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In late autumn, when the coolness first sets in. A young child presents with fever and cough. The syndrome resembles Wind-Warmth (Fengwen) of spring. However, "Warmth" refers to a gradual increase in heat, while "Coolness" implies a gradual decrease in temperature. Illnesses contracted in spring still benefit from the residual solidity and closure of winter storage. Injuries sustained in autumn occur precisely after the dispersal of summer heat. Thus, the deficiency or excess of constitution differs. Wind-Warmth enters from above; Dryness injures from above. The principle is equally applicable. Both involve disease affecting the Lung Qi. People mistakenly identify this as a sudden contraction of Wind-Cold and indiscriminately administer dispersing agents for the Three Yang meridians. This depletes body fluids, exacerbates dryness, leading to panting and urgency, putting the patient in danger. If it is indeed external constraint by sudden cold, with fever, phlegm, and cough, only Congchi Tang (Scallion and Fermented Soybean Decoction) or herbs such as Perillae Caulis (Sugeng), Peucedani Radix (Qianhu), Armeniacae Semen (Xingren), Aurantii Fructus Immaturus (Zhike), and Bunge's Magnolia Flower (Jie) should be used. One or two doses are sufficient. More often, incompetent physicians, knowing it is a heat disease, prescribe Xiebai San (Drain the White Powder) supplemented with Scutellariae Radix (Huangqin) and Phellodendri Cortex (Huanglian). They do not realize that excessive bitterness aids dryness and inevitably leads to other complications. One should use formulas that are pungent, cool, sweet, and moistening. The qi dryness will naturally level out and heal. Do not use bitter-drying agents that consume and scorch stomach fluids.

Autumn-Dryness syndrome affects the Qi level first; treating the Lung is urgent. If it lingers for dozens of days, the pathogen must enter the Blood level, which cannot be treated by light and floating Lung herbs. One must examine the constitution and symptom details. As the ancients said, treating disease requires flexibility, like a pearl rolling on a plate.

A child surnamed Weng, only a few months old, suffered from Autumn-Dryness tidal fever and coughing paroxysms resembling malaria. The pediatrician used dispersing herbs for two days without effect, then hastily ordered weaning. Another physician prescribed Xiebai San plus Scutellariae Radix and Phellodendri Cortex for another two days. The child experienced day-and-night irritability and fever, panting without coughing, and dysentery with sticky discharge. After medication, even the medicinal liquid was passed via stool. I was consulted. I said: Infants rely on milk and food for life. Hunger leads to Spleen-Stomach deficiency and Qi exhaustion, further impairing Lung Qi. I prescribed Polygonati Odorati Rhizoma (Yuzhu), Glycyrrhizae Radix et Rhizoma (Gancao), stir-fried Citri Reticulatae Pericarpium (Guangchenpi), and Bamboo Leaf Heart (Zhuyexin). After one dose, the fever subsided. Subsequently, I prescribed Fragrant Rice (Xiangjingmi), Jujubae Fructus (Nanzao), Citri Reticulatae Pericarpium, Glycyrrhizae Radix et Rhizoma, and Glehniae Radix (Shashen) for two doses. Milk intake was slightly increased, and the mother was instructed to hold the infant at night rather than letting him lie supine. He recovered completely in three days.

Late autumn into winter, sudden cold damages Yang. External contraction causes fever, headache, and body pain, accompanied by vomiting and nausea. The pathogen must originate from the Taiyang (Greater Yang) meridian. If there is thirst and ability to drink water, it indicates internal heat symptoms, meaning pure exterior dispersal is not appropriate. In Cold Damage (Shanghan), Wind injuring the Wei (Defensive) level uses Guizhi Tang (Cinnamon Twig Decoction); Cold injuring the Ying (Nutritive) level uses Mahuang Decoction (Mahuang Tang). Children have loose skin and sweat easily, making them unable to tolerate the pungent-warm potency of Ephedrae Herba (Mahuang) and Cinnamomi Ramulus (Guizhi). For Taiyang exterior pathogens, mild cases use Zisu Ye (Perilla Leaf) and Fangfeng (Saposhnikovia Root) alone or in combination; body pain uses Notopterygii Rhizoma et Radix (Qianghuo). However, these are limited to one dose. Wind-injury syndromes are mostly Lung diseases. The aforementioned Xingren, Zhike, and Jie are pungent and thus possess sweating properties. Congchi Tang is a general essential formula. If limbs are cold, chills occur, vomiting happens, spontaneous dysentery appears, or there is no fever, it indicates Middle Cold interior syndrome. The Three Yin meridians must be differentiated. However, in pediatrics, Taiyin Middle Cold is most common, while Jueyin (Terminal Yin) Middle Cold occurs occasionally. If winter weather should be cold but remains warm, causing storage to leak instead, disease ensues, named Winter-Warmth (Dongwen). Warmth is the gradual onset of heat, unlike cold syndromes which resolve through sweating. If exterior pathogens account for one or two parts, interior heat likely accounts for seven or eight parts. This manifests as macules or erysipelas-like rashes, not merely Wind-Cold. Or, external pathogens clash with internal pathogens, stagnating in the collaterals. Or, consumption of rich flavors generates intense internal heat, causing Wei Qi to fail to harmonize with Ying Qi. Or, evil Qi invades internally, resulting in abdominal pain and dysentery. Treatment must follow the symptoms, prioritizing interior regulation, with slight adjunctive clearing and dispersing. If pungent-warm agents are used, disaster will follow immediately. Regarding rash, smallpox, and epidemic plagues, the Four Qi must be distinguished.