夫顺祥者,福之基;妖孽者,祸之萌。凡出痘之家,最宜内外肃静,吉之兆也。若
有鸦鼠喧关,虚乡火光,蝙蝠入室葱志扑,人感犬哭无时,蛇呈非候,夜生怪梦,病见
死人者,是皆不祥之兆,然外兆虽征而内修克谨,亦可转祸为福也。
痘疮轻者自无乘,逆险从来有后灾,不是毒邪根里得,或因调治误中来。
痘后留邪作肿痈,或为结核论相同,但将毒瓦斯分深浅,莫使余枭透骨缝。
看在何经用引经,肿时不与溃时论,补中托里分虚实,决毒排脓视浅深。
毒散皮肤有数瘢,或为瘾疹或成丹,丹瘤凝结从深论,瘾疹分疏作浅看。
而今泄利又何如,治法难将一例拘,能食渴多知是热,脉微食少又为虚。
泄泻古人原有别,肠垢 溏分冷热。若还脓血并痂皮,勿使汤丸轻止涩。
一向蒸蒸热未除,治宜祥审勿差殊,便难烦渴方为实,清便饥疲本是虚。
终日昏昏似醉人,口中妄语若邪侵,谁知热入心包络,解毒安神泰字精。
沉沉喜睡不知人,饮食俱妄唤不醒,邪毒从今都解散,精神自此渐和平。
痘后须知气血虚,百般疾病贵调持。若兼痂突瘢红紫,解毒凉荣作有余。
夫男女患痘,固无异也。但痘以气为主,而血为附,故气以煦之,血以濡之,一
或不足,则变生焉。女子乃系阴质,十四岁已后出痘者,常恐天癸之行,荣血一走,卫
气随虚,即成陷伏,惟斯异耳。然有痘疹发热,却非天癸之期,经水忽行者,此因毒火
内动,扰乱血海,是以迫经妄行,未及期而至也。其疮必多,其毒必甚,宜玄参地黄
汤,凉血解毒为主,使热得清,毒得解,痘得出,经水止,方无变患。如久不止,则中
气虚弱而成陷伏,十全汤补而托之。更有发热之时,正值天癸之期,经水适来者,此则
积污得去,毒亦稍解,热随血清而疮自出,不须施治,更不必止之,惟过四日而犹不止
者,是又邪乘血室之虚而迫血妄行,为内动中虚之症矣。宜先服小柴胡,加生地黄汤,
以清血室之热,后用十全大补汤,以补气血之虚,令易出易发易靥可也。更恐经走则
虚触其恶气,则痘乘虚多变,宜用芫荽煎汤,洗净其外,两以香艾揉熟去梗,净布包
果紧纳阴中,时时更换,再服参、 、归、地。升麻、僵蚕、蝉蜕之类。虚寒者,加入炒黑干姜。
所谓顺境吉祥,是福气的根基;妖孽怪异,是灾祸的萌芽。凡是出痘(天花)的人家,最宜保持内外环境的肃静,这是吉利的征兆。如果有乌鸦老鼠在关隘喧闹,虚荒之乡火光冲天,蝙蝠飞入室内葱志扑腾,人听到狗无时不哭,蛇出现不合时令,夜里做怪梦,梦中见到死人等,这些都是不祥的征兆。然而,虽然外在征兆已现,只要内心修养谨慎克制,也可以转祸为福。
痘疮轻症的自不会乘势发作,逆证险症从来都有后患,这并非因为毒邪从根底得来,往往是因为调治失误造成的。
痘后遗留邪气导致肿胀痈疽,或者形成结核,其论述与上述相同。只需将毒瓦斯分为深浅程度,不要让残余的恶毒透入骨缝。
根据病变所在的经络使用引经药,肿胀时期不与溃破时期同样论治,补益中气、托毒外出要分辨虚实,决断排毒排脓要看毒邪的深浅。
毒邪散于皮肤留下数个瘢痕,或者成为瘾疹(荨麻疹类),或者形成丹毒。丹瘤凝结要从深层论治,瘾疹分疏则作浅层看待。
现在的泄泻又该如何?治疗方法难以用一种例法拘泥。能进食且口渴多者知道是热证,脉象微弱、饮食减少则是虚证。
关于泄泻,古人原本就有区别,肠垢(痢疾样便)和溏便(稀便)要区分冷证和热证。如果还有脓血并夹杂痂皮,不要使汤剂丸药轻易使用收敛止涩之法。
一直蒸蒸发热未除,治疗应当详审勿出差错。小便困难、烦躁口渴才是实证,小便清利、饥饿疲乏本是虚证。
整天昏昏沉沉像喝醉的人,口中胡言乱语好像邪气侵入,谁知道是热邪进入心包络,解毒安神以“泰”字诀最为精妙。
沉沉欲睡不知人事,饮食都妄想,呼唤不醒,邪毒从此全部解散,精神自此逐渐平和。
痘后须知气血虚弱,各种疾病贵在调理扶持。如果兼见痂皮突起、瘢痕红紫,解毒凉血视为有余之证。
男女患痘,本来没有不同。但痘以气为主,而血为辅,所以气来温煦它,血来濡润它,一旦不足,就会变生他病。女子属于阴质,十四岁以后出痘的,常担心天癸(月经)的到来,营血一走,卫气随之虚弱,即成陷伏证,这是唯独不同的地方。然而有痘疹发热,却非天癸之期,经水忽然行来的,这是因为毒火内动,扰乱血海,因此逼迫经脉妄行,未到经期而至。其疮必多,其毒必甚,适宜用玄参地黄汤,以凉血解毒为主,使热得清,毒得解,痘得出,经水止,才没有变患。如果久不止,则中气虚弱而成陷伏证,用十全汤补益而托举它。更有发热之时,正值天癸之期,经水适逢到来的,这则是积污得以去除,毒邪也稍解,热随血清而疮自然发出,不需要施治,更不必强行止血,只是过了四天仍然不止的,这是又邪气乘血室之虚而逼迫血液妄行,属于内动中虚的病症了。适宜先服小柴胡加生地黄汤,以清血室之热,后用十全大补汤,以补气血之虚,令痘易出、易发、易结痂脱落。更担心经血走泄则虚体触及其恶气,则痘乘虚多变,适宜用芫荽煎汤,洗净其外阴部,再用香艾揉熟去梗,干净布包裹果实紧紧纳入阴道中,时时更换,再服用人参、[缺字]、当归、地黄、升麻、僵蚕、蝉蜕之类。虚寒者,加入炒黑干姜。
Shunxiang (auspicious signs) are the foundation of fortune; yaonie (monsters and omens) are the germination of disaster. In households where smallpox (Dou Chuang, 痘疮) is erupting, it is most appropriate to maintain solemnity and quietness inside and outside, which is an auspicious omen. If there is noise from crows and rats at the gates, firelight in desolate villages, bats fluttering into rooms amidst green onions, people hearing dogs crying incessantly, snakes appearing out of season, strange dreams occurring at night, or seeing dead people in dreams, these are all inauspicious omens. However, although external omens have manifested, if one cultivates oneself with caution and restraint internally, disaster can be turned into fortune.
Mild cases of smallpox naturally do not escalate; adverse and dangerous cases always have subsequent disasters. This is not because toxic pathogens originate from the root, but often due to errors in treatment.
Residual pathogens remaining after smallpox cause swelling and carbuncles, or form tubercles, which are discussed similarly. One must distinguish the depth of the toxic qi, preventing residual evil from penetrating the bone seams.
Use channel-guiding herbs according to the affected meridian; the treatment for swelling differs from that for ulceration. Tonifying the middle and supporting the interior requires distinguishing deficiency and excess; resolving toxins and draining pus depends on the depth of the toxin.
When toxins scatter on the skin leaving several scars, they may manifest as yinzhen (urticaria-like rashes) or chengdan (erysipelas-like redness). Danliu (nodular erysipelas)凝结 requires deep-level analysis, while scattered yinzhen is viewed as superficial.
How should diarrhea now be treated? Therapeutic methods cannot be rigidly confined to a single pattern. The ability to eat and excessive thirst indicate heat; a faint pulse and poor appetite indicate deficiency.
Ancients distinguished diarrhea: changgou (dysenteric discharge) and tangbian (loose stools) differentiate cold from heat. If pus and blood mix with scabs, avoid using decoctions or pills that lightly employ astringent methods to stop diarrhea.
If steaming fever persists without removal, treatment must be carefully examined to avoid error. Difficulty urinating, irritability, and thirst indicate excess; clear urine, hunger, and fatigue indicate deficiency.
Constant drowsiness resembling drunkenness, with delirious speech as if invaded by evil, indicates that heat has entered the Xinbaoluo (Pericardium). Jiedu Anshen (resolving toxins and calming the spirit), particularly the "Tai" principle, is exquisite.
Deep sleep unaware of surroundings, delusions regarding food and drink, unresponsive to calls, indicates that pathogenic toxins are now dispersing, and spirit gradually returns to peace.
After smallpox, one must know that Qi and Blood are deficient; various diseases require careful regulation. If accompanied by protruding scabs and red-purple scars, resolving toxins and cooling the Ying (Nutrient) level is considered treating excess.
Men and women suffering from smallpox are fundamentally no different. However, smallpox is primarily governed by Qi, with Blood as its accessory. Qi warms it, and Blood moistens it. If either is insufficient, complications arise. Women possess Yin constitution. For those who develop smallpox after age fourteen, one often fears the onset of Tiangui (menstruation). When Ying Blood flows away, Wei (Defensive) Qi follows and becomes deficient, leading to collapse and internalization (Xianfu, 陷伏), which is a unique difference.
However, if there is fever from smallpox-rash, yet it is not the time for menstruation, and menses suddenly begin, this is because toxic fire moves internally, disturbing the Xuehai (Sea of Blood), forcing the meridians to flow recklessly before their time. The sores will be numerous, and the toxicity severe. It is suitable to use Xuanshen Dihuang Tang (Scrophulariae and Rehmanniae Decoction), focusing on cooling Blood and resolving toxins, so that heat clears, toxins resolve, smallpox erupts, and menstruation stops, avoiding complications. If bleeding persists for a long time, Middle Qi becomes weak, leading to collapse; Shiquan Tang (Ten Complete Decoction) should be used to tonify and support.
Furthermore, if fever occurs precisely during the menstrual period, and menses arrive just then, this means accumulated filth is expelled, and toxicity is slightly resolved. Heat clears with the Blood, and sores emerge naturally. No treatment is needed, nor is it necessary to stop the bleeding. However, if it continues beyond four days, this indicates pathogenic factors taking advantage of the emptiness of the Xueshi (Blood Chamber) to force reckless blood flow, constituting a syndrome of internal movement and central deficiency. It is suitable to first administer Xiaochaihu Tang plus Sheng Dihuang Tang (Minor Bupleurum Decoction with Fresh Rehmannia) to clear heat from the Blood Chamber, followed by Shiquan Dabu Tang (Ten Complete Great Tonifying Decoction) to tonify Qi and Blood deficiency, allowing the rash to emerge, develop, and crust easily.
One must also fear that if menstruation flows, the deficient body may contact foul qi, causing the smallpox to change unpredictably due to deficiency. It is suitable to use Yansui decoction (Descurainia Soup) to wash the external genitalia. Then, take aromatic mugwort (Xiang Ai, 香艾), rub until soft, remove stems, wrap tightly in clean cloth, and insert firmly into the vagina, changing frequently. Additionally, administer Ren Shen (Ginseng), [missing character], Dang Gui (Angelica Sinensis), Di Huang (Rehmannia), Sheng Ma (Cimicifuga), Jiang Can (Bombyx Batryticatus), Chan Tui (Cicada Slough), etc. For deficiency-cold, add Chao Hei Gan Jiang (Stir-fried Blackged Ginger).