陈文宿先生云∶痘疮之症,有阳盛阴虚,有阴盛阳虚。阳盛者饮冰雪而不知寒;阴盛者饮沸汤而不知热。阳盛则补
阴,用木香散加丁香、官桂;阴盛则补阳,用异功散加木香、当归。窃谓∶经云大寒而甚,热之不热,是无火也,
当益火之源以消阴翳;大热而甚,寒之不寒,是无水也,当壮水之主以镇阳光。若前症发热作渴,手足并冷,大便自
利,喜饮热汤,此阴盛也,宜用十二味异功散、八味丸。若发热作渴,大便秘结,手足并热,喜饮冷水,此阳盛也,宜
用四顺散、六味丸。若烦热作渴,面赤睛白,此为肾经虚热,宜用地黄丸之类,治之及时,亦有生者。京师小儿出痘
或作渴,喜饮冷水者,恣与饮之,再不服药,如期而愈,亦无痘毒之患。盖北方人卧火炕,饮烧酒,有热与水相构而然
也。小儿面色目睛多白者,乃禀肾气虚也,出痘必作渴,用地黄丸煎与恣饮,多有生者。
一小儿痘寒战切牙,泻渴腹胀,手足并冷,时当仲夏,饮沸汤而不知热,此脾胃虚寒之热也,先用十二味异功
散一剂顿安,又用六君、附子一剂,后用五味异功散而愈。
一男子出痘,色紫作渴饮水,腰痛足热耳聋,此禀肾气不足,用加减八味丸料煎与恣饮,热渴顿止,佐以补中益气
汤加五味子、麦门冬,滋其化源而愈。
一小儿十四岁,出痘色黯,两足及腰热痛,便秘咽干、口渴引饮,先君谓禀肾不足,用加减八味丸料作大剂,煎与
恣饮,至二斤,诸症悉退,又佐以益气汤及八珍汤,各十余剂而痊。
一小儿痘疮发热作渴,腹胀寒战切牙,饮冰雪而不知寒,悉似火症,但两足并冷,此阳气虚寒也,先用十二味异
功散一剂,随用五味异功散加姜、桂渐愈,乃去桂,又二剂而痊。
六味地黄丸 治肾虚痘疮发热作渴等症。
熟地黄(八两杵膏) 干山药 山茱萸(肉,各四两) 泽泻 白茯苓 牡丹皮(各三两)
上为末,入地黄膏量加米糊丸如小豆大,煎服尤好。
七味白术散(一名人参白术散) 治胃气虚弱,或因克伐,或因吐泻,口干作渴,饮食少思。如饮冷者去木香。
藿香 白术 木香 白茯苓 甘草(炒) 人参 干葛
上每服五钱,水煎,徐徐服。
八珍汤
十一味木香散
十二味异功散(三方见痘灰白色)
补中益气汤
五味异功散(二方见寒战切牙)
加减八味丸(即六味地黄丸加五味子、肉桂)
清凉饮(方见大便不通)
陈文宿先生说:痘疮的病症,有阳盛阴虚的情况,也有阴盛阳虚的情况。阳气偏盛的人,喝冰雪水也不觉得冷;阴气偏盛的人,喝沸水也不觉得热。阳气偏盛则应当补阴,使用木香散加丁香、官桂;阴气偏盛则应当补阳,使用异功散加木香、当归。我认为:《内经》说,大寒且严重的,用热药治疗却不回暖,这是无火(肾阳虚衰),应当益火之源以消除阴翳(温补肾阳以消散阴寒);大热且严重的,用寒药治疗却不退热,这是无水(肾阴亏虚),应当壮水之主以镇阳光(滋补肾阴以制约阳亢)。如果前述症状表现为发热口渴,手足俱冷,大便自利(腹泻),喜欢喝热汤,这是阴盛的表现,适宜使用十二味异功散、八味丸。如果表现为发热口渴,大便秘结,手足俱热,喜欢喝冷水,这是阳盛的表现,适宜使用四顺散、六味丸。如果表现为烦热口渴,面色红赤而眼白睛色淡,这是肾经虚热,适宜用地黄丸之类治疗,如果治疗及时,也有存活的可能。京城的小儿出痘疮有时出现口渴、喜欢喝冷水的情况,就让他们随意饮用,不再服用其他药物,到预期时间也能痊愈,也没有痘毒的后患。这是因为北方人睡火炕、喝烧酒,体内有热与水相互结合导致的缘故。小儿面色和眼白睛多呈白色,是禀受肾气虚弱的表现,出痘疮必定会口渴,用地黄丸煎汤让他们随意饮用,大多能存活。
有一个小儿出痘疮时寒战咬牙,腹泻口渴腹胀,手足俱冷,当时正值仲夏,喝沸水也不觉得热,这是脾胃虚寒产生的假热,先用十二味异功散一剂顿然安适,又用六君子汤加附子一剂,后用五味异功散而痊愈。
有一个男子出痘疮,痘色紫暗,口渴饮水,腰痛足热耳聋,这是禀受肾气不足,用加减八味丸料煎汤让他随意饮用,热渴顿时停止,辅以补中益气汤加五味子、麦门冬,滋养化源而痊愈。
有一个十四岁的小儿,出痘疮颜色黯黑,两脚及腰部热痛,便秘咽干、口渴引饮,先父认为这是禀受肾气不足,用加减八味丸料做大剂量,煎汤让他随意饮用,服至二斤,各种症状全部消退,又辅以益气汤及八珍汤,各十余剂而痊愈。
有一个小儿出痘疮发热口渴,腹胀寒战咬牙,喝冰雪水也不觉得冷,看起来全像火症,但双脚俱冷,这是阳气虚寒,先用十二味异功散一剂,随后用五味异功散加生姜、肉桂逐渐痊愈,后来去掉肉桂,又服两剂而痊愈。
六味地黄丸 治疗肾虚痘疮发热口渴等症状。
熟地黄(八两捣成膏) 干山药 山茱萸(取肉,各四两) 泽泻 白茯苓 牡丹皮(各三两)
以上研为细末,加入地黄膏,适量加米糊制成如小豆大的丸药,煎服效果尤好。
七味白术散(又名人参白术散) 治疗胃气虚弱,或因攻伐太过,或因吐泻,导致口干口渴,饮食少思。如果喜欢喝冷水的,去掉木香。
藿香 白术 木香 白茯苓 甘草(炒) 人参 干葛
以上每次服用五钱,用水煎煮,慢慢服用。
八珍汤
十一味木香散
十二味异功散(三方见“痘灰白色”章节)
补中益气汤
五味异功散(二方见“寒战切牙”章节)
加减八味丸(即六味地黄丸加五味子、肉桂)
清凉饮(方见“大便不通”章节)
Mr. Chen Wensu said: In the disease of smallpox, there are conditions of excess Yang and deficiency Yin, as well as conditions of excess Yin and deficiency Yang. Those with excess Yang drink ice and snow water without feeling cold; those with excess Yin drink boiling water without feeling heat. When Yang is in excess, one should tonify Yin, using Muxiang San (Wood Fragrance Powder) added with Dingxiang (Clove) and Guangui (Cinnamon Bark). When Yin is in excess, one should tonify Yang, using Yigong San (Extraordinary Efficacy Powder) added with Muxiang (Wood Fragrance) and Danggui (Angelica Sinensis). I hold that: The Classic says, "In cases of severe cold that do not respond to heat therapy, it indicates a lack of Fire (Kidney Yang), and one should benefit the source of Fire to dispel the shadows of Yin (warm and tonify Kidney Yang to dissipate Yin-cold)." In cases of severe heat that do not respond to cold therapy, it indicates a lack of Water (Kidney Yin), and one should strengthen the master of Water to suppress the sunlight (nourish Kidney Yin to control Yang hyperactivity). If the aforementioned symptoms manifest as fever with thirst, coldness of both hands and feet, spontaneous diarrhea, and a preference for hot drinks, this indicates excess Yin, and Shierwei Yigong San (Twelve-Ingredient Extraordinary Efficacy Powder) or Bawei Wan (Eight-Ingredient Pill) should be used. If the symptoms manifest as fever with thirst, constipation, heat in both hands and feet, and a preference for cold drinks, this indicates excess Yang, and Sishun San (Four-Smooth Powder) or Liuwei Wan (Six-Ingredient Pill) should be used. If the symptoms manifest as vexatious heat with thirst, a red face but pale sclera, this indicates deficiency heat of the Kidney channel, and Dihuang Wan (Rehmannia Pill) or similar formulas should be used. If treated in time, survival is possible. In the capital, children contracting smallpox sometimes present with thirst and a preference for cold water; allowing them to drink freely without administering other medicines often leads to recovery by the expected time, without complications from smallpox toxins. This is because northerners sleep on heated kang beds and drink distilled liquor, leading to an internal condition where heat and water interact. Children whose facial complexion and sclera appear mostly white have inherited weakness of Kidney Qi; when they contract smallpox, they will inevitably experience thirst. Administering Dihuang Wan decoction for free drinking often results in survival.
A child presented with chills, teeth grinding, diarrhea, thirst, abdominal distension, and coldness of both hands and feet during smallpox eruption. It was midsummer, yet he drank boiling water without feeling heat. This was false heat due to deficiency-cold of the Spleen and Stomach. Initially, one dose of Shierwei Yigong San brought immediate relief. Then, one dose of Liujunzi Tang (Six-Gentlemen Decoction) added with Fuzi (Aconite Lateral Root) was administered. Finally, Wuwei Yigong San (Five-Ingredient Extraordinary Efficacy Powder) led to full recovery.
A man presenting with smallpox had purple-colored lesions, thirst with desire to drink, lower back pain, heat in the feet, and deafness. This indicated inherited insufficiency of Kidney Qi. Jiajian Bawei Wan (Modified Eight-Ingredient Pill) decoction was administered for free drinking, which immediately stopped the heat and thirst. This was supplemented with Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) added with Wuweizi (Schisandra Fruit) and Maidong (Ophiopogon Tuber), nourishing the source of transformation until recovery.
A fourteen-year-old child presented with dark-colored smallpox lesions, heat and pain in both legs and waist, constipation, dry throat, and thirst with desire to drink. My late father attributed this to inherited Kidney insufficiency. A large dose of Jiajian Bawei Wan decoction was administered for free drinking. After consuming two jin (approx. 1 kg), all symptoms subsided. This was followed by Yi Qi Tang (Boost Qi Decoction) and Bazhen Tang (Eight-Treasure Decoction), each administered for over ten doses, resulting in complete recovery.
A child presented with fever and thirst due to smallpox, abdominal distension, chills, teeth grinding, and drinking ice/snow water without feeling cold. The presentation resembled fire syndromes entirely, except for the coldness of both feet, indicating deficiency-cold of Yang Qi. Initially, one dose of Shierwei Yigong San was given. Subsequently, Wuwei Yigong San added with Shengjiang (Fresh Ginger) and Rongui (Cinnamon Twig) gradually improved the condition. Later, Rongui was removed, and after two more doses, full recovery was achieved.
Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill): Treats symptoms such as fever and thirst in smallpox due to Kidney deficiency.
Shudihuang (Prepared Rehmannia Root, 8 liang pounded into paste) Gan Shanyao (Dried Dioscorea Rhizome) Shanzhuyu (Cornus Officinalis Fruit flesh, 4 liang each) Zexie (Alisma Rhizome) Baifuling (Poria Cocos, 4 liang each) Mudanpi (Moutan Cortex, 3 liang each).
Grind the above into powder, add the Dihuang paste, mix with rice paste in appropriate amounts to form pills the size of small beans. Decocting and taking the medicine is particularly effective.
Qiwei Baizhu San (Seven-Ingredient Atractylodes Macrocephala Powder, also known as Ren Shen Baizhu San): Treats weak Stomach Qi, or dry mouth and thirst with poor appetite caused by excessive purgation or vomiting/diarrhea. If the patient prefers cold drinks, remove Muxiang.
Huoxiang (Patchouli Herb) Baizhu (Atractylodes Macrocephala Rhizome) Muxiang (Vladimiria Root) Baifuling (Poria Cocos) Gancao (Licorice Root, stir-fried) Renshen (Ginseng Root) Gange (Kudzu Root).
Take 5 qian per dose, decoct in water, and take slowly.
Bazhen Tang (Eight-Treasure Decoction)
Shiyiwei Muxiang San (Eleven-Ingredient Wood Fragrance Powder)
Shierwei Yigong San (Twelve-Ingredient Extraordinary Efficacy Powder) [See "Smallpox Ash-White" section for these three formulas]
Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction)
Wuwei Yigong San (Five-Ingredient Extraordinary Efficacy Powder) [See "Chills and Teeth Grinding" section for these two formulas]
Jiajian Bawei Wan (Modified Eight-Ingredient Pill) [i.e., Liuwei Dihuang Wan added with Wuweizi and Rougui]
Qingliang Yin (Cooling Drink) [Formula see "Constipation" section]