暑邪必挟湿。状如外感风寒。忌用柴葛羌防。如肌表热无汗。辛凉轻剂无误。香薷。辛温气升。
热伏易吐。佐苦降。如杏仁川连黄芩。则不吐。宣通上焦。如杏仁连翘薄荷竹叶。暑热深入。
伏热烦渴。白虎汤。六一散。
暑邪首用辛凉。继用甘寒。后用酸泄敛津。不必用下。
暑病头胀如蒙。皆湿盛生热。白虎竹叶。酒湿食滞。加辛温通里。
小儿发热。最多变蒸之热。头绪烦。不能载。详于巢氏病源矣。然春温。夏热。秋凉。冬寒。四季中伤
为病。当按时论治。其内伤饮食治法。不宜混入表药。消滞宜用丸药。洁古东垣已详悉。
徐评 此卷论幼科及看痘之法。和平精切。字字金玉。可法可传。得古人之真诠而融化之。不
愧名家。闻此老太翁为幼科专门。名闻远近。此老既得家学渊源。又于大方诸书探取经络药
性之义。而附益之。所以其理益精。其方益正。不若前所列之诸案。尚多可议处也。
袁 温邪痰嗽。气喘肚膨。四日不解。防发痧。（温邪）
连翘 山栀 牛蒡 杏仁 石膏
汪 痧将退。热未去。肺气不清。咳逆无痰。（热邪留肺）
前胡 桑皮 杏仁 橘红 桔梗 木通 苏子 象贝
王 痧隐太早。咳喘发热。宜开肺气。
薄荷 杏仁 象贝 连翘 桑皮 木通 紫菀 郁金
某 温邪发痧不透。热毒内陷深藏。上熏肺为喘。下攻肠则利。皆冬温火化之症。经云。火淫于
内。治以苦寒。幼科不究病本。不明药中气味。愈治愈剧。至此凶危。（热邪内陷）
川连 黄芩 飞滑石 炒银花 连翘 甘草 丹皮 地骨皮
蒋 喘为肺病。胀乃肝病。因时痧寒热未解。热邪内陷所致。王先生用苦辛酸法极通。然浮肿
腹痛未减。得非经腑之湿热留着欤。
木防己 石膏 杏仁 大豆黄卷 通草 苡仁 连翘
艾 痧退后。呻吟不肯出声。涕泪皆无。唇紫掀肿。乃毒火未经清解。上窍渐闭。气促痰鸣。犹是
温邪客气致此。自当清解务尽。其神识自和。奈何以畏虚滋肺。邪火愈炽矣。（毒火未清）
川连 元参 杏仁 甘草 黄芩 连翘 桔梗 银花
王 痧后。及暮加喉痛咳。
元参 犀角 鲜生地 连翘 花粉 丹皮
邹 咽痛鼻燥唇肿。自利。风温热化发疹。上焦热炽。宜辛凉微苦以泄降。（风温发疹）
连翘 黄芩 犀角 桔梗 牛蒡 杏仁 元参 通草
谭（六岁） 温邪时疠。触自口鼻。秽逆游行三焦。而为麻疹。目赤鼻煤。吐蛔泻蛔。津津汗出。而喘渴欲
饮。当与辛苦寒。刘河间法。世俗不知。佥曰发痧。但以荆防蝉壳升提。火得风 。焰烈莫遏。津
劫至变矣。（疠邪） 凉膈去硝黄加石膏牛蒡赤芍。
张（三岁） 手足烦热。时发赤块。
绿豆壳 卷心竹叶
暑邪必定夹杂湿气。其症状表现如同外感风寒。应当忌用柴胡、葛根、羌活、防风等药物。如果肌表发热且无汗，使用辛凉轻剂不会出错。香薷性味辛温，气味升散，若热邪内伏容易引发呕吐；此时需佐以苦降的药物，如杏仁、川黄连、黄芩，则能防止呕吐，起到宣通上焦的作用，例如使用杏仁、连翘、薄荷、竹叶。若暑热深入体内，出现伏热、烦躁、口渴等症状，可使用白虎汤或六一散。
治疗暑病，首先使用辛凉药物，接着使用甘寒药物，最后使用酸味药物来泄热并收敛津液。通常不需要使用泻下法。
暑病导致头部胀闷如被蒙蔽，都是因为湿气盛而生热所致，可用白虎汤加竹叶。若是酒湿和食积停滞，则需加入辛温通里的药物。
小儿发热，最多见的是“变蒸”引起的发热，头绪繁杂，无法一一详述，这在巢元方的《诸病源候论》中已有详细说明。然而，春温、夏热、秋凉、冬寒，四季中伤邪气致病，应当根据时令进行辨证论治。对于内伤饮食的治疗方法，不宜混入解表药物。消食导滞宜使用丸药，洁古（张元素）、东垣（李杲）对此已有详尽论述。
徐评：这一卷论述儿科及看痘的方法，平和精准，字字珠玑，值得效法传承。得到了古人的真传并能融会贯通，不愧为名家。听说这位老太翁是儿科专家，名声远扬。他既有家学渊源，又在大方诸书中探取经络药性的义理并加以补充，所以他的医理更加精微，处方更加纯正，不像前文所列的那些医案，尚有许多可议论之处。
袁姓患者：温邪引起痰嗽，气喘腹胀，四日未解，担心发展为痧疹。（温邪）
连翘、山栀、牛蒡子、杏仁、石膏。
汪姓患者：痧疹即将消退，但热邪未去，肺气不清爽，咳嗽气逆无痰。（热邪留肺）
前胡、桑白皮、杏仁、橘红、桔梗、木通、苏子、象贝母。
王姓患者：痧疹隐没太早，伴有咳嗽气喘发热，应当宣开肺气。
薄荷、杏仁、象贝母、连翘、桑白皮、木通、紫菀、郁金。
某患者：温邪引发的痧疹透发不透，热毒内陷深藏。向上熏蒸肺部导致喘息，向下攻伐肠道导致腹泻，这都是冬温火化之症。《内经》说：“火淫于内，治以苦寒。”儿科医生不探究病本，不明白药物的气味特性，越治病情越重，到了这种凶险危急的地步。（热邪内陷）
川黄连、黄芩、飞滑石、炒金银花、连翘、甘草、丹皮、地骨皮。
蒋姓患者：喘息是肺病，腹胀是肝病。因时令痧疹寒热未解，导致热邪内陷所致。王先生使用苦辛酸法非常通达。但是浮肿腹痛未减，莫非是经腑的湿热留着不去？
木防己、石膏、杏仁、大豆黄卷、通草、苡仁、连翘。
艾姓患者：痧疹退后，呻吟却不敢出声，涕泪皆无，嘴唇紫色掀肿，这是毒火未经清解，上窍逐渐闭塞，气促痰鸣，仍是温邪客气导致此状。自然应当彻底清解，神识自然会平和。为何因为畏惧虚证而滋腻润肺，导致邪火更加炽盛呢？（毒火未清）
川黄连、玄参、杏仁、甘草、黄芩、连翘、桔梗、金银花。
王姓患者：痧疹之后，傍晚加重喉痛咳嗽。
玄参、犀角、鲜生地、连翘、花粉、丹皮。
邹姓患者：咽痛鼻燥唇肿，自利（腹泻），风温热化发疹，上焦热炽盛，宜用辛凉微苦以泄降。（风温发疹）
连翘、黄芩、犀角、桔梗、牛蒡子、杏仁、玄参、通草。
谭姓（六岁）：温邪时疠之气，从口鼻侵入，秽逆之气游行三焦，从而形成麻疹。目赤鼻黑，吐蛔虫泻蛔虫，出汗津津，气喘口渴想喝水。应当给予辛苦寒之法，参考刘河间的治法。世俗之人不懂，都说是发痧，只用荆芥、防风、蝉蜕升提，火得风助，火势猛烈难以遏制，津液耗竭至发生变证。（疠邪）
凉膈散去掉硝黄，加入石膏、牛蒡子、赤芍。
The pathogenic factor of summerheat (Shu) inevitably carries dampness. Its presentation resembles exterior contraction of wind-cold. It is contraindicated to use Chaihu, Gegen, Qianghuo, and Fangfeng. If there is heat on the muscle surface with no sweating, using a mild acrid-cool formula is not erroneous. Xiangru is acrid-warm and ascending in nature; if heat is latent, vomiting may easily occur. One should assist with bitter-descending herbs such as Xingren, Chuanlian, and Huangqin to prevent vomiting, thereby promoting the diffusion of the Upper Jiao, for example, using Xingren, Lianqiao, Bohe, and Zhuye. If summerheat penetrates deeply, causing latent heat, restlessness, and thirst, Baihu Tang or Liuyi San may be used.
In treating summerheat diseases, one first uses acrid-cool methods, then sweet-cold methods, and finally sour-draining methods to consolidate fluids. Purging is generally unnecessary.
Head distension and a sensation of being covered in summerheat diseases are all due to excessive dampness generating heat; Baihu Tang with Zhuye is appropriate. In cases of alcohol-dampness and food stagnation, acrid-warm interior-penetrating herbs should be added.
Pediatric fever is most commonly due to "bianzheng" (physiological growth fever). The complexities are numerous and cannot be fully detailed here; this has been thoroughly discussed in Chao Shi's *Bing Yuan*. However, spring warmth, summer heat, autumn coolness, and winter cold represent seasonal injuries leading to disease. Treatment should follow the seasonal patterns. For internal injury due to diet, it is inappropriate to mix in exterior-releasing drugs. For resolving stagnation, pill forms are suitable; these methods were detailed by Jiegu (Zhang Yuansu) and Dongyuan (Li Gao).
Xu's Commentary: This volume discusses pediatric medicine and the observation of smallpox/rash. It is peaceful, precise, and every word is like gold and jade, worthy of emulation and transmission. It captures the true essence of ancient masters and integrates it skillfully, living up to the reputation of a renowned expert. It is heard that this elderly gentleman specializes in pediatrics and is famous far and wide. Having inherited family learning, he also explored the principles of meridians and drug properties from major medical texts and supplemented them. Thus, his theories are more refined and his prescriptions more orthodox, unlike the previous cases which had many points open to discussion.
Patient Yuan: Warm pathogen causing phlegm cough, wheezing, and abdominal distension, unresolved after four days; risk of developing rash. (Warm pathogen)
Lianqiao, Shanzhi, Niubang, Xingren, Shigao.
Patient Wang: Rash about to recede, but heat remains; lung qi is unclear, causing cough and regurgitation without phlegm. (Heat pathogen lingering in the Lung)
Qianhu, Sangpi, Xingren, Juhong, Jiegeng, Mutong, Suzi, Xiangbei.
Patient Wang: Rash appeared too early/hidden, with cough, wheezing, and fever; should diffuse lung qi.
Bohe, Xingren, Xiangbei, Lianqiao, Sangpi, Mutong, Ziwan, Yujin.
Certain Patient: Warm pathogen causing incomplete eruption of rash; heat-toxin sinks inward and hides deep. Ascending to smoke the Lung causes wheezing; descending to attack the Intestines causes diarrhea. These are symptoms of winter-warmth transforming into fire. The Classics state: "When fire overflows within, treat with bitter-cold." Pediatricians who do not investigate the root cause and do not understand the flavors and natures of drugs will make the condition worse with treatment, reaching a critical and dangerous state. (Heat pathogen sinking inward)
Chuanlian, Huangqin, Feihuaishi, Chao Yinhuajia, Lianqiao, Gancao, Danpi, Digupi.
Patient Jiang: Wheezing indicates Lung disease; distension indicates Liver disease. Due to unresolved seasonal rash chills and fever, the heat pathogen sank inward. Mr. Wang's use of the bitter-acid-sour method was very thorough. However, edema and abdominal pain have not decreased; could this be damp-heat lingering in the channels and fu-organs?
Mufangji, Shigao, Xingren, Doudahuangjuan, Tongcao, Yiren, Lianqiao.
Patient Ai: After rash receded, groaning but unwilling to speak, no tears or mucus, purple and swollen lips. This is because toxic fire was not cleared; upper orifices are gradually closing, with shortness of breath and rattling phlegm. This is still caused by the guest pathogen of warm evil. One must clear and resolve it completely so that mental clarity returns. Why nourish the Lung with cloying herbs out of fear of deficiency, thereby intensifying the evil fire? (Toxic fire unclarified)
Chuanlian, Yuan Shen, Xingren, Gancao, Huangqin, Lianqiao, Jiegeng, Yinhuajia.
Patient Wang: After rash, throat pain and cough worsen at dusk.
Yuan Shen, Xijiao, Xian Shengdi, Lianqiao, Huafen, Danpi.
Patient Zou: Sore throat, dry nose, swollen lips, spontaneous diarrhea. Wind-warmth transforming into heat causing macules. Upper Jiao heat is blazing; should use acrid-cool slightly bitter to drain and descend. (Wind-warmth causing macules)
Lianqiao, Huangqin, Xijiao, Jiegeng, Niubang, Xingren, Yuan Shen, Tongcao.
Tan (6 years old): Warm pathogen and epidemic pestilence enter via mouth and nose; turbid qi travels through the Triple Burner, resulting in measles. Red eyes, blackened nose, vomiting and purging roundworms, profuse sweating, wheezing, thirst, and desire to drink. Should apply acrid-bitter-cold method, following Liu Hejian's approach. Laypeople do not understand, claiming it is just a rash, and only use Jingjie, Fangfeng, and Chanqiao to raise and lift. Fire aided by wind becomes fierce and uncontrollable; fluids are depleted leading to transformation of the disease. (Pestilential pathogen)
Liangge San minus Xiaofen and Dahuang, plus Shigao, Niubang, Chishao.
Zhang (3 years old): Restless heat in hands and feet, occasionally erupting red patches.
Lüdouke, Juanxin Zhuye.