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Diseases in infants and children are mostly caused by heat. Heat syndromes can be deficient or excess. Excess heat manifests as a red face, red eyes, coarse breathing, dry mouth with thirst, dark and scanty urine with dysuria, hard and constipated stool, five-palm heat (heat sensation in the palms, soles, and chest), restlessness and crying day and night, and high fever. The main treatment should be Da Lianqiao Yin (Great Forsythia Decoction). Deficient heat manifests as a pale face, bluish discoloration around the eyes, weak breath, a cold sensation in the mouth, mental confusion with slow responses, loose stools with frequent urination, night sweats accompanied by low-grade fever. The main treatment should be Xingxing San (Xingxing Powder).

If there are alternating chills and fever, accompanied by irritability, depression, fright, and palpitations, with excess in the upper body and deficiency in the lower body, this is a syndrome of imbalance between cold and heat. If the heat is in the exterior, sweating method should be used; if in the interior, purgative method should be used; if both exterior and interior are hot, dispersing method should be used. If the pathogenic factors in the exterior and interior have been resolved, but heat recurs intermittently, this indicates deficiency in both exterior and interior, Qi failing to return to its origin, and Yang floating outward. Cold-natured medicines should not be administered again; instead, Yang must be consolidated within, allowing the body temperature to normalize naturally. The main treatment should be Shen Ling Bai Zhu San (Ginseng, Poria, and Atractylodes Macrocephala Powder).

There is also tidal fever, where fever occurs at specific times; fright-heat, characterized by manic screaming and mental confusion; night-heat, which starts in the evening and stops in the morning; residual heat and unexhausted cold pathogens; food-heat, where abdominal heat appears first; guan-heat, characterized by bone-steaming tidal fever and night sweats; severe heat, which persists continuously without stopping; vexillating heat, marked by mental restlessness and irritability; accumulated heat, presenting with red cheeks and oral ulcers; wind-heat, presenting with fever after sweating; deficient heat, causing fatigue and weakness; guest-heat, coming and going unpredictably; pi-heat, involving phlegm-saliva cough and drinking water; cold-heat resembling malaria; blood-heat, with fever during the Si and Wu hours (9 AM–1 PM); and rash-heat, with cold ears and nose tips. These sixteen types of heat share similarities but have minor differences. Each syndrome has its specific attribution. Occasionally, two or three syndromes may interact. Treatment should be adjusted according to the severity. Generally, infants possess pure Yang constitution, and their Zang-Fu organs easily generate heat. Changes in Yin and Yang Qi steam outward, causing body heat.

If Liver heat exists, the eyes become red and painful, with tearing and photophobia, or formation of corneal opacities. If Heart heat exists, oral ulcers form, urine becomes dark and swollen, with dribbling and obstruction. If Lung heat exists, epistaxis persists, and large bowel constipation occurs. If Spleen heat exists, excessive saliva and froth flow from the mouth. If Heart and Spleen heat exist, double tongue or wooden tongue develops. If Stomach heat exists, halitosis occurs. If Kidney heat exists, deafness ensues, or pus discharges. These are heats generated by the Five Zang organs, each distinct, and cannot be generalized. Generally, extreme heat generates Wind, and excessive Wind causes palpitations.

Regarding evil heat in the Heart Meridian of infants: The Heart and Small Intestine are interior-exteriorly related and govern fluid reception. They should generally remain patent. Stagnation leads to blockage; smoothness leads to free flow; heat leads to astringency; excess leads to strangury. Calming Heart Fire ensures the smooth flow of the Triple Burner, resolving issues before disease onset rather than treating after symptoms appear. Using the Fifteen-Ingredient Modified Decoction, when one initially feels accumulated heat, guest heat, cold pathogens, or wind pathogens invading the Lung Meridian, the Heart will be affected. If not transmitted solely to the Heart, it transmits to the Small Intestine. This may cause blockage or astringency, red or white urine, dribbling obstruction, and stagnation of Ying and Wei Qi, leading to various diseases such as diaphragmatic heat, red and swollen eyes, white sores on lips and mouth, lack of body fluids, and thick sputum and nasal discharge. Proper handling of both exterior and interior can dissipate fright-wind and eliminate phlegm-heat. The efficacy of Chaiqiao (Forsythiae Fructus) is indeed great.

Da Lianqiao Yin (Great Forsythia Decoction): Chaiqiao (Forsythiae Fructus), Qumai Sui (Herba Siegesbeckiae Spica), Huashi (Talcum), Cheqianzi (Semen Plantaginis), Niubangzi (Fructus Arctii), Chi Shaoyao (Radix Paeoniae Rubra) (each 8 fen); Shanzhizi (Fructus Gardeniae), Mutong (Caulis Akebiae), Danggui (Radix Angelicae Sinensis), Fangfeng (Radix Saposhnikoviae) (each 4 fen); Huangqin (Radix Scutellariae) (1.2 qian); Chaihu (Radix Bupleuri), Gancao (Radix Glycyrrhizae) (each 1.2 qian); Jingjie Sui (Herba Schizonepetae Spica) (5 fen); Chantui (Periostracum Cicadae) (5 fen). Decoct these ingredients as one dose with ten leaves of Zhuye (Bamboo Leaf) and ten roots of Dengcao (Juncus Effusus Root). For wind-phlegm or heat from bianzheng (growth fever), add Maimendong (Radix Ophiopogonis). For excess heat or dan-re (erysipelas heat), add Dahuang (Radix et Rhizoma Rhei). For fetal heat or residual toxicity of rashes, add Boheye (Folium Menthae). For carbuncle-toxic heat, add Dahuang (Radix et Rhizoma Rhei) and Mangxiao (Natrii Sulfas).

Regarding accumulated heat-toxin in infants: Swelling and ulceration of lips and mouth, bleeding from gum gaps, bad breath, hot cheeks, sore throat, restlessness, unresolved residual toxicity of smallpox/rashes, or multiple boils on head, face, and body. The main treatment is Wufu Huadu Dan (Five Blessings Detoxifying Pill).

Wufu Huadu Dan (Five Blessings Detoxifying Pill): Xijiao (Cornu Bubali) (sliced, 3 qian), Jiegeng (Radix Platycodonis) (1 liang), Sheng Dihuang (Radix Rehmanniae Preparata, soaked in rice water), Chi Fuling (Poria cum Radix Pini, peeled), Shiunazi (Fructus Arctii, lightly fried) (each 5 qian), Fugan (Radix Glycyrrhizae Preparata), Piaoxiao (Natrii Sulfas) (each 3 qian), Lianqiao (Forsythiae Fructus), Xuanshen (Radix Scrophulariae) (each 6 qian), Qingdai (Indigo Naturalis) (2 qian). Grind into fine powder, mix with refined honey to make pills the size of longan seeds. Take one pill per dose, dissolved in Bohe Tang (Mint Decoction). If accompanied by fright, coat with Zhusha (Cinnabar).

Regarding the syndrome of bianzheng (growth fever) in infants: This refers to the physiological process of skin growth and bone development, involving changes in spirit and consciousness. Medication is not required. However, if complicated by wind-cold with cough, phlegm-saliva, nasal congestion, heavy voice, or fever from bianzheng, this formula is indicated.

Xingxing San (Xingxing Powder): Ren Shen (Radix Ginseng), Baizhu (Rhizoma Atractylodis Macrocephalae, remove rhizome), Baifuling (Poria, peel off), Gancao (Radix Glycyrrhizae, honey-fried), Jiegeng (Radix Platycodonis), Baishao (Radix Paeoniae Alba, stir-fried), Tianhuafen (Radix Trichosanthis), Xixin (Herba Asari), Boheye (Folium Menthae). Decoct these ingredients. Take 3 qian per dose, decoct in water, and take warm.