《外台秘要》刘氏疗小儿吃奶不稳,三日至七日以来,觉壮热,颜色赤,及鼻孔黄,即恐作撮口。及孩子牙关里
有虫似蜗牛,亦似黄头白蚌螺者方。
上烧竹取沥半合,少许牛黄,与吃即便瘥。
《外台》刘氏又方
上取猪肉少许拭口,即引虫出或自消,便瘥。
(犯风噤附)
《巢氏病源》小儿噤候∶小儿初生,口里忽结聚,生于舌上如黍粟大,令儿不能取乳,名之曰噤。此由在胎
时,热入儿脏,心气偏受热故也。
《圣惠》论凡初生儿,须防三病。一曰撮口,二曰着噤,三曰脐风,皆是急病。就中撮口、着噤尤甚,过
一腊方免此厄。但看面赤喘急,啼声不出者,是撮口状候已重,善救疗者十不得四、五。若牙关紧急,吃乳不稳,
啼声渐小,口吐涎沫,是着噤。常人见大小便皆通,以为冷热所得,殊不知病在喉舌之间,据状亦极重矣,善救
疗者十不得三、四。但根据将护法,防于事先,则必无此患。
《圣惠》又云∶夫小儿初生口噤,此由在胎之时,热入儿心脾,心脾偏受于热,故令口噤者也。
《千金》治噤,赤者心噤,白者肺噤方。
上用鸡屎白枣大,绵裹,以水一合煮二沸,分再服。(《圣惠》治口噤方同用,如豆大三枚,以水下。)
《千金》治小儿口噤方。
鹿角(粉) 大豆(末)
上二味等分,和乳涂上饮儿。
《千金》又方
上用驴乳、猪乳各二升,合煎,得一升五合。服如杏仁许,三、四服瘥。
《千金》治小儿口噤,不能乳方。
上用雀屎四枚末之,着乳头上饮儿,儿大十枚。
《外台》治小儿初生,口噤不开,不收乳方。
上用赤足蜈蚣半枚,去足,炙令焦末,研之绢筛,以猪乳二合和之。三、四服,分与之差。(《圣惠》及《图经》同。)
《外台》崔氏又儿着口噤体热者方。
上暖竹沥二合,分四、五服之。(《兵部手集》、《圣惠》同。)
《外台》∶《古今录验》疗小儿着噤,其病在咽中如麻豆许,令儿吐沫,不能乳哺方。
上取水银如黍米大,与服,觉病无早晚,水银下咽便愈。以意量之,不过小麻子许。(《圣惠》同。)
《食疗》治孩子口噤方。
上以蛇莓研取汁,灌口中,死亦再活。(蛇莓生下湿处,茎端三叶,花黄子赤,似覆盆子。)
《简要济众》治小儿口噤方。
上以晚蚕蛾二枚,炙令黄,为末,蜜和,敷儿口唇内。
《圣惠》治小儿着口噤方。
上刮却上 白HT 了,取雀儿饭瓮子并虫细研,和奶汁绵滤,点口中及涂两颊、齿龈、上 、舌上下。
《圣惠》又方
上用新乌驴粪捩取汁,涂口中,咽亦无妨。
《圣惠》又方
上用川椒一大两,搜面裹为三角HT 样,烧令黄熟,以绵盖儿口,掏去尖如箸头许大,使椒气入口即效。如
未觉,即可作两、三枚,时用一角,气力即盛。
《圣惠》又方
看儿上 有白点子,火急以指甲刮却,仍烧胡粉,纸烛子HT 之,瘥。
《圣惠》治初生儿口噤不开,舌不能吮乳方。
蜘蛛(一枚,去足及口,炙令焦,细研) 猪乳(一合)
上以猪乳和上件散,为三服。徐徐灌之,神妙。
《圣惠》又方
上用牛口HT 草,取绞汁,涂上瘥。
《圣惠》又方
上用白牛尿,取涂口中瘥。
《圣惠》又方
上用东行牛口沫,取涂儿口及额上,即便效。
《圣惠》又方
上用葛蔓烧灰细研,以一字和乳汁,点口中即瘥。
张涣治小儿口噤立圣散方
干蝎梢(七个,为末) 腻粉(末,一钱) 干蜘蛛(一个,去口足,先以新竹于火上炙,取
竹油一蚬壳许,乃竹沥也。浸蜘蛛一宿,炙令焦,取末)
上件并同研令极细,每服一字。用乳汁调,时时滴口中。
《万全方》治小儿着口噤。
上凡遇儿初饮乳后,以发缠指沾清水点拭了,看齿根上有黄筋两条,便以苇刀子割断,点猪乳便瘥。如儿
口难开,但先点猪乳自开。
《秘要指迷》治小儿生下一月日内,牙关紧急,不能饮乳,口噤方。
上用木梳先于怀内令暖,却于耳门尖下腌一七次,其病即安。
《张氏家传》治新生儿口噤方。
蜈蚣(全,一枚) 蝎梢(七个) 硼砂 朱砂(各三铢) 梅花脑 麝香(各一铢)
上件入乳钵研,婴儿口噤以乳母唾调,涂口唇四畔并牙关后,小儿以舌搅药即是安。如有一切急惊,生姜
蜜水调一字服。
附∶犯风噤方
茅先生∶小儿生下一百二十日内,有犯风噤候。口噤眼开,啼声渐小,吃奶不便,吐出白沫。此候为儿在
胎未见日月先受此病,本因母受胎有疾,故受毒瓦斯。生来血气未调,又被风邪所击,故有如此候。所治者,先
下夺命散与吐风涎;(方见急慢惊风门中。)后下醒脾散(有二方。一方见胃气不和门中,一方见慢脾风
门中)夹匀气散与服;(方见胃气不和门中。)
又下雄朱散(方见惊痫门中)夹朱砂膏(方见惊积门中)常服即愈。如见手捉拳,噤口不开,死之候。
《外台秘要》中刘氏治疗小儿吃奶不稳,从出生后三日到七日左右,出现高热、面色红赤,以及鼻孔分泌物发黄,这就恐怕会发展为撮口风。如果看到孩子牙关里有像蜗牛一样的虫,又像是黄头白壳的蚌螺那样的东西,可用以下方子:
取烧竹子得到的竹沥半合,加入少许牛黄,给孩子服用,病立刻就会痊愈。
《外台秘要》中刘氏的另一个方子:
取少许猪肉擦拭孩子的口腔,就能引出虫子或使其自然消失,病即痊愈。
(附:犯风噤)
《诸病源候论》关于小儿噤风的论述:新生儿嘴里突然结聚成块,长在舌头上像黍米和粟米那么大,导致婴儿不能吸吮乳汁,这种病名叫“噤”。这是因为胎儿在母体内时,热邪侵入胎儿脏腑,心气偏受热邪所致。
《太平圣惠方》论述说,凡是初生的婴儿,必须预防三种疾病。一是撮口风,二是着噤风,三是脐风,这些都是急重症。其中撮口风和着噤风尤为严重,过了一个月才能免除这种灾厄。只要看到孩子面红气喘急促,啼哭不出声音的,这是撮口风症状已经很重,善于救治的医生十个人中也救不了四五个。如果孩子牙关紧急,吃奶不稳,啼哭声音逐渐变小,口吐涎沫,这就是着噤风。普通人见孩子大小便都通畅,以为是受冷或受热引起的,却不知道病位在喉舌之间,根据症状来看也非常危重,善于救治的医生十个人中也救不了三四成。但只要依据护理方法,防患于未然,就一定不会有这种祸患。
《太平圣惠方》又说:小儿初生时口噤,这是由于在胎儿时期,热邪侵入孩子的心脾,心脾偏受热邪,所以导致口噤。
《千金方》治疗噤风,面赤的是心噤,面白的是肺噤的方子:
取鸡屎白如枣核大小,用棉布包裹,用水一合煮两沸,分两次服用。(《太平圣惠方》治疗口噤的方子也这样使用,用量如豆子大小的三枚,用水送服。)
《千金方》治疗小儿口噤的方子:
鹿角(研粉)、大豆(研末)
以上两味药等分,混合乳汁涂擦并喂给孩子。
《千金方》的另一个方子:
取驴乳、猪乳各二升,合并煎煮,浓缩至一升五合。每次服用如杏仁大小的量,服用三四次即可痊愈。
《千金方》治疗小儿口噤,不能吸吮乳汁的方子:
取麻雀屎四枚研成粉末,涂在母亲乳头处让孩子吸吮,大一点的孩子可增至十枚。
《外台秘要》治疗小儿初生口噤不开,不能吸吮乳汁的方子:
取赤足蜈蚣半条,去掉脚,烤焦后研成细末,用绢筛过滤,与猪乳二合混合。分三四次给予服用,即可痊愈。(《太平圣惠方》及《本草图经》相同。)
《外台秘要》崔氏治疗小儿着口噤且身体发热的方子:
取温热的竹沥二合,分四五次服用。(《兵部手集》、《太平圣惠方》相同。)
《外台秘要》引用《古今录验》治疗小儿着噤,病位在咽喉中像麻豆大小的疙瘩,导致孩子吐沫,不能哺乳的方子:
取水银如黍米大小,给孩子服用,无论发病早晚,水银咽下病就好了。凭心意控制剂量,不超过小芝麻粒大小即可。(《太平圣惠方》相同。)
《食疗本草》治疗孩子口噤的方子:
取蛇莓研磨取汁,灌入口中,即使死亡也能再救活。(蛇莓生长在潮湿的地方,茎端有三片叶子,花黄色果实红色,形状像覆盆子。)
《简要济众方》治疗小儿口噤的方子:
取晚蚕蛾两枚,烤至黄色,研成粉末,用蜂蜜调和,敷在婴儿嘴唇内侧。
《太平圣惠方》治疗小儿着口噤的方子:
刮去屋檐下的白色苔藓(注:原文“上 白HT”疑为屋漏白苔或类似物,此处依语境译为屋檐白苔/菌类),取雀儿吃饭用的瓦罐及其中的虫体一起细细研磨,混合奶汁用绵布过滤,滴入口中并涂抹在两颊、齿龈、上颚、舌头上下。
《太平圣惠方》的另一个方子:
取新产的乌驴粪便挤压取汁,涂抹在口中,吞下去也无妨。
《太平圣惠方》的另一个方子:
取川椒一大两,用面团包裹做成三角形,烧至黄熟,用绵布盖住孩子的嘴,掏去尖端如筷子头大小的孔,让椒气进入口中即刻见效。如果没见效,可以制作两三个,时常使用一角,药效力量会更盛。
《太平圣惠方》的另一个方子:
观察孩子上颚是否有白点,急忙用指甲刮掉,然后烧胡粉,用纸烛熏烤,病即痊愈。
《太平圣惠方》治疗初生儿口噤不开,舌头不能吸吮乳汁的方子:
蜘蛛(一枚,去掉脚和嘴,烤焦,细研)、猪乳(一合)
用猪乳调和上述药散,分三次服用。慢慢灌服,效果神奇。
《太平圣惠方》的另一个方子:
取牛口中的草(注:原文“牛口HT草”疑指牛口边草或特定草药,此处保留原意),绞取汁液,涂抹患处即可痊愈。
《太平圣惠方》的另一个方子:
取白色的牛尿,涂抹在口中即可痊愈。
《太平圣惠方》的另一个方子:
取向东生长的牛口边的唾液,涂抹在孩子嘴巴和额头上,立刻见效。
《太平圣惠方》的另一个方子:
取葛藤烧成灰,细细研磨,用“一字”量的剂量混合乳汁,滴入口中即可痊愈。
张涣治疗小儿口噤的立圣散方:
干蝎梢(七个,研末)、腻粉(研末,一钱)、干蜘蛛(一个,去掉口和脚,先用新竹子在火上烤,取得竹油一蚬壳许,也就是竹沥。浸泡蜘蛛一夜,烤焦,取末)
以上药物一同研磨至极细,每次服用“一字”量。用乳汁调匀,时时滴入口中。
《万全方》治疗小儿着口噤:
凡是遇到婴儿刚喝完奶后,用头发缠在手指上沾清水擦拭,看牙龈上有两条黄筋,就用苇叶刀割断,点上猪乳即可痊愈。如果孩子嘴巴难开,先点猪乳使其张开。
《秘要指迷》治疗小儿出生一个月内,牙关紧急,不能喝奶,口噤的方子:
先用木梳在怀里暖热,然后在耳门尖下方按压七次,病即安定。
《张氏家传》治疗新生儿口噤的方子:
蜈蚣(全虫,一枚)、蝎梢(七个)、硼砂、朱砂(各三铢)、梅花脑(冰片)、麝香(各一铢)
以上药物放入乳钵中研磨,婴儿口噤时用母乳母亲的唾液调和,涂抹在嘴唇四周及牙关后方,小儿用舌头搅拌药物即是平安。如果有一切急惊风,用生姜蜜水调“一字”量服用。
附:犯风噤方
茅先生:小儿出生一百二十天内,有犯风噤的症状。口噤眼开,啼哭声音逐渐变小,吃奶不便,吐出白沫。这个症状是因为孩子在胎内尚未足月就先受了此病,本来是因为母亲怀孕时有疾病,所以受到毒瓦斯的影响。出生后血气未调和,又被风邪侵袭,所以有此症状。治疗方法,先用夺命散攻下并吐出风涎;(方剂见急慢惊风门中。)后用醒脾散(有两个方子。一个见胃气不和门中,一个见慢脾风门中)配合匀气散一起服用;(方剂见胃气不和门中。)
再服用雄朱散(方剂见惊痫门中)配合朱砂膏(方剂见惊积门中)常服即可痊愈。如果见到手握拳,口噤不开,是死亡的征兆。
*Waitai Mi Yao* (Essential Prescriptions Worth a Thousand Gold) records Liu's method for treating infants with unstable breastfeeding. If, from three to seven days after birth, the infant develops high fever, red complexion, and yellow discharge in the nostrils, there is fear of it developing into *Cuokou* (Mouth Grasping). If worms resembling snails or yellow-headed white-shell clams are seen in the infant's jaw, use the following prescription:
Take half a *he* (unit of volume) of bamboo sap obtained by burning bamboo, add a small amount of *Niuhuang* (Calculus Bovis), and administer to the infant; the illness will immediately resolve.
Another prescription from Liu in *Waitai*:
Take a small amount of pork meat to wipe the mouth; this will draw out the worms or cause them to disappear naturally, and the illness will resolve.
(Attached: Wind-Invading Jin)
*Bingyuan Huohua Jing* (Master on Causes and Manifestations of Diseases) discusses the syndrome of *Jin* (Lockjaw) in infants: When an infant is first born, sudden aggregations appear in the mouth, growing on the tongue like millet grains, causing the infant to be unable to suckle milk. This is named *Jin*. This occurs because heat pathogens entered the fetus's viscera during gestation, causing the Heart Qi to be biased towards heat.
*Taiping Shenghui Fang* (Comprehensive Essential Formulas from the Imperial Library of Taiping Era) states that all newborns must be guarded against three diseases: one is *Cuokou*, two is *Zhuojin*, and three is *Qifeng* (Umbilical Wind). These are all acute and critical conditions. Among them, *Cuokou* and *Zhuojin* are particularly severe, and the danger passes only after one month. If the infant has a red face, panting urgency, and cannot cry, the signs of *Cuokou* are already heavy. Even skilled healers can save less than four or five out of ten. If the jaw is tight, breastfeeding is unstable, crying becomes weaker, and saliva is frothed from the mouth, this is *Zhuojin*. Ordinary people see that urination and defecation are normal and think it is caused by cold or heat, not knowing that the disease lies between the throat and tongue; according to the symptoms, it is extremely critical, and even skilled healers can save less than three or four out of ten. However, if proper nursing care is followed and prevention is done beforehand, such disasters will certainly be avoided.
*Taiping Shenghui Fang* also says: Infantile lockjaw at birth is caused by heat pathogens entering the infant's Heart and Spleen during gestation. Because the Heart and Spleen are biased towards heat, lockjaw results.
*Qianjin Fang* (Prescriptions Worth a Thousand Gold) treats *Jin*: Red complexion indicates Heart *Jin*; white complexion indicates Lung *Jin*. The prescription is:
Take *Jishibai* (White excrement of chickens) the size of a jujube pit, wrap it in cotton, boil in one *he* of water for two boils, and divide into two doses for administration. (*Taiping Shenghui Fang* uses the same method for treating oral lockjaw: three pills the size of beans, administered with water.)
*Qianjin Fang* treats infantile oral lockjaw:
*Lujiao Fen* (Deer Antler Powder), *Dadou Mo* (Soybean Powder)
Mix equal parts of these two ingredients with milk, apply, and feed to the infant.
Another prescription from *Qianjin Fang*:
Take two *sheng* of donkey milk and two *sheng* of pig milk, combine and decoct until reduced to one *sheng* and five *he*. Administer amounts the size of an almond, three or four doses, and the illness will resolve.
*Qianjin Fang* treats infantile oral lockjaw where the infant cannot suckle:
Take four pieces of sparrow feces, powder them, and apply to the nipple for the infant to suckle. For older infants, increase to ten pieces.
*Waitai Mi Yao* treats newborns with oral lockjaw who cannot suckle:
Take half a red-footed centipede, remove the feet, roast until scorched, powder it, and sieve through silk. Mix with two *he* of pig milk. Divide into three or four doses for administration, and the illness will resolve. (*Taiping Shenghui Fang* and *Bencao Tujing* are the same.)
Cui Shi in *Waitai Mi Yao* treats infants with lockjaw and body heat:
Take two *he* of warm bamboo sap, divide into four or five doses for administration. (*Bingbu Shouji* and *Taiping Shenghui Fang* are the same.)
*Waitai Mi Yao* cites *Gujin Luyan* to treat infantile lockjaw where the pathology is in the throat like a hemp seed, causing foaming and inability to feed:
Take mercury the size of a millet grain and administer. Regardless of when the illness started, once the mercury is swallowed, the illness heals. Adjust the dose by judgment, not exceeding the size of a small sesame seed. (*Taiping Shenghui Fang* is the same.)
*Shiliao Bencao* (Food Therapy Materia Medica) treats infantile oral lockjaw:
Grind *She Mei* (Duchesnea indica fruit) to extract juice, and instill into the mouth. It can revive even if death has occurred. (*She Mei* grows in damp places, has three leaves at the stem tip, yellow flowers, and red fruits resembling raspberries.)
*Jianyao Jizhong Fang* (Concise Formulas for Saving Lives) treats infantile oral lockjaw:
Take two evening silkworm moths, roast until yellow, powder them, mix with honey, and apply to the inside of the infant's lips.
*Taiping Shenghui Fang* treats infantile lockjaw:
Scrape off the white moss/tartar from eaves, take the bird-feeder pot and insects found within, grind finely, mix with milk juice, filter through cotton, instill into the mouth, and apply to both cheeks, gums, palate, and upper/lower surfaces of the tongue.
Another prescription from *Taiping Shenghui Fang*:
Extract juice from fresh black donkey manure, apply to the mouth; swallowing is harmless.
Another prescription from *Taiping Shenghui Fang*:
Take one tael of Chuanjiao (Sichuan Pepper), wrap in dough to form a triangle, roast until yellow and cooked, cover the infant's mouth with cotton, scoop out a hole the size of a chopstick tip, allowing the pepper aroma to enter the mouth for immediate effect. If no effect is felt, make two or three such items, using one corner occasionally to intensify the medicinal power.
Another prescription from *Taiping Shenghui Fang*:
Observe if there are white spots on the infant's palate; urgently scrape them off with fingernails, then burn *Hufen* (Lead White), smoke with paper candles, and the illness will resolve.
*Taiping Shenghui Fang* treats newborns with oral lockjaw where the tongue cannot suckle milk:
Spider (one piece, remove feet and mouth, roast until scorched, powder finely), Pig Milk (one *he*).
Mix the above powder with pig milk, divide into three doses. Slowly instill; the effect is miraculous.
Another prescription from *Taiping Shenghui Fang*:
Take grass from the cow's mouth, squeeze to obtain juice, apply to the affected area, and the illness will resolve.
Another prescription from *Taiping Shenghui Fang*:
Apply white cattle urine to the mouth, and the illness will resolve.
Another prescription from *Taiping Shenghui Fang*:
Take saliva from the mouth of an east-facing cow, apply to the infant's mouth and forehead for immediate effect.
Another prescription from *Taiping Shenghui Fang*:
Burn kudzu vines to ash, powder finely, mix with a "yi zi" (small measure) amount of milk juice, instill into the mouth, and the illness will resolve.
Zhang Huan's *Lisheng San* (Establishing Sage Powder) for treating infantile oral lockjaw:
Dry Scorpion Tail (seven pieces, powder), Nifen (Calomel, powder, one qian), Dry Spider (one piece, remove mouth and feet, first roast new bamboo over fire to obtain bamboo oil [bamboo sap] the size of a clam shell; soak spider overnight, roast until scorched, take powder).
Grind all ingredients together until extremely fine. Each dose is "yi zi". Mix with milk juice and drip into the mouth frequently.
*Wanquan Fang* (Myriad Complete Formulas) treats infantile lockjaw:
Whenever an infant finishes breastfeeding, wrap hair around a finger, dip in clear water, and wipe. If two yellow veins are seen at the gum roots, cut them with a reed knife, apply pig milk, and the illness will resolve. If the infant's mouth is hard to open, first apply pig milk to open it.
*Miyao Zhimi* (Secret Essentials Pointing to the Mystery) treats infants within one month of birth who have tight jaws, cannot drink milk, and suffer from lockjaw:
First warm a wooden comb in the bosom, then press under the earlobe tip seven times, and the illness will settle.
*Zhang Family Collection* treats neonatal oral lockjaw:
Centipede (whole, one piece), Scorpion Tail (seven pieces), Pengsha (Borax), Zhusha (Cinnabar, each three zhu), Meihuanao (Borneol), Shexiang (Musk, each one zhu).
Grind all ingredients in a mortar. For infant lockjaw, mix with mother's saliva, apply around the lips and behind the jaw; the infant stirring the medicine with the tongue brings peace. For any acute convulsions, mix "yi zi" with ginger-honey water and administer.
Appendix: Wind-Invading Lockjaw Prescription
Mr. Mao: Within one hundred and twenty days after birth, infants may suffer from wind-invading lockjaw. Symptoms include lockjaw with eyes open, weakening cry, difficulty feeding, and vomiting white foam. This condition arises because the fetus contracted the disease before full term, originally due to maternal illness during pregnancy leading to toxic qi transmission. After birth, blood and qi are unregulated, and wind pathogens strike, causing such symptoms. Treatment involves first administering *Duoming San* (Life-Saving Powder) to purge and expel wind-phlegm (formula see section on Acute and Chronic Convulsions); then administer *Xingpi San* (Spleen-Awakening Powder, two formulas exist: one see Stomach Qi Disharmony section, one see Slow Spleen Wind section) combined with *Yunqi San* (Qi-Balancing Powder, formula see Stomach Qi Disharmony section).
Also administer *Xiongzhu San* (Male Cinnabar Powder, formula see Convulsions and Epilepsy section) combined with *Zhusha Gao* (Cinnabar Paste, formula see Convulsions and Accumulation section) for regular administration until cured. If hands are clenched and mouth locked shut, it is a sign of death.