小儿潮热，或壮热不退，多是变蒸及五脏相胜。不必用药；又多是饮食停积郁热，由中发外，见于肌
表。只理其中，清阳明之热而表热自除。不可认作外感，轻易发汗，用小柴胡轻利等药重伤其内。又潮热
不退，恐是出痘，亦当审察，勿便用药。
愚按前症若因饮食停积，或腹痛、吐泻，或肚腹膨胀，宜用保和丸以消导健脾；若饮食既消，或腹痛
不食，或肚腹膨胀，宜用四君子以保养胃气；若因误行汗下，损伤元气，宜用参、 、归、术、陈皮、甘草以
补中气。大凡伤食，脾胃必损，宜固胃气，庶无变症。若寅、卯、辰时热者，属肝经也；巳、午、未
时热者，属心经也；申、酉、戌时热者，属肺经也；亥、子、丑时热者，属肾经也。当详其虚实而治之。
凡属虚热、实热，投以攻补之剂，其病既不增减，乃是病根深固，而药力未能及耳！须宜多服，功力既至，
诸病悉退，切不可改为别治。设或药不对症，祸在反掌，慎之！
李阁老子，患潮热，饮食如故，自申、酉时甚，至子、丑时方止，遍身似疥，大便秘结，小便赤涩，热
渴饮冷。余以为脾胃实热，传于肺与大肠。先用清凉饮四剂，结热始退；又用四物汤加柴胡、黄连数剂，
其疮渐愈。彼欲速效，另用槐角丸之类，诸症益甚，遂求于施院长，亦用四物汤加柴胡、黄连，加桃仁、赤
芍药，至百剂而愈。（施院长名鉴字银台弟。）
Pediatric tidal fever, or persistent high fever, is mostly due to "Bian Zheng" (a physiological phenomenon in infant growth and development) and the mutual overcoming relationship among the Five Zang organs. Medication is generally unnecessary; furthermore, it is often caused by food stagnation generating stagnant heat, which emanates from the interior to the exterior, manifesting on the skin surface. One should only regulate the interior, clear the heat of the Yangming channel [Yangming Channel], and the exterior fever will naturally resolve. It must not be mistaken for an external contraction [Exogenous Pathogen], nor should sweating methods be lightly employed, nor should formulas such as Xiao Chai Hu Tang (Minor Bupleurum Decoction) or Qing Li Wan (Light Draining Pill) be used indiscriminately, thereby severely damaging the internal Qi. If the tidal fever persists, it may indicate the eruption of smallpox/variolae, requiring careful examination; medication should not be administered hastily.
My commentary: For the aforementioned symptoms, if they are caused by food stagnation, accompanied by abdominal pain, vomiting and diarrhea, or abdominal distension, Bao He Wan (Preserve Harmony Pill) should be used to digest food, guide out stagnation, and strengthen the Spleen. If the food has digested but abdominal pain with loss of appetite or abdominal distension persists, Si Jun Zi Tang (Four Gentlemen Decoction) should be used to nourish and protect Stomach Qi. If the condition results from erroneous use of sweating or purging methods that damaged Yuan Qi (Original Qi), Ren Shen (Ginseng Root), [character missing in original text, likely Bai Zhu or Fu Ling], Dang Gui (Angelica Sinensis Root), Bai Zhu (Atractylodes Macrocephala Rhizome), Chen Pi (Tangerine Peel), and Gan Cao (Licorice Root) should be used to tonify Middle Qi. Generally, food injury damages the Spleen and Stomach; thus, stabilizing Stomach Qi is essential to prevent further pathological changes. Fever occurring during Yin, Mao, and Chen hours belongs to the Liver Channel; fever during Si, Wu, and Wei hours belongs to the Heart Channel; fever during Shen, You, and Xu hours belongs to the Lung Channel; fever during Hai, Zi, and Chou hours belongs to the Kidney Channel. Treatment must be based on a detailed differentiation of deficiency and excess. In cases of deficiency heat or excess heat, if neither attacking nor tonifying agents result in any change in the disease state, it indicates that the pathogenic root is deep-seated and the medicinal efficacy has not yet reached its target. Continued administration is necessary; once sufficient potency is achieved, all ailments will recede. Do not hastily switch to alternative treatments. If the prescription does not match the syndrome, disaster can strike instantly; caution is paramount!
The son of Grand Secretary Li suffered from tidal fever. His diet remained normal. Symptoms worsened during Shen and You hours and ceased only during Zi and Chou hours. His entire body presented with lesions resembling scabies, accompanied by constipation, red and scanty urine, fever, thirst, and a preference for cold drinks. I diagnosed this as Excess Heat in the Spleen and Stomach transmitting to the Lung and Large Intestine. Initially, Qing Liang Yin (Cooling Drink) was administered for four doses, after which the accumulated heat began to subside. Subsequently, Si Wu Tang (Four Substance Decoction) was modified with Chai Hu (Bupleurum Root) and Huang Lian (Coptis Rhizome) for several doses, leading to gradual healing of the sores. Desiring rapid results, he independently used Huai Jiao Wan (Stylocarpus Fruit Pill) and similar preparations, causing his symptoms to exacerbate. He then sought treatment from Dean Shi. Dean Shi also prescribed Si Wu Tang (Four Substance Decoction) modified with Chai Hu (Bupleurum Root) and Huang Lian (Coptis Rhizome), adding Tao Ren (Peach Seed) and Chi Shao Yao (Red Peony Root). After taking over a hundred doses, he recovered. (Dean Shi's name was Jian, courtesy name Yintai, and he was the younger brother.)