《痘疹方》云∶痘疹未出之先,热盛,恐欲起惊,小便不利,导赤散微解之。热入膀胱,如有血淋,犀角汤。初出
不快,小便赤色,生圣散。已出未愈之间,白术散或五苓散加木通。收靥之后,小便不利,烦热而渴,猪苓汤。窃谓前
症当分所因,若小肠热结,用导赤散。肝经热,用柴胡麦门冬汤。脾经热,用犀角汤。肺经热,用生地黄汤。肾经热,
地黄丸。靥后气血虚弱,用八珍汤。中气虚弱,用五味异功散。
一小儿小便不利,口舌生疮,干渴,用导赤散、加味四物汤而脓贯;又用白术散去木香,治之而愈。
一小儿小便不通,口舌如靡,作渴面赤,左尺脉数,此膀胱热结,先用五淋散,而小便利;又用地黄清肺饮、参
四圣散而愈。
一小儿小便数而欠利,面赤口渴,两足发热,此禀阴虚也,地黄、滋肾二丸煎服,用四剂而愈;又用地黄丸料加黄
、当归而痊愈。
一小儿痘将愈,小便不利,服五苓散之类,小便愈少,喘咳唾痰,此脾肺复伤也,先用补中益气汤二剂送滋肾丸,
却用补中益气、五味异功二药而痊。
八正散 治下焦积热,大小便不通,或小便淋涩,脉症俱实者。
大黄(酒炒) 车前子(炒) 瞿麦 蓄 山栀(炒) 木通(各一钱) 甘草(一钱) 滑石(煨,二钱)
上每服二钱,水煎。
滋肾丸
黄柏(炒黑) 知母(炒黑,各二两) 肉桂(二钱)
上为末,水糊丸。
益元散 治痘疹初起,烦躁作渴,小便不通。
滑石(六钱) 甘草(一钱)
每服五六分,白汤调下。
导赤散 治小肠实热,生疮作渴发热,小便秘赤,或小便不利者。(方见作痒搔破)
柴苓汤 治疹泻,小便不利。(方见 症)
五苓散
茯苓 猪苓 白术 泽泻(各等分) 肉桂(减半)
上为末,每服四分,白汤调下。
黄芩清肺饮
黄芩(炒) 山栀(炒,等分)
上每服二钱,水煎。
生地黄汤
生地黄(五钱) 杏仁(去皮尖,二钱) 麦门冬(七钱) 款冬花 陈皮(各三钱) 甘草(二钱五分)
上每服二三钱,水煎。
紫草木通汤 治痘疹不快,小便不利。
紫草 人参 木通 茯苓 糯米(各等分) 甘草(减半)
柴胡麦门冬散(方见作痒抓破)
犀角汤(方见顶陷心烦)
生圣散(方见痘疮出迟)
加味四物汤(方见痘入目)
白术散(即七味白术散)
六味地黄丸(二方见发热属阴阳)
《痘疹方》记载:在痘疹尚未发出之前,如果热势炽盛,担心引发惊风,出现小便不通畅的情况,可用导赤散轻微清解。若热邪侵入膀胱,出现类似血淋的症状,使用犀角汤。痘疹初发不畅,且小便颜色深红,使用生圣散。在痘疹已发出但尚未痊愈期间,使用白术散或五苓散加木通。痘疹收靥(结痂脱落)之后,若出现小便不利、心烦发热且口渴,使用猪苓汤。我认为上述症状应当区分病因:若是小肠热结,用导赤散;肝经有热,用柴胡麦门冬汤;脾经有热,用犀角汤;肺经有热,用生地黄汤;肾经有热,用地黄丸。痘疹收靥后气血虚弱,用八珍汤;中气虚弱,用五味异功散。
有一个小儿小便不通畅,口舌生疮,口干渴,服用导赤散和加味四物汤后,痘疹化脓透发;后来又用去掉了木香的白术散治疗,最终痊愈。
另一个小儿小便完全不通,口舌糜烂如腐烂状,感到口渴,面色发红,左尺脉数,这是膀胱热结所致,先用五淋散,使小便通畅;接着用地黄清肺饮和参四圣散治疗而痊愈。
还有一个小儿小便频数但不利索,面色发红,口渴,两脚发热,这是先天禀赋阴虚所致,服用地黄丸和滋肾丸的煎剂,用了四剂后痊愈;后来又用六味地黄丸的药料加入黄柏、当归,最终痊愈。
有一个小儿痘疹即将痊愈时,出现小便不利,服用五苓散之类的药物后,小便反而更少,出现气喘咳嗽、吐痰的症状,这是脾肺再次受损所致,先用补中益气汤两剂送服滋肾丸,随后再用补中益气汤和五味异功散两种药治疗而康复。
八正散:治疗下焦积热,导致大小便不通,或者小便淋漓涩痛,脉象和症状都表现为实证者。
大黄(酒炒) 车前子(炒) 瞿麦 萹蓄 山栀(炒) 木通(各一钱) 甘草(一钱) 滑石(煨,二钱)
以上药物每次服用二钱,用水煎煮。
滋肾丸
黄柏(炒黑) 知母(炒黑,各二两) 肉桂(二钱)
以上药物研成细末,用水糊制作成丸剂。
益元散:治疗痘疹初起,烦躁作渴,小便不通。
滑石(六钱) 甘草(一钱)
每次服用五六分,用白开水调服。
导赤散:治疗小肠实热,生疮作渴发热,小便短赤,或小便不通畅者。(方剂见“作痒搔破”条下)
五苓散
茯苓 猪苓 白术 泽泻(各等分) 肉桂(减半)
以上药物研成细末,每次服用四分,用白开水调服。
黄芩清肺饮
黄芩(炒) 山栀(炒,等分)
以上药物每次服用二钱,用水煎煮。
生地黄汤
生地黄(五钱) 杏仁(去皮尖,二钱) 麦门冬(七钱) 款冬花 陈皮(各三钱) 甘草(二钱五分)
以上药物每次服用二三钱,用水煎煮。
紫草木通汤:治疗痘疹发出缓慢,小便不通畅。
紫草 人参 木通 茯苓 糯米(各等分) 甘草(减半)
柴胡麦门冬散(方剂见“作痒抓破”条下)
犀角汤(方剂见“顶陷心烦”条下)
生圣散(方剂见“痘疮出迟”条下)
加味四物汤(方剂见“痘入目”条下)
白术散(即七味白术散)
六味地黄丸(两个方剂见“发热属阴阳”条下)
According to the *Douzhen Fang* (Treatise on Smallpox and Measles): Before the eruption of smallpox or measles, if the heat is excessive and there is a fear of inducing convulsions, accompanied by difficult urination, Daochi San (Coptis Decoction) should be used for mild resolution. If heat enters the Bladder, presenting with symptoms similar to bloody strangury, Xijiao Tang (Rhinoceros Horn Decoction) is indicated. If the eruption is slow and the urine is dark red, Shengsheng San (Holy Efficacy Powder) is used. During the period after eruption but before recovery, Baizhu San (Atractylodes Macrocephala Decoction) or Wuling San (Five-Ingredient Poria Decoction) with Mutong (Akebia Stem) may be added. After the scabs fall off, if difficult urination is accompanied by irritability, fever, and thirst, Zhuling Tang (Poria Decoction) is prescribed. I believe that these preceding symptoms should be differentiated by etiology: if it is heat accumulation in the Small Intestine, use Daochi San; if there is heat in the Liver channel, use Chaihu Maimendong Tang (Bupleurum and Ophiopogon Decoction); if there is heat in the Spleen channel, use Xijiao Tang; if there is heat in the Lung channel, use Shengdihuang Tang (Rehmannia Decoction); if there is heat in the Kidney channel, use Dihuang Wan (Rehmannia Pill). After the scabs fall off, if Qi and Blood are deficient, use Bazhen Tang (Eight-Treasure Decoction); if Middle Qi is deficient, use Wuwei Yigong San (Five-Ingredient Extraordinary Merit Powder).
Case 1: A child presented with difficult urination, sores in the mouth and tongue, and dry thirst. After administering Daochi San and Jiawei Siwu Tang (Modified Four Substances Decoction), the pustules erupted and filled with pus. Subsequently, treatment with Baizhu San from which Muxiang (Costus Root) was removed led to recovery.
Case 2: Another child presented with complete urinary retention, mouth and tongue resembling erosion, thirst, flushed face, and a rapid pulse at the left Chi position. This was diagnosed as heat accumulation in the Bladder. Wulin San (Five Strangury Powder) was administered first, resulting in free urination. The child was then cured using Dihuang Qingfei Yin (Rehmannia Lung-Clearing Infusion) and Shen Sixian San (Ginseng Six-Holy Powder).
Case 3: A third child presented with frequent but incomplete urination, flushed face, thirst, and hot feet. This was attributed to congenital Yin deficiency. Dihuang Wan (Rehmannia Pill) and Zishen Wan (Kidney-Nourishing Pill) were decocted and taken over four doses, leading to recovery. Later, the ingredients of Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill) were supplemented with Huangbai (Phellodendron Bark) and Danggui (Angelica Sinensis), resulting in full recovery.
Case 4: A child nearing recovery from smallpox developed difficult urination. After taking Wuling San and similar formulas, urination decreased further, accompanied by wheezing, coughing, and expectoration. This indicated secondary injury to the Spleen and Lungs. Two doses of Buzhong Yiqi Tang (Middle-Boosting Qi-Enhancing Decoction) were given to deliver Zishen Wan. Subsequently, the combination of Buzhong Yiqi Tang and Wuwei Yigong San led to recovery.
Bag Zheng San (Eight-Upright Powder): Treats heat accumulation in the Lower Jiao causing obstruction of both large and small bowel movements, or dribbling and painful urination, where both pulse and symptoms indicate excess patterns.
Dahuang (Rhubarb Rhizome, stir-fried with wine) 1 qian, Cheqianzi (Plantago Seed, stir-fried) 1 qian, Qumai (Dianthus Herb) 1 qian, Pianxu (Polygonum Aviculare Herb) 1 qian, Shanzhi (Gardenia Fruit, stir-fried) 1 qian, Mutong (Akebia Stem) 1 qian, Gancao (Licorice Root) 1 qian, Huashi (Talcum) 2 qian (roasted).
Take 2 qian per dose, decoct in water.
Zishen Wan (Kidney-Nourishing Pill)
Huangbai (Phellodendri Cortex, stir-fried until black) 2 liang, Zhimu (Anemarrhenae Rhizoma, stir-fried until black) 2 liang, Rougui (Cinnamon Bark) 2 qian.
Grind into powder, make pills with water paste.
Yiyuan San (Benefiting Origin Powder): Treats early stage of smallpox/measles with restlessness, thirst, and urinary retention.
Huashi (Talcum) 6 qian, Gancao (Licorice Root) 1 qian.
Take 5-6 fen per dose, mix with warm water.
Daochi San (Coptis Decoction): Treats excess heat in the Small Intestine, manifesting as sores, thirst, fever, dark scanty urine, or difficult urination. (Formula see "Itching and Scratching" section).
Chai Ling Tang (Bupleurum and Poria Decoction): Treats measles with diarrhea and difficult urination. (Formula see "Symptoms" section).
Wuling San (Five-Ingredient Poria Decoction)
Fuling (Poria) equal parts, Zhuling (Polyporus) equal parts, Baizhu (Atractylodes Macrocephala Rhizome) equal parts, Zexie (Alisma Rhizome) equal parts, Rougui (Cinnamon Bark) half dose.
Grind into powder, take 4 fen per dose, mix with warm water.
Huangqin Qingfei Yin (Scutellaria Lung-Clearing Infusion)
Huangqin (Scutellariae Radix, stir-fried) equal parts, Shanzhi (Gardenia Fruit, stir-fried) equal parts.
Take 2 qian per dose, decoct in water.
Shengdihuang Tang (Rehmanniae Radix Decoction)
Shengdihuang (Rehmanniae Radix Recens) 5 qian, Xingren (Prunus Armeniaca Seed, peeled and tip removed) 2 qian, Maimendong (Ophiopogonis Radix) 7 qian, Kuandonghua (Farfarae Flos) 3 qian, Chenpi (Citri Reticulatae Pericarpium) 3 qian, Gancao (Licorice Root) 2.5 qian.
Take 2-3 qian per dose, decoct in water.
Zicao Mutong Tang (Arnebia and Akebia Decoction): Treats slow eruption of smallpox/measles and difficult urination.
Zicao (Arnebiae Radix) equal parts, Renshen (Ginseng Radix) equal parts, Mutong (Akebia Caulis) equal parts, Fuling (Poria) equal parts, Nuomi (Glutinous Rice) equal parts, Gancao (Licorice Root) half dose.
Chaihu Maimendong San (Bupleurum and Ophiopogon Powder) (Formula see "Itching and Scratching" section).
Xijiao Tang (Rhinoceros Horn Decoction) (Formula see "Sunken Crown and Restless Heart" section).
Shengsheng San (Holy Efficacy Powder) (Formula see "Delayed Eruption" section).
Jiawei Siwu Tang (Modified Four Substances Decoction) (Formula see "Smallpox Entering Eyes" section).
Baizhu San (Atractylodes Macrocephala Decoction) (i.e., Qiwei Baizhu San / Seven-Ingredient Atractylodes Macrocephala Decoction).
Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill) (Both formulas see "Fever Belonging to Yin and Yang" section).