治阳毒病。面赤斑斑如锦纹。咽喉痛。吐脓血。五日可治。七日不可治。此汤
升麻（二两。） 当归 甘草（各一两。） 蜀椒（炒去汗。一两。） 鳖甲（手指大一
片。炙。）
上六味。以水四升。煮取一升。顿服之。老小再服取汗。阴毒。去蜀椒、雄黄。
歌曰 （面）赤斑（纹）咽痛毒为阳。鳖甲周遭一指量。半两雄黄升二两。椒归一两草
同行。
元犀按。非常灾疠之气。从口鼻而入咽喉。故阴阳二毒皆咽痛也。阴阳二证。不以寒热
脏腑
之里者为阴。
治阴毒病。面目青。身痛如被杖。咽喉痛。五日可治。七日不可治
歌曰 身痛咽痛面皮青。阴毒苛邪隶在经。（阴毒以面不赤而青。身不斑纹而痛如被杖
别之
去特丁宁。（蜀椒。雄黄二物。阳毒用之者。以阳从阳。欲其速散也。阴毒去之者。恐阴邪
不可劫。而阴气反受损也。）
王晋三云。升麻入阳明太阳二经。升清逐秽。辟百邪。解百毒。统治温厉阴阳二病。如
阳毒为病面赤斑如锦纹。阴毒为病面青身如被杖咽喉痛。毋论阴阳二毒。皆已入营矣。但升
麻仅走二经气分。故必佐当归通络中之血。甘草解络中之毒。微加鳖甲守护营神。俾椒、黄
猛劣之品攻毒透表。不能乱其神明。
阴毒去椒、黄者。太阴主内。不能透表。恐反动厉毒也。肘后、千金方阳毒无鳖甲者。
不欲其守。亦恐留恋厉毒也。
Treat Yang Du disease. The face is red with mottled patterns like brocade. Sore throat. Vomiting of pus and blood. Treatable within five days; untreatable after seven days. This decoction consists of:
Shengma (Cimicifugae Rhizoma, 2 liang) Danggui (Angelicae Sinensis Radix) Gancao (Glycyrrhizae Radix et Rhizoma, each 1 liang) Shujiao (Zanthoxyli Pericarpium, stir-fried to remove moisture, 1 liang) Biejia (Testudinis Carapax et Plastrum, one piece the size of a finger, roasted).
The above six herbs are boiled in four sheng of water until one sheng remains. Take orally at once. For elderly and children, take another dose to induce sweating. For Yin Du, remove Shujiao and Xionghuang.
Song says: Red face with mottled patterns and sore throat indicate Yang Du. Biejia should be about the width of one finger around its edge. Half a liang of Xionghuang and two liang of Shengma; one liang each of Shujiao, Danggui, and Gancao move together.
Yu Xi notes: Extraordinary pestilential qi enters through the mouth and nose into the throat; therefore, both Yin and Yang Du present with sore throat. The Yin and Yang syndromes are not distinguished by cold/heat or zang-fu interior conditions.
Treat Yin Du disease. The face and eyes appear cyanotic. Body pain as if beaten with a club. Sore throat. Treatable within five days; untreatable after seven days.
Song says: Body pain, sore throat, and cyanotic skin indicate Yin Du; the harsh pathogen resides in the meridians. (Yin Du is distinguished from Yang Du by the absence of redness on the face but presence of cyanosis, and absence of mottled patterns on the body but presence of pain as if beaten.) Special emphasis is given here. (Shujiao and Xionghuang are used in Yang Du because yang pathogens require yang herbs for rapid dispersion. They are removed in Yin Du to avoid forcibly attacking yin pathogens, which might damage yin qi.)
Wang Jinsan states: Shengma enters the Yangming and Taiyang meridians, ascending clear qi and expelling turbidity, warding off various evils and resolving toxins. It governs both Yin and Yang aspects of warm pestilence diseases. For instance, Yang Du presents with a red face and brocade-like mottling; Yin Du presents with a cyanotic face, body pain as if beaten, and sore throat. Regardless of whether it is Yin or Yang Du, the pathogen has already entered the Ying level. However, since Shengma only traverses the Qi level of these two meridians, it must be assisted by Danggui to unblock blood in the collaterals, Gancao to resolve toxins in the collaterals, and a small amount of Biejia to protect Ying and Shen. This ensures that the potent and aggressive nature of Shujiao and Xionghuang, when attacking toxins and venting them to the exterior, does not disturb the Spirit.
Shujiao and Xionghuang are removed in Yin Du because the Taiyin governs the interior and cannot vent to the exterior; using them might inadvertently agitate the pestilential toxin. In *Zhouhou Beiji Fang* and *Qianjin Fang*, Biejia is absent in the treatment of Yang Du, likely to prevent stagnation and avoid retaining the pestilential toxin.