温壮与壮热,相类而有小异,一向热而不止是壮热也。但温温然不甚盛是温壮
也。若大便臭而黄者,此腹内有伏热,以四顺饮子治之。若粪白而酸臭,则挟宿食
不消,当服紫霜丸,轻者少服,重者节乳哺,增加丸药,当取微利可也。
紫霜丸(见癖积)
柴苓汤 治小儿温壮,伏热来去。
柴胡(三钱半) 麦门冬(去心) 人参(去芦) 赤茯苓 甘草(各二钱半) 黄芩(五钱)
上锉散。用水煎,入小麦二十粒、竹叶三片。
二黄犀角散 治温壮,心热神不安,大腑秘结。
犀角屑 大黄(酒浸,蒸) 钓藤钩 栀子仁 甘草 黄芩(各半两)
上为末。每服五分,热汤调下,量儿加减。
牛黄散 治温壮,常热或寒热往来。
牛黄(研) 甘草(各半两) 柴胡 栀子(酒炒) 龙胆草(酒炒) 黄芩(炒,各二钱半)
上为末。每服半钱,以金银薄荷汤调下。
惊热者,遍身发热,或热而不甚,面青自汗,睡梦虚惊,颠叫恍忽,有因惊而
生热者,有因热而生惊者,钱氏导赤散、凉惊丸、安神散之类,皆其治也。
七宝散(见前)
天竺黄散 治小儿惊风热。
天竺黄(研) 川郁金 山栀子 白僵蚕(炒,去丝嘴) 蝉壳(去土) 甘草(各等分)
上为末。一岁半钱,熟水、薄荷汤皆可,服不拘时。
甘露散 治小儿惊热,通利小肠,去惊涎,清心腑,止烦渴。安神稳睡加朱砂,名
加朱甘露散。
寒水石(研,软而微青、中有细纹者是) 石膏(研。各二两,坚白、有墙壁,如无、以方
解石代之) 生甘草末(一两)
上件为末和匀。量儿大小,或一钱或半钱,热月冷服,寒月热服,用薄荷汤调
或灯心汤调。被惊心热不安卧皆可服。小便不通快,麦门冬灯心汤。若惊热,入
朱砂少许,不拘时服。一方,有赤茯苓一两。《苏沈方》用滑石,不是石膏。钱氏
名玉露散,每服一字或半钱或一钱,食后,温白汤调下。
辰砂金箔散 治小儿心膈邪热,神志不宁,惊惕烦渴,恍忽怔忡,夜卧不安,齿龈
肿烂,及痰实咳嗽,咽膈不利。
辰砂(另研) 桔梗(各二钱半) 人参 白茯苓(各一钱半) 蛤粉(四钱,飞研)
牙硝(枯,一钱半) 甘草(炙,一钱二分半) 片脑(一分半) 半金箔(一片)
上为末。一岁半钱,薄荷汤调,不拘时。百 小儿脏腑多热,睡卧不稳,大便
不利,蜜汤调一字。
〔本〕治小儿惊热。
全蝎 天南星(取心,为末,一钱) 人参(三钱) 蛇蜕(三钱)
上为末。薄荷蜜汤调下。
温壮与壮热,症状相似但有细微差别。持续高热不退的是壮热。而体温微微升高、热度不盛的是温壮。如果大便气味臭秽且颜色发黄,这是腹内有伏热(潜伏的热邪),用四顺饮子治疗。如果粪便色白且有酸臭味,则是夹杂宿食消化不良,应当服用紫霜丸;病情轻的少量服用,病情重的节制乳食喂养,增加丸药剂量,以取得轻微腹泻为度。
柴苓汤 治疗小儿温壮,伏热忽来忽去。
柴胡(三钱半) 麦门冬(去除心部) 人参(去除芦头) 赤茯苓 甘草(各二钱半) 黄芩(五钱)
以上药材切碎成散剂。用水煎煮,加入小麦二十粒、竹叶三片。
二黄犀角散 治疗温壮,心热导致神志不安,大便秘结不通。
犀角屑 大黄(用酒浸泡,蒸制) 钓藤钩 栀子仁 甘草 黄芩(各半两)
以上药材研为细末。每次服用五分,用热水调服,根据患儿年龄大小酌情增减剂量。
牛黄散 治疗温壮,持续发热或寒热往来(发冷发热交替出现)。
牛黄(研磨) 甘草(各半两) 柴胡 栀子(用酒炒制) 龙胆草(用酒炒制) 黄芩(炒制,各二钱半)
以上药材研为细末。每次服用半钱,用金银花薄荷汤调服。
惊热,表现为全身发热,或者发热但不严重,面色发青,自然出汗,睡眠中做噩梦受惊,突然尖叫、神情恍惚。有的因受惊吓而产生发热,有的因发热而产生惊厥。钱乙的导赤散、凉惊丸、安神散等方剂,都是治疗此病的方法。
天竺黄散 治疗小儿惊风热。
天竺黄(研磨) 川郁金 山栀子 白僵蚕(炒制,去除丝嘴) 蝉壳(去除泥土) 甘草(各等分)
以上药材研为细末。一岁的患儿服用半钱,用熟水或薄荷汤送服,服药时间不拘泥。
甘露散 治疗小儿惊热,通利小肠,去除惊涎(因惊引起的痰涎),清心腑,止烦渴。若加朱砂以安神稳睡,则名为加朱甘露散。
寒水石(研磨,质地柔软微青、中间有细纹的是正品) 石膏(研磨。各二两,质地坚硬洁白、断面如墙壁纹理的为上品,如果没有,可用方解石代替) 生甘草末(一两)
以上药材混合均匀研为细末。根据患儿大小,每次服用一钱或半钱,夏季冷服,冬季热服,用薄荷汤或灯心草汤调服。凡是因受惊吓导致心热不安卧的都可以服用。若小便不通畅,可用麦门冬灯心草汤送服。若是惊热,加入少许朱砂,随时服用。另一配方中,有一两赤茯苓。《苏沈方》使用滑石,而不是石膏。钱乙称之为玉露散,每次服用一字或半钱或一钱,饭后用温白开水调服。
辰砂金箔散 治疗小儿心膈部位邪热,神志不宁,惊惕烦躁口渴,神情恍惚、心悸怔忡,夜间睡眠不安,牙龈肿胀腐烂,以及痰实咳嗽,咽喉膈部不利。
辰砂(单独研磨) 桔梗(各二钱半) 人参 白茯苓(各一钱半) 蛤粉(四钱,飞研处理)
牙硝(枯制,一钱半) 甘草(炙制,一钱二分半) 片脑(一分半) 半金箔(一片)
以上药材研为细末。一岁的患儿服用半钱,用薄荷汤调服,时间不拘。另有说法:小儿脏腑多热,睡眠不稳,大便不利,用蜜汤调服一字量。
〔本〕治疗小儿惊热。
全蝎 天南星(取中心部分,研为末,一钱) 人参(三钱) 蛇蜕(三钱)
以上药材研为细末。用薄荷蜜汤调服。
Wen Zhuang (Warm Excess) and Zhuang Re (High Fever) are similar but have slight differences. Continuous high fever that does not cease is Zhuang Re. Wen Zhuang refers to a condition where the body temperature is slightly elevated, but the heat is not intense. If the stool is foul-smelling and yellow, this indicates latent heat (Fu Re, hidden pathogenic heat) in the abdomen, which should be treated with Si Shun Yin Zi (Four Compliance Decoction). If the stool is white and sour-smelling, it indicates indigestion of retained food; Zishuang Wan (Purple Frost Pill) should be administered. For mild cases, take a small amount; for severe cases, restrict milk feeding, increase the dosage of the pill, and aim for a mild laxative effect.
Chai Ling Tang (Bupleurum and Coix Decoction) treats Wen Zhuang in children, characterized by the ebb and flow of latent heat.
Chai Hu (Bupleuri Radix, 3 qian 1/2), Maidong (Ophiopogonis Radix, heart removed), Renshen (Ginseng Radix et Rhizoma, radix removed), Chifushuling (Poria Cocos with Red Mycelium), Gancao (Licorice Radix et Rhizoma, each 2 qian 1/2), Huangqin (Scutellariae Radix, 5 qian).
Crush into a coarse powder. Decoct in water, adding twenty grains of wheat and three leaves of bamboo.
Erhuang Xijiao San (Two-Yellow and Rhinoceros Horn Powder) treats Wen Zhuang, with heart-heat causing mental restlessness and constipation.
Xijiao (Rhinoceri Cornu, shaved), Dahuang (Rhei Radix et Rhizoma, soaked in wine and steamed), Gouteng (Uncariae Ramulus cum Uncis), Zhizi (Gardeniae Fructus), Gancao (Licorice Radix et Rhizoma), Huangqin (Scutellariae Radix, each half liang).
Grind into a fine powder. Take 5 fen per dose, mixed with hot water, adjusting the dosage according to the child's age.
Niuhuang San (Calculus Bovis Powder) treats Wen Zhuang, presenting as persistent fever or alternating chills and fever.
Niuhuang (Calculus Bovis, ground), Gancao (Licorice Radix et Rhizoma, each half liang), Chai Hu (Bupleuri Radix), Zhizi (Gardeniae Fructus, stir-fried with wine), Longdancao (Gentianae Radix, stir-fried with wine), Huangqin (Scutellariae Radix, stir-fried, each 2 qian 1/2).
Grind into a fine powder. Take half a qian per dose, mixed with a decoction of honeysuckle and mint.
Jing Re (Heat from Fright) presents as generalized fever, or mild fever, cyanosis of the face, spontaneous sweating, fright dreams during sleep, sudden screaming, and mental confusion. Some fevers arise from fright, while some fright arises from fever. Qian Yi's Daochi San (Guide Out Redness Powder), Liangjing Wan (Cooling Fright Pill), Anshen San (Calm Spirit Powder), and similar formulas are treatments for this condition.
Tianzhuhuang San (Infused Bamboo Milk Powder) treats pediatric wind-heat from fright.
Tianzhuhuang (Infusa Bambusae), Chanyujin (Curcumae Radix), Shanzhizi (Gardeniae Fructus), Baijiangcan (Bombyx Batryticatus, stir-fried, remove silk mouth), Chanqiao (Cicadae Periostracum, clean dirt), Gancao (Licorice Radix et Rhizoma, equal parts).
Grind into a fine powder. For a one-year-old child, take half a qian, taken with boiled water or mint tea, at any time.
Ganlu San (Sweet Dew Powder) treats pediatric Jing Re, promoting urination through the small intestine, removing phlegm-saliva from fright, clearing the heart fu, and relieving irritability and thirst. Adding Cinnabar to calm the spirit and stabilize sleep creates Jia Zhu Ganlu San (Cinnabar-Added Sweet Dew Powder).
Hanshuishi (Aqua Calcitae, ground, soft and slightly green with fine veins is authentic), Shigao (Gypsum Fibrosum, ground. Each 2 liang, hard and white with wall-like texture is best; if unavailable, use Spathiae Fibrosum as a substitute), Sheng Gancao Mo (Raw Licorice Radix et Rhizoma powder, 1 liang).
Mix and grind into a uniform powder. According to the child's size, take 1 qian or half a qian. In summer, take cold; in winter, take warm. Mix with mint tea or club-rush tea. It can be taken for anxiety and restlessness due to fright-heat. If urine is blocked, use Ophiopogonis and club-rush tea. For Jing Re, add a little Cinnabar and take at any time. Another prescription includes 1 liang of Chifushuling. *Su Shen Fang* uses Talcum instead of Gypsum. Qian Yi called this Yulu San (Jade Dew Powder); take one zi, half a qian, or one qian after meals, mixed with warm plain water.
Chensha Jinbo San (Cinnabar and Gold Leaf Powder) treats pathogenic heat in the heart and diaphragm of children, causing mental unrest, fright, irritability, and thirst, mental confusion, palpitations, restless sleep at night, swollen and ulcerated gums, as well as cough with phlegm-solidity and obstruction in the throat and diaphragm.
Chensha (Cinnabar, ground separately), Jiegeng (Platycodonis Radix, each 2 qian 1/2), Renshen (Ginseng Radix et Rhizoma), Baifuling (Poria Cocos, each 1 qian 1/2), Haf Fen (Concha Meretricis et Cyclinae, 4 qian, refined and ground), Yanxiao (Natrii Sulfas, calcined, 1 qian 1/2), Gancao (Licorice Radix et Rhizoma, honey-fried, 1 qian 2 fen 1/2), Pian Nao (Borneolum Syntheticum, 1 fen 1/2), Ban Jinbo (Half a sheet of Gold Leaf).
Grind into a fine powder. For a one-year-old child, take half a qian, mixed with mint tea, at any time. Another note: Children's zang-fu organs often have excess heat, leading to unstable sleep and difficult defecation; mix with honey water and take one zi.
[Ben] Treats pediatric Jing Re.
Quanxie (Scorpio), Tiannanxing (Arisaematis Rhizoma, take the center, grind into powder, 1 qian), Renshen (Ginseng Radix et Rhizoma, 3 qian), Shetui (Serpentis Shed Skin, 3 qian).
Grind into a fine powder. Take mixed with mint and honey water.