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Pediatric children suddenly contract seasonal epidemics, which may be accompanied by epidemic diseases, or manifest as epidemic sha (petechiae) or epidemic zhen (rash). If the rash is not fully erupted and the exterior heat is mild, the ancient method advocates using Shengma Gegen Tang (Cinnamon Twig and Kudzu Root Decoction) combined with Xiaodu Xijiao Yin (Antidote Calves' Horn Drink) (ingredients such as: Rhizoma Cimicifugae, Radix Puerariae, Raw Radix Paeoniae Alba, Raw Radix Glycyrrhizae, Fructus Armeniacae Vulgaris, Herba Schizonepetae, Herba Saposhnikoviae, Cornu Bubali, with Herba Abrotani used as a guiding herb); if the rash is not fully erupted and the exterior heat is severe, Sanhuang Shigao Tang (Three Yellows and Gypsum Decoction) is advocated (ingredients such as: Radix Scutellariae, Rhizoma Coptidis, Fructus Gardeniae, Cortex Phellodendri, Semen Sojae Preparatum, Herba Ephedrae, Gypsum Fibrosum, with Allium fistulosum fresh rhizome used as a guiding herb); if the rash has already erupted, Xiaodu Qingdai Yin (Antidote Indigo Naturalis Drink) is advocated (ingredients such as: Gypsum Fibrosum, Radix Anemarrhenae, Cornu Bubali, Raw Radix Glycyrrhizae, Raw Fructus Gardeniae, Raw Rhizoma Coptidis, Natrii Sulfas, Radix Scrophulariae, Radix Bupleuri, Radix Rehmanniae Preparata, Radix Ginseng, Radix Rhei, etc.); if the rash is in its initial stage and the exterior and interior patterns are unclear, Shuangjie Tongsheng Tang (Double-Resolving and Unblocking Supreme Health Decoction) is still advocated (formula see previous text).

[Chen Shouzhen's Note] Seasonal epidemic transmission is not caused by wind-cold pathogenic factors, nor is it an interior excess pattern due to stagnation. When pathogens emerge in the Wei (Defensive) level, it manifests as sha; since Wei governs Qi, the color is white. When pathogens emerge in the Ying (Nutritive) level, it manifests as zhen; since Ying governs Blood, the color is red. If the rash color is pale red, sparse, and dull, it is because the pathogen is in the Sanjiao (Triple Burner). Once the rash is formed, moving from exterior to interior, the pathogen transforms into Yin cold, or this results from excessive intake of cooling medicines; this belongs to Yin sha, Yin ban (ecchymosis), and Yin zhen, and treatment should follow the principles for treating Yin-cold patterns. The following lists the respective symptoms and formulas.

When pediatric children present with sudden external cold exposure while having latent heat internally, pathogenic stagnation causes Qi and Blood obstruction, preventing stasis-induced rashes from reaching the exterior. Phlegm obstruction leads to wheezing and counterflow qi; urgent opening of closure and detoxification is required. The formula uses Lianqiao Xin (Forsythia Heart) 0.5 qian, Fei Huashi (Calcined Talcum) 3 qian, Shichangpu (Rhizoma Acori Tatarinowii) 0.5 fen, Chao Jinyinhua (Stir-fried Flos Lonicerae Japonicae) 0.5 qian, Shegan (Radix Belamcandae) 1 qian, Tongcao (Pith Tetrastigmatism) 0.6 fen, decocted and mixed with one pill of Niuhuang (Calculus Bovis).

When pediatric children have red tongue edges, mental confusion and delirium, symptoms lighter in the morning and heavier at night, and intermittent rash appearance, this indicates toxic pathogens have entered the blood collaterals. Only light agents for venting the rash should be used, combined with aromatic herbs to open the internal orifices. The formula uses Wu Xijiao (Black Water Buffalo Horn) 0.5 fen, Xuanshen Xin (Scrophularia Heart) 2 qian, Lianqiao Xin (Forsythia Heart) 2 qian, Jin Yin Hua (Flos Lonicerae Japonicae) 0.5 qian, Shichangpu (Rhizoma Acori Tatarinowii) 0.3 fen. After decoction, mix with Jinzhi (Human Excrement Juice) 0.5 liang, and grind in half a pill of Niuhuang Wan (Calculus Bovis Pill).

For pediatric children with latent Qi disease, heat accumulating in the Sanjiao (Triple Burner), causing generalized erythema, high fever, irritability, and insomnia, the formula uses Lingyangjiao (Cornu Saigae Tataricae) 0.2 fen, Xijiao Jian (Tip of Cornu Bubali) 0.2 fen, Lianqiao Xin (Forsythia Heart) 2 qian, Xuanshen Xin (Scrophularia Heart) 2 qian, Xian Shengdi (Fresh Radix Rehmanniae) 3 qian, Jinyinhua (Flos Lonicerae Japonicae) 0.5 qian, Tianhuafen (Radix Trichosanthis) 1 qian, Shichangpu (Rhizoma Acori Tatarinowii) 0.3 fen as the dosage.

For pediatric children with epidemic toxic sha-zhen presenting with oral ulcers and hoarseness, the pathology is in the Upper Jiao. The formula uses Wu Xijiao (Black Water Buffalo Horn) 0.3 fen, Xian Shengdi (Fresh Radix Rehmanniae) 2 qian, Xi Xuanshen (Fine Radix Scrophulariae) 0.5 qian, Lianqiao Qiao (Forsythia Husk) 1 qian, Shichangpu (Rhizoma Acori Tatarinowii) 0.2 fen, Jinyinhua (Flos Lonicerae Japonicae) 0.5 qian. Before administration, mix with Jinzhi (Human Excrement Juice) 0.5 liang and Zhibao Dan (Treasure of Life Pill) half a pill.

After pediatric children have had rashes, if latent fire remains unclarified, causing internal heat and body pain, the formula uses Chao Yuzhu (Stir-fried Rhizoma Polygonati Odorati) 3 qian, Baisha Shen (Bashashen / Radix Glehniae) 3 qian, Digupi (Cortex Lycii) 0.5 qian, Chuan Shihu (Rhizoma Dendrobii) 0.5 qian, Yuan Maidong (Original Ophiopogonis Japonicus) 1 qian, Sheng Gancao Shao (Raw Radix Glycyrrhizae Tip) 0.5 fen as a guiding agent.

After pediatric children have had rashes, if internal heat persists, Yin injury occurs leading to poor appetite, the formula uses Sheng Baishao (Raw Radix Paeoniae Alba) 2 qian, Zhi Gancao (Honey-fried Radix Glycyrrhizae) 1 qian, Sheng Bian Dou (Raw Fabae Volgaris) 0.5 qian, Chao Maiya (Stir-fried Fructus Hordei Germinatus) 0.5 qian, Lianxin Maidong (Ophiopogonis Japonicus with Heart) 2 qian, Chuan Shihu (Rhizoma Dendrobii) 2 qian, Qinghao Nao (Artemisiae Annuae Brain/Tip) 0.8 fen, Wugu Chong (Larva Bombyx Batryticatus) 0.6 fen, Biejia Fen (Powder of Carapax Testudinis) 1 qian as the dosage.