小儿睡中惊动,由心肾不足所致。盖心主血与神,肝藏血与魂,肺主气与魄,肾主精与恐。
小儿脏腑脆弱,易为惊恐,恐则气下,惊则心无所根据,神无所归。且夫人之神气,寤则行于
目,寐则栖于肾。今心肾既虚,则不能宁摄精神,故睡中惊动也。治宜清心安神,用茯苓补
心汤加酸枣仁、茯神、五味。亦有惊吓而作者,因击动其肝,故魂不安也。治宜镇惊定魂,
用安神镇惊丸。若饮食间因惊而停滞者,用六君子加神曲、浓朴,食既消而惊未定,用茯苓
补心汤。若木火太过而心神不宁者,用导赤散。风热相搏者,用柴胡栀子散。食郁生痰惊动
不安者,用四君以健脾;神曲、半夏以化痰;山栀、芍药以清热。
治验
一小儿夜睡忽然惊动如搐,大便酸臭而色青,此饮食伤脾而肝旺也。先用异功散加柴胡、升
麻、山栀,又用四味肥儿丸而愈。
一小儿不时睡中惊动发搐,作渴饮冷,左腮青额间赤,先用柴胡清肝散,加钩藤钩四剂以治
肝火,后用五味异功散以健脾,又用地黄丸补肾肝而安。
导赤散(方见心脏)
柴胡栀子散(方见诸热症,即栀子清肝散)
六味丸(方见肾脏)
四君子汤
六君子汤
五味异功散(三方见天钓)
茯苓补心汤(方见喑)
安神镇惊丸(方见急惊)
小儿在睡眠中出现惊动不安的症状,是由心肾两脏不足所导致的。因为心主管血液与神志,肝贮藏血液与魂,肺主管气与魄,肾主管精液与恐惧之情。
小儿的脏腑功能脆弱,容易受到惊恐的影响。恐惧会导致气机下陷,惊吓则使心神失去依托,神志无处归依。而且人的神气,清醒时运行于眼睛,睡眠时潜藏于肾脏。现在心肾既已虚弱,就不能安宁地摄持精神,所以会在睡中惊动。治疗应当清心安神,使用茯苓补心汤,并加入酸枣仁、茯神、五味子。也有因受惊吓而发病的,这是因为击动伤及了肝脏,导致魂不能安守。治疗应当镇惊定魂,使用安神镇惊丸。如果在饮食过程中因惊吓而导致食滞不化的,使用六君子汤加神曲、厚朴;如果食物已经消化但惊悸仍未平复的,使用茯苓补心汤。如果是木火之气太过导致心神不宁的,使用导赤散。如果是风热邪气相互搏结的,使用柴胡栀子散。如果是食积郁而生痰,导致惊动不安的,用四君子汤来健脾;用神曲、半夏来化痰;用山栀、芍药来清热。
治验案例:
有一个小孩夜间睡觉忽然惊动,症状类似抽搐,大便气味酸臭且颜色发青,这是饮食损伤脾胃而肝气旺盛所致。先用异功散加柴胡、升麻、山栀,后又用四味肥儿丸而痊愈。
另一个小孩不时在睡中惊动并发出抽搐,口渴想喝冷水,左腮部发青而额头间发红,先用柴胡清肝散,加钩藤钩四剂以治疗肝火,后用五味异功散来健脾,又用地黄丸补肾肝从而安定病情。
导赤散(方剂见心脏篇)
柴胡栀子散(方剂见诸热症篇,即栀子清肝散)
六味丸(方剂见肾脏篇)
四君子汤
六君子汤
五味异功散(以上三方见天钓篇)
茯苓补心汤(方剂见喑哑篇)
安神镇惊丸(方剂见急惊篇)
Infantile restlessness during sleep is caused by deficiency of the Heart and Kidney. The Heart governs Blood and Shen (Spirit), the Liver stores Blood and Hun (Ethereal Soul), the Lung governs Qi and Po (Corporeal Soul), and the Kidney governs Jing (Essence) and Fear.
The Zang-Fu organs of infants are fragile, making them susceptible to fright and fear. Fear causes Qi to sink downward, while fright leaves the Heart-Shen without foundation and nowhere to reside. Furthermore, the Shen-Qi of a person circulates through the eyes when awake and rests in the Kidneys when asleep. Now that the Heart and Kidney are deficient, they cannot calm and secure the Spirit, resulting in restlessness during sleep. Treatment should focus on clearing the Heart and calming the Shen, using Lingzhi Buxin Tang (Poria Decoction for Nourishing the Heart) with added Suanzaoren (Ziziphus Seed), Fushen (Poria with Hostwood), and Wuweizi (Schisandra Fruit). There are also cases caused by sudden fright, where the Liver is disturbed, causing the Hun to be unsettled. Treatment should focus on settling fright and stabilizing the Hun, using Anshen Zhenjing Wan (Calming the Spirit and Settling Fright Pill). If food stagnation occurs due to fright during eating, use Liujunzi Tang (Six Gentlemen Decoction) with Shenqu (Medicated Leaven) and Houpo (Magnolia Bark); if the food has digested but the fright remains unsettled, use Lingzhi Buxin Tang. If excessive Wood-Fire leads to an unsettled Heart-Shen, use Daochi San (Guide Out Red Powder). If Wind-Heat combats each other, use Chaihu Zhizi San (Bupleurum and Gardenia Powder). If food depression generates Phlegm causing restlessness and fright, use Sijunzi Tang (Four Gentlemen Decoction) to strengthen the Spleen; Shenqu and Banxia (Pinellia Tuber) to transform Phlegm; Zhizi (Gardenia Fruit) and Shaoyao (Peony Root) to clear Heat.
Case Records:
An infant suddenly became restless during night sleep, resembling convulsions, with sour-smelling green stools. This was due to dietary injury to the Spleen and hyperactive Liver. Initially, Yigong San (Extraordinary Power Powder) with Chaihu (Bupleurum Root), Shengma (Cimicifuga Rhizome), and Zhizi (Gardenia Fruit) was used, followed by Siming Fei'er Wan (Four Ingredients for Enriching the Child Pill) until recovery.
Another infant frequently experienced restlessness and convulsions during sleep, with thirst for cold drinks, blueness on the left cheek, and redness on the forehead. Initially, Chaihu Qinggan San (Bupleurum Liver-Clearing Powder) with Gouteng (Uncaria Ramulus with Hook) for four doses was used to treat Liver Fire, followed by Wumei Yigong San (Five-Ingredient Extraordinary Power Powder) to strengthen the Spleen, and Dihuang Wan (Rehmannia Pill) to tonify the Kidney and Liver for stabilization.
Daochi San (Formula see Heart Chapter)
Chaihu Zhizi San (Formula see Various Heat Syndromes Chapter, i.e., Zhizi Qinggan San)
Liujunzi Wan (Formula see Kidney Chapter)
Sijunzi Tang (Four Gentlemen Decoction)
Liujunzi Tang (Six Gentlemen Decoction)
Wumei Yigong San (The above three formulas see Tian Diao Chapter)
Lingzhi Buxin Tang (Formula see Aphonia Chapter)
Anshen Zhenjing Wan (Formula see Acute Convulsion Chapter)