滑氏云。小儿三岁以内。看男左女右。手虎口三节。曰三关。纹色紫热。红伤寒。青惊风。白疳病。黄
色淡红。乃平常小恙。其筋纹宜藏。不宜暴露。若见黑色。则为危险。再脉纹见下截风关为轻。中
截气关为重。上截命关为尤重耳。直透三关为大危。
（痧子吴音 子浙江 疹北音 丹）
痧属阳腑经邪。初起必从表治。症见头痛。喘急咳嗽。气粗呕恶。一日二日即发者轻。三五日者
重。阳病七日外。隐伏不透。邪反内攻。喘不止。必腹痛胀秘闷危矣。治法宜苦辛清热。凉膈去硝
黄。
方书谓足阳明胃疹。如云布密。或大颗如痘。但无根盘。方书谓手太阴肺疹。但有点粒。无片片
者。用辛散解肌。冬月无汗。壮热喘急。用麻杏。如华盖散三拗汤。夏月无汗。用辛凉解肌。葛根前
胡薄荷防风香薷牛蒡枳桔木通之属。
古人以表邪口渴。即加葛根。以其升阳明胃津。热甚烦渴。用石膏辛寒解肌。无汗忌用。
凡疮疹辛凉为宜。连翘辛凉。翘出众草。能升能清。最利幼科。能解小儿六经诸热。
春令发痧从风温。 夏季从暑风。暑必兼湿。秋令从热烁燥气。冬月从风寒。
疹宜通泄。泄泻为顺。下痢五色者亦无妨。惟二便不利者。最多凶症。治法大忌止泻。
痧本六气客邪。风寒暑湿。必从火化。痧既外发。世人皆云邪透。孰谓出没之际。升必有降。胜必
有复。常有痧外发。身热不除。致咽哑龈腐。喘急腹胀。下痢不食。烦躁昏沉。竟以告毙者。皆属里
症不清致变。须分三焦受邪孰多。或兼别病累瘁。须细体认。上焦药用辛凉。中焦药用苦
辛寒。下焦药用咸寒。
上焦药。气味宜以轻。肺主气。皮毛属肺之合。外邪宜辛胜。里甚宜苦胜。若不烦渴。病日多。邪郁
不清。可淡渗以泄气分。
中焦药。痧火在中。为阳明燥化。多气多血。用药气味。苦寒为宜。若日多胃津消烁。苦则助燥劫
津。甘寒宜用。
下焦药。咸苦为主。若热毒下注成痢。不必咸以 坚。但取苦味坚阴燥湿。
古人以痧为经腑之病。忌温燥涩补。所谓痘喜温暖。疹喜清凉也。然常有气弱体虚。表散寒凉
非法。淹淹酿成损怯。但阴伤为多。救阴必扶持胃汁。气衰者亦有之。急当益气。稚年阳体纯刚
之药忌用。幼科方书歌括曰。赤疹遇清凉而消。白疹得温暖而解。此温字。即后人酒酿柽木粗
草纸木棉纱之属。虽不可不知。然近年用者多无益。
痧疳。湿盛热蒸。口舌咽喉疳蚀。若不速治。有穿腮破颊咽闭喘促告毙矣。治之宜早。外治另有
专方。若汤药方法。必轻淡能解上病。或清散亦可。
痧痢乃热毒内陷。与伤寒协热邪尽则痢止同法。忌升提。忌补涩。轻则分利宣通。重则苦寒解
毒。
滑寿曾说：小儿在三岁以内，看手虎口三节，男看左手，女看右手，称为“三关”。指纹颜色紫主热，红主伤寒，青主惊风，白主疳病，淡红色为平常的小病。指纹的筋纹宜隐藏，不宜暴露。如果见到黑色，则病情危险。另外，脉纹见在下截的风关为轻症，在中截的气关为重症，在上截的命关为尤重。如果直透三关，则为大危之症。
（痧子，吴语读音；疹，北音读丹）
痧疹属于阳腑经邪。初起时必须从表证治疗。症状表现为头痛、喘急咳嗽、气粗、呕吐恶心。发病在一天或两天的较轻，发病在三五天的较重。如果是阳病超过七天，疹点隐伏不透，邪气反而内攻，导致喘息不止，必定出现腹痛、腹胀、便秘、闷乱等危重症状。治疗方法宜用苦辛清热之法，凉膈散去掉硝黄。
方书说足阳明胃经的疹，如云布般密集，或者颗粒大如痘疮，但没有根盘。方书说手太阴肺经的疹，只有点粒，没有成片者。治疗用辛散解肌的方法。冬季无汗、壮热喘急的，用麻杏石甘汤类方，如华盖散、三拗汤。夏季无汗的，用辛凉解肌法，选用葛根、前胡、薄荷、防风、香薷、牛蒡子、枳壳、桔梗、木通这类药物。
古人认为表邪口渴，就加葛根，因为它能升发阳明胃津。如果热盛烦渴，用石膏辛寒解肌，但无汗时忌用。
凡是疮疹，以辛凉为宜。连翘味辛凉，出众草之上，既能升散又能清泄，最利于儿科，能解除小儿六经的各种热证。
春季发痧多从风温而来，夏季多从暑风而来，暑邪必然兼夹湿邪，秋季多从热烁燥气而来，冬季多从风寒而来。
疹宜通泄，腹泻为顺证，下痢五色也无妨。唯独二便不利的，最多是凶险病症。治疗方法大忌止泻。
痧本是由于六气客邪所致，风寒暑湿，必然从火化。痧既外发，世人都说是邪气透出，谁曾想到在出没之际，升必有降，胜必有复。常有痧疹外发，身热不退，导致咽喉嘶哑、牙龈腐烂、喘急腹胀、下痢不食、烦躁昏沉，最终死亡的案例，这都是因为里症不清导致变证。必须分辨三焦受邪孰多，或者兼有其他疾病累及身体。必须仔细体认。上焦用药宜用辛凉，中焦用药宜用苦辛寒，下焦用药宜用咸寒。
上焦药，气味宜轻。肺主气，皮毛属肺之合，外邪宜用辛胜，里甚宜用苦胜。如果不烦渴，病日多，邪郁不清，可用淡渗之品以泄气分之邪。
中焦药，痧火在中，为阳明燥化，多气多血，用药气味以苦寒为宜。如果日多胃津消烁，苦味会助燥劫津，宜用甘寒。
下焦药，以咸苦为主。如果热毒下注成痢，不必用咸味以坚阴，只需取苦味以坚阴燥湿。
古人认为痧是经腑之病，忌用温燥涩补。所谓痘疮喜欢温暖，疹子喜欢清凉。然而常有气弱体虚的人，误用发散寒凉非法，拖延酿成损怯之症。但阴伤的情况居多，救阴必须扶持胃汁。气衰的也有，急当益气。年幼阳气纯刚之体，忌用刚猛之药。儿科方书歌诀说：赤疹遇清凉而消，白疹得温暖而解。这个“温”字，即后人用的酒酿、柽柳、粗草纸、木棉纱之类。虽然不可不知，但近年使用的人大多无益。
痧疳，湿盛热蒸，口舌咽喉疳蚀。如果不迅速治疗，会有穿腮破颊、咽闭喘促而死亡的危险。治疗宜早。外治另有专方。如果汤药方法，必用轻淡能解上病的药，或者清散也可。
痧痢乃是热毒内陷，与伤寒协热邪尽则痢止的方法相同。忌升提，忌补涩。轻则分利宣通，重则苦寒解毒。
Hua Shou once said: For children under three years old, observe the three segments at the tiger's mouth of the hand; for boys, the left hand is observed, and for girls, the right hand. This is called the "Three Passes" (San Guan). A purple fingerprint color indicates heat, red indicates cold damage (Shang Han), green indicates convulsive wind (Jing Feng), white indicates malnutrition disease (Gan Bing), and pale red indicates a minor ordinary illness. The vein pattern should be concealed, not exposed. If black is seen, it indicates a dangerous condition. Furthermore, if the vein pattern appears in the lower segment (Wind Pass, Feng Guan), it is mild; in the middle segment (Qi Pass, Qi Guan), it is severe; and in the upper segment (Life Pass, Ming Guan), it is particularly severe. If it penetrates straight through all three passes, it indicates a critical danger.
(Sha Zi, Wu dialect pronunciation; Zhen, Northern dialect pronunciation reads as Dan)
Sha Zhen (Miliaria/Rash) belongs to pathogenic factors of Yang Fu meridians. In the initial stage, treatment must focus on the exterior syndrome. Symptoms include headache, panting and急促 cough, coarse breathing, vomiting, and nausea. Onset within one or two days is mild; onset within three to five days is severe. If Yang disease persists beyond seven days with rash hidden and not emerging, pathogens may attack internally, causing unceasing panting, abdominal pain, distension, constipation, and stifling sensations, which are critical. The treatment method should employ bitter and acrid herbs to clear heat, such as Liang Ge San (Cool the Diaphragm Decoction) without Rhubarb (Da Huang) and Mirabilite (Mang Xiao).
Medical texts state that rash from the Foot-Yangming Stomach meridian is dense like clouds or large like smallpox pustules but lacks a root base. Rash from the Hand-Taiyin Lung meridian presents only as spots without patches. Treatment uses acrid dispersants to release the muscle layer. In winter, with no sweat, high fever, and panting, use formulas like Mahuang Xingren Gancao Shigao Tang (Ephedra, Apricot Kernel, Licorice, and Gypsum Decoction), such as Huagai San or Sannao Tang. In summer, with no sweat, use acrid-cool methods to release the muscle layer, selecting herbs like Ge Gen (Puerariae Radix), Qian Hu (Peucedani Radix), Bo He (Menthae Haplocalycis Herba), Fang Feng (Saposhnikoviae Radix), Xiang Ru (Moslae Herba), Niu Bang Zi (Arctii Fructus), Zhi Ke (Aurantii Fructus), Jie Geng (Platycodonis Radix), and Mu Tong (Akebiae Caulis).
Ancients believed that for exterior pathogens causing thirst, add Ge Gen (Puerariae Radix) because it raises Yangming Stomach fluids. For severe heat with vexation and thirst, use Shi Gao (Gypsum Fibrosum) with acrid-cool properties to release the muscle layer, but avoid it when there is no sweat.
For all sores and rashes, acrid-cool is appropriate. Lian Qiao (Forsythiae Fructus) is acrid and cool, superior among herbs, capable of ascending and clearing, most beneficial for pediatrics, able to resolve various heat syndromes in the six meridians of children.
In spring, Sha erupts following Wind-Warmth (Feng Wen); in summer, following Summerheat-Wind (Shu Feng), where Summerheat inevitably combines with Dampness; in autumn, following Heat scorching Dryness; in winter, following Wind-Cold.
Rash should be vented and purged; diarrhea is a favorable sign, and dysentery with five colors is also acceptable. However, difficulty in urination and defecation indicates mostly fatal cases. Treatment strictly forbids stopping diarrhea.
Sha originates from pathogenic factors of the Six Qi (Wind, Cold, Summerheat, Dampness, Dryness, Fire). Wind, Cold, Summerheat, and Dampness must transform into Fire. Once Sha erupts externally, people say pathogens are expelling out, but who realizes that during emergence and disappearance, ascent must have descent, victory must have retreat. Often, after Sha erupts externally, body heat does not subside, leading to hoarseness, gingival rot, panting, abdominal distension, dysentery, anorexia, restlessness, and coma, ultimately resulting in death. These are due to unclear interior syndromes causing complications. One must distinguish which of the Three Jiao (Upper, Middle, Lower Burners) has more pathogenic influence, or if other diseases are exhausting the body. Carefully analyze. Medicines for the Upper Jiao should be acrid-cool; for the Middle Jiao, bitter-acrid-cool; for the Lower Jiao, salty-cool.
Medicines for the Upper Jiao should have light aroma and flavor. The Lung governs Qi, and skin/hair belong to the Lung's exterior connection. Exterior pathogens are best treated with acrid dominance, while severe interior conditions require bitter dominance. If there is no vexation or thirst, and the disease lasts many days with stagnant pathogens, use bland diuretics to drain Qi-level pathogens.
Medicines for the Middle Jiao: Sha fire is in the center, transforming via Yangming dryness, involving much Qi and Blood. Medicines should be bitter and cold. If many days pass and Stomach fluids are consumed, bitter herbs will aid dryness and deplete fluids; sweet-cold herbs should be used.
Medicines for the Lower Jiao: Salty and bitter are primary. If heat-toxin sinks downward causing dysentery, do not necessarily use salty to firm Yin; simply take bitter to firm Yin and dry Dampness.
Ancients considered Sha a disease of meridians and Fu organs, contraindicating warm, drying, astringent, and tonifying treatments. It is said that smallpox prefers warmth, while rash prefers cooling. However, often those with weak Qi and deficient bodies misuse dispersing and cooling methods improperly, leading to chronic wasting diseases. But Yin injury is more common; saving Yin requires supporting Stomach fluids. Cases of Qi deficiency exist, requiring urgent Qi tonification. Young children have pure-gang Yang constitutions; avoid harsh drugs. Pediatric texts say: Red rash dissipates with cooling; white rash resolves with warmth. This "warmth" refers to later practices using fermented rice wine, Toosendan Fructus (Chuan Xin Ku), coarse paper, cotton yarn, etc. Although this knowledge is necessary, recent usage is often ineffective.
Sha Gan (Malnutrition associated with Sha): Excessive dampness and steaming heat cause Gan erosion of the mouth, tongue, and throat. If not treated quickly, it can lead to cheek perforation, jaw breakage, throat closure, panting, and death. Treatment should be early. External treatment has specific prescriptions. For decoctions, use light and bland herbs to resolve upper disorders, or clearing and dispersing methods.
Sha Dysentery is caused by heat-toxin sinking inward, similar to the method where dysentery stops when pathogens are exhausted in Taiyang-Shaoyang combined heat syndromes. Contraindicate lifting and tonifying/astringing. Mild cases use separation and promotion to unblock; severe cases use bitter-cold to resolve toxins.