《圣惠》∶夫小儿心痛者,本非起于心。即邪客于心主之脉。夫少阴者心也,五脏六腑之所主也,精神之所
舍,其脏坚固,邪不能干。干之即伤心,伤心即神去,神去即死矣。故诸邪在于心者,皆在于心包络脉。包络
者心之别脉也,故少阴不病。夫心痛者,邪气上逆,痞而不散,或伤寒气,邪冷搏于经络,故发心痛也。
茅先生论∶小儿生下五个月日,上至七岁,有结癖在腹成块,如梅核大,来去或似卵大,常叫疼痛不住者。
亦分数类∶在心头痛者,为抱心气;在左胁下痛者,为 气∶在右胁下痛者,为癖气∶在脐下痛者,为吊气。
在心头痛者,下金铃散(方见本门中)夹匀气散与服;(方见胃气不和门中。)在右胁下痛者,下
蓬莪术散夹健脾散与服,在脐下痛者,下芸台散夹茴香散与吃即愈。如见面黑眼花,泻黑血,鼻口冷,手足冷,不进食,
死。(余方并见 癖、吊气本门中注。)
《婴童宝鉴》云∶小儿悒心,啼有时歇者,心痛。
《婴童宝鉴》云∶小儿心痛,是邪气攻于胃管也。
《葛氏肘后》小儿卒心痛,腹胀坚如石,满气喘息方。
上以好盐如鸡子大,浆水三升,煮取三沸,内搅消,取半分,为三服。神验大良。
《外台》范汪芫花汤 主卒心痛连背,背痛连心,心腹并懊。痛如鬼所刺,绞急欲死者。
芫花 大黄(各十分)
上捣,下筛,取四方寸匕,着二升半苦酒中合煎。得一升二合,顿服尽。须臾当吐,吐之便愈。老小从
少起,此疗强实人良。若虚冷心痛,恐未必可服。
《外台》∶《千金》疗老小卒中恶心痛方。
苦参(三两) 好酸醋(一斤半)
上二味,以醋煮苦参,取八合。强人顿服,老小二服。
《圣惠》治小儿心痛,但觉儿将手数数摩心腹即啼,是心痛不可忍。宜服芍药散方
赤芍药 人参(去芦头) 白术 黄芩 川大黄(微炒,锉) 当归(以上各一分)
上件捣,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,分减温服。
《圣惠》治小儿心痛,手足不和。木香散方
木香 白术 桔梗 赤茯苓(各一分) 高良姜(半分)
上件药捣,粗为散。每服一钱,以水一小盏,煎至五分,去滓,稍热频服。量儿大小以意加减。
《圣惠》治小儿心痛不可忍。桃仁散方
桃仁(汤浸,去皮尖、双仁,麸炒微黄) 赤芍药 桔梗 桂心(以上各半两) 甘草(一分,炙微赤,锉)
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,温服。量儿大小以意加减。
《圣惠》治小儿心痛,发歇不定。蓬莪术散方
蓬莪术 人参(去芦头) 桂心 黄芩 木香 地黄 甘草(炙微赤,锉。以上各一分)
上件药捣,细罗为散。每服不计时候,以橘皮汤调下半钱。量儿大小,以意加减服之。
《圣惠》治小儿心痛不止。桂心散方
桂心 当归(锉,微炒) 栀子仁(各半两)
上件药捣,细罗为散。每服不计时候,以橘皮汤调下半钱。量儿大小以意加减。
茅先生治小儿心痛。金铃散
金铃子(炮,去皮棱) 蓬莪术(炮。各一两) 茴香 木香(炮) 荆三棱(炮。各半两)
上件为末。每服一钱、半钱,用热酒调下。
《张氏家传》治男子、女人、小儿脾疼,久肿,心气痛患。
木香(两块,如一皂子大) 丁香(三、七粒) 乳香(半块,如一皂子大) 胡椒(四十九粒) 巴
豆(去皮不出油) 斑蝥(去皮、头、足、翼。各二、七个) 五灵脂(一块,中指大)
上七味为细末,醋糊丸如芥子大。每服三丸,用菖蒲汤下,妇人艾醋汤下,小儿两服至三丸。如衮颤气攻,
痛不忍者,一服应效。
《王氏手集》治心痛不止普救散
延胡索(二两) 香附子(一两)
上为细末,每服一钱,白汤点服。
《王氏手集》应痛散方 治小儿心痛。
石菖蒲(炒) 肉桂(炒。各半两) 五灵脂(二两) 白附子(炮过,土内去火毒) 木
香(炒。各一两) 萝卜子(炒)
上为细末,每服半钱,热酒调下。
《圣惠方》记载:所谓小儿心痛,原本并非心脏本身发病,而是邪气侵袭心主之脉。少阴经属于心脏,是五脏六腑的主宰,也是精神居住的处所,其脏气坚固,邪气不能侵犯。若邪气侵犯,就会损伤心脏;心脏受损则神气离去,神气离去便会死亡。因此,各种邪气侵犯心脏的,实际上都是侵犯心包络之脉。心包络是心脏的别行脉络,所以少阴经本身并不受病。所谓心痛,是由于邪气上逆,气机痞塞而不散,或是感受寒邪,寒气与邪冷搏结于经络,从而引发心痛。
茅先生论述:小儿从出生五个月到七岁之间,腹部有结癖形成肿块,大小如梅核,有时移动或似鸡蛋大,经常呼叫疼痛不止的,也分为几类:在心胸部位疼痛的,称为“抱心气”;在左胁下疼痛的,称为“疰气”(注:原文缺字,据语境推测为疰气或类似气滞病名,此处依原文留白或通假理解,通常指气聚);在右胁下疼痛的,称为“癖气”;在脐下疼痛的,称为“吊气”。对于心胸部位疼痛的,给予金铃散(方剂见本门中),配合匀气散一起服用(方剂见胃气不和门中)。对于右胁下疼痛的,给予蓬莪术散,配合健脾散一起服用。对于脐下疼痛的,给予芸台散,配合茴香散一起服用,即可痊愈。如果见面色发黑、眼花、泻出黑血、鼻口手足冰冷、不能进食,则为死证。(其余方剂均见癖气、吊气本门中的注释。)
《葛氏肘后备急方》治疗小儿突发心痛的腹胀坚硬如石、气满喘息的方子。
用优质盐如鸡蛋大小,浆水三升,煮至沸腾三次,加入其中搅拌使其溶解,取半份,分三次服用。效果神奇且良效。
《外台秘要》收录范汪芫花汤,主治突发心痛牵连背部,背痛牵连心脏,心腹烦闷懊恼,疼痛如被鬼刺,绞痛紧急欲死者。
芫花、大黄(各十分)
将上述药物捣碎,过筛,取四方寸大小的药匕,放入二升半醋中共同煎煮。得到一升二合药液,一次性服完。不久应当呕吐,吐出来病就好了。老人小孩从少量开始服用,此方对体质强壮者疗效好。若是虚冷型心痛,恐怕不一定适合服用。
《外台秘要》收录《千金方》治疗老人小孩突发恶心痛的方子。
苦参(三两)、优质酸醋(一斤半)
将这两味药,用醋煮苦参,取八合药液。体质强者一次服完,老人小孩分两次服用。
《圣惠方》治疗小儿心痛,只要觉得孩子频繁用手抚摸心腹部就啼哭的,这是心痛难忍。适宜服用芍药散方。
赤芍药、人参(去芦头)、白术、黄芩、川大黄(微炒,锉碎)、当归(以上各一分)
将上述药物捣碎,粗罗成散剂。每次服用一钱,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。
《圣惠方》治疗小儿心痛,手足不和。木香散方。
木香、白术、桔梗、赤茯苓(各一分)、高良姜(半分)
将上述药物捣碎,粗制成散剂。每次服用一钱,用水一小盏,煎至五分,去渣,稍热后频服。根据孩子大小酌情加减。
《圣惠方》治疗小儿心痛难忍。桃仁散方。
桃仁(热水浸泡,去皮尖及双仁,麸炒微黄)、赤芍药、桔梗、桂心(以上各半两)、甘草(一分,炙微赤,锉碎)
将上述药物捣碎,粗罗成散剂。每次服用一钱,用水一小盏,煎至五分,去渣。不分时候,温服。根据孩子大小酌情加减。
《圣惠方》治疗小儿心痛,发作间歇不定。蓬莪术散方。
蓬莪术、人参(去芦头)、桂心、黄芩、木香、地黄、甘草(炙微赤,锉碎。以上各一分)
将上述药物捣碎,细罗成散剂。每次服用不分时候,用橘皮汤调服半钱。根据孩子大小,酌情加减服用。
《圣惠方》治疗小儿心痛不止。桂心散方。
桂心、当归(锉碎,微炒)、栀子仁(各半两)
将上述药物捣碎,细罗成散剂。每次服用不分时候,用橘皮汤调服半钱。根据孩子大小,酌情加减。
茅先生治疗小儿心痛的金铃散。
金铃子(炮制,去皮棱)、蓬莪术(炮制。各一两)、茴香、木香(炮制)、荆三棱(炮制。各半两)
将上述药物研为末。每次服用一钱或半钱,用热酒调服。
《张氏家传》治疗男子、女人、小儿脾疼,久肿,心气痛患。
木香(两块,如皂子大)、丁香(三、七粒)、乳香(半块,如皂子大)、胡椒(四十九粒)、巴豆(去皮不出油)、斑蝥(去皮、头、足、翼。各二、七个)、五灵脂(一块,中指大)
将上述七味药研为细末,用醋糊制成如芥菜籽大小的丸药。每次服用三丸,用菖蒲汤送服,妇人用艾醋汤送服,小儿服用两丸至三丸。如果是气攻剧烈颤抖,疼痛难忍的,一服药见效。
《王氏手集》治疗心痛不止的普救散。
延胡索(二两)、香附子(一两)
研为细末,每次服用一钱,用白开水点服。
《王氏手集》应痛散方,治疗小儿心痛。
石菖蒲(炒)、肉桂(炒。各半两)、五灵脂(二两)、白附子(炮制过,去除土内火毒)、木香(炒。各一两)、萝卜子(炒)
研为细末,每次服用半钱,用热酒调服。
According to *Shenghui Fang*: The so-called "heart pain" in children does not originally originate from the heart itself, but rather from pathogenic factors invading the vessels of the Heart Master (Pericardium). The Shaoyin channel belongs to the Heart, which is the master of the five zang and six fu organs and the residence of the spirit. Its organ qi is solid, so pathogens cannot invade it. If invaded, the Heart is damaged; if the Heart is damaged, the spirit departs; if the spirit departs, death ensues. Therefore, when various pathogens affect the Heart, they actually affect the vessels of the Pericardium (Xin Bao Luo). The Pericardium is an alternative vessel of the Heart, so the Shaoyin channel itself does not suffer disease. What is called "heart pain" occurs because pathogenic qi rebels upward, causing stagnation that does not dissipate, or due to injury by cold pathogens, where cold qi and evil cold contend in the meridians, thus inducing heart pain.
Master Mao discusses: For infants from five months old up to seven years old, if there are accumulations (Ji Pi) forming lumps in the abdomen, the size of a plum pit, sometimes moving or as large as an egg, accompanied by constant crying and pain, this is classified into several types: Pain in the chest/heart region is called "Embracing Heart Qi"; pain under the left hypochondrium is called [missing character, likely Zhu Qi]; pain under the right hypochondrium is called "Pi Qi"; pain below the umbilicus is called "Diao Qi". For pain in the chest/heart region, administer Jinling San (Formula seen in this section) combined with Yunqi San (Formula seen in the Stomach Qi Disharmony section). For pain under the right hypochondrium, administer Peng'ezhu San combined with Jianpi San. For pain below the umbilicus, administer Yuntai San combined with Huixiang San, which will lead to recovery. If one sees black complexion, blurred vision, passage of black blood, cold nose/mouth/hands/feet, and inability to eat, this is a fatal sign. (Other formulas are seen in the notes for Ji Pi and Diao Qi sections.)
*Yingtong Baojian* states: When a child's heart feels depressed and crying stops intermittently, this is heart pain.
*Yingtong Baojian* states: Children's heart pain is caused by pathogenic factors attacking the stomach tube (epigastrium).
*Ge Shi Zhou Hou Bei Ji Fang* provides a formula for sudden heart pain in children with abdominal distension hard as stone and fullness of qi with panting.
Take high-quality salt the size of a chicken egg and three sheng of Jiangshui (fermented grain water), boil until it boils three times, add to it and stir until dissolved, take half portion, divide into three doses. It is miraculous and highly effective.
*Waitai Mi Yao* records Fan Wang's Yuanhua Tang, primarily treating sudden heart pain radiating to the back, back pain radiating to the heart, mental restlessness and oppression in the heart and abdomen, pain like being stabbed by ghosts, severe cramping pain threatening death.
Yuanhua (Genkwa Flos), Dahuang (Rhei Radix et Rhizoma) (each 10 fen).
Crush and sieve the above ingredients. Take a square-inch scoop, place in two and a half sheng of Kujiu (bitter vinegar), and decoct together. Obtain one sheng and two he of liquid, take all at once. Vomiting should occur shortly after; upon vomiting, the illness resolves. Start with a smaller dose for elderly and young; this treatment is good for robust individuals. If it is cold-deficiency type heart pain, it may not be suitable.
*Waitai Mi Yao* records *Qianjin Fang* for sudden nausea and pain in elderly and children.
Kushen (Sophorae Flavescentis Radix) (3 liang), Hao Suan Cu (Good Acid Vinegar) (1.5 jin).
Decoct Kushen in the vinegar, obtain eight he of liquid. Robust individuals take it all at once; elderly and children divide into two doses.
*Shenghui Fang* treats children's heart pain: if the child frequently rubs the heart and abdomen with hands and cries, indicating unbearable heart pain, it is appropriate to administer Shaoyao San.
Chishao Yao (Paeoniae Radix Rubra), Ren Shen (Ginseng Radix) (remove rhizome), Baizhu (Atractylodis Macrocephalae Rhizoma), Huangqin (Scutellariae Radix), Chuan Dahuang (Rhei Radix et Rhizoma) (lightly stir-fried, cut), Danggui (Angelicae Sinensis Radix) (each 1 fen).
Crush the above ingredients and sieve coarsely into a powder. Each dose is one qian, decocted in one small cup of water until reduced to five fen, strain. Administer warm at any time, adjusting the dose according to the child's age and size.
*Shenghui Fang* treats children's heart pain with disharmony of hands and feet. Muxiang San.
Muxiang (Aucklandiae Radix), Baizhu (Atractylodis Macrocephalae Rhizoma), Jiegeng (Platycodonis Radix), Chifuling (Poria cum Ligno) (each 1 fen), Gaoliangjiang (Alpiniae Officinarum Rhizoma) (0.5 fen).
Crush the above ingredients and make into a coarse powder. Each dose is one qian, decocted in one small cup of water until reduced to five fen, strain. Drink frequently while slightly warm. Adjust dosage according to the child's size.
*Shenghui Fang* treats unbearable children's heart pain. Taoren San.
Taoren (Persicae Semen) (soaked in hot water, remove skin and tips, double kernels removed, lightly stir-fried with bran until slightly yellow), Chishao Yao (Paeoniae Radix Rubra), Jiegeng (Platycodonis Radix), Guixin (Cinnamomi Cortex) (each half liang), Gancao (Glycyrrhizae Radix et Rhizoma) (1 fen, honey-fried until slightly red, cut).
Crush the above ingredients and sieve coarsely into a powder. Each dose is one qian, decocted in one small cup of water until reduced to five fen, strain. Take warm at any time, adjusting dosage according to the child's size.
*Shenghui Fang* treats children's heart pain with irregular onset and remission. Peng'ezhu San.
Peng'ezhu (Curcumae Longae Rhizoma), Ren Shen (Ginseng Radix) (remove rhizome), Guixin (Cinnamomi Cortex), Huangqin (Scutellariae Radix), Muxiang (Aucklandiae Radix), Dihuang (Rehmanniae Radix), Gancao (Glycyrrhizae Radix et Rhizoma) (honey-fried until slightly red, cut. Each 1 fen).
Crush the above ingredients and sieve finely into a powder. Take half a qian mixed with Chenpi Tang (Tangerine Peel Decoction) at any time, without fixed schedule. Adjust dosage according to the child's size.
*Shenghui Fang* treats persistent children's heart pain. Guixin San.
Guixin (Cinnamomi Cortex), Danggui (Angelicae Sinensis Radix) (cut, lightly stir-fried), Zhizi Ren (Gardeniae Fructus) (each half liang).
Crush the above ingredients and sieve finely into a powder. Take half a qian mixed with Chenpi Tang (Tangerine Peel Decoction) at any time, without fixed schedule. Adjust dosage according to the child's size.
Master Mao's Jinling San for treating children's heart pain.
Jinlingzi (Meliosmae Fructus) (processed, remove skin and edges), Peng'ezhu (Curcumae Longae Rhizoma) (processed. Each 1 liang), Huixiang (Foeniculi Fructus), Muxiang (Aucklandiae Radix) (processed), Jingsanleng (Curcumae Phaeocaulis Rhizoma) (processed. Each half liang).
Grind the above ingredients into powder. Each dose is one qian or half a qian, taken with hot wine.
*Zhang Shi Jia Chuan* treats spleen pain, chronic swelling, and heart qi pain in men, women, and children.
Muxiang (Aucklandiae Radix) (two pieces, size of soap pod), Dingxiang (Caryophylli Flos) (3-7 grains), Ruxiang (Olibanum) (half piece, size of soap pod), Hujiao (Piperis Nigris Fructus) (49 grains), Badou (Crotonis Fructus) (skin removed, oil not expressed), Banmao (Mylabris), Wulingzhi (Trogopterori Faeces) (one piece, size of middle finger).
Remove skin, head, legs, wings from Banmao (2-7 each). Grind the above seven ingredients into fine powder, form pills the size of mustard seeds using vinegar paste. Take three pills per dose, washed down with Changpu Tang (Acori Tatarinowii Rhizoma Decoction); for women, use Ai Cu Tang (Artemisiae Argyi Vinegar Decoction); for children, take two to three pills. If there is violent trembling and qi attack with unbearable pain, one dose yields results.
*Wang Shi Shou Ji* provides Puji San for persistent heart pain.
Yanhusuo (Corydalis Rhizoma) (2 liang), Xiangfuzi (Cyperi Rhizoma) (1 liang).
Grind into fine powder. Take one qian per dose, administered with plain boiled water.
*Wang Shi Shou Ji* Ying Tong San formula for treating children's heart pain.
Shichangpu (Acori Tatarinowii Rhizoma) (stir-fried), Rougui (Cinnamomi Cortex) (stir-fried. Each half liang), Wulingzhi (Trogopterori Faeces) (2 liang), Baifuzi (Typhonii Rhizoma) (processed to remove fire toxicity from soil), Muxiang (Aucklandiae Radix) (stir-fried. Each 1 liang), Luobozi (Brassicae Semens) (stir-fried).
Grind into fine powder. Take half a qian per dose, taken with hot wine.