寿一旦为俗医所误者，可不痛哉！大抵斑疹之候，始觉多咳嗽，身体温壮，面色与四肢俱赤，头痛腰疼，眼睛
黄色，多睡，睡中螈 ，手足厥，耳尖及尻冷，小便赤、大便秘，三部脉洪数、绝大不定，是其候也。其乳下
儿可兼令乳母服药。其证候未全或未明者，但可与升麻散解之；其已明者，即可用大黄青黛散等凉药下之，次
即与白虎汤。（升麻、白虎二方并见疮疹已出未出门。）如秋冬及春寒未用白虎汤之时，但加枣煎服，
不必拘于常法。仲景云∶四
月后天气大热，即可服白虎汤，（方同前。）特言其梗概耳。大率疹 未出，即可下；已出，即不可下；出定，即宜
利大小便。其已出未快者，可与紫草散（方见疮疹出不快门、）救生散、玳瑁散之类。其重者，
以牛李膏散之。（二方并见疮疹
倒门。）或毒攻咽喉者，可与少紫雪及如圣汤，无不效也。（二方并见疮疹攻咽痛门。）其余热不解，
身热烦渴及病疹儿乳母，
俱可与甘露饮。（方见疮疹后解余毒。）或便血者，以牛黄散治之，（方见疮疹便脓血门。）兼宜常
平肝脏，解其败热。虑热毒攻肝，即
冲于目，内生障翳，不急医治，瞳人遂损，尤宜慎之。然已出未平，切忌见杂人，恐劳力之人及狐臭熏触故也。
未愈不可当风，当风即成疮疥。如脓 出，可烧黑丑粪灰随疮贴之，则患愈而无瘢也。及左右不可缺胡荽，盖
能御汗气、恶气故也。如儿能食物，可时更少与葡萄，盖能利小便及取如穗、出快之义也。小儿斑疹本以胎中
积热，及将养温浓，偶胃中热，故乘时而作。《外台》方云∶胃烂即发斑，微者，赤斑出；极者，黑斑出。赤斑
出，五死一生。黑斑出，十死一生。其腑热即为疹，盖热浅也。脏热即为 ，盖热深也。故《证色论》云∶大
者属阴，小者属阳。汲总角而来，以多病之故，因而业医。近年累出诸处治病。当壬申岁，冬无大雪，天气盛
温，逮春初，见小儿多病斑疹，医者类如前说，如投以白虎汤之类，即窃笑云∶白虎汤本治大人，盖不知孙真
人所论大人、小儿为治不殊，但用药痢有多少为异耳，则是未知用药之法，故多失误。今传选诸家及亲经用有
效者，备录为书。
《刘氏家传》∶初虞世以涎比山泽之气，非也。山泽气蒸润而已，故虽山石，气亦能到。譬如，釜上甑蒸气
亦蒸润内外，渗漉涎则浓浊滞碍，非山泽之气可比，中风人涎如鳔胶挽不断，又岂能入关节？初虞世所着《必
用方》大有益于世。虽是谓中风不可吐；又谓小儿疮疹当转泻。此二说误人甚多。小儿疮疹转泻则虚，毒瓦斯内
攻，百无一生。
《张氏家传》惺惺散，出和剂方，小儿伤寒壮热，当先服此药，极验。次服人参羌活散。如壮热未退，切不
可与通利大便及凉药，恐是疮疹。如吃凉药，误矣。
寿（人名）一旦因被庸医误治，难道不令人痛心吗！大抵斑疹的证候，初起时常伴有咳嗽，身体发热且壮热，面色及四肢均发红，头痛腰痛，眼睛发黄，嗜睡，睡眠中抽搐，手足厥冷，耳尖及尾骶部发凉，小便色赤、大便干结，寸关尺三部脉象洪大而数、或极大且不规律，这就是其证候表现。对于吃奶的婴儿，可以同时让乳母服药。如果证候尚未完全显现或尚不明确，只可用升麻散来解表透疹；如果证候已经明显，即可用大黄青黛散等寒凉药物泻下通便，随后立即给予白虎汤。（升麻散、白虎汤两方详见“疮疹已出未出门”章节。）如果是秋冬季节以及春季寒冷时，在未使用白虎汤的时候，只需加入大枣煎服，不必拘泥于常规法则。张仲景说：四月以后天气大热，就可以服用白虎汤，（方剂同前。）这仅仅是概括性地说明罢了。大致原则是：疹子未发出时，即可用泻下法；疹子已发出，就不可再用泻下法；疹子出定之后，就应当通利大小便。对于已经发出但出不畅快的，可与紫草散（方见“疮疹出不快门”）、救生散、玳瑁散之类的药物。病情严重的，用牛李膏消散毒。（这两方详见“疮疹倒门”。）如果有毒邪攻冲咽喉的，可少量配合紫雪和如圣汤服用，没有不有效的。（这两方详见“疮疹攻咽痛门”。）其余热不解，身体发热烦躁口渴以及患斑疹小儿的乳母，都可以给予甘露饮。（方见“疮疹后解余毒”。）如果有便血的，用牛黄散治疗，（方见“疮疹便脓血门。”）同时适宜平抑肝脏之气，解除体内的败热。担心热毒攻入肝脏，就会上冲于眼睛，内生翳障，如果不及时医治，瞳孔就会受损，尤其需要谨慎。然而疹子已出但未平复期间，切忌接触闲杂人等，恐怕劳累之人及狐臭者的气息熏触所致。病未痊愈不可迎风，迎风就会变成疮疥。如果脓液流出，可以烧黑丑粪灰随疮贴敷，那么患处愈合且不留瘢痕。在患儿左右不可缺胡荽，因为它能抵御汗气、恶气。如果孩子能吃食物，可以偶尔少量给予葡萄，因为它有利小便及促使疹子像穗一样顺利、快速发出的作用。小儿斑疹本来是因为胎中积热，加上养育时衣着过暖过厚，偶然导致胃中热盛，所以乘时而发作。《外台秘要》方说：胃烂就会发斑，轻的，出现赤斑；极重的，出现黑斑。出现赤斑，十死中救活一个。出现黑斑，十死中救活一个。腑热就是疹，因为热势浅。脏热就是痘（此处指天花或重症疱疹），因为热势深。所以《证色论》说：大的属阴，小的属阳。我汲总角而来，因为多病的缘故，因而从事医学。近年来多次在各处治病。当壬申年，冬天没有大雪，天气异常温暖，到了春初，看到很多小儿患斑疹，医生们大多像前面所说的那样，比如投以白虎汤之类，我就私下嘲笑说：白虎汤本是治疗大人的，大概不知道孙思邈论述大人、小儿治疗并无不同，只是用药剂量有差异而已，这是不懂得用药的方法，所以多有失误。现在选录各家及亲自验证有效的方剂，详细记录成书。
《刘氏家传》：初虞世将痰涎比作山泽之气，是不对的。山泽之气只是蒸腾湿润而已，所以即使是山石，气息也能到达。譬如，锅上的甑中蒸气也是内外蒸腾湿润，而渗漉出的痰涎则浓浊滞碍，不能与山泽之气相比，中风病人的痰涎像鳔胶一样拉不断，又怎么能进入关节呢？初虞世所著的《必用方》对世间大有益处。虽然他说中风不可吐；又说小儿疮疹应当转泻。这两种说法误导了很多人。小儿疮疹如果转泻则会导致正气虚弱，毒瓦斯内攻，百无一活。
《张氏家传》：惺惺散，出自《太平惠民和剂局方》，小儿伤寒壮热，应当先服用此药，极为灵验。其次服用人参羌活散。如果壮热未退，切不可给予通利大便及寒凉药物，恐怕是疮疹。如果吃了寒凉药物，就错了。
Shou (a person's name) was once mistakenly treated by a quack doctor; is this not truly heartbreaking! Generally speaking, the initial symptoms of macules and papules (rash) often include coughing, body temperature rising with high fever, redness of the face and all four limbs, headache and lower back pain, yellowish eyes, excessive sleepiness, convulsions during sleep, cold extremities, cold ear tips and sacrum, dark urine, and constipation. The pulse at the cun, guan, and chi positions on both wrists is surging, rapid, extremely large, and irregular. These are the characteristic signs. For infants who are still nursing, the mother may also take the medicine concurrently. If the symptoms are not yet fully manifested or are unclear, only Shengma San (Cimicifugae Powder) should be used to resolve the exterior and vent the rash; if the symptoms are already clear, cooling purgatives such as Dahuang Qingdai San (Rhubarb and Indigo Naturalis Powder) can be used to purge heat via the bowels, followed immediately by Baihu Tang (White Tiger Decoction). (Both Shengma San and Baihu Tang are detailed in the chapter "Macules and Papules: After Eruption but Not Yet Fully Out.") In autumn and winter, or during spring when it is still cold, before using Baihu Tang, one may simply add dates for decoction, without strictly adhering to conventional methods. Zhang Zhongjing stated: "After the fourth month, when the weather becomes very hot, Baihu Tang can be administered." (The formula is the same as above.) This is merely a general guideline. In principle, if the rash has not yet erupted, purgation may be used; if it has erupted, purgation should be avoided; once the eruption is established, promoting urination and defecation is appropriate. For those that have erupted but are not coming out smoothly, Zicao San (Arnebiae Powder), Jiusheng San (Life-Saving Powder), or Dai Mao San (Trionyx Powder) may be given. For severe cases, Niuli Gao (Ox Plum Ointment) can be used to dissipate toxicity. (Both formulas are detailed in the chapter "Macules and Papules: Inverted/Receding.") If toxic heat attacks the throat, a small amount of Zixue (Purple Snow) combined with Rusheng Tang (Like-Sage Decoction) can be administered, which is invariably effective. (Both formulas are detailed in the chapter "Macules and Papules: Attacking the Throat causing Pain.") For residual heat that does not resolve, accompanied by fever, restlessness, thirst, or for the nursing mothers of children with rashes, Ganlu Yin (Sweet Dew Drink) is suitable. (Formula detailed in "Resolving Residual Toxicity after Macules and Papules.") If there is blood in the stool, Niuhuang San (Calculus Bovis Powder) should be used for treatment. (Formula detailed in "Macules and Papules: Pus and Blood in Stool.") Simultaneously, it is advisable to soothe the Liver Qi and resolve stagnant heat. One must worry about toxic heat attacking the Liver, which could then rush upward to the eyes, causing internal opacities (cataracts/pannus); if not treated urgently, the pupil will be damaged, so extra caution is required. However, while the rash has erupted but is not yet settled, it is strictly forbidden to contact unrelated people, lest the exertion of laborers or the odor of fox-smell individuals cause irritation. Until recovery, exposure to wind must be avoided, as wind exposure will lead to sores and scabies. If pus discharges, burning black Choufen (Semen Phaseoli Tomentelli Ash) and applying it to the sore will result in healing without scarring. Around the patient, Coriandrum sativum (Hu Sui) should never be lacking, as it can repel sweat odor and foul air. If the child can eat solid food, grapes may be given occasionally in small amounts, as they promote urination and facilitate the smooth and rapid eruption of the rash like an ear of grain. Pediatric macules and papules are originally caused by accumulated heat in the fetus, combined with over-warming during upbringing, leading to sudden stomach heat that erupts at the opportune time. The *Waitai Mi Yao* states: "When the stomach rots, macules appear; mild cases show red macules; extreme cases show black macules." Red macules indicate five deaths for every one survival. Black macules indicate ten deaths for every one survival. Heat in the fu organs results in papules (zhen), indicating shallow heat. Heat in the zang organs results in pustules/variolae (dou), indicating deep heat. Therefore, the *Zheng Se Lun* states: Large lesions belong to Yin, small lesions belong to Yang. I, Ji, came of age early; due to frequent illness, I took up medicine. In recent years, I have practiced in various places. During the Ren Shen year, there was no heavy snow in winter, and the weather was unusually warm. By early spring, many children were suffering from macules and papules. Physicians generally followed the aforementioned methods, such as administering Baihu Tang. I secretly laughed, thinking: "Baihu Tang is intended for adults." They did not realize that Sun Simiao argued that the treatment principles for adults and children are not different, only the dosage varies. This ignorance of dosing methods leads to many errors. Now, I have selected formulas from various schools and those personally verified as effective, compiling them into this book.
*Liu Family Tradition*: Chu Yushi compared phlegm-saliva to the qi of mountains and marshes, which is incorrect. Mountain and marsh qi is merely steaming and moistening; thus, even mountain rocks can be permeated by it. For example, steam from a steamer pot moistens both inside and out. However, excreted phlegm-saliva is thick, turbid, and obstructive, unlike mountain and marsh qi. Phlegm-saliva in stroke patients is like fish bladder glue, unbreakable; how could it enter the joints? Although Chu Yushi’s *Bi Yong Fang* (Essential Formulas) is highly beneficial to the world, his assertion that stroke patients should not be vomited and that pediatric macules/papules should be converted into diarrhea are two statements that have misled many. Converting pediatric macules/papules into diarrhea causes deficiency, allowing toxic qi to attack internally, resulting in death in nearly all cases.
*Zhang Family Tradition*: Xingxing San (Awakening Powder), originating from the *Tai Ping Hui Min He Ji Ju Fang*, is extremely effective as the first medication for children with typhoid fever and high fever. It should be followed by Renshen Qianghuo San (Ginseng and Notopterygium Powder). If high fever persists, do not administer laxatives or cooling medicines, lest it be mistaken for macules/papules. Administering cooling medicines in this case would be a mistake.