痘疮干哕病势沉，毒热上逆正虽禁，实热橘皮竹茹剂，虚寒丁香柿蒂神。
[注]
干哕者，有声无物，其声重大而长，属阳明胃经也，缘毒热上逆所致，
又有胃气不足，不能容受，复有寒邪客于胃中，
使胃气不能中主上行而哕也，
热者橘皮竹茹汤主之，寒者丁香柿蒂汤主之。
(橘皮竹茹汤) 橘红 半夏姜制 麦门冬去心 枇杷叶姜炙 甘草生 竹茹
赤苓 人参 引用芦根水煎服。
(方歌)
橘皮竹茹汤如神，专医胃热呕逆频，橘半麦冬枇杷草，竹茹赤苓与人参。
(丁香柿蒂汤) 丁香 人参 高良姜 柿蒂 水煎服。
(方歌)
丁香柿蒂汤治寒，胃气上逆不得安，丁香良姜人参共，更入柿蒂一同煎。
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痘中杂证
毒盛呕吐二陈良，吞咽不利鼠粘汤，伤食吐酸大安效，气虚作呕和胃方。
[注]
呕者有物有声，吐者有物无声，二证皆属于胃，
痘初出，呕吐者是火邪犯胃，毒气上腾，痘必红紫，宜栀连二陈汤，
自起胀至收靥，呕吐者，是疮集咽门，吞咽不利所致，须用鼠粘子汤，
若伤食呕吐者，吐必腥酸，宜用木香大安九，
设吐后精神困倦，不思饮食，乃胃气虚也，以参砂和胃汤主之。
(栀连二陈汤) 陈皮 半夏姜炒 茯苓 甘草生 栀子姜炒 川黄连姜炒
引用生姜水煎服。
(方歌)
毒气冲胃吐频频，医治须宜用二陈，陈半茯苓生甘草，栀连姜炒效如神。
(加味鼠粘子汤)
桔梗 射干 连翘去心 荆芥 防风 山豆根 鼠粘子炒研
干葛 水煎服
(方歌)
加味鼠粘汤极合，桔梗射干同连翘，荆芥防风山豆根，鼠粘子炒配干葛。
(木香大安丸) 方见惊搐。
(参砂和胃汤) 人参 白术土炒 藿香 茯苓 陈皮 半夏姜制 缩砂仁 甘草炙
引用煨姜水煎服。
(方歌)
虚吐参砂和胃汤，人参白术共藿香，茯苓陈皮制半夏，缩砂甘草引煨姜。
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痘中杂证
痘疮出现干哕，病势沉重，这是毒热之气上逆所致。虽然原则上对于正气虚损者应禁止使用攻伐之法，但若属实热证，宜用橘皮竹茹汤治疗；若属虚寒证，丁香柿蒂汤则效果神奇。
[注]
所谓干哕，是指只有声音而没有呕吐物，其声音宏大且长，这属于阳明胃经的病症。其原因多因毒热之气上逆引起；也有因胃气不足，无法容纳受纳，加之寒邪客居于胃中，导致胃气不能正常主司上行而引发哕症。对于热证，以橘皮竹茹汤为主治方剂；对于寒证，以丁香柿蒂汤为主治方剂。
（橘皮竹茹汤）组成：橘红、半夏（姜制）、麦门冬（去心）、枇杷叶（姜炙）、甘草（生）、竹茹、赤茯苓、人参。引用芦根水煎服。
（方歌）
橘皮竹茹汤效如神，专治胃热引起的频繁呕逆。方中包括橘红、半夏、麦冬、枇杷叶、甘草、竹茹、赤茯苓与人参。
（方歌）
丁香柿蒂汤主治寒证，针对胃气上逆导致的不得安宁。方中丁香、良姜、人参共用，再加入柿蒂一同煎煮。
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痘疹中的杂证
痘疹中因毒盛引起的呕吐，用二陈汤疗效良好；吞咽不利者，用鼠粘子汤；伤食导致的吐酸，用木香大安丸有效；气虚引起的作呕，用和胃方调理。
[注]
呕是指既有声音又有呕吐物，吐是指有呕吐物但没有声音。这两种症状都归属于胃。
在痘疹初出阶段，出现呕吐是因为火邪侵犯胃腑，毒气上腾，此时痘色必呈红紫色，宜用栀连二陈汤治疗；
从起胀到收靥期间，出现呕吐，是因为疮毒聚集于咽门，导致吞咽不利，必须使用鼠粘子汤；
若是伤食引起的呕吐，呕吐物必有腥酸味，宜用木香大安丸；
如果呕吐后精神困倦，不思饮食，这是胃气虚弱的表现，应以参砂和胃汤为主治方剂。
（栀连二陈汤）组成：陈皮、半夏（姜炒）、茯苓、甘草（生）、栀子（姜炒）、川黄连（姜炒）。引用生姜水煎服。
（方歌）
毒气冲犯胃腑导致频频呕吐，医治适宜使用二陈汤。方中包含陈皮、半夏、茯苓、生甘草，加上姜炒的栀子与黄连，效如神验。
（加味鼠粘子汤）组成：桔梗、射干、连翘（去心）、荆芥、防风、山豆根、鼠粘子（炒研）、干葛。水煎服。
（方歌）
加味鼠粘汤极为合适，包含桔梗、射干同连翘，以及荆芥、防风、山豆根，鼠粘子炒制后配伍干葛。
（木香大安丸）方见惊搐章节。
（参砂和胃汤）组成：人参、白术（土炒）、藿香、茯苓、陈皮、半夏（姜制）、缩砂仁、甘草（炙）。引用煨姜水煎服。
（方歌）
虚证呕吐用参砂和胃汤，由人参、白术共配藿香，茯苓、陈皮、姜制半夏，缩砂仁、甘草引煨姜入药。
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痘疹中的杂证
In the context of smallpox, dry hiccups indicate a severe disease progression. This condition is caused by the upward reversal of toxic heat. Although purgative methods are generally contraindicated for patients with deficient righteous qi, if the pattern is excess heat, Chuanpi Zhuru Tang (Tangerine Peel and Bamboo Shavings Decoction) should be used; if the pattern is deficiency-cold, Dingxiang Shidi Tang (Clove and Persimmon Calyx Decoction) is miraculous.
[Note]
Dry hiccups refer to a state where there is sound but no vomitus. The sound is loud and prolonged, indicating involvement of the Yangming Stomach Meridian. The etiology is primarily due to the upward reversal of toxic heat. Alternatively, it may result from insufficient Stomach Qi, which fails to accommodate and receive, compounded by cold pathogens lodging in the Stomach. This prevents Stomach Qi from ascending properly, thereby causing hiccups. For heat patterns, Chuanpi Zhuru Tang is the primary formula; for cold patterns, Dingxiang Shidi Tang is the primary formula.
(Chuanpi Zhuru Tang [Tangerine Peel and Bamboo Shavings Decoction]) Ingredients: Chenpi (Citri Reticulatae Pericarpium), Banxia (Pinelliae Rhizoma, prepared with ginger), Maimendong (Ophiopogonis Radix, heart removed), Pipaye (Eriobotryae Folium, roasted with ginger), Gancao (Glycyrrhizae Radix et Rhizoma, raw), Zhuru (Bambusae Caulis in Taeniam), Chiling (Poria), Renshen (Panacis Ginseng Radix). Decoct with Luzhen (Phragmitis Rhizoma) water as a reference.
(Fangge [Prescription Song])
Chuanpi Zhuru Tang works like magic,
Specially treating frequent vomiting and counterflow due to Stomach heat.
It contains Tangerine Peel, Pinellia, Ophiopogon, Loquat Leaf, Licorice,
Bamboo Shavings, Poria, and Ginseng.
(Dingxiang Shidi Tang [Clove and Persimmon Calyx Decoction]) Ingredients: Dingxiang (Syzygdii Aromatisati Flos), Renshen (Panacis Ginseng Radix), Gaoliangjiang (Alpiniae Officinarum Rhizoma), Shidi (Diospyri Calyx). Decoct with water.
(Fangge [Prescription Song])
Dingxiang Shidi Tang treats cold patterns,
Addressing Stomach Qi counterflow that causes unrest.
Clove, Galangal, and Ginseng are combined,
Along with Persimmon Calyx, decocted together.
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Miscellaneous Syndromes in Smallpox
For vomiting caused by excessive toxicity in smallpox, Erchen Tang (Two-Aged Decoction) is effective. For difficulty in swallowing, Shuniu Tang (Arctii Decoction) is indicated. For vomiting of sour fluid due to food stagnation, Muxiang Da'an Wan (Aucklandia Great Peace Pill) is efficacious. For vomiting due to Qi deficiency, Hewei Fang (Harmonize the Stomach Formula) should be used.
[Note]
Ou (vomiting with sound) involves both sound and vomitus, whereas Tu (spitting up/vomiting without sound) involves vomitus without sound. Both syndromes belong to the Stomach.
During the initial eruption stage of smallpox, vomiting is caused by Fire Pathogens invading the Stomach and Toxic Qi surging upward. In this case, the pustules will appear red or purple, and Zhilian Erchen Tang (Gardenia and Coptis Two-Aged Decoction) is appropriate.
From the swelling stage to the crusting stage, vomiting occurs because the sores accumulate at the pharynx, causing difficulty in swallowing. Shuniu Zi Tang (Arctii Seed Decoction) must be used.
If vomiting is due to food stagnation, the vomitus will have a fishy and sour odor; Muxiang Da'an Wan is suitable.
If after vomiting the patient appears listless and has no appetite, this indicates Stomach Qi deficiency. Shen Sha Hewei Tang (Ginseng and Amomum Harmonize the Stomach Decoction) should be administered.
(Zhilian Erchen Tang [Gardenia and Coptis Two-Aged Decoction]) Ingredients: Chenpi (Citri Reticulatae Pericarpium), Banxia (Pinelliae Rhizoma, stir-fried with ginger), Fuling (Poria), Gancao (Glycyrrhizae Radix et Rhizoma, raw), Zhizi (Gardeniae Fructus, stir-fried with ginger), Chuanhuilian (Coptidis Rhizoma, stir-fried with ginger). Decoct with Shengjiang (Zingiberis Rhizoma Recens) water as a reference.
(Fangge [Prescription Song])
When Toxic Qi rushes to the Stomach causing frequent vomiting,
Treatment requires the use of Erchen Tang.
It includes Tangerine Peel, Pinellia, Poria, and Raw Licorice,
With Gardenia and Coptis stir-fried with ginger, proving as effective as divine intervention.
(Jiawei Shuniu Zi Tang [Modified Arctii Seed Decoction]) Ingredients: Jiegeng (Platycodonis Radix), Shegan (Belamcandae Rhizoma), Lianqiao (Forsythiae Fructus, heart removed), Jingjie (Schizonepetae Herba), Fangfeng (Saposhnikoviae Radix), Shandougen (Sophorae Tonkinensis Radix), Shuniu Zi (Arctii Fructus, stir-fried and ground), Gange (Puerariae Radix). Decoct with water.
(Fangge [Prescription Song])
The Modified Arctii Decoction is highly appropriate,
Combining Platycodon, Belamcanda, and Forsythia.
Schizonepeta and Saposhnikovia are added,
Along with stir-fried Arctii seed paired with Kudzu root.
(Muxiang Da'an Wan [Aucklandia Great Peace Pill]) See the section on Convulsions.
(Shen Sha Hewei Tang [Ginseng and Amomum Harmonize the Stomach Decoction]) Ingredients: Renshen (Panacis Ginseng Radix), Baizhu (Atractylodis Macrocephalae Rhizoma, stir-fried with earth), Huoxiang (Agastaches Herba), Fuling (Poria), Chenpi (Citri Reticulatae Pericarpium), Banxia (Pinelliae Rhizoma, prepared with ginger), Suosharen (Amomi Fructus), Gancao (Glycyrrhizae Radix et Rhizoma, honey-roasted). Decoct with Weijiang (Zingiberis Rhizoma Praeparatum) water as a reference.
(Fangge [Prescription Song])
For deficiency-type vomiting, Shen Sha Hewei Tang is used,
Comprising Ginseng, Atractylodes, and Agastache.
Poria, Tangerine Peel, and Prepared Pinellia are included,
With Amomum and Licorice, guided by Roasted Ginger.
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Miscellaneous Syndromes in Smallpox