小儿之病。惟热居多。夫热有虚有实。实则面红目赤。气粗口干燥渴。小便赤涩。大便
坚
闭。五心烦热。日夜焦啼。发壮热。宜大连翘饮主之。虚则面白眼青。气微。口中清冷。恍
惚神缓。大便稀而小便频。夜则盗汗发虚热。宜惺惺散主之。其有乍冷乍热。怫郁惊惕。上
盛下虚。此冷热不调候也。如热在表宜汗。在里宜下。表里俱热则宜解散。其或表里已解。
热又时来。此表里俱虚。气不归元。而阳浮于外。不可再服凉药。必使阳敛于内。身体自凉
宜参苓白术散主之。又有潮热。则发热有时。惊热颠叫恍惚。夜热夕发旦止。余热寒邪
未尽。食热肚腹先发热。疳热骨蒸盗汗。壮热一向不止。烦热心躁不安。积热颊赤口疮。
风热汗出身热。虚热困倦少力。客热来去不定。癖热涎嗽饮水。寒热发如疟状。血热巳
午时发热疮疹热耳鼻尖冷。十六者大同而小异。诸症得之。各有所归。其间或有三两症交
互者。宜随其轻重而处治之。盖小儿气禀纯阳。脏腑生热。阴阳气变。熏蒸于外。致令身热
也。若肝热则两眼赤痛。流泪羞明。或生翳障。心热则口内生疮。小便赤肿。淋沥不通。肺
热则鼻衄不止。大腑闭结。脾热则多涎沫。口内长流。心脾热则生重舌木舌。胃热则作口
臭。肾热则耳聋。或出脓汁。此五脏所生。热各不同。是不可以概论也。大抵热则生风。风
则悸矣。
一论小儿心经邪热。心与小肠受盛。乃水宝之处。常宜通利。壅则结。滑则利。热则涩
盛则
淋。平凉心火。三焦自顺。不待疾作而解。症成而疗者。疏通有之矣。一十五味加汤使用。
才觉蕴热客热寒邪风邪。冒之肺经。心将受之。不受独传于小肠。或闭或涩。或赤或白。淋
沥不通。荣卫不通。壅之作疾。其发多端。以致膈热。眼目赤肿。唇口白疮。津液不生。涕
唾稠盛。须在表里俱得其宜。惊风悉能散之。痰热亦自除之。连翘之功。可谓大矣。
大连翘饮
连翘 瞿麦穗 滑石 车前子 牛蒡子 赤芍药（各八分） 山栀子 木通 当归 防风
（各四分） 黄芩（一钱二分） 柴胡 甘草（各一钱二分） 荆芥穗（五分） 蝉蜕（五分）
上锉作一剂。竹叶十片。灯草十根。水煎服。风痰热变蒸热。加麦门冬。实热丹热。加
大黄。胎热疮疹余毒。加薄荷叶。痈疽毒热。加大黄、芒硝。
一论小儿蕴积热毒。唇口肿破生疮。牙缝出血。口臭颊热。咽痛烦躁不宁。并痘疹余毒
未解。或头面身体多生疮疖。宜
五福化毒丹
犀角（镑三钱） 桔梗（一两） 生地黄（泔浸） 赤茯苓（去皮） 鼠粘子（微炒各五钱） 粉
草朴硝（各三钱） 连翘 玄参（各六钱） 青黛（二钱）
上为细末。炼蜜为丸。如龙眼大。每服一丸。薄荷汤研化下。兼有惊。加朱砂为衣。
一论小儿变蒸一症。乃小儿蒸皮长骨。变幻精神。不须服药。其有兼伤风咳嗽。痰涎鼻
塞声重。变蒸发热。宜服此方。
惺惺散
人参 白术（去芦） 白茯苓（去皮） 甘草（炙） 桔梗 白芍（炒） 天花粉 细辛 薄荷
叶
上锉。每服三钱。水煎。温服。
小儿的疾病，大多由热邪引起。热证有虚证和实证之分。实证表现为面色红、眼睛赤红、呼吸粗重、口干燥渴、小便短赤涩痛、大便干结不通、五心烦热（手心、脚心及心胸烦热）、日夜焦躁啼哭、发高热，治疗宜用大连翘饮为主方。虚证表现为面色白、眼周发青、气息微弱、口中感觉清冷、神情恍惚且反应迟钝、大便稀溏而小便频数、夜间盗汗并伴有低热，治疗宜用惺惺散为主方。
如果有忽冷忽热的症状，伴有烦躁郁结、惊悸惕动，上部实盛而下部虚弱，这是冷热不调的证候。如果热邪在表，宜用发汗法；热邪在里，宜用泻下法；表里俱热，则宜用解散法。如果表里之邪已解，但热邪又时而发作，这是表里俱虚，气不归元，阳气浮越于外，此时不可再服用寒凉药物，必须使阳气收敛于内，身体自然凉爽，治疗宜用参苓白术散为主方。
又有潮热，即发热有定时；惊热表现为颠狂叫唤、神情恍惚；夜热表现为傍晚发作、清晨停止；余热寒邪未尽；食热表现为腹部先发热；疳热表现为骨蒸潮热、盗汗；壮热表现为持续高热不止；烦热表现为心中烦闷、急躁不安；积热表现为脸颊发红、口舌生疮；风热表现为出汗后身热；虚热表现为困倦乏力；客热表现为来去不定；癖热表现为痰涎咳嗽、饮水；寒热表现为像疟疾一样的寒热交替；血热表现为巳时、午时发热；疮疹热表现为耳朵和鼻尖发冷。这十六种热证大同小异，各种病症得到之后，各有其归属。其间或有两三症交互出现的情况，应根据病情的轻重进行诊治。大概因为小儿禀赋纯阳，脏腑易生热，阴阳之气变化，熏蒸于体表，导致身体发热。
如果肝热，则两眼赤痛、流泪、畏光，或生翳障；心热则口内生疮、小便赤肿、淋沥不通；肺热则鼻衄不止、大肠闭结；脾热则多涎沫、口内流涎不止；心脾热则生重舌、木舌；胃热则口臭；肾热则耳聋，或流出脓汁。这是五脏所生的热，各不相同，不可以一概而论。大抵热极则生风，风盛则心悸。
论述小儿心经邪热：心与小肠互为表里，受盛水液，常宜通利。壅滞则结聚，滑利则通畅，热盛则涩滞，甚则成淋。平抑心火，三焦自然顺调，不必等到疾病发作才解除，等到病症形成才治疗，疏通的方法也就有了。使用十五味加汤，刚觉得蕴热、客热、寒邪、风邪侵袭肺经，心将受邪，若不独传于心，则传于小肠。或闭或涩，或尿赤或尿白，淋沥不通，营卫不通，壅滞而成疾病，发病表现多种多样，以致膈热，眼目赤肿，唇口生疮，津液不生，涕唾稠盛。必须在表里兼顾得当，惊风悉能散去，痰热亦自消除。连翘的功效，可谓大了。
大连翘饮：连翘、瞿麦穗、滑石、车前子、牛蒡子、赤芍药（各八分），山栀子、木通、当归、防风（各四分），黄芩（一钱二分），柴胡、甘草（各一钱二分），荆芥穗（五分），蝉蜕（五分）。以上药材锉碎为一剂，加竹叶十片、灯草十根，水煎服。若有风痰、热变蒸热，加麦门冬；若为实热、丹毒热，加大黄；若为胎热、疮疹余毒，加薄荷叶；若为痈疽毒热，加大黄、芒硝。
论述小儿蕴积热毒：唇口肿破生疮，牙缝出血，口臭颊热，咽痛烦躁不宁，以及痘疹余毒未解，或头面身体多生疮疖，宜用五福化毒丹。
五福化毒丹：犀角（镑三钱），桔梗（一两），生地黄（泔浸），赤茯苓（去皮），鼠粘子（微炒，各五钱），粉草、朴硝（各三钱），连翘、玄参（各六钱），青黛（二钱）。以上研为细末，炼蜜为丸，如龙眼大小。每服一丸，用薄荷汤研化送下。兼有惊风者，加朱砂为衣。
论述小儿变蒸一症：乃小儿蒸皮长骨、变幻精神的过程，不需服药。如果有兼伤风咳嗽、痰涎鼻塞声重、变蒸发热，宜服此方。
惺惺散：人参、白术（去芦）、白茯苓（去皮）、甘草（炙）、桔梗、白芍（炒）、天花粉、细辛、薄荷叶。以上锉碎，每服三钱，水煎，温服。
Diseases in infants and children are mostly caused by heat. Heat syndromes can be deficient or excess. Excess heat manifests as a red face, red eyes, coarse breathing, dry mouth with thirst, dark and scanty urine with dysuria, hard and constipated stool, five-palm heat (heat sensation in the palms, soles, and chest), restlessness and crying day and night, and high fever. The main treatment should be Da Lianqiao Yin (Great Forsythia Decoction). Deficient heat manifests as a pale face, bluish discoloration around the eyes, weak breath, a cold sensation in the mouth, mental confusion with slow responses, loose stools with frequent urination, night sweats accompanied by low-grade fever. The main treatment should be Xingxing San (Xingxing Powder).
If there are alternating chills and fever, accompanied by irritability, depression, fright, and palpitations, with excess in the upper body and deficiency in the lower body, this is a syndrome of imbalance between cold and heat. If the heat is in the exterior, sweating method should be used; if in the interior, purgative method should be used; if both exterior and interior are hot, dispersing method should be used. If the pathogenic factors in the exterior and interior have been resolved, but heat recurs intermittently, this indicates deficiency in both exterior and interior, Qi failing to return to its origin, and Yang floating outward. Cold-natured medicines should not be administered again; instead, Yang must be consolidated within, allowing the body temperature to normalize naturally. The main treatment should be Shen Ling Bai Zhu San (Ginseng, Poria, and Atractylodes Macrocephala Powder).
There is also tidal fever, where fever occurs at specific times; fright-heat, characterized by manic screaming and mental confusion; night-heat, which starts in the evening and stops in the morning; residual heat and unexhausted cold pathogens; food-heat, where abdominal heat appears first; guan-heat, characterized by bone-steaming tidal fever and night sweats; severe heat, which persists continuously without stopping; vexillating heat, marked by mental restlessness and irritability; accumulated heat, presenting with red cheeks and oral ulcers; wind-heat, presenting with fever after sweating; deficient heat, causing fatigue and weakness; guest-heat, coming and going unpredictably; pi-heat, involving phlegm-saliva cough and drinking water; cold-heat resembling malaria; blood-heat, with fever during the Si and Wu hours (9 AM–1 PM); and rash-heat, with cold ears and nose tips. These sixteen types of heat share similarities but have minor differences. Each syndrome has its specific attribution. Occasionally, two or three syndromes may interact. Treatment should be adjusted according to the severity. Generally, infants possess pure Yang constitution, and their Zang-Fu organs easily generate heat. Changes in Yin and Yang Qi steam outward, causing body heat.
If Liver heat exists, the eyes become red and painful, with tearing and photophobia, or formation of corneal opacities. If Heart heat exists, oral ulcers form, urine becomes dark and swollen, with dribbling and obstruction. If Lung heat exists, epistaxis persists, and large bowel constipation occurs. If Spleen heat exists, excessive saliva and froth flow from the mouth. If Heart and Spleen heat exist, double tongue or wooden tongue develops. If Stomach heat exists, halitosis occurs. If Kidney heat exists, deafness ensues, or pus discharges. These are heats generated by the Five Zang organs, each distinct, and cannot be generalized. Generally, extreme heat generates Wind, and excessive Wind causes palpitations.
Regarding evil heat in the Heart Meridian of infants: The Heart and Small Intestine are interior-exteriorly related and govern fluid reception. They should generally remain patent. Stagnation leads to blockage; smoothness leads to free flow; heat leads to astringency; excess leads to strangury. Calming Heart Fire ensures the smooth flow of the Triple Burner, resolving issues before disease onset rather than treating after symptoms appear. Using the Fifteen-Ingredient Modified Decoction, when one initially feels accumulated heat, guest heat, cold pathogens, or wind pathogens invading the Lung Meridian, the Heart will be affected. If not transmitted solely to the Heart, it transmits to the Small Intestine. This may cause blockage or astringency, red or white urine, dribbling obstruction, and stagnation of Ying and Wei Qi, leading to various diseases such as diaphragmatic heat, red and swollen eyes, white sores on lips and mouth, lack of body fluids, and thick sputum and nasal discharge. Proper handling of both exterior and interior can dissipate fright-wind and eliminate phlegm-heat. The efficacy of Chaiqiao (Forsythiae Fructus) is indeed great.
Da Lianqiao Yin (Great Forsythia Decoction): Chaiqiao (Forsythiae Fructus), Qumai Sui (Herba Siegesbeckiae Spica), Huashi (Talcum), Cheqianzi (Semen Plantaginis), Niubangzi (Fructus Arctii), Chi Shaoyao (Radix Paeoniae Rubra) (each 8 fen); Shanzhizi (Fructus Gardeniae), Mutong (Caulis Akebiae), Danggui (Radix Angelicae Sinensis), Fangfeng (Radix Saposhnikoviae) (each 4 fen); Huangqin (Radix Scutellariae) (1.2 qian); Chaihu (Radix Bupleuri), Gancao (Radix Glycyrrhizae) (each 1.2 qian); Jingjie Sui (Herba Schizonepetae Spica) (5 fen); Chantui (Periostracum Cicadae) (5 fen). Decoct these ingredients as one dose with ten leaves of Zhuye (Bamboo Leaf) and ten roots of Dengcao (Juncus Effusus Root). For wind-phlegm or heat from bianzheng (growth fever), add Maimendong (Radix Ophiopogonis). For excess heat or dan-re (erysipelas heat), add Dahuang (Radix et Rhizoma Rhei). For fetal heat or residual toxicity of rashes, add Boheye (Folium Menthae). For carbuncle-toxic heat, add Dahuang (Radix et Rhizoma Rhei) and Mangxiao (Natrii Sulfas).
Regarding accumulated heat-toxin in infants: Swelling and ulceration of lips and mouth, bleeding from gum gaps, bad breath, hot cheeks, sore throat, restlessness, unresolved residual toxicity of smallpox/rashes, or multiple boils on head, face, and body. The main treatment is Wufu Huadu Dan (Five Blessings Detoxifying Pill).
Wufu Huadu Dan (Five Blessings Detoxifying Pill): Xijiao (Cornu Bubali) (sliced, 3 qian), Jiegeng (Radix Platycodonis) (1 liang), Sheng Dihuang (Radix Rehmanniae Preparata, soaked in rice water), Chi Fuling (Poria cum Radix Pini, peeled), Shiunazi (Fructus Arctii, lightly fried) (each 5 qian), Fugan (Radix Glycyrrhizae Preparata), Piaoxiao (Natrii Sulfas) (each 3 qian), Lianqiao (Forsythiae Fructus), Xuanshen (Radix Scrophulariae) (each 6 qian), Qingdai (Indigo Naturalis) (2 qian). Grind into fine powder, mix with refined honey to make pills the size of longan seeds. Take one pill per dose, dissolved in Bohe Tang (Mint Decoction). If accompanied by fright, coat with Zhusha (Cinnabar).
Regarding the syndrome of bianzheng (growth fever) in infants: This refers to the physiological process of skin growth and bone development, involving changes in spirit and consciousness. Medication is not required. However, if complicated by wind-cold with cough, phlegm-saliva, nasal congestion, heavy voice, or fever from bianzheng, this formula is indicated.
Xingxing San (Xingxing Powder): Ren Shen (Radix Ginseng), Baizhu (Rhizoma Atractylodis Macrocephalae, remove rhizome), Baifuling (Poria, peel off), Gancao (Radix Glycyrrhizae, honey-fried), Jiegeng (Radix Platycodonis), Baishao (Radix Paeoniae Alba, stir-fried), Tianhuafen (Radix Trichosanthis), Xixin (Herba Asari), Boheye (Folium Menthae). Decoct these ingredients. Take 3 qian per dose, decoct in water, and take warm.