〔刘提点〕云∶疹痘最要大小腑分晓，所以钱氏四圣散用木通、枳壳极妙若大小腑自流利，则不必苦泥。〔万
〕凡疮疹，小便欲长，大便欲实，经曰∶小便数者，大便必硬。虽二三日不更衣，无苦也，如小水少，则病进，盖
心主疮而属火，心移热于小肠，小肠移热于膀胱，膀胱为津液之府，气化则出，气为火食，不能传化而津液不
出，故小便闷也。疮疹发热，大便欲润，若二三日不行，宜急利之，恐肠胃不通，荣卫不行，疮出转密也，惟疮起
发之后，大便却宜坚实，如能食而大便常行者，不须忌之，若过四五日不行，则热盛生湿，其疮难靥，亦宜微利
之。设使大小便俱不通，则邪毒内
蓄，三焦阻绝，经曰∶一息不运，则机缄穷。故大小便不通者死。
凡痘子，要大小便自调，则里气和，无留邪也，故小便宜长而清，如小便赤涩，导赤散（心）。小便短少，八正散。
疮出太密，小便不通者，连翘汤。盖疮子发热，不
可骤去，惟利小便以折其郁。如痘稠密小便少者，此气血衰少，津液虚耗，非热也，不可利之，反损真阳之气，十
全大补汤（汗）主之。能食者大便宜润，有入必有出也，不能食者大便宜实，存旧谷气以养血气也，如四五日不行，大
便结燥者，用胆导法导之。不通，以三黄丸（热）微利之。如大结腹胀者，以三乙承气汤下之。如大便泄泻，即止之，
盖痘疮要里气实，恐泻得脾胃虚也，轻则理中汤丸（泻利）益黄散（脾）豆蔻丸，甚则陈氏木香散（俱泻利）、异
功散（出不快）主之。
〔闻人氏〕云∶痘出正盛，喘促腹满，手掌心并腋下有汗，或谵语妄言，小便赤而大便不通者，小承气汤（伤寒）
之类下之。若面赤黄，大便秘涩，小便少而或呕者，宜小柴胡汤（发热）。热甚而荣卫闭塞，则毒瓦斯弥蔓，如里毒盛者，
大便不通，小便如血，如表毒盛者，成为痈疮，身上破裂，此皆因不曾解利之故，俱宜犀角地黄汤（失血）、小柴
胡汤加生地黄、四顺饮（发热）、牛黄散（腹痛）、紫雪（大科发热）辈救之。若毒凝血聚，疮成黑色，大小便秘，
喘急烦躁者，治法见验色条。
治大小便俱不通。以皂荚烧灰，存性，为末，米饮调下。
葵子末一合，水一盏，煮至半钟，入猪脂半两，空心服。
【小便不利】《痘疹方》云∶痘疹未出之先，小便不利，热盛者，恐欲起惊，用导赤散（心）微解之。热入膀胱，如
有血淋，犀角地黄汤（失血）。初出不快，小便赤涩，四圣散（见形出不快）。已出而赤涩，白术散（渴）加木通，五苓
散加木香（丹溪用五苓散加麦门冬煎服）。收靥之后，小便不利，烦热而渴，猪苓散（痘后）。〔薛〕前证当分所因，若小
肠热结，用导赤散。肝经热，用柴胡麦门冬汤（痘后）。脾经热，用犀角地黄汤。肺经热，用生地黄汤（痘咳嗽）。肾经
热，地黄丸（肾）。靥后气血虚弱，用八珍汤（虚羸）。中气虚弱，用五味异功散（吐泻）。〔万〕凡疮疹小便少者，
热微，导赤散加山栀仁，热甚，八正散主之。
八正散 治下焦积热，大小便不通，或小便淋涩，脉证俱实者。
大黄（酒炒） 车前子（炒） 瞿麦 蓄 山栀（炒） 木通（各一钱） 滑石（煨，二钱） 甘草（一钱）
上，每服二钱，水煎。
滋肾丸
黄柏（炒黑） 知母（炒黑。各二两） 肉桂（二钱）
上为末，水糊丸。
黄芩清肺饮
黄芩（炒） 山栀（炒等分）
上，每服二钱，水煎。
紫草木通汤 治痘疮出不快，小便不利。
紫草 人参 木通 茯苓 糯米（各等分） 甘草（减半）
上，水煎服。
通关散 此药通心经，利小便。
山栀仁 大黄（炒。各一分） 木通 甘草（炙） 车前子（炒） 赤茯苓 瞿麦 人参 滑石
（各三分） 蓄（炒，五分）
上锉细。用水一盏，灯心十根，煎半盏，温服。
连翘汤
连翘 防风 瞿麦 荆芥穗 木通 车前子 当归 柴胡 赤芍药 白滑石 蝉蜕 黄芩 山栀
子甘草（各五分）
上锉细。加紫草五分，水一盏半，煎一盏，去滓，食前温服。
紫草冬葵汤 治小便不通，毒瓦斯闭塞。
紫草茸 山栀子 黄芩（各一钱二分） 秦艽 苦参（各一钱一分） 冬葵子（一钱半） 露蜂房 白
茯苓 木通 白芍药 泽泻 车前子（各一钱） 蝉蜕（八分）
上锉散。每服四五钱，水煎，食远温服。如急数茎中痛者，加甘草稍八分、苦楝子一钱。如痛甚欲死者，加川牛
膝一钱三分。如有赤如血色者，加胡黄连一钱三分。如溺血者，加当归一钱，川芎一钱，龙骨火 、菟丝子各一钱，
红甚者，加生地黄。白溺者，加使君子各一钱三分、黄连一钱一分、韭子研一钱二分。浊甚者，加桑螵蛸一钱。
【大便秘】〔薛〕陈文宿先生云∶痘疹四五日不大便，以肥猪 白水煮熟，切豆大五七块与食之，滋润脏腑，
疮痂易落，切不可妄投宣利之药，恐真气内虚，疮毒入里。如六七日身壮热，不大便，其脉紧盛，与三味消毒饮（见形）
微利之。窃谓前证，若毒在肌肉而未能尽发，脉浮而紧者，最宜此药疏解其毒。若脉沉而紧者，宜用前
胡枳壳散（喘）疏通毒瓦斯，以绝其源。若口舌咽喉肿痛，疮毒甚也，用射干鼠粘子汤（咽喉）。若大便既通，作渴饮汤，
脾胃气虚也，用人参白术散（渴）。凡燥粪在直肠不能下者，宜用猪胆汁导之，忌用疏利之剂，恐复伤胃气，则疮未出者
不能发出，已出者不能
满靥。大抵分辨虚实，当以手足冷热，或饮水、饮汤验之。〔万〕如发热时大便不行，热微者三黄丸（发热），甚
则承气汤主之。如起发至收靥，大便不行者，用胆导法，不可遽用利药。但疮干黑陷，大便秘，烦躁者，以百祥丸、
牛李膏（黑陷）主之，如无此药，以承气代之。
当归丸
当归（半两） 甘草（一分） 黄连 大黄（各二钱半）
先将当归熬膏子，入药末三味为丸，加服之，以利为度。
枣变百祥丸 治 疹大便秘结。
红牙大戟（去骨，一两） 青州枣（去核，十枚）
上，用水二盏，同煎至水尽为度，去大戟，将枣焙干，可和作剂旋丸。从少至多，以利为度。
洗心散 治痘疮壮热，大小便不利，狂言多渴。
大黄 甘草 当归 麻黄（去节） 白术 芍药 荆芥（各等分）
上 咀。量病轻重多少，姜薄荷煎。温服则平，热服则溏。
三乙承气汤
大黄 芒硝 浓朴 枳实（各一钱） 甘草（五分）
上锉细。水一盏，加生姜一片，煎至七分，去滓，食前热服。
胆导法
用大猪胆一枚，以鹅翎筒、两头截齐，一头入胆中，线牢札定，吹令气满，纳入谷道中，直待气通，取去。
加味四君子汤
人参 白术 黄 白茯苓 甘草 栝蒌根 桔梗
各等分，水煎服。海藏以此治疮疹已出未出，大便秘涩，或时发渴。盖有病者或因禀受不足，或因吐泻之后，
或因汗多，或利小便，元气既虚、津液干涸，不得润滑，而致大便秘涩者，若妄行疏利，何异操刀，必须此
药治之，医家切宜详审，勿令误也。
润肠汤 治虚秘。
当归梢 甘草 生地黄 火麻仁 桃仁泥
水煎服。
紫草麻仁汤 治疮疹大便不通，致毒瓦斯闭塞。
山豆根 紫草（各一钱一分） 鼠粘子 露蜂房 生犀 青皮 桃仁 麻仁 侧柏叶
黄芩（各一钱） 杏仁（一钱二分）
上锉散。每服四五钱，水煎，食远服。秘甚者加乌梅肉七分，不已，再加冬葵子一钱五分。
【刘提点】说：疹痘病最关键在于大小便通畅，所以钱乙的四圣散中使用木通、枳壳非常巧妙。如果大小便自然流利，就不必使用峻烈的泻下药。
【万全】说：凡是疮疹，小便应当长而清，大便应当成形。医经说：小便频数的人，大便必然干硬。即使两三天不大便，也不必痛苦焦虑。如果小便量少，说明病情加重，因为心主疮疹且属火，心将热邪移于小肠，小肠将热邪移于膀胱。膀胱是津液之府，依靠气化作用排出尿液。气被火邪所伤，不能传导化生，导致津液无法排出，所以小便涩闷不畅。疮疹发热时，大便应当滋润，如果两三天不通行，应当紧急通便，恐怕肠胃不通，营卫之气运行受阻，导致疹毒外发过于密集。只有在疮疹起发之后，大便却适宜坚实。如果能进食且大便常通行，不需要禁忌饮食。如果超过四五天不大便，则热盛生湿，疮疹难以结痂愈合，也应当轻微通便。假如大小便都不通，则邪毒内蓄，三焦阻滞隔绝。医经说：一息之气不运转，则生机穷尽。所以大小便不通者死亡。
凡痘疮患儿，大小便自调，则里气平和，没有留滞的邪气。所以小便应当长而清，如果小便赤涩，用导赤散（主治心经热）。小便短少，用八正散。疮疹出得太密，小便不通的，用连翘汤。大概疮疹发热，不可骤然退热，只宜利小便以折服其郁热。如果痘疮稠密且小便少的，这是气血衰少，津液虚耗，并非实热，不可利小便，否则会反损真阳之气，应以十全大补汤（主治汗后虚证）为主治方。能进食的人，大便应当滋润，因为有入必有出；不能进食的人，大便应当结实，以保存旧谷气来滋养血气。如果四五天不大便，大便干结燥硬的，用胆导法引导排便。仍不通的，用三黄丸（主治热证）轻微通便。如果大便严重结滞且腹胀的，用三乙承气汤攻下。如果大便泄泻，即停止用药，因为痘疮需要里气充实，恐怕泄泻导致脾胃虚弱。轻症用理中汤丸（主治泻利）、益黄散（主治脾虚）、豆蔻丸；重症用陈氏木香散（均主治泻利）、异功散（主治出疹不快）为主治方。
【闻人氏】说：痘疮发出正盛时，出现喘促腹满，手掌心和腋下有汗，或谵语妄言，小便赤色而大便不通的，用小承气汤（主治伤寒实证）之类攻下。如果面色赤黄，大便秘涩，小便少且有时呕吐的，宜用小柴胡汤（主治发热）。热势甚重且营卫闭塞，则毒瓦斯弥漫蔓延。如里毒盛的，大便不通，小便如血；如表毒盛的，成为痈疮，身上破裂。这都是因为没有及时解表透利的缘故，都宜用犀角地黄汤（主治失血）、小柴胡汤加生地黄、四顺饮（主治发热）、牛黄散（主治腹痛）、紫雪（主治小儿高热）等药救治。如果毒凝血聚，疮成黑色，大小便秘，喘急烦躁的，治法见“验色”条。
治疗大小便俱不通。用皂荚烧成灰，保留药性，研为末，米汤调服。
葵子末一合，水一盏，煮至半钟，加入猪脂半两，空腹服用。
【小便不利】《痘疹方》说：痘疹未出之前，小便不利，热势盛的，恐怕欲引发惊风，用导赤散轻微解之。热入膀胱，如有血淋，用犀角地黄汤（主治失血）。初出不快，小便赤涩，用四圣散（见形不出快）。已出而赤涩，用白术散（主治渴）加木通，五苓散加木香（丹溪用五苓散加麦门冬煎服）。收靥之后，小便不利，烦热而渴，用猪苓散（痘后证）。【薛己】前面的证候应当分辨病因，若小肠热结，用导赤散。肝经热，用柴胡麦门冬汤（痘后证）。脾经热，用犀角地黄汤。肺经热，用生地黄汤（痘咳嗽）。肾经热，用地黄丸（肾证）。收靥后气血虚弱，用八珍汤（虚羸证）。中气虚弱，用五味异功散（吐泻证）。【万全】凡是疮疹小便少的，热微者，导赤散加山栀仁；热甚者，八正散为主治方。
八正散 治疗下焦积热，大小便不通，或小便淋涩，脉证俱实的。
大黄（酒炒） 车前子（炒） 瞿麦 萹蓄 山栀（炒） 木通（各一钱） 滑石（煨，二钱） 甘草（一钱）
以上药物，每次服二钱，水煎。
滋肾丸
黄柏（炒黑） 知母（炒黑。各二两） 肉桂（二钱）
以上研为末，水糊为丸。
黄芩清肺饮
黄芩（炒） 山栀（炒等分）
以上，每次服二钱，水煎。
紫草木通汤 治疗痘疮出不快，小便不利。
紫草 人参 木通 茯苓 糯米（各等分） 甘草（减半）
以上，水煎服。
通关散 此药通心经，利小便。
山栀仁 大黄（炒。各一分） 木通 甘草（炙） 车前子（炒） 赤茯苓 瞿麦 人参 滑石（各三分） 萹蓄（炒，五分）
以上锉细。用水一盏，灯心十根，煎至半盏，温服。
连翘汤
连翘 防风 瞿麦 荆芥穗 木通 车前子 当归 柴胡 赤芍药 白滑石 蝉蜕 黄芩 栀子 甘草（各五分）
以上锉细。加紫草五分，水一盏半，煎至一盏，去渣，食前温服。
紫草冬葵汤 治疗小便不通，毒瓦斯闭塞。
紫草茸 山栀子 黄芩（各一钱二分） 秦艽 苦参（各一钱一分） 冬葵子（一钱半） 露蜂房 白茯苓 木通 白芍药 泽泻 车前子（各一钱） 蝉蜕（八分）
以上锉散。每次服四五钱，水煎，食远温服。如果急迫且尿道疼痛的，加甘草稍八分、苦楝子一钱。如果痛甚欲死的，加川牛膝一钱三分。如果有血色如血的，加胡黄连一钱三分。如果溺血的，加当归一钱，川芎一钱，龙骨火煅、菟丝子各一钱，红甚的，加生地黄。白溺的，加使君子各一钱三分、黄连一钱一分、韭子研一钱二分。浊甚的，加桑螵蛸一钱。
【大便秘】【薛己】陈文宿先生说：痘疹四五天不大便，用肥猪肉白水煮熟，切如豆大五七块给患儿吃，滋润脏腑，疮痂易落，切不可妄投宣利之药，恐怕真气内虚，疮毒入里。如果六七天身壮热，不大便，其脉紧盛，与三味消毒饮（见形证）轻微通便。我认为前面的证候，若毒在肌肉而未能尽发，脉浮而紧的，最宜此药疏解其毒。若脉沉而紧的，宜用前胡枳壳散（喘证）疏通毒瓦斯，以绝其源。如果口舌咽喉肿痛，疮毒甚也，用射干鼠粘子汤（咽喉证）。如果大便既通，作渴饮汤，是脾胃气虚也，用人参白术散（渴证）。凡燥粪在直肠不能下的，宜用猪胆汁导之，忌用疏利之剂，恐怕再伤胃气，则疮未出的不能发出，已出的不能满靥。大抵分辨虚实，当以手足冷热，或饮水、饮汤来验证。【万全】如发热时大便不行，热微者三黄丸（发热），甚则承气汤主治。如起发至收靥，大便不行的，用胆导法，不可遽用利药。但疮干黑陷，大便秘，烦躁的，以百祥丸、牛李膏（黑陷证）主治，如无此药，以承气汤代替。
当归丸
当归（半两） 甘草（一分） 黄连 大黄（各二钱半）
先将当归熬膏，入药末三味为丸，加服之，以利为度。
枣变百祥丸 治疗痘疹大便秘结。
红牙大戟（去骨，一两） 青州枣（去核，十枚）
以上，用水二盏，同煎至水尽为度，去大戟，将枣焙干，可和作剂旋丸。从少至多，以利为度。
洗心散 治疗痘疮壮热，大小便不利，狂言多渴。
大黄 甘草 当归 麻黄（去节） 白术 芍药 荆芥（各等分）
以上锉咀。量病轻重多少，姜薄荷煎。温服则平，热服则溏。
三乙承气汤
大黄 芒硝 浓朴 枳实（各一钱） 甘草（五分）
以上锉细。水一盏，加生姜一片，煎至七分，去渣，食前热服。
胆导法
用大猪胆一枚，以鹅翎筒、两头截齐，一头入胆中，线牢扎定，吹令气满，纳入谷道中，直待气通，取去。
加味四君子汤
人参 白术 黄芪 白茯苓 甘草 栝蒌根 桔梗
各等分，水煎服。海藏以此治疮疹已出未出，大便秘涩，或时发渴。盖有病者或因禀受不足，或因吐泻之后，或因汗多，或利小便，元气既虚、津液干涸，不得润滑，而致大便秘涩者，若妄行疏利，何异操刀，必须此药治之，医家切宜详审，勿令误也。
润肠汤 治疗虚秘。
当归梢 甘草 生地黄 火麻仁 桃仁泥
水煎服。
紫草麻仁汤 治疗疮疹大便不通，致毒瓦斯闭塞。
山豆根 紫草（各一钱一分） 鼠粘子 露蜂房 生犀 青皮 桃仁 麻仁 侧柏叶 黄芩（各一钱） 杏仁（一钱二分）
以上锉散。每次服四五钱，水煎，食远服。秘甚者加乌梅肉七分，不已，再加冬葵子一钱五分。
[Liu Tidian] stated: In the treatment of variola and exanthema, it is most crucial to ensure the patency of the bowels and bladder. Therefore, Qian Yi's Four Sages Powder (Sisheng San) uses Tongcao (Akebiae Caulis) and Zhiqiao (Aurantii Fructus) with great efficacy. If the bowels and bladder are naturally unobstructed, there is no need to use harsh purgatives.
[Wan Quan] stated: In all cases of exanthema, urination should be copious and clear, and defecation should be formed. The Classics state: "Those who urinate frequently will inevitably have hard stools." Even if there is no bowel movement for two or three days, one need not be distressed. However, if urine volume is scant, the disease is progressing. This is because the Heart governs exanthema and belongs to Fire; Heart heat transfers to the Small Intestine, and Small Intestine heat transfers to the Bladder. The Bladder is the mansion of body fluids; its function relies on Qi transformation to discharge fluids. When Qi is consumed by Fire, it cannot transmit and transform, causing body fluids to fail to discharge, resulting in dysuria and urinary distress. During the fever stage of exanthema, stools should be moist. If there is no bowel movement for two or three days, urgent purgation is indicated to prevent intestinal obstruction, which would hinder the circulation of Ying and Wei (Nutritive and Defensive Qi), leading to an overly dense eruption of rash. Only after the eruption has risen and developed should the stool become firm. If the patient can eat and has regular bowel movements, dietary restrictions are unnecessary. If there is no bowel movement for four or five days, excessive heat generates dampness, making it difficult for the sores to crust over; mild purgation is then appropriate. If both urine and stool are obstructed, pathogenic toxins accumulate internally, blocking the Triple Burner (San Jiao). The Classics state: "If the breath does not move for a single respiration, the mechanism of life is exhausted." Thus, obstruction of both urine and stool leads to death.
In infantile smallpox, if urination and defecation are regulated, the interior Qi is harmonious, and no pathogenic factors remain stagnant. Therefore, urination should be copious and clear. If urine is red and dysuric, Daochi San (Heart Heat) is used. If urine is scanty, Bazheng San is used. If the eruption is too dense and urination is obstructed, Lianqiao Tang is used. Generally, during the fever of exanthema, heat should not be abruptly cleared; rather, promoting urination helps to subdue the constrained heat. If the smallpox is dense and urine is scant, this indicates deficiency of Qi and Blood, and depletion of body fluids, rather than excess heat. Promoting urination in this case would damage True Yang Qi; instead, Shiquan Dabu Tang (Deficiency after Sweating) should be used as the primary formula. Patients who can eat should have moist stools, as there must be intake and output. Those who cannot eat should have solid stools to preserve old grain Qi to nourish Blood and Qi. If there is no bowel movement for four or five days and the stool is dry and hard, the Gallbladder Suppository Method (Dan Dao Fa) should be used. If still obstructed, Sanhuang Wan (Heat) should be used for mild purgation. If there is severe fecal impaction with abdominal distension, Saiyi Chengqi Tang should be used to purge. If diarrhea occurs, medication should be stopped, as smallpox requires strong interior Qi, and diarrhea may weaken the Spleen and Stomach. For mild cases, Lizhong Tang Pills (Diarrhea), Yihuang San (Spleen), or Doukou Wan are used. For severe cases, Chen's Muxiang San (All Diarrhea) or Yigong San (Slow Eruption) are used.
[Renren Shi] stated: When smallpox is erupting vigorously, accompanied by panting, abdominal fullness, sweating on the palms and axillae, delirium, red urine, and constipation, Xiaochengqi Tang (Shanghan) or similar formulas should be used to purge. If the face is red and yellow, stools are dry and difficult, urine is scant, and vomiting occurs occasionally, Xiao Chaihu Tang (Fever) is appropriate. If heat is severe and Ying and Wei are blocked, toxic vapors spread diffusely. If interior toxicity is severe, there is constipation and hematuria; if exterior toxicity is severe, carbuncles and sores form, and the body ruptures. These result from failure to resolve and promote expulsion early. All such cases should be treated with Xijiao Dihuang Tang (Hemorrhage), Xiao Chaihu Tang plus Shengdihuang, Sishun Yin (Fever), Niuhuang San (Abdominal Pain), or Xuexue (Pediatric High Fever). If toxin coagulates and blood gathers, turning sores black, with constipation, panting, and irritability, refer to the "Examination of Color" section.
For total obstruction of urine and stool: Burn Gleditsiae Sinensis Fruit (Zaojiao) to ash, retain its nature, powder it, and administer with rice water.
Take one heaping measure of Abutilon Seed Powder (Kuizi Mo), boil in one cup of water until half remains, add half an ounce of lard, and take on an empty stomach.
[Urinary Difficulty] *Douzhen Fang* states: Before the eruption of smallpox and measles, if urination is difficult and heat is severe, fearing the onset of convulsions, use Daochi San to mildly resolve it. If heat enters the Bladder, presenting as bloody strangury, use Xijiao Dihuang Tang (Hemorrhage). If eruption is slow with red, dysuric urine, use Sisheng San (Appearance/Slow Eruption). If already erupted with red, dysuric urine, use Baizhu San (Thirst) plus Tongcao, or Wuling San plus Muxiang (Danyuan used Wuling San plus Maidong decocted). After crusting, if urination is difficult with irritability, heat, and thirst, use Zhuling San (Post-Varicella). [Xue Ji] stated that previous symptoms should be differentiated by cause: Small Intestine heat accumulation uses Daochi San; Liver Meridian heat uses Chaihu Maidong Tang (Post-Varicella); Spleen Meridian heat uses Xijiao Dihuang Tang; Lung Meridian heat uses Shengdihuang Tang (Measles Cough); Kidney Meridian heat uses Dihuang Wan (Kidney). Post-crusting Qi and Blood deficiency uses Bazhen Tang (Emaciation); Middle Qi deficiency uses Wuwei Yigong San (Vomiting/Diarrhea). [Wan Quan] stated: For scant urination in exanthema, mild heat uses Daochi San plus Zhizi Ren; severe heat uses Bazheng San as the primary formula.
Bazheng San treats lower Jiao accumulated heat, obstruction of urine and stool, or dysuric strangury, with pulse and symptoms indicating excess.
Rhubarb (stir-fried with wine), Plantago Seed (stir-fried), Dianthus Flower, Polygonum Knotweed, Gardenia (stir-fried), Akebia Stem (each 1 qian), Talcum (roasted, 2 qian), Licorice Root (1 qian).
Powder these. Take 2 qian per dose, decoct in water.
Zishen Wan
Phellodendron Bark (charred stir-fry), Anemarrhena Rhizome (charred stir-fry, each 2 liang), Cinnamon Twig (2 qian).
Grind into powder, bind with water paste into pills.
Huangqin Qingfei Yin
Scutellaria Root (stir-fried), Gardenia Fruit (stir-fried, equal parts).
Take 2 qian per dose, decoct in water.
Zicao Mutong Tang treats slow eruption of smallpox and urinary difficulty.
Arnebia Root, Ginseng, Akebia Stem, Poria, Glutinous Rice (equal parts), Licorice Root (half amount).
Decoct in water and take.
Tongguan San opens the Heart Meridian and promotes urination.
Gardenia Seed, Rhubarb (stir-fried, each 1 fen), Akebia Stem, Licorice Root (honey-fried), Plantago Seed (stir-fried), Red Poria, Dianthus Flower, Ginseng, Talcum (each 3 fen), Polygonum Knotweed (stir-fried, 5 fen).
Cut finely. Decoct one cup of water with ten roots of Centella Asiatica (Dengxin) until half remains, take warm.
Lianqiao Tang
Forsythia Fruit, Saposhnikovia Root, Dianthus Flower, Schizonepeta Spikelet, Akebia Stem, Plantago Seed, Angelica Sinensis, Bupleurum Root, Red Peony Root, White Talcum, Cicada Slough, Scutellaria Root, Gardenia Fruit, Licorice Root (each 5 fen).
Cut finely. Add 5 fen of Arnebia Root, decoct one and a half cups of water until one cup remains, strain, and take warm before meals.
Zicao Dongkui Tang treats urinary obstruction due to toxic vapor blockage.
Arnebia Flos, Gardenia Fruit, Scutellaria Root (each 1.2 qian), Gentiana Macrophylla, Sophora Flavescens Root (each 1.1 qian), Abutilon Seed (1.5 qian), Honeycomb, White Poria, Akebia Stem, White Peony Root, Alisma Rhizome, Plantago Seed (each 1 qian), Cicada Slough (0.8 fen).
Cut into pieces. Take 4-5 qian per dose, decoct in water, take warm long after meals. If painful urination is urgent, add Licorice Root Tip (0.8 fen) and Melia Toosendan Fruit (1 qian). If pain is severe and life-threatening, add Cyathula Root (1.3 qian). If urine is bloody, add Picrorhiza Rhizome (1.3 qian). If hematuria, add Angelica Sinensis (1 qian), Ligusticum Chuanxiong Rhizome (1 qian), Dragon Bone (calcined), Cuscuta Seed (each 1 qian); if very red, add Rehmannia Root. If urine is white, add Quisqualis Indica Fruit (1.3 qian), Coptis Rhizome (1.1 qian), Leek Seed powder (1.2 qian). If turbid, add Mantis Egg Case (1 qian).
[Constipation] [Xue Ji] Mr. Chen Wensu said: If smallpox/measles patients do not defecate for four to five days, cook lean pork in plain water until soft, cut into bean-sized pieces (5-7 pieces), and feed them. This moistens the organs and facilitates falling of scabs. Do not recklessly administer purgatives, lest internal True Qi become deficient and toxin enter the interior. If there is high fever for six to seven days without defecation, and the pulse is tight and vigorous, give Sanwei Xiaodu Yin (Appearance) for mild purgation. I believe that if toxin is in the muscle layer and not fully erupted, with a floating and tight pulse, this formula best disperses the toxin. If the pulse is sunken and tight, use Qianhu Zhiqiao San (Panting) to unblock toxic vapors and cut off the source. If mouth, tongue, and throat are swollen and painful, toxin is severe; use Shegan Niu Bang Zi Tang (Throat). If bowels open but thirst for soup occurs, it is Spleen-Stomach Qi deficiency; use Renshen Baizhu San (Thirst). If dry feces are stuck in the rectum, use pig bile suppositories. Avoid purgatives lest they further damage Stomach Qi, preventing un-erupted sores from rising and erupted sores from crusting. Generally, differentiate deficiency and excess by checking hand/foot temperature or desire for cold/hot drinks. [Wan Quan] If constipation occurs during fever, mild heat uses Sanhuang Wan (Fever); severe heat uses Chengqi Tang. From rising to crusting, if constipation persists, use the Gallbladder Suppository Method; do not hastily use laxatives. If sores are dry, black, and sunken, with constipation and irritability, use Baixiang Wan or Niuli Gao (Black Sunken Sores). If unavailable, substitute with Chengqi Tang.
Danggui Wan
Angelica Sinensis (0.5 liang), Licorice Root (1 fen), Coptis Rhizome, Rhubarb (each 2.5 qian).
First, decoct Angelica Sinensis into a paste, mix with the other three powdered herbs, form pills, and take. Stop when bowel movement occurs.
Zao Bian Baixiang Wan treats severe constipation in smallpox/measles.
Red-spined Spurge Root (bone removed, 1 liang), Qingzhou Dates (pitted, 10).
Decoct in two cups of water until water is gone. Remove Spurge, bake dates until dry, and form pills as needed. Start with small doses, increase gradually, stopping at bowel movement.
Xixin San treats high fever in smallpox, difficulty in urination and defecation, delirium, and excessive thirst.
Rhubarb, Licorice Root, Angelica Sinensis, Ephedra Stem (deprived of joints), Atractylodes Macrocephala Rhizome, Peony Root, Schizonepeta Spikelet (equal parts).
Cut into coarse pieces. Decoct with ginger and mint according to severity. Warm administration stabilizes; hot administration causes loose stools.
Saiyi Chengqi Tang
Rhubarb, Mirabilite, Magnolia Bark, Immature Bitter Orange (each 1 qian), Licorice Root (0.5 qian).
Cut finely. Decoct one cup of water with one slice of ginger until 0.7 cup remains, strain, and take hot before meals.
Dan Dao Fa (Gallbladder Suppository Method)
Take one large pig gallbladder. Cut a goose quill tube evenly at both ends. Insert one end into the gallbladder, tie securely with thread, blow air to inflate, insert into the anus, wait for gas passage, then remove.
Jiawei Sijunzi Tang
Ginseng, Atractylodes Macrocephala Rhizome, Astragalus Root, White Poria, Licorice Root, Trichosanthes Root, Platycodon Root (equal parts).
Decoct in water and take. Haizang used this for smallpox/measles whether erupted or not, with constipation or occasional thirst. Patients may have insufficient congenital constitution, or suffer from vomiting/diarrhea, excessive sweating, or diuresis, leading to deficient Yuan Qi and dry body fluids, causing constipation. Reckless purging is like wielding a knife blindly; this formula is essential. Physicians must examine carefully to avoid error.
Runchang Tang treats deficiency-type constipation.
Angelica Sinensis Tail, Licorice Root, Rehmannia Root, Hemp Seed, Peach Kernel Paste.
Decoct in water and take.
Zicao Maren Tang treats constipation in exanthema causing toxic vapor blockage.
Sophora Tonkinensis Root, Arnebia Root (each 1.1 qian), Burdock Fruit, Honeycomb, Raw Rhinoceros Horn (substitute with alternative), Green Tangerina Peel, Peach Kernel, Hemp Seed, Biota Tops, Scutellaria Root (each 1 qian), Apricot Kernel (1.2 qian).
Cut into pieces. Take 4-5 qian per dose, decoct in water, take long after meals. For severe constipation, add 0.7 fen of Sour Plum Flesh. If ineffective, add another 1.5 qian of Abutilon Seed.