爪白便清厥属寒,木香理中汤可痊,爪紫便赤为热厥,金花承气乃良煎。
【注】痘中厥逆之证,有因气血虚寒发厥者,有因毒热郁闭发厥者。爪甲色白,小便
清利,其痘色更见灰陷,泻泄不食等证,此外阳衰、内阴盛,乃寒厥也,以加减陈氏木
香散主之;寒甚者,附子理中汤主之。若爪甲色红,小便赤涩,其痘色更见紫黑,烦躁
闷乱等证,此系阳毒内攻,热极反寒,是热厥也,宜栀子金花汤治之;里实者承气汤下之。
加减陈氏木香散
人参 肉桂 茯苓 半夏(姜制) 白术(土炒) 丁香 肉豆蔻(面裹煨)
甘草(炙) 诃子肉(面裹煨) 木香(煨)
引用生姜,水煎服。
【方歌】木香散疗中外寒,参桂茯苓半夏攒,白术丁香肉豆蔻,甘草诃子木香研。
附子理中汤
人参 附子(制) 甘草(炙) 白术(土炒) 干姜
水煎服。
【方歌】附子理中治虚寒,中外无阳莫留连,人参附子炙甘草,白术干姜一同煎。
栀子金花汤
黄芩 黄连 黄柏 大黄 栀子
水煎服。
【方歌】热厥栀子金花汤,热极反寒服最良,黄芩黄连并黄柏,大黄栀子共煎尝。
承气汤
浓朴(姜炒) 枳实(麸炒) 大黄
水煎服。
【方歌】承气汤能除火热,里实不便毒瓦斯结,浓朴枳实川大黄,煎服便利毒即泄。
指甲色白、小便清长,属于寒厥,可用木香理中汤治愈;指甲色紫、小便赤红,属于热厥,金花承气汤是良方。
【注】痘疹病中的厥逆证候,有因气血虚寒引发厥逆的,有因毒热郁闭引发厥逆的。若指甲颜色发白,小便清利通畅,痘色更加灰暗下陷,伴有腹泻、不能进食等症状,这是外阳衰微、内阴过盛,属于寒厥,以加减陈氏木香散为主治方剂;若寒邪极重者,用附子理中汤主治。如果指甲颜色发红,小便赤红涩痛,痘色更加紫黑,伴有烦躁闷乱等症状,这是阳毒内攻,热极反而出现寒象,属于热厥,宜用栀子金花汤治疗;若里实结滞者,用承气汤攻下。
加减陈氏木香散
人参 肉桂 茯苓 半夏(生姜炮制) 白术(土炒) 丁香 肉豆蔻(面粉包裹煨)
甘草(蜜炙) 诃子肉(面粉包裹煨) 木香(煨)
引用生姜,加水煎服。
【方歌】木香散能治疗内外之寒,人参、肉桂、茯苓、半夏汇聚其中,白术、丁香、肉豆蔻,甘草、诃子、木香研末。
附子理中汤
人参 附子(炮制) 甘草(蜜炙) 白术(土炒) 干姜
加水煎服。
【方歌】附子理中汤治疗虚寒,内外阳气不足不可拖延,人参、附子、炙甘草,白术、干姜一同煎煮。
White nail beds and clear urine indicate Cold Jue (Cold Reversal), which can be cured with Muxiang Lizhong Tang (Cinnamon Twig and Atractylodes Macrocephala Decoction); purple nail beds and red urine indicate Heat Jue (Heat Reversal), for which Jinhua Chengqi Tang is an excellent prescription.
[Note] In the context of smallpox/variola, Jue syndrome may arise from deficiency-cold of Qi and Blood, or from entrapment by toxic heat. If the nail beds are white, urination is clear and profuse, the rash appears grayish and sunken, accompanied by diarrhea and anorexia, this represents exterior Yang decline and interior Yin excess, constituting Cold Jue; it should be treated primarily with Ji Jian Chen Shi Muxiang San (Modified Chen's Costus Powder). If the cold is severe, Fuzi Lizhong Tang (Aconite and Atractylodes Macrocephala Decoction) should be used. Conversely, if the nail beds are red, urination is red and difficult, the rash appears purplish-black, accompanied by restlessness and confusion, this indicates internal attack by Yang toxin where extreme heat manifests as cold symptoms, constituting Heat Jue; Zhi Zi Jin Hua Tang (Gardenia Golden Flower Decoction) is appropriate. If there is interior excess accumulation, Chengqi Tang (Major Order the Qi Decoction) should be used to purge.
Ji Jian Chen Shi Muxiang San (Modified Chen's Costus Powder)
Ren Shen (Ginseng Radix et Rhizoma) Rou Gui (Cinnamomi Cortex) Fu Ling (Poria) Ban Xia (Pinelliae Rhizoma Praeparatum cum Zingibere et Alumine) Bai Zhu (Atractylodis Macrocephalae Rhizoma) Ding Xiang (Caryophylli Flos) Rou Dou Kou (Myristicae Semen) Gan Cao (Glycyrrhizae Radix et Rhizoma Praeparatum cum Melle) He Zi Rou (Terminaliae Chebulae Fructus) Mu Xiang (Aucklandiae Radix)
Add fresh ginger, decoct in water, and take orally.
[Formula Song] Muxiang San treats cold in both interior and exterior, Ginseng, Cinnamon, Poria, and Pinellia gather together, Atractylodes, Clove, and Nutmeg, Licorice, Chebula, and Costus are ground.
Fuzi Lizhong Tang (Aconite and Atractylodes Macrocephala Decoction)
Ren Shen (Ginseng Radix et Rhizoma) Fu Zi (Aconiti Lateralis Radix Praeparata) Gan Cao (Glycyrrhizae Radix et Rhizoma Praeparatum cum Melle) Bai Zhu (Atractylodis Macrocephalae Rhizoma) Gan Jiang (Zingiberis Rhizoma)
Decoct in water and take orally.
[Formula Song] Fuzi Lizhong treats deficiency-cold, when Yang is absent in interior and exterior do not linger, Ginseng, Aconite, and Prepared Licorice, Atractylodes and Dried Ginger decocted together.
Zhi Zi Jin Hua Tang (Gardenia Golden Flower Decoction)
Huang Qin (Scutellariae Radix) Huang Lian (Coptidis Rhizoma) Huang Bo (Phellodendri Chinensis Cortex) Da Huang (Rhei Radix et Rhizoma) Zhi Zi (Gardeniae Fructus)
Decoct in water and take orally.
[Formula Song] For Heat Jue use Zhi Zi Jin Hua Tang, most effective for extreme heat manifesting as cold, Scutellaria, Coptis, and Phellodendrum, Rheum and Gardenia decocted together.
Chengqi Tang (Major Order the Qi Decoction)
Nou Pu (Magnoliae Officinalis Cortex) Zhi Shi (Aurantii Fructus Immaturus) Da Huang (Rhei Radix et Rhizoma)
Decoct in water and take orally.
[Formula Song] Chengqi Tang eliminates fire-heat, interior excess and constipation cause toxic qi accumulation, Magnolia Bark, Aurantium, and Sichuan Rheum, upon decoction and ingestion, bowel movement facilitates and toxins are expelled.