钱氏曰。肾主虚。即胎禀不足之病也。
按经云。肾主骨。骨会大杼。大杼以上喉骨也。项者头之茎。茎弱则头倾矣。大杼以下
也。脊者身之柱。脊弱则身曲矣。脊之下尻骨也。尻骨不成。则儿坐迟矣。尻骨之下。则胯
骨也。胯骨弱。则不能立矣。胯之下膝骨也。膝骨弱。则不能行矣。齿者骨之余。骨气不足
。则齿生迟矣。发者血之余。肾之主血。血不足则发不生矣。皆胎禀不足之病也。谓之五软
。此儿难养。并宜六味丸加当归杜仲牛膝川续断主之。
肾肝在下。母子也。肾主骨。肝主筋。骨属于筋。筋束乎骨。二者相为根据附也。肝虚筋
弱者。亦宜地黄丸主之。乃虚则补其母也。
肾主骨髓。脊者髓之路。脑者髓之海也。肝之脉与肾脉内行于脊骨之中。上会于脑。故头
破解颅脊疳之病。乃肝肾之风热。子传于母之病也。
解颅者有二。或生下之后。头缝四破。头皮光急。日渐长大。眼楞紧小。此髓热也。
又有生下五六个月后。囟门已合而复开者。此等小儿。大数难养。肾肝风热之病。宜加
味泻青丸主之。所谓实则泻其子也。芦荟泻青丸加黄柏黄芩黄连等分碾末蜜丸服。
肝疳者。小儿生后。生疮成饼。状如复盘。此风热也。宜加味泻青丸加蔓荆子白蒺藜炒
脊疳者小儿疳瘦。脊如锯齿。肋骨高起。拍之有声。宜集圣丸加龙胆草栀子仁黄柏同为
丸服。
齿根黑烂。臭息出血者。名走马疳。橡斗散主之。
栎橡子壳。不拘多少。入盐填满。二斗相合。放火中烧过。研末搽牙。
予有一族孙无父。周岁生走马疳。予用尿桶底白 刮下。瓦上焙干。五分。五倍子内
分。鼠妇焙干三分。枯白矾一钱。共研末。先用腊茶叶浸。米泔水洗净。以药付之神效。名
曰不二散。
儿有大病。暴喑失声者。此肾怯也。宜地黄丸加石菖蒲主之。
痘后小儿。有平时大便常难者。后重者。此肾虚血不足病也。难经云。利如下重是也。
不可听信庸医。妄用下剂。宜地黄丸加当归二两火麻仁二两主之。
按照《内经》所说:肾主骨,骨会于大杼穴。大杼穴以上为喉部骨骼。颈部是头部的支柱,颈部虚弱则头部倾斜。大杼穴以下为脊柱。脊柱是身体的支柱,脊柱虚弱则身体弯曲。脊柱之下为尾骶骨。尾骶骨发育不全,则婴儿坐起迟缓。尾骶骨之下为胯骨(髋骨)。胯骨虚弱,则不能站立。胯骨之下为膝骨。膝骨虚弱,则不能行走。牙齿是骨的余气所生,骨气不足,则牙齿生长迟缓。头发是血的余气所生,肾主血,血不足则头发不生。这些都是先天禀赋不足引起的疾病,称为“五软”。这类婴儿难以抚养,均宜用六味地黄丸加当归、杜仲、牛膝、川续断来主治。
肾和肝位于下部,是母子关系。肾主骨,肝主筋。骨依附于筋,筋约束着骨,二者相互依靠附着。肝虚导致筋弱,也宜用地黄丸主治,这是遵循“虚则补其母”的原则。
肾主骨髓,脊柱是髓运行的通道,脑是髓汇聚的海。肝的经脉与肾的经脉在内行于脊柱之中,向上会合于脑。因此出现头项解颅、脊疳等病,乃是肝肾风热之邪,由子脏传于母脏的疾病。
解颅有两种情况:一种是出生后,头缝四向开裂,头皮光亮紧绷,头日渐长大,眼裂紧小,这是髓热的表现。另一种是出生五六个月后,囟门已经闭合又重新开敞的。这类小儿大多难以抚养,属于肾肝风热之病,宜用加味泻青丸主治,这就是所谓“实则泻其子”的方法。芦荟泻青丸加黄柏、黄芩、黄连各等分,研成细末,炼蜜为丸服用。
肝疳:小儿出生后,身上生疮结成饼状,形状像翻过来的盘子,这是风热所致。宜用加味泻青丸加蔓荆子、白蒺藜炒制后同服。
脊疳:小儿患疳积消瘦,脊柱如锯齿状,肋骨高起,拍打时有响声。宜用集圣丸加龙胆草、栀子仁、黄柏共同制成丸药服用。
取栎树橡子壳,数量不限,填入盐使其填满,将两个壳合在一起,放入火中烧过,研成粉末搽牙。
我有一个族孙没有父亲,周岁时患了走马疳。我用尿桶底的白垢刮下,在瓦上焙干五分,五倍子三分,鼠妇(土鳖虫)焙干三分,枯白矾一钱,共研成细末。先用腊茶叶浸泡,再用米泔水洗净患处,敷上药物,效果神奇,名为不二散。
婴儿患大病,突然失声哑巴的,这是肾气怯弱所致。宜用地黄丸加石菖蒲主治。
出痘后的婴儿,平时大便经常困难的,伴有里急后重感的,这是肾虚血不足的病证。《难经》说:“痢疾伴见下重感就是这种情况。”不可听信庸医,妄用泻下剂。宜用地黄丸加当归二两、火麻仁二两主治。
Qian Yi stated: The Kidney primarily manifests deficiency syndromes, which are diseases of insufficient congenital endowment.
According to the *Classic of Internal Medicine* (*Huangdi Neijing*): The Kidney governs the bones; the meeting point of the bones is at Dazhu (BL11). Above Dazhu lies the laryngeal bone. The neck is the stalk of the head; if the stalk is weak, the head tilts. Below Dazhu lies the spine. The spine is the pillar of the body; if the spine is weak, the body curves. Below the spine lies the sacrococcygeal bone. If the sacrococcygeal bone fails to develop properly, the infant sits late. Below the sacrococcygeal bone lie the hip bones (innominate bones); if they are weak, standing is impossible. Below the hips lie the knee bones; if they are weak, walking is impossible. Teeth are the surplus of bones; if bone Qi is insufficient, teeth erupt late. Hair is the surplus of blood; since the Kidney governs blood, if blood is insufficient, hair does not grow. All these are diseases caused by insufficient congenital endowment, termed "Five Softnesses" (Wu Ruan). Such infants are difficult to rear and should generally be treated with Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill) added with Danggui (Angelicae Sinensis Radix), Duzhong (Eucommiae Cortex), Niuxi (Achyranthis Bidentatae Radix), and Chuanxuduan (Dipsaci Radix).
The Kidney and Liver reside in the lower jiao and share a mother-child relationship. The Kidney governs bones, and the Liver governs tendons. Bones attach to tendons, and tendons bind bones; the two rely on each other for support. When Liver deficiency leads to tendon weakness, it is also appropriate to treat with Dihuang Wan (Rehmannia Pill), following the principle of "tonifying the mother when there is deficiency."
The Kidney governs marrow and bone marrow; the spine is the pathway for marrow; the brain is the sea of marrow. The Liver meridian and the Kidney meridian run internally through the spinal column and converge upward at the brain. Therefore, conditions such as Jielu (splitting fontanelle) and Ji Gan (spinal malnutrition) arise from Wind-Heat in the Liver and Kidney, transmitted from the child organ to the mother organ.
Jielu presents in two forms. One type occurs after birth, where the cranial sutures split open in four directions, the scalp becomes shiny and tight, the head enlarges daily, and the eye fissures become narrow; this indicates Marrow Heat. Another type occurs when the fontanelle, having closed after five or six months of age, reopens. These children are generally difficult to rear and suffer from Liver-Kidney Wind-Heat; they should be treated with Jia Wei Xie Qing Wan (Modified Draining Blue Pill), illustrating the principle of "draining the child when there is excess." Lu Hui Xie Qing Wan (Aloe Draining Blue Pill) added with Huangbai (Phellodendri Cortex), Huangqin (Scutellariae Radix), and Huanglian (Coptidis Rhizoma) in equal parts, ground into powder and formed into honey pills, should be taken.
Gan Liver Malnutrition: After birth, the infant develops sores that form cake-like lesions resembling inverted plates; this is due to Wind-Heat. It should be treated with Jia Wei Xie Qing Wan added with Manjingzi (Viticis Semen) and Baijili (Tribuli Fructus) stir-fried together.
Spinal Malnutrition (Ji Gan): The infant suffers from malnutrition emaciation, the spine resembles a sawtooth, ribs protrude high, and percussion produces a sound. It should be treated with Jisheng Wan (Sage Collection Pill) added with Longdancao (Gentianae Radix), Zhizi Ren (Gardeniae Semen), and Huangbai (Phellodendri Cortex), processed into pills.
Blackening and rotting of the gum roots, accompanied by foul breath and bleeding, is named Zouma Gan (Running Horse Malnutrition/Gangrene). It is treated with Xiangdou San (Oak Cup Powder).
Take Oak cups (shell of acorn), any quantity, fill them with salt, join two shells together, roast them in fire, grind into powder, and apply to the teeth.
I had a clan grandson who was fatherless; at one year old, he developed Running Horse Gangrene. I scraped the white sediment from the bottom of a urine bucket, dried it over a tile until dry (5 fen), used 3 fen of Wubeizi (Galla Chinensis), 3 fen of Shufu (Ferulae Rhizoma or similar insect, here likely referring to *Pseudoscorpion* or similar traditional remedy context, often translated as Ferula root or similar, but strictly *Shufu* is *Pseudoscorpion* or *Oniscus*, here likely *Oniscus asellus* / Woodlouse dried), and 1 qian of Kubaijian (Alumen Exsiccatum). These were ground into powder together. First, soak with aged tea leaves, wash with rice water, then apply the medicine. It was highly effective and named Bu'er San (Unparalleled Powder).
When an infant suffers a severe illness and suddenly loses voice (aphonia), this is due to Kidney timidity/weakness. It should be treated with Dihuang Wan added with Shichangpu (Acori Tatarinowii Rhizoma).
Infants after smallpox who have chronic difficulty with bowel movements and tenesmus suffer from Kidney deficiency and Blood insufficiency. The *Classic of Difficult Issues* (*Nan Jing*) states: "Diarrhea/Dysentery with heaviness below is the sign." Do not listen to incompetent physicians who recklessly use purgatives. Instead, treat with Dihuang Wan added with Danggui (2 liang) and Huomaren (Cannabis Seed, 2 liang).