《石壁经》三十六种内伤寒变疹子候歌∶
预先五日战如寒,不觉看来又似痫。才发有同梅李样,眼睛青碧脸红鲜。手心如火发毛立,睡里狂言卧不
安。躁热嫌人拨手睡,又生喘急气相连。二三岁时为疹子,此候须知有病源。智者莫令通脏腑,只将丸散表心
间。能催疹子添光大,(《凤髓经》云∶涎散疹生如片火。)七日如期定却安。
此伤寒不曾表内证,故令毒瓦斯攻内而未曾安也。
又凡在冬月春夏初,切在精明色候,慎不可与惊风一例而治。若有候,但根据前旨,必无夭枉者矣。
《凤髓经》歌括同。有注云∶宜与二圣散,表出后用牛蒡散解。(方见本门中。)
《小儿形证论》四十八候伤寒变疹子歌一同。后云∶此候先有蕴热,忽至风伤腠理,发热狂言,气急生涎,用
天南星丸退心间风涎,微用解表退伤寒。量虚实宣泻、托里散匀气。如不宣,卒未安。(一方并见本门。)
《小儿形证论》四十八候伤寒变疹子歌后云∶此候初如伤寒,或似惊风,须要辨别仔细。既是出在皮肤,只
宜平和汤药解表匀气,更量实肌体肥瘦,聊与通利关窍匀气。(《疹痘论》与诸家疮疹说∶若皮肤中未见,乃可通利。若
是已在皮肤,切忌通利也。盖内虚即毒瓦斯反入,能损人命。)
《凤髓经》二圣散 治小儿疹痘欲出不出,服此发出。
浮萍 香白芷(各等分)
上为细末。每服半钱或一钱,麝香酒下。
《凤髓经》牛蒡散 治小儿疹痘不出,或用药发出后余热未退,发渴热水,乃下血。(斑疹用此药解。)
甘草节 荆芥穗 牛蒡子(略炒)
上等分为末。每服一钱半,解毒薄荷汤下;未出,紫草汤下,进数服。(须得身上出者方下此药。)
《小儿形证论》四十八候天南星丸方 治急惊风,因赤体或浴,或变蒸,遂停留不去。因滞潮热,亦可服。
天南星(一个,去皮) 朱砂(一钱) 蝎(半钱) 轻粉(少许)
上为末,酒面糊丸如绿豆大。每服七粒,薄荷汤下,日进二服。
《四十八候》治伤寒变疮疹通关匀气托里散
人参 麻黄(去节) 甘草节(各一分) 白术 蔓荆子 紫草(各一钱) 白茯苓(半两) 升麻(半分)
上末一钱,疮未出,用好酒调下。如已出,香熟水调下。
《石壁经》中关于三十六种内伤寒转变为疹子的候脉歌诀:
发病前五日,身体战栗如同寒战,仔细观察又似乎像癫痫发作。刚发出皮疹时,形态类似梅花和李花,眼睛周围呈现青碧色,脸颊红润鲜艳。手心发热如火,汗毛竖起,睡眠中说胡话,躺卧不安宁。烦躁燥热,讨厌别人触碰或打扰睡眠,又出现气喘急促、气息相连的症状。通常在二三岁时发生这种疹子,对此病候必须知晓其病因根源。明智的医生不要让药力通达脏腑内部,只需使用丸剂散剂在体表发散心经间的邪气。这样能促进疹子透发并增强正气,(《凤髓经》说:服用涎散后疹子生出,如同片状火焰。)七日如期而至,病情必定安定。
这是因为伤寒没有经过解表治疗导致内证,所以毒瓦斯攻入体内而不能安宁。
另外,凡是发生在冬季、春季和初夏时节,务必仔细辨别面色和脉象,切不可将此类病症与惊风混为一谈进行治疗。如果有上述症状,只要依据前面的原则处理,必定不会有夭折或枉死的后果了。
《凤髓经》的歌诀内容相同。有注释说:适宜服用二圣散,解表之后再用牛蒡散解毒。(方剂见本门类中。)
《小儿形证论》中四十八候伤寒变疹子歌诀内容相同。后面又说:此病候先有蕴积的热邪,忽然受到风邪损伤腠理,导致发热、说胡话、气急生痰涎,使用天南星丸清除心经间的风痰,轻微使用解表药物退去伤寒。根据虚实情况宣通泻下,或使用托里散调和气血。如果不宣通,病情突然不能安宁。(一方剂见本门类中。)
《小儿形证论》四十八候伤寒变疹子歌诀后面说:此病候起初像伤寒,或者类似惊风,需要仔细辨别。既然疹子出在皮肤表面,只宜用平和的汤药解表调和气血,还要根据肌肉的充实程度和身体的肥瘦,稍微给予通利关窍的药物以调和气血。(《疹痘论》与各家疮疹学说:如果皮肤中尚未见到疹子,才可以通利。如果已经在皮肤上显现,切忌通利。因为体内虚弱会导致毒瓦斯反而内陷,能损害人命。)
《凤髓经》二圣散 治疗小儿疹痘想要发出却发不出来,服用此药促使发出。
浮萍 香白芷(各等分)
以上药物研为细末。每次服用半钱或一钱,用麝香酒送服。
《凤髓经》牛蒡散 治疗小儿疹痘不出,或者用药发出后余热未退,出现发热口渴、便血等症状。(斑疹使用此药解毒。)
甘草节 荆芥穗 牛蒡子(略炒)
以上药物研为细末。每次服用一钱半,用解毒薄荷汤送服;若疹子未出,用紫草汤送服,连续服用几次。(必须等到身上已经发出疹子才服用此药。)
《小儿形证论》四十八候天南星丸方 治疗急惊风,因赤身裸体或洗澡,或因变蒸,导致邪气停留不去。因停滞引起潮热,也可以服用。
天南星(一个,去皮) 朱砂(一钱) 全蝎(半钱) 轻粉(少许)
以上药物研为细末,用酒和面糊制成如绿豆大小的丸剂。每次服用七粒,用薄荷汤送服,每日进服两次。
《四十八候》治疗伤寒变疮疹通关匀气托里散
人参 麻黄(去节) 甘草节(各一分) 白术 蔓荆子 紫草(各一钱) 白茯苓(半两) 升麻(半分)
以上药物研为细末,取一钱,疮疹未出时,用好酒调服。如果已经发出,用熟水调服。
Song of the "Shibi Jing" on the thirty-six types of internal cold damage transforming into rash:
Five days prior to onset, the body trembles as if in chills; upon careful observation, it resembles epilepsy. Upon eruption, the lesions resemble plum blossoms or apricot flowers; the eyes appear cyan-green, and the face is red and fresh. The palms are hot like fire, hair stands erect, delirious speech occurs during sleep, and restlessness prevents comfortable lying down. Irritability and heat make one dislike being touched or disturbed during sleep, accompanied by panting and rapid breathing. This condition typically affects children aged two or three; one must understand the root cause of this pathology. Wise physicians should not allow medicinal force to penetrate the internal organs, but rather use pills and powders to disperse pathogenic factors from the heart region superficially. This can promote the eruption of rashes and enhance vital energy (Zheng Qi). (The "Fengsui Jing" states: After taking the Saliva Powder, rashes emerge like patches of fire.) By the seventh day, as scheduled, the condition will stabilize.
This occurs because the cold damage was not treated with exterior-releasing methods, leading to internal syndromes where toxic pathogens attack internally without settling.
Furthermore, during winter, early spring, and early summer, one must carefully observe complexion and pulse characteristics. It is crucial not to treat such conditions indiscriminately as convulsive disorders (Jing Feng). If these signs are present, adhering to the aforementioned principles ensures no premature death or mismanagement.
The verses in the "Fengsui Jing" are identical. A note indicates: Ersheng San (Two Sages Powder) should be administered first to release the exterior, followed by Niubang San (Arctopus Powder) for detoxification. (Formula see within this category.)
The forty-eight patterns song on cold damage transforming into rash in "Xiao'er Xingzheng Lun" is identical. It further states: This pattern initially presents with accumulated heat, suddenly exposed to wind damaging the interstices (Cou Li), causing fever, delirium, rapid breathing, and phlegm secretion. Tiannanxing Wan (Arisaema Pill) is used to clear wind-phlegm from the heart region, combined with mild exterior-releasing herbs to resolve cold damage. Treatment involves promoting drainage according to deficiency or excess, or using Tuoli San (Support Interior Powder) to harmonize Qi and Blood. Without proper promotion, sudden instability may occur. (One formula see within this category.)
Following the song in "Xiao'er Xingzheng Lun": This pattern initially resembles cold damage or convulsions, requiring careful differentiation. Since the rash appears on the skin, only mild decoctions should be used to release the exterior and harmonize Qi. Dosage should be adjusted based on muscle tone and body constitution, slightly promoting the opening of orifices to harmonize Qi. (The "Zhen Dou Lun" and other theories on sores and rashes state: Purging/drainage is permissible only if the rash has not yet appeared on the skin. If already visible on the skin, purging is strictly contraindicated. Internal deficiency allows toxic pathogens to retreat inward, potentially causing death.)
Ersheng San (Two Sages Powder) from "Fengsui Jing": Treats pediatric rash/pox that fails to erupt; promotes eruption.
Floating Duckweed (Pinyin: Fuping; English: Hydrocotyle Japonica Herb) and Fragrant Angelica Root (Pinyin: Xiang Baizhi; English: Angelica Dahurica Root) in equal parts.
Grind into fine powder. Take half a qian or one qian per dose, washed down with Musk Wine.
Niubang San (Arctopus Powder) from "Fengsui Jing": Treats pediatric rash/pox that does not erupt, or residual heat after eruption, manifesting as fever, thirst, and hematochezia. (Used for resolving macules and papules.)
Licorice Joint (Pinyin: Gancao Jie; English: Glycyrrhiza Uralensis Root Stipule) , Schizonepeta Spike (Pinyin: Jingjie Sui; English: Schizonepeta Tenuifolia Spikelet), and Arctopus Fruit (Pinyin: Niubangzi; English: Arctium Lappa Fruit) (lightly fried).
Grind into powder. Take one and a half qian per dose, washed down with Detoxifying Mint Decoction; if the rash has not erupted, wash down with Purple Perilla Leaf Decoction, taken several times. (Must ensure the rash has appeared on the body before administering this medicine.)
Tiannanxing Wan (Arisaema Pill) Formula from "Xiao'er Xingzheng Lun" Forty-Eight Patterns: Treats acute convulsive disorder due to naked exposure or bathing, or due to metabolic transformation (Bian Zheng), causing pathogenic stagnation. Also applicable for stagnant tidal fever.
Arisaema Rhizome (Pinyin: Tiannanxing; English: Pinelliae Rhizoma Preparatum) (one rhizome, peeled), Cinnabar (Pinyin: Zhusha; English: Cinnabaris), Scorpion (Pinyin: Xia; English: Scorpio), and Calomel (Pinyin: Qingfen; English: Hydrargyri Chloridum Solubile) (a small amount).
Grind into powder, mix with wine and flour paste to form pills the size of mung beans. Take seven pills per dose, washed down with Mint Decoction, twice daily.
Tongguan Yunqi Tuoli San (Pass Through Orifices, Harmonize Qi, Support Interior Powder) from "Forty-Eight Patterns" for treating cold damage transforming into sores and rashes:
Ginseng Root (Pinyin: Renshen; English: Panax Ginseng Radix et Rhizoma), Ephedra Stem (Pinyin: Mahuang; English: Ephedrae Herba) (de-seamed), Licorice Joint (Pinyin: Gancao Jie; English: Glycyrrhiza Uralensis Root Stipule) (each one fen), Atractylodes Macrocephala Rhizome (Pinyin: Baizhu; English: Atractylodis Macrocephalae Rhizoma), Vitex Fruit (Pinyin: Manjingzi; English: Viticis Fructus), Purple Gromwell Root (Pinyin: Zicao; English: Lithospermi Radix), Poria (Pinyin: Baifuling; English: Polyporus), and Cimicifuga Rhizome (Pinyin: Shengma; English: Cimicifugae Rhizoma) (half a fen).
Grind into powder. Take one qian. If the sore/rash has not erupted, take with good wine. If already erupted, take with well-cooked water.