葶苈大枣汤 泻白散 大顺散 牡蛎泽泻散 五苓散 越婢汤 甘遂半夏汤 控涎丹 五子五皮汤
子和桂苓汤 禹功丸 茯苓防己汤 中满分消汤 小青龙汤 木防己汤
附记一徐姓小儿。单胀数月。幼科百治无功。佥用肥儿丸万安散磨积丹绿矾丸鸡肫药俱不
效。余谓气分不效。宜治血络。所谓络瘀则胀也。用归须桃仁延胡山甲蜣螂 虫灵脂山楂之
类为丸。十日全愈。
吐泻一症。幼儿脾胃受伤。陡变惊搐最多。若是不正秽气触入。或口食寒冷。应用正气散。六
和汤。五积散之类。正气受伤。肢冷呃忒。呕吐自利。即用钱氏益黄散。有痰用星附六君子汤理
中汤等。倘热气深伏。烦渴引饮。呕逆者。连香饮黄连竹茹橘皮半夏汤。热闭神昏用至宝丹。寒
闭用来复丹。
稚年夏月。食瓜果水寒之湿。着于脾胃。令人泄泻。其寒湿积聚。未能遽化热气。必用辛温香窜
之气。古方中消瓜果之积。以丁香肉桂。或用麝香。今七香饼治泻。亦祖此意。其平胃散胃苓汤
亦可用。
疟因暑发居多。方书虽有痰食寒热瘴疠之互异。幼稚之疟。都因脾胃受病。然气怯神弱。初病
惊痫厥逆为多。在夏秋之时。断不可认为惊痫。大方疟症。须分十二经。与咳症相等。若幼科庸
俗。但以小柴胡去参。或香薷葛根之属。不知柴胡劫肝阴。葛根竭胃汁。致变屡矣。幼科纯阳。
暑为热气。症必热多烦渴。邪自肺受者。桂枝白虎汤。二进必愈。其有冷食不运。有足太阴脾病
见症。初用正气。或用辛温。如草果生姜半夏之属。方书谓草果治太阴独胜之寒。知母治阳明
独胜之热。疟久色夺。唇白汗多。馁弱。必用四兽饮。阴虚内热。必用鳖甲首乌知母。便渐溏者忌
用。久疟营伤。寒胜加桂姜。拟国中末疟门用药于左。
初病暑风湿热疟药 脘痞闷 枳壳 桔梗 杏仁 浓朴（二味喘最宜） 栝蒌皮 山栀 香豉
头痛宜辛凉轻剂 连翘 薄荷 赤芍 羚羊角 蔓荆子 滑石（淡渗清上）
重则用石膏 口渴用花粉 烦渴用竹叶石膏汤 热甚则用黄芩黄连山栀
夏季身痛属湿。羌防辛温宜忌。宜用木防己蚕砂。
暑热邪伤。初在气分。日多不解。渐入血分。反渴不多饮。唇舌绛赤。芩连膏知不应。必用血药。谅
佐清气热一味足矣。
轻则用青蒿 丹皮（汗多忌） 犀角 竹叶心 玄参 鲜生地 细生地 木通（亦能发汗）
淡竹叶
若热久痞结泻心汤选用。
又夏月热久入血。最多蓄血一症。 语昏狂。看法以小便清长者。大便必黑为是。桃仁承气汤
为要药。
幼稚疟久。面肿腹膨。泄泻不欲食。或囊肿。或跗肿。必用东垣益气以升阳。倘脾阳消惫。前方
不应。用理中汤。或钱氏益黄散。得效二三日。须投五苓散一二日。再与异功参苓白术散之类。
必全好。徐忠可注金匮有云。幼儿未进谷食者。患疟久不止。用冰糖浓汤。余试果验。
疟多用乌梅。以酸泄木安土之意。用常山草果。乃劫其太阴之寒。以常山极走。使二邪不相
并之谓。用人参生姜曰露姜饮。一以固元。一以散邪。取通神明去秽恶之气。总之久疟气馁。凡
壮胆气。皆可止疟。未必真有疟鬼。又疟邪既久。深入血分。或结疟母。鳖甲煎丸。设用煎方。活血
通络可矣。
葶苈大枣汤、泻白散、大顺散、牡蛎泽泻散、五苓散、越婢汤、甘遂半夏汤、控涎丹、五子五皮汤、子和桂苓汤、禹功丸、茯苓防己汤、中满分消汤、小青龙汤、木防己汤。
附记一：徐姓患儿，腹部胀大数月。儿科医生用尽各种方法治疗均无效。大家都使用肥儿丸、万安散、磨积丹、绿矾丸、鸡肫药等药物，但都不见效。我认为病在气分的治疗无效，应当治疗血络。所谓“络脉瘀阻则导致胀满”。使用当归须、桃仁、延胡索、穿山甲、蜣螂虫、五灵脂、山楂等药材制成丸药。十日后完全痊愈。
呕吐腹泻这一病症，幼儿脾胃受伤后，突然转变为惊风抽搐的情况最多。如果是不正秽浊之气侵入，或者口食寒冷之物，应当应用正气散、六和汤、五积散之类的方剂。如果正气受损，出现四肢冰冷、呃逆、呕吐、自发性腹泻等症状，立即使用钱乙的益黄散。如果有痰，使用星附六君子汤、理中汤等。倘若热气深伏体内，烦躁口渴想喝水，伴有呕吐逆气的症状，使用连香饮、黄连竹茹橘皮半夏汤。热邪闭阻导致神志昏迷的，使用至宝丹；寒邪闭阻的，用来复丹。
年幼孩子在夏季，食用瓜果生冷之水导致的湿邪，附着于脾胃，使人发生泄泻。其寒湿积聚，不能迅速转化为热气，必须使用辛温芳香走窜的气味药物。古方中消除瓜果积滞的方法，是用丁香、肉桂，或者使用麝香。现在的七香饼治疗泄泻，也是遵循这个意思。平胃散、胃苓汤也可以使用。
疟疾大多因暑邪引发。医书虽然记载有痰食、寒热、瘴疠等不同病因，但儿童的疟疾，都因为脾胃受病。然而儿童元气怯弱、精神虚弱，初发病时多为惊痫、厥逆。在夏秋之时，绝对不能误认为是惊痫。成人的疟症，必须区分十二经，与咳嗽病症相当。如果儿科庸俗医生，只用小柴胡汤去掉人参，或者使用香薷、葛根之类，不知道柴胡会劫夺肝阴，葛根会耗竭胃汁，导致病情变化屡见不鲜。幼儿属纯阳之体，暑为热气，症状必定热多烦渴。邪气从肺经受受的，使用桂枝白虎汤，服用两次必定痊愈。那些有冷食不消化的，有足太阴脾病见症的，初起使用正气散，或者使用辛温药物，如草果、生姜、半夏之类。医书说草果治疗太阴经独盛的寒邪，知母治疗阳明经独盛的热邪。疟疾日久面色苍白无华，嘴唇发白，汗多，身体虚弱，必须使用四兽饮。阴虚内热的，必须使用鳖甲、首乌、知母。大便逐渐变溏的忌用。久疟损伤营血，寒邪胜者加桂枝、干姜。拟定国家末期疟门用药如下：
初病暑风湿热疟药：脘腹痞闷，用枳壳、桔梗、杏仁、厚朴（这两味药对喘证最适宜）、瓜蒌皮、山栀、香豉。头痛宜用辛凉轻剂：连翘、薄荷、赤芍、羚羊角、蔓荆子、滑石（淡渗清上焦）。重证则用石膏。口渴用花粉。烦渴用竹叶石膏汤。热甚则用黄芩、黄连、山栀。
夏季身痛属于湿邪，羌活、防风等辛温药物宜忌用。宜用木防己、蚕砂。
暑热邪气伤人，初在气分，日子久了不解，渐渐进入血分，反而口渴但不多饮，嘴唇舌头绛红赤色。黄芩、黄连膏如果不应效，必须使用血分药物，稍微佐以清气热的一味药就足够了。
轻证用青蒿、丹皮（汗多者忌用）、犀角、竹叶心、玄参、鲜生地、细生地、木通（也能发汗）、淡竹叶。
如果热久导致痞结，选用泻心汤类。
另外夏季热久入血，最多见蓄血这一病症。谵语昏狂，诊法看小便清长通畅的，大便必定是黑色的，这是对的。桃仁承气汤是关键药物。
幼稚疟疾日久，面部浮肿，腹部膨隆，泄泻不想吃东西，或者睾丸肿胀，或者足背肿胀，必须使用李东垣益气升阳的方法。如果脾阳消亡疲惫，前方不应效，使用理中汤，或者钱乙的益黄散。得到效果两三天后，必须投予五苓散一二日，再给予异功散、参苓白术散之类的药物。必定完全康复。徐忠可注释《金匮要略》时说，幼儿未进食谷物的，患疟疾日久不止，用冰糖浓汤。我尝试果然有效。
疟疾多用乌梅，是以酸味泄木气、安土气的意思。使用常山、草果，乃是劫夺太阴经的寒邪，因为常山药性极善走窜，使两种邪气不相并合的意思。用人参、生姜称为露姜饮，一方面固护元气，一方面发散邪气，取通达神明、去除秽恶之气的功效。总之久疟导致气馁，凡是能壮胆气的，都可以止疟，未必真有疟鬼。又疟邪既然日久，深入血分，或者结成疟母，使用鳖甲煎丸。如果设用煎剂，活血通络就可以了。
Tingli Dazao Decoction (Radish Seed and Jujube Decoction), Xiebai San (Drain White Powder), Dashun San (Great Smooth Powder), Muli Zexie San (Oyster Shell and Alisma Powder), Wuling San (Five-Ingredient Powder with Poria), Yebiao Tang (Guard the Exterior Decoction), Gansui Banxia Tang (Kansui and Pinellia Decoction), Kongxian Dan (Control Phlegm Pill), Wuzi Wupi Tang (Five Seeds and Five Peels Decoction), Hezi Guiling Tang (He Zi's Cinnamon and Polyporus Decoction), Yugong Wan (Yu Gong Pill), Fuling Fangji Tang (Poria and Stephania Decoction), Zhongman Fenxiao Tang (Middle Fullness Dissipating Decoction), Xiao Qinglong Tang (Minor Blue Dragon Decoction), Mu Fangji Tang (Stephania and Magnolia Bark Decoction).
Appendix 1: A pediatric patient surnamed Xu suffered from abdominal distension for several months. Pediatricians tried various treatments without success. Everyone used Fei'er Wan (Child-Nourishing Pill), Wan'an San (Ten Thousand Safety Powder), Moji Dan (Grinding Accumulation Pill), Lüfan Wan (Green Alum Pill), and Jizhen Yao (Chicken Gizzard Medicine), but none were effective. I reasoned that treating the Qi level was ineffective; it is necessary to treat the collaterals. As the saying goes, "When collaterals are obstructed by stasis, distension occurs." Pills made of Danggui Xu (Angelica Sinensis Root Tip), Taoren (Persicae Semen), Yanhusuo (Corydalis Rhizome), Shanjia (Manis Squama), Qianglang Chong (Silphidae Insect), Lingzhi (Pistacia Resina), and Shanzha (Crataegi Fructus) were administered. The patient recovered completely in ten days.
Vomiting and diarrhea: When a toddler's Spleen and Stomach are injured, sudden transformation into convulsions is most common. If foul turbid qi invades, or if cold food is ingested, Zhengqi San (Regulate Qi Powder), Liuhe Tang (Six-Harmony Decoction), or Wuji San (Five-Accumulations Powder) should be applied. If healthy qi is damaged, presenting with cold limbs, hiccups, vomiting, and spontaneous diarrhea, use Qian Yi's Yihuang San (Protect Yellow Powder). If phlegm is present, use Xingfu Liujunzi Tang (Pinellia and Atractylodes Six-Gentleman Decoction) or Lizhong Tang (Regulate the Middle Decoction). If heat qi is deeply entrenched, causing restlessness, thirst with desire to drink, and vomiting/reversal, use Lianxiang Yin (Fragrant Decoction) or Huanglian Zhuru Jupi Banxia Tang (Coptis, Bamboo Shavings, Tangerine Peel, and Pinellia Decoction). For heat closure causing unconsciousness, use Zhibao Dan (Precious Treasure Pill); for cold closure, use Laifu Dan (Return to Normal Pill).
In young children during summer, dampness from eating melons, fruits, and cold water adheres to the Spleen and Stomach, causing diarrhea. This accumulated cold-dampness cannot quickly transform into heat; therefore, acrid-warm and aromatic penetrating agents must be used. Ancient formulas for resolving fruit accumulation use Dingxiang (Caryophylli Flos), Rougui (Cinnamomi Cortex), or Shexiang (Moschus). The modern Qixiang Bing (Seven-Fragrance Cake) for treating diarrhea follows this principle. Pingwei San (Settle the Stomach Powder) and Weiling Tang (Stomach and Alisma Decoction) can also be used.
Malaria is mostly caused by summerheat. Although medical texts cite differences such as phlegm-food retention, cold-heat, and miasma, childhood malaria stems from Spleen-Stomach pathology. However, due to deficient Qi and weak spirit, initial symptoms often manifest as convulsions, epilepsy, or reversal. During summer and autumn, one must absolutely not mistake it for convulsions or epilepsy. Adult malaria cases require differentiation according to the Twelve Meridians, similar to cough syndromes. Vulgar pediatricians merely use Xiaochaihu Tang (Minor Bupleurum Decoction) minus Renshen (Ginseng), or herbs like Xiangru (Elsholtziae Herba) and Gegen (Puerariae Radix), unaware that Chaihu (Bupleuri Radix) depletes Liver Yin and Gegen exhausts Stomach fluids, leading to frequent complications. Children possess pure Yang constitution; summerheat is hot qi, so symptoms inevitably involve much heat, restlessness, and thirst. If the pathogen enters via the Lung, GuiZhi Baihu Tang (Cinnamon Twig and White Tiger Decoction) should be used; two doses will surely cure. For those with undigested cold food showing signs of Taiyin Spleen disease, initially use Zhengqi San or acrid-warm herbs like Caoguo (Tsaoko Fructus), Shengjiang (Zingiberis Rhizoma Recens), and Banxia (Pinelliae Rhizoma). Texts state Caoguo treats excessive cold in Taiyin, while Zhimu (Anemarrhenae Rhizoma) treats excessive heat in Yangming. For chronic malaria with pallor, white lips, profuse sweating, and weakness, Sibao Yin (Four Beasts Drink) is essential. For Yin deficiency with internal heat, Biejia (Testudinis Carapax et Plastrum), Shouwu (Polygoni Multiflori Radix), and Zhimu are required. These are contraindicated if stools become loose. Chronic malaria damaging Ying blood with excess cold adds Guizhi (Cinnamomi Ramulus) and Ganjiang (Zingiberis Rhizoma). Medications for late-stage malaria are listed below:
For early-stage summerheat-damp-wind-heat malaria: Epigastric fullness/stuffiness uses Zhike (Aurantii Fructus), Jiegeng (Platycodonis Radix), Xingren (Armeniacae Semen Amarum), Houpo (Magnoliae Officinalis Cortex) [these two are best for asthma], Gualou Pi (Trichosanthis Pericarpium), Shanzhi (Gardeniae Fructus), and Xiangchi (Fermented Soybean). Headache suits acrid-cool light agents: Lianqiao (Forsythiae Fructus), Bohe (Menthae Haplocalycis Herba), Chishao (Paeoniae Radix Rubra), Lingyangjiao (Rhinocerotis Cornu - *Note: Substitute with Buffalo Horn in practice*), Manjingzi (Viticis Fructus), Huashi (Talcum) [diuretic to clear upper jiao]. Severe cases use Shigao (Gypsum Fibrosum). Thirst uses Huafen (Trichosanthis Radix). Restless thirst uses Zhuye Shigao Tang (Bamboo Leaf and Gypsum Decoction). Intense heat uses Huangqin (Scutellariae Radix), Huanglian (Coptidis Rhizoma), and Shanzhi.
Summer body pain belongs to dampness; Qianghuo (Notopterygii Rhizoma et Radix) and Fangfeng (Saposhnikoviae Radix) acrid-warm agents are contraindicated. Use Mufangji (Stephaniae Tetrandrae Radix) and Can Sha (Bombyx Batryticatus residue).
Summerheat-pathogen injuring the body starts in the Qi level. If unresolved after many days, it gradually enters the Blood level, paradoxically causing thirst but little desire to drink, with crimson lips and tongue. If Huanglian and Huangqin preparations fail, blood-invigorating herbs are necessary, aided by only one herb to clear Qi-level heat.
Mild cases use Qinghao (Artemisiae Annuae Herba), Danpi (Moutan Cortex) [contraindicated if sweating profusely], Xijiao (Rhinocerotis Cornu - *Note: Substitute with Water Buffalo Horn*), Zhuyexin (Phyllostachys Nigra Leaves), Xuanshen (Scrophulariae Radix), Xian Shengdi (Rehmanniae Radix Recens), Xi Shengdi (Rehmanniae Radix Preparata), Mutong (Akebiae Caulis) [also induces sweating], and Dan Zhuye (Phyllostachys Nigra Leaves).
If heat persists causing epigastric knotting, select from Xiexin Tang (Drain the Epigastrium Decoction) variants.
Additionally, prolonged summerheat entering the Blood level frequently causes Blood Stasis syndrome. Delirium, confusion, and mania indicate this. Diagnosis relies on clear, long urination, implying black stools. Tao Ren Chengqi Tang (Persicae Semen and Magnesium Sulfate Decoction) is the key medicine.
Chronic childhood malaria with facial swelling, abdominal distension, diarrhea, anorexia, scrotal edema, or dorsal foot edema requires Li Dongyuan's method of tonifying Qi to raise Yang. If Spleen Yang is exhausted and previous formulas fail, use Lizhong Tang or Qian's Yihuang San. After efficacy for 2-3 days, administer Wuling San for 1-2 days, followed by Yigong San (Extra-Efficacy Powder) or Shenling Baizhu San (Ginseng, Poria, and Atractylodes Macrocephala Powder). Full recovery is expected. Xu Zhongke, annotating the *Jin Gui Yao Lue*, stated that for toddlers who have not yet eaten grain, chronic unresolving malaria can be treated with strong sugar water decoction. My trials confirmed its efficacy.
Malaria treatment often uses Wumei (Mume Fructus) to sourly drain Wood and calm Earth. Changshan (Dichroae Radix) and Caoguo are used to raid Taiyin cold. Changshan is extremely mobile, preventing the two pathogens from combining. Renshen and Shengjiang constitute Lujiang Yin (Dew Ginger Drink): one secures Yuan Qi, the other disperses pathogens, aiming to clarify the mind and remove foul qi. In essence, chronic malaria depletes Qi; any herb strengthening Gallbladder Qi can stop malaria; there is no need to believe in malaria ghosts. Furthermore, since malaria pathogens linger and enter the Blood level, forming a Mamo (Malaria Mass), Biejia Jian Wan (Softshell Turtle Pill) is used. If decoctions are prescribed, blood-invigorating and collateral-unblocking methods suffice.