论曰∶夫生民之道,自微而着,由小而大,此物理灼然,不待经史,证据可知。然小儿气
禀微弱,故《短剧方》云∶人生六岁以上为小,六岁以下,经不全载,所以乳下婴儿有疾难治
者,皆为无所根据。至如小儿斑疹一候,不惟脉理难辨,而治疗最比他病尤重。觉证与伤寒
阴痫相近,通都辅郡,名医辈出,则犹能辨其一二。远地左邑,执病不精,失于详审,投药暴
妄。加之小儿脏腑娇嫩,易为伤动,斑疹未出,往往疑为伤风,即以麻黄等药重发其汗,遂使
表虚里实。若为阴痫治之,便用温惊药品,则热势愈盛。直至三四日证候已定,方得以斑疹
药治之,则所失多矣。大率世俗医者,斑疹欲出,多以热药发之,遂使胃中热极。其初作时
即斑疹见于皮下,其已出者变黑色而内陷,既见不快,尤用热药,熏蒸其疾,斑疹得热则出
愈难。转生热证,大小便不通,更以巴豆取积药下之,则使儿脏腑内虚,热又不除,邪气益
深,变为喘满便血,或为 痈,身体裂破,遂使百年之寿一旦为俗医所误者,可不痛哉。大抵
斑疹之候,始觉多咳嗽,身体温壮,面色与四肢俱赤,头痛腰疼,眼睛黄色,多睡中螈 ,手
足厥,耳尖及尻冷,小便赤,大便秘,三部脉洪数绝大不定是其候也。其乳下儿可兼令乳母
服药。其证候未全或未明者,但可与升麻散解之。其已明者即可用大黄青黛等凉药下之,次
即与白虎汤。如秋冬及春寒未用白虎汤之时,但加枣煎服,不必拘于常法。仲景云∶四月后
天气大热,即可服白虎汤,特言其梗概耳,大率疹 未出即可下。已出即不可下。出足即
宜利大小便。其已出未快者可与紫草散,救生散,玳瑁散之类,其重者以牛李膏散之。或毒
攻咽喉者,可少与紫雪及如圣汤,无不效也。其余热不解,身热烦渴及病疹儿母俱可与甘
露饮。或便血者以牛黄散治之兼宜常平肝脏,解其败热,虑热毒攻肝,即冲于目,内生障翳,
不遇医治,瞳人遂损,尤宜慎之。然已出未平,
切忌见杂人,恐劳力之人,及狐臭熏触故也。未愈不可当风,即成疮痂。如脓 出可烧黑丑
粪灰,随疮贴之,则速愈而无瘢也。及左右不可阙胡荽,盖能御汗气辟恶气故也。如儿能食
物,可时与少葡萄,盖能利小便,及取如穗出快之义也。小儿斑疹本以胎中积热,及将养温
浓,偶胃中热,故乘时而作。《外台方》云∶胃烂即发斑。微者赤斑出,极者黑斑出。赤出五死
一生,黑斑出十死一生。其腑热即为疹,盖热浅也。脏热即为 ,盖热深也。故《证色论》云∶
大者属阴,小者属阳。汲总角而来,以多病之故,因而业医。近年累出诸处治病。当壬申岁
冬无大雪,天气盛温,逮春初,见小儿多病斑疹。医者颇如前说,如投以白虎汤之类,即窃
笑云白虎汤本治大人。盖不知孙真人所论大人小儿为治不殊,但用药剂有多少为异耳。则
是未知用药之法,故多失误。今博选诸家及亲经用有效者方,备录为书。
It is said: The way of human life grows from subtle to manifest, from small to large. This is an obvious principle of nature, evident without the need for classics or history, known through evidence. However, children have weak innate constitution. Therefore, *Duanju Fang* states: "Those above six years old are considered 'small' (children); below six years old, [medical texts] do not fully record [their diseases]. Thus, illnesses in nursing infants are difficult to treat due to lack of theoretical basis." Regarding the condition of macules and rashes in children, not only are pulse patterns difficult to distinguish, but treatment is more critical than other diseases. The symptoms resemble Yin Epilepsy (*Yin Xian*) in Cold Damage (*Shanghan*). In prosperous cities and commanderies, where famous doctors abound, one or two cases may be correctly identified. But in remote counties, physicians lacking precision in diagnosis and failing to examine carefully, administer drugs rashly and arrogantly. Furthermore, children's zang-fu organs are delicate and easily injured. Before macules and rashes erupt, they are often mistaken for Wind-Cold invasion, and heavy sweating agents like Ephedrae Herba (*Mahuang*) are used, leading to exterior deficiency and interior excess. If treated as Yin Epilepsy with warming and calming-agitation medicines, heat intensifies. Only after three or four days, when the syndrome is fixed, are macule-and-rash remedies applied, resulting in significant error. Generally, secular physicians use hot herbs to induce eruption when macules/rashes are about to appear, causing extreme heat in the Stomach. Initially, macules appear subcutaneously; those already erupted turn black and sink inward. Since these look unfavorable, hot herbs are further used to fumigate the disease, making eruption harder due to heat. This transforms into heat syndromes with constipation and urinary retention. Using Castor Seed (*Badou*) to purge accumulation then causes internal deficiency of the zang-fu, while heat remains unremoved and pathogenic factors deepen. This leads to wheezing, fullness, hematochezia, or carbuncles, with body fissures. Thus, a lifespan of a century is lost in a day due to misdiagnosis by mediocre physicians—can this not be lamented?
Generally, the early signs of macules/rashes include cough, warm-to-hot body temperature, redness of the face and limbs, headache, lumbar pain, yellow eyes, somnolence with convulsions during sleep, cold extremities, cold ear tips and sacrum, red urine, and dry stool. The pulse at the Cun, Guan, and Chi positions is flooding, rapid, extremely large, and irregular. For nursing infants, the mother may take medicine concurrently. If the syndrome is incomplete or unclear, Shengma San can be used to resolve and vent. If clear, cooling purgatives like Rhubarb (*Dahuang*) and Indigo Naturalis (*Qingdai*) may be used, followed by Baihu Tang. In autumn, winter, or early spring when cold persists, there is no need to strictly follow standard methods; simply decoct with dates. Zhang Zhongjing stated: "After the fourth month, when weather is very hot, Baihu Tang may be taken," which refers only to the general principle. Generally, if rashes have not erupted, purgation is suitable; if erupted, it is not. Once fully erupted, promoting urination and defecation is appropriate. For those erupted but not smoothly, Zicao San, Jiusheng San, or Dai Mao San may be used. For severe cases, Niuli Gao disperses toxicity. If toxin attacks the throat, Zixue or Rusheng Tang may be given in small amounts, with high efficacy. For residual heat, fever, irritability, and thirst, both the child and the mother may receive Ganlu Yin. For hematochezia, Niuhuang San treats it, while also soothing the Liver to resolve stale heat, preventing heat-toxin from attacking the Liver and ascending to the eyes, causing cataracts/opacities. Without proper treatment, the pupil may be damaged; caution is essential. When eruptions are present but not settled, avoid contact with strangers, fearing fatigue or fox odor may aggravate the condition. Do not expose to wind before healing, lest scabs form. If pus exudes, burning Black Morning Glory Seed (*Hei Chou*) ash and applying it to the sore promotes rapid healing without scars. Perilla (*Husui*) should always be available nearby, as it repels sweat and evil qi. If the child can eat, give small amounts of grapes occasionally, as they promote urination and symbolize smooth, rapid eruption. Pediatric macules/rashes originate from accumulated heat in the womb and excessive warmth in nurturing, combined with occasional stomach heat, triggering onset. *Waitai Fang* states: "Stomach rot causes macules." Mild cases show red macules; severe cases show black macules. Red macules indicate five deaths to one survival; black macules indicate ten deaths to one survival. Fu-organ heat causes rashes (shallow heat). Zang-organ heat causes pustules/severe lesions (deep heat). Thus, *Zhengse Lun* states: Large lesions belong to Yin, small ones to Yang. I, Ji Zongjiao, entered medicine due to frequent illness in my youth. Recently, I have practiced in various places. In the winter of the Ren-Shen year, there was little snow, and the weather was unusually warm. By early spring, many children suffered from macules/rashes. Physicians acted as described previously, such as prescribing Baihu Tang. I secretly laughed, saying Baihu Tang is for adults. This ignorance stems from not knowing that Sun Simiao taught that adult and pediatric treatments are similar, differing only in dosage. Lacking knowledge of medication principles leads to errors. Now, I have selected effective formulas from various sources and personal experience, compiling them into this book.