钱仲阳云∶小儿正伤寒者，谓感冒寒邪，壮热头痛，鼻塞流涕，畏寒拘急是也。夹惊者，因
惊而又感寒邪，或因伤寒热极生风，是热乘于心，心神易动，故发搐也。用薄荷散、人参羌
活散之类解之，甚者，抱龙丸。夹食者，或先伤于风寒，后复停滞饮食，或先停滞饮食，而
后伤于风寒，以致发热，气粗嗳气，壮热头疼，腹胀作痛，大便酸臭，先用解散，次与消导
；不解者，用大柴胡汤。周岁已前伤寒热轻者，用惺惺散；周岁已后，须解表微汗。若五六
日不除，邪入于经络，传变多端，不可枚举。若夫荣卫俱伤者，羌活冲和汤主之，过此则少
阳、阳明二经，在于半表半里肌肉之间，脉不浮沉。外症在阳明，则目疼鼻干，不得眠，脉
洪而长，以葛根解肌升麻等汤治之。在少阳，则耳聋脉弦数，小柴胡汤加减和之。若少阳阳
明俱病，小柴胡加葛根、芍药，传入阳明，为里脉沉实，谵妄恶热，六七日不大便，口燥咽
干而渴。用大柴胡汤，重则三一承气汤，若兼三焦俱病，则痞满燥实，宜大承气汤。三阳之
邪在里为患，不头痛恶寒而反渴，此为温病，当遵仲景法治之。其余正伤寒症，治自有专方
，不复赘论。其兼惊兼食者，各从本症治之。
治验（散见各证）
抱龙丸 治伤风瘟疫，身热气粗，痰实壅嗽，常服安神镇惊，亦治痘疹壮热。
牛胆南星（一两） 天竺黄 雄黄 辰砂（二钱） 麝香（少许）
上为末，煮甘草汁丸，樱桃大阴干，每服一丸，薄荷汤下，气喘有痰加枯矾。
愚按∶前方若风热痰嗽，或急惊发搐，昏睡切牙，形病俱实，宜用此方。若初冒风寒，咳嗽
痰盛气喘者，属客邪内作，先用十味参苏饮。客邪既解，而腹胀吐泻，发搐切牙，睡而露睛
，属脾肺气虚，用五味异功散，切忌祛痰表散。若过服克伐之剂，以致前症者，尤宜温补脾
肺。
红绵散 治伤风咳嗽，鼻塞或流清涕。
全蝎（五个） 麻黄（去节） 僵蚕 白芷 川芎 桔梗 天麻（各二钱） 甘草 苏木
上为末，每服一钱，加红绵少许，水煎，有热加荆芥。
葛根解肌渴 治发热恶寒，头痛项强，伤寒温病。
葛根（四分） 桂（一分） 黄芩 甘草 白芍药（各三分） 麻黄（二分）
上姜枣水煎服。
三乙承气汤 治脏腑积热，痞满燥实坚胀。
甘草 枳实（麸炒） 浓朴（姜制） 大黄 芒硝（各等分）
上姜水煎服。
升麻汤 治小儿中风头痛，增寒壮热，肢体疼痛，鼻干不得眠。兼治疮症，已发未发皆可服
。
甘草 白芍药 升麻 干葛（各等分）
上为末，每服一钱，水煎服。
小柴胡汤
大承气汤
大柴胡汤（三方见痉症）
惺惺散（方见咳嗽）
葛根解肌汤
抱龙丸（二方见伤寒）
薄荷汤（方见瘰 ）
人参羌活散（方见惊风）
钱仲阳说：小儿患正伤寒，是指感受寒邪，出现高热、头痛、鼻塞流涕、怕冷且身体拘急不舒的症状。夹惊者，是因为受到惊吓后又感染了寒邪，或者因为伤寒热极生风，热气侵犯心脏，心神容易动荡，所以发生抽搐。治疗用薄荷散、人参羌活散之类来解表，病情严重的，用抱龙丸。夹食者，或者是先受了风寒，后来饮食停滞，或者是先有饮食停滞，后来又受了风寒，导致发热、气粗、嗳气、高热头痛、腹胀疼痛、大便酸臭。治疗先用解表药，再用消导药；如果表证不解，用大柴胡汤。周岁以内的婴儿患伤寒且热势较轻的，用惺惺散；周岁以上的，需要解表并令其微微出汗。如果五六天病邪仍未去除，邪气进入经络，传变情况多种多样，无法一一列举。如果是营卫俱伤的情况，用羌活冲和汤主治。过了这个阶段，就是少阳经和阳明经的病证，病位在半表半里的肌肉之间，脉象既不浮也不沉。外症表现在阳明经的，会出现眼睛疼痛、鼻干、失眠，脉象洪大而长，用葛根解肌升麻等方剂治疗。表现在少阳经的，会出现耳聋、脉弦数，用小柴胡汤加减调和。如果少阳和阳明两经同时发病，用小柴胡汤加葛根、芍药。邪气传入阳明经，成为里证，脉象沉实，出现胡言乱语、怕热，六七天不大便，口燥咽干而渴。用大柴胡汤，病情重的用三一承气汤。如果兼有三焦都生病的情况，出现痞满燥实，宜用大承气汤。三阳经的邪气在体内为患，不头痛恶寒反而口渴，这是温病，应当遵循张仲景的方法治疗。其余的正伤寒症状，治疗自有专门的方剂，不再赘述。那些兼夹惊风和夹食的，分别按照各自的病症治疗。
治验（散见于各证候）
抱龙丸：治疗伤风瘟疫，身热气粗，痰实壅盛咳嗽，常服可安神镇惊，也治疗痘疹高热。
配方：牛胆南星（一两）、天竺黄、雄黄、辰砂（二钱）、麝香（少许）。
制法与用法：以上药物研成细末，煮甘草汁为丸，如樱桃大小，阴干。每次服用一丸，用薄荷汤送下，若气喘有痰，加入枯矾。
按语：前面的方子如果用于风热痰嗽，或急惊风发作抽搐，昏睡磨牙，形体和病邪都属实证，适宜使用此方。如果是初感风寒，咳嗽痰多气喘的，属于客邪内作，先用十味参苏饮。客邪解除后，如果出现腹胀吐泻、抽搐磨牙、睡觉时眼睛露白，属于脾肺气虚，用五味异功散，切忌使用祛痰解表的药物。如果过服攻伐的药物，导致上述症状的，尤其应该温补脾肺。
红绵散：治疗伤风咳嗽，鼻塞或流清涕。
配方：全蝎（五个）、麻黄（去节）、僵蚕、白芷、川芎、桔梗、天麻（各二钱）、甘草、苏木。
制法与用法：以上药物研成细末，每次服用一钱，加入少许红绵，用水煎服，若有热象，加入荆芥。
葛根解肌渴：治疗发热恶寒，头痛项强，伤寒温病。
配方：葛根（四分）、桂（一分）、黄芩、甘草、白芍药（各三分）、麻黄（二分）。
制法与用法：以上药物用生姜和大枣水煎服。
三乙承气汤：治疗脏腑积热，痞满燥实坚胀。
配方：甘草、枳实（麸炒）、浓朴（姜制）、大黄、芒硝（各等分）。
制法与用法：以上药物用姜水煎服。
升麻汤：治疗小儿中风头痛，增寒壮热，肢体疼痛，鼻干不得眠。兼治疮症，无论已发未发皆可服用。
配方：甘草、白芍药、升麻、干葛（各等分）。
制法与用法：以上药物研成细末，每次服用一钱，用水煎服。
小柴胡汤
大承气汤
大柴胡汤（三方见痉症章节）
惺惺散（方见咳嗽章节）
葛根解肌汤
抱龙丸（二方见伤寒章节）
薄荷汤（方见瘰疬章节）
人参羌活散（方见惊风章节）
Qian Zhongyang stated: "Zheng Shanghan (True Cold Damage) in children refers to contracting cold pathogenic factors, manifesting as high fever, headache, nasal congestion with runny nose, aversion to cold, and physical stiffness." Jia Jing (Accompanying Fright) occurs due to contracting cold after a fright, or because extreme heat from Shanghan generates wind; the heat affects the Heart, causing the Shen (Spirit) to become unstable, leading to convulsions. Treatment involves using Bohe San (Mint Powder) or Renshen Qianghuo San (Ginseng and Nephrolepis Decoction) to resolve the exterior; for severe cases, Baolong Wan (Embrace Dragon Pill) is used. Jia Shi (Accompanying Food Stagnation) occurs either when one first contracts wind-cold and then suffers from food stagnation, or when food stagnation exists first and is followed by wind-cold contraction, resulting in fever, coarse breathing, belching, high fever, headache, abdominal distension and pain, and sour-smelling stools. Initially, use exterior-resolving methods, followed by digestion-promoting methods; if the exterior is not resolved, Da Chai Hu Tang (Major Bupleurum Decoction) is used. For infants under one year old with mild heat in Shanghan, Xingxing San (Sparkling Powder) is used; for those over one year old, exterior resolution with slight sweating is required. If the pathogen persists for five to six days without relief, it enters the meridians, leading to diverse transformations that cannot be exhaustively listed. In cases where both Ying (Nutritive Qi) and Wei (Defensive Qi) are injured, Qianghuo Chonghe Tang (Notopterygium Harmonizing Decoction) is the primary treatment. Beyond this stage, the Shaoyang (Lesser Yang) and Yangming (Yang Brightness) meridians are involved, located between the exterior and interior within the muscle layer, presenting with pulses that are neither floating nor sinking. Exterior symptoms manifesting in the Yangming meridian include eye pain, dry nose, insomnia, and a洪 (Surging) and long pulse; these are treated with Gegen Jiemi Shengma Tang (Kudzu Root Muscle-Relieving and Cimicifuga Decoction). Manifestations in the Shaoyang meridian include deafness and a弦 (Wiry) rapid pulse, treated with Xiaochai Hu Tang (Minor Bupleurum Decoction) with modifications. If both Shaoyang and Yangming meridians are diseased, Xiaochai Hu Tang is modified with Gegen (Kudzu Root) and Shaoyao (Peony Root). When the pathogen transmits into the Yangming interior, presenting with a沉 (Deep) solid pulse, delirium, aversion to heat, constipation for six to seven days, dry mouth, parched throat, and thirst, Da Chai Hu Tang is used. For severe cases, Sanyi Chengqi Tang (Three-One Bowel-Purging Decoction) is indicated. If all three Jiao (Sanjiao/Upper, Middle, Lower Burners) are affected, presenting with fullness, obstruction, dryness, and solidity, Dachengqi Tang (Major Bowel-Purging Decoction) is appropriate. When pathogens of the Three Yang meridians cause internal disorders, characterized by absence of headache and aversion to cold but presence of thirst, this is classified as Wenbing (Warm Disease), and treatment should follow Zhang Zhongjing's methods. Other Zheng Shanghan symptoms have specific formulas, so they will not be reiterated. Cases involving both Jing and Shi should be treated according to their respective primary syndromes.
Clinical Experiences (Scattered across various syndromes)
Baolong Wan: Treats wind-cold epidemic fevers, body heat, coarse breathing, phlegm-solidity obstructing cough, and serves as a daily tonic for calming the Spirit and subduing fright; also treats high fever during smallpox/rash diseases.
Ingredients: Niudan Nanting (Cow Gallbladder Rhizoma Arisaematis, 1 liang), Tianzhu Huang (Calamush Sclerotium), Xionghuang (Realgar), Chensha (Cinnabar, 2 qian), Shexiang (Moschus, a small amount).
Preparation and Administration: Grind into powder, boil Gancao (Licorice Root) juice to form pills the size of cherries, dry in shade. Take one pill per dose with Bohe Tang (Mint Decoction); add Kufan (Alum) if there is wheezing with phlegm.
Commentary: The aforementioned formula is suitable for wind-heat phlegm-cough or acute infantile convulsions with drowsiness and teeth-grinding, where both the constitution and pathogen are excess patterns. If initially exposed to wind-cold with profuse phlegm cough and wheezing, it belongs to exogenous pathogens acting internally; use Shimwei Renshen Suyu Yin (Ten-Ingredient Ginseng and Perilla Infusion) first. Once the exogenous pathogen is resolved, if abdominal distension, vomiting, diarrhea, convulsions, teeth-grinding, and sleeping with eyes open occur, it indicates Spleen and Lung Qi deficiency; use Wuwei Yigong San (Five-Ingredient Yi Gong Powder). Avoid phlegm-resolving and exterior-releasing drugs. If previous symptoms result from excessive use of draining agents, warming and tonifying the Spleen and Lung is especially indicated.
Hongmian San: Treats wind-cold cough, nasal congestion, or clear rhinorrhea.
Ingredients: Quanxie (Whole Scorpion, 5 units), Mahuang (Ephedrae Herba, nodes removed), Jiangcan (Bombyx Batryticatus), Baizhi (Angelicae Dahuricae Radix), Chuanxiong (Ligustici Chuanxiong Rhizoma), Jiegeng (Platycodonis Radix), Tianma (Gastrodiae Rhizoma, each 2 qian), Gancao (Licorice Root), Sumu (Sappan Wood).
Preparation and Administration: Grind into powder. Take 1 qian per dose, add a small amount of Hongmian (Red Cotton Silk), decoct with water. Add Jingjie (Schizonepetae Herba) if heat signs are present.
Gegen Jiemi Ke: Treats fever with aversion to cold, headache and neck stiffness, Shanghan and Wenbing.
Ingredients: Gegen (Puerariae Lobatae Radix, 4 fen), Gui (Cinnamomi Ramulus, 1 fen), Huangqin (Scutellariae Radix), Gancao (Licorice Root), Baishaoyao (Paeoniae Radix Alba, each 3 fen), Mahuang (Ephedrae Herba, 2 fen).
Preparation and Administration: Decoct with Shengjiang (Zingiberis Rhizoma Recens) and Dazao (Jujubae Fructus) and water.
Sanyi Chengqi Tang: Treats accumulated heat in Zang-Fu organs, presenting with epigastric fullness, obstruction, dryness, solidity, hardness, and distension.
Ingredients: Gancao (Licorice Root), Zhishi (Aurantii Fructus Immaturus, bran-fried), Houpo (Magnoliae Officinalis Cortex, ginger-processed), Dahuang (Rhei Radix et Rhizoma), Mangxiao (Natrii Sulfas, equal parts).
Preparation and Administration: Decoct with Shui (Water) and Shengjiang (Zingiberis Rhizoma Recens).
Shengma Tang: Treats pediatric wind-stroke headache, increased chills and high fever, limb pain, dry nose, and insomnia. Also treats skin sores/rashes; can be taken regardless of whether the rash has erupted or not.
Ingredients: Gancao (Licorice Root), Baishaoyao (Paeoniae Radix Alba), Shengma (Cimicifugae Rhizoma), Gange (Puerariae Lobatae Radix, equal parts).
Preparation and Administration: Grind into powder. Take 1 qian per dose, decoct with water.
Xiaochai Hu Tang (Minor Bupleurum Decoction)
Dachengqi Tang (Major Bowel-Purging Decoction)
Da Chai Hu Tang (Major Bupleurum Decoction) [See Convulsion Syndrome chapter]
Xingxing San (Sparkling Powder) [See Cough chapter]
Gegen Jiemi Tang (Kudzu Root Muscle-Relieving Decoction)
Baolong Wan (Embrace Dragon Pill) [See Shanghan chapter]
Bohe Tang (Mint Decoction) [See Scrofula chapter]
Renshen Qianghuo San (Ginseng and Nephrolepis Powder) [See Infantile Convulsion chapter]