风痰一证，乳儿最多，四时皆有。大概冬春之交宜温散，荆防甘桔橘半生姜杏仁苏子
之类。夏令宜清散，杏仁牛蒡栀子之类。秋令宜清润，枳壳栝蒌之类。冬令严寒有用麻黄汤
而解者。肺为娇嫩之脏，总宜疏解不得妄投丸散。
德按∶徐洄溪曰，嗽药中多用桔梗，桔梗升提，甘桔汤中用之以载甘草上行，治少阴之
喉痛。与治嗽，宜清降之法，非宜服之，往往令人气逆痰升，不得着枕。愚窃以谓小儿不知咯
痰，尤当慎用。
肺虽喜润，胃中湿痰宜燥。小儿乳腻生痰，外证有鼻水多涕泪，二陈为治痰总剂，合
之前胡桔梗荆防苏子枳壳麦芽杏仁之类，或加生姜葱白，结者散之，保赤之善也。
肺喜润，润之中亦有分辨，如杏仁苏子温而润者也，宜于冬春。杏仁牛蒡散而润者也，
宜于夏。杏仁栝蒌则清而润者矣，宜于秋燥。能知此等界限，则用药不杂。
栝蒌一味能发呕，易滑泄，乳儿无用栝蒌之理。谷食之儿燥火伤肺，嗽久不止，乃可用之。
半夏毒轻，姜汁制而陈者性平，故可入君子汤。南星毒烈实非良药，制以牛胆之苦寒，
病久胶结或可少投，时行感冒无可用之理。竹沥姜汁之润下，海石之咸能软坚，尤非风痰可轻试者。
书云蚕与马并属午火，在卦为离，主心，又云蚕食而不饮，性燥，得湿则腐，得风则僵，
故能宣风化痰，辛温之药也，风寒闭结者宜之，痰热结聚非所宜也。肺为贮痰之器，只有
开提一法，为解化之用。世俗之化痰丸，徒伤胃气耳。至若王隐君之礞石滚痰丸为治顽痰
怪证而设，于小儿有何干涉。
风痰乳滞小儿轻，病不从疏解而事丸散，杀儿实多，目睹心伤，为之苦口。
论广东蜡丸及人家制送丸散之误
药之治病务在临时变通，非调补之有赖于丸也。以时行之风痰壅闭，理当随时用药，
自制丸散尚不可服，而何有于蜡丸。蜡丸制于广东，不离麝桂，挟利者货之。四方愚夫愚妇
误服而受害者，不可知凡几。医家执而从误是诚何心。孔子云∶未达不敢尝。予尝语送药之
家必系以方，使服者但然无疑。若送药无方，昧者求之，有识之士其肯服乎。
德按∶《素问·异法方宜篇》言西方人生病，其治宜毒药。可见外国药水丸散半多辛烈
有毒，其味酸涩其性收引，倘中国人外感风寒暑湿切勿以身轻试，然信奉西法者终难与之
言辩也。
风痰这一证候，在婴儿中最为多见，一年四季都会发生。大致来说，冬春交替之时适宜用温散法，选用荆芥、防风、甘草、桔梗、橘红、半夏、生姜、杏仁、苏子之类的药物。夏季适宜用清散法，选用杏仁、牛蒡子、栀子之类的药物。秋季适宜用清润法，选用枳壳、瓜蒌之类的药物。冬季严寒时，有用麻黄汤治愈的案例。肺是娇嫩之脏，总宜采用疏解之法，不可妄投丸药和散剂。
德按：徐洄溪说，咳嗽药中多用桔梗，桔梗具有升提作用，在甘桔汤中使用它是为了载着甘草上行，治疗少阴经的喉痛。这与治疗咳嗽宜用清降之法不同，如果不加辨别服用桔梗，往往会导致气逆痰升，无法安枕入睡。我私下认为，小儿不会咳吐痰液，更应当慎用桔梗。
肺虽然喜欢滋润，但胃中的湿痰则宜用燥湿法治疗。小儿因乳汁油腻而生痰，外证表现为鼻水多、涕泪多，二陈汤是治疗痰证的通用方剂，将其与前胡、桔梗、荆芥、防风、苏子、枳壳、麦芽、杏仁等药物合用，或者加入生姜、葱白，以解散结聚之痰，这是保全赤子健康的善法。
肺喜欢滋润，但在滋润之中也有分辨，如杏仁、苏子属于温而润的药物，适宜于冬春季节使用；杏仁、牛蒡子属于散而润的药物，适宜于夏季使用；杏仁、瓜蒌则属于清而润的药物，适宜于秋季燥邪伤肺时使用。能知晓这些界限，用药就不会杂乱。
瓜蒌一味药容易引发呕吐，且容易导致滑泄，没有给婴儿使用瓜蒌的道理。只有食用谷物的儿童，因燥火损伤肺脏，咳嗽日久不止，才可以使用瓜蒌。
半夏毒性较轻，用姜汁炮制且存放陈久的半夏性味平和，所以可以入君子汤（此处指代调理脾胃的方剂）。南星毒性猛烈，实在不是良药，虽用牛胆汁之苦寒来制约，但对于病久胶结难愈的痰证或许可以少量投用，对于时行感冒则完全没有使用的道理。竹沥、姜汁具有润下作用，海浮石咸能软坚，这些都不是风痰证可以轻易尝试的药物。
医书说蚕与马并属午火，在八卦中为离卦，主心。又说蚕只吃桑叶不饮水，性质燥烈，遇湿则腐烂，遇风则僵硬，因此能够宣散风邪、化解痰浊，属于辛温类药物，适宜于风寒闭结之证，痰热结聚者并不适宜。肺是贮存痰液的脏器，只有开提一法，起到解化之用。世俗所谓的化痰丸，只会徒然损伤胃气罢了。至于王隐君创制的礞石滚痰丸，是为治疗顽痰怪证而设的，与小儿疾病有何关联呢？
风痰兼有乳滞的小儿病情较轻，如果病不从疏解入手反而使用丸散，导致死亡的案例很多，这是我亲眼目睹、内心悲伤的，因此不得不苦口婆心地告诫。
论广东蜡丸及民间自制送药丸散的错误
药物治病关键在于临时变通，并非调补才依赖丸药。对于时行风痰壅闭之证，理当随时用药，连自制的丸散尚且不可服用，何况是广东产的蜡丸呢？蜡丸制作于广东，不离麝香、肉桂，夹杂利市之物贩卖。四方愚夫愚妇误服受害的，不知有多少。医家固执地跟随这种错误，这究竟是何居心？孔子说：“未曾了解透彻，不敢轻易尝试。”我曾对送药的人家说，必须附上药方，使服用者心中坦然无疑。如果送来的药没有药方，无知之人盲目求治，有见识的人士怎肯服用呢？
德按：《素问·异法方宜篇》说西方人生病，其治疗适宜用毒药。可见外国药水、丸散大多辛烈有毒，味道酸涩，性质收引，如果中国人外感风寒暑湿，切勿以身轻试，然而信奉西法的人终究难以与他们争辩。
Wind-phlegm is a syndrome most common in infants, occurring throughout all four seasons. Generally speaking, during the transition from winter to spring, warm-dispersing methods are appropriate, using herbs such as Jingjie (Schizonepetae Herba), Fangfeng (Saposhnikoviae Radix), Gancao (Glycyrrhizae Radix et Rhizoma), Jiegeng (Platycodonis Radix), Juhong (Citri Reticulatae Pericarpium), Banxia (Pinelliae Rhizoma), Shengjiang (Zingiberis Rhizoma Recens), Xingren (Armeniacae Semen Amarum), and Suzi (Perillae Fructus). In summer, clear-dispersing methods are appropriate, using herbs such as Xingren (Armeniacae Semen Amarum), Niubangzi (Arctii Fructus), and Zhizi (Gardeniae Fructus). In autumn, clearing and moistening methods are appropriate, using herbs such as Zhike (Aurantii Fructus) and Gualou (Trichosanthis Fructus). In the severe cold of winter, cases have been resolved with Mahuang Tang (Ephedra Decoction). The Lung is a delicate and tender organ; it should always be treated with dispersing and resolving methods, and one must not recklessly administer pill or powder formulations.
De notes: Xu Huixi stated that Jiegeng (Platycodonis Radix) is frequently used in cough medicines. Jiegeng has an ascending and lifting action. In Ganjie Tang (Licorice and Platycodon Decoction), it is used to carry Gancao (Glycyrrhizae Radix et Rhizoma) upward to treat sore throat due to Shaoyin (Lesser Yang) channel pathology. This differs from the treatment of cough, which should employ clearing and descending methods. Taking Jiegeng indiscriminately often leads to rebellious Qi and rising phlegm, making it impossible to lie down comfortably. I personally believe that since infants do not know how to expectorate phlegm, Jiegeng should be used with particular caution.
Although the Lung prefers moisture, damp-phlegm in the Stomach should be treated with drying methods. Infants generate phlegm due to the greasiness of breast milk. Externally, symptoms include excessive nasal discharge, tears, and mucus. Erchen Tang (Two-Aged Decoction) is the general formula for treating phlegm. It can be combined with Qianhu (Peucedani Radix), Jiegeng (Platycodonis Radix), Jingjie (Schizonepetae Herba), Fangfeng (Saposhnikoviae Radix), Suzi (Perillae Fructus), Zhike (Aurantii Fructus), Maiya (Hordei Fructus Germinatus), and Xingren (Armeniacae Semen Amarum). One may also add Shengjiang (Zingiberis Rhizoma Recens) and Congbai (Allii Fistulosi Bulbus) to disperse congealed phlegm, which is a beneficial approach for preserving the health of infants.
The Lung prefers moisture, but distinctions must be made within moistening strategies. For instance, Xingren (Armeniacae Semen Amarum) and Suzi (Perillae Fructus) are warm and moistening, suitable for winter and spring. Xingren (Armeniacae Semen Amarum) and Niubangzi (Arctii Fructus) are dispersing and moistening, suitable for summer. Xingren (Armeniacae Semen Amarum) and Gualou (Trichosanthis Fructus) are clearing and moistening, suitable for autumn dryness. Understanding these boundaries ensures that medication is not mixed indiscriminately.
Gualou (Trichosanthis Fructus) alone can induce vomiting and cause loose stools; there is no rationale for using it in infants. It may only be used in children who have started eating grain, where dry-fire damages the Lung, resulting in persistent chronic cough.
Banxia (Pinelliae Rhizoma) has mild toxicity. When processed with ginger juice and aged, its nature becomes neutral, allowing it to be included in Junzi Tang (Gentleman's Decoction). Nanxing (Arisaematis Rhizoma) is toxic and fierce, truly not a good medicine. Although its toxicity can be mitigated by the bitter-cold property of ox gall, it might be used in small doses for long-standing, stubbornly adherent phlegm, but there is no rationale for using it in epidemic colds. Zhu Li (Bambusa Textilis Sap) and Jiang Zhi (Zingiberis Juice) have moistening and descending properties; Hai Shi (Pumex) is salty and softens hardness. These are not substances to be lightly tried for wind-phlegm.
Medical texts state that silkworms and horses both belong to the Fire of Wu (Noon), corresponding to the Li trigram in the Bagua, governing the Heart. It is also said that silkworms eat but do not drink, possessing a dry nature; they rot when wet and stiffen when exposed to wind. Therefore, they can disperse wind and resolve phlegm, belonging to acrid-warm herbs, suitable for wind-cold closure, but not for phlegm-heat accumulation. The Lung is the vessel storing phlegm; only the method of opening and lifting serves to resolve and transform it. Secular phlegm-resolving pills merely damage Stomach Qi. As for Wang Yinjun's Mengshi Gun Tan Wan (Lapis Auripigmenti Rolling Phlegm Pill), it was designed for treating stubborn phlegm and strange syndromes, having no relevance to pediatric diseases.
Wind-phlegm with milk stagnation in infants is a mild condition. If the disease is not addressed through dispersing and resolving, but instead treated with pills and powders, many infants die. I have witnessed this with my own eyes and feel heartbroken, hence my earnest admonition.
On the Errors of Guangdong Wax Pills and Homemade Medicinal Powders Sent by Others
Medicines for treating diseases require flexibility according to the moment; they are not relied upon for tonic supplementation via pills. For epidemic wind-phlegm obstruction, one should use medications adapted to the situation. Even self-made pills and powders should not be taken, let alone Guangdong wax pills. Wax pills are manufactured in Guangdong, containing musk and cinnamon, and are sold for profit. Countless ignorant people in various regions have suffered harm from taking them mistakenly. What is the mindset of physicians who persistently follow such errors? Confucius said, "If one does not understand, one dares not taste." I have told those delivering medicine that they must attach a prescription, so that the user takes it with peace of mind and no doubt. If delivered medicine comes without a prescription, and ignorant people seek treatment blindly, would discerning individuals dare to take it?
De notes: The *Suwen* (Basic Questions) chapter on "Different Methods Suitable for Different Regions" states that people in the West fall ill, and their treatment is suitable for "toxic drugs." This indicates that foreign liquid medicines, pills, and powders are mostly acrid, fierce, toxic, sour, astringent, and possess contracting properties. If Chinese people contract external wind-cold, wind-heat, summerheat, or dampness, they must not lightly test their bodies against them. However, those who advocate Western methods are ultimately difficult to reason with.