小儿伤风,属肺居多。症见身热脉浮,指纹红紫而长,涕流、鼻塞、声重者是。古法主香苏散(如紫苏叶、
香附、苍术、陈皮、炙甘草、姜,葱白为引)。
〔真按〕风邪伤卫,卫主皮毛,内合于肺,故见上症。然单
独伤风在肺,儿体柔脆,不宜过表。但用桑叶、苦杏仁、化橘红、淅贝母、炒枳壳、炙甘草,一剂风散热退为度。
小儿太阳伤风,阳浮而阴弱,阳浮者热自发,阴弱者汗自出,淅淅恶风,翕翕发热。古法主桂枝汤(如桂枝、
白芍、甘草、姜枣为引)。
〔真按〕桂枝汤为治太阳伤风自汗而设。儿体受风,未必恰在足太阳经,使从发散阳经,恐虽汗而仍不解。
但用薄荷五分,连翘六分。浙贝母、化橘红、北沙参各一钱,生甘草三分。一剂为度。汗多者不用薄荷,改用桑
叶一钱。
小儿初因击破皮肉,视为寻常,殊不知风邪乘虚而袭,为破伤风,变证多端。古之按症治法列下。
(一)口噤身强直者,古法主定风散(如防风、天南星等分),以姜汁和温酒调服。再以滓敷破口上。
(二)发热红肿,风邪欲传经络而未深入者,古法主水调膏(如杏仁研为泥,和白面等分),新汲水调服。
再以膏涂伤肿处。
(三)风痰痉阴痉者,古法主参归养荣汤(如人参、当归、川芎、白芍、熟地、白术、茯苓、陈皮各一钱,
甘草五分,姜枣为引,水煎服)。
(四)痰火痉者,古法主栝蒌枳实汤(如栝蒌仁、枳实、桔梗、贝母、片芩、栀子、陈皮、茯苓、麦冬、
人参、当归、苏子各八分,甘草三分),和竹沥姜汁服。
(五)口 噤、肢体反张者,古法主全蝎散(如蝎梢七个,为末)热酒调服。
(六)抽搦反张者,古法主大蜈蚣散(如蜈蚣一条,江鳔三钱,为末),每服一钱,防风羌活煎汤调下。
(七)角弓反张、牙关紧急者,古法主二乌丸(如生川乌、白芷、天麻各二钱,生草乌、雄黄各一钱,为
末,酒糊和丸)。每服温酒下十丸。
(八)风痰盛者,古法主乌蛇散(如乌蛇六钱,麻黄一两,草乌炮干姜、炮附子、川芎、白附子、天麻各
五钱,蝎梢二钱半,为末),热酒调服。
(九)手足战掉不已者,古法主朱砂指甲散〔如水飞朱砂、姜制天南星、独活(各二钱,)入手足爪甲烧
存性六钱,为末〕,热酒调下。
(十)血凝昏闷者,古法主乌鸦散(如乌鸦翎一钱,烧灰酒调服)。
〔真按〕小儿因跌扑或铁器打破伤风,先用敷药为要。轻者但用真象皮粉敷之,如无真象皮粉,即用明天麻、
羌活、防风、生南星(姜汁炒)、白芷,各一分,白附子一钱二分,共研极细末,敷之。裹紧勿见风,内以白糖
调开水服之,一二日收口落疤即愈。
重者风邪暗袭伤处发肿,宜速治之,不然则成痉矣。但用苏木三分,当归、生地、赤芍、防风各五分,炙
甘草三分,水煎服。可以疏风活血。外用紫金锭磨敷即愈。
小儿伤风,大多属于肺系疾病。症状表现为身体发热、脉象浮取明显,指纹呈现红紫色且延伸较长,伴有流鼻涕、鼻塞、声音沉闷等表现。古法治疗主要以香苏散为主(包含紫苏叶、香附、苍术、陈皮、炙甘草,以生姜和葱白为药引)。
〔陈守真按语〕风邪损伤卫气,卫气主管皮毛,内应于肺,因此出现上述症状。然而,单纯的风邪伤及肺部,由于小儿体质柔嫩脆弱,不宜使用过于强烈的发汗解表药物。仅使用桑叶、苦杏仁、化橘红、浙贝母、炒枳壳、炙甘草,服用一剂,以风邪散去、热退为限度。
小儿太阳伤风,脉象表现为阳部浮而阴部弱。阳浮意味着热气自然散发,阴弱意味着汗水自然流出,伴有淅淅恶风(像冷水洒在身上一样怕风)、翕翕发热(像羽毛覆盖般的轻微发热)。古法治疗主要以桂枝汤为主(包含桂枝、白芍、甘草,以生姜和大枣为药引)。
〔陈守真按语〕桂枝汤是专门为治疗太阳伤风导致的自汗症而设立的。小儿受风侵袭,病位未必恰好位于足太阳膀胱经,如果强行发散阳经之风,恐怕即使出汗了病情仍不能解除。仅使用薄荷五分,连翘六分,浙贝母、化橘红、北沙参各一钱,生甘草三分。服用一剂为限度。如果出汗较多者,不使用薄荷,改用桑叶一钱。
小儿起初因击打导致皮肉破损,常被视作寻常小事,殊不知风邪乘虚而入,引发破伤风,变证繁多。古代根据症状列出的治疗方法如下:
(一)牙关紧闭、身体强直者,古法主要用定风散(如防风、天南星等量),用姜汁调和温酒送服。再用药渣敷在伤口上。
(二)发热红肿,风邪欲传入经络但未深入者,古法主要用水调膏(如将杏仁研成泥状,与白面等量混合),用新汲水调和服用。再用药膏涂抹在受伤肿胀处。
(三)风痰痉证或阴痉证者,古法主要用参归养荣汤(如人参、当归、川芎、白芍、熟地黄、白术、茯苓、陈皮各一钱,甘草五分,以生姜和大枣为引,水煎服用)。
(四)痰火痉证者,古法主要用栝蒌枳实汤(如栝蒌仁、枳实、桔梗、贝母、黄芩、栀子、陈皮、茯苓、麦冬、人参、当归、苏子各八分,甘草三分),配合竹沥和姜汁服用。
(五)牙关紧闭、肢体反张者,古法主要用全蝎散(如蝎梢七个,研为粉末),用热酒调和服用。
(六)抽搐反张者,古法主要用大蜈蚣散(如蜈蚣一条,江鳔三钱,研为粉末),每次服用一钱,用防风、羌活煎成的汤剂送服。
(七)角弓反张、牙关紧急者,古法主要用二乌丸(如生川乌、白芷、天麻各二钱,生草乌、雄黄各一钱,研为粉末,用酒糊制作成丸药)。每次用温酒送服十丸。
(八)风痰盛者,古法主要用乌蛇散(如乌蛇六钱,麻黄一两,炮干姜、炮附子、川芎、白附子、天麻各五钱,蝎梢二钱半,研为粉末),用热酒调和服用。
(九)手足颤抖不止者,古法主要用朱砂指甲散(如水飞朱砂、姜制天南星、独活各二钱,放入手足爪甲中烧至存性共六钱,研为粉末),用热酒调和送服。
(十)血凝导致昏闷者,古法主要用乌鸦散(如乌鸦翎一钱,烧成灰后用酒调和服用)。
〔陈守真按语〕小儿因跌倒或被铁器打破皮肤引发的破伤风,首先外用敷药是关键。轻症只需使用真象皮粉外敷即可;如果没有真象皮粉,可使用明天麻、羌活、防风、生南星(用姜汁炒制)、白芷各一分,白附子一钱二分,共同研磨成极细的粉末,外敷于患处。包扎紧密封闭,避免见风,内服白糖调开的开水,一二天后收口结痂即可痊愈。
重症则是风邪暗中侵袭伤口导致肿胀,应当迅速治疗,否则就会发展成痉证。仅使用苏木三分,当归、生地黄、赤芍、防风各五分,炙甘草三分,水煎服用。可以起到疏风活血的作用。外用紫金锭磨碎后敷涂即可痊愈。
Pediatric wind-cold, mostly belongs to the Lung system. Symptoms include body heat and a floating pulse (pulse felt lightly at the surface), red-purple finger veins extending long, runny nose, nasal congestion, and hoarseness. Ancient methods primarily use Xiangsu San (Perilla Leaf and Cyperus Powder) as the main formula (containing Perillae Folium [Zisuye], Cyperi Rhizoma [Xiangfu], Atractylodis Rhizoma [Cangzhu], Citri Reticulatae Pericarpium [Chenpi], Glycyrrhizae Radix et Rhizoma Preparata [Zhigancao], with Zingiberis Rhizoma Freshum [Shengjiang] and Allii Fistulosi Bulbus [Congbai] as guides).
[Chen Shouzhen's Note]: Wind pathogen damages the Defensive Qi (Wei Qi), which governs the skin and hair and internally connects with the Lung, thus presenting the above symptoms. However, isolated wind-cold affecting the Lung, given the child's tender and fragile constitution, should not be treated with overly strong diaphoretic (sweat-inducing) methods. Use only Mori Folium [Sangye], Armeniacae Semen Amarum [Kuxingren], Exocarpium Citri Grandis [Huajuhong], Fritillariae Thunbergii Bulbus [Zhebeimu], Aurantii Fructus Immaturus Preparatus [Chao Zhike], and Glycyrrhizae Radix et Rhizoma Preparata [Zhigancao]. One dose is sufficient, aiming for the dispersion of wind-heat.
Pediatric Taiyang wind-cold presents with a pulse that is floating on the Yang position and weak on the Yin position. Floating Yang indicates spontaneous heat emission; weak Yin indicates spontaneous sweating. The patient experiences chills like cold water sprinkling on them (Xi Xi e feng) and mild fever like feathers covering them (Xi Xi fa re). Ancient methods primarily use Guizhi Tang (Cinnamon Twig Decoction) as the main formula (containing Cinnamomi Ramulus [Guizhi], Paeoniae Radix Alba [Baishao], Glycyrrhizae Radix et Rhizoma [Gancao], with Zingiberis Rhizoma Freshum [Shengjiang] and Jujubae Fructus [Dazao] as guides).
[Chen Shouzhen's Note]: Guizhi Tang is specifically designed to treat spontaneous sweating in Taiyang wind-cold. When a child contracts wind, the pathology may not precisely reside in the Foot-Taiyang Bladder Meridian. Forcing the dispersal of wind from the Yang meridians may result in sweating without resolution of the condition. Use only Bohe (Menthae Haplocalycis Herba) 5 fen, Lianqiao (Forsythiae Fructus) 6 fen, Zhebeimu (Fritillariae Thunbergii Bulbus), Huajuhong (Exocarpium Citri Grandis), and Beishashen (Glehniae Radix) each 1 qian, and Sheng Gancao (Raw Glycyrrhizae Radix et Rhizoma) 3 fen. One dose is sufficient. If sweating is excessive, omit Bohe and replace it with Sangye (Mori Folium) 1 qian.
Initially, pediatric injuries involving broken skin and flesh are often regarded as trivial matters. Little do they know that wind pathogen invades via the deficiency, causing Tetanus (Po Shang Feng), with numerous variable manifestations. Ancient treatment methods categorized by symptoms are listed below:
(1) For trismus (lockjaw) and body rigidity, ancient methods primarily use Dingfeng San (Wind-Stabilizing Powder) (such as Fangfeng [Saposhnikoviae Radix] and Tian Nanxing [Arisaematis Rhizoma] in equal parts), mixed with Ginger Juice and warm wine for oral administration. The dregs are then applied to the wound.
(2) For fever and redness/swelling, where wind pathogen intends to transmit to the meridians but has not deeply penetrated, ancient methods primarily use Shuitiao Gao (Water-Mixed Paste) (such as Almond paste mixed with flour in equal parts), taken orally after mixing with fresh well-water. The paste is then applied to the injured swollen area.
(3) For wind-phlegm spasms or Yin-spasms, ancient methods primarily use Shengui Yangrong Tang (Ginseng and Angelica Nourishing Blood Decoction) (such as Renshen [Ginseng Radix et Rhizoma], Danggui [Angelicae Sinensis Radix], Chuanxiong [Ligustici Chuanxiong Rhizoma], Baishao [Paeoniae Radix Alba], Shudi [Rehmanniae Radix Preparata], Baizhu [Atractylodis Macrocephalae Rhizoma], Fuling [Poria], Chenpi [Citri Reticulatae Pericarpium] each 1 qian, Gancao [Glycyrrhizae Radix et Rhizoma] 5 fen, with Shengjiang and Dazao as guides, decocted in water).
(4) For phlegm-fire spasms, ancient methods primarily use Gualou Zhishi Tang (Trichosanthes Fruit and Immature Bitter Orange Decoction) (such as Gualou Ren [Trichosanthis Semen], Zhishi [Aurantii Fructus Immaturus], Jiegeng [Platycodonis Radix], Beimu [Fritillariae Bulbus], Pian Huangqin [Scutellariae Radix], Zhizi [Gardeniae Fructus], Chenpi, Fuling, Maidong [Ophiopogonis Radix], Renshen, Danggui, Suzi [Perillae Fructus] each 8 fen, Gancao 3 fen), taken with Zhu Li (Bamboo Sap) and Jiang Zhi (Ginger Juice).
(5) For trismus and limb opisthotonos (backward arching), ancient methods primarily use Quanxie San (Scorpion Powder) (such as 7 scorpion tails, ground into powder), taken with hot wine.
(6) For convulsions and opisthotonos, ancient methods primarily use Da Wugong San (Large Centipede Powder) (such as one centipede and 3 qian of Jiangbiao [Hydrargyrum], ground into powder). Take 1 qian per dose, guided by a decoction of Fangfeng and Qianghuo [Notopterygii Rhizoma et Radix].
(7) For opisthotonos and severe jaw stiffness, ancient methods primarily use Erwu Wan (Two Wu Pills) (such as Sheng Chuanwu [Prepared Aconiti Radix lateralis], Baizhi [Angelicae Dahuricae Radix], Tianma [Gastrodiae Rhizoma] each 2 qian, Sheng Caowu [Prepared Aconiti Radix], Xionghuang [Realgar] each 1 qian, ground into powder, formed into pills with wine paste). Take ten pills per dose with warm wine.
(8) For abundant wind-phlegm, ancient methods primarily use Wushe San (Black Snake Powder) (such as Wushe [Zaocys] 6 qian, Mahuang [Ephedrae Herba] 1 liang, Pao Ganjiang [Prepared Zingiberis Rhizoma], Pao Fuzi [Prepared Aconiti Lateralis Radix], Chuanxiong, Baifuzi [Aconiti Kusnezoffii Radix], Tianma each 5 qian, Quanxie tail 2.5 qian, ground into powder), taken with hot wine.
(9) For incessant trembling of hands and feet, ancient methods primarily use Zhusha Zhijia San (Cinnabar Nail Powder) (such as Shuifei Zhusha [Washed Cinnabar], Jiangzhi Tian Nanxing [Ginger-processed Arisaematis Rhizoma], Duhuo [Angelicae Pubescentis Radix] each 2 qian, placed in hand/foot nails, burned until carbonized, totaling 6 qian, ground into powder), taken with hot wine.
(10) For blood stasis causing coma and oppression, ancient methods primarily use Wuya San (Crow Powder) (such as 1 qian of Crow Feathers, burned to ash, taken with wine).
[Chen Shouzhen's Note]: For pediatric tetanus caused by falls or iron tools breaking the skin, external application of medicine is paramount. For mild cases, simply apply genuine Xiangpi (Eleutherocauci Cortex) powder. If genuine Xiangpi powder is unavailable, use Mingtianma [Gastrodiae Rhizoma], Qianghuo, Fangfeng, Sheng Nanxing [Raw Arisaematis Rhizoma] (stir-fried with ginger juice), and Baizhi each 1 fen, and Baifuzi 1.2 qian. Grind all into an extremely fine powder and apply externally. Wrap tightly to avoid exposure to wind. Internally, take white sugar dissolved in boiled water. Healing occurs with scabbing within one to two days.
For severe cases, wind pathogen secretly invades the wound causing swelling; prompt treatment is necessary, otherwise, it will develop into spasms. Use only Sumu [Sappan Wood] 3 fen, Danggui, Shengdi [Rehmanniae Radix], Chishao [Paeoniae Radix Rubra], and Fangfeng each 5 fen, and Zhigancao 3 fen. Decoct in water. This can disperse wind and invigorate blood. Externally, grind Zijin Ding (Purple Gold锭) and apply; healing will follow.