薛己曰。仲景云、火入肺则烦。入肾则躁。夫心者。君火也。火旺则金燔水亏。而火独存。故肺肾合而为躁也。活
人云。但烦热者。虚烦也。诸虚烦热。与伤寒相似。但不恶寒。鼻不疼。故知非伤寒也。头不疼。脉不紧。故知非里寒
也。不可发汗攻下。当与竹叶汤。兼呕。橘皮汤。又心虚则先烦而后渴。翕翕发热。其脉浮紧而大是也。盖烦者。心中
烦扰为内热。故属阳。躁者。肢体躁动。或踝身为外热。故属阴。外热者。无根之火也。是以为虚。在小儿当辨其HT
煎不安。是烦。HT 不定。是躁。
HT煎者。心经有热。精神恍惚。烦满生惊。HT 者。心经有风。烦躁惊搐也。热甚者。黄连解毒汤。轻者。导赤
散。风热者。至宝丹。脉数而实。便闭者。神芎丸。此皆实热之治法也。若烦而头痛短气。口干咽燥。不渴者。虚也。
四君加芎归。烦不得眠。酸枣仁汤。面戴阳。目内赤。六脉洪大。按之全无者。血虚发躁。当归补血汤。若躁而踝体。
欲入并中。脉沉细或浮大。按之如无者。此皆阴盛发躁。宜参附汤。有回生之功也。
汉张仲景。创论伤寒。六经分治。阴阳并观。传变不一。贵探其原。表则易治。里岂易痊。三阳为表。里症常兼。
三阴为里。表症亦繁。病机叠出。不一其端。合并两感。欲辨难言。汗吐下法。不误则安。男妇大小。大概皆然。然而
小儿。还须另看。脏腑娇嫩。六气未完。外邪易犯。乳食多愆。一旦病至。身热如煎。头疼骨痛。合眼赤颧。或汗无汗。
发渴咽干。种种形症。病则相牵。谓为伤寒。宁曰否焉。然而幼稚。杂病多般。惊疳痰食。痘疹烦冤。总皆发热。躁扰
相干。设若误认。时日迁延。如大人法。治之必偏。百十三方。立毙下咽。如是死者。良属可怜。如是死者。医罪曷宽。
审音察色。详辨为先。内伤外感。务究其根。脉或罔据。三关细研。毋俾病势。变幻缠绵。再参疫疠。夏热春温。中风
中湿。暑 弥漫。认病毋错。方治求全。庶几是儿。寿保彭 。
Xue Ji stated: Zhang Zhongjing said, when fire enters the Lung, it causes Fan (restlessness); when it enters the Kidney, it causes Zao (agitation). The Heart is the Minister Fire. When fire is excessive, it scorches Metal (Lung) and depletes Water (Kidney), leaving fire to exist alone. Thus, the combination of Lung and Kidney results in Zao. The *Huoren* (Book of Vitality) states: cases with only Fan-heat are termed Xu-Fan (deficiency restlessness). Various Xu-Fan-heat symptoms resemble Shanghan (Cold Damage), but without aversion to cold or nasal pain, one knows it is not Shanghan. Without headache or a tight pulse, one knows it is not Interior Cold. Sweating (Fa-Han) and purging (Gong-Xia) methods should not be used; instead, Zhuye Tang (Bamboo Leaf Decoction) should be given. If accompanied by vomiting, Jupi Tang (Tangerine Peel Decoction) is indicated. Furthermore, Heart Qi deficiency leads to Fan first, followed by thirst, accompanied by slight fever and a pulse that is floating, tight, and large. Generally, Fan refers to mental restlessness due to internal heat, thus belonging to Yang; Zao refers to physical agitation or external heat at the ankles and body, thus belonging to Yin. External heat is "fire without root," hence it is deficiency. In children, one must distinguish between HT Jian (restless spirit) and HT Bu Ding (unstable spirit). HT Jian indicates Heat in the Heart Meridian, causing vague spirit, mental fullness, and fright; HT Bu Ding indicates Wind in the Heart Meridian, causing restlessness, fright, and convulsions. For severe heat, Huanglian Jiedu Tang (Coptis Decoction for Resolving Toxicity) is used; for mild cases, Daochi San (Guide Out Red Powder); for Wind-Heat, Zhibao Dan (Precious Treasure Pill); for rapid and solid pulses with constipation, Shenxiong Wan (Shenxiong Pill). These are all treatments for Excess-Heat. If there is Fan with headache, shortness of breath, dry mouth and throat but no thirst, it is Deficiency; Sijun Zi Tang (Four Gentlemen Decoction) plus Chuanxiong Danggui (Ligusticum and Angelica) is used. For Fan preventing sleep, Suanzaoren Tang (Sour Jujube Seed Decoction) is used. For facial flushing like Daiyang (wearing yang), red inner eyes, and large six-pulse positions that vanish upon deep pressure, it is Zao caused by Blood Deficiency; Danggui Buxue Tang (Angelica Tonifying Blood Decoction) is used. If there is Zao with cold ankles and body, desire to curl up in warmth, and a pulse that is deep and fine or floating and large but vanishes upon pressure, this is Zao caused by Excess-Yin; Shenfu Tang (Ginseng and Aconite Decoction) is appropriate, which has the merit of reviving the dying.
Zhang Zhongjing of the Han Dynasty created the Treatise on Cold Damage, dividing treatment by Six Channels, observing both Yin and Yang. Transmission varies, so it is crucial to explore the origin. Exterior patterns are easy to treat; how can Interior patterns be easily cured? The Three Yang channels belong to the Exterior, where Interior patterns often coexist; the Three Yin channels belong to the Interior, where Exterior patterns are also complex. Pathogenic mechanisms emerge in layers with many aspects. Combined infections or simultaneous exterior-interior involvement are difficult to describe. Sweating, emesis, and purging methods ensure safety if applied correctly. This generally applies to men, women, and all ages. However, for children, a different approach is needed. Their zang-fu organs are delicate, and the Six Qi are not yet complete; they are easily invaded by external pathogens and prone to dietary errors. Once illness strikes, the body heats up as if boiling, with headache and bone pain, red malar bones when eyes are closed. There may be sweating or no sweating, thirst and dry throat. Various symptoms interrelate. Is it Shanghan? Indeed, it might be. Yet children suffer from various miscellaneous diseases: fright, gan syndrome, phlegm-food retention, and distress from smallpox/rashes. All involve fever and agitated disturbance. Misdiagnosis leads to delay. Treating them like adults will inevitably lead to bias. Of the 113 formulas, using them incorrectly will cause death upon ingestion. Such deaths are pitiful. Such deaths, how can the physician's fault be forgiven? Listen to the voice and observe the complexion; detailed differentiation is paramount. Investigate the root of interior injury and exterior contraction. Pulse diagnosis may be unreliable; carefully examine the three finger sections (infantile pulse diagnosis). Do not let the disease condition become变幻 (changeable) and lingering. Also consider epidemics, summer heat, spring warmth, wind-stroke, dampness invasion, and pervasive summer heat. Recognize the disease without error and seek comprehensive treatment. Only then can the child's life be preserved, ensuring longevity like Peng Zu.