小儿表症。谓外感风寒。其见证必先发热。然发热之证有三。最宜详辨。不可一概混同
也。其在冬月感于寒者。头痛。身痛。项背强。恶寒。壮热无汗。脉浮而紧。此太阳表证。
药得法。一汗即解。详见实论。其感于风者。头痛鼻塞。流涕。发热。或有汗恶风。或无汗
恶寒。或咳嗽干呕。脉浮而数。或紧。此四时之感冒是也。治法不可大发散。微表之即已
如易简参苏饮。惺惺散之类主之。大抵近日人情。爱护小儿者众。富贵之家。重衣浓褥。贫
贱之子亦皆衣絮。以致汗液不断。腠理疏泄。偶触微风。即成感冒。是以迩来小儿。冬月
感寒之症。百无一二。而伤风发热之症恒多也。至若内因于虚。发热之症极多。最为疑似。
人殊不知。更宜详辨。如阳虚生寒。阴虚发热。血虚发躁而热。气虚自汗不能食而热。气虚
注夏而热。暑湿合病而热。汗后阴虚。阳无所附而热。汗后阳虚。阴无所附而热。阳气下入
阴中。昼安静。夜烦躁而热。重阳无阴。夜安静。昼烦躁而热。以上诸症。同一发热也。若
误表之必死。其次则又有变蒸之热。将发痘疹之热。亦同一发热也。而援守各异。每见庸
医。一遇发热。动皆表散。殊不知病有微甚。热有虚实。虽同一发热。而治法殊途。攻补迥
。业幼科者。于临症之际。务宜细心体认。必先问其病之新久。曾未服药。以及一切爱恶
状。然后再察其热之温壮。形之强弱。脉之虚实。色之夭泽。合四者以决之。庶无误人于夭
札也。盖外感为暴病。其发热也骤。必手背热。脉浮。身热无汗。仍须分别虚实以治之。详
见虚实门。若无手背热脉浮身热无汗等症。或发热已久。则非外感证矣。治者审焉。
小儿的表证，是指外感风寒邪气。其临床表现必然先出现发热症状。然而，发热的病证有三种情况，最应当仔细辨别，不可一概而论、混同处理。
如果在冬季感受寒邪，会出现头痛、身体疼痛、项背部僵硬拘急、恶寒、高热且无汗、脉象浮而紧的症状。这是太阳表证。如果用药得当，通过发汗即可解除病邪。详细内容参见“实论”章节。
如果是感受风邪，会出现头痛、鼻塞、流鼻涕、发热，或者伴有出汗且怕风，或者无汗但怕冷，或者咳嗽、干呕，脉象浮而数，或者紧。这是四季常见的感冒病症。治疗方法不可使用过于猛烈的发散药物，只需轻微解表即可痊愈。例如使用易简参苏饮、惺惺散等方剂为主进行治疗。
大抵近来人们爱护小儿的风气很盛，富贵人家给小儿穿厚重的衣服、铺厚实的褥子，贫贱人家的孩子也都穿着棉絮衣物，导致小儿汗液不断排出，腠理（皮肤毛孔）疏松泄越，偶尔接触到微风，就会形成感冒。因此近来的小儿，在冬季感受寒邪的病症，百中无一二，而伤风发热的病症却非常多见。
至于因为内在虚损导致的发热，病症极多，最为容易混淆误判，人们往往不知道这一点，更应当仔细辨别。例如：阳虚生内寒，阴虚导致发热，血虚导致烦躁而热，气虚导致自汗、不能进食而发热，气虚在夏季加重而发热，暑湿合病而发热，发汗后阴虚，阳气无所依附而发热，发汗后阳虚，阴气无所依附而发热，阳气下陷进入阴分，白天安静，夜间烦躁而发热，重阳无阴，白天安静，夜间烦躁而发热。以上这些病症，虽然都是发热，但如果误用解表法治疗，必然导致死亡。
其次又有变蒸之热（婴幼儿生长发育过程中的生理性发热），以及即将发出痘疹之前的发热，也都是表现为发热。但其病因和治法各不相同。经常见到庸医，一遇到发热就动辄使用表散药物，却不知道疾病有轻重之分，热证有虚实之别。虽然同样是发热，但治疗方法截然不同，攻补策略迥异。从事儿科的医生，在临症时务必细心体察认知，必须先询问发病的新久、是否曾服药，以及患儿的一切喜恶状态。然后再观察发热的程度、体形的强弱、脉象的虚实、面色的枯润，综合这四方面来判断决断，这样才能避免将人误治致死。
一般来说，外感属于暴病，其发热来得突然，必定表现为手背发热、脉浮、身热无汗，但仍需分别虚实来治疗。详细内容参见“虚实门”。如果没有手背热、脉浮、身热无汗等症状，或者发热时间已久，那就不是外感证了。治疗者应当审慎判断。
Pediatric exterior syndromes refer to exogenous contraction of Wind-Cold. The clinical manifestations invariably begin with fever. However, there are three types of febrile conditions that require careful differentiation; they must not be treated indiscriminately as a single entity.
If contracted in winter due to Cold pathogen, symptoms include headache, body pain, stiffness and rigidity of the neck and back, aversion to cold, high fever without sweating, and a floating and tight pulse. This is an Exterior Syndrome of the Taiyang (Greater Yang) Channel. If the medication is appropriate, the condition can be resolved through diaphoresis (sweating). For detailed information, see the "Excess Syndromes" chapter.
If contracted due to Wind pathogen, symptoms include headache, nasal congestion, rhinorrhea, fever, possibly accompanied by sweating and aversion to wind, or no sweating but aversion to cold, or cough and dry retching. The pulse may be floating and rapid, or tight. These are common colds occurring in all four seasons. The treatment method should not involve excessive dispersion; mild release of the exterior is sufficient. Formulas such as Yijian Rensu Yin (Easy-to-Use Ginseng and Perilla Decoction) and Xingxing San (Stirring Up Powder) are primarily used.
Generally speaking, recent trends show that people are overly protective of children. Wealthy families dress children in heavy clothes and thick bedding, while even poor children wear cotton-padded garments. This leads to continuous sweating and laxity of the Cou Li (pores and interstices). Consequently, slight exposure to wind easily results in a common cold. Therefore, among contemporary children, cases of Winter Cold contraction account for only one or two out of a hundred, whereas cases of Wind-Injury with fever are very common.
Regarding fevers caused by internal deficiency, there are numerous variations, making them highly prone to misdiagnosis. People often fail to recognize this, necessitating careful differentiation. Examples include: Cold generated from Yang deficiency; Fever generated from Yin deficiency; Irritability and heat from Blood deficiency; Spontaneous sweating, inability to eat, and heat from Qi deficiency; Summerheat exacerbation and heat from Qi deficiency; Heat from combined Summerheat-Dampness disease; Heat after sweating due to Yin deficiency where Yang has no attachment; Heat after sweating due to Yang deficiency where Yin has no attachment; Heat with daytime calmness and nighttime irritability due to Yang Qi sinking into Yin; Heat with daytime calmness and nighttime irritability due to Excess Yang and absence of Yin. Although all these present as fever, misusing exterior-releasing methods will inevitably lead to death.
Secondly, there is heat from Bian Zheng (physiological growth-related fever in infants), and heat preceding the eruption of smallpox/variolae. These also present as fever but have distinct etiologies and treatments. It is frequently observed that incompetent physicians, upon encountering fever, indiscriminately use dispersing methods. They fail to realize that diseases vary in severity and fevers differ in excess and deficiency. Although presenting as fever, the treatment approaches diverge significantly, with attacking and tonifying strategies being entirely different. Practitioners of pediatrics must carefully observe and comprehend during clinical practice. One must first inquire about the duration of the illness, prior medication history, and the child’s preferences and aversions. Then, assess the degree of fever, physical strength, pulse quality (excess or deficiency), and complexion luster. Integrating these four aspects allows for accurate diagnosis, thereby preventing fatal medical errors.
Generally, exogenous pathogens cause acute illnesses characterized by sudden onset of fever, typically manifesting as heat in the dorsal hands, floating pulse, and body heat without sweating. Differentiation between excess and deficiency remains necessary. For details, see the "Excess and Deficiency" section. If symptoms such as heat in the dorsal hands, floating pulse, or body heat without sweating are absent, or if the fever has persisted for a long time, it is not an exogenous exterior syndrome. Physicians must exercise prudent judgment.