痰者,水饮停积胸膈之间,结聚痰也。小儿饮乳,因冷热不调,停积胸膈之间,结聚成
痰。痰多,则令儿饮乳不下,吐涎沫,变结而微壮热也;痰实,壮热不止,则发惊痫。
三焦不调,则寒气独留,膈上不通,则令儿乳哺不得消下,噫气酸臭,胸膈痞满,甚则
气息喘急。
五脏不和,三焦不调,有寒冷之气客之,则令乳哺不消化,结聚成 瘕癖结也。其
状∶按之不动,有形 者,症也;推之浮移者,瘕也;其弦急牢强,或在左,或
在右,癖也。皆由冷气、痰水、食饮结聚所成,故云 瘕癖结也。
否者,塞也。小儿胸膈热实,腹内有留饮,致令荣卫痞塞,腑脏之气不宣通。其病,腹
纳气结胀满,或时壮热是也。
小儿宿食不消者,脾胃冷故也。小儿乳哺饮食,取冷过度,冷气积于脾胃,脾胃则冷。
胃为水谷之海,脾气磨而消之,胃气和调,则乳哺消化。若伤于冷,则宿食不消。诊其三部
脉沉者,乳不消也。
小儿食不可过饱,饱则伤脾,脾伤不能磨消于食,令小儿四肢沉重,身体苦热,面黄腹
大是也。
痰证,是由于水饮停滞积聚在胸膈之间,凝结聚结而成的痰。小儿在喝奶时,如果冷热调节不当,导致乳汁停滞积聚在胸膈之间,凝结聚结形成痰。痰多,会导致小儿吃不下奶,吐出涎沫,身体变得结实并伴有轻微发热;如果是痰实之证,高热持续不退,就会引发惊痫(小儿惊风癫痫)。
三焦(运行元气和水液的通道)功能失调,寒气独自停留,膈上气机不通畅,导致小儿乳食无法消化下行,出现打嗝且气味酸臭,胸膈部位痞塞胀满,严重时气息喘促急促。
五脏功能不和,三焦功能失调,又有寒冷之气侵袭,导致乳食无法消化,凝结聚结形成瘕癖结(腹内结块病证)。其症状表现:按压不动、有固定形状的,称为“症”;推动可以移动浮移的,称为“瘕”;脉象弦急牢强,结块或在左侧或在右侧的,称为“癖”。这些皆由冷气、痰水、饮食凝结聚结所造成,所以称为瘕癖结。
“否”(pǐ),意为闭塞。小儿胸膈热盛实证,腹内有留滞的水饮,导致营卫(营气和卫气)痞塞阻滞,腑脏之气不能宣通。其病症表现为腹部纳气后气结胀满,有时伴有高热。
小儿宿食不消,是因为脾胃虚寒的缘故。小儿喝奶进食,如果受冷过度,冷气积聚于脾胃,导致脾胃虚寒。胃是水谷汇聚的海,脾气负责研磨消化,胃气调和,则乳食得以消化。如果受到寒冷损伤,就会导致宿食不消。诊察其三部脉象沉伏的,说明乳食未消。
小儿饮食不可过饱,过饱则会伤脾,脾受伤后不能磨化消化食物,导致小儿四肢沉重,身体苦于发热,面色发黄,腹部膨大。
小儿如果有嗜食(食欲亢进或异食)的表现,吃完仍不知饱足,而且不长肌肉。这也表现为腹部膨大,大便次数多且腹泻,也称为豁泄(一种慢性腹泻),这是由于肠胃固摄失职的缘故。
小儿乳食喂养不调,损伤了脾胃,导致脾胃衰弱,不能正常进食,血气减少损耗,不能滋养肌肉,从而形体消瘦枯槁,脏腑之气不宣通,感到阵阵苦热,这被称为哺露(指小儿因脾胃虚弱导致的消瘦发热病证)。
Tan syndrome refers to phlegm formed by the stagnation and accumulation of fluid retention between the chest and diaphragm, where it condenses and gathers. When infants drink milk, if there is improper regulation of cold and heat, the milk stagnates and accumulates between the chest and diaphragm, condensing into phlegm. Excessive phlegm causes the infant to be unable to suckle, spit out saliva and foam, become physically firm with slight fever; if it is a phlegm-excess condition with persistent high fever, it may develop into Jingxian (infantile convulsions and epilepsy).
When the Sanjiao (Triple Burner, the pathway for Yuan Qi and fluids) functions disharmoniously, cold pathogen lingers alone. If the upper diaphragm is obstructed, the infant's milk and food cannot be digested and descended, resulting in belching with a sour and foul odor, chest and diaphragm stuffiness and fullness, and in severe cases, panting and rapid breathing.
If the Zang organs are disharmonious and the Sanjiao functions poorly, and cold pathogen invades, milk and food fail to digest, condensing into Jia Pi Jie (abdominal masses). The manifestations are as follows: masses that do not move upon pressure and have a fixed shape are called "Zheng"; masses that can be pushed and shift position are called "Jia"; masses associated with wiry, tight, and firm pulse qualities, located either on the left or right side, are called "Pi". All these are caused by the condensation and accumulation of cold qi, phlegm-fluids, and food-drink, hence termed Jia Pi Jie.
"Pi" means obstruction. In infants with excess heat in the chest and diaphragm and retained fluids in the abdomen, Ying and Wei (Nutritive and Defensive Qi) become obstructed, and the Qi of the Fu organs fails to circulate freely. The disease presents as abdominal Qi knotting and distension, sometimes accompanied by high fever.
Infantile undigested food retention is due to Spleen-Stomach cold. If infants consume excessive cold during feeding, cold Qi accumulates in the Spleen and Stomach, causing them to become cold. The Stomach is the sea of water and grain; the Spleen grinds and digests it. When Stomach Qi is harmonious, milk and food are digested. If injured by cold, undigested food remains. Palpating the three positions of the pulse reveals a deep pulse, indicating undigested milk/food.
Infants should not be overfed; overfeeding injures the Spleen. When the Spleen is injured, it cannot grind and digest food, leading to heavy limbs, body heat discomfort, yellowish complexion, and abdominal distension in the infant.
Some infants exhibit polyphagia (excessive appetite), feeling unsated even after eating, yet failing to gain muscle mass. This also presents with abdominal distension, frequent stools with diarrhea, known as Huo Xie (a type of chronic diarrhea), which is due to the failure of the intestines and stomach to maintain control.
Improper feeding damages the Spleen and Stomach, leading to their weakness. They cannot accept food, causing depletion of Blood and Qi, which fails to nourish muscles, resulting in emaciation and wasting (Chai Pi Lei Lu). The obstruction of Fu organ Qi leads to intermittent bitter heat, a condition termed Bu Lu (wasting-thirst syndrome related to feeding).