小儿不时发惊,乃肺虚不能平肝木也。用五味、肉桂、人参平之。
急惊用铁衣针砂,非但化涎镇心,且可抑推肝邪。惊而吐泻,丁香五分,白术一钱,肉
果七分,共末,姜汤下。急惊脉刚急,金枣丸、琥珀丸皆可服。
金枣丸
天麻(三钱,米炒) 枳壳(酒炒) 牛黄(各一钱) 劈砂 块雄黄 槐角(各二钱) 麝香
(七分) 胆星(三钱) 半夏(姜制,三钱) 皂角(酒炒,一分) 用枣肉(二两,) 巴豆(六
同火煨,煨熟去巴豆,用枣捣丸如黄豆大,朱砂为衣,随证用汤化下一丸。
琥珀丸
天竺黄,僵蚕 雄黄 钩藤 天麻 柏子仁 益智(各五钱) 珍珠 琥珀 胆星(姜汁
炒) 牛黄(各一钱) 麝香(五分) 全蝎(去头足,二十个) 竹节白附子(大者三钱) 冰片(
三分) 蜈蚣(一条) 犍猪爪(四枚)
共蜜丸,金箔十张为衣,随证用汤化下一丸。
慢惊一证,小儿最剧之候也。盖因三脏受病,先后天皆伤也。肾藏精主恐,肝主气主动
主升,心主脉主惊。惊者,心气动而肝随以升,肾气为肝气吊动而精气亦随之而并于上,则
肾精不藏矣。精不藏则下虚,肝气升则上实,故惊证肾无不虚,而肝无不实也。痰者,精气
之变也,精并于上而痰,得肝火扶之,内而心胸上下,外而经络手足,无非痰气矣。盖肝主
气,心主脉,肾主痰,心、肝、肾三经之证,而心、肝、肾三经之经络,皆痰之道路也。然
犹易治也,只须用姜、桂敛而下之,兼用通经清水之剂即安矣。所以易治者,脾气尚能运动
而药力可行,升降之机犹在我也。若一传于脾则难矣,脾气滞于痰则胃不运,胃不运则后天
之气病,而先天之虚处更无所生,则肾精益枯,肾枯则肝火益起,火益起则痰益盛,痰盛则
四肢九窍百骸,无非痰气闭塞而生机息矣,不死何待?所可恨者,人但见痰害之甚,而一以
消痰为事,消痰固好,奈不消其本而消其末,是犹抱薪救火也。以消痰之剂皆伤脾胃,伐肾
耗元之味耳。故遇急惊,其证实,其来路浅,治痰而痰易退,虽不合法,然犹似逐一无能小
贼,尚易除也。至于慢惊,则根深势猛,倘不从其来处着力,而亦以逐小贼之法治之,是使
激其怒而行性也,岂可救治哉!用药皆宜通行下降,温中纳气为主,炮姜、肉桂、
苏梗、广皮、远志、茯神、铁衣、甘草、五味、人参之类,皆可用也。舍此而消痰,我不知其可也。
金箔镇心丸(治慢惊、惊痫)
人参 茯神 紫河车 琥珀(各一钱) 甘草(五分) 朱砂 珍珠(各一钱)
蜜丸,金箔为衣。
疳疾初起,乃是食郁则为火,甘草、薄荷、煎汤送下四圣丸。久则脾虚,如大人之怯证
小儿吃土、米、瓦灰等物,有疳虫也。用诃子肉、白术各一两,使君子肉、甘草各五钱
,麦芽八两,同所好之物为细末,白糖调服。
小儿不时出现惊厥,是由于肺气虚弱,不能制约肝木(肝气)。使用五味子、肉桂、人参来平抑它。
急惊风(急性惊厥)使用铁衣针砂,不仅能化解痰涎、镇安心神,而且可以抑制并推散肝经邪气。如果惊厥伴有呕吐和腹泻,用丁香五分、白术一钱、肉豆蔻七分,共研为细末,用姜汤送服。急惊风脉象刚劲急促,金枣丸、琥珀丸都可以服用。
金枣丸
天麻(三钱,用米炒制)、枳壳(酒炒制)、牛黄(各一钱)、劈砂、块状雄黄、槐角(各二钱)、麝香(七分)、胆南星(三钱)、半夏(姜汁制,三钱)、皂角(酒炒制,一分)。用枣肉(二两),巴豆(六粒,火煨至熟,去掉巴豆,只用枣肉捣烂制成如黄豆大小的丸药,以朱砂为衣,根据证候用汤剂化开服用一丸。
琥珀丸
天竺黄、僵蚕、雄黄、钩藤、天麻、柏子仁、益智仁(各五钱)、珍珠、琥珀、胆南星(姜汁炒制)、牛黄(各一钱)、麝香(五分)、全蝎(去头足,二十个)、竹节白附子(大的三钱)、冰片(三分)、蜈蚣(一条)、犍猪爪(四枚)。
共研为蜜丸,用金箔十张作为外衣,根据证候用汤剂化开服用一丸。
慢惊风这一证候,是小儿最严重的状况。大概是因为三脏受病,先后天都受到损伤。肾藏精主恐,肝主气主动主升,心主脉主惊。惊厥发作时,心气动而肝气随之上升,肾气被肝气牵引而动,精气也随之并聚于上部,那么肾精就不能固藏了。精不固藏则下部虚,肝气上升则上部实,所以惊证没有肾不虚的,也没有肝不实的。痰,是精气变化而成的,精气并聚于上部而成痰,得到肝火的扶持,内而在心胸上下,外而在经络手足,无非都是痰气了。大概肝主气,心主脉,肾主痰,心、肝、肾三经的证候,以及心、肝、肾三经的经络,都是痰气通行的道路。然而这还算容易治疗,只需用生姜、肉桂收敛并引导下行,兼用通经清利水湿的药剂就能安宁了。之所以容易治疗,是因为脾气尚能运化,药力可以发挥作用,升降的机制还掌握在我手中。如果一旦传变到脾就难治了,脾气停滞于痰中则胃不运化,胃不运化则后天之气生病,而后天虚弱之处更无法生化,那么肾精就会枯竭,肾枯竭则肝火更加旺盛,火越旺盛则痰越盛,痰越盛则四肢九窍百骸,无非都是痰气闭塞而生机停息了,不死还等什么?令人遗憾的是,人们只见痰害严重,而一味以消痰为事,消痰固然好,但不消除根本而只消除表象,这就像抱着柴草去救火一样。因为消痰的药剂都是损伤脾胃、伐肾耗损元气的药物。所以遇到急惊风,其证属实,病位浅,治疗痰症而痰容易消退,虽然不完全合乎法度,但还像驱逐一个个无能的贼寇,尚且容易清除。至于慢惊风,则根深势猛,如果不从病源着力,也用驱逐小贼的方法治疗,这是激怒它而使其任性发作,怎么可以救治呢!用药都宜于通行下降,以温中纳气为主,炮姜、肉桂、苏梗、广陈皮、远志、茯神、铁衣、甘草、五味子、人参之类,都可以使用。舍弃这些而去消痰,我不知道那怎么行得通。
金箔镇心丸(治疗慢惊风、惊痫)
人参、茯神、紫河车、琥珀(各一钱)、甘草(五分)、朱砂、珍珠(各一钱)。
蜜丸,用金箔作为外衣。
疳疾初起,是由于饮食郁结化为火,用甘草、薄荷煎汤送下四圣丸。时间久了则脾虚,像大人患怯证一样。小儿吃土、米、瓦灰等物,是有疳虫所致。用诃子肉、白术各一两,使君子肉、甘草各五钱,麦芽八两,同其所喜爱的食物一起研为细末,用白糖调服。
Infants and children who frequently experience convulsions (Jing) suffer from deficiency of the Lung Qi, which fails to restrain Liver Wood. Use Wuweizi (Schisandrae Fructus), Rougui (Cinnamomi Cortex), and Renshen (Ginseng Radix et Rhizoma) to pacify it.
For Ji Jing Feng (Acute Convulsive Disorder), Tieyi Zhensha (Iron-coated Nodules) is used; not only does it resolve phlegm and calm the Heart Spirit, but it also suppresses and disperses pathogenic factors in the Liver channel. If convulsions are accompanied by vomiting and diarrhea, use Dingxiang (Caryophylli Flos) 5 fen, Baizhu (Atractylodis Macrocephalae Rhizoma) 1 qian, and Rougu (Myristicae Semen) 7 fen, ground into powder, and taken with Ginger Decoction. For Ji Jing Feng with a rigid and rapid pulse, Jinzao Wan (Golden Date Pill) and Hupo Wan (Amber Pill) can be administered.
Jinzao Wan (Golden Date Pill)
Tianma (Gastrodiae Rhizoma) 3 qian, stir-fried with rice; Zhiqiao (Aurantii Fructus) processed with wine; Niuhuang (Bovis Calculus) 1 qian each; Pisha (Nodulus Ferri); Xionghuang (Realgar) block form; Huaijiao (Gleditsiae Sinensis Fructus) 2 qian each; Shexiang (Moschus) 7 fen; Danningxing (Arisaematis Cum Bile) 3 qian; Banxia (Pinelliae Rhizoma) prepared with ginger juice, 3 qian; Saojiao (Gleditsiae Sinensis Spina) processed with wine, 1 fen. Use Jiaorou (Date Flesh) 2 liang. Badou (Crotonis Fructus) 6 grains, fire-roasted until cooked, discard the seeds, mash the date flesh, and form pills the size of soybeans. Coat with Zhusha (Cinnabar). Administer one pill dissolved in a decoction appropriate to the syndrome.
Hupo Wan (Amber Pill)
Tianzhuhuang (Calami Tini) 5 qian each; Jiangcan (Bombyx Batryticatus); Xionghuang (Realgar); Gouteng (Uncariae Ramulus cum Uncis); Tianma (Gastrodiae Rhizoma); Baiziren (Platycladi Semen); Yizhiren (Alpiniae Oxyphyllae Fructus); Zhenzhu (Margarita); Hupo (Succinum); Danningxing (Arisaematis Cum Bile) stir-fried with ginger juice; Niuhuang (Bovis Calculus) 1 qian each; Shexiang (Moschus) 5 fen; Quanxie (Scorpio) remove head and feet, 20 individuals; Zhujie Baifuzi (Typhonii Rhizoma) large ones, 3 qian; Bingpian (Borneolum Syntheticum) 3 fen; Wugong (Scolopendra) 1 piece; Jianzhuzhao (Pes Porci) 4 pieces.
Grind together and form honey pills. Coat with 10 sheets of Jinbo (Gold Leaf). Administer one pill dissolved in a decoction appropriate to the syndrome.
Man Jing Feng (Chronic Convulsive Disorder) is the most severe condition in infants and children. It arises because three zang organs are diseased, damaging both the Pre-heaven and Post-heaven sources. The Kidney stores essence and governs fear; the Liver governs qi, movement, and ascending; the Heart governs vessels and fright. In convulsions, Heart qi moves and Liver qi ascends with it; Kidney qi is pulled by Liver qi, causing essence and qi to gather upward, thus failing to store Kidney essence. When essence is not stored, there is deficiency below; when Liver qi ascends, there is excess above. Therefore, in convulsive disorders, the Kidney is invariably deficient, and the Liver invariably excessive. Phlegm is a transformation of essence and qi; when essence and qi gather upward, phlegm forms. Supported by Liver Fire, this phlegm-qiu exists internally in the chest and heart, and externally in the meridians and limbs. The Liver governs qi, the Heart governs vessels, and the Kidney governs phlegm. The manifestations of the Heart, Liver, and Kidney channels, as well as their meridians, serve as pathways for phlegm. However, this is relatively easy to treat; simply use Shengjiang (Zingiberis Rhizoma) and Rougui (Cinnamomi Cortex) to astringe and guide downward, combined with agents that unblock meridians and clear dampness, and peace will be restored. It is easy to treat because Spleen qi still functions, allowing medicinal power to act, and the mechanism of ascending and descending remains under control. If it transmits to the Spleen, it becomes difficult to treat. If Spleen qi stagnates due to phlegm, the Stomach fails to transform; if the Stomach fails to transform, Post-heaven qi becomes diseased, and the deficiency of Pre-heaven has no source to generate from. Then Kidney essence dries up; when Kidney essence dries, Liver fire rises further; as fire rises, phlegm increases; as phlegm increases, the four limbs, nine orifices, and entire body become blocked by phlegm-qiu, and vital energy ceases. Death is inevitable. What is regrettable is that people only see the severity of phlegm harm and focus solely on resolving phlegm. While resolving phlegm is good, doing so without addressing the root while treating the branch is like carrying firewood to save a fire. Phlegm-resolving agents are substances that damage the Spleen and Stomach and deplete Kidney yuan qi. Therefore, in Ji Jing Feng, where the syndrome is excess and the disease path is shallow, treating phlegm allows it to recede easily. Although this may not strictly follow standard methods, it is akin to chasing away incompetent thieves, which is still easy to accomplish. As for Man Jing Feng, the roots are deep and the momentum fierce. If one does not exert effort at the source of the disease but instead uses methods for chasing small thieves, one provokes its anger and allows it to run rampant; how can such a case be saved? Medications should generally promote circulation and descend, focusing on warming the middle and grasping qi. Paoyang (Zingiberis Rhizoma Preparatum), Rougui (Cinnamomi Cortex), Sugeng (Perillae Caulis), Guangpi (Citri Reticulatae Pericarpium), Yuanzhi (Polygalae Radix), Fushen (Poria with Hostwood), Tieyi (Iron-coated Nodules), Gancao (Glycyrrhizae Radix et Rhizoma), Wuweizi (Schisandrae Fructus), and Renshen (Ginseng Radix et Rhizoma) are all usable. To abandon these for phlegm resolution, I do not know how that could work.
Jinbo Zhenxin Wan (Gold-Leaf Calming Heart Pill) (Treats Man Jing Feng, Jing Xian)
Renshen (Ginseng Radix et Rhizoma), Fushen (Poria with Hostwood), Ziheche (Placenta Humana), Hupo (Succinum) 1 qian each; Gancao (Glycyrrhizae Radix et Rhizoma) 5 fen; Zhusha (Cinnabar), Zhenzhu (Margarita) 1 qian each.
Form honey pills, coat with Jinbo (Gold Leaf).
At the onset of Gan Ji (Childhood Malnutrition Syndrome), food stagnation transforms into fire. Use Gancao (Glycyrrhizae Radix et Rhizoma) and Bohe (Menthae Haplocalycis Herba) decocted in water to deliver Sixiang Wan (Six Sages Pill). Over time, Spleen deficiency occurs, resembling timidity in adults. Children eating soil, rice, or roof tile ash have Gan Chong (parasitic worms associated with malnutrition). Use Hezi Rou (Terminaliae Chebulae Mesocarp) and Baizhu (Atractylodis Macrocephalae Rhizoma) 1 liang each; Shijunzi Rou (Quisqualis Fructus) and Gancao (Glycyrrhizae Radix et Rhizoma) 5 qian each; Maiya (Hordei Fructus Germinatus) 8 liang. Grind together with foods the child prefers into fine powder, and take mixed with white sugar.