巢氏云∶小儿恶核者，乃风热毒瓦斯，与血气相搏，结成顽核，生于项颈，遇风寒所折，不消结成瘰 ，久而溃脓成
疮者也。凡有此症，宜服清凉饮子及升麻汤等药，汤氏贴恶核瘰 各有妙方。千金连翘丸、千金龙胆汤皆可服。
清凉饮子 见第四十问。
连翘丸 治小儿无故寒热，强健如故，而身体颈项结核瘰 ，及肠胁背里有坚核不痛，名为结风气肿。
连翘 桑白皮 白头翁 牡丹皮 防风 黄柏 桂心 香豉 独活 秦艽（各半两） 海藻（二钱半）
上为末，炼蜜为丸如梧桐子大，每服十丸或二十丸，灯心汤下。
千金龙胆汤 见第三问。
大圣散 治瘰 ，消风毒肿，上壅内热，多生瘾疹，风丹风证。食煎爆多致此疾。
羌活 荆芥 升麻 薄荷 防风 甘草 大黄 黄芩 玄参（各等分） 或加赤芍药、连翘
上各等分为末，每二钱，水一盏，煎六分温服。又方用牡蛎二两、火 为末，玄参一两，甘草半两为末，每二钱，
清茶调下。
百问云∶发斑有两证，有温毒发斑，有胃烂发斑也。温毒发斑者，为冬月温暖，人感乖戾之气，未即病发，至春或
被积寒所折，毒瓦斯不得泄，至天气暄热，温毒始发，则肌肉斑烂瘾疹如绵纹，其治用葛根橘皮汤、黄连橘皮汤主之。若
胃烂发斑者、伤寒未下即发斑，下早亦发斑，盖不当下而下之，热气乘虚入胃，当下失下，则胃热不得泄，所以皆发斑
也。凡发斑不可用表药，盖表虚里实，若发其汗，重令开泄，更增斑烂，表虚故也，玄参升麻汤、化斑汤主之。伤寒发
斑，只是热气在脏腑，先攻肠胃，里蕴成疮，方发出外，赤者易治，黑者难治，盖毒瓦斯入胃之深故也，羌活散加蝉蜕治
斑亦可。
葛根橘皮汤 治冬温，未即病，春被积寒所折，不得发泄，至天气暄热，其温毒始发，肌中斑烂瘾疹如绵纹，
咳嗽心闷，但呕吐清汁，服此药即静。兼治小儿麻痘疮。
葛根 陈皮 杏仁（去皮尖） 麻黄（去节） 知母 黄芩 甘草（各半两）
上锉散，白水煎，有热不吐，去陈皮。冷证去黄芩、知母。
黄连橘皮汤 治温毒发斑，兼治麻证，泄泻并去血。
黄连（一两） 陈皮 杏仁（去皮尖） 枳实（炒） 麻黄（去节） 葛根（各半两） 浓朴（制） 甘草（炙、
各一钱半）
上锉散，每服二钱，白水煎服，亦治烦渴，或不用浓朴、甘草。
玄参升麻汤 治伤寒、发汗吐下后，毒瓦斯不散，表虚里实，热发于外，故身斑如绵纹状，甚则烦躁谵语。兼治
喉闭肿痛。
玄参 升麻 甘草（炙、各半两）
上锉散，每服二钱，水一盏，煎六分，去滓服。又煎升麻汤，内加玄参亦可。
化斑汤
人参 石膏 葳蕤 知母 甘草（各二钱半）
上锉散，每服二钱，水一盏，入糯米半合，煎六分，米熟为度，温服。
羌活散 见第二十问人参羌活散。
巢元方说：小儿恶核，是风热毒气与血气相互搏结，形成坚硬的核块，生于颈部，若遇风寒侵袭，不能消散，进而结成瘰疬，日久溃烂化脓成为疮疡。凡是出现这种症状，适宜服用清凉饮子及升麻汤等药物，汤氏针对恶核瘰疬各有妙方。千金连翘丸、千金龙胆汤都可以服用。
清凉饮子 见第四十问。
连翘丸 治疗小儿无故出现寒热往来，身体强健如常，但颈项部出现结核瘰疬，以及肠胁背部里有坚硬且不痛的核块，这叫做结风气肿。
药材：连翘、桑白皮、白头翁、牡丹皮、防风、黄柏、桂心、香豉、独活、秦艽（各半两），海藻（二钱半）。
以上药物研为细末，用炼蜜制成梧桐子大小的药丸，每次服用十丸或二十丸，用灯心草煎汤送服。
千金龙胆汤 见第三问。
大圣散 治疗瘰疬，消除风毒肿胀，缓解上壅的内热，治疗多发的瘾疹、风丹及风证。因食用煎炸爆炒食物过多容易导致此病。
药材：羌活、荆芥、升麻、薄荷、防风、甘草、大黄、黄芩、玄参（各等分），或者加入赤芍药、连翘。
以上药物各取等分研为细末，每次取二钱，用水一盏，煎至六分，温服。另一方法是用牡蛎二两煅烧后研为细末，玄参一两研为细末，甘草半两研为细末，每次取二钱，用清茶调服。
《婴童百问》说：发斑有两种证候，一种是温毒发斑，一种是胃烂发斑。所谓温毒发斑，是因为冬季气候温暖，人感受了乖戾之气，当时没有立即发病，到了春季又被积寒所遏制，毒气无法宣泄，等到天气炎热时，温毒才开始发作，此时肌肉出现斑烂和瘾疹，状如绵纹，治疗使用葛根橘皮汤、黄连橘皮汤为主。如果是胃烂发斑，则是伤寒病未经攻下就发斑，攻下过早也会发斑，大概是因为不应当攻下而误用了攻下法，热气乘虚进入胃中；或者应当攻下却未能及时攻下，导致胃热无法宣泄，所以都会发斑。凡是发斑都不可使用解表药，因为这是表虚里实的证候，如果发汗，会再次导致腠理开泄，加重斑烂，这是因为表虚的缘故，治疗使用玄参升麻汤、化斑汤为主。伤寒发斑，只是热气在脏腑之中，先攻治肠胃，里热蕴结形成疮疡，然后才发出体外，颜色红的容易治疗，颜色黑的难治，这是因为毒气深入胃部的缘故，羌活散加蝉蜕治疗发斑也可以。
葛根橘皮汤 治疗冬温病，当时未立即发病，春季被积寒所遏制，无法发泄，等到天气炎热，温毒开始发作，肌肤中出现斑烂和瘾疹，状如绵纹，伴有咳嗽胸闷，只呕吐清稀汁液，服用此药即可平静。兼治小儿麻疹痘疮。
药材：葛根、陈皮、杏仁（去皮尖）、麻黄（去节）、知母、黄芩、甘草（各半两）。
以上药物切碎成散剂，用清水煎煮，如果有热象且不呕吐，去掉陈皮。如果是冷证，去掉黄芩、知母。
药材：黄连（一两）、陈皮、杏仁（去皮尖）、枳实（炒）、麻黄（去节）、葛根（各半两）、浓朴（制）、甘草（炙，各一钱半）。
以上药物切碎成散剂，每次服用二钱，用清水煎服，也治疗烦渴，或者不用浓朴、甘草。
玄参升麻汤 治疗伤寒，经过发汗、催吐、攻下之后，毒气不散，表虚里实，热气发于体表，所以身上出现像绵纹一样的斑，严重时烦躁谵语。兼治喉闭肿痛。
以上药物切碎成散剂，每次服用二钱，用水一盏，煎至六分，去渣服用。另外煎煮升麻汤，加入玄参也可以。
以上药物切碎成散剂，每次服用二钱，用水一盏，加入糯米半合，煎至六分，米熟为止，温服。
Chao Yuanfang stated: Xiao'er Ehe (pediatric hard nodules) refers to wind-heat toxic qi clashing with blood and qi, forming stubborn nodules that arise in the neck. If affected by wind-cold, they fail to dissipate and develop into Luoli (scrofula), which eventually ulcerate and suppurate over time. For such symptoms, it is appropriate to administer Qingliang Yinzi (Cooling Decoction) and Shengma Tang (Cimicifuga Decoction), among other medicines. Tang Shi had various effective prescriptions for Ehe and Luoli. Qianjin Lianqiao Wan (Million Gold Forsythia Pill) and Qianjin Longdan Tang (Million Gold Gentian Decoction) are also suitable.
Qingliang Yinzi (Cooling Decoction) - See Question 40.
Lianqiao Wan (Forsythia Pill): Treats children who experience unexplained alternating chills and fever yet remain physically robust, but present with tubercles and scrofula in the neck, as well as hard, painless nodules within the intestines, hypochondrium, and back. This condition is termed Jie Fengqi Zhong (accumulation of wind-qi swelling).
Ingredients: Lianqiao (Forsythiae Fructus), Sangbaipi (Mori Cortex), Baitouweng (Pulsatillae Radix), Mudanpi (Moutan Cortex), Fangfeng (Saposhnikoviae Radix), Huangbai (Phellodendri Cortex), Guixin (Cinnamomi Ramulus), Xiangchi (Fermented Soybean), Duhuo (Angelicae Pubescentis Radix), Qinjiao (Gentianae Macrophyllae Radix) [each 15g], Haizao (Sargassum) [8g].
Grind all ingredients into powder, mix with refined honey to form pills the size of paulownia seeds. Take 10 or 20 pills per dose, washed down with Dengxin Tang (Juncus Decoction).
Qianjin Longdan Tang (Million Gold Gentian Decoction) - See Question 3.
Dasheng San (Great Sage Powder): Treats Luoli (scrofula), dissipates wind-toxic swelling, relieves internal heat rising upward, and treats frequent urticaria, wind-dan (wind wheals), and wind syndromes. Excessive consumption of fried and roasted foods often causes this disease.
Ingredients: Qianghuo (Notopterygii Rhizoma et Radix), Jingjie (Schizonepetae Spica), Shengma (Cimicifugae Rhizoma), Bohe (Menthae Haplocalycis Herba), Fangfeng (Saposhnikoviae Radix), Gancao (Glycyrrhizae Radix et Rhizoma), Dahuang (Rhei Radix et Rhizoma), Huangqin (Scutellariae Radix), Xuanshen (Scrophulariae Radix) [equal parts], optionally add Chishao Yao (Paeoniae Radix Rubra) and Lianqiao (Forsythiae Fructus).
Grind equal parts into powder. Take 6g per dose, decoct with 200ml water until reduced to 120ml, and take warm. Another method uses Muli (Ostreae Concha) 60g calcined and powdered, Xuanshen (Scrophulariae Radix) 30g powdered, and Gancao (Glycyrrhizae Radix et Rhizoma) 15g powdered. Take 6g per dose, mixed with clear tea.
The text "Baiwen" states: There are two types of Fa Ban (maculopapular eruption): Wendu Fa Ban (warm-toxin maculopapular eruption) and Weilan Fa Ban (stomach-rot maculopapular eruption). Wendu Fa Ban occurs when mild winter weather allows people to contract aberrant qi. The illness does not manifest immediately; by spring, accumulated cold obstructs the release of toxins. When the weather becomes hot, the warm-toxin erupts, causing muscle tissue to rot with eruptions resembling cotton patterns. Treatment primarily uses Gegen Jupi Tang (Pueraria and Tangerine Peel Decoction) and Huanglian Jupi Tang (Coptis and Tangerine Peel Decoction).
If Weilan Fa Ban occurs, it happens when Shaoyang Shanghan (cold damage syndrome) presents with eruptions before purgation, or if purgation is performed too early. Generally, purging when not indicated allows heat qi to enter the stomach due to deficiency; conversely, failing to purge when indicated prevents stomach heat from escaping. Thus, eruptions occur in both cases. In all cases of Fa Ban, exterior-releasing herbs should not be used because the pattern involves deficient exterior and excess interior. Sweating further opens the pores, worsening the eruptions due to the deficient exterior. Treatment primarily uses Xuanshen Shengma Tang (Scrophularia and Cimicifuga Decoction) and Huaban Tang (Resolve Maculae Decoction).
In Shaoyang Shanghan, Fa Ban results from heat qi residing in the zang-fu organs. One must first attack the intestines and stomach; once interior accumulation forms sores, they emerge externally. Red eruptions are easier to treat; black eruptions are difficult, indicating deep penetration of toxic qi into the stomach. Qianghuo San (Notopterygium Powder) added with Chantui (Cicada Slough) can also treat eruptions.
Gegen Jupi Tang (Pueraria and Tangerine Peel Decoction): Treats Dongwen (winter-warmth disease). Initially asymptomatic, it is obstructed by accumulated cold in spring, preventing release. When weather heats up, warm-toxin erupts, causing skin eruptions resembling cotton patterns, cough, chest oppression, and vomiting of clear fluid. Administration brings calmness. It also treats pediatric measles and smallpox.
Ingredients: Gegen (Puerariae Lobatae Radix), Chenpi (Citri Reticulatae Pericarpium), Xingren (Armeniacae Semen Amarum, peeled and tip removed), Mahuang (Ephedrae Herba, nodes removed), Zhimu (Anemarrhenae Rhizoma), Huangqin (Scutellariae Radix), Gancao (Glycyrrhizae Radix et Rhizoma) [each 15g].
Cut into pieces for decoction in plain water. If there is heat without vomiting, remove Chenpi. For cold patterns, remove Huangqin and Zhimu.
Huanglian Jupi Tang (Coptis and Tangerine Peel Decoction): Treats Wendu Fa Ban (warm-toxin maculopapular eruption), also treats measles, diarrhea, and bloody stool.
Ingredients: Huanglian (Coptidis Rhizoma) [30g], Chenpi (Citri Reticulatae Pericarpium), Xingren (Armeniacae Semen Amarum, peeled and tip removed), Zhishi (Aurantii Fructus Immaturus, stir-fried), Mahuang (Ephedrae Herba, nodes removed), Gegen (Puerariae Lobatae Radix) [each 15g], Houpo (Magnoliae Officinalis Cortex, processed), Gancao (Glycyrrhizae Radix et Rhizoma, honey-fried) [each 4.5g].
Cut into pieces for decoction. Take 6g per dose, decoct in plain water. Also treats irritability and thirst. Alternatively, omit Houpo and Gancao.
Xuanshen Shengma Tang (Scrophularia and Cimicifuga Decoction): Treats Shaoyang Shanghan after sweating, vomiting, or purging, where toxic qi has not dispersed. The exterior is deficient while the interior is excess, causing heat to manifest externally as maculae resembling cotton patterns. Severe cases involve restlessness and delirium. Also treats Hou Bi (throat closure) with swelling and pain.
Ingredients: Xuanshen (Scrophulariae Radix), Shengma (Cimicifugae Rhizoma), Gancao (Glycyrrhizae Radix et Rhizoma, honey-fried) [each 15g].
Cut into pieces. Take 6g per dose, decoct with 200ml water until reduced to 120ml, strain, and take. Alternatively, decoct Shengma Tang and add Xuanshen.
Huaban Tang (Resolve Maculae Decoction)
Ingredients: Renshen (Ginseng Radix et Rhizoma), Shigao (Gypsum Fibrosum), Wei Yu (Polygonati Odorati Rhizoma), Zhi Mu (Anemarrhenae Rhizoma), Gancao (Glycyrrhizae Radix et Rhizoma) [each 7.5g].
Cut into pieces. Take 6g per dose, decoct with 200ml water and half a he of glutinous rice until the rice is cooked. Take warm.
Qianghuo San (Notopterygium Powder) - See Ren Shen Qiang Huo San (Ginseng and Notopterygium Powder) in Question 20.