古人以小儿为哑科，最为难治矣，因其不能自言疾苦，体弱易变，以及痘疹之异耳。余
为不然。惟小儿之病，虽不能自言病状，惟无七情之扰，其所患者不过外感风寒、暑湿之
邪，内伤不越乳滞、饮食而已，其头绪简略，甚为易治。奈何世多不察，致市医诈欺，妄立惊
风一科，每用重镇开窍丸药，禁绝乳食，致质
弱稚体，何堪受此酷烈，往往变出角弓反张、搐掣之状；又妄加针刺，疼痛啼泣，实令人目
击心伤。是以推测仲景《金匮》文义，豁然有悟。仲景云∶无汗为刚痉，有汗为柔痉。隐与
小儿之病象相符。况小儿质嫩，不耐风寒，偶觉感触，即见身热、筋强，甚则反张、搐搦等
状，与《金匮》痉病证候隐合。庸医不知，遂妄立惊风之名以惑人。余绎其理，小儿之病，脾
胃独多，情志未通，脾胃用事。奈近世庸医，妄执小儿肝火独甚，将一切脾胃见症，皆误认肝
火。不思肝为春生之脏，初生之肝，岂可指为病薮，以生气当病气，殊属庸妄已极哉！或谓
小儿为纯阳体质，言出钱乙，奈庸俗不知，引为口实，非古人所及知。盖小儿为稚阳，惟易
病热，兼以乳滞变痰，于是有热痰、风痉之症，乃小儿恒有之病。奈何世之庸工，捏造急惊、
慢惊以误人哉。
余临证四十余年，每遇泻青色稀粪，昼夜频频，知其中阳不能变化为土之黄色，反为木
乘之青色，此为厥阴浊气所干，当从扶土抑木以获效，方用附子理中丸一钱，开水泡化，两
次分进，粪即转为黄色，泻亦止也。若昧者，往往误认为肝病，岂不冤哉。大抵小儿阴气未
全，易于化热，若见口舌诸窍甚干、大渴能饮者，亟投甘寒之剂；挟实者、舌苔黄腻、口有热
臭之气，亟宜荡涤之。缘小儿纯阳，柔脆之脏腑尤易枯涸，急下存阴，转危而安矣。至于阳
明热甚痉厥之证，市医名之急惊，余惟清阳明热邪，则肝火自平。若妄投镇惊息风，是速其
危哉。至久病中虚，土不镇木而显风象者，谓之慢惊，宜急进附子理中汤，或加温补如肉
桂、黄 等品，以追失散之虚阳，转危而安。每见庸愚用清散重镇，是下井而加之石矣。更有
一种妇人，妄用针刺，名曰挑惊，或捏人中，或口咬指捏、口吸脐眼等妄治，真是惨毒恶事，
目不忍睹。其痘疹以寒热、虚实为准，则唯一切有毒奇异之物，慎勿妄用，亦勿拘执幼科成
法，而不达变通，以误人哉。余为济世拯危，特将实验心法不忍秘而不宣，今录于简末以公
于世，是亦保婴仁术之意耳。
澜按∶小儿之病，宋有钱乙着《小儿直诀》一书，言之详明。奈何市医不知讨论古书，仅
守家传方法，妄立惊风之名，用金石毒物制为丸药；为欺骗财帛计，又有妖妇创能挑惊指捏
等法，其害尤甚庸医。先生目睹心伤，阐明治法，以拯人之危并示戒一切，唤醒愚庸以保赤
子，并将历验心得秘法录出，以示后进，可谓仁至义尽者也。
惟记中急下存阴，仅言其法，未载方药者，欲后人三反之意。余恐浅学未能深造精
微，仍然茫无定识，或蹈清散、重镇之法，依然无济苍生，今拟二法∶法用泻青丸清肝泄热，
用钱氏赤散以攻邪涤痰。考赤散之功用，能消滞涤痰，最有益于小儿。近见京中雅观斋所售
之万应保赤散，即此方也。每服一分。若病在上即吐痰，病在下即便痰，即能愈病，诚妙法
也。假如痰热甚，可服回春丹。此丹较赤散功缓，善泄热清痰，惟虚寒者不可服，售药者未
将寒热标明。考回春丹泄热清痰，近见广东丸药广告中，皆谓治急、慢惊风，其言大谬。慢惊
因脾虚者多，岂可再投凉泄以戕正。今特揭出，以免误人。以后回春丹仿单中务将慢惊二
字删去，功德莫大焉。
古人称儿科为“哑科”，认为是最难治疗的科室，因为小儿不能自己诉说病痛，身体柔弱且病情变化迅速，以及痘疹等疾病的特殊性。我却持不同看法。我认为，虽然小儿患病时无法自述症状，但他们没有七情（喜、怒、忧、思、悲、恐、惊）的干扰，所患疾病不外乎外感风寒、暑湿之邪，内伤不超出乳食停滞、饮食不当而已，其病因头绪简单，其实很容易治疗。无奈世间大多人不明此理，导致市井医生欺诈，妄立“惊风”这一病科，每用重镇开窍的丸药，禁止乳食，致使体质柔弱的稚童难以承受如此酷烈的治疗，往往出现角弓反张、抽搐掣动等症状；又胡乱施加针刺，导致疼痛啼哭，实在令人目睹心伤。因此，我推测仲景《金匮要略》的文义，豁然开朗有所领悟。仲景说：无汗的为刚痉，有汗的为柔痉。这与小儿的病象暗合。况且小儿体质娇嫩，不耐受风寒，偶尔感触邪气，就出现身热、筋脉强直，甚至反张、抽搐等状，与《金匮要略》中痉病的证候暗中吻合。庸医不懂这些，于是妄立“惊风”之名来迷惑世人。我推究其理，小儿的疾病多与脾胃有关，因为情志未通，脾胃功能主导。无奈近世庸医，固执地认为小儿肝火独盛，将一切脾胃见症，都误认为是肝火。他们不思肝为春生之脏，初生的肝脏，岂能指为病源，把生气当作病气，这真是庸妄到了极点！有人称小儿为纯阳体质，这话出自钱乙，但庸俗之人不知其中深意，引为借口，这不是古人所能预知的。实际上小儿为稚阳之体，只容易生病热，加上乳食停滞变生痰浊，于是有热痰、风痉之症，这是小儿常有的病。无奈世间的庸医，捏造急惊、慢惊之名来误导人。
我在临证四十多年中，每当遇到泻青色稀粪，昼夜频繁，知道这是中阳不能运化变为土的黄色，反而被木气乘袭呈现的青色，此为厥阴浊气干扰，应当从扶土抑木的方法获取疗效，方剂用附子理中丸一钱，开水泡化，分两次服用，粪便即转为黄色，腹泻也就停止了。如果愚昧者，往往误认为是肝病，这岂不是冤枉吗？大抵小儿阴气未全，易于化热，若见到口舌诸窍非常干燥、大渴能饮的，应立即投予甘寒的药剂；兼有实邪的，舌苔黄腻、口中有热臭之气，应立即荡涤邪气。因为小儿纯阳，柔脆的脏腑尤其容易枯涸，急下存阴，就能转危为安。至于阳明热甚导致的痉厥证，市井医生称为急惊，我只需清阳明热邪，则肝火自然平息。如果妄投镇惊息风的药物，是加速其危险啊。至于久病中虚，土不镇木而显现风象的，称为慢惊，宜急进附子理中汤，或加温补如肉桂、黄芪等品，以追回失散的虚阳，转危为安。常见愚蠢者用清散重镇之法，这简直是落井下石。更有另一种妇人，妄用针刺，名为挑惊，或者捏人中，或者口咬指捏、口吸脐眼等妄治，真是惨毒恶事，让人不忍目睹。其痘疹以寒热、虚实为准绳，那么对于一切有毒奇异之物，切勿妄用，也不要拘执幼科的成法，而不通达变通，从而误导人。我为了济世拯危，特意将实验心得之法不忍秘而不宣，现在记录在书末以公之于世，这也是保婴仁术的心意罢了。
澜按：小儿的疾病，宋代有钱乙撰写了《小儿直诀》一书，论述得详细明确。无奈市井医生不知讨论古书，仅守家传方法，妄立惊风之名，用金石毒物制成丸药；为了欺骗钱财，又有妖妇创制能挑惊、指捏等方法，其危害比庸医更甚。先生目睹心伤，阐明治法，以拯救人的危难并警示一切，唤醒愚庸以保护婴儿，并将历验心得的秘法录出，以示后进，可谓仁至义尽了。
只是记中提到的急下存阴，仅言其法，未载方药，是想让后人反复思考之意。我担心浅学之人未能深造精微，仍然茫然没有定识，或许蹈袭清散、重镇之法，依然无济于苍生，现在拟定二法：法用泻青丸清肝泄热，用钱氏赤散以攻邪涤痰。考证赤散的功效，能消滞涤痰，最有益于小儿。近来见京中雅观斋所售的万应保赤散，就是这个方子。每服一分。如果病在上则吐痰，病在下则便痰，就能治愈疾病，真是妙法。假如痰热很盛，可服用回春丹。此丹较赤散功效缓和，善于泄热清痰，只有虚寒者不可服用，卖药的未将寒热标明。考证回春丹泄热清痰，近来见广东丸药广告中，都说治急、慢惊风，这种说法大错特错。慢惊因脾虚者多，岂可再投凉泄之药以伤害正气。现在特别揭露出来，以免误导人。以后回春丹说明书中务必将慢惊二字删去，功德莫大焉。
The ancients referred to pediatrics as the "mute department," considering it the most difficult to treat, because children cannot verbally describe their suffering, their bodies are weak and prone to rapid changes, and due to the uniqueness of diseases such as smallpox and chickenpox. I hold a different view. I believe that although children cannot describe their symptoms when ill, they are free from disturbances by the Seven Emotions (joy, anger, worry, thought, sadness, fear, fright). Their ailments do not exceed external contraction of wind-cold or summerheat-dampness pathogens, nor internal injury beyond milk stagnation or improper diet. The etiology is simple and straightforward, making it actually quite easy to treat. Regrettably, many in the world fail to understand this, leading to quackery among market physicians who fabricate a separate category for "Convulsion" (Jing Feng). They frequently employ heavy sedatives and orifice-opening pills while forbidding milk and food, causing frail young bodies to suffer cruelly. This often results in conditions like opisthotonos (rigid arching of the back) and convulsions; furthermore, they recklessly apply acupuncture, causing pain and crying, which is truly heartbreaking to witness. Therefore, upon speculating on the meaning of Zhang Zhongjing's *Jin Gui Yao Lue* (Essential Prescriptions of the Golden Cabinet), I had a sudden enlightenment. Zhongjing stated: absence of sweating indicates Gang Jing (Rigid Spasm), while presence of sweating indicates Rou Jing (Flaccid Spasm). This implicitly matches the clinical presentation of pediatric diseases. Moreover, children have delicate constitutions and cannot tolerate wind-cold; even slight exposure can lead to fever and muscle stiffness, or even opisthotonos and convulsions, which implicitly align with the syndrome manifestations of Spasm disease described in the *Jin Gui Yao Lue*. Quacks, ignorant of these facts, arbitrarily created the name "Convulsion" to confuse people. Upon reasoning through this, I found that pediatric diseases are predominantly related to the Spleen and Stomach, as emotional development is incomplete, and Spleen-Stomach functions dominate. Yet, modern quacks stubbornly insist that children possess excessive Liver Fire, misinterpreting all Spleen-Stomach symptoms as Liver Fire. They fail to realize that the Liver is the organ of spring growth; how can an initially developing Liver be labeled as the source of disease, treating vital Qi as pathogenic Qi? This is utterly absurd! Some claim that children have a "Pure Yang" constitution, a statement originating from Qian Yi, but vulgar practitioners misuse it without understanding its depth, which was not anticipated by the ancients. In reality, children have a "Tender Yang" constitution, making them prone to heat diseases. Combined with milk stagnation transforming into phlegm, conditions such as Heat-Phlegm and Wind-Spasm arise, which are common in children. Nevertheless, quacks fabricate terms like Acute Convulsion and Chronic Convulsion to mislead people.
In my forty-plus years of clinical practice, whenever I encountered frequent passage of greenish watery stools day and night, I recognized that the Middle Jiao Yang failed to transform into the yellow color associated with Earth, instead showing green due to Wood overacting. This indicated interference by Turbid Qi of the Jueyin channel. Treatment should focus on Supporting Earth and Suppressing Wood to achieve efficacy, using Fuzi Lizhong Wan (Aconite Decoction to Warm the Middle) one qian, dissolved in hot water, administered in two divided doses. The stool would then turn yellow, and diarrhea would cease. If ignorant practitioners mistakenly attribute this to Liver disease, it is indeed unjust. Generally, children's Yin Qi is not fully developed, making them prone to transformation into heat. If one observes extreme dryness in the mouth, tongue, and orifices, along with intense thirst and ability to drink, sweet-cold formulas should be administered immediately. If accompanied by excess pathogens, indicated by a yellow greasy tongue coating and foul breath, purgation is urgently required. Because children are Pure Yang, their tender Zang-Fu organs are particularly susceptible to drying up; urgent purgation to preserve Yin can turn danger into safety. Regarding spasm and syncope caused by severe Yangming heat, which market physicians call Acute Convulsion, I merely clear Yangming heat pathogens, after which Liver fire naturally subsides. Recklessly administering sedatives and wind-extinguishing herbs only accelerates the crisis. As for chronic deficiency of the Middle Jiao, where Earth fails to anchor Wood, manifesting wind-like symptoms, this is called Chronic Convulsion. It requires urgent administration of Fuzi Lizhong Tang (Aconite Decoction to Warm the Middle), possibly adding warming tonics such as Rougui (Cinnamon Bark) or Huangqi (Astragalus Root) to retrieve scattered deficient Yang and turn danger into safety. I often see foolish practitioners using clearing-scattering and heavy-sedating methods, which is akin to adding stones to a well when someone has already fallen in. Furthermore, some women recklessly use acupuncture, termed "Picking Convulsion," or pinch the Renzhong point, bite fingers, or suck the umbilicus—these are cruel and evil practices, unbearable to witness. For smallpox and chickenpox, treatment must be based on cold/heat and deficiency/excess. Therefore, toxic and bizarre substances must never be used recklessly, nor should one rigidly adhere to established pediatric formulas without adapting to changes, thereby misleading patients. To save lives and alleviate crises, I dare not keep my empirically verified insights secret. I record them here at the end of this book to share with the world, embodying the benevolent art of protecting infants.
Lan notes: Regarding pediatric diseases, Qian Yi of the Song Dynasty authored *Xiao'er Zhijue* (Direct Rules for Children), discussing them in detail. Unfortunately, market physicians ignore ancient texts, relying solely on family traditions, fabricating the term "Convulsion," and using toxic mineral substances to make pills. To deceive people for money, cunning women invented methods like "picking convulsion" and finger pinching, causing harm even greater than quack doctors. Witnessing this with heartache, Mr. [the author] clarified treatment methods to save people from danger and warn others, awakening the ignorant to protect infants, and recording his validated insights for future generations. This demonstrates utmost benevolence and righteousness.
However, the text mentions "urgent purgation to preserve Yin" but does not list specific prescriptions, intending for later practitioners to reflect deeply. Fearing that shallow learners may lack profound understanding and remain confused, potentially falling into the trap of clearing-scattering and heavy-sedating methods without benefiting the populace, I now propose two methods: Use Xieqing Wan (Drain Green Pill) to clear the Liver and drain heat, and use Qianshi Chisan (Qian's Red Powder) to attack pathogens and eliminate phlegm. Examining the function of Chisan, it eliminates stagnation and clears phlegm, being highly beneficial for children. Recently, I observed that the Wan Ying Baochi San (Ten-Thousand-Response Infant Protection Powder) sold by Yaguan Zhai in Beijing is essentially this formula. The dosage is one fen per administration. If the pathology is upper, vomiting phlegm occurs; if lower, passing phlegm in stool occurs, both indicating cure. This is indeed a wonderful method. If phlegm-heat is severe, Huichun Dan (Spring Return Pill) can be taken. This pill has a milder effect than Chisan, excelling in draining heat and clearing phlegm, but is contraindicated for deficiency-cold patterns. Sellers fail to indicate cold/heat distinctions. Research shows that Huichun Dan drains heat and clears phlegm; recent advertisements for Guangdong pills claim it treats both acute and chronic convulsions, which is grossly incorrect. Chronic convulsion is mostly due to Spleen deficiency; how can cooling purgatives be used to damage healthy Qi? I hereby expose this to prevent further misinformation. It would be a great merit if manufacturers remove the words "Chronic Convulsion" from the instructions for Huichun Dan.