小儿生后，有五软五硬之证。乃胎元怯弱，禀受先天阳气不足，不耐寒暑，少为六淫所犯，便尔五软见焉。
五软者，头项软，身体软，口软，肌肉软，手足软，是为五软。然头项软，肝肾病也。肝主筋，肾主骨，肝肾不
足，故头项软而无力。手足软，脾胃病也。脾主四肢，脾胃不足，故手软而懒于抬，足软而慵于步也。身体软，
阳衰髓怯，遍身羸弱，而不能强立。口软者，虚舌退场门，而懒于言。肌肉软者，肉少而皮宽，身体虚 之象也。
总之，本于先天不足，宜地黄丸以补肝肾，而所以更重者在胃。盖胃为五脏六腑之化源，宜补中益气汤，升举其
脾气。但得脾胃一旺，则脏气有所禀，诸软之症，其庶几矣。
五硬者，手硬，足硬，腰硬，肉硬，颈硬也。仰头取气，难以动摇，气壅疼痛，连于胸膈。手心脚心，冰冷
而硬，此阳气不荣四体也，为独阴无阳，难治。若肚筋青急，乃木乘土位，俱宜六君子汤加姜桂、升麻、柴胡，
以补脾平肝。若面青而小腹硬者不治。
六味地黄汤 （见前喘哮方内）
补中益气汤（见前泄泻方内）
六君子汤（见前咳嗽方内）。外加干姜、上桂、升麻、柴胡。
陈飞霞曰∶小儿赤游丹毒，皆由心火内壅，热与血搏，或起于手足，或发于头面胸背，游移上下，其热如
火，痛不可言，赤如丹砂，故名丹毒。自腹出四肢易治，自四肢入腹难治。治丹之法，用辛凉解表，使毒渐消，
方可搽敷。若先不解表，遽用搽敷，必逼毒入腹，以致不救。小儿一岁外者易治，未周岁者难治。然治之得法，
无论大小。予尝治百日内外火丹，从阴囊下起，按法治之，三日后阴囊去一壳而愈。
小儿十种丹毒，如三日不治，攻入肠胃则不救。宜逐一辨认，根据方治之，百不一失。凡治丹毒，俱宜先
服防风升麻汤，以解毒发表，次用瓷锋针去其血，则毒随血而散，至神至捷，百发百中。
防风升麻汤 治十种丹毒用。
防风（一钱） 升麻（五分） 栀仁（一钱） 麦冬（一钱） 荆芥穗（一钱） 木通（一钱） 干葛（一钱）
薄荷（一钱） 玄参（一钱） 牛蒡子（一钱） 粉甘草（一钱） 便闭加大黄利之。灯心十茎，水煎热服。
瓷针砭法
用上清瓷器，轻轻敲破，取其锋锐者一枚，将箸头劈破，横夹瓷针，露锋于外，将线扎紧，以瓷锋正对丹
毒之处，另以箸一条，于瓷箸上轻轻敲之，其血自出，多刺更妙。毒血出尽，立时见功。治丹若不砭去恶血，
十不救一。
十种丹证∶一、飞灶丹。从头顶肿起，然后散开，先用葱白捣取自然汁，涂之效。二、走灶丹。从头顶起，
红肿异常，用红豆饭研末，鸡蛋清调涂。三、鬼火丹。从面部红肿起，用灶心土研末，鸡蛋清调涂。四、天火
丹。从背上起赤点，用桑白皮切
碎，焙干为末，米醋调涂。五、天灶丹。从两臂赤肿黄色起，用柳木烧炭研末，净水调涂。六、水丹。先从两胁
起赤肿，用多年锈铁磨浓汁，猪油调涂。七、葫芦丹。先从脐下起红肿，用尖槟榔切碎，焙干研末，米醋调涂。
八、野火丹。先从两脚起红肿，用乳香去油研末，羊油调涂。九、烟火丹。从脚背上起红肿，用猪槽下土研末、
麻油调涂。十、胡漏丹。从阴囊下起红肿，用门槛之下千脚土，羊油调涂。更有胎毒重者，遍体皆是，速用芸
苔子（即油菜子）一两，酒一大壶和研滤去渣，取酒复热数沸，不拘时，温服二盏。又方芸苔，即油菜，取叶捣
烂敷之，随手即消。如无鲜菜，干者为未调敷。凡丹毒遍身，或连腰周，百方不能治者，惟此最神。
After birth, infants may present with the syndromes of "Five Softnesses" (Wu Ruan) and "Five Stiffnesses" (Wu Ying). These arise from a weak fetal constitution and insufficient congenital Yang Qi (vital energy), making them unable to tolerate cold or heat. A slight invasion by the Six Exogenous Pathogens (Wind, Cold, Summerheat, Dampness, Dryness, Fire) leads to the manifestation of the Five Softnesses.
The Five Softnesses refer to softness of the head and neck, body, mouth, muscles, and hands and feet. Softness of the head and neck is a disorder of the Liver and Kidney. The Liver governs the sinews, and the Kidneys govern the bones; deficiency in the Liver and Kidneys results in weakness and lack of strength in the head and neck. Softness of the hands and feet is a disorder of the Spleen and Stomach. The Spleen governs the four limbs; deficiency in the Spleen and Stomach causes the hands to be too weak to lift and the feet to be too sluggish to walk. Body softness is due to declining Yang Qi and weak marrow, resulting in general emaciation and weakness, preventing the child from standing upright. Mouth softness manifests as a flaccid tongue protruding from the mouth and reluctance to speak. Muscle softness presents as scant flesh and loose skin, indicating a state of bodily deficiency.
In summary, these symptoms stem from congenital insufficiency. It is appropriate to use Dihuang Wan (Rehmannia Pill) to tonify the Liver and Kidneys, but greater emphasis should be placed on the Stomach. As the Stomach is the source of transformation for the Zang-Fu organs, it is appropriate to use Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) to raise the Spleen Qi. Once the Spleen and Stomach are robust, the Zang-Fu organs will receive their nourishment, and the various softness syndromes will likely resolve.
The Five Stiffnesses refer to stiffness of the hands, feet, waist, muscles, and neck. The infant extends the head to breathe, finds movement difficult, experiences Qi stagnation and pain radiating to the chest and diaphragm. The palms and soles are cold and stiff, indicating that Yang Qi fails to nourish the four limbs. This represents an excess of Yin without Yang and is difficult to treat. If the abdominal veins appear blue and tense, it indicates Wood overacting on Earth; in such cases, Liujunzi Tang (Six Gentlemen Decoction) augmented with Ganjiang (Dried Ginger), Rougui (Cinnamon Bark), Shengma (Cimicifugae Rhizoma), and Chaihu (Bupleuri Radix) should be used to tonify the Spleen and soothe the Liver. If the face is cyanotic and the lower abdomen is hard, the condition is incurable.
Liuyi Dihuang Tang (Six-Ingredient Rehmannia Decoction) (See Asthma/Wheezing formulas above)
Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) (See Diarrhea formulas above)
Liujunzi Tang (Six Gentlemen Decoction) (See Cough formulas above). Augmented with Ganjiang (Dried Ginger), Shanggui (Cinnamon Twig), Shengma (Cimicifugae Rhizoma), and Chaihu (Bupleuri Radix).
Chen Feixia stated: Infantile erysipelas (Chi You Dan Du) is caused by internal congestion of Heart Fire, where Heat collides with Blood. It may originate in the hands and feet or erupt on the head, face, chest, and back, wandering up and down. The heat feels like fire, the pain is unbearable, and the color is red like cinnabar, hence the name "Dan Du" (Red Poison). Erysipelas originating from the abdomen and spreading to the limbs is easy to treat; one originating from the limbs and entering the abdomen is difficult to treat. The treatment for erysipelas involves using Acrid-Cool Exterior-Resolving methods to gradually dissipate the toxin before applying topical preparations. If exterior-resolving is not performed first and topical applications are used hastily, the toxin will be forced into the abdomen, leading to untreatable conditions. Infants older than one year are easier to treat; those under one year are difficult. However, if treated correctly, both young and old can be cured. I once treated a case of Huo Dan (Fire Erysipelas) in an infant within 100 days, starting from below the scrotum. Following this method, after three days, the scrotal skin shed, and the infant recovered.
If the ten types of infantile erysipelas are not treated within three days, the toxin attacking the intestines and stomach becomes incurable. Each type must be identified individually and treated according to its specific formula, ensuring near-perfect success. For all cases of erysipelas, it is appropriate to first administer Fangfeng Shengma Tang (Saposhnikovia and Cimicifuga Decoction) to resolve toxicity and release the exterior, followed by bloodletting using a porcelain needle. This allows the toxin to disperse with the blood, yielding miraculous and rapid results with high efficacy.
Fangfeng Shengma Tang (Saposhnikovia and Cimicifuga Decoction) Used for the ten types of erysipelas.
Fangfeng (Saposhnikoviae Radix) - 1 qian
Shengma (Cimicifugae Rhizoma) - 5 fen
Zhiren (Gardeniae Semen) - 1 qian
Maidong (Ophiopogonis Tuber) - 1 qian
Jingjie Sui (Schizonepetae Spica) - 1 qian
Mutong (Akebiae Caulis) - 1 qian
Gange (Puerariae Radix) - 1 qian
Bohe (Menthae Haplocalycis Herba) - 1 qian
Xuanshen (Scrophulariae Radix) - 1 qian
Niubangzi (Arctii Fructus) - 1 qian
Fen Gancao (Glycyrrhizae Radix et Rhizoma Preparata) - 1 qian
If constipation is present, add Dahuang (Rhei Radix et Rhizoma) to promote bowel movement. Ten stems of Dengxincao (Junci Medullae), decocted in water and taken hot.
Porcelain Needle Scarification Method
Take a fine porcelain vessel and gently break it to obtain a sharp shard. Split the tip of a chopstick horizontally to clamp the porcelain shard, exposing the sharp edge. Tie it securely with thread. Position the porcelain edge directly against the erysipelas lesion. Hold another chopstick and gently tap the one holding the shard. Blood will flow out naturally; multiple pricks are better. Once the toxic blood is fully expelled, immediate improvement is seen. If scarification to remove bad blood is not performed when treating erysipelas, fewer than one in ten patients will survive.
Ten Types of Erysipelas Syndromes:
1. Feizao Dan (Flying Kiln Erysipelas): Swelling starts at the crown of the head and then spreads. Apply fresh juice extracted from Congbai (Allii Fistulosi Bulbus) for effectiveness.
2. Zouzao Dan (Wandering Kiln Erysipelas): Starts at the crown, with severe redness and swelling. Grind Hongdou Fan (Red Bean Rice) into powder, mix with Egg White (Jidan Qing), and apply.
3. Guohuo Dan (Ghost Fire Erysipelas): Redness and swelling start on the face. Grind Zaoxintu (Caosinis Cauda) into powder, mix with Egg White (Jidan Qing), and apply.
4. Tianhuo Dan (Heaven Fire Erysipelas): Red spots appear on the back. Crush Sangbaipi (Mori Cortex), dry it by roasting, grind into powder, mix with Rice Vinegar (Micu), and apply.
5. Tianzao Dan (Heaven Kiln Erysipelas): Redness, swelling, and yellowing start on both arms. Burn Liu Mu (Salix Twig) to charcoal, grind into powder, mix with clean water, and apply.
6. Shuidan (Water Erysipelas): Redness and swelling start on both hypochondriac regions. Grind rusted iron from many years into a thick paste/juice, mix with Zhu You (Porcine Fat), and apply.
7. Hulu Dan (Gourd Erysipelas): Redness and swelling start below the navel. Crush Jian Binglang (Arecae Semen Acutum), dry by roasting, grind into powder, mix with Rice Vinegar (Micu), and apply.
8. Yehuo Dan (Wild Fire Erysipelas): Redness and swelling start on both feet. Remove oil from Rushiang (Boswelliae Resina), grind into powder, mix with Yang You (Caprine Fat), and apply.
9. Yanhuo Dan (Smoke Fire Erysipelas): Redness and swelling start on the dorsum of the foot. Grind Tu from under pig troughs into powder, mix with Mayou (Sesame Oil), and apply.
10. Hulou Dan (Hu Funnel Erysipelas): Redness and swelling start below the scrotum. Grind Qianjiao Tu (Soil from under door thresholds) into powder, mix with Yang You (Caprine Fat), and apply.
For severe cases of congenital toxin covering the whole body, quickly take Yuntaizi (Brassicae Napus Semen/Canola Seed) 1 liang and a large pot of Jiu (Alcohol). Grind and mix, filter to remove dregs. Reheat the liquid until boiling several times. Drink two cups warm at any time. Another prescription: Use Yuncai (Brassicae Chinensis Folium/Chinese Cabbage Leaves), crush and apply topically; it resolves immediately. If fresh vegetables are unavailable, use dried ones ground into powder for application. For erysipelas covering the entire body or encircling the waist, which resists all other treatments, this method is the most miraculous.