麻喜清凉痘喜温。痘麻治法不同伦。麻苗痘实无人解。首尾调和法宜遵。
痘麻两症。皆系胎毒。均属心火。而麻则喜清凉之药。如古方化斑汤。以元参易人参。去升
麻、甘草、早米。万氏升斑汤去白桔梗、甘草是也。痘喜温补之剂。如保元汤是也。故麻喜清凉。痘
宜温补。人皆知之。而首尾调和之道。人多不晓。何也。夫麻只要发出得尽。则毒便解。若于初热
将出时。而一味寒凉。冰伏其毒。麻必难以透表。而毒不得解。所以初出至正收。宜安处暖室。勿
用峻寒之剂。使之易透。是麻亦喜和暖也。痘则必待苗而秀。秀而实。脓成而后毒解。若于痘成
实之时。用大温热之药。则反溃烂不收。是痘后亦喜清凉也。业斯道者。须知治麻贵乎审首。治
痘贵乎审尾。无过寒妄热。使温凉相宜。而阴阳自和矣。
古方化斑汤
人参 石膏 知母 牛蒡子 连翘 地骨皮 淡竹叶 升麻 甘草 早米一撮引。
万氏化斑汤
元参 知母 石膏 牛蒡子 麦冬 淡竹叶 桔梗 甘草 水煎服。
麻热远近难定期。半月七八日有之。发热四日疹始现。轻清平安顺症时。
麻症发热。有近则五、六日而出。远则八、九日、或十日、半月乃出。总以发热四日内现标者。
其麻多轻。然必须解毒。若初热之时。既表之后。红影见于肌肤。切宜戒口避风。如或不禁。则皮
毛闭密。毒瓦斯难泄。或变紫黑。或生痰涎。致变惊搐而不治。若遇此候。宜以消毒饮去甘草。加犀
角汁主之。如极渴欲饮水者。只宜少与葱白汤。以滋其渴。又有作寒作热。至于终日不退者。然始
热之际。必见面赤眼肿。多涕多泪。咳嗽连声等外症。宜详察之。慎勿临症恍惚。夫麻之出。其
状如粟。红垒而起。间有不出。或只头面有四肢无者。此则天行时气。湿热在脾。以致昏睡发热。
麻不出现者。当以消风散去人参、川芎、浓朴。加连翘、牛蒡子、粉葛、荆芥、枳壳、薄荷、羌活。只
用三分治之。如或不应。以小柴胡汤去半夏、人参。加牛蒡子、当归身、熟石膏治之。倘风热不散。
久必咳嗽不已。愚按消风散、小柴胡汤二方内之人参、川芎、羌活、浓朴、僵蚕、柴胡、半夏、甘
草、及陈皮等药。麻方禁用之药。根据法删去之。合二方。仅得赤茯苓、黄芩、蝉蜕。俱系三味耳。而
用以治湿热在脾。昏睡发热。致麻不出现等候。其有济耶。此的系坊间误人。断不宜用。愚意莫若
以宣毒发表汤（见第五条）去升麻、桔梗、甘草。加猪苓、泽泻。以泄脾湿。以解其肌之为当也。
消毒饮 治麻出一日。为风寒所冲而收。麻毒内攻。急用此方。免致胃烂不救。
牛蒡子（四钱） 荆芥（二钱） 防风（五钱） 生甘草（一钱） 加乌犀角屑更妙。水煎服。
消风散（子和方）
人参 川芎 羌活 僵蚕 浓朴 陈皮 蝉蜕 茯苓 为末。白汤下。
小柴胡汤 半表半里和解之剂。
人参 黄芩 柴胡 半夏 甘草 姜三片、红枣三枚引。
麻疹喜欢清凉，痘疮喜欢温补。两者的治疗方法截然不同。关于麻疹初起如苗、痘疮后期结实的机理，很少有人能真正理解，因此应当遵循“首尾调和”的治疗原则。
痘疮和麻疹这两种病症，都属于胎毒，都归属于心火范畴。但是麻疹适宜使用清凉的药物，例如古方中的化斑汤（将人参替换为玄参，去掉升麻、甘草、早米），以及万全的升斑汤（去掉白桔梗、甘草）。痘疮则适宜使用温补的药剂，例如保元汤。所以人们都知道麻疹喜清凉，痘疮宜温补。然而，“首尾调和”的道理，很多人并不知晓。为什么呢？因为麻疹只要能够透发干净，毒邪就能解除。如果在初热将要出疹的时候，一味地使用寒凉药物，就会像冰一样伏住毒邪，导致麻疹难以透达体表，毒邪也就无法解除。所以在初出到正收的阶段，适宜让患儿处于温暖的房间，不要使用峻烈的寒凉药剂，使疹子容易透出，这也是麻疹喜欢温和的原因。痘疮则必须等到痘苗长出、灌浆结实，脓液形成后毒邪才能解除。如果在痘疮成实的时候，使用大温大热的药物，反而会导致溃烂不收敛。所以痘疮后期也喜欢清凉。从事这一行业的人，必须知道治疗麻疹贵在审查初期，治疗痘疮贵在审查后期，不要过度使用寒凉或温热药物，使温凉适宜，阴阳自然调和。
古方化斑汤：人参、石膏、知母、牛蒡子、连翘、地骨皮、淡竹叶、升麻、甘草，加早米一撮作为药引。
万氏化斑汤：玄参、知母、石膏、牛蒡子、麦冬、淡竹叶、桔梗、甘草，水煎服。
麻疹发热的时间远近难以定期，有的需要七八天，有的甚至半个月。如果发热四天后疹子才出现，属于轻症，是平安顺症的时期。
麻疹症状发热，快的五、六天出疹，慢的八、九天，或者十天、半个月才出。总之，在发热四天内现出红点的，麻疹通常较轻。然而必须解毒。如果在初热阶段，表证已解之后，肌肤上出现红影，一定要忌口避风。如果不能做到，毛孔闭塞，毒气难以宣泄，可能会变成紫黑色，或者生痰涎，导致惊厥抽搐而死亡。如果遇到这种情况，适宜用消毒饮去掉甘草，加入犀角汁来主治。如果极度口渴想喝水，只适宜少量给予葱白汤来缓解口渴。又有表现为忽冷忽热，整天不退的情况。但在开始发热时，必然见面部发红、眼睛肿胀、多涕多泪、连续咳嗽等外在症状，应当详细观察。千万不要临诊时恍惚不定。麻疹发出的样子像粟米，红色隆起。也有不出疹的，或者只有头面有疹而四肢没有的，这是天行时气，湿热困脾，导致昏睡发热，麻疹不出现的状况。应当用消风散去掉人参、川芎、厚朴，加入连翘、牛蒡子、粉葛、荆芥、枳壳、薄荷、羌活，仅用三分剂量治疗。如果无效，用小柴胡汤去掉半夏、人参，加入牛蒡子、当归身、熟石膏治疗。如果风热不散，久必咳嗽不止。我按语认为，消风散和小柴胡汤这两方中的人参、川芎、羌活、厚朴、僵蚕、柴胡、半夏、甘草及陈皮等药物，都是治疗麻疹禁用的药物。根据法则删去这些药，合并两方，只剩下赤茯苓、黄芩、蝉蜕这三味药。用来治疗湿热在脾、昏睡发热导致麻疹不出的情况，能有疗效吗？这确实是坊间误导人的方子，绝对不宜使用。我的意见不如用宣毒发表汤（见第五条）去掉升麻、桔梗、甘草，加入猪苓、泽泻，以泄脾湿，透解肌表，这样更为妥当。
消毒饮：治疗麻疹发出一天，因受风寒冲击而隐退，麻毒内攻，急用此方，以免导致胃烂不治。
牛蒡子（四钱）、荆芥（二钱）、防风（五钱）、生甘草（一钱），加乌犀角屑更好，水煎服。
Mumps (Measles) prefers coolness, while Smallpox prefers warmth. The treatment principles for the two are distinct. Few understand the distinction between the initial stage of mumps and the final stage of smallpox; therefore, one should follow the method of "harmonizing the beginning and end."
Both smallpox and mumps stem from fetal toxins and belong to Heart Fire. However, mumps is suitable for cool-natured medicines, such as the ancient formula Huaban Tang (Hua Ban Decoction), where Ginseng Radix et Rhizoma (Renshen) is replaced by Scrophulariae Radix (Xuanshen), and Ephedrae Herba (Shengma), Glycyrrhizae Radix et Rhizoma (Gancao), and Coicis Semen (Zaomi) are removed; or Wan's Shengban Tang (Sheng Ban Decoction), which removes Platycodonis Radix (Jiegeng) and Glycyrrhizae Radix et Rhizoma (Gancao). Smallpox is suitable for warm-tonifying agents, such as Baoyuan Tang (Bao Yuan Decoction). Thus, it is well known that mumps prefers coolness and smallpox prefers warmth. However, many do not understand the principle of "harmonizing the beginning and end." Why? Because if mumps can be fully erupted, the toxin is resolved. If, during the initial heat phase before eruption, cold-natured drugs are used exclusively, the toxin will be frozen like ice, making it difficult for the rash to penetrate the exterior, and the toxin will not resolve. Therefore, from the initial emergence to the main recovery phase, it is appropriate to keep the patient in a warm room and avoid harsh cold-natured preparations to facilitate eruption; this indicates that mumps also favors warmth. Smallpox, however, must wait until the pustules form, mature, and fill with pus before the toxin resolves. If strongly warming and hot drugs are used when the smallpox pustules are full, it may cause ulceration and failure to heal. Thus, the later stage of smallpox also favors coolness. Practitioners must know that treating mumps requires careful examination of the early stage, while treating smallpox requires careful examination of the late stage. One must avoid excessive cold or heat, ensuring a balance of warmth and coolness so that Yin and Yang naturally harmonize.
Ancient Huaban Tang: Ginseng Radix et Rhizoma (Renshen), Gypsum Fibrosum (Shigao), Anemarrhenae Rhizoma (Zhimu), Arctii Fructus (Niubangzi), Forsythiae Fructus (Lianqiao), Lycii Cortex (Digupi), Lophatheri Herba (Dan Zhuye), Ephedrae Herba (Shengma), Glycyrrhizae Radix et Rhizoma (Gancao), with a pinch of Coicis Semen (Zaomi) as an adjuvant.
Wan's Huaban Tang: Scrophulariae Radix (Xuanshen), Anemarrhenae Rhizoma (Zhimu), Gypsum Fibrosum (Shigao), Arctii Fructus (Niubangzi), Ophiopogonis Tuber (Maidong), Lophatheri Herba (Dan Zhuye), Platycodonis Radix (Jiegeng), Glycyrrhizae Radix et Rhizoma (Gancao), decocted in water.
The timing of fever in mumps varies and is difficult to predict; it may take seven to eight days, or even half a month. If the rash appears after four days of fever, it indicates a mild case, which is a favorable progression.
In mumps, fever may erupt in five to six days, or slowly in eight to nine days, ten days, or even half a month. Generally, if red spots appear within four days of fever onset, the mumps is usually mild. However, detoxification is necessary. After the initial heat phase and exterior syndrome are addressed, if red shadows appear on the skin, one must strictly observe dietary restrictions and avoid wind. Failure to do so will cause pore closure, preventing toxin expulsion, potentially leading to purple-black discoloration or phlegm-saliva production, resulting in convulsions and death. In such cases, Xiaodu Yin (Xiao Du Drink) without Glycyrrhizae Radix et Rhizoma (Gancao) plus Rhinocerotis Cornu (Xijiao) juice is indicated. If extreme thirst occurs, only small amounts of Allii Fistulosi Bulbus (Congbai) soup should be given to moisten the throat. There are also cases of alternating chills and fever lasting all day. Initially, symptoms include red face, swollen eyes, excessive discharge and tears, and continuous coughing; these must be carefully observed. Do not hesitate during diagnosis. The appearance of mumps resembles millet grains, red and raised. Some cases show no eruption, or only on the head and face with none on the limbs; this is due to epidemic qi and damp-heat in the Spleen, causing lethargy, fever, and non-eruption of mumps. In such cases, Xiaofeng San (Xiao Feng Powder) should have Ginseng Radix et Rhizoma (Renshen), Ligustici Chuanxiong Rhizoma (Chuanxiong), and Magnoliae Officinalis Cortex (Houpo) removed, and Forsythiae Fructus (Lianqiao), Arctii Fructus (Niubangzi), Puerariae Radix (Fenge), Schizonepetae Spica (Jingjie), Aurantii Fructus (Zhike), Menthae Haplocalycis Herba (Bohe), and Notopterygii Rhizoma et Radix (Qianghuo) added. Use only 3 fen for treatment. If ineffective, use Xiao Chaihu Tang (Xiao Chai Hu Decoction) without Pinelliae Rhizoma (Banxia) and Ginseng Radix et Rhizoma (Renshen), adding Arctii Fructus (Niubangzi), Angelicae Sinensis Radix (Danggui), and Prepared Gypsum Fibrosum (Shigao). If wind-heat persists, chronic cough will ensue. My commentary notes that Ginseng Radix et Rhizoma (Renshen), Ligustici Chuanxiong Rhizoma (Chuanxiong), Notopterygii Rhizoma et Radix (Qianghuo), Magnoliae Officinalis Cortex (Houpo), Bombyx Batryticatus (Jiangcan), Bupleuri Radix (Chaihu), Pinelliae Rhizoma (Banxia), Glycyrrhizae Radix et Rhizoma (Gancao), and Tangerine Peel (Chenpi) found in Xiaofeng San and Xiao Chaihu Tang are contraindicated in mumps treatments. Removing these according to the rules leaves only Red Poria (Chifuling), Scutellariae Radix (Huangqin), and Cicada Slough (Chantui)—just three herbs. Using these to treat damp-heat in the Spleen causing lethargy, fever, and non-eruption of mumps is unlikely to be effective. This is indeed a misleading prescription from bookshops and should not be used. I suggest using Xuandu Fabiao Tang (Xuandu Fabiao Decoction - see Item 5) without Ephedrae Herba (Shengma), Platycodonis Radix (Jiegeng), and Glycyrrhizae Radix et Rhizoma (Gancao), adding Polyporus (Zuling) and Alisma Rhizoma (Zexie) to drain Spleen dampness and release the muscle layer, which is more appropriate.
Xiaodu Yin: Treats mumps that have erupted for one day but retract due to wind-cold invasion, causing internal attack of mumps toxin. Use urgently to prevent fatal gastric rot.
Arctii Fructus (Niubangzi, 4 qian), Schizonepetae Spica (Jingjie, 2 qian), Saposhnikoviae Radix (Fangfeng, 5 qian), Raw Glycyrrhizae Radix et Rhizoma (Sheng Gancao, 1 qian). Adding Rhinocerotis Cornu (Xijiao) is better. Decoct in water.
Xiaofeng San (Formula by Liu Wansu): Ginseng Radix et Rhizoma (Renshen), Ligustici Chuanxiong Rhizoma (Chuanxiong), Notopterygii Rhizoma et Radix (Qianghuo), Bombyx Batryticatus (Jiangcan), Magnoliae Officinalis Cortex (Houpo), Tangerine Peel (Chenpi), Cicada Slough (Chantui), Poria (Fuling). Grind into powder, take with plain boiled water.
Xiao Chaihu Tang: A harmonizing agent for half-exterior and half-interior syndromes.
Ginseng Radix et Rhizoma (Renshen), Scutellariae Radix (Huangqin), Bupleuri Radix (Chaihu), Pinelliae Rhizoma (Banxia), Glycyrrhizae Radix et Rhizoma (Gancao), with three slices of Zingiberis Rhizoma Recens (Shengjiang) and three Jujubae Fructus (Hongzao) as adjuvants.