上年秋燥冬暖,略无霜雪,河井并涸,吾杭自九月间起,天花流行,十不救五,小儿之殇于是者,日以百计。孟
英曰∶此痘“疫”也。治法当与常痘有异,惜幼科未之察耳。且天令发泄,不主闭藏,入春恐多喉患,特刊“加味
三豆饮”,俾未种痘者,预服免患,将出者,恣饮冀轻。又劝人频服“青龙白虎汤”,以杜春来喉恙,不料其言果应,
三春不雨,喉症甚多。医者犹不悟其致病之因,仅知发散,正如火上添油。孟英胸有成竹,一以仲景白虎汤为救焚主
剂,若已及于营分者,用(王)晋三犀角地黄汤相机加减,又刊青龙白虎汤暨锡类散方,广为印送,赖此以活
者,不可胜数。
附∶加味三豆饮
生绿豆 生黄豆 生黑大豆或用生白扁豆亦可 生甘草 金银花,水煎服。
孟英自注云∶古方三豆饮,为痘疹始终可服之妙药。未出时常服,痘可使稀;将出时急服,重可冀轻;已出
时恣服,逆可转顺;尽出时频服,毒可易清。俗传种痘是“密室烘花”,更有初生小儿,于十八日内服药,令其出
痘之法,是揠苗助长,此等矫揉造作,阴受其害者,古今
来不知几恒河沙数矣。至于种种稀痘之方,皆无意义,或以毒药损人元气,或以秽物致生别恙,慎勿为其所惑。惟
此方药极简易,性最平和,味不恶劣,易办易服,不必论其体质,久服无弊,诚尽善尽美之王道药也。杭人惑于患
痘不食豆之说,甚属可鄙,今特辨明,冀人醒悟。凡小儿能啜饮后,即以此药日日代茶,诚保赤之首章焉。原方用
赤豆,性燥伤阴,予以黑大豆易之,更有补阴之绩,虽燥令燥体,皆无碍矣,再益银花、甘草,而化毒之功尤胜,
或疑银花性凉,似难久用,不知三豆皆谷也,性能实脾,得银花以济之,更觉冲和。况小儿体禀纯阳,极宜此甘凉
补阴之味,岂特稀痘,尤能明目消疳,不生疮疖泄泻等病,其功未能殚述也。
附∶青龙白虎汤
橄榄 生莱菔,水煎服。
孟英自注云∶此予自制方也。橄榄色青,清足厥阴内寄之火风,而靖其上腾之焰。莱菔色白,化手太阴外来
之燥热,而肃其下行之气。合而为剂,消经络留滞之痰,解膏粱鱼面之毒,用以代茶,则龙驯虎伏,藏府清和,岂
但喉病之可免耶?且二味处处皆有,人人可服。物异功优,久任无弊,实能弭未形之患,勿以平淡而忽诸。
附∶锡类散
象牙屑(焙) 真珠(各三分) 飞净青黛(六分) 梅花冰片(三厘) 壁钱(二十个,俗名“喜儿窠”,木板上
者勿用) 西牛黄 人指甲(各五厘),男病用女,女病用男,合送济人,须分别
配之,共研极细粉,吹患处,流出恶涎即愈。
孟英自注云∶此专治烂喉痧疹之神方也。尤鹤年附载于《金匮翼》云∶张符瑞传此方以得子,故予之名曰“锡类散”。
胡韵梅,年已逾冠,因夜坐感寒,患头痛恶冷,呕吐肢冷。孟英视之曰∶舌绛脉数,痘疹之候。断非受寒也。
幸胡平昔钦信,遂与清透药服之。次日,点形圆绽,细询,果未出痘,但火势甚炽,恐其惑于俗论,嘱请专科王蔚文
会诊,所见略同。一路清凉,自起发至落茄(痂),毫不杂一味温升攻托之药,而满身密布,形色粗紫,浆脓茄(痂)
黑,便秘不饥,渴无一息之停,苟不如是用药,其能免乎?此《建中琐言》之所以有功于世也。
周鹤亭令郎,年甫五龄,痘后月余,清凉药尚未辍,忽发壮热。幼科治之,势益张。肢 面赤,呕吐苔黄,渴
而溺清,时或昏厥,证交六日。其外祖何新之邀孟英诊之,脉甚弦洪滑数,心下拒按,便秘汗多。投小陷胸(
汤)加石膏、知母、花粉、竹叶、枇杷叶、贝母、雪羹,二剂,各恙皆减,溲赤便行,继与清养而安。
去年秋季干燥,冬季温暖,几乎没有霜雪,河流和井水都干涸了。我们杭州从九月开始,天花流行,十个人中救不活五个,因此夭折的儿童每天以百计。孟英说:这是“痘疫”(天花引发的瘟疫)。治疗方法应当与普通的天花不同,可惜儿科医生没有察觉这一点。况且天时主发泄,不主闭藏,进入春季恐怕会有多发的咽喉疾病,特意刊印“加味三豆饮”,让尚未接种天花的人预先服用以避免患病,即将出痘的人大量饮用希望病情减轻。又劝人频繁服用“青龙白虎汤”,以杜绝春天到来的咽喉病症,没想到他的话果然应验,整个春季没有下雨,喉症非常多。医生们仍然不明白致病的原因,只知道发散解表,这正像火上浇油。孟英胸有成竹,一律以张仲景的白虎汤作为救急的主方,如果病邪已经深入营分者,使用王晋三的犀角地黄汤根据情况加减,又刊印青龙白虎汤以及锡类散的方子,广泛印发赠送,依靠这些方法救活的人,数不胜数。
附:加味三豆饮
生绿豆、生黄豆、生黑大豆(或者也可以用生白扁豆)、生甘草、金银花,用水煎服。
孟英自己注释说:古方的三豆饮,是治疗痘疹从头到尾都可服用的妙药。在痘疹未发出时常服,可以使痘疹稀疏;即将发出时急服,重症可以期望减轻;已经发出时大量服用,逆证可以转为顺证;全部发出后频繁服用,毒邪容易清除。世俗传说种痘是“密室烘花”,更有初生婴儿,在十八天内服药,使其出痘的方法,这是拔苗助长,这种矫揉造作,暗中受害的人,从古至今不知有多少(如恒河沙数)。至于各种稀痘的方子,都没有意义,有的用毒药损伤人的元气,有的用污秽之物导致其他疾病,千万不要被它们迷惑。只有这个方子药物极其简易,性质最平和,味道不恶劣,容易办到也容易服用,不必讨论其体质,长期服用没有弊端,确实是尽善尽美的王道之药。杭州人受患痘不吃豆的说法迷惑,非常可鄙,现在特别辨明,希望人们醒悟。凡是小儿能够喝下之后,就以此药每天代替茶水,这确实是保护儿童健康的首要章节。原方用赤豆,性质燥烈伤阴,我用黑大豆替换它,更有补阴的功效,即使是燥令燥体,也没有妨碍了,再增加银花、甘草,而化解毒邪的功效尤其显著,有人怀疑银花性质凉,似乎难以久用,不知道三豆都是谷物,性能实脾,得到银花的辅助,更觉得冲和。何况小儿体质禀赋纯阳,极适宜这种甘凉补阴的味道,岂止是使痘疹稀疏,更能明目消疳,不生疮疖泄泻等疾病,它的功效不能详尽叙述。
孟英自己注释说:这是我自制的方子。橄榄色青,清足厥阴肝经内寄的火风,而平息其上腾的火焰。莱菔色白,化手太阴肺经外来的燥热,而肃降其下行的气机。合而为剂,消除经络中留滞的痰,解膏粱鱼面之毒,用来代替茶水,则龙驯虎伏,脏腑清和,难道只是可以避免喉病吗?而且这两味药到处都有,人人可以服用。物品不同但功效优良,长期任用没有弊端,确实能消除未形成的祸患,不要因为平淡而忽视它。
附:锡类散
象牙屑(焙干)、真珠(各三分)、飞净青黛(六分)、梅花冰片(三厘)、壁钱(二十个,俗名“喜儿窠”,木板上的不要用)、西牛黄、人指甲(各五厘),男病用女指甲,女病用男指甲,配合送服济人,必须分别配制,共研成极细粉,吹于患处,流出恶涎即愈。
孟英自己注释说:这是专门治疗烂喉痧疹的神方。尤鹤年附载于《金匮翼》中说:张符瑞传此方得以得子,所以我给它取名“锡类散”。胡韵梅,年龄已过二十岁,因为夜间坐着感受寒邪,患头痛恶冷,呕吐肢冷。孟英诊视后说:舌质绛红脉数,这是痘疹的征候。绝对不是受寒。幸好胡某平素钦佩信任,于是给予清透药服用。第二天,痘点形状圆绽,仔细询问,果然未出痘,但火势非常炽盛,恐怕他受世俗言论迷惑,嘱咐请专科医生王蔚文会诊,所见大致相同。一路清凉,从起发到结痂,毫不夹杂一味温升攻托的药,而满身密布,形色粗紫,浆脓结痂黑,便秘不饥,口渴一刻不停,如果不这样用药,能免除灾祸吗?这就是《建中琐言》之所以对世人有功的原因。
周鹤亭的公子,年仅五岁,出痘后一个多月,清凉药还没有停,忽然发生壮热。儿科医生治疗,病情更加嚣张。肢体面部赤红,呕吐苔黄,口渴而小便清,时而昏厥,症状持续六天。他的外祖父何新之邀请孟英诊视,脉象甚弦洪滑数,心下拒按,便秘汗多。投用小陷胸汤加石膏、知母、花粉、竹叶、枇杷叶、贝母、雪羹,两剂后,各种症状都减轻,小便变赤大便通行,继予清养而安。
Last autumn was dry, and winter was warm, with almost no frost or snow; rivers and wells were all dried up. Starting from September, smallpox (Tianhua) became epidemic in our Hangzhou, where five out of ten patients could not be saved, and the number of children dying daily reached hundreds. Meng Ying said: This is "smallpox plague" (Douyi). The treatment method should differ from ordinary smallpox, but unfortunately, pediatricians failed to notice this. Moreover, the seasonal climate favors dispersal rather than storage, so it is feared that there will be many throat diseases in spring. Therefore, I specially published "Modified Three-Bean Decoction" so that those who had not yet been inoculated could take it in advance to prevent infection, and those about to develop smallpox could drink it freely to hope for a milder course. I also advised people to frequently take "Green Dragon White Tiger Decoction" to prevent throat ailments in spring. Unexpectedly, my words came true; there was no rain throughout the spring, and throat symptoms were very common. Physicians still did not understand the cause of the disease, knowing only how to use diaphoretic methods, which was like adding oil to fire. Meng Ying had a clear plan and uniformly used Zhang Zhongjing's Baihu Tang (White Tiger Decoction) as the main emergency remedy. If the pathogen had already entered the Ying level (Nutritive Level), he used Wang Jin San's Xijiao Dihuang Tang (Rhino Horn and Rehmannia Decoction) with modifications according to circumstances. He also published the formulas for Green Dragon White Tiger Decoction and Xilei San, distributing them widely. Countless lives were saved by these means.
Appendix: Modified Three-Bean Decoction
Raw Mung Bean, Raw Soybean, Raw Black Soybean (or Raw White Hyacinth Bean), Raw Licorice Root, Honeysuckle Flower. Decoct in water and take orally.
Meng Ying annotated: The ancient formula Three-Bean Decoction is a wonderful medicine that can be taken throughout the entire course of smallpox and rashes. When taken frequently before eruption, it can make the rash sparse; when taken urgently as eruption begins, severe cases can hope for mildness; when taken abundantly after eruption, adverse conditions can turn into favorable ones; when taken frequently after complete eruption, toxins can be easily cleared. Folklore claims that inoculation is like "baking flowers in a sealed room." There are even methods where infants are given medicine within eighteen days of birth to induce smallpox, which is akin to pulling shoots to help them grow. Such artificial manipulations have caused hidden harm to countless people throughout history, like the sands of the Ganges. As for various formulas to thin out smallpox, they are meaningless; some use toxic drugs to damage vital energy, while others use filth to cause other diseases. One must not be confused by them. Only this formula is extremely simple, with the mildest nature, unpalatable taste, easy to obtain and take, without need to consider constitution, and safe for long-term use. It is indeed a perfect "King's Way" medicine. People in Hangzhou are misled by the belief that one should not eat beans during smallpox, which is despicable. I clarify this now to awaken people. Once children can drink it, using this medicine daily instead of tea is indeed the first chapter in protecting infant health. The original formula uses Red Bean, which is drying and injures Yin. I replaced it with Black Soybean, which has better Yin-nourishing effects. Even in dry climates or dry constitutions, it causes no harm. Adding Honeysuckle and Licorice further enhances detoxification. Some doubt that Honelysuckle's cool nature makes it unsuitable for long-term use, but the three beans are grains that strengthen the Spleen. With Honeysuckle's assistance, the combination becomes harmonious. Furthermore, children possess pure Yang constitution, making them highly suitable for such sweet-cool Yin-nourishing flavors. Not only does it thin the rash, but it also brightens the eyes, eliminates malnutrition-related disorders, and prevents skin boils, diarrhea, etc. Its merits cannot be fully enumerated.
Appendix: Green Dragon White Tiger Decoction
Olive, Raw Radish. Decoct in water and take orally.
Meng Ying annotated: This is a formula I created myself. Olives are green and clear the fire-wind harbored within the Foot Jueyin Liver Meridian, calming its flaming ascent. Radishes are white and transform the dry-heat coming externally from the Hand Taiyin Lung Meridian, directing its Qi downward. Combined, they eliminate stagnant phlegm in the collaterals and resolve toxicity from rich foods and fish/noodles. Used as a substitute for tea, they tame the dragon and subdue the tiger, bringing harmony to the Zang-Fu organs. Does it merely prevent throat diseases? These two ingredients are available everywhere and suitable for everyone. Though different items, their efficacy is superior, safe for long-term use, truly preventing latent disasters. Do not ignore them because they seem plain.
Appendix: Xilei San
Calcium Carbonate (from Ivory, calcined), Real Pearl (each 3 fen), Refined Indigo Naturalis (6 fen), Plum Blossom Borneol (3 li), Spider Web Nests (20 units, commonly known as "Xi'er Ke"; do not use those on wooden boards), Western Buffalo Calculus, Human Nail (each 5 li). For male patients, use female nails; for female patients, use male nails. Combine to benefit others, ensuring separate preparation. Grind into an ultra-fine powder and insufflate onto the affected area. Healing occurs once foul saliva discharges.
Meng Ying annotated: This is a divine prescription specifically for treating sore-throat scarlet fever and rashes. You Henian included it in *Jinkui Yi* stating that Zhang Furui transmitted this formula and subsequently had a son, hence I named it "Xilei San" (Bestowing Similarity/Quality). Hu Yunmei, aged over twenty, caught cold while sitting at night, suffering from headache, aversion to cold, vomiting, and cold limbs. Upon examination, Meng Ying noted: crimson tongue and rapid pulse, indicating signs of smallpox/rash. It was definitely not a cold. Fortunately, Hu trusted him, so he administered clearing and penetrating herbs. The next day, the lesions appeared round and open. Upon detailed inquiry, it was confirmed that smallpox had not erupted, but the fire heat was intense. Fearing confusion due to folk theories, he requested consultation with specialist Wang Weiwen. Their views were largely identical. Throughout the process, from onset to crusting, no warming, ascending, or attacking tonics were mixed. Despite dense distribution, coarse purple color, black pus/crusts, constipation, anorexia, and ceaseless thirst, the patient survived solely due to this medication. This explains why *Jianzhong Suoyan* has contributed to the world.
Zhou Hetings son, only five years old, continued taking cooling medicines more than a month after smallpox eruption, suddenly developed high fever. Pediatric treatment exacerbated the condition. Limbs and face were red, vomiting with yellow coating, thirsty but with clear urine, occasional syncope, lasting six days. His maternal grandfather, He Xinzi, invited Meng Ying to diagnose. The pulse was wiry, surging, slippery, and rapid; epigastric region was tender to pressure, with constipation and excessive sweating. He prescribed Xiaoxianxiong Tang (Minor Trapped Chest Decoction) plus Gypsum, Anemarrhena, Trichosanthes Root, Bamboo Leaf, Loquat Leaf, Fritillaria, and Xuegeng (Snow Soup). After two doses, all symptoms decreased, urination turned red, and bowel movements resumed. Subsequent nourishing and clearing treatments led to recovery.