（附小儿丹毒 痘后毒）
脉浮者。消风为主。
脉浮数者。祛风清热。
脉数。按之沉实者。解表攻里。
一妇患斑作痒。脉浮。以消风散（八十）四剂而愈。（此凭症也。）
一妇患斑作痒。脉浮数。以人参败毒散（六四）二剂少愈。更以消风散（八十）四剂而安。
一人患斑。色赤紫。 痛发热。喜冷。脉沉实。以防风通圣散（六）一剂顿退。又以荆防
败毒散。（七）加芩、连。四剂而愈。
一老患疹。色微赤。作痒发热。以人参败毒散（六四）二剂少愈。以补中益气汤。加黄芩
、山栀而愈。（此凭症也。）
一妇患斑痒痛。大便秘。脉沉实。以四物加芩、连、大黄、槐花而愈。（此凭症也。）
一儿患斑作痛。发热烦渴。欲服清凉饮下之。诊脉不实。举按不数。此邪在经络不可下
。用解毒防风汤二剂而安。
此症小儿多患之。须审在表在里。及邪之微甚而治之。前人谓首尾俱不可下者。何也。
首不可下者为斑。未见于表下。则邪气不得伸越。又脉症有表而无里。故禁首不可下也。尾
不可下者。斑毒已显于外。内无根蒂。大便不实。无一切里症。下之则斑气逆陷。故不可下
一人作痒发热。以消毒犀角饮（二百四二）一剂作吐泻。此邪上下俱出也。毒自解。少顷
吐泻俱止。其疹果消。吐泻后。□脉七诊。此小儿和平脉也。邪已尽矣。不须治。果愈。
洁古云。斑疹为症各异。发 肿于外者。少阳属三焦相火也。谓之斑。 小红靥行于
中不出者。属少阴君火也。谓之疹。凡显斑症。若有吐泻者。慎勿乱治而多吉。谓邪上下出
也。斑疹并出。小儿难禁。是以别生他症也。首尾不可下。大抵安里之药多。发表之药少。
秘则微疏之。令邪气不壅并而作次以出。使儿易禁也。身温暖者顺。身凉者逆。
一子痘毒。及时针刺。毒不内侵。数日而愈。
大抵古人制法。浅宜砭。深宜刺。使瘀血去于毒聚之始则易消。况小儿气血又弱。脓成
而不针砭。鲜不毙矣。
一儿臂患痘毒作烧。按之复起。此脓胀痛而然。遂刺之。以托里而愈。
痘后肢节作肿而色不赤。宜金银花散。（百七十）更以生黄豆末。热水调敷。干以水润。
自消。若敷六七日。脓已成。急刺之。宜服托里药。
一儿痘疮已愈。腿上数枚。变疳蚀陷。用雄黄、铜绿等分为末。敷。兼金银花散而愈。
遍身。用出蛾绵茧填实白矾末。烧候汁干。取出为末。放地上。碗盖良久。出火毒。敷之。
一儿痘后搔痒。搔破成疮。脓水淋漓。用经霜陈茅草为末。敷之。及铺席上。兼服金银
花散（百七十）而愈。若用绿豆、活石末亦可。似不及茅草功速。
一儿周岁患丹毒。延及遍身如血染。用瓷锋击刺。遍身出黑血。以神功散（七十）涂之。
服大连翘饮而愈。
又儿未盈月。阴囊患此。为前治之而愈。
又儿不欲刺。毒入腹而死。 河间云。丹从四肢延腹者不治。予尝刺毒未入腹者。无不
一小儿腿患丹如霞。游走不定。先以麻油涂患处。砭出恶血。更以金银花散。（百七十）
一剂而安。（此凭症也。）
一小儿遍身皆赤。砭之。投解毒药即愈。（此凭症也。）
一人患丹毒。 痛便秘。脉数而实。服防风通圣散不应。令砭患处去恶血。仍用前药即愈。
（此凭脉症也。）
一小儿患之。外势须轻。内则大便不利。此在脏。服大连翘饮。敷神功散而瘥。（此凭
一小儿遍身亦赤。不从砭治。以致毒瓦斯入腹而死。 此症乃恶毒热血。蕴蓄于命门。遇
而合起也。如霞片者。须砭去恶血为善。如肿起赤色。游走不定者。宜先以升麻油涂患处砭
之。以泄其毒。凡从四肢起入腹者不治。须知丹有数种。治者有数法。无如砭之为善。常见
患稍重者不用砭法。俱不救也。
（附：小儿丹毒、痘后余毒）
脉象浮的，以消风散为主治方。
脉象浮而数的，采用祛风清热的治法。
脉象数，重按感觉沉实的，采用解表攻里的治法。
有一位妇女患斑疹且瘙痒，脉象浮，服用消风散（第八十首方）四十剂后痊愈。（这是依据症状治疗的。）
有一位妇女患斑疹且瘙痒，脉象浮数，服用人参败毒散（第六十四首方）两剂后稍见好转，接着再服用消风散（第八十首方）四剂后病情安定。
有一位男子患斑疹，颜色赤紫，疼痛发热，喜冷饮，脉象沉实，服用防风通圣散（第六首方）一剂后症状顿时消退，又服用荆防败毒散（第七首方）加黄芩、黄连，四剂后痊愈。
一位老人患疹，颜色微红，瘙痒发热，服用人参败毒散（第六十四首方）两剂后稍见好转，再用补中益气汤加黄芩、山栀后痊愈。（这是依据症状治疗的。）
一位妇女患斑疹，瘙痒疼痛，大便秘结，脉象沉实，服用四物汤加黄芩、黄连、大黄、槐花后痊愈。（这是依据症状治疗的。）
一个幼儿患斑疹且疼痛，发热烦躁口渴，想要服用清凉饮进行泻下治疗。诊察脉象不实，轻举重按都不数急。这是邪气在经络，不可使用泻下法。使用解毒防风汤两剂后病情安定。
这种病症小儿多患有。必须审察病邪是在表还是在里，以及邪气的轻重来治疗。前人说发病初期和末期都不可使用泻下法，为什么呢？
初期不可泻下是因为斑疹尚未透发于体表，如果此时强行泻下，则邪气无法向外发散透越；而且脉症表现为只有表证而没有里证，所以禁止初期使用泻下法。
末期不可泻下是因为斑疹毒邪已经明显显露于体外，体内没有病根，大便不成形，没有任何里证，如果此时使用泻下法，会导致斑疹之气逆乱内陷，所以不可使用泻下法。
有一个孩子瘙痒发热，服用消毒犀角饮（第二百四十二首方）一剂后出现呕吐腹泻。这是邪气从上下两个途径排出，毒邪自然解除。过了一会儿，呕吐腹泻停止，皮疹果然消退。吐泻之后，经过七次诊脉，这是小儿平和的脉象，说明邪气已尽，不需要再治疗，果然痊愈。
洁古（张元素）说：斑和疹是两种不同的病症。发于外部红肿的是少阳三焦相火所致，称为斑；小红点隐伏于中间不能透发出来的是少阴君火所致，称为疹。凡是出现斑疹症状，如果有呕吐腹泻的情况，千万不要胡乱治疗，这样大多吉利，因为这是邪气从上下排出的表现。斑疹同时发出，小儿难以承受，因此会衍生其他病症。发病初期和末期都不可泻下，大体上使用安里的药物较多，发表的药物较少。如果大便秘结，则轻微疏通，使邪气不壅滞积聚而依次透出，让小儿容易耐受。身体温暖的为顺证，身体凉冷的为逆证。
一个孩子的痘毒，及时用针刺治疗，毒邪没有向内侵袭，几天后痊愈。
大体上古人制定的治疗方法，浅表的适合用砭石，深部的适合用针，使瘀血在毒邪聚集之初就被去除，这样就容易消除。何况小儿气血虚弱，脓液形成而不进行针砭治疗，很少有不死亡的。
一个幼儿手臂患痘毒并伴有烧灼感，按压后皮肤凹陷随即恢复，这是脓液胀痛所致。于是刺破排脓，配合托里药治疗后痊愈。
痘疮愈合后四肢关节肿胀但颜色不红，适宜使用金银花散（第一百七十首方），再用生黄豆粉，热水调匀外敷，干了用水润湿，自然消散。如果外敷六七天，脓已形成，应立即刺破，适宜服用托里药。
一个幼儿痘疮已经痊愈，但腿上有几处变成疳疮蚀烂凹陷，用雄黄、铜绿等分研末，外敷，兼服金银花散后痊愈。
遍身患处，用出蛾后的空茧填实白矾末，烧至汁液干涸，取出研成粉末，放在地上，用碗盖住很久以去火毒，然后外敷。
一个幼儿痘后瘙痒，抓破形成疮口，脓水淋漓，用经霜的陈旧茅草研末，外敷，并在席子上铺陈，兼服金银花散（第一百七十首方）后痊愈。如果使用绿豆、滑石粉也可以，但不如茅草见效快。
一个周岁幼儿患丹毒，蔓延至遍身如同被血染红，用瓷锋击刺，遍身流出黑血，涂抹神功散（第七十首方），服用大连翘饮后痊愈。
另一个未满月的婴儿，阴囊患此病，用前面的方法治疗而痊愈。
还有一个婴儿不愿意接受针刺，毒邪进入腹部而死。河间（刘完素）说：丹毒从四肢蔓延至腹部的属于不治之症。我曾针刺那些毒邪尚未进入腹部的患者，无不治愈。
一个幼儿腿部患丹毒，状如晚霞，游走不定，先用麻油涂抹患处，用砭石放出恶血，再服用金银花散（第一百七十首方）一剂后病情安定。（这是依据症状治疗的。）
一个幼儿遍身皆红，用砭石治疗，投予解毒药即痊愈。（这是依据症状治疗的。）
一个人患丹毒，疼痛便秘，脉象数而实，服用防风通圣散无效，令其砭刺患处去除恶血，仍用前药即痊愈。（这是依据脉症治疗的。）
一个幼儿患此病，外在形势较轻，但内部大便不通利，这是病在脏，服用大连翘饮，外敷神功散后病愈。（这是依据……[原文此处似有缺漏，依语境推断为凭脉症或病位]）
一个幼儿遍身亦红，不接受砭石治疗，导致毒瓦斯进入腹部而死。这种病症乃是恶毒热血，蕴蓄于命门，遇……[原文此处似有缺漏]而并发。如霞片状的，必须砭去恶血才好。如肿胀隆起红色，游走不定的，适宜先用升麻油涂抹患处，用砭石刺之，以泄其毒。凡是从四肢发起进入腹部的属于不治之症。须知丹毒有好几种，治疗方法也有好几种，没有比砭石疗法更好的了。常见患病稍重者不使用砭石疗法，最终都无法救治。
(Attached: Infantile Erysipelas, Residual Toxin after Smallpox)
When the pulse is floating (Fu), the treatment should primarily focus on dispelling wind using Xiaofeng San (Wind-Dispersing Powder).
When the pulse is floating and rapid (Fu Shu), the method of dispelling wind and clearing heat should be employed.
When the pulse is rapid (Shu) and feels deep and solid (Chen Shi) upon heavy pressure, the method of releasing the exterior and purging the interior should be used.
A woman suffered from macules with itching; her pulse was floating. She was cured after taking forty doses of Xiaofeng San (Formula No. 80). (This case relied on symptoms.)
A woman suffered from macules with itching; her pulse was floating and rapid. After two doses of Renshen Baidu San (Ginseng Detoxification Powder, Formula No. 64), she improved slightly. Subsequently, four doses of Xiaofeng San (Formula No. 80) stabilized her condition.
A man suffered from macules that were red-purple in color, accompanied by pain, fever, and a preference for cold drinks. His pulse was deep and solid. One dose of Fangfeng Tongsheng San (Saposhnikovia Universal Relief Powder, Formula No. 6) caused immediate remission. He was then cured after four doses of Jingfang Baidu San (Schizonepeta and Saposhnikovia Detoxification Powder, Formula No. 7) added with Huangqin (Scutellariae Radix) and Lian (Coptidis Rhizoma).
An elderly person suffered from papules that were slightly red, with itching and fever. After two doses of Renshen Baidu San (Formula No. 64), he improved slightly. He was cured by using Buzhong Yiqi Tang (Middle-Supplementing and Qi-Boosting Decoction) added with Huangqin (Scutellariae Radix) and Zhizi (Gardeniae Fructus). (This case relied on symptoms.)
A woman suffered from itchy and painful macules with constipation. Her pulse was deep and solid. She was cured by using Siwu Tang (Four Substance Decoction) added with Huangqin (Scutellariae Radix), Lian (Coptidis Rhizoma), Dahuang (Rhei Radix et Rhizoma), and Huaihua (Sophorae Flos). (This case relied on symptoms.)
A child suffered from painful macules with fever, restlessness, and thirst. There was an intention to use Qingliang Yin (Cooling Drink) for purgation. However, the pulse was not solid, and neither light nor heavy pressure revealed a rapid quality. This indicated that the pathogen was in the meridians and channels, so purgation was contraindicated. Two doses of Jiedu Fangfeng Tang (Detoxifying Saposhnikovia Decoction) stabilized his condition.
This disease is common in children. Treatment must assess whether the pathogen is in the exterior or interior, and its severity. Ancients stated that purgation is contraindicated at both the beginning and the end of the illness. Why?
Purgation is contraindicated at the beginning because macules have not yet erupted on the surface. If purged prematurely, the pathogenic qi cannot extend outward. Moreover, if the pulse and symptoms show only exterior signs without interior signs, purgation is prohibited.
Purgation is contraindicated at the end because the toxin has already manifested externally, there is no internal root, the stool is loose, and there are no interior syndromes. Purging at this stage would cause the macular qi to reverse and sink inward, hence it is contraindicated.
One child had itching and fever. After one dose of Xiaodu Xijiao Yin (Detoxifying Rhinohorn Drink, Formula No. 242), he experienced vomiting and diarrhea. This indicated that the pathogen was exiting through both upper and lower pathways, resolving the toxin naturally. Soon after, vomiting and diarrhea ceased, and the rash disappeared. Following the vomiting and diarrhea, seven pulse diagnoses were taken, revealing a peaceful pulse typical of healthy children, indicating the pathogen was exhausted. No further treatment was needed, and he recovered.
Jiegu (Zhang Yuansu) said: Macules and papules are different conditions. Swelling and redness appearing externally belong to the Shaoyang Triple Burner Ministerial Fire and are called macules (Ban). Small red spots remaining internally without erupting belong to the Shaoyin Sovereign Fire and are called papules (Zhen). In cases of macules, if vomiting or diarrhea occurs, do not treat recklessly; this is auspicious as it indicates the pathogen is exiting via upper and lower routes. When macules and papules erupt simultaneously, infants may not tolerate it well, leading to secondary complications. Generally, purgation is contraindicated at the start and end. Formulas that stabilize the interior are more common than those that release the exterior. If constipated, mildly unblock to prevent pathogenic congestion, allowing gradual eruption so the infant can tolerate it. A warm body indicates a favorable prognosis; a cold body indicates unfavorable.
A child’s smallpox toxin was treated with timely needle pricking, preventing internal invasion, and he recovered in a few days.
Generally, ancient methods dictate that superficial lesions are suitable for Bian stone therapy, while deeper ones require needles. Removing blood stasis at the onset of toxin accumulation facilitates resolution. Given that infants have weak qi and blood, failure to prick or scarify when pus forms rarely spares them from death.
An infant’s arm suffered from smallpox toxin with a burning sensation; pressing left an indentation that rebounded, indicating distension from pus. It was pricked, and the patient recovered with interior-supporting herbs.
After smallpox healing, swelling occurred in the limbs without redness. Jin Yin Hua San (Honeysuckle Powder, Formula No. 170) was appropriate, along with applying raw soybean powder mixed with hot water. Re-wetting when dry allowed natural resolution. If applied for six to seven days and pus formed, immediate pricking was required, along with interior-supporting herbs.
An infant’s smallpox had healed, but several lesions on the legs became ulcerated and depressed. Equal parts Xionghuang (Realgar) and Tonglv (Malachite Green) were powdered and applied externally, combined with Jin Yin Hua San (Formula No. 170), resulting in recovery.
For generalized lesions, empty silkworm cocoons were filled with Baijian (Alumen), burned until dry, powdered, placed on the ground under a bowl for a long time to remove fire toxicity, and then applied externally.
An infant suffered post-smallpox itching, scratching until ulcers formed with oozing pus. Cangjiu Maocao (Old Mugwort Grass exposed to frost) was powdered and applied, spread on mats, and combined with oral Jin Yin Hua San (Formula No. 170) for recovery. Lv dou (Mung Bean) and Huashi (Talcum) could also be used, though less effective than grass.
A one-year-old infant suffered from erysipelas spreading over the body like blood dye. Ceramic sharp points were used to prick, evacuating black blood from the whole body. Shengong San (Divine Merit Powder, Formula No. 70) was applied topically, and Da Lianqiao Yin (Large Forsythia Drink) was administered orally, leading to recovery.
Another infant under one month old suffered from this on the scrotum and was cured by the aforementioned treatments.
Another infant refused pricking; the toxin entered the abdomen, causing death. Hejian (Liu Wansu) stated: Erysipelas spreading from limbs to the abdomen is incurable. I have successfully pricked cases where the toxin had not yet entered the abdomen.
An infant suffered from erysipelas resembling rosy clouds, wandering and不定 (uncertain/migratory). First, sesame oil was applied to the lesion, followed by Bian stone therapy to evacuate bad blood. One dose of Jin Yin Hua San (Formula No. 170) stabilized the condition. (This case relied on symptoms.)
An infant had generalized redness. Bian stone therapy was used, and detoxifying herbs led to recovery. (This case relied on symptoms.)
An adult suffered from erysipelas with pain and constipation; the pulse was rapid and solid. Fangfeng Tongsheng San was ineffective. Pricking the lesion to evacuate bad blood, followed by the previous medication, resulted in recovery. (This case relied on pulse and symptoms.)
An infant suffered from this; external signs were mild, but internal constipation indicated involvement of the Zang organs. Da Lianqiao Yin was administered, and Shengong San was applied externally, leading to improvement. (This case relied on...)
An infant had generalized redness but rejected Bian stone therapy; the toxic vapor entered the abdomen, causing death. This condition involves evil toxic hot blood accumulating in the Mingmen (Gate of Life), triggering outbreaks. For cloud-like patches, evacuating bad blood via pricking is best. For swollen, red, migratory lesions, apply Shengma Oil (Cimicifugae Radix Oil) to the site and prick to drain toxicity. Cases starting from limbs and entering the abdomen are incurable. Note that there are several types of erysipelas and several treatments, none superior to Bian stone therapy. Commonly, those with slightly severe conditions who reject pricking are not saved.