外台曰。肘后言比岁有病。天下发斑疮。头面及身。须臾周遍。
状如火疮。皆戴白浆。随决随生。不即疗。剧者数日必死。疗得瘥后。
疮瘢紫黯。弥岁方减。此恶毒之气也。世人云。建武中于南阳击虏所
得。乃呼为虏疮。诸家参详作疗用之有效方。取好蜜。通身摩疮上。
或以蜜煎升麻。数数拭之。亦佳。
又曰。永徽四年。此疮从西域东流于海内。但煮葵叶蒜齑啖之
则止。鲜羊血入口亦止。巢氏曰。表虚里实。热毒内盛。攻于脏腑。余
气流于肌肉。遂于皮肤毛孔之中。结成此疮。重者匝遍其身。状如火
疮。若根赤头白则毒轻。若紫色则毒重。其疮如豌豆。亦曰豌豆疮。
脉洪数者。是其候也。
活人书曰。小儿疮疹与伤寒相类。头痛。身热。足冷。脉数。疑似
之间。只与升麻汤丸。缘升麻解肌。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
转也。世人不学。乃云。初觉以药利之。宣其毒也。误已。又云。疮豆
已出。不可疏转。出得已定。或脓血大盛。即用疏利。亦非也。大抵疮
症皆不可下。小儿身热。耳冷。尻冷。咳嗽。辄用利药。则毒瓦斯入里杀
人。但与化毒汤、紫草木通汤、鼠粘子汤。出得太盛。则用犀角地黄
汤解之。若疮出不快。烦躁不得眠者。水解散、麻黄黄芩汤、升麻黄
芩汤、活血散主之。疮黑倒靥。猪尾膏、无比散、龙脑膏子。无不验
也。若热毒攻咽喉痛。如圣汤。疮毒入眼。决明散、拨云散、密蒙花
散、通圣散、蛤粉散主之。治疮疹之法。无出此矣。
庞氏曰。天下豌豆疮。自汉魏以前。经方家不载。或云建武中南
阳征虏所得。俗呼虏疮。其后名医虽论发斑候。是发汗吐下后。热毒
不散。表虚里实。热气凑于外。故身体发斑。又说豌豆 疮。表虚里
实。一如发斑之理别之。热毒内盛。攻于脏腑。余气流于肌肉。遂于
皮肤毛孔中。结成此疮。既是里实。热毒内盛。则欲发未发。疮斑未
见。皆宜下之。疮已瘥。则再下之。此病有三种。一则发斑。俗谓之麻
子。其毒犹轻。二则豌豆。其毒最重。多是冬温所变。凡觉冬间有非节
之暖。疮毒未发。即如法下之。次第服预防之药。则毒瓦斯内消。不
得作矣。有不因冬暖四时自行者。亦如法下之。古方虽有治法。而不
详备。疑当时热毒不甚。鲜有死者。近岁此疾。岁岁未尝无也。甚者
夭枉十有五六。虽则毒瓦斯内坏不治。因医为咎。又大半矣。若身痛壮
热头疼。不与小汗。何由表散。大腑久秘。毒攻腰胁。或心腹胀满。不
与微利。何由释去。故当消息汗下。然则寒药固不当行。温药反增热
毒。若势太甚。脉候洪数。凉性之药。不阻表里气者。亦可通用。若寒
气阻滞。脉候浮迟。则温性之药。不阻表里气者。可冀冰释。云不可
汗下寒热之药。只可紫草一味者。乃滞隅之流。只是遭遇轻疾。以自
瘥为功。若值重病。则拱手待毙也。世有权贵自信。不任医师忌冷热
汗下。病或不救。则责医者谬误。斯又可为伤叹。小儿多染此患。故
此方多用小汤剂。大人宜倍用之。活人书小儿大人疮疹。已发未发。
皆宜服升麻汤。
又曰。伤温病。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。并宜犀角地黄汤以消化瘀血。及疮
疹出得太盛。亦以此汤解之。
又曰。天行热毒。生豌豆疮。出不快。益烦躁昏愦。或虽出。身体
尚热者。宜麻黄黄芩汤以发其表。无汗者。宜用之。有汗者非。
又曰。小儿时行。疮豆出不快。烦躁不眠者。宜升麻黄芩汤加木
香一钱半以杀其毒。有汗者尤宜服。
又曰。小儿疮豆。已出未出。并宜服化毒汤、紫草木通汤。
又曰。豆疮欲出。未透皮肤。热气攻咽喉。眼赤心烦。宜鼠粘子
汤。
又曰。天行头痛。壮热一日二日。及疮 未出。烦躁。或出尚身体发热者。宜水解散去大黄芍药。只用四味。
又曰。疮子不出。宜活血散。以白芍一钱。温热水调下。
又曰。疮子倒靥。宜猪尾膏。小猪儿尾。铁刀刺血一两。入生龙脑少许。同研。和水调下。
又曰。疹疮有一切恶候及黑陷。并宜服无比散。取下恶物便安。
又曰。豌豆疮出未透。心烦狂躁。气喘妄语。或见鬼神。或已发
而陷伏。皆宜速治。宜龙脑膏子。
又曰。痘疮入眼生翳。有决明散、拨云散、密蒙花散、通圣散、蛤
粉散。皆宜择而用之。
庞氏曰。温毒发斑大疫难救兼治豌豆疮不出。宜地黄膏。
又曰。天行发斑疮。须臾遍身皆戴白浆。皆恶物也。
又曰。凡觉冬温。将来春夏必发斑豆。小儿辈于冬暖时。预服漏
芦汤下之。下后。逐日空心饮甘草汁。直候腹疼乃止。或下后饮羊血
一盏。则不发。
雍曰。冬温时。小儿逐日宜服鼠粘子汤。则斑豆喉痹赤目口疮
皆不发。下后。煎甘草黑豆竹叶汤亦好。三晋人不用黑豆。用槐豆尤
胜。羊血。当根据外台法。若下后服之。非宜。
又曰。时行豌豆疮。以槿皮二两。细切。水一升。煮半升。去渣。
分服之。此晋王中令方也。
又曰。初得病。便惊狂不眠。浑身热。汗出。问之。身不憎寒。亦
不恶风。其脉如数。以漏芦根汤下之。甚数者。以大承气汤下之。疮豆伤寒亦然。
又曰。小儿时行疮豆。恐相传染。先服漏芦汤下之。本治热毒痈疽赤白诸丹毒疮疖。雍曰。今根据朱氏法。但存
其说。
又曰。疮豆毒瓦斯不出。烦闷。热毒瓦斯攻腰。或胁腹疼不可忍。大便不通。五杏汤主之。
又曰。热气在表。已发汗未解。或吐下后。热毒不散。烦躁谵语。
此为表虚里实。热气燥于外。故身发斑如锦文。或不因汗下。始得病
一日二日便发。皆由温疫热毒瓦斯使然。甚则发豌豆疮。其色白或赤。
发于皮肤。头作浆。戴白脓者。其毒则轻。其紫黑色者作根。隐隐在
肌肉里。其毒则甚。十死一生。甚者五内七窍皆有疮形如豌豆。故以
名焉。脉洪数者。是其候也。雍曰。疮靥则有紫黑色。初生者。皆赤根白头。
又曰。天行热毒未解。欲生豌豆。发热疼痛。宜解肌发汗。葛根石膏汤。
又曰。斑豆始有白 。忽搐入腹。渐作紫黑色。有脓。日夜啼叫烦乱。宜郁金散。
又曰。此疾小便涩。有血者。中坏也。疮黑靥无脓。十死不治。斑
豆烦喘。小便不利。鳖甲汤。定烦喘。竹沥饮子。又定烦喘。麻黄甘草汤。
又曰。常行豆疮。紫草汤最良。患其服之太少。不能中病。但多
槌切好紫草以沃之。候温去渣服。紫草半升。汤一升为准。
又曰。疮出不快。碎红花子一合。水半升。煎百沸。去渣服。
又曰。斑豆已出。不可发表。更增斑烂。以虚故也。
又曰。疮出不快。表里不解。烦喘。大便闭。气攻腹满。宜犀角升麻汤。
又曰。斑豆服凉药太过。咳嗽。手足冷。脉迟。甘草干姜汤。
又曰。豆疮已出定。芒硝猪胆汁和。研匀涂之。勿动。痂落无痕。仍卧黄土末上良。
又曰。天行豆疮。预服三豆饮则不发。
又曰。疮豆发斑。下利赤黄。或脓血。遍身发热。宜栀子薤豉汤。（八卷）
雍曰。庞氏钱氏诸方。如活人书有缺药症及用之不应者。则取之。
钱氏曰。凡小儿面燥。囟赤。目亦赤。呵欠烦闷。乍凉乍热。咳嗽
喷嚏。足稍冷。夜卧惊悸多眠。并疮疹症。惟用温凉药治之。
又曰。小儿在胎。食五脏血秽。生下。则其毒当出。故疮疹之状。
皆如五脏之液。雍曰。世医言初年不出。至老亦出。此说不经见。庞氏亦无是说。第俚俗有此言。恐钱朱未能免俗
也。
又曰。发热潮热三日以上。热入皮肤。即发疮疹。而不甚咳者。热留肤腠之间故也。
又曰。疮疹尻凉者。顺候也。若疮黑陷。耳尻反热者。逆也。用牛李膏、百祥丸。多至三服。若
不愈者。死病也。
又曰。凡疮疹一发便出尽者。必重。疮夹疹出者。半轻半重也。
出希者轻。里外肥红者轻。外黑里赤者。微重。外白里黑。大重。疮端
里黑点如针孔者。势剧也。青干紫陷。昏睡。汗出不止。烦躁热渴。腹
满啼喘。大小便不通者。困也。凡疮当令乳母忌口。不可令小儿饥。
及受风冷。必变紫黑。难治。
又曰。有大热者。宜利小便。有小热者。宜解毒。若黑紫干陷者。百祥丸下之。不黑者。切不可下。
又曰。疮疹更看时月逆顺。大抵属阳。故春夏病为顺。秋冬病为逆。
又曰。春脓泡。夏黑陷。秋斑子。冬疹子。亦不为顺。雍谓钱氏大
抵拘于脏。谓脓泡为肺金。黑陷为肾水。斑子为心火。疹子为脾土。
皆克四时。故不为顺也。然则黑陷者。何时不为逆也。
又曰。重病犹十活四五。黑者无问何时。十难救一。其候或寒战
噤牙。或身黄肿紫。宜急以百祥丸下之。复恶寒不已。身冷汗出。耳
轮反热者。死病也。下后身热气温。欲饮水者。可治之。宜解毒。不宜
妄下。若能食而痂头焦起。或未焦而喘实者。可下之。雍曰。平时医
者有候疮痂头焦而下者。云欲下余热。不作 痈也。若症中果见有
余热。及疮后脉不衰。信可下。若症无余热。脉已衰弱。则如何敢下。
疮后儿已虚。又下则重虚之。非惟将息不起。又因虚别成大病。脏腑
脆弱。故病未已。新病复加。则难治。不可不慎也。但当解余热。
又曰。身热烦渴。腹满加喘。大小便涩而赤。闷乱大吐。此当利
小便。不瘥者。宣风散下之。若六七日痂未焦。是内发热。热气蒸皮
肤。故不得痂焦也。宣风散导之。磨生犀角解之。
又曰。若疮入腹为脓血。及连痂皮得出者。脾气实也。出则安。
若泻米谷及乳不化者。是脾虚自泻也。必难治。
The *Waitai Miyao* records: The *Zhouhou Beiji Fang* mentions that in recent years, a disease has been prevalent, causing macules and pustules to erupt all over the body. From the head and face to the entire body, it spreads within moments.
The symptoms resemble fire-toxin sores, with each lesion topped by white pus. Once the pustules rupture, new ones immediately form. If not treated promptly, severe cases will inevitably result in death within a few days. After recovery from treatment, the resulting scars are purple and dark, taking a year to fade. This is caused by malignant toxic qi. People say this disease was acquired during the Jianwu era of the Eastern Han Dynasty when campaigning against rebels in Nanyang, hence it is called "Lu Chuang" (Barbarian Sore). Various schools have studied it and formulated effective treatments. One method involves applying high-quality honey all over the body onto the sores. Alternatively, boiling Shengma (Cimicifugae Rhizoma) with honey and frequently wiping the affected area is also good.
It is further stated: In the fourth year of Yonghui (Tang Gaozong's reign), this sore spread eastward from the Western Regions to the Central Plains. Boiling Kuye (Malvae Folium) and garlic paste for consumption can stop the progression. Consuming fresh sheep blood can also halt the condition. Chao Yuanfang states that this occurs due to exterior deficiency and interior excess, with heat toxin flourishing internally, attacking the Zang-Fu organs. The residual qi flows into the muscles, forming these sores within the skin pores. In severe cases, they cover the whole body, resembling fire-toxin sores. If the base is red and the head white, the toxin is mild; if purple, the toxin is severe. These sores resemble peas, thus also called "Pea Sore". A surging and rapid pulse is a sign of this disease.
The *Huo Ren Shu* states: Pediatric eruptions resemble Taiyang disease (Exterior Syndrome). Symptoms include headache, fever, cold feet, and a rapid pulse. When differentiation is difficult, only Shengma Tang (Cimicifuga Decoction) pills should be given. Because Shengma releases the muscle layer and treats eruptions, it can be taken whether the eruption has appeared or not. However, purgation must strictly be avoided; this is the greatest taboo. Fever in Taiyang disease should not be purged; furthermore, eruption fever located at the exterior must certainly not be purged. Unlearned people claim that one should use laxatives at the onset to disperse toxins. This is wrong. Another claim is that once eruptions appear, purgation is forbidden. Yet others suggest that once eruptions are established or suppurate heavily, purgation should be used. This is also incorrect. Generally, eruption conditions should never be purged. For pediatric fever, cold ears, cold buttocks, and cough, using purgatives allows toxin to enter the interior, leading to death. One should instead use Huadu Tang (Detoxification Decoction), Zicao Mutong Tang (Arnebia and Akebia Decoction), or Niuzi Tang (Arctii Decoction). If eruptions appear excessively, Xijiao Dihuang Tang (Rhinoceros Horn and Rehmannia Decoction) should be used to resolve them. If eruptions fail to emerge, accompanied by restlessness and insomnia, Shuijie San (Water-Resolving Powder), Mahuang Huangqin Tang (Ephedra and Scutellaria Decoction), Shengma Huangqin Tang (Cimicifuga and Scutellaria Decoction), or Huoxue San (Blood-Invigorating Powder) should be administered. If eruptions turn black and invert (collapse), Zhuwei Gao (Pig Tail Ointment), Wubi San (Incomparable Powder), or Longnao Gaozi (Borneol Ointment) are invariably effective. If heat toxin attacks the throat causing pain, Rusheng Tang (Like-Sage Decoction) is indicated. If toxin enters the eyes, Jueming San (Cassia Seed Powder), Boyun San (Cloud-Piercing Powder), Mimenghua San (Blind-Cherry Blossom Powder), Tongsheng San (Universal Salvation Powder), or Haifen San (Clam Shell Powder) are indicated. These constitute the methods for treating eruptions.
Pang Shi states: Pea sores were not recorded by classic formula practitioners before the Han and Wei dynasties. Some say they originated from the Nanyang campaign during the Jianwu era, commonly called Lu Chuang. Later famous physicians discussed macule eruptions, attributing them to heat toxin remaining after sweating, vomiting, or purging, leading to exterior deficiency and interior excess, with heat qi gathering on the surface, causing macules. Pea sores share the mechanism of exterior deficiency and interior excess but differ in that heat toxin flourishes internally, attacking Zang-Fu, with residual qi flowing into muscles to form sores in skin pores. Since there is interior excess and internal heat toxin, purgation is appropriate both before emergence (when spots are not yet visible) and after recovery to clear residual toxin. There are three types: 1. Macules, commonly called measles, with milder toxin; 2. Pea sores, with the heaviest toxin, often resulting from abnormal winter warmth. Upon sensing abnormal winter warmth, before toxin emerges, purgation should be performed according to protocol, followed by preventive medicines to dissipate toxin internally. Those occurring spontaneously in other seasons should also be purged. Ancient formulas lack detail, likely because heat toxin was less severe then, resulting in fewer deaths. Recently, this disease occurs annually. Severe cases see 50-60% mortality. While some attribute death to internal toxin destruction, many are due to medical error. If there is body pain, high fever, and headache, failure to induce slight sweating prevents exterior dispersion. If constipation persists with toxin attacking waist/flanks or abdominal distension, failure to induce slight purgation prevents relief. Thus, sweating and purging must be weighed carefully. Cold herbs should not be abused; warm herbs may increase heat toxin. If the condition is severe with a surging/rapid pulse, cooling herbs that do not obstruct Qi flow between exterior and interior may be used generally. If cold qi obstructs with a floating/slow pulse, warm herbs that do not obstruct Qi flow may melt the illness like ice. Claiming that only Zicao (Arnebiae Radix et Rhizoma) alone is usable, rejecting sweating/purging/cold/heat therapies, reflects narrow-mindedness; such cases involve mild illness resolving spontaneously. In severe cases, this approach leads to helplessness. Arrogant nobles distrust physicians, fearing cold/heat and sweating/purging. If the patient dies, they blame the doctor. This is lamentable. Children are prone to this; thus, small decoctions are used. Adults should double the dose. *Huo Ren Shu* states Shengma Tang is suitable for adult and pediatric eruptions regardless of stage.
It is further stated: In Warm Injury, if sweating is neglected while blood stasis exists internally, or if epistaxis/hematemesis is incomplete leaving residual stasis, presenting with yellow complexion and black stool, Xijiao Dihuang Tang should be used to resolve stasis. It is also used for excessive eruptions.
It is further stated: In epidemic heat toxin causing pea sores with slow emergence, increased restlessness/confusion, or persistent fever despite emergence, Mahuang Huangqin Tang should be used to release the exterior. It is indicated for no sweat; contraindicated for those with sweat.
It is further stated: For pediatric epidemic eruptions with slow emergence, restlessness, and insomnia, Shengma Huangqin Tang plus Muxiang (Aucklandiae Radix) 1.5 qian is indicated to neutralize toxin. Especially suitable for those with sweat.
It is further stated: For pediatric eruptions, whether emerged or not, Huadu Tang and Zicao Mutong Tang are suitable.
It is further stated: For bean sores attempting to emerge but not penetrating the skin, with heat attacking the throat, red eyes, and irritability, Niuzi Tang is indicated.
It is further stated: For epidemic headache, high fever for one to two days, unemerged eruptions, restlessness, or persistent fever after emergence, Shuijie San without Dahuang (Rhei Radix et Rhizoma) and Shaoyao (Paeoniae Radix), using only the remaining four ingredients, is indicated.
It is further stated: For unemerged eruptions, Huoxue San is indicated. Take Baishao (White Peony Root) 1 qian, mix with warm water, and take orally.
It is further stated: For inverted/collapsed eruptions, Zhuwei Gao is indicated. Obtain one liang of blood from a piglet's tail via iron knife puncture, add a little raw Longnao (Borneolum Syntheticum), grind together, mix with water, and take orally.
It is further stated: For all adverse signs and black inversion of rashes, Wubi San is indicated. Evacuation of evil matter brings relief.
It is further stated: For pea sores not fully penetrated, with irritability, mania, panting, delirium, hallucinations, or erupted sores collapsing inward, prompt treatment with Longnao Gaozi is indicated.
It is further stated: For痘疮 (smallpox) entering the eyes causing opacity, Jueming San, Boyun San, Mimenghua San, Tongsheng San, and Haifen San are available for selection.
Pang Shi states: For severe epidemic macule eruptions difficult to save, combined with poor pea sore emergence, Dihuang Gao (Rehmannia Ointment) is indicated.
It is further stated: Epidemic macule sores spreading rapidly over the body with white pus caps are all evil matter.
It is further stated: Upon sensing winter warmth, eruptions are certain in spring/summer. Children should take Loulu Tang (Euphorbiae Pekinensis Decoction) to purge during warm winters. After purging, drink Gancao juice (Licorice Juice) daily on an empty stomach until abdominal pain occurs, then stop. Or, drink one cup of sheep blood after purging to prevent eruption.
Guo Yong states: During winter warmth, children should take Niuzi Tang daily to prevent macules, peas, throat bi, red eyes, and mouth sores. After purging, Gancao, Heidou (Black Soybean), and Zhuye (Bamboo Leaf) decoction is also good. In the Jin region, Huaidou (Sophora Flower/Bud) is preferred over Heidou. Sheep blood should follow *Waitai* methods; taking it after purging is inappropriate.
It is further stated: For epidemic pea sores, use Jinpi (Hibiscus Tiliaceus Bark) 2 liang, finely cut, boil in 1 sheng water to 0.5 sheng, strain, and divide doses. This is a formula from Wang Zhongling of the Jin Dynasty.
It is further stated: At onset, if there is惊狂 (fright/manic behavior), insomnia, whole-body heat, sweating, no aversion to cold/wind, and a pulse resembling rapidity, purge with Loulu Gen Tang (Euphorbia Root Decoction). If the pulse is very rapid, use Dachengqi Tang (Major Order the Qi Decoction). This applies to eruptions and Taiyang disease as well.
It is further stated: To prevent contagion of pediatric epidemic eruptions, first purge with Loulu Tang. Originally for heat toxin carbuncles, erysipelas, and boils. Guo Yong states: Following Zhu Shi's method, we retain this statement.
It is further stated: For eruptions where toxin does not exit, causing stifling oppression, heat toxin attacking the waist or unbearable flank/abdominal pain, and constipation, Wu Xing Tang (Five Apricot Decoction) is indicated.
It is further stated: Heat at the exterior, unresolved after sweating, or lingering heat toxin after vomiting/purging, causing restlessness and delirium, indicates exterior deficiency and interior excess. Heat燥 (dryness/agitation) on the exterior causes macules resembling brocade patterns. Even without sweating/purging, appearing within one to two days of onset is due to epidemic heat toxin. Severe cases develop pea sores, white or red, on skin with pus heads. White pus indicates mild toxin. Purple/black roots hidden in muscles indicate severe toxin, with a 90% mortality rate. Severe cases affect five zang and seven orifices with pea-like sores, hence the name. Surging/rapid pulse is the sign. Guo Yong notes: Scabs are purple/black; newly born lesions have red bases and white heads.
It is further stated: For unresolved epidemic heat toxin wanting to generate peas, with fever and pain, Ge Gen Shigao Tang (Pueraria and Gypsum Decoction) is indicated to release the muscle layer and induce sweating.
It is further stated: For macules/peas initially having white points, suddenly convulsing inward, turning purple/black with pus, and crying/restless day and night, Yujin San (Curcuma Powder) is indicated.
It is further stated: If urination is涩 (difficult/astringent) with blood, the condition is deteriorating. Black scabs without pus are incurable (100% mortality). For macule/pea restlessness/panting with dysuria, Biejia Tang (Softshell Turtle Decoction) is used. For calming restlessness/panting, Zhuli Yinzi (Bamboo Sap Drink) or Mahuang Gancao Tang (Ephedra and Licorice Decoction) are used.
It is further stated: For common pea sores, Zicao Tang (Arnebia Decoction) is best. Fear of insufficient dosage failing to hit the pathology requires chopping good Zicao, soaking in water, warming, straining, and drinking. Standard: 0.5 sheng Zicao to 1 sheng water.
It is further stated: For slow eruption, boil 1 he of crushed Honghua Zi (Carthamus Seed) in 0.5 sheng water for 100 boils, strain, and drink.
It is further stated: Once macules/peas have emerged, do not use exterior-releasing methods, as this increases maculation due to deficiency.
It is further stated: For slow eruption, unresolved exterior/interior, restlessness/panting, constipation, and abdominal distension from Qi attack, Xijiao Shengma Tang (Rhinoceros Horn and Cimicifuga Decoction) is indicated.
It is further stated: For macules/peas over-treated with cooling herbs, causing cough, cold extremities, and slow pulse, Gancao Ganjiang Tang (Licorice and Dried Ginger Decoction) is indicated.
It is further stated: For established豆疮 (bean sores), mix Mangxiao (Natrii Sulfas) and Zhuyedan (Porci Bile) evenly, apply topically without disturbance. Scabs fall off without scars. Sleeping on yellow earth powder is beneficial.
It is further stated: For epidemic bean sores, preemptive San Dou Yin (Three Bean Drink) prevents eruption.
It is further stated: For eruptions with macules, bloody/yellow diarrhea or pus, and whole-body fever, Zhizi Xiechi Tang (Gardenia and Allium Decoction) is indicated. (Volume 8)
Guo Yong states: For formulas by Pang Shi, Qian Shi, etc., if *Huo Ren Shu* lacks indications or efficacy, adopt alternatives.
Qian Shi states: For pediatric dry face, red fontanelle, red eyes, yawning, irritability, alternating chills/fever, cough/sneezing, cold feet, nighttime fright/insomnia/sleepiness, these are eruption signs. Treat only with warm/cool herbs.
It is further stated: Fetuses ingest blood impurities from five zang; post-birth, toxins must exit. Hence eruption shapes resemble five zang fluids. Guo Yong notes: Folk doctors claim eruptions delayed until old age lack canonical basis. Pang Shi denies this; it is merely folklore, perhaps influencing Qian/Zhu.
It is further stated: Fever/tidal fever lasting >3 days entering skin causes eruptions without significant cough, indicating heat retained in skin/fascia.
It is further stated: Cool buttocks in eruptions is a favorable sign. Black inversion with hot ears/buttocks is unfavorable. Use Niuli Gao (Prunus Ointment) and Baixiang Wan (Hundred Auspicious Pills), up to three doses. Non-response indicates fatal disease.
It is further stated: Eruptions emerging completely at once are severe. Mixed eruptions/rashes are moderate. Sparse eruptions are mild. Red inside/outside is mild. Black outside/red inside is slightly severe. White outside/black inside is very severe. Pinpoint black dots inside eruption tips indicate critical condition. Cyan/dry/purple/inverted, lethargy, profuse sweating, restlessness/thirst, abdominal distension/panting, urinary/fecal retention indicate exhaustion. Nursing mothers must observe dietary restrictions; infants must not starve or catch wind/cold, lest eruptions turn purple/black and become hard to treat.
It is further stated: High heat benefits diuresis; low heat benefits detoxification. Black/purple/dry/inverted eruptions require Baixiang Wan purgation. Non-black eruptions must not be purged.
It is further stated: Consider seasonal reversal/favorability. Eruptions belong to Yang; Spring/Autumn onset is favorable, Winter/Fall is unfavorable.
It is further stated: Spring pustules, Summer black inversion, Autumn macules, Winter rashes are not favorable. Guo Yong argues Qian Shi links these to Zang elements (Pustules=Lung/Metal, Inversion=Kidney/Water, Macules=Heart/Fire, Rashes=Spleen/Earth), clashing with seasons. But when is black inversion not unfavorable?
It is further stated: Severe cases have 40-50% survival. Black eruptions have <10% survival regardless of season. Signs include chills/jaw-clenching or yellow/swollen/purple skin; urgently purge with Baixiang Wan. Persistent chills, cold sweat, hot ear rims indicate death. Post-purge, if fever resolves, temperature normalizes, and thirst arises, treatable. Detoxify, do not purge recklessly. If eating and scabs crust, or non-crusted with excess panting, purgation is possible. Guo Yong notes: Doctors sometimes purge after scabbing to clear residual heat/toxin. If residual heat and strong pulse exist post-eruption, purgation is valid. If no residual heat and weak pulse, purgation is dangerous. Post-eruption deficiency compounded by purgation worsens depletion, potentially causing new diseases due to fragile Zang-Fu. Caution is essential; only clear residual heat.
It is further stated: Fever/thirst, abdominal distension/panting, difficult/red urination/stool, severe vomiting/diarrhea requires diuresis. If ineffective, Xuansan San (Dispersing Wind Powder) purges. If scabs don't crust after 6-7 days, internal heat steams skin preventing crusting. Use Xuansan San to guide out, ground Raw Xijiao (Rhinoceros Horn) to resolve.
It is further stated: If eruptions turn to pus/blood in abdomen or expel with scabs, Spleen Qi is solid; resolution brings peace. If undigested milk/grain stools occur, Spleen deficiency self-purges; difficult to treat.