一儿水痘不易生长，壮热烦躁。以百解散得微汗愈。
一儿出水痘，不作浆而 结干枯，身热烦躁。余谓倒陷也。皆由风寒壅窒腠理，失于解
散故也。以葛根汤加荆防翘蝉木通治之，肿退遍身红点，余谓余毒发疹，用荆防解毒汤愈。
一儿夏月出水痘稠密间多黑陷，烦渴，便秘，壮热。余谓热毒太甚，以三黄丸利之，又香
薷饮合黄连解毒汤治之愈。
一儿水痘结疔于上龈，溃齿穿鼻。余谓痘时失于解散，毒乘阳明。以清胃汤合解毒汤愈。
一儿水痘失于解散，痘或脓疮不敛。余以绵茧散敷之，又收欤解毒之剂愈。
又有风块游走遍体，或赤，或白，或痒，或痛，由风热淫毒蕴于气血，相搏而生，也用升
麻葛根汤加荆防薄荷治之。
秦氏景明曰∶夫疹发热之初，多似伤寒，惟疹子即痧麻，则咳嗽喷嚏，鼻流清涕，眼胞
浮肿，其泪汪汪，面浮腮赤，恶心干呕为异耳。但见此候便要谨避风寒，戒荤腥浓味，用药以
表散之，俾皮肤通畅，腠理开豁，疹毒易出也。痘疹之发虽曰胎毒，未有不由天行厉气而发
者，故一时传染彼此皆出。用药发散必先明其岁气，如时令温暖以辛凉之药发之，防风解毒
汤。暄热以辛寒之药发之，黄连解毒汤。严寒以辛温之药发之，桂枝解毒汤。时寒时暖以辛
平之药发之，升麻解毒汤。用升麻参术乃权宜之法，须因时用药不可误作伤寒，妄施汗下反
伐天和也。此言大有精细，又须看其虚实，如
大便闭结，烦热，甚而发不出者，以酒大黄利之；吐泻不止，以参术之类补之。经曰∶毋实
实，毋虚虚，损不足，补有余。夭人性命也。出之太迟发表为贵，出之太甚解毒为先。母伐天
和，尝观岁气。寒风凛凛，毒瓦斯郁而不行。炎日蒸蒸，邪气乘而作厉。或施温补勿助其邪，
或用寒凉休犯其胃。制其过但取其平，诛其暴必欲其已。远寒远热阴阳之胜负不齐，责实责
虚人禀之强弱或异。大抵麻疹以发散为主，用药发散而疹随见则毒尽解矣。若发不出再加
药发之，如加味麻黄散，外以芫荽酒糟蒸热擦之，用姜汁和酒浆搽抹亦验。自头至足为齐。
若出而头面愈多者为佳，若迟延日久而不能出，反加腹胀气喘昏眩闷乱烦躁而死矣。
看麻出法多于耳后、顶上、腰 先见，其顶尖而不长，其形小而匀净者，吉也。若色红
者，兼火化也证轻，化斑汤主之，人参白虎汤主之。如色白者血不足也，养荣汤主之。如紫
赤干燥晦暗乃火盛毒炽，六一散主之，四物汤去生地加柴胡黄芩干葛红花牛蒡子连翘之
类，滋阴凉血而毒自除，所谓养阴退阳之义也，此证五死一生，如大青汤元参化毒汤亦可
选用。若黑煤伏隐者则火毒尤甚，此证十死一生不可不明察之，而乌得混为施治也。
一个患儿水痘难以透发，高热烦躁。使用百解散后微微出汗而痊愈。
另一个患儿出水痘，但不能化脓结痂反而干枯，身体发热烦躁。我认为是痘毒内陷（倒陷）。这都是因为风寒闭塞腠理，未能及时疏散所致。用葛根汤加荆芥、防风、连翘、蝉蜕、木通治疗，肿胀消退后遍身出现红点，我认为是余毒引发疹子，用荆防解毒汤治愈。
还有一个患儿在夏季出水痘，痘粒稠密且多呈黑色下陷，烦渴，便秘，高热。我认为是热毒太盛，用三黄丸通便泄热，又用香薷饮合黄连解毒汤治疗而愈。
又一个患儿水痘在上牙龈结成疔疮，导致牙齿溃烂穿孔鼻子。我认为是出痘时失于疏散，毒邪侵袭阳明经。用清胃汤合解毒汤治愈。
还有一个患儿水痘失于疏散，痘疮或脓疱不收敛。我用绵茧散外敷，又用收敛解毒的药物内服而愈。
又有风团游走遍体，颜色或红或白，或痒或痛，这是由于风热淫毒蕴结在气血中，相互搏结而生成的，也用升麻葛根汤加荆芥、防风、薄荷治疗。
秦氏景明说：疹子发热初期，大多类似伤寒，只有疹子即痧麻，会有咳嗽喷嚏，流清涕，眼睑浮肿，眼泪汪汪，面部浮肿腮部发红，恶心干呕等特异症状。只要见到这些证候就要谨慎避开风寒，忌食荤腥浓味，用药以发散为主，使皮肤通畅，腠理开豁，疹毒容易透出。痘疹的发生虽然说是胎毒，但没有不是由天行厉气引发的，所以一时之间会彼此传染都发病。用药发散必须先明确当年的岁气（气候特点），如时令温暖用辛凉药物发散，用防风解毒汤；天气暄热用辛寒药物发散，用黄连解毒汤；严寒时用辛温药物发散，用桂枝解毒汤；时寒时暖时用辛平药物发散，用升麻解毒汤。使用升麻参术是权宜之计，必须因时用药，不可误作伤寒，妄施汗下法反而损伤天和之气。这番话非常精细，还必须看其虚实，如大便闭结，烦热，甚至痘出不来的，用酒大黄通便；吐泻不止的，用人参、白术之类补益。经文说：不要使实证更实，不要使虚证更虚，损害不足的，补充有余的，这是夭折人性命啊。痘疹发出太迟，发散为贵；发出太甚，解毒为先。不要损伤天和之气，要观察岁气。寒风凛冽，毒瓦斯郁滞不行；烈日炎炎，邪气乘势发作成厉。或者施用温补不要助长邪气，或者使用寒凉不要侵犯胃气。抑制过偏但求取平和，诛伐暴烈必欲使其平息。远离寒冷和炎热，阴阳胜负不齐；责求实邪或虚损，人体禀赋强弱各异。大抵麻疹以发散为主，用药发散而疹子随之显现则毒尽解了。如果发不出来再加药发散，如加味麻黄散，外用芫荽酒糟蒸热擦拭，用姜汁和酒浆搽抹也有效。从头到足出齐为度。如果出而头面部位更多者为佳，如果迟延日久而不能出，反而加上腹胀气喘昏眩闷乱烦躁而死。看麻疹发出的方法多于耳后、顶上、腰部先见，其痘尖而不长，形状小而匀净者，为吉兆。如果颜色红的，兼有火化，证候轻，用化斑汤主治，人参白虎汤主治。如果颜色白的，是血不足，用养荣汤主治。如果紫赤干燥晦暗，乃是火盛毒炽，用六一散主治，四物汤去生地加柴胡、黄芩、干葛、红花、牛蒡子、连翘之类，滋阴凉血而毒自除，这就是所谓养阴退阳的意思，此证五死一生，如大青汤、元参化毒汤也可选用。如果黑煤伏隐者则火毒尤甚，此证十死一生，不可不明察之，怎么能混同施治呢？
A child's chickenpox failed to erupt, accompanied by high fever and irritability. The patient recovered after taking Baijie San (Hundred-Resolutions Powder) and sweating slightly.
Another child developed chickenpox that failed to suppurate or scab over, instead becoming dry and withered, with body heat and irritability. I diagnosed this as "Dao Xian" (inverted collapse/internalization of the rash). This was caused by wind-cold obstructing the Cou Li (skin pores and interstices), failing to be dispersed. It was treated with Gegen Tang (Kudzu Root Decoction) plus Jing Jie (Schizonepetae Herba), Fang Feng (Saposhnikoviae Radix), Lian Qiao (Forsythiae Fructus), Chan Tui (Cicadae Periostracum), and Mu Tong (Akebiae Caulis). After the swelling subsided, red spots appeared all over the body; I diagnosed this as residual toxins causing a secondary rash, which was cured using Jingfang Jiedu Tang (Schizonepeta and Saposhnikovia Detoxification Decoction).
A third child developed dense chickenpox with blackened, sunken lesions during summer, accompanied by irritability, thirst, constipation, and high fever. I diagnosed this as excessive heat toxin. It was treated with Sanhuang Wan (Three-Yellows Pill) to promote bowel movement, followed by Xiangru Yin (Mosla Drink) combined with Huanglian Jiedu Tang (Coptis Detoxification Decoction), resulting in recovery.
Another child had chickenpox forming ding (carbuncles) on the upper gums, leading to ulcerated teeth and perforated nose. I diagnosed this as failure to disperse the pathogen during the eruption phase, allowing toxin to attack the Yangming channel. It was cured using Qingwei Tang (Stomach-Clearing Decoction) combined with Jiedu Tang (Detoxification Decoction).
Yet another child suffered from non-healing pustules due to lack of dispersion during the chickenpox phase. I applied Mianjian San (Silkworm Cocoon Powder) externally and treated internally with astringent and detoxifying agents, leading to recovery.
There were also cases of urticaria (wind blocks) wandering across the body, appearing red or white, itchy or painful. These arose from wind-heat toxic pathogens accumulating in the Qi and Blood, clashing and generating the condition. They were treated with Shengma Gegen Tang (Ephedra and Kudzu Root Decoction) plus Jing Jie, Fang Feng, and Bo He (Menthae Haplocalycis Herba).
Qin Shiming stated: At the initial stage of fever in measles, symptoms often resemble Shanghan (Cold Damage). However, distinct features of measles (Sha Ma) include coughing, sneezing, clear nasal discharge, swollen eyelids, watery eyes, facial puffiness, reddish cheeks, nausea, and dry retching. Upon observing these signs, one must strictly avoid wind and cold, abstain from rich meat and strong flavors, and use dispersing medications to open the skin and Cou Li, facilitating the eruption of the measles toxin. Although the eruption of pox and measles is attributed to fetal toxins, they invariably arise from epidemic qi (Tianxing Liqi). Thus, transmission occurs rapidly among contacts. When using dispersing medications, one must first ascertain the seasonal climate (Suqi). If the season is warm, use acrid-cool herbs for dispersion, such as Fangfeng Jiedu Tang (Windscreen Detoxification Decoction). If hot, use acrid-cold herbs, such as Huanglian Jiedu Tang. If severe cold prevails, use acrid-warm herbs, such as Guizhi Jiedu Tang (Cinnamon Twig Detoxification Decoction). If weather fluctuates between cold and warm, use acrid-neutral herbs, such as Shengma Jiedu Tang. Using Shengma (Bupleuri Radix or Cimicifugae Rhizoma) with Renshen (Ginseng Radix et Rhizoma) and Baizhu (Atractylodis Macrocephalae Rhizoma) is only a temporary expedient; medication must adapt to the times. Do not mistake this for Shanghan and recklessly apply sweating or purging methods, which would damage the Harmonious Heaven (Tianhe). This analysis is meticulous. One must also assess deficiency and excess. For constipation, irritability, and failure to erupt, use Jiuhuanglian (Wine-processed Rhubarb) to purge. For persistent vomiting and diarrhea, tonify with Renshen and Baizhu. The Classic states: "Do not reinforce excess, do not deplete deficiency." Doing so shortens life. If eruption is too delayed, dispersion is paramount; if eruption is too vigorous, detoxification is priority. Do not harm Tianhe; observe the seasonal climate. In biting cold, toxins stagnate; in scorching heat, evil qi acts violently. Warm tonics should not aid evil; cold clears should not injure the Stomach. Moderate extremes to achieve balance; suppress violence to ensure cessation. Distance oneself from extreme cold and heat, as Yin-Yang dominance varies; address excess or deficiency according to constitutional strength. Generally, measles treatment focuses on dispersion. If herbs induce eruption, the toxin resolves. If eruption fails, add dispersing agents like Jia Wei Mahuang San (Modified Ephedra Powder). Externally, rub with steamed Yuanxu (Coriandri Fructus) and wine lees, or apply ginger juice mixed with wine; this is effective. Eruption should cover the head to toe evenly. Abundant eruption on the head and face is auspicious. Delayed eruption with abdominal distension, asthma, dizziness, confusion, and irritability leads to death. Measles typically appear first behind the ears, on the crown, and waist. Small, uniform, pointed lesions are auspicious. Red color indicates fire transformation; the syndrome is mild, treated with Huaban Tang (Spot-Transforming Decoction) or Renshen Baitu Tang (Ginseng White Tiger Decoction). Pale color indicates blood deficiency, treated with Yangrong Tang (Nourishing Harmony Decoction). Purple-red, dry, and dull color indicates excessive fire and intense toxin, treated with Liuyi San (Six-to-One Powder) or Siwu Tang (Four Substances Decoction) modified with Chaihu (Bupleuri Radix), Huangqin (Scutellariae Radix), Gegen, Honghua (Carthami Flos), Niubangzi (Arctii Fructus), and Lianqiao. This nourishes Yin and cools blood, eliminating toxin—the principle of "nourishing Yin to retreat Yang." This syndrome has a five-to-one mortality rate; Daqing Tang (Great Blue Decoction) or Yuanshen Huadu Tang (Scrophularia Detoxification Decoction) may also be selected. Blackened, hidden lesions indicate severe fire toxin, with a ten-to-one mortality rate. This must be carefully distinguished; one cannot treat indiscriminately.