylodis Rhizoma), Houpo (Magnoliae Officinalis Cortex) stir-fried with ginger juice, Gancao (Glycyrrhizae Radix et Rhizoma), Zhuling (Polyporus), Chifuling (Poria cum Rubro), Zexie (Alismatis Rhizoma), Mutong (Akebiae Caulis), Baizhu (Atractylodis Macrocephalae Rhizoma), Guangui (Cinnamomi Ramulus), Huashi (Talcum), Fangji (Stephaniae Tetrandrae Radix), Wujia Pi (Acanthopanacis Cortex), Shengjiang Pi (Zingiberis Recens Cortex). For cases caused by panting, add Mahuang (Ephedrae Herba), Xingren (Armeniacae Semen), and Sangbaipi (Mori Cortex). For abdominal distension, add Dafupi (Arecae Pericarpium), Muxiang (Aucklandiae Radix), Binglang (Areca Semen), and Sugeng (Perillae Caulis), and remove Gancao (Glycyrrhizae Radix et Rhizoma). For Qi deficiency, add Renshen (Ginseng Radix), using Dengxincao (Junci Medullia) as a guide, decocted in flowing water, and taken warm.
Bath Method: At noon, boil scallions in water until boiling vigorously. Bathe in a wind-sheltered place. Cover the body to induce slight sweating. Performing this daily according to this prescription is very effective.
Ancestral method for treating edema: Use only Weiling Wan (Gastrodia and Atractylodes Macrocephala Pill), swallowed with a decoction of Wujia Pi (Acanthopanacis Cortex) and Dengxincao (Junci Medullia) made with flowing water. Combine with external bath therapy.
For edema accompanied by shortness of breath, blackish complexion, faint and fine pulse, and inability to eat, the condition is incurable.
Song Ci: Xi Jiang Yue (West River Moon):
Infants suffering from edema may have weak fetal Qi, suddenly attacked by wind-damp exterior pathogens, causing swelling throughout the body; or after various illnesses treated with sweating or purging, Spleen deficiency combined with wind exposure leads to worrying edema. Differentiate severity to select the appropriate formula.
Use Weiling Wan (Gastrodia and Atractylodes Macrocephala Pill) for mild cases, and modified formulas for severe ones. Combine with bath therapy for peace and stability; this method is eternally established since ancient times. Do not overuse sweating or purging. Over-supplementation is also inadvisable. Only by following these methods can one save the infant and be called a healer.
Generally, the treatment of edema requires understanding "opening the ghost gate" and "purifying the clean mansion." Common herbs include Mutong (Akebiae Caulis), Fangji (Stephaniae Tetrandrae Radix), Wujia Pi (Acanthopanacis Cortex), Suye (Perillae Folium), Cheqianzi (Plantaginis Semen), and Huashi (Talcum). Use Shen Shi Si Ling Yin (Damp-Draining Four Poria Drink) to promote dampness excretion, and tonify the Spleen and calm the Stomach appropriately. Decoct with Dengxincao (Junci Medullia) and flowing water, and take early every morning.
To recognize fatal signs of edema: shortness of breath, blackish complexion, and restlessness indicate a difficult prognosis with faint, fine pulses and inability to eat. Umbilical eversion and stool resembling sheep droppings suggest collapse like Mount Tai falling, which is hard to support. Sudden severe panting indicates Lung Jing (Lung Meridian) deficiency; even with miraculous pills, rescue is impossible.