气虚不靥症,宜人参、黄 、炙甘草、肉桂、白芷、白术、陈皮、萆 、山药、何
首乌、酒炒当归、白芍、熟地、茯苓、米仁、木香、丁香、肉果、炮姜、莲肉、附
子、陈米、龙眼、木通之类,随候采用。凡贯浆后用参 ,宜参多 少,盖补中重而固
表轻也,且 性升托令肺甚难靥,况痘欲回而 托之则升降不定而毒反攻内矣。
血热倒靥症,宜天虫、甲片、酒炒芩连、生地、当归、赤芍、酒红花、烧人粪、
连翘、牛蒡子、玄参、生甘草、桔梗、角刺、紫草茸、粘米、大桑虫、人牙、龙脑、
猪尾血、狗蝇之类,随候采用。凡自见点以至灌脓俱欲气血同毒,升浮长养,故药宜
归、芎、参、 、鹿茸、肉桂之类;自浆足以至落痂,俱欲气血收敛成就,故药宜连
翘、米仁、茯苓、首乌、芍药、木通之类、既利脓浆下行,复助其收,秋冬实之令也。
至于倒靥者,虽当靥期,其毒末得浆化,即欲靥而内攻也,故名倒靥,其治犹当类采初
起攻托血热之药矣。
正虚症,宜人参、熟地、当归、酒炒白芍、枣仁、茯神、茯苓、麦冬、五味、桔
梗、远志、白术、米仁、山药、黄 、甘草、陈皮、大枣、圆眼、莲肉、陈米、木香、诃
子、肉果、炮姜、桂、附之类,随候采用。
邪实症,宜连翘、当归、芍药、生地、玄参、土贝母、甘草、金银花、粘子、丹
皮、桔梗、酒炒苓连,栀子、龙胆。地丁草、花粉、灯心、乳香、没药、角刺、血竭、僵
蚕、白芷、牛黄、珍珠之类,随候采用。
以上凡气虚条内,备列平补温补两类药品于中,以愚随候采用。其凉补之味,补入
血热条内,盖气有余者便是火,虚热者不可投凉药耳。
气虚导致痘疹不能结痂的症状,适宜选用人参、黄芪、炙甘草、肉桂、白芷、白术、陈皮、萆薢、山药、何首乌、酒炒当归、白芍、熟地黄、茯苓、薏苡仁、木香、丁香、肉豆蔻、炮姜、莲子肉、附子、陈仓米、龙眼肉、木通等药物,根据具体证候灵活选用。凡是痘疹进入灌浆期后使用人参,应当注意人参用量宜多还是宜少,因为此时重在补益中气而轻于固护肌表,且人参性味升提托举,若使肺气过于升散则很难结痂,况且痘疹欲退时若再强行托举,会导致气机升降紊乱,反而使毒邪内攻。
血热导致痘疹倒陷不能结痂的症状,适宜选用天虫(僵蚕)、穿山甲片、酒炒黄芩黄连、生地黄、当归、赤芍、酒红花、烧人粪、连翘、牛蒡子、玄参、生甘草、桔梗、皂角刺、紫草茸、粘米、大桑虫、人牙、龙脑(冰片)、猪尾血、狗蝇等药物,根据具体证候灵活选用。凡是自见点直至灌脓阶段,都要求气血与毒邪一同升浮生长,所以药物适宜选用当归、川芎、人参、黄芪、鹿茸、肉桂等;自浆足至落痂阶段,都要求气血收敛成就,所以药物适宜选用连翘、薏苡仁、茯苓、首乌、芍药、木通等,既利于脓浆下行,又帮助收口,这是顺应秋冬收藏之令。至于倒靥者,虽然到了应结痂的时期,但毒邪尚未化为脓浆,即使想结痂也会向内攻伐,所以名叫倒靥,其治疗仍应当类似初起时攻托血热的药物来选用。
正虚症状,适宜用人参、熟地黄、当归、酒炒白芍、酸枣仁、茯神、茯苓、麦冬、五味子、桔梗、远志、白术、薏苡仁、山药、黄芪、甘草、陈皮、大枣、圆眼(龙眼肉)、莲子肉、陈仓米、木香、诃子、肉豆蔻、炮姜、桂枝、附子等药物,根据具体证候灵活选用。
邪实症状,适宜用连翘、当归、芍药、生地黄、玄参、土贝母、甘草、金银花、粘子(葶苈子或指代某类种子药,此处保留原名)、牡丹皮、桔梗、酒炒黄芩黄连、栀子、龙胆草、地丁草、天花粉、灯心草、乳香、没药、皂角刺、血竭、僵蚕、白芷、牛黄、珍珠等药物,根据具体证候灵活选用。
以上凡在气虚条内,备列平补和温补两类药品在其中,以便我随证候灵活选用。那些凉补性质的药物,补充列入血热条内,因为气有余便是火,虚热者不可投用凉药。
For symptoms of failure to form scabs due to Qi deficiency, it is appropriate to select Ren Shen (Ginseng Radix), Huang Qi (Astragali Radix), Zhi Gan Cao (Honey-fried Licorice Root), Rou Gui (Cinnamon Bark), Bai Zhi (Angelicae Dahuricae Radix), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Chen Pi (Tangerine Peel), Bi Xie (Dioscoreae Hypoglaucae Rhizoma), Shan Yao (Dioscoreae Rhizoma), He Shou Wu (Polygoni Multiflori Radix), Jiu Chao Dang Gui (Wine-processed Angelicae Sinensis Radix), Bai Shao (Paeoniae Radix Alba), Shu Di Huang (Rehmanniae Radix Preparata), Fu Ling (Poria), Yi Yi Ren (Coicis Semen), Mu Xiang (Aucklandiae Radix), Ding Xiang (Caryophylli Flos), Rou Dou Kou (Myristicae Semen), Pao Jiang (Prepared Ginger), Lian Rou (Lotus Seed), Fu Zi (Aconiti Lateralis Radix Preparata), Chen Mi (Stored Rice), Long Yan Rou (Longan Aril), and Mu Tong (Akebiae Caulis), selecting according to the specific syndrome. When using Ren Shen after the pustule stage has begun, one must consider whether the dosage should be high or low; this is because the treatment prioritizes tonifying the Middle Jiao while lightly securing the exterior. Moreover, Ren Shen has an ascending and lifting nature; if it causes excessive lung Qi ascent, scabbing will be difficult. Furthermore, if the pox is about to resolve but is forcibly lifted, it will cause irregular ascending and descending of Qi, leading to the counter-attack of toxins inward.
For symptoms of inverted scabbing due to Blood heat, it is appropriate to select Tian Chong (Bombyx Batryticatus), Jia Pian (Testudo Carapax et Plastrum), Jiu Chao Qin Lian (Wine-processed Scutellariae Radix and Coptidis Rhizoma), Sheng Di Huang (Rehmanniae Radix), Dang Gui (Angelicae Sinensis Radix), Chi Shao (Paeoniae Radix Rubra), Jiu Hong Hua (Wine-processed Carthami Flos), Shao Ren Fen (Burned Human Feces), Lian Qiao (Forsythiae Fructus), Niu Bang Zi (Arctii Fructus), Xuan Shen (Scrophulariae Radix), Sheng Gan Cao (Raw Licorice Root), Jie Geng (Platycodonis Radix), Jiao Ci (Gleditsiae Spina), Zi Cao Rong (Arnebiae Radix seu Rhizoma), Zhan Mi (Sticky Rice), Da Sang Chong (Large Silkworm), Ren Ya (Human Tooth), Long Nao (Borneolum Syntheticum), Zhu Wei Xue (Porcine Tail Blood), and Gou Ying (Canis Flea), selecting according to the specific syndrome. From the initial appearance of spots until pus formation, Qi and Blood are desired to ascend and float together with the toxin for growth and nourishment; therefore, medicines such as Dang Gui, Chuan Xiong, Ren Shen, Huang Qi, Lu Rong (Cervi Cornu Pantotrichum), and Rou Gui are suitable. From the time the pustules are full until the scabs fall off, Qi and Blood are desired to converge and mature; therefore, medicines such as Lian Qiao, Yi Yi Ren, Fu Ling, Shou Wu, Shao Yao, and Mu Tong are suitable. This facilitates the downward flow of pus and plasma while assisting in contraction, complying with the principle of storage in autumn and winter. As for inverted scabbing, although it occurs during the period when scabs should form, the toxin has not yet transformed into pus; even if scabbing is attempted, it attacks inward. Hence it is named inverted scabbing, and its treatment should still involve selecting medicines similar to those used for attacking and lifting blood heat at the initial stage.
For symptoms of true deficiency, it is appropriate to use Ren Shen, Shu Di Huang, Dang Gui, Jiu Chao Bai Shao, Zao Ren (Ziziphi Spinosae Semen), Fu Shen (Poria with Hostwood), Fu Ling, Mai Dong (Ophiopogonis Radix), Wu Wei Zi (Schisandrae Chinensis Fructus), Jie Geng, Yuan Zhi (Polygalae Radix), Bai Zhu, Yi Yi Ren, Shan Yao, Huang Qi, Gan Cao, Chen Pi, Da Zao (Jujubae Fructus), Yuan Yan (Longan Aril), Lian Rou, Chen Mi, Mu Xiang, He Zi (Terminalia Chebulae Fructus), Rou Dou Kou, Pao Jiang, Gui Zhi (Cinnamomi Ramulus), and Fu Zi, selecting according to the specific syndrome.
For symptoms of pathogenic excess, it is appropriate to use Lian Qiao, Dang Gui, Shao Yao, Sheng Di Huang, Xuan Shen, Tu Bei Mu (Fritillariae Thunbergii Bulbus), Gan Cao, Jin Yin Hua (Lonicerae Japonicae Flos), Zhan Zi (likely referring to a seed herb, kept as original name), Mu Dan Pi (Moutan Cortex), Jie Geng, Jiu Chao Qin Lian, Zhi Zi (Gardeniae Fructus), Long Dan Cao (Gentianae Radix), Di Ding Cao (Violaris Herba), Hua Fen (Trichosanthis Radix), Deng Xin Cao (Junci Medulla), Ru Xiang (Olibanum), Mo Yao (Myrrha), Jiao Ci, Xue Jie (Santalum Album), Jiang Can (Bombyx Batryticatus), Bai Zhi, Niu Huang (Bovis Calculus), and Zhen Zhu (Margarita), selecting according to the specific syndrome.
In all the above items under Qi deficiency, both mild tonifying and warm tonifying categories of medicines are listed for flexible selection according to the syndrome. Those with cool-tonifying properties are added to the Blood Heat section, because excess Qi transforms into fire, and those with deficient heat should not be administered cooling medicines.