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The *Classic of Medicine* (Huangdi Neijing) states: All pain, itching, and sores belong to Heart Fire.

Wan Quan elaborates: Heart Fire refers to the Sovereign Fire (Jun Huo). The Sovereign focuses on virtue and does not produce toxicity. Those causing itching, pain, and sores are actually the work of the Minister Fire (Xiang Huo) of the Mingmen (Gate of Life).

All sores in children are caused by fetal toxins (Tai Du). The Mingmen is located in the right kidney. Although it is said that men use it to store essence and women use it to connect to the uterus (Bao), there is originally latent fire within the parents' Mingmen. At the beginning of embryonic formation, the fetus receives this fire. After birth, this fire must erupt, manifesting as carbuncles, erysipelas, rashes, tinea, and all kinds of malignant sores. This is called fetal toxin. The ancients established regulations; at the time of a newborn's birth, there were methods for wiping the mouth and applying Coptis Rhizome (Huanglian), Licorice Root (Gancao), and Cinnabar (Zhusha). These were all established for detoxification. Later generations followed these methods, combining the above three methods with the umbilical cord and other medicines, naming it "Yuying Yanling Jiedu Dan" (Infant Nourishing and Longevity Detoxification Pill). The prescription is fully recorded in the previous section on childhood diseases.

Li Dongyuan's treatment of red thread tumors and Zhu Danxi's treatment of strangury both involved detoxification methods, as seen in *Gezhi Yulun*. Please seek them extensively.

I established a formula using Danxi's Sanbu Wan (Three Tonifying Pills), half raw and half wine-fried; Licorice Root (Gancao), half raw and half honey-fried, each in equal parts, ground into powder. Formed into pills the size of hemp seeds using snow water, coated with one-half part of Realgar (Xionghuang) prepared by water levigation, and taken down with light fermented soybean tea (Dandouchi Tang). It is beneficial to take it within the first two lunar months after birth. In years when epidemic pox occurs, it is especially suitable to take it.

For newborns, the Yuying Yanling Jiedu Dan can be taken to resolve fetal toxins. For those who have already developed sores, the Suyuan Jiedu Tang (Source-Tracing Detoxification Decoction) should be used. If the nursing mother suffers from a dan tumor (Dan Liu), which is the most severe form of fetal toxin, also known as the Red Thread Tumor or Dragon-Wrapping Fire Belt, this is a malignant disease of infants. Children over two years old can be cured, but those under one year old are difficult to treat, with only one or two successes out of a hundred. The affected area is swollen and hard, very red, cannot be touched, feels like burning copper flowing, and spreads downward. If it starts from the head and reaches the heart, death ensues; if it starts from the feet and reaches the kidneys, death ensues. Ancient prescriptions offer no viable treatments. Only the family-tradition Leech Needle Method (Qizhen Fa) and Bian Stone Therapy (Bian Fa) can release the evil qi and drain the fire toxin, curing six or seven out of ten cases. This is indeed a good method. As the Classic says, "For blood disorders, puncture them." One must absolutely avoid applying cold medicines externally, as this will cause the fire toxin to stagnate and fail to vent. If it enters the abdomen, it causes abdominal distension, abdominal pain, asthma, mania, and convulsions, leading to certain death. It is appropriate to use the complete Tongsheng San (Unimpeded Dispersion), finely chopped, soaked in wine, dried, fried, and ground into an extremely fine powder, taken mixed with honey water. Externally, bathe with a decoction of Tongsheng San plus Honeysuckle Vine and Leaves (Jinyinhua Tengye). This is a water-soaking method, also based on the principle of "venting fire stagnation." If convulsions appear before the rash, it is treatable; Tongsheng San is the primary formula. Alternatively, use Daochi San (Guide Out Redness Powder) plus Forsythia Fruit (Lianqiao), Scrophularia Root (Xuanshen), Saposhnikovia Root (Fangfeng), and Schizonepeta Spike (Jingjie Sui), along with Xieqing Wan (Drain Green Pill). If the rash appears before convulsions, it is untreatable.

Tinea and scabies that are dry are treatable; Humaren Pill (Huma Wan) is the primary formula. If they are oozing and ulcerated, with no intact skin left, and the child cries day and night, it is untreatable. Absolutely do not apply medicines containing Arsenic Trioxide (Pishuang), Sulfur (Liuhuang), or Mercury (Shuiyin) powders, as the toxic vapors will enter the abdomen through the deficiency, causing convulsions and asthma, resulting in death.

**Humaren Pill (Huma Wan)**
Sesamum Indicum Seed (Huma Ren, stir-fried), Sophora Flavescens Root (Kushen), Chrysanthemum Morifolium Flower (Ganjuhua), Arctium Lappa Seed (Niumuzi, stir-fried), Acorus Tatarinowii Rhizome (Shichangpu), Polygonum Multiflorum Root (Heshouwu), Clematis Chinensis Root (Weilingxian), Vitex Trifolia Fruit (Manjingzi), Zaocys (Wushaoshe, soaked in wine).
Take down with Bamboo Leaf Decoction (Zhuye Tang). This is one of the thirteen ancestral formulas.

To treat childhood sores and scabies, the nursing mother should be regulated, primarily using Suyuan Jiedu Tang.
Ginseng Radix (Renshen), Angelica Sinensis Root (Guishen), Paeonia Rubra Root (Chishaoyao), Ligusticum Chuanxiong Rhizome (Chuanxiong), Coptis Rhizome (Huanglian, wine-fried), Forsythia Fruit (Lianqiao), Akebia Caulis (Mutong), Rehmannia Glutinosa Root (Shengdihuang), Citrus Reticulata Pericarp (Chenpi), Licorice Root (Gancao). Decoct in water and take. Feed a small amount to the infant, which is best. Another version includes Bamboo Sap (Zhuli).

When a newborn has widespread dry, itchy insect scabies and likes to be rubbed and patted, I formulated a prescription: Zaocys (Wushaoshe) soaked in wine, baked dry, meat taken (1 qian); Sophora Flavescens Root (Kushen) soaked in wine (2 qian); Sesamum Indicum Seed (Huma Ren, stir-fried) and Tribulus Terrestris Fruit (Bajili, stir-fried and thorns removed) each (1.5 qian). Grind all into powder. Use the wine from soaking the snake and Sophora to make a paste for pills. Take down with Licorice Decoction (Gancao Tang) for cure.

A five-year-old boy develops pustular sores all over his body every spring. This is fetal toxin. I advised against using topical applications, fearing the toxicity of arsenic and sulfur powders entering the abdomen through deficiency. He was cured by taking Humaren Pill. Acupoints Fengchi (GB20), Xuehai (SP10), Quchi (LI11), and Zusanli (ST36) were moxa-burned, and it never recurred.

If childhood sores enter the abdomen, causing abdominal distension, obstruction of urination and defecation, asthma, or convulsions, first treat with Xionghuang Jiedu Wan (Realgar Detoxification Pill).
Rooster Comb Realgar (Xionghuang, water-levigated, 2 qian), Curcuma Aromatica Rhizome (Zhen Yujin), Rheum Palmatum Root (Zhuang Dahuang) each (2 qian), Croton Seed Frost (Badoushuang, 1 qian). Another version omits Rheum. Grind uniformly. Make pills with water paste, size of mung beans. Take 1-2 pills per dose, down with clear tea. This is one of the thirteen ancestral formulas.

Li Sishou of Huangzhou had a son of five months with widespread wet scabies that suddenly dried up. He summoned Wan Quan for advice. Wan Quan said, "Sores appearing with cessation of fright requires no worry." Several doctors failed to treat it.

Children developing carbuncles and toxins should not be lightly needled, lest tendons and bones be injured. Be cautious.

After one month, a son developed a carbuncle in the oral cavity. An external surgeon, Officer Hu, needled it, severing the bone, and he could not be saved.

If a child has tubercles under the neck or around the ears, this is due to heat. Do not treat it as Scrofula (Luoli). Internal administration of crab claws, external acupuncture, and cauterizing medicines will kill the child. Beware. My family-tradition Xiaojie Shenyin Wan (Eliminating Knots Divine Response Pill) is newly established and truly a divine prescription.
Scutellaria Baicalensis Root (Huangqin, wine-fried), Coptis Rhizome (Huanglian, stir-fried), Gardenia Jasminoides Seed (Shanzhiren), Fritillaria Thunbergii Bulb (Sheng Beimu), Ecklonia Kelp (Hai Kunbu, wine-fried), Sargassum Thallus (Haizao, washed), Platycodon Grandiflorus Root (Jiegeng), Ophiopogon Japonicus Root (Maidong, stir-fried). Equal parts. Make pills with paste, size of Coicis Semen (Eshi). Take one pill per dose, down with wine.

Zhu Zhensan's third son from Qishui had a kernel the size of a plum growing above the larynx. He asked me for treatment. I stated that *Bing Yuan Shi* says: Tubercles are heat. Consulting the classics regarding laryngeal medicines, I established a formula for him. He bought the medicine, processed it, ground it into powder, and took it with warm water. It was effective. Those suffering from this condition who take it will find it invariably effective. Thus, it was named Shenyin Dan (Divine Response Pill).

Shi Biquan from Tuanfeng, retired at home, had only one young master who developed a tubercle on the neck. Confused by doctors treating it as Scrofula, corrosive medicines were used, making it swell larger. This is the pathway of the Ren Mai (Conception Vessel). The primordial qi was damaged, leading to a Gan syndrome (Childhood Malnutrition Syndrome). Doctors did not recognize the syndrome. By the time I was invited, the situation was hopeless.

Wang Siquan's four-year-old daughter had a tubercle behind her ear. She asked me. I said, "It is not Scrofula, but a Phlegm Nodule (Tan He)." No treatment is needed; it will not cause harm. Confused by other doctors and treated as Scrofula, excessive doses of blister beetle (Banmao) internal-resolving medicines damaged the spleen and stomach, leading to death from Gan-Lao (Malnutrition Consumption). How sorrowful. Machdao (Marine Swelling) often occurs around the ears, swelling, hardening, reddening, and hurting. Commonly called Mumps. Apply Sandu San (Disperse Toxicity Powder) externally. It is miraculous.
The main prescription uses raw Mung Bean (Lv Dou), ground into fine powder, mixed with strong vinegar into a paste, applied and replaced. Miraculous effect.
Another prescription for tubercles uses Chinese Gall (Wubeizi) ground into fine powder, taken mixed with vinegar. All effective. These are all family-tradition prescriptions.

For肥疮 (Fei Chuang - Greasy Sores/Pediculosis Capitis) with pus and blood accumulating and not healing for a long time, use soot from the stove on cooked leather and Rosin (Songxiang), ground together, mixed with sesame oil for application. If worms persist, process Mercury (Shuiyin) and Lead (Qian) in a bell, rub with finger saliva, and apply. All worms will die.

For soft boils not healing, simply grind Zijin Dan (Purple Gold Pill) with water and apply. When pus dries up, it heals itself. Alternatively, apply Sophora Flavescens Root (Kushen) powder.

For sores that are red and ulcerated around the ears, under the nose, or between the eyebrows, use Calamine (Luganshi) and Cuttlebone (Haipiaoxiao) ground into powder, mixed with one-third Mercuric Chloride (Qingfen), and applied evenly.

For sores on the dorsum of the foot, with intermittent itching and pain, not healing for a long time, commonly called Cow Neck Tinea, apply oil rendered from Chicken Egg Yolk (Jizihuang).

Sores on the tongue indicate Heat in the Heart and Spleen meridians. Apply Bailian San (Phellodendron and Coptis Powder).
Raw Phellodendron Amurense Bark (Huangbai), Raw Coptis Rhizome (Huanglian), Raw Rehmannia Glutinosa Root (Sheng Dihuang) in equal parts; Areca Seed (Binglang), halved. Grind into fine powder and apply.

For sores all over the mouth and tongue preventing breastfeeding and eating, take Xixin San (Cleanse Heart Powder).
Rhubarb Root (Dahuang), Ephedra Stem (Mahuang), Atractylodes Macrocephala Rhizome (Baizhu), Angelica Sinensis Root (Danggui), Peony Root (Shaoyao), Schizonepeta Spike (Jingjie Sui), Licorice Root (Gancao), Mint Leaf (Bohaye) in equal parts. Chop, decoct in water, and take. Also apply Bailian San.

For white snow-like sores all over the mouth, also known as Thrush (E Kou Chuang). My late father used Cinnabar (Zhusha) and Alum (Baifan) ground into powder and applied to the mouth and tongue with effect. Also, feed a rooster glutinous rice stuffed in its mouth until consumed, then use the water from washing the rooster to clean the area.

A child suffered from mouth and tongue sores. Medicines prescribed by doctors, both internal and external, such as Scutellaria, Coptis, Anemarrhena, and Phellodendron, were ineffective. I said, "This is caused by Heart Heat. Bitter flavors enter the Heart but aggravate heat, hence ineffective." I gave him Xixin San. One dose brought peace.

My nephew, son of Li Zhongan, had sores all over his mouth, throat, lips, and tongue. He requested medicine. I formulated a prescription: Bailian (1 qian), Cinnabar and Alum (0.5 qian each), Porcellio (Shufu, baked dry, 0.3 qian). Grind finely and apply. Immediate effect. Truly a miraculous prescription.

For children with double tongue or double gums, use a triangular needle to prick and release blood. Internally take Dongyuan's Liangge San (Cooling Diaphragm Powder). For all oral diseases, acupuncture is the fastest.

Protruding tongue indicates Heart Heat; Daochi San is used. Playing tongue indicates Spleen Heat; Xiehuang San is the primary formula.

Qian Yi said: The Heart governs fright and houses the spirit. Children have weak Heart Qi. Hearing loud noises or seeing strange objects or people inevitably disturbs their spirit. This is called Ke Wu (Guest Intolerance).

After fright, the qi does not dissipate, stagnates to generate phlegm, phlegm generates heat, and heat generates wind. Convulsions occurring in this manner are what Qian Yi referred to as "qi reversing causing convulsions and frightening." This is why the term "Jing Feng" (Fright Wind) is distinct.

For convulsions caused by fright, this is Hyperactive Heart Fire overcoming Liver Wood. First stop the convulsions. Take Daochi San as a decoction to swallow Hejian's Danggui Longhui Wan (Angelica and Gelsemium Pill) to calm the spirit, or primarily use Qian's Anshen Wan (Calming Spirit Pill). If there is phlegm-saliva obstruction, first reduce the phlegm using Chen Sha Gao (Cinnabar Paste), then stop convulsions, then calm the spirit.
Chen Sha Gao reduces phlegm excellently.
Cinnabar (Water-levigated, 3 qian), Borax (Pengsha), Marine Salt Crystal (Mayaxiao) each (1.5 qian), Mirabilite (Xuanmingfen, 2 qian), Scolopendra (Quanchi, detoxified), Pearl (Zhenzhu) each (1 qian), Musk (Shexiang).
For fetal fright, take down with milk and jujube date decoction.

My late father's Zhisheng Baoming Dan (Supreme Holy Life-Preserving Pill) for treating fright wind is found in the Liver section. Here, add Cicada Slough (Chantui, 1 qian) and Quinine Seed (Shijunzi, 1.5 qian).

The son of Wu Qingxi, Magistrate of Yingshan County, suffered from fright wind. Various doctors treated it as wind without effect. Urgent messengers were sent to summon me. Upon seeing the Magistrate, I said, "This is not wind, but caused by fright. Wind is treated from the Liver; fright is treated from the Heart. Without recognizing the etiology, how can there be effectiveness?" I used Zhisheng Baoming Dan. Convulsions stopped. The next day, officials and scholars came to inquire. The Magistrate said, "The reputation is well-deserved. Indeed a good doctor. He has his own ideas upon first sight, unlike others who struggle. Keep him for several days and treat him generously before returning."

The Heart belongs to Fire and dislikes heat. Heart heat causes irritability and frequent night crying. Daochi San is the primary formula. Even if crying day and night, it is suitable to take it.

The young master of Zhang Dingshi, Magistrate of this county, was four months old and had no breast milk. A robust woman was hired to nurse him. One night he cried loudly and incessantly. Doctor Gan Dayong was consulted. Initially diagnosed as abdominal pain, Lizhong Tang was ineffective. Then diagnosed as food stagnation, Yihuang San was ineffective. Night crying intensified. I was urgently summoned. Gan Dayong explained the situation, implying I should agree with him. The Heart dislikes heat; the medicine contained Dried Ginger (Ganjiang) and Clove (Dingxiang). How could this not assist fire and worsen the illness? I examined the young master. The Magistrate said, "Night crying for four days." I said, "There are four types of night crying; Heart vexation is one." The Magistrate asked, "Food stagnation? Abdominal pain?" I said, "Abdominal pain presents with a bluish face; food stagnation presents with a pale face. Now the face is very red, confirming Heart vexation." Gan Dayong withdrew. I administered Daochi San plus Ophiopogon Root ( Maidong) and Imperata Rhizome root tip (Dengxincao). One dose. Next morning, I visited. Gan Dayong came out saying, "He cried until dawn." I sighed; he rejoiced that his medicine didn't match the disease, unaware the illness had retreated. I entered and asked. The Magistrate said, "He cried severely last night." I told him, "The young master is well. His high body was unwell, fasting for four days and nights. Last night the illness retreated, craving milk. The nurse was outside, so the crying last night was illness-crying. Last night's crying was hunger-crying." The Magistrate joyfully said, "Strange! Since the nurse arrived, he hasn't cried again." The illness indeed retreated.

Heart heat may present with a preference for lying face down or supine. Daochi San and Sanhuang Xiexin Wan (Three Yellows Draining Heart Pill) are indicated.

Children are stubborn. They cannot lose people they usually love or toys they play with. Losing them causes mental distress; distress damages the Spleen, leading to lethargy and loss of appetite. Not getting what they want causes anger; anger damages the Liver, leading to incessant crying. This violates the Heart, called Guest Intolerance becoming illness. People and objects not usually loved or seen should not be shown to them. Seeing them causes fright; fright damages the Heart. Unseen people should not be allowed near. Forced proximity causes fear; fear damages the Kidney, leading to epilepsy in children. All these are Guest Intolerance illnesses. Today's parents use figures of authority to stop children, like elders stopping night crying. Doctors, because children refuse medicine, use needles and moxibustion to force them, causing illness.

Hu Xixu Bo, official attendant of the Chu Mansion and eldest son of Sanxi Weng, was sickly in childhood and entrusted to my care. On the seventh day of the seventh lunar month in the Dingyou year, at one year old, Sanxi Weng invited me to a Qixi gathering. After sunset, he cried incessantly. I examined him and found no illness. Returning to the seat, he cried severely during the first watch. The mother urged another examination. Indeed, no illness. I asked, "Why cry at dusk?" He cried through the first watch. I considered external signs showed no pathology, but saw the child looking left and right at the person on duty, as if having lost something, unable to speak, only crying. This is stubborn crying. I urgently questioned. The person on duty said, "The toy the child played with today was a jade seal, now put away." I ordered it retrieved and given to him. The child smiled and crying stopped. Sanxi Weng said, "Like protecting an infant, seeking with sincere heart. Excellent." We added wine and returned drunk with joy.