虚热病后营卫弱,神倦气乏用补中,呕渴竹叶石膏治,面赤尿白厥白通。
【注】虚热者,因小儿病后气血虚弱,营卫尚未调匀之故。其证神倦气乏,宜用补中
益气汤治之。若兼口渴引饮而呕者,宜用竹叶石膏汤治之。又有阴盛格阳,外浮发热者,
其面色虽赤,然小便必清白,四肢必厥逆,宜用白通汤收敛阳气,热退自愈。
补中益气汤(方见飧泄)
竹叶石膏汤
竹叶 石膏〔 (按:石膏生用为宜)〕 人参 粳米 麦冬(去心) 甘草(生) 半夏(姜制)
引用生姜,水煎服。
【方歌】病后虚热烦渴呕,皆因气弱胃津亡,竹叶石膏参麦草,半夏粳米共生姜。
白通汤
干姜 附子(制) 葱
水煎服。
【方歌】虚热原于阴格阳,真寒假热白通汤,散寒姜附葱白茎,厥回热退自然康。
实热积热午潮热,腹胀尿红大便难,烦渴口疮腮颊赤,凉膈大柴效通仙。
【注】小儿有余积热,以致午后潮热,蒸蒸有汗,肚腹胀满,小便赤,大便难,烦渴
啼叫,口舌生疮,腮颊红赤,脉洪数有力,法宜清热通利。时时热者,凉膈散主之;午后
潮热者,大柴胡汤主之。
凉膈散(方见急惊风)
大柴胡汤(方见伤寒)
小儿养生食与乳,撙节失宜积滞成,停乳伤食宜分晰,因证调治保安宁。
【注】夫乳与食,小儿资以养生者也。胃主纳受,脾主运化,乳贵有时,食贵有节,可
免积滞之患。若父母过爱,乳食无度,则宿滞不消而病成矣。医者当别其停乳、伤食之
异,临证斟酌而施治焉。
虚热证多见于病后,此时营卫之气虚弱,出现精神疲倦、气力不足的症状,应当使用补中益气汤进行调理。如果伴有呕吐和口渴,应使用竹叶石膏汤治疗;若见面色发红、小便清长、四肢厥冷,则属于阴盛格阳证,应使用白通汤治疗。
【注】所谓虚热,是因为小儿在患病之后气血虚弱,营卫之气尚未调和均匀所致。其症状表现为精神疲倦、气力不足,适宜使用补中益气汤治疗。如果兼有口渴想喝水且伴有呕吐的情况,适宜使用竹叶石膏汤治疗。还有因阴寒内盛、格拒阳气于外而导致外浮发热的情况,虽然面色发红,但小便必定清长,四肢必定厥冷,适宜使用白通汤收敛阳气,待热退后自然痊愈。
竹叶石膏汤
药材:竹叶、石膏(按:石膏宜生用)、人参、粳米、麦冬(去心)、甘草(生用)、半夏(姜制)。
用法:加入生姜为引,加水煎煮后服用。
【方歌】病后虚热烦渴呕,皆因气弱胃津亡,竹叶石膏参麦草,半夏粳米共生姜。
【方歌】虚热原于阴格阳,真寒假热白通汤,散寒姜附葱白茎,厥回热退自然康。
实热证与积滞化热常表现为午后潮热,腹部胀满,小便红赤,大便困难,心烦口渴,口舌生疮,腮颊发红,使用凉膈散或大柴胡汤疗效显著。
【注】小儿体内有余留的积热,导致午后出现如潮水般定时发作的热象,身体蒸蒸发热且有汗出,肚腹胀满,小便颜色深赤,大便排泄困难,心烦口渴啼哭,口舌生疮,腮颊红赤,脉象洪大而数且有力,治法适宜清热通利。时时发热者,以凉膈散为主方;午后潮热者,以大柴胡汤为主方。
小儿的养生依赖于饮食与乳汁,如果节制失当就会形成积滞。停乳和伤食应当加以区分,根据具体证候进行调整治疗以保平安。
【注】乳汁与食物,是小儿赖以生存养生的物质基础。胃主受纳,脾主运化,哺乳贵在有时限,进食贵在有节制,这样可以避免积滞的祸患。如果父母过分溺爱,导致乳食无度,那么宿存的积滞无法消除而生病。医生应当辨别是停乳还是伤食的不同,临证时斟酌施治。
Post-illness deficiency heat arises from weakened Ying and Wei (nutritive and defensive qi) qi; when spirit is fatigued and Qi is deficient, Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) should be used. If accompanied by vomiting and thirst, Zhu Ye Shi Gao Tang (Bamboo Leaf and Gypsum Decoction) treats it; if the face is red, urine is clear/white, and extremities are cold (Jue), Bai Tong Tang (White Connecting Decoction) is indicated.
[Note] Deficiency heat refers to the condition where, due to weak Qi and Blood after illness in children, Ying and Wei qi have not yet harmonized. The symptoms include mental fatigue and Qi deficiency, for which Bu Zhong Yi Qi Tang is suitable. If accompanied by excessive thirst with drinking and vomiting, Zhu Ye Shi Gao Tang is suitable. Furthermore, in cases of Yin excess repelling Yang, causing floating heat on the exterior, although the complexion may be red, the urine will certainly be clear and white, and the four extremities will be cold (Jue). In such cases, Bai Tong Tang should be used to gather and secure the Yang Qi; once the heat subsides, health will naturally return.
Bu Zhong Yi Qi Tang (See Formula under Sundry Diarrhea)
Zhu Ye Shi Gao Tang (Bamboo Leaf and Gypsum Decoction)
Herbs: Zhu Ye (Bamboo Leaf), Shi Gao (Gypsum Fibrosum [Note: Raw use is appropriate]), Ren Shen (Ginseng Radix et Rhizoma), Jing Mi (Oryza Sativa Semen), Mai Dong (Ophiopogonis Tuber, heart removed), Gan Cao (Licorice Root, raw), Ban Xia (Pinelliae Tuber, ginger-processed).
Usage: Use Sheng Jiang (Fresh Ginger) as a guide, decoct in water and take orally.
[Formula Song] Post-illness deficiency heat, vexation, thirst, and vomiting, / All stem from weak Qi and loss of Stomach fluids. / Bamboo leaf, gypsum, ginseng, licorice, and lily bulb, / Pinellia, rice, and fresh ginger together.
Bai Tong Tang (White Connecting Decoction)
Herbs: Gan Jiang (Dried Ginger), Fu Zi (Aconiti Lateralis Radix Praeparata, processed), Cong Bai (Scallion White).
Usage: Decoct in water and take orally.
[Formula Song] Deficiency heat originates from Yin repelling Yang, / True cold and false heat treated by Bai Tong Tang. / Dispel cold with dried ginger, prepared aconite, and scallion stalks, / When cold extremities return and heat retreats, natural recovery follows.
Excess heat and accumulated heat often manifest as tidal fever in the afternoon, abdominal distension, reddish urine, and difficult defecation. Vexation, thirst, mouth ulcers, and red cheeks can be effectively treated with Liang Ge San (Cool the Upper Jiao Powder) or Da Chai Hu Tang (Major Bupleurum Decoction).
[Note] Children often retain residual accumulated heat, leading to tidal fever in the afternoon with steaming heat and sweating, abdominal fullness, dark red urine, difficult stool, vexation, thirst, crying, mouth and tongue sores, and red cheeks. The pulse is surging (Hong), rapid (Shu), and forceful. The treatment principle should be to clear heat and promote free flow. For constant fever, Liang Ge San is the primary formula; for tidal fever in the afternoon, Da Chai Hu Tang is the primary formula.
Liang Ge San (Cool the Upper Jiao Powder) (See Formula under Acute Convulsive Disorder)
Da Chai Hu Tang (Major Bupleurum Decoction) (See Formula under Cold Damage)
Infant health relies on diet and breast milk; improper regulation leads to food stagnation. One must distinguish between milk retention and food injury, treating according to the specific syndrome to ensure peace and safety.
[Note] Milk and food are the substances that sustain infant life. The Stomach governs reception, and the Spleen governs transformation and transportation. Nursing should be timed appropriately, and eating should be moderate, thereby avoiding the hazard of stagnation. If parents indulge their children excessively, leading to unregulated intake of milk and food, retained stagnation will fail to digest and disease will arise. Physicians must differentiate between milk retention and food injury, exercising discretion in clinical practice to administer treatment.