《幼科发挥》治疗小儿黄疸思想探微

Exploring the treatment thoughts of infantile jaundice in Youke Fahui

在《幼科发挥》中,万全对小儿黄疸的诊治认识承袭钱乙对“胃怯”“胃不和”所致小儿黄疸的学术思想,同时在此基础上进一步提出湿热食积、郁蒸脾胃,或脾胃虚弱、湿邪内聚而发黄的观点,强调“调理脾胃者,医中之王道,节戒饮食者却病之良方”;在论治小儿黄疸方面,立足于小儿禀赋特性,因人而异,慎苦寒清泄,并将“重脾胃而慎苦寒清泄,调理饮食以固脾胃,小儿用药贵在和平”的思想贯穿始终,同时更要时时顾护脾胃,重在健脾助运以祛湿清热,以达到退黄的效果。

In Youke Fahui,WAN Quan's understanding of the diagnosis and treatment of infantile jaundice inherited QIAN Yi's academic thoughts regarding jaundice in infants caused by“stomach deficiency”and“disharmony of the stomach.”On this basis,WAN Quan further proposed that damp-heat and food stagnation can lead to the suppression of spleen and stomach,or that spleen and stomach weakness can result in internal accumulation of dampness and subsequent jaundice.He emphasized that“regulating the spleen and stomach is the golden rule in medicine,and moderation in diet is the best prescription for preventing disease.”In treating infantile jaundice,WAN Quan focused on the innate characteristics of infants,treated each case individually,and cautioned against the excessive use of bitter-cold herbs for purging.Throughout his treatment approach,he adhered to the principles of“emphasizing the spleen and stomach while cautiously using bitter-cold purging,regulating diet to strengthen the spleen and stomach,and using medications that are gentle and harmless for infants.”Additionally,he always prioritized protecting the spleen and stomach,strengthening spleen and promoting digestion in order to remove dampness and clear heat,so as to achieve the effect of jaundice regression.