小儿发热非一端,或因食积或因寒,有实有虚有积热,说与医人仔细看。
发热面红,气粗口渴,啼哭烦躁,唇红,小便赤色,解表即退。宜服∶
黄芩 紫苏 苏荷 防风 柴胡 虫蜕 连翘 木通 车前 荆芥(各五分) 灯芯为引。
发热面白,眼青气微,神倦,温补即退。宜服∶
洋参 白术 茯苓 半夏 虫蜕 骨地 广皮 天麻(姜炒) 甘草(各五分)
发热面赤,气促,两鼻扇动,汗多,此肺窍不通,肺火有余。宜服∶
牛蒡子(炒) 枳壳 苏子 北芥 莱菔子 钩藤 茯苓 苏荷 桔梗 云皮 广香 蒲黄
(各一钱) 北辛 牙皂(各二分)
微热面白,气促,两鼻扇动,体虚者。宜服∶
党参(二钱) 云苓 陈皮 半夏(各一钱) 肉桂(五分) 炙草 黑姜(各六分) 当归(一钱) 大红
枣(二枚为引)
虚热日久,手足心热,下午益甚,时热时退,虚烦口渴,宜服∶
生地 枣皮 怀山药 茯苓 当归 地骨皮 熟地 丹皮 泽泻 麦冬(去心。各一钱)
北味(七粒) 乌梅 红枣(各一枚) 为引。
疳积发热,肌瘦,大便艰涩,汗下不能,积热也。宜服∶
郁金 胆星 熟军 使君(去壳) 红曲(各二钱) 共为末,红糖水调服。
发热咳嗽,鼻塞声重,宜服∶
前胡 桑皮 苏荷 桔梗 干葛 紫苏 知母(各一钱) 北辛(三分) 杏霜(去油,一钱) 水
煎服。
久热,面目浮肿,鼻流清涕,此体虚复冒风寒,宜服∶
黄 白术 当归 升麻 柴胡 陈皮 党参 桂枝 防风(各一钱) 甘草(三分) 姜、枣
为引。
发热,鼻中出血,宜服∶
桑皮 杏仁 丹皮 白芍 骨皮 侧柏叶(炒) 甘草 荆芥(各一钱) 不用引,水煎服。
小儿夜啼 用灯花五朵研烂,涂娘乳上,令小儿食乳自安。一方青黛研水服之。一方五
倍子研末水调,填脐上即安。
小儿发热的原因并非只有一种,可能是由于饮食积滞,也可能是感受寒邪;病情有实证、虚证以及积热证之分,请医生仔细辨证诊治。
若患儿发热且面色发红,呼吸粗重,口渴,啼哭烦躁,嘴唇红润,小便颜色深赤,采用解表法即可退热。适宜服用的方剂为:黄芩、紫苏、苏梗与薄荷(此处“苏荷”指苏梗和薄荷)、防风、柴胡、蝉蜕、连翘、木通、车前子、荆芥(各五分),以灯芯草作为药引。
若患儿发热但面色苍白,眼周发青,气息微弱,精神疲倦,采用温补法即可退热。适宜服用的方剂为:西洋参、白术、茯苓、半夏、蝉蜕、骨碎补与地黄(此处“骨地”指骨碎补和地黄)、广陈皮、天麻(姜汁炒制)、甘草(各五分)。
若患儿发热且面色红赤,气促,双侧鼻孔扇动,汗出较多,这是肺窍不通,肺火亢盛所致。适宜服用的方剂为:牛蒡子(炒制)、枳壳、苏子、北芥子(此处“北芥”通常指芥子或旋覆花,结合语境及后续莱菔子,多指降气化痰之芥子)、莱菔子、钩藤、茯苓、苏梗与薄荷、桔梗、云皮(此处“云皮”可能指桑白皮或地骨皮,结合肺火语境,常指桑白皮泻肺火,亦有可能指牡丹皮清血热,暂按原文保留)、广木香、蒲黄(各一钱),细辛、牙皂(各二分)。
若患儿微热且面色苍白,气促,双侧鼻孔扇动,体质虚弱者。适宜服用的方剂为:党参(二钱)、云茯苓、陈皮、半夏(各一钱)、肉桂(五分)、炙甘草、黑姜(即炮姜,各六分)、当归(一钱),以大红枣(两枚)作为药引。
若为虚热日久,手足心发热,下午症状加重,时热时退,伴有虚烦口渴,适宜服用的方剂为:生地黄、山茱萸、怀山药、茯苓、当归、地骨皮、熟地黄、牡丹皮、泽泻、麦冬(去心,各一钱),五味子(七粒),乌梅、红枣(各一枚)作为药引。
若因疳积导致发热,肌肉消瘦,大便干结难解,发汗和攻下法均不适用,此为积热所致。适宜服用的方剂为:郁金、胆南星、熟大黄、使君子(去壳)、红曲(各二钱),共研为细末,用红糖水调服。
若发热并伴有咳嗽,鼻塞,声音沉重,适宜服用的方剂为:前胡、桑白皮、苏梗与薄荷、桔梗、干葛根、紫苏、知母(各一钱),细辛(三分),杏仁霜(去油,一钱),加水煎服。
若长期发热,面目浮肿,流清鼻涕,这是体质虚弱又外感风寒所致,适宜服用的方剂为:黄芪、白术、当归、升麻、柴胡、陈皮、党参、桂枝、防风(各一钱),甘草(三分),生姜、大枣作为药引。
若发热且鼻中出血,适宜服用的方剂为:桑白皮、杏仁、牡丹皮、白芍、地骨皮、侧柏叶(炒制)、甘草、荆芥(各一钱),不加药引,加水煎服。
小儿夜啼:取五朵灯花研烂,涂抹在母亲乳头之上,让小儿吃奶后自然安静。另一方法是用青黛研成粉末,用水冲服。还有一种方法是用五倍子研成粉末,用水调匀,填敷在肚脐上,即可安神。
Pediatric fever arises from various causes, such as food stagnation or cold invasion; conditions may be excess, deficiency, or heat accumulation due to stagnation. Physicians must examine carefully to differentiate the syndrome.
If the child has fever with a red face, coarse breathing, thirst, restlessness and crying, red lips, and dark urine, releasing the exterior will resolve the fever. The appropriate prescription is: Huangqin (Scutellariae Radix), Zisu (Perillae Folium), Sugan and Bohé (Stem of Perilla and Folium Menthae), Fangfeng (Saposhnikoviae Radix), Chaihu (Bupleuri Radix), Chongtui (Cicadae Periostracum), Lianqiao (Forsythiae Fructus), Mutong (Akebiae Caulis), Cheqian (Plantaginis Semen), Jingjie (Schizonepetae Spica) (each 0.15 g), using Dengxincao (Junci Medulla) as an guide drug.
If the child has fever with a pale face, bluish eyes, weak breath, and mental fatigue, warming and tonifying will resolve the fever. The appropriate prescription is: Yangshen (Panacis Quinquefolii Radix), Baizhu (Atractylodis Macrocephalae Rhizoma), Fuling (Poria), Banxia (Pinelliae Rhizoma), Chongtui (Cicadae Periostracum), Gusuibu and Dihuang (Drynariae Rhizoma and Rehmanniae Radix), Guangpi (Citri Reticulatae Pericarpium), Tianma (Gastrodiae Rhizoma) (stir-fried with ginger juice), Gancao (Glycyrrhizae Radix et Rhizoma) (each 0.15 g).
If the child has fever with a red face, rapid breathing, flaring of nostrils, and profuse sweating, this indicates obstruction of the lung orifices and excess lung fire. The appropriate prescription is: Niubangzi (Arctii Fructus) (stir-fried), Zhike (Aurantii Fructus), Su Zi (Perillae Fructus), Beijie (Brassicae Semen or Inulae Flos, contextually likely Brassicae Semen for descending qi), Laifuzi (Raphani Semen), Gouteng (Uncariae Ramulus cum Uncis), Fuling (Poria), Sugan and Bohé (Stem of Perilla and Folium Menthae), Jiegeng (Platycodonis Radix), Yunpi (likely Sangbaipi or Mudanpi, retained as Yunpi), Guangxiang (Aquilariae Lignum Resinatum), Puhuang (Typhae Pollen) (each 0.3 g), Beixin (Asari Radix et Rhizoma), Yazao (Gleditsiae Spina) (each 0.06 g).
If the child has slight fever with a pale face, rapid breathing, flaring of nostrils, and constitutional deficiency, the appropriate prescription is: Dangshen (Codonopsis Radix) (0.6 g), Yunling (Poria), Chenpi (Citri Reticulatae Pericarpium), Banxia (Pinelliae Rhizoma) (each 0.3 g), Rougui (Cinnamomi Cortex) (0.15 g), Zhigancao (Prepared Glycyrrhizae Radix et Rhizoma), Heijiang (Prepared Zingiberis Rhizoma) (each 0.18 g), Danggui (Angelicae Sinensis Radix) (0.3 g), Hongdazao (Jujubae Fructus) (two pieces) as a guide drug.
If there is prolonged deficiency fever with heat in the palms and soles, worsening in the afternoon, intermittent fever, deficiency irritability, and thirst, the appropriate prescription is: Shengdi (Rehmanniae Radix), Zaopi (Corni Fructus), Huai shanyao (Dioscoreae Hypoglaucae Rhizoma), Fuling (Poria), Danggui (Angelicae Sinensis Radix), Digupi (Phellodendri Cortex or Lycii Cortex, contextually Digupi usually refers to Lycii Cortex/Digupi), Shudi (Prepared Rehmanniae Radix), Danpi (Moutan Cortex), Zexie (Alismatis Rhizoma), Maidong (Ophiopogonis Radix) (heart removed, each 0.3 g), Beiwei (Schisandrae Fructus) (seven grains), Wumei (Mume Fructus), Hongdazao (Jujubae Fructus) (each one piece) as a guide drug.
If fever is caused by gan accumulation (malnutrition due to parasitic infection or indigestion), with emaciation and hard stools, where diaphoresis and purgation are contraindicated, this is heat accumulation. The appropriate prescription is: Yujin (Curcumae Radix), Danning (Arisaema cum Bile), Shujun (Prepared Rheum Palmati Radix), Shijunzi (Quisqualis Fructus) (shell removed), Hongqu (Red Yeast Rice) (each 0.6 g), ground into powder and taken with brown sugar water.
If fever is accompanied by cough, nasal congestion, and heavy voice, the appropriate prescription is: Qianhu (Peucedani Radix), Sangbai (Mori Cortex), Sugan and Bohé (Stem of Perilla and Folium Menthae), Jiegeng (Platycodonis Radix), Gan Ge (Puerariae Lobatae Radix), Zisu (Perillae Folium), Zhimu (Anemarrhenae Rhizoma) (each 0.3 g), Beixin (Asari Radix et Rhizoma) (0.09 g), Xingshuang (Amandus Amarus prepared as paste, oil removed) (0.3 g), decocted in water.
If there is prolonged fever with facial and ocular edema and clear nasal discharge, this is constitutional deficiency complicated by wind-cold invasion. The appropriate prescription is: Huangqi (Astragali Radix), Baizhu (Atractylodis Macrocephalae Rhizoma), Danggui (Angelicae Sinensis Radix), Shengma (Cimicifugae Rhizoma), Chaihu (Bupleuri Radix), Chenpi (Citri Reticulatae Pericarpium), Dangshen (Codonopsis Radix), Guizhi (Cinnamomi Ramulus), Fangfeng (Saposhnikoviae Radix) (each 0.3 g), Gancao (Glycyrrhizae Radix et Rhizoma) (0.09 g), with Shengjiang (Zingiberis Rhizoma Recens) and Hongdazao (Jujubae Fructus) as guide drugs.
If fever is accompanied by epistaxis, the appropriate prescription is: Sangbai (Mori Cortex), Xingren (Pruni Semen), Danpi (Moutan Cortex), Baishao (Paeoniae Radix Alba), Gupi (Lycii Cortex or Phellodendri Cortex, contextually Digupi/Gupi), Cebaiye (Platycladi Cacumen) (stir-fried), Gancao (Glycyrrhizae Radix et Rhizoma), Jingjie (Schizonepetae Spica) (each 0.3 g), without guide drug, decocted in water.
Pediatric night crying: Grind five dried flower heads of Oryza sativa (Denghua) into a paste, apply to the mother's nipple, and let the infant suckle to calm down. Another method is to take Qingdai (Indigo Naturalis) powder mixed with water. Another method is to take Wubeizi (Galae Chinensis) powder mixed with water and apply it to the umbilicus to achieve calmness.