初虞世曰。马脾风者。暴喘而兼胀满也。大小便硬。宜急下之。用牛黄夺命散。后用白虎汤平之。马脾风。若患在
百日内者。不治。
吴绶曰。有马脾风者。因寒邪入肺。寒郁为热。痰喘上气。肺胀 。若不速治。立见危亡。宜用辰砂二钱半。甘
遂一钱半。轻粉五分。共为末。每取一字。以温浆水少许。上滴香油一点。挑药在油花上。待沉下却去浆水。灌之。即
名马脾风散。此方甚妙也。
泪为肝液。哭乃肺声。风袭肝脏。内外风并。惟风煽热。乘于心经。火热逞风。刑铄肺金。金木相击。悲哭声惊。
或日或夜。阴阳互争。亦因母怒。乳哺热生。热移肝脏。肝火莫平。乃多惊哭。其用弗宁。亦因母欲。孕时过淫。淫火
炎炽。致令毒停。既生之后。有触哭应。亦因母冷。孕时寒凝。邪气入胞。儿与之迎。生后邪郁。儿腹膨 。正气相搏。
张啼倾。亦因父气。肾弱亏精。儿禀之产。肾阴不荣。虚火炎上。忽作啼鸣。丹溪论此。必致归冥。然则啼哭。病因
匪轻。或寒或热。或吓或撄。或胸腹痛。或触神灵。务观其势。各究其情。勿云常事。任彼涕淋。
巢元方曰。小儿有 啼者。在胎时其母伤于风冷。邪气入胞。伤于脏腑。故儿生之后。邪犹在儿腹内。邪动与正气
搏则腹痛。故儿 张蹙气而啼也。钩藤膏。
钱乙曰。小儿惊啼者。谓睡梦中忽然啼而惊觉。邪热乘心也。安神丸。寒夜啼者。脾脏寒冷。当夜阴盛之时相感。
故痛而啼也。钱氏当归丸。热夜啼者。腹热痛。夜啼面赤。唇焦便赤。用人参汤下三黄丸。
张涣曰。婴儿在胎之时。其母将养一切不如法。及取凉饮冷食过度。冷气入儿肠胃。使胎气不强。致生下羸弱多病。
俯仰多啼。名曰 啼。宜养脏汤。
王履曰。小儿夜啼有四症。一曰寒。二曰热。三曰口疮重舌。四曰客忤。寒则腹痛而啼。面青白。口有冷气。手足
腹俱冷。曲腰而啼。宜六神散、益黄散。热则心躁而啼。面赤。小便赤。口中热。腹暖。或有汗。仰身而啼。或上半夜
仰身有汗而啼。面赤身热者。必痰热也。到晓方息。宜导赤散加黄芩。口疮重舌。则吮乳不待。口到乳上即啼。身额皆
微热。急取灯照之。根据口疮重舌为治。客忤者。或见非常之物。与未识之人。或经神庙佛寺。与鬼神气相忤而啼。有日
啼惊。夜必黄昏前后尤甚者。钱氏安神丸。
庞安常曰。小儿夜啼。作心经有热有虚治之。灯心散、黄连饮、蝉花散。月内夜啼惊搐者。乃胎中受惊所致。镇惊
散。有痰者。抱龙丸。
李 曰。初生月内多啼者。凡胎热、胎毒、胎惊。皆从此而散。且无奇疾。
鳌按。李氏此说。甚是。故凡儿啼。只宜轻手扶抱。任其自哭自止。切不可勉强按住。或令吮乳止之。若无
他病。亦不必服药。以上诸家方治。亦为有他病者备用。非谓夜啼必服药也。
初虞世说：所谓马脾风，是指突然发作的喘息并伴有腹部胀满。大小便干结坚硬，应当紧急使用泻下法治疗。可用牛黄夺命散。之后再用白虎汤来平复病情。如果马脾风发生在出生百日内的婴儿身上，则属于不治之症。
吴绶说：患有马脾风的，是因为寒邪侵入肺部，寒气郁结化为热邪，导致痰多气喘、气逆上冲、肺脏胀满。如果不迅速治疗，立刻就会危及生命。适宜用辰砂二钱半、甘遂一钱半、轻粉五分，共同研成细末。每次取一字量的药粉，用少许温浆水，滴入一点香油，将药粉挑在油花上，待药粉沉下去后倒掉浆水，灌服给患儿。这就叫马脾风散。这个方子非常奇妙。
眼泪是肝脏的液汁，哭声是肺脏的声音。风邪侵袭肝脏，内外之风相合，只有风煽动热邪，乘袭心经。火热猖獗生风，克制灼伤肺金（五行中金克木，此处指火克金或金木相战影响肺），金与木相互冲击，导致悲伤哭泣和惊悸。有时白天哭，有时晚上哭，阴阳之气互相争斗。这也可能是因为母亲发怒，乳汁产生热邪，热邪移入肝脏，肝火无法平息，从而导致容易惊哭，心神不宁。也可能是因为母亲欲望过度，怀孕期间房事不节，淫火炽盛，导致毒邪停滞。出生后，遇到触动而啼哭，也是因为母亲受冷，怀孕时寒气凝结，邪气进入胞宫，胎儿与之相遇。出生后邪气郁结，小儿腹部膨隆，正气与邪气相搏，导致张口啼哭、身体倾斜。这也是因为父亲元气不足，肾弱精亏，胎儿禀受此气出生，肾阴不能滋养，虚火上炎，忽然发出啼鸣。朱丹溪论述这种情况，认为必然会导致死亡。然而，小儿啼哭的原因并不轻微，可能是寒证，可能是热证，可能是惊吓，可能是外邪侵犯，可能是胸腹痛，也可能是触犯了神灵。务必观察其态势，分别探究其情由，不要认为是平常小事，任由孩子泪流不止。
巢元方说：小儿有腹胀啼哭的情况，是在胎中时母亲受了风冷，邪气进入胞宫，损伤脏腑，所以孩子出生后，邪气仍在腹内。邪气变动与正气搏结则引起腹痛，所以孩子腹胀、皱眉、气促而啼哭。可用钩藤膏。
钱乙说：小儿惊啼，是指在睡梦中忽然啼哭并惊醒，这是邪热乘袭心经所致。可用安神丸。寒性夜啼，是因为脾脏寒冷，在夜间阴气旺盛的时候相互感应，所以因疼痛而啼哭。可用钱氏当归丸。热性夜啼，表现为腹部热痛，夜间啼哭时面色红赤，嘴唇焦干，小便色赤。用人参汤送服三黄丸。
张涣说：婴儿在胎中时，母亲调养一切不合规范，以及贪凉饮冷食过度，冷气进入小儿肠胃，使胎气不强，导致出生后体弱多病，俯仰之间多啼哭，名叫腹胀啼。宜用养脏汤。
王履说：小儿夜啼有四种症状。一是寒证，二是热证，三是口疮重舌，四是客忤（受到外界异常事物或陌生人的惊吓）。寒证则腹痛而啼，面色青白，口中呼出冷气，手足腹部都冷，弯腰啼哭。宜用六神散、益黄散。热证则心烦躁而啼，面色红赤，小便红赤，口中发热，腹部温暖，或有汗出，仰卧身体啼哭。或者上半夜仰卧有汗而啼，若面色红赤身体发热，必定是痰热所致。到了早晨才停止。宜用导赤散加黄芩。口疮重舌，则吸吮乳头时不等含住，嘴巴碰到乳头就啼哭，身体和额头都微热，急忙取灯照看口腔，根据口疮重舌进行治疗。客忤，即看到不寻常的事物，见到不认识的人，或者经过神庙佛寺，与鬼神之气相冲突而啼哭。有的白天啼哭受惊，夜晚黄昏前后尤其严重。可用钱氏安神丸。
庞安常说：小儿夜啼，按心经有热和有虚两种情况治疗。可用灯心散、黄连饮、蝉花散。满月内夜啼且惊厥抽搐的，是胎中受惊所致。可用镇惊散。有痰的，可用抱龙丸。
李姓医家说：出生一个月内多啼哭的，凡是胎热、胎毒、胎惊，都会由此散发出去，而且不会有奇特的疾病。
沈金鳌按语：李氏的这种说法，非常正确。所以凡是小儿啼哭，只宜轻轻手扶怀抱，任其自然哭止，切不可强行按住，或用喂奶来制止。如果没有其他疾病，也不必服药。以上各位医家的方治，也是为有其他疾病的患儿备用的，并非说夜啼就一定要服药。
Chu Yushi stated: "Ma Pi Feng" (Horse Spleen Wind) refers to sudden onset of wheezing accompanied by abdominal distension. The stool and urine are hard and dry; urgent purgation is indicated. Use Niuhuang Huoming San (Calculus Bovis Decoction for Snatching Life). Subsequently, use Baihu Tang (White Tiger Decoction) to calm the condition. If Ma Pi Feng occurs in infants within one hundred days after birth, it is incurable.
Wu Shou stated: Cases of Ma Pi Feng arise from cold pathogenic factors invading the lungs, where cold stagnates and transforms into heat, leading to phlegm, wheezing, rebellious Qi, and lung distension. If not treated promptly, critical danger and death will ensue immediately. It is appropriate to use Chen Sha (Cinnabar) 2.5 qian, Gansui (Radix Kansui) 1.5 qian, and Qingfen (Calomel) 0.5 fen, ground together into powder. Take a dose equivalent to one "yi" character, add a small amount of warm fermented rice water, drop one point of sesame oil on top, place the medicine on the oil droplet, wait for it to sink, discard the rice water, and administer the mixture orally. This is named Mapi Feng San (Horse Spleen Wind Powder). This prescription is excellent.
Tears are the fluid of the Liver; crying is the sound of the Lungs. Wind pathogens attack the Liver, combining internal and external wind. Only when wind stirs up heat does it invade the Heart Meridian. Exuberant fire generates wind, punishing and scorching Lung Metal. The conflict between Metal and Wood leads to sorrowful crying and fright. Crying may occur during the day or night, with Yin and Yang qi contending. This may also result from the mother's anger, causing heat in the breast milk, which transfers to the Liver, making Liver Fire uncontrollable, leading to frequent frightful crying and restlessness. Alternatively, it may stem from excessive maternal desire during pregnancy, causing intense lust-fire and toxin retention. After birth, crying triggered by contact may be due to maternal coldness; cold coagulation during pregnancy allowed pathogenic factors to enter the uterus, meeting the fetus. Post-birth, pathogenic stagnation causes infant abdominal distension, where healthy Qi contends with pathogens, resulting in gaping mouth crying and body tilting. This may also be due to the father's weak Yuan Qi and deficient essence; the fetus inherits this constitution, leading to insufficient nourishment by Kidney Yin, with deficiency fire flaming upward, causing sudden crying. Zhu Danxi discussed this condition, stating it inevitably leads to death. Thus, the causes of infant crying are significant, potentially involving cold, heat, fright, invasion, chest/abdominal pain, or spiritual disturbance. One must observe the manifestation and investigate the specific cause, not dismissing it as a common matter while letting the child weep profusely.
Chao Yuanfang stated: Infants with abdominal distension and crying had mothers who were injured by wind-cold during pregnancy, allowing pathogenic factors to enter the uterus and damage the Zang-Fu organs. Consequently, after birth, pathogens remain in the infant's abdomen. When pathogens move and contend with healthy Qi, abdominal pain occurs, causing the infant to cry with distended abdomen, furrowed brows, and labored breathing. Use Gouteng Gao (Uncaria Paste).
Qian Yi stated: Infant frightful crying refers to suddenly crying and waking from sleep due to pathogenic heat invading the Heart. Use Anshen Wan (Spirit-Calming Pill). Cold-type night crying results from cold in the Spleen, resonating with the abundant Yin of the night, causing pain and crying. Use Qian Shi Danggui Wan (Qian's Angelica Pill). Heat-type night crying presents with abdominal heat-pain, night crying with red face, dry lips, and red urine. Administer Sanhuang Wan (Three Yellow Pill) with Ginseng Decoction.
Zhang Huan stated: During pregnancy, if the mother's care was improper, or if she excessively consumed cold drinks and foods, cold Qi entered the infant's intestines and stomach, weakening fetal Qi. This resulted in a frail, sickly infant prone to crying upon movement after birth, termed "Abdominal Distension Crying." Use Yangzang Tang (Nourish Viscera Decoction).
Wang Lü stated: There are four types of infant night crying: Cold, Heat, Mouth Ulcers with Double Tongue, and Ke Wu (External Shock/Fright). Cold type involves abdominal pain crying, blue-white complexion, cold breath, cold extremities and abdomen, and crying with bent waist. Use Liushen San (Six Spirits Powder) and Yihuang San (Yellow-Regulating Powder). Heat type involves heart irritability crying, red face, red urine, hot mouth, warm abdomen, possibly sweating, and crying while lying on back. If upper body sweats and cries in the first half of the night with red face and fever, it is likely Phlegm-Heat. It stops by dawn. Use Daochi San (Direct Red Powder) plus Huangqin (Scutellaria Root). Mouth ulcers and double tongue cause crying when the nipple touches the mouth; the body and forehead are slightly hot. Inspect with a lamp and treat based on the oral lesions. Ke Wu involves crying due to encountering unusual objects, strangers, or temples/shrines, clashing with spiritual energies. Some cry with fright during the day, worsening around dusk. Use Qian Shi Anshen Wan (Qian's Spirit-Calming Pill).
Pang Anchang stated: Treat infant night crying according to Heart Meridian Heat or Deficiency. Use Dengxin San (Juncus Effusus Powder), Huanglian Yin (Coptis Decoction), or Chanhua San (Cicada Flower Powder). For full-month infants with night crying and convulsions caused by prenatal fright, use Zhenjing San (Fright-Calming Powder). For cases with phlegm, use Baolong Wan (Embrace Dragon Pill).
Li stated: Frequent crying in the first month of life allows fetal heat, toxins, and fright to dissipate, preventing strange diseases.
Shen Jin'ao commented: Li's view is very correct. Therefore, for general infant crying, one should gently hold the child and allow natural crying to cease. Do not forcibly restrain them or stop crying by forcing breastfeeding. If no other illness exists, medication is unnecessary. The aforementioned prescriptions by various masters are reserved for infants with other illnesses and do not imply that all night crying requires medication.