属少阳。三焦相火。有色痕而无头粒。重者红如锦纹。疹属少阴君火。浮小而有头粒
。随
一则下之早。一则下之晚。乃外感热病发斑也。阴症发斑。皆出背胸之间手足虽有。亦稀少
而微红。此无根失守之火。聚于胸中。止独熏肺。传于皮肤。而为斑点。但如蚊蚋蚤虱形
状
。而非锦纹也。内伤发斑者。胃气极重。一身之火游行于外。所致轻如蚊迹。多在手足也。
疹虽属少阴君火。见于面多者。乃心火入肺而然。背上多者。足太阳膀胱火热而然。胸前多
者。足阳明火热而然。四肢多者。脾与心火热而然也。又有所谓瘾疹者。多属脾。隐隐然
在皮肤之间。故曰瘾疹。发则多痒不仁。有风热风湿之殊。又有所谓丹疹者。皆恶热毒血蓄于
命门。遇相火合发。即发也。色有赤白。热有微甚耳。在小儿得之名曰赤瘤。自有治法。见哑
阳浮而数。阴实而大。火盛于表。故阳浮而数。下焦实热。故阴实而大。
消斑青黛饮 治热传里。里实有虚。血热不散。热气乘虚。出于皮肤而为斑。色黑者不
治。
枣二枳。竹叶十五片。不拘时服。
玄参升麻汤 治热毒发斑。咽痛烦躁谵语。
玄参 升麻 甘草(各二钱) 石膏 知母(各二钱五分)
水煎服。
消毒犀角汤 治 及瘾疹。
牛蒡子(五钱) 荆芥 甘草 防风(各二钱)
水煎温服。
消风散 治丹疹。属血风血热。
荆芥 甘草 陈皮 浓朴(各五钱) 白僵蚕 人参 蝉蜕 茯苓 防风(各二钱) 川芎
藿香 羌活(各一钱)
上为末。每服三钱。清茶调下。
通圣散 治诸 。身上热疹子。
防风 川芎 当归 麻黄 薄荷 连翘 芒硝 大黄 白芍(各二钱) 黄芩 石膏 桔
梗滑石 荆芥 山栀 白术 甘草(各一钱五分) 水煎热服。
属于少阳经。三焦相火(寄居于三焦的命门之火)所致者,皮肤上有红色痕迹但没有颗粒状突起。病情重的,颜色红得像锦缎上的花纹一样。疹子属于少阴君火(心包络之火),形态浮浅细小且有颗粒状突起。
(关于斑与疹的鉴别及成因):一则是因为攻下法使用得太早,一则是因为攻下法使用得太晚,这导致了外感热病出现发斑的症状。阴证发斑,大多出现在背部和胸部之间,虽然手脚上也有,但稀少且颜色微红。这是无根失守的虚火,聚集在胸中,只单独熏蒸肺部,然后传变到皮肤,形成斑点。形状像蚊子、虻虫、跳蚤、虱子的叮咬痕迹,而不是像锦缎那样的花纹。内伤导致的发斑,是因为胃气极重,全身的火气游行于体表之外,所以症状轻微,像蚊子的痕迹,多出现在手脚部位。
(关于疹子分布部位的辨证):虽然疹子属于少阴君火,但如果面部多见,是心火传入肺脏所致;如果背部多见,是足太阳膀胱经火热所致;如果胸前多见,是足阳明经火热所致;如果四肢多见,是脾脏和心脏火热所致。
(关于瘾疹和丹疹):又有所谓“瘾疹”的,大多属于脾脏病变,隐隐约约在皮肤之间,所以叫瘾疹。发作时大多瘙痒且感觉麻木不仁,有风热和风湿的区别。又有所谓“丹疹”的,都是恶毒的热血蓄积在命门,遇到相火合并发作,就会立即发病。颜色有赤色和白色之分,热势有轻微和严重之别。在小儿身上得此病名叫“赤瘤”,自有其治疗方法。(原文此处中断,“见哑”后内容缺失)
(脉象分析):阳脉浮而数,阴脉实而大。这是因为火邪盛于体表,所以阳脉浮而数;下焦有实热,所以阴脉实而大小。
消斑青黛饮:治疗热邪传入里部,里实兼有虚损,血热不散,热气乘虚而出,发于皮肤成为斑疹。如果颜色发黑则难以治愈。方药组成:栀子二枚,竹叶十五片。不拘时候服用。
玄参升麻汤:治疗热毒发斑,伴有咽喉疼痛、烦躁、说胡话(谵语)。方药组成:玄参、升麻、甘草(各二钱),石膏、知母(各二钱五分)。用水煎服。
消毒犀角汤:治疗斑疹及瘾疹。方药组成:牛蒡子(五钱),荆芥、甘草、防风(各二钱)。用水煎温服。
消风散:治疗丹疹。属于血风和血热所致。方药组成:荆芥、甘草、陈皮、厚朴(各五钱),白僵蚕、人参、蝉蜕、茯苓、防风(各二钱),川芎、藿香、羌活(各一钱)。以上药物研为细末,每次服用三钱,用清茶调服。
通圣散:治疗各种斑疹。身上发热出疹子。方药组成:防风、川芎、当归、麻黄、薄荷、连翘、芒硝、大黄、白芍(各二钱),黄芩、石膏、桔梗、滑石、荆芥、山栀、白术、甘草(各一钱五分)。用水煎热服。
Belongs to the Shaoyang (Lesser Yang) channel. The Sanjiao Xianghuo (Ministerial Fire of the Sanjiao) manifests as red marks on the skin without granular protrusions. In severe cases, the color is red like brocade patterns. Rashes belong to the Shaoyin Junhuo (Monarch Fire of the Shaoyin); they are superficial, small, and have granular protrusions.
(Regarding the differentiation and etiology of macules and rashes): One cause is the premature use of purgative methods, and another is the delayed use of purgative methods, leading to the manifestation of macules in exogenous febrile diseases. Macules resulting from Yin syndromes mostly appear between the back and chest; although present on the hands and feet, they are sparse and slightly red. This is due to rootless and unanchored fire gathering in the chest, solely steaming the Lung, and then transmitting to the skin, forming spots. Their shape resembles bites from mosquitoes, horseflies, fleas, or lice, rather than brocade-like patterns. Macules caused by internal injury result from excessive Stomach Qi, causing the fire of the whole body to wander outside the body surface; thus, the symptoms are mild, resembling mosquito bites, and mostly occur on the hands and feet.
(Differentiation based on rash distribution): Although rashes belong to the Shaoyin Junhuo, if they appear predominantly on the face, it is due to Heart Fire entering the Lung; if predominant on the back, it is due to heat-fire of the Foot-Taiyang Bladder channel; if predominant on the chest, it is due to heat-fire of the Foot-Yangming channel; if predominant on the limbs, it is due to heat-fire of the Spleen and Heart.
(Regarding Yin Zhen and Dan Zhen): There is also what is called "Yin Zhen" (Urticaria), which mostly belongs to the Spleen. It appears faintly within the skin, hence the name. Upon eruption, it causes itching and numbness, with distinctions between Wind-Heat and Wind-Dampness. There is also what is called "Dan Zhen" (Erythema/Rash), which results from evil toxic blood accumulating in the Mingmen (Gate of Life). When combined with Xianghuo (Ministerial Fire), it erupts immediately. The color may be red or white, and the heat may be slight or severe. In children, this condition is named "Chi Liu" (Red Tumor), which has its own treatment methods. (The original text breaks here, following "see aphonia...")
(Pulse Analysis): The Yang pulse is floating and rapid, and the Yin pulse is solid and large. Because fire is abundant on the exterior, the Yang pulse is floating and rapid. Because there is excess heat in the Lower Jiao, the Yin pulse is solid and large.
Xiaoban Qingdai Yin (Macule-Dispersing Indigo Decoction): Treats heat transmitting to the interior, where interior excess coexists with deficiency. Blood heat does not disperse, and heat qi takes advantage of the deficiency to emerge through the skin, forming macules. If the color is black, it is difficult to treat. Formula: Gardenia (Zizhi) two fruits, Bamboo leaves (Zhuye) fifteen leaves. Take at any time.
Xuanshen Shengma Tang (Scrophulariae and Cimicifugae Decoction): Treats macules caused by heat-toxin, accompanied by sore throat, irritability, and delirious speech. Formula: Scrophulariae Radix (Xuanshen), Cimicifugae Rhizoma (Shengma), Glycyrrhizae Radix et Rhizoma (Gancao) (each 2 qian); Gypsum Fibrosum (Shigao), Anemarrhenae Rhizoma (Zhimu) (each 2.5 qian). Decoct in water and take.
Xiaodu Xijiao Tang (Detoxifying and Horn-of-Rhinoceros Decoction): Treats macules/rashes and urticaria. Formula: Arctii Fructus (Niubangzi) (5 qian), Schizonepetae Herba (Jingjie), Glycyrrhizae Radix et Rhizoma (Gancao), Saposhnikoviae Radix (Fangfeng) (each 2 qian). Decoct in water and take warm.
Xiaofeng San (Wind-Expelling Powder): Treats erythema/rash. Belongs to Blood-Wind and Blood-Heat. Formula: Schizonepetae Herba (Jingjie), Glycyrrhizae Radix et Rhizoma (Gancao), Citri Reticulatae Pericarpium (Chenpi), Magnoliae Officinalis Cortex (Houpo) (each 5 qian); Bombyx Batryticatus (Bai Jiangcan), Ginseng Radix et Rhizoma (Renshen), Cicadae Periostracum (Chantui), Poria (Fuling), Saposhnikoviae Radix (Fangfeng) (each 2 qian); Chuanxiong Rhizoma (Chuanxiong), Agastaches Herba (Huoxiang), Notopterygii Rhizoma et Radix (Qianghuo) (each 1 qian). Grind the above into powder. Take 3 qian per dose, mixed with clear tea.
Tongsheng San (Universal Salvation Powder): Treats various macules/rashes. Heat rash on the body. Formula: Saposhnikoviae Radix (Fangfeng), Chuanxiong Rhizoma (Chuanxiong), Angelicae Sinensis Radix (Danggui), Ephedrae Herba (Mahuang), Menthae Haplocalycis Herba (Bohe), Forsythiae Fructus (Lianqiao), Natrii Sulfas (Mangxiao), Rheomi Radix et Rhizoma (Dahuang), Paeoniae Radix Alba (Baishao) (each 2 qian); Scutellariae Radix (Huangqin), Gypsum Fibrosum (Shigao), Platycodonis Radix (Jiegeng), Talcum (Huashi), Schizonepetae Herba (Jingjie), Gardeniae Fructus (Shanzhi), Atractylodis Macrocephalae Rhizoma (Baizhu), Glycyrrhizae Radix et Rhizoma (Gancao) (each 1.5 qian). Decoct in water and take hot.