小儿或因惊搐，或变蒸，或食积，或寒热往来，误服解表、泻利之药，伤损脾胃，气血难以发生，面
黄肌瘦，目动，切牙，发稀，足弱不能行步。此属胃虚，非肝肾也，当长缓调理，复全胃气可也。
愚按药饵偏胜之味，脾胃非所宜也。况小儿之疾，多因乳食不调，寒温失节，亏损脾胃元气，根本
不固，而邪得以致之。亦有因乳母六淫、七情、饮食、起居所致。苟不明其本末、辨其缓急，而误用峻厉之
药，重伤脾胃生生之气，变症百出，促其夭亡，谁之咎也？丹溪先生《慈幼论》言之详矣。
小儿身常发风斑及脚指常红肿，此脾经风热也。用防风通圣散去硝、黄，加鼠粘子、酒炒黄连，为末服
之；亦用防风、白芷、薄荷、黄连、黄芩、黄 、黄柏煎汤，避风而浴。
愚按前症若因脾气不足，湿热下注，宜用参、 、
归、术以补脾气；升麻、柴胡以升阳气；茯苓、泽泻以导湿热。若因食郁内热，宜用四君子汤以健脾胃；山
楂、神曲以消饮食；山栀、川芎以清肝热。若因风邪收敛腠理，或浴出见风而患者，宜用补中益气汤以补元
气，加芎、芷、羌活以散风邪。洁古先生云∶斑发于肤外而多痛，疹隐于肤内而多痒。大抵安里之药为主，
发表之药为佐。
一小儿，瘙痒，发热，体倦，少食。此脾肺气虚，外邪相搏。先用消风散二剂，随用补中益气汤加茯
苓、芍药而愈。
一小儿，患此作痛，热渴，服发表之剂，其症益甚，形气倦怠，脉浮而数，此邪在经络，误散表而损
其真也。用人参安胃散、补中益气汤而愈。
一小儿，作痒，发热，用犀角消毒散，顿作吐泻，此邪气上下俱出也。其疹果消，勿药自愈。
一小儿，阴囊赤肿，余作胎毒治之而瘥。后患发热、痰喘等症，诊其母有郁火血热，用解郁凉血之
药，子母俱服而愈。又患吐泻，小便赤涩，两目 动，视其寅卯关脉赤，此属风热。用柴胡清肝散加钩
藤钩、木贼草，一剂即愈。
一小儿，腿如霞游走不定，先以麻油涂患处，砭出恶血，其毒即散，用九味解毒散，一剂而安。
一小儿患之，外势虽轻，内苦便秘。此患在脏也，
服大连翘饮，敷神功散而瘥。
小儿可能因为惊风抽搐，或者变蒸（婴幼儿生长发育过程中的生理现象），或者食积停滞，或者寒热往来，误服了解表、泻下的药物，损伤了脾胃，导致气血难以化生，出现面色萎黄、肌肉消瘦、眼睛跳动、咬牙、头发稀疏、双腿无力不能行走等症状。这属于胃气虚弱，并非肝肾病变，应当长期缓慢地调理，恢复胃气即可痊愈。
我按语：药物偏颇峻烈之性，脾胃并不适宜承受。况且小儿的疾病，多因乳食不调，寒暖失节，亏损了脾胃元气，根本不稳固，外邪才得以入侵。也有因乳母感受六淫邪气、七情内伤、饮食起居不当所致的。如果不明白疾病的本末、辨别病情的缓急，而误用峻猛激烈的药物，严重伤害脾胃生生不息之气，导致各种变证百出，加速其夭折，这是谁的过错呢？丹溪先生在《慈幼论》中已经论述得很详细了。
小儿身体经常发出风斑，且脚趾经常红肿，这是脾经风热所致。使用防风通圣散去掉芒硝、大黄，加入牛蒡子、酒炒黄连，研为细末服用；也可以使用防风、白芷、薄荷、黄连、黄芩、黄芪、黄柏煎汤，避风洗浴。
我按语：上述病症如果是因为脾气不足，湿热下注，宜用人参、[缺字]、当归、白术来补益脾气；升麻、柴胡来提升阳气；茯苓、泽泻来引导湿热排出。如果是因食滞郁结产生内热，宜用四君子汤来健运脾胃；山楂、神曲来消食导滞；山栀、川芎来清肝热。如果是因风邪收敛腠理，或者洗澡后受风而发病的，宜用补中益气汤来补益元气，加川芎、白芷、羌活来疏散风邪。洁古先生曾说：斑发于皮肤表面且多疼痛，疹隐于皮肤内部且多瘙痒。大抵以安里（固护内脏）的药物为主，发表（发散表邪）的药物为辅。
有一个小儿，瘙痒，发热，身体疲倦，食欲减少。这是脾肺气虚，与外邪相搏结。先用消风散两剂，随后用补中益气汤加茯苓、芍药而痊愈。
有一个小儿，患此症感到疼痛，发热口渴，服用了解表的药剂，症状更加严重，形体气息倦怠，脉象浮而数，这是邪气在经络，误用发散表邪的方法损伤了正气。用人参安胃散、补中益气汤而痊愈。
有一个小儿，作痒，发热，用了犀角消毒散，顿时发生呕吐腹泻，这是邪气从上下两方面排出的表现。他的皮疹果然消退，不用服药也能自愈。
有一个小儿，阴囊赤肿，我将其作为胎毒治疗而痊愈。后来出现发热、痰喘等症状，诊察其母亲有郁火血热，使用解郁凉血的药物，母子同服而痊愈。又出现吐泻，小便赤涩，两眼跳动，诊察其寅卯关脉色赤，这属于风热。用柴胡清肝散加钩藤、木贼草，一剂即愈。
The child may suffer from convulsions due to fright, or physiological changes during growth (Bianzheng), or food stagnation, or alternating chills and fever. If they mistakenly take exterior-releasing or purgative medicines, the Spleen and Stomach are damaged, making it difficult for Qi and Blood to be generated. Symptoms include sallow complexion, emaciation, eye twitching, teeth grinding, sparse hair, and weak legs unable to walk. This belongs to Stomach deficiency, not Liver or Kidney pathology. It should be managed with long-term, gradual regulation to restore Stomach Qi.
My commentary: Medicines with extreme properties are not suitable for the Spleen and Stomach. Moreover, children's diseases often arise from irregular diet, improper temperature regulation, which deplete Spleen and Stomach Yuan Qi. When the root is not solid, pathogens can invade. Some cases are caused by the nursing mother's exposure to the Six Evils, emotional disturbances, or improper diet and lifestyle. If one does not understand the origin and progression of the disease, nor distinguish between urgent and chronic conditions, and mistakenly uses harsh and potent medicines, it severely damages the life-generating Qi of the Spleen and Stomach. This leads to various complications and accelerates premature death. Whose fault is this? Mr. Danxi discussed this in detail in *Ci You Lun* (Treatise on Nurturing Children).
If a child frequently develops wind spots on the body and redness/swelling of the toes, this is Wind-Heat in the Spleen Meridian. Use Fangfeng Tongsheng San (Windproof Unblocking Holy Powder) removing Mangxiao (Mirabilite) and Dahuang (Rhubarb), adding Niubangzi (Arctii Fructus) and Jiuchao Huanglian (Coptidis Rhizoma fried with wine), ground into powder for oral administration. Alternatively, decoct Fangfeng (Saposhnikoviae Radix), Baizhi (Angelicae Dahuricae Radix), Bohe (Menthae Haplocalycis Herba), Huanglian (Coptidis Rhizoma), Huangqin (Scutellariae Radix), Huangqi (Astragali Radix), and Huangbai (Phellodendri Cortex) in water, and bathe while avoiding wind.
My commentary: For the aforementioned symptoms, if caused by Spleen Qi deficiency with Damp-Heat pouring downward, use Renshen (Ginseng Radix et Rhizoma), [missing character], Danggui (Angelicae Sinensis Radix), and Baizhu (Atractylodis Macrocephalae Rhizoma) to tonify Spleen Qi; Shengma (Cimicifugae Rhizoma) and Chaihu (Bupleuri Radix) to raise Yang Qi; Fuling (Poria) and Zexie (Alismatis Rhizoma) to drain Damp-Heat. If caused by food stagnation generating internal heat, use Sijunzi Tang (Four Gentlemen Decoction) to strengthen the Spleen and Stomach; ShanZha (Crataegi Fructus) and Shenqu (Massa Medicata Fermentata) to digest food; Shanzhi (Gardeniae Fructus) and Chuanxiong (Ligustici Chuanxiong Rhizoma) to clear Liver Heat. If caused by Wind pathogen constricting the Couli (pores), or contracting wind after bathing, use Buzhong Yiqi Tang (Decoction for Supplementing the Middle and Augmenting the Qi) to tonify Yuan Qi, adding Chuanxiong (Ligustici Chuanxiong Rhizoma), Baizhi (Angelicae Dahuricae Radix), and Qianghuo (Notopterygii Rhizoma et Radix) to disperse Wind pathogen. Mrie Jiegu stated: Ban (macules) appear on the skin surface and are often painful; Zhen (papules/rash) hide within the skin and are often itchy. Generally, medicines that stabilize the interior serve as the main treatment, while exterior-releasing medicines serve as auxiliaries.
One child presented with itching, fever, fatigue, and poor appetite. This was Spleen and Lung Qi deficiency with external pathogens clashing. Initially treated with Xiaofeng San (Eliminate Wind Powder) for two doses, followed by Buzhong Yiqi Tang (Decoction for Supplementing the Middle and Augmenting the Qi) added with Fuling (Poria) and Shaoyao (Paeoniae Radix), resulting in recovery.
Another child suffered pain from this condition, with fever and thirst. After taking exterior-releasing agents, symptoms worsened. The child appeared fatigued in form and Qi, with a floating and rapid pulse. This indicated pathogens in the meridians, where mistaken dispersal damaged true Qi. Treated with Ren'an Wei San (Ginseng Stomach-Calming Powder) and Buzhong Yiqi Tang (Decoction for Supplementing the Middle and Augmenting the Qi), leading to recovery.
Another child had itching and fever. After using Xijiao Xiaodu San (Rhino Horn Detoxification Powder), vomiting and diarrhea occurred suddenly. This indicated pathogens exiting through both upper and lower pathways. The rash indeed subsided, and the child recovered without further medication.
Another child had redness and swelling of the scrotum. I treated it as fetal toxin, leading to improvement. Later, the child developed fever and phlegm-wheezing. Examination revealed the mother had constrained Fire and Blood Heat. Using medicines to resolve constraint and cool blood, both mother and child took the herbs and recovered. Subsequently, the child experienced vomiting, diarrhea, dark scanty urine, and eye twitching. Palpation of the Yin-Mao Guan pulse showed redness, indicating Wind-Heat. Treated with Chaihu Qinggan San (Bupleurum Liver-Clearing Powder) added with Goutenguncus Uncariae cum Ramulis uncinatis) and Muzeicao (Equiseti Hiemalis Herba), recovering after one dose.
Another child had leg lesions resembling rosy clouds moving unpredictably. First, Sesame Oil was applied to the affected area, and Bianci (pricking therapy) was used to release evil blood, dispersing the toxin. Then, Jiwei Jiedu San (Nine-Ingredient Detoxification Powder) was administered, bringing stability after one dose.
Another child presented with mild external signs but severe internal constipation. This indicated the pathology was in the Zang organs. Treated with Da Lianqiao Yin (Large Forsythia Drink) and topical application of Shengong San (Divine Efficacy Powder), resulting in recovery.