程 见点若隐若现。神倦不宁。势如闷伏。表里俱不宣畅。双解固宜。再佐以芳香搜逐。使蕴伏
之毒透发为主。（见点闷症） 紫雪丹。
周 热闭心胞络中。目绽。口开。舌缩。两手撮空。发痉。溺通便涩。血分大伤。九日险期。按法图幸。
勉与紫雪丹二钱。开水调缓缓下。用茶铫。倘得神苏痉舒。方有生机。
又 神醒。舌绛紫音缩。渴饮不已。心胞热闭虽开。而在里脂液已涸。古人以心热消渴。多系脏
阴现症。不可攻夺明矣。
鲜生地 竹叶心 元参 知母 银花露 金汁 先用紫雪（一钱）
龚 初起腰足俱 。肝肾蕴毒不得外越。目泛匝舌。继增喘促。是紧闷不治之症。诸医佥用石
膏大黄。然此药仅通阳明胃腑之壅。未能搜逐肝肾至阴之脏。读宋医钱仲阳直诀。毒伏于
阴。亦有下夺之法。其制方曰。枣变百祥丸。乃百中望一二生全者。（肝肾蕴毒闷症）
红芽大戟（五钱） 红枣（五枚）
水煮。至枣熟去核及大戟汤。但用枣肉研化开水送。
某 毒伏不肯宣透。气滞血凝。焉能起绽成浆。七八险关。诊视肉肿疮枯。神躁不安。议疏利内
壅。佐活血透肌法。
犀角 紫草 炒楂 鲜生地 酒浸大黄 红花 青皮 丹皮 连翘 牛蒡 茅根笋尖汤代水。
俞 发热五六日来。神烦不宁。腹膨咳逆。询知二三日前。眉间见点数粒。状如麸 。随即隐伏
不见。乃毒重壅遏。闷伏景象。设或发出。亦属重险。且甫生六月。胃乏谷气。难进汤药。拟进紫
雪须少。搜其蕴蓄之邪。使其神安再商。紫雪丹（一分）。
高 点虽繁密。根脚绽立。寒凉药不宜太重。可以维持收功。
犀角 连翘 牛蒡 炒楂 紫草 丹皮 天虫 桔梗
庞（二朝） 神倦腹痛。点粒繁琐。地界不清。是时邪毒火兼重。急进双解法。使大便稍通。六腑气宣。则
痘毒外透再商。
犀角 连翘 牛蒡 酒大黄 紫草 青皮 桃仁 炒楂 木通 生石膏 荆芥 笋尖
程 成片不立。顶焦黑滞。肝肺毒重。不能起胀。焉得化毒。今喘咳交加。九朝难过。
羚羊角 元参 连翘 天虫 土贝 紫草 炒楂 丹皮 银花地丁汤代水。
钱（三朝） 虽未发齐。其点形繁密。色泽不润。重险何疑。今痧未全退。尚宜清解。
犀角 生石膏 炒楂 紫草 连翘 牛蒡 赤芍 桔梗 木通
程（三朝） 身小气弱。布痘繁稠。用药不宜寒凉。五日后受得补托。可冀有成。
连翘 牛蒡 炒楂 红花 天虫 川芎 归身 桔梗 炒干荷叶
毛 身小气弱。浆发惊窜属虚。
人参 炒归身 炙草 广皮 炒白芍 炒黄米
童（四朝） 痘形粘着肌肉。不肯起绽高立。兼之繁红壳薄。乃时火毒火交炽。而元气素亏体质。目今
六日前。时疠未彻。宜先清解活血提顶。希冀磊磊分成地界再究。
犀角 羚羊 元参 丹皮 炒楂 秦皮 紫草茸 银花
郑 痘发犹热身热咳嗽。乃风温入肺未解。诊其点粒粘着不爽。温邪郁滞气血。更体质素虚。
议开肺气以宣之。活血以疏动之。冀其形色充长。若一进沉降。恐无好音。
连翘 桔梗 红花 牛蒡 甘草 炒楂 郁金 丹皮 鸡冠血
又 昨进轻扬提顶活血。痘形颇长。所嫌色不光润。蓬松盘 。有干塌无浆之虑。今明时气将
解。气血用事。况正欲纳谷。苦寒不但冰伏毒瓦斯。更防大伤胃口。古人于重症更加详慎者为
此。
川芎 当归 天虫 桔梗 甘草 角刺 紫草茸 丹皮 炒楂
又（六朝） 进和气血法。形色略润。究不肥绽。焉得起胀成浆。议进十宣散法。
人参 川芎 归身 广皮 紫草茸 天虫
红花 白芷 甘草 桔梗
张（四朝） 船小重载。难许全功。勉议进鸡鸣散二分。
陆（五朝） 点虽不密。色滞形痿。痰多呛逆如嘶。是痘虽发出。毒犹在内。上冲心肺。故有喘
咳不宁之象。进凉血透毒法。
羚羊 桔梗 甘草 紫草 丹皮 川贝 连翘 元参 射干 天虫 西牛黄（一分）
朱（四朝）
炒黄米 炒山楂 红花 笋尖
又（五朝） 身小痘多。元气最薄。胃腑未纳谷味。汤药大过。须虑呕泄。宜少少与药。扶过八九风波。方
得平安。
川芎 炒当归 桔梗 甘草 黄米 鸡冠血
又（六朝） 薄嫩无浆。仍宜内托。
黄 防风 归身 川芎 紫草茸 丹皮 天虫 桔梗 甘草 鸡冠血
宋（五朝） 颧颊形似红沙。余痘干枯不润。昨进清毒活血。续发点子盈千。仲仁谓毒重壅闭气血。必
干焦退缩。今五朝形象。仅似初齐。痘以十二日为常数。已经壅遏未发三日矣。当此质薄神
弱。恐难延多日。即或望其堆沙发臭。然必在旬日以外。目下总以解毒清凉。八九波涛汹涌。
恐难人力稳全。
犀角 羚羊角 川连 炒楂 土贝母 紫草茸 元参 鲜生地 连翘 丹皮 牛蒡子 猪尾血
吴（五朝半） 痘子分颗。原属纯正。所嫌色滞干枯。防八九痒塌。凉药兼以活血。是为平
准方法。看守勿懈为上。
羚羊角 丹皮 连翘 炒楂 紫草茸 黄连 元参 天虫 生地 鸡冠血
孙 肌柔白嫩。体质是虚。但布痘必由时疠感触。地中六气。咸从火化。疠固客气。相混气血。若
非清解。何以透达。今视色油红。按形松 怯。再视面部肌肉先肿。痘形未具起胀之象。体症
未为合局。虑进锐退速。清凉解毒。佐以提顶。在五六日之法。然险症变迁不一。未可以经常
定论。
羚羊角 连翘 丹皮 天虫 生甘草 紫草茸 川连 炒楂 桔梗
银花汤煎。和入鸡冠血数滴。
汪（五朝） 痘形繁琐成片。色紫滞。乃火毒重险症。藉身大气旺。扶持十四险关。冀其发
臭堆沙。庶几可以图幸。
犀角 羚羊角 桔梗 炒楂 连翘 天虫 紫草茸 丹皮 石膏 银花 地丁 牛蒡
猪尾血 冰片
又（六朝） 虽血热毒重。犹幸八龄体坚。急清解活血。莫令痰阻废食。扶持堆沙。可望向安。照前方
去石膏地丁天虫牛蒡加川连元参土贝。
查 痘子成浆。湿气蕴于皮毛。与热气相蒸。内应乎肺。发出罩痘疹。宜忌荤腥。轻清理肺。淡渗
消其湿热。验其体质最薄。慎勿过剂。
苡仁 茯苓 连翘 地骨皮 通草 桑叶 白沙参 甘草
顾 痘发由络。其毒不化而转陷。亦归于络。当世略晓攻补而已。读古人书。辛香温煦。乃治毒
陷大法。
人参 肉桂 炙草 丁香 浓朴 诃子皮
广皮 木香 前胡 茯苓
徐 未纳谷食。但以汤药。所以滑泄不止。头仰胸突。拥痰身热。肺热未清。不可骤补。翁仲仁有
泄泻安宁。大虚少毒之议。姑以和中清咽再商。
桔梗 甘草 炒归 川芎 广皮 炒楂
炒黄米汤煎。冲鸡冠血。
又（七朝） 身小痘密。气弱难任。虽清浆三四。防护宜慎。八九日不致损破。可以有成。
人参 黄 炙草 紫茸 天虫 广皮 川芎 归身 浓朴 炒楂 加炒冬米
孙（七朝） 色娇皮薄。浆汁未灌。缘身小痘多。气血交亏。不能运毒化浆。八九日期。最有痒
塌之虑。扶过十二朝无变。庶几可望有成。进参归鹿茸汤法。
人参 归身 鹿茸 生黄 炙草 广皮 浓朴 煨木香
又（八朝） 照前方加肉果炒冬米。
又 浆清四五。不能充灌。因元气馁弱不振。不能 炼毒瓦斯成浆。恐有内陷之虑。再进补托。冀
其堆沙。或可回春。
人参 黄 广皮 炙草 木香 鹿茸 归身 肉果 坎 官桂
又（十三朝） 靥痂甚薄。中凝血迹。兼之呛逆带呕。食入便有不化之形。此虚中有毒。非纯补
纯清之症。
炒川贝 炒银花 茯苓 苡仁 甘草 地骨皮
杨（八朝） 阔塌瘪陷。浆色白滞不荣。谓之气衰毒陷。所冀堆沙加食。一线机耳。
人参 黄 川芎 归身 木香 炙草 广皮 桂心
又（十一朝） 浆满堆沙。四肢圆绽。但气弱恐其不肯收痂。必实脾利水为法。
人参 冬术 炙草 茯苓 新会皮 白芍
又（十三朝） 已经堆沙加食。都是向安之象。便溏滑腻。皆寒凉伤里肠。中脂垢自下。当脾胃药中。少佐
固肠。以久延不已。尚贻变症。
人参 熟术 诃子 广皮 肉果 白芍 木香 炙草 茯苓
又（十六朝） 纳食不化腹膨便粪白色。要之胃滞当消。脾弱宜补。古称痞满属气。气行滞通。但痘后虚
体。纯消犹恐变症。
人参 焦术 炒楂 木香 焦麦芽 广皮 茯苓 泽泻
鲍（九朝） 浆不外达。毒欲内陷。已经切牙。滑泻呕恶。内症诸款。皆属深畏。十二十
四。总属险关。痘子毒瓦斯。必气元旺。冀其托出。议以陈氏木香散。救里托毒。
人参 木香 丁香 官桂 炒归身 浓朴 广皮 肉果 诃子皮
孙 面肿目泛。头摇微呕。肝风离体。乘上逆攻。此乃变惊欲厥之象。夫相火寄于肝胆。气敛痘
痂。宜进凉解清毒。倘得微热缓。仍进谷。方有佳音。
羚羊角 川连 钩藤 石菖蒲 黑山栀 胆星 天麻 连翘
又 肝风热定。疳蚀亦缓。仍宜清热解毒。但不可犯胃。
羚羊角 连翘 胆星 丹皮 炒银花 金石斛 茯苓
诸（十三朝） 痘已收靥。然痂落太早。恐有余毒。今泻止溺短。宜进清凉。佐以分利。
生苡仁 百合 茯苓 川斛 白沙参 炒麦冬
某 已经回痂。不宜再进补剂。恐气血壅滞。致有余毒变幻。宗翁仲仁清凉以助结痂之法。
黄芩 银花 川贝 甘草 地骨皮 桔梗 连翘 苡仁
胡（十五朝） 虽然堆沙靥痂。切牙发呛。毒瓦斯未尽。上冲心肺。补清皆在难进。扶过十八日后。
痈毒尚可疗治。若发疳蚀。恐难全愈。
炒麦冬 白沙参 苡仁 川贝 炒银花 地骨皮
沈（十三朝） 浆未充满。忽然干涸。即是倒靥。切牙寒战。元气大亏。非峻补难挽。
人参 鹿茸 炒当归 桂心 桂圆 煨木香
程 回痂太早。余毒流走四肢。臂腿肿痛。议活血解毒。
连翘 小生地 当归 赤芍 刺蒺藜 丹皮 夏枯草 银花 酒半小杯
吴（十四朝） 呛咳呕逆腹膨。都是余毒内闭。小便少。大便溏。不得爽。倘再加喘急。便是棘手。
必得疡毒外发。可望挽回。
桑白皮 大腹皮 绿豆皮 茯苓皮 飞滑石 生甘草梢
查 痂后发痧。系肺热未清。宜辛凉佐以解余毒。
连翘 杏仁 桑皮 地骨皮 黄芩 木通 银花 牛蒡 夏枯草
吴（十四朝） 薄浆回痂。毒瓦斯未化。已有疳蚀之患。理进清解余毒。但勉进稀粥。溏泻未罢。
胃未旺相。脾气积弱。议以渗利分消。仿古痘毒当利小便意。
桑皮 地骨皮 连翘 茯苓 川贝 苡仁 银花
某 痘未退痂痧火内逼为喘。
川连 犀角 连翘 银花 元参 大贝 丹皮 地骨皮
又 痧火未清。
川连 黄芩 山栀 连翘 银花 杏仁 甘草
沈 薄浆回痂。毒瓦斯未尽。只宜清肺解毒。
炒川贝 茯苓 苡仁 车前 炒泽泻 炒银花
徐（十六朝） 疳毒已发咳呛未止。痂落如麸。肌色 白。虽属气血交虚。但痘后余毒。未可骤补。议进和
脾胃利湿方法。疳毒宜速调治。恐日久愈虚。致有慢惊之虑。
苡仁 川斛 茯苓 百合 广皮 炒泽泻
沈（二十一朝） 痰呛失音。不嗜食物。昼则稍安。暮夜烦躁。此肺热未肃。磨耐多日。体气阳亢阴亏。肝风内
炽。突起惊厥可虑。
地骨皮 甘草 生地炭 绿豆皮 炒丹皮 炒川贝 川斛
李（二十朝） 纳食呕吐。脾胃不和。肝风内动。肢浮肉肿。治宜培土制木。以缓肝风。冀免惊疳之患。
人参 茯苓 炒芍 生谷芽 藿香 广皮 半夏曲
冯（二十八朝） 痂靥粘连。神气昏昧。元为浆泄而乏。变幻慢惊欲脱。此皆稚年阳亢阴亏。羞明目窜。肝阴
乏绝。恐难再振。
人参 茯神 枣仁 归身 炙草 炒杞子
生白芍
又（三十七朝） 阳极则烦。阴涸为躁。夜甚剧。自从阴分设法。益虚和阳为治。
人参 熟地 芡实 茯苓 建莲 远志 炒山药 五味
杨 点来不爽。顶有水痕微焦。此时气传染。胎毒未发。乃水赤之类痘耳。
连翘 牛蒡 丹皮 赤芍 飞滑石 木通 山栀 甘草
邵 痘中复感温邪。口鼻触入。由中道以布及络脉。目泛失明。左肢不举。少腹突起肿满。两足
皆痿。询知痘见六日。陡然头摇烦躁而得。小便淋滴。大便渐塞。乃厥阴肝热。疝瘕失其疏泄。
内风旋转。腑阳不通。经言暴肿暴胀。皆风火变动。至于迅速病来。其能食消运。热化自可杀
谷。考古辛散酸泄甘缓三法。难图腑络壅结。仲景于厥阴条例。有下之利不止者死之大戒。
议进咸苦以通在下结热。愚见若此。再与高明商酌良治。
川楝子 小茴 芦荟 山栀 橘红 龙胆草
方诸水七匙。
徐评 诸案切近。和平之中。又能沉着变化。备前人之所未备。去其疵而取其纯。我郡有如此
名家。而不师法。偏拾庸妄人唾余。不论何人。不问虚实。总以石膏大黄种种恶毒之药。大剂灌
程某：痘疹初现时，点粒若隐若现。精神疲倦且心神不宁。病势如同被闷伏在内。表里之气都不宣畅。虽然应当使用双解法（表里双解），但还需辅以芳香之品来搜剔逐除毒邪，以使蕴伏的毒邪透发出来为主。（这是见点闷症的治法）紫雪丹。
周某：热邪闭阻在心包络中。眼睛瞪大。嘴巴张开。舌头卷缩。两手在空中抓握。发生痉挛。小便通畅但大便干涩。血分受到严重损伤。正处于第九天的危险期。按照法则治疗以求侥幸痊愈。勉强给予紫雪丹二钱，用开水调匀后缓缓服下。使用茶铫煎煮。如果能使神志清醒、痉挛缓解，方有生机。
又诊：神志已醒。舌质绛紫且声音短促。口渴想喝水不止。心包的热闭虽然已经开通，但在里的脂液已经枯竭。古人认为心热导致的消渴症，多属于脏阴不足的现症。不可以使用攻伐之法，这是很明确的。
鲜生地 竹叶心 玄参 知母 银花露 金汁 先用紫雪（一钱）
龚某：发病初期腰足都出现症状。肝肾蕴藏的毒邪不能向外透越。眼睛浑浊泛白，舌苔满布。随后增加气喘急促的症状。这是紧闷不治的病症。各位医生都用石膏和大黄。然而这些药物仅能通泄阳明胃腑的壅滞，未能搜剔逐除肝肾这一至阴之脏的毒邪。读宋代医家钱仲阳的《直诀》，毒邪伏于阴分，也有下夺的方法。其制方名为枣变百祥丸，这是百中希望能有一二人存活的方法。（这是肝肾蕴毒闷症的治法）
红芽大戟（五钱） 红枣（五枚）
用水煮，直到枣熟，去掉枣核和大戟的药汤。只取枣肉研化，用开水送服。
某人：毒邪潜伏不肯宣透，气机阻滞，血液凝滞，怎么能起绽成浆呢？处于第七八天的危险关卡。诊视肌肉肿胀，疮口干枯，神志躁动不安。建议疏利内部的壅滞，辅助活血透肌的方法。
犀角 紫草 炒山楂 鲜生地 酒浸大黄 红花 青皮 丹皮 连翘 牛蒡子 用茅根笋尖汤代替水煎药。
俞某：发热五六天，神情烦躁不宁。腹部膨隆，咳嗽气逆。询问得知两三天前，眉间见到几粒痘点，形状像麸皮一样。随即隐伏不见。这是毒重壅遏，闷伏的景象。即使发出，也属于重险之症。况且孩子刚出生六个月，胃气缺乏谷气滋养，难以进服汤药。拟进紫雪丹需少量，搜剔其蕴蓄的邪气，使其神志安宁后再做商量。紫雪丹（一分）。
高某：痘点虽然繁密，但根部脚底绽立稳固。寒凉药不宜太重。可以维持并收功。
犀角 连翘 牛蒡子 炒山楂 紫草 丹皮 天虫（僵蚕） 桔梗
庞某（发病第二天）：精神疲倦，腹痛。痘点繁琐杂乱，界限不清。此时是时邪毒火兼重的情况。急进双解法，使大便稍微通畅，六腑之气宣通，则痘毒外透后再做商量。
犀角 连翘 牛蒡子 酒大黄 紫草 青皮 桃仁 炒山楂 木通 生石膏 荆芥 笋尖
程某：痘点成片但不站立，顶部焦黑滞涩。肝肺毒重，不能起胀，怎么能化解毒邪呢？如今喘咳交加，第九天难过。
羚羊角 玄参 连翘 天虫 土贝母 紫草 炒山楂 丹皮 用银花地丁汤代替水煎药。
钱某（发病第三天）：虽然痘未发齐，但其点形繁密，色泽不润泽，重险无疑。如今痧未全退，尚宜清解。
犀角 生石膏 炒山楂 紫草 连翘 牛蒡子 赤芍 桔梗 木通
程某（发病第三天）：身体小气弱，布痘繁稠。用药不宜寒凉。五日后受得补托，可期望有成。
连翘 牛蒡子 炒山楂 红花 天虫 川芎 归身 桔梗 炒干荷叶
毛某：身体小气弱，浆发惊窜属于虚证。
人参 炒归身 炙甘草 广陈皮 炒白芍 炒黄米
童某（发病第四天）：痘形粘着肌肉，不肯起绽高立。加之颜色繁红壳薄，这是时火毒火交炽，而元气素亏体质。目前距离发病六天前，时疠未彻。宜先清解活血提顶，希望磊磊分明分成地界再作研究。
犀角 羚羊角 玄参 丹皮 炒山楂 秦皮 紫草茸 银花
郑某：痘发犹热，身热咳嗽。这是风温入肺未解。诊其点粒粘着不爽，温邪郁滞气血，更兼体质素虚。建议开肺气以宣通它，活血以疏动它。希望其形色充长。如果一进沉降药，恐怕没有好结果。
连翘 桔梗 红花 牛蒡子 甘草 炒山楂 郁金 丹皮 鸡冠血
又诊：昨日进轻扬提顶活血药，痘形颇长。所嫌颜色不光润，蓬松盘曲，有干塌无浆的忧虑。现在明日天气将解，气血用事。况且正欲纳谷，苦寒不但冰伏毒瓦斯，更防大伤胃口。古人对于重症更加详慎就是这个原因。
川芎 当归 天虫 桔梗 甘草 角刺 紫草茸 丹皮 炒山楂
又诊（第六天）：进和气血法，形色略润。终究不肥绽，怎么能起胀成浆呢？建议进十宣散法。
人参 川芎 归身 广陈皮 紫草茸 天虫
红花 白芷 甘草 桔梗
张某（发病第四天）：船小重载，难许全功。勉议进鸡鸣散二分。
陆某（发病第五天）：痘点虽不密，但色滞形痿。痰多呛逆如嘶哑。是痘虽发出，毒犹在内。上冲心肺，故有喘咳不宁之象。进凉血透毒法。
羚羊角 桔梗 甘草 紫草 丹皮 川贝 连翘 玄参 射干 天虫 西牛黄（一分）
又诊（第五天）：身小痘多，元气最薄。胃腑未纳谷味，汤药大过，须虑呕泄。宜少少与药，扶过八九风波，方得平安。
川芎 炒当归 桔梗 甘草 黄米 鸡冠血
又诊（第六天）：薄嫩无浆，仍宜内托。
黄芪 防风 归身 川芎 紫草茸 丹皮 天虫 桔梗 甘草 鸡冠血
宋某（发病第五天）：颧颊形似红沙。其余痘干枯不润。昨日进清毒活血药，续发点子盈千。仲仁说毒重壅闭气血，必干焦退缩。如今第五天形象，仅似初齐。痘以十二日为常数。已经壅遏未发三日矣。当此质薄神弱，恐难延多日。即或望其堆沙发臭，然必在旬日以外。目下总以解毒清凉。八九波涛汹涌，恐难人力稳全。
犀角 羚羊角 川黄连 炒山楂 土贝母 紫草茸 玄参 鲜生地 连翘 丹皮 牛蒡子 猪尾血
吴某（发病五天半）：痘子分颗，原属纯正。所嫌色滞干枯，防八九痒塌。凉药兼以活血，是为平准方法。看守勿懈为上。
羚羊角 丹皮 连翘 炒山楂 紫草茸 黄连 玄参 天虫 生地 鸡冠血
孙某：肌柔白嫩，体质是虚。但布痘必由时疠感触，地中六气，咸从火化。疠固客气，相混气血。若非清解，何以透达。今视色油红，按形松怯。再视面部肌肉先肿，痘形未具起胀之象，体症未为合局。虑进锐退速，清凉解毒，佐以提顶，在五六日之法。然险症变迁不一，未可以经常定论。
羚羊角 连翘 丹皮 天虫 生甘草 紫草茸 川黄连 炒山楂 桔梗
银花汤煎，和入鸡冠血数滴。
汪某（发病第五天）：痘形繁琐成片，色紫滞，乃火毒重险症。藉身大气旺，扶持十四险关，冀其发臭堆沙，庶几可以图幸。
犀角 羚羊角 桔梗 炒山楂 连翘 天虫 紫草茸 丹皮 石膏 银花 地丁 牛蒡
猪尾血 冰片
又诊（第六天）：虽血热毒重，犹幸八龄体坚。急清解活血，莫令痰阻废食，扶持堆沙，可望向安。照前方去石膏地丁天虫牛蒡加川连元参土贝。
查某：痘子成浆，湿气蕴于皮毛，与热气相蒸，内应乎肺，发出罩痘疹。宜忌荤腥，轻清理肺，淡渗消其湿热。验其体质最薄，慎勿过剂。
苡仁 茯苓 连翘 地骨皮 通草 桑叶 白沙参 甘草
顾某：痘发由络，其毒不化而转陷，亦归于络。当世略晓攻补而已。读古人书，辛香温煦，乃治毒陷大法。
人参 肉桂 炙甘草 丁香 浓朴 诃子皮
广陈皮 木香 前胡 茯苓
徐某：未纳谷食，但以汤药，所以滑泄不止。头仰胸突，拥痰身热，肺热未清，不可骤补。翁仲仁有泄泻安宁，大虚少毒之议。姑以和中清咽再商。
桔梗 甘草 炒当归 川芎 广陈皮 炒山楂
炒黄米汤煎，冲鸡冠血。
又诊（第七天）：身小痘密，气弱难任。虽清浆三四，防护宜慎。八九日不致损破，可以有成。
人参 黄芪 炙甘草 紫茸 天虫 广陈皮 川芎 归身 浓朴 炒山楂 加炒冬米
孙某（第七天）：色娇皮薄，浆汁未灌。缘身小痘多，气血交亏，不能运毒化浆。八九日期，最有痒塌之虑。扶过十二朝无变，庶几可望有成。进参归鹿茸汤法。
人参 归身 鹿茸 生黄芪 炙甘草 广陈皮 浓朴 煨木香
又诊（第八天）：照前方加肉果炒冬米。
又诊：浆清四五，不能充灌。因元气馁弱不振，不能炼毒瓦斯成浆，恐有内陷之虑。再进补托，冀其堆沙，或可回春。
人参 黄芪 广陈皮 炙甘草 木香 鹿茸 归身 肉果 坎炝 官桂
又诊（第十三天）：靥痂甚薄，中凝血迹。兼之呛逆带呕，食入便有不化之形。此虚中有毒，非纯补纯清之症。
炒川贝 炒银花 茯苓 苡仁 甘草 地骨皮
杨某（第八天）：阔塌瘪陷，浆色白滞不荣。谓之气衰毒陷。所冀堆沙加食，一线机耳。
人参 黄芪 川芎 归身 木香 炙甘草 广陈皮 桂心
又诊（第十一天）：浆满堆沙，四肢圆绽。但气弱恐其不肯收痂。必实脾利水为法。
人参 冬术 炙甘草 茯苓 新会皮 白芍
又诊（第十三天）：已经堆沙加食，都是向安之象。便溏滑腻，皆寒凉伤里肠，中脂垢自下。当脾胃药中，少佐固肠，以久延不已，尚贻变症。
人参 熟术 诃子 广陈皮 肉果 白芍 木香 炙甘草 茯苓
又诊（第十六天）：纳食不化腹膨便粪白色。要之胃滞当消，脾弱宜补。古称痞满属气，气行滞通。但痘后虚体，纯消犹恐变症。
人参 焦术 炒山楂 木香 焦麦芽 广陈皮 茯苓 泽泻
鲍某（第九天）：浆不外达，毒欲内陷。已经切牙，滑泻呕恶，内症诸款，皆属深畏。十二十四，总属险关。痘子毒瓦斯，必气元旺，冀其托出。议以陈氏木香散，救里托毒。
人参 木香 丁香 官桂 炒归身 浓朴 广陈皮 肉果 诃子皮
孙某：面肿目泛，头摇微呕，肝风离体，乘上逆攻。此乃变惊欲厥之象。夫相火寄于肝胆，气敛痘痂，宜进凉解清毒。倘得微热缓，仍进谷，方有佳音。
羚羊角 川黄连 钩藤 石菖蒲 黑山栀 胆星 天麻 连翘
又诊：肝风热定，疳蚀亦缓。仍宜清热解毒，但不可犯胃。
羚羊角 连翘 胆星 丹皮 炒银花 金石斛 茯苓
诸某（第十三天）：痘已收靥，然痂落太早，恐有余毒。今泻止溺短，宜进清凉，佐以分利。
生苡仁 百合 茯苓 川石斛 白沙参 炒麦冬
某人：已经回痂，不宜再进补剂，恐气血壅滞，致有余毒变幻。宗翁仲仁清凉以助结痂之法。
黄芩 银花 川贝 甘草 地骨皮 桔梗 连翘 苡仁
胡某（第十五天）：虽然堆沙靥痂，切牙发呛，毒瓦斯未尽，上冲心肺，补清皆在难进。扶过十八日后，痈毒尚可疗治。若发疳蚀，恐难全愈。
炒麦冬 白沙参 苡仁 川贝 炒银花 地骨皮
沈某（第十三天）：浆未充满，忽然干涸，即是倒靥。切牙寒战，元气大亏，非峻补难挽。
人参 鹿茸 炒当归 桂心 桂圆 煨木香
程某：回痂太早，余毒流走四肢，臂腿肿痛。议活血解毒。
连翘 小生地 当归 赤芍 刺蒺藜 丹皮 夏枯草 银花 酒半小杯
吴某（第十四天）：呛咳呕逆腹膨，都是余毒内闭。小便少，大便溏，不得爽。倘再加喘急，便是棘手。必得疡毒外发，可望挽回。
桑白皮 大腹皮 绿豆皮 茯苓皮 飞滑石 生甘草梢
查某：痂后发痧，系肺热未清。宜辛凉佐以解余毒。
连翘 杏仁 桑皮 地骨皮 黄芩 木通 银花 牛蒡 夏枯草
吴某（第十四天）：薄浆回痂，毒瓦斯未化，已有疳蚀之患。理进清解余毒。但勉进稀粥，溏泻未罢，胃未旺相，脾气积弱。议以渗利分消，仿古痘毒当利小便意。
桑皮 地骨皮 连翘 茯苓 川贝 苡仁 银花
某人：痘未退痂，痧火内逼为喘。
川黄连 犀角 连翘 银花 玄参 大贝 丹皮 地骨皮
沈某：薄浆回痂，毒瓦斯未尽，只宜清肺解毒。
炒川贝 茯苓 苡仁 车前 炒泽泻 炒银花
徐某（第十六天）：疳毒已发，咳呛未止，痂落如麸，肌色苍白。虽属气血交虚，但痘后余毒，未可骤补。议进和脾胃利湿方法。疳毒宜速调治，恐日久愈虚，致有慢惊之虑。
苡仁 川石斛 茯苓 百合 广陈皮 炒泽泻
沈某（第二十天）：痰呛失音，不嗜食物。昼则稍安，暮夜烦躁。此肺热未肃，磨耐多日，体气阳亢阴亏，肝风内炽，突起惊厥可虑。
地骨皮 甘草 生地炭 绿豆皮 炒丹皮 炒川贝 川石斛
李某（第二十天）：纳食呕吐，脾胃不和，肝风内动，肢浮肉肿。治宜培土制木，以缓肝风。冀免惊疳之患。
人参 茯苓 炒芍 生谷芽 藿香 广陈皮 半夏曲
冯某（第二十八天）：痂靥粘连，神气昏昧，元为浆泄而乏，变幻慢惊欲脱。此皆稚年阳亢阴亏，羞明目窜，肝阴乏绝，恐难再振。
人参 茯神 枣仁 归身 炙甘草 炒杞子
生白芍
又诊（第三十七天）：阳极则烦，阴涸为躁，夜甚剧。自从阴分设法，益虚和阳为治。
人参 熟地 芡实 茯苓 建莲 远志 炒山药 五味子
杨某：点来不爽，顶有水痕微焦。此时气传染，胎毒未发，乃水赤之类痘耳。
连翘 牛蒡子 丹皮 赤芍 飞滑石 木通 山栀 甘草
邵某：痘中复感温邪，口鼻触入，由中道以布及络脉，目泛失明，左肢不举，少腹突起肿满，两足皆痿。询知痘见六日，陡然头摇烦躁而得。小便淋滴，大便渐塞。乃厥阴肝热，疝瘕失其疏泄，内风旋转，腑阳不通。经言暴肿暴胀，皆风火变动。至于迅速病来，其能食消运，热化自可杀谷。考古辛散酸泄甘缓三法，难图腑络壅结。仲景于厥阴条例，有下之利不止者死之大戒。议进咸苦以通在下结热。愚见若此，再与高明商酌良治。
川楝子 小茴 芦荟 山栀 橘红 龙胆草
方诸水七匙。
徐某评：诸案切近，和平之中，又能沉着变化，备前人之所未备，去其疵而取其纯。我郡有如此名家，而不师法，偏拾庸妄人唾余，不论何人，不问虚实，总以石膏大黄种种恶毒之药，大剂灌
Cheng: When the smallpox spots first appear, they are indistinct and fleeting. The spirit is fatigued and restless. The condition resembles being stifled or trapped internally. Both the exterior and interior qi are not smooth and unobstructed. Although a dual-release method (releasing both exterior and interior) is appropriate, it should be assisted by aromatic substances to search out and expel the pathogenic factors, with the main goal of allowing the pent-up toxins to surface. (This is the treatment for "stifled eruption" when spots first appear). Zixue Dan (Purple Snow Pill).
Zhou: Heat has closed off the Pericardium collateral network. The eyes are wide open. The mouth is agape. The tongue is retracted. The hands are grasping at empty air. Spasms have occurred. Urination is clear but defecation is difficult. The blood level is severely damaged. It is the ninth day, a critical period. Following the prescribed method to seek a lucky recovery. Prescribed Zixue Dan (Purple Snow Pill), two qian, mixed with boiling water and administered slowly. Decocted using a tea pot. If consciousness returns and spasms subside, there will be hope for life.
Re-examination: Consciousness has returned. The tongue is crimson-purple and speech is hoarse/short. There is incessant thirst and desire to drink. Although the heat closure in the Pericardium has opened, the fluids and essence within are exhausted. Ancients stated that heart-heat causing polydipsia is mostly a manifestation of visceral yin deficiency. It is clear that purgative methods should not be used.
Fresh Rehmanniae Radix (Sheng Dihu) Heart of Bamboo Leaves (Zhuye Xin) Scrophulariae Radix (Xuanshen) Anemarrhenae Rhizoma (Zhimu) Silver Flower Dew (Yinhua Lu) Human Feces Decoction (Jinzhi) First use Zixue (one qian).
Gong: At the onset, the waist and feet were affected. The toxins accumulated in the Liver and Kidney could not vent outward. The eyes were cloudy and the tongue was coated. Subsequently, panting and urgency increased. This is a critical, untreatable condition of tightness and stifling. All physicians used Gypsum Fibrosum (Shigao) and Rheum Palmatum (Dahuang). However, these drugs only clear the stagnation of the Yangming Stomach fu organ; they cannot search out and expel the toxins from the extreme-yin organs of the Liver and Kidney. Reading Qian Zhongyang's *Zhijue* from the Song Dynasty, it states that toxins hidden in the yin can also be treated with purgation. The formula is called Zaobian Baixiang Wan. It is a method where one hopes for survival in one or two out of a hundred cases. (Treatment for Liver-Kidney toxin accumulation and stifling). Hongya Daji (Red-spotted Euphorbia Root, five qian) Red Dates (five pieces).
Boil in water until the dates are cooked. Remove the pits and the decoction of the Daji. Use only the date flesh, ground and dissolved in boiling water for administration.
Certain Patient: Toxins are hidden and refuse to vent. Qi stagnates and Blood coagulates. How can they erupt and form pustules? During the seventh or eighth day, a critical juncture. Examination shows swollen flesh and withered sores. The spirit is restless and uneasy. Propose to dredge internal stagnation and assist with invigorating Blood and penetrating the muscle layer.
Rhinoceros Horn (Xijiao) Arnebiae Radix seu Lithospermi Radix (Zicao) Stir-fried Hawthorn Seed (Chao Zha) Fresh Rehmanniae Radix (Xian Shengdi) Wine-soaked Rheum Palmatum (Jiu Jin Dahuang) Safflower (Honghua) Citri Reticulatae Pericarpium (Qingpi) Moutan Cortex (Danpi) Forsythiae Fructus (Lianqiao) Arctii Fructus (Niubang) Decoct with Reed Rhizome and Bamboo Shoot Tips soup as water.
Yu: Fever for five to six days. Restless and uneasy spirit. Abdominal distension, coughing and rebellious Qi. Inquiry reveals that two or three days ago, a few spots appeared on the glabella, resembling bran flakes. They subsequently disappeared and became hidden. This indicates heavy toxins obstructing and stifling. Even if they erupt, it belongs to severe danger. Moreover, the infant is only six months old, lacking Gu Qi (Grain Qi) in the Stomach, making it difficult to take herbal decoctions. Prescribe a small dose of Zixue Dan to search out and eliminate the accumulated pathogens, calming the spirit before further discussion. Zixue Dan (one fen).
Gao: Although the spots are dense, the base stands firm. Cold-natured drugs should not be too heavy. Maintenance and conclusion of treatment can be achieved.
Rhinoceros Horn (Xijiao) Forsythiae Fructus (Lianqiao) Arctii Fructus (Niubang) Stir-fried Hawthorn Seed (Chao Zha) Arnebiae Radix seu Lithospermi Radix (Zicao) Moutan Cortex (Danpi) Bombyx Batryticatus (Tianchong) Platycodonis Radix (Jiegeng)
Pang (Day 2): Fatigue, abdominal pain. Spots are numerous and messy, boundaries unclear. At this time, seasonal evil toxins and fire are combined and severe. Urgently apply dual-release method to slightly promote bowel movement. Once the Qi of the Six Fu organs is unobstructed, the smallpox toxins will vent outward, and treatment can be adjusted.
Rhinoceros Horn (Xijiao) Forsythiae Fructus (Lianqiao) Arctii Fructus (Niubang) Wine-processed Rheum Palmatum (Jiu Dahuang) Arnebiae Radix seu Lithospermi Radix (Zicao) Citri Reticulatae Pericarpium (Qinghua) Peach Kernel (Taoren) Stir-fried Hawthorn Seed (Chao Zha) Akebia Caulis (Mutong) Raw Gypsum Fibrosum (Sheng Shigao) Schizonepetae Spica (Jingjie) Bamboo Shoot Tips
Cheng: Spots form patches but do not stand erect. The apex is scorched black and stagnant. Liver and Lung toxins are heavy. Cannot swell up. How can toxins be transformed? Now panting and coughing alternate. The ninth day is hard to pass.
Antelope Horn (Lingyangjiao) Scrophulariae Radix (Xuanshen) Forsythiae Fructus (Lianqiao) Bombyx Batryticatus (Tianchong) Fritillaria Thunbergii Bulb (Tu Bei) Arnebiae Radix seu Lithospermi Radix (Zicao) Stir-fried Hawthorn Seed (Chao Zha) Moutan Cortex (Danpi) Decoct with Honeysuckle and Vinca Vine soup as water.
Qian (Day 3): Although not all erupted, the spots are dense and lusterless. Severe danger is undeniable. Currently, the rash has not fully subsided. Clearing and resolving is still appropriate.
Rhinoceros Horn (Xijiao) Raw Gypsum Fibrosum (Sheng Shigao) Stir-fried Hawthorn Seed (Chao Zha) Arnebiae Radix seu Lithospermi Radix (Zicao) Forsythiae Fructus (Lianqiao) Arctii Fructus (Niubang) Red Peony Root (Chishao) Platycodonis Radix (Jiegeng) Akebia Caulis (Mutong)
Cheng (Day 3): Small body, weak Qi. Dense distribution of spots. Medications should not be too cold-cooling. After five days, tonification and support can be applied, hoping for success.
Forsythiae Fructus (Lianqiao) Arctii Fructus (Niubang) Stir-fried Hawthorn Seed (Chao Zha) Safflower (Honghua) Bombyx Batryticatus (Tianchong) Ligusticum Chuanxiong Rhizome (Chuanxiong) Angelica Sinensis Radix Root (Guishen) Platycodonis Radix (Jiegeng) Stir-fried Dry Lotus Leaf (Chao Gan Heye)
Mao: Small body, weak Qi. Convulsions during pus formation indicate deficiency.
Ginseng Radix (Renshen) Stir-fried Angelica Sinensis Radix (Chao Guishen) Honey-fried Licorice Root (Zhigancao) Tangerine Peel (Guangpi) Stir-fried White Peony Root (Chao Baishao) Stir-fried Yellow Rice (Chao Huangmi)
Tong (Day 4): Spots adhere to the muscles, refusing to erupt and stand high. Plus, they are densely red with thin crusts. This is an intensification of seasonal fire toxins, combined with constitutionally deficient Yuan Qi. Regarding the six days prior to now, the epidemic pathogen was not fully resolved. Prioritize clearing heat, resolving stasis, and lifting the top. Hope for distinct separation of boundaries before further investigation.
Rhinoceros Horn (Xijiao) Antelope Horn (Lingyang) Scrophulariae Radix (Xuanshen) Moutan Cortex (Danpi) Stir-fried Hawthorn Seed (Chao Zha) Bark of Qin Tree (Qinpi) Purple Grass Velvet (Zicao Rong) Honeysuckle (Yinhua)
Zheng: Smallpox erupted while fever persists, accompanied by cough. Wind-warmth has entered the Lung and is not resolved. Palpation shows spots adhering uncomfortably. Warm pathogens stagnate Qi and Blood, compounded by constitutionally weak physique. Propose opening Lung Qi to ventilate, and invigorating Blood to move freely. Hope for full development of color and shape. If sinking and descending herbs are used immediately, good outcomes are unlikely.
Forsythiae Fructus (Lianqiao) Platycodonis Radix (Jiegeng) Safflower (Honghua) Arctii Fructus (Niubang) Licorice Root (Gancao) Stir-fried Hawthorn Seed (Chao Zha) Curcuma Aromatica Rhizome (Yujin) Moutan Cortex (Danpi) Cock Comb Blood (Jiguan Xue)
Re-examination: Yesterday, light, ascending, and blood-invigorating herbs were given. Spot shapes grew well. The concern is lack of luster. Fluffy and curled, with fear of drying up without pus. Tomorrow, atmospheric Qi will resolve, and Qi and Blood will function. Moreover, appetite is returning. Bitter-cold herbs not only freeze the toxins but also severely damage the stomach appetite. Ancients were more cautious with severe cases for this reason.
Ligusticum Chuanxiong Rhizome (Chuanxiong) Angelica Sinensis Radix (Danggui) Bombyx Batryticatus (Tianchong) Platycodonis Radix (Jiegeng) Licorice Root (Gancao) Thorny Twig (Jiaoci) Purple Grass Velvet (Zicao Rong) Moutan Cortex (Danpi) Stir-fried Hawthorn Seed (Chao Zha)
Re-examination (Day 6): Applied harmonizing Qi and Blood method. Color and shape slightly moist. Ultimately not plump or erupting. How can swelling and pus formation occur? Propose Shixuan San (Ten-Accumulation Powder).
Ginseng Radix (Renshen) Ligusticum Chuanxiong Rhizome (Chuanxiong) Angelica Sinensis Radix Root (Guishen) Tangerine Peel (Guangpi) Purple Grass Velvet (Zicao Rong) Bombyx Batryticatus (Tianchong)
Safflower (Honghua) White Angelica Root (Baizhi) Licorice Root (Gancao) Platycodonis Radix (Jiegeng)
Zhang (Day 4): Small boat carrying heavy load. Hard to achieve complete success. Tentatively prescribe Jiming San (Crowing Rooster Powder), two fen.
Lu (Day 5): Spots are not dense, but color is stagnant and shape is flaccid. Phlegm is abundant, choking and wheezing like a hoarse voice. Although spots have erupted, toxins remain inside. Rushing upward to Heart and Lung, hence panting, coughing, and restlessness. Apply cooling blood and penetrating toxin method.
Antelope Horn (Lingyangjiao) Platycodonis Radix (Jiegeng) Licorice Root (Gancao) Arnebiae Radix seu Lithospermi Radix (Zicao) Moutan Cortex (Danpi) Sichuan Fritillaria Bulb (Chuanbei) Forsythiae Fructus (Lianqiao) Scrophulariae Radix (Xuanshen) Belamcanda Rhizome (Shegan) Bombyx Batryticatus (Tianchong) Western Buffalo Calculus (Xi Niuhuang, one fen)
Zhu (Day 4)
Stir-fried Yellow Rice (Chao Huangmi) Stir-fried Hawthorn (Chao Shanzha) Safflower (Honghua) Bamboo Shoot Tips
Re-examination (Day 5): Small body, many spots. Yuan Qi is thinnest. Stomach has not accepted food. Herbal dosage is too heavy; worry about vomiting and diarrhea. Administer medicine in small amounts. Survive the turbulence of days eight and nine to achieve peace.
Ligusticum Chuanxiong Rhizome (Chuanxiong) Stir-fried Angelica Sinensis Radix (Chao Danggui) Platycodonis Radix (Jiegeng) Licorice Root (Gancao) Yellow Rice (Huangmi) Cock Comb Blood (Jiguan Xue)
Re-examination (Day 6): Thin and tender, no pus. Still need internal support.
Astragalus Membranaceus Root (Huangqi) Saposhnikovia Root (Fangfeng) Angelica Sinensis Radix Root (Guishen) Ligusticum Chuanxiong Rhizome (Chuanxiong) Purple Grass Velvet (Zicao Rong) Moutan Cortex (Danpi) Bombyx Batryticatus (Tianchong) Platycodonis Radix (Jiegeng) Licorice Root (Gancao) Cock Comb Blood (Jiguan Xue)
Song (Day 5): Cheeks resemble red sand. Remaining spots are dry and lusterless. Yesterday, cleared toxins and invigorated blood. Continuously erupted thousands of spots. Zhongren said heavy toxins block Qi and Blood, leading to dryness, scorching, and shrinking. Current Day 5 appearance is only similar to initial completion. Twelve days is the standard duration for smallpox. Already blocked and un-erupted for three days. With thin quality and weak spirit, fear it cannot last long. Even hoping for piled eruption and odor, it must be after ten days. Currently, total detoxification and cooling. Days eight and nine will be turbulent; human effort may not stabilize it completely.
Rhinoceros Horn (Xijiao) Antelope Horn (Lingyangjiao) Coptis Chinensis Rhizome (Chuanlian) Stir-fried Hawthorn Seed (Chao Zha) Fritillaria Thunbergii Bulb (Tu Bei) Purple Grass Velvet (Zicao Rong) Scrophulariae Radix (Xuanshen) Fresh Rehmanniae Radix (Xian Shengdi) Forsythiae Fructus (Lianqiao) Moutan Cortex (Danpi) Arctii Fructus (Niubangzi) Pig Tail Blood (Zhuwei Xue)
Wu (Day 5.5): Spots are distinct, originally pure. Concern is stagnant color and dryness. Fear itching and collapse on days eight and nine. Cooling herbs combined with blood-invigorating ones is the standard method. Vigilant care is best.
Antelope Horn (Lingyangjiao) Moutan Cortex (Danpi) Forsythiae Fructus (Lianqiao) Stir-fried Hawthorn Seed (Chao Zha) Purple Grass Velvet (Zicao Rong) Coptis Chinensis Rhizome (Huanglian) Scrophulariae Radix (Xuanshen) Bombyx Batryticatus (Tianchong) Rehmanniae Glutinosa Radix (Shengdi) Cock Comb Blood (Jiguan Xue)
Sun: Soft, white, and tender skin. Constitution is deficient. But smallpox distribution must be due to seasonal epidemics. The six Qi in the earth all transform into fire. Epidemic is external guest, mixing with Qi and Blood. Without clearing and resolving, how can it penetrate? Now color is oily red, pressing feels loose and fearful. Facial muscles swell first. Spot shape lacks swelling indication. Symptoms do not fit the pattern. Fear rapid advance and quick retreat. Cooling and detoxifying, assisted by lifting the top, is the method for days five and six. However, dangerous conditions change unpredictably; cannot rely on general rules.
Antelope Horn (Lingyangjiao) Forsythiae Fructus (Lianqiao) Moutan Cortex (Danpi) Bombyx Batryticatus (Tianchong) Raw Licorice Root (Sheng Gancao) Purple Grass Velvet (Zicao Rong) Coptis Chinensis Rhizome (Chuanlian) Stir-fried Hawthorn Seed (Chao Zha) Platycodonis Radix (Jiegeng)
Decoct with Honeysuckle soup, mix in a few drops of Cock Comb Blood.
Wang (Day 5): Spots are numerous and form patches. Color is purple and stagnant. Fire toxin is severe and dangerous. Rely on strong body Qi to support through fourteen critical days. Hope for foul-smelling, piled eruption. Then there is a chance for survival.
Rhinoceros Horn (Xijiao) Antelope Horn (Lingyangjiao) Platycodonis Radix (Jiegeng) Stir-fried Hawthorn Seed (Chao Zha) Forsythiae Fructus (Lianqiao) Bombyx Batryticatus (Tianchong) Purple Grass Velvet (Zicao Rong) Moutan Cortex (Danpi) Gypsum Fibrosum (Shigao) Honeysuckle (Yinhua) Vinca Vine (Diding) Arctii Fructus (Niubang)
Pig Tail Blood (Zhuwei Xue) Borneolum Syntheticum (Bingpian)
Re-examination (Day 6): Although Blood heat and heavy toxins, fortunately age eight and body is strong. Urgently clear heat, resolve toxins, and invigorate blood. Do not let phlegm obstruct and cause loss of appetite. Support piled eruption, hope for improvement. Follow previous prescription, remove Gypsum Fibrosum, Vinca Vine, Bombyx Batryticatus, Arctii Fructus. Add Coptis Chinensis Rhizome, Scrophulariae Radix, Fritillaria Thunbergii Bulb.
Cha: Pustules formed. Dampness accumulates in skin and hair, steaming with heat, internally affecting Lung. Erupted with covering rash. Avoid meat and fish. Lightly clear and regulate Lung. Mild diuresis to eliminate damp-heat. Constitution is very thin; avoid overdosing.
Coix Seed (Yiren) Poria (Fuling) Forsythiae Fructus (Lianqiao) Lycii Cortex (Digupi) Tetrapanacis Medulla (Tongcao) Mulberry Leaf (Sangye) White Sand Ginseng (Baishashen) Licorice Root (Gancao)
Gu: Eruption originates from collaterals. Toxins do not transform but sink back, also returning to collaterals. Contemporary doctors only know attack and tonify. Reading ancients' books, pungent-aromatic and warming methods are the major principle for treating toxin sinking.
Ginseng Radix (Renshen) Cinnamon Twig (Rougui) Honey-fried Licorice Root (Zhigancao) Clove (Dingxiang) Magnolia Bark (N Hou) Terminalia Chebula Retz. Fruit (Hezizi Pi)
Tangerine Peel (Guangpi) Aucklandiae Radix (Muxiang) Peucedani Radix (Qianhu) Poria (Fuling)
Xu: Has not eaten grain. Only taking herbal decoctions, hence continuous slippery diarrhea. Head tilted back, chest protruding, phlegm congestion, body heat. Lung heat not cleared. Cannot abruptly tonify. Weng Zhongren suggested that if diarrhea stabilizes, it is great deficiency with little toxin. Tentatively harmonize middle and clear throat for discussion.
Platycodonis Radix (Jiegeng) Licorice Root (Gancao) Stir-fried Angelica Sinensis Radix (Chao Gui) Ligusticum Chuanxiong Rhizome (Chuanxiong) Tangerine Peel (Guangpi) Stir-fried Hawthorn Seed (Chao Zha)
Decoct with Stir-fried Yellow Rice soup, mix in Cock Comb Blood.
Re-examination (Day 7): Small body, dense spots. Weak Qi cannot bear much. Although clear pus forms three or four times, protection must be careful. If not damaged or broken by days eight and nine, success is possible.
Ginseng Radix (Renshen) Astragalus Membranaceus Root (Huangqi) Honey-fried Licorice Root (Zhigancao) Purple Velvet (Zirong) Bombyx Batryticatus (Tianchong) Tangerine Peel (Guangpi) Ligusticum Chuanxiong Rhizome (Chuanxiong) Angelica Sinensis Radix Root (Guishen) Magnolia Bark (N Hou) Stir-fried Hawthorn Seed (Chao Zha) Add Stir-fried Winter Rice
Sun (Day 7): Delicate color, thin skin. Pus not filled. Due to small body and many spots, Qi and Blood are mutually deficient. Cannot transport toxins and transform pus. Days eight and nine have greatest fear of itching and collapse. Survive twelve days without change, then hope for success. Apply Shen-Gui-Lurong Tang method.
Ginseng Radix (Renshen) Angelica Sinensis Radix Root (Guishen) Deer Antler (Lurong) Raw Astragalus Membranaceus Root (Sheng Huangqi) Honey-fried Licorice Root (Zhigancao) Tangerine Peel (Guangpi) Magnolia Bark (N Hou) Calcined Aucklandiae Radix (Wei Muxiang)
Re-examination (Day 8): Follow previous prescription, add Nutmeg (Rouguo) and Stir-fried Winter Rice.
Re-examination: Clear pus four or five times, cannot fill. Because Yuan Qi is weak and listless, cannot refine toxins into pus. Fear internal sinking. Re-apply tonification and support. Hope for piled eruption, perhaps recover spring.
Ginseng Radix (Renshen) Astragalus Membranaceus Root (Huangqi) Tangerine Peel (Guangpi) Honey-fried Licorice Root (Zhigancao) Aucklandiae Radix (Muxiang) Deer Antler (Lurong) Angelica Sinensis Radix Root (Guishen) Nutmeg (Rouguo) Umbilical Cord (Kan) Cassia Twig (Guangui)
Re-examination (Day 13): Crusts are very thin, coagulated blood traces inside. Plus choking and retching. Food enters but appears undigested. This is deficiency with toxins, not purely tonifying or purely clearing.
Stir-fried Sichuan Fritillaria Bulb (Chuanbei) Stir-fried Honeysuckle (Chao Yinhua) Poria (Fuling) Coix Seed (Yiren) Licorice Root (Gancao) Lycii Cortex (Digupi)
Yang (Day 8): Broad, collapsed, sunken. Pus color is white, stagnant, and dull. Called Qi decline and toxin sinking. Hope for piled eruption and increased appetite, the only ray of hope.
Ginseng Radix (Renshen) Astragalus Membranaceus Root (Huangqi) Ligusticum Chuanxiong Rhizome (Chuanxiong) Angelica Sinensis Radix Root (Guishen) Aucklandiae Radix (Muxiang) Honey-fried Licorice Root (Zhigancao) Tangerine Peel (Guangpi) Cinnamon Heart (Guixin)
Re-examination (Day 11): Pus full, piled eruption. Limbs round and erupted. But weak Qi fears inability to crust. Must strengthen Spleen and promote urination as method.
Ginseng Radix (Renshen) Atractylodes Macrocephala Rhizome (Dongzhu) Honey-fried Licorice Root (Zhigancao) Poria (Fuling) Xinhui Peel (Xinhui Pi) White Peony Root (Baishao)
Re-examination (Day 13): Already piled eruption and eating. Signs of approaching safety. Loose, slippery stool. All caused by cold-cooling damaging interior intestines. Middle essence and filth descend naturally. In Spleen-Stomach medicines, add a little intestinal-astringing herb. If prolonged, it may lead to complications.
Ginseng Radix (Renshen) Prepared Atractylodes Rhizome (Shuzhu) Terminalia Chebula Retz. Fruit (Hezi) Tangerine Peel (Guangpi) Nutmeg (Rouguo) White Peony Root (Baishao) Aucklandiae Radix (Muxiang) Honey-fried Licorice Root (Zhigancao) Poria (Fuling)
Re-examination (Day 16): Food not digested, abdominal distension, white feces. Stomach stagnation should be eliminated. Spleen weakness should be tonified. Ancients called bloating and fullness related to Qi. Qi moves, stagnation clears. But post-smallpox deficient body, pure elimination still fears complications.
Ginseng Radix (Renshen) Charred Atractylodes Rhizome (Jiaozhu) Stir-fried Hawthorn Seed (Chao Zha) Aucklandiae Radix (Muxiang) Charred Barley Sprout (Jiaoma Ya) Tangerine Peel (Guangpi) Poria (Fuling) Alisma Rhizome (Zexie)
Bao (Day 9): Pus does not reach outside. Toxin wants to sink internally. Already grinding teeth. Slippery diarrhea, vomiting, nausea. Internal symptoms are all deeply feared. Days ten to twenty-four are total critical junctures. Smallpox toxins require strong Yuan Qi to push them out. Propose Chen's Muxiang San to save the interior and support expulsion of toxins.
Ginseng Radix (Renshen) Aucklandiae Radix (Muxiang) Clove (Dingxiang) Cassia Twig (Guangui) Stir-fried Angelica Sinensis Radix Root (Chao Guishen) Magnolia Bark (N Hou) Tangerine Peel (Guangpi) Nutmeg (Rouguo) Terminalia Chebula Retz. Fruit (Hezizi Pi)
Sun: Face swollen, eyes cloudy. Head shaking, slight vomiting. Liver wind leaves the body, riding upward to attack. This is transformation into convulsion, impending syncope. Ministerial fire resides in Liver and Gallbladder. Qi收敛s to form crusts. Should apply cooling resolution and toxin clearing. If slight heat subsides and appetite returns, then good news.
Antelope Horn (Lingyangjiao) Coptis Chinensis Rhizome (Chuanlian) Uncaria Ramulus cum Uncis (Gouteng) Acorus Tatarinowii Rhizome (Shichangpu) Black Gardenia Fruit (Hei Shanzhi) Areca Catalpae Semen (Danning) Gastrodia Elata (Tianma) Forsythiae Fructus (Lianqiao)
Re-examination: Liver wind and heat settled. Malnutrition erosion also slowed. Still should clear heat and detoxify. But do not offend the Stomach.
Antelope Horn (Lingyangjiao) Forsythiae Fructus (Lianqiao) Areca Catalpae Semen (Danning) Moutan Cortex (Danpi) Stir-fried Honeysuckle (Chao Yinhua) Dendrobium Officinale Stem (Jinshihu) Poria (Fuling)
Zhu (Day 13): Smallpox has crusted. But crusts fell too early. Fear residual toxins. Now diarrhea stopped, urination short. Should apply cooling, assisted by separating and draining.
Raw Coix Seed (Sheng Yiren) Lily Bulb (Baihe) Poria (Fuling) Chuan Dendrobium Stem (Chuan Hu) White Sand Ginseng (Baishashen) Stir-fried Ophiopogon Tuber (Chao Maidong)
Certain Patient: Already crusted. Should not continue tonics. Fear Qi and Blood stagnation, leading to residual toxin transformations. Follow Weng Zhongren's method of cooling to assist crusting.
Scutellariae Radix (Huangqin) Honeysuckle (Yinhua) Sichuan Fritillaria Bulb (Chuanbei) Licorice Root (Gancao) Lycii Cortex (Digupi) Platycodonis Radix (Jiegeng) Forsythiae Fructus (Lianqiao) Coix Seed (Yiren)
Hu (Day 15): Although piled eruption and crusting, teeth grinding and choking. Toxins not exhausted. Rushing upward to Heart and Lung. Tonifying and clearing are both difficult to administer. Survive past eighteen days. Carbuncle toxins can still be treated. If malnutrition erosion occurs, hard to fully heal.
Stir-fried Ophiopogon Tuber (Chao Maidong) White Sand Ginseng (Baishashen) Coix Seed (Yiren) Sichuan Fritillaria Bulb (Chuanbei) Stir-fried Honeysuckle (Chao Yinhua) Lycii Cortex (Digupi)
Shen (Day 13): Pus not full, suddenly dried up. This is inverted crusting. Teeth grinding, chills. Yuan Qi greatly depleted. Only strong tonification can salvage.
Ginseng Radix (Renshen) Deer Antler (Lurong) Stir-fried Angelica Sinensis Radix (Chao Danggui) Cinnamon Heart (Guixin) Longan Aril (Guiyuan) Calcined Aucklandiae Radix (Wei Muxiang)
Cheng: Crusting too early. Residual toxins flow to limbs. Arm and leg swelling and pain. Propose invigorating blood and detoxifying.
Forsythiae Fructus (Lianqiao) Little Fresh Rehmanniae Radix (Xiao Shengdi) Angelica Sinensis Radix (Danggui) Red Peony Root (Chishao) Tribulus Terrestris Fruit (Ciji Li) Moutan Cortex (Danpi) Prunella Vulgaris Spica (Xiakucao) Honeysuckle (Yinhua) Half small cup of wine
Wu (Day 14): Choking, coughing, vomiting, abdominal distension. All residual toxins internally closed. Urine scanty, stool loose, not smooth. If panting urgency adds, it becomes tricky. Must get ulcer toxins to vent externally to hope for recovery.
Mulberry Root Bark (Sangbaipi) Areca Peel (Dafupi) Mung Bean Skin (Lv Dou Pi) Poria Cocost Wood (Fuling Pi) Calcined Talcum (Fei Huashi) Raw Licorice Root Tip (Sheng Gancao Shao)
Cha: Rash after crusting. Lung heat not cleared. Should apply pungent-cool, assisted by resolving residual toxins.
Forsythiae Fructus (Lianqiao) Apricot Seed (Xingren) Mulberry Root Bark (Sangpi) Lycii Cortex (Digupi) Scutellariae Radix (Huangqin) Akebia Caulis (Mutong) Honeysuckle (Yinhua) Arctii Fructus (Niubang) Prunella Vulgaris Spica (Xiakucao)
Wu (Day 14): Thin pus, crusting. Toxins not transformed. Already malnutrition erosion risk. Reasonably apply clearing and resolving residual toxins. But barely eat thin porridge. Diarrhea not finished. Stomach not vigorous. Spleen Qi accumulated weakness. Propose permeating and draining to separate and eliminate. Imitate ancient idea that smallpox toxins should promote urination.
Mulberry Root Bark (Sangpi) Lycii Cortex (Digupi) Forsythiae Fructus (Lianqiao) Poria (Fuling) Sichuan Fritillaria Bulb (Chuanbei) Coix Seed (Yiren) Honeysuckle (Yinhua)
Certain Patient: Smallpox not shed crust. Rash fire internally forces panting.
Coptis Chinensis Rhizome (Chuanlian) Rhinoceros Horn (Xijiao) Forsythiae Fructus (Lianqiao) Honeysuckle (Yinhua) Scrophulariae Radix (Xuanshen) Large Fritillaria Bulb (Dabei) Moutan Cortex (Danpi) Lycii Cortex (Digupi)
Re-examination: Rash fire not cleared.
Coptis Chinensis Rhizome (Chuanlian) Scutellariae Radix (Huangqin) Gardenia Fruit (Shanzhi) Forsythiae Fructus (Lianqiao) Honeysuckle (Yinhua) Apricot Seed (Xingren) Licorice Root (Gancao)
Shen: Thin pus, crusting. Toxins not exhausted. Only clear Lung and detoxify.
Stir-fried Sichuan Fritillaria Bulb (Chuanbei) Poria (Fuling) Coix Seed (Yiren) Plantago Seed (Cheqian) Stir-fried Alisma Rhizome (Chao Zexie) Stir-fried Honeysuckle (Chao Yinhua)
Xu (Day 16): Malnutrition toxin erupted. Coughing and choking not stopped. Crusts fall like bran. Muscle color pale white. Although Qi and Blood mutually deficient, post-smallpox residual toxins cannot be abruptly tonified. Propose harmonizing Spleen-Stomach and promoting dampness. Malnutrition toxin should be treated quickly. Fear prolonged illness leads to greater deficiency, causing slow convulsion.
Coix Seed (Yiren) Chuan Dendrobium Stem (Chuan Hu) Poria (Fuling) Lily Bulb (Baihe) Tangerine Peel (Guangpi) Stir-fried Alisma Rhizome (Chao Zexie)
Shen (Day 21): Phlegm choking, loss of voice. Dislike food. Slightly peaceful during day. Restless at night. Lung heat not肃 (clear/settled). Endured many days. Body Qi Yang hyperactive, Yin deficient. Liver wind internally blazing. Sudden convulsion is concerning.
Lycii Cortex (Digupi) Licorice Root (Gancao) Charred Rehmanniae Glutinosa Radix (Sheng Dizhi) Mung Bean Skin (Lv Dou Pi) Stir-fried Moutan Cortex (Chao Danpi) Stir-fried Sichuan Fritillaria Bulb (Chao Chuanbei) Chuan Dendrobium Stem (Chuan Hu)
Li (Day 20): Eating causes vomiting. Spleen-Stomach disharmony. Liver wind internally moves. Limb floating, flesh swelling. Treatment should cultivate Earth to control Wood, to缓 (slow) Liver wind. Hope to avoid convulsion and malnutrition.
Ginseng Radix (Renshen) Poria (Fuling) Stir-fried Peony Root (Chao Shao) Raw Grain Sprout (Sheng Guya) Agastache Herb (Huoxiang) Tangerine Peel (Guangpi) Pinellia Fermented Paste (Banxia Qu)
Feng (Day 28): Crusts stick together. Spirit confused. Originally lacked due to pus leakage. Transforming into slow convulsion, impending collapse. All due to young age Yang hyperactive, Yin deficient. Shy eyes, wandering gaze. Liver Yin exhausted. Fear hard to revive.
Ginseng Radix (Renshen) Poria Cum Pine Root (Fushen) Ziziphus Jujuba Seed (Zaoren) Angelica Sinensis Radix Root (Guishen) Honey-fried Licorice Root (Zhigancao) Stir-fried Goji Berry (Chao Qizi)
Raw White Peony Root (Sheng Baishao)
Re-examination (Day 37): Extreme Yang causes vexation. Yin exhaustion causes agitation. Worse at night. Plan from Yin level. Tonify deficiency and harmonize Yang.
Ginseng Radix (Renshen) Prepared Rehmanniae Glutinosa Radix (Shudi) Euryale Seed (Qianshi) Poria (Fuling) Jian Lotus Seed (Jianlian) Polygala Root (Yuanzhi) Stir-fried Chinese Yam (Chao Shanyao) Schisandra Berry (Wuweizi)
Yang: Spots come irregularly. Apex has water marks, slightly scorched. Seasonal Qi transmission. Fetal toxin not erupted. This is Water-Red type smallpox.
Forsythiae Fructus (Lianqiao) Arctii Fructus (Niubang) Moutan Cortex (Danpi) Red Peony Root (Chishao) Calcined Talcum (Fei Huashi) Akebia Caulis (Mutong) Gardenia Fruit (Shanzhi) Licorice Root (Gancao)
Shao: Caught warm pathogen again during smallpox. Entered via mouth and nose. Spread from middle pathway to collaterals. Eyes cloudy, blindness. Left limb immobile. Lower abdomen protrudes, swollen. Both legs paralyzed. Inquiry reveals on sixth day of spots, suddenly head shaking, irritability. Urination dripping. Defecation gradually blocked. Jueyin Liver heat. Hernia masses lose their dispersing and draining. Internal wind rotates. Fu Yang not unobstructed. Classics say sudden swelling and distension are all wind-fire movements. As disease comes rapidly, ability to eat and digest means heat transforms and kills grain. Studying ancients' pungent-dispersing, sour-draining, sweet-slowing three methods, hard to plan for Fu-collateral obstruction. Zhang Zhongjing in Jueyin regulations has great warning: purging leading to non-stop diarrhea is death. Propose salty-bitter to unblock lower knot-heat. My view is thus. Discuss with experts for good treatment.
Toosendan Fruit (Chuanlianzi) Fennel Seed (Xiaohui) Aloe (Luhui) Gardenia Fruit (Shanzhi) Tangerine Peel (Juhong) Gentiana Scabra Root (Longdancao)
Fangzhu Water seven spoons.
Xu's Comment: All cases are close to reality. Peaceful yet capable of steady changes. Prepare what predecessors did not. Remove flaws and keep purity. Our county has such famous masters, yet do not follow their methods. Instead pick up the spittle of mediocre and absurd people. Regardless of person, regardless of deficiency or excess, always use Gypsum Fibrosum, Rheum Palmatum and various toxic drugs in large doses to灌 (force-feed)