《巢氏病源》小儿往来五脏烦满候∶风邪外客于皮肤，而内痰饮渍于腑脏，致令血气不和，阴阳交争，故寒
热往来。而热乘五脏，气渍不泄，故寒热往来而五脏烦满。
《玉诀》小儿寒热虚积候歌∶
频频发热藏中图，有积因伤未退除；颊赤口疮多躁渴，痰生不食胃还虚。
此患先调气；次取虚积，下涎；后补虚即安也。
《玉诀》又寒热虚积候云∶此候先调气，次解虚热，有热不去，下真珠丸取（方在后。）
《玉诀》真珠丸 治小儿寒热虚积，五脏烦满；及下风涎积滞，惊食疳积。
南星 半夏 滑石（各末二钱） 轻粉（四钱匕） 巴豆（二、七粒，去心、油）
上末之，面糊丸芥子大。每服十五、二十丸。煎葱汤吞下。
《巢氏病源》小儿寒热往来腹痛候∶风邪外客于皮肤，而内痰饮渍于腑脏，血气不和，则阴阳交争，故寒热
往来。而脏虚本挟宿寒，邪入于脏，与寒相搏，而击于脏气，故寒热往来而复痛也。
《千金》治小儿寒热进退，啼呼腹痛。生地黄汤方
生地黄 桂心（各二两）
上 咀，以水三升，煮取一升，期岁以下服二合，以上三合。
《圣惠》治小儿寒热往来，啼呼腹痛。宜服赤芍药散方
赤芍药 当归（锉碎，微炒） 寒水石 甘草（炙微赤，锉） 黄芩（各半两） 桂心（一两）
上件药捣，粗罗为散。每服一钱，以水一小盏，入生地黄半分，煎至五分，去滓。不计时候温服。量儿大
小加减服之。
《圣惠》治小儿胁下有气块，腹痛喘逆，气息难为，往来寒热，羸瘦不食。马通粟丸方
马通内粟 细辛 紫菀（洗去苗土） 杏仁（汤浸去皮尖、双仁，麸炒微黄。各三分） 石膏 五
味子 秦艽（去苗） 白茯苓 半夏（汤洗七遍去滑。各一分）
上件药捣，罗为末，炼蜜和丸如麻子大。每服以粥饮下五丸，日三服。量儿大小以意加减。
《婴孺》治少小寒热进退，啼呼腹痛。六味汤方
地黄 桂心（各八分） 芍药 寒水石 黄芩（炙） 甘草（炙。各二分）
上切细，以水三升，煮一升半。一岁儿二合至三合量与服之。
The *Chao Shi Bing Yuan* (Source of Diseases by Chao) describes the syndrome of alternating cold and heat with five-zang fullness in children: Wind-pathogen externally invades the skin, while internal phlegm-fluids soak into the fu-organs, causing disharmony of blood and qi and contention between yin and yang, thus resulting in alternating cold and heat. When heat pathogen attacks the five zang organs, qi becomes soaked and fails to diffuse, hence presenting with alternating cold and heat accompanied by fullness and distress in the five zang.
The *Yu Jue* (Jade Decree) contains a song regarding the syndrome of alternating cold and heat with deficiency accumulation in children:
Frequent fever indicates accumulation within the viscera, caused by injury where the accumulation has not yet resolved; red cheeks, mouth sores, excessive irritability and thirst, generation of phlegm, anorexia, and stomach deficiency.
Treatment for this condition should first regulate Qi; then resolve deficiency accumulation and descend saliva/phlegm; finally tonify deficiency to achieve stability.
The *Yu Jue* further states regarding the syndrome of alternating cold and heat with deficiency accumulation: This syndrome requires first regulating Qi, then resolving deficiency-heat. If the heat persists, use Zhenzhu Wan (Pearl Pill) to purge it (formula follows).
Zhenzhu Wan (Pearl Pill) from the *Yu Jue*: Treats pediatric alternating cold and heat, deficiency accumulation, and five-zang fullness; as well as descending wind-phlegm stagnation, treating Jing-Shi Gan-Ji (convulsion-food-gan accumulation).
Tian Nan Xing (Arisaema Rhizome), Ban Xia (Pinellia Rhizome), Hua Shi (Talcum), each powdered to two qian; Qing Fen (Calomel), four qian bi; Ba Dou (Croton Seed), two to seven grains, remove heart and oil.
Grind all ingredients into powder, mix with wheat paste to form pills the size of mustard seeds. Administer 15–20 pills per dose, swallowed with decocted scallion water.
The *Chao Shi Bing Yuan* describes the syndrome of alternating cold and heat with abdominal pain in children: Wind-pathogen externally invades the skin, while internal phlegm-fluids soak into the fu-organs, causing disharmony of blood and qi and contention between yin and yang, thus resulting in alternating cold and heat. Since the zang organs are inherently deficient and harbor old cold, when pathogenic factors enter the zang and contend with cold, striking the zang qi, alternating cold and heat occurs accompanied by pain.
The *Qian Jin Fang* (Essential Prescriptions Worth a Thousand Gold) provides Sheng Di Huang Tang (Rehmannia Root Decoction) for pediatric alternating cold and heat, crying, and abdominal pain:
Sheng Di Huang (Rehmanniae Radix), Gui Xin (Cinnamomi Cortex), each two liang.
Cut the herbs, add three sheng of water, boil to obtain one sheng. Infants under one year take two he; those over one year take three he.
The *Tai Ping Sheng Hui Fang* (Holy Prescriptions of Great Peace) provides Chi Shao Yao San (Red Peony Powder) for pediatric alternating cold and heat, crying, and abdominal pain:
Chi Shao Yao (Paeoniae Radix Rubra), Dang Gui (Angelicae Sinensis Radix) [cut and lightly stir-fried], Han Shui Shi (Halloysitum), Gan Cao (Glycyrrhizae Radix et Rhizoma) [roasted until slightly red and cut], Huang Qin (Scutellariae Radix), each half liang; Gui Xin (Cinnamomi Cortex), one liang.
Pound the herbs, sieve coarsely to make a powder. Take one qian per dose, add half a qian of fresh Sheng Di Huang (Rehmanniae Radix) to a small cup of water, boil down to half a cup, strain. Warm and administer regardless of meal time. Adjust dosage according to the child's age and size.
The *Tai Ping Sheng Hui Fang* also provides Ma Tong Su Wan (Horse Dung Millet Pill) for pediatric subcostal mass, abdominal pain, wheezing, difficult breathing, alternating cold and heat, emaciation, and anorexia:
Ma Tong Nei Su (Millet from Horse Dung), Xi Xin (Asari Radix et Rhizoma), Zi Wan (Adenophorae Radix) [washed to remove seedlings and soil], Xing Ren (Armeniacae Semen Amarum) [soaked in hot water, peel and remove tips/double kernels, stir-fried with bran until slightly yellow], each three fen; Shi Gao (Gypsum Fibrosum), Wu Wei Zi (Schisandrae Fructus), Qin Jiao (Gentianae Macrophyllae Radix) [remove seedlings], Bai Fu Ling (Poria), Ban Xia (Pinelliae Rhizoma) [washed seven times in hot water to remove slipperiness], each one fen.
Pound the herbs, sieve into powder, mix with refined honey to form pills the size of hemp seeds. Administer five pills per dose with millet gruel drink, three times daily. Adjust according to the child's age and size.
The *Ying Ru Shu* (Book for Infants and Children) provides Liu Wei Tang (Six-Ingredient Decoction) for infants and young children with alternating cold and heat, crying, and abdominal pain:
Di Huang (Rehmanniae Radix), Gui Xin (Cinnamomi Cortex), each eight fen; Shao Yao (Paeoniae Radix), Han Shui Shi (Halloysitum), Huang Qin (Scutellariae Radix) [roasted], Gan Cao (Glycyrrhizae Radix et Rhizoma) [roasted], each two fen.
Cut finely, add three sheng of water, boil to obtain one and a half sheng. For one-year-old infants, administer two to three he as appropriate.