巢氏云∶小儿中恶者,是鬼邪之气卒中于人也。无问大小,若阴阳顺理,荣卫
平调,神守强,则邪不干正,若精气衰弱,则鬼毒恶气中之。其状,先无他病,卒
然心腹刺痛,闷乱欲死是也。凡中恶腹大而满,脉紧大而浮者死,紧细而微者生。
余势不尽,停滞脏腑之间,更发后变为疰也。治法,先下苏合香丸,未醒,以皂
角末搐鼻,次服沉香降气汤加人参、茯苓,又能辟邪,客忤亦宜服。
苏合香丸 治传尸骨蒸,诸项劳瘵,顺气化痰,卒暴心痛,鬼魅疟疾,霍乱吐泻,
赤白下痢,小儿惊搐。
苏合香油(五钱,入安息香膏内) 安息香(一两,另为末,用无灰酒半升,熬膏) 丁香 青木香 白檀
香沉香 荜茇 香附米 诃子(煨,取肉) 乌犀(镑屑) 朱砂(研,水飞。各一两) 薰陆香
片脑(研。各五钱) 麝香(七钱半)
上为细末,用安息香膏入炼蜜和剂,丸如芡实大。空心,用沸汤化下,小儿一
丸,老人四丸,酒下亦可。用蜡纸裹一丸,弹子大,用绯绢袋盛,常带之,一切
邪神不敢近。去脑,名麝香苏合丸,治一切邪神及胸膈噎塞,肠中虚鸣,宿食不
消,余证并同。
沉香降气汤
降真香 沉香 白胶香 虎胫骨(酥炙) 人参 鬼箭 草龙胆(各五钱)
上为末,次入雄黄五钱,麝香一钱,炼蜜丸。乳香汤化下。又,令儿带及烧卧内尤妙。
《葛氏肘后》救卒死,或先病痛,或常居寝卧奄忽而绝,皆是中恶,救之方。
上取葱黄心刺其鼻,男左女右,入七八寸,小儿量度之,若使目中血出佳。扁
鹊法同。是后吹耳条中,葛言,此云刺鼻,故别为一法。
又方 上令二人以衣壅口,吹其两耳,极则易人,可以筒吹之,并捧其肩上,侧身
远之,莫临死人上。
又方 上以葱叶针耳,耳中、鼻中血出者莫怪,无血难治,有血是候,时当捧两
手,忽放之,须臾,死人目当举,手捞人,言痛乃止。又,男刺左鼻,女刺右鼻
中,令入七八寸余,大效,小儿量度之。亦治自缢死,此与扁鹊方同。
又方 上以绵渍好酒中,须臾,置死人鼻中,手按令汁入鼻中,并持其手足,莫令惊。
又方 上视其上唇里弦,有白如黍米大,以针决去之。
又方 上以小便灌其面,数回,即能语,此扁鹊法也。
又方 上末皂荚,如大豆吹其两鼻中,嚏则气通矣。
又方 上割雄鸡颈,取血以涂其面,干复涂,并以灰营死人一周。
又方 以管吹下部,令数人互吹之,气通则活。
《千金》治卒忤方 此病,即今人所谓中恶者,与卒死、鬼击、亦相类,为治皆参取而用之。
上,盐八合,以水三升,煮取一升半,二服,得吐即愈。
《备急方》云∶治鬼击,若小便不通,笔头七枚,烧作灰,末和服之,即通。
《圣惠》桃奴散 治小儿中恶,心腹坚胀疼痛,颜色青黑,大便不通。
桃奴(五枚) 甘草(一分,炙微赤,锉) 麝香(细研,一钱) 杏仁(二十枚,汤浸,去皮尖双仁,麸炒微黄)
桔梗(去芦头) 赤芍药 黄芩 柴胡(去苗) 川升麻 川大黄(锉,微炒) 鬼臼(去毛。各半两)
上件药捣,粗罗为散。每服一钱,以水一小盏,煎至五分,去滓,不计时候温
服,以利为度,量儿大小,心意加减。
《圣惠》鬼箭羽散 治小儿中恶,心坚强卒痛欲困。
鬼箭羽 真珠(末。各一分) 羚羊角(屑) 桔梗(去芦头) 川朴硝 川升麻 赤芍药 柴胡
(去苗) 黄芩(各半两) 桃仁(十枚,汤浸,去皮尖双仁,麸炒微黄) 川大黄(一两,锉,微炒)
上,制,服法同前。
《圣惠》雄黄丸 治小儿中恶心痛,辟除邪气。
雄黄(细研) 真珠(末。各半两) 麝香 牛黄(各细研,一钱) 巴豆(二十粒,去皮膜心,研,纸裹,压出
油)
上件药,都研令匀,入枣瓤及炼蜜和丸,如粟米大。每服以薄荷汤下三丸,量儿大小,加减服之。
《婴孺》鬼箭羽汤 治小儿中恶,心腹坚强,卒痛欲困。
鬼箭羽(三分) 朱砂(一分) 羚羊角(屑) 桔梗 鬼臼 朴硝(汤成下。各半分) 升麻 芍药 柴
胡(各五分) 黄芩(六分) 大黄(八分) 桃仁(四十九个,炒,去皮尖)
上以水四升,煮一升二合,二岁儿为四分,更量儿大小与服之。
《葛氏肘后》灸法 以绳围其死人肘腕,男左女右毕,伸绳,从背上大椎度以下,又
从此灸横行各半绳,此法三灸各三,即起。又,令爪其病患人中取醒,不起者,
卷其手,灸下文头随年壮,又灸鼻中三壮也,又灸颐下宛宛中名承浆穴十壮,大
效。又灸两足大指爪甲聚毛中七壮,此华陀法,一云三七壮。又灸脐中百壮也。
巢元方说:小儿中恶,是鬼邪之气突然侵袭人体所致。无论年龄大小,如果阴阳调和,营卫气血平衡,神气坚固,那么邪气就不能侵犯正气;如果精气衰弱,就会被鬼毒恶气所侵。其症状表现为,起初没有其他疾病,突然感到心腹刺痛,烦闷混乱,几乎要死去。凡是中恶且腹部胀大满闷,脉象紧大而浮的,预后不良(死证);脉象紧细而微弱的,预后良好(生证)。如果病势未尽,停滞在脏腑之间,再次发作后会转变为“疰”病(一种慢性传染性或迁延性病症)。治疗方法,先用苏合香丸通窍开闭,若未苏醒,用皂角末吹入鼻腔取嚏,接着服用沉香降气汤并加入人参、茯苓,此方能辟除邪气,对于客忤(外来的惊吓或邪气)也适宜服用。
苏合香丸:治疗传尸骨蒸(类似肺结核的虚劳病),各种劳瘵病,顺气化痰,突发心痛,鬼魅疟疾,霍乱吐泻,赤白痢疾,小儿惊风抽搐。
配方:苏合香油(五钱,融入安息香膏中)、安息香(一两,另研为末,用无灰酒半升熬成膏)、丁香、青木香、白檀香、沉香、荜茇、香附米、诃子(煨后取肉)、乌犀(镑成屑)、朱砂(研细,水飞法处理,以上各一两)、薰陆香、片脑(冰片,研细,以上各五钱)、麝香(七钱半)。
以上药物研为细末,用安息香膏和炼蜜调和,制成如芡实大小的药丸。空腹时,用沸水化开服下,小儿服一丸,老人服四丸,用酒送服也可以。用蜡纸包裹一丸,如弹子大小,用红色丝绢袋盛装,随身携带,一切邪神不敢靠近。去掉冰片,名为麝香苏合丸,治疗一切邪神作祟及胸膈噎塞,肠中虚鸣,宿食不消,其余证候治疗相同。
沉香降气汤:
配方:降真香、沉香、白胶香、虎胫骨(酥炙)、人参、鬼箭羽、草龙胆(各五钱)。
以上药物研为末,再加入雄黄五钱、麝香一钱,用炼蜜制成丸剂。用乳香汤化开服下。另外,让患儿佩戴或在卧室内焚烧此药,效果更佳。
《葛氏肘后方》救治猝死的方法,或者先有病痛,或者平时起居睡眠中突然断气,都是中恶,以下是急救方法。
上方:取葱的黄心刺入鼻孔,男子左鼻,女子右鼻,深入七八寸,小儿酌情减量,如果能使眼中出血则更好。扁鹊的方法相同。后来在吹耳条中提到,葛洪说这是刺鼻法,所以单独列为一种方法。
又一方:上方让两个人用衣服堵住口鼻,向双耳吹气,极尽力气后换人,可以用管子吹,同时托住患者的肩膀,侧身远离,不要正对着死者头部。
又一方:上方用葱叶针扎耳朵,如果耳中和鼻中出血不要奇怪,不出血难治,出血是好转的征兆,此时应当托住双手,忽然松开,一会儿,死者的眼睛会睁开,手会抓人,说痛了才停止。另外,男子刺左鼻,女子刺右鼻,深入七八寸多,效果显著,小儿酌情减量。也治疗自缢死亡,这与扁鹊的方法相同。
又一方:上方用棉絮浸泡在好酒中,一会儿,放在死者鼻中,用手按压使汁液进入鼻腔,并握住手足,不要让患者受惊。
又一方:上方观察其上唇内侧是否有像黍米大小的白色颗粒,如有,用针挑破去除。
又一方:上方用小便浇灌面部,多次后,患者就能说话,这是扁鹊的方法。
又一方:上方将皂荚研末,如大豆大小,吹入双鼻孔,打喷嚏则气机通畅。
又一方:上方割开公鸡颈部,取血涂抹在患者面部,干了再涂,并用灰烬围在死者周围一圈。
《千金方》治疗卒忤的方法:此病,就是今人所说的中恶,与猝死、鬼击相似,治疗都参考这些方法使用。
上方:盐八合,用水三升,煮取一升半,分两次服用,呕吐后即痊愈。
《备急方》说:治疗鬼击,如果小便不通,取笔头七个,烧成灰,研末调服,小便即通。
《圣惠方》桃奴散:治疗小儿中恶,心腹坚硬胀满疼痛,面色青黑,大便不通。
配方:桃奴(五枚)、甘草(一分,炙至微红,锉碎)、麝香(细研,一钱)、杏仁(二十枚,热水浸泡,去皮尖及双仁,麸炒至微黄)、桔梗(去芦头)、赤芍药、黄芩、柴胡(去苗)、川升麻、川大黄(锉碎,微炒)、鬼臼(去毛,以上各半两)。
以上药物捣碎,粗筛为散。每次服一钱,用水一小盏,煎至五分,去渣,不限时候温服,以腹泻为度,根据患儿大小,酌情加减。
《圣惠方》鬼箭羽散:治疗小儿中恶,心部坚硬突然疼痛欲昏倒。
配方:鬼箭羽、真珠(末,以上各一分)、羚羊角(屑)、桔梗(去芦头)、川朴硝、川升麻、赤芍药、柴胡(去苗)、黄芩(各半两)、桃仁(十枚,热水浸泡,去皮尖及双仁,麸炒至微黄)、川大黄(一两,锉碎,微炒)。
以上药物制备,服法同前。
《圣惠方》雄黄丸:治疗小儿中恶心痛,辟除邪气。
配方:雄黄(细研)、真珠(末,以上各半两)、麝香、牛黄(各细研,一钱)、巴豆(二十粒,去皮膜心,研细,用纸包裹,压榨出油)。
以上药物,都研匀,加入枣瓤及炼蜜和丸,如粟米大小。每次用薄荷汤送下三丸,根据患儿大小,酌情加减服用。
《婴孺书》鬼箭羽汤:治疗小儿中恶,心腹坚硬,突然疼痛欲昏倒。
配方:鬼箭羽(三分)、朱砂(一分)、羚羊角(屑)、桔梗、鬼臼、朴硝(汤成时下,以上各半分)、升麻、芍药、柴胡(各五分)、黄芩(六分)、大黄(八分)、桃仁(四十九个,炒,去皮尖)。
以上用水四升,煮取一升二合,两岁儿童分四次服用,再根据患儿大小调整剂量服用。
《葛氏肘后方》灸法:用绳子围绕死者的手腕,男子左腕,女子右腕,量好后伸直绳子,从背上的大椎穴向下量,再从该点横向各量半根绳子的长度,在此处施灸,这种方法每处灸三次,即可苏醒。另外,用手指掐按患者的人中穴使其苏醒,如果不醒,卷起手臂,灸手腕横纹处随年龄定壮数,再灸鼻中三壮,又灸下巴凹陷处名为承浆穴十壮,效果显著。又灸两足大脚趾甲聚毛处七壮,这是华佗的方法,一说三七壮。又灸脐中一百壮。
Chao Yuanfang stated: Pediatric Zhong'e (Sudden Attack by Evil Qi) is caused by the sudden invasion of ghostly or evil qi into the human body. Regardless of age, if Yin and Yang are harmonious, Ying and Wei (Defensive and Nutritive Qi) are balanced, and Shen (Spirit) is robust, then pathogenic factors cannot invade healthy Qi; however, if Jing (Essence) and Qi are weak, one will be invaded by ghostly toxins and evil qi. The manifestation is characterized by no prior illness, followed suddenly by stabbing pain in the heart and abdomen, severe distress, confusion, and a sensation of impending death. In cases of Zhong'e with abdominal distension and fullness, a pulse that is tight, large, and floating indicates a fatal prognosis; a pulse that is tight, fine, and faint indicates a survivable prognosis. If the pathogenic influence lingers and stagnates within the Zang-Fu organs, subsequent recurrences may transform into Zhu disease (a chronic, infectious, or lingering condition). The treatment method involves first administering Suhe Xiang Wan (Styrax Pill) to open the orifices; if consciousness is not restored, blow powder made from Gengjie (Gleditsia Sinensis Fruit) into the nasal cavity to induce sneezing, followed by oral administration of Chenxiang Jiangqi Tang (Aucklandia Descending Qi Decoction) supplemented with Renshen (Ginseng) and Fuling (Poria), which can also repel evil qi and is suitable for Ke Wu (sudden fright or external evil invasion).
Suhe Xiang Wan (Styrax Pill): Treats Chuanshen Guzheng (consumptive fever resembling tuberculosis), various Laozai diseases (chronic wasting conditions), regulates Qi and resolves phlegm, sudden severe chest pain, malarial fevers attributed to demonic influences, Huoluan (cholera-like syndrome with vomiting and diarrhea), dysentery with red and white discharge, and pediatric convulsions.
Ingredients: Suhe Xiang You (Styrax Oil, 5 qian, incorporated into Anshixiang paste); Anshixiang (Benzoin Resin, 1 liang, separately ground into powder, boiled with half sheng of unadulterated wine into a paste); Dingxiang (Caryophylli Flos); Qingmuxiang (Lithospermi Radix et Rhizoma); Baitanxiang (Santalum Album Lignum); Chenxiang (Aquilariae Lignum Resinatum); Bibo (Long Pepper Fruit); Xiangfumiao (Cyperi Rhizoma); Hezi (Arecae Semen, roasted for flesh extraction); Wuxi (Rhinocerotis Cornu, shaved into flakes); Zhusha (Cinnabaris, finely ground and processed by water flotation) [each 1 liang]; Xunluxiang (Olibanum); Piannao (Borneolum Syntheticum, finely ground) [each 5 qian]; Shexiang (Moschus, 7.5 qian).
Grind all ingredients into a fine powder. Mix with Anshixiang paste and refined honey to form pills the size of Euphorbia seed (Qianshi). Take on an empty stomach, dissolved in boiling water. Children take one pill; elderly take four pills. Taking with wine is also acceptable. Wrap one pill in wax paper, sized like a bullet, and carry it in a crimson silk pouch; all evil spirits dare not approach. Removing Piannao yields Moxiang Suhe Wan (Musk Styrax Pill), treating all evil influences, chest and diaphragm obstruction, intestinal rumbling, undigested food retention, and other similar conditions.
Chenxiang Jiangqi Tang (Aucklandia Descending Qi Decoction):
Ingredients: Jiangzhenxiang (Daemonorops Draco Resina); Chenxiang (Aquilariae Lignum Resinatum); Baijiaoxiang (Agarwood Resin? *Note: Likely refers to a specific resinous wood or frankincense variant, literal translation used*); Hu Jing Gu (Pantheris Os, roasted with butter); Renshen (Ginseng Radix et Rhizoma); Guijianyu (Ardisiae Caulis); Caolongdan (Gentianae Radix) [each 5 qian].
Grind into powder. Add Xionghuang (Realgar, 5 qian) and Shexiang (Moschus, 1 qian). Form pills with refined honey. Dissolve in Ruxiang Tang (Frankincense Decoction) before ingestion. Alternatively, have the child wear the medication or burn it near the sleeping area for optimal effect.
Ge Hong's *Zhouhou Beiji Fang* (Emergency Prescriptions Kept Up One's Sleeve) methods for resuscitation from sudden death, or sudden cessation of life during rest or sleep due to Zhong'e:
Method 1: Pierce the nasal cavity with the yellow core of a scallion (Congbai). For males, use the left nostril; for females, the right. Insert approximately 7-8 cun; adjust for children. Bleeding from the eyes is considered a favorable sign. Bian Que’s method is identical. Later texts refer to this as blowing into the ears, but Ge Hong distinguishes this nasal piercing method.
Method 2: Have two assistants cover the mouth and nose with cloth, then blow air forcefully into both ears, switching persons when exhausted. A tube may be used for blowing. Support the shoulders, position oneself laterally at a distance, and avoid facing the head directly.
Method 3: Pierce the ears with a scallion leaf. Bleeding from the ears and nose is expected; lack of bleeding suggests difficult treatment, while bleeding indicates recovery. Hold both hands, then suddenly release them. The eyes should open, and hands may grasp; cease manipulation upon verbalization of pain. Alternatively, pierce the left nostril for males and right for females, inserting 7-8+ cun. Effective for hanging victims as well, consistent with Bian Que’s method. Adjust dosage/depth for children.
Method 4: Soak cotton in good wine, place in the nostrils, and press gently to allow juice entry. Hold limbs to prevent惊 (fright/spasm).
Method 5: Inspect the inner upper lip for white spots resembling millet grains. Puncture and remove if present.
Method 6: Pour urine over the face repeatedly until speech resumes. This is Bian Que’s method.
Method 7: Grind Gengjie (Gleditsia Sinensis Fruit) into powder the size of soybeans. Blow into both nostrils. Sneezing indicates restoration of Qi flow.
Method 8: Cut the neck of a male rooster, apply blood to the face repeatedly until dry. Surround the body with ash.
Method 9: Use a tube to blow into the lower orifice (anus). Multiple persons may alternate. Restoration of Qi leads to revival.
Qianjin Fang (Prescriptions Worth a Thousand Gold) for Cu Wu (Sudden Violation): This condition corresponds to modern Zhong'e, similar to Sudden Death and Guiji (Ghost Strike). Treatments are integrated.
Method: Boil 8 he of salt in 3 sheng of water until reduced to 1.5 sheng. Divide into two doses. Vomiting indicates cure.
Beiji Fang (Emergency Prescriptions) states: For Guiji (Ghost Strike) with urinary retention, burn 7 pen tips to ash, grind, and administer orally to restore urination.
Shenghui Fang Taonuo San (Peach Slave Powder): Treats pediatric Zhong'e with hard, distended, painful abdomen, cyanotic/black complexion, and constipation.
Ingredients: Taonuo (Dried Peach Fruit, 5 pieces); Gancao (Licorice Root, 1 fen, roasted slightly red, cut); Shexiang (Moschus, 1 qian, finely ground); Xingren (Apricot Seed, 20 pieces, soaked, peeled, split, bran-roasted); Jiegeng (Platycodon Root, de-radicle); Chishao (Red Peony Root); Huangqin (Scutellaria Root); Chaihu (Bupleurum Root, de-radicle); Chuan Shengma (Cimicifugae Rhizoma); Chuan Dahuang (Rhei Radix et Rhizoma, cut, lightly roasted); Guijiu (Podophylli Fructus, de-hair) [each 0.5 liang].
Crush and sieve coarsely. Take 1 qian per dose, decoct in 1 small cup of water until 0.5 cup remains. Strain and take warm at any time. Stop when bowel movement occurs. Adjust based on child’s size and discretion.
Shenghui Fang Guijianyu San (Ardisia Caulis Powder): Treats pediatric Zhong'e with hard heart region, sudden severe pain, and dizziness.
Ingredients: Guijianyu (Ardisiae Caulis); Zhenzhu (Pearl, powdered, each 1 fen); Lingyangjiao (Saiga Tataricae Cornu, shaved); Jiegeng (Platycodon Root, de-radicle); Chuan Puxiao (Natrii Sulfas); Chuan Shengma (Cimicifugae Rhizoma); Chishao (Red Peony Root); Chaihu (Bupleurum Root, de-radicle); Huangqin (Scutellaria Root) [each 0.5 liang]; Taoren (Peach Seed, 10 pieces, soaked, peeled, split, bran-roasted); Chuan Dahuang (Rhei Radix et Rhizoma, 1 liang, cut, lightly roasted).
Preparation and administration same as above.
Shenghui Fang Xionghuang Wan (Realgar Pill): Treats pediatric Zhong'e with heart pain, expelling evil qi.
Ingredients: Xionghuang (Realgar, finely ground); Zhenzhu (Pearl, powdered, each 0.5 liang); Shexiang (Moschus); Niuhuang (Calculus Bovis, finely ground, each 1 qian); Badou (Crotonis Fructus, 20 seeds, peeled, heart removed, ground, wrapped in paper, pressed to remove oil).
Grind uniformly. Mix with date pulp and refined honey to form pills the size of millet seeds. Administer 3 pills per dose with Bohe Tang (Mint Decoction). Adjust based on child’s size.
Yingru Book Guijianyu Tang (Ardisia Caulis Decoction): Treats pediatric Zhong'e with hard heart/abdomen, sudden severe pain, and dizziness.
Ingredients: Guijianyu (Ardisiae Caulis, 3 fen); Zhusha (Cinnabaris, 1 fen); Lingyangjiao (Saiga Tataricae Cornu, shaved); Jiegeng (Platycodon Root); Guijiu (Podophylli Fructus); Puxiao (Natrii Sulfas, add when decoction is ready, each 0.5 fen); Shengma (Cimicifugae Rhizoma); Shaoyao (Paeoniae Radix); Chaihu (Bupleurum Root, each 5 fen); Huangqin (Scutellaria Root, 6 fen); Dahuang (Rhei Radix et Rhizoma, 8 fen); Taoren (Peach Seed, 49 pieces, roasted, peeled, split).
Decoct in 4 sheng of water until 1.2 sheng remains. For a two-year-old, divide into four doses. Adjust according to child’s size.
Ge Hong's *Zhouhou Beiji Fang* Moxibustion Method: Measure the circumference of the wrist with a string (left for males, right for females). Extend the string from the Dazhui (GV14) acupoint down the back. Mark horizontal points half the string length from the center. Moxibustiate these three points, three times each, to revive. Additionally, press the Renzhong (GV26) acupoint. If unresponsive, roll the arm and moxibustiate the Wenrou point (near wrist crease) according to age in moxa cones (Zhuang). Also moxibustiate the nasal tip (3 Zhuang), Chengjiang (CV24) in the chin depression (10 Zhuang), and the junction of hair on the big toenails (7 Zhuang, Hua Tuo’s method, or 3x7 Zhuang). Finally, moxibustiate the umbilicus (100 Zhuang).