小儿大小便时时审看。小便如米泔或澄停，少顷变作泔浊，此脾胃湿热也，若大便泔白色，或如鱼冻，
或带红，或色黄黑，此积滞湿热也，宜理脾消滞，清中宫，去湿热，节饮食。若忽然变青，此是变蒸也，
不必用药；若久不愈，用补脾制肝药一、二服，亦不宜多用。
愚按小便如泔，或大便泔白，宜用肥儿丸；若积滞黄黑，宜用四君子加黄连、木香；若色青日久不复，
或兼泄泻，或兼腹痛，当用六君子加木香、芍药；若肌体色黄，小便不利，发黄脱落，鼻下疮痍，嗜土，
少食，大便青褐色者，须用栀子茯苓汤。（详见治疳要药下。）
小儿病，大率属脾土、肝木二经。肝只是有余，有余之病似重急，而为治却易，见效亦速；脾只是不
足，不足之病似轻缓，而为治却难，见效亦迟。二经为病，惟脾居多，用药最要分别。若肝木自旺，则为
急惊，目直视或动摇，手足搐搦，风痰上壅等症，此为有余，宜伐木泻肝、降火清心。若脾胃虚而肝木来
侮，亦见惊搐动摇诸症，但其势微缓，名曰慢惊，宜补养脾胃，不可错认，将脾经误作肝经治也。
愚按急惊乃风火之症，脾土受制，肝经实热者，用泻青丸径伐其肝，或导赤散以泻其子；肝经虚热
者，用六味地黄丸以滋肾水，补中益气汤以养脾土∶
则风木自息，脾土自安矣。若因乳食不调，脾胃亏损，木来侮土，似慢惊而见抽搐、摇头、札目、切牙等症，
宜用六君子加钩藤钩。若脾胃亏损，寒水反来侮土，成慢惊而见前症，用前药加姜、桂；如未应，更加附
子，多有复苏者。
举人杜克宏子，发热，抽搐，口噤，痰涌，此肝胆经实火之症，即急惊风也。先用泻青丸一服，又用
六味丸二服，诸症顿退，乃以小柴胡汤加芎、归、山栀、钩藤钩而安，却用补中益气汤而愈。
仔细审视小儿的大小便情况。如果小便像米泔水一样，或者静止片刻后变得浑浊，这是脾胃湿热的表现；如果大便呈米白色，或像鱼冻状，或带红色，或颜色黄黑，这是积滞湿热所致，应当采用调理脾胃、消除积滞、清中焦、去除湿热的方法，并节制饮食。如果突然变成青色，这是“变蒸”（婴幼儿生长发育过程中的生理现象），不需要用药；如果久不痊愈，服用一两剂补脾制肝的药物即可，也不宜多用。
我按语：小便如米泔色，或大便呈米白色，适宜使用肥儿丸；如果是积滞导致的黄黑色大便，适宜在四君子汤基础上加黄连、木香；如果颜色青且日久不恢复，或者兼有泄泻，或者兼有腹痛，应当使用六君子汤加木香、芍药；如果身体发黄，小便不利，头发脱落，鼻子下方生疮，嗜食泥土，食欲减退，大便呈青褐色者，必须使用栀子茯苓汤。（详见治疗疳积的要药部分。）
小儿的疾病，大多属于脾土和肝木两经。肝气通常有余，有余的病证看起来严重急迫，但治疗起来却容易，见效也快；脾气通常不足，不足的病证看起来轻微缓慢，但治疗起来却困难，见效也慢。这两经发病，以脾居多，用药时最要加以区分。如果肝木自旺，就会发生急惊风，出现眼睛直视或颤动、手足抽搐、风痰上涌等症状，这属于有余之证，应当采用伐木泻肝、降火清心的方法。如果脾胃虚弱而肝木来相侮（克制），也会出现惊搐动摇等诸症，但病情势态微缓，称为慢惊风，应当补养脾胃，不可错误辨认，将脾经的病误作肝经来治疗。
我按语：急惊风是风火之症，脾土受制，肝经实热者，用泻青丸直接伐肝，或用导赤散泻其子脏（心）；肝经虚热者，用六味地黄丸滋补肾水，用补中益气汤滋养脾土，这样风木之气自然平息，脾土自然安宁。如果是因乳食不调，导致脾胃亏损，肝木来侮脾土，症状类似慢惊风而出现抽搐、摇头、眨眼、磨牙等症，适宜使用六君子汤加钩藤钩。如果脾胃亏损，寒水反来侮土，形成慢惊风并出现前述症状，使用前药加生姜、肉桂；如果无效，再加附子，多有苏醒的病例。
举人杜克宏的儿子，发热、抽搐、口噤（牙关紧闭）、痰涌，这是肝胆经实火的病症，即急惊风。先用一服泻青丸，又用二服六味地黄丸，各种症状顿时消退，接着用小柴胡汤加川芎、当归、山栀、钩藤钩而安定，最后用补中益气汤治愈。
Carefully examine the urination and defecation of infants and children. If the urine resembles rice washings or becomes turbid after standing for a short while, this indicates damp-heat in the Spleen and Stomach. If the stool is white like rice washings, or resembles fish jelly, or contains blood, or is yellowish-black, this indicates stagnation with damp-heat. The treatment should involve regulating the Spleen, eliminating stagnation, clearing the Middle Jiao (Central Burner), removing damp-heat, and controlling diet. If it suddenly turns green, this is "Bian Zheng" (a physiological phenomenon related to infant growth and development), and no medication is needed; if it persists without improvement, one or two doses of herbs that tonify the Spleen and control the Liver may be used, but excessive use is not advisable.
My commentary: For urine resembling rice washings or stool being white like rice washings, Fei Er Wan (Child-Nourishing Pill) is appropriate. For yellowish-black stools due to stagnation, Si Jun Zi Tang (Four Gentlemen Decoction) added with Huang Lian (Coptidis Rhizoma) and Mu Xiang (Aucklandiae Radix) is suitable. If the color remains green for a long time without recovery, accompanied by diarrhea or abdominal pain, Liu Jun Zi Tang (Six Gentlemen Decoction) added with Mu Xiang and Shao Yao (Paeoniae Radix) should be used. If the body appears jaundiced, urination is difficult, hair falls out, sores appear under the nose, there is pica (craving earth), poor appetite, and the stool is greenish-brown, Zhi Zi Fu Ling Tang (Gardenia and Poria Decoction) must be used. (See details on essential herbs for treating Gan syndrome below.)
Pediatric diseases generally belong to the Spleen Earth and Liver Wood meridians. The Liver typically has excess Qi; diseases of excess appear severe and urgent but are easier to treat and respond quickly. The Spleen typically has deficient Qi; diseases of deficiency appear mild and slow but are difficult to treat and respond slowly. Among diseases of these two meridians, Spleen disorders are more common, making precise differentiation in medication crucial. If Liver Wood flares up spontaneously, it causes Acute Convulsion (Ji Jing Feng), characterized by staring eyes, tremors, limb convulsions, and upward surging of wind-phlegm. This is an excess condition, treated by subduing Wood, purging the Liver, descending fire, and clearing the Heart. If Spleen-Stomach deficiency allows Liver Wood to invade (overact upon) it, similar symptoms of convulsions and tremors occur, but the progression is milder, known as Chronic Convulsion (Man Jing Feng). Treatment should focus on nourishing and tonifying the Spleen-Stomach; one must not mistakenly diagnose a Spleen meridian disorder as a Liver meridian disorder.
My commentary: Acute Convulsion is a Wind-Fire syndrome where Spleen Earth is constrained by Liver Fire Excess. Use Xie Qing Wan (Drain Green Pill) to directly purge the Liver, or Dao Chi San (Direct to the Heart Powder) to drain its son organ (Heart). For Liver Yin Deficiency with Empty Heat, use Liu Wei Di Huang Wan (Six-Ingredient Pill with Rehmannia) to nourish Kidney Water, and Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) to nourish Spleen Earth; thus, Wind Wood will naturally subside, and Spleen Earth will stabilize. If improper breastfeeding or diet damages the Spleen-Stomach, allowing Liver Wood to invade Earth, presenting symptoms similar to Chronic Convulsion such as convulsions, head shaking, blinking, and teeth grinding, use Liu Jun Zi Tang added with Gou Teng Gou (Uncariae Ramulus cum Uncis). If Spleen-Stomach damage leads to Cold Water invading Earth, resulting in Chronic Convulsion with the aforementioned symptoms, add Sheng Jiang (Zingiberis Rhizoma Recens) and Rou Gui (Cinnamomi Cortex) to the previous formula; if ineffective, add Fu Zi (Aconiti Lateralis Radix Preparata), with many cases recovering consciousness.
The son of Scholar Du Kehong presented with fever, convulsions, trismus (lockjaw), and profuse phlegm. This was a syndrome of Excess Fire in the Liver and Gallbladder meridians, specifically Acute Convulsion Wind. Initially, one dose of Xie Qing Wan was administered, followed by two doses of Liu Wei Di Huang Wan, which caused all symptoms to recede immediately. Subsequently, Xiao Chai Hu Tang (Minor Bupleurum Decoction) added with Chuan Xiong (Ligustici Chuanxiong Rhizoma), Dang Gui (Angelicae Sinensis Radix), Shan Zhi (Gardeniae Fructus), and Gou Teng Gou stabilized the condition. Finally, Bu Zhong Yi Qi Tang cured the patient.