一忌荤腥生冷风寒。夫谷气通,肉气滞。凡是荤腥,俱能滞毒,所以忌也。果生则难克
化,物冷则能冰伏,冰伏不化,毒乃滞留,又当忌也。若风寒闭塞,毛窍不开,则毒瓦斯何由
出乎?此数端者,俱不可犯也。
一忌骤用寒凉。麻虽热症,固不宜用辛热之剂。然初热之际,虚实之症未形,轻重之势
未见,遂骤以苦寒之药而峻攻之。几何不冰伏其毒而不得出,其反至于内攻乎?故善治者,
惟达毒而不郁毒,只解毒而不冰毒也。
一忌误用辛热。麻本热症,若复投辛热之药,是犹火上复加薪也,以火助火。其毒不愈
横乎?然麻症初起之时,亦有四肢厥冷者,然热极似寒之故,切不可妄认虚寒而妄投以热药
也。即遇天时大寒,亦宜置暖室,切不可因严寒而遂投以辛热之物,以济腹中之火也。
一忌误用补涩。毒火之发,最要疏通,尤嫌补涩。盖疏通则毒外泄而解,补涩则毒滞内
留为殃。但初发之时,症多吐泻,愚夫愚妇急欲止之,若误用参、术、砂仁补涩之药,则关
闭塞,毒滞于中,必作内攻之祸矣!
夫痘为阴毒,其势更缓,或死或生,尚判之于成浆之日。麻为阳毒,其热甚烈,若存若
没,早定之于方出之时。故发热三日,麻当现于皮肤。若腠理紧秘,风寒严束,气滞于中,
毒凝于内,不能出现,则毒作内攻,须臾告变。故痘则虑难成浆,麻则惧其不出。麻前痘后
,最为紧要,此古今之通议也。当发热三日之间,急宜观形察色,审声辨症,以为调治之方
。如声重鼻塞,肌粟恶寒,是为风寒所束,宜用加味升麻汤∶升麻、干葛、防风、荆芥、牛
蒡、连翘、桔梗、木通、赤芍、甘草、柴胡、黄芩、陈皮、蝉蜕、元参,加葱白水煎,热服
,令取微汗,一二服间其麻即出。如大热熏蒸,肌肤干燥,目赤唇紫,毛发焦竖,烦渴不安
,惊狂颠谵,二便秘结而出不快者,乃热毒盛壅故也。宜用栀仁解毒汤∶栀子、黄芩、黄连
、石膏、知母、牛蒡、连翘、升麻、柴胡、防风、赤芍、甘草,大便秘加酒大黄,烦躁加麦
冬,嗽甚者加杏仁、桔梗、花粉,惊谵用抱龙丸或牛黄丸,无汗腠理秘加大黄,再用紫苏煎
水令热气熏之,或用酒遍身擦之,然后以被盖片时,其麻即出。治风寒闭者亦如是。若为秽
气所触而出不快,则用沉香、檀香、荆芥烧烟熏之。
又有毒瓦斯本盛,元气又亏而出不快者,宜用人参白虎汤∶台党二钱,石膏四钱,知母一
钱五分,加升麻、防风、牛蒡、炒芩、水煎服。
孟氏治麻方∶石膏二两( )、荆芥、地骨皮、桔梗各八钱,赤芍、牛蒡、薄荷、陈皮、
枳壳各六钱,川贝、甘草各四钱,红花三钱,干葛、归尾、桑白皮各一钱,共为末,每服三
钱,开水下。此方能发表透肌、清毒活血、理肺消痰、清胃解结,不拘四时皆可服,诚治麻
之良方也。
一忌食用荤腥、生冷食物及感受风寒。谷物之气通畅,肉类之气易滞涩。凡是荤腥之物,都能使毒邪滞留,所以应当禁忌。水果生吃则难以消化,食物过冷则能使寒气冰伏体内,寒气冰伏不化,毒邪就会滞留,这也应当禁忌。如果风寒闭塞毛孔,汗孔不开,那么毒气从哪里散发出去呢?这几方面,都不可触犯。
二忌突然使用寒凉药物。麻疹虽然属于热证,固然不适宜使用辛热之剂。然而在初发热的时候,虚证和实证的症候尚未显现,轻重的趋势还未见到,就骤然用苦寒的药物猛烈攻伐。这样怎能不使毒邪冰伏而不能透发,反而导致内攻呢?所以善于治疗的人,只是通达毒邪而不郁闭毒邪,只是解除毒邪而不冰伏毒邪。
三忌误用辛热药物。麻疹本是热证,如果再投用辛热的药物,这就好比火上又加柴薪,以火助火。毒邪难道不会更加猖獗吗?然而麻疹初起之时,也有四肢厥冷的情况,这是热极似寒的缘故,切不可错误地认为是虚寒而妄投热药。即使遇到天气大寒,也应当安置在温暖的房间,切不可因为严寒就立即投用辛热的物品,来资助腹中的火热。
四忌误用补益收敛药物。毒火的发作,最重要的是疏通,尤其忌讳补益收敛。因为疏通则毒邪向外发泄而解,补益收敛则毒邪滞留在体内留下祸患。但在初发之时,症状多有呕吐腹泻,愚笨的百姓急于止住它,如果误用人参、白术、砂仁等补涩的药物,则会导致关窍闭塞,毒邪滞留于中,必然造成内攻的祸患!
痘疮属于阴毒,其势较为缓慢,或死或生,还要等到成浆的那一天才能判定。麻疹属于阳毒,其热势非常猛烈,若存若没,早在刚发出的时候就能定夺。所以发热三天后,麻疹应当在皮肤上显现。如果腠理紧密闭塞,风寒严密封束,气机滞塞于中,毒邪凝结在内,不能透发出来,那么毒邪就会内攻,顷刻之间病情就会变化。所以痘疮担心的是难以成浆,麻疹恐惧的是不能透发。麻疹之前、痘疮之后,最为紧要,这是古今通用的议论。在发热三天的期间,应当急切观察形态色泽,审视声音辨别症候,以此作为调治的依据。如声音重浊鼻塞,肌肤起粟粒恶寒,这是被风寒所束缚,宜用加味升麻汤:升麻、干葛、防风、荆芥、牛蒡子、连翘、桔梗、木通、赤芍、甘草、柴胡、黄芩、陈皮、蝉蜕、玄参,加葱白用水煎煮,热服,令其微微出汗,服用一二剂后麻疹即可发出。如大热熏蒸,肌肤干燥,眼睛红赤嘴唇紫暗,毛发焦枯竖起,烦躁口渴不安,惊狂谵语,大小便不通畅而出疹不快,这是热毒盛实壅滞的缘故。宜用栀仁解毒汤:栀子、黄芩、黄连、石膏、知母、牛蒡子、连翘、升麻、柴胡、防风、赤芍、甘草,大便秘结加酒大黄,烦躁加麦冬,咳嗽严重加杏仁、桔梗、天花粉,惊狂谵语用抱龙丸或牛黄丸,无汗腠理密闭加大黄,再用紫苏煎水让热气熏蒸,或者用酒遍身擦拭,然后用被子盖一会儿,麻疹即可发出。治疗风寒闭塞的情况也是如此。如果被秽气触碰而导致出疹不快,则用沉香、檀香、荆芥烧烟熏之。
又有毒瓦斯本来强盛,元气又亏损而导致出疹不快的,宜用人参白虎汤:党参二钱,石膏四钱,知母一钱五分,加升麻、防风、牛蒡子、炒黄芩,用水煎服。
孟氏治疗麻疹方:石膏二两(捣碎),荆芥、地骨皮、桔梗各八钱,赤芍、牛蒡子、薄荷、陈皮、枳壳各六钱,川贝母、甘草各四钱,红花三钱,干葛、当归尾、桑白皮各一钱,共研为末,每次服用三钱,开水送下。此方能发表透肌、清毒活血、理肺消痰、清胃解结,不拘四季都可以服用,确实是治疗麻疹的良好方剂。
One taboo is to avoid consuming meat, raw and cold foods, and exposure to wind-cold. Grain qi flows smoothly, whereas meat qi tends to stagnate. All kinds of meat and fish can cause the retention of pathogenic toxins, hence they are taboo. Raw fruits are difficult to digest, and cold foods can cause "ice-fu" (freezing stagnation). If this freezing stagnation does not resolve, the toxin will remain retained, which is also taboo. If wind-cold blocks the pores and hair follicles do not open, how can the toxic vapors be expelled? These several aspects must not be violated.
The second taboo is the sudden use of cold-cooling medicines. Although measles is a heat syndrome and indeed should not be treated with acrid-warm agents, at the initial stage of fever, when the patterns of deficiency and excess have not yet manifested and the severity has not become apparent, suddenly attacking with bitter-cold drugs will likely cause the toxin to freeze-stagnate and fail to erupt, leading instead to internal attack. Therefore, skilled practitioners only facilitate the flow of the toxin without allowing it to stagnate, and resolve the toxin without freezing it.
The third taboo is the mistaken use of acrid-warm medicines. Measles is fundamentally a heat syndrome; administering acrid-warm drugs is like adding firewood to a fire, using fire to assist fire. Will the toxin not become even more rampant? However, at the onset of measles, there may be cold limbs due to extreme heat mimicking cold. One must not mistakenly diagnose this as deficiency-cold and recklessly administer warm drugs. Even in severe cold weather, one should stay in a warm room and must not immediately administer acrid-warm substances to fuel the fire within the abdomen.
The fourth taboo is the mistaken use of tonifying and astringent medicines. When toxic fire erupts, the most important principle is unblocking and draining; tonifying and astringing are particularly disliked. Unblocking allows the toxin to drain outward and resolve, while tonifying and astringing cause the toxin to stagnate internally and create disaster. At the initial stage, symptoms often include vomiting and diarrhea. Laypeople anxiously seek to stop these symptoms; if they mistakenly use tonifying and astringent herbs such as Codonopsis Radix (Renshen), Atractylodis Rhizoma (Baizhu), and Amomi Fructus (Sharen), the orifices will become blocked, the toxin will stagnate in the middle, and inevitable internal attack disasters will occur!
Smallpox belongs to yin-toxin, its progression is slower, and survival or death is determined when pustules form. Measles belongs to yang-toxin, its heat is fierce, appearing and disappearing, and its outcome is determined early when the rash first emerges. Thus, after three days of fever, the measles rash should appear on the skin. If the couli (skin pores) are tight and closed, and wind-cold binds strictly, causing qi stagnation in the interior and toxin condensation inside, preventing eruption, the toxin will attack inward, and changes will occur instantly. Therefore, smallpox worries about failing to form pustules, while measles fears failure to erupt. The period before measles and after smallpox is of utmost importance, a consensus throughout history. During the three days of fever, one must urgently observe the form and color, examine the voice and differentiate the syndrome, to formulate treatment strategies. If the voice is heavy, nasal congestion occurs, and the skin presents with gooseflesh and aversion to cold, this indicates binding by wind-cold. Use Modified Shengma Decoction: Chuanma Huangqi (Radix Cimicifugae), Gegen (Puerariae Lobatae Radix), Fangfeng (Saposhnikoviae Radix), Jingjie (Perillae Folium), Niubangzi (Arctii Fructus), Lianqiao (Forsythiae Fructus), Jiegeng (Platycodonis Radix), Mutong (Akebiae Caulis), Chishao (Paeoniae Radix Rubra), Gancao (Glycyrrhizae Radix et Rhizoma), Chaihu (Bupleuri Radix), Huangqin (Scutellariae Radix), Chenpi (Citri Reticulatae Pericarpium), Chantui (Cicadae Periostracum), Yuanshen (Scrophulariae Radix), plus Congbai (Allii Fistulosi Bulbus) decocted in water, taken hot to induce slight sweating. After one or two doses, the measles will erupt. If there is intense heat steaming, dry skin, red eyes, purple lips, scorched and erect hair, restlessness, thirst, discomfort, delirium, convulsions, and slow eruption due to constipation of both bowels and urine, this is due to excessive heat-toxin accumulation. Use Zhiren Jiedu Decoction: Zhizi (Gardeniae Fructus), Huangqin (Scutellariae Radix), Huanglian (Coptidis Rhizoma), Shigao (Gypsum Fibrosum), Zhimu (Anemarrhenae Rhizoma), Niubangzi (Arctii Fructus), Lianqiao (Forsythiae Fructus), Shengma (Radix Cimicifugae), Chaihu (Bupleuri Radix), Fangfeng (Saposhnikoviae Radix), Chishao (Paeoniae Radix Rubra), Gancao (Glycyrrhizae Radix et Rhizoma). Add Jiuhuangda (Prepared Rheum Palmatum Radix et Rhizoma) for severe constipation, Maidong (Ophiopogonis Radix) for irritability, Xingren (Armeniacae Semen Amarum) and Jiegeng (Platycodonis Radix) for severe cough, Huafen (Paeoniae Radix Alba) for phlegm-heat, Baolong Wan (Protect Dragon Pill) or Niuhuang Wan (Calculus Bovis Pill) for delirium and convulsions. For anhidrosis and closed couli, add Da Huang (Rhei Radix et Rhizoma), fumigate with Zi Su (Perillae Folium) decoction steam, or rub the body with wine, then cover with a blanket for a short time, and the measles will erupt. Treatment for wind-cold closure is similar. If eruption is hindered by foul air, smoke with Chenxiang (Aquilariae Lignum Resinatum), Tanxiang (Santalum Album Lignum), and Jingjie (Perillae Folium).
In cases where toxic vapors are abundant but yuan qi (original qi) is deficient, leading to slow eruption, use Renshen Baitu Decoction: Taidangshen (Codonopsis Radix) 2 qian, Shigao (Gypsum Fibrosum) 4 qian, Zhimu (Anemarrhenae Rhizoma) 1.5 qian, plus Shengma (Radix Cimicifugae), Fangfeng (Saposhnikoviae Radix), Niubangzi (Arctii Fructus), and fried Huangqin (Scutellariae Radix), decocted in water and taken orally.
Mr. Meng's formula for treating measles: Shigao (Gypsum Fibrosum) 2 liang (crushed), Jingjie (Perillae Folium), Gudupi (Lycii Cortex), Jiegeng (Platycodonis Radix) each 8 qian; Chishao (Paeoniae Radix Rubra), Niubangzi (Arctii Fructus), Bohe (Menthae Haplocalycis Herba), Chenpi (Citri Reticulatae Pericarpium), Zhike (Aurantii Fructus Immaturus) each 6 qian; Chuanbei (Fritillariae Cirrhosae Bulbus), Gancao (Glycyrrhizae Radix et Rhizoma) each 4 qian; Honghua (Carthami Flos) 3 qian; Gegen (Puerariae Lobatae Radix), Guiwei (Angelicae Sinensis Radix), Sangbaipi (Mori Cortex) each 1 qian. Grind all into powder. Take 3 qian per dose, washed down with boiling water. This formula releases the exterior and penetrates the muscle, clears toxicity and invigorates blood, regulates the lungs and resolves phlegm, clears the stomach and resolves knots. It can be taken in any season and is indeed an excellent formula for treating measles.