小儿血淋，因心热伤于血分，热气传入于胞，日久则尿血同出，遂成血淋，茎中不时作痛，古法主小蓟子饮
（如通草、滑石、淡竹叶、当归、小蓟、炒栀子、生甘草、蒲黄、藕节等味，水煎空心服）。
若茎中痛甚者，古法主五淋散（如当归、赤芍、苦葶苈、炒黄芩、木通、栀子、车前子、淡竹叶、滑石、葵
子、生甘草、赤茯苓，引用葱白）。
〔真按〕小儿血淋，必有瘀血蓄于茎中、割痛难忍，急用通则不痛之法，方以鲜生地三钱，白归身五分，赤芍
药钱半，鲜竹叶二十片，滑石块三钱，车前子八分，引用真西琥珀五分。
《经》曰∶身痛而色微黄，齿垢黄，耳目上黄，黄胆也。又曰∶溺黄赤安卧者曰黄胆，已食如饥者曰胃疸。
古人论小儿黄胆一证，皆云湿热郁久，外发肌肤，其候遍身面目皆黄，甚则深黄，面如烟熏之状，其中又有阴阳
之别。如面红口渴，尿赤色亮身热者，乃脾家湿热，此阳黄也；口不渴而色暗黄，身冷如冰者，乃脾肾寒湿，此
阴黄也。
阴阳既有差别，惟阳黄又宜分表里，阴黄又宜分脾肾，此古人立论如此。然究其实，则小儿因湿热发黄者少，
因脾虚发黄者多。盖脾土强者，足以捍御湿热，必不生黄；惟有脾虚不运，所以湿热乘之。此正理也，因作黄胆解。
小儿阳黄一证，原因湿热而成，表实无汗者，古法主茵陈麻黄汤，外发其汗（如茵陈蒿、麻黄二味，水煎加
黄酒少许服之，使黄从表解也）。
里实二便秘涩，腹满者，古法主茵陈蒿汤（如茵陈蒿、川大黄、栀子，引用灯芯），使黄从里解也。
若表有汗，里不便秘腹满，是表里无证，不可汗下，古法主茵陈五苓散（如茵陈蒿、赤苓、猪苓、泽泻、土
炒白术、肉桂，引用灯芯），使黄从水道利之则愈。
〔真按〕阳黄证因湿多成热，热则生黄，故谓之湿热证，必见身热烦渴，或躁扰不宁，或消谷善饥，或小便热
痛，或大便秘结，其脉实而有力，此证不拘外感风湿、内伤饮食，皆能致之。
但察儿之元气尚强，脾胃无损，而湿热果盛者，则宜清火邪，利小便。方用生野术一钱，炒野术一钱，川浓朴一
钱，白茯苓二钱，结猪苓钱半，宣泽泻钱半，茵陈蒿钱半，黑栀子八分，生黄柏八分，炙甘草五分。
若大便秘结热甚者，本方加生锦纹五分。
小儿血淋，是由于心热损伤了血分，热气传入膀胱（胞），日久之后尿液与血液一同排出，从而形成血淋，尿道中不时感到疼痛。古法主要采用小蓟饮子（包含通草、滑石、淡竹叶、当归、小蓟、炒栀子、生甘草、蒲黄、藕节等药材，用水煎煮，空腹服用）。如果尿道疼痛剧烈，古法主要采用五淋散（包含当归、赤芍、苦葶苈、炒黄芩、木通、栀子、车前子、淡竹叶、滑石、葵子、生甘草、赤茯苓，以葱白为引药）。
〔陈守真按〕小儿血淋，必然有瘀血蓄积在尿道中，刺痛难忍，急需运用“通则不痛”的治疗原则。方剂使用鲜生地三钱，白归身五分，赤芍药一钱半，鲜竹叶二十片，滑石块三钱，车前子八分，以真西琥珀五分为引药。
《黄帝内经》说：身体疼痛且面色微黄，牙齿垢腻发黄，耳部和目眦发黄，这是黄胆病。又说：小便黄赤且嗜睡的是黄胆病，吃完饭却感觉像饿了一样的是胃疸病。古人论述小儿黄胆这一病症，都说这是因为湿热郁结日久，外发于肌肤，症状表现为全身和面目都发黄，严重的甚至深黄，面色像被烟熏过一样，其中又有阳黄和阴黄的区别。如面色红、口渴、尿色赤亮、身体发热，这是脾脏的湿热，属于阳黄；口不渴且面色暗黄、身体冷如冰，这是脾肾寒湿，属于阴黄。
既然阴阳有区别，那么阳黄又适宜区分表证和里证，阴黄又适宜区分脾证和肾证，这是古人立论的方式。然而究其实际，小儿因湿热导致发黄的较少，因脾虚导致发黄的较多。因为脾土强健，足以抵御湿热，必定不会发黄；只有脾虚不能运化，所以湿热趁机侵袭。这才是正确的道理，因此撰写黄胆解。
小儿阳黄这一病症，原因是湿热所致。表实无汗的，古法主要采用茵陈麻黄汤，通过发汗使邪气从体表解除（如茵陈蒿、麻黄两味药，用水煎煮，加入少许黄酒服用，使黄色从表而解）。里实二便不通涩滞、腹部胀满的，古法主要采用茵陈蒿汤（如茵陈蒿、川大黄、栀子，以灯芯为引药），使黄色从体内解除。如果有表证但已有汗出，里没有便秘腹满，说明表里均无实证，不可使用发汗或攻下法，古法主要采用茵陈五苓散（如茵陈蒿、赤茯苓、猪苓、泽泻、土炒白术、肉桂，以灯芯为引药），使黄色通过水道利出则痊愈。
〔陈守真按〕阳黄证是因为湿气多转化为热，热则产生黄疸，所以称为湿热证，必然出现身体发热烦躁口渴，或者躁动不安，或者食欲旺盛容易饥饿，或者小便热痛，或者大便秘结，脉象实而有力。此证不论是由外感风湿还是内伤饮食引起，都能导致此病。
只要观察患儿元气尚强，脾胃没有受损，且湿热确实旺盛的，就应当清泻火邪，通利小便。方剂使用生野术一钱，炒野术一钱，川厚朴一钱，白茯苓二钱，结猪苓一钱半，宣泽泻一钱半，茵陈蒿一钱半，黑栀子八分，生黄柏八分，炙甘草五分。如果大便秘结且热势严重的，在本方基础上加生锦纹五分。
Pediatric hematuria (blood strangury) arises from heart heat injuring the blood level, with heat qi transmitting to the bladder. Over time, urine and blood are excreted together, forming hematuria, accompanied by intermittent pain in the urethra. Ancient methods primarily prescribe Xiaojizi Yin (Little Thistle Seed Decoction), containing Tongcao, Huashi, Dan Zhuye, Danggui, Xiaoji, Chao Zhizi, Sheng Gancao, Puhuang, Ou Jie, etc., decocted in water and taken on an empty stomach. If the pain in the urethra is severe, ancient methods primarily prescribe Wulin San (Five Stranguries Powder), containing Danggui, Chishao, Ku Tingli, Chao Huangqin, Mutong, Zhizi, Cheqianzi, Dan Zhuye, Huashi, Kuizi, Sheng Gancao, Chifuling, with Congbai (green onion white) as a guide drug.
[Chen Shouzhen's Note] Pediatric hematuria must involve blood stasis accumulating in the urethra, causing unbearable stabbing pain. Urgently apply the principle of "patency relieves pain." The prescription uses Xianshengdi (fresh Rehmanniae Radix) 3 qian, Baiguishen (white Angelicae Sinensis Radix) 5 fen, Chishaoyao (red Peony Root) 1.5 qian, Xian Zhuye (fresh bamboo leaf) 20 pieces, Huashikuai (talcum stone chunks) 3 qian, Cheqianzi (Plantago Seed) 8 fen, with Zhen Xi Hupo (genuine Western Amber) 5 fen as a guide drug.
The *Classic* states: "Body pain with slightly yellow complexion, yellow dental plaque, yellow ears and eyes indicates jaundice." It also says: "Yellow-red urine with lethargy is called jaundice; feeling hungry after eating is called gastric jaundice." Ancients discussed pediatric jaundice, stating it results from long-term stagnation of damp-heat erupting onto the skin and muscles. Symptoms include yellowing of the whole body and face, sometimes deep yellow with a soot-like appearance. There is a distinction between yin and yang jaundice. A red face, thirst, bright red urine, and fever indicate spleen damp-heat, which is yang jaundice. Lack of thirst, dark yellow complexion, and cold body like ice indicate spleen-kidney cold-dampness, which is yin jaundice.
Since yin and yang differ, yang jaundice should be differentiated into exterior and interior syndromes, while yin jaundice should be differentiated into spleen and kidney syndromes, as per ancient theories. However, in reality, few children develop jaundice due to damp-heat; most do so due to spleen deficiency. Strong spleen earth can defend against damp-heat, preventing jaundice; only when the spleen is deficient and fails to transport does damp-heat invade. This is the correct principle, hence this treatise on jaundice.
Pediatric yang jaundice is caused by damp-heat. For exterior excess with no sweat, ancient methods prescribe Yinchin Mahuang Tang (Artemisiae Scopariae and Ephedra Decoction) to induce sweating and release pathogens from the exterior (Yinchenhao and Mahuang decocted in water with a little yellow wine, allowing the jaundice to resolve via the surface). For interior excess with constipation and abdominal fullness, ancient methods prescribe Yinchin Hao Tang (Artemisiae Scopariae and Rhubarb Decoction) to resolve jaundice from the interior (Yinchenhao, Chuan Dahuang, Zhizi, with Dengxin as a guide drug). If there is sweating at the exterior but no constipation or abdominal fullness at the interior, indicating no exterior-interior excess syndrome, sweating or purging methods are contraindicated. Ancient methods prescribe Yinchin Wuling San (Artemisiae Scopariae and Five-Ingredient Powder with Poria Decoction) to promote urination and resolve jaundice through the water passages (Yinchenhao, Chiling, Zhuling, Zexie, Tu Chao Baizhu, Rougui, with Dengxin as a guide drug).
[Chen Shouzhen's Note] Yang jaundice occurs when dampness transforms into heat, producing jaundice, thus termed damp-heat syndrome. Symptoms necessarily include fever, irritability, and thirst, or restlessness, or polyphagia, or hot painful urination, or constipation, with a solid and forceful pulse. This syndrome can result from external wind-damp invasion or internal dietary injury.
If the child's yuan qi is strong, the spleen and stomach are undamaged, and damp-heat is indeed excessive, one should clear fire pathogens and promote urination. The prescription uses Sheng Yezhu (raw wild Atractylodes) 1 qian, Chao Yezhu (fried wild Atractylodes) 1 qian, Chuan Nongpu (Sichuan Magnolia Bark) 1 qian, Bai Fuling (white Poria) 2 qian, Jie Zhuling (knot Polyporus) 1.5 qian, Xuan Zexie (prepared Alisma) 1.5 qian, Yinchenhao 1.5 qian, Hei Zhizi (black Gardenia) 8 fen, Sheng Huangbai (raw Phellodendron) 8 fen, Zhi Gancao (honey-fried Licorice) 5 fen. If there is severe constipation and heat, add Sheng Jinwen (raw Rheum) 5 fen to this formula.