痘后出麻为正疹。此由胎毒发于心。一次出现不再出。正麻名儿始为真。
婴儿初离母胎中。遍身斑驳似朱红。亦由胎毒生斯候。莫作时行麻疹攻。
婴儿当值炎热天。遍身忽似出麻然。此名风瘾非胎毒。不须用药也会痊。
正麻之出。由于胎毒。其出也。必在出痘之后。或隔两三月。或隔半年、一年之久。甚至八、九
年之远。感正麻之气而出一次。后再不复出矣。奶麻者。小儿初生未盈月时。遍身红点。斑驳如
朱。皆由儿在母胎中。受有热毒所致。故生下发见于皮肤。不可认作时行麻疹。妄用汤剂。盖婴儿
脏腑娇脆。气血怯弱。不能胜受汤丸。宜以溯源解毒汤与乳母服之可耳。若风瘾者。亦有似于
麻疹。乃发在幼孩甫生一月、半周、一岁之间。时值天气炎热。感风热而作。此不由于胎毒。乃
皮肤小疾。感风热客于脾肺二家所致。不在正麻之列。常见出一次又出一次。亦有连出不已者。
天关大利害。不必用药而自散。倘身热不退。只宜微用疏风清热之剂。一服即愈。以荆防发表汤
除红花主之。如身不热者。不必用药。免致诛伐无过。然亦当慎风寒。戒荤腥、生冷、辛辣等物。
勿以其无关利害而忽诸。恐触动风热而生他病。论云。风瘾身热不退。宜疏风清热。以荆防发
表汤主之。细按方内。止有荆芥、防风疏风之品。并无清热之药。且川芎上行头目。当归血中气
药。楂肉长于消肉积。甘草虽能和药解毒。其实有调中益气之功。桔梗性上升。能阻各药不得
下达。并非清热之品。且云除红花。反不若红花之能散赤肿解疹毒之犹为可用也。愚意莫若用
防风败毒散(见第五条)去甘草、桔梗、杏仁。加元参、黄芩、地骨皮。以疏风清热退潮之为妥当耳。
朱曰 此三种。各有主名。各有治法。医家必先识此。始不混乱。
源解毒汤(又名解毒汤)解胎毒良方。
当归身 川芎 生地黄 白芍药 人参 连翘 黄连 陈皮 木通 生甘草 淡竹叶引。
荆防发表汤 此方大能疏风清热。能散风热客于手足太阴。致发风瘾、及麻疹。连热三四日。而
始见标。而不甚烦躁。
荆芥穗 防风 桔梗 枳壳(麸炒) 苏叶 川芎 当归(各五分) 干葛(八分) 红花(二分) 杏仁
(去皮尖炒) 牛蒡子(炒研各七分) 楂肉(去核一钱) 生甘草(去皮三分) 连翘(五分) 水煎服。
夏天炎热。加酒炒黄芩。(五分)冬月严寒。加麻黄。(三分)或加羌活。(五分)小便赤涩黄。加木通。(去皮七分)
痘疹之后出麻,属于正麻。这是由于胎毒发于心所致。一生只出现一次,不会再出。真正的正麻,名字才叫“真”。
婴儿刚离开母体时,全身斑驳,颜色像朱砂红一样。这也是由胎毒引起的病症。不要把它当作流行性的麻疹来治疗。
婴儿如果在炎热的天气里,全身忽然好像出了麻疹一样。这叫做风瘾,不是胎毒引起。不需要用药也会痊愈。
正麻的发出,是由于胎毒。它的发作,一定是在出痘之后。或者间隔两三个月,或者间隔半年、一年之久。甚至长达八、九年。感受了正麻的邪气而发作一次,之后再也不会复发了。
奶麻,是指小儿出生未满月时,全身出现红点,斑驳如朱砂色。这都是因为婴儿在母胎中,受到热毒所致。所以出生后发见于皮肤。不可误认为是流行性麻疹,胡乱使用汤药。因为婴儿脏腑娇嫩脆弱,气血怯弱,不能承受汤丸药物的攻伐。适宜让乳母服用溯源解毒汤即可。
至于风瘾,也有类似麻疹的表现。它发生在幼儿出生一个月、半岁或一岁之间。正值天气炎热,感受风热而发病。这不由于胎毒,而是皮肤的轻微疾病,因风热客居于脾肺二经所致。不属于正麻的范畴。常见的是出一次又出一次,也有连续不断发作的。虽然病情看似不严重,但也不必用药,它会自行消散。如果身体发热不退,只宜轻微使用疏风清热的方剂,服一次即可痊愈。用荆防发表汤(去除红花)主治。如果身体不发热,不必用药,以免错误地攻击无病的部位。但也应当注意防风寒,忌食荤腥、生冷、辛辣等食物。不要因为觉得它关系不大就忽视它。恐怕触动风热而产生其他疾病。医论说:风瘾身热不退,宜疏风清热,以荆防发表汤主治。仔细分析该方内部,只有荆芥、防风是疏风的药物,并没有清热的药。而且川芎上行头目,当归是血中的气药,山楂肉擅长消除肉食积滞,甘草虽然能和药解毒,其实有调中益气的功效,桔梗性上升,能阻碍各药不得下达,都不是清热的药物。况且原文说去掉红花,反而不如保留红花,因为红花更能消散赤肿、解疹毒,更为可用。我的意见不如用防风败毒散(见第五条),去掉甘草、桔梗、杏仁,加入玄参、黄芩、地骨皮,以起到疏风清热、退潮热的效果,这样更为妥当。
朱氏说:这三种病,各有主要名称,各有治疗方法。医生必须先识别清楚,才不会混乱。
溯源解毒汤(又名解毒汤):是解除胎毒的良好方剂。
组成:当归身、川芎、生地黄、白芍药、人参、连翘、黄连、陈皮、木通、生甘草,淡竹叶为引。
荆防发表汤:此方大能疏风清热,能疏散客居于手足太阴经的风热,导致发生风瘾及麻疹。症见发热三四日,才开始显现症状,且没有严重的烦躁。
组成:荆芥穗、防风、桔梗、枳壳(麸炒)、苏叶、川芎、当归(各五分)、干葛(八分)、红花(二分)、杏仁(去皮尖炒)、牛蒡子(炒研,各七分)、山楂肉(去核一钱)、生甘草(去皮三分)、连翘(五分)。水煎服。
夏天炎热,加酒炒黄芩(五分)。冬天严寒,加麻黄(三分)。或者加羌活(五分)。小便赤涩发黄,加木通(去皮七分)。
After smallpox, the appearance of measles is called "Zheng Ma" (True Measles). This arises from fetal toxin originating in the Heart. It appears only once in a lifetime and does not recur. The true name for this condition is "Zheng Ma."
When an infant has just left the womb, the whole body becomes mottled with red spots resembling cinnabar red. This condition is also caused by fetal toxin. It should not be treated as epidemic measles.
If an infant, during hot weather, suddenly develops a rash resembling measles, it is called "Feng Yin" (Wind Urticaria/Rash), not caused by fetal toxin. It will heal spontaneously without medication.
The eruption of Zheng Ma is due to fetal toxin. Its onset must occur after smallpox. It may be separated by two or three months, half a year, or even one year. In extreme cases, it may be delayed for eight or nine years. After contracting the Qi of Zheng Ma and erupting once, it never recurs.
"Nai Ma" (Milk Measles) refers to infants under one month old who develop red, mottled spots on their bodies resembling cinnabar. This is caused by heat-toxin contracted within the maternal womb, manifesting on the skin after birth. It must not be mistaken for epidemic measles, nor should decoctions be administered recklessly. Infants have delicate viscera and weak Qi and Blood, unable to withstand the harsh effects of herbal pills and decoctions. It is advisable for the nursing mother to take Suyuan Jiedu Tang instead.
As for Feng Yin, it resembles measles but occurs in young children between one month, six months, and one year of age. Triggered by hot weather and contraction of Wind-Heat, it is not due to fetal toxin but is a minor skin disorder caused by Wind-Heat lodging in the Spleen and Lung meridians. It does not belong to the category of Zheng Ma. It is common for it to erupt multiple times or continuously. Although generally not severe, medication is unnecessary as it resolves spontaneously. If fever persists, mild formulas for dispersing Wind and clearing Heat should be used; one dose suffices. Jingfang Fabiao Tang (excluding Honghua) is indicated. If there is no fever, medication should be avoided to prevent attacking healthy tissue unnecessarily. However, care should be taken to avoid Wind-Cold, and foods such as meat, raw/cold items, and spicy substances should be avoided. Do not neglect it thinking it is harmless, lest Wind-Heat be triggered causing other diseases. Medical texts state: For persistent fever in Feng Yin, disperse Wind and clear Heat using Jingfang Fabiao Tang. Upon close examination of this formula, it contains only Jingjie and Fangfeng for dispersing Wind, lacking herbs for clearing Heat. Furthermore, Chuanxiong ascends to the head and eyes; Danggui regulates Qi within Blood; Shan Zha removes food stagnation; Gancao harmonizes herbs and detoxifies but primarily tonifies the Middle and benefits Qi; Jiegeng has an ascending nature that hinders the downward action of other herbs. None are truly clearing Heat. Moreover, excluding Honghua is unwise, as Honghua effectively dissipates redness and swelling and resolves measles toxin. My opinion suggests using Fangfeng Baidu San (see Article 5), removing Gancao, Jiegeng, and Xingren, and adding Xuanshen, Huangqin, and Digupi to effectively disperse Wind, clear Heat, and reduce tidal fever.
Zhu stated: These three conditions each have distinct names and treatment methods. Physicians must clearly distinguish them to avoid confusion.
Suyuan Jiedu Tang (also known as Jiedu Tang): An excellent formula for resolving fetal toxin.
Ingredients: Danggui Shen, Chuanxiong, Sheng Dihuang, Baishao, Renshen, Lianqiao, Huanglian, Chenpi, Mutong, Sheng Gancao, with Dan Zhuye as a guide.
Jingfang Fabiao Tang: This formula strongly disperses Wind and clears Heat,疏散 (dispersing) Wind-Heat lodged in the Hand and Foot Taiyin meridians, which causes Feng Yin and measles. Symptoms include fever for three to four days before the rash appears, without severe irritability.
Ingredients: Jingjie Sui, Fangfeng, Jiegeng, Zhike (bran-fried), Ziye, Chuanxiong, Danggui (each 5 fen), Gange (8 fen), Honghua (2 fen), Xingren (skin and tip removed, fried), Niubangzi (fried and ground, each 7 fen), Shan Zha (core removed, 1 qian), Sheng Gancao (skin removed, 3 fen), Lianqiao (5 fen). Decoct in water and drink.
In summer heat, add Jiuhuang Qin (wine-fried Huangqin, 5 fen). In winter cold, add Mahuang (3 fen). Alternatively, add Qianghuo (5 fen). If urine is dark, scanty, and yellow, add Mutong (skin removed, 7 fen).