〔薛〕杨梅疮乃天行时毒，亦有传染而患之，或禀赋所得者，受证在肝，故多起
于下部，治失其宜，多致蚀伤眼目，腐败肾茎，拳挛肢节。初起之时，上体多者先
用荆防败毒散。下体多者先用龙胆泻肝汤。大便秘者用大连翘饮，后用换肌消毒散。
若蚀伤眼目，兼用九味芦荟丸、六味地黄丸。肢节拳挛，兼用蠲痹解毒汤。若因脾
胃亏损而不能愈者，先用异功散，后用换肌消毒散。若用轻粉之药，多致败证也。
按∶杨梅疮起于近代，多淫夫御不洁之妇，传染而致者，其在小儿，得之乳
抱传染者轻，得之父母遗体者重，治法与大人同，更当求之专科，薛氏治法，未可
尽遵用也。
换肌消毒散 （一名草 散） 治杨梅疮，不拘初患、日久，并效。
土茯苓（即萆 ） 当归 白芷 甘草 皂角刺 薏苡仁 白藓皮 木瓜（不犯铁器。各等分）
上，水煎，食前，并空心服。
又方 治大人之剂，如用前方未应，或儿长大，宜用此方。
土茯苓（五钱） 当归 白芷 皂角刺（炒） 薏苡仁（各一钱） 白藓皮 木瓜（不犯铁器）
木通 金银花（各七分） 甘草 连翘 防风（各五分） 茯苓 芍药（各一钱，炒） 黄 （炒，二
钱） 川芎 生地黄（各八分）
上，作二三剂，水煎出，幼者作一剂煎，分两三次服。
【薛己】杨梅疮属于天行时毒（流行性疫毒），也有因传染而患病的，或是先天禀赋所得的。病邪受纳于肝脏，所以多从身体下部发起。如果治疗不当，常导致眼睛受损、肾脏及阴茎腐败、肢体关节屈曲挛缩。在疾病初起阶段，如果上部症状较多，先用荆防败毒散；下部症状较多，先用龙胆泻肝汤。大便秘结者用大连翘饮，随后用换肌消毒散。如果已经蚀伤眼睛，兼用九味芦荟丸和六味地黄丸。肢体关节屈曲挛缩，兼用蠲痹解毒汤。如果是由于脾胃亏损导致无法痊愈的，先用异功散，后用换肌消毒散。如果使用轻粉类药物，大多会导致病情恶化成为败证。
按语：杨梅疮兴起于近代，多是淫乱之夫与不洁妇女接触，通过传染所致。对于小儿而言，通过乳母怀抱传染者病情较轻，通过父母遗传（胎传）者病情较重。治疗方法与成人相同，但更应当寻求儿科专科诊治。薛氏的治疗方法，不可完全照搬使用。
换肌消毒散（又名草薢散）：治疗杨梅疮，无论初发还是日久，均有效。
药材：土茯苓（即萆薢）、当归、白芷、甘草、皂角刺、薏苡仁、白藓皮、木瓜（不可接触铁器）。以上各等分。
用法：以上药材，加水煎煮，饭前空腹服用。
又一方：治疗成人的方剂。如果用前方无效，或者患儿年龄较大，适宜使用此方。
药材：土茯苓（五钱）、当归、白芷、皂角刺（炒制）、薏苡仁（各一钱）、白藓皮、木瓜（不可接触铁器）、木通、金银花（各七分）、甘草、连翘、防风（各五分）、茯苓、芍药（各一钱，炒制）、黄芪（炒制，二钱）、川芎、生地黄（各八分）。
用法：以上药材，制成两到三剂的量，加水煎煮取汁。年幼者将一剂药煎煮后，分两三次服用。
[Xue Ji] Yangmei chuang (Syphilis/Kanekuri disease) belongs to Tianxing shidu (epidemic toxic pathogens). It can also be contracted through infection or acquired congenitally. The pathogenic factor is received by the Liver, so it often originates from the lower part of the body. If treatment is inappropriate, it may lead to damage to the eyes, corruption of the kidneys and penis, and flexion contracture of the limbs and joints. At the initial stage, if symptoms are more prevalent in the upper body, Jingfang Baidu San (Atractylodes and Saposhnikovia Decoction to Overcome Toxic Pathogens) should be used first. If symptoms are more prevalent in the lower body, Longdan Xiegan Tang (Gentiana Decoction to Drain the Liver) should be used first. For those with constipation, Dalianqiao Yin (Large Forsythia Drink) is used, followed by Huanji Xiaodu San (Muscle-Replacing Detoxification Powder). If the eyes have been eroded, Jiuwei Lushui Wan (Nine-Ingredient Aloe Pill) and Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill) are used concurrently. For flexion contracture of the limbs and joints, Juanbi Jiedu Tang (Bi-Syndrome-Dispelling and Detoxification Decoction) is used concurrently. If the condition cannot be cured due to Spleen and Stomach deficiency, Yigong San (Yi-Gong Powder) is used first, followed by Huanji Xiaodu San. The use of Qinfen (Calomel/Mercurous chloride) drugs often leads to a deterioration into a defeat syndrome (Bai Zheng).
Commentary: Yangmei chuang emerged in recent times, mostly caused by promiscuous men contacting unclean women, leading to transmission. In children, those infected through nursing and holding have a milder condition, while those inheriting it from their parents (congenital transmission) have a severe condition. The treatment methods are the same as for adults, but one should seek specialized pediatric diagnosis and treatment. Xue's treatment methods should not be blindly followed.
Huanji Xiaodu San (also known as Caixie San): Treats Yangmei chuang, effective regardless of whether it is newly onset or long-standing.
Herbs: Tufuling (Smilax Glabra Rhizome, i.e., Bibi), Danggui (Angelica Sinensis Root), Baizhi (Angelica Dahurica Root), Gancao (Licorice Root), Zaojiaoci (Gleditsia Sinensis Thorn), Yiyiren (Coix Seed), Baixianpi (Dictamnus Cortex), Mugua (Chaenomelis Fructus - avoid iron vessels). All in equal parts.
Usage: Decoct these herbs in water and take on an empty stomach before meals.
Another Prescription: A formula for adults. If the previous prescription is ineffective, or if the child has grown older, this prescription is suitable.
Herbs: Tufuling (5 qian), Danggui, Baizhi, Zaojiaoci (stir-fried), Yiyiren (each 1 qian), Baixianpi, Mugua (avoid iron vessels), Mutong (Akebia Caulis), Jinyinhua (Lonicerae Japonicae Flos, each 7 fen), Gancao, Lianqiao (Forsythiae Fructus), Fangfeng (Saposhnikoviae Radix, each 5 fen), Fuling (Poria), Shaoyao (Paeoniae Radix, each 1 qian, stir-fried), Huangqi (Astragali Radix, stir-fried, 2 qian), Chuanxiong (Ligustici Chuanxiong Rhizoma), Shengdihuang (Rehmanniae Radix, each 8 fen).
Usage: Prepare two to three doses. Decoct in water to extract the liquid. For young children, decoct one dose and divide it into two or three servings.