〔钱〕五脏各有一证 肝脏水 肺脏脓 心脏 脾脏疹 归肾变黑。〔海〕
肝脏水 色或青，肺脏脓 色或白，脾脏疹或如麸糠色，心脏 其色赤，变归肾则
色黑矣，此五色。凡痘疹，一色者善，或二色三色相合而作者凶。第一大小不等
小儿在胎十月，食五脏秽血，生下则其毒当出，故疮疹之状，皆五脏之液，肝主泪，
肺主涕，心主血，脾为裹血。其疮出有五名，肝为水 ，以泪出如水，其色青而小。
肺为脓 ，以涕稠浊如脓，其色白而大。心为 ，主血，其色赤而小，次于水 。
脾为疹，其色赤黄，而小。涕泪出多，故脓 、水 皆大，血荣于内，所出不多，
故、疹皆小。又，病水 、脓 者涕泪俱少，以液从疮出故也，譬如泡中容
水，水去，则泡瘦矣。〔娄〕上水 者，俗谓之水痘也。脓 者，俗谓之痘子也。
者，俗谓之 子也。疹者，俗谓之麻子也。痘之形状最大，水痘次之， 、 、
又次之，麻子最小，隐隐如麻子也。〔张〕四脏之疮，名状不同，肝为水 ，肝之
液为泪，泪出如水，其色微青而小。肺为脓 ，肺之液为涕，涕如脓，色微白而大。
心主血，其疮为 ，色赤而小。脾主裹血，其疮为疹，色赤黄而浅。此言其初发之
状不同如此，及五七日后，不问其初出自何脏，悉成血 ，血 成脓 ，脓 之后，
结痂 而愈矣。或谓肺为脓 ，而血 之后又成脓 何耶？盖肺为脓 者，言其初
出淡淡如脓，其色白而非黄，若血 后所结脓 ，乃其疮已熟，包裹黄脓，其色黄
而非白，所言脓 虽同，而所以为脓 则不同也。又如脾为疹，亦自其初出色黄微
亦，有小 疮而言之耳，其成脓结痂，收靥而愈，与所谓肤疹者，名同而实则大不
同也。心为 ，与所谓温毒、冬温、发 者，亦大不同。〔万〕凡疮疹五脏见证，
要察何脏之证为甚，即主其脏之毒多，如肝证毒多者，必发水 ，生瘙痒，成目疾，
宜预解肝之毒，羌活汤加青皮、柴胡。肺证毒多者，必增喘嗽烦渴不止，手掐眉
目鼻面，宜预解肺之毒，泻白散合甘桔汤，加牛蒡子、天花粉。心证毒多者，必
伏不起，谵妄饮水，烦哭切牙，宜预解心之毒，导赤散加黄连、辰砂。脾证毒多
者，必成灰白色，痒 吐利，宜预保养脾胃，以解其毒，四君子汤、调元汤，加白
芍药、防风、连翘。肾不见平证，耳 俱热者，死候也。
羌活汤（发热） 泻白散（肺） 甘枯汤（咽喉） 导赤散（心） 四君子汤（吐泻）
调元汤（即保元汤）
【钱乙】五脏各自有一种证候：肝脏对应水痘，肺脏对应脓疱，心脏对应斑疹，脾脏对应疹子，归入肾脏则变为黑色。【海藏】
肝脏的水痘，颜色可能发青；肺脏的脓疱，颜色可能发白；脾脏的疹子，颜色可能像麸皮糠色；心脏的斑疹，颜色发红；若病邪归肾，则颜色变黑，这就是五色。凡是痘疹，只呈现一种颜色的预后良好，如果出现两种或三种颜色混合出现的，预后凶险。第一，大小不等的痘疹，小儿在母胎中十月，摄入了五脏的秽浊之血，出生后这些毒素应当排出，所以疮疹的形态，都是五脏津液的体现。肝主泪，肺主涕，心主血，脾统血。其疮疹发出有五种名称：肝为水痘，因为眼泪流出如水，颜色微青且颗粒小；肺为脓疱，因为鼻涕稠浊如脓，颜色微白且颗粒大；心为斑疹，主血，颜色赤红且颗粒小，次于水痘；脾为疹，颜色赤黄且颗粒小。因为涕泪排出较多，所以脓疱和水痘颗粒较大；血液荣养于内，排出不多，所以斑疹和疹子颗粒较小。另外，患水痘、脓疱的患者，涕泪都很少，因为津液都从疮疹排出了，譬如水泡里装着水，水排出去后，水泡就干瘪了。【娄全善】上述的水痘，俗称水痘；脓疱，俗称痘子；斑疹，俗称疹子；疹子，俗称麻子。痘的形状最大，水痘次之，斑疹、疹子又次之，麻子最小，隐隐约约像麻子一样。【张元素】四脏的疮疹，名称和形态不同。肝为水痘，肝的津液是泪，泪流出如水，颜色微青且小；肺为脓疱，肺的津液是涕，涕如脓，颜色微白且大；心主血，其疮为斑疹，颜色赤红且小；脾主统血，其疮为疹，颜色赤黄且浅。这是说它们初发时的形态如此，等到五七日后，不论最初出自哪一脏，都变成血痂，血痂化脓，脓疱之后，结痂而痊愈。有人问：肺为脓疱，为什么血痂之后又成脓呢？大概肺为脓疱，是说它初出时淡淡如脓，颜色白而不是黄；若血痂后所结成的脓，乃是疮已成熟，包裹着黄脓，颜色黄而不是白。所说的脓疱虽然同名，但形成脓的原因却不同。又如脾为疹，也是从其初发时颜色黄微赤，有小疮而言的，等到化成脓、结痂、收靥而愈，与所谓的肤疹，名字相同但实质大不相同。心为斑疹，与所谓的温毒、冬温、发斑等，也截然不同。【万密斋】凡是疮疹五脏见证，要观察是哪一脏的证候严重，就说明该脏的毒邪多。如肝证毒多者，必然发水痘，产生瘙痒，形成眼疾，宜预先解除肝毒，用羌活汤加青皮、柴胡。肺证毒多者，必然增加喘咳、烦渴不止，手抓眉目鼻面，宜预先解除肺毒，用泻白散合甘桔汤，加牛蒡子、天花粉。心证毒多者，必然伏陷不起，谵语妄言、想喝水，烦躁哭泣、咬紧牙关，宜预先解除心毒，用导赤散加黄连、辰砂。脾证毒多者，必然变成灰白色，瘙痒、呕吐腹泻，宜预先保养脾胃，以解其毒，用四君子汤、调元汤，加白芍药、防风、连翘。肾没有平和的证候，如果耳朵和手脚都发热，是死症。
羌活汤（主治发热） 泻白散（主治肺） 甘桔汤（主治咽喉） 导赤散（主治心） 四君子汤（主治吐泻） 调元汤（即保元汤）
[Qian Yi] Each of the five Zang organs has a corresponding manifestation: the Liver corresponds to *shui dou* (water pox), the Lungs to *nong bao* (pus-filled blisters), the Heart to *ban zhen* (macules and papules), the Spleen to *zhen* (rash), and when it transforms into the Kidneys, it turns black. [Hai Zang]
The Liver's *shui dou* may appear greenish; the Lungs' *nong bao* may appear white; the Spleen's *zhen* may resemble the color of bran; the Heart's *ban zhen* appears red; if the pathogen returns to the Kidneys, the color becomes black. These are the five colors. In general, for variola and exanthems, a single color indicates a favorable prognosis, while a mixture of two or three colors indicates an ominous prognosis. First, regarding the varying sizes of lesions: during the ten months in the womb, the infant consumes the turbid blood of the five Zang organs. After birth, these toxins must be expelled; thus, the appearance of sores and rashes reflects the fluids of the five Zang organs. The Liver governs tears, the Lungs govern nasal mucus, the Heart governs blood, and the Spleen manages blood containment. There are five names for these eruptions: The Liver manifests as *shui dou* because tears flow like water, appearing greenish and small; the Lungs manifest as *nong bao* because nasal mucus is thick and turbid like pus, appearing whitish and large; the Heart manifests as *ban zhen*, governing blood, appearing reddish and small, secondary to *shui dou*; the Spleen manifests as *zhen*, appearing reddish-yellow and small. Because nasal mucus and tears are discharged abundantly, the *nong bao* and *shui dou* are larger; since blood nourishes internally and is not discharged as much, the *ban zhen* and *zhen* are smaller. Furthermore, patients with *shui dou* or *nong bao* have little nasal mucus or tears, because the fluids are exhausted through the sores. It is like a blister containing water; once the water leaves, the blister shrivels. [Lou Quanshan] The aforementioned *shui dou* is commonly known as chickenpox; *nong bao* is commonly known as smallpox; *ban zhen* is commonly known as measles rash; *zhen* is commonly known as measles. Smallpox lesions are the largest, followed by chickenpox, then *ban zhen* and *zhen*, with measles being the smallest, appearing faintly like millet seeds. [Zhang Yuansu] The sores of the four Zang organs differ in name and form. The Liver presents as *shui dou*; its fluid is tears, which flow like water, appearing slightly green and small. The Lungs present as *nong bao*; its fluid is nasal mucus, which resembles pus, appearing slightly white and large. The Heart governs blood, presenting as *ban zhen*, appearing red and small. The Spleen governs blood containment, presenting as *zhen*, appearing reddish-yellow and superficial. This describes their initial appearance. However, after five to seven days, regardless of which organ they originated from, they all transform into bloody scabs (*xue jie*), the bloody scabs turn into pus (*nong jie*), and after the pus stage, they crust over and heal. One might ask: If the Lungs present as *nong bao*, why do bloody scabs later form pus? The reason is that when the Lungs present as *nong bao*, it refers to the initial eruption being faint and pus-like, white rather than yellow. The pus formed after the bloody scab stage indicates the sore is mature, enclosing yellow pus, which is yellow rather than white. Although both are called *nong bao*, the nature of the pus differs. Similarly, the Spleen presenting as *zhen* refers to the initial yellowish-red color with small sores. When it matures into pus, forms scabs, and heals, it is fundamentally different from what is termed cutaneous rash, despite sharing the name. The Heart's *ban zhen* is also significantly different from warm toxicity, winter-warmth, or other types of macular eruptions. [Wan Mingzhai] In observing the five Zang manifestations of sores and rashes, one must determine which Zang organ's syndrome is most severe, indicating that this organ harbors the most toxin. If Liver toxin is excessive, *shui dou* will erupt, causing itching and eye diseases; one should preemptively resolve Liver toxin using Qianghuo Tang (Notopterygium Decoction) augmented with Qingpi (Aurantii Fructus Pericarpium) and Chaihu (Bupleuri Radix). If Lung toxin is excessive, wheezing, coughing, persistent thirst, and irritability will increase, with the patient scratching the eyebrows, eyes, nose, and face; one should preemptively resolve Lung toxin using Xiebai San (Drain White Powder) combined with Ganjie Tang (Licorice and Platycodon Decoction), augmented with Niubangzi (Arctii Fructus) and Tianhuafen (Trichosanthis Radix). If Heart toxin is excessive, the eruption may fail to rise, accompanied by delirium, desire for water, restlessness, crying, and teeth grinding; one should preemptively resolve Heart toxin using Daochi San (Guide Out Red Powder) augmented with Huanglian (Coptidis Rhizoma) and Chen Sha (Cinnabar). If Spleen toxin is excessive, the lesions may turn grayish-white, accompanied by itching, vomiting, and diarrhea; one should preemptively protect the Spleen and Stomach to resolve the toxin, using Sijunzi Tang (Four Gentlemen Decoction) or Tiaoyuan Tang (Regulate Origin Decoction), augmented with Baishao Yao (Paeoniae Radix Alba), Fangfeng (Saposhnikoviae Radix), and Lianqiao (Forsythiae Fructus). The Kidneys do not present with balanced syndromes; if the ears and extremities are hot, it is a sign of death.
Qianghuo Tang (for fever) Xiebai San (for Lungs) Ganjie Tang (for throat) Daochi San (for Heart) Sijunzi Tang (for vomiting and diarrhea) Tiaoyuan Tang (i.e., Baoyuan Tang)