论曰小儿乳食不下，吐涎沫而微壮热者，痰实也。此因乳哺冷热不调，停积胸膈，或水
饮留滞，气不升降，致令痰热壅滞，壮热烦闷，心神不宁，不瘥则变惊痫之病。
治小儿痰实，壮热头痛。石膏汤方
石膏（别捣研一两一分） 大黄（锉炒一两半） 柴胡（去苗一两一分） 升麻 知母
（焙）
黄芩（去黑心） 芍药 枳实（去瓤麸炒各三分） 甘草（炙一两半） 大青（半两）
上一十味，粗捣筛。每二钱匕，水一盏，入生姜少许，同煎至六分，去滓分温三服，量
大小加减。
治小儿八岁以上，热结痰实，不能食。大黄汤方
大黄（锉炒一两） 柴胡（去苗） 升麻 黄芩（去黑心） 知母（焙） 芍药 栀子
仁（各三
分） 枳实（去瓤麸炒黄半两） 细辛（去苗叶一分）
上九味，粗捣筛。每二钱匕，水一盏，入竹叶十片，同煎至六分，去滓分温三服。早晚
各一，量儿大小加减。
治小儿百日以来痰实。柴胡汤方
柴胡（去苗三分） 当归（切焙一分） 赤茯苓（去黑皮） 大黄（锉炒各半两） 甘
草（炙一
分）
上五味，粗捣筛。每一钱匕，水半盏，煎至三分，去滓分温三服，早晚各一，量儿大小
，以意加减。
治小儿百日以来，痰实壮热兼惊。龙齿汤方
龙齿 大黄（锉炒各一分） 枳壳（大者一枚去瓤麸炒黄） 朴硝 甘草（炙锉各一分）
上五味，粗捣筛。每服一钱匕，水半盏，煎至三分，去滓食前温服，日二，量儿大小加
减。
治小儿百日以来痰实。人参饮方
人参（半两） 赤芍药（一分）
上二味，粗捣筛。每一钱匕，水半盏，入生姜一片，同煎至三分，去滓分温三服，量儿
大小加减。
治小儿痰实壮热。茯苓汤方
赤茯苓（去黑皮） 人参 黄芩（去黑心） 大黄（锉炒各半两）
上四味，粗捣筛。八九岁儿，每服二钱匕，水一盏，煎至半盏，去滓温服、日再。更量
儿大小加减。
治小儿痰壅结实。四通汤方
桔梗（炒） 大黄（锉炒各半两） 陈橘皮（汤浸去白焙） 紫菀（去苗土各一分）
上四味，粗捣筛。每服一钱匕，水八分，煎至四分，去滓食后温服，日再，更量儿大小
加减。
论述说：小儿乳食不能下咽，吐出涎沫并伴有轻微高热，这是痰实证。这是因为哺乳喂养冷热不调，导致食物停滞积聚在胸膈之间，或者水饮停留滞留，气机升降失常，致使痰热壅塞阻滞，出现高热烦闷，心神不安，如果不治愈则会转变为惊痫病。
治疗小儿痰实，症状为高热头痛的石膏汤方：
石膏（另捣碎研细一两一分） 大黄（锉碎炒制一两半） 柴胡（去苗一两一分） 升麻 知母（焙干）
黄芩（去除黑心部分） 芍药 枳实（去除瓤麸皮炒制各三分） 甘草（炙制一两半） 大青（半两）
以上十味药，粗捣筛过。每次取二钱匕，加水一盏，放入少许生姜，一同煎煮至六分，滤去药渣，分三次温服，根据患儿年龄大小酌情增减剂量。
治疗八岁以上小儿，热结痰实，不能进食的大黄汤方：
大黄（锉碎炒制一两） 柴胡（去苗） 升麻 黄芩（去除黑心部分） 知母（焙干） 芍药 栀子仁（各三分） 枳实（去除瓤麸皮炒黄半两） 细辛（去苗叶一分）
以上九味药，粗捣筛过。每次取二钱匕，加水一盏，放入十片竹叶，一同煎煮至六分，滤去药渣，分三次温服。早晚各一次，根据患儿年龄大小酌情增减剂量。
治疗百日以来患有痰实的小儿的柴胡汤方：
柴胡（去苗三分） 当归（切后焙干一分） 赤茯苓（去除黑皮） 大黄（锉碎炒制各半两） 甘草（炙制一分）
以上五味药，粗捣筛过。每次取一钱匕，加水半盏，煎煮至三分，滤去药渣，分三次温服，早晚各一次，根据患儿年龄大小，凭医者判断酌情增减。
治疗百日以来患有痰实、高热兼有惊风的龙齿汤方：
龙齿 大黄（锉碎炒制各一分） 枳壳（大的一个，去瓤麸皮炒黄） 朴硝 甘草（炙制锉碎各一分）
以上五味药，粗捣筛过。每次服用一钱匕，加水半盏，煎煮至三分，滤去药渣，饭前温服，每日两次，根据患儿年龄大小酌情增减。
治疗百日以来患有痰实的人参饮方：
人参（半两） 赤芍药（一分）
以上两味药，粗捣筛过。每次取一钱匕，加水半盏，放入一片生姜，一同煎煮至三分，滤去药渣，分三次温服，根据患儿年龄大小酌情增减。
治疗小儿痰实高热的茯苓汤方：
赤茯苓（去除黑皮） 人参 黄芩（去除黑心部分） 大黄（锉碎炒制各半两）
以上四味药，粗捣筛过。八九岁的小儿，每次服用二钱匕，加水一盏，煎煮至半盏，滤去药渣温服，每日两次。再根据患儿年龄大小酌情增减。
治疗小儿痰壅结实证的四通汤方：
桔梗（炒制） 大黄（锉碎炒制各半两） 陈橘皮（汤浸后去白焙干） 紫菀（去苗土各一分）
以上四味药，粗捣筛过。每次服用一钱匕，加水八分，煎煮至四分，滤去药渣，饭后温服，每日两次，再根据患儿年龄大小酌情增减。
It is stated that when infants and children refuse milk and food, salivate excessively, and present with slight high fever, this constitutes Phlegm-Excess Syndrome (Tan Shi Zheng). This condition arises from improper regulation of the temperature of milk and food during feeding, leading to stagnation and accumulation in the chest and diaphragm. Alternatively, it may result from retained fluids and drinks causing impaired ascending and descending of Qi, thereby resulting in the congestion and obstruction of Phlegm-Heat. Symptoms include high fever, restlessness, and mental unease. If left untreated, it may transform into Convulsive Epilepsy (Jing Xian Bing).
Gypsum Decoction (Shigao Tang) for treating Phlegm-Excess in children with high fever and headache:
Gypsum (Shigao, separately pounded and ground) 1 liang 1 fen; Rhubarb (Dahuang, chopped and stir-fried) 1 liang 5 qian; Bupleurum Root (Chaihu, radix removed) 1 liang 1 fen; Cimicifuga Rhizome (Shengma); Anemarrhena Rhizome (Zhimu, baked); Scutellaria Root (Huangqin, black heart removed); Paeonia Root (Shaoyao); Immature Bitter Orange (Zhishi, pith removed, bran-roasted) each 3 qian; Licorice Root (Gancao, honey-fried) 1 liang 5 qian; Indigo Folium (Daqing) 0.5 liang.
The above ten ingredients are coarsely crushed and sifted. For each dose, take 2 qianbi (approx. 6-9g), add one zhan (approx. 200ml) of water, a small amount of fresh ginger, and decoct together until reduced to 0.6 zhan. Strain and divide into three warm doses, adjusting according to the child's age and size.
Rhubarb Decoction (Dahuang Tang) for treating children aged eight years and above with heat-binding phlegm-excess and inability to eat:
Rhubarb (Dahuang, chopped and stir-fried) 1 liang; Bupleurum Root (Chaihu, radix removed); Cimicifuga Rhizome (Shengma); Scutellaria Root (Huangqin, black heart removed); Anemarrhena Rhizome (Zhimu, baked); Paeonia Root (Shaoyao); Gardenia Seed (Zhizi Ren) each 3 qian; Immature Bitter Orange (Zhishi, pith removed, bran-roasted until yellow) 0.5 liang; Asarum Root (Xixin, radix and leaves removed) 1 fen.
The above nine ingredients are coarsely crushed and sifted. For each dose, take 2 qianbi, add one zhan of water, ten leaves of bamboo (Zhuye), and decoct together until reduced to 0.6 zhan. Strain and divide into three warm doses. Administer once in the morning and once in the evening, adjusting according to the child's age and size.
Bupleurum Decoction (Chaihu Tang) for treating phlegm-excess in children since infancy (within 100 days):
Bupleurum Root (Chaihu, radix removed) 3 qian; Angelica Sinensis Root (Danggui, sliced and baked) 1 fen; Red Poria (Chifuling, black skin removed); Rhubarb (Dahuang, chopped and stir-fried) 0.5 liang each; Licorice Root (Gancao, honey-fried) 1 fen.
The above five ingredients are coarsely crushed and sifted. For each dose, take 1 qianbi, add half a zhan of water, and decoct until reduced to 0.3 zhan. Strain and divide into three warm doses, administered once in the morning and once in the evening, adjusting at the practitioner's discretion based on the child's age and size.
Dragon Tooth Decoction (Longchi Tang) for treating phlegm-excess, high fever, and convulsions in children since infancy:
Dragon Tooth (Longchi); Rhubarb (Dahuang, chopped and stir-fried) 1 fen each; Auricle of Immature Bitter Orange (Zhike, large one, pith removed, bran-roasted until yellow); Mirabilite (Puxiao); Licorice Root (Gancao, honey-fried and chopped) 1 fen each.
The above five ingredients are coarsely crushed and sifted. For each dose, take 1 qianbi, add half a zhan of water, and decoct until reduced to 0.3 zhan. Strain and administer warm before meals, twice daily, adjusting according to the child's age and size.
Ginseng Drink (Renshen Yin) for treating phlegm-excess in children since infancy:
Ginseng Root (Renshen) 0.5 liang; Red Paeonia Root (Chishaoyao) 1 fen.
The above two ingredients are coarsely crushed and sifted. For each dose, take 1 qianbi, add half a zhan of water and one slice of fresh ginger, and decoct together until reduced to 0.3 zhan. Strain and divide into three warm doses, adjusting according to the child's age and size.
Poria Decoction (Fuling Tang) for treating phlegm-excess and high fever in children:
Red Poria (Chifuling, black skin removed); Ginseng Root (Renshen); Scutellaria Root (Huangqin, black heart removed); Rhubarb (Dahuang, chopped and stir-fried) 0.5 liang each.
The above four ingredients are coarsely crushed and sifted. For children aged eight or nine, take 2 qianbi per dose, add one zhan of water, and decoct until reduced to half a zhan. Strain and administer warm, twice daily. Adjust further according to the child's age and size.
Situang Decoction (Sitong Tang) for treating phlegm congestion and solidification in children:
Platycodon Root (Jiegeng, stir-fried); Rhubarb (Dahuang, chopped and stir-fried) 0.5 liang each; Aged Tangerine Peel (Chenju pi, soaked in hot water, white pith removed, baked); Aster Root (Ziwan, radix and soil removed) 1 fen each.
The above four ingredients are coarsely crushed and sifted. For each dose, take 1 qianbi, add 0.8 zhan of water, and decoct until reduced to 0.4 zhan. Strain and administer warm after meals, twice daily. Adjust further according to the child's age and size.