《巢氏病源》伤寒发痘疮候∶伤寒热毒瓦斯盛,多发 疮。其疮色白或赤,发于皮肤。头作瘭浆戴白脓者,其
毒则轻;有紫黑色,作根隐隐在肌肉里,其毒重。则甚者,五内七窍皆有疮,形如发痘,故以名焉。
茅先生∶小儿生下有麻痘候,各有所说。痘候,早晨浑身微微地热,日午后大热,眼白加黄色,两胁下吸
吸动,更发甚如惊风,遍身大热,手足逆冷,此病属脏。所治者只用独胜散与发痘,(方见疮疹已出未出门。)慎不得泻,
恐水入大肠,痘子不出,泻下如赤豆汁及朝出暮 。或出如掌大,赤色及痘口内有臭气,唇黑色,死候。大凡
痘只得用独胜散散发出痘,将息安乐后,可用青金丹取下余积。(方见积聚门中。)后用匀气散补之。(方
见胃气不和门中。)常服朱
砂膏(方见惊积门中)即愈。第一先莫吐泻,恐水入大肠成恶候。
茅先生小儿麻候∶浑身微热,午后大热,眼不白不黄,微加赤色,手足冷,吐逆,此候属腑。所治者亦根据
痘候调理,恶候一同。
《婴童宝鉴》∶小儿疹痘为脏腑积热发于皮肤为之。其热在腑,发之即疹也,腑属阳。其发之微热在脏,发
之即痘也,脏属阴。发之甚、未发,同一治。未出,可下,解热而退;既出,慎勿下之及冷药逼之!其病不出,
在内害人也。
《婴童宝鉴》斑痘死候∶斑痘出后热不去,大泻而渴。有此疾,皆因已出后服冷药,逼在肺中也。烦躁,迷
闷不食,大小便难。
《五关贯真珠囊》小儿痘疮所主候∶凡小儿痘疮,疮外应之候。若壮热汗不流,先躁而出者,主心也;先嗽
而出如砂子形者,主肺也;先肚痛而出疹子者,主脾也;先如疟而发渴,后为水 或有黯血者,主肾也;先目
赤如珠,暗流羞明,出疮子或有硬脓而不破者,主肝也。
茅先生麻痘不通治恶候歌∶
斑疮出后热难除,冷药先冰在腹居。渴甚泻多便溺涩,不餐躁发命须臾。
《玉诀》小儿斑疹候歌∶
伤寒胃热作斑疮,倒 因风气受伤。太过损肝多紫黑,大为阴盛小为阳。
此患未出,多不辨之。只作伤寒调治,多误。如太过者,解之。
《玉诀》小儿斑疹候歌∶目涩语声短,发热有时凉。手耳如冰冷,三关洪又长。
(又一《玉诀》斑疹候歌与此同。但第一句云∶气喘声多促,余三句并同。又云∶宜发散)
《石壁经》三十六种内疮子候歌(《凤体经》以此候为伤寒变麻子,歌括一同∶)
小儿疮子候偏多,咳嗽涎潮作久 。发热发寒(发寒一云发惊)如怕物,
看灯停目眼光多(四十八候此句云∶惊如羊眼白相过。)
喉中自响如 ,吐后常添气不和。梦里发来如急搐,唇红脸赤脉交多。渴水心烦多躁热,耳冰足冷发温和。
舌上有疮如粟子,定知三日热来多。此病变成麻子候,草将凉药与相过。认取证形为妙手,只须平药病消磨。
此因温热毒瓦斯在人,至春,人感寒邪,阴阳相错,在腑作细赤疮疹,在脏则为痘疮。虽有前候,切看手足
稍冷,尻阴冷,腹中痛硬,是疮疹候。若误投惊药则反受毒邪内攻,其疮不出;更服热药,则使疮 陷而受死
矣。但服调气升发散药,必愈。
《巢氏病源》中关于伤寒引发痘疮的论述:伤寒导致热毒之气旺盛,容易引发疮疡。这些疮疡颜色或白或红,发于皮肤表面。如果疮头形成脓疱且顶部有白色脓液,说明毒邪较轻;如果呈现紫黑色,且根部隐没在肌肉深处,说明毒邪深重。病情严重的,五脏和七窍都会出现疮疡,形状类似发痘,因此以此命名。
茅先生论述:小儿出生后若出现麻痘症状,各家说法不一。关于痘候的表现:早晨全身微微发热,到了日午后则高热,眼白部分发黄,两胁下呼吸时伴有抽动,有时发作起来像惊风一样,遍身大热,手足逆冷,这种病症属于脏病。治疗时只用独胜散来透发痘疮(方剂见“疮疹已出未出门”章节)。切记不可使用泻下法,恐怕水湿进入大肠,导致痘子无法透出;若腹泻如赤豆汁样,或者早上发出晚上就内陷死亡;或者痘疮大片如手掌大小,颜色赤红且痘口内有臭气,嘴唇发黑,这些都是死症征兆。大凡痘疮只能用独胜散发散透疹,待患儿调理安康后,可用青金丹清除体内余留积滞(方剂见“积聚门”)。之后用匀气散补益身体(方剂见“胃气不和门”)。常服朱砂膏(方剂见“惊积门”)即可痊愈。首先切忌呕吐腹泻,恐怕水湿入大肠形成恶候。
茅先生论小儿麻疹症状:浑身微热,午后高热,眼睛不白也不黄,略微发红,手足冰冷,呕吐逆气,这种症状属于腑病。治疗方法也根据痘候进行调理,恶候表现相同。
《婴童宝鉴》论述:小儿疹痘是由于脏腑积热发于皮肤所致。热邪在腑,发出即为疹,腑属阳。热邪在脏,发出即为痘,脏属阴。无论发病轻重、是否已发,治疗原则基本一致。未出之时,可酌情攻下,以解热退火;既已发出,切记不可攻下或用寒凉药物逼迫!若病邪不出,会在体内危害人体。
《婴童宝鉴》论斑痘死症:斑痘发出后热势不退,伴有大泻和口渴。患此疾,多因痘出后服用寒凉药物,导致邪气逼入肺中。表现为烦躁、神志昏闷、不思饮食,大小便困难。
《五关贯真珠囊》论小儿痘疮的主应脏腑症状:凡是小儿痘疮,其外在表现对应不同脏腑。若壮热无汗,先烦躁而后出疹,主应心脏;先咳嗽而出,形态如砂粒,主应肺脏;先腹痛而出疹,主应脾脏;先像疟疾一样发作并口渴,随后出现水疱或有暗红色血液,主应肾脏;先目赤如珠,畏光流泪,出疮后或有硬脓不破,主应肝脏。
茅先生麻痘不通治恶候歌诀:
斑疮发出后热势难除,因先用寒凉药使寒气凝结在腹部。
极度口渴、腹泻严重、小便涩痛,
不吃东西、烦躁发作,生命危在旦夕。
《玉诀》小儿斑疹候歌诀:
伤寒胃热导致斑疮,倒靥(痘疮内陷)是因为风气受伤。
太过损伤肝脏多呈紫黑色,大为阴盛小为阳证。
此病在未发出前,大多难以辨别。
只按伤寒调治,容易误诊。如属太过者,应予疏散解表。
《玉诀》小儿斑疹候歌诀:
眼睛干涩、语声短促,发热有时退凉。
手耳如冰冷,三关脉象洪大而长。
(另一首《玉诀》斑疹候歌与此相同。但第一句说:气喘声音急促,其余三句相同。又说:宜用发散法)
《石壁经》三十六种内疮子候歌诀(《凤体经》将此候视为伤寒变成的麻子,歌诀内容相同):
小儿疮子症状偏多,咳嗽痰潮持续很久。
发热发寒(发寒一说为发惊),如同害怕异物,
看灯时眼神停滞、目光呆滞(四十八候中此句说:惊悸如羊眼白眼过多)。
喉中自响如痰鸣,吐后常添气机不和。
梦中发作如急搐,唇红脸赤脉象交错。
渴欲饮水、心烦多躁热,耳朵冰凉、足冷但身体温和。
舌上有疮如粟米状,定知三日热度增多。
此病变成麻子候,切勿将寒凉药与之相过。
认清证候形态为妙手,只需平和药物即可消除疾病。
此病是因为温热毒气在人身上,到了春季,人感受寒邪,阴阳错乱,在腑作细赤疮疹,在脏则为痘疮。虽然有前述症状,但切要看手足稍冷,尻阴冷,腹中痛硬,这才是疮疹候。若误投惊风药,则反而受毒邪内攻,导致疮出不来;更服热药,则会使疮陷没而致死。但服用调气升发散药,必定痊愈。
According to *Chao Shi Bing Yuan* (Source of Diseases by Master Chao) regarding the syndrome of measles and smallpox induced by cold damage: When the pathogenic heat-toxin qi is vigorous in cold damage, sores are likely to occur. These sores may be white or red and appear on the skin. If the sore head forms a pustule with white pus at the top, the toxin is mild; if it appears purple-black with roots hidden deep within the muscles, the toxin is severe. In serious cases, sores appear in the five zang organs and seven orifices, resembling eruptive diseases, hence the name.
Master Mao states: Regarding the signs of measles and smallpox in infants after birth, various theories exist. For the smallpox syndrome: there is slight fever all over the body in the morning, becoming high fever in the afternoon; the whites of the eyes turn yellow; there is sucking movement under both hypochondria; sometimes attacks resemble wind-stroke (Jing Feng), with high fever all over and cold extremities. This disease belongs to the Zang organs. Treatment uses only Dusheng San (Single Victory Powder) to vent the smallpox (see formula for "Measles/Smallpox Erupted but Not Fully Open"). Caution against using purgatives, lest water enter the large intestine, preventing the eruption of smallpox; diarrhea like red bean juice, or eruption in the morning and involution in the evening, or eruptions as large as a palm, red in color with foul odor from the pores, black lips—these are signs of death. Generally, smallpox should only be treated with Dusheng San to promote eruption. After the child recovers and becomes comfortable, Qingjin Dan (Green Golden Pill) can be used to clear residual accumulation (see formula in "Accumulation Section"). Subsequently, Yunqi San (Qi-Balancing Powder) is used for tonification (see formula in "Stomach Qi Disharmony Section"). Regular use of Zhusha Gao (Cinnabar Paste) (see formula in "Wind-Stroke Accumulation Section") leads to recovery. First, avoid vomiting and diarrhea, lest water enter the large intestine causing adverse syndromes.
Master Mao on infant measles syndrome: Slight fever all over, high fever in the afternoon, eyes neither white nor yellow but slightly reddish, cold hands and feet, vomiting and regurgitation. This syndrome belongs to the Fu organs. Treatment follows the regulation for smallpox syndrome, with identical adverse syndromes.
*Ying Tong Bao Jian* (Treasure Mirror for Infants and Children) states: Infant measles and smallpox arise from accumulated heat in the zang-fu organs manifesting on the skin. Heat in the Fu organs manifests as measles; Fu belongs to Yang. Heat in the Zang organs manifests as smallpox; Zang belongs to Yin. Whether mild or severe, erupted or not, treatment principles are similar. Before eruption, purgation may be considered to resolve heat; once erupted, caution against purgation or forcing with cold medicines! If the pathogen does not exit, it harms the interior.
*Ying Tong Bao Jian* on fatal signs of macules and smallpox: Fever persists after macules/smallpox erupt, accompanied by profuse diarrhea and thirst. This condition often results from taking cold medicines after eruption, forcing pathogens into the Lung. Symptoms include irritability, mental confusion, anorexia, and difficulty in urination and defecation.
*Wu Guan Guan Zhen Zhu Nang* (Five Passages Piercing the Pearl Pouch) on main signs of infant smallpox corresponding to organs: For infant smallpox, external signs correspond to specific organs. High fever without sweat, preceded by restlessness then eruption, corresponds to the Heart; cough preceding eruption, shaped like sand grains, corresponds to the Lung; abdominal pain preceding eruption, corresponds to the Spleen; malaria-like onset with thirst, followed by blisters or dark blood, corresponds to the Kidney; red eyes like pearls, photophobia, hard pus that does not break upon eruption, corresponds to the Liver.
Master Mao's Song on Adverse Syndromes of Blocked Measles/Smallpox:
After macules erupt, fever is hard to remove; cold medicines first froze the abdomen.
Extreme thirst, profuse diarrhea, painful urination,
No food intake, irritability arises, life hangs in the balance.
*Yu Jue* (Jade Decree) Song on Infant Macules and Rashes Syndrome:
Cold damage stomach heat causes macules and sores; involution (Dao Yan) occurs due to wind-pathogen injury.
Excessive damage to the Liver results in purple-black colors; major cases indicate Yin excess, minor cases Yang.
Before this illness erupts, it is rarely distinguished. Treating it merely as cold damage leads to errors. If excessive, resolve it via dispersal.
*Yu Jue* Song on Infant Macules and Rashes Syndrome:
Dry eyes and short voice, fever comes and goes with cooling.
Hands and ears feel ice-cold, the Three Passages pulse is surging and long.
(Another *Yu Jue* song on macules/rashes is identical except the first line says: Asthma and rapid breathing; the other three lines are the same. It also states: Dispersal is appropriate.)
*Shi Bi Jing* (Stone Wall Classic) Song on Thirty-Six Types of Internal Sores (The *Feng Ti Jing* considers this syndrome to be measles transformed from cold damage; the song is identical):
Infant sore symptoms are numerous; coughing and tidal phlegm persist for a long time.
Fever and chills (chills said by some to be fright), as if fearing objects,
Gazing at lamps, eyes remain fixed with much gaze (In the 48 syndromes, this line says: Fright resembles sheep's eyes with white passing through).
Self-sounding in the throat like rattling, after vomiting, qi disharmony often increases.
Awakening from dreams like acute convulsions, red lips and face, interlaced pulses.
Thirst for water, heart vexation, much irritability and heat, cold ears and feet but moderate body temperature.
Sores on the tongue like millet grains, surely knowing heat will increase in three days.
This illness transforms into measles syndrome; do not pass cool medicines to it.
Recognizing the evidence and form is the skill of a master; simply use mild medicines to eliminate the disease.
This illness is due to warm-heat toxins in the person. In spring, humans contract cold pathogens, yin and yang become disordered. In the Fu organs, fine red rashes form; in the Zang organs, smallpox forms. Although the aforementioned signs exist, one must check if hands and feet are slightly cold, the perineum is cold, and the abdomen is painful and hard; these are signs of rash/smallpox. If mistakenly administered anti-fright medicines, the toxic pathogen attacks internally, preventing eruption; if hot medicines are taken, the sores collapse leading to death. However, administering Qi-regulating and ascending-dispersing medicines will ensure recovery.