典藏书目

It is said: The way of human life grows from subtle to manifest, from small to large. This is an obvious principle of nature, evident without the need for classics or history, known through evidence. However, children have weak innate constitution. Therefore, *Duanju Fang* states: "Those above six years old are considered 'small' (children); below six years old, [medical texts] do not fully record [their diseases]. Thus, illnesses in nursing infants are difficult to treat due to lack of theoretical basis." Regarding the condition of macules and rashes in children, not only are pulse patterns difficult to distinguish, but treatment is more critical than other diseases. The symptoms resemble Yin Epilepsy (*Yin Xian*) in Cold Damage (*Shanghan*). In prosperous cities and commanderies, where famous doctors abound, one or two cases may be correctly identified. But in remote counties, physicians lacking precision in diagnosis and failing to examine carefully, administer drugs rashly and arrogantly. Furthermore, children's zang-fu organs are delicate and easily injured. Before macules and rashes erupt, they are often mistaken for Wind-Cold invasion, and heavy sweating agents like Ephedrae Herba (*Mahuang*) are used, leading to exterior deficiency and interior excess. If treated as Yin Epilepsy with warming and calming-agitation medicines, heat intensifies. Only after three or four days, when the syndrome is fixed, are macule-and-rash remedies applied, resulting in significant error. Generally, secular physicians use hot herbs to induce eruption when macules/rashes are about to appear, causing extreme heat in the Stomach. Initially, macules appear subcutaneously; those already erupted turn black and sink inward. Since these look unfavorable, hot herbs are further used to fumigate the disease, making eruption harder due to heat. This transforms into heat syndromes with constipation and urinary retention. Using Castor Seed (*Badou*) to purge accumulation then causes internal deficiency of the zang-fu, while heat remains unremoved and pathogenic factors deepen. This leads to wheezing, fullness, hematochezia, or carbuncles, with body fissures. Thus, a lifespan of a century is lost in a day due to misdiagnosis by mediocre physicians—can this not be lamented?

Generally, the early signs of macules/rashes include cough, warm-to-hot body temperature, redness of the face and limbs, headache, lumbar pain, yellow eyes, somnolence with convulsions during sleep, cold extremities, cold ear tips and sacrum, red urine, and dry stool. The pulse at the Cun, Guan, and Chi positions is flooding, rapid, extremely large, and irregular. For nursing infants, the mother may take medicine concurrently. If the syndrome is incomplete or unclear, Shengma San can be used to resolve and vent. If clear, cooling purgatives like Rhubarb (*Dahuang*) and Indigo Naturalis (*Qingdai*) may be used, followed by Baihu Tang. In autumn, winter, or early spring when cold persists, there is no need to strictly follow standard methods; simply decoct with dates. Zhang Zhongjing stated: "After the fourth month, when weather is very hot, Baihu Tang may be taken," which refers only to the general principle. Generally, if rashes have not erupted, purgation is suitable; if erupted, it is not. Once fully erupted, promoting urination and defecation is appropriate. For those erupted but not smoothly, Zicao San, Jiusheng San, or Dai Mao San may be used. For severe cases, Niuli Gao disperses toxicity. If toxin attacks the throat, Zixue or Rusheng Tang may be given in small amounts, with high efficacy. For residual heat, fever, irritability, and thirst, both the child and the mother may receive Ganlu Yin. For hematochezia, Niuhuang San treats it, while also soothing the Liver to resolve stale heat, preventing heat-toxin from attacking the Liver and ascending to the eyes, causing cataracts/opacities. Without proper treatment, the pupil may be damaged; caution is essential. When eruptions are present but not settled, avoid contact with strangers, fearing fatigue or fox odor may aggravate the condition. Do not expose to wind before healing, lest scabs form. If pus exudes, burning Black Morning Glory Seed (*Hei Chou*) ash and applying it to the sore promotes rapid healing without scars. Perilla (*Husui*) should always be available nearby, as it repels sweat and evil qi. If the child can eat, give small amounts of grapes occasionally, as they promote urination and symbolize smooth, rapid eruption. Pediatric macules/rashes originate from accumulated heat in the womb and excessive warmth in nurturing, combined with occasional stomach heat, triggering onset. *Waitai Fang* states: "Stomach rot causes macules." Mild cases show red macules; severe cases show black macules. Red macules indicate five deaths to one survival; black macules indicate ten deaths to one survival. Fu-organ heat causes rashes (shallow heat). Zang-organ heat causes pustules/severe lesions (deep heat). Thus, *Zhengse Lun* states: Large lesions belong to Yin, small ones to Yang. I, Ji Zongjiao, entered medicine due to frequent illness in my youth. Recently, I have practiced in various places. In the winter of the Ren-Shen year, there was little snow, and the weather was unusually warm. By early spring, many children suffered from macules/rashes. Physicians acted as described previously, such as prescribing Baihu Tang. I secretly laughed, saying Baihu Tang is for adults. This ignorance stems from not knowing that Sun Simiao taught that adult and pediatric treatments are similar, differing only in dosage. Lacking knowledge of medication principles leads to errors. Now, I have selected effective formulas from various sources and personal experience, compiling them into this book.