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Pediatric hematuria (blood strangury) arises from heart heat injuring the blood level, with heat qi transmitting to the bladder. Over time, urine and blood are excreted together, forming hematuria, accompanied by intermittent pain in the urethra. Ancient methods primarily prescribe Xiaojizi Yin (Little Thistle Seed Decoction), containing Tongcao, Huashi, Dan Zhuye, Danggui, Xiaoji, Chao Zhizi, Sheng Gancao, Puhuang, Ou Jie, etc., decocted in water and taken on an empty stomach. If the pain in the urethra is severe, ancient methods primarily prescribe Wulin San (Five Stranguries Powder), containing Danggui, Chishao, Ku Tingli, Chao Huangqin, Mutong, Zhizi, Cheqianzi, Dan Zhuye, Huashi, Kuizi, Sheng Gancao, Chifuling, with Congbai (green onion white) as a guide drug.

[Chen Shouzhen's Note] Pediatric hematuria must involve blood stasis accumulating in the urethra, causing unbearable stabbing pain. Urgently apply the principle of "patency relieves pain." The prescription uses Xianshengdi (fresh Rehmanniae Radix) 3 qian, Baiguishen (white Angelicae Sinensis Radix) 5 fen, Chishaoyao (red Peony Root) 1.5 qian, Xian Zhuye (fresh bamboo leaf) 20 pieces, Huashikuai (talcum stone chunks) 3 qian, Cheqianzi (Plantago Seed) 8 fen, with Zhen Xi Hupo (genuine Western Amber) 5 fen as a guide drug.

The *Classic* states: "Body pain with slightly yellow complexion, yellow dental plaque, yellow ears and eyes indicates jaundice." It also says: "Yellow-red urine with lethargy is called jaundice; feeling hungry after eating is called gastric jaundice." Ancients discussed pediatric jaundice, stating it results from long-term stagnation of damp-heat erupting onto the skin and muscles. Symptoms include yellowing of the whole body and face, sometimes deep yellow with a soot-like appearance. There is a distinction between yin and yang jaundice. A red face, thirst, bright red urine, and fever indicate spleen damp-heat, which is yang jaundice. Lack of thirst, dark yellow complexion, and cold body like ice indicate spleen-kidney cold-dampness, which is yin jaundice.

Since yin and yang differ, yang jaundice should be differentiated into exterior and interior syndromes, while yin jaundice should be differentiated into spleen and kidney syndromes, as per ancient theories. However, in reality, few children develop jaundice due to damp-heat; most do so due to spleen deficiency. Strong spleen earth can defend against damp-heat, preventing jaundice; only when the spleen is deficient and fails to transport does damp-heat invade. This is the correct principle, hence this treatise on jaundice.

Pediatric yang jaundice is caused by damp-heat. For exterior excess with no sweat, ancient methods prescribe Yinchin Mahuang Tang (Artemisiae Scopariae and Ephedra Decoction) to induce sweating and release pathogens from the exterior (Yinchenhao and Mahuang decocted in water with a little yellow wine, allowing the jaundice to resolve via the surface). For interior excess with constipation and abdominal fullness, ancient methods prescribe Yinchin Hao Tang (Artemisiae Scopariae and Rhubarb Decoction) to resolve jaundice from the interior (Yinchenhao, Chuan Dahuang, Zhizi, with Dengxin as a guide drug). If there is sweating at the exterior but no constipation or abdominal fullness at the interior, indicating no exterior-interior excess syndrome, sweating or purging methods are contraindicated. Ancient methods prescribe Yinchin Wuling San (Artemisiae Scopariae and Five-Ingredient Powder with Poria Decoction) to promote urination and resolve jaundice through the water passages (Yinchenhao, Chiling, Zhuling, Zexie, Tu Chao Baizhu, Rougui, with Dengxin as a guide drug).

[Chen Shouzhen's Note] Yang jaundice occurs when dampness transforms into heat, producing jaundice, thus termed damp-heat syndrome. Symptoms necessarily include fever, irritability, and thirst, or restlessness, or polyphagia, or hot painful urination, or constipation, with a solid and forceful pulse. This syndrome can result from external wind-damp invasion or internal dietary injury.

If the child's yuan qi is strong, the spleen and stomach are undamaged, and damp-heat is indeed excessive, one should clear fire pathogens and promote urination. The prescription uses Sheng Yezhu (raw wild Atractylodes) 1 qian, Chao Yezhu (fried wild Atractylodes) 1 qian, Chuan Nongpu (Sichuan Magnolia Bark) 1 qian, Bai Fuling (white Poria) 2 qian, Jie Zhuling (knot Polyporus) 1.5 qian, Xuan Zexie (prepared Alisma) 1.5 qian, Yinchenhao 1.5 qian, Hei Zhizi (black Gardenia) 8 fen, Sheng Huangbai (raw Phellodendron) 8 fen, Zhi Gancao (honey-fried Licorice) 5 fen. If there is severe constipation and heat, add Sheng Jinwen (raw Rheum) 5 fen to this formula.