麻黄(去节) 人参 黄芩 芍药 甘草 川芎 杏仁 防己(各一钱) 肉桂(五分) 防风(一
钱五分) 附子(三分)
水煎服。
此症若兼阳明,须加葛根、升麻。此症若兼少阳,另用小柴胡加桂枝、钩藤。
大黄(二钱) 枳实(一钱) 浓朴(八分) 甘草(一钱) 元明粉(一钱五分
水煎服。
凡发斑有四症,一曰伤寒,二曰温毒,三曰时气,四曰阴症。伤寒发斑者,盖因当汗不
汗,当下不下,或妄投热药,以致热毒蕴结,发为斑疹,《千金方》云∶红赤者胃热,紫赤
者热甚,紫黑者胃烂也。凡斑既出,须得脉洪大有力,身温,足暖为顺;若脉沉小,足冷,
元气弱者,为逆候也。凡治斑症,不宜发汗,汗之则增斑烂。又不宜早下,下早则斑毒内陷
如脉洪数,热甚烦渴者,用三黄解毒汤,或犀角大青汤以清之。若脉弱者,加人参主之。
倘昏闷、谵语、大便四五日不通,以调胃承气汤微利之。如未可下,即用前犀角大青汤,加
梨汁、蜜糖以润之。大抵解胃热、胃烂之毒,必以黄连、大青、犀角、元参、升麻、真青黛
、石膏、知母、黄芩、山栀、黄柏之类,要在审察病情合宜而用之。温毒发斑者,冬应寒而反
温,或冬令感寒,春夏之交,发为温热之病,热毒蕴蓄,发为斑也。犀角大青汤主之。时气
发斑者,天时不正之气也,人感之或憎寒壮热,发为斑疹。凡大红点,发于皮肤之上者,谓
之斑;小红点,行于皮肤之中者,谓之疹。盖疹轻而斑重也。疹发于肺,宜用升麻葛根汤,
加大力子以散之。斑出于胃,犀角大青汤以清之。若时气传染,中无实热,加味逍遥散去白
术,加元参、生地以解之。阴症发斑者,寒伏于下,逼其无根失守之火,聚于胸中,上熏于
肺,致发斑点,如蚊蚤咬痕,此非斑也,与调中温胃之剂,其点自退。理中汤主之。
麻黄(去除节段) 人参 黄芩 芍药 甘草 川芎 杏仁 防己(各一钱) 肉桂(五分) 防风(一钱五分) 附子(三分)
用水煎煮后服用。
此症如果兼有阳明病(阳明经受邪所致的病证),必须加入葛根、升麻。此症如果兼有少阳病(少阳经受邪所致的病证),另外使用小柴胡汤加桂枝、钩藤。
大黄(二钱) 枳实(一钱) 浓朴(八分) 甘草(一钱) 元明粉(一钱五分)
用水煎煮后服用。
凡是发斑疹有四种病症,一是伤寒,二是温毒,三是时气,四是阴症。伤寒发斑疹的,大概是因为应当发汗而没有发汗,应当攻下而没有攻下,或者乱投热性药物,导致热毒蕴结,引发斑疹,《千金方》说:颜色红赤的是胃热,紫赤的是热势严重,紫黑色的是胃腑腐烂。凡是斑疹发出,必须脉象洪大有力,身体温暖,脚部暖和为顺证;如果脉象沉小,脚冷,元气虚弱,为逆证。凡是治疗斑疹病症,不宜发汗,发汗则会加重斑疹溃烂。也不宜过早攻下,过早攻下则斑毒内陷。如果脉象洪数,热势严重且烦渴的,使用三黄解毒汤,或犀角大青汤来清解。如果脉象弱,加入人参为主治。倘若出现神志昏闷、胡言乱语、大便四五日不通的情况,用调胃承气汤轻微通利。如果还不可以攻下,就立即使用前文提到的犀角大青汤,加入梨汁、蜂蜜糖来润燥。大体上解除胃热、胃腑腐烂的毒邪,必须以黄连、大青、犀角、元参、升麻、真青黛、石膏、知母、黄芩、山栀、黄柏之类,关键在于审察病情合宜而使用。温毒发斑疹的,冬天应该寒冷却反而温暖,或者冬季感受寒邪,在春夏之交,发作成温热病,热毒蕴蓄,引发斑疹。以犀角大青汤主治。时气发斑疹的,是气候不正之气,人感染它可能憎恶寒冷且壮热,引发斑疹。凡是大红点,发于皮肤表面的,称为斑;小红点,行于皮肤之中的,称为疹。大概疹轻而斑重。疹发于肺,宜用升麻葛根汤,加入大力子(牛蒡子)来疏散。斑出于胃,用犀角大青汤来清解。如果是时气传染,体内没有实热,用加味逍遥散去白术,加入元参、生地来解表。阴症发斑疹的,寒邪伏于下部,逼迫其无根失守之火,聚于胸中,向上熏蒸于肺,导致发斑点,像蚊子蚤子咬的痕迹,这并非真正的斑疹,给予调理中焦、温养胃气的药剂,斑点自然消退。以理中汤主治。
Ephedrae Herba (Mahuang, 麻黄) [devoid of nodes] Ginseng Radix (Renshen, 人参) Scutellariae Radix (Huangqin, 黄芩) Paeoniae Radix Alba (Baishao, 芍药) Glycyrrhizae Radix et Rhizoma (Gancao, 甘草) Chuanxiong Rhizoma (Chuanxiong, 川芎) Armeniacae Semen Amarum (Xingren, 杏仁) Stephaniae Tetrandrae Radix (Fangji, 防己) [each 1 qian] Cinnamomi Ramulus (Guizhi, 肉桂) [5 fen] Saposhnikoviae Radix (Fangfeng, 防风) [1.5 qian] Aconiti Lateralis Radix Preparata (Fuzi, 附子) [3 fen]
Decoct in water and take orally.
If this syndrome is accompanied by Yangming disease (disease pattern due to pathogenic invasion of the Yangming channel), Ge Gen (Puerariae Lobatae Radix) and Sheng Ma (Cimicifugae Rhizoma) must be added. If this syndrome is accompanied by Shaoyang disease (disease pattern due to pathogenic invasion of the Shaoyang channel), use Xiao Chai Hu Tang (Minor Bupleurum Decoction) with added Guizhi (Cinnamomi Ramulus) and Gou Teng (Uncariae Ramulus cum Uncis).
Rhei Radix et Rhizoma (Dahuang, 大黄) [2 qian] Immature Trichosanthis Fructus (Zhishi, 枳实) [1 qian] Magnoliae Officinalis Cortex (Houpo, 厚朴/浓朴) [8 fen] Glycyrrhizae Radix et Rhizoma (Gancao, 甘草) [1 qian] Natrii Sulfas (Yuanmingfen, 元明粉) [1.5 qian]
Decoct in water and take orally.
There are four types of rashes: first, Shanghan (Cold Damage); second, Wendu (Warm Toxin); third, Shiqi (Seasonal Qi); fourth, Yinzheng (Yin Syndrome). The occurrence of rashes in Shanghan is generally due to failure to induce sweating when indicated, or failure to purge when indicated, or the indiscriminate administration of hot-natured medicines, leading to the accumulation of heat toxin and the eruption of macules and papules. As stated in *Qianjin Fang*: red and bright indicates Stomach Heat; purple-red indicates severe heat; purple-black indicates rotting of the Stomach. Once macules and papules have erupted, a surging and forceful pulse, warm body, and warm feet indicate a favorable prognosis (Shun); a deep and small pulse, cold feet, and deficient Yuan Qi indicate an unfavorable prognosis (Ni). In treating rash syndromes, inducing sweating is contraindicated, as it will exacerbate the ulceration of the rash. Purging too early is also contraindicated, as it causes the rash toxin to sink inward. If the pulse is surging and rapid, with severe heat, restlessness, and thirst, use San Huang Jie Du Tang (Three-Yellow Detoxification Decoction) or Xi Jiao Da Qing Tang (Rhinoceros Horn and Isatis Decoction) to clear the heat. If the pulse is weak, add Renshen (Ginseng Radix) as the principal ingredient. If there is stupor, delirious speech, and constipation for four to five days, use Tiao Wei Cheng Qi Tang (Regulate the Stomach and Order the Qi Decoction) to mildly promote bowel movement. If purging is not yet appropriate, immediately use the aforementioned Xi Jiao Da Qing Tang (Rhinoceros Horn and Isatis Decoction) with added Li Zhi (Pear Juice) and Mi Tang (Honey Syrup) to moisten. Generally, to resolve toxins of Stomach Heat and Stomach Rot, herbs such as Huanglian (Coptidis Rhizoma), Da Qing Ye (Isatidis Folium), Xi Jiao (Rhinoceronis Cornu), Xuanshen (Scrophulariae Radix), Shengma (Cimicifugae Rhizoma), Zhen Qingdai (Indigo Naturalis), Shigao (Gypsum Fibrosum), Zhimu (Anemarrhenae Rhizoma), Huangqin (Scutellariae Radix), Zhizi (Gardeniae Fructus), and Huangbai (Phellodendri Cortex) are used. The key lies in examining the condition and using them appropriately. Wendu (Warm Toxin) causing rashes occurs when winter should be cold but is instead warm, or when cold is contracted in winter and manifests as a warm-heat disease at the transition of spring and summer; accumulated heat toxin causes rashes. This is treated primarily with Xi Jiao Da Qing Tang (Rhinoceros Horn and Isatis Decoction). Shiqi (Seasonal Qi) causing rashes results from abnormal climatic qi; upon infection, one may experience aversion to cold and high fever, leading to rashes. Large red spots on the surface of the skin are called Ban (Macules); small red spots within the skin are called Zhen (Papules). Generally, Zhen is mild and Ban is severe. Zhen originates from the Lung; use Shengma Gegen Tang (Cimicifuga and Kudzu Decoction) with added Dalizi (Armeniacae Semen Amarum/Babulezi) to disperse it. Ban originates from the Stomach; clear it with Xi Jiao Da Qing Tang (Rhinoceros Horn and Isatis Decoction). If it is contagious Shiqi without excess heat in the interior, use Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder) without Baizhu (Atractylodis Macrocephalae Rhizoma), adding Xuanshen (Scrophulariae Radix) and Shengdi (Rehmanniae Radix) to resolve it. Yinzheng (Yin Syndrome) causing rashes involves cold stagnating below, forcing rootless and unanchored fire to gather in the chest, steaming upward to the Lung, resulting in spots resembling mosquito bites. These are not true rashes; administer formulas that regulate the Middle and warm the Stomach, and the spots will recede spontaneously. This is treated primarily with Lizhong Tang (Regulate the Middle Decoction).