小儿盘肠气者,痛则曲腰干啼,额上有汗,皆由肝经风邪所搏也。肝肾居下,故痛则曲腰。
干啼者,风燥其液,故无泪也。额上有汗者,风木助心火也。口闭足冷者,脾气不营也。下
利青粪者,肝木乘脾也,皆由产下澡洗受风冷所致,当服钩藤膏之类。若乳母及儿受寒邪者
,用沉香汤之类。若儿额间有汗,口闭脚冷,乃虚寒也,用当归散或沉香降气汤之类。若面
赤唇焦,小便不通,小腹胀痛者,乃小肠热也,用人参汤送下三黄丸。若痛不止,煎葱汤淋
揉其腹,就以热葱熨脐腹间,良久尿出痛止;或以乳香、没药、木香各少许,水煎灌匙许。
若因乳母饮食停滞者,用保和丸;怀抱气郁者,加味归脾汤;怒动肝火者,加味逍遥散;子
母俱服之,并佳。
治验
一小儿曲腰啼叫,右腮青黑,此脐腹内痛,因脾土虚寒,肝木乘之也。用六君子加木香、钩
藤钩即愈。
一小儿因乳母大怒,亦患前症,面赤而啼,小便不利,用加味逍遥散加木通、车前子,母子
服之并愈。
一小儿啼叫面赤,手足不冷,用钩藤饮随愈。后因其母饮酒浓味,仍作啼,手足发热,又用
前药加生地黄而愈;后又面青,手足冷,啼叫吐泻,其粪腥秽,用助胃膏一服而安。
一小儿患前症,曲腰而啼,额间出汗,足冷唇青粪青,先用钩藤膏治愈。后复患,仍用钩藤
膏而痛减半,又煎葱汤熨洗其腹,腹痛遂安。
一小儿唇青足冷,啼声不绝,用助胃膏一服稍安。又食生冷之物,前症仍作,更泄泻不止,
先用六君子加木香、干姜一剂,乃去木香、干姜又二剂,其泻顿止,又用四君子少加升麻四
剂,饮食加进。
一小儿十四岁,腹痛吐泻,手足常冷,肌体瘦弱。余谓∶所禀命门火虚也。用六君子汤、八
味丸渐愈。毕姻后,因房劳勤读,感冒发汗,继以饮食劳倦,朝凉暮热,饮食不思,用六君
子、十全大补二汤寻愈。后不慎饮食起居,午前脐下热起,则遍身如炙;午后自足寒至腰如
冰,热时脉洪大,按之如无,两尺微甚,寒时则六脉微细如绝,汤粥稍离火,食之即腹中觉
冷,此亦禀命门火衰之症也,用补中益气汤、八味丸,各百余服渐愈。后大吐血,别误服犀
角地黄丸一剂,病益甚,饮食顿减,面色 白,手足厥冷,或时发热,寒时脉微细而短者,
阳气虚微也。热时脉洪大而虚者,阴火虚旺也,余用十全大补及八珍汤、六君子之类,但能
扶持而血不止,复因劳役吐血甚多,脉洪大鼓指,按之如无,而两寸脉短,此阳气大虚也。
用人参一两、附子一钱,佐以补中益气汤数剂,诸症渐退。乃减附子五分,又各数剂,脉症
悉退。乃每服人参五钱、炮姜五分,月余始愈。
当归散 治脏寒腹痛 面青手冷,夜啼不乳。
当归 白芍药 人参 甘草(炙,二分) 桔梗 橘皮(去白。各一钱)
上为末,水煎半盏,时时少与服。
沉香降气汤 治气不升降,胸膈痞塞,心腹胀满,喘促短气,干哕烦满,咳嗽痰涎,口中无
味,嗜卧不食。
香附子(二两半) 沉香 砂仁(各一钱) 甘草(七钱半)
上为末,每服一钱,入盐少许,沸汤点,平旦空心服。
愚按∶前方若乳母中气郁滞,不能升降,患此症致儿作痛者,亦用之。
三黄丸(方见疝气)
加味归脾汤
加味逍遥散
钩藤膏(三方见内钓)
助胃膏(方见热吐)
魏香散
六君子汤(二方见内钓)
四神丸(方见脱肛)
八味丸
地黄丸(并见肾脏)
补中益气汤(方见虚羸)
小儿盘肠气,发作时腰部弯曲、干哭无泪,额头出汗,这都是由肝经受风邪侵袭所致。肝肾位于下焦,所以疼痛时腰部会弯曲。
所谓干哭,是因为风邪燥烈耗伤津液,所以没有眼泪。额头出汗,是因为风木之气助长心火。口闭脚冷,是脾气虚弱不能濡养四肢。大便排出青色粪便,是肝木克制脾土的表现。这些症状都是由出生后洗澡时受风寒引起的,应当服用钩藤膏之类的方剂。如果乳母和婴儿都受到寒邪侵袭,使用沉香汤之类的方剂。如果婴儿额头有汗,口闭脚冷,这是虚寒证,使用当归散或沉香降气汤之类的方剂。如果面色红赤、嘴唇焦枯、小便不通、小腹胀痛,这是小肠有热,用人参汤送服三黄丸。如果疼痛不止,煎煮葱汤淋洗并揉搓腹部,再用热葱熨烫脐腹部位,很久之后尿液排出,疼痛停止;或者用少许乳香、没药、木香,水煎后每次灌服一勺。如果是由于乳母饮食停滞导致的,使用保和丸;如果是因情绪抑郁导致的气机郁滞,使用加味归脾汤;如果是因愤怒引发肝火,使用加味逍遥散;母子同时服用,效果都很好。
治验案例:
一个婴儿腰部弯曲啼叫,右脸颊青黑,这是脐腹内部疼痛,原因是脾土虚寒,肝木乘虚侵袭。使用六君子汤加入木香、钩藤,随即痊愈。
一个婴儿因为乳母大怒,也患上上述症状,面红啼哭,小便不利,使用加味逍遥汤加入木通、车前子,母子同服后痊愈。
一个婴儿啼哭面红,手脚不冷,使用钩藤饮随即痊愈。后来因为母亲饮酒及食用浓味食物,再次出现啼哭,手脚发热,又用前面的药物加入生地黄而治愈;后来又出现面色发青,手脚冰冷,啼哭呕吐腹泻,粪便腥臭秽浊,服用一剂助胃膏后安定。
一个婴儿患上述病症,弯腰啼哭,额头出汗,脚冷唇青粪便青,先用钩藤膏治愈。后来复发,仍用钩藤膏使疼痛减半,又煎葱汤熨洗腹部,腹痛于是安定。
一个婴儿唇青脚冷,啼哭声不停,服用一剂助胃膏后稍安。又吃了生冷食物,前症复发,更加泄泻不止,先用六君子汤加入木香、干姜一剂,然后去掉木香、干姜再服两剂,腹泻立刻停止,又用四君子汤少量加入升麻连服四剂,饮食逐渐增加。
一个十四岁的男孩,腹痛呕吐腹泻,手脚常年冰冷,身体瘦弱。我说:这是禀赋命门火虚。使用六君子汤、八味丸逐渐痊愈。结婚后,因为房事劳累和读书过度,感冒发汗后,接着因饮食劳倦,早晨凉晚上热,不想吃东西,使用六君子汤、十全大补汤两个方剂很快痊愈。后来不慎饮食起居,午前脐下热气升起,则全身像被炙烤一样;午后寒气从脚底升至腰部像冰一样,发热时脉象洪大,按下去好像没有,两尺脉微弱至极,寒冷时六脉微细几乎摸不到,汤粥稍微离开火源,吃下去就觉得腹中寒冷,这也是禀赋命门火衰的症状,使用补中益气汤、八味丸,各服用一百多剂才逐渐痊愈。后来大吐血,误服一剂犀角地黄丸,病情加重,饮食突然减少,面色苍白,手脚厥冷,有时发热,寒冷时脉微细短促,这是阳气虚微。发热时脉洪大而虚,这是阴火虚旺。我使用十全大补汤及八珍汤、六君子汤之类,只能扶持住但血止不住,又因劳累吐血很多,脉洪大鼓指,按下去好像没有,且两寸脉短,这是阳气大虚。使用人参一两、附子一钱,配合补中益气汤数剂,各种症状逐渐消退。于是减少附子五分,又各服数剂,脉象症状全部消退。于是每服人参五钱、炮姜五分,一个多月才痊愈。
当归散 治疗脏寒腹痛,面色青,手脚冷,夜间啼哭不吃奶。
当归、白芍药、人参、甘草(炙,二分)、桔梗、橘皮(去白,各一钱)。
以上研为末,水煎半盏,时时少量服用。
沉香降气汤 治疗气机不升降,胸膈痞塞,心腹胀满,喘促短气,干呕烦闷,咳嗽痰涎,口中无味,嗜睡不想吃东西。
香附子(二两半)、沉香、砂仁(各一钱)、甘草(七钱半)。
以上研为末,每服一钱,加入少许盐,沸水冲服,清晨空腹服用。
我按语:前方若因乳母中气郁滞,不能升降,导致患儿此症作痛的,也可以使用。
三黄丸(方见疝气)
加味归脾汤
加味逍遥散
钩藤膏(三方见内钓)
助胃膏(方见热吐)
魏香散
六君子汤(二方见内钓)
四神丸(方见脱肛)
八味丸
地黄丸(并见肾脏)
补中益气汤(方见虚羸)
Pediatric Pan Chang Qi (Intestinal Colic) is characterized by curvature of the waist, dry crying without tears, and sweating on the forehead during pain episodes. These symptoms are all caused by Wind pathogenic factors attacking the Liver Meridian (Liver Channel). Since the Liver and Kidney reside in the Lower Jiao (Lower Burner), pain causes the waist to curve.
Dry crying refers to crying without tears because Wind-Dryness depletes body fluids. Sweating on the forehead occurs because Wind-Wood assists Heart Fire. Closed mouth and cold feet indicate Spleen Qi deficiency failing to nourish the limbs. Passing green stool indicates Wood overacting on Earth (Liver invading Spleen). All these conditions result from exposure to Wind-Cold during bathing after birth. One should administer formulas such as Gouteng Gao (Uncaria Paste). If both the wet nurse and the infant are affected by Cold pathogenic factors, use formulas such as Chenxiang Tang (Agarwood Decoction). If the infant has sweating on the forehead, a closed mouth, and cold feet, this is a Deficiency-Cold syndrome; use Danggui San (Angelica Powder) or Chenxiang Jiangqi Tang (Agarwood Descending Qi Decoction). If the face is red, lips are scorched/dry, urination is obstructed, and there is distension and pain in the lower abdomen, this is Heat in the Small Intestine; administer Sanhuang Wan (Three Yellows Pill) delivered with Renshen Tang (Ginseng Decoction). If pain persists, decoct Scallion Soup to wash and rub the abdomen, then apply hot scallions to moxa the umbilical and abdominal area; after a long time, urination will occur and pain will cease. Alternatively, use small amounts of Rushiang (Frankincense), Moyao (Myrrh), and Muxiang (Aucklandia Root), decoct in water, and administer spoonfuls orally. If caused by food stagnation in the wet nurse, use Baohe Wan (Preserve Harmony Pill); if due to emotional depression causing Qi stagnation, use Jiawei Guipi Tang (Modified Gui Pi Decoction); if triggered by anger stirring up Liver Fire, use Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder). Both mother and child taking these remedies yields good results.
Clinical Cases:
One infant curved his waist and cried, with the right cheek appearing cyanotic and dark. This indicated internal pain in the umbilical and abdominal region, caused by Spleen Earth Deficiency-Cold allowing Liver Wood to invade. Using Liujunzi Tang (Six Gentlemen Decoction) added with Muxiang (Aucklandia Root) and Goutenggou (Uncaria Rhynchophylla Hook) resulted in immediate recovery.
One infant suffered the aforementioned symptoms due to his wet nurse's great anger, presenting with a red face, crying, and difficult urination. Using Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder) added with Mutong (Akebia Vine Stem) and Cheqianzi (Plantago Seed), administered to both mother and child, led to full recovery.
One infant cried with a red face but had no cold hands and feet. Using Gouteng Yin (Uncaria Decoction) led to quick recovery. Later, due to the mother consuming alcohol and rich flavors, the crying recurred with hot hands and feet. The previous prescription was used with Sheng Dihuang (Rehmannia Root) added, resulting in cure. Subsequently, the face turned blue, hands and feet became cold, accompanied by crying, vomiting, and diarrhea with foul-smelling stools. One dose of Zhugao Gao (Stomach-Assisting Paste) brought stability.
One infant suffered from the aforementioned condition, curving the waist while crying, with sweating on the forehead, cold feet, blue lips, and green stool. Initially cured with Gouteng Gao (Uncaria Paste). Upon recurrence, Gouteng Gao reduced the pain by half. Then, Scallion Soup was decocted to wash and apply heat to the abdomen, relieving the abdominal pain.
One infant had blue lips, cold feet, and incessant crying. One dose of Zhugao Gao provided slight relief. After eating raw/cold foods, the previous symptoms returned with persistent diarrhea. Initially treated with one dose of Liujunzi Tang (Six Gentlemen Decoction) added with Muxiang (Aucklandia Root) and Ganjiang (Dried Ginger). Then, Muxiang and Ganjiang were removed, and two more doses were given, stopping the diarrhea abruptly. Subsequently, Sizijunzi Tang (Four Gentlemen Decoction) with a small amount of Shengma (Cimicifuga Rhizome) was taken for four doses, improving dietary intake.
A fourteen-year-old boy suffered from abdominal pain, vomiting, diarrhea, chronically cold hands and feet, and emaciation. I stated: This is an innate deficiency of Mingmen Fire (Gate of Life Fire). Gradual improvement was achieved using Liujunzi Tang (Six Gentlemen Decoction) and Bawei Wan (Eight-Ingredient Pill). After marriage, due to sexual exertion and excessive reading, followed by a cold treated with sweating, and subsequent dietary/labor fatigue, he experienced morning chills and evening fevers, loss of appetite. He recovered quickly using Liujunzi Tang (Six Gentlemen Decoction) and Shiquan Dabu Tang (Ten Significant Tonifying Decoction). Later, neglecting diet and lifestyle, he felt heat rising from below the navel before noon, making his whole body feel like being roasted; in the afternoon, coldness rose from the feet to the waist like ice. During fever, the pulse was surging and large but empty upon pressure, with extremely weak Chi pulses (Kidney pulses). During chills, all six pulses were minute and fine, nearly imperceptible; even warm congee tasted cold in the stomach. This is also a symptom of innate Mingmen Fire Decline. Using Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) and Bawei Wan (Eight-Ingredient Pill), each taken over a hundred times, led to gradual recovery. Later, he suffered massive hematemesis. Misusing Xijiao Dihuang Wan (Rhino Horn and Rehmannia Pill) aggravated the illness, causing sudden reduction in appetite, pale complexion, cold extremities, intermittent fever. Chills presented with minute, fine, short pulses indicating severe Yang Qi deficiency. Fever presented with surging, large, yet empty pulses indicating deficient Yin Fire flaring. I used Shiquan Dabu Tang (Ten Significant Tonifying Decoction), Bazhen Tang (Eight Treasure Decoction), and Liujunzi Tang (Six Gentlemen Decoction). These could only sustain him while bleeding continued. Due to labor-induced massive hematemesis, the pulse became surging, large, and drum-like under the finger but empty upon pressure, with short Cun pulses (Lung/Heart pulses), indicating severe Yang Qi deficiency. I prescribed Ren Shen (Ginseng Root) 1 liang and Fu Zi (Prepared Aconite Lateral Root) 1 qian, assisted by several doses of Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction), gradually retreating various symptoms. Then, Fu Zi (Prepared Aconite Lateral Root) was reduced by 5 fen, and several more doses were taken until pulse and symptoms completely subsided. Finally, each dose contained Ren Shen (Ginseng Root) 5 qian and Pao Jiang (Roasted Ginger Rhizome) 5 fen, leading to recovery after more than a month.
Danggui San (Angelica Powder): Treats Zang Cold abdominal pain, cyanotic face, cold hands, night crying, and refusal to suckle.
Ingredients: Dang Gui (Angelica Sinensis Root), Bai Shao Yao (White Peony Root), Ren Shen (Ginseng Root), Gan Cao (Licorice Root, honey-fried, 2 fen), Jie Geng (Platycodon Root), Ju Pi (Tangerine Peel, pith removed, 1 qian each).
Process: Grind into powder. Decoct in water to obtain half a cup. Administer small amounts frequently.
Chenxiang Jiangqi Tang (Agarwood Descending Qi Decoction): Treats failure of Qi ascending and descending, chest and diaphragm oppression, heart and abdominal distension/fullness, panting and shortness of breath, dry retching and irritability, cough with phlegm-saliva, tastelessness in the mouth, lethargy, and anorexia.
Ingredients: Xiang Fu Zi (Cyperus Rhizome, 2.5 liang), Chen Xiang (Agarwood), Sha Ren (Amomum Fruit, 1 qian each), Gan Cao (Licorice Root, 7.5 qian).
Process: Grind into powder. Take 1 qian per dose, add a little salt, brew with boiling water. Take on an empty stomach in the early morning.
Commentary: If the wet nurse suffers from middle Qi stagnation and failure of ascending/descending, causing the infant to have pain, this formula may also be used.
Sanhuang Wan (Three Yellows Pill) (Formula see Hernia)
Jiawei Guipi Tang (Modified Gui Pi Decoction)
Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder)
Gouteng Gao (Uncaria Paste) (See Internal Hook for three formulas)
Zhugao Gao (Stomach-Assisting Paste) (Formula see Hot Vomiting)
Weixiang San (Wei Fragrance Powder)
Liujunzi Tang (Six Gentlemen Decoction) (See Internal Hook for two formulas)
Shenshen Wan (Four Spirits Pill) (Formula see Rectal Prolapse)
Bawei Wan (Eight-Ingredient Pill)
Dihuang Wan (Rehmannia Pill) (See Kidney Disease)
Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) (Formula see Emaciation)