小儿溺血，为精窍之病，乃尿与血先后分出者也。古法主牛膝四物汤（如牛膝、木通、郁金、甘草梢、瞿麦、
当归、川芎、生地、赤芍等味）。
〔真按〕小儿溺血，固属罕见，若有此证，方用鲜生地钱半，生牛膝一钱，细木通八分，赤芍药一钱，瞿麦
穗五分，白云苓二钱，引用灯花一颗。
《经》曰∶阳之汗，以天地之雨名之。又曰∶阳加于阴，谓之汗。又曰∶心为汗。夫心之所藏，在内者为血，
在外者为汗。汗乃人之津液，存于阳者为津，存于阴者为液，发泄于外者为汗。若汗无故而出者，乃因阴阳偏胜
也。如小儿无因而汗自出者，谓之自汗。自汗属阳，有虚实之别。虚者汗出翕翕，发热恶寒，乃表虚也。汗出蒸
蒸，发热不恶寒，乃里实也。表虚者法当固表，里实者法当攻热。又有睡则汗出，觉则汗止，谓之盗汗。盗汗主
阴虚，然当分心虚不固，心火伤阴二候。心虚当补心，心热当凉血，最宜详辨，因作汗解。
小儿表虚， 自汗，古法主玉屏风散（如蜜炙黄 、防风、土炒白术等味）。
若恶寒冷，阳气虚也，古法主桂枝汤（如白芍、桂枝、炙甘草）。加炙附子，引用姜、枣。
阳明里实。蒸蒸自汗。古法主白虎汤（如 石膏、生知母、生甘草、粳米等味）以清之。
便秘者。古法主调胃承气汤（如大黄、芒硝、甘草，引用生姜）以攻之。
〔真按〕自汗一证，多由心肾两虚而得之者。然阴虚阳必凑
之，故发热而自汗。阳虚阴必凑之，故发厥而自汗。皆阴阳偏胜之见端也。小儿脏腑娇嫩，皮腠未密，或重衣浓
被，致五内生热，热搏于心，故心腋不能自存，而额汗出也。额为心之位，宜收敛心气，固心血，方以炒党参二
钱，白归身五分，另有 猪心切一薄片，共煎汤，空心服之。
若大病后，气血两虚，津液自汗，或潮热，或寒热发过之后，身凉自汗，日久令儿黄瘦，失治则变蒸疸，急
宜固其真元。方用嫩黄 一钱，炒党参八分，漂白术八分，炙甘草五分，引用龙眼肉三枚。
若脾虚泄泻自汗后，而遍身冷，有时遇泻则无汗，不泻则有汗，此为大虚之候，急用真人参三钱（无力者用
西党参三钱）。生金钱术二钱，北干姜一钱，炙甘草一钱，以挽救之。
泻止，除去干姜不用，加炙黄 一钱，同煎。
小儿自汗，上至胸，下至脐，此胃虚也，宜补胃。方用四君子汤加黄 。
小儿肺虚自汗，面唇俱白，六脉无力，盖因久嗽所致。方用四君子汤加麦芽、五味子。
Pediatric hematuria (blood in urine) is a disease of the essence orifice, characterized by the sequential discharge of urine and blood. Ancient methods primarily utilized Niuxi Siwu Tang (Cowherb and Four Substances Decoction), containing herbs such as Achyranthis Bidentatae Radix (Niuxi), Akebiae Caulis (Mutong), Curcumae Aromaticae Rhizoma (Yujin), Glycyrrhizae Radix et Rhizoma caulis (Gancao Shao), Dianthi Herba (Qumai), Angelicae Sinensis Radix (Danggui), Ligustici Chuanxiong Rhizoma (Chuanxiong), Rehmanniae Radix (Shengdi), and Paeoniae Radix Rubra (Chishao).
[Commentary by Chen Shouzhen] Pediatric hematuria is indeed rare; if this syndrome occurs, the prescription uses fresh Rehmanniae Radix (Sheng Dihu) 1.5 qian, raw Achyranthis Bidentatae Radix (Sheng Niuxi) 1 qian, fine Akebiae Caulis (Xi Mutong) 8 fen, Paeoniae Radix Rubra (Chishao) 1 qian, Dianthi Spica (Qumai Sui) 5 fen, Poria Cocos with White Bark (Bai Yunling) 2 qian, using one flower of the lamp wick (Denghua) as an adjuvant.
The *Classic* states: The sweating of Yang Qi can be named after the rain of heaven and earth. It also states: When Yang acts upon Yin, it is called sweat. Furthermore: The Heart governs sweat. What the Heart stores internally is Blood, and externally it manifests as sweat. Sweat is the body's Jin-Ye (body fluids); those existing in the Yang aspect are termed Jin (thin fluids), those in the Yin aspect are termed Ye (thick fluids), and those excreted to the exterior are termed sweat. If sweat emerges without cause, it is due to the excess of either Yin or Yang. For instance, when children sweat spontaneously without reason, it is called spontaneous sweating (Zihan). Spontaneous sweating belongs to Yang syndromes and has distinctions between deficiency and excess. Deficiency presents with mild sweating (Xixi), fever, and aversion to cold, indicating Exterior Deficiency. Excessive sweating (Zhengzheng), fever without aversion to cold, indicates Interior Excess. The treatment for Exterior Deficiency should focus on consolidating the Exterior, while the treatment for Interior Excess should focus on purging Heat. There is also night sweating (Daohan), where sweating occurs during sleep and stops upon waking. Night sweating is primarily due to Yin deficiency, but one must distinguish between two patterns: Heart Qi deficiency failing to secure, and Heart Fire damaging Yin. Heart deficiency requires tonifying the Heart, while Heart heat requires cooling the Blood. These must be carefully differentiated; thus, this chapter on resolving sweat is composed.
For pediatric Exterior Deficiency with spontaneous sweating, ancient methods primarily used Yupingfeng San (Jade Windscreen Powder), containing honey-fried Astragali Radix (Huangqi), Saposhnikoviae Radix (Fangfeng), and earth-fried Atractylodis Macrocephalae Rhizoma (Baizhu).
If there is aversion to cold and fear of cold, it indicates Yang Qi deficiency; ancient methods primarily used Guizhi Tang (Cinnamon Twig Decoction), containing Paeoniae Radix Alba (Baishao), Cinnamomi Ramulus (Guizhi), and honey-fried Glycyrrhizae Radix et Rhizoma (Zhigancao). Add honey-fried Aconiti Lateralis Radix Praeparata (Fu Zi), using ginger and jujube as adjuvants.
For Yangming Interior Excess with excessive spontaneous sweating, ancient methods primarily used Baihu Tang (White Tiger Decoction), containing Gypsum Fibrosum (Shigao), Anemarrhenae Rhizoma (Zhimu), raw Glycyrrhizae Radix et Rhizoma (Gancao), and Oryza Sativa (Jingmi), to clear Heat.
In cases of constipation, ancient methods primarily used Tiaowei Chengqi Tang (Regulate the Stomach and Direct Downward Decoction), containing Rhei Radix et Rhizoma (Dahuang), Natrii Sulfas (Mangxiao), Glycyrrhizae Radix et Rhizoma (Gancao), using fresh Zingiberis Rhizoma Recens (Shengjiang) as an adjuvant, to purge accumulation.
[Commentary by Chen Shouzhen] The syndrome of spontaneous sweating often arises from dual deficiency of the Heart and Kidney. However, if Yin is deficient, Yang inevitably congregates externally, causing fever and spontaneous sweating. If Yang is deficient, Yin inevitably congregates internally, causing cold extremities (Jue) and spontaneous sweating. These are initial signs of Yin-Yang imbalance. Children have delicate Zang-Fu organs and loose skin pores. Overdressing or heavy bedding can cause internal heat in the five Zang organs. This heat combats the Heart, causing Heart Qi and Heart Blood to fail to remain within, resulting in sweating on the forehead. The forehead is the seat of the Heart; thus, it is appropriate to consolidate Heart Qi and secure Heart Blood. The prescription uses stir-fried Codonopsis Radix (Dangshen) 2 qian, white Angelicae Sinensis Radix root section (Baiguishen) 5 fen, along with one thin slice of porcine heart, decocted together to take on an empty stomach.
After a severe illness, if both Qi and Blood are deficient, leading to spontaneous sweating of body fluids, tidal fever, or spontaneous sweating after the resolution of alternating chills and fever, prolonged neglect will cause the child to become sallow and emaciated. Untreated, it may transform into Zhengdan (steaming jaundice). It is urgent to consolidate the True Yuan. The prescription uses tender Astragali Radix (Huangqi) 1 qian, stir-fried Codonopsis Radix (Dangshen) 8 fen, bleached Atractylodis Macrocephalae Rhizoma (Baizhu) 8 fen, and honey-fried Glycyrrhizae Radix et Rhizoma (Zhigancao) 5 fen, using three longan arils (Longyanrou) as an adjuvant.
Following spontaneous sweating after spleen-deficiency diarrhea, if the whole body becomes cold, and there is no sweating during diarrhea but sweating when not having diarrhea, this is a sign of severe deficiency. Urgently use genuine Ren Shen 3 qian (or Western Codonopsis Radix [Xidangshen] 3 qian if strength is lacking), raw Atractylodis Macrocephalae Rhizoma (Jinqianshu) 2 qian, dried northern Zingiberis Rhizoma (Ganjiang) 1 qian, and honey-fried Glycyrrhizae Radix et Rhizoma (Zhigancao) 1 qian to rescue the condition.
Once diarrhea ceases, remove the dried ginger and add honey-fried Astragali Radix (Huangqi) 1 qian, decocting together.
If a child's spontaneous sweating extends from the chest down to the umbilicus, this indicates Stomach deficiency, suitable for tonifying the Stomach. The prescription uses Sijunzi Tang (Four Gentlemen Decoction) plus Huangqi.
For pediatric Lung deficiency with spontaneous sweating, presenting with pale face and lips and weak pulses in all six positions, likely caused by chronic coughing, the prescription uses Sijunzi Tang (Four Gentlemen Decoction) plus Hordei Fructus Germinatus (Maiya) and Schisandrae Chinensis Fructus (Wuweizi).