己巳春。长男甫六岁。次男甫三岁。于元旦次日。俱发热见疹。余初不知疹之根源。以为婴儿
生下时。口含恶血。开声咽下。其后发为疹毒。治疹自当攻发。即用清凉透发之剂服之。次朝略增
十余点。究不畅达。心甚惶惑。长男七月而生。先天怯薄。问其胸膈宽否何如。答曰、饥甚。又问口
味燥苦何如。答曰、淡甚。因知其虚。即投 、术、苓、甘、桂枝、红花、一二剂。次朝疹发遍身。热稍
退。而神情犹烦躁。夜发热、频咳嗽。至一月方安。盖因见点之初。过服表剂。虚其经脉故也。次男
尚幼。未省人事。不能致词。上冬患肺风痰喘证。诸药不效。服麻杏桂枝石膏汤一剂而痊。谓其
禀质略强。不与长男同。其疹不透。必寒凝毒甚。因与苏、麻、前、杏、黄芩、石膏药。红点不增。又
与紫苏、葱、姜、芫荽等熏之熨之。疹总不出。乃与同道诸公商之。俱云舍透发并无别法。至五日
而口吐蛔虫。儿医曰、此热极虫生。余有牛黄散可以服之。牛黄散。即大黄末也。一服。痰喘止而
神气稍平。自是此儿遂无言矣。计无可施。复针百会穴。开其 门。服西黄分许。及诸单方。观其
形证。实不能生。友人张卫生来望。因曰、此大虚大寒证也。今既无言。又不能食。恐无济矣。然
心犹不忍。勉投参附。含药而亡。因自叹曰、此庸医现身食报。天理当然。自身行医。何尤乎人。
因悔昔日所见之皆非。益信治病求本之不谬。次日。有同居甥汪姓者。伊芳子出 。已经三日。见
余际悲伤。不邀诊视。自用前、杏、麻黄、石膏药一二剂。疹出二十余点。不能再增。心胸烦闷。不得
已而告余。乞余诊视。余曰、若再攻发。即如吾子矣。急与 、术、芎、归、桂、苓、红花等。服一剂而
热退身安。余自此始悟疹之根源。凡治疹。但调其气血。和其经络。寒凉攻发。概置之不用。所以
屡治而屡效也。（朱曰 寒凉攻发而外。又有调气血和经络一法。金针度人。须当切记。）次年春。
友人吴题仙之子甫二岁。出 。延儿医马圣则兄延医之。攻发不透。神情恍惚。喘急不宁。又延余
诊视。余往吴宅。圣兄先至。余视之。知其虚也。因告主人曰、若但发 。 断不出。必至身命不
保。主人曰、为之奈何。余曰、惟有温补药一剂。益其脏腑。安其肠胃。助其气血。方可。圣兄曰、吾
治四朝。不能透发。悉听尊裁。余即与 、术、姜、桂、归、芍、苓、甘、银花、红花诸味。一剂而安。次
日仍用原方。加人参一钱。此后并不服药。连服独参汤数日。霍然矣。又有夏姓耀如之子出 。其
颜色紫黯。神气不宁。余曰、此证大凶。治须得法。连看二次。皆用温散药。次早。其家人来告曰、
口吐蛔虫。另有药否。余曰、昨药二剂。俱服否耶。曰、尚存一剂。因与附子八分。令入药内煎服。
自此遂无音耗。越三载。至其家。见其子长大。余因问曰、昔年出 吐蛔。何由得愈。其家答曰、
服先生之药后。因无力相延。仗天复庇。得以渐愈。余默叹曰、因死吾子。得生他人。治疹之法。可
无憾矣。余因附载斯册。虽不能见信于儿医。而正道阐明。实有裨于儿科治疹之根源。而为有子
出者所当致慎也夫。
己巳年春天，我的长子刚满六岁，次子刚满三岁。在正月初一的第二天，两个孩子都发热并出现了皮疹。起初我不了解出疹的根本原因，认为婴儿出生时口中含着恶血，啼哭时咽下，之后便化为疹毒。治疗出疹自然应当采用攻逐透发的方法，于是立即给他们服用清凉透发的药剂。第二天，皮疹仅增加了十余点，终究没有畅达透出，我心里非常惶恐困惑。
长子是七个月早产的，先天体质虚弱怯弱。我询问他胸膈是否宽舒，回答说非常饥饿；又问他口中有无燥苦之感，回答说味道很淡。由此判断他是虚证，随即投用白术、茯苓、甘草、桂枝、红花等药物，服用一两剂后，第二天皮疹发遍全身，热度稍退，但神情仍然烦躁。夜间发热，频繁咳嗽，直到一个月后才安稳下来。这是因为初见皮疹时，过度服用了发散表邪的药物，导致经脉空虚的缘故。
次子年纪尚小，不懂人事，无法表达。他在去年冬天曾患肺风痰喘证，各种药物都不见效，服用麻杏桂枝石膏汤一剂就好了。我说他禀赋体质略强，与长子不同。他的皮疹不透，一定是寒凝毒盛所致。因此给他用了紫苏、麻黄、前胡、杏仁、黄芩、石膏等药，红点并没有增加。我又用紫苏、葱白、生姜、芫荽等药物熏蒸熨烫，皮疹始终出不来。于是我与同行各位医生商量，大家都说除了透发之外没有别的方法。到了第五天，孩子嘴里吐出蛔虫。儿科医生说：“这是热极生虫。”我有牛黄散可以服用。这里的牛黄散，实际上就是大黄末。服用一次后，痰喘停止，神气稍微平稳。从此以后，这个孩子就再也不能说话了。计谋用尽，无可奈何，又针刺百会穴，开通其窍，服用少许西黄（麝香）以及各方单方。观察他的形证，实在不能存活了。朋友张卫生前来探望，说道：“这是大虚大寒之证。现在既然不能说话，又不能进食，恐怕难以救治了。然而我心里还是不忍心，勉强投用参附汤，含药而亡。于是我叹息道：‘这是庸医现世受报，天理当然。我自己行医，怎么能责怪别人呢？’因此后悔过去所见皆非，更加相信治病求本的道理是正确的。
第二天，有同住的外甥汪姓人家，他的儿子出疹已经三天。看见我正悲伤，没有邀请我诊治，自行使用了前胡、杏仁、麻黄、石膏等药物一二剂，皮疹出了二十余点，不能再增加。心胸烦闷，不得已来告诉我，乞求我诊治。我说：“如果再攻逐透发，就会像我的儿子一样了。”急忙给予白术、苍术、川芎、当归、桂枝、茯苓、红花等药，服用一剂后热退身安。我从这时才开始领悟出疹的根本原因。凡是治疗出疹，只要调理气血，调和经络，对于寒凉攻发的方法，一概置之不用。所以屡治而屡效。（朱曰：除了寒凉攻发之外，又有调气血和经络这一方法，这是金针度人的秘诀，必须牢记。）
次年春天，朋友吴题仙的儿子刚两岁，出疹。请儿科医生马圣则诊治。攻发不透，神情恍惚，喘急不安。又请我去诊治。我前往吴宅，马兄先到。我看诊后，知道他是虚证。于是告诉主人说：“如果只发疹，疹断然出不来，必定危及生命。”主人问：“该怎么办？”我说：“只有温补药一剂，益其脏腑，安其肠胃，助其气血，才可以。”马兄说：“我治疗了四天，不能透发，完全听从您的裁决。”我随即给予白术、苍术、干姜、桂枝、当归、白芍、茯苓、甘草、金银花、红花等味，服用一剂后病情安定。第二天仍用原方，加入人参一钱。此后不再服药，连服独参汤数日，霍然痊愈。
又有夏姓耀如的儿子出疹。其颜色紫暗，神气不宁。我说：“这个证候大凶，治疗须得法。”连续看了两次，都用温散药。第二天早上，他的家人来告知说：“孩子吐蛔虫，另有药吗？”我说：“昨天的两剂药，都服了吗？”回答说：“还存有一剂。”于是给予附子八分，令其入药内煎服。从此就没有音讯了。过了三年，我到他家，见到他的儿子长大了。我问：“往年出疹吐蛔，是如何痊愈的？”他家回答说：“服用先生的药后，因为无力再延请医生，仗赖上天保佑，得以逐渐痊愈。”我默默叹息：“因为我的失误害死了自己的儿子，却救了别人的儿子。治疗出疹的方法，可以说没有遗憾了。”我因此附录记载在这本书中，虽然不能让儿科医生相信，但阐明了正道，确实对儿科治疗出疹的根本有所帮助，也是那些有孩子出疹的人所应当谨慎对待的啊。
In the spring of the Jisi year, my eldest son was just six years old, and my second son was just three. On the day after the New Year's Day, both children developed fever and rashes. Initially, I did not understand the root cause of rashes, believing that infants hold foul blood in their mouths at birth, which is swallowed when they cry, later transforming into rash toxins. Therefore, treating rashes should naturally involve attacking and venting them out. I immediately administered cooling and venting formulas. The next day, only a few more spots appeared, and they failed to emerge smoothly. I felt extremely anxious and confused.
The eldest son was born prematurely at seven months, with an innate weak constitution. I asked if his chest and diaphragm felt open; he replied that he was very hungry. I then asked if his mouth tasted dry or bitter; he replied that it was bland. From this, I determined it was a deficiency pattern. I immediately prescribed Atractylodis Rhizoma (Baizhu), Poria (Fuling), Glycyrrhizae Radix et Rhizoma (Gancao), Cinnamon Twig (Guizhi), and Safflower Honghua. After one or two doses, the rash spread over his entire body the next day, and the fever subsided slightly, but his spirit remained irritable. He had night fevers and frequent coughs, only stabilizing after a month. This was because excessive use of exterior-releasing agents during the initial appearance of the rash had depleted his meridians.
The second son was still too young to understand matters or speak. In the previous winter, he suffered from Lung Wind Phlegm-Wheezing Syndrome (Feifeng Tanxuan Zheng), for which various medicines were ineffective. However, one dose of Mahuang Xingguo Guizhi Shigao Tang (Ephedra, Apricot Kernel, Cinnamon Twig, and Gypsum Decoction) cured him. I said his constitutional quality was slightly stronger than his brother's. His rash failed to emerge, likely due to cold coagulation and severe toxin retention. Therefore, I gave him Perilla Leaf (Zisu), Ephedra Herba (Mahuang), Peucedani Radix (Qianhu), Apricot Kernel (Xingren), Scutellariae Radix (Huangqin), and Gypsum (Shigao). The red spots did not increase. I then fumigated and pressed him with Perilla Leaf, Scallion Stem (Congbai), Ginger (Shengjiang), and Coriander Herb (Yansui), but the rash still did not emerge. I consulted with fellow physicians, who all claimed there was no method other than venting. By the fifth day, the child vomited roundworms. The pediatric doctor said, "This is heat extreme generating worms." I had Niuhuang San (Calculus Bovis Powder), which is actually Rhubarb powder (Dahuang Mo). After one dose, the phlegm-wheezing stopped, and his spirit calmed slightly. From then on, the child became mute. With no further options, I acupunctured the Baihui GV20 point to open the orifices, administered a small amount of Moschus (Xi Huang), and tried various single-herb prescriptions. Observing his signs and symptoms, survival seemed impossible. My friend Zhang Weisheng came to visit and said, "This is a severe deficiency and cold pattern. Since he cannot speak or eat, it is unlikely to be helped. Yet, my heart cannot bear it. I reluctantly administered Renshen Fuzi Tang (Ginseng and Aconite Decoction). He died with the medicine in his mouth. I sighed, 'This is the retribution for quack doctors appearing in the world; it is natural justice. Since I practice medicine myself, how can I blame others?' Thus, I regretted my past errors and firmly believed that seeking the root in treatment is infallible.
The next day, a relative by marriage, surnamed Wang, whose son had been having rashes for three days, saw me grieving and did not invite me to consult. Instead, he self-administered Peucedani Radix, Apricot Kernel, Ephedra Herba, and Gypsum for one or two doses. Only twenty-plus spots emerged, unable to increase further. He felt chest irritability and distress, and finally told me, begging for my consultation. I said, "If you continue to attack and vent, it will be like my son." I urgently prescribed Atractylodis Rhizoma, Cyperi Rhizoma (Cangzhu), Chuanxiong Rhizoma (Chuanxiong), Angelicae Sinensis Radix (Danggui), Cinnamon Twig, Poria, and Safflower. After one dose, the fever subsided, and he became peaceful. From this, I began to realize the root cause of rashes. In treating rashes, one should only regulate Qi and Blood and harmonize the meridians, completely avoiding cooling and attacking methods. Hence, my treatments were repeatedly successful. (Zhu noted: Besides cooling and attacking, regulating Qi/Blood and harmonizing meridians is another method. This golden needle passed down must be remembered.)
In the spring of the following year, the son of my friend Wu Tixian, aged two, developed rashes. He was treated by a pediatric doctor, Ma Shengze. The venting was unsuccessful; the child showed absent-mindedness, panting, and restlessness. I was invited to consult. Upon arriving at Wu's house, Brother Ma had already seen the patient. After examining him, I knew it was a deficiency pattern. I told the host, "If we only try to vent the rash, it will definitely not emerge, and life will be endangered." The host asked, "What should we do?" I said, "Only one dose of warming and tonifying medicine can help its viscera, settle its intestines and stomach, and assist its Qi and Blood." Brother Ma said, "I have treated him for four days without success; I leave it entirely to your judgment." I immediately prescribed Atractylodis Rhizoma, Cyperi Rhizoma, Dried Ginger (Ganjiang), Cinnamon Twig, Angelicae Sinensis Radix, White Peony Root (Baishao), Poria, Glycyrrhizae Radix et Rhizoma, Lonicerae Japonicae Flos (Jinyinhua), and Safflower. After one dose, he stabilized. The next day, I used the same formula, adding Codonopsis Radix (Renshen) 1 qian. No further medication was needed; he recovered rapidly after taking Ginseng Monoparty Decoction (Dushen Tang) for several days.
Another case involved the son of Xia Yaoru, who developed rashes. His complexion was purplish-dark, and his spirit was restless. I said, "This is a highly ominous condition; treatment requires proper method." I examined him twice consecutively, using warming and dispersing medicines. The next morning, his family reported, "He vomited roundworms. Is there another medicine?" I asked, "Did he take both doses from yesterday?" They replied, "One dose remains." I then prescribed Aconiti Lateralis Radix Praeparata (Fuzi) 8 fen to be decocted with the remaining medicine. Thereafter, there was no news. Three years later, I visited his home and saw the boy grown up. I asked, "How did he recover from the vomiting of roundworms during the rash last year?" The family replied, "After taking your medicine, due to lack of funds to hire further doctors, relying on Heaven's protection, he gradually recovered." I silently sighed, "Because of my mistake, I lost my own son but saved another's. My methods for treating rashes are now without regret." I appended this record to this book. Although pediatric doctors may not believe it, clarifying the correct path truly benefits the understanding of the roots of treating rashes in pediatrics, and those whose children develop rashes should be cautious.