万全的小儿情志观

孟艳丽 苏琪 张雯

〔摘要〕 基于对万全著作《幼科发挥》《育婴家秘》的文献研究，分析万全诊疗调护小儿情志相关疾病的理论并进行系统概括总结。从小儿情志的生理观、疾病观、养护观以及万全小儿情志相关疾病验案4个方面进行阐述。万全认为小儿情志具有“稚嫩之神，禀赋各偏”“神用渐发，随形而长”的生理观，小儿情志病的病因病机以“胎毒欲火，敛郁神气”“客忤惊吓，感受异气”为主，辨治方法主张“审明原因，顺其情志”，注重保护稚嫩之神、调畅母亲情志及规范教养行为。以期较为全面地揭示万全治疗小儿情志相关疾病的学术观点，并为小儿情志病的中医诊疗提供指导。

〔关键词〕 小儿;情志;万全;幼科发挥;育婴家秘;客忤

〔中图分类号〕R229       〔文献标志码〕A       〔文章编号〕doi：10.3969/j.issn.1674-070X.2021.05.023

The Theory of Childrens Emotions of Wan Quan

MENG Yanli1， SU Qi1， ZHANG Wen2*

（1. Beijing University of Chinese Medicine， Beijing 100029， China; 2. The Third Affiliated Hospital of Beijing

University of Chinese Medicine， Beijing 100029， China）

〔Abstract〕 Based on the literature research of Wan Quan's works "You Ke Fa Hui" and "Yu Ying Jia Mi"， this paper analyzed and made a systematic summary on Wan Quan's theory about diagnosis， treatment and nursing of children's emotion-related diseases. From the physiological view of children's emotion， disease view， conservation view and Wan Quan children's emotion related disease test case four aspects were elaborated. Wan Quan thinks that children's emotions have the physiological view of "immature spirit， different endowment" and "gradual development of mental function and growth with form"， the etiology and pathogenesis of children's emotional diseases are mainly "fetal toxicity， desire for fire， scared to see strangers"， "disobedience and fear， feeling abnormal Qi". The method of differentiation of symptoms and signs advocates " to examine the causes and follow the emotions"， and pays attention to the protection of the immature spirit， the regulation of mother's emotions and the regulation of parenting behavior. The purpose of this paper is to reveal Wan Quan's academic views on the treatment of children's emotional diseases， and to provide guidance for the diagnosis and treatment of children's emotional diseases in traditional Chinese medicine.

〔Keywords〕 children; emotions; Wan Quan; You Ke Fa Hui; Yu Ying Jia Mi; scared to see strangers

万全，号密斋，明代医家，湖北罗田人[1]，出身于儿科世家，继承钱乙思想，博采众家之长，尤其擅长小儿疾病的诊治[2]。在古代医家中，万全较早的关注了情志对小儿疾病的影响[3]，尤其强调小儿情志病的预防和养护，以“审明病因，顺其情志”为防治大法，主张保护“稚神”，以神导形，母子同养，调形合神，注重固护脾胃，并擅长采用内治、外治结合精神行为疗法等综合进行治疗，为现代小儿情志病的诊治提供了理论指导，现将万全的情志观总结如下。

1 小兒情志的生理观

1.1  稚嫩之神，禀赋各偏

万全认为小儿初生，知觉尚未成熟，也鲜与外物接触，容易受所见所闻影响而引神动情，所以说小儿多是“神怯而易生惊”[2]42，不建议让其闻大声、见异人、接异物。……