悲哭者肺之声,泪者肝之液也。若六脉弦紧者,先以温汤浸其身取汗,次以凉膈散之类清其
内热,此张子和治法如此。若因乳母怒火,遗热于肝,肝火炎炽,反侮肺金,金木相击,故
悲哭有声者,宜用六君、柴胡、山栀,以补脾清肝;用六味丸,以壮水生木。有因惊风,过
服祛风燥血之药而致者;有因吐泻,内亡津液而致者;及禀父肾阴不足,不能生肝者,治各
审之。若小儿忽然大叫作声者,不治。此禀肾阴不足,虚火炎上故也,用六味丸,多有生者
。仍参览夜啼、客忤、惊啼、重舌、口疮、天钓、内钓等症。
治验
一小儿每忽哭白睛多,每悲面色赤。余谓∶禀赋肾虚,火妄动而然也。用地黄丸。半载后,
虽哭而面色不赤,诸症皆愈。
一周岁儿,痰嗽哭不已,用抱龙丸,少止,良久亦然。余视其右腮洁白,左腮青赤,此肺肝
二经,相击而作。先用泻白散祛肺邪;次用柴胡栀子散平肝木;后用地黄丸滋肾水,而痊。
一小儿 啼叫,额间青黑,此惊风肝木乘脾,腹中作痛也。先用六君子汤加木香、柴胡、
钩藤钩,啼叫渐缓;更加当归,又二剂而安。
一小儿发热夜啼,乳食不进,昏迷抽搐,痰盛口噤,脉纹如水字,此脾肺气虚,风木所乘,
痰食积于胸腹也。先用大安丸,后用六君子加钩藤钩,而痊。
凉膈散(方见疮伤)
防风通圣散(方见风症)
六君子汤(方见内钓)
六味地黄丸(方见肾脏)
抱龙丸(方见伤寒)
泻白散(方见肺脏)
柴胡栀子散(方见发热)
大安丸(即保和丸加白术,方见内钓)
悲哭是肺的声音表现,流泪是肝的体液外泄。如果六脉呈现弦紧之象,先用温水浸泡身体使其出汗,再用凉膈散之类的方剂清除体内的热邪,这是张子和的治疗方法。如果是由于乳母怒火未平,余热传入肝脏,导致肝火炽盛,反向克制肺金(五行中木克金,此处指肝木反侮肺金),金木相争,从而出现悲哭有声的症状,适宜使用六君子汤、柴胡、山栀,以补益脾气、清泻肝火;配合使用六味地黄丸,以滋补肾水来涵养肝木。也有因惊风,过度服用祛风燥血的药物而导致的;有因吐泻,体内津液耗伤而导致的;以及先天禀赋父亲肾阴不足,不能滋养肝脏的,治疗时需仔细审察病因。如果小儿突然大声呼叫且声音异常,属于不治之症。这是因为禀受肾阴不足,虚火上炎所致,使用六味地黄丸,大多可以治愈。此外还应参考夜啼、客忤、惊啼、重舌、口疮、天钓、内钓等病症。
医案验录:
有一个小孩经常突然哭泣,白眼球充血较多,每次悲伤时面色发红。我认为是先天禀赋肾虚,虚火妄动所致。使用地黄丸治疗。半年后,虽然仍有哭泣现象,但面色不再发红,所有症状都痊愈了。
一个周岁的婴儿,因痰嗽不停哭泣,使用抱龙丸后稍有好转,但过了一会儿又恢复原状。我观察他右腮颜色洁白,左腮青赤,这是肺经和肝经相互冲突所致。先用泻白散祛除肺经邪气;再用柴胡栀子散平抑肝木;最后用地黄丸滋补肾水,从而痊愈。
有一个小孩啼叫不止,额头部位呈现青黑色,这是惊风导致肝木乘袭脾土,腹部作痛。先用六君子汤加入木香、柴胡、钩藤钩,啼叫逐渐缓和;再加入当归,又服两剂后安定下来。
有一个小孩发热并夜间啼哭,吃奶进食困难,神志昏迷抽搐,痰多且牙关紧闭,指纹形态如水字,这是脾肺气虚,被风木之邪所乘,痰食积滞于胸腹所致。先用大安丸,后用六君子汤加钩藤钩,从而痊愈。
凉膈散(方剂见“疮伤”章节)
防风通圣散(方剂见“风症”章节)
六君子汤(方剂见“内钓”章节)
六味地黄丸(方剂见“肾脏”章节)
抱龙丸(方剂见“伤寒”章节)
泻白散(方剂见“肺脏”章节)
柴胡栀子散(方剂见“发热”章节)
大安丸(即保和丸加白术,方剂见“内钓”章节)
Wailing and crying are the vocal manifestations of the Lung, while tears are the fluid secretions of the Liver. If the six pulses (radial arteries) present a wiry and tight quality, one should first soak the body in warm water to induce sweating, and subsequently use formulas such as Liangge San (Cool the Diaphragm Powder) to clear internal heat; this is the treatment method employed by Zhang Zihe. If the condition arises because the nursing mother harbors unvented anger, allowing residual heat to transfer to the Liver, causing Liver Fire to blaze and counter-attack Metal (Lung), resulting in a conflict between Wood and Metal, thereby producing wailing sounds, it is appropriate to use Liu Jun Zi Tang (Six Gentlemen Decoction), Chai Hu (Bupleurum Root), and Shan Zhi (Gardenia Fruit) to tonify Spleen Qi and clear Liver Fire; combined with Liu Wei Di Huang Wan (Six-Ingredient Rehmannia Pill) to strengthen Kidney Water to nourish Liver Wood. There are also cases caused by convulsions due to fright, where excessive use of wind-dispelling and blood-drying herbs leads to the condition; cases caused by vomiting and diarrhea leading to the depletion of internal body fluids; and cases where the child inherits insufficient Kidney Yin from the father, failing to generate Liver Wood. The treatment for each must be carefully examined. If a child suddenly cries out loudly with an abnormal voice, it is considered incurable. This is due to insufficient inherited Kidney Yin causing deficient fire to flare upward; using Liu Wei Di Huang Wan often results in recovery. One should also refer to conditions such as Night Crying, Guest Stupefaction, Frightened Crying, Double Tongue, Mouth Sores, Heavenly Hook (Convulsions with head retraction), and Internal Hook (Abdominal colic).
Clinical Cases:
A child frequently cried suddenly with significant congestion in the whites of the eyes, and his face turned red when sad. I diagnosed this as congenital Kidney deficiency with reckless movement of fire. I prescribed Dihuang Wan (Rehmannia Pill). After half a year, although he still cried, his complexion was no longer red, and all symptoms resolved.
A one-year-old infant cried incessantly due to phlegm and coughing. Bao Long Wan (Dragon-Holding Pill) provided slight relief, but the symptoms returned after a while. Upon examination, I observed that his right cheek was pure white, while the left cheek was greenish-red. This indicated a conflict between the Lung and Liver meridians. I first used Xie Bai San (Drain White Powder) to dispel Lung pathogenic factors; then used Chai Hu Zhi Zi San (Bupleurum and Gardenia Powder) to pacify Liver Wood; finally, I used Dihuang Wan to nourish Kidney Water, leading to a cure.
A child cried out continuously with a bluish-black discoloration on the forehead. This indicated that Fright-convulsion caused Liver Wood to overact upon Spleen Earth, resulting in abdominal pain. I first used Liu Jun Zi Tang (Six Gentlemen Decoction) augmented with Mu Xiang (Aucklandia Root), Chai Hu (Bupleurum Root), and Gou Teng Gou (Uncaria Rhynchophylla Hook). The crying gradually subsided. I then added Dang Gui (Angelica Sinensis Root), and after two more doses, the child stabilized.
A child presented with fever, night crying, refusal of milk and food, coma with convulsions, profuse phlegm, and locked jaw. The fingerprint pattern resembled the character "water" (Shui). This indicated deficiency of Spleen and Lung Qi, attacked by Wind-Wood pathogenic factors, with phlegm and food stagnation accumulating in the chest and abdomen. I first used Da An Wan (Great Peace Pill), followed by Liu Jun Zi Tang augmented with Gou Teng Gou (Uncaria Rhynchophylla Hook), resulting in a cure.
Liangge San (See formula under "Sores and Injuries")
Fangfeng Tongsheng San (See formula under "Wind Conditions")
Liu Jun Zi Tang (See formula under "Internal Hook")
Liu Wei Di Huang Wan (See formula under "Kidney Organ")
Bao Long Wan (See formula under "Cold Damage")
Xie Bai San (See formula under "Lung Organ")
Chai Hu Zhi Zi San (See formula under "Febrile Disease")
Da An Wan (i.e., Bao He Wan plus Atractylodis Macrocephalae Rhizoma, See formula under "Internal Hook")