痧疹防风解毒汤
防风(八分) 荆芥(八分) 薄荷(七分) 牛蒡子(一钱,炒研) 石膏(一钱) 知母(八分)
连翘(一钱) 淡竹叶(八分) 木通(八分) 枳壳(七八) 桔梗(八分) 甘草(三分)
上水一钟煎八分,不拘时服。
王氏曰∶痧疹初发以肺经药主之,风温虽分逐年岁气杂至,要皆轻清之邪或从口鼻,或
袭三焦,四时皆有,惟春为甚。聂久吾曰∶治痧疹最忌误用辛热,骤用寒凉,治以防风解毒汤
防风荆芥薄荷牛蒡,以辛散之。石膏知母连翘淡竹叶辛寒以清之,木通通气,枳壳疏表,桔
梗甘草载引诸药以达肺经。缪仲醇曰∶痧疹不宜根据证施治,惟当治肺,使痧疹发出,毒邪解化,则了无余蕴矣。
德按∶天时阴雨地居新屋,宜加银花贯仲西河柳活芦根;毒盛者加紫雪丹。
痧疹竹叶石膏汤
竹叶(三十片) 石膏(五钱) 西河柳叶(五钱) 牛蒡子(一钱五分,炒研) 荆芥穗(一钱)
蝉蜕(一钱) 薄荷叶(一钱) 麦门冬(去心,二钱) 知母(蜜炙,一钱)
干葛(一钱五分) 元参(二钱) 甘草(一钱) 冬米(一撮)
上水一钟八分煎五分,不拘时服。
王氏曰∶痧疹热邪壅于肺,逆传于心胞络。喘咳烦闷躁乱狂越者,非西河柳不能解。
仲醇间尝独用西河柳叶风干为细末,水调服四钱喘躁立定;水浆不入口者,灌之可生。力
赞其为神秘之方。又云∶慎勿用定喘药,惟应大剂竹叶石膏汤加西河柳两许,另出心裁立
一汤方,表里施治盖以客邪犯心肺二经,营卫并伤,非独主于里也。大凡灼热固表无汗而见
诸证者,则有竹叶石膏之辛凉解肌发汗,热毒蕴里而见诸证者,则有西河柳之咸温润燥开
结和营以解天行时热。至于十味佐使之药,不外乎润肺解肌清营透毒毋容议也。
德按∶若已经表伤气液者,急当救阴生津
液为先。
痧疹麻黄散
麻黄(蜜,酒拌炒去节) 升麻(酒炒) 人中黄 牛蒡子(炒研) 蝉蜕(去头足,各等分)
上为末,每服三钱,水煎服。
王氏曰∶严寒之时,风邪袭肺,玄窍为寒所闭,目微红,泪汪汪,鼻塞喘嗽,咽肿,此痧
疹不得出也,治以蜜酒炒麻黄温卫发汗,酒炒升麻入营开泄温风,佐以人中黄清解温热,使
以牛蒡蝉蜕祛风出疹。仲醇曰∶肺气虚者升麻宜轻,重用必喘,学人宜临证斟酌。
痧疹防风解毒汤
防风(八分) 荆芥(八分) 薄荷(七分) 牛蒡子(一钱,炒研) 石膏(一钱) 知母(八分)
连翘(一钱) 淡竹叶(八分) 木通(八分) 枳壳(七八) 桔梗(八分) 甘草(三分)
以上药材加水一钟,煎至八分满,不拘时间服用。
王氏说:痧疹初发时,应以肺经药物为主治。风温虽然根据每年的岁气不同而有所变化,但都属于轻清的邪气,或者从口鼻侵入,或者侵袭三焦,四季都有发生,只有春季最为严重。聂久吾说:治疗痧疹最忌讳误用辛热药物,也忌讳突然使用寒凉药物。治疗应使用防风解毒汤中的防风、荆芥、薄荷、牛蒡子,以辛散的方法发散邪气。石膏、知母、连翘、淡竹叶性味辛寒,用来清热;木通通行气机,枳壳疏解表邪,桔梗和甘草作为引经药,引导诸药到达肺经。缪仲醇说:痧疹不应当仅仅根据症状来施治,只应当治疗肺脏,使痧疹发出,毒邪得以化解,那么就没有残留的隐患了。
德按语:如果天时阴雨,居住在刚建成的新屋里,应当加入金银花、贯众、西河柳、活芦根;如果毒盛,加入紫雪丹。
痧疹竹叶石膏汤
竹叶(三十片) 石膏(五钱) 西河柳叶(五钱) 牛蒡子(一钱五分,炒研) 荆芥穗(一钱)
蝉蜕(一钱) 薄荷叶(一钱) 麦门冬(去心,二钱) 知母(蜜炙,一钱)
干葛(一钱五分) 元参(二钱) 甘草(一钱) 冬米(一撮)
以上药材加水一钟八分,煎至五分满,不拘时间服用。
王氏说:痧疹的热邪壅塞在肺,逆传于心包络。出现喘息咳嗽、烦闷躁乱、狂越不安等症状的,非西河柳不能解除。
仲醇曾经单独使用西河柳叶,风干后研成细末,用水调服四钱,喘息烦躁立即平定;如果水浆无法入口,灌服也可以救活。极力称赞其为神秘的方剂。又说:千万不要使用定喘药,只应该用大剂量的竹叶石膏汤加入约一两西河柳,另辟蹊径创立一个汤方,表里同治。这是因为客邪侵犯心肺二经,营卫同时受伤,不仅仅是在里证。凡是身体灼热、固表无汗而出现各种症状的,就有竹叶石膏汤的辛凉解肌发汗作用;热毒蕴结在里而出现各种症状的,就有西河柳的咸温润燥、开结和营的作用,以解除天行时热。至于其余十味辅助佐使之药,不外乎润肺、解肌、清营、透毒,无需多议。
德按语:如果已经因为发汗过度损伤了气液,应当紧急救治阴津,生津液为先。
痧疹麻黄散
麻黄(蜜,酒拌炒去节) 升麻(酒炒) 人中黄 牛蒡子(炒研) 蝉蜕(去头足,各等分)
以上药材研为细末,每次服用三钱,用水煎服。
王氏说:严寒之时,风邪侵袭肺脏,玄府被寒气闭塞,眼睛微红,泪水汪汪,鼻塞喘息咳嗽,咽喉肿痛,这是痧疹不得发出的表现,治疗用蜜酒炒制的麻黄温煦卫气并发汗,酒炒升麻入营分开泄温风,佐以人中黄清解温热,使药以牛蒡子和蝉蜕祛风出疹。仲醇说:肺气虚的人,升麻用量宜轻,重用必然导致气喘,学习者应当根据临证情况斟酌。
Fangfeng Jiedu Decoction for Measles (Measles Fangfeng Detoxification Decoction)
Fangfeng (Radix Saposhnikoviae, 8 fen), Jingjie (Herba Schizonepetae, 8 fen), Bohe (Herba Menthae, 7 fen), Niubangzi (Fructus Arctii, 1 qian, stir-fried and crushed), Shigao (Gypsum Fibrosum, 1 qian), Zhimu (Rhizoma Anemarrhenae, 8 fen), Lianqiao (Fructus Forsythiae, 1 qian), Dan Zhuyez (Folium Bambusae, 8 fen), Mutong (Caulis Akebiae, 8 fen), Zhiqiao (Pericarpium Aurantii Immaturum, 7-8 fen), Jiegeng (Radix Platycodonis, 8 fen), Gancao (Radix Glycyrrhizae, 3 fen).
Take one zhong of water, decoct until reduced to eight-tenths, take at any time.
Wang said: When measles first appear, treatment should primarily target the Lung Meridian. Although Wind-Warmth varies according to the annual climate qi, it is essentially a light and clear pathogen that enters either through the mouth and nose or invades the Sanjiao. It occurs in all four seasons, but is most severe in spring. Nie Jiuwu said: The greatest taboo in treating measles is the mistaken use of acrid-warm herbs or the sudden use of cold-heat herbs. Treatment should employ Fangfeng, Jingjie, Bohe, and Niubangzi from the Fangfeng Jiedu Decoction to disperse the pathogen with acrid properties. Shigao, Zhimu, Lianqiao, and Dan Zhuyez are acrid-cold and used to clear heat; Mutong promotes the flow of qi, Zhiqiao disperses exterior pathogens, and Jiegeng and Gancao act as guiding herbs to direct the other medicines to the Lung Meridian. Miao Zhongchun said: Measles should not be treated solely based on symptoms; rather, one should treat the Lung, allowing the measles to erupt so that the toxic pathogen can be resolved, leaving no residual pathology.
De's commentary: If the weather is rainy and damp, or if living in a newly constructed house, add Yinhua (Flos Lonicerae), Guanzhong (Rhizoma Dryopteridis Crassirhizomatis), Xihe Liu (Ramulus Salicis Capreae), and Huo Lugen (Rhizoma Phragmitis). If the toxicity is severe, add Zixue Dan (Purple Snow Pill).
Zhuye Shigao Decoction for Measles (Measles Bamboo Leaf Gypsum Decoction)
Zhuye (Folium Bambusae, 30 leaves), Shigao (Gypsum Fibrosum, 5 qian), Xihe Liuye (Folium Salicis Capreae, 5 qian), Niubangzi (Fructus Arctii, 1.5 qian, stir-fried and crushed), Jingjiesui (Spica Schizonepetae, 1 qian), Chantui (Periostracum Cicadae, 1 qian), Boheye (Folium Menthae, 1 qian), Maimendong (Radix Ophiopogonis, peeled heart, 2 qian), Zhimu (Rhizoma Anemarrhenae, honey-fried, 1 qian), Gange (Radix Puerariae, 1.5 qian), Yuanshen (Radix Scrophulariae, 2 qian), Gancao (Radix Glycyrrhizae, 1 qian), Dongmi (Oryza Sativa, a pinch).
Take one zhong and eight-tenths of water, decoct until reduced to five-tenths, take at any time.
Wang said: In measles, heat pathogens obstruct the Lung and transmit reversely to the Pericardium Collateral. For cases presenting with panting, cough, restlessness, agitation, mania, and hyperactivity, only Xihe Liu can resolve the condition.
Zhongchun once used Xihe Liye alone, dried in the wind, ground into fine powder, and taken mixed with water (4 qian); panting and agitation subsided immediately. Even if the patient cannot swallow fluids, administering this can save their life. He highly praised it as a miraculous prescription. He also stated: Do not use anti-asthmatic drugs. Instead, use a large dose of Zhuye Shigao Decoction plus approximately one liang of Xihe Liu, creating a new formula that treats both the interior and exterior. This is because the external pathogen invades the Heart and Lung meridians, damaging both Ying and Wei levels, not just affecting the interior. Generally, when there is burning heat, fixed exterior, and no sweat accompanied by various symptoms, the acrid-cool action of Zhuye Shigao Decoction resolves the muscle layer and induces sweating. When heat toxins are accumulated in the interior causing various symptoms, Xihe Liu's salty, warm, moistening, and drying actions open knots, harmonize Ying, and resolve epidemic warmth. The remaining ten auxiliary and guiding herbs serve to moisten the Lung, resolve the muscle layer, clear Ying, and vent toxins, which requires no further discussion.
De's commentary: If Qi and Yin fluids have already been damaged by excessive sweating, urgently rescue Yin and generate fluids as the priority.
Mahuang San for Measles (Measles Ephedra Powder)
Mahuang (Herba Ephedrae, honey-processed, wine-mixed, stir-fried, nodes removed), Shengma (Rhizoma Cimicifugae, wine-processed), Renzhonghuang (Calculus Intestinalis Bovis), Niubangzi (Fructus Arctii, stir-fried and crushed), Chantui (Periostracum Cicadae, heads and feet removed, equal parts).
Grind into powder. Take 3 qian each time, decoct in water and drink.
Wang said: During severe cold, Wind-Evil invades the Lung, and the Xuanqiao (pores) are closed by cold. Symptoms include slightly red eyes, watery eyes, nasal congestion, panting, cough, and swollen throat. This indicates that measles cannot erupt. Treatment uses honey-wine stir-fried Mahuang to warm the Wei level and induce sweating, wine-processed Shengma to enter the Ying level and release warm wind, assisted by Renzhonghuang to clear and resolve warm-heat, and guided by Niubangzi and Chantui to dispel wind and bring out the rash. Zhongchun said: For those with deficient Lung Qi, the dosage of Shengma should be light; heavy use will inevitably cause panting. Practitioners should exercise discretion based on clinical presentation.