小儿在胎，食五脏血秽，伏于命门。若遇天行时热，或乳食所伤，或惊恐所触，则其毒
当出。初起之候，面燥腮赤，目胞亦赤，呵欠顿闷，乍凉乍热，咳嗽嚏喷，手足梢冷，惊悸多
睡。宜究其何藏所发，察其何因所起。令乳母亦须节饮食，慎风寒。五脏各有一证，肝藏水
青色而小，肺藏脓 色白而大，心藏斑色赤而小，脾藏疹小次斑，故色赤黄浅也。先发脓
后发疹子者顺，先疹子后斑者顺，反此为逆。惟肾无候，但见KT 冷耳冷是也。若寒水来
侮，故黑陷而耳KT 反热，为逆也。（ 同 音泡）
如发潮热三日以上，出不甚多，而热不止者，未尽也。潮热随出，如早食潮热不已，为水
之类也，一发便出尽者重，疮夹疹者半轻半重也。出稀者轻，里外微红者轻，外黑里赤者
微重，外白里黑者大重也，疮端里黑点如针孔者势最剧也。青干紫陷，昏睡汗出，烦躁热渴，
腹胀啼喘，二便不通者困也。有大热，利小便解热毒。若紫黑干陷，或寒战切牙，或身黄肿
紫者，急下之。复寒热不已，身冷出汗，耳KT 反热者，死证也，此肾气大旺，脾虚不能制故也。
下后身热气温饮水者可治，以脾土胜，肾寒去，而温热也。不黑者不可下，下则内虚归肾。
大抵疮疹属阳，在春夏为顺，秋冬为逆，冬月肾旺盛，寒病多归肾，变黑。又当辨春脓 ，夏
黑陷，秋斑子、冬疹子者，十活四五，黑者十难救一。
身热烦渴腹满而喘，便涩面赤闷乱大吐，此当利小便，不瘥者，下之。若能食而痂头焦
起，或未焦而喘实者，亦可下之。若五七日痂不焦是内热也，宜导之，生犀汁解之。
斑疹作搐为脾虚而肝旺乘之，心火妄动，风热相搏也，当泻心肝补脾土。
疮黑而忽便脓血并痂皮者乃脾气实，肾邪退而病安也。泄泻而乳食不化者，脾虚不能制肾，故难治。
徐洄溪曰∶此即近世痘疮之证，其病与斑疹同列，并无起胀成浆收靥等说。大抵宋时之
疮形治法不过如此。近日愈变愈重，与斑疹绝不相类，治亦回别。因知天下之病，随时随地
变化无穷，所以《内经》有五运六气、异法方宜等论，为医者苟不能知天运之转移，及五方之
体性，终有偏执之处，不可以称上工也。
泻青丸方 治肝经实热，急惊搐搦，脉洪实。
当归（焙） 草龙胆（焙） 川芎 山栀子仁
川大黄 羌活 防风（焙）
上等分为末，炼蜜和丸，如芡实大，每服半丸或壹丸，煎竹叶汤同沙糖化下。
导赤散 治小儿心热，上窜切牙，小肠实热，小便秘赤。
生地黄 生甘草 木通（各等分）
上为末，每服三钱，水一盏，入竹叶同煎至五分，食后温服。一本不用甘草用黄芩。
泻心汤 治小儿心气实，气涩不得通，喜仰卧。
黄连
上为末，每服五分，临卧温水化下。
泻黄散（又名泻脾散） 治脾胃实热弄舌。
藿香叶（七钱五分） 山栀子仁（一两） 石膏（五钱） 甘草（七钱五分） 防风（三两，焙）
上锉，用蜜酒微炒香，为细末，每服一二钱，水一盏至五分，温服清汁。
异功散 治脾胃虚弱，吐泻不思乳食。
人参 茯苓（去皮） 白术 陈皮 甘草（各等分）
上为细末，每服二三钱，水一盏，生姜大枣同煎至七分，食前温服。
附《颅囟经》和平饮子 治小儿初生日，与∶
人参 茯苓 甘草 升麻（各一分）
上水煎，时时与之，临时冷加白术，热加芒硝。
益黄散（又名补脾散） 治脾胃虚寒，呕吐泄泻，及治脾疳腹大身瘦。
陈皮（一两，去皮） 丁香（二钱），一方用木香诃子（炮，去核） 青皮（去白） 炙甘草（各五钱）
上为末，三岁儿一钱半，水半盏，煎三分，食前服。
白术散 治脾胃久虚，呕吐泄泻，但欲饮水，乳食不进。
人参（二钱五分） 白茯苓 白术（炒） 藿香叶 葛根（各五钱） 木香（二钱） 甘草（一钱）
上 咀，每服三钱，水煎，热甚烦渴去木香，《本事方》。
白术散 治小儿呕吐，脉迟细有寒，白术 人参（各二钱五分） 半夏曲（二钱） 茯苓 干姜 甘草（各
一钱）
上为细末，每服二钱，水一盏，姜（三片），枣（一枚）擘去核，煎至七分，去渣温服，日二三服。
泻白散 治肺实热盛，咳嗽气急痰喘。
地骨皮 桑白皮（炒各一两） 炙甘草（一钱）
上锉散，入粳米一撮，水二小盏，煎七分，食前服。
阿胶散（又名补肺散） 治肺虚咳嗽，气粗喘促口渴。
阿胶（一两五钱，麸炒） 黍粘子（炒香） 甘草（炙，各二钱五分） 马兜铃（五钱，焙） 杏仁（七个，去皮
尖炒） 糯米（一两，炒）
上为末，每服一二钱，水一盏，煎至六分，食后温服。
曾氏《活幼心书》补肺散去黍粘子，加茯苓。
地黄丸（又名六味丸） 治肾怯失音，HT 开不合，神不足，目中白睛多，面色 白等虚证。
熟地黄（八钱，酒洗） 山萸肉 山薯蓣（各四钱） 泽泻 牡丹皮 白茯苓（各三钱，去皮）
上为末，炼蜜丸如梧子大，空心，温水化下二十丸。
寇氏《全幼心鉴》去泽泻加人参鹿茸名参茸地黄丸，治禀赋不足，肾气虚弱，骨髓枯竭，
解颅语迟，齿生缓，行步多艰。
生犀角汁 治疮疹不快，吐血衄血。
生乌犀角（磨汁）
玉露散（又名甘露散） 治伤热吐泻，汗退场门渴，脉浮洪大。
寒水石 石膏（各半两） 生甘草（一钱）
上为细末，每服一匙，或半钱一钱，食后温汤调下。
甘桔汤 治小儿肺热。
桔梗（二两） 甘草（一两）
上为粗末，每服二钱，水一盏煎至七分，去滓，食后温服，加荆芥防风名如圣汤。
董氏《斑诊备急方》加恶实麦门冬，亦名如圣汤。
阎氏孝忠附方
小儿耳冷KT 冷，手足乍冷乍热，面赤，时嗽嚏惊悸，此疮疹欲发也。未能辨认，间服升
麻葛根汤，消毒散，已发未发皆宜服；仍用胡荽酒，黄柏膏；暑月烦躁，食后与白虎汤，玉露
散；热盛与紫雪；咽痛或生疮与甘桔汤，甘露饮子。余根据钱氏说。
大人同。
升麻葛根汤 治伤寒温疫风热，壮热头痛肢体痛，疮疹已发未发并宜服之。
升麻 干葛 芍药 甘草（各半两，炙）
上为粗末，每服四钱，水一盏半，煎至一盏，量大小与之，温服无时。
《千金方》无甘草有黄芩，名四物解肌汤，治少小伤寒。
消毒散 治疮疹未出；或已出，未能匀遍，又治一切疮。凉膈去痰治咽痛。
牛蒡子（二两，炒） 甘草（半两） 荆芥穗（一两）
上为粗末，每服三钱，水一盏半，煎至一盏，温服不拘时。
《活人书》鼠粘子汤有防风，治证同。
黄柏膏 治疮疹已出，用此涂面，用胡荽酒。
黄柏（一两，去皮） 甘草（四两） 新绿豆（一两半）
上为细末，生油调，从耳前至眼轮，并浓涂之，日三两次。如早用疮不上面，纵有亦少。
胡荽酒 胡荽（细切四两，以好酒二盏，煎一二沸，入胡荽，再煎少时，用物合定放冷）
上每吸一二口，微喷从顶至足匀遍，勿喷头面。病患左右常令有胡荽，即能辟去汗气，疮疹出快。
疮疹忌外人及秽触之物，虽不可受风冷，然亦不可拥遏，常令衣服得中，并虚凉处坐卧。
甘露饮子 治心胃热，咽痛口舌生疮，并疮疹已发未发并可服。又治热上攻牙龈肿，牙齿动摇。
生地黄（焙） 熟地黄（焙） 天门冬（去心焙） 麦门冬（去心焙） 枇杷叶（去毛） 黄芩（去心） 石斛
（去苗） 枳壳（去穣麸炒） 甘草（炙） 山茵陈叶
上各等分，为粗末，每服二钱，水一盏，煎八分，食后温服。牙齿动摇，牙龈肿热，含漱渫
并服。《活人书》曰∶胃中客热，口臭不思饮食，或饥烦不欲食，齿龈肿疼，脓血，舌口咽中有
疮，赤眼，目睑重不欲开，疮疹已发未发并宜服此。《本事方》无麦冬犀角尖，治胃热口臭牙宣，赤眼口疮，一切疮疼。
白虎汤 解暑毒烦躁，身热，痰盛，头痛，口燥，大渴。
知母（一两半，焙） 甘草（半两，炒） 石膏（四两） 白粳米（八钱）
上为粗末，每服三钱，水一盏，煎至八分。食后温冷随意服，气虚人加人参同煎。
紫雪 治惊痫百病，烦热涎厥，及伤寒胃热发斑，一切热毒喉痹肿痛，又治疮疹毒瓦斯上攻咽喉，水浆不下。
黄金（十两） 寒水石 磁石 滑石 石膏（各四两八钱，并捣碎）
以上用水五升，煮至四升，去滓入下项药∶
玄参（一两六钱，捣碎） 木香（捣碎） 羚羊角屑 犀角屑 沉香（各半两，捣碎） 升麻（一两六钱，捣
碎） 丁香（一钱，捣碎） 甘草（八钱，炙锉。）
以上八味入前药汁中，再煮取一升五合，去滓入下项药∶
硝石（三两一钱） 芒硝亦得 朴硝（一斤，精者）
以上二味入前汁中，微火上煎，柳木篦搅不住手，候有七合，投在木盆中半日，欲凝入下项药∶
朱砂（三钱，研飞） 麝香当门子（一钱一字，研）
以上二味入前药中搅匀，寒之二日。
上件成紫色霜雪，每服一字至五分，冷水调下，大小以意加减。咽喉危急病，捻少许，干
咽立效，又治大人香港脚，毒遍内外，烦热不解，口中生疮，狂易叫走，瘴疫毒疠，卒死，温疟，
五尸，五疰，大能解诸药毒。每服一钱至二钱，冷水调下，并食后服。
小儿在母胎中时，摄入了五脏的血液污秽之物，潜伏于命门。如果遇到天行时热（流行性温热病邪），或者因乳食损伤，或受惊恐触动，那么其中的毒邪就会发作。初起时的症状表现为：面部干燥、两腮发红，眼睑也发红，频繁打哈欠且神情呆滞闷倦，忽冷忽热，咳嗽打喷嚏，手脚指尖发凉，惊悸多睡。应当探究是哪一脏所引发的病变，观察是由什么原因引起的。还要让乳母节制饮食，注意防范风寒。五脏各自对应一种证候：肝藏水痘，颜色青而颗粒小；肺藏脓疱，颜色白而颗粒大；心藏斑疹，颜色红而颗粒小；脾藏疹子，比斑疹稍小，所以颜色呈浅赤黄色。先发脓疱后出疹子的为顺证，先出疹子后发斑的为顺证，反之则为逆证。只有肾脏没有特定的外在征象，只表现为耳朵和囟门发冷。如果寒水之气来克制心火，导致黑陷且耳朵和囟门反而发热，这是逆证。（“KT”音同“泡”，指囟门）
如果潮热持续三天以上，皮疹出不太多，但热势不退，说明毒邪未尽。潮热随皮疹而出，如果早晨进食后潮热不止，属于水痘一类；一发出来就全部发出的病情较重；疮疹夹杂疹子的病情半轻半重。出得稀疏的病情轻，内外都微红的病情轻，外黑内红的病情稍重，外白内黑的病情很重，疮端内部有像针孔一样的黑点，形势最危急。出现青色干枯、紫色下陷，昏睡出汗，烦躁热渴，腹胀啼哭喘息，大小便不通的，病情危困。有大热的情况，通过利小便来解除热毒。如果出现紫黑色干枯下陷，或者寒战咬牙，或者身体发黄肿胀发紫的，必须急用攻下法。如果反复寒热不退，身体冰冷出汗，耳朵和囟门反而发热，这是死证，这是因为肾气过旺，脾虚不能制约的缘故。攻下之后，如果身体发热但体温温和，能喝水的可以治愈，这是因为脾土胜复，肾寒去除，转为温热的状态。如果不黑则不可攻下，攻下会导致内脏虚弱，病邪归并于肾。
大体上，疮疹属于阳证，在春夏季节发病为顺证，秋冬季节发病为逆证。冬季肾气旺盛，寒病多归于肾，变为黑色。还应当辨别春季出脓疱、夏季黑陷、秋季出斑疹、冬季出疹子的情况，这类情况十分之四五可以存活，黑色的十分之难救活一个。
身体发热、烦渴、腹部胀满而气喘，大便涩滞、面色红赤、胸闷烦乱、剧烈呕吐，这应当通利小便，如果不好转，再用攻下法。如果能进食且痂皮焦起，或者尚未焦起但气喘实证的，也可以攻下。如果在五到七天时痂皮不焦，这是内热，应当导泄，用生犀角汁解毒。
斑疹引发抽搐，是因为脾虚而肝旺乘袭，心火妄动，风热相搏所致，应当泻心肝之火，补益脾土。
疮色黑而忽然排出脓血并脱落痂皮的，是脾气充实，肾邪退去而病情安定的表现。腹泻且乳食不消化的，是脾虚不能制约肾水，所以难以治疗。
徐洄溪说：这就是近代所说的痘疮病症，其病与斑疹并列，并没有起胀、成浆、收靥等说法。大体上宋代的疮形治法不过如此。近来越变越严重，与斑疹完全不同，治疗方法也截然不同。因此知道天下的疾病，随时随地变化无穷，所以《内经》中有五运六气、异法方宜等论述，作为医生如果不能知晓天运的转移以及五方的体质特性，终究会有偏执之处，不可以称为上等医生。
泻青丸方：治疗肝经实热，急惊风抽搐，脉象洪实。
当归（焙干）、草龙胆（焙干）、川芎、山栀子仁、川大黄、羌活、防风（焙干）。
以上药物等分为末，用炼蜜调和做成丸药，如芡实大小，每次服用半丸或一丸，用竹叶汤煎好，加入砂糖融化后送服。
导赤散：治疗小儿心热，向上窜动咬牙，小肠实热，小便短赤。
生地黄、生甘草、木通（各等分）。
以上药物研为末，每次服用三钱，用水一盏，加入竹叶同煎至五分，饭后温服。另一版本不用甘草而用黄芩。
泻心汤：治疗小儿心气实，气机涩滞不通，喜欢仰卧。
黄连。
以上药物研为末，每次服用五分，临睡前用温水化开送服。
泻黄散（又名泻脾散）：治疗脾胃实热导致的弄舌。
藿香叶（七钱五分）、山栀子仁（一两）、石膏（五钱）、甘草（七钱五分）、防风（三两，焙干）。
以上药物切碎，用蜜酒微炒至香，研为细末，每次服用一二钱，用水一盏煎至五分，温服清汁。
异功散：治疗脾胃虚弱，呕吐腹泻不想吃奶。
人参、茯苓（去皮）、白术、陈皮、甘草（各等分）。
以上药物研为细末，每次服用二三钱，用水一盏，加入生姜、大枣同煎至七分，饭前温服。
附《颅囟经》和平饮子：治疗小儿出生第一天，给予：
人参、茯苓、甘草、升麻（各一分）。
以上用水煎煮，时时喂给，临时根据情况加白术（寒证）或芒硝（热证）。
益黄散（又名补脾散）：治疗脾胃虚寒，呕吐腹泻，以及治疗脾疳腹大身瘦。
陈皮（一两，去皮）、丁香（二钱），一方用木香、诃子（炮制，去核）、青皮（去白）、炙甘草（各五钱）。
以上药物研为末，三岁儿童服用一钱半，用水半盏，煎至三分，饭前服用。
白术散：治疗脾胃久虚，呕吐腹泻，只想喝水，不吃乳食。
人参（二钱五分）、白茯苓、白术（炒）、藿香叶、葛根（各五钱）、木香（二钱）、甘草（一钱）。
以上药物切碎，每次服用三钱，用水煎煮，如果热甚烦渴去掉木香（出自《本事方》）。
白术散：治疗小儿呕吐，脉迟细有寒。
白术、人参（各二钱五分）、半夏曲（二钱）、茯苓、干姜、甘草（各一钱）。
以上药物研为细末，每次服用二钱，用水一盏，加入生姜（三片）、大枣（一枚，掰开去核），煎至七分，去渣温服，每日二三次。
泻白散：治疗肺实热盛，咳嗽气急痰喘。
地骨皮、桑白皮（炒，各一两）、炙甘草（一钱）。
以上药物切碎散入粳米一撮，用水二小盏，煎至七分，饭前服用。
阿胶散（又名补肺散）：治疗肺虚咳嗽，气粗喘促口渴。
阿胶（一两五钱，麸炒）、黍粘子（炒香）、甘草（炙，各二钱五分）、马兜铃（五钱，焙）、杏仁（七个，去皮尖炒）、糯米（一两，炒）。
以上药物研为末，每次服用一二钱，用水一盏，煎至六分，饭后温服。
曾氏《活幼心书》中的补肺散去黍粘子，加茯苓。
地黄丸（又名六味丸）：治疗肾怯失音，囟门开不合，神气不足，眼中白睛多，面色㿠白等虚证。
熟地黄（八钱，酒洗）、山萸肉、山薯蓣（各四钱）、泽泻、牡丹皮、白茯苓（各三钱，去皮）。
以上药物研为末，炼蜜做成梧桐子大小的丸药，空腹时用温水化开二十丸送服。
寇氏《全幼心鉴》中去泽泻加人参、鹿茸，名为参茸地黄丸，治疗禀赋不足，肾气虚弱，骨髓枯竭，解颅语迟，牙齿生长缓慢，行走困难。
玉露散（又名甘露散）：治疗伤热吐泻，汗退肛门渴，脉浮洪大。
寒水石、石膏（各半两）、生甘草（一钱）。
以上药物研为细末，每次服用一匙，或半钱一钱，饭后用温开水调服。
甘桔汤：治疗小儿肺热。
桔梗（二两）、甘草（一两）。
以上药物研为粗末，每次服用二钱，用水一盏煎至七分，去渣，饭后温服，加入荆芥、防风名为如圣汤。
董氏《斑诊备急方》中加入恶实、麦门冬，也叫如圣汤。
阎氏孝忠附方：
小儿耳朵冷、囟门冷，手脚忽冷忽热，面赤，时常咳嗽喷嚏惊悸，这是疮疹将要发出的征兆。如果不能辨认，间歇服用升麻葛根汤、消毒散，已发未发都适宜服用；仍用胡荽酒、黄柏膏；暑月烦躁，饭后给白虎汤、玉露散；热盛给紫雪；咽痛或生疮给甘桔汤、甘露饮子。其余依据钱乙的说法。
成人同样适用。
升麻葛根汤：治疗伤寒温疫风热，壮热头痛肢体痛，疮疹已发未发都适宜服用。
升麻、干葛、芍药、甘草（各半两，炙）。
以上药物研为粗末，每次服用四钱，用水一盏半，煎至一盏，根据年龄大小给予，随时温服。
《千金方》中没有甘草而有黄芩，名为四物解肌汤，治疗少小伤寒。
消毒散：治疗疮疹未出；或已出但不能均匀遍布，又治疗一切疮疡。凉膈去痰治疗咽痛。
牛蒡子（二两，炒）、甘草（半两）、荆芥穗（一两）。
以上药物研为粗末，每次服用三钱，用水一盏半，煎至一盏，温服不拘时间。
《活人书》中的鼠粘子汤有防风，治疗证候相同。
黄柏膏：治疗疮疹已出，用此涂抹面部，配合胡荽酒使用。
黄柏（一两，去皮）、甘草（四两）、新绿豆（一两半）。
以上药物研为细末，用生油调和，从耳前至眼轮，并浓涂之，每天两三次。如果早点用，疮不上脸，即使有也很少。
胡荽酒：胡荽（细切四两，用好酒二盏，煎一二沸，放入胡荽，再煎少许时候，用东西盖好放冷）。
每次吸一二口，微微喷洒从头至足均匀遍，不要喷头部面部。病患左右常令有胡荽，就能辟去汗气，促使疮疹快点发出。
疮疹忌讳外人及秽浊触碰之物，虽然不可受风冷，但也不可过度捂遏，常令衣服适中，并在虚凉处坐卧。
甘露饮子：治疗心胃热，咽痛口舌生疮，以及疮疹已发未发都可服用。又治疗热上攻牙龈肿，牙齿动摇。
生地黄（焙）、熟地黄（焙）、天门冬（去心焙）、麦门冬（去心焙）、枇杷叶（去毛）、黄芩（去心）、石斛（去苗）、枳壳（去穣麸炒）、甘草（炙）、山茵陈叶。
以上各等分，为粗末，每次服用二钱，用水一盏，煎八分，饭后温服。牙齿动摇，牙龈肿热，含漱并服用。《活人书》说：胃中客热，口臭不思饮食，或饥烦不欲食，齿龈肿疼，脓血，舌口咽中有疮，赤眼，目睑重不欲开，疮疹已发未发都适宜服用此方。《本事方》没有麦冬犀角尖，治疗胃热口臭牙宣，赤眼口疮，一切疮疼。
白虎汤：解暑毒烦躁，身热，痰盛，头痛，口燥，大渴。
知母（一两半，焙）、甘草（半两，炒）、石膏（四两）、白粳米（八钱）。
以上药物研为粗末，每次服用三钱，用水一盏，煎至八分。饭后温冷随意服用，气虚人加人参同煎。
紫雪：治疗惊痫百病，烦热涎厥，以及伤寒胃热发斑，一切热毒喉痹肿痛，又治疗疮疹毒瓦斯上攻咽喉，水浆不下。
黄金（十两）、寒水石、磁石、滑石、石膏（各四两八钱，并捣碎）。
以上用水五升，煮至四升，去渣，加入以下药物：
玄参（一两六钱，捣碎）、木香（捣碎）、羚羊角屑、犀角屑、沉香（各半两，捣碎）、升麻（一两六钱，捣碎）、丁香（一钱，捣碎）、甘草（八钱，炙锉）。
以上八味加入前药汁中，再煮取一升五合，去渣，加入以下药物：
硝石（三两一钱）、芒硝也可、朴硝（一斤，精者）。
以上二味加入前汁中，微火上煎，柳木篦不停搅拌，候有七合，投入木盆中半天，欲凝固时加入以下药物：
朱砂（三钱，研飞）、麝香当门子（一钱一字，研）。
以上二味加入前药中搅匀，冷却两天。
上述制成紫色霜雪状，每次服用一字至五分，冷水调下，大小以意加减。咽喉危急病，捻少许，干咽立效，又治疗大人香港脚，毒遍内外，烦热不解，口中生疮，狂易叫走，瘴疫毒疠，卒死，温疟，五尸，五注，大能解诸药毒。每次服用一钱至二钱，冷水调下，并饭后服用。
When a child is in the womb, they ingest the blood impurities of the five Zang organs, which lie dormant in the Mingmen (Gate of Life). If exposed to epidemic heat pathogens or injured by milk and food, or triggered by fright, the toxins within will erupt. The initial symptoms include: dry face with red cheeks, red eyelids, frequent yawning with a dull expression, alternating chills and fever, coughing and sneezing, cold fingertips, palpitations, and excessive sleepiness. One must investigate which Zang organ is affected and identify the cause. The nursing mother should also regulate her diet and avoid wind and cold. Each of the five Zang organs corresponds to a specific manifestation: the Liver stores water-poxes, which are blue-green and small; the Lungs store pustules, which are white and large; the Heart stores macules, which are red and small; the Spleen stores papules, which are smaller than macules, hence appearing light red-yellow. Eruption of pustules followed by papules is a favorable course; eruption of papules followed by macules is also favorable; the reverse indicates an unfavorable course. Only the Kidneys have no specific external sign, manifesting merely as cold ears and fontanelles. If Cold Water overacts on Fire, causing blackening and sinking with hot ears and fontanelles, it is an unfavorable course. ("KT" sounds like "Pao", referring to the fontanelle)
If tidal fever persists for more than three days without significant eruption and the fever does not cease, it indicates incomplete toxin expulsion. Tidal fever accompanying eruption: if morning eating triggers persistent tidal fever, it belongs to the water-pox category; immediate full eruption indicates severe condition; eruptions mixed with papules indicate moderate severity. Sparse eruptions are mild; slight redness inside and out is mild; black outside and red inside is slightly severe; white outside and black inside is very severe; black dots like needle holes at the base of the lesions indicate the most critical situation. Cyanotic dryness, purple sinking, lethargy with sweating, irritability, thirst, abdominal distension, crying and wheezing, and obstruction of urination and defecation indicate a critical state. For high fever, promote urination to resolve heat toxicity. For purple-black dry sinking, chattering teeth, or yellowish-purple swelling, urgent purgation is required. If alternating chills and fever persist, body becomes cold with sweating, and ears/fontanelles become hot, it is a death sign, caused by excessive Kidney Qi failing to be controlled by the Spleen. After purgation, if the body is warm and the patient can drink, it is treatable, indicating Spleen Earth has recovered, Kidney Cold has gone, and warmth has returned. If not black, do not purge, as purging leads to internal deficiency and pathogen retreating to the Kidneys.
Generally, sores and rashes belong to Yang. Eruptions in Spring and Summer are favorable; in Autumn and Winter, unfavorable. In winter, Kidney Qi is prosperous, cold diseases often retreat to the Kidneys, turning black. One must also distinguish between spring pustules, summer black sinking, autumn macules/papules, and winter papules; four or five out of ten survive, while black cases rarely save one in ten.
Body heat, irritability, thirst, abdominal fullness, wheezing, difficult urination, red face, chest oppression, confusion, and severe vomiting require promoting urination first; if ineffective, use purgation. If the patient can eat and scabs are dry and lifting, or even if not dry but with excess wheezing, purgation may be used. If scabs do not dry after five to seven days, it indicates internal heat; use guiding methods and raw rhinoceros horn juice to resolve it.
Macules and rashes accompanied by convulsions are due to Spleen deficiency allowing Liver excess to invade, with reckless Heart Fire and wind-heat conflict; treat by draining Heart and Liver and tonifying Spleen Earth.
Black sores suddenly discharging pus and blood along with scab shedding indicate Spleen Qi is solid, Kidney pathogen recedes, and the disease resolves. Diarrhea with undigested milk and food indicates Spleen deficiency failing to control Kidney Water, making it difficult to treat.
Xu Huixi said: This is the condition of smallpox in recent times, listed alongside macules and rashes, without descriptions of rising, blistering, or scabbing. Generally, Song dynasty treatments for sores were limited to this. Recently, conditions have worsened and differ greatly from macules and rashes, requiring distinct treatments. Thus, diseases change infinitely with time and place. Hence, the *Neijing* discusses Five Movements and Six Qi, and different methods for different regions. A physician who cannot understand the shift of heavenly cycles and the nature of the five directions will remain biased and cannot be called a superior doctor.
Xie Qing Wan Formula: Treats Liver channel excess heat, acute infantile convulsions, and surging, solid pulse.
Dang Gui (Roasted), Cao Long Dan (Roasted), Chuan Xiong, Shan Zhi Zi Ren, Chuan Da Huang, Qiang Huo, Fang Feng (Roasted).
Grind equal parts into powder, mix with refined honey to make pills the size of Euryale seeds. Take half to one pill per dose, decocted with Zhu Ye (Bamboo Leaf) tea and dissolved sugar.
Dao Chi San: Treats infantile Heart heat, upward窜动 (crawling/moving) with teeth grinding, Small Intestine excess heat, and scanty dark urine.
Sheng Di Huang, Sheng Gan Cao, Mu Tong (equal parts).
Grind into powder. Take 3 qian per dose, decoct with one sheng of water and Zhu Ye until reduced to 0.5 sheng. Take warm after meals. Another version uses Huang Qin instead of Gan Cao.
Xie Xin Tang: Treats infantile Heart Qi excess, qi stagnation preventing flow, preference for lying on back.
Huang Lian.
Grind into powder. Take 0.5 fen per dose, dissolve in warm water before bed.
Xie Huang San (also known as Xie Pi San): Treats Spleen-Stomach excess heat causing tongue protrusion/playfulness.
Huo Xiang Ye (7.5 qian), Shan Zhi Zi Ren (1 liang), Shi Gao (5 qian), Gan Cao (7.5 qian), Fang Feng (3 liangs, roasted).
Chop ingredients, stir-fry lightly with honey wine until fragrant, grind to fine powder. Take 1-2 qian per dose, decoct with one sheng of water until reduced to 0.5 sheng. Take the clear liquid warm.
Yi Gong San: Treats Spleen-Stomach weakness, vomiting, diarrhea, and refusal of milk/food.
Ren Shen, Fu Ling (peeled), Bai Zhu, Chen Pi, Gan Cao (equal parts).
Grind to fine powder. Take 2-3 qian per dose, decoct with one sheng of water, Sheng Jiang (Ginger), and Da Zao (Jujube) until reduced to 0.7 sheng. Take warm before meals.
Appendix: *Lun Xi Jing* He Ping Yin Zi: Given on the first day of birth to infants.
Ren Shen, Fu Ling, Gan Cao, Sheng Ma (each 1 fen).
Decoct in water, administer frequently. Add Bai Zhu for cold conditions, Mang Xiao for heat conditions.
Yi Huang San (also known as Bu Pi San): Treats Spleen-Stomach deficiency-cold, vomiting, diarrhea, and Spleen Gi (malnutrition) with abdominal distension and emaciation.
Chen Pi (1 liang, peeled), Ding Xiang (2 qian); another formula uses Mu Xiang, He Zi (roasted, pitted), Qing Pi (peeled), Zhi Gan Cao (each 5 qian).
Grind to powder. For a three-year-old, take 1.5 qian, decoct with half a sheng of water until reduced to 0.3 sheng. Take before meals.
Bai Zhu San: Treats chronic Spleen-Stomach deficiency, vomiting, diarrhea, desire only to drink water, and refusal of milk/food.
Ren Shen (2.5 qian), Bai Fu Ling, Bai Zhu (stir-fried), Huo Xiang Ye, Ge Gen (each 5 qian), Mu Xiang (2 qian), Gan Cao (1 qian).
Chop ingredients. Take 3 qian per dose, decoct in water. Remove Mu Xiang if heat is severe with irritability and thirst (*Ben Shi Fang*).
Bai Zhu San: Treats infantile vomiting, slow/thin pulse indicating cold.
Bai Zhu, Ren Shen (each 2.5 qian), Ban Xia Qu (2 qian), Fu Ling, Gan Jiang, Gan Cao (each 1 qian).
Grind to fine powder. Take 2 qian per dose, decoct with one sheng of water, Sheng Jiang (3 slices), and Da Zao (1 piece, pitted) until reduced to 0.7 sheng. Strain and take warm. Take 2-3 times daily.
Xie Bai San: Treats Lung excess heat with severe cough, rapid breathing, and phlegm-wheezing.
Di Gu Pi, Sang Bai Pi (stir-fried, each 1 liang), Zhi Gan Cao (1 qian).
Chop and scatter with a pinch of Jing Mi (Rice). Decoct with two small shengs of water until reduced to 0.7 sheng. Take before meals.
E Jiao San (also known as Bu Fei San): Treats Lung deficiency cough, coarse breathing, wheezing, and thirst.
E Jiao (1.5 liangs, bran-roasted), Shu Nian Zi (roasted until fragrant), Zhi Gan Cao, Ma Dou Ling (5 qian, roasted), Xing Ren (7 pieces, peeled and tip removed, stir-fried), Nuomi (1 liang, stir-fried).
Grind to powder. Take 1-2 qian per dose, decoct with one sheng of water until reduced to 0.6 sheng. Take warm after meals.
Zeng’s *Huo You Xin Shu* removes Shu Nian Zi and adds Fu Ling.
Di Huang Wan (also known as Liu Wei Wan): Treats Kidney weakness with loss of voice, open/unhealed fontanelle, lack of spirit, prominent whites of eyes, and pale complexion (deficiency signs).
Shu Di Huang (8 qian, washed in wine), Shan Yu Rou, Shan Shu Yao (each 4 qian), Ze Xie, Mu Dan Pi, Bai Fu Ling (peeled, each 3 qian).
Grind to powder, mix with refined honey to make pills the size of Sophora seeds. Take 20 pills on an empty stomach, dissolved in warm water.
Kou’s *Quan You Xin Jian* removes Ze Xie, adds Ren Shen and Lu Rong, named Shen Rong Di Huang Wan. Treats congenital insufficiency, weak Kidney Qi, marrow depletion, delayed fontanelle closure, delayed speech, delayed tooth eruption, and difficulty walking.
Sheng Xi Jiao Zhi: Treats slow eruption of sores/rashes, hematemesis, and epistaxis.
Sheng Wu Xi Jiao (grind to juice).
Yu Lu San (also known as Gan Lu San): Treats heat injury with vomiting/diarrhea, thirst after sweat subsides, floating/surging/large pulse.
Han Shui Shi, Shi Gao (each 0.5 liang), Sheng Gan Cao (1 qian).
Grind to fine powder. Take one spoonful, or 0.5-1 qian per dose, mixed with warm water after meals.
Gan Jie Tang: Treats infantile Lung heat.
Jie Geng (2 liangs), Gan Cao (1 liang).
Grind to coarse powder. Take 2 qian per dose, decoct with one sheng of water until reduced to 0.7 sheng. Strain and take warm after meals. Adding Jing Jie and Fang Feng makes Ru Sheng Tang.
Dong’s *Ban Zhen Bei Ji Fang* adds Niuxiangzi and Mai Men Dong, also named Ru Sheng Tang.
Yan Shi Xiaozhong Supplementary Formulas:
Cold ears and fontanelle, alternating cold/hot limbs, red face, occasional cough/sneeze/palpitations indicate impending sores/rashes. If identification is unclear, intermittently take Sheng Ma Ge Gen Tang or Xiao Du San, suitable for both pre-eruption and post-eruption stages. Also use Hu Su Jiu (Coriander Wine) and Huang Bo Gao. For summer irritability, give Bai Hu Tang or Yu Lu San after meals. For severe heat, give Zi Xue. For sore throat or oral ulcers, give Gan Jie Tang or Gan Lu Yin Zi. Remainder follows Qian Yi’s theories.
Adults apply similarly.
Sheng Ma Ge Gen Tang: Treats Shang Han, warm epidemics, wind-heat, high fever, headache, limb pain. Suitable for sores/rashes whether erupted or not.
Sheng Ma, Gan Ge, Shao Yao, Gan Cao (each 0.5 liang, roasted).
Grind to coarse powder. Take 4 qian per dose, decoct with 1.5 shengs of water until reduced to 1 sheng. Adjust dosage by age. Take warm anytime.
*Qian Jin Fang* omits Gan Cao and adds Huang Qin, named Si Wu Jie Ji Tang, treating pediatric Shang Han.
Xiao Du San: Treats sores/rashes not yet erupted; or erupted but unevenly distributed. Also treats all sores. Clears Heat from Middle Jiao, removes phlegm, treats sore throat.
Niu Bang Zi (2 liangs, stir-fried), Gan Cao (0.5 liang), Jing Jie Sui (1 liang).
Grind to coarse powder. Take 3 qian per dose, decoct with 1.5 shengs of water until reduced to 1 sheng. Take warm anytime.
*Huo Ren Shu*’s Shu Nian Zi Tang includes Fang Feng and treats identical conditions.
Huang Bo Gao: Treats erupted sores/rashes. Apply to face using Hu Su Jiu.
Huang Bo (1 liang, peeled), Gan Cao (4 liangs), Xin Lv Dou (1.5 liangs).
Grind to fine powder, mix with raw oil. Apply thickly from ear front to eye orbit. Apply 2-3 times daily. Early application prevents facial eruption or minimizes it.
Hu Su Jiu: Hu Su (Coriander, finely cut 4 liangs). Decoct with 2 shengs of good wine for 1-2 boils. Add Coriander, simmer briefly, cover and cool.
Inhale 1-2 mouthfuls, spray gently from head to foot evenly. Do not spray head/face. Keep Coriander near the patient to repel sweat odor and hasten eruption.
Sores/rashes forbid contact with outsiders and filth. While avoiding wind/cold, do not over-wrap. Maintain moderate clothing and sit/lie in cool, airy places.
Gan Lu Yin Zi: Treats Heart/Stomach heat, sore throat, oral ulcers. Suitable for sores/rashes erupted or not. Also treats heat attacking gums causing swelling and loose teeth.
Sheng Di Huang (roasted), Shu Di Huang (roasted), Tian Men Dong (heart removed, roasted), Mai Men Dong (heart removed, roasted), Pi Pa Ye (hairs removed), Huang Qin (heart removed), Shi Hu (roots removed), Zhi Ke (pith removed, bran-roasted), Zhi Gan Cao, Shan Yin Chen Ye.
Equal parts, coarse powder. Take 2 qian per dose, decoct with one sheng of water until reduced to 0.8 sheng. Take warm after meals. For loose teeth/gum swelling/heat, gargle and swallow. *Huo Ren Shu* states: Stomach guest heat, bad breath, loss of appetite, or hunger irritability, gum swelling/pain/pus/blood, ulcers in tongue/mouth/throat, red eyes, heavy eyelids. Suitable for sores/rashes erupted or not. *Ben Shi Fang* omits Mai Dong and Xi Jiao Jian, treating Stomach heat, bad breath, gum recession, red eyes, oral ulcers, and all sores.
Bai Hu Tang: Resolves summer heat toxicity, irritability, body heat, profuse phlegm, headache, dry mouth, extreme thirst.
Zhi Mu (1.5 liangs, roasted), Gan Cao (0.5 liang, stir-fried), Shi Gao (4 liangs), Bai Jing Mi (8 qian).
Grind to coarse powder. Take 3 qian per dose, decoct with one sheng of water until reduced to 0.8 sheng. Take warm or cool after meals as desired. Add Ren Shen for Qi deficiency.
Zi Xue: Treats convulsions/epilepsy, irritability/phlegm syncope, Shang Han Stomach heat with macules, all heat-toxic throat bi/swelling, and sores/rashes toxins attacking throat preventing swallowing.
Huang Jin (10 liangs), Han Shui Shi, Ci Shi, Hua Shi, Shi Gao (each 4.8 liangs, crushed).
Decoct in 5 shengs of water until reduced to 4 shengs. Strain. Add:
Xuan Shen (1.6 liangs, crushed), Mu Xiang (crushed), Ling Yang Jiao Xie, Xi Jiao Xie, Chen Xiang (each 0.5 liang, crushed), Sheng Ma (1.6 liangs, crushed), Ding Xiang (1 qian, crushed), Zhi Gan Cao (8 qian, roasted/chopped).
Add these eight to the previous decoction, boil until 1.5 shengs remain. Strain. Add:
Xiao Shi (3.1 qian), Mang Xiao (acceptable), Po Xiao (1 jin, refined).
Add these two to the liquid, simmer on low heat, stirring constantly with willow wood spatula until 0.7 sheng remains. Pour into wooden basin, let stand half a day. When about to congeal, add:
Zhu Sha (3 qian, refined powder), She Xiang Dang Men Zi (1 qian 1 zi, ground).
Mix these two thoroughly into the previous medicine, cool for two days.
Result is purple frost/snow. Take 1 zi to 5 fen per dose, mixed with cold water. Adjust dosage by severity. For critical throat emergencies, take a tiny amount dry for immediate effect. Also treats adult gout, internal/external toxins, unresolved irritability, oral ulcers, mania/wandering, miasma/plague, sudden death, warm malaria, Wu Shi, Wu Zhu. Greatly resolves various drug poisons. Take 1-2 qian per dose, mixed with cold water, after meals.