《巢氏病源》小儿伤寒余热往来候∶伤寒是寒气客于皮肤，搏于血气，腠理闭密，气不宣泄，蕴积生热，使
头痛体疼而壮热也。其余热往来者，是邪气与正气交争，正气胜则邪气却散，故寒热俱歇。若邪气未尽者，时
干于正气，正气为邪气所干，则壅否还热，故余热往来不已。
《巢氏病源》∶小儿伤寒已得下后，热不除者，余势未尽，故其状肉常温温赤热也。
《圣惠》∶夫小儿伤寒，若四、五日后热即入里，即宜下之。下之得利后，热犹不除者，是余热未尽故也。
汉东王先生云∶小儿发热，日中可，夜而热甚，天明后凉，谓之伤寒余热未解矣。
《圣惠》治小儿伤寒二、三日，已服药，得汗后余热未除，宜服逐毒瓦斯葳蕤散方
葳蕤 川大黄（锉微，炒） 川升麻 甘草（炙微赤，锉） 黄芩 大青（各半两）
上件药捣，粗罗为散。每服一钱，以水一小盏，煎至五分，去滓。不计时候，量儿大小加减服之。
《圣惠》治小儿伤寒，汗利以后，余热不除，口干心烦，不欲乳食。黄 散方
黄 知母 赤茯苓 甘草（炙微赤，锉） 黄芩（各一分） 麦门冬（半两，去心，焙）
上件药捣，粗罗为散。每服一钱，以水一小盏，煎至五分，去滓。不计时候，温服。量儿大小加减服之。
《圣惠》治小儿伤寒，得汗利后，余热不除，心神烦躁，夜卧不安。黄连散方
黄连（去须） 大青 川升麻 赤茯苓 人参（去芦头） 地骨皮 黄芩 甘草（炙微赤，锉。各一分） 犀角屑
（半分） 麦门冬（半两，去心，焙）
上件药捣，粗罗为散。每服一钱，以水一小盏，煎至五分，去滓。不计时候，温服。量儿大小加减服之。
《圣惠》治小儿伤寒，汗利以后，余热不解，身体疼痛，心神虚烦，不思乳食。麦门冬散方
麦门冬 川升麻 柴胡（去苗） 前胡（各半两，去芦头） 元参 犀角屑 子芩 葛根 赤芍药 甘草（炙微赤，
锉。各一分）
上件药捣，粗罗为散。每服一钱，以水一小盏，入生姜少许，煎至五分，去滓，不计时候，温服。量儿大
小以意加减。
《圣惠》治小儿伤寒后，余热不除，心神不安。宜服茯神丸方
茯神 麦门冬（去心，焙） 铁粉 朱砂（并细研。各半两） 犀角屑 栀子仁 白藓皮 川升麻 元参 车前子
（各一分）
上件药捣罗为末，与铁粉、朱砂同研令匀，炼蜜和丸如绿豆大。不计时候，以温水下五丸。量儿大小加减
服之。
《圣惠》治小儿伤寒后，余热不除，四肢不利。宜用此汤浴方
川大黄 甘草 防风（去芦头） 丹参 白术（各半两） 雷丸（三分）
上件药捣，粗罗为散。每服用一两，以水三升，煎至二升半，去滓。看冷热，于密室中浴儿，后宜避风，
隔日再用。（《婴孺方》先用猪脂和此药摩儿头至足，令遍身；又取三指撮，白水在内和三升，煮三沸，浴儿，谓之摩膏
方。）
太医局白虎汤 治伤寒大汗出后，表证已解，心胃大烦渴，欲饮水及吐。或下痢后七、八日，邪毒不解，热结
在里，表里俱热，时时恶风，大渴，舌生干燥，而烦欲饮水数升者，宜服之。又治夏月中暑毒，汗出恶寒，
身热而渴。
石膏（洗，二十五斤） 知母（一百五十两） 甘草（烟，七十五两）
上为细末。每服三钱，以水一盏半，入粳米三十余粒，煎至一盏，滤去滓，温服。小儿量力少少与之。或
加人参少许同煎亦得。食后服此药。立夏后、立秋前可服；春时及立秋后，并亡血、虚家并不可服。（治伤寒，本
当取仲景白虎汤，方证牵引。缘此方叙出邪毒不解，热结在里，故再收之。）
《婴孺》治伤寒。除热粉散
雷丸（三两） 牡蛎 桂心（各一两）
上为粉，以粉儿身上。
张涣清凉汤方 解伤寒邪热余毒。
当归 大黄 生地黄（各一两） 芍药 甘草（炙。各半两）
上件药捣，罗为细末。每服一钱，以水八分，入竹叶、薄荷各少许，煎至五分，去滓温服。
长沙医者丁时发传黄 散方 治小儿伤寒，汗利以后，余热不除，口干心烦，不欲乳食。
黄 知母 茯苓 人参 甘草（炙。各一钱） 麦门冬（半两，去心）
上为末。每服一钱，水一小盏，煎至五分，去滓，不计时候服。
《巢氏病源》中关于小儿伤寒余热往来的论述：伤寒是寒气侵袭皮肤，与血气相搏结，导致腠理（皮肤纹理及汗孔）闭塞严密，气机无法宣泄，蕴积而生热，从而引起头痛、身体疼痛和高烧。所谓余热往来，是指邪气与正气相互交争，当正气战胜时，邪气便消散，因此寒热症状都会停止。如果邪气尚未清除干净，偶尔干扰正气，正气被邪气所扰，则气机壅滞再次发热，所以余热往来不止。
《巢氏病源》指出：小儿伤寒经过泻下治疗后，热势仍未消除的，是因为残余的病势未尽，所以表现为肌肉温度正常但局部温热发红发热。
《圣惠方》记载：小儿伤寒，如果在四、五天后热邪传入体内，就应当使用泻下法。泻下后虽然通了大便，但热势仍然不消除的，这是因为余热未尽的缘故。
汉东王先生说：小儿发热，白天较轻，夜间加重，天亮后转凉，这称为伤寒余热未解。
《圣惠方》治疗小儿伤寒二、三天，已经服药并出汗后，余热仍未消除的，适宜服用逐毒瓦斯葳蕤散方：
葳蕤、川大黄（切碎微炒）、川升麻、甘草（炙至微红，切碎）、黄芩、大青（各半两）。
以上药物捣碎，粗筛成散剂。每次服用一钱，用水一小盏，煎至五分，去渣。不限时间，根据患儿年龄大小调整剂量服用。
《圣惠方》治疗小儿伤寒，发汗或泻下后，余热不除，口干心烦，不想吃奶进食的，黄耆散方：
黄耆、知母、赤茯苓、甘草（炙至微红，切碎）、黄芩（各一分）、麦门冬（半两，去心，焙干）。
以上药物捣碎，粗筛成散剂。每次服用一钱，用水一小盏，煎至五分，去渣。不限时间，温服。根据患儿年龄大小调整剂量服用。
《圣惠方》治疗小儿伤寒，发汗或泻下后，余热不除，心神烦躁，夜间睡眠不安的，黄连散方：
黄连（去须）、大青、川升麻、赤茯苓、人参（去芦头）、地骨皮、黄芩、甘草（炙至微红，切碎，各一分）、犀角屑（半分）、麦门冬（半两，去心，焙干）。
以上药物捣碎，粗筛成散剂。每次服用一钱，用水一小盏，煎至五分，去渣。不限时间，温服。根据患儿年龄大小调整剂量服用。
《圣惠方》治疗小儿伤寒，发汗或泻下后，余热不解，身体疼痛，心神虚烦，不思吃奶进食的，麦门冬散方：
麦门冬、川升麻、柴胡（去苗）、前胡（各半两，去芦头）、元参、犀角屑、子芩、葛根、赤芍药、甘草（炙至微红，切碎，各一分）。
以上药物捣碎，粗筛成散剂。每次服用一钱，用水一小盏，加入少许生姜，煎至五分，去渣，不限时间，温服。根据患儿年龄大小酌情加减。
《圣惠方》治疗小儿伤寒后，余热不除，心神不安的，适宜服用茯神丸方：
茯神、麦门冬（去心，焙干）、铁粉、朱砂（均细研，各半两）、犀角屑、栀子仁、白藓皮、川升麻、元参、车前子（各一分）。
以上药物捣罗成粉末，与铁粉、朱砂一起研磨均匀，用炼蜜调和制成如绿豆大小的丸剂。不限时间，用温水送服五丸。根据患儿年龄大小调整剂量服用。
《圣惠方》治疗小儿伤寒后，余热不除，四肢活动不利的，适宜用此汤浴方：
川大黄、甘草、防风（去芦头）、丹参、白术（各半两）、雷丸（三分）。
以上药物捣碎，粗筛成散剂。每次服用一两，用水三升，煎至二升半，去渣。调节水温冷热，在密室中给患儿洗浴，洗后应注意避风，隔日再用。（《婴孺方》先用猪脂混合此药涂抹患儿从头到脚全身；又取三指撮的药量，放入三升水中，煮三沸，给患儿洗浴，这称为摩膏方。）
太医局白虎汤：治疗伤寒大汗出后，表证已解，心胃大烦渴，想喝水甚至呕吐。或者在下痢后七、八天，邪毒未解，热结在里，表里俱热，时时怕风，极度口渴，舌面干燥，烦躁想喝几升水的，适宜服用。又治疗夏季中暑毒，出汗怕冷，身热而渴。
石膏（洗净，二十五斤）、知母（一百五十两）、甘草（烟炙，七十五两）。
以上研为细末。每次服用三钱，用水一盏半，加入粳米三十余粒，煎至一盏，滤去渣，温服。小儿根据体力少量给予。也可以加少许人参同煎亦可。饭后服用此药。立夏后、立秋前可以服用；春季及立秋后，以及失血者、体虚者均不可服用。（治疗伤寒，本应引用张仲景的白虎汤，方证相应。因为此方叙述了邪毒未解，热结在里的情况，所以再次收录。）
《婴孺方》治疗伤寒的除热粉散：
雷丸（三两）、牡蛎、桂心（各一两）。
以上制成粉剂，扑在患儿身上。
张涣清凉汤方：解除伤寒邪热余毒。
当归、大黄、生地黄（各一两）、芍药、甘草（炙，各半两）。
以上药物捣碎，罗筛成细末。每次服用一钱，用水八分，加入少许竹叶、薄荷，煎至五分，去渣温服。
长沙医者丁时发传授的黄耆散方：治疗小儿伤寒，发汗或泻下后，余热不除，口干心烦，不想吃奶进食。
黄耆、知母、茯苓、人参、甘草（炙，各一钱）、麦门冬（半两，去心）。
以上研为粉末。每次服用一钱，水一小盏，煎至五分，去渣，不限时间服用。
According to *Chao Shi Bing Yuan* (Source of Diseases by Master Chao) regarding the lingering heat with alternating chills and fever in children after cold damage: Cold damage occurs when cold qi invades the skin, contending with blood and qi, causing the cou li (skin pores and texture) to close tightly. The qi cannot be vented, accumulates, and generates heat, resulting in headache, body pain, and high fever. The so-called "lingering heat with alternation" refers to the contention between pathogenic factors and healthy qi. When healthy qi prevails, the pathogenic factors dissipate, and thus both chills and fever cease. However, if the pathogenic factors are not completely cleared, they occasionally interfere with healthy qi. When healthy qi is disturbed by the pathogens, qi stagnation leads to recurrent fever; therefore, the lingering heat persists with alternation.
*Chao Shi Bing Yuan* states: In children with cold damage, if the heat remains unremoved after purgative treatment, it indicates that the residual pathogenic momentum has not yet exhausted. Consequently, the manifestation is characterized by muscles feeling normal in temperature but locally warm, red, and hot.
*Sheng Hui Fang* records: For pediatric cold damage, if heat enters the interior after four or five days, purgation should be employed. If, after purgation and bowel movement, the heat still does not subside, it is because the lingering heat has not been fully cleared.
Mr. Wang from Handong stated: In children with fever, if the condition is mild during the day, severe at night, and cools down after dawn, this is termed "lingering heat of cold damage not yet resolved."
*Sheng Hui Fang* prescribes the Zudu Wasia Weirui San (Poison-Expelling Weirui Powder) for pediatric cold damage where, after two to three days of medication and sweating, the lingering heat remains unremoved:
Weirui (*Polygonatum odorati Rhizoma*), Chuan Dahuang (*Rhei Radix et Rhizoma*, chopped and lightly stir-fried), Chuan Shengma (*Cimicifugae Rhizoma*), Gancao (*Glycyrrhizae Radix et Rhizoma*, honey-fried until slightly red and chopped), Huangqin (*Scutellariae Radix*), Daqing (*Isatidis Folium*) (each 0.5 liang).
Crush the above herbs, sift into a coarse powder. Take 1 qian per dose, decoct with one small cup of water until reduced to 0.5 cup, strain. Administer at any time, adjusting the dosage according to the child's age and size.
*Sheng Hui Fang* prescribes the Huangqi San (Astragalus Powder) for pediatric cold damage where, after diaphoresis or purgation, lingering heat persists accompanied by dry mouth, mental restlessness, and anorexia/refusal to nurse:
Huangqi (*Astragali Radix*), Zhimu (*Anemarrhenae Rhizoma*), Chi Fuling (*Poria Cocos with Red Core*), Gancao (*Glycyrrhizae Radix et Rhizoma*, honey-fried until slightly red and chopped), Huangqin (*Scutellariae Radix*) (each 1 fen); Maimendong (*Ophiopogonis Tuber*, 0.5 liang, heart removed, baked).
Crush the above herbs, sift into a coarse powder. Take 1 qian per dose, decoct with one small cup of water until reduced to 0.5 cup, strain. Administer warm at any time, adjusting the dosage according to the child's age and size.
*Sheng Hui Fang* prescribes the Huanglian San (Coptis Powder) for pediatric cold damage where, after diaphoresis or purgation, lingering heat persists accompanied by mental irritability and restless sleep at night:
Huanglian (*Coptidis Rhizoma*, remove roots), Daqing (*Isatidis Folium*), Chuan Shengma (*Cimicifugae Rhizoma*), Chi Fuling (*Poria Cocos with Red Core*), Renshen (*Ginseng Radix*, remove rhizome), Digupi (*Lycii Cortex*), Huangqin (*Scutellariae Radix*), Gancao (*Glycyrrhizae Radix et Rhizoma*, honey-fried until slightly red and chopped) (each 1 fen); Xijiao Xie (*Rhinocerotis Cornu Section*, 0.5 fen); Maimendong (*Ophiopogonis Tuber*, 0.5 liang, heart removed, baked).
Crush the above herbs, sift into a coarse powder. Take 1 qian per dose, decoct with one small cup of water until reduced to 0.5 cup, strain. Administer warm at any time, adjusting the dosage according to the child's age and size.
*Sheng Hui Fang* prescribes the Maimendong San (Ophiopogon Powder) for pediatric cold damage where, after diaphoresis or purgation, lingering heat persists accompanied by body pain, mental deficiency with vexation, and refusal to nurse:
Maimendong (*Ophiopogonis Tuber*), Chuan Shengma (*Cimicifugae Rhizoma*), Chaihu (*Bupleuri Radix*, remove seedlings), Qianhu (*Peucedani Radix*) (each 0.5 liang, remove rhizome); Yuan Shen (*Scrophulariae Radix*), Xijiao Xie (*Rhinocerotis Cornu Section*), Ziqin (*Scutellariae Radix*), Gegen (*Puerariae Radix*), Chi Shaoyao (*Paeoniae Radix Rubra*), Gancao (*Glycyrrhizae Radix et Rhizoma*, honey-fried until slightly red and chopped) (each 1 fen).
Crush the above herbs, sift into a coarse powder. Take 1 qian per dose, decoct with one small cup of water plus a little fresh ginger root until reduced to 0.5 cup, strain. Administer warm at any time, adjusting the dosage according to the child's age and size.
*Sheng Hui Fang* prescribes the Fushen Wan (Poria Pill) for pediatric cold damage where lingering heat persists accompanied by mental unrest:
Fushen (*Poria Cocos with Hostwood*), Maimendong (*Ophiopogonis Tuber*, heart removed, baked), Tiefen (*Ferrum*), Zhusha (*Cinnabaris*, both finely ground) (each 0.5 liang); Xijiao Xie (*Rhinocerotis Cornu Section*), Zhizi Ren (*Gardeniae Fructus Seed*), Baixianpi (*Dictamni Cortex*), Chuan Shengma (*Cimicifugae Rhizoma*), Yuan Shen (*Scrophulariae Radix*), Cheqianzi (*Plantaginis Semen*) (each 1 fen).
Grind the above herbs into fine powder, mix evenly with Ferrum and Cinnabaris. Blend with refined honey to form pills the size of mung beans. Administer five pills with warm water at any time, adjusting the dosage according to the child's age and size.
*Sheng Hui Fang* prescribes this herbal bath decoction for pediatric cold damage where lingering heat persists accompanied by impaired limb mobility:
Chuan Dahuang (*Rhei Radix et Rhizoma*), Gancao (*Glycyrrhizae Radix et Rhizoma*), Fangfeng (*Saposhnikoviae Radix*, remove rhizome), Danshen (*Salviae Miltiorrhizae Radix et Rhizoma*), Baizhu (*Atractylodis Macrocephalae Rhizoma*) (each 0.5 liang); Leiwan (*Wormia*).
Crush the above herbs, sift into a coarse powder. Use 1 liang per bath, decoct with three sheng of water until reduced to 2.5 sheng, strain. Adjust the water temperature appropriately, bathe the child in a sealed room, and avoid wind exposure afterward. Repeat every other day. (*Ying Ru Fang* first rubs the child's body from head to toe with lard mixed with these herbs; then takes three finger-pinches of the herb, adds it to three sheng of clear water, boils for three cycles, and uses it for bathing. This is called the Mo Gao Formula.)
Tai Yi Ju Baihu Tang (White Tiger Decoction): Treats cases where, after profuse sweating in cold damage, the exterior syndrome has resolved, but there is extreme thirst and irritability in the heart and stomach, desire to drink water, or vomiting. Or, seven to eight days after dysentery, if the pathogenic toxin is unresolved, heat is knotted in the interior, presenting with simultaneous exterior and interior heat, occasional aversion to wind, extreme thirst, a dry tongue, and intense irritability with a desire to drink several cups of water. It is also indicated for summerheat-toxin from heatstroke, presenting with sweating, aversion to cold, body heat, and thirst.
Shigao (*Gypsum Fibrosum*, washed, 25 jin), Zhimu (*Anemarrhenae Rhizoma*, 150 liang), Gancao (*Glycyrrhizae Radix et Rhizoma*, smoke-fried, 75 liang).
Grind into fine powder. Take 3 qian per dose, decoct with one and a half cups of water plus more than thirty grains of Jingmi (*Oryza Sativa Japonica Group*) until reduced to one cup, filter, and administer warm. Give small amounts to children according to their strength. Adding a little Renshen (*Ginseng Radix*) for simultaneous decoction is also acceptable. Take after meals. Can be taken from Lixia (Start of Summer) to Liqiu (Start of Autumn); it is contraindicated in spring, after Liqiu, in patients with blood loss, and in those with deficiency. (For treating cold damage, Zhang Zhongjing's Baihu Tang should originally be cited due to matching formula and syndrome. Since this formulation addresses unresolved pathogenic toxins and heat knotted in the interior, it is included again here.)
*Ying Ru Fang* Chu Re Fen San (Heat-Removing Powder) for treating cold damage:
Leiwan (*Wormia*, 3 liang), Musi (*Ostreae Concha*), Guixin (*Cinnamomi Ramulus*) (each 1 liang).
Process into powder and apply to the child's body.
Zhang Huan Qingliang Tang (Cooling Decoction): Resolves lingering toxic heat from cold damage.
Danggui (*Angelicae Sinensis Radix*), Dahuang (*Rhei Radix et Rhizoma*), Sheng Dihuang (*Rehmanniae Radix Recens*) (each 1 liang); Shaoyao (*Paeoniae Radix*), Gancao (*Glycyrrhizae Radix et Rhizoma*, honey-fried) (each 0.5 liang).
Crush the above herbs, sift into fine powder. Take 1 qian per dose, decoct with 0.8 cup of water plus a little Zhu Ye (*Bambusae Folium*) and Bohe (*Menthae Haplocalycis Herba*), reduce to 0.5 cup, strain, and administer warm.
Huangqi San (Astragalus Powder) transmitted by Ding Shifa, a physician from Changsha: Treats pediatric cold damage where, after diaphoresis or purgation, lingering heat persists accompanied by dry mouth, mental restlessness, and anorexia/refusal to nurse.
Huangqi (*Astragali Radix*), Zhimu (*Anemarrhenae Rhizoma*), Fuling (*Poria Cocos*), Renshen (*Ginseng Radix*), Gancao (*Glycyrrhizae Radix et Rhizoma*, honey-fried) (each 1 qian); Maimendong (*Ophiopogonis Tuber*, 0.5 liang, heart removed).
Grind into powder. Take 1 qian per dose, decoct with one small cup of water until reduced to 0.5 cup, strain. Administer at any time.