其子在腹中，十月之间随母呼吸。呼吸者阳气也，而生动作，滋益精气神，饥渴皆随母血，儿随日长，筋骨皮
肉血脉形气俱足，十月降生，口中尚有恶血，啼声一发，随吸而下，此恶血复归命门胞中，僻于一隅，隐伏而
不发，直至儿因内伤乳食，湿热之气下陷，合于肾中，二火交攻，荣气不从，逆于肉理，恶血乃发。诸 疹皆
出于肾水，其疡后聚肉理，归于阳明，故三番 始显之症，皆足太阳壬膀胱克丙小肠，其始出皆见于面，终
归于阳明肉理，热化为脓者也。二火炽盛，反胜寒水，遍身俱出，此皆从足太阳传变中来也。
〔钱〕始发潮热，三日以上，热晕入皮肤，即发疮疹，而不甚多者，热留皮腠之间，潮热随脏出，如早食
潮热不已，为水泡之类也。（巳午潮热为 ，申酉潮热为脓 ，辰戌丑未潮热为疹也。）
〔王〕验 法∶若三日未觉形迹，当以生酒涂身上，时时看之，状如蚤痕者是也。或曰∶伤寒伤食潮热，
与疹不能辨者，宜以辛凉之剂调之，五日已里发出即汗，五日已外无者，非 也，各随应见而治之。
〔阎〕治小儿壮热昏睡，伤风，风热疮疹，伤食皆相似，未能辨认间，服升麻葛根汤、惺惺散、小柴胡汤
甚验，盖此数药通治之不致误也。惟伤食则大便酸臭，不消化，畏食或吐，宜以药下之。（海藏云∶宜以药下
之者，当察其所伤何物，生硬寒热不等，不可遽以巴豆之类大毒之药下之。升麻葛根汤，太阴阳明也。惺惺散，
治风热咽不利，脾不和，少阳渴，小便不利也。小柴胡汤，治往来寒热，胸胁微痛，少阳也。然欲知其经，
当以脉别之。）
小儿耳冷尻冷，手足乍暖乍凉，面赤，时嗽时嚏，惊悸，此疮疹欲发候也。未能辨认间，服升麻汤、消毒
散，已发未发皆宜服。仍用胡荽酒、黄柏膏。暑月烦躁，食后与白虎汤、玉露散。热盛，与紫雪。咽喉或生疮，
与甘桔汤、甘露散，余根据前说。大人小儿同治法，惟大小不同耳。（海藏云∶消毒散，太阳药也。
白虎汤，治身热目疼鼻干不得卧，阳明药也。甘露散，肺肾药也。甘桔汤，少阳药也。紫雪，天冬、麦冬、黄芩、生
地为血剂。玉露散，肺肾药也。石膏、寒水石为气剂，以上五方，皆泻时暑之药。）
升麻葛根汤 治伤寒瘟疫，风热壮热头痛，疮疹已、未发，并宜服之。
升麻 葛根 芍药 甘草（炙。各等分）
上同为细末，每服四钱，水一盏半，煎至一盏，无时温服。（海藏云∶升麻葛根汤，太阳阳明之药。
陈文中云∶身热腹痛者，身热泄泻者，身热惊悸者，身热汗出者，身热足冷者，俱不宜服升麻葛根汤。
张巽之云∶凡痘见 点，忌葛根汤，恐发得表虚也。）
惺惺散 治小儿风热疮疹，伤寒时气，头痛壮热，目涩多睡，咳唾气壅，鼻塞清涕。
白术 桔梗 细辛 栝蒌根 人参 茯苓 甘草（各等分）
上 咀，每服二钱，水一盏，生姜三片，入薄荷三叶，煎至半盏，时时与服。《活人》云∶加防风、
川芎，亦各随经也。（海藏云∶惺惺散，治风热咽不利，脾不和，少阳渴小便不利也。）
上二方发表平剂。
王朝奉四物解肌汤
芍药 黄芩 升麻 葛根
每服四钱，水一盏．煎至七分，去渣服。或云∶小儿伤寒疫疠，潮热疮疹，五日已衰，疑似不能辨别者，
并皆辛凉之剂调之，即以四物汤解肌之类。（海藏云∶此论即有表也。若内伤，腹中有物，未得大便而发
热者，当以食药去其物则可。若得便后仍发热在表者，亦宜此解肌汤，比钱氏升麻葛根汤减甘草加黄芩，
以有表热之意也。）
〔田〕防风苍术汤 治小儿邪热在表，恶风恶寒，疮疹未出，可解表发 疹。
防风（半两） 苍术 石膏（各一两） 甘草（炙，半两） 川芎 黄芩（各二两）
上为粗末，每服二钱，生姜三片，薄荷七叶，水煎，日二服。（此方恶寒者宜用之。）
上二方辛凉之剂，表有热者宜之。
大便酸臭不消化，畏食或吐，乃内伤饮食，宜枳术丸。伤冷食饮，神应丸。
〔丹〕一男子年十六岁，发热而昏，目无视，耳无闻，两手脉皆豁大而略数，知其为劳伤矣。时里中多发
痘者，虽不知人，与药则饮，与粥则食，遂教以参、 、当归、苍术、陈皮，大料浓与之，饮至二十
余帖，痘始出。又二十帖，则成脓 ，身无全肤。或曰∶病劳可畏，何不用陈氏全方治之？予曰∶此但
虚耳，无寒也，只前方守之。又数十帖而安。后询其病因，为先四五日恐有出痘之患，遂极力采樵，
连日出汗甚多。
〔钱〕五脏各有一证∶肝脏水 ，肺脏脓 ，心脏 ，脾脏疹，归肾变黑。
〔海〕肝脏水 ，色或青；肺脏脓 ，色或白；脾脏疹，或如麸糠色；心脏 ，其色赤；变归肾则色黑矣。
此五色，凡痘疹一色者善，或二色三色相合而作者凶。第一大小不等。
小儿在胎十月，食五脏秽血，生下则其毒当出，故疮疹之状，皆五脏之液。肝主泪，肺主涕，心主血，脾
为裹血。其疮出有五名，肝为水 ，其液出如水，其色青而小；肺为脓 ，以涕稠浊如脓，其色白而大；心为
主血，其色赤而小，次于水 ；脾为疹，其色赤黄而小。涕泪出多，故脓 水 皆大。血荣于内，所出不多，
故疹皆小。又病水 脓 者，涕泪俱少，以液从疮出故也。譬如泡中容水，水去则泡瘦矣。
上水 者，俗谓之水痘也。脓 者，俗谓之痘子也。 者，俗谓之 子也。疹者，俗谓之麻子也。痘之
形状最大，水痘次之， 又次之，麻子最小，隐隐如麻子也。
更看时月重轻。大抵疮疹属阳，出则为顺，故春夏病为顺，秋冬病为逆。冬月肾旺又盛寒，病多归肾变黑。
又当辨春脓 ，夏黑陷，秋 子，冬疹子，亦不顺也。
凡疮疹只出一般者善。先发脓 ，后发疹子者顺。先发水 ，后发疹子者逆。先发脓 ，后水 多者顺，
少者逆。先发水 ，后发 子，多者逆，少者顺。先发疹子，后发 子者顺。先发脓 ，后发 子者逆。（海藏云∶
此一句足以知杂出者诸脏相合而不齐也，用药亦难矣。前断云五色各随五脏，亦有二色相合，或有三色，即无
定也。此与前后脓水 疹大小不同，先后逆顺大意相若。）
凡疮疹若出辨视轻重∶若一发便出尽者，必重也；痘夹疹者，半轻半重也；出稀者轻；里外肥红者轻；外
黑里白者微重也；外白里黑者，大重也；疮端里黑如针孔者，热剧也；青干黑陷，昏睡，汗出不止，烦
躁热渴，腹胀啼喘，大小便不通者，困也。凡疮疹当乳母慎口，不可令饥，及受风寒，必归肾变黑难治。
（海藏云∶或热极反兼水化者，亦能变黑，当以凉药主之，不可不察，以脉别之可也。或有出色正者，内
素有热，头反陷，色或灰青似黑，中有针眼下陷，当急以青凉药疏之。便结者，大黄、牵牛之类。便
软者，金花丸之类主之。）
〔陈〕轻者作三次出，大小不一等，头面稀少，眼中无根窠红，肥满光泽。重者一齐并出，密如蚕种，
身热腹胀，疮灰白色，稠密无缝，泻渴不止，头温足冷。轻变重，犯房室，不忌口，先曾泻，饮冷水，
饵凉药。重变轻，避风寒，常和暖，大便稠，不燥渴，忌生冷，忌外人。
上饮冷水甘凉药，若内有实热者，不须忌之。
二日三日痘疮始见，微微才出，如粟米大，或如黍米大，或如绿豆大，似水珠光泽明净者佳，不须服药。
四日五日，痘疮大小不等，根窠红活，光泽明净者轻。如稠密陷顶，灰白色，泻渴者重。六日七日，痘疮肥红
光泽者轻。如身温气促，口干腹胀，足指冷者重。八日九日，痘疮长足肥满，苍蜡色者轻。如寒战闷乱，腹胀
烦渴，气急切牙者，至重也。十日十一日，痘疮当靥，疮痂欲落而愈。如身热闷乱，腹胀泄泻，寒战切牙者重。
〔钱〕黄柏膏 如疮疹已出，此药涂面，次用胡荽酒外治法。
黄柏（一两） 绿豆粉（二两） 甘草（四两） 红花（二两）
上同为细末，生油调，从耳前至眼眶并浓涂之，日三两次。如早涂疮不至面，纵有亦少。（彭氏云∶
痘疹护眼，人多用胭脂。据亢医云∶不如钱氏黄柏膏最好，诸家护眼法无出此方也。）
〔萧〕痘疮初出，用鼠粘子为末，水调敷囟门，并无患眼，亦妙。
胡荽酒
胡荽一味，细切，四两，以好酒二盏，煎一二沸，入胡荽再煎少时，用物合定，放温，每吸一大口，
微喷从顶至足匀遍，勿喷头面，病患左右常令有胡荽气，即能辟去污气，疮疹出快。
〔丹〕痘疹初出时，或未出时，见时人有患者，宜预服此药，多者令少，重者令轻。以丝瓜近蒂三寸，连
皮子烧灰存性，为末，砂糖拌匀，干吃。入朱砂末更妙。
〔垣〕消毒救苦汤 治 症悉具，消化便令不出；若已出稀者，再不生 。十一月立此方，随四时加减，惟通造
化，明药性者能之。
麻黄根 羌活 防风（各五分） 柴胡 川芎（各二分） 细辛 本（二分） 升麻（五分） 葛根 黄芩（酒
炒。
各二分） 黄连（三分） 黄柏（酒炒，五分） 红花（少许） 苏木（一分） 归身（三分） 吴茱萸（半分） 白
术（一分）
苍术（二分） 甘草（生） 橘皮（各一分） 连翘（半钱，初出者减，出大者加） 生地（五分）
上 咀，每服五钱，水二大盏，煎至一盏，去渣，稍热服。 疹者因内伤必出 ，乃荣气逆故也，大禁牵
牛、巴豆峻药，宜半夏、枳实、大黄、益智仁之类去泻止吐。若耳尖冷，呵欠睡惊，嚏喷眼涩，知必出 也。宜
升麻 葛根 白芍药 甘草 归身 连翘（各等分）
上 咀，水煎服。此定法也，后随症加减。
如肺出脓 ，先显喘嗽，或气高而喘促，少加人参、黄芩，以泻伏火而补元气。如心出小红 ，必先见嗌
干惊悸，身热，肌肉肿，脉弦洪，少加黄连。如命门出瘾疹，必先骨痛身热，其疼痛不敢动摇，少加生地、
黄柏。诸 疹皆为阴症疮，皆因内伤乳食，脾胃不足，荣气逆行。虽火势内炽，阴覆其外，故钱氏制四物
升麻汤发之。如有传变症，根据加减法服之。
〔世〕如疹痘则发于脾，宜陈氏人参清膈散。（疹者皮肤隐隐如麻，名曰麻子。）水 者多因伤寒热毒而发，
宜升麻散及羌活散。
〔丹〕疮干者宜退火，湿者用泻湿。退火止用轻剂，荆芥、升麻、葛根、连翘之类；泻湿乃肌表间湿，宜
用风药，防风、白芷之类。痘初起时，自汗不妨，盖湿热熏蒸而起故也。
〔世〕痘疮不治症有七∶一戛齿，痘黑陷，喉中涎喘，因先受风冷，血气虚弱，即变此症。二憎寒困倦，
痘子缩伏。三疮作坑，内无脓血，或黑色泡，或疮迹作黑色。四痘痈壅肿，痘毒变疳，口臭，龈烂牙落。五声
哑气噎，或咽药腹中鸣。六痘初出，而半在皮肤带紫黑色不出者。七误于疏转，气哑者。凡出前后心密，及两
手心两足心密者，皆不可治。
〔陈〕论痘不治有五∶痒塌，寒战，切牙，烦躁不止。紫黑色，喘渴不宁。头温，足冷，闷乱欲饮水。目
睛上视，啮齿气促，泄泻不止。灰白色，陷顶，腹胀，喘渴不止。
〔《活》〕小儿疮疹，与伤寒相类。头痛，身热，足冷，脉数。疑似之间，只与升麻汤解肌，兼治疮子，
已发未发皆可服。但不可疏转，此为大戒。伤寒身热，固不可下。疮疹发热在表，犹不可转。世人不学，乃云
初觉以药利之，宣其毒也，误矣。（海藏云∶此论虽当，在经则可，若热甚过极，足冷，或内伤腹热足冷，宜
以寒药如洗心调胃及化食药通膈之类主之。然当求责脏腑秘与不秘，脉道何如耳。许氏云∶上热下冷，伤食也。
疹初热，手足亦冷，惟伤寒一身尽热，不与足冷相类，此伤食非伤冷也。若伤冷，不宜用。王德孚用感应丸
治之。）痘疮已出，不可疏转。出得已定，脓血太盛，却用疏利，亦非也。（海藏云∶此言若在经而出不尽者
为当，若腹胃有垢腻，便时后重如痢疾，及脉滑在里者，亦当微下。）大抵疮疹首尾皆不可下。（海藏云∶脏腑
有凝滞者，不可拘此。）小儿身耳尻冷，咳嗽，辄用利药即害人。（海藏云∶此言里和而少阳之气在经热者，故
用化毒犀角汤为气出里，若气未出，里未尽，求责疏利亦可。）凡治疹痘，才泻则令内陷，决不可轻易转下。
惟大小便多日不利，宜微微利之。及痘已靥，尚有余热停留，或作热，或作疮痍，或成痈，宜四顺饮下之，不特
消余毒，亦免生他症，累试累验。每见疹痘者，服发表麻黄药出汗，阳气尽出肤表，遂至 烂脏虚，虚则腹痛自
利，或作寒战，或作阴痫，死者多矣。
〔陈〕痘疮自初出至已愈之际，父母切忌房事。
〔世〕凡痘疮，勿令亲近狐臭漏腋者，房中淫欲者，及妇人经候，醉酒荤秽，硫黄蚊药，一切腥臊疫污蒸
湿，误烧油发，五辛，泼粪淋尿，熬油煎卵，俱当忌之。
〔海〕疮疹，忌外人及秽触之物，虽不受风冷，亦不可拥遏，常令衣服得中，并温凉处坐卧。
其子在母腹中，经过十个月的孕育，随着母亲的呼吸而生长。呼吸属于阳气，这种阳气的运动滋养并补充精气神，胎儿的饥渴感也随母体血液的变化而变化。婴儿随着日子增长，筋骨、皮肤、肌肉、血脉、形体和气机都发育完备，十月期满降生时，口中还残留有恶血；啼哭一声后，随着吸气，这些恶血随之排出体外，这部分恶血重新回到命门和胞宫之中，偏居一隅，隐伏而不发作。直到后来因为内伤乳食，湿热之气下陷，与肾中的相火结合，两火交攻，导致营气运行不畅，逆乱于肌肉纹理之间，恶血这才发作。所有的疹子都源于肾水，其后聚集在肌肉纹理间，归于阳明经，所以三次反复才显现的症状，都是足太阳膀胱经（壬）克制手小肠经（丙）的表现。痘疮初起时都出现在面部，最终归于阳明经的肌肉纹理，热邪转化为脓液。二火炽盛，反而胜过寒水，导致遍身发出痘疮，这都是从足太阳经传变而来的。
〔钱乙〕痘疮开始发作时有潮热，持续三天以上，热晕侵入皮肤，随即发出疮疹，如果数量不多，说明热邪停留在皮腠之间。潮热随脏腑之气外出，如果早晨进食后潮热不止，就会形成水泡之类的症状。（巳时、午时的潮热形成水疱，申时、酉时的潮热形成脓疱，辰时、戌时、丑时、未时的潮热形成疹子。）
〔王好古〕观察痘疮的方法：如果三天后还没有看到形迹，应当用生酒涂抹全身，时时观察，形状像跳蚤咬痕的就是痘疮。有人说：伤寒或伤食引起的潮热，与痘疮难以辨别时，宜用辛凉的药物调理。如果在五日内发出并出汗，如果是五日之后没有发出的，就不是痘疮，应分别根据应该出现的症状进行治疗。
〔阎孝忠〕治疗小儿壮热昏睡、伤风、风热疮疹、伤食等症状，它们都很相似，在未能辨认清楚之前，服用升麻葛根汤、惺惺散、小柴胡汤非常有效，因为这些药物能通治这些情况而不会误诊。只有伤食会导致大便酸臭、不消化、畏食或呕吐，适宜用下药通便。（海藏说：所谓适宜用下药通便，应当观察所伤之物是什么，生冷硬热各不相同，不可贸然使用巴豆等大毒药物进行峻下。升麻葛根汤，是治疗太阴、阳明病的药。惺惺散，治疗风热咽喉不利、脾不和、少阳口渴、小便不利。小柴胡汤，治疗往来寒热、胸胁微痛，属少阳病。然而要确定是哪一经的病，应当通过脉象来辨别。）
小儿耳朵冷、尾骨冷，手脚忽冷忽热，面色红赤，时而咳嗽时而打喷嚏，惊悸，这是痘疮将要发作的征兆。在未能辨认清楚之前，服用升麻汤、消毒散，无论痘疮已发或未发都适宜服用。同时使用胡荽酒、黄柏膏外敷。暑天烦躁，饭后给予白虎汤、玉露散。热势旺盛，给予紫雪。咽喉生疮，给予甘桔汤、甘露散，其余情况依照前面的说法。大人和小儿的治法相同，只是剂量大小不同罢了。（海藏说：消毒散，是太阳经的药。白虎汤，治疗身体发热、眼睛疼痛、鼻子干燥、无法安卧，是阳明经的药。甘露散，是肺肾经的药。甘桔汤，是少阳经的药。紫雪，由天冬、麦冬、黄芩、生地黄组成，属于血分剂。玉露散，是肺肾经的药。石膏、寒水石属于气分剂，以上五个方子，都是泻除时令暑热的药物。）
升麻葛根汤 治疗伤寒瘟疫，风热引起的壮热头痛，痘疮已发或未发，都适宜服用。
升麻、葛根、芍药、甘草（炙。各等分）
将上述药物研为细末，每次服用四钱，加水一盏半，煎至一盏，随时温服。（海藏说：升麻葛根汤，是太阳、阳明经的药。陈文中说：身体发热伴腹痛的，身体发热伴泄泻的，身体发热伴惊悸的，身体发热伴汗出的，身体发热伴脚冷的，都不宜服用升麻葛根汤。张巽之说：凡是痘疮见到斑点，忌用葛根汤，恐怕导致表虚。）
惺惺散 治疗小儿风热疮疹，伤寒时气，头痛壮热，眼睛干涩多睡，咳嗽痰多气壅，鼻塞流清涕。
白术、桔梗、细辛、栝蒌根、人参、茯苓、甘草（各等分）
将药物切碎，每次服用二钱，加水一盏，生姜三片，薄荷三叶，煎至半盏，时时喂服。《活人书》说：加防风、川芎，也是根据经络辨证加减。（海藏说：惺惺散，治疗风热咽喉不利、脾不和、少阳口渴、小便不利。）
以上两个方子是发表平和之剂。
王朝奉四物解肌汤
芍药、黄芩、升麻、葛根
每次服用四钱，加水一盏，煎至七分，去渣服用。有人说：小儿患伤寒疫病，潮热疮疹，五日后病情衰退，疑似不能辨别时，都用辛凉药物调理，即用四物汤解肌之类。（海藏说：这个论述即是有表证的情况。如果是内伤，腹中有积滞，未得大便而发热，应当用食药去除积滞即可。如果得便后仍然发热在表，也适宜用此解肌汤，比钱乙的升麻葛根汤减去甘草加入黄芩，以体现解除表热的意图。）
〔田宗武〕防风苍术汤 治疗小儿邪热在表，恶风恶寒，痘疮未出，可以解表发疹。
防风（半两）、苍术、石膏（各一两）、甘草（炙，半两）、川芎、黄芩（各二两）
将药物研为粗末，每次服用二钱，生姜三片，薄荷七叶，水煎，每日两次服用。（此方适用于恶寒者。）
以上两个方子是辛凉之剂，适用于表有热者。
大便酸臭不消化，畏食或呕吐，这是内伤饮食，适宜用枳术丸。伤冷食饮，用神应丸。
〔朱丹溪〕一个十六岁的男子，发热且昏迷，眼睛看不见，耳朵听不见，两手脉搏都豁大而略数，我知道这是劳伤所致。当时乡里多发痘疮，虽然此人不知人事，但给药则喝，给粥则吃，于是教他用人参、黄芪、当归、苍术、陈皮，大剂量浓煎给他喝，喝了二十多帖后，痘疮才开始发出。又喝了二十帖，则成脓疱，身上没有完好的皮肤。有人说：患劳病可畏，为何不用陈文中的全方治疗？我说：这只是虚证，没有寒邪，只守前方治疗。又喝了数十帖而痊愈。后来询问病因，是因为前四五日担心会有出痘的祸患，于是极力砍柴打草，连日出汗很多。
〔钱乙〕五脏各有一种证候：肝脏生水疱，肺脏生脓疱，心脏生斑，脾脏生疹，归肾则变为黑色。
〔王海藏〕肝脏生水疱，颜色可能青；肺脏生脓疱，颜色可能白；脾脏生疹，或如麸糠色；心脏生斑，其色赤；归肾则色黑矣。这五种颜色，凡痘疹只有一种颜色的为善，如果有两种或三种颜色混合而成的为凶。第一点看大小不等。
小儿在胎中十月，食用五脏的秽血，出生后其毒素应当排出，所以疮疹的形状，都是五脏的津液。肝主泪，肺主涕，心主血，脾包裹血。其疮出有五种名称，肝为水疱，其液体流出如水，颜色青而小；肺为脓疱，以鼻涕稠浊如脓，颜色白而大；心为主血，颜色赤而小，次于水疱；脾为疹，颜色赤黄而小。鼻涕眼泪流出多，所以脓疱水疱都大。血荣养于内，排出不多，所以疹子都小。另外患水疱脓疱病的人，鼻涕眼泪都少，因为津液从疮口流出的缘故。譬如泡中容纳水，水去则泡瘦了。
上面的水疱，俗称为水痘。脓疱，俗称为痘子。斑，俗称为斑子。疹，俗称为麻子。痘的形状最大，水痘次之，斑又次之，麻子最小，隐隐约约像麻子一样。
更要看季节的轻重。大抵疮疹属阳，发出则为顺证，所以春夏发病为顺，秋冬发病为逆。冬月肾气旺盛又盛寒，病多归肾变为黑色。还应当辨别春生脓疱，夏黑陷，秋生斑，冬生疹子，也不顺。
凡疮疹只出一种的为善。先发脓疱，后发疹子的为顺。先发水疱，后发疹子的为逆。先发脓疱，后水疱多的为顺，少的为逆。先发水疱，后发斑，多的为逆，少的为顺。先发疹子，后发斑的为顺。先发脓疱，后发斑的为逆。（海藏说：这一句足以知道杂出者是诸脏相合而不整齐，用药也难了。前面的断语说五色各随五脏，也有二色相合，或有三种，就没有定规了。这与前后脓水斑疹大小不同，先后逆顺的大意相近。）
凡疮疹如果出来辨别轻重：如果一发就出尽的，必定重；痘夹疹的，半轻半重；出稀的轻；内外肥红的轻；外黑里白的微重；外白里黑的，大重；疮端里黑如针孔的，热剧；青干黑陷，昏睡，汗出不止，烦躁热渴，腹胀啼喘，大小便不通的，困顿。凡疮疹应当让乳母慎戒口腹，不可令婴儿饥饿，以及受风寒，必归肾变为黑色难治。（海藏说：或者热极反兼水化者，也能变黑，应当用凉药主治，不可不察，通过脉象辨别即可。或者有颜色正常的，体内素有热，头反而陷下，颜色或灰青似黑，中有针眼下陷，当急用清凉药疏解。便秘的，用大黄、牵牛之类。便软的，用金花丸之类主治。）
〔陈文中〕轻的痘疮分三次发出，大小不一，头面稀少，眼中无根窠红，肥满光泽。重的痘疮一齐并出，密如蚕种，身体发热腹胀，疮灰白色，稠密无缝，泻渴不止，头温足冷。轻变重，是因为犯房事，不忌口，先前曾腹泻，饮冷水，服凉药。重变轻，是因为避风寒，常保持温暖，大便稠，不燥渴，忌生冷，忌外人。
上面饮用冷水甘凉药，如果内有实热者，不需要忌口。
二日三日痘疮始见，微微才出，如粟米大，或如黍米大，或如绿豆大，似水珠光泽明净者为佳，不需要服药。
四日五日，痘疮大小不等，根窠红活，光泽明净者为轻。如稠密陷顶，灰白色，泻渴的为重。六日七日，痘疮肥红光泽者为轻。如身温气促，口干腹胀，足指冷的为重。八日九日，痘疮长足肥满，苍蜡色者为轻。如寒战闷乱，腹胀烦渴，气急切牙的，至重。十日十一日，痘疮当结痂，疮痂欲落而愈。如身热闷乱，腹胀泄泻，寒战切牙的重。
〔钱乙〕黄柏膏 如果疮疹已出，此药涂面，其次用胡荽酒外治法。
黄柏（一两）、绿豆粉（二两）、甘草（四两）、红花（二两）
将上述药物研为细末，用生油调匀，从耳前至眼眶并浓涂之，每天两三次。如果早涂，疮不至面部，纵有也少。（彭氏说：痘疹护眼，人多用胭脂。据亢医说：不如钱氏的黄柏膏最好，各家护眼法没有超过此方的。）
〔萧氏〕痘疮初出，用鼠粘子为末，水调敷囟门，并无患眼之患，也很妙。
胡荽酒
胡荽一味，细切，四两，用好酒二盏，煎一二沸，放入胡荽再煎少许时间，用物体盖住，放温，每次吸一大口，微喷从头至足均匀遍洒，不要喷头部面部，病患左右常令有胡荽气味，就能辟去污气，使疮疹出得快。
〔朱丹溪〕痘疹初出时，或未出时，见有人患病，宜预先服用此药，多的令少，重的令轻。以丝瓜近蒂三寸，连皮子烧灰存性，为末，砂糖拌匀，干吃。加入朱砂末更妙。
〔李东垣〕消毒救苦汤 治疗痘症悉具，消化便令不出；如果已出稀的，再不生痘。十一月立此方，随四季加减，唯有通晓造化、明了药性的人才能做到。
麻黄根、羌活、防风（各五分）、柴胡、川芎（各二分）、细辛、藁本（二分）、升麻（五分）、葛根、黄芩（酒炒。各二分）、黄连（三分）、黄柏（酒炒，五分）、红花（少许）、苏木（一分）、当归身（三分）、吴茱萸（半分）、白术（一分）、苍术（二分）、甘草（生）、橘皮（各一分）、连翘（半钱，初出者减，出大的加）、生地黄（五分）
将药物切碎，每次服用五钱，加水两大盏，煎至一盏，去渣，稍热服。痘疹因内伤必然发出，是营气逆乱的原因，大禁牵牛、巴豆峻药，宜用半夏、枳实、大黄、益智仁之类去泻止吐。如果耳尖冷，呵欠睡惊，喷嚏眼涩，知道必然出痘。宜用升麻、葛根、白芍药、甘草、当归身、连翘（各等分）
将药物切碎，水煎服。这是定法，随后随症加减。
如果肺出脓疱，先显喘嗽，或气高而喘促，少加人参、黄芩，以泻伏火而补元气。如果心出小红斑，必先见咽干惊悸，身热，肌肉肿，脉弦洪，少加黄连。如果命门出瘾疹，必先骨痛身热，其疼痛不敢动摇，少加生地黄、黄柏。诸斑疹皆为阴症疮，皆因内伤乳食，脾胃不足，营气逆行。虽然火势内炽，阴覆其外，所以钱乙制四物升麻汤发之。如有传变症，根据加减法服用。
〔世传〕如疹痘则发于脾，宜陈氏人参清膈散。（疹者皮肤隐隐如麻，名曰麻子。）水疱者多因伤寒热毒而发，宜升麻散及羌活散。
〔朱丹溪〕疮干者宜退火，湿者用泻湿。退火只用轻剂，荆芥、升麻、葛根、连翘之类；泻湿乃肌表间湿，宜用风药，防风、白芷之类。痘初起时，自汗不妨，盖湿热熏蒸而起故也。
〔世传〕痘疮不治症有七：一咬牙，痘黑陷，喉中涎喘，因先受风冷，血气虚弱，即变此症。二憎寒困倦，痘子缩伏。三疮作坑，内无脓血，或黑色泡，或疮迹作黑色。四痘痈壅肿，痘毒变疳，口臭，龈烂牙落。五声哑气噎，或咽药腹中鸣。六痘初出，而半在皮肤带紫黑色不出者。七误于疏转，气哑者。凡出前后心密，及两手心两足心密的，都不可治。
〔陈文中〕论痘不治有五：痒塌，寒战，切牙，烦躁不止。紫黑色，喘渴不宁。头温，足冷，闷乱欲饮水。目睛上视，啮齿气促，泄泻不止。灰白色，陷顶，腹胀，喘渴不止。
〔《活人书》〕小儿疮疹，与伤寒相类。头痛，身热，足冷，脉数。疑似之间，只与升麻汤解肌，兼治疮子，已发未发皆可服。但不可疏转，这是大戒。伤寒身热，固不可下。疮疹发热在表，犹不可转。世人不学，乃云初觉以药利之，宣其毒也，误矣。（海藏说：这个论述虽然恰当，在经则可，如果热甚过极，足冷，或内伤腹热足冷，宜用寒药如洗心调胃及化食药通膈之类主治。然而应当求责脏腑秘与不秘，脉道如何。许氏说：上热下冷，伤食也。疹初热，手足亦冷，惟伤寒一身尽热，不与足冷相类，此伤食非伤冷也。若伤冷，不宜用。王德孚用感应丸治之。）痘疮已出，不可疏转。出得已定，脓血太盛，却用疏利，也不是。（海藏说：这话如果在经而出不尽者为当，如果腹胃有垢腻，便时后重如痢疾，及脉滑在里者，也应当微下。）大抵疮疹首尾皆不可下。（海藏说：脏腑有凝滞者，不可拘泥于此。）小儿身耳尻冷，咳嗽，辄用利药即害人。（海藏说：这话是说里和而少阳之气在经热者，故用化毒犀角汤为气出里，如果气未出，里未尽，求责疏利也可。）凡治疹痘，才泻则令内陷，决不可轻易转下。惟大小便多日不利，宜微微利之。及痘已靥，尚有余热停留，或作热，或作疮痍，或成痈，宜四顺饮下之，不仅消余毒，也免生他症，屡试屡验。每见疹痘者，服发表麻黄药出汗，阳气尽出肤表，遂至腐烂脏虚，虚则腹痛自利，或作寒战，或作阴痫，死者多矣。
〔世传〕凡痘疮，勿令亲近狐臭漏腋者，房中淫欲者，及妇人经候，醉酒荤秽，硫黄蚊药，一切腥臊疫污蒸湿，误烧油发，五辛，泼粪淋尿，熬油煎卵，俱当忌之。
The fetus in the womb, over ten months, grows by following the mother's breathing. Breathing is Yang Qi; its movement nourishes and supplements Essence, Qi, and Spirit. Hunger and thirst follow the maternal blood. As days pass, the child's sinews, bones, skin, flesh, blood vessels, form, and Qi all develop fully. Upon birth after ten months, there is still foul blood in the mouth. With the first cry, upon inhalation, this foul blood is expelled downward. This foul blood returns to the Mingmen (Gate of Life) and Baozhong (Uterus), residing in a corner, hidden and dormant, not manifesting until later. It manifests only when internal injury from milk and food causes damp-heat to sink, combining with the Kidney fire. The two fires attack each other, causing Ying (Nutritive) Qi to fail to flow smoothly, reversing into the muscle tissue, at which point the foul blood erupts. All rashes originate from Kidney Water. Afterward, they gather in the muscle tissue and return to the Yangming channel. Thus, symptoms that appear after three rounds are due to the Foot Taiyang Ren Bladder overcoming Hand Shaoyang Bing Small Intestine. Initially appearing on the face, they ultimately return to the Yangming muscle tissue, where heat transforms into pus. When the two fires are blazing, they overcome Cold Water, causing eruptions all over the body. These all result from transmission via the Foot Taiyang channel.
[Qian Yi] Initial tidal fever lasts more than three days. Heat mist penetrates the skin, immediately causing sores and rashes. If not numerous, it indicates heat remaining between the skin and interstices. Tidal fever follows organ Qi outward. If morning meal-induced tidal fever persists, it forms blister-like lesions. (Tidal fever during Si and Wu hours forms water blisters; Shen and You hours form pus blisters; Chen, Xu, Chou, and Wei hours form rashes.)
[Wang Haogu] Examination method: If no signs appear after three days, apply raw wine to the body and observe frequently. Lesions resembling flea bites are indicative. Some say: Differentiating tidal fever from Shanghan (Cold Damage) or food stagnation from rashes can be difficult. Use acrid-cool formulas to regulate. If eruption and sweating occur within five days, it is confirmed. If none appear after five days, it is not a rash. Treat according to corresponding manifestations.
[Yan Xiaozhong] For pediatric high fever, lethargy, wind-cold, wind-heat sores/rashes, and food stagnation—which present similarly—before differentiation, administering Shengma Gegen Tang (Cinnamon Twig and Kudzu Decoction), Xingxing San (Awakening Powder), or Xiao Chaihu Tang (Minor Bupleurum Decoction) is highly effective, as these formulas treat broadly without error. Only food stagnation presents with sour-smelling, undigested stool, aversion to eating, or vomiting, requiring purgatives. [Haizang notes: Purgation should target the specific ingested substance, varying in nature (raw, hard, cold, hot). Do not hastily use harsh toxins like Radix Crotonis (Badou). Shengma Gegen Tang treats Taiyin and Yangming channels. Xingxing San treats wind-heat throat obstruction, Spleen disharmony, Shaoyang thirst, and dysuria. Xiao Chaihu Tang treats alternating chills and fever, slight chest/hypochondriac pain, belonging to Shaoyang. Determine the channel via pulse diagnosis.]
Pediatric cold ears and buttocks, alternating warm/cool hands and feet, red face, intermittent cough/sneezing, and palpitations indicate impending rash eruption. Before differentiation, administer Shengma Tang (Cimicifuga Decoction) or Xiaodu San (Detoxification Powder), suitable for both pre- and post-eruption stages. Also apply Huisu Jiu (Coriander Wine) and Huangbai Gao (Phellodendron Ointment). For summer irritability, give Baihu Tang (White Tiger Decoction) or Yulu San (Jade Dew Powder) after meals. For intense heat, give Zixue (Purple Snow). For throat sores, give Ganjie Tang (Licorice and Platycodon Decoction) or Ganlu San (Sweet Dew Powder). Adult and pediatric treatments are identical, differing only in dosage. [Haizang notes: Xiaodu San is a Taiyang formula. Baihu Tang treats body heat, eye pain, nasal dryness, and insomnia (Yangming). Ganlu San targets Lung/Kidney. Ganjie Tang targets Shaoyang. Zixue contains Tian Dong, Mai Dong, Huang Qin, and Sheng Di Huang (Blood-level agents). Yulu San targets Lung/Kidney. Shi Gao and Hanshui Shi are Qi-level agents. All five clear seasonal summer heat.]
Shengma Gegen Tang (Cimicifuga and Kudzu Decoction): Treats Shanghan plague, wind-heat high fever/headache, and rashes (pre/post-eruption).
Ingredients: Shengma (Cimicifetae Rhizoma), Gegen (Puerariae Lobatae Radix), Shaoyao (Paeoniae Radix Alba), Zhigancao (Prepared Glycyrrhizae Radix et Rhizoma) in equal parts.
Grind to fine powder. Take 4 qian per dose with 1.5 cups water, decoct to 1 cup. Warm take anytime. [Haizang: Taiyang/Yangming formula. Chen Wenzhong: Contraindicated for fever with abdominal pain, diarrhea, palpitations, sweating, or cold feet. Zhang Xunzhi: Avoid Gegen Tang when spots appear, fearing exterior deficiency.]
Xingxing San (Awakening Powder): Treats pediatric wind-heat rashes, Shanghan epidemic, headache, high fever, dry eyes, somnolence, cough/phlegm congestion, nasal congestion/clear discharge.
Ingredients: Baizhu (Atractylodis Macrocephalae Rhizoma), Jiegeng (Platycodonis Radix), Xixin (Asari Radix et Rhizoma), Gualougen (Trichosanthis Radix), Renshen (Ginseng Radix), Fuling (Poria), Zhigancao (Prepared Glycyrrhizae Radix et Rhizoma) in equal parts.
Cut into pieces. Take 2 qian per dose with 1 cup water, 3 slices ginger, 3 mint leaves. Decoct to half cup. Administer frequently. *Liuren* adds Fangfeng and Chuanxiong based on channel. [Haizang: Treats wind-heat throat obstruction, Spleen disharmony, Shaoyang thirst/dysuria.]
These two are mild exterior-releasing formulas.
Wang Chaofeng Siwu Jiexi Tang (Four Substances Muscle-Releasing Decoction):
Shaoyao, Huangqin, Shengma, Gegen.
Take 4 qian per dose with 1 cup water, decoct to 0.7 cup, strain. Some say: For pediatric Shanghan/plague, tidal fever/rashes declining after five days where differentiation is unclear, use acrid-cool formulas like Siwu Tang for muscle release. [Haizang: This addresses exterior patterns. For internal injury with abdominal mass and fever before bowel movement, use food-digesting purgatives. If fever remains in the exterior after bowel movement, this Jiexi Tang is suitable. Compared to Qian’s Shengma Gegen Tang, it removes Gancao and adds Huangqin to address exterior heat.]
[Tian Zongwu] Fangfeng Cangzhu Tang (Saposhnikovia and Atractylodes Decoction): Treats pediatric pathogenic heat in the exterior, aversion to wind/cold, unruptured rashes. Releases exterior and induces rash.
Ingredients: Fangfeng (Saposhnikoviae Radix, 0.5 liang), Cangzhu (Atractylodis Rhizoma, 1 liang), Shigao (Gypsum Fibrosum, 1 liang), Zhigancao (Prepared Glycyrrhizae Radix et Rhizoma, 0.5 liang), Chuanxiong (Ligusticum Chuanxiong Rhizoma, 2 liang), Huangqin (Scutellariae Radix, 2 liang).
Coarse powder. Take 2 qian per dose with 3 slices ginger, 7 mint leaves. Decoct in water. Twice daily. (Suitable for aversion to cold.)
These two are acrid-cool formulas for exterior heat.
Sour-smelling, undigested stool, aversion to eating/vomiting indicates internal food injury. Use Zhizhu Wan (Immature Bitter Orange and Atractylodes Pill). For cold food injury, use Shenyin Wan.
[Zhu Danxi] A 16-year-old male presented with fever, coma, blindness, deafness, and large, slightly rapid pulses. Diagnosed as labor injury. During a local plague, though unconscious, he drank medicine and ate porridge when offered. Prescribed Renshen, Huangqi, Danggui, Cangzhu, and Chenpi in large doses. After 20+ doses, rashes erupted. After another 20 doses, pus formed, leaving no intact skin. Asked why not use Chen’s full formula? I replied: This is pure deficiency, no cold. Stick to the formula. After dozens more doses, he recovered. Cause: Fear of rash eruption led to excessive woodcutting and sweating for several days.
[Qian Yi] Each Zang has one syndrome: Liver produces water blisters, Lungs produce pus blisters, Heart produces macules, Spleen produces papules/rashes, Kidney turns black.
[Haizang] Liver water blisters may be green; Lung pus blisters may be white; Spleen rashes may be bran-colored; Heart macules are red; Kidney transformation is black. Uniform color is auspicious; mixed colors (2-3) are ominous. First, assess size inequality.
Fetuses consume Zang filth-blood for ten months. Post-birth, toxins must exit; thus, sore shapes reflect Zang fluids. Liver governs tears, Lungs govern nasal mucus, Heart governs blood, Spleen envelops blood. Five types of eruptions: Liver = water blisters (fluid like water, green, small); Lungs = pus blisters (mucus thick like pus, white, large); Heart = blood macules (red, small, secondary to water blisters); Spleen = rashes (red-yellow, small). Abundant mucus/tears make pus/water blisters large. Blood nourishes internally, excretes little, making rashes small. Conversely, if mucus/tears are scarce, fluid exits via sores, shrinking them (like a bubble losing water).
Water blisters = Shuidou (Water Pox). Pus blisters = Douzi (Smallpox). Macules = Banzi (Spots). Rashes = Mazizi (Measles). Size order: Smallpox > Water Pox > Spots > Measles (smallest, faint).
Assess seasonality. Rashes are Yang; eruption is smooth. Spring/Autumn illness is smooth; Winter/Spring is reverse. Winter Kidney prosperity + cold leads to blackening. Differentiate: Spring pus blisters, Summer black depression, Autumn spots, Winter measles are also unfavorable.
Single-type eruption is good. Order: Pus blisters then rashes (smooth); Water blisters then rashes (reverse); Pus blisters then many water blisters (smooth); Few water blisters (reverse); Water blisters then many spots (reverse); Few spots (smooth); Rashes then spots (smooth); Pus blisters then spots (reverse). [Haizang: Mixed eruptions indicate disordered Zang harmony, complicating treatment. Colors vary by Zang; fixed rules do not apply. Similar to previous logic on size/order.]
Severity assessment: Erupting all at once = severe; Smallpox mixed with rashes = moderate; Sparse = mild; Plump/red inside/out = mild; Black outside/white inside = slightly severe; White outside/black inside = very severe; Black center like needle hole = extreme heat; Green/dry/black/depressed, lethargy, profuse sweat, irritability/thirst, abdominal distension/breathlessness, constipation = critical. Nursing mothers must avoid dietary indiscretion, hunger, and wind/cold to prevent Kidney blackening. [Haizang: Extreme heat mimicking water transformation causes blackening; use cooling herbs, verify via pulse. Normal color but depressed head/grey-green/black with needle-hole depression requires urgent cooling/dispersing. Constipation: Dahuang/Fu Ling. Loose stool: Jinhua Wan.]
[Chen Wenzhong] Mild cases erupt in three waves, unequal sizes, sparse on face, no red roots in eyes, plump/shiny. Severe cases erupt simultaneously, dense as silkworm eggs, fever/abdominal distension, grey-white, seamless, persistent diarrhea/thirst, warm head/cold feet. Mild turning severe: sexual activity, dietary laxity, prior diarrhea, cold water, cooling meds. Severe turning mild: avoiding wind/cold, warmth, formed stool, no thirst, avoiding cold/raw/outsiders.
Drinking cold water/green-cools is permitted if interior excess heat exists.
Days 2-3: Tiny eruptions (millet/mung bean size), shiny/clear = good. No meds needed.
Days 4-5: Unequal size, red/vibrant roots, shiny = mild. Dense/depressed/grey-white/diarrhea/thirst = severe.
Days 6-7: Plump/red/shiny = mild. Warm body/fast breath/dry mouth/abdominal distension/cold toes = severe.
Days 8-9: Full/plump, waxy grey = mild. Chills/confusion/distension/thirst/jaw clenching = critical.
Days 10-11: Crusting/falling = healing. Fever/confusion/diarrhea/chills/jaw clenching = severe.
[Qian Yi] Huangbai Gao (Phellodendron Ointment): Apply to face after eruption, followed by Huisu Jiu external treatment.
Ingredients: Huangbai (Phellodendri Cortex, 1 liang), Lvdou Fen (Vigna Mungo Powder, 2 liang), Gancao (Glycyrrhizae Radix et Rhizoma, 4 liang), Honghua (Carthami Flos, 2 liang).
Fine powder, mix with raw oil. Apply thickly from ear front to eye orbit, 2-3 times daily. Early application prevents facial spread. [Peng: Rouge used for eyes, but Kangyi prefers Huangbai Gao as superior.]
[Xiao]: Mouse burdock root powder applied to fontanelle with water prevents eye complications.
Huisu Jiu (Coriander Wine): 4 liang finely cut Coriandrum Sativum Fructus, decocted in 2 cups good wine. Boil briefly, add coriander, simmer. Cover, cool. Inhale deeply, spray lightly from head to foot (avoid face). Maintain coriander scent around patient to dispel turbidity and accelerate eruption.
[Zhu Danxi]: Prophylactic measure when seeing others with rash. Burn 3 cun of loofah near stem (with skin/pulp) to ash. Mix with brown sugar, take dry. Adding Cinnabar is better.
[Li Dongyuan] Xiaodu Jiuku Tang (Detoxification and Salvation Decoction): Prevents eruption if digestion is complete; stops new eruptions if sparse. Formulated in November, adjusted seasonally. Requires understanding of natural laws and herb properties.
Ingredients: Mahuang Gen (Ephedrae Radix et Rhizoma), Qianghuo (Notopterygii Rhizoma et Radix), Fangfeng (Saposhnikoviae Radix, 5 fen each); Chaihu (Bupleuri Radix), Chuanxiong (Ligusticum Chuanxiong Rhizoma, 2 fen each); Xixin (Asari Radix et Rhizoma), Ben Cao (Ligustici Rhizoma, 2 fen); Shengma (Cimicifetae Rhizoma, 5 fen); Gegen (Puerariae Lobatae Radix), Huangqin (Scutellariae Radix, wine-fried, 2 fen each); Huanglian (Coptidis Rhizoma, 3 fen); Huangbai (Phellodendri Cortex, wine-fried, 5 fen); Honghua (Carthami Flos,少许); Sumu (Sappan Lignum, 1 fen); Guishen (Angelicae Sinensis Radix, 3 fen); Wuzhuyu (Evodiae Fructus, 0.5 fen); Baizhu (Atractylodis Macrocephalae Rhizoma, 1 fen); Cangzhu (Atractylodis Rhizoma, 2 fen); Sheng Gancao (Raw Glycyrrhizae Radix et Rhizoma), Ju Pi (Citri Reticulatae Pericarpium, 1 fen each); Lianqiao (Forsythiae Fructus, 0.5 qian, reduce if early, increase if large); Sheng Di Huang (Rehmanniae Radix, 5 fen).
Cut pieces. Take 5 qian with 2 large cups water, decoct to 1 cup, strain, drink warm. Rash eruption due to internal injury/Ying reversal. Strictly forbid harsh purgatives (Qian Niu, Badou). Use Banxia, Zhishi, Dahuang, Yizhiren to stop vomiting/diarrhea. Signs of eruption: cold ear tips, yawning, startle sleep, sneezing, dry eyes. Formula: Shengma, Gegen, Baishaoyao, Gancao, Guishen, Lianqiao (equal parts). Decoct. Fixed method, adjust by symptoms.
Lung pus blisters: Asthma/cough, high qi/panting. Add Renshen, Huangqin to drain latent fire/nourish Yuan Qi. Heart red macules: Dry throat, palpitations, fever, muscle swelling, string-taut-large pulse. Add Huanglian. Mingmen itch-rash: Bone pain, fever, immobility due to pain. Add Sheng Di Huang, Huangbai. All rashes are Yin-sores due to internal milk/food injury, Spleen/Stomach deficiency, Ying reversal. Fire burns internally, Yin covers externally. Qian’s Siwu Shengma Tang releases them. Follow transmission protocols.
[Transmission] Rash/smallpox originates in Spleen. Use Chen’s Renshen Qingge San. (Rash = faint hemp-like skin marks). Water blisters often due to Shanghan heat-toxin. Use Shengma San and Qianghuo San.
[Zhu Danxi] Dry sores require fire reduction (light agents: Jingjie, Shengma, Gegen, Lianqiao). Wet sores require damp-draining (wind agents: Fangfeng, Baizhu). Initial sweating is acceptable due to damp-heat steaming.
[Transmission] Seven untreatable smallpox syndromes: 1. Jaw clenching, black depressed sores, salivary panting (from wind-cold/Qi-Blood weakness). 2. Aversion to cold, fatigue, shrunk sores. 3. Pitted sores, no pus/blood, black blisters/traces. 4. Abscess/swelling, toxin turning to ulcer, bad breath, gum rot/tooth loss. 5. Hoarseness/choking, abdominal rumbling when swallowing. 6. Partial purple-black non-erupting sores. 7. Mistaken purgation leading to Qi hoarseness. Dense sores on chest/back/palms/soles are untreatable.
[Chen Wenzhong] Five untreatable signs: Itching collapse, chills, jaw clenching, incessant irritability. Purple-black, panting/thirst/restlessness. Warm head/cold feet, confusion/thirst. Eyes rolling up, jaw clenching/fast breath, incessant diarrhea. Grey-white, depressed crown, abdominal distension, panting/thirst.
*[Liuren]* Pediatric rash resembles Shanghan: Headache, fever, cold feet, rapid pulse. In doubt, use Shengma Tang to release muscle/treat rash (pre/post). Never purge. Shanghan fever cannot be purged. Exterior rash fever cannot be turned inward. Laypeople mistakenly believe purging expels toxicity. [Haizang: Valid for channel heat. If extreme heat/cold feet or internal heat/cold feet, use cold herbs (Xi Xin, Tiao Wei, Hua Shi) to open diaphragm. Check Zang fu blockage/pulse. Xu: Upper heat/lower cold = food stagnation. Rash initial heat includes cold limbs; Shanghan is whole-body heat. Food stagnation differs from cold injury. Wang Defu uses Yinggan Wan.] Do not purge after eruption. If pus/blood excessive, purging is wrong. [Haizang: Valid if incomplete channel eruption. If abdominal grease/heaviness/dysentery-like pulse slippery interior, mild purging is okay.] Generally, never purge rash at start or end. [Haizang: Unless Zang fu stagnation exists.] Purging harms children with cold ears/buttocks/cough. [Haizang: Interior harmonious, Shaoyang channel heat. Use Huadu Xijiao Tang. If Qi not out/interior not cleared, mild purging acceptable.] Purging causes internal collapse. Only mildly promote bowels/bladder if blocked for days. After crusting, residual heat may cause fever/sores/abscesses. Use Sishun Yin to purge, clearing toxins/preventing sequelae. Proven effective. Sweating with Ma Huang exhausts Yang Qi to surface, causing organ decay/deficiency, abdominal pain/diarrhea, chills/Yin epilepsy, death.
[Chen Wenzhong] Parents must abstain from sex from eruption to recovery.
[Transmission] Avoid contact with fox odor, armpit leakage, sexually active individuals, menstruating women, drunk/meat-eaters, sulfur/mosquito coils, fishy/foul/epidemic humidity, burnt oil hair, five pungents, feces/urine spills, fried oil/eggs.
[Haizang] Avoid outsiders and filthy contacts. Even without wind-cold, do not restrict airflow. Keep clothing moderate, sit/lie in warm/cool places.