巢氏云∶小儿滞颐者、涎流出而渍于颐间也,此由脾冷涎多故也。脾之液为涎,脾胃虚冷,不能收制其津液,故流
出渍于颐也。张氏温脾丹主之。一法百药煎含咽,其涎自不出亦截法也。益黄散亦治此症,温脾散亦可服。
张涣温脾丹 治滞颐。
半夏曲 丁香 木香(各一两) 干姜 白术 青皮 陈皮(各半两)
上为末,糊丸如黍米大,一岁十丸,二岁二十丸,大小加减,米汤下。
温胃散 治滞颐,涎流出渍于颐上,此由脾冷涎多故也。
半夏(泡) 人参 甘草 干姜 肉豆蔻 白术(各半两) 丁香(一两)
上为末,每服二钱,生姜三片,煎食前温服。
益黄散 见第八问。
(羚羊角丸,治五六岁不走。)
仲阳云∶龟胸者,乃肺热胀满攻于胸膈,即成龟胸,又乳母多食五辛而成此疾。龟背者,儿生下客风吹脊,入于骨
髓,即成龟背,治以龟尿,点其背上骨节。取尿之法,当放龟于荷叶上,候龟眼四顾,急用镜照之,其尿自出。圣惠论
小儿龟胸者,缘肺热气胀满而成此疾,乳母多食辛辣之物,亦成此候,或乳母有宿乳乳儿,亦成此疾,常捏去宿乳,则
无此症也,当用圣惠龟背丸治之。圣惠论龟背者,小儿初生,未满半周,强令早坐,遂使客风吹脊,故令背高如龟之状
也。有灸法可疗,当灸第三椎骨下两傍各一寸半肺 穴,又第五椎骨下两傍二寸半心 穴,又第七椎骨下两傍各一寸半
膈俞穴。以小儿中指节为一寸,艾炷如小麦大,但三、五壮而止。又有鹤膝证,小儿禀受不足,血气不充,故肌肉瘦薄,
骨节呈露如鹤之膝,抑亦肾虚而得之,钱氏地黄丸加鹿茸以补肾气。又有行迟之症,乃血气不充、则髓不满骨,故软弱
而不能行,抑亦肝肾俱虚而得之,肝主筋,筋弱而不能束也,地黄丸加牛膝、五加皮及酒炙鹿茸,又有五加皮散治之,
又治龟胸,有龟胸丸以散其热,松蕊丹、百合丹治龟胸、龟背尤佳。
龟胸丸 治小儿龟胸、龟背,缘肺热气胀满而渐成此疾。乳母多食辛辣之物,亦能成此症。
大黄(煨、一钱) 天门冬(去心) 百合 杏仁(去皮尖、炒) 木通(去节) 枳壳(麸炒) 桑白皮(蜜炙)
甜葶苈(炒) 朴硝(各五钱)
上为细末,炼蜜丸如芡实大,每用一丸,温汤化服食后。
枳壳防风丸
枳壳(麸炒) 防风(去芦) 独活(去芦) 大黄(煨) 前胡(去芦) 当归 麻黄(去节、各一钱)
上为细末,面糊丸如黍米大,每服十丸,米饮食后服。
巢元方说:小儿滞颐,是指口水流出并浸渍在面颊部位。这是由于脾脏虚冷、涎液过多所致。脾的体液是涎,脾胃虚寒,不能固摄津液,所以口水流出并浸渍在面颊。张涣主张用温脾丹治疗。另一种方法是含服百药煎让其咽下,这样涎液自然不再流出,这也是一种截断病势的方法。益黄散也能治疗此症,温脾散也可以服用。
张涣的温脾丹,用于治疗滞颐。
药材及用量:半夏曲、丁香、木香(各一两);干姜、白术、青皮、陈皮(各半两)。
制法与用法:将上述药物研为细末,用米糊制成如黍米大小的丸剂。一岁的患儿每次服用十丸,两岁的服用二十丸,根据年龄大小酌情增减,用米汤送服。
温胃散,用于治疗滞颐,症状为口水流出浸渍在面颊上,这也是因为脾冷涎多所致。
药材及用量:半夏(炮制)、人参、甘草、干姜、肉豆蔻、白术(各半两);丁香(一两)。
制法与用法:将上述药物研为细末。每次服用二钱,加入生姜三片,煎煮后于饭前温服。
益黄散,参见第八问。
(羚羊角丸,用于治疗五六岁还不会走路的小儿。)
钱乙说:龟胸,是由于肺热胀满,邪气攻冲胸膈,从而形成龟胸。此外,乳母如果多吃五辛食物,也会导致此病。龟背,是因为婴儿出生后受到客风侵袭脊柱,邪气深入骨髓,从而形成龟背。治疗方法是用龟尿点涂在背部的骨节处。取龟尿的方法是:把龟放在荷叶上,等待龟眼四处张望时,急忙用镜子照射它,它的尿液就会流出。《太平圣惠方》论述小儿龟胸,认为是由于肺热气胀满而形成的疾病。乳母多吃辛辣食物,也会造成这种症状;或者乳母有积存的乳汁喂哺婴儿,也会引起此病,经常捏去积存的乳汁,就不会有此症状了,应当使用《圣惠方》中的龟背丸来治疗。《太平圣惠方》论述龟背,说是小儿初生未满周岁时,强行让他过早坐立,致使客风侵袭脊柱,导致背部隆起像乌龟的形状一样。有灸法可以治疗,应当灸第三椎骨下方两侧各一寸半处的肺俞穴,第五椎骨下方两侧二寸半处的心俞穴,以及第七椎骨下方两侧各一寸半处的膈俞穴。以小儿中指中节长度为一寸,艾炷大小如小麦粒,只需灸三到五壮即可停止。另外还有鹤膝证,这是因为小儿先天禀赋不足,气血不充盈,导致肌肉瘦薄,骨节显露像鹤的膝盖一样,这也是肾虚所致,可用钱乙的地黄丸加入鹿茸以补肾气。另外还有行迟的症状,这是因为气血不充盈,髓海不满骨骼,所以肢体软弱而不能行走,这也是肝肾俱虚所致。肝主筋,筋弱则不能约束骨骼。可用地黄丸加入牛膝、五加皮以及酒炙鹿茸,另有五加皮散也可治疗。治疗龟胸,有用龟胸丸来疏散其热毒,松蕊丹、百合丹治疗龟胸、龟背效果尤佳。
龟胸丸,用于治疗小儿龟胸、龟背,原因是肺热气胀满逐渐形成此病。乳母多吃辛辣食物,也能造成此症。
药材及用量:大黄(煨制,一钱);天门冬(去心)、百合、杏仁(去皮尖,炒制)、木通(去节)、枳壳(麸炒)、桑白皮(蜜炙)、甜葶苈(炒制)、朴硝(各五钱)。
制法与用法:将上述药物研为细末,用炼蜜制成如芡实大小的丸剂。每次服用一丸,饭后用温水化开服用。
枳壳防风丸
药材及用量:枳壳(麸炒)、防风(去芦头)、独活(去芦头)、大黄(煨制)、前胡(去芦头)、当归、麻黄(去节,各一钱)。
制法与用法:将上述药物研为细末,用面糊制成如黍米大小的丸剂。每次服用十丸,饭后用米饮送服。
Chao Yuanfang stated: "Infantile drooling" (Zhi Yi, accumulation of saliva in the chin area) refers to saliva flowing out and soaking the cheeks. This is caused by coldness in the Spleen leading to excessive saliva. The fluid of the Spleen is saliva; when the Spleen and Stomach are deficient and cold, they fail to control the body fluids, causing them to flow out and soak the cheeks. Zhang Huan advocated using *Wen Pi Dan* (Warm the Spleen Pill). Another method is to swallow *Bai Yao Jian* (Hundred Medicines Decoction), which naturally stops the saliva flow, serving as a method to intercept the pathogenic factor. *Yi Huang San* (Benefit the Yellow Powder) can also treat this condition, and *Wen Pi San* (Warm the Spleen Powder) may also be administered.
Zhang Huan's *Wen Pi Dan* (Warm the Spleen Pill) treats infantile drooling.
Ingredients: Banxia Qu (Prepared Pinellia Curd), Dingxiang (Clove), Muxiang (Aucklandiae Radix) (each 1 liang); Ganjiang (Dried Ginger), Baizhu (Atractylodis Macrocephalae Rhizoma), Qingpi (Green Tangerine Peel), Chenpi (Tangerine Peel) (each 0.5 liang).
Preparation and Administration: Grind the above ingredients into fine powder, mix with rice paste to form pills the size of millet seeds. For one-year-olds, administer 10 pills per dose; for two-year-olds, 20 pills per dose. Adjust according to age and severity, taken with rice soup.
*Wen Wei San* (Warm the Stomach Powder) treats infantile drooling, where saliva flows out and soaks the cheeks, also caused by Spleen coldness and excessive saliva.
Ingredients: Banxia (Pinelliae Rhizoma, processed), Renshen (Ginseng Radix et Rhizoma), Gancao (Licorice Root), Ganjiang (Dried Ginger), Roudoukou (Myristicae Semen), Baizhu (Atractylodis Macrocephalae Rhizoma) (each 0.5 liang); Dingxiang (Clove) (1 liang).
Preparation and Administration: Grind the above ingredients into fine powder. Take 2 qian per dose, add 3 slices of fresh ginger, decoct, and take warm before meals.
*Yi Huang San* (Benefit the Yellow Powder): See Question 8.
(*Lingyang Jiao Wan* (Antelope Horn Pill) treats infants aged five or six who cannot walk.)
Qian Yi stated: "Tortoise chest" (Gui Xiong) results from lung heat causing distension and fullness that attacks the chest and diaphragm, forming tortoise chest. Additionally, if the nursing mother consumes too much "five pungent spices" (Wu Xin), this disease can occur. "Tortoise back" (Gui Bei) occurs when postnatal exogenous wind invades the spine and penetrates the bone marrow after birth, forming tortoise back. The treatment involves applying turtle urine to the vertebral joints on the back. To obtain turtle urine, place the turtle on a lotus leaf; when the turtle looks around, quickly shine a mirror on it, and its urine will flow out. *Taiping Shenghui Fang* discusses infantile tortoise chest, attributing it to lung heat causing distension and fullness. If the nursing mother eats spicy foods, this symptom can also arise. If the nursing mother has retained milk fed to the infant, this disease may also result; frequently expressing the retained milk prevents this symptom. One should use *Gui Bei Wan* (Tortoise Back Pill) from *Shenghui Fang*. *Taiping Shenghui Fang* discusses tortoise back, stating that if an infant under one year old is forced to sit too early, exogenous wind invades the spine, causing the back to protrude like a tortoise shell. Moxibustion can treat this: moxa should be applied to Feishu (BL-13, Lung Shu) located 1.5 cun lateral to the lower border of the third thoracic vertebra, Xinshu (BL-15, Heart Shu) located 2.5 cun lateral to the lower border of the fifth thoracic vertebra, and Geshu (BL-17, Diaphragm Shu) located 1.5 cun lateral to the lower border of the seventh thoracic vertebra. Use 1 cun defined by the middle joint of the infant's finger. The moxa cone should be the size of a wheat grain. Stop after three to five moxa cones. There is also "Crane knee" syndrome, caused by insufficient congenital endowment and lack of Qi and Blood, resulting in thin muscles and exposed joints resembling crane knees. This is also due to Kidney deficiency. Qian Yi's *Dihuang Wan* (Rehmannia Pill) with added Lurong (Deer Antler) can tonify Kidney Qi. There is also delayed walking, caused by insufficient Qi and Blood failing to fill the bones with marrow, resulting in weakness and inability to walk. This is also due to deficiency of both Liver and Kidney. The Liver governs tendons; weak tendons fail to bind the joints. *Dihuang Wan* (Rehmannia Pill) with added Niuxi (Achyranthis Bidentatae Radix), Wujia Pi (Acanthopanacis Cortex), and Jiuzhi Lurong (Deer Antler prepared with wine) can be used. *Wujia Pi San* (Acanthopanacis Cortex Powder) is also effective. For tortoise chest, *Gui Xiong Wan* (Tortoise Chest Pill) disperses heat. *Songrui Dan* (Pine Pollen Pill) and *Baihe Dan* (Lily Bulb Pill) are particularly excellent for treating tortoise chest and tortoise back.
*Gui Xiong Wan* (Tortoise Chest Pill) treats infantile tortoise chest and tortoise back, caused gradually by lung heat and distension. Nursing mothers eating spicy foods can also cause this condition.
Ingredients: Dahuang (Rhei Radix et Rhizoma, roasted, 1 qian); Tianmendong (Asparagi Radix, heart removed), Baihe (Lilii Bulbus), Xingren (Armeniacae Semen Amarum, skin and tip removed, stir-fried), Mutong (Akebiae Caulis, nodes removed), Zhiqiao (Aurantii Fructus, bran-stir-fried), Sangbaipi (Mori Cortex, honey-fried), Tiantingli (Descurainiae Semen seu Lepidii Semen, stir-fried), Puxiao (Natrii Sulfas) (each 5 qian).
Preparation and Administration: Grind into fine powder, mix with refined honey to form pills the size of Chinese quince seeds. Take one pill per dose, dissolve in warm water, and administer after meals.
*Zhiqiao Fangfeng Wan* (Immature Bitter Orange and Saposhnikovia Pill)
Ingredients: Zhiqiao (Aurantii Fructus, bran-stir-fried), Fangfeng (Saposhnikoviae Radix, awn removed), Duhuo (Angelicae Pubescentis Radix, awn removed), Dahuang (Rhei Radix et Rhizoma, roasted), Qianhu (Peucedani Radix, awn removed), Danggui (Angelicae Sinensis Radix), Mahuang (Ephedrae Herba, nodes removed) (each 1 qian).
Preparation and Administration: Grind into fine powder, mix with flour paste to form pills the size of millet seeds. Take 10 pills per dose, administered after meals with rice drink.