小儿受暑之后,复感风寒,其证发热无汗,口渴饮水,面色红赤,干呕恶心,或腹中绞痛。嗜卧懒食,古
法主二香饮(如苏叶、藿香、茯苓、扁豆、浓朴、陈皮、半夏、甘草、大腹皮、白芷、桔梗、黄连、香薷,引用
生姜、灯芯)。
〔真按〕香薷辛温升散,即使以苦降之杏仁芩连制之,总不适用。但以苏叶五分,藿香五分,茯苓钱半,浓
朴八分,扁豆衣一钱,川黄连三分,引用鲜荷梗二钱、灯芯三十寸,为剂。
小儿伤暑气虚,症见身热有汗,头痛口渴,烦躁不宁,足冷恶寒,气乏神倦者,可于清暑之中,少加人参以益气。
小儿伤暑夹食,或吐或泻者,但用川浓朴一钱,扁豆衣钱半,山楂二钱,猪苓三钱,枳实五分,生甘草三分,
鲜荷叶边钱半为引。
小儿暑风,因暑热攻肝,而状似惊风者,其症烦渴身热有汗,手足抽搐,急宜利火降痰,但用川黄连六分,
连翘钱半,黑栀子五分,飞滑石三钱,细木通八分,淡黄芩八分,小枳实八分,栝蒌霜钱半,车前子一钱,生甘
草三分,鲜荷花露一两,冲药徐徐服之。
小儿暑热冲心,或挟痰上冲,以致精神昏愦者,但用辰砂益元散三钱,灯芯三十寸,煎汤化抱龙丸一分服之。
湿邪有三大原因,曰天地人。何则?属于天者,雨露之湿,从天而下降也。属于地者,泥水之湿,由地之所
生也。属于人者,酒浆之快饮,生冷之恣食,汗衣之穿,湿席之卧,澡浴衣履之不干,无一非人自取之地。经
曰∶诸湿胀满,皆属于脾。是治湿固当以理脾为先着,然湿因于寒为寒湿,因于热为热湿,因于风为风湿,因于
燥为燥湿,是湿又当视其所因而通变之。治湿之法∶湿在上宜散,湿在中宜燥,湿在下宜清,然此亦守经之法。
施于小儿,又当大而变之之谓化,化而不可知之之谓神,法虽不能尽详,爰照一隅之举,为伤湿病。
小儿在感受暑邪之后,又复感风寒,其症状表现为发热且无汗,口渴想喝水,面色红赤,干呕恶心,或者腹部绞痛。精神嗜睡,懒于进食,古代医法主张使用二香饮(包含苏叶、藿香、茯苓、扁豆、浓朴、陈皮、半夏、甘草、大腹皮、白芷、桔梗、黄连、香薷,煎药时加入生姜、灯芯作为引经药)。
〔陈守真按语〕香薷性味辛温,具有升散作用,即使使用苦降性质的杏仁、黄芩、黄连来制约它,总体上也不适用。因此建议改用苏叶五分,藿香五分,茯苓一钱半,浓朴八分,扁豆衣一钱,川黄连三分,煎药时加入鲜荷梗二钱、灯芯三十寸作为引经药,以此配伍成方。
小儿因伤暑导致气虚,症状见身体发热且有汗,头痛口渴,烦躁不安,脚部发冷并怕冷,气息虚弱、精神疲倦的,可以在清解暑热的方剂中,少量加入人参以补益元气。
小儿伤暑兼夹食积,出现呕吐或腹泻症状的,仅使用川浓朴一钱,扁豆衣一钱半,山楂二钱,猪苓三钱,枳实五分,生甘草三分,鲜荷叶边一钱半作为引经药。
小儿患暑风病,因暑热之邪攻冲肝脏,症状类似惊风,表现为烦渴、身热有汗,手足抽搐,应当紧急采用利火降痰的方法,仅使用川黄连六分,连翘一钱半,黑栀子五分,飞滑石三钱,细木通八分,淡黄芩八分,小枳实八分,栝蒌霜一钱半,车前子一钱,生甘草三分,鲜荷花露一两,将药物混合后徐徐服用。
小儿暑热之邪冲犯心脏,或者挟带痰浊上冲,导致精神昏沉迷糊的,仅使用辰砂益元散三钱,灯芯三十寸,煎汤送服抱龙丸一分。
湿邪产生的原因主要有三个方面,即天、地、人。什么是属于天的?雨露湿气,是从天空下降而来的。什么是属于地的?泥水湿气,是由地面滋生出来的。什么是属于人的?痛快饮酒,恣意食用生冷食物,穿着汗湿的衣服,卧于潮湿的席子,洗澡后衣服鞋履不干,这些无一不是人自己招致的。《内经》说:“各种湿邪导致的胀满病症,都归属于脾。”所以治疗湿病固然应当以调理脾胃为首要步骤,然而湿邪若因寒邪引起则为寒湿,因热邪引起则为热湿,因风邪引起则为风湿,因燥邪引起则为燥湿,因此治疗湿病又应当根据其所夹杂的病因而灵活变通。治疗湿病的方法:湿邪在上焦宜用发散法,湿邪在中焦宜用燥湿法,湿邪在下焦宜用清利法,但这只是遵循经典的原则。应用于小儿时,又应当在大的原则下进行变化,这种变化称为“化”,变化到不可预知的地步称为“神”。治疗方法虽不能详尽列举,现举一例,以说明伤湿病的治疗。
After a child contracts summerheat (Shu, 暑) and subsequently is exposed to wind-cold (Fenghan, 风寒), the symptoms include fever without sweating, thirst with desire to drink, flushed complexion, dry retching or nausea, or colicky abdominal pain. The child may exhibit lethargy and loss of appetite. Ancient methods primarily recommend Erxiang Yin (Two Fragrances Decoction), which contains Perillae Folium (Suye, 紫苏叶), Agastache Herba (Huoxiang, 藿香), Poria (Fuling, 茯苓), Dolichos Lablab Seed (Bian Dou, 扁豆), Magnolia Bark (Nongpu, 厚朴), Citrus Reticulatae Pericarpium (Chenpi, 陈皮), Pinellia Rhizome (Banxia, 半夏), Glycyrrhiza Root (Gancao, 甘草), Areca Peel (Dafupi, 大腹皮), Angelica Dahurica Root (Baizhi, 白芷), Platycodon Root (Jiegeng, 桔梗), Coptis Rhizome (Huanglian, 黄连), and Elsholtzia Herba (Xiangru, 香薷), with Fresh Ginger (Shengjiang, 生姜) and Juncus Effusus Spike (Dengxin, 灯芯) as guides.
[Commentary by Chen Shouzhen] Xiangru (Elsholtzia Herba) is acrid and warm in nature, possessing ascending and dispersing properties. Even if its action is restrained by bitter-descending agents such as Apricot Kernel (Xingren, 杏仁), Scutellaria Root (Huangqin, 黄芩), and Coptis Rhizome (Huanglian, 黄连), it is generally not suitable. Therefore, it is recommended to use Perillae Folium (Suye, 紫苏叶) 1.5g, Agastache Herba (Huoxiang, 藿香) 1.5g, Poria (Fuling, 茯苓) 4.5g, Magnolia Bark (Nongpu, 厚朴) 2.4g, Dolichos Lablab Seed Coat (Biandouyi, 扁豆衣) 3g, and Coptis Rhizome (Chuan Huanglian, 川黄连) 0.9g, with Fresh Lotus Stem (Xian Hegeng, 鲜荷梗) 6g and Juncus Effusus Spike (Dengxin, 灯芯) 10cm as guides, prepared as a decoction.
When a child suffers from summerheat leading to Qi deficiency, presenting with fever accompanied by sweating, headache, thirst, restlessness, cold feet, aversion to cold, weak breath, and mental fatigue, Ginseng Radix et Rhizoma (Renshen, 人参) should be added in small amounts to tonify Qi within a formula that clears summerheat.
For children suffering from summerheat complicated by food stagnation, manifesting as vomiting or diarrhea, use only Magnolia Bark (Chuan Nongpu, 川浓朴) 3g, Dolichos Lablab Seed Coat (Biandouyi, 扁豆衣) 4.5g, Hawthorn Fruit (Shanzha, 山楂), Polyporus (Zhu Ling, 猪苓) 9g, Immature Bitter Orange (Zhishi, 枳实) 1.5g, Raw Licorice Root (Sheng Gancao, 生甘草) 0.9g, and Fresh Lotus Leaf Margin (Xian Heyebian, 鲜荷叶边) 4.5g as a guide.
Pediatric Summerwind Disease (Shufeng, 暑风) occurs when summerheat-heat attacks the Liver, resembling convulsive disorders. Symptoms include irritability, thirst, fever with sweating, and spasms of the hands and feet. It is urgent to clear fire and descend phlegm. Use Coptis Rhizome (Chuan Huanglian, 川黄连) 1.8g, Forsythia Fruit (Lianqiao, 连翘) 4.5g, Gardenia Fruit (Hei Zhizi, 黑栀子) 1.5g, Calcined Talcum (Fei Huashi, 飞滑石) 9g, Akebia Caulis (Xi Mutong, 细木通) 2.4g, Scutellaria Root (Dan Huangqin, 淡黄芩) 2.4g, Immature Bitter Orange (Xiao Zhishi, 小枳实) 2.4g, Trichosanthes Powder (Gualou Shuang, 栝蒌霜) 4.5g, Plantago Seed (Cheqianzi, 车前子) 3g, Raw Licorice Root (Sheng Gancao, 生甘草) 0.9g, and Fresh Lotus Flower Dew (Xian Hehua Lu, 鲜荷花露) 30ml. Mix the herbs and administer slowly.
When summerheat-heat rushes to the Heart in children, or when it carries phlegm upward, causing mental confusion and stupor, use Cinnabar Yi Yuan San (Chensha Yiyuan San, 辰砂益元散) 9g and Juncus Effusus Spike (Dengxin, 灯芯) 10cm. Decoct these in water and dissolve Baolong Wan (Bao Long Pill, 抱龙丸) 0.3g to administer orally.
The causes of Dampness (Shi, 湿) are threefold: Heaven, Earth, and Human. What belongs to Heaven? Rain and dew moisture descend from the sky. What belongs to Earth? Mud and water moisture arise from the ground. What belongs to Human? Rapid consumption of alcoholic beverages, excessive intake of raw and cold foods, wearing sweat-soaked clothes, sleeping on damp mats, and not drying clothes and shoes after bathing—none of these are not self-inflicted. The Classic states: "All dampness-induced distension and fullness belong to the Spleen." Therefore, treating dampness must prioritize regulating the Spleen. However, dampness caused by Cold becomes Cold-Dampness; by Heat, Heat-Dampness; by Wind, Wind-Dampness; by Dryness, Dryness-Dampness. Thus, treatment must vary according to the causative factor. Methods for treating dampness: Dampness in the Upper Jiao should be dispersed; Dampness in the Middle Jiao should be dried; Dampness in the Lower Jiao should be cleared. These are standard classical methods. When applied to children, further transformation is required. This transformation is called "Hua" (Transformation); when transformation reaches an unpredictable level, it is called "Shen" (Spirit/Divine). Although methods cannot be exhaustively detailed, one example is provided here regarding diseases caused by Dampness.