痘本先天因时而发,痧亦时气所感,而胎元之毒因之俱发。凡痘未现点前痧胀,必烦闷
痰涎,甚至昏迷沉重不省人事,此其候也。小儿滑疾之脉,类于痧症厥厥动摇之脉,虽若疑
似难明,然有痧筋可辨,不可针,单用药清之,宜木一方,透痧兼发其痘,痧自退,痘自起
矣。若痘点既形触秽痘隐者,诸痘科自悉。
痘后气虚,尤宜防护,尝有收靥结痂,安然无事,一遇暑侵秽触即成痧胀,忽然生变,
人多认为恶痘所致,大误。
一七岁子脱痂光洁,饮食行步如旧,迨二十五朝,忽叫喊发晕,脉微细而伏,若恶痘余
毒兆变,脉当沉紧有力,今脉症不合,痧筋历历可指,用竹二合竹四方即苏。后小腹痛变痢
,用当归五钱,山楂一钱,熟军五分,童便微温饮之。即愈。
痘前痘后见有痧筋,止可用药,切忌针刺。
疮痛者,心火血热所致,脓肿作痛,必渐而来,非若兼痧之骤而可畏,况疮脉多洪数,
兼痧脉固不同,筋又可验。
一女患疮半载,一日酒后血热,且食鸡鹅,脓疮大盛,与凉血解毒药,更觉昏迷饱闷,
脉不洪数反沉微,必痧使然,刺头顶一针,指顶数针,稍清爽,犹胀闷,用木二方、木三方
愈。
痧毒留滞腠理即成肿毒,宜先放痧,用解毒散痧药以除其根,然后审十二经络脏腑,分
阴阳寒热处治,轻则消之,重则托之,虚则补之,实则泻之。红肿甚者属阳,用木三方。白
色平肿不起发者属阴,用木四方。毒有半阳半阴,用木二方。穿破后贴太乙膏。若无脓只流
毒水,或脓少血多,用飞龙夺命丹研碎些须填太乙膏中,拔去毒水脓血后,单贴膏,毒口难
收掺红玉散(木四、五)。
一人遍身疼痛,背发一毒,黑烂痛苦,脉沉微,指头黑色,而恶热饮。此痧变恶毒,用
冷围药而成背疽也。令去围药,放痧讫,俟痧气已绝,用木四方温托之,外敷如前法,另有
木五方选用。
附∶痧后调理,说见后木六、七、八方。
痘疹本是先天禀赋,随季节气候而发作;痧症也是感受时行疫气所致,而胎元中的毒邪也随之全部爆发。凡是痘疹尚未出点之前出现痧胀症状的,必然伴有烦闷、痰涎壅盛,甚至昏迷沉重、不省人事,这就是其征候。小儿脉象滑利疾速,类似于痧症中厥逆动摇的脉象,虽然看起来疑似难辨,但有“痧筋”可以辨别。这种情况不可用针刺,只能单用药剂清解,适宜使用木方一,既能透发痧毒又能促使痘疹发出,痧毒自然消退,痘疹自然起发。如果痘点已经形成,却因接触秽浊之气导致痘疹隐伏不出,各种痘科医书自有详细论述。
痘疹后期正气虚弱,尤其应当注意防护。曾经有患儿痘疮收靥结痂后,安然无事,一旦遇到暑热侵袭或秽浊之气触动,立刻形成痧胀,突然发生变故。人们多认为是恶毒痘疹所致,这是极大的错误。
有一个七岁男孩痘痂脱落,皮肤光洁,饮食行走如常,等到第二十五天早晨,忽然叫喊头晕,脉象微细而伏匿。如果是恶痘余毒将要变证,脉象应当沉紧有力,如今脉象与症状不符,且痧筋清晰可数,使用竹方二和竹方四后随即苏醒。后来小腹痛并变为痢疾,使用当归五钱、山楂一钱、熟大黄五分,用童便微温送服。随即痊愈。
在痘前或痘后见到有痧筋的,只可用药物治疗,切忌针刺。
疮疡疼痛,是由心火血热引起的;脓肿作痛,必然是逐渐发生的,不像兼夹痧症那样突然且令人畏惧。况且疮疡的脉象多洪大数急,兼夹痧症的脉象固然不同,通过观察痧筋又可以验证。
有一个女子患疮半年,一天酒后血热,又吃了鸡鹅肉,脓疮盛大,给予凉血解毒药物后,反而更加昏迷饱闷,脉象不洪数反而沉微,这必定是痧症所致。刺头顶一针,手指顶端数针,稍微清爽一些,但仍有胀闷感,使用木方二、木方三治愈。
痧毒留滞于腠理就形成肿毒,适宜先进行放痧治疗,使用解毒散痧的药物以去除病根,然后审视十二经络脏腑,分辨阴阳寒热进行处置。轻症则消散它,重症则托毒外出,虚证则补益,实证则泻下。红肿严重的属于阳证,使用木方三。白色平坦肿胀不起发的属于阴证,使用木方四。毒邪有半阳半阴性质的,使用木方二。穿破后贴敷太乙膏。如果没有脓液只流出毒水,或者脓少血多,将飞龙夺命丹研碎少许填入太乙膏中,拔出毒水脓血后,单独贴膏药,若毒口难以收敛,掺入红玉散(即木方四、木方五)。
一个人遍身疼痛,背部生发一个毒疮,黑烂痛苦,脉象沉微,手指头黑色,却厌恶热饮。这是痧症转变为恶毒,因为使用冷围药而导致成为背疽。命令去掉围药,放痧完毕,等待痧气已绝,使用木方四温补托毒,外敷方法如前所述,另有木方五可选用。
附注:痧后的调理方法,详见后文的木方六、七、八。
Measles (Dòuzhěn) originates from congenital predisposition and erupts according to seasonal changes; Sha syndrome (Shāzhèng, acute toxic heat condition) is also caused by contracting epidemic pathogens, and the toxins in the fetal origin are thereby fully released. Whenever Sha distension occurs before the measles spots appear, there must be restlessness, phlegm-saliva accumulation, and even coma, heaviness, and loss of consciousness; this is its clinical presentation. The pulse of children is slippery and rapid, resembling the pulse of Sha syndrome where there is trembling due to syncope. Although it may seem ambiguous and difficult to distinguish, "Sha veins" (visible subcutaneous veins indicating Sha toxin) can be identified. Acupuncture should not be used here; instead, only herbal medicine should be used for clearing. It is appropriate to use Mu Formula 1 (Mù Fāng Yī), which both resolves Sha toxin and promotes the eruption of measles. The Sha toxin will naturally recede, and the measles will naturally rise. If the measles spots have already formed but remain hidden due to contact with filth, various measles treatment texts have their own detailed explanations.
After measles, when Qi deficiency prevails, special care and protection are especially necessary. There have been cases where a child's scabs had healed and crusted over, appearing safe and sound, but upon encountering summer heat or filth, Sha distension suddenly developed, leading to abrupt complications. People often mistakenly attribute this to malignant measles toxins, which is a great error.
A seven-year-old boy had his scabs fall off, leaving smooth skin, with diet and movement returning to normal. On the morning of the twenty-fifth day, he suddenly cried out with dizziness. His pulse was minute, fine, and deep-hidden. If this were a sign of residual toxins from malignant measles transforming, the pulse would be deep, tight, and forceful. However, the pulse and symptoms do not match; the Sha veins are clearly visible and countable. After using Zhu Formula 2 (Zhú Fāng Èr) and Zhu Formula 4 (Zhú Fāng Sì), he immediately regained consciousness. Later, he suffered from lower abdominal pain and dysentery. He was treated with five qian of Danggui (Angelicae Sinensis Radix), one qian of Shanzha (Crataegi Fructus), and five fen of Shujun (Prepared Rhizoma Rhei), taken warm with infant urine. He recovered immediately.
When Sha veins are seen before or after measles, only herbal medication should be used; acupuncture is strictly prohibited.
Soreness and pain in sores are caused by Heart fire and blood heat. Pain from abscesses develops gradually, unlike the sudden and frightening onset associated with concurrent Sha syndrome. Moreover, the pulse for sores is typically surging and rapid, which is definitely different from the pulse of concurrent Sha; observing the Sha veins provides further verification.
A woman suffered from a sore for half a year. One day, after drinking alcohol, her blood became hot, and she consumed chicken and goose meat. Her purulent sore became severe. After administering herbs to cool the blood and resolve toxicity, she felt even more comatose and bloated. Her pulse was no longer surging and rapid but became deep and minute. This was undoubtedly caused by Sha. One needle was inserted into the top of the head, and several needles into the tips of the fingers. She felt slightly refreshed but still experienced bloating. She was cured using Mu Formula 2 (Mù Fāng Èr) and Mu Formula 3 (Mù Fāng Sān).
When Sha toxins stagnate in the interstices (Còulǐ, pores and muscle interspaces), they form swellings and toxic masses. It is appropriate to first perform Sha release (Fàngshā, pricking to bleed), then use detoxifying and Sha-resolving herbs to eliminate the root cause. Subsequently, examine the twelve meridians and zang-fu organs, differentiate yin and yang, cold and heat, and treat accordingly. For mild cases, dissipate the pathogen; for severe cases, expel the toxin outward; for deficiency patterns, tonify; for excess patterns, purge. Severe redness and swelling belong to Yang patterns, treated with Mu Formula 3 (Mù Fāng Sān). White, flat swelling that does not rise belongs to Yin patterns, treated with Mu Formula 4 (Mù Fāng Sì). Toxins with mixed Yang-Yin characteristics are treated with Mu Formula 2 (Mù Fāng Èr). After ulceration, apply Taiyi Plaster (Tàiyǐ Gāo). If there is no pus but only toxic fluid flows, or if there is little pus and much blood, crush a small amount of Feilong Duoming Dan (Fēilóng Duómìng Dān, Flying Dragon Life-Grabbing Pill) and mix it into the Taiyi Plaster. After extracting the toxic fluid, pus, and blood, apply the plaster alone. If the toxic wound is difficult to close, sprinkle Hongyu San (Hóngyù Sān, Red Jade Powder) (i.e., Mu Formula 4 and Mu Formula 5).
A person suffered from body-wide pain and developed a toxic mass on the back, which turned black, rotted, and caused severe pain. His pulse was deep and minute, his fingertips were black, yet he disliked hot drinks. This was Sha transforming into malignant toxin, complicated by the use of cold compress wraps, resulting in a carbuncle on the back. He was instructed to remove the compress wraps, undergo Sha release, and wait until the Sha qi subsided. Then, Mu Formula 4 (Mù Fāng Sì) was used to warm and support the expulsion of toxins. External application followed the previous method, with Mu Formula 5 (Mù Fāng Wǔ) available as an alternative selection.
Appendix: Methods for post-Sha recovery and regulation are discussed in Mu Formulas 6, 7, and 8 below.