《巢氏病源》∶小儿温病者,是冬时严寒,人有触冒之。寒气入肌肉,当时不即发,至春得暖气而发,则头
痛壮热,谓之温病。又冬时应寒而反暖,其气伤人即发,亦使人头痛壮热,谓之冬温病。凡邪之伤人,皆由触
冒,所以感之。小儿虽不能触冒,其乳母抱持解脱,不避风邪、冷热之气,所以感病也。
《巢氏病源》小儿温病下利候∶温病下利者,是肠胃宿虚,而感于温热之病,热气入于肠胃,与水谷相搏,
肠虚则泄,故下利也。
《巢氏病源》小儿温病鼻衄候∶温病鼻衄者,热乘于气而入血也。肺候身之皮毛,主于气,开窍于鼻。温病
则邪先客皮肤而搏于气,结聚成热,热乘于血,血得热则流散。发从鼻出者,为衄也。凡候热病,鼻欲衄,其
数发汗,汗不出。或初染病已来都不汗,而鼻燥喘,鼻息气有声。如此者,必衄也。小儿衄血,至一升数合,
热因得歇;若至一斗数升,则死矣。
《巢氏病源》小儿温病结胸候∶凡温热之病,四五日之后,热入里,内热腹满者,宜下之。若热未入里,而
下之早者,里虚气逆,热结胸上,则胸痞满短气,谓之结胸也。
仲景论冬伤于寒,春为温病。
太医局柴胡石膏散 治时行温疫,壮热恶风,头痛体疼,鼻塞咽干,心胸烦满,寒热往来,痰实咳嗽,涕唾稠
粘方。
柴胡(去苗) 石膏 前胡(去苗) 干葛(锉) 赤芍药(各五十两) 黄芩 桑根白皮(锉) 荆芥穗(去土。
各三十七两半) 升麻(二十五两)
上为粗末。每服二钱,水一盏,入生姜三片,豉十余粒,同煎七分,去滓。稍热服,小儿分作三服。更
量大小加减,不计时候。
太医局人参羌活散 治小儿寒邪温病,时疫疮疹,头痛体疼,壮热多睡,及治潮热烦渴,痰实咳嗽方。
人参 羌活 独活 柴胡(并去苗) 芎 枳壳(去瓤,麸炒黄) 白茯苓(去皮) 甘草(炙。各一两) 前
胡(去芦头) 桔梗 地骨皮(去土) 天麻(酒浸,炙。各半两)
上为散。每服一钱,以水七分,入薄荷少许,煎至五分,去滓温服。不计时候。
太医局升麻葛根汤 治大人、小儿时气温疫方,与伤寒钱乙方同。
《三十六种》夜热昼凉温病候,用除温散方。
大黄 朴硝(研。各一分) 牵牛粉(半两) 槟榔(二个)
上件为末。每服半钱,煎黄芩汤调下,临卧时服。
《庄氏家传》∶春间疫气欲作,为先气壅畏风,痰嗽头昏,鼻寒困闷,是其疾也。当先以甘桂汤理之,凡春气动,
先以此汤驱之,无问大人、小儿也。此方赵彦祖朝散传之杜顺甫中散,余与杜季子、季杨同官尉氏,因求得
之。本名五胡,余恶而易名为甘桂汤。
甘草(炙) 官桂(去皮) 五味子 黄芩(各一两半) 柴胡(四两)
上 咀。每服三钱,水一盏,姜五片,煎七分,去滓温服。以二服滓再合煎一服。政和二年壬辰,余在澧
阳,是春疫疾大作,诸小儿服此药皆免。
《王氏手集》防风散 解时疫温病,咳喘烦渴,头痛体疼,目涩多睡,肌肉蠕动,痰逆忪悸。
防风 川芎 甘草(炙) 香白芷(各二两) 菊花(一两)
上为细末。每服一钱,煎荆芥汤调,放温服。
《巢氏病源》:小儿温病,是因为冬季严寒时,人体触犯了寒邪。寒气侵入肌肉,当时并未立即发病,到了春季遇到暖气温煦时才发作,出现头痛、高热等症状,这称为温病。另外,如果冬季本该寒冷却反而温暖,这种反常之气伤人即发,同样使人头痛、高热,这称为冬温病。凡是邪气伤人,都是因为触犯冒犯所致,所以才会感邪。小儿虽然不能主动去触犯外邪,但如果乳母在抱持或照顾孩子时疏忽大意,不避开风邪以及冷热之气,也会导致孩子感邪生病。
《巢氏病源》小儿温病下利候:温病引起的下利(腹泻),是因为肠胃素来虚弱,又感染了温热病邪,热气进入肠胃,与水谷相互搏结,肠道虚损则导致泄泻,所以出现下利症状。
《巢氏病源》小儿温病鼻衄候:温病引起的鼻出血,是热邪乘袭气分进而深入血分所致。肺主司身体的皮毛,主管气机,开窍于鼻。温病发生时,邪气先客居于皮肤并搏结于气分,郁结化热,热邪再乘入血分,血液受热则流动散乱。从鼻子流出血液的,就称为鼻衄。凡是诊察热病,若发现鼻孔干燥欲作衄血之兆,且多次发汗后汗仍不出;或者初染病以来从未出汗,且鼻燥、气喘、呼吸有声。像这种情况,必然会发生鼻衄。小儿鼻衄出血量达到一升数合,热势便可得以消退;若出血量达到一斗数升,则会导致死亡。
《巢氏病源》小儿温病结胸候:凡是温热病,经过四五天后,热邪传入体内,出现内热、腹部胀满的症状,应当采用攻下法治疗。如果热邪尚未传入体内,而过早使用攻下法,会导致里气虚弱、气机上逆,热邪结聚于胸膈之上,从而出现胸脘痞闷、胀满、短气等症状,这称为结胸。
太医局柴胡石膏散:治疗时行温疫,症见高热、恶风、头痛、身体疼痛、鼻塞、咽干、心胸烦闷胀满、寒热往来、痰实咳嗽、鼻涕唾沫稠粘的方剂。
药材:柴胡(去苗)、石膏、前胡(去苗)、干葛(锉碎)、赤芍药(各五十两)、黄芩、桑根白皮(锉碎)、荆芥穗(去土,各三十七两半)、升麻(二十五两)。
制法与用法:以上药物捣成粗末。每次服用二钱,用水一盏,加入生姜三片、豆豉十余粒,共同煎煮至七分,滤去药渣。稍热时服用,小儿分三次服用。更应根据患儿大小酌情加减剂量,不拘泥于服药时间。
太医局人参羌活散:治疗小儿寒邪温病、时行疮疹,症见头痛、身体疼痛、高热、嗜睡,以及治疗潮热、烦渴、痰实咳嗽的方剂。
药材:人参、羌活、独活、柴胡(均去苗)、川芎、枳壳(去瓤,麸炒至黄)、白茯苓(去皮)、甘草(炙,各一两)、前胡(去芦头)、桔梗、地骨皮(去土)、天麻(酒浸,炙,各半两)。
制法与用法:以上药物研为散剂。每次服用一钱,用水七分,加入少许薄荷,煎煮至五分,滤去药渣温服。不拘泥于服药时间。
太医局升麻葛根汤:治疗大人、小儿时气温疫的方剂,与伤寒钱乙方的用法相同。
《三十六种》夜热昼凉温病候:使用除温散方。
药材:大黄、朴硝(研细,各一分)、牵牛粉(半两)、槟榔(二个)。
制法与用法:以上药物研为末。每次服用半钱,用黄芩汤煎汁调服,临睡前服用。
《庄氏家传》:春季疫病将要流行时,会出现气机壅滞、畏风、痰嗽、头晕、鼻寒困闷等症状,这就是该疾病的表现。应当先用甘桂汤调理。凡是春季气候变动,都应用此汤驱除邪气,无论大人还是小儿均可使用。此方由赵彦祖朝散传给杜顺甫中散,我与杜季子、季杨同在尉氏县任职时,因此求得此方。原名“五胡”,我因厌恶其名称而改名为“甘桂汤”。
药材:甘草(炙)、官桂(去皮)、五味子、黄芩(各一两半)、柴胡(四两)。
制法与用法:以上药物切碎。每次服用三钱,用水一盏,加生姜五片,煎煮至七分,滤去药渣温服。将前两服的药渣合并再煎一次作为一服。政和二年壬辰年,我在澧阳,那年春季瘟疫大作,所有服用此药的小儿都得以避免感染。
《王氏手集》防风散:解时令疫病温病,症见咳喘、烦渴、头痛、身体疼痛、眼睛干涩、多睡、肌肉跳动、痰逆、心悸。
药材:防风、川芎、甘草(炙)、香白芷(各二两)、菊花(一两)。
制法与用法:以上药物研为细末。每次服用一钱,用荆芥汤煎汁调服,放温后服用。
Nest's Pathogenesis of Diseases (Chao Shi Bing Yuan): Pediatric warm diseases occur when, during the severe cold of winter, individuals are exposed to cold pathogens. The cold qi enters the muscles but does not manifest immediately; it emerges in spring when warmed by the seasonal heat, presenting with headache and high fever, termed "warm disease" (Wen Bing). Furthermore, if winter should be cold but instead becomes warm, this abnormal qi injures the body and causes immediate onset, also resulting in headache and high fever, termed "winter-warm disease" (Dong Wen Bing). Generally, pathogenic factors injure the body through exposure and contact, which is how infection occurs. Although children cannot actively expose themselves to pathogens, if the wet nurse is negligent in holding or caring for the child and fails to avoid wind pathogens and extreme hot or cold air, the child will become infected.
Nest's Pathogenesis of Diseases: Prognosis of Diarrhea in Pediatric Warm Disease: Diarrhea caused by warm disease arises from pre-existing deficiency in the intestines and stomach, combined with infection by warm-heat pathogens. Heat qi enters the intestines and stomach, clashing with food and fluids. Due to intestinal deficiency, diarrhea ensues.
Nest's Pathogenesis of Diseases: Prognosis of Epistaxis in Pediatric Warm Disease: Epistaxis in warm disease occurs when heat penetrates the qi level and enters the blood level. The Lung governs the skin and hair, controls Qi, and opens into the nose. In warm disease, pathogenic factors first lodge in the skin and clash with Qi, condensing into heat. This heat then invades the blood; blood heated becomes fluid and scatters. When blood flows out from the nose, it is called epistaxis. In observing febrile diseases, if the nose appears dry and prone to bleeding, and repeated sweating fails to produce sweat, or if no sweat has occurred since the initial infection accompanied by dry nose, panting, and noisy respiration, epistaxis is inevitable. If a child bleeds one sheng plus several he, the heat may subside; however, if bleeding reaches one dou plus several sheng, death will result.
Nest's Pathogenesis of Diseases: Prognosis of Chest Binding in Pediatric Warm Disease: For warm-heat diseases, after four or five days, if heat enters the interior causing internal heat and abdominal fullness, purgation should be employed. However, if purgation is used prematurely before heat has entered the interior, it causes interior deficiency and rebellious Qi, leading heat to bind above the chest, resulting in chest oppression, fullness, and shortness of breath, termed "chest binding" (Jie Xiong).
Zhang Zhongjing discussed that injury by cold in winter leads to warm disease in spring.
Imperial Medical Bureau Chaihu Shigao San (Bupleurum and Gypsum Powder): Treats epidemic warm diseases characterized by high fever, aversion to wind, headache, body pain, nasal congestion, dry throat, chest and heart irritability and fullness, alternating chills and fever, phlegm-stasis cough, and thick sticky sputum.
Ingredients: Chai Hu (Bupleuri Radix), Shi Gao (Gypsum Fibrosum), Qian Hu (Peucedani Radix), Gan Ge (Puerariae Lobatae Radix), Chi Shao Yao (Paeoniae Radix Rubra) [each 50 liang], Huang Qin (Scutellariae Radix), Sang Gen Bai Pi (Mori Cortex), Jing Jie Sui (Schizonepetae Spica) [each 37.5 liang], Sheng Ma (Cimicifugae Rhizoma) [25 liang].
Preparation and Administration: Grind into coarse powder. Take 2 qian per dose, add one cup of water, three slices of fresh ginger, and more than ten grains of Dou Chi (Fermented Soybean), decoct until reduced to 0.7 parts, strain, and drink while slightly warm. For children, divide into three doses. Adjust dosage according to age and size; time of administration is unrestricted.
Imperial Medical Bureau Renshen Qianghuo San (Ginseng and Notopterygium Powder): Treats pediatric cold-pathogen warm disease, epidemic sores and rashes, headache, body pain, high fever, and lethargy; also treats tidal fever, irritability, thirst, and phlegm-stasis cough.
Ingredients: Ren Shen (Ginseng Radix et Rhizoma), Qiang Huo (Notopterygii Rhizoma et Radix), Du Huo (Angelicae Pubescentis Radix), Chai Hu (Bupleuri Radix), Xiong Qiong (Ligustici Chuanxiong Rhizoma), Zhi Ke (Aurantii Fructus), Bai Fu Ling (Poria), Gan Cao (Glycyrrhizae Radix et Rhizoma) [each 1 liang], Qian Hu (Peucedani Radix), Jie Geng (Platycodonis Radix), Di Gu Pi (Lycii Cortex), Tian Ma (Gastrodiae Rhizoma) [each 0.5 liang].
Preparation and Administration: Grind into powder. Take 1 qian per dose, add 0.7 cups of water and a little Bo He (Menthae Haplocalycis Herba), decoct until reduced to 0.5 parts, strain, and take warm. Time of administration is unrestricted.
Imperial Medical Bureau Shengma Gegen Tang (Cimicifuga and Pueraria Decoction): Treats epidemic warm diseases in adults and children; same as Qian Yi's formula for Cold Damage.
The Thirty-Six Types: Prognosis of Night-Fever Day-Cool Warm Disease: Use Chuwen San (Remove-Warm Powder).
Ingredients: Da Huang (Rhei Radix et Rhizoma), Po Xiao (Natrii Sulfas) [each 1 fen], Qian Niu Fen (Pharbitidis Semen Pulvis), Bing Lang (Arecae Semen) [2 pieces].
Preparation and Administration: Grind into powder. Take 0.5 qian per dose, mix with Huang Qin Tang (Scutellaria Decoction) and take at bedtime.
Zhuang Family Tradition: In spring, when epidemic qi is about to arise, symptoms include Qi stagnation, aversion to wind, phlegm-cough, dizziness, nasal coldness, and chest stuffiness. This is the manifestation of the disease. One should first treat with Gan Gui Tang (Licorice and Cinnamon Decoction). Whenever spring Qi moves, use this decoction to dispel pathogens, regardless of adult or child. This formula was passed down from Zhao Yanzu to Du Shunfu. I obtained it while serving together with Du Jizi and Ji Yang in Weishi County. Originally named "Wu Hu," I disliked the name and changed it to "Gan Gui Tang."
Ingredients: Gan Cao (Glycyrrhizae Radix et Rhizoma), Guan Gui (Cinnamomi Cortex), Wu Wei Zi (Schisandrae Chinensis Fructus), Huang Qin (Scutellariae Radix) [each 1.5 liang], Chai Hu (Bupleuri Radix) [4 liang].
Preparation and Administration: Cut into small pieces. Take 3 qian per dose, add one cup of water and five slices of ginger, decoct until reduced to 0.7 parts, strain, and take warm. Combine the residues of two doses to decoct once more as one dose. In the year Renchen of Zhenghe Era (1112 AD), I was in Liyang. Epidemic disease was rampant that spring; all children who took this medicine were spared.
Wang's Hand Collection: Fangfeng San (Saposhnikovia Powder): Resolves epidemic warm diseases, cough and asthma, irritability and thirst, headache, body pain, dry eyes, lethargy, muscle twitching, rebellious phlegm, and palpitations.
Ingredients: Fang Feng (Saposhnikoviae Radix), Chuan Xiong (Ligustici Chuanxiong Rhizoma), Gan Cao (Glycyrrhizae Radix et Rhizoma), Xiang Bai Zhi (Angelicae Dahuricae Radix) [each 2 liang], Ju Hua (Chrysanthemi Flos) [1 liang].
Preparation and Administration: Grind into fine powder. Take 1 qian per dose, mix with Jing Jie Tang (Schizonepeta Decoction), let cool to warm temperature, and take.