【歌】热彻标形必定稀，根红色泽满而肥。清便自可身无羌，饮食如常不用医。出不快时尤可发，密宜解
毒勿教迟。鲜红恐后翻成紫，泄痢须知里气虚。五六日来生痒塌，切牙寒噤异功宜。疮稠力薄难肥满，大剂参
归及桂 ，紫草川芎香白芷，更加糯米复何疑。青干黑陷溲便涩，可用宣风急下之。身热烦渴微腹满，喘而便
秘面红 ，心烦闷乱溲黄
赤，利水还须导赤除。七八日来犹发热，内因热盛外蒸皮，故使斑疮痂不着，宣风散子入生犀。耳居反热知归
肾，黑陷分明有死期。百祥丸泻膀胱火，下后身温饮水奇，急用温脾为上策，十中一二可扶持。
【论】夫痘疮皆由子在母胎中受其三秽液毒，停蓄脏腑，皆太阴湿土壅滞，君、相二火之所作。因小儿真
气既盛，正气初旺，邪无所容，或风寒伤于表，食饮伤于里，其毒由是发焉。故因外者治外，因内者治内，内
外皆和，其痘自出。至于恶寒者发之，表太热者夺之，里渴者清之，秘者通之，惊者安之，泄者分之，虚者补
之，寒者温之，热者和之，不可执一，大抵如伤寒随经用药，最为高论。若轻者，发热四、五日；热彻始出，
其疮必稀，故前后心无，头面稀少，明润光泽，作三、四次出，无内外邪证，便溺如常，饮食如故，此受之
最轻也，不用服药自已。其一热便涌出，密如针头，不分根脚，尚有表邪，时忽泄利呕逆，饮食不进，或烦闷
不安，或狂躁不宁，大、小便秘涩不通，疮色鲜红，或灰白而不泽，或隐隐在于皮肤中，或咳嗽鼻喷不止，或
腰痛不能立起，耳居反热，身体反冷，恶寒振栗，切牙，痒塌，燥渴不止，黑陷青紫倒靥，此皆沉重之候也。
必审其寒、热、虚、实而调之，则无不效矣。大抵寒为虚，热为实。气虚寒则宜温补，气实热则宜清凉，血虚
则宜补血，血热则宜解毒，必取其气血中和，无过不及可也。凡痘灰白不红，绽不起，发出不快，昏暗陷顶，
皆表寒而虚。二便清，饮食不化，身凉，手、足、口气俱冷，不渴，少食，唇白涕清，皆里寒而虚。此表、里
虚寒之证，急宜温脾胃，补气血，当用参、 、四物、木香、肉桂等药，以助贯脓收靥。夫表虚者，以补气为
主而补血次之。里虚者，于补血之中而
兼补气。苟能补气，而脾胃自壮，胃气随畅，在后必无陷伏之忧；既能补血，则气血周流，送毒出尽，不致凝
滞，在后必无痒塌之患。凡红紫干滞，黑陷焦枯者，皆表热而实。大便秘结，小便赤涩，身热鼻干，气热唇燥，
烦渴者，皆里热而实。此表、里实热之证，急宜凉血解毒，当用化毒汤、红花、紫草、黄芩、牡丹皮、蝉蜕、
鼠粘、荆芥之类。如表热者，宜清凉解表，而分利次之。里热者，则重于解毒而兼清凉，或在二、三日之前，
热毒盛者，微下之亦可。盖凉血不至红紫，解毒则免黑陷。故表虚不补，则成外剥；里虚不补，则成内攻；表
实过补，则不结靥；里实过补，则发痈毒，所以痘证变迁无常，若色一转，又当变通，不可拘于一定也。
气虚
凡气虚之证，初发身热，手足厥冷，乍凉乍热，精神倦怠，肌肉 白，饮食减少，四肢倦而睡卧安静，
便清自调，虚证无疑。未见点前，用参 饮加轻剂发散，如∶紫苏、防风、白芷。见点之后，用参 饮加轻剂
开提，如∶川芎、桔梗。见点四日之后，重用参 饮，随病加减处治。七、八日浆足之后，保婴百补汤调养气
血而已。此证末梢，塌陷黑靥者，多用木香异功散收功。
血热
凡血热之证，初发身热壮盛，腮红脸赤，毛焦色枯，烦躁，渴欲饮水，日夜啼哭，睡卧不宁，好睡冷处，
小便赤涩，热证无疑。未出之前，治从升麻葛根汤或升麻流气饮，虽皆可服，纵不若十神解毒汤为稳。既出至
见点三、四日后，热证悉平，势将行浆，从太乙保和汤加减。八、九日浆足之后，则有保婴百补汤调养之。
毒盛
凡热毒壅遏之证，初发身热壮盛，腮红脸赤，毛焦皮燥，气粗喘满，腹胀烦躁，狂言谵语，睡卧不宁，大
便秘结，小便赤涩，面浮眼胀，多啼多怒，的系热毒壅遏。未见点时，先须升麻葛根汤一服，随服羌活散郁汤。
至见点三日之内，诸证悉平，势将行浆，则服益元透肌散加减。浆足之后，即服保婴百补汤调养而已。六、七
日外，有紫黑干枯及青灰干白陷者，则有夺命、大造、百祥、牛李、猪尾、宣风、独圣等方，皆可审用。惟曾
经泄泻，有木香异功证，则从木香异功散治之。
参 保元汤
治气虚痘证。
人参（一钱） 黄 （二钱） 甘草（五分，初热生用，出定炙用） 官桂（三分）
上锉，加生姜三片，糯米一撮，水煎，入人乳温服。
按∶参、 、甘草性味甘温，专补中气之虚，而又加官桂以制其血。血在内，引而出之；血在外，引而
入之。参、 非桂之逐血引导，则不能独树其功也。又加生姜、糯米，以助参、 之力。
十神解毒汤
治血热痘证，古人用黄连解毒汤，恐骤用寒凉，不惟冰伏，热毒反出不快，抑且热毒为其所抑，则郁于
脏腑，或肚痛腹胀，内溃而死者有之，岂若此方内外分消，用之为当？
生地 丹皮 赤芍 归尾 红花 川芎 桔梗 木通 连翘 腹皮
身热壮盛加葛根、前胡；毒盛绵密咽痛，加甘草、荆芥、鼠粘子；口渴烦躁加麦冬、天花粉；大便秘加
枳壳、前胡、酒蒸大黄；小便短涩，睡卧不宁，谵语加山栀、竹叶、
灯心；发斑加玄参、犀角、紫草。
羌活散郁汤
治毒盛壅遏喘胀，或为风寒外搏者。
羌活 防风 白芷 荆芥 桔梗 地骨皮 川芎 紫草 甘草 连翘 恶实 大腹皮
上为粗散，水一钟，灯心十四茎，煎六分，温服。
太乙保和汤（又名紫草透肌汤）
专治血热痘证。服十神解毒汤后，热证悉去，内外和平，见点三日之后，不易长大，用之则能保和元气，
活血解毒，助痘成浆。
紫草 川芎 山楂 桔梗 人参 甘草 生地 红花 木通 糯米 生姜 灯心
升麻葛根汤
治痘初发热疑似之间。
葛根 升麻 甘草 芍药
生姜煎服。
益元透肌散
专治壅热痘证。服羌活散郁汤后，壅证悉开，气血和平，见点三、四日后不肥大，不成浆者，用之则能
匀气解毒，透肌达表，领出元阳，助痘成浆而易结脓窠也。
鼠粘 蝉蜕 陈皮 桔梗 木通 山楂 川芎 紫草 人参 甘草
大枣、灯心，煎服。
异功散
治表虚痒塌，内虚泄泻，寒战切牙，头温足冷。
木香 官桂 人参 附子 当归 白术 茯苓 陈皮 浓朴 丁香 肉果 半夏
木香散
治痘灰白表虚，内虚泄泻腹胀。
木香 丁香 人参 甘草 茯苓 腹皮 桂心 青皮 前胡 诃子 煨姜 大枣
保婴百补汤
治痘疮八、九日浆足之后别无他证，以此方调养气血，资补脾胃。若有别证，随虚实加减。
当归 芍药 熟地 山药 人参 白术 茯苓 甘草 黄 大枣
水煎，温服。
【歌诀】热毒透发透彻，痘形必然稀疏；根部红润色泽饱满肥厚。大小便正常且身体无寒热异常，饮食如常则无需治疗。若痘出不快，尤其应当助其发散；若痘出过密，宜解毒勿使延误。鲜红色恐随后转为紫色，泄痢须知是里气虚弱。五六日出现瘙痒塌陷，咬牙寒战适宜用异功散。疮形稠密但正气薄弱难以饱满，大剂量使用人参、当归及桂枝，配合紫草、川芎、香白芷，再加上糯米，还有什么可怀疑的？若痘色青干黑陷且小便涩滞，可用宣风散急下攻逐。身热烦渴微腹满，气喘且便秘面红，心烦闷乱小便黄赤，利水还需用导赤散清除。七八日仍发热，内因热盛外蒸皮肤，致使斑疮痂皮不着，宣风散加生犀角。耳部反热知是归肾之象，黑陷分明有死期。百祥丸泻膀胱火，下后身温饮水神奇，急用温脾汤为上策，十中一二可扶持。
【论述】痘疮皆因胎儿在母胎中受三秽液毒邪，停蓄于脏腑，皆由太阴湿土壅滞，以及君火、相二火所作所致。因小儿真气既盛，正气初旺，邪气无所容留，或因风寒伤于体表，食饮伤于体内，毒邪由此发出来。所以因外邪引起的治外，因内邪引起的治内，内外调和，痘疮自然发出。至于恶寒者发散表邪，表太热者夺其实热，里渴者清其内热，便秘者通其大便，惊悸者安其神志，泄泻者分利其湿，虚证者补其正气，寒证者温其阳气，热证者和解其热，不可固执一端，大体上如同伤寒病随经用药，是最高的论断。若病情轻者，发热四五天；热毒透发透彻后才发出，其疮必稀疏，故前后心没有，头面部稀少，明亮润泽光泽，分三四次发出，无内外邪证，大小便如常，饮食如故，这是受邪最轻的，不用服药自己会好。其一发热就涌出，密如针头，不分根脚，尚有表邪，时而忽泄利呕逆，饮食不进，或烦闷不安，或狂躁不宁，大小便秘涩不通，疮色鲜红，或灰白而不润泽，或隐隐在于皮肤中，或咳嗽鼻喷不止，或腰痛不能立起，耳部反热，身体反冷，恶寒振栗，咬牙，瘙痒塌陷，燥渴不止，黑陷青紫倒靥，这都是沉重的征候。必须审察其寒、热、虚、实而调治它，则没有不有效的。大体上寒为虚，热为实。气虚寒则宜温补，气实热则宜清凉，血虚则宜补血，血热则宜解毒，必须取其气血中和，不过分也不不足即可。凡是痘色灰白不红，绽不起，发出不快，昏暗陷顶，都是表寒而虚。二便清，饮食不化，身凉，手、足、口气俱冷，不渴，少食，唇白涕清，都是里寒而虚。这是表、里虚寒的证候，急宜温脾胃，补气血，当用人参、黄芪、四物汤、木香、肉桂等药，以助贯脓收靥。表虚者，以补气为主而补血次之。里虚者，于补血之中而兼补气。如果能补气，脾胃自然强壮，胃气随之通畅，在后必无陷伏的忧虑；既能补血，则气血周流，送毒出尽，不致凝滞，在后必无瘙痒塌陷的祸患。凡是红紫干滞，黑陷焦枯者，都是表热而实。大便秘结，小便赤涩，身热鼻干，气热唇燥，烦渴者，都是里热而实。这是表、里实热的证候，急宜凉血解毒，当用化毒汤、红花、紫草、黄芩、牡丹皮、蝉蜕、牛蒡子、荆芥之类。如表热者，宜清凉解表，而分利次之。里热者，则重于解毒而兼清凉，或在二、三日之前，热毒盛者，轻微攻下亦可。因为凉血不至红紫，解毒则免黑陷。所以表虚不补，则成外剥；里虚不补，则成内攻；表实过补，则不结痂；里实过补，则发痈毒，所以痘证变迁无常，若颜色一转，又当变通，不可拘泥于一定之法。
气虚
凡是气虚的证候，初发身热，手足厥冷，乍凉乍热，精神倦怠，肌肉苍白，饮食减少，四肢倦而睡卧安静，便清自调，虚证无疑。未见痘点前，用参芪饮加轻剂发散，如：紫苏、防风、白芷。见点之后，用参芪饮加轻剂开提，如：川芎、桔梗。见点四日之后，重用参芪饮，随病加减处治。七、八日浆足之后，保婴百补汤调养气血而已。此证末梢，塌陷黑靥者，多用木香异功散收功。
血热
凡是血热的证候，初发身热壮盛，腮红脸赤，毛焦色枯，烦躁，渴欲饮水，日夜啼哭，睡卧不宁，好睡冷处，小便赤涩，热证无疑。未出之前，治从升麻葛根汤或升麻流气饮，虽皆可服，纵不若十神解毒汤为稳。既出至见点三、四日后，热证悉平，势将行浆，从太乙保和汤加减。八、九日浆足之后，则有保婴百补汤调养之。
毒盛
凡是热毒壅遏的证候，初发身热壮盛，腮红脸赤，毛焦皮燥，气粗喘满，腹胀烦躁，狂言谵语，睡卧不宁，大便秘结，小便赤涩，面浮眼胀，多啼多怒，的确系热毒壅遏。未见点时，先须升麻葛根汤一服，随服羌活散郁汤。至见点三日之内，诸证悉平，势将行浆，则服益元透肌散加减。浆足之后，即服保婴百补汤调养而已。六、七日外，有紫黑干枯及青灰干白陷者，则有夺命、大造、百祥、牛李、猪尾、宣风、独圣等方，皆可审用。惟曾经泄泻，有木香异功证，则从木香异功散治之。
参芪保元汤
治气虚痘证。
人参（一钱） 黄芪（二钱） 甘草（五分，初热生用，出定炙用） 官桂（三分）
以上锉碎，加生姜三片，糯米一撮，水煎，入人乳温服。
按：参、芪、甘草性味甘温，专补中气之虚，而又加官桂以制其血。血在内，引而出之；血在外，引而入之。参、芪非桂之逐血引导，则不能独树其功也。又加生姜、糯米，以助参、芪之力。
十神解毒汤
治血热痘证，古人用黄连解毒汤，恐骤用寒凉，不惟冰伏，热毒反出不快，抑且热毒为其所抑，则郁于脏腑，或肚痛腹胀，内溃而死者有之，岂若此方内外分消，用之为当？
生地 丹皮 赤芍 归尾 红花 川芎 桔梗 木通 连翘 腹皮
身热壮盛加葛根、前胡；毒盛绵密咽痛，加甘草、荆芥、牛蒡子；口渴烦躁加麦冬、天花粉；大便秘加枳壳、前胡、酒蒸大黄；小便短涩，睡卧不宁，谵语加山栀、竹叶、灯心；发斑加玄参、犀角、紫草。
羌活散郁汤
治毒盛壅遏喘胀，或为风寒外搏者。
羌活 防风 白芷 荆芥 桔梗 地骨皮 川芎 紫草 甘草 连翘 牛蒡子 大腹皮
以上为粗散，水一钟，灯心十四茎，煎六分，温服。
太乙保和汤（又名紫草透肌汤）
专治血热痘证。服十神解毒汤后，热证悉去，内外和平，见点三日之后，不易长大，用之则能保和元气，活血解毒，助痘成浆。
紫草 川芎 山楂 桔梗 人参 甘草 生地 红花 木通 糯米 生姜 灯心
升麻葛根汤
治痘初发热疑似之间。
葛根 升麻 甘草 芍药
生姜煎服。
益元透肌散
专治壅热痘证。服羌活散郁汤后，壅证悉开，气血和平，见点三、四日后不肥大，不成浆者，用之则能匀气解毒，透肌达表，领出元阳，助痘成浆而易结脓窠也。
牛蒡子 蝉蜕 陈皮 桔梗 木通 山楂 川芎 紫草 人参 甘草
大枣、灯心，煎服。
异功散
治表虚痒塌，内虚泄泻，寒战切牙，头温足冷。
木香 官桂 人参 附子 当归 白术 茯苓 陈皮 浓朴 丁香 肉果 半夏
木香散
治痘灰白表虚，内虚泄泻腹胀。
木香 丁香 人参 甘草 茯苓 腹皮 桂心 青皮 前胡 诃子 煨姜 大枣
保婴百补汤
治痘疮八、九日浆足之后别无他证，以此方调养气血，资补脾胃。若有别证，随虚实加减。
当归 芍药 熟地 山药 人参 白术 茯苓 甘草 黄芪 大枣
水煎，温服。
[Song] When the heat is thoroughly cleared, the rash form will inevitably be sparse; with a red root, lustrous color, full and plump. Normal bowel movements and urination, no chills or fever in the body, normal diet and appetite require no medical treatment. If eruption is slow, it is especially advisable to promote dispersion; if the eruption is too dense, resolve toxicity without delay. Fresh red color may fearfully turn purple later; diarrhea and dysentery indicate deficiency of interior Qi. Itching and collapsing after five to six days: Yi Gong San (Extraordinary Efficacy Powder) is suitable for teeth grinding and chills. Dense sores but weak strength make them difficult to fill out; use large doses of Renshen (Ginseng Root), Danggui (Angelicae Sinensis Radix), and Guizhi (Cinnamon Twig), along with Zicao (Arnebiae Radix seu Lithospermi Radix), Chuanxiong (Ligustici Chuanxiong Rhizoma), Xiangbaizhi (Angelicae Dahuricae Radix), and additionally Nuomi (Glutinous Rice), what could there be to doubt? If the sores are green, dry, black, and sunken with scanty and painful urination, use Xuan Feng San (Promote Wind Powder) for urgent purgation. Body heat, irritability, thirst, slight abdominal fullness, panting with constipation, red face, mental restlessness, and yellow-red urine: diuresis still requires Dao Chi San (Direct the Yellow Powder) to clear. Fever persisting after seven to eight days: internally due to excessive heat steaming the exterior skin, causing spots and sores to fail to scab; add Sheng Xi Jiao (Rhinoceros Horn) to Xuan Feng San. Heat returning to the ears indicates return to the Kidney; distinct black sinking signifies a fatal prognosis. Bai Xiang Wan (Hundred Auspicious Pills) drains Bladder fire; after purgation, warmth returns to the body and drinking water is miraculous; urgently using Wen Pi Tang (Warm the Spleen Decoction) is the best strategy, saving one or two out of ten cases.
[Dissertation] All smallpox arise from the fetus receiving toxic fluids of the three impurities within the maternal womb, accumulating in the Zang-Fu organs. This is caused by stagnation of Taiyin Damp Earth and the actions of Ministerial Fire and Sovereign Fire. Because the child's True Qi is abundant and Righteous Qi is initially strong, pathogenic factors have nowhere to reside. Whether wind-cold injures the exterior or food and drink injure the interior, the toxicity erupts from this. Therefore, treat the exterior for external causes, treat the interior for internal causes; when interior and exterior are harmonized, the smallpox naturally erupt. For those with aversion to cold, disperse the exterior; for those with excessive exterior heat, drain the excess; for those with interior thirst, clear the interior; for constipation, unblock the bowels; for fright, calm the spirit; for diarrhea, separate and drain dampness; for deficiency, tonify; for cold, warm; for heat, harmonize. Do not adhere rigidly to one method. Generally, it is like treating Shaoyang disease according to the meridians, which is the highest theory. For mild cases, fever lasts four to five days; once heat is thoroughly cleared, eruption begins, and the sores must be sparse. Thus, there are none on the anterior and posterior chest, few on the head and face, bright and lustrous, erupting in three or four waves, without exterior or interior pathogenic signs, normal urination and defecation, and normal diet; this is the lightest infection, requiring no medicine as it heals spontaneously. In other cases, eruption surges immediately upon fever onset, dense as needle heads, without distinct roots, indicating residual exterior pathogen. There may be sudden diarrhea, vomiting, anorexia, irritability, restlessness, mania, or constipation of both bowels and bladder. The sore color may be fresh red, or grayish-white and dull, or faintly visible within the skin. There may be incessant coughing and sneezing, lower back pain preventing standing, heat returning to the ears while the body feels cold, aversion to cold with shivering, teeth grinding, itching and collapsing, unquenchable dry thirst, black sinking, green-purple inversion of crusts. These are all grave signs. One must examine whether it is cold, heat, deficiency, or excess and regulate accordingly, then there will be no ineffectiveness. Generally, cold indicates deficiency, heat indicates excess. Qi deficiency with cold requires warming and tonifying; Qi excess with heat requires cooling and clearing; Blood deficiency requires nourishing Blood; Blood heat requires resolving toxicity. One must seek harmony between Qi and Blood, neither excessive nor insufficient. Any sores that are grayish-white, non-everted, slow to erupt, dark, and sunken at the apex indicate Exterior Cold and Deficiency. Clear urine and stool, undigested food, cool body, cold hands, feet, breath, and mouth, no thirst, poor appetite, white lips, and clear nasal discharge indicate Interior Cold and Deficiency. These are Exterior and Interior Cold-Deficiency patterns; urgently warm the Spleen and Stomach, tonify Qi and Blood, using drugs such as Renshen (Ginseng Root), Huangqi (Astragali Radix), Si Wu Tang (Four Substances Decoction), Muxiang (Aucklandiae Radix), and Rougui (Cinnamomi Cortex) to assist pus formation and crusting. For Exterior Deficiency, prioritize tonifying Qi and secondarily nourishing Blood. For Interior Deficiency, combine tonifying Qi with nourishing Blood. If Qi is tonified, the Spleen and Stomach strengthen naturally, Stomach Qi flows smoothly, and there will be no worry of sinking later; if Blood is nourished, Qi and Blood circulate freely, expelling all toxins without stagnation, and there will be no risk of itching and collapsing later. Any sores that are red-purple, dry, and stagnant, or black, sunken, scorched, and withered indicate Exterior Heat and Excess. Constipation, red and scanty urine, body heat, dry nose, hot breath, dry lips, irritability, and thirst indicate Interior Heat and Excess. These are Exterior and Interior Heat-Excess patterns; urgently cool the Blood and resolve toxicity, using Huadu Tang (Resolve Toxicity Decoction), Honghua (Carthami Flos), Zicao (Arnebiae Radix seu Lithospermi Radix), Huangqin (Scutellariae Radix), Mudanpi (Moutan Cortex), Chan Tui (Cicadae Periostracum), Niubangzi (Arctii Fructus), and Jingjie (Schizonepetae Spica). For Exterior Heat, cool and clear the exterior, followed by separating and draining. For Interior Heat, focus more on resolving toxicity combined with cooling. If it is before the second or third day and heat-toxin is severe, mild purgation is also acceptable. Cooling Blood prevents red-purple discoloration; resolving toxicity prevents black sinking. Therefore, failing to tonify Exterior Deficiency leads to external peeling; failing to tonify Interior Deficiency leads to internal attack; over-tonifying Exterior Excess prevents crusting; over-tonifying Interior Excess leads to carbuncles and sores. Thus, smallpox changes unpredictably; if the color shifts, one must adapt, not adhering rigidly to fixed rules.
Qi Deficiency
For Qi Deficiency patterns: initial fever, cold extremities, alternating chills and fever, mental fatigue, pale muscles, reduced appetite, limb weakness with quiet sleep, normal clear urine and stool, undoubtedly a deficiency pattern. Before spots appear, use Shenqi Yin (Ginseng and Astragalus Drink) with mild dispersing agents such as Zisu (Perillae Folium), Fangfeng (Saposhnikoviae Radix), and Baizhi (Angelicae Dahuricae Radix). After spots appear, use Shenqi Yin with mild uplifting agents such as Chuanxiong (Ligustici Chuanxiong Rhizoma) and Jiegeng (Platycodonis Radix). After four days since appearance, heavily use Shenqi Yin, adjusting according to the disease. After seven to eight days when pustules are full, simply use Baoying Baibu Tang (Infant Protection Hundred Tonics Decoction) to nourish Qi and Blood. For cases at the end stage with collapsed black crusts, mostly use Muxiang Yigong San (Aucklandia Extraordinary Efficacy Powder) to conclude treatment.
Blood Heat
For Blood Heat patterns: initial intense fever, red cheeks and face, dry and dull hair, irritability, thirst wanting to drink, crying day and night, restless sleep, preference for cool places, red and scanty urine, undoubtedly a heat pattern. Before eruption, treat with Shengma Gegen Tang (Ephedra and Kudzu Decoction) or Shengma Liushi Yin (Ephedra Flowing Qi Drink); although both can be taken, Shishen Jiedu Tang (Ten Gods Resolving Toxicity Decoction) is steadier. From eruption until three or four days after spots appear, once heat signs subside and pustule formation is imminent, adjust Taiyi Baohe Tang (Supreme Harmony Protecting Decoction). After eight or nine days when pustules are full, use Baoying Baibu Tang for nourishment.
Toxicity Excess
For Heat-Toxin Obstruction patterns: initial intense fever, red cheeks and face, dry and rough skin, coarse breathing and panting, abdominal distension and irritability, delirious speech, restless sleep, constipation, red and scanty urine, facial swelling and eye bulging, frequent crying and anger, indeed Heat-Toxin Obstruction. Before spots appear, first take Shengma Gegen Tang, followed by Qianghuo San Yu Tang (Notopterygium Dispersing Depression Powder). Within three days of spots appearing, once all signs subside and pustule formation is imminent, take Yiyuan Touji San (Benefit Origin Penetrating Muscle Powder) adjusted. After pustules are full, simply take Baoying Baibu Tang for nourishment. After six or seven days, for purple-black dry ones or green-gray dry-white sunken ones, use Duoming (Snatching Life), Dazao (Great Creation), Baixiang (Hundred Auspicious), Niuli (Cow Plum), Zhuwei (Pig Tail), Xuanfeng (Promote Wind), Dusheng (Unique Sages) formulas, selecting appropriately based on examination. Only if there has been diarrhea with Muxiang Yigong signs, treat with Muxiang Yigong San.
Shenqi Baoyuan Tang
Treats Qi Deficiency smallpox patterns.
Renshen (Ginseng Root) (1 qian), Huangqi (Astragali Radix) (2 qian), Gancao (Licorice Root) (0.5 qian, raw for initial heat, roasted after eruption), Guizhi (Cinnamon Twig) (0.3 qian).
Crush these, add three slices of Shengjiang (Fresh Ginger Rhizome) and a pinch of Nuomi (Glutinous Rice), decoct in water, add human milk, and take warm.
Note: Renshen, Huangqi, and Gancao are sweet and warm, specifically tonifying Middle Qi deficiency, and adding Guizhi regulates Blood. Blood inside is guided out; Blood outside is guided in. Without Guizhi guiding Blood, Renshen and Huangqi cannot achieve their unique efficacy alone. Adding Shengjiang and Nuomi assists the power of Renshen and Huangqi.
Shishen Jiedu Tang
Treats Blood Heat smallpox patterns. Ancients used Huanglian Jiedu Tang (Coptis Resolving Toxicity Decoction), fearing that sudden use of cold/cool herbs would freeze the pathogen, causing heat-toxin to fail to erupt quickly, and suppressing heat-toxin leading to stagnation in Zang-Fu, potentially causing abdominal pain, distension, internal rupture, and death. Is this formula not better for dispersing toxicity internally and externally?
Shengdi (Rehmanniae Radix), Danpi (Moutan Cortex), Chishao (Paeoniae Radix Rubra), Guiwei (Angelicae Sinensis Radix Caulis), Honghua (Carthami Flos), Chuanxiong (Ligustici Chuanxiong Rhizoma), Jiegeng (Platycodonis Radix), Mutong (Akebiae Caulis), Lianqiao (Forsythiae Fructus), Fupi (Tangerine Peel - likely referring to Dahuang Fu Pi or similar, context implies abdominal distension relief),
If intense body heat, add Gegen (Puerariae Radix) and Qianhu (Peucedani Radix); if severe toxicity, dense sores, sore throat, add Gancao (Licorice Root), Jingjie (Schizonepetae Spica), Niubangzi (Arctii Fructus); if thirsty and irritable, add Maidong (Ophiopogonis Radix) and Tianhuafen (Trichosanthis Radix); if constipated, add Zhike (Aurantii Fructus), Qianhu (Peucedani Radix), Jiuzheng Dahuang (Wine-steamed Rheum Palmatum Root); if scanty painful urination, restless sleep, delirium, add Zhizi (Gardeniae Fructus), Zhuye (Bambusae Folium), Dengxin Cao (Junci Medulla); if macules appear, add Xuanshen (Scrophulariae Radix), Xijiao (Rhinoceros Horn), Zicao (Arnebiae Radix seu Lithospermi Radix).
Qianghuo San Yu Tang
Treats severe toxicity obstruction with panting and distension, or wind-cold attacking the exterior.
Qianghuo (Notopterygii Rhizoma et Radix), Fangfeng (Saposhnikoviae Radix), Baizhi (Angelicae Dahuricae Radix), Jingjie (Schizonepetae Spica), Jiegeng (Platycodonis Radix), Digupi (Lycii Cortex), Chuanxiong (Ligustici Chuanxiong Rhizoma), Zicao (Arnebiae Radix seu Lithospermi Radix), Gancao (Licorice Root), Lianqiao (Forsythiae Fructus), E Shi (Arctii Fructus), Dafupi (Arecae Pericarpium).
Grind into coarse powder, decoct one zhong of water with fourteen stems of Dengxin Cao (Junci Medulla) to yield six parts, take warm.
Taiyi Baohe Tang (Also known as Zicao Touji Tang / Arnebia Penetrating Muscle Decoction)
Specifically treats Blood Heat smallpox patterns. After taking Shishen Jiedu Tang, if heat signs disappear and interior/exterior are harmonious, and after three days since spots appear they do not easily enlarge, using this formula protects and harmonizes Yuan Qi, invigorates Blood, resolves toxicity, and assists smallpox in forming pustules.
Zicao (Arnebiae Radix seu Lithospermi Radix), Chuanxiong (Ligustici Chuanxiong Rhizoma), Shanzha (Crataegi Fructus), Jiegeng (Platycodonis Radix), Renshen (Ginseng Root), Gancao (Licorice Root), Shengdi (Rehmanniae Radix), Honghua (Carthami Flos), Mutong (Akebiae Caulis), Nuomi (Glutinous Rice), Shengjiang (Fresh Ginger Rhizome), Dengxin Cao (Junci Medulla).
Shengma Gegen Tang
Treats early smallpox fever where diagnosis is uncertain.
Gegen (Puerariae Radix), Shengma (Leonuri Herba), Gancao (Licorice Root), Shaoyao (Paeoniae Radix).
Decoct with Shengjiang (Fresh Ginger Rhizome) and take.
Yiyuan Touji San
Specifically treats obstructive Heat smallpox patterns. After taking Qianghuo San Yu Tang, if obstruction signs open and Qi/Blood are harmonious, and after three to four days since spots appear they are not plump or forming pustules, using this formula balances Qi, resolves toxicity, penetrates muscle to reach the exterior, guides out Yuan Yang, assists smallpox in forming pustules, and facilitates easy crusting.
Niubangzi (Arctii Fructus), Chantui (Cicadae Periostracum), Chenpi (Tangerine Peel), Jiegeng (Platycodonis Radix), Mutong (Akebiae Caulis), Shanzha (Crataegi Fructus), Chuanxiong (Ligustici Chuanxiong Rhizoma), Zicao (Arnebiae Radix seu Lithospermi Radix), Renshen (Ginseng Root), Gancao (Licorice Root).
Decoct with Dazao (Jujubae Fructus) and Dengxin Cao (Junci Medulla) and take.
Yigong San
Treats Exterior Deficiency with itching/collapsing, Interior Deficiency with diarrhea, chills with teeth grinding, warm head and cold feet.
Muxiang (Aucklandiae Radix), Guizhi (Cinnamon Twig), Renshen (Ginseng Root), Fuzi (Aconiti Lateralis Radix Praeparata), Danggui (Angelicae Sinensis Radix), Baizhu (Atractylodis Macrocephalae Rhizoma), Fuling (Poria), Chenpi (Tangerine Peel), Houpo (Magnoliae Officinalis Cortex), Dingxiang (Caryophylli Flos), Rougu (Myristicae Semen), Banxia (Pinelliae Rhizoma Praeparatum).
Muxiang San
Treats gray-white smallpox with Exterior Deficiency, Interior Deficiency with diarrhea and abdominal distension.
Muxiang (Aucklandiae Radix), Dingxiang (Caryophylli Flos), Renshen (Ginseng Root), Gancao (Licorice Root), Fuling (Poria), Fupi (Tangerine Peel/Arecae Pericarpium context dependent, here likely Tangerine Peel for distension), Guixin (Cinnamomi Cortex), Qingpi (Citri Reticulatae Pericarpium Viride), Qianhu (Peucedani Radix), Hezi (Terminaliae Chebulae Fructus), Weijiang (Roasted Fresh Ginger Rhizome), Dazao (Jujubae Fructus).
Baoying Baibu Tang
Treats smallpox after eight or nine days when pustules are full and no other symptoms exist; uses this formula to nourish Qi and Blood, supplement Spleen and Stomach. If other symptoms exist, adjust according to deficiency/excess.
Danggui (Angelicae Sinensis Radix), Shaoyao (Paeoniae Radix), Shudi (Rehmanniae Radix Preparata), Shanyao (Dioscoreae Rhizoma), Renshen (Ginseng Root), Baizhu (Atractylodis Macrocephalae Rhizoma), Fuling (Poria), Gancao (Licorice Root), Huangqi (Astragali Radix), Dazao (Jujubae Fructus).
Decoct in water and take warm.