(胎疸附)
《巢氏病源》小儿黄胆病候∶黄胆之病,由脾胃气实,而外有温气乘之,变生热。脾与胃合,候肌肉,俱象
土,其色黄。胃为水谷之海,热搏水谷气,蕴积成黄,蒸发于外,身疼膊背强,大小便涩,皮肤、面目、齿爪
皆黄,小便如屋尘色,着物皆黄是也。小便宣利者,易治;若心腹,小便涩者,多难治也。不渴者易治,渴者
难治。脉沉细而腹满者,死也。
《巢氏病源》小儿胎疸候∶小儿在胎,其母脏气有热,熏蒸于胎,至生下小儿体皆黄,谓之胎疸也。
钱乙论黄相似云∶身皮目皆黄者,黄病也。身痛膊背强,大小便涩,一身尽黄,面目、指爪皆黄,小便如
屋尘色,着物皆黄,渴者难治,此黄胆也。二证多病于大病后。别有一证,不因病后,身微黄者,胃热也。
大人亦同。又有面黄腹大食土,渴者脾疳也。又有自生而身黄者,胎疸也。古书云∶诸疸皆热,色深黄者是
也。若淡黄兼白者,胃怯,胃不和也。
《婴童宝鉴》小儿百日黄胆歌∶
百日孩儿急发黄,非干温疫与时殃,当来只为胎中热,慎莫交人灸作疮。
《千金翼》秦王九疸散 兼治大人、小儿方。
胃疸∶食多喜饮,栀子仁主之。
心疸∶烦心心中热,茜根主之。
肾疸∶唇干,葶苈子主之。(熬。)
脾疸∶尿赤出少惕惕恐,栝蒌主之。
膏疸∶饮少尿多,秦椒、瓜蒂主之。(椒汁膏。一作肺。)
舌疽∶渴而数便,钟乳主之。
肉疸∶小便白,凝水石主之(研)。
髓疸∶目深多嗜卧,牡蛎、泽泻主之。
肝疸∶胃热饮多水激肝,白术主之。
上一十一味等分,随病所在加半,捣、筛为散。饮服五分匕,日三,稍稍加之方寸匕。儿小者量与之。
茅先生治小儿面黄肿方。
瓜蒂(半两) 丁香(一钱)
上为末。每服一字,搐入鼻中,取下黄水从鼻中出,然后用天竺黄散与服。(方见实热门中。)
茅先生治小儿遍身二十四般瘅毒方。
屋下乘漏泥 灶心土 白缮土 寒水石
上四味等分。每用为末,使鸡子清调涂便没此患。先用实积牛黄丸通下。(方见实热门中。)后补,常服天竺黄散。
(方见同前。)
《婴孺》治小儿身体面目悉黄,此是荣卫气伏热于内所为。蛴螬丸方
干蛴螬 大枣(取肉。各一升) 虫 虻虫 杏仁(各半升) 地黄(十两) 黄芩 芍
药(各三两) 水蛭(一百个) 甘草(炙,半斤。又云半升)
上为末。炼蜜丸小豆大,酒下三丸,日三。
张涣治小儿黄疽。双连丹方
川黄连(去须) 胡黄连(各一两)
上件捣,罗为细末。用黄瓜一枚去瓤,留一小盖子,入药末后以盖子盖定;用面裹慢火烧令面焦,去面捣
熟,丸绿豆大。每服七粒至十粒,温水下。量儿大小以意加减。
《惠眼观证》治黄胆水肿丁香散方
丁香(七粒) 瓜蒂(四十九个) 砂(一分)
上为末令细。黄昏时 荷根丁子点药,入鼻搐之。一更时腥臭水出渐脓,至五更水尽,一夜三、五遍换丁
子。次日调气至,日夜根据前用之。五夜烂肉落,方住药,以乌犀膏(方见风热门中)吃一月日。
《惠眼观证》治小儿黄疽,遍身虚肿,其色如金。藿香散方
藿香(一分) 瓜蒂(四十九个) 赤小豆(四十粒)
上为末。每服一字半,搐入两鼻中。须臾黄水出,至二更待头痛即住。次日自腰以上黄退白色。
《惠眼观证》∶截腰下黄色。大青饮子方
大青 燕口连翘 甘草(炙) 黄芩 田蓝(如皂角子) 川芎(各等分)
上为末,每服一大匙。水一碗半,煎至半碗,一日之内作六服,须臾小便下如金色。如此吃五日。
《吉氏家传》治小儿身体黄及小便黄,眼白睛黄,即是疸也。宜此方。
茵陈 大黄(各一分) 山栀子仁(三个) 朴硝(一分)
上以水五合,煎二合,去滓服之。
《吉氏家传》又方
桑白皮 麻黄(去节) 秦艽(各一分) 大黄(二分)
上以水三合,入牛乳三合,同煎二合半,一岁儿日服一合。
《吉氏家传》又方
茵陈(二分) 大黄 秦艽(各三分) 山栀子仁 郁李仁(别杵如泥) 朴硝(各四分)
上件末,蜜丸梧桐子大,熟水化下。
长沙医者郑愈传治瘅,时行身热遍体黄。升麻散方
升麻 甘草(炙。各二钱) 常山(一分)
上为末。每服半钱,枣子一个,水八分,同煎四分,隔宿露了。天明、早晨服。奶母忌毒物。
(胎疸附)
《巢氏病源》中关于小儿黄疸病的论述:黄疸病,是由于脾胃之气实盛,同时外受温邪侵袭,化热而生。脾与胃相表里,主司肌肉,二者均对应五行中的土,其色为黄。胃是水谷汇聚之海,热邪与水谷之气搏结,蕴积而成黄色,蒸发于体表,表现为身体疼痛、肩背僵硬、大小便涩滞,皮肤、面目、牙齿和指甲皆发黄,小便颜色如屋尘般浑浊,沾染衣物后留下黄色痕迹,这就是黄疸的症状。若小便通利者,容易治疗;若心腹部不适且小便涩滞者,大多难以治疗。口不渴者易治,口渴者难治。脉象沉细且腹部胀满者,预后不良,属死证。
《巢氏病源》中关于小儿胎疸的论述:小儿在母胎中时,若母亲脏腑之气有热,热气熏蒸胎儿,导致婴儿出生后全身发黄,这称为胎疸。
钱乙论述相似的黄疸症状说:身体皮肤和眼睛都发黄的,是黄病。身体疼痛、肩背僵硬、大小便涩滞、全身尽黄、面目和指爪皆黄、小便如屋尘色、沾染衣物皆黄、口渴难治的,这是黄疸。这两种证候多在大病之后发生。另有另一种证候,并非因病后引起,身体微黄的,是胃热所致。成人也是如此。又有面色黄、腹部大、想吃泥土且口渴的,是脾疳。又有出生后即身体发黄的,是胎疸。古书说:各种黄疸都属于热证,颜色深黄的即是如此。若淡黄兼白者,是胃气虚弱、胃功能不和的表现。
《婴童宝鉴》中关于小儿百日黄疸的歌诀:
百日大的婴儿突然发黄,这不是由温疫或时行疾病引起的,原本只是因为胎中积热,千万不要让人施灸以免造成疮疡。
《千金翼方》秦王九疸散,兼治成人和小儿的方剂。
胃疸:饮食多且喜欢饮水,用栀子仁主治。
心疸:心烦、心中发热,用茜根主治。
肾疸:嘴唇干燥,用葶苈子主治。(需熬制。)
脾疸:尿色红赤且量少、惊恐不安,用栝蒌主治。
膏疸:饮水少但尿多,用秦椒、瓜蒂主治。(制成椒汁膏。一说对应肺疸。)
舌疽:口渴且频繁小便,用钟乳石主治。
肉疸:小便色白,用凝水石主治(需研碎)。
髓疸:眼窝深陷、嗜睡,用牡蛎、泽泻主治。
肝疸:胃热、饮水多、水气激惹肝脏,用白术主治。
以上十一味药等分,根据病情所在部位增加半量,捣碎、过筛制成散剂。每次服用五分匕,每日三次,逐渐增加至一方寸匕。幼儿酌情减量服用。
茅先生治疗小儿面黄肿的方剂。
瓜蒂(半两) 丁香(一钱)
以上药物研为末。每次服用一字量,搐入鼻中,引出黄水从鼻中流出,然后用天竺黄散内服。(方剂见实热门中。)
茅先生治疗小儿遍身二十四种疸毒的方剂。
屋下漏泥 灶心土 白缮土 寒水石
以上四味药等分。每次取药末,用鸡蛋清调和涂抹,即可避免此患。先用实积牛黄丸通便泄下。(方剂见实热门中。)后续补充,常服天竺黄散。(方剂见前文。)
《婴孺集》治疗小儿身体面目全部发黄,这是由于营卫之气伏热于内所致。蛴螬丸方
干蛴螬 大枣(取肉。各一升) 虫 虻虫 杏仁(各半升) 地黄(十两) 黄芩 芍药(各三两) 水蛭(一百个) 甘草(炙,半斤。另一说法为半升)
以上药物研为末。用炼蜜制成小豆大小的丸剂,酒送服三丸,每日三次。
张涣治疗小儿黄疸的双连丹方
川黄连(去须) 胡黄连(各一两)
以上药物捣碎,过筛成细末。取黄瓜一枚,去掉瓤,留一小盖子,将药末放入其中,盖上盖子;用面粉包裹,慢火烘烤至面焦,去掉面粉,捣熟,制成绿豆大小的丸剂。每次服用七粒至十粒,温水送服。根据幼儿大小酌情加减。
《惠眼观证》治疗黄疸水肿的丁香散方
丁香(七粒) 瓜蒂(四十九个) 砂(一分)
以上药物研为细末。黄昏时用荷根丁子蘸药,搐入鼻中。一更时分,腥臭的水流出并逐渐化脓,至五更时分水流尽,一夜更换三到五次丁子。次日调顺气机后,日夜按此前方法使用。五夜后腐肉脱落,方可停药,服用乌犀膏(方见风热门中)一个月。
《惠眼观证》治疗小儿黄疸,遍身虚肿,颜色如金。藿香散方
藿香(一分) 瓜蒂(四十九个) 赤小豆(四十粒)
以上药物研为末。每次服用一字半,搐入两个鼻孔中。片刻后黄水流出,至二更时分待头痛即停止用药。次日自腰部以上黄色消退变白。
《惠眼观证》:截断腰以下黄色。大青饮子方
大青 燕口连翘 甘草(炙) 黄芩 田蓝(如皂角子大小) 川芎(各等分)
以上药物研为末,每次服用一大匙。加水一碗半,煎至半碗,一日之内分六次服用,片刻后小便排出如金色液体。如此连续服用五日。
《吉氏家传》治疗小儿身体黄及小便黄,眼白睛黄,即是疸病。宜用此方。
茵陈 大黄(各一分) 山栀子仁(三个) 朴硝(一分)
以上用水五合,煎至二合,去渣服用。
《吉氏家传》又一方
桑白皮 麻黄(去节) 秦艽(各一分) 大黄(二分)
以上用水三合,加入牛乳三合,同煎至二合半,一岁幼儿每日服用一合。
《吉氏家传》又一方
茵陈(二分) 大黄 秦艽(各三分) 山栀子仁 郁李仁(另捣如泥) 朴硝(各四分)
以上药物制成末,蜂蜜制成梧桐子大小的丸剂,熟水化开服用。
长沙医者郑愈传授治疗疸病,时行病身热遍体黄。升麻散方
升麻 甘草(炙。各二钱) 常山(一分)
以上药物研为末。每次服用半钱,配一个枣子,加水八分,同煎至四分,隔夜露置。天明早晨服用。哺乳的母亲忌食有毒食物。
(Accompanying Fetal Jaundice)
*Chao Shi Bing Yuan* (Source of Diseases by Chao Yuanfang) on the manifestation of pediatric jaundice: Jaundice arises from excess Qi in the Spleen and Stomach, compounded by external invasion of warm pathogens, transforming into heat. The Spleen and Stomach are exterior-interior paired organs, governing the muscles, and both correspond to the Earth element, whose color is yellow. The Stomach is the sea of water and grain; when heat combats with the Qi of water and grain, it accumulates and transforms into yellow, evaporating to the exterior. Symptoms include body pain, stiffness of the shoulders and back, difficult urination and defecation, yellowing of the skin, face, eyes, teeth, and nails, urine turbid like house dust, staining clothes yellow. This is jaundice. If urination is free and unobstructed, it is easy to treat; if there is discomfort in the heart and abdomen with obstructed urination, it is mostly difficult to treat. Those without thirst are easy to treat; those with thirst are difficult to treat. A deep, fine pulse with abdominal fullness indicates a fatal prognosis.
*Chao Shi Bing Yuan* on fetal jaundice in children: While in the womb, if the mother's organ Qi has heat, this heat steams and affects the fetus. Upon birth, the infant's entire body is yellow, which is called fetal jaundice.
Qian Yi discusses similar jaundice symptoms: When the skin and eyes are yellow, it is a yellow disease. Body pain, shoulder and back stiffness, difficult urination and defecation, whole-body yellowing, yellow face, eyes, fingers, and nails, urine like house dust, staining clothes yellow, and difficulty due to thirst characterize jaundice. These two conditions often occur after severe illness. Another condition, not occurring post-illness but with slight yellowing of the body, is stomach heat. Adults present similarly. There is also a condition with a yellow face, distended abdomen, pica (eating earth), and thirst, known as spleen gan (wasting-thirst syndrome). Those yellow since birth have fetal jaundice. Ancient texts state that all jaundices are heat-related, specifically those with deep yellow color. Pale yellow mixed with white indicates weak stomach Qi and disharmony of the Stomach.
Song of Hundred-Day Jaundice in *Ying Tong Bao Jian*:
The hundred-day-old child suddenly turns yellow,
Not caused by epidemic or seasonal pestilence,
It originates solely from heat accumulated in the womb,
Beware of moxibustion causing sores.
*Qian Jin Yi Fang* (Supplement to Essential Prescriptions for Emergencies) Qin Wang Nine Jaundices Powder, treating adults and children.
Stomach Jaundice: Excessive eating and desire to drink, treated with Gardenia Seed (Zhi Zi Ren).
Heart Jaundice: Vexation and heat in the heart, treated with Qian Cao Gen (Madder Root).
Kidney Jaundice: Dry lips, treated with Ting Li Zi (Descurainia Seed). (Roasted.)
Spleen Jaundice: Red, scanty urine and timidity/fear, treated with Gua Lou (Trichosanthes Fruit).
Gao (Fat/Paste) Jaundice: Little drinking but frequent urination, treated with Qin Jiao (Gentiana Macrophylla) and Gua Di (Melon Twig). (Make into pepper juice paste. Alternatively interpreted as Lung Jaundice.)
Tongue Abscess/Jaundice: Thirst and frequent urination, treated with Zhong Ru (Galactite/Stalactite).
Flesh Jaundice: White urine, treated with Ning Shui Shi (Halloysitum). (Ground.)
Marrow Jaundice: Sunken eyes, excessive sleepiness, treated with Mu Li (Oyster Shell) and Ze Xie (Alisma Rhizome).
Liver Jaundice: Stomach heat, excessive drinking, water qi agitating the liver, treated with Bai Zhu (Atractylodes Rhizome).
Take the above eleven ingredients in equal parts, adding half more according to the affected area. Pound, sieve, and make into powder. Take five fen bi per dose, three times daily, gradually increasing to one cun bi. Adjust dosage for small children.
Mr. Mao's prescription for pediatric facial yellow swelling.
Gua Di (Melon Twig) (half liang) Ding Xiang (Clove) (one qian)
Pound into powder. Take one zi amount, insufflate into the nose to discharge yellow fluid. Then administer Tian Zhu Huang (Calaminus) powder internally. (Formula see in Real Heat section.)
Mr. Mao's prescription for twenty-four types of jaundice toxins covering the whole body.
Wu Xia Cheng Lou Ni (Mud from under eaves) Zao Xin Tu (Kitchen Hearth Earth) Bai Shan Tu (White Mountain Soil) Han Shui Shi (Halloysitum)
Take the above four ingredients in equal parts. Apply powder mixed with egg white topically to prevent this affliction. First, administer Shi Ji Niu Huang Wan (Real Accumulation Calculus Bovis Pill) to purge bowels. (Formula see in Real Heat section.) Subsequently, commonly administer Tian Zhu Huang San (Calaminus Powder). (Formula see above.)
*Ying Ru Ji* treats pediatric whole-body and facial yellowing, caused by latent heat within Ying and Wei Qi. Xi Lao Wan (Earthworm Pill) Formula
Dried Xi Lao (Earthworm) Da Zao (Jujube Fruit, flesh only) (each one sheng) Chong (Insect) Meng Chong (Blue Bottle Fly Larva) Xing Ren (Apricot Seed) (each half sheng) Di Huang (Rehmannia Root) (ten liang) Huang Qin (Scutellaria Root) Shao Yao (Peony Root) (each three liang) Shui Zhi (Leech) (one hundred pieces) Gan Cao (Licorice Root, roasted) (half jin. Or half sheng.)
Pound into powder. Make pills the size of soybeans using refined honey. Take three pills with wine, three times daily.
Zhang Huan's Shuang Lian Dan (Double Coptis Pill) for pediatric jaundice.
Chuan Huang Lian (Coptis Rhizome, remove roots) Hu Huang Lian (Picrorhiza Rhizome) (each one liang)
Pound and sieve into fine powder. Take one cucumber, remove pulp, keep a small lid. Insert powder, cover with lid. Wrap in dough, slow-roast until dough is charred. Remove dough, pound熟 (cook/soften), make pills the size of mung beans. Take seven to ten pills each time with warm water. Adjust based on child's age and size.
*Hui Yan Guan Zheng* Ding Xiang San (Clove Powder) for jaundice edema.
Ding Xiang (Clove) (seven grains) Gua Di (Melon Twig) (forty-nine grains) Sha (Sand/Glass) (one fen)
Pound into fine powder. At dusk, use He Gen Ding Zi (Lotus Root Tip) to dip medicine and insufflate into nose. At first watch (approx. 9-11 PM), foul-smelling water discharges and gradually suppurates. By fifth watch (3-5 AM), water flow ceases. Change tip three to five times overnight. Next day, regulate Qi and continue usage day and night. After five nights, rotting flesh falls off, then stop medication. Administer Wu Xi Gao (Black Rhinoceros Horn Ointment) (see Wind Heat section) for one month.
*Hui Yan Guan Zheng* Huo Xiang San (Patchouli Powder) for pediatric jaundice, generalized edema, color like gold.
Huo Xiang (Patchouli) (one fen) Gua Di (Melon Twig) (forty-nine grains) Chi Xiao Dou (Adzuki Bean) (forty grains)
Pound into powder. Take one and a half zi amounts, insufflate into both nostrils. Yellow water discharges shortly after. Stop when headache occurs at second watch. Next day, yellow recedes to white from waist up.
*Hui Yan Guan Zheng*: To cut off yellow below the waist. Da Qing Yin Zi (Isatis Decoction) Formula.
Da Qing (Isatis Leaf) Yan Kou Lian Qiao (Forsythia Fruit from swallow's nest) Gan Cao (Licorice Root, roasted) Huang Qin (Scutellaria Root) Tian Lan (Isatis Root) Chuan Xiong (Ligusticum Rhizome) (equal parts)
Pound into powder. Take one large spoonful. Add one and a half bowls of water, decoct to half bowl. Divide into six doses within one day. Urine will discharge like golden liquid shortly after. Continue for five days.
*Ji Shi Jia Chuan* treats pediatric body yellow, urine yellow, and scleral yellow, indicating jaundice. Use this formula.
Yin Chen (Artemisia Capillaris) Da Huang (Rhubarb Root) (each one fen) Shan Zhi Zi Ren (Gardenia Seed) (three grains) Po Xiao (Mirabilite) (one fen)
Add five he of water, decoct to two he. Strain and take.
*Ji Shi Jia Chuan* Another Formula.
Sang Bai Pi (Mulberry Root Bark) Ma Huang (Ephedra Stem, remove joints) Qin Jiao (Gentiana Macrophylla) (each one fen) Da Huang (Rhubarb Root) (two fen)
Add three he of water and three he of cow milk. Decoct together to two and a half he. One-year-old infant takes one he daily.
*Ji Shi Jia Chuan* Another Formula.
Yin Chen (Artemisia Capillaris) (two fen) Da Huang (Rhubarb Root) Qin Jiao (Gentiana Macrophylla) (each three fen) Shan Zhi Zi Ren (Gardenia Seed) Yu Li Ren (Prunus japonica Seed, pounded separately into paste) Po Xiao (Mirabilite) (each four fen)
Make into powder, form pills the size of paulownia seeds with honey. Dissolve in cooked water and take.
Zheng Yu, a physician from Changsha, transmitted a treatment for jaundice with epidemic fever and whole-body yellowing. Sheng Ma San (Cimicifuga Powder) Formula.
Sheng Ma (Cimicifuga Rhizome) Gan Cao (Licorice Root, roasted) (each two qian) Chang Shan (Dichroa Root) (one fen)
Pound into powder. Take half qian each time with one jujube fruit. Add eight fen of water, decoct to four fen. Leave exposed overnight. Take at dawn/morning. Nursing mothers must avoid toxic foods.