虫吐胃热或胃寒,色变时疼呕清涎,寒热当以阴阳辨,化虫加减理中痊。
【注】虫吐之证有二∶有以胃经热蒸者,有以胃经寒迫者,皆能令虫不安,扰乱胃中
而作吐也。其证唇色或红或白,胃口时痛时止,频呕清涎。属寒属热,当从阴阳之证辨
之,热者化虫丸主之,寒者加减理中汤主之。
化虫丸
芜荑(五钱) 鹤虱 苦楝根皮 胡粉 使君子肉 槟榔(各一两) 枯矾(二钱五分)
上为细末,面糊为丸,量儿大小与之。
加减理中汤
人参 干姜 白术(土炒) 川椒
引用乌梅一个,水煎服。
【方歌】加减理中寒吐虫,人参干姜白术从,川椒乌梅伏虫动,煎成服下即安宁。
虚吐多因胃弱成,神倦囟动睡露睛,自利不渴频呕吐,丁沉四君药最灵。
丁沉四君子汤
人参 白术(土炒) 茯苓 炙甘草 丁香 沉香
引用煨姜,水煎服。
【方歌】胃虚呕吐不思食,丁沉四君治最宜,参术苓草补其胃,丁香沉香温其脾。
小儿实吐腹胀满,二便不利痞硬疼,发渴思凉吐酸臭,三一承气可收功。
【注】实吐者,小儿平素壮实,偶而停滞,胸腹胀满,二便秘涩,痞硬疼痛,口渴思饮
寒凉,吐多酸臭也。宜用三一承气汤下之,二便利而吐止矣。
三一承气汤
芒硝 生大黄 枳实(麸炒) 甘草(生) 浓朴(姜炒)
引用生姜,水煎服。
【方歌】三一承气治实吐,涤滞通塞功最着,芒硝相配生大黄,枳实甘草同浓朴。
虫吐:胃热或胃寒均可导致虫吐,呕吐物颜色变化,伴有阵发性疼痛和清稀涎沫。治疗时需辨别寒热属性,依据阴阳辨证,使用化虫丸加减或理中汤加减即可痊愈。
【注】虫吐这一证候有两种情况:一种是由于胃经热气熏蒸所致,另一种是由于胃经寒气逼迫所致。这两种情况都会使寄生虫不安宁,扰乱胃部功能从而引发呕吐。其症状表现为嘴唇颜色或红或白,胃口处时痛时止,频繁呕吐清稀涎沫。属于寒证还是热证,应当从阴阳证候的角度进行辨别。属热证的,以化虫丸为主方治疗;属寒证的,以加减理中汤为主方治疗。
化虫丸
芜荑(五钱) 鹤虱 苦楝根皮 胡粉 使君子肉 槟榔(各一两) 枯矾(二钱五分)
以上药材研成细末,用面糊制作成丸剂,根据患儿年龄大小给予服用。
加减理中汤
人参 干姜 白术(土炒) 川椒
引用乌梅一枚,加水煎煮后服用。
【方歌】加减理中汤治疗因寒引起的虫吐,方中包含人参、干姜、白术,川椒与乌梅可抑制虫体活动,煎服后即可安宁。
虚吐:多因胃气虚弱而成,表现为精神疲倦、囟门跳动、睡眠时眼睛半睁(露睛),自发性腹泻且不口渴,频繁呕吐,丁沉四君子汤疗效最佳。
丁沉四君子汤
人参 白术(土炒) 茯苓 炙甘草 丁香 沉香
引用煨姜,加水煎煮后服用。
【方歌】胃虚导致的呕吐且不思饮食,用丁沉四君子汤治疗最为适宜,人参、白术、茯苓、甘草补益胃气,丁香、沉香温煦脾阳。
小儿实吐:表现为腹部胀满,大小便不通畅,腹部痞块坚硬且疼痛,口渴想喝凉水,呕吐物酸臭,三一承气汤可收效。
【注】实吐的情况是,小儿平时身体壮实,偶尔出现食积停滞,导致胸腹胀满,大小便涩滞不通,腹部痞硬疼痛,口渴想饮用寒凉之物,呕吐物多为酸臭味。适宜使用三一承气汤攻下积滞,待大小便通畅后,呕吐自然停止。
Chong Tu (Vomiting due to Parasites): Vomiting caused by parasites may result from Stomach Heat or Stomach Cold. The vomitus color changes, accompanied by intermittent pain and vomiting of clear saliva. Treatment requires differentiation of Cold and Heat based on Yin and Yang principles; using modified Hua Chong Wan (Paricide Pill) or modified Lizhong Tang (Modified Cinnamon Twig and Ginger Decoction) will lead to recovery.
[Note] There are two types of Chong Tu (Vomiting due to Parasites): one is caused by the steaming of Heat in the Stomach Meridian, and the other by the forcing of Cold in the Stomach Meridian. Both conditions cause parasites to become restless, disturbing the Stomach and inducing vomiting. Symptoms include lips that are either red or white, intermittent pain at the epigastrium, and frequent vomiting of clear saliva. Whether it belongs to Cold or Heat should be differentiated according to Yin and Yang syndromes. For Heat patterns, Hua Chong Wan (Paricide Pill) is the primary formula; for Cold patterns, Jiajian Lizhong Tang (Modified Lizhong Decoction) is the primary formula.
Hua Chong Wan (Paricide Pill)
Meliis Fructus (Wuyi, 芜荑) (5 qian), Dipsaci Radix (Heshi, 鹤虱), Meliae Cortex Radicis (Kulian Genpi, 苦楝根皮), Arsenicum Album (Hufen, 胡粉), Quingren Semen (Shijunzi Rou, 使君子肉), Arecae Semen (Binglang, 槟榔) (each 1 liang), Alum (Kufan, 枯矾) (2.5 qian).
Grind all ingredients into fine powder, form pills with wheat paste, and administer according to the child's age and size.
Jiajian Lizhong Tang (Modified Lizhong Decoction)
Ren Shen (Ginseng Radix et Rhizoma), Gan Jiang (Zingiberis Rhizoma), Bai Zhu (Atractylodis Macrocephalae Rhizoma, stir-fried with soil), Chuanjiao (Sichuan Pepper).
Add one Wumei (Mume Fructus), decoct in water, and take orally.
[Fang Ge - Formula Song]: Jiajian Lizhong Tang treats parasitic vomiting due to Cold. It contains Ren Shen, Gan Jiang, and Bai Zhu. Chuanjiao and Wumei suppress parasite activity. After decoction and administration, peace is restored.
Xu Tu (Deficiency Vomiting): Often arises from weak Stomach Qi. Symptoms include mental fatigue, pulsation of the fontanelle, eyes remaining half-open during sleep (Lou Jing), spontaneous diarrhea without thirst, and frequent vomiting. Dingchen Sijunzi Tang (Dingchen Four Gentlemen Decoction) is most effective.
Dingchen Sijunzi Tang (Dingchen Four Gentlemen Decoction)
Ren Shen (Ginseng Radix et Rhizoma), Bai Zhu (Atractylodis Macrocephalae Rhizoma, stir-fried with soil), Fu Ling (Poria), Zhi Gancao (Prepared Licorice Root), Dingxiang (Caryophylli Flos), Chenxiang (Aquilariae Lignum Resinatum).
Add Wei Jiang (Stir-baked Ginger), decoct in water, and take orally.
[Fang Ge - Formula Song]: For vomiting due to Stomach deficiency with loss of appetite, Dingchen Sijunzi Tang is most suitable. Ren Shen, Bai Zhu, Fu Ling, and Gancao tonify the Stomach; Dingxiang and Chenxiang warm the Spleen.
Xiao'er Shi Tu (Pediatric Excess Vomiting): Characterized by abdominal distension and fullness, difficulty in urination and defecation, epigastric hardness and pain, thirst with a desire for cold drinks, and sour-smelling vomitus. Sanyi Chengqi Tang can achieve success.
[Note] Shi Tu (Excess Vomiting) occurs when a child who is usually robust experiences occasional food stagnation. This leads to chest and abdominal distension, difficult and scanty urination and defecation, epigastric hardness and pain, thirst with a desire for cold beverages, and predominantly sour-smelling vomitus. It is appropriate to use Sanyi Chengqi Tang to purge the accumulation. Once urination and defecation become smooth, vomiting will cease.
Sanyi Chengqi Tang
Mangxiao (Natrii Sulfas), Sheng Dahuang (Rhei Radix et Rhizoma), Zhishi (Aurantii Fructus Immaturus, stir-fried with bran), Gancao (Licorice Root, raw), Houpo (Magnoliae Officinalis Cortex, stir-fried with ginger juice).
Add Shengjiang (Fresh Ginger), decoct in water, and take orally.
[Fang Ge - Formula Song]: Sanyi Chengqi Tang treats excess vomiting, with outstanding efficacy in purging stagnation and unblocking obstruction. Mangxiao paired with Sheng Dahuang, along with Zhishi, Gancao, and Houpo.