《痘疹方》若云∶痘疮已出未靥之间,喘渴,白术散;甚者木香散。收靥后,腹胀喘渴,大便利,小便涩,葶苈木
香散。喘嗽,五味子汤。喘渴靥后,余毒不除,大便坚实,前胡枳壳散。头疼身热,恶寒微喘,是有表邪也,用参苏饮。
窃谓前症若因脾肺虚弱,宜用白术散。脾肺虚寒,宜用木香散。热毒内蕴,紫草甘草枳壳汤。风邪外感,用参苏饮。内
外壅滞,人参清膈散。大便自利,小便涩滞,葶苈木香散。大便坚实,前胡枳壳散。
一小儿痰喘,痘赤作痛,热渴喜饮冷水,大便不利,此胃经实热,先用前胡枳壳散,诸症渐退,又用犀角地黄汤而
靥。
一小儿面赤有痰,口干作渴,右寸口脉洪数,此心火刑肺金,用人参平肺散一剂,又用地黄丸料,四剂而痊。
一小儿痘赤而痛,喘嗽作渴,脉洪数,左尺右寸为甚,此肾火上炎,乘肺为患,用地黄丸料,煎与恣饮,如期而靥。
一小儿十四岁,痘方愈而喘促咳嗽,余谓脾肺气虚,用五味子汤而愈。后停食发热喘嗽,用五味异功散而安,用补
中益气汤而痊。
一男子出痘,愈而喘嗽面赤,服参苏饮,面色痘痕皆白,此脾肺气虚而复伤也,用补中益气、五味异功散而痊。
一小儿喘渴面白,手足时冷,此脾肺气虚,用人参白术散、五味异功散而愈。
一小儿痘将愈,喘渴腹胀,大便不结,小便涩,此脾肺气虚而然也,先用葶苈木香散,又用人参白术散而愈。
一小儿痘出气喘,大便秘结,手足并热,作渴饮冷,用前胡枳壳散而安,但饮食少面白,此邪气去而真气虚也,用
补中益气汤、五味异功散而愈。
一小儿十四岁,痘方愈而喘,手足不热,余谓脾肺气虚,用补中益气汤而愈。后停食发热,手足不冷,余谓脾气虚
热而喘嗽,用五味异功散,二剂而热退;又用补中益气汤而痊。
一小儿痘疮,狂喘躁热,作渴饮冷,痰涎不利,先君谓热毒壅滞,用人参清膈散、犀角地黄汤,各一剂顿愈;又用
当归补血汤而愈。
一男子痘愈,而喘嗽面赤。服发表之剂,喘嗽益甚,面色痘痕皆白,手足并冷,余谓脾肺之气复伤而虚寒也,用补
中益气汤加干姜一剂,元气渐复,却佐以八珍汤而痊。
一男子痘愈,而患喘发热恶寒,余用十全大补汤。不信,反服清热之剂,汗出如雨,身热如炎,面目、痘痕如赭赤。
余曰∶汗多亡阳而虚热也。后果殁。
六味凉血消毒散
犀角(如无,用升麻) 牡丹皮 当归 生地黄 赤芍药 生甘草(等分)
上每服三五钱,水煎。
紫草甘草枳壳汤
紫草 甘草 枳壳(各等分)
上每服一二钱,水煎。
五味子汤
参苏饮
前胡枳壳散(三方见涕唾稠粘)
六味地黄丸
人参白术散(一名七味白术散,二方见发热属阴阳)
圣济犀角地黄汤(方见顶陷心烦)
人参清膈散(即十六味清膈散,方见顶陷心烦)
十一味木香散(方见痘灰白色)
葶苈木香散(方见腹胀气促)
《痘疹方》中说:在痘疮已经发出但尚未结痂脱落期间,如果出现气喘、口渴的症状,使用白术散;如果症状严重,使用木香散。在痘疮结痂脱落后,如果出现腹部胀满、气喘、口渴,同时大便通畅、小便涩滞不通,使用葶苈木香散。如果出现气喘咳嗽,使用五味子汤。如果在痘疮结痂脱落后仍有气喘、口渴,且余毒未清、大便干结坚硬,使用前胡枳壳散。如果出现头痛、身体发热、怕冷、轻微气喘,这是有表邪(外感病邪)的表现,使用参苏饮。
我认为上述病症如果是由于脾肺虚弱引起的,适宜使用白术散。如果是脾肺虚寒,适宜使用木香散。如果是热毒内蕴,使用紫草甘草枳壳汤。如果是风邪外感,使用参苏饮。如果是内外气机壅滞,使用人参清膈散。如果是大便自利(腹泻)、小便涩滞,使用葶苈木香散。如果是大便干结坚硬,使用前胡枳壳散。
有一个小孩患痰喘,痘疮颜色红赤且疼痛,发热口渴喜欢喝冷水,大便不通畅,这是胃经实热证,先用前胡枳壳散,各种症状逐渐消退后,又用犀角地黄汤治疗而痊愈结痂。
有一个小孩面色红赤且有痰,口干作渴,右寸口脉象洪大数急,这是心火刑克肺金(心火过旺损伤肺阴),用人参平肺散一剂,又用地黄丸药料,服用四剂后痊愈。
有一个小孩痘疮红赤且疼痛,气喘咳嗽作渴,脉象洪大数急,左尺脉和右寸脉尤为明显,这是肾火上炎,乘袭肺部致病,用地黄丸药料煎汤让患儿大量饮用,如期结痂痊愈。
有一个十四岁的小孩,痘疮刚刚痊愈却出现气喘急促、咳嗽,我认为这是脾肺气虚,用五味子汤治疗而痊愈。后来因停食(饮食积滞)导致发热、气喘咳嗽,用五味异功散治疗而安定,再用补中益气汤治疗而痊愈。
有一个男子出痘疮,痊愈后出现气喘咳嗽、面色红赤,服用参苏饮后,面色和痘痕都变得苍白,这是脾肺气虚又再次受损,用补中益气汤、五味异功散治疗而痊愈。
有一个小孩气喘口渴、面色苍白,手足时常发冷,这是脾肺气虚,用人参白术散、五味异功散治疗而痊愈。
有一个小孩痘疮即将痊愈时,出现气喘口渴、腹部胀满,大便不干燥,小便涩滞,这是脾肺气虚所致,先用葶苈木香散,又用人参白术散治疗而痊愈。
有一个小孩痘疮发出时气喘,大便秘结,手足并热,作渴想喝冷水,用前胡枳壳散治疗而安宁,但饮食减少、面色苍白,这是邪气去除而真气虚弱,用补中益气汤、五味异功散治疗而痊愈。
有一个十四岁的小孩,痘疮刚痊愈就气喘,手足不热,我认为这是脾肺气虚,用补中益气汤治疗而痊愈。后来因停食发热,手足不冷,我认为这是脾气虚导致的虚热而气喘咳嗽,用五味异功散,两剂后热退;又用补中益气汤治疗而痊愈。
有一个小孩患痘疮,狂躁气喘、燥热,作渴想喝冷水,痰涎不利,我的先父认为是热毒壅滞,用人参清膈散、犀角地黄汤,各服一剂即痊愈;又用当归补血汤治疗而痊愈。
有一个男子痘疮痊愈后,出现气喘咳嗽、面色红赤。服用发表(解表)的药物,气喘咳嗽更加严重,面色和痘痕都变白,手足并冷,我认为这是脾肺之气再次受损而变为虚寒,用补中益气汤加干姜,一剂后元气逐渐恢复,随后辅以八珍汤治疗而痊愈。
有一个男子痘疮痊愈后,患气喘、发热、怕冷,我用十全大补汤治疗。他不相信,反而服用清热药物,结果汗出如雨,身体热得像火烧一样,面目和痘痕像赭石色一样红赤。我说:这是出汗过多导致亡阳而产生的虚热。后果然死亡。
六味凉血消毒散
犀角(如果没有,可以用升麻代替) 牡丹皮 当归 生地黄 赤芍药 生甘草(以上药材等分)
以上每服三五钱,用水煎煮。
紫草甘草枳壳汤
紫草 甘草 枳壳(各等分)
以上每服一二钱,用水煎煮。
六味地黄丸
人参白术散(又名七味白术散,这两个方剂见“发热属阴阳”章节)
圣济犀角地黄汤(方剂见“顶陷心烦”章节)
人参清膈散(即十六味清膈散,方剂见“顶陷心烦”章节)
十一味木香散(方剂见“痘灰白色”章节)
葶苈木香散(方剂见“腹胀气促”章节)
The *Douzhen Fang* (Formulas for Smallpox and Rashes) states: During the period when smallpox pustules have erupted but not yet crusted, if wheezing and thirst occur, use Baizhu San (Atractylodes Macrocephala Powder); if symptoms are severe, use Muxiang San (Costus Root Powder). After the crusts fall off, if abdominal distension, wheezing, and thirst occur, accompanied by free stool passage and astringent/difficult urination, use Tingli Muxiang San (Descurainia Seed and Costus Root Powder). If wheezing and coughing occur, use Wuzi Zi Tang (Schisandra Decoction). If after crusting there remains wheezing and thirst with residual toxins uneliminated and hard stools, use Qianhu Zhike San (Peucedanum and Aurantium Decoction). If headache, body heat, aversion to cold, and slight wheezing occur, this indicates exterior pathogenic factors; use Shen Su Yin (Ginseng and Perilla Infusion).
I submit that if the aforementioned symptoms are due to Spleen and Lung deficiency, it is appropriate to use Baizhu San. If Spleen and Lung deficiency-cold, it is appropriate to use Muxiang San. If internal accumulation of heat-toxin, use Zicao Gancao Zhike Tang (Arnebia, Licorice, and Aurantium Decoction). If external contraction of wind-pathogen, use Shen Su Yin. If internal and external stagnation, use Renshen Qingge San (Ginseng and Clear Diaphragm Powder). If spontaneous diarrhea and astringent urination, use Tingli Muxiang San. If hard stools, use Qianhu Zhike San.
A child presented with phlegm-wheezing, red and painful pustules, fever, thirst preferring cold water, and constipation. This is excess-heat in the Stomach channel. First, Qianhu Zhike San was used; as symptoms gradually subsided, Xijiao Dihuang Tang (Rhinoceros Horn and Rehmannia Decoction) was administered, leading to complete recovery and crusting.
Another child presented with a red face, phlegm, dry mouth, and thirst. The pulse at the right Cun position was surging and rapid. This indicates Heart fire insulting Lung metal. One dose of Renping Pingfei San (Ginseng and Leveling Lung Powder) was given, followed by Liuwei Dihuang Wan (Six-Ingredient Pill with Rehmannia) for four doses, resulting in recovery.
Another child presented with red and painful pustules, wheezing, coughing, and thirst. The pulse was surging and rapid, particularly at the left Chi and right Cun positions. This indicates Kidney fire flaming upward and attacking the Lungs. Liuwei Dihuang Wan decoction was prepared for the patient to drink freely, leading to timely crusting and recovery.
A fourteen-year-old child presented with wheezing and coughing immediately after smallpox recovery. I diagnosed Spleen and Lung Qi deficiency and treated with Wuzi Zi Tang, resulting in recovery. Later, due to food stagnation causing fever, wheezing, and coughing, Wuwei Yigong San (Five-Ingredient Virtue-Enhancing Powder) was used to stabilize the condition, followed by Buzhong Yiqi Tang (Middle-Warming and Qi-Supplementing Decoction) for full recovery.
A man presented with wheezing, coughing, and a red face after smallpox recovery. After taking Shen Su Yin, his complexion and scar marks turned pale. This indicated Spleen and Lung Qi deficiency compounded by further injury. He was treated with Buzhong Yiqi Tang and Wuwei Yigong San, resulting in recovery.
A child presented with wheezing, thirst, pale complexion, and intermittently cold hands and feet. This is Spleen and Lung Qi deficiency. Treatment with Renshen Baizhu San (Ginseng and Atractylodes Powder) and Wuwei Yigong San led to recovery.
A child presenting with impending smallpox recovery showed wheezing, thirst, abdominal distension, non-hard stools, and astringent urination. This is caused by Spleen and Lung Qi deficiency. Initially, Tingli Muxiang San was used, followed by Renshen Baizhu San, resulting in recovery.
A child presented with wheezing upon smallpox eruption, constipation, hot hands and feet, and thirst preferring cold water. Qianhu Zhike San was used to alleviate symptoms. However, due to poor appetite and pale complexion, indicating that pathogens had cleared but true Qi was deficient, Buzhong Yiqi Tang and Wuwei Yigong San were used for recovery.
A fourteen-year-old child presented with wheezing immediately after smallpox recovery, with no heat in the hands and feet. I diagnosed Spleen and Lung Qi deficiency and treated with Buzhong Yiqi Tang, resulting in recovery. Later, food stagnation caused fever without cold extremities. I diagnosed Spleen Qi deficiency generating false heat leading to wheezing and coughing. Wuwei Yigong San was administered for two doses, reducing fever; subsequently, Buzhong Yiqi Tang was used for full recovery.
A child presented with manic wheezing, restlessness, heat, thirst preferring cold water, and difficult expectoration of phlegm. My late father diagnosed heat-toxin stagnation. Ren Shen Qingge San and Xijiao Dihuang Tang were each administered for one dose, resulting in immediate recovery; Danggui Buxue Tang (Angelica Sinensis and Astragalus Blood-Nourishing Decoction) was then used for final recovery.
A man presented with wheezing, coughing, and a red face after smallpox recovery. After taking exterior-releasing agents, wheezing and coughing worsened, and his complexion and scars turned pale with cold extremities. I diagnosed re-injury to Spleen and Lung Qi resulting in deficiency-cold. Buzhong Yiqi Tang plus Ganjiang (Dried Ginger) was administered for one dose, gradually restoring Yuan Qi; subsequently, Bazhen Tang (Eight-Treasure Decoction) was supplemented for recovery.
A man presented with wheezing, fever, and aversion to cold after smallpox recovery. I prescribed Shiquan Dabu Tang (Ten-Ingredient Great Tonifying Decoction). Distrustful, he instead took heat-clearing agents. Consequently, he sweated profusely like rain, his body heat became intense like flames, and his face, eyes, and scars turned ochre-red. I stated: "Profuse sweating leads to Yang collapse and false heat." He subsequently died.
Liunian Liangxue Xiaodu San (Six-Ingredient Cooling Blood and Detoxicating Powder)
Xijiao (Rhinoceros Horn) (If unavailable, use Shengma/Cimicifugae Rhizoma) Mudanpi (Moutan Cortex) Danggui (Angelicae Sinensis Radix) Shengdihuang (Rehmanniae Radix) Chishaoyao (Paeoniae Radix Rubra) Sheng Gancao (Glycyrrhizae Radix et Rhizoma) (Equal parts)
Take 3-5 qian per dose, decoct in water.
Zicao Gancao Zhike Tang (Arnebia, Licorice, and Aurantium Decoction)
Zicao (Arnebiae Radix) Gancao (Glycyrrhizae Radix et Rhizoma) Zhike (Aurantii Fructus) (Equal parts)
Take 1-2 qian per dose, decoct in water.
Wuzi Zi Tang (Schisandra Decoction)
Shen Su Yin (Ginseng and Perilla Infusion)
Qianhu Zhike San (Peucedanum and Aurantium Powder) (See three formulas under "Thick Phlegm and Saliva")
Liuwei Dihuang Wan (Six-Ingredient Pill with Rehmannia)
Renshen Baizhu San (Ginseng and Atractylodes Powder) (Also known as Qiwei Baizhu San; see two formulas under "Fever Belonging to Yin and Yang")
Shengji Xijiao Dihuang Tang (Sage Relief Rhinoceros Horn and Rehmannia Decoction) (Formula seen under "Sunken Vertex and Restless Heart")
Renshen Qingge San (Ginseng and Clear Diaphragm Powder) (i.e., Shi-liuwei Qingge San; Formula seen under "Sunken Vertex and Restless Heart")
Shiyiwei Muxiang San (Eleven-Ingredient Costus Root Powder) (Formula seen under "Ashy-White Pustules")
Tingli Muxiang San (Descurainia Seed and Costus Root Powder) (Formula seen under "Abdominal Distension and Shortness of Breath")