秋深初凉。稚年发热咳嗽。证似春月风温症。但温乃渐热之称。凉即渐冷之意。春月为病。犹冬
藏固密之余。秋令感伤。恰值夏热发泄之后。其体质之虚实不同。但温自上受。燥自上伤。理亦
相等。均是肺气受病。世人误认暴感风寒。混投三阳发散。津劫燥甚。喘急告危。若果暴凉外束。
身热痰嗽。只宜葱豉汤。或苏梗前胡杏仁枳桔之属。仅一二剂亦可。更有粗工。亦知热病。与泻
白散加芩连之属。不知愈苦助燥。必增他变。当以辛凉甘润之方。气燥自平而愈。慎勿用苦燥。
劫烁胃汁。
秋燥一症。气分先受。治肺为急。若延绵数十日之久。病必入血分。又非轻浮肺药可医。须审体
质症端。古谓治病当活泼泼地。如盘走珠耳。
翁姓子方数月。秋燥潮热。咳嗽如疟。幼科用发散药二日不效。忙令禁乳。更医用泻白散。再
加芩连二日。昼夜烦热。喘而不咳。下痢粘腻。药后竟痢药水。延余诊之。余曰稚年以乳食为
命。饿则胃虚气馁。肺气更不爽矣。与玉竹甘草炒广皮竹叶心。一剂热缓。继与香粳米南枣
广皮甘草沙参二剂。与乳少进。令夜抱勿倒。三日全愈。
深秋入冬。暴冷折阳。外感发热。头痛身痛。呕恶。必从太阳。若渴能饮水者。里热见症。即非纯以
表散。伤寒每以风伤卫。用桂枝法。寒伤营。用麻黄法。小儿肌疏易汗。难任麻桂辛温。表邪太阳
治用。轻则紫苏防风一二味。身痛用羌活。然不过一剂。伤风症亦肺病为多。前杏枳桔之属。辛
胜即是汗药。其葱豉汤。乃通用要方。若肢冷寒战。呕吐自痢。或身无热。即从中寒里症。三阴须
分。但小儿科。太阴中寒最多。厥阴间有。若冬令应寒。气候温暖。当藏反泄。即能致病。名曰冬温。
温为欲热之渐。非寒症得汗而解。若涉表邪一二。里热必兼七八。是瘾疹丹痧。非徒风寒。或外
受之邪。与里邪相薄。亦令郁于经络。或饮醇浓味。里热炽烈。而卫气不与营分相和。或不正直
入内侵。即有腹痛下痢诸症。其治法按症。必以里症为主。稍兼清散有诸。设用辛温。祸不旋踵
矣。至于痧痘时疠。须分四气也。
深秋时节，初感凉意。幼儿出现发热、咳嗽症状。此证候看似春季的风温病。但“温”是指逐渐转热的过程，“凉”则是逐渐变冷的意思。春季患病，尚有余留的冬季闭藏固密之正气；而秋季感受邪气，正值夏季阳气发泄之后。因此，两者的体质虚实情况不同。风温自上焦受邪，燥邪亦自上焦损伤人体，其道理也是相同的。都是肺脏受到病邪侵袭。世人错误地将其认定为突然感受风寒，胡乱投用三阳经的发散药物，导致津液被劫夺，燥邪更甚，出现气喘急促，病情危急。如果确实是暴凉外束，身体发热、痰多咳嗽，只适宜使用葱豉汤，或者苏梗、前胡、杏仁、枳壳、桔梗这类药物，仅服用一两个剂量即可。更有庸医，虽然知道这是热病，却使用泻白散加上黄芩、黄连等苦寒药物，不知道越苦寒越助长燥邪，必然增加其他变证。应当使用辛凉甘润的方剂，气分燥热自然平息而痊愈。千万不要使用苦燥的药物，劫烁胃中津液。
秋燥这一病症，气分先受邪，治疗以清肺为急务。如果拖延数十日之久，病邪必然深入血分，这就不是轻浮的肺经药物所能医治的了。必须审察患者的体质和症候端绪。古人说治病应当活泼灵动，如同盘中之珠滚动一样灵活。
姓翁的孩子才几个月大，患秋燥潮热，咳嗽如疟疾般阵作。儿科医生用了两天发散药无效，急忙令其停止吃奶。换医生后使用泻白散，再加黄芩、黄连两天。孩子昼夜烦热，气喘但不咳嗽，下痢粘腻物，服药后竟然连药液都拉出来。请我诊治。我说：幼儿以乳食为生，饥饿则胃虚气馁，肺气更加不畅。给予玉竹、甘草、炒广陈皮、竹叶心，服用一剂后热势缓解。继而又给予香粳米、南枣、广陈皮、甘草、沙参，服用两剂后，少量给予乳汁，并嘱咐夜间抱着孩子不要让他仰卧。三天后完全痊愈。
深秋入冬之际，突然寒冷折伤阳气。外感发热，头痛身痛，呕吐恶心。病邪必从太阳经开始。如果口渴能饮水，则是里热显现的症状，这就不能单纯使用解表发散的方法。伤寒通常认为风邪伤卫分，用桂枝法；寒邪伤营分，用麻黄法。小儿肌肤疏松易出汗，难以承受麻黄、桂枝的辛温峻烈。对于太阳经表邪的治疗，轻微的用紫苏、防风一两味药，身痛的用羌活。但这不过是一剂的量。伤风症也多属于肺病，前面的杏仁、枳壳、桔梗这类药物，辛散胜即具有发汗作用。葱豉汤乃是通用的重要方剂。如果出现四肢冰冷、寒战、呕吐、自发性下痢，或者身体无发热，这就是中寒里证。三阴经需要区分。但是小儿科中，太阴中寒最为多见，厥阴中寒偶尔有见。如果冬季应当寒冷，气候却温暖，该闭藏反而发泄，就能致病，名叫冬温。温是即将转热的渐进过程，不像寒症可以通过发汗而解。如果涉及表邪一二分，里热必然兼七八分。这是瘾疹丹痧，不仅仅是风寒。或者是外受的邪气与里邪相互搏结，也令邪气郁滞于经络。或者是饮用浓烈酒食，里热炽盛，而卫气不与营分相调和，或者不正之气入侵体内，就会出现腹痛下痢等症状。其治疗方法按症候而定，必须以治疗里证为主，稍微兼用清热发散的方法。如果使用辛温药物，灾祸立刻就会降临。至于痧痘时疠，必须分辨四气的影响。
In late autumn, when the coolness first sets in. A young child presents with fever and cough. The syndrome resembles Wind-Warmth (Fengwen) of spring. However, "Warmth" refers to a gradual increase in heat, while "Coolness" implies a gradual decrease in temperature. Illnesses contracted in spring still benefit from the residual solidity and closure of winter storage. Injuries sustained in autumn occur precisely after the dispersal of summer heat. Thus, the deficiency or excess of constitution differs. Wind-Warmth enters from above; Dryness injures from above. The principle is equally applicable. Both involve disease affecting the Lung Qi. People mistakenly identify this as a sudden contraction of Wind-Cold and indiscriminately administer dispersing agents for the Three Yang meridians. This depletes body fluids, exacerbates dryness, leading to panting and urgency, putting the patient in danger. If it is indeed external constraint by sudden cold, with fever, phlegm, and cough, only Congchi Tang (Scallion and Fermented Soybean Decoction) or herbs such as Perillae Caulis (Sugeng), Peucedani Radix (Qianhu), Armeniacae Semen (Xingren), Aurantii Fructus Immaturus (Zhike), and Bunge's Magnolia Flower (Jie) should be used. One or two doses are sufficient. More often, incompetent physicians, knowing it is a heat disease, prescribe Xiebai San (Drain the White Powder) supplemented with Scutellariae Radix (Huangqin) and Phellodendri Cortex (Huanglian). They do not realize that excessive bitterness aids dryness and inevitably leads to other complications. One should use formulas that are pungent, cool, sweet, and moistening. The qi dryness will naturally level out and heal. Do not use bitter-drying agents that consume and scorch stomach fluids.
Autumn-Dryness syndrome affects the Qi level first; treating the Lung is urgent. If it lingers for dozens of days, the pathogen must enter the Blood level, which cannot be treated by light and floating Lung herbs. One must examine the constitution and symptom details. As the ancients said, treating disease requires flexibility, like a pearl rolling on a plate.
A child surnamed Weng, only a few months old, suffered from Autumn-Dryness tidal fever and coughing paroxysms resembling malaria. The pediatrician used dispersing herbs for two days without effect, then hastily ordered weaning. Another physician prescribed Xiebai San plus Scutellariae Radix and Phellodendri Cortex for another two days. The child experienced day-and-night irritability and fever, panting without coughing, and dysentery with sticky discharge. After medication, even the medicinal liquid was passed via stool. I was consulted. I said: Infants rely on milk and food for life. Hunger leads to Spleen-Stomach deficiency and Qi exhaustion, further impairing Lung Qi. I prescribed Polygonati Odorati Rhizoma (Yuzhu), Glycyrrhizae Radix et Rhizoma (Gancao), stir-fried Citri Reticulatae Pericarpium (Guangchenpi), and Bamboo Leaf Heart (Zhuyexin). After one dose, the fever subsided. Subsequently, I prescribed Fragrant Rice (Xiangjingmi), Jujubae Fructus (Nanzao), Citri Reticulatae Pericarpium, Glycyrrhizae Radix et Rhizoma, and Glehniae Radix (Shashen) for two doses. Milk intake was slightly increased, and the mother was instructed to hold the infant at night rather than letting him lie supine. He recovered completely in three days.
Late autumn into winter, sudden cold damages Yang. External contraction causes fever, headache, and body pain, accompanied by vomiting and nausea. The pathogen must originate from the Taiyang (Greater Yang) meridian. If there is thirst and ability to drink water, it indicates internal heat symptoms, meaning pure exterior dispersal is not appropriate. In Cold Damage (Shanghan), Wind injuring the Wei (Defensive) level uses Guizhi Tang (Cinnamon Twig Decoction); Cold injuring the Ying (Nutritive) level uses Mahuang Decoction (Mahuang Tang). Children have loose skin and sweat easily, making them unable to tolerate the pungent-warm potency of Ephedrae Herba (Mahuang) and Cinnamomi Ramulus (Guizhi). For Taiyang exterior pathogens, mild cases use Zisu Ye (Perilla Leaf) and Fangfeng (Saposhnikovia Root) alone or in combination; body pain uses Notopterygii Rhizoma et Radix (Qianghuo). However, these are limited to one dose. Wind-injury syndromes are mostly Lung diseases. The aforementioned Xingren, Zhike, and Jie are pungent and thus possess sweating properties. Congchi Tang is a general essential formula. If limbs are cold, chills occur, vomiting happens, spontaneous dysentery appears, or there is no fever, it indicates Middle Cold interior syndrome. The Three Yin meridians must be differentiated. However, in pediatrics, Taiyin Middle Cold is most common, while Jueyin (Terminal Yin) Middle Cold occurs occasionally. If winter weather should be cold but remains warm, causing storage to leak instead, disease ensues, named Winter-Warmth (Dongwen). Warmth is the gradual onset of heat, unlike cold syndromes which resolve through sweating. If exterior pathogens account for one or two parts, interior heat likely accounts for seven or eight parts. This manifests as macules or erysipelas-like rashes, not merely Wind-Cold. Or, external pathogens clash with internal pathogens, stagnating in the collaterals. Or, consumption of rich flavors generates intense internal heat, causing Wei Qi to fail to harmonize with Ying Qi. Or, evil Qi invades internally, resulting in abdominal pain and dysentery. Treatment must follow the symptoms, prioritizing interior regulation, with slight adjunctive clearing and dispersing. If pungent-warm agents are used, disaster will follow immediately. Regarding rash, smallpox, and epidemic plagues, the Four Qi must be distinguished.