己巳春。长男甫六岁。次男甫三岁。于元旦次日。俱发热见疹。余初不知疹之根源。以为婴儿
生下时。口含恶血。开声咽下。其后发为疹毒。治疹自当攻发。即用清凉透发之剂服之。次朝略增
十余点。究不畅达。心甚惶惑。长男七月而生。先天怯薄。问其胸膈宽否何如。答曰、饥甚。又问口
味燥苦何如。答曰、淡甚。因知其虚。即投 、术、苓、甘、桂枝、红花、一二剂。次朝疹发遍身。热稍
退。而神情犹烦躁。夜发热、频咳嗽。至一月方安。盖因见点之初。过服表剂。虚其经脉故也。次男
尚幼。未省人事。不能致词。上冬患肺风痰喘证。诸药不效。服麻杏桂枝石膏汤一剂而痊。谓其
禀质略强。不与长男同。其疹不透。必寒凝毒甚。因与苏、麻、前、杏、黄芩、石膏药。红点不增。又
与紫苏、葱、姜、芫荽等熏之熨之。疹总不出。乃与同道诸公商之。俱云舍透发并无别法。至五日
而口吐蛔虫。儿医曰、此热极虫生。余有牛黄散可以服之。牛黄散。即大黄末也。一服。痰喘止而
神气稍平。自是此儿遂无言矣。计无可施。复针百会穴。开其 门。服西黄分许。及诸单方。观其
形证。实不能生。友人张卫生来望。因曰、此大虚大寒证也。今既无言。又不能食。恐无济矣。然
心犹不忍。勉投参附。含药而亡。因自叹曰、此庸医现身食报。天理当然。自身行医。何尤乎人。
因悔昔日所见之皆非。益信治病求本之不谬。次日。有同居甥汪姓者。伊芳子出 。已经三日。见
余际悲伤。不邀诊视。自用前、杏、麻黄、石膏药一二剂。疹出二十余点。不能再增。心胸烦闷。不得
已而告余。乞余诊视。余曰、若再攻发。即如吾子矣。急与 、术、芎、归、桂、苓、红花等。服一剂而
热退身安。余自此始悟疹之根源。凡治疹。但调其气血。和其经络。寒凉攻发。概置之不用。所以
屡治而屡效也。（朱曰 寒凉攻发而外。又有调气血和经络一法。金针度人。须当切记。）次年春。
友人吴题仙之子甫二岁。出 。延儿医马圣则兄延医之。攻发不透。神情恍惚。喘急不宁。又延余
诊视。余往吴宅。圣兄先至。余视之。知其虚也。因告主人曰、若但发 。 断不出。必至身命不
保。主人曰、为之奈何。余曰、惟有温补药一剂。益其脏腑。安其肠胃。助其气血。方可。圣兄曰、吾
治四朝。不能透发。悉听尊裁。余即与 、术、姜、桂、归、芍、苓、甘、银花、红花诸味。一剂而安。次
日仍用原方。加人参一钱。此后并不服药。连服独参汤数日。霍然矣。又有夏姓耀如之子出 。其
颜色紫黯。神气不宁。余曰、此证大凶。治须得法。连看二次。皆用温散药。次早。其家人来告曰、
口吐蛔虫。另有药否。余曰、昨药二剂。俱服否耶。曰、尚存一剂。因与附子八分。令入药内煎服。
自此遂无音耗。越三载。至其家。见其子长大。余因问曰、昔年出 吐蛔。何由得愈。其家答曰、
服先生之药后。因无力相延。仗天复庇。得以渐愈。余默叹曰、因死吾子。得生他人。治疹之法。可
无憾矣。余因附载斯册。虽不能见信于儿医。而正道阐明。实有裨于儿科治疹之根源。而为有子
出者所当致慎也夫。
In the spring of the Jisi year, my eldest son was just six years old, and my second son was just three. On the day after the New Year's Day, both children developed fever and rashes. Initially, I did not understand the root cause of rashes, believing that infants hold foul blood in their mouths at birth, which is swallowed when they cry, later transforming into rash toxins. Therefore, treating rashes should naturally involve attacking and venting them out. I immediately administered cooling and venting formulas. The next day, only a few more spots appeared, and they failed to emerge smoothly. I felt extremely anxious and confused.
The eldest son was born prematurely at seven months, with an innate weak constitution. I asked if his chest and diaphragm felt open; he replied that he was very hungry. I then asked if his mouth tasted dry or bitter; he replied that it was bland. From this, I determined it was a deficiency pattern. I immediately prescribed Atractylodis Rhizoma (Baizhu), Poria (Fuling), Glycyrrhizae Radix et Rhizoma (Gancao), Cinnamon Twig (Guizhi), and Safflower Honghua. After one or two doses, the rash spread over his entire body the next day, and the fever subsided slightly, but his spirit remained irritable. He had night fevers and frequent coughs, only stabilizing after a month. This was because excessive use of exterior-releasing agents during the initial appearance of the rash had depleted his meridians.
The second son was still too young to understand matters or speak. In the previous winter, he suffered from Lung Wind Phlegm-Wheezing Syndrome (Feifeng Tanxuan Zheng), for which various medicines were ineffective. However, one dose of Mahuang Xingguo Guizhi Shigao Tang (Ephedra, Apricot Kernel, Cinnamon Twig, and Gypsum Decoction) cured him. I said his constitutional quality was slightly stronger than his brother's. His rash failed to emerge, likely due to cold coagulation and severe toxin retention. Therefore, I gave him Perilla Leaf (Zisu), Ephedra Herba (Mahuang), Peucedani Radix (Qianhu), Apricot Kernel (Xingren), Scutellariae Radix (Huangqin), and Gypsum (Shigao). The red spots did not increase. I then fumigated and pressed him with Perilla Leaf, Scallion Stem (Congbai), Ginger (Shengjiang), and Coriander Herb (Yansui), but the rash still did not emerge. I consulted with fellow physicians, who all claimed there was no method other than venting. By the fifth day, the child vomited roundworms. The pediatric doctor said, "This is heat extreme generating worms." I had Niuhuang San (Calculus Bovis Powder), which is actually Rhubarb powder (Dahuang Mo). After one dose, the phlegm-wheezing stopped, and his spirit calmed slightly. From then on, the child became mute. With no further options, I acupunctured the Baihui GV20 point to open the orifices, administered a small amount of Moschus (Xi Huang), and tried various single-herb prescriptions. Observing his signs and symptoms, survival seemed impossible. My friend Zhang Weisheng came to visit and said, "This is a severe deficiency and cold pattern. Since he cannot speak or eat, it is unlikely to be helped. Yet, my heart cannot bear it. I reluctantly administered Renshen Fuzi Tang (Ginseng and Aconite Decoction). He died with the medicine in his mouth. I sighed, 'This is the retribution for quack doctors appearing in the world; it is natural justice. Since I practice medicine myself, how can I blame others?' Thus, I regretted my past errors and firmly believed that seeking the root in treatment is infallible.
The next day, a relative by marriage, surnamed Wang, whose son had been having rashes for three days, saw me grieving and did not invite me to consult. Instead, he self-administered Peucedani Radix, Apricot Kernel, Ephedra Herba, and Gypsum for one or two doses. Only twenty-plus spots emerged, unable to increase further. He felt chest irritability and distress, and finally told me, begging for my consultation. I said, "If you continue to attack and vent, it will be like my son." I urgently prescribed Atractylodis Rhizoma, Cyperi Rhizoma (Cangzhu), Chuanxiong Rhizoma (Chuanxiong), Angelicae Sinensis Radix (Danggui), Cinnamon Twig, Poria, and Safflower. After one dose, the fever subsided, and he became peaceful. From this, I began to realize the root cause of rashes. In treating rashes, one should only regulate Qi and Blood and harmonize the meridians, completely avoiding cooling and attacking methods. Hence, my treatments were repeatedly successful. (Zhu noted: Besides cooling and attacking, regulating Qi/Blood and harmonizing meridians is another method. This golden needle passed down must be remembered.)
In the spring of the following year, the son of my friend Wu Tixian, aged two, developed rashes. He was treated by a pediatric doctor, Ma Shengze. The venting was unsuccessful; the child showed absent-mindedness, panting, and restlessness. I was invited to consult. Upon arriving at Wu's house, Brother Ma had already seen the patient. After examining him, I knew it was a deficiency pattern. I told the host, "If we only try to vent the rash, it will definitely not emerge, and life will be endangered." The host asked, "What should we do?" I said, "Only one dose of warming and tonifying medicine can help its viscera, settle its intestines and stomach, and assist its Qi and Blood." Brother Ma said, "I have treated him for four days without success; I leave it entirely to your judgment." I immediately prescribed Atractylodis Rhizoma, Cyperi Rhizoma, Dried Ginger (Ganjiang), Cinnamon Twig, Angelicae Sinensis Radix, White Peony Root (Baishao), Poria, Glycyrrhizae Radix et Rhizoma, Lonicerae Japonicae Flos (Jinyinhua), and Safflower. After one dose, he stabilized. The next day, I used the same formula, adding Codonopsis Radix (Renshen) 1 qian. No further medication was needed; he recovered rapidly after taking Ginseng Monoparty Decoction (Dushen Tang) for several days.
Another case involved the son of Xia Yaoru, who developed rashes. His complexion was purplish-dark, and his spirit was restless. I said, "This is a highly ominous condition; treatment requires proper method." I examined him twice consecutively, using warming and dispersing medicines. The next morning, his family reported, "He vomited roundworms. Is there another medicine?" I asked, "Did he take both doses from yesterday?" They replied, "One dose remains." I then prescribed Aconiti Lateralis Radix Praeparata (Fuzi) 8 fen to be decocted with the remaining medicine. Thereafter, there was no news. Three years later, I visited his home and saw the boy grown up. I asked, "How did he recover from the vomiting of roundworms during the rash last year?" The family replied, "After taking your medicine, due to lack of funds to hire further doctors, relying on Heaven's protection, he gradually recovered." I silently sighed, "Because of my mistake, I lost my own son but saved another's. My methods for treating rashes are now without regret." I appended this record to this book. Although pediatric doctors may not believe it, clarifying the correct path truly benefits the understanding of the roots of treating rashes in pediatrics, and those whose children develop rashes should be cautious.