Library

Pediatric variola (smallpox) and rashes present with numerous signs, including prolonged coughing and increased phlegm; when heat patterns are prominent, the mind and spirit are restless as if fearing objects, and during convulsions, the eyes roll upward revealing the whites like those of a sheep. Observing the eyes while looking at a lamp reveals flame-like glints in the pupils; vomiting is accompanied by rebellious Qi clashing internally. Around ten years of age, children may experience seizures during sleep; lips are red, cheeks are crimson, and meridians are interlaced. Drinking soup or water causes mental restlessness and head fullness with heat; ears and feet are cold, and fever occurs without regularity; granules resembling millet seeds appear on the tongue, indicating that recovery will occur within three days. Before this disease manifests, early treatment is advisable; do not apply cooling medicines to the child. It is best to carefully distinguish the physical signs and symptoms, using only mild medicines to harmonize the body.

Mr. Liu stated: Chu Yushi's *Bi Yong Fang* (Must-Have Prescriptions) is highly beneficial to the world. However, his assertion that rashes should be treated by purging downward has misled many. This is because the appropriateness of prescriptions varies, and children's innate constitution differs in terms of deficiency and excess. Generally, if pediatric rashes lead to diarrhea, the interior becomes deficient, preventing toxic factors from being expelled outward; instead, they attack the interior, becoming trapped and latent, often resulting in premature death. Mr. Zhang discussed medication, stating that for rashes, one should administer Xingxing San (Stupefying Powder), followed by Renshen Qianghuo San (Ginseng and Notopterygium Decoction). If high fever persists, one must absolutely avoid purgatives and warm-hot medicines, lest they prevent the rash from erupting. Neither Zhang's nor Chu Yushi's theories should be rigidly adhered to; rather, one must apply warming or purging methods according to the specific indications present at the time of diagnosis, which have been detailed elsewhere. Practitioners should apply these principles flexibly.

Fever presents in various forms, and rashes also cause fever. While the bodily heat is similar, the etiology differs; thus, one must analyze accompanying signs to differentiate them accurately. Fever resembling malaria with periodic onset is called tidal fever (Chao Re); fever where appetite remains unchanged is called wind-heat (Feng Re); fever accompanied by heat in the head and abdomen, with lines on the right forehead, is called food-heat (Shi Re); fever with excessive thirst leading to diarrhea is called gan-heat (Gan Re); fever with sweating around the upper and lower lips, a white spot appearing in the center of the lips, and coldness in the ear canals is called bianzheng (developmental fever); fever with blue lines at the hairline on the center of the forehead extending to the glabella, triggering palpitations, is called fright-heat (Jing Re); fever with reddish, painful skin and frequent crying is called dan-re (erysipelas-heat); fever with closed eyes and a red face is called fetal-heat (Tai Re); fever with a red face, sweating, clear nasal discharge, and blue veins on the left forehead is called wind-cold-heat (Shang Feng Re); fever with a sallow-green complexion, cold nose and ears, aversion to cold, absence of sweat, blue veins on the left forehead, and cold extremities is called shaoyang-cold-heat (Shang Han Re). Additionally, during bianzheng, if an epidemic cold pathogen is encountered, the ears and genitals may become hot. In contrast, rash-related fever presents differently: yawning, lethargy, occasional palpitations, alternating chills and fever, intermittent cold extremities, redness of the face and cheeks, coughing, and sneezing are all characteristic heat signs of rashes.