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The ten fingers of the infant are all cold, while the forehead is hot to the touch with three fingers; the body has high fever, the face is red but pale, and without movement there will inevitably be convulsions. This is a symptom of Shanghan (Cold Damage).

Method for releasing the exterior: Push Tiantianmen (Open Heavenly Gate), Fen Yinyang (Divide Yin and Yang), push Sanguan (Three Passages); if the constitution is robust, induce heavy sweating; rub Taiyang (Sun Temple) and Wailaogong (Outer Labor Palace); circulate Bagua (Eight Trigrams) by pushing from Gen to Kan. For mild symptoms, massage alone leads to self-healing; for severe symptoms, use Yuanxiao fire moxibustion to stabilize. If the constitution is weak, stop immediately after sweating. The treatment for girls is reversed; administer Xiong Su Yin (Ligusticum and Perilla Decoction).

There are cases where extreme cold mimics heat: the face is red like water-red peach blossoms, there is thirst but the lips are not dry, the tongue is not red or purple, the stool is green, and the urine is clear and copious. This is extreme cold. The "mimicking heat" is due to the redness of the face and the appearance of thirst. Treatment is the same as the previous method.

If there is thirst, constipation, and reddish urine, it indicates internal heat with external cold injury. The primary approach should be to first release the exterior and then clear the interior. For the exterior, use Xiong Su Yin; for the interior, decoct Baifu (Poria), Banxia (Pinellia), Chenpi (Tangerine Peel), Lianqiao (Forsythia), Mutong (Akebia), Zhike (Bitter Orange), and Gancao (Licorice) for administration.

The grandson of Tian San Gongzu in this prefecture was two years old, suffering from a condition of embracing wind-cold with fever. Local physicians, seeing fever accompanied by palpitations and fright, treated it as Jingfeng (Wind-Stroke/Convulsion). After several days without improvement, I diagnosed based on the hot forehead and cold fingers, administering one dose of Xiong Su Yin. I instructed them to stay overnight. Before the mat was cleared, a servant reported that the young master's fever had subsided. This is a verification that fever must be distinguished between exterior and interior.

During the Guichou imperial examinations, the grandson of Xu Gong, Director of the Imperial Guard in Shengjing, was half a year old and suffered from Shanghan. Initially, pediatricians from the Imperial Medical Academy failed to correctly release the exterior. Later, at the court, my fellow townsman Chen Shi'an, Vice Director, mentioned this to me. I went to Guichi Guesthouse to invite myself to treat him. The child's body was cold as ice, lanugo was erect, the complexion was dull and dark, and he was unconscious. Knowing that cold pathogen was hidden internally, I prescribed one dose of Tianbao Caiwei Tang. I instructed: "If fever occurs at night, come tomorrow for treatment; otherwise, nothing can be done." Indeed, fever occurred at night. One more dose of the previous decoction resolved the fever. Mr. Xu said, "Fever and defervescence, same medicine, different effect, truly strange." I said, "Ordinary exterior patterns resolve with one dose. In this case, the pathogen was suppressed internally by erroneous medication. Yesterday's dose drove the pathogen to the muscle layer; when the exterior pattern manifested, the pathogen naturally caused heat. Using the original formula plus one more dose resolved the exterior and removed the heat. There is nothing strange about it." Mr. Xu said, "Chen Shi'an previously praised your father as the best in pediatrics. Truly, the name matches the reality." He offered 100 taels of silver as a gift. I declined, saying, "My family has treated infants for two generations, never accepting any gratitude money." After repeated refusals, he wished to recruit me into the Imperial Medical Academy. I declined again, saying, "My mother is alive; I am in the capital, watching the clouds frequently. I appreciate your kindness." Mr. Xu stopped. This is a sign of "killing thieves at the gate."

Zhang Cunru, Fangbo (Provincial Administrator), had a newborn son who initially contracted Jingfeng. Early local doctors treated it as food stagnation with digestive agents, worsening the condition. I used Banxia (Pinellia) 4 qian, Shengjiang (Fresh Ginger) 1 qian, and Fangfeng (Saposhnikovia) 2 qian. One dose cured it. This is a verification of appropriate medication leading to miraculous effects.

The daughter of Zhang Zhongzun in my county was ill. Local doctors treated her for over ten days without success. When I returned to the county, Zhang Zhongzun heard of my arrival and invited me. As the maid carried the child five or six steps away from the seat, I saw her face was shiny and floating, lacking vital luster. I said, "No need to bring her closer, please return." Zhang Zhongzun asked about the condition. I said, "The Lung Qi is exhausted; it is incurable." The next day, she indeed died. This is a verification of knowing fatal conditions through observing facial color.