前贤议曰∶小儿证候，最易虚易实，要施治得宜，如隆暑戒用附子，隆寒戒用大黄。
若用之，是实实虚虚，损不足而益有余。此亦理到之论。以愚评之，拘一法者，不足以
善兵，泥一说者，不足以善学，在乎通变而已。记尝城居，侯自牧次子五岁，盛夏泄泻，
面垢烦渴，耳尻冷，惊悸多，诊其心肝脉浮而洪大，脾肺脉虚而细数，予曰∶面垢渴泻，
脉虚细数者，此中暑也。惊悸发热，耳尻俱冷，心肝脉洪大者，此豆疮欲作也。先服黄
连香藿散，解利暑气，续投陈氏异功散，再加附子，与之实脾，二日泻止，三日疮见，不
旬余而收全功。此隆暑用附子之效也。又本路总管杨侯幼子四岁，腊月得患惊风搐掣，诸
医调治，前证俱解，但神昏不食，四肢微冷，已五日矣，前医用醒脾助阳之药，不一而足。
余诊六脉，独脾脉沉滑，余脉微缓，脾脉沉而滑者，此积蕴在脾，乃为脾约，当主大便不利，非阴厥也。彼曰∶然。遂
用泻黄散加大黄，水煎，并三服，大府一通，神气清而饮食进，随获安可。此隆寒用大黄之功也。用
药如用兵，当用岂容自已，如五月渡沪，雪夜平蔡何待秋高马肥而后为之。若拘以四时
取用，则兵药无成功矣。愚不敏，历医五十余载，凡调理旬月外婴孩有病，所用寒凉温
燥之剂，必先明标本，辨虚实，然后处之以药，屡试辄效，此特又在察色听声，心诚求
之而得，非假脉取。三岁之上小儿，以色合脉。尤其为妙。尝用已验活法。拯疗诸疾，危
而复安者多矣。姑以杨侯二家疑难之证，详述于前，非矜能也。
前代贤人议论说：小儿的证候，最容易表现为虚证或实证，治疗必须得当。就像盛夏酷暑时忌讳使用附子，严冬严寒时忌讳使用大黄一样。
如果违背这一原则使用，就是使实证更实、虚证更虚，损害本已不足的正气而增加邪气的有余。这也是合乎道理的精辟论述。
依我评价而言，拘泥于一种方法的人，不足以善于用兵；固守一种说法的人，不足以善于治学，关键在于懂得通融变化罢了。
我曾居住在城中，侯自牧的次子五岁，盛夏时节患泄泻，面色垢浊、烦躁口渴，耳朵和尾骶部发冷，惊悸频繁。
诊察其心脉和肝脉浮取洪大，脾脉和肺脉虚弱而细数。我说：面色垢浊、口渴、泄泻，脉象虚弱细数的，这是中暑。
惊悸、发热，耳朵和尾骶部都冷，心脉和肝脉洪大的，这是痘疮即将发作的表现。
先服用黄连香薷散（Huanglian Xiangru San），以解除暑热之气，接着投予陈氏异功散（Chen Shi Yigong San），再加附子（Fuzi, Aconite Lateralis Radix Preparata）来温补脾土。
两天后泄泻停止，三天后痘疮发出，不到十天便取得了痊愈的效果。这就是盛夏使用附子的功效。
又同路总管杨侯的小儿子四岁，腊月里患上惊风抽搐，各位医生调理治疗，前面的症状都解除了，但神志昏迷、不能进食，四肢微冷，已经五天了。
前医使用了醒脾助阳的药物，不止一次。
我诊察六部脉象，只有脾脉沉滑，其余脉象微缓。脾脉沉而滑的，这是积滞蕴结在脾脏，属于脾约（Pi Yue, Spleen Restriction），应当主诉大便不通利，并非阴寒厥逆。
他说：对。于是使用泻黄散（Xiehuang San）加大黄（Dahuang, Rheum Palmatum Rhizoma），水煎服，共三剂，大便一通，神志清爽且饮食进用，随即获得安宁。
这就是严冬使用大黄的功效。
用药如同用兵，应当使用时岂容犹豫？就像五月渡泸水、雪夜平定蔡州，何必等到秋高气爽、马匹肥壮之后才行动呢？
如果拘泥于四季的常规取用法则，那么军队和药物都无法取得成功。
我资质愚钝，行医五十多年，凡是调理超过旬月的婴儿患病，所使用的寒凉或温燥药剂，必定先明确标本，辨别虚实，然后处方用药，屡试屡效。
这特别在于观察面色、听取声音，诚心探求而得到的经验，并非单纯依靠脉诊。
对于三岁以上的儿童，结合面色与脉象诊断，尤其为妙。
我曾经使用已验证的有效方法，救治各种疾病，使危重病情转危为安的案例很多。
姑且将杨侯两家疑难的病例详细叙述在前面，并不是为了炫耀才能。
The sages of old discussed: The syndromes in children are prone to both deficiency and excess; treatment must be appropriate. Just as one should avoid using Fuzi (Aconite Lateralis Radix Preparata) during the height of summer heat, and avoid using Dahuang (Rheum Palmatum Rhizoma) during the depth of winter cold.
If these are used contrary to this principle, it constitutes "reinforcing the excess and depleting the deficiency," damaging what is insufficient and benefiting what is already excessive. This is also a sound argument based on reason.
In my evaluation, those who adhere rigidly to a single method are not sufficient for managing warfare; those who stick strictly to a single theory are not sufficient for mastering learning. The key lies in understanding flexibility and adaptation.
I once resided in the city. Hou Zimu's second son, aged five, suffered from diarrhea in midsummer. He presented with a dirty complexion, irritability, thirst, cold ears, and a cold sacrum, along with frequent palpitations and fright.
Palpation revealed that his Heart and Liver pulses were floating and surging-large, while his Spleen and Lung pulses were deficient, fine, and rapid. I said: A dirty complexion, thirst, and diarrhea with deficient, fine, and rapid pulses indicate Summerheat invasion (Zhongshu).
Palpitations, fever, coldness of the ears and sacrum, and surging-large Heart and Liver pulses indicate that smallpox (Douchuang) is about to erupt.
First, administer Huanglian Xiangru San (Coptis and Elsholtzia Decoction) to resolve the summerheat pathogen. Subsequently, administer Chen Shi Yigong San (Master Chen's Extraordinary Efficacy Powder), adding Fuzi (Aconite Lateralis Radix Preparata) to strengthen the Spleen.
After two days, the diarrhea ceased; after three days, the eruptions appeared. Within ten days, full recovery was achieved. This demonstrates the efficacy of using Fuzi in midsummer.
Furthermore, the young son of Marshal Yang, aged four, contracted convulsive wind (Jingfeng) in the twelfth lunar month. Various physicians treated him, resolving the initial symptoms, but he remained comatose, anorexic, with slightly cold limbs for five days.
Previous doctors had administered numerous doses of herbs to awaken the Spleen and assist Yang.
Upon palpating the six pulses, only the Spleen pulse was deep and slippery, while the other pulses were faint and moderate. A deep and slippery Spleen pulse indicates accumulation stagnation within the Spleen, constituting Pi Yue (Spleen Restriction), which typically presents with difficulty in defecation, rather than Yin Cold Jue (Yin Jue, Yin-type Reversal Cold).
He agreed. Thus, Xiehuang San (Drain the Yellow Powder) was prescribed with added Dahuang (Rheum Palmatum Rhizoma), decocted in water. After three doses, the bowels moved freely, consciousness cleared, appetite returned, and peace was restored.
This demonstrates the merit of using Dahuang in deep winter.
Using medicine is like using troops; when application is necessary, hesitation is unacceptable. It is akin to crossing the Lu River in May or pacifying Caizhou on a snowy night; why wait for autumn when the weather is crisp and horses are fat?
If one rigidly adheres to seasonal conventions for usage, neither armies nor medicines will achieve success.
Though I am dull-witted, having practiced medicine for over fifty years, whenever treating infants ill for more than ten days, whether using cooling or warming-drying formulas, I first clarify the root and branch, differentiate deficiency and excess, and then prescribe medication. These attempts have repeatedly proven effective.
This expertise is derived particularly from observing complexion and listening to voice, seeking sincerely through mental engagement, rather than relying solely on pulse diagnosis.
For children above three years of age, combining complexion observation with pulse diagnosis is especially excellent.
I have employed these verified methods to treat various diseases, rescuing many critical cases to safety.
I briefly detail the difficult cases of the two families mentioned above, not to boast of my skills.