茅先生伤寒失音语不得方
金毛狗脊 甘草(等分)
上为末。每服一钱,用黄蜡一块,指头大,水六分,同煎四分服。
《集验方》治小儿伤寒失音不能语
桂(指面大)
上,含桂口中,渐渐声音如旧。
张涣按∶小儿肺气通于鼻,气为阳,若气受风寒,停滞鼻间则成鼻塞,气寒使
津液不收则多涕,若冷气久不散,脓涕结聚,使鼻不闻香臭则成 鼻,若挟热则鼻
干,皆妨害乳食。〔薛〕巢氏云∶鼻乃肺之窍,皮毛腠理乃肺之主,此因风邪客于
肺而鼻塞不利者,宜用消风散。或用葱白七茎,入油腻粉少许,擂摊绢帛上,掌中
护温,贴囟门。因惊仆气散,血无所羁而鼻衄者,用异功散加柴胡、山栀。左脸青
而兼赤者,先用柴胡清肝散,后用地黄丸。上脸赤,乃肺大肠实热也,用泻白散。
鼻色赤,乃脾胃实热也,用泻黄散。微赤,乃脾经虚热也,用异功散加升麻、柴胡。
色深黄,用《济生》犀角地黄汤,后用杨氏地黄散。淡白色,用六君子汤。颏间色
赤,用四物汤加山栀;赤甚,用五淋散。小便赤色,用六味丸、补中益气汤。唇色白,
用六君子汤。久不愈用麦门冬饮子。若初病元气未亏,乳食如常,发热壮热,二便
秘结,作渴饮水,卧不露睛者,悉属形病俱实,当治邪气。若病久元气已亏,食少
发热,口干饮汤,呕吐泄泻,肢体畏寒,卧而露睛者,悉属形病俱虚,当补正气为要。
茅先生治疗伤寒导致失音、无法说话的方子:
金毛狗脊和甘草(各取等量)
将上述药材研磨成粉末。每次服用一钱,取一块如手指头大小的黄蜡,加入六分水,与药粉一同煎煮至剩余四分水时服用。
《集验方》治疗小儿伤寒失音、不能说话的方法:
桂枝(大小如硬币面)
将桂枝含在口中,声音会逐渐恢复如旧。
张涣按语:小儿的肺气与鼻相通,气属于阳,如果气受到风寒侵袭,停滞在鼻间就会形成鼻塞;寒气使津液无法收摄就会导致多涕;如果冷气久久不散,脓性鼻涕积聚,导致鼻子闻不到香味和臭味,就形成了“鼻渊”(注:原文此处可能有缺字或通假,结合上下文指鼻病);如果夹杂热邪则会导致鼻干,这些情况都会妨害吃奶和进食。〔薛〕巢氏说:鼻是肺的窍道,皮毛腠理是肺的主管部分,这是因为风邪客居于肺而导致鼻塞不利的,适宜使用消风散。或者用葱白七根,加入少许油腻面粉,研磨后摊在绢帛上,用手掌护温,贴在囟门上。因为惊吓跌倒导致气散,血液失去约束而流鼻血的,使用异功散加柴胡、山栀。左脸发青且兼有红色的,先用柴胡清肝散,后用六味地黄丸。上脸部发红,是肺和大肠实热的表现,使用泻白散。鼻子颜色发红,是脾胃实热的表现,使用泻黄散。颜色微红,是脾经虚热的表现,使用异功散加升麻、柴胡。颜色深黄,使用《济生方》中的犀角地黄汤,之后用杨氏地黄散。颜色淡白,使用六君子汤。下巴间颜色发红,使用四物汤加山栀;红色严重,使用五淋散。小便颜色赤红,使用六味丸、补中益气汤。嘴唇颜色白,使用六君子汤。久治不愈的用麦门冬饮子。如果初病时元气未亏损,吃奶进食如常,发热或高热,二便秘结,口渴想喝水,睡觉时眼睛不露出的,都属于形质和病邪都实的证候,应当治疗邪气。如果生病日久元气已亏损,吃得少且发热,口干想喝热水,呕吐泄泻,肢体畏寒,睡觉时眼睛露出的,都属于形质和病邪都虚的证候,应当以补益正气为关键。
Mao Xiansheng’s Prescription for Loss of Voice Due to Cold Damage, Inability to Speak:
*Glehniae Radix* (Guizhi, 狗脊) and *Glycyrrhizae Radix et Rhizoma* (Gancao, 甘草) in equal parts.
Pulverize the above ingredients. Take one qian per dose. Boil a piece of yellow beeswax (size of a fingertip) with six parts water until reduced to four parts, then administer the decoction.
*Jiyan Fang* (Collection of Proven Prescriptions) Treatment for Pediatric Cold Damage with Loss of Voice and Inability to Speak:
*Cinnamomi Ramulus* (Guizhi, 桂), size resembling the face of a coin.
Hold the cinnamon twig in the mouth; gradually, the voice will return to normal.
Zhang Huan’s Commentary: The lung qi of children connects with the nose. Qi belongs to Yang. If Qi is affected by wind-cold and stagnates in the nasal cavity, it results in nasal congestion. Coldness prevents the retention of body fluids, leading to excessive rhinorrhea. If cold qi lingers for a long time, purulent nasal discharge accumulates, causing anosmia (loss of smell), resulting in nasal disease. If accompanied by heat, it causes dryness of the nose. All these conditions interfere with suckling and eating. [Xue] Chao Shi stated: The nose is the orifice of the Lung, and the skin, hair, and interstices are governed by the Lung. Nasal congestion due to wind-pathogen lodging in the Lung should be treated with Xiaofeng San (Wind-Expelling Powder). Alternatively, use seven stalks of scallion white mixed with a small amount of greasy flour, ground and spread on silk fabric. Warm it in the palm and apply it to the fontanelle. For epistaxis caused by fright or falling, leading to scattered Qi and uncontrolled blood flow, use Yigong San (Extraordinary Efficacy Powder) added with Bupleuri Radix (Chaihu, 柴胡) and Gardeniae Fructus (Shanzhi, 山栀). If the left cheek is blue-green and reddish, first use Chaihu Qinggan San (Bupleurum Liver-Clearing Powder), followed by Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill). Redness on the upper face indicates excess heat in the Lung and Large Intestine; treat with Xiebai San (Drain White Powder). Redness of the nose indicates excess heat in the Spleen and Stomach; treat with Xiehuang San (Drain Yellow Powder). Slight redness indicates deficiency heat in the Spleen channel; treat with Yigong San added with Cimicifugae Rhizoma (Shengma, 升麻) and Bupleuri Radix (Chaihu, 柴胡). Deep yellow color indicates treatment with Xijiao Dihuang Tang (Rhinoceros Horn and Rehmannia Decoction) from *Jisheng Fang*, followed by Yangshi Dihuang San (Yang’s Rehmannia Powder). Pale white color indicates use of Liujunzi Tang (Six-Gentlemen Decoction). Redness between the chin indicates use of Siwu Tang (Four-Agent Decoction) added with Gardeniae Fructus (Shanzhi, 山栀); if very red, use Wulin San (Five-Dampness Powder). Red urine indicates use of Liuwei Wan (Six-Ingredient Pill) and Buzhong Yiqi Tang (Middle-Warming and Qi-Supplementing Decoction). White lips indicate use of Liujunzi Tang (Six-Gentlemen Decoction). For chronic cases not healing, use Maidong Yinzi (Ophiopogon Drink). If at the onset of illness, Yuan Qi (Original Qi) is not depleted, suckling and eating are normal, fever or high fever is present, bowel movements and urination are constipated, thirst with desire to drink water exists, and eyes do not protrude during sleep, all belong to patterns where both form and pathogen are excess; treat by expelling the pathogen. If the illness has lasted long, Yuan Qi is depleted, food intake is low with fever, mouth is dry with desire for warm drinks, vomiting and diarrhea occur, limbs feel cold, and eyes protrude during sleep, all belong to patterns where both form and pathogen are deficiency; tonifying Zheng Qi (Upright Qi) is essential.