小儿之病，其热惟多，夫热有虚有实。实则面赤浓黄，气粗口热，燥渴唇肿，大小便难，掀揭露衣，烦啼暴叫。虚
则面色青白，恍忽神缓，口中清冷，嘘气软弱，泄泻多尿，夜出虚汗。其或乍凉乍温，怫郁惊惕，上盛下泄，水谷不分，
此则冷热不调之症。虚则败毒散加木香当归。然小儿表里俱热，面黄颊赤，唇燥口干，小便赤涩。大便焦黄，先以四顺
清凉饮为之疏利，其热即去。或表未解也，当先用惺惺散，少加麻黄去节以取其汗，或用柴胡散，则表热已除，又当和
解，其热自平。若惊热、风热、积热，可服宽热散下之，保寿散、金粉散、以退余热可也。
败毒散 治伤寒、温疫、风湿，头目昏眩，四肢痛，憎寒壮热，项强目睛疼。寻常风眩、拘倦、风痰，身体项
疼，及寒壅咳嗽，鼻塞声重，寒热，并治之。
柴胡（洗、去芦） 前胡 川芎 枳壳（炒） 羌活 独活 白茯苓 桔梗（炒） 人参（各二两） 甘草（半两）
上为粗末，每服二钱，生姜薄荷煎，加地骨皮、天麻。或锉散，加蝉蜕防风。治惊热，可加芍药、干葛、黄芩。无
汗加麻黄。
四顺清凉饮 见第四十四问。
惺惺散 治小儿风热疮疹，伤寒时气，头痛壮热，目涩多睡，咳嗽喘粗，鼻塞清涕。
天花粉 人参 细辛（去叶） 茯苓（去皮） 白术 甘草（炙） 桔梗（各等分）
上锉散，每服五钱，水一小盏，入薄荷三叶，同煎至四分，温服。如要和气，即入生姜煎服，不拘时。
柴胡散 治小儿伤寒无汗，有表症，壮热头疼，身体痛，口干烦渴，小便赤，大便秘涩，夹惊腮肿。
石膏 黄芩 甘草 赤芍药 葛根（各二钱半） 麻黄（去节） 柴胡（半两）
上锉散，三岁儿每服二钱，水小盏，生姜少许，葱白三寸，豆豉二十粒，煎至五分，去滓温服，不拘时，汗出为效。
热嗽加杏仁去皮尖二钱，五味子三钱。
宽热散 治小儿中恶天吊，手足搐候，服牛黄膏得渐安，只腹肚有热未退，早晨亦可进一服宽热散。兼小儿食
癖积，婴孩惊乳癖，服此药则下恶物，或成块如鼻涕腥臭，觉得肚腰渐消，稍思乳食。
朴硝 甘草（各半两） 大黄（锦纹者，一两） 枳壳（去瓤，一两，以水润之，以巴豆四十九粒去皮同炒，去巴
豆）
上四味为末，以瓷器收之，每服一字或半钱，用薄荷七叶煎汤调下一呷，或入砂糖一块皂子大在内，以薄荷汤调匀，
早晨未乳食前灌下。或儿壮加添药末，儿或弱则减药末，或儿子通身生疮热毒者，可早晨与一服，推出毒瓦斯。
保寿散 治婴孩惊热、潮热、风热、虚热，头额温壮，白日夜间多啼，伤湿鼻流清涕，喉咽时时有清涕，夜多
睡卧不稳，或手足口舌生小热毒疮，或因吃着喜怒乳食，胸膈不快，时复吐 呕乳，忽因人物所惊，日夜间手足心热，
痰壅咳嗽，兼患天吊急惊风候。
白茯苓 人参 川雄黄 牙硝 甘草（炙各二两） 麝香 牛黄 梅花脑子（各少许无亦得）
上八味，细研，入锡合内收之，汤使如后金粉散。
金粉散 治婴孩惊热、风热、虚热、潮热，手足心热，口多涎唾。面色红赤，头额身体温热，日夜 呀，鼻流
清涕，咳嗽，上膈壅热，口鼻喉舌手足浑身头项生毒热疮，夜卧不安，吐 呕逆，乳食不化，胸膈不快，变蒸温壮，或
有惊潮热，并宜服之，常服镇心化涎压惊。风搐候，服牛黄膏得手足搐住，病势稍轻，但有些少余热，亦宜进三、两服。
川雄黄（半两别研） 白芍药 牙硝 脑子 麝香（各少许）
上件研令细，以锡盒收之，每遇此证，一岁儿半钱，二、三岁一钱，并薄荷汤调下，金银薄荷汤尤好，常服可防百
病。
【论不可服冷药证】
足胫冷 腹虚胀 粪色青 面 白 呕乳奶 眼珠青
【论不可服热药证】
足胫热 两腮红 大便秘 小便黄 渴不止 上气急 脉紧急
小儿的疾病，发热症状最为多见。发热有虚证和实证之分。实证表现为面色红赤或浓黄，呼吸粗重，口中有热气，烦躁口渴，嘴唇肿胀，大小便困难，掀开衣物，烦躁啼哭并突然大叫。虚证则表现为面色青白，精神恍惚且反应迟钝，口中感觉清冷，气息微弱软弱，腹泻且尿多，夜间出虚汗。如果病情忽冷忽热，伴有郁闷、惊惕不安，上部邪盛而下部泄泻，水谷不分，这属于冷热不调的病症。对于虚证，可用败毒散加木香、当归治疗。然而，若小儿表里俱热，见面色黄而两颊红赤，嘴唇干燥口干，小便赤涩，大便焦黄，应先使用四顺清凉饮进行疏利通便，热邪即可去除。如果表证尚未解除，应当先用惺惺散，稍加去节的麻黄以发汗，或者使用柴胡散，待表热消除后，再进行和解治疗，热邪自然平息。若是惊热、风热、积热，可服用宽热散攻下，再用保寿散、金粉散以清除余热。
败毒散：治疗伤寒、温疫、风湿引起的头目昏眩，四肢疼痛，憎寒壮热，项强目睛疼痛。同时也治疗寻常的风眩、拘挛疲倦、风痰，身体及项部疼痛，以及寒邪壅滞引起的咳嗽，鼻塞声重，寒热往来等症。
方剂组成：柴胡（洗净、去芦头）、前胡、川芎、枳壳（炒）、羌活、独活、白茯苓、桔梗（炒）、人参（以上各二两），甘草（半两）。
制法与用法：将上述药物捣成粗末，每次服用二钱，用生姜、薄荷煎汤送服。也可加入地骨皮、天麻。或者制成散剂，加入蝉蜕、防风。治疗惊热时，可加入芍药、干葛、黄芩。无汗者可加入麻黄。
四顺清凉饮：见第四十四问。
惺惺散：治疗小儿风热疮疹，伤寒时气，头痛壮热，眼睛干涩多睡，咳嗽气喘粗重，鼻塞流清涕。
方剂组成：天花粉、人参、细辛（去叶）、茯苓（去皮）、白术、甘草（炙）、桔梗（以上各等分）。
制法与用法：将药物切碎成散剂，每次服用五钱，用水一小盏，加入三片薄荷，共同煎至四分之三量，温服。如果要调和胃气，可加入生姜煎服，不拘时间。
柴胡散：治疗小儿伤寒无汗，有表证，壮热头疼，身体疼痛，口干烦渴，小便赤，大便秘结涩滞，夹带惊风腮肿。
方剂组成：石膏、黄芩、甘草、赤芍药、葛根（以上各二钱半），麻黄（去节），柴胡（半两）。
制法与用法：将药物切碎成散剂，三岁儿童每次服用二钱，用水一小盏，加入少许生姜、葱白三寸、豆豉二十粒，煎至五分，去渣温服，不拘时间，以出汗为见效。热嗽者加杏仁（去皮尖）二钱，五味子三钱。
宽热散：治疗小儿中恶天吊（急惊风的一种），手足抽搐，服用牛黄膏后逐渐安定，但腹部仍有热未退，早晨也可服用一剂宽热散。兼治小儿食癖积滞，婴儿惊乳癖，服用此药后可排出恶物，有时呈块状如鼻涕般腥臭，感觉肚子腰部逐渐消退，开始想吃乳食。
方剂组成：朴硝、甘草（以上各半两），大黄（选用锦纹者，一两），枳壳（去瓤，一两，用水润湿，与巴豆四十九粒去皮同炒，然后去掉巴豆）。
制法与用法：将上述四味药研成粉末，用瓷器密封保存。每次服用一字或半钱，用七片薄荷煎汤调服一口，或者加入一块皂子大小的砂糖在内，用薄荷汤调匀，在早晨未吃乳食前灌服。如果患儿体质强壮，可增加药末剂量；如果患儿体弱，则减少药末剂量。如果患儿全身生疮热毒，可在早晨服用一剂，以推出毒瓦斯。
保寿散：治疗婴儿惊热、潮热、风热、虚热，头额温热壮热，白天夜间多啼哭，伤湿导致鼻流清涕，咽喉时常有清涕，夜间睡眠不稳，或者手足口舌生小热毒疮，或者因饮食喜怒乳食导致胸膈不快，时而呕吐乳食，忽然因外界事物惊吓，日夜间手足心热，痰壅咳嗽，兼患天吊急惊风候。
方剂组成：白茯苓、人参、川雄黄、牙硝、甘草（炙，以上各二两），麝香、牛黄、梅花脑子（以上各少许，没有也可以）。
制法与用法：将上述八味药细细研磨，放入锡盒内密封保存。用法如同后面的金粉散。
金粉散：治疗婴儿惊热、风热、虚热、潮热，手足心热，口中多涎唾。面色红赤，头额身体温热，日夜张口呼吸，鼻流清涕，咳嗽，上膈壅热，口鼻喉舌手足浑身头项生毒热疮，夜间睡眠不安，呕吐逆气，乳食不化，胸膈不快，变蒸期温热壮热，或者有惊潮热，都适宜服用。常服可镇心安神、化解痰涎、压制惊风。风搐候，服用牛黄膏使手足抽搐停止，病势稍轻，但还有些许余热，也适宜服用两三剂。
方剂组成：川雄黄（半两，单独研磨）、白芍药、牙硝、脑子、麝香（以上各少许）。
制法与用法：将上述药物研磨细腻，用锡盒密封保存。遇到此类病症，一岁婴儿服用半钱，二至三岁服用一钱，均用薄荷汤调下，金银薄荷汤更好。常服可预防百病。
The diseases of infants and children most frequently involve fever. Fever can be classified into deficiency-type (Xu) and excess-type (Shi). Excess-type fever presents with a ruddy or deep yellow complexion, coarse breathing, heat in the mouth, irritability and thirst, swollen lips, difficulty in urination and defecation, uncovering the body, irritability, crying, and sudden loud shouting. Deficiency-type fever presents with a bluish-white complexion, vague spirit and sluggish reaction, a cold sensation in the mouth, weak and soft breath, diarrhea with frequent urination, and night sweats. If the condition alternates between cold and warm, accompanied by depression, fright, and startle, with excess pathogenic factors above and diarrhea below, where water and grain are not separated, this is a syndrome of disharmony between cold and heat. For deficiency syndromes, Baidu San (Defeat Toxin Powder) added with Muxiang (Aucklandiae Radix) and Danggui (Angelicae Sinensis Radix) can be used. However, if an infant has both exterior and interior heat, presenting with a yellow complexion and red cheeks, dry lips and mouth, reddish and scanty urine, and scorched yellow stool, Sishun Qingliang Yin (Four-Obedience Clearing and Cooling Decoction) should first be used to promote drainage and unblocking, after which the heat will dissipate. If the exterior syndrome has not yet resolved, Xingxing San (Xingxing Powder) should be used first, with a small amount of Mahuang (Ephedrae Herba, de-stemmed) added to induce sweating, or Chaihu San (Bupleurum Powder) can be used. Once the exterior heat is eliminated, harmonizing treatment should follow, and the heat will naturally subside. For fright-heat, wind-heat, or accumulation-heat, Kuanre San (Broaden Heat Powder) can be taken to purge, followed by Baoshou San (Longevity Preservation Powder) and Jinfen San (Gold Dust Powder) to clear residual heat.
Baidu San (Defeat Toxin Powder): Treats headache and dizziness caused by Shanghan (Cold Damage), Wenyi (Plague-like diseases), and Fengshi (Wind-Dampness); pain in the four limbs; aversion to cold with high fever; stiffness of the neck and eye pain. It also treats common wind-dizziness, spasmodic fatigue, wind-phlegm, body and neck pain, as well as cough due to cold obstruction, nasal congestion with heavy voice, and alternating chills and fever.
Ingredients: Chaihu (Bupleuri Radix, washed and de-rhizomed), Qianhu (Peucedani Radix), Chuanxiong (Ligustici Chuanxiong Rhizoma), Zhike (Aurantii Fructus, stir-fried), Qianghuo (Notopterygii Rhizoma et Radix), Duhuo (Angelicae Pubescentis Radix), Baifuling (Poria, white part), Jiegeng (Platycodonis Radix, stir-fried), Renshen (Ginseng Radix et Rhizoma) — each 2 liang; Gancao (Glycyrrhizae Radix et Rhizoma) — 0.5 liang.
Preparation and Administration: Grind into coarse powder. Take 2 qian per dose, decocted with Shengjiang (Zingiberis Rhizoma Recens) and Bohe (Menthae Haplocalycis Herba). Alternatively, add Gudupi (Lycii Cortex) and Tianma (Gastrodiae Rhizoma). Or prepare as a powder, adding Chanui (Cicadae Periostracum) and Fangfeng (Saposhnikoviae Radix). For treating fright-heat, add Shaoyao (Paeoniae Radix), Gange (Puerariae Radix), and Huangqin (Scutellariae Radix). For absence of sweat, add Mahuang (Ephedrae Herba).
Sishun Qingliang Yin (Four-Obedience Clearing and Cooling Decoction): See Question 44.
Xingxing San (Xingxing Powder): Treats infantile wind-heat sores and rashes, Shanghan (Cold Damage) and seasonal qi pathogens, headache with high fever, dry eyes with excessive sleepiness, cough with coarse breathing, nasal congestion with clear discharge.
Ingredients: Tianguafen (Trichosanthis Radix), Renshen (Ginseng Radix et Rhizoma), Xixin (Asari Radix et Rhizoma, de-leafed), Fuling (Poria), Baizhu (Atractylodis Macrocephalae Rhizoma), Gancao (Glycyrrhizae Radix et Rhizoma, honey-fried), Jiegeng (Platycodonis Radix) — all in equal parts.
Preparation and Administration: Cut into pieces and make into a powder. Take 5 qian per dose, with one small cup of water and three leaves of Bohe (Menthae Haplocalycis Herba), decocted until reduced to three-quarters volume, take warm. To harmonize the qi, add Shengjiang (Zingiberis Rhizoma Recens) and decoct; time is not restricted.
Chaihu San (Bupleurum Powder): Treats infantile Shanghan (Cold Damage) with no sweat and exterior syndrome; high fever and headache; body pain; dry mouth with irritability and thirst; reddish urine; constipation with difficult passage; complicated by fright and mumps.
Ingredients: Shigao (Gypsum Fibrosum), Huangqin (Scutellariae Radix), Gancao (Glycyrrhizae Radix et Rhizoma), Chishaoyao (Paeoniae Radix Rubra), Gegen (Puerariae Radix) — each 2.5 qian; Mahuang (Ephedrae Herba, de-stemmed); Chaihu (Bupleuri Radix) — 0.5 liang.
Preparation and Administration: Cut into pieces and make into a powder. For a three-year-old child, take 2 qian per dose, with one small cup of water, a little Shengjiang (Zingiberis Rhizoma Recens), three cun of Congbai (Allii Fistulosi Bulbus), and twenty Douchi (Sojae Semen Praeparatum), decoct until reduced to half volume, remove dregs and take warm; time is not restricted. Effectiveness is indicated by sweating. For hot cough, add Xingren (Armeniacae Semen Amarum, peeled and de-seeded) 2 qian and Wuweizi (Schisandrae Chinensis Fructus) 3 qian.
Kuanre San (Broaden Heat Powder): Treats infantile Zhong'e Tianiao (acute convulsive disorder), twitching of hands and feet. After taking Niuhuang Gao (Calculus Bovis Ointment) for gradual relief, if abdominal heat remains, one dose of Kuanre San can be taken in the morning. It also treats infantile food stagnation and infanticolic fright-milk stagnation. Taking this medicine expels foul matter, sometimes in clumps resembling nasal mucus with a fishy odor, leading to gradual reduction of abdominal and waist distension and increased desire for milk and food.
Ingredients: Puxiao (Natrii Sulfas), Gancao (Glycyrrhizae Radix et Rhizoma) — each 0.5 liang; Dahuang (Rhei Radix et Rhizoma, selected for brocade pattern) — 1 liang; Zhike (Aurantii Fructus, de-albedo) — 1 liang, moistened with water, stir-fried together with forty-nine seeds of Badou (Crotonis Fructus, peeled), then discard Badou.
Preparation and Administration: Grind the four ingredients into powder and store in a porcelain vessel. Take one zi or half a qian per dose, mixed with one sip of decoction made from seven leaves of Bohe (Menthae Haplocalycis Herba). Alternatively, add a piece of rock sugar the size of a soap nut, mix evenly with Bohe decoction, and administer before morning feeding. Increase the powder dosage for strong children; decrease for weak children. If the child has widespread toxic heat sores, administer one dose in the morning to expel toxic vapors.
Baoshou San (Longevity Preservation Powder): Treats infantile fright-heat, tidal heat, wind-heat, and deficiency-heat; warmth and heat on the forehead; excessive crying day and night; clear nasal discharge due to dampness injury; clear discharge in throat and pharynx; restless sleep at night; small toxic heat sores on hands, feet, mouth, and tongue; chest and diaphragm discomfort due to dietary emotions or milk intake; occasional vomiting of milk; sudden fright from external stimuli; heat in palms and soles day and night; phlegm obstruction and cough; complicated by Tianiao acute fright-wind syndrome.
Ingredients: Baifuling (Poria, white part), Renshen (Ginseng Radix et Rhizoma), Chuanxionghuang (Realgar), Yaxiao (Natrii Sulfatis Crystalloides), Gancao (Glycyrrhizae Radix et Rhizoma, honey-fried) — each 2 liang; Shexiang (Moschus), Niuhuang (Calculus Bovis), Meihua Nao (Borneolum Syntheticum) — each a small amount (optional).
Preparation and Administration: Finely grind the eight ingredients and store in a tin box. Use as described in Jinfen San below.
Jinfen San (Gold Dust Powder): Treats infantile fright-heat, wind-heat, deficiency-heat, and tidal heat; heat in palms and soles; excessive salivation; ruddy complexion; warmth and heat on head, forehead, and body; open-mouth breathing day and night; clear nasal discharge; cough; upper jiao heat obstruction; toxic heat sores on mouth, nose, throat, tongue, hands, feet, whole body, head, and neck; restless sleep at night; vomiting and regurgitation; indigestion of milk and food; chest and diaphragm discomfort; febrile disease during developmental periods (Bianzheng); or fright-tidal heat. All are suitable for this formula. Regular use calms the heart, transforms phlegm, and suppresses fright. For wind-convulsion syndrome, after taking Niuhuang Gao (Calculus Bovis Ointment) to stop hand and foot twitching and reduce severity, if slight residual heat remains, two or three doses are appropriate.
Ingredients: Chuanxionghuang (Realgar) — 0.5 liang (separately ground), Baishaoyao (Paeoniae Radix Alba), Yaxiao (Natrii Sulfatis Crystalloides), Naonao (Borneolum Syntheticum), Shexiang (Moschus) — each a small amount.
Preparation and Administration: Grind finely and store in a tin box. For such conditions, administer half a qian for one-year-olds, one qian for two-to-three-year-olds, mixed with Bohe decoction. Yinjin Bohe Tang (Silver and Gold Mint Decoction) is particularly good. Regular use prevents various diseases.
[Discussion on Syndromes Where Cold Medicines Should Not Be Taken]
Cold lower legs and shins, abdominal deficiency bloating, green stool color, pale face, vomiting milk, blue eye whites.
[Discussion on Syndromes Where Hot Medicines Should Not Be Taken]
Hot lower legs and shins, red cheeks, constipation, yellow urine, unquenchable thirst, upward rushing of qi with rapid breathing, urgent and tight pulse.