叶、重加大青、少佐升麻、或加紫草、红花、或加桃仁、归尾。）此治温毒、热疫、
疹并发。及时行烂喉丹疹。出死入生之正法眼藏也。凡温热病发 疹。予每用俞氏透 解
毒汤加葛根石膏。若温毒热疫及烂喉痧。或发 疹。或发丹痧。皆主清瘟败毒饮加减。
二方皆屡投辄验。较之秦皇士透化 疹之升麻清胃汤。（升麻、鲜生地、丹皮、川连、
木通、生甘草、误食荤腥者、加山楂、砂仁。）奏功尤捷。独内 一证。最难诊察。特
述赵晴初《存存斋医》话一则。（荣斋按∶内 一则出自吴坤安伤寒指掌第三卷。赵氏也
是转载而来的。）时毒温疫。口鼻吸受。直行中道。邪伏募原。毒凝气滞。发为内 。
犹内痈之类。其证似躁非躁。耳热面红。目赤口干。手足指冷。或作寒噤。心烦气急。
不欲见火。恶闻人声。甚则昏不知人。郑声作笑。其脉短滑。其舌苔多
黄浊。中见黑点。或纯黑中见红点。或黑苔聚于中心。治宜宣通气血。解毒化 为主。
（银花、连翘、僵蚕、钩藤勾、紫花地丁、赤芍、丹皮、紫草、楂肉、人中黄等。）得
脉和神清。方为毒化 解。但其 发于肠胃嗌膈之间。肌肤间不得而见。往往不知为
证。而误治者多矣。此则俞氏所未备。节录之。以为临证之一助。
【荣斋按】本节俞氏所说，大致可分为阳证发 、阴证发 两类，何氏补出“内
”一则，是需要的。但尚有“伏 ”一证，也是伤寒发 中的一个重要证候，临床时也
常有看到，俞氏只在论脉条内讲起“脉伏而 亦伏”一语，对于症状和治法，却没有提
及；这是罅漏，应予补充，兹从吴坤安伤寒指掌录入，庶几比较完备。吴坤安说∶“凡
伤寒邪入太阴，脉静神呆，舌心灰黑，防有“伏 ”。或时感之症。过经不解，舌苔灰
黑，或舌心黑晕，肌表不甚发热，脉象亦似沉缓，但神识不清，或郑声作笑，此阳邪陷
入太阴，防有“伏 内发”；其脉静身凉，非邪退正复也，乃阳邪陷于阴分也。法宜宣
通气血，透提 毒，以实证治之；如连翘、赤芍、银花、紫草、生楂肉、槟榔、天虫、
刺蒺藜、犀角尖、角刺之类；透之提之， 疹外达，自然毒透神清。”廉臣先生对“透
”方法，另有一种经验，特介绍如下∶“温病发 之际，用清营透络，解毒化 而
仍不透，往往用攻下逐毒，腑气一通，而 始大透，伏邪从 而解者，亦常见之。”这
方法虽从吴又可书中得来，但通过经验家的实验，更值得我们珍视了。
（叶天士、重楼等医家，加大青叶、少量佐以升麻，或者加入紫草、红花，或者加入桃仁、当归尾。）这是治疗温毒、热疫、疹并发。以及时行烂喉丹疹。转危为安的正法眼藏啊。凡是温热病发疹。我每次使用俞氏透解毒汤加葛根石膏。如果是温毒热疫及烂喉痧。或者发疹。或者发丹痧。都主张用清瘟败毒饮加减。这两个方子都屡次投药立即见效。比起秦皇士透化疹的升麻清胃汤。（升麻、鲜生地、丹皮、川连、木通、生甘草、误食荤腥者、加山楂、砂仁。）奏效尤其快捷。唯独内陷这一证候。最难诊察。特别叙述赵晴初《存存斋医话》一则。（徐荣斋按：内陷一则是出自吴坤安《伤寒指掌》第三卷。赵氏也是转载而来的。）时毒温疫。口鼻吸入。直行中道。邪气伏于募原。毒凝气滞。发为内陷。如同内痈之类。其症状似躁动非躁动。耳热面红。目赤口干。手足指冷。或者出现寒战。心烦气急。不喜欢见火。厌恶听到人声。甚至昏迷不省人事。说胡话发笑。其脉短滑。其舌苔多黄浊。中间见到黑点。或者纯黑中见到红点。或者黑苔聚于中心。治疗应当宣通气血。解毒化陷为主。（银花、连翘、僵蚕、钩藤勾、紫花地丁、赤芍、丹皮、紫草、楂肉、人中黄等。）等到脉象平和神志清醒。才是毒化陷解。但是这种内陷发于肠胃嗌膈之间。肌肤间不得而见。往往不知道是内陷证。而误治的人很多了。这是俞氏所没有完备的。节录它。作为临证的一点点帮助。
【徐荣斋按】本节俞氏所说。大致可分为阳证发疹、阴证发疹两类。何氏补出“内陷”一则。是需要的。但还有“伏疹”一证。也是伤寒发疹中的一个重要证候。临床时也常常看到。俞氏只在论脉条内讲起“脉伏而疹亦伏”一语。对于症状和治法。却没有提及；这是疏漏。应当补充。兹从吴坤安《伤寒指掌》录入。庶几比较完备。吴坤安说：“凡伤寒邪入太阴。脉静神呆。舌心灰黑。防有‘伏疹’。或者是时感之症。过经不解。舌苔灰黑。或舌心黑晕。肌表不甚发热。脉象亦似沉缓。但神识不清。或郑声作笑。这是阳邪陷入太阴。防有‘伏疹内发’；其脉静身凉。不是邪退正复也。乃是阳邪陷于阴分也。治法应当宣通气血。透提疹毒。以实证治之；如连翘、赤芍、银花、紫草、生楂肉、槟榔、天虫、刺蒺藜、犀角尖、角刺之类；透之提之。疹毒外达。自然毒透神清。”廉臣先生对“透疹”方法。另有一种经验。特别介绍如下：“温病发疹之际。用清营透络。解毒化疹而仍然不透。往往用攻下逐毒。腑气一通。而疹始大透。伏邪从疹而解者。也常见之。”这方法虽然从吴又可书中得来。但通过经验家的实验。更值得我们珍视了。
(Ye Tianshi, Chong Lou, etc., add Dahqingye [Cynanchum atratum], a small amount of Shengma [Rhizoma Cimicifugae] as an assistant, or add Zicao [Arnebiae Radix seu Cortex], Honghua [Carthami Flos], or add Taoren [Persicae Semen], Guiwei [Radix Angelicae Sinensis tail].) This is the orthodox method for treating Wendu [Warm Toxin], Reyi [Heat Epidemic], concurrent rash, and also Shixing Lanhou Danzhen [Seasonal Rotting Throat Erythema]. It is the true eye treasury for turning death into life. Whenever Wenyue Bing [Warm-Heat Disease] presents with rash, I usually use Yushi Toujie Du Tang (Yu's Decoction for Venting and Resolving Toxins) added with Gegen [Puerariae Radix] and Shigao [Gypsum Fibrosum]. If it is Wendu, Reyi, and Lanhou Sha [Rotting Throat Sand], whether presenting with rash or Dan Sha [Erythematous Sand], one should mainly use Qingwen Baidu Yin (Decoction for Clearing Plague and Resolving Toxins) with modifications. Both prescriptions have been repeatedly used with immediate efficacy, achieving results more swiftly than Qin Huangshi's Shengma Qingwei Tang (Cimicifuga Decoction to Clear the Stomach) [Shengma, Xian Shengdi [Rehmanniae Radix Recens], Danpi [Moutan Cortex], Chuanlian [Coptidis Rhizoma], Mutong [Akebiae Caulis], Sheng Gancao [Glycyrrhizae Radix et Rhizoma]; if pork or fish is mistakenly consumed, add Shanzha [Crataegi Fructus], Sharen [Amomi Fructus]].] Only the syndrome of Neixian [Internal Collapse/Depression] is the most difficult to diagnose. Therefore, I specially recount one entry from Zhao Qingchu's *Cuncunzhai Yihua* [Medical Conversations]. (Xu Rongzhai notes: The entry on Neixian comes from Wu Kun'an's *Shanghan Zhizhang*, Volume 3. Mr. Zhao also reprinted it.) When Shidu [Seasonal Toxins] and Wenyi [Warm Epidemics] are inhaled through the mouth and nose, they travel directly along the central pathway, with pathogens hiding in Muyuan [Damo Yuan, a location between the interior and exterior], toxins condensing and Qi stagnating, leading to Neixian. It is similar to Neiyong [Internal Abscess]. Its symptoms appear restless yet not truly restless, with hot ears and red face, red eyes and dry mouth, cold fingers and toes, or chills, mental restlessness and rapid breathing, aversion to fire, and dislike of human voices. In severe cases, coma and unconsciousness occur, with muttering and laughing. The pulse is short and slippery. The tongue coating is mostly yellow and turbid, with black spots in the center, or pure black with red spots, or black coating gathered in the center. Treatment should focus on promoting the circulation of Qi and Blood, resolving toxins, and transforming depression [Yinhua]. [Yinhuajin [Lonicerae Japonicae Flos], Lianqiao [Forsythiae Fructus], Jiangcan [Bombyx Batryticatus], Goutenggou [Uncariae Ramulus cum Uncis], Zihuadiding [Violaris Herba], Chishao [Paeoniae Radix Rubra], Danpi, Zicao, Zharon [Ziziphus Spinosae Semen processed], Renzhonghuang [Human excrement processed], etc.] Only when the pulse becomes harmonious and the spirit clears can it be said that the toxin has transformed and the depression resolved. However, this Neixian manifests between the intestines, stomach, pharynx, and diaphragm, and cannot be seen on the skin surface. Often, people do not realize it is Neixian, leading to many misdiagnoses and mistreatments. This was incomplete in Mr. Yu's work. I excerpted it to serve as an aid in clinical practice.
[Xu Rongzhai Note:] What Mr. Yu said in this section can roughly be divided into two categories: Yang Syndrome Rash and Yin Syndrome Rash. Mr. He's addition of "Neixian" is necessary. But there is also the syndrome of "Fu Zhen" [Hidden Rash], which is also an important syndrome in Shanghan Rash, often seen in clinical practice. Mr. Yu only mentioned the phrase "pulse hidden and rash also hidden" in the section discussing pulses, but did not mention symptoms and treatment methods; this is an omission and should be supplemented. Here, I record it from Wu Kun'an's *Shanghan Zhizhang* to make it relatively complete. Wu Kun'an said: "Whenever Shanghan pathogens enter Taiyin, with a quiet pulse and dull spirit, and gray-black coating in the center of the tongue, one must guard against 'Fu Zhen'. Or in cases of seasonal infections, if the disease persists beyond its expected stage, with gray-black tongue coating or a black halo in the center of the tongue, slight fever on the body surface, and a pulse that seems deep and slow, but with unclear consciousness or muttering and laughing, this indicates Yang pathogens sinking into Taiyin, guarding against 'Fu Zhen internal manifestation'; a quiet pulse and cool body do not mean pathogen retreat and righteous recovery, but rather Yang pathogens sinking into the Yin aspect. The method should promote the circulation of Qi and Blood, vent and elevate Zhen Du [Rash Toxin], and treat it as an Excess syndrome; such as Lianqiao, Chishao, Yinhuajin, Zicao, raw Zharon, Binglang [Arecae Semen], Tianchong [Mylabris], Cijili [Tribuli Fructus], Xijiaojian [Rhinocerotis Cornu tip], Jiaoci [Acanthopanacis Cortex], etc.; by venting and elevating, the rash toxin reaches the exterior, naturally allowing the toxin to clear and the spirit to recover." Mrianchen had another experience regarding the method of "Tou Zhen" [Venting Rash], which is introduced below: "When Wenyue presents with rash, if Qingying Touluo [Clearing Nutrient Level and Venting Collaterals] and Jiedu Huazhen [Resolving Toxins and Transforming Rash] fail to produce transparency, one often uses Gongxia Zhudu [Attacking Interior to Expel Toxins]. Once the Fu organ Qi flows freely, the rash then greatly vents, and Fu Xie [Hidden Pathogens] resolving through the rash is also commonly seen." Although this method comes from Wu Youke's book, it is even more worth cherishing through the experimentation of experienced clinicians.]