此方治小儿因伤寒、瘟疫,或痘疹、吐泻等症,病久气虚,四肢抽搐,项背后反,两目
天吊,口流涎沫,昏沉不省人事,皆效。
黄 (一两五钱,生) 党参(三钱) 白术(二钱) 甘草(二钱) 当归(二钱) 白芍(二
钱) 枣仁(三钱,炒) 山萸(一钱) 枸杞子(二钱) 故纸(一钱) 核桃(一个,连皮打碎)
水煎服。
此方分两,指四岁小儿而言;若两岁,分两可以减半;若一岁,分量可用三分之一
;若两三个月,分两可用四分之一。又不必拘于副数。余治此症,一日之间,常有用两三副
者。服至不抽,必告知病家,不可因不抽,遂不服药,必多服数副,气足方妥。
方歌
可保立苏故纸枣,术归芍药参 草,
山萸枸杞水煎服,一个核桃带壳捣。
夫小儿痘疹,自汉至今,着书立方者,不可胜数。大抵不过分顺险逆,辨别轻重死生,
并无
;有遵解毒汤,用犀角、黄连者。痘本一体,用药竟不相同。遇顺险之痘,查小儿壮弱,分
别补泻清凉,用之皆可望生。唯一见逆症,遂无方调治,即云天数当然,此不知痘之本源故
也。或曰∶古人若不知痘之本源,如何见逆痘便知几天死?余曰∶此非古人知痘之本源也,
因看痘多,知某日见苗,某日何形,某日何色,某日何症,治之不效,至某日必死。古人知
逆痘几天死者,盖由此也。如知痘之本源,岂无方调治?或曰∶如君所言,痘之逆症有救乎
?余曰∶痘之险症,随手而愈,不足论。至于逆症,皆有本源,辨明本源,岂不可救?如余所
治,闷痘不出,周身攒簇,细密如蚕壳,平板如蛇皮,不热即出,见点紫黑,周身细密无缝
,紫白灰色相间,蒙头、锁口、锁项、托腮,皮肉不肿,通身水泡,不起胀行浆,不化脓结
痂,见
,胃口不开,至危之时,头不能抬,足歪不正,两目天吊,项背后反等逆症,初见之时,辨
明虚实,皆可望生。易此理者,知余补前人之未及,救今人之疑难;不明此理者,妄加评论
,以余言为狂妄,而不知非狂也,知痘之本源也。不似诸家议论,出痘总是胎毒。诸书又曰
∶自汉以前无出痘者。既云胎毒,汉以前人独非父母所生。此论最为可笑。若根据古人之论,
有谓胎毒藏于脏腑,而何以未出痘以前,脏腑安然无病?有谓胎毒藏于肌肉,而何未出痘以
前
花。信如斯言,因惊恐跌仆,伤食感冒,触动而发,则是自不小心。伏思出花正盛时,非止
一人出花,少则一方,多则数省,莫非数省之人,同时皆不小心?此论更为无理。再见世上
种痘之医,所种之痘,无论多少,无一不顺。若是胎毒,毒必有轻重,毒重者痘必险,何以
能无一不顺?由此思之,如何胎毒二字,牢不可破,殊不知痘非胎毒,乃胞胎内血中之浊气
也。儿在母腹,始因一点真精凝结成胎,以后生长脏腑肢体,全赖母血而成,胞胎内血中浊
气,降生后仍藏荣血之中,遇天行触浊气之瘟疫,由口鼻而入气管,由气管达血管,将血中
浊气,逐之自皮肤而出,色红似花,故名天花,形圆如痘,故名曰痘。总之,受瘟疫轻,瘟
毒随花而出,出花必顺;受瘟疫重,疫毒在内逗留,不能随花而出,出花必险;受瘟疫至重
,瘟疫在内烧炼其血,血受烧炼,其血必凝,血凝色必紫,血死色必黑,痘之紫黑,是其证
也。死血阻塞道路,瘟疫之毒,外不得由皮肤而出,必内攻脏腑,脏腑受毒火煎熬,随变生
各脏逆症。正对痘科书中所言某经逆痘,不知非某经逆痘也,乃某经所受之瘟毒也。痘之顺
逆,在受瘟疫之轻重。治痘之紧要,全在除瘟毒之方法。瘟毒不除,花虽少而必死。瘟毒若
除,花虽多不致伤生。痘科书中,但论治胎毒,而不知治瘟毒,纵知治瘟毒,而不知瘟毒巢
穴在血。若辨明瘟毒轻重,血之通滞,气之虚实,立救逆痘于反掌之间,此所谓知其要者,
一言而终耳。
此方用于治疗小儿因伤寒、瘟疫,或痘疹、吐泻等病症,病程日久导致气虚,出现四肢抽搐、项背部向后反折(角弓反张)、两眼向上翻视(天吊)、口流涎沫、神志昏沉不省人事等症状,均有疗效。
黄芪(一两五钱,生用) 党参(三钱) 白术(二钱) 甘草(二钱) 当归(二钱) 白芍(二钱) 酸枣仁(三钱,炒制) 山茱萸(一钱) 枸杞子(二钱) 补骨脂(一钱,即故纸) 核桃(一个,连皮打碎)
水煎服。
此处所列药量,是针对四岁小儿而言;若是两岁小儿,药量可减半;若是一岁小儿,药量可用三分之一;若是两三个月大的婴儿,药量可用四分之一。也不必拘泥于固定的剂数。我治疗这类病症时,一天之内,常有使用两三剂的情况。服药至抽搐停止后,必须告知患儿家属,不要因为抽搐停止就立即停药,一定要多服几剂,待元气充足才算稳妥。
方歌:
可保立苏汤含补骨脂与枣仁,白术、当归、白芍、人参、甘草,
山茱萸、枸杞子用水煎服,再加一个带壳捣碎的核桃。
关于小儿痘疹,从汉代至今,著书立说、制定方剂的,不可胜数。大体上不过是区分顺证与险逆证,辨别病情的轻重和生死预后,并没有(真正触及根本的论述);有的遵循解毒汤,使用犀角、黄连。痘疮本是一种疾病,用药却竟然完全不同。遇到顺证或险证的痘疮,查看小儿体质的强弱,分别采用补法、泻法、清凉法,使用这些方法都可以期望痊愈。唯独一见逆证,就没有方子可以调治,便说是天数注定必然死亡,这是不了解痘疮本源的原因啊。有人说:如果古人不知道痘疮的本源,为什么看到逆证痘疮就能知道几天后会死?我说:这并不是古人知道了痘疮的本源,而是因为看诊痘疮的人多,知道哪一天出疹子,哪一天是什么形态,哪一天是什么颜色,哪一天有什么症状,治疗无效,到了某一天必然死亡。古人知道逆证痘疮几天会死,大概就是这样形成的。如果真知道了痘疮的本源,难道没有方子可以调治吗?又问:像您所说的,痘疮的逆证有救吗?我说:痘疮的险证,随手就能治愈,不值得讨论。至于逆证,都有本源,辨明本源,难道不能救治吗?像我治疗的案例:闷痘不出,周身密集簇拥,细密得像蚕壳,平坦如蛇皮,不发热就出疹,见点呈紫黑色,周身细密无缝,紫、白、灰色相间,蒙头、锁口、锁项、托腮,皮肉不肿胀,通身水泡,不起胀行浆,不化脓结痂,见到……胃口不开,到了极度危险的时候,头抬不起来,脚歪斜不正,两眼向上翻视,项背部向后反折等逆证,在初见之时,辨明虚实,都可以期望痊愈。改变这个理论的,是知道我补充了前人的不足,挽救了今人的疑难;不明白这个理论的,妄加评论,认为我的话狂妄,却不知道我并不狂妄,而是知道了痘疮的本源。不像各家议论,认为出痘总是胎毒。各种书籍又说:汉代以前没有出痘的人。既然说是胎毒,汉代以前的人难道不是父母所生吗?这种论调最为可笑。如果依据古人的论述,有人说胎毒藏在脏腑,那为什么在未出痘以前,脏腑安然无病?有人说胎毒藏在肌肉,那为什么未出痘以前……(原文此处似有缺漏,推测为“无花”或类似表述)。相信这样的话,是因为惊恐跌仆、伤食感冒,触动而发作,那就是自己不小心。我想,出痘正盛的时候,不止一个人出痘,少则一个地方,多则几个省份,莫非这几个省份的人,同时都不小心吗?这种论调更为无理。再见到世上种痘的医生,所种的痘,无论多少,无一不顺。如果是胎毒,毒必有轻重,毒重者痘必险,怎么能做到无一不顺呢?由此思考,为什么“胎毒”二字牢不可破,殊不知痘不是胎毒,而是胞胎内血中的浊气。胎儿在母腹中,开始因为一点真精凝结成胎,以后生长脏腑肢体,全靠母血而成,胞胎内血中的浊气,出生后仍藏在营血之中,遇到天行触浊气的瘟疫,由口鼻进入气管,由气管到达血管,将血中的浊气,驱逐从皮肤而出,颜色红似花,所以名叫天花,形状圆如痘,所以名叫痘。总之,受瘟疫轻,瘟毒随花而出,出花必顺;受瘟疫重,疫毒在内逗留,不能随花而出,出花必险;受瘟疫至重,瘟疫在内烧炼其血,血受烧炼,其血必凝,血凝色必紫,血死色必黑,痘之紫黑,就是它的征象。死血阻塞道路,瘟疫之毒,外不得由皮肤而出,必内攻脏腑,脏腑受毒火煎熬,随即变生各脏逆证。正是对应痘科书中所说的某经逆痘,不知道那不是某经的逆痘,而是某经受到的瘟毒。痘疮的顺逆,在于受瘟疫的轻重。治疗痘疮的关键,全在于清除瘟毒的方法。瘟毒不除,花虽少也必死。瘟毒若除,花虽多也不致伤生。痘科书中,只谈论治疗胎毒,而不知道治疗瘟毒,即使知道治疗瘟毒,也不知道瘟毒的巢穴在血。如果能辨明瘟毒的轻重,血的通畅与否,气的虚实,立刻在反掌之间拯救逆痘,这就是所谓的懂得关键的人,一句话就能终结(道理)。
This formula is used to treat children suffering from Qi deficiency due to prolonged illness caused by cold damage (Shanghan), epidemic febrile diseases, or smallpox/rash, vomiting, and diarrhea. It presents with symptoms such as convulsions of the four limbs, opisthotonos (backward arching of the neck and back), upward deviation of the eyes (Tian Diao), drooling, deep coma, and loss of consciousness. It is effective for all these conditions.
Huangqi (Astragali Radix, 1.5 liang, raw) Dangshen (Codonopsis Radix, 3 qian) Baizhu (Atractylodis Macrocephalae Rhizoma, 2 qian) Gancao (Glycyrrhizae Radix et Rhizoma, 2 qian) Danggui (Angelicae Sinensis Radix, 2 qian) Baishao (Paeoniae Radix Alba, 2 qian) Zaoren (Ziziphi Spinosae Semen, 3 qian, stir-fried) Shanyuzhu (Corni Fructus, 1 qian) Gouqizi (Lycii Fructus, 2 qian) Guozhi (Psoraleae Fructus, 1 qian) Hetao (Juglandis Semen, one piece, crushed with shell)
Decoct in water and take orally.
The dosages listed above refer to a four-year-old child; for a two-year-old, the dosage can be halved; for a one-year-old, one-third of the dosage may be used; for infants of two to three months, one-quarter of the dosage may be used. There is no need to rigidly adhere to the number of doses. In my treatment of such cases, it is common to administer two or three doses within a single day. Once the convulsions cease, you must inform the family not to stop medication immediately just because the convulsions have stopped; several additional doses should be taken until the Qi is sufficient to ensure stability.
Formula Verse:
Kebao Lisu contains Psoralea and Jujube Seed,
Atractylodes, Angelica, White Peony, Codonopsis, and Licorice,
Cornus and Lycium decocted in water,
Plus one walnut crushed with its shell.
Regarding pediatric smallpox/rash, from the Han Dynasty to the present, there are countless books written and formulas created. Generally, they merely distinguish between favorable (Shun) and unfavorable/adverse (Xian/Ni) patterns, differentiating severity and prognosis of life and death, without addressing the root cause. Some follow the Jiedu Tang (Detoxification Decoction), using Xijiao (Rhinoceros Horn) and Huanglian (Coptidis Rhizoma). Smallpox is essentially one disease, yet the medications used are completely different. For favorable or severe smallpox, by assessing the child's strength and weakness, and applying tonifying, purging, or cooling methods accordingly, recovery can be expected. However, once an adverse pattern appears, there are no formulas for treatment, and it is simply declared as "destiny," leading to death. This stems from ignorance of the true origin of smallpox. One might ask: If the ancients did not know the origin of smallpox, how could they predict death based on the appearance of adverse rashes? I reply: This was not because the ancients knew the origin of smallpox, but because they saw many cases and learned that if rash appeared on Day X, took Form Y, showed Color Z, and presented Symptom W, and treatment failed, death would occur on Day N. The ancients' ability to predict death likely arose from this empirical observation. If they truly understood the origin of smallpox, surely there would be formulas for treatment? Another question: As you say, can adverse smallpox be saved? I reply: Severe smallpox responds readily to treatment and is not worth discussing. As for adverse patterns, they all have an origin; if this origin is clarified, can they not be cured? Take my treatments: Stifled smallpox failing to erupt, densely clustered over the body, fine like silkworm cocoons, flat like snake skin, appearing without fever, presenting as purple-black spots, densely packed without gaps, mixed with purple, white, and gray colors, covering the head, locking the mouth, locking the neck, swelling the cheeks, with non-swollen skin and flesh, generalized blisters, failing to swell and fill with pus, failing to suppurate and form scabs... poor appetite, and at critical moments, inability to lift the head, foot deformity, upward deviation of the eyes, and opisthotonos. At the initial stage, if deficiency and excess are distinguished, recovery can be expected. Those who reject this theory fail to see that I am supplementing what predecessors missed and resolving current difficulties; those who do not understand this theory criticize me as arrogant, unaware that I am actually revealing the true origin of smallpox. Unlike other schools that claim smallpox is always "fetal toxin." Other texts state: There were no smallpox cases before the Han Dynasty. If it is fetal toxin, were people before the Han not born of parents? This argument is laughable. If we follow ancient theories claiming fetal toxin resides in the Zang-Fu organs, why were the organs healthy before eruption? If it resides in the muscles, why were there no lesions before eruption? Believing that fright, falls, food stagnation, or colds trigger it implies negligence. Consider that during peak outbreaks, it affects not just one person, but regions or provinces. Did everyone in multiple provinces simultaneously become negligent? This is absurd. Furthermore, doctors performing variolation produce only favorable outcomes regardless of quantity. If it were fetal toxin, toxicity would vary in severity, making severe cases dangerous; how could variolation always yield favorable results? Thus, why is the concept of "fetal toxin" so unbreakable? In fact, smallpox is not fetal toxin, but turbid Qi within the blood of the conception vessel. When the fetus forms in the womb, it begins with a essence condensing into a embryo. Subsequent growth of organs and limbs relies entirely on maternal blood. The turbid Qi in the blood of the conception vessel remains hidden in the Ying (Nutritive) blood after birth. When encountering epidemic pathogens that disturb turbid Qi, it enters via the nose and mouth into the airways, then reaches the blood vessels, driving the turbid Qi out through the skin. Its color is red like flowers, hence called Tianhua (Heavenly Flowers); its shape is round like pockmarks, hence called Dou (Smallpox). In summary: Light exposure to epidemic pathogens allows toxins to exit with the rash, resulting in a favorable course; heavy exposure causes toxins to linger internally, unable to exit with the rash, resulting in a severe course; extremely heavy exposure burns the blood internally. Burnt blood coagulates, turning purple; dead blood turns black. Purple-black smallpox indicates this condition. Dead blood blocks pathways, preventing external expulsion of epidemic toxins, forcing them to attack internal Zang-Fu organs. The Zang-Fu suffer from toxic fire, generating adverse patterns corresponding to various meridians. What smallpox texts call "adverse smallpox of a specific meridian" is actually not meridian-specific adverse smallpox, but epidemic toxin affecting that meridian. The favorability or adversity of smallpox depends on the severity of the epidemic infection. The key to treating smallpox lies entirely in eliminating the epidemic toxin. If the toxin is not eliminated, even few lesions will lead to death. If the toxin is eliminated, even numerous lesions will not be fatal. Smallpox texts discuss treating fetal toxin but ignore epidemic toxin; even if they acknowledge epidemic toxin, they fail to recognize its nest is in the blood. By distinguishing the severity of epidemic toxin, the patency of blood, and the deficiency/excess of Qi, one can save adverse smallpox instantly. This is what is meant by: "He who understands the essentials needs but one word to conclude."