疹证初起,多有泄泻不止者,其毒火正可因泻而减,此殊无
妨,若出透之后,而泻红黄色粪者,乃内有伏热也,与泄泻过甚者,俱宜以加味三苓散与之,一服即愈,切不可
用参术诃蔻补涩之剂,以图速止,否则必多变证,轻则变为休息痢,重则变为腹胀喘满而不可救,戒之戒之。
附加味三苓散方
结猪苓(七分) 细木通(七分) 车前子(七分) 赤茯苓(七分) 宣泽泻(八分) 酒炒黄芩(五分)
炒研牛蒡子(五分) 川黄连(二分) 引用灯芯(五十寸)
疹证见形,三日之后,当渐次没落,不疾不徐,方为无病,若一二日疹即收没,此为太速,因调摄不谨,或
为风寒所袭,或为邪秽所触,以致毒反内攻,轻则烦渴谵狂,重则神昏闷乱,古法主内服荆防解毒汤(如薄荷、
连翘、荆芥、防风、黄芩、黄连、牛蒡子、大青叶、犀角、人中黄,引用灯芯、芦根)。
亦有当散不散者,因有虚热留滞于肌表也,其证潮热烦渴,口燥咽干,切不用纯用寒凉之剂,古法主柴胡四
物汤(如柴胡、白芍、当归、川芎、生地、人参、淡竹叶、地骨皮、知母、黄芩、麦冬,引用生姜、红枣)。
〔真按〕疹证因风寒邪秽所伤,收没太早,方用荆防解毒,正合病情,兹拟鲜大青叶二钱,北防风一钱,酒
黄芩一钱,酒黄连五分,连翘壳一钱,人中黄一钱,荆芥穗六分,犀角片五分,苏薄荷六分,引用灯芯一束,鲜
芦根二钱,牛蒡子一钱。
若虚热留滞肌表,方用鲜生地三钱,台党参钱半,当归尾八分,软柴胡五分,炒白芍一钱,炒知母一钱,酒
黄芩八分,蜜炙桑白皮八分,淡竹叶五分,麦冬去芯一钱,引用小红枣一枚。
麻疹病症在初期,常伴有持续不止的腹泻,此时体内的毒火正可借由排泄而减轻,这完全没有妨碍。若皮疹透发之后,排出红黄色的粪便,这是体内有潜伏的热邪所致;对于此类情况以及泄泻过于严重的患者,都适宜服用加味三苓散,服药一次即可痊愈。切不可使用人参、白术、诃子、肉豆蔻等具有补益收敛作用的药物来图谋快速止泻,否则必然导致多种变证:轻则转变为休息痢(时好时坏的痢疾),重则转变为腹胀气喘胸闷且无法救治,务必警惕。
附加味三苓散方剂组成:
猪苓(七分) 细木通(七分) 车前子(七分) 赤茯苓(七分) 宣泽泻(八分) 酒炒黄芩(五分)
炒研牛蒡子(五分) 川黄连(二分) 引用灯芯(五十寸)
麻疹病症显现出形态后,三天左右应当逐渐消退,不快不慢,这才是没有病情的表现。如果一两天内皮疹就迅速收没,这属于消退太快,是因为护理不慎,或被风寒侵袭,或被污秽邪气触动,导致毒素反而向内攻陷。轻则出现烦躁口渴、胡言乱语甚至狂躁,重则出现神志昏迷、烦闷混乱。古法主张内服荆防解毒汤(包含薄荷、连翘、荆芥、防风、黄芩、黄连、牛蒡子、大青叶、犀角、人中黄,引用灯芯、芦根)。
也有该发散却未能发散的情况,这是因为虚热留滞于肌表所致。其症状表现为潮热、烦躁口渴、口燥咽干。切忌单纯使用寒凉性质的药物。古法主张使用柴胡四物汤(包含柴胡、白芍、当归、川芎、生地、人参、淡竹叶、地骨皮、知母、黄芩、麦冬,引用生姜、红枣)。
〔作者按语〕麻疹因受风寒和污秽邪气伤害,导致皮疹收没过早,此时使用荆防解毒汤,正符合病情。现拟定处方:鲜大青叶二钱,北防风一钱,酒黄芩一钱,酒黄连五分,连翘壳一钱,人中黄一钱,荆芥穗六分,犀角片五分,苏薄荷六分,引用灯芯一束,鲜芦根二钱,牛蒡子一钱。
若是虚热留滞于肌表,则使用以下方剂:鲜生地三钱,台党参钱半,当归尾八分,软柴胡五分,炒白芍一钱,炒知母一钱,酒黄芩八分,蜜炙桑白皮八分,淡竹叶五分,麦冬去芯一钱,引用小红枣一枚。
In the initial stage of measles (Rash Disease), there is often persistent diarrhea. At this time, the pathogenic heat-toxin can be reduced through excretion, which poses no harm whatsoever. However, if after the rash has fully erupted, red or yellow stools are passed, this indicates latent heat within the interior. For such cases, as well as those with severe diarrhea, it is appropriate to administer Jiawei Sanling San (Modified Three-Ling Powder). One dose will result in a cure. One must absolutely avoid using tonifying and astringent agents containing Renshen (Ginseng Root), Baizhu (Atractylodis Rhizoma), Hezi (Chebulae Fructus), and Doukou (Amomi Fructus Rotundus) to seek rapid cessation of diarrhea; otherwise, various complications will inevitably arise. Mildly, it may transform into Xixi Li (Intermittent Dysentery); severely, it may transform into abdominal distension, wheezing, and fullness that is incurable. Take heed, take heed.
Formula for Jiawei Sanling San (Modified Three-Ling Powder):
Zhuling (Polyporus), 7 fen; Mutong (Akebiae Caulis), 7 fen; Cheqianzi (Plantaginis Semen), 7 fen; Chifuling (Poria with Hostwood), 7 fen; Zexie (Alismatis Rhizoma), 8 fen; Huangqin (Scutellariae Radix), stir-fried with wine, 5 fen; Niubangzi (Arctii Fructus), stir-fried and ground, 5 fen; Huanglian (Coptidis Rhizoma), 2 fen; Yin yong Dengxincao (Luminae Amentum), 50 cun.
After the measles rash appears, it should gradually fade over three days, neither too fast nor too slow, which indicates health. If the rash recedes within one or two days, this is considered too rapid. This is due to careless nursing, invasion by wind-cold, or contact with foul pathogens, causing the toxin to retreat inward. Mildly, it presents with irritability, thirst, delirium, and mania; severely, it presents with coma, confusion, and restlessness. Ancient methods advocate internal administration of Jingfang Jiedu Tang (Jingjie and Fangfeng Detoxification Decoction), which includes Bohe (Menthae Haplocalycis Herba), Lianqiao (Forsythiae Fructus), Jingjie (Schizonepetae Spica), Fangfeng (Saposhnikoviae Radix), Huangqin (Scutellariae Radix), Huanglian (Coptidis Rhizoma), Niubangzi (Arctii Fructus), Daqingye (Isatidis Folium), Xijiao (Rhino Ceruos), Renzhonghuang (Natrii Sulfas), with Dengxincao (Luminae Amentum) and Lugeng (Phragmitis Rhizoma) as guides.
There are also cases where the rash should disperse but fails to do so, caused by deficient heat lingering on the muscle surface. The symptoms include tidal fever, irritability, thirst, dry mouth, and dry throat. Purely cold-natured agents must not be used. Ancient methods advocate Chaihu Siwu Tang (Bupleurum Four-Substance Decoction), which includes Chaihu (Bupleuri Radix), Baishao (Paeoniae Radix Alba), Danggui (Angelicae Sinensis Radix), Chuanxiong (Chuanxiong Rhizoma), Shengdi (Rehmanniae Radix), Renshen (Ginseng Root), Danzhuye (Lophatheri Herba), Digupi (Lycii Cortex), Zhimu (Anemarrhenae Rhizoma), Huangqin (Scutellariae Radix), Maidong (Ophiopogonis Tuber), with Shengjiang (Zingiberis Rhizoma Recens) and Hongzao (Jujubae Fructus) as guides.
[Author's Note] When measles is injured by wind-cold and foul pathogens, leading to premature recession of the rash, the use of Jingfang Jiedu Tang is precisely in accordance with the condition. I hereby prescribe: Xian Daqingye (Fresh Isatidis Folium), 2 qian; Bei Fangfeng (Northern Saposhnikoviae Radix), 1 qian; Jiu Huangqin (Scutellariae Radix, wine-processed), 1 qian; Jiu Huanglian (Coptidis Rhizoma, wine-processed), 5 fen; Lianqiao Qiao (Forsythiae Fructus shell), 1 qian; Renzhonghuang (Natrii Sulfas), 1 qian; Jingjie Sui (Schizonepetae Spica), 6 fen; Xijiao Pian (Rhino Ceruos slice), 5 fen; Su Bohe (Menthae Haplocalycis Herba, Su variety), 6 fen; Yin yong Dengxincao (Luminae Amentum), one bundle; Xian Lugeng (Fresh Phragmitis Rhizoma), 2 qian; Niubangzi (Arctii Fructus), 1 qian.
If deficient heat lingers on the muscle surface, the following formula is used: Xian Shengdi (Fresh Rehmanniae Radix), 3 qian; Tai Dangshen (Codonopsis Radix from Taiyuan), 1.5 qian; Danggui Wei (Angelicae Sinensis Radix tail), 8 fen; Ruan Chaihu (Bupleuri Radix, soft variety), 5 fen; Chao Baishao (Paeoniae Radix Alba, stir-fried), 1 qian; Chao Zhimu (Anemarrhenae Rhizoma, stir-fried), 1 qian; Jiu Huangqin (Scutellariae Radix, wine-processed), 8 fen; Mi Zhi Sangbaipi (Mori Cortex, honey-fried), 8 fen; Danzhuye (Lophatheri Herba), 5 fen; Maidong Qu Xin (Ophiopogonis Tuber, core removed), 1 qian; Yin yong Xiao Hongzao (Small Jujubae Fructus), one piece.