〔曾〕一月后婴孩,忽乳不下咽,肚硬如石,赤如朱,撮口而哭,面青唇黑,手足口气俱冷是也。
始因断脐带不紧,为风冷所乘,证亦危急,以白芍药汤(疝)、乌梅散、一字金(脐风)投之,日久则难愈。更参考脐
风证内议论。
乌梅散 治腹疼,及初生婴孩脐下冷痛,疝气等疾。
乌梅(去核) 玄胡索 粉草(半生半炙。各五钱) 乳香 没药 钓藤(各二钱半)
上件 咀。每服二钱,水一盏,煎七分,空心温服。
〔汤〕小儿腹痛曲腰,干哭无泪,面青白,唇黑肢冷,为盘肠内钓。凡有此证,急煎葱汤淋洗其腹,
揉之,葱熨脐腹间良久,尿自痛中出,其疼立止,续次
服药。
乳香 没药(各少许,透明者、细研)
上件,木香一块于乳钵内磨,水一分,滚数沸,调乳没末。此药只一服效。
〔薛〕小儿盘肠气者,痛则曲腰干啼,额上有汗,皆由肝经风邪所搏也,肝肾居下,故痛则曲腰,干啼者,
风燥其液,故无泪也,额上有汗者,风木助心火也,口闭足冷者,脾气不营也,下利青粪者,肝木乘脾也,
皆由产下澡洗受风冷所致,当服钓藤膏之类。若乳母及儿受寒邪者,用沉香汤之类。若儿额间有汗,口闭脚冷,
乃虚寒也,用当归散(见前)或沉香降气汤之类。若面赤唇焦,小便不通,小腹胀痛者,乃小肠热也,用人参汤
送下三黄丸(里热)。若因乳母饮食停滞者,用保和丸(宿食)。怀抱气郁者,加味归脾汤(惊悸)。怒动肝
火者加味逍遥散(虚热)。子母俱服,并佳。
钱氏钓藤膏 治小儿腹中极痛,干啼后偃,名盘肠内钓。
乳香(研) 没药(研) 木香 姜黄(各四钱) 木鳖子仁(二十一个)
上,先将后三味同为细末,次研入上二味,炼蜜和成剂收贮。每一岁儿可服半
皂子大,余以意加减,煎钓藤汤化下,无时。次用魏香散。
魏香散
蓬术(半两) 阿魏(一钱)
上,先用温水化阿魏,浸蓬术一昼夜,焙干,为细末。每服一字或半钱,煎紫苏米饮空心调下。
蒜乳丸 治冷证腹痛夜啼。
大蒜(一稞,慢火煨香熟,研烂) 乳香(另研,五分)
上,研为丸如芥菜子大。每服七粒,乳汁送下。
异香散 治小儿诸般吊证,角弓反张,胸高脐凸。
用透明没药一味为末,姜汤调下。
【曾氏论述】婴儿满月之后,突然乳汁无法咽下,腹部坚硬如石头,颜色红赤如朱砂,口唇紧缩而哭,面色发青、嘴唇发黑,手足及口中呼出的气息都冰冷,这就是锁肚痛的症状。
起初是因为剪断脐带时包扎不紧,导致风冷邪气侵袭,病情也很危急,应使用白芍药汤(治疗疝气)、乌梅散、一字金(治疗脐风)来投喂,如果拖延日久则难以治愈。更详细的讨论可参考“脐风证”中的相关论述。
乌梅散:治疗腹痛,以及初生婴儿脐下冷痛、疝气等疾病。
药材组成:乌梅(去核)、玄胡索、粉草(一半生用,一半炙用,各五钱)、乳香、没药、钓藤(钩藤)(各二钱半)。
制法与用法:将上述药材切碎。每次服用二钱,加水一盏,煎至七分,空腹时温服。
【汤氏论述】小儿腹痛弯腰,干哭无泪,面色青白,嘴唇发黑,四肢冰冷,这是盘肠内钓痛。凡是出现这种症状,应立即煎煮葱汤淋洗其腹部,揉搓腹部,用葱熨烫脐部及腹部良久,尿液自然从疼痛中排出,疼痛立即停止,随后再服药。
药材组成:乳香、没药(各少许,选用透明的,细研成粉)。
制法与用法:取木香一块在乳钵中研磨,加入一分水,煮沸几滚,调和乳香和没药的粉末。此药只需服用一次即见效。
【薛氏论述】小儿患盘肠气病,疼痛时弯曲腰部干啼,额头出汗,这都是由肝经风邪搏结所致。肝肾位于下部,所以疼痛时弯曲腰部;干啼是因为风燥消耗了津液,所以没有眼泪;额头出汗是因为风木助长心火;口闭脚冷是因为脾气不能濡养四肢;大便泻下青色粪便,是肝木克制脾土所致。这些病症都是由出生后洗澡时受风冷引起的,应当服用钓藤膏之类的药物。如果乳母和婴儿受到寒邪侵袭,使用沉香汤之类的药物。如果婴儿额头有汗,口闭脚冷,属于虚寒证,使用当归散(见前文)或沉香降气汤之类的药物。如果面红唇焦,小便不通,小腹胀痛,这是小肠热证,用人参汤送服三黄丸(治疗里热)。如果是由于乳母饮食停滞引起的,使用保和丸(治疗宿食)。怀抱气郁的,加味归脾汤(治疗惊悸)。怒动肝火的,加味逍遥散(治疗虚热)。母子同服,效果更佳。
钱氏钓藤膏:治疗小儿腹中极度疼痛,干啼后身体僵直,名为盘肠内钓。
药材组成:乳香(研)、没药(研)、木香、姜黄(各四钱)、木鳖子仁(二十一个)。
制法与用法:先将后三种药材共同研为细末,然后研入前两种药材,用炼蜜调和成药剂保存。每一岁大的婴儿可服用半个皂荚子大小的药量,其余根据情况增减,用钓藤汤煎化后服用,不限时间。随后服用魏香散。
魏香散:
药材组成:蓬术(半两)、阿魏(一钱)。
制法与用法:先用温水化开阿魏,浸泡蓬术一昼夜,焙干,研为细末。每次服用一字或半钱,用紫苏米饮煎好后空腹调服。
蒜乳丸:治疗冷证腹痛夜啼。
药材组成:大蒜(一头,慢火煨至香熟,研烂)、乳香(另研,五分)。
制法与用法:研制成如芥菜子大小的丸剂。每次服用七粒,用乳汁送下。
[From Zeng] After one month of age, infants may suddenly be unable to swallow milk, with an abdomen hard as stone and red as cinnabar, mouth puckering while crying, a cyan face with black lips, and cold extremities and breath. This is known as Suodu Tong (Lock-belly Pain).
Initially, this occurs because the umbilical cord was not tied tightly, allowing Wind-Cold pathogens to invade. The condition is critical; it should be treated with Baishaoyao Tang (White Peony Decoction for Hernia), Wumei San (Mume Powder), or Yizijin (One-Character Gold for Umbilical Tetanus). If left untreated for a long time, it becomes difficult to cure. For further discussion, refer to the section on Umbilical Tetanus (Qifeng Zheng).
Wumei San: Treats abdominal pain, as well as cold pain below the umbilicus and hernia in newborn infants.
Ingredients: Wumei (Mume Fructus, pitted), Xuanhusuo (Corydalis Rhizome), Fencǎo (Licorice Root, half raw, half roasted, each 5 qian), Ruxiang (Frankincense), Moyao (Myrrh), Diaoteng (Uncaria Rhynchophylla, each 2.5 qian).
Preparation and Administration: Coarsely crush the above ingredients. Take 2 qian per dose, add one cup of water, decoct until reduced to 70%, and take warm on an empty stomach.
[From Tang] Infants with abdominal pain bend their waists, cry dryly without tears, have a pale-cyan face, black lips, and cold limbs. This is called Panchang Neidiao Tong (Coiled-internally Hooked Abdominal Pain). For any such case, immediately decoct a scallion soup to wash the abdomen, rub it, and apply hot scallion compresses to the umbilical and abdominal area for a prolonged period. Once urine passes from the pain, the pain stops immediately, followed by oral medication.
Ingredients: Ruxiang (Frankincense), Moyao (Myrrh) (each a small amount, transparent variety, finely ground).
Preparation and Administration: Grind a piece of Muxiang (Aucklandiae Radix) in a mortar with one part water, boil briefly, and mix with the powdered Frankincense and Myrrh. This medicine is effective after just one dose.
[From Xue] When infants suffer from Panchang Qi (Coiled-internally Hooked Qi), they bend their waists and cry dryly when in pain, with sweat on the forehead. This is caused by Wind-Evil attacking the Liver Meridian. Since the Liver and Kidneys reside in the lower jiao, pain causes them to bend their waists. Dry crying results from Wind-Dryness consuming body fluids, hence no tears. Sweat on the forehead occurs because Wind-Wood assists Heart-Fire. Closed mouth and cold feet indicate that Spleen-Qi fails to nourish the extremities. Diarrhea with green stool indicates Liver-Wood overacting on Spleen-Earth. All these conditions are caused by exposure to Wind-Cold during bathing after birth. One should administer Diaoteng Gao (Uncaria Paste) and similar formulas. If both the nursing mother and the infant are affected by Cold-Evil, use Chenxiang Tang (Aquilaria Decoction). If the infant has sweat on the forehead, closed mouth, and cold feet, it is a Deficiency-Cold pattern; use Danggui San (Angelica Powder, see previous text) or Chenxiang Jiangqi Tang (Aquilaria Descending-Qi Decoction). If the face is red, lips are scorched, urination is obstructed, and there is distension and pain in the lower abdomen, it is Small Intestine Heat; administer Sanhuang Wan (Three-Yellow Pill) delivered with Ren Shen Tang (Ginseng Decoction) to treat Interior Heat. If caused by food stagnation in the nursing mother, use Baohe Wan (Preserve Harmony Pill) for retained food. For emotional depression and Qi stagnation, use Jiawei Guipi Tang (Modified Restore the Spleen Decoction) for palpitations and fright. For Liver-Fire stirred by anger, use Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder) for Deficiency-Heat. It is best if both mother and child take the medicine.
Qian's Diaoteng Gao: Treats extreme abdominal pain in infants, where they cry dryly and then lie stiffly, known as Panchang Neidiao Tong.
Ingredients: Ruxiang (Frankincense, ground), Moyao (Myrrh, ground), Muxiang (Aucklandiae Radix), Jianghuang (Curcumae Longae Rhizoma) (each 4 qian), Mugiezi Ren (Strychnos Semen, 21 kernels).
Preparation and Administration: First, grind the last three ingredients into a fine powder, then incorporate the first two ingredients. Mix with refined honey to form a paste for storage. For every year of age, administer a dose the size of half a soap pod. Adjust according to circumstances. Decoct Diaoteng Tang (Uncaria Decoction) to dissolve the pill before administration, at any time. Subsequently, administer Weixiang San.
Weixiang San:
Ingredients: Pengzhu (Curcumae Phaeocaulis Rhizoma, 0.5 liang), Awèi (Asafoetida, 1 qian).
Preparation and Administration: First, dissolve the Asafoetida in warm water, soak the Curcumae Phaeocaulis Rhizoma for one day and night, bake dry, and grind into a fine powder. Take one zi or half a qian per dose, mixed with Zi Su Mi Yin (Perilla Seed Drink) on an empty stomach.
Suanru Wan: Treats abdominal pain and night crying due to Cold patterns.
Ingredients: Dasuan (Allii Sativi Bulbus, one clove, slow-roasted until fragrant and ripe, mashed), Ruxiang (Frankincense, separately ground, 5 fen).
Preparation and Administration: Grind into pills the size of mustard seeds. Take seven pills per dose, delivered with breast milk.
Yixiang San: Treats various types of "hooked" syndromes in infants, including opisthotonos (Jiaogong Fanzhang), high chest, and protruding umbilicus.
Administration: Use only transparent Moyao (Myrrh), ground into powder, taken with Ginger Decoction.