巢氏云∶尸疰者,是五尸之中一尸疰也,人无问小大,腹内皆有尸虫,尸虫为
性忌恶,多接引外邪共为患害,小儿血气衰弱者,精神亦羸,故尸疰因而为病,其
状沉嘿,不的知病之处,或寒热淋漓,涉引岁月,遂至于死,死又疰易旁人,故名
之为尸疰也。张涣论小儿亦有疰病,与大人所病无异,久后疰易旁人,传染骨肉,
如尸疰蛊毒之类是也。
《外台·张仲景》治大人小儿飞尸
走马汤方
巴豆(去心皮,熬) 杏仁(去皮尖。各二枚)
上二味,取绵缠,捶令极碎,投热汤二合,捻取白汁服之。须臾瘥,未瘥,更
一服,老小量之。通疗鬼击,有尸疰者,常蓄此药,用验。忌野猪肉芦笋。《备急》同。
《圣惠》木香散 治小儿尸疰,心腹满胀疼痛,不可忍。
木香 鬼箭羽 桔梗(去芦头) 当归(锉,微炒) 紫苏茎叶(各半两) 槟榔(三分)
上件药捣,罗为粗散。每服一钱,以水一小盏,入生姜少许,煎至五分,去滓,
不计时候温服,更量儿大小,加减服之。
犀角散 治小儿尸疰及中恶诸病,皆主之。
犀角(屑) 川升麻 木香 川大黄(锉碎,微炒) 桑根白皮(锉) 槟榔(各半两) 麝香(一钱,细研)
桃仁(二七枚,汤浸,去皮尖双仁,麸炒微黄)
上件药捣,细罗为散。每服以温水调下半钱,日四五服,更量儿大小加减服之。
〔张涣〕雌黄丹 治尸疰病。
雌黄 雄黄(各细研) 川大黄(慢火炮黑) 鬼臼(去毛。各一两) 桃仁(三十个,汤浸去皮尖,研) 白头
翁(半两。以上并为细末,次用)
麝香(一分,另研) 巴豆(十粒,去皮心膜,纸裹,压去油)
上件都研匀,以羊脂五两熔,和诸药成膏。服如黍米大三粒至五粒,荆芥汤
冷下,量儿大小加减。
立效汤
川大黄(炮,锉) 干桃柳叶(洗,焙干。各一两) 栀子仁 赤芍药(各半两) 以上捣罗为细末,次用
朱砂(细研水飞,一两) 麝香(别研) 雄黄(别研。各一分)
上件都拌匀。每服一钱蜜汤调下,量儿大小加减。
巢元方说:尸疰,是五尸中的一种。无论年龄大小,人的腹内都有尸虫。尸虫的特性是厌恶洁净,喜欢招引外邪共同造成危害。小儿血气衰弱,精神也虚弱,所以容易因尸疰而发病。其症状表现为神情沉默,不能明确指出病痛所在,有时出现寒热交替、淋漓不尽的症状,拖延经年累月,最终导致死亡。死后病气又会传染给旁人,所以称为尸疰。张涣论述小儿也有疰病,与成人所患无异,日久后病气会传染给旁人,侵蚀骨肉,如尸疰、蛊毒之类就是这种情况。
《外台秘要》引用张仲景的方子,治疗大人和小孩的飞尸走马汤方:
巴豆(去掉心皮,炒制) 杏仁(去掉皮尖。各两枚)
以上两味药,用绵纸包裹,捶打至极碎,投入热水二合中,揉搓取白色汁液服用。片刻后病愈,若未愈,再服一次,老人小孩酌情减量。此方通治鬼击,有尸疰者常备此药,使用有效。忌食野猪肉和芦笋。《备急千金要方》记载相同。
《太平圣惠方》木香散,治疗小儿尸疰,心腹胀满疼痛,难以忍受。
木香 鬼箭羽 桔梗(去掉芦头) 当归(切碎,微炒) 紫苏茎叶(各半两) 槟榔(三分)
以上药物捣碎,过筛成粗散。每次服用一钱,用水一小盏,加入少许生姜,煎至五分,去渣,不分时候温服,并根据患儿大小调整剂量。
犀角散,治疗小儿尸疰及中恶等诸病,均主治。
犀角(锉屑) 川升麻 木香 川大黄(切碎,微炒) 桑根白皮(切碎) 槟榔(各半两) 麝香(一钱,细研)
桃仁(十四枚,热水浸泡,去皮尖双仁,麸炒微黄)
以上药物捣碎,细罗成散剂。每次用温水调服半钱,每日四到五次,并根据患儿大小调整剂量。
〔张涣〕雌黄丹,治疗尸疰病。
雌黄 雄黄(各细研) 川大黄(慢火煨黑) 鬼臼(去毛。各一两) 桃仁(三十个,热水浸泡去皮尖,研碎) 白头翁(半两。以上均为细末,其次用)
麝香(一分,另研) 巴豆(十粒,去皮心膜,用纸包裹,压榨去油)
以上全部研匀,用羊脂五两熔化,调和诸药成膏。每次服用三至五粒如黍米大小的药丸,用荆芥汤冷服,根据患儿大小调整剂量。
立效汤
川大黄(炮制,切碎) 干桃柳叶(洗净,焙干。各一两) 栀子仁 赤芍药(各半两) 以上捣罗成细末,其次用
朱砂(细研水飞,一两) 麝香(另研) 雄黄(另研。各一分)
以上全部拌匀。每次服用一钱,用蜜汤调下,根据患儿大小调整剂量。
Chao Yuanfang stated: Shizhu (Corpse Transmission) is one of the five types of "Shi" (Corpse) pathogens. Regardless of age, everyone harbors "Shi worms" within their abdomen. The nature of these worms is to abhor purity and attract external pathogenic factors to cause harm together. Children with weak blood and qi also have depleted spirit, making them susceptible to illness caused by Shizhu. Its manifestations include a taciturn demeanor and an inability to pinpoint the exact location of pain; sometimes there are alternating chills and fever with profuse sweating. If left untreated for years, it may lead to death. After death, the pathogenic influence can transmit to others, hence the name Shizhu (Corpse Transmission). Zhang Huan discussed that children also suffer from Zhu diseases, which are no different from those in adults. Over time, the disease transmits to others, infecting bones and flesh, such as in cases of Shizhu and Gu Du (Poisonous Worm Disease).
*Waitai Miyao* cites Zhang Zhongjing's formula for treating Feishi (Flying Corpse) and Zouma (Running Horse) in adults and children:
**Zouma Tang (Running Horse Decoction)**
*Crotonis Fructus (Baidu Dou)* (remove heart and skin, stir-fry); *Semen Armeniacae Amarum (Xingren)* (remove skin and tip. Each: 2 seeds).
Crush the above two ingredients into a fine powder using a silk cloth wrap. Add 2 he of hot water, squeeze out the white juice, and administer orally. The condition should resolve shortly; if not, administer another dose. Dosage should be adjusted according to age and constitution. This formula effectively treats Guiji (Ghost Strike). Those suffering from Shizhu should keep this medicine on hand for verified efficacy. Avoid eating wild boar meat and reeds (*Lusun*). Same record in *Beiji Qianjin Yaofang*.
**Muxiang San (Costus Powder)** from *Taiping Shenghui Fang*, treating pediatric Shizhu characterized by abdominal distension and unbearable pain.
*Muxiang (Aucklandiae Radix)*; *Guijianyu (Cornus Swinhoei Branch)*; *Jiegeng (Platycodonis Radix)* (remove radix head); *Danggui (Angelicae Sinensis Radix)* (cut, slight stir-fry); *Zisu Jingye (Perillae Caulis et Folium)* (each: 0.5 liang); *Binglang (Arecae Semen)* (0.3 fen).
Pulverize the above herbs into a coarse powder. Take 1 qian per dose, decoct with 1 small cup of water and a little fresh ginger until reduced to 0.5 cup. Strain and take warm at any time. Adjust dosage based on the child's size.
**Xijiao San (Rhinoceros Horn Powder)**, treating pediatric Shizhu and various cases of Zhong'e (Sudden Evil Invasion), serving as a primary treatment.
*Xijiao (Rhinocerotis Cornu)* (shave into chips); *Chuan Shengma (Bupleuri Radix)*; *Muxiang (Aucklandiae Radix)*; *Chuan Dahuang (Rhei Radix et Rhizoma)* (cut, slight stir-fry); *Sangbaipipi (Mori Cortex)* (cut); *Binglang (Arecae Semen)* (each: 0.5 liang); *Shexiang (Moschus)* (1 qian, finely ground); *Taoren (Persicae Semen)* (14 seeds, soak in hot water, remove skin and tip, stir-fry with bran until slightly yellow).
Pulverize the above herbs into a fine powder. Mix 0.5 qian with warm water for oral administration, 4-5 times daily. Adjust dosage based on the child's size.
**Cihuang Dan (Realgar Orpiment Pill)** by [Zhang Huan], treating Shizhu disease.
*Cihuang (Orpiment)*; *Xionghuang (Realgar)* (each, finely ground); *Chuan Dahuang (Rhei Radix et Rhizoma)* (slow-fire roasted until black); *Guijiao (Podophylli Fructus)* (remove hairs. Each: 1 liang); *Taoren (Persicae Semen)* (30 seeds, soak in hot water, remove skin and tip, grind); *Baitouweng (Pulsatillae Radix)* (0.5 liang. All above made into fine powder, then use):
*Shexiang (Moschus)* (1 fen, separately ground); *Baidu Dou (Crotonis Fructus)* (10 grains, remove skin, heart, and membrane, wrap in paper, press to remove oil).
Grind all ingredients uniformly. Melt 5 liang of sheep fat and mix with the herbal powders to form a paste. Administer 3 to 5 pills the size of millet seeds. Take with cold *Jingjie* (Schizonepetae Spica) decoction. Adjust dosage based on the child's size.
**Lixiao Tang (Instant Efficacy Decoction)**
*Chuan Dahuang (Rhei Radix et Rhizoma)* (processed, cut); *Gan Taoliuye (Dried Peach and Willow Leaves)* (wash, dry-roast. Each: 1 liang); *Zhizi Ren (Gardeniae Semen)*; *Chishaoyao (Paeoniae Radix Rubra)* (each: 0.5 liang. Above crushed and sifted into fine powder, then use):
*Zhusha (Cinnabar)* (finely ground via water levigation, 1 liang); *Shexiang (Moschus)* (separately ground); *Xionghuang (Realgar)* (separately ground. Each: 1 fen).
Mix all ingredients evenly. Take 1 qian per dose, mixed with honey water. Adjust dosage based on the child's size.