此症由娠母过食辛辣煎炙之物,或久卧火炕,内热炽盛,波及生儿,降生后复感风邪,将血中已蕴之热毒引
起,发为游风丹毒。失治能漫延全身,变症百出,亦能致命也。俗云风疹风疙疸者是。其症象小儿身上忽然红肿,
或分点粒,或成片断,胀痛发痒,甚至满身皆有,游走无定。万不可用手抓搔,因指甲梢有毒,能引外风,立刻
全身皆起,且能起至二层三层。斯时起到何处,何处肌肤即行麻木痒痛。入口内小儿即不能吮乳,到心口上,小
儿即心中慌乱,啼不住声。再甚涕泪皆干,丹毒转向里攻进,侵及神经,筋青鼻煽,痉挛抽搐,立时发措手也。
其初跳见白斑,渐透黄色光亮,皮中恍如有水,胀破即流黄水,黄水到处,同样之症型旋生,湿烂痛痒,名为水
丹。多生腿膝等处,属
脾肺有风热而湿也。又有头面身体起赤红平点,不发热而干燥作痛痒,起多即连成云片,名为赤游丹,是血分有
火而受风也。又有遍身起扁疙疸与肉皮同色,无热而微胀痛兼痒,游走不定,是为膜冷所致。又名冷丹,由胎毒
未能发出肌肤,外受风寒郁遏也。又有腰间红肿一圈,名缠腰,甚毒火甚更,是心包及内肾有毒热感风邪而成,其
发甚速,顷刻伤生,无法救治也。总之丹毒起于胸腹及于四肢者,其症象顺而吉,起于四肢及于胸腹者,症象逆
而危,治疗之宜急也。今将各项丹症的治法药方列下,按症之现象,应服何等方剂,即对症与小儿服之,自可
应症而愈也。治水丹应用天保采薇汤,此症湿盛,脾气因之不运化,湿热郁积成毒,复感外间风邪而起,治法宜
用利湿清热,疏风邪,通脾气法,使其热清风去湿开气通,脾能营运,毒自解也。
天保采薇汤方(原方减味)
酒羌活(五分) 炙前胡(一钱) 半夏曲(一钱) 广陈皮(八分) 赤芍药(八分) 云茯苓(一钱)
炒枳壳(六分) 苦桔梗(七分) 苍术(八分) 酒川芎(五分) 银柴胡(五分) 生甘草(三分) 以上
各药用水一茶碗半,煎成半茶碗,连续与儿服之。此是周岁小儿服剂,若五岁上下,药剂须加倍。不然恐病大
药小,无济无事。至于皮肤之湿烂处,再用青蛤散擦之,即止痒消肿,结痂生肌也。辅助汤剂,收湿防腐,解其
外毒,更能收内外兼治之功效。散方列下∶
青蛤散方
蛤粉(一两) 真青黛(三钱) 石膏(二两) 轻粉(五钱) 川黄柏(五钱) 以上各药共研成极
细末,先用麻油调成块,随用多少分下一小块。次用凉泻之成稀糊状,满湿烂地方均涂之。如痂浓去痂再涂,真神
效方也,治赤游丹应用四物消风饮,此症为血液不清,积热生毒,流行周身四肢头面等处。不即发现赤游丹症,
亦必发于皮肤
外间,处处成为疮结。今因外间的引诱风邪一鼓荡,热毒随血流皮肤中,遂受激而发为赤游丹也。宜用散风、解
毒、活血、清热之四物消风饮治之。能致其血液畅行,风自消散,郁热能清,毒亦自解也。四物消风饮方列下∶
四物消风饮方
细生地(一钱) 当归身(八分) 炒荆芥(八分) 赤芍药(七分) 酒川芎(五分) 北防风(八分)
白苏皮(六分) 秋蝉蜕(七分) 薄荷叶(七分) 酒独活(五分) 银柴胡(五分) 大红枣(一枚)
以上各药用水一茶碗半,煎成半茶碗,频频与儿服之。此方量数为一岁内小儿之剂,若至五岁上下,须加剂一倍、
或加一倍半。酌量症的轻重,及年龄的大小,与药之分量,比较准确,放心给儿服之,必能立见切效,此方剂
是消此等风毒之效药也。不过丹症愈后,须谨记发物,例如鱼腥鸡鹅等动风燥血之品,尤须忌之,否则再犯则难
治。重者能攻入心胃,即作大冷大热,心忙乱呕吐。若果到此场合,急先服口药的加重剂,以急解内毒走黄;再
用磁锋砭去恶血,则毒随血散,冷热立止,呕吐亦安定。此法至神捷,万勿稍延手术,致不可救也。
磁锋砭法
取磁器之细薄者,轻轻敲破,用其最锋利的小块。用新竹筷一双,将竹筷头劈开,横夹磁盘于中,露锋刃于
外,用丝线将夹磁盘之上下扎紧。以手拿扎磁锋的竹筷下部,使磁锋正对丹毒处立放之。再用他手另拿一竹筷,
在夹磁锋的竹筷磁锉之向上部,轻轻往复敲之,其恶血自在患处津出,不可用力敲打,以防砭深伤及肌肉。各处
发现之丹毒,均可使此手术以砭之。若未痊愈,不妨再行砭法一次,总以红消,肿散,吐止,心安为定。治冷膜
丹应用防风升麻汤。此症之原因,为热毒内蕴,将行发现于外。猝遇外间之风寒一激,将热毒之出路截住,全身
的肤膜均行冷开,毒不能外泄所致。然周身的气化,无一息之停留,热毒即
乘此时机,随气道窜行于皮肤之外,故无热而起风泡,或不变皮色而发疙疸。其症象微痛而痒极,至于不能须臾
忍奈。但以手搔之,顷刻遍起全身,斯时必感觉周身难受。若流走至口内、及心口窝两处,亦甚险要,不可疏忽
失治也。治法宜用解肌、散风、通络、消毒之防风升麻汤,使其表皮之寒松解,热毒即行开散,风邪能消,膜络
自通也。其内服之防风升麻汤,及外擦之止痒药包方列后∶
防风升麻汤方
北防风(一钱) 绿升麻(六分) 生栀衣(七分) 麦门冬(五分) 荆芥穗(八分) 细木通(七分)
粉葛根(七分) 薄荷梗(六分) 小玄参(五分) 牛蒡子(一钱) 粉丹皮(六分) 青连翘(一钱) 以上
各药共享水一茶碗,煎成半茶碗,频频与儿服之。此药为一岁以内之剂,若五岁以内之小儿,须更加一倍药与服
始可。不然病重药轻,无济于事。若兼大便闭结,口味不开,头旋晕甚者,是胃满肠燥,热不下行,燥火转往上
攻,须加酒大黄(一钱)、炒枳壳(一钱),即可通胃气以消滞,攻下小便,能使燥火从下去也。
止痒药包方(附用法)
北防风(一钱) 荆芥穗(一钱) 天水散(一钱)
三味共研极细末,用白夏布一块将药末包住,夏布上端用线扎之,以有药末下之端,做成乳形微大之状,用
之遍擦头面肢,及前心后背等处起风泡与白遍疙疸的地方,大能清热散风,立即止痒止痛,神效无比。又可以免
用指爪搔痒,能致肌肤破裂,遗毒血络,发肿溃烂也。
This condition arises from the pregnant mother consuming excessive amounts of pungent, fried, and roasted foods, or lying for a long time on a heated kang (brick bed), leading to intense internal heat that affects the fetus. After birth, the infant contracts wind pathogens, which stir up the heat-toxin already accumulated in the blood, resulting in "Youfeng Dandu" (Wandering Carbuncle and Erysipelas). If left untreated, it can spread over the whole body, manifesting myriad complications, and may even be fatal. This is what folk medicine refers to as "Fengzhen" (Wind Urticaria) or "Feng Gedan" (Wind Gout/Carbuncle).
The symptoms present as sudden redness and swelling on the infant's body, appearing either as scattered granules or confluent patches, accompanied by distending pain and itching. In severe cases, it covers the entire body and migrates without a fixed location. It must never be scratched with hands, as toxins under the fingernails can introduce external wind pathogens, causing immediate generalized eruption, potentially affecting the second and third layers of skin. At this stage, wherever the eruption occurs, the skin becomes numb, itchy, and painful. If the toxin enters the mouth, the infant cannot suckle milk; if it reaches the chest area, the infant experiences mental panic and incessant crying. In more advanced stages, tears and nasal discharge dry up, the carbuncle-erysipelas turns inward, invading the nervous system, leading to cyanotic tendons, flaring nostrils, spasms, and convulsions, presenting an emergency situation.
Initially, white spots appear, gradually revealing a yellowish luster, with fluid accumulation beneath the skin. When these rupture, yellow fluid flows out; wherever this fluid spreads, similar lesions arise, characterized by wet rot, pain, and itching, termed "Shuidan" (Water Carbuncle). These often occur on the legs and knees, attributed to wind-heat in the Spleen and Lung combined with dampness. Another variant presents as flat, red spots on the head, face, and body, without fever but with dry, painful, and itchy sensations. When numerous, they merge into cloud-like patches, called "Chiyou Dan" (Red Wandering Carbuncle), caused by fire in the Blood level contracting wind pathogens. Yet another form features flat bumps identical in color to the skin, without fever but with slight distending pain and itching, migrating unpredictably. This is caused by "Membrane Cold," also known as "Lengdan" (Cold Carbuncle), resulting from fetal toxins failing to erupt through the skin due to external wind-cold constraint. A specific type involves a ring of redness and swelling around the waist, named "Chanyao" (Waist-Coiling), which is highly toxic with intense fire-heat. It results from toxic heat in the Pericardium and Kidney contracting wind pathogens. Its onset is rapid, potentially fatal within moments, and incurable.
In summary, when carbuncle-erysipelas originates in the chest and abdomen and spreads to the limbs, the progression is favorable ("Shun") and auspicious. When it starts in the limbs and spreads to the chest and abdomen, the progression is adverse ("Ni") and critical, requiring urgent treatment. The following treatments and prescriptions are listed. Based on the specific manifestations, administer the corresponding formula to the infant for recovery.
For treating "Shuidan," use "Tianbao Caiwei Tang." This condition involves excess dampness impairing Spleen Qi transformation, leading to damp-heat accumulation forming toxins, compounded by external wind pathogens. The treatment principle should focus on draining dampness, clearing heat, dispersing wind pathogens, and unblocking Spleen Qi. This allows heat to clear, wind to disperse, dampness to resolve, and Qi to flow freely, enabling the Spleen to function normally so the toxin resolves naturally.
**Tianbao Caiwei Tang Formula** (Modified from original):
Jiu Qianghuo (Alcohol-treated Notopterygii Rhizoma et Radix, 5 fen), Zhi Qianhu (Honey-fried Peucedani Radix, 1 qian), Banxia Qu (Pinelliae Fermentatum, 1 qian), Guang Chenpi (Aged Tangerine Peel, 8 fen), Chi Shaoyao (Red Peony Root, 8 fen), Yun Fuling (Poria, 1 qian), Chao Zhike (Stir-fried Aurantii Fructus, 6 fen), Ku Jiegeng (Bitter Platycodon Root, 7 fen), Cangzhu (Atractylodis Rhizoma, 8 fen), Jiu Chuanxiong (Alcohol-treated Chuanxiong Rhizome, 5 fen), Yin Chaihu (Stellariae Radix, 5 fen), Sheng Gancao (Raw Licorice Root, 3 fen). Decoct these herbs in 1.5 tea bowls of water until reduced to 0.5 tea bowl. Administer continuously to the infant. This dosage is for a one-year-old child; for children around five years old, double the dosage. Otherwise, the disease severity may outweigh the medication's potency. For wet, rotten skin areas, apply "Qingge San" externally to stop itching, reduce swelling, promote scabbing, and regenerate tissue. This topical aid complements the decoction by absorbing dampness, preventing putrefaction, and resolving external toxins, achieving both internal and external therapeutic effects.
**Qingge San Powder:**
Ge Fen (Concha Meretricis Pulverized, 1 liang), Zhen Qingdai (Indigo Naturalis, 3 qian), Shigao (Gypsum Fibrosum, 2 liang), Qingfen (Calomelas, 5 qian), Chuan Huangbai (Phellodendri Cortex, 5 qian). Grind all ingredients into an extremely fine powder. Mix with sesame oil to form a paste; take a small amount as needed. Dilute with cool water to a thin paste consistency and apply evenly over the wet, rotten areas. Remove scabs and pus before reapplying. This is a miraculous formula.
For treating "Chiyou Dan," use "Siwu Xiaofeng Yin." This condition stems from impure blood, accumulated heat generating toxins, circulating throughout the body, limbs, head, and face. If not immediately identified as Chiyou Dan, it manifests as pustules everywhere on the skin surface. External wind pathogens agitate the heat-toxin flowing in the blood vessels and skin, triggering the eruption. The treatment should employ Siwu Xiaofeng Yin to disperse wind, resolve toxins, invigorate blood, and clear heat. This promotes smooth blood circulation, dissipates wind, clears stagnant heat, and resolves toxins.
**Siwu Xiaofeng Yin Formula:**
Xi Shengdi (Rehmanniae Radix Preparata, 1 qian), Danggui Shen (Angelicae Sinensis Radix, 8 fen), Chao Jingjie (Schizonepetae Spica, stir-fried, 8 fen), Chi Shaoyao (Red Peony Root, 7 fen), Jiu Chuanxiong (Alcohol-treated Chuanxiong Rhizome, 5 fen), Bei Fangfeng (Saposhnikoviae Radix, 8 fen), Bai Supi (Perillae Caulis Cortex, 6 fen), Qiu Chantui (Cicadae Molt, 7 fen), Bohe Ye (Menthae Haplocalycis Herba, 7 fen), Jiu Duhuo (Angelicae Pubescentis Radix, alcohol-treated, 5 fen), Yin Chaihu (Stellariae Radix, 5 fen), Da Hongzao (Jujubae Fructus, 1 piece). Decoct these herbs in 1.5 tea bowls of water until reduced to 0.5 tea bowl. Administer frequently to the infant. This dosage is for infants under one year; for children around five years old, increase the dosage by one or one-and-a-half times. Adjust based on disease severity and age for accuracy. This formula is highly effective for eliminating wind-toxins. After recovery, strictly avoid "Fa Wu" (stimulating foods) such as fish, poultry (chicken, goose), etc., which stir wind and dry blood. Failure to observe these dietary restrictions may lead to recurrence, which is difficult to treat. Severe cases may see toxins attacking the Heart and Stomach, causing extreme cold/fever, palpitations, and vomiting. In such emergencies, first administer a heavy dose of emergency medicine to rapidly resolve internal toxins and prevent "Zouhuang" (toxins spreading dangerously). Then, use "Cifeng Bian" (magnetic cupping/lancing) to drain bad blood, allowing toxins to disperse with the blood, stopping temperature fluctuations and vomiting instantly. This method is swift and miraculous; do not delay surgery, or the condition may become incurable.
**Cifeng Bian Method (Magnetic Lancing):**
Take thin porcelain shards, gently breaking them to obtain the sharpest pieces. Split the tip of a pair of new bamboo chopsticks horizontally to夹 (clamp) a porcelain shard between them, exposing the sharp edge outward. Tie the top and bottom securely with silk thread. Hold the lower part of the chopsticks with one hand, positioning the magnetic edge vertically against the carbuncle site. With the other hand, use another chopstick to gently tap the upper part of the clamping chopsticks repeatedly. Bad blood will naturally exude from the lesion. Do not strike forcefully to avoid deep injury to muscles. This procedure can be applied to any carbuncle sites. If not fully healed, repeat once until redness subsides, swelling dissipates, vomiting stops, and the heart feels calm.
For treating "Lengmo Dan" (Cold Membrane Carbuncle), use "Fangfeng Shengma Tang." The cause is internal heat-toxin attempting to erupt externally but being blocked by sudden external wind-cold, causing the skin membranes to close tightly and trapping the toxin. However, vital Qi movement never ceases; the heat-toxin seizes this opportunity to窜行 (crawling/migrating) along the Qi pathways outside the skin. Thus, wind blisters appear without fever, or bumps arise without skin color change. Symptoms include mild pain and extreme itching, unbearable for even a moment. Scratching causes immediate widespread eruption and general discomfort. If the toxin migrates to the mouth or heart pit, it is extremely dangerous and must not be neglected. Treatment requires Fangfeng Shengma Tang to release the muscle layer, disperse wind, unblock collaterals, and detoxify. This relaxes the cold constriction of the epidermis, allowing heat-toxin to dissipate, wind pathogens to vanish, and membrane collaterals to open.
**Fangfeng Shengma Tang Formula:**
Bei Fangfeng (Saposhnikoviae Radix, 1 qian), Lv Shengma (Cimicifugae Rhizoma, green variety, 6 fen), Sheng Zhiyi (Gardeniae Arillus, raw, 7 fen), Maidong (Ophiopogonis Tuber, 5 fen), Jingjie Sui (Schizonepetae Spica, 8 fen), Xi Mutong (Akebiae Caulis, 7 fen), Fen Gegen (Puerariae Lobatae Radix, 7 fen), Bohe Geng (Menthae Haplocalycis Herba stem, 6 fen), Xiao Xuanshen (Scrophulariae Radix, 5 fen), Niuzi (Arctii Fructus, 1 qian), Fen Danpi (Moutan Cortex, 6 fen), Qing Lianqiao (Forsythiae Fructum, green variety, 1 qian). Decoct these herbs in one tea bowl of water until reduced to half a tea bowl. Administer frequently to the infant. This dosage is for infants under one year; for children under five, double the dosage. Otherwise, weak medication cannot treat severe disease. If constipation, loss of appetite, and severe dizziness accompany the condition, indicating full stomach, dry intestines, downward stagnation of heat, and upward attack of dry-fire, add Jiu Dahuang (Rhei Radix et Rhizoma, alcohol-treated, 1 qian) and Chao Zhike (Stir-fried Aurantii Fructus, 1 qian) to regulate Stomach Qi, eliminate stagnation, and promote urination, allowing dry-fire to exit downward.
**Zhiyang Yao Bao Formula (Anti-Itch Medicine Packet - With Usage Instructions):**
Bei Fangfeng (Saposhnikoviae Radix, 1 qian), Jingjie Sui (Schizonepetae Spica, 1 qian), Tianshui San (Tianshui San, 1 qian).
Grind these three ingredients into an extremely fine powder. Wrap the powder in a piece of white linen cloth, tying the top end with thread. Shape the bottom end containing the powder into a slightly larger-than-nipple form. Use this packet to rub thoroughly over the head, face, limbs, anterior chest, posterior back, and any areas with wind blisters or white bumps. It effectively clears heat, disperses wind, and instantly stops itching and pain with miraculous efficacy. It also prevents scratching with fingernails, which could break the skin, leave toxins in the blood collaterals, and cause swelling and ulceration.