（附论）
夫时气在表。已发汗未解。或吐下后毒瓦斯不散。烦躁谬语。此为表虚里实。热气燥于外。
故身体发斑如锦纹。凡发斑不可用发表药。令疮开泄更增斑烂。虚故也。
方
升麻散（出圣惠方）治时气表里不解。热毒在脏。致斑疮。
升麻（一两） 犀角屑（一两） 玄参（一两） 秦艽（一两） 子芩（一两） 柴胡
（一两去苗）
杏仁（汤浸去皮尖双仁麸炒微黄一两） 甘草（炙微赤锉一两） 上为散。每服五钱。以水
一中
盏。煎至五分。去滓。不计时候。温服。
又方（出圣惠方）
玄参（一两） 川升麻（一两） 甘草（炙微赤一两） 上为散。每服五钱。以水一大
盏。煎
至五分。去滓。不计时候。温服。
羚羊角散（出圣惠方）治时气壅毒不退发斑。遍身烦热。大小便不利。
羚羊角屑（一两） 栀子仁（一两） 麦门冬（一两去心） 川麻黄（一两） 川大黄
（锉碎微
炒一两） 玄参（一两） 黄 （一两锉） 甘草（炙微赤锉一两） 赤芍药（一两） 上
为散。每
服五钱。以水一大盏。煎至五分。去滓。不计时候。温服。
葛根散（出圣惠方）治冬温未即为病。至夏得热。其冬温毒瓦斯始出肌中。斑
烂瘾疹如锦纹。喘咳闷。呕吐清涎。
葛根（锉一两） 陈橘皮（汤浸去白瓤焙一两） 麻黄（去根节一两） 知母（一两） 黄
芩
（一两） 甘草（炙微赤锉一两） 杏仁（汤浸去皮尖双仁麸炒微黄一两外台秘要用各二两）
上
为散。每服五钱。以水一大盏。入生姜半分。煎至五分。去滓。不计时候服。外台秘要。以
水七升。煮取三升。分温三服。呕吐当先定。便宜消息。忌海藻、菘菜。名葛根橘皮汤。
治时气赤斑疮出后。胸中恶热。疮盛。（出圣惠方）
鸡子（二枚去壳） 酽醋（二合） 猪胆汁（三合） 上药相和。煎十余沸。放温。不
计时候。
分温三服。
治时气热毒在脏腑中。欲发赤斑。（出圣惠方）
地黄汁（五合） 豉（二合） 麝香（一钱细研） 上于锅中。以炼成猪脂半斤相和。
煎十余
沸。滤去滓。入麝香搅令匀。每服二合。尽服之。毒当从肉中为汗出。便愈。
又方（出圣惠方）
以生虾蟆一枚。去肠肚。烂研。以水一大盏。绞取汁。顿服。或五月五日午时收者。烧
灰细研。冷水调服益佳。
治天行热病。若发赤黑斑如疹。（出活人书）
用青木香二两。以水二升。煮取一升。顿服之效。
卑膏汤（出活人书）治时行温毒发斑。大疫难救。病源。夫人冬月触冒寒毒
者
。至春始发病。初在表。或已发汗吐下。而表证未罢。毒瓦斯不散。故发斑疮。又冬月天
时温暖。人感乖候之气未即发病。至春又被积寒所折。毒瓦斯不得泄。至夏遇热。其春
寒解。冬温毒始发出于肌肤。斑烂瘾疹如锦纹也。
生地黄（半斤切打碎） 好豉（一升） 上以猪膏二斤。合前药煎五六沸。令三分减。
去滓。
研雄黄、麝香如大豆者。纳中搅匀。尽服之。毒便从皮中出。则愈。忌芜荑。
黑奴丸（出肘后方）治温毒发斑者。五死一生。黑斑者。十死一生。大疫难
救者。治天行斑疮。须臾遍身皆戴白浆。此是恶毒之气所致。
用冬葵菜叶煮。以蒜齑啖之则止。
治天行时病发斑疮。头面及身须臾周匝。状如火烧。疮皆戴白浆。随没随生。不治
。数日必死。治后疮盘黯黑。一岁方减。此恶毒之气所为。
用水煮升麻。绵渍洗之。酒煮尤妙。但痛难忍。
黄连橘皮汤（出活人书）治冬温未即病。至春被积寒所折不得发。至夏热。
其春寒解。冬温毒始发出肌中。斑烂瘾疹如锦纹而咳。心闷。呕吐清汁。眼赤。口疮
。下部生疮。
黄连（四两去须） 橘皮 杏仁（去皮尖双仁） 枳实（炙一作枳壳） 麻黄（去节） 葛
根
（各二两） 浓朴（炙） 甘草（炙各一两） 上锉。以水八升。煮取三升。分三服令尽。
且消息。
下当先止。忌猪肉、冷水、海藻、菘菜等。
漏芦橘皮汤 治冬温未即病。至春被积寒所折不得发。至夏热。其春寒解。冬温
毒始发出肌中。斑烂瘾疹如锦纹而咳。心闷。呕吐清汁。眼赤。口疮。下部亦生疮。
漏芦（二两） 橘皮（二两） 甘遂（二两） 麻黄（去节二两） 杏仁（去皮尖双仁
二两） 黄
芩（二两） 上锉。以水九升。煮取三升。分四服。得下为佳。一方有知母、枳实、白薇、
升
麻、大黄、甘草。为十二味。
治天行发斑疮。头面及身须臾周匝。状如火疮。皆戴白浆。随没随生。若不急治
。数日即死。（方见治时行病发疮）
治时气发疮瘾。
用葡萄研酒食之。甚效。
治时气天行病发疮。
用升麻五两。以水二升。入蜜同煎三沸。半服。半敷疮上。即瘥。
（附论）
时行疫病邪气在肌表。已经发汗但病未解除。或者在吐法、下法之后，毒热之气仍未消散。出现烦躁不安、胡言乱语的症状。这属于表虚里实的证候。热气燥盛于体表。
因此身体发出斑疹，色泽如锦缎花纹般绚丽。凡是发斑疹，不可使用发表解表的药物。因为这样会使疮口开泄，反而加重斑疹溃烂。这是因为正气虚弱所致。
方剂
升麻散（出自《圣惠方》）。治疗时行疫病表里同病不解。热毒蕴结在脏腑。导致出现斑疮。
升麻（一两） 犀角屑（一两） 玄参（一两） 秦艽（一两） 黄芩（一两） 柴胡（一两，去苗）
杏仁（汤浸去皮尖及双仁，麸炒至微黄，一两） 甘草（炙至微赤，锉碎，一两） 以上药材研为散剂。每次服用五钱。用水一中盏。煎煮至五分水量。滤去药渣。不限时候。温服。
又一方（出自《圣惠方》）
玄参（一两） 川升麻（一两） 甘草（炙至微赤，一两） 以上药材研为散剂。每次服用五钱。用水一大盏。煎煮至五分水量。滤去药渣。不限时候。温服。
羚羊角散（出自《圣惠方》）。治疗时行疫病壅滞之毒不退而发斑。遍身烦热。大小便不通利。
羚羊角屑（一两） 栀子仁（一两） 麦门冬（一两，去心） 川麻黄（一两） 川大黄（锉碎，微炒，一两） 玄参（一两） 黄芪（一两，锉） 甘草（炙至微赤，锉碎，一两） 赤芍药（一两） 以上药材研为散剂。每次服用五钱。用水一大盏。煎煮至五分水量。滤去药渣。不限时候。温服。
葛根散（出自《圣惠方》）。治疗冬温病未及时发作。到了夏季感受热邪。此时冬季的温毒之气才开始发出于肌肤之中。出现斑烂瘾疹，色泽如锦缎花纹。气喘咳嗽胸闷。呕吐清稀涎沫。
葛根（锉碎，一两） 陈橘皮（汤浸去白瓤，焙干，一两） 麻黄（去根节，一两） 知母（一两） 黄芩（一两） 甘草（炙至微赤，锉碎，一两） 杏仁（汤浸去皮尖及双仁，麸炒至微黄，一两；《外台秘要》用各二两） 以上药材研为散剂。每次服用五钱。用水一大盏。加入生姜半分。煎煮至五分水量。滤去药渣。不限时候服用。《外台秘要》记载：用水七升。煮取三升。分三次温服。呕吐症状应当先平息。适宜酌情观察调整。忌食海藻、菘菜（白菜）。此方名为葛根橘皮汤。
治疗时行疫病赤色斑疮发出后。胸中恶热。疮势盛大。（出自《圣惠方》）
鸡蛋（二枚，去壳） 浓醋（二合） 猪胆汁（三合） 以上药物混合。煎煮十余次沸腾。放温。不限时候。分三次温服。
治疗时行疫热毒蕴结在脏腑中。想要发出赤色斑疹。（出自《圣惠方》）
地黄汁（五合） 豆豉（二合） 麝香（一钱，细研） 以上放入锅中。用炼成的猪脂半斤与之混合。煎煮十余次沸腾。滤去药渣。加入麝香搅匀。每次服用二合。全部服完。毒气应当从肌肉中化为汗液排出。病即痊愈。
又一方（出自《圣惠方》）
用生蟾蜍一枚。去除肠肚。捣烂。用水一大盏。绞取汁液。一次性顿服。或者收集五月五日午时的蟾蜍。烧成灰后细研。冷水调服效果更好。
治疗天行热病。如果发出赤黑色斑疹如同疹子一般。（出自《活人书》）
用青木香二两。用水二升。煮取一升。一次性顿服见效。
卑膏汤（出自《活人书》）。治疗时行温毒发斑。大瘟疫难以救治。病源解析：人在冬季触犯寒毒。
到了春季才发病。起初邪气在肌表。或者已经经过发汗、吐法、下法。但表证未罢。毒热之气不散。所以发斑疮。另外冬季天时温暖。人感受了乖戾的气候之气并未立即发病。到了春季又被积寒所遏制。毒热之气不得宣泄。到了夏季遇到热邪。此时的春寒解除。冬季的温毒才开始发出于肌肤。出现斑烂瘾疹，色泽如锦缎花纹。
生地黄（半斤，切碎打碎） 好豆豉（一升） 以上用猪膏二斤。与前药一起煎煮五六次沸腾。使药液减少三分之一。滤去药渣。研磨雄黄、麝香如大豆大小。纳入药液中搅匀。全部服完。毒气便会从皮肤中透出。则病愈。忌食芜荑。
黑奴丸（出自《肘后方》）。治疗温毒发斑者。预后极差，十死一生。出现黑斑者。更加凶险，十死一生。大瘟疫难以救治者。治疗天行斑疮。须臾之间遍身都长出白色脓浆。这是恶毒之气所致。
用冬葵菜叶煮汤。配合蒜泥食用则能止住病情。
治疗天行时病发斑疮。头面及身体须臾之间遍布。状如火烧。疮疡都带有白色脓浆。随破随生。不治疗。数日内必死。治疗后疮盘颜色黯黑。一年才能消退。这是恶毒之气所为。
用水煮升麻。用绵布浸泡清洗患处。用酒煮效果尤其好。只是疼痛难忍。
黄连橘皮汤（出自《活人书》）。治疗冬温病未及时发作。到了春季被积寒所遏制无法发散。到了夏季受热。
此时春寒解除。冬季的温毒才开始发出于肌肤之中。出现斑烂瘾疹，色泽如锦缎花纹并伴有咳嗽。心中闷乱。呕吐清稀汁液。眼睛发红。口腔生疮。下部也生疮。
黄连（四两，去须） 橘皮 杏仁（去皮尖及双仁） 枳实（炙，一作枳壳） 麻黄（去节） 葛根（各二两） 厚朴（炙） 甘草（炙，各一两） 以上锉碎。用水八升。煮取三升。分三次服完。且需酌情观察调整。
大便通利应当先停止（指若腹泻严重需停药或调整）。忌食猪肉、冷水、海藻、菘菜等。
漏芦橘皮汤。治疗冬温病未及时发作。到了春季被积寒所遏制无法发散。到了夏季受热。此时春寒解除。冬季的温毒才开始发出于肌肤之中。出现斑烂瘾疹，色泽如锦缎花纹并伴有咳嗽。心中闷乱。呕吐清稀汁液。眼睛发红。口腔生疮。下部也生疮。
漏芦（二两） 橘皮（二两） 甘遂（二两） 麻黄（去节，二两） 杏仁（去皮尖及双仁，二两） 黄芩（二两） 以上锉碎。用水九升。煮取三升。分四次服用。以得下利为佳。另一版本有知母、枳实、白薇、升麻、大黄、甘草。共十二味药。
治疗天行发斑疮。头面及身体须臾之间遍布。状如火疮。都带有白色脓浆。随破随生。如果不紧急治疗。数日即死。（方剂见治时行病发疮部分）
(Attached Discussion)
When the seasonal pathogenic factor is in the exterior, and sweating has been administered without resolution, or after vomiting and purging therapies where the toxic heat has not dispersed, leading to restlessness and delirious speech, this constitutes a pattern of exterior deficiency and interior excess. The hot qi燥 (dryness/heat) dominates the exterior.
Therefore, macules appear on the body with patterns resembling brocade. In cases of macule eruption, exterior-releasing drugs must not be used, as this will cause sores to open and leak, worsening the macular erosion due to deficiency.
Formulas
Shengma San (Cinnamon Twig Powder, from *Shenghui Fang*) treats seasonal epidemic diseases where both exterior and interior are unresolved. Heat toxins reside in the zang organs, causing macules and sores.
Shengma (Rhizoma Cimicifugae, 1 liang) Xijiao xie (Hornis Rhinocerotis Cutis, 1 liang) Xuanshen (Radix Scrophulariae, 1 liang) Qinjiao (Radix Gentianae Macrophyllae, 1 liang) Zihuang (Radix Scutellariae, 1 liang) Chaihu (Radix Bupleuri, 1 liang, remove seedlings)
Xingren (Semen Armeniacae Amarum, soaked in water, remove skin and tips, double-kernel wheat-bran fried until slightly yellow, 1 liang) Gancao (Radix Glycyrrhizae Uralensis, honey-fried until slightly red, cut into pieces, 1 liang). Grind all into powder. Take 5 qian per dose. Add one zhong cup of water. Decoct until five fen of liquid remains. Remove dregs. Take warm at any time.
Another Formula (from *Shenghui Fang*)
Xuanshen (Radix Scrophulariae, 1 liang) Chuan Shengma (Rhizoma Cimicifugae, 1 liang) Gancao (Radix Glycyrrhizae Uralensis, honey-fried until slightly red, 1 liang). Grind all into powder. Take 5 qian per dose. Add one da cup of water. Decoct until five fen of liquid remains. Remove dregs. Take warm at any time.
Lingyangjiao San (Antelope Horn Powder, from *Shenghui Fang*) treats seasonal epidemic diseases where stagnant toxins do not retreat, causing macule eruption. Generalized irritability and heat. Difficulty in urination and defecation.
Lingyangjiao xie (Cornu Saigae Tataricae, 1 liang) Zhizi ren (Semen Gardeniae, 1 liang) Maimendong (Radix Ophiopogonis, 1 liang, remove heart) Chuan Mahuang (Herba Ephedrae, 1 liang) Chuan Dahuang (Radix et Rhizoma Rhei, crushed, slightly fried, 1 liang) Xuanshen (Radix Scrophulariae, 1 liang) Huangqi (Radix Astragali Membranacei, 1 liang, cut) Gancao (Radix Glycyrrhizae Uralensis, honey-fried until slightly red, cut, 1 liang) Chishaoyao (Radix Paeoniae Rubra, 1 liang). Grind all into powder. Take 5 qian per dose. Add one da cup of water. Decoct until five fen of liquid remains. Remove dregs. Take warm at any time.
Gegen San (Pueraria Root Powder, from *Shenghui Fang*) treats Winter-Warmth disease that did not manifest immediately. Upon encountering summer heat, the winter-warmth toxin begins to emerge from the muscles and skin. Macules and lichenoid eruptions appear like brocade patterns. Wheezing, coughing, chest oppression. Vomiting clear saliva.
Gegen (Radix Puerariae Lobatae, cut, 1 liang) Chen Jupi (Pericarpium Citri Reticulatae, soaked in water, white pith removed, baked, 1 liang) Mahuang (Herba Ephedrae, remove roots and joints, 1 liang) Zhimu (Rhizoma Anemarrhenae, 1 liang) Huangqin (Radix Scutellariae, 1 liang) Gancao (Radix Glycyrrhizae Uralensis, honey-fried until slightly red, cut, 1 liang) Xingren (Semen Armeniacae Amarum, soaked in water, remove skin and tips, double-kernel wheat-bran fried until slightly yellow, 1 liang; *Waitai Miyao* uses 2 liang each). Grind all into powder. Take 5 qian per dose. Add one da cup of water and half a fen of fresh ginger. Decoct until five fen of liquid remains. Remove dregs. Take at any time. *Waitai Miyao*: Use seven sheng of water, boil down to three sheng. Divide into three warm doses. Stop vomiting first. Adjust according to condition. Avoid Algae (Zaohai) and Chinese Cabbage (Songcai). Named Gegen Jupi Tang (Pueraria and Tangerine Peel Decoction).
Treats post-eruption of red macules in seasonal epidemics. Malignant heat in the chest. Severe sores. (From *Shenghui Fang*)
Jizi (Ovum Gallus Domesticum, two eggs, shell removed) Yan Cu (Strong Vinegar, 2 he) Zhu Danzhi (Bile Suilla, 3 he). Mix medicines. Boil for more than ten boils. Let cool to warm. Take in three warm doses at any time.
Treats heat toxins in the zang and fu organs during seasonal epidemics, intending to erupt red macules. (From *Shenghui Fang*)
Dihuang zhi (Juice of Radix Rehmanniae Recens, 5 he) Chi (Fermen Sojae Preparatum, 2 he) Shexiang (Moschus, 1 qian, finely ground). Place in a pot. Mix with half a jin of refined suet. Boil for more than ten boils. Filter out dregs. Add Shexiang and stir evenly. Take 2 he per dose. Finish the dose. Toxins should exit as sweat from the flesh. Then recovery occurs.
Another Formula (from *Shenghui Fang*)
Use one live Bufo bufo gargarizans. Remove intestines and stomach. Pound thoroughly. Add one da cup of water. Squeeze to extract juice. Take in one dose. Or collect those gathered at noon on the fifth day of the fifth lunar month. Burn to ash, grind finely. Mix with cold water for administration; this is better.
Treats Tianxing (Epidemic) febrile diseases. If red-black macules appear like rashes. (From *Huoren Shu*)
Use Qingmuxiang (Radix Aucklandiae, 2 liang). Add two sheng of water. Boil down to one sheng. Take in one dose for efficacy.
Beigao Tang (Beigao Decoction, from *Huoren Shu*) treats seasonal warm-toxin macule eruption. Great plagues are difficult to save. Etiology: When people are exposed to cold toxins in winter,
disease manifests only in spring. Initially in the exterior. Even if sweating, vomiting, or purging have been performed, exterior signs persist. Toxic heat does not disperse, hence macules and sores erupt. Additionally, if winter weather is warm, people may contract abnormal qi without immediate illness. In spring, accumulated cold suppresses it, preventing toxin discharge. In summer, heat arrives. Spring cold resolves, and winter-warmth toxins finally erupt from the skin, causing macules and lichenoid eruptions like brocade patterns.
Sheng Dihuang (Radix Rehmanniae Recens, half a jin, chopped and crushed) Hao Chi (Fermen Sojae Preparatum, one sheng). Combine with two jin of suet. Boil previous medicines for five or six boils. Reduce by one-third. Remove dregs. Grind Xionghuang (Realgar) and Shexiang (Moschus) to soybean size. Incorporate into liquid. Stir evenly. Take all. Toxins will exit through the skin. Recovery follows. Avoid Yuan Yi (Seed of Prunus mume).
Heinu Wan (Black Slave Pill, from *Zhouhou Fang*) treats warm-toxin macule eruption. Prognosis: five deaths, one life. Black macules: ten deaths, one life. Great plagues difficult to save. Treats Tianxing macule sores. Within moments, the whole body is covered with white pustules. This is caused by malignant toxic qi.
Boil Dongkuicai leaves. Eat with garlic paste to stop progression.
Treats Tianxing seasonal diseases with macule sores. Head, face, and body become covered within moments. Appearance like fire burns. Sores bear white pus. They rupture and regenerate continuously. Without treatment, death occurs within days. After treatment, sore bases remain dark black. It takes one year to subside. This is caused by malignant toxic qi.
Boil Shengma in water. Soak and wash affected areas with cotton cloth. Boiling in wine is superior. However, pain is unbearable.
Huanglian Jupi Tang (Coptis and Tangerine Peel Decoction, from *Huoren Shu*) treats Winter-Warmth disease that did not manifest immediately. Suppressed by accumulated cold in spring, unable to erupt. Heated in summer.
Spring cold resolves. Winter-warmth toxins emerge from muscles. Macules and lichenoid eruptions like brocade patterns with cough. Chest oppression. Vomiting clear fluid. Red eyes. Oral ulcers. Ulcers in the lower body.
Huanglian (Radix Coptidis, four liang, remove stamens) Jupi (Pericarpium Citri Reticulatae) Xingren (Semen Armeniacae Amarum, remove skin and tips, double-kernel) Zhishi (Fructus Aurantii Immaturus, honey-fried, alternatively Zhike) Mahuang (Herba Ephedrae, remove joints) Gegen (Radix Puerariae Lobatae) (each 2 liang) Houpo (Cortex Magnoliae Officinalis, honey-fried) Gancao (Radix Glycyrrhizae Uralensis, honey-fried) (each 1 liang). Cut into pieces. Add eight sheng of water. Boil down to three sheng. Divide into three doses. Consume completely. Monitor condition.
If diarrhea occurs, stop first. Avoid pork, cold water, Algae (Zaohai), and Chinese Cabbage (Songcai).
Loulu Jupi Tang (Acanthopanacis Cortex and Tangerine Peel Decoction). Treats Winter-Warmth disease that did not manifest immediately. Suppressed by accumulated cold in spring, unable to erupt. Heated in summer.
Spring cold resolves. Winter-warmth toxins emerge from muscles. Macules and lichenoid eruptions like brocade patterns with cough. Chest oppression. Vomiting clear fluid. Red eyes. Oral ulcers. Ulcers also in the lower body.
Loulu (Radix Euphorbiae Humifusae, 2 liang) Jupi (Pericarpium Citri Reticulatae, 2 liang) Gansui (Radix Euphorbiae Kansui, 2 liang) Mahuang (Herba Ephedrae, remove joints, 2 liang) Xingren (Semen Armeniacae Amarum, remove skin and tips, double-kernel, 2 liang) Huangqin (Radix Scutellariae, 2 liang). Cut into pieces. Add nine sheng of water. Boil down to three sheng. Divide into four doses. Obtaining loose stools is desirable. Another version includes Zhimu (Rhizoma Anemarrhenae), Zhishi (Fructus Aurantii Immaturus), Baiwei (Radix Clematidis Armandii), Shengma (Rhizoma Cimicifugae), Dahuang (Radix et Rhizoma Rhei), Gancao (Radix Glycyrrhizae Uralensis). Twelve ingredients total.
Treats Tianxing macule sores. Head, face, and body become covered within moments. Appearance like fire sores. All bear white pus. They rupture and regenerate continuously. If not treated urgently, death occurs within days. (Formula see section on treating seasonal epidemic sores)
Treats seasonal qi sores and lichenoid eruptions.
Grind Putao (Vitis vinifera fruit) and eat with wine. Very effective.
Treats seasonal qi Tianxing disease sores.
Use Shengma (Rhizoma Cimicifugae, 5 liang). Add two sheng of water. Boil with honey for three boils. Half taken internally. Half applied externally to sores. Disease heals.