夫小儿伤寒得之与大人无异，所异治者，兼惊而已，又有因夹惊食而得，治法与大人一同，但小其分剂，使药性稍
差耳。仲景云∶春气温和，夏气炎热，秋气清凉，冬气冷冽，此则四时正气之序也。冬时严寒，触冒之者，乃名伤寒耳。
其伤于四时之气，皆能为病。冬受寒毒之气，其实时而病者，头痛身疼，肌肤热而恶寒，名曰伤寒。其不实时病者，寒
毒藏于肌肤之间，至春夏阳气发生，则寒毒与阳气相搏于荣卫之间，其病与冬时即病无异，但因春而发，名曰温病。至
夏而发，名曰热病。阳热未盛，为寒所制，病名为温，阳热。已盛，寒不能制，病名为热，故太医均谓之伤寒也。然热
病伤寒，温病时气，传变无异也，凡时气者，四时之间，有不正之气也，为春应暖而反寒，夏应热而反冷，秋应凉而反
热，
冬应寒而反温，非其时而有其气，气之中人，则头疼壮热，咳嗽气粗，烦渴心躁，恍忽惊悸，传变与伤寒无异，故一岁
之中，病无长少，率相似者，此则时行之气，俗谓之天行是也。治法三四月或有暴寒，其时阳气尚弱，为寒所折，病热
犹轻，升麻汤、解肌汤主之。五六月阳气已盛，为寒所折，病热则重。七八月阳气已衰，为寒所折，病热亦微，调中汤、
射干汤、半夏桂甘汤，可选用也。秋湿冬温，治湿则利小便，治冬温亦宜解利。其利小便也，则以五苓散辈，其解利冬
温，宜葳蕤汤。盖冬温者，感温气而作，寒疫者，暴寒折人，非触冒之过，其治法不同，所施寒热温凉之剂亦异，不可
拘以日数，发汗吐下，随症施行。要之治热以寒、温而行之，治温以清、冷而行之，治寒以热、凉而行之，治清以温、
平而行之，以平为期，不可过剂，此为大法，汤氏有七宝散加减服之，并与乳母服尤好，有热者、升麻汤加柴胡、黄芩、
川芎等剂治之，柴胡石膏汤极效。
升麻汤 治小儿时行瘟疫，头痛发热，肢体烦疼，及疮疹已发未发，疑似之间。治伤寒伤风，头痛憎寒壮热，
肢体疼痛，鼻干不得睡。兼治寒暄不时，人多疫疠，乍暖脱着，及暑热之忽变阴寒，身体疼痛，头重如石者，可加柴胡，
无汗加麻黄。
升麻（一钱） 葛根（一钱） 白芍药（一钱） 甘草（炙一钱）
上锉散，每服三钱，水一盏，煎至六分，去滓温服，疮疹亦准此。服药已身凉，止药。加紫苏、茯苓、川芎，名升
麻苏叶散，有热加黄芩，咽喉痛加桔梗，发丹加玄参效。
解肌汤 治伤寒温病，时行寒疫，头痛项强畏寒，肢体拘急，骨节烦疼，腰脊强痛，胸膈烦闷，无汗恶风壮热。
葛根（一两） 麻黄（去节、半两） 芍药（半两） 甘草（半两） 桂枝（二钱半、千金方无此一味）
上锉散，每服三钱，水一盏，枣一枚，煎至六分，去滓稍热服，以汗出为度。夏月加石膏、升麻，各一钱。
调中汤 治夏末秋初，忽有暴寒，折于盛暑。热结于四肢，则壮热头疼，寒伤于胃，则下利，或血、或赤、或
白，壮热迷闷脉数，宜下之。
大黄（七钱半） 桔梗（炒、半两） 本（半两） 茯苓（半两） 甘草（半两） 干葛（半两） 黄芩（半两）
芍药（半两） 白术（半两）
上 咀，白水煎，量大小加减服，得快气利，壮热便歇。去大黄，加黄连枳壳，止利尤妙，或加地榆，或加当归皆
可。感风加荆芥。秋宜下，当用大黄疏利。
射干汤 治初秋夏月豪雨冷，及天行暴寒，其热喜伏于内，咳嗽气急，喉哑失声，干嗽无唾，喉中如梗。
半夏（汤泡、五钱） 生姜（炮、四钱） 射干（二钱） 杏仁（去皮尖、二钱） 甘草（炙二钱） 紫菀（二钱）
肉桂（二钱） 枳实（炒、二钱） 当归（二钱） 橘皮（二钱） 独活（二钱） 麻黄（去节、汤泡、二钱）
上 咀，每服三钱，水一盏，煎至六分，去滓温服。
半夏桂甘汤 治伏气之病，谓非时有暴寒，中人，伏于少阴经，始不觉病，旬月乃发，脉便微弱，咽痛，似伤
寒，非喉痹之病，次必下利。始用半夏桂甘汤主之，次用四逆散，此病一二日便瘥，古方谓之肾伤寒。
半夏（洗、二两） 桂心（二两） 甘草（炙、二两）
上锉如麻豆大，每服三钱，水一盏，煎至六分，放冷，少含细咽之，入生姜三片煎。
五苓散 治伤寒温热病、表里未解，头痛发热，口燥咽干，烦渴饮水，或水入即吐，或小便不利，及汗出表解，
烦渴不止，又治霍乱吐利，燥渴引饮。
泽泻（二两半） 猪苓（二两半） 白术（一两半） 茯苓（一两半） 桂（一两）
上为细末，每服二钱，热汤调下，不拘时，服讫多饮热汤，有汗出即愈。又治瘀热在里，身发黄胆，浓煎茵陈汤下，
食前服，疸病发渴，及中暑引饮，亦可用水调服。小儿加白术末少许，如发虚加绵黄 、人参末少许，十六问辰砂五苓
散参用。
葳蕤汤 治风温、冬温，及春月中风、伤寒，发热头疼，咽干舌强，胸腹满，腰脊强。
葛根（半两） 葳蕤（三钱） 石膏（一两） 白薇（半两） 羌活（半两） 麻黄（半两） 川芎（半两） 杏
仁（去皮尖、半两） 甘草（炙、半两） 木香（半两）
上 咀，每服三钱，水一盏，煎至八分，去滓温服。
七宝散 治时气头昏体热、此药大人可服，小儿同乳母服。
紫苏（三两） 香附（炒、三两） 陈皮（一两） 甘草（炙一两） 桔梗（去芦、一两） 白芷（一两） 川芎
（一两）
上咀，每服二钱，水半盏，姜一片，枣一枚，煎三分，去滓服。有热加葛根、升麻、荆芥。
柴胡石膏汤 治时行温疫，壮热恶风，头痛体疼，鼻塞咽干，心胸烦满，寒热往来，痰热咳嗽，涕唾稠粘并疗
之。
桑白皮（三两） 黄芩（三两） 升麻（二两半） 石膏（五两） 前胡（去芦、五两） 赤芍药（五两） 干葛
（五两） 柴胡（五两） 荆芥穗（三两） 无汗加麻黄、半夏、北五味
上为粗末，每服二钱，水一盏，生姜二片，淡豉十粒，煎至七分，去滓，稍热服。小儿分作三服，量大小加减，不
拘时候。
Pediatric cold damage (Shanghan, a disease caused by pathogenic cold) in children is no different from that in adults. The difference lies in the treatment, which must also address convulsions (Jing, often referring to febrile seizures or fright-induced symptoms in pediatrics). Additionally, some cases arise from a combination of convulsions and food retention; the treatment methods are the same as for adults, but the dosages are slightly reduced to moderate the medicinal properties. Zhang Zhongjing stated: Spring climate is mild, summer is hot, autumn is cool, and winter is cold; this is the sequence of the normal qi of the four seasons. When one is exposed to the severe cold of winter, it is named cold damage (Shanghan). Injuries from the qi of the four seasons can all cause disease. If one contracts cold toxic qi in winter and falls ill immediately, presenting with headache, body ache, feverish skin, and aversion to cold, it is named cold damage (Shanghan). If one does not fall ill immediately, the cold toxic qi hides between the skin and muscles. When yang qi arises in spring and summer, the cold toxic qi contends with yang qi between the Ying (Nutritive) and Wei (Defensive) levels. The pathology is no different from immediate winter illness, but because it erupts in spring, it is named warm disease (Wenbing). If it erupts in summer, it is named heat disease (Rebing). When yang-heat is not yet vigorous and is constrained by cold, the disease is named warm (Wen); when yang-heat is already vigorous and cannot be constrained by cold, the disease is named heat (Re). Thus, imperial physicians generally refer to them all as cold damage (Shanghan). However, the transmission and transformation of heat disease, cold damage, warm disease, and seasonal epidemics are identical. Seasonal epidemic diseases (Shiqi) refer to abnormal qi present during the four seasons, such as spring being warm but turning cold, summer being hot but turning cool, autumn being cool but turning hot, and winter being cold but turning warm. When there is qi contrary to the season, and this qi invades the person, it causes headache, high fever, cough with coarse breathing, vexation, thirst, mental restlessness,恍惚 (huanghu, confusion/fright), and palpitations. Its transmission is no different from cold damage. Therefore, throughout the year, regardless of age, patients present with similar symptoms; this is the qi of the time epidemic (Shixing zhiqi), commonly known as heavenly circulation (Tianxing).
Regarding treatment: In the third and fourth months, if there is sudden cold, the yang qi is still weak and suppressed by cold, so the heat pathology is mild; Shengma Tang (Cinnamon Twig Decoction - *Note: Text says Shengma Tang but ingredients suggest Ge Gen Tang variant or specific local formula, sticking to text name*) and Ji Ji Tang (Muscle-Releasing Decoction) should be used. In the fifth and sixth months, yang qi is vigorous but suppressed by cold, so the heat pathology is severe. In the seventh and eighth months, yang qi is declining and suppressed by cold, so the heat pathology is slight; Tiao Zhong Tang (Middle-Regulating Decoction), She Gan Tang (Belamcanda Decoction), and Ban Xia Gui Gan Tang (Pinellia, Cinnamon, and Licorice Decoction) may be selected. For autumn dampness and winter warmth, treating dampness requires promoting urination, and treating winter warmth also requires releasing and purging. Promoting urination can be done with Wu Ling San (Five-Ingredient Powder with Poria), and releasing winter warmth is suitable with Zhe Yu Tang (Polygonatum Decoction). Winter warmth arises from contracting warm qi; cold epidemic (Hanyi) is caused by sudden cold suppressing people, not merely by exposure. Their treatments differ, and the cold, heat, warm, and cool agents applied are also distinct. One should not be bound by the number of days; sweating, vomiting, and purging should be administered according to the syndrome. Generally, treat heat with cold herbs taken warm; treat warmth with clearing herbs taken cold; treat cold with hot herbs taken cool; treat coolness with warming herbs taken at room temperature. Aim for balance, do not overdose; this is the major principle. Tang Shi’s Qi Bao San (Seven-Treasure Powder) can be taken with modifications; it is especially good if taken by the nursing mother simultaneously. For those with heat, Shengma Tang added with Chai Hu (Bupleurum), Huang Qin (Scutellaria), and Chuan Xiong (Ligusticum) can be used; Chai Hu Shi Gao Tang (Bupleurum and Gypsum Decoction) is extremely effective.
Shengma Tang: Treats pediatric seasonal epidemics, headache, fever, limb discomfort and pain, and rashes whether erupted or not, in cases of doubt. It treats cold damage and wind-cold, headache, aversion to cold with high fever, limb pain, dry nose, and insomnia. It also treats irregular cold and warmth, widespread epidemics, sudden changes from warmth to undressing, and sudden shifts from summer heat to yin-cold, causing body pain and heavy head like a stone. Add Chai Hu; if there is no sweat, add Ma Huang (Ephedra).
Ingredients: Sheng Ma (Cimicifugae Rhizoma, 1 qian), Ge Gen (Puerariae Radix, 1 qian), Bai Shao Yao (Paeoniae Radix Alba, 1 qian), Gan Cao (Glycyrrhizae Radix et Rhizoma, roasted, 1 qian).
Preparation: Cut into pieces to make a powder. Take 3 qian per dose, decoct with one cup of water until reduced to 0.6 cups, remove dregs, and take warm. Apply similarly for rashes. Stop medication once the body cools. Adding Zi Su Ye (Perillae Folium), Fu Ling (Poria), and Chuan Xiong forms Sheng Ma Su Ye San (Cimicifuga and Perilla Leaf Powder). Add Huang Qin for heat, Jie Geng (Platycodonis Radix) for sore throat, and Xuan Shen (Scrophulariae Radix) for erysipelas.
Ji Ji Tang: Treats cold damage and warm disease, seasonal cold epidemics, headache, neck stiffness, aversion to cold, limb spasm, bone and joint pain, back and spine stiffness, chest and diaphragm oppression, anhidrosis, aversion to wind, and high fever.
Ingredients: Ge Gen (1 liang), Ma Huang (Epimedii Herba? No, Ephedrae Herba, de-stemmed, 0.5 liang), Shao Yao (Paeoniae Radix, 0.5 liang), Gan Cao (Glycyrrhizae Radix et Rhizoma, 0.5 liang), Gui Zhi (Cinnamomi Ramulus, 2.5 qian; absent in Qian Jin Fang).
Preparation: Cut into pieces. Take 3 qian per dose, decoct with one cup of water and one jujube until reduced to 0.6 cups, remove dregs, and take slightly warm. The goal is sweating. In summer, add Shi Gao (Gypsum Fibrosum) and Sheng Ma, each 1 qian.
Tiao Zhong Tang: Treats late summer and early autumn, where sudden cold strikes amidst intense heat. Heat binding in the limbs causes high fever and headache; cold injuring the stomach causes diarrhea, which may be bloody, red, or white. With high fever, confusion, and rapid pulse, purgation is indicated.
Ingredients: Da Huang (Rhei Radix et Rhizoma, 7.5 qian), Jie Geng (Platycodonis Radix, stir-fried, 0.5 liang), Ben Cao (Ligustici Chuanxiong Rhizoma? Text says "Ben", likely Gaoben/Ligusticum sinense, 0.5 liang), Fu Ling (Poria, 0.5 liang), Gan Cao (Glycyrrhizae Radix et Rhizoma, 0.5 liang), Gan Ge (Puerariae Radix, 0.5 liang), Huang Qin (Scutellariae Radix, 0.5 liang), Shao Yao (Paeoniae Radix, 0.5 liang), Bai Zhu (Atractylodis Macrocephalae Rhizoma, 0.5 liang).
Preparation: Cut into pieces. Decoct in plain water, adjusting dosage based on age/size. Obtain free bowel movement, and high fever will cease. Remove Da Huang, add Huang Lian (Coptidis Rhizoma) and Zhi Ke (Aurantii Fructus), which is excellent for stopping diarrhea. Alternatively, add Di Yu (Sanguisorbae Radix) or Dang Gui (Angelicae Sinensis Radix). Add Jing Jie (Schizonepetae Herba) for wind invasion. Autumn requires purgation, using Da Huang to unblock.
She Gan Tang: Treats heavy rain and cold in early autumn and mid-summer, and sudden cold from heavenly circulation. Heat tends to hide internally, causing cough, shortness of breath, hoarseness, loss of voice, dry cough without sputum, and sensation of obstruction in the throat.
Ingredients: Ban Xia (Pinelliae Rhizoma, soaked in water, 5 qian), Sheng Jiang (Zingiberis Rhizoma Recens, roasted, 4 qian), She Gan (Belamcandae Rhizoma, 2 qian), Xing Ren (Armeniacae Semen Amarum, peeled and stemmed, 2 qian), Gan Cao (Glycyrrhizae Radix et Rhizoma, roasted, 2 qian), Zi Wan (Asteris Radix, 2 qian), Rou Gui (Cinnamomi Cortex, 2 qian), Zhi Shi (Aurantii Fructus Immaturus, stir-fried, 2 qian), Dang Gui (Angelicae Sinensis Radix, 2 qian), Ju Pi (Citri Reticulatae Pericarpium, 2 qian), Du Huo (Angelicae Pubescentis Radix, 2 qian), Ma Huang (Ephedrae Herba, de-stemmed, soaked in water, 2 qian).
Preparation: Cut into pieces. Take 3 qian per dose, decoct with one cup of water until reduced to 0.6 cups, remove dregs, and take warm.
Ban Xia Gui Gan Tang: Treats latent qi disease, defined as sudden non-seasonal cold invading the body and hiding in the Shaoyin channel. Initially asymptomatic, it manifests after ten days to a month with weak pulse, sore throat, resembling cold damage but not Hou Bi (throat bi), followed inevitably by diarrhea. Start with Ban Xia Gui Gan Tang, then use Si Ni San (Four Counterflow Powder). This disease resolves in one or two days; ancient texts call it Kidney Cold Damage.
Ingredients: Ban Xia (Pinelliae Rhizoma, washed, 2 liang), Gui Xin (Cinnamomi Cortex, 2 liang), Gan Cao (Glycyrrhizae Radix et Rhizoma, roasted, 2 liang).
Preparation: Cut into hemp-seed sized pieces. Take 3 qian per dose, decoct with one cup of water until reduced to 0.6 cups, let cool, hold in mouth and swallow slowly. Add three slices of Sheng Jiang.
Wu Ling San: Treats cold damage and warm-hot diseases where exterior and interior are unresolved, presenting with headache, fever, dry mouth and throat, vexation and thirst for drinking, or vomiting immediately after drinking, or difficult urination. Also treats post-sweating resolution of exterior with persistent vexation and thirst, and Huoluan (cholera-like disorder) with vomiting and diarrhea, dry thirst, and desire to drink.
Ingredients: Ze Xie (Alismatis Rhizoma, 2.5 liang), Zhu Ling (Polyporus, 2.5 liang), Bai Zhu (Atractylodis Macrocephalae Rhizoma, 1.5 liang), Fu Ling (Poria, 1.5 liang), Gui (Cinnamomi Ramulus, 1 liang).
Preparation: Grind into fine powder. Take 2 qian per dose, mix with hot water, anytime. Drink plenty of hot water after taking; recovery occurs with sweating. Also treats stasis-heat in the interior causing jaundice; administer with concentrated Yin Chen Hao Tang (Artemisiae Scopariae Herba Decoction) before meals. For jaundice with thirst and heatstroke with desire to drink, water administration is also acceptable. For children, add a little Bai Zhu powder; if deficiency is present, add a little Mian Huang Qi (Astragali Radix) and Ren Shen (Ginseng Radix et Rhizoma) powder. Refer to Question 16's Chen Sha Wu Ling San (Cinnabar Five-Ingredient Powder).
Zhe Yu Tang: Treats wind-warmth, winter-warmth, and wind-stroke or cold damage in spring, presenting with fever, headache, dry throat, stiff tongue, chest and abdominal fullness, and back and spine stiffness.
Ingredients: Ge Gen (Puerariae Radix, 0.5 liang), Zhe Yu (Polygonati Rhizoma, 3 qian), Shi Gao (Gypsum Fibrosum, 1 liang), Bai Wei (Anemarrhenae Rhizoma, 0.5 liang), Qiang Huo (Notopterygii Rhizoma et Radix, 0.5 liang), Ma Huang (Ephedrae Herba, 0.5 liang), Chuan Xiong (Ligustici Chuanxiong Rhizoma, 0.5 liang), Xing Ren (Armeniacae Semen Amarum, peeled and stemmed, 0.5 liang), Gan Cao (Glycyrrhizae Radix et Rhizoma, roasted, 0.5 liang), Mu Xiang (Aucklandiae Radix, 0.5 liang).
Preparation: Cut into pieces. Take 3 qian per dose, decoct with one cup of water until reduced to 0.8 cups, remove dregs, and take warm.
Qi Bao San: Treats seasonal epidemic dizziness and body heat. Adults can take this; children should take it together with their nursing mother.
Ingredients: Zi Su Ye (Perillae Folium, 3 liang), Xiang Fu (Cyperi Rhizoma, stir-fried, 3 liang), Chen Pi (Citri Reticulatae Pericarpium, 1 liang), Gan Cao (Glycyrrhizae Radix et Rhizoma, roasted, 1 liang), Jie Geng (Platycodonis Radix, de-rhizome, 1 liang), Bai Zhi (Angelicae Dahuricae Radix, 1 liang), Chuan Xiong (Ligustici Chuanxiong Rhizoma, 1 liang).
Preparation: Cut into pieces. Take 2 qian per dose, decoct with half a cup of water, one slice of ginger, and one jujube until reduced to 0.3 cups, remove dregs, and take. Add Ge Gen, Sheng Ma, and Jing Jie for heat.
Chai Hu Shi Gao Tang: Treats seasonal warm epidemics, high fever with aversion to wind, headache and body pain, nasal congestion, dry throat, chest and heart vexation and fullness, alternating chills and fever, phlegm-heat cough, and thick sticky nasal discharge and sputum.
Ingredients: Sang Bai Pi (Mori Cortex, 3 liang), Huang Qin (Scutellariae Radix, 3 liang), Sheng Ma (Cimicifugae Rhizoma, 2.5 liang), Shi Gao (Gypsum Fibrosum, 5 liang), Qian Hu (Peucedani Radix, de-rhizome, 5 liang), Chi Shao Yao (Paeoniae Radix Rubra, 5 liang), Gan Ge (Puerariae Radix, 5 liang), Chai Hu (Bupleuri Radix, 5 liang), Jing Jie Sui (Schizonepetae Spica, 3 liang). Add Ma Huang, Ban Xia, and Bei Wu Wei (Schisandrae Chinensis Fructus) if no sweat.
Preparation: Grind into coarse powder. Take 2 qian per dose, decoct with one cup of water, two slices of ginger, and ten grains of Dan Chi (Fermented Soybean), until reduced to 0.7 cups, remove dregs, and take slightly warm. Divide into three doses for children, adjusting for size/age, anytime.