陈文宿先生云∶痘疮收靥之后,浑身壮热,经日不除,别无他症,用柴胡麦门冬散,如不退,服人参白术散。若风
热咳嗽,咽喉不利,用桔梗甘草防风汤。窃谓∶前症有因热毒未解者,有因胃气虚热者,有因胃气实热者,其因不能枚
举,当临症制宜而药之。
一小儿咽痛壮热,痘痕色赤,手微热,此余毒未解,用柴胡麦门冬散而安。七日之后复热,手指初捏似热,久捏则
冷,此脾气虚也,用五味异功散而痊。
一小儿痘咽痛,大便不实,口渴饮汤,手足不热,此脾胃虚弱也,用人参白术散,而大便实。但不时寒热,用加味
逍遥散而愈。
一小儿痘咽痛,发热作渴,面赤饮冷,此胃经实热也,用射干鼠粘子汤而愈。因食浓味复发,手足并热,用泻黄散
一剂而痊。
一小儿痘咽痛,发热饮冷,大便黄色,手足指热,此脾胃实热也,用泻黄、清胃二散,各一剂而愈。后因乳母食浓
味,儿口角流涎,不能吮乳,仍用前药治母而愈。
一小儿痘咽痛足热,余谓此禀足三阴虚而无根之火上炎也,古人有云,痘归肾经,必不可救,当用壮水之剂,亦有
生者。奈彼不悟,翌日果腰痛咽哑,始信余言,乃用大剂地黄丸料加五味子,并补中益气汤而愈。
一男子出痘,上体甚热,两足俱冷,喉痛作渴,疮亦不起发,此禀肾经虚热也,以六味地黄丸料,煎与恣饮,渐
愈,又与八珍汤而痊。
一小儿面色素白,出痘咽痛,发热面赤,作渴饮汤,手足指冷,此禀足三阴虚也,用大剂加减八味丸料,煎与恣
饮,又以益气汤助其脾胃,以滋化源,痛止热退而愈。
射干鼠粘子汤 治痘疹咽喉作痛,及痘疹后痈疽疮毒。
鼠粘子(即牛蒡子) 甘草 升麻 射干(各二钱)
上水煎,量服之。
泻黄散 治脾胃实热患疮,口渴饮冷。
藿香叶(七叶) 石膏( ,五钱) 甘草(三钱) 防风 山栀仁(炒,各一两)
上为末,每二钱水煎,入蜜少许。婴儿乳母服之。
六味地黄丸(方见痘疮发热属阳属阴)
清胃散(方见痘不结痂)
八珍汤(方见顶陷灰白)
人参白术散(即七味白术散)
柴胡麦门冬散(方见作痒抓破)
加减八味丸(即六味丸加五味子、肉桂)
加味逍遥散(方见欲靥不靥)
五味异功散
补中益气汤(二方见寒战切牙)
陈文宿先生说:痘疮结痂脱落之后,全身高热,多日不退,没有其他症状,使用柴胡麦门冬散;如果热势不退,服用人参白术散。如果有风热引起的咳嗽,咽喉不适,使用桔梗甘草防风汤。我认为:上述病症有的因为热毒未解,有的因为胃气虚导致的虚热,有的因为胃气实导致的实热,病因不能一一列举,应当根据具体病情灵活用药。
有一个小孩咽痛、高热,痘痕颜色发红,手部轻微发热,这是余毒未解,使用柴胡麦门冬散而痊愈。七天后再次发热,手指初捏感觉发热,久捏则变冷,这是脾气虚弱,使用五味异功散而康复。
有一个小孩出痘后咽痛,大便不成形,口渴想喝热水,手脚不发热,这是脾胃虚弱,使用人参白术散,使大便恢复正常。但时不时出现寒热往来,使用加味逍遥散而治愈。
有一个小孩出痘后咽痛,发热且口渴,面色红赤,喜欢喝冷饮,这是胃经实热,使用射干鼠粘子汤而治愈。后来因为吃了浓腻厚味的食物导致复发,手脚都发热,使用泻黄散一剂而康复。
有一个小孩出痘后咽痛,发热想喝冷饮,大便呈黄色,手指发热,这是脾胃实热,使用泻黄散和清胃散各一剂而治愈。后来因为乳母吃了浓腻厚味的食物,婴儿嘴角流口水,无法吸吮乳汁,仍然用前面的药方治疗乳母而痊愈。
有一个小孩出痘后咽痛、脚部发热,我认为这是禀赋不足导致足三阴经虚损,无根之火上浮所致。古人曾说:“痘疮归于肾经,必不可救”,应当使用滋补肾水的药物,也有存活的可能。无奈家属不理解,第二天果然出现腰痛、声音嘶哑,才相信我的话,于是使用大剂量的地黄丸料加入五味子,并配合补中益气汤而治愈。
一个男子出痘,上半身非常热,双脚冰冷,喉咙痛且口渴,痘疮也不能起发,这是禀赋导致肾经虚热,用六味地黄丸料煎汤让他大量饮用,逐渐好转,又服用八珍汤而康复。
一个小孩子面色素白,出痘后咽痛,发热面红,口渴想喝热水,手指冰冷,这是禀赋导致足三阴经虚损,使用大剂量的加减八味丸料煎汤让他大量饮用,又以益气汤辅助其脾胃,以滋养化源,疼痛停止、热退而痊愈。
射干鼠粘子汤:治疗痘疹咽喉疼痛,以及痘疹后出现的痈疽疮毒。
牛蒡子(即鼠粘子) 甘草 升麻 射干(各二钱)
以上用水煎煮,酌情服用。
泻黄散:治疗脾胃实热患疮疡,口渴喜冷饮。
藿香叶(七片) 石膏(煅,五钱) 甘草(三钱) 防风 山栀仁(炒,各一两)
以上研为细末,每次取二钱用水煎煮,加入少许蜂蜜。婴儿及乳母服用。
六味地黄丸(方剂见“痘疮发热属阳属阴”章节)
清胃散(方剂见“痘不结痂”章节)
八珍汤(方剂见“顶陷灰白”章节)
人参白术散(即七味白术散)
柴胡麦门冬散(方剂见“作痒抓破”章节)
加减八味丸(即六味丸加五味子、肉桂)
加味逍遥散(方剂见“欲靥不靥”章节)
五味异功散
补中益气汤(这两个方剂见“寒战切牙”章节)
Mr. Chen Wensu said: After the pox scabs fall off, if there is high fever all over the body that persists for days without other symptoms, use Chaihu Maidong San (Bupleurum and Ophiopogon Powder). If the fever does not subside, administer Renshen Baizhu San (Ginseng and Atractylodes Macrocephala Powder). If there is cough due to wind-heat and throat discomfort, use Jiegeng Gancao Fangfeng Tang (Platycodon, Licorice, and Saposhnikovia Decoction). I believe that the aforementioned conditions may be caused by unresolved heat-toxin, deficiency-heat due to weak stomach qi, or excess-heat due to strong stomach qi. The causes cannot be listed exhaustively; one must prescribe medication flexibly according to the specific clinical presentation.
A child presented with sore throat and high fever after pox, with red pox scars and slightly warm hands. This indicated residual toxin not yet cleared. He recovered after taking Chaihu Maidong San (Bupleurum and Ophiopogon Powder). Seven days later, he developed recurrent fever. His fingers felt warm upon initial touch but cold upon prolonged holding, indicating Spleen qi deficiency. He was cured using Wuwei Yigong San (Five-Ingredient Powder with Perilla Leaf for Strengthening the Qi).
Another child had a sore throat after pox, loose stools, thirst for drinking hot water, and cool extremities. This indicated Spleen and Stomach weakness. He was treated with Renshen Baizhu San (Ginseng and Atractylodes Macrocephala Powder), which solidified his stools. However, he experienced intermittent chills and fever, which were resolved using Jiawei Xiaoyao San (Modified Free and Easy Wanderer Plus Cinnamon and Angelica Powder).
A third child presented with sore throat after pox, fever, thirst, flushed face, and preference for cold drinks. This indicated excess-heat in the Stomach channel. He was cured using Shegan Niuzangzi Tang (Belamcanda and Arctium Decoction). The condition recurred after consuming rich and greasy food, accompanied by warmth in both hands and feet. One dose of Xiehuang San (Drain the Yellow Powder) led to recovery.
A fourth child had sore throat after pox, fever with desire for cold drinks, yellow stool, and warm fingertips. This indicated excess-heat in the Spleen and Stomach. He was cured using one dose each of Xiehuang San (Drain the Yellow Powder) and Qingwei San (Clear the Stomach Powder). Later, because the wet nurse consumed rich and greasy food, the infant drooled from the mouth corners and could not suckle milk. Treating the mother with the previous prescriptions cured the infant.
A fifth child had sore throat after pox and warm feet. I considered this to be caused by congenital deficiency of the Three Yin channels of the Foot, leading to floating fire from rootlessness. The ancients stated, "If pox enters the Kidney channel, it is incurable." One should use formulas that nourish Water (Kidney Yin), and survival is possible. Unfortunately, the family did not understand. The next day, the child indeed developed lower back pain and hoarseness, confirming my diagnosis. He was then cured using a large dose of Dihuang Wan (Rehmannia Pill) formula with added Wuweizi (Schisandra Fruit), combined with Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction).
A man presenting with pox had extreme heat in the upper body and coldness in both feet, along with sore throat, thirst, and failure of the pox to erupt. This indicated congenital deficiency-heat in the Kidney channel. He was given Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill) formula decocted in water to drink freely, gradually improving. He was subsequently cured using Bazhen Tang (Eight-Treasure Decoction).
A child with a pale complexion presented with sore throat after pox, fever, flushed face, thirst for hot water, and cold fingertips. This indicated congenital deficiency of the Three Yin channels of the Foot. He was given a large dose of Jiawei Bawei Wan (Modified Eight-Ingredient Pill) formula decocted in water to drink freely. Additionally, Yiqi Tang (Qi-Augmenting Decoction) was used to support the Spleen and Stomach and nourish the source of transformation. The pain ceased, the fever subsided, and he recovered.
Shegan Niuzangzi Tang (Belamcanda and Arctium Decoction): Treats sore throat due to pox/rash and carbuncles/sores/toxins following pox/rash.
Niuzangzi (Arctii Fructus, i.e., Niu Bang Zi) 2 qian, Gancao (Licoriae Radix et Rhizoma) 2 qian, Shengma (Cimicifugae Rhizoma) 2 qian, Shegan (Belamcandae Rhizoma) 2 qian.
Decoct in water and take an appropriate amount.
Xiehuang San (Drain the Yellow Powder): Treats sores due to excess-heat in the Spleen and Stomach, with thirst and preference for cold drinks.
Huoxiang Ye (Pogostemonis Patchouli Folium) 7 leaves, Shigao (Gypsum Fibrosum, calcined) 5 qian, Gancao (Licoriae Radix et Rhizoma) 3 qian, Fangfeng (Saposhnikoviae Radix) 1 liang, Shanzhiren (Gardeniae Semen Preparatum, stir-fried) 1 liang.
Grind into powder. Take 2 qian per dose, decoct in water, and add a little honey. Suitable for infants and nursing mothers.
Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill) (See formula under "Pox Fever Belongs to Yang or Yin")
Qingwei San (Clear the Stomach Powder) (See formula under "Pox Does Not Form Scabs")
Bazhen Tang (Eight-Treasure Decoction) (See formula under "Depressed Crown Ashen White")
Renshen Baizhu San (Ginseng and Atractylodes Macrocephala Powder) (i.e., Qiwei Baizhu San / Seven-Ingredient Atractylodes Macrocephala Powder)
Chaihu Maidong San (Bupleurum and Ophiopogon Powder) (See formula under "Itching and Scratching Open")
Jiawei Bawei Wan (Modified Eight-Ingredient Pill) (i.e., Liuwei Dihuang Wan plus Wuweizi and Rougui)
Jiawei Xiaoyao San (Modified Free and Easy Wanderer Plus Cinnamon and Angelica Powder) (See formula under "Desire for Scabbing but Failing to Scab")
Wuwei Yigong San (Five-Ingredient Powder with Perilla Leaf for Strengthening the Qi)
Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) (Both formulas see "Chattering Teeth and Trembling")