凡痘疮已靥。烦渴不止。或头温足冷。或腹胀。或泻。或切牙。多致难愈。急用十一味木香散以
救之。已上之症。若误用蜜水生冷之物。则转加热渴而死。
愚按前症。属脾胃亏损。内真寒而外假热耳。非温补不救。如前药未应。用十全大补汤。加附子
以纯补之。○一小儿头生一疖。出脓将愈。忽疖间肿胀。发痘二十余颗。遍身赤点。用快 汤而渐出。
用紫草散倍加参、 而出完。用托里消毒散而脓贯。用托里散而疮靥。○一小儿痘已靥。其痕色赤而
错纵。日食粥七八碗。作渴面赤。先用白术散二剂。渴减五六。粥减太半。又用四君加芜荑、黄连
二剂。痕平色退。乃用八珍汤。加芜荑、山栀而痊。○一小儿痘疮愈后泄泻。饮食不化。此脾肾气虚。
用六君加补骨脂、肉豆蔻治之而愈。○一小儿痘疮将愈。患泄泻。侵晨为甚。饮食不化。属脾肾虚也。
朝用补中益气汤。夕用二神丸而愈。
凡身壮热。经日不除。如无他症。用六味柴胡麦门冬散治之。热退即止。如不愈。服七味人参白
术散。
愚按前症。若肝胆热毒。用柴胡麦门冬散。若肝经血虚。用四物汤。加黄 、柴胡。若中气虚热。
用人参白术散。
一男子患痘疮。作痛。发热不止。其势可畏。皆以为不起。施银台用消毒救苦汤治之。诸症顿退。
予先用仙方活命饮。痛全止。又用八珍汤。加紫草三钱。四剂贯脓而靥。○一小儿患痘。稠密大痛。
发热。势甚危急。先君用消毒救苦汤一剂。安卧良久。遍身出小痘。顿消。再剂贯脓而靥。
凡身壮热。大便坚实。或口舌生疮。咽喉肿痛。皆疮毒未尽。用四味射干鼠粘子汤。如不应。用
七味人参白术散。
愚按前症。若壮热饮冷。属热毒在表。宜用前汤。若兼大便不通。属热毒在内。少用四顺清凉饮。
若热毒既去。胃气虚而发热。用七味人参白术散。若因阴血亏损而发热。用四物汤。○一小儿六岁患
痘。第七日根颗赤痛。大便秘结。小便赤涩。烦躁饮冷。或用清凉解毒之剂。未应。钱密庵以为热毒
内蕴。用四顺清凉饮一剂。并猪胆汁导下结粪而安。又用犀角地黄汤。其痘自靥。○一小儿痘疮。发
热作渴。 赤胀痛。大便秘结。先用四顺清凉饮一剂。诸症顿退。又用四味鼠粘子汤一剂。诸症全退。
再用紫草汤而贯脓。用消毒饮而痘靥。○一小儿痘愈而声喑。面赤。足心发热。小便赤少。先君以为
肾经虚热。用六味地黄丸、补中益气汤而愈。其时患是症。用清热解毒者俱不起。○一小儿十一岁患痘。第四日根盘红
活起发。因痛甚不止。至七日。形气甚倦。痘色淡而欲陷。此因痛盛而伤元气也。先用仙方活命饮一剂
而痛止。再用八珍汤而贯靥。
凡风热咳嗽。咽膈不利。用三味桔梗甘草防风汤治之。如不应。用七味人参白术散主之。
愚按前症。如痘热内作。宜用桔梗甘草防风汤。如兼痰热咳嗽。佐以抱龙丸。若气虚痰涎壅上。
宜用人参白术散。以补脾肺。○一小儿痘疮十二日。患咳嗽十余日不愈。所服皆发表化痰。余曰。此
脾肺气虚。复伤真气而变肺痈也。不信。仍服前药。果吐脓血。用桔梗汤而愈。○一小儿痘将愈。咳
嗽。面色黄白。嗽甚则赤。用五味异功散调补而愈。
凡涕唾稠粘。身热鼻干。大便如常。小便黄赤。用十六味人参清膈散。如不应。用七味人参白术
散。
愚按前症。属脾肺蕴热。痘邪为患。用清膈散解散邪气。若脾肺虚热。不能司摄。用人参白术散
调补中气。○一小儿痘赤壮热。咳嗽痰甚。烦热作渴。用人参清膈散一剂。诸症顿退。日用芹菜汁。
旬余而靥。○一小儿痘疮。狂喘躁热。作渴饮冷。痰涎不利。先君用十六味清膈散、犀角地黄汤各一
剂顿愈。又用当归补血汤而愈。○一小儿痘赤狂喘。大便不利。先君以犀角地黄汤、芹菜汁而痊。○
一小儿痘愈后。涕唾口干。饮汤鼻塞。或腹作胀。先用白术散二剂。后用六君子汤而愈。
凡痰实壮热。胸中烦闷。大便坚实。卧则喘急。速用五味前胡枳壳汤治之。
愚按前症。若因肠胃蕴热。宜急用前汤。缓则热毒延内。多致有误。○一小儿患痘赤痛。痰喘作
渴。大便不利。钱密庵用前胡枳壳散一剂。诸症顿退。又用济生犀角地黄汤二剂。月余而愈。○一小
儿第八日。根颗赤肿。胀痛作渴。大便下黑血。烦渴。痰喘。饮冷。呻吟求治。施银台以为血热。毒
蓄于内。用圣济犀角地黄汤一剂。诸症悉退。又用消毒丸。及化班汤而愈。○一小儿痘根色赤。作痛
发热。口渴喜冷。大便坚实。用清凉饮一剂。痛热少减。再剂便利渴止。却用圣济犀角地黄汤而安。
用芹菜汁而靥。○一小儿痘根色赤。作痛。热渴喜饮冷水。大便不利。先用五味前胡枳壳散。大便利
而热渴减。又用圣济犀角地黄汤而安。用芹菜汁而靥。○一小儿大便不利。小便赤涩。作渴饮冷。先
君用凉膈散一剂渐愈。又用济生犀角地黄汤。及芹菜汁而痊。若乳母有肝火。儿患此症。必用加味逍
遥。加黄芩、犀角。兼治其母。○一小儿痘已愈而痕赤作痛。内热作渴。二便不利。先君用济生犀角
地黄汤。及芹菜汁而痊。后用四物黄 而安。○一小儿痘痕白。或时痒。作渴饮汤。大便稀溏。先君
用五味异功散。加当归、黄 而瘥。○一小儿豆痕白。时或痒。先君以为气血俱虚。用八珍汤补之。
不信。自用解毒之剂后。卒变慢脾风而殁。惜哉。
凡饮冰雪不知寒者。阳盛阴虚也。饮沸得不知热者。阴盛阳虚也。阳盛则补阴。木香散加丁香、
官桂。阴盛则补阳。异功散加木香、当归每一两药。共加一钱。
愚按阳盛者。当用清凉饮以补阴。阴盛者当用异功散以补阳。须审的实而用。若或少差。死在反
掌。前云乃传写之误。
凡痘疮首尾。若误饮冷水。疮靥之后。其痂迟落。或生痈肿。或成疳蚀。盖脾胃属土而主肌肉。
水湿所伤。则津液衰少。荣卫涩滞。不能周流。故疮痂迟落而生痈肿。
愚按痘痈之类。属血热未解而内作。外邪搏于肌肤之间。或余毒蕴结。经络轻则肌表津淫瘙痒。
重则肢节壅肿作痛。若余毒炽盛。先用仙方活命饮以解其毒。却用托里消毒散。毒瓦斯将尽。用四君、
归、 、以补托元气。大凡痘疮始末。皆系脾胃之气所主。若饮食药饵失宜。多致变症。故凡饮食少
思。内热晡热者。属脾胃气虚血弱。佐以四君、芎、归、黄 、升麻。若饮食如常。发热作痛者。属
气血亏弱。余毒为患。佐以射干鼠粘子汤。若饮食如常。发热作痛。大便秘结者。属热毒内蕴。用大
连翘饮。如不应。仙方活命饮。若根赤而作痒。血虚也。四物加牡丹皮。色白而作痒。血虚也。四君
加当归、芍药。色赤而作痛。血热也。四物加连翘、金银花。肿而不溃。血气虚也。用托里消毒散。
溃而不愈。脾气虚也。用六君子汤。○一小儿痘毒蚀陷。敷以雄黄散。及服加味解毒散而愈。○一小
儿痘毒。遍身腐溃。脓水淋漓。以经霜茅草研末。铺于寝席。更服九味解毒散顿愈。用神效当归膏敷
之而痊。○一小儿痘毒后。腿膝肿痛。此脾肾虚而毒流注。先用活命饮四剂。肿痛顿减。再用补中益
气汤。及六味地黄丸而痊。○一小儿腿膝肿溃而脓水不
止。内热晡热。体倦肌瘦。先君以为元气复伤。用补阴八珍汤、六味丸。三月余而愈。○一小儿痘已
愈。两目昏闭。先君用鼠粘子汤。加山栀、龙胆草、犀角、目开而有赤白翳。佐以蛇蜕散。外用二粉
散寻愈。
凡疮疹已靥未愈之间。五脏未实。肌肉尚虚。血气未复。被风邪相搏。则津液涩滞。遂成疳蚀。
宜用雄黄散、绵茧散等药治之。久而不愈则溃。多治不起。
愚按前症。属足阳明胃经。其方解毒杀虫之剂。若毒发于外。元气未伤者。用之多效。若胃气伤
损。邪火上炎者。用芜荑汤、六味丸。若赤痛者。用小柴胡汤。加生地黄。肝脾疳症。必用四味肥儿
丸。及人参白术散。更佐以九味芦荟丸。○一女子痘痂将脱。因其秽气。以汤浴已。而身热如炙。四
肢强直如发痉然。此腠理开泄。热毒乘虚而入。用十全大补汤一剂顿安。○一小儿痘出甚密。先四肢
患毒脓溃而愈。后口患疳。涎蚀牙龈。先用大芜荑汤、活命饮各一剂。又用清胃散加犀角。及蝉蜍丸
而愈。后发热作渴。口中作痛。服蝉蜍丸。搽人中黄而安。
凡是痘疮已经结痂脱落，但烦渴症状仍不止息，或者出现头部温热而足部发冷、腹部胀满、腹泻、咬牙等症状的，大多会导致病情难以痊愈。此时应紧急使用十一味木香散来救治。上述这些症状，如果误用蜂蜜水或生冷食物，就会导致病情加重，出现发热和极度口渴而死。
我按语认为：前述症状，属于脾胃亏损，内部是真寒而外部是假热罢了。如果不采用温补疗法就无法挽救。如果前面的药物没有效果，可以使用十全大补汤，加入附子以进行纯补。
○有一个小儿头部生了一个疖子，脓液流出即将愈合时，突然疖子周围肿胀，并发出二十多颗痘疹，全身出现赤色斑点。使用快痘汤使痘疹逐渐发出；使用紫草散并加倍加入人参、黄芪，使痘疹出齐；使用托里消毒散使脓液充盈；使用托里散使疮口结痂。
○有一个小儿痘疮已经结痂，留下的疤痕颜色红赤且纵横交错，每天吃七八碗粥，感到口渴且面色发红。先用白术散服用两剂，口渴减少五到六成，喝粥的量也减少了一半以上。又用四君子汤加入芜荑、黄连服用两剂，疤痕变平、颜色消退。然后使用八珍汤，加入芜荑、山栀而痊愈。
○有一个小儿痘疮痊愈后出现泄泻，饮食不消化，这是脾肾气虚所致。使用六君子汤加入补骨脂、肉豆蔻治疗而痊愈。
○有一个小儿痘疮将要痊愈时，患上了泄泻，清晨时分尤为严重，饮食不消化，这属于脾肾虚损。早晨服用补中益气汤，晚上服用二神丸而痊愈。
凡是身体高热，经过多日不退，如果没有其他症状，使用六味柴胡麦门冬散治疗。热退即停药。如果不见好转，服用七味人参白术散。
我按语认为：前述症状，如果是肝胆热毒，使用柴胡麦门冬散；如果是肝经血虚，使用四物汤，加入黄芩、柴胡；如果是中气虚热，使用人参白术散。
一个男子患痘疮，疼痛，发热不止，形势令人畏惧，大家都认为他活不成了。施银台使用消毒救苦汤治疗，各种症状顿时消退。我先使用仙方活命饮，疼痛完全停止。又使用八珍汤，加入三钱紫草，服用四剂后脓液充盈并结痂。
○一个小儿患痘，痘粒稠密且剧烈疼痛，发热，形势非常危急。先父使用一剂消毒救苦汤，患儿安静躺卧很久，全身发出小痘，顿时消退。再服用一剂后脓液充盈并结痂。
凡是身体高热，大便干结坚硬，或者口腔舌头生疮，咽喉肿痛，这都是疮毒未尽。使用四味射干鼠粘子汤。如果无效，使用七味人参白术散。
我按语认为：前述症状，如果高热且想喝冷水，属于热毒在体表，适宜使用前方的汤剂。如果兼有大便不通，属于热毒在体内，少量使用四顺清凉饮。如果热毒已经去除，胃气虚弱而发热，使用七味人参白术散。如果是因为阴血亏损而发热，使用四物汤。
○一个六岁小儿患痘，第七天痘根和痘头红赤疼痛，大便秘结，小便红赤涩痛，烦躁且想喝冷水。有人使用清凉解毒的药物，没有效果。钱密庵认为是热毒内蕴，使用一剂四顺清凉饮，并用猪胆汁引导排出结粪，从而安定下来。又使用犀角地黄汤，痘疮自然结痂。
○一个小儿痘疮，发热口渴，睾丸红肿胀痛，大便秘结。先用一剂四顺清凉饮，各种症状顿时消退。又用一剂四味鼠粘子汤，各种症状全部消退。再用紫草汤使脓液充盈，使用消毒饮使痘疮结痂。
○一个小儿痘疮痊愈后声音嘶哑，面色发红，脚心发热，小便红赤量少。先父认为是肾经虚热，使用六味地黄丸、补中益气汤而痊愈。当时患这种症状的人，使用清热解毒药物的都未能存活。
○一个十一岁小儿患痘，第四天痘根盘红活起发，因为疼痛不止，到了第七天，形体气息非常疲倦，痘色淡白且有下陷趋势。这是因为疼痛剧烈损伤了元气。先用一剂仙方活命饮使疼痛停止，再用八珍汤使脓液充盈并结痂。
凡是风热咳嗽，咽喉膈膜不利，使用三味桔梗甘草防风汤治疗。如果无效，使用七味人参白术散主治。
我按语认为：前述症状，如果是痘热在内发作，适宜使用桔梗甘草防风汤。如果兼有痰热咳嗽，辅助使用抱龙丸。如果是气虚导致痰涎壅塞于上，适宜使用人参白术散，以补益脾肺。
○一个小儿痘疮第十二天，患咳嗽十多天未愈。所服用的都是发表化痰的药物。我说：这是脾肺气虚，再次损伤真气而变成肺痈。患者不信，仍然服用前药，果然吐出脓血。使用桔梗汤而痊愈。
○一个小儿痘疮将要痊愈时咳嗽，面色黄白，咳嗽剧烈时面色发红。使用五味异功散调理补益而痊愈。
凡是鼻涕唾液粘稠，身体发热，鼻子干燥，大便正常，小便黄赤，使用十六味人参清膈散。如果无效，使用七味人参白术散。
我按语认为：前述症状，属于脾肺蕴藏热毒，痘邪为害，使用清膈散解散邪气。如果是脾肺虚热，不能固摄，使用人参白术散调补中气。
○一个小儿痘色红赤高热，咳嗽痰多，烦热口渴，使用一剂人参清膈散，各种症状顿时消退。每日饮用芹菜汁，十几天后结痂。
○一个小儿痘疮，狂躁喘息燥热，口渴想喝冷水，痰涎不利。先父使用十六味清膈散、犀角地黄汤各一剂，顿时痊愈。又使用当归补血汤而痊愈。
○一个小儿痘色红赤狂躁喘息，大便不利。先父使用犀角地黄汤、芹菜汁而痊愈。
○一个小儿痘疮痊愈后，鼻涕唾液口干，喝汤时鼻塞，或者腹部胀气。先用白术散服用两剂，后用六君子汤而痊愈。
凡是痰实高热，胸中烦闷，大便干结坚硬，躺下则气喘急促，迅速使用五味前胡枳壳汤治疗。
我按语认为：前述症状，如果是由于肠胃蕴藏热毒，应当紧急使用前方的汤剂。如果迟缓，热毒会深入体内，多会导致延误病情。
○一个小儿患痘色红赤疼痛，痰喘口渴，大便不利。钱密庵使用一剂前胡枳壳散，各种症状顿时消退。又使用济生犀角地黄汤两剂，一个多月后痊愈。
○一个小儿第八天，痘根和痘头红赤肿胀，胀痛口渴，大便排出黑血，烦躁口渴，痰喘，喝冷水，呻吟求治。施银台认为是血热，毒蓄积在体内，使用圣济犀角地黄汤一剂，各种症状全部消退。又使用消毒丸，以及化斑汤而痊愈。
○一个小儿痘根颜色红赤，疼痛发热，口渴喜欢冷饮，大便干结坚硬。使用清凉饮一剂，疼痛发热稍微减轻。再服用一剂后大小便利畅，口渴停止。却改用圣济犀角地黄汤而安定。使用芹菜汁而结痂。
○一个小儿痘根颜色红赤，疼痛，热渴喜欢喝冷水，大便不利。先用五味前胡枳壳散，大便通畅后热渴减轻。又使用圣济犀角地黄汤而安定。使用芹菜汁而结痂。
○一个小儿大便不利，小便红赤涩痛，口渴想喝冷水。先父使用凉膈散一剂逐渐痊愈。又使用济生犀角地黄汤，以及芹菜汁而痊愈。如果乳母有肝火，孩子患这种症状，必须使用加味逍遥散，加入黄芩、犀角，同时治疗母亲。
○一个小儿痘疮已愈但疤痕红赤疼痛，内热口渴，大小便不利。先父使用济生犀角地黄汤，以及芹菜汁而痊愈。后用四物汤加入黄芪而安定。
○一个小儿痘痕白色，有时瘙痒，口渴想喝热水，大便稀溏。先父使用五味异功散，加入当归、黄芪而病愈。
○一个小儿痘痕白色，偶尔瘙痒。先父认为是气血俱虚，使用八珍汤补益。患者不信，自行使用解毒药物后，最终转变为慢脾风而死。可惜啊。
凡是喝冰雪水不知道冷的，是阳盛阴虚。喝沸水不知道热的，是阴盛阳虚。阳盛则补阴，使用木香散加入丁香、官桂。阴盛则补阳，使用异功散加入木香、当归。每一两药，共加一钱（指加入的丁香、官桂或木香、当归的量）。
我按语认为：阳盛者，应当使用清凉饮以补阴；阴盛者，应当使用异功散以补阳。必须仔细审察确实无误后再使用。如果稍有差错，死亡就在反掌之间。前面所说的（关于冰雪沸水的论述）乃是传写之误。
凡是痘疮从头到尾，如果误饮冷水，在疮痂脱落后，痂皮迟迟不落，或者生痈肿，或者形成疳蚀。这是因为脾胃属土而主肌肉，被水湿所伤，则津液衰少，营卫涩滞，不能周流全身，所以疮痂迟落而生痈肿。
我按语认为：痘痈之类，属于血热未解而在内发作，外邪搏结于肌肤之间，或者余毒蕴结。经络轻则肌表津液渗出瘙痒，重则肢节壅肿疼痛。如果余毒炽盛，先用仙方活命饮以解除其毒，然后用托里消毒散。毒气将尽时，使用四君子汤、当归、黄芪，以补益托举元气。大凡痘疮始末，都由脾胃之气所主宰。如果饮食药饵失当，多会导致变症。所以凡是饮食少思、午后内热的，属于脾胃气虚血弱，辅助使用四君子汤、川芎、当归、黄芪、升麻。如果饮食如常，发热疼痛的，属于气血亏弱，余毒为害，辅助使用射干鼠粘子汤。如果饮食如常，发热疼痛，大便秘结的，属于热毒内蕴，使用大连翘饮。如果无效，使用仙方活命饮。如果痘根红赤且瘙痒，是血虚，使用四物汤加入牡丹皮。如果痘色白且瘙痒，是血虚，使用四君子汤加入当归、芍药。如果痘色红赤且疼痛，是血热，使用四物汤加入连翘、金银花。如果肿胀但不溃破，是血气虚，使用托里消毒散。如果溃破但不愈合，是脾气虚，使用六君子汤。
○一个小儿痘毒，遍身腐溃，脓水淋漓。用经霜的茅草研成粉末，铺在寝席上，再服用九味解毒散顿时痊愈。使用神效当归膏敷贴而痊愈。
○一个小儿痘毒后，腿膝肿痛，这是脾肾虚而毒气流注。先用活命饮四剂，肿痛顿时减轻。再用补中益气汤，及六味地黄丸而痊愈。
○一个小儿腿膝肿溃而脓水不止，内热午后热甚，体倦肌瘦。先父认为是元气再次受伤，使用补阴八珍汤、六味地黄丸，三个多月后痊愈。
○一个小儿痘已痊愈，两眼昏闭。先父使用鼠粘子汤，加入山栀、龙胆草、犀角，眼睛睁开后有赤白翳障。辅助使用蛇蜕散。外用二粉散寻即痊愈。
凡是疮疹已经结痂但未完全痊愈之间，五脏尚未充实，肌肉尚且虚弱，血气尚未恢复，被风邪相搏结，则津液涩滞，遂成疳蚀。适宜使用雄黄散、绵茧散等药物治疗。时间久了不愈则会溃烂，大多治疗不好。
我按语认为：前述症状，属于足阳明胃经。那些解毒杀虫的方剂，如果毒发于外，元气未受损伤的，使用多有疗效。如果胃气受损，邪火上炎的，使用芜荑汤、六味地黄丸。如果红赤疼痛的，使用小柴胡汤，加入生地黄。肝脾疳症，必须使用四味肥儿丸，及人参白术散。更辅助使用九味芦荟丸。
○一个女子痘痂将要脱落，因为污秽之气，用热水洗澡后，身体热得像烧烤一样，四肢强直像发痉厥一样。这是因为腠理开泄，热毒乘虚而入。使用一剂十全大补汤顿时安定。
○一个小儿痘出得非常密集，先四肢患毒脓溃而愈，后来口患疳，涎液腐蚀牙龈。先用大芜荑汤、活命饮各一剂。又使用清胃散加入犀角，及蝉蜍丸而痊愈。后来发热口渴，口中疼痛，服用蝉蜍丸，搽人中黄而安定。
Whenever the smallpox pustules have crusted over, but irritability and thirst persist, or if there is warmth in the head with coldness in the feet, abdominal distension, diarrhea, or teeth grinding, these conditions often lead to difficult recovery. In such emergencies, use Shiyiwei Muxiang San (Eleven-Ingredient Aromatic Root Powder) to rescue the patient. For the above symptoms, if honey water or raw/cold foods are mistakenly consumed, the condition will worsen with increased heat and extreme thirst, potentially leading to death.
My commentary: The aforementioned symptoms belong to Spleen-Stomach deficiency and damage, where there is true cold internally and false heat externally. Without warm tonification, rescue is impossible. If the previous medicines are ineffective, use Shiquan Dabu Tang (Ten-Agent Great Tonifying Decoction), adding Fuzi (Prepared Aconite Root) for pure tonification.
○ A child had a boil on the head that was suppurating and about to heal. Suddenly, swelling appeared around the boil, accompanied by the eruption of more than twenty smallpox pustules and red spots all over the body. Use Kuaixiao Tang (Rapid Eruption Decoction) to allow the pustules to emerge gradually. Use Zicao San (Arnebia Powder) with doubled doses of Renshen (Ginseng Root) and Huangqi (Astragalus Root) to complete the eruption. Use Tuoli Xiaodu San (Support Interior and Eliminate Toxin Powder) to promote suppuration. Use Tuoli San (Support Interior Powder) to facilitate crusting.
○ A child’s smallpox had crusted over, leaving red, crisscrossed scars. The child ate seven or eight bowls of porridge daily, felt thirsty, and had a red face. First, administer Baizhu San (Atractylodes Macrocephala Powder) for two doses; thirst decreases by 50-60%, and porridge intake drops by half. Then, use Sijunzi Tang (Four Gentlemen Decoction) added with Wuyi (Changium Fruit) and Huanglian (Coptis Rhizome) for two doses; the scars flatten and color fades. Finally, use Bazhen Tang (Eight Treasure Decoction) added with Wuyi and Zhizi (Gardenia Fruit) for recovery.
○ A child suffered from diarrhea after smallpox recovery, with undigested food in stools, indicating Qi deficiency of the Spleen and Kidney. Treat with Liujunzi Tang (Six Gentlemen Decoction) added with Buguzhi (Psoralea Fruit) and Roudoukou (Nutmeg) for cure.
○ A child developing diarrhea as smallpox was nearing recovery, worse in the early morning, with undigested food, indicates Spleen-Kidney deficiency. Administer Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) in the morning, andershenshewan (Two Divine Pills) in the evening for cure.
Whenever there is high fever persisting for days without other symptoms, use Liuwei Chaihu Maidong San (Six-Ingredient Bupleurum and Ophiopogon Powder) for treatment. Stop medication once the fever subsides. If ineffective, take Qiwu Renshen Baizhu San (Seven-Ingredient Ginseng and Atractylodes Powder).
My commentary: For the aforementioned symptoms, if due to Liver-Gallbladder heat toxin, use Chaihu Maidong San. If due to Liver meridian Blood deficiency, use Siwu Tang (Four Substance Decoction) added with Huangqin (Scutellaria Root) and Chaihu (Bupleurum Root). If due to Middle-Jiao Qi deficiency with heat, use Renshen Baizhu San.
A man suffered from painful smallpox with persistent high fever, a dire situation everyone deemed fatal. Shi Yintai treated him with Xiaodu Jiuku Tang (Eliminate Toxin and Relieve Distress Decoction); all symptoms receded instantly. I first used Xianfang Huoming Yin (Immortal Formula for Preserving Life Infusion), stopping the pain completely. Then used Bazhen Tang (Eight Treasure Decoction) with three qian of Zicao (Arnebia Root) for four doses, leading to suppuration and crusting.
○ A child had dense, severely painful smallpox with high fever, in critical condition. My father administered one dose of Xiaodu Jiuku Tang; the child slept peacefully for a long time, small pustules erupted all over, and symptoms vanished. After another dose, suppuration and crusting occurred.
Whenever there is high fever, hard stool, mouth/tongue ulcers, or swollen/painful throat, it indicates residual toxin. Use Siwei Shegan Niuzibang Tang (Four-Ingredient Belamcanda and Burdock Seed Decoction). If ineffective, use Qiwu Renshen Baizhu San.
My commentary: For the aforementioned symptoms, if high fever with desire for cold drinks indicates heat toxin in the exterior, use the aforementioned decoction. If accompanied by constipation, it indicates heat toxin in the interior; use a small amount of Sixun Qingliang Yin (Four-Obedience Cooling Clearing Infusion). If heat toxin is cleared but fever persists due to Stomach Qi deficiency, use Qiwu Renshen Baizhu San. If fever is due to Yin-Blood deficiency, use Siwu Tang.
○ A six-year-old child on the seventh day of smallpox had red, painful roots and heads, constipation, dark/scanty urine, irritability, and desire for cold drinks. Cooling and detoxifying agents failed. Qian Mi’an diagnosed internal heat toxin accumulation and prescribed one dose of Sixun Qingliang Yin, along with pig bile to guide out hardened feces, stabilizing the patient. Then used Xijiao Dihuang Tang (Rhino Horn and Rehmannia Decoction), allowing natural crusting.
○ A child with smallpox had fever, thirst, scrotal redness/swelling/pain, and constipation. First, one dose of Sixun Qingliang Yin reduced symptoms instantly. Then one dose of Siwei Niuzibang Tang cleared all symptoms. Follow with Zicao Tang (Arnebia Decoction) for suppuration, and Xiaodu Yin (Toxin-Eliminating Infusion) for crusting.
○ A child became hoarse after smallpox recovery, with red face, hot soles, and scanty dark urine. My father diagnosed Kidney meridian deficiency heat, treating with Liuwei Dihuang Wan (Six-Ingredient Pill with Rehmannia) and Buzhong Yiqi Tang for cure. Those using cooling/detoxifying agents at that time did not survive.
○ An eleven-year-old child on the fourth day had vibrant red, rising smallpox roots. Due to severe pain, by the seventh day, the child was exhausted, and the pustules were pale and sinking. This was Yuan Qi (Original Qi) damaged by excessive pain. First, one dose of Xianfang Huoming Yin stopped the pain. Then, Bazhen Tang promoted suppuration and crusting.
Whenever wind-heat cough and pharyngeal obstruction occur, use Sanwei Jiegeng Gancao Fangfeng Tang (Three-Ingredient Platycodon, Licorice, and Saposhnikovia Decoction) for treatment. If ineffective, use Qiwu Renshen Baizhu San as the main treatment.
My commentary: For the aforementioned symptoms, if internal smallpox heat arises, use Jiegeng Gancao Fangfeng Tang. If accompanied by phlegm-heat cough, assist with Baolong Wan (Embrace Dragon Pill). If Qi deficiency causes phlegm-fluids obstructing the upper jiao, use Renshen Baizhu San to tonify Spleen-Lung.
○ A child on the twelfth day of smallpox had a cough lasting over ten days despite taking exterior-releasing and phlegm-resolving drugs. I stated this was Spleen-Lung Qi deficiency, further damaging True Qi and transforming into Lung Abscess. The patient refused to believe, continued previous meds, and vomited pus and blood. Treated with Jiegeng Tang (Platycodon Decoction) for cure.
○ A child coughing as smallpox neared recovery, with yellowish-white face and reddening upon severe coughing. Treated with Wuwei Yigong San (Five-Agent Extraordinary Skill Powder) for regulation and tonification for cure.
Whenever thick sticky nasal/salivary secretions, fever, dry nose, normal stool, and yellow-dark urine occur, use Shi-liuwei Renshen Qingge San (Sixteen-Ingredient Ginseng Clearing Diaphragm Powder). If ineffective, use Qiwu Renshen Baizhu San.
My commentary: The aforementioned symptoms belong to Spleen-Lung accumulated heat caused by smallpox evil. Use Qingge San to dissipate evil qi. If Spleen-Lung deficiency heat fails to control fluids, use Renshen Baizhu San to regulate and tonify Middle Qi.
○ A child with red, high-fever smallpox, severe cough/phlegm, irritability, and thirst. One dose of Renshen Qingge San reduced symptoms instantly. Daily celery juice led to crusting within ten days.
○ A child with smallpox had manic panting, restlessness, heat, thirst for cold drinks, and difficult phlegm. My father used Shi-liuwei Qingge San and Xijiao Dihuang Tang, one dose each, for instant cure. Followed by Danggui Buxue Tang (Angelica Tonifying Blood Decoction) for full recovery.
○ A child with red, manic-panting smallpox and constipation. My father cured with Xijiao Dihuang Tang and celery juice.
○ A child with post-smallpox dry mouth/throat, nasal congestion when drinking soup, or abdominal distension. First, Baizhu San for two doses, then Liujunzi Tang for cure.
Whenever phlegm-excess high fever, chest oppression, hard stool, and dyspnea when lying down occur, urgently use Wuwei Qianhu Zhike Tang (Five-Ingredient Peucedanum and Aurantium Decoction).
My commentary: For the aforementioned symptoms, if due to intestinal/colonic heat accumulation, urgently use the aforementioned decoction. Delay allows heat toxin to penetrate inward, causing errors.
○ A child with red, painful smallpox, phlegm-panting, thirst, and constipation. Qian Mi’an used one dose of Qianhu Zhike San, reducing symptoms instantly. Then two doses of Jisheng Xijiao Dihuang Tang for cure over a month.
○ A child on the eighth day had red/swollen roots/heads, painful/thirsty, passing black blood in stool, irritability, thirst, phlegm-panting, cold drink desire, and groaning. Shi Yintai diagnosed blood heat and internal toxin accumulation, using Shengji Xijiao Dihuang Tang for one dose, clearing all symptoms. Then used Xiaodu Wan (Toxin-Eliminating Pill) and Huaban Tang (Spot-Dissipating Decoction) for cure.
○ A child with red, painful, febrile smallpox roots, thirst for cold, and hard stool. One dose of Qingliang Yin reduced pain/heat slightly. Two doses normalized bowels and stopped thirst. Then switched to Shengji Xijiao Dihuang Tang for stability. Celery juice led to crusting.
○ A child with red, painful smallpox roots, heat/thirst for cold water, and constipation. First, Wuwei Qianhu Zhike San; normalization of bowels reduced heat/thirst. Then Shengji Xijiao Dihuang Tang for stability. Celery juice led to crusting.
○ A child with constipation, dark/scanty urine, and thirst for cold drinks. My father used Liangge San (Cool Diaphragm Powder) for gradual improvement. Then Jisheng Xijiao Dihuang Tang and celery juice for cure. If the nursing mother has Liver fire, the child suffering this must be treated with Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder) added with Huangqin and Xijiao, treating both mother and child.
○ A child with healed but red/painful scars, internal heat/thirst, and urinary/bowel difficulty. My father cured with Jisheng Xijiao Dihuang Tang and celery juice. Stabilized later with Siwu Tang added with Huangqi.
○ A child with white scars, occasional itching, thirst for hot drinks, and loose stools. My father used Wuwei Yigong San added with Danggui and Huangqi for cure.
○ A child with white, occasionally itchy scars. My father diagnosed dual Qi-Blood deficiency, using Bazhen Tang for tonification. The patient refused, self-administered detoxifying agents, and died of Manpen Feng (Slow Spleen Wind). Regrettable.
Those who drink ice/snow water without feeling cold indicate Yang excess and Yin deficiency. Those who drink boiling water without feeling heat indicate Yin excess and Yang deficiency. For Yang excess tonifying Yin, use Muxiang San added with Dingxiang (Clove) and Guangui (Cinnamon Bark). For Yin excess tonifying Yang, use Yigong San added with Muxiang and Danggui. Add one qian of the added herbs per liang of base medicine.
My commentary: For Yang excess, use Qingliang Yin to tonify Yin. For Yin excess, use Yigong San to tonify Yang. Must verify accurately before use. Even slight error can cause instant death. The previous statement regarding ice/boiling water was a transcription error.
If cold water is mistakenly drunk throughout the smallpox course, after crusting, scabs fall late, or abscesses/gan erosion form. This is because Spleen-Stomach (Earth) governs muscles; injury by water-dampness depletes Jin-Ye (Body Fluids), causing Ying-Wei (Nutritive-Defensive) stagnation and failure to circulate, thus delaying scab falling and causing abscesses.
My commentary: Smallpox abscesses belong to unresolved Blood heat acting internally, with external pathogens clashing in skin/muscle, or residual toxin accumulation. Mild cases cause surface fluid exudation and itching; severe cases cause limb/joint swelling and pain. If residual toxin is fierce, first use Xianfang Huoming Yin to resolve toxin, then Tuoli Xiaodu San. As toxin exhausts, use Sijunzi Tang, Danggui, and Huangqi to tonify and support Yuan Qi. Generally, smallpox stages are governed by Spleen-Stomach Qi. Improper diet/medication leads to complications. For poor appetite and afternoon internal heat, it is Spleen-Stomach Qi deficiency and Blood weakness; assist with Sijunzi Tang, Chuanxiong, Danggui, Huangqi, and Shengma. For normal appetite with fever/pain, it is Qi-Blood weakness with residual toxin; assist with Shegan Niuzibang Tang. For normal appetite with fever/pain and constipation, it is internal heat toxin; use Dalianqiao Yin. If ineffective, use Xianfang Huoming Yin. For red roots with itching, it is Blood deficiency; Siwu Tang added with Mudanpi. For white color with itching, it is Blood deficiency; Sijunzi Tang added with Danggui and Shaoyao. For red color with pain, it is Blood heat; Siwu Tang added with Lianqiao and Jinyinhua. For swelling without ulceration, it is Qi-Blood deficiency; use Tuoli Xiaodu San. For ulceration without healing, it is Spleen Qi deficiency; use Liujunzi Tang.
○ A child with smallpox toxin erosion/sinking was treated with Xionghuang San (Realgar Powder) topically and Jiawei Jiedu San (Modified Detoxifying Powder) orally for cure.
○ A child with widespread smallpox toxin ulceration and dripping pus. Crushed frost-exposed Maocao (Mugwort-like grass) powder was spread on bedding, plus Jiwei Jiedu San (Nine-Ingredient Detoxifying Powder) orally for instant cure. Applied Shenxiao Danggui Gao (Divine Efficacy Angelica Ointment) topically for recovery.
○ A child with leg/knee swelling/pain after smallpox toxin, due to Spleen-Kidney deficiency and toxin flow. Four doses of Huoming Yin reduced swelling/pain instantly. Then Buzhong Yiqi Tang and Liuwei Dihuang Wan for cure.
○ A child with leg/knee ulceration, continuous pus, internal heat, afternoon fever, fatigue, and emaciation. My father diagnosed re-injury of Yuan Qi, using Buyin Bazhen Tang (Yin-Tonifying Eight Treasure Decoction) and Liuwei Wan for cure over three months.
○ A child with closed/blind eyes after smallpox recovery. My father used Niuzibang Tang (Burdock Seed Decoction) added with Zhizi, Longdancao (Gentian Root), and Xijiao. Eyes opened, revealing red/white nebula. Assisted with Shetui San (Snake Slough Powder). Topical Erfen San (Two Powder Powder) led to quick recovery.
When rash/pustules have crusted but not fully healed, the Five Zang organs are not solid, muscles are weak, and Qi-Blood not restored. Clash with Wind Evil causes fluid stagnation, leading to gan erosion. Treat with Xionghuang San, Mianjian San (Silkworm Cocoon Powder), etc. Prolonged non-healing leads to ulceration, often untreatable.
My commentary: The aforementioned symptoms belong to the Foot-Yangming Stomach Meridian. Antitoxic/antiparasitic formulas are effective if toxin erupts outward and Yuan Qi is intact. If Stomach Qi is damaged and evil fire flares upward, use Wuyi Tang and Liuwei Dihuang Wan. If red/painful, use Xiao Chaihu Tang added with Shengdihuang (Rehmannia Root). Liver-Spleen gan syndrome requires Siwei Fei’er Wan (Four-Ingredient Child-Nourishing Pill) and Renshen Baizhu San, assisted by Jiwei Lushui Wan (Nine-Ingredient Aloe Pill).
○ A girl’s smallpox scabs were about to fall. Due to foul air, she bathed in hot water, resulting in burning fever and rigid limbs like spasms. This was due to open pores allowing heat toxin to enter via deficiency. One dose of Shiquan Dabu Tang brought instant peace.
○ A child with very dense smallpox had toxic suppuration on limbs that healed, followed by oral gan eroding gums. First, Da Wuyi Tang and Huoming Yin, one dose each. Then Qingwei San (Clear Stomach Powder) added with Xijiao, and Chanchu Wan (Cicada Larva Pill) for cure. Later fever/thirst/mouth pain stabilized with Chanchu Wan and Renzhonghuang (Human Waste Charcoal) application.