\r赤游丹\p04-a41a206.bmp\r
《内经》运气丹 皆属火。
经曰∶少阳司天，客胜则丹疹外发，及为丹 是也。
《圣惠》云∶夫一切丹毒者，为人身体忽然变赤如丹之状，故谓之丹毒也。或发
手足，或发腹上如手大，皆风热恶毒所为，重者亦有疽之类也。若不急治，则痛不可
忍；久则坏烂，出脓血数升。若发于节间，便令人四肢毒肿，入于腹则杀人，小儿得之最为急也。
戴复庵曰∶发丹色状不一，痒痛亦异，大概因血热肌虚，气邪所搏而发。然色赤
者多，以赤故谓之丹，有发而色白，谓之冷瘼。此病多缘肌肉疏为风邪所袭而成。风
热则赤，风冷则白，今人但呼赤为丹，白为瘼，古方亦名为瘾疹，非特分寒热，亦
兼备四气。近世方论呼白为婆瘼，赤为血风。
朱丹溪曰∶内伤 者，胃气极虚，一身如火游外所致，宜补以降之。
刘涓子《鬼遗方》云∶丹者恶毒之疮，
五色无痛为丹毒，痒者为风丹。
陈实功曰，赤游丹又名火丹，乃心火妄动，三焦风热乘之，故发于肌肤之表。有
干湿之不同，红白之各异。干者色红形如云片，上起风粟作痒发热，此属心肝二经
之火，治以凉心泻肝，化斑解毒汤主之。湿者色多黄白，大小不等，流水作烂多痛，此
属脾肺二经湿热，宜清肺泻脾，除湿胃苓汤主之。腰胁生之，肝火妄动，又名缠腰
丹，柴胡清肝汤主之。甚者急以细磁锋砭血，精猪肉片贴之。（《正宗》）
许学士曰∶飞灶丹从头顶红肿光起，（宜葱白自然汁调白芨末涂。）吉灶丹乃膀胱经风热，
从头上向脑后红肿，（宜赤小豆紫荆皮末，用鸡子清或酒调涂。）鬼火丹乃手足阳明经风热，从面上
起红肿，（宜蜜调制柏散或鸡子清调伏龙肝末涂之。）天火丹乃肾经中热毒，膀胱风热，从脊背起
赤肿，（宜一二年陈羊油熔化，调羌活末涂之。）天灶丹从两臂赤肿少黄色，或一臂，乃手阳明风
热，（宜柳枝烧灰，水调涂之，或冲和膏涂。）水激丹两
胁虚肿红热，乃足少阳胆经风热，（宜有孕母猪屎烧灰，蜡水涂之。）胡吹丹从脐上起黄肿者，是
任脉中热与湿，（宜醋调槟榔末涂，或酒调冲和膏涂。）野火丹从两腿上起赤肿如火烧，乃足阳明
经中风热，（宜羊油调乳香末涂，或捣火丹草和醋涂，或水调白芨末涂之。）烟火丹从两足背上起赤肿
痛，乃足三阳经风热，亦有足底心起，是足少阴肾经大热，（宜香油调猪石槽下土涂之，或蜜
调制柏散涂。）胡漏丹从阴上起，或黄肿赤肿，乃足厥阴肝经虚火发于外。（宜羊油调屋漏土涂之，或调制柏散醋涂。）
又曰∶此俱小儿受胎内之毒，如三日不治，攻入肠胃必死。
又曰∶凡小儿未满百日发丹，不拘是何丹，必死。
窦汉卿曰∶游丹发于头者何以治之，必须将患儿眠在床上，以脚跟一头加砖一二
块，以坠毒瓦斯于头，再用磁锋砭之，使毒瓦斯毒血皆从头顶而出，若乳母抱立在身砭
之，则毒瓦斯顺下，遂壅咽喉，必难生矣。近观同道之友，颠倒砭之，不行其手法以害诸儿，故不辞琐琐，又申明之。
又曰∶凡丹入于腹中，饱闷脐凸，体若燔炭者死。
又曰∶内丹从胁下至腰下肿，发赤色至腰则死。
申斗垣曰∶内丹言赤色如涂朱，映于肉里，故名内丹，似板而微肿。如发于渊
腋金门等穴，或右或左，皆少阳胆经，一二日者可治；如连腰脐青紫及大痛，或大
小便不通，皆不可治，死之必矣。（《启玄》）
又曰∶夹豆丹者赤也，如涂赤朱于皮肤之上，乃热毒蕴蓄恶血，命门相火合而
发起，与痘相兼而生。如霞片浮而薄者易治；浓而紫者难痊。当顺天时，若暑热以
通圣辛凉之剂解之，严寒以升麻葛根辛温之剂解之。痘疮既发，正合其宜，又有失
于调护，受风热则血沸腾，感寒冷则血凝泣，亦可用涂敷之法于外。
又曰∶丹从腹往四肢者生，从四肢入
腹者无救。
窦汉卿曰∶赤丹急用磁锋砭去紫血，自下而上，则毒血流上，不可逆砭，急用乳
香末鸡子清调匀涂砭处，时以芭蕉根汁涂之。
又曰∶又有一种烂皮火丹，用莲蓬 、面粉、伏龙肝、黄柏末和匀干掺。
李东垣曰∶丹毒者，谓人身忽然赤如涂丹之状，故谓之丹毒。世俗有云赤瘤，或
因有疮误而相触，四畔 赤，谓之疮瘤。凡丹毒之疾，皆游走不定，状如云气者是也。
小儿得之，最忌百日之内，谓之胎瘤。以其气血嫩弱，脏腑柔脆，难任镰针，所以忌也。
冯鲁瞻曰∶赤紫丹瘤皆心火内郁而发，赤如丹砂，故名曰丹。因热毒客于皮肤，搏
于气血而风乘之，阴滞于阳则发丹毒。热极生风，片刻之间，游走遍体，虚热则痒，
实热则痛。自腹而达于四肢者易治。自四肢而归于腹者难疗。书虽有五色之分，十
丹之异，总不出血热而属于心，心火内炽，客风外乘，风胜则树木皆摇，故令游走殊
速。名为丹者。以心应火而色赤也。色红者生，白者气虚挟痰，紫者毒盛，色青如
苔者死。赤者名赤游丹，热毒感之深也。其状赤肿，片片如胭脂涂染，或发于手足，或
发于头面胸背，令儿躁闷腹胀，其热如火，痛不可忍，游走遍体，流行甚速，须急治
之；若一入腹入肾，即不可救。白者名曰白游风，感风湿之轻证也。其候流块作痒，
壮热憎寒，鼻塞脑闷，咳嗽吐逆。其治之法，赤者清凉解毒，甚则砭去恶血，以药
涂之，白者不过疏散渗湿而已。火灼疮者，先天之热毒也，火走空窍，故必于口鼻眼
目，阴囊粪门之处红点如癣，渐成红泡，逾日而穿，赤色无皮，如汤火 炙之状，痛
苦殊甚，睡卧不安，一二日间周身能腐；若至囟门肿气，阴毒肿亮者不治。及一切丹
毒入脏，脐突出浆，面颊紫浮，噎气不乳，手足拳禁，大小便绝，胸背血点，舌生黑
疮，心胸紫肿者，皆为不治。然小儿脏腑娇嫩，凡一切丹毒，必先内服解毒，方可
外敷。盖毒易入难出，肌肉受伤其害轻，脏腑受伤其害速耳。（《锦囊》）
陈实功曰∶小儿赤游丹乃受毒于未生前，发病于有生后。盖身在胞胎，皆赖父
精母血借以生养，父母不能节其欲，多致淫火猖炽，胎必侵受；既生之后，热汤洗
浴，烘熏衣物，触动内毒；欲发之时，先必发热啼叫惊搐，次生红肿光亮发热，瞬
息游走无定，发无定处，先从头额起者名天灶丹。治以升麻葛根汤，母子同服。余
皆起于腹背，腹背流入四肢者轻；起于四肢流入胸背者重。有此总宜砭去恶血为要。
砭血之后，先用猪精肉缝片贴之，一时许，以金黄散用水芭蕉根捣汁调敷。如毒瓦斯入
里，腹胀坚硬不乳者，紫雪散下之，三日后身渐彻凉，砭血之处，肉便软活，声清
腹软，乳哺如常者顺，反此为逆。（《正宗》）
钱青抡曰∶天火丹从背上起赤点疤，（桑白皮为末，羊脂调涂。）水激丹从两胁虚肿起，（生
铁锉末，猪粪调涂之。）缠腰丹腰生一红蕾，两边生红筋，缠至脐必死，（金墨磨浓和雄黄末涂之。）冷
丹白颜料者，（用姜皮一撮煎汤洗之。）热丹红颜料者，（紫背浮萍煎汤洗之。）丹瘤或生颏下如樱桃，
突出色赤而光者是也。（宜以绵羊脑子同朴硝研烂贴患处，立效。）丹疹遍身红点如洒朱者是也。（用
防己半两，朴硝、犀角、黄芩、黄 、升麻各一钱，加竹沥煎服，即愈。）火丹遍身红肿是也。（用当归、赤
芍、甘草、大黄各等分，每服三钱，水半盅，煎三四分，食后服，亦效。）火丹发于足踝者，（用芸薹菜捣敷，
随手即消。）赤游风丹忽然肿痒，流行不止一处者是也，此证至急，救迟则死。（用雄黄、五倍
子各等分为末，醋调涂之，或用无名异为末，葱汁调涂立消，或用铁锈水涂之即消，或用新生荷叶捣烂
入盐少许，涂之即消。）
《黄帝内经》中关于五运六气的论述指出，丹毒均归属于火邪。
经典医籍记载：当少阳相火司天之年，客气偏胜则会导致丹疹外发，以及出现丹毒症状，说的就是这种情况。
《太平圣惠方》中说：凡是各种丹毒，都是人体皮肤突然变得像丹砂一样红润，所以称为丹毒。有的发作在手足，有的发作在腹部，大小如手掌，这都是由风热恶毒引起的，严重的也属于疽的范畴。如果不紧急治疗，疼痛将难以忍受；时间久了则会溃烂，流出数升脓血。如果发作在关节之间，就会让人四肢肿胀有毒；如果毒气进入腹部，则会致死，小儿患此病最为危急。
戴复庵说：丹毒发作时的颜色和形态各不相同，瘙痒和疼痛的表现也不一样，大体上是因为血热肌虚，气分邪气搏结而引发。其中颜色发红的居多，因为红色所以称为丹，也有发作时颜色发白的，称为冷瘼（一种白色的丹毒）。这种病多是因为肌肉腠理疏松，被风邪侵袭而成。感受风热则发红，感受风冷则发白，现在的人只把红色的叫作丹，白色的叫作瘼，古代方书也称之为瘾疹，这不仅区分了寒热，也兼备了风、寒、暑、湿四气的致病因素。近世的方论把白色的称为婆瘼，红色的称为血风。
朱丹溪说：内伤导致的丹毒，是胃气极度虚弱，全身如火焰游走于体表所致，适宜用补益法来降火。
刘涓子在《鬼遗方》中说：丹是恶毒的疮疡，五色而无疼痛的是丹毒，发痒的是风丹。
陈实功说，赤游丹又名火丹，是由于心火妄动，三焦的风热乘虚侵袭，所以发作在肌肤表面。有干性和湿性之分，红色和白色也有差异。干性的颜色红，形状像云片，上面起风粟样小疙瘩并伴有瘙痒发热，这属于心肝二经的火邪，治疗以凉心泻肝为主，主方用化斑解毒汤。湿性的颜色多黄白，大小不等，流水溃烂且疼痛较多，这属于脾肺二经的湿热，宜清肺泻脾，主方用除湿胃苓汤。如果在腰胁部生长，是肝火妄动，又名缠腰丹，主方用柴胡清肝汤。病情严重的，急需用细磁锋刺破皮肤放血，并用精瘦猪肉切片贴敷。（出自《外科正宗》）
许学士说：飞灶丹从头顶开始红肿光亮，（宜用葱白自然汁调和白及末涂抹。）吉灶丹是膀胱经的风热，从头部向脑后红肿，（宜用赤小豆和紫荆皮末，用鸡蛋清或酒调匀涂抹。）鬼火丹是手足阳明经的风热，从面部起红肿，（宜用蜜调制柏散或用鸡蛋清调伏龙肝末涂抹。）天火丹是肾经的热毒和膀胱的风热，从脊背起赤肿，（宜用一二年陈年的羊油熔化，调和羌活末涂抹。）天灶丹从两臂赤肿略带黄色，或者只有一只手臂，这是手阳明经的风热，（宜用柳枝烧成灰，用水调匀涂抹，或者用冲和膏涂抹。）水激丹在两胁部虚肿红热，这是足少阳胆经的风热，（宜用怀孕母猪的粪便烧成灰，用蜡水调匀涂抹。）胡吹丹从肚脐上方起黄肿，这是任脉中的热与湿，（宜用醋调槟榔末涂抹，或用酒调冲和膏涂抹。）野火丹从两腿上起赤肿像火烧一样，这是足阳明经中风热，（宜用羊油调乳香末涂抹，或者捣碎火丹草加醋涂抹，或者用水调白及末涂抹。）烟火丹从两足背上起赤肿痛，这是足三阳经的风热，也有从足底心发起的，这是足少阴肾经的大热，（宜用香油调猪石槽下的泥土涂抹，或者用蜜调制柏散涂抹。）胡漏丹从阴部发起，或者黄肿赤肿，这是足厥阴肝经的虚火发散于外。（宜用羊油调屋漏土涂抹，或者用调制柏散加醋涂抹。）
又说：这些都是小儿在胎内受毒所致，如果三天不治疗，毒气攻入肠胃必定死亡。
又说：凡是未满百日的小儿发丹，不管是什么类型的丹，必定死亡。
窦汉卿说：游丹发作在头部该如何治疗？必须让患儿躺在床上，在脚跟下垫一两块砖，以坠压毒气使其下行至头部，再用磁锋刺破皮肤放血，使毒气和毒血都从头顶排出。如果让乳母抱着站立着进行砭刺，那么毒气会顺行向下，随即壅塞咽喉，必定难以存活。近来观察同行的朋友，颠倒操作砭刺方法，不按正确手法施治从而害死了许多孩子，所以我不辞繁琐，再次申明这一点。
又说：凡是丹毒进入腹中，出现腹胀满闷、肚脐凸出，身体像燃烧的炭火一样高热者，必死。
又说：内丹从胁下延伸到腰部以下肿胀，发赤色蔓延到腰部则死。
申斗垣说：内丹是指红色像涂了朱砂一样，映现于肉里，所以叫内丹，摸起来像木板一样微肿。如果发作在渊腋、金门等穴位，或者左右一侧，都属于少阳胆经，一二天内可以治疗；如果连累腰脐部位呈现青紫色且剧烈疼痛，或者大小便不通，都不可治疗，必定死亡。（出自《启玄微旨》）
又说：夹豆丹是红色的，像涂了赤朱在皮肤上，这是热毒蕴蓄恶血，命门相火合而发起，常与痘疹并发。如果像霞片那样浮薄容易治疗；浓厚而紫色的难痊愈。应当顺应天时，如果是暑热天气，用通圣散这类辛凉剂解表；严寒天气用升麻葛根汤这类辛温剂解表。痘疮既然发出，正合适宜。又有因护理不当，感受风热则血液沸腾，感受寒冷则血液凝滞，也可以用外敷的方法治疗。
又说：丹毒从腹部往四肢扩散的能生还，从四肢进入腹部的无法救治。
窦汉卿说：赤丹急需用磁锋刺去紫血，必须自下而上砭刺，这样毒血才能向上流出，不可逆向砭刺，急用乳香末和鸡蛋清调匀涂抹砭刺处，时常以芭蕉根汁涂抹。
又说：还有一种烂皮火丹，用莲蓬壳、面粉、伏龙肝、黄柏末混合均匀干撒。
李东垣说：丹毒，是说人身突然变红像涂了丹砂的样子，所以叫丹毒。世俗有说法称赤瘤，或者因为疮口误触，四周发红，称为疮瘤。凡是丹毒的疾病，都是游走不定，形状像云气一样的。小儿得了这个病，最忌讳在百日之内，称为胎瘤。因为小儿气血嫩弱，脏腑柔脆，难以承受镰针的刺激，所以忌讳使用。
冯鲁瞻说：赤紫丹瘤都是心火内郁而发，红得像丹砂，所以叫丹。因为热毒客居皮肤，搏结于气血并被风邪侵袭，阴气阻滞于阳气则发丹毒。热极生风，片刻之间，游走遍体，虚热则痒，实热则痛。从腹部到达四肢的容易治疗。从四肢回归腹部的难治。书籍虽然有五色之分，十种丹的不同，总不出血热而归属于心，心火内炽，客风外乘，风胜则树木皆摇，所以令其游走特别快。命名为丹，是因为心对应火而色赤。颜色红的预后好，白色的气虚挟痰，紫色的毒盛，颜色青如苔藓的死。红色的名叫赤游丹，热毒感之深重。其状赤肿，片片像胭脂涂染，有的发作在手足，有的发作在头面胸背，让孩子烦躁胸闷腹胀，其热如火，疼痛难以忍受，游走遍体，流行速度很快，必须紧急治疗；如果一旦进入腹部和肾脏，就不可救药。白色的名叫白游风，是感受风湿的轻证。其候流块作痒，壮热憎寒，鼻塞脑闷，咳嗽吐逆。其治疗方法，红色的清凉解毒，严重的刺去恶血，用药涂抹；白色的不过疏散渗湿而已。火灼疮，是先天热毒，火走空窍，所以一定在口鼻眼目、阴囊肛门之处出现红点像癣一样，逐渐变成红泡，过一天后破溃，赤色无皮，像汤火烫伤的样子，痛苦非常严重，睡卧不安，一两天间周身可能腐烂；如果到了囟门肿气，阴毒肿亮的不治。以及一切丹毒入脏，脐突出浆，面颊紫浮，噎气不乳，手足拳禁，大小便绝，胸背血点，舌生黑疮，心胸紫肿的，都是不治之症。然而小儿脏腑娇嫩，凡是一切丹毒，必须先内服解毒，才可以外敷。因为毒气易入难出，肌肉受伤危害轻，脏腑受伤危害迅速罢了。（出自《幼科金针锦囊》）
陈实功说：小儿赤游丹是在出生前受毒，出生后发病。身体在胞胎中，都依赖父精母血借以生养，父母不能节制欲望，多导致淫火猖獗，胎儿必然侵受；出生后，用热水洗澡，烘烤熏蒸衣物，触动内毒；将要发作时，先必定发热啼叫惊搐，接着产生红肿光亮发热，瞬息游走无定，发无定处，先从额头起的叫天灶丹。治疗用升麻葛根汤，母子同服。其余的都起于腹背，腹背流入四肢的较轻；起于四肢流入胸背的较重。有此病总宜砭去恶血为关键。砭血之后，先用猪精肉缝片贴敷，约一小时后，用金黄散用水芭蕉根捣汁调敷。如果毒气入里，腹胀坚硬不喝奶的，用紫雪散攻下，三日后身体渐渐彻凉，砭血之处，肉便软活，声音清脆腹部柔软，吃奶如常的为顺证，反之则为逆证。（出自《外科正宗》）
钱青抡说：天火丹从背上起赤点疤，（桑白皮为末，羊脂调涂。）水激丹从两胁虚肿起，（生铁锉末，猪粪调涂之。）缠腰丹腰生一红蕾，两边生红筋，缠至脐必死，（金墨磨浓和雄黄末涂之。）冷丹白颜料者，（用姜皮一撮煎汤洗之。）热丹红颜料者，（紫背浮萍煎汤洗之。）丹瘤或生颏下如樱桃，突出色赤而光者是也。（宜以绵羊脑子同朴硝研烂贴患处，立效。）丹疹遍身红点如洒朱者是也。（用防己半两，朴硝、犀角、黄芩、黄 、升麻各一钱，加竹沥煎服，即愈。）火丹遍身红肿是也。（用当归、赤芍、甘草、大黄各等分，每服三钱，水半盅，煎三四分，食后服，亦效。）火丹发于足踝者，（用芸薹菜捣敷，随手即消。）赤游风丹忽然肿痒，流行不止一处者是也，此证至急，救迟则死。（用雄黄、五倍子各等分为末，醋调涂之，或用无名异为末，葱汁调涂立消，或用铁锈水涂之即消，或用新生荷叶捣烂入盐少许，涂之即消。）
Chi You Dan (Red Roaming Erysipelas)
The *Huangdi Neijing* (Yellow Emperor's Inner Canon), in its discussions on the Five Movements and Six Qi, states that erysipelas all belongs to Fire.
The classics state: "When Shaoyang (Lesser Yang) governs the year, if the guest pathogen prevails, it causes red rashes to erupt externally, as well as erysipelas." This refers to such cases.
*Tai Ping Sheng Hui Fang* (Comprehensive Essential Formulas for the Universal Benevolent Sages) says: "Regarding all types of erysipelas, the human body suddenly turns red like cinnabar, hence it is called erysipelas." It may erupt on the hands and feet, or on the abdomen, sized like a palm. All are caused by wind-heat and malignant toxins; severe cases also belong to the category of carbuncles (Ju). If not treated urgently, the pain will be unbearable; over time, it will ulcerate and discharge several sheng (a unit of volume) of pus and blood. If it erupts between the joints, it causes toxic swelling of the four limbs; if the toxin enters the abdomen, it leads to death. Infants contracting this disease face the most critical situation.
Dai Fu'an said: "The color and shape of erysipelas vary, and so do the sensations of itching and pain. Generally, it arises from blood heat and muscle deficiency, with qi pathogens clashing and causing eruption. Red ones are common; because they are red, they are called 'Dan' (Cinnabar/Red). There are also white eruptions, called Leng Mo (Cold Erysipelas)." This disease often occurs due to loose muscle texture being invaded by wind pathogens. Wind-heat causes redness; wind-cold causes whiteness. Nowadays, people only call red ones 'Dan' and white ones 'Mo'. Ancient formulas also named them Yin Zhen (Urticaria/Hives). This not only distinguishes cold from heat but also encompasses the four climatic factors (Wind, Cold, Summer-Heat, Dampness). Recent medical theories call white ones 'Po Mo' and red ones 'Xue Feng' (Blood Wind).
Zhu Danxi said: "Erysipelas caused by internal injury results from extremely deficient Stomach Qi, with the whole body feeling like fire roaming externally. It is suitable to use tonification to descend the fire."
Liu Juanzi in *Gui Yi Fang* (Ghost Remnant Formulas) said: "Dan is a malignant toxic sore. Those with five colors and no pain are erysipelas; those that itch are Wind Dan."
Chen Shigong said: "Chi You Dan (Red Roaming Erysipelas), also known as Huo Dan (Fire Erysipelas), is caused by reckless movement of Heart Fire, with wind-heat of the San Jiao (Triple Burner) taking advantage of the weakness, thus erupting on the surface of the skin. There are dry and wet types, differing in red and white colors. The dry type is red in color, shaped like cloud patches, with wind-grain-like papules rising on top, accompanied by itching and fever. This belongs to the fire of the Heart and Liver meridians. Treatment should cool the Heart and drain the Liver, using Hua Ban Jie Du Tang (Spot-Transforming Detoxification Decoction) as the main formula. The wet type is mostly yellowish-white, varying in size, weeping fluid, ulcerating, and painful. This belongs to damp-heat of the Spleen and Lung meridians. One should clear the Lungs and drain the Spleen, using Chu Shi Wei Ling Tang (Dampness-Removing Wei Ling Decoction) as the main formula. If it grows on the waist and hypochondrium, it is reckless Liver Fire, also known as Chan Yao Dan (Waist-Coiling Erysipelas), treated mainly with Chai Hu Qing Gan Tang (Bupleurum Liver-Clearing Decoction). In severe cases, urgently use fine magnetic tips to prick the blood, and apply slices of lean pork to the affected area." (From *Wai Ke Zheng Zong*)
Xu Xueshi said: "Fei Zao Dan (Flying Stove Erysipelas) starts with red swelling and brightness from the top of the head. (Suitable to mix scallion white natural juice with Baidi powder and apply.) Ji Zao Dan (Auspicious Stove Erysipelas) is wind-heat of the Bladder Meridian, starting from the head towards the back of the neck with red swelling. (Suitable to mix Xiaodou and Zijingpi powder, using egg white or wine to apply.) Gui Huo Dan (Ghost Fire Erysipelas) is wind-heat of the Hand-Yangming meridians, starting with red swelling on the face. (Suitable to mix Mi Zhi Bo San with honey or egg white and Fulonggan powder to apply.) Tian Huo Dan (Heavenly Fire Erysipelas) is heat-toxin of the Kidney Meridian and wind-heat of the Bladder, starting with red swelling on the spine. (Suitable to melt 1-2 year old sheep fat, mix with Qianghuo powder and apply.) Tian Zao Dan (Heavenly Stove Erysipelas) presents with red swelling and slight yellowing on both arms, or one arm. This is wind-heat of the Hand-Yangming meridian. (Suitable to burn willow branches to ash, mix with water to apply, or apply Chonghe Gao.) Shui Ji Dan (Water-Splashed Erysipelas) presents with virtual swelling, redness, and heat on both hypochondriums. This is wind-heat of the Foot-Shaoyang Gallbladder Meridian. (Suitable to burn feces of a pregnant sow to ash, mix with wax water to apply.) Hu Chui Dan (Hu Blown Erysipelas) starts with yellow swelling above the navel. This is heat and dampness in the Ren Mai (Conception Vessel). (Suitable to mix Binglang powder with vinegar to apply, or Chonghe Gao with wine.) Ye Huo Dan (Wild Fire Erysipelas) starts with red swelling on both legs like burning fire. This is wind-heat in the Foot-Yangming Meridian. (Suitable to mix Ruxiang powder with sheep fat, or crush Huodan Cao and mix with vinegar, or mix Baiji powder with water to apply.) Yan Huo Dan (Smoke-Fire Erysipelas) starts with red swelling and pain on the dorsum of both feet. This is wind-heat of the Foot-Taiyang, Foot-Yangming, and Foot-Shaoyang meridians. Some start from the sole of the foot, indicating excessive heat in the Foot-Shaoyin Kidney Meridian. (Suitable to mix Xiangyou with soil from under pig troughs, or Mi Zhi Bo San to apply.) Hu Lou Dan (Hu Leaking Erysipelas) starts from the genitalia, presenting as yellow or red swelling. This is deficient fire of the Foot-Jueyin Liver Meridian erupting externally. (Suitable to mix Yangyou with Wulou Tu, or Zhi Bo San with vinegar to apply.)"
It is further stated: "These are all caused by toxins received in the womb. If not treated within three days, the toxin attacks the intestines and stomach, leading to certain death."
It is further stated: "For any infant under 100 days old who develops erysipelas, regardless of the type, death is inevitable."
Dou Hanqing said: "How to treat You Dan (Roaming Erysipelas) erupting on the head? One must lay the infant on a bed, place one or two bricks under the heels to weigh down and drive the toxic vapor downwards to the head, then prick with magnetic tips to allow toxic vapor and blood to exit from the top of the head. If held upright by the nurse during pricking, the toxic vapor will flow downwards, blocking the throat, making survival difficult. Recently, I have observed colleagues performing pricking incorrectly, harming many children. Therefore, I do not shy away from triviality and reiterate this point."
It is further stated: "Whenever erysipelas enters the abdomen, causing fullness, distension, protruding umbilicus, and a body hot as burning charcoal, death ensues."
It is further stated: "For Nei Dan (Internal Erysipelas), if swelling extends from below the ribs to below the waist, and redness spreads to the waist, death occurs."
Shen Douyuan said: "Nei Dan refers to redness like applied vermilion, visible within the flesh, hence the name. It feels board-like with slight swelling. If it erupts at points such as Yuanxi and Jinmen, on either right or left, it belongs to the Shaoyang Gallbladder Meridian and is treatable within one to two days. If it involves the waist and umbilicus turning blue-purple with severe pain, or if urination and defecation are blocked, it is untreatable and death is certain." (From *Qi Xuan Wei Zhi*)
It is further stated: "Jia Dou Dan (Bean-Clasping Erysipelas) is red, like vermilion painted on the skin. It is caused by heat-toxin accumulating with evil blood, combined with Mingmen (Gate of Life) ministerial fire erupting. It often occurs alongside smallpox. If it floats thinly like rosy clouds, it is easy to treat; if thick and purple, it is difficult to cure. One should follow the seasons: in summer heat, use Tongsheng San (Universal Salvation Powder) or similar acrid-cool agents to resolve it; in severe cold, use Shengma Gegen Tang (Cimicifuga and Pueraria Decoction) or similar acrid-warm agents. Once smallpox erupts, this timing is appropriate. Neglect in care can lead to wind-heat causing blood boiling, or cold causing blood stagnation. External application methods can also be used."
It is further stated: "Erysipelas spreading from the abdomen to the four limbs indicates survival; entering the abdomen from the four limbs indicates no hope of rescue."
Dou Hanqing said: "For Chi Dan (Red Erysipelas), urgently use magnetic tips to remove purple blood. Prick from bottom to top so toxic blood flows upward; do not prick against the flow. Urgently apply Ruxiang powder mixed with egg white to the pricked area, and frequently apply juice from Banana Root."
It is further stated: "There is another type called Lan Pi Huo Dan (Rotting Skin Fire Erysipelas). Mix lotus pod shells, flour, Fulonggan, and Huangbai powder evenly and sprinkle dry."
Li Dongyuan said: "Erysipelas refers to the human body suddenly turning red like applied cinnabar, hence the name. Secularly called 'Chi Liu' (Red Tumor), or caused by touching wounds, causing surrounding redness, called 'Chuang Liu' (Sore Tumor). All diseases of erysipelas wander不定 (without fixed location), resembling cloud vapor. For infants, it is most taboo within 100 days, called 'Tai Liu' (Fetal Tumor). Because their Qi and Blood are tender and weak, and Zang-Fu organs are soft and fragile, they cannot withstand the knife-needle, hence the taboo."
Feng Luzhan said: "Chi Zi Dan Liu (Red-Purple Erysipelas Tumor) all erupt from internally depressed Heart Fire, red like cinnabar, hence called Dan. Heat-toxin lodges in the skin, clashes with Qi and Blood, and is ridden by wind. Yin stagnates in Yang, causing erysipelas. Extreme heat generates wind, wandering the body in moments. Deficient heat causes itching; excess heat causes pain. Spreading from abdomen to limbs is easy to treat; returning from limbs to abdomen is difficult. Although books mention five colors and ten types of Dan, it all stems from blood heat belonging to the Heart. Heart fire blazes internally, guest wind strikes externally. When wind prevails, trees shake; thus, it wanders very fast. Named 'Dan' because the Heart corresponds to Fire and the color is red. Red color indicates life; white indicates Qi deficiency with phlegm; purple indicates盛 (excess) toxin; green-blue like moss indicates death. Red is named Chi You Dan, indicating deep infection of heat-toxin. Its appearance is red swelling, patchy like rouge, erupting on hands, feet, head, face, chest, or back, causing irritability, chest oppression, abdominal distension, heat like fire, unbearable pain, wandering the body, flowing rapidly. Must treat urgently; if it enters abdomen and Kidneys, it is incurable. White is named Bai You Feng (White Roaming Wind), a mild syndrome of wind-dampness. Symptoms include flowing lumps with itching, high fever with aversion to cold, nasal congestion, brain stuffiness, cough, and vomiting. Treatment: Red type uses cooling and detoxification; severe cases prick out evil blood and apply medicine. White type uses only dispersing and draining dampness. Huo Zhuo Chuang (Fire-Burning Sore) is congenital heat-toxin. Fire travels through hollow orifices, appearing as red spots like tinea on mouth, nose, eyes, ears, scrotum, and anus, gradually becoming red blisters, breaking after a day, leaving red skinless areas like scalds, with extreme pain, restlessness, and potential total body rot within 1-2 days. If fontanelle swells with Qi, or Yin-Du swells brightly, it is untreatable. Also, all erysipelas entering Zang organs, with protruding umbilicus discharging plasma, purple-floating cheeks, choking refusing milk, clenched fists, cessation of urination/defecation, blood spots on chest/back, black sores on tongue, purple-swelling of heart/chest, are all untreatable. However, infants have delicate Zang-Fu organs. For all erysipelas, one must first take internal detoxifying herbs before external application. Toxins enter easily but exit hard; injury to muscles is minor harm, injury to Zang-Fu is rapid and severe harm." (From *You Ke Jin Zhen Jin Nang*)
Chen Shigong said: "Infant Chi You Dan receives toxins before birth and manifests after birth. While in the womb, nourishment relies on father's essence and mother's blood. If parents cannot restrain desires, rampant lust-fire inevitably invades the fetus. After birth, hot baths, drying clothes with heat/smoke, touch off internal toxins. Before eruption, there is fever, crying, and convulsions, followed by red swelling, brightness, and heat, wandering instantly without fixed location. Starting from forehead is named Tian Zao Dan. Treat with Shengma Gegen Tang, taken by both mother and child. Others start on abdomen/back. Abdomen/back spreading to limbs is mild; limbs spreading to chest/back is severe. Total principle is to prick out evil blood. After pricking, first apply slices of lean pork for about an hour, then apply Jinhuang San mixed with juice crushed from water banana root. If toxic vapor enters interior, causing hard abdominal distension and refusal to nurse, administer Xuexue San (Purple Snow Powder). After three days, if body cools completely, flesh at pricked site becomes soft and active, voice clear, abdomen soft, and nursing normal, it is a favorable sign (Shun); otherwise, it is unfavorable (Ni)." (From *Wai Ke Zheng Zong*)
Qian Qinglun said: "Tian Huo Dan starts with red spot scars on the back. (Powdered Sangbaipi mixed with sheep fat to apply.) Shui Ji Dan starts with virtual swelling on both hypochondriums. (Powdered raw iron filings mixed with pig manure to apply.) Chan Yao Dan has a red bud on the waist with red veins on both sides; if it coils to the navel, death ensues. (Thick gold ink mixed with Xionghuang powder to apply.) Leng Dan (Cold Dan) appears as white pigment. (Boil a pinch of Jiangpi [Ginger Peel] in water to wash.) Re Dan (Hot Dan) appears as red pigment. (Boil Zibeifuping [Mint/Floating Duckweed] in water to wash.) Dan Liu (Erysipelas Tumor) sometimes grows under the chin like a cherry, protruding, red, and shiny. (Grind mutton brain with Puxiao [Mirabilite] until paste-like, apply to lesion for immediate effect.) Dan Zhen (Erysipelas Rash) presents as red dots all over the body like sprinkled vermilion. (Use Fangji 1.5 liang, Puxiao, Xijiao, Huangqin, Huangqi, Shengma each 1 qian, add Zhuli [Bamboo Sap], decoct and drink for cure.) Huo Dan (Fire Erysipelas) presents with red swelling all over the body. (Equal parts Danggui, Chishao, Gancao, Dahuang. Take 3 qian per dose, half cup water, decoct to 3-4 fen, take after meals, also effective.) Huo Dan erupting on ankles. (Crush Yuntaicai [Rapeseed Greens] and apply, disappears immediately.) Chi You Feng Dan (Red Roaming Wind Erysipelas) suddenly swells and itches, flowing to more than one place. This condition is extremely urgent; delayed rescue leads to death. (Equal parts Xionghuang and Wubeizi powdered, mixed with vinegar to apply. Or Wu Mingyi powder mixed with scallion juice for immediate disappearance. Or rust water applied for disappearance. Or fresh lotus leaves crushed with a little salt applied for disappearance.)"