甲、概况
小儿因父母之遗传，或乳母之积热，及饮食腐浊之气，久蓄肠胃，以致血气凝滞，结而成毒。重者
则成为内痈，轻者外发为疮疡。治宜内托外疏，切忌毒药峻攻。疮疡之种类，约有舌疮、口
疮、秃疮、疥疮、黄水粘疮、鹤膝风痛、流注、痈疽等。兹分述其治法如下（参看第三章第七节胎毒条）。
乙、治法
小儿疮疡结成，外治通用方，宜四黄散。舌疮，内服三黄汤，或以桑白皮汁涂乳头上，与儿吮之。
若脾胃虚弱，腹痛恶寒，口舌生疮者，宜六君子汤加干姜、肉桂。口疮，若口内糜烂出
血者，内服犀角、连翘、生地、玄参、丹皮之属，外敷消黄散，口内白腐不甚疼痛者，内服百解散，外敷立
效散、黄金散。秃疮，内服苦参丸，外用苦参为末，油调敷之，或用地沥青膏涂敷。疥疮，内服四君子汤加栝
蒌根、桔梗，外治春用柳条、荆芥，夏用枣叶、槐枝，秋冬用苦参，均煎浓汤洗之。黄水粘疮，内服犀
角消毒散，日久粘水不绝者，脾胃已虚，宜异功散，外用轻粉、樟脑各二钱，大枫子（去壳）、川椒各四十
九粒，杏仁一钱，共为细末，地沥青调敷之。鹤膝风痛，膝内作痛， 肿色赤，内服宜大防风汤或百解散和
五苓散加麻黄、姜、葱煎服，肿硬色白而不作脓者难治。流注，初起外用葱熨法，内服宜消之，已成脓者须
内托。又凡小儿痈疽，与成人大致相同，治法初起宜清凉解毒，脓成宜托里透脓，善后宜培补脾胃，
兼泄余毒，则大旨当为不谬也。
附方
（一）四黄散 外用。治小儿身上一切热毒疮疾，燥痒抓破，有汁不干。
黄连 黄柏 黄芩 大黄 滑石（各五钱） 五倍子（二钱半）
晒研为末，每用二三钱，清油调涂患处。
（二）三黄汤 见第三章第三节。
（三）六君子汤 见第五章第三节。
（四）消黄散 外用。治风热上攻，舌硬肿大。
风化硝 蒲黄（各五钱）
先以蒲黄研为细末，再同朴硝研匀，外用点揩舌之上下。
（五）百解散 治疮疡。
干葛 升麻 赤芍 甘草 黄芩 麻黄 肉桂
（六）立效散 外用。治小儿喉痹。
硼砂 龙脑 雄黄 朴硝（各五分）
研为极细末，干掺之。
（七）黄金散 外用。治口舌疮毒，痘疮后目生翳膜。
黄柏（蜜润透，晒干再润，多次） 粉甘草（各一两）
研为细末，点患处。
（八）苦参丸 治痂疥瘙痒。
苦参（一斤） 皂角（二斤）
将皂角滤浓汁，和苦参末为丸。一方无皂角有菖蒲、乌蛇。
（九）地沥青膏 外用。治小儿头上肥疮，羊胡疮，奶癣疮，脓窠疮。
地沥青（一斤） 麻油（四两） 明矾 铜绿（各二两） 铅粉（一两）
共入锅内熬成红色，下黄蜡，入羊胆汁或猪胆汁一个，搅匀，瓷钵收贮。
（十）四君子汤 见第三章第五节。
（十一）犀角消毒散 治斑疹丹毒积毒，发于肌表，头面生疮，或痛或痒。
犀角（二分） 牛蒡子 甘草 荆芥 防风（各五分） 金银花（三分）
清水煎服。
（十二）异功散 见第三章第六节。
（十三）大防风汤 治足三阴经亏损，外邪乘虚入内，致腿膝疼痛，或成鹤膝风，附骨疽等证。
防风 白术 羌活 人参 川芎 白芍 附子 牛膝（各一钱）
肉桂 黄 杜仲 熟地 甘草（各五分）
加生姜三片，清水煎服。
（十四）五苓散 见第三章第五节。
（十五）葱熨法 外用。治痈疽风痰，流注，便毒，结块。
葱一握，炙热捣烂作饼，敷于痛处，用浓布二三层，以熨斗熨之，再内服托毒内消之剂。
A. Overview
Pediatric children, due to parental heredity, or accumulated heat in the wet nurse, as well as the foul and turbid qi from diet, may have these factors accumulate long-term in the intestines and stomach. This leads to stagnation of Qi and Blood (Qi and Blood), resulting in the formation of toxic pathogens. Severe cases develop into internal abscesses (Nei Yong), while mild cases manifest externally as sores and ulcers (Chuang Yang). Treatment should employ internal support and external dispersal methods; it is strictly forbidden to use harsh toxic drugs for aggressive attack. The types of sores and ulcers include tongue sores, oral ulcers, baldness ringworm, scabies, yellow water sticky sores, knee-crane wind pain, flowing deposits (Liu Zhu), carbuncles and sores (Yong Ju), etc. Their treatment methods are described below (see Chapter 3, Section 7, Fetal Toxin).
B. Treatment Methods
For formed pediatric sores and ulcers, the general external treatment formula is Sihuang San (Four Yellows Powder). For tongue sores, internally administer Sanhuang Tang (Three Yellows Decoction), or apply mulberry root bark juice to the nipple for the infant to suckle. If there is Spleen and Stomach deficiency with abdominal pain, aversion to cold, and oral/tongue sores, use Liujunzi Tang (Six Gentlemen Decoction) added with Ganjiang (Dried Ginger) and Rougui (Cinnamon Bark). For oral ulcers, if there is erosion and bleeding inside the mouth, internally administer Rhinoceros Horn (Xijiao), Forsythia (Lianqiao), Rehmannia Root (Shengdi), Scrophularia Root (Xuanshen), and Moutan Bark (Danpi); externally apply Xiaohuang San (Eliminate Yellows Powder). If white putrid matter in the mouth is not severe and pain is slight, internally administer Baisan Jie (Hundred Dissolutions), and externally apply Lixiao San (Instant Effect Powder) and Huangjin San (Golden Powder). For baldness ringworm, internally administer Kushen Wan (Sophora Pill), and externally apply Sophora Root powder mixed with oil, or apply Bitumen Ointment. For scabies, internally use Sijunzi Tang (Four Gentlemen Decoction) added with Trichosanthes Root (Gualou Gen) and Platycodon Root (Jiegeng). Externally, in spring use willow twigs and Schizonepeta (Jingjie); in summer use jujube leaves and locust branches; in autumn and winter use Sophora Root. All are decocted into strong washes. For yellow water sticky sores, internally administer Xijiao Xiaodu San (Rhinoceros Horn Detoxification Powder). If discharge persists for a long time indicating Spleen and Stomach deficiency, use Yigong San (Extraordinary Power Powder). Externally, mix Calomel (Qingfen) and Camphor (Zhangnao) each 2 qian,除去 shell Large Maple Seeds ( Dafengzi) and Sichuan Pepper (Chuanjiao) each 49 grains, and Almond (Xingren) 1 qian, grind into fine powder, and apply mixed with bitumen. For knee-crane wind pain, characterized by internal knee pain and red swelling, internally use Dafangfeng Tang (Great Wind-Expelling Decoction) or combine Baisan Jie with Wuling San (Five Ling Powder) added with Ephedra (Mahuang), Ginger, and Scallion. If swelling is hard, white, and does not suppurate, it is difficult to treat. For flowing deposits (Liu Zhu), initially apply the Scallion Ironing Method externally, and internally use dispersive methods; if suppuration has occurred, internal support is required. Generally, pediatric carbuncles and sores are similar to those in adults: initial treatment requires cooling and detoxification; once pus forms, internal support and pus penetration are needed; for recovery, tonify Spleen and Stomach and drain residual toxins. Following this general principle ensures correctness.
Appendix Formulas
(1) Sihuang San (Four Yellows Powder): External use. Treats all heat-toxin sores on the body, dry itching, broken skin with non-drying exudate. Coptis Rhizome (Huanglian), Phellodendron Bark (Huangbai), Scutellaria Root (Huangqin), Rhubarb (Dahuang), Talcum (Huashi) [each 5 qian]; Chinese Gall (Wubeizi) [2.5 qian]. Sun-dry and grind to powder. Use 2-3 qian per application, mix with clear sesame oil, and apply to affected area.
(2) Sanhuang Tang (Three Yellows Decoction): See Chapter 3, Section 3.
(3) Liujunzi Tang (Six Gentlemen Decoction): See Chapter 5, Section 3.
(4) Xiaohuang San (Eliminate Yellows Powder): External use. Treats wind-heat attacking upward, causing stiff and swollen tongue. Weathered Niter (Fenghua Xiao) and Pollen Typhae (Puhuang) [each 5 qian]. First grind Puhuang to fine powder, then mix evenly with Niter. Apply externally to rub the upper and lower parts of the tongue.
(5) Baisan Jie (Hundred Dissolutions): Treats sores and ulcers. Kudzu Root (Gange), Platycodon Root (Shengma), Red Peony Root (Chishao), Licorice Root (Gancao), Scutellaria Root (Huangqin), Ephedra (Mahuang), Cinnamon Bark (Rougui).
(6) Lixiao San (Instant Effect Powder): External use. Treats pediatric throat obstruction (Hou Bi). Borax (Pengsha), Borneol (Longnao), Realgar (Xionghuang), Niter (Puxiao) [each 5 fen]. Grind to extremely fine powder and sprinkle dry onto the affected area.
(7) Huangjin San (Golden Powder): External use. Treats mouth and tongue sore toxins, and corneal opacity after smallpox. Phellodendron Bark (Huangbai) [moistened with honey, dried, repeated multiple times] and Sweet Licorice Root (Fen Gancao) [each 1 liang]. Grind to fine powder and apply to affected area.
(8) Kushen Wan (Sophora Pill): Treats crusty scabies and itching. Sophora Root (Kushen) [1 jin], Gleditsia Sinensis Fruit (Zaojiao) [2 jin]. Filter Gleditsia to obtain thick juice, mix with Sophora powder to form pills. Another prescription excludes Gleditsia and includes Acorus (Changpu) and Black Snake (Wushe).
(9) Bitumen Ointment (Diqingyou Gao): External use. Treats pediatric head fatty sores, beard-like sores, milk eczema, and pustular sores. Bitumen [1 jin], Sesame Oil [4 liang], Alum (Mingfan), Verdigris (Tonglv) [each 2 liang], Lead White (Qianfen) [1 liang]. Boil together in a pot until red, add Beeswax (Huangla), add one sheep bile or pig bile, stir well, and store in a porcelain jar.
(10) Sijunzi Tang (Four Gentlemen Decoction): See Chapter 3, Section 5.
(11) Xijiao Xiaodu San (Rhinoceros Horn Detoxification Powder): Treats erysipelas and toxin accumulation manifesting on the skin surface, sores on head and face, with pain or itching. Rhinoceros Horn (Xijiao) [2 fen], Arctium Seed (Niubangzi), Licorice Root (Gancao), Schizonepeta (Jingjie), Saposhnikovia Root (Fangfeng) [each 5 fen], Honeysuckle Flower (Jinyinhua) [3 fen]. Decoct in clear water and take orally.
(12) Yigong San (Extraordinary Power Powder): See Chapter 3, Section 6.
(13) Dafangfeng Tang (Great Wind-Expelling Decoction): Treats deficiency of the three Yin meridians of the foot, allowing external pathogens to enter due to weakness, causing leg and knee pain, or forming knee-crane wind, deep-rooted abscesses, etc. Saposhnikovia Root (Fangfeng), Atractylodes Macrocephala Rhizome (Baizhu), Notopterygium Rhizome (Qianghuo), Ginseng (Renshen), Ligusticum Chuanxiong Rhizome (Chuanxiong), White Peony Root (Baishao), Prepared Aconite Root (Fuzi), Achyranthes Root (Niuxi) [each 1 qian]. Cinnamon Bark (Rougui), Scutellaria Root (Huangqin), Eucommia Bark (Duzhong), Prepared Rehmannia Root (Shudi), Licorice Root (Gancao) [each 5 fen]. Add three slices of fresh ginger, decoct in clear water, and take orally.
(14) Wuling San (Five Ling Powder): See Chapter 3, Section 5.
(15) Scallion Ironing Method (Congyi Fa): External use. Treats carbuncles, sores, wind-phlegm, flowing deposits, groin abscesses, and nodules. Take a handful of scallions, heat and mash into a cake, apply to the painful area, cover with two to three layers of thick cloth, and iron over it with an ironing tool. Then internally administer herbs that support the interior and resolve toxins.