小儿盗汗有二,虚实两分∶心虚者,阴气不敛也,睡则多惊,古法主酸枣仁汤(如当归、炒白芍、生地、茯
苓、炒酸枣仁、炒知母、炒黄柏、五味子、人参、炙黄 等味)。
心热者,火伤于阴也,身多烦热,古法主当归六黄汤(如当归、生地、熟地、黄芩、黄柏、黄连、炙黄 ,
引用浮麦)。
〔真按〕小儿睡中汗出,醒来则止,此心虚盗汗。宜和心气,养心血。但用前拟自汗本方党参、归身、
猪心等味,服之即愈。
若睡中遍身有汗,觉来久不干者,此食积盗汗脾冷所致。方
用正广皮八分,杭青皮八分,诃子肉四分,粉甘草四分,公丁香三分,引用五谷虫五分。
附诸汗外治法∶凡诸汗服药不止者,用五倍子一个,研细末,醋和作一小饼,贴肚脐,以带扎之,即能见效。
黄帝曰∶肺之令人咳,何也。歧伯曰∶五脏六腑皆令人咳,非独肺也。夫肺为华盖,口鼻相通,息之出入,
气之升降,必由之路,故专主气。《经》曰∶形寒饮冷则伤肺。由儿衣太薄及冷冻饮料之类,伤于寒也。《经》曰∶
热伤肺。由儿衣太浓,爱养过度,伤于热也。又曰∶皮毛者肺之合。皮毛先受邪气,邪气得从其合,使气上而不
下,逆而不收,充塞咽嗌,故令咳嗽也。
《病机式要》云∶咳嗽谓有声有痰,因肺气受伤,动乎脾湿而然也。咳谓无痰而有声,肺气伤而不清也。嗽
谓无声而有痰,脾虚动而为痰也。
二者虽俱属肺病,然又有肺寒肺热之分,食积分寒之别,宜详辨之。
脏腑皆令人咳,然必脏腑各受其邪,而终皆不离乎肺也。但因痰而嗽者痰为重,主治在脾;因咳而动痰者,
肺为重,主治在肺。
以时言之∶清晨咳者,属痰火;午前嗽者,属胃火;午后嗽者,属阴虚;黄昏嗽者,火浮于肺,二便嗽者,
食积滞于三焦;肺实者,烦嗽抱首,面赤反食;肺虚者,气逆虚鸣,面目白飧泄;肺热者,痰腥而稠,身热喘满,
鼻干面红,手捏眉目;肺寒者,嗽多痰清,面白而喘,恶风多涕。
又因其虚实寒热,调理各不相同,因作咳嗽解。
小儿盗汗有两种情况,分为虚证和实证两类:心气虚弱者,是由于阴气不能收敛所致,睡眠时容易受惊,古法治疗主要使用酸枣仁汤(包含当归、炒白芍、生地、茯苓、炒酸枣仁、炒知母、炒黄柏、五味子、人参、炙黄芪等药物)。
心火亢盛者,是由于火热损伤了阴液,身体多有烦热感,古法治疗主要使用当归六黄汤(包含当归、生地、熟地、黄芩、黄柏、黄连、炙黄芪,并引用浮小麦作为药引)。
〔真按〕(陈守真按语)小儿在睡眠中出汗,醒来后汗止,这是心气虚弱导致的盗汗。适宜调和心气,滋养心血。只需使用前文拟定的自汗基础方(党参、归身、猪心等药物),服用后即可痊愈。
如果在睡眠中全身都有汗出,醒来后很久汗液仍不干燥,这是由于食积停滞导致脾脏寒冷所引起的盗汗。处方使用正广皮八分,杭青皮八分,诃子肉四分,粉甘草四分,公丁香三分,引用五谷虫五分。
附列各种汗症的外治法:凡是各种汗症服药后仍不止汗的,取一个五倍子,研成细末,用醋调和做成一个小饼,贴在肚脐上,用带子扎紧,即可见效。
黄帝问道:肺为什么会让人咳嗽呢?歧伯回答说:五脏六腑的疾病都能导致咳嗽,并不仅仅是肺的问题。肺被称为华盖(覆盖于其他脏腑之上的脏器),通过口鼻与外界相通,呼吸的出入、气的升降,都必须经过肺这一通道,所以肺专门主管气机。《内经》说:形体受寒或饮用冷物会损伤肺。这是因为婴儿衣物太薄以及食用冷冻饮料等,受到了寒邪的伤害。《内经》又说:热邪会损伤肺。这是因为婴儿衣物太厚,养育过度,受到了热邪的伤害。又说道:皮毛是肺的外合部位。皮毛先受到邪气侵袭,邪气便顺着其相合的关系内传,使肺气上逆而不能下行,气机逆乱而不收敛,充塞咽喉,从而导致咳嗽。
《病机式要》中说:咳嗽是指既有声音又有痰,是因为肺气受伤,触动脾湿而形成的。咳是指没有痰但有声音,是肺气受伤而不清利所致。嗽是指没有声音但有痰,是脾虚产生痰湿所致。
这两种症状虽然都属于肺病,但又有肺寒和肺热的区别,食积也有寒热之分,应当详细辨别。
五脏六腑都能导致咳嗽,但必定是各脏腑分别受到邪气侵袭,最终都不离开肺的影响。但是因为痰而导致嗽的,以痰为重,治疗重点在脾;因为咳嗽而引发动痰的,以肺为重,治疗重点在肺。
从时间上来分析:清晨咳嗽的,属于痰火;午前嗽的,属于胃火;午后嗽的,属于阴虚;黄昏时嗽的,是火气浮越于肺;大小便时咳嗽的,是食积停滞在三焦;肺实证的,表现为烦躁咳嗽、抱头、面红且反常地想吃东西;肺虚证的,表现为气逆虚鸣、面色苍白、大便稀溏;肺热证的,表现为痰液腥臭且粘稠、身体发热、气喘胸闷、鼻子干燥、面色发红、手揉眉目;肺寒证的,表现为咳嗽多、痰液清稀、面色苍白且气喘、怕风、鼻涕多。
又根据其虚、实、寒、热的不同,调理方法各不相同,因此撰写了这篇咳嗽解。
There are two types of night sweats in children, divided into deficiency and excess patterns: In cases of Heart Qi deficiency (Heart Qi Deficiency), the Yin energy fails to consolidate. The child is prone to fright during sleep. The ancient method primarily prescribes Suanzaoren Tang (Sour Jujube Seed Decoction), which includes Danggui (Angelicae Sinensis Radix), Chao Baishao (Fried White Peony Root), Shengdi (Rehmanniae Radix), Fuling (Poria), Chao Suanzaoren (Fried Sour Jujube Seed), Chao Zhimu (Fried Anemarrhenae Rhizoma), Chao Huangbai (Fried Phellodendri Cortex), Wuweizi (Schisandrae Fructus), Renshen (Ginseng Radix et Rhizoma), and Zhi Huangqi (Honey-fried Astragali Radix).
In cases of Heart Heat (Heart Fire Hyperactivity), fire damages the Yin fluids, resulting in general restlessness and heat sensation. The ancient method primarily prescribes Danggui Liuhuang Tang (Angelica Hexa-Huang Decoction), which includes Danggui (Angelicae Sinensis Radix), Shengdi (Rehmanniae Radix), Shudi (Prepared Rehmanniae Radix), Huangqin (Scutellariae Radix), Huangbai (Phellodendri Cortex), Huanglian (Coptidis Rhizoma), Zhi Huangqi (Honey-fried Astragali Radix), with Fumai (Tritici Levigati Fructus) used as a guide drug.
[Commentary by Chen Shouzhen] Night sweats in children that cease upon waking indicate Heart Qi deficiency causing night sweats. It is appropriate to harmonize Heart Qi and nourish Heart Blood. Simply using the previously proposed base formula for spontaneous sweating (Dangshen [Codonopsis Radix], Guishen [Angelicae Sinensis Radix], Zhu Xin [Porcis Cor]), taken orally, will lead to recovery.
If there is generalized sweating throughout the body during sleep, which remains wet for a long time after waking, this is night sweats caused by food stagnation leading to Spleen Cold. The prescription uses Zheng Guangpi (Aurantii Pericarpium Rubrum, specifically from Guangdong), Hang Qingpi (Aurantii Pericarpium Viride, specifically from Hangzhou), Hezi Rou (Terminaliae Chebulae Fructus Carnosum), Fen Gancao (Glycyrrhizae Radix et Rhizoma Preparata), Gong Dingxiang (Syzygii Aromatisati Flos), with Wugu Chong (Larva Bomby Mori Batryticata) used as a guide drug.
Appendix: External treatments for various types of sweating: For any type of sweating that does not stop despite oral medication, take one Wubeizi (Galla Chinensis), grind it into fine powder, mix with vinegar to form a small cake, apply it to the navel (Shenque, CV8), and secure it with a belt. This will yield effective results.
The Yellow Emperor asked: Why does the Lung cause coughing? Qibo replied: Diseases of the five Zang organs and six Fu organs can all cause coughing; it is not exclusive to the Lung. The Lung is known as the "Canopy" (Huagai), covering other organs. It connects via the mouth and nose to the exterior. The entry and exit of breath, and the ascending and descending of Qi, must pass through the Lung; thus, the Lung exclusively governs Qi. The Classics state: "Cold affecting the form and cold drinks injure the Lung." This occurs because infants wear too little clothing or consume frozen beverages, thereby injuring the Lung with Cold pathogens. The Classics also state: "Heat injures the Lung." This occurs because infants are dressed too warmly or cared for excessively, thereby injuring the Lung with Heat pathogens. It is further stated: "The skin and hair are the external correspondence of the Lung." When the skin and hair are first invaded by pathogenic factors, these pathogens enter via their corresponding organ, causing Lung Qi to ascend rather than descend, becoming rebellious and failing to consolidate. This blocks the throat and pharynx, resulting in coughing.
Bingji Shi Yao states: Cough (Kesu) refers to symptoms with both sound and phlegm, arising from Lung Qi injury stirring up Spleen dampness. Ke (Ke) refers to symptoms with sound but no phlegm, caused by Lung Qi injury and lack of clarity. Sou (Sou) refers to symptoms with phlegm but no sound, caused by Spleen deficiency generating phlegm.
Although both conditions belong to Lung diseases, there are distinctions between Lung Cold and Lung Heat, and between Cold and Excess/Heat in food stagnation; these must be carefully differentiated.
While the five Zang and six Fu organs can all cause coughing, each must receive its respective pathogen, yet the pathology ultimately always involves the Lung. However, when coughing is driven by phlegm (Sou), the phlegm is the primary issue, and treatment focuses on the Spleen; when coughing (Ke) stirs up phlegm, the Lung is the primary issue, and treatment focuses on the Lung.
Analyzing by time: Coughing in the early morning belongs to Phlegm-Fire; coughing before noon belongs to Stomach Fire; coughing in the afternoon belongs to Yin Deficiency; coughing at dusk indicates Fire floating to the Lung; coughing during urination or defecation indicates Food Stagnation obstructing the Sanjiao (Triple Burner); in cases of Lung Excess, there is irritability, coughing while holding the head, flushed face, and paradoxical appetite; in cases of Lung Deficiency, there is rebellious Qi with empty wheezing, pale complexion, and loose stools; in cases of Lung Heat, phlegm is fishy and thick, accompanied by fever, panting, chest fullness, dry nose, red face, and rubbing of the eyebrows and eyes; in cases of Lung Cold, there is frequent coughing with clear phlegm, pale face, panting, aversion to wind, and excessive nasal discharge.
Furthermore, regulation and treatment vary according to deficiency, excess, cold, and heat. Therefore, this section on the analysis of coughing is composed.