（第三十四）
小儿丹毒赤游肿者，盖热毒客于腠理，搏于血气，发于外皮上，赤如丹砂，热毒与血相击，
而风乘之，所以赤肿游走遍身也。此由乳母食酒面煎炙等物过度，与夫烘衣与儿，不候冷即着，
多成此疾。或发于手足，或发于头面、胸背，令儿燥闷，腹胀如火，其痛不可言。有入腹之证，
便不可救。仍小儿一周之内，皮毛肌肉，筋骨髓脑，五脏六腑，荣卫，皆未坚固，譬如草木茸芽
之状，未经寒暑，即娇嫩不坚。故小儿一周之内，不可频频洗浴。恐湿热之气，郁蒸不散，遂
成赤游肿，或片片如胭脂涂染，皆肿而壮热。若毒入腹中者，则腹胀硬，多致不救。凡此证候，
皆洗浴脱着而得之也。赤游丹肿者，急用蜞针法刺之，使吮其恶血而毒解矣。次服水
黄散、葛根白术散、五和散，皆可选而用之。及丹热、实热、龙带热者，并用大连翘汤加大灯
心煎服，败毒散，解毒丸并宜服之。
犀角解毒散 治小儿赤白丹瘤，壮热狂躁，睡卧不安，胸膈痞闷，咽喉肿痛，遍身丹毒。
牛蒡子（炒，两半） 荆芥（半两） 防风 甘草（各二钱半） 犀角（钱半）
上咀，每服三钱，竹叶煎，食远服。
防风升麻汤 治小儿丹瘤赤肿。
防风 升麻 山栀 麦门冬 木通 甘草（各一钱）
上咀，竹叶煎服。
碧绿散
绿豆粉（半两） 大黄末（二钱）
和匀，姜汁、薄荷汁，蜜调涂患处。
冰黄散 治小儿赤瘤丹毒。
芒硝（半两） 大黄（一钱）
为细末，新汲水调涂患处。
拂毒散 治小儿诸风热，阴毒肿核，已结未溃。
半夏（一两） 贝母 大黄 朴硝 五倍子（各半两）
上末，醇醋调涂患处，干再涂，仍服疏风化毒剂。
白玉散 治赤游丹毒。
滑石 寒水石（各一两）
上为末，米醋调涂肿处，或肿至外肾有破处，只用水调。
五和汤 治赤游肿。
当归 茯苓 大黄（各七钱） 甘草（半两） 枳壳（七钱半）
上咀，每服三钱，水煎服。
升麻散 治五种丹毒。
升麻 郁金 桔梗 甘草 葛根 天花粉（各等分）
为末，薄荷汤入蜜少许调下。
蜞针法 治赤游丹毒，一切肿痛。
先用湿纸搭毒上，看其肿处一点先干即是正顶。以大笔管一个，安于顶上，却以水蜞
一条于管中，频频以冷水灌之，吮其脓血出，其毒自散。如毒甚，可用三、四条方见功。更
蜞要脱大，即吮其血，吮其正穴，其蜞必死。若不吮其恶血，十无一生。如血不止，以藕节
泥涂之即止。
一方 治赤游丹肿，用青黛、五味为末，井水入蜜调敷。
一方 治赤丹急发，一时无药，恐其入腹，以瓷器打碎，以锋刺红肿处，其毒血出即愈。
急救方 治小儿丹毒，用灶心土研细，新汲水调涂，干则易上。
败毒散、清毒饮并治丹肿。（方见伤寒门。）
（第三十四）
小儿丹毒赤游肿，是因为热毒侵袭腠理，与血气搏结，发于皮肤表面，颜色红如丹砂。热毒与血液相互冲击，风邪趁机侵入，所以出现红色肿胀并游走遍全身。这通常是由于乳母过度食用酒、面食、煎炸烤炙等食物，或者用烘烤过的衣物给婴儿穿着，不待冷却就接触身体，多导致此病。病症可能发作于手足，或头面、胸背，使患儿烦躁闷乱，腹部胀满如火烧，疼痛难以言喻。若有毒邪入腹的证候，则无法救治。另外，婴儿出生一周内，皮毛肌肉、筋骨骨髓脑髓、五脏六腑、营卫之气，都尚未坚固，就像草木初生的嫩芽一样，未经过寒暑考验，因而娇嫩不坚。所以婴儿出生一周内，不可频繁洗浴。恐怕湿热之气郁结蒸腾不散，遂形成赤游肿，或成片如胭脂涂抹染色，皆伴有肿胀和高热。若毒邪进入腹中，则腹部胀硬，多导致死亡。凡是这些证候，都是由于洗浴后脱衣受凉而得的。对于赤游丹肿，急需使用蜞针法刺破患处，让水蛭吸吮恶血，从而使毒邪解除。随后服用黄散、葛根白术散、五和散，均可选择使用。以及患有丹热、实热、龙带热者，均使用大连翘汤加大灯心草煎服，败毒散、解毒丸也适宜服用。
犀角解毒散：治疗小儿赤白丹瘤，高热狂躁，睡眠不安，胸膈痞闷，咽喉肿痛，遍身丹毒。
牛蒡子（炒，半两） 荆芥（半两） 防风 甘草（各二钱半） 犀角（一钱半）
以上药物切碎，每次服用三钱，用竹叶煎汤，饭后服用。
防风升麻汤：治疗小儿丹瘤赤肿。
防风 升麻 山栀 麦门冬 木通 甘草（各一钱）
以上药物切碎，用竹叶煎服。
碧绿散
绿豆粉（半两） 大黄末（二钱）
混合均匀，用姜汁、薄荷汁、蜂蜜调匀涂于患处。
冰黄散：治疗小儿赤瘤丹毒。
芒硝（半两） 大黄（一钱）
研为细末，用新汲水调匀涂于患处。
拂毒散：治疗小儿各种风热，阴毒肿核，已结未溃。
半夏（一两） 贝母 大黄 朴硝 五倍子（各半两）
研为末，用纯醋调匀涂于患处，干了再涂，同时服用疏风化毒剂。
白玉散：治疗赤游丹毒。
滑石 寒水石（各一两）
研为末，用米醋调匀涂于肿胀处，如果肿胀至外生殖器有破损处，只用水调匀。
五和汤：治疗赤游肿。
当归 茯苓 大黄（各七钱） 甘草（半两） 枳壳（七钱半）
以上药物切碎，每次服用三钱，水煎服。
升麻散：治疗五种丹毒。
升麻 郁金 桔梗 甘草 葛根 天花粉（各等分）
研为末，用薄荷汤调入少许蜂蜜送服。
蜞针法：治疗赤游丹毒，一切肿痛。
先用湿纸贴在毒肿上，观察肿处哪一点先干，那一点就是正顶。取一个大笔管，安放在正顶上，然后将一条水蛭放入管中，频频用冷水浇灌它，使其吸吮脓血流出，毒邪自然消散。如果毒邪严重，可用三、四条才能见效。更要注意水蛭要选大的，即能吸吮其血，吸吮其正穴，水蛭必死。如果不吸吮恶血，十人中没有一人能活。如果血不止，用藕节泥涂敷即可止血。
另一方：治疗赤游丹肿，用青黛、五味子研为末，井水加蜂蜜调敷。
另一方：治疗赤丹急发，一时没有药物，恐怕毒邪入腹，将瓷器打碎，用锋利边缘刺红肿处，毒血流出即愈。
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Pediatric erysipelas with red wandering swelling is caused by heat-toxin invading the interstices (Couli, the space between skin and muscle), struggling with blood and qi, manifesting on the outer skin, red like cinnabar. The heat-toxin strikes against the blood, and wind takes advantage of this, resulting in red swelling that wanders all over the body. This condition often arises from the wet nurse consuming excessive amounts of alcohol, wheat products, fried, roasted, or grilled foods, or from using clothes dried by heat for the infant without waiting for them to cool before dressing the child, which frequently leads to this disease. The eruption may occur on the hands and feet, or on the head, face, chest, and back, causing the infant restlessness and stifling sensation, abdominal distension as if filled with fire, and unbearable pain. If there are signs of toxin entering the abdomen, it becomes incurable. Furthermore, within the first week after birth, an infant's skin, muscles, sinews, bones, marrow, brain, five zang organs, six fu organs, and Ying-Wei (Nutritive and Defensive Qi) are not yet firm, resembling the tender sprouts of grass and trees that have not yet experienced cold and heat, thus remaining delicate and unsteady. Therefore, infants should not be bathed frequently within the first week. It is feared that damp-heat qi will stagnate and steam without dispersing, thereby forming red wandering swelling, appearing in patches like rouge applied to the skin, accompanied by swelling and high fever. If the toxin enters the abdomen, the abdomen becomes distended and hard, often leading to death. All these syndromes are acquired through bathing followed by exposure due to undressing. For red wandering dan swelling, the leech acupuncture method (Qizhen Fa) should be urgently employed to puncture the area, allowing the leeches to suck out the foul blood so that the toxin is resolved. Subsequently, Shuihuang San, Gegen Baizhu San, and Wuhe San can be selected for use. For those suffering from Dan Re (Erysipelas Heat), Shi Re (Excess Heat), or Long Dai Re (Dragon Belt Heat), Dalianqiao Tang with Dengxincao (Fimbristylis Aëriginea) added should be decocted and taken; Baidu San and Jiedu Wan are also suitable.
Xijiao Jiedu San: Treats pediatric red and white dan liu, high fever, mania and restlessness, sleep disturbance, chest and diaphragm stuffiness, sore throat and swelling, and generalized erysipelas.
Niu Bang Zi (Stir-fried, 1.5 liang) Jing Jie (0.5 liang) Fang Feng Gan Cao (each 2.5 qian) Xi Jiao (1.5 qian)
Crush the herbs. Take 3 qian per dose, decocted with Zhu Ye (Bamboo Leaves), taken well after meals.
Fang Feng Shengma Tang: Treats pediatric dan liu with red swelling.
Fang Feng Shengma Shan Zhi Mai Men Dong Mu Tong Gan Cao (each 1 qian)
Crush the herbs, decoct with Zhu Ye (Bamboo Leaves) and take.
Bilü San
Lü Dou Fen (0.5 liang) Da Huang Mo (2 qian)
Mix evenly, and apply to the affected area mixed with Jiang Zhi (Ginger Juice), Bo He Zhi (Mint Juice), and honey.
Binghuang San: Treats pediatric red liu and erysipelas.
Mang Xiao (0.5 liang) Da Huang (1 qian)
Grind into fine powder, mix with fresh well water, and apply to the affected area.
Fudu San: Treats various wind-heat conditions in children, yin-toxin swollen nodes that are formed but not ulcerated.
Ban Xia (1 liang) Bei Mu Da Huang Pu Xiao Wu Bei Zi (each 0.5 liang)
Grind into powder, mix with pure vinegar, and apply to the affected area. Reapply when dry. Also administer Shufeng Huadu Ji internally.
Baiyu San: Treats red wandering erysipelas.
Hua Shi Han Shui Shi (each 1 liang)
Grind into powder, mix with rice vinegar, and apply to the swollen area. If the swelling extends to the external genitalia with broken skin, use only water for mixing.
Wuhe Tang: Treats red wandering swelling.
Dang Gui Fu Ling Da Huang (each 7 qian) Gan Cao (0.5 liang) Zhi Ke (7.5 qian)
Crush the herbs. Take 3 qian per dose, decocted in water.
Shengma San: Treats five types of erysipelas.
Shengma Yu Jin Jie Geng Gan Cao Ge Gen Tian Hua Fen (equal parts)
Grind into powder, take with Bo He Tang (Mint Decoction) mixed with a little honey.
Qizhen Fa (Leech Acupuncture Method): Treats red wandering erysipelas and all swellings and pains.
First, place a wet paper strip over the toxic swelling. Observe which single point on the swelling dries first; this is the "Zheng Ding" (Main Peak). Place a large brush tube over this peak, insert one leech into the tube, and frequently pour cold water over it to induce it to suck out the pus and blood, causing the toxin to dissipate naturally. If the toxin is severe, three or four leeches may be needed to achieve efficacy. Ensure the leeches are large enough to suck the blood from the Zheng Xue (Correct Acupoint); the leech will die if it sucks the correct point. If the foul blood is not sucked out, fewer than one in ten will survive. If bleeding does not stop, apply Oujie Ni (Lotus Rhizome Mud) to stop it.
Another prescription: For red wandering dan swelling, grind Qing Dai (Indigo Naturalis) and Wu Wei Zi (Schisandra Berry) into powder, mix with well water and honey, and apply.
Another prescription: For acute onset of red dan, when no medicine is available at hand, fearing toxin entry into the abdomen, break a porcelain vessel and use the sharp edge to prick the red and swollen area until toxic blood flows out, then it heals.
Emergency Prescription: For pediatric erysipelas, grind Zaoxin Tu (Calcined Hearth Soil) into fine powder, mix with fresh well water, apply to the area, and replace when dry.
Baidu San and Qingdu Yin both treat dan swelling. (See Formulas in the Shanghan Section.)