〔薛〕杨梅疮乃天行时毒，亦有传染而患之，或禀赋所得者，受证在肝，故多起
于下部，治失其宜，多致蚀伤眼目，腐败肾茎，拳挛肢节。初起之时，上体多者先
用荆防败毒散。下体多者先用龙胆泻肝汤。大便秘者用大连翘饮，后用换肌消毒散。
若蚀伤眼目，兼用九味芦荟丸、六味地黄丸。肢节拳挛，兼用蠲痹解毒汤。若因脾
胃亏损而不能愈者，先用异功散，后用换肌消毒散。若用轻粉之药，多致败证也。
按∶杨梅疮起于近代，多淫夫御不洁之妇，传染而致者，其在小儿，得之乳
抱传染者轻，得之父母遗体者重，治法与大人同，更当求之专科，薛氏治法，未可
尽遵用也。
换肌消毒散 （一名草 散） 治杨梅疮，不拘初患、日久，并效。
土茯苓（即萆 ） 当归 白芷 甘草 皂角刺 薏苡仁 白藓皮 木瓜（不犯铁器。各等分）
上，水煎，食前，并空心服。
又方 治大人之剂，如用前方未应，或儿长大，宜用此方。
土茯苓（五钱） 当归 白芷 皂角刺（炒） 薏苡仁（各一钱） 白藓皮 木瓜（不犯铁器）
木通 金银花（各七分） 甘草 连翘 防风（各五分） 茯苓 芍药（各一钱，炒） 黄 （炒，二
钱） 川芎 生地黄（各八分）
上，作二三剂，水煎出，幼者作一剂煎，分两三次服。
【薛己】杨梅疮是天地间流行的时行毒邪，也有通过接触传染而患上的，或者是先天禀赋遗传所得的。病位主要在肝脏，所以多从身体下部开始发作。如果治疗不当，常常会导致眼睛被侵蚀损伤，阴茎腐败，四肢关节屈曲挛缩。在疾病初起阶段，如果上部症状较多，先用荆防败毒散；如果下部症状较多，先用龙胆泻肝汤。大便秘结不通的，用大连翘饮，之后再用换肌消毒散。如果已经出现眼睛被侵蚀损伤的情况，兼用九味芦荟丸、六味地黄丸。如果出现四肢关节屈曲挛缩，兼用蠲痹解毒汤。如果是由于脾胃亏损导致病情无法痊愈的，先用异功散，之后再用换肌消毒散。如果使用轻粉这类药物，大多会导致病情恶化成为败证。
按语：杨梅疮兴起于近代，多因男子与不洁女子发生性行为，通过传染所致。对于小儿而言，通过哺乳怀抱等日常接触传染者病情较轻，通过父母遗传（胎传）者病情较重。治疗方法与成人相同，但更应当寻求儿科专科医生的诊治。薛氏的治疗方法，不可完全照搬遵循。
换肌消毒散（又名草薢散）：治疗杨梅疮，无论是初发还是日久，都有效。
药材组成：土茯苓（即萆薢）、当归、白芷、甘草、皂角刺、薏苡仁、白鲜皮、木瓜（注意不要接触铁器）。以上各药等分。
用法：以上药材，加水煎煮，饭前空腹服用。
又一方：这是治疗成人的方剂。如果使用前一方无效，或者患儿年龄较大，适宜使用此方。
药材组成：土茯苓（五钱）、当归、白芷、皂角刺（炒制）、薏苡仁（各一钱）、白鲜皮、木瓜（注意不要接触铁器）、木通、金银花（各七分）、甘草、连翘、防风（各五分）、茯苓、芍药（各一钱，炒制）、黄芪（炒制，二钱）、川芎、生地黄（各八分）。
用法：以上药材，制成两到三剂的量，加水煎煮取汁。年幼患儿将一剂药煎好，分两三次服用。
[Xue Ji] Yangmei chuang (Syphilis) is a seasonal toxic pathogen prevalent in the environment. It can also be contracted through transmission or acquired congenitally. The pathology resides in the Liver, thus it often originates from the lower body. If treatment is inappropriate, it may lead to erosion and damage of the eyes, corruption of the penis, and flexion contracture of the limbs and joints. At the initial stage, if symptoms are predominantly on the upper body, Jingfang Baidu San (Atractylodes and Saposhnikovia Decoction to Relieve Toxicity) should be used first. If symptoms are predominantly on the lower body, Longdan Xiegan Tang (Gentian Liver-Draining Decoction) should be used first. For cases with constipation, Dalianqiao Yin (Large Forsythia Drink) is used, followed by Huanji Xiaodu San (Skin-Rejuvenating and Toxin-Clearing Powder). If there is erosion and damage to the eyes, Jiuwei Lushui Wan (Nine-Ingredient Aloe Pill) and Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill) are used concurrently. For flexion contracture of the limbs and joints, Juanbi Jiedu Tang (Bi-Syndrome-Dispelling and Toxin-Clearing Decoction) is used concurrently. If the condition fails to heal due to Spleen and Stomach deficiency, Yigong San (Extraordinary Assistance Powder) is used first, followed by Huanji Xiaodu San (Skin-Rejuvenating and Toxin-Clearing Powder). The use of Qinfen (Calomel) often leads to deterioration into a terminal syndrome.
Commentary: Yangmei chuang (Syphilis) emerged in recent times, mostly caused by transmission through sexual contact between men and unclean women. In children, infection via nursing and holding is mild, whereas inheritance from parents (congenital transmission) is severe. The treatment methods are the same as for adults, but consultation with pediatric specialists is necessary. Xue’s treatment methods should not be blindly followed entirely.
Huanji Xiaodu San (Skin-Rejuvenating and Toxin-Clearing Powder), also known as Caojie San: Treats Yangmei chuang (Syphilis), effective regardless of whether it is newly onset or chronic.
Ingredients: Tufuling (Smilax Glabrae Rhizoma, i.e., Bibi), Danggui (Angelicae Sinensis Radix), Baizhi (Angelicae Dahuricae Radix), Gancao (Glycyrrhizae Radix et Rhizoma), Zaojiaoci (Gleditsiae Spina), Yiyiren (Coicis Semen), Baixianpi (Dictamni Cortex), Mugua (Chaenomelis Fructus). Note: Do not use iron utensils for Mugua. All ingredients in equal proportions.
Preparation and Administration: Decoct with water. Take before meals on an empty stomach.
Another Prescription: This is a formula for adults. If the previous prescription is ineffective, or if the child has grown older, this prescription is suitable.
Ingredients: Tufuling (Smilax Glabrae Rhizoma, 5 qian), Danggui (Angelicae Sinensis Radix), Baizhi (Angelicae Dahuricae Radix), Zaojiaoci (Gleditsiae Spina, stir-fried, 1 qian each), Yiyiren (Coicis Semen, 1 qian), Baixianpi (Dictamni Cortex), Mugua (Chaenomelis Fructus, do not use iron utensils), Mutong (Akebiae Caulis), Jinyinhua (Lonicerae Japonicae Flos, 7 fen each), Gancao (Glycyrrhizae Radix et Rhizoma), Lianqiao (Forsythiae Fructus), Fangfeng (Saposhnikoviae Radix, 5 fen each), Fuling (Poria), Shaoyao (Paeoniae Radix, stir-fried, 1 qian each), Huangqi (Astragali Radix, stir-fried, 2 qian), Chuanxiong (Ligustici Chuanxiong Rhizoma), Shengdihuang (Rehmanniae Radix, 8 fen each).
Preparation and Administration: Prepare two to three doses. Decoct with water. For young children, decoct one dose at a time and divide into two or three servings.