小儿寒胀，由中气素寒，冷滞郁结，身不热，口不渴，唇青，手足厥冷，气喘腹胀，先用生姜一钱，熟附子
一钱，真沉香屑二分，浓煎服，重胀消后，更用五味异功散调补其脾胃。
小儿热胀，或伤寒入里化热，大便闭结，小便短赤，浑身壮热，面赤烦躁，可用小枳实钱半，生锦纹大黄八
分，油浓朴钱半，大腹皮钱半，缩砂仁五分，服之胀消便通，改用四君子加浓朴、砂仁，调理为妥。
《经》曰∶心移热于肺，为膈消。又曰∶二阳结谓之消。夫消渴枯燥之急也。
凡渴而多饮，为上消，肺热也。多食善饥，为中消，胃热也。渴而小便数，膏浊不禁，为下消，肾热也。
虽为火盛水衰之证，然由虚热者多，实热者少，若作有余治之，则误矣。始而心肺消渴，脾肾消中，或肾虚
消浊，传染日久，则肠胃合消，五脏干燥，精神疲怠，以致消瘦四肢，则元气难以骤复矣。因作三消鲜。
小儿消渴，由心火动而消上，上消乎心，移热于肺，渴饮茶水，饮之又渴，名曰上消。小便最多，由其水
不能停，所以饮水无厌，凡饮一溲一者可治，饮一溲二者不可治，古法主莲花饮（如白莲须、粉干葛、茯苓、生
地、黄连、天花粉、人参、北五味、知母、炙甘草、淡竹叶，引用灯芯）。
〔真按〕小儿口渴消水，方用制天冬钱半，浓麦冬二钱，天花粉一钱，枯黄芩一钱，盐知母一钱，炙甘草五分，
西洋参五分。
小儿寒胀，是由于中气（脾胃之气）原本虚寒，导致寒气凝滞、郁结所致。表现为身体不发热，口不渴，嘴唇发青，手脚冰凉，气喘且腹部胀满。治疗时，先用生姜一钱，熟附子一钱，真沉香屑二分，浓煎后服用。待重度胀满消退后，再用五味异功散（由人参、白术、茯苓、甘草、陈皮组成）来调补脾胃。
小儿热胀，可能是伤寒邪气入里化热，或者大便闭结不通，小便短少色赤，全身高热，面色红赤，烦躁不安。可用小枳实钱半，生锦纹大黄八分，油厚朴钱半，大腹皮钱半，缩砂仁五分，服用后胀满消除、大便通畅，随后改用四君子汤（由人参、白术、茯苓、甘草组成）加入厚朴、砂仁进行调理为宜。
《黄帝内经》说：心将热邪移于肺，称为膈消（上消的一种）。又说：阳明经（胃与大肠）气机郁结称为消渴病。消渴病是津液干枯的急症。
凡是口渴且多饮的，称为上消，病机为肺热。食量大且容易饥饿的，称为中消，病机为胃热。口渴且小便频数，尿液浑浊如脂膏而难以控制，称为下消，病机为肾热。
虽然这些都属于火盛水衰的证候，但大多由虚热引起，实热较少。如果当作实证有余来治疗，就会出错。起初若是心肺消渴、脾肾消中，或肾虚导致尿浊，若病程迁延日久，则会导致肠胃俱消，五脏干燥，精神疲惫倦怠，进而四肢消瘦，此时元气就难以迅速恢复了。因此撰写了“三消鲜”这一方论。
小儿消渴，是由心火亢动向上灼伤，影响上焦。上消关乎于心，热邪移于肺，导致口渴想喝茶水，喝了之后依然口渴，这叫做上消。小便量最多，是因为水液无法在体内停留，所以饮水没有满足感。凡是喝一份水排出一份尿的还可以治疗，喝一份水排出两份尿的就不可治疗。古法主张使用莲花饮（包含白莲须、粉干葛、茯苓、生地、黄连、天花粉、人参、北五味、知母、炙甘草、淡竹叶，以灯芯草为引）。
〔陈守真按语〕针对小儿口渴消水的情况，处方用制天冬钱半，麦冬二钱，天花粉一钱，枯黄芩一钱，盐知母一钱，炙甘草五分，西洋参五分。
Pediatric cold distension arises from a constitutional deficiency-cold of the Middle Qi (Spleen and Stomach Qi), leading to stagnation and constraint of cold pathogens. Manifestations include absence of fever, lack of thirst, cyanosis of the lips, coldness of the extremities, asthma, and abdominal distension. Initially, treat with 1 qian of Shengjiang (Fresh Ginger), 1 qian of Shu Fuzi (Prepared Aconite Root), and 2 fen of Zhen Chenxiang (Agarwood Powder), decocted strongly for administration. After severe distension subsides, use Wuwei Yigong San (Five-Ingredient Powder for Extraordinary Efficacy) to regulate and tonify the Spleen and Stomach.
Pediatric heat distension may result from Taiyang disease pathogens entering the interior and transforming into heat, or from constipation and scanty, dark red urine. Symptoms include high-grade fever throughout the body, flushed face, and irritability. Use 1.5 qian of Xiao Zhishi (Immature Bitter Orange), 8 fen of Sheng Jinwen Dahuang (Raw Rhubarb), 1.5 qian of You Houpo (Magnolia Bark processed with oil), 1.5 qian of Dafupi (Areca Peel), and 5 fen of Suosharen (Amomum Fruit). Upon resolution of distension and passage of stool, switch to Sizijunzi Tang (Four Gentlemen Decoction) augmented with Houpo and Sharen for appropriate regulation.
The *Classic* states: "When Heart heat transfers to the Lung, it is called Ge Xiao (Diaphragmatic Consumption)." It also states: "Constraint of the Two Yang meridians is termed Xiao." Xiao Ke (Wasting-Thirst) is an acute condition characterized by dryness and depletion of fluids.
Generally, excessive thirst accompanied by polydipsia is classified as Upper Xiao, attributed to Lung Heat. Excessive hunger with frequent eating is Middle Xiao, attributed to Stomach Heat. Thirst accompanied by frequent urination, with turbid, fatty urine that cannot be controlled, is Lower Xiao, attributed to Kidney Heat.
Although these conditions manifest as excess fire and deficient water, they are predominantly caused by deficiency-heat rather than excess-heat. Treating them as excess syndromes would be erroneous. Initially, if there is Heart-Lung consumption, Spleen-Kidney middle consumption, or Kidney deficiency leading to turbid urine, prolonged transmission will lead to consumption of the intestines and stomach, dryness of the five zang organs, mental fatigue, and emaciation of the limbs. At this stage, Yuan Qi (Primal Qi) becomes difficult to restore rapidly. Therefore, the following discussion on the three consumptions is presented.
Pediatric Xiao Ke arises from hyperactive Heart Fire affecting the upper jiao. Upper Xiao involves the Heart, with heat transferring to the Lung, causing thirst for tea and water; despite drinking, thirst persists, termed Upper Xiao. Urine volume is maximal because fluids fail to remain in the body, resulting in insatiable drinking. If one unit of fluid intake results in one unit of urine output, the condition is treatable; if one unit of intake results in two units of output, it is untreatable. Ancient methods advocate Lianhua Yin (Lotus Flower Decoction), containing Bai Lianxu (Stamen Nelumbinis), Fen Ganjie (Pueraria Root powder), Fuling (Poria), Shengdi (Rehmannia Root), Huanglian (Coptis Rhizome), Tianhuafen (Trichosanthes Root), Renshen (Ginseng Root), Bei Wuwei (Schisandra Berry), Zimu (Anemarrhena Rhizome), Zhi Gancao (Honey-fried Licorice Root), Danzhuye (Bamboo Leaf), using Dengxincao (Juncus Effusus) as a guide.
[Chen Shouzhen's Note]: For pediatric thirst and fluid consumption, prescribe Zhi Tiandong (Prepared Asparagus Root) 1.5 qian, Nong Maidong (Ophiopogon Tuber) 2 qian, Tianhuafen (Trichosanthes Root) 1 qian, Ku Huangqin (Scutellaria Root) 1 qian, Yan Zimu (Salt-processed Anemarrhena Rhizome) 1 qian, Zhi Gancao (Honey-fried Licorice Root) 5 fen, and Xiyangshen (American Ginseng Root) 5 fen.