川归 甘草 吴茱萸 陈皮 地黄
治痘不透 紫草 红花子 芍药 川归 胡妥子 煎服。
剪刀草汁调原蚕砂敷之
又猪心血,调片脑成膏,以紫草茸汤化,无脑以辰砂代,敷之;治斑疮倒靥。
又论 自吐泻者为吉,谓邪出也,治宜消毒解火;大便不利,当微利之。
身温者顺,身凉者逆,切忌热药。
又当分气血。虚而补之。云恶血留于命门,待气虚血虚脾虚相火生焉,其证
呵欠嚏喷,足冷寒热。气虚四君子主之,血虚四物汤主之。
吐泻少食为里虚 陷白倒靥灰白为表虚。
不吐泻能食为实 宜解毒芩连是也,实而更补,必结痈疽。
解毒方 丝瓜仁(单方亦可) 升麻 芍药(酒炒) 甘草 唐球 黑豆 犀角 辰砂
脉小,大便赤青飧泄,手足温者生,寒者难已。
小儿一十六岁前,纯阳为热多也。肝只有余,肾尚不足,肠胃尚脆,饮
食难化,食则为痰为积。其病有四∶曰惊、曰疳、曰吐泻。其原有二,曰饱暖。
张皆归之湿热,常以牵牛、大黄、木通、以治小儿诸病。
惊 热痰主急惊,当泻,降火下痰丸(养血药作汤下。)
脾虚主慢惊,用补。朱砂安神丸(参术汤下)。生人血研辰砂、蝉蜕,治急慢惊风。
疳 因土湿(或积或虫。)
黄连(炒二钱) 胡黄连(去果子积五钱) 阿魏(去肉积醋煮) 神曲(各一钱五) 丸如米大。
一方加芦荟、胡黄连、神曲、麦 、使君子、肉果(半两,)木香、槟榔(二钱,)糊
丸治虫积、一切疳。
啼 因肝热。
黄连(姜汁炒) 甘草 竹叶 煎服。
吐泻 因脾虚,食积痢。
炒神曲 苍术 活石 芍药 黄芩 白术 甘草 陈皮 茯苓
上下保和丸。
又 胡黄连 黄连 芜荑 神曲(炒) 山楂 青皮 陈皮 芦荟 丸服。
血痢 三黄丸
治疗痘疹透发不畅:紫草、红花子、芍药、川当归、胡妥子,煎汤服用。
又法:用猪心血调拌片脑(冰片)制成膏状,以紫草茸煎汤化开;若无片脑,可用辰砂代替,外敷;用于治疗斑疮倒靥(痘疹内陷)。
又论述:出现自发性呕吐腹泻的为吉兆,说明邪气外出,治疗宜消毒解毒、清泻火邪;若大便不通利,应当轻微通下。
身体温暖的为顺证,身体发凉的为逆证,切忌使用热性药物。
又应当分辨气血虚实。虚证则予以补益。所谓恶血留滞于命门,待气虚、血虚、脾虚时,相火便会妄动,其症状表现为呵欠、喷嚏、足部寒冷、寒热往来。气虚者以四君子汤为主方,血虚者以四物汤为主方。
呕吐腹泻、食欲不振属于里虚;痘疹塌陷、颜色灰白、倒靥属于表虚。
不呕吐腹泻、能进食属于实证,适宜使用解毒的黄芩、黄连等药物;实证若再进补,必然导致痈疽结聚。
解毒方:丝瓜仁(单方亦可)、升麻、芍药(酒炒)、甘草、唐球、黑豆、犀角、辰砂。
凡是丹毒从四肢向腹部蔓延者死。
脉象细小,大便呈赤青色且完谷不化的泄泻,手足温暖者可生,手足寒冷者难治。
小儿在十六岁之前,体质属纯阳,故热证较多。肝气只有余而肾气尚不足,肠胃尚娇嫩,饮食难以消化,食物停滞则化为痰或积滞。其病症主要有四种:惊风、疳积、呕吐、腹泻。其病因主要有二:过饱、过暖。张子和将所有病症都归结为湿热,常用牵牛子、大黄、木通来治疗小儿各种疾病。
惊风:热痰所致的主急惊风,应当泻实降火,使用降火下痰丸(用养血药煎汤送服)。
脾虚所致的主慢惊风,应当补益,使用朱砂安神丸(用人参、白术汤送服)。用人血研细拌辰砂、蝉蜕,可治疗急慢惊风。
黄连(炒二钱)、胡黄连(用于去除果子积五钱)、阿魏(用于去除肉积,醋煮)、神曲(各一钱五分),制成如米粒大小的丸剂。
另一配方加芦荟、胡黄连、神曲、麦芽、使君子、肉豆蔻(半两)、木香、槟榔(二钱),糊丸服用,治疗虫积及一切疳积。
炒神曲、苍术、伏龙肝(活石)、芍药、黄芩、白术、甘草、陈皮、茯苓。
Chuan Dang Gui (Radix Angelicae Sinensis), Gan Cao (Radix Glycyrrhizae), Wu Zhu Yu (Fructus Evodiae), Chen Pi (Pericarpium Citri Reticulatae), Di Huang (Radix Rehmanniae).
For treating acne/pox that fails to erupt fully: Zi Cao (Radix Arnebiae), Hong Hua Zi (Semen Carthami), Shao Yao (Radix Paeoniae Rubra or Radix Paeoniae Alba), Chuan Dang Gui (Radix Angelicae Sinensis), Hu Tuo Zi, decocted and taken orally.
Apply a mixture of Jian Dao Cao (Herba Centipedae) juice and Yuan Can Sha (Faeces Bombyx Batryticatus) externally.
Another method: Mix Zhu Xin Xue (Cor Suis) with Pian Nao (Borneolum Syntheticum) to form a paste; dissolve it in a decoction of Zi Cao Rong (Flos Arnebiae); if Borneol is unavailable, use Chen Sha (Cinnabaris) as a substitute, and apply externally; used for treating inverted pox lesions.
Further discussion: Spontaneous vomiting and diarrhea are auspicious signs, indicating the expulsion of pathogenic factors; treatment should focus on detoxification and clearing fire. If bowel movements are difficult, mild purgation is indicated.
A warm body indicates a favorable course (Shun), while a cold body indicates an unfavorable course (Ni); hot-natured drugs must be strictly avoided.
One must also differentiate between Qi and Blood deficiencies and excesses. Deficiency patterns require tonification. It is said that evil blood stagnates in the Ming Men (Gate of Life); when Qi deficiency, Blood deficiency, and Spleen deficiency occur, Ministerial Fire (Xiang Huo) arises. Symptoms include yawning, sneezing, cold feet, and alternating chills and fever. For Qi deficiency, Si Jun Zi Tang (Four Gentlemen Decoction) is the primary formula; for Blood deficiency, Si Wu Tang (Four Substance Decoction) is the primary formula.
Vomiting, diarrhea, and poor appetite indicate Interior Deficiency. Sunken, inverted, or grayish-white pox lesions indicate Exterior Deficiency.
Absence of vomiting/diarrhea and ability to eat indicate Excess patterns; detoxifying herbs such as Huang Qin (Radix Scutellariae) and Huang Lian (Rhizoma Coptidis) are appropriate. Tonifying an Excess pattern will inevitably lead to carbuncles and sores.
Detoxification Formula: Si Gua Ren (Semen Luffae), Sheng Ma (Rhizoma Cimicifugae), Shao Yao (Radix Paeoniae, stir-fried with wine), Gan Cao (Radix Glycyrrhizae), Tang Qiu, Hei Dou (Semen Sojae Preparatum), Xi Jiao (Cornu Rhinocerotis), Chen Sha (Cinnabaris).
Black sunken pox accompanied by heat behind the ears and at the sacrum indicates death;
Pox/rash accompanied by asthma/wheezing indicates death;
Any Dan Du (erysipelas/toxic heat) spreading from the limbs into the abdomen indicates death.
If the pulse is small, stools are red-green and undigested (Sun Xie), and hands/feet are warm, survival is possible; if hands/feet are cold, recovery is difficult.
Children under sixteen years of age possess a "Pure Yang" constitution, thus prone to Heat patterns. The Liver has surplus Qi, but the Kidney is still deficient; the intestines and stomach are fragile, making digestion difficult. Food stagnation transforms into Phlegm or Accumulation. There are four main diseases: Jing Feng (Convulsions), Gan Ji (Malnutrition/Worms), Tu Xie (Vomiting/Diarrhea). The root causes are two: overfeeding and excessive warmth. Zhang Zi He attributed all these conditions to Damp-Heat, commonly using Qian Niu Zi (Semen Pharbitidis), Da Huang (Radix et Rhizoma Rhei), and Mu Tong (Caulis Akebiae) to treat pediatric diseases.
Jing Feng (Convulsions): Acute convulsions caused by Heat-Phlegm require draining and lowering fire; Jiang Huo Xia Tan Wan (Fire-Lowering and Phlegm-Expelling Pill) is used (taken with a decoction of blood-nourishing herbs).
Chronic convulsions caused by Spleen deficiency require tonification; Zhu Sha An Shen Wan (Cinnabar Calming the Spirit Pill) is used (taken with a decoction of Ren Shen and Bai Zhu). Human blood mixed with powdered Cinnabar and Chan Tui (Periostracum Cicadae) treats acute and chronic convulsions.
Gan Ji (Malnutrition): Caused by Earth Dampness (due to accumulation or worms).
Huang Lian (Rhizoma Coptidis, stir-fried, 2 qian), Hu Huang Lian (Rhizoma Coptidis Chinensis, for fruit accumulation, 5 qian), A Wei (Collyrium Ferreum, for meat accumulation, vinegar-boiled), Shen Qu (Massa Medicata Fermentata, 1.5 qian each). Form pills the size of rice grains.
Another prescription adds Lu Hui (Resina Aloes), Hu Huang Lian, Shen Qu, Mai Ya (Fructus Hordei Germinatus), Shi Jun Zi (Semen Quarinae), Rou Dou Kou (Semen Myristicae, 0.5 liang), Mu Xiang (Radix Aucklandiae), and Bing Lang (Arecae Semen, 2 qian). Made into honey/husk pills to treat worm accumulation and all types of Gan Ji.
Crying/Tearing: Caused by Liver Heat.
Huang Lian (stir-fried with ginger juice), Gan Cao (Radix Glycyrrhizae), Zhu Ye (Folium Bambusae), decocted and taken orally.
Tu Xie (Vomiting/Diarrhea): Caused by Spleen deficiency and food-stagnation dysentery.
Stir-fried Shen Qu, Cang Zhu (Rhizoma Atractylodis Macrocephalae), Huo Shi (Dragon's Bone/Fossilized Wood), Shao Yao, Huang Qin, Bai Zhu, Gan Cao, Chen Pi, Fu Ling.
Shang Xia Bao He Wan (Upper and Lower Harmonizing Pills).
Another prescription: Hu Huang Lian, Huang Lian, Wu Yi (Fructus Tsoosapae), Shen Qu (stir-fried), Shan Zha (Fructus Crataegi), Qing Pi (Pericarpium Citri Reticulatae Viride), Chen Pi, Lu Hui. Taken as pills.
Blood Dysentery: San Huang Wan (Three Yellows Pill).