小儿实热者，头昏颊赤，口内热，小便赤涩，状如豆汁，大便坚硬，或秘涩不
通，腹急，宜四顺饮子、大黄朴硝汤、八珍散，略挨动脏腑，即安。〔杨〕实则面
赤浓黄，气粗口热，燥渴唇肿，大小便难，掀揭露衣，烦啼暴叫，宜四顺清凉饮加
柴胡。薛氏又有伸体而卧，睡不露睛，手足指热等证。
按∶实中宜分表里，表实宜汗，里实宜下，半表半里宜和解，今一以利下为
主，非通论也。治法并方，更于后表里条内求之。云岐云∶小儿实热在内者，四
顺饮之类，在上者，吐之。丹溪云∶小儿热病，六一散妙药也。
〔茅先生〕三解牛黄散 治实热，潮热。
白僵蚕 全蝎（炙） 防风 白附子 桔梗 川大黄 甘草（炙） 白茯苓 川黄芩 人
参川郁金（皂角水煮）
等分，未服半钱一钱，薄荷蜜汤调。
牛黄凉膈丸 治风壅痰实，蕴积不散，头痛面赤，心烦潮热，痰涎壅塞，咽膈不利，
精神恍忽，睡卧不安，口干多渴，唇焦咽痛，颔颊赤肿，口舌生疮。
牛黄（一两一分） 甘草（ ，十两） 寒水石 牙硝（枯） 石膏（各二十两） 紫石英（飞）
脑麝（各五两） 胆星（柒两半）
末之，蜜丸，每两作三十丸。温薄荷人参汤、嚼一丸，食后服。常服，半丸。
治急惊，并薄荷水化。
小儿实热证，表现为头部昏沉、两颊发红，口腔内感觉发热，小便颜色深红且排尿涩痛，尿液状如豆汁，大便干结坚硬，或便秘不通，腹部拘急不适。治疗适宜使用四顺饮子、大黄朴硝汤、八珍散，轻微通导脏腑积滞，即可安宁。〔杨氏〕认为：实证则面色红赤而浓黄，呼吸粗重，口中有热气，烦躁口渴，嘴唇肿胀，大小便困难，掀开衣物暴露身体，烦躁啼哭并突然大叫。适宜使用四顺清凉饮加柴胡。薛氏又有身体伸展而卧，睡眠时眼睛不睁开（露睛），手足指头发热等证候。
按语：实证中应当区分表里，表实适宜发汗，里实适宜攻下，半表半里适宜和解。如今一概以通利攻下为主，并非通达的论述。治疗方法及方剂，更可在后文“表里”条内寻求。云岐说：小儿实热在体内的，用四顺饮之类；实热在上部的，用吐法。丹溪说：小儿热病，六一散是妙药。
〔茅先生〕三解牛黄散，治疗实热、潮热。
白僵蚕、全蝎（炙）、防风、白附子、桔梗、川大黄、甘草（炙）、白茯苓、川黄芩、人参、川郁金（用皂角水煮）。
以上药材等分，未服用前每次取半钱至一钱，用薄荷蜜汤调服。
牛黄凉膈丸，治疗风壅痰实，蕴积不散，头痛面赤，心烦潮热，痰涎壅塞，咽喉膈部不利，精神恍惚，睡卧不安，口干多渴，嘴唇焦裂咽痛，下颌脸颊赤肿，口舌生疮。
牛黄（一两一分）、甘草（十两）、寒水石、牙硝（枯制）、石膏（各二十两）、紫石英（飞研）、脑麝（各五两）、胆星（七两半）。
研为细末，用蜂蜜制成丸剂，每两药粉作三十丸。饭后温薄荷人参汤送服一丸。常服者，服半丸。
治疗急惊风，并用薄荷水化开服用。
In cases of excess heat in children, symptoms include dizziness and redness of the cheeks, a sensation of heat in the mouth, dark and scanty urine resembling bean juice, hard or constipated stools, abdominal urgency. Treatment with Sishun Yinzi (Four Compliance Decoction), Dahuang Puxiao Tang (Rhubarb and Saltpeter Decoction), or Bazhen San (Eight Treasures Powder) is appropriate; once the internal organs are slightly unblocked, peace will be restored. [Yang] states that in excess patterns, the face is deeply red and yellow, breathing is coarse, there is oral heat, dryness and thirst with swollen lips, difficulty in urination and defecation, the child pulls off clothes to expose the body, cries irritably and shouts suddenly. Si Shun Qingliang Yin (Four Compliance Cooling Decoction) with Chaihu (Bupleuri Radix) is indicated. Xue also described syndromes such as lying with the body extended, sleeping with eyes not fully open (exposing the pupils), and heat in the fingers of hands and feet.
Commentary: Excess patterns should be differentiated into exterior and interior. Exterior excess requires sweating (diaphoresis), interior excess requires purgation, and half-exterior half-interior patterns require harmonization. To focus solely on purgation is not a comprehensive theory. For treatment methods and formulas, refer to the "Exterior and Interior" section later. Yunqi stated: For excess heat inside the body in children, use formulas like Sishun Yin; for excess heat above, use emesis. Danxi stated: For pediatric heat diseases, Liu Yi San (Six-One Powder) is an excellent remedy.
[Mao Xiansheng] Sanjie Niuhuang San (Three-Resolving Calculus Cow-bezoar Powder) treats excess heat and tidal fever.
Bai Jiangcan (Bombyx Batryticatus), Quanxie (Scorpio - roasted), Fangfeng (Saposhnikoviae Radix), Baifuzi (Aconiti Kusnezoffii Rhizoma), Jiegeng (Platycodonis Radix), Chuan Dahuang (Rhei Radix et Rhizoma), Gancao (Glycyrrhizae Radix et Rhizoma - roasted), Bai Fuling (Poria), Chuan Huangqin (Scutellariae Radix), Renshen (Ginseng Radix et Rhizoma), Chuan Yujin (Curcumae Radix - boiled in Gengjiao water).
Equal parts. Before administration, take 0.5 qian to 1 qian, mixed with honey water infused with Bohe (Menthae Haplocalycis Herba).
Niuhuang Liangge Wan (Cow-bezoar Cooling Diaphragm Pill) treats wind-stagnation and phlegm-excess, accumulation without dispersion, headache and redness of the face, vexation and tidal fever, obstruction by phlegm-saliva, discomfort in the throat and diaphragm, mental confusion, restless sleep, dry mouth with excessive thirst, cracked lips and sore throat, redness and swelling of the jaw and cheeks, sores in the mouth and tongue.
Niuhuang (Calculus Bovis, 1 liang 1 fen), Gancao (Glycyrrhizae Radix et Rhizoma, 10 liang), Hanshuishi (Aqua Stibitum Molybdici), Yaxiao (Natrii Sulfas - calcined), Shigao (Gypsum Fibrosum, each 20 liang), Zhi Shiyin (Fluoritum), Naoshe (Moschus and Borneolum Syntheticum, each 5 liang), Danning (Arisaematis Cum Bile).
Grind into powder, make pills with honey. Each liang of powder makes 30 pills. Take one pill after meals, washed down with warm Bohe Renshen Tang (Mint and Ginseng Decoction). For regular maintenance, take half a pill.
For treating Ji Jing Feng (Acute Convulsive Disorder), dissolve in Bohe Shui (Mint Water).