陈紫山曰∶夜啼有四∶有风热,有心热,有寒疝,有误受惊恐。风热者,为衣裳太浓、过于温暖,邪热攻心,
心与小肠为表里,夜啼而遗溺者是也。心热者,见灯愈哭者是也。寒疝者,遇寒即啼是也。误受惊恐者,面色紫黑,气
郁如怒,若有恐惧,睡中惊跳是也。
治法∶推上三关,推下六腑,清心经,水底捞明月,分阴阳法,掐肝经。
如寒疝痛啼,宜运动四横纹,揉脐下,并一窝风。
涂蔚生曰∶凡陈紫山之所谓惊字,与风字有混者,余概以风字易之。若其字句间有可简裁者,余亦略为删去,
务使其言简而意赅,理明而词达。至推拿法有可乘者,余仍录之,以为补助。兹附陈紫山水底捞明月法。
陈紫山曰∶医以左手拿住儿掌向上,以右手滴一点水于儿内劳宫,随用右手四指扇七下。再滴水于心经,又
滴水于天河,天河即肱湾。医者用口吹上四五口,将儿中指屈之,医者仍用左大指掐住,右手捏拳,将中指节自心
经上按摩到曲池,横空在下二指。如此四五次,在三关踢、凉行背上往六腑踢,凉入心肌。此
大凉之法,不可任意乱用。
陈紫山曰∶凡重舌者生于舌下,挺露如舌,故曰重舌。然脾之络脉系舌旁,肝之络脉系舌本,心之络脉系舌
根,此三经或为湿热风寒所中,则舌卷缩,或舒长,或肿满。木舌者舌肿硬而妨乳食,由于风热盛也。盖舌者心
之苗,心热则生疮破裂,肝壅则血出如涌泉,脾闭则白苔如云,热则肿满,风则强木,口合不开,四肢壮热,气
喘语涩即其候也。
治法∶推上三关,心经,脾经,推下六腑,运八卦,运水入土,分阴阳,清天河水。
涂蔚生曰∶舌虽为心之苗,而他脏亦分发于其上。脾属土,宜居舌之中间;肝属木,宜居舌之两旁;肾属水,
宜居舌之根本;心属火,宜居舌尖;肺属金,虽无所配,而其位居至高,就舌尖以诊寒热,亦可诊肺之寒热矣。
紫山所配舌之位次,未免有误。
陈紫山说:夜啼有四种情况:有风热引起的,有心热引起的,有寒疝引起的,有误受惊恐引起的。风热型的,是因为衣服穿得太厚、过于温暖,邪热攻心,心与小肠互为表里,表现为夜间啼哭且遗尿的,就是这种情况。心热型的,表现为看见灯光就哭得更厉害的,就是这种情况。寒疝型的,表现为遇到寒冷就啼哭的,就是这种情况。误受惊恐型的,表现为面色紫黑,气机郁结像发怒一样,好像很恐惧,睡觉时惊跳的,就是这种情况。
治疗方法:推上三关,推下六腑,清心经,水底捞明月法,分阴阳法,掐肝经。
如果是寒疝疼痛导致的啼哭,适宜运动四横纹,揉脐下,以及一窝风穴。
涂蔚生说:凡是陈紫山所说的“惊”字和“风”字有混淆的地方,我都一概用“风”字来代替。如果其中有些词句可以简化删减,我也稍微删去一些,务必使语言简练而意思完备,道理明确而文辞通达。至于推拿手法中有可取之处,我仍然记录下来,作为补充。这里附上陈紫山的“水底捞明月”法。
陈紫山说:医生用左手握住婴儿的手掌向上,用右手滴一点水在婴儿的内劳宫穴,随即用右手四指扇七下。再滴水在心经,又滴水于天河(天河即肘窝)。医生用口吹上四五口气,将婴儿的中指弯曲,医生仍用左手大拇指掐住,右手握拳,将中指节从心经上按摩到曲池穴(曲池穴位于肘横纹外侧端,距肘中二寸处,此处原文描述为“横空在下二指”,结合语境及小儿推拿常规,指沿前臂中线向下至肘部)。如此操作四五次,在三关部位踢打,凉行背上往六腑方向踢打,使凉意进入心肌。这是大凉的方法,不可以随意乱用。
陈紫山说:凡是重舌,都生长在舌头下面,挺露出来像另一个舌头,所以叫重舌。然而脾的络脉联系在舌旁,肝的络脉联系在舌根,心的络脉联系在舌根底部,这三条经络如果被湿热风寒所侵袭,就会导致舌头卷缩,或者伸长,或者肿胀满闷。木舌表现为舌头肿胀坚硬而影响吃奶进食,这是由于风热盛造成的。大概舌头是心的外候,心热就会生疮破裂,肝气壅滞就会出血如涌泉,脾气闭塞就会出现白苔如云,热则肿胀满闷,风则僵硬如木,嘴巴合不拢,四肢壮热,气喘且言语涩滞,这就是它的征候。
治疗方法:推上三关,心经,脾经,推下六腑,运八卦,运水入土,分阴阳,清天河水。
涂蔚生说:舌头虽然是心的外候,但其他脏腑也分别反映在舌头上。脾属土,应该居于舌头的中间;肝属木,应该居于舌头的两旁;肾属水,应该居于舌头的根本;心属火,应该居于舌尖;肺属金,虽然没有什么特定的配合位置,但其位居最高,通过观察舌尖来诊断寒热,也可以诊断肺的寒热了。紫山对舌位的配属,未免有误。
Chen Zishan stated: There are four types of night crying (Yeti): those caused by wind-heat, heart-heat, cold hernia, and accidental fright. The wind-heat type results from clothing being too thick or overly warm, allowing pathogenic heat to attack the Heart. Since the Heart and Small Intestine are exterior-interiorly related, this manifests as night crying accompanied by enuresis (bedwetting). The heart-heat type is characterized by intensified crying upon seeing a lamp. The cold hernia type is characterized by crying triggered by cold exposure. The accidental fright type presents with a purplish-black complexion, qi stagnation resembling anger, apparent fearfulness, and startle jumps during sleep.
Treatment methods include: pushing up the Three Gates (Shang San Guan), pushing down the Six Fu organs (Xia Liu Fu), clearing the Heart Meridian (Qing Xin Jing), retrieving the bright moon from the bottom of the water (Shuidi Lao Mingyue), separating yin and yang (Fen Yin Yang), and pinching the Liver Meridian (Qia Gan Jing).
For night crying due to pain from cold hernia, it is appropriate to move the Four Horizontal Creases (Yun Sihengwen), rub below the navel (Rou Qixia), and apply to the One Nest Wind acupoint (Yiwofeng).
Tu Weisheng stated: Wherever Chen Zishan’s text confuses the characters for "fright" (Jing) and "wind" (Feng), I uniformly replace them with "wind". If any phrases can be simplified or deleted, I have done so briefly, aiming for concise language with complete meaning, clear principles, and expressive wording. Regarding tuina techniques that are viable, I have retained them as supplements. Here, I attach Chen Zishan’s "Retrieving the Bright Moon from the Bottom of the Water" technique.
Chen Zishan stated: The practitioner holds the infant's palm upward with the left hand. With the right hand, drip a drop of water onto the infant's Neilaogong (Inner Laogong, PC8) point, then fan seven times with the four fingers of the right hand. Drip another drop on the Heart Meridian, and another on the Tianhe River (Tianhe River refers to the cubital fossa anterior midline). The practitioner blows four or five breaths over the area. Bend the infant's middle finger; the practitioner secures it with the left thumb while making a fist with the right hand. Massage from the Heart Meridian up to the Qu Chi (LI11) point along the middle finger joint. [Note: The original text describes moving from Heart meridian to Qu Chi, mentioning "two fingers below the transverse space," which anatomically corresponds to the forearm/elbow region]. Repeat this four or five times. Kick/tap along the Three Gates, coolly stroke the back towards the Six Fu channels, allowing the cooling sensation to enter the myocardium. This is a major cooling method and must not be used arbitrarily.
Chen Zishan stated: Heavy tongue (Chongshe) always arises beneath the tongue, protruding like a second tongue, hence the name. The collateral vessels of the Spleen connect to the sides of the tongue; those of the Liver connect to the root of the tongue; those of the Heart connect to the base of the tongue. If these three meridians are invaded by damp-heat, wind, or cold, the tongue may curl inward, extend long, or become swollen and full. Wooden tongue (Mushe) presents as a swollen, stiff tongue that interferes with suckling and eating, caused by excessive wind-heat. Generally, the tongue is the sprout of the Heart; heart-heat causes ulcers and rupture; liver congestion causes bleeding like a gushing spring; spleen closure results in white coating like clouds; heat causes swelling and fullness; wind causes stiffness like wood, preventing mouth opening, accompanied by intense heat in the four limbs, panting, and slurred speech. These are its signs.
Treatment methods include: pushing up the Three Gates, Heart Meridian, Spleen Meridian; pushing down the Six Fu organs; moving the Eight Trigrams (Yun Bagua); moving water into earth (Yun Shui Ru Tu); separating yin and yang; and clearing the Tianhe River.
Tu Weisheng stated: Although the tongue is the sprout of the Heart, other zang-fu organs also manifest upon it. The Spleen belongs to Earth and should reside in the center of the tongue; the Liver belongs to Wood and should reside on the sides of the tongue; the Kidney belongs to Water and should reside at the root of the tongue; the Heart belongs to Fire and should reside at the tip of the tongue; the Lung belongs to Metal. Although it has no specific pairing, it occupies the highest position. Diagnosing cold and heat at the tongue tip can also diagnose lung cold and heat. The positional distribution of the tongue proposed by Zishan is somewhat erroneous.