小儿天真未凿。鲜五发之毒。亦无善恶之诊。其轻小疮疡。自可淋涤敷贴之。所谓频沐更衣外宣无病。
不得已而药之。乃下法也。然必兼调乳母为确。其有大症。载前专科无异。第以小儿所司者。莫如丹毒
等类。今则独加详焉。
丹者受毒于未形之先。发病于有生之后。由胎养失宜所致。预辨之法。小儿无故眼生浓眵。或眼胞红
晕。微有气喘。夜则烦啼。此欲发丹之候也。急服蓝根等药。潜消其毒。已有赤肿者。即用芸苔等类。外锉
其锋。然必兼吮砭洗贴等法治之。始获全效。
胎热丹毒 初发赤肿光亮。游走遍身者。由热毒之气极与血相搏而风乘之也。故又名之曰赤游风
也。初宜升麻葛根汤表之。次用百解散、驱风散清之。甚者大连翘饮。如腹胀不乳。毒瓦斯入里也。紫雪散
下之。外则吮之砭之。淋洗之。随用精猪肉片贴之。一时许。换药敷之。甚者日换二次。三日后身凉腹软。
声清乳哺如常。砭处肉活者顺。反此者逆。
丹起于腹背。流入于四肢者顺。起于四肢。流入于腹背阴囊者逆。
胎惊丹毒 初则面生水豆根脚微红。出没无定次至颈项丹赤如珠。再次延及胸乳间者。由孕母受
惊传袭于儿胎也。先用四圣散洗目。内服之药照前胎热。如微有痰喘作搐者。少加解惊药。
食滞丹毒 初发赤晕。行而缓慢。非若胎热之暴速者。此由食滞所致。治宜先消其食。食滞消而丹仍
作者。用药与胎热药同。
吮法砭法 丹毒之法。急令人用甘草煎浓汁漱口净。随患处遍吮之。使毒各聚一处。淋洗之。敷贴之。
自效。甚者吮毕。随行砭法。如赤晕走彻遍身。难以悉砭者。令人吮胸背四肢等数处而砭之。令微出血
以泻其毒。血红者轻。紫者重。黑者死。或出白汁如珠亮。如水晶手粘起丝者重。砭毕。随以药水淋洗之。
用精猪肉薄片贴之。一时许换药敷之。甚者日换敷二次。次日如肿未全消。再量行砭法。洗敷照前。第
砭时不可刮尽其血。血尽则出黄水矣。若身弱者有不测之变。盖为血去而气不能独居也。
又儿生百日之内。不可砭之。以其肌肉不能任也。如患在头。令儿倒卧。头要低些。用铍针自下而上。偏
针挑之出血。令毒从顶出。不行砭法。敷药同前。
丹名虽多。其源则一。总以右法施之。自验。(砭法见首卷针砭门)
凡治风丹。宜解毒托里。令微通利。使元气内护而排外邪。慎用硝黄等大下之剂。若夫发散太过。则表
虚热。赤不退者。补中益气汤。加防风、白芷。寒凉太过。则胃虚热。赤不退者。异功散加升麻、
柴胡。或兼发搐者四君子汤加升麻、当归、钩藤。如丹毒已解。发热作渴不食者。七味白术散。
小儿天真未开,极少发生五发之毒(指痘、疹、斑、疮、丹等五种发于体表的疾病),也没有善恶预后的诊断。对于轻微的疮疡,自然可以通过清洗、敷贴等方法处理,这就是所谓的经常沐浴更衣,外部宣通而无病。
如果不得已而用药治疗,属于攻下法。然而必须同时调理乳母才确切。那些严重的病症,记载在前面的专科中并无不同。只是小儿所患的,莫过于丹毒这类疾病,现在则单独加以详细论述。
丹毒是在胎儿形成之前受毒,在出生后发病。这是由于胎养失宜所致。预先辨别的方法:小儿无故眼睛生出浓稠眼屎,或眼睑红晕,轻微气喘,夜间烦躁啼哭,这是将要发丹的征兆。急服蓝根等药物,暗中消除其毒气。已经有红肿的,立即使用芸苔等类药物,外用挫败其锋芒。然而必须配合吮吸、砭刺、清洗、敷贴等方法治疗,才能取得完全疗效。
胎热丹毒:初起时赤肿光亮,游走遍身,是由热毒之气极盛与血相搏,风邪乘虚而入所致。所以又叫做赤游风。初期适宜用升麻葛根汤发表,其次用百解散、驱风散清解。严重的用大连翘饮。如果出现腹胀不进食,是毒瓦斯入里,用紫雪散攻下。外用吮吸、砭刺、淋洗,随即用精猪肉片贴敷。约一小时后,换药敷上。严重的每天换两次。三天后身体凉快,腹部柔软,声音清脆,吃奶如常。砭刺处肌肉鲜活为顺证,反之则为逆证。
丹毒从腹背发起,流入四肢的为顺证;从四肢发起,流入腹背及阴囊的为逆证。
胎惊丹毒:初起面部生水痘样颗粒,根部微红,出没不定,接着颈部丹赤如珠,再次蔓延至胸乳之间。这是由于孕妇受惊,传袭给胎儿所致。先用四圣散洗眼,内服药物照前胎热丹毒的方法。如果轻微有痰喘抽搐,稍加解惊药物。
食滞丹毒:初起赤晕,行进缓慢,不像胎热那样暴速。这是由食积停滞所致。治疗应当先消食。食积消除后丹毒仍然发作的,用药与胎热丹毒相同。
吮法和砭法:治疗丹毒的方法,急忙让人用甘草煎煮浓汁漱口干净,随后在患处遍部吮吸,使毒气聚集在一处,然后清洗,敷贴,自然有效。严重的吮吸完毕后,随即进行砭刺法。如果赤晕走窜遍身,难以全部砭刺,让人吮吸胸背四肢等几处后进行砭刺,令微微出血以泻出毒气。血色红者轻,紫者重,黑者死。或者流出白色汁液如珠亮,像水晶手粘起丝的重症。砭刺完毕,随即用药水淋洗,用精猪肉薄片贴敷。约一小时后换药敷上。严重的每天换敷两次。第二天如果肿胀未全消,再酌情进行砭刺,清洗敷贴照旧。只是砭刺时不可刮尽血液,血尽则会流出黄水。如果身体虚弱会有不测的变化,这是因为血去而气不能独存。
另外婴儿出生一百天之内,不可砭刺,因为其肌肉不能承受。如果患病在头部,让婴儿倒卧,头要低一些,用铍针自下而上,偏侧针刺挑破出血,令毒气从头顶排出,不进行砭刺法,敷药同前。
丹毒名称虽多,其根源则一。总以上述方法施治,自然验证。(砭法见首卷针砭门)
凡是治疗风丹,适宜解毒托里,令大便轻微通利,使元气在内护卫而排除外邪。慎用硝黄等大下之剂。如果发散太过,导致表虚热,赤色不退的,用补中益气汤,加防风、白芷。寒凉太过,导致胃虚热,赤色不退的,用异功散加升麻、柴胡。或者兼有抽搐的,用四君子汤加升麻、当归、钩藤。如果丹毒已解,发热口渴不进食的,用七味白术散。
The infant's innocence is uncarved, rarely suffering from the "Five Eruptions" (referring to five types of eruptive skin diseases such as smallpox, measles, spots, sores, and carbuncles), and there are no diagnoses of good or bad prognoses. For minor sores and ulcers, they can naturally be treated by washing and applying dressings; this is what is meant by frequent bathing and changing clothes to promote external circulation and prevent disease.
If medication is unavoidable for treatment, it belongs to the purgative method. However, it is essential to simultaneously regulate the wet nurse for certainty. Severe conditions are recorded in previous specialized sections without difference. It is merely that among infants, the most common afflictions are those like Dan Du (carbuncle toxin/red spreading erysipelas). Therefore, these are now detailed exclusively.
Dan Du receives toxin before form manifests, and illness appears after life begins. This is caused by improper fetal nourishment. The method for preliminary identification: if an infant inexplicably produces thick ocular discharge, or has red halos around the eyelids, slight asthma, and cries restlessly at night, these are signs of impending Dan Du. Urgently administer drugs such as Lan Gen (Scrophulariae Radix) to secretly dissipate the toxin. If redness and swelling have already appeared, immediately use Yun Tai (Brassica rapa var. pekinensis) and similar herbs externally to blunt its sharpness. However, one must combine sucking, Bian (pricking bloodletting), washing, and dressing methods to achieve full efficacy.
Tai Re Dan Du (Fetal Heat Carbuncle Toxin): Initially presenting with bright red swelling wandering all over the body, it is caused by extreme heat-toxin qi clashing with blood, allowing wind to take advantage. Hence, it is also called Chi You Feng (Red Wandering Wind). Initially, Sheng Ma Ge Gen Tang (Ephedra and Kudzu Decoction) should be used to release the exterior. Subsequently, Bai Jie San (Hundred Dissolution Powder) and Qu Feng San (Wind-Expelling Powder) should be used to clear the heat. In severe cases, Da Lian Qiao Yin (Large Forsythia Decoction) is used. If abdominal distension occurs and the infant refuses milk, it indicates toxin qi entering the interior; Zi Xue San (Purple Snow Powder) should be administered to purge. Externally, apply sucking, pricking, and washing, followed immediately by applying slices of lean pork. After about an hour, change the dressing. In severe cases, change twice daily. After three days, if the body cools, the abdomen softens, the voice becomes clear, and feeding returns to normal, it is a favorable sign. Flesh at the pricked sites remaining active indicates a favorable prognosis; the opposite indicates an unfavorable prognosis.
Dan Du originating from the abdomen and back, flowing into the limbs, is favorable. Originating from the limbs, flowing into the abdomen, back, and scrotum, is unfavorable.
Tai Jing Dan Du (Fetal Shock Carbuncle Toxin): Initially, water-blister-like bumps appear on the face with slightly red roots, appearing and disappearing unpredictably. Next, the neck becomes red like pearls. Subsequently, it spreads to between the chest and breasts. This is caused by the pregnant mother experiencing shock, which transmits to the fetus. First, wash the eyes with Si Sheng San (Four Sages Powder). Internal medication follows the same protocol as Fetal Heat Dan Du. If there is slight phlegm, asthma, or convulsions, add a small amount of anti-shock medication.
Shi Zhi Dan Du (Food Stagnation Carbuncle Toxin): Initially presenting with red halos, progressing slowly, unlike the sudden speed of Fetal Heat. This is caused by food stagnation. Treatment should first focus on resolving food stagnation. If Dan Du persists after food stagnation is resolved, use the same medication as for Fetal Heat Dan Du.
Sucking and Pricking Methods: For treating Dan Du, urgently have someone boil Gan Cao (Licorice Root) into a concentrated decoction to rinse the mouth clean. Then, suck over the affected area thoroughly to gather the toxin in one place, followed by washing and applying dressings, which will naturally prove effective. In severe cases, after sucking, proceed to the pricking method. If red halos spread throughout the body, making complete pricking difficult, have someone suck several areas on the chest, back, and limbs before pricking them. Allow slight bleeding to vent the toxin. Red blood indicates mild condition, purple indicates severe, and black indicates death. Alternatively, if white juice flows out like bright pearls or crystal strands sticking to the hand, it is severe. After pricking, wash with medicinal liquid and apply thin slices of lean pork. Change the dressing after about an hour. In severe cases, change twice daily. If swelling does not fully subside the next day, re-evaluate and perform pricking again, washing and dressing as before. However, do not scrape all blood during pricking; if all blood is removed, yellow fluid will flow out. If the body is weak, unpredictable changes may occur because Qi cannot exist independently after Blood loss.
Furthermore, infants within one hundred days of birth should not undergo pricking, as their muscles cannot withstand it. If the lesion is on the head, lay the infant supine with the head lower, and use a Pi Zhen (Bilade needle) to prick from bottom to top, piercing laterally to bleed, allowing toxin to exit from the crown. Do not use the general pricking method; apply dressings as before.
Although Dan Du has many names, its source is one. Applying the above methods generally will yield verified results. (Pricking method is seen in the first volume, Acupuncture and Pricking Section.)
For treating Wind Dan, it is appropriate to resolve toxicity and support the interior, ensuring slight bowel movement to allow Yuan Qi (Original Qi) to protect internally and expel external pathogens. Use caution with strong purgatives like Xiao Huang (Mirabilite and Rhubarb). If dispersing is excessive, leading to exterior deficiency heat where redness does not recede, use Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) added with Fang Feng (Saposhnikovia Root) and Bai Zhi (Angelica Dahurica). If cold-cooling is excessive, leading to stomach deficiency heat where redness does not recede, use Yi Gong San (Yi Gong Powder) added with Sheng Ma (Cimicifugae Rhizoma) and Chai Hu (Bupleuri Radix). If accompanied by convulsions, use Si Jun Zi Tang (Four Gentlemen Decoction) added with Sheng Ma, Dang Gui (Angelica Sinensis), and Gou Teng (Uncariae Ramulus cum Uncis). If Dan Du has resolved but fever, thirst, and anorexia persist, use Qi Wei Bai Zhu San (Seven-Ingredient Atractylodes Macrocephala Powder).