受胎七月，其形已成，食母秽液入儿五脏，至十
月满胃脘中；生时口中有不洁，以手拭净则无疾病，以黄连汁压之，乃下脐粪及秽液也（云云）。内一脏
受秽，乃出疮疹，疮疹未出，五脏皆见病症。初欲病时，先呵欠、烦闷，肝也；时发惊悸，心也；乍凉
乍热，手足冷，脾也；面赤，腮颊赤，嗽嚏，肺也；惟肾在脏腑下，
不能食秽，故无候也。凡五脏毒，若去归一症，肝则水 ，肺脓 ，心斑，脾疹，惟肾无症。疮黑属肾，由
不慎或内虚也，用抱龙丸数服愈，以其别无他候故也。又疮疹因小儿真气既盛，正气既旺，邪无所客，故是
以或因寒之伤表，或伤里，斑由是生焉！中外皆和，其斑自出。至于未显时，外伤者，升麻汤主之；内伤者，
枳术丸；若伤冷湿，神应丸；恶寒者，宜防风苍术汤发之，表大热者，夺之。通言三阳，阳盛则必气上
行。大渴者，白虎汤；小渴者，凉膈散；大便秘结，桃仁承气汤下之。四顺饮子、柴胡饮子察其在气在血；
小便不通，导赤散、八正散之类，求上下二焦何经用
之；惊者，凉惊丸，重者泻青丸，泄者治分寒热，寒则异功散、四君子汤，热则泽泻茯苓汤。已显斑症
出皮肤时，如出不快，化斑汤；出太多，犀角地黄汤、地骨皮鼠粘子汤、咽喉不利，甘桔粘子汤；烦者，
甘桔栀子杨；肺不利，紫草茸甘草枳壳汤；太阳出不快，荆芥甘草防风汤；四肢出不快，防风芍药甘草
汤。或发不透、倒靥黑陷，极为利害，紫草、木通、甘草、枳壳、黄 等分服之。斑疹遗毒，或肝虚入眼，
或肺虚为疥癣，或为痈疖，发在骨节肾虚也，发在肌肉脾虚也，或在筋，或在头面，或齿疳蚀、咽喉肿痛，
各随本经而见，皆毒蕴积而成，由其始不早治，或医者之失时也。斑疹脓不焦，此末治失清凉也，察何经而
凉之；或下之而成大肃之气，则必不致脓而不痂矣！斑疹，以疮发 肿于外，属少阳三焦相火，谓之斑；
以靥行于皮肤之中不出者，属少阴，谓之疹（云云）。东垣谓太阳寒水起于右肾之下，煎熬左肾，足太阳
膀胱寒水夹脊逆流上头下额，逆手太阳丙丁火不得传道，逆于面上故显面赤诸症。盖壬癸水克丙丁也，斑症
皆从寒水逆流
而作。夫胞者，一名赤宫，一名丹田，一名命门，主男子藏精施化，女人系胞受胎，俱是化生之原，非
五行也，非水亦非火，天地之异名，象坤土之生万物。
夫人始生，血海始净，一日二日，精胜其血则为男子；三日四日，血海已旺，精不胜血则为女子。
乃二物相抟，常先身生谓之神，又谓之精，释道以为本来面目是也。其子在母腹中，十月之间，随母呼吸，
母呼亦呼，母吸亦吸者，阳气也，而主动作，滋益精气神，饥渴食饮母血，儿随日长，皮肉筋骨形气
血脉俱足，十月降生，口中尚有恶秽，啼声一发，随吸而下，复归命门胞中，僻于一隅，伏而不发，直至
内伤乳食，湿热之气下流合于肾中，二火交战，营气不从，逆于肉里，恶血乃散发。诸斑疮皆出于膀胱壬
水，其疡溃后，坏肉里归于阳明，此皆从足太阳传变中来。当外发寒邪使令消散，内泻二火不令交攻，其
中又令湿气上归，复其本位，可一二服立已，曰消毒救苦汤。又谓斑疹皆营气逆而寒覆其表，宜以四味升麻
汤加归身、连翘；如肺成脓，斑先显，喘嗽，或气高而喘促，
加人参、黄芩以泻伏火而补元气；如心出小红斑，先血溢、惊悸，加黄连；如命门出瘾疹，先必骨疼身热。
其痛不敢动摇，少加生地黄、黄柏。诸疹先因乳食伤，脾胃不足，营气逆行，虽火势内炽，阴覆其表，
以四味升麻汤发之随妥，皆本仲景分经络，辨气血，定表里，如伤寒而用耳！戴人谓疮疹从胎毒而出者，
三焦少阳相火为也，症发与伤寒兼行，必先发热恶寒，头项痛，腰脊强，从太阳传至四、五日始发，
先从两胁下有之，次及身表，渐及四肢。经曰∶少阳客胜，丹 外发；谓痛疮痒，皆属心火。岂有寒乎？
初头痛，身热恶寒，此发疮 之候，脉皆浮大有力；亦与伤寒、时气、惊风、宿乳一概难辨。宜先解之，
有二法∶亢阳炎热之时，以辛凉解之；久寒凝冽之时，以辛温解之。辛凉，凉膈、通圣散之类，辛温，升麻
葛根之类。二法之后，次以白虎加人参，冷服之勿辍，盖防疮疹发喘，人参止喘，四时皆宜，用以救肺金
受火邪致不足也。或出不匀，大小不齐，以蝉壳烧灰，淡酒调服，不半日即匀，或用百祥丸、柴甘饮子皆
可，服至六七日疮疹出全，可用调胃凉膈下之。每治黑陷腹内，喘乏死病者，白虎加人参，凉膈加当归、桔
梗，连进数服，使卧凉处，以凉水灌其面目手足，使循经而入，如醉而
醒，是亦开结散郁之端，如此救活甚多。宋陈文中以疮疹发迟倒陷等病，用木香散、异功散。大热发之，
岂宜例用？诸说不同，钱氏谓内外所伤；感其胎毒为当，李氏谓皆因内伤者，不若钱氏以先微寒入而成疮
疹之一语为该内外也。治是症者，果二火热盛，泻之分气血表里，辨时令寒热、禀质壮怯、病状轻重，随
宜用药，初无执一之说。此篇所叙举其大概耳！其祥非笔舌可尽。
受孕七月，胎儿形体已经形成，母体的秽浊液体进入胎儿的五脏，到十月胎满时充满胃脘；出生时口中会有不洁之物，用手擦拭干净则无疾病，若用黄连汁压迫舌根，则会排出脐粪及秽浊液体（云云）。内脏中有一脏受秽浊之气影响，就会发出疮疹，在疮疹未发出之前，五脏都会表现出病症。刚开始生病时，先出现呵欠、烦闷，这是肝的病变；时常发生惊悸，这是心的病变；忽冷忽热，手脚发凉，这是脾的病变；面色红赤，腮颊红赤，咳嗽喷嚏，这是肺的病变；只有肾位于脏腑下方，不能食用秽浊之物，所以没有特定的征候。凡是五脏的毒邪，如果归结为一种症状，肝表现为水疱，肺表现为脓疱，心表现为斑，脾表现为疹，只有肾没有症状。疮色黑属肾，是由于不慎或体内虚弱所致，服用几剂抱龙丸即可痊愈，因为它没有其他兼症。另外，疮疹是因为小儿真气旺盛，正气强盛，邪气无法停留，所以或因寒邪伤表，或伤里，斑由此产生！内外调和，斑自然发出。至于尚未显现时，外感伤的，用升麻汤主治；内伤的，用枳术丸；若伤于冷湿，用神应丸；恶寒的，宜用防风苍术汤发散；表证大热的，用攻下法清除。通说三阳经，阳气盛则必然气上行。大渴的，用白虎汤；小渴的，用凉膈散；大便秘结的，用桃仁承气汤攻下。四顺饮子、柴胡饮子要察看在气分还是在血分；小便不通的，用导赤散、八正散之类，探究上焦和下焦哪条经络适用；受惊的，用凉惊丸，重的用泻青丸，腹泻的要分辨寒热，寒的用异功散、四君子汤，热的用泽泻茯苓汤。当斑症已显，发出皮肤时，如发出不畅，用化斑汤；发出太多，用犀角地黄汤、地骨皮鼠粘子汤；咽喉不利，用甘桔粘子汤；烦躁的，用甘桔栀子杨；肺气不利的，用紫草茸甘草枳壳汤；太阳经发出不畅，用荆芥甘草防风汤；四肢发出不畅，用防风芍药甘草汤。或者发不透、倒靥黑陷，极为严重，用紫草、木通、甘草、枳壳、黄芩等量服用。斑疹遗留的毒邪，或肝虚入眼，或肺虚导致疥癣，或成为痈疖，发在骨节是肾虚，发在肌肉是脾虚，或在筋，或在头面，或齿疳蚀、咽喉肿痛，各随本经而表现，都是毒邪蕴积而成，由于开始没有早治，或医生延误了时机。斑疹脓液不焦枯，这是治疗末期失于清凉，察看是哪条经络而予以清凉；或者攻下后形成肃杀之气，那么必然不会化脓而不结痂了！斑疹，以疮发肿于外，属少阳三焦相火，称为斑；以靥行于皮肤之中不出者，属少阴，称为疹（云云）。李东垣认为太阳寒水起于右肾之下，煎熬左肾，足太阳膀胱寒水夹脊逆流上头下额，逆手太阳丙丁火不得传道，逆于面上故显面赤诸症。盖壬癸水克丙丁也，斑症皆从寒水逆流而作。胞宫，一名赤宫，一名丹田，一名命门，主男子藏精施化，女人系胞受胎，俱是化生之源，非五行，非水亦非火，是天地之异名，象坤土之生万物。人刚出生时，血海始净，一日二日，精胜其血则为男子；三日四日，血海已旺，精不胜血则为女子。乃二物相抟，常先身生谓之神，又谓之精，释道以为本来面目是也。其在母腹中，十月之间，随母呼吸，母呼亦呼，母吸亦吸者，阳气也，而主动作，滋益精气神，饥渴食饮母血，儿随日长，皮肉筋骨形气血脉俱足，十月降生，口中尚有恶秽，啼声一发，随吸而下，复归命门胞中，僻于一隅，伏而不发，直至内伤乳食，湿热之气下流合于肾中，二火交战，营气不从，逆于肉里，恶血乃散发。诸斑疮皆出于膀胱壬水，其疡溃后，坏肉里归于阳明，此皆从足太阳传变中来。当外发寒邪使令消散，内泻二火不令交攻，其中又令湿气上归，复其本位，可一二服立已，曰消毒救苦汤。又谓斑疹皆营气逆而寒覆其表，宜以四味升麻汤加当归身、连翘；如肺成脓，斑先显，喘嗽，或气高而喘促，加人参、黄芩以泻伏火而补元气；如心出小红斑，先血溢、惊悸，加黄连；如命门出瘾疹，先必骨疼身热。其痛不敢动摇，少加生地黄、黄柏。诸疹先因乳食伤，脾胃不足，营气逆行，虽火势内炽，阴覆其表，以四味升麻汤发之随妥，皆本仲景分经络，辨气血，定表里，如伤寒而用耳！戴元礼认为疮疹从胎毒而出者，三焦少阳相火为也，症发与伤寒兼行，必先发热恶寒，头项痛，腰脊强，从太阳传至四、五日始发，先从两胁下有之，次及身表，渐及四肢。经曰∶少阳客胜，丹熛外发；谓痛疮痒，皆属心火。岂有寒乎？初头痛，身热恶寒，此发疮痘之候，脉皆浮大有力；亦与伤寒、时气、惊风、宿乳一概难辨。宜先解之，有二法∶亢阳炎热之时，以辛凉解之；久寒凝冽之时，以辛温解之。辛凉，凉膈、通圣散之类，辛温，升麻葛根之类。二法之后，次以白虎加人参，冷服之勿辍，盖防疮疹发喘，人参止喘，四时皆宜，用以救肺金受火邪致不足也。或出不匀，大小不齐，以蝉壳烧灰，淡酒调服，不半日即匀，或用百祥丸、柴甘饮子皆可，服至六七日疮疹出全，可用调胃凉膈下之。每治黑陷腹内，喘乏死病者，白虎加人参，凉膈加当归、桔梗，连进数服，使卧凉处，以凉水灌其面目手足，使循经而入，如醉而醒，是亦开结散郁之端，如此救活甚多。宋陈文中以疮疹发迟倒陷等病，用木香散、异功散。大热发之，岂宜例用？诸说不同，钱氏谓内外所伤；感其胎毒为当，李氏谓皆因内伤者，不若钱氏以先微寒入而成疮疹之一语为该内外也。治是症者，果二火热盛，泻之分气血表里，辨时令寒热、禀质壮怯、病状轻重，随宜用药，初无执一之说。此篇所叙举其大概耳！其详非笔舌可尽。
At seven months of gestation, the fetus's form is already established; maternal turbid fluids enter the five zang organs, filling the stomach and epigastrium by the tenth month. At birth, there is unclean matter in the mouth; if wiped clean by hand, no disease occurs. If pressed with *Coptidis Rhizoma* (Huanglian) juice, umbilical feces and turbid fluids are discharged (etc.). If internal organs are contaminated by turbidity, sores and rashes erupt. Before eruption, all five zang organs manifest symptoms. Initially, yawning and restlessness indicate the Liver; frequent palpitations and fright indicate the Heart; alternating cold and heat with cold extremities indicate the Spleen; facial redness, malar flush, coughing, and sneezing indicate the Lung. Only the Kidney, located inferiorly, does not ingest turbidity, thus having no specific signs. Regarding toxins of the five zang organs converging into one syndrome: Liver manifests as vesicles, Lung as pustules, Heart as macules, Spleen as papules, while the Kidney has no manifestation. Black sores belong to the Kidney, caused by imprudence or internal deficiency; taking several doses of *Baolong Wan* (Dragon Embracing Pill) cures it, as there are no other accompanying signs. Furthermore, sores and rashes arise because the child's true qi is robust and righteous qi is vigorous, leaving no room for pathogens. Thus, whether injured by cold on the exterior or interior, macules arise from this! When interior and exterior are harmonious, macules emerge spontaneously. Before manifestation, for external injury, *Shengma Tang* (Cimicifugae Decoction) is indicated; for internal injury, *Zhizhu Wan* (Atractylodis and Immature Bitter Orange Pill); for cold-damp injury, *Shenyin Wan*; for aversion to cold, *Fangfeng Cangzhu Tang* (Saposhnikoviae and Atractylodis Macrocephalae Decoction) to induce sweating; for intense exterior heat, use purgation. Generally speaking regarding the three yang meridians, excess yang causes qi to ascend. For severe thirst, *Baihu Tang* (White Tiger Decoction); for mild thirst, *Liangge San* (Cool the Diaphragm Powder); for severe constipation, *Taoren Chengqi Tang* (Peach Kernel and Rheum Decoction) to purge. *Sishun Yinzi* and *Chaihu Yinzi* require differentiation between qi and blood levels; for urinary obstruction, *Daochi San* or *Bazheng San*, investigating which meridian of the upper or lower jiao applies; for fright, *Liangjing Wan* (Cool Fright Pill), severe cases *Xieqing Wan* (Drain Green Pill); for diarrhea, differentiate cold and heat—cold uses *Yigong San* and *Sijunzi Tang* (Four Gentlemen Decoction), heat uses *Zexie Fuling Tang*. When macules visibly appear on the skin but fail to erupt smoothly, *Huaban Tang* (Transform Macules Decoction) is used; if too many erupt, *Xijiao Dihuang Tang* (Rhinoceros Horn and Rehmannia Decoction) or *Digupi Niuzibangzi Tang*; for throat obstruction, *Ganjie Niuzibangzi Tang*; for irritability, *Ganjie Zhizi Yang*; for lung obstruction, *Zicao Rong Gancao Zhike Tang*; for sluggish eruption via the Taiyang channel, *Jingjie Gancao Fangfeng Tang*; for sluggish eruption in limbs, *Fangfeng Shaoyao Gancao Tang*. If eruption is incomplete, or if lesions invert and turn black—a critical condition—equal parts of *Zicao* (Arnebiae Radix et Rhizoma), *Mutong* (Akebiae Caulis), *Gancao* (Glycyrrhizae Radix et Rhizoma), *Zhike* (Aurantii Fructus Immaturus), and *Huangqin* (Scutellariae Radix) are taken. Residual toxins from sores and rashes may invade the eyes due to Liver deficiency, cause tinea due to Lung deficiency, or lead to carbuncles and furuncles. Eruptions at bone joints indicate Kidney deficiency; at muscles, Spleen deficiency; at sinews, head/face, gum erosion, or throat swelling/pain, each follows its respective meridian. All result from accumulated toxin due to delayed treatment or medical error. Non-crusting pus indicates failure to apply cooling therapy late in the course; identify the meridian and cool it. Purging may create a desiccating qi, preventing pus formation and crusting. Sores and rashes swelling externally belong to the Shaoyang Sanjiao Ministerial Fire, termed "macules" (ban); those remaining within the skin without emerging belong to the Shaoyin, termed "rashes" (zhen). Li Dongyuan stated that Taiyang Cold Water originates below the right kidney, boiling the left kidney. Foot-Taiyang Bladder cold water flows up along the spine to the head and forehead, obstructing Hand-Taiyang Bing-Ding Fire transmission, causing facial redness. This reflects Ren-Gui Water overcoming Bing-Ding Fire; macules arise from cold water counter-flow. The Bao Palace, also called Red Palace, Dantian, or Mingmen, stores essence in men and governs conception in women. It is the source of transformation, not part of the Five Elements, neither water nor fire, but a name for Heaven and Earth, symbolizing Kun Earth generating all things. At conception, the Blood Sea is pure. Days 1-2: Essence exceeds blood, forming male. Days 3-4: Blood Sea prospers, blood exceeds essence, forming female. These two combine; what precedes the body is called Spirit (Shen) or Essence (Jing), interpreted by Buddhists and Daoists as original nature. During the ten months in the womb, the fetus breathes with the mother, inhaling and exhaling accordingly. This is Yang Qi, active, nourishing essence, qi, and spirit. Feeding on maternal blood, the fetus grows until full term. Upon birth, foul matter remains in the mouth; the first cry triggers inhalation, drawing it down to return to the Mingmen/Bao Palace, where it lies dormant until internal injury from milk/food causes damp-heat to flow downward into the Kidney. The two fires clash, Ying Qi rebels, stagnates in the flesh, and evil blood disperses. All sores originate from Bladder Ren Water; after ulceration, necrotic tissue returns to Yangming. This progression stems from Foot-Taiyang transmission. External cold should be dispersed; internal dual-fire should be purged to prevent conflict; dampness should be guided upward to restore its position. One or two doses of *Xiaodu Jiuku Tang* (Detoxify and Save from Suffering Decoction) can cure it immediately. Others state sores/rashes involve rebellious Ying Qi covered by cold; treat with *Siwei Shengma Tang* (Four-Ingredient Cimicifuga Decoction) plus *Danggui Shen* (Angelica Sinensis Root) and *Lianqiao* (Forsythiae Fructus). If Lung forms pus, macules appear first with wheezing/cough or rapid breathing, add *Renshen* (Ginseng Radix et Rhizoma) and *Huangqin* to drain latent fire and tonify Yuan Qi. If Heart shows small red macules with bleeding/fright, add *Huanglian* (Coptidis Rhizoma). If Mingmen shows urticaria with bone pain/fever and immobility, add small amounts of *Shengdihuang* (Rehmanniae Radix) and *Huangbai* (Phellodendri Cortex). Initial rash often stems from milk/food injury, Spleen/Stomach deficiency, and rebellious Ying Qi. Despite internal fire blazing and yin covering the exterior, *Siwei Shengma Tang* induces smooth eruption. This follows Zhang Zhongjing’s principles of differentiating meridians, qi/blood, and exterior/interior, akin to treating Cold Damage. Dai Ren argued sores/rashes from fetal toxin are driven by Shaoyang Sanjiao Ministerial Fire, presenting with fever, aversion to cold, headache, neck stiffness, and back rigidity, transmitting from Taiyang over 4-5 days, starting at hypochondrium, spreading to body and limbs. Classics state: Shaoyang guest excess causes erysipelas; pain, sores, itching belong to Heart Fire. Where is the cold? Initial headache, fever, aversion to cold are signs of sore eruption; pulse is floating, large, and forceful. Differentiation from Cold Damage, seasonal qi, fright wind, or retained milk is difficult. First, resolve the exterior using two methods: in hot weather, use acrid-cool resolution (e.g., *Liangge San*, *Tongsheng San*); in cold weather, use acrid-warm resolution (e.g., *Shengma Gegen Tang*). Afterwards, administer *Baihu Jia Renshen Tang* (White Tiger Plus Ginseng Decoction) cold continuously to prevent asthma; Ginseng stops asthma, suitable for all seasons to rescue Lung Metal from Fire damage. For uneven eruption, burn Cicada Slough, mix with light wine; uniformity returns within half a day. Alternatively, use *Baixiang Wan* or *Chaigan Yinzi*. By day 6-7, when eruptions are complete, use *Tiaowei Liangge San* to purge. For black inversion with abdominal distress, asthma, and impending death, use *Baihu Jia Renshen Tang* or *Liangge San* plus *Danggui* and *Jiegeng*, administered continuously. Place patient in cool area, pour cool water on face/hands/feet to guide medicine through meridians; awakening like from drunkenness opens blockages and dissipates depression, saving many lives. Song Dynasty Chen Wenzhong used *Muxiang San* and *Yigong San* for delayed or inverted eruptions. Using heat-inducing methods universally is inappropriate. Views differ. Qian Yi attributed it to internal/external injury and fetal toxin; Li Shi believed it was purely internal. Qian’s phrase "initial slight cold entering causes sores/rashes" better encompasses both. Treatment depends on determining if dual-fire is excessive, purging based on qi/blood/exterior/interior, considering season, constitution, and severity. There is no single rigid method. This chapter summarizes general principles; details exceed words.