夹疹之痢最难当,毒热凝结移大肠,腹痛下痢赤白色,悉用清热导滞良。
注∶麻疹作痢谓之夹疹痢,因毒热未解,移于大肠所致也。有腹痛欲解,或赤或白,与
赤白相兼者,悉用清热导滞汤主之,不可轻投涩剂。
清热导滞汤
山楂 浓朴(姜制) 生甘草 枳壳(麸炒) 槟榔 当归 白芍(酒炒) 条芩(酒炒) 连翘(去心)
牛蒡子(炒研) 青皮(炙) 黄连(吴茱萸炒)
引用生姜水煎服。
方歌∶痢用清热导滞汤,山楂朴草枳槟榔,归芍条芩翘牛蒡,青皮黄连引生姜。
小儿发疹腹中疼,毒郁肠胃食滞凝,曲腰啼叫眉频蹙,加味平胃散堪行。
注∶麻疹腹痛者,由食滞凝结,毒瓦斯不得宣发于外。故不时曲腰啼叫,两眉频蹙,须以
加味平胃散治之,滞消毒解,而痛自除矣。
加味平胃散
防风 升麻 枳壳(麸炒) 葛根 苍术(炒) 陈皮 浓朴(姜炒) 南山楂 麦芽(炒) 生甘草
引用生姜灯心水煎服。
方歌∶加味平胃散如神,防风升麻枳葛根,苍陈浓朴楂芽草,生姜灯心水煎匀。
疹家衄血莫仓惶,毒从衄解妙非常,衄甚吹鼻发灰散,内服犀角地黄汤。
注∶肺开窍于鼻,毒热上冲,肺气载血妄行,则衄作矣。然衄中有发散之义,以毒从衄
解不须止之。但不可太过,过则血脱而阴亡也。如衄甚者,宜外用发灰散吹入鼻中,内服犀角地黄汤,其血可止。
发灰散
取壮实人头发洗净,阴阳瓦 成灰,放地上去火性,研细末,吹入鼻中,血衄自止。
犀角地黄汤
粉丹皮 白芍药 犀角 生地黄
便硬者加川大黄。
水煎服。
方歌∶犀角地黄汤,治衄效非常,丹皮芍犀地,便秘加大黄。
夹疹之痢最难当,毒热凝结移大肠,腹痛下痢赤白色,悉用清热导滞良。
伴有麻疹的痢疾最为难治,毒热邪气凝结并转移至大肠,出现腹痛、排泄赤白相间的脓血便,全部使用清热导滞的方法治疗最为适宜。
注∶麻疹作痢谓之夹疹痢,因毒热未解,移于大肠所致也。有腹痛欲解,或赤或白,与赤白相兼者,悉用清热导滞汤主之,不可轻投涩剂。
注释:麻疹并发痢疾称为“夹疹痢”,是因为毒热邪气尚未解除,转移到大肠所导致的。如果有腹痛想要排便,排出物或是红色、或是白色,或者赤白相间的情况,都应当以清热导滞汤为主进行治疗,不可以轻易使用收敛固涩的药物。
清热导滞汤
山楂 浓朴(姜制) 生甘草 枳壳(麸炒) 槟榔 当归 白芍(酒炒) 条芩(酒炒) 连翘(去心)
牛蒡子(炒研) 青皮(炙) 黄连(吴茱萸炒)
引用生姜水煎服。
方歌∶痢用清热导滞汤,山楂朴草枳槟榔,归芍条芩翘牛蒡,青皮黄连引生姜。
小儿发疹腹中疼,毒郁肠胃食滞凝,曲腰啼叫眉频蹙,加味平胃散堪行。
小儿出疹时腹部疼痛,是因为毒邪郁结在肠胃,食物停滞凝聚,导致身体弯曲腰部、啼哭叫喊、双眉频繁皱起,此时使用加味平胃散治疗是可行的。
注∶麻疹腹痛者,由食滞凝结,毒瓦斯不得宣发于外。故不时曲腰啼叫,两眉频蹙,须以加味平胃散治之,滞消毒解,而痛自除矣。
注释:麻疹期间出现腹痛,是由于食物停滞凝结,毒邪之气不能在体表宣散透发。所以患者不时地弯腰啼哭,双眉紧皱,必须用加味平胃散来治疗,待积滞消除、毒邪解散,疼痛自然就会去除。
加味平胃散
防风 升麻 枳壳(麸炒) 葛根 苍术(炒) 陈皮 浓朴(姜炒) 南山楂 麦芽(炒) 生甘草
引用生姜灯心水煎服。
方歌∶加味平胃散如神,防风升麻枳葛根,苍陈浓朴楂芽草,生姜灯心水煎匀。
疹家衄血莫仓惶,毒从衄解妙非常,衄甚吹鼻发灰散,内服犀角地黄汤。
患麻疹的人出现鼻出血不要惊慌,毒邪通过鼻出血得以宣泄是非常巧妙的,如果鼻出血严重,可以用发灰散吹入鼻腔,同时内服犀角地黄汤。
注∶肺开窍于鼻,毒热上冲,肺气载血妄行,则衄作矣。然衄中有发散之义,以毒从衄解不须止之。但不可太过,过则血脱而阴亡也。如衄甚者,宜外用发灰散吹入鼻中,内服犀角地黄汤,其血可止。
注释:肺开窍于鼻子,毒热邪气向上冲逆,肺气带动血液妄行,就会导致鼻出血。然而鼻出血中包含着发散邪气的意义,因为毒邪可以通过鼻出血而解除,所以不需要强行止血。但是出血量不能过多,如果过度,会导致血脱和阴液耗竭。如果鼻出血严重的,适宜外用发灰散吹入鼻中,内服犀角地黄汤,这样血液就可以停止。
发灰散
取壮实人头发洗净,阴阳瓦 成灰,放地上去火性,研细末,吹入鼻中,血衄自止。
发灰散:选取身体健康强壮之人的头发,清洗干净后,用阴阳瓦煅烧成灰烬,放置在地上去除火气,研磨成细末,吹入鼻孔中,鼻出血自然会停止。
Dysentery accompanying measles is the most difficult to manage; toxic heat condenses and shifts to the Large Intestine (Da Chang, 大肠), causing abdominal pain and dysentery with red and white discharge. All such cases are best treated with methods that clear heat and guide out stagnation.
Note: Dysentery occurring alongside measles is termed "Measles-Accompanied Dysentery" (Jia Zhen Li, 夹疹痢). It is caused by unresolved toxic heat shifting into the Large Intestine. If there is abdominal pain with an urge to defecate, and the discharge is either red, white, or a mixture of both, Qing Re Dao Zhi Tang (Clear Heat and Guide Out Stagnation Decoction) should be primarily used. Astringent agents should not be lightly administered.
Qing Re Dao Zhi Tang (Clear Heat and Guide Out Stagnation Decoction)
Shan Zha (Crataegi Fructus), Hou Po (Magnoliae Officinalis Cortex processed with ginger), Sheng Gan Cao (Glycyrrhizae Radix et Rhizoma), Zhi Qiao (Aurantii Fructus processed with bran), Bing Lang (Arecae Semen), Dang Gui (Angelicae Sinensis Radix), Bai Shao (Paeoniae Radix Alba processed with wine), Tiao Qin (Scutellariae Radix processed with wine), Lian Qiao (Forsythiae Fructus, heart removed), Niu Bang Zi (Arctii Fructus stir-fried and ground), Qing Pi (Citri Reticulatae Pericarpium Viride roasted), Huang Lian (Coptidis Rhizoma stir-fried with Evodiae Fructus).
Decoct with fresh ginger and water for oral administration.
Prescription Verse: For dysentery, use Qing Re Dao Zhi Tang, containing Shan Zha, Hou Po, Gan Cao, Zhi Qiao, and Bing Lang; Dang Gui, Bai Shao, Tiao Qin, Lian Qiao, and Niu Bang Zi; Qing Pi and Huang Lian, guided by fresh ginger.
When children develop rashes accompanied by abdominal pain, it indicates toxic qi stagnating in the Stomach and Intestines with food retention condensing. The child bends the waist, cries out, and frequently frowns. Jia Wei Ping Wei San (Modified Ping Wei Powder) is suitable for treatment.
Note: Abdominal pain during measles eruption is due to food retention condensing, preventing toxic qi from being vented externally. Consequently, the patient intermittently bends the waist, cries, and frowns frequently. It is necessary to treat this with Jia Wei Ping Wei San; once the retention is eliminated and the toxin resolved, the pain will naturally cease.
Jia Wei Ping Wei San (Modified Ping Wei Powder)
Fang Feng (Saposhnikoviae Radix), Sheng Ma (Cimicifugae Rhizoma), Zhi Qiao (Aurantii Fructus processed with bran), Ge Gen (Puerariae Lobatae Radix), Cang Zhu (Atractylodis Rhizoma stir-fried), Chen Pi (Citri Reticulatae Pericarpium), Hou Po (Magnoliae Officinalis Cortex stir-fried with ginger), Nan Shan Zha (Crataegi Fructus), Mai Ya (Hordei Fructus Germinatus stir-fried), Sheng Gan Cao (Glycyrrhizae Radix et Rhizoma).
Decoct with fresh ginger and Deng Xin Cao (Junci Medullae) in water for oral administration.
Prescription Verse: Jia Wei Ping Wei San is miraculous; Fang Feng, Sheng Ma, Zhi Qiao, and Ge Gen; Cang Zhu, Chen Pi, Hou Po, Shan Zha, Mai Ya, and Gan Cao; decoct evenly with fresh ginger and Deng Xin Cao.
For patients with measles experiencing epistaxis (Nü Xue, 衄血), do not panic. Toxic heat resolving through bleeding is highly effective. If epistaxis is severe, apply Fa Hui San (Hair Ash Powder) insufflated into the nose, and internally administer Xi Jiao Di Huang Tang (Rhinoceros Horn and Rehmannia Decoction).
Note: The Lung opens into the nose. When toxic heat rushes upward, the Lung Qi drives blood to move recklessly, causing epistaxis. However, epistaxis contains the principle of dispersal; since the toxin resolves through bleeding, it does not need to be stopped forcibly. But it must not be excessive, as over-bleeding leads to blood loss and Yin exhaustion. In cases of severe epistaxis, it is appropriate to externally insufflate Fa Hui San into the nose and internally administer Xi Jiao Di Huang Tang, which can stop the bleeding.
Fa Hui San (Hair Ash Powder)
Take clean hair from a robust individual, calcine it between two tiles (Yin Yang Wa, 阴阳瓦) until it turns to ash, place it on the ground to remove its fire nature, grind it into fine powder, and insufflate it into the nose. Epistaxis will stop spontaneously.
Xi Jiao Di Huang Tang (Rhinoceros Horn and Rehmannia Decoction)
Mu Dan Pi (Moutan Cortex), Bai Shao Yao (Paeoniae Radix Alba), Xi Jiao (Rhinocerotis Cornu), Sheng Di Huang (Rehmanniae Radix).
If stool is hard, add Da Huang (Rhei Radix et Rhizoma).
Decoct with water for oral administration.
Prescription Verse: Xi Jiao Di Huang Tang is extremely effective for treating epistaxis; Mu Dan Pi, Bai Shao, Xi Jiao, and Sheng Di Huang; if constipation exists, add Da Huang.