汉东王先生论小儿发热形瘦多渴,吃食不长肌肉者,谓之疳热。汤氏云∶疳热
当服进食丸(方见癖)磨积,仍间服化虫丸,后服鳖甲散退热,次服肥儿丸(疳瘦)。
汤氏鳖甲散 治疳劳骨热。
鳖甲(九肋者,汤浸,用童便涂炙) 黄 (蜜炙) 白芍药(各一两) 生熟地黄 地骨皮 当归 人
参(去芦。各半两)
上 咀。每服二钱,水半盏煎服。
化虫丸 治疳热。
白芜荑 黄连 神曲 麦芽(各炒,等分)
上末,糊丸如黍米大。空心米饮下。猪胆汁尤佳。
猪肚丸 治骨蒸疳劳,肌体黄瘦。
木香(半两) 黄连 生地黄 鳖甲(九肋者,汤浸,用童便涂炙) 银柴胡(去芦) 青皮(各一两)
上为末,猪肚一枚,入药于内,以线缠之,于砂罐内悬胎煮熟,取出细研,猪
肚为丸,如麻子大。米饮送下,量大小加减,不拘时服。
龙胆丸(三因) 治疳病发热。
龙胆草 黄连 使君子肉 青皮(各等分)
上为末,猪胆汁和丸,如桐子大。每服三十丸,临卧熟水下,量儿加减。
〔世〕乌犀丸 治小儿疳热,腹内生虫,肚大手足疲弱,丁奚 羸。(此方治疳热如神。)
黑牵牛(二两) 使君子(肉,七钱半) 青皮(二两) 雷丸(二钱半) 苦楝皮(一方不用楝皮,用芦荟二钱
半)
鹤虱(各半两)
上,同入锅内炒焦,为末,面糊丸黍米大。三岁儿二十丸,米饮下,食前。
二丁丸 治乳癖、食癖、疳热。
白丁香(半两) 丁香 密陀僧(各一两) 韶粉(一钱) 硫黄(三钱)
上为细末,糊丸如小豆大。三岁儿十丸,日晡时米饮下,饮乳者乳汁下。次日
当取下恶物,热即随退,加黄莺屎一钱,尤妙。
《谭氏殊圣》金瓜丸 治小儿疳热,身多壮热,黄瘦。久服令肥。
黄连 黄柏 甘草(微炮) 青皮(各等分)
上为末,入麝香少许,用 猪胆一枚,入药胆内,线扎定,入石器中,浆水煮
五七沸取出,风吊一宿,丸如绿豆大。每服五七丸,米饮下,量儿加减。《玉诀》
方同,外以朱砂为衣,仍治脾疳。《博济方》同,《刘氏家传方》亦同,云∶或添
胡黄连,若早晨服使君子丸,晚服金瓜丸,永无疾,消食长肌肉。《庄氏家传方》
同,仍加夜明砂一味,等分。《赵氏方》亦同,名凉疳药,长沙朱司理以为有神效。
芦荟丸 治小儿惊热疳不思食。
芦荟 熊胆 朱砂(各二钱半) 青黛(七钱半) 诃梨勒(煨取肉,三钱) 麝香(一钱)
上为末,糯米饭为丸,如麻子大。空心随岁数与之,用沙糖水咽下五、七丸。
〔茅先生〕柴胡散 治小儿疳热,四肢如柴,不能起止。
柴胡 知母 贝母(去心) 茯苓 茯神 干葛 甘草(炙。各等分)
上为末,每服用小麦一匙头,药一匙头,水一盏,同煎六分。去滓服。
六物黄芩汤 治少小腹大短气,热有进退,食不安谷,为之不化。
黄芩 大青 甘草(炙) 麦门冬(去心) 石膏(碎。各半两) 桂皮(三钱)
上每服三钱,水一盏,煎至七分。去滓温服。
〔庄氏〕青黛丸 治疳热。
青黛(研,一两) 胡黄连 宣连 天竺黄(研。各半两) 朱砂(水飞,二钱半) 麝香(研,一钱) 肉
豆蔻(二个) 牛黄(半钱,研) 干蟾(一枚,端午日取者,酒浸,洗去肠肚,涂酥炙黄)
上件,除研药外,为末再同研匀,绿豆粉煮糊、丸如芥子大。每服空心、夜后,
熟水下三丸。恐绿豆粉难和丸,绿豆面作糊亦得。
〔王氏〕使君子散 治疳热。
上用使君子不以,多少曝干,为末。空心米饮下。大者一钱,小者半钱,取虫出为度。
猪肚黄连丸(直指) 治疳热流注,遍身疮蚀,或潮热肚胀,或渴。
用雄猪肚(净洗,一具) 宣连(净五两) 锉细,水和润,纳肚中,线缝,放五升粳米上
蒸至烂,入臼中,加少蒸饭,捣千杵,丸小桐子大。每服二十丸,米饮下。仍服
调血清心之剂佐之。(凡儿病,不出于疳,则出于热,热则生痰,常须识此。)
柴胡饮 治骨蒸疳气,五心烦热,日晡转盛,口干无味,渴多身瘦,胸满痰紧,小
便黄色,食减神昏。
北柴胡(去芦,净洗) 人参(去芦) 当归(酒洗) 黄芩 赤芍药 甘草(炙。各一两) 大黄(生用) 桔
梗(去芦,锉,炒) 北五味子(去梗) 半夏(汤煮透,去滑。各半两)
上锉,每服二钱,水一盏,乌梅一亚,姜二片,煎七分。无时温服。
汉东王先生论述小儿发热、形体消瘦、多饮口渴、进食后不长肌肉的情况,称之为疳热(由疳积引起的虚热)。汤氏说:治疗疳热应当服用进食丸(方剂见癖积章节)以磨消积滞,同时间歇服用化虫丸驱虫,之后服用鳖甲散退热,接着服用肥儿丸(治疗疳积消瘦)。
汤氏鳖甲散 治疗疳劳骨蒸热。
鳖甲(选用九肋的,用开水浸泡,用童子尿涂抹后炙烤) 黄耆(用蜂蜜炙烤) 白芍药(各一两) 生地黄和熟地黄 地骨皮 当归 人参(去除芦头。各半两)
以上药物切碎。每次服用二钱,加水半盏煎煮后服用。
化虫丸 治疗疳热。
白芜荑 黄连 神曲 麦芽(各炒制,等量)
以上研为细末,用糊状物制成如黍米大小的丸药。空腹时用米汤送服。用猪胆汁送服效果更佳。
猪肚丸 治疗骨蒸疳劳,身体发黄消瘦。
木香(半两) 黄连 生地黄 鳖甲(九肋的,用开水浸泡,用童子尿涂抹后炙烤) 银柴胡(去除芦头) 青皮(各一两)
以上研为细末,取一个猪肚,将药物放入其中,用线缠绕封口,在砂罐内悬吊煮熟,取出后细细研磨,以猪肚肉为粘合剂制成如麻子大小的丸药。用米汤送服,根据患儿年龄大小调整剂量,不拘泥于固定时间服用。
龙胆丸(出自《三因极一病证方论》) 治疗疳病发热。
龙胆草 黄连 使君子肉 青皮(各等量)
以上研为细末,用猪胆汁调和制成如桐子大小的丸药。每次服用三十丸,睡前用温水送服,根据患儿情况调整剂量。
〔世〕乌犀丸 治疗小儿疳热,腹内生虫,腹部胀大,手足疲弱,丁奚疳(一种严重的疳积病,形容四肢枯瘦而腹部胀大)、羸瘦(极度消瘦)。(此方治疗疳热效果神奇。)
黑牵牛(二两) 使君子(肉,七钱半) 青皮(二两) 雷丸(二钱半) 苦楝皮(另一版本不用楝皮,改用芦荟二钱半)
鹤虱(各半两)
以上一同放入锅内炒至焦黄,研为细末,用面糊制成如黍米大小的丸药。三岁儿童服用二十丸,饭前用米汤送服。
二丁丸 治疗乳癖、食癖、疳热。
白丁香 丁香 密陀僧(各一两) 韶粉(一钱) 硫黄(三钱)
以上研为细末,用糊状物制成如小豆大小的丸药。三岁儿童服用十丸,傍晚时分用米汤送服,喝奶的婴儿用乳汁送服。次日应当排出恶浊之物,热邪随即消退,若加入一钱黄莺屎,效果尤其奇妙。
《谭氏殊圣》金瓜丸 治疗小儿疳热,身体多有壮热,发黄消瘦。长期服用可使身体丰肥。
黄连 黄柏 甘草(微炒) 青皮(各等量)
以上研为细末,加入少许麝香,取一个猪胆,将药物装入胆内,用线扎紧,放入石器中,用米浆水煮五到七沸后取出,悬挂风干一夜,制成如绿豆大小的丸药。每次服用五到七丸,用米汤送服,根据患儿情况调整剂量。《玉诀》中的方剂相同,外用朱砂为衣,同时治疗脾疳。《博济方》相同,《刘氏家传方》也相同,说:或者添加胡黄连,如果早晨服用使君子丸,晚上服用金瓜丸,可永无疾病,帮助消化并增长肌肉。《庄氏家传方》相同,仍加一味夜明砂,等量使用。《赵氏方》也相同,名为凉疳药,长沙朱司理认为有神奇疗效。
芦荟丸 治疗小儿惊热疳积、不思饮食。
芦荟 熊胆 朱砂(各二钱半) 青黛(七钱半) 诃梨勒(煨制后取肉,三钱) 麝香(一钱)
以上研为细末,用糯米饭制成如麻子大小的丸药。空腹时根据年龄给予,用沙糖水吞服五到七丸。
〔茅先生〕柴胡散 治疗小儿疳热,四肢枯瘦如柴,不能站立行走。
柴胡 知母 贝母(去心) 茯苓 茯神 干葛 甘草(炙。各等量)
以上研为细末,每次服用时取小麦一匙头,药末一匙头,加水一盏,共同煎煮至六分。过滤去渣后服用。
六物黄芩汤 治疗少腹部胀大、气短,热势时有进退,饮食不安、谷物不化。
黄芩 大青 甘草(炙) 麦门冬(去心) 石膏(捣碎。各半两) 桂皮(三钱)
以上每次服用三钱,加水一盏,煎煮至七分。过滤去渣后温服。
〔庄氏〕青黛丸 治疗疳热。
青黛(研磨,一两) 胡黄连 宣连(安徽产的黄连) 天竺黄(研磨。各半两) 朱砂(水飞法处理,二钱半) 麝香(研磨,一钱) 肉豆蔻(二个) 牛黄(半钱,研磨) 干蟾(一枚,端午节采集的,用酒浸泡,洗净肠肚,涂酥油炙烤至黄色)
以上药材,除已研磨的药外,其余研为细末再共同研磨均匀,用绿豆粉煮成的糊状物制作,制成如芥菜籽大小的丸药。每次空腹、夜间,用温水送服三丸。担心绿豆粉难以和丸,用绿豆面作糊也可以。
〔王氏〕使君子散 治疗疳热。
以上使用使君子,不论多少,晒干后研为细末。空腹用米汤送服。成人用量一钱,小儿用量半钱,以排出虫体为度。
猪肚黄连丸(出自《直指方》) 治疗疳热流注,遍身疮疡溃烂,或潮热腹胀,或口渴。
使用雄猪肚(洗净,一个) 宣连(净重五两) 锉碎,用水湿润,纳入肚中,用线缝合,放在五升粳米上蒸至烂熟,放入臼中,加入少量蒸饭,捣一千杵,制成如小桐子大小的丸药。每次服用二十丸,用米汤送服。同时服用调理血清心的药剂辅助治疗。(凡是小儿生病,不是疳积就是热证,热则生痰,必须认识这一点。)
柴胡饮 治疗骨蒸疳气,五心烦热,傍晚加重,口干无味,口渴身体消瘦,胸满痰紧,小便黄色,食欲减退精神昏沉。
北柴胡(去芦头,洗净) 人参(去芦头) 当归(酒洗) 黄芩 赤芍药 甘草(炙。各一两) 大黄(生用) 桔梗(去芦头,锉碎,炒制) 北五味子(去梗) 半夏(开水煮透,去滑腻。各半两)
以上切碎,每次服用二钱,加水一盏,乌梅半个,生姜两片,煎煮至七分。随时温服。
Mr. Wang of Handong discusses the condition in children characterized by fever, emaciation, excessive thirst, and failure to gain muscle mass despite eating, which is termed Gan Re (Gan heat). Mr. Tang states: For Gan Re, one should administer Jin Shi Wan (Digestion-Enhancing Pill; formula see Pi) to grind away accumulation, intermittently take Hua Chong Wan (Worm-Dissolving Pill), subsequently use Biejia San (Turtle Shell Powder) to reduce fever, and then take Fei Er Wan (Flesh-Nourishing Pill; for Gan emaciation).
Biejia San by Mr. Tang treats Gan Lao bone-steaming heat.
Bie Jia (Tartaric Turtle Shell, specifically nine-ribbed variety, soaked in boiling water, brushed with child's urine, and roasted) Huang Qi (Astragali Radix, honey-roasted) Bai Shao Yao (White Peony Root, each 1 liang) Sheng Di Huang (Rehmanniae Radix, raw) and Shu Di Huang (Rehmanniae Radix, prepared) Di Gu Pi (Lycii Cortex) Dang Gui (Angelicae Sinensis Radix) Ren Shen (Ginseng Radix et Rhizoma, radix removed, each 0.5 liang)
The above are coarsely chopped. Take 2 qian per dose, decoct in half zhan of water, and drink.
Hua Chong Wan treats Gan Re.
Bai Wu Yi (Alpiniae Katsumadai Semen) Huang Lian (Coptidis Rhizoma) Shen Qu (Massae Fermentatae Medicamentosa) Mai Ya (Hordei Fructus Germinatus, each stir-fried, equal parts)
Grind into fine powder, make pills with paste the size of millet seeds. Take on an empty stomach with rice water. Taking with pig bile is especially good.
Zhu Du Wan treats bone-steaming Gan Lao and yellowish, emaciated body.
Mu Xiang (Aucklandiae Radix, 0.5 liang) Huang Lian (Coptidis Rhizoma) Sheng Di Huang (Rehmanniae Radix, raw) Bie Jia (Tartaric Turtle Shell, nine-ribbed, soaked in boiling water, brushed with child's urine, and roasted) Yin Chai Hu (Stellariae Radix, radix removed) Qing Pi (Citri Reticulatae Pericarpium Viride, each 1 liang)
Grind into powder. Take one pig stomach, place the medicine inside, tie securely with thread, suspend in a clay pot, and boil until tender. Remove and finely grind. Use the pig stomach meat as a binder to make pills the size of hemp seeds. Take with rice water, adjusting dosage according to age. Take at any time.
Long Dan Wan (from *San Yin Fang*) treats Gan disease fever.
Long Dan Cao (Gentianae Radix) Huang Lian (Coptidis Rhizoma) Shi Jun Zi Rou (Quisqualis Semen, flesh only) Qing Pi (Citri Reticulatae Pericarpium Viride, equal parts)
Grind into powder, mix with pig bile to make pills the size of paulownia seeds. Take 30 pills per dose before sleep with warm water, adjusting dosage according to the child.
[Shi] Wu Xi Wan treats pediatric Gan Re, intestinal parasites, abdominal distension, weak limbs, Ding Xi (a severe form of gan characterized by a distended abdomen and emaciated limbs), and Lei (emaciation). (This formula is miraculous for Gan Re.)
Hei Qian Niu (Pharbitidis Semen, 2 liang) Shi Jun Zi (Quisqualis Semen, flesh, 7.5 qian) Qing Pi (Citri Reticulatae Pericarpium Viride, 2 liang) Lei Wan (Omphalophora Mollissima Semen, 2.5 qian) Ku Lian Pi (Meliae Cortex, some versions omit this and use Lu Hui 2.5 qian instead)
Ni Xi (Chrysanthemi Indici Flos, each 0.5 liang)
Stir-fry together in a pan until scorched, grind into powder, and make pills with flour paste the size of millet seeds. For a three-year-old, take 20 pills before meals with rice water.
Er Ding Wan treats Ru Pi (breast lump), Shi Pi (food stagnation), and Gan Re.
Bai Ding Xiang (Vomer Bone) Ding Xiang (Caryophylli Flos) Mi Duo Seng (Lithargyrum, each 1 liang) Shao Fen (Lead White, 1 qian) Liu Huang (Sulfur, 3 qian)
Grind into fine powder, make pills with paste the size of small beans. For a three-year-old, take 10 pills at dusk with rice water; for nursing infants, take with breast milk. The next day, foul matter should be discharged, and the fever will recede. Adding 1 qian of Huang Ying Shi (Oriental Magpie Droppings) is especially excellent.
*Jin Gua Wan* from *Tan Shi Shu Sheng* treats pediatric Gan Re, persistent high fever, yellowish emaciation. Long-term use leads to robustness.
Huang Lian (Coptidis Rhizoma) Huang Bo (Phellodendri Cortex) Gan Cao (Licorice Root, lightly roasted) Qing Pi (Citri Reticulatae Pericarpium Viride, equal parts)
Grind into powder, add a small amount of She Xiang (Moschus). Take one pig gallbladder, insert the medicine inside, tie tightly with thread, place in a stone vessel, boil in rice water for five to seven boils, remove, hang to air-dry overnight, and make pills the size of mung beans. Take 5-7 pills per dose with rice water, adjusting dosage according to the child. The formula in *Yu Jue* is identical, coated with Zhu Sha (Cinnabar), and also treats Pi Gan (Spleen Gan). It is the same in *Bo Ji Fang* and *Liu Shi Jia Chuan Fang*, which adds Hu Huang Lian (Scutellariae Barbatae Radix); taking Shi Jun Zi Wan in the morning and Jin Gua Wan at night ensures health, aids digestion, and promotes muscle growth. The *Zhuang Shi Jia Chuan Fang* is similar but adds Ye Ming Sha (Typhlonis Faeces) in equal parts. The *Zhao Shi Fang* is also similar, named Liang Gan Yao (Cooling Gan Medicine); Zhu Simi of Changsha considers it miraculous.
Lu Hui Wan treats pediatric Jing Re (startle fever) and Gan anorexia.
Lu Hui (Aloe) Xiong Dan (Ursi Bile) Zhu Sha (Cinnabar, each 2.5 qian) Qing Dai (Indigo Naturalis, 7.5 qian) He Li Le (Terminalia Chebula Fruit, baked, flesh only, 3 qian) She Xiang (Moschus, 1 qian)
Grind into powder, make pills with glutinous rice paste the size of hemp seeds. Take on an empty stomach according to age, swallowing 5-7 pills with sugar water.
[Mr. Mao] Chai Hu San treats pediatric Gan Re, limbs emaciated like firewood, inability to stand or walk.
Chai Hu (Bupleuri Radix) Zhi Mu (Anemarrhenae Rhizoma) Bei Mu (Fritillariae Cirrhosae Bulbus, heart removed) Fu Ling (Poria) Fu Shen (Poria with Hostwood) Gan Ge (Puerariae Radix) Gan Cao (Licorice Root, roasted, equal parts)
Grind into powder. For each dose, take one spoonful of wheat and one spoonful of powder, add one zhan of water, decoct to six-tenths. Strain and drink.
Liu Wu Huang Qin Tang treats lower abdominal distension, shortness of breath, fluctuating fever, food intolerance, and indigestion.
Huang Qin (Scutellariae Radix) Da Qing (Isatidis Folium) Gan Cao (Licorice Root, roasted) Mai Men Dong (Ophiopogonis Tuber, heart removed) Shi Gao (Gypsum Fibrosum, crushed, each 0.5 liang) Gui Pi (Cinnamomi Cortex, 3 qian)
Take 3 qian per dose, add one zhan of water, decoct to seven-tenths. Strain and take warm.
[Zhuang Shi] Qing Dai Wan treats Gan Re.
Qing Dai (Indigo Naturalis, ground, 1 liang) Hu Huang Lian (Scutellariae Barbatae Radix) Xuan Lian (Coptidis Rhizoma from Anhui) Tian Zhu Huang (Calami Tintinnabuli) (each ground, 0.5 liang) Zhu Sha (Cinnabar, water-floating method, 2.5 qian) She Xiang (Moschus, ground, 1 qian) Rou Dou Kou (Myristicae Semen, two pieces) Niu Huang (Bovis Calculus, 0.5 qian, ground) Gan Chan (Dry Bufo, one piece collected on Dragon Boat Festival, soaked in wine, cleaned of entrails, brushed with butter, and roasted until yellow)
Except for the already ground ingredients, grind the rest into powder and mix thoroughly. Make pills with paste made from boiled mung bean flour, the size of mustard seeds. Take 3 pills on an empty stomach and at night with warm water. If mung bean flour is difficult to use, mung bean powder paste is acceptable.
[Wang Shi] Shi Jun Zi San treats Gan Re.
Take Shi Jun Zi (Quisqualis Semen), dry it in the sun, and grind into powder. Take on an empty stomach with rice water. Adult dose: 1 qian; child dose: 0.5 qian. Continue until worms are expelled.
Zhu Du Huang Lian Wan (from *Zhi Zhi Fang*) treats Gan Re flowing through meridians, widespread ulcerative sores, tidal fever with abdominal distension, or thirst.
Use a male pig stomach (cleaned, one whole) and Xuan Lian (Coptidis Rhizoma, cleaned, 5 liang). Chop finely, moisten with water, place inside the stomach, sew shut, and steam over five sheng of japonica rice until tender. Place in a mortar, add a little steamed rice, pound 1,000 times, and make pills the size of small paulownia seeds. Take 20 pills per dose with rice water. Also take agents that nourish blood, clear serum, and calm the heart as adjuvants. (Note: Pediatric illnesses generally fall into Gan or Heat categories; heat generates phlegm, so this must be recognized.)
Chai Hu Yin treats bone-steaming Gan Qi, heat in the five hearts, worsening at dusk, dry mouth with no taste, thirst with emaciation, chest fullness with tight phlegm, yellow urine, reduced appetite, and mental confusion.
Bei Chai Hu (Bupleuri Radix, radix removed, washed clean) Ren Shen (Ginseng Radix et Rhizoma, radix removed) Dang Gui (Angelicae Sinensis Radix, wine-washed) Huang Qin (Scutellariae Radix) Chi Shao Yao (Paeoniae Radix Rubra) Gan Cao (Licorice Root, roasted, each 1 liang) Da Huang (Rhei Radix et Rhizoma, raw) Jie Geng (Platycodonis Radix, radix removed, chopped, stir-fried) Bei Wu Wei Zi (Schisandrae Fructus, stems removed) Ban Xia (Pinelliae Tuber, boiled thoroughly, slippery texture removed, each 0.5 liang)
Chop coarsely. Take 2 qian per dose, add one zhan of water, half a wumei (Chinese plum), and two slices of ginger. Decoct to seven-tenths. Take warm at any time.