仲景论曰∶有翕翕（音吸）发热，有蒸蒸热，此分汗下之不同。翕者若翕之所覆，明其热在表也，属上太阳第一证，
以桂枝汤主之。蒸者如熏蒸之甚，主其热在胃也，属阳明三十二证，以调胃承气汤下之。此仲景法也。缘
小儿之热，似是而非，若同而异。有伤寒热，变蒸热，积热，麻豆热，惊风热，潮热，骨
蒸热，有表里俱虚而热，有热虽同，名则异可不明辨标本以施治乎？须令验证，对证用
药，斯为的论。伤寒热，十指稍冷，鼻流清涕，发热无汗，面惨凌振，右腮有紫纹，治
法载于伤寒条内，变蒸热，温温微热，气粗惊少， 乳泻黄，上唇尖有小泡，如水珠子，
即变蒸也，不须用药攻治。如兼他证者，当根据其所感之候，略与和解，不必重剂可也。盖
变者变其形容，蒸者蒸长肌肉，三十二日为一变，六十四日为一蒸。又三大蒸，积五百
一十二日，变蒸毕而形气血脉筋骨全矣。夫变蒸之说，再考明医陈氏书，载十变之内，五
蒸存焉。又有三大蒸，计其数恰五百一十二日，最为明矣。积热，眼胞浮肿，面黄足冷，
发热从头至肚愈甚，或闻饮食之气恶心，及腹疼呕吐，治法详载伤积论中。麻豆热，面
赤足冷，身发壮热，呵欠顿闷，咳嗽腰疼，时或作惊，腹痛自痢，及中指独自冷者是也。治
法详见疮疹证内。惊风热，遍身发热而光，自汗心悸不宁，脉数烦躁，治法与急惊证同。所
用药饵，必先解表。潮热，有午后发热，或日晡发热，对时如潮水之应，不瘥是也。先
用百解散发表，次以当归散及三解散治之。脉实者下之，宜大柴胡汤，虚浮散者微汗之，用
百解散。若发热而呕者，小柴胡汤主之。虚热，因病后发热无时，一日三五次者，此客
热乘虚而作，先以胃苓汤加黄 末，温米清汤调服，次投钱氏白术散，或固真汤，带凉
服，及用温盐汤，参入凉水送下黑锡丹，固守元气。骨蒸热，身体虚赢，遇晚二发，有
热无寒，醒后渴汗方止，此乃疳病之余毒，传作骨蒸，或腹内有癖块，有时微痛，用参苓
白术散，姜、枣，三棱煎汤调服，或投化癖丸，先疗脾虚宿滞，次以柴胡饮为治，仍忌
鸡酒羊面毒物。有小儿热证用表里药后，其热俱退，既退复热者何也。疗病至此，难以
概举，或再解表攻里，或施凉剂，热见愈甚，以阴阳辨之，何者为是。推其原乃表里俱虚，
而阳浮于外，阴伏于内，所以又发热，宜用温平之药和其里，则体热自除。投钱氏白术
散，去木香加扁豆，水煎，及黄 六一汤、安神散，自然平复。若日久汗多，烦渴食减，脉
微缓，喜饮热，可服真武汤，虽附子性温，取其收敛阳气，内有芍药性寒，一寒一温，亭
分得宜，用之无不验矣。
张仲景论述说：有像羽毛覆盖般的翕翕发热，有像熏蒸般的蒸蒸热，这区分了发汗和攻下两种不同的治法。翕翕发热如同被衣物覆盖时的温热感，说明病邪在表，属于太阳经第一证，用桂枝汤主治。蒸蒸热如同热气熏蒸般剧烈，说明病邪在胃腑，属于阳明经第三十二证，用调胃承气汤攻下治疗。这是张仲景的治法。
因为小儿的热证，看似相似实则不同，表面相同而实质各异。有的伤寒热，变蒸热，积滞热，麻豆热（类似天花或麻疹初期的热），惊风热，潮热，骨蒸热；有的表里俱虚而发热。虽然发热症状相同，但名称各异，难道不需要明辨标本以实施治疗吗？必须通过验证症状，对症用药，这才是确切的论断。
伤寒热，表现为十指稍冷，鼻流清涕，发热无汗，面色惨淡且战栗，右腮有紫纹，治疗方法记载在伤寒条文中。变蒸热，表现为微微发热，气息粗重但惊恐较少，大便泄泻呈黄色，上唇尖有小泡，像水珠一样，这就是变蒸热，不需要用药攻治。如果兼有其他证候，应当根据所感受的病候，略予和解，不必使用重剂即可。所谓“变”，是指改变形体容貌；“蒸”，是指蒸长肌肉。每三十二日为一变，六十四日为一蒸。又有三大蒸，累计五百一十二日，变蒸结束，此时形体、气血、脉象、筋骨便都健全了。关于变蒸的说法，再考证明代医家陈氏的书，其中记载在十变之内，存留五种蒸证。又有三大蒸，计算天数恰好是五百一十二日，最为明确。
积滞热，表现为眼睑浮肿，面色发黄，足部发冷，发热从头至腹部越来越严重，或者闻到饮食的气味就恶心，以及腹痛呕吐，治疗方法详细记载在伤积论中。麻豆热，表现为面红足冷，身体发出壮热，打哈欠且感到闷乱，咳嗽腰痛，时常出现惊悸，腹痛并自下痢，中指独自发冷就是这种病。治疗方法详见疮疹证内。惊风热，表现为全身发热且光亮，自汗，心悸不安，脉搏快且烦躁，治疗方法与急惊证相同。所用药物，必须先解表。
潮热，表现为午后发热，或者傍晚时分发热，按时发作如潮水应期而至，病情不缓解就是这种病。先用百解散发表，再用当归散及三解散治疗。脉实者攻下，宜用大柴胡汤；脉虚浮散者微发其汗，用百解散。如果发热且呕吐，用小柴胡汤主治。虚热，表现为病后发热无固定时间，一天发作三五次，这是客热乘虚而入所致，先用胃苓汤加黄连末，用温米汤调服，接着投予钱乙的白术散，或固真汤，带凉服用，并用温盐汤，掺入凉水送服黑锡丹，以固守元气。
骨蒸热，表现为身体虚弱消瘦，每晚发作两次，有热无寒，醒来后口渴出汗才停止，这是疳病的余毒，传变为骨蒸，或者腹内有癖块，有时轻微疼痛，用参苓白术散，加生姜、大枣，用三棱煎汤调服，或者投用化癖丸，先治疗脾虚宿食停滞，再用柴胡饮治疗，仍然忌食鸡肉、酒类、羊肉、面条等毒物。
有些小儿热证在使用表里药后，热势全部消退，既已消退却又复热的，为什么呢？治疗疾病到了这一步，难以一概列举，或者再次解表攻里，或者施用凉剂，热势反而加重，需要用阴阳理论来辨别，哪种是正确的。推究其根源，乃是表里俱虚，阳气浮越于外，阴气伏藏于内，所以又发热，宜用温平的药物调和其里，则体表热自然消除。投予钱乙的白术散，去掉木香加入扁豆，水煎服，以及黄芪六一汤、安神散，自然平复。如果日久汗多，烦渴食减，脉象微缓，喜欢喝热水，可服用真武汤，虽然附子性温，取其收敛阳气的作用，方内有芍药性寒，一寒一温，比例得当，使用没有不灵验的。
Zhang Zhongjing stated: There is "xi xi" (feather-like) fever and "zheng zheng" (steaming) fever; this distinguishes the different applications of sweating (diaphoresis) and purging methods. "Xi xi" fever, resembling the warmth under a feather cover, indicates that the heat is in the exterior (biao), belonging to the first syndrome of Taiyang disease (Taiyang Exterior Syndrome), treated primarily with Guizhi Tang (Cinnamon Twig Decoction). "Zheng zheng" fever, intense like steaming, indicates that the heat is in the stomach (wei), belonging to the thirty-second syndrome of Yangming disease (Yangming Interior Syndrome), treated by purging with Tiaowei Chengqi Tang (Stomach-Regulating Purgative Decoction). This is Zhang Zhongjing's method.
Because pediatric febrile conditions appear similar but are actually different, superficially identical yet substantively distinct. There are cold damage fever (Shanghan re), bianzheng fever, accumulated heat fever, madou fever (fever resembling early-stage smallpox/measles), jingfeng fever (convulsive fever), tidal fever, bone-steaming fever; there is also fever due to simultaneous deficiency of the interior and exterior. Although the symptom of fever is the same, the names differ; must one not clearly distinguish the root and branch to apply treatment? One must verify the symptoms and medicate according to the syndrome; this is the accurate principle.
Cold damage fever presents with slightly cold fingertips, clear nasal discharge, fever without sweat, a pale and trembling facial expression, and purple markings on the right cheek. The treatment method is recorded in the Cold Damage chapters. Bianzheng fever presents with mild low-grade fever, coarse breathing but less fright, yellow loose stools, and small blisters on the tip of the upper lip like water beads; this is bianzheng fever, requiring no medicinal intervention. If accompanied by other syndromes, one should provide slight harmonization based on the contracted pathogen, without using heavy doses. "Bian" refers to changing appearance; "zheng" refers to steaming and growing muscles. Every 32 days constitutes one "bian"; every 64 days constitutes one "zheng". Furthermore, the three major "zhengs" accumulate over 512 days; upon completion of bianzheng, the form, qi, blood, pulse, sinews, and bones are fully developed. Regarding the theory of bianzheng, further examination of Chen Shi's book from the Ming Dynasty records five types of steaming within ten changes. Adding the three major steams, the total count is exactly 512 days, which is most clear.
Accumulated heat fever presents with swollen eyelids, sallow complexion, cold feet, fever intensifying from head to abdomen, nausea upon smelling food, abdominal pain, and vomiting. The treatment method is detailed in the Treatise on Food Stagnation. Madou fever presents with red face, cold feet, severe body heat, yawning and chest stuffiness, cough and lower back pain, occasional惊悸 (palpitations/fright), abdominal pain with spontaneous diarrhea, and isolated coldness of the middle finger. The treatment method is detailed in the Chapters on Eruptions. Jingfeng fever presents with generalized shiny fever, spontaneous sweating, palpitations and restlessness, rapid pulse, and irritability. The treatment is the same as for acute jingfeng (convulsion) syndromes. Medications used must first resolve the exterior.
Tidal fever presents with fever in the afternoon or during the You hour (5-7 PM), occurring regularly like the tide, unrelieved. First use Baijie San (Hundred-Resolution Powder) to release the exterior, then treat with Danggui San (Angelica Powder) and Sansanjie San (Three-Resolutions Powder). If the pulse is excess, purge it; Da Chaihu Tang (Major Bupleurum Decoction) is suitable. If the pulse is deficient, floating, and scattered, induce slight sweating with Baijie San. If fever is accompanied by vomiting, Xiao Chaihu Tang (Minor Bupleurum Decoction) is indicated.
Deficiency fever presents with irregular fever after illness, occurring three to five times a day; this is exogenous heat taking advantage of deficiency. First, administer Weiling Tang (Stomach-Lining Decoction) with added Huanglian (Coptis Rhizome) powder, mixed with warm rice water. Next, administer Qian Yi's Baizhu San (Atractylodes Macrocephala Powder) or Guzhen Tang (Solidify True Decoction), taken cool. Also, use warm salt water mixed with cool water to send down Heixi Dan (Black Tin Pill) to consolidate Yuan Qi (Primordial Qi).
Bone-steaming fever presents with emaciation and weakness, two episodes per evening, heat without chills, thirst and sweating only after waking. This is the residual toxin of Gan disease (malnutrition/parasitic disease) transmitting into bone-steaming, or abdominal masses (pi kuai) causing occasional mild pain. Use Shenling Baizhu San (Ginseng, Poria, and Atractylodes Macrocephala Powder) with ginger and jujube, mixed with Sanleng decoction (Sparganium decoction); or administer Huapi Wan (Mass-Resolving Pill). First treat spleen deficiency and retained stagnation, then treat with Chaihu Yin (Bupleurum Drink). Avoid toxic foods such as chicken, alcohol, mutton, and noodles.
Why does fever return after subsiding following the administration of interior-exterior resolving medicines in pediatric heat syndromes? Treatment at this stage cannot be summarized generally; whether re-resolving the exterior and purging the interior, or applying cooling agents, may cause the heat to worsen. One must differentiate using Yin and Yang theory to determine correctness. Tracing the origin, it is due to simultaneous deficiency of the interior and exterior, with Yang floating outward and Yin hiding inward, thus causing recurrent fever. It is appropriate to use warm and neutral medicines to harmonize the interior, so that body heat naturally eliminates. Administer Qian Yi's Baizhu San, removing Muxiang (Vladimiria Root) and adding Doukou (Amomum Fruit), decocted in water; along with Huangqi Liuyi Tang (Astragalus Six-to-One Decoction) and Anshen San (Spirit-Calming Powder), leading to natural recovery. If prolonged sweating leads to irritability, thirst, reduced appetite, faint and slow pulse, and preference for hot drinks, Zhenwu Tang (True Warrior Decoction) can be taken. Although Fuzi (Prepared Aconite Root) is warm, it is used for its ability to consolidate Yang Qi; inside, Shaoyao (Peony Root) is cold. With one cold and one warm, balanced appropriately, its efficacy is invariably verified.