小儿有病多发热，表里虚实宜分别，观形察色辨因由，审证切脉有妙诀，
表证须汗裹下之，虚则宜补实则泻，平昔体认要精详，方得临时无遗阙。
[注]
小儿发热有表里虚实之异，治亦有汗下补泻之殊，
须观形察色，审证切脉以别之，
惟在平昔讲习精详，临证庶不致误。
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发热门
表热之证因外感，脉浮发热恶风寒，头痛身疼而无汗，十神通圣表为先。
[注]
小儿外感寒邪，脉浮发热，恶风恶寒，头疼身痛无汗，
此表热也，宜十神汤主之，
若兼内热者，双解通圣汤两解之。
（十神汤）升麻 葛根 麻黄 香附醋炒 陈皮 苏叶 赤芍药 川芎 香白芷
甘草生 引用生姜水煎服。
(方歌)
十神汤治表热证，升麻干葛共麻黄，香附陈皮苏叶芍，芎芷甘草引生姜。
(双解通圣汤) 方见伤寒。
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发热门
里热之证因内热，遍身蒸热小便红，面赤唇焦舌燥渴，调胃白虎解毒清。
[注]
小儿肥甘过度，必生内热，
以致发热蒸蒸，小便赤涩，面赤唇焦，舌燥而渴，
脉实有力者先以调胃承气汤下之，不愈用白虎汤，或黄连解毒汤清之。
(调胃承气汤) 大黄 芒硝 甘草 引用生姜水煎服。
(方歌)
谓胃承气治裹热，大黄甘草共芒硝，引用生姜水煎服，大使通利热自消。
(白虎汤) 石膏煆 知母生 甘草生 粳米 水煎服。
(方歌)胃热白虎汤，知母生用良，石膏合甘草，粳米共煎嗜。
(黄连解毒汤) 黄芩 黄连 栀子 黄蘖 水煎服。
(方歌)黄连解毒汤，清热效非常，芩连栀子蘖，煎服保安康。
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发热门
Pediatric diseases often manifest as fever; it is necessary to differentiate between exterior and interior, deficiency and excess. Observe the physical form and complexion to identify the etiology, and carefully assess symptoms and palpate the pulse to grasp the essential principles.
For exterior syndromes, sweating methods should be employed, and purgation must not be used inappropriately; deficiency syndromes require tonification, while excess syndromes require purging. Thorough understanding of medical theories in daily practice ensures no omissions or errors during clinical application.
[Note]
Fever in children varies by exterior/interior and deficiency/excess patterns, requiring distinct treatments such as diaphoresis, purgation, tonification, or draining.
Differentiation must be achieved through observing physical signs, inspecting the complexion, assessing symptoms, and palpating the pulse.
Success depends on meticulous study and practice beforehand to avoid misdiagnosis during clinical encounters.
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Fever Category
Exterior heat syndrome arises from external pathogenic invasion, characterized by a floating pulse, fever, aversion to wind and cold, headache, body ache, and absence of sweating. Treatment prioritizes Jiu Shen Tang (Nine Divine Decoction) to release the exterior.
[Note]
When pediatric patients are affected by external cold pathogens, presenting with a floating pulse, fever, aversion to wind and cold, headache, body pain, and anhidrosis,
this constitutes an exterior heat syndrome, for which Shi Shen Tang (Ten Divine Decoction) is indicated.
If internal heat is also present, Shuang Jie Tong Sheng Tang (Double-Resolving Universal Sage Decoction) should be used to resolve both exterior and interior simultaneously.
(Shi Shen Tang / Ten Divine Decoction) Cimicifugae Rhizoma (Shengma), Puerariae Radix (Gegen), Ephedrae Herba (Mahuang), Cyperi Rhizoma (Xiangfu, stir-fried with vinegar), Citri Reticulatae Pericarpium (Chenpi), Perillae Folium (Suye), Paeodiae Radix Rubra (Chishao), Chuanxiong Rhizoma (Chuanxiong), Angelicae Dahuricae Radix (Baizhi), Glycyrrhizae Radix et Rhizoma (Gancao, raw). Decoct with fresh ginger juice as a guide.
(Prescription Song)
Shi Shen Tang treats exterior heat, combined with Shengma, Gan Ge, and Mahuang; Xiangfu, Chenpi, Suye, and Shaoyao; Chuanxiong, Baizhi, Gancao, guided by fresh ginger.
(Shuang Jie Tong Sheng Tang / Double-Resolving Universal Sage Decoction) See the Treatise on Cold Damage chapter.
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Fever Category
Interior heat syndrome stems from internal heat accumulation, manifesting as generalized steaming fever, red urine, flushed face, cracked lips, dry tongue, and thirst. Treatment involves Tiao Wei Cheng Qi Tang (Regulate the Stomach Order the Qi Decoction), Bai Hu Tang (White Tiger Decoction), or Huang Lian Jie Du Tang (Coptis Decoction for Resolving Toxicity) to clear heat.
[Note]
Excessive consumption of rich and sweet foods by children inevitably generates internal heat,
leading to steaming fever, reddish and scanty urination, facial flushing, cracked lips, dry tongue, and thirst.
If the pulse is forceful and excess, first administer Tiao Wei Cheng Qi Tang (Regulate the Stomach Order the Qi Decoction) to purge; if ineffective, use Bai Hu Tang (White Tiger Decoction) or Huang Lian Jie Du Tang (Coptis Decoction for Resolving Toxicity) to clear the heat.
(Tiao Wei Cheng Qi Tang / Regulate the Stomach Order the Qi Decoction) Rheum Radix et Rhizoma (Dahuang), Natrii Sulfas (Mangxiao), Glycyrrhizae Radix et Rhizoma (Gancao). Decoct with fresh ginger juice as a guide.
(Prescription Song)
Tiao Wei Cheng Qi Tang treats interior heat, combining Dahuang, Gancao, and Mangxiao; decoct with fresh ginger juice, promoting bowel movement to eliminate heat naturally.
(Bai Hu Tang / White Tiger Decoction) Gypsum Fibrosum (Shigao, calcined), Anemarrhenae Rhizoma (Zhimu, raw), Glycyrrhizae Radix et Rhizoma (Gancao, raw), Oryzae Semen (Jingmi). Decoct in water.
(Prescription Song) For stomach heat, Bai Hu Tang is effective; Zhimu used raw is excellent; combined with Shigao and Gancao, cooked together with Jingmi for consumption.
(Huang Lian Jie Du Tang / Coptis Decoction for Resolving Toxicity) Scutellariae Radix (Huangqin), Coptidis Rhizoma (Huanglian), Gardeniae Fructus (Zhizi), Phellodendri Cortex (Huangbo). Decoct in water.
(Prescription Song) Huang Lian Jie Du Tang has extraordinary heat-clearing effects; Huangqin, Huanglian, Zhizi, and Huangbo decocted ensure safety and health.
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Fever Category