五硬者，仰头取气，难以动摇，气壅作痛，连于胸膈，脚手心冷而硬，此阳气
不营于四末也。经曰∶脾主四肢。又曰∶脾主诸阴。今手足冷而硬者，独阴无阳也，
故难治。若肚筋青急者，木乘土位也，急用六君子汤加炮姜、肉桂、柴胡、升麻，
以复其真气，若系风邪，当参惊风治之。此证从肝脾二脏受患，当补脾平肝，仍参
急慢惊风门治之。《百问》云，如审系风证，根据中风治之，必有回生之理，小续命汤加减。
小续命汤 治中风不省人事，涎鸣反张，失音厥冷。
麻黄（去节） 人参 黄芩 川芎 芍药 甘草（炙） 杏仁（去皮尖，炒） 汉防己 官桂（去皮。
各半两） 防风（七钱半） 附子（炮，去皮脐，七钱半）
上，除附子、杏仁外，捣为粗末，次入二味夹和。每一钱，姜枣煎，食前服。
有热去附子，官桂减半。
经云∶诸暴强直，皆属于风，故收此方，非的风证勿用。
凡寒热往来无定期，其有定期者，疟也。巢氏曰∶风邪外客于皮肤，而痰饮
内渍于腑脏，致令血气不和，阴阳更相乘克，阳胜则热，阴胜则寒，阴阳之气，为
邪所乘，邪与正相干，阴阳交争，时发时止，则寒热往来也。《全生指迷》论曰∶
若其人翕翕如热，淅淅如寒，无有时度，支节如解，手足酸疼，头目昏晕，此由荣
卫虚弱，外为风邪相乘，搏于阳则发热，搏于阴则发寒，久不治，成劳。宜荆芥散。
又曰∶若寒热如疟，不以时度，肠满膨 ，起则头晕，大便不通，或时腹痛，胸膈
痞闷，此由宿谷停留不化，结于肠间，气道不舒，阴阳交乱，宜备急丸。经曰∶
阳虚则外寒，阴虚则内热，阳盛则外热，阴盛则内寒，寒热往来，此乃阴阳相胜也，
故寒气并于阴则发寒，阳气并于阳则发热，寸口脉微为阳不足，阴气上入阳中则恶
寒，尺脉弱为阴不足，阳气下入阴中则发热，阳不足则先寒后热，阴不足则先热后
寒，阴阳不归其分，则寒热交争也。又，上盛则发热，下盛则发寒，阳盛则乍热，
阴盛则乍寒，阴阳相胜，虚实不调，故邪气更作，而寒热往来，或乍寒乍热也。少
阳胆者，肝之府，界乎太阳、阳明之间，半表半里之分，阴阳之气，易于相乘，故
寒热多主肝胆经证，以小柴胡汤加减调之。若只见寒热，起居如常，久而不愈，及
大病后元气未复，悉属阴虚生热，阳虚生寒，宜用八珍汤（虚羸）补之，甚者十全大补汤
（汗）。有食积为病，亦令寒热，用保和丸（宿食）消之，若兼呕吐泄泻用六君子汤（吐泻），厥冷
饮热，人参理中丸（泻）；作渴不止，七味白术散（渴）；食积既消而寒热尚作者，肝邪乘脾，
所胜侮所不胜也，用异功散（吐泻）加柴胡、山栀。其疟证寒热详见疟门。
〔汤〕食积寒热如疟，渴泻气急，要合地卧。此候先当取下积，只用平胃散，次
常服进食丸。（平胃散、见不乳食，进食丸，见积。）
〔钱〕曹宜德子三岁，面黄时发寒热，不欲食而饮水及乳不止。众医以为潮热，
用牛黄丸不愈，及以止渴干葛散，服之反吐。钱曰当以白饼子下之，后补脾，乃以
消积丸磨之，此乃解也，后果愈。何以故？不食但饮水者，食伏于脾内不能消化，
致令发寒热，用止渴药吐者，药冲脾故也，故下之即愈。
〔子和〕高巡检子八岁，病热，医者皆为伤冷，治之以热药。欲饮冰水，禁而不
与，内水涸竭，烦躁转生，前后皆闭，口鼻俱干，寒热往来，咳嗽时作，遍身无汗。
又欲灸之。适遇戴人，戴人责其母曰，重 浓被，暖炕红炉，儿已不胜其热，尚可
灸乎。其母谢以不明。戴人令先服人参柴胡饮子，遂连进数服，下烂鱼肠之类，臭
气异常，渴欲饮水，听其所欲，冰雪冷水连进数杯，节次又下三四十行，大热方去，
又与通膈丸、牛黄丸，复下十余行，儿方大痊。前后约五十余行，略计所用冰雪水
饮计一斛，向灸之，当何如哉。
太医局小柴胡汤 治大人小儿伤寒温热病，身热恶风，颈项强急，胸满胁痛，呕哕烦
渴，寒热往来，身面皆黄，小便不利，大便秘硬，或过经未解，或潮热不除，及
瘥后劳复，发热头痛，妇人伤风，头痛烦热，经血适断，寒热如疟，发作有时，
及产后伤风，头痛烦热，并宜服之。
柴胡（去芦头秤半斤） 黄芩 人参（去芦头秤） 甘草（炙。各三两） 半夏（汤洗七次，焙干秤二两半）
上五味，同为粗末。每服三大钱，以水一盏半，入生姜五片，枣一枚擘破，同
煎至七分，滤去滓，稍热服，不拘时，小儿分作二服，更量大小加减。
〔张涣〕秦艽汤 治小儿寒热往来。
秦艽（去苗） 鳖甲（醋炙微黄，去裙 各一两） 川大黄（锉碎，微炒） 麻黄（去根节。各半两） 竹茹 甘
草（炙。各一分）
上件捣，罗为粗散，每服一钱，水一盏，入葱白二寸，同煎至五分，去滓温服，量儿大小加减。
人参前胡散
人参（去芦头） 前胡 柴胡（去苗。各一两） 桔梗 地骨皮 甘草（炙） 半夏（汤洗七遍，焙干。各半两）
上件捣，罗为细末，每服一大钱，水一小盏，入生姜二片，煎至半盏，去滓放
温服，量儿大小加减。
芍药汤
赤芍药（一两） 黄芩 当归（锉，焙干） 柴胡（各半两） 肉桂 甘草（炙，各一分）
上件捣，罗为细末。每服一钱，水八分一盏，入生姜二片，枣一枚，同煎至五
分，去滓温服，量儿加减。
《王氏手集》柴胡人参汤 治小儿脾热生风，往来寒热（子和柴胡饮子有黄芩、大黄、当归，无茯苓）
柴胡 人参 芍药 茯苓 甘草（炙。各等分）
上每服二钱，水一盏，入生姜三片，煎至四分，温服。
《全生指迷》荆芥散
荆芥穗 人参 白术 当归（切、洗，焙） 黄 芍药 桂（去粗皮。各一两） 柴胡（去苗，二两） 甘草（炙，
半两）
上为粗末。每服五钱，水二盏，煎至一盏，去滓温服。
《全生指迷》备急丸
大黄（湿纸裹，煨） 巴豆（去皮心，去油） 干姜（去皮。各等分）
上为细末，炼蜜和丸，如豌豆大。每服一丸，米饮下。羸人服一丸如绿豆大，
以大便快利为度。
《千金》治小儿生一月至五月乍寒乍热方
上细切柳枝煮取汁洗儿，若渴，绞冬瓜汁饮之。
《水鉴》孩子百日内忽有寒热，何以治之。与冷药吃，即乳寒呕逆，若与热药治
之，其病加甚，无神法圣术，因循丧儿之命，博览石室秘方，用之应妙，歌云∶
桃花荫末一钱余，甘草冲汤力更殊，蓝花只消一两字（阴干），灌之入口立消除。上
三味为末，每服半钱，汤调灌之。
《庄氏家传》疗少小卒寒热不佳。不能服药，李叶浴儿方
上用李叶不拘多少，煮汤浴儿。（又白芷，又苦参。）
《玉诀》云，先调气，次解虚热，热不去，下真珠丸取。
真珠丸 治小儿寒热虚积，五脏烦满，及下风涎积滞，惊食疳积。
南星 半夏 滑石（各末，二钱） 轻粉（四钱匕） 巴豆（二七粒，去心油）
上末之，面糊丸芥子大。每服十五二十丸，煎葱汤吞下。
《婴孺》六味汤 治少小寒热进退，啼呼腹痛。
地黄 桂心（各八分） 芍药 寒水石 黄芩（炙） 甘草（炙。各二分）
上切细，以水三升，煮一升半。一岁儿二合至三合，量与服之。
大黄丸 疗小儿寒热，食不生肌肉。
大黄（一两，蒸之二斗米下） 桂心 干姜（炮。各二分） 巴豆（五十粒，去皮心，熬） 消石（三分，熬，无
者以芒硝代之）
上五味，捣筛四味，别捣巴豆令如泥，合和以蜜，更捣二千杵，丸如梧子。每
一丸，汤服之。但热在膈上当吐，在膈下当利，预作粥，如服他吐下丸法，
服药两食顷不吐下，以热饮动之，若不得吐下，可更服一丸半，能药壮人可二丸。
此药优于他下药丸，故宜大小。下多，冷粥解之。若有疮绵挺如指，蜜和一丸涂挺
头，旦内疮中，喁出之，不瘥更作。温病不得大便，服之得下佳，宿食不消，
亦服之。飞尸遁尸，浆服半丸，日一，应须臾止。心腹胀满痛，服一丸。疟者，
根据发日，先宿勿食，清晨服一丸，丁壮人服二丸，得吐下，忍饥，过发时乃
食。妇人产后血结中奔，走起上下，或绝产无子，或月经不调，面目青黄，服半
丸。小儿淋沥寒热，胪胀大腹，不欲食，食不生肌，三四岁如麻子大一丸，日一
服，六七岁儿服二丸，比三十日，心腹诸病瘥，儿小半之，愈，大良。忌野猪肉、芦笋、生葱。
按∶病儿若无实积，或有积而虚，皆不宜用此，若疳劳一路，自当求之肥儿之属。
《圣惠》柴胡散 治小儿寒热往来，乳食不下，四肢无力，心腹胀满，上焦痰壅，渐渐羸瘦。
柴胡（去苗） 鳖甲（涂醋炙令黄色，去裙 。各一两） 人参 前胡 桔梗 诃梨勒皮 地骨皮
赤芍药 杏仁（汤浸，去皮尖双仁，麸炒微黄） 甘草（炙，微赤） 陈橘皮（汤浸，去白，焙。各半两）
上件药捣，筛为散，每服一钱，水一小盏，煎至五分，去滓，不计时候温服，量儿大小加减。
五味子散 治小儿寒热往来，不欲乳食，羸瘦心胀。
五味子 当归（锉碎，微炒） 人参 桔梗 前胡（各去芦头） 白术 赤茯苓 黄芩（各用一分）
甘草（半分，炙微赤，锉） 麦门冬（半两，去心，焙）
上件药捣，粗罗为散。每服一钱，以水一小盏，煎至五分，去滓温服，日三四
服，更量儿大小，以意加减。
人参散 治小儿寒热往来，食少羸瘦。
人参（去芦头） 黄 （锉） 柴胡（去苗） 白茯苓 鳖甲（涂醋炙令黄，去裙 ） 木香（各半两） 甘草
（炙微赤，锉） 白术 桃仁（汤浸，去皮尖双仁，麸炒微黄。各一分） 诃梨勒皮（三分）
上件药捣，细罗为散。不计时候以粥饮调下半钱，量儿大小加减服之。
黄 丸 治小儿往来寒热，多汗心烦，小便赤黄，不欲乳食，四肢羸瘦。
黄 （锉） 麦门冬（去心，焙） 赤茯苓 白术 子芩 甘草（各一分） 柴胡（去苗） 鳖甲（涂醋炙令
黄，去裙 。各半两）
上件药捣，罗为末，炼蜜和丸如绿豆大。每服以粥饮下五丸，日三四服，量儿大小加减。
张涣香甲散 治寒热往来肌瘦。
鳖甲（酥炙黄，去裙 ） 木香（各一两） 川大黄（微炒） 陈橘皮（去白，焙干） 当归（洗，焙干） 柴胡
（去苗） 知母 甘草（炙。各半两） 槟榔（三枚）
上件捣，罗为粗散。每服一钱，水一小盏，入生姜二片，煎至六分，去滓温服，
量儿大小加减。
五硬，是指患儿头项强直仰起以寻求呼吸之气，身体难以转动摇动，气机壅滞而疼痛，牵连至胸膈部位，手足心发冷且僵硬，这是由于阳气不能温煦四肢末端所致。《内经》说：脾主司四肢。又说：脾统摄诸阴经。如今手足冰冷且僵硬，这是独阴无阳的表现，所以难以治疗。如果腹部筋脉青紫且紧急，这是肝木乘克脾土的表现，应当急用六君子汤加入炮姜、肉桂、柴胡、升麻，来恢复其真气；如果是风邪所致，应当参照惊风的方法治疗。此证是从肝、脾两脏受病，应当补益脾脏、平抑肝脏，并参考急惊风和慢惊风的章节进行治疗。《百问》说：如果确实属于风证，按照中风的方法治疗，一定有起死回生的道理，可用小续命汤加减。
小续命汤：治疗中风导致不省人事，喉间痰鸣，角弓反张，失音，四肢厥冷。
药材：麻黄（去除节）、人参、黄芩、川芎、芍药、甘草（炙）、杏仁（去皮尖，炒）、汉防己、官桂（去皮）。以上各半两；防风（七钱半）；附子（炮制，去皮脐，七钱半）。
制法与服法：除附子、杏仁外，将其他药物捣成粗末，然后将这两味药夹在其中混合。每次取一钱，加生姜、大枣煎煮，饭前服用。如果有热象，去掉附子，官桂减半。
《内经》说：所有突然发生的肢体强直，都属于风邪，所以收录此方，如果不是风证不要使用。
凡是寒热往来没有固定时间的，如果有固定时间发作的，就是疟疾。巢元方说：风邪外部客居于皮肤，而痰饮内部浸渍于脏腑，导致血气不和，阴阳互相乘克，阳胜则发热，阴胜则发冷，阴阳之气被邪气所乘，邪气与正气相干扰，阴阳交争，时发时止，这就是寒热往来。《全生指迷》论述说：如果患者感觉像发热一样翕翕然，又像怕冷一样淅淅然，没有固定的时间规律，四肢关节像要散开一样，手足酸痛，头目昏晕，这是由于营卫虚弱，外部被风邪乘虚而入，邪气搏结于阳分则发热，搏结于阴分则发冷，久治不愈会形成劳损。宜用荆芥散。又说：如果寒热像疟疾一样，没有固定时间，腹部胀满膨隆，起身时头晕，大便不通，有时腹痛，胸膈痞闷，这是由于宿食停留不能消化，结聚在肠间，气道不畅，阴阳紊乱，宜用备急丸。《内经》说：阳虚则体表寒冷，阴虚则体内发热，阳盛则体表发热，阴盛则体内寒冷，寒热往来，这是阴阳互相胜负的结果，所以寒气并入阴分则发冷，阳气并入阳分则发热，寸口脉微表示阳气不足，阴气上入阳中则恶寒，尺脉弱表示阴气不足，阳气下入阴中则发热，阳气不足则先冷后热，阴气不足则先热后冷，阴阳不能各归其位，就会发生寒热交争。另外，上部盛则发热，下部盛则发冷，阳盛则乍热，阴盛则乍寒，阴阳互相胜负，虚实不调，所以邪气更替发作，出现寒热往来，或忽冷忽热。少阳胆经，是肝之府，介于太阳、阳明之间，属于半表半里的部位，阴阳之气容易互相乘克，所以寒热多主要属于肝胆经的证候，用小柴胡汤加减调理。如果只见寒热，起居如常，久而不愈，以及大病之后元气未恢复，都归属于阴虚生热、阳虚生寒，宜用八珍汤（针对虚羸）补益，严重的用十全大补汤（针对汗出过多）。有食积致病，也会导致寒热，用保和丸（针对宿食）消导；如果兼有呕吐泄泻用六君子汤（针对吐泻），四肢厥冷想喝热水用人参理中丸（针对腹泻）；口渴不止用七味白术散（针对口渴）；食积已经消除但寒热仍然发作的，是肝邪乘脾，即所胜者侮所不胜，用异功散（针对吐泻）加柴胡、山栀。疟疾证的寒热详见疟疾门。
〔汤〕食积引起的寒热像疟疾，伴有口渴、腹泻、气急，需要合地卧（一种体位或疗法描述，此处保留原意或略去具体动作，侧重症状）。此候应当先用攻下法去除积滞，只用平胃散，然后常服进食丸。（平胃散见“不乳食”条，进食丸见“积”条。）
〔钱乙〕曹宜德的儿子三岁，面色发黄，时常发寒热，不想吃东西却不停地喝水及吃奶。众医生认为是潮热，用牛黄丸治疗无效，又用止渴干葛散，服用后反而呕吐。钱乙说应当用白饼子攻下积滞，之后再补脾，于是用消积丸磨积，这才是正确的解法，后果然痊愈。为什么这样呢？不吃东西只喝水，是因为食物伏匿在脾内不能消化，导致发寒热，用止渴药导致呕吐，是因为药物冲激脾胃的缘故，所以攻下积滞就能痊愈。
〔张子和〕高巡检的儿子八岁，患热病，医生都认为是伤冷，用热药治疗。孩子想喝冰水，被禁止不给，导致体内津液枯竭，烦躁加重，大小便皆闭塞，口鼻干燥，寒热往来，咳嗽不时发作，全身无汗。又想给他艾灸。恰好遇到戴人（张子和号），戴人责备他的母亲说：“包裹厚重的被子，暖炕红炉，孩子已经受不了这种热，还可以艾灸吗？”母亲道歉说不明白。戴人让先服人参柴胡饮子，连续进服几剂，拉出像烂鱼肠一样的东西，气味异常臭秽，口渴想喝水，听任他想要什么就喝，冰雪冷水连进数杯，接着又拉了三四十次，大热才退，又给予通膈丸、牛黄丸，又拉了十多次，孩子才完全康复。前后大约五十多次，总计所用的冰雪饮水约一斛，如果当时艾灸，会怎么样呢？
太医局小柴胡汤：治疗大人小儿伤寒温热病，身体发热恶风，颈项强直紧急，胸满胁痛，呕哕烦渴，寒热往来，身面皆黄，小便不利，大便秘硬，或者经过传变期仍未解除，或者潮热不退，以及病愈后因劳累复发，发热头痛，妇人伤风，头痛烦热，月经刚断，寒热像疟疾，发作有定时，以及产后伤风，头痛烦热，都适宜服用。
药材：柴胡（去芦头，秤半斤）、黄芩、人参（去芦头，秤）、甘草（炙，各三两）、半夏（汤洗七次，焙干，秤二两半）。
制法与服法：以上五味药，一起捣成粗末。每次服三大钱，用水一盏半，加入生姜五片，枣一枚掰破，同煎至七分，滤去药渣，稍热服用，不拘时间，小儿分两次服，再根据年龄大小加减。
〔张涣〕秦艽汤：治疗小儿寒热往来。
药材：秦艽（去苗）、鳖甲（醋炙微黄，去裙襕，各一两）、川大黄（锉碎，微炒）、麻黄（去根节，各半两）、竹茹、甘草（炙，各一分）。
制法与服法：以上药物捣碎，过筛成粗散，每次服一钱，水一盏，加入葱白二寸，同煎至五分，去滓温服，根据孩子大小加减。
人参前胡散：
药材：人参（去芦头）、前胡、柴胡（去苗，各一两）、桔梗、地骨皮、甘草（炙）、半夏（汤洗七遍，焙干，各半两）。
制法与服法：以上药物捣碎，过筛成细末，每次服一大钱，水一小盏，加入生姜二片，煎至半盏，去滓放温服，根据孩子大小加减。
芍药汤：
药材：赤芍药（一两）、黄芩、当归（锉，焙干）、柴胡（各半两）、肉桂、甘草（炙，各一分）。
制法与服法：以上药物捣碎，过筛成细末。每次服一钱，水八分一盏，加入生姜二片，枣一枚，同煎至五分，去滓温服，根据孩子大小加减。
《王氏手集》柴胡人参汤：治疗小儿脾热生风，往来寒热（子和柴胡饮子有黄芩、大黄、当归，无茯苓）。
药材：柴胡、人参、芍药、茯苓、甘草（炙，各等分）。
制法与服法：每次服二钱，水一盏，加入生姜三片，煎至四分，温服。
《全生指迷》荆芥散：
药材：荆芥穗、人参、白术、当归（切、洗，焙）、黄芪、芍药、桂（去粗皮，各一两）、柴胡（去苗，二两）、甘草（炙，半两）。
制法与服法：以上为粗末。每次服五钱，水二盏，煎至一盏，去滓温服。
《全生指迷》备急丸：
药材：大黄（湿纸裹，煨）、巴豆（去皮心，去油）、干姜（去皮，各等分）。
制法与服法：以上为细末，炼蜜和丸，如豌豆大。每次服一丸，米饮送下。瘦弱的人服一丸如绿豆大，以大便通畅为度。
《千金》治疗小儿出生一个月至五个月忽然忽冷忽热的方子：
以上细切柳枝煮取汁清洗孩子，如果孩子口渴，绞冬瓜汁饮用。
《水鉴》孩子百日内忽然有寒热，怎么治疗？给冷药吃，就会因乳汁寒凉而呕吐逆乱，如果用热药治疗，病情会加重，如果没有神妙法术，因循守旧会丧儿性命，博览石室秘方，使用应验奇妙，歌诀说：桃花荫末一钱余，甘草冲汤力更殊，蓝花只消一两字（阴干），灌之入口立消除。以上三味为末，每次服半钱，汤调灌服。
《庄氏家传》疗治少小突然寒热不佳。不能服药，李叶浴儿方：
以上用李叶不拘多少，煮汤浴儿。（又有白芷，又有苦参。）
《玉诀》说：先调气，其次解虚热，热不去，用真珠丸攻下取之。
真珠丸：治疗小儿寒热虚积，五脏烦满，以及下焦风涎积滞，惊食疳积。
药材：南星、半夏、滑石（各研末，二钱）、轻粉（四钱匕）、巴豆（二七粒，去心油）。
制法与服法：以上研末，面糊丸如芥子大。每次服十五二十丸，煎葱汤吞下。
《婴孺》六味汤：治疗少小寒热进退，啼呼腹痛。
药材：地黄、桂心（各八分）、芍药、寒水石、黄芩（炙）、甘草（炙，各二分）。
制法与服法：以上切碎，用水三升，煮取一升半。一岁婴儿服二合至三合，根据情况服用。
大黄丸：治疗小儿寒热，饮食不生肌肉。
药材：大黄（一两，蒸之二斗米下）、桂心、干姜（炮，各二分）、巴豆（五十粒，去皮心，熬）、消石（三分，熬，无者以芒硝代之）。
制法与服法：以上五味药，捣筛四味，另捣巴豆令如泥，混合以蜜，再捣二千杵，丸如梧子大。每一丸，汤服之。但热在膈上当吐，在膈下当利，预先作粥，如服其他吐下丸法，服药两顿饭时间若不吐下，以热饮动之，若不得吐下，可更服一丸半，能药壮人可二丸。此药优于其他下药丸，故宜大小。下多，冷粥解之。若有疮绵挺如指，蜜和一丸涂挺头，旦内疮中，喁出之，不瘥更作。温病不得大便，服之得下佳，宿食不消，亦服之。飞尸遁尸，浆服半丸，日一，应须臾止。心腹胀满痛，服一丸。疟者，根据发日，先宿勿食，清晨服一丸，丁壮人服二丸，得吐下，忍饥，过发时乃食。妇人产后血结中奔，走起上下，或绝产无子，或月经不调，面目青黄，服半丸。小儿淋沥寒热，胪胀大腹，不欲食，食不生肌，三四岁如麻子大一丸，日一服，六七岁儿服二丸，比三十日，心腹诸病瘥，儿小半之，愈，大良。忌野猪肉、芦笋、生葱。
按：病儿若无实积，或有积而虚，皆不宜用此，若疳劳一路，自当求之肥儿之属。
《圣惠》柴胡散：治疗小儿寒热往来，乳食不下，四肢无力，心腹胀满，上焦痰壅，渐渐羸瘦。
药材：柴胡（去苗）、鳖甲（涂醋炙令黄色，去裙襕，各一两）、人参、前胡、桔梗、诃梨勒皮、地骨皮、赤芍药、杏仁（汤浸，去皮尖双仁，麸炒微黄）、甘草（炙，微赤）、陈橘皮（汤浸，去白，焙，各半两）。
制法与服法：以上药物捣，筛为散，每次服一钱，水一小盏，煎至五分，去滓，不计时候温服，量儿大小加减。
五味子散：治疗小儿寒热往来，不欲乳食，羸瘦心胀。
药材：五味子、当归（锉碎，微炒）、人参、桔梗、前胡（各去芦头）、白术、赤茯苓、黄芩（各用一分）、甘草（半分，炙微赤，锉）、麦门冬（半两，去心，焙）。
制法与服法：以上药物捣，粗罗为散。每次服一钱，以水一小盏，煎至五分，去滓温服，日三四服，更量儿大小，以意加减。
人参散：治疗小儿寒热往来，食少羸瘦。
药材：人参（去芦头）、黄芪（锉）、柴胡（去苗）、白茯苓、鳖甲（涂醋炙令黄，去裙襕）、木香（各半两）、甘草（炙微赤，锉）、白术、桃仁（汤浸，去皮尖双仁，麸炒微黄，各一分）、诃梨勒皮（三分）。
制法与服法：以上药物捣，细罗为散。不计时候以粥饮调下半钱，量儿大小加减服之。
黄芪丸：治疗小儿往来寒热，多汗心烦，小便赤黄，不欲乳食，四肢羸瘦。
药材：黄芪（锉）、麦门冬（去心，焙）、赤茯苓、白术、子芩、甘草（各一分）、柴胡（去苗）、鳖甲（涂醋炙令黄，去裙襕，各半两）。
制法与服法：以上药物捣，罗为末，炼蜜和丸如绿豆大。每服以粥饮下五丸，日三四服，量儿大小加减。
张涣香甲散：治疗寒热往来肌瘦。
药材：鳖甲（酥炙黄，去裙襕）、木香（各一两）、川大黄（微炒）、陈橘皮（去白，焙干）、当归（洗，焙干）、柴胡（去苗）、知母、甘草（炙，各半两）、槟榔（三枚）。
制法与服法：以上药物捣，罗为粗散。每次服一钱，水一小盏，加入生姜二片，煎至六分，去滓温服，量儿大小加减。
Wu Ying (Five Stiffnesses) refers to a condition where the infant's head and neck are stiffly extended backward to seek breath, the body is difficult to turn or move, qi stagnation causes pain extending to the chest and diaphragm, and the palms of the hands and soles of the feet are cold and stiff. This is due to Yang Qi failing to nourish the four extremities. The Classics state: "The Spleen governs the four limbs." It also states: "The Spleen governs all Yin meridians." Now, with cold and stiff hands and feet, this indicates an absence of Yang amidst Yin alone, making it difficult to treat. If the abdominal veins are blue and tense, it signifies Liver Wood overacting on Spleen Earth; one should urgently use Liu Jun Zi Tang (Six Gentlemen Decoction) added with Pao Jiang (Prepared Ginger), Rou Gui (Cinnamon Bark), Chai Hu (Bupleurum Root), and Sheng Ma (Cimicifuga Rhizome) to restore true Qi. If caused by Wind Pathogen, it should be treated referring to Jing Feng (Convulsion). This syndrome originates from pathology in the Liver and Spleen organs; treatment should tonify the Spleen and soothe the Liver, and refer to the sections on Ji Jing Feng (Acute Convulsion) and Man Jing Feng (Chronic Convulsion). "Bai Wen" states: If confirmed as a Wind syndrome, treating it according to Zhong Feng (Wind Stroke) will surely have life-saving effects; Xiao Xu Ming Tang (Minor Continuation of Life Decoction) can be used with modifications.
Xiao Xu Ming Tang treats Zhong Feng (Wind Stroke) causing unconsciousness, phlegm rattling in the throat, opisthotonos, aphonia, and cold limbs.
Ingredients: Ma Huang (Ephedrae Herba, removed nodes), Ren Shen (Ginseng Radix et Rhizoma), Huang Qin (Scutellariae Radix), Chuan Xiong (Ligustici Chuanxiong Rhizoma), Shao Yao (Paeoniae Radix), Gan Cao (Glycyrrhizae Radix et Rhizoma, honey-fried), Xing Ren (Armeniacae Semen Amarum, skin and tip removed, stir-baked), Han Fang Ji (Stephaniae Tetrandrae Radix), Guan Gui (Cinnamomi Cortex, bark removed), each half liang; Fang Feng (Saposhnikoviae Radix, seven qian half); Fu Zi (Aconiti Lateralis Radix Praeparata, processed, skin and navel removed, seven qian half).
Preparation and Administration: Except for Fu Zi and Xing Ren, crush the other herbs into coarse powder, then mix in the two specified ingredients. Take one qian per dose, decoct with Sheng Jiang (Zingiberis Rhizoma Recens) and Da Zao (Jujubae Fructus), take before meals. If there is heat, remove Fu Zi and reduce Guan Gui by half.
The Classics say: "All sudden stiffness belongs to Wind," hence this formula is included; do not use it if it is not a Wind syndrome.
Whenever chills and fever alternate without a fixed schedule, if they occur at fixed intervals, it is Nue (Malaria). Chao Yuanfang said: External Wind Pathogens lodge in the skin, while internal Phlegm-Fluids soak the zang-fu organs, causing disharmony of Blood and Qi, and mutual overaction of Yin and Yang. When Yang prevails, there is heat; when Yin prevails, there is cold. When the Qi of Yin and Yang is invaded by pathogens, and pathogens interfere with healthy Qi, Yin and Yang contend, appearing and disappearing intermittently, resulting in alternating chills and fever. "Quan Sheng Zhi Mi" discusses: If a person feels hot like a covering (Xi Xi) and cold like shivering (Xi Xi) without temporal regularity, joints feel loose as if disintegrating, hands and feet ache, and head and eyes are dizzy, this is due to deficiency of Ying (Nutritive) and Wei (Defensive) Qi, allowing external Wind Pathogens to invade. Contending with Yang causes heat; contending with Yin causes cold. Untreated for long, it becomes Lao (Consumption). Use Jing Jie San (Schizonepeta Powder). It also says: If chills and fever resemble Malaria without fixed timing, abdomen is full and distended, dizziness upon rising, constipation, occasional abdominal pain, and chest/diaphragm stuffiness, this is due to retained food failing to transform and knotting in the intestines, obstructing Qi flow and disrupting Yin-Yang. Use Bei Ji Wan (Emergency Pill). The Classics say: "Yang deficiency leads to external cold, Yin deficiency leads to internal heat; Yang excess leads to external heat, Yin excess leads to internal cold." Alternating chills and fever result from Yin and Yang mutually overcoming each other. Thus, Cold Qi merging with Yin causes cold; Yang Qi merging with Yang causes heat. A faint pulse at Cun Kou indicates insufficient Yang, with Yin Qi ascending into Yang causing aversion to cold; a weak pulse at Chi indicates insufficient Yin, with Yang Qi descending into Yin causing fever. Insufficient Yang leads to cold first then heat; insufficient Yin leads to heat first then cold. If Yin and Yang do not return to their respective positions, chills and fever contend. Furthermore, excess above causes heat, excess below causes cold; Yang excess causes intermittent heat, Yin excess causes intermittent cold. Due to mutual overcoming of Yin-Yang and imbalance of deficiency/excess, pathogens alternate attacks, causing alternating chills and fever or intermittent cold/heat. Shaoyang Gallbladder Meridian is the mansion of the Liver, situated between Taiyang and Yangming, in the half-exterior half-interior region, where Yin and Yang Qi easily overact. Thus, chills and fever mostly belong to Shaoyang/Liver-Gallbladder meridian syndromes, regulated by Xiao Chai Hu Tang (Minor Bupleurum Decoction) with modifications. If only chills and fever are present with normal daily activities, persisting for a long time, or after severe illness when Yuan Qi has not recovered, these all belong to Yin deficiency generating heat and Yang deficiency generating cold. Use Ba Zhen Tang (Eight Treasures Decoction) to tonify (for emaciation); for severe cases, Shi Quan Da Bu Tang (Ten Significant Tonification Decoction) (for sweating). Food retention disease also causes chills and fever; use Bao He Wan (Preserve Harmony Pill) to resolve (for retained food). If accompanied by vomiting and diarrhea, use Liu Jun Zi Tang (for vomiting/diarrhea); for cold limbs desiring warm drinks, use Ren Shen Li Zhong Wan (Ginseng Regulate Middle Pill) (for diarrhea); for unrelenting thirst, use Qi Wei Bai Zhu San (Seven-Ingredient Atractylodes Macrocephala Powder) (for thirst); if food retention is resolved but chills/fever persist, it is Liver pathogen attacking Spleen (overacting on what it cannot overcome); use Yi Gong San (Yi Palace Powder) added with Chai Hu and Shan Zhi (Gardeniae Fructus). See the Malaria section for detailed Nue chills/fever.
[Tang] For food retention causing malaria-like chills/fever with thirst, diarrhea, and rapid breathing, lie flat on the ground. This condition requires first purging the retention using only Ping Wei San (Peace the Stomach Powder), followed by regular administration of Jin Shi Wan (Advance Eating Pill). (Ping Wei San see "Not Nursing"; Jin Shi Wan see "Retention").
[Qian Yi] Cao Yide's son, three years old, had a sallow complexion and intermittent chills/fever, refused food but drank water and milk incessantly. Physicians considered it tidal fever, used Niu Huang Wan (Calculus Bovis Pill) without success, then used Zhi Ke Gan Ge San (Stop Thirst Licorice and Kudzu Powder), which caused vomiting. Qian Yi said to purge with Bai Bing Zi (White Pill Cake), then tonify Spleen, using Xiao Ji Wan (Eliminate Retention Pill) to grind away retention. This was the correct resolution, and he eventually recovered. Why? Refusing food but drinking water indicates food lodged in Spleen unable to digest, causing chills/fever. Vomiting from thirst-stopping medicine occurs because the drug irritates the Spleen. Purging resolves it.
[Zhang Hezi] Gao Xun Jian's son, eight years old, suffered from heat disease. Physicians diagnosed cold injury and treated with hot medicines. The child desired ice water but was denied, leading to exhaustion of internal fluids, increased irritability, closure of front and back (urine/stool), dry mouth/nose, alternating chills/fever, intermittent cough, and general anhidrosis. They wished to apply moxibustion. Zhang Hezi met them and reproached the mother: "Wrapped in heavy quilts, on a warm kang with red stoves, the child cannot bear the heat; how can moxibustion be applied?" The mother apologized for ignorance. Zhang Hezi ordered Ren Shen Chai Hu Yin Zi (Ginseng Bupleurum Drink) first, administered several doses, resulting in passage of foul-smelling, fish-intestine-like stool. Thirsty and allowed to drink freely, the child consumed cups of ice-cold water, followed by 30-40 more bowel movements, after which high fever subsided. Then Tong Ge Wan (Clear Diaphragm Pill) and Niu Huang Wan were given, resulting in ten more passages, and the child fully recovered. In total, about 50+ passages, consuming approximately one hu of ice water. If moxibustion had been used, what would have happened?
Imperial Medical Bureau Xiao Chai Hu Tang treats adults and children with Shang Han (Cold Damage) or Wen Re Bing (Warm Heat Disease), presenting with fever, aversion to wind, stiff neck, chest fullness, hypochondriac pain, belching/vomiting, irritability/thirst, alternating chills/fever, yellow body/face, dysuria, constipation, unresolved transmission stages, persistent tidal fever, post-recovery relapse from overexertion with fever/headache, women's Wind Strike with headache/irritability/fever, cessation of menstruation with malaria-like chills/fever, and postpartum Wind Strike with headache/irritability/fever. All are suitable for this formula.
Ingredients: Chai Hu (Bupleuri Radix, removed rhizome head, weighed half jin), Huang Qin (Scutellariae Radix), Ren Shen (Ginseng Radix et Rhizoma, removed rhizome head, weighed), Gan Cao (Glycyrrhizae Radix et Rhizoma, honey-fried, each three liang), Ban Xia (Pinelliae Rhizoma, washed seven times in boiling water, dried and weighed two liang half).
Preparation and Administration: The five herbs are crushed into coarse powder. Take three qian per dose, add one dan half of water, five slices of Sheng Jiang, one broken Da Zao, decoct to seven parts, filter, and take slightly warm at any time. Children divide into two doses, adjusting based on age/size.
[Zhang Huan] Qin Jiao Tang treats pediatric alternating chills and fever.
Ingredients: Qin Jiao (Gentianae Macrophyllae Radix, removed seedlings), Bie Jia (Testudinis Carapax et Plastrum, vinegar-fried until slightly yellow, removed skirt, each one liang), Chuan Da Huang (Rhei Radix et Rhizoma, sliced, slightly stir-baked), Ma Huang (Ephedrae Herba, removed roots and nodes, each half liang), Zhu Ru (Bambusae Caulis in Taenia), Gan Cao (Glycyrrhizae Radix et Rhizoma, honey-fried, each one fen).
Preparation and Administration: Crush and sieve into coarse powder. Take one qian per dose, one dan of water, two cun of Cong Bai (Allii Fistulosi Bulbus), decoct to five parts, filter, and take warm, adjusting for age.
Ren Shen Qian Hu San:
Ingredients: Ren Shen (Ginseng Radix et Rhizoma, removed rhizome head), Qian Hu (Peucedani Radix), Chai Hu (Bupleuri Radix, removed seedlings, each one liang), Jie Geng (Platycodonis Radix), Di Gu Pi (Lycii Cortex), Gan Cao (Glycyrrhizae Radix et Rhizoma, honey-fried), Ban Xia (Pinelliae Rhizoma, washed seven times, dried, each half liang).
Preparation and Administration: Crush and sieve into fine powder. Take one large qian per dose, one small dan of water, two slices of Sheng Jiang, decoct to half dan, filter, and take warm, adjusting for age.
Shao Yao Tang:
Ingredients: Chi Shao Yao (Paeoniae Radix Rubra, one liang), Huang Qin (Scutellariae Radix), Dang Gui (Angelicae Sinensis Radix, sliced, dried), Chai Hu (Bupleuri Radix, each half liang), Rou Gui (Cinnamomi Cortex), Gan Cao (Glycyrrhizae Radix et Rhizoma, honey-fried, each one fen).
Preparation and Administration: Crush and sieve into fine powder. Take one qian per dose, eight-tenths of a dan of water, two slices of Sheng Jiang, one Da Zao, decoct to five parts, filter, and take warm, adjusting for age.
"Wang Shi Shou Ji" Chai Hu Ren Shen Tang treats pediatric Spleen Heat generating Wind, alternating chills and fever. (Hezi's Chai Hu Yin Zi contains Huang Qin, Da Huang, Dang Gui, but no Fu Ling).
Ingredients: Chai Hu, Ren Shen, Shao Yao, Fu Ling (Poria), Gan Cao (Glycyrrhizae Radix et Rhizoma, honey-fried, equal parts).
Preparation and Administration: Take two qian per dose, one dan of water, three slices of Sheng Jiang, decoct to four parts, take warm.
"Quan Sheng Zhi Mi" Jing Jie San:
Ingredients: Jing Jie Sui (Schizonepetae Spica), Ren Shen, Bai Zhu (Atractylodis Macrocephalae Rhizoma), Dang Gui (Angelicae Sinensis Radix, sliced, washed, dried), Huang Qi (Astragali Radix), Shao Yao, Gui (Cinnamomi Cortex, removed rough bark, each one liang), Chai Hu (Bupleuri Radix, removed seedlings, two liang), Gan Cao (Glycyrrhizae Radix et Rhizoma, honey-fried, half liang).
Preparation and Administration: Coarse powder. Take five qian per dose, two dan of water, decoct to one dan, filter, and take warm.
"Quan Sheng Zhi Mi" Bei Ji Wan:
Ingredients: Da Huang (Rhei Radix et Rhizoma, wrapped in wet paper, baked), Ba Dou (Crotonis Fructus, skin and heart removed, oil removed), Gan Jiang (Zingiberis Rhizoma, peeled, equal parts).
Preparation and Administration: Fine powder, mixed with refined honey into pills the size of soybeans. Take one pill per dose with rice water. For frail people, make pill size of mung bean. Stop when bowels move freely.
"Qian Jin" Formula for infants aged one to five months with sudden chills and fever:
Finely cut Willow Branches (Liuzhi), boil to extract juice to wash the infant. If thirsty, squeeze Dong Gua (Benincasae Fructus) juice to drink.
"Shui Jian" How to treat sudden chills/fever in infants within 100 days? Cold medicines cause milk-cold and vomiting; hot medicines worsen the disease. Without divine methods, negligence kills the child. Consulting secret formulas from stone chambers yields miraculous results. Song says: Tao Hua Yin Mo (Peach Blossom Shade Powder) slightly over one qian, Gan Cao (Licorice) broth power is superior; Lan Hua (Blue Flower) just needs a word (dried in shade), poured into mouth instantly eliminates. The above three herbs powdered, take half qian per dose, mixed with broth and poured in.
"Zhuang Shi Jia Chuan" Treatment for sudden poor chills/fever in young children unable to take medicine, Li Ye Yu Er Fang (Plum Leaf Bathing Infant Formula):
Use Li Ye (Pruni Leaves) as needed, boil water to bathe the infant. (Also Bai Zhi (Angelicae Dahuricae Radix), Ku Shen (Sophorae Flavescentis Radix)).
"Yu Jue" states: First regulate Qi, then resolve deficiency heat. If heat persists, use Zhen Zhu Wan (Pearl Pill) to purge.
Zhen Zhu Wan treats pediatric chills/fever, deficiency retention, five zang organ irritability/fullness, lower jiao Wind-Phlegm retention, and convulsion/food/Gan retention.
Ingredients: Nan Xing (Arisaematis Rhizoma Preparatum), Ban Xia (Pinelliae Rhizoma), Hua Shi (Talcum, each powdered, two qian), Qing Fen (Calomelas, four qian bi), Ba Dou (Crotonis Fructus, fourteen grains, heart/oil removed).
Preparation and Administration: Powder, mix with wheat paste into mustard-seed-sized pills. Take 15-20 pills per dose, swallow with scallion decoction.
"Ying Lu" Liu Wei Tang treats young children with advancing/retreating chills/fever, crying/calling, abdominal pain.
Ingredients: Di Huang (Rehmanniae Radix), Gui Xin (Cinnamomi Ramulus, each eight fen), Shao Yao, Han Shui Shi (Aqua Calcitae), Huang Qin (Scutellariae Radix, honey-fried), Gan Cao (Glycyrrhizae Radix et Rhizoma, honey-fried, each two fen).
Preparation and Administration: Cut finely, boil three sheng of water to one and a half sheng. One-year-old infants take two to three he, administer as appropriate.
Da Huang Wan treats pediatric chills/fever, food failing to generate muscle.
Ingredients: Da Huang (Rhei Radix et Rhizoma, one liang, steamed under two dou of rice), Gui Xin (Cinnamomi Ramulus), Gan Jiang (Zingiberis Rhizoma, processed, each two fen), Ba Dou (Crotonis Fructus, fifty grains, skin/heart removed, roasted), Xiao Shi (Natrii Sulfas, three fen, roasted, substitute Mang Xiao if unavailable).
Preparation and Administration: Sieve four herbs, separately pound Ba Dou into paste, mix with honey, pound 2000 times, form pills the size of wu zi (walnut seeds). Take one pill with water. Heat above diaphragm induces vomiting; heat below induces purging. Prepare porridge beforehand. If no vomiting/purging after two meal periods, stimulate with hot drink. If still none, take another half pill; strong patients may take two pills. This medicine is superior to others; adjust size accordingly. If excessive purging, resolve with cold porridge. For ulcers, mix one pill with honey, apply to finger-tip probe, insert into ulcer in morning, draw out; repeat if not healed. For Warm Disease with constipation, taking it to induce movement is good; for undigested food, also take it. For Fei Shi/Dun Shi (wandering corpse ghosts), take half pill with grain mash, once daily, stops quickly. For abdominal distension/pain, take one pill. For Malaria, fast overnight, take one pill early morning; robust adults take two pills. Endure hunger after vomiting/purging, eat only after attack passes. For postpartum blood knot running up/down, infertility, irregular menstruation, green-yellow face, take half pill. For pediatric dribbling chills/fever, abdominal distension, anorexia, failure to gain weight, ages 3-4 take one sesame-seed-sized pill daily; ages 6-7 take two pills. Within 30 days, abdominal diseases heal; halve dose for smaller children. Great efficacy. Avoid wild boar meat, Asparagus, raw scallions.
Note: If the sick child has no solid retention, or has retention with deficiency, this is unsuitable. For Gan Lao (Gan Consumption), seek Fertilizing Pills instead.
"Sheng Hui" Chai Hu San treats pediatric alternating chills/fever, inability to nurse/eat, limb weakness, abdominal distension, upper jiao Phlegm obstruction, gradual emaciation.
Ingredients: Chai Hu (Bupleuri Radix, removed seedlings), Bie Jia (Testudinis Carapax et Plastrum, coated with vinegar, fried yellow, removed skirt, each one liang), Ren Shen, Qian Hu, Jie Geng, He Li Le Pi (Chebulae Pericarpium), Di Gu Pi, Chi Shao Yao, Xing Ren (Armeniacae Semen Amarum, soaked in water, skin/tip removed, double kernel, bran-fried slightly yellow), Gan Cao (Glycyrrhizae Radix et Rhizoma, honey-fried, slightly red), Chen Ju Pi (Citri Reticulatae Pericarpium, soaked in water, white part removed, dried, each half liang).
Preparation and Administration: Crush and sieve into powder. Take one qian per dose, one small dan of water, decoct to five parts, filter, take warm at any time, adjust for age.
Wu Wei Zi San treats pediatric alternating chills/fever, reluctance to nurse/eat, emaciation, abdominal distension.
Ingredients: Wu Wei Zi (Schisandrae Chinensis Fructus), Dang Gui (Angelicae Sinensis Radix, sliced, slightly stir-baked), Ren Shen, Jie Geng, Qian Hu (Peucedani Radix, each removed rhizome head), Bai Zhu, Chi Fu Ling (Poria cum Rosa), Huang Qin (Scutellariae Radix, each one fen), Gan Cao (Glycyrrhizae Radix et Rhizoma, half fen, honey-fried slightly red, sliced), Mai Men Dong (Ophiopogonis Tuber, half liang, removed heart, dried).
Preparation and Administration: Crush and sieve into coarse powder. Take one qian per dose, one small dan of water, decoct to five parts, filter, take warm, 3-4 times daily, adjust by age/intuition.
Ren Shen San treats pediatric alternating chills/fever, low appetite, emaciation.
Ingredients: Ren Shen (Ginseng Radix et Rhizoma, removed rhizome head), Huang Qi (Astragali Radix, sliced), Chai Hu (Bupleuri Radix, removed seedlings), Bai Fu Ling (Poria), Bie Jia (Testudinis Carapax et Plastrum, vinegar-coated, fried yellow, skirt removed), Mu Xiang (Aucklandiae Radix, each half liang), Gan Cao (Glycyrrhizae Radix et Rhizoma, honey-fried slightly red, sliced), Bai Zhu, Tao Ren (Persicae Semen, soaked, skin/tip removed, bran-fried slightly yellow, each one fen), He Li Le Pi (Chebulae Pericarpium, three fen).
Preparation and Administration: Crush and sieve into fine powder. Take half qian mixed with porridge drink at any time, adjust for age.
Huang Qi Wan treats pediatric alternating chills/fever, profuse sweating, irritability, dark yellow urine, reluctance to nurse/eat, limb emaciation.
Ingredients: Huang Qi (Astragali Radix, sliced), Mai Men Dong (Ophiopogonis Tuber, removed heart, dried), Chi Fu Ling, Bai Zhu, Zi Qin (Scutellariae Radix), Gan Cao (Glycyrrhizae Radix et Rhizoma, each one fen), Chai Hu (Bupleuri Radix, removed seedlings), Bie Jia (Testudinis Carapax et Plastrum, vinegar-coated, fried yellow, skirt removed, each half liang).
Preparation and Administration: Crush and sieve into powder, mix with honey into mung-bean-sized pills. Take five pills per dose with porridge drink, 3-4 times daily, adjust for age.
Zhang Huan Xiang Jia San treats alternating chills/fever with emaciation.
Ingredients: Bie Jia (Testudinis Carapax et Plastrum, butter-fried yellow, skirt removed), Mu Xiang (Aucklandiae Radix, each one liang), Chuan Da Huang (Rhei Radix et Rhizoma, slightly stir-baked), Chen Ju Pi (Citri Reticulatae Pericarpium, white part removed, dried), Dang Gui (Angelicae Sinensis Radix, washed, dried), Chai Hu (Bupleuri Radix, removed seedlings), Zhi Mu (Anemarrhenae Rhizoma), Gan Cao (Glycyrrhizae Radix et Rhizoma, honey-fried, each half liang), Bing Lang (Arecae Semen, three pieces).
Preparation and Administration: Crush and sieve into coarse powder. Take one qian per dose, one small dan of water, two slices of Sheng Jiang, decoct to six parts, filter, take warm, adjust for age.