小儿时毒，因感四时不正之气，致鼻面耳项或咽喉赤肿，寒热头痛，甚者恍惚不宁，咽喉闭塞，状如伤寒，五七日
间亦能杀人。脉浮数者邪在表，脉沉涩者邪在里。在表用葛根牛蒡子汤，在里用栀子仁汤，表里俱病者，犀角升麻汤；
甚则宜砭，及用通气散，宜泄其毒，旬日自消。若不消而欲作脓者，用托里消毒散。欲收敛者，用托里散。若咽肿不能
言，头肿不能食者，必死。
一小儿患此三日，二便调和，用葛根牛蒡子汤，漫肿悉退，惟颊间赤肿，欲作脓，用活命饮二服，外用代针膏而脓
出；再用托里消毒散而愈。
一小儿肿赤 痛，此欲作脓也，用托里消毒散，二剂脓成，针之肿痛顿减，又二剂渐愈，却以柴胡栀子散加白芷、
升麻，与母服之而愈。
一小儿肿 作痛，药不能下咽，先用通气散，连作嚏，却用犀角升麻汤，乳食稍进，肿痛渐消，仍服数剂而脓血渐
少，母服加味逍遥散而愈。
一小儿患之，咽喉作痛，二便自调，用葛根牛蒡子汤三剂、甘桔汤四剂，肿痛渐愈。诊乳母左关脉弦数，用加味逍
遥散，母子 服而消。
一小儿患之，赤肿作渴。外敷、内服皆寒凉之药，余欲洗去敷药，急用发散表邪、开通腠理之剂。不信，仍用前药，
遂致不救。
通气散 治时毒 痛，咽喉不利，取嚏以泄其毒。
玄胡索 猪牙皂角 川芎（各一钱） 藜芦（五分） 羊踯躅花（三分）
上为细末，用纸捻蘸少许 鼻内，取嚏为效。
甘桔汤 治肺经壅热，胸膈不利，咽喉肿痛，痰涎壅盛（方见时毒）
犀角升麻汤 治风热口唇颊车连牙肿痛。
犀角镑（二钱） 升麻 防风 羌活 川芎 白芷（各五钱） 黄芩 甘草（各一钱） 白附子（四分）
上每服三五钱。
栀子仁汤 治时毒肿痛，大便秘结。
郁金 枳壳（麸炒） 升麻 山栀仁 牛蒡子（研碎炒） 大黄（炒。各等分）
上为细末，每服二三钱，蜜水调服。
葛根牛蒡子汤 治时毒肿痛，消毒解热。
葛根 管仲 甘草 江西豆豉 牛蒡子（半生半炒研碎。各等分）
上每服三五钱，水煎。
柴胡栀子散（方见胁痈）
托里消毒散
代针膏
托里散
仙方活命饮（四方并见热毒疮疡）
加味逍遥散（方见发热不止）
Pediatric Shidu (Seasonal Toxicity), caused by contracting the abnormal Qi of the four seasons, results in redness and swelling of the nose, face, ears, neck, or throat, accompanied by aversion to cold, fever, and headache. In severe cases, it may cause mental confusion and restlessness, throat obstruction, resembling Shanghan (Cold Damage Disease). It can be fatal within five to seven days. A floating and rapid pulse indicates the pathogen is at the Exterior; a deep and choppy pulse indicates the pathogen is at the Interior. For pathogens at the Exterior, use Gegen Niuziang Tang (Kudzu and Burdock Seed Decoction); for pathogens at the Interior, use Zhizi Ren Tang (Gardenia Seed Decoction); for simultaneous involvement of both Exterior and Interior, use Xijiao Shengma Tang (Rhinoceros Horn and Cimicifuga Decoction). In severe cases, Bianfa (Bleeding with stone needles) is appropriate, along with Tongqi San (Ventilation Powder), to vent the toxicity, which will naturally subside after about ten days. If the toxicity does not subside and suppuration is imminent, use Tuoli Xiaodu San (Interior-Supporting and Toxin-Expelling Powder). If wound contraction is desired, use Tuoli San (Interior-Supporting Powder). If throat swelling prevents speech and head swelling prevents eating, death is inevitable.
A child suffered from this condition for three days, with normal urination and defecation. After administering Gegen Niuziang Tang, the diffuse swelling completely receded, except for redness and swelling on the cheeks, indicating impending suppuration. Two doses of Huoming Yin (Life-Preserving Drink) were administered internally, and Daizhen Gao (Needle-Replacement Plaster) was applied externally, leading to pus discharge. Subsequently, Tuoli Xiaodu San was used, resulting in recovery.
Another child presented with red, swollen, and painful lesions, indicating impending suppuration. Tuoli Xiaodu San was administered; after two doses, pus formed. Puncture drainage immediately reduced pain and swelling. After another two doses, gradual improvement occurred. The mother was then given Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder, specifically Chaihu Zhizi San with Bai Zhi and Sheng Ma added), and both mother and child recovered.
A third child presented with swelling and pain, unable to swallow medication. Tongqi San was first used to induce sneezing to vent toxicity. Then, Xijiao Shengma Tang was administered. Food and milk intake slightly improved, and swelling and pain gradually subsided. After several more doses, pus and blood decreased. The mother took Jiawei Xiaoyao San, leading to recovery.
A fourth child suffered from the condition with sore throat, while urination and defecation remained normal. Three doses of Gegen Niuziang Tang and four doses of Ganjie Tang (Licorice and Platycodon Decoction) gradually alleviated swelling and pain. Examination of the lactating mother's Left Guan pulse revealed a wiry and rapid quality. Jiawei Xiaoyao San was prescribed for both mother and child, leading to resolution.
A fifth child presented with redness, swelling, and thirst. Both topical and internal treatments consisted of cold-natured herbs. I wished to wash off the topical application and urgently prescribe agents to disperse exterior pathogens and open the Cou Li (pores/skin texture). The family refused, continuing with the previous medications, which ultimately led to untreatable deterioration and death.
Tongqi San: Treats Shidu-induced pain and swelling, throat discomfort, inducing sneezing to vent toxicity.
Yan Hu Suo (Corydalis Rhizome), Zhu Ya Zao Jiao (Toothed Soap Pod), Chuan Xiong (Ligusticum Rhizome) (each 1 qian), Li Lu (Veratrum Rhizome) (0.5 qian), Yang Zhi Zhu Hua (Daphne Odora Flower) (0.3 qian).
Grind into fine powder. Dip a paper twist in a small amount and insert into the nostrils to induce sneezing as the therapeutic effect.
Ganjie Tang: Treats Lung Meridian congestion-heat, chest and diaphragm discomfort, sore throat and swelling, and excessive phlegm-saliva (Formula details see "Shidu").
Xijiao Shengma Tang: Treats wind-heat causing soreness and swelling of lips, Jiache acupoint area, and teeth.
Xi Jiao (Rhinoceros Horn, shaved) (2 qian), Sheng Ma (Cimicifuga Rhizome), Fang Feng (Saposhnikovia Root), Qiang Huo (Notopterygium Rhizome), Chuan Xiong (Ligusticum Rhizome), Bai Zhi (Angelica Dahurica Root) (each 5 qian), Huang Qin (Scutellaria Root), Gan Cao (Licorice Root) (each 1 qian), Bai Fu Zi (Aconitum Caraganifolium Tuber) (0.4 qian).
Each dose: 3-5 qian.
Zhizi Ren Tang: Treats Shidu-induced swelling and pain with constipation.
Yu Jin (Curcuma Radix), Zhi Ke (Bitter Orange Fruit, bran-fried), Sheng Ma (Cimicifuga Rhizome), Shan Zhi Ren (Gardenia Seed), Niu Bang Zi (Arctium Fruit, crushed and fried), Da Huang (Rhubarb Root, fried) (equal parts).
Grind into fine powder. Each dose: 2-3 qian, taken with honey-water.
Gegen Niuziang Tang: Treats Shidu-induced swelling and pain, detoxifying and clearing heat.
Ge Gen (Kudzu Root), Guan Zhong (Polygala Root), Gan Cao (Licorice Root), Jiang Xi Dou Chi (Fermented Soybean from Jiangxi), Niu Bang Zi (Arctium Fruit, half raw half fried, crushed) (equal parts).
Each dose: 3-5 qian, decocted in water.
Chaihu Zhizi San (Formula details see "Hypochondriac Abscess")
Tuoli Xiaodu San (Interior-Supporting and Toxin-Expelling Powder)
Daizhen Gao (Needle-Replacement Plaster)
Tuoli San (Interior-Supporting Powder)
Xianfang Huoming Yin (Prescribed Life-Preserving Drink) (The above four formulas are detailed under "Heat-Toxic Carbuncles and Ulcers")
Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder) (Formula details see "Unremitting Fever")