〔薛〕胎毒发丹者，因胎毒内伏，或频浴热汤，或着烘衣，或乳母饮食七情内热，
助邪为患。发于头面四肢，延及胸腹，色赤，游走不定。古人云从四肢起入腹囊者
皆不治，当急令人随患处遍吮毒血，各聚一处砭出之，急服活命饮，惟百日内忌砭，
以其肌肉难任也。若发散过剂，表虚热而赤不退者，用补中益气汤加防风、白芷。
寒凉过剂，胃气受伤而热赤不退者，用异功散加柴胡、升麻。或兼发搐等证，用四
君、升麻、当归、钓藤钩。若复用攻毒，必致不起。头额间患者，当卧镰砭之。
一小儿患丹，赤晕走彻遍身，难以悉砭，令人吮四肢胸背数处，使毒血各凝聚而砭之，
先用活命饮末酒调二服，又以金银花、甘草节、为末，用人乳汁调服渐愈。月余后
两足皆肿，仍砭之，服前药而痊。数日后两足复赤，或用犀角解毒丸之类，致乳食
不进，肚腹膨胀。此复伤脾胃而然也，敷神功散，服补中益气汤加茯苓而痊。一小
儿腿如霞片，游走不定。先以麻油涂患处，砭出恶血，其毒即散，用九味解毒散而
安。一小儿，臂患之，砭出毒血而愈，惑于人言，服护心散以杜后患，服之，吐泻腹
胀，患处复赤，手足并冷。余谓此脾胃虚弱，前药复伤。用六君子汤一剂顿愈，又
以异功散加升麻、柴胡、而痊。一小儿腿上患之，神思如故，乳食如常。余谓毒发
于肌表。令急砭出毒血自愈。不信，外敷寒凉，内服峻剂，腹胀不乳而死。一小儿
患此，二便不利，阴囊肚腹俱胀急。用砭法，随以活命饮加漏芦、木通、大黄、为
末，时用热酒调服，至两许，二便俱通，诸证顿退，却去三味，仍前时服而愈。一
小儿患此，二便不利，腹胀咳嗽。用活命饮加漏芦、木通、麻黄为末，时时热酒
调服，二便随通，遍身出汗，诸证顿退，鼻息似绝，无气以动，时或似躁。此邪气
去而元气虚也，急用当归补血汤而愈。砭法，治丹毒赤色游走不定，令口吮毒血，
各聚一处，用细瓷器击碎，取锋芒者，以箸头劈开夹之，甩线缚定，两指轻撮箸头，
稍令瓷芒对聚血处，再用箸一根频击，刺出毒血。轻者止用口吮出毒，用药敷之。
如患在头者不用砭法，止宜用针卧倒挑患处，以出毒血，迟则毒血入腹而难起矣。
神功散治丹毒最效，若砭后毒甚者宜用，如毒轻者，砭后不可用，恐砭处皮肤既破，
草乌能作痛也。（方见前条。）
【薛己】胎毒发丹，是由于胎毒内伏，或因频繁用热水洗澡，或穿着烘烤过的衣物，或乳母因饮食及七情（喜、怒、忧、思、悲、恐、惊）导致体内产生内热，从而助长邪气为患。病症发作于头面四肢，蔓延至胸腹部，皮肤色红，游走不定。古人说，如果从四肢发起并传入腹部的，都属于不治之症。应当立即让人在患处周围吮吸毒血，使其聚集在一处后用砭石刺破排出。随后急服活命饮。只有出生百天内的婴儿忌用砭法，因为他们的肌肉难以承受。如果发散药物使用过量，导致表虚发热且红色不退的，使用补中益气汤加防风、白芷。如果寒凉药物使用过量，损伤胃气导致热赤不退的，使用异功散加柴胡、升麻。或者兼有抽搐等症状的，使用四君子汤、升麻、当归、钓藤钩。如果再次使用攻毒药物，必然导致死亡。发生在头额间的患者，应当采用卧镰砭法。
有一个小孩患丹毒，红色晕圈遍布全身，难以全部用砭石刺破，于是让人吮吸四肢、胸部和背部的几处，使毒血各自凝聚后再进行砭刺。先用活命饮粉末，用酒调服两剂，又以金银花、甘草节研成粉末，用人乳汁调服，逐渐痊愈。一个多月后双脚肿胀，仍然用砭法，服用前面的药物而康复。几天后双脚再次变红，有人使用犀角解毒丸之类的药物，导致乳食不进，肚腹胀满。这是再次损伤脾胃所致，敷神功散，服用补中益气汤加茯苓而痊愈。
另一个小孩腿部像霞片一样发红，游走不定。先用麻油涂抹患处，砭出恶血，毒素随即消散，使用九味解毒散而安定。还有一个小孩手臂患病，砭出毒血后痊愈，但听信他人言语，服用护心散以杜绝后患，结果服药后出现呕吐、腹泻、腹胀，患处再次变红，手脚冰凉。我认为这是脾胃虚弱，之前的药物再次损伤了身体。使用六君子汤一剂即愈，后又用异功散加升麻、柴胡而痊愈。
还有一个小孩腿上患病，神志清醒如常，吃奶进食正常。我认为这是毒发于肌表。命令紧急砭出毒血即可自愈。家属不信，外敷寒凉药物，内服峻猛药物，导致腹胀不吃奶而死。
还有一个小孩患此病，大小便不通利，阴囊和肚腹都胀急。使用砭法，随即用活命饮加漏芦、木通、大黄研成粉末，不时用热酒调服，服到一两左右，大小便都通畅，各种症状顿时消退，然后去掉这三味药，继续按时服用而痊愈。
还有一个小孩患此病，大小便不通利，腹胀咳嗽。用活命饮加漏芦、木通、麻黄研成粉末，时时用热酒调服，大小便随即通畅，全身出汗，各种症状顿时消退，鼻息微弱似绝，没有力气活动，偶尔似乎烦躁。这是邪气已去但元气虚弱所致，紧急使用当归补血汤而痊愈。
关于砭法：治疗丹毒赤色游走不定的情况，令人口吮毒血，使其聚集在一处，用细瓷器击碎，取有锋芒的部分，用筷子头劈开夹住，用线绑紧，两个手指轻轻捏住筷子头，稍微让瓷器的锋芒对准聚集毒血的地方，再用一根筷子频繁敲击，刺出毒血。轻的只用口吮出毒血，用药敷上。如果患处在头部，不用砭法，只宜用针卧倒挑刺患处，以排出毒血，迟则毒血入腹就难治了。
神功散治疗丹毒非常有效，如果砭后毒势严重的适宜使用；如果毒势轻的，砭后不可用，恐怕砭处皮肤已经破损，草乌会引起疼痛。（方剂见前条。）
[Xue Ji] Dan toxin eruption (Erysipelas caused by fetal toxin) arises from fetal toxin latent within, or due to frequent bathing in hot water, wearing garments heated by drying, or maternal internal heat generated by diet and the seven emotions (joy, anger, worry, thought, sadness, fear, shock), which aids the pathogen to cause disease. It erupts on the head, face, and limbs, extending to the chest and abdomen; the skin is red and migratory. The ancients stated that cases starting from the limbs and entering the abdomen are incurable. One should immediately have someone suck the toxic blood around the affected area, gather it to one spot, and pierce it with a Bian stone (stone needle). Then urgently administer Huoming Yin (Life-Saving Decoction). Only infants under 100 days old are contraindicated for Bian therapy, as their muscles cannot withstand it. If dispersing agents are overdosed, leading to deficient exterior heat and persistent redness, use Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) plus Fangfeng (Saposhnikovia Root) and Baizhi (Angelica Dahurica). If cold-cooling agents are overdosed, damaging Stomach Qi and causing persistent heat and redness, use Yigong San (Extraordinary Efficacy Powder) plus Chaihu (Bupleurum Root) and Shengma (Cimicifuga Rhizome). If accompanied by convulsions, use Sijunzi Tang (Four Gentlemen Decoction), Shengma, Danggui (Angelica Sinensis), and Gouteng (Uncaria Ramulus cum Uncis). If poison-expelling drugs are used again, death is inevitable. For lesions on the forehead, the lying sickle Bian method should be used.
A child suffered from erysipelas, with red halos spreading over the entire body, making it difficult to pierce all areas. Someone was instructed to suck the toxic blood at several points on the limbs, chest, and back, allowing the toxic blood to coagulate locally before piercing. First, two doses of Huoming Yin powder were taken mixed with wine. Then, Jinyinhua (Lonicerae Japonicae Flos) and Gancaojie (Glycyrrhizae Radix et Rhizoma joint) were powdered and taken mixed with human breast milk, leading to gradual recovery. Over a month later, both feet swelled; Bian therapy was applied again, and the previous medicine cured him. A few days later, the feet turned red again. Someone used Xijiao Jiedu Wan (Rhinoceros Horn Detoxification Pills), causing loss of appetite and abdominal distension. This was due to further injury to the Spleen and Stomach. Shengong San (Divine Efficacy Powder) was applied externally, and Buzhong Yiqi Tang plus Fuling (Poria) was administered internally, resulting in recovery.
Another child had leg lesions resembling cloud patches, migratory in nature. Sesame oil was first applied to the affected area, and evil blood was pierced out, dispersing the toxin. Jiwei Jiedu San (Nine-Ingredient Detoxification Powder) was used to settle the condition. Another child had arm lesions; after piercing out toxic blood, he recovered. However, influenced by others' words, he took Huxin San (Heart-Protecting Powder) to prevent future recurrence. After taking it, he experienced vomiting, diarrhea, and abdominal distension; the lesion turned red again, and his hands and feet became cold. I reasoned this was due to Spleen and Stomach deficiency and further injury from previous medicines. One dose of Liujunzi Tang (Six Gentlemen Decoction) brought immediate cure, followed by Yigong San plus Shengma and Chaihu for full recovery.
Another child had leg lesions but maintained normal mental state and feeding habits. I reasoned the toxin erupted on the muscle surface. I ordered urgent Bian therapy to pierce out toxic blood for self-healing. The family did not believe me, applied cold-cooling herbs externally, and administered harsh medicines internally, leading to abdominal distension, refusal to nurse, and death.
Another child suffered from this condition with difficulty in urination and defecation, and swelling/urgency in the scrotum and abdomen. Bian therapy was used, followed by Huoming Yin plus Loulu (Euphorbiae Pekinensis Radix), Mutong (Akebiae Caulis), and Dahuang (Rhei Radix et Rhizoma) powdered and taken intermittently with warm wine. After consuming about one tael, urination and defecation became smooth, and all symptoms receded. The three ingredients were then removed, and the remaining formula was continued to achieve recovery.
Another child suffered from this with difficulty in urination and defecation, abdominal distension, and cough. Huoming Yin plus Loulu, Mutong, and Mahuang (Ephedrae Herba) was powdered and taken intermittently with warm wine. Urination and defecation soon became smooth, the whole body sweated, and all symptoms receded. Nasal breathing seemed absent, there was no energy to move, and occasional restlessness occurred. This indicated the pathogenic qi had left but the healthy qi was deficient. Urgent administration of Danggui Buxue Tang (Angelica Tonifying Blood Decoction) resulted in recovery.
Regarding Bian therapy: For treating erysipelas with migratory redness, allow the mouth to suck the toxic blood until it gathers in one place. Crush fine porcelain, take the sharp fragments, split them with the end of a chopstick, bind them with thread, hold the chopstick ends lightly with two fingers, position the porcelain shard against the gathered toxic blood, and strike frequently with another chopstick to pierce out the toxic blood. For mild cases, only sucking out the toxic blood and applying medicine is sufficient. If the lesion is on the head, Bian therapy is not used; instead, a needle should be laid horizontally to pick/stab the affected area to release toxic blood. Delay may cause the toxic blood to enter the abdomen, becoming hard to treat.
Shengong San is most effective for treating erysipelas. It should be used if the toxin is severe after Bian therapy. If the toxin is mild, it should not be used after Bian therapy, as the broken skin at the puncture site combined with Caowu (Aconiti Lateralis Radix Praeparata) may cause pain. (Formula seen in the previous section.)