能止炎若仅以苦寒从事不加双解则是不通风火之情激成燎原之势势必猛烈犹甚气焰愈增推疫之气从风从火风火相生变
端甚速然风之惟性宜疏而火之情尚达所以凉剂中必兼疏达也以此盖寒凉之性非下即闭适与疏达相反实是拂其情性何怪
电掣风驰激之生变假如醋暑大热赤日悬空虽骤雨而无风不但气不转凉而反因之加热正是热为雨遏热气何得而宣但有
微风疏动燥气便觉消除使再加雨润之即转太和气象此双解之所以富施尤贵重施者三也
时行疫气虽易染人未尽见人而染何也自召之也召之何由由夫人之气质素弱藩篱又疏于是疫从口鼻而传痧自肌肤而
染者谓之传染抑人正气虽足而或外伏他邪则是素有伏邪更感时行而发者谓之感发更有外强中干虽身无伏邪而赋质偏胜
则是气有所偏疫乘其偏而胃冒受者谓之感冒必也正气内充更无夙疾少神志之烦绝劳顿之役不传不染其殆庶几
岐伯曰不相染者正气存内邪不可干是疫之入也必乘其虚然虚有内外故感有浅深气有偏胜故症有疑似其在内气实而
外气虚者虽感冒轻微亦应见微病故认症难真辨之之法惟咳嗽肤痒脉象弦而带数隐约痧形在所必见其袭于皮毛者则内应乎
肺
故目赤者以白珠属肺肤痒者以肺主皮毛喉痛者以喉为肺管溏泄者以大肠为肺之表邪从表泄咳嗽者为邪袭肺经是皆皮毛
冒疫其象如此抑有皮毛闭密邪不能侵而困乏或其身四肢感冒者则内应乎脾而脾与胃又相为表里故肢痒者以脾主四肢液
干者为脾不输津化作渴者为胃热思饮呕恶者为胃邪上越不思饮食者为邪袭胃经不寐者为胃为燥屎发痧者为邪达肌表是
皆因正气内充外冒疫邪而不能循经入内者其象又如此均为疑似之症最为误作他邪故特为之辨别以明似是之非
痧之一症昔人概以斑疹麻疹目之独麻一症系发先天之阳毒外此则大块者如斑者曰 细织如锦者曰疹黍粒如沙者曰
痧而其实白疹发胃阳之邪丹痧泄胃阴之毒阴阳赤白虽有区分 疹痧麻悉归胃腑故古人一概统论不分痧目科条吴又可则
混于温叶天士吴鞠通悉叙于温病而时贤更于痧之中别出红痧喉痧闷痧风痧 子疹子等用名目不一其义则同前论已详言之
矣乃若风痧等类譬犹强弩之末气势虽微中人亦厉有不咳嗽不发热不过喉间微痛皮肤作痒而已邪本轻微人多轻忽苟忽之
将酿成闷痧难于救药其故以人既干邪则腠理常开卫气渐弛而正弱正气既弱则口鼻呼吸尤易内传况复身中伏疫即从腠理
而循经隧由经隧而干脏腑内外附应其势甚速星星之火可以燎原故古人常谓祸忽于隐微病生于不觉诫人防其渐也至于闷
痧形状亦不过微恶寒热痧点依稀状与风痧相似独神昏鼾睡面黯身清则大异于风痧良由感疫极深体弱难任无力发出或加
他邪再束或为凉药误投闷闭于中发泄不出势成内陷而死故曰闷痧俗有发痧一症即由所谓暑月中恶阴凝腹痛之痞气也既
非传染复非疫厉俗曰胀痧乌痧钓脚痧绞肠痧等症与疫相反而俗亦谓之痧者尤当附以辨明盖疫痧者传染时行而发阴痧者
卒中恶气而然恶气者何即矢气也矢气者乃浊秽所积杂挟阴邪感人之身如矢中的其气阴凝故不传染爰盛夏之时亦阳
尽发于外六阴尽藏于内故夏气升而井水寒人身应乎天地脏腑应属寒凉藩篱因而不密以故阴邪易干矢气易入入则直射贯
革痛楚难胜若无伏邪而感者立致容颜惨黯腹痛肠鸣闭阻气机四肢厥冷只须推拿揉刮使血气频分频合阳气疏通矢气遂从
肌肉传达而出渐露痧外呈勿药亦可自愈然须一周日不能饮水饮则邪留经络一遇寒凉愤郁最易举发不可不知若有伏邪而
更干矢气则宜射肠腑立致血脉凝泣营卫失司霍乱吐泻钓脚绞肠痛不可耐厥逆身僵人事不省亟以辛热之品逐其凝寒芳香
灵明之药导其关窍俾气血流畅阳和颊开立可立愈故无论轻重而腹痛肠鸣者在所不免良以腹内寒凉复袭矢气于是腹为寒
凝而疼痛肠即阻结而如绞此绞肠之所以名也至于钓脚乃足为三阴脉络发源之所阴从下受故伤阴络凝泣脚不能伸而为钓
救之不及命毙须臾是皆中恶腹痛痞气阴凝之症俗虽谓之发痧实与疫痧之痧有异即传染与不传染所由分也
一烂喉痧症咽喉不甚肿痛初起时身现微红似有似无之状脉伏肢凉面青唇紫口闭流涎目睛直视指甲青滞胸腹饱胀气
促神昏四肢搐抽等症此闷痧也虽百无一生亦不忍坐视其毙速用卧龙丹多吹两鼻多嚏为吉随用薄荷钱许煎汤磨紫金锭二枚
频灌之候形色少转再进煎剂如无以上诸搬闭象不宜轻用吹嚏辛燥之药
喉痧症初起色紫而艳来势甚猛即用疡医大全痧疹论中方归尾紫草桃仁蒲黄地丁等药KT 酌出之颇能见效
闷痧一症多有卧龙丹难开其闭者故特以枣塞鼻随息出入开喉起闭一方于最后以补缺略试无不效功异回生幸勿轻视
一喉痧症无论已畅未畅之时若咽喉痛肿不堪形色紫艳尚未溃烂或已破未深而项外漫肿坚硬痰气壅闭汤水难下者急
用喉针在喉之两旁高肿处刺入分许二三下咯去黑紫毒血随时便可下药亦不致于大溃
刺喉痧用针刺两手大指内侧爪甲根分许即少商穴也刺入分许挤尽紫血最能开泄肺经热毒
喉痧内外不甚肿痛可进汤水不甚肿痛色淡不艳溃烂过深皆不必刺如脉细神昏毒已内陷亦不必刺
喉痧呕吐肢凉皆缘阳明疫邪壅闭以致腠理不开气结不舒不可作寒症治之以投辛温如苍术浓朴半夏肉桂附子生姜
之类
又初见痧形似有似无骤然惊搐者亦不宜用若寒镇惊之药如牛黄苏合等丸此但透达痧疹得畅自能渐愈如喉已溃烂芫
荽观音柳棉线纱樱桃核一切忌用即不溃烂疫痧温热均不相宜
疫痧烂喉症犀角地黄汤一方须审定而后用书中虽未载明临症务宜斟酌用
【疏达法】痧邪在表火不内炽痧热稀轻神清喉不烂者为先达后清之法
葛根汤 治身热神清痧隐稀疏舌白脉郁而喉不甚烂者宜之
葛根 牛蒡 荆芥 蝉衣 连翘 郁金 甘草 桔梗
加减桔根汤 治无汗痧隐舌白脉郁喉烂不甚者
葛根 牛蒡 香豉 枳壳 薄荷 马勃 蝉衣 荆芥 防风 连翘 焦查 赤芍 甘草
香豉饮 治痧隐脉郁喉腐舌燥症虽乍起津液不足神虽清爽邪火内伏者宜之
香豉 牛蒡 荆芥 桔梗 连翘 栀子 马勃 大贝 人中黄 共三方
【清散法】疫痧重者疏散清化宜并进也表邪未除疏散固不可少 疫毒内炽清化更不可迟表邪末也火炽本也症虽乍起
而
灼热无汗痧隐成片喉烂神烦是火炽已也甚若仍泥于无汗痧隐而必一味疏达恐愈疏而汗愈无痧愈隐矣愈达而神愈昏喉愈烂
矣罔顾治本之火而徒治表之邪舍本求末焉能奏效故立清散一门表本兼赅邪火并治如常山蛇击首应尾能处洞然
葛根汤 治灼热神昏烦躁喉腐脉弦痧隐成片不分颗粒无汗舌垢者宜之
犀角 葛根 牛蒡 桔梗 连翘 山栀 蝉衣 荆芥 马勃 查炭 人中黄
犀豉汤 治烂喉痧隐脉弦神昏烦躁热甚汗少舌绛口渴症虽乍起而疫火燎原有内陷之势神昏甚者兼用万氏牛黄
丸
犀角 香豉 牛子 荆芥 连翘 山栀 马勃 大贝 蝉衣 赤芍 桔梗 甘草 共二方
【清化法】疫痧之火迅而烈清化之剂不可缓尤不可轻若表邪未解内火已炽须见于疫火未肆之前而先化其毒故散必兼
清若毒焰已炽则是冠发捕奏功难效矣倘表邪已解火炽方盛痧透脉弦喉烂舌绛口渴神烦此时清化不重用正如杯水救车薪
决其无效
犀角地黄汤 治痧点已透火灼液亏脉弦数大喉烂舌绛者宜之如火灼液亏舌绛喉烂即痧未透发疏达品中亦宜加
之此汤乃化毒救液之妙剂
犀角 地黄 丹皮 赤芍
犀角二鲜汤 治痧点虽透而喉烂极甚脉弦大而口渴神烦舌绛唇干火炽液涸者宜之
犀角 连翘 大贝 元参 山栀 羚羊角 鲜生地 鲜沙参 人中黄 人中白 银花 生石羔 川黄连 马勃
陈金汁
夺命饮 治痰极盛津液干涸舌绛口渴神烦喉烂脉象弦大痧点云密者宜之
川连 石羔 犀角 生地 丹皮 赤芍 青黛 马勃 大贝 连翘 元参 金汁 羚羊 沙参 人中黄
清肺饮 治痧点已透喉烂渐轻神爽热淡而咳嗽者未平者
宜之 桑叶 沙参 羚羊 连翘 桔梗 甘草 橘红 贝母 共四方
【下夺之剂】不得已而为之也表邪未解内火已炽可以助疏达之品而为斩关之将者双解散是也表邪已解火炽犹甚可以
佐清化之品而有夺门之能者四虎饮是也重剂可施于正强邪实之人正强邪实而表邪未解者必无汗痧隐喉烂神烦便闭脉实施
之双解不亦宜乎表邪既解者必得汗痧密喉烂神燥脉实
便闭进以四虎饮不亦宜乎此重剂之所为不得已而设也
双解散 治痧点隐约喉烂气秽神烦便闭目赤脉实病势初起正强邪实者宜之
大黄 芒硝 葛根 牛蒡 荆芥 连翘 薄荷 蝉衣 枳壳 人中黄 桔梗
四虎饮 治痧虽透而烂喉极甚脉象弦数目赤便闭神烦舌绛痰火甚者宜之
大黄 黄连 犀角 石羔 知母 元参 生地 青黛 马勃 共二方
【救液】是佐使之一法火盛液亏者必需之疫痧不离乎火火甚者液必亏病必危救液之品化其毒于恬淡之中养其阴于未
涸之候佐疏达之品不嫌其凝寒佐清化之方无忧其液涸救液之剂曷可缓哉
五鲜饮 治舌绛而干脉弦数大痧隐而喉腐不甚者可与葛根汤并服痧隐而喉烂者可与犀豉齐进
鲜沙参 鲜生地 鲜茅根 鲜芦根 甘蔗汁
育阴煎 治痧透肌燥舌绛液干喉烂便闭脉弦无神者宜之
元武板 鳖甲 生地 丹皮 大贝 金汁 麦冬 知母 沙参 花粉 元参 犀角 共二方
吹喉十宝丹 专治烂喉症无论已溃未溃肿色艳生并治痘毒以及痧疹后牙疳杨梅后毒结咽喉功能消肿止痛化毒
生肌仙方也其效如神万勿增减
牛黄（三分） 大贝（三分） 人中白（ 五分） 琥珀（五分） 青鱼胆（五分大者） 珍珠（六分） 梅片（五
厘） 人指甲（四分） 马勃（三分） 硼砂（四分） 共研极细末专治此症其他喉科谷症自有喉科吹药未可概用之
敷项颈方实时毒门中二味拔毒散雄黄 生凡 专治痧疹后毒结项外温肿坚硬无论其色红白效验如神
专敷项外漫肿名紫金丹即尿池中多年碎砖炭火 红入醋中泡再 再泡五六次取研末每两入射香一分用醋白蜜各半
熬滚调敷如塌皮形色紫艳用菜油加蛋清之喉风缠喉项肿者均可用
鲜土牛膝根捣汁炖温时饮并治一切喉症消肿散因止痛化痰如神
驱瘟辟邪法 生军（二两） 茵陈（一两） 茅术（五钱） 降香（一两） 研末不时烧熏之惟病患卧室不能
用恐防
呛喉喉闭塞鼻方专治喉闭汤水不入
将药纳枣塞鼻中使药气随鼻息而入喉关乃开惟药性燥烈不可着肉敷点用红枣切破一头去核将药少许纳入枣中线扎封枣
口左痛塞右鼻右痛塞左鼻若小孩鼻孔小枣不能塞或用棉花包扎塞亦可但不能令药贴靠着肉以免肿泡之患若喉闭势重者
用双枣两鼻齐塞亦可此方不但用之痧喉喉闭一症即凡伤寒各种喉闭气息不通命在垂危多具起死回生之力神妙异常勿轻
视
蟾酥（七分） 细辛（四分） 辰砂（三分） 射香（二分五厘） 冰片（二分半） 牙皂（四分） 生半夏（三
分）
辛夷（四分） 刚子即巴豆（四分去油） 牛黄（二分） 雄黄（四分） 共研细末收贮
喉闭一症气机阻闭药不能下咽命在垂危虽良医亦无策往往为闭所绝纵卧龙丹紫金丹开关各法不克得一喷嚏者百无
一生此方合药塞入鼻内只要膺前犹觉跳动气息虽极细微但得一丝未绝无不痰气渐松人事转醒有经数时而苏者有周昼夜
而起者神效良方
人中白散 专治男妇大小口舌糜烂走马牙疳并咽喉肿痛牙床腐溃等症
青黛（一钱） 月石（一钱） 儿茶（一钱） 薄荷（五分） 梅片（二分） 人中白（一钱） 元明粉（五分） 西
黄（三分） 珍珠（五分） 共研细末搽患处
牙疳神方 治痧 走马牙疳先用冬青叶煎水漱净再以此药敷上
青黛（一钱） 牛黄（二分） 人中白（一钱 ） 回龙骨（一钱 ） 血余炭（一钱） 冰片（三分） 珍珠（五
分） 旧红毡子炭（一钱） 小红枣（七枚去核入雄黄少许 ） 共研细末收好勿泄气
按前焦疫痧方乃为疫痧烂喉专症而设并无杂挟他邪并挟寒挟湿均为疫症之常爰采朱铁山数方补其阙略铁山所论谓
当察其发热之始时令寒暄酌而治用倘严寒是挟虽桂枝葛根麻黄亦均可用勿以辛温而迟疑此言诚非墨守经曰必先岁气母
伐天和其斯之谓故其方中有升麻白芷苍术柴胡各禁药虽悖治疫之旨然疫中系有是症故虽在禁而不得以禁之特为录出以
备一格聊为神而明之之用
荆防葛根汤 治风寒外来皮肤闭密痧疹逡巡不出又治形寒乍热咽喉肿痛咳嗽胸闷鼻塞呕恶两目汪汪手足指冷
脉来濡数或现浮数宜服此汤
荆芥（一钱五分） 防风（一钱五分） 甘草（四分） 桔梗（一钱五分） 牛蒡（三钱） 蝉衣（一钱） 枳壳
（一钱）
象贝（一钱五分） 葛根（一钱五分） 杏仁（三钱便溏勿用）
升麻葛根汤 治体质弱痧不透达
升麻（一钱） 葛根（一钱） 赤芍（八分） 甘草（四分）
加减透邪汤 治痧不透达服升麻葛根汤仍不达再服此汤
能够平息炎症，如果仅仅使用苦寒药物进行治疗，而不采用表里双解的方法，这就没有顺应风火之邪的性情。风火相煽，会形成燎原之势，病情势必更加猛烈。气焰越盛，疫毒之气便随着风和火而蔓延，风火相生，变端发生得非常迅速。然而，风的特性适宜疏泄，火的性质尚需通达，所以在凉性药剂中必须兼用疏达（疏通气机、透达邪气）的药物。这是因为寒凉药物的性质要么下行，要么闭郁，恰好与疏达的作用相反，这实际上是违背了风火的性情，难怪病情会像电掣风驰一样迅猛，受到刺激后产生变故。
例如，在酷暑大热、赤日当空之时，即使突然下起暴雨但没有风，空气不仅不会转凉，反而因为热气被雨水遏制而无法宣散，导致气温升高。只有有微风轻轻吹动，燥热之感便会消除；如果再加以雨水的滋润，就会转为太和（平和舒适）的气象。这就是为什么“双解法”（表里双解）如此丰富且珍贵，尤其适用于这种情况。
时行疫气虽然容易传染给人，但并非见到病人就一定会被感染，这是为什么呢？是因为患者自身招致的。怎么招致的呢？是由于人的体质素来虚弱，藩篱（卫外功能）疏松，于是疫毒从口鼻传入，痧毒从肌肤染入，这叫做“传染”。或者，人体正气虽然充足，但外部潜伏着其他病邪，即素有伏邪，又感受了时行疫气而发病，这叫做“感发”。更有甚者，外表强壮内里空虚，身体虽然没有伏邪，但禀赋偏胜，导致气机有所偏颇，疫毒乘其偏颇而侵犯，这叫做“感冒”。必须做到正气内部充盈，没有宿疾，减少神志上的烦扰，杜绝劳顿的役使，才能不传不染，大概接近于理想状态了。
岐伯说：“不相染者，正气存内，邪不可干。”所以疫毒入侵，必定是趁着人体虚损的时候。然而虚损有内虚和外虚之分，所以感邪有浅深之别；气机有偏胜，所以症状有疑似之处。如果在内气实而外气虚，虽然感冒轻微，也应该出现微小的病症，因此辨认症状难以确切。辨别的方法是：如果咳嗽、皮肤瘙痒、脉象弦而带数，隐约可见痧形，这是必然的。邪气侵袭皮毛，则内应于肺。所以眼睛发红，是因为白珠属肺；皮肤瘙痒，是因为肺主皮毛；喉咙痛，是因为喉为肺之管；腹泻，是因为大肠为肺之表；邪气从表而泄，咳嗽是因为邪气侵袭肺经。这些都是皮毛冒受疫毒的表现，征象就是这样。
另外，如果皮毛闭密，邪气不能侵入，而出现困乏，或者四肢感冒，则内应于脾。而脾与胃又互为表里。所以四肢瘙痒，是因为脾主四肢；津液干枯，是因为脾不能输布津液；化作口渴，是因为胃热思饮；呕吐恶心，是因为胃邪上逆；不思饮食，是因为邪气侵袭胃经；失眠，是因为胃中有燥屎；发痧，是因为邪气达于肌表。这些都是因为正气内部充实，外部冒受疫邪，但不能循经入内所致，征象又是这样。这两种情况都是疑似之症，最容易误认为是其他邪气，所以特意进行辨别，以阐明似是而非的道理。
关于“痧”这一病症，过去的人一概将其归为斑疹、麻疹一类。唯独“麻”这一症，是发先天之阳毒；除此之外，大块如斑的叫“斑”，细织如锦的叫“疹”，黍粒如沙的叫“痧”。其实，白疹是发胃阳之邪，丹痧是泄胃阴之毒。阴阳赤白虽有区分，但疹、痧、麻都归属于胃腑，所以古人一概统论，不分痧科和目科的条框。吴又可将其混同于温病，叶天士、吴鞠通也都叙述在温病之中。而当代贤者更在痧之中别出红痧、喉痧、闷痧、风痧、子疹子等名目，虽然用名不一，但其义相同，前文已详细论述过。
至于风痧等类别，譬如强弩之末，气势虽然微弱，中人亦厉害。有的不咳嗽、不发热，只是喉间微痛、皮肤作痒而已。邪气本轻微，人多轻忽，如果忽视它，将酿成闷痧，难以救药。其原因是人既感受邪气，腠理常开，卫气渐弛，正气变弱。正气既弱，口鼻呼吸尤易内传。况且身中若有伏疫，即从腠理而循经隧，由经隧而干脏腑，内外附应，其势甚速。“星星之火，可以燎原”，所以古人常说祸患始于隐微，病生于不觉，告诫人们防止其渐长。
至于闷痧的形状，也不过微恶寒热，痧点依稀，状与风痧相似。唯独神昏鼾睡、面色黯黑、身体清冷，则大大异于风痧。良由感受疫毒极深，体弱难任，无力发出，或者加他邪再束，或者为凉药误投，闷闭于中，发泄不出，势成内陷而死。所以说闷痧。
俗话说的“发痧”一症，即是由所谓暑月中恶、阴凝腹痛的痞气所致。既然不是传染，也不是疫厉，俗称胀痧、乌痧、钓脚痧、绞肠痧等症，与疫相反，但俗亦谓之痧，尤其应当附加辨别说明。盖因疫痧是传染时行而发，阴痧是卒中恶气而然。什么是恶气？就是矢气（放屁）。矢气乃是浊秽所积，杂挟阴邪，感人之身如矢中的，其气阴凝，所以不传染。
正值盛夏之时，阳气尽发于外，六阴尽藏于内，所以夏气升而井水寒。人身应乎天地，脏腑应属寒凉，藩篱因而并不严密，所以阴邪易干，矢气易入。入则直射贯革，痛楚难胜。若无伏邪而感者，立致容颜惨黯、腹痛肠鸣、闭阻气机、四肢厥冷。只须推拿揉刮，使血气频分频合，阳气疏通，矢气遂从肌肉传达而出，渐渐露出痧外，呈现勿药亦可自愈之象。然而须一周日，不能饮水，饮则邪留经络，一遇寒凉愤郁，最易举发，不可不知。
若有伏邪而更干矢气，则宜射肠腑，立致血脉凝泣、营卫失司、霍乱吐泻、钓脚绞肠、痛不可耐、厥逆身僵、人事不省。亟以辛热之品逐其凝寒，芳香灵明之药导其关窍，俾气血流畅，阳和颊开，立可痊愈。故无论轻重，而腹痛肠鸣在所不免。良以腹内寒凉复袭矢气，于是腹为寒凝而疼痛，肠即阻结而如绞，此绞肠之所以名也。至于钓脚，乃足为三阴脉络发源之所，阴从下受，故伤阴络凝泣，脚不能伸而为钓。救之不及，命毙须臾。是皆中恶腹痛、痞气阴凝之症，俗虽谓之发痧，实与疫痧之痧有异，即传染与不传染所由分也。
一、烂喉痧症：咽喉不甚肿痛，初起时身现微红，似有似无之状，脉伏肢凉，面青唇紫，口闭流涎，目睛直视，指甲青滞，胸腹饱胀，气促，神昏，四肢搐抽等症，此闷痧也。虽百无一生，亦不忍坐视其毙。速用卧龙丹多吹两鼻，多嚏为吉。随用薄荷钱许煎汤，磨紫金锭二枚，频灌之。候形色少转，再进煎剂。如无以上诸般闭象，不宜轻用吹嚏辛燥之药。
喉痧症初起色紫而艳，来势甚猛，即用《疡医大全·痧疹论》中方，归尾、紫草、桃仁、蒲黄、地丁等药，酌情透出之，颇能见效。
闷痧一症，多有卧龙丹难开其闭者，故特以枣塞鼻，随息出入，开喉起闭一方，于最后以补缺略。试无不效，功异回生，幸勿轻视。
一、喉痧症：无论已畅未畅之时，若咽喉痛肿不堪，形色紫艳，尚未溃烂，或已破未深而项外漫肿坚硬，痰气壅闭，汤水难下者，急用喉针在喉之两旁高肿处刺入分许二三下，咯去黑紫毒血，随时便可下药，亦不致于大溃。
刺喉痧用针刺两手大指内侧爪甲根分许，即少商穴也。刺入分许，挤尽紫血，最能开泄肺经热毒。
喉痧内外不甚肿痛，可进汤水，不甚肿痛色淡不艳，溃烂过深，皆不必刺。如脉细神昏，毒已内陷，亦不必刺。
喉痧呕吐、肢凉，皆缘阳明疫邪壅闭，以致腠理不开，气结不舒，不可作寒症治，而以投辛温如苍术、浓朴、半夏、肉桂、附子、生姜之类。
又初见痧形似有似无，骤然惊搐者，亦不宜用若寒镇惊之药，如牛黄苏合等丸。此但透达痧疹，得畅自能渐愈。如喉已溃烂，芫荽、观音柳、棉线纱、樱桃核一切忌用，即不溃烂，疫痧温热均不相宜。
疫痧烂喉症犀角地黄汤一方，须审定而后用。书中虽未载明，临症务宜斟酌用。
【疏达法】痧邪在表，火不内炽，痧热稀轻，神清喉不烂者，为先达后清之法。
葛根汤：治身热神清，痧隐稀疏，舌白脉郁而喉不甚烂者宜之。
葛根、牛蒡、荆芥、蝉衣、连翘、郁金、甘草、桔梗。
加减桔根汤：治无汗，痧隐舌白，脉郁喉烂不甚者。
葛根、牛蒡、香豉、枳壳、薄荷、马勃、蝉衣、荆芥、防风、连翘、焦查、赤芍、甘草。
香豉饮：治痧隐脉郁，喉腐舌燥，症虽乍起，津液不足，神虽清爽，邪火内伏者宜之。
香豉、牛蒡、荆芥、桔梗、连翘、栀子、马勃、大贝、人中黄。共三方。
【清散法】疫痧重者，疏散清化宜并进也。表邪未除，疏散固不可少；疫毒内炽，清化更不可迟。表邪末也，火炽本也。症虽乍起而灼热无汗，痧隐成片，喉烂神烦，是火炽已也。甚若仍泥于无汗痧隐而必一味疏达，恐愈疏而汗愈无，痧愈隐矣；愈达而神愈昏，喉愈烂矣。罔顾治本之火而徒治表之邪，舍本求末，焉能奏效？故立清散一门，表本兼赅，邪火并治，如常山蛇击首应尾，能处洞然。
葛根汤：治灼热神昏烦躁，喉腐脉弦，痧隐成片，不分颗粒，无汗舌垢者宜之。
犀角、葛根、牛蒡、桔梗、连翘、山栀、蝉衣、荆芥、马勃、查炭、人中黄。
犀豉汤：治烂喉痧隐，脉弦神昏烦躁，热甚汗少，舌绛口渴，症虽乍起而疫火燎原有内陷之势，神昏甚者兼用万氏牛黄丸。
犀角、香豉、牛子、荆芥、连翘、山栀、马勃、大贝、蝉衣、赤芍、桔梗、甘草。共二方。
【清化法】疫痧之火迅而烈，清化之剂不可缓，尤不可轻。若表邪未解，内火已炽，须见于疫火未肆之前而先化其毒，故散必兼清。若毒焰已炽，则是冠发捕奏功难效矣。倘表邪已解，火炽方盛，痧透脉弦，喉烂舌绛，口渴神烦，此时清化不重用，正如杯水救车薪，决其无效。
犀角地黄汤：治痧点已透，火灼液亏，脉弦数大，喉烂舌绛者宜之。如火灼液亏，舌绛喉烂，即痧未透发，疏达品中亦宜加之。此汤乃化毒救液之妙剂。
犀角、地黄、丹皮、赤芍。
犀角二鲜汤：治痧点虽透而喉烂极甚，脉弦大而口渴神烦，舌绛唇干，火炽液涸者宜之。
犀角、连翘、大贝、元参、山栀、羚羊角、鲜生地、鲜沙参、人中黄、人中白、银花、生石羔、川黄连、马勃、陈金汁。
夺命饮：治痰极盛，津液干涸，舌绛口渴，神烦喉烂，脉象弦大，痧点云密者宜之。
川连、石羔、犀角、生地、丹皮、赤芍、青黛、马勃、大贝、连翘、元参、金汁、羚羊、沙参、人中黄。
清肺饮：治痧点已透，喉烂渐轻，神爽热淡而咳嗽者未平者宜之。
桑叶、沙参、羚羊、连翘、桔梗、甘草、橘红、贝母。共四方。
【下夺之剂】不得已而为之也。表邪未解，内火已炽，可以助疏达之品而为斩关之将者，双解散是也。表邪已解，火炽犹甚，可以佐清化之品而有夺门之能者，四虎饮是也。重剂可施于正强邪实之人。正强邪实而表邪未解者，必无汗、痧隐、喉烂、神烦、便闭、脉实，施之双解不亦宜乎？表邪既解者，必得汗、痧密、喉烂、神燥、脉实、便闭，进以四虎饮不亦宜乎？此重剂之所为，不得已而设也。
双解散：治痧点隐约，喉烂气秽，神烦便闭，目赤脉实，病势初起，正强邪实者宜之。
大黄、芒硝、葛根、牛蒡、荆芥、连翘、薄荷、蝉衣、枳壳、人中黄、桔梗。
四虎饮：治痧虽透而烂喉极甚，脉象弦数目赤，便闭神烦，舌绛痰火甚者宜之。
大黄、黄连、犀角、石羔、知母、元参、生地、青黛、马勃。共二方。
【救液】是佐使之一法。火盛液亏者必需之。疫痧不离乎火，火甚者液必亏，病必危。救液之品，化其毒于恬淡之中，养其阴于未涸之候，佐疏达之品不嫌其凝寒，佐清化之方无忧其液涸。救液之剂，曷可缓哉！
五鲜饮：治舌绛而干，脉弦数大，痧隐而喉腐不甚者，可与葛根汤并服；痧隐而喉烂者，可与犀豉齐进。
鲜沙参、鲜生地、鲜茅根、鲜芦根、甘蔗汁。
育阴煎：治痧透肌燥，舌绛液干，喉烂便闭，脉弦无神者宜之。
元武板、鳖甲、生地、丹皮、大贝、金汁、麦冬、知母、沙参、花粉、元参、犀角。共二方。
吹喉十宝丹：专治烂喉症，无论已溃未溃，肿色艳生，并治痘毒以及痧疹后牙疳、杨梅后毒结咽喉，功能消肿止痛、化毒生肌仙方也，其效如神，万勿增减。
牛黄（三分）、大贝（三分）、人中白（五分）、琥珀（五分）、青鱼胆（五分大者）、珍珠（六分）、梅片（五厘）、人指甲（四分）、马勃（三分）、硼砂（四分）。共研极细末，专治此症。其他喉科谷症自有喉科吹药，未可概用之。
敷项颈方：实时毒门中二味拔毒散，雄黄、生凡。专治痧疹后毒结项外温肿坚硬，无论其色红白，效验如神。
专敷项外漫肿名紫金丹：即尿池中多年碎砖，炭火红入醋中泡，再再泡五六次，取研末。每两入射香一分，用醋白蜜各半熬滚调敷。如塌皮形色紫艳，用菜油加蛋清之喉风缠喉项肿者均可用。
鲜土牛膝根捣汁炖温时饮，并治一切喉症，消肿散因止痛化痰如神。
驱瘟辟邪法：生军（二两）、茵陈（一两）、茅术（五钱）、降香（一两）。研末不时烧熏之。惟病患卧室不能用，恐防呛喉。
喉闭塞鼻方：专治喉闭，汤水不入。将药纳枣塞鼻中，使药气随鼻息而入喉关，乃开。惟药性燥烈，不可着肉敷点。用红枣切破一头，去核，将药少许纳入枣中，线扎封枣口。左痛塞右鼻，右痛塞左鼻。若小孩鼻孔小，枣不能塞，或用棉花包扎塞亦可，但不能令药贴靠着肉，以免肿泡之患。若喉闭势重者，用双枣两鼻齐塞亦可。此方不但用之痧喉喉闭一症，即凡伤寒各种喉闭，气息不通，命在垂危，多具起死回生之力，神妙异常，勿轻视。
蟾酥（七分）、细辛（四分）、辰砂（三分）、射香（二分五厘）、冰片（二分半）、牙皂（四分）、生半夏（三分）、辛夷（四分）、刚子即巴豆（四分去油）、牛黄（二分）、雄黄（四分）。共研细末收贮。
喉闭一症，气机阻闭，药不能下咽，命在垂危，虽良医亦无策，往往为闭所绝。纵卧龙丹、紫金丹开关各法不克得一喷嚏者，百无一生。此方合药塞入鼻内，只要膺前犹觉跳动，气息虽极细微，但得一丝未绝，无不痰气渐松，人事转醒。有经数时而苏者，有周昼夜而起者，神效良方。
人中白散：专治男妇大小口舌糜烂、走马牙疳，并咽喉肿痛、牙床腐溃等症。
青黛（一钱）、月石（一钱）、儿茶（一钱）、薄荷（五分）、梅片（二分）、人中白（一钱）、元明粉（五分）、西黄（三分）、珍珠（五分）。共研细末搽患处。
牙疳神方：治痧、走马牙疳。先用冬青叶煎水漱净，再以此药敷上。
青黛（一钱）、牛黄（二分）、人中白（一钱）、回龙骨（一钱）、血余炭（一钱）、冰片（三分）、珍珠（五分）、旧红毡子炭（一钱）、小红枣（七枚去核入雄黄少许）。共研细末收好，勿泄气。
按前焦疫痧方，乃为疫痧烂喉专症而设，并无杂挟他邪，并挟寒挟湿，均为疫症之常。爰采朱铁山数方补其阙略。铁山所论谓当察其发热之始，时令寒暄，酌而治用。倘严寒是挟，虽桂枝、葛根、麻黄亦均可用，勿以辛温而迟疑。此言诚非墨守，经曰：“必先岁气，母伐天和”，其斯之谓故。其方中有升麻、白芷、苍术、柴胡各禁药，虽悖治疫之旨，然疫中系有是症，故虽在禁而不得以禁之。特为录出，以备一格，聊为神而明之之用。
荆防葛根汤：治风寒外来，皮肤闭密，痧疹逡巡不出。又治形寒乍热，咽喉肿痛，咳嗽胸闷，鼻塞呕恶，两目汪汪，手足指冷，脉来濡数或现浮数，宜服此汤。
荆芥（一钱五分）、防风（一钱五分）、甘草（四分）、桔梗（一钱五分）、牛蒡（三钱）、蝉衣（一钱）、枳壳（一钱）、象贝（一钱五分）、葛根（一钱五分）、杏仁（三钱，便溏勿用）。
升麻葛根汤：治体质弱，痧不透达。
升麻（一钱）、葛根（一钱）、赤芍（八分）、甘草（四分）。
加减透邪汤：治痧不透达，服升麻葛根汤仍不达，再服此汤。
If inflammation can be stopped by merely employing bitter-cold herbs without applying a method that resolves both exterior and interior, it fails to accommodate the nature of wind-fire pathogens, thereby inciting a prairie-fire momentum. The severity will inevitably become even more intense. As the inflammatory qi increases, the epidemic qi follows wind and fire; since wind and fire generate each other, pathological changes occur with great speed. However, the nature of wind is suitable for dispersal, while the nature of fire requires unblocking and reaching out. Therefore, cooling prescriptions must include herbs that disperse and unblock. This is because the nature of cold herbs is either downward-draining or closing, which is contrary to dispersal and unblocking; in fact, it goes against the nature of wind and fire. No wonder conditions deteriorate rapidly like lightning and galloping wind, triggering complications.
For instance, during extreme summer heat under a scorching sun, even if sudden rain falls without wind, the air does not cool down but becomes hotter due to the rain suppressing the heat. This is because heat is blocked by rain, preventing the release of hot qi. Only when a gentle breeze stirs does the dryness dissipate; combined with rain moisture, a state of harmonious peace is restored. This illustrates why the "Double Resolution Method" (Shuangjie Fa) is rich in application and highly valued.
Although seasonal epidemic qi is easily transmitted to others, infection does not occur simply upon seeing a patient. It is self-attributed. How is it induced? When a person's constitution is inherently weak and their defensive barrier (Wei Qi) is loose, the epidemic qi enters through the mouth and nose, and sha toxin infects through the skin and muscles; this is called "contagion." Alternatively, if a person has sufficient righteous qi but harbors latent pathogens externally, they suffer from pre-existing latent pathogens exacerbated by seasonal epidemic qi; this is called "induced onset." Furthermore, some appear strong externally but are hollow internally; although they lack latent pathogens, their innate endowment is biased, causing qi deviation. The epidemic qi exploits this bias to invade; this is called "cold damage" (Ganmao). One must have abundant internal righteous qi, no chronic diseases, minimal mental distress, and avoid physical exhaustion to achieve non-transmission and non-infection. Only then does one approach health.
Qibo stated: "Those who do not infect each other possess internal righteous qi, making them impervious to evil." Thus, epidemic invasion occurs by exploiting deficiency. Deficiency varies internally and externally, leading to shallow or deep infection; qi bias leads to similar yet distinct symptoms. In cases where internal qi is solid but external qi is deficient, even mild cold damage manifests as minor illness, making symptom identification difficult. Differentiation relies on observing cough, skin itching, wiry and rapid pulse, and faint sha rashes. These are inevitable signs. Pathogens attacking the hair and skin correspond internally to the Lung. Hence, red eyes indicate white sclera belonging to the Lung; skin itching indicates the Lung governs skin and hair; sore throat indicates the throat is the Lung's tube; diarrhea indicates the Large Intestine is the exterior of the Lung; cough resulting from pathogen expulsion indicates pathogen attacking the Lung meridian. All these are manifestations of sha pathogen invading the hair and skin.
Conversely, if the hair and skin are dense, preventing pathogen invasion, but fatigue or limb coldness occurs, it corresponds internally to the Spleen. Since the Spleen and Stomach are exterior-interior partners, limb itching indicates the Spleen governs limbs; dry fluids indicate the Spleen fails to transport fluids; thirst indicates Stomach heat; nausea/vomiting indicates Stomach evil rising; loss of appetite indicates pathogen attacking the Stomach meridian; insomnia indicates dry stool in the Stomach; sha eruption indicates pathogen reaching the muscle layer. These occur when internal righteous qi is strong, repelling external epidemic pathogens so they cannot enter via meridians. Both scenarios present ambiguous symptoms often mistaken for other pathogens, necessitating specific differentiation to clarify misconceptions.
Historically, "sha" was generally categorized under macules and papules. Only "ma" (measles) stems from congenital Yang toxicity. Others include large patches like macules ("ban"), fine woven patterns like papules ("zhen"), and millet-grain-like spots ("sha"). White rash releases Stomach Yang pathogens; crimson sha releases Stomach Yin toxins. Although Yin/Yang and red/white differ, all belong to the Stomach Fu organ, hence ancient texts treated them collectively without distinction. Wu Keyou conflated them with warm diseases; Ye Tianshi and Wu Jutong included them in warm disease discussions. Contemporary experts further distinguished red sha, throat sha, stifled sha, wind sha, and child rash. Despite varied names, meanings remain consistent, as detailed previously.
Wind sha, though weak like an exhausted arrow, remains dangerous. Symptoms may lack cough or fever, presenting only slight throat pain and skin itching. Due to mild pathology, people often neglect it, risking progression to stifled sha, which is hard to treat. Neglect allows pores to remain open, weakening Wei Qi and righteous qi, facilitating internal transmission via mouth/nose. If latent epidemic qi exists, it travels through meridians to organs, accelerating rapidly. "A single spark can start a prairie fire," warning against ignoring early signs.
Stifled sha resembles wind sha with slight aversion to cold/heat and faint rashes, but differs significantly with coma, snoring, dark complexion, and clear body temperature. Deep epidemic infection in weak bodies prevents eruption; external pathogens or incorrect cooling herbs cause internal blockage, leading to internal collapse and death.
Commonly called "fa sha" involves summer heatstroke, evil qi stagnation, abdominal pain, and痞气 (pi syndrome). Unlike contagious epidemics, it results from sudden exposure to foul odors (flatulence/fecal gas), which carries yin pathogens. Summer heat pushes yang outward, leaving yin inside, making the body susceptible to yin pathogens entering through pores. Without latent pathogens, symptoms include pale face, abdominal pain, borborygmus, qi obstruction, and cold limbs. Massage promotes blood/qi flow, releasing qi through muscles as sha, potentially healing spontaneously within a week. Drinking water should be avoided initially to prevent pathogen retention. With latent pathogens, symptoms worsen to blood coagulation, disharmony of Ying/Wei, cholera-like vomiting/diarrhea, leg curling, severe pain, coma, and rigidity. Urgent treatment requires pungent-hot herbs to dispel cold and aromatic herbs to open orifices, restoring qi/blood flow. Abdominal pain and cramping stem from cold congealing in the abdomen and intestines blocking qi flow. Leg curling ("diao jiao") results from yin meridian injury at the foot origin. Untreated, it causes rapid death. These non-contagious conditions differ fundamentally from contagious sha.
1. Rotten Throat Sha: Mild throat swelling/pain initially, faint red body rash, hidden pulse, cold limbs, blue face/purple lips, closed mouth with salivation, fixed gaze, purple nails, chest/abdominal fullness, shortness of breath, coma, and limb convulsions indicate stifled sha. Mortality is high, but immediate treatment with Wolong Dan insufflated into nostrils to induce sneezing, followed by Mentha decoction ground with Zijin Ding, is crucial. Avoid pungent-dry insufflations unless closure symptoms persist.
2. Throat Sha: Initial purple-bright rash with aggressive onset responds well to *Yu Yi Da Quan* formulas containing Angelicae Sinensis Radix, Arnebiae Radix, Persicae Semen, Coccidis Pollen, and Violae Herba.
3. Stifled Sha: Often resistant to Wolong Dan. A date-stuffed nasal insufflation method opens the throat effectively.
4. Severe Throat Sha: For uncontrollable throat swelling, purple color, neck swelling, phlegm obstruction, and inability to swallow, puncture high swollen areas on both sides of the throat with a throat needle to drain black-purple toxic blood before administering medication.
5. Sha Puncture: Pricking Shaoshang (LU-11) at the thumb nail root drains purple blood, effectively clearing Lung heat-toxin.
6. Contraindications for Puncture: Do not puncture if swelling/pain is mild, rash is pale, ulceration is deep, or if pulse is thready with coma indicating internalized toxin.
7. Vomiting/Cold Limbs in Throat Sha: Caused by Yangming epidemic pathogen blocking pores and qi. Treat with pungent-warm herbs like Atractylodis Rhizoma, Magnoliae Cortex, Pinelliae Rhizoma, Cinnamomi Cortex, Aconiti Lateralis Radix Praeparata, and Zingiberis Rhizoma, not as cold syndromes.
8. Initial Faint Rash with Convulsions: Avoid cold-calming herbs like Calculus Bovis and Suhe Xiang Wan. Allow sha to vent naturally. Avoid irritants like Elsholtzia, Salvia plebeia, cotton thread, and cherry pits if ulcers exist; these are unsuitable for epidemic sha regardless of ulceration.
9. Xi Jiao Di Huang Tang: Use cautiously after confirmation for rotten throat sha.
[Dispersing Method] For sha pathogen in exterior without internal fire, light heat, clear spirit, and intact throat, use dispersal first, then clearing.
Ge Gen Tang: For fever, clear spirit, sparse hidden rash, white tongue, depressed pulse, and mild throat erosion.
Ingredients: Puerariae Lobatae Radix, Arctii Fructus, Schizonepetae Spica, Bombyx Batryticatus, Forsythiae Fructus, Curcumae Turmericum, Glycyrrhizae Radix et Rhizoma, Platycodonis Radix.
Modified Ge Gen Tang: For no sweat, hidden rash, white tongue, depressed pulse, and mild throat erosion.
Ingredients: Puerariae Lobatae Radix, Arctii Fructus, Fermented Soybean, Aurantii Fructus, Menthae Haplocalyx, Malvae Silvestris Flos, Bombyx Batryticatus, Schizonepetae Spica, Saposhnikoviae Radix, Forsythiae Fructus, Scorched Hawthorn Fruit, Red Peony Root, Glycyrrhizae Radix et Rhizoma.
Xiang Chi Yin: For hidden rash, depressed pulse, eroded throat, dry tongue, early stage with insufficient fluids but clear spirit and internal latent fire.
Ingredients: Fermented Soybean, Arctii Fructus, Schizonepetae Spica, Platycodonis Radix, Forsythiae Fructus, Gardeniae Fructus, Malvae Silvestris Flos, Fritillariae Bulbus, Humanis Alumen. Total three formulas.
[Clearing and Dispersing Method] For severe epidemic sha, simultaneous dispersal and clearing is essential. If exterior pathogen persists, dispersal is necessary; if internal epidemic toxin burns, clearing is urgent. Exterior is secondary, internal fire is primary. Burning heat, no sweat, clustered hidden rash, eroded throat, and irritability indicate internal fire dominance. Blindly dispersing without addressing fire leads to worsening symptoms. This section addresses both exterior and interior.
Ge Gen Tang: For burning heat, coma, irritability, eroded throat, wiry pulse, clustered hidden rash, no sweat, and greasy tongue.
Ingredients: Rhinocerotis Cornu (substitute with Water Buffalo Horn), Puerariae Lobatae Radix, Arctii Fructus, Platycodonis Radix, Forsythiae Fructus, Gardeniae Fructus, Bombyx Batryticatus, Schizonepetae Spica, Malvae Silvestris Flos, Charred Hawthorn Fruit, Humanis Alumen.
Xi Jiao Chi Tang: For eroded throat, hidden rash, wiry pulse, coma, irritability, high fever, little sweat, crimson tongue, thirst, and risk of internal collapse. Combine with Wan Shi Niu Huang Wan for severe coma.
Ingredients: Rhinocerotis Cornu (substitute with Water Buffalo Horn), Fermented Soybean, Arctii Fructus, Schizonepetae Spica, Forsythiae Fructus, Gardeniae Fructus, Malvae Silvestris Flos, Fritillariae Bulbus, Bombyx Batryticatus, Red Peony Root, Platycodonis Radix, Glycyrrhizae Radix et Rhizoma. Total two formulas.
[Clearing and Transforming Method] Epidemic sha fire is rapid and fierce; clearing agents must not be delayed or used lightly. If exterior pathogen remains but internal fire burns, transform toxin before fire spreads. If fire flares up, transformation alone fails. Once exterior resolves and fire peaks (rash visible, wiry pulse, eroded throat, crimson tongue, thirst, irritability), heavy clearing is required, akin to saving a burning cart with a cup of water.
Xi Jiao Di Huang Tang: For visible rash, fluid depletion, wiry-rapid-large pulse, eroded throat, and crimson tongue. Add to dispersing herbs if rash is hidden but fire/fluid depletion signs exist. This formula transforms toxin and nourishes fluids.
Ingredients: Rhinocerotis Cornu (substitute with Water Buffalo Horn), Rehmanniae Radix Preparata, Moutan Cortex, Red Peony Root.
Xi Jiao Er Xian Tang: For visible rash but severe throat erosion, wiry-large pulse, thirst, irritability, crimson tongue, dry lips, blazing fire, and depleted fluids.
Ingredients: Rhinocerotis Cornu (substitute with Water Buffalo Horn), Forsythiae Fructus, Fritillariae Bulbus, Scrophulariae Radix, Gardeniae Fructus, Antilopis Cornu, Fresh Rehmanniae Radix, Fresh Glehniae Radix, Humanis Alumen, Humanis Excrementium Dealbatum, Lonicerae Japonicae Flos, Gypsum Fibrosum, Coptidis Rhizoma, Malvae Silvestris Flos, Chen Jin Zhi.
Duo Ming Yin: For excessive phlegm, dried fluids, crimson tongue, thirst, irritability, eroded throat, wiry-large pulse, and cloud-like dense rash.
Ingredients: Coptidis Rhizoma, Gypsum Fibrosum, Rhinocerotis Cornu (substitute with Water Buffalo Horn), Rehmanniae Radix, Moutan Cortex, Red Peony Root, Indigo Naturalis, Malvae Silvestris Flos, Fritillariae Bulbus, Forsythiae Fructus, Scrophulariae Radix, Jin Zhi, Antilopis Cornu, Glehniae Radix, Humanis Alumen.
Qing Fei Yin: For visible rash, improving throat erosion, clear spirit, reduced heat, and persistent cough.
Ingredients: Mori Folium, Glehniae Radix, Antilopis Cornu, Forsythiae Fructus, Platycodonis Radix, Glycyrrhizae Radix et Rhizoma, Citri Reticulatae Pericarpium, Fritillariae Bulbus. Total four formulas.
[Downward Expulsion Agents] Used reluctantly. If exterior pathogen remains and internal fire burns, Shuangjie San assists dispersal as a "gate-breaking general." If exterior resolves and fire remains intense, Si Hu Yin aids clearing as a "door-snatching agent." Heavy agents suit strong patients with excess pathogens. Unresolved exterior presents with no sweat, hidden rash, eroded throat, irritability, constipation, and solid pulse; Shuangjie San is appropriate. Resolved exterior presents with sweat, dense rash, eroded throat, dry spirit, solid pulse, and constipation; Si Hu Yin is appropriate.
Shuangjie San: For faint rash, eroded throat, foul odor, irritability, constipation, red eyes, solid pulse, early stage, strong constitution, and excess pathogens.
Ingredients: Rheii Radix et Rhizoma, Mirabilite, Puerariae Lobatae Radix, Arctii Fructus, Schizonepetae Spica, Forsythiae Fructus, Menthae Haplocalyx, Bombyx Batryticatus, Aurantii Fructus, Humanis Alumen, Platycodonis Radix.
Si Hu Yin: For visible rash but severe throat erosion, wiry-rapid pulse, red eyes, constipation, irritability, crimson tongue, and severe phlegm-fire.
Ingredients: Rheii Radix et Rhizoma, Coptidis Rhizoma, Rhinocerotis Cornu (substitute with Water Buffalo Horn), Gypsum Fibrosum, Anemarrhenae Rhizoma, Scrophulariae Radix, Rehmanniae Radix, Indigo Naturalis, Malvae Silvestris Flos. Total two formulas.
[Nourishing Fluids] A supportive method. Fire excess depletes fluids; epidemic sha involves fire, so severe fire depletes fluids, endangering life. Nourishing fluids transforms toxin gently and preserves yin before depletion, complementing dispersing/clearing herbs without causing cold stagnation or fluid exhaustion.
Wu Xian Yin: For crimson dry tongue, wiry-rapid-large pulse, hidden rash, and mild throat erosion. Take with Ge Gen Tang; if erosion exists, take with Xi Jiao Chi Tang.
Ingredients: Fresh Glehniae Radix, Fresh Rehmanniae Radix, Fresh Imperatae Rhizoma, Fresh Phragmitis Rhizoma, Sacchari Canis Juice.
Yu Yin Jian: For visible rash, dry skin, crimson tongue, dried fluids, eroded throat, constipation, wiry pulse, and lack of spirit.
Ingredients: Chelonis Carapax et Plastrum, Trionycis Carapax, Rehmanniae Radix, Moutan Cortex, Fritillariae Bulbus, Jin Zhi, Ophiopogonis Radix, Anemarrhenae Rhizoma, Glehniae Radix, Bletillae Rhizoma, Scrophulariae Radix, Rhinocerotis Cornu (substitute with Water Buffalo Horn). Total two formulas.
Chui Hou Shi Bao Dan: Specifically for rotten throat, whether ulcerated or not, with bright swelling. Also treats smallpox toxin, post-sha gum disease, and post-syphilis throat nodules. Reduces swelling, stops pain, transforms toxin, and generates flesh. Do not alter ingredients.
Ingredients: Calculus Bovis (3 fen), Fritillariae Bulbus (3 fen), Humanis Excrementium Dealbatum (5 fen), Succinum (5 fen), Cyprini Carassii Bilis (5 fen, large), Margarita (6 fen), Borax (4 fen), Humanis Unguis (4 fen), Malvae Silvestris Flos (3 fen), Menthol (0.5 li). Grind to fine powder. Not for general throat ailments.
Fu Xiang Jing Fang: From Real Toxicology, Er Wei Ba Du San (Realgar and Alum). Treats post-sha toxin nodules on neck, hard and warm, regardless of color.
Zhuan Fu Xiang Man Zhong (Zijin Dan): Made from old urine-pool bricks fired and soaked in vinegar 5-6 times, ground to powder. Add 1 fen Musk per liang. Boil with equal parts vinegar and white honey, apply topically. For collapsed skin/purple color, use vegetable oil and egg white. Suitable for throat wind and neck swelling.
Fresh Achyranthes Bidentata Root juice, warmed and drunk, treats all throat ailments, reducing swelling and resolving phlegm/pain miraculously.
Qu Wen Pi Xie Fa: Rheii Radix et Rhizoma (2 liang), Artemisiae Scopariae Herba (1 liang), Atractylodis Rhizoma (5 qian), Costi Radix (1 liang). Grind and burn for fumigation. Avoid in patient's bedroom to prevent choking.
Hou Bi Sai Bi Fang: For throat closure preventing swallowing. Stuff medicine into a date, insert into nostril opposite the painful side. Medicine is harsh; do not touch mucosa directly. For children, wrap in cotton. For severe cases, stuff both nostrils. Effective for various throat closures and critical conditions.
Ingredients: Chan Su (7 fen), Asari Radix et Rhizoma (4 fen), Cinnabaris (3 fen), Moschus (2.5 li), Borax (2.5 li), Gleditsiae Sinensis Spina (4 fen), Pinelliae Rhizoma Crude (3 fen), Xanthii Fructus (4 fen), Crotonis Fructus (4 fen, oil removed), Calculus Bovis (2 fen), Realgar (4 fen). Grind fine, store.
Hou Bi Syndrome: Qi blockage prevents swallowing. Even skilled doctors fail if sneezing isn't induced by Wolong Dan/Zijin Ding. This nasal insufflation works if chest pulsates and breath exists, loosening phlegm and restoring consciousness within hours to days.
Ren Zhong Bai San: For oral/throat ulcers, gangrenous stomatitis, throat swelling, and gum erosion.
Ingredients: Indigo Naturalis (1 qian), Humanis Excrementium Dealbatum (1 qian), Camelliae Seed Tea (1 qian), Menthae Haplocalyx (5 fen), Menthol (2 fen), Humanis Excrementium Dealbatum (1 qian), Natrii Sulfas (5 fen), Oxis Gallae (3 fen), Margarita (5 fen). Grind fine, apply locally.
Ya Gan Shen Fang: For sha/gangrenous stomatitis. Rinse with Wintergreen leaf decoction, then apply.
Ingredients: Indigo Naturalis (1 qian), Calculus Bovis (2 fen), Humanis Excrementium Dealbatum (1 qian), Fossil Bone (1 qian), Hair Charcoal (1 qian), Menthol (3 fen), Margarita (5 fen), Old Red Carpet Charcoal (1 qian), Small Red Dates (7, pitted with Realgar). Grind fine, seal tightly.
Note: Previous formulas target epidemic sha/rotten throat specifically. Zhu Tieshan's additions address cold/damp complications. He advises adjusting for seasonal cold using Gui Zhi, Ge Gen, or Ma Huang if needed, respecting seasonal qi. Formulas containing Sheng Ma, Bai Zhi, Cang Zhu, Chai Hu are recorded despite being contraindicated in typical epidemic treatment, as they address specific concurrent symptoms.
Jing Fang Ge Gen Tang: For wind-cold blocking pores, delaying sha eruption. Also for chills, intermittent fever, throat swelling, cough, chest tightness, nasal congestion, vomiting, watery eyes, cold fingers, and soggy-rapid or floating-rapid pulse.
Ingredients: Schizonepetae Spica (1.5 qian), Saposhnikoviae Radix (1.5 qian), Glycyrrhizae Radix et Rhizoma (4 fen), Platycodonis Radix (1.5 qian), Arctii Fructus (3 qian), Bombyx Batryticatus (1 qian), Aurantii Fructus (1 qian), Fritillariae Bulbus (1.5 qian), Puerariae Lobatae Radix (1.5 qian), Armeniacae Semen Amarum (3 qian, avoid if loose stools).
Sheng Ma Ge Gen Tang: For weak constitutions with incomplete sha eruption.
Ingredients: Cimicifugae Rhizoma (1 qian), Puerariae Lobatae Radix (1 qian), Red Peony Root (8 fen), Glycyrrhizae Radix et Rhizoma (4 fen).
Jiajian Tou Xie Tang: For sha failing to erupt after Sheng Ma Ge Gen Tang.