小儿有病多发热，表里虚实宜分别，观形察色辨因由，审证切脉有妙诀，表证须汗里下之，虚则宜补
实则泻，平昔体认要精详，方得临时无遗阙。
【注】小儿发热有表、里、虚、实之异，治亦有汗、下、补、泻之殊。须观形、察色、
审证、切脉以别之。惟在平昔讲习精详，临证庶不致误。
表热之证因外感，脉浮发热恶风寒，头痛身疼而无汗，十神通圣表为先。
【注】小儿外感寒邪，脉浮，发热，恶风，恶寒，头疼，身痛，无汗，此表热也，宜十
神汤主之。若兼内热者，双解通圣汤两解之。
十神汤
升麻 葛根 麻黄 苏叶 香附（醋炒） 陈皮 赤芍药 川芎 香白芷 甘草（生）
引用生姜，水煎服。
【方歌】十神汤治表热证，升麻干葛共麻黄，香附陈皮苏叶芍，芎芷甘草引生姜。
双解通圣汤
里热之证因内热，遍身蒸热小便红，面赤唇焦舌燥渴，调胃白虎解毒清。
【注】小儿肥甘过度，必生内热，以致发热蒸蒸，小便赤涩，面赤唇焦，舌燥而渴。脉
实有力者，先以调胃承气汤下之；不愈用白虎汤，或黄连解毒汤清之。
调胃承气汤
大黄 芒硝 甘草
引用生姜，水煎服。
【方歌】调胃承气治里热，大黄甘草共芒硝，引用生姜水煎服，大便通利热自消。
白虎汤
石膏〔 （按:
石膏生用为宜）〕 知母（生） 甘草（生） 粳米
水煎服。
【方歌】胃热白虎汤，知母生用良，石膏合甘草，粳米共煎尝。
黄连解毒汤
黄芩 黄连 栀子 黄柏
水煎服。
【方歌】黄连解毒汤，清热效非常，芩连栀子柏，煎服保安康。
Pediatric diseases often present with fever; one must distinguish whether the pathology is in the exterior or interior, and whether it is deficiency or excess. By observing the physical form and inspecting the complexion, one identifies the etiology; by carefully assessing the syndrome pattern and palpating the pulse, one grasps the subtle principles of diagnosis and treatment. For exterior syndromes, diaphoresis (sweating method) should be employed; for interior syndromes, purgation (draining method) should be used. Deficiency patterns require tonification, while excess patterns require purgation. One must cultivate precise understanding through daily study to ensure no omissions or errors during clinical practice.
[Note] Pediatric fever varies by location (exterior/interior) and nature (deficiency/excess), necessitating distinct treatments such as diaphoresis, purgation, tonification, or purging. Differentiation relies on observing the form, inspecting the complexion, assessing the syndrome, and palpating the pulse. Only through meticulous study in peacetime can one avoid mistakes at the bedside.
Exterior heat syndromes arise from external pathogenic invasion, characterized by a floating pulse, fever, aversion to wind and cold, headache, body ache, and absence of sweating. Treatment prioritizes Jiu Shen Tang (Nine Spirit Decoction) to release the exterior.
[Note] When children contract cold pathogens externally, presenting with a floating pulse, fever, aversion to wind/cold, headache, body pain, and anhidrosis, this constitutes an exterior heat syndrome, best treated primarily with Shishen Tang (Ten Spirit Decoction). If accompanied by internal heat, Shuangjie Tongsheng Tang (Double-Resolving Universal Sage Decoction) should be used to resolve both exterior and interior simultaneously.
Shishen Tang (Ten Spirit Decoction)
Shengma (Cimicifugae Rhizoma), Gegen (Puerariae Lobatae Radix), Mahuang (Ephedrae Herba), Zi Su Ye (Perillae Folium), Xiangfu (Cyperi Rhizoma, vinegar-fried), Chenpi (Citri Reticulatae Pericarpium), Chi Shaoyao (Paeoniae Radix Rubra), Chuanxiong (Ligustici Chuanxiong Rhizoma), Xiang Baizhi (Angelicae Dahuricae Radix), Gancao (Glycyrrhizae Radix et Rhizoma, raw).
Use fresh ginger as a guide herb, decoct in water and take orally.
[Prescription Verse] Shishen Tang treats exterior heat syndrome, combining Shengma, Gegen, and Mahuang; Xiangfu, Chenpi, Zi Su Ye, and Shaoyao; along with Chuanxiong, Baizhi, Gancao, guided by fresh ginger.
Shuangjie Tongsheng Tang (Double-Resolving Universal Sage Decoction)
Interior heat syndromes stem from internal heat, manifesting as generalized steaming fever, red urine, flushed face, cracked lips, dry tongue, and thirst. Treatment may involve Tiaowei Chengqi Tang (Regulate the Stomach and Purge the Intestines Decoction), Baihu Tang (White Tiger Decoction), or Huanglian Jiedu Tang (Coptis Detoxification Decoction) to clear heat.
[Note] Excessive consumption of rich and sweet foods in children inevitably generates internal heat, leading to steaming fever, dark and scanty urination, facial flushing, lip cracking, dry tongue, and thirst. If the pulse is forceful and excess, first administer Tiaowei Chengqi Tang to purge; if ineffective, use Baihu Tang or Huanglian Jiedu Tang to clear heat.
Tiaowei Chengqi Tang (Regulate the Stomach and Purge the Intestines Decoction)
Dahuang (Rhei Radix et Rhizoma), Mangxiao (Natrii Sulfas), Gancao (Glycyrrhizae Radix et Rhizoma).
Use fresh ginger as a guide herb, decoct in water and take orally.
[Prescription Verse] Tiaowei Chengqi Tang treats interior heat, combining Dahuang, Gancao, and Mangxiao; guided by fresh ginger in water decoction, once bowel movements are unobstructed, the heat naturally dissipates.
Baihu Tang (White Tiger Decoction)
Shigao (Gypsum Fibrosum) [Note: Raw usage is preferred], Zhimu (Anemarrhenae Rhizoma, raw), Gancao (Glycyrrhizae Radix et Rhizoma, raw), Jingmi (Oryza Sativa Germen).
Decoct in water and take orally.
[Prescription Verse] For stomach heat, Baihu Tang is indicated; raw Zhimu is excellent; combined with Shigao and Gancao, decocted together with Jingmi.
Huanglian Jiedu Tang (Coptis Detoxification Decoction)
Huangqin (Scutellariae Radix), Huanglian (Coptidis Rhizoma), Zhizi (Gardeniae Fructus), Huangbai (Phellodendri Cortex).
Decoct in water and take orally.
[Prescription Verse] Huanglian Jiedu Tang possesses extraordinary heat-clearing efficacy; Huangqin, Huanglian, Zhizi, and Huangbai, when decocted and taken, ensure health and safety.