尝谓小儿病证虽多。而疮疹最为重病。何则。疮疹之病。盖初起疑似难辨。投以他药。不惟无益。
抑又害之。况不言受病之状。孰知畏恶之由。父母爱子。急于救疗医者失察。用药差舛。鲜有不致夭
横者。文中每思及此。恻然于心。因取家藏已验之方。集为一卷。名之曰小儿痘疹方论。刻梓流布。
以广古人活幼之意。顾不韪欤。
和安郎判太医局兼翰林良医陈文中谨书
夫小儿在胎之时。乃母五脏之液所养成形也。其母不知禁戒。纵情浓味。好啖辛酸。或食毒物。
其气传于胞胎之中。此毒发为疮疹。名曰三秽液毒。○一、五脏六腑秽液之毒。发为水泡疮。○二、
皮膜筋肉秽液之毒。发为脓血水 疮。三、毒既出。发为疹痘疮也。子母俱忌食葱 、薤蒜、醋酒、
盐酱、獐兔、鸡犬、鱼腥等物。世俗未晓。将为发举。往往罔顾其后。误伤者多矣。
况小儿痘疹未出已出之间。有类伤寒之状。憎寒壮热。身体疼痛。大便黄稠。此正病也。若无他
疾。不必服药。
愚按痘疹。若小儿首尾平和。自有勿药之喜。盖其肠胃软弱易为虚实。故必不得已。折其太过。
益其不足可也。
凡疗疮疹。先分表里虚实。如表里俱实者。其疮易出易靥。表里俱虚者反是。表
实里虚者。其疮易出难靥。表虚里实者亦反是。若始出一日至十日。浑身壮热。大便黄稠。乃表里俱
实。其疮必光泽起发满肥。且易靥也。
愚按治痘疹之法。与痈疽无异。若邪气在里而实热者。用前胡、枳壳散元气。怯而虚热者。用参
四圣散。虚弱者。用紫草木香汤。虚寒者。用参 内托散。虚寒内脱者。用木香散。若邪气在表而实
热者。用麻黄甘葛汤。此要法也。余见各症。
凡疮疹已出未出之间。或泻渴。或腹胀。或气促。谓之里虚。急用十一味木香散治之。
愚按经云真气夺则虚。邪气胜则实。实谓邪气实而真气虚也。然倒靥泻渴等症。若喜热饮食。手
足并冷。或不食呕吐者。是为阳气虚寒也。用辛热之剂补之。喜冷冻饮料食。手足不冷。或唇舌黑裂者。
阳气实热也。用苦寒之剂泻之。
凡疮疹已出未愈之间。不光泽。不起发。不红活。谓之表虚。急用十二味异功散治之。
愚按张翼之云。吐泻少食为里虚陷伏。倒靥灰白为表虚。二者俱见。为表里俱虚。用异功散救之。
甚至姜、附、灵、砂、亦可用。若止里虚。减官桂。止表虚。减肉豆蔻。若能食便闭而陷伏倒靥者为
里实。轻用射干鼠粘子汤。重用前胡枳壳散。下利吐泻能食为里实。若用食里则结痈毒。红活绽凸为
表实。若用补表。
则溃烂不结痂。凡痘一见斑点。便忌葛根汤。恐发得表虚也。
凡痘疮已出未愈之间。不光泽。不起发。不红活。或腹胀。或泻渴。或气促。谓之表里俱虚。急
用十二味异功散。送七味肉豆蔻丸治之。
愚按前症。审悉表里虚寒。急用前法。缓则不救。○一小儿出痘。不起发、红活、腹胀、泻渴。
皆以为不治。施院使谓表里虚寒。用十二味异功散一剂。即起发红活。诸症顿退。又用参 内托散贯
脓而靥。○儒者薛戒甫子五岁。出痘三四日。下紫血。日数滴。至八日不止而疮不起。御医钱春林谓
脾气虚寒。用木香散二剂。用丁香十一粒。人参五钱。一日服之。次日痘皆起而有脓。由是血渐止。
二十余日而愈。○一小儿起发、红活。但不时作痒。口干作渴。便血。面赤发热。先君谓肠胃有热。
先用济生犀角地黄汤。加柴胡一剂。诸症渐退。形体倦怠。此邪气去而形气虚弱耳。用四君子汤。加
当归、黄 、红花。二剂而安。○一小儿痘疹赤痛。烦热作渴。或便血。或衄血。先君用犀角地黄汤
而血愈。又用紫草快 汤。加黄 、芍药而
愈。后疮痕色白。用四君、归、 治之而痊。○一小儿出痘吐血。其痘赤痛如锥。或疮出血。余谓肝
火炽盛。用小柴胡汤加生地一剂。随用济生犀角地黄汤一剂顿愈。又用芹菜汁而痊。○一小儿痘疮下
血而不起发。先君谓气血不足。用紫草快 汤。加参、 、归、术治之。血止疮起。但贯脓迟缓。用
八珍汤倍加参、 。数剂疮靥而根白痒。此气血虚而热也。用八珍汤二十余剂而愈。○一小儿痘疹。
大便下血。小便甚赤。疮颗色赤。发热饮冷。先君谓热毒郁滞。先用八正散一剂。后用解毒防风汤一
剂顿愈。又饮芹菜汁而全痊。○一小儿痘正发而便血。倦怠少食。作渴饮汤。余谓倦怠便血。此脾虚
而不能摄血也。少食作渴。此脾虚而津液短少也。用五味异功散。加升麻、紫草。治之而愈。○一小
儿便血。腹胀困倦。发热口干饮汤。四肢逆冷。先君以为脾气虚寒不能摄血。用五味异功散。加丁香
十粒。炮姜五分。二剂血止。痘贯而靥。○一小儿七岁。患痘疮腹胀八九日矣。先君云当急补脾土。
不信。仍服消毒之药。忽大便下血甚多而殁。○一小儿作渴。泄泻。发热饮冷。唇舌皱裂。泻粪秽臭。
先君以为内热所作。用前胡枳壳散一剂稍愈。又用清凉饮加漏芦。乳母服之。儿顿安。凡小儿斑驳疹
毒之病。俗言疹子。是肺胃蕴热。因时气熏发于外。状如蚊、蚤所咬。赤则十生一死。黑则十死一生。
大抵遇春而生发。至夏而长成。乃阳气熏蒸。故得生成者也。脏腑调和。血气充实。则易出易靥。盖
因内无冷气。外常和暖也。凡痘疹热渴。切不可与瓜、柿、蜜水等冷物。及清凉饮、消毒散等药。恐
伤脾胃。则腹胀喘闷。寒战切牙而难治。盖切牙者。齿槁也。乃血气不荣。不可妄作热治。
愚按前症。若兼吐泻。手足指冷者。属内虚寒而外假热也。急用木香散。如不应。用异功散。若
大便不通。渴欲饮冷者。则前所禁蜜水之类。又当用矣。但宜审其热之虚实。若属虚热者。虽欲水拒
之而不饮。当用人参白术散。热渴自止。属实热者自甚。索水且喜而饮之。当以犀角磨水服。诸症即
解。其后亦无余毒之患矣。北方出疹。不拘冬夏。若喜冷者。再不用药。但与水饮。无有不愈。盖北
方地燥而又睡热炕故也。○一妇人患时疫将愈更出痘。疮大起发。体倦痛甚则昏愦。烦渴饮汤。不思
食。用十全大补汤及朱砂末。其痛顿止。食进体健。仍用前汤。倍加参 。十余剂而贯脓。又数剂而
愈。○一妊妇发热作渴。遍身骨节作痛。用仙方活命饮二剂。诸症稍愈。至十一日出痘百余颗。形气
甚倦。用紫草木香散。又出少许。但口干作渴。用人参白术散而渴止。用八珍汤。加丹皮、柴胡而贯
脓。后去丹皮、柴胡。倍加参、 。数剂而痘靥。○一男子年将三十出痘。根窠赤痛。发热作渴。服
紫草饮之类。前症益甚。痘裂出血。余用小柴胡加生地、犀角。二剂诸症顿减。又用圣济犀角地黄汤
而贯脓。再用八珍汤而结痂。○一小儿烦燥。饮冷不止。先君用济生犀角地黄汤顿愈。后渴而喜热。
又用当归补血汤而痊。惟倦怠少食。用七味白术散而瘥。○一小儿患此。饮冷不止。或痘胀痛。先君
用济生犀角地黄汤。并芹菜汁而顿愈。
凡痘疹出不快。多属于虚。若误谓热毒壅盛。妄用宣利之剂。致脏腑受冷。荣卫涩滞。不能运达
肌肤。则疮不能起发。充满后不结实。或痂痒塌。烦燥喘渴而死。
愚按前症。亦有各经热盛壅遏而出不快者。亦有毒甚痘疔而不能发起者。亦有余毒而溃痒者。当
细审其因而药之。○一小儿九岁。出痘六日。痒塌寒战。院使钱密庵用十一味木香散二剂。贯脓。用
参托里散而靥。后痕白作痒。用十全大补汤而愈。○一小儿痘疮。脓未满。面赤
作痒。余谓气血虚而有热。欲用温补之剂。不信。乃服清热之药。至十三日疮痘色赤。虚烦作渴。腹
痛不食。手足逆冷而殁。○一小儿未周岁。痘疮 痛出血。哭不能已。诊其母有肝火。先用小柴胡。
加山栀、生地与母服。子饮数滴顿愈。又用加味逍遥散而痊。○一小儿出痘。内有痘疔数枚。虽挑破
出黑血。热毒不解。余痘不发。皆以为不治。先君以仙方活命饮徐灌一剂。痘疔解而诸痘亦愈。○一
小儿痘疔。患在臀间。色黑大痛。挑出黑血。仍服。坚痛。皆以为不治。先君用膈蒜灸数壮。痛止。
色淡而软。挑出黑血甚多。灌以活命饮。患处及诸痘贯脓而愈。
凡小儿才觉伤风身热。是否痘疹。便服四味升麻葛根汤。
愚按痘疹未明而元气实者。最宜前汤。若元气虚者。又当详治。恐发得表虚而痘难出也。○一儒
者年三十余。因劳役倦怠发热。服补中益气汤数剂。发赤点以为 。另服升麻葛根汤一剂。更加恶寒。
仍服益气汤四剂。至九日出痘甚多。余用八珍汤。加黄 、白芷、紫草四剂。至二十日脓始贯。用十
全大补汤。月余而靥。
凡痘疹始出。一日至五七日之间。虽身热或腹胀。足梢冷。或身热泻渴。或身
热惊悸。腹胀。或身热出汗者。服十一味木香散。
愚按前症属脾气虚寒假热。非此药不救。如未应。佐以六君子。专补脾气。更不应。加木香。补
骨脂、肉豆蔻。兼补肾气。○一小儿第五日不红活。至九日贯脓不满。余谓气血虚弱。用十全大补汤
治之。庶无后患。不信。至脱痂痕作痒色白。至十四日而殁。○一小儿第七日脓清不满。形气倦怠。
饮食少思。大便不实。用托里散二剂。手足指冷。切牙作渴。用木香散。倍用参、 一剂。诸症顿退。
又用参 四圣散四剂而愈。
凡泻水谷。或白色。或淡黄。煎十一味木香散。送十味肉豆蔻丸治之。泻止者住服。不止者多服。
愚按前症。若察其外症。若唇青指冷。睡而露睛。口鼻气寒。泻色青白。脾肾虚寒也。用前药六
君子汤。加补骨脂、肉豆蔻。若色赤体热。睡不露睛。口鼻气热。泻色黄赤。脾土实热也。用泻黄散。
○一小儿腹胀。渴泻。气促体倦。先君以为表里俱虚。用六君子汤加归、 。送四神丸一服。诸症顿
退。疮势顿正。但脓迟而渴。仍用前汤。加归、 二剂。疮色红活。形体颇安。任其贯脓而痊。
凡泻频。津液内耗。血气不荣。疮虽起发。亦不能靥也。如身温腹胀。切牙喘渴者难治。缘谷食
去多。津液枯渴。饮水荡散真气。故多死矣。速与十一味木香散救之。如不应。急用十二味异功散。
愚按前症。兼手足指冷。面色青白等症者。属阳气虚寒。急用木香散。阳气脱陷。用异功散。脾
气虚弱。用六君子汤。血气虚弱。用八珍汤。不应。用十全大补汤。○一小儿第九日不红活。不贯脓。
云殁于十三日。陈院长谓属虚寒。用十一味木香散二剂。渐红活。贯脓。又用紫草木香汤。及人参白
术散而愈。○族侄孙衍庆六岁。出痘稀少。疮痂悉落。至十三日。身烦热而畏寒。手足逆冷。浓衣围
火不能温。皆谓不治。余思大热而不热者。是无火也。急用人参理中汤煎服一杯。肢体顿温。更用人
参白术散调理而痊。○一男子年二十余。发热烦燥。痘黯出血。足热腰痛。用圣济犀角地黄汤二剂而
贯脓。用地黄丸料数剂而疮靥。○一男子年将三十。出痘色紫。作渴饮水。腰痛足热耳聋。余谓肾虚
之症。用加减八味丸料。煎与恣饮。热渴顿止。佐以补中益气汤。加五味。麦冬而愈。○一小儿十二
岁。出痘色黯。两足及腰热痛。便秘。咽舌干渴。引饮不绝。众谓肾虚不治。先君用加减八味丸料作
大剂。煎与恣饮。至二斤。诸症悉退。又佐以补中益气。及八珍汤各十余剂而痊。
凡四五日不大便。用嫩猪脂一块。以白水煮熟。切豆大与食之。令脏腑滋润。使疮痂易落。切不
可妄投宣泻之药。元气内虚。则疮毒入里。多伤儿也。
愚按前症。若因热内蕴。宜用射干鼠粘子汤解之。或发热作喝。或口舌生疮。或咽喉作痛。并宜
用之。
凡疮疹初出。两三日至十三日。当忌外人及卒暴风寒秽恶之气。轻者三次出。大小不一。头面稀
少。眼中无根。窠红肥满光泽也。重者一齐出。如蚕种灰白色。稠密泻渴。身温腹胀。头温足冷也。
轻变重者犯房室。不忌口。先曾泻饮冷水。饵凉药也。重变轻者避风寒。常和暖。大便稠也。
愚按丹溪先生云。痘疹密则毒甚。用人参败毒散、犀角地黄汤。或以凉药解之。虽数帖亦不妨。
○一小儿痘疹甚密。至九日贯脓不满。色不红活。或云当殁于十二日。余以为气血虚弱。用八珍汤内
加糯米百粒。数剂。至十五日。脓完色正。结痂而愈。○一小儿五岁。出痘密而色白。属虚弱也。始
末悉。用补托之药而安。旬余。饮食过多。忽作呕吐。面白兼青。目唇牵动。先君以为慢脾风症。用
五味异功散。加升麻、柴胡。不信。翌日手足时搐。服煎药而不应。急加木香、干姜。二剂而愈。○
一小儿第五日矣。稠密色黑。烦躁喜冷。先君以为火极似水。令恣饮芹汁。烦热顿止。乃以地黄丸料
服之。至二十余日而愈。
凡身热发烦渴者。宜用六味人参麦门冬散治之。如不应。用七味人参白术散。
愚按前症。若渴而饮冷者。脾胃实热。宜用麦门冬散。若渴而饮汤者。气虚热渴。宜用白术散。
若大渴引饮。面赤。血虚发躁也。用当归补血汤。
我曾认为，小儿的病症虽然繁多，但疮疹（天花、麻疹等出疹性传染病）是最为严重的疾病。为什么呢？因为疮疹在初起时症状相似，难以辨别，如果误投其他药物，不仅无益，反而有害。况且如果不说明受病的缘由，谁又知道畏惧和厌恶的原因呢？父母疼爱孩子，急于求医治疗，而医生若失于考察，用药错误，很少有不导致孩子夭折横死的。我每次想到这些，心中便感到悲痛。于是选取家中收藏的已经验证有效的方剂，汇编成一卷，命名为《小儿痘疹方论》，刻印流传，以推广古人爱护幼童的本意。这样做难道不对吗？
和安郎、判太医局兼翰林良医陈文中 谨书
小孩子在母体胎儿时期，是由母亲五脏的津液滋养而成形的。如果母亲不知道禁忌，放纵口腹之欲，食用浓烈厚味的食物，喜好辛辣酸味，或者食用有毒之物，这些毒气会传入胞胎之中。这种毒发出来就成为疮疹，名叫“三秽液毒”。一、五脏六腑秽浊之液中的毒，发为水泡疮；二、皮膜筋肉秽浊之液中的毒，发为脓血水疱；三、毒既发出，发为疹痘疮。此时母子都应忌食葱、蒜、韭菜、醋、酒、盐酱、獐兔肉、鸡犬肉、鱼腥等物。世俗之人不懂这个道理，认为这些食物能发散痘毒，往往不顾后果，误伤孩子的情况很多。
况且小儿出痘疹，在未出和已出之间，有类似伤寒的症状：憎恶寒冷且高热，身体疼痛，大便黄稠，这是正常的病状。如果没有其他疾病，不必服药。
我按语：痘疹，如果小儿从头到尾病情平和，自然会有不用药而愈的喜悦。这是因为小儿肠胃软弱，容易虚实变化，所以必须不得已时，才去折损其太过，补益其不足。
凡是治疗疮疹，先要分辨表里虚实。如果表里俱实，疮疹就容易发出也容易结痂；表里俱虚则相反。表实里虚者，疮易出难结痂；表虚里实者也相反。如果从初出一日到十日，浑身壮热，大便黄稠，这是表里俱实，其疮必然光泽、起发、饱满肥硕，且容易结痂。
我按语：治疗痘疹的方法，与治痈疽没有不同。如果邪气在里且实热，用前胡枳壳散疏散元气；怯弱而虚热者，用参四圣散；虚弱者，用紫草木香汤；虚寒者，用参内托散；虚寒内脱者，用木香散。如果邪气在表且实热，用麻黄甘葛汤。这是关键的方法。其余见各症。
凡是疮疹已出未出之间，出现腹泻口渴，或腹胀，或气促，这叫做里虚，急用十一味木香散治疗。
我按语：经书说真气耗夺则为虚，邪气亢盛则为实。所谓实，是指邪气实而真气虚。然而倒靥（痘疮塌陷不灌浆）、泻渴等症状，如果喜欢热饮食，手足并冷，或不进食呕吐，这是阳气虚寒，应用辛热药剂补益。喜欢冷冻饮料食物，手足不冷，或唇舌黑裂，这是阳气实热，应用苦寒药剂泻火。
凡是疮疹已出未愈之间，不光泽，不起发，不红活，这叫做表虚，急用十二味异功散治疗。
我按语：张翼之说，吐泻少食为里虚陷伏，倒靥灰白为表虚。两者都出现，为表里俱虚，用异功散救治。甚至姜、附子、灵脂、砂仁等药也可使用。如果仅是里虚，减去官桂；仅表虚，减去肉豆蔻。如果能进食但便秘且陷伏倒靥的为里实，轻用射干鼠粘子汤，重用前胡枳壳散。下利吐泻但能进食的为里实，如果用补益药则会结成痈毒。红活绽凸为表实，如果用补表药，则会溃烂不结痂。凡是痘疮一见斑点，就忌用葛根汤，恐怕导致表虚。
凡是痘疮已出未愈之间，不光泽，不起发，不红活，或腹胀，或泻渴，或气促，这叫做表里俱虚，急用十二味异功散，送服七味肉豆蔻丸治疗。
我按语：上述病症，审察确知表里虚寒，急用前述方法，迟缓则无法救治。○一个小孩出痘，不起发、不红活、腹胀、泻渴，都认为是不治之症。施院使认为是表里虚寒，用十二味异功散一剂，痘即起发红活，诸症顿退。又用参内托散灌浆结痂。○儒者薛戒甫的儿子五岁，出痘三四天，排出紫血，每天几滴，到第八天不止且痘不起。御医钱春林认为是脾气虚寒，用木香散两剂，加丁香十一粒、人参五钱，一天服完。第二天痘皆起而有脓，由此血渐止，二十多天痊愈。○一个小孩起发、红活，只是不时作痒，口干作渴，便血，面赤发热。家父认为是肠胃有热，先用济生犀角地黄汤，加柴胡一剂，诸症渐退。形体倦怠，这是邪气去而形气虚弱，用四君子汤，加当归、黄芪、红花，两剂而安。○一个小孩痘疹赤痛，烦热作渴，或便血，或鼻出血。家父用犀角地黄汤而血止。又用紫草快痘汤，加黄芪、芍药而愈。后来疮痕色白，用四君子汤、当归、黄芪治疗而痊愈。○一个小孩出痘吐血，其痘赤痛如锥刺，或疮出血。我认为是肝火炽盛，用小柴胡汤加生地一剂，随即用济生犀角地黄汤一剂顿愈。又用芹菜汁而痊愈。○一个小孩痘疮下血而不起发，家父认为是气血不足，用紫草快痘汤，加人参、黄芪、当归、白术治疗。血止疮起，但灌浆迟缓，用八珍汤倍加人参、黄芪。数剂后疮结痂且根部白痒，这是气血虚而有热，用八珍汤二十多剂而愈。○一个小孩痘疹，大便下血，小便很赤，疮颗色赤，发热饮冷。家父认为是热毒郁滞，先用八正散一剂，后用解毒防风汤一剂顿愈。又饮芹菜汁而全痊。○一个小孩痘正发而便血，倦怠少食，作渴饮汤。我认为是倦怠便血，这是脾虚不能摄血；少食作渴，这是脾虚而津液短少。用五味异功散，加升麻、紫草，治疗而愈。○一个小孩便血，腹胀困倦，发热口干饮汤，四肢逆冷。家父认为是脾气虚寒不能摄血，用五味异功散，加丁香十粒、炮姜五分，两剂血止，痘灌浆结痂。○一个小孩七岁，患痘疮腹胀八九日了。家父说应当急补脾土，家属不信，仍服消毒之药，忽然大便下血甚多而死。○一个小孩作渴，泄泻，发热饮冷，唇舌皱裂，泻粪秽臭。家父认为是内热所作，用前胡枳壳散一剂稍愈。又用清凉饮加漏芦，乳母服用，婴儿顿时安宁。凡小儿斑驳疹毒之病，俗言疹子，是肺胃蕴热，因时气熏发于外，状如蚊、蚤所咬。红色则十生一死，黑色则十死一生。大抵遇到春天而生发，到夏天而长成，乃阳气熏蒸，所以得生成。脏腑调和，血气充实，则易出易结痂。这是因为内无冷气，外常和暖。凡是痘疹热渴，切不可给瓜、柿、蜜水等冷物，及清凉饮、消毒散等药，恐怕损伤脾胃，则腹胀喘闷，寒战切牙而难治。所谓切牙，是牙齿枯槁，乃血气不荣，不可妄作热证治疗。
我按语：上述病症，如果兼有吐泻，手足指冷，属于内虚寒而外假热，急用木香散，如不应，用异功散。如果大便不通，渴欲饮冷，那么前面所禁的蜜水之类，又当使用了。但应审察热的虚实。如果属虚热，虽然想喝水却拒绝饮用，当用人参白术散，热渴自止。属实热则热势更甚，索水且喜欢饮用，当以犀角磨水服，诸症即解，其后也无余毒之患。北方出疹，不拘冬夏，如果喜欢冷的，再不用药，只给水饮，无不痊愈。因为北方地燥而又睡热炕的缘故。○一个妇人患时疫将愈更出痘，疮大起发，体倦痛甚则昏愦，烦渴饮汤，不思食。用十全大补汤及朱砂末，其痛顿止，食进体健，仍用前汤，倍加人参、黄芪。十余剂后灌浆，又数剂而愈。○一个孕妇发热作渴，遍身骨节作痛，用仙方活命饮两剂，诸症稍愈。至第十一天出痘百余颗，形气甚倦，用紫草木香散，又出少许。但口干作渴，用人参白术散而渴止。用八珍汤，加丹皮、柴胡而灌浆。后去丹皮、柴胡，倍加人参、黄芪。数剂后痘结痂。○一个男子年将三十出痘，根窠赤痛，发热作渴，服紫草饮之类，前症益甚，痘裂出血。我用小柴胡加生地、犀角，两剂诸症顿减。又用圣济犀角地黄汤而灌浆，再用八珍汤而结痂。○一个小孩烦躁，饮冷不止，家父用济生犀角地黄汤顿愈。后渴而喜热，又用当归补血汤而痊愈。惟倦怠少食，用七味白术散而瘥。○一个小孩患此病，饮冷不止，或痘胀痛，家父用济生犀角地黄汤，并芹菜汁而顿愈。
凡是痘疹出不快，多属于虚。如果误认为是热毒壅盛，妄用宣利之剂，致脏腑受冷，营卫涩滞，不能运达肌肤，则疮不能起发，充满后不结实，或痂痒塌，烦躁喘渴而死。
我按语：上述病症，也有各经热盛壅遏而出不快者，也有毒甚痘疔而不能发起者，也有余毒而溃痒者，应当细审其因而药之。○一个小孩九岁，出痘六天，痒塌寒战，院使钱密庵用十一味木香散两剂，灌浆，用参托里散而结痂。后痕白作痒，用十全大补汤而愈。○一个小孩痘疮，脓未满，面赤作痒，我认为是气血虚而有热，想用温补之剂，家属不信，乃服清热之药。至第十三日疮痘色赤，虚烦作渴，腹痛不食，手足逆冷而死。○一个小孩未满周岁，痘疮肿痛出血，哭不能已。诊其母有肝火，先用小柴胡，加山栀、生地给母亲服用，婴儿喝几滴即愈。又用加味逍遥散而痊愈。○一个小孩出痘，内有痘疔数枚，虽挑破出黑血，热毒不解，余痘不发，皆以为不治。家父以仙方活命饮徐徐灌服一剂，痘疔解而诸痘亦愈。○一个小孩痘疔，患在臀间，色黑大痛，挑出黑血，仍服坚痛，皆以为不治。家父用膈蒜灸数壮，痛止，色淡而软，挑出黑血甚多，灌以活命饮，患处及诸痘灌浆而愈。
我按语：痘疹未明而元气实者，最宜前方。若元气虚者，又当详治，恐怕发得表虚而痘难出。○一个儒者年三十余，因劳役倦怠发热，服补中益气汤数剂，发赤点以为是疹，另服升麻葛根汤一剂，更加恶寒，仍服益气汤四剂。至第九日出痘甚多，我用八珍汤，加黄芪、白芷、紫草四剂，至二十日脓始贯，用十全大补汤，月余而结痂。
凡是痘疹始出，一日至五七日之间，虽身热或腹胀，足梢冷，或身热泻渴，或身热惊悸，腹胀，或身热出汗者，服十一味木香散。
我按语：上述病症属脾气虚寒假热，非此药不救。如未应，佐以六君子汤，专补脾气，更不应，加木香、补骨脂、肉豆蔻，兼补肾气。○一个小孩第五日不红活，至第九日灌浆不满，我认为是气血虚弱，用十全大补汤治之，庶无后患，家属不信，至脱痂痕作痒色白，至第十四日而死。○一个小孩第七日脓清不满，形气倦怠，饮食少思，大便不实，用托里散两剂，手足指冷，切牙作渴，用木香散，倍用参、黄芪一剂，诸症顿退。又用参四圣散四剂而愈。
凡是泻水谷，或白色，或淡黄，煎十一味木香散，送服十味肉豆蔻丸治疗。泻止者停服，不止者多服。
我按语：上述病症，如果察其外症，若唇青指冷，睡而露睛，口鼻气寒，泻色青白，是脾肾虚寒，用前药六君子汤，加补骨脂、肉豆蔻。若色赤体热，睡不露睛，口鼻气热，泻色黄赤，是脾土实热，用泻黄散。○一个小孩腹胀，渴泻，气促体倦，家父认为是表里俱虚，用六君子汤加当归、黄芪，送服四神丸一服，诸症顿退，疮势顿正。但脓迟而渴，仍用前汤，加当归、黄芪两剂，疮色红活，形体颇安，任其灌浆而痊愈。
凡是泻频，津液内耗，血气不荣，疮虽起发，也不能结痂。如身温腹胀，切牙喘渴者难治。缘谷食去多，津液枯渴，饮水荡散真气，故多死矣。速与十一味木香散救之。如不应，急用十二味异功散。
我按语：上述病症，兼手足指冷，面色青白等症者，属阳气虚寒，急用木香散。阳气脱陷，用异功散。脾气虚弱，用六君子汤。血气虚弱，用八珍汤。不应，用十全大补汤。○一个小孩第九日不红活，不灌浆，云殁于十三日，陈院长认为是虚寒，用十一味木香散两剂，渐红活，灌浆，又用紫草木香汤，及人参白术散而愈。○族侄孙衍庆六岁，出痘稀少，疮痂悉落，至第十三日，身烦热而畏寒，手足逆冷，浓衣围火不能温，皆谓不治。我思大热而不热者，是无火也，急用人参理中汤煎服一杯，肢体顿温，更用人参白术散调理而痊愈。○一个男子年二十余，发热烦躁，痘黯出血，足热腰痛，用圣济犀角地黄汤两剂而灌浆，用地黄丸料数剂而疮结痂。○一个男子年将三十，出痘色紫，作渴饮水，腰痛足热耳聋，我认为是肾虚之症，用加减八味丸料，煎与恣饮，热渴顿止，佐以补中益气汤，加五味子、麦冬而愈。○一个小孩十二岁，出痘色黯，两足及腰热痛，便秘，咽舌干渴，引饮不绝，众谓肾虚不治，家父用加减八味丸料作大剂，煎与恣饮，至二斤，诸症悉退，又佐以补中益气，及八珍汤各十余剂而痊愈。
凡是四五日不大便，用嫩猪脂一块，以白水煮熟，切豆大与食之，令脏腑滋润，使疮痂易落，切不可妄投宣泻之药，元气内虚，则疮毒入里，多伤儿也。
我按语：上述病症，如果因热内蕴，宜用射干鼠粘子汤解之。或发热作喝，或口舌生疮，或咽喉作痛，并宜用之。
凡是疮疹初出，两三日至十三日，当忌外人及卒暴风寒秽恶之气。轻者三次出，大小不一，头面稀少，眼中无根，窠红肥满光泽也。重者一齐出，如蚕种灰白色，稠密泻渴，身温腹胀，头温足冷也。轻变重者犯房室，不忌口，先曾泻饮冷水，饵凉药也。重变轻者避风寒，常和暖，大便稠也。
我按语：丹溪先生说，痘疹密则毒甚，用人参败毒散、犀角地黄汤，或以凉药解之，虽数帖亦不妨。○一个小孩痘疹甚密，至第九日灌浆不满，色不红活，或云当殁于十二日，我认为是气血虚弱，用八珍汤内加糯米百粒，数剂，至第十五日，脓完色正，结痂而愈。○一个小孩五岁，出痘密而色白，属虚弱也。始终悉用补托之药而安。旬余，饮食过多，忽作呕吐，面白兼青，目唇牵动，家父认为是慢脾风症，用五味异功散，加升麻、柴胡，家属不信，翌日手足时搐，服煎药而不应，急加木香、干姜，两剂而愈。○一个小孩第五天了，稠密色黑，烦躁喜冷，家父认为是火极似水，令恣饮芹汁，烦热顿止，乃以地黄丸料服之，至二十余日而愈。
凡是身热发烦渴者，宜用六味人参麦门冬散治之。如不应，用七味人参白术散。
我按语：上述病症，如果渴而饮冷者，脾胃实热，宜用麦门冬散。若渴而饮汤者，气虚热渴，宜用白术散。若大渴引饮，面赤，血虚发躁也，用当归补血汤。
I have often said that although pediatric diseases are numerous, pox and rashes (infectious exanthematous diseases such as smallpox and measles) are the most severe. Why? Because in the early stage of pox and rashes, symptoms are similar and difficult to distinguish. Administering other medications not only fails to help but may cause harm. Moreover, without explaining the cause of the disease, who would know the reasons for fear and aversion? Parents love their children and are eager for medical treatment. If physicians fail to examine carefully and prescribe incorrectly, it is rare that the child does not die prematurely. Whenever I think of this, my heart feels sorrowful. Therefore, I selected verified effective prescriptions from my family collection, compiled them into one volume, named it *Xiao'er Douzhen Fanglun* (Treatise on Prescriptions for Pediatric Pox and Rashes), had it printed and circulated, to promote the ancient intention of protecting young children. Is this not correct?
He'an Lang, Director of the Imperial Medical Bureau and Hanlin Liangyi, Chen Wenzhong, respectfully wrote.
When a child is in the womb, its form is nurtured by the fluids of the mother's five zang organs. If the mother ignores dietary taboos, indulges in rich and strong flavors, prefers pungent and sour foods, or consumes toxic substances, these toxic qi transmit into the fetal sac. This toxicity erupts as pox and rashes, known as "Three Filthy Fluid Toxins." First, toxins from the filthy fluids of the five zang and six fu organs manifest as blister sores. Second, toxins from the filthy fluids of the skin, membranes, muscles, and tendons manifest as pustular and bloody blisters. Third, once the toxin emerges, it manifests as rash and pox sores. At this time, both mother and child must avoid eating scallions, garlic, wild onions, vinegar, alcohol, salt, soy sauce, roe deer, rabbit, chicken, dog meat, and fishy foods. Laypeople do not understand this, believing these foods can disperse the pox toxin, often disregarding consequences, leading to many misfortunes.
Furthermore, between the pre-eruption and post-eruption stages of pediatric pox and rashes, there are symptoms resembling Taiyang syndrome (disease of the Taiyang channel): aversion to cold with high fever, body pain, and thick yellow stool. This is the normal progression of the disease. If there are no other illnesses, medication is unnecessary.
My commentary: For pox and rashes, if the child remains stable throughout, there is naturally the joy of recovery without medication. This is because a child's intestines and stomach are weak and prone to deficiency and excess patterns. Thus, only when absolutely necessary should one reduce excess and tonify deficiency.
In treating pox and rashes, one must first differentiate exterior/interior and deficiency/excess. If both exterior and interior are excess, the sores will erupt and crust easily; if both are deficient, the opposite occurs. If the exterior is excess and interior deficient, sores erupt easily but crust with difficulty; if the exterior is deficient and interior excess, the opposite occurs. From the first day to the tenth day after initial eruption, if the whole body has high fever and thick yellow stool, this indicates both exterior and interior excess. The sores will likely be lustrous, raised, full, and plump, and will crust easily.
My commentary: The method for treating pox and rashes is no different from treating carbuncles and ulcers. If pathogenic factors are in the interior with excess heat, use Qianhu Zhike San (Peucedanum and Aurantium Powder) to disperse yuan qi. For those who are timid with deficient heat, use Shensi San (Ginseng Four-Saints Powder). For weakness, use Zicao Muxiang Tang (Arnebia and Aucklandia Decoction). For deficiency-cold, use Shenti Tuoli San (Ginseng Supporting Interior Powder). For deficiency-cold with internal collapse, use Muxiang San (Aucklandia Powder). If pathogenic factors are in the exterior with excess heat, use Mahuang Gan Ge Tang (Ephedra and Pueraria Decoction). These are key methods. See other symptoms elsewhere.
During the period when pox and rashes are emerging or have emerged, if diarrhea and thirst occur, or abdominal distension, or shortness of breath, this is called interior deficiency. Urgently treat with Shi Yi Wei Muxiang San (Eleven-Aucklandia Powder).
My commentary: The Classics state that depletion of true qi leads to deficiency, while dominance of pathogenic factors leads to excess. "Excess" refers to pathogenic excess and true qi deficiency. However, in conditions like inverted crusting (sores collapsing without suppurating) and diarrhea/thirst, if the patient prefers hot drinks, has cold hands and feet, or vomits without eating, this is yang deficiency-cold. Treat with acrid-hot tonics. If the patient prefers cold drinks, has warm hands and feet, or has black/cracked lips and tongue, this is yang excess-heat. Treat with bitter-cold purgatives.
During the period when pox and rashes have emerged but not healed, if they lack luster, do not rise, and are not red/vibrant, this is called exterior deficiency. Urgently treat with Shi Er Wei Yigong San (Twelve-Yigong Powder).
My commentary: Zhang Yizhi stated that vomiting, diarrhea, and poor appetite indicate interior deficiency with sinking; inverted, gray-white sores indicate exterior deficiency. If both are present, it is exterior-interior deficiency, treated with Yigong San. Even ginger, aconite, liquidambar, and amomum can be used. If only interior deficiency exists, remove Guigui (Cinnamon Bark); if only exterior deficiency exists, remove Rou Doukou (Nutmeg). If the patient can eat but has constipation with sinking/inverted sores, this is interior excess. Lightly use Shegan Niuzi Tang (Belamcanda and Burdock Decoction); heavily use Qianhu Zhike San. If there is diarrhea/vomiting but the patient can eat, this is interior excess. Using tonics here will lead to carbuncle formation. Red, protruding sores indicate exterior excess. Using exterior tonics here will cause ulceration without crusting. Once pox spots appear, Gegen Tang (Kudzu Decoction) is contraindicated to avoid causing exterior deficiency.
During the period when pox sores have emerged but not healed, if they lack luster, do not rise, are not red/vibrant, or present with abdominal distension, diarrhea/thirst, or shortness of breath, this is exterior-interior deficiency. Urgently treat with Shi Er Wei Yigong San, administered with Qi Wei Rou Doukou Wan (Seven-Nutmeg Pills).
My commentary: In the aforementioned cases, if exterior-interior deficiency-cold is confirmed, urgently apply the above methods; delay means no rescue. ○ A child with pox that did not rise, was not red/vibrant, had abdominal distension, and diarrhea/thirst was considered incurable. Physician Shi Yuan-shi diagnosed exterior-interior deficiency-cold and prescribed one dose of Shi Er Wei Yigong San. The sores immediately became red/vibrant and rose, symptoms subsided. Then Shenti Tuoli San was used to suppurate and crust. ○ The son of Confucian scholar Xue Jiefu, aged five, developed pox. On days three to four, he passed purple blood, a few drops daily. By day eight, bleeding continued and sores did not rise. Imperial Physician Qian Chunlin diagnosed spleen qi deficiency-cold and prescribed two doses of Muxiang San, plus eleven cardamoms and five qian of Ginseng, taken in one day. The next day, all sores rose and suppurated, bleeding stopped gradually, and he recovered in over twenty days. ○ A child with rising, red/vibrant pox experienced intermittent itching, dry mouth/thirst, bloody stool, red face, and fever. My father diagnosed intestinal/stomach heat and prescribed Jisheng Xijiao Dihuang Tang (Jisheng Rhinoceros Horn and Rehmannia Decoction) with Chai Hu (Bupleurum) for one dose. Symptoms gradually subsided. Fatigue indicated pathogen departure and constitutional weakness; Si Junzi Tang (Four Gentlemen Decoction) with Dang Gui (Angelica), Huang Qi (Astragalus), and Hong Hua (Safflower) for two doses brought peace. ○ A child with red/painful pox, irritability, fever/thirst, bloody stool, or epistaxis was treated by my father with Xijiao Dihuang Tang to stop bleeding, then Zicao Kuaizhen Tang (Arnebia Rapid-Rash Decoction) with Huang Qi and Bai Shao (White Peony) for cure. Later, white scars were treated with Si Junzi Tang, Dang Gui, and Huang Qi for recovery. ○ A child with pox vomited blood; sores were red/painful like needle pricks, or bled. I diagnosed liver fire blazing and prescribed Xiao Chai Hu Tang (Minor Bupleurum Decoction) with Sheng Di Huang (Rehmannia) for one dose, followed immediately by Jisheng Xijiao Dihuang Tang for one dose, resulting in immediate cure. Celery juice was also used for full recovery. ○ A child with pox had lower GI bleeding and failed to rise. My father diagnosed qi/blood deficiency and prescribed Zicao Kuaizhen Tang with Ren Shen (Ginseng), Huang Qi, Dang Gui, and Bai Zhu (Atractylodes). Bleeding stopped, sores rose, but suppuration was slow. Bazhen Tang (Eight-Treasure Decoction) with doubled Ren Shen and Huang Qi was used for several doses until crusting occurred with white, itchy roots. This was qi/blood deficiency with heat; Bazhen Tang for over twenty days led to cure. ○ A child with pox had bloody stool, dark red urine, red sores, fever, and desire for cold drinks. My father diagnosed stagnant heat-toxin and prescribed Bazheng San (Eight-Righteous Powder) for one dose, then Jiedu Fangfeng Tang (Detoxifying Saposhnikovia Decoction) for one dose, resulting in immediate cure. Celery juice ensured full recovery. ○ A child with active pox had bloody stool, fatigue, poor appetite, thirst for hot drinks. I diagnosed fatigue/bloody stool as spleen deficiency failing to control blood; poor appetite/thirst as spleen deficiency with short fluids. Wuwei Yigong San (Five-Ingredient Yigong Powder) with Sheng Ma (Cimicifuga) and Zi Cao (Arnebia) cured him. ○ A child with bloody stool, abdominal distension, fatigue, fever, dry mouth/thirst for hot drinks, and cold limbs was diagnosed by my father as spleen qi deficiency-cold failing to control blood. Wuwei Yigong San with ten cardamoms and half qian of Pao Jiang (Prepared Ginger) for two doses stopped bleeding, allowing suppuration and crusting. ○ A seven-year-old child had abdominal distension from pox for eight to nine days. My father advised urgent spleen tonification, but the family refused, continuing detoxifying herbs. Sudden massive bloody stool ensued, leading to death. ○ A child with thirst, diarrhea, fever, desire for cold drinks, wrinkled/cracked lips/tongue, and foul-smelling stool was diagnosed by my father as internal heat. Qianhu Zhike San for one dose improved symptoms slightly. Qingliang Yin (Cooling Infusion) with Lou Lu (Euphorbia) was given to the nursing mother, bringing instant relief to the infant. Folk name for斑驳 rash poison is "zhenzi"; it is lung/stomach accumulated heat, triggered by seasonal qi, appearing like mosquito/flea bites. Red lesions: ten live, one dies. Black lesions: ten die, one lives. Generally, spring promotes growth, summer completes maturation, due to yang qi steaming. Harmonized viscera and充盈 blood/qi allow easy eruption and crusting, as there is no internal cold and external warmth prevails. For pox/rash fever/thirst, melon, persimmon, honey water, etc., and Qingliang Yin, Xiaodu San are strictly forbidden to avoid damaging spleen/stomach, which causes abdominal distension, wheezing, chattering teeth, and difficult treatment. Chattering teeth indicate withered teeth due to lack of blood/qi nourishment; do not mistakenly treat as heat.
My commentary: In the aforementioned cases, if accompanied by vomiting/diarrhea and cold fingers/toes, it is interior deficiency-cold with exterior false-heat. Urgently use Muxiang San; if ineffective, use Yigong San. If constipation and desire for cold drinks exist, the previously forbidden honey water may be used. However, differentiate heat deficiency vs. excess. If deficient heat, the patient wants water but refuses to drink; use Renshen Baizhu San (Ginseng and Atractylodes Powder) to stop fever/thirst. If excess heat, thirst worsens, and the patient seeks and enjoys drinking water; grind Xijiao (Rhinoceros Horn) in water for administration; symptoms resolve, leaving no residual toxin. Northern rashes occur regardless of season. If the patient likes cold, no medicine is needed; only water ensures cure, due to northern dry climate and heated kang beds. ○ A woman recovering from epidemic disease developed pox. Sores erupted large, body fatigue/pain caused fainting, irritability/thirst for hot drinks, anorexia. Shiquan Dabu Tang (Ten Complete Tonifying Decoction) and Cinnabar powder stopped pain instantly, improved appetite and strength. Continued with modified Shiquan Dabu Tang with doubled Ren Shen and Huang Qi. After over ten doses, suppuration occurred; several more doses led to cure. ○ A pregnant woman with fever/thirst and generalized joint pain took Xianfang Huoming Yin (Immortal Formula for Life-Preserving Decoction) for two doses, improving symptoms. On day eleven, over a hundred pox appeared; extreme fatigue followed. Zicao Muxiang San was used, producing a few more sores. Dry mouth/thirst was treated with Renshen Baizhu San to stop thirst. Bazhen Tang with Dan Pi (Moutan) and Chai Hu suppurated. Dan Pi and Chai Hu were removed, Ren Shen and Huang Qi doubled; several doses led to crusting. ○ A man near thirty developed pox with red/painful bases, fever/thirst. Taking Zicao Yin worsened symptoms; sores cracked and bled. I prescribed Xiao Chai Hu Tang with Sheng Di Huang and Xijiao for two doses, reducing symptoms drastically. Shengji Xijiao Dihuang Tang suppurated; Bazhen Tang crusted. ○ A child with irritability and incessant cold drink intake was cured instantly by my father using Jisheng Xijiao Dihuang Tang. Later, thirst preferred hot drinks; Dang Gui Bu Xue Tang (Angelica Tonifying Blood Decoction) cured this. Fatigue/poor appetite was treated with Qiwei Baizhu San (Seven-Ingredient Atractylodes Powder) for recovery. ○ A child with this condition drank cold incessantly, or had painful/swollen pox. My father used Jisheng Xijiao Dihuang Tang and celery juice for instant cure.
Slow pox eruption usually indicates deficiency. Mistaking it for heat-toxin stagnation and wrongly using purgatives/laxatives causes cold in viscera, sluggish ying/wei qi, preventing nutrient delivery to skin. Sores fail to rise, remain unfirm after filling, or itch/collapse. Irritability, wheezing, thirst, and death may follow.
My commentary: Some cases of slow eruption are due to heat stagnation in various channels, or severe toxin/nodules preventing eruption, or residual toxin causing ulceration/itching. Carefully diagnose the cause and medicate accordingly. ○ A nine-year-old child, day six of pox, had itchy/collapsed sores and chills. Dean Qian Mi'an prescribed two doses of Shi Yi Wei Muxiang San for suppuration, then Cantuo Li San for crusting. White, itchy scars later healed with Shiquan Dabu Tang. ○ A child with incomplete suppuration, red face, and itching was diagnosed by me as qi/blood deficiency with heat, suggesting warm tonics. Family refused, choosing cooling herbs. By day thirteen, sores were red, with empty irritability/thirst, abdominal pain, anorexia, and cold limbs, leading to death. ○ A child under one year old had painful, bleeding pox and uncontrollable crying. Diagnosis revealed mother had liver fire. Xiao Chai Hu Tang with Shan Zhi (Gardenia) and Sheng Di Huang was given to the mother; infant drank a few drops and healed instantly. Jiawei Xiaoyao San cured the mother. ○ A child had several pox nodules. Despite lancing and draining black blood, heat-toxin persisted, and other sores did not erupt; considered incurable. My father slowly administered Xianfang Huoming Yin for one dose; nodules resolved, and all sores healed. ○ A child had a pox nodule on the buttocks, black and severely painful. Lancing drained black blood, but hardness/pain persisted; considered incurable. My father applied moxibustion with隔蒜 (garlic-pierced moxa) for several moxa cones. Pain stopped, color faded, texture softened. Lancing drained much black blood; Huoming Yin was infused. Lesion and other sores suppurated and healed.
Whenever a child shows wind-cold fever, suspecting pox/rash, administer Siwei Shengma Gegen Tang (Four-Ingredient Cimicifuga and Kudzu Decoction).
My commentary: For unclear pox/rash with solid yuan qi, this formula is best. For deficient yuan qi, detailed treatment is required to avoid exterior deficiency hindering eruption. ○ A Confucian scholar, over thirty, suffered fatigue/fever from labor. Several doses of Buzhong Yiqi Tang (Tonify Middle and Augment Qi Decoction) produced red spots mistaken for rash. He took Shengma Gegen Tang for one dose, worsening aversion to cold. He resumed Yiqi Tang for four doses. By day nine, many pox erupted. I prescribed Bazhen Tang with Huang Qi, Bai Zhi (Angelica Dahurica), and Zi Cao for four doses. Suppuration began on day twenty. Shiquan Dabu Tang was used; crusting occurred after a month.
Between day one and five to seven of initial pox/rash, even with fever, abdominal distension, cold toes, fever/diarrhea-thirst, fever/palpitations/distension, or fever/sweating, administer Shi Yi Wei Muxiang San.
My commentary: These cases belong to spleen qi deficiency with false-heat; this medicine is essential for rescue. If ineffective, add Liujunzi Tang (Six-Gentlemen Decoction) to tonify spleen qi. If still ineffective, add Muxiang, Buguzhi (Psoralea), and Rou Doukou to tonify kidney qi. ○ A child was not red/vibrant on day five, with incomplete suppuration on day nine. I diagnosed qi/blood deficiency and prescribed Shiquan Dabu Tang to prevent future issues. Family refused. By day fourteen, with white, itchy scars, the child died. ○ A child on day seven had thin, incomplete suppuration, fatigue, poor appetite, and loose stools. Tuoli San for two doses resulted in cold fingers/toes, chattering teeth, and thirst. Muxiang San with doubled Ren Shen and Huang Qi for one dose subsided symptoms. Shensi San for four doses cured him.
For watery stool, white or pale yellow, decoct Shi Yi Wei Muxiang San and administer with Shi Wei Rou Doukou Wan (Ten-Nutmeg Pills). Stop if diarrhea ceases; continue if it persists.
My commentary: Examine external signs. Blue lips, cold fingers, sleeping with eyes open, cold nose/mouth breath, and blue/white stool indicate spleen/kidney deficiency-cold. Use previous prescription: Liujunzi Tang with Buguzhi and Rou Doukou. Red complexion, body heat, closed eyes during sleep, hot nose/mouth breath, and yellow/red stool indicate spleen earth excess-heat. Use Xiexiang San (Drain Yellow Powder). ○ A child with abdominal distension, thirst/diarrhea, shortness of breath, and fatigue was diagnosed by my father as exterior-interior deficiency. Liujunzi Tang with Dang Gui and Huang Qi, administered with Sishen Wan (Four-Spirit Pills) for one dose, subsided symptoms and corrected pox trend. Delayed suppuration/thirst continued with previous decoction plus Dang Gui and Huang Qi for two doses; sores became red/vibrant, constitution stabilized, allowing natural suppuration and cure.
Frequent diarrhea depletes fluids, causing blood/qi deficiency. Even if sores rise, they cannot crust. Warm body, abdominal distension, chattering teeth, wheezing/thirst indicate difficult treatment. Due to excessive loss of grain/food, fluid exhaustion, and drinking water scattering true qi, death is common. Urgently administer Shi Yi Wei Muxiang San. If ineffective, urgently use Shi Er Wei Yigong San.
My commentary: Cases with cold fingers/toes and blue/white complexion indicate yang deficiency-cold; urgently use Muxiang San. Yang collapse uses Yigong San. Spleen qi deficiency uses Liujunzi Tang. Blood/qi deficiency uses Bazhen Tang. If ineffective, use Shiquan Dabu Tang. ○ A child on day nine was not red/vibrant or suppurating, predicted to die on day thirteen. Dean Chen diagnosed deficiency-cold, prescribing two doses of Shi Yi Wei Muxiang San. Gradually became red/vibrant and suppurated. Zicao Muxiang Tang and Renshen Baizhu San cured him. ○ Cousin Sun Yanqing, aged six, had sparse pox. Scabs fell off by day thirteen. Fever, aversion to cold, cold limbs despite heavy clothing and fire were deemed incurable. I reasoned that intense heat without warmth indicates absence of fire. Urgently administered Ren Shen Lizhong Tang (Ginseng and Middle-Warming Decoction); limbs warmed instantly. Ren Shen Baizhu Tang regulated recovery. ○ A man in his twenties had fever, irritability, dark bleeding pox, hot feet, and lower back pain. Shengji Xijiao Dihuang Tang for two doses suppurated; Dihuang Wan material for several doses crusted. ○ A man nearing thirty had purple pox, thirst/drinking, lower back pain, hot feet, and deafness. I diagnosed kidney deficiency and prescribed Jiajian Bawei Wan (Modified Eight-Ingredient Pills) material in large doses. Thirst/fever stopped instantly. Buzhong Yiqi Tang with Wuweizi (Schisandra) and Maidong (Ophiopogon) aided recovery. ○ A twelve-year-old child had dark pox, hot/painful feet/waist, constipation, dry throat/tongue, and incessant drinking. Others deemed kidney deficiency incurable. My father prepared large doses of Jiajian Bawei Wan material, administered generously up to two jin. Symptoms subsided. Buzhong Yiqi and Bazhen Tang for over ten doses each cured him.
If no bowel movement for four to five days, use a piece of fresh pig fat, boiled in clear water, cut bean-sized, and fed to moisten viscera and facilitate scab falling. Do not recklessly use purgatives; internal yuan qi deficiency allows toxin to enter the interior, harming the child.
My commentary: If internal heat accumulation is the cause, Shegan Niuzi Tang resolves it. Also suitable for fever/thirst, mouth/tongue sores, or sore throat.
From two to thirteen days after initial pox/rash emergence, avoid outsiders and sudden exposure to wind-cold and foul air. Mild cases erupt in three waves, varying sizes, sparse on head/face, no root in eyes, with red, full, lustrous pits. Severe cases erupt simultaneously, gray-white like silkworm eggs, dense with diarrhea/thirst, warm body/abdominal distension, warm head/cold feet. Mild turning severe involves sexual activity, dietary indiscretion, prior cold water diarrhea, or cooling medicines. Severe turning mild involves avoiding wind-cold, maintaining warmth, and thick stool.
My commentary: Mr. Danxi stated that dense pox indicates severe toxin; use Renshen Baidu San (Ginseng Resisting Toxin Powder), Xijiao Dihuang Tang, or cooling medicines. Several doses are acceptable. ○ A child with very dense pox had incomplete suppuration by day nine, non-red/vibrant color. Predicted death on day twelve, I diagnosed qi/blood deficiency. Bazhen Tang with one hundred glutinous rice grains for several doses. By day fifteen, suppuration complete, color correct, crusted and healed. ○ A five-year-old with dense, white pox indicated deficiency. Consistent use of tonifying/supporting herbs brought peace. Over ten days, overeating caused sudden vomiting, pale/blue face, eye/lip twitching. My father diagnosed Manpi Feng (Slow Spleen Wind) and prescribed Wuwei Yigong San with Sheng Ma and Chai Hu. Family refused. Next day, limb spasms occurred; decoction ineffective. Urgently added Muxiang and Gan Jiang (Dried Ginger); two doses cured him. ○ A child on day five had dense, black pox, irritability, preference for cold. My father diagnosed extreme fire resembling water, allowed free celery juice intake. Fever/irritability stopped instantly. Dihuang Wan material was then administered; healed in over twenty days.
For body heat, irritability, and thirst, use Liuwei Renshen Maidong San (Six-Ingredient Ginseng and Ophiopogon Powder). If ineffective, use Qiwei Renshen Baizhu San (Seven-Ingredient Ginseng and Atractylodes Powder).
My commentary: Thirst with cold drink preference indicates spleen/stomach excess-heat; use Maidong San. Thirst with hot drink preference indicates qi deficiency with heat/thirst; use Baizhu San. Great thirst with drawing in drinks, red face, and irritability indicates blood deficiency; use Dang Gui Bu Xue Tang.