小儿有不能语者。其证有三。一者心气不足。心系舌本。气营而举之。则舌本动而语声作矣。今气怯而不能
营用于舌。故不能语也。此证已在五气项下具之。二者卒不能语。因风寒之邪。干于哑门。联系舌本。使舌本紧
急。故卒不能语也。又一证喉咙为气之道路。会厌为声之门户。暴为风客于喉厌。则失
音而语声不出。非不能语也。三者因病后不能语。此因服清药以利小便。致肾虚而不能上接于阳。故不能语。昔
钱乙治王氏慢惊病愈后。有声而不能语。众以为失音。乙曰。既失音何开目而能饮食。又牙不噤。口不紧。而能
咽药。众医皆不晓。乙曰。此因用清药利小便。致虚肾气。不能上接于阳故也。遂用地黄丸补肾。而渐渐能言。
一月而愈。其方本集载之。外收方具后。
菖蒲散
治感风寒。客于哑门。卒不能语。
菖蒲 桂心 远志(去心甘草水煮各一分)
上为细末。每一钱。水一钟。煎至五分。温服无时。
桂散
治风寒客于喉厌。语声不出。
川芎(三分) 远志(去心甘草水煮三分) 麦门冬(去心三分) 人参(去芦半两)
上为细末。炼蜜和丸小豆大。平旦空心米饮下五丸。日三。儿大加之。久服取效。
小儿有渴而饮水者。此因脏腑有热。热则藏燥。故多体热发烦。亡耗津液。即令作渴。欲饮水以解之也。又
有疳渴。吐泻发渴。霍乱发渴者。各逐本项具之。阎孝忠云。凡小儿诸渴。因亡失津液引饮
者。但多煎钱氏白术散与服。使任意取足饮之。弥多弥好。其方本集所载。热渴者叙方于后。
莲汤散
治婴小发渴心燥。以粉霜研极细。每婴孩一字。三四岁下者半钱。煎莲花汤调下。冬月无花时。莲肉代之。
香葛汤
治渴甚津液燥少。
木香 干葛根(锉) 人参(去芦各一两) 白茯苓 藿香叶(去土) 甘草(炙各半两)
上为细末。次用麝香半钱研细。入药拌匀。每服半钱。或者一钱。生姜汤调。温服无时。
葛根汤
治体热烦渴。
葛根 人参(去芦各一两) 麦门冬(去心) 白茯苓 泽泻 甘草(炙各半两)
上为细末。每服一钱。水八分。入生姜二片。薄荷三叶。煎六分。去滓温。量大小服。无时。
凉肌丸
治肌热脸赤。烦渴躁闷。
龙胆草(去芦二两) 玄参(去芦一两) 当归(去芦洗净一两)
上为细末。炼蜜和丸绿豆大。每服一二十丸。竹叶汤下。无时。
葛根饮子
治热渴久不止。以葛根半两锉碎。水一盏。煎至六分。去滓频频服。无时。
神蛎散
治一切诸渴。以大牡蛎。于腊日端午日。用黄泥裹 通赤。放冷。去泥为细末。取活鲫鱼煎汤调下半钱。只
一二服。瘥。
治小儿热渴久不止 以石莲心三十个炒黄。浮萍一分。水一钟,生姜少许。同煎至六分。去滓。每服半合。
徐徐服。
小儿中有不能说话的,其证候有三种。一是心气不足。心经的系脉连于舌根,气充盛则推动舌根运动,于是发出声音说话。现在气虚怯弱,不能滋养运用舌体,所以不能说话。这个证候已经在“五气”条目下详细记载了。二是突然不能说话,这是因为风寒邪气,侵袭哑门穴,联系到舌根,使舌根拘急紧张,所以突然不能说话。还有一种证候,喉咙是气息通行的道路,会厌是声音发出的门户,突然被风邪客居于喉部和会厌,导致失音而发不出声音,这并不是真的不能说话。三是病后不能说话,这是因服用清热药以利小便,导致肾虚而不能上接阳气,所以不能说话。以前钱乙治疗王氏患慢惊风病愈后,有声音但不能说话,众人都认为是失音。钱乙说:“既然失音,为什么能睁眼并能饮食?而且牙关不紧闭,口唇不僵硬,却能吞咽药物。”众医生都不明白。钱乙说:“这是因为用了清热利小便的药,导致肾气虚弱,不能上接于阳的缘故。”于是用地黄丸补肾,病人渐渐能说话了,一个月痊愈。该方剂原本收录在《集》中,另外收录的方剂在后面列出。
菖蒲散
治疗感受风寒,邪气客居哑门穴,突然不能说话。
石菖蒲 桂心 远志(去心,用甘草水煮,各一分)
以上研为细末。每次取一钱,用水一钟,煎至五分,随时温服。
桂散
治疗风寒客居于喉部与会厌,声音发不出。
川芎(三分) 远志(去心,用甘草水煮三分) 麦门冬(去心三分) 人参(去芦半两)
以上研为细末,用炼蜜调和制成如小豆大小的丸剂。清晨空腹时,用米饮送服五丸,每日三次。年龄较大的儿童酌情加量,久服见效。
小儿中有口渴而饮水的,这是由于脏腑有热,热则脏腑干燥,所以身体多有发热、烦躁,耗伤津液,这就导致口渴,想要饮水来缓解它。又有疳积引起的口渴、吐泻引起的口渴、霍乱引起的口渴等,各自在本项下详细记载。阎孝忠说:凡是小儿各种口渴,因亡失津液而引水喝的,只要多煎煮钱乙的白术散给患儿服用,让患儿任意喝足。喝得越多越好。该方剂原本收录在《集》中。热渴的方剂叙述在后面。
莲汤散
治疗婴幼儿发病口渴、心燥。用轻粉研至极细,每个婴儿一字量,三四岁以下者半钱,煎莲花汤调服。冬季没有莲花时,用莲肉代替。
香葛汤
治疗极度口渴、津液干燥稀少。
木香 干葛根(锉碎) 人参(去芦各一两) 白茯苓 藿香叶(去土) 甘草(炙各半两)
以上研为细末,其次用麝香半钱研细,加入药粉拌匀。每次服用半钱或一钱,用生姜汤调服,随时温服。
葛根汤
治疗身体发热、烦渴。
葛根 人参(去芦各一两) 麦门冬(去心) 白茯苓 泽泻 甘草(炙各半两)
以上研为细末。每次服用一钱,用水八分,加入生姜两片、薄荷三叶,煎至六分,去渣温热服用,根据年龄大小决定剂量,随时服用。
凉肌丸
治疗肌肤发热、脸红、烦渴躁闷。
龙胆草(去芦二两) 玄参(去芦一两) 当归(去芦洗净一两)
以上研为细末,用炼蜜调和制成如绿豆大小的丸剂。每次服用一二十丸,用竹叶汤送服,随时服用。
葛根饮子
治疗热渴长久不止。用葛根半两锉碎,用水一盏,煎至六分,去渣频频服用,随时服用。
神蛎散
治疗一切各种口渴。在大牡蛎,于腊日或端午日,用黄泥包裹烧至通红,放冷,去掉泥土研为细末。取活鲫鱼煎汤调下半钱,只服一两次,病愈。
There are children who cannot speak. This condition presents in three types. The first is deficiency of Heart Qi (Heart Qi). The Heart meridian connects to the root of the tongue; when Qi is sufficient, it moves the tongue root, producing speech. Now, due to deficient and timid Qi that cannot nourish and utilize the tongue, speech is absent. This syndrome has been detailed under the section on "Five Qi" (Five Pathogenic Factors related to Emotions/Organs). The second type is sudden inability to speak, caused by Wind-Cold pathogenic factors invading the Yamen (GV6) acupoint, affecting the tongue root, causing stiffness and tension of the tongue root, thus resulting in sudden aphonia. Another presentation involves the throat as the pathway for Qi and the epiglottis as the gate for sound; if suddenly invaded by Wind pathogens lodging in the throat and epiglottis, voice loss occurs without speech, which is not true aphonia. The third type is inability to speak after an illness, caused by the use of cooling herbs to promote urination, leading to Kidney Deficiency where Qi cannot ascend to connect with Yang, hence the inability to speak. Previously, Qian Yi treated a child named Wang who, after recovering from slow convulsions, had a voice but could not speak. Others considered this aphonia. Qian Yi said, "If it were aphonia, how could he open his eyes and eat/drink? Moreover, his teeth are not clenched, his mouth is not tight, yet he can swallow medicine." The other physicians did not understand. Qian Yi stated, "This is because cooling diuretics were used, depleting Kidney Qi so it cannot ascend to connect with Yang." He subsequently administered Dihuang Wan (Rehmannia Pill) to tonify the Kidney, and the child gradually regained speech, recovering fully within a month. The formula is recorded in the original collection; additional formulas are listed below.
Changpu San (Acorus Powder)
Treats sudden aphonia due to Wind-Cold invading the Yamen (GV6) acupoint.
Shichangpu (Rhizoma Acori Tatarinowii), Guixin (Cortex Cinnamomi), Yuanzhi (Radix Polygalae) [decored, boiled in Licorice Decoction, each 1 fen].
Grind into fine powder. Take 1 qian per dose, decoct in 1 zhong of water until reduced to 0.5 zhong, take warm at any time.
Gui San (Cinnamon Powder)
Treats aphonia due to Wind-Cold lodging in the throat and epiglottis.
Chuanxiong (Radix Ligustici Chuanxiong, 3 fen), Yuanzhi (Radix Polygalae) [decored, boiled in Licorice Decoction, 3 fen], Maimendong (Radix Ophiopogonis, 3 fen), Renshen (Radix Ginseng) [de-rooted, 0.5 liang].
Grind into fine powder, mix with refined honey to form pills the size of small beans. Take 5 pills on an empty stomach in the morning with rice water, three times daily. Increase dosage for older children; long-term administration yields results.
Children who feel thirsty and drink water do so because of Heat in the Zang-Fu organs. Heat causes dryness in the viscera, leading to body heat and irritability, consuming Body Fluids (Jin-Ye), resulting in thirst and the desire to drink to relieve it. There are also cases of thirst due to Gan accumulation (Gan Syndrome), vomiting and diarrhea, or Huoluan (Cholera-like disorder); these are detailed in their respective sections. Yan Xiaozhong stated: For all pediatric thirst cases caused by fluid depletion leading to drinking, simply decoct Qian Yi's Baizhu San (Atractylodes Macrocephala Powder) and administer it freely. The more they drink, the better. The formula is recorded in the original collection. Formulas for Heat-Thirst are described below.
Lian Tang San (Lotus Soup Powder)
Treats infantile thirst and heart dryness. Use Qingfen (Calomelas) ground extremely fine. For infants, one zi dose; for children under three or four years old, half a qian. Mix with decocted Lotus Soup and administer. In winter when lotus flowers are unavailable, use lotus seeds instead.
Xiang Ge Tang (Costus and Pueraria Decoction)
Treats severe thirst with scanty fluids.
Muxiang (Radix Aucklandiae), Gegen (Radix Puerariae Lobatae) [cut], Renshen (Radix Ginseng) [de-rooted, each 1 liang], Baifuling (Poria), Huoxiangye (Folium Pogostemonis), Zhigancao (Prepared Radix Glycyrrhizae) [each 0.5 liang].
Grind into fine powder. Then grind 0.5 qian of Shexiang (Moschus) finely and mix with the powder. Take 0.5 qian or 1 qian per dose, mixed with Ginger Soup, take warm at any time.
Gegen Tang (Pueraria Decoction)
Treats body heat and irritability with thirst.
Gegen (Radix Puerariae Lobatae), Renshen (Radix Ginseng) [de-rooted, each 1 liang], Maimendong (Radix Ophiopogonis), Baifuling (Poria), Zexie (Rhizoma Alismatis), Zhigancao (Prepared Radix Glycyrrhizae) [each 0.5 liang].
Grind into fine powder. Take 1 qian per dose, add 0.8 zhong of water, two slices of fresh ginger, and three leaves of Bohe (Folium Menthae). Decoct until reduced to 0.6 zhong, strain, and take warm. Dosage varies by age; take at any time.
Liangji Wan (Cool Muscle Pills)
Treats skin heat, facial redness, irritability, thirst, and restlessness.
Longdancao (Radix Gentianae), Xuanshen (Radix Scrophulariae), Danggui (Radix Angelicae Sinensis) [washed, each 1 liang; Longdancao 2 liang].
Grind into fine powder, mix with refined honey to form pills the size of mung beans. Take 10-20 pills per dose with Bamboo Leaf Soup; take at any time.
Gegen Yinzi (Pueraria Drink)
Treats persistent Heat-Thirst. Cut 0.5 liang of Gegen (Radix Puerariae Lobatae), decoct in one zhan of water until reduced to 0.6 zhan, strain, and take frequently at any time.
Shenli San (Divine Oyster Powder)
Treats all types of thirst. On the last day of the lunar year or Dragon Boat Festival, wrap large oyster shells in yellow mud and fire until red hot. Let cool, remove mud, and grind into fine powder. Take half a qian mixed with soup from live crucian carp. One or two doses cure the condition.
To treat persistent Heat-Thirst in children: Stir-fry 30 Stone Lotus Hearts (Shilianxin) until yellow, add 1 fen of Fuping (Herba Lemnae), one zhong of water, and a little fresh ginger. Decoct until reduced to 0.6 zhong, strain. Take half he per dose slowly.