里寒之状。大小便利。面青目白。或因脏腑素虚。或因误服凉药。而见疮白神倦。吐泻
呕恶
。气促肢冷。或腹胀腹痛。以致痘出不快。或已出而陷伏倒靥者。宜六气煎。九味异功煎。
十二味异功散之类主之。若已见齐。或行浆之际。为凉药所误。以致吐泻寒战切牙者。
木香散。十二味异功散之类主之。然此二方。温则有余。补则不足。不若用九味异功煎为最
妙。若因误食生冷。而致腹胀腹痛。或吐泻者。理中汤。加肉桂木香。或四君子。加干姜木
香之类主之。若胃气虚寒。腹痛喜按者。黄 建中汤主之。若脾肾虚寒。小腹作痛。泻利不
止者。胃关煎主之。大抵里寒之症。必由误服寒凉攻伐之剂所致。奈何近日幼科。胸中毫无
的确明见。粗浅浮躁。肆用寒凉。致令小儿阳气受伤。里虚变逆。死者多矣。深堪哀悯。有
人心者。其亦知所以自省矣。
里热之状。烦躁狂言。口干大渴。内热自汗。小便赤涩。大便秘结。脉见沉数有力。宜
退火
丹。四顺清凉饮之类主之。若衄血。元参地黄汤。加陈墨汁主之。溺血。大厘清饮主之。若
已出未出之际。衄血或溺血者。并宜犀角地黄汤主之。血止后。即宜用调元汤主之。或少加
木通。若初见发热。便觉大渴。
唇焦舌燥者。宜葛根解毒汤主之。若火迫庚金而协热作泻者。必其脉见洪数。身有大热
。口
有大渴。喜冷恶热。烦躁多汗。中满气粗。痘色 肿红紫。口鼻热赤。小水涩痛。禀赋素实
者。宜黄芩汤主之。然此症不多。断不可以此汤误治虚寒泄泻也。慎之慎之。又或已未见点
之时。咽肿喉痛者。甘桔汤。加牛蒡主之。若已见齐。起胀灌浆之时。而见喉痛者。此因喉
内有痘作痛。收靥时自愈。不必治之。若痘已出齐。而脾肺有热。作渴喜冷者。宜人参麦
门冬散主之。若痘出而夹 夹疹。烦躁大渴。妄言妄见。双解散主之。以上皆当与各条参看
。果属里热。始无贻误。倘稍涉疑似。则害人不浅矣。慎之慎之。
里寒证的表现：大小便正常，面色青白。这可能是由于脏腑原本虚弱，或者误服了寒凉药物，导致疮疡颜色苍白、精神疲倦、呕吐腹泻、恶心、气短肢冷，或者腹胀腹痛，致使痘疹发出不畅，或者已经发出却陷入伏倒、结痂过早的情况。适宜使用六气煎、九味异功煎、十二味异功散等方剂主治。如果痘疹已经出齐，或者正在行浆阶段，因误用寒凉药物而导致呕吐腹泻、寒战咬牙的，适宜使用木香散、十二味异功散等方剂主治。然而这两个方剂，温补有余而滋补不足，不如使用九味异功煎最为巧妙。如果是因误食生冷食物，导致腹胀腹痛，或者呕吐腹泻的，适宜使用理中汤，加入肉桂、木香，或者四君子汤，加入干姜、木香等方剂主治。如果胃气虚寒，腹痛且喜欢按压的，适宜使用黄芪建中汤主治。如果脾肾虚寒，小腹部疼痛，腹泻不止的，适宜使用胃关煎主治。大抵来说，里寒症，必定是由误服寒凉攻伐的药物所导致的。可惜近来的儿科医生，胸中没有确切明确的见解，粗浅浮躁，肆意使用寒凉药物，致使小儿阳气受伤，里虚发生逆证，死亡的很多，实在令人哀悯。有良心的人，也应该知道自我反省了。
里热证的表现：烦躁狂言，口干大渴，内热自汗，小便赤涩，大便秘结，脉象沉数有力。适宜使用退火丹、四顺清凉饮等方剂主治。如果出现鼻出血，适宜使用元参地黄汤，加入陈墨汁主治。出现尿血，适宜使用大厘清饮主治。如果痘疹处于将出未出之际，出现鼻出血或尿血的，都适宜使用犀角地黄汤主治。血止之后，立即适宜使用调元汤主治，或者稍微加入木通。如果初见发热，就感觉大渴，嘴唇焦裂舌头干燥的，适宜使用葛根解毒汤主治。如果火热逼迫肺金（庚金）而伴随热邪作泻的，必定脉象洪数，身体有大热，口有大渴，喜冷恶热，烦躁多汗，胸中胀满气粗，痘色肿胀红紫，口鼻热赤，小便涩痛，禀赋素来实盛的，适宜使用黄芩汤主治。然而这种症状不多见，绝对不可以用这个方剂误治虚寒泄泻啊。谨慎再谨慎。又或者在痘疹尚未见点的时候，咽喉肿痛，适宜使用甘桔汤，加入牛蒡子主治。如果痘疹已经出齐，起胀灌浆的时候，出现喉痛的，这是因为喉内有痘疹作痛，收靥时自然痊愈，不必治疗。如果痘疹已经出齐，而脾肺有热，口渴喜冷饮的，适宜使用人参麦门冬散主治。如果痘疹发出而夹杂麻疹，烦躁大渴，胡言乱语产生幻觉的，适宜使用双解散主治。以上情况都应当与各条内容参照查看，确实属于里热证，才不会造成延误。倘若稍涉疑似情况，则害人不浅啊。谨慎再谨慎。
The manifestations of Interior Cold syndrome: Normal urination and defecation, bluish complexion with white eyes. This may be due to inherent deficiency of the Zang-Fu organs, or misadministration of cold-natured medicines, resulting in pale sores, mental fatigue, vomiting and diarrhea, nausea, shortness of breath, and cold limbs, or abdominal distension and pain, causing the eruption of smallpox to be sluggish, or having erupted but sinking inward, collapsing, or scabbing prematurely. It is appropriate to use Liuqi Jian (Six Qi Decoction), Jiawei Yigong Jian (Nine-Ingredient Modified Yi Gong Decoction), Shierwei Yigong San (Twelve-Ingredient Yi Gong Powder) and similar formulas as the main treatment. If the lesions have fully appeared, or during the stage of blister filling, and mismanagement by cold medicines has led to vomiting, diarrhea, severe chills, and teeth grinding, Muxiang San (Aucklandia Powder) and Shierwei Yigong San (Twelve-Ingredient Yi Gong Powder) are appropriate. However, these two formulas are sufficient in warming but insufficient in tonifying; it is better to use Jiawei Yigong Jian (Nine-Ingredient Modified Yi Gong Decoction) for optimal effect. If abdominal distension and pain, or vomiting and diarrhea, are caused by mistakenly consuming raw or cold foods, Lizhong Tang (Regulate the Middle Decoction) added with Rougui (Cinnamon Bark) and Muxiang (Aucklandiae Radix), or Sijunzi Tang (Four Gentlemen Decoction) added with Ganjiang (Dried Ginger) and Muxiang (Aucklandiae Radix), should be used. If stomach Qi deficiency and cold present with abdominal pain that prefers pressure, Huangqi Jianzhong Tang (Astragalus Decoctum to Establish the Middle) is indicated. If spleen and kidney deficiency-cold present with lower abdominal pain and continuous diarrhea, Weiguan Jian (Stomach Gate Decoction) is indicated. Generally speaking, Interior Cold syndromes must result from the misadministration of cold-natured and purgative agents. Regrettably, recent pediatric practitioners lack precise and clear understanding, being superficial and impetuous, recklessly using cold medicines, thereby injuring the children's Yang Qi and causing Interior deficiency with adverse transformations, leading to many deaths. This is deeply pitiable. Those with a conscience should know how to reflect upon themselves.
The manifestations of Interior Heat syndrome: Restlessness, delirious speech, dry mouth with excessive thirst, internal heat with spontaneous sweating, dark and scanty urine, constipation, and a deep, rapid, and forceful pulse. Tuohuo Dan (Fire-Removing Pill) and Sishun Qingliang Yin (Four-Smooth Clearing-Cooling Decoction) are appropriate. If epistaxis occurs, Yuanshen Dihuang Tang (Scrophulariae and Rehmanniae Decoction) added with Chenmo Zhi (Ink Juice) is indicated. For hematuria, Dali Qingyin (Great Purification Decoction) is indicated. If epistaxis or hematuria occurs while the rash is about to appear or has not yet appeared, Xijiao Dihuang Tang (Rhinoceros Horn and Rehmanniae Decoction) is appropriate for all cases. After bleeding stops, immediately use Tianyuan Tang (Nourishing Origin Decoction), possibly adding Mutong (Akebiae Caulis). If fever appears initially accompanied by excessive thirst, cracked lips, and dry tongue, Gegen Jiedu Tang (Puerariae Root and Detoxification Decoction) is indicated. If fire forces Metal (Lungs) leading to diarrhea with heat, the pulse will likely be surging and rapid, with high body heat, extreme thirst, preference for cold and aversion to heat, restlessness, profuse sweating, chest fullness, coarse breathing, swollen red-purple rash color, hot and red mouth and nose, painful and difficult urination, and inherent robust constitution, Huangqin Tang (Scutellaria Decoction) is indicated. However, this syndrome is rare; one must absolutely not misuse this formula to treat deficiency-cold diarrhea. Be extremely cautious. Or, when no spots are visible yet, if there is throat swelling and pain, Ganjie Tang (Licorice and Platycodon Decoction) added with Niubangzi (Arctii Fructus) is indicated. If throat pain occurs when the rash has fully appeared and is rising/filling, this is because the rash inside the throat causes pain; it will heal itself during the scabbing stage and requires no treatment. If the rash has fully appeared, but spleen and lung heat cause thirst with preference for cold drinks, Renshen Maidong San (Ginseng and Ophiopogonis Powder) is indicated. If the rash appears mixed with measles, accompanied by restlessness, excessive thirst, delirium, and visual hallucinations, Shuangjie San (Double-Resolution Powder) is indicated. All the above should be cross-referenced with respective sections. Only if it is truly an Interior Heat syndrome can errors be avoided. If there is any ambiguity, the harm to people will be profound. Be extremely cautious.