《百问》云∶小儿唇红如丹,即发渴;红甚焦黑则危笃。若三焦虚烦,作渴者,用三黄汤。
伤寒后唇口焦者,用白虎汤、竹叶汤。泻痢作渴者,用四苓散之类,常治暑积心脾。烦渴引
饮者,用白虎汤。下痢脾虚作渴者,用七味白术散。热结膀胱,小便秘,渴者,用五苓散。
上焦虚热者,用四君子汤。膏粱积热者,用清胃散。脾胃积热者,用泻黄散。中气虚热者,
用异功散。肾水虚热者,用六味丸。其余疳症发热,各详本症。胎禀所致者,当各审其因,
若误用寒凉降火,脾胃复伤,则腹胀而为败症矣。
治验
一小儿发热作渴,用泻黄散,大便重坠,口角流涎,仍欲泻火。余曰∶鼻准青白多而黄色少
,属脾胃虚寒,肝木所侮。盖口角流涎,胃气不能统摄也;大便重坠,脾气不能升上也。不
信,另用凉剂,果眉唇微动,四肢微搐。余曰∶此虚极而变慢惊风矣。用六君、当归、木香
、炮姜、钩藤钩二剂益甚,意欲更剂。余曰∶此药力未及也。仍以前药加附子一片,服之即
安;去附子,又二剂而愈。
一小儿吐泻,后患渴症,饮食少思,肌体消瘦,用七味白术散,渴渐止,五味异功散加升麻
饮食渐进;又用补中益气汤,肌肉顿生。
一小儿嗜膏粱甘味,发热作渴,小便白浊,用四味肥儿丸,佐以泻黄散稍愈。复伤食吐泻,
服消食丸,胃气复伤,饮食少思,肢体倦怠而渴,先用七味白术散而渴止,次用五味异功散
而痊。
一小儿面目色白,患渴症,唾痰发热,服清热化痰之药,大便洞泻,小便频数,此脾胃虚而
复伤也,朝用补中益气汤,夕用四神丸,诸症渐愈,又佐以六味地黄丸而愈。
一小儿十五岁,用心太过,两足发热,日晡益甚,服人参固本丸之类,热益甚,痰涎上涌,
体倦更唾痰,服化痰滋阴之剂,痰热益甚,更头目眩晕,体倦少食。请余治,仍欲清热化痰
滋阴。余曰∶两足发热,肾经阴虚也;痰涎上涌,肾不能摄也;头目眩晕,胃气不能上升也
;此禀赋不足,劳疫过度而然耳。遂朝用补中益气汤,夕用加减八味丸,元气渐复,诸症渐
愈。但用心于功课,即头晕发热,用前药即愈。毕姻后,诸症复作,服前药半载而痊。后再发,更大小
便牵痛,用补中益气汤、八味地黄丸、独参汤而得生。
竹叶石膏汤
石膏(一钱) 半夏(三分) 甘草 人参(各二分) 麦门冬(十粒) 竹叶(一握)
上生姜汁一匙,水煎服。
三黄汤
黄芩 黄连 黄柏(各等分)
上水煎服。
白虎汤(方见发热)
五苓散(方见五淋)
七味白术散(方见积滞)
四君子汤
六君子汤
清胃散
异功散(四方见内钓)
六味丸(方见肾脏)
四苓散(即五苓散去肉桂)
补中益气汤(方见虚羸)
四味肥儿丸(方见寒吐)
四神丸(方见惊泻)
消食丸(方见呕吐乳)
《百问》中说:小儿嘴唇红得像涂了丹砂一样,就会发生口渴;如果红色严重变成焦黑色,病情就危险了。如果是三焦虚烦引起的口渴,使用三黄汤。
伤寒病愈后嘴唇口角焦枯的,使用白虎汤、竹叶汤。因泻痢引起口渴的,使用四苓散之类的方剂,通常治疗暑热积滞于心脾。烦躁口渴且大量饮水的,使用白虎汤。因下痢导致脾虚而口渴的,使用七味白术散。热邪结聚在膀胱,小便不通畅且口渴的,使用五苓散。上焦有虚热的,使用四君子汤。因饮食肥甘厚味积热导致的,使用清胃散。脾胃积热的,使用泻黄散。中气虚弱而有虚热的,使用异功散。肾水不足而有虚热的,使用六味丸。其余疳症发热的,分别详细查看本病症。由胎禀(先天体质)原因导致的,应当仔细审查病因,如果误用寒凉降火的药物,会再次损伤脾胃,导致腹胀并演变为败症。
治验记录
有一个小儿发热并口渴,使用泻黄散,出现大便重坠感,口角流涎,仍然想要泻火。我说:鼻头颜色青白多而黄色少,属于脾胃虚寒,被肝木所克制。因为口角流涎,是胃气不能统摄津液;大便重坠,是脾气不能升举所致。家属不信,另外使用凉性药剂,果然出现眉毛和嘴唇轻微抽动,四肢轻微抽搐。我说:这是极度虚弱而转变为慢惊风了。使用六君子汤、当归、木香、炮姜、钩藤钩,服用两剂后病情加重,家属打算更换药方。我说:这是药力还没有达到效果。仍然用前面的药方加上一片附子,服用后即安稳;去掉附子,再服两剂而痊愈。
有一个小儿呕吐腹泻,后来患口渴症,饮食减少不想吃,身体消瘦,使用七味白术散,口渴逐渐停止,改用五味异功散加升麻,饮食逐渐进补;又使用补中益气汤,肌肉迅速生长恢复。
有一个小儿嗜好肥甘厚味的食物,发热并口渴,小便浑浊色白,使用四味肥儿丸,配合泻黄散稍见好转。又因伤食导致呕吐腹泻,服用消食丸,胃气再次受伤,饮食减少不想吃,肢体倦怠且口渴,先用七味白术散使口渴停止,接着用五味异功散而痊愈。
有一个小儿面色苍白,患口渴症,吐痰发热,服用清热化痰的药物,导致大便洞泻,小便频数,这是脾胃虚弱而又被药物损伤的缘故,早晨服用补中益气汤,晚上服用四神丸,各种症状逐渐痊愈,又配合六味地黄丸而痊愈。
有一个十五岁的小儿,用心过度,两脚发热,傍晚时分更加严重,服用人参固本丸之类的药物,热势更加严重,痰涎上涌,身体疲倦更多吐痰,服用化痰滋阴的药剂,痰热更加严重,进而出现头目眩晕,身体疲倦进食少。请我诊治,仍然想要清热化痰滋阴。我说:两脚发热,是肾经阴虚;痰涎上涌,是肾不能摄纳;头目眩晕,是胃气不能上升;这是禀赋不足,劳役过度所致。于是早晨服用补中益气汤,晚上服用加减八味丸,元气逐渐恢复,各种症状逐渐痊愈。但只要用心于功课,就会头晕发热,服用前面的药即痊愈。结婚后,各种症状复发,服用前面的药半年而痊愈。后来又发作,更伴有大小便牵拉疼痛,使用补中益气汤、八味地黄丸、独参汤而得以存活。
竹叶石膏汤
石膏(一钱) 半夏(三分) 甘草 人参(各二分) 麦门冬(十粒) 竹叶(一握)
以上药材加入生姜汁一匙,用水煎煮后服用。
白虎汤(方剂见发热章节)
五苓散(方剂见五淋章节)
七味白术散(方剂见积滞章节)
四君子汤
六君子汤
清胃散
异功散(上述四方见内钓章节)
六味丸(方剂见肾脏章节)
四苓散(即五苓散去肉桂)
补中益气汤(方剂见虚羸章节)
四味肥儿丸(方剂见寒吐章节)
四神丸(方剂见惊泻章节)
消食丸(方剂见呕吐乳章节)
The *Baiwen* states: If a child's lips are red like cinnabar, thirst will develop; if the redness becomes severe and turns scorched black, the condition is critical. If thirst arises from deficiency heat and irritability in the San Jiao (Triple Burner), use Sanhuang Tang (Three Yellows Decoction).
If the lips and mouth become scorched after a Shanghan (Cold Damage) disease, use Baihu Tang (White Tiger Decoction) or Zhuye Tang (Bamboo Leaf Decoction). If thirst arises from diarrhea and dysentery, use Siling San (Four-Ingredient Powder) and similar formulas, typically treating summerheat accumulation in the Heart and Spleen. For irritability, thirst, and excessive drinking, use Baihu Tang (White Tiger Decoction). For thirst arising from Spleen deficiency due to dysentery, use Qiwei Baizhu San (Seven-Ingredient Atractylodes Macrocephala Powder). For thirst with difficulty in urination due to heat binding in the Bladder, use Wuling San (Five-Ingredient Powder with Poria). For deficiency heat in the Upper Jiao, use Sijunzi Tang (Four Gentlemen Decoction). For heat accumulation from rich and sweet foods, use Qingwei San (Stomach-Clearing Powder). For heat accumulation in the Stomach and Spleen, use Xiehuang San (Drain Yellow Powder). For deficiency heat due to Middle Qi deficiency, use Yigong San (Extraordinary Merit Powder). For deficiency heat due to Kidney Water insufficiency, use Liuwei Wan (Six-Ingredient Pill). For fever associated with other Gan disorders (malnutrition syndromes), refer to the specific syndrome descriptions. For conditions caused by prenatal endowment, carefully investigate the etiology. If cold-natured fire-draining herbs are mistakenly used, the Spleen and Stomach will be further damaged, leading to abdominal distension and a deteriorating syndrome.
Case Records
A child presented with fever and thirst. After using Xiehuang San (Drain Yellow Powder), the child experienced a sensation of heaviness and bearing down during defecation and drooling at the corners of the mouth, while still exhibiting signs suggesting a need to drain fire. I stated: The nose tip shows more blue-white than yellow, indicating Spleen-Stomach deficiency-cold and oppression by Liver Wood. Drooling at the mouth corners indicates the Stomach Qi's inability to control fluids; the sensation of heaviness in defecation indicates the Spleen Qi's inability to ascend. The family did not believe this and used cooling agents instead. Consequently, the eyebrows and lips twitched slightly, and the limbs convulsed slightly. I stated: This is extreme deficiency transforming into Slow Convulsion Wind. We used Liujunzi Tang (Six Gentlemen Decoction), Danggui (Angelicae Sinensis Radix), Muxiang (Aucklandiae Radix), Paoyang (Prepared Ginger), and Goutenggou (Uncariae Ramulus cum Uncis) for two doses, but the condition worsened. The family intended to change the prescription. I stated: The medicinal power has not yet taken effect. We continued with the previous formula, adding one slice of Fuzi (Aconiti Lateralis Radix Praeparata). Upon administration, the child stabilized; after removing Fuzi and administering two more doses, the child recovered.
A child suffered from vomiting and diarrhea, subsequently developing thirst, reduced appetite, and emaciation. We used Qiwei Baizhu San (Seven-Ingredient Atractylodes Macrocephala Powder), which gradually stopped the thirst. We then switched to Wuwei Yigong San (Five-Ingredient Extraordinary Merit Powder) with Shengma (Cimicifugae Rhizoma), leading to gradual improvement in dietary intake. Finally, we used Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction), resulting in rapid muscle regeneration.
A child had a preference for rich and sweet foods, presenting with fever, thirst, and turbid white urine. We used Siwei Fei'er Wan (Four-Ingredient Child-Nourishing Pill) assisted by Xiehuang San (Drain Yellow Powder), which led to slight improvement. Later, food stagnation caused vomiting and diarrhea. The child took Xiaoshi Wan (Digestive Aid Pill), which further injured Stomach Qi, leading to reduced appetite, limb fatigue, and thirst. We first used Qiwei Baizhu San (Seven-Ingredient Atractylodes Macrocephala Powder) to stop the thirst, followed by Wuwei Yigong San (Five-Ingredient Extraordinary Merit Powder), leading to recovery.
A child with a pale complexion suffered from thirst, expectoration of phlegm, and fever. After taking heat-clearing and phlegm-resolving drugs, the child experienced watery diarrhea and frequent urination, indicating that the Spleen and Stomach were deficient and further injured by medication. We administered Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) in the morning and Sishen Wan (Four Spirits Pill) in the evening. Various symptoms gradually improved, and the addition of Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill) led to full recovery.
A fifteen-year-old child exerted the mind excessively, presenting with heat in both feet, worsening in the late afternoon. After taking Ren Shen Gu Ben Wan (Ginseng Solidifying Root Pill) and similar preparations, the heat intensified, accompanied by surging phlegm-saliva, fatigue, increased expectoration, dizziness, and poor appetite. Upon consultation, the family requested heat-clearing, phlegm-resolving, and yin-nourishing treatments. I stated: Heat in the feet indicates Yin deficiency in the Kidney Meridian; surging phlegm-saliva indicates the Kidney's failure to grasp; dizziness indicates the Stomach Qi's failure to ascend. This results from insufficient congenital endowment and excessive labor/strain. We prescribed Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) in the morning and Jiaban Bawei Wan (Modified Eight-Ingredient Pill) in the evening. Vital Qi gradually recovered, and symptoms improved. However, mental exertion on studies triggered dizziness and fever, which resolved with the previous medicines. After marriage, symptoms recurred. Taking the previous medicines for half a year led to recovery. Later, upon recurrence accompanied by pulling pain in urination and defecation, the child survived through the use of Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction), Bawei Dihuang Wan (Eight-Ingredient Rehmannia Pill), and Dushen Tang (Single Ginseng Decoction).
Zhuye Shigao Tang (Bamboo Leaf and Gypsum Decoction)
Shigao (Gypsum Fibrosum, 1 qian), Banxia (Pinelliae Rhizoma, 3 fen), Gancao (Glycyrrhizae Radix et Rhizoma), Renshen (Ginseng Radix) (each 2 fen), Maimendong (Ophiopogonis Radix, 10 grains), Zhuye (Bambusae Folium, one handful).
Add one spoonful of Shengjiangzhi (Zingiberis Rhizoma Recens Juice), decoct in water, and take orally.
Sanhuang Tang (Three Yellows Decoction)
Huangqin (Scutellariae Radix), Huanglian (Coptidis Rhizoma), Huangbai (Phellodendri Cortex) (equal parts).
Decoct in water and take orally.
Baihu Tang (White Tiger Decoction) (See formula under Fever)
Wuling San (Five-Ingredient Powder with Poria) (See formula under Five Types of Dysuria)
Qiwei Baizhu San (Seven-Ingredient Atractylodes Macrocephala Powder) (See formula under Food Stagnation)
Sijunzi Tang (Four Gentlemen Decoction)
Liujunzi Tang (Six Gentlemen Decoction)
Qingwei San (Stomach-Clearing Powder)
Yigong San (Extraordinary Merit Powder) (See the above four formulas under Internal Hook)
Liuwei Wan (Six-Ingredient Pill) (See formula under Kidney Disorders)
Siling San (Four-Ingredient Powder) (i.e., Wuling San minus Rougui/Cinnamomi Cortex)
Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) (See formula under Emaciation)
Siwei Fei'er Wan (Four-Ingredient Child-Nourishing Pill) (See formula under Cold Vomiting)
Sishen Wan (Four Spirits Pill) (See formula under Convulsive Diarrhea)
Xiaoshi Wan (Digestive Aid Pill) (See formula under Vomiting Milk)