《巢氏病源》小儿恶核候∶恶核者,是风热毒瓦斯与血气相搏结成核,生颈边,又遇风寒所折,遂不消不溃,
名为恶核者也。
《圣惠》治小儿风热,项边生恶核,寒热肿痛。五香散方
木香 麝香(细研) 薰陆香 鸡舌香 麻黄(去根节) 海藻(洗去咸味) 射干(各一分) 沉香 黄芩 连
翘枳实(麸炒微黄) 川升麻(各半两) 川大黄(一两,锉碎,微炒)
上件药捣,罗为散。每服一钱,以水一小盏煎至五分,去滓,入竹沥半合,更煎一两沸,量儿大小分减温服。
《圣惠》治小儿风热,项腋下有恶核不消,大便多秘,心神烦热。丹参散方
丹参 川升麻 防风(去芦头) 牛蒡子(微炒) 甘草(炙微赤,锉) 川大黄(锉碎,微炒) 黄 (锉) 连
翘(各半两) 露蜂房(一分,微炙) 枳壳(三分,麸炒微黄,去瓤)
上件药捣,粗罗为散。每服一钱,以水一小盏煎至五分,去滓放温。量儿大小加减服之。
《圣惠》治小儿项生恶核,壮热不止。升麻散方
川升麻 射干 连翘 犀角(屑) 川大黄(锉碎,微炒) 川朴硝(各半两)
上捣,粗罗为散。每服一钱,水一小盏煎至五分,去滓放温,量儿大小分减服之。
《圣惠》治小儿忽寒热,项颈生恶核,肩背拘急。连翘散方
连翘(三分) 海藻(洗去咸味) 榆白皮(锉) 牡丹 桂心 白头翁 防风(去芦头) 黄柏(锉) 香豉 独
活秦艽(去苗。各半两)
上捣,罗为末,炼蜜和丸如麻子大。每服温水下五丸,日三服。量儿大小加减。
《圣惠》治小儿胸间积热毒风气不散,连项生恶核,烦热不已。元参丸方
元参 汉防己 羌活 木香 栀子仁 赤芍药 牛蒡子(微炒) 川升麻(各半两) 连翘(三分) 川大黄(一
两,锉碎,微炒)
上捣,罗为末,炼蜜和丸如绿豆大。每服以米饮下五丸,日三服。量儿大小加减。
《圣惠》治小儿热毒风肿生恶核令内消,赤小豆散方
赤小豆 猪牙皂荚 硝石 黄药 木鳖子(各半两) 川大黄(一两,锉碎,微炒)
上件药捣,细罗为散。用鸡子清调涂,日三、四用之。
《刘氏家传》连翘煎 治小儿无寒热,强健如故,身体结核瘰 及心胁腹背内有坚核不通,名为结风气肿方。
连翘 白芨 白头翁 牡丹皮 防风(去芦) 黄柏 羌活(去芦) 秦艽(去土) 豉(炒,以上各秤四分) 海
藻(洗净焙干) 桂(去皮。各秤二分)
上炼蜜和丸如绿豆大。三岁儿米饮下五粒至十粒,五岁以上以意加之,熟水下。
《巢氏病源》中关于小儿恶核的论述:所谓恶核,是指风热毒邪与人体血气相互搏结,凝聚形成核状肿块,生长在颈部侧面;如果又受到风寒的侵袭遏制,导致肿块既不消散也不化脓溃破,这种病症就称为恶核。
《太平圣惠方》治疗小儿因风热引起的颈部侧面出现恶核,伴有寒热交替、肿胀疼痛的症状。五香散方剂组成如下:
木香、麝香(细研)、薰陆香、鸡舌香、麻黄(去除根和节)、海藻(清洗以去除咸味)、射干(以上各取一分);沉香、黄芩、连翘、枳实(用麸皮炒至微黄)、川升麻(以上各取半两);川大黄(一两,锉碎后微炒)。
将上述药物捣碎,过筛制成散剂。每次服用一钱,用水一小盏煎煮至剩余五分水量,滤去药渣,加入竹沥半合,再煮沸一两分钟,根据患儿年龄大小调整剂量,温服。
《太平圣惠方》治疗小儿因风热导致项部及腋下出现不消退的恶核,大便多秘结,心神烦躁发热。丹参散方剂组成如下:
丹参、川升麻、防风(去除芦头)、牛蒡子(微炒)、甘草(炙至微赤并锉碎)、川大黄(锉碎后微炒)、黄芪(锉碎)、连翘(以上各取半两);露蜂房(一分,微炙)、枳壳(三分,用麸皮炒至微黄并去除瓤)。
将上述药物捣碎,粗筛制成散剂。每次服用一钱,用水一小盏煎煮至剩余五分水量,滤去药渣放温。根据患儿年龄大小增减剂量服用。
《太平圣惠方》治疗小儿颈部出现恶核,高热持续不退。升麻散方剂组成如下:
川升麻、射干、连翘、犀角(锉成屑)、川大黄(锉碎后微炒)、川朴硝(以上各取半两)。
将上述药物捣碎,粗筛制成散剂。每次服用一钱,用水一小盏煎煮至剩余五分水量,滤去药渣放温,根据患儿年龄大小调整剂量服用。
《太平圣惠方》治疗小儿突然出现的寒热症状,颈部侧面出现恶核,肩背部拘急僵硬。连翘散方剂组成如下:
连翘(三分)、海藻(清洗以去除咸味)、榆白皮(锉碎)、牡丹皮、桂心、白头翁、防风(去除芦头)、黄柏(锉碎)、香豉、独活、秦艽(去除苗叶,以上各取半两)。
将上述药物捣碎,过筛制成粉末,用炼蜜调和制成如麻子大小的丸剂。每次用温水送服五丸,每日三次。根据患儿年龄大小增减剂量。
《太平圣惠方》治疗小儿胸间积聚的热毒风气不散,连累颈部出现恶核,烦热不止。元参丸方剂组成如下:
元参、汉防己、羌活、木香、栀子仁、赤芍药、牛蒡子(微炒)、川升麻(以上各取半两);连翘(三分);川大黄(一两,锉碎后微炒)。
将上述药物捣碎,过筛制成粉末,用炼蜜调和制成如绿豆大小的丸剂。每次用米汤送服五丸,每日三次。根据患儿年龄大小增减剂量。
《太平圣惠方》治疗小儿因热毒风肿产生恶核,使其内部消散。赤小豆散方剂组成如下:
赤小豆、猪牙皂荚、硝石、黄药、木鳖子(以上各取半两);川大黄(一两,锉碎后微炒)。
将上述药物捣碎,细筛制成散剂。用鸡蛋清调匀涂抹患处,每日使用三到四次。
《刘氏家传》连翘煎方,治疗小儿没有寒热症状,身体强健如常,但体表有结核瘰疬,或者心胁腹背内部有坚硬不通的核块,这种病症名为结风气肿。方剂组成如下:
连翘、白芨、白头翁、牡丹皮、防风(去除芦头)、黄柏、羌活(去除芦头)、秦艽(去除泥土)、豉(炒制,以上各称四分);海藻(洗净焙干)、桂(去皮,以上各称二分)。
用炼蜜调和制成如绿豆大小的丸剂。三岁儿童用米汤送服五粒至十粒,五岁以上儿童酌情增加用量,用熟水送服。
According to *Chao Shi Bing Yuan* (Source of Diseases by Chao Yuanfang) regarding the condition of "Ehe" (Malignant Nodules) in children: The so-called "Ehe" refers to a nodule formed when wind-heat toxic pathogens contend and knot with the body's blood and qi. It arises on the side of the neck. If further constrained by wind-cold, causing the nodule neither to dissipate nor suppurate, it is named "Ehe".
*Tai Ping Sheng Hui Fang* (Imperial Grace Formulary of the Taiping Era) treats pediatric cases of wind-heat causing malignant nodules on the side of the neck, accompanied by alternating chills and fever, swelling, and pain. Formula: Wuxiang San (Five-Aromatic Powder).
Ingredients: Mugwort Wood (Mu Xiang), Musk (Shexiang, finely ground), Frankincense (Xunlu Xiang), Clove (Jishe Xiang), Ephedrae Herba (Mahuang, roots and nodes removed), Sargassum Thallus (Haizao, washed to remove saltiness), Belamcanda Rhizome (Shegan) [each 1 fen]; Agarwood (Chenxiang), Scutellaria Root (Huangqin), Forsythia Fruit (Lianqiao), Aurantium Fructus (Zhishi, bran-fried until slightly yellow), Cimicifugae Rhizoma (Chuan Shengma) [each 0.5 liang]; Rheum Radix et Rhizoma (Chuan Dahuang, 1 liang, sliced and lightly fried).
Procedure: Pound the above ingredients and sieve into a powder. Take 1 qian per dose, decoct with one small cup of water until reduced to half a cup, strain the dregs, add half he of Bamboo Sap (Zhuli), boil for one or two more boils, and administer warm in divided doses according to the child's age.
*Tai Ping Sheng Hui Fang* treats pediatric cases where wind-heat causes persistent malignant nodules in the neck and axilla, frequent constipation, and mental restlessness with heat. Formula: Danshen San (Salvia Miltiorrhiza Powder).
Ingredients: Salvia Miltiorrhiza Root (Danshen), Cimicifugae Rhizoma (Chuan Shengma), Saposhnikovia Root (Fangfeng, radix removed), Arctii Fructus (Niubangzi, lightly fried), Glycyrrhizae Radix et Rhizoma (Gancao, honey-fried until slightly red and sliced), Rheum Radix et Rhizoma (Chuan Dahuang, sliced and lightly fried), Astragali Radix (Huangqi, sliced), Forsythia Fruit (Lianqiao) [each 0.5 liang]; Vespa Nidus (Lufengfang, 1 fen, lightly roasted), Aurantium Fructus (Zhiqiao, 3 fen, bran-fried until slightly yellow and pith removed).
Procedure: Pound the above ingredients and coarsely sieve into a powder. Take 1 qian per dose, decoct with one small cup of water until reduced to half a cup, strain and let cool to warm. Adjust dosage according to the child's age.
*Tai Ping Sheng Hui Fang* treats pediatric cases of malignant nodules on the neck with persistent high fever. Formula: Shengma San (Cimicifuga Powder).
Ingredients: Cimicifugae Rhizoma (Chuan Shengma), Belamcanda Rhizome (Shegan), Forsythia Fruit (Lianqiao), Rhinoceros Horn (Xijiao, sliced into chips), Rheum Radix et Rhizoma (Chuan Dahuang, sliced and lightly fried), Natrii Sulfas (Chuan Puxiao) [each 0.5 liang].
Procedure: Pound and coarsely sieve into a powder. Take 1 qian per dose, decoct with one small cup of water until reduced to half a cup, strain and let cool to warm. Administer in divided doses according to the child's age.
*Tai Ping Sheng Hui Fang* treats sudden onset of chills and fever in children, malignant nodules on the neck, and stiffness/tension in the shoulders and back. Formula: Lianqiao San (Forsythia Powder).
Ingredients: Forsythia Fruit (Lianqiao, 3 fen), Sargassum Thallus (Haizao, washed to remove saltiness), Ulmus Alba Cortex (Yu Baipi, sliced), Moutan Cortex (Mudanpi), Cinnamomi Ramulus (Guixin), Pulsatillae Radix (Baitouweng), Saposhnikovia Root (Fangfeng, radix removed), Phellodendri Cortex (Huangbai, sliced), Fermented Soybean (Xiangchi), Angelicae Pubescentis Radix (Duhuo), Gentianae Macrophyllae Radix (Qinjiao, radix removed) [each 0.5 liang].
Procedure: Pound, sieve into powder, and mix with refined honey to form pills the size of hemp seeds. Take five pills with warm water, three times daily. Adjust dosage according to the child's age.
*Tai Ping Sheng Hui Fang* treats accumulation of heat-toxic wind qi in the chest that fails to dissipate, leading to malignant nodules extending to the neck and incessant irritability and heat. Formula: Yuanshen Wan (Scrophularia Pill).
Ingredients: Scrophulariae Radix (Yuanshen), Stephaniae Tetrandrae Radix (Han Fangji), Notopterygii Rhizoma et Radix (Qianghuo), Mugwort Wood (Mu Xiang), Gardeniae Fructus (Zhizi Ren), Paeoniae Radix Rubra (Chishaoyao), Arctii Fructus (Niubangzi, lightly fried), Cimicifugae Rhizoma (Chuan Shengma) [each 0.5 liang]; Forsythia Fruit (Lianqiao, 3 fen); Rheum Radix et Rhizoma (Chuan Dahuang, 1 liang, sliced and lightly fried).
Procedure: Pound, sieve into powder, and mix with refined honey to form pills the size of mung beans. Take five pills with rice drink, three times daily. Adjust dosage according to the child's age.
*Tai Ping Sheng Hui Fang* treats malignant nodules arising from heat-toxic wind swelling in children, aiming for internal resolution. Formula: Chixiaodou San (Adzuki Bean Powder).
Ingredients: Adzuki Bean (Chixiaodou), Gleditsia Sinensis Spine (Zhuyazaojia), Natrii Nitras (Xiaoshi), Polygoni Multiflori Caulis (Huangyao), Momordica Cochinchinensis Seed (Mubiezi) [each 0.5 liang]; Rheum Radix et Rhizoma (Chuan Dahuang, 1 liang, sliced and lightly fried).
Procedure: Pound and finely sieve into a powder. Mix with egg white and apply topically. Use three to four times daily.
*Liu Shi Jia Chuan* (Liu Family Transmission) Lianqiao Jian (Forsythia Decoction) treats children who have no chills or fever and are physically strong as usual, but present with subcutaneous tubercles/lymphadenopathy (Luoli) or hard, obstructive nodules internally within the heart, hypochondrium, abdomen, and back. This condition is named "Jie Feng Qi Zhong" (Knotting Wind-Qi Swelling).
Ingredients: Forsythia Fruit (Lianqiao), Bletillae Rhizoma (Baiji), Pulsatillae Radix (Baitouweng), Moutan Cortex (Mudanpi), Saposhnikovia Root (Fangfeng, radix removed), Phellodendri Cortex (Huangbai), Notopterygii Rhizoma et Radix (Qianghuo, radix removed), Gentianae Macrophyllae Radix (Qinjiao, soil removed), Fermented Soybean (Chi, stir-fried) [each 4 fen]; Sargassum Thallus (Haizao, washed and dried over fire), Cinnamomi Ramulus (Gui, bark removed) [each 2 fen].
Procedure: Mix with refined honey to form pills the size of mung beans. For three-year-olds, take five to ten pills with rice drink; for those over five years old, increase dosage as appropriate, taken with boiled water.