肝者属足厥阴也，其性刚赖血以涵养，自两胁以下及小腹前阴等处，皆其所司的部位。最易动气作痛，又
易因热生风，其风
能升至颠顶，作晕与痛于头部，旁及两太阳穴而痛胀。其病色属青，常发现于左颧及目 ，或鼻准两边及眉心。
故肝病实，则目白轮现赤，大叫呵欠顿闷。若肝病虚，则呵欠切牙。有风则目斜视而不灵活。有热则怒视而眼
皮肿胀。若肝热盛伤阴血，复下迫脾胃，已成疳积者，则白膜遮睛，儿必现躁急而哭叫，哭甚则咽喉胃胀气
噎，以致小溲赤短或溲难行，大便闭结，或下黑绿色粪便。又有一种症象，小儿无故猝发冷热，手寻衣领，或
手乱捻物，或两手撮空摸床，为惊吓丧魂病也。设不知病原而误治，再行稽延时日，儿病转危，即现目睛视物
不动，或目合不开，或目瞪不合，或哭而无泪，或不哭而泪自出。凡此等象，皆为肝绝，不能救治也。
心者属手少阴也，其部位在胸下正中岐骨微下陷处。凡额上舌尖手足心等处，亦均为其所司。最要者能调节
血液周全，润养全体之各神经，及纤微末梢等神经。其自然之力能生发智能，发言语和哭笑。心无表症，其所
得病者皆属于里也。心不受邪，既不能动，尤不能痛。凡觉心动或心痛者，均胃痛或气滞也。若真是心动或心
痛的病，一点钟都不迟延，即行死去也。心有实火，则叫哭发热，饮水无度，而小溲短赤或点滴均无。心有虚
火，则困卧迷睡，悸动不安，目瞪无神，或舌尖赤破，或舌短音低，此象病久者恒见之。若热盛津液干枯，虽
渴极亦不可多与饮料，须急保液生津，方能有救。盖阴津不随盛热炙干，津回液布，病终能愈也。故小儿有时
不现表症病象，而有烦躁不宁，睡卧不安，叫哭不乳时，须先检查身体头面四肢有无热象。如何处有热，均
当细心辨之。属于何病的里热，何部为热之发源，根据之以定症名，后再求治疗其症的药剂，如斯之谨慎研求，
焉有不能治愈之病者，盖心部病无表症，不似外感的发热，为通体全热，为通日夜均热。此则一部分热，热有
早晚轻重久暂之不同，亦甚易辨。不过热之实虚，乃热之地位是否紧要，或须急施治，或不能急
治，必须细心推求，以小儿稚体脆弱，治错药误均不能承受。设稍有出入，追悔莫及。且小儿均不易服药，用药
又必求其有力，一剂服后功效立见始可，万无试探投药治疗之余地。不过小儿各病单纯的多，又无七情六欲之
戕贼，认症施治较成年人似易为力。其难者小儿自不能言病能病象，及病之所在，亦不能明白举出也。故小儿之
久病脾虚连及心气弱，虽症象现火象，亦必先顾心气虚，服强心助气药。心气得助力，自能气回液布，虚火归原，
不治热而热自退也。设此等假症象，为医者再不明医理；不细心推求症象。见热治热，率尔一意凉药滥用，以
为热必可退。孰知心气正在弱虚不绝如缕之时，又经此凉药一打击，必至阳亡于上，阴竭于下，神经立起变化，
周身一痉挛，立即死亡也，可不慎哉。此是久病心气虚，尚易辨别，但稍明病情医理，即可延医无舛。今有一
种病，心气受不可抵御的压迫，强力侵袭，心气立呈微弱，神经亦随之发生重大变化，不立时起抽搐，即立时
神智昏迷，或厥然而倒，不省人事。此症为何？即夏日中暑，俗名所谓暑风症也。此症虽非病久心气虚可比，
然心不受邪，其影响人的生命，重大危急可知也。故亦须先顾其心气，速用强心助气药，使心气有所借力，中
心有所生，外邪之侵袭力自微，神经之变化亦自能回复平静，抽搐亦即随之而定也。然后再佐以清暑利湿芳香
通络药，斯症无不立即痊愈也。不过病久心气虚弱，其来也缓，亦不能立即医治痊愈。至于中暑的心气虚弱，
其来也暴，然医治得法，其症平复如初，可立而待。其痊愈之快慢不同，是受病的久暂问题也。至心脏之于
人生，其关系至重且大，较之于其他各脏，尤为紧要。一经发现受病牵及于心，即须特别注意。无论其实热虚
热，及病之久暂，均必先保护心气，不使毫厘受伤。其他病症医治如法，虽危重亦必可渐渐向痊也。舌为心之
苗，心部若有实热，或温疹出齐时候，热已退净，唯咳嗽尚盛，医者不知用养阴清肺药，养血液以善其后，
俾发过的壮热，及出
过的赤疹，在在都得用药回复其已伤之血液，万不可使其余的火复燃。不然在病患血液大亏之后，元气未复，
身体虚弱，天然的抵抗能力，一点皆无，肺之余炎能乘心部的实热，复行披猖。此时舌尖即起白泡溃烂，痛
甚不能饮食。若再稽延，立起重舌木舌等危险紧急症候。又有温疹病体初愈，正气未复之时，口味初开，胃
力尚弱之时，此时亦甚紧要。若任何病患满意的进食，胃力不能承受，停滞不能运化，积聚生热，亦乘心部
之实热，向外发泄。其症象为谵语迷睡，舌苔黄浓垢腻，或口糜舌烂，成为种种变态的重病。此候治疗下之
不可，恐体弱不能任受，气弱防其虚脱，不用下剂。此紧急之热邪，不容缓治，毒热从何处，用何方剂可去
耶？到此地步，进退维谷，治疗之运用真棘手矣。故吾曰只心部之病，心无表症，心不受邪，心部的重要，
与人之生命有重大密切的关系。无论其实热虚热，及受病的久暂，若发觉心部受病为主要，必用强心药护持
之，再治其他之脏腑各兼症即可。至于剧烈咳嗽，痰壅气喘或起重舌木舌，症象危急，或口糜舌烂，谵妄迷
睡等等症象，虽然已至危险程度，然非心脏的主病。是肺胃部之余火复燃，乘心脏之热而炽盛，及肺胃两部
为主体，心脏为连带波及。不必兼用强心剂，迳用清肺胃之药，以解其热毒。各急症能稍转轻，慢慢向愈后，
仍须养阴增液养血助气等法，以善其后也。
脾于生理亦属重要之脏，为足太阴经，后天之本也。故婴儿落生后，天然能吸乳汁以养生命，下受命
门之以蒸化谷食，上输谷食之精液，以灌溉其他各脏腑。所以人的生命存活元原，独脾脏之功用为最大。然
其性喜燥而恶湿，一受湿渍，则运化之力衰，而肝即乘以侮之。位在中焦，凡眼胞鼻准及四肢皆其分也。与
胃相表里，故用药略同，脾之病无表症，凡病皆属于里。脾虚
者，右关脉必细软，指纹现浅红而暗淡。其症象为呕吐，为泄泻，为久痢，为腹痛，为肢软，为面黄肌瘦，为发
肿鼓脉，为积滞不化饮食化痰，为脱肛肠红等症。脾实者，右关脉必沉数，指纹现红明色。其症为气积血滞，为痞
满虫积，为痰饮腹痛等症。脾寒者，右关脉必沉迟，指纹现淡红兼青暗色，唇舌必白淡无血色。其症为呕吐泄泻，
为白痢腹痛，为湿肿阴黄胆，为四肢冷厥脱等症。脾热者，右关脉必洪数，指纹现红明兼紫色，舌苔腻而黄，或唇
赤舌亦赤。其症为热吐或流涎，为洞泻或泻渤，为赤痢腹下坠，为目胞肿痛或眩晕，为阴黄胆等症。脾之病均有
其他脏腑之症。故各症的治法用药，至后各症分门类时，再详细论之。兹不过言脾病之种数，及脉象指纹现色，
辨别其虚实寒热而已。实则迷睡，烦躁夜卧不安，发热夜甚，至天将明热又渐轻，始能得二三小时之安睡，可见
迷睡是脾实而热使之然也。虚则食乳不化，呕吐泄泻，日久脾虚及肾，即成慢脾风等症，甚为难治。伤于湿则发
皮水肿，或作腹痛胀，或成黄胆，脾痛则腹必痛，脾已结疳，必现肚大筋青，饮食过量而肌肉削，发毛枯焦。脾热
则口出气息必臭，唇疮口糜，或吐舌舐唇。脾寒则口角流涎，或嗳腐吐酸，或虫出于口。此脾病之大略，随其现
象见症，用药延医可以也。
肺者，手太阴经也。属脏其体甚娇脆，内主周身气化，外主周身皮毛，为人身体气布之总机关。凡声之出入，
气之呼吸，均为肺的主力，始能得其调节清畅，其性畏火而仇寒，故遇燥而痰涎壅滞即咳嗽，遇寒侵袭，反抗驱除
亦发咳。凡耳白及右颊鼻孔等处，皆其表现于体外的分野。肺之于生命关系太大，须加意保护。不使寒火相侵，能
长保其清宁之体，身自坚壮，寿臻大年也。故肺寒热所伤，则均现气逆音不流利，甚者作喘作咳，或哮吼音哑，受
风伤则喷嚏，或流清涕而鼻塞，呼吸不利而头痛，或现头重及旋晕。若咳嗽不止，相连能咳数十百声，使人气均
回不过来，急成面红筋粗，鼻涕眼泪，咳嗽喷嚏，连连不断，吐食呕
水，小儿当此，焉能支持，症状更属紧急。此盖盛寒包肺，肺叶全闭也。治之得法应手奏效，否则不堪设想也。
若鼻孔干眼涩，或鼻衄血，鼻头赤环唇赤烂，喘满咳嗽，痰涎壅阻气管，黄糊粘满两眼，此为风热郁于肺，肺窍阻
痰，不能自如收放也。症象看似甚重，其实不是险症。用清火散风药一剂，风散热解，肺叶消其肿胀，气布痰开，
即恢如初，各症象一扫而愈。他若发壮热咳嗽，气急颐肿，或项肿喉痛等象，为肺病兼胃病也。治法须肺胃两部并
重，自易痊愈。若发壮热咳嗽，头痛肢酸，遍身及头面发赤点，或白尖云片等症状，为 疹等病，亦为肺胃两部
均感外邪而病也。治法须肺胃兼顾，清热祛邪解毒活血，即可缓缓向愈。不过此两条虽为肺胃兼病，然又兼温毒
时症，不能与肺受盛寒风热，所现症状相比拟，更不能与肺胃兼病同治法。临床延医时，务必详细辨别，庶不能误。
不然以小儿之未长成身体，娇嫩的肺，焉能受之也。至小儿因久嗽患龟背等症象，是肺叶因湿痰及火的侵袭而肿
胀，横膈膜上腔属性积不下，必须向外发展。而此时小儿之全体骨胳均未长成，不能坚实无抵抗力量。至于前后胁
骨尤为脆软，收束不住。故肺的膨胀力能隔骨肉向外凸出，形成此俗云之前鸡胸后罗锅的症象，在病名上说是龟
胸龟背。治疗之法，当除湿热之痰而消肿胀，可使肺叶突出之部分，收缩撤消。不过肺虽撤消，生命无碍，至已
突出受伤之前胸后背的胁骨，十九不能复其本来形象，终身留此遗憾。故小儿之病，既知与肺有关，即须急早诊
治，万不可迁延日久，致成此龟胸龟背之恶症也。再有一种为咳久气虚，面目浮肿，颜色 白，食少便泻，是小
儿疳症。乃肺脾两虚，有成慢惊风之趋向。治须养阴敛肺扶脾等法，切不可再用宣肺降痰等药，克伐正气，以致
无挽救小儿生命之法也。
肾者，足少阴经也，专司骨。凡全身骨胳、牙齿、尾尻等均属之。目瞳、两耳、囟顶、为其分野。牙不能生，
囟门不合，四
肢骨软，是为肾气不足也。肾热，则小便短赤，混浊涩痛，热极则起马牙、重舌、及鹅口白等。肾寒，则小溲频
数，大便溏，或呕吐完谷不化。若瞳孔散大，或瞀冥昏暗，舌短音无，肾气虚极将脱也。至眼起灰翳，小溲自
遗，小便缩，乳头缩，环唇眉心均青，四肢冷过肘膝者，肾气寒极将绝也。他若耳流灰臭脓水，是湿热成毒，在
肾作肿也。凡关于此等之种种症象，均应从肾脏病治之。不过肾脏为人生命的关系甚大，小儿之寿夭壮弱慧愚，
均视肾之实虚而定。故病在先天后天，必须辨清。临床之虚实寒热，更当审慎明了，以为对症延医。不然先天后
天病症小有出入，遗留小儿后来病根，或不幸成为终身痼疾。虚实寒热，用药稍错，立见死亡，为患更烈。为
儿科医者，万分注意可也。总之脾肺二脏，最容易受病。例如内伤乳食，外感风寒温邪，或中暑热，吐泻霍乱。保
护人对小儿身体稍疏护持；脾肺二脏感受外界侵袭，本身之天然抵抗力量，立即起反射作用，以驱除外来的寒
热风邪于体外，某呈现于外者，即所谓成病之症象也。至于心肝肾三脏，与外界接触的机会甚少，本不易受病。
况小儿一秉天真，无七情之内伤，无六欲之外伤，在饱食憩眠中即行长成，何致感疾病。就偶有病痛，亦不过
在经，不能入腑，况入脏乎？故疾病不能直接侵及，何致有伤也。若脾肺二脏感受的内伤乳食，外伤风寒不能清
解，失或延医之时效，或冶法错误，或药物错投，病能即渐渐向里攻进，心肝肾三脏到此地步，虽欲不受波及，
不可得矣。
肝归属于足厥阴经，其性质刚烈，依赖血液来滋养涵养。从两胁以下直到小腹及前阴等部位，都是肝所管辖的区域。肝最容易动气导致疼痛，又容易因热而生风，这种风气能上升到头顶，引起头部眩晕和疼痛，并向两侧太阳穴蔓延，造成胀痛。肝病显现的颜色为青色，常出现在左颧骨、眼睛，或鼻准两侧及眉心处。如果肝实证，则眼白部分出现红血丝，大声呼叫、打哈欠并感到胸闷憋气。若肝虚证，则表现为打哈欠和磨牙。若有风邪，则眼睛斜视且不灵活。若有热邪，则怒目而视且眼皮肿胀。如果肝热盛极损伤阴血，进而向下压迫脾胃，已经形成疳积病，则会出现白膜遮蔽瞳孔的情况，小儿必定表现出烦躁急迫而哭叫，哭声剧烈时会导致咽喉和胃部胀气噎塞，以致小便赤短或排尿困难，大便闭结，或者排出黑绿色的粪便。还有一种症状表现，小儿无故突然发作寒热交替，手去抓摸衣领，或双手乱捻物品，或两手在空中摸索床铺，这是惊吓导致丧魂的病证。如果不知道病因而误治，再拖延时日，小儿病情转危，就会现出眼球注视物体不动，或眼睛闭合不睁开，或眼睛瞪大不能闭合，或哭而无泪，或不哭而眼泪自出的现象。凡此种种征象，都属于肝气绝败，无法救治了。
心归属于手少阴经，其部位在胸下正中岐骨微陷处。凡是额头、舌尖、手足心等部位，也都是心所管辖的。最重要的是心能调节血液周全运行，滋润养育全身各神经及细微末梢等神经。心的自然功能能生发智能，发出言语和哭笑声。心没有表证，其所患疾病都属于里证。心不受外邪侵袭，既不会跳动异常，尤其不会疼痛。凡是感觉心动或心痛的人，实际上都是胃痛或气滞所致。如果是真正的心动或心痛病，不到一小时就会死亡。心有实火，则叫喊哭泣、发热，饮水无度，小便短赤甚至点滴全无。心有虚火，则困倦卧睡、迷糊嗜睡，心悸不安，眼睛瞪大无神，或舌尖红破，或舌体短缩声音低微，这种征象在久病患者中常见。如果热盛导致津液干枯，虽然极度口渴也不宜多给饮料，必须紧急保液生津，才有救活的可能。因为阴津不被盛热烤干，津液恢复布散，病终能痊愈。所以小儿有时不现表症病象，而有烦躁不宁、睡卧不安、叫哭不吃奶时，须先检查身体头面四肢有无热象。哪里发热，都应当细心辨别。属于何病的里热，何处为热的发源地，根据这些来确定证名，然后再寻求治疗该证的药剂，如此谨慎研究探求，哪有不能治愈的疾病呢？因为心部疾病没有表证，不像外感发热那样全身全热、昼夜均热。这只是一部分发热，发热有早晚轻重久暂的不同，也很容易辨别。不过热的虚实，乃在于热的位置是否紧要，或须紧急施治，或不能紧急治疗，必须细心推求，因为小儿体质脆弱，用药错误均不能承受。设稍有出入，追悔莫及。而且小儿都不易服药，用药又必须力求有力，一剂服后功效立见才可以，万万没有试探投药治疗的余地。不过小儿各病单纯的居多，又没有七情六欲的伤害，认症施治较成年人似乎更容易。其难点在于小儿自己不能说出病症表现及病之所在，也不能明确指出来。所以小儿久病脾虚连及心气弱，虽然症状现出火象，也必须先顾护心气虚弱，服用强心助气药。心气得助力，自然能气回液布，虚火归原，不直接治热而热自退。假如这些假症状，医者再不明了医理；不细心推求症状。见热治热，轻率地一味滥用凉药，以为热必可退。殊不知心气正在虚弱不绝如缕之时，又经此凉药一打击，必然导致阳气亡于上，阴竭于下，神经立即起变化，周身痉挛，立即死亡，能不谨慎吗？这是久病心气虚，尚易辨别，只要稍明病情医理，即可延医无误。现在有一种病，心气受不可抵御的压迫，强力侵袭，心气立即呈现微弱，神经也随之发生重大变化，不立即起抽搐，就立即神智昏迷，或昏倒不省人事。这是什么症呢？即夏日中暑，俗名所谓暑风症。此症虽非久病心气虚可比，然而心不受邪，其影响人的生命，重大危急可知。故也必须先顾护其心气，速用强心助气药，使心气有所借力，心中有所生发，外邪的侵袭力自然微弱，神经的变化亦自然回复平静，抽搐也就随之而定。然后再佐以清暑利湿芳香通络药，此症无不立即痊愈。不过病久心气虚弱，其来势缓，也不能立即医治痊愈。至于中暑的心气虚弱，其来势暴，然医治得法，其症平复如初，可以立等可待。其痊愈快慢不同，是受病久暂的问题。至于心脏对于人生，关系至重且大，较之于其他各脏，尤为紧要。一经发现受病牵及于心，就必须特别注意。无论其实热虚热，及病之久暂，都必须先保护心气，不使毫厘受伤。其他病症医治如法，虽危重也必可渐渐向愈。舌为心之苗窍，心部若有实热，或温疹出齐时候，热已退净，唯咳嗽尚盛，医者不知用养阴清肺药，养血以善其后，使得发过的壮热，及出过的赤疹，处处都得用药回复其已伤的血液，万万不可使其余的火复燃。不然在病患血液大亏之后，元气未复，身体虚弱，天然的抵抗能力，一点皆无，肺之余炎能乘心部的实热，复行猖獗。此时舌尖即起白泡溃烂，痛甚不能饮食。若再拖延，立即起重舌木舌等危险紧急症候。又有温疹病体初愈，正气未复之时，口味初开，胃力尚弱之时，此时亦甚紧要。若任何病患满意进食，胃力不能承受，停滞不能运化，积聚生热，亦乘心部之实热，向外发泄。其症状为谵语迷睡，舌苔黄浓垢腻，或口糜舌烂，成为种种变态的重病。此候治疗下之不可，恐体弱不能任受，气弱防其虚脱，不用下剂。此紧急之热邪，不容缓治，毒热从何处，用何方剂可去耶？到此地步，进退维谷，治疗之运用真棘手矣。所以说只有心部之病，心无表症，心不受邪，心部的重要，与人之生命有重大密切的关系。无论其实热虚热，及受病的久暂，若发觉心部受病为主要，必用强心药护持之，再治其他之脏腑各兼症即可。至于剧烈咳嗽，痰壅气喘或起重舌木舌，症状危急，或口糜舌烂，谵妄迷睡等等症状，虽然已至危险程度，然非心脏的主病。是肺胃部之余火复燃，乘心脏之热而炽盛，及肺胃两部为主体，心脏为连带波及。不必兼用强心剂，径用清肺胃之药，以解其热毒。各急症能稍转轻，慢慢向愈后，仍须养阴增液养血助气等法，以善其后也。
脾在生理上也属于重要之脏，为足太阴经，是后天之本。所以婴儿出生后，天然能吸乳汁以养生命，下受命门之火以蒸化谷食，上输谷食之精液，以灌溉其他各脏腑。所以人的生命存活本源，独脾脏之功用为最大。然而其性喜燥而恶湿，一旦受湿渍，则运化之力衰，而肝即乘以侮之。脾位在中焦，凡是眼睑、鼻准及四肢都是脾的分野。与胃相表里，故用药略同。脾之病无表证，凡病皆属于里。脾虚者，右关脉必细软，指纹现浅红而暗淡。其症状为呕吐，为泄泻，为久痢，为腹痛，为肢软，为面黄肌瘦，为发肿鼓脉，为积滞不化饮食化痰，为脱肛肠红等症状。脾实者，右关脉必沉数，指纹现红明色。其症为气积血滞，为痞满虫积，为痰饮腹痛等症状。脾寒者，右关脉必沉迟，指纹现淡红兼青暗色，唇舌必白淡无血色。其症为呕吐泄泻，为白痢腹痛，为湿肿阴黄胆，为四肢冷厥脱等症状。脾热者，右关脉必洪数，指纹现红明兼紫色，舌苔腻而黄，或唇赤舌亦赤。其症为热吐或流涎，为洞泻或泻渤，为赤痢腹下坠，为目胞肿痛或眩晕，为阴黄胆等症状。脾之病均有其他脏腑之症。故各症的治法用药，至后各症分门类时，再详细论之。兹不过言脾病之种数，及脉象指纹现色，辨别其虚实寒热而已。实则迷睡，烦躁夜卧不安，发热夜甚，至天将明热又渐轻，始能得二三小时之安睡，可见迷睡是脾实而热使之然也。虚则食乳不化，呕吐泄泻，日久脾虚及肾，即成慢脾风等症状，甚为难治。伤于湿则发皮水肿，或作腹痛胀，或成黄疸，脾痛则腹必痛，脾已结疳，必现肚大筋青，饮食过量而肌肉削，发毛枯焦。脾热则口出气息必臭，唇疮口糜，或吐舌舐唇。脾寒则口角流涎，或嗳腐吐酸，或虫出于口。此脾病之大略，随其现象见症，用药延医可以也。
肺者，手太阴经也。属脏其体甚娇脆，内主周身气化，外主周身皮毛，为人身体气布之总机关。凡是声音之出入，气之呼吸，均为肺的主力，始能得其调节清畅，其性畏火而仇寒，故遇燥而痰涎壅滞即咳嗽，遇寒侵袭，反抗驱除亦发咳。凡是耳廓白色及右颊鼻孔等处，皆是其表现于体外的分野。肺对于生命关系太大，须加意保护。不使寒火相侵，能长保其清宁之体，身自坚壮，寿臻大年也。故肺寒热所伤，则均现气逆音不流利，甚者作喘作咳，或哮吼音哑，受风伤则喷嚏，或流清涕而鼻塞，呼吸不利而头痛，或现头重及旋晕。若咳嗽不止，相连能咳数十百声，使人气均回不过来，急成面红筋粗，鼻涕眼泪，咳嗽喷嚏，连连不断，吐食呕水，小儿当此，焉能支持，症状更属紧急。此盖盛寒包肺，肺叶全闭也。治之得法应手奏效，否则不堪设想也。若鼻孔干眼涩，或鼻衄血，鼻头赤环唇赤烂，喘满咳嗽，痰涎壅阻气管，黄糊粘满两眼，此为风热郁于肺，肺窍阻痰，不能自如收放也。症状看似甚重，其实不是险症。用清火散风药一剂，风散热解，肺叶消其肿胀，气布痰开，即恢如初，各症状一扫而愈。他若发壮热咳嗽，气急颐肿，或项肿喉痛等象，为肺病兼胃病也。治法须肺胃两部并重，自易痊愈。若发壮热咳嗽，头痛肢酸，遍身及头面发赤点，或白尖云片等症状，为疹等疾病，亦为肺胃两部均感外邪而病也。治法须肺胃兼顾，清热祛邪解毒活血，即可缓缓向愈。不过此两条虽为肺胃兼病，然又兼温毒时症，不能与肺受盛寒风热，所现症状相比拟，更不能与肺胃兼病同治法。临床延医时，务必详细辨别，庶不能误。不然以小儿之未长成身体，娇嫩的肺，焉能受之也。至小儿因久嗽患龟背等症状象，是肺叶因湿痰及火的侵袭而肿胀，横膈膜上腔属性积不下，必须向外发展。而此时小儿之全体骨骼均未长成，不能坚实无抵抗力量。至于前后肋骨尤为脆软，收束不住。故肺的膨胀力能隔骨肉向外凸出，形成此俗云之前鸡胸后罗锅的症状象，在病名上说是龟胸龟背。治疗之法，当除湿热之痰而消肿胀，可使肺叶突出之部分，收缩撤消。不过肺虽撤消，生命无碍，至已突出受伤之前胸后背的肋骨，十九不能复其本来形象，终身留此遗憾。故小儿之病，既知与肺有关，即须急早诊治，万不可迁延日久，致成此龟胸龟背之恶症也。再有一种为咳久气虚，面目浮肿，颜色㿠白，食少便泻，是小儿疳症。乃肺脾两虚，有成慢惊风之趋向。治须养阴敛肺扶脾等法，切不可再用宣肺降痰等药，克伐正气，以致无挽救小儿生命之法也。
肾者，足少阴经也，专司骨。凡是全身骨骼、牙齿、尾尻等均属之。目瞳、两耳、囟顶，为其分野。牙不能生，囟门不合，四肢骨软，是为肾气不足也。肾热，则小便短赤，混浊涩痛，热极则起马牙、重舌、及鹅口白等。肾寒，则小溲频数，大便溏，或呕吐完谷不化。若瞳孔散大，或瞀冥昏暗，舌短音无，肾气虚极将脱也。至眼起灰翳，小溲自遗，小便缩，乳头缩，环唇眉心均青，四肢冷过肘膝者，肾气寒极将绝也。他若耳流灰臭脓水，是湿热成毒，在肾作肿也。凡关于此等之种种症状，均应从肾脏病治之。不过肾脏为人生命的关系甚大，小儿之寿夭壮弱慧愚，均视肾之实虚而定。故病在先天后天，必须辨清。临床之虚实寒热，更当审慎明了，以为对症延医。不然先天后天病症小有出入，遗留小儿后来病根，或不幸成为终身痼疾。虚实寒热，用药稍错，立见死亡，为患更烈。为儿科医者，万分注意可也。总之脾肺二脏，最容易受病。例如内伤乳食，外感风寒温邪，或中暑热，吐泻霍乱。保护人对小儿身体稍疏护持；脾肺二脏感受外界侵袭，本身之天然抵抗力量，立即起反射作用，以驱除外来的寒风热邪于体外，某呈现于外者，即所谓成病之症状象也。至于心肝肾三脏，与外界接触的机会甚少，本不易受病。况小儿一秉天真，无七情之内伤，无六欲之外伤，在饱食憩眠中即行长成，何致感疾病。就偶有病痛，亦不过在经，不能入腑，况入脏乎？故疾病不能直接侵及，何致有伤也。若脾肺二脏感受的内伤乳食，外伤风寒不能清解，失或延医之时效，或冶法错误，或药物错投，病能即渐渐向里攻进，心肝肾三脏到此地步，虽欲不受波及，不可得矣。
The Liver belongs to the Foot Jueyin Meridian (Foot Shaoyin Channel). Its nature is rigid and relies on blood for nourishment and containment. The areas from both hypochondriac regions downwards, including the lower abdomen and anterior yin, are all under its jurisdiction. It is most prone to moving qi causing pain, and easily generates wind due to heat. This wind can rise to the vertex of the head, causing dizziness and pain in the head, spreading to both temporal acupoints causing distension and pain. The pathological color associated with Liver disease is green, often appearing on the left cheekbone, eyes, or both sides of the nasal tip and between the eyebrows. In cases of Liver Excess, redness appears on the sclera (white part of the eye), accompanied by loud crying, yawning, and sudden chest tightness. If Liver Deficiency occurs, it manifests as yawning and teeth grinding. With Wind pathogen, the eyes deviate and lack flexibility. With Heat pathogen, there is an angry gaze and swollen eyelids. If severe Liver Heat damages Yin and Blood, subsequently pressing down on the Spleen and Stomach, leading to Infantile Malnutrition (Gan Accumulation), a white membrane may obscure the pupil. The child will inevitably show restlessness and crying; if the crying is intense, it causes Qi stagnation and choking in the throat and stomach, resulting in scanty dark urine or difficulty urinating, constipation, or passage of black-green stool. Another symptom pattern involves children suddenly developing alternating chills and fever without cause, grasping at clothing collars, randomly twisting objects with hands, or groping at the bed with empty hands; this is a condition of fright causing loss of soul. If the cause is unknown and treated incorrectly, delaying treatment will worsen the condition, presenting with eyes staring fixedly without movement, eyes closed and unable to open, eyes wide open and unable to close, crying without tears, or not crying but tears flowing spontaneously. All these signs indicate Liver Qi Exhaustion, which is incurable.
The Heart belongs to the Hand Shaoyin Meridian. Its location is in the center below the chest, slightly depressed at the xiphoid process. Areas such as the forehead, tongue tip, and palms/soles are also under its jurisdiction. Most importantly, the Heart regulates blood circulation comprehensively, moistening and nourishing all nerves throughout the body, including fine nerve endings. Its natural function generates intelligence, speech, and expressions like crying and laughing. The Heart has no Exterior Syndrome; diseases affecting it belong to the Interior. The Heart does not accept external pathogens directly; thus, it does not palpitate abnormally nor does it typically hurt. Any sensation of Heart palpitation or Heart pain is actually caused by Stomach pain or Qi stagnation. If it were truly Heart palpitation or Heart pain, death would occur within an hour. Heart Excess Fire manifests as crying, fever, excessive thirst, and scanty dark urine or anuria. Heart Deficiency Fire manifests as lethargy, drowsiness, palpitations with unease, wide-eyed gaze lacking spirit, red/broken tongue tip, short tongue with low voice; this sign is common in chronic illness. If severe Heat dries up Body Fluids, even extreme thirst should not be quenched with large amounts of fluids immediately; instead, urgent preservation of fluids and generation of Jin-Ye is required for salvation. Because if Yin fluids are not roasted dry by intense Heat, and once fluids return and distribute, the disease can ultimately heal. Therefore, when children do not show Exterior symptoms but exhibit irritability, restless sleep, and crying while refusing milk, one must first check for heat signs on the body, head, face, and limbs. One must carefully distinguish where the heat is located. Based on identifying the source of the Interior Heat and determining the syndrome name, appropriate herbal formulas can then be sought. Such careful investigation ensures curability. Since Heart diseases have no Exterior symptoms, unlike External Contraction fevers which cause whole-body heat day and night, Heart-related heat is localized, varying in timing, severity, and duration, making it easy to distinguish. However, whether the heat is Excess or Deficient depends on the criticality of its location, dictating whether urgent treatment is needed. This requires careful analysis because children's delicate constitutions cannot tolerate medication errors. Even slight deviations lead to regret. Moreover, children find it difficult to take medicine, so prescriptions must be potent, showing immediate efficacy after one dose; there is no room for trial-and-error therapy. Fortunately, pediatric diseases are often simple, and children are free from the damaging effects of the Seven Emotions and Six Desires, making diagnosis easier than in adults. The difficulty lies in the child's inability to verbalize symptoms or locate the pathology. Thus, in chronic Spleen Deficiency affecting Heart Qi, even if Fire-like symptoms appear, one must first protect the deficient Heart Qi using Cardiotonic and Qi-boosting herbs. Once Heart Qi receives support, Qi returns, fluids distribute, and Deficiency Fire returns to its origin; treating the heat directly is unnecessary as it subsides naturally. If physicians fail to understand medical principles and blindly treat heat with cooling herbs for such pseudo-symptoms, they strike the already fragile Heart Qi, potentially causing Yang collapse above and Yin exhaustion below, leading to immediate neural changes, convulsions, and death. How cautious must one be? Chronic Heart Qi Deficiency is relatively easy to identify; understanding basic pathology prevents error. However, consider a condition where Heart Qi suffers irresistible compression and strong invasion, causing immediate weakness and major neural changes, leading to convulsions, coma, or sudden collapse. What is this? It is Summerheat Stroke, commonly known as "Summerwind." Although not comparable to chronic Heart Qi Deficiency, the Heart's role in life is vital, and its impact here is critically dangerous. Thus, protecting Heart Qi with cardiotonics is essential to counteract external pathogens, calming neural changes and stopping convulsions. Subsequently, adding herbs that clear Summerheat, drain dampness, and unblock collaterals ensures rapid recovery. Chronic Heart Qi Deficiency develops slowly and heals slowly; Summerheat-induced deficiency develops rapidly but resolves quickly with correct treatment. The difference lies in the duration of the pathogenic factor. The Heart's relationship to life is paramount, more critical than other Zang organs. Once pathology affects the Heart, special attention is required. Regardless of Excess/Deficient Heat or duration, Heart Qi must be protected. Other diseases, if treated correctly, will gradually recover even if critical. The tongue is the sprout of the Heart. If Heart Excess Heat exists, or after warm-rash eruption subsides but cough persists, physicians must use Yin-nourishing Lung-clearing herbs to nourish blood and conclude treatment properly, ensuring recovered blood compensates for losses from high fever and rash. One must never allow residual fire to reignite. Otherwise, after significant blood depletion and incomplete Yuan Qi recovery, with weak resistance, residual Lung inflammation can exploit Heart Excess Heat, becoming rampant. This leads to white blisters and ulceration on the tongue tip, severe pain preventing eating. Delay results in dangerous conditions like Double Tongue or Wooden Tongue. Similarly, during early recovery from warm-rash, when Zheng Qi is not restored and Stomach Qi is weak, proper diet is crucial. If food intake exceeds Stomach capacity, stagnation generates heat, exploiting Heart Excess Heat to vent outward. Symptoms include delirium, drowsiness, thick yellow greasy tongue coating, or mouth ulcers/tongue erosion, becoming severe abnormal diseases. Purging is contraindicated due to weakness and risk of collapse, yet urgent heat-toxin requires prompt resolution. This dilemma makes treatment difficult. Therefore, only Heart diseases lack Exterior symptoms and do not accept external pathogens directly. The Heart's importance is closely tied to life. If Heart pathology is primary, regardless of heat type or duration, cardiotonics must be used first, followed by treating concurrent organ syndromes. Severe cough, phlegm obstruction, asthma, Double/Wooden Tongue, mouth ulcers, delirium, etc., though dangerous, are not primary Heart diseases. They result from residual Lung/Stomach fire igniting upon Heart heat, with Lung/Stomach as the main site and Heart secondarily involved. No cardiotonics are needed; simply clear Lung/Stomach heat-toxin. As acute symptoms subside, continue with Yin-nourishing, fluid-generating, blood-nourishing, and Qi-boosting methods to conclude treatment.
The Spleen is physiologically important, belonging to the Foot Taiyin Meridian, and is the Root of Post-Heaven Acquired Constitution. After birth, infants naturally suckle milk to sustain life. The Mingmen Fire steams and digests grain/food below, while the Spleen transports essence upwards to irrigate other Zang organs. Thus, the Spleen's function is greatest for sustaining life. Its nature prefers dryness and dislikes dampness; once soaked by dampness, its transformation power declines, allowing the Liver to overact against it (Wood insulting Earth). Located in the Middle Jiao, it governs eyelids, nasal tip, and limbs. Paired with the Stomach as Interior-Exterior, their treatments are similar. Spleen diseases have no Exterior symptoms; all are Interior. Spleen Deficiency presents with fine/soft Right Guan pulse, pale-red/dim fingerprint. Symptoms: vomiting, diarrhea, chronic dysentery, abdominal pain, limb weakness, sallow emaciation, edema/distension, food stagnation/phlegm-damp, rectal prolapse/redness. Spleen Excess presents with deep-rapid Right Guan pulse, bright red fingerprint. Symptoms: Qi/Blood stagnation, fullness/lumps, parasitic accumulation, phlegm-fluid abdominal pain. Spleen Cold presents with deep-slow Right Guan pulse, pale-red/green-dark fingerprint, pale lips/tongue. Symptoms: vomiting/diarrhea, white dysentery/abdominal pain, damp-edema/Yellow Jaundice, cold extremities/collapse. Spleen Heat presents with surging-rapid Right Guan pulse, bright red/purple fingerprint, greasy yellow tongue coating or red lips/tongue. Symptoms: hot vomiting/salivation, profuse watery diarrhea, red dysentery/tenesmus, swollen eyelids/dizziness, Yellow Jaundice. Spleen diseases often involve other organs; detailed treatments are discussed later. Here we merely list types and pulse/fingerprint colors to distinguish Excess/Deficiency/Cold/Heat. Excess: drowsiness, irritability, restless night sleep, fever worse at night, lightening at dawn allowing brief sleep; drowsiness is caused by Spleen Excess Heat. Deficiency: undigested milk/food, vomiting/diarrhea; long-term Spleen Deficiency affecting Kidney leads to Slow Spleen Wind, very hard to treat. Dampness injury: skin edema, abdominal pain/distension, jaundice. Spleen pain: abdominal pain. Spleen Gan: large belly, visible veins, muscle wasting, dry hair despite adequate intake. Spleen Heat: foul breath, lip sores/mouth ulcers, protruding tongue licking lips. Spleen Cold: drooling at mouth corners, belching sour rot, worms in mouth. These are general Spleen patterns; treatment follows symptoms.
The Lung belongs to the Hand Taiyin Meridian. As a Zang organ, it is delicate, governing internal Qi transformation and external skin/hair, acting as the central hub for Qi distribution. Voice production and respiration rely on the Lung's strength for regulation and clarity. It fears Fire and hates Cold; thus, dryness causing phlegm-stagnation leads to cough, and Cold invasion triggering defense mechanisms also causes cough. White ear cartilage, right cheek, and nostrils are its external manifestations. The Lung's relation to life is immense and requires protection from Cold/Fire to maintain purity/strength and longevity. Lung Cold/Heat injury causes Qi rebellion, hoarse voice, wheezing, cough, or hoarse barking sounds. Wind injury causes sneezing, clear rhinorrhea, nasal congestion, difficult breathing, headache, heavy head, or vertigo. Uninterrupted coughing (dozens/hundreds of times) causing breath-holding, red face, prominent veins, runny nose/eyes, continuous sneezing/coughing, vomiting food/water is extremely urgent for children. This is severe Cold enveloping the Lung, closing lung lobes completely. Correct treatment works instantly; otherwise, consequences are dire. Dry nostrils, gritty eyes, epistaxis, red nose ring/chapped lips, wheezing/cough, phlegm blocking airways, yellow discharge sticking eyes indicates Wind-Heat stagnating in Lung, obstructing orifices with phlegm, impairing opening/closing. Though severe-looking, it is not critical. One dose of clearing-fire dispersing-wind herbs resolves wind/heat, reduces lung swelling, distributes Qi, clears phlegm, and restores health. High fever/cough, rapid breathing/swollen cheeks, or neck swelling/sore throat indicates Lung-Stomach combined disease. Treating both Lungs and Stomach ensures recovery. High fever/cough, headache/body ache, red spots/cloud-like patches on body/head/face indicates Rash diseases, also Lung-Stomach external contraction. Treatment requires addressing both, clearing heat, expelling pathogens, detoxifying, and invigorating blood for gradual recovery. Note: These two cases involve Warm-Toxin seasonal diseases, distinct from Lung Cold/Heat or pure Lung-Stomach disease; clinical differentiation is vital to avoid error. Children's immature bodies and tender Lungs cannot withstand misdiagnosis. Chronic cough causing tortoise-back (Kyphosis) results from Lung lobe swelling due to damp-phlegm/fire, pushing diaphragm upward. Immature bones cannot resist this expansion, especially fragile ribs, causing anterior Chicken Breast and posterior Hunchback (Tortoise Chest/Back). Treatment removes damp-heat phlegm and reduces swelling, retracting protruding parts. While life is unaffected, deformed bones rarely regain original shape, leaving lifelong regret. Early diagnosis is crucial to prevent this. Another pattern: chronic cough Qi Deficiency, facial edema, pale complexion, poor appetite/diarrhea indicates Infantile Malnutrition (Gan Syndrome), Lung-Spleen Dual Deficiency trending toward Slow Convulsion. Treatment requires nourishing Yin, astringing Lung, supporting Spleen. Do NOT use Lung-dispersing/phlegm-descending herbs that damage Zheng Qi, leaving no hope for rescue.
The Kidney belongs to the Foot Shaoyin Meridian, exclusively governing bones. All skeletal structures, teeth, and sacrum/coccyx belong to it. Pupil, ears, and fontanelle are its external domains. Failure of teeth eruption, unclosed fontanelle, and soft limb bones indicate Kidney Qi Deficiency. Kidney Heat causes scanty dark turbid painful urine; extreme heat leads to Horse Teeth, Double Tongue, and Thrush. Kidney Cold causes frequent urination, loose stools, or vomiting undigested food. Dilated pupils, blurred vision, short tongue/no voice indicate extreme Kidney Qi Deficiency nearing collapse. Gray film on eyes, urinary incontinence, retracted penis/nipples, blue-green hue around lips/brows, cold limbs past elbows/knees indicate extreme Kidney Cold nearing extinction. Gray smelly pus from ears indicates Damp-Heat toxicity swelling in Kidney. All such symptoms should be treated as Kidney disease. The Kidney's relation to life is profound; a child's lifespan, strength, and intelligence depend on Kidney Excess/Deficiency. Congenital vs. Acquired diseases must be distinguished. Clinical Excess/Deficiency/Cold/Heat must be clearly identified for targeted treatment. Errors leave root causes or lifelong chronic diseases. Medication errors in Excess/Deficiency/Cold/Heat lead to immediate death. Pediatricians must be extremely vigilant. In summary, Spleen and Lung are most susceptible to disease. Internal injury from milk/food, external contraction of Wind-Cold/Warmth, or Summerheat/Dysentery/Holier Cholera trigger reflex responses in Spleen/Lung to expel pathogens externally, manifesting as disease symptoms. Heart, Liver, Kidney rarely contact the exterior and are less prone to disease. Children possess innate innocence, free from emotional/internal injuries or desire/external injuries, growing well in feeding/sleeping. Occasional illnesses remain in Channels, not entering Fu organs, let alone Zang organs. Thus, direct invasion is rare. However, if Spleen/Lung internal/external injuries are not cleared timely, or treatment/methods are wrong, pathology advances inward, eventually affecting Heart, Liver, Kidney, making avoidance impossible.