千金方论曰。小儿未能涉冒霜雪。乃不病伤寒也。然天行非节
之气。其亦得之。有如行瘟之年。小儿出腹患斑者。治其时行节度。故如大人之法。但用药分剂少异。药少冷耳。
又曰。治小儿未满百日。伤寒鼻衄。身热呕逆。麦冬汤。
又曰。治少小伤寒。芍药四物解肌汤。
又曰。治少小伤寒。发热咳嗽。头面热者。麻黄汤。（活人书减桂
半两。加石膏。名石膏麻桂汤。）
又曰。治小儿伤寒。以葛根汁淡竹沥各六合。二味相和。二三岁
儿。分三服。百日儿酌服。不宜生。煮服佳。
又曰。治小儿时气。枇杷叶三两。捣。以水五升。煮十沸。取汁。
日五六遍淋之。若复发热。烧雄鼠屎二三枚。用水调服之。
又曰。治小儿伤寒久不除。瘥后复剧。瘦瘠骨立。五味子汤。
又曰。治少小伤寒。宜莽草汤。治之避眼与阴。
又曰。小儿伤寒发黄者。捣土瓜根汁三合服之。
又曰。捣青麦汁服之。
又曰。韭根汁澄清。滴儿鼻中如大豆许。即
出黄水瘥。
又曰。小豆二七粒。瓜蒂二七枚。糯米四十粒。以少许吹鼻中。
活人书论小儿伤寒曰。治法与大人同。但小分剂。药性差凉耳。
寻常风壅发热。痰嗽烦渴。惺惺散主之。咽喉不利。痰实咳嗽。鼠粘
子汤主之。头额身体温热。大便黄赤。腹中有热。四顺散、连翘散、三
黄丸主之。头额身体温热。大便白而酸臭者。胃中有食积。双丸主
之。小儿无异疾。惟饮食过度。不能自节。心腹胀满。身热头疼。双丸
悉主之。小儿身体潮热。头目碎痛。心烦神躁。小便赤。大便燥。此热
剧也。洗心散、调胃承气汤主之。头疼发热。偎人畏寒者。此伤寒症
也。升麻汤主之。无汗者。麻黄黄芩汤。有汗者。升麻黄芩汤。皆要药
也。小儿寻常不可过当服凉药。胃冷虫动。其症与惊相类。医者不能
辨。往往复进惊药。如脑麝之类。遂发吐。胃虚而成慢惊者多矣。小
儿须有热症。方可疏转。仍忌用丸子药利之。以大黄川芎等 咀。作
汤液。以荡涤蕴热。盖丸子巴豆。可攻食积耳。雍曰。此症不止小儿
伤寒症。亦多及余病。故详录之。
又曰。治小儿风热。及伤寒时气。疮疹发热。宜惺惺散。
又曰。治伤寒中风。头痛。憎寒壮热。肢节痛。发热恶寒。鼻干不
得睡。兼治小儿大人疮疹已发未发。皆可服。寒暄不时。人多疾疫。
乍暖脱着。及暴热之次。忽变阴寒。身体疼痛。沉重如石者。升麻汤
主之。
又曰。治胸中客热。口舌咽中生疮。赤眼。目睑重不欲开。疮疹
已发未发。宜服甘露饮子。
又曰。洗心散通治麸豆疮。时行瘟疫。狂
语多渴者。
又曰。连翘饮子治小儿一切热。
又曰。解大人小儿膈热。
退壅盛。凉心经。宜四顺散。
又曰。治小儿伤寒。发热咳嗽。头面热
者。宜石膏麻桂汤。（千金名麻黄汤）
庞氏曰。小儿伤寒。发热自汗。多啼。宜葛根芍药汤。
又曰。小儿
伤寒。不解。发惊。妄言语。狂躁潮热。钩藤大黄汤。
又曰。小儿伤寒。结胸。其项强眼翻。弄舌搐搦。如发痫状。久则
哽气。但啼声不出。医亦多作惊风治之。其脉浮滑。试以指按心下则
痛而啼。宜半夏黄连栝蒌汤。斟酌大小服之。当出黄涎。便瘥。
又曰。小儿伤寒。始因壮热不除。被汤丸下后。其症一如前结胸
状。但啼声不出。医又以惊风治之。多服凉药无验。此由误下后。毒
气结在心胸。内热吐涎。涎裹药。不能宣行所致。宜服荡涎散取下黑
黄涎。犹包裹诸药。啼声一出即安。雍曰。此因初误下后。凉药不宣
通。方服荡涎散。
又曰。小儿伤寒。蒸起风热发痫。手足搐搦而不省。蛇皮汤。
又曰。小儿伤寒。胃中有热。烦闷不食。至日晚潮热颊赤。躁乱
呕吐。芦根汤。
又曰。小儿伤寒后。盗汗。体热。咽干。犀角黄 汤。
The *Qianjin Fang* (Prescriptions Worth a Thousand Gold) discusses: Infants have not been exposed to frost and snow, therefore they do not suffer from Shanghan (Cold Damage). However, if they encounter abnormal seasonal epidemic Qi (pathogenic factors), they can also fall ill. For example, in years when plague is prevalent, newborns may contract maculopapular rashes shortly after birth. The treatment should follow the protocols for seasonal epidemics; thus, the methods are largely the same as those for adults, but with slightly smaller dosages and cooler medicinal properties.
It further states: To treat infants under one hundred days old suffering from Shanghan presenting with epistaxis (nosebleed), fever, vomiting, and regurgitation, use Maidong Tang (Ophiopogon Decoction).
It further states: To treat young children with Shanghan, use Shaoyao Siwu Jiemi Tang (Peony Four-Substance Muscle-Releasing Decoction).
It further states: To treat young children with Shanghan presenting with fever, cough, and heat in the head and face, use Mahuang Tang (Ephedra Decoction). (*Huoren Shu* [Book of Vitality] reduces Guizhi by half an liang and adds Shigao, naming it Shigao Magui Tang [Gypsum and Cinnamon Twig Decoction]).
It further states: To treat pediatric Shanghan, take 6 he of Gegen juice (Kudzu Root Juice) and Danzhuli (Bamboo Sap), mix the two ingredients. For children aged two or three, divide into three doses; for infants around one hundred days old, administer according to discretion. Raw administration is not recommended; boiled administration is better.
It further states: To treat pediatric shiqi (seasonal qi disease), take 3 liang of Pipaye (Loquat Leaf), crush it, add 5 sheng of water, boil ten times, and collect the juice. Administer externally as a wash or internally five to six times daily. If fever recurs, burn 2-3 pieces of Xiongshushi (Male Rat Feces), mix with water, and administer orally.
It further states: To treat pediatric Shanghan that persists for a long time without resolution, or recurs severely after recovery, resulting in emaciation and visible bones, use Wuweizi Tang (Schisandra Decoction).
It further states: To treat young children with Shanghan, Mangcao Tang (Marsdenia Decoction) is suitable, but care must be taken to avoid the eyes and genitalia.
It further states: For pediatric Shanghan presenting with jaundice, crush and administer 3 he of Tugua Gen juice (Trichosanthes Kirilowii Root Juice).
It further states: Crush and administer Qingmai juice (Green Wheat Juice).
It further states: Clarify Jiugen juice (Chinese Chive Root Juice) and drip into the infant's nostrils, in an amount the size of a soybean. Yellow fluid will discharge, leading to recovery.
It further states: Take 14 Chi Xiao Dou (Adzuki Beans), 14 Gouti (Melon Sepal), and 40 Nuomi (Glutinous Rice). Take a small amount and insufflate into the nostrils.
*Huoren Shu* (Book of Vitality) discusses pediatric Shanghan: The treatment principles are the same as for adults, but with smaller dosages and slightly cooler medicinal properties.
For common wind-phlegm obstruction causing fever, phlegm-cough, irritability, and thirst, Xingxing San (Awakening Powder) is indicated. For throat discomfort, phlegm-solidity, and cough, Niubangzi Tang (Arctium Decoction) is indicated. For warmth in the head/forehead and body, yellow-red stool, and heat in the abdomen, Sishun San (Four-Harmony Powder), Lianqiao San (Forsythia Powder), and Sanhuang Wan (Three-Yellow Pill) are indicated. For warmth in the head/forehead and body, with white, sour-smelling stool, indicating food retention in the stomach, Shuangwan (Double Pills) is indicated. If children have no other diseases but suffer from overeating and lack of self-restraint, leading to abdominal distension, fullness, fever, headache, Shuangwan is indicated for all such cases.
If a child has tidal fever, fragmented pain in the head and eyes, irritability, restlessness, red urine, and dry stool, this indicates severe heat. Xixin San (Heart-Washing Powder) and Tiaowei Chengqi Tang (Regulate the Stomach and Descend Rebellion Decoction) are indicated.
If there is headache, fever, huddling close to others, and aversion to cold, this is a Shanghan syndrome. Shengma Tang (Cimicifuga Decoction) is indicated. For those without sweat, Mahuang Huangqin Tang (Ephedra and Scutellaria Decoction) is used; for those with sweat, Shengma Huangqin Tang (Cimicifuga and Scutellaria Decoction) is used. Both are essential medicines.
Children should generally not be given excessive cooling medicines. If this causes cold stomach and moving parasites, the symptoms resemble Jingfeng (Wind Convulsion). If physicians cannot distinguish them, they often administer Jingfeng medicines again, such as Nao (Brain) and Shexiang (Musk), leading to vomiting. Many cases of Manjingfeng (Slow Wind Convulsion) arise from deficiency of the stomach. Children should only be treated with purgatives/dispersants if there are clear heat syndromes. Pills containing Radix Crotonis (Badou) should be avoided for purging; instead, Da Huang (Rhubarb) and Chuanxiong (Szechwan Lovage Rhizome) should be chopped and decocted to sweep away accumulated heat, as Badou pills are only suitable for attacking food retention. Guo Yong states: This discussion covers not only pediatric Shanghan but also many other diseases, so it is recorded in detail here.
It further states: To treat pediatric wind-heat, as well as Shanghan, shiqi, and rash fever, Xingxing San is suitable.
It further states: To treat Shanghan and Zhongfeng (Wind Strike) presenting with headache, aversion to cold with high fever, joint pain, fever, aversion to wind, dry nose, and insomnia, which also applies to pediatric and adult rashes whether erupted or not: When weather is erratic, epidemics are common, and people dress improperly due to sudden warmth or cold, or after sudden heat turns suddenly cold, causing body pain and heaviness like stone, Shengma Tang is indicated.
It further states: To treat guest-heat in the chest, sores in the mouth, tongue, and throat, red eyes, heavy eyelids unwilling to open, and rashes whether erupted or not, Ganlu Yinzi (Sweet Dew Drink) is indicated.
It further states: Xixin San is universally indicated for Tianhua (Smallpox), shixing wenyi (seasonal plagues), delirious speech, and excessive thirst.
It further states: Lianqiao Yinzi (Forsythia Drink) treats all heat syndromes in children.
It further states: To resolve diaphragmatic heat in adults and children, reduce excess heat, and cool the Heart Meridian, Sishun San is indicated.
It further states: To treat pediatric Shanghan presenting with fever, cough, and heat in the head and face, Shigao Magui Tang is indicated. (*Qianjin Fang* names this Mahuang Tang).
Pang Shi states: For pediatric Shanghan presenting with fever, spontaneous sweating, and frequent crying, Gegen Shaoyao Tang (Kudzu and Peony Decoction) is indicated.
It further states: For pediatric Shanghan that does not resolve, leading to convulsions, delirium, mania, restlessness, and tidal fever, Gouteng Dahuang Tang (Uncaria and Rhubarb Decoction) is indicated.
It further states: For pediatric Shanghan presenting with JieXiong (Chest Binding), stiff neck, upward rolling of eyes, protruding tongue, and spasms resembling epilepsy. In prolonged cases, there is choking breath, inability to cry out, and physicians often mistake it for Jingfeng. The pulse is floating and slippery. Pressing the epigastrium causes pain and crying. Banxia Huanglian Gualou Tang (Pinellia, Scutellaria, and Trichosanthes Fruit Decoction) is indicated, with dosage adjusted for age. Yellow phlegm should be discharged, leading to recovery.
It further states: Pediatric Shanghan initially presents with persistent high fever. After being treated with decoctions or pills for purging, symptoms resemble JieXiong, but the child cannot cry out. Physicians treat it as Jingfeng, administering cooling medicines without effect. This is due to toxic Qi binding in the heart and chest after mistaken purging, causing internal heat and salivation, where the saliva wraps the medicine preventing its dispersion. Dangxian San (Phlegm-Sweeping Powder) is indicated to discharge black-yellow phlegm, which contains the wrapped medicines. Once the child cries, peace returns. Guo Yong states: This occurs because cooling medicines failed to circulate after initial mistaken purging; only then should Dangxian San be administered.
It further states: Pediatric Shanghan steams up wind-heat triggering epilepsy, with spasms of hands and feet and loss of consciousness. Shepi Tang (Snake Skin Decoction) is indicated.
It further states: Pediatric Shanghan with heat in the stomach, irritability, anorexia, tidal fever at dusk, red cheeks, restlessness, and vomiting. Lugeng Tang (Reed Rhizome Decoction) is indicated.
It further states: Post-pediatric Shanghan with night sweats, body heat, and dry throat. Xijiao Dihuang Tang (Rhino Horn and Rehmannia Decoction - inferred from context "Xijiao Huang...") is indicated.