Library

It is a baseless fallacy in pediatrics to claim that children under the age of eight do not suffer from Shanghan (Cold Damage). However, infants and older children require different treatments. Infants have tender and fragile bones and sinews, making them unable to withstand pathogenic cold. When the pathogen first enters the Taiyang channel (a syndrome caused by pathogenic invasion of the Foot-Taiyang Bladder meridian), the infant immediately presents with lethargy, high fever throughout the body, and muscle spasms. If physicians fail to differentiate the condition carefully and misdiagnose it as Jingfeng (a syndrome characterized mainly by convulsions), disaster will ensue immediately. At the initial stage, it is inappropriate to use diaphoretic methods to release the exterior, as excessive sweating may lead to the loss of Yang Qi. Instead, one should urgently employ Ji Ji (releasing the muscle layer) methods to allow the exterior pathogens to exit from the outside, thereby avoiding the risk of transforming into Jing disease (a syndrome characterized by stiffness of the neck and back and opisthotonos).

Guizhi Fangfeng Tang (Cinnamon Twig and Saposhnikovia Decoction): Treats Shanghan in infants aged half a year to one year, and even up to three or five years old. The initial symptoms include fever, heavy body, yellowish or pale complexion, rapid breathing, hot breath, frequent yawning, and chest stuffiness. This formula quickly dissipates pathogens in the skin and muscles; it can stop sweating if present, and induce sweating if absent. It is the premier exterior-releasing formula in pediatrics.
Ingredients: Tender Guizhi (Ramulus Cinnamomi), Bei Fangfeng (Radix Saposhnikoviae) (each 1.5 qian); Baishao (Radix Paeoniae Alba) (2 qian); Lao Shengjiang (Rhizoma Zingiberis Recens); Zhi Cao (Radix Glycyrrhizae Preparata) (each 1 qian); Da Hongzao (Fructus Jujubae) (5 pieces).
Preparation: Decoct in water and take warm. If there is phlegm, add Baijiezi (Semen Sinapis Albae) 1 qian. If vomiting occurs, add Chenpi (Pericarpium Citri Reticulatae) and Zhi Banxia (Rhizoma Pinelliae Preparatum) each 1 qian. If heat is severe, add Chaihu (Radix Bupleuri) 1 qian. If the chest feels tight and breathing is rapid, add Zhike (Fructus Aurantii) 1 qian.

Xiao Chaihu Tang (Minor Bupleurum Decoction): Treats interior-heat syndromes manifesting as aversion to heat, tendency to expose the head and face, flailing of hands and feet, foul hot breath, irritability, thirst, and spontaneous sweating.
Ingredients: Chaihu (Radix Bupleuri) (1.5 qian); Renshen (Radix Ginseng) (0.7 qian); Huangqin (Radix Scutellariae); Fa Xia (Rhizoma Pinelliae Preparatum) (each 1 qian); Zhi Cao (Radix Glycyrrhizae Preparata) (0.5 qian).
Modifications: Add Shigao (Gypsum Fibrosum) and Zhimu (Radix Anemarrhenae). If the aforementioned interior-heat symptoms are accompanied by throwing off clothes, coarse breathing, scanty dark urine, and dry constipation, use Xiao Chaihu Tang removing Banxia, adding Zhuang Huang (Radix et Rhizoma Rhei) 1 qian, decocted with Shengjiang and Hongzao. If it is Shanghan complicated by food stagnation, manifesting as high fever, headache, belching, abdominal distension, and sour-smelling diarrhea, use Chaihu 1.5 qian, Zhi Banxia, Chishao (Radix Paeoniae Rubra), Zhuang Huang each 1 qian, Xiao Zhishi (Fructus Aurantii Immaturus) 0.8 qian, Shengjiang 3 slices, and Hongzao 1 piece, decocted together.

For Yin syndromes with interior deficiency, presenting with cold forehead, cold hands and feet, cold breath, dull complexion, and diarrhea, use Lizhong Tang (Regulate the Middle Decoction). (Formula see "Non-Convulsion" section.) If the stool is greenish-yellow, add Chao Huanglian (Rhizoma Coptidis, stir-fried) 1.5 qian and Jiu Shaoyao (Radix Paeoniae Alba, wine-treated) 1 qian within the formula. If cold is severe, add You Rougui (Cortex Cinnamomi Optimus) 1 qian and Fuzi (Radix Aconiti Lateralis Preparata) 0.7 qian, decocted in water and taken warm.

Xingxing San (Stimulating Powder): Treats pediatric cases where true Yuan Qi is insufficient, Qi and Blood are weak, internal injury coexists with external heat, and the patient cannot tolerate exterior-releasing methods.
Ingredients: Renshen (Radix Ginseng); Fuling (Poria); Baishao (Radix Paeoniae Alba, stir-fried); Jiegeng (Radix Platycodi); Huafen (Radix Platycodonis, wine-stir-fried); Chuanxiong (Rhizoma Chuanxiong); Bei Fangfeng (Radix Saposhnikoviae) (each 1 qian); Bei Xixin (Herba Asari) (0.5 qian); Baizhu (Rhizoma Atractylodis Macrocephalae) (1.5 qian); Shengjiang (Rhizoma Zingiberis Recens) (3 slices); Hongzao (Fructus Jujubae) (3 pieces).
Preparation: Decoct in water and take warm.

The treatment principles for pediatric Shanghan are the same as those for adult medicine; for details, refer to the book *Jicheng*.
For coughs caused by wind-cold common cold in the four seasons, use Renshen Baidu San (Ginseng Detoxification Powder). For coughs with difficult expectoration, administer twice daily until the phlegm is cleared.
Renshen Baidu San (Ginseng Detoxification Powder): See formula in "Misdiagnosed Convulsion" section. Also treats initial symptoms of Shanghan such as fever and headache.