儿曷为乎有难？曰∶天时人事为之也，难于天者一，难于人者二。天之大德曰生，曷为乎难儿
也？曰∶天不能不以阴阳五行化生万物；五行之运，不能不少有所偏，在天原所以相制，在儿任其
气则生，不任其气则难，虽天亦莫可如何也，此儿之难于天者也。其难于人者奈何？曰∶一难于儿
之父母，一难于庸陋之医。天下之儿皆天下父母所生，天下父母有不欲其儿之生者乎？曷为乎难
于父母耶？曰∶即难于父母欲其儿之生也。父母曰∶人生于温，死于寒。故父母惟恐其儿之寒也。
父母曰∶人以食为天，饥则死。故父母惟恐其儿之饥也。天下之儿，得全其生者此也；天下之儿，或
受其难者，亦此也。谚有之曰∶小儿无冻饿之患，有饱暖之灾。此发乎情，不能止乎义礼，止知以慈
为慈，不知以不慈为慈，此儿之难于父母者也。天下之医，操生人之术，未有不欲天下之儿之生，未有不利天下之儿之
生，天下之儿之难，未有不赖天下之医之有以生之也。然则医也者，所以补天与父母之不逮以生儿者也，曷为乎天下之
儿。难于天下之医也？曰∶天下若无医，则天下之儿难犹少，且难于天与父母无怨也。人受生于天与父母，即
难于天与父母，又何怨乎？自天下之医愈多，斯天下之儿难愈广，以受生于天于父母之儿，而难于天
下之医，能无怨乎？曷为乎医愈多，而儿之难愈广也？曰∶医也者，顺天之时，测气之偏，适人之情，
体物之理，名也，物也，象也，数也，无所不通，而受之以谦，而后可以言医，尤必上与天地呼吸相通，
下与小儿呼吸相通，而守之以诚，而后可以为医。奈何挟生人之名，为利己之术，不求岁气，不畏天
和，统举四时，率投三法，毫无知识，囿于见闻，并不知察色之谓何，闻声之谓何，朝微夕甚之谓之
何，或轻或重之谓何，甚至一方之中，外自太阳，内至厥阴，既与发表，又与攻里，且坚执小儿纯阳之
说，无论何气使然，一以寒凉为准，无论何邪为病，一以攻伐为先，谬造惊风之说，惑世诬民；妄为疳
疾之丸，戕生伐性；天下之儿之难，宁有终穷乎？前代贤医，历有辨难，而未成书？瑭虽不才，愿解儿难。
为什么小儿会有难治之症？回答说：这是天时和人事造成的。难于天时的情况有一项，难于人事的情况有两项。上天的大德在于赋予生命，为什么反而让小儿难以生存呢？回答说：上天不能不依靠阴阳五行来化生万物；五行的运行，不可能完全没有偏颇。在天体运行中，这种偏颇原本是用来相互制约的，但对于小儿来说，顺应其体质之气就能生存，不顺应其体质之气就会发生危难，即使是上天也无可奈何，这就是小儿难于天时的原因。
至于难于人事的情况是怎样的呢？回答说：一是难于小儿的父母，二是难于平庸浅陋的医生。天下的孩子都是天下父母所生，天下的父母难道有不希望自己的孩子存活下来的吗？那为什么又难于父母呢？回答说：正是难于父母那种“希望孩子存活”的心情。父母说：“人靠温暖而生，受寒冷而死。”所以父母唯恐孩子着凉。父母说：“人以食物为天，饥饿就会死。”所以父母唯恐孩子挨饿。天下能够保全生命的孩子，是因为这些（过度的保护）；天下遭受危难的孩子，也是因为这些（过度的保护）。俗话说：“小儿没有冻饿的祸患，却有饱暖带来的灾难。”这是出于情感，不能以礼义来节制，只知道以溺爱为慈爱，不知道以不过度干预为慈爱，这就是小儿难于父母的原因。
天下的医生，掌握救人的技术，没有不希望天下孩子存活的，没有不致力于让天下孩子存活的，天下孩子的危难，没有不依赖天下医生来挽救生命的。那么医生，是用来弥补天和父母在养育孩子方面的不足从而让孩子存活的，为什么天下的孩子反而难于天下的医生呢？回答说：如果天下没有医生，那么孩子的危难还比较少，而且孩子对于天和父母的危难也没有怨恨。人由天和父母赋予生命，即使难于天和父母，又有什么可怨恨的呢？自从天下的医生越来越多，天下孩子的危难也就越来越广泛。那些由天和父母赋予生命的孩子，却难于天下的医生，能不产生怨恨吗？
为什么医生越多，孩子的危难就越广泛呢？回答说：所谓医生，是要顺应天时的变化，推测五行的偏颇，适应人的性情，体察事物的道理，对名、物、象、数无所不通，并且以谦逊的态度来接受这些知识，然后才可以称为医生。尤其必须上与天地气息相通，下与小儿气息相通，并且以诚心坚守，然后才可以成为医生。奈何有些人挟持救人的名义，行谋利之实，不探究当年的岁气，不敬畏天和，统括四季，一律投用三种方法（汗、吐、下），毫无知识，局限于见闻，甚至不知道观察面色意味着什么，听声音意味着什么，早晨轻微晚上加重意味着什么，病情或轻或重意味着什么。甚至在一张方子中，外从太阳经到内至厥阴经，既用发表药，又用攻里药。并且固执地坚持“小儿纯阳”的说法，无论是什么邪气致病，一律以寒凉药为准；无论是什么病邪，一律以攻伐为先。荒谬地制造出“惊风”的说法，迷惑世人欺骗百姓；妄造治疗疳疾的药丸，残害生命损伤本性。天下的孩子的危难，难道有穷尽的时候吗？前代的贤明医生，曾经多次辨析这些疑难，但没有形成著作。我吴瑭虽然不才，愿意解答这些关于小儿的难题。
Why do children face difficulties in survival? The answer is: This is caused by the timing of heaven (natural environment) and human affairs. There is one aspect that is difficult due to heaven, and two aspects that are difficult due to humans. The great virtue of Heaven is to give life; why then is it difficult for children? The answer is: Heaven cannot help but transform and generate all things through Yin and Yang and the Five Elements. The movement of the Five Elements inevitably has some bias. In the heavens, this bias serves to mutually restrain each other; however, for a child, if they accommodate their Qi constitution, they survive; if they do not accommodate it, they face danger. Even Heaven can do nothing about this; this is what makes children difficult due to Heaven.
How are they difficult due to humans? The answer is: First, it is difficult due to the parents of the children; second, it is difficult due to mediocre and shallow doctors. All children in the world are born of all parents in the world. Do all parents not wish for their children to live? Why then is it difficult due to parents? The answer is: It is precisely difficult because of the parents' desire for their children to live. Parents say: "Humans are born from warmth and die from cold." Therefore, parents fear their children getting cold. Parents say: "Humans rely on food as heaven; hunger leads to death." Therefore, parents fear their children going hungry. Those children in the world who fully preserve their lives do so because of this [over-protection]; those children in the world who suffer difficulties also do so because of this. As the proverb says: "Children have no worry of freezing or starving, but have disaster from being full and warm." This arises from emotion and cannot be stopped by righteousness and propriety. They only know to show love as affection, but do not know to show love by not being overly affectionate. This is what makes children difficult due to parents.
All doctors in the world wield the art of saving lives. None do not wish for the children of the world to live, and none do not strive for the survival of the children of the world. The difficulties of the children of the world rely on the doctors of the world to save them. Then, what is the purpose of a doctor? It is to supplement the shortcomings of Heaven and parents to ensure the survival of children. Why then are the children of the world difficult due to the doctors of the world? The answer is: If there were no doctors in the world, the difficulties of the children would be fewer, and there would be no resentment towards Heaven and parents regarding these difficulties. Humans receive life from Heaven and parents; even if difficult due to Heaven and parents, why would there be resentment? Since there are more and more doctors in the world, the difficulties of the children in the world have become more widespread. Children who received life from Heaven and parents now face difficulties due to the doctors of the world; how can there be no resentment?
Why does the increase in doctors lead to an increase in children's difficulties? The answer is: A doctor should follow the timing of Heaven, measure the bias of Qi, adapt to human emotions, and comprehend the principles of things. One must understand names, objects, images, and numbers thoroughly, and accept them with humility before one can speak of medicine. Furthermore, one must connect breath with Heaven and Earth above, and connect breath with children below, maintaining sincerity, before one can truly be called a doctor. How can some people, holding the name of saving lives, practice the art of benefiting themselves? They do not seek the annual Qi, nor do they revere the Harmony of Heaven. They treat all four seasons uniformly, indiscriminately applying three methods (sweating, vomiting, purging), possessing no knowledge, confined by their limited experience. They do not even know what observing facial color signifies, what listening to voice signifies, what it means when symptoms are mild in the morning and severe in the evening, or what it means when conditions vary in severity. Even within a single prescription, they cover everything from Taiyang (Greater Yang) externally to Jueyin (Terminal Yin) internally, using both exterior-releasing and interior-attacking herbs simultaneously. Moreover, they rigidly adhere to the theory that "children possess pure Yang," regardless of the pathogenic factor involved, standardizing on cold and cool herbs; regardless of the pathogen causing the disease, prioritizing attacking and reducing methods. They absurdly create the concept of "Convulsion Wind" (Jing Feng), confusing the world and deceiving the people; they recklessly produce pills for treating Gan disease (malnutrition/parasitic disorders), destroying life and damaging nature. Will the difficulties of the children of the world ever end? Sages and virtuous doctors of previous dynasties have repeatedly辨析 (analyzed and clarified) these difficulties, but did not compile them into books. Although I, Wu Tang, am untalented, I am willing to resolve the difficulties of children.