谷空而响答,形动而影随,举此而得彼也。故钱氏云∶热应时而出,是见热而知脏腑明
矣,且以一日而观之,寅卯辰时热者,属肝,为水 ,巳午未热者,属心,为斑,子丑寅热
者,脾疹也,耳肾不受秽,无证,但出疮疹变黑属肾,申酉戌时热者,属肺,为脓 。观其
热发有时,亦知疮疹之所本,是亦即前录后之先见也。
人之将理,失之于微。积微成损,故冰浓三尺,非一日之寒,蕴热而斑毒,非一日之热
,皆积微成着也。大抵小儿自然阳盛而阴微,况朝夕饮啜热乳,兼重衣温浓,帏帐周密,则
伤皮肤,害血脉,疮疡发黄,是生多疾,此蕴热而斑毒者,表里皆受热也宜预服升麻汤、消
、毒散、紫草汤、油剂为良。又有伤寒发斑,为感寒毒,失于解利,邪气盛则实,实则热,
热毒而斑生遍身,如被蚊蚤所啮,不作疮胞起,但赤斑点者,此五死一生之证。作黑点者,
九死一生之证,名曰发斑。非疮痘之比,皆称曰斑。故因而及之,疮痘有数证,疹起如痱疮
,随出随愈,此名麸疹,其毒轻。疮痘如豆,水 如泪而青,小脓 有脓而大,其形各异。
又有心斑脾疹,五脏各有所主,不可不知。
人之平居乐逸,则心神安静,气体和平。及其病,则阴阳偏胜,盛衰虽不同,故令虚实
不齐,是以疮疹已出,不能遍匀。前人治法,透肌解毒而已,使毒得出肌,透消解气,既无
壅遏,则自然出匀也。用必胜散快毒丹令出快,紫草饮、胡荽酒、红粉丹自然匀顺之。
谷中空虚则产生回响,形体移动则影子跟随,通过这一端可以推知另一端。所以钱乙说:热象按时辰出现,这是通过观察热象来了解脏腑状况的明证。并且以一天中的时辰来观察:寅、卯、辰时发热,属于肝,表现为水痘;巳、午、未时发热,属于心,表现为斑疹;子、丑、寅时发热,属于脾,表现为脾疹;耳和肾不受秽浊之气影响,没有特定症状,但疮疹变黑归属于肾;申、酉、戌时发热,属于肺,表现为脓疱。观察热象发作有定时,也就知道了疮疹的根本来源,这也是前面提到的“见微知著”的先兆表现。
人在即将患病之前,往往在细微之处失于防范。微小的积累形成损害,所以冰厚三尺,不是一天的寒冷所能造成的;蕴积热毒导致斑疹,也不是一天的发热就能形成的,这都是由微小积累而成显著病变的结果。大抵小儿天生阳气旺盛而阴气微弱,况且早晚饮用热奶,加上穿着厚重衣物保暖,帷帐严密不透风,就会损伤皮肤,危害血脉,导致疮疡发黄,从而生出多种疾病。这种因蕴积热毒而生斑疹的情况,是表里都受热邪侵袭,适宜预先服用升麻汤、消毒散、紫草汤、油剂,效果良好。又有伤寒发斑,是因为感受寒毒,未能及时解表透邪,邪气盛实,实则生热,热毒遍布全身而生斑疹,像被蚊虫跳蚤叮咬一样,不起水泡疮胞,只是红色斑点,这是十死一生的危重证候。如果变成黑点,则是十死一生(九死一生)的危重证候,名叫发斑。这不同于疮痘,都统称为斑。因此顺便提及,疮痘有多种证候,疹子起如痱子疮,随出随愈,这叫麸疹,其毒性较轻。疮痘如豆粒,水疱如泪滴且色青,小脓疱有脓且较大,形态各不相同。又有“心斑”、“脾疹”,五脏各有主管,不可不知。
人在平时安乐舒适时,心神安静,气血平和。等到生病时,阴阳偏胜,盛衰虽然不同,所以导致虚实不齐,因此疮疹发出后不能均匀分布。前人治疗方法,主要是透肌解毒,使毒邪从肌表透出,透散消解气机郁滞,既然没有壅塞遏阻,那么自然就会出得均匀。使用必胜散、快毒丹令其快速发出,用紫草饮、胡荽酒、红粉丹使其自然均匀顺遂。
An empty valley produces an echo; a moving form casts a following shadow. By observing one, the other can be deduced. Therefore, Qian Yi stated: "Heat appearing at specific times allows one to discern the condition of the Zang-Fu organs through the observation of heat." Furthermore, observing by the hours of the day: fever occurring during Yin, Mao, and Chen hours belongs to the Liver (Gan), manifesting as Shui Dou (water pox); fever during Si, Wu, and Wei hours belongs to the Heart (Xin), manifesting as Ban (macules/rashes); fever during Zi, Chou, and Yin hours belongs to the Spleen (Pi), manifesting as Pi Zhen (spleen rash); the Ear and Kidney (Shen) are not affected by turbid pathogens and have no specific symptoms, but if sores and rashes turn black, they belong to the Kidney; fever during Shen, You, and Xu hours belongs to the Lung (Fei), manifesting as Nong Pao (pustules). Observing that fever occurs at fixed times reveals the root origin of sores and rashes; this is also the "seeing the subtle to know the significant" precursor mentioned earlier.
When people are about to fall ill, they often fail to guard against it in minute details. Accumulation of the minute leads to damage; thus, ice three feet thick is not the result of one day's cold, and heat accumulation leading to toxic macules is not the result of one day's fever. All these are cases where the minute accumulates to become significant. Generally, children naturally possess abundant Yang and deficient Yin. Moreover, drinking hot milk morning and night, combined with heavy clothing for warmth and tight-fitting curtains, damages the skin and harms the blood vessels, causing sores to turn yellow and generating various diseases. In cases of toxic macules arising from accumulated heat, both the exterior and interior are affected by heat pathogens. It is advisable to take Shengma Tang (Cimicifugae Decoction), Xiaodu San (Detoxification Powder), Zicao Tang (Arnebiae Decoction), and oil preparations in advance for good results. There is also "Fa Ban" (eruption of macules) caused by Shanghan (Cold Damage), resulting from contracting cold pathogens and failing to resolve them properly. When pathogenic Qi becomes excessive and solid, it generates heat; toxic heat spreads over the whole body causing macules, resembling bites from mosquitoes or fleas, without forming blister-like sores, but merely red spots. This is a critical syndrome with a mortality rate of nine out of ten. If they turn into black spots, it is a syndrome with a mortality rate of nine out of ten, named Fa Ban. This differs from Chuang Dou (smallpox/variolous sores), yet all are collectively called Ban. Thus, it is mentioned here: Chuang Dou has several syndromes. Zhen (rashes) appear like Fei Chuang (prickly heat), emerging and healing simultaneously; this is called Fu Zhen (bran rash), with mild toxicity. Chuang Dou resembles bean grains; water blisters resemble teardrops and are greenish; small pustules contain pus and are larger. Their shapes vary. There are also "Xin Ban" (Heart Macules) and "Pi Zhen" (Spleen Rashes); each of the Five Zang organs has its specific manifestation, which must not be ignored.
When people live in peace and comfort, their Shen (Spirit) is calm, and their Qi and Blood (Qi Xue) are harmonious. When illness strikes, Yin and Yang become unbalanced. Although the degrees of excess and deficiency differ, this leads to unevenness in Deficiency and Excess patterns. Consequently, after sores and rashes emerge, they may not distribute evenly. Ancient treatment methods focused on venting the muscle layer and resolving toxicity, allowing pathogens to exit via the skin, dispersing and resolving Qi stagnation. With no obstruction, the eruption naturally becomes even. Using Bisheng San (Victory Guarantee Powder) and Kaidu Dan (Rapid Toxin Expelling Pill) facilitates rapid eruption, while Zicao Yin (Arnebiae Drink), Huisui Jiu (Coriander Wine), and Hongfen Dan (Red Powder Pill) ensure natural, even distribution.