夫痧麻。出自六腑。先动阳分。而后归于阴经。故标属阴。而本属阳也。如未出时。或
已
寒之药发之。时令严寒。以辛热之药发之。时令或寒或热。以辛平之药发之。但发得出。则
毒尽解若发不出。再加药发之。要其大纲。虽是热症。然不可骤用凉药。恐遏绝邪气于内。
而不得出。多有不救者。宜解毒发散为主。若发热之时。遍身汗出者。此毒从汗散。有鼻中
血出者。此毒从血解。若上吐下利。则毒从吐利解。俱不可遽止。若太过斟酌止之。痧已出
。其色喜红润极忌紫黑。如有咽喉肿痛。不能饮食者。此毒火拂郁。上熏咽喉也。咳嗽口干
心烦者。此毒在心肺。发未尽也。痧已出。而泻尤不止者。最为恶候。出已遍身。而尤拂拂
烦热。频作呕吐者。此毒未尽。留连于脾胃之间也。
解毒汤 治痧症初起。天时温暖。
防风 薄荷 荆芥 石膏 知母(各八分) 桔梗 甘草 牛蒡子 连翘 木通 枳壳(
各六分) 淡竹叶二十片煎服。
清毒汤 治初起夏月大热。
黄连 黄芩 防风 荆芥(各一钱) 桔梗 石膏 玄参 木通 山栀仁(各八分) 淡竹
叶二十片。煎服。
化毒汤 治痧症初起。冬月寒冷。
桂枝 麻黄 赤芍 防风(各八分) 荆芥 羌活 桔梗 人参 川芎(各五分) 牛蒡子
(一钱) 生姜三片。煎服。
清宁汤 治症汗出太多。鼻血不止。
当归 连翘 石膏 黄连(各一钱) 生地 麦门冬 玄胡(各七分) 甘草(二分) 浮小
麦一钱。煎服。
玄桔汤 治痧症。咽喉肿痛。
玄参 桔梗 牛蒡子 连翘 天花粉 甘草(各一钱) 淡竹甘片。煎服。
清金饮 治痧症咳嗽。口干心烦。
天花粉 桔梗 桑皮 知母(各七分) 玄参 连翘 干葛(各八分) 灯心三十茎。煎服
必胜饮 治痧已出。而泻不止。
陈皮 浓朴 苍术 白茯苓 牛蒡子 泽泻 木通(各八分) 生姜一片。食前煎服。
和荣散 治痧已出。浑身发热。
当归 川芎 生地 麦门冬 白芍 木通 甘草(各八分) 灯心三十茎。煎服。
灵功饮 治痧后痢疾。
当归 黄连 川芎(各八分) 人参(三分) 广木香 枳壳 滑石 槟榔(各六分) 甘草
(一分) 灯心三十茎。食前温服。
治痧发不出 葱一握。捣汁一盏。入酒浆一盏同服。
又秘方 樱桃核四十九粒。甘草五分。煎服。
痧出紫黑。急以人粪烧存性。酒调五分。立刻变红。
痧症和麻疹,病邪源自六腑。起初在阳分(体表及气分)活动,随后转入阴经(脏腑及血分)。因此,其外在表现属阴,而根本病因属阳。
如果在疹子未发出时,遇到时令严寒,应用辛热性质的药物来发散透疹;如果时令或寒或热,应用辛平性质的药物来发散透疹。只要能将疹毒发散出来,体内的毒素就能彻底解除。如果发不出来,需要再加药辅助发散。虽然这类病症总体属于热证,但不可突然使用寒凉药物,恐怕会遏制邪气于体内,导致无法透出,这样往往会导致病情危重甚至死亡。治疗应以解毒发散为主。
如果在发热期间,全身出汗,这是毒素随汗液散出;如果鼻中出血,这是毒素随血液排出;如果出现上吐下泻,这是毒素随呕吐和排泄物排出。这些情况都不可立即强行止住。如果过度斟酌而强行制止,后果严重。
痧疹已经发出后,颜色以红润为佳,最忌讳紫黑色。如果有咽喉肿痛、不能饮食的情况,这是毒火拂郁,向上熏蒸咽喉所致。如果有咳嗽、口干、心烦的症状,这是毒素在心肺,尚未完全发散。痧疹已经发出,但腹泻仍然不止的,是最为凶险的征候。痧疹已遍布全身,但仍然感到烦热不适,频繁呕吐的,这是毒素未尽,滞留于脾胃之间。
解毒汤:治疗痧症初起,天气温暖时。
防风、薄荷、荆芥、石膏、知母(各八分),桔梗、甘草、牛蒡子、连翘、木通、枳壳(各六分),淡竹叶二十片,煎服。
清毒汤:治疗初起夏季大热时。
黄连、黄芩、防风、荆芥(各一钱),桔梗、石膏、玄参、木通、山栀仁(各八分),淡竹叶二十片,煎服。
化毒汤:治疗痧症初起,冬季寒冷时。
桂枝、麻黄、赤芍、防风(各八分),荆芥、羌活、桔梗、人参、川芎(各五分),牛蒡子(一钱),生姜三片,煎服。
清宁汤:治疗症状表现为汗出太多、鼻血不止。
当归、连翘、石膏、黄连(各一钱),生地、麦门冬、玄胡索(各七分),甘草(二分),浮小麦一钱,煎服。
玄桔汤:治疗痧症引起的咽喉肿痛。
玄参、桔梗、牛蒡子、连翘、天花粉、甘草(各一钱),淡竹甘片(注:原文可能有误,通常指淡竹叶或甘草,此处依原文保留“淡竹甘片”,结合上下文推测可能为淡竹叶与甘草之合称或笔误,按字面翻译),煎服。
清金饮:治疗痧症引起的咳嗽、口干、心烦。
天花粉、桔梗、桑皮、知母(各七分),玄参、连翘、干葛(各八分),灯心草三十茎,煎服。
必胜饮:治疗痧疹已发出,但腹泻不止。
陈皮、浓朴、苍术、白茯苓、牛蒡子、泽泻、木通(各八分),生姜一片,饭前煎服。
和荣散:治疗痧疹已发出,浑身发热。
当归、川芎、生地、麦门冬、白芍、木通、甘草(各八分),灯心草三十茎,煎服。
灵功饮:治疗痧症后的痢疾。
当归、黄连、川芎(各八分),人参(三分),广木香、枳壳、滑石、槟榔(各六分),甘草(一分),灯心草三十茎,饭前温服。
治疗痧疹发不出:葱一把,捣取汁液一盏,加入酒浆一盏,同服。
痧疹发出呈紫黑色,紧急情况下用人粪烧至存性(保留药材基本性质),用酒调服五分,立刻变为红色。
Sha (toxic rash) and Ma (measles) originate from the Six Fu Organs. Initially, they affect the Yang aspect (the exterior and Qi level), and subsequently return to the Yin meridians (Zang-Fu organs and Blood level). Therefore, the manifestation is attributed to Yin, while the root cause is attributed to Yang.
If the eruption has not yet appeared, and the seasonal climate is severely cold, acrid-warm herbs should be used to induce dispersion. If the seasonal climate is either cold or hot, acrid-neutral herbs should be used for dispersion. As long as the eruption can be brought out, the toxins will be completely resolved. If it cannot be dispersed, additional medication should be added to assist in dispersion. Although these conditions are generally heat syndromes, sudden use of cold-cooling medicines must be avoided, lest they suppress the pathogenic factors inside, preventing them from exiting, which often leads to untreatable cases. The treatment should primarily focus on resolving toxicity and inducing dispersion.
During fever, if sweating occurs all over the body, this indicates that the toxin is dispersing through sweat. If bleeding occurs from the nose, this indicates that the toxin is resolving through blood. If vomiting and diarrhea occur, this indicates that the toxin is resolving through emesis and purgation. In all these cases, immediate cessation of these excretory processes should not be attempted. Over-cautious intervention to stop them may lead to severe consequences.
Once the Sha rash has erupted, a rosy-red color is desirable, while purple-black is strictly contraindicated. If there is swelling and pain in the throat with inability to eat or drink, this is due to toxic fire stagnating and steaming upward into the throat. If there is cough, dry mouth, and irritability, this indicates that the toxin resides in the Heart and Lungs and has not yet fully dispersed. If the Sha rash has erupted but diarrhea persists without stopping, this is considered a most ominous sign. If the rash covers the entire body but the patient still feels persistent irritability and heat, accompanied by frequent vomiting, this indicates that the toxin is incomplete and lingering between the Spleen and Stomach.
Jiedu Tang (Detoxification Decoction): Treats early-stage Sha syndrome when the weather is warm.
Fangfeng (Saposhnikovia Root), Bohe (Mint), Jingjie (Schizonepeta Spike), Shigao (Gypsum Fibrosum), Zhimu (Anemarrhenae Rhizoma) (each 8 fen); Jiegeng (Platycodon Root), Gancao (Licorice Root), Niubangzi (Arctii Fructus), Lianqiao (Forsythiae Fructus), Mutong (Akebiae Caulis), Zhike (Aurantii Fructus) (each 6 fen); Danzhuye (Lophatheri Herba) 20 leaves. Decoct and take orally.
Qingdu Tang (Clearing Toxicity Decoction): Treats early-stage syndrome during summer with intense heat.
Huanglian (Coptidis Rhizoma), Huangqin (Scutellariae Radix), Fangfeng (Saposhnikovia Root), Jingjie (Schizonepeta Spike) (each 1 qian); Jiegeng (Platycodon Root), Shigao (Gypsum Fibrosum), Xuanshen (Scrophulariae Radix), Mutong (Akebiae Caulis), Shanzhiren (Gardeniae Semen) (each 8 fen); Danzhuye (Lophatheri Herba) 20 leaves. Decoct and take orally.
Huadu Tang (Transforming Toxicity Decoction): Treats early-stage Sha syndrome during winter with cold weather.
Guizhi (Cinnamomi Ramulus), Mahuang (Ephedrae Herba), Chishao (Paeoniae Radix Rubra), Fangfeng (Saposhnikovia Root) (each 8 fen); Jingjie (Schizonepeta Spike), Qianghuo (Notopterygii Rhizoma et Radix), Jiegeng (Platycodon Root), Renshen (Ginseng Radix), Chuanxiong (Ligustici Chuanxiong Rhizoma) (each 5 fen); Niubangzi (Arctii Fructus) (1 qian); Shengjiang (Zingiberis Rhizoma Recens) 3 slices. Decoct and take orally.
Qingning Tang (Clearing Tranquility Decoction): Treats symptoms of excessive sweating and unceasing epistaxis.
Danggui (Angelicae Sinensis Radix), Lianqiao (Forsythiae Fructus), Shigao (Gypsum Fibrosum), Huanglian (Coptidis Rhizoma) (each 1 qian); Shengdi (Rehmanniae Radix), Maidong (Ophiopogonis Radix), Xuanhu (Curcumae Radix) (each 7 fen); Gancao (Licorice Radix et Rhizoma) (2 fen); Xiaomai (Tritici Fructus) 1 qian. Decoct and take orally.
Xuanjie Tang (Scrophularia and Platycodon Decoction): Treats Sha syndrome with swelling and pain in the throat.
Xuanshen (Scrophulariae Radix), Jiegeng (Platycodon Root), Niubangzi (Arctii Fructus), Lianqiao (Forsythiae Fructus), Tianhuafen (Trichosanthis Radix), Gancao (Licorice Radix et Rhizoma) (each 1 qian); Danzhu Gan Pian (likely referring to Danzhuye and Gancao, or a specific preparation). Decoct and take orally.
Qingjin Yin (Clearing Metal Beverage): Treats Sha syndrome with cough, dry mouth, and irritability.
Tianhuafen (Trichosanthis Radix), Jiegeng (Platycodon Root), Sangbai Pi (Mori Cortex), Zhimu (Anemarrhenae Rhizoma) (each 7 fen); Xuanshen (Scrophulariae Radix), Lianqiao (Forsythiae Fructus), Genge (Puerariae Lobatae Radix) (each 8 fen); Dengxin Cao (Junci Medulla) 30 stems. Decoct and take orally.
Bisheng Yin (Invincible Beverage): Treats Sha rash that has erupted but is accompanied by persistent diarrhea.
Chenpi (Citri Reticulatae Pericarpium), Houpo (Magnoliae Officinalis Cortex), Cangzhu (Atractylodis Rhizoma), Baifuling (Poria), Niubangzi (Arctii Fructus), Zexie (Alismatis Rhizoma), Mutong (Akebiae Caulis) (each 8 fen); Shengjiang (Zingiberis Rhizoma Recens) 1 slice. Decoct and take before meals.
Herong San (Harmonizing Nutrient Powder): Treats Sha rash that has erupted with generalized fever.
Danggui (Angelicae Sinensis Radix), Chuanxiong (Ligustici Chuanxiong Rhizoma), Shengdi (Rehmanniae Radix), Maidong (Ophiopogonis Radix), Baishao (Paeoniae Radix Alba), Mutong (Akebiae Caulis), Gancao (Licorice Radix et Rhizoma) (each 8 fen); Dengxin Cao (Junci Medulla) 30 stems. Decoct and take orally.
Linggong Yin (Spiritual Merit Beverage): Treats dysentery following Sha syndrome.
Danggui (Angelicae Sinensis Radix), Huanglian (Coptidis Rhizoma), Chuanxiong (Ligustici Chuanxiong Rhizoma) (each 8 fen); Renshen (Ginseng Radix) (3 fen); Muxiang (Aucklandiae Radix), Zhike (Aurantii Fructus), Huashi (Kaolin), Binglang (Arecae Semen) (each 6 fen); Gancao (Licorice Radix et Rhizoma) (1 fen); Dengxin Cao (Junci Medulla) 30 stems. Take warm before meals.
Treatment for Sha that fails to erupt: Take one handful of Congbai (Allii Fistulosi Bulbus), crush to extract juice (one cup), mix with one cup of wine, and take together.
Another secret prescription: Take 49 Yingtao He (Prunus pseudocerasus seeds), Gancao (Licorice Radix et Rhizoma) 5 fen. Decoct and take orally.
For Sha rash erupting in purple-black color: Urgently use Renfen (Human Feces) burned until "preserving nature" (charred but retaining properties), mixed with wine, taken at a dose of 5 fen. The color will immediately turn red.