蝉壳末
上用水煎羊子肝汤，调服一二钱。
凡痘疮才欲着痂，即用酥或面油不住润之，可揭即揭去。若不润及，迟揭疮痂，硬即隐
成瘢痕，终身受累。（附）
凡小儿实热疏转后，如无虚证，不可妄温补。热必随生，（附）
余平生刻意方药，察脉按证，虽有定法，而探源应变，自谓妙出意表。盖脉难以消息求
证，不可言语取者，褪褓之婴，孩提之童。尤甚焉。故专一为业，垂四十年。因缘遭遇，供奉
禁掖，累有薄效，误被恩宠。然小儿之疾，阴阳为痫最大，而医所覃思，经有备论；至于斑疹
之候，蔑然危恶反惊搐，伤寒二痫大同，而用药甚异，投剂小差，悖谬难整，而医者恬不为
虑。比得告归里中广川，及之出方一秩示予，予开卷而惊叹曰∶是予平昔之所究心者，而子
乃不言，传而得之。予深嘉及之少年，艺术之精，而又惬素所愿以授人者，于是辄书卷尾焉。
时元佑癸酉八年十月丙申日翰林医官太医丞赐紫金鱼袋钱乙题董氏《小儿斑疹备急方论》全
此一卷论小儿疮疹。疮疹与伤寒相类，头疼身热，足冷脉数，疑似之间，只与升麻汤。缘
升麻汤解肌兼治疮子，已发未发皆可服，但不可疏转，此为大戒。伤寒身热固不可下，疮疹
发热在表尤不可转，世人不学乃云初觉以药利之，宣其毒也。误矣。又云疮豆已出不可疏
转，出得已定或脓血太盛，却用疏利亦非也。大抵疮疹首尾皆不可下。小儿身热，耳冷，尻
冷、咳嗽辄用利药，即毒瓦斯入里杀人，但与化毒汤，紫草木通汤，鼠粘子汤；出得太盛，即用
犀角地黄汤解之；若疮痘出不快，烦躁不得眠者，水解散，麻黄黄芩汤，升麻黄芩汤，活血散
主之；黑疮倒厌，猪尾膏，无比散，龙脑膏子无不验也；若热毒攻咽喉痛，如圣汤；疮豆入眼，
决明散，拨云散，密蒙花散，通圣散，蛤粉散主之。治疮疹法无出此矣。
升麻汤 治伤寒中风，头痛憎寒壮热，支体痛，发热畏寒，鼻干不得睡。兼治小儿大人
疮疹已发未发，皆可服，兼治寒暄不时，人多疾疫，乍暖脱着，及暴热之次忽变阴寒，身体疼痛，头重如石者。
升麻 白芍药 甘草炙 干葛（各等分）
上锉如麻豆大，每服五钱，以水一盏半，煎至八分，去滓，温服。若太假寒，即热服，若热即温服。疮疹亦
准此，服药已，身凉止药。小儿量度多少服，如老儿吃，去芍药加柴胡一两，人参半两，雪白芍药一分。
犀角地黄汤 治伤寒及温病应发汗而不发汗，内有瘀血者，及鼻衄吐血不尽，内有余，
瘀血面黄，大便黑者，此方主消化瘀血，兼治疮疹出得太盛，以此解之。
芍药（三分） 生地黄（半斤） 牡丹皮（去心，一两） 犀角（一两，屑，如无以升麻代之）
上锉如麻豆大，每服五钱匕，水一盏半，煎取一盏。有热如狂者，加黄芩二两；其人脉
大来迟，腹不满自言满者，为无热，更不用黄芩也。
麻黄黄芩汤 治小儿伤寒无汗，头疼发热，恶寒，兼治天行热气，生豌豆疮，不快，益烦躁昏愦，或出尚身疼
热者。
麻黄（去节，一两） 黄芩 赤芍药（各半两） 甘草（炙） 桂枝（去皮，各一分）
上捣罗为细末，每服二钱，滚水调下日三服。
升麻黄芩汤 治小儿伤风有汗，头疼发热恶寒，若时行疮痘出不快，烦躁不眠者，加木香（一钱五分）。
升麻 葛根 黄芩 芍药（各三钱） 甘草（炙，一钱半）
上锉如麻豆大，每服二钱，以水一中盏，煎至六分，去滓，温服。
化毒汤 治小儿疮痘已出未出并皆服之。
紫草嫩者 升麻 甘草（炙，各半两）
上锉如麻豆大，以水二盏，糯米五十粒，煎至一盏，去滓，温服。
德按∶刘氏《幼幼新书》加木通二钱五分，
名曰夺命散，此疮疹之祖方也。
紫草木通汤 治小儿疮疹。
紫草（去芦） 木通 人参 茯苓（去皮） 糯米（各等分） 甘草（半之）
上锉如麻豆大，每服四钱匕，以水一盏半，煎至一盏，去滓，温服。
鼠粘子汤 治疹痘欲出未能得透，皮肤热，气攻咽喉，眼赤心烦者。
鼠粘子（四两，炒香） 甘草（一两） 防风（半两） 荆芥穗（二两）
上捣罗为末，每服二钱，沸汤点服，食后临卧，逐日三服，大利咽膈，化痰涎止嗽。若春
冬间，常服免生疮疖，老幼皆宜服。
水解散 治天行头痛壮热一二日，兼治 疮未出烦躁，或出尚身体发热。
大黄 黄芩 桂心 甘草（炙） 芍药（各二两） 麻黄（四两，去节汤泡焙）
上捣罗为末，患者以生熟汤浴讫，以暖水调下二钱，相次二服，得汗利便瘥。强实人服
二方寸匕。此调风实之人，三伏中宜用。若去大黄，即春夏通用。
活血散 治疮子或出不快。
用白芍药末一钱酒调，如欲止痛用温热水调下。
猪尾膏 治疮子倒厌黑陷。
用小猪儿尾尖刺血三两点，入生龙脑少许，同研，新汲水调下立效，惟实热证，方可用此。
无比散 治疮疹恶候不快，及黑疮子，应一切恶候。
牛黄 麝香 龙脑 腻粉（各一分，研细） 朱砂（一两，先研如粉）
上为极细粉，小儿一字，大人五分，水银少许，同小 猪尾上血三两滴，新汲水少许，
同调服，先安稳得睡，然后取转，下如烂鱼肠蒲桃穗之类涎臭恶物便安，小儿用奶乳汁滴尤妙。
龙脑膏子 治时疾发豌豆疮，及赤疮子未透，心烦狂躁，气喘妄语，或见鬼神，或已发
而陷伏，皆宜速治，不尔毒入脏必死。
生龙脑（一钱）
上细研，旋滴猪心血和丸，芡实大，每服一丸。心烦狂躁者用紫草汤化下，若疮子陷伏
者用温酒化下，少时心神便定得睡，疮疹发透，根据常将息也。
附阎氏方 治伏热在心，昏瞀不省，或误服热药，搐热冒昧不知人，及疮疹倒厌黑陷。
生梅花脑子研半字或一字，取新杀猪心一个，取心中血同研作大丸，用新汲水少许化
下，未省再服；如疮疹陷伏者，温酒化下。
如圣汤 治小儿疮疹，毒攻咽喉肿痛。
桔梗（一两） 牛蒡子（炒，一两） 生甘草（一两） 麦门冬（去心，半两）
上为细末，每服二钱，沸汤点，细细呷服，入竹叶煎服尤妙。
决明散 治疹痘疮入眼。
右决明子（一分） 栝蒌根（半分） 赤芍药（一分） 甘草（一分，炙）
上捣罗为末，每服半钱，蜜水调下，日进三服。
拨云散 治疹痘疮入眼及生翳。
桑螵蛸（真者一两，炙令焦，细研）
上捣罗为细末，入麝香少许，令匀，每服二钱，生米泔调下，临卧服之。
密蒙花散 治疹痘疮并诸毒瓦斯入眼。
密蒙花（一钱半，净） 青葙子 决明子 车前子（各半钱）
上为细末，用羊肝一片，破开作三片，掺药令匀，却合作一片，以湿纸七重裹，塘灰火中煨熟，空心食。
通望散 治疹痘疮入眼及生翳。
白菊花（一两），如无以甘菊花代之 绿豆皮 谷精草（去根，各一两）
上捣罗为末，每服用一大钱，干柿一个，生粟米泔一盏，共一处，煎后，米泔尽，只将干
柿去核吃之，不拘时候，一日可吃三枚，日浅者五七日可效，远者半月愈矣。
蛤粉散 治小儿疮子入眼。
谷精草 蛤粉（各等分）
上为末，每服一钱匕，猪肝二两许，批开掺药，卷了青竹叶，裹麻缕缠定，水一碗煮令
熟，入收口瓷缸内，熏眼后，温取食，日作，不过十日退。
Powdered Cicada Slough (Cicadae Periostracum).
Boil the above in sheep liver soup, and take one or two qian with the decoction.
Whenever a smallpox rash is just about to form scabs, immediately moisten it continuously with butter or flour oil. Remove the scabs as soon as they can be peeled off. If not moistened, delaying the removal of scabs will cause them to harden and leave permanent scars, causing lifelong suffering. (Appendix)
For children with excess heat syndromes who have undergone purgation, if there are no signs of deficiency, do not recklessly use warming and tonifying methods. Heat will inevitably arise. (Appendix)
Throughout my life, I have dedicated myself to studying herbal prescriptions, examining pulses and differentiating syndromes. Although there are established principles, I believe that exploring the root causes and adapting to changes yields effects that are wonderfully beyond expectation. This is especially true for infants in swaddling clothes and young children, whose pulse conditions are difficult to ascertain through words alone. Thus, I have made this my sole profession for nearly forty years. By chance, I was admitted to serve in the imperial palace, achieving modest results and receiving undeserved imperial favor. However, among pediatric diseases, convulsions and epilepsy caused by yin-yang imbalance are the most severe. While physicians ponder deeply on this, medical classics have already provided detailed discussions. Regarding rashes and macules, the condition is often perilous and malignant, frequently accompanied by convulsions and tremors. These present similarly to the two types of epilepsy caused by Cold Damage (Shanghan), yet the medicinal approaches differ significantly. A slight error in prescription leads to irreparable mistakes, yet physicians remain complacent. Recently, Dong Jizhi, who had retired to his hometown in Guangchuan, showed me a collection of his prescriptions. Opening the volume, I exclaimed: "This is what I have devoted myself to studying, yet you kept it secret until now." I deeply admire Jizhi's mastery of medicine in his youth and appreciate his willingness to share his knowledge, fulfilling his long-held wish. Thus, I wrote this at the end of the volume.
Written on the day Bing Shen of the tenth month of the eighth year of Yuanyou (1093 AD) by Qian Yi, Hanlin Medical Officer, Grand Master of the Imperial Medical Bureau, recipient of the Purple Gold Fish Bag, upon the completion of Dong's *Treatise on Emergency Prescriptions for Pediatric Rashes*.
This volume discusses pediatric rashes and sores. Rashes resemble Cold Damage (Shanghan), presenting with headache, fever, cold feet, and rapid pulse. In cases of doubt, only Shengma Tang (Cinnamon Twig Decoction - Note: actually Primula Decoction) should be used. Because Shengma Tang releases the muscle layer and treats rashes, it can be taken whether the rash has erupted or not. However, purgation is strictly forbidden; this is the greatest taboo. In Cold Damage, fever should not be treated with purgatives; in rashes, when heat is in the exterior, purgation is even more contraindicated. Unlearned people claim that early intervention with purgatives helps expel toxins. This is erroneous. It is also said that once rashes have erupted, purgation is forbidden. Even if pus and blood are excessive after eruption, using purgatives is incorrect. Generally, rashes should never be treated with purgatives from start to finish. For children with fever, cold ears, cold buttocks, and cough, using purgatives allows toxins to enter the interior and kill. Instead, use Huadu Tang (Detoxification Decoction), Zicao Mutong Tang (Arnebia and Akebia Decoction), or Niuzi Tang (Burdock Seed Decoction); if eruptions are too profuse, use Xijiao Dihuang Tang (Rhinoceros Horn and Rehmannia Decoction) to resolve it; if eruptions are slow, accompanied by irritability and insomnia, use Shuijie San (Water-Resolving Powder), Mahuang Huangqin Tang (Ephedra and Scutellaria Decoction), Shengma Huangqin Tang (Primula and Scutellaria Decoction), or Huoxue San (Blood-Invigorating Powder); for black, inverted, or sunken rashes, Zhuwei Gao (Pig Tail Ointment), Wubi San (Incomparable Powder), or Longnao Gaozi (Borneol Pills) are all effective; if heat-toxins attack the throat causing pain, use Rusheng Tang (Like-Sage Decoction); if rashes affect the eyes, use Jueming San (Cassia Seed Powder), Boyun San (Cloud-Piercing Powder), Mimenghua San (Mimosa Flower Powder), Tongsheng San (Universal Salvation Decoction), or Hafan San (Clam Shell Powder). These are the methods for treating rashes.
**Shengma Tang (Primula Decoction)** Treats Cold Damage and Wind Strike, with headache, aversion to cold, high fever, limb pain, fever, chills, dry nose, and inability to sleep. Also treats pediatric and adult rashes, whether erupted or not. Additionally treats irregular weather patterns, epidemics, improper dressing due to sudden warmth, and sudden shifts from intense heat to cold, causing body pain and heavy head.
*Ingredients:* Shengma (Primulae Radix), Baishao Yao (White Peony Root), Gancao (Licorice Root, honey-fried), Gange (Kudzu Root) in equal parts.
*Preparation:* Cut into pieces the size of hemp seeds. Take five qian per dose. Boil in 1.5 cups of water until reduced to 0.8 cups. Strain and take warm. If there is false cold, take hot; if heat, take warm. For rashes, follow this method. Stop medication once the body cools. Children adjust dosage according to age. For elderly patients, remove Baishao Yao and add Chaihu (Bupleurum Root) 1 liang, Renshen (Ginseng Root) 0.5 liang, and Xuebai Shaoyao (Snow-white Peony Root) 0.1 fen.
**Xijiao Dihuang Tang (Rhinoceros Horn and Rehmannia Decoction)** Treats Cold Damage and Warm Diseases where sweating was indicated but not performed, resulting in internal blood stasis. Also treats incomplete epistaxis or hematemesis, residual internal heat, yellow complexion due to stasis, and black stool. This formula resolves blood stasis and treats excessively profuse rashes.
*Ingredients:* Shaoyao (Peony Root) 3 fen, Sheng Dihuang (Fresh Rehmannia Root) 0.5 jin, Mudan Pi (Tree Peony Bark, heart removed) 1 liang, Xijiao (Rhinoceros Horn, powdered) 1 liang (if unavailable, substitute with Shengma).
*Preparation:* Cut into pieces the size of hemp seeds. Take 5 qian-bi per dose. Boil in 1.5 cups of water until 1 cup remains. If there is heat with manic behavior, add Huangqin (Scutellaria Root) 2 liang. If the pulse is large but slow, and the abdomen feels full despite not being distended, there is no heat; do not use Huangqin.
**Mahuang Huangqin Tang (Ephedra and Scutellaria Decoction)** Treats pediatric Cold Damage with no sweat, headache, fever, and aversion to cold. Also treats epidemic heat, slow eruption of pox-like sores, increased irritability and confusion, or persistent body pain and heat after eruption.
*Ingredients:* Mahuang (Ephedra Stem, nodes removed) 1 liang, Huangqin (Scutellaria Root) 0.5 liang, Chishaoyao (Red Peony Root) 0.5 liang, Gancao (Licorice Root, honey-fried) 1 fen, Guizhi (Cinnamon Twig, bark removed) 1 fen.
*Preparation:* Pound and sieve into fine powder. Take 2 qian per dose, mixed with boiling water. Take three times daily.
**Shengma Huangqin Tang (Primula and Scutellaria Decoction)** Treats pediatric Wind Strike with sweat, headache, fever, and aversion to cold. If epidemic rashes erupt slowly with irritability and insomnia, add Muxiang (Aucklandia Root) 1.5 qian.
*Ingredients:* Shengma (Primulae Radix) 3 qian, Gegen (Kudzu Root) 3 qian, Huangqin (Scutellaria Root) 3 qian, Shaoyao (Peony Root) 3 qian, Gancao (Licorice Root, honey-fried) 1.5 qian.
*Preparation:* Cut into pieces the size of hemp seeds. Take 2 qian per dose. Boil in 1 cup of water until reduced to 0.6 cups. Strain and take warm.
**Huadu Tang (Detoxification Decoction)** Can be taken by children whether rashes/sores have erupted or not.
*Ingredients:* Zicao (Arnebia Root, tender) 0.5 liang, Shengma (Primulae Radix) 0.5 liang, Gancao (Licorice Root, honey-fried) 0.5 liang.
*Preparation:* Cut into pieces the size of hemp seeds. Boil in 2 cups of water with 50 grains of glutinous rice until reduced to 1 cup. Strain and take warm.
*Note:* Liu's *Youyou Xinshu* adds Mutong (Akebia Caulis) 2.5 qian, naming it *Duoming San* (Life-Seizing Powder), which is the ancestral formula for rashes.
**Zicao Mutong Tang (Arnebia and Akebia Decoction)** Treats pediatric rashes.
*Ingredients:* Zicao (Arnebia Root, rhizome removed) equal parts, Mutong (Akebia Caulis) equal parts, Renshen (Ginseng Root) equal parts, Fuling (Poria) equal parts, Nuomi (Glutinous Rice) equal parts, Gancao (Licorice Root) half the amount of others.
*Preparation:* Cut into pieces the size of hemp seeds. Take 4 qian-bi per dose. Boil in 1.5 cups of water until 1 cup remains. Strain and take warm.
**Niuzi Tang (Burdock Seed Decoction)** Treats rashes/pox that desire to erupt but cannot penetrate, with hot skin, qi attacking the throat, red eyes, and irritability.
*Ingredients:* Niuzi (Burdock Fruit, stir-fried until fragrant) 4 liang, Gancao (Licorice Root) 1 liang, Fangfeng (Saposhnikovia Root) 0.5 liang, Jingjiesui (Schizonepeta Spike) 2 liang.
*Preparation:* Pound and sieve into powder. Take 2 qian per dose, steeped in boiling water. Take after meals and before bed, three times daily. Benefits the throat and diaphragm, transforms phlegm, and stops coughing. Regular use in spring and winter prevents sores and boils; suitable for old and young.
**Shuijie San (Water-Resolving Powder)** Treats epidemic headache and high fever for one to two days. Also treats irritability before rash eruption or persistent body heat after eruption.
*Ingredients:* Dahuang (Rhubarb Root) 2 liang, Huangqin (Scutellaria Root) 2 liang, Guixin (Cinnamon Bark) 2 liang, Gancao (Licorice Root, honey-fried) 2 liang, Shaoyao (Peony Root) 2 liang, Mahuang (Ephedra Stem, nodes removed, soaked in water and dried) 4 liang.
*Preparation:* Pound and sieve into powder. After bathing the patient in lukewarm water, mix 2 qian with warm water. Take two doses consecutively. Recovery occurs with sweating and bowel movement. Robust individuals may take 2 fangcun bi. Suitable for wind-excess constitutions in midsummer. Removing Dahuang makes it suitable for spring and summer.
**Huoxue San (Blood-Invigorating Powder)** Treats rashes that erupt slowly.
*Usage:* Mix 1 qian of Baishao Yao (White Peony Root) powder with wine. To relieve pain, mix with warm water.
**Zhuwei Gao (Pig Tail Ointment)** Treats inverted, black, or sunken rashes.
*Usage:* Prick the tip of a piglet's tail to obtain 2-3 drops of blood. Mix with a small amount of raw Longnao (Borneol). Grind together. Take mixed with fresh well-water. Effective immediately. Only for excess-heat syndromes.
**Wubi San (Incomparable Powder)** Treats malignant/rash complications, black rashes, and all adverse conditions.
*Ingredients:* Niuhuang (Calculus Bovis) 1 fen, Shexiang (Musk) 1 fen, Longnao (Borneol) 1 fen, Nifen (Calomel) 1 fen (all finely ground), Zhusha (Cinnabar) 1 liang (ground to powder).
*Preparation:* Make an extremely fine powder. Dosage: Infant 1 zi, Adult 5 fen. Mix with a little Yinchun (Mercurius), 3 drops of pig tail blood, and a little fresh well-water. Take mixed. The patient sleeps peacefully first, then wakes up. Expulsion of foul-smelling phlegm resembling rotten fish intestines or grape clusters indicates recovery. Using breast milk for infants is excellent.
**Longnao Gaozi (Borneol Pills)** Treats epidemic fevers with pox-like sores, red rashes not fully erupted, irritability, mania, panting, delirium, hallucinations, or rashes that have erupted but sunk/inverted. Must be treated quickly; otherwise, toxins entering the zang organs lead to death.
*Ingredients:* Sheng Longnao (Raw Borneol) 1 qian.
*Preparation:* Grind finely. Mix with pig heart blood to form pills the size of Euryale seeds. Take one pill per dose. For irritability/mania, dissolve in Zicao Tang (Arnebia Decoction). For sunken rashes, dissolve in warm wine. Calms the mind, promotes sleep, and ensures rash eruption. Follow routine care thereafter.
**Appendix: Yan's Formula** Treats latent heat in the heart, dizziness, unconsciousness, or confusion from mistakenly taking hot medicines. Also treats inverted, black, or sunken rashes.
*Usage:* Grind Sheng Meihuanao (Raw Borneol) to half or one zi. Take one freshly slaughtered pig heart, extract the blood, and grind with the borneol to form large pills. Dissolve in a little fresh well-water. Re-administer if consciousness is not regained. For sunken rashes, dissolve in warm wine.
**Rusheng Tang (Like-Sage Decoction)** Treats pediatric rashes where toxins attack the throat causing swelling and pain.
*Ingredients:* Jiegeng (Platycodon Root) 1 liang, Niubangzi (Arctii Fructus, stir-fried) 1 liang, Sheng Gancao (Raw Licorice Root) 1 liang, Maimendong (Ophiopogon Tuber, heart removed) 0.5 liang.
*Preparation:* Make into fine powder. Take 2 qian per dose, steeped in boiling water. Sip slowly. Adding Zhuye (Bamboo Leaf) for decoction is superior.
**Jueming San (Cassia Seed Powder)** Treats rashes/pox affecting the eyes.
*Ingredients:* Juemingzi (Cassiae Semen) 1 fen, Gualougen (Trichosanthes Root) 0.5 fen, Chishaoyao (Red Peony Root) 1 fen, Gancao (Licorice Root, honey-fried) 1 fen.
*Preparation:* Pound and sieve into powder. Take 0.5 qian per dose, mixed with honey-water. Take three times daily.
**Buyun San (Cloud-Piercing Powder)** Treats rashes/pox affecting the eyes and forming nebulae.
*Ingredients:* Sangpiaoxiao (Mantis Egg-case, authentic, 1 liang, roasted until scorched and finely ground).
*Preparation:* Sieve into fine powder. Add a little Shexiang (Musk) and mix evenly. Take 2 qian per dose, mixed with raw rice wash water. Take before bed.
**Mimenghua San (Mimosa Flower Powder)** Treats rashes/pox and various toxins entering the eyes.
*Ingredients:* Mimenghua (Adhatodis Folium) 1.5 qian (cleaned), Qingxiangzi (Celosiae Semen) 0.5 qian, Juemingzi (Cassiae Semen) 0.5 qian, Cheqianzi (Plantaginis Semen) 0.5 qian.
*Preparation:* Make into powder. Take one slice of sheep liver, cut into three pieces, sprinkle powder evenly, reassemble into one piece. Wrap in seven layers of wet paper. Roast in ash fire. Eat on an empty stomach.
**Tongwang San (Universal Vision Powder)** Treats rashes/pox affecting the eyes and forming nebulae.
*Ingredients:* Baijuhua (Chrysanthemi Flos) 1 liang (substitute with Ganjuhua if unavailable), Ludoupi (Vigna Radiata Peel) 1 liang, Gujingcao (Sparganii Herba, roots removed) 1 liang.
*Preparation:* Pound and sieve into powder. Take 1 da qian per dose. Combine with one dried persimmon and 1 cup of raw millet wash water. Decoct until water is gone. Eat the dried persimmon without the pit. Any time. Up to three per day. Early cases improve in 5-7 days; late cases heal in half a month.
**Hafan San (Clam Shell Powder)** Treats pediatric rashes affecting the eyes.
*Ingredients:* Gujingcao (Sparganii Herba) equal parts, Hafan (Concha Arcae) equal parts.
*Preparation:* Make into powder. Take 1 qian-bi per dose. Take approx. 2 liang of pork liver, slice open, sprinkle powder inside, roll in green bamboo leaves, bind with hemp thread. Boil in 1 cup of water until cooked. Place in a narrow-mouthed porcelain jar. Steam the eyes, then eat the liver while warm. Daily application. Clears within ten days.