痰火稍退,余热尚存者,古法主琥珀抱龙丸(如人参、琥珀、茯神、山药、甘草、天竺黄、檀香、枳壳、枳
实、辰砂、胆星、金箔等味,研末蜜丸),淡姜汤化下。
脾虚多痰者,古法主清心涤痰汤(如竹茹、橘红、半夏、茯苓、枳实、甘草、麦冬、枣仁、人参、菖蒲、南
星、黄连,引用生姜,水煎服)。
〔真按〕痰火闭证善后方剂,只要清热养血,方用细生地二钱,玫瑰炒竹茹钱半,黑山栀五分,青蒿脑八分,
粉丹皮一钱,
生白芍八分,生甘草梢五分,甘澜水煎服。
此症或缘禀赋虚弱,土虚木盛者有之,或由急惊过用峻利之药,以致转成此证者,亦有之。发时缓缓搐搦,
时作时止,面色淡黄,或青白相兼,身必温和,昏睡眼合,或睡卧露睛,脉来迟缓,大便青色,此乃脾胃虚弱,
元气损伤,虚而夹痰者,古法主醒脾汤(如人参、白术、茯苓、天麻、半夏、橘红、全蝎、僵蚕、甘草、木香、
仓米、胆南星,引用生姜)。
脾虚夹痰者,古法主缓肝理脾汤(如桂枝、人参、茯苓、白芍、白术、陈皮山药、扁豆、甘草,引用煨姜、大枣)。
〔真按〕时俗所谓慢惊风者,即木侮土也。小儿受暑受寒,或伤乳食,皆能作吐作泻,或吐泻交作,久则
脾土虚弱,肝木乘之,其泻渐见青色,面部痿白带青,手足微搐无力,神气恹恹不振,慎防暴脱,若手足一边摇
动者,十难救其一二,初起即宜用五味异功散加减,方以炒白术二钱,云茯苓三钱,炙甘草五分,化州橘红一钱,
扁豆衣钱半,猪苓半钱,泽泻钱半。吐泻加藿香梗五分,川浓朴六分。若手足皆冷,脉息细微,唇舌痿白,此将
脱之证,方用西党参钱半,炒白术三钱,北干姜五分,上肉桂二分,炙甘草一钱,温中回阳,以救其脱。
痰火症状稍退,但体内仍有残余热邪的情况,古法主张使用琥珀抱龙丸(包含人参、琥珀、茯神、山药、甘草、天竺黄、檀香、枳壳、枳实、辰砂、胆星、金箔等药材,研磨成粉末后用蜂蜜制成丸剂),用淡姜汤送服。
脾脏虚弱且多痰的患者,古法主张使用清心涤痰汤(包含竹茹、橘红、半夏、茯苓、枳实、甘草、麦冬、枣仁、人参、菖蒲、南星、黄连,引用生姜作为药引,加水煎煮后服用)。
〔陈守真按语〕针对痰火闭阻证善后调理的方剂,关键在于清热和养血。方用细生地二钱,玫瑰炒竹茹一钱半,黑山栀五分,青蒿脑八分,粉丹皮一钱,生白芍八分,生甘草梢五分,用甘澜水煎煮后服用。
此病证有的因为先天禀赋虚弱,导致土虚木盛;有的因为急惊风治疗时过度使用峻烈攻下的药物,以致转变为这种证候。发作时抽搐缓慢,时断时续,面色淡黄,或青白相间,身体必然温和,昏睡且眼睛闭合,或者睡觉时眼睛睁开露出眼珠,脉象迟缓,大便呈青色。这是脾胃虚弱,元气受损,因虚而夹杂痰浊的表现。古法主张使用醒脾汤(包含人参、白术、茯苓、天麻、半夏、橘红、全蝎、僵蚕、甘草、木香、仓米、胆南星,引用生姜)。
脾虚夹杂痰浊的患者,古法主张使用缓肝理脾汤(包含桂枝、人参、茯苓、白芍、白术、陈皮、山药、扁豆、甘草,引用煨姜、大枣)。
〔陈守真按语〕世俗所说的慢惊风,即属于“木侮土”的病理机制。小儿感受暑气或寒气,或者乳食损伤,都能引起呕吐和腹泻,或者吐泻同时发生。日久则脾土虚弱,肝木乘虚克制脾土,其腹泻逐渐变为青色,面部萎黄带青,手足轻微抽搐无力,精神萎靡不振,需谨防阳气暴脱。如果手足出现一侧摇动的情况,十人中难救一二。初起时宜用五味异功散加减,方用炒白术二钱,云茯苓三钱,炙甘草五分,化州橘红一钱,扁豆衣一钱半,猪苓半钱,泽泻一钱半。若伴有吐泻,加藿香梗五分,川厚朴六分。如果手足皆冷,脉象细微,嘴唇和舌色萎白,这是即将脱证的危象,方用西党参一钱半,炒白术三钱,北干姜五分,上肉桂二分,炙甘草一钱,以温中回阳,挽救脱证。
When phlegm-fire symptoms have subsided slightly but residual heat remains, ancient methods primarily recommend Hu Po Bao Long Wan (Amber Embracing Dragon Pill, containing herbs such as Renshen [Ginseng Radix], Hupo [Succinum], Fushen [Poria with Hostwood], Shanyao [Dioscoreae Rhizoma], Gancao [Licorice Root], Tianzhu Huang [Bambusae Caulis in Taeniae], Tanxiang [Santalum Album Lignum], Zhike [Aurantii Fructus Immaturus], Zhishi [Aurantii Fructus Immaturus], Chensha [Cinnabaris], Dansheng [Arisaematis Cum Bile], Jinbo [Folium Aurum et Argentum], etc., ground into powder and formed into pills with honey), taken down with weak ginger decoction.
For patients with Spleen deficiency and excessive phlegm, ancient methods primarily recommend Qing Xin Di Tan Tang (Clear Heart and Purge Phlegm Decoction, containing Zhuru [Bambusae Caulis in Taeniae], Juhong [Citri Reticulatae Pericarpium], Banxia [Pinelliae Rhizoma], Fuling [Poria], Zhishi [Aurantii Fructus Immaturus], Gancao [Licorice Root], Maimai Dong [Ophiopogonis Radix], Zao Ren [Ziziphi Spinosae Semen], Renshen [Ginseng Radix], Changpu [Acori Tatarinowii Rhizoma], Nanxing [Arisaematis Cum Bile], Huanglian [Coptidis Rhizoma], using Shengjiang [Zingiberis Rhizoma Recens] as a guide drug, decocted in water for oral administration).
[Chen Shouzhen's Note:] For post-treatment formulas for the syndrome of phlegm-fire obstruction, the key lies in clearing heat and nourishing blood. The formula uses Xi Shengdi [Rehmanniae Radix Recens] 2 qian, Rose-fried Zhuru [Bambusae Caulis in Taeniae] 1.5 qian, Hei Shanzhi [Gardeniae Fructus] 0.5 fen, Qinghao Nao [Artemisiae Annuae Herba Cortex], Fen Danpi [Moutan Cortex] 1 qian, Sheng Baishao [Paeoniae Radix Alba] 0.8 qian, Sheng Gancao Shao [Glycyrrhizae Radix et Rhizoma] 0.5 fen, decocted in Ganlan Water [water boiled vigorously to create ripples] for oral administration.
This condition may arise from congenital weakness leading to Earth deficiency and Wood excess, or it may result from the overuse of harsh purgative drugs during the treatment of acute convulsions, transforming into this syndrome. During attacks, there is slow twitching and convulsion, intermittent in nature. The complexion is pale yellow or a mix of cyan and white. The body temperature is necessarily mild. The patient sleeps deeply with eyes closed, or sleeps with eyes open revealing the whites. The pulse is slow and sluggish, and stool is green. This indicates Spleen-Stomach weakness, damage to Yuan Qi [Original Qi], and phlegm accumulation due to deficiency. Ancient methods primarily recommend Xing Pi Tang (Awaken the Spleen Decoction, containing Renshen [Ginseng Radix], Baizhu [Atractylodis Macrocephalae Rhizoma], Fuling [Poria], Tianma [Gastrodiae Rhizoma], Banxia [Pinelliae Rhizoma], Juhong [Citri Reticulatae Pericarpium], Quanxie [Scorpio], Jiangcan [Bombyx Batryticatus], Gancao [Licorice Root], Muxiang [Aucklandiae Radix], Cangmi [Coicis Semen], Danshanxing [Arisaematis Cum Bile], using Shengjiang [Zingiberis Rhizoma Recens]).
For patients with Spleen deficiency complicated by phlegm, ancient methods primarily recommend Huan Gan Li Pi Tang (Soothe Liver and Regulate Spleen Decoction, containing Guizhi [Cinnamomi Ramulus], Renshen [Ginseng Radix], Fuling [Poria], Baishao [Paeoniae Radix Alba], Baizhu [Atractylodis Macrocephalae Rhizoma], Chenpi [Citri Reticulatae Pericarpium], Shanyao [Dioscoreae Rhizoma], Bian Dou [Lablab Seed], Gancao [Licorice Root], using Wei Jiang [Zingiberis Rhizoma Praeparatum] and Dazao [Jujubae Fructus] as guide drugs).
[Chen Shouzhen's Note:] What is commonly known as slow convulsions refers to the pathological mechanism of "Wood insulting Earth." When children are affected by summer-heat or cold, or suffer from dietary injury, it can cause vomiting and diarrhea, or simultaneous vomiting and diarrhea. Over time, Spleen Earth becomes weak, and Liver Wood overacts upon it. The diarrhea gradually turns green, the face appears sallow with a bluish tint, hands and feet exhibit slight twitching and weakness, and spirit is listless. One must be cautious of sudden collapse. If one side of the hands and feet trembles, only one or two out of ten might be saved. At the onset, Wu Wei Yi Gong San (Five-Ingredient Powder to Benefit the Work) should be used with modifications: Chao Baizhu [Stir-fried Atractylodis Macrocephalae Rhizoma] 2 qian, Yun Fuling [Yunnan Poria] 3 qian, Zhi Gancao [Honey-fried Licorice Root] 0.5 fen, Huazhou Juhong [Huazhou Citri Reticulatae Pericarpium] 1 qian, Biandou Yi [Lablab Seed Coat] 1.5 qian, Zhuling [Polyporus] 0.5 qian, Zexie [Alismatis Rhizoma] 1.5 qian. Add Huoxiang Geng [Agastaches Herba Stem] 0.5 fen and Chuan Houpo [Magnoliae Officinalis Cortex] 0.6 fen if vomiting and diarrhea occur. If hands and feet are cold, the pulse is fine and minute, and lips and tongue are sallow and white, this is a pre-collapse syndrome. Use Xidangshen [Western Codonopsis Radix] 1.5 qian, Chao Baizhu [Stir-fried Atractylodis Macrocephalae Rhizoma] 3 qian, Bei Ganjiang [Northern Zingiberis Rhizoma] 0.5 fen, Shang Rougui [Superior Cinnamomi Cortex] 0.2 fen, Zhi Gancao [Honey-fried Licorice Root] 1 qian, to warm the middle and restore Yang to rescue from collapse.