稚年五疳。犹大方之五劳。虽方书有五脏之分。是症夏令为多。固从脾胃。盖小儿乳食杂进。运
化不及。初断乳后。果腥杂进。气伤滞聚。致热蒸于里。肌肉消瘦。腹大肢细。名曰丁奚。或善食。或
不嗜食。或渴饮无度。或便泻白色。久延不已。多致凶危。宜忌食生冷腥肥凝滞。治法初用清热
和中分利。次则疏补佐运。常有继病。治之无效。待妊妇产过自愈者。
夏季霍乱吐泻。通用藿香正气散。
水泻。宜分利。四苓散。寒加姜桂 热用芩连。
腹痛宜疏气。调气用木香青皮。有滞加炒楂肉浓朴。重则加莱菔子槟榔。
腹痛有热。用芩芍枳实。有寒则用草果砂仁吴萸。
吐泻后。能食。便反秘结者愈。不能食。神怯色痿者。防慢惊。治法调中温中。若有余热烦渴。甘寒
或甘酸救津。故木瓜之酸。制暑通用要药。
春月暴暖忽冷。先受温邪。继为冷束。咳嗽痰喘最多。辛解忌温。只用一剂。大忌绝谷。若甚者宜
昼夜竖抱勿倒三四日。夫轻为咳。重为喘。喘急则鼻掀胸挺。
春温皆冬季伏邪。详于大方诸书。幼科亦有伏邪。治从大方。然暴感为多。如头痛恶寒发热。喘
促鼻塞身重。脉浮无汗。原可表散。春令温舒。辛温宜少用。阳经表药。最忌混乱。至若身热咳喘
有痰之症。只宜肺药辛解。泻白散。加前胡牛蒡薄荷之属。消食药。只宜一二味。若二便俱通者。
消食少用。须辨表里上中下。何者为急施治。
春季温暖。风温极多。温变热最速。若发散风寒消食。劫伤津液。变症尤速。
初起咳嗽喘促。通行用。
薄荷（汗多不用） 连翘 象贝 牛蒡 花粉 桔梗 沙参 木通 枳壳 橘红 桑皮 甘草
山栀（泄泻不用） 苏子（泻不用降气）
表解。热不清。用。
黄芩 连翘 桑皮 花粉 地骨皮 川贝 知母 山栀
里热不清。早上凉。晚暮热。即当清解血分。久则滋清养阴。若热陷神昏。痰升喘促。急用牛黄丸
至宝丹之属。
按风温乃肺先受邪。遂逆传心胞。治在上焦。不与清胃攻下同法。吾乡幼科当此。初投发散消
食。不应。改用柴芩栝蒌枳实川连。再下夺不应。多致危殆。皆因不明手经之病耳。
若寒痰阻闭。亦有喘急胸高。不可与前法。用三白吐之。或妙香丸。
小儿疳积病，相当于成人的五劳七伤。虽然医书中有五脏疳的分类，但这种病症在夏季更为多见。其根本原因确实在于脾胃。因为小儿乳食混杂进食，脾胃运化能力不足，刚断奶后，又摄入水果、鱼肉等杂食，导致气机受损、食滞积聚，进而使热气蒸腾于体内。表现为肌肉消瘦、腹部胀大、四肢细弱，这种症状称为“丁奚”。有的患儿食欲旺盛，有的则食欲不振，有的口渴饮水无度，有的大便泻下白色稀便。若病程迁延不愈，多会导致凶险危重的后果。治疗上应忌食生冷、腥膻、肥腻及凝滞难消化的食物。初期治法宜清热和中、分利湿浊；随后则宜疏理气机、补益脾胃并佐以助运化之品。常有继发疾病，若治疗无效，有时需等待产妇生产过后（注：此处原文语境可能有误或指特定民俗疗法/护理环境变化），病情方可自愈。
水样腹泻，宜采用分利湿浊的方法，方用四苓散。若属寒证，加生姜、肉桂；若属热证，用黄芩、黄连。
腹痛宜疏理气机，调气可用木香、青皮。若有食滞，加炒山楂肉、厚朴；重症则加莱菔子、槟榔。
腹痛伴有热象者，用黄芩、白芍、枳实。伴有寒象者，用草果、砂仁、吴茱萸。
吐泻之后，若能进食且大便反而秘结，是向愈的征兆。若不能进食，精神萎靡、面色萎黄者，要防止发展为慢惊风。治法宜调理中焦、温中健脾。若有余热烦渴，宜用甘寒或甘酸之法以救津液。因此，木瓜的酸味特性，是制作解暑通用药物的重要成分。
春季天气突然变暖又忽冷，先感受温邪，继而被寒气束缚，最容易引起咳嗽痰喘。辛散解表时忌用温燥药，只用一剂即可。绝对禁止绝食。若病情严重，宜昼夜竖抱患儿，避免倒置三四天。轻症为咳，重症为喘。喘急时会出现鼻孔煽动、胸部挺起等症状。
春温病多是冬季潜伏的邪气所致，这在成人医书中已有详述。儿科也有伏邪，治疗原则参照成人医书。但儿科多以暴感（急性外感）为主，如头痛、恶寒、发热、气喘急促、鼻塞、身体沉重、脉浮、无汗等，原本可以用发汗解表法。春季气候温和舒展，辛温解表药宜少用。阳经解表药最忌讳混乱使用。至于身热、咳嗽、气喘、有痰的症状，只宜用入肺经的药物进行辛散解表，方用泻白散，加入前胡、牛蒡子、薄荷等药。消食药只宜用一二味。若大小便都通畅的，消食药要少用。必须辨别表里、上中下三焦的病位，看哪一个是当务之急再施治。
春季温暖，风温病极多。温邪转化为热邪的速度非常快。如果发散风寒或消食导滞，会劫伤津液，变证发生尤其迅速。
初起出现咳嗽、气喘急促时，通行使用的方药如下：
薄荷（汗多者不用）、连翘、象贝母、牛蒡子、天花粉、桔梗、沙参、木通、枳壳、橘红、桑白皮、甘草、山栀（泄泻者不用）、苏子（腹泻者不用降气药）。
表证已解，但热不清除，使用以下药物：
黄芩、连翘、桑白皮、天花粉、地骨皮、川贝母、知母、山栀。
里热不清除，表现为早晨凉、傍晚热，即应当清解血分之热。日久则需滋阴清热养阴。若热邪陷入心包导致神昏，痰涌气喘急促，急用牛黄丸、至宝丹之类的药物。
按语：风温病是肺先受邪气侵袭，随即逆传于心包络。治疗重点在上焦，不与清胃攻下的方法相同。我家乡的儿科医生遇到这种情况，起初投用发散消食药，无效后，改用柴胡、黄芩、瓜蒌、枳实、黄连。再用攻下法也不见效，多导致病情危殆。这都是因为不明白手太阴肺经病变的缘故。
Pediatric *gan* (malnutrition syndrome due to improper feeding and spleen-stomach dysfunction) is analogous to the "five labors" (chronic deficiency syndromes) in adults. Although medical texts classify it according to the five Zang organs, this condition is more prevalent in summer. Its root lies indeed in the Spleen and Stomach. This is because children consume mixed milk and food, and their digestive transformation capacity is insufficient. After weaning, if they ingest fruits and fish/meat indiscriminately, Qi injury and food stagnation accumulate, causing heat to steam internally. Manifestations include emaciated muscles, distended abdomen, and thin limbs; this symptom complex is named "Ding Xi" (a specific type of severe pediatric malnutrition). Some infants have a good appetite, others lack appetite, some drink excessively due to thirst, and others pass white loose stools. If the disease lingers without resolution, it often leads to critical and dangerous conditions. Dietary restrictions should include avoiding raw, cold, fishy, greasy, and hard-to-digest foods. The initial treatment method involves clearing heat, harmonizing the middle Jiao, and separating turbidity from clear fluids. Subsequently, one should soothe Qi tonification assisted by promoting digestion. There are often secondary illnesses; if treatment fails, sometimes the condition may resolve spontaneously after the mother gives birth (Note: This phrase likely refers to a specific contextual or folk remedy context within the original text).
For cholera-like vomiting and diarrhea occurring in summer, Huoxiang Zhengqi San (Agastache Powder for Regulating the Qi and Correcting the Turbidity) is generally used.
For watery diarrhea, separation of turbidity is indicated. Si Ling San (Four-Poria Decoction) is used. For cold patterns, add Sheng Jiang (Zingiberis Rhizoma Recens) and Rou Gui (Cinnamomi Cortex); for heat patterns, use Huang Qin (Scutellariae Radix) and Lian Lian (Coptidis Rhizoma).
For abdominal pain, soothing Qi is appropriate. Tiao Qi (regulating Qi) can use Mu Xiang (Aucklandiae Radix) and Qing Pi (Citri Reticulatae Pericarpium Viride). If there is stagnation, add Chao Zha Rou (Fried Crataegi Fructus) and Hou Po (Magnoliae Officinalis Cortex); for severe cases, add Lai Fu Zi (Raphani Semen) and Bing Lang (Arecae Semen).
For abdominal pain with heat signs, use Huang Qin (Scutellariae Radix), Bai Shao (Paeoniae Radix Alba), and Zhi Shi (Aurantii Fructus Immaturus). For cold signs, use Cao Guo (Tsaoko Fructus), Sha Ren (Amomi Fructus Rotundus), and Wu Zhu Yu (Evodiae Fructus).
After vomiting and diarrhea, if the patient can eat and stool becomes constipated, it indicates recovery. If the patient cannot eat, shows spirit fatigue, and sallow complexion, one must guard against slow convulsions (*man jing*). The treatment method should regulate the middle and warm the center. If there is residual heat with irritability and thirst, sweet-cold or sweet-sour methods should be used to rescue body fluids. Therefore, the sour nature of Mu Gua (Chaenomelis Fructus) makes it an essential herb for general summerheat-resolving preparations.
In spring, sudden warmth followed by cold causes the body to first contract warm pathogens, then be constrained by cold. Cough with phlegm and wheezing are most common. When using acrid-releasing methods, avoid warm-hot herbs; use only one dose. Absolute fasting is prohibited. If the condition is severe, hold the infant upright day and night, avoiding inversion, for three to four days. Mild cases present as cough; severe cases as wheezing. In acute wheezing, nasal flaring and chest retraction occur.
Spring-warmth diseases are mostly caused by latent pathogens from winter, detailed in adult medical texts. Pediatrics also has latent pathogens, and treatment follows adult principles. However, acute external contraction is more common in children, presenting with headache, aversion to cold, fever, rapid breathing, nasal congestion, heavy body, floating pulse, and absence of sweating. These can originally be treated with diaphoresis. Since spring climate is mild and舒展 (expansive), acrid-warm releasing herbs should be used sparingly. Yang-meridian exterior-releasing herbs are strictly forbidden from chaotic use. As for symptoms of fever, cough, wheezing, and phlegm, only lung-meridian herbs for acrid release are suitable. Xie Bai San (Drain White Powder) is used, added with Qian Hu (Peucedani Radix), Niu Bang Zi (Arctii Fructus), and Bo He (Menthae Haplocalycis Herba). Digestion-promoting herbs should be limited to one or two types. If both urine and stool are unobstructed, digestion-promoting herbs should be used sparingly. One must differentiate between exterior/interior and upper/middle/lower Jiao to determine which aspect is urgent for treatment.
In spring, when it is warm, wind-warmth diseases are very common. Warm pathogens transform into heat rapidly. If one uses diaphoresis for wind-cold or digestion-promoting methods, it will deplete body fluids, and pathological changes occur even faster.
At the onset, with cough and rapid breathing, the following are commonly used:
Bo He (Menthae Haplocalycis Herba) (avoid if sweating is profuse), Lian Qiao (Forsythiae Fructus), Xiang Bei (Fritillariae Thunbergii Bulbus), Niu Bang Zi (Arctii Fructus), Hua Fen (Trichosanthis Radix), Jie Geng (Platycodonis Radix), Sha Shen (Glehniae Radix), Mu Tong (Akebiae Caulis), Zhi Ke (Aurantii Fructus), Ju Hong (Citri Reticulatae Pericarpium), Sang Pi (Mori Cortex), Gan Cao (Glycyrrhizae Radix et Rhizoma), Shan Zhi (Gardeniae Fructus) (avoid if diarrhea), Su Zi (Perillae Fructus) (avoid Qi-descending action if diarrhea).
If the exterior is resolved but heat remains unclear, use:
Huang Qin (Scutellariae Radix), Lian Qiao (Forsythiae Fructus), Sang Pi (Mori Cortex), Hua Fen (Trichosanthis Radix), Di Gu Pi (Lycii Cortex), Chuan Bei (Fritillariae Cirrhosae Bulbus), Zhi Mu (Anemarrhenae Rhizoma), Shan Zhi (Gardeniae Fructus).
If interior heat is not cleared, characterized by coolness in the morning and fever in the evening, one should clear and resolve blood-level heat. Prolonged cases require nourishing yin and clearing heat. If heat collapses into the pericardium causing coma, with rising phlegm and wheezing, urgently use Niu Huang Wan (Calculus Bovis Pill) or Zhi Bao Dan (Precious Treasure Elixir).
Commentary: Wind-warmth is a disease where the Lung first contracts the pathogen, which then reversely transmits to the Pericardium. Treatment focuses on the Upper Jiao and differs from methods that clear the Stomach and purge accumulation. Pediatricians in my hometown, encountering this, initially prescribe diaphoretic and digestion-promoting herbs. When ineffective, they switch to Chai Hu (Bupleuri Radix), Huang Qin (Scutellariae Radix), Gua Lou (Trichosanthis Fructus), Zhi Shi (Aurantii Fructus Immaturus), and Chuan Lian (Meliae Cortex - *Note: Text says Chuan Lian but usually implies Chuan Lian Zi or similar, here likely referring to a formula component like Huang Lian based on context 'Chuan Lian' might be a typo for 'Chuan Lian Zi' or just 'Huang Lian' mentioned later? Actually text says 'Chai Qin Gua Zhi Chuan Lian', likely Chai Hu, Huang Qin, Gua Lou, Zhi Shi, Chuan Lian Zi/Huang Lian*). Then they attempt purgation, which also fails, leading to critical danger. This is all due to ignorance of hand-meridian (Lung) pathology.
If cold-phlegm obstruction occurs, presenting with wheezing, shortness of breath, and elevated chest, the previous methods are contraindicated. Use San Bai (Three Whites - *likely referring to a specific emetic formula involving Bai Fan, etc.*) to induce vomiting, or Miao Xiang Wan (Miraculous Incense Pill).