夫小儿伤寒而脏气实者。即寒气与脏气相搏。而壮热者谓之挟实也。挟有二种。有冷有
热。
皆壮
治小儿四五岁。伤寒壮热。挟实。心腹胀闷。大黄散方。
川大黄（一两锉微炒） 甘草（半两炙微赤锉） 麦门冬（半两去心焙） 细辛（半两）
黄芩
（半
上件药。捣粗罗为散。每服一钱。以水一小盏。
煎至五分。去滓。不计时候温服。量儿大小。以意加减。
治小儿伤寒挟实。壮热心烦。柴胡散方。
柴胡（三分去苗） 当归（一分） 赤茯苓（半两） 川大黄（半两锉碎微炒） 甘草
（一分炙
微赤
上件药。捣粗罗为散。每服一钱。以水一小盏。
煎至五分。去滓。不计时候温服。量儿大小。以意加减。
治小儿百日以来。伤寒。挟实壮热。多惊心躁。犀角散方。
犀角屑〔一两（分）〕 龙胆（一分去芦头） 川大黄（半两锉碎微炒） 川朴硝（一
分） 甘
草（
上件药。捣粗罗为散。每服一钱。以水一小盏。
煎至五分。去滓。不计时候。量儿大小。以意加减。
治小儿伤寒挟实。心腹胀满。不欲乳食。浓朴散方。
浓朴（半两刮去皱皮涂生姜汁灸令香熟） 川大黄（一分锉碎微炒） 人参（一分去芦
头）
陈橘皮（一分汤浸去白瓤焙） 甘草（一分炙微赤锉） 朴硝（一分）
上件药。捣粗罗为散。每服一钱。以水一小盏。
煎至五分。去滓。不计时候温服。随儿大小。以意加减。
治小儿伤寒挟实。壮热。增寒头痛。赤芍药散方。
赤芍药（一分） 知母（一分） 子芩（一分） 人参（一分去芦头） 枳壳（一分麸
炒微黄去
瓤）
上件药。捣粗罗为散。每服一钱。以水一小盏。入青竹叶七片。
煎至五分。去滓。不计时候温服。随儿大小。增减服之。
凡是小儿患伤寒且脏腑之气实盛的，就是寒气与脏腑之气相互搏结，从而出现高热症状的，称为“挟实”。挟实有两种类型：有冷挟和热挟。
治疗四五岁小儿患伤寒，出现高热、挟实，伴有心胸腹部胀闷的症状，用大黄散方。
川大黄（一两，锉碎后微炒） 甘草（半两，炙至微红并锉碎） 麦门冬（半两，去心后焙干） 细辛（半两） 黄芩（半两）
以上药物，捣碎并筛成粗末。每次服用一钱，用水一小盏，煎煮至剩余五分水量，滤去药渣。不分时候温服。根据患儿年龄大小，酌情加减剂量。
治疗小儿患伤寒挟实，出现高热、心中烦乱的症状，用柴胡散方。
柴胡（三分，去苗） 当归（一分） 赤茯苓（半两） 川大黄（半两，锉碎后微炒） 甘草（一分，炙至微红并锉碎）
以上药物，捣碎并筛成粗末。每次服用一钱，用水一小盏，煎煮至剩余五分水量，滤去药渣。不分时候温服。根据患儿年龄大小，酌情加减剂量。
治疗小儿出生百日以来，患伤寒，挟实高热，多伴有受惊、心烦躁动的症状，用犀角散方。
犀角屑（一两） 龙胆（一分，去芦头） 川大黄（半两，锉碎后微炒） 川朴硝（一分） 甘草（一分，炙至微红并锉碎）
以上药物，捣碎并筛成粗末。每次服用一钱，用水一小盏，煎煮至剩余五分水量，滤去药渣。不分时候，根据患儿年龄大小，酌情加减剂量。
治疗小儿患伤寒挟实，心胸腹部胀满，不想吃奶或食物，用浓朴散方。
浓朴（半两，刮去皱皮，涂生姜汁灸至香熟） 川大黄（一分，锉碎后微炒） 人参（一分，去芦头） 陈橘皮（一分，汤浸后去白瓤焙干） 甘草（一分，炙至微红并锉碎） 朴硝（一分）
以上药物，捣碎并筛成粗末。每次服用一钱，用水一小盏，煎煮至剩余五分水量，滤去药渣。不分时候温服。根据患儿年龄大小，酌情加减剂量。
治疗小儿患伤寒挟实，高热，怕冷增加并头痛，用赤芍药散方。
赤芍药（一分） 知母（一分） 子芩（一分） 人参（一分，去芦头） 枳壳（一分，麸炒至微黄并去瓤）
以上药物，捣碎并筛成粗末。每次服用一钱，用水一小盏，加入青竹叶七片，煎煮至剩余五分水量，滤去药渣。不分时候温服。根据患儿年龄大小，增减服用量。
When a child contracts cold damage (Shanghan) and possesses excess internal organ qi, the cold pathogen contends with the internal organ qi, resulting in high fever; this condition is termed "Jia Shi" (Complicated Excess). There are two types of Jia Shi: cold-type and heat-type.
For treating four- or five-year-old children who have contracted cold damage (Shanghan), presenting with high fever, Jia Shi (Complicated Excess), and abdominal distension and stuffiness, use the Da Huang San (Rhubarb Powder) formula.
Radix et Rhizoma Rhei (Da Huang, Rhubarb Root and Rhizome) [1 liang, crushed and lightly stir-fried], Radix Glycyrrhizae Preparata (Gan Cao, Prepared Licorice Root) [0.5 liang, honey-fried until slightly red and crushed], Fructus Oryzae Sativae (Mai Men Dong, Ophiopogon Tuber) [0.5 liang, heart removed and baked], Herba Asari (Xi Xin, Asarum Herb) [0.5 liang], Radix Scutellariae (Huang Qin, Scutellaria Root) [0.5 liang].
Crush the above ingredients into a coarse powder. Administer 1 qian per dose by decocting in one small cup of water until reduced to half a cup's volume. Strain the dregs and administer warm, regardless of meal times. Adjust the dosage according to the child's age and size.
For treating children with cold damage (Shanghan) complicated by excess (Jia Shi), presenting with high fever and mental restlessness, use the Chai Hu San (Bupleurum Powder) formula.
Radix Bupleuri (Chai Hu, Bupleurum Root) [3 fen, radix removed], Radix Angelicae Sinensis (Dang Gui, Angelica Sinensis Root) [1 fen], Poria Cocos cum Ligno Rubro (Chi Fu Ling, Red Poria) [0.5 liang], Radix et Rhizoma Rhei (Da Huang, Rhubarb Root and Rhizome) [0.5 liang, crushed and lightly stir-fried], Radix Glycyrrhizae Preparata (Gan Cao, Prepared Licorice Root) [1 fen, honey-fried until slightly red and crushed].
Crush the above ingredients into a coarse powder. Administer 1 qian per dose by decocting in one small cup of water until reduced to half a cup's volume. Strain the dregs and administer warm, regardless of meal times. Adjust the dosage according to the child's age and size.
For treating infants over one hundred days old who have contracted cold damage (Shanghan), presenting with Jia Shi (Complicated Excess) and high fever, often accompanied by fright and irritability, use the Xi Jiao San (Rhinoceros Horn Powder) formula.
Cornu Rhinocerotis (Xi Jiao, Rhinoceros Horn) [1 liang], Radix et Rhizoma Gentianae (Long Dan, Gentian Root and Rhizome) [1 fen, rhizome removed], Radix et Rhizoma Rhei (Da Huang, Rhubarb Root and Rhizome) [0.5 liang, crushed and lightly stir-fried], Natrii Sulfas (Piao Xiao, Mirabilite) [1 fen], Radix Glycyrrhizae Preparata (Gan Cao, Prepared Licorice Root) [1 fen, honey-fried until slightly red and crushed].
Crush the above ingredients into a coarse powder. Administer 1 qian per dose by decocting in one small cup of water until reduced to half a cup's volume. Strain the dregs and administer, regardless of meal times. Adjust the dosage according to the child's age and size.
For treating children with cold damage (Shanghan) complicated by excess (Jia Shi), presenting with abdominal distension and fullness, and anorexia for milk or food, use the Hou Po San (Magnolia Bark Powder) formula.
Cortex Magnoliae Officinalis (Hou Po, Magnolia Bark) [0.5 liang, wrinkled skin scraped off, coated with ginger juice, and roasted until fragrant], Radix et Rhizoma Rhei (Da Huang, Rhubarb Root and Rhizome) [1 fen, crushed and lightly stir-fried], Radix Ginseng (Ren Shen, Ginseng Root) [1 fen, rhizome removed], Pericarpium Citri Reticulatae (Chen Pi, Tangerine Peel) [1 fen, soaked in hot water, white pith removed, and baked], Radix Glycyrrhizae Preparata (Gan Cao, Prepared Licorice Root) [1 fen, honey-fried until slightly red and crushed], Natrii Sulfas (Piao Xiao, Mirabilite) [1 fen].
Crush the above ingredients into a coarse powder. Administer 1 qian per dose by decocting in one small cup of water until reduced to half a cup's volume. Strain the dregs and administer warm, regardless of meal times. Adjust the dosage according to the child's age and size.
For treating children with cold damage (Shanghan) complicated by excess (Jia Shi), presenting with high fever, increased aversion to cold, and headache, use the Chi Shao Yao San (Red Peony Root Powder) formula.
Radix Paeoniae Rubra (Chi Shao Yao, Red Peony Root) [1 fen], Rhizoma Anemarrhenae (Zhi Mu, Anemarrhena Rhizome) [1 fen], Radix Scutellariae (Zi Qin, Scutellaria Root) [1 fen], Radix Ginseng (Ren Shen, Ginseng Root) [1 fen, rhizome removed], Fructus Aurantii (Zhi Ke, Bitter Orange Fruit) [1 fen, stir-fried with bran until slightly yellow and pith removed].
Crush the above ingredients into a coarse powder. Administer 1 qian per dose by decocting in one small cup of water with seven leaves of Phyllostachys viridis (Qing Zhu Ye, Green Bamboo Leaf) until reduced to half a cup's volume. Strain the dregs and administer warm, regardless of meal times. Adjust the dosage up or down according to the child's age and size.