身后出不快者，足太阳经也，用荆芥甘草防风汤；身前出不快者，手阳明经也，用升麻
葛根汤；四肢出不快者，足阳明经也，用防风芍药甘草汤。此皆解毒升发之剂也，不可不知。
右编曰述古上
缪氏仲醇曰∶痧疹者，手太阴肺足阳明胃二经之火热发而为病者也。小儿居多，大人亦
时有之。殆时气瘟疫之类欤。其证类多咳嗽，多嚏，眼中多泪，多泄泻，多痰，多热，多渴，多
烦闷，甚则躁乱，咽痛，唇焦，神昏是其候也。治法当以清凉发散为主。药用辛寒甘寒苦寒
以升发之，惟忌酸收，最宜辛散，误施温补，祸不旋踵。辛散如荆芥穗干葛西河柳石膏麻黄
鼠粘子；清凉如玄参栝蒌根薄荷竹叶青黛；甘寒如麦门冬生甘草蔗浆；苦寒如黄芩黄连黄
柏贝母连翘皆应用之药也。量证轻重，制剂大小，中病则已，毋太过焉。
痧疹乃肺胃热邪所致，初发时必咳嗽，宜清热透毒，不得止嗽。疹后咳嗽，但用贝母栝
蒌根甘草麦门冬苦桔梗玄参薄荷以清余热，消痰壅则自愈，慎勿用五味子等收敛之剂。若
多喘，喘者热邪壅于肺故也，慎勿用定喘药，惟应大剂竹叶石膏汤加西河柳两许，玄参薄
荷各二钱。如冬天寒甚痧毒为寒气郁于内，不得透出者，加蜜酒炒麻黄一剂立止。凡热势甚
者，可用白虎汤加西河柳，忌用升麻，服之必喘。若多泄泻，慎勿止泻，惟用黄连升麻干葛
甘草则泻自止。疹家不忌泻，泻则阳明之邪热
得解，是亦表里分消之义也。倘痧后泄泻及便脓血，皆由热邪内陷故也，大忌止涩，惟宜升
散，仍用升麻干葛白芍甘草黄连扁豆花，便脓血则加滑石末，必自愈。其或痧后生疮不已，
余热未尽故也，宜用金银花连翘荆芥穗玄参甘草黄连木通浓煎饮之良。
痧疹不宜根据证施治，惟当治本，本者手太阴足阳明二经之邪热也。解其邪热则诸证自退矣。
治痧疹发不出，喘嗽烦躁，闷乱狂越。
西河柳叶风干为细末，水调四钱，顿服立定，此神秘方也。
又方 仲醇立
蝉蜕（一钱） 鼠粘子（炒研，一钱五分） 荆芥穗（一钱） 玄参（二钱） 生甘草（一钱） 麦冬（一钱
五分，去心） 干葛（一钱五分） 薄荷叶（一钱） 知母（一钱） 西河柳（五钱） 竹叶（三十片） 甚者，
加石膏（五钱） 冬米（一撮）
又方 加黄芩黄连黄柏等治之。
冬月痧疹因寒不得发透，喘渴闷乱，烦躁不定，用麻黄去节，汤泡过，以蜜酒拌炒，加一
钱，或七八分于治痧药中，一服立透。药用干葛麦冬贝母前胡荆芥穗玄参西河柳甘草知母一服，而痧疹立透。
缪氏《本草经疏》
赤柽木（一名西河柳，又名观音柳，三眠柳）味甘，微咸，气温，无毒。近世有以治痧疹
热毒不能出，用为发散之神药。经曰∶少阴所至为疡疹，正刘守真所谓诸痛痒疮疡，皆属心
火之旨也。盖热毒炽于肺胃，则发斑疹于肌肉
间。以肺主皮毛，胃主肌肉也。此药正入肺胃心三经，三经毒解则邪透肌肤，而内热自消。
此皆开发升散，甘咸微温之功用也。
主治∶同石膏知母薄荷荆芥穗玄参牛蒡子麦冬竹叶连翘黄芩甘草之属，治斑疹发不
出，或虽发不透，如热甚毒炽，舌生芒刺，大渴谵语，斑色紫黑者，加入三黄石膏汤内大效。
单用及兼各药并主痧疹首尾诸证。
汪氏双池曰∶赤柽柳一名西河柳。枝叶似柏实，柳类也。生水泽旁，天将雨则木有云气
上蒸，故又名雨师。性味甘辛咸寒，能泻肺热，散瘀血，挹润泽之气以上行而宣毒，去郁麻证，用之最良。
身后出疹缓慢者，属足太阳经病变，使用荆芥甘草防风汤；身前出疹缓慢者，属手阳明经病变，使用升麻葛根汤；四肢出疹缓慢者，属足阳明经病变，使用防风芍药甘草汤。这些方剂都是具有解毒和升发透疹作用的药剂，不可不知。
缪仲醇说：痧疹（麻疹/风疹类疾病）是由于手太阴肺经和足阳明胃经的火热之邪引发而成的疾病。多见于小儿，成人偶尔也有患病。这大概属于时行疫病之类吧。其症状大多表现为咳嗽、打喷嚏多、眼中流泪多、腹泻多、痰多、发热、口渴、烦闷，严重时出现躁动混乱、咽喉疼痛、嘴唇焦裂、神志昏迷，这些都是其征候。治疗方法应当以清凉发散为主。药物宜选用辛寒、甘寒、苦寒性质的药材来升发透疹，唯独忌讳酸收类药物，最适宜辛散类药物，误用温补药物，灾祸随即而至。辛散类药物如荆芥穗、干葛（葛根）、西河柳、石膏、麻黄、鼠粘子（牛蒡子）；清凉类药物如玄参、栝蒌根（天花粉）、薄荷、竹叶、青黛；甘寒类药物如麦门冬、生甘草、蔗浆；苦寒类药物如黄芩、黄连、黄柏、贝母、连翘，这些都是应当应用的药物。根据病情的轻重，决定制剂的大小，达到治疗效果即可停止，不要过度用药。
痧疹是由肺胃热邪引起的，初发时必然咳嗽，应当清热透毒，不能强行止咳。疹出之后的咳嗽，只需用贝母、栝蒌根、甘草、麦门冬、苦桔梗、玄参、薄荷来清除余热，消除痰液壅滞，病症自然痊愈，千万不要使用五味子等收敛类药物。如果喘息严重，喘息是因为热邪壅塞于肺部所致，千万不要使用定喘药，只应使用大剂量的竹叶石膏汤，加入西河柳两许，玄参、薄荷各二钱。如果是冬天寒气很重，痧毒被寒气郁结在体内，无法透出的情况，加入蜜酒炒制的麻黄一剂，症状立刻停止。凡是热势非常严重的，可以使用白虎汤加西河柳，忌用升麻，服用升麻必定导致喘息。如果腹泻严重，千万不要止泻，只需用黄连、升麻、干葛、甘草，腹泻自然会停止。患痧疹的人不忌讳腹泻，腹泻则阳明经的邪热得以解除，这也是表里分消的道理。倘若疹后腹泻以及大便带脓血，都是由热邪内陷所致，绝对忌讳使用涩肠止泻药，只宜升散，仍用升麻、干葛、白芍、甘草、黄连、扁豆花，若大便带脓血则加入滑石末，病症必自愈。或者疹后疮疡不止，是因为余热未尽，适宜用金银花、连翘、荆芥穗、玄参、甘草、黄连、木通浓煎饮用，效果良好。
治疗痧疹不应仅仅根据表面症状施治，而应当治本，本是指手太阴肺经和足阳明胃经的邪热。解除了邪热，各种症状自然消退。
治疗痧疹发出困难，伴有喘息、咳嗽、烦躁、闷乱、狂越不安。
西河柳叶风干研成细末，用水调服四钱，一次性服下，症状立刻安定，这是神秘的方剂。
又一方 由缪仲醇制定
蝉蜕（一钱） 鼠粘子（炒后研碎，一钱五分） 荆芥穗（一钱） 玄参（二钱） 生甘草（一钱） 麦冬（一钱五分，去心） 干葛（一钱五分） 薄荷叶（一钱） 知母（一钱） 西河柳（五钱） 竹叶（三十片） 病情严重的，加石膏（五钱） 粳米（一撮）。
冬季痧疹因寒气侵袭无法透发，出现喘息、口渴、闷乱、烦躁不安，使用麻黄去节，用热水浸泡过，再用蜜酒拌炒，加入一钱或七八分到治疗痧疹的药物中，服用一次立刻透发。药用干葛、麦冬、贝母、前胡、荆芥穗、玄参、西河柳、甘草、知母，服用一次，痧疹立刻透发。
缪氏《本草经疏》记载：
赤柽木（又名西河柳，又名观音柳，三眠柳），味甘，微咸，气温，无毒。近代有用它治疗痧疹热毒不能透发的情况，将其作为发散的神药。医经说：少阴经气所至表现为疡疹，正是刘守真所说的“诸痛痒疮疡，皆属于心火”的宗旨。因为热毒炽盛于肺胃，就会在肌肉间发为斑疹。由于肺主皮毛，胃主肌肉。此药正入肺、胃、心三经，三经毒解则邪气透达肌肤，内部热邪自然消除。这都是开发升散，甘咸微温的功效。
主治：同石膏、知母、薄荷、荆芥穗、玄参、牛蒡子、麦冬、竹叶、连翘、黄芩、甘草等药配合，治疗斑疹发出困难，或虽然发出但不透彻，如热势甚重、毒气炽盛、舌生芒刺、大渴、谵语、斑色紫黑的情况，加入三黄石膏汤内效果显著。
单独使用及兼用其他药物，均主治痧疹从头到尾的各种症状。
汪双池说：赤柽柳又名西河柳。枝叶像柏树果实，属于柳类。生长在水泽旁边，天将下雨时树木上方有云气蒸腾，所以又名雨师。性味甘甜、辛、咸、寒，能泻肺热，散瘀血，汲取润泽之气上行以宣发毒邪，去除郁结的麻证，使用它最为良效。
If the eruption is slow on the back, it belongs to the Foot-Taiyang Meridian; use Jingjie Gancao Fangfeng Tang (Schizonepeta, Licorice, and Saposhnikovia Decoction). If the eruption is slow on the front of the body, it belongs to the Hand-Yangming Meridian; use Shengma Gegen Tang (Cimicifuga and Pueraria Decoction). If the eruption is slow in the four limbs, it belongs to the Foot-Yangming Meridian; use Fangfeng Shaoyao Gancao Tang (Saposhnikovia, Peony, and Licorice Decoction). These are all agents for resolving toxicity and promoting eruption, which must not be ignored.
Miao Zhongchun stated: Shazhen (measles/rubella-like diseases) is a disease caused by the fire-heat pathogens of the Hand-Taiyin Lung Meridian and the Foot-Yangming Stomach Meridian. It occurs mostly in children, but adults occasionally suffer from it as well. It probably belongs to the category of seasonal epidemics. Its symptoms mostly include coughing, frequent sneezing, excessive tearing in the eyes, frequent diarrhea, phlegm accumulation, fever, thirst, and irritability. In severe cases, restlessness, confusion, sore throat, cracked lips, and coma occur, which are its signs. The treatment method should focus on cooling and dispersing. Medicinals should be selected with acrid-cold, sweet-cold, or bitter-cold properties to promote eruption. Sour-astringent drugs are strictly contraindicated, while acrid-dispersing drugs are most suitable. Mistakenly using warming-tonifying drugs will lead to immediate disaster. Acrid-dispersing drugs include Jingjie Sui (Schizonepeta Spike), Gan Ge (Pueraria Root), Xihe Liu (Tamarix Twig), Shigao (Gypsum Fibrosum), Mahuang (Ephedra Herba), and Shuniuzi (Arctii Fructus); cooling drugs include Xuanshen (Scrophulariae Radix), Gualou Gen (Trichosanthis Radix), Bohe (Menthae Haplocalycis Herba), Zhuye (Bambusa Leaves), and Qingdai (Indigo Naturalis); sweet-cold drugs include Maidong (Ophiopogonis Radix), Sheng Gancao (Raw Glycyrrhizae Radix et Rhizoma), and Zhe Jiang (Sugar Cane Juice); bitter-cold drugs include Huangqin (Scutellariae Radix), Huanglian (Coptidis Rhizoma), Huangbai (Phellodendri Cortex), Beimu (Fritillariae Bulbus), and Lianqiao (Forsythiae Fructus), all of which are applicable medicinals. Based on the severity of the condition, determine the dosage; stop when the illness is cured, avoiding excessive medication.
Shazhen is caused by heat pathogens in the lungs and stomach. At the initial stage, coughing is inevitable; one should clear heat and vent toxins, and must not forcibly suppress the cough. For coughing after the rash appears, only use Beimu, Gualou Gen, Gancao, Maidong, Kujiegeng (Platycodonis Radix), Xuanshen, and Bohe to clear residual heat and eliminate phlegm congestion; the condition will heal spontaneously. Do not use astringent agents like Wuweizi (Schisandrae Fructus). If wheezing is severe, it is due to heat pathogens obstructing the lungs; do not use antitussive/wheezing-relieving drugs. Instead, use a large dose of Zhuye Shigao Tang (Bamboo Leaf and Gypsum Decoction) with two xu of Xihe Liu, and two qian each of Xuanshen and Bohe. In winter, if cold is severe and shazhen toxins are depressed internally by cold qi, preventing eruption, add one dose of Mahuang stir-fried with honey and wine; the symptoms will stop immediately. For cases with very high fever, Baihu Tang (White Tiger Decoction) with Xihe Liu can be used, but Shengma (Cimicifugae Rhizoma) is contraindicated, as it will inevitably cause wheezing. If diarrhea is severe, do not stop it; simply use Huanglian, Shengma, Gan Ge, and Gancao, and the diarrhea will stop naturally. Patients with shazhen do not need to fear diarrhea; diarrhea allows the heat pathogens of the Yangming meridian to resolve, which aligns with the principle of dissipating pathogens from both exterior and interior. If diarrhea persists after the rash, or if pus and blood appear in the stool, it is due to heat pathogens sinking inward. Astringents are strictly forbidden; one should use ascending and dispersing methods, specifically Shengma, Gan Ge, Baishao (Paeoniae Radix Alba), Gancao, Huanglian, and Biandouhua (Lablab Flower). If pus and blood appear in the stool, add Huashi (Talcum Powder); the condition will heal spontaneously. If sores persist after the rash, it is because residual heat remains; decoct Jinyinhua (Lonicerae Japonicae Flos), Lianqiao, Jingjie Sui, Xuanshen, Gancao, Huanglian, and Mutong (Akebiae Caulis) thickly for drinking, which is effective.
Treatment of shazhen should not rely solely on symptomatic therapy but must treat the root, which refers to the heat pathogens of the Hand-Taiyin Lung and Foot-Yangming Stomach meridians. Once the heat pathogens are resolved, all symptoms will recede.
For shazhen that fails to erupt, accompanied by wheezing, coughing, irritability, oppression, confusion, and mania:
Dry Xihe Liu leaves, grind into fine powder, mix with water, take 4 qian at once; the symptoms will settle immediately. This is a mysterious prescription.
Another Prescription formulated by Zhongchun:
Chan Tui (Cicada Slough, 1 qian), Shuniuzi (Arctii Fructus, fried and ground, 1.5 qian), Jingjie Sui (Schizonepeta Spike, 1 qian), Xuanshen (Scrophulariae Radix, 2 qian), Sheng Gancao (Raw Licorice, 1 qian), Maidong (Ophiopogonis Radix, dehearted, 1.5 qian), Gan Ge (Pueraria Root, 1.5 qian), Bohe Ye (Mint Leaf, 1 qian), Zhimu (Anemarrhenae Rhizoma, 1 qian), Xihe Liu (Tamarix Twig, 5 qian), Zhuye (Bamboo Leaf, 30 slices). For severe cases, add Shigao (Gypsum Fibrosum, 5 qian) and Dongmi (Rice Grain, a pinch).
Another Prescription: Add Huangqin, Huanglian, and Huangbai to treat.
In winter, if shazhen cannot erupt due to cold, causing wheezing, thirst, oppression, and restlessness, use Mahuang (Ephedra Herba) with nodes removed, soaked in hot water, then stir-fried with honey and wine. Add 1 qian or 7-8 fen to the shazhen formula; one dose will cause immediate eruption. The formula includes Gan Ge, Maidong, Beimu, Qianhu (Peucedani Radix), Jingjie Sui, Xuanshen, Xihe Liu, Gancao, and Zhimu. One dose results in immediate eruption.
Recorded in Miao's *Bencao Jing Shulou* (*Elucidation of Materia Medica*):
Chichengmu (Red Tamarisk), also known as Xihe Liu, Guanyin Liu, or Sanmian Liu, has a sweet taste, slightly salty, warm nature, and is non-toxic. In recent times, it has been used as a divine drug for dispersing shazhen heat toxins that fail to erupt. The classics state: "What arrives at Shaoyin manifests as ulcers and rashes," which aligns with Liu Shouzhen's assertion that "all pain, itching, ulcers, and sores belong to Heart Fire." Since heat toxins blaze in the lungs and stomach, macules and rashes erupt between the muscles. As the lungs govern skin and hair, and the stomach governs muscles, this herb enters the Lung, Stomach, and Heart meridians. When the toxins in these three meridians are resolved, evil pathogens penetrate the skin, and internal heat dissipates. This demonstrates the functions of opening, ascending, and dispersing, characterized by sweet, salty, and slightly warm properties.
Indications: Used in combination with Shigao, Zhimu, Bohe, Jingjie Sui, Xuanshen, Niuzi (Arctii Fructus), Maidong, Zhuye, Lianqiao, Huangqin, and Gancao to treat macules and rashes that fail to erupt or do not erupt thoroughly. In cases of severe heat and blazing toxins, with prickles on the tongue, extreme thirst, delirium, and purple-black macules, adding it to Sanhuang Shigao Tang (Three Yellows and Gypsum Decoction) yields significant effects. Used alone or combined with other herbs, it treats all stages of shazhen.
Wang Shuangchi stated: Chichengliu (Red Tamarisk), also known as Xihe Liu, has branches and leaves resembling cypress cones, belonging to the willow family. It grows beside water marshes; before rain, clouds evaporate above the trees, hence the name Yushi (Rain Master). Its nature is sweet, acrid, salty, and cold. It can drain lung heat, dispel blood stasis, draw moistening energy upward to vent toxins, and remove stagnant miasma causing measles. It is the best choice for such conditions.