幼科谓八岁以前无伤寒，此无稽之谈也。但乳子与小儿异治，乳子筋骨柔脆，不耐伤寒
，初入太阳，即人事昏沉，浑身壮热，筋脉牵强，医者不详辨误，认为惊风，其祸立至。初
起不宜发表，恐汗多亡阳，急宜解肌，使表邪从外而出，斯无变痉之虞。
桂枝防风汤 治半周一岁以至三五岁幼儿伤寒，初起发热体重，面黄或白，喘急，口中
气热，呵欠顿闷。速以此方解散肌肤之邪，有汗能止，无汗能发，为幼科解表之第一方。
嫩桂枝 北防风（各钱半） 白芍（二钱） 老生姜 炙草（各一钱） 大红枣（五枚）
水煎热服。有痰，加白芥子一钱。有呕吐，加陈皮、制半夏各一钱。热重，加柴胡一钱
。胸紧气急，加枳壳一钱。
小柴胡汤 治里热恶热，出头露面，扬手掷足，口气热臭，烦渴自汗。
柴胡（钱半） 人参（七分） 黄芩 法夏（各一钱） 炙草（五分）
加石膏、知母。若前里热症兼有掀衣气粗、小便赤短、大便燥结者，用小柴胡汤去半夏
，加庄黄一钱，姜枣煎服。若夹食伤寒，壮热头痛，嗳气腹胀，大便酸臭，用柴胡钱半，制
半夏、赤芍、庄黄各一钱，小枳实八分，姜三片，枣一枚，同煎。
阴症里虚，头额冷，手足冷，口中气冷，面色暗淡，大便泻，用理中汤。（方见“非搐”
。）若泄出青黄，方内加黄 ，炒，钱半，酒芍一钱。寒甚者，再加好肉桂一钱、附子七分，
水煎温服。
惺惺散 治小儿真元不足，气血怯弱，内伤外热，不能受表。
人参 茯苓 白芍（炒） 桔梗 花粉（酒炒） 川芎 北防风（各一钱） 北细辛（五分） 白术（钱半）
生姜（三片） 红枣（三枚） 水煎热服。
小儿伤寒类治，与大方科同，详见《集成》。
治四时感冒伤风咳嗽，用人参败毒散。凡咳嗽痰不应者，每日二服，以痰豁为度。
人参败毒散 方见“误搐”。并治伤寒初起发热头痛等症。
儿科中认为八岁以前的儿童不会患伤寒，这是一种毫无根据的谬论。但是，婴儿与较大儿童的治法不同，婴儿筋骨柔嫩脆弱，难以承受伤寒之邪。病邪初入太阳经（足太阳膀胱经受邪所致的表证），患儿即出现人事昏沉、全身高热、筋脉拘急抽搐等症状。如果医生不仔细辨证而误诊为惊风（以抽搐为主要表现的病证），祸患立刻就会发生。疾病初起时不宜使用发汗解表的方法，恐怕出汗过多导致阳气亡失，应当紧急采用解肌（解除肌表之邪）的方法，使在表的邪气从体外排出，这样就没有转变为痉病（以项背强直、角弓反张为特征的病证）的担忧了。
桂枝防风汤：治疗半周岁至一周岁乃至三至五岁的幼儿患伤寒，初起时发热、身体沉重、面色发黄或苍白、气喘急促、口中气息灼热、频繁打呵欠且感到胸闷烦闷。迅速使用此方解散肌肤间的邪气，有汗者能止汗，无汗者能发汗，是儿科解表的第一方剂。
药材组成：嫩桂枝、北防风（各1.5钱）、白芍（2钱）、老生姜、炙甘草（各1钱）、大红枣（5枚）。
煎服法：加水煎煮后热服。若有痰，加白芥子1钱；若呕吐，加陈皮、制半夏各1钱；若热象重，加柴胡1钱；若胸部紧束、气喘急促，加枳壳1钱。
小柴胡汤：治疗里热证表现为怕热、喜欢将头脸伸出被外、扬手掷足、口气热臭、烦躁口渴、自汗出。
药材组成：柴胡（1.5钱）、人参（0.7钱）、黄芩、法半夏（各1钱）、炙甘草（0.5钱）。
加减法：加入石膏、知母。如果前述里热症状兼有掀开衣服、呼吸粗重、小便短赤、大便干燥结滞的情况，用小柴胡汤去掉半夏，加入庄黄（大黄的一种）1钱，加生姜、大枣煎服。如果是夹食伤寒（因饮食停滞兼感风寒），表现为壮热头痛、嗳气腹胀、大便酸臭，用柴胡1.5钱，制半夏、赤芍、庄黄各1钱，小枳实0.8钱，生姜3片，大枣1枚，共同煎煮服用。
阴证里虚证，表现为额头冷、手足冷、口中气息冷、面色暗淡、大便泄泻，使用理中汤。（方剂见“非搐”章节。）如果泄出的粪便呈青黄色，方剂中加入炒黄的黄连1.5钱，酒白芍1钱。寒邪严重者，再加优质肉桂1钱、附子0.7钱，水煎温服。
惺惺散：治疗小儿先天真元不足，气血怯弱，内伤兼外热，不能耐受发汗解表之法。
药材组成：人参、茯苓、白芍（炒）、桔梗、天花粉（酒炒）、川芎、北防风（各1钱）、北细辛（0.5钱）、白术（1.5钱）、生姜（3片）、红枣（3枚）。
煎服法：加水煎煮后热服。
小儿伤寒的治疗原则，与成人科相同，详见《集成》一书。
治疗四季感冒伤风引起的咳嗽，使用人参败毒散。凡是咳嗽但痰液排不出来的，每日服用两次，直到痰液豁然而出为止。
人参败毒散：方剂见“误搐”章节。并治疗伤寒初起出现的发热、头痛等症状。
It is a baseless fallacy in pediatrics to claim that children under the age of eight do not suffer from Shanghan (Cold Damage). However, infants and older children require different treatments. Infants have tender and fragile bones and sinews, making them unable to withstand pathogenic cold. When the pathogen first enters the Taiyang channel (a syndrome caused by pathogenic invasion of the Foot-Taiyang Bladder meridian), the infant immediately presents with lethargy, high fever throughout the body, and muscle spasms. If physicians fail to differentiate the condition carefully and misdiagnose it as Jingfeng (a syndrome characterized mainly by convulsions), disaster will ensue immediately. At the initial stage, it is inappropriate to use diaphoretic methods to release the exterior, as excessive sweating may lead to the loss of Yang Qi. Instead, one should urgently employ Ji Ji (releasing the muscle layer) methods to allow the exterior pathogens to exit from the outside, thereby avoiding the risk of transforming into Jing disease (a syndrome characterized by stiffness of the neck and back and opisthotonos).
Guizhi Fangfeng Tang (Cinnamon Twig and Saposhnikovia Decoction): Treats Shanghan in infants aged half a year to one year, and even up to three or five years old. The initial symptoms include fever, heavy body, yellowish or pale complexion, rapid breathing, hot breath, frequent yawning, and chest stuffiness. This formula quickly dissipates pathogens in the skin and muscles; it can stop sweating if present, and induce sweating if absent. It is the premier exterior-releasing formula in pediatrics.
Ingredients: Tender Guizhi (Ramulus Cinnamomi), Bei Fangfeng (Radix Saposhnikoviae) (each 1.5 qian); Baishao (Radix Paeoniae Alba) (2 qian); Lao Shengjiang (Rhizoma Zingiberis Recens); Zhi Cao (Radix Glycyrrhizae Preparata) (each 1 qian); Da Hongzao (Fructus Jujubae) (5 pieces).
Preparation: Decoct in water and take warm. If there is phlegm, add Baijiezi (Semen Sinapis Albae) 1 qian. If vomiting occurs, add Chenpi (Pericarpium Citri Reticulatae) and Zhi Banxia (Rhizoma Pinelliae Preparatum) each 1 qian. If heat is severe, add Chaihu (Radix Bupleuri) 1 qian. If the chest feels tight and breathing is rapid, add Zhike (Fructus Aurantii) 1 qian.
Xiao Chaihu Tang (Minor Bupleurum Decoction): Treats interior-heat syndromes manifesting as aversion to heat, tendency to expose the head and face, flailing of hands and feet, foul hot breath, irritability, thirst, and spontaneous sweating.
Ingredients: Chaihu (Radix Bupleuri) (1.5 qian); Renshen (Radix Ginseng) (0.7 qian); Huangqin (Radix Scutellariae); Fa Xia (Rhizoma Pinelliae Preparatum) (each 1 qian); Zhi Cao (Radix Glycyrrhizae Preparata) (0.5 qian).
Modifications: Add Shigao (Gypsum Fibrosum) and Zhimu (Radix Anemarrhenae). If the aforementioned interior-heat symptoms are accompanied by throwing off clothes, coarse breathing, scanty dark urine, and dry constipation, use Xiao Chaihu Tang removing Banxia, adding Zhuang Huang (Radix et Rhizoma Rhei) 1 qian, decocted with Shengjiang and Hongzao. If it is Shanghan complicated by food stagnation, manifesting as high fever, headache, belching, abdominal distension, and sour-smelling diarrhea, use Chaihu 1.5 qian, Zhi Banxia, Chishao (Radix Paeoniae Rubra), Zhuang Huang each 1 qian, Xiao Zhishi (Fructus Aurantii Immaturus) 0.8 qian, Shengjiang 3 slices, and Hongzao 1 piece, decocted together.
For Yin syndromes with interior deficiency, presenting with cold forehead, cold hands and feet, cold breath, dull complexion, and diarrhea, use Lizhong Tang (Regulate the Middle Decoction). (Formula see "Non-Convulsion" section.) If the stool is greenish-yellow, add Chao Huanglian (Rhizoma Coptidis, stir-fried) 1.5 qian and Jiu Shaoyao (Radix Paeoniae Alba, wine-treated) 1 qian within the formula. If cold is severe, add You Rougui (Cortex Cinnamomi Optimus) 1 qian and Fuzi (Radix Aconiti Lateralis Preparata) 0.7 qian, decocted in water and taken warm.
Xingxing San (Stimulating Powder): Treats pediatric cases where true Yuan Qi is insufficient, Qi and Blood are weak, internal injury coexists with external heat, and the patient cannot tolerate exterior-releasing methods.
Ingredients: Renshen (Radix Ginseng); Fuling (Poria); Baishao (Radix Paeoniae Alba, stir-fried); Jiegeng (Radix Platycodi); Huafen (Radix Platycodonis, wine-stir-fried); Chuanxiong (Rhizoma Chuanxiong); Bei Fangfeng (Radix Saposhnikoviae) (each 1 qian); Bei Xixin (Herba Asari) (0.5 qian); Baizhu (Rhizoma Atractylodis Macrocephalae) (1.5 qian); Shengjiang (Rhizoma Zingiberis Recens) (3 slices); Hongzao (Fructus Jujubae) (3 pieces).
Preparation: Decoct in water and take warm.
The treatment principles for pediatric Shanghan are the same as those for adult medicine; for details, refer to the book *Jicheng*.
For coughs caused by wind-cold common cold in the four seasons, use Renshen Baidu San (Ginseng Detoxification Powder). For coughs with difficult expectoration, administer twice daily until the phlegm is cleared.
Renshen Baidu San (Ginseng Detoxification Powder): See formula in "Misdiagnosed Convulsion" section. Also treats initial symptoms of Shanghan such as fever and headache.