《巢氏病源》小儿伤寒候∶伤寒者,冬时严寒而人触冒之,寒气入腠理,搏于血气,则发寒热、头痛、体疼,
谓之伤寒。又春时应暖而反寒,此非其时有其气,伤人即发病,谓之时行伤寒者。小儿不能触冒寒气,而病伤
寒者,多由大人解脱之时久,故令寒气伤之,是以小儿亦病之。诊其脉来一投而止者,便是得病一日;假令六
投而止者,便是得病六日。其脉来洪者易治,细微者难治也。
《巢氏病源》小儿伤寒解肌发汗候∶伤寒是寒气客于皮肤,寒从外搏于血气,腠理闭密,冷气在内不得外泄,
蕴积,故头痛、壮热、体疼。所以须解其肌肤,令腠理开。津液为汗,发泄其气则热歇。凡伤寒无问长幼男女,
于春夏宜发汗。又脉浮大宜发汗。所以然者,病在表故也。
《千金》论曰∶夫小儿未能冒涉霜雪,乃不病伤寒也。大人解脱之久,伤于寒冷则不论耳。然天行非节之气,
其亦得之。有时行疾疫之年,小儿出腹便患斑者也。治其时行节度,故如大人法,但用药分剂少异,药小冷耳。
《圣惠》论∶凡婴孩伤寒,不可以燥药发汗也。发汗,则孩子一向躁极于脏腑,热极伤于心气,多厥不可治
也。若以性寒汤药,阳受于冷,冷热相击,孩子一向惊叫不睡,热冲于脑,头缝开张,皮肉筋脉急胀,不可治
也。若以性热汤药饵之,乃助于阳也。阳极则阴必争也。四肢汗出如油,手足或热或冷,多狂癫惊 ,即不可
治也。
茅先生∶小儿有伤寒候。身微热,KT 吐乳,鼻塞,咳嗽。此候因抱儿子当风处,吹着背俞至此。所治者,
当日下天麻散二服(方见本门中),朱砂膏二服(方见惊积门中)。其患即愈,不得误动脏腑。
茅先生∶伤寒变蒸,夹惊夹食,中风,所中伤寒各说有一。因根据根源各别下药,有殊如调理。上件伤寒
传变,吐不可止,大小便不通,大渴,耳内脓出,身上生斑点赤,心狂,眼视,鼻口干燥,死候不治。
汉东王先生《家宝》伤寒病证∶婴孩小儿单伤寒者,浑身壮热,鼻流清涕,身上寒毛起,咳嗽欲喘,宜用
解伤寒红绵散三、二服,间调胃气,进乳食观音散三、二服。如有余热未退,睡里多惊,须进七宝轻青丹三、二
服,(红绵散、轻青丹方并见本门中。)再服调胃气观音散三、二服。(方见胃气不和门中。)
汉东王先生《家宝》∶小儿伤寒可医者七。
鼻内清水是伤寒。鼻者是肺之外应。伤寒,故外风吹着身,皮毛及发皆主于肺,故令外涕流出清水,身寒
毛立,后则身热躁叫,口干,耳冷,汗出,是伤寒。伤寒者,是邪气伤其正气,正气软弱,则不能主于身,被邪
气攻出,故为汗。汗出多则令面黄无力,后若不止,则体虚生风,宜补实之。
鼻塞是伤寒。伤寒是外邪伤肺,所受则正在肺,邪气伤正气则滞,荣卫不通,故乃鼻塞。是发汗后更与通
关药耳。
面赤是伤寒。伤寒是伤气及邪气入腹。其肺当旺,不肯受邪。肺者受患,其初传心则心气虚,故令面赤则
口干,夜间不卧,阴阳相克,日中可解,则凉药服之。
吐白水是伤寒。何以吐白水?其伤寒受在于胃,其胃气为邪所伤,胃弱则吐白水。若吐食则入脾,瘥后须
变身黄。脾胃俱象土,故色黄,宜早暖脾胃耳。
两眼黄赤是伤寒。伤寒是先受在脾,在其色黄。次传在肝,主眼,故邪伤于肝,故共脾邪入之,故令眼黄
赤,宜以洗肝后发汗耳。
小便黄赤是伤寒。伤寒者,寒气伤肺,肺虚故不受,于心,心实传腑。心以小肠为腑,受邪则滞荣气,则
赤,后则尿如血。通小便后取之。
不可医者六∶
伤寒面黑者不治。伤寒气伤皮肤,本入肺,肺传肾。肾主水,水属北方,其色黑。复传心,心属火。其水
大能克火,故令面黑,不治。
伤寒大小肠痛不治。其伤寒受在肺,肺以大肠为腑,脏不能受,倒传出一脏,不再传入心,则火克金;心
将小肠为腑,故大小便痛耳。
伤寒忽作邪声不治。此是伤寒,邪气伤肺。肺主声,肺被邪伤,绝则声出不回。如便作邪声,是肺绝也。
伤寒叫声不出不治。此是伤寒入肾失解,肾气绝,不能作声,即死耳。
伤寒粪黑不治。何以泻黑血粪?其伤寒邪伤肺,肺绝不能行血。其血黑色,从大肠中下,如死鹅鸭一般,
即死。如大便无赤黑不妨,却是热盛,宜与凉药耳。
伤寒爪黑不治。爪黑者,伤寒传肝,其邪胜,正气绝。肝主筋及主诸爪甲,肝绝则不能荣于爪,故为死之
形也。
上件,其伤寒皆是邪气伤于脏腑,滞其血气则寒热,血脉乱,不能饮食。其头痛面赤者,则是阳毒。其面
青不语、多哭、身寒,是为阴毒。凡伤寒,三日前宜汗,三日后宜转。又云∶阴毒宜回阳,(先与热药,后方汗。)阳毒
宜解。(先与凉药,后与汗之。)取转亦此说,三日前汗,三日后转,此大略之言耳。(有初得便宜转者,有得之三、两日
后宜汗者,不可拘此。)
《婴童宝鉴》∶小儿伤寒为客风伤于腠理,攻于皮肤,故身热、头痛、不食、气多呕逆、惊啼、面赤而喘。
《活人书》序∶小儿伤寒与大人治法一般,但分剂小、药性差凉耳。寻常风壅发热,鼻涕痰嗽,烦渴。惺惺散主之。
(方与钱乙同,见本门中。)咽喉不利,痰实咳嗽,鼠粘子汤主之。(方见疮疹门中。)头额身体温热,大便黄赤,腹中
有热,四顺散、(方与葛氏同,见温壮门中。)连翘饮、三黄丸主之。头额身体温热,大便白而酸臭者,胃中有食积,双
丸
主之。(三方见本门中。)小儿无异疾,唯饮食过度,不能自节,心腹胀满,身热头痛,此双丸悉治之。小儿身体潮热,
头目碎痛,心神烦躁,小便赤,大便秘,此热剧也,洗心散、(方见伤寒大小便不通门。)调胃承气汤主之。(方见伤寒
自汗门。)头疼、发热,偎人、恶寒者,此伤寒证也,升麻汤主之。(方见伤寒口内生疮门中,十物升麻汤。)无汗者,
麻黄黄芩汤;有汗者,升麻黄芩汤,皆要药也。(二方并见本门。)小儿寻常不可过当服凉药,胃冷虫动,其证与惊相类。
医人不能辨,往往复进惊药,加脑、麝之类,遂发吐、胃虚而成慢惊者多矣。小儿须有热证方可疏转,仍慎用丸子药利
之,当以大黄、川芎等 咀,作汤液,以荡涤蕴热。盖丸子巴豆乃攻食积耳。
翰林待诏杨大邺问∶小儿伤寒瘟疫者为何?答曰∶神气虽丸,性情未定,衣裳不择于浓薄;或恣情而脱着,
娇纵不常,生冷尽意;或过餐寒热之物,因此致患头疼、气促、发热增寒;或饮多尚渴;或虚汗连连,精神KT
。因绵绵用药,须精审其根源,察病表里,仍看脉体,未可便下,切须要知虚实,消停药分,切在意处方治之。
《惠眼观证》∶伤寒外证,一见眼睛黄赤及鼻塞,遍身壮热,口鼻出清水,非时冷汗,加之咳嗽气闭、毛起,
小便如粉汁,此皆是伤寒候。伤寒候如觉面带黑色,大小肠干痛,上吐下泻,气又刺痛,耳内脓及眼生浮膜,
皆恶候也。
《惠眼观证》∶小儿伤寒形候亦分数类。有兼惊、挟实、惊气、温候三证。一兼惊者,因患惊风,三日后治得惊退,
第四日至五日忽有嗽,息粗大,面色恍惚,变动无时,上渴不止,急且治脾,宜下麦汤散(方末见)、平胃丸(方见哕
逆门中)、附子散(方见虚寒门中)。万一记之,不得下冷药,恐冰却脾气,伏热不退。二挟实者,本因孩儿肥实,吃
食无度,伤饱而闭却胃气。其候呕逆,一见唇红面赤,便问曾吐呕逆无,如已曾吐呕逆,必须头痛或泻不止,乃用 汤
丸。(方见急慢惊风门中。)通利后匀气散、(方见胃气不和门中。)夹麦汤散服之。惊气者,本因气膨胀,咳嗽,咽喉中
涎响,心间烦躁,脏腑疼痛,梦中虚惊,先用乌犀膏(方见热门中)滚涎,次下麦汤散及大惊丸(方见一切惊门中),
相夹服至两日方下 汤丸,通利一二日,气行后常服醒脾平胃汤药。如伤寒后,或遍身生黑黯血,所谓兰斑形证,下可
用药。三温壮者,亦浑身微热面红,常困睡,微汗,因客风吹着毛窍,冷气急,鼻塞,大体与变蒸相似,只下麦汤散与
红绵散(红绵散方见疮疹已出未出门中,)治之亦安。
《小方脉》论伤寒皆因三阴三阳受病,缘未辨东西,不能言语,虽即遍身壮热,四肢不任,其状多喘,难为
识候。凡伤寒与诸热疾皆同,奈诸热不生呻吟,惟伤寒呻吟眉聚是也。宜服麦煎散。(方未见。)
茅先生小儿初受伤寒候歌∶
小儿伤寒身壮热,面赤唇红眼赤黄,身上寒毛初凛凛,更兼冷汗润汪汪。鼻中清涕涓涓滴,小便如粉又如
浆,上喘鼻塞将加嗽,口干呕逆是寻常。看有诸般难治疗,别为章句好看详。
茅先生小儿伤寒死候歌∶
伤寒吐不止,便溺更难通,汗后发热渴,耳中疮溃脓。身生斑黑点,鼻丘出倾筒,咳嗽四肢厥,心狂下所
攻。体软睡不寤,腹胀喘声雄,手足心热痛,此候命须终。
茅先生小儿又伤寒死候歌∶
小儿伤寒面黑色,耳内有脓声噎塞。气逆吐泻转加增,大肠干泄眼浮极。医士精神还更昏,千万归泉休废力。
《玉诀》小儿伤寒候歌∶
鼻多清涕肺伤风,寒气相传鼻不通,壮热脉浮生内热,发惊涎盛转加浓。
夫小儿伤寒者,先与治风,后与下涎,次谓胃气也。
《石壁经》三十六种正受伤寒候歌∶
伤寒初得浑身热,恶哭多啼无喜悦,眼红脸赤类惊风,(《凤髓经》此一句云∶只看眼急以惊风。)却被医人道惊热。
但须凉膈莫令渴,渴便饮水无休歇。若将三黄散子服,汗出身轻便无热。
风邪寒入肌体,汗闭热气内蕴,致使烦躁而多渴,喘嗽,汗不得泄,发热不止。若服冷药太甚,则使汗不出而反作
别候也。须先出汗,次凉膈方愈。若不然,则慢脾、慢惊缘此得之。(《凤髓经》歌同,仍注云∶与三黄散,方见本门
中,次麦汤散方未见。)
《小儿形证论》四十八候,正受伤寒歌一同。后云∶此为正受伤寒,目急、壮热,气喘嗽,面赤。先与解表
散吃(方见慢惊风门中),后用南星丸退风热(方见伤寒变疹门中)。如不退,却将三黄散与吃(方见本门中。)
《千金》治少小伤寒莽草汤浴方
莽草(半斤) 牡蛎(四两) 雷丸(三十枚) 蛇床子(一升) 大黄(一两)
上五味 咀,以水三斗,煮取一斗半。适寒温,以浴儿,避眼及阴。
《千金》治小儿伤寒方。
葛根(汁) 淡竹沥(各六合)
上二味相和,二三岁儿分三服,百日儿斟酌服之,不宜生服,煮服佳。(《婴孺方》同,乃云∶只生服,不用煮。)
《千金》治少小伤寒。芍药四物解肌汤方
芍药 黄芩 升麻 葛根(各半两)
上四味 咀,以水三升,煮取九合,去滓。分服,期岁以上分三服。(《伤寒证治》方同,云∶又治小儿疮疹之候,
与伤寒温疫相似,疑似之间先可与之。)
《千金》治夏月伤寒,四肢烦疼,发热,其人喜烦,呕逆满剧如祸祟;寒热相搏,故令喜烦。七物黄连汤方
黄连 茯苓 黄芩(各十八铢) 芍药 葛根(各一两) 甘草(炙,一两六铢) 小麦(三合)
上各 咀,以水七升煮取三升。冷分三服,不能一升者,可稍稍服之,汤势定乃卧。药去毒瓦斯,服汤之后,
胸中热及咽喉痛皆瘥。其明日复煮一剂,如法服之。服此汤无毒,但除热下气、安病患。小儿服者,取三分
之一,以水四升,煮得二升,稍稍服。
《仙人水鉴》孩子伤寒方。
栀子仁(一枚) 枣(一枚,烧灰) 牙硝(一分)
上以古字钱两文烧令赤,水中淬。如此七度,将此水调三味,灌之立愈。
《仙人水鉴》孩子百日内患伤寒壮热,速宜疗之。
铧铁(一斤,烧令通赤,以水二斗淬之,如此三七遍,煎取二停,更入柳叶七片,浴儿不用) 胡油麻(二十一粒)
松柏叶(二七枚) 牙硝 乳香(各一分) 金箔(一片) 白芥子(三七粒)
上并捣为散,蜜丸如弹子大。以青物裹一丸,如烧香法,熏儿双足,微有汗出便瘥。
《仙人水鉴》∶小孩三岁以下,忽患伤寒阴阳二毒。此因母之毒瓦斯所致。庸医多不会,自见壮热不食、多睡,便
以冷药及冷物与吃,即儿转不安加甚。盖药热动风,药寒呕逆,宜使此走马散子方
大黄(末,一两,水醋煮令如) 干地龙(一粒,末入) 牙硝(一分)
上为末,同研三百下,令荫干;再捣为末,生姜汁调灌,立见神验(量多少灌。)
《圣惠》治小儿四五岁伤寒,壮热头痛。射干散方
射干 甘草(炙微赤,锉) 川升麻 杏仁(汤浸,去皮尖、双仁,麸炒微黄) 赤芍药 石膏(各半两) 麻黄
(三分,去根节) 桂心(一分)
上件药捣,粗罗为散。每服一钱,以水一小盏,煎至五分,去滓。不计时候,量儿大小加减,温服。
《圣惠》治小儿伤寒发热,四肢烦疼。解肌散方
赤芍药(半两) 杏仁(汤浸,去皮尖、双仁,麸炒微黄) 桂心 川大黄(锉碎,微炒) 甘草(炙微赤,锉。
各一分) 麻黄(三分,去根节)
《巢氏病源》关于小儿伤寒的论述:所谓伤寒,是冬季严寒之时,人感受了寒气,寒气侵入腠理(皮肤纹理及汗孔),与血气相搏结,从而出现恶寒发热、头痛、身体疼痛的症状,这被称为伤寒。另外,春季本应温暖却反而寒冷,这种非其时而有其气的情况,伤人后随即发病,称为时行伤寒。小儿并不能主动去触犯冒犯寒气,而患上伤寒的,大多是因为大人给孩子脱衣解带的时间太久,导致寒气侵袭所致,因此小儿也会患此病。诊察脉象,如果脉搏跳动一次就停止(指脉律不齐或间歇),这是得病一天的表现;假如脉搏跳动六次才停止一次,这是得病六天的表现。脉象洪大的容易治疗,脉象细微难寻的则难以治疗。
《巢氏病源》关于小儿伤寒解肌发汗的论述:伤寒是寒气客居在皮肤之间,寒气从外部与血气相搏,导致腠理闭塞致密,冷气在体内无法向外宣泄,蕴积体内,所以出现头痛、高热、身体疼痛。因此必须解除肌肤之邪,使腠理开泄。津液化为汗液,发泄出体内的邪气,热势就会消退。凡是伤寒,不论长幼男女,在春夏季节适宜采用发汗法。另外,脉象浮大的也适宜发汗。之所以这样,是因为病邪在表的原因。
《千金方》论述说:小儿未能涉足霜雪,按理说不应患伤寒。但如果大人给孩子脱衣过久,孩子受寒冷伤害,那就不在此限了。然而遇到天时反常的非节之气,小儿也会患病。在有流行疾疫的年份,小儿出生不久就会患斑疹类疾病。治疗时行的节度,方法如同成人,只是用药剂量稍小,药性偏凉而已。
《太平圣惠方》论述:凡是婴孩患伤寒,不可以用燥烈药物发汗。如果发汗,会导致孩子脏腑极度躁动,热极损伤心气,多出现四肢厥逆且不可治愈。如果用性寒的汤药,阳气受到冷邪冲击,冷热相击,孩子会一直惊叫不睡,热气冲撞脑部,导致头缝开张,皮肉筋脉急胀,也不可治愈。如果用性热的汤药喂服,则会助长阳热。阳极则阴必争,会出现四肢出汗如油,手足或热或冷,多狂癫惊风,即不可治愈。
茅先生:小儿有伤寒的证候。身体微热,呕吐乳食,鼻塞,咳嗽。这个证候是因为抱着孩子在风口处,背俞穴受了风寒所致。治疗者,当天服用天麻散两服(方剂见本门中),朱砂膏两服(方剂见惊积门中)。病情即可痊愈,不得误伤脏腑。
茅先生:伤寒变蒸,夹惊夹食,中风,所中的伤寒各有说法。因为根源各不相同,下药也有差异,不同于一般的调理。上述伤寒传变,呕吐不止,大小便不通,大渴,耳内流脓,身上生赤色斑点,心狂,眼视不明,鼻口干燥,这些都是死候,不可治愈。
汉东王先生《家宝》论伤寒病证:婴孩小儿单纯患伤寒的,浑身壮热,鼻流清涕,身上寒毛竖起,咳嗽欲喘,宜用解伤寒红绵散二至三服,中间调理胃气,进服观音散二至三服。如有余热未退,睡眠中多惊悸,须进服七宝轻青丹二至三服(红绵散、轻青丹方剂均见本门中),再服调胃气观音散二至三服(方剂见胃气不和门中)。
汉东王先生《家宝》:小儿伤寒可治疗的有七种情况。
鼻内流出清水是伤寒。鼻子是肺的外应器官。伤寒,是因为外风吹袭身体,皮毛及毛发都主属于肺,所以导致鼻涕流出清水,身寒毛立,随后身体发热躁叫,口干,耳朵冷,出汗,这是伤寒。伤寒,是邪气伤害正气,正气软弱,就不能主宰身体,被邪气攻出,所以出汗。汗出过多会导致面色黄而无力气,如果汗止不住,则体虚生风,宜补益充实正气。
鼻塞是伤寒。伤寒是外邪伤害肺,邪气受纳于肺,邪气伤正气则气机滞涩,营卫不通,所以鼻塞。这是在发汗后给予通关药罢了。
面赤是伤寒。伤寒是伤气及邪气入腹。此时肺当旺,不肯受邪。肺受病患,初传于心则心气虚,所以导致面赤则口干,夜间不卧,阴阳相克,日中时可缓解,则服用凉药。
吐白水是伤寒。为什么吐白水?伤寒受在于胃,胃气为邪所伤,胃弱则吐白水。如果吐食物则涉及脾,病愈后须变身黄。脾胃俱属土,故色黄,宜早暖脾胃。
两眼黄赤是伤寒。伤寒是先受在于脾,其色黄。次传在肝,肝主眼,所以邪伤于肝,故连同脾邪入之,导致眼黄赤,宜以洗肝后发汗。
小便黄赤是伤寒。伤寒是寒气伤肺,肺虚故不受邪,传入于心,心实传腑。心以小肠为腑,受邪则滞涩荣气,则色赤,随后尿如血。通利小便后取效。
不可治疗的有六种:
伤寒面黑者不治。伤寒邪气伤皮肤,本入肺,肺传肾。肾主水,水属北方,其色黑。复传心,心属火。水大能克火,所以导致面黑,不治。
伤寒大小肠痛不治。伤寒受在肺,肺以大肠为腑,脏不能受邪,倒传出一脏,不再传入心,则火克金;心将小肠为腑,所以大小便痛。
伤寒忽作邪声不治。这是伤寒,邪气伤肺。肺主声,肺被邪伤,绝则声音出不回。如便作邪声,是肺绝也。
伤寒叫声不出不治。这是伤寒入肾失解,肾气绝,不能作声,即死。
伤寒粪黑不治。为什么泻黑血粪?伤寒邪伤肺,肺绝不能行血。其血黑色,从大肠中下,如死鹅鸭一般,即死。如大便无赤黑不妨,却是热盛,宜与凉药。
伤寒爪黑不治。爪黑者,伤寒传肝,其邪胜,正气绝。肝主筋及主诸爪甲,肝绝则不能荣于爪,故为死形也。
上述这些,伤寒皆是邪气伤于脏腑,滞其血气则寒热,血脉乱,不能饮食。其头痛面赤者,则是阳毒。其面青不语、多哭、身寒,是为阴毒。凡伤寒,三日前宜汗,三日后宜转。又说:阴毒宜回阳(先与热药,后方汗),阳毒宜解(先与凉药,后与汗之)。取转亦此说,三日前汗,三日后转,这是大略之言。(有初得便宜转者,有得之三、两日后宜汗者,不可拘泥于此。)
《婴童宝鉴》:小儿伤寒为客风伤于腠理,攻于皮肤,所以身热、头痛、不食、气多呕逆、惊啼、面赤而喘。
《活人书》序:小儿伤寒与大人治法一般,但分剂小、药性差凉耳。寻常风壅发热,鼻涕痰嗽,烦渴。惺惺散主之。(方与钱乙同,见本门中。)咽喉不利,痰实咳嗽,鼠粘子汤主之。(方见疮疹门中。)头额身体温热,大便黄赤,腹中有热,四顺散、(方与葛氏同,见温壮门中。)连翘饮、三黄丸主之。头额身体温热,大便白而酸臭者,胃中有食积,双丸主之。(三方见本门中。)小儿无异疾,唯饮食过度,不能自节,心腹胀满,身热头痛,此双丸悉治之。小儿身体潮热,头目碎痛,心神烦躁,小便赤,大便秘,此热剧也,洗心散、(方见伤寒大小便不通门。)调胃承气汤主之。(方见伤寒自汗门。)头疼、发热,偎人、恶寒者,此伤寒证也,升麻汤主之。(方见伤寒口内生疮门中,十物升麻汤。)无汗者,麻黄黄芩汤;有汗者,升麻黄芩汤,皆要药也。(二方并见本门。)小儿寻常不可过当服凉药,胃冷虫动,其证与惊相类。医人不能辨,往往复进惊药,加脑、麝之类,遂发吐、胃虚而成慢惊者多矣。小儿须有热证方可疏转,仍慎用丸子药利之,当以大黄、川芎等 咀,作汤液,以荡涤蕴热。盖丸子巴豆乃攻食积耳。
翰林待诏杨大邺问:小儿伤寒瘟疫者为何?答曰:神气虽丸,性情未定,衣裳不择于浓薄;或恣情而脱着,娇纵不常,生冷尽意;或过餐寒热之物,因此致患头疼、气促、发热增寒;或饮多尚渴;或虚汗连连,精神KT。因绵绵用药,须精审其根源,察病表里,仍看脉体,未可便下,切须要知虚实,消停药分,切在意处方治之。
《惠眼观证》:伤寒外证,一见眼睛黄赤及鼻塞,遍身壮热,口鼻出清水,非时冷汗,加之咳嗽气闭、毛起,小便如粉汁,此皆是伤寒候。伤寒候如觉面带黑色,大小肠干痛,上吐下泻,气又刺痛,耳内脓及眼生浮膜,皆恶候也。
《惠眼观证》:小儿伤寒形候亦分数类。有兼惊、挟实、惊气、温候三证。一兼惊者,因患惊风,三日后治得惊退,第四日至五日忽有嗽,息粗大,面色恍惚,变动无时,上渴不止,急且治脾,宜下麦汤散(方末见)、平胃丸(方见哕逆门中)、附子散(方见虚寒门中)。万一记之,不得下冷药,恐冰却脾气,伏热不退。二挟实者,本因孩儿肥实,吃食无度,伤饱而闭却胃气。其候呕逆,一见唇红面赤,便问曾吐呕逆无,如已曾吐呕逆,必须头痛或泻不止,乃用 汤丸。(方见急慢惊风门中。)通利后匀气散、(方见胃气不和门中。)夹麦汤散服之。惊气者,本因气膨胀,咳嗽,咽喉中涎响,心间烦躁,脏腑疼痛,梦中虚惊,先用乌犀膏(方见热门中)滚涎,次下麦汤散及大惊丸(方见一切惊门中),相夹服至两日方下 汤丸,通利一二日,气行后常服醒脾平胃汤药。如伤寒后,或遍身生黑黯血,所谓兰斑形证,下可用藥。三温壮者,亦浑身微热面红,常困睡,微汗,因客风吹着毛窍,冷气急,鼻塞,大体与变蒸相似,只下麦汤散与红绵散(红绵散方见疮疹已出未出门中,)治之亦安。
《小方脉》论伤寒皆因三阴三阳受病,缘未辨东西,不能言语,虽即遍身壮热,四肢不任,其状多喘,难为识候。凡伤寒与诸热疾皆同,奈诸热不生呻吟,惟伤寒呻吟眉聚是也。宜服麦煎散。(方未见。)
茅先生小儿初受伤寒候歌:
小儿伤寒身壮热,面赤唇红眼赤黄,身上寒毛初凛凛,更兼冷汗润汪汪。鼻中清涕涓涓滴,小便如粉又如浆,上喘鼻塞将加嗽,口干呕逆是寻常。看有诸般难治疗,别为章句好看详。
茅先生小儿伤寒死候歌:
伤寒吐不止,便溺更难通,汗后发热渴,耳中疮溃脓。身生斑黑点,鼻丘出倾筒,咳嗽四肢厥,心狂下所攻。体软睡不寤,腹胀喘声雄,手足心热痛,此候命须终。
茅先生小儿又伤寒死候歌:
小儿伤寒面黑色,耳内有脓声噎塞。气逆吐泻转加增,大肠干泄眼浮极。医士精神还更昏,千万归泉休废力。
《玉诀》小儿伤寒候歌:
鼻多清涕肺伤风,寒气相传鼻不通,壮热脉浮生内热,发惊涎盛转加浓。
夫小儿伤寒者,先与治风,后与下涎,次谓胃气也。
《石壁经》三十六种正受伤寒候歌:
伤寒初得浑身热,恶哭多啼无喜悦,眼红脸赤类惊风,(《凤髓经》此一句云∶只看眼急以惊风。)却被医人道惊热。但须凉膈莫令渴,渴便饮水无休歇。若将三黄散子服,汗出身轻便无热。
风邪寒入肌体,汗闭热气内蕴,致使烦躁而多渴,喘嗽,汗不得泄,发热不止。若服冷药太甚,则使汗不出而反作别候也。须先出汗,次凉膈方愈。若不然,则慢脾、慢惊缘此得之。(《凤髓经》歌同,仍注云∶与三黄散,方见本门中,次麦汤散方未见。)
《小儿形证论》四十八候,正受伤寒歌一同。后云∶此为正受伤寒,目急、壮热,气喘嗽,面赤。先与解表散吃(方见慢惊风门中),后用南星丸退风热(方见伤寒变疹门中)。如不退,却将三黄散与吃(方见本门中。)
《千金方》治少小伤寒莽草汤浴方
莽草(半斤) 牡蛎(四两) 雷丸(三十枚) 蛇床子(一升) 大黄(一两)
上五味 咀,以水三斗,煮取一斗半。适寒温,以浴儿,避眼及阴。
《千金方》治小儿伤寒方。
葛根(汁) 淡竹沥(各六合)
上二味相和,二三岁儿分三服,百日儿斟酌服之,不宜生服,煮服佳。(《婴孺方》同,乃云∶只生服,不用煮。)
《千金方》治少小伤寒。芍药四物解肌汤方
芍药 黄芩 升麻 葛根(各半两)
上四味 咀,以水三升,煮取九合,去滓。分服,期岁以上分三服。(《伤寒证治》方同,云∶又治小儿疮疹之候,与伤寒温疫相似,疑似之间先可与之。)
《千金方》治夏月伤寒,四肢烦疼,发热,其人喜烦,呕逆满剧如祸祟;寒热相搏,故令喜烦。七物黄连汤方
黄连 茯苓 黄芩(各十八铢) 芍药 葛根(各一两) 甘草(炙,一两六铢) 小麦(三合)
上各 咀,以水七升煮取三升。冷分三服,不能一升者,可稍稍服之,汤势定乃卧。药去毒瓦斯,服汤之后,胸中热及咽喉痛皆瘥。其明日复煮一剂,如法服之。服此汤无毒,但除热下气、安病患。小儿服者,取三分之一,以水四升,煮得二升,稍稍服。
《仙人水鉴》孩子伤寒方。
栀子仁(一枚) 枣(一枚,烧灰) 牙硝(一分)
上以古字钱两文烧令赤,水中淬。如此七度,将此水调三味,灌之立愈。
《仙人水鉴》孩子百日内患伤寒壮热,速宜疗之。
铧铁(一斤,烧令通赤,以水二斗淬之,如此三七遍,煎取二停,更入柳叶七片,浴儿不用) 胡油麻(二十一粒) 松柏叶(二七枚) 牙硝 乳香(各一分) 金箔(一片) 白芥子(三七粒)
上并捣为散,蜜丸如弹子大。以青物裹一丸,如烧香法,熏儿双足,微有汗出便瘥。
《仙人水鉴》∶小孩三岁以下,忽患伤寒阴阳二毒。此因母之毒瓦斯所致。庸医多不会,自见壮热不食、多睡,便以冷药及冷物与吃,即儿转不安加甚。盖药热动风,药寒呕逆,宜使此走马散子方
大黄(末,一两,水醋煮令如) 干地龙(一粒,末入) 牙硝(一分)
上为末,同研三百下,令荫干;再捣为末,生姜汁调灌,立见神验(量多少灌。)
《太平圣惠方》治小儿四五岁伤寒,壮热头痛。射干散方
射干 甘草(炙微赤,锉) 川升麻 杏仁(汤浸,去皮尖、双仁,麸炒微黄) 赤芍药 石膏(各半两) 麻黄(三分,去根节) 桂心(一分)
上件药捣,粗罗为散。每服一钱,以水一小盏,煎至五分,去滓。不计时候,量儿大小加减,温服。
《太平圣惠方》治小儿伤寒发热,四肢烦疼。解肌散方
赤芍药(半两) 杏仁(汤浸,去皮尖、双仁,麸炒微黄) 桂心 川大黄(锉碎,微炒) 甘草(炙微赤,锉。各一分) 麻黄(三分,去根节)
According to *Chao Shi Bing Yuan* (Source of Diseases by Master Chao) regarding pediatric Shanghan (Cold Damage): Shanghan refers to the condition where, during the severe cold of winter, a person is exposed to cold qi. The cold qi enters the cili (skin texture and pores), combats with the blood and qi, resulting in aversion to cold, fever, headache, and body pain; this is called Shanghan. Additionally, when spring should be warm but instead becomes cold, this is an abnormal climate occurring out of season. When it injures people and causes immediate illness, it is called Shixing Shanghan (Epidemic Cold Damage). Children cannot actively expose themselves to cold qi, yet they suffer from Shanghan mostly because adults have left them undressed for too long, allowing cold qi to invade. Thus, children also contract this disease. In pulse diagnosis, if the pulse beats once and then stops (indicating irregularity or intermittent pause), it signifies one day since onset; if the pulse beats six times before stopping once, it signifies six days since onset. A surging (Hong) pulse indicates ease of treatment, while a fine and subtle (Xi Wei) pulse indicates difficulty in treatment.
According to *Chao Shi Bing Yuan* regarding the release of muscle layer and sweating for pediatric Shanghan: Shanghan occurs when cold qi lodges in the skin. Cold combats with blood and qi from the outside, causing the cili to close tightly. Cold qi accumulates inside without being able to vent outward, leading to headache, high fever, and body pain. Therefore, it is necessary to resolve the pathogen from the muscle layer, allowing the cili to open. Body fluids transform into sweat, venting the pathogenic qi, which subsides the heat. For all cases of Shanghan, regardless of age, gender, or status, sweating therapy is suitable in spring and summer. Furthermore, a floating and large (Fu Da) pulse indicates suitability for sweating therapy. This is because the pathogen is at the exterior level.
*Qian Jin Fang* (Essential Prescriptions Worth a Thousand Gold) states: Children do not venture into frost and snow, so theoretically they should not suffer from Shanghan. However, if adults leave them undressed for too long and they are injured by cold, this exception applies. Nevertheless, encountering abnormal seasonal climates, children can also fall ill. In years of epidemic diseases, infants may contract maculopapular rashes shortly after birth. The treatment principles follow those for adults, but with smaller dosages and cooler medicinal properties.
*Tai Ping Sheng Hui Fang* (Holy惠民 Formulas of the Taiping Era) states: For infants and young children suffering from Shanghan, drying-hot herbs should not be used to induce sweating. Inducing sweating will cause extreme agitation in the zang-fu organs, excessive heat damaging Heart Qi, often leading to irreversible limb coldness (Jue Ni). If cold-natured decoctions are used, Yang Qi clashes with cold pathogens, causing continuous crying and insomnia, heat rushing to the brain, opening of cranial sutures, and distension of skin, flesh, tendons, and vessels, which is incurable. If hot-natured decoctions are administered, they assist Yang heat. Extreme Yang leads to contention of Yin, resulting in oily sweat on limbs, alternating hot and cold extremities, mania, epilepsy, and convulsions, which is also incurable.
Master Mao: Pediatric Shanghan presents with slight fever, vomiting of milk, nasal congestion, and coughing. This condition arises from holding the child in drafty areas, exposing the Back-Shu points to wind-cold. Treatment involves administering Tianma San (Gastrodia Powder) two doses and Zhusha Gao (Cinnabar Paste) two doses on the same day (formulas see respective sections). The illness will resolve without injuring the zang-fu organs.
Master Mao: Shanghan transformation and steaming, combined with fright and food stagnation, as well as wind-stroke, each have distinct explanations. Since the root causes differ, herbal prescriptions vary significantly from general regulation. Regarding the progression of Shanghan, unceasing vomiting, obstruction of urination and defecation, extreme thirst, purulent discharge from ears, red macules on the body, mental restlessness, visual disturbances, and dryness of nose and mouth are signs of death and are incurable.
Mr. Wang of Handong, *Jia Bao* (Family Treasure), on Shanghan syndromes: Infants with pure Shanghan present with whole-body high fever, clear nasal discharge, piloerection, coughing with wheezing. It is appropriate to use Jie Shanghan Hongmian San (Red Cotton Powder for Resolving Shanghan) two to three doses, interspersed with Guanyin San (Guanyin Powder) to regulate Stomach Qi and promote feeding, two to three doses. If residual heat remains and the child startles easily during sleep, Qibao Qingqing Dan (Seven-Treasure Light Green Pill) two to three doses should be given (Hongmian San and Qingqing Dan formulas see respective sections), followed again by Guanyin San two to three doses (formula see Stomach Qi Disharmony section).
Mr. Wang of Handong, *Jia Bao*: There are seven treatable conditions in pediatric Shanghan.
Clear fluid from the nose indicates Shanghan. The nose is the external opening of the Lung. Shanghan is caused by external wind invading the body; hair follicles and skin are governed by the Lung, hence clear nasal discharge occurs, accompanied by piloerection, followed by fever, agitation, dry mouth, cold ears, and sweating. Shanghan is when pathogenic qi injures righteous qi; when righteous qi is weak, it cannot govern the body, and pathogenic qi forces it out as sweat. Excessive sweating leads to sallow complexion and weakness. If sweating does not stop, deficiency generates wind, requiring tonification and consolidation.
Nasal congestion indicates Shanghan. External pathogenic qi injures the Lung; the pathogen resides in the Lung, injuring righteous qi and causing stagnation, blocking Ying and Wei circulation, resulting in nasal congestion. This requires patent-nose medicines after sweating.
Red face indicates Shanghan. Shanghan injures Qi and allows pathogenic qi to enter the abdomen. The Lung is prosperous and refuses the pathogen. If the Lung suffers, the pathogen transmits to the Heart, causing Heart Qi deficiency, leading to red face, dry mouth, and insomnia at night. Yin and Yang clash; relief may occur at noon, treated with cooling medicines.
Vomiting clear water indicates Shanghan. Why clear water? Shanghan affects the Stomach; Stomach Qi is injured by pathogens. Weak Stomach Qi leads to vomiting clear water. If food is vomited, the Spleen is involved; recovery may lead to jaundice. Spleen and Stomach belong to Earth, hence yellow color; warming the Spleen and Stomach early is advised.
Yellow-red eyes indicate Shanghan. Shanghan first affects the Spleen (color yellow), then transmits to the Liver (governs eyes). Pathogen injures the Liver, combining with Spleen pathogen, causing yellow-red eyes. Liver-clearing followed by sweating is indicated.
Yellow-red urine indicates Shanghan. Cold pathogen injures the Lung; Lung deficiency fails to contain the pathogen, transmitting to the Heart. Heart excess transmits to its Fu organ, the Small Intestine. Pathogen stagnates Ying Qi, causing redness, eventually bloody urine. Promoting urination brings resolution.
Six untreatable conditions:
Black face in Shanghan is untreatable. Pathogen injures skin, enters Lung, transmits to Kidney. Kidney governs Water, belongs to North, color black. Transmits to Heart (Fire). Water overcomes Fire, causing black face, untreatable.
Pain in Large and Small Intestines is untreatable. Pathogen in Lung; Lung pairs with Large Intestine. Zang cannot accept pathogen, reverses transmission. Fire overcomes Metal. Heart pairs with Small Intestine, causing pain in bowel movements.
Sudden abnormal sounds in Shanghan are untreatable. Pathogen injures Lung. Lung governs voice. Lung destruction leads to sound that does not return. Abnormal sounds indicate Lung destruction.
Inability to cry in Shanghan is untreatable. Pathogen enters Kidney without resolution. Kidney Qi is exhausted, unable to produce sound, leading to death.
Black stool in Shanghan is untreatable. Why black bloody stool? Pathogen injures Lung; Lung destruction fails to move Blood. Black blood passes through Large Intestine, resembling dead goose/duck blood, leading to death. If no red/black stool, it indicates excess heat, treated with cooling medicines.
Black fingernails in Shanghan are untreatable. Black nails indicate transmission to Liver; pathogen wins, righteous Qi exhausted. Liver governs tendons and nails. Liver destruction fails to nourish nails, indicating death.
Generally, Shanghan involves pathogenic qi injuring zang-fu, stagnating blood and qi, causing chills and fever, chaotic meridians, and inability to eat. Headache and red face indicate Yang Du (Toxin). Blue-green face, muteness, excessive crying, and cold body indicate Yin Du. For Shanghan, sweating is suitable within three days; transformation/resolution is suitable after three days. Yin Du requires restoring Yang (hot medicine first, then sweating); Yang Du requires resolving (cool medicine first, then sweating). These are general rules; exceptions exist.
*Ying Tong Bao Jian*: Pediatric Shanghan is caused by guest wind injuring cili and attacking skin, resulting in fever, headache, anorexia, frequent vomiting, fright crying, red face, and wheezing.
Preface to *Huo Ren Shu*: Pediatric Shanghan treatment is similar to adults, but with smaller dosages and cooler properties. For common wind-phlegm obstruction with fever, runny nose, phlegmy cough, and irritability/thirst, Xingxing San is indicated. For throat discomfort, phlegm-stasis cough, Niu Bang Zi Tang is indicated. Warm forehead/body with yellow-red stool and abdominal heat is treated with Si Shun San, Lian Qiao Yin, or San Huang Wan. White sour-smelling stool indicates food stagnation in Stomach, treated with Shuang Wan. For children with no other ailments, only overeating causing abdominal distension, fever, and headache, Shuang Wan treats all. For tidal fever, fragmented head/eye pain, mental烦躁, red urine, and constipation (severe heat), Xixin San or Tiaowei Chengqi Tang are indicated. Headache, fever, clinging to others, and aversion to cold indicate Shanghan, treated with Shengma Tang. No sweating: Mahuang Huangqin Tang; Sweating: Shengma Huangqin Tang. These are essential formulas. Children should not excessively take cooling medicines; cold Stomach triggers worms, mimicking fright. Misdiagnosis leads to adding camphor/musk, causing vomiting and chronic fright due to Stomach deficiency. Heat syndromes require gentle purgation; pills with croton seed attack food stagnation. Use Dahuang and Chuanxiong decoctions to cleanse accumulated heat.
Yang Daye, Hanlin Daizhao, asks: What causes pediatric Shanghan and plague? Answer: Although spirits are complete, temperament is unsettled. Clothing choices vary; arbitrary dressing changes, indulgence in cold/raw foods, or excessive hot/cold foods cause headache, shortness of breath, fever/chills, thirst despite drinking, continuous sweating, and lethargy. Medication must carefully examine roots, interior/exterior, and pulse. Determine deficiency/excess, adjust dosages, and prescribe accordingly.
*Hui Yan Guan Zheng*: Exterior signs of Shanghan include yellow-red eyes, nasal congestion, whole-body high fever, clear discharge from mouth/nose, spontaneous cold sweat, cough, airway closure, piloerection, and powdery urine. These are Shanghan signs. Black face, painful dry intestines, vomiting/diarrhea, stabbing pain, ear pus, and eye membranes are ominous signs.
*Hui Yan Guan Zheng*: Pediatric Shanghan forms are categorized. One type combines with fright: After treating fright for three days, sudden cough, coarse breathing, fluctuating complexion, and incessant thirst appear on days 4-5. Urgently treat Spleen with Maitang San, Pingwei Wan, or Fuzi San. Do not use cold medicines to avoid freezing Spleen Qi and retaining latent heat. Another type involves excess: Due to obesity and overeating, Stomach Qi is blocked. Symptoms include vomiting, red lips/face. If vomiting occurred, headache or diarrhea follows; use specific pills/powders. After purgation, use Yunqi San and Maitang San. Fright Qi type: Caused by Qi distension, cough, salivary rattling in throat, heart烦躁, organ pain, and dream fright. First use Wuxi Gao to roll phlegm, then Maitang San and Dajing Wan. Take together for two days, then purgatives. After Qi moves, regularly use Xingpi Pingwei Tang. Post-Shanghan black-purple blood spots (Lanban) require medication. Warmth/Heat type: Slight fever, red face, drowsiness, slight sweat, caused by guest wind entering hair pores, urgent cold qi, nasal congestion. Similar to transformation steaming; treat with Maitang San and Hongmian San.
*Xiao Fang Mai*: Shanghan results from Three Yin and Three Yang involvement. Infants cannot speak or distinguish directions; although having whole-body fever and limb weakness, with wheezing, symptoms are hard to identify. Unlike other febrile diseases, Shanghan features groaning and knit brows. Maijian San is indicated.
Master Mao's Song on Initial Pediatric Shanghan Signs:
Pediatric Shanghan brings high fever, red face, red lips, yellow-red eyes, piloerection, and profuse cold sweat. Clear nasal drip, powdery urine, upper wheezing, nasal congestion, impending cough, dry mouth, and vomiting are common. Observe various difficult-to-treat signs, detailed in separate chapters.
Master Mao's Song on Death Signs in Pediatric Shanghan:
Unstopping vomiting, difficult urination/defecation, fever/thirst after sweating, ear abscesses with pus. Black macules on body, nasal discharge like pouring tubes, cough with limb coldness, mental madness, lower attacks. Soft body, unrousable sleep, abdominal distension with loud wheezing, hot/painful palms/soles indicate inevitable death.
Master Mao's Song on Further Death Signs in Pediatric Shanghan:
Black face, ear pus, choking sounds. Reversing Qi, vomiting/diarrhea increasing, dry large intestine, extreme eye swelling. Physician's spirit dims; cease effort as death approaches.
*Yu Jue* Song on Pediatric Shanghan Signs:
Clear nasal discharge indicates Lung wind-cold. Cold transmits, blocking nose. High fever, floating pulse, internal heat, fright with abundant saliva intensifies.
For pediatric Shanghan, first treat wind, then reduce saliva, then regulate Stomach Qi.
*Shi Bi Jing* Song on 36 Types of True Shanghan:
Initial Shanghan brings whole-body heat, crying, no joy, red eyes/face resembling fright (some texts say look at tight eyes for fright). Doctors mistake it for fright-heat. Cool Diaphragm, prevent thirst. If thirsty, drink continuously. Taking San Huang San induces light sweating and resolves heat.
Wind-cold enters muscles, sweat closes, heat accumulates internally, causing烦躁, thirst, cough, inability to sweat, persistent fever. Excessive cold medicines prevent sweating and create other signs. Must sweat first, then cool Diaphragm to cure. Otherwise, slow Spleen/Fright results. (*Feng Sui Jing* song is same, notes San Huang San formula in this section, Maitang San unseen).
*Xiao Er Xing Zheng Lun*: 48 signs, true Shanghan song is same. Follows: True Shanghan with tight eyes, high fever, wheezing/cough, red face. First give Jiebiao San (see Slow Fright section), then Nanxing Wan to dispel wind-heat (see Shanghan-Rash section). If unresolved, use San Huang San (see this section).
*Qian Jin Fang* Mangcao Decoction Bath for Pediatric Shanghan:
Mangcao (Half jin), Muli (Four liang), Leiwan (Thirty pieces), Shechuangzi (One sheng), Dahuang (One liang).
Grind these five herbs. Boil in three dou of water to obtain one and half dou. Adjust temperature, bathe child, avoiding eyes and genitals.
*Qian Jin Fang* Formula for Pediatric Shanghan:
Gegen Juice, Danzhuli (Each six he).
Mix two ingredients. For 2-3 year olds, divide into three doses. For 100-day infants, adjust dosage. Raw consumption is not recommended; boiling is better. (*Ying Ru Fang* agrees, stating raw consumption without boiling).
*Qian Jin Fang* Shaoyao Siwu Jiemi Tang for Pediatric Shanghan:
Shaoyao, Huangqin, Shengma, Gegen (Each half liang).
Grind four ingredients. Boil in three sheng of water to obtain nine he. Strain. Divide doses. For children over one year, three doses. (*Shanghan Zhengzhi* formula is same, stating it also treats pediatric rash similar to Shanghan/warm plague; use in doubtful cases).
*Qian Jin Fang* Qi Wu Huanglian Tang for Summer Shanghan with Limb Pain, Fever, Irritability, Vomiting:
Huanglian, Fuling, Huangqin (Each eighteen zhu), Shaoyao, Gegen (Each one liang), Gancao (Roasted, one liang six zhu), Xiaomai (Three he).
Grind each. Boil in seven sheng of water to obtain three sheng. Cool and divide into three doses. If unable to take one sheng, take small amounts. Lie down after pulse stabilizes. Medicine removes toxic qi. Chest heat and throat pain resolve after taking. Boil another dose next day and take as directed. This decoction is non-toxic, clears heat, directs Qi downward, and calms the patient. For children, take one-third dose: boil in four sheng of water to obtain two sheng, take small amounts.
*Xian Ren Shui Jian* Formula for Child Shanghan:
Zhizi Ren (One piece), Zao (One piece, burnt to ash), Yaxiao (One fen).
Burn two ancient coins until red, quench in water. Repeat seven times. Use this water to mix the three ingredients and administer. Immediate cure.
*Xian Ren Shui Jian* Treatment for Infant under 100 Days with Shanghan High Fever:
Huatie (One jin, heated red, quenched in two dou of water, repeat 21 times, boil to two parts), Huyouma (21 seeds), Songbai Ye (14 leaves), Yaxiao, Ruxiang (Each one fen), Jinbo (One piece), Baijiezhi (21 seeds).
Grind into powder, honey-pill like bullet size. Wrap one pill in green vegetable matter, burn like incense, fumigate child's feet. Slight sweating indicates cure.
*Xian Ren Shui Jian*: Children under three suddenly suffering Yin-Yang Du (Toxin) from Shanghan, caused by maternal toxic qi. Quack doctors fail to recognize this; seeing fever, anorexia, and lethargy, they give cold medicines/foods, worsening the condition. Hot medicines stir wind, cold medicines cause vomiting. Use Zouma San:
Dahuang (Powder, one liang, boiled in water/vinegar to paste), Gan Dilong (One earthworm, powdered), Yaxiao (One fen).
Grind together 300 times, shade dry. Grind again. Mix with fresh ginger juice and administer. Immediate effect (dose according to severity).
*Tai Ping Sheng Hui Fang* Shegan San for 4-5 Year Olds with Shanghan High Fever/Headache:
Shegan, Gancao (Roasted slightly red, chopped), Chuan Shengma, Xingren (Soaked in water, peeled, double-kernel removed, bran-roasted slightly yellow), Chi Shaoyao, Shigao (Each half liang), Mahuang (Three qian, roots/joints removed), Guixin (One fen).
Grind medicines, sieve coarsely. Take one qian per dose, boil in one small cup of water to half a cup. Strain. Take warm at any time, adjusting for child's size.
*Tai Ping Sheng Hui Fang* Jiemi San for Pediatric Shanghan Fever/Limb Pain:
Chi Shaoyao (Half liang), Xingren (Soaked, peeled, double-kernel removed, bran-roasted slightly yellow), Guixin, Chuan Dahuang (Chopped, slightly roasted), Gancao (Roasted slightly red, chopped. Each one fen), Mahuang (Three qian, roots/joints removed).