小儿弄舌者。其证有二。一者心热。心系舌本。热则舌本干涩而紧,故时时吐弄舒缓之。二者脾热。脚络
连舌。热则舌亦干涩而紧。故时时吐弄舒缓之,皆欲饮水。心热则发渴。脾热则津液耗。皆引饮。二证相似,宜
加审别。心热者面赤。睡即口中气热。时时烦躁。喜就其冷。切牙上窜。治宜退热。脾热者大便稠硬。赤黄色。
面黄身亦微黄。治宜微导之。不可用冷药。又不可转下。若误下之。则脾胃虚。津液耗。又加五心烦热。面黄肌
瘦。变为疳也。若大病未已。用药弄舌者。大凶也。今叙方于后。
人参知母散
治心热弄舌。
知母(一两) 蓝叶(半两) 人参(去芦半两) 钩藤(一分) 川升麻(一分) 干葛(一分) 黄芩
(一分)
上为细末。每服一钱。水八分。入竹沥三两滴,煎至五分。去滓温服。无时。
泻黄散
治脾热弄舌。
藿香叶(去土七钱) 山栀子仁(一两) 石膏(半两) 甘草(三两) 防风(去芦并叉枝切焙四两)
上并锉。以蜜酒洒拌匀。炒香燥。为细末。每服一钱。水一盏。煎至六分。去滓放温。取清汁服。一方有
山药二两。
小儿 病。其论有二。一者圣惠云。小儿生十余月以后。母又娠。因以乳儿。令儿生病。其候精神不爽。身
体痿瘁。骨立发落。名曰 病。又曰继病,又曰交奶。二者巢氏云。小儿在母胎妊之时。其母被恶神导其腹中胎
气。至儿生下。往往 羸。微微下痢。寒热往来。毛发焦竖。多嗔不悦。其候颇似于疳。今叙方于后。
虎骨丹
治 病。
虎头骨(涂酥炙黄一两) 鬼臼(一两) 草龙胆(去芦一两) 鬼箭(取羽一两) 琥珀(半两令研)
白胶香(半两令研)
上为细末。同研匀。炼蜜和丸黍米大,每服十粒。乳香汤下。无时。
又方 治如前。取伏翼(蝙蝠是也)烧灰研细末,粥饮调下半钱。日三。若炙令香熟。嚼烂哺儿。亦效。
如得重一斤者尤佳。又得黄精自然汁。涂炙之。最良。
又方 治如前。取伯劳鸟毛。与儿带之。(又名博劳,又名 )
小儿弄舌的症状,主要有两种证型。一种是心热。心的经络联系于舌根,热邪会导致舌根干燥、涩滞且紧绷,因此孩子会不时地吐出舌头并舒缓它。另一种是脾热。足太阴脾经的络脉连接于舌,热邪也会导致舌头干燥、涩滞且紧绷,所以也会不时地吐舌舒缓,并且都想喝水。心热会引起口渴;脾热则导致津液耗损,同样会引水自救。这两种证候相似,应当仔细辨别。心热的表现是面色发红,睡眠时口中气息发热,时常烦躁不安,喜欢靠近冷处,磨牙,眼球上窜。治疗宜用清热退火的方法。脾热的表现是大便干结坚硬,颜色赤黄,面色发黄,身体也微黄。治疗宜用轻微疏导的方法,不可使用寒凉药物,也不可用攻下法。如果误用攻下法,会导致脾胃虚弱,津液耗损,再加上五心烦热(手心、脚心和心口烦热),面色萎黄,肌肉消瘦,演变为疳积病。如果是大病未愈期间,因用药不当而出现弄舌症状的,预后极差,属大凶之兆。现将相关方剂叙述如下。
人参知母散
治疗心热引起的弄舌。
知母(一两) 蓝叶(半两) 人参(去芦头半两) 钩藤(一分) 川升麻(一分) 干葛(一分) 黄芩(一分)
以上药材研为细末。每次服用一钱,加水八分,滴入竹沥三两滴,煎煮至五分水量,滤去药渣,温服。不限时间。
泻黄散
治疗脾热引起的弄舌。
藿香叶(去土七钱) 山栀子仁(一两) 石膏(半两) 甘草(三两) 防风(去芦头及叉枝,切碎焙干四两)
以上药材切碎,用蜜酒喷洒拌匀,炒至香燥,研为细末。每次服用一钱,加水一盏,煎煮至六分水量,滤去药渣,放温后取清汁服用。另一版本方剂中含有山药二两。
小儿[注:原文此处缺字,根据上下文及“圣惠”、“巢氏”论述,通常指“哺露”或“交奶”等病,但依原文忠实翻译,此处保留空缺或泛指此类病症]病。其理论有两种说法。一是《太平圣惠方》记载:小儿出生十个月以后,母亲再次怀孕,因为继续哺乳婴儿,导致婴儿生病。其表现为精神不振,身体瘦弱憔悴,骨骼突出,头发脱落,这种病名叫[注:原文缺字,通常为“哺露”或类似名称]病。又叫做继病,又叫做交奶。二是巢元方记载:小儿在母胎中时,母亲受到恶神干扰腹中胎气,等到孩子出生后,往往身体瘦弱,微微下痢,寒热往来,毛发焦枯竖起,多怒不悦。其症状颇似疳积病。现将相关方剂叙述如下。
虎骨丹
治疗上述疾病。
虎头骨(涂酥炙至黄色一两) 鬼臼(一两) 草龙胆(去芦头一两) 鬼箭(取带羽部分一两) 琥珀(半两,令其研碎) 白胶香(半两,令其研碎)
以上药材研为细末,混合均匀。用炼蜜调和制成如黍米大小的丸药,每次服用十粒,用乳香汤送下。不限时间。
又一方:治疗方法同上。取伏翼(即蝙蝠)烧成灰,研成细末,用粥饮调服半钱,每日三次。如果将其烤熟嚼烂喂给孩子,也有效。如果能得到重达一斤的蝙蝠尤佳。另外,如果用黄精的自然汁涂抹并烘烤,效果最好。
又一方:治疗方法同上。取伯劳鸟的羽毛,给孩子佩戴。(伯劳鸟又名博劳,又名[注:原文缺字])
The symptom of "playing with the tongue" (rolling or protruding the tongue) in infants and young children mainly presents in two syndromes. One is Heart Heat. The Heart meridian connects to the root of the tongue; heat causes the tongue root to become dry, rough, and tight, leading the child to frequently protrude and retract the tongue to relieve discomfort. The other is Spleen Heat. The collateral vessels of the Foot-Taiyin Spleen connect to the tongue; heat similarly causes the tongue to become dry, rough, and tight, resulting in frequent tongue protrusion and a desire for water. Heart Heat induces thirst, while Spleen Heat consumes body fluids (Jin-Ye), also leading to a desire for drinking. These two syndromes are similar and require careful differentiation. In Heart Heat, symptoms include a red complexion, hot breath during sleep, frequent irritability, a preference for cool places, teeth grinding, and upward deviation of the eyes. Treatment should focus on clearing heat and reducing fire. In Spleen Heat, symptoms include hard and dry stools that are reddish-yellow, a sallow complexion, and slight yellowing of the body. Treatment should involve mild guiding/dredging methods; cold medicines must not be used, nor should purgative methods be employed. If mistakenly treated with purgatives, it will lead to deficiency of the Spleen and Stomach, consumption of body fluids, addition of five-palm heat (heat sensation in the palms, soles, and chest), sallow complexion, emaciation, and transformation into Infantile Malnutrition (Gan Syndrome). If "tongue playing" occurs due to medication during an unresolved severe illness, the prognosis is extremely poor (ominous). The following prescriptions are listed below.
**Renshen Zhimu San (Ginseng and Anemarrhena Powder)**
Treats tongue playing caused by Heart Heat.
* Zhi Mu (Anemarrhenae Rhizoma, 1 liang)
* Lan Ye (Isatidis Folium, 0.5 liang)
* Renshen (Panacis Ginseng Radix, de-gorged, 0.5 liang)
* Gouteng (Uncariae Ramulus cum Uncis, 1 fen)
* Chuan Shengma (Bupleuri Radix, 1 fen)
* Gan Ge (Puerariae Lobatae Radix, 1 fen)
* Huang Qin (Scutellariae Radix, 1 fen)
Grind all ingredients into a fine powder. Take 1 qian per dose, add 8 fen of water and 3 drops of Zhu Li (Bambusae Succus), decoct until 5 fen of liquid remains, strain, and take warm. Administer at any time.
**Xiehuang San (Drain Yellow Powder)**
Treats tongue playing caused by Spleen Heat.
* Huoxiang Ye (Agastaches Folium, cleaned, 7 qian)
* Shanzhizi Ren (Gardeniae Fructus Semen, 1 liang)
* Shigao (Gypsum Fibrosum, 0.5 liang)
* Gancao (Glycyrrhizae Radix et Rhizoma, 3 liang)
* Fangfeng (Saposhnikoviae Radix, de-gorged and forked branches removed, cut and roasted, 4 liang)
Chop all ingredients, sprinkle with honey and wine, mix well, roast until fragrant and dry, then grind into a fine powder. Take 1 qian per dose, add 1 zhan of water, decoct until 6 fen of liquid remains, strain, let cool to warm, and drink the clear liquid. Another version includes Shanyao (Dioscoreae Rhizoma, 2 liang).
Regarding [Text Missing: Likely referring to "Bulu" or related infant diseases] disease in infants, there are two theoretical explanations. First, *Taiping Shenghui Fang* states: After an infant is over ten months old, if the mother becomes pregnant again and continues breastfeeding, the infant may fall ill. Symptoms include mental dullness, physical emaciation and weakness, prominent bones, and hair loss. This condition is named [Text Missing], also known as "Ji Bing" (Successive Disease) or "Jiao Nai" (Cross-Nursing). Second, Chao Yuanfang states: During gestation, if the mother is disturbed by evil spirits affecting the fetal qi, the newborn often suffers from emaciation, mild dysentery, alternating chills and fever, scorched and erect hair, and irritability. These symptoms resemble Gan Syndrome (Infantile Malnutrition). The following prescriptions are listed below.
**Hugu Dan (Tiger Bone Pill)**
Treats the aforementioned disease.
* Hutou Gu (Tigris Ossis Capitis, coated with su [animal fat] and roasted to yellow, 1 liang)
* Jiujiao (Podophylli Fructus, 1 liang)
* Caolongdan (Gentianae Radix, de-gorged, 1 liang)
* Guijian (Araliae Cordatae Ramulus, taking the feathered part, 1 liang)
* Hupo (Succinum, half liang, ground)
* Baijiaoxiang (Pistaciae Resina, half liang, ground)
Grind all ingredients into a fine powder and mix uniformly. Combine with refined honey to form pills the size of millet seeds. Take 10 pills per dose, administered with Xurong Tang (Frankincense Decoction). Administer at any time.
Another prescription: Treat as above. Take Fuyi (Vespertilio, i.e., bat), burn to ash, grind into a fine powder, and take half a qian mixed with porridge drink, three times daily. If roasted until fragrant and chewed thoroughly to feed the infant, it is also effective. A bat weighing one jin is particularly desirable. Additionally, applying natural juice of Huangjing (Polygonati Rhizoma) before roasting yields the best results.
Another prescription: Treat as above. Take Bolao Niao Mao (Laniidae plumage) and have the infant wear it. (Bolao is also known as Boluo, also known as [Text Missing]).