圣惠方曰。小儿冷热不调。乳哺不节。使阴阳清浊之气相干。而变乱肠胃间。则成霍乱而心腹痛者。冷热气与正气
相击。或上攻心。下攻腹。故痛。
巢元方曰。毒瓦斯吐者。春夏以汤与儿。肠胃脆弱。不胜药势。逆吐下不止。药熏脏腑。烦懊顿乏。为中毒瓦斯吐下。
千金藿香汤。
曾氏曰。论吐之原。难以枚举。有冷吐、热吐、积吐、伤风嗽吐、伤乳吐。吐则同而症则异。冷吐者。乳片不消。
多吐而少出。脉沉微。面白眼慢。气缓神昏。额汗。此因风寒入胃。或食生冷。或伤宿乳。胃虚不纳而出。宜当归散加
煨
姜、陈皮。或间投冲和饮、理中汤。不效。参香饮。热吐者。面赤唇红。吐次少而出多。乳片消。面色黄。遍体热甚。
或因暑气在胃。或食热物。精神不慢。而多烦躁。此热吐也。宜大顺饮、香薷饮。误服热药。先投绿豆饮解之。次止吐
药。积吐者。眼胞浮。面微黄。足冷肚热。日轻夜重。儿大者。脉沉缓。此宿冷滞脾。故吐黄酸水。或有清痰。脉实而
渴。为食积所伤。吐酸 气。或宿食并出。儿小者。 乳不化是也。先五苓散和解。次乌犀丸。最小者三棱散。伤风嗽
吐者。热生风。风生痰。痰结胸中。肺气不顺。连嗽不止。和痰吐出。此为嗽吐痰壅而作。乃为实症。先投清肺饮。小
柴胡汤。若嗽久肺虚。土不生金。面白唇燥。干嗽干呕而无痰。可温补为主。茯苓浓朴汤、惺惺散。伤乳吐者。才乳哺
后即吐。或少停而吐。此因乳饮无度。脾弱不运故也。三棱散。此外又有风痰吐。乃是伤寒不解。吐乳夹痰。若多时。
必要生风。青州白丸子、半夏散。挟惊吐。张涣三香丹。疳积吐。本事方。凡霍乱吐不止者。伏龙肝细末二钱。白扁豆
炒煎汤调下。立止。若扁豆嫩苗更好。
钱己曰。小儿经年吐乳。眼慢粪秽。有筋膜者。乃父母交感时吃乳所致。名曰交精吐奶。宜益黄散。五疳保童丸。
谭殊圣曰。小儿惊膈吐还频。日夜连连不暂停。 水槐黄泔淀汁。和虫乳食一时喷。丁香研共生犀服。五胆牛黄主
有勋。若有得逢如此药。值饶危困却还魂。(此名归命丹)
《圣惠方》说:小儿冷热不调,乳哺不节,导致阴阳清浊之气相互干扰,在肠胃间变乱,从而形成霍乱并伴随心腹痛。这是因为冷热气与正气相击,有的向上攻心,有的向下攻腹,所以产生疼痛。
巢元方说:毒瓦斯引起的呕吐,如果在春夏季节给小儿服用汤药,由于肠胃脆弱,不能承受药力,会导致逆吐和下利不止。药物熏蒸脏腑,引起烦闷懊恼、极度疲乏,这属于中毒瓦斯引起的吐泻。可用千金藿香汤治疗。
曾氏说:论述呕吐的起因,难以一一列举。有冷吐、热吐、积吐、伤风嗽吐、伤乳吐。呕吐的表现相同但症状各异。冷吐者,乳汁片状未消化,多吐而少出,脉象沉微,面色白,眼睛迟缓,气息缓弱,神志昏沉,额头出汗。这是因风寒入胃,或吃了生冷食物,或伤了宿乳,胃虚不能纳受而吐出。适宜用当归散加煨姜、陈皮,或者间歇投服冲和饮、理中汤。如果无效,用参香饮。热吐者,面红唇赤,呕吐次数少而出量多,乳汁已消化,面色黄,全身发热严重。或因暑气在胃,或吃了热物,精神不萎靡反而多烦躁。这是热吐。适宜用大顺饮、香薷饮。误服热药后,先投绿豆饮解毒,再止吐。积吐者,眼睑浮肿,面色微黄,脚冷肚子热,白天轻晚上重。年龄较大的小儿,脉象沉缓,这是宿冷停滞在脾,所以吐出黄酸水,或有清痰,脉实且口渴,为食积所伤,吐出酸气,或宿食一起吐出。年龄较小的小儿,是乳汁不化。先用五苓散和解,再用乌犀丸。最小的用三棱散。伤风嗽吐者,热生风,风生痰,痰结聚胸中,肺气不顺,连续咳嗽不止,带着痰吐出。这是因为咳嗽导致痰壅而发作,属于实证。先投清肺饮、小柴胡汤。如果咳嗽日久导致肺虚,土不生金,面白唇燥,干咳干呕而无痰,应以温补为主。可用茯苓浓朴汤、惺惺散。伤乳吐者,刚喂奶后就吐,或少停一会儿才吐。这是因哺乳无度,脾弱不能运化所致。用三棱散。此外又有风痰吐,这是伤寒未解,吐乳夹痰,若时间过长,必然生风。用青州白丸子、半夏散。挟惊吐,用张涣的三香丹。疳积吐,用《本事方》中的方剂。凡霍乱呕吐不止者,用伏龙肝细末二钱,白扁豆炒后煎汤调服,立即停止。如果用扁豆嫩苗更好。
钱己说:小儿经年吐乳,眼睛迟缓,粪便秽臭,有筋膜者,是父母交感时吃乳所致。名叫交精吐奶。适宜用益黄散、五疳保童丸。
谭殊圣说:小儿惊膈呕吐频繁,日夜连连不停止。用水槐黄泔淀汁,混合虫乳食一时喷出。丁香研碎同生犀角服用,五胆牛黄主要有功勋。如果有幸遇到这样的药,即使值遇危困也能还魂。(此名归命丹)
The *Shenghui Fang* states: When a child's cold and heat are unbalanced, and breastfeeding is irregular, the yin and yang, clear and turbid qi interfere with each other, causing chaos in the intestines and stomach, resulting in Huoluan (cholera-like syndrome) accompanied by heart and abdominal pain. This occurs because the cold and hot qi strike against the healthy qi; some attack upward to the heart, while others attack downward to the abdomen, thus causing pain.
Chao Yuanfang states: Vomiting caused by toxic vapors often occurs when decoctions are given to children during spring and summer. Due to their fragile intestines and stomach, they cannot withstand the potency of the medicine, leading to persistent regurgitation/vomiting and diarrhea. The medication steams the zang-fu organs, causing restlessness, vexation, and extreme fatigue; this is classified as vomiting and diarrhea due to toxic vapor poisoning. Qianjin Huoxiang Tang (Huo Xiang Decoction from the Thousand Gold Formulas) may be used.
Zeng Shi states: Discussing the origins of vomiting, it is difficult to list them all. There are cold vomiting, hot vomiting, accumulation vomiting, wind-cold cough-induced vomiting, and milk-injury vomiting. Although the act of vomiting is similar, the symptoms differ. In cold vomiting, milk curds are undigested; there is much vomiting but little discharge, the pulse is deep and faint, the complexion is white, the eyes are sluggish, the breath is weak, consciousness is dull, and sweat appears on the forehead. This is caused by wind-cold invading the stomach, consumption of raw/cold foods, or damage from retained milk; the deficient stomach fails to receive food and expels it. Dang Gui San (Angelica Powder) with roasted ginger and Chen Pi (Tangerine Peel) is suitable, or alternatively, Chonghe Yin (Harmonizing Drink) or Lizhong Tang (Regulate the Middle Decoction) administered intermittently. If ineffective, Shenxiang Yin (Ginseng and Aromatic Drink) is used. In hot vomiting, the face is red and lips are crimson; vomiting episodes are few but volume is large, milk curds are digested, the complexion is yellow, and the whole body is very hot. This may be due to summer-heat qi in the stomach or consumption of hot foods; the spirit is not lethargic but rather irritable and restless. This is hot vomiting. Dashun Yin (Great Smoothness Drink) or Xiangru Yin (Elsholtzia Drink) are appropriate. If hot medicines were mistakenly taken, first administer Ludou Yin (Mung Bean Drink) to detoxify, then stop the vomiting. In accumulation vomiting, the eyelids are puffy, the complexion is slightly yellow, feet are cold while the belly is hot, symptoms are lighter during the day and heavier at night. In older children, the pulse is deep and slow, indicating retained cold stagnating in the spleen, leading to vomiting of yellow, sour fluid or clear phlegm; the pulse is excess and there is thirst, indicating injury from food accumulation, vomiting of sour gas, or expulsion of retained food. In younger children, it is simply undigested milk. First use Wuling San (Five Ingredient Powder) to harmonize, then Wu Xi Wan (Black Rhinoceros Pill). For the youngest infants, San Leng San (Curcuma Powder) is used. In wind-cold cough-induced vomiting, heat generates wind, wind generates phlegm, phlegm knots in the chest, lung qi becomes obstructed, leading to continuous coughing and vomiting up phlegm. This arises from cough-induced phlegm obstruction and is an excess syndrome. First administer Qingfei Yin (Clear Lung Drink) and Xiao Chaihu Tang (Minor Bupleurum Decoction). If chronic cough leads to lung deficiency, where earth fails to generate metal, presenting with pale face, dry lips, dry cough, and dry retching without phlegm, warm tonification should be the primary method. Fuling Nongpo Tang (Poria and Magnolia Bark Decoction) or Xingxing San (Awakening Powder) may be used. In milk-injury vomiting, vomiting occurs immediately after feeding or after a short pause. This is due to excessive breastfeeding and weak spleen failing to transport. San Leng San (Curcuma Powder) is used. Additionally, there is wind-phlegm vomiting, which results from unresolved shanghan (cold damage), where vomited milk contains phlegm; if prolonged, wind will inevitably arise. Qingzhou Baiwanzi (Qingzhou White Pills) or Banxia San (Pinellia Powder) are indicated. For vomiting complicated by fright, Zhang Huan's Sanxiang Dan (Three Fragrances Pill) is used. For ganji (malnutrition) vomiting, formulas from *Ben Shi Fang* are used. For any case of Huoluan with persistent vomiting, take 2 qian of fine powder from Fulonggan (Dragon's House Earth), mix with decoction of fried Bai Biandou (White Hyacinth Bean), and ingest; vomiting stops immediately. Tender shoots of the bean are even better.
Qian Ji states: Children who have vomited milk for years, with sluggish eyes and foul-smelling stool containing membrane-like substances, suffer from Jiaojing Tuna (Intercourse Essence Milk-Vomit), caused by nursing during parental conception. Yihuang San (Yellow Regulating Powder) and Wugan Baotong Wan (Five Gan Protecting Child Pill) are suitable.
Tan Shusheng states: Children with fright-diaphragm vomiting vomit frequently, continuously day and night. Use sediment juice from water locust pods mixed with insect-milk food to spray out simultaneously. Grind Dingxiang (Clove) and mix with fresh Xijiao (Rhinoceros Horn); Wudan Niuhuang (Five Gall Bladder Calculus and Bovine Calculus) holds great merit. If one encounters such medicine, even in critical danger, the soul can be restored. (This is named Guiming Dan [Life-Restoring Pill])