(十三)痧疹的颜色以鲜红明亮为吉,如果颜色淡白,则是心血不足的表现。如果颜色过于红赤或呈深紫色,说明血分有热;如果出现黑色,则预后不良,主死证。此时可投用犀角大青汤,以期获得万一的救治机会。
(十四)痧疹患者如果有汗自出,这是正气驱邪、肌表自然解除的好现象;如果痧疹伴有鼻出血或牙龈出血且自行停止,这也是邪气有了排泄途径的好现象,这两种情况都不应强行止住。
但是,得汗固然是好事,但如果出汗过多会导致阳气亡失,所以体质虚弱的人,不宜使用过强的发汗解表法;鼻衄固然不必强行止住,但如果出血过多会耗伤血液,也应当予以止血处理。
(十五)痧疹伴随咳嗽,连续不断,这是邪气通过肺脏向外宣泄的表现。所以在痧疹刚发出之时,咳嗽剧烈是最佳的现象;如果在痧疹透发完全之后,疹子开始隐没消退时,仍然咳嗽不止,并伴有气逆喘息的症状,宜选用清咽滋肺汤来清泻肺热。如果咳嗽痰多者,去掉方中的麦冬,加入橘皮和茯苓。
(13) The color of variola (smallpox/rubella-like rash) is auspicious when it is bright red. If the color is pale white, it indicates insufficiency of Heart Blood (Xin Xue). If the color is excessively red or dark purple, it indicates heat in the Blood level (Xue Re); if it turns black, it signifies a fatal prognosis. In such cases, Xi Jiao Da Qing Tang (Rhino Horn and Indigo Decoction) may be administered to hope for a chance of recovery.
(14) When the patient with variola has spontaneous sweating, this is favorable as it indicates the natural resolution of the pathogen from the exterior (Biao). When the patient experiences spontaneous epistaxis (nosebleed) or gingival bleeding, this is also favorable as it provides a pathway for the pathogen to exit. Neither condition should be forcibly stopped.
However, while sweating is beneficial, excessive sweating leads to the collapse of Yang Qi (Wang Yang); therefore, individuals with weak constitutions should not undergo overly aggressive diaphoretic treatment. Although epistaxis need not be forcibly stopped, excessive bleeding consumes Blood; thus, it should be controlled if severe.
(15) Coughing that is continuous and unceasing during variola indicates that the pathogen is being excreted through the Lung. Therefore, when the rash is just emerging, severe coughing is considered an optimal sign. However, if after the rash has fully erupted and begins to fade, the patient continues to cough incessantly accompanied by rebellious Qi and wheezing (Shang Qi Chan Xi), Qing Yan Zi Fei Tang (Throat-Clearing and Lung-Nourishing Decoction) should be used to clear Lung Heat. For those with copious phlegm due to cough, remove Ophiopogonis Radix (Mai Dong) and add Citri Reticulatae Pericarpium (Ju Pi) and Poria (Fu Ling).