辛辣香甜与热汤。婴儿乳母俱忌尝。果能禁谨不违法。管教始终保安康。
麻喜清凉最忌温。燥热药饵勿沾唇。误用能助其邪火。壅蔽内攻救无门。
辛辣之味与热汤水。患麻之人。多酷好之。何则。盖麻属火候。火蕴于内。得辛辣热物。而痰
火暂快。故多喜食。儿患麻者。须宜禁戒。庶无后患。如或因其喜饮。遂以胡椒茱萸作汤。或醇酒、
姜蒜、韭薤之类。与食而顺其欲。暂虽快畅。久则痰火益甚。至麻变紫黑。或二便闭结。或成血痢。
肠头露出。或生牙疳。或唇舌破裂。或喉中痰响 。或五窍出血。或大热不止。至胃火益甚。而
饮食即吐不能下者。种种恶候。因而生焉。若食乳孩子。乳母亦当禁忌。倘不禁忌。而食辛辣等
物。凡食其乳。必至变证不测。可不慎乎。夫患麻之人。辛辣之物。既当忌食。而治麻医家。用药立
方。辛热燥悍之品。慎勿妄施。如桂枝、麻黄、羌活、独活、白芷、川芎、苍术、香附、果仁、白术、丁
香、木香、砂仁、肉豆蔻、肉桂之类。不可轻使。若于麻初热之时。而误用之。反助其毒。使毒瓦斯壅
蔽而不得出。致有内攻之患。即有麻疹初起。而见四肢逆冷者。乃火极似水之故。不可妄投热药。
麻现自然温和。昔人谓天气大寒。宜用辛热。以桂枝汤之类发之。不知天气大寒。只宜置之暖室。
谨避风寒可也。且天气纵极严寒。而人身中之热毒。未必因天寒而减。而因天寒遽用辛热以治
麻证。岂理也哉。庸工执泥岁气时令。大寒宜用辛热之药发之之说。譬诸麻疹初出。而有呕吐。医
不知此为常候。而用苍术以平胃。丁香、砂仁以暖胃。设有头疼。而用川芎、白芷、羌活、独活以治
头疼。譬有手足稍冷者。遂即用桂枝、肉桂以温其手足。殊不知麻证之作呕吐者。乃火热蒸于胃
也。头疼者乃火毒上攻也。今反以辛温之药攻之。是犹抱薪救火也。至于手足稍冷者。乃热极似
寒之象。俟麻出透。而手足自温。医家不明。而谓桂枝可达于四肢之末。肉桂可以温经回阳。而遽
用之。是误之又误。陷人性命。良可叹也。执天寒而用辛热之说者。何殊乎是。倘有误服辛热之药
助其邪火。烦渴便闭。致麻不出。危笃之极者。以清阳汤去升麻、桔梗、甘草主之。愚按邪火内攻。
渴烦致麻不出。而兼有便闭者。加黑白丑牛以下之。是亦釜底抽薪之义也。
朱曰 骤用寒凉与误用辛热。又医家所最易患者。盖麻正出时。必仍发热。医者为退热
计而骤用寒凉。此大误也。又医者不知麻为热证。或用麻黄附子细辛汤辛温解
散。亦足误事。
清阳汤
荆芥穗 防风 前胡 连翘 元参(各四分) 薄荷叶 牛蒡子 枳壳 黄芩 木通 麦冬
淡竹叶(各三分) 桔梗(四分) 升麻(三分) 甘草(二分) 姜、灯心引。(姜皮并宜)
辛辣、香甜的食物以及热汤,婴儿及其乳母都必须禁忌食用。如果能谨慎遵守这些禁忌而不违背,就能保证孩子始终平安健康。
麻疹(一种急性出疹性传染病)喜欢清凉的环境,最忌讳温热。燥热的药物切勿沾唇误服。如果误用,会助长体内的邪火,导致毒气壅塞内攻,届时将无药可救。
辛辣的味道和热汤水,患麻疹的人往往非常喜好。为什么呢?因为麻疹属于“火候”之证,火热蕴积在体内,遇到辛辣热物时,痰火暂时得到舒缓,所以患者多喜欢吃这类食物。幼儿患麻疹时,必须严格禁止食用此类食物,以免留下后患。如果因为孩子喜欢喝,就用胡椒、吴茱萸煮汤,或者给予醇酒、姜蒜、韭菜、小葱等食物来顺从他们的欲望,虽然暂时感到畅快,但久而久之会使痰火更加严重。导致麻疹颜色变为紫黑色,或者大小便闭塞不通,或者变成血痢,直肠脱垂,或者生牙疳,或者嘴唇舌头破裂,或者喉咙里有痰鸣声,或者五官出血,或者高热不退,导致胃火更盛,饮食即吐无法下咽等各种恶候,因此产生。如果是吃奶的婴儿,乳母也应当禁忌。如果不加禁忌而食用辛辣等物,凡是吃了这种乳汁的婴儿,必然会导致病情发生不可预测的变化,能不谨慎吗?
凡患麻疹的人,辛辣之物既然应当忌食,那么治疗麻疹的医生,在用药立方方面,对于辛热燥悍的药物,千万不要随意使用。如桂枝、麻黄、羌活、独活、白芷、川芎、苍术、香附、杏仁、白术、丁香、木香、砂仁、肉豆蔻、肉桂之类,不可轻易使用。如果在麻疹初起发热的时候误用这些药,反而会助长毒势,使毒气壅塞而不能透发出来,导致毒气内攻的祸患。即使有麻疹初起而见到四肢逆冷的情况,这也是“火极似水”的缘故,不可妄投热药。麻疹自然透出时,身体会呈现温和的状态。古人说天气大寒时,宜用辛热药,用桂枝汤之类的方剂来发汗解表。这是不了解实际情况,天气大寒时,只适宜将病人安置在温暖的房间里,小心避开风寒即可。况且天气纵然极其严寒,人体内的热毒未必会因为天寒而减少。却因为天寒就急忙用辛热药来治疗麻疹证,这符合道理吗?庸医拘泥于岁气时令,认为大寒时节宜用辛热药发汗的说法,就像这样:比如麻疹刚发出,而有呕吐症状,医生不知道这是正常现象,就用苍术来平胃,丁香、砂仁来暖胃;假设有头痛,就用川芎、白芷、羌活、独活来治头痛;假如手足稍微发冷,就立即用桂枝、肉桂来温暖手足。殊不知麻疹证出现呕吐,是因为火热蒸腾于胃;头痛是因为火毒上攻。现在反而用辛温的药去攻伐它,这就像是抱着柴草去救火一样。至于手足稍微发冷的情况,是热极似寒的现象,等到麻疹出透,手足自然会变暖。医生不明白这一点,认为桂枝可以通达四肢末端,肉桂可以温经回阳,就急忙使用它们,这是错误中的错误,陷人性命于险境,实在令人叹息。那些坚持天寒就用辛热说法的人,与这种情况有什么区别呢?如果有误服辛热药物助长邪火,导致烦躁口渴、大便闭塞,致使麻疹不能透发,病情危重至极的情况,以清阳汤去掉升麻、桔梗、甘草为主方治疗。我按语认为,邪火内攻,因口渴烦躁导致麻疹不出,并且兼有大便闭塞的,加入黑白丑牛(牵牛子)以下泄通便。这也是“釜底抽薪”的道理。
朱氏说:骤然使用寒凉药与误用辛热药,又是医生最容易犯的错误。大概麻疹正在发出的时候,必然仍然发热。医生为了退热而骤然使用寒凉药,这是很大的错误。另外医生不知道麻疹是热证,或者使用麻黄附子细辛汤这种辛温解表的方剂,也足以误事。
清阳汤
荆芥穗、防风、前胡、连翘、玄参(各四分)、薄荷叶、牛蒡子、枳壳、黄芩、木通、麦冬、淡竹叶(各三分)、桔梗(四分)、升麻(三分)、甘草(二分),生姜皮、灯心草为引。(姜皮为宜)
Spicy, sweet foods and hot soups must be avoided by both infants and their nursing mothers. If these prohibitions are strictly observed without violation, the child can be ensured safety and health throughout the illness.
Measles (an acute exanthematous infectious disease) prefers coolness and most abhors warmth. Do not let dry-heat-inducing medicines touch your lips. Misuse will exacerbate the pathogenic fire within, causing toxic qi to stagnate and attack internally, leaving no way to save the patient at that point.
The taste of spicy food and hot soups is often highly favored by those suffering from measles. Why? Because measles belongs to the category of "fire heat" syndromes; fire accumulates internally. Upon encountering spicy and hot substances, the phlegm-fire temporarily finds relief, hence the preference for such foods. Infants with measles must be strictly prohibited from consuming these items to prevent future complications. If one indulges the child's desire for drinks by preparing decoctions of Piper nigrum (Black Pepper) and Evodiae Fructus (Wuzhuyu), or providing strong wine, ginger, garlic, leeks, and Allium tuberosum (Chinese Chives) to satisfy their cravings, although there may be temporary comfort, it will eventually worsen the phlegm-fire. This can lead to the rash turning purple-black, constipation of stool and urine, bloody dysentery, prolapse of the rectum, gingival gangrene, cracking of lips and tongue, rattling of phlegm in the throat, bleeding from the five orifices, unceasing high fever, worsening stomach fire leading to vomiting immediately after eating, and various other ominous signs. For nursing infants, the mother must also observe dietary restrictions. If she fails to do so and consumes spicy foods, any milk consumed by the infant will inevitably lead to unpredictable changes in the condition. Can one afford to be careless?
Since those with measles must avoid spicy foods, physicians treating measles must also be cautious about prescribing pungent, hot, and drying herbs. Herbs such as Cinnamomi Ramulus (Guizhi), Ephedrae Herba (Mahuang), Notopterygii Rhizoma et Radix (Qianghuo), Angelicae Pubescentis Radix (Duhuo), Angelicae Dahuricae Radix (Baizhi), Ligustici Chuanxiong Rhizoma (Chuanxiong), Atractylodis Rhizoma (Cangzhu), Cyperi Rhizoma (Xiangfu), Armeniacae Semen Amarum (Xingren), Atractylodis Macrocephalae Rhizoma (Baizhu), Caryophylli Flos (Dingxiang), Aucklandiae Radix (Muxiang), Amomi Fructus Rotundus (Sharen), Myristicae Semen (Roudoukou), and Cinnamomi Cortex (Rougui) should not be used lightly. If these are mistakenly used during the initial fever stage of measles, they will instead assist the toxicity, causing toxic qi to stagnate and preventing it from venting out, leading to the danger of internal attack. Even if there is coldness of the four limbs at the onset of measles, this is due to "extreme heat resembling water." One must not recklessly administer hot medicines. When the measles naturally erupts, the body temperature becomes moderate. Ancients stated that on extremely cold days, pungent-hot medicines should be used to induce sweating with formulas like Guizhi Tang (Cinnamon Twig Decoction). This demonstrates a lack of understanding: on extremely cold days, it is only appropriate to keep the patient in a warm room and carefully avoid wind and cold. Moreover, even if the weather is extremely cold, the heat-toxin within the human body does not necessarily decrease due to the cold. To hastily use pungent-hot medicines to treat measles because of the cold weather—does this make sense? Quack doctors adhere rigidly to seasonal theories, claiming that extreme cold requires pungent-hot medicines to vent the disease. Consider this analogy: when measles first appears accompanied by vomiting, the doctor, unaware that this is a common symptom, uses Cangzhu (Atractylodis Rhizoma) to calm the stomach, and Dingxiang (Caryophylli Flos) and Sharen (Amomi Fructus Rotundus) to warm the stomach. If there is headache, they use Chuanxiong (Ligustici Chuanxiong Rhizoma), Baizhi (Angelicae Dahuricae Radix), Qianghuo (Notopterygii Rhizoma et Radix), and Duhuo (Angelicae Pubescentis Radix) to treat the headache. If the hands and feet are slightly cold, they immediately use Guizhi (Cinnamomi Ramulus) and Rougui (Cinnamomi Cortex) to warm the extremities. They fail to realize that vomiting in measles syndrome is caused by heat-fire steaming the stomach, and headache is caused by fire-toxin attacking upward. Now, using pungent-warm medicines to attack these symptoms is like carrying firewood to put out a fire. As for the slight coldness of the hands and feet, it is a sign of "extreme heat resembling cold." Once the measles have fully erupted, the hands and feet will naturally become warm. Doctors who do not understand this believe that Guizhi can reach the extremities of the four limbs and Rougui can warm the meridians and restore yang, so they hastily use them. This is an error compounded by another error, trapping patients' lives, which is truly lamentable. Those who insist on using pungent-hot medicines due to cold weather are no different from this scenario. If a patient mistakenly takes pungent-hot medicines, exacerbating the pathogenic fire, resulting in irritability, thirst, and constipation, thereby preventing the measles from erupting, reaching a critical state, the treatment should be Qingyang Tang (Clear Yang Decoction) with Shengma (Cimicifugae Rhizoma), Jiegeng (Platycodonis Radix), and Gancao (Glycyrrhizae Radix et Rhizoma) removed. In my analysis, if pathogenic fire attacks internally, causing thirst and irritability that prevents the measles from erupting, accompanied by constipation, add Heibai Chouniu (Semen Kochiae Album et Rubrum / Black and White Morning Glory Seeds) to purge downward. This embodies the principle of "removing firewood from under the cauldron."
Zhu stated: Hasty use of cold-cooling medicines and misuse of pungent-hot medicines are errors most easily committed by physicians. Generally, when measles is erupting, fever persists. Physicians, aiming to reduce fever, hasty use cold-cooling medicines, which is a major mistake. Furthermore, if physicians do not recognize measles as a heat syndrome and use Xinwen Jiebiao (Pungent-Warm Exterior-Releasing) formulas like Mahuang Fuzi Xixin Tang (Ephedra, Aconite, and Asarum Decoction), it is sufficient to cause mishaps.
Qingyang Tang (Clear Yang Decoction)
Jingjie Sui (Schizonepetae Spica), Fangfeng (Saposhnikoviae Radix), Qianhu (Peucedani Radix), Lianqiao (Forsythiae Fructus), Xuanshen (Scrophulariae Radix) [each 4 fen], Bohe Ye (Menthae Haplocalycis Folium), Niubangzi (Arctii Fructus), Zhike (Aurantii Fructus Immaturus), Huangqin (Scutellariae Radix), Mutong (Akebiae Caulis), Maidong (Ophiopogonis Radix), Danzhuye (Lophatheri Herba) [each 3 fen], Jiegeng (Platocodonis Radix) [4 fen], Shengma (Cimicifugae Rhizoma) [3 fen], Gancao (Glycyrrhizae Radix et Rhizoma) [2 fen]. Use Ginger Peel (Jiangpi) and Dengxincao (Junci Medulla) as guides. (Ginger peel is preferred).