（余发斑附）
《巢氏病源》小儿患斑毒病候∶斑毒之病，是热毒入胃，而胃主肌肉，其热挟毒蕴积于胃，毒瓦斯熏发于肌肉，
状如蚊蚤所啮；赤斑起，周匝遍体。此病或者伤寒，或时气，或温病，皆由热不时歇，故热入胃变成毒，乃发
斑也。凡发赤斑者十生一死，黑者十死一生。
汉东王先生《家宝》斑疮、水痘病证论∶凡婴孩、小儿伤寒，温壮蕴积，发积发热，热气入胃，胃主肌肉，
其热蕴积于胃，毒瓦斯熏发于肌肉，状如蚊子所啮，变成斑毒赤者。生黑者亦如得此候，宜用麦汤散三、二服解
之；宜下透关散三、两服，更进败毒散三、二服。如下前药不退，须进槐花散一服。（四方并见本门中。）微利用观音散
调胃（方见胃气不和门中），及再用七宝轻青丹（方见单伤寒门）。根据前资次用药。
《活人书》论伤寒小儿、大人治，一般但小分剂，药差凉耳。问∶发斑者，何也？发斑有二证∶有温毒发斑，
有热病发斑。温毒发斑，是冬月触冒寒毒，至春始发，已于第六卷温毒门论之矣。（第六卷温毒门∶间初春，病患肌肉
发斑，疮疹如锦纹。或咳，心闷但呕者，何也？此名温毒也。温毒发斑者，冬时触冒寒毒，至春始发，病初在表，或一
发汗、吐、下，而表证未罢，毒瓦斯不散，故发斑，黑膏主之。又有冬月温暖，人感乖戾之气，冬末即病，至春或被积寒
所折，毒瓦斯不得泄，至天气喧热，温毒始发，则肌肉斑烂，瘾疹如锦纹而咳，心闷，但呕清汁，葛根橘皮汤主之，黄连
橘皮汤尤佳。）若热病发斑，与时气发斑并同。或未发汗，或已经汗下而热毒不散，表虚里实，热毒乘虚出于皮肤，所
以发斑疮瘾疹如锦纹，俗名麸疮。《素问》谓之疹。（发斑者下之早，热气乘虚入胃故也。下之太迟，热留胃中亦发斑，
或服热药道多亦发斑。微者，赤斑出，五死一生；剧者，黑斑出，十死一生。）大抵发斑不可用表药，盖表虚里实，若发
其汗，重令开泄，更增斑烂也，皆当用化斑汤。此方乃白虎加人参汤中添入葳蕤也。元参升麻汤、阿胶大青四物汤、猪
胆鸡子汤；或与紫雪，大妙。可下者，用调胃承气汤。（暑月病阳重者，常宜体候，见微有斑，即急治之。）
《婴童宝鉴》小儿斑毒歌∶
伤寒毒热胃中存，忽作斑疮出满身。若见口唇乌似墨，只应长往在逡巡。
《小儿形证论》四十八候 伤寒胃发斑歌∶
伤寒胃热作斑疮，倒压因风气受伤。损汗内虚多紫黑，大者为阴小者阳。
《惠济》小儿斑毒候歌∶
斑毒常推是豆疮，肺并肾脏有风伤。浑身壮热四肢冷，肺里烦冤痛莫当。胃发连皮肌肉下，好交心热变
清凉。次与调脾仍赶趁，体令舌黑在堤防。
《仙人水鉴》治孩子赤斑疮方。
牙硝（六分） 地龙（一条） 赤小豆 薰陆香（各少许。若无薰陆香，以川郁金代之。）
上以新汲水调二钱，涂取瘥。
《圣惠》治小儿热毒，发斑不止，心神烦闷。大青散方
大青 元参 川升麻 川大黄（锉碎，微炒） 甘草（炙微赤，锉） 栀子仁（各半两）
上件药捣筛为散。每服一钱，以水一小盏，煎至五分，去滓。不计时候温服，量儿大小加减服之。
《圣惠》治小儿阳毒壅盛发斑，心躁，皮肤 痛。犀角散方
犀角屑 川升麻 白藓皮 栀子仁 漏芦 川大黄（锉碎，微炒） 甘草（炙微赤，锉） 赤芍药（各半两） 寒
水石（一两）
上件药捣筛为散。每服一钱，以水一小盏，煎至五分，去滓。不计时候，量儿大小分减温服。
《圣惠》治小儿斑疮，大便壅滞，心神烦躁。宜服大黄散方
川大黄（锉碎，微炒） 甘草（炙微赤，锉） 黄芩 枳壳（麸炒微黄，去瓤。各半两）
上件药捣细为散。不计时候，以新汲水调下一钱。三岁以下可服半钱。
《圣惠》又方
犀角屑 川升麻（各一分） 甘草（半分，炙微赤，锉） 川大黄（半两，锉碎，微炒）
上件药捣，粗罗为散。每服一钱，以水一小盏，煎至五分，去滓。量儿大小分减服之。
《圣惠》治小儿发斑，散恶毒瓦斯方。
上以生葵菜叶绞取汁，少少与服之。
《圣惠》治小儿斑疮及疹、痘疮，心神躁烦，眠卧不安。毒黛散方
青黛（半两）
上细研青黛为散，每服暖磨刀水调下半钱，日三服。更量儿大小加减，服之。
《圣惠》又方
上煮黑豆汁，徐徐温服之。
汉东王先生《家宝》治婴孩、小儿伤寒，咳嗽温壮，水痘。麦汤散方
地骨皮（炒） 甘草（炙） 滑石（各半分） 麻黄（去节） 人参 知母 羌活 大黄（用湿纸裹，煨令熟，切）
甜葶苈（用纸隔炒。各一分）
上为末，每服婴孩、小儿一字或半钱。五、四岁一钱。以水一药注或半银盏，入小麦或七粒，或十四粒，
煎十数沸服。
汉东王先生《家宝》治婴孩小儿斑疮、水痘，心躁发渴，大小便不通及小便赤色，口舌生疮，通心经。透关散
方
地扁竹（半两，取嫩枝叶，焙） 山栀子仁（一分半，炒） 大黄 木通 车前子（各炒） 滑石 瞿麦（去粗梗）
甘草（炙。各一分）
上为末。每服婴孩一字；二、三岁半钱；四、五岁一钱。以水一药注或半银盏，入紫草三寸，煎十数沸温
服。
汉东王先生《家宝》治婴孩、小儿斑疮、水痘，退热解躁。败毒散方
芍药 甘草（炙。各一钱） 雄黄（一钱，醋炙）
上为末。每服婴孩一字；二、三岁半钱；四、五岁一钱。蜜汤调下。
汉东王先生《家宝》治婴孩、小儿斑毒不退。槐花散方
槐花 赤豆（各炒，二钱） 麝香（少许）
上为末。每服婴孩半字，用麦汤调下；三、四岁一字以上，用温酒调下，只进一服。如腹中微利，即用调
胃观音散补之。（方见胃气不和门中。）
《活人书》黑膏方
好豉（一升） 生地黄（半斤，切碎）
上二味，以猪膏二斤，合露之，煎令三分减一，绞去滓，用雄黄、麝香如大豆者，内中搅和，尽服之。毒
便从皮中出，则愈。忌芜荑。
《活人书》葛根橘皮汤
葛根 橘皮 杏仁（去皮尖，研，炒） 知母 黄芩 麻黄（去节） 甘草（炙。各半两）
上锉如麻豆大。每服五钱，以水一盏半，煎至一中盏，去滓温服。
《活人书》黄连橘皮汤
黄连（四两，去须） 橘皮 杏仁 枳实 麻黄 葛根 浓朴 甘草（各一两）
上锉如麻豆大。每服抄五钱匕，用水一小盏半，煎至一盏，去滓服。下痢当先止。
《活人书》化斑汤
人参 石膏（各半两） 葳蕤 知母 甘草（各一分）
上锉如麻豆大。每服抄五钱匕，水一盏半，入糯米一合，煎至八分。取米熟为度，去滓温服。
《活人书》元参升麻汤
元参 升麻 甘草（炙。各半两）
上锉如麻豆大。每服抄五钱匕，以水一盏半，煎至七分，去滓温服。
《活人书》阿胶大青四物汤
大青（四两） 阿胶 甘草（各炙。一两） 豉（八合）
上锉如麻豆大。每服抄五钱匕，以水一盏半，煎至一盏，旋入胶，再煎令烊。
《活人书》猪胆鸡子汤
猪胆 苦酒（各三合） 鸡子（一枚）
上三味和合，煎三沸。强人尽服，羸人煎六、七沸服，汗出瘥。
《活人书》仲景调胃承气汤，（方见伤寒自汗门中。）
(Attached: Other cases of macule eruption)
*Chao Shi Bing Yuan* (Source of Diseases by Chao Yuanfang) discusses the syndrome of infants and children suffering from ban du disease (plague-toxin disease): Ban du is a condition where heat-toxin enters the Stomach. Since the Stomach governs muscles, heat combined with toxin accumulates in the Stomach, and toxic vapors fumigate and erupt into the muscles. The appearance resembles bites from mosquitoes or fleas; red macules appear, covering the entire body. This disease may arise from Shanghan (Cold Damage), seasonal epidemics, or Wenbing (Warm Diseases), all caused by persistent heat entering the Stomach and transforming into toxin, thereby causing macule eruption. For those presenting with red macules, nine out of ten survive and one dies; for those with black macules, nine out of ten die and one survives.
Mr. Wang of Handong's *Jia Bao* (Family Treasure) discusses the syndromes of ban chuang (macule sores) and shui dou (water pox): Whenever infants or children suffer from Shanghan, with accumulated warm-fever and rising heat, heat qi enters the Stomach. As the Stomach governs muscles, heat accumulates within, and toxic vapors fumigate into the muscles, resembling mosquito bites, transforming into red ban du. If black macules form, it follows a similar pattern. It is appropriate to use Mai Tang San (Wheat Decoction Powder) two or three times to resolve the pathogen; Tou Guan San (Penetrating Passages Powder) two or three times, followed by Bai Du San (Defeating Toxin Powder) two or three times. If these do not subside, Huai Hua San (Sophora Flower Powder) should be administered once. (These four formulas are found in their respective sections.) For mild cases, Guanyin San (Guanyin Powder) can be used to regulate Stomach Qi (see section on Disharmony of Stomach Qi), and Qibao Qingqing Dan (Seven-Treasure Light Green Pill) can be used again (see section on Simple Shanghan). Medications should be administered sequentially according to the above principles.
*Huo Ren Shu* (Book of Saving Lives) discusses the treatment of Shanghan for both infants/children and adults, which is generally the same, but with smaller dosages and slightly cooler properties. Question: What is macule eruption? There are two types of macule eruption: Wendu Faban (Macule eruption due to Warm-Toxin) and Rebing Faban (Macule eruption due to Heat Disease). Wendu Faban occurs when cold-toxin is contracted in winter and manifests in spring, as discussed in Volume 6 under the Warm-Toxin section. (Volume 6 Warm-Toxin Section: In early spring, if patients develop macules on the skin, with sores and rashes like brocade patterns, accompanied by cough, chest oppression, and vomiting only clear fluid, this is named Wendu. Wendu Faban results from contracting cold-toxin in winter and manifesting in spring. Initially at the exterior, if sweating, vomiting, or purging methods are applied prematurely without resolving the exterior syndrome, the toxin remains unresolved, leading to macule eruption, treated with Hei Gao (Black Ointment). Alternatively, if the winter is unusually warm and people contract aberrant qi, falling ill late in winter, and then being suppressed by accumulated cold in spring preventing toxin excretion, when the weather becomes hot, Wendu erupts, causing macular rotting, urticaria-like brocade patterns, cough, chest oppression, and vomiting clear juice, treated with Gegen Jupi Tang (Pueraria and Tangerine Peel Decoction); Huanglian Jupi Tang (Coptis and Tangerine Peel Decoction) is even better.) If it is Rebing Faban, it is the same as Shibqi Faban (Macule eruption due to Seasonal Epidemic). Whether unsweated or already subjected to sweating/purging with unresolved heat-toxin, resulting in exterior deficiency and interior excess, heat-toxin exploits the deficiency to emerge through the skin, causing macule sores and urticaria like brocade patterns, commonly known as Fu Chuang (Bran Sores). *Suwen* calls this Zhen (Rash). (Macule eruption occurs because purging was done too early, allowing heat to enter the Stomach via deficiency. Purging too late also causes heat to remain in the Stomach and erupt. Overuse of hot medicines also causes eruption. Mild cases show red macules, five deaths to one survival; severe cases show black macules, ten deaths to one survival.) Generally, macule eruption should not be treated with exterior-releasing drugs, because the exterior is deficient and the interior is excess. Sweating would force further opening and exacerbate the macular rotting. All such cases should use Huaban Tang (Resolve Macules Decoction). This formula is Baizhu Jia Renshen Tang (White Tiger Plus Ginseng Decoction) with added Weihui (Polygonatum). Yuanshen Shengma Tang (Scrophularia and Cimicifuga Decoction), Ejiao Daqing Siwu Tang (Donkey-Hide Gelatin and Indigo Naturalis Four-Substance Decoction), Zhudan Jizi Tang (Pig Gallbladder and Egg Yolk Decoction); or combined with Zixue (Purple Snow), which is excellent. If purgation is indicated, use Tiaowei Chengqi Tang (Regulate the Stomach and Order the Qi Decoction). (In summer months with heavy Yang-pathogens, observe closely; if slight macules appear, treat urgently.)
*Yingtong Baojian* (Baby and Child Precious Mirror) Song on Pediatric Ban Du:
Shanghan toxic heat resides in the Stomach, suddenly erupting as macule sores over the whole body. If the lips turn black as ink, death is imminent.
*Xiao'er Xingzheng Lun* (Discussion on Infantile Signs and Syndromes) Syndrome 48, Song on Stomach Macule Eruption from Shanghan:
Shanghan stomach heat creates macule sores, collapse due to wind-pathogen injury. Damaged sweating and internal deficiency often result in purple-black hues; large spots indicate Yin, small spots indicate Yang.
*Huiji* (Benefiting Mercy) Song on Pediatric Ban Du Syndrome:
Ban du is often attributed to bean pox, with wind-injury affecting the Lung and Kidney. Whole-body high fever with cold limbs, unbearable pain and oppression in the Lung. Stomach involvement extends to skin and muscles, requiring clearing Heart heat to cool. Next, harmonize the Spleen promptly, guarding against black tongue indicating critical condition.
*Xianren Shuijian* (Immortal Water Mirror) Formula for treating infant red macule sores.
Yaxiao (Sodium Sulfate, 6 fen) Dilong (Earthworm, 1 piece) Chi Xiaodou (Adzuki Bean) Xunluxiang (Frankincense, a little each. If frankincense is unavailable, substitute with Chuan Yujin/Sichuan Turmeric.)
Mix the above with fresh well-water to make a paste of 2 qian, apply topically until healed.
*Shenghui* (Holy Grace Formulas) Daqing San (Great Blue Powder) for treating pediatric heat-toxin, continuous macule eruption, and mental restlessness.
Daqing (Isatidis Radix) Yuanshen (Scrophulariae Radix) Chuan Shengma (Cimicifugae Rhizoma) Chuan Dahuang (Rhei Radix et Rhizoma, sliced and lightly stir-fried) Gancao (Licorice Root, honey-fried and sliced) Zhizi Ren (Gardeniae Semen, half liang each)
Pulverize the above herbs. Take 1 qian per dose, decoct in one small cup of water until reduced to half a cup, strain. Take warm at any time, adjusting dosage based on child's age.
*Shenghui* Xijiao San (Rhinoceros Horn Powder) for treating pediatric yang-toxin congestion with macule eruption, irritability, and skin pain.
Xijiao Xiao (Rhinocerotis Cornu, shredded) Chuan Shengma Chuan Baixianpi (Dictamni Cortex) Zhizi Ren Loulu (Euphorbiae Humifusae Herba) Chuan Dahuang Gancao (honey-fried and sliced) Chishao Yao (Paeoniae Radix Rubra, half liang each) Hanshuishi (Calcitritum, one liang)
Pulverize the above herbs. Take 1 qian per dose, decoct in one small cup of water until reduced to half a cup, strain. Take warm at any time, adjusting dosage based on child's age.
*Shenghui* Dahuang San (Rhubarb Powder) for treating pediatric macule sores with constipation and mental agitation.
Chuan Dahuang Gancao Huangqin (Scutellariae Radix) Zhike (Aurantii Fructus Immaturus, bran-fried and pith removed, half liang each)
Pulverize finely. Take 1 qian mixed with fresh well-water at any time. Children under three years old take half a qian.
*Shenghui* Another Formula
Xijiao Xiao Chuan Shengma (each 1 fen) Gancao (half fen, honey-fried and sliced) Chuan Dahuang (half liang, sliced and lightly stir-fried)
Pulverize and sieve coarsely. Take 1 qian per dose, decoct in one small cup of water until reduced to half a cup, strain. Adjust dosage based on child's age.
*Shenghui* Formula to dissipate evil toxic vapors in pediatric macule eruption.
Extract juice from fresh Malva verticillata leaves and administer small amounts orally.
*Shenghui* Duidai San (Indigo Powder) for treating pediatric macule sores, rashes, and smallpox with mental restlessness and sleep disturbance.
Qingdai (Indigo Naturalis, half liang)
Grind Qingdai finely into powder. Take half a qian mixed with warm knife-scraping water, three times daily. Adjust dosage based on child's age.
*Shenghui* Another Formula
Decoct Vigna angularis (black soybean) juice and take warm slowly.
Mr. Wang of Handong's *Jia Bao* Maidang San (Wheat Decoction Powder) for treating infant/child Shanghan with cough, warm-fever, and water pox.
Digupi (Lycii Cortex) Gancao (honey-fried) Huashi (Talcum, half fen each) Mahuang (Ephedrae Herba, nodes removed) Renshen (Ginseng Radix et Rhizoma) Zhi Mu (Anemarrhenae Rhizoma) Qianghuo (Notopterygii Rhizoma et Radix) Dahuang (wrapped in wet paper, baked until cooked, sliced)
Tian Tingli (Descurainiae Semen, stir-fried between papers, 1 fen each)
Pulverize. Infants/children take 1 zi or half a qian. Four-to-five-year-olds take 1 qian. Decoct with one medicinal measure or half a silver cup of water, adding seven or fourteen grains of Wheat, boil vigorously for ten times, and take.
Mr. Wang of Handong's *Jia Bao* Touguan San (Penetrating Passages Powder) for treating infant/child macule sores/water pox with irritability, thirst, urinary/fecal retention, dark urine, mouth/tongue sores, and unblocking the Heart Meridian.
Dibianzhu (Phyllostachys pubescens tender branches/leaves, dried) Shanzhizi Ren (Gardeniae Semen, fried, 1.5 fen) Dahuang Mutong (Akebiae Caulis) Cheqianzi (Plantaginis Semen, fried each) Huashi Qumai (Dianthi Herba, coarse stems removed)
Gancao (honey-fried, 1 fen each)
Pulverize. Infants take 1 zi; two-to-three-year-olds take half a qian; four-to-five-year-olds take 1 qian. Decoct with one medicinal measure or half a silver cup of water, adding three cun of Zicao (Arnebiae Radix et Rhizoma), boil vigorously, and take warm.
Mr. Wang of Handong's *Jia Bao* Baidu San (Defeating Toxin Powder) for treating infant/child macule sores/water pox, reducing fever and relieving irritability.
Shaoyao (Paeoniae Radix) Gancao (honey-fried, 1 qian each) Xionghuang (Realgar, 1 qian, vinegar-fried)
Pulverize. Infants take 1 zi; two-to-three-year-olds take half a qian; four-to-five-year-olds take 1 qian. Take mixed with honey water.
Mr. Wang of Handong's *Jia Bao* Huaihua San (Sophora Flower Powder) for treating persistent infant/child ban du.
Huaihua (Sophorae Flos) Chidou (Adzuki Bean, fried each, 2 qian) Shexiang (Musk, a little)
Pulverize. Infants take half a zi, taken with wheat decoction; three-to-four-year-olds take more than 1 zi, taken with warm wine, single dose only. If mild diarrhea occurs, supplement with Tiaowei Guanyin San (Regulate Stomach Guanyin Powder) (see section on Disharmony of Stomach Qi).
*Huo Ren Shu* Hei Gao (Black Ointment) Formula
Haoshi (Fermented Soybean, one sheng) Sheng Dihuang (Rehmanniae Radix, half jin, chopped)
Combine the above two with two jin of Pig Fat (Zhi Gao), expose to dew, decoct until one-third is lost, strain, add Realgar and Musk sized like soybeans, mix thoroughly, and consume entirely. Toxin will exit through the skin, and the patient will recover. Avoid Elaeagnus commutata (Wuyi).
*Huo Ren Shu* Gegen Jupi Tang (Pueraria and Tangerine Peel Decoction)
Gegen (Puerariae Lobatae Radix) Jupi (Citri Reticulatae Pericarpium) Xingren (Pruni Semen, peeled, core removed, ground, fried) Zhi Mu Huangqin (Scutellariae Radix) Mahuang Gancao (honey-fried, half liang each)
Cut into sizes like hemp seeds. Take 5 qian per dose, decoct in one and a half cups of water until reduced to one cup, strain, and take warm.
*Huo Ren Shu* Huanglian Jupi Tang (Coptis and Tangerine Peel Decoction)
Huanglian (Coptidis Rhizoma, four liang, remove roots) Jupi Xingren Zhishi (Aurantii Fructus Immaturus) Mahuang Gegen Houpo (Magnoliae Officinalis Cortex) Gancao (one liang each)
Cut into sizes like hemp seeds. Take five qian-bi (spoonfuls) per dose, decoct in one and a half small cups of water until reduced to one cup, strain, and take. Diarrhea should be stopped first.
*Huo Ren Shu* Huaban Tang (Resolve Macules Decoction)
Renshen (Ginseng Radix et Rhizoma) Shigao (Gypsum Fibrosum, half liang each) Weihui (Polygonati Odorati Rhizoma) Zhi Mu Gancao (one fen each)
Cut into sizes like hemp seeds. Take five qian-bi per dose, add one he of Glutinous Rice to one and a half cups of water, decoct until eight-tenths remain. Cook until rice is soft, strain, and take warm.
*Huo Ren Shu* Yuanshen Shengma Tang (Scrophularia and Cimicifuga Decoction)
Yuanshen (Scrophulariae Radix) Shengma (Cimicifugae Rhizoma) Gancao (honey-fried, half liang each)
Cut into sizes like hemp seeds. Take five qian-bi per dose, decoct in one and a half cups of water until reduced to seven-tenths, strain, and take warm.
*Huo Ren Shu* Ejiao Daqing Siwu Tang (Donkey-Hide Gelatin and Indigo Naturalis Four-Substance Decoction)
Daqing (Isatidis Folium, four liang) Ejiao (Asini Corii Colla) Gancao (honey-fried, one liang each) Shihao (Fermented Soybean, eight he)
Cut into sizes like hemp seeds. Take five qian-bi per dose, decoct in one and a half cups of water until reduced to one cup, then add gelatin and decoct until melted.
*Huo Ren Shu* Zhudan Jizi Tang (Pig Gallbladder and Egg Yolk Decoction)
Zhudan (Suis Fel) Kujiu (Vinegar, three he each) Jizi (Galli Ovum, one egg)
Combine the three, boil three times. Strong individuals take all at once; weak individuals boil six or seven times and take. Recovery follows sweating.
*Huo Ren Shu* Zhang Zhongjing's Tiaowei Chengqi Tang (Regulate the Stomach and Order the Qi Decoction) (See section on Shanghan with Spontaneous Sweating).