痧症。即疹子。又名 子。准绳云。痧症初起。用升麻葛根汤（散足阳明邪热）合泻白散
（清手太阴邪热）其间宜加桔梗牛蒡荆芥连翘等。（兼解两经之毒也）尤为至当。次日标形。颧
鼻见点多者最吉。以其清阳喜上升也。第二日葛根可去。
恶其开肌腠而干津液也。若热甚势重。前汤加白虎芩粉之类。断不可少。若服药后而热愈甚
者。正毒达之故也。得大汗而毒自解矣。若略见标而不见形者。此为痧毒不透。后必防疳。宜从
养阴治。甘露饮主之。必多服乃效。亦从汗解。乃屡验者。有一等小儿乳疳。一日可解。不必尽三
朝九朝之说。以清火为主。兼解可也。缘小儿禀质尚弱。神气有限。如过粗工。不审虚实。发散
过多。必致正气虚脱。而不可救者。多矣。有痧毒痰喘甚者。虽用石膏黄连。如水淋石。要知是
痧毒痰火壅结上焦之故。宜用栝蒌霜枳壳花粉金沸草等清痰清火。如挟气虚者。加人参立应。如
痰上壅盛者。可用牛黄珍珠散。痧症腹痛者。乃毒郁于阳明故也。宜服升麻石膏黄连之类。如恶
毒郁于大肠者。苦梗开之。痧症多泄泻。慎勿止涩。惟用升麻葛根黄连甘草。则泻自止。
痧家不忌泄泻。泻则阳明之邪热得解。是亦表里分消之义也。
痧后泄泻。及便脓血。皆由热邪内陷故也。大忌止涩。惟宜升散。仍用升麻葛根汤。加黄连
扁豆。若便脓血。则加滑石未必愈。
痧症不宜根据症施治。惟当治本。本者。手太阴足阳明两经之邪热也。解其邪热。则诸症自退
矣。（痘疹两症。当参文中陈氏仲阳钱氏立斋。薛氏罗田万氏晨峰程氏东皋。徐氏改斋友氏景
岳张氏。近日建中费氏。亦有宣发。皆宜详究。不可偏守一见以误世。）
升麻葛根汤
升麻 葛根 白芍 甘草
痧症，就是疹子。又被称为“沙疹”。《准绳》中说：痧症初起时，使用升麻葛根汤（疏散足阳明经的邪热）配合泻白散（清泄手太阴经的邪热），其间适宜加入桔梗、牛蒡子、荆芥、连翘等药物。（兼以解除这两条经络的毒邪）这尤为恰当。第二天如果皮疹显现，颧骨和鼻子部位出现斑点较多的最为吉利，因为清气喜欢向上运行。第二天就可以去掉葛根了，因为它会开泄肌表腠理而耗伤津液。如果热势严重且病势沉重，在前方的基础上加入白虎汤及黄芩、石膏粉之类的药物，是绝对不能少的。如果服药后热势反而更加严重的，这是正气将毒邪透达出来的缘故，通过出大汗毒邪自然就会解除。如果稍微见到皮疹显露但未能完全透发出来，这就是痧毒不透达的表现，后来必须防备疳积证，应当从滋养阴液的角度治疗，以甘露饮为主方。必须多服用才能见效，也是通过汗法来解表，这是经过多次验证有效的。有一类小儿乳疳，一天就可以解决，不必拘泥于三日或九日的说法，以清泻火邪为主，兼以解毒也可以。因为小儿体质尚且虚弱，神气有限，如果遇到粗疏的医生，不审察虚实情况，发散药物过多，必然导致正气虚脱，而无法救治的情况很多。有痧毒导致痰喘非常严重的，虽然使用石膏、黄连，也像用水淋石头一样无效，要知道这是痧毒与痰火壅结在上焦的缘故，适宜用瓜蒌霜、枳壳、天花粉、金沸草等药物来清化痰热、清泻火邪。如果夹杂气虚的，加入人参立刻见效。如果痰浊上壅严重的，可以使用牛黄珍珠散。痧症出现腹痛的，是因为毒邪郁结在阳明经的缘故，适宜服用升麻、石膏、黄连之类的药物。如果恶毒郁结在大肠的，用桔梗来宣开它。痧症多见泄泻，千万不要使用止涩药物，只用升麻、葛根、黄连、甘草，那么泄泻自然停止。患痧症的人不忌讳泄泻，泄泻则阳明经的邪热得以解除，这也是表里分消的道理。
痧症之后出现的泄泻，以及大便脓血，都是由热邪内陷的缘故。绝对禁忌使用止涩药物，只适宜升散，仍然使用升麻葛根汤，加入黄连、扁豆。如果大便脓血，那么加入滑石未必能治愈。
治疗痧症不应当根据症状直接施治，只应当治本。所谓本，就是手太阴肺经和足阳明胃经两条经络的邪热。解除了这两条经络的邪热，那么各种症状自然就会消退。（痘疹这两种病症，应当参考文中提到的陈氏仲阳、钱氏、立斋、薛氏、罗田万氏晨峰、程氏东皋、徐氏改斋、友氏景岳、张氏，以及近日建中费氏，也有宣发之法，都应当详细研究，不可偏执一端见解而误人世间。）
Sha disease (Sha Syndrome), also known as rash, is alternatively called "Sha Zhen" (Sand Rash). According to *Zhunsheng* (Standard Rules): At the initial stage of Sha disease, Shengma Gegen Tang (Ephedra and Pueraria Decoction) should be used to dissipate pathogenic heat from the Foot-Yangming meridian, combined with Xiebai San (White-Draining Powder) to clear pathogenic heat from the Hand-Taiyin meridian. It is advisable to add Jiegeng (Platycodon Root), Niubangzi (Arctii Fructus), Jingjie (Schizonepetae Herba), and Lianqiao (Forsythiae Fructus) during this process, as they jointly resolve toxicity in these two meridians; this approach is particularly appropriate. On the second day, if the rash appears, having numerous spots on the cheekbones and nose is most auspicious, because clear Yang qi prefers to ascend. By the second day, Gegen (Puerariae Radix) can be removed, as it opens the muscle layer and interstices, thereby drying up body fluids. If the heat is severe and the condition critical, adding Baizhu Tang (White Tiger Decoction) along with Huangqin (Scutellariae Radix) and Gao Fen (Gypsum Fibrosum powder) to the previous formula is indispensable. If the heat becomes more intense after taking medicine, this is due to the righteous Qi driving out the toxicity; a profuse sweating will naturally resolve the toxicity. If only slight signs of the rash appear without full eruption, this indicates that Sha toxicity has not fully penetrated outward, and one must subsequently guard against Gan accumulation (nutritional deficiency syndrome in children). Treatment should focus on nourishing Yin, using Ganlu Yin (Sweet Dew Decoction) as the primary formula. It must be taken in large quantities to be effective, utilizing the sweating method to release the exterior, which has been verified repeatedly. For a certain type of pediatric Ru Gan (Infantile Gan syndrome related to breastfeeding), resolution can occur within one day, without adhering strictly to the theories of three or nine days. The main principle is clearing fire, supplemented by resolving toxicity. This is because children's constitution is still weak, and their Shen Qi (Spiritual Qi) is limited. If treated by incompetent physicians who fail to assess excess or deficiency, and use too many dispersing agents, it will inevitably lead to the collapse of righteous Qi, resulting in untreatable conditions. In cases where Sha toxicity causes severe phlegm and wheezing, even using Shigao (Gypsum Fibrosum) and Huanglian (Coptidis Rhizoma) may be ineffective, like pouring water on stone; one must recognize that this is due to Sha toxicity and phlegm-fire obstructing the Upper Jiao. It is appropriate to use Gualou Shuang (Dried Fruit of Trichosanthes), Zhike (Aurantii Fructus), Huafen (Trichosanthis Radix), and Jinfeicao (Boehmeriae Folium) to clear phlegm and fire. If accompanied by Qi deficiency, adding Renshen (Ginseng Radix et Rhizoma) yields immediate results. If phlegm obstruction is severe, Niuhuang Zhenzhu San (Calculus Bovis and Pearl Powder) can be used. Abdominal pain in Sha disease is caused by toxicity stagnating in the Yangming meridian; thus, Shengma (Cimicifugae Rhizoma), Shigao, and Huanglian are suitable. If malignant toxicity stagnates in the Large Intestine, Jiegeng (Platycodon Root) should be used to open it. Diarrhea is common in Sha disease; one must strictly avoid astringents. Using Shengma, Gegen, Huanglian, and Gancao (Glycyrrhizae Radix et Rhizoma) will naturally stop the diarrhea. Patients with Sha disease do not need to fear diarrhea, as it allows the pathogenic heat of the Yangming meridian to be resolved, embodying the principle of distributing pathogens from both the interior and exterior.
Diarrhea following Sha disease, as well as dysentery with pus and blood, are all caused by the internal sinking of pathogenic heat. Astringents are strictly contraindicated; only dispersing and ascending methods are suitable. One should continue using Shengma Gegen Tang (Ephedra and Pueraria Decoction) with added Huanglian (Coptidis Rhizoma) and Bidou (Dolichos Lablab Seed). If there is pus and blood in the stool, adding Huashi (Talcum) may not necessarily cure it.
Treatment of Sha disease should not be based merely on symptoms but must address the root cause. The root refers to the pathogenic heat in the Hand-Taiyin and Foot-Yangming meridians. Once this pathogenic heat is resolved, all symptoms will naturally recede. (For both smallpox and measles, one should refer to the works of Chen Zhongyang, Qian Yi, Li Zhihe, Xue Ji, Luo Tian Wan Chenfeng, Cheng Donggao, Xu Gaizhai, You Jingyue, Zhang Congzheng, and recently Fei Jianzhong, who also advocated dispersion and emission. All these sources should be studied in detail; one must not adhere to a single viewpoint to mislead the world.)
Shengma Gegen Tang (Ephedra and Pueraria Decoction)
Shengma (Cimicifugae Rhizoma)
Gegen (Puerariae Radix)
Baishao (Paeoniae Radix Alba)
Gancao (Glycyrrhizae Radix et Rhizoma)