益黄散治脾胃虚冷，故用丁香暖胃，二皮理胃、消食化痰，诃子涩肠胃、止泄固气，甘草和中，仍加
白术为当。若非虚冷，泄泻清白及无食积者，去青皮、丁香，加白术、茯苓可也。温胆汤除痰止吐，加白术、
芍药、黄连，便是制肝补脾之药。
愚按益黄散乃温补脾胃之剂也。若呕吐。腹痛、泄痢清白，口鼻气冷者，乃寒水反来侮土也，宜用钱
氏益黄散。若因热药巴豆之类，或因暑热、伤乳食，损其脾胃而成，吐泻口鼻气热者，乃胃中气虚风热
也，宜用东垣安胃散。
小儿八岁以下无伤寒，虽有感冒伤风，鼻塞、流
涕、发热、咳嗽，以降痰为主，略加微解。凡散利败毒，非幼稚所宜。或冒轻者，不必用药，候二、三日，
多有自愈。
愚按前症若手足冷，或腹胀，脾虚也，用六君子汤加升麻、柴胡；若腹胀，或气喘，肺虚也，用四君
子汤加柴胡、升麻。经云肺主气而司皮毛，肺虚则腠理不密，外邪易感。凡发表之后，其邪既去，用补脾
肺以实其表，庶风邪不能再入。往往表散之后，热嗽不退，复行发表，多变坏症。
吴江史玄年子，伤风，用表散化痰之药，痰盛咳嗽，肚腹膨大，面色 白。此脾土虚不能生肺金也。
余用六君子汤加桔梗，一剂顿愈。至三日前症仍作，鼻中流涕，此复伤风寒所致。用前药加桑皮、杏仁、
桔梗而愈。
史少参季子，喘嗽，胸腹膨胀，泄泻不食，此饮食伤脾土，而不能生肺金也。用六君子汤，一剂，诸
症悉愈。
史木川子，六岁，感冒咳嗽，发散过度，喘嗽，不食，用六君子汤加桔梗而愈。时四月，随其父巡视
耕种，忽发寒战，仍复咳嗽，或用发表之剂，痰中有血。余曰∶此成肺痈也。次日吐痰兼脓，用桔梗汤而
愈。后元气未复，大便似痢，或用五苓、黄连、枳实之类，痰喘、目札、四肢抽搐。余曰∶此脾气败而变
慢脾风也。辞不治，果然。
益黄散用于治疗脾胃虚寒证，因此使用丁香温暖胃腑，陈皮与青皮调理胃气、消除食积并化解痰湿，诃子收敛肠胃、止住泄泻并固摄元气，甘草调和脾胃之气，再加上白术则更为恰当。如果不是虚寒证，且泄泻物清稀无食物残渣者，应去掉青皮和丁香，加入白术和茯苓即可。温胆汤能祛除痰浊、止住呕吐，若加入白术、芍药、黄连，便成为制约肝木、补益脾土的方剂。
我按语：益黄散是温补脾胃的方剂。如果出现呕吐、腹痛、泄泻物清稀、口鼻呼出气体寒冷等症状，这是寒水之气反侮脾土的表现，适宜使用钱乙的益黄散。如果是因服用巴豆等热性药物，或因暑热、乳食损伤导致脾胃受损，出现吐泻且口鼻呼出气体发热等症状，这是胃气虚弱兼有风热的表现，适宜使用李东垣的安胃散。
八岁以下的小儿不会患伤寒病，即使患有感冒伤风，出现鼻塞、流涕、发热、咳嗽等症状，治疗应以降化痰涎为主，略微配合轻微的发散解表药。凡是使用发散、通利、败毒的药物，都不适合幼童使用。如果是病情轻微的感冒，不必用药，等待两三天后，大多会自愈。
我按语：上述症状如果伴有手足冰冷，或腹部胀满，属于脾虚，应使用六君子汤加入升麻、柴胡；如果伴有腹部胀满，或气喘，属于肺虚，应使用四君子汤加入柴胡、升麻。《内经》记载肺主一身之气而主管皮毛，肺气虚弱则腠理不紧密，外邪容易侵袭。凡是在发汗解表之后，外邪已经去除，应当用补益脾肺的方法来充实体表，这样风邪才不能再侵入。往往在发汗解表之后，热性咳嗽不退，又再次使用发汗解表的方法，很容易转变为危重的坏证。
吴江人史玄年的儿子，患伤风，使用了发汗解表和化痰的药物，导致痰多咳嗽，肚腹膨大，面色苍白。这是脾土虚弱不能生养肺金的表现。我使用六君子汤加入桔梗，一剂药后立刻痊愈。过了三天前症复发，鼻中流涕，这是再次受到风寒所致。使用前面的药物加入桑白皮、杏仁、桔梗而治愈。
史少参的小儿子，出现喘咳，胸腹部膨胀，泄泻且不进食，这是饮食损伤脾土，而不能生养肺金的表现。使用六君子汤，一剂药后，所有症状全部痊愈。
史木川的儿子，六岁，患感冒咳嗽，因发汗解表过度，导致喘咳，不能进食，使用六君子汤加入桔梗而治愈。当时是四月，他跟随父亲巡视农田耕作，忽然发生寒战，再次咳嗽，有人使用发汗解表的药剂，导致痰中带血。我说：“这已成肺痈了。”第二天吐出带有脓液的痰，使用桔梗汤而治愈。后来元气尚未恢复，大便似痢疾状，有人使用五苓散、黄连、枳实之类的药物，导致痰喘、眼睛眨动频繁、四肢抽搐。我说：“这是脾气败坏而转变为慢脾风。”推辞不治，果然（孩子死了）。
Yihuang San (Benefit Yellow Powder) is used to treat deficiency-cold of the Spleen and Stomach; therefore, Dingxiang (Clove) is used to warm the Stomach, Chenpi (Aged Tangerine Peel) and Qingpi (Green Tangerine Peel) regulate the Stomach, resolve food stagnation, and transform phlegm, Hezi (Chebula Fruit) astringes the intestines and stomach, stops diarrhea, and consolidates Qi, Gancao (Licorice Root) harmonizes the Middle Jiao, and adding Baizhu (Atractylodes Macrocephala Rhizome) is appropriate. If it is not deficiency-cold, and the diarrhea is clear without food accumulation, remove Qingpi and Dingxiang, and add Baizhu and Fuling (Poria) instead. Wendan Tang (Warm Gallbladder Decoction) eliminates phlegm and stops vomiting; adding Baizhu, Shaoyao (White Peony Root), and Huanglian (Coptis Rhizome) transforms it into a formula that subdues Liver Wood and tonifies Spleen Earth.
My commentary: Yihuang San is a formula for warming and tonifying the Spleen and Stomach. If there are symptoms such as vomiting, abdominal pain, diarrhea with clear discharge, and cold breath from the mouth and nose, this indicates Cold Water counter-acting and insulting Earth (Spleen); Qian Yi's Yihuang San should be used. If caused by taking hot drugs like Badou (Croton Seed), or due to summer-heat damaging milk and food intake, injuring the Spleen and Stomach, resulting in vomiting and diarrhea with hot breath from the mouth and nose, this indicates deficiency of Stomach Qi with Wind-Heat; Li Dongyuan's Anwei San (Stomach-Anchoring Powder) should be used.
Children under eight years old do not suffer from Shanghan (Cold Damage). Even if they have a common cold or wind invasion presenting with nasal congestion, runny nose, fever, and cough, treatment should focus primarily on descending phlegm, with only slight addition of mild dispersing agents. Formulas that disperse, drain, or detoxify are not suitable for young children. For mild cases of wind invasion, medication is unnecessary; waiting two or three days often leads to spontaneous recovery.
My commentary: Regarding the aforementioned conditions, if accompanied by cold hands and feet or abdominal distension, it indicates Spleen Deficiency; use Liu Junzi Tang (Six Gentlemen Decoction) added with Shengma (Cimicifuga Rhizome) and Chaihu (Bupleurum Root). If accompanied by abdominal distension or wheezing, it indicates Lung Deficiency; use Si Junzi Tang (Four Gentlemen Decoction) added with Chaihu and Shengma. The Classics state that the Lung governs Qi and controls the skin and hair. When Lung Qi is deficient, the interstices (Couli) are not tight, making external pathogens easy to invade. After releasing the exterior through sweating, once the pathogen is eliminated, one should tonify the Spleen and Lung to strengthen the exterior, so that Wind pathogens cannot re-enter. Often, after exterior release, if heat-induced cough persists and exterior-releasing methods are applied again, it easily transforms into severe adverse syndromes.
The son of Shi Xuan Nian from Wujiang contracted a wind invasion and was treated with exterior-releasing and phlegm-resolving medicines, leading to excessive phlegm, cough, abdominal distension, and pale complexion. This indicates Spleen Earth deficiency failing to generate Lung Metal. I used Liu Junzi Tang added with Jiegeng (Platycodon Root); one dose resulted in immediate recovery. Three days later, the previous symptoms recurred with a runny nose, caused by re-injury from wind-cold. Using the previous prescription added with Sangbaipi (Mulberry Bark), Xingren (Apricot Seed), and Jiegeng led to recovery.
The youngest son of Vice Minister Shi suffered from wheezing and cough, chest and abdominal distension, diarrhea, and anorexia. This indicates dietary injury to Spleen Earth failing to generate Lung Metal. Using Liu Junzi Tang, all symptoms were cured after one dose.
The son of Shi Muchuan, aged six, had a cold with cough. Due to excessive exterior-releasing treatment, he developed wheezing and cough, and could not eat. Using Liu Junzi Tang added with Jiegeng led to recovery. It was April, and while accompanying his father to inspect farming, he suddenly experienced chills and recurrent cough. Someone administered exterior-releasing formulas, causing blood in the sputum. I said, "This has become Fei Yong (Lung Abscess)." The next day, he expectorated pus mixed with sputum, and was cured using Jiegeng Tang (Platycodon Decoction). Later, when Yuan Qi (Primal Qi) had not yet recovered, his stool resembled dysentery. Someone used Wuling San (Five-Ingredient Powder with Poria), Huanglian, Zhishi (Immature Bitter Orange), etc., leading to phlegm-wheezing, frequent blinking of eyes, and convulsions of the four limbs. I said, "This is Spleen Qi failure transforming into Man Pi Feng (Slow Spleen Wind)." I declined to treat, and indeed (the child died).