钱乙论温冷用药云∶东都张氏孙九岁,病肺热。他医以犀、珠、龙、麝、生牛黄治之,一月不愈。其证嗽
喘闷乱,饮水不止,全不能食。钱氏用使君子丸、益黄散。张曰∶本有热,何以又行温药?他医用凉药攻之,
一月尚无效。钱曰∶凉药久则寒,不能食。小儿虚不能食,当补脾。候饮食如故,即泻肺经,病必愈矣。服补
脾药二日,其子欲饮食,钱以泻白散泻肺,遂愈十分。张曰∶何以不虚?钱曰∶先实其脾,然后泻肺,故不虚也。
《谭氏殊圣》方∶小儿频嗽又饶啼,喘息时时似火堆。此是乳食冲膈热,莫冤神灶恐延迟。沙糖元剑涂酥炙,杵
合根据方请不疑。更取麦门知母等、三焦洗了是良医。
知母散
知母 麦门冬 甘草(各一分,生) 皂角(半分,去皮,酥炙,用盆子合出火毒)
上为末。每服二钱,水一盏,同煎至八分,分五服,放冷下。
《婴童宝鉴》治小儿咳嗽,解风热。一捻金方
白僵蚕(直者,一两) 甘草(半两,炙) 延胡索(一分)
上件为散。每服一捻,齑汁调下。
《良方》治小儿热嗽。
马牙硝 白矾(各八两) 黄丹(一分)
上同研,入合子固济,火烧令红;覆润地一夜,再研,加龙脑半钱。甘草汤下一字,或半钱。
《张氏家传》治孩儿虚热,生涎、咳嗽。人参散方
人参 贝母(去心,炒) 款冬花(去皮) 半夏(水煮透,干为末,用姜汁作饼子,焙干) 甘
草(炙黄。各一钱)
上件为细末。每服半钱,水四分,入杏仁二粒,去皮尖,同煎至二分,温服。
《庄氏家传》治小儿脾肺壅热、咳嗽,金华散。并气粗喘。
贝母(七分) 汉防己 甘草(炙。各半分) 马牙硝(半两)
上件为细末。每服半钱,水四分或一钱,煎。温服,一日三服。如壅甚,时时与服无妨。
《吉氏家传》治小儿上焦壅热及心肺虚热,嗽不止。清肺丸
好连翘(一两) 脑子(少许,研)
上末,炼蜜丸弹子大。食后临卧含化。忌猪肉、湿面。
长沙医者丁时发传半夏散 治小儿肺热咳嗽,止泻润肺。
半夏(一两,姜汁) 贝母(三分) 柴胡(去芦) 杏仁(炒,研) 川升麻 桑白
皮(炙) 地骨皮 款冬花 麦门冬(去心) 马兜苓 青橘皮(各半两) 甘草(一分,炙)
上为末。每服一钱,薄荷一叶,绵一片裹药末,用水一盏,生姜一片,枣半枚,煎五分。用盏盛,放火上,
时时温服。忌生冷、毒物。
钱乙论述温热与寒凉药物的使用原则时说:东都洛阳张氏的孙子九岁,患有肺热病。其他医生用犀角、珍珠、龙骨、麝香、生牛黄等寒凉药物治疗,一个月病情未愈。患儿的症状表现为咳嗽、气喘、胸闷烦躁,不断饮水,完全无法进食。钱乙使用了使君子丸和益黄散。张先生问道:“孩子本来就有热证,为什么又要用温性药物?”其他医生用凉药攻伐,一个月仍然没有效果。钱乙说:“凉药久服会导致体内寒盛,从而不能进食。小儿体质虚弱且不能进食,应当补益脾胃。等到饮食恢复正常后,再清泻肺经的热邪,病必定痊愈。”服用补脾药物两天后,患儿想要进食,钱乙随即使用泻白散清泻肺热,于是病情痊愈了十分之八。张先生问:“为什么不会导致正气虚损?”钱乙说:“先充实其脾胃,然后再清泻肺热,所以不会造成虚损。”
《谭氏殊圣》中的方剂:小儿频繁咳嗽且多啼哭,喘息时时像火堆一样炽热。这是因为乳食冲撞膈部产生热邪,不要怪罪神灶(指迷信因素),恐怕会延误治疗。沙糖元剑涂酥炙烤,捣碎混合根据原方制作不要怀疑。再取麦门冬、知母等药材,清洗三焦部位是良医的做法。(注:此处原文诗句较为晦涩,部分字词如“元剑”、“神灶”可能存在传抄错误或特定隐喻,译文尽量贴合字面及语境)
知母散
组成:知母、麦门冬、甘草(各一分,生用)、皂角(半分,去皮,用酥油炙烤,用盆子覆盖以去除火毒)。
制法与用法:将上述药材研为细末。每次服用二钱,加水一盏,同煎至八分,分五次服用,放冷后服用。
《婴童宝鉴》记载的治疗小儿咳嗽、解除风热的方剂:一捻金方
组成:白僵蚕(直条者,一两)、甘草(半两,炙烤)、延胡索(一分)。
制法与用法:将上述药材制成散剂。每次服用一捻的量,用醋汁调服。
《良方》记载的治疗小儿热嗽方剂。
组成:马牙硝、白矾(各八两)、黄丹(一分)。
制法与用法:将上述药材共同研磨,放入盒子中密封加固,火烧至红色;倒扣在湿润的地面上过夜,再次研磨,加入龙脑半钱。用甘草汤送服一字量或半钱量。
《张氏家传》记载的治疗孩儿虚热、生涎、咳嗽的人参散方。
组成:人参、贝母(去心,炒制)、款冬花(去皮)、半夏(水煮透,干燥后研为细末,用姜汁做成饼状,焙干)、甘草(炙至黄色,各一钱)。
制法与用法:将上述药材制成细末。每次服用半钱,加水四分,放入杏仁两粒,去皮尖,同煎至二分,温服。
《庄氏家传》记载的治疗小儿脾肺壅热、咳嗽,以及气粗喘息的金华散。
组成:贝母(七分)、汉防己、甘草(炙,各半分)、马牙硝(半两)。
制法与用法:将上述药材制成细末。每次服用半钱,加水四分或一钱,煎煮。温服,一日三次。如果壅滞严重,随时服用也无妨。
《吉氏家传》记载的治疗小儿上焦壅热及心肺虚热,咳嗽不止的清肺丸。
组成:好连翘(一两)、脑子(少许,研磨)。
制法与用法:将上述药材研为细末,用炼蜜制成如弹子大小的丸剂。饭后临睡前含化服用。忌食猪肉、湿面。
长沙医者丁时发传授的半夏散,治疗小儿肺热咳嗽,止泻润肺。
组成:半夏(一两,用姜汁处理)、贝母(三分)、柴胡(去芦头)、杏仁(炒制,研磨)、川升麻、桑白皮(炙烤)、地骨皮、款冬花、麦门冬(去心)、马兜铃、青橘皮(各半两)、甘草(一分,炙烤)。
制法与用法:将上述药材研为细末。每次服用一钱,用薄荷一叶,绵片包裹药末,加水一盏,生姜一片,枣半枚,煎至五分。用盏盛装,放在火上,时时温服。忌食生冷、毒物。
Qian Yi discussed the principles of using warm and cold medicines, stating: The grandson of Mr. Zhang in Dongdu (Luoyang), aged nine, suffered from lung heat. Other physicians treated him with rhinoceros horn, pearl, dragon bone, musk, and raw buffalo gallstone for a month without improvement. His symptoms included coughing, wheezing, chest tightness, restlessness, incessant thirst, and complete inability to eat. Qian Yi prescribed Shijunzi Wan (Quisqualis Pill) and Yihuang San (Yellow-Protecting Powder). Mr. Zhang asked, "The child originally had heat; why use warm medicines?" Other physicians used cold medicines to attack the pathogen, but there was no effect after a month. Qian Yi said, "Prolonged use of cold medicines leads to internal cold, resulting in an inability to eat. Since the child is deficient and cannot eat, one should tonify the spleen. Once normal eating habits are restored, then clear the heat from the Lung meridian, and the illness will surely be cured." After two days of taking spleen-tonifying medicine, the child desired food. Qian Yi then used Xiebai San (White-Draining Powder) to drain lung heat, resulting in an eighty percent recovery. Mr. Zhang asked, "Why does this not cause deficiency?" Qian Yi replied, "By first solidifying the spleen and then draining the lungs, deficiency is avoided."
From *Tan Shi Shu Sheng*: When children cough frequently and cry often, their panting resembles a blazing fire heap at times. This is due to heat generated by milk and food obstructing the diaphragm; do not blame the divine stove, lest treatment be delayed. Use sugar-coated sword-shaped confections baked with butter, pounded and mixed according to the prescription without doubt. Additionally, take Ophiopogon Radix (Maidong) and Anemarrhena Rhizome (Zhimu); cleansing the Triple Burner makes one a good physician.
Zhimu San (Anemarrhena Powder)
Ingredients: Anemarrhena Rhizome (Zhimu), Ophiopogon Radix (Maidong), Licorice Root (Gancao) (each 1 fen, raw); Gleditsia Sinensis Fruit (Zaojiao) (0.5 fen, peeled, baked with butter, covered in a basin to remove fire toxicity).
Preparation and Administration: Grind the above ingredients into powder. Take 2 qian per dose, add 1 zhan of water, decoct together until 0.8 zhan remains. Divide into five doses. Allow to cool before administration.
*Yingtong Baojian* records the formula Yinianjin (One-Pinch Gold) for treating pediatric cough and resolving wind-heat.
Ingredients: White Silkworm (Baijiangcan) (straight ones, 1 liang), Licorice Root (Gancao) (0.5 liang, honey-fried), Corydalis Tuber (Yanhusuo) (1 fen).
Preparation and Administration: Grind the above ingredients into a powder. Take a pinch (yinnian) per dose, mixed with vinegar juice for administration.
*Liang Fang* records a formula for treating pediatric heat cough.
Ingredients: Natrii Sulfas Crystallisatus (Mayaxiao), Alum (Baifan) (each 8 liang), Minium (Huandan) (1 fen).
Preparation and Administration: Grind the above ingredients together, place in a container, seal tightly, and heat in fire until red. Invert over moist ground overnight. Grind again, adding Borax (Longnao) 0.5 qian. Administer 1 zi or 0.5 qian dosage with Licorice Decoction.
*Zhang Shi Jia Chuan* records Renshen San (Ginseng Powder) for treating childhood deficiency-heat, salivation, and cough.
Ingredients: Ginseng Root (Renshen), Fritillaria Bulb (Beimu) (core removed, stir-fried), Winter Flower Bud (Kuandonghua) (peeled), Pinellia Tuber (Banxia) (boiled thoroughly in water, dried, ground to powder, made into cakes with ginger juice, baked dry), Licorice Root (Gancao) (honey-fried to yellow, each 1 qian).
Preparation and Administration: Grind the above ingredients into fine powder. Take 0.5 qian per dose, add 0.4 zhan of water, include 2 apricot kernels (Xingren) (peeled and cored), decoct together until 0.2 zhan remains. Take warm.
*Zhuang Shi Jia Chuan* records Jinhua San (Golden Flower Powder) for treating pediatric spleen-lung qi stagnation and heat, cough, and coarse breathing with asthma.
Ingredients: Fritillaria Bulb (Beimu) (7 fen), Stephania Tetrandra (Hanfangji), Licorice Root (Gancao) (honey-fried, each 0.5 fen), Natrii Sulfas Crystallisatus (Mayaxiao) (0.5 liang).
Preparation and Administration: Grind the above ingredients into fine powder. Take 0.5 qian per dose, add 0.4 zhan or 1 qian of water, decoct. Take warm, three times daily. If stagnation is severe, frequent administration is permissible.
*Ji Shi Jia Chuan* records Qingfei Wan (Lung-Clearing Pill) for treating upper jiao stagnation-heat and heart-lung deficiency-heat in children, causing incessant cough.
Ingredients: Forsythia Fruit (Lianqiao) (good quality, 1 liang), Borneol (Naobao) (a small amount, ground).
Preparation and Administration: Grind into powder, mix with refined honey to make pills the size of bullet seeds. Let dissolve in the mouth after meals and before sleep. Avoid pork and damp wheat products.
Ding Shifa, a physician from Changsha, passed down Banxia San (Pinellia Powder) for treating pediatric lung-heat cough, stopping diarrhea, and moistening the lungs.
Ingredients: Pinellia Tuber (Banxia) (1 liang, processed with ginger juice), Fritillaria Bulb (Beimu) (3 fen), Bupleurum Root (Chaihu) (rhizome removed), Apricot Kernel (Xingren) (stir-fried, ground), Cimicifuga Rhizome (Chuanshengma), Mulberry Root Bark (Sangbaipi) (honey-fried), Groundcherry Root (Digupi), Winter Flower Bud (Kuandonghua), Ophiopogon Radix (Maidong) (core removed), Aristolochia Manshuriensis Fruit (Madouling), Green Tangerine Peel (Qingjupi) (each 0.5 liang), Licorice Root (Gancao) (1 fen, honey-fried).
Preparation and Administration: Grind into powder. Take 1 qian per dose. Wrap the powder in a piece of cotton with one mint leaf. Add 1 zhan of water, one slice of ginger, and half a jujube. Decoct until 0.5 zhan remains. Keep in a cup on the fire and take warm occasionally. Avoid cold/raw foods and toxic substances.