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Translation:

It is discussed that when a child has heat, excessive heat generates phlegm; excessive phlegm generates fright (Jing); excessive fright generates wind; excessive wind causes convulsions; if it worsens further, the jaw becomes rigid; if even more severe, opisthotonos and upward gaze occur; at this point, phlegm-saliva obstructs the jaw.

When wind-heat is extreme, it blocks the meridians, immediately causing convulsions and spasms; phlegm-dampness stagnates in the stomach region, leading to mental confusion and unconsciousness; as the pathogen enters the Zhongwan area, the limbs become cramped. All these conditions result from the blockage of orifices and the stagnation of Qi and blood in the hundred vessels. Some recover through clearing heat, some through calming fright, some through extinguishing wind, and some through resolving phlegm and unblocking orifices. These are all outcomes of treating according to symptoms. One must not fail to thoroughly investigate the root cause of the disease.

If the pathology lies in heat, do not treat recklessly; if in phlegm, do not treat recklessly; if in fright, do not treat recklessly; if in wind, do not hastily treat for fright; if in wind, do not hastily treat for convulsions. Generally, when treating pediatric diseases where the issue is fright caused by phlegm-heat, one should only clear heat and resolve phlegm, and the fright will subside naturally. Where the issue is wind caused by agitation of fright, one should only benefit the spirit and resolve phlegm, and the wind will dissipate naturally. Where the issue is phlegm-saliva, one must urgently clear heat and resolve phlegm; if convulsions are present, one must use methods to extinguish wind and calm fright. This is considered the supreme skill of medicine. If one acts rashly based on subjective intent, although treating for fright, if phlegm is not resolved and heat is not cleared, how can the fright stop? If wind is not dispersed because phlegm-heat is not transformed, how can phlegm be removed? Thus, the so-called "non-treatment treatment" is precisely what constitutes "treatment." Students should pay deep attention to this aspect, focusing on investigating gains and losses, thereby achieving a comprehensive and thorough mastery of medical principles.

It is discussed that when a child's Zang organs are cold and Fu organs are cold, with the large intestine failing to maintain control, it is collectively termed diarrhea. One must distinguish severity and investigate the pace. Loose stools, diarrhea, incontinence, purging, and bucket-like discharge are five different types; how can they be treated uniformly?

"Loose stools" refer to waste materials that do not consolidate, appearing thick yet resembling diarrhea but not quite; "diarrhea" refers to episodes occurring without fixed timing, sometimes with loss of awareness during expulsion; "purging" refers to direct spraying and splashing, indicating Qi escaping from within; "incontinence" refers to food passing directly through the intestines without digestion; "bucket-like discharge" refers to sudden massive expulsion, like a barrel collapsing, leaving nothing behind. From this, we know it stems from cold deficiency in the Zang and Fu organs. The onset speed and severity of diarrhea can be inferred.

Whenever a child's stool is green, it is because the Spleen is constrained by the Liver meridian. The Liver belongs to Yi Wood and controls Ji Earth (Spleen). Due to the interaction of overcoming and being overcome, the true nature manifests as green. This is due to Zang-Fu cold deficiency, not Fright. Additionally, if stool starts yellow and turns green after a while, it indicates mild Zang cold; if ingested medicine passes through unchanged, it indicates severe cold and slipperiness. In cases of deficiency-type incontinence, fatigue sets in after just three or five episodes. If one does not urgently warm the Zang organs, regulate the Stomach, smooth the San Jiao, and harmonize Ying and Wei, the condition will rapidly progress to slow Fright syndrome. Given such urgency, attempting to treat sequentially with anti-diarrheal agents is often too late. One must prioritize warming the Zang and Fu organs; once warmed, how can cold remain in the intestines? Using hot herbs to forcibly stop diarrhea may cause heat to trigger other ailments. One should first administer intestinal-astringent herbs, then tonify Stomach Qi. One must not act rashly or overdose with hot herbs. If the Zang-Fu are extremely deficient and cold, causing the child to suffer with cold limbs, this is termed a "Ni" (adverse/rebellious) syndrome. In such cases, Hei Fu Zi (Black Prepared Aconite), Bai Zhu (Atractylodes Macrocephala Rhizome), and Gan Jiang (Dried Ginger) should be used, dosed according to severity. Whenever hot herbs are administered and diarrhea stops but dysentery ensues, this is inevitable. Excellent formulas for managing diarrhea are listed later; please study them carefully to grasp their essence.