治小儿肝经火旺，目睛频动，痰气上升，或壮热惊搐，面色红，脉有力，脾胃无伤，宜泻肝火。
川芎（八分） 当归（酒洗） 柴胡 橘红 枳壳（炒） 天麻（各六分） 甘草（四分） 茯苓
白芍药（炒，各八分） 黄连（四分，酒炒） 薄荷（三分）
上每服二钱，姜、水煎服。
愚按前症若肝经风热而自病，宜用本方；若肝经血燥而自病，宜用六味丸；若肝木克脾土，宜用四君
子汤加升麻、柴胡；若肺金克肝木，宜用泻白散；若肾水不能生肝木，宜用六味丸；若愈后惊悸不寐，或
寐中发搐、切牙，宜用归脾汤加茯苓、五味。盖有余者，邪气实也；不足者，真气虚也。凡病有余，当认
为不足，经云邪之所凑，其气必虚。
少参王阳湖孙，八岁，伤股骨，正体科续之。余视其面，青而兼黄，口角微掣动，此乃肝木侮脾症也。
且气血筋骨皆资脾土而生，但壮脾气，则所伤自愈。遂用六君子汤加钩藤钩、当归，三十余剂诸症悉愈。
一小儿，三岁，因惊抽搐，发热，痰盛，久用抱龙丸等药以清风痰，反致面色或赤或青。余谓此心肝
二经血虚风热而生痰，不足之象也。先用六味地黄丸，以滋养肝肾，佐以六君子汤，少加柴胡、升麻，以
调补脾胃，诸症顿退而痊。
治小儿脾经不足，土败木侮，目睛微动，四肢微搐，或潮热往来，脾胃有伤，饮食少进，或泄泻，呕
吐，面色黄，脉无力，宜补脾胃。
白术（一钱三分） 黄 （蜜炙） 川芎 当归（酒洗） 陈皮 人参 肉豆蔻（煨） 神曲
干葛（各五分） 白芍药（一钱，酒炒） 黄连 甘草（炙，各四分） 半夏 白茯苓（各七分）
上姜、水煎服。
愚按前症若因脾胃虚弱，用五味异功散补之，虚寒者加木香，或再加炮姜温之；若因脾气下陷，用补
中益气汤举之，作渴者用七味白术散主之；若因脾胃虚弱，寒水侮土，用六君子加木香、炮姜温之；若因
脾胃虚弱，肝木侮土，用补中益气汤加苓、芍、半夏调之，若因肝木太过，脾土受制，用小柴胡汤加炒山
栀平之；若因伤鱼肉等物，宜六君子汤，更加山楂、砂仁消之；若因伤生冷，腹痛，或泻利清白，宜六君
子汤加砂仁、木香、炮姜温之；若因伤辛热停滞，呕
吐酸水，或大便积利不快，用六君子汤加黄连、吴茱萸、木香和之；若食积去而泄泻不止，用四君子汤加
肉豆蔻、补骨脂、木香、煨姜以补脾肾；若泄泻止而饮食少思，宜用白术散以补脾胃。
一小儿，伤食发热，面赤，或用养胃汤、枳实、黄连、山楂治之，更加腹胀，午后发热，按其腹不
痛。余以为饮食虽化，而脾胃复伤，用六君子汤数剂而痊。
一小儿，伤食发热，呕吐，面赤，服消导、清热之剂，饮食已消，热、赤如故。余曰∶此胃经虚热耳！
用四君子汤加升麻、柴胡各二分，四剂而痊。
一小儿，伤食发热，面赤，抽搐，呕吐，气喘，吐痰。余以为饮食伤脾发热，肺气虚弱所致耳！用六
君子汤再加炒黑黄连、山栀各二分，一剂顿安。（余见各类。）
治小儿心血虚，睡中惊动不安，或受惊吓而作，主清心安神降痰。
人参 半夏（汤泡） 酸枣仁（去壳炒） 茯神（去心，各一钱） 当归（酒洗） 橘红
赤芍药（各七分） 五味子（五粒，杵） 甘草（炙，三分）
上水煎，入姜汁、竹沥少许，入牛黄半分尤妙。若温暖之月，心经多热，加生地黄、山栀仁各五分，
麦门冬七分，淡竹叶。若方饮食，因惊而停滞者，须
先消饮食，然后治惊，惊药内仍加白术、麦芽以理脾胃。盖惊则气散，宜收补其气；惊则痰聚，宜消化其
痰。
愚按前症若心血不足而心神惊悸者，宜用本方；若木火太过而心神不宁者，宜用导赤散；若木火
翕合，风热相搏而病者，用柴胡栀子散；若肝火虚弱，木火未济而病者，用六味丸；若因脾胃食郁生
痰，惊动不安者，宜用四君子汤以健脾，神曲、半夏、麦芽以化痰，山栀、芍药以清热；若因饮食停滞，
肚腹膨胀，或呕吐泄泻，宜用六君子汤以健脾，用浓朴、神曲以消食。如有痰搐惊症，仍用本方调治。
如见肝经之症，加钩藤钩，方内赤芍药易以白芍药。（治验见各症类。）
治小儿食积，郁热发于肌表，潮热往来，主理中清阳明之热。
白术（炒） 山楂 白芍药（炒，各一钱） 黄连（炒） 枳实（麸炒） 川芎 香附米（炒）
升麻（各七分） 干葛（一钱二分） 甘草 炙草（各三分）
上用姜、水煎服。若食积去后，潮热未除，减山楂，枳实、香附、川芎，加人参、黄 、陈皮各五
分，再加白术二、三分。有痰加半夏六分。
愚按前症若食积去而热不退，用五味异功散以补胃气；若作呕，少食，用四君子加藿香、半夏以安中
气，若泄泻，不食，宜用六君子汤加升麻、柴胡以升
补脾气；若久泻不已，宜用补中益气汤以升补阳气；若虚寒，加炮姜、木香，如不应，佐以四神丸以补脾
肾；若体瘦，潮热，口渴，大便不调，宜用肥儿丸以消疳积。若不分脾气虚实、有无食积，概用克伐消导、
寒凉清热之剂，复伤脾胃生气，反为难治之症。
儒者薛衡甫子，年七岁，身羸，发热，面黄，皆以为内伤瘀血，欲下之。余谓乃脾脏受伤，投以六君
子汤加煨姜，两服，饮食顿进，数服，诸症全愈。
一小儿，饮食停滞，服消导之剂。余曰∶此脾胃气虚，故饮食不能克化也。法当调补为善，若数用克
伐之剂，脾气益伤，饮食愈停矣。已而腹内又结一块，寒热，潮热，食少，作渴，大便不实。余用四君子
汤，饮食渐增，又用补中益气汤而愈。
一小儿，肚腹膨胀，饮食即泻，手足逆冷。余以为脾气虚寒，先用人参理中丸，后用六君子汤而愈。
一小儿，常患停滞，数服克伐消导之剂，以致脾胃虚甚，患吐泻慢脾风而卒。（余见各症类。）
治小儿发热感冒，鼻流清涕，或咳嗽吐痰。轻者且勿药，候一、二日多自愈，重者用轻和之剂。
橘红 半夏（炮） 桔梗 川芎（各五分） 白茯苓 桑皮（蜜炙，各七分） 甘草（炙）
防风（各四分） 薄荷 枯黄芩（炒，各三分） 白术（一钱）
上每服二钱，姜、水煎服。
愚按前症若腠理不密，外邪所感，郁于肺而为患者，宜用本方；若脾胃气虚，不能生肺金而致患者，
用补中益气汤；若脾胃气实，肺气壅滞而大肠不利者，用泻黄散；若心火上炎，消烁肺金而致咳嗽者，
用六味丸。大凡元气素弱，或患病日久，宜用补中益气汤为主，加以半夏、茯苓、桔梗；若见发搐、切牙
等症，皆虚热所迫，亦宜用之；若痰盛，少佐以抱龙丸。若风邪既退，而热痰未已，但健中气，则痰自化
而病自愈；若用化痰利气之药，则中气愈虚，痰热愈甚矣。
一小儿，伤风咳嗽，发热，服解表之剂，更加喘促，出汗。余以为肺脾气虚，欲用补中益气汤加五味子
补之。不信，乃服二陈、桑皮、杏仁、枳壳、桔梗之剂，前症益甚，又加发搐、痰壅。余仍用前药更加钩
藤钩而痊。盖小儿脏腑脆嫩，气血易虚，所用之药虽为平和，亦有偏胜之味，须审察病气形气虚实、在表
在里之不同，而治之可也。（治法见伤风鼻流涕条。）
治小儿大便色泔白及小便浊或澄之如米泔者，此疳病也。
白术 黄连（姜水炒） 白茯苓 泽泻 山楂 白芍药（炒，各一钱） 青皮（四分） 甘草（三分）
上姜、水煎服。
愚按前症若因脾气虚而兼湿热者，宜用四味肥儿
丸；若兼泄泻，当以白术散间服。
治疳丸 小儿要药。
胡黄连 芦荟 使君子 黄连（各五钱，炒） 神曲（炒，一两） 阿魏 青黛（二钱，另研）
麝香（少许，另研）
上为末，稀糊丸黍米大。每服十丸，清汤下。
愚按前方乃肝脾疳症之药也。或内疳，或疮发于外亦效。盖疳，干也。或因哺食太早，或因恣食甘肥，
或因峻剂重亡津液，虚火上炎，或因乳母饮食、起居、七情、劳逸所致。
若口内生疮，身体壮热，腮唇赤色，或咽干饮水，掌热，便赤，盗汗，烦热，啮齿，虚惊。此心经
内外疳也，宜用安神丸主之。
若鼻疮，目烂，体瘦，疮癣，或耳前后、项、腋、小腹、内股、玉茎、阴丸肿溃，小便不调，摇头，侧
目，白膜遮睛，羞明，畏日，肚大青筋，口渴，下痢。此肝经内外疳也，用地黄、芦荟二丸主之。
若头发稀少，生疮成穗，人中口吻赤烂，或腹大脚细，呕吐泄泻，饮食不思，口干嗜土，泻下酸臭，
小便白浊，合目昏睡，恶闻木音。此脾经内外疳也，用肥儿丸主之。
若鼻外生疮，咽喉不利，颈肿，齿痛，咳嗽，寒热，皮肤皱错，欠伸，少气，鼻痒出涕，鼻衄，目黄，小
便频数。此肺经内外疳也，用地黄清肺饮主之。
若脑热，身瘦，手足如冰，寒热往来，滑泄，肚痛，口臭干渴，齿龈溃烂，面黧爪黑，遍身生疮，
耳内出水。此肾经内外疳也，用地黄丸主之。
大凡虚火上炎，或痘毒上攻，名曰走马疳，为患甚速。敷雄黄散，服大芜荑汤。此症轻则牙龈腐烂，
唇吻肿痛；重则牙齿蚀落，腮颊透烂，饮食不入者，为不治。
一小儿，二岁，茎痿湿痒，后阴囊 肿，茎中作痛，时出白津。余以为肝火，用龙胆泻肝汤、六味地
黄丸而痊。
一小儿，睾丸作痛，小便赤涩，寒热，作呕，乃肝脾之症，用小柴胡汤加山栀、车前子、茯苓而愈。
一小儿，睾丸肿硬，小便黄涩，用小柴胡汤加山栀、车前子并芦荟丸而消。
一小儿，腹内结块，或作痛，或上攻，小便不调，用龙胆泻肝汤、芦荟丸而愈。后形气消铄，发热作
渴。此肝木制伏脾土，用补中益气汤及芦荟丸而愈。
一小儿，自脱胎时两目赤肿，或作痒，或生翳。此胎内之肝火也，用芦荟、六味二丸而愈。
一女子，十五岁，患瘰 ，身发赤晕，形气倦怠。此肝火、血虚所致，用加味逍遥散而赤晕愈，用益气
汤、六味丸而瘰 消。
一小儿，下疳溃烂，发热作痛；一小儿茎中作痒，不时搔捻；一小儿茎中溃痛，小便秘涩，日晡尤
甚，一小儿目痒出水，或项间结核，或两眼连札，或阴囊瘙痒∶俱属肝火，皆用九味芦荟丸，并愈。（余见各
类。）
治小儿大病后面黄肌瘦，目时动，齿微咬，发稀少，未能大行，因误服解表、泻利伤克诸药而致者，
宜长缓调理，复全胃气。
白术（一钱二分） 白芍药（酒炒） 白茯苓（各八分） 人参 陈皮 川芎（各六分） 甘草（炙）
黄（蜜炙） 当归（酒洗，各四分） 半夏 山楂（各六分）
上用姜、枣、水煎服。
安神镇惊丸 惊退后调理，安心神，养气血，和平预防之剂。
天竺黄（另研） 人参 茯神 南星（姜制，各五钱） 酸枣仁（炒） 麦门冬 当归（酒洗）
生地黄（酒洗） 赤芍药（炒，各三钱） 薄荷 木通 黄连（姜汁炒） 山栀（炒） 辰砂（另研）
牛黄（另研） 龙骨（火 ，各二钱） 青黛（一钱，另研）
上为末，蜜丸绿豆大。淡姜汤送下，每服三、五丸。
愚按前二方根本之治，防微杜渐之法也。但镇惊丸内多苦寒、辛散、分利之味，病后不宜轻用，恐复
伤胃气，而变生他症也。若饮食停滞而见他症，当消导为主；若脾胃损伤而见他症，当健中气。大凡病后
元气未复，或因克伐之剂元气复伤，而见前症，但用升补阳气为主，诸症自愈，若专攻其病则误矣。
一小儿，七岁，患急惊将愈，而发热惊悸，或用祛风化痰之剂，更加惊搐，吐痰喘嗽，腹膨，少食，
恶寒，又用抱龙等丸，更加大便似痢，寒热往来，殊类风症。先君视之，以为脾气亏损，诸经无所资养而
然。用四君子汤为主，少用升麻、柴胡以升补阳气而愈。
治小儿齿肿，流涎，腮肿，马牙，主阳明之热。
升麻 川芎 白芍药 半夏（炒，各七分） 干葛 生甘草 防风 黄连（酒炒，各五分）
石膏（火 过） 白术（各一钱） 白芷（三分）
上水煎，每服二钱。若能漱药者，则含药漱而吐之。漱药不用白术、半夏。
愚按马牙、重舌，因胎毒胃热所致，若用线针刺破出血即愈，不必服药；若因饮食所伤，脾胃虚热而
致，宜用七味白术散；若服热药损伤脾胃发热而致，或口舌生疮，宜用人参安胃散；若久病脾胃虚热，口
内如无皮状，宜用七味白术散；若脾经阴血不足，午后益甚，宜用四物汤加白术、茯苓、炙草；若脾经阳
气下陷，午后益甚，宜用补中益气汤，并用茱萸涂脚心；若疳积虚火炎上，龈齿腐烂，当从疳治，亦有滞
颐口角流涎，此由脾气虚冷，不能制其津液也，宜用
温脾散；若脾经实热，舌纵涎下，宜用泻黄散。大凡小儿四时皆以养元气、健脾胃为主。若屡有痰症，屡
服驱风泻火之药，多患前症，其轻者能节饮食、慎调理，不药自愈。
To treat children with excessive fire in the Liver channel, frequent eye movements, rising phlegm-qi, or high fever with convulsions, red complexion, and forceful pulse, where the Spleen and Stomach are undamaged, it is appropriate to drain Liver fire.
Chuanxiong Rhizome (8 fen) Danggui Radix (washed with wine) Bupleuri Radix Citri Reticulatae Pericarpium Aurantii Fructus Immaturus (stir-fried) Gastrodiae Rhizoma (each 6 fen) Glycyrrhizae Radix et Rhizoma (4 fen) Poria
Paeoniae Radix Alba (stir-fried, each 8 fen) Coptidis Rhizoma (4 fen, stir-fried with wine) Menthae Haplocalycis Herba (3 fen)
Take each dose of 2 qian, decoct with ginger and water, and take orally.
My commentary: For the aforementioned symptoms, if caused by wind-heat in the Liver channel originating from within, this formula is appropriate; if caused by blood dryness in the Liver channel originating from within, Liuwei Wan (Six-Ingredient Rehmannia Pill) is appropriate; if Liver wood overacts on Spleen earth, Six Gentlemen Decoction added with Cimicifugae Rhizoma and Bupleuri Radix is appropriate; if Lung metal overacts on Liver wood, Xiebai San (Drain White Powder) is appropriate; if Kidney water fails to generate Liver wood, Liuwei Wan is appropriate; if after recovery there is palpitation and insomnia, or convulsions and teeth grinding during sleep, Guipi Tang (Restore the Spleen Decoction) added with Poria and Schisandrae Fructus is appropriate. Generally, excess indicates pathogenic qi is substantial; deficiency indicates true qi is deficient. In cases of excess disease, one should recognize underlying deficiency, as the classics state: "Where pathogenic qi gathers, qi must be deficient."
The grandson of Wang Yanghu, Shaocan, aged eight, suffered a fracture of the femur, which was set by orthopedic specialists. I observed his face was blueish-yellow, with slight twitching at the corners of the mouth, indicating Liver wood insulting Spleen earth. Since qi, blood, sinews, and bones all depend on Spleen earth for nourishment, strengthening Spleen qi will allow the injury to heal itself. Thus, I used Liujunzi Tang (Six Gentlemen Decoction) added with Uncariae Ramulus cum Uncis and Danggui Radix. After more than thirty doses, all symptoms resolved completely.
A three-year-old child experienced convulsions and fever due to fright, with abundant phlegm. Long-term use of Baolong Wan (Embrace Dragon Pill) and other medicines to clear wind-phlegm instead resulted in a complexion that alternated between red and blue. I considered this to be blood deficiency in the Heart and Liver channels, generating phlegm due to wind-heat, indicative of deficiency. I first used Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill) to nourish the Liver and Kidneys, assisted by Liujunzi Tang, with small amounts of Bupleuri Radix and Cimicifugae Rhizoma to regulate and tonify the Spleen and Stomach. All symptoms subsided rapidly, and he recovered.
To treat children with insufficiency of the Spleen channel, failure of Earth insulting Wood, slight eye movements, slight limb convulsions, or tidal fever, where the Spleen and Stomach are damaged, food intake is reduced, or there is diarrhea, vomiting, yellow complexion, and weak pulse, it is appropriate to tonify the Spleen and Stomach.
Bai Zhu Rhizoma (1 qian 3 fen) Huang Qi Radix Astragali (honey-roasted) Chuanxiong Rhizome Danggui Radix (washed with wine) Chenpi Pericarpium Citri Reticulatae Ren Shen Radix Ginseng Myristicae Semen (roasted) Shen Qu Mass Medicinal Fermentata
Ge Gen Radix Puerariae (each 5 fen) Bai Shao Radix Paeoniae Alba (1 qian, stir-fried with wine) Huang Lian Rhizoma Coptidis Gan Cao Radix et Rhizoma (roasted, each 4 fen) Ban Xia Tuber Pinelliae Preparatum Bai Fu Ling Poria (each 7 fen)
Decoct with ginger and water, and take orally.
My commentary: For the aforementioned symptoms, if due to Spleen-Stomach weakness, Wumei Yigong San (Five-Ingredient Extraordinary Efficacy Powder) should be used to tonify; for deficiency-cold, add Mu Xiang Radix Aucklandiae, or additionally Pao Jiang Rhizoma Zingiberis Preparatum to warm; if due to sinking of Spleen qi, Buzhong Yiqi Tang (Supplement the Middle and Augment the Qi Decoction) should be used to lift; if accompanied by thirst, Qiwei Baizhu San (Seven-Ingredient Atractylodes Macrocephala Powder) is indicated; if due to Spleen-Stomach weakness with Cold Water insulting Earth, Liujunzi Tang added with Mu Xiang and Pao Jiang should be used to warm; if due to Spleen-Stomach weakness with Liver Wood insulting Earth, Buzhong Yiqi Tang added with Poria, Paeoniae Radix Alba, and Pinelliae Tuber should be used to regulate; if due to excessive Liver Wood subduing Spleen Earth, Xiaochaihu Tang (Minor Bupleurum Decoction) added with stir-fried Gardeniae Fructus should be used to level; if due to damage from fish or meat, Liujunzi Tang added with Hawthorn Fruit and Amomi Fructus Rotundus should be used to digest; if due to damage from cold/raw foods, abdominal pain, or clear/white diarrhea, Liujunzi Tang added with Amomi Fructus Rotundus, Mu Xiang, and Pao Jiang should be used to warm; if due to stagnation from pungent/hot foods, vomiting of sour fluid, or difficult defecation with accumulation, Liujunzi Tang added with Coptidis Rhizoma, Evodiae Fructus, and Mu Xiang should be used to harmonize; if diarrhea persists after food stagnation resolves, Sijunzi Tang (Four Gentlemen Decoction) added with Myristicae Semen, Psoraleae Fructus, Mu Xiang, and roasted ginger should be used to tonify Spleen and Kidney; if diarrhea stops but appetite remains poor, Baizhu San (Atractylodes Macrocephala Powder) is appropriate to tonify Spleen and Stomach.
One child had fever and red face due to food stagnation. Someone treated him with Yangwei Tang (Nourish Stomach Decoction), Aurantii Fructus Immaturus, Coptidis Rhizoma, and Hawthorn Fruit, which worsened abdominal distension and afternoon fever, though pressing the abdomen revealed no pain. I believed that although the food had digested, the Spleen and Stomach were re-injured. He recovered after several doses of Liujunzi Tang.
Another child had fever, vomiting, and red face due to food stagnation. After taking digestive and heat-clearing agents, the food had digested, but fever and redness persisted. I said: This is empty heat in the Stomach channel! He recovered after four doses of Sijunzi Tang added with 2 fen each of Cimicifugae Rhizoma and Bupleuri Radix.
Another child had fever, red face, convulsions, vomiting, asthma, and expectoration due to food stagnation. I considered this to be heat generated by food injuring the Spleen, combined with Lung qi deficiency. He recovered after one dose of Liujunzi Tang added with 2 fen each of charred Coptidis Rhizoma and Gardeniae Fructus. (See other categories for details.)
To treat children with Heart blood deficiency, restlessness and惊动 (startling) during sleep, or episodes triggered by fright, the main approach is to clear the Heart, calm the spirit, and descend phlegm.
Ren Shen Radix Ginseng Ban Xia Tuber Pinelliae Preparatum (soaked in water) Suanzaoren Semen Ziziphi Spinosae (shelled and stir-fried) Fushen Poria Cum Radix Pinelli (decored, each 1 qian) Danggui Radix Citri Reticulatae Pericarpium Chi Shao Radix Paeoniae Rubra (each 7 fen) Wuweizi Fructus Schisandrae (5 grains, crushed) Gancao Radix et Rhizoma (roasted, 3 fen)
Decoct with water, add a little Ginger Juice and Bamboo Sap. Adding 0.5 fen of Calculus Bovis (Niuhuang) is especially good. In warm months, when the Heart channel often has heat, add 5 fen each of Rehmanniae Radix Preparata and Gardeniae Fructus, and 7 fen of Ophiopogonis Tuber, plus Lophatheri Herba. If food stagnates due to fright immediately after eating, one must first resolve the food stagnation before treating the fright. The anti-fright formula should still include Atractylodis Macrocephalae Rhizoma and Hordei Fructus Germinatus to regulate the Spleen and Stomach. Fright scatters qi, so it is appropriate to gather and tonify qi; fright gathers phlegm, so it is appropriate to resolve phlegm.
My commentary: For the aforementioned symptoms, if due to insufficient Heart blood causing Heart spirit palpitations and fright, this formula is appropriate; if due to excessive Wood-Fire causing restless Heart spirit, Daochi San (Guide Out Red Powder) is appropriate; if due to Wood-Fire combining with Wind-Heat clashing, Chaihu Zhizi San (Bupleurum and Gardenia Powder) is appropriate; if due to weak Liver fire and unharmonized Wood-Fire, Liuwei Wan is appropriate; if due to Spleen-Stomach food depression generating phlegm causing unrest, Sijunzi Tang should be used to strengthen the Spleen, Shen Qu, Ban Xia, and Hordei Fructus Germinatus to resolve phlegm, and Gardeniae Fructus and Paeoniae Radix to clear heat; if due to food stagnation causing abdominal distension, vomiting, or diarrhea, Liujunzi Tang should be used to strengthen the Spleen, and Magnoliae Officinalis Cortex and Shen Qu to digest food. For phlegm-convulsion-fright syndromes, continue using this formula for regulation. If Liver channel symptoms appear, add Uncariae Ramulus cum Uncis, and replace Chi Shao Radix Paeoniae Rubra with Bai Shao Radix Paeoniae Alba. (Treatment records see various syndrome categories.)
To treat children with food stagnation,郁热 (depressed heat) manifesting on the skin surface, and tidal fever, the main approach is to regulate the Middle and clear Heat of the Yangming channel.
Bai Zhu Rhizoma (stir-fried) Crataegi Fructus Bai Shao Radix Paeoniae Alba (stir-fried, each 1 qian) Huang Lian Rhizoma Coptidis (stir-fried) Zhi Shi Fructus Aurantii Immaturus (bran-stir-fried) Chuanxiong Rhizome Cyperi Rhizoma (stir-fried)
Shengma Rhizoma Cimicifugae (each 7 fen) Ge Gen Radix Puerariae (1 qian 2 fen) Gancao Radix et Rhizoma Zhi Gancao Radix et Rhizoma Glycyrrhizae Preparata (each 3 fen)
Decoct with ginger and water, and take orally. If tidal fever persists after food stagnation resolves, reduce Crataegi Fructus, Zhi Shi, Cyperi Rhizoma, and Chuanxiong Rhizome; add 5 fen each of Ren Shen, Huang Qi, and Chenpi; add another 2-3 fen of Bai Zhu. If there is phlegm, add 6 fen of Ban Xia.
My commentary: For the aforementioned symptoms, if heat persists after food stagnation resolves, Wumei Yigong San should be used to tonify Stomach qi; if there is vomiting and poor appetite, Sijunzi Tang added with Agastaches Herba and Ban Xia should be used to stabilize Middle qi; if there is diarrhea and refusal to eat, Liujunzi Tang added with Cimicifugae Rhizoma and Bupleuri Radix should be used to lift and tonify Spleen qi; if chronic diarrhea persists, Buzhong Yiqi Tang should be used to lift and tonify Yang qi; if deficiency-cold, add Pao Jiang and Mu Xiang; if ineffective, assist with Sishen Wan (Four Spirits Pill) to tonify Spleen and Kidney; if emaciated with tidal fever, thirst, and irregular bowels, Fei'er Wan (Fatten Child Pill) should be used to eliminate malnutrition accumulations. If one does not distinguish between Spleen qi deficiency/excess or presence/absence of food stagnation, and generally uses purgative/digestive or cold/cool heat-clearing agents, it repeatedly damages the vital qi of the Spleen and Stomach, turning it into a difficult-to-treat condition.
Xue Hengfu, a scholar, had a seven-year-old son who was emaciated, febrile, and had a yellow face. Everyone assumed it was internal injury with blood stasis and wanted to purge. I considered it an injury to the Spleen organ and administered Liujunzi Tang added with roasted ginger. After two doses, food intake improved drastically; after several doses, all symptoms resolved completely.
One child had food stagnation and took digestive agents. I said: This is Spleen-Stomach qi deficiency, hence food cannot be transformed. The method should be to regulate and tonify. If purgative agents are used repeatedly, Spleen qi will be further injured, and food stagnation will worsen. Later, a lump formed in the abdomen, with chills, fever, tidal fever, poor appetite, thirst, and loose stools. I used Sijunzi Tang, food intake gradually increased, and then Buzhong Yiqi Tang cured him.
One child had abdominal distension, immediate diarrhea after eating, and cold extremities. I considered this Spleen qi deficiency-cold. He recovered after first using Renshen Lizhong Wan (Ginseng Regulate the Middle Pill) and then Liujunzi Tang.
One child frequently suffered from stagnation. Multiple courses of purgative/digestive agents led to severe Spleen-Stomach deficiency, resulting in slow Spleen Wind with vomiting and diarrhea, leading to death. (See other syndrome categories.)
To treat children with fever and common cold, runny clear nose, or cough with expectoration. For mild cases, do not medicate initially; wait one or two days as they often self-resolve. For severe cases, use mild and harmonizing agents.
Chenpi Pericarpium Citri Reticulatae Ban Xia Tuber Pinelliae Preparatum (processed) Jiegeng Radix Platycodonis Chuanxiong Rhizome (each 5 fen) Bai Fu Ling Poria Sang Bai Pi Cortex Mori (honey-roasted, each 7 fen) Gancao Radix et Rhizoma (roasted)
Fangfeng Radix Saposhnikoviae (each 4 fen) Bohe Menthae Haplocalycis Herba Ku Huangqin Radix Scutellariae (stir-fried, each 3 fen) Bai Zhu Rhizoma (1 qian)
Take each dose of 2 qian, decoct with ginger and water, and take orally.
My commentary: For the aforementioned symptoms, if due to loose pores allowing external pathogens to invade and stagnate in the Lung causing illness, this formula is appropriate; if due to Spleen-Stomach qi deficiency failing to generate Lung Metal, Buzhong Yiqi Tang is appropriate; if due to Spleen-Stomach qi excess, Lung qi congestion, and large intestine dysfunction, Xiehuang San (Drain Yellow Powder) is appropriate; if due to Heart Fire flaring up and consuming Lung Metal causing cough, Liuwei Wan is appropriate. Generally, for those with inherently weak Yuan qi or long-standing illness, Buzhong Yiqi Tang should be the primary formula, added with Ban Xia, Poria, and Jiegeng. If convulsions and teeth grinding appear, these are driven by empty heat, and this formula is also appropriate. If phlegm is abundant, assist slightly with Baolong Wan. If wind-pathogen has retreated but hot phlegm remains, only by strengthening Middle qi will phlegm transform and illness heal; using phlegm-resolving and qi-moving drugs will further weaken Middle qi and worsen hot phlegm.
One child had wind-cold cough and fever. After taking exterior-releasing agents, wheezing and sweating worsened. I considered this Lung-Spleen qi deficiency and wanted to use Buzhong Yiqi Tang added with Wuweizi to tonify. He did not believe me and took Erchen Tang, Sang Bai Pi, Xingren Semen Armeniacae Amarum, Zhi Shi, and Jiegeng. The previous symptoms worsened, adding convulsions and phlegm obstruction. I again used the previous medicine added with Uncariae Ramulus cum Uncis, and he recovered. Children's organs and viscera are delicate, and qi and blood easily become deficient. Even mild medicines have biased flavors. One must examine the deficiency/excess of pathological qi and form qi, and whether the pathogen is in the exterior or interior, before treating. (Treatment methods see Wind-Cold with Runny Nose section.)
To treat children with milky-white stool and turbid urine, or urine that clears like rice wash water, this is a Gan (malnutrition) disease.
Bai Zhu Rhizoma Huang Lian Rhizoma Coptidis (stir-fried with ginger water) Bai Fu Ling Poria Ze Xia Rhizoma Alismatis Crataegi Fructus Bai Shao Radix Paeoniae Alba (stir-fried, each 1 qian) Qingpi Pericarpium Citri Reticulatae Viride (4 fen) Gancao Radix et Rhizoma (3 fen)
Decoct with ginger and water, and take orally.
My commentary: For the aforementioned symptoms, if due to Spleen qi deficiency with damp-heat, Siwei Fei'er Wan (Four-Ingredient Fatten Child Pill) is appropriate; if accompanied by diarrhea, Baizhu San should be taken intermittently.
Zhi Gan Wan (Gan-Dissolving Pill) is an essential medicine for children.
Huhuanglian Radix Coptidis Chinensis (each 5 qian, stir-fried) Lu Hui Aloe (each 5 qian, stir-fried) Shi Junzi Semen Quisqualis (each 5 qian, stir-fried) Huang Lian Rhizoma Coptidis (each 5 qian, stir-fried) Shen Qu Mass Medicinal Fermentata (stir-fried, 1 liang) A Wei Resina Ferulae Qingdai Indigo Naturalis (2 qian, separately ground)
Shexiang Moschus (a little, separately ground)
Grind into powder, make pills with thin paste the size of millet seeds. Take ten pills each time, washed down with clear soup.
My commentary: The above formula is for Liver-Spleen Gan syndromes. It is effective for internal Gan or sores manifesting externally. Gan means dryness. It may be caused by early weaning, excessive consumption of sweet/greasy foods, harsh medicines severely depleting body fluids, empty fire flaring up, or caused by the wet nurse's diet, lifestyle, emotions, or overwork/rest imbalance.
If there are sores in the mouth, high fever, red cheeks/lips, dry throat desiring water, hot palms, red urine, night sweats, irritability, teeth grinding, and false fright, this is Heart channel internal/external Gan. Anshen Wan (Calming Spirit Pill) is indicated.
If there are nasal sores, rotting eyes, emaciation, sores/ringworm, swelling/ulceration behind ears, neck, armpits, lower abdomen, inner thighs, penis, and testicles, irregular urination, head shaking, squinting, white membrane covering pupils, photophobia, fear of sunlight, large belly with visible veins, thirst, and dysentery, this is Liver channel internal/external Gan. Dihuang Wan and Luhui Wan are indicated.
If hair is sparse, growing sores in tufts, red/rotting philtrum/mouth corners, large belly with thin legs, vomiting/diarrhea, loss of appetite, dry mouth craving earth, sour/foul-smelling diarrhea, cloudy white urine, sleeping with eyes closed, and aversion to wooden sounds, this is Spleen channel internal/external Gan. Fei'er Wan is indicated.
If there are sores outside the nose, throat discomfort, neck swelling, toothache, cough, chills/fever, wrinkled skin, yawning, shortness of breath, itchy nose with discharge, epistaxis, yellow eyes, and frequent urination, this is Lung channel internal/external Gan. Dihuang Qingfei Yin (Rehmannia Clearing Lung Decoction) is indicated.
If there is brain heat, emaciation, ice-cold hands/feet, alternating chills/fever, slippery diarrhea, abdominal pain, bad breath/thirst, ulcerated gums/black nails, widespread sores, and ear discharge, this is Kidney channel internal/external Gan. Dihuang Wan is indicated.
Generally, empty fire flaring up or acne toxin attacking upwards is called Zouma Gan (Running Horse Gan), which causes harm very rapidly. Apply Xionghuang San (Realgar Powder) and take Da Wuyi Tang (Large Wormwood Decoction). Mild cases involve gum rot and lip/swelling pain; severe cases involve tooth erosion, cheek perforation, and inability to eat, which are incurable.
A two-year-old child had flaccid, itchy, damp penis, swollen scrotum, penile pain, and occasional white discharge. I considered this Liver fire. He recovered using Longdan Xiegan Tang (Gentian Drain Liver Decoction) and Liuwei Dihuang Wan.
One child had testicular pain, red/scanty urine, chills/fever, and vomiting. This was a Liver-Spleen syndrome. He recovered using Xiaochaihu Tang added with Gardeniae Fructus, Plantaginis Semen, and Poria.
One child had hard/swollen testicles and yellow/scanty urine. He recovered using Xiaochaihu Tang added with Gardeniae Fructus, Plantaginis Semen, and Luhui Wan.
One child had an abdominal mass, sometimes painful or moving upward, with irregular urination. He recovered using Longdan Xiegan Tang and Luhui Wan. Later, his physique wasted, with fever and thirst. This was Liver Wood subduing Spleen Earth. He recovered using Buzhong Yiqi Tang and Luhui Wan.
One child had red/swollen eyes since birth, sometimes itchy or developing nebula. This was intrauterine Liver fire. He recovered using Luhui and Liuwei two pills.
A fifteen-year-old girl suffered from scrofula, red halos on the body, and fatigue. This was caused by Liver fire and blood deficiency. She recovered from red halos using Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder) and from scrofula using Yiqi Tang and Liuwei Wan.
One child had ulcerated genital sores with fever/pain; one child had itchy penis scratching constantly; one child had ulcerated penile pain with scanty urine worsening at dusk; one child had itchy/weeping eyes, neck lumps, crossed eyes, or itchy scrotum: all belong to Liver fire. All recovered using Jiwei Luhui Wan (Nine-Ingredient Aloe Pills). (See other categories.)
To treat children with yellow face and emaciation after serious illness, frequent eye movements, slight teeth grinding, sparse hair, inability to walk well, caused by mistakenly taking exterior-releasing, purgative, or damaging agents, it is appropriate to regulate slowly and restore Stomach qi.
Bai Zhu Rhizoma (1 qian 2 fen) Bai Shao Radix Paeoniae Alba (wine-stir-fried) Bai Fu Ling Poria (each 8 fen) Ren Shen Radix Ginseng Chenpi Pericarpium Citri Reticulatae Chuanxiong Rhizome (each 6 fen) Gancao Radix et Rhizoma (roasted)
Huang Qi Radix Astragali (honey-roasted) Danggui Radix (wine-washed, each 4 fen) Ban Xia Tuber Pinelliae Preparatum Shan Zha Fructus Crataegi (each 6 fen)
Decoct with ginger, jujube, and water, and take orally.
Anshen Zhenjing Wan (Calming Spirit and Suppressing Fright Pill) is for post-fright regulation, calming the spirit, nourishing qi and blood, and peaceful prevention.
Tianzhu Huang Borax (separately ground) Ren Shen Radix Ginseng Fushen Poria Cum Radix Pinelli Nanxing Rhizoma Arisaematis Preparatum (ginger-processed, each 5 qian) Suanzaoren Semen Ziziphi Spinosae (stir-fried) Maimendong Tuber Ophiopogonis Danggui Radix (wine-washed)
Shengdi Huang Radix Rehmanniae (wine-washed) Chi Shao Radix Paeoniae Rubra (stir-fried, each 3 qian) Bohe Menthae Haplocalycis Herba Mutong Caulis Akebiae Huanglian Rhizoma Coptidis (ginger juice-stir-fried) Zhizi Fructus Gardeniae (stir-fried) Chensha Cinnabaris (separately ground)
Niuhuang Calculus Bovis (separately ground) Longgu Os Femoris (calcined, each 2 qian) Qingdai Indigo Naturalis (1 qian, separately ground)
Grind into powder, make pills with honey the size of mung beans. Wash down with light ginger soup, take 3-5 pills each time.
My commentary: The previous two formulas are fundamental treatments and methods for preventing problems before they arise. However, Zhenjing Wan contains many bitter-cold, acrid-dispersing, and separating/draining ingredients, making it unsuitable for post-illness use without caution, lest it re-injure Stomach qi and generate other syndromes. If food stagnation presents with other symptoms, digestion should be prioritized; if Spleen-Stomach damage presents with other symptoms, strengthening Middle qi should be prioritized. Generally, if Yuan qi is unrepaid after illness, or re-injured by purgatives presenting with previous symptoms, primarily using lifting and tonifying Yang qi will resolve all symptoms spontaneously. Specializing in attacking the disease would be a mistake.
A seven-year-old child was recovering from acute fright convulsions but had fever and palpitations. Someone used wind-dispelling and phlegm-resolving agents, worsening convulsions, phlegm expectoration, asthma, abdominal distension, poor appetite, and aversion to cold. Then Baolong Wan was used, worsening stool to resemble dysentery, with alternating chills/fever, resembling wind syndrome. My late father examined him, considering it Spleen qi depletion, leaving meridians without nourishment. Using Sijunzi Tang as the main formula, with small amounts of Cimicifugae Rhizoma and Bupleuri Radix to lift and tonify Yang qi, he recovered.
To treat children with swollen teeth, drooling, swollen cheeks, and Ma Ya (horse teeth), the main approach is to clear Heat of the Yangming channel.
Shengma Rhizoma Cimicifugae Chuanxiong Rhizome Bai Shao Radix Paeoniae Alba Ban Xia Tuber Pinelliae Preparatum (stir-fried, each 7 fen) Ge Gen Radix Puerariae Sheng Gancao Radix et Rhizoma Glycyrrhizae Raw Fangfeng Radix Saposhnikoviae Huanglian Rhizoma Coptidis (wine-stir-fried, each 5 fen)
Shigypsum Fibrosum (calcined) Bai Zhu Rhizoma (each 1 qian) Baizhi Rhizoma Angelicae Dahuricae (3 fen)
Decoct with water, take 2 qian per dose. If capable of gargling, hold the medicine in the mouth and spit it out. Do not use Bai Zhu or Ban Xia for gargling.
My commentary: Ma Ya (horse teeth) and Chongshe (double tongue) are caused by fetal toxin and Stomach heat. If pricked with thread until bleeding occurs, it heals immediately; medication is unnecessary. If caused by food injury and Spleen-Stomach empty heat, Qiwei Baizhu San is appropriate. If caused by heat medicines injuring Spleen-Stomach leading to fever or mouth/tongue sores, Renshen Angwei San (Ginseng Calming Stomach Powder) is appropriate. If chronic Spleen-Stomach empty heat leaves the mouth feeling skinless, Qiwei Baizhu San is appropriate. If Spleen channel Yin-blood is insufficient, worsening in the afternoon, Siwu Tang (Four Substances Decoction) added with Bai Zhu, Poria, and roasted Gancao is appropriate. If Spleen channel Yang qi sinks, worsening in the afternoon, Buzhong Yiqi Tang is appropriate, applied with Evodiae Fructus to the soles. If Gan accumulation empty fire flares up causing gum/tooth rot, treat according to Gan; there is also drooling at the mouth corners due to Spleen qi deficiency-cold failing to control fluids, for which Wenpi San (Warm Spleen Powder) is appropriate. If Spleen channel excess heat causes tongue protrusion and drooling, Xiehuang San is appropriate. Generally, children throughout the four seasons should prioritize nourishing Yuan qi and strengthening the Spleen and Stomach. If phlegm syndromes recur and wind-dispelling/fire-draining medicines are taken repeatedly, these symptoms often occur. Mild cases can self-resolve with dietary restraint and careful regulation without medication.