吐泻除是明知停食受寒。方可消导如枳术二陈平胃之类。其余吐泻。乃肝木乘土而来。急以
七味白术散安之。万不失一。暑月尤宜补正。吐加半夏七分。(姜汁制)泻加白芍一钱。(酒洗炒)
七味白术散
白术 人参 茯苓 藿香 木香 干葛 甘草
煨姜引。
惊病。无论轻重。一味用五味异功散。加软柴胡钩藤钩。即为外物所惊。亦是木气虚而受。
切勿投抱龙镇惊等丸。(有小儿感症。初起脉细数。日久不愈。则目窜手搐。症已败矣。正寓意
草所谓伤寒。非惊风也。今人动作惊治。往往致殆。不知此症与大人伤寒败症同。缘禀赋阴亏。故
脉如此细数。当从六味左归治。然亦危矣。)
疳病。无论五疳虚实。一味五味异功散。加黄连木香。万不失一。若头大肚大筋青四肢独细
。即黄连木香。亦不可用。一味参苓白术散主之。如疳而有虫。五味异功散。加虾蟆川连。大便
必似水而焦赤无渣是也。甚至经月累年。每用五味异功散一料。加虾蟆一枚酒炙。川连五钱姜汁
拌炒。(吐泻惊疳诸症。须主薛长洲订保婴全书。此则未免要而未备耳。)
五味异功散
陈皮 人参 白术 茯苓 甘草
参苓白术散
人参 茯苓 白术 米仁 山药 扁豆 芡实
砂仁 桔梗 川连 甘草(一方有葛根)
吐泻症,除非明确知道是由于停食或受寒引起的,才可以使用消食导滞的方剂,如枳术二陈汤、平胃散之类。其余的吐泻症,都是由于肝木乘克脾土所致,应立即使用七味白术散来调理,这样万无一失。在暑热月份,尤其应当注重补益正气。呕吐者加半夏七分(用姜汁炮制),腹泻者加白芍一钱(用酒洗并炒制)。
七味白术散
白术、人参、茯苓、藿香、木香、干葛(葛根)、甘草。
以煨姜为引。
惊病,无论病情轻重,一味地使用五味异功散,加入软柴胡和钩藤钩。如果是因外物惊吓所致,也是因为肝木之气虚弱而受到惊扰。切勿投用抱龙丸、镇惊丸等药物。(有些小儿感受外邪,初起时脉象细数,日久不愈,则出现眼球上窜、手足抽搐的症状,此时病情已经败坏。正如寓意草中所说,伤寒并非惊风。现在的人动辄按惊风治疗,往往导致危险。不知道此症与大人的伤寒危重证候相同,是因为禀赋阴液亏虚,所以脉象如此细数。应当从六味左归饮治疗,但这也属于危重病症了。)
疳病,无论是五疳中的虚证还是实证,一味地使用五味异功散,加入黄连和木香,万无一失。如果患儿头大、肚子大、筋脉显露,唯独四肢细瘦,那么即使黄连和木香也不可用,应单独使用参苓白术散主治。如果疳病伴有虫积,则在五味异功散中加入虾蟆(蟾蜍)和黄连,大便必然像水一样且焦赤无渣。甚至经过数月或数年,每次使用五味异功散一料,加入一枚经酒炙制的虾蟆和五钱用姜汁拌炒的黄连。(对于吐泻、惊风、疳积诸症,应以薛生白(薛长洲)编订的《保婴全书》为主,本书未免显得简略而不完备。)
For vomiting and diarrhea, only when it is clearly known to be caused by food stagnation or cold invasion can one use formulas for resolving stagnation and guiding out food, such as Zhizhu Erchen Tang (Bitter Orange and Atractylodes with Two-Ingredient Decoction) or Pingwei San (Stomach-Pacifying Powder). Other cases of vomiting and diarrhea are caused by Liver Wood overacting on Spleen Earth; they should be immediately settled with Qiwei Baizhu San (Seven-Ingredient Atractylodes Macrocephala Decoction), which is infallible. During the summer months, it is especially appropriate to tonify healthy Qi. For vomiting, add Banxia (Pinelliae Rhizoma) 7 fen (processed with ginger juice); for diarrhea, add Baishao (Paeoniae Radix Alba) 1 qian (washed with wine and stir-fried).
Qiwei Baizhu San (Seven-Ingredient Atractylodes Macrocephala Decoction)
Baizhu (Atractylodis Macrocephalae Rhizoma), Renshen (Ginseng Radix et Rhizoma), Fuling (Poria), Huoxiang (Agastaches Herba), Muxiang (Aucklandiae Radix), Gan Ge (Puerariae Radix), Gancao (Glycyrrhizae Radix et Rhizoma).
Use Wei Jiang (Roasted Ginger) as a guide.
For Jing Bing (Startling Disease), regardless of severity, use Wuyi Yigong San (Five-Agent Yi-Gong Powder) alone, adding Ruan Chaihu (Soft Bupleuri Radix) and Goutenggou (Uncariae Ramulus cum Uncis). If the condition is due to startling by external objects, it is also because the Wood Qi is deficient and thus susceptible. Do not administer Bao Long Wan (Dragon-Holding Pill) or Zhen Jing Wan (Calming Startling Pill). (Some children suffering from exogenous pathogens present with a fine and rapid pulse at onset; if unresolved for a long time, symptoms such as upward deviation of the eyes and hand spasms appear, indicating a deteriorated condition. As stated in *Yiyu Cao*, "Shanghan" (Cold Damage) is not "Jing Feng" (Wind of Startling). Nowadays, people often treat this as Wind of Startling, which frequently leads to danger. They do not realize that this condition is similar to critical Shanghan patterns in adults, originating from congenital Yin deficiency, hence the fine and rapid pulse. It should be treated according to Liuwei Zuogui (Six-Ingredient Left-Restoring Decoction), although it remains critical.)
For Gan Bing (Childhood Malnutrition Syndrome), whether it is the deficiency or excess type among the Five Gan syndromes, use Wuyi Yigong San (Five-Agent Yi-Gong Powder) alone, adding Huanglian (Coptidis Rhizoma) and Muxiang (Aucklandiae Radix), which is infallible. However, if the child has a large head, distended abdomen, visible veins, and thin limbs, even Huanglian and Muxiang should not be used; instead, Shenling Baizhu San (Ginseng, Poria, and Atractylodes Macrocephala Powder) should be used exclusively. If Gan Bing is accompanied by intestinal parasites, add Xama (Bufo bufo gargarizans, Toad) and Chuanlian (Coptidis Rhizoma) to Wuyi Yigong San; the stool will necessarily resemble water, dark red, and residue-free. Even after months or years, each dose of Wuyi Yigong San may include one Jiuzhi Xama (Toad roasted with wine) and 5 qian of Chuanlian (stir-fried with ginger juice). (For various syndromes including vomiting, diarrhea, startling, and Gan, one should primarily refer to *Baoying Quanshu* compiled by Xue Changzhou [Xue Shengbai]; this text is somewhat incomplete in comparison.)
Wuyi Yigong San (Five-Agent Yi-Gong Powder)
Chenpi (Citri Reticulatae Pericarpium), Renshen (Ginseng Radix et Rhizoma), Baizhu (Atractylodis Macrocephalae Rhizoma), Fuling (Poria), Gancao (Glycyrrhizae Radix et Rhizoma).
Shenling Baizhu San (Ginseng, Poria, and Atractylodes Macrocephala Powder)
Renshen (Ginseng Radix et Rhizoma), Fuling (Poria), Baizhu (Atractylodis Macrocephalae Rhizoma), Yiyiren (Coicis Semen), Shanyao (Dioscoreae Rhizoma), Bian Dou (Phaseoli Fructus), Qianshi (Nelumbinis Semen), Sharen (Amomi Fructus Rotundus), Jiegeng (Platycodonis Radix), Chuanlian (Coptidis Rhizoma), Gancao (Glycyrrhizae Radix et Rhizoma). (One prescription includes Gegen/Puerariae Radix.)