五月十五日以后,吐泻,身壮热,此热也。小儿脏腑,十分中九分热也。或因伤热乳
食,吐乳不消,泻深黄色,玉露散主之。
六月十五日以后,吐泻,身温似热,脏腑六分热四分冷也。吐呕,乳食不消,泻黄白
色,似渴,或食乳或不食乳。食前少服益黄散;食后多服玉露散。
七月七日以后,吐泻,身温凉,三分热七分冷也。不能食乳,多似睡,闷乱哽气,长出
气,睡露睛,唇白多哕,欲大便,不渴。食前多服益黄散;食后少服玉露散。
八月十五日以后,吐泻,身冷无阳也。不能食乳,干哕,泻青褐水。当补脾,益黄散主
之。不可下也。
脾胃不和,不能食乳,致肌瘦。亦因大病或吐泻后,脾胃尚弱,不能传化谷气也。有冷
者,时时下利,唇口青白;有热者,温壮身热,肌肉微黄。此冷热虚羸也。冷者,木香丸主之。
夏月不可服,如有证则少服之。热者,胡黄连丸主之。冬月不可服,如有证则少服之。
夫嗽者,肺感微寒。八九月间,肺气大旺,病嗽者,其病必实,非久病也。其证面赤、
痰盛、身热,法当以葶苈丸下之。若久者,不可下也。十一月、十二月嗽者,乃伤风嗽也,风
从背脊第三椎肺俞穴入也,当以麻黄汤汗之。有热证,面赤、饮水、涎热、咽喉不利者,宜
兼甘桔汤治之。若五七日间,其证身热,痰盛,唾粘者,以褊银丸下之。有肺盛者,咳而后
喘,面肿,欲饮水,有不饮水者,其身即热,以泻白散泻之。若伤风咳嗽五七日,无热证而
但嗽者,亦葶苈丸下之,后用化痰药。有肺虚者,咳而哽气,时时长出气,喉中有声,此久
病也,以阿胶散补之。痰盛者,先实脾,后以褊银丸微下之,涎退即补肺,补肺如上法。有
嗽而吐水,或青绿水者,以百祥丸下之。有嗽而吐痰涎、乳食者,以白饼子下之,有嗽而
咯脓血者,乃肺热,食后服甘桔汤。久嗽者,肺亡津液,阿胶散补之。咳而痰实,不甚喘,
而面赤,时饮水者,可褊银丸下之。治嗽大法∶盛即下之,久即补之,更量虚实,以意增损
五月十五日以后,出现吐泻,身体高热,这是热证。小儿脏腑中,有十分之九是热的。如果是因为伤于热性的乳食,导致呕吐出的乳汁不消化,排泄物呈深黄色,主治方剂为玉露散。
六月十五日以后,出现吐泻,体温温和似有热感,脏腑状态为六分热、四分冷。表现为呕吐,乳食不消化,排泄物呈黄白色,似乎口渴,有时吃乳有时不吃乳。饭前少量服用益黄散;饭后大量服用玉露散。
七月七日以后,出现吐泻,体温温和偏凉,脏腑状态为三分热、七分冷。不能进食乳汁,大多时候像睡着一样,烦躁不安、气闷、叹气、长出气,睡觉时眼睛半睁(睡露睛),嘴唇发白且频繁呃逆,想大便但不口渴。饭前大量服用益黄散;饭后少量服用玉露散。
八月十五日以后,出现吐泻,身体寒冷,阳气不足。不能进食乳汁,干呕,排泄物为青褐色水样便。应当补脾,主治方剂为益黄散。不可使用泻下法。
呕吐乳汁,排泄物发黄,是伤了热性乳食所致。呕吐乳汁,排泄物发青,是伤了冷性乳食所致。这两种情况都应当使用泻下法。
脾胃不和,不能进食乳汁,导致肌肉消瘦。也常因大病或吐泻之后,脾胃依然虚弱,不能运化谷气所致。其中有寒证的,时常腹泻,嘴唇和口色青白;其中有热证的,身体温热壮热,肌肉微黄。这属于冷热虚损羸瘦。寒证,主治方剂为木香丸。夏季不宜服用,如果有相应症状则少量服用。热证,主治方剂为胡黄连丸。冬季不宜服用,如果有相应症状则少量服用。
至于咳嗽,是肺感受了轻微寒气。在八九月间,肺气旺盛,患咳嗽病的,其病势必然实盛,不是久病。其症状见面赤、痰多、身热,治法应当用葶苈丸泻下。如果是久咳,则不可泻下。十一月、十二月咳嗽的,是伤风咳嗽,风邪从背部第三椎骨的肺俞穴侵入,治法应当用麻黄汤发汗。如果有热证,见面赤、饮水、涎液热、咽喉不利者,宜兼用甘桔汤治疗。如果在五到七天内,症状为身热、痰多、唾沫粘稠的,用褊银丸泻下。如果有肺盛者,咳嗽而后气喘,面部浮肿,想喝水或不喝水,身体即发热,用泻白散清泻肺热。如果是伤风咳嗽五七天,没有热证而只是咳嗽的,也用葶苈丸泻下,之后再用化痰药。如果有肺虚者,咳嗽伴气闷,时常长出气,喉中有声音,这是久病,用阿胶散补益。痰多者,先充实脾土,后用褊银丸轻微泻下,涎液消退后即补肺,补肺的方法如上所述。有咳嗽并吐出清水,或青绿色水的,用百祥丸泻下。有咳嗽并吐出痰涎、乳食的,用白饼子泻下。有咳嗽并咯出脓血的,是肺热,饭后服用甘桔汤。久咳者,肺中津液枯竭,用阿胶散补益。咳嗽且痰实,不甚气喘,面赤,时常饮水的,可用褊银丸泻下。治疗咳嗽的大法:实证即泻下它,久病即补益它,更要衡量虚实程度,酌情增减。
After the 15th day of the fifth lunar month, vomiting and diarrhea occur with high fever; this is a Heat syndrome. In infants, the internal organs are nine-tenths Heat. If caused by injury from hot milk or food, leading to undigested vomited milk and deep yellow stools, Yu Lu San (Dewy Powder) is the primary formula.
After the 15th day of the sixth lunar month, vomiting and diarrhea occur with a warm body temperature resembling heat; the organ state is six-tenths Heat and four-tenths Cold. Symptoms include vomiting, indigestion of milk and food, yellowish-white stools, apparent thirst, and variable feeding habits (sometimes nursing, sometimes not). Take Yi Huang San (Yellow-Protecting Powder) in small amounts before meals; take Yu Lu San (Dewy Powder) in large amounts after meals.
After the 7th day of the seventh lunar month, vomiting and diarrhea occur with a warm and cool body temperature; the organ state is three-tenths Heat and seven-tenths Cold. The infant cannot nurse, appears mostly lethargic/sleepy, restless, sighs frequently, takes long breaths, sleeps with eyes partially open (sleeping with exposed eyes), has white lips with frequent hiccups, desires to defecate but feels no thirst. Take Yi Huang San (Yellow-Protecting Powder) in large amounts before meals; take Yu Lu San (Dewy Powder) in small amounts after meals.
After the 15th day of the eighth lunar month, vomiting and diarrhea occur with a cold body and lack of Yang Qi. The infant cannot nurse, experiences dry heaving, and passes greenish-brown watery stools. One should tonify the Spleen; Yi Huang San (Yellow-Protecting Powder) is the primary formula. Purging methods must not be used.
Vomiting milk with yellow stools indicates injury from hot milk. Vomiting milk with green stools indicates injury from cold milk. Both conditions require purging.
Spleen-Stomach disharmony prevents nursing, leading to emaciation. This also occurs after severe illness or prolonged vomiting/diarrhea when the Spleen-Stomach remains weak and cannot transform grain Qi. In cases of Cold, there is frequent loose stool with blue-white lips and mouth; in cases of Heat, there is warm-to-high fever with slightly yellow muscles. These are Cold/Heat deficiency and emaciation syndromes. For Cold, Mu Xiang Wan (Aucklandia Pill) is the primary formula. It is not suitable for summer use; if symptoms arise, take small amounts. For Heat, Hu Huang Lian Wan (Coptis Pill) is the primary formula. It is not suitable for winter use; if symptoms arise, take small amounts.
Regarding cough, it results from the Lung being affected by slight Cold. Between the eighth and ninth lunar months, Lung Qi is vigorous; thus, cough illnesses at this time are necessarily Excess patterns, not chronic conditions. Symptoms include red face, abundant phlegm, and fever; the treatment method is to purge using Ting Li Wan (Descurainia Pill). If chronic, purging is contraindicated. Cough occurring in the eleventh and twelfth lunar months is Wind-Cold cough; Wind pathogen enters via the Fei Shu (BL13) acupoint on the third thoracic vertebra of the back. The treatment method is to induce sweating using Ma Huang Tang (Ephedra Decoction). If accompanied by Heat signs such as red face, desire for water, hot saliva, and throat obstruction, Gan Jie Tang (Licorice and Magnolia Bark Decoction) should be added. Within five to seven days, if symptoms include fever, abundant phlegm, and sticky sputum, Pian Yin Wan (Plantago Pill) is used to purge. In cases of Lung Excess, cough followed by wheezing, facial swelling, desire or non-desire for water, and immediate fever, Xie Bai San (Drain White Powder) is used to drain the Lung. If Wind-Cold cough persists for five to seven days without Heat signs but only cough, Ting Li Wan (Descurainia Pill) is used to purge, followed by phlegm-resolving herbs. In cases of Lung Deficiency, cough with air hunger, frequent long sighs, and sounds in the throat indicates a chronic condition; E Jiao San (Donkey-Hide Gelatin Powder) is used to tonify. If phlegm is abundant, first strengthen the Spleen, then mildly purge with Pian Yin Wan (Plantago Pill); once saliva/phlegm recedes, tonify the Lung using the aforementioned method. If cough produces clear water or greenish-blue fluid, Bai Xiang Wan (Hundred Auspicious Pills) is used to purge. If cough produces phlegm-saliva or undigested milk/food, Bai Bing Zi (White Cake Pellets) is used to purge. If cough produces pus and blood, it indicates Lung Heat; Gan Jie Tang (Licorice and Magnolia Bark Decoction) is taken after meals. In chronic cough where Lung fluids are depleted, E Jiao San (Donkey-Hide Gelatin Powder) is used to tonify. In cough with solid phlegm, mild wheezing, red face, and frequent water drinking, Pian Yin Wan (Plantago Pill) can be used to purge. The general principle for treating cough: purge if Excess, tonify if chronic; always assess Deficiency/Excess and adjust accordingly.