小儿之病，其热惟多，夫热有虚有实。实则面赤浓黄，气粗口热，燥渴唇肿，大小便难，掀揭露衣，烦啼暴叫。虚
则面色青白，恍忽神缓，口中清冷，嘘气软弱，泄泻多尿，夜出虚汗。其或乍凉乍温，怫郁惊惕，上盛下泄，水谷不分，
此则冷热不调之症。虚则败毒散加木香当归。然小儿表里俱热，面黄颊赤，唇燥口干，小便赤涩。大便焦黄，先以四顺
清凉饮为之疏利，其热即去。或表未解也，当先用惺惺散，少加麻黄去节以取其汗，或用柴胡散，则表热已除，又当和
解，其热自平。若惊热、风热、积热，可服宽热散下之，保寿散、金粉散、以退余热可也。
败毒散 治伤寒、温疫、风湿，头目昏眩，四肢痛，憎寒壮热，项强目睛疼。寻常风眩、拘倦、风痰，身体项
疼，及寒壅咳嗽，鼻塞声重，寒热，并治之。
柴胡（洗、去芦） 前胡 川芎 枳壳（炒） 羌活 独活 白茯苓 桔梗（炒） 人参（各二两） 甘草（半两）
上为粗末，每服二钱，生姜薄荷煎，加地骨皮、天麻。或锉散，加蝉蜕防风。治惊热，可加芍药、干葛、黄芩。无
汗加麻黄。
四顺清凉饮 见第四十四问。
惺惺散 治小儿风热疮疹，伤寒时气，头痛壮热，目涩多睡，咳嗽喘粗，鼻塞清涕。
天花粉 人参 细辛（去叶） 茯苓（去皮） 白术 甘草（炙） 桔梗（各等分）
上锉散，每服五钱，水一小盏，入薄荷三叶，同煎至四分，温服。如要和气，即入生姜煎服，不拘时。
柴胡散 治小儿伤寒无汗，有表症，壮热头疼，身体痛，口干烦渴，小便赤，大便秘涩，夹惊腮肿。
石膏 黄芩 甘草 赤芍药 葛根（各二钱半） 麻黄（去节） 柴胡（半两）
上锉散，三岁儿每服二钱，水小盏，生姜少许，葱白三寸，豆豉二十粒，煎至五分，去滓温服，不拘时，汗出为效。
热嗽加杏仁去皮尖二钱，五味子三钱。
宽热散 治小儿中恶天吊，手足搐候，服牛黄膏得渐安，只腹肚有热未退，早晨亦可进一服宽热散。兼小儿食
癖积，婴孩惊乳癖，服此药则下恶物，或成块如鼻涕腥臭，觉得肚腰渐消，稍思乳食。
朴硝 甘草（各半两） 大黄（锦纹者，一两） 枳壳（去瓤，一两，以水润之，以巴豆四十九粒去皮同炒，去巴
豆）
上四味为末，以瓷器收之，每服一字或半钱，用薄荷七叶煎汤调下一呷，或入砂糖一块皂子大在内，以薄荷汤调匀，
早晨未乳食前灌下。或儿壮加添药末，儿或弱则减药末，或儿子通身生疮热毒者，可早晨与一服，推出毒瓦斯。
保寿散 治婴孩惊热、潮热、风热、虚热，头额温壮，白日夜间多啼，伤湿鼻流清涕，喉咽时时有清涕，夜多
睡卧不稳，或手足口舌生小热毒疮，或因吃着喜怒乳食，胸膈不快，时复吐 呕乳，忽因人物所惊，日夜间手足心热，
痰壅咳嗽，兼患天吊急惊风候。
白茯苓 人参 川雄黄 牙硝 甘草（炙各二两） 麝香 牛黄 梅花脑子（各少许无亦得）
上八味，细研，入锡合内收之，汤使如后金粉散。
金粉散 治婴孩惊热、风热、虚热、潮热，手足心热，口多涎唾。面色红赤，头额身体温热，日夜 呀，鼻流
清涕，咳嗽，上膈壅热，口鼻喉舌手足浑身头项生毒热疮，夜卧不安，吐 呕逆，乳食不化，胸膈不快，变蒸温壮，或
有惊潮热，并宜服之，常服镇心化涎压惊。风搐候，服牛黄膏得手足搐住，病势稍轻，但有些少余热，亦宜进三、两服。
川雄黄（半两别研） 白芍药 牙硝 脑子 麝香（各少许）
上件研令细，以锡盒收之，每遇此证，一岁儿半钱，二、三岁一钱，并薄荷汤调下，金银薄荷汤尤好，常服可防百
病。
【论不可服冷药证】
足胫冷 腹虚胀 粪色青 面 白 呕乳奶 眼珠青
【论不可服热药证】
足胫热 两腮红 大便秘 小便黄 渴不止 上气急 脉紧急
The diseases of infants and children most frequently involve fever. Fever can be classified into deficiency-type (Xu) and excess-type (Shi). Excess-type fever presents with a ruddy or deep yellow complexion, coarse breathing, heat in the mouth, irritability and thirst, swollen lips, difficulty in urination and defecation, uncovering the body, irritability, crying, and sudden loud shouting. Deficiency-type fever presents with a bluish-white complexion, vague spirit and sluggish reaction, a cold sensation in the mouth, weak and soft breath, diarrhea with frequent urination, and night sweats. If the condition alternates between cold and warm, accompanied by depression, fright, and startle, with excess pathogenic factors above and diarrhea below, where water and grain are not separated, this is a syndrome of disharmony between cold and heat. For deficiency syndromes, Baidu San (Defeat Toxin Powder) added with Muxiang (Aucklandiae Radix) and Danggui (Angelicae Sinensis Radix) can be used. However, if an infant has both exterior and interior heat, presenting with a yellow complexion and red cheeks, dry lips and mouth, reddish and scanty urine, and scorched yellow stool, Sishun Qingliang Yin (Four-Obedience Clearing and Cooling Decoction) should first be used to promote drainage and unblocking, after which the heat will dissipate. If the exterior syndrome has not yet resolved, Xingxing San (Xingxing Powder) should be used first, with a small amount of Mahuang (Ephedrae Herba, de-stemmed) added to induce sweating, or Chaihu San (Bupleurum Powder) can be used. Once the exterior heat is eliminated, harmonizing treatment should follow, and the heat will naturally subside. For fright-heat, wind-heat, or accumulation-heat, Kuanre San (Broaden Heat Powder) can be taken to purge, followed by Baoshou San (Longevity Preservation Powder) and Jinfen San (Gold Dust Powder) to clear residual heat.
Baidu San (Defeat Toxin Powder): Treats headache and dizziness caused by Shanghan (Cold Damage), Wenyi (Plague-like diseases), and Fengshi (Wind-Dampness); pain in the four limbs; aversion to cold with high fever; stiffness of the neck and eye pain. It also treats common wind-dizziness, spasmodic fatigue, wind-phlegm, body and neck pain, as well as cough due to cold obstruction, nasal congestion with heavy voice, and alternating chills and fever.
Ingredients: Chaihu (Bupleuri Radix, washed and de-rhizomed), Qianhu (Peucedani Radix), Chuanxiong (Ligustici Chuanxiong Rhizoma), Zhike (Aurantii Fructus, stir-fried), Qianghuo (Notopterygii Rhizoma et Radix), Duhuo (Angelicae Pubescentis Radix), Baifuling (Poria, white part), Jiegeng (Platycodonis Radix, stir-fried), Renshen (Ginseng Radix et Rhizoma) — each 2 liang; Gancao (Glycyrrhizae Radix et Rhizoma) — 0.5 liang.
Preparation and Administration: Grind into coarse powder. Take 2 qian per dose, decocted with Shengjiang (Zingiberis Rhizoma Recens) and Bohe (Menthae Haplocalycis Herba). Alternatively, add Gudupi (Lycii Cortex) and Tianma (Gastrodiae Rhizoma). Or prepare as a powder, adding Chanui (Cicadae Periostracum) and Fangfeng (Saposhnikoviae Radix). For treating fright-heat, add Shaoyao (Paeoniae Radix), Gange (Puerariae Radix), and Huangqin (Scutellariae Radix). For absence of sweat, add Mahuang (Ephedrae Herba).
Sishun Qingliang Yin (Four-Obedience Clearing and Cooling Decoction): See Question 44.
Xingxing San (Xingxing Powder): Treats infantile wind-heat sores and rashes, Shanghan (Cold Damage) and seasonal qi pathogens, headache with high fever, dry eyes with excessive sleepiness, cough with coarse breathing, nasal congestion with clear discharge.
Ingredients: Tianguafen (Trichosanthis Radix), Renshen (Ginseng Radix et Rhizoma), Xixin (Asari Radix et Rhizoma, de-leafed), Fuling (Poria), Baizhu (Atractylodis Macrocephalae Rhizoma), Gancao (Glycyrrhizae Radix et Rhizoma, honey-fried), Jiegeng (Platycodonis Radix) — all in equal parts.
Preparation and Administration: Cut into pieces and make into a powder. Take 5 qian per dose, with one small cup of water and three leaves of Bohe (Menthae Haplocalycis Herba), decocted until reduced to three-quarters volume, take warm. To harmonize the qi, add Shengjiang (Zingiberis Rhizoma Recens) and decoct; time is not restricted.
Chaihu San (Bupleurum Powder): Treats infantile Shanghan (Cold Damage) with no sweat and exterior syndrome; high fever and headache; body pain; dry mouth with irritability and thirst; reddish urine; constipation with difficult passage; complicated by fright and mumps.
Ingredients: Shigao (Gypsum Fibrosum), Huangqin (Scutellariae Radix), Gancao (Glycyrrhizae Radix et Rhizoma), Chishaoyao (Paeoniae Radix Rubra), Gegen (Puerariae Radix) — each 2.5 qian; Mahuang (Ephedrae Herba, de-stemmed); Chaihu (Bupleuri Radix) — 0.5 liang.
Preparation and Administration: Cut into pieces and make into a powder. For a three-year-old child, take 2 qian per dose, with one small cup of water, a little Shengjiang (Zingiberis Rhizoma Recens), three cun of Congbai (Allii Fistulosi Bulbus), and twenty Douchi (Sojae Semen Praeparatum), decoct until reduced to half volume, remove dregs and take warm; time is not restricted. Effectiveness is indicated by sweating. For hot cough, add Xingren (Armeniacae Semen Amarum, peeled and de-seeded) 2 qian and Wuweizi (Schisandrae Chinensis Fructus) 3 qian.
Kuanre San (Broaden Heat Powder): Treats infantile Zhong'e Tianiao (acute convulsive disorder), twitching of hands and feet. After taking Niuhuang Gao (Calculus Bovis Ointment) for gradual relief, if abdominal heat remains, one dose of Kuanre San can be taken in the morning. It also treats infantile food stagnation and infanticolic fright-milk stagnation. Taking this medicine expels foul matter, sometimes in clumps resembling nasal mucus with a fishy odor, leading to gradual reduction of abdominal and waist distension and increased desire for milk and food.
Ingredients: Puxiao (Natrii Sulfas), Gancao (Glycyrrhizae Radix et Rhizoma) — each 0.5 liang; Dahuang (Rhei Radix et Rhizoma, selected for brocade pattern) — 1 liang; Zhike (Aurantii Fructus, de-albedo) — 1 liang, moistened with water, stir-fried together with forty-nine seeds of Badou (Crotonis Fructus, peeled), then discard Badou.
Preparation and Administration: Grind the four ingredients into powder and store in a porcelain vessel. Take one zi or half a qian per dose, mixed with one sip of decoction made from seven leaves of Bohe (Menthae Haplocalycis Herba). Alternatively, add a piece of rock sugar the size of a soap nut, mix evenly with Bohe decoction, and administer before morning feeding. Increase the powder dosage for strong children; decrease for weak children. If the child has widespread toxic heat sores, administer one dose in the morning to expel toxic vapors.
Baoshou San (Longevity Preservation Powder): Treats infantile fright-heat, tidal heat, wind-heat, and deficiency-heat; warmth and heat on the forehead; excessive crying day and night; clear nasal discharge due to dampness injury; clear discharge in throat and pharynx; restless sleep at night; small toxic heat sores on hands, feet, mouth, and tongue; chest and diaphragm discomfort due to dietary emotions or milk intake; occasional vomiting of milk; sudden fright from external stimuli; heat in palms and soles day and night; phlegm obstruction and cough; complicated by Tianiao acute fright-wind syndrome.
Ingredients: Baifuling (Poria, white part), Renshen (Ginseng Radix et Rhizoma), Chuanxionghuang (Realgar), Yaxiao (Natrii Sulfatis Crystalloides), Gancao (Glycyrrhizae Radix et Rhizoma, honey-fried) — each 2 liang; Shexiang (Moschus), Niuhuang (Calculus Bovis), Meihua Nao (Borneolum Syntheticum) — each a small amount (optional).
Preparation and Administration: Finely grind the eight ingredients and store in a tin box. Use as described in Jinfen San below.
Jinfen San (Gold Dust Powder): Treats infantile fright-heat, wind-heat, deficiency-heat, and tidal heat; heat in palms and soles; excessive salivation; ruddy complexion; warmth and heat on head, forehead, and body; open-mouth breathing day and night; clear nasal discharge; cough; upper jiao heat obstruction; toxic heat sores on mouth, nose, throat, tongue, hands, feet, whole body, head, and neck; restless sleep at night; vomiting and regurgitation; indigestion of milk and food; chest and diaphragm discomfort; febrile disease during developmental periods (Bianzheng); or fright-tidal heat. All are suitable for this formula. Regular use calms the heart, transforms phlegm, and suppresses fright. For wind-convulsion syndrome, after taking Niuhuang Gao (Calculus Bovis Ointment) to stop hand and foot twitching and reduce severity, if slight residual heat remains, two or three doses are appropriate.
Ingredients: Chuanxionghuang (Realgar) — 0.5 liang (separately ground), Baishaoyao (Paeoniae Radix Alba), Yaxiao (Natrii Sulfatis Crystalloides), Naonao (Borneolum Syntheticum), Shexiang (Moschus) — each a small amount.
Preparation and Administration: Grind finely and store in a tin box. For such conditions, administer half a qian for one-year-olds, one qian for two-to-three-year-olds, mixed with Bohe decoction. Yinjin Bohe Tang (Silver and Gold Mint Decoction) is particularly good. Regular use prevents various diseases.
[Discussion on Syndromes Where Cold Medicines Should Not Be Taken]
Cold lower legs and shins, abdominal deficiency bloating, green stool color, pale face, vomiting milk, blue eye whites.
[Discussion on Syndromes Where Hot Medicines Should Not Be Taken]
Hot lower legs and shins, red cheeks, constipation, yellow urine, unquenchable thirst, upward rushing of qi with rapid breathing, urgent and tight pulse.