小儿惊后目微动切牙者,皆病后亡津液,不能荣其筋脉也。亦有肝惊虚热而生风者,当审其
气血有余不足而治之。其日中发热饮冷而动者,气有余也,用泻青丸。夜间盗汗及睡不宁而
动者,血不足也,用地黄丸。或因肝经风邪传于脾肾者亦令切牙,先用柴胡清肝散,次用五
味异功散,六味地黄丸。若因脾胃虚热,用补中益气汤加芍药、山栀,实热用泻黄散。盖牙
床属手足阳明故也。若肝肾热用六味地黄丸。
治验
奚氏女六岁,忽然发惊目动切牙,或睡中惊搐痰涎壅盛,或用化痰祛风等药,益甚。余曰∶
面青而见前症,乃属肝木克脾土,不能摄涎而上涌也。当滋肾水生肝血,则风自息而痰自消
矣。遂用六味丸而愈。
一小儿患前症,痰涎自流,用惊风之药,其症益甚,脾胃益虚,视其面色痿黄,口中吐痰,
用六君子补中益气汤而愈。
导赤散(方见心脏)
地黄丸(方见肾脏)
泻青丸(方见肝脏)
补中益气汤(方见虚羸)
六味地黄丸(方见肾脏)
六君子汤(方见天钓)
经曰∶诸风掉眩,皆属肝木。木得风则摇动,乃肝经火盛而生虚风也。汤氏治郑都承子摇头
便血七年,用祛风药、止血药,百试无效。此肝经风热所乘,土受木克,不能摄血而溃入大
肠,故便血不止,遂制清肝益胃汤,以平肝益脾祛风热,兼服胃风汤,旬余诸症悉愈。便血
者风木摇动,则土受凌虐,而不能统血也。或食酸味过多,以益其肝致令阴结。经曰∶结阴
者便血一升,再结二升,三结三升。又邪在五脏,则阴脉不和,阴脉不和,则血留之,结阴
之病,阴气内结不得外行,渗入肠间,故便血也。血亦有乳母恚怒,风热炽盛,或肝木伤脾
,使清气不升。或风邪侵入大肠者。治法∶若因风热,用柴胡清肝散。若因怒火,用加味小
柴胡汤。若清气不升,脾气下陷者,用补中益气汤。若风邪侵于大肠者,用清肝益胃丸。肝
经血热妄行者,用六味地黄丸。脾土不能培肝木者,用六君、柴胡、钩藤钩。肝木胜脾土者
,用四君、芍药、钩藤钩。结阴者,用平胃地榆汤。
治验
一小儿伤风咳嗽痰涌。余谓∶脾虚肺弱,腠理不密,风邪外乘。用六君子汤加桔梗、桑皮、
杏仁而愈;后饮食停滞,作泻腹胀,仍用六君子加山楂、浓朴而安。又停食作泻,服消导之
药,更加咳嗽。余谓∶当调补脾土。不信。自用发表克滞,前症益甚,更加摇头。余以天麻
散倍加钩藤钩及异功散而愈。
一小儿项间结核,面色痿黄,肌体消瘦,切牙抽搐,头摇目札,此肝木克脾土也。用六君子
汤及九味芦荟丸顿愈。
一小儿病后,遇惊即痰甚,切牙抽搐,摇头作泻,恪服脑、麝、朱砂等药,以致慢惊而卒。
犀角屑 甘草 全蛇蜕(炙黄) 钩藤钩子 麻黄(去节,一钱) 黄 (蜜炙) 羌活 防风 白
芍药
上为末,枣肉杵丸桐子大。每服五十丸,食后薄荷汤下。
《海藏食疗》云∶蛇蜕主去风邪明目。治小儿一百二十种惊痫寒热等症,蛊毒安胎,炒用又
治风痫、弄舌摇头。故前方用之。
平胃地榆汤 治结阴便血。
白术 陈皮 茯苓 浓朴 葛根(各五分) 地榆(七分) 干姜(五分) 炙甘草 当归 炒神曲 白
芍药 人参 益智(各三分) 升麻 附子(炮。各一钱)
上每服一钱,水煎服。
胃风汤(方见偏风口噤)
柴胡清肝散(方见诸热症)
加味小柴胡汤(方见肝脏)
补中益气汤(方见虚羸)
六味地黄丸(方见肾脏)
泻白散(方见肺脏)
六君子汤
四君子汤(二方见天钓)
天麻散(方见内嗽)
异功散(方见天钓)
九味芦荟丸(方见疳症)
小儿在惊风发作后出现眼球微动、咬紧牙齿的症状,都是因为病后津液耗损,无法濡养筋脉所致。也有因肝受惊吓、虚热内生而引动肝风的,应当审查其气血的有余或不足来进行治疗。如果在白天发热、喜饮冷水且伴有上述症状,属于气有余(实证),使用泻青丸。如果在夜间盗汗、睡眠不安且伴有上述症状,属于血不足(虚证),使用地黄丸。如果是因为肝经的风邪传变至脾肾,也会导致咬紧牙齿,先使用柴胡清肝散,随后使用五味异功散和六味地黄丸。如果是由于脾胃虚热引起,使用补中益气汤加芍药、山栀;若是实热,则使用泻黄散。这是因为牙床归属于手阳明大肠经和足阳明胃经的缘故。如果是肝肾有热,使用六味地黄丸。
治验记录:
奚氏的女儿六岁,忽然发生惊风,出现眼球微动、咬紧牙齿,有时在睡眠中惊厥抽搐、痰涎壅盛,之前使用了化痰祛风等药物,病情反而加重。我说:面色发青并出现前述症状,属于肝木克制脾土,导致脾不能统摄涎液而上涌。应当滋补肾水以滋养肝血,这样风邪自会平息,痰浊自会消除。于是使用六味地黄丸治愈。
另一个小儿患有前述症状,痰涎自流,使用了治疗惊风的药物,症状更加严重,脾胃更加虚弱,观察其面色萎黄,口中吐痰,使用六君子汤合补中益气汤治愈。
导赤散(方剂见心脏章节)
地黄丸(方剂见肾脏章节)
泻青丸(方剂见肝脏章节)
补中益气汤(方剂见虚羸章节)
六味地黄丸(方剂见肾脏章节)
六君子汤(方剂见天钓章节)
《内经》说:各种风病引起的肢体摇动、眩晕,都归属于肝木。肝木遇到风就会摇动,这是肝经火盛而生虚风的表现。汤氏治疗郑都承的儿子摇头便血七年,使用祛风药、止血药,尝试多次均无效。这是肝经风热所侵袭,脾土受到肝木克制,不能统摄血液而溃入大肠,所以便血不止。于是配制清肝益胃汤,以平抑肝火、补益脾气、祛除风热,兼服胃风汤,十几天后所有症状全部痊愈。便血是因为风木摇动,导致脾土受凌辱虐待,而不能统摄血液。或者因为食用过多酸味食物,助长肝气,导致阴气凝结。《内经》说:结阴病,便血一升;再次凝结,便血二升;三次凝结,便血三升。另外,邪气在五脏,会导致阴脉不和,阴脉不和,血液就会停滞,形成结阴病。阴气在内凝结不得向外运行,渗入肠间,所以导致便血。血证也有因乳母愤怒,导致风热炽盛,或者肝木损伤脾土,使清气不升。或者风邪侵入大肠的情况。治疗方法:如果是因为风热,使用柴胡清肝散。如果是因为怒火,使用加味小柴胡汤。如果是因为清气不升、脾气下陷,使用补中益气汤。如果是因为风邪侵入大肠,使用清肝益胃丸。肝经血热妄行出血的,使用六味地黄丸。脾土不能培补肝木的,使用六君子汤、柴胡、钩藤钩。肝木胜过脾土的,使用四君子汤、芍药、钩藤钩。结阴病的,使用平胃地榆汤。
治验记录:
一个小儿伤风咳嗽、痰多涌出。我认为:这是脾虚肺弱,腠理不紧密,风邪外袭所致。使用六君子汤加桔梗、桑白皮、杏仁治愈;后来饮食停滞,导致腹泻腹胀,仍然使用六君子汤加山楂、厚朴而安定。又有一次停食导致腹泻,服用消导药物后,咳嗽更加严重。我认为:应当调补脾土。患儿家属不信。自行使用发表攻滞的药物,前面的症状更加严重,并增加了摇头症状。我用天麻散加倍加入钩藤钩及异功散治愈。
一个小儿颈部有结核,面色萎黄,身体消瘦,咬紧牙齿、抽搐,摇头、眨眼,这是肝木克制脾土的表现。使用六君子汤及九味芦荟丸迅速治愈。
一个小儿病后,遇到惊吓就痰多,咬紧牙齿、抽搐,摇头、腹泻,严格服用牛黄、麝香、朱砂等药物,导致慢惊风而死亡。
犀角屑 甘草 全蛇蜕(炙至黄色) 钩藤钩子 麻黄(去节,一钱) 黄芪(蜜炙) 羌活 防风 白芍药
以上药物研为细末,用枣肉捣烂制成梧桐子大小的丸药。每次服用五十丸,饭后用薄荷汤送服。
《海藏食疗》说:蛇蜕主要用来去除风邪、明目。治疗小儿一百二十种惊痫寒热等症,蛊毒安胎,炒用又可治疗风痫、弄舌摇头。所以前面的方剂中使用它。
平胃地榆汤 治疗结阴便血。
白术 陈皮 茯苓 厚朴 葛根(各五分) 地榆(七分) 干姜(五分) 炙甘草 当归 炒神曲 白芍药 人参 益智仁(各三分) 升麻 附子(炮制。各一钱)
以上每服一钱,用水煎服。
胃风汤(方剂见偏风口噤章节)
柴胡清肝散(方剂见诸热症章节)
加味小柴胡汤(方剂见肝脏章节)
补中益气汤(方剂见虚羸章节)
六味地黄丸(方剂见肾脏章节)
泻白散(方剂见肺脏章节)
六君子汤
四君子汤(两方见天钓章节)
天麻散(方剂见内嗽章节)
异功散(方剂见天钓章节)
九味芦荟丸(方剂见疳症章节)
After a child suffers from convulsions (Jingfeng), slight eye movements and teeth grinding occur due to the depletion of body fluids after illness, which fails to nourish the tendons and vessels. There are also cases where liver fright and deficiency heat generate internal wind; treatment should be based on an assessment of whether Qi and Blood are in excess or deficiency. If fever occurs during the day, with a desire for cold drinks accompanied by these symptoms, it indicates Qi excess, treated with Xieqing Wan (Drain the Liver Pill). If night sweats and restless sleep occur with these symptoms, it indicates Blood deficiency, treated with Dihuang Wan (Rehmannia Pill). If wind pathogen from the Liver channel transmits to the Spleen and Kidney, causing teeth grinding, first use Chaihu Qinggan San (Bupleurum Clearing the Liver Powder), followed by Wuwei Yigong San (Five-Ingredient Extraordinary Efficacy Powder) and Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill). If caused by deficiency heat in the Spleen and Stomach, use Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) added with Shaoyao (White Peony Root) and Shanzhi (Gardenia Fruit); if caused by excess heat, use Xiehuang San (Drain the Spleen Powder). This is because the gums belong to the Hand-Yangming Large Intestine and Foot-Yangming Stomach channels. If there is heat in the Liver and Kidney, use Liuwei Dihuang Wan.
Case Record:
The six-year-old daughter of the Xi family suddenly developed convulsions with eye movements and teeth grinding, sometimes experiencing convulsive twitching and excessive phlegm-saliva during sleep. Previous treatments with phlegm-resolving and wind-dispelling herbs worsened the condition. I stated: "The bluish complexion combined with the aforementioned symptoms indicates Liver Wood overacting on Spleen Earth, failing to control saliva, causing it to surge upward. One should nourish Kidney Water to generate Liver Blood, so that wind will subside and phlegm will dissipate." Consequently, Liuwei Wan was administered, resulting in a cure.
Another child suffered from the aforementioned symptoms with spontaneous drooling. Treatment with convulsion medicines worsened the condition and further weakened the Spleen and Stomach. Observing the sallow complexion and expectoration of phlegm, Liu Junzi Tang (Six-Gentlemen Decoction) combined with Buzhong Yiqi Tang was used, leading to recovery.
Daochi San (Formula see Heart Chapter)
Dihuang Wan (Formula see Kidney Chapter)
Xieqing Wan (Formula see Liver Chapter)
Buzhong Yiqi Tang (Formula see Emaciation Chapter)
Liuwei Dihuang Wan (Formula see Kidney Chapter)
Liu Junzi Tang (Formula see Tiandiao Chapter)
The Classic states: "All wind disorders involving tremors and dizziness belong to Liver Wood." When Wood encounters wind, it shakes; this represents deficiency wind generated by excessive fire in the Liver channel. Tang Shi treated the son of Prefect Zheng, who had head-shaking and hematochezia for seven years. Treatments with wind-dispelling and hemostatic herbs were ineffective. This was caused by wind-heat invading the Liver channel, where Spleen Earth was controlled by Liver Wood, failing to contain blood, which ulcerated into the Large Intestine, causing persistent hematochezia. Thus, Qinggan Yiwei Tang (Clear the Liver and Benefit the Stomach Decoction) was formulated to pacify the Liver, benefit the Spleen, and dispel wind-heat, along with concurrent administration of Weifeng Tang (Stomach Wind Decoction). After more than ten days, all symptoms resolved. Hematochezia occurs because wind-Wood shaking causes Spleen Earth to be oppressed, failing to control blood. Alternatively, excessive consumption of sour flavors may augment Liver Qi, leading to Yin condensation. The Classic states: "In Jieyin (Condensed Yin) disease, one sheng of blood is passed in stool; if condensed again, two sheng; if condensed thrice, three sheng." Furthermore, pathogens in the five Zang organs cause disharmony in the Yin pulses; disharmony leads to blood stasis, forming Jieyin disease. Internal condensation of Yin Qi prevents its outward circulation, allowing it to seep into the intestines, thus causing hematochezia. Other causes include a wet nurse's anger leading to vigorous wind-heat, or Liver Wood injuring Spleen Earth, preventing the ascent of clear Qi, or wind pathogen invading the Large Intestine. Treatment methods: For wind-heat, use Chaihu Qinggan San. For anger-fire, use Jiawei Xiaochaihu Tang (Modified Minor Bupleurum Decoction). For failure of clear Qi to ascend and sinking of Spleen Qi, use Buzhong Yiqi Tang. For wind pathogen invading the Large Intestine, use Qinggan Yiwei Wan. For reckless bleeding due to Liver channel blood-heat, use Liuwei Dihuang Wan. For Spleen Earth failing to nurture Liver Wood, use Liu Junzi Tang, Chaihu, and Goutenggou (Uncaria Rhynchophylla). For Liver Wood overcoming Spleen Earth, use Si Junzi Tang, Shaoyao, and Goutenggou. For Jieyin disease, use Pingwei Diyu Tang.
Case Record:
A child suffered from wind-cold cough with surging phlegm. I reasoned: "Spleen deficiency and Lung weakness lead to loose interstices, allowing external wind pathogen to invade." Treatment with Liu Junzi Tang added with Jiegeng (Platycodon Root), Sangpi (Mulberry Bark), and Xingren (Apricot Seed) resulted in a cure. Later, food stagnation caused diarrhea and abdominal distension; Liu Junzi Tang added with Shanzha (Hawthorn Fruit) and Houpo (Magnolia Bark) restored health. On another occasion, food stagnation caused diarrhea, but after taking digestive herbs, the cough worsened. I advised tonifying Spleen Earth. The family did not believe this and self-administered exterior-releasing and stagnation-breaking herbs, worsening previous symptoms and adding head-shaking. I treated with Tianma San (Gastrodia Powder) with doubled Goutenggou and Yigong San, resulting in a cure.
A child presented with cervical lymphadenopathy, sallow complexion, emaciation, teeth grinding, convulsions, head-shaking, and blinking. This indicated Liver Wood overacting on Spleen Earth. Treatment with Liu Junzi Tang and Jiawei Lushui Wan (Nine-Ingredient Aloe Pill) led to rapid recovery.
A child, after recovering from illness, experienced excessive phlegm upon fright, teeth grinding, convulsions, head-shaking, and diarrhea. Strict administration of Niu Huang (Calculus Bovis), Shexiang (Moschus), and Zhusha (Cinnabar) led to slow convulsions and death.
Xi Jiao Xie (Rhinoceros Horn Chips) Gancao (Licorice Root) Quan Shetui (Whole Snake Molt, roasted yellow) Goutenggou Zi (Uncaria Rhynchophylla Hook) Mahuang (Ephedra Stem, nodes removed, 1 qian) Huangqi (Astragalus Root, honey-roasted) Qianghuo (Notopterygium Rhizome) Fangfeng (Saposhnikovia Root) Baishaoyao (White Peony Root)
Grind into powder, mix with jujube flesh to form pills the size of tung seeds. Take 50 pills per dose, washed down with mint decoction after meals.
"Hai Zang Shi Liao" states: "Snake molt primarily removes wind pathogen and brightens the eyes. It treats 120 types of pediatric convulsions, epilepsy, colds, fevers, gu poison, and calms the fetus. Roasted, it treats wind epilepsy and tongue-playing/head-shaking." Hence, it is included in the aforementioned formula.
Pingwei Diyu Tang (Peace the Stomach and Cudweed Decoction) treats Jieyin hematochezia.
Baizhu (Atractylodes Macrocephala Rhizome) Chenpi (Tangerine Peel) Fuling (Poria) Houpo (Magnolia Bark) Gegen (Kudzu Root) (each 0.5 fen) Diyu (Sanguisorba Root) (0.7 fen) Ganjiang (Dried Ginger) (0.5 fen) Zhigancao (Honey-fried Licorice) Danggui (Angelica Sinensis) Chao Shenqu (Fried Medicated Leaven) Baishaoyao (White Peony Root) Renshen (Ginseng Root) Yizhi (Alpinia Oxyphylla Fruit) (each 0.3 fen) Shengma (Cimicifuga Rhizome) Fuzi (Aconite Lateral Root, processed) (each 1 qian)
Take 1 qian per dose, decoct in water and drink.
Weifeng Tang (Stomach Wind Decoction) (Formula see Deviated Mouth and Locked Jaw Chapter)
Chaihu Qinggan San (Bupleurum Clearing the Liver Powder) (Formula see Various Heat Syndromes Chapter)
Jiawei Xiaochaihu Tang (Modified Minor Bupleurum Decoction) (Formula see Liver Chapter)
Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) (Formula see Emaciation Chapter)
Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill) (Formula see Kidney Chapter)
Xiebai San (Drain the Lung Powder) (Formula see Lung Chapter)
Liu Junzi Tang
Si Junzi Tang (Four-Gentlemen Decoction) (Both formulas see Tiandiao Chapter)
Tianma San (Gastrodia Powder) (Formula see Internal Cough Chapter)
Yigong San (Extraordinary Efficacy Powder) (Formula see Tiandiao Chapter)
Jiawei Lushui Wan (Nine-Ingredient Aloe Pill) (Formula see Infantile Malnutrition Chapter)