万密斋治李氏女痘,脓成将靥,忽腹胀且痛,气喘呻吟。曰∶疮既胖壮,脓又饱满,其脉弦滑,此非痘毒,
乃伤食也。询之,因食鸡肉、糯米饭。曰∶宜急下之。或谓痘疮首尾不可下,恐虚其里,不靥也。曰∶病不执
方,药贵对症,有是病则有是药,下之无妨。遂以原物作汤,吞丁香脾积丸,得利而安。
金氏子,痘成脓时,忽腹胀作痛,气喘烦闷,其痘光壮饱满,非毒也,必曾伤食。果因面食过饱,亦用前
方法,得利病稍定。再用钱氏异功散加青皮、山楂,一服愈。
费建中治严孝廉子,六岁,丙戌仲夏见痘,干红色涩,顶陷不松,身热如烙,烦躁不宁。按其腹膈愁痛,
口嗳腐气。此毒火内伏,中宫停滞也。以大黄二钱,青皮钱许,蝉蜕、荆芥、赤芍、红花、地丁,用山楂一两,
煎汤代水,连二剂,下宿物甚多,痘顿起,色 赤。前方加黄连、生地,渐放白成浆。第热未和,前方服至十
二朝,始收功。
费建中子二岁,孟夏见痘,壮热昏迷,干红稠密,然得分珠,亦不脚塌。至三日,绝无起势,气粗烦闷,
转矢气,极臭。因痘前食一苎头圆子重,以枳实、山楂、桔梗、前胡、广皮、麦芽、赤芍、蝉蜕、牛蒡,去结
屎甚多,即起发红润,后虽甚密,幸获收功。
施氏子痘,始事者,极其升发,四日不起,狂烦叫喊至哑,目时上窜。视其根窠尚在,但稠密矾红,顶陷
干滞,身反凉。按其胸膈手足皆起,诊其右手寸关,洪滑而实,此内积重而闭塞也。以枳实五钱,青皮、前胡
各三钱,桔梗五分,佐以荆芥、蝉蜕,用山楂二两,煎汤代水,连夜进两头汁,次午又进一剂,下午去宿垢极
多,犹有鸡肉未化者。将晚,又行一次,即顿然起发,神安,身大热,色未转,以得通达,火毒发见于外也。
改用凉血清解,色渐红活,浆渐肥脓而收功。
万密斋治疗李姓女子的痘疮,脓液已经形成即将结痂时,突然腹部胀满且疼痛,气喘并呻吟。他说:痘疮既然饱满壮实,脓液又充足,脉象弦滑,这不是痘毒,而是伤食所致。询问病因,是因为吃了鸡肉和糯米饭。他说:应当紧急使用泻下法。有人说道:痘疮从头到尾都不可用泻下法,恐怕会虚损里气,导致无法结痂。他说:治病不固执于固定方剂,用药贵在对症,有什么病就用什么药,使用泻下法无妨。于是用原食物煮汤,吞服丁香脾积丸,排便后病情安定。
金氏的儿子,在痘疮成脓时,突然腹胀作痛,气喘烦闷,痘疮光亮壮实饱满,不是毒邪所致,必定是曾经伤食。果然因为面食吃得过饱,也采用前面的方法,排便后病情稍定。再用钱乙的异功散加青皮、山楂,一服药后痊愈。
费建中治疗严孝廉的儿子,六岁,丙戌年仲夏出现痘疮,痘色干红涩滞,顶部凹陷不舒展,身体发热如火烙,烦躁不安。按压其腹部膈间感到愁苦疼痛,口中嗳出腐臭气味。这是毒火内伏,中焦脾胃停滞所致。用大黄二钱,青皮约一钱,蝉蜕、荆芥、赤芍、红花、地丁,用山楂一两,煎汤代替水,连续服用两剂,排出宿便很多,痘疮顿时隆起,颜色转赤。前方加入黄连、生地,逐渐变白成浆。但热势未平,前方服用至第十二天,才收效。
费建中的儿子两岁,孟夏出现痘疮,高热昏迷,痘色干红稠密,但能分清颗粒,也不塌陷。到第三天,完全没有起发的迹象,气粗烦闷,放屁极臭。因为出痘前吃了一个重达一两的苎头圆子,用枳实、山楂、桔梗、前胡、广皮、麦芽、赤芍、蝉蜕、牛蒡,排出结屎很多,痘疮随即起发发红润,后来虽然很稠密,幸好获得收效。
施氏儿子的痘疮,刚开始时极其升发,第四天不起发,狂躁烦乱叫喊以至失声,眼睛不时向上窜视。看其根部还在,但稠密如矾红,顶部凹陷干滞,身体反而发凉。按压其胸膈手足皆隆起,诊察右手寸关部,脉象洪滑而实,这是内积严重而闭塞所致。用枳实五钱,青皮、前胡各三钱,桔梗五分,佐以荆芥、蝉蜕,用山楂二两,煎汤代替水,连夜进服两头汁(猪胆汁与牛胆汁),次日中午又进服一剂,下午排出宿垢极多,还有未消化的鸡肉。傍晚,又排便一次,痘疮顿时起发,神志安宁,身体大热,颜色未转,这是因为得以通达,火毒发见于外。改用凉血清解之法,颜色渐红活,浆液渐肥脓而收效。
Wan Mizhai treated a girl of the Li family suffering from smallpox. When the pustules had formed and were about to crust, she suddenly experienced abdominal distension and pain, shortness of breath, and groaning. He said: "The pustules are plump and robust, and the pus is abundant; her pulse is wiry and slippery. This is not smallpox toxin, but food stagnation." Upon inquiry, it was found that she had eaten chicken meat and glutinous rice. He said: "Urgent purgation is required." Some argued: "Purgation should not be used at any stage of smallpox, for fear of weakening the interior and preventing crusting." He replied: "Treatment does not adhere to fixed formulas; medicine must suit the condition. If there is this disease, use this medicine; purgation is harmless." Thus, he decocted the original food items into a soup and administered Dingxiang Piji Wan (Dingxiang Spleen Accumulation Pill) orally. After defecation, the patient stabilized.
The son of the Jin family, when his smallpox pustules were forming pus, suddenly developed abdominal distension and pain, shortness of breath, and irritability. His pustules were bright, plump, and full, indicating it was not toxin-related but definitely caused by food stagnation. Indeed, he had overeaten wheat-based foods. The same method was used; after defecation, the condition slightly stabilized. Then, Yigong San (Modified Yi Gong Powder) from Qian's formula, augmented with Qingpi (Qingpi, 青皮) and Shanzha (Shanzha, 山楂), was administered. One dose resulted in recovery.
Fei Jianzhong treated the son of Yan Xiaolian, aged six. In mid-summer of the Bingxu year, smallpox appeared. The lesions were dry, red, and rough, with depressed tops that did not relax. The body heat was like burning iron, accompanied by restlessness and agitation. Palpation of the abdomen and diaphragm revealed tenderness and distress, and belching emitted a putrid odor. This indicated internal retention of toxic fire and stagnation in the middle jiao (middle burner). Da Huang (Rhubarb Root and Rhizome) 2 qian, Qingpi (Green Citrus Peel) approximately 1 qian, Chantui (Cicada Slough), Jingjie (Schizonepeta Spike), Chi Shao (Red Peony Root), Hong Hua (Safflower), and Dideng (Viola Herba) were used. Shan Zha (Hawthorn Fruit) 1 liang was decocted to replace water. Two doses were taken consecutively, resulting in the passage of much retained matter. The smallpox lesions instantly rose, and their color turned red. Coptis Rhizome (Huanglian) and Rehmannia Root (Shengdi) were added to the previous prescription. Gradually, the lesions whitened and filled with pus. However, the heat had not yet harmonized. The previous prescription continued until the twelfth day before success was achieved.
Fei Jianzhong’s own son, aged two, presented with smallpox in early summer. He suffered from high fever and coma. The lesions were dry, red, and dense, but distinct as individual pearls, without collapsing. By the third day, there was no sign of eruption. Breathing was coarse, and he felt irritable and stifled, passing flatus that was extremely foul-smelling. This was due to having eaten one Zhutu Yuanzi (a dumpling made from Chinese Ramie Root) weighing one liang prior to the onset of smallpox. Zhi Shi (Immature Bitter Orange), Shanzha (Hawthorn Fruit), Jiegeng (Platycodon Root), Qianhu (Peucedani Radix), Guangpi (Tangerine Peel), Maiya (Barley Sprout), Chi Shao (Red Peony Root), Chantui (Cicada Slough), and Niubang (Arctium Fruit) were used. Much impacted stool was expelled, and the lesions immediately erupted with a reddish and moist appearance. Although they remained very dense later, recovery was eventually achieved.
A boy of the Shi family presented with smallpox. Initially, the eruption was vigorous, but by the fourth day, it failed to rise further. He became manic, irritable, and screamed until hoarse, with his eyes rolling upward intermittently. Inspection showed the roots of the lesions were still present, but they were dense, resembling alum-red, with depressed and dry tops. The body temperature was actually cool. Palpation of the chest, diaphragm, and extremities revealed swelling. Pulse diagnosis of the right hand Cun and Guan positions showed a surging, slippery, and excess quality. This indicated severe internal accumulation and blockage. Zhi Shi (Immature Bitter Orange) 5 qian, Qingpi (Green Citrus Peel) and Qianhu (Peucedani Radix) each 3 qian, Jiegeng (Platycodon Root) 0.5 fen, assisted by Jingjie (Schizonepeta Spike) and Chantui (Cicada Slough), were prescribed. Shan Zha (Hawthorn Fruit) 2 liang was decocted to replace water. Two heads' juice (pig bile and cattle bile) was administered overnight. At noon the next day, another dose was given. In the afternoon, much retained filth was passed, including undigested chicken meat. Late in the evening, another bowel movement occurred, and the lesions instantly erupted. The spirit calmed, body temperature rose significantly, though the color had not yet changed. This was because the blockage was cleared, allowing the fire-toxin to manifest externally. The treatment was changed to cooling the blood and clearing resolution. The color gradually became vibrant red, the pus became plentiful, and recovery was achieved.