疹属阳毒，感之则暴悍酷烈，为害匪细，变态顷刻。所以发热时，最宜解表散邪，必令发出
透彻，乃无余毒蕴热之患。或表发不透，或风寒阻塞，或误饮食，或犯禁忌，疹虽收而余证作者
多矣。疹后自宜热退，若拂热犹在，随证详审。如呕吐，仍用前方。便秘加制大黄。若胸高如圭
，肩耸而喘，口鼻出血，面红或青枯黯，皆为恶候。然亦有肺虚，为毒所遏而发喘，连声不已，
用止嗽清肺方参酌。如日夜烦躁，谵语狂乱，主方调六一散（方见暑门）加辰砂灯心汤下。小
便赤短，五苓散（方见便癃）加芩连煎调辰砂服。
烦躁谵语，升麻葛根汤、辰砂六一散服。随所见证，以后方酌用。
止嗽清肺∶知母 贝母 天门冬 麦冬 桔梗 软石膏 杏仁 马兜铃（等分） 糯米百粒
，水煎服。热加连翘。
气热鼻燥，毛焦咳嗽∶麦门冬 桔梗（各二钱） 知母（一钱） 荆芥（取穗一钱） 天粉
石菖蒲（一寸，九节者） 诃子肉（各四分） 水煎服。
余毒不尽加防风、牛蒡、甘草。
热乘肺金，声哑咳喘∶当归（酒洗） 白芍（酒炒） 生地黄（酒洗） 陈皮 贝母 栝蒌
仁白茯苓 片黄芩（酒炒） 栀子（炒） 天门冬 玄参 麦门冬 桑皮 杏仁 热加黄连、
石膏、苏梗、甘草。水煎服。
嗽不止∶陈皮 半夏 茯苓 黄连（姜炒） 甘草 竹茹水煎服。
泻不止∶猪苓 泽泻 滑石 赤芍 黄连（姜炒） 升麻 甘草 水煎服。未止，加止泻药。
痢不止∶黄芩 芍药（各一钱半） 黄连 枳壳 当归 木通 生地（各七分）
不通加酒大黄。后重，木香，另磨槟榔。水煎。
汗不止∶黄 黄连 黄柏 黄芩 生地 熟地黄 酸枣仁 当归 加浮小麦一撮，水煎服。
鼻衄出血∶玄参 丹皮 生地 茅花（无，用根汁） 片黄芩 栀子 石膏（等分） 甘草
（减半） 水煎，调百草霜服。
咽喉肿痛∶黄连（二钱） 黄芩（二钱） 黄柏（一钱五分） 苦参（一钱） 玄胡索 乳
香（各三分） 雄黄 孩儿茶（各五分）上各为细末，研匀，芦管吹入喉中。
心神恍惚，夜卧不安∶黄连（二钱） 当归 生地 远志（甘草煮，剥） 茯神 人参 酸
枣仁（炒） 丹参 柏子仁 石菖蒲 麦冬 甘草（炙。各一钱） 上为末，入金箔三张，山药
糊丸，朱砂为衣，每服一钱，灯心竹叶汤送下。
疹后痈毒，肢节肿痛∶羌活 穿山甲（炒，研末。各一两） 金银花 白芷梢 大黄（各五钱）
甘草节（一钱） 乳香（制研，二钱） 上为末，每服一钱。用牙皂角刺同煎，酒调下，发汗出
为度。
咽喉肿痛，不能饮食∶甘草 桔梗（各二钱） 玄参（一钱） 连翘 牛蒡子 射干 山豆根
（各五分） 上水煎服。
（前吹叶入薄荷、甘草、桔梗、玄参、山根末，蜜丸噙化，效。）
走马牙疳，龈肉黑烂∶人中白 芦荟 使君子肉 龙胆草 胡黄连 五灵脂（等分） 上
为末，蒸饼，糊丸黍米大，每服一钱，临睡白汤下。
敷方 （牙疳黑烂） 雄黄（水飞，一钱） 黄柏（研末，二钱） 麝香（五厘） 上研
匀，先用艾煎汤洗净，次敷药。
又方 五倍子（研末，二钱） 雄黄（水飞，五钱） 枯矾（八分） 蚕蜕纸（烧灰，一钱
）上研匀，先温米泔、乱发洗净，敷药。（痘前后牙疳急，宜敷。服。有传于两颊浮肿，穿溃
死者）
疹后水蓄证，因渴时多饮所致。水停于胃为呕哕，入脾为肿胀，宜利水实脾，猪苓、泽泻、
茯苓、白术。入肺为喘咳，加葶苈。入心惊悸，宜赤苓、木通。入肝胁痛，加芫花。入肾、膀胱
，小便不利，车前子。疹后昼夜发热，毛发焦枯，皮肤干槁，肌肉羸瘦，清热丸（方见牙疳门
主方。）如忽然心腹绞痛汗出，乃元气亏损，失于补养，外虽似安，内虚未实，偶中恶气，多致
不救。及睡中露睛，手足厥冷，欲作慢脾风，不救之证。
热甚失血∶犀角地黄汤（方见血门）加三黄、栀子、茵陈、木通，小便泄火。
疹时食鸡、鱼，终身皮肤粟起，天行疹时重出。食猪肉，每岁出疹之月下痢。食盐醋，每岁
月咳嗽。食五辛，则生惊、热不时，必四十九日或百日无忌。
（贺千秋传）痘痒或痛∶桦皮、乳香、茵陈和匀，烧熏及熏被盖，立止。
痘泻，三日前毒火发，药重加黄连，愈。三日无功，痘疹后余毒泻，干柯根（即刀茅，）
煎汁服安。
痘喘，白花地丁煎服，愈。火痘毒盛，捣绞汁和白酒浆少许服，效。
稀痘神方∶金银花为末，砂糖调，经年服。或再花连藤煎汤作饮。
痧疹喘急闷乱∶西河柳研末（四钱，）水调服愈（发疹药中重加，大效。疹后痢，砂糖调柳
服。）
〔补遗〕惺惺散 小儿变蒸发热，痰嗽，风寒时疫，痘疹大行，气不和。
人参 白术 茯苓 芍药 桔梗 天粉 细辛 甘草（等分） 为末二钱，生姜、薄荷煎
。热，柴胡。随证加。
Rash (Zhen) belongs to Yang Toxicity. Upon infection, the condition is violent and fierce, causing significant harm with rapid transformations. Therefore, during the fever stage, it is most appropriate to resolve the exterior and disperse pathogens, ensuring the rash erupts thoroughly to avoid complications from residual toxicity and accumulated heat. If the exterior is not adequately released, or if blocked by wind-cold, or due to dietary errors or violation of taboos, even after the rash subsides, many residual symptoms may arise. After the rash, body temperature should naturally return to normal; if residual heat persists, careful differentiation based on specific symptoms is required. For vomiting, use the previous formula; for constipation, add prepared Rhizoma et Radix Pinelliae (Zhida Huang). Symptoms such as a chest protruding like a 'gui' shape, shoulder shrugging with panting, bleeding from mouth and nose, or a red or cyanotic/dark/withered complexion are all ominous signs. However, some cases involve lung deficiency where toxicity obstructs the airways causing continuous wheezing; in such cases, refer to the Zhisou Qingfei Fang (Stop Coughing and Clear Lung Formula). For day-and-night restlessness, delirium, and mania, the main formula is Tiao Liuyi San (Regulate Six-One Powder) (see Summer Heat section), taken with Chen Sha Dengxin Tang (Cinnabar and Juncus Decoction). For dark and scanty urine, use Wuling San (Five-Ingredient Powder with Poria) (see Urinary Obstruction section) added with Radix Scutellariae (Huangqin) and Radix Coptidis (Huanglian), decocted and mixed with Cinnabar.
For restlessness and delirium, take Shengma Gegen Tang (Cimicifugae and Puerariae Root Decoction) or Chen Sha Liuyi San. Use subsequent formulas according to observed symptoms.
**Zhisou Qingfei Fang (Stop Coughing and Clear Lung Formula):** Radix Anemarrhenae (Zhimu), Fritillariae Bulbus (Beimu), Asparagi Radix (Tianmendong), Ophiopogonis Radix (Maidong), Platycodonis Radix (Jiegeng), Gypsum Fibrosum (Ruanshigao), Armeniacae Semen Amarum (Xingren), Aristolochiae Fructus (Madouling) (equal parts), plus 100 grains of glutinous rice. Decoct in water and take. Add Forsythiae Fructus (Lianqiao) if heat is severe.
**For Qi-heat, dry nose, withered hair, and cough:** Ophiopogonis Radix (Maimendong), Platycodonis Radix (Jiegeng) (each 2 qian), Radix Anemarrhenae (Zhimu) (1 qian), Schizonepetae Herba (Jingjie) taking only the spikes (1 qian), Tianfen Shi Changpu (Acorus Tatarinowii, 1 cun, preferably nine-jointed), Pericarpium Arecae Preparatum (Hezi Rou) (each 4 fen). Decoct in water and take.
**For incomplete clearance of residual toxicity:** Add Saposhnikoviae Radix (Fangfeng), Arctii Fructus (Niubang), and Glycyrrhizae Radix et Rhizoma (Gancao).
**When Heat attacks Metal (Lung), causing hoarseness, cough, and asthma:** Radix Angelicae Sinensis (Danggui) washed in wine, Radix Paeoniae Alba (Baishao) fried in wine, Rehmanniae Radix (Shengdihuang) washed in wine, Citri Reticulatae Pericarpium (Chenpi), Fritillariae Bulbus (Beimu), Trichosanthis Semen (Gualou Ren), Poria (Fuling), Radix Scutellariae (Pian Huangqin) fried in wine, Gardeniae Fructus (Zhizi) stir-fried, Asparagi Radix (Tianmendong), Scrophulariae Radix (Xuanshen), Ophiopogonis Radix (Maidong), Cortex Mori Radicis (Sangpi), Armeniacae Semen Amarum (Xingren). If heat is severe, add Radix Coptidis (Huanglian), Gypsum Fibrosum (Shigao), Perilla Caulis (Sugeng), and Glycyrrhizae Radix et Rhizoma (Gancao). Decoct in water and take.
**For persistent cough:** Citri Reticulatae Pericarpium (Chenpi), Pinelliae Rhizoma (Banxia), Poria (Fuling), Radix Coptidis (Huanglian) stir-fried with ginger, Glycyrrhizae Radix et Rhizoma (Gancao), Bamboo Shavings (Zhuru). Decoct in water and take.
**For persistent diarrhea:** Polyporus (Zhuling), Alismatis Rhizoma (Zexie), Talcum (Huashi), Radix Paeoniae Rubra (Chishao), Radix Coptidis (Huanglian) stir-fried with ginger, Cimicifugae Rhizoma (Shengma), Glycyrrhizae Radix et Rhizoma (Gancao). Decoct in water and take. If ineffective, add anti-diarrheal herbs.
**For persistent dysentery:** Radix Scutellariae (Huangqin), Radix Paeoniae (Shaoyao) (each 1.5 qian), Radix Coptidis (Huanglian), Aurantii Fructus Immaturus (Zhike), Radix Angelicae Sinensis (Danggui), Akebiae Caulis (Mutong), Rehmanniae Radix (Shengdi) (each 0.7 qian). If obstruction exists, add Rhizoma et Radix Pinelliae (Jiu Dahuang). For tenesmus, add Aucklandiae Radix (Muxiang), and separately grind Arecae Semen (Binglang). Decoct in water and take.
**For persistent sweating:** Astragali Radix (Huangqi), Radix Coptidis (Huanglian), Phellodendri Cortex (Huangbai), Radix Scutellariae (Huangqin), Rehmanniae Radix (Shengdi), Rehmanniae Radix Preparata (Shudihuang), Ziziphi Spinosae Semen (Suanzaoren), Radix Angelicae Sinensis (Danggui). Add a pinch of Tritici Fructus (Fuxiaomai). Decoct in water and take.
**For epistaxis (Nosebleed):** Scrophulariae Radix (Xuanshen), Moutan Cortex (Danpi), Rehmanniae Radix (Shengdi), Spike of Imperatae Rhizoma (Maohua - if unavailable, use root juice), Radix Scutellariae (Pian Huangqin), Gardeniae Fructus (Zhizi), Gypsum Fibrosum (Shigao) (equal parts), Glycyrrhizae Radix et Rhizoma (Gancao) (half dose). Decoct in water, mix with Bai Cao Shuang (soot from burning hundred herbs), and take.
**For sore throat and swelling:** Radix Coptidis (Huanglian) (2 qian), Radix Scutellariae (Huangqin) (2 qian), Phellodendri Cortex (Huangbai) (1.5 qian), Sophorae Flavescentis Radix (Kushen) (1 qian), Corydalis Rhizoma (Yanhusuo), Resina Draconis (Ruxiang) (each 3 fen), Realgar (Xionghuang), Child's Tea (Haiercha) (each 5 fen). Grind all into fine powder, mix well, and insufflate into the throat using a reed tube.
**For mental confusion and restless sleep at night:** Radix Coptidis (Huanglian) (2 qian), Radix Angelicae Sinensis (Danggui), Rehmanniae Radix (Shengdi), Polygalae Radix (Yuanzhi) boiled in licorice water and peeled, Spirit of Poria (Fushen), Ginseng Radix (Renshen), Ziziphi Spinosae Semen (Suanzaoren) stir-fried, Salviae Miltiorrhizae Radix (Danshen), Biota Seed (Baiziren), Acori Tatarinowii Rhizoma (Shichangpu), Ophiopogonis Radix (Maidong), Glycyrrhizae Radix et Rhizoma (Gancao) roasted (each 1 qian). Grind into powder, add three sheets of Gold Leaf, form pills with Yam paste, coat with Cinnabar. Take 1 qian per dose, delivered with Dengxin Zhuye Tang (Juncus and Bamboo Leaf Decoction).
**For post-rash carbuncles/toxicity and limb/joint swelling:** Notopterygii Rhizoma et Radix (Qianghuo), Manis Squama (Chuanshanjia) stir-fried and powdered (each 1 liang), Lonicerae Japonicae Flos (Jinyinhua), Peucedani Radix (Baizhi Shao), Rhizoma et Radix Pinelliae (Dahuang) (each 5 qian), Glycyrrhizae Radix et Rhizoma (Ganjie) (1 qian), Resina Draconis (Ruxiang) processed and powdered (2 qian). Grind into powder, take 1 qian per dose. Decoct with Gleditsiae Sinensis Spina (Yazaojiaoci), mix with wine, and take until sweating occurs.
**For sore throat unable to eat:** Glycyrrhizae Radix et Rhizoma (Gancao), Platycodonis Radix (Jiegeng) (each 2 qian), Scrophulariae Radix (Xuanshen) (1 qian), Forsythiae Fructus (Lianqiao), Arctii Fructus (Niubangzi), Belamcandae Rhizoma (Shegan), Sophorae Radix (Shandougen) (each 5 fen). Decoct in water and take.
(Note: The insufflation formula mentioned earlier can be enhanced by adding Menthae Haplocalycis Herba (Bohe), Glycyrrhizae Radix et Rhizoma (Gancao), Platycodonis Radix (Jiegeng), Scrophulariae Radix (Xuanshen), and Sophorae Radix (Shandougen) powder, formed into honey pills for sucking.)
**For Gangrenous Stomatitis (Zouma Yagan) with black/rotten gums:** Human Calcined Bone (Renzhongbai), Aloe (Luhui), Quisqualis Fructus (Shijunzi), Gentianae Radix et Rhizoma (Longdancao), Coptidis Rhizoma (Huhuanglian), Trogopterori Faeces (Wulingzhi) (equal parts). Grind into powder, make pills with steamed wheat cake paste, size of millet seeds. Take 1 qian per dose before bed with warm water.
**External Application Formula (for Gangrenous Stomatitis):** Realgar (water-ground, 1 qian), Phellodendri Cortex (powdered, 2 qian), Moschus (Muxiang) (5 li). Grind uniformly. First wash the area with Mugwort decoction, then apply the medicine.
**Another Formula:** Myrobalan (powdered, 2 qian), Realgar (water-ground, 5 qian), Alum (Kufan) (8 fen), Silkworm Molting Paper (burnt to ash, 1 qian). Grind uniformly. Wash the area first with warm rice water and human hair, then apply. (For acute gangrenous stomatitis before/after chickenpox/smallpox. Apply externally. Note: If untreated, it may spread to cheek swelling and perforation leading to death.)
**Post-Rash Water Retention Syndrome:** Caused by excessive drinking when thirsty. Water stagnating in the Stomach causes vomiting/hiccups; entering the Spleen causes swelling. Treat by promoting urination and strengthening the Spleen using Polyporus (Zhuling), Alismatis Rhizoma (Zexie), Poria (Fuling), and Atractylodis Macrocephalae Rhizoma (Baizhu). Water entering the Lung causes asthma/cough; add Descurainiae Semen (Tingli). Water entering the Heart causes palpitations; use Red Poria (Chiling) and Akebiae Caulis (Mutong). Water entering the Liver causes hypochondriac pain; add Genkwa Flos (Yuanhua). Water entering the Kidney/Bladder causes difficult urination; use Plantaginis Semen (Cheqianzi).
If after the rash there is day-and-night fever, withered hair, dry skin, and emaciation, use Qingre Wan (Clear Heat Pill) (see Gangrenous Stomatitis section). If sudden colic with sweating occurs, this indicates Yuan Qi (Original Qi) depletion and lack of nourishment. Although the exterior seems calm, internal deficiency remains; accidental exposure to evil qi often leads to untreatable conditions. Also, sleeping with eyes half-open, cold extremities, and signs of Man Pi Feng (Slow Spleen Wind) are signs of untreatable conditions.
**Heat excess causing hemorrhage:** Xijiao Dihuang Tang (Rhinoceros Horn and Rehmannia Decoction) (see Blood section) added with San Huang (Three Yellows), Gardeniae Fructus (Zhizi), Artemisiae Scopariae Herba (Yinchen), and Akebiae Caulis (Mutong) to promote urination and drain fire.
Eating chicken or fish during the rash period causes lifelong skin eruptions resembling millet grains, or recurrence during epidemic rashes. Eating pork causes dysentery in the month corresponding to the annual rash occurrence. Eating salt and vinegar causes coughing in that month annually. Eating Five Pungent Spices causes fright and irregular fever; abstinence must be maintained for 49 or 100 days.
**(From He Qianqiu's transmission)** For itching or pain in smallpox: Birch bark, Resina Draconis (Ruxiang), and Artemisiae Scopariae Herba (Yinchén) mixed evenly, burned for fumigation and to smoke bedding, stops immediately.
For smallpox diarrhea: If within the first three days, toxic fire is erupting, use heavy doses of Radix Coptidis (Huanglian) to cure. If no effect after three days, it is diarrhea from residual toxicity after rash; decoct Gan Ke Gen (Dry Branch Root, i.e., Dao Mao grass root) and take the juice to settle.
For smallpox asthma: Decoct and take Baihua Di Ding (Hedyotis diffusa). For Fire Smallpox with intense toxicity, crush, extract juice, mix with a little white wine mash, and take; effective.
**Divine Formula for Mildening Rash:** Lonicerae Japonicae Flos (Jinyinhua) powdered, mixed with rock sugar, taken for years. Or boil Lonicerae Japonicae Flos with vines as tea.
**For Sha Rash with urgent asthma and distress:** Xihe Liu (Tamarix Ramulus) powdered (4 qian), mixed with water and taken to cure. (Add heavily to rash-inducing medicines for great effect. For post-rash dysentery, mix with rock sugar and take.)
[Supplement] **Xingxing San:** For pediatric transformation fever, phlegm-cough, wind-cold seasonal epidemics, widespread smallpox/rash, and disharmony of Qi.
Ginseng Radix (Renshen), Atractylodis Macrocephalae Rhizoma (Baizhu), Poria (Fuling), Radix Paeoniae (Shaoyao), Platycodonis Radix (Jiegeng), Trichosanthes Radix (Tianfen), Asari Radix et Rhizoma (Xixin), Glycyrrhizae Radix et Rhizoma (Gancao) (equal parts). Grind into powder, take 2 qian, decoct with Ginger and Mint. Add Bupleuri Radix (Chaihu) if heat is severe. Adjust according to symptoms.