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*Shanghan Yunyao* (Summary of Cold Damage) states: In pediatric cases of cold damage, aversion to cold, limb stiffness/tension, and fever typically occur together. However, when the pathogen is in the exterior, aversion to cold persists day and night until sweating occurs, at which point it resolves. The manifestation of aversion to cold involves cuddling close to others, curling up the body, pulling clothes tight, nasal congestion, and excessive runny nose; this constitutes an exterior syndrome. It is appropriate to treat with mild diaphoresis using formulas such as Jieji Tang (Muscle-Relieving Decoction), Xiao Shi Qinglong Tang (Xiao's Green Dragon Decoction), or Baidu San (Poison-Detoxifying Powder). If there is aversion to cold accompanied by interior excess, the patient will likely expose their head and face, wave hands and kick feet, throw off clothes, and exhibit coarse breathing; this constitutes an interior syndrome. It is appropriate to treat with purgation and drainage using formulas such as Daxiehu Tang (Major Bupleurum Decoction), Sishun Yin (Four-Compliance Drink), or Xixin San (Washing Heart Powder). If the forehead is cold, hands and feet are cold, breath is cold, complexion is dull and dark, and diarrhea presents with greenish-white stool, this is termed a Yin syndrome. It is appropriate to treat with warming methods using formulas such as Wuji San (Five Accumulations Powder) or Lizhong Tang (Regulate the Middle Decoction); for severe cases, Sini Tang (Frigid Extremities Decoction) is the primary treatment.

Cases complicated by fright arise because the child was frightened while simultaneously contracting cold pathogens, or because high fever from cold damage leads to extreme heat generating wind. This represents heat invading the Heart; since the Heart governs blood vessels and the Shen (Spirit) is easily disturbed, the invasion of heat causes convulsions. One must not administer medications intended for treating fright directly; instead, dispersing and resolving methods are appropriate, using formulas such as Wangshi Bohe San (Wang's Mint Powder) or Renshen Qianghuo San (Ginseng and Notopterygium Powder); for severe cases, Baolong Wan (Embracing Dragon Pill) is the primary treatment.

Cases complicated by food stagnation may result from cold injury followed by food injury, or food injury followed by cold injury, leading to fever, coarse breathing, belching, abdominal heat, abdominal distension, upper body heat with lower body coldness, or sour-smelling stools. These should initially be treated with dispersing methods, followed by digestion-promoting and stagnation-resolving methods; for severe cases, pushing-down purgative methods are used. Initially use Baidu San (Poison-Detoxifying Powder), followed by Huoxiang Zhengqi San (Agarweed Harmonizing Qi Powder) added with Shenqu (Medicated Leaven), Maiya (Sprouted Barley), Tangqiuzi (Crataegus Fruit), Sharen (Amomum Fruit), and Xiangfu (Cyperus Rhizome); if interior excess exists, add Zhishi (Immature Bitter Orange) and Qingpi (Aged Tangerine Peel); if the exterior is not resolved, add Ruanmiao Chaihu (Soft-stemmed Bupleurum), Huangqin (Scutellaria Root), and Huanglian (Coptis Rhizome); if still unresolved, purge with Daxiehu Tang (Major Bupleurum Decoction).

Regarding fever from chancres/rashes, it differs from ordinary cold damage. Signs include red cheeks, irritability, frequent sneezing, yawning, mental restlessness, palpitations, drowsiness, coldness at the tips of the ears and nose, and coldness in both hands and feet. Fever from cold damage transmits from the exterior to the interior, whereas fever from chancres/rashes emerges from the interior to the exterior. Therefore, mild and neutral agents are appropriate. For high fever, detoxification is appropriate, using formulas such as Gegen Tang (Kudzu Decoction) or Shensu Yin (Ginseng and Perilla Drink).

Dr. Tang states: Generally, the treatment method for pediatric cold damage is as follows: for children under one year old with mild heat, Xingxing San (Awakening Spirit Powder) is administered; for those over one year old, immediate exterior resolution with mild sweating is ideal. Heat must subside within one day and night to ensure safety. Many contemporary physicians fail to induce sweating, allowing the pathogen to persist for five to six days, enter the meridians, contend with blood and qi, transform into various syndromes, or generate wind-stroke, gradually progressing to critical conditions and endangering life. How can one not be cautious?