经曰∶诸痛痒疮疡，皆属心火。
按∶疮疖疥癣，小儿独多。由胎毒淫火使然也。治之者，宜清热解毒，使之外出可也。倘医者视为泛常，
不先内托解毒，误用砒、硫毒药搽之，逼毒内入，以致疮忽自平，其证腹胀便闭，身无血色，目闭不开，手足
动摇。此毒瓦斯内攻也。
此条与方脉之发背痈疽，偶伤风湿，而手足搐搦，角弓反张者，大不相侔。盖彼因误伤风湿而病痉，此因
误用搽敷而致搐。病因不同，治宜各别。速服雄黄解毒丸微下之，疮出则吉，疮不出如喘者死。
雄黄解毒丸 治疮疡毒瓦斯内攻，腹胀便闭，身无血色，目闭不开。并能解一切疮疥之毒，更可下痰追
虫打积。
明雄黄（一钱） 川郁金（二钱） 巴豆霜（一钱）
上为细末，醋打米糊为丸，绿豆大。每服三五丸，白汤送下，以利为度。
痘禀先天胎元之毒，遇时行而即发，其证初起，两眼含泪，珠如水晶，鼻气出粗，睡中惊惕，两耳纹现，
恶热不恶寒，痘证也。
按∶初起发热三四日间，应与疏通腠理，微解表邪，使毒瓦斯易出；若不行疏散，以致腠理固闭，热盛神昏
而搐矣。此常候也。先宜人参败毒散升散之，次用导赤散加朱砂，以制其猖撅。痘出则吉，屡搐者凶。
收靥后作搐，此痘毒倒陷，雄黄解毒丸紫草汤下。痘复出者吉，搐不止者凶。五六卷痘疹门论证最详，
宜考。
《幼幼集成》中记载的沆瀣丹，其方剂内容见本书第二卷“胎病论”章节。
磁锋砭法（一种用磁石磨成的针具刺破皮肤放血或排毒的外治法），其操作方法见本书第四卷“丹毒证治”章节。
《黄帝内经》中说：各种疼痛、瘙痒、疮疡，都归属于心火。
按语：疖子、痈疽、疥疮、癣疾，在小儿身上最为多见。这是由于胎毒和淫火所致。治疗时，应当采用清热解毒的方法，使毒邪从体表排出即可。如果医生将其视为寻常小病，不先采用内托解毒之法，反而误用砒霜、硫磺等毒药进行外敷涂抹，逼迫毒邪向内侵入，导致疮疡突然平塌消失，出现腹部胀满、大便闭塞、面色苍白无血色、眼睛紧闭不开、手足动摇等症状。这是毒瓦斯向内攻冲的表现。
这一条所述情况，与内科脉证中的发背痈疽，或因偶然感受风湿之邪而导致手足抽搐、角弓反张（身体向后弯曲如弓状）的情况，大不相同。因为后者是因误伤风湿而引发痉病，前者是因误用外敷药物而导致抽搐。病因不同，治疗方法也应当区别对待。此时应迅速服用雄黄解毒丸，使其轻微泻下，若疮疡能重新发出则预后良好，若疮不出且出现喘息症状则预后不良。
雄黄解毒丸：用于治疗疮疡毒瓦斯内攻，症见腹部胀满、大便闭塞、面色苍白无血色、眼睛紧闭不开。并能解除一切疮疥的毒邪，还可用于下痰、驱虫、消积。
配方：明雄黄（一钱）、川郁金（二钱）、巴豆霜（一钱）。
将上述药材研成细末，用醋调和米糊制成丸药，大小如绿豆。每次服用三至五丸，用白开水送服，以大便通畅为度。
痘疹禀受先天胎元之毒，遇到时行疫气就会发作。其初期症状表现为：两眼含泪，眼珠像水晶一样明亮，鼻息粗重，睡眠中惊悸惕动，耳后纹现出，怕热不怕冷，这是痘证的特征。
按语：在初起发热三四天期间，应当采用疏通腠理（皮肤毛孔及皮下组织间隙）、轻微解表散邪的方法，使毒邪容易排出；如果不进行疏散，导致腠理固闭，热势亢盛导致神志昏迷并引发抽搐，这是常见的病情变化。此时应先用人参败毒散来升散透毒，随后使用导赤散加入朱砂，以制约毒邪的猖獗。若痘疹顺利发出则预后良好，反复抽搐者预后凶险。若在痘疹收靥（结痂脱落）后出现抽搐，这是痘毒内陷倒伏的表现，应用雄黄解毒丸配合紫草汤送服。若痘疹再次发出则预后良好，抽搐不止者预后凶险。第五、六卷“痘疹门”中对相关论证最为详细，宜参考查阅。
The *Hangxie Dan* (Hanging Mist Pill) recorded in *Youyou Jicheng* can be found in the "Fetal Disease Discussion" chapter of Volume 2.
The *Cifeng Bianfa* (Magnetic Point Method) is described in the "Treatment of Erysipelas and Toxemia" chapter of Volume 4.
The *Classic of Medicine* states: All pain, itching, sores, and ulcers belong to Heart Fire.
Commentary: Boils, abscesses, scabies, and tinea are most common in children. This is caused by fetal toxins and excessive fire. Treatment should employ clearing heat and detoxifying methods to allow the pathogenic factors to exit from the exterior. If physicians treat it as a trivial matter and fail to first use internal support and detoxification, but instead mistakenly apply toxic medicines such as Realgar (Realgar) or Sulfur externally, they may force the toxin inward. This results in the sudden flattening of sores, accompanied by abdominal distension, constipation, pallor, closed eyes that cannot open, and trembling of the limbs. This indicates the internal attack of toxic vapors.
This condition differs significantly from cases in internal medicine pulse-syndrome differentiation where carbuncles on the back occur, or where accidental exposure to wind-dampness leads to limb spasms and opisthotonos (body bent backward like a bow). The latter arises from wind-dampness causing spasm disease, whereas the former results from spasms due to mistaken external application. Since the etiologies differ, treatments must also differ. One should quickly administer *Xionghuang Jiedu Wan* (Realgar Detoxification Pill) to induce mild purgation. If the sores re-emerge, the prognosis is auspicious; if the sores do not emerge and wheezing occurs, the prognosis is fatal.
*Xionghuang Jiedu Wan*: Treats internal attack of toxic vapors from sores and ulcers, characterized by abdominal distension, constipation, pallor, and closed eyes. It can also resolve toxins from all types of sores and scabies, and further aids in expelling phlegm, driving out parasites, and resolving accumulations.
Ingredients: Ming Xionghuang (Realgar, 1 qian), Chuan Yujin (Curcuma Aromatica Rhizome, 2 qian), Badou Shuang (Croton Seed Frost, 1 qian).
Grind the above ingredients into a fine powder. Use vinegar to mix with rice paste to form pills, sized like mung beans. Take three to five pills each time, swallowed with warm water. Stop when bowel movement becomes smooth.
Varicella (Smallpox/Chickenpox) inherits the toxicity of the congenital fetal origin. When encountering epidemic pathogens, it manifests immediately. Initial symptoms include: eyes filled with tears, pupils shining like crystal, coarse nasal breathing, startle during sleep, appearance of ear veins, aversion to heat without aversion to cold. These are characteristics of varicella.
Commentary: During the initial fever lasting three to four days, one should employ methods to unblock the couli (skin pores and interstitial spaces) and slightly release exterior pathogens, facilitating the expulsion of toxic vapors. If dispersal is not performed, leading to the closure of couli, intense heat causing coma and spasms, this represents a common progression. Initially, *Renshen Baidu San* (Ginseng Detoxification Powder) should be used to ascend and disperse, followed by *Daochi San* (Guide Out Red Powder) added with Cinnabar to restrain the rampant toxin. If the rash emerges smoothly, the prognosis is auspicious; frequent spasms indicate a ominous prognosis. If spasms occur after the rash has crusted over, this indicates the reversal and sinking of varicella toxin. Administer *Xionghuang Jiedu Wan* with Zicao Tang (Arnebia Decoction). If the rash re-emerges, the prognosis is auspicious; continuous spasms indicate an ominous prognosis. Volumes 5 and 6, under the "Varicella and Rash" section, provide the most detailed arguments, which should be consulted.