〔薛〕小儿惊后目微动切牙者,皆病后亡津液,不能荣其筋脉也,亦有肝经虚热
而生风者,当审其气血有余不足而治之。其日中发热饮冷而动者,气有余也,用泻
青丸。夜间盗汗及睡不宁而动者,血不足也,用地黄丸。或因肝经风邪传于脾肾
者,亦令切牙,先用柴胡清肝散,次用五味异功散、六味地黄丸。若因脾胃虚热,
用补中益气汤加芍药、山栀。实热用泻黄散。盖牙床属手足阳明故也。若肝肾热,
用六味地黄丸。
〔薛〕小儿惊泻者,肝主惊,肝木也,盛则必传克于脾,脾土既衰,则乳食不化,
水道不调,故泄泻色青或兼发搐者,盖青乃肝之色,搐乃肝之证也。亦有因
乳母脾虚受惊,及怒动肝火而致者,经曰∶怒则气逆,甚则呕血及飧泄,法当平
肝补肺,慎勿用峻攻之药,脾气益虚,肝邪弥甚,甚至抽搐反张者,亦肝火炽盛,中州
亏损之变证也。凡见惊证,即宜用四君、六君、异功散、等方加白附子定风,柴胡
平肝引经以杜渐,则必不至泻搐而自安矣,今已见泻吐惊搐,尚不知补脾平肝,以
保命、抱龙、镇惊等药治之,其亦去生远矣。
蝉蜕钓藤饮 治肚疼惊啼。
钓藤钩 天麻 茯苓 川芎 白芍药(各三钱) 甘草 蝉蜕(各一两)
上,入灯心,水煎服。
阎氏云∶惊风或泄泻等证烦渴者,皆津液内耗也,不问阴阳,宜煎钱氏白术散,
使满意取足饮之,弥多弥好。
清心丸 治惊热烦躁。
人参 茯神 防风 朱砂 柴胡(各三钱) 金箔(三十片)
上为末,炼蜜丸,如桐子大。每服一二丸,竹沥调下。
神芎丸 治风热壅滞,头目昏眩,口舌生疮,牙齿疳蚀,或遍身疮疥,切牙惊惕怔
忡,烦躁作渴,或大便涩滞,或积热腹满,惊风潮搐等证。
大黄(生) 黄芩(各二两) 生牵牛末(一两) 滑石(四两) 黄连 薄荷叶 川芎(各半两)
上为末,水糊丸桐子大。每服三四丸,温热水下。
【薛己】小儿在受惊之后,出现眼睛微动、咬牙的症状,都是因为病后津液耗损,不能濡养筋脉所致;也有因肝经虚热而生风的情况,应当审查其气血的有余或不足来进行治疗。如果在白天发热、想喝冷饮且伴有症状发作,这是气有余的表现,使用泻青丸。如果在夜间盗汗、睡眠不安且伴有症状发作,这是血不足的表现,使用地黄丸(此处指六味地黄丸)。如果是因为肝经的风邪传变到脾肾,也会导致咬牙,先用柴胡清肝散,再用五味异功散、六味地黄丸。如果是因脾胃虚热,使用补中益气汤加芍药、山栀。实热证使用泻黄散。这是因为牙床属于手足阳明经的缘故。如果是肝肾热,使用六味地黄丸。
【薛己】小儿患惊泻,肝主惊,五行属木,肝气旺盛则必然克制脾土,脾土虚弱,导致乳食不消化,水道不调畅,所以出现泄泻、大便色青或兼有抽搐的症状。青色是肝的本色,抽搐是肝的病证表现。也有因乳母脾虚受惊,以及愤怒引动肝火而导致的。医经说:愤怒会导致气机上逆,严重时会出现呕血和完谷不化的泄泻。治法应当平抑肝木、补益肺金,千万不要使用峻猛的攻下药,否则脾气更加虚弱,肝邪更加严重,甚至出现抽搐、角弓反张等症状,这也是肝火炽盛、中焦脾胃亏损的变证。凡是见到惊证,就应当立即使用四君子汤、六君子汤、异功散等方剂,加入白附子以定风,柴胡以平肝并作为引经药,从而杜绝病情发展,这样一定不至于发生泄泻抽搐而能自行安宁。如今已经出现泄吐、惊搐,还不知道用补脾平肝的方法,反而用保命丹、抱龙丸、镇惊丸等药物治疗,这就离生机越来越远了。
蝉蜕钓藤饮 治疗肚子疼、惊啼。
钓藤钩、天麻、茯苓、川芎、白芍药(各三钱),甘草、蝉蜕(各一两)。
以上药材,加入灯心草,用水煎服。
阎氏说:惊风或泄泻等病症出现烦渴的,都是体内津液消耗所致,不分阴阳属性,适宜煎煮钱乙的白术散,让患儿满意地足量饮用,越多越好。
清心丸 治疗惊热烦躁。
人参、茯神、防风、朱砂、柴胡(各三钱),金箔(三十片)。
以上药材研为细末,用炼蜜制成丸子,如梧桐子大小。每次服用一二丸,用竹沥送服。
神芎丸 治疗风热壅滞,头目昏眩,口舌生疮,牙齿疳蚀,或者全身疮疥,咬牙惊惕怔忡,烦躁作渴,或者大便涩滞,或者积热腹满,惊风潮搐等病症。
大黄(生)、黄芩(各二两),生牵牛末(一两),滑石(四两),黄连、薄荷叶、川芎(各半两)。
以上药材研为细末,用水糊制作成梧桐子大小的丸子。每次服用三四丸,用温热水送服。
[Xue] After a child suffers from fright, slight eye movements and teeth grinding are all due to the depletion of body fluids after illness, which fails to nourish the sinews and vessels. There are also cases where deficiency heat in the Liver channel generates wind. One should examine whether Qi and Blood are in excess or deficiency and treat accordingly. If fever occurs during the day, with a desire for cold drinks and symptom exacerbation, this indicates an excess of Qi; use Xie Qing Wan (Drain the Green Pill). If night sweats occur and restlessness during sleep accompanies the movements, this indicates a deficiency of Blood; use Di Huang Wan (Rehmannia Pill). If it is caused by Wind pathogen in the Liver channel transmitting to the Spleen and Kidney, causing teeth grinding, first use Chai Hu Qing Gan San (Bupleurum Liver-Clearing Powder), followed by Wu Wei Yi Gong San (Five-Ingredient Powder for Supporting Meridian Function) and Liu Wei Di Huang Wan (Six-Ingredient Rehmannia Pill). If caused by deficiency heat in the Spleen and Stomach, use Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) added with Bai Shao Yao (White Peony Root) and Shan Zhi (Gardenia Fruit). For excess heat, use Xie Huang San (Drain the Yellow Powder). This is because the gums belong to the Foot and Hand Yangming channels. If there is heat in the Liver and Kidney, use Liu Wei Di Huang Wan (Six-Ingredient Rehmannia Pill).
[Xue] In children suffering from fright-induced diarrhea, the Liver governs fright and belongs to Wood. When Liver Wood is excessive, it inevitably overacts upon Spleen Earth. Once Spleen Earth is weakened, milk and food fail to transform, and the water passages become disordered, resulting in diarrhea with green stool or accompanied by convulsions. Green is the color of the Liver, and convulsions are the manifestation of Liver pathology. There are also cases caused by the wet nurse having Spleen deficiency with fright, or anger stirring up Liver Fire. The Classics state: "Anger causes Qi to rebel; severely, it leads to vomiting blood and undigested diarrhea." The treatment method should be to calm the Liver and tonify the Lung. Do not use harsh purgatives, as this will further weaken the Spleen Qi and intensify the Liver pathogen, potentially leading to convulsions and opisthotonos. These are variations caused by blazing Liver Fire and deficiency of the Middle Jiao. Whenever fright patterns are seen, one should immediately use Si Jun Zi Tang (Four Gentlemen Decoction), Liu Jun Zi Tang (Six Gentlemen Decoction), or Yi Gong San (Yi Gong Powder), adding Bai Fu Zi (Typhonii Rhizoma) to settle wind, and Chai Hu (Bupleuri Radix) to calm the Liver and guide the medicine, thereby preventing progression. This ensures that diarrhea and convulsions do not occur, allowing for natural recovery. Now that diarrhea, vomiting, fright, and convulsions have already appeared, if one does not know to tonify the Spleen and calm the Liver, but instead uses Bao Ming Dan (Life-Preserving Pill), Bao Long Wan (Embracing Dragon Pill), or Zhen Jing Wan (Fright-Calming Pill), the patient is far from survival.
Chantui Diaoteng Yin (Cicada Slough and Uncaria Decoction) treats abdominal pain and frightful crying.
Diaoteng Gou (Uncariae Ramulus cum Uncis), Tianma (Gastrodiae Rhizoma), Fuling (Poria), Chuanxiong (Ligustici Chuanxiong Rhizoma), Baishao Yao (Radix Paeoniae Alba) (each 3 qian); Gancao (Glycyrrhizae Radix et Rhizoma), Chantui (Periostracum Cicadae) (each 1 liang).
Add Dengxincao (Junci Medulla), decoct in water, and take orally.
Yan states: For fright-wind or diarrhea presenting with vexation and thirst, these are all due to internal consumption of body fluids. Regardless of Yin or Yang patterns, it is appropriate to decoct Qian's Baizhu San (Atractylodis Macrocephalae Powder) and allow the child to drink sufficient amounts to satisfaction; the more, the better.
Qingxin Wan (Clear the Heart Pill) treats fright-heat and irritability.
Renshen (Ginseng Radix et Rhizoma), Fushen (Poria cum Pinellia), Fangfeng (Saposhnikoviae Radix), Zhusha (Cinnabaris), Chaihu (Bupleuri Radix) (each 3 qian); Jinbo (Folium Aureum) (30 pieces).
Grind into powder, mix with refined honey to form pills the size of paulownia seeds. Take 1-2 pills per dose, administered with Zhuli (Bambusae Caulis in Taenia).
Shenxiong Wan (Divine Ligusticum Pill) treats stagnation of Wind-Heat, dizziness and vertigo of the head and eyes, sores in the mouth and tongue, dental caries, generalized skin sores and scabies, teeth grinding, fright, palpitations, irritability and thirst, constipation, abdominal fullness due to accumulated heat, and symptoms such as fright-wind and tidal convulsions.
Dahuang (Rhei Radix et Rhizoma, raw), Huangqin (Scutellariae Radix) (each 2 liang); Sheng Qianniu Mo (Semen Pharbitidis Pulveratum, raw) (1 liang), Huashi (Talcum) (4 liang); Huanglian (Coptidis Rhizoma), Bohe Ye (Menthae Haplocalycis Folium), Chuanxiong (Ligustici Chuanxiong Rhizoma) (each 0.5 liang).
Grind into powder, bind with water paste to form pills the size of paulownia seeds. Take 3-4 pills per dose, administered with warm water.