按襁褓小儿。体属纯阳。所患热病最多。世俗医者。固知谓六气之邪。皆从火化。饮食停留。
郁蒸变热。惊恐内迫。五志动极皆阳。奈今时治法。初则发散解肌。以退表热。仍混入消导。继用清热
苦降。或兼下夺。再令病家禁绝乳食。每致胃气索然。内风来乘。变见惊痫。告毙甚多。附记世俗
通套之方药于左。不可不知。不足取法也。
防风 荆芥 葛根 前胡 桔梗 木通 赤芍 卜子 浓朴 陈皮 山楂 麦芽 枳壳 神曲
钩藤 夏佐香薷冬佐麻黄羌活。
两三日热不解。
柴胡 前胡 黄连 黄芩 山栀 连翘 薄荷 葛根 木通 钩藤 浓朴 枳实 栝蒌实
丸剂必用大黄。
四五日不解。但言食滞未尽。表里不和。总以柴芩小陷胸。若呕逆烦渴。用竹茹黄连半夏。若痰
多喘促。即用葶苈杏仁苏子卜子胆星贝母。甚者加牛黄。此皆套法。所当戒也。
屡清消不愈。便无方法。苟不变惊。必曰骨蒸孩劳。所用药饵。不分气血阴阳。但知见症施治。如
早凉暮热。必用。
地骨皮 丹皮 生地 元参 甘草 北沙参 石斛 知母
有痰。加
苏子 杏仁 贝母 橘红 胆星 桔梗
其 钩藤石斛茯苓谷芽之属。每剂必用。总之取无故疲药。待其自愈。倘有变症。希冀掩饰而
已。
愚按婴儿肌肉柔脆不耐风寒。六腑五脏气弱。乳汁难化。内外二因之病自多。然有非风寒。竟
致外感。不停滞已属内伤。其故何欤。尝思人在气交之中。春夏地气之升。秋冬天令之降。呼出
吸入。与时消息。间有秽浊吸入。即是三焦受邪。过募原直行中道。必发热烦躁。倘幼医但执前
药。表散消导。清火通便。病轻或有幸成。病重必然颠覆。钱仲阳云。粪履不可近襁褓小儿。余言
非无据矣。四十年来治效颇多。略述其概云。
夫春温夏热。秋凉冬寒。四时之序也。春应温而反大寒。夏应热而反大凉。秋应凉而反大热。冬
应寒而反大温。皆不正之乖气也。病自外感。治从阳分。若因口鼻受气。未必恰在足太阳经矣。
大凡吸入之邪。首先犯肺。发热咳喘。口鼻均入之邪。先上继中。咳喘必兼呕逆 胀。虽因外邪。
亦是表中之里。设宗世医发散阳经。虽汗不解。幼稚质薄神怯。日期多延。病变错综。兹以四气
常法列左。
根据观察，襁褓中的婴儿，体质属于“纯阳”（指小儿生机旺盛，阳气偏盛），所患的热病最多。世俗的医生，固然知道六气（风、寒、暑、湿、燥、火）的邪气，都会从火化热；饮食停滞，郁结蒸腾变为热邪；惊恐内迫，五志（喜、怒、忧、思、恐）动极皆属阳。然而现今的治疗方法，起初用发散解肌的方法，来退去表热，仍然混杂加入消食导滞的药物；接着使用清热苦降的药物，或者兼用泻下攻夺的方法；再让病人家属禁止乳食。这往往导致胃气枯竭，内风乘虚而入，变生惊痫，死亡的人很多。附记世俗通用的套方药在下面，不可不知道，这些是不值得效法的。
防风、荆芥、葛根、前胡、桔梗、木通、赤芍、萝卜子（莱菔子）、厚朴、陈皮、山楂、麦芽、枳壳、神曲、钩藤。夏季佐以香薷，冬季佐以麻黄、羌活。
两三天热不退。
柴胡、前胡、黄连、黄芩、山栀、连翘、薄荷、葛根、木通、钩藤、厚朴、枳实、栝蒌实。丸剂必须用大黄。
四五天不退，只说是食滞未尽，表里不和，总用柴胡、黄芩和小陷胸汤。如果呕吐逆乱、烦躁口渴，用竹茹、黄连、半夏。如果痰多喘促，就用葶苈子、杏仁、苏子、萝卜子、胆南星、贝母。严重的加牛黄。这些都是套路方法，应当戒除。
屡次清热消导都不愈，便没有办法了。如果不变成惊风，一定说是骨蒸孩劳（小儿慢性消耗性疾病）。所用的药物，不分气血阴阳，只知道见症施治。如早晚凉暮晚热，必用地骨皮、丹皮、生地、元参、甘草、北沙参、石斛、知母。
有痰，加苏子、杏仁、贝母、橘红、胆南星、桔梗。
那些钩藤、石斛、茯苓、谷芽之类的药，每剂必用。总之是取一些无功效的药，等待其自愈。如果有变症，只是希望掩饰而已。
我按：婴儿肌肉柔脆，不耐风寒，六腑五脏之气弱，乳汁难消化，内外两种病因导致的病自然多。然而有的并非风寒，竟致外感；没有停滞已属内伤。这是什么缘故呢？我曾思考，人在气交之中，春夏地气上升，秋冬天令下降，呼出吸入，与时消息（随着时节变化而调整）。间或有秽浊之气吸入，即是三焦受邪，经过募原直行中道，必然发热烦躁。如果幼科医生只执着于前面的药物，表散、消导、清火、通便，病轻或许侥幸成功，病重必然颠覆。钱仲阳说：“粪履（脏鞋）不可靠近襁褓小儿。”我的话不是没有依据的。四十年来治疗效果颇多，略述其大概。
春温夏热，秋凉冬寒，这是四时的顺序。春应温而反大寒，夏应热而反大凉，秋应凉而反大热，冬应寒而反大温，这都是不正的乖戾之气。病自外感，治疗从阳分入手。如果因口鼻受气，未必恰好在足太阳经。
大凡吸入的邪气，首先犯肺，发热咳喘。口鼻均入的邪气，先上继中，咳喘必兼呕逆、胀满。虽然因外邪，也是表中之里。如果遵循世医发散阳经的方法，即使发汗也不解。幼稚体质薄弱、神气怯弱，日期多拖延，病变错综复杂。这里列出四气常法如下。
According to observation, infants in swaddling clothes have a constitution belonging to "Pure Yang" (indicating vigorous growth and predominant yang qi in children), and thus suffer most frequently from heat diseases. Secular physicians, although aware that the pathogens of the Six Qi (Wind, Cold, Summer-heat, Dampness, Dryness, Fire) all transform into fire/heat; that food stagnation leads to heat through depression and steaming; and that internal pressure from fright and excessive movement of the Five Emotions (Joy, Anger, Worry, Thought, Fear) are all Yang, find that current treatment methods initially employ diaphoresis and muscle-releasing techniques to reduce exterior heat, yet still indiscriminately add digestive and promoting agents. Subsequently, they use bitter-cold descending drugs for clearing heat, or combine them with purgative attacks, and instruct families to strictly forbid milk and food. This often results in exhaustion of Stomach Qi, allowing Internal Wind to take advantage, manifesting as convulsions and epilepsy, with many deaths reported. The following common prescription formulas of secular practice are recorded below; one must know them, but they are not worthy of emulation.
Fangfeng (Saposhnikoviae Radix), Jingjie (Perillae Fructus), Gegen (Puerariae Lobatae Radix), Qianhu (Peucedani Radix), Jiegeng (Platycodonis Radix), Mutong (Akebiae Caulis), Chishao (Paeoniae Radix Rubra), Boluozhi (Raphani Semen), Houpo (Magnoliae Officinalis Cortex), Chenpi (Citri Reticulatae Pericarpium), Shanzha (Crataegi Fructus), Maiya (Hordei Fructus Germinatus), Zhike (Aurantii Fructus Immaturus), Shenqu (Massa Medicata Fermentata), Gouteng (Uncariae Ramulus cum Uncis). In summer, add Xiangru (Elsholtziae Herba); in winter, add Mahuang (Ephedrae Herba) and Qianghuo (Notopterygii Rhizoma et Radix).
If fever persists for two or three days:
Chaihu (Bupleuri Radix), Qianhu (Peucedani Radix), Huanglian (Coptidis Rhizoma), Huangqin (Scutellariae Radix), Shanzhi (Gardeniae Fructus), Lianqiao (Forsythiae Fructus), Bohe (Menthae Haplocalycis Herba), Gegen (Puerariae Lobatae Radix), Mutong (Akebiae Caulis), Gouteng (Uncariae Ramulus cum Uncis), Houpo (Magnoliae Officinalis Cortex), Zhishi (Aurantii Fructus Immaturus), Gualou Shi (Trichosanthis Fructus). For pills, Dahuang (Rhei Radix et Rhizoma) is essential.
If unresolved after four or five days, assuming only incomplete food stagnation and disharmony between interior and exterior, generally use Chaihu (Bupleuri Radix), Huangqin (Scutellariae Radix), and Xiaoxianxiong Tang (Minor Trapped-in-the-Chest Decoction). If there is vomiting, reflux, irritability, and thirst, use Zhuru (Bambusae Caulis in Taeniam), Huanglian (Coptidis Rhizoma), and Banxia (Pinelliae Rhizoma). If there is excessive phlegm and panting, use Tinglizi (Descurainiae Semen seu Lepidii Semen), Xingren (Armeniacae Semen Amarum), Suzi (Perillae Fructus), Boluozhi (Raphani Semen), Dansheng (Arisaematis Cum Bile), and Beimu (Fritillariae Thunbergii Bulbus). In severe cases, add Niuhuang (Bovis Calculus). These are all routine methods and should be avoided.
If repeated clearing of heat and digestion fails, no method remains. Unless it transforms into convulsions, it is invariably diagnosed as Guteng Hailao (Childhood Bone-stealing Consumption Disease). The medications used do not distinguish between Qi/Blood or Yin/Yang; they merely treat symptoms as they appear. For example, for early coolness and evening heat, Digupi (Lycii Cortex), Danpi (Moutan Cortex), Shengdi (Rehmanniae Radix), Yuanshen (Scrophulariae Radix), Gancao (Glycyrrhizae Radix et Rhizoma), Beishashen (Glehniae Radix), Shihu (Dendrobii Caulis), and Zhimu (Anemarrhenae Rhizoma) are used.
For phlegm, add Suzi (Perillae Fructus), Xingren (Armeniacae Semen Amarum), Beimu (Fritillariae Thunbergii Bulbus), Juhong (Citri Reticulatae Pericarpium Rubrum), Dansheng (Arisaematis Cum Bile), and Jiegeng (Platycodonis Radix).
Herbs such as Gouteng (Uncariae Ramulus cum Uncis), Shihu (Dendrobii Caulis), Fuling (Poria), and Guya (Hordei Fructus Germinatus) are used in every dose. In essence, ineffective herbs are taken, waiting for self-healing. If complications arise, it is merely to cover up the failure.
My commentary: Infants have soft and fragile muscles, unable to withstand Wind-Cold; their Qi of the Six Fu Organs and Five Zang Organs is weak, and milk is difficult to digest, so diseases caused by both internal and external factors are naturally numerous. However, some cases are not due to Wind-Cold yet result in exterior contraction; others involve interior injury without stagnation. What is the reason? I have pondered that humans exist within the intersection of Qi. In spring and summer, Earth Qi ascends; in autumn and winter, Heaven's mandate descends. Exhalation and inhalation adjust with the times. Occasionally, turbid miasma is inhaled, causing the Sanjiao (Triple Burner) to be attacked. It passes through the Mu Yuan (Sea of Origin) and moves directly along the central pathway, inevitably causing fever and irritability. If pediatricians stick rigidly to previous drugs—diaphoresis, digestion promotion, fire clearing, and bowel unblocking—mild cases might luckily succeed, but severe cases will surely collapse. Qian Zhongyang said, "Dirty shoes should not approach infants." My words are well-founded. Over forty years, my clinical efficacy has been considerable; here I briefly outline the general principles.
Spring warmth, summer heat, autumn coolness, winter cold constitute the order of the four seasons. Spring should be warm but turns severely cold; summer should be hot but turns severely cool; autumn should be cool but turns severely hot; winter should be cold but turns severely warm. These are all aberrant and discordant Qi. Diseases arise from exterior contraction, and treatment starts from the Yang aspect. If pathogens enter via mouth and nose, they may not necessarily affect the Foot-Taiyang Meridian first.
Generally, inhaled pathogens first attack the Lung, causing fever, cough, and panting. Pathogens entering via both mouth and nose act first on the upper jiao then the middle jiao; cough and panting are accompanied by vomiting, reflux, and distension. Although caused by exterior pathogens, this is also "interior within the exterior." If one follows the secular physicians' method of dispersing Yang meridians, sweating will not resolve the condition. Due to the thin constitution and timid spirit of young children, the duration prolongs, and pathological changes become complex. Here, the standard methods for the four Qi are listed below.