《圣惠》夫小儿嗽而呀呷作声者,由胸膈痰多,嗽动于痰上,搏于咽喉之间,痰
与气相击,随嗽动息,呀呷有声。其咳嗽本体虽同,至于治疗则加消痰破饮之药,以此为异尔。
《圣惠》射干散 治小儿咳嗽,心胸痰壅,攻咽喉作呀呷声。
射干 麻黄(去根节) 紫菀(洗去苗土) 桂心(以上各半两) 半夏(半分,汤洗七遍,去滑) 甘草(炙微
赤,锉,一分)
上件药捣,粗罗为散。每服一钱,以水一小盏,入生姜少许,煎至五分,去滓,
入蜜半茶匙,搅令匀,不计时候,量儿大小,分减温服。
陈橘皮散 治小儿咳嗽,咽中作呀呷声。
陈橘皮(汤浸,去白,焙) 桑根白皮(锉) 杏仁(汤浸,去皮尖,麸炒黄) 甘草(炙微赤,锉) 甜葶苈(隔
纸炒令紫色。以上各一分)
上件药捣,粗罗为散,每服一钱,以水一小盏,煎至五分,去滓放温,量儿大小加减服。
萝卜子散 治小儿咳嗽喘急,作呀呷声。
萝卜子(微炒) 麻黄(去根节。各一分) 灯心(一大束) 皂荚子(十枚,煨,去皮) 甘草(炙微赤,锉,
半分)
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,
量儿大小,以意分减温服。
蝉壳散 治小儿心胸痰壅,咳嗽咽喉不利,常作声。
蝉壳(微炒) 半夏(汤洗七遍,去滑) 甘草(炙微赤,锉) 汉防己(各一分) 桔梗(去芦) 陈橘皮(汤
浸,去
白,焙。各半两)
上件药捣,细罗为散。每服以生姜粥饮调下一字,三岁以上,加之半钱。
《圣惠》又方(《太医局方》以此治痰嗽,名辰砂半夏丸)
半夏(汤洗七遍,去滑) 甜葶苈(隔纸炒令紫色) 杏仁(汤浸,去皮尖双仁,麸炒微黄。各一分) 朱砂(细
研,
飞) 五灵脂(各半分)
上件药捣,罗为末,用生姜自然汁煮糊和丸,如绿豆大。每服煎麻黄汤下三丸,
日三服,量儿大小以意加减。
〔张涣〕桔梗汤 治小儿咳嗽呀呷,咽膈不利。
桔梗 半夏(泡七次) 紫苏叶(炒) 石膏 甘草(炙。各半两) 皂荚(烧灰存性,一分)
上件捣,罗为细末,每服一钱,水一盏,入生姜三片,煎五分,放温,时时与儿服。
《圣惠方》论述:小儿咳嗽时发出呀呷(形容痰鸣声)的声音,是因为胸膈间痰液过多,咳嗽时带动痰液上行,阻滞于咽喉之间,痰与气相互搏击,随着咳嗽的动作和气息的起伏,从而发出呀呷之声。虽然其咳嗽的根本病机相同,但在治疗上则需增加消除痰饮、破除水饮的药物,以此作为区别。
《圣惠方》射干散:治疗小儿咳嗽,心胸部位痰浊壅盛,攻冲咽喉导致发出呀呷声。
药材:射干、麻黄(去除根部和节)、紫菀(清洗去除苗叶和泥土)、桂心(以上各半两)、半夏(半分,用热水清洗七遍,去除滑腻感)、甘草(炙至微红,切碎,一分)。
制法与用法:将上述药物捣碎,粗筛为散剂。每次服用一钱,用水一小盏,加入少许生姜,煎煮至剩余五分药液,滤去药渣,加入半茶匙蜂蜜,搅拌均匀,不限时间,根据患儿年龄大小,分次减量温服。
陈橘皮散:治疗小儿咳嗽,咽喉中发出呀呷声。
药材:陈橘皮(热水浸泡,去除白色内皮,焙干)、桑根白皮(切碎)、杏仁(热水浸泡,去除皮尖,用麦麸炒至黄色)、甘草(炙至微红,切碎)、甜葶苈(隔纸炒至紫色。以上各一分)。
制法与用法:将上述药物捣碎,粗筛为散剂。每次服用一钱,用水一小盏,煎煮至剩余五分药液,滤去药渣放温,根据患儿年龄大小调整剂量服用。
萝卜子散:治疗小儿咳嗽气喘急促,发出呀呷声。
药材:萝卜子(轻微炒制)、麻黄(去除根部和节。各一分)、灯心草(一大束)、皂荚子(十枚,煨制,去皮)、甘草(炙至微红,切碎,半分)。
制法与用法:将上述药物捣碎,粗筛为散剂。每次服用一钱,用水一小盏,煎煮至剩余五分药液,滤去药渣,不限时间,根据患儿年龄大小,酌情分次减量温服。
蝉壳散:治疗小儿心胸痰浊壅盛,咳嗽咽喉不利,经常发出声音。
药材:蝉壳(轻微炒制)、半夏(热水清洗七遍,去除滑腻感)、甘草(炙至微红,切碎)、汉防己(各一分)、桔梗(去除芦头)、陈橘皮(热水浸泡,去除白色内皮,焙干。各半两)。
制法与用法:将上述药物捣碎,细筛为散剂。每次服用时,用生姜粥饮调服一字量,三岁以上儿童,增加半钱量。
《圣惠方》又一方(《太医局方》将此方用于治疗痰嗽,名为辰砂半夏丸):
药材:半夏(热水清洗七遍,去除滑腻感)、甜葶苈(隔纸炒至紫色)、杏仁(热水浸泡,去除皮尖及双仁,用麦麸炒至微黄。各一分)、朱砂(细研,飞制)、五灵脂(各半分)。
制法与用法:将上述药物捣碎,过筛为粉末,用生姜自然汁煮糊调和制成丸药,大小如绿豆。每次服用三丸,用麻黄汤煎送下,每日三次,根据患儿年龄大小酌情加减。
〔张涣〕桔梗汤:治疗小儿咳嗽呀呷,咽膈部位不利。
药材:桔梗、半夏(泡七次)、紫苏叶(炒制)、石膏、甘草(炙。各半两)、皂荚(烧成灰但保留药性,一分)。
制法与用法:将上述药物捣碎,过筛为细末。每次服用一钱,用水一盏,加入生姜三片,煎煮至五分,放温,不时给患儿服用。
According to the *Shenghui Fang* (Sanitary Formulas of the Holy Era): When a child coughs and produces a rattling sound (ya-xia, describing the sound of phlegm), it is due to excessive phlegm in the chest and diaphragm. The coughing action drives the phlegm upward, where it obstructs between the throat and the larynx. The phlegm and Qi strike against each other, and with the movement of coughing and the rhythm of breathing, the ya-xia sound is produced. Although the fundamental nature of the cough is the same, treatment differs by adding herbs that eliminate phlegm and break down fluid retention.
**Shéyān San (Belamcanda Powder)** from *Shenghui Fang*: Treats pediatric cough, with phlegm turbidity congested in the heart and chest, attacking the throat and causing a ya-xia sound.
Ingredients: *Shegan* (Belamcandae Rhizoma), *Mahuang* (Ephedrae Herba, roots and nodes removed), *Ziwan* (Asteris Radix et Rhizoma, washed to remove seedlings and soil), *Guixin* (Cinnamomi Cortex, half tael each); *Banxia* (Pinelliae Rhizoma, 0.5 fen, boiled seven times to remove slipperiness); *Gancao* (Glycyrrhizae Radix et Rhizoma, roasted until slightly red, cut into pieces, 1 fen).
Preparation and Administration: Pound the above ingredients and sieve coarsely to make a powder. Take 1 qian per dose, add to one small cup of water with a little fresh ginger, decoct until reduced to 0.5 cup. Strain the dregs, add half a tea spoon of honey, and stir well. Administer warm, at any time, adjusting the amount according to the child's age and size.
**Chénjúpí San (Aged Tangerine Peel Powder)**: Treats pediatric cough with a ya-xia sound in the throat.
Ingredients: *Chénjúpí* (Citri Reticulatae Pericarpium, soaked in hot water, white pith removed, dried), *Sanggénbáipí* (Mori Cortex, cut), *Xìngrén* (Armeniacae Semen Amarum, soaked in hot water, skin and tips removed, stir-fried with bran until yellow), *Gancao* (Glycyrrhizae Radix et Rhizoma, roasted until slightly red, cut), *Tiántínglì* (Descurainiae Semen seu Lepidii Semen, fried between papers until purple; all above 1 fen each).
Preparation and Administration: Pound the above ingredients and sieve coarsely to make a powder. Take 1 qian per dose, add to one small cup of water, decoct until reduced to 0.5 cup. Strain, let cool to warm, and adjust dosage according to the child's age.
**Luóbózǐ San (Radish Seed Powder)**: Treats pediatric cough with panting and urgency, producing a ya-xia sound.
Ingredients: *Luóbózǐ* (Raphani Semen, lightly stir-fried), *Mahuang* (Ephedrae Herba, roots and nodes removed; 1 fen each), *Dēngxīn* (Junci Medulla, one large bundle), *Zàojiáo* (Gleditsiae Fructus Spina, ten pods, baked, skin removed), *Gancao* (Glycyrrhizae Radix et Rhizoma, roasted until slightly red, cut, 0.5 fen).
Preparation and Administration: Pound the above ingredients and sieve coarsely to make a powder. Take 1 qian per dose, add to one small cup of water, decoct until reduced to 0.5 cup. Strain, administer warm at any time, adjusting the amount based on the child's age and discretion.
**Chánké San (Cicada Slough Powder)**: Treats pediatric phlegm congestion in the heart and chest, cough with throat obstruction, and frequent sounds.
Ingredients: *Chánké* (Cicadae Periostracum, lightly stir-fried), *Banxia* (Pinelliae Rhizoma, boiled seven times to remove slipperiness), *Gancao* (Glycyrrhizae Radix et Rhizoma, roasted until slightly red, cut), *Hàn Fángjǐ* (Stephaniae Tetrandrae Radix; 1 fen each), *Jiégtěng* (Platycodonis Radix, radix removed), *Chénjúpí* (Citri Reticulatae Pericarpium, soaked in hot water, white pith removed, dried; half tael each).
Preparation and Administration: Pound the above ingredients and sieve finely to make a powder. Take one "zi" measure mixed with fresh ginger porridge drink. For children over three years old, increase by half a qian.
**Another Formula from *Shenghui Fang*** (Known as *Chensha Banxia Wan* / Cinnabar Pinellia Pill in *Taiyi Ju Fang* for treating phlegm-cough):
Ingredients: *Banxia* (Pinelliae Rhizoma, boiled seven times to remove slipperiness), *Tiántínglì* (Descurainiae Semen seu Lepidii Semen, fried between papers until purple), *Xìngrén* (Armeniacae Semen Amarum, soaked in hot water, skin and tips and twin kernels removed, stir-fried with bran until slightly yellow; 1 fen each), *Zhūshā* (Cinnabaris, finely ground and purified), *Wǔlíngzhī* (Trogopterori Faeces; 0.5 fen each).
Preparation and Administration: Pound the above ingredients and sieve into powder. Use natural juice of fresh ginger to cook into a paste and form pills the size of mung beans. Take three pills per dose, washed down with *Mahuang Tang* (Ephedra Decoction), three times a day, adjusting according to the child's age and discretion.
*[Zhang Huan]* **Jiégtěng Tāng (Platycodon Decoction)**: Treats pediatric cough with ya-xia sound and obstruction in the throat and diaphragm.
Ingredients: *Jiégtěng* (Platycodonis Radix), *Banxia* (Pinelliae Rhizoma, soaked seven times), *Zǐsūyè* (Perillae Folium, stir-fried), *Shígāo* (Gypsum Fibrosum), *Gancao* (Glycyrrhizae Radix et Rhizoma, roasted; half tael each), *Zàojiào* (Gleditsiae Fructus Spina, burned to ash but retaining efficacy, 1 fen).
Preparation and Administration: Pound the above ingredients and sieve into fine powder. Take 1 qian per dose, add to one cup of water with three slices of fresh ginger, decoct until reduced to 0.5 cup. Let cool to warm, and administer frequently to the child.