痘出正盛逢临产，束手无策势最险，无恙十全大补治，恶露未尽黑神散。
[注]
孕妇当痘正出之际，忽然欲产，俟产育后无他恙者，
只宜大补气血，十全大补汤主之，
若腹中微痛，此恶露未尽也，黑神散主之。
(十全大补汤) 方见结痂落痂证治。
(黑神散)
当归 川芎 熟地黄 青皮醋炙 香附醋炙 蒲黄 桂心 干姜 水煎温服。
(方歌)
恶露末净黑神良，当归川芎熟地黄，青皮香附俱醋炙，蒲黄桂心合干姜。
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男妇年长出痘门
产后如逢出痘疮，惟凭补益莫惊慌，十全大补全功效，勿用寒凉致损伤。
[注]
妇人产后气血已伤，又遇出痘，则气血之供用难给，不能领载其毒，
惟宜大补气血，以十全大补汤治之，
切不可妄用寒凉之剂，致伤生发之机也。
(十全大补汤) 方见结痂落痂证治。
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麻为正疹亦胎毒，毒伏六府感而出，初发之状有类痘，形尖渐密不浆殊，
始终调护须留意，较痘虽轻变化速。
[注]
疹非一类，有瘙疹瘾疹温疹，
盖痘疹皆非正疹也，惟麻疹则为正疹，
亦胎元之毒伏于六府，感天地邪阳火旺之气，
自肺脾而出，故多咳嗽喷嚏，鼻流清涕，眼泪汪汪，两胞浮肿，
身热二三日，或四五日始见点于皮肤之上，形如麻粒，色若桃花，
间有类于痘大者，此麻疹初发之状也，
形尖疏稀，惭次稠密，有颗粒而无根，晕微起泛而不生浆，
此麻疹见形之后大异于痘也，
须留神调治，始终不可一毫疏忽，较之于痘虽稍轻，
而变化之速则在顷刻也。
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痘疹正处于旺盛阶段时，若恰逢产妇临产，此时医生往往束手无策，病情最为凶险。若产妇在出痘期间平安分娩且无其他并发症，应使用十全大补汤（Shiquan Dabu Tang, Ten Complete Great Supplement Decoction）进行调理；若产后恶露（postpartum lochia，即子宫内残留的血液和组织液）尚未排尽，则应使用黑神散（Heishen San, Black Spirit Powder）。
[注释]
孕妇在痘疹正发出之际，忽然出现临产征兆，待分娩结束后若无其他病症，只适宜大补气血，以十全大补汤为主治方剂。若腹部有轻微疼痛，这是恶露未尽的表现，应以黑神散为主治方剂。
（十全大补汤）方剂详情见“结痂落痂证治”章节。
（黑神散）
药材组成：当归（Angelicae Sinensis Radix）、川芎（Chuanxiong Rhizoma）、熟地黄（Rehmanniae Radix Preparata）、青皮（Citri Reticulatae Pericarpium Viride，醋炙处理）、香附（Cyperi Rhizoma，醋炙处理）、蒲黄（Typhae Pollen）、桂心（Cinnamomi Cortex）、干姜（Zingiberis Rhizoma Preparata）。水煎煮后温服。
（方歌）
恶露未净用黑神散疗效良，包含当归、川芎、熟地黄，青皮与香附均需醋炙，再合蒲黄、桂心及干姜。
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男女成年后长出痘疮的情况
产后若遭遇出痘疮，只需依靠补益之法，不必惊慌。十全大补汤具有全面功效，切勿使用寒凉药物以免造成伤害。
[注释]
妇女产后气血已经受损，又遇到出痘疹，那么气血的供应难以满足需求，无法承载和排出毒素。只宜大补气血，以十全大补汤治疗。切不可妄用寒凉性质的药剂，以免损伤生机发越之机。
（十全大补汤）方剂详情见“结痂落痂证治”章节。
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麻子（麻疹病毒引起的皮疹）属于正疹，也是胎毒（congenital toxin，胎儿时期积累的毒性物质）所致。毒邪潜伏于六腑（six fu organs，指胆、胃、小肠、大肠、膀胱、三焦），感受外界邪气而发作。初发时的症状类似痘疹，但形态尖细，逐渐变得密集，且不化脓浆，这与痘疹截然不同。整个病程期间的调护必须留意，虽然比痘疹稍轻，但病情变化迅速。
[注释]
疹并非单一类型，有瘙疹（pruritic rash）、瘾疹（urticaria/hives）、温疹（warm rash）等。可以说痘疹都不属于正疹，只有麻疹才称为正疹。这也是胎元之毒潜伏于六腑，感受天地之间邪阳火旺之气，从肺脾二脏发出。因此常伴有咳嗽、喷嚏、流清涕、眼泪汪汪、眼睑浮肿等症状。身体发热二三日，或四五日后才开始在皮肤上出现斑点，形状如麻粒，颜色像桃花。间或有类似痘疹较大的情况，这是麻疹初发的状态。形态尖细稀疏，逐渐变得稠密，有颗粒感但没有根基，周围微红晕起但不生脓浆。这是麻疹显现形态后与痘疹截然不同的地方。必须留神调治，从头到尾不可有一丝疏忽。相较于痘疹虽然稍轻，但变化之快则在顷刻之间。
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When the variola (smallpox) is in its peak eruption phase and coincides with labor, medical intervention is often helpless, making the condition most critical. If the woman delivers safely during the eruption without other complications, Shiquan Dabu Tang (Ten Complete Great Supplement Decoction) should be used for treatment; if the postpartum lochia has not yet cleared, Heishen San (Black Spirit Powder) should be administered.
[Annotation]
When a pregnant woman experiences sudden labor while the variola is erupting, if she delivers safely without other ailments afterward, it is appropriate to greatly tonify Qi and Blood, using Shiquan Dabu Tang as the primary formula. If there is slight abdominal pain, this indicates that the lochia has not fully cleared, and Heishen San should be used.
(The formula for Shiquan Dabu Tang can be found in the section on "Treatment of Crusting and Scab Falling".)
(Heishen San)
Ingredients: Angelicae Sinensis Radix (Danggui), Chuanxiong Rhizoma (Chuanxiong), Rehmanniae Radix Preparata (Shudihuang), Citri Reticulatae Pericarpium Viride (Qingpi, processed with vinegar), Cyperi Rhizoma (Xiangfu, processed with vinegar), Typhae Pollen (Puhuang), Cinnamomi Cortex (Guixin), Zingiberis Rhizoma Preparata (Ganjiang). Decoct in water and take warm.
(Rhyme Formula)
For lochia that has not cleared, Heishen San is excellent;
Contains Danggui, Chuanxiong, and Shudihuang;
Qingpi and Xiangfu are both vinegar-processed;
Combined with Puhuang, Guixin, and Ganjiang.
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On Variola Eruption in Adult Men and Women After Childbirth
If variola occurs after childbirth, rely solely on tonification methods and do not panic. Shiquan Dabu Tang offers comprehensive efficacy; avoid using cold-natured medicines to prevent injury.
[Annotation]
After childbirth, a woman's Qi and Blood are already depleted. If she encounters variola, her Qi and Blood may be insufficient to carry and expel the toxins. It is essential to greatly tonify Qi and Blood, treating with Shiquan Dabu Tang. One must absolutely avoid recklessly using cold-natured preparations, which would damage the mechanism of life generation and growth.
(The formula for Shiquan Dabu Tang can be found in the section on "Treatment of Crusting and Scab Falling".)
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Mei (measles/rash) belongs to the category of Zhengzhen (true rash) and is also caused by congenital toxin (Tai Du). The toxin lies latent in the Six Fu Organs (Six Bowels) and manifests upon exposure to external pathogenic factors. The initial presentation resembles variola, but the lesions are pointed, gradually become dense, and do not form pus or blisters, which is distinct from variola. Careful management throughout the course is necessary; although milder than variola, the changes occur rapidly.
[Annotation]
Rashes are not a single entity; there are pruritic rashes (Saozhen), urticaria (Yinzhen), and warm rashes (Wenzhen). Generally, variola and other rashes are not considered "Zhengzhen"; only measles constitute the true rash. This is also due to congenital toxin lying latent in the Six Fu Organs, triggered by external evil Yang fire-wind qi, emerging from the Lung and Spleen. Therefore, symptoms such as coughing, sneezing, clear nasal discharge, watery eyes, and eyelid edema are common. After fever for two to three days, or four to five days, spots begin to appear on the skin, resembling hemp seeds, with colors like peach blossoms. Occasionally, larger lesions resembling variola may appear, which represents the initial stage of measles eruption. The lesions are pointed, initially sparse and gradually becoming dense, having granular texture but no root, with slight erythema but no pus formation. This differs significantly from variola after the manifestation phase. Vigilant treatment is required from start to finish without any negligence. Although slightly milder than variola, the speed of change is instantaneous.
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