始终多涕本为吉。鼻干无涕肺腑热。其间形症有数般。叮咛良工细认识。
鼻通多涕。肺气顺也。所谓多涕者。鼻常有涕。非鼻涕暂见比也。麻症得肺腑平和。鼻无阻
塞。此为顺候。初热至出时。多涕者皆为吉兆。收后亦以多涕为易治。至于鼻干无涕。必须鼻孔之
内。绝无物塞。而鼻干燥。方是真候。此乃肺腑热极闭塞而不通也。初热未出之时见之。其症必
重。以清肺饮去陈皮、五味子、桔梗、甘草。合清扬饮子(见五十条)除甘草、淡竹叶。加石膏、黄
芩。更量加蜜酒炒麻黄。以解表而疏通肺气。或以聂氏第二清肺饮。去柴胡、陈皮、僵蚕、桔梗、归
尾、淡竹叶。合苏葛汤(见第六条)去柴胡、赤芍、甘草。加枳壳治之。若已出大热。致鼻干无涕
者。此症亦重。宜以全书除热清肺汤(见五十五条)加黄连、地骨皮、连翘、牛蒡子、枳壳、治之。或
暂有而暂无涕者。虽重亦可救。以杏仁清肺汤去桔梗、甘草。加黄芩治之。又有先无涕。其后热
退鼻通有涕者。又有因热甚。鼻外被塞。干结似无涕者。以利金汤(见五十条)去桔梗、甘草、生
姜、陈皮。加牛蒡子、黄芩、赤茯苓、连翘治之。或更加桑白皮、杏仁治之。以上数症。总皆要气血
通畅。虽凶可救。医家须宜详察施治。
朱曰 多涕者。肺热浅也。鼻干者。肺热深也。两言可以蔽之。但伤风肺气闭者。亦多
涕。
清肺饮
杏仁 贝母 茯苓(各一钱) 陈皮 桔梗 五味子 甘草(各五分) 水煎服。
聂氏第二清肺饮 治麻出四五日。尚有余毒留于肺胃。多咳嗽气粗。外热不退。
熟石膏 生地黄(各一钱五分) 元参(一钱) 柴胡(一钱) 麦冬(二钱) 陈皮(六分) 枯
黄芩(酒炒) 当归尾 知母(炒) 淡竹叶(炒) 桔梗(各七分) 僵蚕(炒五条) 生甘草(去皮
三分) 灯心引。水煎服。
杏仁清肺汤
杏仁 麦冬 贝母 款冬花 牛蒡子 桔梗 甘草 水煎服。
始终多涕本为吉。鼻干无涕肺腑热。其间形症有数般。叮咛良工细认识。
(译文:麻疹病程中始终鼻涕多,这本是吉兆;若鼻干无涕,则是肺与腑热盛的表现。其中的症状表现有好几种,叮嘱高明的医生要仔细辨识。)
鼻通多涕。肺气顺也。所谓多涕者。鼻常有涕。非鼻涕暂见比也。麻症得肺腑平和。鼻无阻 塞。此为顺候。初热至出时。多涕者皆为吉兆。收后亦以多涕为易治。至于鼻干无涕。必须鼻孔之 内。绝无物塞。而鼻干燥。方是真候。此乃肺腑热极闭塞而不通也。初热未出之时见之。其症必 重。以清肺饮去陈皮、五味子、桔梗、甘草。合清扬饮子(见五十条)除甘草、淡竹叶。加石膏、黄 芩。更量加蜜酒炒麻黄。以解表而疏通肺气。或以聂氏第二清肺饮。去柴胡、陈皮、僵蚕、桔梗、归 尾、淡竹叶。合苏葛汤(见第六条)去柴胡、赤芍、甘草。加枳壳治之。若已出大热。致鼻干无涕 者。此症亦重。宜以全书除热清肺汤(见五十五条)加黄连、地骨皮、连翘、牛蒡子、枳壳、治之。或 暂有而暂无涕者。虽重亦可救。以杏仁清肺汤去桔梗、甘草。加黄芩治之。又有先无涕。其后热 退鼻通有涕者。又有因热甚。鼻外被塞。干结似无涕者。以利金汤(见五十条)去桔梗、甘草、生 姜、陈皮。加牛蒡子、黄芩、赤茯苓、连翘治之。或更加桑白皮、杏仁治之。以上数症。总皆要气血 通畅。虽凶可救。医家须宜详察施治。
(译文:鼻子通畅且鼻涕多,说明肺气调顺。所谓“多涕”,是指鼻腔经常有鼻涕,并非暂时出现的情况。麻疹患者如果脏腑功能平和,鼻腔没有阻塞,这属于顺证。从初期发热到疹子透发阶段,鼻涕多都是吉兆。疹子消退后,鼻涕多也意味着病情容易治疗。至于鼻干无涕,必须是鼻孔内部完全没有分泌物堵塞,且鼻腔感觉干燥,这才是真正的病候。这是肺与腑热邪极盛、气机闭塞不通所致。如果在初期发热、疹子尚未透发时出现这种情况,病情必然严重。应使用清肺饮,去掉陈皮、五味子、桔梗、甘草,配合清扬饮子(参见第五十条),去掉清扬饮子中的甘草、淡竹叶,加入石膏、黄芩,并酌情加入用蜜酒炒制的麻黄,以解除表邪并疏通肺气。或者使用聂氏第二清肺饮,去掉柴胡、陈皮、僵蚕、桔梗、当归尾、淡竹叶,配合苏葛汤(参见第六条),去掉苏葛汤中的柴胡、赤芍、甘草,加入枳壳来治疗。如果疹子已经透发且高热,导致鼻干无涕的,病情也很严重。适宜使用本书中的除热清肺汤(参见第五十五条),加入黄连、地骨皮、连翘、牛蒡子、枳壳来治疗。如果是暂时有鼻涕随后又消失的,虽然病情较重,但也可以救治。使用杏仁清肺汤,去掉桔梗、甘草,加入黄芩来治疗。还有的是起初没有鼻涕,后来热退后鼻子通畅且有鼻涕的;还有的是因为热邪太盛,鼻孔外部被痂皮或分泌物堵塞,干燥结块看起来像没有鼻涕的。对于后者,使用利金汤(参见第五十条),去掉桔梗、甘草、生姜、陈皮,加入牛蒡子、黄芩、赤茯苓、连翘来治疗。或者再加桑白皮、杏仁治疗。以上几种情况,总的原则是要保持气血通畅,即使是凶险的病症也有救。医生必须详细诊察并施以治疗。)
朱曰 多涕者。肺热浅也。鼻干者。肺热深也。两言可以蔽之。但伤风肺气闭者。亦多 涕。
(译文:朱丹溪说:鼻涕多,说明肺热较浅;鼻干,说明肺热较深。这两句话可以概括其要点。但是,伤风导致肺气闭塞的患者,也会出现鼻涕多的情况。)
清肺饮
杏仁 贝母 茯苓(各一钱) 陈皮 桔梗 五味子 甘草(各五分) 水煎服。
(译文:清肺饮方剂组成:杏仁、贝母、茯苓(各一钱),陈皮、桔梗、五味子、甘草(各五分)。用水煎煮后服用。)
聂氏第二清肺饮 治麻出四五日。尚有余毒留于肺胃。多咳嗽气粗。外热不退。
熟石膏 生地黄(各一钱五分) 元参(一钱) 柴胡(一钱) 麦冬(二钱) 陈皮(六分) 枯 黄芩(酒炒) 当归尾 知母(炒) 淡竹叶(炒) 桔梗(各七分) 僵蚕(炒五条) 生甘草(去皮 三分) 灯心引。水煎服。
(译文:聂氏第二清肺饮,治疗麻疹发出四五天,仍有残余毒邪滞留于肺胃,常表现为咳嗽、呼吸急促、体表发热不退。方剂组成:熟石膏、生地黄(各一钱五分),玄参(一钱),柴胡(一钱),麦冬(二钱),陈皮(六分),枯黄芩(酒炒),当归尾,知母(炒),淡竹叶(炒),桔梗(各七分),僵蚕(炒五条),生甘草(去皮三分)。以灯心草为药引,用水煎煮后服用。)
The persistence of nasal discharge is originally a auspicious sign. Dry nose with no discharge indicates heat in the Lung and Bowels. There are several types of manifestations among them. I urge skilled physicians to recognize them carefully.
Nasal patency with abundant discharge signifies smooth Lung Qi. The term "abundant discharge" refers to the constant presence of nasal mucus, not merely a transient occurrence. In measles, if the internal organs are harmonious and the nasal passages are unobstructed, this is a favorable prognosis (Shun Hou). From the initial fever stage until the eruption phase, abundant discharge is always an auspicious omen. Even after the rash subsides, abundant discharge indicates that the condition is easy to treat. Regarding dry nose with no discharge, it must be confirmed that there is absolutely no obstruction inside the nostrils and the nose feels dry; only then is it a true pathological sign. This results from extreme heat in the Lung and Bowels causing blockage and lack of free flow. If seen during the initial fever before eruption, the symptoms will necessarily be severe. Use Qingfei Yin (Clear the Lung Decoction), removing Chenpi (Tangerine Peel), Wuweizi (Schisandra Berry), Jiegeng (Platycodon Root), and Gancao (Licorice Root). Combine it with Qingyang Yinzi (Clearing and Raising Decoction) (see Article 50), removing Gancao and Danzhuye (Lophatherum Herb), and adding Shigao (Gypsum Fibrosum) and Huangqin (Scutellaria Root). Additionally, add Honey-processed Mahuang (Ephedra Stem) according to dosage, to release the exterior and unblock Lung Qi. Alternatively, use Nie's Second Qingfei Yin (Nie's Second Clear the Lung Decoction), removing Chaihu (Bupleurum Root), Chenpi, Jiangcan (Bombyx Batryticatus), Jiegeng, Dangguiwei (Angelica Sinensis Tail), and Danzhuye. Combine it with Sugge Tang (Perilla and Kudzu Decoction) (see Article 6), removing Chaihu, Chishao (Red Peony Root), and Gancao, and adding Zhike (Aurantii Fructus) for treatment. If the rash has erupted accompanied by high fever, leading to a dry nose with no discharge, the condition is also severe. It is appropriate to use Chu Re Qingfei Tang (Heat-Removing Lung-Clearing Decoction) from the book (see Article 55), adding Huanglian (Coptis Rhizome), Digupi (Phellodendri Cortex), Lianqiao (Forsythia Fruit), Niubangzi (Arctii Fructus), and Zhike for treatment. If there is temporary discharge that subsequently ceases, although serious, it can still be saved. Use Xingren Qingfei Tang (Apricot Kernel Clear the Lung Decoction), removing Jiegeng and Gancao, and adding Huangqin for treatment. There are also cases where there was initially no discharge, but later as the fever subsided, the nose became patent with discharge. There are also cases where due to severe heat, the external part of the nose is blocked, dry and crusted, appearing as if there is no discharge. For these, use Lijin Tang (Golden Liquid Decoction) (see Article 50), removing Jiegeng, Gancao, Shengjiang (Fresh Ginger), and Chenpi, adding Niubangzi, Huangqin, Chifuling (Poria Cocos with Red Skin), and Lianqiao for treatment. Or additionally add Sangbaipi (Morus Alba Bark) and Xingren for treatment. All the above conditions generally require the free flow of Qi and Blood. Even if ominous, they can be saved. Physicians must examine carefully and administer treatment accordingly.
Zhu said: Abundant discharge indicates shallow Lung heat. Dry nose indicates deep Lung heat. These two statements summarize the essence. However, patients with Wind-cold injuring the Lung and blocking Lung Qi may also have abundant discharge.
Qingfei Yin (Clear the Lung Decoction)
Xingren (Apricot Seed), Beimu (Fritillaria Bulb), Fuling (Poria) (each 1 qian), Chenpi (Tangerine Peel), Jiegeng (Platycodon Root), Wuweizi (Schisandra Berry), Gancao (Licorice Root) (each 0.5 qian). Decoct in water and take orally.
Nie's Second Qingfei Yin (Nie's Second Clear the Lung Decoction)
Treats measles erupting for four or five days, with residual toxic heat remaining in the Lung and Stomach, manifesting as frequent coughing, coarse breathing, and persistent external fever.
Shushigao (Calcined Gypsum Fibrosum), Shengdihuang (Rehmanniae Radix) (each 1.5 qian), Yuan Shen (Scrophulariae Radix) (1 qian), Chaihu (Bupleuri Radix) (1 qian), Maidong (Ophiopogonis Tuber) (2 qian), Chenpi (Tangerine Peel) (0.6 qian), Ku Huangqin (Scutellariae Radix, dried/wine-fried), Dangguiwei (Angelicae Sinensis Radix Caulis), Zhimu (Anemarrhenae Rhizoma, fried), Danzhuye (Lophatheri Herba, fried), Jiegeng (Platycodonis Radix) (each 0.7 qian), Jiangcan (Bombyx Batryticatus, fried) (5 pieces), Sheng Gancao (Raw Glycyrrhizae Radix et Rhizoma, peeled) (0.3 qian). Use Dengxin (Junci Medulla) as a guide. Decoct in water and take orally.
Xingren Qingfei Tang (Apricot Kernel Clear the Lung Decoction)
Xingren (Apricot Seed), Maidong (Ophiopogonis Tuber), Beimu (Fritillaria Bulb), Kua Donghua (Adenophorae Flos), Niubangzi (Arctii Fructus), Jiegeng (Platycodonis Radix), Gancao (Glycyrrhizae Radix et Rhizoma). Decoct in water and take orally.