幼儿断乳纳食。值夏月脾胃主气。易于肚膨泄泻。头热。手足心热。形体日瘦。或烦渴善食。渐成
五疳积聚。当审体之强弱。病之新久。有余者当疏胃清热。食入粪色白。或不化。当健脾佐消导
清热。若湿热内郁。虫积腹痛。导滞驱虫微下之。缓调用肥儿丸之属。
夏季秋热。小儿泄泻。或初愈未愈。满口皆生疳蚀。尝有阻塞咽喉致危者。此皆在里湿盛生热。
热气蒸灼。津液不升。湿热偏伤气分。治在上焦。或佐淡渗。世俗常刮西瓜翠衣治疳。取其
轻扬渗利也。
夏季湿热郁蒸。脾胃气弱。水谷之气不运。温者内蕴为热。渐至浮肿腹胀。小水不利。治之非法。
水湿久渍。逆行犯肺。必生咳嗽喘促。甚则坐不得卧。俯不能仰。危期速矣。大凡喘必生胀。胀必
生喘。方书以先喘后胀者治在肺。先胀后喘者治在脾。亦定论也。金匮有风水皮水石水正水
黄汗。以分表里之治。河间有三焦分消。子和有磨积逐水。皆有奥义。学人不可不潜心体认。难
以概述。阅近代世俗论水湿喘胀之症。以内经开鬼门取汗为表治。分利小便洁净府为里治。
经旨病能篇。谓诸湿肿满。皆属于脾。以健脾燥湿为稳治。治之不效。技穷束手矣。不知凡病皆
本乎阴阳。通表利小便。乃宣经气利腑气。是阳病治法。暖水脏。温脾肾。补方以驱水。是阴病治
法。治肺痹以轻开上。治脾必佐温通。若阴阳表里乖违。脏真日漓。阴阳不运。亦必作胀。治以通
阳。乃可奏绩。如局方禹余粮丸。甚至三焦交阻。必用分消。肠胃窒塞。必用下夺。然不得与伤寒
实热同例。擅投硝黄枳朴。扰动阴血。若太阴脾脏饮湿阻气。温之补之不应。欲用下法。少少甘
遂为丸可也。其治实症选用方法备采。
幼儿断奶后开始进食固体食物。正值夏季，脾胃当令，容易出现腹部膨隆、泄泻、头部发热、手足心发热、身体日渐消瘦等症状。或者出现烦躁口渴、食欲亢进，逐渐演变成五疳积聚之证。应当审察患儿体质的强弱以及病程的新久。若属有余之证（实证），应当疏理胃气、清解热邪；若食入后粪便颜色发白，或食物不消化，应当健脾并佐以消食导滞、清热之法。若是湿热内郁，伴有虫积腹痛，则用导滞驱虫药轻微攻下，缓解期调用肥儿丸之类的方剂调理。
夏季至秋初天气炎热，小儿泄泻，或者刚刚痊愈但尚未完全恢复，满口生出疳蚀疮疡。曾经有因咽喉阻塞而导致危重情况的。这都是在体内湿气盛而生热，热气蒸腾灼烧，导致津液不能上升，湿热偏伤气分。治疗应着眼于上焦，或者佐以淡味渗湿利水之品。世俗常用刮取西瓜翠衣来治疗疳疾，是取其性质轻扬、渗湿利水的作用。
夏季湿热郁蒸，脾胃之气虚弱，水谷精微之气不能运化，温煦之气内蕴化为热邪，逐渐导致浮肿、腹胀、小便不利。如果治疗不当，水湿长期浸渍，逆而上行侵犯肺脏，必然产生咳嗽、气喘急促，甚至严重到无法平卧，俯身或仰面都困难，危险期很快就会到来。大凡喘症必伴随胀症，胀症必伴随喘症。医书认为先喘后胀的，病位在肺；先胀后喘的，病位在脾，这也是确定的结论。《金匮要略》中有风水、皮水、石水、正水、黄汗等分类，用以区分表里治法。刘河间有三焦分消的理论，张子和有磨积逐水的方法，其中都有深奥的道理。学习者不可不潜心体会认识，难以在此概述。阅读近代世俗关于水湿喘胀病症的论述，引用《内经》中“开鬼门”即发汗作为表治，分利小便、洁净府作为里治。《素问·病能篇》说各种湿肿满闷，都归属于脾，主张以健脾燥湿为稳妥治法。如果治疗无效，便技穷束手无策了。不知道凡是疾病都根源于阴阳失调。通表发汗、利小便，是宣通经气、利导腑气，这是阳病的治疗方法。温暖水脏（肾）、温补脾肾，用补益方剂来驱除水湿，这是阴病的治疗方法。治疗肺痹要轻轻开启上焦，治疗脾病必须佐以温通之法。如果阴阳表里乖违，脏腑真气日益亏损，阴阳运行停滞，也必然发生胀症。治疗应以通阳为主，才能取得疗效。如《局方》中的禹余粮丸，甚至三焦交阻不通时，必须用分消法；肠胃窒塞不通时，必须用下夺法。然而不能与伤寒实热证同等对待，擅自投用硝石、大黄、枳实、厚朴等峻猛药物，会扰动阴血。如果是太阴脾脏寒饮湿邪阻滞气机，用温补法无效，想要用下法，可以少量使用甘遂制成丸药服用。其治疗实证选用的方法详见采录。
After weaning, infants begin to consume solid food. During the summer months, when the Spleen and Stomach are in their dominant phase, it is easy for them to develop abdominal distension, diarrhea, heat in the head, heat in the palms and soles, and progressive emaciation. Alternatively, they may present with irritability, thirst, and hyperphagia, gradually evolving into the "Five Gu" (Pediatric Malnutrition Syndromes) and accumulation disorders. One must assess the strength of the child's constitution and the duration of the disease. If it is an excess syndrome, one should regulate the Stomach Qi and clear Heat; if stools are white after eating or food is undigested, one should strengthen the Spleen and assist with digestive-promoting and heat-clearing methods. If Damp-Heat is internally constrained with intestinal parasites causing abdominal pain, use methods to guide out stagnation and expel parasites with mild purgation; during the convalescent phase, use formulas such as Fei'er Wan (Child-Nourishing Pill) for regulation.
From summer to early autumn heat, pediatric diarrhea occurs, or the condition has just healed but not fully resolved, leading to Gu erosion ulcers covering the entire mouth. There have been cases where throat obstruction led to critical danger. These are all due to excessive internal Dampness generating Heat, with Heat steaming and scorching, preventing Jin-Ye (Body Fluids) from ascending, and Damp-Heat disproportionately injuring the Qi aspect. Treatment should focus on the Upper Jiao (Upper Burner), possibly assisted by light diuretic and damp-draining agents. Secular practice often uses scraped watermelon rind (Xi Gua Cui Yi) to treat Gu diseases, taking advantage of its light, ascending, and damp-draining properties.
In summer, Damp-Heat is constrained and steaming, while Spleen and Stomach Qi is weak, failing to transport the essence of water and grain. The warming Qi accumulates internally transforming into Heat, gradually leading to edema, abdominal distension, and difficult urination. If treated incorrectly, long-term immersion in Water-Dampness reverses upward to invade the Lung, inevitably causing cough and panting/shortness of breath, severe enough that the patient cannot lie flat, nor can they bend forward or extend backward, indicating an imminent critical period. Generally, panting generates distension, and distension generates panting. Medical texts state that if panting precedes distension, the pathology is in the Lung; if distension precedes panting, the pathology is in the Spleen. This is a definitive conclusion. *Jin Gui Yao Lue* classifies Feng Shui (Wind Edema), Pi Shui (Skin Edema), Shi Shui (Stone Edema), Zheng Shui (Regular Edema), and Huang Han (Yellow Sweat) to distinguish between exterior and interior treatments. Liu Hejian proposed San Jiao Fen Xiao (Separate Elimination via the Three Burners), and Zhang Hezi advocated Mo Ji Zhu Shui (Grinding Accumulations and Driving Out Water), both containing profound principles. Students must ponder and recognize these deeply; they cannot be summarized here. Reading recent secular discussions on Water-Dampness, panting, and distension syndromes, which cite *Nei Jing*'s "Kai Gui Men" (opening the ghost gate/sweating) as exterior treatment and separating/diuresis ("Jing Jian Fu") as interior treatment: *Su Wen - Bing Neng Pian* states that all dampness, swelling, and fullness belong to the Spleen, advocating strengthening the Spleen and drying Dampness as a stable treatment. If this fails, practitioners are at a loss. They fail to realize that all diseases originate from Yin-Yang imbalance. Releasing the exterior and promoting urination is to circulate Jing Qi and facilitate Fu organ Qi; this is the treatment method for Yang diseases. Warming the Water Organ (Kidney) and warming the Spleen-Kidney, using tonifying formulas to drive out water, is the treatment method for Yin diseases. Treating Lung Bi requires gently opening the Upper Jiao; treating Spleen disorders must be assisted by warming and unblocking methods. If Yin-Yang and exterior-interior relationships are disordered, and Zhen Qi (True Qi) of the organs declines daily, with Yin-Yang circulation stagnant, distension will also occur. Treatment should focus on unblocking Yang Qi to achieve results. For example, Yu Yu Liang Wan from *Ju Fang*, or even when the Three Burners are mutually obstructed, Fen Xiao (separate elimination) must be used; when the intestines and stomach are blocked, Xia Duo (purging/downward draining) must be used. However, this cannot be equated with Excess-Heat in Shang Han (Cold Damage); arbitrarily administering Xing (Niter), Huang Qin (Rhubarb), Zhi Shi (Immature Bitter Orange), and Hou Po (Magnolia Bark) will disturb Yin Blood. If Taiyin Spleen Cold-Fluid and Dampness obstruct Qi, and warming/tonifying fails, and one wishes to use purgation, Gan Sui (Kansui Root) can be used in small amounts made into pills. The methods selected for treating excess syndromes are detailed in the collected references.