陈文宿先生云∶痘疮自始出至十三日当忌外人。恐有卒暴风寒秽恶或狐臭之气触之,父母仍忌房事。若痘欲靥不
靥,其痂欲落不落,若腹胀烦躁,忌食水蜜生冷之物,若食之,转渴而死,急与木香散救之。如身热烦渴者,宜服人参
麦门冬散。身热大渴,人参白术散,如不愈,仍服木香散。窃谓前症乃脾胃气虚,津液不足所致,非实热为患也。如身
热烦躁,手足发热,脾胃有热也,用人参麦门冬散。身热作渴,手足微冷者,脾胃气虚也,用人参白术散。腹胀泄泻,
或寒战切牙,脾胃虚寒也,用十一味木香散。泄泻气促,手足并冷,脾气脱陷也,用十二味异功散。凡疮结痂作靥,皆
由元气充实而内融也。若审见虚弱,便与滋补,血气无亏,可保终吉。若见不靥而投补剂,恐不及而误矣。
一小儿十二岁,出痘不靥,腹胀泄泻不食,手足并冷。先君谓脾气虚寒。用十一味木香散一剂,诸症顿愈,再剂不
时索食,但恶寒,此脾气犹虚也,用五味异功散加木香及六君子汤,而诸症愈;又用参 内托散而痂脱。
一男子三十岁,遍身发热作痛,有赤颗旬余,始知为痘,用参 四圣散、托里散各四剂,欲靥不靥,用十全大补
汤数剂而痂脱。
一妊妇出痘月余,欲靥不靥,面赤晡热,此肝脾血虚而有热也,先用加味逍遥散热退,又用八珍、牡丹皮而热止。
但气血皆虚,用十全大补汤而痂脱。
一小儿出痘,贯脓不靥,症如实热,余谓血气虚甚之假热也,用十全大补汤数剂渐愈,忽又恶寒,余又曰此邪气退
而真气遂见虚象也,仍用前药内参、 各五钱,数剂而愈。
十全大补汤 治禀赋不足,寒热自汗,食少体瘦,发热作渴,头痛眩晕。(方见气促)
逍遥散(即加味逍遥散去牡丹皮、山栀) 治乳母肝脾有热,致痘疮欲靥不靥,欲落不落。
当归 甘草(炙) 芍药(酒炒) 茯苓 白术(炒) 柴胡(各一钱)
上水煎,母子同服。
十一味木香散
十二味异功散(二方见痘灰白色)
六君子汤(方见痘灰白色)
五味异功散(方见寒战切牙)
人参麦门冬散(方见发热口渴烦躁不止)
人参白术散(方见靥发热)
参 托里散
托里散(二方见痘痈)
陈文宿先生说:痘疮从刚发出到第十三天,应当忌讳外人接触。恐怕有突然的暴风寒邪、污秽恶气或狐臭之气触碰到患儿,父母也应仍忌讳房事。如果痘疮想要结痂却未能结痂,痂皮想要脱落却未能脱落,若出现腹胀烦躁的症状,应忌讳食用水、蜜及生冷食物,如果吃了这些,会导致转加口渴而死,需紧急给予木香散来救治。如身体发热且烦渴的,适宜服用人参麦门冬散。身体发热且大渴的,用人参白术散;如果病愈不了,仍然服用木香散。我认为上述症状是由于脾胃气虚、津液不足所导致的,并非实热为患。如果身体发热烦躁,手足发热,这是脾胃有热,使用人参麦门冬散。身体发热作渴,手足微微发冷的,是脾胃气虚,使用人参白术散。腹胀泄泻,或者寒战咬牙的,是脾胃虚寒,使用十一味木香散。泄泻气促,手足都冷,是脾气脱陷,使用十二味异功散。凡是疮疡结痂成靥,都是由元气充实而内部融合所致。如果审察见到虚弱,就给予滋补,血气没有亏损,可以保全最终吉祥。如果见到未结痂就投用补剂,恐怕来不及而误事。
一个十二岁的儿童,出痘后不结痂,腹胀泄泻且不进食,手足都冷。先父认为是脾气虚寒。使用十一味木香散一剂,各种症状立刻痊愈,再服药后不时索要食物,只是怕冷,这是脾气仍然虚弱,使用五味异功散加入木香以及六君子汤,各种症状痊愈;又使用参内托散而痂皮脱落。
一个三十岁的男子,遍身发热疼痛,有红色颗粒十几天,才知道是痘疮,使用参四圣散、托里散各四剂,想要结痂却未能结痂,使用十全大补汤数剂而痂皮脱落。
一个孕妇出痘一个多月,想要结痂却未能结痂,面部发红且傍晚发热,这是肝脾血虚而有热,先用加味逍遥散热退去,又用八珍汤、牡丹皮而热止。但气血都虚弱,使用十全大补汤而痂皮脱落。
一个儿童出痘,化脓后不结痂,症状像实热,我认为是血气非常虚弱的假热,使用十全大补汤数剂逐渐痊愈,忽然又恶寒,我又说这是邪气退去而真气显现出虚象,仍然使用前药中的人参等,各五钱,数剂而痊愈。
十全大补汤 治疗禀赋不足,寒热自汗,食少体瘦,发热作渴,头痛眩晕。(方剂见气促条下)
逍遥散(即加味逍遥散去牡丹皮、山栀) 治疗乳母肝脾有热,导致痘疮想要结痂却未能结痂,想要脱落却未能脱落。
当归 甘草(炙) 芍药(酒炒) 茯苓 白术(炒) 柴胡(各一钱)
以上用水煎煮,母子同服。
人参白术散(方剂见靥发热条下)
参托里散
Mr. Chen Wensu said: From the initial eruption of smallpox until the thirteenth day, contact with outsiders should be avoided. One must fear that sudden wind-cold pathogens, foul or evil odors, or fox odor may touch the patient; parents should also abstain from sexual intercourse. If the pustules desire to heal (scab over) but fail to do so, and the scabs desire to fall off but fail to do so, and if abdominal distension and irritability occur, one must avoid consuming water, honey, and raw/cold foods. If consumed, it will lead to intensified thirst and death; urgently administer Muxiang San (Aucklandia Powder) to rescue. If there is fever with irritability and thirst, Ren Shen Maidong San (Ginseng and Ophiopogon Powder) is suitable. If there is fever with intense thirst, use Renshen Baizhu San (Ginseng and Atractylodes Macrocephala Powder); if not cured, continue using Muxiang San. I believe these symptoms are caused by deficiency of Spleen-Stomach Qi and insufficient body fluids, not by excess heat. If there is fever with irritability and hot hands and feet, this indicates heat in the Spleen and Stomach; use Ren Shen Maidong San. If there is fever with thirst and slightly cold hands and feet, this indicates deficiency of Spleen-Stomach Qi; use Renshen Baizhu San. If there is abdominal distension and diarrhea, or chills with teeth grinding, this indicates deficiency-cold of the Spleen and Stomach; use Shi Yi Wei Muxiang San (Eleven-Ingredient Aucklandia Powder). If there is diarrhea with shortness of breath and cold hands and feet, this indicates sinking of Spleen Qi; use Shi Er Wei Yigong San (Twelve-Ingredient Yigong Powder). Whenever sores form scabs and heal, it is due to the sufficiency of Yuan Qi (Original Qi) allowing internal fusion. If weakness is identified, tonification should be provided immediately; if Blood and Qi are not depleted, ultimate auspiciousness can be ensured. However, if tonics are administered before healing occurs, it may be too late and cause error.
A twelve-year-old child had smallpox that did not heal, accompanied by abdominal distension, diarrhea, anorexia, and cold hands and feet. My father attributed this to deficiency-cold of Spleen Qi. After one dose of Shi Yi Wei Muxiang San, all symptoms resolved instantly. After a second dose, the child occasionally asked for food but still feared cold, indicating that Spleen Qi was still deficient. Wu Wei Yigong San (Five-Ingredient Yigong Powder) with added Muxiang and Liu Jun Zi Tang (Six-Gentleman Decoction) were used, resolving all symptoms; subsequently, Can Ni Tuo Li San (Ginseng Internal-Supporting Powder) was used, leading to scab detachment.
A thirty-year-old man suffered from generalized fever and pain with red spots for over ten days, later identified as smallpox. He received four doses each of Can Si Sheng San (Ginseng Four-Sages Powder) and Tuo Li San (Internal-Supporting Powder). When the lesions desired to heal but failed, he received several doses of Shi Quan Da Bu Tang (Ten-Ingredient Great Tonifying Decoction), resulting in scab detachment.
A pregnant woman had smallpox for over a month, desiring to heal but failing, with a red face and afternoon tidal fever. This indicated Liver and Spleen Blood deficiency with heat. Jia Wei Xiao Yao San (Modified Free and Easy Wanderer Powder) was first used to reduce the fever, followed by Ba Zhen Tang (Eight-Treasure Decoction) and Mu Dan Pi (Moutan Cortex) to stop the fever. Since both Qi and Blood were deficient, Shi Quan Da Bu Tang was used, leading to scab detachment.
A child had smallpox that suppurated but did not heal, presenting with symptoms resembling excess heat. I considered this false heat due to severe deficiency of Qi and Blood. Several doses of Shi Quan Da Bu Tang gradually improved the condition. Suddenly, aversion to cold appeared. I stated that this indicated the pathogenic factor receding and the true Qi revealing a deficient state. The previous medicine, with increased amounts of Ginseng, was used at five qian each, curing the patient after several doses.
Shi Quan Da Bu Tang (Ten-Ingredient Great Tonifying Decoction): Treats congenital insufficiency, spontaneous sweating with alternating cold and heat, poor appetite, emaciation, fever with thirst, headache, and dizziness. (Formula see under Shortness of Breath)
Xiao Yao San (Free and Easy Wanderer Powder): (i.e., Jia Wei Xiao Yao San minus Mu Dan Pi and Zhi Zi) Treats wet nurses with Liver-Stomach heat causing smallpox lesions that desire to heal but fail, and scabs that desire to fall off but fail.
Dang Gui (Angelicae Sinensis Radix), Gan Cao (Prepared Glycyrrhizae Radix et Rhizoma), Shao Yao (Paeoniae Radix Alba stir-fried with wine), Fu Ling (Poria), Bai Zhu (Atractylodis Macrocephalae Rhizoma stir-fried), Chai Hu (Bupleuri Radix) (each 1 qian).
Decoct in water; mother and infant take together.
Shi Yi Wei Muxiang San (Eleven-Ingredient Aucklandia Powder)
Shi Er Wei Yigong San (Twelve-Ingredient Yigong Powder) (See formulas under "Gray-White Smallpox")
Liu Jun Zi Tang (Six-Gentleman Decoction) (See formula under "Gray-White Smallpox")
Wu Wei Yigong San (Five-Ingredient Yigong Powder) (See formula under "Chills and Teeth Grinding")
Ren Shen Maidong San (Ginseng and Ophiopogon Powder) (See formula under "Unceasing Fever, Thirst, and Irritability")
Renshen Baizhu San (Ginseng and Atractylodes Macrocephala Powder) (See formula under "Fever after Healing")
Can Ni Tuo Li San (Ginseng Internal-Supporting Powder)
Tuo Li San (Internal-Supporting Powder) (See formulas under "Smallpox Carbuncle")