《圣惠》儿多涎者,风热壅脾,积聚成涎,即乳食不下,涎沫结实,而生壮热。小儿多涎,由脾气不足,不
能四布津液而成,若不治其本,益中气,而徒去其痰涎,痰涎虽病液,亦元气所附,去之不已,遂成虚脱,余见
惊搐壮热等证,医以下痰,小见功效,屡下之,而致夭亡者,屡矣。钱氏治朱监簿子五岁,夜发热,晓如故。
医以铁粉丸下涎,病益甚,至五日,大引饮。钱取白术散(痘渴)一两,煎三升,任意服。朱疑其泻。钱曰纵泻勿怪,
但不
可下耳!止泻、治痰、退热、清神,皆此药也。又煎三升服,稍尽,愈。第三日又服三升,不渴无涎,投
阿胶散(喘嗽)二服,安。
半夏丸 治痰证,若惊搐后风涎潮作,服之神效。
半夏(生用二两) 赤茯苓(去皮) 枳壳(制各一两) 风化朴硝(二钱半)
上,前三味锉焙为末,入乳钵同朴硝杵匀,用生姜自然汁煮糯米粉为丸,绿豆大。每服三十丸至五十丸,仍以
淡姜汤食后临睡送下。儿小,煮丸如粟谷大。
白附丸 通治小儿咳嗽有痰,感冒发热,吐泻心神不安,神效。
南星(二两) 半夏 白附子 白矾(各一两)
上为细末,姜汁糊丸,如桐子大。一岁儿服八丸,用薄荷汤化下。(南星、半夏用冬藏雪水,于六月六日浸起,
晒干又浸,凡九次方用)
胆星天竺丸 治小儿痰涎上壅,喘嗽不休。
牛胆南星(一两) 半夏(汤泡,去皮脐,姜汁制) 白附子(汤泡,去皮脐。各五钱) 天竺黄(三钱) 天麻
防风(各二钱) 辰砂(一钱,另研、水飞)
上为末。甘草膏为丸,芡实大。每服一丸,空心、薄荷淡姜汤化下。
牛蒡子散 治小儿心脾壅热,多涎。
牛蒡子 栀子仁 甘草 川硝 郁金(各半两) 枳壳(一分,麸炒微黄,去瓤)
上件药捣,细罗为散,入龙脑半钱,同研令匀。不计时候,用薄荷水调下半钱。量儿大小,加减服之。
〔万全〕郁金散 治小儿风热,镇心压涎。
郁金(一两,用皂角二梃, 水一碗以来,慢煮郁金令干,用水净洗、锉) 天竺黄 马牙硝 甘草
(炙。各半两) 朱砂(一分,研) 龙脑(一钱,研)
上件药捣,罗为末,都研令匀。每服半钱,用麦门冬熟水调下。量儿大小,以意加减服。
小朱砂丸 治小儿眠睡多惊,化风壅痰涎,安神。
朱砂(一两,别研) 天南星(牛胆内制者) 人参 茯苓 珍珠(研) 半夏(生姜半两,同以水煮
一二百沸,取出焙干。各秤末半两) 龙脑 麝香(各少许)
上件同研匀。以水浸蒸饼为丸,如黍米大。每服四五丸,不计时候,煎金银
汤下。
〔张涣〕治小儿多涎,乳食不下,涎不流出者,乃名脾热多涎,宜。金朱丹
朱砂(细研、水飞) 半夏(汤浸七遍) 牛胆南星(各一两) 白茯苓(半两。三味为末) 石膏(
半两,细研、水飞) 金箔(二十片,研)
上件,都拌匀,再细研,用生姜自然汁和,如黍米大。每服十粒,煎人参汤下,乳后。
〔谭氏〕金珠丸 治小儿惊悸心忪,化涎痰,利胸膈烦热,止咳嗽。
天南星(炮) 白矾(焙) 半夏(汤浸,七钱) 朱砂(研细,各半两) 人参 干山药(各一钱)
腻粉(二钱) 金箔(十片)
上为细末,薄荷汁同水打糊为丸,如绿豆大,金箔为衣。每服一丸,食后,生姜汤下。量力服。
半夏丸 治小儿脾热,乳食不下,胸膈多涎。
半夏(半分,生姜汤洗七遍,去滑) 皂角子仁(半两)
上件药捣、罗为末。用生姜汁和丸,如麻子大。不计时候,以温水下三丸。随
儿大小,以意加减。
〔刘氏〕消乳痰丸 此方,出禁中,小儿无疾,亦宜常服。
大半夏(半两,切作头子大,用萝卜一个,亦切作头子大,用水一碗煮,水尽为度,不用萝卜)
人参(二钱半,取末、二钱)
上二味,焙干,同为细末,生姜自然汁煮糊为丸,如绿豆大。每服二十丸,或三十丸,生姜汤下,食
后服。看儿大小加减。
《圣惠方》中提到,小儿多涎症,是由于风热邪气壅滞脾脏,积聚形成涎液,导致乳食无法下咽,涎沫凝结结实,从而产生壮热。小儿多涎,根源在于脾气不足,不能正常布散津液所致。如果不治疗其根本原因,补益中气,而仅仅去除痰涎,虽然痰涎是病理产物,但也依附于元气,若过度去除,会导致虚脱。我见过惊搐、壮热等证候,医生用攻下法祛痰,起初见效,但多次使用攻下法,导致患儿夭折的情况屡见不鲜。钱乙曾治疗朱监簿的五岁儿子,夜间发热,早晨恢复正常。医生用铁粉丸攻下痰涎,病情反而加重,到了第五天,患儿大量饮水。钱乙取白术散(用于痘疹口渴)一两,煎煮成三升,让患儿随意服用。朱监簿怀疑这药会致泻。钱乙说:“即使腹泻也不要奇怪,只是不可再用攻下药罢了!”此药具有止泻、治痰、退热、清神的作用。又煎煮三升给患儿服用,稍许服完,病愈。第三天又服用三升,不再口渴且无涎液,再投服阿胶散(用于喘嗽)两剂,病情安定。
半夏丸:治疗痰证,若在惊搐后风涎潮动发作,服用此药有显著疗效。
药材:半夏(生用二两)、赤茯苓(去皮)、枳壳(制,各一两)、风化朴硝(二钱半)。
制法:将前三味药材切碎焙干研为细末,放入乳钵中与朴硝一同杵匀,用生姜自然汁煮糯米粉制成丸药,大小如绿豆。每次服用三十至五十丸,饭后临睡前用淡姜汤送服。幼儿可将丸药煮小如粟谷大。
白附丸:通治小儿咳嗽有痰、感冒发热、吐泻及心神不安,疗效显著。
药材:南星(二两)、半夏、白附子、白矾(各一两)。
制法:研为细末,用姜汁调糊制成丸药,大小如梧桐子。一岁的患儿服用八丸,用薄荷汤化开送下。(注:南星、半夏需用冬季储藏的雪水,在六月六日浸泡取出,晒干后再浸泡,如此反复九次后方可使用)
胆星天竺丸:治疗小儿痰涎上壅,喘咳不止。
药材:牛胆南星(一两)、半夏(汤泡,去皮脐,姜汁制)、白附子(汤泡,去皮脐,各五钱)、天竺黄(三钱)、天麻、防风(各二钱)、辰砂(一钱,另研、水飞)。
制法:研为细末,用甘草膏制成丸药,大小如芡实。每次服用一丸,空腹时用薄荷淡姜汤化开送下。
牛蒡子散:治疗小儿心脾壅热,多涎。
药材:牛蒡子、栀子仁、甘草、川硝、郁金(各半两)、枳壳(一分,麸炒微黄,去瓤)。
制法:将上述药材捣碎,过细筛成为散剂,加入龙脑半钱,共同研磨均匀。不限时候,用薄荷水调服半钱。根据患儿年龄大小,酌情加减服用。
〔万全〕郁金散:治疗小儿风热,镇心安神,压制涎液。
药材:郁金(一两,用皂角二根,水一碗以上,慢火煮郁金至干,用水洗净、切碎)、天竺黄、马牙硝、甘草(炙,各半两)、朱砂(一分,研)、龙脑(一钱,研)。
制法:将上述药材捣碎,过筛成为细末,共同研磨均匀。每次服用半钱,用麦门冬熟水调服。根据患儿年龄大小,酌情加减服用。
小朱砂丸:治疗小儿睡眠中易受惊,化解风邪壅滞之痰涎,安神定志。
药材:朱砂(一两,别研)、天南星(牛胆内制者)、人参、茯苓、珍珠(研)、半夏(生姜半两,同水煮一二百沸,取出焙干,各秤取半两粉末)、龙脑、麝香(各少许)。
制法:将上述药材共同研磨均匀。用水浸湿蒸饼制成丸药,大小如黍米。每次服用四五丸,不限时候,煎金银汤送服。
〔张涣〕治小儿多涎,乳食不下,涎液不流出者,名为脾热多涎,宜用金朱丹。
药材:朱砂(细研、水飞)、半夏(汤浸七遍)、牛胆南星(各一两)、白茯苓(半两,这三味研为细末)、石膏(半两,细研、水飞)、金箔(二十片,研)。
制法:将上述药材拌匀,再次细研,用生姜自然汁调和,制成如黍米大的丸药。每次服用十粒,饭后用人参汤送服。
〔谭氏〕金珠丸:治疗小儿惊悸心慌,化解涎痰,利胸膈烦热,止咳嗽。
药材:天南星(炮)、白矾(焙)、半夏(汤浸,七钱)、朱砂(研细,各半两)、人参、干山药(各一钱)、腻粉(二钱)、金箔(十片)。
制法:研为细末,用薄荷汁和水打糊制成丸药,大小如绿豆,以金箔为衣。每次服用一丸,饭后用生姜汤送服。根据体力酌情服用。
半夏丸:治疗小儿脾热,乳食不下,胸膈多涎。
药材:半夏(半分,生姜汤洗七遍,去滑)、皂角子仁(半两)。
制法:将上述药材捣碎、过筛成为细末。用生姜汁和丸,大小如麻子。不限时候,用温水送服三丸。根据患儿年龄大小,酌情加减。
〔刘氏〕消乳痰丸:此方出自宫廷禁方,小儿即便无病,也适宜常服。
药材:大半夏(半两,切作头子大,用萝卜一个,亦切作头子大,用水一碗煮,水尽为度,不用萝卜)、人参(二钱半,取末、二钱)。
制法:将上述两味药材焙干,共同研为细末,用生姜自然汁煮糊制成丸药,大小如绿豆。每次服用二十或三十丸,饭后用生姜汤送服。根据患儿年龄大小酌情加减。
According to the *Shenghui Fang*, excessive salivation in infants and children is caused by wind-heat pathogenic factors obstructing the Spleen, leading to the accumulation of phlegm-fluids. This results in an inability to take milk or food, solidification of saliva and froth, and the onset of high fever. The condition of excessive salivation in children stems from insufficient Spleen Qi, which fails to distribute body fluids properly. If the root cause is not treated by tonifying Middle Qi, and only the phlegm-fluids are removed, although phlegm-fluids are pathological products, they are also attached to Yuan Qi (Original Qi). Excessive removal will lead to deficiency collapse. I have witnessed cases of convulsions and high fever where physicians used purgative methods to expel phlegm; although initial effects were seen, repeated purgation often led to premature death. Qian Yi once treated the five-year-old son of Supervisor Zhu, who had night fevers that resolved by morning. A physician administered Tie Fen Wan (Iron Powder Pill) to purge phlegm, but the condition worsened. By the fifth day, the child was drinking excessively. Qian Yi prescribed Bai Zhu San (Atractylodes Macrocephala Powder) for thirst associated with smallpox, one tael, decocted into three sheng, to be taken freely. Mr. Zhu suspected it might cause diarrhea. Qian Yi stated, "Do not be surprised if diarrhea occurs; simply do not use purgatives!" This formula stops diarrhea, treats phlegm, reduces fever, and clears the spirit. After taking another three sheng, slightly finishing the dose, the child recovered. On the third day, another three sheng were taken; thirst and salivation ceased. Two doses of E Jiao San (Donkey-hide Gelatin Powder) for cough and wheezing were then administered, stabilizing the condition.
Ban Xia Wan (Pinellia Pill): Treats phlegm syndromes. It is highly effective for tidal movements of wind-phlegm following convulsions.
Ingredients: Ban Xia (Pinelliae Rhizoma, raw, 2 liang), Chi Fu Ling (Poria with Red Hosta Root, peeled), Zhi Ke (Immature Bitter Orange, processed, each 1 liang), Feng Hua Pu Xiao (Weathered Mirabilite, 2 qian 5 fen).
Preparation: Finely chop and roast the first three ingredients, grind into powder, and mix thoroughly with Mirabilite in a mortar. Use fresh ginger juice to cook glutinous rice flour to form pills the size of mung beans. Administer 30–50 pills per dose, taken after meals and before sleep with light ginger soup. For young children, boil the pills until they are the size of millet grains.
Bai Fu Wan (White Head Pill): Universally treats pediatric cough with phlegm, cold-induced fever, vomiting/diarrhea, and restlessness, with remarkable efficacy.
Ingredients: Nan Xing (Arisaema Cum Bile, 2 liang), Ban Xia (Pinelliae Rhizoma), Bai Fu Zi (Typhonii Rhizoma), Bai Fan (Alumen, each 1 liang).
Preparation: Grind into fine powder, bind with ginger juice paste into pills the size of paulownia seeds. One-year-old children take 8 pills, dissolved in mint soup. (Note: Arisaema and Pinellia should be soaked in snow water stored from winter, starting on the sixth day of the sixth lunar month, dried, and re-soaked nine times before use.)
Dan Xing Tian Zhu Wan (Gall-nut Star and Tianshu Pill): Treats upward obstruction of phlegm-fluids in children, causing incessant cough and wheezing.
Ingredients: Niu Dan Nan Xing (Arisaema Cum Bile prepared with Ox Gall, 1 liang), Ban Xia (Pinelliae Rhizoma, decocted, peeled, processed with ginger juice), Bai Fu Zi (Typhonii Rhizoma, decocted, peeled, each 5 qian), Tian Zhu Huang (Bambusae Sabinae Concretio, 3 qian), Tian Ma (Gastrodiae Rhizoma), Fang Feng (Saposhnikoviae Radix, each 2 qian), Chen Sha (Cinnabar, 1 qian, separately ground and levigated).
Preparation: Grind into powder, bind with Licorice paste into pills the size of Euryale seeds. Take one pill per dose on an empty stomach, dissolved in light ginger-mint soup.
Niu Bang Zi San (Arctii Fructus Powder): Treats heat accumulation in the Heart and Spleen in children, resulting in excessive salivation.
Ingredients: Niu Bang Zi (Arctii Fructus), Zhi Zi Ren (Gardeniae Semen), Gan Cao (Licorice Root), Chuan Xiao (Mirabilite), Yu Jin (Curcumae Radix, each half liang), Zhi Ke (Immature Bitter Orange, 1 fen, bran-fried until slightly yellow, placenta removed).
Preparation: Crush the herbs, sieve finely, add Long Nao (Borneolum Syntheticum, half qian), and grind uniformly. Take half qian mixed with mint water at any time. Adjust dosage according to the child's age and size.
[Wan Quan] Yu Jin San (Curcuma Powder): Treats wind-heat in children, calms the Heart, and suppresses salivation.
Ingredients: Yu Jin (Curcumae Radix, 1 liang, boiled slowly with two stalks of Gleditsia Sinensis in over one bowl of water until dry, washed clean, and chopped), Tian Zhu Huang (Bambusae Sabinae Concretio), Ma Ya Xiao (Mirabilite), Zhi Gan Cao (Roasted Licorice Root, each half liang), Zhu Sha (Cinnabar, 1 fen, ground), Long Nao (Borneolum Syntheticum, 1 qian, ground).
Preparation: Crush, sieve, and grind all ingredients uniformly. Take half qian per dose, mixed with cooked Ophiopogon Decoction. Adjust dosage according to the child's age and size.
Xiao Zhu Sha Wan (Small Cinnabar Pill): Treats startle during sleep in children, resolves wind-obstruction and phlegm-fluids, and calms the Spirit.
Ingredients: Zhu Sha (Cinnabar, 1 liang, separately ground), Tian Nan Xing (Arisaema Cum Bile prepared in Ox Gall), Ren Shen (Ginseng Radix et Rhizoma), Fu Ling (Poria), Zhen Zhu (Margarita), Ban Xia (Pinelliae Rhizoma, boiled with half liang of fresh ginger for 100–200 boils, then dried and ground, each yielding half liang of powder), Long Nao (Borneolum Syntheticum), She Xiang (Moschus, each a small amount).
Preparation: Grind uniformly. Bind with steamed dough soaked in water into pills the size of millet seeds. Take 4–5 pills per dose at any time, taken with decoction of gold and silver.
[Zhang Huan] To treat excessive salivation in children where milk/food cannot be swallowed and saliva does not flow out, named "Spleen Heat with Excessive Salivation," use Jin Zhu Dan (Gold and Cinnabar Pill).
Ingredients: Zhu Sha (Cinnabar, finely ground and levigated), Ban Xia (Pinelliae Rhizoma, soaked in boiling water seven times), Niu Dan Nan Xing (Arisaema Cum Bile prepared with Ox Gall, each 1 liang), Bai Fu Ling (Poria, half liang; these three are ground into powder), Shi Gao (Gypsum Fibrosum, half liang, finely ground and levigated), Jin Bo (Folium Aurum, 20 sheets, ground).
Preparation: Mix uniformly, grind again finely, and bind with fresh ginger juice into pills the size of millet seeds. Take 10 pills per dose after milk feeding, with Ginseng Decoction.
[Tan Shi] Jin Zhu Wan (Gold and Pearl Pill): Treats palpitations and fright in children, resolves phlegm-fluids, relieves chest diaphragm heat, and stops cough.
Ingredients: Pao Tian Nan Xing (Processed Arisaema), Bei Bai Fan (Calcined Alumen), Ban Xia (Pinelliae Rhizoma, soaked in boiling water, 7 qian), Zhu Sha (Cinnabar, finely ground, each half liang), Ren Shen (Ginseng Radix et Rhizoma), Gan Shan Yao (Dioscoreae Rhizoma, each 1 qian), Ni Fen (Calomelas, 2 qian), Jin Bo (Folium Aurum, 10 sheets).
Preparation: Grind into fine powder, bind with mint juice and water paste into pills the size of mung beans, coated with gold leaf. Take one pill per dose after meals, with ginger soup. Adjust dosage according to strength.
Ban Xia Wan (Pinellia Pill): Treats Spleen heat in children, inability to take milk/food, and excessive phlegm in the chest and diaphragm.
Ingredients: Ban Xia (Pinelliae Rhizoma, half fen, washed seven times in ginger soup to remove slipperiness), Zao Jiao Zi Ren (Gleditsiae Sinensis Seed Kernel, half liang).
Preparation: Crush and sieve into powder. Bind with ginger juice into pills the size of hemp seeds. Take 3 pills with warm water at any time. Adjust dosage according to the child's age and size.
[Liu Shi] Xiao Ru Tan Wan (Eliminate Milk Phlegm Pill): This formula originates from imperial prescriptions and is suitable for regular use even in healthy children.
Ingredients: Da Ban Xia (Large Pinelliae Rhizoma, half liang, cut into large chunks, boiled with one radish cut similarly in one bowl of water until water is exhausted, discard radish), Ren Shen (Ginseng Radix et Rhizoma, 2 qian 5 fen, take 2 qian of powder).
Preparation: Roast both ingredients until dry, grind into fine powder, and bind with fresh ginger juice paste into pills the size of mung beans. Take 20–30 pills per dose after meals with ginger soup. Adjust dosage according to the child's age and size.