《巢氏病源》小儿伤寒呕候∶伤寒是寒气客于皮肤,搏于血气,腠理闭密,气不宣泄,蕴积生热,故头痛体
疼而壮热。其呕者,是胃气虚热乘虚入胃,胃得热则气逆,故呕也。
《活人书》论伤寒 小儿、大人治法,一般但小分剂,药性差凉耳。问∶呕者,何也?无阳则厥,无阴则呕。呕者,
足阳明胃之经。足阳明之气下行,今厥而上行,故为气逆,气逆则呕。仲景云∶呕多虽不大便,不可下,可与小柴胡汤。
上焦得通,津液得下,胃气因和,浃然汗出而解。大抵呕证不一,各有治法。要之,小柴胡汤尤相主当耳。与小柴胡汤,
胸胁满而呕,日哺发潮热者,可小柴胡汤加芒硝也。若呕不止,心下急,郁郁微烦者,与大柴胡也。若大便秘者,方加
大黄。(大柴胡治呕最妙,为内有枳实故也。枳实去微、压虚气,须是去大黄。仲景云∶呕多,虽有阳明,慎不可下。
官局桔梗汤最良,亦用枳实耳。)古人治呕多用半夏加生姜。孙真人云∶生姜是呕家圣药。仲景治呕皆用之。(太阳与阳
明合病,必下利,若不和但呕者,葛根加半夏汤主之。胸中有热,胃中有邪气,腹痛欲呕者,黄连汤主之。太阳与少阳
合病,而自利若呕者,黄芩加半夏生姜汤主之。)金匮诸呕吐,谷不得下者,小半夏汤、小半夏加茯苓汤、小半夏加橘
皮汤主之,皆可选用也。呕而发热者,小柴胡汤主之。呕而发渴者,猪苓汤主之。先呕却渴者,此为欲解,急与之。先
渴却呕者,为水停心下,此属饮家。仲景云∶本渴饮水而呕者,柴胡不中与也。宜治膈间有水,赤茯苓汤主之。若少阴
证而呕者,真武汤去附子加生姜也。若汗、若吐、若下后,虚烦不得眠,若呕者,栀子生姜豉汤主之。伤寒瘥后呕者,
有余热在胃脘也,竹叶汤加生姜主之。又问∶有干呕者,何也?大凡呕者,饮食不下。干呕者,今人所谓噎也,或因汗
出,或因有水,或下利,脾胃有热,故便干呕,官局桔梗汤最佳。仲景治法,汗自出、干呕者,桂枝证也。表不解,心
下有水气,干呕发热者,小青龙也。身凉汗出,两胁痛,或干呕者,十枣汤也。少阴下利,脉微,与白通汤。利不止,
厥逆无脉,干呕烦者,白通加猪胆汁汤也。少阴下利,里寒外热,脉微欲绝,或干呕者,通脉四逆汤也。干呕吐涎沫,
头痛者,吴茱萸汤也。(《伤寒论》云∶食谷欲呕,属阳明也,吴茱萸汤主之。得汤反剧者,属上焦也,仲景无治法。大
抵吴茱萸汤,治少阳证也。谷入胃而呕属阳明,宜与小柴胡。)若病患直患呕吐,而复脚弱或疼,乃是香港脚,当作香港脚
治之。
《圣惠》治小儿伤寒烦热,头痛呕逆。麦门冬散方
麦门冬(去心) 石膏(细研。各三分) 甘草(半两,炙微赤,锉)
上件药捣,粗罗为散。每服取一大钱,以水一小盏,煎至五分,去滓。不计时候,量儿大小分减温服。
《圣惠》治小儿伤寒,吐逆不定。藿香散方
藿香 丁香 木香(各一两) 葛根(一两,锉) 人参(去芦头) 甘草(炙微赤,锉。各半两)
上件捣药,粗罗为散。每服一钱,以水一小盏,煎至五分,去滓。量儿大小临时分减,温服。(《圣惠》二方,一
凉一温,须善用之。
《婴孺》治小儿伤寒壮热,呕吐。芦根汤方
生芦根(切,五合) 知母(十二分) 淡竹青皮(五分)
上水三升,煮一升,为三服。一岁儿方,大小增减用,更用冬瓜汁一升,却减水一升煮妙。
《活人书》仲景小柴胡汤,方见伤寒头汗门中。
《活人书》仲景柴胡加芒硝汤
柴胡(一两三钱) 黄芩 人参 甘草(各半两) 半夏(四钱半,汤洗) 芒硝(一两)
上锉如麻豆大。每服抄五钱匕,生姜四片,枣一枚,水一盏半,煮至八分,去滓,内芒硝,更微沸,温服。
《活人书》仲景大柴胡汤
柴胡(四两) 黄芩 芍药(各一两半) 半夏(一两一分) 枳实(二枚,炙)
上锉如麻豆大。每服抄五钱匕,生姜四片,枣一个,水一盏半,煮至八分,去滓温服,以利为度。未利再
服。(本方无大黄,欲下者加大黄二两。)
《活人书》官局桔梗汤
桔梗 半夏 陈皮(各一两) 枳实(半两)
上为粗末。每服三钱匕,水一盏,生姜五片,煎至七分,去滓温服。
《活人书》仲景古方,半夏加生姜名小半夏汤方
半夏(大者七枚,切碎) 生姜(薄切五片)
上同用水一盏,煎至半盏,去滓,食后温服。
《活人书》仲景葛根加半夏汤
葛根(一两) 麻黄(三分,去节) 甘草(炙) 芍药 桂枝(去皮,半两) 半夏(二分半)
上锉如麻豆大。每服抄五钱匕,生姜四片,枣子一枚,煎至八分,去滓温服。覆取微汗。
《活人书》仲景黄连汤
黄连 甘草(炙) 干姜 桂枝(各三两) 人参(二两) 半夏(二两半)
上锉如麻豆大。每十钱匕,枣二枚,以水三盏,取一盏半,去滓分二服。
《活人书》仲景黄芩加半夏生姜汤
芍药 甘草(各二分) 黄芩(三分) 半夏(二分半)
上锉。每服五钱,生姜四片,大枣一枚,以水二盏,煮至八分,去滓温服。
《活人书》小半夏加茯苓汤,方见伤寒头汗出门中。
《活人书》仲景小半夏加橘皮汤
半夏(大者七枚,切碎) 生姜(薄切五片) 橘皮(一大片)
上同用水一盏,煎至半盏,去滓,食后温服。
《活人书》仲景猪苓汤,方见伤寒咳嗽门中。
《活人书》仲景赤茯苓汤,方见伤寒头汗门中。
《活人书》仲景真武汤,方见伤寒咳嗽门中。
《活人书》仲景栀子生姜豉汤
栀子(七枚) 生姜(二两半) 香豉(二合)
上分二服,以水二盏,先煮栀子、生姜至一盏,内豉同煮,取七分,去滓温服。得快吐,止后服。
《活人书》仲景竹叶加生姜汤,方见伤寒鼻衄门中。
《活人书》仲景桂枝汤,方见伤寒自汗门中。
《活人书》仲景小青龙汤,方见伤寒咳嗽门中。
《活人书》仲景十枣汤
芫花(炒赤,熬) 甘遂 大戟
上各等分,捣筛秤末,合和之,入臼中,再杵治三、二百下,先以水一升半,煮肥枣子十枚,煮取八合,
去滓,内药末。强人一钱匕,羸人可半钱,再单饮枣汤送下,平旦服。若下少病不除者,明日更服加半钱,
利后糜粥自养。合下不下,令人胀满,通身浮肿而死。
《活人书》仲景白通汤
附子(一枚,生用) 干姜(一两)
上锉如麻豆大。每服抄五钱匕,水一盏半,入葱白四寸,煮至七分,去煎滓温服。
《活人书》仲景白通加猪胆汁汤
附子(半个,生用去皮) 干姜(半两) 葱白(二茎) 溺(二合半) 猪胆(汁,半合)
上以水一盏,煮至五分,去滓,内猪胆汁和相得,分温再服。
《活人书》仲景通脉四逆汤
甘草(二两,炙) 附子(大者,去皮,一个) 干姜(一两,炮)
面赤者,加连须葱九茎。腹中痛者,去葱加芍药二两。呕者,加生姜二两。咽痛,去芍药加桔梗一两。利
止、脉不出者,去桔梗加人参二两。
上锉如麻豆大。每服抄五钱匕,以水一盏半,煮至八分,去滓温服。未瘥,急更作一剂,其脉续续出者愈。
《活人书》仲景吴茱萸汤
吴茱萸(一两二钱,汤洗三遍) 人参(三分,去芦头)
上锉如麻豆大。每服四钱,生姜五片,枣子一个,以水二盏半,煮取八分,去滓。分二服。
《庄氏家传》治小儿伤寒头痛,和气止逆,止渴。人参散
人参(去芦头) 白术 麻黄(去根节) 藿香叶 甘草(炙微赤,锉) 干葛(以上各一分) 石膏(透明者,
半两)
上为末。每服一钱,水一盏,葱白一寸,豉三十粒,煎五分,去滓温服。
长沙医者丁时发传人参散 治小儿伤寒。调顺阴阳,和脾胃,定吐逆,止渴。
人参(一两) 木香 茯苓 藿香 甘草(炙。各一分) 干葛(二分)
上为末。每服一钱,煎五分,温温服。
《巢氏病源》中关于小儿伤寒呕吐的论述:伤寒是寒气侵入皮肤,与血气相搏结,导致腠理(皮肤纹理及汗孔)闭塞严密,体内之气无法宣泄,郁积而生热,因此出现头痛、身体疼痛和高烧。那些发生呕吐的,是因为胃气虚弱,热气乘虚侵入胃部,胃受热后气机逆乱,所以发生呕吐。
《活人书》论述伤寒时提到,小儿和大人的治疗方法大体相同,只是剂量较小,药性偏凉罢了。有人问:为什么会呕吐?答:没有阳气则四肢厥冷,没有阴液则发生呕吐。呕吐属于足阳明胃经的病证。足阳明胃经的气机本应下行,如今反而厥逆上行,所以称为气逆,气逆就会导致呕吐。张仲景说:呕吐频繁的人,即使大便不通,也不可用攻下法,可给予小柴胡汤。上焦气机通畅,津液得以输布下行,胃气因而调和,全身微微出汗而病愈。大抵呕吐的证候不一,各有相应的治法。总之,小柴胡汤尤为恰当。若服用小柴胡汤后,胸胁胀满且呕吐,每日下午定时发潮热的,可在小柴胡汤中加入芒硝。如果呕吐不止,心下部拘急不适,心中烦闷微躁的,给予大柴胡汤。如果大便秘结的,才加入大黄。(大柴胡汤治疗呕吐效果极佳,因为方中含有枳实。枳实能消除痞满、压制虚浮之气,此时必须去掉大黄。张仲景说:呕吐多者,即使有阳明腑实证,也务必不可攻下。官方局方的桔梗汤最为良效,其中也用到了枳实。)古人治疗呕吐多用半夏加生姜。孙思邈说:生姜是治疗呕吐的圣药。张仲景治疗呕吐都使用它。(太阳经与阳明经同时发病,必然下利,如果不下利但呕吐的,以葛根加半夏汤为主治。胸中有热,胃中有邪气,腹痛想呕吐的,以黄连汤为主治。太阳经与少阳经同时发病,且自下利或呕吐的,以黄芩加半夏生姜汤为主治。)《金匮要略》中各种呕吐,饮食无法咽下的,以小半夏汤、小半夏加茯苓汤、小半夏加橘皮汤为主治,均可选用。呕吐且发热的,以小柴胡汤为主治。呕吐且发渴的,以猪苓汤为主治。先呕吐而后感到口渴的,这是病情将要解除的迹象,应立即给予饮水。先口渴而后呕吐的,是水饮停聚在心下,这属于饮家范畴。张仲景说:原本口渴喝水却发生呕吐的,不宜使用柴胡剂。应当治疗膈间有水饮,以赤茯苓汤为主治。如果是少阴病证而呕吐的,用真武汤去掉附子加入生姜。如果在发汗、催吐或攻下之后,出现虚烦不得睡眠,或者呕吐的,以栀子生姜豉汤为主治。伤寒病愈后出现呕吐的,是余热留在胃脘所致,以竹叶汤加生姜为主治。又问:什么是干呕?答:大凡呕吐,是指饮食不下。干呕,就是今人所说的噎塞感,可能因为出汗,或有水饮,或下利,脾胃有热,所以导致干呕,官方局方的桔梗汤最佳。张仲景的治疗法则中,自然出汗、干呕的,属于桂枝汤证。表证未解,心下有停水气,干呕且发热的,用小青龙汤。身体凉爽出汗,两胁疼痛,或干呕的,用十枣汤。少阴病下利,脉象微弱,用白通汤。下利不止,四肢厥冷无脉,干呕且心烦的,用白通加猪胆汁汤。少阴病下利,内寒外热,脉微欲绝,或干呕的,用通脉四逆汤。干呕并吐出涎沫,伴有头痛的,用吴茱萸汤。(《伤寒论》说:进食后想呕吐的,属于阳明病,用吴茱萸汤主治。服药后症状反而加剧的,属于上焦病,张仲景未记载治法。大抵吴茱萸汤治疗少阳证较为适宜。食物入胃而呕吐属于阳明病,宜用小柴胡汤。)如果病人直接患有呕吐,并且脚部软弱或疼痛,那是香港脚(脚气病),应按香港脚治疗。
《太平圣惠方》治疗小儿伤寒烦热、头痛呕吐的麦门冬散方:
麦门冬(去心) 石膏(细研。各三分) 甘草(半两,炙至微红,切碎)
以上药物捣碎,粗筛为散。每次取一大钱,用水一小盏,煎至五分,去渣。不分时候,根据孩子大小减量,温服。
《太平圣惠方》治疗小儿伤寒,呕吐不定时的藿香散方:
藿香 丁香 木香(各一两) 葛根(一两,切碎) 人参(去芦头) 甘草(炙至微红,切碎。各半两)
以上药物捣碎,粗筛为散。每次取一钱,用水一小盏,煎至五分,去渣。根据孩子大小临时减量,温服。(《太平圣惠方》这两个方子,一个偏凉,一个偏温,须善于运用。)
《婴孺书》治疗小儿伤寒高烧、呕吐的芦根汤方:
生芦根(切,五合) 知母(十二分) 淡竹青皮(五分)
以上用水三升,煮取一升,分三次服用。这是一岁儿童的方子,根据年龄大小增减使用,另外加入冬瓜汁一升,相应减少水量一升来煮,效果更好。
《活人书》引用张仲景的柴胡加芒硝汤:
柴胡(一两三钱) 黄芩 人参 甘草(各半两) 半夏(四钱半,开水洗) 芒硝(一两)
以上切碎如麻豆大小。每次取五钱匕,生姜四片,大枣一枚,水一盏半,煮至八分,去渣,加入芒硝,再稍微煮沸,温服。
《活人书》引用张仲景的大柴胡汤:
柴胡(四两) 黄芩 芍药(各一两半) 半夏(一两一分) 枳实(二枚,炙)
以上切碎如麻豆大小。每次取五钱匕,生姜四片,大枣一个,水一盏半,煮至八分,去渣温服,以下利为度。未下利者可再服。(原方无大黄,想要攻下的加大黄二两。)
《活人书》官方局方的桔梗汤:
桔梗 半夏 陈皮(各一两) 枳实(半两)
以上为粗末。每次取三钱匕,水一盏,生姜五片,煎至七分,去渣温服。
《活人书》引用张仲景的古方,半夏加生姜名为小半夏汤方:
半夏(大的七枚,切碎) 生姜(薄切五片)
以上同用水一盏,煎至半盏,去渣,饭后温服。
《活人书》引用张仲景的葛根加半夏汤:
葛根(一两) 麻黄(三分,去节) 甘草(炙) 芍药 桂枝(去皮,半两) 半夏(二分半)
以上切碎如麻豆大小。每次取五钱匕,生姜四片,大枣一枚,煎至八分,去渣温服。覆盖衣被取微汗。
《活人书》引用张仲景的黄连汤:
黄连 甘草(炙) 干姜 桂枝(各三两) 人参(二两) 半夏(二两半)
以上切碎如麻豆大小。每次取十钱匕,大枣二枚,水三盏,煮取一盏半,去渣分两次服用。
《活人书》引用张仲景的黄芩加半夏生姜汤:
芍药 甘草(各二分) 黄芩(三分) 半夏(二分半)
以上切碎。每次取五钱,生姜四片,大枣一枚,水二盏,煮至八分,去渣温服。
《活人书》引用张仲景的小半夏加橘皮汤:
半夏(大的七枚,切碎) 生姜(薄切五片) 橘皮(一大片)
以上同用水一盏,煎至半盏,去渣,饭后温服。
《活人书》引用张仲景的栀子生姜豉汤:
栀子(七枚) 生姜(二两半) 香豉(二合)
以上分两次服用,水二盏,先煮栀子、生姜至一盏,加入香豉同煮,取七分,去渣温服。若得快吐,停止后续服用。
《活人书》引用张仲景的十枣汤:
芫花(炒赤,熬) 甘遂 大戟
以上各等分,捣碎过秤成末,混合均匀,放入臼中,再捣杵三、二百下。先用一升半水,煮肥大枣十枚,煮取八合,去渣,加入药末。体质强者服一钱匕,体弱者服半钱,单独饮用枣汤送下,清晨空腹服用。如果泻下少而病不除的,第二天再服增加半钱,泻下后用稀粥调养。该下不下,会导致腹胀满,全身浮肿而死。
《活人书》引用张仲景的白通汤:
附子(一枚,生用) 干姜(一两)
以上切碎如麻豆大小。每次取五钱匕,水一盏半,加入葱白四寸,煮至七分,去渣温服。
《活人书》引用张仲景的白通加猪胆汁汤:
附子(半个,生用去皮) 干姜(半两) 葱白(二茎) 尿(二合半) 猪胆(汁,半合)
以上用水一盏,煮至五分,去渣,加入猪胆汁调和均匀,分两次温服。
《活人书》引用张仲景的通脉四逆汤:
甘草(二两,炙) 附子(大的,去皮,一个) 干姜(一两,炮)
面色红的,加带须葱九茎。腹中痛的,去葱加芍药二两。呕吐的,加生姜二两。咽痛的,去芍药加桔梗一两。利止、脉不出者,去桔梗加人参二两。
以上切碎如麻豆大小。每次取五钱匕,水一盏半,煮至八分,去渣温服。未痊愈,立即再制一剂,脉搏连续出现者即愈。
《活人书》引用张仲景的吴茱萸汤:
吴茱萸(一两二钱,开水洗三遍) 人参(三分,去芦头)
以上切碎如麻豆大小。每次取四钱,生姜五片,大枣一个,水二盏半,煮取八分,去渣。分两次服用。
《庄氏家传》治疗小儿伤寒头痛,调和气息止逆,止渴的人参散:
人参(去芦头) 白术 麻黄(去根节) 藿香叶 甘草(炙微红,切碎) 干葛(以上各一分) 石膏(透明的,半两)
以上为末。每次取一钱,水一盏,葱白一寸,豆豉三十粒,煎至五分,去渣温服。
长沙医者丁时发传授的人参散:治疗小儿伤寒。调顺阴阳,和脾胃,定吐逆,止渴。
人参(一两) 木香 茯苓 藿香 甘草(炙。各一分) 干葛(二分)
以上为末。每次取一钱,煎至五分,温温服。
According to *Chao Shi Bing Yuan* (Source of Diseases by Chao), regarding vomiting in pediatric cold damage: Cold damage is caused by cold qi invading the skin, clashing with blood and qi, causing the cou li (skin pores and interstices) to close tightly. The internal qi cannot be vented, accumulates, and generates heat, resulting in headache, body pain, and high fever. In cases of vomiting, it is due to deficiency of stomach qi allowing heat to invade the stomach vacuously. When the stomach receives heat, the qi becomes rebellious, leading to vomiting.
*Huo Ren Shu* (Book that Revives People) discusses that the treatment for cold damage in children and adults is generally the same, except that the dosage is smaller and the medicinal properties are cooler. A question arises: Why does vomiting occur? The answer is: Without yang, there is cold extremities; without yin, there is vomiting. Vomiting belongs to the Foot Yangming Stomach meridian. The qi of the Foot Yangming should descend; now it rebels and ascends, hence termed "rebellious qi," which causes vomiting. Zhang Zhongjing stated: If there is frequent vomiting, even if there is constipation, purgatives should not be used; Xiaochaihu Tang (Minor Bupleurum Decoction) may be given. Once the upper jiao is unblocked and fluids descend, the stomach qi harmonizes, and the patient recovers through a slight sweat. Generally, vomiting syndromes vary and have specific treatments. However, Xiaochaihu Tang is particularly appropriate. If after taking Xiaochaihu Tang, one has fullness in the chest and hypochondrium with vomiting, and tidal fever in the late afternoon, Mangxiao (Mirabilite) can be added to Xiaochaihu Tang. If vomiting persists, with urgency in the epigastrium and mild vexation, Dachaihu Tang (Major Bupleurum Decoction) should be given. If there is severe constipation, Dahuang (Rhubarb Rhizome) is added. (Dachaihu Tang is excellent for treating vomiting because it contains Zhishi (Immature Bitter Orange). Zhishi removes stagnation and suppresses deficient qi; in this context, Dahuang should be removed. Zhang Zhongjing said: With frequent vomiting, even if there is Yangming syndrome, purgatives must be avoided cautiously. Guanju Jiegeng Tang (Official Bureau Platycodon Decoction) is very effective and also uses Zhishi.) Ancients often treated vomiting with Banxia (Pinellia Tuber) plus Shengjiang (Fresh Ginger). Sun Simiao said: Shengjiang is the holy medicine for vomiting. Zhang Zhongjing used it in all his treatments for vomiting. (When Taiyang and Yangming meridians are affected simultaneously, diarrhea is inevitable; if there is no diarrhea but only vomiting, Gegen Banxia Tang (Kudzu and Pinellia Decoction) is the primary treatment. If there is heat in the chest and pathogenic qi in the stomach, with abdominal pain and desire to vomit, Huanglian Tang (Coptis Decoction) is the primary treatment. When Taiyang and Shaoyang meridians are affected simultaneously, with spontaneous diarrhea or vomiting, Huangqin Banxia Shengjiang Tang (Scutellaria, Pinellia, and Fresh Ginger Decoction) is the primary treatment.) Regarding various vomitings in *Jingui Yaolue* where food cannot go down, Xiaobanxia Tang (Minor Pinellia Decoction), Xiaobanxia Fuling Tang (Minor Pinellia and Poria Decoction), and Xiaobanxia Chupi Tang (Minor Pinellia and Tangerine Peel Decoction) are the primary treatments and can be selected as appropriate. For vomiting with fever, Xiaochaihu Tang is the primary treatment. For vomiting with thirst, Zhuling Tang (Polyporus Decoction) is the primary treatment. If vomiting occurs first followed by thirst, this indicates the disease is resolving; give water immediately. If thirst occurs first followed by vomiting, it indicates fluid retention in the heart region, belonging to the category of fluid retention diseases. Zhang Zhongjing said: If one is thirsty, drinks water, and then vomits, Chaihu formulas are not suitable. One should treat water in the intercostal region with Chifuling Tang (Red Poria Decoction). If Shaoyin syndrome presents with vomiting, Zhenwu Tang (True Warrior Decoction) with Fuzi (Aconite Root) removed and Shengjiang added is used. After sweating, vomiting, or purging, if there is empty vexation, insomnia, or vomiting, Zhizi Shengjiang Chi Tang (Gardenia, Fresh Ginger, and Fermented Soybean Decoction) is the primary treatment. For vomiting after recovery from cold damage, it is due to residual heat in the stomach; Zhuye Tang (Bamboo Leaf Decoction) with Shengjiang is used. Another question: What is dry heaving? Generally, vomiting means inability to keep food down. Dry heaving, what people call now as choking sensation, can be caused by sweating, fluid retention, or diarrhea, with heat in the spleen and stomach, leading to dry heaving. Guanju Jiegeng Tang is best. Zhang Zhongjing's methods state: Spontaneous sweating with dry heaving belongs to Guizhi Tang (Cinnamon Twig Decoction) syndrome. If the exterior is not resolved, there is fluid qi in the epigastrium, with dry heaving and fever, Xiao Qinglong Tang (Minor Blue Dragon Decoction) is used. If the body is cool with sweating, pain in both hypochondria, or dry heaving, Shizao Tang (Ten Jujube Decoction) is used. For Shaoyin diarrhea with weak pulse, Baitong Tang (White Passage Decoction) is used. If diarrhea persists, with cold extremities and absent pulse, dry heaving and vexation, Baitong Zhu Danzhi Tang (White Passage Decoction with Pig Bile) is used. For Shaoyin diarrhea with interior cold and exterior heat, pulse faint and near extinction, or dry heaving, Tongmai Sini Tang (Pulse-Resuscitating Counter-Yang Decoction) is used. Dry heaving with salivary foam and headache is treated with Wuzhuyu Tang (Evodia Decoction). (*Shanghan Lun* states: Desire to vomit after eating belongs to Yangming; Wuzhuyu Tang is primary. If symptoms worsen after taking the decoction, it belongs to the upper jiao; Zhang Zhongjing did not provide a treatment. Generally, Wuzhuyu Tang treats Shaoyang syndrome. Vomiting after food enters the stomach belongs to Yangming, suitable for Xiaochaihu Tang.) If a patient suffers directly from vomiting and has weak or painful legs, it is Hongxiangjiao (Beriberi), and should be treated as such.
*Tai Ping Sheng Hui Fang* (Holy Grace Formulas of the Taiping Era) formula Maidong San (Ophiopogon Powder) for pediatric cold damage with irritability, fever, headache, and vomiting:
Maidong (Ophiopogon Tuber, heart removed) and Shigao (Gypsum Fibrosum, finely ground) each 3 fen; Gancao (Licorice Root, 0.5 liang, roasted until slightly red, chopped).
Crush the above herbs, sift coarsely into powder. Take one large qian per dose, add one small zhan of water, boil to 0.5 zhan, strain. Take warm at any time, adjusting dosage according to the child's age.
*Tai Ping Sheng Hui Fang* formula Huoxiang San (Agastache Powder) for pediatric cold damage with irregular vomiting:
Huoxiang (Agastache Herb), Dingxiang (Clove), Muxiang (Aucklandia Root) each 1 liang; Gegen (Kudzu Root, 1 liang, chopped); Renshen (Ginseng Root, rhizome removed); Gancao (Licorice Root, 0.5 liang, roasted until slightly red, chopped).
Crush and sift coarsely. Take one qian per dose, add one small zhan of water, boil to 0.5 zhan, strain. Adjust dosage according to the child's age, take warm. (These two formulas from *Sheng Hui Fang*, one cooling and one warming, must be used skillfully.)
*Ying Ru Shu* (Infant and Child Book) formula Lugeng Tang (Reed Rhizome Decoction) for pediatric cold damage with high fever and vomiting:
Sheng Lugeng (Fresh Reed Rhizome, cut, 5 he); Zhimu (Anemarrhena Rhizome, 12 fen); Danzhu Qingpi (Bark of Light Bamboo, 5 fen).
Add 3 sheng of water, boil to 1 sheng, divide into three doses. This is the formula for a one-year-old; adjust up or down based on size. Adding 1 sheng of Donggua Zhi (Winter Melon Juice) and reducing water by 1 sheng during boiling yields better results.
*Huo Ren Shu* cites Zhang Zhongjing's Xiaochaihu Tang, see Cold Damage Head Sweat section.
*Huo Ren Shu* cites Zhang Zhongjing's Chaihu Jia Mangxiao Tang (Bupleurum Plus Mirabilite Decoction):
Chaihu (Bupleurum Root, 1 liang 3 qian); Huangqin (Scutellaria Root), Renshen (Ginseng Root), Gancao (Licorice Root) each 0.5 liang; Banxia (Pinellia Tuber, 4.5 qian, washed with hot water); Mangxiao (Mirabilite, 1 liang).
Cut into sizes like hemp seeds. Take five qian bi per dose, with four slices of Shengjiang and one jujube, 1.5 zhan of water, boil to 0.8 zhan, strain, add Mangxiao, simmer briefly, take warm.
*Huo Ren Shu* cites Zhang Zhongjing's Dachaihu Tang:
Chaihu (4 liang); Huangqin, Shaoyao (Peony Root) each 1.5 liang; Banxia (1 liang 1 fen); Zhishi (Immature Bitter Orange, 2 pieces, roasted).
Cut into sizes like hemp seeds. Take five qian bi per dose, with four slices of Shengjiang and one jujube, 1.5 zhan of water, boil to 0.8 zhan, strain, take warm. Stop when bowel movement occurs. If no bowel movement, take again. (Original formula has no Dahuang; add 2 liang Dahuang if purging is desired.)
*Huo Ren Shu* Official Bureau Jiegeng Tang:
Jiegeng (Platycodon Root), Banxia, Chenpi (Tangerine Peel) each 1 liang; Zhishi (0.5 liang).
Make into coarse powder. Take three qian bi per dose, one zhan of water, five slices of Shengjiang, boil to 0.7 zhan, strain, take warm.
*Huo Ren Shu* cites Zhang Zhongjing's ancient formula, Banxia Jia Shengjiang named Xiaobanxia Tang:
Banxia (large ones, 7 pieces, chopped); Shengjiang (thinly sliced, 5 pieces).
Add one zhan of water, boil to half zhan, strain, take warm after meals.
*Huo Ren Shu* cites Zhang Zhongjing's Gegen Banxia Tang:
Gegen (1 liang); Mahuang (Ephedra Herb, 3 fen, nodes removed); Gancao (roasted); Shaoyao; Guizhi (Cinnamon Twig, bark removed, 0.5 liang); Banxia (2.5 fen).
Cut into sizes like hemp seeds. Take five qian bi per dose, with four slices of Shengjiang and one jujube, boil to 0.8 zhan, strain, take warm. Cover to induce slight sweat.
*Huo Ren Shu* cites Zhang Zhongjing's Huanglian Tang:
Huanglian (Coptis Rhizome), Gancao (roasted), Ganjiang (Dried Ginger), Guizhi each 3 liang; Renshen (2 liang); Banxia (2.5 liang).
Cut into sizes like hemp seeds. Take ten qian bi per dose, two jujubes, 3 zhan of water, boil to 1.5 zhan, strain, divide into two doses.
*Huo Ren Shu* cites Zhang Zhongjing's Huangqin Banxia Shengjiang Tang:
Shaoyao, Gancao each 2 fen; Huangqin (3 fen); Banxia (2.5 fen).
Cut. Take five qian per dose, with four slices of Shengjiang and one jujube, 2 zhan of water, boil to 0.8 zhan, strain, take warm.
*Huo Ren Shu* Xiaobanxia Fuling Tang, see Cold Damage Head Sweat section.
*Huo Ren Shu* cites Zhang Zhongjing's Xiaobanxia Chupi Tang:
Banxia (large ones, 7 pieces, chopped); Shengjiang (thinly sliced, 5 pieces); Chupi (one large piece).
Add one zhan of water, boil to half zhan, strain, take warm after meals.
*Huo Ren Shu* cites Zhang Zhongjing's Zhuling Tang, see Cold Damage Cough section.
*Huo Ren Shu* cites Zhang Zhongjing's Chifuling Tang, see Cold Damage Head Sweat section.
*Huo Ren Shu* cites Zhang Zhongjing's Zhenwu Tang, see Cold Damage Cough section.
*Huo Ren Shu* cites Zhang Zhongjing's Zhizi Shengjiang Chi Tang:
Zhizi (Gardenia Fruit, 7 pieces); Shengjiang (2.5 liang); Xiangchi (Fermented Soybean, 2 he).
Divide into two doses. Add 2 zhan of water, first boil Zhizi and Shengjiang to 1 zhan, add Chi, boil together to 0.7 zhan, strain, take warm. If rapid vomiting occurs, stop subsequent doses.
*Huo Ren Shu* cites Zhang Zhongjing's Zhuye Jia Shengjiang Tang, see Cold Damage Epistaxis section.
*Huo Ren Shu* cites Zhang Zhongjing's Guizhi Tang, see Cold Damage Spontaneous Sweating section.
*Huo Ren Shu* cites Zhang Zhongjing's Xiao Qinglong Tang, see Cold Damage Cough section.
*Huo Ren Shu* cites Zhang Zhongjing's Shizao Tang:
Yuanhua (Genkwa Flower, fried red, processed), Gansui (Kansui Root), Daji (Euphorbia Root) in equal parts.
Pulverize and mix. Place in mortar, pound 300-200 times. First boil 10 fat jujubes in 1.5 sheng of water to obtain 0.8 sheng, strain, add herbal powder. Strong persons take one qian bi, weak persons take half qian bi, taken alone with jujube decoction at dawn. If evacuation is insufficient and disease remains, increase by half qian bi the next day. Nourish with millet porridge after evacuation. Failure to evacuate leads to distension, general edema, and death.
*Huo Ren Shu* cites Zhang Zhongjing's Baitong Tang:
Fuzi (Aconite Lateral Root, raw, one piece); Ganjiang (1 liang).
Cut into sizes like hemp seeds. Take five qian bi per dose, 1.5 zhan of water, add four cun of Congbai (Green Onion White), boil to 0.7 zhan, strain, take warm.
*Huo Ren Shu* cites Zhang Zhongjing's Baitong Zhu Danzhi Tang:
Fuzi (half piece, raw, peeled); Ganjiang (0.5 liang); Congbai (two stems); Niao (Urine, 2.5 he); Zhu Dan (Pig Gallbladder Juice, 0.5 he).
Add one zhan of water, boil to 0.5 zhan, strain, add Zhu Danzhi, mix well, divide into two warm doses.
*Huo Ren Shu* cites Zhang Zhongjing's Tongmai Sini Tang:
Gancao (2 liang, roasted); Fuzi (large one, peeled); Ganjiang (1 liang, processed).
If face is red, add nine stalks of Lianxu Cong (Green Onion with roots). If abdominal pain, remove Cong and add Shaoyao (2 liang). If vomiting, add Shengjiang (2 liang). If sore throat, remove Shaoyao and add Jiegeng (1 liang). If diarrhea stops and pulse does not return, remove Jiegeng and add Renshen (2 liang).
Cut into sizes like hemp seeds. Take five qian bi per dose, 1.5 zhan of water, boil to 0.8 zhan, strain, take warm. If not cured, immediately prepare another dose. Recovery occurs when pulse returns continuously.
*Huo Ren Shu* cites Zhang Zhongjing's Wuzhuyu Tang:
Wuzhuyu (Evodia Fruit, 1 liang 2 qian, washed three times with hot water); Renshen (3 fen, rhizome removed).
Cut into sizes like hemp seeds. Take four qian per dose, with five slices of Shengjiang and one jujube, 2.5 zhan of water, boil to 0.8 zhan, strain. Divide into two doses.
*Zhuang Shi Jia Chuan* formula Renshen San (Ginseng Powder) for pediatric cold damage headache, harmonizing qi, stopping rebellion, and quenching thirst:
Renshen (rhizome removed), Baizhu (Atractylodes Macrocephala Rhizome), Mahuang (nodes removed), Huoxiangye (Agastache Leaf), Gancao (roasted until slightly red, chopped), Gange (Dried Kudzu Root) each 1 fen; Shigao (transparent, 0.5 liang).
Make into powder. Take one qian per dose, one zhan of water, one cun of Congbai, thirty grains of Chi, boil to 0.5 zhan, strain, take warm.
Changsha physician Ding Shifa transmitted Renshen Powder: Treats pediatric cold damage. Harmonizes yin and yang, strengthens spleen and stomach, stops vomiting, and quenches thirst.
Renshen (1 liang); Muxiang, Fuling (Poria), Huoxiang, Gancao (roasted) each 1 fen; Gange (2 fen).
Make into powder. Take one qian per dose, boil to 0.5 zhan, take warm slowly.