议曰虚则作疾实亦是病按实理虚遣病去疾内知其冷热外审其症候三实两虚神不安居三虚
两
实人有得夫虚之为病其候则速实之为病其候则缓实未致害虚即作祸迅矣肝心脾肺肾子母相生
肺
肝脾肾心五脏相克且如脾胃经虚呕哕不食又心气不足惊悸有作所疗子母俱虚小便闭涩利之
可乎所以知其内者母虚靠子实子虚籍母荣其又肺家有热宜泻之否大肠滑利宜温之可医工但究
母虚理其子实若攻其子则母亦虚所谓母能令子实子能令母虚脾病泻心理实致虚矣
议曰伤寒豆疹皆论表里二义不同所受反是伤寒所传从表入里豆疹所发自里出表作热形症
与伤
寒颇似病家不究轻重所受相尚与服升麻葛根汤或过剂饮饵其表已解其汗不止汗出稍多里虚作
渴且热乘热悉化疹豆自然回出所缘逐其热利其表遍出虽多疹亦不成豆亦不是比此小赤自其热
力有限里外不相续荣卫不加助即于中道而废渐作黑陷非食毒感风之咎自是助发大过失其自然
之理至死莫知其由是谓利表伤里故也使良方妙剂难以助平哀哉
议曰小儿发热一症与大人同热在三焦方渴肺惊下利虚烦方渴上盛下虚方渴水火不相济方
渴伏
暑蕴热方渴津液燥竭方渴渴症本无但有其热热在乎表攻动其里里自无热受之以虚表热传里反
致其渴表里俱虚引饮入脾头面手足受湿虚浮作肿医工下之从增其病宜与扶表救里庶几有命方
得获幸疾症于此死者多矣
议曰：虚证可以导致疾病，实证也是病。按照实证的道理去处理虚证，就会使疾病加重、病情恶化。内在要知晓其寒热属性，外在要审察其症候表现。如果是三实两虚，神志就不安；如果是三虚两实，人就会患病。
所谓虚证为病，其发病迅速；实证为病，其发病缓慢。实证尚未造成危害时，虚证就已经酿成祸患，其势迅猛。肝、心、脾、肺、肾五脏之间，子母相生；肺、肝、脾、肾、心五脏之间，存在相克关系。
例如，脾胃经虚弱，会出现呕吐、呃逆、不能进食的症状；心气不足，就会出现惊悸。对于子母俱虚的小儿，出现小便闭涩不通，如果用利水的方法治疗，可以吗？因此，懂得内在机理的人知道：母脏虚弱依靠子脏的充实来补救，子脏虚弱借助母脏的荣养来恢复。
如果肺家有热，是否应该泻之？大肠滑利，是否可以用温法治疗？医生只探究母脏的虚损，调理子脏的实证。如果攻伐子脏，母脏也会随之虚弱。这就是所谓的“母能令子实，子能令母虚”。脾病而泻心，就是“理实致虚”的道理了。
议曰：伤寒和痘疹都论述表里两方面的含义，但二者不同，所受邪气相反。伤寒的病传变是从表入里；痘疹的病发是从里出表。发热的外形症候与伤寒颇为相似。患儿家属不究辨轻重，所受的邪气相互混杂，服用升麻葛根汤（Shengma Gegen Tang, Cinnamon Twig and Pueraria Root Decoction）或者用药过量，虽然表证已解，但汗出不止。汗出稍多，导致里虚而生渴，且热邪乘虚而入，全部化为疹豆。自然回出的疹豆，虽然遍身发出，数量虽多，但也不能成为正常的痘疮，只是比此更小的赤色斑点而已。这是因为热力有限，表里不相接续，营卫之气不加助益，就在中途衰竭，逐渐变成黑陷。这不是因为食毒或感风的过错，而是由于助发（不当治疗）的大过失。违背了自然的规律，直到死亡也不知道原因，这叫做“利表伤里”（通过过度解表而损伤里气）。即使有良方妙剂也难以帮助平复，可悲啊！
议曰：小儿发热这一症状，与大人的情况相同。热在三焦，所以口渴；肺受惊扰并伴有下利、虚烦，所以口渴；上盛下虚，所以口渴；水火不相济，所以口渴；伏暑蕴热，所以口渴；津液燥竭，所以口渴。
渴症本身并没有固定的病因，只有热象。热在体表，攻动其里，里自无热，却因受之以虚，表热传入里部，反而导致其渴。如果表里俱虚，引饮入脾，头面手足受湿，就会虚浮作肿。医生如果用下法治疗，只会增加病情。应当给予扶表救里的方法，或许还有生机。此类疾症在此死者很多矣。
Translation:
It is said that deficiency syndromes can give rise to disease, and excess syndromes are also diseases. Treating a deficiency syndrome according to the principles for an excess syndrome will aggravate the illness and worsen the condition. One must understand the cold or heat nature internally and examine the clinical manifestations externally. In cases of three excesses and two deficiencies, the Shen (Spirit) becomes unsettled; in cases of three deficiencies and two excesses, the person falls ill.
Regarding the pathology of deficiency, its onset is rapid; regarding the pathology of excess, its onset is slow. Before an excess syndrome causes harm, a deficiency syndrome may already have precipitated disaster, moving swiftly. The Liver, Heart, Spleen, Lung, and Kidney generate each other in a Mother-Child relationship. The Lung, Liver, Spleen, Kidney, and Heart restrain each other in a controlling cycle.
For instance, when the Stomach and Spleen meridians are deficient, symptoms such as vomiting, hiccups, and inability to eat occur. When Heart Qi is insufficient, palpitations and fright arise. If both the Mother and Child organs are deficient, resulting in urinary retention and difficulty, would it be appropriate to treat with diuretics? Therefore, those who understand internal mechanisms know that when the Mother organ is deficient, it relies on the fullness of the Child organ to compensate; when the Child organ is deficient, it relies on the nourishment of the Mother organ to recover.
If there is heat in the Lung home, should it be purged? If the Large Intestine is slippery and loose, is warming therapy applicable? Physicians often only investigate the deficiency of the Mother organ and regulate the excess of the Child organ. If one attacks the Child organ, the Mother organ will also become deficient. This is what is meant by "The Mother can cause the Child to be full, and the Child can cause the Mother to be deficient." Treating Spleen disease by purging the Heart represents the principle of "regulating excess leading to deficiency" (Li Shi Zhi Xu).
It is said that both Shanghan (Cold Damage) and Douzhen (Smallpox/Chickenpox) discuss the concepts of exterior and interior, but they differ significantly and involve opposite pathogenic transmissions. Shanghan transmits from the exterior to the interior, whereas Douzhen originates from the interior and emerges to the exterior. The feverish physical signs and symptoms are quite similar to Shanghan. Families of patients, failing to distinguish the severity, mix up the received pathogens, and administer Shengma Gegen Tang (Cinnamon Twig and Pueraria Root Decoction) or overdose it. Although the exterior syndrome has resolved, sweating continues incessantly. Excessive sweating leads to interior deficiency and thirst, while heat enters the deficiency and transforms entirely into rashes and pustules. Naturally emerging rashes, though widespread and numerous, fail to develop into proper pustules, appearing merely as small red spots. This occurs because the heat power is limited, the interior and exterior are not continuous, and Ying (Nutritive) and Wei (Defensive) Qi do not receive assistance, causing them to fail midway and gradually turn black and depressed. This is not due to food toxicity or wind invasion, but rather a major error caused by improper promotion of eruption. Violating natural laws, death occurs without understanding the cause. This is termed "benefiting the exterior while injuring the interior" (Li Biao Shang Li). Even with excellent prescriptions, it is difficult to restore balance. How tragic!
It is said that pediatric fever is the same as in adults. Heat in the Sanjiao (Triple Burner) causes thirst; Lung shock with diarrhea and empty irritability causes thirst; upper excess and lower deficiency cause thirst; failure of Water and Fire to interact causes thirst; latent summerheat and accumulated heat cause thirst; exhaustion of body fluids causes thirst.
Thirst itself has no fixed etiology, only the presence of heat. If heat is at the exterior and agitates the interior, the interior itself has no heat, but due to receiving deficiency, exterior heat transmits to the interior, paradoxically causing thirst. If both exterior and interior are deficient, drinking water enters the Spleen, dampness affects the head, face, hands, and feet, leading to edema. If physicians use purgative methods, they only exacerbate the disease. One should employ methods to support the exterior and rescue the interior, perhaps preserving life. Many die from such conditions.