小儿积热者表里俱热则遍身皆热颊赤口干小便赤大便焦黄先以清凉四顺饮子利动脏腑热
则去
既去复热者里热已解而表热未解也当用惺惺散或红绵散内加麻黄微发汗表热乃去表热去后又
发热者何也世医到此尽不能晓或再用凉药或再解表或以谓不可医误致夭伤者甚多此表里俱虚
气不归元而阳浮于外所以再发热非热症也只用六神散入粳米煎和其胃气则收阳气归内身体便
凉热重者用银白散
小儿血热者每早食后发热夜则凉世医多谓虚劳或谓疳热此血热也宜用猪胆丸
小儿发痫俗云惊风有阴阳症因身热面赤而发搐搦上视牙关紧硬者阳症也因吐泻或只吐不
泻日
渐面色白脾虚成冷而发惊不甚搐搦微微目上视手足微动者阴症也阳症用凉药阴症用温药不可
一概作惊风治也又有一症欲发疮疹先身热惊跳或发搐搦此非惊风当服发散药
小儿暑月多吐泻其症不一宜详审用药不可差谬有伏暑吐泻小水必不利宜服五苓散香薷散
有伤
食吐泻者其吐及粪皆有酸臭气宜服感应丸三方易知今不复载泻多日口唇白及粪色亦白及泻粪
颇多者因而成冷也宜以前方六神散每二钱匕加附子末一钱匕煎作三四服以防变痫也
小儿暑月多泻者一则伏暑心藏热小水不利
清浊不分因成泄泻可服五苓散或大顺散二药皆用沸汤调若小水快而泻者冷泻也宜于六神散内
加附子煎服若肚大泻色白者疳泻也宜服官局六神丸泻者不可急以热药止之若以热药止之便变
成痢凡病痢者皆因有积赤痢热积也白痢冷积也赤白痢冷热不调之积也赤多白少者热多而冷少
也白多赤少者冷多而热少也
小儿积热证，若表里俱热，则全身发热，面颊红赤，口干，小便色赤，大便焦黄。应先服用清凉四顺饮子以通利脏腑；待热势消退后，若热邪去除，病情缓解，则停药；若热退后又复发，说明里热已解而表热未除，此时应当使用惺惺散或红绵散，并加入麻黄，轻微发汗，表热方可解除。若表热解除后再次发热，原因何在？世间的医生到了这一步大多不能明白，有的再用凉药，有的再解表，或者认为不可医治，导致误治夭折者甚多。这是因为表里俱虚，气不归元，阳气浮越于外，所以再次发热并非热症。只需使用六神散，加入粳米煎服，调和胃气，使阳气回归体内，身体便会凉爽。热势重者，使用银白散。
小儿血热证，每天早晨饭后发热，夜间则凉爽。世医多认为是虚劳或疳热，这其实是血热。适宜使用猪胆丸。
小儿患癫痫，俗称惊风，有阴证和阳证之分。因身体发热、面颊红赤而发作抽搐、眼睛上翻、牙关紧闭的，是阳证。因呕吐腹泻，或只吐不泻，日渐面色苍白，脾虚生寒而引发惊风，抽搐不甚剧烈，微微眼睛上翻，手足轻微抖动的，是阴证。阳证用凉药，阴证用温药，不可一概当作惊风治疗。又有一种症状，欲发疮疹前，先身体发热、惊跳或发生抽搐，这不是惊风，应当服用发散药。
小儿在暑月容易呕吐腹泻，症状不一，宜详细审察用药，不可差错。若有伏暑引起的吐泻，小便必然不利，适宜服用五苓散或香薷散。若有伤食引起的吐泻，其呕吐物和粪便都有酸臭气味，适宜服用感应丸。这三个方子容易知晓，此处不再记载。若腹泻日久，口唇及粪便颜色变白，且腹泻量多，这是因而成寒证，适宜用前方中的六神散，每二钱匕加附子末一钱匕，煎作三四次服用，以防转变为癫痫。
小儿在暑月多腹泻，一则是因为伏暑导致心藏热，小便不利，清浊不分，因而形成泄泻，可服用五苓散或大顺散，这两种药都用沸水调服。若小便通畅而腹泻，则是冷泻，适宜在六神散中加入附子煎服。若肚子大、粪便色白的，是疳泻，适宜服用官局六神丸。腹泻不可急于用热药止泻，若用热药止泻，就会变成痢疾。凡是患痢疾的人，都是因为体内有积滞：赤痢是热积，白痢是冷积，赤白相兼痢是冷热不调之积。赤多白少，是热多冷少；白多赤少，是冷多热少。
For pediatric accumulation-heat syndrome, if both the exterior and interior are hot, the whole body will be feverish, with red cheeks, dry mouth, dark urine, and scorched yellow stools. Initially, administer Qingliang Sishun Yinzi (Clearing Heat and Smoothing Four Decoction) to promote bowel movement and clear the viscera; once the heat is cleared, discontinue the medication. If the fever returns after subsiding, it indicates that the interior heat has resolved but the exterior heat remains. In this case, Xingxing San (Stirring Spirit Powder) or Hongmian San (Red Cotton Powder) should be used, with added Ephedrae Herba (Mahuang, 麻黄) to induce slight sweating, so that the exterior heat may dissipate. If fever recurs after the exterior heat is cleared, what is the cause? Most contemporary physicians fail to understand this at this stage; some use cooling medicines again, others attempt to release the exterior again, or declare it incurable, leading to many premature deaths due to mismanagement. This occurs because both the exterior and interior are deficient, Qi fails to return to its origin, and Yang floats outward. Thus, the recurrent fever is not a heat syndrome. Simply use Liushen San (Six Spirits Powder) with Oryzae Semen (Jingmi, 粳米) decocted together to harmonize Stomach Qi, allowing Yang to return inward, and the body temperature will normalize. For severe heat cases, Yinbai San (Silver White Powder) is used.
Pediatric blood-heat syndrome presents with fever every morning after eating, while the body feels cool at night. Contemporary physicians often attribute this to deficiency consumption (Xu Lao, 虚劳) or malnutrition heat (Gan Re, 疳热), but this is actually blood heat. Zhudan Wan (Pig Gallbladder Pill) is appropriate.
Pediatric epilepsy, commonly known as "startle wind" (Jing Feng, 惊风), has yin and yang syndromes. When accompanied by body fever, red face, convulsions, upward gaze, and locked jaw, it is a yang syndrome. When caused by vomiting and diarrhea, or only vomiting without diarrhea, leading to progressively pale complexion, spleen deficiency generating cold, and resulting in mild startle wind with slight convulsions, upward gaze, and minor limb tremors, it is a yin syndrome. Yang syndromes are treated with cooling medicines, and yin syndromes with warming medicines; they must not all be treated indiscriminately as startle wind. Another condition involves pre-eruption of sores and rashes, where the child first experiences body fever, startle jumps, or convulsions; this is not startle wind, and dispersing medicines should be administered.
During summer months, children are prone to vomiting and diarrhea with various symptoms, requiring careful diagnosis and precise medication. For vomiting and diarrhea due to latent summerheat, urination is invariably difficult; Wuling San (Five-Ingredient Powder with Poria) or Xiangru San (Elsholtzia Powder) are suitable. For vomiting and diarrhea due to food stagnation, both vomitus and feces have a sour and foul odor; Yinggan Wan (Miraculous Response Pill) is indicated. These three formulas are straightforward and are not repeated here. If diarrhea persists for days, causing white lips and white-colored feces, along with large volume of stool, it indicates transformation into cold syndrome. Use the aforementioned Liushen San (Six Spirits Powder), adding one qian of Aconiti Lateralis Radix Preparata (Fuzi, 附子) powder per two qian of the powder base, decocted and divided into three or four doses, to prevent transformation into epilepsy.
Pediatric diarrhea in summer months arises primarily from two causes: latent summerheat causing heat in the Heart viscus, leading to difficult urination and failure to separate clear from turbid, resulting in diarrhea; Wuling San (Five-Ingredient Powder with Poria) or Dashun San (Great Smoothness Powder) can be taken, mixed with boiling water. If urination is smooth but diarrhea persists, it is cold diarrhea; add Aconiti Lateralis Radix Preparata (Fuzi, 附子) to Liushen San (Six Spirits Powder) and decoct. If the abdomen is distended and feces are white, it is gan diarrhea (malnutrition diarrhea); Guanju Liushen Wan (Official Bureau Six Spirits Pill) is suitable. Diarrhea should not be abruptly stopped with hot medicines; doing so will transform it into dysentery. All cases of dysentery are caused by internal accumulation: red dysentery is due to heat accumulation, white dysentery is due to cold accumulation, and mixed red-and-white dysentery is due to imbalance of cold and heat. Red predominating over white indicates more heat and less cold; white predominating over red indicates more cold and less heat.