痈疽证治已详疡医准绳，其在小儿，虽肌体柔脆，而天真未凿，鲜五发之毒，
亦无五善七恶之诊，初生周 前后，遍体生疮，俗忌疗治，其他小小痈疖，自可敷
贴而消，若憎寒壮热，沉困躁扰，为心腹之害，又当求其本而治之，乳下婴儿，母
子俱服，是在医师神而明之，无按图索骥之理，薛氏乃掇大科痈疽证治，赘附《保
婴》，近于骈拇枝指矣，若夫溯流穷源，明经络，分表里，审顺逆，则无大小之异，
有专科书在，又何赘焉。今第以小儿所专者集为是编，以至危且急，杀人顷刻，莫
如丹毒，故首列之，且独加详焉。
〔郑〕夫疮疡，皆因脏腑不调，经络壅滞而得，或由胎毒，或者风化为虫，或则
热气有盛，或者惊入皮肤，其大者是滞于血脉而横出于皮肤之间，若节其气血则易
破，若或风缠，则生瘾轸，或者外邪所入，即多KT 痒而不定，其食毒则滞死其血气，
久则化为脓也。或作惊疮者，惊本无物，亦蹉其血气，在脏而为积，在腑故出皮肤
为疮，发遍身而四肢难较。风疮，亦发遍身，其形甚小，世呼为疥热毒疮，发
处不定，节滞其血，故作疮虫窠，疮常发于胫后作其窠，窠内有虫如虮子，盖因腹
中蛲虫随气而化，其疮即较而再发，或片子如癣相似，甚有死血痒，若以药敷较，
只是归腹中，须是取却虫方瘥，及与杀虫药。
〔曾〕《内经》曰∶诸痛痒疮疡，皆属心火。火郁内发，致有斯疾，盖心主乎血，
血热生风，热郁内甚，递相传袭，故火能生土，血注阳明主肌肉，风热与血热相搏，
发见皮肤，其名不一，有黄脓而白者，土生金，母归子也，始生微痒而热轻，肿痛
溃烂为热极，血凝化水，气滞成脓，甚至寒热作而饮食减，尤为可虑，宜宣泄风毒，
凉心经，解胃热，用当归散加黄连、升麻、干葛，水姜葱灯心煎服，及三解散、牛
蒡汤、木通散，虽服，涂以四黄散、一抹金。
当归散（潮热） 三解散（惊） 牛蒡汤（咽喉） 木通散（淋）
四黄散 治小儿身上一切热毒疮疾燥痒，抓破有汁不干。
净黄连 黄柏 黄芩 大黄 滑石（五味各半两） 五倍子（去虫屑，二钱半）
上锉、晒，为末。用清油和调二钱至三钱，涂搽患处。仍服四顺散、消毒饮。
一抹金 治小儿遍身生疮，溃烂如糜梨，燥痛，脓汁不干。
藜芦（净洗，焙） 蛇床子（去埃土） 红丹（水飞过。三味各五钱） 硫黄 赤石脂 明白矾（火飞过）
五倍子（去虫屑） 黄柏（去粗皮。五味二钱半） 轻粉（五十帖）
上，前八味或晒或焙，为末，仍同轻粉在乳钵再杵匀，用生肥猪膏碎切，以瓦
钵和药末烂杵。涂抹患处，或清油调搽亦可。
〔汤〕小儿血气凝滞，而有热毒之气乘之，故结聚成痈疖肿毒也，未结之先，微见
有红头 子、隐起作疼者，急用不语唾、夜半频频涂之（饮酒了不可用）即消散。若已结成，
当用天乌散贴方。若内显躁热不宁等证，即须内服漏芦散，真良方也，热甚者用青
解毒丸，四顺清凉饮加防风、连翘，玄参剂亦可服，五福化毒丹尤良，连翘汤可服，
青露散掩之留小孔，后用惊毒掩子收疮口。热甚者凉膈散亦可服。（方类列于后）
关于痈疽的证治，在《疡医准绳》中已有详细记载。对于小儿而言，虽然肌肤柔嫩脆弱，但天真未失，极少发生“五发”之毒，也没有“五善七恶”的诊断指征。在出生前后，若遍体生疮，世俗忌讳治疗；其他小的痈疖，自然可以通过敷贴消除。如果出现憎寒壮热、神志沉困躁扰等症状，这是心腹内部的危害，应当探求根本原因进行治疗。对于哺乳期的婴儿，母子应共同服药，这取决于医师的神妙明察，不能机械地按图索骥。薛氏（薛己）只是摘录了成人科痈疽的证治，附加在《保婴撮要》中，这就像多余的脚趾和树枝一样累赘。如果追溯本源，明了经络，分辨表里，审察顺逆，那么无论大小疾病都没有区别，因为有专科书籍存在，又何必赘述呢？现在仅将小儿特有的病症汇编成此篇，其中最为危急且迅速致人死亡的，莫过于丹毒，所以首先列出，并且单独加以详述。
〔郑〕认为：疮疡，都是由于脏腑不调、经络壅滞而形成的，有的源于胎毒，有的由风邪化为虫，有的则是热气过盛，或者是惊邪侵入皮肤。大的疮疡是气血滞留在血脉中，横溢于皮肤之间，如果节制其气血则容易破溃；如果被风邪缠绕，则会产生瘾疹（荨麻疹样皮疹）；如果是外邪侵入，往往多表现为瘙痒且部位不定；食毒则会使血气停滞死亡，时间久了会化为脓液。有的称为惊疮，惊本身没有实质之物，但也耗损血气，在脏则为积聚，在腑则出于皮肤成为疮疡，发作遍布全身而四肢难以痊愈。风疮也发作于全身，形态很小，世人称之为疥。热毒疮发作部位不定，阻滞血液，因此形成疮窠（疮疡基底），疮常发生在小腿后侧形成窠，窠内有如虮子般的虫，这是因为腹中的蛲虫随气机变化所致，疮愈合后再发，或者像癣片一样，甚至有死血引起的瘙痒，如果用药物敷贴止痒，毒素只会回归腹部，必须去除虫子才能痊愈，并服用杀虫药。
〔曾〕引用《内经》说：各种疼痛、瘙痒、疮疡，都属于心火。火郁结在内而发作，导致这种疾病，因为心主血，血热生风，热郁结在内很严重，依次传变侵袭，所以火能生土，血注于阳明经（主肌肉），风热与血热相互搏结，发见于皮肤，名称不一。有黄脓带白色的，是土生金，母归子的关系，开始微痒而热轻，肿痛溃烂则是热极，血凝化水，气滞成脓，甚至出现寒热往来而饮食减少，尤其令人担忧。适宜宣泄风毒，清心经，解胃热，使用当归散加黄连、升麻、干葛，用水、姜、葱、灯心草煎服，以及三解散、牛蒡汤、木通散，虽然内服，外用涂抹四黄散、一抹金。
当归散（主治潮热） 三解散（主治惊风） 牛蒡汤（主治咽喉病） 木通散（主治淋证）
四黄散：治疗小儿身上一切热毒疮疾燥痒，抓破后有汁液不干。
净黄连、黄柏、黄芩、大黄、滑石（五味各半两），五倍子（去虫屑，二钱半）。
以上切碎、晒干，研为末。用清油和调二钱至三钱，涂搽患处。同时服用四顺散、消毒饮。
一抹金：治疗小儿遍身生疮，溃烂如糜烂的梨肉，干燥疼痛，脓汁不干。
藜芦（洗净，焙干）、蛇床子（去埃土）、红丹（水飞。三味各五钱）、硫黄、赤石脂、明白矾（火飞）、五倍子（去虫屑）、黄柏（去粗皮。五味各二钱半）、轻粉（五十帖的量）。
以上前八味或晒或焙，研为末，再同轻粉在乳钵中杵匀，用生肥猪膏切碎，以瓦钵和药末烂杵。涂抹患处，或用清油调搽也可以。
〔汤〕认为：小儿血气凝滞，而有热毒之气乘虚而入，所以结聚成痈疖肿毒。在未结聚之前，微微见到有红头的小疙瘩、隐起作疼的，急用无言语者的唾液、半夜时分频频涂之（饮酒者不可用），即可消散。如果已经结成，应当用天乌散贴敷。如果内部显现躁热不宁等证候，就必须内服漏芦散，真是良方，热甚的用青解毒丸，四顺清凉饮加防风、连翘，玄参剂也可以服用，五福化毒丹尤其好，连翘汤可以服用，青露散掩之留小孔，后用惊毒掩子收口。热甚的也可以服用凉膈散。（方剂类别列在后面）
Regarding the syndrome and treatment of carbuncles and ulcers, it has been detailed in *Yangyi Zhunsheng*. For infants and children, although their flesh and skin are tender and fragile, their innate purity is intact, and they rarely suffer from the "Five Emergencies" (Wu Fa) toxins, nor do they present with the diagnostic signs of "Five Auspicious and Seven Inauspicious" conditions. Around the time of birth, if sores appear all over the body, folk custom forbids treatment; other minor boils and furuncles can naturally be resolved by external application. However, if symptoms such as aversion to cold with high fever, lethargy, restlessness, and agitation occur, these indicate internal harm to the heart and abdomen, and one must seek the root cause to treat them. For breastfeeding infants, both mother and child should take medicine together; this depends on the physician's divine insight and understanding, rather than mechanically following a guide. Xue Shi (Xue Ji) merely excerpted the syndrome and treatment of adult carbuncles and ulcers and appended it to *Baoying*, which is like adding superfluous toes or branches. If one traces the source, understands the meridians, distinguishes exterior and interior, and assesses favorable and unfavorable prognoses, there is no difference between diseases of adults and children, as specialized books exist, making further elaboration unnecessary. Here, we only compile those conditions specific to infants and children. Among them, nothing is more critical and rapidly fatal than erysipelas (Dan Du); therefore, it is listed first and treated in detail.
[Zheng] states: Carbuncles and ulcers arise from disharmony of the Zang-Fu organs and stagnation of the meridians. They may stem from fetal toxins, wind transforming into parasites, excessive heat, or fright invading the skin. Large lesions result from blood and qi stagnating in the vessels and overflowing into the skin; if blood and qi are regulated, they rupture easily. If entangled by wind, urticaria-like rashes (Yin Zhen) develop. If invaded by external pathogens, itching occurs at unpredictable sites. Food toxicity causes stagnation and death of blood and qi, eventually turning into pus over time. Some are called "Fright Sores"; fright itself has no physical substance but consumes blood and qi. In the Zang organs, it forms accumulations; in the Fu organs, it emerges on the skin as sores, spreading over the whole body but difficult to heal in the limbs. Wind sores also spread over the body, appearing very small, commonly known as scabies (Jie). Heat-toxin sores appear at variable sites, blocking blood flow, thus forming sore nests (Ke). These often appear behind the calves, containing lice-like parasites within the nest, caused by pinworms in the abdomen transforming with the Qi. The sores heal and recur, resembling tinea patches, or causing severe itching due to stagnant blood. Applying medication to stop itching only drives the toxin back to the abdomen; healing requires removing the parasites and administering anti-parasitic drugs.
[Zeng] cites the *Neijing*: "All pain, itching, and carbuncles belong to Heart Fire." When fire is constrained internally and erupts, this disease arises. Since the Heart governs blood, blood heat generates wind. Severe internal heat constraint transmits sequentially. Fire generates Earth; blood flows into the Yangming meridian (which governs muscles). Wind-heat and blood heat contend, manifesting on the skin under various names. Some have yellow pus with white color, representing Earth generating Metal (Mother returning to Child), starting with mild itching and light heat. Severe swelling, pain, and ulceration indicate extreme heat. Blood coagulates and transforms into water; Qi stagnation forms pus. Even chills and fever with reduced appetite are particularly concerning. It is appropriate to vent wind-toxin, cool the Heart meridian, and resolve Stomach heat. Use Danggui San (Angelica Decoction) added with Huanglian (Coptis Rhizome), Shengma (Cimicifugae Rhizome), and Genge (Puerariae Radix), decocted with water, ginger, green onion, and Jiaoxin (Nymphcae Nelumbinis Plumule). Also consider Sanjie San (Three-Unbinding Powder), Niubang Tang (Arctii Decoction), and Mutong San (Akebia Decoction). While taking these internally, apply Sihuang San (Four-Yellows Powder) and Yimojin (One Stroke of Gold) externally.
Danggui San (for tidal fever) | Sanjie San (for fright) | Niubang Tang (for throat disorders) | Mutong San (for strangury)
Sihuang San: Treats all heat-toxin sores and dry itching on the infant's body, where broken skin oozes fluid that does not dry.
Pure Huanglian (Coptidis Rhizoma), Huangbai (Phellodendri Cortex), Huangqin (Scutellariae Radix), Dahuang (Rhei Radix et Rhizoma), Huashi (Talcum) (each half liang), Wubeizi (Galla Chinensis) (free of insect debris, two qian and half).
Crush, sun-dry, and powder. Mix two to three qian with refined sesame oil, and apply to the affected area. Concurrently administer Sishun San (Four-Harmonizing Powder) and Xiaodu Yin (Detoxifying Decoction).
Yimojin: Treats widespread sores on the infant's body, ulcerated like rotting pear flesh, with dry pain and non-drying pus.
Lilu (Veratri Viridis Rhizoma) (cleaned, baked), Shechuangzi (Cnidii Fructus) (free of dust), Hongdan (Minium) (water-purified; each five qian for these three), Liuhuang (Sulfur), Chishizhi (Halloysit Rubrum), Mingfan (Alumen) (fire-purified), Wubeizi (Galla Chinensis) (free of insect debris), Huangbai (Phellodendri Cortex) (bark removed; each two qian and half for these five), Qingfen (Calomelas) (amount for fifty patches).
The first eight ingredients are either sun-dried or baked and powdered. Grind uniformly with Calomelas in a mortar. Chop fresh fat pork suet finely, mix with the powder in a clay mortar until smooth. Apply to the lesion, or mix with refined sesame oil for application.
[Tang] states: Infants' blood and qi stagnate, allowing heat-toxin qi to invade, resulting in clustered boils, furuncles, and swellings. Before clustering, slight red-headed papules or tender, raised bumps may appear. Immediately apply saliva from a mute person frequently at midnight (do not use if the patient has consumed alcohol) to dissipate them. If already formed, apply Tianwu San (Heavenly Black Powder). If internal signs of restlessness and heat appear, internally administer Loulu San (Euphorbiae Fissae Radix Decoction), which is an excellent formula. For severe heat, use Qingjiedu Wan (Green Detoxification Pill), Sishun Qingliang Yin (Four-Harmonizing Cooling Drink) added with Fangfeng (Saposhnikoviae Radix) and Lianqiao (Forsythiae Fructus), or Xuanshen Ji (Scrophulariae Radix Preparation). Wufu Huadu Dan (Five-Blessings Detoxification Pill) is particularly good; Lianqiao Tang (Forsythiae Decoction) can be taken. Cover with Qinglu San (Green Dew Powder), leaving a small opening, and later use Jingdu Yanzi to close the wound. For severe heat, Liangge San (Cooling Diaphragm Powder) can also be used. (Formulas are listed below.)