小儿春月受风,其气已温,肺位受邪在先,此手太阴气分先病,失治则入手厥阴心包络血分,气血两伤,
古法多主荆、防、
柴、葛,加入枳、朴、杏、苏之属,发散消导,变证甚速。
〔真按〕风温肺病,治在上焦,初起发热喘嗽,但用薄荷叶一钱,栝蒌皮钱半,北沙参三钱,霜桑叶二钱,
川贝母一钱,牛蒡八分,连翘钱半,热重加生石膏二钱,鲜竹叶十五片,上焦得开,则邪自解矣。
经云∶先夏至病温,后夏至病暑。长夏湿令,暑必兼湿,暑伤气分,湿亦伤气,汗则耗气伤阳,胃汁大受劫
炼,变症由此而多。然暑病古之专方甚少,皆以白虎汤为主,次亦主香薷散(如香薷、扁豆、浓朴、甘草四味)。
〔真按〕香薷辛温气升,热伏易吐,古方大顺散,香薷必佐杏仁,取杏仁苦降泄气,以监香薷。然治小儿
暑湿之症,仍不适用。初起但用鲜竹叶三十片,六一散三钱,苏薄荷六分,连翘心钱半,鲜荷叶一角,光杏仁钱
半为剂。热甚烦渴无湿者,前方除去六一散不用,加 石膏三钱,炒知母钱半。
秋疫因秋令感伤,恰值夏热发泄之后,小儿体质虚实不同,往往混投发散,津液被劫,喘急告危,古法多
用荆、防、前胡、葛根之属,发散解肌为主。
〔真按〕秋疫一症,气分先受,治肺为急,勿使热郁内蒸,逆传膻中,至天君震动,状若痫症。一切苦寒
沉降及腻滞阴药,俱在禁例。但用西瓜翠衣钱半,鲜石菖蒲五分,薄荷尖八分,嫩桑叶二钱,薏米仁钱半,白茯
苓二钱,川郁金八分,淡竹叶二钱,忍冬藤钱半,服后肺气清肃,则营卫两和。
小儿在春季感受风邪,此时气候已经转温,肺脏部位首先受到邪气侵袭,这是手太阴肺经的气分先发病;若失治误治,病邪则会传入手厥阴心包络的血分,导致气血两伤。
古代医法多主张使用荆芥、防风、柴胡、葛根,加入枳实、厚朴、杏仁、紫苏这类药物,以发散表邪、消食导滞,但病情变化非常迅速。
〔陈守真按语〕风温引起的肺病,治疗重点在上焦。初起出现发热、气喘咳嗽时,仅用薄荷叶一钱,瓜蒌皮一钱半,北沙参三钱,霜桑叶二钱,川贝母一钱,牛蒡子八分,连翘一钱半;若热势重,加生石膏二钱,鲜竹叶十五片。上焦气机得以开通,邪气自然解除。
《内经》说:夏至之前发生的温病称为温病,夏至之后发生的称为暑病。长夏季节湿气当令,暑邪必然兼夹湿邪。暑邪损伤气分,湿邪也损伤气分,发汗会耗气伤阳,胃中津液大受煎熬,变证因此增多。然而,古代治疗暑病的专用方剂很少,多以白虎汤为主,其次也用香薷散(由香薷、扁豆、厚朴、甘草四味药组成)。
〔陈守真按语〕香薷性辛温且气机上浮,若有热伏容易引发呕吐。古方大顺散中,香薷必配伍杏仁,取杏仁苦降泄气之性,来制约香薷的上浮之气。然而,这并不适用于治疗小儿的暑湿病症。初起时只需用鲜竹叶三十片,六一散三钱,苏薄荷六分,连翘心一钱半,鲜荷叶一角,光杏仁一钱半作为药剂。若热盛烦渴且无湿邪者,前方去掉六一散不用,加生石膏三钱,炒知母一钱半。
秋疫是因为秋季感受时邪所致,正值夏季炎热发泄之后,小儿体质虚实不同,往往被混用发散药物,导致津液被劫夺,出现喘息急促等危重症状。古法多用荆芥、防风、前胡、葛根这类药物,以发散解肌为主。
〔陈守真按语〕秋疫这一病症,气分先受邪,急当治肺,不要使热邪郁结内蒸,逆传至膻中,导致心神震动,症状类似痫症。一切苦寒沉降及黏腻阻滞的阴药,都在禁忌之列。只需用西瓜翠衣一钱半,鲜石菖蒲五分,薄荷尖八分,嫩桑叶二钱,薏苡仁一钱半,白茯苓二钱,川郁金八分,淡竹叶二钱,忍冬藤一钱半。服药后肺气清肃,则营卫调和。
In spring, when children are affected by wind pathogens, the climate is already warm. The Lung position is invaded first; this constitutes an initial disease of the Qi level of the Hand-Taiyin (Lung) meridian. If mismanaged, it progresses to the Blood level of the Hand-Jueyin (Pericardium), resulting in damage to both Qi and Blood.
Ancient methods often advocated using Jingjie (Schizonepetae Spica), Fangfeng (Saposhnikoviae Radix), Chaihu (Bupleuri Radix), and Gegen (Puerariae Lobatae Radix), added with Zhishi (Aurantii Fructus Immaturus), Houpo (Magnoliae Officinalis Cortex), Xingren (Armeniacae Semen Amarum), and Zisu (Perillae Folium), to release the exterior and promote digestion. However, pathological changes occur very rapidly.
[Chen Shouzhen's Note:] For Wind-Warmth affecting the Lung, treatment focuses on the Upper Jiao (Upper Burner). In the initial stage presenting with fever, wheezing, and cough, only use Bohe Ye (Menthae Haplocalycis Folium) 3g, Gualou Pi (Trichosanthis Pericarpium) 4.5g, Beishashen (Glehniae Radix) 9g, Shuang Sangye (Mori Folium Frost-treated) 6g, Chuanbeimu (Fritillariae Cirrhosae Bulbus) 3g, Niubangzi (Arctii Fructus) 2.4g, Lianqiao (Forsythiae Fructus) 4.5g. If heat is severe, add Sheng Shigao (Gypsum Fibrosum) 6g and Xian Zhuye (Phyllostachidis Viridis Folium) 15 leaves. Once the Upper Jiao is opened, the pathogen will resolve spontaneously.
The Classic states: "Warmth occurring before the Summer Solstice is called Warm Disease; that occurring after the Summer Solstice is called Summerheat." During the Late Summer, Dampness commands the season, so Summerheat inevitably combines with Dampness. Summerheat damages the Qi level, and Dampness also damages the Qi level. Sweating consumes Qi and injures Yang, severely depleting Stomach fluids, leading to numerous complications. However, ancient specialized formulas for treating Summerheat are few; most prioritize Baihu Tang (White Tiger Decoction), followed by Xiangru San (Elsholtzia Powder, composed of Xiangru, Bian Dou, Houpo, Gancao).
[Chen Shouzhen's Note:] Xiangru is acrid-warm and its Qi ascends; if Heat is latent, it easily induces vomiting. In the ancient formula Dashun San, Xiangru must be assisted with Xingren, utilizing Xingren’s bitter-descending property to drain Qi and supervise/restrain Xiangru’s ascending nature. However, this is still not applicable for treating pediatric Summerheat-Dampness. In the initial stage, use only Xian Zhuye 30 leaves, Liuyi San (Six-to-One Powder) 9g, Su Bohe (Menthae Haplocalycis Herba) 1.8g, Lianqiao Xin (Forsythiae Fructus Cor) 4.5g, Xian Heye (Nelumbinis Folium) one corner, Guang Xingren (Armeniacae Semen Amarum) 4.5g as a decoction. If heat is intense with thirst and restlessness but without Dampness, remove Liuyi San from the previous formula and add Shigao 9g and Chao Zhimu (Anemarrhenae Rhizoma Stir-fried) 4.5g.
Autumn Epidemic arises from contracting pathogens during Autumn, precisely after the venting of Summer heat. Children have varying constitutions of deficiency or excess; often, dispersing agents are indiscriminately administered,劫ting Body Fluids, leading to urgent wheezing and critical danger. Ancient methods mostly used Jingjie, Fangfeng, Qianhu (Peucedani Radix), and Gegen to primarily disperse the exterior and release the muscle layer.
[Chen Shouzhen's Note:] Regarding the syndrome of Autumn Epidemic, the Qi level is affected first, making the treatment of the Lung urgent. One must prevent Heat from stagnating internally and steaming, which could reverse-transmit to the Danzhong (Conception Vessel/Pericardium region), causing agitation of the Heavenly Ruler (Heart/Mind), resembling Epilepsy (Xian Syndrome). All bitter-cold, sinking-depressing, and cloying-stagnant Yin-nourishing herbs are contraindicated. Use only Xigua Cuiyi (Citrulli Lanati Exocarpium) 4.5g, Xian Shichangpu (Acori Tatarinowii Rhizoma Fresh) 1.5g, Bohe Jian (Menthae Haplocalycis Apiculus) 2.4g, Nen Sangye (Mori Folium Tender) 6g, Yimiren (Coicis Semen) 4.5g, Baifuling (Poria) 6g, Chuan Yujin (Curcumae Radix) 2.4g, Dan Zhuye (Phyllostachidis Viridis Folium) 6g, Rendongteng (Lonicerae Japonicae Caulis et Folium) 4.5g. After administration, if Lung Qi becomes clear and descending, Ying (Nutritive) and Wei (Defensive) harmonize.