近来丹痧一症，患者甚多，患而死者，亦复不少，世人因方书未及，治亦无从措手，或云辛散，或云凉解，或云苦
寒泄热，俱师心自用，各守专门，未尝探其本源。按仲师《金匮》书，“阳毒之为病，面赤斑斑如锦纹，咽喉痛，吐脓血，
五日可治，七日不可治，升麻鳖甲汤主之”之文，细绎其义，实与此症相类，何会心者之绝少耶？惟是升麻鳖甲汤，盖
以升麻升透厉毒，鳖甲泄热守神，当归和血调营，甘草泻火解毒，正《内经》“热淫于内，治以咸寒，佐以甘苦”之旨。
而内有蜀椒、雄黄，似当加于阴毒方中，或因传写之讹耳。一转移间，则于阳毒、阴毒之义，尤为贴切，而人之用之者，
亦鲜疑畏矣。今如遇此丹痧一证，当于经义详之，毋谓古人之未及也，不揣愚陋，用敢质之同人。
读《难经·四十二难》有脏腑之长短、轻重、广狭，受盛之数，余窃以为未必然。如人轻重、长短不齐，饮食多寡
不一，即可类推也。即长短尚有以中指屈曲而取中节之 角以量之论，而受盛水谷之升合，迥然各异。可见吾侪看书，
要在圆通活泼，未可拘泥成说也。
阅景岳《新方》中于大温中饮方下，有“从补血而散，而云腾致雨之妙，则仲景犹所未及”句，窃谓伤寒方中，仲
师用炙甘草汤，有桂、酒、地、麦、胶、麻之品，非阳根于阴，汗化于液，云腾致雨之妙乎？未可谓其未及也。
近来丹痧（一种以咽喉肿痛、肌肤发疹为特征的急性传染病）这一病症，患者非常多，患病后死亡的也不在少数。世人因为医书方剂中对此症记载不足，治疗时便无从下手。有的主张用辛散之法，有的主张用凉解之法，有的主张用苦寒之品泄热，这些都是各自主观臆断，固守自己的专长，未曾探究疾病的本源。
按照张仲景《金匮要略》中的记载：“阳毒病（感受阳热毒邪所致的一类疾病）的症状是：面部红赤，斑纹如锦缎般绚丽，咽喉疼痛，吐出脓血，发病五天可以治愈，七天则难以治愈，用升麻鳖甲汤主治。”仔细推究其中的义理，其实与丹痧症非常相似，为什么能领会其中深意的人如此稀少呢？
至于升麻鳖甲汤，主要是利用升麻提升透发厉毒，鳖甲清热并守护神气，当归调和血液并调理营分，甘草泻火并解毒，这正符合《黄帝内经》中“热邪淫盛于体内，用咸寒之品为主治，辅以甘苦之品”的宗旨。而方中含有蜀椒和雄黄，似乎应当加在阴毒方的治疗中，这可能是由于传抄书写造成的错误吧。只要稍微转换一下思路，那么对于阳毒、阴毒的含义就更为贴切，而使用此方的人，也就很少有怀疑和畏惧的了。如今如果遇到丹痧这一证候，应当依据经典经义来详细辨析，不要说古人没有涉及到此症，我不揣冒昧，敢于向各位同仁请教。
读《难经·四十二难》中提到脏腑的长度、重量、宽窄以及受纳容纳的数量，我私下认为未必完全正确。比如人的体重、身高各不相同，饮食的多少也不一样，由此可以类推。即使有通过中指弯曲取中节指骨角来测量身高的说法，但人体受纳水谷的具体容量（升合），却截然不同。由此可见，我们读书，关键在于圆通灵活，不可拘泥于既定的学说。
阅读张景岳《新方八阵》中关于大温中饮方下的注释，其中有“从补血而发散，体现出云腾致雨的精妙，这是张仲景所未及的”这句话，我私下认为，在伤寒方剂中，张仲景使用炙甘草汤，含有桂枝、酒、地黄、麦冬、阿胶、麻黄等药物，这不正是阳气根植于阴液，汗液化生于津液，体现云腾致雨精妙的例子吗？不能说是张仲景未能达到这种境界。
Recently, the condition of Dan Sha (a acute infectious disease characterized by sore throat and skin rash) has been very common among patients, and many have died from it. Because medical texts have not adequately covered this condition, practitioners find themselves at a loss for treatment methods. Some advocate acrid-dispersing methods, some advocate cooling-resolving methods, and some advocate bitter-cold herbs to drain heat. All these approaches are based on subjective assumptions, with each practitioner sticking to their own specialty, without ever exploring the root cause of the disease.
According to Zhang Zhongjing's *Jin Gui Yao Lue* (*Essential Prescriptions of the Golden Cabinet*), "The disease of Yang Du (a category of diseases caused by pathogenic yang-heat toxins) presents with a red face and mottled rashes like brocade patterns, sore throat, and vomiting of pus and blood. If treated within five days, it is curable; if after seven days, it is difficult to cure. Shengma Biejia Tang (Cinnamon Twig and Turtle Shell Decoction) should be used." Carefully analyzing the meaning of this text, it is actually very similar to Dan Sha. Why are there so few people who can grasp its essence?
As for Shengma Biejia Tang, it primarily uses Shengma (Rhizoma Cimicifugae) to ascend and vent toxic pathogens, Biejia (Carapax et Plastrum Testudinis) to clear heat and preserve spirit, Danggui (Radix Angelicae Sinensis) to harmonize blood and regulate Ying (nutritive qi), and Gancao (Radix Glycyrrhizae) to purge fire and detoxify. This aligns perfectly with the principle in *Huangdi Neijing* (*The Yellow Emperor's Inner Canon*): "When heat dominates internally, treat with salty-cold substances, assisted by sweet-bitter ones." The formula contains Shujiao (Fructus Zanthoxyli) and Xionghuang (Realgar), which seem more appropriate for Yin Du (Yin toxin) formulas, possibly due to transcription errors during copying. A slight shift in perspective makes the distinction between Yang Du and Yin Du even more precise, reducing hesitation and fear among those using the formula. Therefore, when encountering Dan Sha today, one should carefully examine the classic principles rather than claiming that ancients did not address this condition. Presuming my ignorance, I dare to submit this for discussion with fellow practitioners.
Reading Chapter 42 of *Nan Jing* (*Classic of Difficult Issues*), which discusses the length, weight, width, and capacity of zang-fu organs, I privately believe this is not necessarily accurate. For instance, human body weights and heights vary, as do dietary intakes; thus, generalizations cannot be rigidly applied. Even if there are theories about measuring height by bending the middle finger to measure the middle joint, the actual volume (sheng/he units) of water and grain retained by individuals differs significantly. This shows that when studying texts, we must remain flexible and open-minded, avoiding dogmatic adherence to established doctrines.
In Zhang Jingyue's *Xin Fang Ba Zhen* (*New Formulas of the Eight Arrays*), under the description of Da Wen Zhong Yin (Great Warming Middle Drink), it states: "From nourishing blood to dispersing, achieving the wonder of clouds rising and rain falling, a level Zhang Zhongjing had not reached." I respectfully disagree. In treating cold damage (Shang Han), Zhang Zhongjing used Zhigancao Tang (Prepared Licorice Decoction), containing Guizhi (Ramulus Cinnamomi Cassiae), wine, Dihuang (Radix Rehmanniae Preparata), Maidong (Rhizoma Ophiopogonis), Ejiao (Colla Corii Asini), and Mahuang (Herba Ephedrae). Is this not precisely the manifestation of yang rooted in yin, and sweat transforming from fluids—the wonder of clouds rising and rain falling? It cannot be said that Zhang Zhongjing failed to achieve this.