吴又可治孕妇瘟疫,用三承气兴利除害于反掌之间固已,但方中定当减去芒硝。盖芒硝乃软
坚之物,用之能使胎化为水。倘痞满燥实坚皆俱,极数用生大黄而止,否则止用熟军为妥,胎与
肠胃绝不相关,大黄荡肠胃而破坚燥,未闻能下胞孕者,服之何害。至云大黄为安胎之圣药,是
专为里症应下者言之。若邪尚在表者,当速散其表邪,毋使内陷,为上乘也。
HT 胎散 孕妇瘟疫,恐伤胎气。
嫩卷荷叶(晒干,宜平时收贮。临时急用则烘干,五钱) 蚌粉(二钱五分)
上共为末,每用新汲水入蜜,调服三钱,再作一剂,涂腹上。
又方 井底泥涂足心。治孕娠时症,令子不安。
又方 用灶底中对锅脐土,研细,水调服,仍涂脐,干再换。
涂脐散 井底泥、青黛、伏龙肝,共末调匀,涂脐上。干,再换。
黄豆煎 大黄豆六十粒,水二盅,煎一盅,取汗。病重再一服。
妊娠热病,车辖脂、黄酒和服。 青羊屎研烂,涂脐安胎。
又方 鸡子十枚,纳井中,令冷,取出打破,吞之,令胎不动。
妊娠时行并感寒,大鲫鱼一尾,烧存性,研,黄酒冲服。如无汗,腹中热痛,醋和服,取汗。
热病,葛根汁频服。
瘟疫盛行之时,小儿如有发热等症,或可断其为疫,倘瘟疫不行之年,而小儿忽感瘟疫,于
何辨之哉?亦辨之于抖然身热而已。第伤寒瘟疫皆身热,又当细问乳
母,曾否突然脱衣,洗浴入水,当风而寝等事,果实无感冒,方可向瘟疫上找寻。又必验其有目
赤便赤,舌干苔黄黑,日晡潮热,谵语斑黄,或大便秘结,或挟热下利赤胶等症,方可断其为
瘟疫。若妄意杂症为瘟疫,则又失之矣。吴又可专言俗医妄意小儿瘟疫为杂症者,是只见一边矣。
总之,辨小儿瘟疫是极难的事。
桃叶浴法 桃叶三四两,熬水,日五六遍浇淋之。再用雄鼠屎微烧,取二枚,研,水和服。
二香散 (天行壮热。)
木香(末,三分) 檀香(末,三分)
清水和服。(仍用温水调涂囟门。)
吴又可治疗孕妇患瘟疫,使用三承气汤(通腑泄热的方剂)在极短时间内兴利除害,这已经很好了,但方中应当减去芒硝。因为芒硝是软化坚硬之物的药物,使用它可能导致胎儿化为水液而流失。如果痞、满、燥、实、坚五种症状全部具备,最多使用生大黄即可停止,否则只使用熟大黄更为稳妥。胎儿与肠胃绝不相关,大黄虽然能荡涤肠胃、破除坚燥,但未听说能导致堕胎的,服用它有什么危害呢?至于说大黄是安胎的圣药,这是专门针对里有实热证应当使用下法的情况而言的。如果邪气还在体表,应当迅速疏散表邪,不要使其内陷,这才是上等的治法。
HT 胎散:用于孕妇患瘟疫,担心损伤胎气。
嫩卷荷叶(晒干,宜平时收藏储备。临时急需使用时则烘干,用量五钱),蚌粉(二钱五分)。
以上共同研为细末,每次取新汲取的凉水加入蜂蜜,调服三钱,再制作一剂,涂抹于腹部。
又一方:用井底泥涂抹足心。治疗妊娠期间患时行疫病,使胎儿不安稳。
又一方:用灶底中间锅底脐周围的土,研细,用水调服,同时涂抹肚脐,干了再更换。
涂脐散:由井底泥、青黛、伏龙肝组成,共同研末调匀,涂抹于肚脐上。干了再更换。
黄豆煎:大黄豆六十粒,加水两盅,煎至一盅,取汗出。病情重的再服一次。
又一方:鸡蛋十个,放入井水中浸泡至冷,取出打破,吞食,以使胎儿安定不动。
妊娠期间感受时行疫气并兼感寒邪:取大鲫鱼一条,烧存性(烧焦保留药性),研细,用黄酒冲服。如无汗,腹中热痛,用醋调和服用,以取汗。
瘟疫盛行之时,小儿如果有发热等症状,或许可以断定其为瘟疫;倘若在瘟疫不流行的年份,而小儿突然感染瘟疫,从何处辨别呢?也是通过突然身体发热来辨别。只是伤寒和瘟疫都会出现身热,又应当详细询问乳母,是否曾突然脱衣、洗浴入水、当风而寝等情况,确实没有感冒,才可以向瘟疫方面寻找依据。还必须验证其有眼睛发红、大便发红、舌干苔黄黑、日晡潮热(下午3-5点发热加重)、谵语(胡言乱语)、斑黄,或者大便秘结,或者挟热下利赤胶(痢疾样便)等症状,才可以断定为瘟疫。如果妄意将杂症当作瘟疫,那就错了。吴又可专门指责俗医妄意将小儿瘟疫当作杂症,这是只见到了问题的一个方面。总之,辨别小儿瘟疫是非常困难的事。
桃叶浴法:桃叶三四两,熬水,每天五六遍浇淋身体。再用雄鼠屎轻微烧焦,取两枚,研细,用水调服。
二香散:(适用于天行壮热,即流行性高热。)
木香(末,三分),檀香(末,三分)。
用清水调和服用。(仍用温水调匀后涂抹囟门。)
Wu Youke treated pregnant women suffering from plague using San Chengqi Tang (Three Inheriting Decoctions, a formula for purging heat and accumulation), achieving benefit and eliminating harm within a very short time, which was already excellent. However, Mangxiao (Natrii Sulfas) should be removed from the prescription. This is because Mangxiao is a substance that softens hardness; its use could cause the fetus to dissolve into fluid. If symptoms of pi (glomus), man (fullness), zao (dryness), shi (excess), and jian (hardness) are all present, one may use Sheng Dahuang (Raw Radix et Rhizoma Rhei) at most and then stop; otherwise, it is more appropriate to use only Shu Jun (Prepared Radix et Rhizoma Rhei). The fetus and the intestines and stomach are absolutely unrelated. Although Dahuang can cleanse the intestines and stomach and break up hardness and dryness, there is no record of it causing abortion. What harm would there be in taking it? As for the claim that Dahuang is the sacred medicine for calming the fetus, this statement applies specifically to cases with interior excess syndromes requiring purgation. If the pathogenic factor remains in the exterior, one should rapidly disperse the exterior pathogen to prevent it from sinking inward, which is the superior treatment method.
HT Ta San: Used for pregnant women suffering from plague, fearing damage to fetal qi.
Nen Juan Heye (Dried tender coiled lotus leaf, preferably stored in advance; if needed urgently, dry it by heating, dosage 5 qian), Bangfen (Concha Tridacnidae, dosage 2.5 qian).
Grind the above together into fine powder. For each dose, mix with fresh well water and honey, take 3 qian orally. Prepare another dose to apply topically on the abdomen.
Another prescription: Apply mud from the bottom of a well to the soles of the feet. Treats fetal restlessness caused by seasonal epidemic diseases during pregnancy.
Another prescription: Use soil from the center of the stove base around the pot's rim, grind finely, mix with water for oral administration, and simultaneously apply to the umbilicus. Replace when dry.
Tumi San (Umbilical Application Powder): Composed of Jingdi Ni (Mud from the bottom of a well), Qingdai (Indigo Naturalis), and Fulonggan (Caulis Longan or Dragon Bone depending on context, here likely Arsenolite or similar earthy substance used in folk remedies, literally "Dragon Sitting Liver"), ground together and mixed evenly. Apply to the umbilicus. Replace when dry.
Huangdou Jian (Soybean Decoction): 60 large soybeans, add two zhong of water, decoct until one zhong remains. Induce sweating. If the condition is severe, administer another dose.
Pregnancy febrile disease: Chegu Zhi (Grease from chariot wheel axles) taken with Huangjiu (Yellow wine).
Qingyangshi (Excrement of black sheep) ground into a paste, applied to the umbilicus to calm the fetus.
Another prescription: Take ten chicken eggs, immerse them in a well until cold, remove, crack open, and swallow to stabilize the fetus.
Pregnancy complicated by seasonal epidemic qi and cold invasion: Take one large crucian carp, burn until carbonized but retaining medicinal properties, grind finely, and wash down with Huangjiu. If there is no sweat and abdominal heat pain, mix with vinegar and take to induce sweating.
Febrile disease: Ge Gen juice (Puerariae Lobatae Radix juice) taken frequently.
During times of rampant plague, if children exhibit symptoms such as fever, one might tentatively diagnose plague. However, in years when plague is not prevalent, and a child suddenly contracts plague, how can it be distinguished? It is distinguished by sudden onset of body heat. Since both Shanghan (Cold Damage) and plague present with body heat, one must carefully inquire of the wet nurse whether the child suddenly undressed, bathed in water, or slept facing the wind. Only if there is indeed no common cold can one look towards plague as the diagnosis. One must also verify the presence of red eyes, red stool, dry tongue with yellow or black coating, tidal fever at dusk (ri bu chao re), delirium, yellowish macules, or constipation, or dysentery-like diarrhea with bloody mucus. Only then can it be diagnosed as plague. Mistakenly identifying miscellaneous diseases as plague is an error. Wu Youke specifically criticized ordinary physicians for mistakenly identifying pediatric plague as miscellaneous diseases; this view only sees one side of the issue. In summary, distinguishing pediatric plague is extremely difficult.
Taoye Yu Fa (Peach Leaf Bath Method): Use 3-4 liang of peach leaves, decoct in water, and pour over the body 5-6 times daily. Then, take two pieces of Xiong Shushi (Stercor Muscerdomestici Fermentatus, male rat feces), lightly roast, grind, and take with water.
Erxiang San (Two Fragrances Powder): (For Tianxing Zhuang Re, i.e., epidemic high fever.)
Muxiang (Aucklandiae Radix, powdered, 3 fen), Tanxiang (Santalum Album Lignum, powdered, 3 fen).
Mix with clear water for oral administration. (Still apply with warm water to the fontanelle.)