小儿大小便时时审看。小便如米泔或澄停，少顷变作泔浊，此脾胃湿热也，若大便泔白色，或如鱼冻，
或带红，或色黄黑，此积滞湿热也，宜理脾消滞，清中宫，去湿热，节饮食。若忽然变青，此是变蒸也，
不必用药；若久不愈，用补脾制肝药一、二服，亦不宜多用。
愚按小便如泔，或大便泔白，宜用肥儿丸；若积滞黄黑，宜用四君子加黄连、木香；若色青日久不复，
或兼泄泻，或兼腹痛，当用六君子加木香、芍药；若肌体色黄，小便不利，发黄脱落，鼻下疮痍，嗜土，
少食，大便青褐色者，须用栀子茯苓汤。（详见治疳要药下。）
小儿病，大率属脾土、肝木二经。肝只是有余，有余之病似重急，而为治却易，见效亦速；脾只是不
足，不足之病似轻缓，而为治却难，见效亦迟。二经为病，惟脾居多，用药最要分别。若肝木自旺，则为
急惊，目直视或动摇，手足搐搦，风痰上壅等症，此为有余，宜伐木泻肝、降火清心。若脾胃虚而肝木来
侮，亦见惊搐动摇诸症，但其势微缓，名曰慢惊，宜补养脾胃，不可错认，将脾经误作肝经治也。
愚按急惊乃风火之症，脾土受制，肝经实热者，用泻青丸径伐其肝，或导赤散以泻其子；肝经虚热
者，用六味地黄丸以滋肾水，补中益气汤以养脾土∶
则风木自息，脾土自安矣。若因乳食不调，脾胃亏损，木来侮土，似慢惊而见抽搐、摇头、札目、切牙等症，
宜用六君子加钩藤钩。若脾胃亏损，寒水反来侮土，成慢惊而见前症，用前药加姜、桂；如未应，更加附
子，多有复苏者。
举人杜克宏子，发热，抽搐，口噤，痰涌，此肝胆经实火之症，即急惊风也。先用泻青丸一服，又用
六味丸二服，诸症顿退，乃以小柴胡汤加芎、归、山栀、钩藤钩而安，却用补中益气汤而愈。
Carefully examine the urination and defecation of infants and children. If the urine resembles rice washings or becomes turbid after standing for a short while, this indicates damp-heat in the Spleen and Stomach. If the stool is white like rice washings, or resembles fish jelly, or contains blood, or is yellowish-black, this indicates stagnation with damp-heat. The treatment should involve regulating the Spleen, eliminating stagnation, clearing the Middle Jiao (Central Burner), removing damp-heat, and controlling diet. If it suddenly turns green, this is "Bian Zheng" (a physiological phenomenon related to infant growth and development), and no medication is needed; if it persists without improvement, one or two doses of herbs that tonify the Spleen and control the Liver may be used, but excessive use is not advisable.
My commentary: For urine resembling rice washings or stool being white like rice washings, Fei Er Wan (Child-Nourishing Pill) is appropriate. For yellowish-black stools due to stagnation, Si Jun Zi Tang (Four Gentlemen Decoction) added with Huang Lian (Coptidis Rhizoma) and Mu Xiang (Aucklandiae Radix) is suitable. If the color remains green for a long time without recovery, accompanied by diarrhea or abdominal pain, Liu Jun Zi Tang (Six Gentlemen Decoction) added with Mu Xiang and Shao Yao (Paeoniae Radix) should be used. If the body appears jaundiced, urination is difficult, hair falls out, sores appear under the nose, there is pica (craving earth), poor appetite, and the stool is greenish-brown, Zhi Zi Fu Ling Tang (Gardenia and Poria Decoction) must be used. (See details on essential herbs for treating Gan syndrome below.)
Pediatric diseases generally belong to the Spleen Earth and Liver Wood meridians. The Liver typically has excess Qi; diseases of excess appear severe and urgent but are easier to treat and respond quickly. The Spleen typically has deficient Qi; diseases of deficiency appear mild and slow but are difficult to treat and respond slowly. Among diseases of these two meridians, Spleen disorders are more common, making precise differentiation in medication crucial. If Liver Wood flares up spontaneously, it causes Acute Convulsion (Ji Jing Feng), characterized by staring eyes, tremors, limb convulsions, and upward surging of wind-phlegm. This is an excess condition, treated by subduing Wood, purging the Liver, descending fire, and clearing the Heart. If Spleen-Stomach deficiency allows Liver Wood to invade (overact upon) it, similar symptoms of convulsions and tremors occur, but the progression is milder, known as Chronic Convulsion (Man Jing Feng). Treatment should focus on nourishing and tonifying the Spleen-Stomach; one must not mistakenly diagnose a Spleen meridian disorder as a Liver meridian disorder.
My commentary: Acute Convulsion is a Wind-Fire syndrome where Spleen Earth is constrained by Liver Fire Excess. Use Xie Qing Wan (Drain Green Pill) to directly purge the Liver, or Dao Chi San (Direct to the Heart Powder) to drain its son organ (Heart). For Liver Yin Deficiency with Empty Heat, use Liu Wei Di Huang Wan (Six-Ingredient Pill with Rehmannia) to nourish Kidney Water, and Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) to nourish Spleen Earth; thus, Wind Wood will naturally subside, and Spleen Earth will stabilize. If improper breastfeeding or diet damages the Spleen-Stomach, allowing Liver Wood to invade Earth, presenting symptoms similar to Chronic Convulsion such as convulsions, head shaking, blinking, and teeth grinding, use Liu Jun Zi Tang added with Gou Teng Gou (Uncariae Ramulus cum Uncis). If Spleen-Stomach damage leads to Cold Water invading Earth, resulting in Chronic Convulsion with the aforementioned symptoms, add Sheng Jiang (Zingiberis Rhizoma Recens) and Rou Gui (Cinnamomi Cortex) to the previous formula; if ineffective, add Fu Zi (Aconiti Lateralis Radix Preparata), with many cases recovering consciousness.
The son of Scholar Du Kehong presented with fever, convulsions, trismus (lockjaw), and profuse phlegm. This was a syndrome of Excess Fire in the Liver and Gallbladder meridians, specifically Acute Convulsion Wind. Initially, one dose of Xie Qing Wan was administered, followed by two doses of Liu Wei Di Huang Wan, which caused all symptoms to recede immediately. Subsequently, Xiao Chai Hu Tang (Minor Bupleurum Decoction) added with Chuan Xiong (Ligustici Chuanxiong Rhizoma), Dang Gui (Angelicae Sinensis Radix), Shan Zhi (Gardeniae Fructus), and Gou Teng Gou stabilized the condition. Finally, Bu Zhong Yi Qi Tang cured the patient.