《保婴集》云∶ 出潮时，五液俱全，则经络宣通，无有留邪。若五液不足，各有余邪也。汗不足则发热，
涕不足为鼻渊，泪不足则为珠管（睛珠起星），吐不足则为牙疳，泻不足则为肠 。此皆 毒余邪，当随证而
治之。
《青囊集》云∶ 出之际，为风阻遏，不能全收者，即当服疏散肌表之剂，则 疹自退矣。若色变青紫，
此热毒内攻也。攻
于脾则呕吐；攻于胃则不食；攻于肝则筋急，遍身疼痛；攻于心则舌黑面黑，神昏谵语；攻于肺则喘促，摇头
掣手，甚则鼻塞舌干唇焦，不省人事。此皆恶候也。如或身热，小水短赤，神不昏，胸不突，腹不胀，庶或可
治也。
《保婴集》云∶肺受毒则胀壅喘急，脾受毒则呕吐困倦，胃受毒则满闷不食，肝受毒则目闭不开，心受毒
则语言不清，肾受毒则黑陷而不能救矣。
霖按∶《 疹全书》及李豆仙诸论，治法未淳，然辨证处细针密缕，发前人所未发，学人宜细心参玩也。
《圣济总录》云∶小儿疮疹审得其证，速疏利脏腑，然亦须详审。若大便已利，疮已出者，皆不可疏，亦不
可汗。若发其表，则疮空开泄，更增斑斓。仓公、扁鹊常用油剂、草剂，其法最妙。大率汤剂之用，所以透肌
和里，开通中外，使疹毒通快，不致壅瘀，去其邪毒，乃得痊差。然食乳婴孩与童子疮疹，治法不同。婴孩之
病，唯宜调节乳母，令气血清和，乳汁通利，最为要法。若初断乳儿，则以汤剂和其阴阳，调其荣卫。既差之
后，尤宜利其脏腑，以去其余毒。此治疮疹大法。
紫草汤方
治断乳儿并童儿患疹痘候，初觉多似伤寒，面与四肢俱赤，壮热头痛，腰脊疼，足厥冷，眼黄赤，脉浮洪，
至数数大不定，小便赤少，大便多秘，才觉四肢、色候及脉俱是疹痘疾，未攻皮毛穴出者，便可以服饵和匀脏
腑，疏泄逐下药。按仓公论云∶可服油剂，不可用燥药并冷药。若疹已结在皮毛穴处，微微出，即不可疏泄。
或疹出太盛，窦穴脓水者，却可疏利也。或未与疏转，即急服紫草汤。
紫草二两，以百沸浸草，用物盖，勿令泄气。凡二月至百日孩服半药注子，五七月儿服一药注子，一二岁儿
服半合，三四岁儿服一合。疹虽出，其势亦轻，常服无妨。
生油汤剂
治儿脏腑伏热，未成疹子，四肢微觉有热，食物似减，头发干直，额上微热用此方。
生麻油一钟，令如人体温，以热水一小钟放入油内，不住手
搅，令水尽如蜜。夜卧时，二三岁服二蚬壳，五七岁三蚬壳，十岁以上儿三大蚬壳，大人服三合。食良久与服，
服了卧时。如三五服后，大小便利，肌热退，则疹痘不复发也。
霖按∶近世所传，治痧疹发不透而气喘者，急用芝麻五合，滚水泡之，乘热熏头面，即复出，谓有起死回生
之功。盖一由脏腑利毒下行，一由皮毛发毒外出，用法不同，其义则一。
万密斋曰∶痘疹皆胎毒所发，毒者火也，故痘子大而 肿者，少阳三焦火也。阳道常饶，故大而肿。疹子小
而碎密者，少阴心火也，阴道常乏，故小而密。三焦水谷之道路，脾胃主纳水谷，治痘专以脾胃为主。心肺属阳
而位乎上，心火旺则肺受之，治疹专以肺为主，观其咳嗽者，火炎则肺叶焦举也。鼻流清涕者，鼻为肺之窍，以
火铄金，而液自流也。目中泪出者，肺热则移于肝，肝之窍在目也。或手掐眉目唇鼻及面者，肺热证也。
疮疹之证，其初发热，与伤寒相似，但疹子则面颊赤，咳嗽喷嚏，鼻流清涕，目中泪出，呵欠喜睡，或吐泻，
或手掐眉目鼻面。宜用升麻葛根汤，不可作伤寒妄用汗下也。汗之则增其热，为衄血，为咳血，为口疮咽痛，为
目赤痛，为烦躁，为大小便不通；下之则虚其里，为滑泄，为滞下。经曰∶必先岁气，毋伐天和。言不可妄汗
下也。如手足梢微冷，恶寒而无汗，面色青惨而不舒，左额有青纹者，伤寒之热也；手足梢微温，发热有汗，面
赤而光者，伤风之热也，并宜惺惺散发散之。目胞肿而右颊有青筋，发热而头额腹肚最甚，或兼呕吐腹疼者，伤
食之热也，备急丸下之。面色青红，额正中有纹，手掌心有汗，时作惊惕，手络脉微动而发热者，此惊热也，泻
青丸、牛黄清心丸主之。身热而倍能食，唇红颊赤，大小便秘，胁下汗者，此风热也，宣风散主之。已上诸热，
久而不去，内外感发，则所蕴疮疹之毒，亦能乘间而出矣。
升麻葛根汤 解发痘疹之良方。
葛根 升麻 甘草 白芍药（各等分）
上锉细，水一盏，煎七分，去滓，温服无时。
惺惺散 解发痘疹良方。
人参 桔梗 甘草（炙） 白茯苓 栝蒌根 白术（各等分） 细辛（少许）
上为末，每服二钱，水一盏，入薄荷叶五片，煎七分，温服，不拘时候。（一方有防风、川芎。）
备急丸
木香（二钱五分） 大黄 牵牛末（各五钱）
上为细末，神曲糊丸，绿豆大，每服五七丸，食前山楂煎汤下。
泻青丸 治肝热作搐良方。
羌活 大黄（煨） 川芎 当归 防风 山栀仁 龙胆草（各等分）
上为末，炼蜜和丸，鸡头子大，每服半丸至一丸，竹叶汤同沙糖水化下。
牛黄清心丸 治心热神昏。
牛黄（二分半） 辰砂（一钱五分） 黄连（五钱，生） 郁金（二钱） 黄芩（三钱） 山栀仁（三钱）
共研细末，腊雪水调面糊为丸，如黍米大，每服七八丸，灯芯汤送下。
宣风散 治黑陷里实，以代百祥丸、牛李膏。
槟榔（二个） 陈皮（五钱） 甘草（五钱） 牵牛（四两，用半生半炒，取头末一两）
上为末，三二岁蜜汤调下半钱，以上一钱，食前服。
疹喜清凉，痘喜温暖，此法人皆知之。然疹子初出，亦须和暖则易出。所以发苗之初，只要发出得尽，则毒
便解。非若痘必苗而秀，秀而实，而后毒解也。痘子成实之时，若大温热，则反溃烂不收，是痘之后亦喜清凉
也。故治痘疹者，无过热，无过寒，
温凉适宜，阴阳自和，是为得之。
疹子只怕不能得出，若出尽则便毒解。故治疹子者，发热之时，当察时令寒暄，以药发之如时。大寒以桂枝
葛根汤发之；大热以升麻葛根汤（方见前）。合人参白虎汤发之；不寒不热，以荆防败毒散发之。如兼疫疠之
气，以人参败毒散发之。如尽一剂不出，再作本汤发之。外用胡荽洒，以苎麻蘸酒遍身戛之，务令亟出。如三四
作更不出，加腹中胀痛，气上喘促，昏闷谵妄者，必死证也。
桂枝葛根汤
桂枝 葛根 升麻 防风 赤芍药 甘草（各一钱）
上锉细，加生姜三片，淡豆豉一钱，水一盏，煎至七分，去渣，温服无时。
人参白虎汤（又名化斑汤） 解斑疹良方。
人参（一钱） 知母（三钱） 甘草（一钱） 石膏（五钱） 糯米（一合）
上锉细，水二盏，煎待米熟去渣，温服无时。
荆防败毒散 疹痘之发散药也。
荆芥穗 柴胡 甘草 人参 桔梗 川芎 青防风 茯苓 枳壳 前胡 羌活 独活
上锉细，加薄荷五叶，水一盏，煎七分，去渣温服。
人参败毒散 解疫疠、发痘疹之良方，又主腰痛，四时通用。
羌活 独活 前胡 柴胡 川芎 枳壳 茯苓 桔梗 人参（各等分） 甘草（减半）
上锉细，加生姜三叶，水一盏半，煎至一盏，去滓，温服无时。（一方加薄荷少许）
胡荽酒 治倒陷。
胡荽四两切，以好酒二盏，煎一两沸，入胡荽，用物盖定再煎，勿令泄气。放冷，每吸一两口微喷，从背
至足遍，勿喷头
面。病患常令闻荽气。
发热六七日以后，明是疹子，却不见出，此皮肤坚浓，腠理闭密。又或为风寒袭之，曾有吐利，乃伏也。急
用托里发表之剂，麻黄汤去杏仁，加蝉蜕、升麻。外用胡荽酒（方见前），散麻刮之。如一向未更衣者，毒甚
于里，伏而不出，河间凉膈散加牛蒡子主之，发之解之。再不出者，死证也。
麻黄汤
麻黄 杏仁 甘草（各等分） 石膏（倍用）
上锉细，加腊茶叶一钱，水一盏，煎七分去渣，不拘时服。（一方无石膏，有桑白皮。）
河间凉膈散 解痘疹表里俱热，纯阳无阴之豆。
大黄 朴硝 甘草（各五分） 连翘（一分） 栀子 黄芩 薄荷（各一分半） 淡竹叶（五片）
上锉细，作一服。水一盏，煎八分，去滓，入蜜一匙，和匀服。
疹子初发热时，未见出现，咳嗽百十声不已，上气喘气，面浮目胞肿，时卧时起，此毒火内蒸，肺叶焦举，
宜甘桔汤合人参白虎汤（方见前）去人参加牛蒡子、薄荷叶主之。
甘桔汤 解咽喉之良方。
甘草（二钱） 桔梗（一钱）
上锉细，水一盏，煎七分，去渣，食后温服。
疹子发热，或自汗出，或鼻衄者，不须止之，亦发散之义。故汗者，毒从汗散；衄者，毒从衄解。但不可太
过。如汗太多，人参白虎汤（方见前）合黄连解毒汤主之；衄太多，玄参地黄汤主之。
黄连解毒汤 此解火毒痘疹通用方。
黄连 黄芩 黄柏 栀子（各等分）
上锉细，水一盏半，煎至一盏，去渣，热服。
玄参地黄汤 治痘疹衄血。
玄参 生地黄 牡丹皮 栀子仁（各一钱半） 甘草 升麻（各五分） 白芍药（一钱）
上锉细，加炒蒲黄半钱，水一盏，煎七分，去渣，温服。
疹子发热吐利，纯是热证，不可作寒论，乃火邪内迫。上焦多吐，下焦多利，中焦吐利并多。自利宜黄芩
汤。吐利宜黄芩加半夏汤。自利里急后重者，宜黄连解毒汤（方见前）合天水散主之。
黄芩汤 治协热而利。
黄芩（一钱半） 甘草（炙，一钱） 白芍药（六钱）
上锉细，加大枣二枚，水一盏，煎七分，食前温服。
黄芩加半夏汤
即前黄芩汤加半夏二钱，生姜一钱。
天水散 治痘干燥而痛。
白滑石（四两） 甘草（一两）
共为细末，白汤调服。或用涂痘子甚佳，以蜜水调刷之。
痘疹咽痛，亦是常候，乃毒火上熏而痛也，勿作喉痹同论，妄用针刺。喉痹内作痈肿，故宜针决去恶血。
痘疹只是咽干作痛，宜甘桔汤（方见前），加牛蒡子，或射干鼠粘子汤，细细咽之。
射干鼠粘子汤 治咽喉痛。
射干（一两） 鼠粘子（四两，炒香） 甘草 升麻（各一两）
上锉细散，每服二钱，水一盏煎服。
疹子渴喜饮水，纯是火邪，肺焦胃干，心火内亢故也。初发热渴者，升麻葛根汤（方见前）加天花粉、麦
门冬。渴甚者人参白虎汤（方见前）合黄连解毒汤（方见前）主之。
痘疮贵三四次出，谓出匀。 疹贵一齐涌出，谓出尽。疹子只要得出便轻减。以火照之，遍身如涂朱之状，
此将出之兆。出形细密与痘疮密者相似，但疹子随出随没，非若痘子之以渐长大也。出形鲜红与伤寒发斑相似，
但疹子粒粒成疮，非若斑子皮红成片如蚊蚤之迹也。
痘疹之色不可同论。大抵痘子怕太红，皮嫩易破，必生瘙痒；疹子喜通红，疹发于心，红者火之正色也。
若疹色淡白者，心血不足，养血化斑汤主之。色太红焰，或微紫者，血热也；或出太甚者，并宜大青汤主之。
黑者死证也。
养血化斑汤 治白疹。
当归身 生地黄 红花 蝉蜕 人参（各等分）
共锉细，水一盏，姜一片，煎六分，去渣，温服无时。
大青汤 治斑疹火毒良方。
大青 生地黄 玄参 石膏 知母 甘草 木通 地骨皮 荆芥穗（各等分）
共锉细，水一盏，淡竹叶十二片，煎七分，去滓，温服，不拘时。
疹子出没常以六时为准。假如子后出，午时即收；午时出者，子时即收。乃阳生阴成，阴生阳成，造化自
然之数也。凡此旋出旋收者轻。若一出连绵三四日不收者，乃阳毒太甚，宜大青汤（方见前）解之。逡巡不出者，
乃风寒外束，皮肤闭密也，宜荆防败毒散（方见前）主之。
疮疹非热不出。疹子欲出，则遍身发热，或烦躁，或头眩，或身拘急。及既出，则身便凉，诸病悉解，此一
层疹子随收矣。如疹子即出，热甚不减，此毒壅遏，宜大青汤（方见前）解其表。便涩者，以黄连解毒汤（方见前）
合人参白虎汤（方见前），或大连翘汤解其里。大便不通者，河间凉膈散（方见前）加牛蒡子。
大连翘汤 此解里热之良方，痘疹通用。
连翘 防风 瞿麦 荆芥穗 车前子 当归 柴胡 蝉蜕 赤芍药 白滑石 木通 黄芩 甘草 山栀子（各五
分）
上锉细，加紫草五分，水一盏半，煎至一盏，去渣，食前温服。（《博爱心鉴》有牛蒡子，名大连翘饮。）
凡疹子只要出得尽，则毒邪解散，正气和平。如拂拂发热，
烦闷不宁，如蛇在灰，如蚓在尘之状，或呕吐，或注泄，此毒邪壅遏，尚未出尽。烦热者，宜黄连解毒汤（方见
前）；呕泄者，柴胡橘皮汤。并外用胡荽酒（方见前），以苎麻蘸酒遍身戛之。待疹子出尽，则烦热自去，呕
泄自止矣。
柴胡橘皮汤
柴胡 橘皮 黄芩 半夏 人参 白茯苓（各等分）
上锉细，加竹茹一团，生姜一片，水一盏，煎七分，去滓，温服无时。
According to *Baoying Ji* (Collection for Protecting Infants): During the eruption of rashes, if the "five fluids" (sweat, nasal discharge, tears, saliva, and stool) are all sufficient, the meridians will be unobstructed, and no pathogenic factors will remain. If the five fluids are insufficient, corresponding residual pathogens will exist. Insufficient sweating leads to fever; scanty nasal discharge results in Bi Yuan (nasal sinusitis); scanty tears lead to Zhu Guan (corneal opacity); scanty vomiting results in Ya Gan (necrotizing gingivostomatitis); and scanty diarrhea leads to Chang Pi (dysentery or intestinal inflammation). These are all residual pathogens of the rash toxin, and treatment should be based on the specific syndrome.
According to *Qingnang Ji*: At the time of eruption, if the process is obstructed by wind pathogens, preventing complete release, one should administer decoctions that disperse pathogens from the muscle layer, and the rashes will naturally recede. If the rash color turns cyanotic or purple, this indicates internal attack by heat toxins. Heat toxin attacking the Spleen causes vomiting; attacking the Stomach causes anorexia; attacking the Liver causes tendon stiffness and generalized body pain; attacking the Heart causes black tongue and face, coma, and delirium; attacking the Lungs causes panting and shortness of breath, head shaking, and hand jerking, and in severe cases, nasal congestion, dry tongue, scorched lips, and unconsciousness. These are all ominous signs. However, if there is body heat, scanty dark urine, but clear consciousness, no chest distension, and no abdominal bloating, there may still be hope for cure.
*Baoying Ji* states: Poison affecting the Lungs causes chest fullness, obstruction, and rapid breathing; poison affecting the Spleen causes vomiting and fatigue; poison affecting the Stomach causes epigastric fullness and inability to eat; poison affecting the Liver causes eyes closed and unable to open; poison affecting the Heart causes unclear speech; and poison affecting the Kidneys causes black sinking of the rash, which is incurable.
Ye Lin's commentary: The treatments in *Zhen Quan Shu* (Complete Book of Rashes) and the theories of Li Doushan et al. are not entirely pure, but their differentiation of syndromes is meticulous, uncovering issues previously unaddressed. Students should study them carefully.
*Shengji Zonglu* (General Records of Sage Medicine) states: For pediatric sores and rashes, once the syndrome is accurately identified, the organs and bowels should be rapidly purged and unblocked, but this must be done with detailed caution. If the stool has already been purged and the sores have erupted, neither purgatives nor diaphoretics should be used. Using diaphoresis would cause the pores to open excessively, making the rash more mottled. Cang Gong and Bian Que often used oil-based and herbal preparations, a method considered most excellent. Generally, the use of decoctions serves to penetrate the muscle layer and harmonize the interior, opening both inside and outside, allowing the rash toxin to flow freely without stagnation, thereby removing the evil toxin and achieving recovery. However, the treatment for sores and rashes differs between nursing infants and older children. For infants, it is best to regulate the mother, ensuring her Qi and Blood are clear and harmonious, and her milk flows smoothly, which is the most crucial method. For weaned children, decoctions should be used to harmonize Yin and Yang and regulate Ying and Wei (Nutritive and Defensive Qi). After recovery, it is especially important to promote bowel movement to remove residual toxins. This is the general principle for treating sores and rashes.
**Zicao Tang (Lithospermum Decoction)**
Treats weaned children and older children suffering from rashes and smallpox. Initially, symptoms resemble Taiyang disease (exogenous febrile disease), with redness of the face and limbs, high fever, headache, back and spine pain, cold feet, yellow-red eyes, floating and surging pulse with irregular rate and size, scanty dark urine, and frequent constipation. As soon as the limbs, complexion, and pulse indicate rash/smallpox before the toxin has penetrated the skin and hair follicles, this medicine can be taken to harmonize the Zang-Fu organs and gently purge the toxin. According to Cang Gong's discussion: Oil preparations can be taken, but drying or cold medicines should be avoided. If the rash has already formed at the skin level and is slightly emerging, purgation should not be used. If the rash is too abundant with pus in the follicles, purgation may be appropriate. If purgation has not yet been administered, Zicao Tang should be taken urgently.
Zicao (Lithospermi Radix et Rhizoma) 2 liang, soaked in boiling water, covered to prevent steam loss. Infants aged 2 months to 100 days take half a "yao zhu zi" dose; children aged 5-7 months take one dose; 1-2 year olds take half a "he"; 3-4 year olds take one "he". Even if the rash has emerged, the condition is mild, and regular use is harmless.
**Shengyou Tang (Raw Sesame Oil Decoction)**
Treats latent heat in children's organs before rash formation, slight heat in limbs, reduced appetite, dry straight hair, and slight forehead heat.
Raw sesame oil 1 zhong, warmed to body temperature. Add 1 small zhong of hot water to the oil, stirring continuously until the water integrates into the oil like honey. At bedtime, 2-3 year olds take two clam shell measures; 5-7 year olds take three; over 10 years old take three large clam shells; adults take 3 he. Take after a meal, then lie down. After 3-5 doses, if urination and defecation become smooth and skin heat subsides, the rash/smallpox will not recur.
Ye Lin's commentary: Recent practices for treating Sha Zhen (scarlet fever-like rash) that fails to erupt fully with asthma involve using 5 he of sesame seeds soaked in boiling water, steaming the head and face while hot, causing the rash to re-emerge, claiming miraculous life-saving effects. This works because one aspect promotes downward drainage of toxin via the bowels, and the other promotes outward dispersion via the skin. Although methods differ, the principle is the same.
Wan Mizhai said: Smallpox and rashes are caused by fetal toxin, which is Fire. Large, swollen smallpox lesions are due to Shaoyang Sanjiao (Triple Burner) fire. Since the Yang pathway is usually abundant, they are large and swollen. Small, dense rashes are due to Shaoyin Heart fire. Since the Yin pathway is usually deficient, they are small and dense. The Sanjiao is the pathway for food and fluid; the Spleen and Stomach govern ingestion. Treating smallpox focuses primarily on the Spleen and Stomach. The Heart and Lungs belong to Yang and are located superiorly; excessive Heart fire affects the Lungs. Treating rashes focuses primarily on the Lungs. Coughing indicates fire flaring up causing lung tissue to dry and retract. Clear nasal discharge occurs because the nose is the orifice of the Lungs; fire melting metal causes fluid to flow. Tearing occurs because Lung heat transfers to the Liver, whose orifice is the eyes. Scratching eyebrows, eyes, lips, nose, and face indicates Lung heat.
The initial fever of sores and rashes resembles Taiyang disease, but rashes present with red cheeks, coughing, sneezing, clear nasal discharge, tearing, yawning, drowsiness, vomiting/diarrhea, or scratching facial features. Use Shengma Gegen Tang (Ephedra and Kudzu Decoction). Do not mistakenly use diaphoresis or purgation as for Taiyang disease. Diaphoresis increases heat, leading to epistaxis, hemoptysis, mouth ulcers, sore throat, red painful eyes, irritability, and urinary/fecal retention. Purgation empties the interior, leading to incontinence or dysentery. The Classics state: "First consider the annual Qi, do not violate Heavenly Harmony." This means do not recklessly use diaphoresis or purgation. Cold fingertips/toes, aversion to cold, no sweat, sallow/gloomy complexion, and blue lines on the left forehead indicate Taiyang heat; warm fingertips/toes, fever with sweat, bright red face indicate Wind-Strike heat; both should be treated with Xingxing San (Xingxing Powder). Swollen eyelids, blue veins on the right cheek, severe fever in head/forehead/abdomen, vomiting/abdominal pain indicate Food-Stagnation heat; treat with Beiji Wan (Emergency Pill) to purge. Blue-red complexion, central forehead line, sweaty palms, occasional fright, slight vessel pulsation with fever indicate Fright-Heat; treat with Xie Qing Wan (Drain Green Pill) and Niuhuang Qingxin Wan (Calves' Horn Clearing Heart Pill). Fever with increased appetite, red lips/cheeks, constipation, sweating under ribs indicates Wind-Heat; treat with Xuanfeng San (Dispel Wind Powder). If these heats persist, internal and external interactions allow the accumulated rash toxin to emerge.
**Shengma Gegen Tang (Ephedra and Kudzu Decoction)** An excellent formula for releasing smallpox/rashes.
Gegen (Puerariae Radix), Shengma (Cimicifugae Rhizoma), Gancao (Glycyrrhizae Radix), Baishao (Paeoniae Radix Alba) in equal parts.
Finely chopped, decocted in 1 sheng of water to 0.7 sheng, strain, take warm at any time.
**Xingxing San (Xingxing Powder)** An excellent formula for releasing smallpox/rashes.
Renshen (Ginseng Radix et Rhizoma), Jiegeng (Platycodonis Radix), Gancao (Glycyrrhizae Radix, prepared), Baifuling (Poria), Gualougen (Trichosanthis Radix), Baizhu (Atractylodis Macrocephalae Rhizoma) in equal parts; Xixin (Asari Radix et Rhizoma) a little.
Powdered, take 2 qian per dose with 1 sheng water and 5 mint leaves, decocted to 0.7 sheng, take warm anytime. (Another version includes Fangfeng and Chuanxiong.)
**Beiji Wan (Emergency Pill)**
Muxiang (Aucklandiae Radix) 2.5 qian, Dahuang (Rhei Radix et Rhizoma), Qianniu Mò (Pharbitidis Semen) 5 qian each.
Fine powder, pill with Shenqu paste, size of mung beans. Take 5-7 pills before meals with Schisandra decoction.
**Xie Qing Wan (Drain Green Pill)** Excellent for Liver-Heat convulsions.
Qianghuo (Notopterygii Rhizoma et Radix), Dahuang (Rhei Radix et Rhizoma, baked), Chuanxiong (Ligustici Chuanxiong Rhizoma), Danggui (Angelicae Sinensis Radix), Fangfeng (Saposhnikoviae Radix), Shanzhiren (Gardeniae Fructus), Longdancao (Gentianae Radix) in equal parts.
Powdered, honey-pilled, size of corn kernels. Take 0.5-1 pill dissolved in Bamboo Leaf soup with rock sugar.
**Niuhuang Qingxin Wan (Calves' Horn Clearing Heart Pill)** Treats Heart-Heat with coma.
Niuhuang (Calculus Bovis) 2.5 fen, Chen Sha (Cinnabaris) 1.5 qian, Huanglian (Coptidis Rhizoma, raw) 5 qian, Yujin (Curcumae Radix) 2 qian, Huangqin (Scutellariae Radix) 3 qian, Shanzhiren (Gardeniae Fructus) 3 qian.
Fine powder, pill with larch snow water and flour paste, size of millet grains. Take 7-8 pills with Nard root soup.
**Xuanfeng San (Dispel Wind Powder)** Treats black sinking with interior excess, replacing Baixiang Wan and Niuli Gao.
Binglang (Arecae Semen) 2 pieces, Chenpi (Citri Reticulatae Pericarpium) 5 qian, Gancao (Glycyrrhizae Radix) 5 qian, Qianniu (Pharbitidis Semen) 4 liang (half raw, half fried, take first flush 1 liang).
Powdered, 2-3 year olds take half qian with honey water, older children/adults take 1 qian before meals.
Rashes prefer coolness; smallpox prefers warmth, a fact known to all. However, early rash eruption requires warmth to facilitate emergence. Initially, complete eruption resolves the toxin. Unlike smallpox, which requires stages of budding, flowering, and fruiting before toxin resolution, rashes resolve once fully erupted. When smallpox matures, excessive heat causes ulceration; thus, late-stage smallpox also prefers coolness. Therefore, treating smallpox/rashes requires avoiding extreme heat or cold; moderate warmth and coolness harmonize Yin and Yang, which is correct.
Rashes only fear failure to erupt; complete eruption resolves toxin. During fever, observe seasonal climate. Severe cold: use Guizhi Gegen Tang (Cinnamon Twig and Kudzu Decoction); severe heat: use Shengma Gegen Tang combined with Renshen Baihu Tang (Ginseng White Tiger Decoction); neutral: use Jingfang Baidu San (Schizonepeta and Saposhnikovia Detoxifying Powder). With epidemic Qi: use Renshen Baidu San (Ginseng Detoxifying Powder). If one dose fails, repeat. Externally, use Huisu Jiu (Coriander Wine), dipping Ramie in wine to rub the body, urging eruption. If repeated attempts fail, accompanied by abdominal distension/pain, wheezing, coma, and delirium, death is certain.
**Guizhi Gegen Tang (Cinnamon Twig and Kudzu Decoction)**
Guizhi (Cinnamomi Ramulus), Gegen (Puerariae Radix), Shengma (Cimicifugae Rhizoma), Fangfeng (Saposhnikoviae Radix), Chishao (Paeoniae Radix Rubra), Gancao (Glycyrrhizae Radix) 1 qian each.
Chopped, add 3 ginger slices, 1 qian Dan Dou Chi (Fermented Soybean), 1 sheng water, decoct to 0.7 sheng, strain, take warm anytime.
**Renshen Baihu Tang (Ginseng White Tiger Decoction)**, also known as Huaban Tang, an excellent formula for macules/rashes.
Renshen (Ginseng Radix et Rhizoma) 1 qian, Zhimu (Anemarrhenae Rhizoma) 3 qian, Gancao (Glycyrrhizae Radix) 1 qian, Shigao (Gypsum Fibrosum) 5 qian, Nuomi (Oryza Sativa Glutinosa) 1 he.
Chopped, 2 sheng water, cook until rice is soft, strain, take warm anytime.
**Jingfang Baidu San (Schizonepeta and Saposhnikovia Detoxifying Powder)** A dispersing agent for rashes/smallpox.
Jingjie Sui (Schizonepetae Spica), Chaihu (Bupleuri Radix), Gancao (Glycyrrhizae Radix), Renshen (Ginseng Radix et Rhizoma), Jiegeng (Platycodonis Radix), Chuanxiong (Ligustici Chuanxiong Rhizoma), Qingfangfeng (Saposhnikoviae Radix), Fuling (Poria), Zhike (Aurantii Fructus Immaturus), Qianhu (Peucedani Radix), Qianghuo (Notopterygii Rhizoma et Radix), Duhuo (Angelicae Pubescentis Radix).
Chopped, add 5 mint leaves, 1 sheng water, decoct to 0.7 sheng, strain, take warm.
**Renshen Baidu San (Ginseng Detoxifying Powder)** Excellent for epidemics and releasing smallpox/rashes; also treats lower back pain, usable in all seasons.
Qianghuo (Notopterygii Rhizoma et Radix), Duhuo (Angelicae Pubescentis Radix), Qianhu (Peucedani Radix), Chaihu (Bupleuri Radix), Chuanxiong (Ligustici Chuanxiong Rhizoma), Zhike (Aurantii Fructus Immaturus), Fuling (Poria), Jiegeng (Platycodonis Radix), Renshen (Ginseng Radix et Rhizoma) in equal parts; Gancao (Glycyrrhizae Radix) half amount.
Chopped, add 3 ginger leaves, 1.5 sheng water, decoct to 1 sheng, strain, take warm anytime. (Another version adds mint.)
**Huisu Jiu (Coriander Wine)** Treats inverted/retracted rash.
Huisu (Coriandri Fructus) 4 liang chopped, good wine 2 sheng, boil briefly, add Huisu, cover and simmer to prevent steam loss. Cool, inhale/spray lightly from back to feet, avoiding head/face. Patient should constantly smell coriander.
After 6-7 days of fever, if rash is evident but not appearing, skin is thick and pores closed, or due to Wind-Cold invasion with prior vomiting/diarrhea (latent pathogen). Urgently use tonifying and releasing agents: Mahuang Tang (Ephedra Decoction) minus Xingren, adding Chantui (Cicadae Periostracum) and Shengma. Externally use Huisu Jiu and scrape with hemp. If constipated, toxin is severe internally; use Hejian Liangge San (He Jian's Cooling Palate Powder) plus Niubangzi (Arctii Fructus) to release. Failure to erupt again indicates death.
**Mahuang Tang (Ephedra Decoction)**
Mahuang (Ephedrae Herba), Xingren (Armeniacae Seminum Amarum), Gancao (Glycyrrhizae Radix) in equal parts; Shigao (Gypsum Fibrosum) double amount.
Chopped, add 1 qian winter tea leaf, 1 sheng water, decoct to 0.7 sheng, strain, take anytime. (Another version lacks Shigao, adds Sangbaipi.)
**Hejian Liangge San (He Jian's Cooling Palate Powder)** Treats exterior-interior heat in smallpox/rashes, pure Yang without Yin.
Dahuang (Rhei Radix et Rhizoma), Pu Xiao (Natrii Sulfas), Gancao (Glycyrrhizae Radix) 5 fen each; Lianqiao (Forsythiae Fructus) 1 fen; Zhizi (Gardeniae Fructus), Huangqin (Scutellariae Radix), Bohe (Menthae Haplocalycis Herba) 1.5 fen each; Danzhuye (Lophatheri Herba) 5 leaves.
Chopped, one dose. 1 sheng water, decoct to 0.8 sheng, strain, add 1 spoon honey, mix, take.
When rashes first fever without eruption, persistent coughing, upper body panting, facial/eyelid swelling, restlessness, this is internal toxin-fire steaming, lung tissue drying. Use Ganjie Tang (Licorice and Platycodon Decoction) combined with Renshen Baihu Tang minus Renshen, adding Niubangzi and Bohe.
**Ganjie Tang (Licorice and Platycodon Decoction)** Excellent for throat relief.
Gancao (Glycyrrhizae Radix) 2 qian, Jiegeng (Platycodonis Radix) 1 qian.
Chopped, 1 sheng water, decoct to 0.7 sheng, strain, take warm after meals.
If rash fever presents with spontaneous sweating or epistaxis, do not stop it; this is part of the dispersing process. Sweating disperses toxin; epistaxis resolves toxin. Avoid excess. Excessive sweating: Renshen Baihu Tang combined with Huanglian Jiedu Tang (Coptis Decoction for Resolving Toxin); excessive epistaxis: Xuanshen Dihuang Tang (Scrophularia and Rehmannia Decoction).
**Huanglian Jiedu Tang (Coptis Decoction for Resolving Toxin)** General formula for Fire-Toxin smallpox/rashes.
Huanglian (Coptidis Rhizoma), Huangqin (Scutellariae Radix), Huangbai (Phellodendri Cortex), Zhizi (Gardeniae Fructus) in equal parts.
Chopped, 1.5 sheng water, decoct to 1 sheng, strain, take hot.
**Xuanshen Dihuang Tang (Scrophularia and Rehmannia Decoction)** Treats epistaxis in smallpox/rashes.
Xuanshen (Scrophulariae Radix), Sheng Dihuang (Rehmanniae Radix Recens), Mudanpi (Moutan Cortex), Zhiziren (Gardeniae Fructus) 1.5 qian each; Gancao (Glycyrrhizae Radix), Shengma (Cimicifugae Rhizoma) 5 fen each; Baishao (Paeoniae Radix Alba) 1 qian.
Chopped, add 0.5 qian fried Puhuang (Typhae Pollen), 1 sheng water, decoct to 0.7 sheng, strain, take warm.
Rash fever with vomiting/diarrhea is purely Heat, not Cold; it is Fire pathogen forcing inward. Upper Jiao: mostly vomiting; Lower Jiao: mostly diarrhea; Middle Jiao: both. Spontaneous diarrhea: Huangqi Tang (Scutellaria Decoction). Vomiting/Diarrhea: Huangqi Jia Banxia Tang (Scutellaria plus Pinellia Decoction). Diarrhea with tenesmus: Huanglian Jiedu Tang combined with Tianshui San (Heaven and Earth Powder).
**Huangqi Tang (Scutellaria Decoction)** Treats協热利 (diarrhea with accompanying heat).
Huangqin (Scutellariae Radix) 1.5 qian, Gancao (Glycyrrhizae Radix, prepared) 1 qian, Baishao (Paeoniae Radix Alba) 6 qian.
Chopped, add 2 dates, 1 sheng water, decoct to 0.7 sheng, take warm before meals.
**Huangqi Jia Banxia Tang (Scutellaria plus Pinellia Decoction)**
Previous Huangqi Tang plus Banxia (Pinelliae Rhizoma) 2 qian, Shengjiang (Zingiberis Rhizoma Recens) 1 qian.
**Tianshui San (Heaven and Earth Powder)** Treats dry, painful smallpox.
Bai Huashi (Talcum) 4 liang, Gancao (Glycyrrhizae Radix) 1 liang.
Fine powder, take with plain water. Or apply externally with honey water.
Sore throat in smallpox/rashes is common, caused by toxin-fire flaring upward; do not confuse with Hou Bi (throat bi-syndrome) requiring needle drainage of blood stasis. Smallpox/rash throat pain is dry/painful; use Ganjie Tang plus Niubangzi, or Shegan Niubangzi Tang (Belamcanda and Arctii Decoction), sip slowly.
**Shegan Niubangzi Tang (Belamcanda and Arctii Decoction)** Treats sore throat.
Shegan (Belamcandae Rhizoma) 1 liang, Niubangzi (Arctii Fructus, fried fragrant) 4 liang, Gancao (Glycyrrhizae Radix), Shengma (Cimicifugae Rhizoma) 1 liang each.
Chopped, take 2 qian with 1 sheng water, decocted.
Thirst and desire for water in rashes is purely Fire pathogen, drying Lungs/Stomach, hyperactive Heart Fire. Initial fever/thirst: Shengma Gegen Tang plus Tianhuafen (Trichosanthis Radix) and Maidong (Ophiopogonis Radix). Severe thirst: Renshen Baihu Tang combined with Huanglian Jiedu Tang.
Smallpox benefits from multiple eruptions (even distribution); rashes benefit from simultaneous eruption (completeness). Lighter if fully erupted. Illuminated, rash looks like cinnabar coating—sign of impending eruption. Fine density resembles smallpox, but rashes appear and disappear quickly, unlike smallpox which grows gradually. Bright red resembles exanthema in Taiyang disease, but rashes form individual pustules, unlike macules which are flat red patches like flea bites.
Colors differ. Smallpox fears excessive redness (thin skin, easy rupture, itching); rashes prefer thorough redness (Heart-origin, red is true Fire color). Pale white rash: Heart-Blood deficiency, use Yangxue Huaban Tang (Nourish Blood Resolve Macule Decoction). Too red/flaming or slightly purple: Blood Heat; excessive eruption: Daqing Tang (Isatis Decoction). Black: death sign.
**Yangxue Huaban Tang (Nourish Blood Resolve Macule Decoction)** Treats white rash.
Danggui Shen (Angelicae Sinensis Radix), Sheng Dihuang (Rehmanniae Radix Recens), Honghua (Carthami Flos), Chantui (Cicadae Periostracum), Renshen (Ginseng Radix et Rhizoma) in equal parts.
Chopped, 1 sheng water, 1 ginger slice, decoct to 0.6 sheng, strain, take warm anytime.
**Daqing Tang (Isatis Decoction)** Excellent for rash/smallpox Fire-Toxin.
Daqing (Isatidis Folium), Sheng Dihuang (Rehmanniae Radix Recens), Xuanshen (Scrophulariae Radix), Shigao (Gypsum Fibrosum), Zhimu (Anemarrhenae Rhizoma), Gancao (Glycyrrhizae Radix), Mutong (Akebiae Caulis), Digupi (Lycii Cortex), Jingjie Sui (Schizonepetae Spica) in equal parts.
Chopped, 1 sheng water, 12 Danzhuye, decoct to 0.7 sheng, strain, take warm anytime.
Rash emergence/disappearance follows a 6-hour cycle. Erupting after Zi hour (11pm-1pm) resolves at Wu hour (11am-1pm); erupting at Wu resolves at Zi. This is natural generation of Yin/Yang. Rapid emergence/resolution is mild. Continuous eruption for 3-4 days without resolution: excessive Yang-Toxin, use Daqing Tang. Delayed eruption: Wind-Cold constriction, closed skin, use Jingfang Baidu San.
Sores/rashes require heat to erupt. Pre-eruption: generalized fever, irritability, dizziness, stiffness. Post-eruption: body cools, symptoms resolve, rash recedes. If fever persists after eruption: toxin stagnation, use Daqing Tang to resolve exterior. Scanty urination: Huanglian Jiedu Tang combined with Renshen Baihu Tang, or Dalianqiao Tang to resolve interior. Constipation: Hejian Liangge San plus Niubangzi.
**Dalianqiao Tang (Large Forsythia Decoction)** Excellent for resolving interior heat, universal for smallpox/rashes.
Lianqiao (Forsythiae Fructus), Fangfeng (Saposhnikoviae Radix), Qumai (Dianthi Herba), Jingjie Sui (Schizonepetae Spica), Cheqianzi (Plantaginis Semen), Danggui (Angelicae Sinensis Radix), Chaihu (Bupleuri Radix), Chantui (Cicadae Periostracum), Chishao (Paeoniae Radix Rubra), Bai Huashi (Talcum), Mutong (Akebiae Caulis), Huangqin (Scutellariae Radix), Gancao (Glycyrrhizae Radix), Shanzhizi (Gardeniae Fructus) 5 fen each.
Chopped, add 5 fen Zicao (Lithospermi Radix et Rhizoma), 1.5 sheng water, decoct to 1 sheng, strain, take warm before meals. (*Boxin Jian* adds Niubangzi, named Dalianqiao Yin).
If rashes erupt fully, toxin dissipates, Zheng Qi harmonizes. If slight fever, irritability, restlessness (like snake in ash, worm in dust), vomiting, or diarrhea, toxin is stagnant, not fully erupted. Irritation/heat: Huanglian Jiedu Tang; vomiting/diarrhea: Chaihu Jupi Tang (Bupleurum and Tangerine Peel Decoction). Externally use Huisu Jiu, rubbing body with Ramie dipped in wine. Once fully erupted, irritation/vomiting/diarrhea cease.
**Chaihu Jupi Tang (Bupleurum and Tangerine Peel Decoction)**
Chaihu (Bupleuri Radix), Jupi (Citri Reticulatae Pericarpium), Huangqin (Scutellariae Radix), Banxia (Pinelliae Rhizoma), Renshen (Ginseng Radix et Rhizoma), Baifuling (Poria) in equal parts.
Chopped, add bamboo shaving and 1 ginger slice, 1 sheng water, decoct to 0.7 sheng, strain, take warm anytime.