《圣惠》论∶小儿龟背者,由坐儿稍早,为客风吹着脊骨,风气连于髓,使背高如龟之状也。
钱乙论龟背∶龟背者,肺热胀满,攻于胸膈,即成龟胸。又乳母多食五辛亦成。又儿生下,客风入骨,逐
于骨髓,即成龟背。治以龟尿点节骨。取尿水法∶当莲叶安龟在上,后以镜照之,自尿出,以物盛之。
张涣论∶婴儿生后一百八十日,始 骨成,方能独坐。若强令儿坐,坐之太早,即客风寒,吹着儿背及脊至
骨,传入于髓,使背高如龟之状,乃日龟背。宜松蕊丹(方在后。)
《圣惠》治小儿龟背。麻黄丸方
麻黄(三分,去根节) 桂心 独活 防风(去芦头) 赤芍药 川大黄(锉,微炒) 枳壳(麸炒
微黄,去瓤) 松花(以上各半两)
上件捣,罗为末,炼蜜和丸如绿豆大。每服以粥饮下五丸,日三服。量儿大小,以意加减。
《圣惠》又方
槟榔 川大黄(锉,微炒。各半两) 桂心 前胡(去芦头) 防风(去芦头) 赤芍药 独活 诃梨
勒皮 枳壳(麸炒微黄,去瓤) 松花(干用) 麻黄(去根节。以上各一分)
上件药捣,罗为末,炼蜜丸如麻子大。每服以粥饮下五丸,日三服。量儿大小以意加减。
《圣惠》又方
龟尿摩背上瘥。
张涣松药丹 治小儿龟背。
松花(洗,焙干) 枳壳(麸炒,去瓤) 防风(去芦头) 独活(以上各一两) 麻黄(去根节) 川
大黄(炮) 前胡 桂(以上各半两)
上件药捣,罗为细末,炼蜜和如黍米大。每服十粒,粥饮下。量儿大小加减。
《吉氏家传》治龟背方∶大抵小儿此病,为生时被客风吹拍着背,风透于骨髓,使背高如龟状。独活丸方
独活 防风 桂心 大黄(各二分) 麻黄(去节) 枳壳(炙) 芍药(各一分)
上件为细末,蜜丸如梧桐子大。每服十丸,米饮下。
《圣惠》灸法∶小儿龟背,生时被客风拍着脊骨,风达于髓所致。灸肺 、心 、鬲 各三壮,炷如小麦大。
肺在第三椎下两旁各一寸半。心 在第五椎下两旁各一寸半。鬲 在第七椎下两旁各一寸半。
《太平圣惠方》论述:小儿龟背,是因为让婴儿过早坐立,导致客风侵袭脊骨,风气连及骨髓,使得背部隆起如同龟壳的形状。
钱乙论述龟背:所谓龟背,是肺热胀满,邪气攻冲胸膈,从而形成龟胸。另外,乳母如果过多食用五辛(葱、蒜、韭、薤、兴渠),也会导致此病。还有,婴儿出生后,客风侵入骨骼,逐行于骨髓,就会形成龟背。治疗可用龟尿点涂节骨。取龟尿的方法:将莲叶放在乌龟上方,然后用镜子照射它,龟尿自然流出,用容器盛接即可。
张涣论述:婴儿出生后一百八十天,骨骼才发育成形,才能独自坐立。如果强行让婴儿坐立,坐得太早,客风寒邪吹袭婴儿背部及脊柱直至骨骼,传入骨髓,使背部隆起如龟状,这就叫做龟背。适宜使用松蕊丹(方剂在后面)。
《太平圣惠方》治疗小儿龟背的麻黄丸方:
麻黄(三分,去掉根和节) 桂心 独活 防风(去掉芦头) 赤芍药 川大黄(锉碎,微炒) 枳壳(麸炒至微黄,去掉瓤) 松花(以上各半两)
以上药物捣碎,过筛成细末,用炼蜜调和制成如绿豆大小的丸剂。每次服用五丸,用米粥汤送服,每日三次。根据患儿大小,酌情增减剂量。
《太平圣惠方》又一方:
槟榔 川大黄(锉碎,微炒,各半两) 桂心 前胡(去掉芦头) 防风(去掉芦头) 赤芍药 独活 诃梨勒皮 枳壳(麸炒至微黄,去掉瓤) 松花(干用) 麻黄(去掉根节,以上各一分)
以上药物捣碎,过筛成细末,用炼蜜调和制成如麻子大小的丸剂。每次服用五丸,用米粥汤送服,每日三次。根据患儿大小酌情增减剂量。
张涣松药丹 治疗小儿龟背:
松花(清洗,焙干) 枳壳(麸炒,去掉瓤) 防风(去掉芦头) 独活(以上各一两) 麻黄(去掉根节) 川大黄(炮制) 前胡 桂(以上各半两)
以上药物捣碎,过筛成细末,用炼蜜调和制成如黍米大小的丸剂。每次服用十粒,用米粥汤送服。根据患儿大小酌情增减。
《吉氏家传》治疗龟背方:大抵小儿此病,是由于出生时被客风吹拍背部,风邪透入骨髓,使背部隆起如龟状。独活丸方:
独活 防风 桂心 大黄(各二分) 麻黄(去掉节) 枳壳(炙) 芍药(各一分)
以上药物研成细末,用蜂蜜调和制成如梧桐子大小的丸剂。每次服用十丸,用米汤送服。
《太平圣惠方》灸法:小儿龟背,是由于出生时被客风吹拍脊骨,风邪达于骨髓所致。灸肺俞穴、心俞穴、膈俞穴各三壮,艾炷如小麦大小。肺俞穴在第三椎下两旁各一寸半处。心俞穴在第五椎下两旁各一寸半处。膈俞穴在第七椎下两旁各一寸半处。
Taiping Shenghui Fang discusses: Infantile torticollis-like back deformity (Gui Bei), results from allowing infants to sit too early, causing exogenous wind pathogens to invade the spinal column. The wind pathogenic factors connect with the marrow, causing the back to protrude high like the shell of a turtle.
Qian Yi discusses Gui Bei: What is called Gui Bei involves lung heat and distension, where pathogenic factors attack the chest and diaphragm, resulting in Gui Xiong (turtle chest). Additionally, if the nursing mother consumes excessive amounts of "Five Pungent Spices" (Wu Xin: garlic, chives, leeks, scallions, and asafoetida), this condition may also arise. Furthermore, after birth, exogenous wind enters the bones and travels through the bone marrow, leading to Gui Bei. Treatment involves applying turtle urine to the articular bones. Method for obtaining turtle urine: Place a lotus leaf above the turtle, then shine a mirror upon it; the urine will naturally excrete, and should be collected in a vessel.
Zhang Huan discusses: Infants' bones do not fully form until one hundred and eighty days after birth, at which point they can sit independently. If forced to sit too early, exogenous cold-wind pathogens blow upon the infant's back and spine, penetrating into the bones and transmitting to the marrow, causing the back to protrude like a turtle's shell; this is termed Gui Bei. Songrui Dan (formula follows) is suitable.
Taiping Shenghui Fang treats infantile Gui Bei with Mahuang Wan (Ephedra Pill):
Mahuang (Ephedrae Herba) (3 fen, remove roots and nodes), Guixin (Cinnamomi Cortex), Duhuo (Angelicae Pubescentis Radix), Fangfeng (Saposhnikoviae Radix, remove rhizome head), Chishaoyao (Paeoniae Radix Rubra), Chuandahuang (Rhei Radix et Rhizoma, crushed, slightly stir-fried), Zhike (Aurantii Fructus, bran-fried until slightly yellow, remove pith), Songhua (Pinus pollen) (each 0.5 liang above).
Crush and sieve the above ingredients into fine powder. Mix with refined honey to form pills the size of mung beans. Administer five pills per dose with millet gruel broth, three times daily. Adjust dosage according to the child's age and size.
Taiping Shenghui Fang, another formula:
Binglang (Arecae Semen), Chuandahuang (Rhei Radix et Rhizoma, crushed, slightly stir-fried) (each 0.5 liang), Guixin (Cinnamomi Cortex), Qianhu (Peucedani Radix, remove rhizome head), Fangfeng (Saposhnikoviae Radix, remove rhizome head), Chishaoyao (Paeoniae Radix Rubra), Duhuo (Angelicae Pubescentis Radix), Helilepi (Terminalia Chebulae Pericarpium), Zhike (Aurantii Fructus, bran-fried until slightly yellow, remove pith), Songhua (Pinus pollen, dried), Mahuang (Ephedrae Herba, remove roots and nodes) (each 1 fen above).
Crush and sieve the above ingredients into fine powder. Mix with refined honey to form pills the size of hemp seeds. Administer five pills per dose with millet gruel broth, three times daily. Adjust dosage according to the child's size.
Taiping Shenghui Fang, another method:
Massage the back with turtle urine to achieve cure.
Zhang Huan's Songyao Dan treats infantile Gui Bei:
Songhua (Pinus pollen, wash and dry-roast), Zhike (Aurantii Fructus, bran-fried, remove pith), Fangfeng (Saposhnikoviae Radix, remove rhizome head), Duhuo (Angelicae Pubescentis Radix) (each 1 liang above), Mahuang (Ephedrae Herba, remove roots and nodes), Chuandahuang (Rhei Radix et Rhizoma, processed), Qianhu (Peucedani Radix), Gui (Cinnamomi Ramulus) (each 0.5 liang above).
Crush and sieve the above ingredients into fine powder. Mix with refined honey to form pills the size of brocorn millet. Administer ten pills per dose with millet gruel broth. Adjust dosage according to the child's size.
Jishi Jiachuan treats Gui Bei: Generally, this disease in children arises because, at birth, exogenous wind strikes the back, penetrating into the bone marrow, causing the back to protrude like a turtle. Duhuo Wan (Angelica Pill):
Duhuo (Angelicae Pubescentis Radix), Fangfeng (Saposhnikoviae Radix), Guixin (Cinnamomi Cortex), Dahuang (Rhei Radix et Rhizoma) (each 2 fen), Mahuang (Ephedrae Herba, remove nodes), Zhike (Aurantii Fructus, roasted), Shaoyao (Paeoniae Radix) (each 1 fen above).
Grind the above ingredients into fine powder. Mix with honey to form pills the size of sophora seeds. Administer ten pills per dose with rice water.
Taiping Shenghui Fang Moxibustion Method: Infantile Gui Bei is caused by exogenous wind striking the spinal column at birth, reaching the bone marrow. Moxibustion on Feishu (BL13), Xinshu (BL15), and Geshu (BL17), three moxa cones each, with cone size resembling wheat grains. Feishu (BL13) is located 1.5 cun lateral to the lower border of the third thoracic vertebra. Xinshu (BL15) is located 1.5 cun lateral to the lower border of the fifth thoracic vertebra. Geshu (BL17) is located 1.5 cun lateral to the lower border of the seventh thoracic vertebra.