小儿癖气久不瘥者,灸中脘一穴,章门二穴,各七壮。章门在大横外,直脐,
季胁肋端,侧卧,曲上足,伸下足,举臂取之。中脘在上脘下一寸,脐上四寸,居
心蔽骨与脐之中,从 下取病患四指定穴,并炙脐后脊骨中二七壮,无不验。
洁古论渴有三种一者,实热积于心脾,烦躁大渴引饮,宜白虎汤。谓不因吐
泻大病,忽然而作。二者,因久病,或取转过度,致脾虚引饮,宜白术散。三者,
因患湿热病,热结膀胱,小便不利,大渴引饮,有表里证者,宜五苓散主之。《百
问》云∶小儿唇红如丹,即发渴,红甚焦黑,则危笃,若三焦虚烦作渴者,用三黄
汤。伤寒后唇口焦者,用白虎汤、竹叶汤。泻痢作渴者,用四苓散之类。常治暑积心
脾烦渴引饮者,用白虎汤。下利脾虚作渴,用七味白术散。热结膀胱小便秘,渴者,
用五苓散。上焦虚热者,用四君子汤。膏粱积热者,用清胃散。脾胃积热者,用泻
黄散。中气虚热者,用异功散。肾水虚热者,用六味丸。其余疳证发热,各详本证。
胎禀所致者,当各审其因,若误用寒凉降火,脾胃复伤,则腹胀而为败证矣。
白虎汤(发热)
三黄汤
黄芩 黄连 黄柏(各等分)
上,水煎服。
《圣惠》黄连散 治小儿心肺积热,渴不止,咽喉干痛。
黄连(去须) 射干 川升麻 白茯苓 麦门冬(去心,焙) 玄参 甘草(炙微赤,锉) 桑根白
皮黄芩(各半两)
上件药捣,粗罗为散。每服一钱,以水一小盏,入青竹叶七片,煎五分,去渣,
入蜜半合,更煎一两沸,放温,时时与儿呷之。
麦门冬散 治小儿心肺热壅,口渴不止。
麦门冬(去心) 栀子仁 犀角(屑) 知母 甘草(炙) 黄芩(各半两)
上为散。每服一钱,水一盏,入竹叶七片,煎五分,不计时候服,亦可量儿大
小、分减服。
《圣惠》银饮子 治小儿热渴不止。
银(五两) 石膏 寒水石 蚕蛹茧(各二两)
上件药,以水三升,入银石三味、煎至一升,去银石,次下蛹茧,煎至七合,
去渣,每服半合,不计时候,温温服之,量儿大小加减。
栝蒌根散 治小儿热渴不止,烦闷。
栝蒌根(三分) 黄芩 知母(各半两)
上件药捣,罗为散。每服一钱,以水一小盏,入小麦、粟米一百粒,煎至五分,
去渣,不计时候温服,量儿大小,以意加减。
又方
栝蒌根(三分) 黄芩(半两) 小麦(半合)
上件,以水三盏,煎取一盏,去渣,不计时服,量儿大小加减。
又方
生葛汁 竹沥(各二合)
上件汁相和令匀,不拘时,服半合,量儿大小加减。
〔茅先生〕胡黄连散 治小儿诸渴,及疳渴,解诸般热。
胡黄连 麦门冬 干葛 玄参 甘草(炙) 枇杷叶(炙,去毛)
上各等分,为末。每服一钱,水七分一盏。生姜一片,同煎五分,后放蜜三五
滴同煎,至四分、温服。
对于小儿癖气(腹内结块)久治不愈的情况,可灸中脘穴1个,章门穴2个,每穴各施艾炷7壮。章门穴位于大横穴外侧,与脐水平,季肋末端处;取穴时让患儿侧卧,弯曲上方腿,伸直下方腿,举起手臂来定位。中脘穴位于上脘穴下一寸,脐上四寸,处于心蔽骨(剑突)与脐的中点;取穴时从下往上用患者四指并拢定穴,同时灸脐后脊柱正中处14壮,疗效无不确切。
洁古认为口渴有三种类型:其一,实热积于心脾,表现为烦躁、极度口渴且大量饮水,适宜用白虎汤。这种口渴并非由吐泻大病引起,而是突然发作的。其二,因久病或过度攻下,导致脾虚而引水自救,适宜用白术散。其三,因患湿热病,热邪结于膀胱,小便不利,极度口渴且大量饮水,伴有表证和里证者,适宜用五苓散主治。《百问》记载:小儿嘴唇红如涂丹,即会发生口渴,若红色甚重变为焦黑色,则病情危重;若是三焦虚烦所致口渴,可用三黄汤。伤寒后唇口焦裂者,用白虎汤、竹叶汤。泻痢所致口渴者,用四苓散之类。常治暑热积于心脾引起的烦躁口渴、大量饮水者,用白虎汤。下利(腹泻)致脾虚口渴者,用七味白术散。热结膀胱、小便短赤、口渴者,用五苓散。上焦虚热者,用四君子汤。膏粱厚味积热者,用清胃散。脾胃积热者,用泻黄散。中气虚热者,用异功散。肾水虚热者,用六味丸。其余疳证发热,详见本证论述。由胎禀体质所致者,应当仔细审察病因,如果误用寒凉降火药物,会再次损伤脾胃,导致腹胀而成为败证。
白虎汤(用于发热)
三黄汤
黄芩、黄连、黄柏(各等分)
以上药材,加水煎煮服用。
《圣惠方》黄连散:治疗小儿心肺积热,口渴不止,咽喉干痛。
黄连(去须)、射干、川升麻、白茯苓、麦门冬(去心,焙干)、玄参、甘草(炙至微赤,锉碎)、桑根白皮、黄芩(各半两)
以上药材捣碎,粗筛为散剂。每次服用一钱,用水一小盏,加入青竹叶七片,煎至五分,去渣,加入蜂蜜半合,再煎一两沸,放温,时时给患儿啜饮。
麦门冬散:治疗小儿心肺热壅,口渴不止。
麦门冬(去心)、栀子仁、犀角(屑)、知母、甘草(炙)、黄芩(各半两)
以上药材制成散剂。每次服用一钱,用水一盏,加入竹叶七片,煎至五分,不限时候服用,也可根据患儿大小减量服用。
《圣惠方》银饮子:治疗小儿热渴不止。
银(五两)、石膏、寒水石、蚕蛹茧(各二两)
以上药材,用水三升,放入银、石膏、寒水石三味药,煎至一升,去掉银和石头,接着放入蛹茧,煎至七合,去渣,每次服用半合,不限时候,温服,根据患儿大小加减用量。
栝蒌根散:治疗小儿热渴不止,烦闷。
栝蒌根(三分)、黄芩、知母(各半两)
以上药材捣碎,筛为散剂。每次服用一钱,用水一小盏,加入小麦、粟米一百粒,煎至五分,去渣,不限时候温服,根据患儿大小酌情加减。
又一方
栝蒌根(三分)、黄芩(半两)、小麦(半合)
以上药材,用水三盏,煎取一盏,去渣,不限时候服用,根据患儿大小加减用量。
又一方
生葛汁、竹沥(各二合)
以上两种汁液混合均匀,不拘时候,服用半合,根据患儿大小加减用量。
〔茅先生〕胡黄连散:治疗小儿各种口渴,以及疳渴,解除各种热邪。
胡黄连、麦门冬、干葛、玄参、甘草(炙)、枇杷叶(炙,去毛)
以上各等分,研为末。每次服用一钱,用水七分一盏,生姜一片,同煎至五分,后放入蜂蜜三五滴同煎,至四分,温服。
For pediatric cases of *pi qi* (abdominal masses) that persist despite prolonged treatment, moxibustion may be applied to Zhongwan (CV 12), one point, and Zhangmen (LR 13), two points, with seven moxa cones (*zhuang*) per point. Zhangmen is located lateral to Dahuang (SP 15), level with the umbilicus, at the end of the costal margin; for needling or moxibustion positioning, have the patient lie on their side, flex the upper leg, extend the lower leg, and raise the arm. Zhongwan is located one cun below Shangwan (CV 13), four cun above the umbilicus, midway between the xiphoid process and the umbilicus; position the point using the patient's four fingers measured from below, and simultaneously apply fourteen moxa cones to the midline of the spine posterior to the umbilicus; this method is invariably effective.
Jieguo posits three types of thirst: First, excess heat accumulating in the Heart and Spleen, manifesting as irritability and extreme thirst with copious drinking, is treated with Baihu Tang (White Tiger Decoction). This type arises suddenly and is not caused by severe vomiting or diarrhea. Second, due to chronic illness or excessive purgation leading to Spleen deficiency and compensatory water intake, Baizhu San (Atractylodes Macrocephala Powder) is indicated. Third, in cases of damp-heat disease where heat binds in the Bladder, causing dysuria, extreme thirst with copious drinking, and both exterior and interior symptoms, Wuling San (Five-Ingredient Powder with Poria) is the primary treatment. The *Baiwen* states: If a child's lips are red like cinnabar, thirst will develop; if the redness becomes severe and turns scorched black, the condition is critical. For thirst caused by deficiency-fire irritability in the Triple Burner, Sanhuang Tang (Three-Yellow Decoction) is used. For scorched lips and mouth following a cold injury, Baihu Tang and Zhuye Tang (Bamboo Leaf Decoction) are used. For thirst caused by dysentery, Siling San (Four-Ingredient Powder) is used. For summer-heat accumulation in the Heart and Spleen causing irritability, thirst, and copious drinking, Baihu Tang is used. For thirst due to Spleen deficiency following diarrhea, Qiwei Baizhu San (Seven-Ingredient Atractylodes Macrocephala Powder) is used. For thirst associated with heat binding in the Bladder and scanty urination, Wuling San is used. For deficiency-heat in the Upper Jiao, Sijunzi Tang (Four-Gentlemen Decoction) is used. For heat accumulation from rich foods, Qingwei San (Stomach-Clearing Powder) is used. For heat accumulation in the Spleen and Stomach, Xiehuang San (Drain Yellow Powder) is used. For deficiency-heat due to Middle Qi deficiency, Yigong San (Extraordinary Merit Powder) is used. For deficiency-heat due to Kidney Yin deficiency, Liuwei Wan (Six-Ingredient Pill) is used. For other fevers associated with *gan* syndrome, refer to the specific syndrome descriptions. For conditions caused by congenital constitution, the etiology must be carefully examined; misusing cold and cooling herbs to descend fire will further damage the Spleen and Stomach, leading to abdominal distension and a deteriorating prognosis.
Baihu Tang (for fever)
Sanhuang Tang
Huangqin (Scutellariae Radix), Huanglian (Coptidis Rhizoma), Huangbai (Phellodendri Cortex) (equal parts)
Decoct these ingredients in water and take orally.
*Shenghui Fang* Huanglian San: Treats pediatric heart and lung excess heat, persistent thirst, and dry, painful throat.
Huanglian (Coptidis Rhizoma) (remove roots), Shegan (Belamcandae Rhizoma), Chuan Shengma ( Cimicifugae Rhizoma), Baifuling (Poria), Maidong (Ophiopogonis Radix) (remove core, bake), Xuanshen (Scrophulariae Radix), Gancao (Glycyrrhizae Radix et Rhizoma) (stir-fry until slightly reddish, chop), Sangbaipipi (Mori Cortex), Huangqin (Scutellariae Radix) (each half liang)
Pound the ingredients into a coarse powder. Take one qian per dose, decoct with one small cup of water and seven leaves of Qingzhuye (Green Bamboo Leaf) until reduced to five fen, strain, add half he of honey, boil briefly, allow to cool to warm temperature, and give to the child to sip occasionally.
Maidong San: Treats pediatric heart and lung heat congestion with persistent thirst.
Maidong (Ophiopogonis Radix) (remove core), Zhizi Ren (Gardeniae Semen), Xijiao (Rhinocerotis Cornu), Zhimu (Anemarrhenae Rhizoma), Gancao (Glycyrrhizae Radix et Rhizoma) (stir-fry), Huangqin (Scutellariae Radix) (each half liang)
Process into a powder. Take one qian per dose, decoct with one cup of water and seven bamboo leaves until reduced to five fen, take at any time, or adjust dosage according to the child's age and size.
*Shenghui Fang* Yin Yin Zi: Treats persistent heat-thirst in children.
Yin (Silver) (five liang), Shigao (Gypsum Fibrosum), Hanshuishi (Halloysitum Rubrum), Can Yong Jian (Bombyx Batryticatus cocoon remnants) (each two liang)
Add three sheng of water to the silver, gypsum, and halloysite; decoct until reduced to one sheng, remove the silver and stones, then add the cocoons; decoct until reduced to seven he, strain. Take half he per dose at any time, warm, adjusting dosage based on the child's size.
Gualougen San: Treats persistent heat-thirst and irritability in children.
Gualougen (Trichosanthis Radix) (three fen), Huangqin (Scutellariae Radix), Zhimu (Anemarrhenae Rhizoma) (each half liang)
Pound and sieve the ingredients into a powder. Take one qian per dose, decoct with one small cup of water, one hundred grains of Xiaomai (Tritici Fructus) and Sumi (Setariae Fructus), until reduced to five fen, strain, take warm at any time, adjusting dosage based on the child's size.
Another prescription
Gualougen (Trichosanthis Radix) (three fen), Huangqin (Scutellariae Radix) (half liang), Xiaomai (Tritici Fructus) (half he)
Decoct three cups of water until reduced to one cup, strain, take at any time, adjusting dosage based on the child's size.
Another prescription
Sheng Ge Zhi (Puerariae Radix juice), Zhuli (Bambusa Textilis Cacumen sap) (each two he)
Mix the juices evenly, take half he at any time, adjusting dosage based on the child's size.
[Mao Xiansheng] Huhuanglian San: Treats various types of thirst in children, including *gan* thirst, and resolves various heat pathogens.
Huhuanglian (Coicis Semen? Note: Context implies Coptidis or similar bitter-cold, but text says Hu Huang Lian - likely Corydalis Bungeana or similar, standard is often interpreted as specific bitter herb, here kept as Huhuanglian), Maidong (Ophiopogonis Radix), Gange (Puerariae Radix), Xuanshen (Scrophulariae Radix), Gancao (Glycyrrhizae Radix et Rhizoma) (stir-fry), Pipaye (Loquat Folium) (stir-fry, remove hairs)
Equal parts, grind into powder. Take one qian per dose, decoct with seven-tenths of a cup of water and one slice of Shengjiang (Zingiberis Rhizoma Recens) until reduced to five fen, add three to five drops of honey, decoct until reduced to four fen, take warm.