天行厉气瘟疫病，为病挨门合境同，皆由邪自口鼻入，故此传染迅如风，
当分表裹阴阳毒，因时取治审重轻，古法皆以攻为急，荆防普济救苦攻。
[注]
瘟疫一证，乃天地之厉气流行，沿门阖户，无论老少强弱，触之者即病，
盖邪气自口鼻而入，故传染之速迅如风火，
但毒有在表在里在阴在阳之分，
其或发或攻或清，当因春风夏热秋凉冬寒之四时各异，
随人虚实，量乎轻重以施治也，
古法皆以攻毒为急者，以邪自口鼻而入，在里之病多故也，
发以荆防败毒散，清以普济消毒饮，攻以二圣救苦丹，
则酌量合直审度医治，庶几临证时有得心应手之妙矣。
(荆防败毒散) 方见风瘟
(普济消毒饮)
黄芩酒炒 黄连酒炒 陈皮 桔梗 板蓝根 升麻 柴胡 薄荷
连翘去心 牛蒡子炒研 僵蚕炒 马勃 甘草生 元参 引用灯心水煎服。
(方歌)
普济消毒清时瘟，芩连陈桔板蓝根，升柴薄荷翘牛蒡，僵蚕马勃草元参。
(二圣救苦丹)
大黄四两 皂角二两 以上为末，水丸，每服一钱 量儿大小与之，
用无根水下。
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瘟疫门
伤寒疹□失汗下，时气初感即其然，表邪覆郁荣卫分，外泛皮脉痧疹□，
疳白疹红如肤粟，□红如豆片连连，红轻赤重黑多死，淡红稀暗是阴□，
未透升麻消毒治，热盛三黄石膏煎，已透消□青黛饮，痧疹表裹双解先。
[注]
伤寒发□疹痧，皆因汗下失宜，外邪覆郁，内热泛出而成也，
惟时气传染，感而即出，亦犹疫之为病，烈而速也，
发于卫分则为痧，卫主气，故色白如肤粟也，
发于荣分则为疹□，荣主血，故色红，
肤浅为疹，深重为□，□形如豆，甚则成片连连，
□疹之色红者轻，赤者重，黑者死，此以色辨热之浅深验死生也，
若其色淡红，稀暗者，皆因邪在三阳已成，□疹由外入里，邪从阴化，
或过服凉药所致，是为阴□阴痧阴疹，法当从阴寒治也，
□出未透，表热轻者，宜升麻葛根汤合消毒犀角饮治之，
表热重者，宜三黄石膏汤发之，
已透者，用消□青黛饮加减清之，
疹痧初起，表裹不清，用双解通圣汤先通表里，余法同前。
(升麻葛根汤合消毒犀角饮) 升麻 葛根 芍药 甘草生 牛蒡子 荆芥
防风 犀角 引用芫荽水煎服。
(方歌)
升麻消毒表□疹，升葛芍草蒡荆防，偣加犀角急煎服，表实热盛另有方。
(三黄石膏汤) 黄连 黄芩 栀子 黄蘖 豆豉 麻黄 石膏 引用生葱水煎服。
(方歌)
三黄石膏发□疹，表实热盛有奇功，连芩枙蘖与豆豉，麻黄石膏生用葱。
(消□青黛饮)
石膏煆 知母 犀角 甘草生 栀子生 川连生 青黛 元参 柴胡 生地
人参 大黄 引用姜枣水煎，临服人苦酒一匙和服。
(方歌)
消□青黛消毒□，石知犀角草栀连，青黛元参柴生地，人参大黄斟酌添。
(双解通圣汤) 方见伤寒。
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Epidemic diseases caused by the pestilential Qi of Heaven and Earth spread from door to door and throughout the region, all identical in manifestation. This is because the pathogenic factor enters through the mouth and nose; therefore, its transmission is as rapid as the wind.
One must differentiate between exterior and interior, and Yin and Yang poisons, treating according to the seasons and carefully assessing severity. Ancient methods prioritized purging urgently, using Jingfang Baidu San (Jingfang Decoction for Overcoming Toxins) and Puji Xiaodu Yin (Puji Detoxifying Decoction) to rescue and attack.
[Annotation]
The syndrome of epidemic disease is the circulation of the pestilential Qi of Heaven and Earth, spreading from household to household. Regardless of age or strength, anyone who contacts it falls ill immediately.
Since the pathogenic Qi enters through the mouth and nose, its transmission is as swift as wind and fire.
However, the poison may be located in the exterior or interior, in Yin or Yang.
Its treatment—whether inducing sweating, purging, or clearing heat—must vary according to the four seasons: spring wind, summer heat, autumn coolness, and winter cold.
Treatment should be administered based on the patient's deficiency or excess and the degree of severity.
Ancient methods prioritized purging toxins because pathogens entering via the mouth and nose often cause interior diseases.
Induce sweating with Jingfang Baidu San (Jingfang Decoction for Overcoming Toxins), clear heat with Puji Xiaodu Yin (Puji Detoxifying Decoction), and purge with Ersheng Jiuku Dan (Two Sages' Rescue and Bitter Pill).
By carefully measuring and judging the condition, one can achieve skillful and effective results during clinical practice.
(Jingfang Baidu San) See Wind Epidemic for the formula.
(Puji Xiaodu Yin)
Huangqin (Scutellariae Radix) stir-fried with wine, Huanglian (Coptidis Rhizoma) stir-fried with wine, Chenpi (Citri Reticulatae Pericarpium), Jiegeng (Platycodonis Radix), Banlangen (Isatidis Radix), Shengma (Cimicifugae Rhizoma), Chaihu (Bupleuri Radix), Bohe (Menthae Haplocalycis Herba), Lianqiao (Forsythiae Fructus) with heart removed, Niubangzi (Arctii Fructus) stir-fried and crushed, Jiangcan (Bombyx Batryticatus) stir-fried, Mabo (Pleurotus Ostreatus), Gancao (Glycyrrhizae Radix et Rhizoma) raw, Yuan Shen (Scrophulariae Radix). Use Dengxin Cao (Junci Medullia) water as a guide for decoction and administration.
(Formula Song)
Puji Xiaodu clears seasonal epidemics,
Huangqin, Huanglian, Chenpi, Jiegeng, Banlangen.
Shengma, Chaihu, Bohe, Lianqiao, Niubangzi,
Jiangcan, Mabo, Gancao, Yuan Shen.
(Ersheng Jiuku Dan)
Dahuang (Rhei Radix et Rhizoma) four taels, Zaojiao (Gleditsiae Sinensis Spina) two taels. Grind the above into powder, make water pills. Take one qian per dose, adjusted for the child's size, washed down with Wugenxia (water from under the eaves).
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Epidemic Disease Section
In Typhoid Fever, if rash/scarlet fever is missed after sweating or purging, or in early seasonal epidemic infection, this occurs naturally. Exterior pathogens are covered and stagnant in the Ying (Nutrient) and Wei (Defensive) levels, manifesting externally on the skin and vessels as Sha (petechiae) and Zhen (papules/rash).
White spots resemble skin millet grains, red rashes resemble beans or appear in continuous patches. Red indicates mildness, crimson indicates severity, black indicates death. Pale red and sparse/dark indicate Yin [rash].
If not fully erupted, treat with Shengma Xiaodu [Decoction]; if heat is excessive, use Sanhuang Shigao Tang (Three Yellows and Gypsum Decoction); if already erupted, use Xiao [Rash] Qingdai Yin (Clear [Rash] Indigo Decoction); for Sha and Rash involving both exterior and interior, use Shuangjie [Decoction] first.
[Annotation]
Typhoid Fever presenting with [rash], Zhen, and Sha is all due to improper sweating or purging, where exterior pathogens are covered and stagnant, causing internal heat to surge outward.
Only seasonal epidemic infections transmit and erupt immediately upon contact, similar to epidemic diseases which are fierce and rapid.
Erupting at the Wei level becomes Sha; Wei governs Qi, hence the color is white like skin millet grains.
Erupting at the Ying level becomes Zhen/[Kou]; Ying governs Blood, hence the color is red.
Superficial eruptions are Zhen (papules/rash); deep/severe eruptions are [Kou] (pustules/petechiae); [Kou] resembles beans, and severely, they appear in continuous patches.
Red color in [Kou]/Zhen indicates mildness, crimson indicates severity, black indicates death. This uses color to distinguish the depth of heat and verify life or death.
If the color is pale red, sparse, and dark, it is because the pathogen has formed in the Three Yang levels, and [Kou]/Zhen moves from exterior to interior, transforming into Yin.
Or it is caused by over-administration of cooling medicines. This is Yin [Kou], Yin Sha, Yin Zhen; the method should treat according to Yin-Cold.
If [Kou] has not fully erupted and exterior heat is mild, use Shengma Gegen Tang (Shengma and Pueraria Decoction) combined with Xiaodu Xijiao Yin (Detoxifying and Rhino Horn Decoction) to treat it.
If exterior heat is severe, use Sanhuang Shigao Tang (Three Yellows and Gypsum Decoction) to induce eruption.
If already erupted, use Xiao [Kou] Qingdai Yin (Clear [Kou] Indigo Decoction) with modifications to clear heat.
At the initial stage of Sha and Rash, if exterior and interior are unclear, use Shuangjie Tongsheng Tang (Double-Resolving and Universal Salvation Decoction) to first unblock exterior and interior; other methods are the same as before.
(Shengma Gegen Tang combined with Xiaodu Xijiao Yin) Shengma (Cimicifugae Rhizoma), Gegen (Puerariae Lobatae Radix), Shaoyao (Paeoniae Radix Alba), Gancao (Glycyrrhizae Radix et Rhizoma) raw, Niubangzi (Arctii Fructus), Jingjie (Schizonepetae Herba), Fangfeng (Saposhnikoviae Radix), Xijiao (Rhino Cornu - *Note: Substitute with Buffalo Horn/Shuiniujiao in modern practice*). Use Yuansui (Coriandri Fructus) water as a guide for decoction and administration.
(Formula Song)
Shengma Xiaodu treats exterior [Kou] and Zhen,
Shengma, Gegen, Shaoyao, Gancao, Niubangzi, Jingjie, Fangfeng.
Add Xijiao (Rhino Horn) and decoct urgently;
For exterior excess and intense heat, there is another formula.
(Sanhuang Shigao Tang) Huanglian (Coptidis Rhizoma), Huangqin (Scutellariae Radix), Zhizi (Gardeniae Fructus), Huangbo (Phellodendri Cortex), Douchi (Sojae Preparata), Mahuang (Ephedrae Herba), Shigao (Gypsum Fibrosum). Use Shengcong (Raw Allii Fistulosi Bulbus) water as a guide for decoction and administration.
(Formula Song)
Sanhuang Shigao induces eruption for [Kou] and Zhen,
Exterior excess and intense heat find miraculous efficacy here.
Huanglian, Huangqin, Zhizi, Huangbo, and Douchi,
Mahuang, Shigao, raw, with Congbai.
(Xiao [Kou] Qingdai Yin) Shigao (Gypsum Fibrosum) calcined, Zhimu (Anemarrhenae Rhizoma), Xijiao (Rhino Cornu), Gancao (Glycyrrhizae Radix et Rhizoma) raw, Zhizi (Gardeniae Fructus) raw, Chuanlian (Coptidis Rhizoma) raw, Qingdai (Indigo Naturalis), Yuan Shen (Scrophulariae Radix), Chaihu (Bupleuri Radix), Shengdi (Rehmanniae Radix), Renshen (Ginseng Radix), Dahuang (Rhei Radix et Rhizoma). Use Jiangzao (Ginger and Jujube) water for decoction; before administration, mix with one spoonful of Ren Ku Jiu (human sour wine/vinegar).
(Formula Song)
Xiao [Kou] Qingdai detoxifies [Kou],
Shigao, Zhimu, Xijiao, Gancao, Zhizi, Chuanlian.
Qingdai, Yuan Shen, Chaihu, Shengdi,
Renshen, Dahuang, add with discretion.
(Shuangjie Tongsheng Tang) See Typhoid Fever for the formula.
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