暴喘而胀满也。田氏云∶暴喘,俗传为马脾风也,大小便哽,宜急下之,用牛黄
夺命散,后用白虎汤平之。马脾风在百日内者不治。
牛黄夺命散 治小儿肺胀喘满,胸膈起急,两胁扇动,陷下作坑,两鼻窍张,闷乱
嗽喝,声嗄而不鸣,痰涎潮塞,俗云马脾风,若不治,死在旦夕。
白牵牛 黑牵牛(各一两,半生半熟) 川大黄 槟榔(各一两)
上为细末。三岁儿每服二钱,冷浆水调下。涎多,加腻粉少许,无时,加蜜少许。
无价散 治风热喘促,闷乱不安,俗谓之马脾风。
辰砂(二钱半) 轻粉(五钱) 甘遂(面裹者,焙干,一钱半)
上为细末。每服一字,用温浆水少许,入滴油一点,挑药在上,沉下去,却以
浆水灌之,立效。
又一法,小儿喘胀,俗谓之马脾风,又谓之风喉者。以草茎量病儿手中指里近
掌纹至中指尖截断,如此二茎,自乳上微斜直立,两茎于稍尽头横一茎,两头尽头
点穴,灸三壮,此法多曾见愈。
《万全方》小儿有惊啼,有夜啼,有躯啼。夫惊啼者,由风邪乘心,脏腑生热,
热则精神不定,睡卧不安,故惊啼。夜啼者,脏冷也,夜则阴盛,阴盛相感,痛甚
于昼,故令夜啼。一云有犯触禁忌,亦令儿夜啼,可作法术断之。其躯啼者,由腹
中痛甚,儿身躯张,气蹙而啼也。又有胎寒而啼者,此儿在胎时已受病也,其状肠
胃虚冷,不消乳哺,腹胀下痢,颜色青白,而时或啼叫是也。〔薛〕悲哭者,肺之
声,泪者,肝之液也,若六脉弦紧者,先以温汤渍其身取汗,次以凉膈散之类清其
内热,此张子和治法如此。若因乳母怒火遗热于肝,肝火炎炽,反侮肺金,金木相
击,故悲哭有声者,宜用六君、柴胡、山栀以补脾清肝,用六味丸以壮水生木。
有因惊风,过服祛风燥血之药而致者,有因吐泻内亡津液而致者,及禀父肾阴不足
不能生肝者,治各审之。若小儿忽然大啼作声,丹溪谓必死,此禀肾阴不足,虚火
炎上故也,用六味丸多有生者。仍参览夜啼、客忤、惊啼、重舌、口疮、天钓、内钓等证。
钱氏蝉花散 治惊风夜啼,切牙咳嗽,及疗咽喉壅痛。
蝉花(和壳) 白僵蚕(直者,酒炒熟) 甘草(炙。各一分) 延胡索(半分)
上为末。一岁一字,四五岁半钱,蝉壳汤下。
《本事方》治小儿拗哭。龙齿散
龙齿 蝉壳(去翅足泥土) 钓藤(有钩子者) 羌活 茯苓 人参(各等分)
上为末。每服一大钱,煎六分,去渣,温热服。
子和治一小儿悲苦,弥日不休,两手脉弦而紧。戴人曰,心火甚则乘肺,肺不
受其屈故哭。肺主悲,王太仆云∶心烁则痛甚,故烁甚悲亦甚。先令浴,以温汤
渍形以为汗也,肺主皮毛,汗出则肺热散,浴止而啼亦止矣。仍命服凉膈散加当
归、桔梗,以竹叶、生姜、朴硝同煎服,泻膈中之邪热。
暴发性喘息并伴有胸腹胀满。田氏说:暴发性喘息,民间俗称“马脾风”,大小便不通畅,应当紧急使用泻下法治疗,用牛黄夺命散,之后用白虎汤来平息病情。百日内的婴儿患此病者难以治愈。
牛黄夺命散 治疗小儿肺胀引起的喘息胸闷,胸膈部拘急不适,两胁像扇子一样扇动,胸部凹陷成坑,鼻孔张开,烦躁不安,咳嗽气喘,声音嘶哑不能发声,痰涎如潮水般堵塞气道,民间称为马脾风,如果不治疗,死亡就在早晚之间。
白牵牛、黑牵牛(各一两,一半生用,一半炒熟)、川大黄、槟榔(各一两)
以上药物研成细末。三岁的幼儿每次服用二钱,用冷浆水调服。如果痰多,加入少许腻粉;如果没有时间限制,可加入少许蜂蜜。
无价散 治疗风热引起的喘息急促,烦躁不安,民间称为马脾风。
辰砂(二钱半)、轻粉(五钱)、甘遂(用面粉包裹后焙干,一钱半)
以上药物研成细末。每次服用一字量,用少量温浆水,滴入一点油,将药挑在油上,使其沉下去,然后用浆水灌服,立即见效。
另一种方法,小儿喘息胀满,民间称为马脾风,又叫做风喉。用草茎测量患儿手中指内侧从掌纹到中指指尖的长度并截断,取两根这样的草茎,从乳头上方微斜直立放置,两根草茎的稍尽头横向放置第三根草茎,在两头尽头处标记穴位,施灸三壮,这种方法我见过多次治愈的案例。
《万全方》记载小儿有惊啼、夜啼、躯啼三种情况。所谓惊啼,是因为风邪侵袭心脏,脏腑产生内热,热盛则精神不定,睡眠卧躺不安稳,所以出现惊啼。所谓夜啼,是因为内脏寒冷,夜间阴气旺盛,阴寒相互感应,疼痛比白天更严重,所以导致夜间啼哭。另一种说法是触犯禁忌,也会导致婴儿夜间啼哭,可以用法术来解除。所谓躯啼,是因为腹部剧烈疼痛,婴儿身体伸展紧张,气息急促而啼哭。还有因胎寒而啼哭的,这是婴儿在母胎中就已经患病,症状表现为肠胃虚冷,不能消化乳食,腹部胀满,腹泻痢疾,面色青白,时而啼叫。〔薛己〕悲哭,是肺的声音表现,眼泪是肝的体液表现,如果六脉呈现弦紧之象,先用温水浸泡身体使其出汗,再用凉膈散之类的药物清除内部热邪,这是张子和的治疗方法。如果是由于乳母怒火将余热遗留在肝脏,肝火炎炽盛,反克肺金,金木相击,所以出现悲哭有声的情况,适宜用六君子汤、柴胡、山栀来补脾清肝,用六味丸来滋水涵木。有的因惊风,过度服用祛风燥血药物而导致,有的因吐泻体内津液流失而导致,以及禀受父亲肾阴不足不能滋养肝脏的,治疗时需仔细审察。如果小儿突然大声啼哭,丹溪认为必死无疑,这是因为禀受肾阴不足,虚火上炎所致,使用六味丸大多能救活。仍请参考夜啼、客忤、惊啼、重舌、口疮、天钓、内钓等证候。
钱氏蝉花散 治疗惊风夜啼,咬牙咳嗽,以及治疗咽喉壅塞疼痛。
蝉花(带壳)、白僵蚕(直挺的,酒炒熟)、甘草(炙。各一分)、延胡索(半分)
以上药物研成粉末。一岁的婴儿服用一字量,四至五岁服用半钱,用蝉蜕汤送服。
《本事方》治疗小儿拗哭。龙齿散
龙齿、蝉壳(去除翅膀、足和泥土)、钩藤(带钩子的)、羌活、茯苓、人参(各等分)
以上药物研成粉末。每次服用一大钱,煎煮至六分量的药液,去渣,温热服用。
张子和治疗一个悲伤痛苦、整天不停啼哭的小儿,两手脉象弦而紧。戴人说,心火过盛会乘袭肺脏,肺不接受这种委屈所以哭泣。肺主悲,王太仆说:心火灼烧则疼痛严重,所以灼烧越厉害,悲哭也越厉害。先让患儿洗澡,用温水浸泡身体以发汗,肺主皮毛,出汗则肺热消散,洗澡停止后啼哭也就停止了。仍然命令服用凉膈散加当归、桔梗,用竹叶、生姜、朴硝同煎服用,以泻除膈中的邪热。
Sudden wheezing accompanied by chest and abdominal distension. Tian stated: Sudden wheezing is commonly known as "Ma Pi Feng" (Horse Spleen Wind) in folk medicine, with obstruction of urination and defecation; it requires urgent purgation using Niuhuang Duoming San (Calculus Bovis Decoction for Snatching Life), followed by Baihu Tang (White Tiger Decoction) to calm the condition. Infants under one hundred days old suffering from this disease are considered incurable.
Niuhuang Duoming San (Calculus Bovis Decoction for Snatching Life) treats pediatric lung distension with wheezing and fullness, urgency in the chest and diaphragm, flapping movement of the two hypochondria, sunken depressions in the chest resembling pits, dilated nostrils, restlessness, coughing and panting, hoarse voice without sound, and tidal accumulation of phlegm and saliva blocking the airways. It is commonly called Ma Pi Feng (Horse Spleen Wind). If untreated, death occurs within a day or night.
Bai Qian Niu (Fructus Pharbitidis, White), Hei Qian Niu (Fructus Pharbitidis, Black) (each 1 liang, half raw and half processed); Chuan Da Huang (Radix et Rhizoma Rhei, Sichuan); Bing Lang (Areca Seed, each 1 liang).
Grind all into fine powder. For a three-year-old child, administer 2 qian per dose, mixed with cold Jiang Shui (fermented rice water). If there is excessive phlegm, add a small amount of Ni Fen (Calomel); if no time restriction applies, add a little honey.
Wujia San (Priceless Powder) treats wind-heat causing rapid breathing and restlessness, commonly referred to as Ma Pi Feng (Horse Spleen Wind).
Chen Sha (Cinnabar, 2.5 qian); Qing Fen (Calomel, 5 qian); Gan Sui (Radix Euphorbiae Kansui, wrapped in flour and baked dry, 1.5 qian).
Grind all into fine powder. Administer one zi (a very small measure) per dose. Use a small amount of warm Jiang Shui (fermented rice water), add one drop of oil, place the medicine on top of the oil so it sinks, then pour in the Jiang Shui. Effect is immediate.
Another method: For pediatric wheezing and distension, commonly called Ma Pi Feng (Horse Spleen Wind) or Feng Hou (Wind Throat). Measure a grass stem against the patient's middle finger from the inner palm crease to the fingertip, and cut it. Take two such stems. Place them slightly obliquely upright above the nipple. Place a third stem horizontally across the tips of the first two. Mark the points at both ends of the horizontal stem. Apply moxibustion with three zhuang (cones). This method has been seen to cure many cases.
The Wan Quan Fang states that infants have Jing Ti (Fright Crying), Ye Ti (Night Crying), and Qu Ti (Body Crying). Jing Ti (Fright Crying) arises when wind-pathogen attacks the Heart, generating heat in the Zang-Fu organs. Heat causes instability of spirit and restless sleep, leading to fright crying. Ye Ti (Night Crying) is due to cold in the viscera; Yin is abundant at night, and Yin-cold resonates, causing pain worse than during the day, hence night crying. Another view suggests violating taboos also causes night crying, which can be resolved with magical rites. Qu Ti (Body Crying) results from severe abdominal pain, where the infant stretches their body, breath becomes constrained, and they cry. There is also crying due to Tai Han (Fetal Cold), meaning the infant contracted illness while in the womb. Symptoms include deficiency-cold of the intestines and stomach, inability to digest milk, abdominal distension, diarrhea/dysentery, bluish-white complexion, and intermittent crying. [Xue Ji] Bei Ku (Sad Crying) is the sound of the Lung; tears are the fluid of the Liver. If the six pulses are wiry and tight, first soak the body in warm water to induce sweating, then use drugs like Liang Ge San (Cool the Diaphragm Powder) to clear internal heat. This is Zhang Zihe's treatment method. If caused by the nursing mother's anger leaving residual heat in the Liver, causing Liver Fire to blaze and counter-attack Lung Metal, with Metal and Wood clashing, resulting in sad crying with sound, use Liu Jun Zi Tang (Six Gentlemen Decoction), Chai Hu (Bupleuri Radix), and Shan Zhi (Gardeniae Fructus) to tonify the Spleen and clear the Liver, and use Liu Wei Di Huang Wan (Six-Ingredient Pill with Rehmannia) to strengthen Water to nourish Wood. Some cases result from excessive use of wind-dispelling and blood-drying drugs for convulsions; some from loss of body fluids due to vomiting and diarrhea; and some from congenital insufficiency of the Father's Kidney Yin failing to generate Liver Wood. Treatments must be carefully examined. If an infant suddenly cries loudly, Danxi considered it a sign of impending death, attributing it to congenital Kidney Yin insufficiency causing Deficient Fire to flare upward. Using Liu Wei Di Huang Wan (Six-Ingredient Pill with Rehmannia) often saves lives. Refer also to Ye Ti (Night Crying), Ke Wu (Guest Hostility), Jing Ti (Fright Crying), Chong She (Double Tongue), Kou Chuang (Mouth Sores), Tian Diao (Heavenly Angling/Convulsion), and Nei Diao (Internal Angling/Internal Convulsion) syndromes.
Qian Shi Chan Hua San (Chan Hua Powder by Qian Yi) treats fright-convulsions with night crying, teeth grinding, coughing, and throat congestion/pain.
Chan Hua (Entomata Cordyceps, with shell); Bai Jiang Can (Bombyx Batryticatus, straight ones, stir-fried with wine until cooked); Gan Cao (Licorice Root, honey-fried. Each 1 fen); Yan Hu Suo (Corydalis Rhizome, 0.5 fen).
Grind into powder. For a one-year-old, administer one zi; for four to five years old, half a qian. Take down with Chan Ke Tang (Cicada Slough Decoction).
The Ben Shi Fang treats Ao Ku (Stubborn Crying) in infants. Long Chi San (Dragon Tooth Powder).
Long Chi (Dental Fossils); Chan Ke (Periostracum Cicadae, remove wings, feet, and dirt); Gou Teng (Uncaria Ramulus, with hooks); Qiang Huo (Notopterygii Rhizoma et Radix); Fu Ling (Poria); Ren Shen (Ginseng Radix. Equal parts).
Grind into powder. Administer one large qian per dose. Decoct with enough water to yield six parts liquid, strain, and take warm.
Zhang Zihe treated an infant who cried bitterly and continuously for days. The pulses in both hands were wiry and tight. Dai Ren said: Excessive Heart Fire attacks the Lung; the Lung does not accept this oppression, hence crying. The Lung governs sadness. Wang Taipu stated: When Heart Fire scorches, pain is severe; thus, when scorching is severe, sadness/crying is also severe. First, he ordered a bath, soaking the body in warm water to induce sweat. Since the Lung governs skin and hair, sweating dissipates Lung heat. After bathing stopped, crying also ceased. He then prescribed Liang Ge San (Cool the Diaphragm Powder) added with Dang Gui (Angelicae Sinensis Radix) and Jie Geng (Platycodonis Radix), decocted together with Zhu Ye (Bambusa Leaf), Sheng Jiang (Zingiberis Rhizoma Recens), and Po Xiao (Natrii Sulfas), to drain pathogenic heat from the diaphragm.