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Wan Mizhai treated the son of a Chu provincial judge (Chuo Nie). At nine months old, the child developed fever, and the family feared it was variola (smallpox) or rubeola (measles). Wan Mizhai was summoned and examined the child, determining it was not variola/rubeola but bianzheng (a physiological developmental phase in infants characterized by mild fever and other symptoms). When asked how to differentiate them, Wan said: "By calculating the days, the timing corresponds to bianzheng; by observing the symptoms, there are no signs of variola/rubeola." The questioner then asked about the manifestations of variola. Wan replied: "Variola toxins are fluids from the five zang organs, so each organ manifests one specific symptom. Yawning and palpitations indicate the Heart; neck stiffness and irritability indicate the Liver; coughing and sneezing indicate the Lungs; vomiting, diarrhea, and lethargy indicate the Spleen; and a cool body indicates the Kidney. Since the young master lacks these symptoms, we know it is not variola, but rather that the bianzheng phase is subsiding." The next day, the child indeed recovered.

Ye Tianshi stated: "In summer and autumn, when children suffer from diarrhea, or have recently recovered but are not fully healed, and develop gan erosion (oral mucosal ulceration) all over the mouth, obstructing the throat and causing critical conditions, this is due to excessive dampness in the interior generating heat. The heat steams and scorches, preventing fluids from ascending, and damp-heat disproportionately injures the qi level. Treatment should focus on the upper jiao, possibly assisted by light diuretic methods. Common practice involves scraping watermelon rind (xigua cui yi) to treat gan, utilizing its light and dispersing diuretic properties."

Wu Fuxian treated a child whose throat suddenly swelled with severe pain. Rice broth and water could not be swallowed, creating a critical situation. Wu said: "This is called suo hou feng (locking throat wind). By pricking the Shaoshang (LU11) and Ran Gu (KI2) acupoints with silver needles to bleed, the throat immediately relaxed. After giving him tea, he could swallow without discomfort, and food intake resumed."

Another child frequently protruded his tongue. Cooling medications failed to cure him. Wu said: "This is called nong she (playing with the tongue), which differs from tu she (protruding tongue)." Xue Xinpu explained: "Tu she results from excess heat in the Spleen channel, where the tongue extends and stays out; nong she results from deficient heat in the Spleen channel, where the tongue intermittently extends and retracts." Following Xue Xinpu's established formula, Yi Gong San (Extraordinary Power Powder) combined with Gouteng (Uncaria rhynchophylla) cured the condition. (Yi Gong Si Jun Zi Tang is Si Jun Zi Tang plus Chen Pi.)

Chao Yuanfang noted: "Zhi yi (drooling) in children refers to saliva flowing out and soaking the cheeks/chin area. This is caused by cold spleen and excessive saliva. The fluid of the Spleen is saliva; when the Spleen and Stomach are deficient and cold, they fail to control the fluids, causing them to flow onto the cheeks. Zhang Shi Wen Pi Dan is indicated for this condition. Another method is to hold Bai Yao Jian (Galla Chinensis) in the mouth to swallow, which stops salivation naturally; this is also a blocking method. Huang San and Wen Pi San are also effective for this condition." (From *Dong Yuan Shi Shu*).

Wan Mizhai’s grandson had ulcers all over his mouth, affecting the throat, lips, and tongue. Wan prescribed: Huang Lian (Coptidis Rhizoma) 1 qian, Zhu Sha (Cinnabaris) and Bai Fan (Alumen) 5 fen, Shu Fu (Stableia/Oniscus asellus) dried and roasted 3 fen. These were ground into fine powder and applied topically, yielding immediate effect. It was an unusual prescription.

A child suffered from oral and lingual ulcers. Treatments using Huang Qin (Scutellariae Radix), Huang Lian, Zhi Mu (Anemarrhenae Rhizoma), and Huang Bo (Phellodendri Cortex)—all bitter-cold herbs—were ineffective. I reasoned: "This is caused by Heart heat. Bitter flavors enter the Heart and may exacerbate the heat, hence the ineffectiveness." I prepared Xi Xin San (Wash the Heart Powder) for him, which brought relief after one dose. The formula contained equal parts of Da Huang (Rhei Radix et Rhizoma), Ma Huang (Ephedrae Herba), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Dang Gui (Angelicae Sinensis Radix), Bai Shao (Paeoniae Radix Alba), Jing Jie (Schizonepetae Spica), Bo He (Menthae Haplocalycis Herba), and Gan Cao (Glycyrrhizae Radix et Rhizoma), decocted in water. Additionally, Bai Lian San was applied topically. (Note: This still utilizes bitter-cold herbs.)

Another child had ulcers on the tongue and cracked lips, unable to suck milk, crying day and night. Seeking treatment, I used Xi Xin San decocted with Zhu Ye (Phyllostachdis Folium) to clear internal heat, and applied Bai Lian San externally, which proved effective.

Jiang Zhongfang treated a child who initially presented with a fragmented tongue, followed by generalized fever. Some attributed it to wind invasion and food stagnation, prescribing diaphoretic and digestive-promoting herbs. Jiang said: "This will be of no benefit." Indeed, after administration, the fever worsened, and liquids became difficult to ingest. Jiang then administered Huang Lian (Coptidis Rhizoma) 5 qian (likely a typo for a smaller dose), decocted in water, given slowly. The course of treatment cured the child. When asked for the rationale, Jiang explained: "If fever precedes the tongue fragmentation, it is due to wind and food stagnation generating heat. Here, the tongue fragmentation preceded the fever, indicating extreme hyperactivity of Heart fire. Combined with the subsequent fever, this signifies extreme internal heat with fire manifesting outwardly."