医方论治大紧兹分四大证∶一曰表热，一曰里热，一曰虚热，一曰实热。证治俱详《幼
幼集成》。
小儿表热者。发热时喜人怀抱，畏缩恶风寒，不欲露出头面，面带惨色，口不渴，清便
自调，吮乳口不热，或鼻塞流涕，或喷嚏。初起一汗可解用加味香苏饮，见“误搐”。元气
怯弱者，加人参、白术。或用葱豉汤，热服取汗亦可。重者用人参败毒散，方俱见上“误搐
”。风寒发热兼吐泻者，系脾胃虚怯，不用发散，用五苓饮煎送理中丸，见“非搐”。
里热者。发热时喜露头面，仰身卧，扬手掷足揭去衣被，渴欲饮水。吮乳不休者，口渴
也。吮乳口热，小便赤，大便闭，宜解利之∶用导赤散，见“初生啼器”，加黑栀仁、当归
、川芎、防风各七分。大便秘者，加庄黄七分。并用罨脐法，或蜜煎导法以通之。若每日巳
午时发热，过夜则退去，此心经血热也。轻则用导赤散，方见“初生”。重则用四顺清凉散
，方见下页，不必加药。
虚热者。多从大泻之后，或温热，或潮热，（如潮汐有期，）或渴，或不渴，神气困倦，四
肢少力，大小便如常，宜补之∶四君子汤，方见上“非搐”，加炮姜五分、红枣肉三枚，以
灶心土三两，化水澄清煎服。有潮热者，再加酒芍二两，柴胡、淡竹叶各六分。夜间作热，
旦则退去，是血虚也，六味地黄汤，见下“龟胸”，加炙龟版、当归、白芍。又，伤寒无汗
，发汗热不退，下之热仍不退，乃表里俱虚，宜四君子汤，见“非搐”，加山药，炒；扁豆
，浸去壳，炒，各二钱。
实热者。面赤腮燥，鼻孔干，喜就冷，或合面卧，或仰面卧，露出手足，揭去衣被，大
渴不休，大小便闭。宜微下之∶用《集成》沆瀣丹，方见后“痢疾”。或用四顺清凉散∶杭
白芍二钱、当归、庄黄各一钱，炙甘草五分，加连翘、黄芩、川芎各八分，枳壳、荷叶各四
分，槟榔五分，灯草十茎，水煎服。如大便仍秘，再用罨脐、蜜导等法通之。其伤于热
、暑湿、疳积等症发热者，散见各门，并详《幼幼集成》，可参考焉。
医方论述治疗原则，大致分为四大证型：一是表热，二是里热，三是虚热，四是实热。具体的证候与治疗详见《幼幼集成》一书。
小儿患表热证时，发热时喜欢被人抱着，畏缩怕冷怕风，不愿意露出头脸，面色惨淡，口不渴，大小便正常，吸吮乳汁时口唇不热，或者伴有鼻塞流涕，或者打喷嚏。初起时通过发汗即可解除，使用加味香苏饮（见“误搐”章节）。若元气虚弱者，加入人参、白术。或者使用葱豉汤，热服以取汗也可。病情较重者，使用人参败毒散，方剂均见上文“误搐”章节。若是风寒发热兼有呕吐腹泻，属于脾胃虚怯，不宜使用发散药，应用五苓饮煎汤送服理中丸，见“非搐”章节。
患里热证时，发热时喜欢露出头脸，仰卧伸身，扬手踢脚，掀开衣被，口渴想喝水。吸吮乳汁不停止的，是因为口渴。吸吮乳汁时口唇热，小便颜色深红，大便干结不通，应当解表清热：使用导赤散（见“初生啼器”章节），加入黑栀子仁、当归、川芎、防风各七分。大便秘结的，加入庄黄（即大黄）七分。同时配合敷脐法，或者蜜煎导法来通便。如果每天巳时、午时发热，到了夜间就退去，这是心经血热。轻症用导赤散，方剂见“初生”章节。重症用四顺清凉散，方剂见下页，不需要再加其他药物。
患虚热证时，多发生在严重腹泻之后，或者是温热，或者是潮热（如潮汐一样有定时），或者口渴，或者不渴，精神困倦，四肢无力，大小便如常，应当补益：使用四君子汤（方剂见上“非搐”章节），加入炮姜五分、红枣肉三枚，用灶心土三两化水澄清后煎服。有潮热的，再加入酒炒白芍二两，柴胡、淡竹叶各六分。夜间发热，早晨退去的，是血虚，使用六味地黄汤（见下“龟胸”章节），加入炙龟版、当归、白芍。另外，伤寒无汗，发汗后热不退，攻下后热仍不退，这是表里俱虚，宜用四君子汤（见“非搐”章节），加入山药（炒）、扁豆（浸去壳，炒），各二钱。
患实热证时，面颊红赤，腮部干燥，鼻孔干，喜欢靠近冷处，或者趴着睡，或者仰面睡，露出手脚，掀开衣被，极度口渴不止，大小便闭塞。应当轻微攻下：使用《集成》中的沆瀣丹，方剂见后“痢疾”章节。或者使用四顺清凉散：杭白芍二钱、当归、庄黄各一钱，炙甘草五分，加入连翘、黄芩、川芎各八分，枳壳、荷叶各四分，槟榔五分，灯草十茎，水煎服。如果大便仍然秘结，再用敷脐、蜜导等方法通便。那些因伤于热、暑湿、疳积等病症引起的发热，分散在各门中，并详细记载在《幼幼集成》中，可以参考。
Medical discussions on treatment principles are generally divided into four major syndromes: one is Exterior Heat (Biao Re), two is Interior Heat (Li Re), three is Deficiency Heat (Xu Re), and four is Excess Heat (Shi Re). The specific manifestations and treatments are detailed in the book *You You Ji Cheng* (Comprehensive Collection for Infants and Children).
When infants suffer from Exterior Heat, they prefer to be held during fever, shrink away fearing cold and wind, do not wish to expose their heads and faces, have a pale/dull complexion, no thirst, normal urination and defecation, cool lips when suckling milk, or may present with nasal congestion and runny nose, or sneezing. At the onset, sweating can resolve it; use Jia Wei Xiang Su Yin (Modified Fragrant and Perilla Decoction) (see "Mismanaged Convulsions"). If the primordial Qi (Yuan Qi) is weak, add Renshen (Ginseng Root) and Baizhu (Atractylodes Rhizome). Alternatively, Cong Chi Tang (Scallion and Fermented Soybean Decoction) taken hot to induce sweating is also effective. For severe cases, Renshen Bai Du San (Ginseng and Anti-epidemic Powder) is used; all formulas are seen above under "Mismanaged Convulsions". If wind-cold heat is accompanied by vomiting and diarrhea, it belongs to Spleen and Stomach deficiency and timidity; dispersing methods should not be used. Instead, use Wu Ling Yin (Five-Ingredient Poria Decoction) decocted to swallow Li Zhong Wan (Regulate the Middle Pill); see "Non-convulsive".
For Interior Heat, during fever, the child prefers to expose their head and face, lies supine with body extended, throws hands and feet about, removes clothes and blankets, feels thirsty and desires water. Continuous suckling indicates thirst. Hot lips when suckling, dark red urine, and constipation indicate the need to relieve exterior and clear heat: use Dao Chi San (Guide Out Redness Powder) (see "Newborn Crying"), adding Hei Zhi Ren (Black Gardenia Seed), Danggui (Angelica Sinensis), Chuanxiong (Ligusticum Rhizome), and Fangfeng (Saposhnikovia Root), each 0.7 fen. For severe constipation, add Zhuang Huang (Rhubarb Rhizome) 0.7 fen. Simultaneously apply the Umbilical Compress Method or Honey Suppository Method to promote bowel movement. If fever occurs daily at Si (9-11 AM) and Wu (11 AM-1 PM) hours and subsides overnight, this is Heart Meridian Blood Heat. Mild cases use Dao Chi San (formula seen under "Newborn"); severe cases use Si Shun Qing Liang San (Four-Obedient Cooling Powder) (formula seen on the next page), without adding other herbs.
Deficiency Heat often follows severe diarrhea, presenting as warm heat or tidal fever (regular like tides), with or without thirst, mental fatigue, limb weakness, and normal urination/defecation; tonification is appropriate: use Si Jun Zi Tang (Four Gentlemen Decoction) (formula seen above under "Non-convulsive"), adding Pao Jiang (Prepared Ginger) 0.5 fen and three dates (red date flesh). Decoct with clarified water made from 3 liang of Zaoxin Tu (Caoline). For those with tidal fever, add further Jiu Shaos (Wine-fried White Peony Root) 2 liang, Chaihu (Bupleurum Root), and Dan Zhu Ye (Lophatherum Leaf), each 0.6 fen. Fever occurring at night and subsiding at dawn indicates Blood Deficiency; use Liu Wei Di Huang Tang (Six-Ingredient Rehmannia Pill Decoction) (seen below under "Turtle Chest"), adding Zhi Guiban (Processed Turtle Shell), Danggui, and Baishao (White Peony Root). Additionally, if cold damage presents with no sweat, and fever persists after sweating, or remains after purgation, this indicates both Exterior and Interior Deficiency; use Si Jun Zi Tang (see "Non-convulsive"), adding Shan Yao (Chinese Yam, stir-fried) and Bian Dou (Hyacinth Bean, soaked, shelled, stir-fried), each 2 qian.
Excess Heat presents with red cheeks, dry parotids, dry nostrils, preference for cold, lying prone or supine, exposing limbs, removing clothes/blankets, extreme unceasing thirst, and urinary/defecatory obstruction. Mild purgation is indicated: use Hangxie Dan (Hangxie Pill) from *Ji Cheng* (see "Dysentery" below). Or use Si Shun Qing Liang Sang: Hang Baishao (White Peony Root) 2 qian, Danggui, Zhuang Huang each 1 qian, Zhi Gancao (Licorice Root, honey-fried) 0.5 fen, added with Lianqiao (Forsythia Fruit), Huangqin (Scutellaria Root), Chuanxiong each 0.8 fen, Zhi Qiao (Immature Bitter Orange) and He Ye (Lotus Leaf) each 0.4 fen, Binglang (Areca Seed) 0.5 fen, Dengcao (Juncus Effusus Stem) 10 stems; decoct in water and take. If stool remains obstinate, use umbilical compress, honey suppository, etc., to promote evacuation. Fevers caused by injury from heat, summer-dampness, or malnutrition accumulation (Gan Ji) are scattered across various sections and detailed in *You You Ji Cheng*; refer to them for consultation.