(状如锦纹,其中有空缺处,如云头样者,为 ,遍身无空处,疏密不等者、为疹)
〔万〕疹一名麻子,君火所为也。(或曰脾为疹)经曰∶少阴所至,为疡疹,在人则心火主之。夫心火亢甚,则
制已所胜,焚灼肺金,肺主皮毛,故疹毒见于皮肤之间,如蚊蚤所咬之状。痘疮只出一般者善,若与疹毒并出,
谓之夹疹,其候极恶,惟痘本稀疏而夹疹者,庶乎可治。疮本稠密,与疹并出,彼此相混,琐碎莫辨,急用辛凉之
药发而解之,如疹毒渐消,疮本磊落者,亦可治也。疹痘相并,毒不少减,此危恶之疾,孰能料其生乎。疮出夹
疹者,荆防败毒散主之,疹毒消者,可治。如疮收靥后复出疹者,此余毒解散之兆,不须治之。
〔薛〕夫疹乃风邪外患,痘为胎毒内发,二证并作,脏腑俱病也。二者相杂,赤晕发 ,痘疮愈盛,误
谓痘出太密,多不可救,然此乃夹疹痘也,当治以人参羌活散,疹毒即解,痘势亦退,其元气亏损,不能
结痂,当补脾胃为急也。〔翁〕痘内夹出丹疹者,不必治之,当以托痘为主,痘出,而疹自消矣。
荆防败毒散
柴胡 甘草 人参 桔梗 川芎 茯苓 枳壳 前胡 羌活 独活 荆芥穗 防风(各等分)
上锉细。加薄荷五叶,水一盏,煎七分,去滓温服。
人参羌活散 治时气痘疹,兼于发表。
人参 羌活 独活 柴胡 前胡 桔梗 茯苓 枳壳 川芎 天麻 甘草 地骨皮(各三分)
上,入薄荷五叶,姜水煎服。
上,表证多者宜之。
清和饮
地骨皮(鲜者) 麦门冬(去心。各二钱) 生地黄 知母 贝母 橘红 茯苓 甘草 荆芥穗(各七分
)牛蒡子(炒、研,一钱半) 桔梗(五分) 全栝蒌(一钱)
上,里证多者宜之。虚者,加人参、黄 。
(皮疹形态像锦缎上的花纹,其中有空隙处,形状像云头一样的,称为“痧”;全身没有空隙处,疏密不等的,称为“疹”。)
〔万全〕疹又名叫麻子,是由君火引起的。(有人说脾引起疹病)《内经》说:少阴经气所至,表现为疮疡和疹,在人体中心脏之火主管它。如果心火亢盛至极,就会克制它所胜的脏腑,焚烧灼伤肺金,肺主皮毛,所以疹毒显现于皮肤之间,像被蚊子、跳蚤叮咬的样子。痘疮只出一种形态的是顺证,如果与疹毒同时发出,称为夹疹,其病情极其凶险,只有痘疮本身稀疏而夹杂疹子的,或许还可以治疗。如果痘疮本身稠密,与疹子一起发出,彼此混杂,琐碎难辨,急需使用辛凉的药物发散解表,如果疹毒逐渐消退,痘疮原本磊落分明者,也可以治疗。疹和痘同时出现,毒邪并不减少,这是危险凶恶的疾病,谁能预料其能否存活呢。痘疮发出时夹杂疹子的,用荆防败毒散主治,疹毒消退后,就可以治疗。如果在痘疮收靥(结痂脱落)后又发出疹子,这是余毒解散的征兆,不需要治疗。
〔薛己〕疹是风邪外患,痘是胎毒内发,两种病症同时发作,脏腑都受病了。两者相互掺杂,赤色晕圈发出,痘疮更加旺盛,误认为是痘出得太密,大多不可救治,然而这是夹疹痘,应当用人参羌活散治疗,疹毒随即解除,痘势也会减退。如果是元气亏损,不能结痂,应当以补益脾胃为急务。〔翁仲仁〕痘疮内部夹杂发出丹疹的,不必专门治疗,应当以托举痘疮为主,痘疮发出后,疹子自然就会消退。
荆防败毒散
柴胡、甘草、人参、桔梗、川芎、茯苓、枳壳、前胡、羌活、独活、荆芥穗、防风(各等分)
以上药材切碎细末。加入薄荷五片,水一盏,煎至七分,去渣温服。
人参羌活散 治疗时气痘疹,兼有发表功效。
人参、羌活、独活、柴胡、前胡、桔梗、茯苓、枳壳、川芎、天麻、甘草、地骨皮(各三分)
以上药材,加入薄荷五片,姜水煎服。
以上方剂,表证多的患者适宜使用。
清和饮
地骨皮(鲜品)、麦门冬(去心,各二钱)、生地黄、知母、贝母、橘红、茯苓、甘草、荆芥穗(各七分)、牛蒡子(炒、研碎,一钱半)、桔梗(五分)、全栝蒌(一钱)
以上药材,里证多的患者适宜使用。体虚者,加人参、黄芪。
(The rash resembles patterns on brocade, with empty spaces in the middle, resembling cloud heads, is termed "Sha" (sand-like rash); those without empty spaces all over the body, varying in density, are termed "Zhen" (measles-like rash).)
[Wan Quan] Zhen is also known as Mazu (smallpox/measles), caused by the Ministerial Fire. (Some say it is caused by the Spleen.) The Classic states: "When Shaoyin [Heart and Small Intestine meridians] qi arrives, it manifests as sores and rashes; in humans, Heart Fire governs it." If Heart Fire becomes hyperactive and extreme, it controls what it overcomes, burning and scorching Lung Metal. Since the Lung governs the skin and hair, the Zhen toxin appears between the skin layers, resembling bites from mosquitoes or fleas. It is auspicious if variola (smallpox) lesions appear uniformly; however, if they erupt simultaneously with Zhen toxin, it is called "Jia Zhen" (complicated measles/smallpox). This condition is extremely malignant. Only when the primary smallpox lesions are sparse while complicated by Zhen can it potentially be treated. If the primary smallpox lesions are dense and erupt together with Zhen, mixing indistinguishably and intricately, urgent treatment with acrid-cool herbs to disperse and resolve is required. If the Zhen toxin gradually subsides and the primary smallpox lesions remain distinct and clear, it can also be treated. When Zhen and variola appear together, the toxin does not decrease; this is a critical and malignant disease, who can predict survival? For cases where variola erupts complicated by Zhen, Jingfang Baidu San (Atractylodes and Saposhnikovia Decoction for Overcoming Toxicity) is the principal formula; once the Zhen toxin subsides, treatment is viable. If Zhen reappears after the variola has crusted and fallen off, this indicates the dispersal of residual toxin and requires no treatment.
[Xue Ji] Zhen is an external pathogenic wind invasion, while variola is an internal eruption of fetal toxin. When both conditions occur simultaneously, the Zang-Fu organs are all affected. When the two mix, red halos appear, and the variola becomes more vigorous. Misinterpreting this as excessively dense smallpox often leads to untreatable outcomes. However, this is actually Jia Zhen Dao (smallpox complicated by measles). It should be treated with Renshen Qianghuo San (Ginseng and Notopterygium Decoction). Once the Zhen toxin is resolved, the momentum of the variola will also recede. In cases of Yuan Qi (Original Qi) deficiency preventing scab formation, tonifying the Spleen and Stomach is the urgent priority. [Weng Zhongren] For cases where Dan Zhen (red rash) erupts within the variola, specific treatment is unnecessary; the focus should be on supporting the eruption of the variola. Once the variola erupts, the Zhen will naturally subside.
Jingfang Baidu San (Atractylodes and Saposhnikovia Decoction for Overcoming Toxicity)
Chai Hu (Bupleuri Radix), Gan Cao (Glycyrrhizae Radix et Rhizoma), Ren Shen (Ginseng Radix), Jie Geng (Platycodonis Radix), Chuan Xiong (Ligustici Chuanxiong Rhizoma), Fu Ling (Poria), Zhi Ke (Aurantii Fructus Immaturus), Qian Hu (Peucedani Radix), Qiang Huo (Notopterygii Rhizoma et Radix), Du Huo (Angelicae Pubescentis Radix), Jing Jie Sui (Schizonepetae Spica), Fang Feng (Saposhnikoviae Radix) (equal parts).
Coarse powder. Add five leaves of Bo He (Menthae Haplocalycis Herba), one cup of water, decoct to seven-tenths, remove dregs, and take warm.
Renshen Qianghuo San (Ginseng and Notopterygium Decoction)
Indicated for epidemic variola and rashes, with exterior-dispersing properties.
Ren Shen (Ginseng Radix), Qiang Huo (Notopterygii Rhizoma et Radix), Du Huo (Angelicae Pubescentis Radix), Chai Hu (Bupleuri Radix), Qian Hu (Peucedani Radix), Jie Geng (Platycodonis Radix), Fu Ling (Poria), Zhi Ke (Aurantii Fructus Immaturus), Chuan Xiong (Ligustici Chuanxiong Rhizoma), Tian Ma (Gastrodiae Rhizoma), Gan Cao (Glycyrrhizae Radix et Rhizoma), Di Gu Pi (Lycii Cortex) (each 3 fen).
Add five leaves of Bo He (Menthae Haplocalycis Herba), decoct with ginger-infused water, and take.
The above formulas are suitable for patients with predominant exterior syndromes.
Qinghe Yin (Clear and Harmonizing Decoction)
Di Gu Pi (Lycii Cortex, fresh), Mai Men Dong (Ophiopogonis Tuber, heart removed) (each 2 qian), Sheng Di Huang (Rehmanniae Radix), Zhi Mu (Anemarrhenae Rhizoma), Bei Mu (Fritillariae Cirrhosae Bulbus), Ju Hong (Citri Reticulatae Pericarpium Rubrum), Fu Ling (Poria), Gan Cao (Glycyrrhizae Radix et Rhizoma), Jing Jie Sui (Schizonepetae Spica) (each 7 fen), Niu Bang Zi (Arctii Fructus, stir-fried and crushed) (1.5 qian), Jie Geng (Platycodonis Radix) (5 fen), Quan Gua Lou (Trichosanthis Fructus) (1 qian).
The above formula is suitable for patients with predominant interior syndromes. For deficiency patterns, add Ren Shen (Ginseng Radix) and Huang Qi (Astragali Radix).