脉浮者,消气为主。脉浮数者,祛风清热。脉沉数者,泻火为主。脉数按之沉实者,解
表攻里。
一妇人患 ,作痒脉浮,以消风散,四剂而愈。
一妇人患 ,作痒脉浮数,以人参败毒散,二剂稍愈;更以消风散,四剂而安。
一男子患 ,色赤紫 痛,发热喜冷,脉沉实,以防风通圣散,一剂顿退;又以荆防败
毒散加芩、连,四剂而愈。
一妇人患斑,痒痛,大便秘,脉沉实,以四物汤加芩、连、大黄、槐花,治之而愈。
一老人患疹,色微赤,作痒,发热,以人参败毒散,二剂稍愈;以补中益气汤,加黄芩
、山栀而愈。
一小儿患疹作痛,发热烦渴,欲服清凉饮下之。诊其脉不实,举指不数,此邪在经络也
,不
王海藏曰∶前人云∶首尾俱不可下者,何也?曰∶首不可下者,为 未见于表,下则邪气不
得伸越,此脉证有表而无里,故禁首不可下也;尾不可下者,为 毒已显于外,内无根蒂,
大便不实,无一切里证,下之则 气逆陷,故禁尾不可下也。一儿作痒发热,以消毒犀角饮
,一剂作吐泻,此邪气上下俱出也,毒自解,少顷吐泻俱止,其疹果消。吐泻后,脉见七至
,此小儿和平之脉也,邪已尽矣,不须治,果愈。洁古云∶ 疹之病,其为证各异。发 肿
于外者,属少阳三焦相火也,谓之 ;小红靥行皮肤之中,不出者,属少阳君火也,谓之疹
凡显 证,若自吐泻者,慎勿乱治,而多吉,谓邪气上下皆出也, 疹并出,小儿难禁,是
以别生他证也。首尾不可下,大抵安里之药多,发表之药少,秘则微疏之,令邪气不壅,并
令其次第出,使儿易禁也。身温暖者顺,身凉者逆。
一男子患丹毒, 痛便秘,脉数而实,服防风通圣散不应,令砭患处,去恶血,仍用前
药即愈。
一小儿腿患丹如霞,游走不定,先以麻油涂患处,砭出恶血,毒即散;更以金银花散,
一剂而安。
一小儿患之,外势虽轻,内则大便不利,此患在脏也,服大连翘饮,敷神效散而瘥。
一小儿遍身皆赤,砭之,投解毒药而即愈。
一小儿遍身亦赤,不从砭治,以致毒瓦斯入腹,遂不救,此症乃恶毒热血,蕴蓄于命门,
遇相
,砭之以泄其毒。凡从四肢起入腹者不治。虽云,丹有数种,治有数法,无如砭之为善,常
见患稍重者,不用砭法,俱不救也。
附方
消风散(方见疮疥门)
荆防败毒散(方见溃疡发热门)
四物汤(方见瘰 门)
防风通圣散(方见天泡疮门)
人参败毒散
补中益气汤(二方见溃疡发热门)
清凉饮(方见发背门)
消毒犀角饮子 治 或瘾疹瘙痒或作痛,及风热疮毒。
牛蒡子(二钱) 荆芥 防风(各一钱半) 甘草(三分) 作一剂,水一钟,煎五分,徐徐
服。
解毒防风汤 治 或瘾疹,痒或作痛。
防风(一钱) 地骨皮 黄 芍药 荆芥 枳壳(炒,各二钱) 作一剂,水一钟,煎五
分,徐徐服。
金银花散(方见作呕门)
神功散(方见发背门)
大连翘饮(方见天泡疮门)
砭法 治小儿丹毒色赤,游走不定,用细磁击碎,取其锋芒者一块,以箸一根,
劈开
头,令毒血遇刺皆出,却以神功散敷搽。毒入腹者,不救。
脉象浮的,以消散气机郁滞为主。脉象浮而数的,以祛风清热为主。脉象沉而数的,以泻火为主。脉数且重按感觉沉实的,需解表攻里。
一位妇人患丹毒(一种皮肤红肿热痛的急性感染性疾病),瘙痒,脉象浮,用消风散治疗,四剂后痊愈。
一位妇人患丹毒,瘙痒,脉象浮数,用人参败毒散治疗,两剂后稍有好转;接着改用消风散,四剂后安定。
一位男子患丹毒,颜色赤紫且疼痛,发热喜冷,脉象沉实,用防风通圣散治疗,一剂后症状顿退;又用荆防败毒散加黄芩、黄连,四剂后痊愈。
一位妇人患斑疹,瘙痒疼痛,大便秘结,脉象沉实,用四物汤加黄芩、黄连、大黄、槐花治疗,痊愈。
一位老人患疹,颜色微红,瘙痒,发热,用人参败毒散治疗,两剂后稍有好转;后用补中益气汤加黄芩、山栀,痊愈。
一个小孩患疹,疼痛,发热烦渴,想要服用清凉饮来攻下。诊察其脉象不实,轻取不数,这是邪气在经络,不应该攻下。
王海藏说:前人讲“首尾都不可攻下”,为什么呢?回答说:开始阶段不可攻下,是因为邪气尚未完全透发于体表,如果攻下则邪气不能向外伸展透越,此时脉证表现为有表证而无里证,所以禁止在初期攻下;结尾阶段不可攻下,是因为毒邪已经明显显露于外部,内部没有根基,大便不实,没有任何里证,如果攻下则会导致正气逆陷,所以禁止在后期攻下。一个小孩瘙痒发热,用消毒犀角饮治疗,一剂后出现呕吐和腹泻,这是邪气从上下两个途径同时排出,毒邪自然解除,不久呕吐腹泻停止,疹子果然消退。吐泻之后,脉象呈现每息七至,这是小儿平和正常的脉象,邪气已经排尽,不需要再治疗,果然痊愈。洁古说:疹病,其证候各不相同。发肿于外部的,属于少阳三焦相火,称为丹;小红点行于皮肤之中,不出者,属于少阳君火,称为疹。凡是显现出丹疹证候的,如果自行呕吐或腹泻,千万不要乱治,大多吉利,这是因为邪气从上下都排出了。如果丹和疹同时发出,小儿难以承受,因此会衍生其他病症。总的来说,初期和后期都不可攻下,安里的药物多,发表的药物少,如果便秘则轻微疏通,使邪气不壅滞,并使其依次透出,使小儿容易耐受。身体温暖的为顺证,身体凉的为逆证。
一个男子患丹毒,疼痛便秘,脉象数而实,服用防风通圣散无效,令医生用砭石刺破患处,放出恶血,仍然使用前面的药物即痊愈。
一个小男孩腿部患丹毒如霞光般,游走不定,先用麻油涂抹患处,用砭石刺出恶血,毒邪随即消散;再用金银花散,一剂后安定。
一个小男孩患丹毒,外部形势虽然轻微,内部却大便不利,这是病位在脏腑,服用大连翘饮,外敷神效散而痊愈。
一个小男孩遍身皆红,用砭石刺破,投用解毒药即痊愈。
一个小男孩遍身亦红,不从砭石治疗,导致毒瓦斯进入腹部,最终无法救治,这种症候是恶毒热血蕴蓄于命门,遇到相火激发,需要用砭石来泄其毒邪。凡是毒邪从四肢发起并传入腹部的,属于不治之症。虽然说丹毒有多种,治疗方法也有多种,但没有比砭法更好的了,常见病情稍重的患者,不使用砭法,都无法救治。
附方
消毒犀角饮子 治疗丹毒或瘾疹瘙痒或疼痛,以及风热疮毒。
牛蒡子(二钱) 荆芥 防风(各一钱半) 甘草(三分) 作为一剂,用水一钟,煎煮至五分,慢慢服用。
解毒防风汤 治疗丹毒或瘾疹,痒或疼痛。
防风(一钱) 地骨皮 黄芪 芍药 荆芥 枳壳(炒,各二钱) 作为一剂,用水一钟,煎煮至五分,慢慢服用。
金银花散(方剂见作呕门)
砭法 治疗小儿丹毒色红,游走不定,用细磁击碎,取其有锋芒的一块,用一根筷子劈开头部,让毒血遇刺全部流出,然后用神功散敷搽。毒邪进入腹部的,无法救治。
If the pulse is floating, the treatment should primarily focus on dissipating Qi stagnation. If the pulse is floating and rapid, wind-heat should be dispelled and heat cleared. If the pulse is deep and rapid, fire should be purged. If the pulse is rapid and feels deep and solid upon heavy pressure, both the exterior should be resolved and the interior attacked.
A woman suffered from Dan Du (a type of acute skin infection characterized by redness, swelling, heat, and pain), with itching and a floating pulse. She was treated with Xiaofeng San (Wind-Dispersing Powder) for four doses and recovered.
Another woman suffered from Dan Du, with itching and a floating-rapid pulse. She was treated with Renshen Baidu San (Ginseng Detoxifying Powder) for two doses, showing slight improvement; subsequently, Xiaofeng San was used for four doses, leading to stability.
A man suffered from Dan Du, presenting with dark red-purple discoloration, pain, fever, and a preference for cold drinks, with a deep-solid pulse. He was treated with Fangfeng Tongsheng San (Saposhnikovia Unblocking and Safeguarding Powder) for one dose, resulting in immediate symptom relief; then Jingfang Baidu San (Schizonepeta and Saposhnikovia Detoxifying Powder) plus Huangqin (Scutellariae Radix) and Lianzi (Coptidis Rhizoma) were administered for four doses, leading to recovery.
A woman suffered from macules/rashes, with itching, pain, constipation, and a deep-solid pulse. She was treated with Siwu Tang (Four Substances Decoction) plus Huangqin, Lianzi, Dahuang (Rhei Radix et Rhizoma), and Huaihua (Sophorae Flos), and recovered.
An elderly person suffered from rashes, with slight redness, itching, and fever. They were treated with Renshen Baidu San for two doses, showing slight improvement; then Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) plus Huangqin and Shanzhi (Gardeniae Fructus) was administered, leading to recovery.
A child suffered from rashes with pain, fever, restlessness, and thirst, desiring to take Qingliang Yin (Cooling Drink) to purge the bowels. Upon examination, the pulse was not solid, and light pressure did not reveal rapidity; this indicated that the pathogenic factor was in the meridians and channels, so purgation was contraindicated.
Wang Haicang stated: The ancients said that "neither the beginning nor the end stages should be purged." Why? The answer is: Purging is contraindicated at the beginning because the pathogenic factor has not yet fully manifested on the exterior; purging would prevent the pathogen from extending outward. At this stage, the pulse and symptoms indicate an exterior pattern without an interior pattern, hence purging is prohibited initially. Purging is contraindicated at the end because the toxic factor has already clearly appeared externally, lacking internal roots, with loose stools and no interior signs; purging would cause the Qi to collapse inward, hence it is prohibited at the end. A child with itching and fever was treated with Xiaodu Xijiao Yin (Detoxifying and Rhinoceros Horn Cooling Drink); after one dose, vomiting and diarrhea occurred. This indicates that the pathogenic factor was expelled from both upper and lower pathways, and the toxin naturally resolved. Shortly after, vomiting and diarrhea ceased, and the rash indeed subsided. After vomiting and diarrhea, the pulse showed seven beats per breath, which is a normal, harmonious pulse for children, indicating that the pathogen has been completely expelled. No further treatment is needed, and indeed, the child recovered. Jiegu said: In rash diseases, the manifestations vary. Swelling appearing on the exterior belongs to the Minister Fire of the Shaoyang Sanjiao (Triple Burner) and is called Dan; small red spots moving within the skin but not emerging belong to the Sovereign Fire of the Shaoyang and are called Zhen. Whenever Dan or Zhen symptoms appear, if spontaneous vomiting or diarrhea occurs, do not treat recklessly; prognosis is generally good, as the pathogen is being expelled from both upper and lower pathways. If Dan and Zhen erupt simultaneously, children may not tolerate it well, potentially leading to other complications. Generally, neither the beginning nor the end stages should be purged; formulas that stabilize the interior are more numerous than those that release the exterior. If constipated, mildly unblock to prevent pathogenic stagnation, allowing the pathogens to emerge sequentially, making it easier for the child to tolerate. Warm body temperature indicates a favorable course; cool body temperature indicates an unfavorable course.
A man suffered from Dan Du, with pain, constipation, and a rapid-solid pulse. Taking Fangfeng Tongsheng San was ineffective. The affected area was pricked with Bian stones (stone lancets) to release evil blood, and the previous medication was continued, leading to recovery.
A young boy had Dan-like erythema on his leg, wandering and unstable. First, sesame oil was applied to the affected area, and Bian stone therapy was used to release evil blood, causing the toxin to dissipate; then Jinyinhua San (Honeysuckle Powder) was administered for one dose, leading to stability.
A young boy suffered from Dan Du. Although the external presentation was mild, internally there was difficulty in defecation, indicating the disease involved the Zang organs. He took Dalianqiao Yin (Large Cardamom Drink) and applied Shenxiao San (Divine Efficacy Powder) externally, recovering.
A young boy had erythema all over his body. After Bian stone therapy, detoxifying medicines were administered, leading to immediate recovery.
Another young boy had erythema all over his body. Because he did not undergo Bian stone therapy, the toxic vapors entered the abdomen, leading to death. This condition involves malignant toxic hot blood accumulating in the Mingmen (Gate of Life), triggered by Minister Fire. Bian stone therapy should be used to drain the toxin. Cases where the toxin originates from the limbs and enters the abdomen are incurable. Although there are several types of Dan Du and several treatment methods, none are superior to Bian stone therapy. It is commonly observed that patients with slightly severe conditions who do not receive Bian stone therapy cannot be saved.
Attached Formulas
Xiaofeng San (See formula in Chuangjie Men - Sores and Scabies Section)
Jingfang Baidu San (See formula in Kuiyang Farem Men - Ulceration and Fever Section)
Siwu Tang (See formula in Luoli Men - Scrofula Section)
Fangfeng Tongsheng San (See formula in Tianpaochuang Men - Blister Disease Section)
Renshen Baidu San
Buzhong Yiqi Tang (Both formulas see Ulceration and Fever Section)
Qingliang Yin (See formula in Fabei Men - Carbuncle on Back Section)
Xiaodu Xijiao Yin Zi Treats Dan Du or Urticaria with itching or pain, and wind-heat sores/toxins.
Niubangzi (Arctii Fructus, 2 qian) Jingjie (Schizonepetae Herba) Fangfeng (Saposhnikoviae Radix, each 1.5 qian) Gancao (Glycyrrhizae Radix et Rhizoma, 0.3 qian). As one dose, boil with one zhong of water until reduced to five fen, take slowly.
Jiedu Fangfeng Tang Treats Dan Du or Urticaria, with itching or pain.
Fangfeng (Saposhnikoviae Radix, 1 qian) Digupi (Lycii Cortex) Huangqi (Astragali Radix) Shaoyao (Paeoniae Radix) Jingjie (Schizonepetae Herba) Zhike (Citri Reticulatae Pericarpium, stir-fried, each 2 qian). As one dose, boil with one zhong of water until reduced to five fen, take slowly.
Jinyinhua San (See formula in Zuou Men - Vomiting Section)
Shengong San (See formula in Fabei Men - Carbuncle on Back Section)
Dalianqiao Yin (See formula in Tianpaochuang Men - Blister Disease Section)
Bian Fa (Bian Stone Therapy) Treats pediatric Dan Du with red color and wandering instability. Crush fine porcelain into fragments, select one piece with sharp edges. Use a chopstick split at the tip to prick the area, ensuring all toxic blood is released. Then apply Shengong San externally. If the toxin enters the abdomen, it is incurable.