小儿溺血，为精窍之病，乃尿与血先后分出者也。古法主牛膝四物汤（如牛膝、木通、郁金、甘草梢、瞿麦、
当归、川芎、生地、赤芍等味）。
〔真按〕小儿溺血，固属罕见，若有此证，方用鲜生地钱半，生牛膝一钱，细木通八分，赤芍药一钱，瞿麦
穗五分，白云苓二钱，引用灯花一颗。
《经》曰∶阳之汗，以天地之雨名之。又曰∶阳加于阴，谓之汗。又曰∶心为汗。夫心之所藏，在内者为血，
在外者为汗。汗乃人之津液，存于阳者为津，存于阴者为液，发泄于外者为汗。若汗无故而出者，乃因阴阳偏胜
也。如小儿无因而汗自出者，谓之自汗。自汗属阳，有虚实之别。虚者汗出翕翕，发热恶寒，乃表虚也。汗出蒸
蒸，发热不恶寒，乃里实也。表虚者法当固表，里实者法当攻热。又有睡则汗出，觉则汗止，谓之盗汗。盗汗主
阴虚，然当分心虚不固，心火伤阴二候。心虚当补心，心热当凉血，最宜详辨，因作汗解。
小儿表虚， 自汗，古法主玉屏风散（如蜜炙黄 、防风、土炒白术等味）。
若恶寒冷，阳气虚也，古法主桂枝汤（如白芍、桂枝、炙甘草）。加炙附子，引用姜、枣。
阳明里实。蒸蒸自汗。古法主白虎汤（如 石膏、生知母、生甘草、粳米等味）以清之。
便秘者。古法主调胃承气汤（如大黄、芒硝、甘草，引用生姜）以攻之。
〔真按〕自汗一证，多由心肾两虚而得之者。然阴虚阳必凑
之，故发热而自汗。阳虚阴必凑之，故发厥而自汗。皆阴阳偏胜之见端也。小儿脏腑娇嫩，皮腠未密，或重衣浓
被，致五内生热，热搏于心，故心腋不能自存，而额汗出也。额为心之位，宜收敛心气，固心血，方以炒党参二
钱，白归身五分，另有 猪心切一薄片，共煎汤，空心服之。
若大病后，气血两虚，津液自汗，或潮热，或寒热发过之后，身凉自汗，日久令儿黄瘦，失治则变蒸疸，急
宜固其真元。方用嫩黄 一钱，炒党参八分，漂白术八分，炙甘草五分，引用龙眼肉三枚。
若脾虚泄泻自汗后，而遍身冷，有时遇泻则无汗，不泻则有汗，此为大虚之候，急用真人参三钱（无力者用
西党参三钱）。生金钱术二钱，北干姜一钱，炙甘草一钱，以挽救之。
泻止，除去干姜不用，加炙黄 一钱，同煎。
小儿自汗，上至胸，下至脐，此胃虚也，宜补胃。方用四君子汤加黄 。
小儿肺虚自汗，面唇俱白，六脉无力，盖因久嗽所致。方用四君子汤加麦芽、五味子。
小儿尿血，属于精窍部位的病变，表现为尿液与血液先后排出。古代医法主要使用牛膝四物汤（包含牛膝、木通、郁金、甘草梢、瞿麦、当归、川芎、生地、赤芍等药物）。
〔陈守真按语〕小儿尿血，确实属于罕见病症，若出现此证，处方用鲜生地一两半，生牛膝一钱，细木通八分，赤芍药一钱，瞿麦穗五分，白云苓二钱，煎药时加入灯花一颗作为药引。
《黄帝内经》说：阳气的汗出，可以用天地降雨来比喻。又说：阳气作用于阴气，就称为汗。还说：心主管汗液。心所藏之物，在内为血，在外为汗。汗是人体津液的一种，存在于体表属阳的称为津，存在于体内属阴的称为液，发泄于体外的称为汗。如果汗液无故而出，是因为阴阳偏盛所致。如小儿没有原因而自然出汗，称为自汗。自汗属于阳证，有虚证和实证的分别。虚证表现为汗出柔和（翕翕），伴有发热恶寒，这是表虚。汗出蒸蒸（大量持续），发热但不恶寒，这是里实证。表虚证治法应当固护肌表，里实证治法应当攻逐热邪。又有睡觉时出汗，醒来后汗止，称为盗汗。盗汗主因是阴虚，但应当区分是心气虚弱不固，还是心火损伤阴液两种情况。心气虚当补心，心热当凉血，最宜详细辨别，因此撰写了汗解这一章节。
小儿表虚，自汗，古代医法主要使用玉屏风散（包含蜜炙黄芪、防风、土炒白术等药物）。
如果怕冷畏寒，是阳气虚衰，古代医法主要使用桂枝汤（包含白芍、桂枝、炙甘草）。加用炙附子，煎药时引用生姜、大枣。
阳明经里实证。蒸蒸自汗。古代医法主要使用白虎汤（包含石膏、生知母、生甘草、粳米等药物）以清热。
便秘者。古代医法主要使用调胃承气汤（包含大黄、芒硝、甘草，煎药时引用生姜）以攻下。
〔陈守真按语〕自汗这一病症，多由心肾两虚引起。然而阴虚则阳气必凑集于外，所以发热而自汗。阳虚则阴气必凑集于内，所以发厥逆而自汗。这都是阴阳偏盛的初期表现。小儿脏腑娇嫩，皮肤腠理不紧密，或者穿衣过厚盖被过重，导致五脏内生热，热邪搏结于心，所以心气和心血不能自持，而出现额头出汗。额头是心的部位，宜收敛心气，固摄心血，方剂用炒党参二钱，白归身五分，另取猪心切一片，共同煎汤，空腹服用。
如果在大病之后，气血两虚，津液随汗外泄，或出现潮热，或寒热发作过后，身体凉爽却自汗，日久会导致小儿面色萎黄消瘦，若不及时治疗则会变成蒸疸，急需固护真元。方剂用嫩黄芪一钱，炒党参八分，漂白术八分，炙甘草五分，煎药时引用龙眼肉三枚。
如果是脾虚泄泻自汗后，全身发冷，有时腹泻时无汗，不腹泻时有汗，这是大虚的证候，急用人参三钱（体质弱者用西党参三钱），生金钱术二钱，北干姜一钱，炙甘草一钱，以挽救病情。
腹泻停止后，去掉干姜不用，加用炙黄芪一钱，共同煎煮。
小儿自汗，从上至胸部，下至肚脐，这是胃虚，宜补胃。方剂用四君子汤加黄芪。
小儿肺虚自汗，面色嘴唇均苍白，六脉无力，大概是因为久咳所致。方剂用四君子汤加麦芽、五味子。
Pediatric hematuria (blood in urine) is a disease of the essence orifice, characterized by the sequential discharge of urine and blood. Ancient methods primarily utilized Niuxi Siwu Tang (Cowherb and Four Substances Decoction), containing herbs such as Achyranthis Bidentatae Radix (Niuxi), Akebiae Caulis (Mutong), Curcumae Aromaticae Rhizoma (Yujin), Glycyrrhizae Radix et Rhizoma caulis (Gancao Shao), Dianthi Herba (Qumai), Angelicae Sinensis Radix (Danggui), Ligustici Chuanxiong Rhizoma (Chuanxiong), Rehmanniae Radix (Shengdi), and Paeoniae Radix Rubra (Chishao).
[Commentary by Chen Shouzhen] Pediatric hematuria is indeed rare; if this syndrome occurs, the prescription uses fresh Rehmanniae Radix (Sheng Dihu) 1.5 qian, raw Achyranthis Bidentatae Radix (Sheng Niuxi) 1 qian, fine Akebiae Caulis (Xi Mutong) 8 fen, Paeoniae Radix Rubra (Chishao) 1 qian, Dianthi Spica (Qumai Sui) 5 fen, Poria Cocos with White Bark (Bai Yunling) 2 qian, using one flower of the lamp wick (Denghua) as an adjuvant.
The *Classic* states: The sweating of Yang Qi can be named after the rain of heaven and earth. It also states: When Yang acts upon Yin, it is called sweat. Furthermore: The Heart governs sweat. What the Heart stores internally is Blood, and externally it manifests as sweat. Sweat is the body's Jin-Ye (body fluids); those existing in the Yang aspect are termed Jin (thin fluids), those in the Yin aspect are termed Ye (thick fluids), and those excreted to the exterior are termed sweat. If sweat emerges without cause, it is due to the excess of either Yin or Yang. For instance, when children sweat spontaneously without reason, it is called spontaneous sweating (Zihan). Spontaneous sweating belongs to Yang syndromes and has distinctions between deficiency and excess. Deficiency presents with mild sweating (Xixi), fever, and aversion to cold, indicating Exterior Deficiency. Excessive sweating (Zhengzheng), fever without aversion to cold, indicates Interior Excess. The treatment for Exterior Deficiency should focus on consolidating the Exterior, while the treatment for Interior Excess should focus on purging Heat. There is also night sweating (Daohan), where sweating occurs during sleep and stops upon waking. Night sweating is primarily due to Yin deficiency, but one must distinguish between two patterns: Heart Qi deficiency failing to secure, and Heart Fire damaging Yin. Heart deficiency requires tonifying the Heart, while Heart heat requires cooling the Blood. These must be carefully differentiated; thus, this chapter on resolving sweat is composed.
For pediatric Exterior Deficiency with spontaneous sweating, ancient methods primarily used Yupingfeng San (Jade Windscreen Powder), containing honey-fried Astragali Radix (Huangqi), Saposhnikoviae Radix (Fangfeng), and earth-fried Atractylodis Macrocephalae Rhizoma (Baizhu).
If there is aversion to cold and fear of cold, it indicates Yang Qi deficiency; ancient methods primarily used Guizhi Tang (Cinnamon Twig Decoction), containing Paeoniae Radix Alba (Baishao), Cinnamomi Ramulus (Guizhi), and honey-fried Glycyrrhizae Radix et Rhizoma (Zhigancao). Add honey-fried Aconiti Lateralis Radix Praeparata (Fu Zi), using ginger and jujube as adjuvants.
For Yangming Interior Excess with excessive spontaneous sweating, ancient methods primarily used Baihu Tang (White Tiger Decoction), containing Gypsum Fibrosum (Shigao), Anemarrhenae Rhizoma (Zhimu), raw Glycyrrhizae Radix et Rhizoma (Gancao), and Oryza Sativa (Jingmi), to clear Heat.
In cases of constipation, ancient methods primarily used Tiaowei Chengqi Tang (Regulate the Stomach and Direct Downward Decoction), containing Rhei Radix et Rhizoma (Dahuang), Natrii Sulfas (Mangxiao), Glycyrrhizae Radix et Rhizoma (Gancao), using fresh Zingiberis Rhizoma Recens (Shengjiang) as an adjuvant, to purge accumulation.
[Commentary by Chen Shouzhen] The syndrome of spontaneous sweating often arises from dual deficiency of the Heart and Kidney. However, if Yin is deficient, Yang inevitably congregates externally, causing fever and spontaneous sweating. If Yang is deficient, Yin inevitably congregates internally, causing cold extremities (Jue) and spontaneous sweating. These are initial signs of Yin-Yang imbalance. Children have delicate Zang-Fu organs and loose skin pores. Overdressing or heavy bedding can cause internal heat in the five Zang organs. This heat combats the Heart, causing Heart Qi and Heart Blood to fail to remain within, resulting in sweating on the forehead. The forehead is the seat of the Heart; thus, it is appropriate to consolidate Heart Qi and secure Heart Blood. The prescription uses stir-fried Codonopsis Radix (Dangshen) 2 qian, white Angelicae Sinensis Radix root section (Baiguishen) 5 fen, along with one thin slice of porcine heart, decocted together to take on an empty stomach.
After a severe illness, if both Qi and Blood are deficient, leading to spontaneous sweating of body fluids, tidal fever, or spontaneous sweating after the resolution of alternating chills and fever, prolonged neglect will cause the child to become sallow and emaciated. Untreated, it may transform into Zhengdan (steaming jaundice). It is urgent to consolidate the True Yuan. The prescription uses tender Astragali Radix (Huangqi) 1 qian, stir-fried Codonopsis Radix (Dangshen) 8 fen, bleached Atractylodis Macrocephalae Rhizoma (Baizhu) 8 fen, and honey-fried Glycyrrhizae Radix et Rhizoma (Zhigancao) 5 fen, using three longan arils (Longyanrou) as an adjuvant.
Following spontaneous sweating after spleen-deficiency diarrhea, if the whole body becomes cold, and there is no sweating during diarrhea but sweating when not having diarrhea, this is a sign of severe deficiency. Urgently use genuine Ren Shen 3 qian (or Western Codonopsis Radix [Xidangshen] 3 qian if strength is lacking), raw Atractylodis Macrocephalae Rhizoma (Jinqianshu) 2 qian, dried northern Zingiberis Rhizoma (Ganjiang) 1 qian, and honey-fried Glycyrrhizae Radix et Rhizoma (Zhigancao) 1 qian to rescue the condition.
Once diarrhea ceases, remove the dried ginger and add honey-fried Astragali Radix (Huangqi) 1 qian, decocting together.
If a child's spontaneous sweating extends from the chest down to the umbilicus, this indicates Stomach deficiency, suitable for tonifying the Stomach. The prescription uses Sijunzi Tang (Four Gentlemen Decoction) plus Huangqi.
For pediatric Lung deficiency with spontaneous sweating, presenting with pale face and lips and weak pulses in all six positions, likely caused by chronic coughing, the prescription uses Sijunzi Tang (Four Gentlemen Decoction) plus Hordei Fructus Germinatus (Maiya) and Schisandrae Chinensis Fructus (Wuweizi).