女人疹痘最难医,阴血时常有日亏、待得疹疮将发日,只愁天癸又当期。
发热经行非正时,火邪迫血血奔驰,急须凉血停为美,莫待中虚悔却迟。
发热期逢经水行,毒邪得解免烦蒸,过期不止须当虑,补气温令冷出匀。
发热适逢经水断,血室空虚防他变。若然谵妄神不清,热入血室治勿缓。
女子居经日已余,岂堪疮疹病来加,却愁血海停污垢,更怕胞门伏毒邪。
崩漏无时血已枯,泻而不满脏中虚,岂堪当此天行病,济弱扶危救弱躯。
妊娠疮痘治尤难,惟有安胎法最先,不可令胎轻触动,胎元触动命将残。
疮正甚时临正产,几人束手功莫展,消除恶露相时行,补益元神体忌惮。
产后如逢出疹疮,此时胎去免忧惶,只须补益收功效。若犯寒气生气伤。
疹属君火,气本少阴传于其子兮,故为胃脾之证,乘于其妻兮,现乎皮毛之分,亦
胎毒之所发,因疫疠而后成咳嗽喷嚏兮,辛金炼于丁火,顿闷泪出兮,君主御乎将军,
迎而夺之兮其锋易挫,随而坚之兮,其锐难胜。如折勾萌兮,斧斤不用,敬待燎原兮,
玉石俱焚,其色如斑,兮抬之有迹,其形似痘兮,视之无津,朝出暮收兮,发之于阳,
暮出朝收兮,发之于阴。变化莫测,出没靡定,大抵受亦未恶黑,治者喜凉而忌温。赤
如点朱兮光,明彰显之象,黑如洒墨兮,火郁曛昧之甚,制以酸凉兮,收炎光于丽泽,
投以辛热兮,纵赫曦于重明。痘欲尽发而不留,疹欲昼出而无病。或邪气之郁遏兮,留
而不去。或正气之损伤兮,困而未伸。毒归五脏,变有四证,毒归脾胃兮,泄泻不止而
变利。毒归心肝兮,烦热不退而发惊。咳嗽久而血出兮,毒归于肺。牙龈烂而疳蚀兮。
毒归于肾。轻者纵制以乡善,平之有功;重者,拒敌而肆恶,攻之不胜。牙若脱落兮,
崩砂之状可畏。声若哑嘎兮,狐惑之证难明。应出不出兮,发之须晓。应收不收兮,
解之应明。色淡白兮为虚,宜温养血,色紫黑兮血热,宜化毒清。发不出而烦躁兮,虞
不能腊。黑不变而谵妄兮,食不及新。蒸蒸兮,色赤痢。滴滴兮,胸高肩耸。疳烂兮漏
腮缺唇。休夸三世之妙手,难留一息之游魂,岂不闻误服汤丸兮,不如勿药,又不见
特犯禁忌兮、可以自省。爱吃咸酸兮,咳嗽连绵而未已。喜啖生燥兮,火热燔灼而不
宁,甘甜过而齿龋,生冷多而粪清,鸡则生风之畜,鱼则动火之鳞,鸡鱼贪而乱食,风
火并而后舋,邪反滋甚兮,为斑疹而不息,毒反深入兮,值疫疠而再经,斯则疹之遗毒,亦若痘之余证。
妇女患疹痘是最难治疗的病症,因为阴血时常有日久的亏损。等到疹疮将要发作的日子,又担心月经(天癸)正好来潮。
发热期间如果恰逢月经来潮,这不是正常的时候,这是火邪逼迫血液,导致血液运行急促狂奔。必须紧急采用凉血的方法使经血停止,这才是最好的处理,不要等到中气虚弱时才后悔已经太迟了。
如果在发热期间遇到月经来潮,毒邪随着经血得以解除,可以避免烦热蒸腾;但如果经期过期不止,就必须考虑补气温阳,让疹毒均匀地透发出来。
如果在发热时恰逢月经突然中断,这是因为血室空虚,要防止发生其他变证。如果出现胡言乱语、神志不清的症状,这是热入血室,治疗不可迟缓。
女子如果有停经数月才来一次月经的情况(居经),身体本就虚弱,哪里还能承受疮疹疾病的侵袭?更令人担忧的是血海中停滞的污血,以及害怕胞门潜伏着毒邪。
崩漏无定时且血液已经枯竭,泻下而腹部不胀满,这是脏腑内部虚弱。哪里还能承受这种时行疫病的治疗?只能救助虚弱,扶持危难,挽救微弱的躯体。
妊娠期患疮痘治疗尤其困难,只有安胎的方法最为优先。不可以让胎元轻易受到触动,一旦胎元被触动,性命就会受到严重威胁。
当疮疹正严重时恰逢分娩,很少有人能束手无策却施展不出功效。需要消除恶露并应对时行病,但补益元神时又要忌惮身体的承受能力。
产后如果遇到出疹疮,此时胎儿已去,无需再担忧惊惶。只需要通过补益的方法来收效。如果触犯寒气,就会损伤生气。
疹属于君火,其气本源于少阴经传于其子经(心包/三焦等关系,此处指代脏腑生克或经络传变),所以表现为胃脾的证候;若乘袭其妻经(肺),则显现于皮毛之分。这也是胎毒所引发的,因疫疠之气而后形成咳嗽喷嚏。辛金(肺)炼于丁火(心),导致顿时胸闷、流泪。君主(心)抵御将军(肝/邪气),迎头痛击则其锋芒容易挫败,顺势固守则其锐气难以战胜。就像折断刚发芽的草木一样,不需要斧斤砍伐;恭敬地等待燎原之势,则是玉石俱焚。疹的颜色像斑纹,抬起来有痕迹;形状似痘,看起来没有津液光泽。早晨发出傍晚消退,是发于阳分;傍晚发出早晨消退,是发于阴分。变化莫测,出没不定。大致来说,受邪未恶黑时,治疗者喜欢用凉法而忌讳温法。红色如点朱砂般光亮,是彰显之象;黑色如洒墨汁般晦暗,是火郁极甚之象。用酸凉之法制约,是在丽泽(水)中收敛炎光;投以辛热之法,则是纵容赫曦(烈日之火)在重明之中蔓延。痘欲尽发而不留滞,疹欲昼出而无病患。或者是邪气郁遏,停留不去;或者是正气受损,困顿未能伸展。毒归五脏,变化有四种证候:毒归脾胃,则泄泻不止而变为痢疾;毒归心肝,则烦热不退而发惊风;咳嗽久而出血,是毒归于肺;牙龈腐烂而疳蚀,是毒归于肾。轻症即使加以妥善控制,也能平复有功;重症则拒敌肆虐,攻之不胜。牙齿脱落,状如崩砂,令人畏惧;声音嘶哑,状如狐惑之证,难以辨明。应当发出而未发出的,发汗透疹须要知晓法度;应当收敛而未收敛的,解毒清热应当明白原理。颜色淡白为虚证,宜温养血液;颜色紫黑为血热,宜化解毒热。发不出来而烦躁,忧虑不能存活(腊在此处可能指代生机断绝或特定语境下的死亡隐喻,结合上下文意为危重);黑色不变而胡言乱语,饮食不及新进。蒸蒸发热,面色赤红伴痢疾;滴滴出汗,胸高肩耸。疳烂导致漏腮缺唇。不要夸耀三世妙手的神技,也难以留住一口气的游魂。难道没听说过误服汤药丸剂,不如不服药吗?又没看见特别触犯禁忌的,可以自我反省。爱吃咸酸食物,会导致咳嗽连绵不断;喜吃生冷燥烈食物,会导致火热燔灼不得安宁。甘甜过度则牙齿龋坏,生冷过多则粪便清稀。鸡是生风的畜类,鱼是动火的鳞类。贪吃鸡鱼而乱食,风火并行而后产生祸患。邪气反而滋盛,导致斑疹不息;毒邪反而深入,正值疫疠再次经过。这就是疹病的遗毒,也像痘病的余证一样。
Women suffering from rashes and smallpox are the most difficult cases to treat, as their Yin blood is often chronically deficient. When the rash is about to erupt, one worries that menstruation (Tian Gui) may coincide with this time.
If menstruation occurs during fever, it is not the proper timing; this indicates Fire pathogen forcing blood to rush recklessly. It is urgent to employ cooling-blood methods to stop the bleeding, which is ideal; do not wait until the Middle Jiao becomes deficient, for regret will come too late.
If menstruation coincides with fever, the toxic pathogen may be resolved through the flow of blood, avoiding烦热 (stifling heat). However, if the period persists beyond its expected duration, one must consider tonifying Qi and warming Yang to ensure the uniform eruption of the rash.
If menstruation stops abruptly during fever, the Blood Chamber is empty, raising the risk of other complications. If delirium and unclear consciousness occur, this is Heat entering the Blood Chamber, requiring prompt treatment without delay.
For women with infrequent menstruation (Ju Jing), where cycles extend over months, the body is already weakened and ill-equipped to withstand the assault of rash diseases. One fears stagnant impurities in the Sea of Blood and latent toxic pathogens in the Uterus Gate.
With irregular uterine bleeding (Beng Lou) leading to blood depletion, and diarrhea without abdominal fullness indicating internal organ deficiency, the patient is too weak to endure epidemic diseases. Treatment must focus on aiding the weak and rescuing the critical condition.
Treating rash or smallpox during pregnancy is particularly difficult; the primary method is to stabilize the fetus. The fetus must not be lightly disturbed, as disturbing the fetal origin can endanger life.
When severe rash coincides with childbirth, few physicians can achieve success without hesitation. One must eliminate lochia while managing the epidemic disease, but when tonifying the Primordial Yuan Qi, one must be cautious of the body's tolerance.
Postpartum rash eruption requires no anxiety regarding the fetus since it has been delivered. Tonification and supplementation are sufficient to achieve efficacy. However, exposure to Cold Qi will damage the vital Qi.
Rash belongs to Sovereign Fire. Its Qi originates from the Shaoyin channel and transmits to its "son" channels, thus manifesting as Stomach and Spleen syndromes. If it attacks its "wife" channel (Lung), it appears in the skin and hair level. This is also an eruption of fetal toxicity, followed by epidemic pestilence causing cough and sneezing. Metal (Xin) is refined by Fire (Ding), leading to sudden chest oppression and tearing. The Sovereign (Heart) defends against the General (Liver/Pathogen); attacking head-on easily breaks its momentum, while following and consolidating makes its sharpness hard to overcome. Like snapping young shoots, no axe is needed; waiting for the prairie fire results in jade and stone burning together. Rash color resembles spots, leaving traces when lifted; shape resembles pustules, appearing without moisture/gloss. Erupting in the morning and subsiding in the evening indicates emission from Yang; erupting in the evening and subsiding in the morning indicates emission from Yin. Changes are unpredictable, appearing and disappearing without fixed patterns. Generally, if the color is not yet dark/black, practitioners prefer cooling and avoid warming. Red like cinnabar points with brightness is a manifest image; black like spilled ink is extreme Fire stagnation and obscurity. Controlling with sour-cool methods gathers flame light in Li Ze (Water/Lake); administering pungent-hot methods indulges He Xi (Scorching Sun) in Chong Ming. Pustules desire complete eruption without retention; rash desires daytime eruption without illness. Or pathogenic Qi is depressed and retained, unable to leave; or Righteous Qi is damaged, trapped and unable to expand. Toxicity returning to the Five Zang organs produces four types of changes: Toxicity returning to Spleen/Stomach causes incessant diarrhea becoming dysentery; toxicity returning to Heart/Liver causes persistent irritability and heat leading to convulsions; prolonged cough with blood indicates toxicity returning to Lung; rotten gums with gan erosion indicate toxicity returning to Kidney. Mild cases, even if controlled properly, can be pacified successfully; severe cases resist attack and act maliciously, proving unconquerable by force. Teeth falling out resembles Bang Sha (Falling Sand), which is terrifying; hoarse voice resembles Hu Huo syndrome, which is hard to clarify. Cases that should erupt but do not require knowledge of eruption methods; cases that should subside but do not require clarity in resolution methods. Pale white color indicates deficiency, suitable for warming and nourishing blood; purple-black color indicates blood heat, suitable for resolving toxicity and clearing heat. Failure to erupt with restlessness suggests danger of death; unchanging black color with delirium suggests inability to eat fresh food. Steaming heat with red complexion and dysentery; dripping sweat with high chest and raised shoulders. Gan erosion leads to leaking cheeks and cleft lip. Do not boast of three-generation miraculous skills, as they cannot retain a wandering soul with only one breath remaining. Have you not heard that mistakenly taking decoctions and pills is worse than taking no medicine? Have you not seen that specifically violating taboos allows for self-reflection? Loving salty and sour foods leads to continuous coughing; preferring raw and dry foods leads to unquiet burning fire. Excessive sweet food causes dental caries; excessive cold/raw food causes clear stools. Chicken is a beast that generates wind; fish is a scale-bearing creature that moves fire. Greedily eating chicken and fish disrupts harmony, causing wind and fire to combine and create disaster. Pathogenic factors instead proliferate, causing relentless maculopapular rash; toxins instead penetrate deeply, encountering epidemic pestilence again. This is the residual toxin of rash, similar to the residual symptoms of smallpox.