疹属君火,气本少阴,传于其子兮,故为脾胃之证,乘于其妻兮,现乎皮毛之分,
亦胎毒之所发,因疫疠而后成。咳嗽喷嚏兮,辛金炼于丁火,顿闷泣出兮,君主御
乎将军。(将军,肝也。)迎而夺之兮,其锋易挫,
随而击之兮,其锐难胜,如折勾萌兮,斧斤不用,苟待燎原兮,玉石俱焚。
其色如斑兮,摸之有迹,其形似痘兮,视之无津,朝出暮收兮,发之于阳,暮出
朝收兮,发之于阴,变化莫测,出没靡定。大抵爱赤而恶黑,治者喜凉而忌温,赤如
点朱兮,光明彰显之象,黑如洒墨兮,火郁曛昧之甚,制以酸凉兮,收炎光于丽泽,
投以辛热兮,纵赫曦于重明。
败毒防风,开发斩关之将。(人参败毒散,防风通圣散。)解毒连翘,制伏降虏之兵。(黄连
解毒汤,连翘饮。)如锦烂熳兮,服化斑而艳敛,(化斑汤。)似火熏蒸兮,饮凉膈而热清。(东垣凉
膈散。)咽痛兮甘桔、牛蒡,止咳嗽更能润肺;(甘桔汤。)溺涩兮导赤、芍药,定惊悸又可凉
心。(导赤散,一名火府汤。)便秘兮承气、胆导。(调元承气汤,胆导法。)便泄兮黄芩、猪苓。(黄芩
芍药汤,猪苓汤。)大渴兮膈焦,置栝蒌于白虎,(白虎汤。)苦烦兮里热,加山栀于安神。(安神丸。)
无伐天和兮,使阴阳之适调,勿犯胃气兮,虽攻补之不尽。
痘欲尽发而不留,疹欲尽出而无病,或邪气之郁遏兮,留而不去,或正气之损伤
兮,困而未伸。毒归五脏,变有四证,毒归脾胃兮,泄泻不止而变痢;毒归心肝兮,
烦热不退而发惊;咳嗽久而血出兮,毒归于肺;牙齿烂而疳蚀兮,毒归于肾。轻者
从制以向善,平之有功,重者拒敌而肆恶,攻之不胜。
热不除者,调元汤加麦冬、知母,作搐兮兼以抱龙温惊;(琥珀抱龙丸,钱氏温惊丸。)咳
不止者,阿胶散(小阿胶散。)加杏仁、枳实,带血兮专以补肺太平。(钱氏补肺阿胶散,《十药神
书》太平丸。)注下兮异功猪苓、泽泻,(钱氏异功散。)虚滑者大作参苓,(参苓白术散。)滞下兮异
攻当归、芍药,休息者少与真人。(真人养脏汤。)惟有牙疳之病,原呼走马之名,初息臭而
腐肉,渐血出而穿龈,内服地黄丸制其火怪,(地黄丸。)外擦蚊蛤兮杀其 精,(蚊蛤散。)牙
若脱落兮,崩砂之状可畏,声若哑嗄兮,狐惑之证难明。
应出不出兮发之,初惺惺,次通圣,夺命大发而有效;(惺惺散,防风通圣散,夺命丹。)应
收不收兮解之,初葛根,次化 ,凉膈大解而最灵。(升麻葛根汤,化 汤,河间凉膈散。)色
淡白兮为虚,四物去川芎加红花、桂枝;(四物汤。)色紫黑兮血热,化 去人参加元参烧
粪。(化 汤。)夺命发 疹之圣,(夺命丹。)无价解疫疠之神。(无价散。)发不出而烦躁兮虞不
能腊,黑不变而谵妄兮食不及新,热蒸蒸兮色赤,痢滴滴兮气惺。羸瘦骨肉之脱,螈
神识之昏,喘急兮胸高耸,疳烂兮漏腮缺唇,休夸三世之妙手,难留一息之游魂。
岂不闻误服汤丸兮,不如勿药,又不见特犯禁忌兮,可以自省。爱吃咸酸兮,咳
嗽连绵而不已,喜啖辛燥兮,火热燔灼而不宁,甘甜过而齿龋,生冷多而粪清。鸡
乃生风之畜,鱼则动火之鳞,鸡鱼贪而乱食,风火并而启舋。邪反滋甚兮为 疹而
不息,毒反深入兮值疫疠而再经,斯则疹之遗毒,亦若痘之余证。
欲决内伤,须详外证。目常赤痛兮青童抱火,鼻常鼽衄兮素女卧薪。病牙齿以
终身兮,玄武困于汤镬,发癫痫而连年兮,朱雀惊于烧林,溲数短涩兮乃州都之遭火,
便溏垢蛊兮必仓廪之被焚。哮喘炎上之象,丹瘤赤瘭之形,唇舌多疮兮,门户残烟未
熄,咽喉常肿兮,管龠余烬犹存。苟求其故兮,则一言之可尽,欲拔其本兮,岂一
旦之能平,噫!此赋之作,效蛙之鸣,词虽鄙俚兮积如累石,法则疹秘兮故曰碎金。
疹属于君火,其气本源于少阴经,传变至子脏(脾),因此表现为脾胃的证候;乘袭于妻脏(肺),则显现于皮毛之间。这也是胎毒的发作,因疫疠之气而后形成。咳嗽、喷嚏,是因为辛金(肺)被丁火(心/君火)炼化;突然胸闷、哭泣而出,是因为君主(心)受到将军(肝)的抵御。(将军,指肝脏。)迎着病势而攻夺,它的锋芒容易受挫;顺着病势而追击,它的锐气难以战胜。就像折断刚萌发的嫩芽一样,不需要动用斧头;如果姑息等待它像燎原大火一样蔓延,那么玉石都会一起烧毁。
疹的颜色像斑疹,摸上去有痕迹;形状似痘疮,看过去没有津液。早晨出来傍晚消退,是从阳分发出;傍晚出来早晨消退,是从阴分发出。变化莫测,出没不定。大致上喜爱红色而厌恶黑色,治疗者喜欢清凉而忌讳温热。红得像朱砂点染,是光明彰显的象;黑得像泼墨,是火郁遏晦暗到了极点。用酸凉的药物来制约,就能在丽泽(比喻滋润之地)中收敛炎光;投以辛热的药物,就会在重明(比喻极度炎热)中放纵赫烈的阳光。
败毒防风(指人参败毒散、防风通圣散等方中的防风),是开发斩关的将领。解毒连翘(指黄连解毒汤、连翘饮等方中的连翘),是制伏降虏的士兵。皮疹如锦缎般烂漫,服用化斑汤后艳丽收敛;如火焰熏蒸,饮用凉膈散后热气清除。咽痛用甘桔汤、牛蒡子,止咳嗽更能润肺;小便涩滞用导赤散、芍药,定惊悸又可凉心。便秘用承气汤、胆导法。腹泻用黄芩、猪苓。大渴说明膈焦,在白虎汤中加入栝蒌;苦烦说明里有热,在安神丸中加入山栀。不要破坏天和(自然和谐),使阴阳适度调和;不要侵犯胃气,虽然攻补之法未必穷尽。
痘疮希望全部发出而不遗留,疹子希望全部透出而无病患。或者因为邪气郁遏,停留不去;或者因为正气损伤,困顿未能伸展。毒邪归于五脏,变化有四种证候:毒归脾胃,泄泻不止而变为痢疾;毒归心肝,烦热不退而发惊风;咳嗽久了咳血,毒邪归于肺;牙齿腐烂且生疳蚀,毒邪归于肾。轻者顺从制约法则趋向好转,平复有功;重者抗拒敌对肆意作恶,攻伐不胜。
热不退的,用调元汤加麦冬、知母;出现抽搐的,兼用琥珀抱龙丸、钱氏温惊丸。咳嗽不止的,用小阿胶散加杏仁、枳实;带血的,专门用补肺太平丸。注下(严重腹泻)用异功散、猪苓、泽泻;虚滑的,大量使用参苓白术散;痢疾用异功散加当归、芍药;休息痢少量给予真人养脏汤。惟有牙疳这一病,原本叫走马牙疳,起初口臭腐肉,渐渐出血穿龈,内服地黄丸制约火怪,外擦蚊蛤散杀灭精邪。牙齿若脱落,崩砂状的可畏;声音若嘶哑,狐惑证的难辨。
应当出而未出的,发汗解表,初起用惺惺散,次用防风通圣散,夺命丹大发透疹而有效;应当收而未收的,解肌清热,初起用葛根汤,次用化斑汤,河间凉膈散大解而最灵。颜色淡白为虚,四物汤去掉川芎加红花、桂枝;颜色紫黑为血热,化斑汤去掉人参加玄参烧粪(此处原文可能有误或特指某种用法,暂译)。夺命丹是发疹的圣药,无价散是解除疫疠的神方。发不出来而烦躁,担心不能度过腊日(指危重);黑不变色而谵妄,饮食不及新鲜(指病情恶化)。热蒸蒸颜色赤红,痢滴滴气息清醒。身体羸瘦骨肉脱失,螈疭神识昏乱,喘急胸高耸,疳烂漏腮缺唇,不要夸耀三世妙手,难留一息游魂。
难道没听说误服汤丸,不如不服药吗?又没看见特别触犯禁忌,可以自我反省。爱吃咸酸,咳嗽连绵不已;喜吃辛燥,火热燔灼不宁;甘甜过多导致龋齿,生冷过多导致粪便清稀。鸡是生风的畜类,鱼是动火的鳞类,贪吃鸡鱼扰乱进食,风火并起引发祸端。邪气反而滋盛,成为疹而不休止;毒邪反而深入,正值疫疠再次经过。这就是疹的遗毒,也像痘的后遗症。
想要决断内伤,必须详察外证。眼睛常赤痛,像青童抱火;鼻子常流涕衄血,像素女卧薪。因病损牙齿终身,像玄武困于汤镬;患癫痫连年,像朱雀惊于烧林。小便频数短涩,是州都(膀胱)遭火;大便溏垢如蛊,必是仓廪(脾胃)被焚。哮喘是炎上之象,丹瘤赤瘭之形,唇舌多疮,门户残烟未熄;咽喉常肿,管龠余烬犹存。如果探求其根源,一句话可以说尽;想要拔除根本,难道能一夜平复吗?唉!这篇赋的创作,效仿青蛙鸣叫,词虽鄙陋却积累如石,法则关于疹秘,所以叫《碎金》。
Rash belongs to the Sovereign Fire (Jun Huo), its Qi originates from the Shaoyin channel. When transmitted to its "son" organ (Spleen), it manifests as a Spleen-Stomach syndrome; when invading its "wife" organ (Lung), it appears in the skin and hair layer. It is also the eruption of fetal toxin, formed subsequently due to epidemic pestilence. Coughing and sneezing occur because Metal (Lung) is refined by Ding Fire (Heart/Sovereign Fire); sudden chest oppression and weeping arise because the Sovereign (Heart) resists the General (Liver). (The General refers to the Liver.) Attacking against the momentum of the disease easily breaks its sharpness; following the momentum to strike makes its锐气 (vigor) hard to overcome. Like snapping a budding sprout, no axe is needed; but if one waits for it to spread like a prairie fire, both jade and stone will be burned together.
The color of the rash resembles macules, and touching it reveals texture; its shape resembles smallpox, but visually it lacks fluid. Erupting in the morning and subsiding in evening indicates emission from the Yang aspect; erupting in the evening and subsiding in morning indicates emission from the Yin aspect. Its changes are unpredictable, appearing and disappearing without fixed patterns. Generally, it favors red and dislikes black; practitioners prefer cooling and avoid warming. Red like cinnabar dots represents a bright and manifest image; black like spilled ink represents extreme stagnation and obscurity of fire. Using sour-cooling herbs gathers the inflammatory light in moist places; administering acrid-hot herbs unleashes intense heat in blazing conditions.
Fangfeng (Saposhnikoviae Radix) in Baodu formulas (such as Renshen Baidu San [Ginseng Decoction for Overcoming Toxins] and Fangfeng Tongsheng San [Saposhnikovia Universal Relief Powder]) acts as the general who opens gates and cuts through passes. Lianqiao (Forsythiae Fructus) in Jiedu formulas (such as Huanglian Jiedu Tang [Coptis Decoction for Overcoming Toxins] and Lianqiao Yin [Forsythia Drink]) acts as the soldier who subdues rebels. If the rash spreads like brocade, taking Huaban Tang [Hua Ban Decoction]收敛s its brilliance; if it steams like fire, drinking Liange San [Cooling the Diaphragm Powder] clears the heat. For sore throat, Ganjie Tang [Licorice and Platycodon Decoction] and Niubangzi (Arctii Fructus) moisten the lungs and stop cough; for dysuria, Daochi San [Guide Out Redness Powder] and Shaoyao (Paeoniae Radix) calm palpitations and cool the heart. For constipation, Chengqi Tang [Chengqi Decoction] or Dan Dao (Gallbladder Enema) are used; for diarrhea, Huangqin (Scutellariae Radix) and Zhuling (Polyporus) are employed. For excessive thirst indicating scorching diaphragm, Gualou (Trichosanthis Fructus) is added to Baihu Tang [White Tiger Decoction]; for bitter vexation indicating interior heat, Shanzhi (Gardeniae Fructus) is added to Anshen Wan [Calming the Spirit Pill]. Do not disrupt Tianhe (Heavenly Harmony), allowing Yin and Yang to adjust moderately; do not violate Stomach Qi, even if attack and tonification methods are not exhausted.
Smallpox desires to fully erupt without retention; rash desires to fully emerge without illness. Sometimes pathogenic factors are stagnant and obstructed, remaining and not departing; sometimes Zhengqi (Upright Qi) is damaged, trapped and unable to extend. Toxin returning to the Five Zang organs produces four types of transformation: Toxin in Spleen/Stomach causes persistent diarrhea transforming into dysentery; Toxin in Heart/Liver causes persistent irritability and heat leading to convulsions; prolonged cough with blood indicates Toxin in Lung; rotting teeth and canker sores indicate Toxin in Kidney. Mild cases follow restraint rules to improve, achieving success through pacification; severe cases resist attack and act maliciously, proving unconquerable by assault.
For unremoved heat, use Tiaoyuan Tang [Tiaoyuan Decoction] with Maidong (Ophiopogonis Radix) and Zhimu (Anemarrhenae Rhizoma); for convulsions, add Hupo Baolong Wan [Amber Embracing Dragon Pill] and Qianshi Wenjing Wan [Qian's Calming Convulsion Pill]. For unceasing cough, use Xiao Ejiao San [Minor Donkey-Hide Gelatin Powder] with Xingren (Prunus Semen) and Zhishi (Aurantii Fructus); for bloody sputum, specialize in Bufe Taiping Wan [Tonify Lung Peace Pill]. For profuse diarrhea, use Yigong San [Yigong Powder], Zhuling, and Zexie (Alismatis Rhizoma); for deficiency and slipping, heavily use Shenling Baizhu San [Ginseng, Poria, and Atractylodes Macrocephala Powder]; for dysentery, use Yigong San with Danggui (Angelicae Sinensis Radix) and Shaoyao; for chronic intermittent dysentery, give Renzhen Yangzang Tang [True Human Nourishing Viscera Decoction] sparingly. Only for Ya Gan (Gum Gangrene), originally called Zouma (Running Horse) name: initially foul breath and rotting flesh, gradually bleeding and perforating gums; internally take Dihuang Wan [Rehmannia Pill] to restrain fire monsters; externally apply Wen Ge San [Mosquito Shell Powder] to kill spirits. If teeth fall out, the appearance of Bengsha (Collapsing Sand) is terrifying; if voice becomes hoarse, the condition of Huhuo (Hu and Huo diseases) is hard to clarify.
When eruption should occur but does not, promote release: start with Xingxing San [Xingxing Powder], then Fangfeng Tongsheng San; Duoming Dan [Duoming Pill] greatly promotes eruption and is effective. When resolution should occur but does not, resolve and clear: start with Gegen Tang [Kudzu Root Decoction], then Huaban Tang; Hejian Liange San [He Jian's Cooling Diaphragm Powder] greatly resolves and is most spiritual. Pale white color indicates deficiency: Siwu Tang [Four Substances Decoction] remove Chuanxiong add Honghua (Carthami Flos) and Guizhi (Cinnamomi Ramulus); purple-black color indicates Blood Heat: Huaban Tang remove Renshen add Xuanshen (Scrophulariae Radix) and burn feces (Note: Text implies specific preparation). Duoming Dan is the sage for promoting rash; Wuja San [Priceless Powder] is the divine for resolving epidemics. Failure to erupt with restlessness worries inability to survive past La day; black color unchanged with delirium means food intake fails to meet freshness needs. Steaming heat with red color, dripping dysentery with clear spirit. Emaciation and bone-muscle loss, convulsions and confused consciousness, panting with high chest, canker sores with leaking cheeks and missing lips—do not boast of three-generation skill, hard to retain a breath of wandering soul.
Have you not heard that mistakenly taking decoctions and pills is worse than taking no medicine? Have you not seen that specifically violating taboos allows self-reflection? Loving salty and sour foods leads to continuous coughing; preferring pungent and dry foods causes burning heat and unrest; excessive sweet foods cause dental caries; excessive cold/raw foods cause clear stools. Chicken is an animal generating Wind; fish is a scale creature stirring Fire. Greedily eating chicken and fish disrupts diet, causing Wind and Fire to jointly provoke disaster. Pathogenic factors instead proliferate, becoming persistent rash; toxins instead penetrate deep, meeting epidemic pestilence again. This is the residual toxin of rash, similar to sequelae of smallpox.
To decide internal injury, must detail external signs. Eyes often red and painful like Qingtong embracing fire; nose often runs and bleeds like Sunu lying on firewood. Disease damaging teeth lifelong like Xuanwu trapped in boiling water; epilepsy year after year like Zhuque startled by burning forest. Frequent short dysuria is Zhou Du (Bladder) suffering fire; loose foul stool like parasite is Canglin (Spleen/Stomach) being burned. Asthma is an image of flaming upward; Danliu (Red Swelling) and Chibiao (Red Blister) are shapes; many sores on lips and tongue, residual smoke at the gate not extinguished; constant swelling in throat, lingering embers in the pipe remain. If seeking the cause, one word suffices; if aiming to pull up the root, how can it be flattened overnight? Alas! This fu poem imitates frog croaking; words though humble accumulate like stones; principles regarding rash secrets are thus called Suijin (Broken Gold).