痘疮自初出至收靥时。脏腑俱虚。外邪易触。饮食易伤。必须避风寒。调饮食。日用胡荽、红
枣、大黄、乳香焚之。若血热毒盛。禁烧胡荽、红枣之属。恐变烦渴焦痒之患。如煎油炒豆杀牲腥
血。硫黄、脑、麝诸香。葱、蒜粪秽之气。房事淫气。异服生人。及锣钹金器之声。俱宜避之。
勿令洗面。恐生水损眼故也。眼鼻勿动其痂。则无眼吊鼻 之患。行坐勿令太早。免致腰酸脚痛
之虞。能食者。与鲫鱼、白鲞之类。切不可与生冷瓜、柿、梨、橘。韭、蒜、醋、酱。 粽、鸡、
鹅、椒。姜辛辣等物。鸡子害目。亦不可食。近世多用鲜笋、鲜鱼发痘。若脾胃虚寒者。误与。每
致泄泻不食。如天大寒。盖覆常宜温暖。恐毒瓦斯为寒所滞。则痘不能生发也。如天大热。勿使客
热与毒相并。致增烦躁溃烂也。其麻疹比之出痘固轻。然调治失宜。风寒不避。祸不旋踵。一切
辛辣浓味。助火酸收之物。咸须禁食。如酸醋、胡椒、猪肉、核桃及梅、杏、樱桃、梨、柿、荸
荠等类。若误犯之。则有伏慝焦紫。喘胀声喑而难救也。误食鸡则终身肌肤粟起。误食糖霜。多
发疳蚀。必俟两月后。方无禁忌也。
麻疹者。手足太阴阳明二经蕴热所发。小儿居多。大人亦时有之。是亦时气传染之类。其发
热时多咳嗽多嚏多呕。眼中如泪。面浮腮赤。多泻多痰。多热多渴。多烦闷。甚则躁乱咽痛。唇焦
神昏。通身红赤。起而成粒。匀净而小。斜目视
之。隐隐皮肤之下。以手摸之。磊磊肌肉之间。其形若疥。其色若丹。以其阳气从上。故头面愈
多者为顺。法当清凉发散为主。药用辛散以升发之。凉润以清解之。切忌酸收。凡动气燥悍及一切
温补之药。慎不可犯。误用祸不旋踵。辛散如荆芥、薄荷、前胡、葛根、麻黄、石膏、鼠粘子。
凉润如黑参、栝蒌根、葳蕤、麦冬、生甘草、芩、连、贝母、连翘、竹叶。皆应用之药。又当随
所发月时。量儿大小。及见证轻重而为制剂。若渐出渐收者。其势虽轻。而热尚未平。须防喘急。
若连绵三四日者。其势虽盛。而热已发泄。必无他变。宜大青汤。或消毒饮加黑参、石膏、麦冬、
竹叶。若发热时遍身汗出。或衄血者。此毒解也。勿遽止之。若汗出太多。血流不止。当以清肺
汤去款冬、杏仁加麻黄根以敛汗。犀角地黄汤以止血。迟则气虚神耗。为难治也。若发热时。或呕
吐。或自利者。此火邪内逼。毒瓦斯上下行也。俱宜清热解毒利小便。切勿止涩。大凡疹证发热时
。未有不渴者。但当与绿豆灯心汤。勿与冷冻饮料。致成水蓄。多生变幻也。即荤腥酒面生冷水果。
咸须禁之。麻疹多有热痰在肺。初发时必咳嗽。宜清热透表。不得止嗽。麻后咳嗽。切忌辛温酸
涩。但用清咽滋肺汤以清余热。痰壅自愈。多喘者。热邪壅肺也。切勿定喘。惟应大剂竹叶石膏
汤去半夏加贝母、黑参、薄荷。如冬天寒甚。麻毒为寒郁于内。不得透出而喘。加蜜酒炒麻黄。一
剂立止。夏月热势甚者。即用白虎汤加竹叶。忌用升麻。误服必喘。然喘为肺气壅遏。故喘必兼
嗽。而张口抬肩者。肺窍不通。不治也。故谚有喘而咳嗽者可疗。喘而不嗽者难医之语。又其证
多泄泻。慎勿止涩。惟宜芩、连、葛根。则泻自止。疹家不忌泻。泻则阳明之邪热得解。是亦表
里分消之义。又有疹收之后。饮食如常。卒然心腹绞痛。遍身冷汗如冰者。此元气虚弱而中恶气也
。朝发夕死。勿妄治之。凡麻疹以鲜明似锦为吉。黑晦如煤最凶。头面不出者重。红紫黯惨者重。
咽喉肿痛不食者重。黑黯干枯。一出即没者不治。鼻扇张
目无神者不治。鼻青粪黑者不治。牙疳臭烂者不治。疹之牙疳。最为难治。外用无比散吹之。内
服加味清胃散更加荆芥、石膏。缓则不救。疹中诸患。不宜根据证施治。惟当治本。本者。手太阴
足阳明二经之邪热也。解其邪热。则诸证自退矣。有夹痘而出者。此毒瓦斯太盛。故一齐涌出。不
必治疹。但当托痘为主。然治痘宜温。治疹宜凉。此又不可不审。大人男妇出疹。当与外感并治。
惟清凉解表。随天时寒暑施治。凡麻痘并作。脏腑风热交患也。麻乃风邪外感。痘为胎毒内发。
二者相杂。赤晕发 。多有误认痘出太密而委之不救。殊不知其为疹夹痘也。当与化斑汤续续频
进。麻毒解而痘自起矣。有种行浆疹子。极似痘。最难看。然痘则必有顶盘。疹虽有浆。而头粒
必不坚。根盘必无红晕也。疹后痘不结痂。乃元气亏损。当大补脾胃为主。不可误认邪热未尽。
复与清热退火之药。
During the period from the initial eruption to the crusting and falling off of smallpox (Dou Chuang), the Zang-Fu organs are all deficient, making them susceptible to external pathogens and dietary injuries. It is essential to avoid wind and cold, regulate diet, and daily burn Hu Suo (Coriander), Hong Zao (Red Date), Da Huang (Rhubarb), and Ru Xiang (Frankincense) for fumigation. If blood heat and toxin accumulation are severe, burning Hu Suo and Hong Zao is prohibited, as it may cause complications such as irritability, thirst, and scaly itching. Just as one should avoid the odors of frying oil beans, slaughtering animals, sulfur, Bing Pian (Borneol), She Xiang (Musk), green onions, garlic, feces, sexual arousal, strangers' breath, and the sound of gongs and cymbals, these must also be avoided. Washing the face should be avoided to prevent water damage to the eyes. Do not touch the scabs on the eyes and nose to avoid complications like ptosis or nasal collapse. Early walking or sitting should be prevented to avoid soreness in the waist and pain in the legs. For those who can eat, provide crucian carp or Bai Xiang (dried fish). Absolutely avoid raw and cold melons, persimmons, pears, oranges, leeks, garlic, vinegar, sauces, zongzi, chicken, goose, Sichuan pepper, ginger, and other spicy foods. Eggs harm the eyes and should not be eaten. In recent times, fresh bamboo shoots and fresh fish are often used to promote smallpox eruption; if given mistakenly to those with Spleen-Stomach deficiency-cold, it often leads to diarrhea and loss of appetite. In extreme cold, bedding should be kept warm to prevent toxins from being stagnated by cold, which would hinder the eruption of lesions. In extreme heat, avoid allowing external heat to combine with toxins, causing increased irritability and ulceration. Measles (Ma Zhen) is indeed milder than smallpox, but if treatment and care are improper and wind-cold is not avoided, disaster will follow swiftly. All spicy, strong-flavored, fire-assisting, and astringent foods must be forbidden, such as vinegar, black pepper, pork, walnuts, plums, apricots, cherries, pears, persimmons, and water chestnuts. Mistakenly consuming these can lead to latent toxins, scorched-purple discoloration, wheezing, abdominal distension, hoarseness, and untreatable conditions. Mistakenly eating chicken causes lifelong milia-like eruptions; mistakenly eating sugar frost often leads to gan erosion. Only after two months are there no more dietary restrictions.
Measles is caused by heat accumulation in the Hand-Taiyin and Foot-Yangming meridians, predominantly affecting children, though adults occasionally suffer from it. It belongs to the category of epidemic contagious diseases. During fever, patients often exhibit coughing, sneezing, vomiting, tearing eyes, facial swelling, red cheeks, diarrhea, phlegm, heat, thirst, and irritability. Severe cases may present with restlessness, sore throat, cracked lips, coma, generalized erythema, and papular eruptions that are uniform and small. When viewed obliquely, they appear faintly under the skin; when touched, they feel distinct within the muscles. Their shape resembles scabies, and their color resembles cinnabar. Since Yang Qi ascends, lesions appearing mostly on the head and face indicate a favorable course. The treatment principle should focus on cooling and dispersing. Medications should use acrid-dispersing agents to promote eruption and cool-moistening agents to clear and resolve heat. Astringents are strictly contraindicated. Any drugs that move Qi aggressively or are warming and tonifying must be avoided; misuse leads to immediate disaster. Acrid-dispersing herbs include Jing Jie (Schizonepeta), Bo He (Mint), Qian Hu (Peucedanum), Ge Gen (Kudzu Root), Ma Huang (Ephedra), Shi Gao (Gypsum), and Niu Bang Zi (Arctii Fructus). Cool-moistening herbs include Hei Shen (Scrophulariae Radix, referred to here as Black Ginseng/Xuan Shen), Gua Lou Gen (Trichosanthis Radix), Wei Yu (Polygonati Rhizoma), Mai Dong (Ophiopogonis Radix), Sheng Gan Cao (Raw Licorice), Qin (Scutellariae Radix), Lian (Coptidis Rhizome), Bei Mu (Fritillariae Bulbus), Lian Qiao (Forsythiae Fructus), and Zhu Ye (Bamboo Leaf). These are applicable medications. Dosage and formulation should be adjusted according to the month of onset, the child's size, and the severity of symptoms. If lesions erupt and recede gradually, the condition is mild, but heat has not yet subsided; watch out for wheezing. If lasting three to four days continuously, the condition is severe, but heat has been vented, so no other changes are expected; use Da Qing Tang or Xiao Du Yin added with Hei Shen, Shi Gao, Mai Dong, and Zhu Ye. If sweating occurs all over the body during fever, or epistaxis happens, this indicates toxin resolution; do not abruptly stop sweating or bleeding. If sweating is excessive or bleeding does not stop, use Qing Fei Tang removing Ku Dong Hua and Xing Ren, adding Ma Huang Gen to arrest sweating, and Xi Jiao Di Huang Tang to stop bleeding. Delay leads to Qi deficiency and spirit exhaustion, making it difficult to treat. If vomiting or spontaneous diarrhea occurs during fever, this indicates internal逼迫 by Fire Pathogen and upward/downward movement of toxins. Clear heat, detoxify, and promote urination; never use astringents. Generally, measles patients with fever are always thirsty; provide Mung Bean and Lamp Heart Decoction, avoiding cold drinks to prevent fluid retention and further complications. Meat, alcohol, noodles, raw/cold fruits must all be forbidden. Measles often involves heat-phlegm in the Lungs; coughing is inevitable at onset. Clear heat and vent the exterior; do not suppress cough. Post-measles coughing: strictly avoid acrid-warm and astringent herbs; use Qing Yan Zi Fei Tang to clear residual heat, resolving phlegm obstruction naturally. Wheezing indicates Heat Pathogen obstructing the Lungs; do not simply stop wheezing. Use large doses of Zhu Ye Shi Gao Tang removing Ban Xia, adding Bei Mu, Hei Shen, and Bo He. In severe winter cold, if Measles-Toxin is constrained internally by cold causing wheezing, add Mi Jiu Chao Ma Huang (Honey-wine fried Ephedra); one dose stops it immediately. In summer with severe heat, use Bai Hu Tang plus Zhu Ye; avoid Sheng Ma. Misuse causes wheezing. Wheezing is due to Lung Qi obstruction, so it usually accompanies coughing. Open-mouth shoulder-lifting indicates blocked Lung Orifices and is untreatable. Hence the proverb: "Wheezing with cough is treatable; wheezing without cough is hard to cure." Diarrhea is common in measles; do not use astringents. Use Qin, Lian, and Ge Gen to stop diarrhea naturally. Measles patients do not fear diarrhea; diarrhea resolves Yangming Heat, embodying the principle of resolving exterior and interior simultaneously. After measles resolution, if the patient eats normally but suddenly suffers heart/abdominal colic and icy cold sweats, this is Yuan Qi deficiency with Evil Qi invasion. Death occurs from morning to evening; do not treat rashly. Bright, brocade-like rashes are auspicious; dark, coal-like ones are ominous. Absence on head/face, purple-dark discoloration, sore throat preventing eating, dry-black shriveled lesions disappearing immediately, flaring nostrils with dull eyes, blue nostrils with black stool, and foul-smelling gangrenous gums are all grave or untreatable signs. Gangrene in measles is hardest to treat; apply Wu Bi San externally and Jiawei Qing Wei San plus Jing Jie and Shi Gao internally. Delay is fatal. Various complications of measles should not be treated symptomatically but by addressing the root: Heat-Toxin in the Hand-Taiyin and Foot-Yangming meridians. Resolving this heat clears all symptoms. Cases where measles and smallpox erupt together indicate excessive Toxin-Heat erupting simultaneously; do not treat measles, but focus on supporting smallpox eruption. Smallpox treatment favors warmth; measles treatment favors cooling; this distinction must be carefully considered. Adult measles should be treated concurrently with exterior syndromes, using cooling exterior-resolving methods adjusted for seasonal climate. Simultaneous measles and smallpox involve Wind-Heat in Zang-Fu. Measles is external Wind-Pathogen; smallpox is internal Fetal Toxin. Mixed presentation with erythematous halos is often mistaken for dense smallpox, leading to abandonment. Actually, it is measles complicating smallpox. Continuously administer Hua Ban Tang; once measles toxin resolves, smallpox will rise. Some vesicular rashes resemble smallpox closely and are hard to distinguish. Smallpox has a definite crown/base; vesicles have soft heads and no red halo at the base. If post-measles smallpox fails to crust, it indicates Yuan Qi depletion; strongly tonify Spleen and Stomach. Do not mistake this for lingering Heat-Toxin and administer clearing/cooling drugs again.