陈文宿先生云∶痘疮六日至七日，肥满红活光泽，八日至九日，肥满苍蜡色者，皆不须服药。如身温气促，口干肚
胀，足冷寒战切牙，饮水泻渴者，急用木香散加官桂、丁香服之，如不愈，服异功散。盖切牙者，齿槁也。窃谓∶前症
若手足并冷，渴饮热汤，大便泄泻者，阳气虚寒也，宣热补之。手足不冷，大便不利，渴饮温汤者，脾气虚热也，宜调
补之。手足不热，大便不利，渴饮热汤者，脾胃虚弱也，宜温补之。治者审焉！
一小儿出痘，寒战切牙，四肢蜷缩，大便自利，手足并冷，喜饮热汤，此阳气虚寒也，用十二味异功散末二钱；诸
症顿退；又用人参白术散、参 四圣散而靥。
一小儿十四岁，面色忽赤忽黑，出痘寒战切牙，作渴烦热，喜饮热汤，此阳气虚寒也，用十全大补汤散，烦渴顿
止，乃以八珍倍加参 ，至脓贯又作渴面赤，此脓成而血气虚也。用当归补血汤、八珍汤而靥，至月余面赤烦渴，或时
昏愦，痘痕如赭，或时作痒，脉洪大，按之如无，此血脱也，用大剂当归补血汤而安。
一小儿痘疮，寒战切牙，内热作渴，形气倦怠，虽起发而欠红活，此阳气虚弱也，用参 四圣散而结痂，忽作泻发
热，此脾气虚也，用人参白术散、参 内托散而靥。
一小儿痘疮，切牙面黄饮汤，此阳气虚弱也，用五味异功散加木香而愈。后仍切牙面赤作渴，至夜为甚，此脾肾阴
虚也，用地黄丸、大补汤而愈。
一小儿脓不贯，兼寒战切牙腹胀，属脾胃虚弱，用四君、肉桂、归、 、肉豆蔻，又用参 四圣散而痊，后用托里
散、四君子汤而靥。
一小儿痒塌寒战切牙，喜饮温汤，手足不热，属阳气虚弱也，用参 四圣散，诸症已退，用参 托里散，其浆渐
贯，用十全大补汤，其痂顿靥。
一小儿十四岁，痘将愈忽寒战，手足并冷，脉微细而不及两寸，乃脾气虚热，用五味异功散、独参汤、十全大补汤
而愈。
一妇人愈后寒战，脉浮大，按之微细，此血气虚也，用
十全大补汤三十余剂而愈。后因劳，寒热往来，寒时手足如冰，热时手足如炙，脉浮大，重按则细，此阳气虚甚也，朝
用补中益气汤加桂、附各一钱；夕用八味丸料，倍加桂、附，各五十余剂而安。
一小儿切牙作渴，面色忽白忽赤，脉洪数按之无力，左关尺为甚，此属肾虚也，用地黄丸、补中益气汤寻愈。后因
惊面青目赤，呵欠切牙，手寻衣领，此肝经虚热，用加减八味丸料，煎与恣饮，顿安，又用补中益气汤而痊。
一小儿切牙，作渴饮冷，大便微秘，寒战痘赤，多在身侧，此属胆经虚热也，用小柴胡汤、柴胡麦门散各一剂，又
用加味四物汤而痊。
当归补血汤 治痘疮血气亏损，或妄服峻剂，致血气俱虚，肌热大渴喜饮，目赤面红，昼夜不息，其脉洪大而
虚，重按全无。其症似宜服白虎汤，但脉不长实为可验耳，若服白虎汤必死。
黄 （炙，一两） 当归（二钱）
上水煎，徐徐服。
补中益气汤
人参 黄 （炒） 白术 甘草 当归 陈皮（各一钱） 柴胡 升麻（各二分）
上姜枣水煎，徐徐服。
五味异功散
人参 茯苓 白术（炒） 甘草 陈皮
上每服二三钱，姜枣水煎。为末调服亦可。
加减八味丸（即六味丸加五味子四两、肉桂一两） 治肾经阴虚，虚火上炎，作渴切牙，或口舌生疮，或痰涎
涌盛。
六味地黄丸（加肉桂、附子各一两，名八味丸。二方见发热属阴属阳）
独参汤（方见腹胀气促）
小柴胡汤（方见 症）
十一味木香散
十二味异功散（二方见痘灰白色）
十全大补汤（方见腹胀气促）
八珍汤
柴胡麦门冬散（二方见顶陷灰白）
参 四圣散（方见顶陷心烦）
七味白术散（方见痘发热，即人参白术散）
陈文宿先生说：痘疮发病第六至第七天，若痘粒饱满、红润鲜活且有光泽，第八至第九天，若痘粒饱满但呈苍白色或蜡黄色，这些情况都不需要服药。如果患者身体温热但气息急促，口干腹胀，脚冷、寒战、咬牙，口渴饮水且伴有腹泻，应紧急使用木香散加入官桂、丁香服用；如果症状未愈，再服用异功散。大概咬牙是因为牙齿枯槁所致。我私下认为：前述症状如果手脚都冷，想喝热汤，大便泄泻，这是阳气虚寒，应当用温补法治疗。如果手脚不冷，大便不通畅，想喝温水，这是脾气虚热，应当调理补益。如果手脚不热，大便不通畅，想喝热汤，这是脾胃虚弱，应当温补治疗。诊治者需仔细审察！
有一个小孩出痘，出现寒战、咬牙，四肢蜷缩，大便自利（自然排泄），手脚都冷，喜欢喝热汤，这是阳气虚寒，用十二味异功散粉末二钱；各种症状立刻消退；又用人参白术散、参四圣散而结痂痊愈。
有一个十四岁的小孩，面色忽红忽黑，出痘时寒战、咬牙，烦热口渴，喜欢喝热汤，这是阳气虚寒，用十全大补汤散剂，烦渴立刻停止，接着用八珍汤加倍人参、黄芪，直到脓液充满痘疮后又出现口渴面赤，这是脓成后血气虚弱。用当归补血汤、八珍汤而结痂痊愈，到了一个月后仍然面赤烦渴，有时昏沉迷糊，痘痕像赭石色，有时发痒，脉象洪大但重按无力，这是血脱证，用大剂量当归补血汤而安定。
有一个小孩患痘疮，寒战、咬牙，内热口渴，形体气息倦怠，虽然起发但不够红润鲜活，这是阳气虚弱，用参四圣散而结痂，忽然发生腹泻发热，这是脾气虚，用人参白术散、参内托散而结痂痊愈。
有一个小孩患痘疮，咬牙、面色黄、想喝水，这是阳气虚弱，用五味异功散加入木香而痊愈。后来仍然咬牙、面赤、口渴，到夜间加重，这是脾肾阴虚，用地黄丸、大补汤而痊愈。
有一个小孩痘疮脓液未充盈，兼有寒战、咬牙、腹胀，属于脾胃虚弱，用四君子汤、肉桂、当归、黄芪、肉豆蔻，又用参四圣散而痊愈，后来用托里散、四君子汤而结痂痊愈。
有一个小孩痘疮瘙痒塌陷、寒战、咬牙，喜欢喝温水，手脚不热，属于阳气虚弱，用参四圣散，各种症状已退，用参托里散，其浆液逐渐充盈，用十全大补汤，其痂皮立刻结落。
有一个十四岁的小孩，痘疮将愈时忽然寒战，手脚都冷，脉象微细且不及两寸，这是脾气虚热，用五味异功散、独参汤、十全大补汤而痊愈。
有一个妇人病愈后寒战，脉象浮大，重按微细，这是血气虚，用十全大补汤三十多剂而痊愈。后来因劳累，出现寒热往来，寒冷时手脚如冰，发热时手脚如炙烤，脉象浮大，重按则细，这是阳气极度虚弱，早晨用补中益气汤加桂枝、附子各一钱；晚上用八味丸药料，加倍桂枝、附子，各五十多剂而安定。
有一个小孩咬牙、口渴，面色忽白忽红，脉象洪数但重按无力，左关尺部尤为明显，这属于肾虚，用地黄丸、补中益气汤寻即痊愈。后来因为受惊面色青、眼睛红，打哈欠、咬牙，手抓衣领，这是肝经虚热，用加减八味丸药料，煎汤让其随意饮用，立刻安定，又用补中益气汤而痊愈。
有一个小孩咬牙、口渴想喝冷水，大便轻微便秘，寒战、痘色红，多在身体侧面，这属于胆经虚热，用小柴胡汤、柴胡麦门冬散各一剂，又用加味四物汤而痊愈。
当归补血汤 治疗痘疮血气亏损，或者误服峻猛药剂，导致血气俱虚，肌肤发热、大渴喜饮，眼睛红、面色红，昼夜不停，脉象洪大而虚，重按完全无感。其症状似乎适合服用白虎汤，但脉象不长实可作为验证依据，如果服用白虎汤必死无疑。
补中益气汤
人参 黄（炒） 白术 甘草 当归 陈皮（各一钱） 柴胡 升麻（各二分）
以上用姜枣水煎煮，慢慢服用。
五味异功散
人参 茯苓 白术（炒） 甘草 陈皮
以上每次服用二三钱，用姜枣水煎煮。制成粉末调服也可以。
加减八味丸（即六味丸加五味子四两、肉桂一两） 治疗肾经阴虚，虚火上炎，口渴、咬牙，或者口舌生疮，或者痰涎涌盛。
六味地黄丸（加肉桂、附子各一两，名为八味丸。两方见发热属阴属阳章节）
小柴胡汤（方见疟症章节）
十二味异功散（两方见痘灰白色章节）
柴胡麦门冬散（两方见顶陷灰白章节）
参四圣散（方见顶陷心烦章节）
Mr. Chen Wensu said: On the sixth to seventh day of smallpox, if the pustules are plump, red, fresh, and lustrous, or on the eighth to ninth day, if they are plump but appear pale or waxy-yellow, medication is not required. However, if the patient has a warm body but rapid breathing, dry mouth, abdominal distension, cold feet, chills, teeth grinding, thirst with drinking, and diarrhea, Muxiang San (Wood Fragrance Powder) should be administered urgently with Guigui (Cinnamon Twig) and Dingxiang (Clove). If there is no improvement, Yigong San (Yi Gong Powder) should be taken. Generally, teeth grinding is due to the withering of the teeth. I personally believe: If the aforementioned symptoms include cold hands and feet, a desire to drink hot water, and loose stools, this indicates Deficiency-Cold of Yang Qi, which should be treated with warming and tonifying methods. If the hands and feet are not cold, bowel movements are obstructed, and there is a desire to drink warm water, this indicates Deficiency-Heat of Spleen Qi, which should be regulated and tonified. If the hands and feet are not hot, bowel movements are obstructed, and there is a desire to drink hot water, this indicates Weakness of the Spleen and Stomach, which should be treated with warming and tonifying methods. Practitioners must examine carefully!
A child presented with smallpox, exhibiting chills, teeth grinding, curled limbs, spontaneous loose stools, and cold hands and feet, with a preference for hot drinks. This indicates Deficiency-Cold of Yang Qi. Twelve-Ingredient Yigong San was administered in powder form, two qian; all symptoms subsided immediately. Subsequently, Renshen Baizhu San (Ginseng and Atractylodes Macrocephala Powder) and Shensi Sixiao San were used until scabs formed.
A fourteen-year-old child presented with fluctuating facial complexion (alternating red and black), chills, teeth grinding, irritability, heat, thirst, and a preference for hot drinks during smallpox eruption. This indicates Deficiency-Cold of Yang Qi. Shiquan Dabu Tang (Ten Ingredients Great Tonifying Decoction) in powder form was used, stopping the irritability and thirst immediately. Then, Bazhen Tang (Eight Treasures Decoction) with doubled Renshen (Ginseng) and Huangqi (Astragalus Root) was used. When pus filled the pustules, thirst and facial redness recurred, indicating Blood and Qi deficiency after pus formation. Danggui Buxue Tang (Danggui Tonifies Blood Decoction) and Bazhen Tang were used until scabs formed. Over a month later, facial redness, irritability, and thirst persisted, with occasional confusion, hematite-colored scar marks, itching, and a洪大 (Surging-Large) pulse that vanished upon heavy pressure, indicating Blood Loss. A large dose of Danggui Buxue Tang stabilized the condition.
A child with smallpox exhibited chills, teeth grinding, internal heat, thirst, fatigue in form and Qi, with eruptions that lacked redness and freshness. This indicates Weakness of Yang Qi. Shensi Sixiao San was used until scabs formed. Suddenly, diarrhea and fever occurred, indicating Spleen Qi deficiency. Renshen Baizhu San and Shenni Tuosuo San were used until scabs formed.
A child with smallpox exhibited teeth grinding, yellowish complexion, and a desire to drink water. This indicates Weakness of Yang Qi. Wuwei Yigong San (Five-Ingredient Yi Gong Powder) with Muxiang (Aucklandia Root) was used for recovery. Later, teeth grinding, facial redness, and thirst recurred, worsening at night, indicating Yin Deficiency of the Spleen and Kidney. Dihuang Wan (Rehmannia Pill) and Dabu Tang (Great Tonifying Decoction) were used for recovery.
A child with smallpox had unfilled pus, accompanied by chills, teeth grinding, and abdominal distension, belonging to Spleen and Stomach weakness. Sijunzi Tang (Four Gentlemen Decoction), Rougui (Cinnamon Bark), Danggui (Angelica Sinensis), Huangqi (Astragalus Root), and Roudoukou (Nutmeg) were used, followed by Shensi Sixiao San for recovery. Later, Tuoli San (Support Interior Powder) and Sijunzi Tang were used until scabs formed.
A child with itchy, collapsed smallpox, chills, teeth grinding, a preference for warm drinks, and non-hot hands and feet, indicated Weakness of Yang Qi. Shensi Sixiao San was used, subsiding the symptoms. Shenni Tuoli San was used, allowing the fluid to gradually fill the pustules. Shiquan Dabu Tang was used, causing immediate scabbing.
A fourteen-year-old child experienced sudden chills as smallpox was nearing resolution, with cold hands and feet and a subtle, thin pulse not reaching both Cun positions. This indicates Deficiency-Heat of Spleen Qi. Wuwei Yigong San, Dushen Tang (Single Ginseng Decoction), and Shiquan Dabu Tang were used for recovery.
A woman experienced chills after recovery, with a floating, large pulse that became subtle upon heavy pressure, indicating Blood and Qi deficiency. Shiquan Dabu Tang was administered for over thirty doses for recovery. Later, due to overwork, alternating chills and fever occurred. During chills, hands and feet were ice-cold; during fever, they were hot as if roasted. The pulse was floating and large but thin upon heavy pressure, indicating severe Yang Qi deficiency. In the morning, Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) with Guizhi (Cinnamon Twig) and Fuzi (Prepared Aconite Root), one qian each, was used. In the evening, Bawei Wan (Eight-Ingredient Pill) material with doubled Guizhi and Fuzi was used. Over fifty doses of each stabilized the condition.
A child exhibited teeth grinding, thirst, fluctuating facial complexion (white and red), and a洪数 (Surging-Rapid) pulse that was powerless upon heavy pressure, especially at the Left Guan and Chi positions, indicating Kidney Deficiency. Dihuang Wan and Buzhong Yiqi Tang were used for recovery. Later, due to fright, the face turned green, eyes red, with yawning, teeth grinding, and hand grasping at clothing collars. This indicates Deficiency-Heat of the Liver Meridian. Jiajian Bawei Wan (Modified Eight-Ingredient Pill) material was decocted and allowed to be drunk freely, providing immediate relief. Buzhong Yiqi Tang was then used for recovery.
A child exhibited teeth grinding, thirst for cold drinks, slight constipation, chills, and red smallpox mostly on the sides of the body. This indicates Deficiency-Heat of the Gallbladder Meridian. Xiao Chaihu Tang (Minor Bupleurum Decoction) and Chaihu Maidong San (Bupleurum and Ophiopogon Powder) were each administered for one dose, followed by Jiawei Siwu Tang (Modified Four Substances Decoction) for recovery.
Danggui Buxue Tang treats blood and Qi depletion from smallpox, or blood and Qi deficiency caused by the mistaken use of harsh purgatives. Symptoms include skin heat, extreme thirst with drinking, red eyes, red face, persisting day and night, and a洪大 (Surging-Large) yet empty pulse that vanishes upon heavy pressure. Although symptoms seem suitable for Baihu Tang (White Tiger Decoction), the lack of a long and solid pulse confirms the diagnosis. Administering Baihu Tang would be fatal.
Huangqi (Roasted, one liang), Danggui (two qian).
Decoct in water and take slowly.
Buzhong Yiqi Tang
Renshen (Ginseng), Huangqi (Stir-fried), Baizhu (Atractylodes Macrocephala), Gancao (Licorice), Danggui (Angelica Sinensis), Chenpi (Tangerine Peel) (one qian each), Chaihu (Bupleurum), Shengma (Cimicifuga) (two fen each).
Decoct with Ginger and Jujube, and take slowly.
Wuwei Yigong San
Renshen, Fuling (Poria), Baizhu (Stir-fried), Gancao, Chenpi.
Take two to three qian per dose, decoct with Ginger and Jujube. Can also be taken as powder mixed with water.
Jiajian Bawei Wan (Six-Ingredient Pill plus Siweizi [Schisandra] four liang, Rougui [Cinnamon Bark] one liang) treats Yin Deficiency of the Kidney Meridian, with Deficient Fire flaming upward, causing thirst, teeth grinding, mouth and tongue sores, or excessive phlegm and saliva.
Liuhuang Dihuang Wan (Six-Ingredient Rehmannia Pill) (Add Rougui and Fuzi, one liang each, named Bawei Wan. See Fever Belonging to Yin or Yang for formulas.)
Dushen Tang (See Abdominal Distension and Rapid Breathing for formula.)
Xiao Chaihu Tang (See Malaria Syndrome for formula.)
Shiyiwei Muxiang San (Eleven-Ingredient Wood Fragrance Powder)
Shiwei Yigong San (Twelve-Ingredient Yi Gong Powder) (See Ashy-White Smallpox for formulas.)
Shiquan Dabu Tang (Ten Ingredients Great Tonifying Decoction) (See Abdominal Distension and Rapid Breathing for formula.)
Bazhen Tang (Eight Treasures Decoction)
Chaihu Maidong San (Bupleurum and Ophiopogon Powder) (See Sunken and Ashy-White Pustules for formulas.)
Shensi Sixiao San (See Sunken Pustles with Restlessness for formula.)
Qiwei Baizhu San (Seven-Ingredient Atractylodes Powder) (See Smallpox Fever for formula, i.e., Renshen Baizhu San.)