疹者。太阴肺经风热所致。与 绝不相同。而治法亦异。盖疹之发也。乘于
时气。无论长幼男女。传染不一。或呼 子。或称麻子。吴俗则为之痧。总名
曰疹。乃另一种。非 疹之疹也。其形密似针头。其色淡若桃花。头面愈多
者佳。以肺位至高也。上见咳嚏。下见泄泻。以肺与大肠为表里也。宜辛凉。
不宜温热。以兑为燥胜也。宜辛散。不宜苦寒。以肺主皮毛也。温之则火烁
金而毒不解。寒之则热内伏而邪不化。总以荆防薄荷大力葛根前桔之
属。发透为主。使毒尽出皮肤。而鲜内攻之患。最为上策。冬月大寒。不易出
者。稍加麻黄。夏月大热。不易解者。宜入连翘。胃气弱。以米饮助之。邪不在
胃也。中气实。以枳朴平之。暂假则易也。至孕妇发痘而胎不宜堕者。痘喜
内实也。发疹而胎不自固者。疹喜内虚也。然欲安之而卒不可得。又何故。
盖胞系于肾。金为之母。今发疹则肺家之血。尽出于外。肾经绝生化之源。
而无以自养。故胎必堕而罕留也。又岂得与 同日语哉。且 以二三日
之间。即化为轻。疹以六七日之内。渐没为安。则又殊矣。
按忆自己丑及壬辰癸巳。疹症大行。无论长幼。阖境相沿。比余诊之。则
咳嗽喷嚏泄泻。甚至目红鼻衄咽痛声哑。众咸作 治。予曰。此皆属肺
经症。乃疹而非 也。考之方书。独于幼科准绳得之。犹未惬意。内弟孙
子大起专幼科。性嗜学。乃出朱惠民传心录示余。余读之。见其方法井
井。治验昭昭。予遵而行之。百不爽一。任其变幻而总以发透为主。其间
有停食者。有失血者。有胎孕者。略为加减。或兼消兼清。而孕未有不堕
者。孕堕而疹未有不愈者。余于是时。莫不应手取效。又岂敢忘其所自
哉。姑识之。
治验
一女子食面停滞。而疹甚稠密。余先与托疹。胸膈胀满。加卜子浓朴而胸
始宽。疹亦透。但能食者多。而此其百一耳。
一男人发疹。因服凉药。腹痛泄泻。疹色淡白。余与白茯苓炙甘草浓朴陈
皮葛根桔梗薄荷煨姜二剂。腹痛止而疹红绽乃愈。
一男子夏令发疹。幼科加麻黄羌活。鼻衄不止。咽痛声哑。予与玄参连翘
甘桔鼠粘薄荷等清凉而安。盖疹不虑其多而虑其伏。伏则喘急鼻扇。
甚则成疳痢劳瘵。多至不救。更有一人之身而二三发者。乃时气所感。
非比痘症终生一次不可不知。
荆防饮
防风 荆芥 鼠粘子（焙研） 前胡 桔梗 苏薄荷 陈皮 葛根（各一钱）
甘草（二分） 山楂肉（一钱五分）
加生姜一片。芫荽一撮。无则用子。如发透。去荆防。胸膈不宽。加枳朴。痰
多。加苏子。泻甚。去鼠粘。咽痛。加射干。火毒。加玄参。腹痛。加茯苓浓朴。二
剂后。去荆防。加薄荷一钱。枳壳一钱。一疹本肺经。世俗动以羌活太阳
药燥之。一失也。其害则为咽痛烦躁尤轻。又以石膏汤寒其胃。一失也。
其害则变异顷刻。立致其死。衔冤者可不大畏哉。
疹，是由太阴肺经感受风热邪气所致。这与痘（天花）截然不同。治疗方法也完全不同。大抵疹的发生，是乘袭当时的时行疫气，无论老少男女，传染情况不一。有的称为“疹子”，有的称为“麻子”。吴地风俗称之为“痧”。总名为疹，这是另一种病，并非痘疹之疹。
其形态细密如针头，颜色淡红似桃花。头面部皮疹较多的为吉兆，因为肺脏位置最高。上部可见咳嗽喷嚏，下部可见泄泻，这是因为肺与大肠互为表里的缘故。治疗宜用辛凉之法，不宜用温热之法，因为兑卦象征燥金胜复。宜用辛散之法，不宜用苦寒之法，因为肺主皮毛。若用温药，则火热灼伤肺金而毒邪不解；若用寒药，则热邪内伏而邪气不能化解。总之，以荆芥、防风、薄荷、牛蒡子、葛根、前胡、桔梗等药物为主，以透发疹毒为首要原则，使毒邪完全透出皮肤，从而避免内攻脏腑的祸患，这是上策。
冬季严寒，疹不易发出者，可稍加麻黄。夏季酷热，疹不易消退者，宜加入连翘。胃气虚弱者，可用米汤辅助正气，因为邪气不在胃中。中气充实者，可用枳实、厚朴来平调，暂时借用这些药物容易见效。至于孕妇患痘而胎元不易堕落的，是因为痘喜体内充实；患疹而胎元自然不稳固的，是因为疹喜体内虚损。然而想要安胎却最终无法做到，这是什么原因呢？盖因胞宫系于肾，金（肺）为水（肾）之母。如今发疹，肺家之血尽出于体表，导致肾经失去生化之源，而无以滋养胎元，所以胎必堕而很少能保留。这又岂能与痘同日而语呢？而且痘在二三日之间，即可化为轻症；疹在六七日之内，逐渐隐没方为平安，这也是不同的地方。
按：回忆己丑年及壬辰、癸巳年，疹症大流行，无论老少，全境相继感染。等到我诊治时，患者出现咳嗽、喷嚏、泄泻，甚至眼睛发红、鼻出血、咽喉痛、声音嘶哑。众人皆当作痘来治。我说：“这些都属肺经病症，是疹而非痘。”查阅医书，仅在《幼科准绳》中找到相关记载，但还不够满意。我的内弟孙子大起专门从事儿科，生性喜好学习，于是拿出朱惠民的《传心录》给我看。我阅读后，见其方法井然有序，治疗效果显著。我遵照执行，百无一失。任凭病情如何变幻，始终以透发疹毒为主。其间有停食者，有失血者，有孕妇者，略作加减，或兼用消导、清解之法，结果没有导致流产的。若流产了，疹却没有不痊愈的。我当时无不随手取效，又怎敢忘记它的来源呢？姑且记录下来。
治验案例：
一女子吃面食导致停滞，疹出非常稠密。我先给予托疹的药物，胸膈胀满，加入莱菔子、厚朴后胸部才宽舒，疹也透发出来。但能进食的人多，这只是极少数情况。
一男子发疹，因服用凉药，导致腹痛泄泻，疹色淡白。我给予白茯苓、炙甘草、厚朴、陈皮、葛根、桔梗、薄荷、煨姜，服两剂后，腹痛停止，疹色红绽而愈。
一男子夏令发疹，儿科医生加了麻黄、羌活，导致鼻衄不止，咽痛声哑。我给予玄参、连翘、甘桔、鼠粘子（牛蒡子）、薄荷等清凉药物而安定。大概疹不怕多发，只怕潜伏。潜伏则气喘急促、鼻翼扇动，严重时形成疳积、痢疾、劳瘵，多至无法救治。更有一种人身上发作两三次，这是时气所感，不像痘症终生只发一次，不可不知道。
荆防饮
防风、荆芥、鼠粘子（焙干研碎）、前胡、桔梗、苏薄荷、陈皮、葛根（各一钱），甘草（二分），山楂肉（一钱五分）。
加生姜一片，芫荽一撮，若无则用子（指芫荽子）。如疹已透发，去掉荆芥、防风。胸膈不宽舒，加枳实、厚朴。痰多，加苏子。泄泻严重，去掉鼠粘子。咽喉痛，加射干。火毒盛，加玄参。腹痛，加茯苓、厚朴。两剂后，去掉荆芥、防风，加薄荷一钱，枳壳一钱。
疹本属肺经，世俗动不动就用羌活等太阳经药物燥湿，这是一失。其危害则是咽喉痛、烦躁，还算是轻的。又用石膏汤寒凉其胃，又是一失。其危害则是病情变异顷刻之间，立即致死。含冤者可不大畏惧吗？
Rash (Zhen) is caused by wind-heat pathogen affecting the Taiyin Lung Meridian. It is completely different from Smallpox (Dou), and its treatment method is also distinct. Generally, the occurrence of rash is due to contracting the prevailing seasonal epidemic qi. Regardless of age or gender, the transmission varies. Some call it "Zhenzi," others "Mazi." In the Wu region, it is commonly referred to as "Sha." The general name is Rash, which is a different disease, not the rash associated with Smallpox.
Its morphology is dense like needle heads, and its color is pale like peach blossoms. A greater number of rashes on the head and face is auspicious because the Lung resides at the highest position. Upper symptoms include coughing and sneezing; lower symptoms include diarrhea, reflecting the exterior-interior relationship between the Lung and the Large Intestine. Treatment should employ acrid-cool methods, avoiding warm-hot methods, as the Dui trigram symbolizes dryness overcoming metal. Acrid-dispersing methods are suitable, while bitter-cold methods are not, because the Lung governs the skin and hair. Using warm herbs causes fire to scorch metal (Lung), leaving the toxin unresolved; using cold herbs causes heat to lie latent internally, preventing the pathogen from transforming. Therefore, the primary approach uses herbs such as Jingjie (Schizonepetae Herba), Fangfeng (Saposhnikoviae Radix), Bohe (Menthae Haplocalycis Herba), Niubangzi (Arctii Fructus), Gegen (Puerariae Lobatae Radix), Qianhu (Peucedani Radix), and Jiegeng (Platycodonis Radix). The main goal is to vent the eruption thoroughly, allowing the toxin to fully emerge through the skin, thereby avoiding the danger of internal attack on the organs. This is the best strategy.
In winter, when severe cold prevents eruption, slightly add Mahuang (Ephedrae Herba). In summer, when intense heat prevents resolution, add Lianqiao (Forsythiae Fructus). If Stomach Qi is weak, assist with rice water, as the pathogen is not in the Stomach. If Middle Qi is solid, regulate with Zhishi (Aurantii Fructus Immaturus) and Houpo (Magnoliae Officinalis Cortex); temporary use facilitates recovery. Regarding pregnant women, Smallpox tends not to cause miscarriage because Smallpox favors internal fullness; Rash tends to cause instability because Rash favors internal emptiness. However, if one desires to secure the fetus but fails, why is this? Because the uterus is connected to the Kidney, and Metal (Lung) is the mother of Water (Kidney). When Rash erupts, the blood of the Lung meridian flows entirely outward, cutting off the source of generation for the Kidney meridian, leaving it unable to nourish itself. Thus, the fetus inevitably aborts and rarely remains. How can this be compared to Smallpox? Furthermore, Smallpox often becomes mild within two to three days, whereas Rash is considered safe only when it gradually fades within six to seven days; this is another difference.
Note: Recalling the years of Ji Chou, Ren Chen, and Gui Si, Rash was rampant. Regardless of age, the entire region was affected. Upon my diagnosis, patients presented with coughing, sneezing, diarrhea, and even red eyes, epistaxis, sore throat, and hoarseness. The public treated them as Smallpox. I stated, "These all belong to Lung Meridian syndromes; they are Rash, not Smallpox." Consulting medical texts, I found records only in *Youke Zhunsheng* (Standard Guidelines for Pediatrics), yet I was not fully satisfied. My brother-in-law, Sun Zidaqi, who specialized in pediatrics and loved learning, showed me Zhu Huimin's *Chuanxin Lu* (Record of Heart Transmission). Reading it, I found the methods orderly and the treatments effective. Following these, I succeeded in nearly every case. Regardless of variations—whether accompanied by food stagnation, hemorrhage, or pregnancy—I made slight modifications, sometimes adding digestive or clearing methods. Consequently, no pregnancies were lost. If a miscarriage occurred, the Rash invariably healed. At that time, I achieved results effortlessly. How could I forget its origin? I record this here.
Case Records:
1. A woman had food stagnation from eating noodles, resulting in very dense Rash. I initially administered herbs to support the eruption. Due to chest and diaphragm distension, I added Laifuzi (Raphani Semen) and Houpo (Magnoliae Officinalis Cortex), after which her chest relaxed, and the Rash erupted. However, most patients could eat; this was a rare exception.
2. A man developed Rash but took cooling herbs, leading to abdominal pain and diarrhea, with pale white Rash. I prescribed Baifuling (Poria), Zhigancao (Glycyrrhizae Radix et Rhizoma Preparata), Houpo (Magnoliae Officinalis Cortex), Chenpi (Citri Reticulatae Pericarpium), Gegen (Puerariae Lobatae Radix), Jiegeng (Platycodonis Radix), Bohe (Menthae Haplocalycis Herba), and Wei Jiang (Zingiberis Rhizoma Preparatum). After two doses, abdominal pain ceased, the Rash turned red and bloomed, and he recovered.
3. A man developed Rash in summer. The pediatrician added Mahuang (Ephedrae Herba) and Qianghuo (Notopterygii Rhizoma et Radix), causing persistent epistaxis, sore throat, and hoarseness. I prescribed Xuan Shen (Scrophulariae Radix), Lianqiao (Forsythiae Fructus), Gan Jie (Licorice and Platycodon), Shuniu (Arctii Fructus), and Bohe (Menthae Haplocalycis Herba) to cool and settle him. Generally, Rash is not feared for being excessive but for being latent. Latency leads to panting, nasal flaring, and potentially progresses to infantile malnutrition (Gan), dysentery, or consumption, often proving fatal. Additionally, some individuals experience multiple eruptions in their lifetime, caused by seasonal qi, unlike Smallpox which occurs only once in a lifetime. This must be known.
Jingfang Yin (Schizonepeta and Saposhnikovia Decoction)
Fangfeng (Saposhnikoviae Radix), Jingjie (Schizonepetae Spica), Shuniu Zi (Arctii Fructus, roasted and ground), Qianhu (Peucedani Radix), Jiegeng (Platycodonis Radix), Su Bohe (Menthae Haplocalycis Herba), Chenpi (Citri Reticulatae Pericarpium), Gegen (Puerariae Lobatae Radix) (each 1 qian), Gancao (Glycyrrhizae Radix et Rhizoma) (0.2 qian), Shanzha Rou (Crataegi Fructus) (1.5 qian).
Add one slice of Shengjiang (Zingiberis Rhizoma Recens), a pinch of Yuanxu (Coriandri Fructus); if unavailable, use Yuanxu Zi. Once the Rash is fully vented, remove Jingjie and Fangfeng. If the chest/diaphragm feels unrelieved, add Zhishi (Aurantii Fructus Immaturus) and Houpo (Magnoliae Officinalis Cortex). For excessive phlegm, add Suzi (Perillae Fructus). For severe diarrhea, remove Shuniu Zi. For sore throat, add Shegan (Belamcandae Rhizoma). For fire-toxin, add Xuan Shen (Scrophulariae Radix). For abdominal pain, add Fuling (Poria) and Houpo (Magnoliae Officinalis Cortex). After two doses, remove Jingjie and Fangfeng, add Bohe (Menthae Haplocalycis Herba) 1 qian, and Zhike (Aurantii Fructus) 1 qian.
Rash originates from the Lung Meridian. Secular practitioners often mistakenly use drying herbs like Qianghuo (Notopterygii Rhizoma et Radix) targeting the Taiyang Meridian; this is an error. Its harm includes sore throat and irritability, though relatively mild. Another error is using Shigao Tang (Gypsum Decoction) to cold the Stomach; this leads to sudden changes in condition and immediate death. Those who suffer unjustly should indeed fear this greatly.