按五脏虚实补泻之法。引经解之。经云。邪气盛则实。真气夺则虚。所谓实则泻之者。
邪气也。虚则补之者。补其真气也。如真气实则为无病儿矣。岂有泻之者乎。云肝常有余。
脾常不足者。此却是本脏之气也。盖肝乃少阳之气。儿之初生。如木方萌。乃少阳生长之气
。以渐而壮。故有余也。肠胃脆薄。谷气未充。此脾所以不足也。
小儿五色修明。声音清响。此心肺之气足也。乳食能进。大小便调。此肠胃之气足也。
手足和暖。筋骨刚健。此皆肾肝之气足也。是谓无病易养。不宜妄投药饵。诛罚无过也。
如面色 白。声音微小。此心肺不足也。乳食减少。吐痢频并。此肠胃不足也。颅解项
手足痿弱。此肝肾不足也。是儿多病难养。此以形体之虚实。辨五脏之强弱也。有病者。各
宜随五脏之虚实。按方治之。
小儿热证有七 面腮红 大便秘 小便黄 渴不止 上气急 脉弦急 足胫热（以上不
宜服热药）
小儿冷证有七 面 白 粪青色 腹虚胀 眼珠青 呕奶乳 脉微沉 足胫冷（以上不
宜服寒药）
此热证者。邪气实也。宜用寒凉泻之。如服热药谓之实实。寒证者。真气虚也。宜用温
热补之。如服寒药。谓之虚虚。经云。毋实实。毋虚虚。毋夭人长命。此之谓也。
根据五脏虚实补泻的方法，引用经典来解释。医经说：邪气亢盛就表现为实证，真气耗损就表现为虚证。所谓“实则泻之”，是指祛除邪气；“虚则补之”，是指补益真气。如果真气充实，那就是健康的儿童了，哪里还有需要泻法的情况呢？
常说“肝常有余，脾常不足”，这指的是本脏的气机状态。因为肝属于少阳之气，婴儿初生，如同树木刚刚萌芽，具有少阳生长之气，逐渐强壮，所以说是“有余”。肠胃脆薄，谷气尚未充盈，这就是脾“不足”的原因。
小儿面色红润鲜明，声音清脆响亮，这是心肺之气充足的表现。乳食能进，大小便调匀，这是肠胃之气充足的表现。手足温暖，筋骨强健，这都是肾肝之气充足的表现。这就叫做没有疾病、容易养育，不应当胡乱投药，以免无过而受罚（诛伐无罪）。
如果面色㿠白，声音微弱，这是心肺不足。乳食减少，呕吐泄痢频繁并发，这是肠胃不足。囟门迟闭（颅解），项软，手足痿弱无力，这是肝肾不足。这样的孩子多病且难养，这是通过形体的虚实，来辨别五脏的强弱。如果有病，各自应当根据五脏的虚实，按照方剂治疗。
小儿热证有七种表现：面颊腮部发红，大便秘结，小便黄赤，口渴不止，气逆喘急，脉象弦急，足胫发热（以上情况不宜服用温热药物）。
小儿寒证有七种表现：面色㿠白，粪便色青，腹部虚胀，眼珠发青，呕吐奶乳，脉象微沉，足胫寒冷（以上情况不宜服用寒凉药物）。
这些热证，是邪气实盛的表现，适宜用寒凉药物来泻除。如果服用温热药，就叫作“实实”（使实证更实）。寒证，是真气虚弱表现，适宜用温热药物来补益。如果服用寒凉药，就叫作“虚虚”（使虚证更虚）。医经说：“不要使实证更实，不要使虚证更虚，不要损害人的寿命。”说的就是这个道理。
According to the methods of tonification and purgation for the deficiency and excess patterns of the Five Zang organs, we cite the classics to explain. The Classics state: "When pathogenic factors are exuberant, it is Excess; when true Qi is depleted, it is Deficiency." What is meant by "purge what is Excess" is eliminating pathogenic factors; "tonify what is Deficient" is replenishing true Qi. If true Qi were substantial, the child would be disease-free, so how could there be a need for purgation?
The statement that "the Liver is often in a state of Excess, while the Spleen is often in a state of Deficiency" refers to the qi status of these specific organs. The Liver belongs to Shaoyang (Lesser Yang) qi. A newborn infant is like a tree just sprouting, possessing the growing qi of Shaoyang, which gradually strengthens; thus, it is considered "Excess." The intestines and stomach are fragile and thin, and the qi from grains has not yet filled them; this is why the Spleen is considered "Deficient."
If a child's complexion is bright and clear, and their voice is crisp and resonant, this indicates that the Heart and Lung qi are sufficient. If they can take milk and food well, and bowel movements and urination are regular, this indicates that the Intestine and Stomach qi are sufficient. If hands and feet are warm, and bones and sinews are strong, this indicates that the Kidney and Liver qi are sufficient. This is called being disease-free and easy to nurture; one should not recklessly administer medicines, thereby punishing without fault.
If the complexion is pale white, and the voice is faint, this indicates Heart and Lung Deficiency. If milk and food intake decreases, and vomiting and dysentery occur frequently, this indicates Intestine and Stomach Deficiency. If the fontanelle remains open (cranial suture separation), the neck is weak, and limbs are flaccid and weak, this indicates Kidney and Liver Deficiency. Such children are prone to illness and difficult to nurture. This is distinguishing the strength or weakness of the Five Zang organs based on the excess or deficiency of the physical form. When illness exists, treatment should follow the formulas according to the deficiency and excess patterns of each Zang organ.
There are seven signs of Heat patterns in infants: redness of the cheeks and temples, constipation, yellow urine, unquenchable thirst, upward rushing of Qi with rapid breathing, wiry and rapid pulse, and heat in the lower legs and shins (for the above, hot-warm medicines are inappropriate).
There are seven signs of Cold patterns in infants: pale white complexion, greenish stool, abdominal distension due to emptiness, bluish-white sclera, vomiting of milk, faint and deep pulse, and coldness in the lower legs and shins (for the above, cold-cool medicines are inappropriate).
These Heat patterns represent an Excess of pathogenic factors and are suitable for treatment with cold-cool herbs to purge. Administering hot-warm medicines in such cases is termed "making Excess more Excessive" (Shi Shi). Cold patterns represent a Deficiency of true Qi and are suitable for treatment with warm-hot herbs to tonify. Administering cold-cool medicines in such cases is termed "making Deficiency more Deficient" (Xu Xu). The Classics state: "Do not make Excess more Excessive, do not make Deficiency more Deficient, do not shorten human life." This is what is meant.