徐仲光治一痘,不见出,吐泻不已,服升发益盛。此虚症,宜温补药升发,以透肌散,六君子汤加升、蝉、
姜、桂、陈米、枣而愈,以其热静痘娇也。若执痘未齐而不补真元,反致伏陷矣。
一痘后吐泻,类霍乱,此外感兼内伤也,藿香正气散、藿香五苓散。因兼暑食,加味二陈汤治愈。
一痘后吐蛔,乃气血虚,无谷气以养,蛔求食而出也,二陈汤加连翘、连、枣、姜、芍而愈。
一痘起胀吐蛔,乃胃热而久不能食,虫为热迫,但闻食气则上涌出,安蛔汤而愈。然多有不治者,虽痘匀
朗,浆半足,若久不食,而服剂不止者,土虚而木乘之,必至肿消目闭,倒陷而死。
费养恒治冯宪副孙痘,两日稠密无缝,皮薄色淡,身凉而静,睡不合目而困倦,面光白,吐蛔数条,俱已
死,此虚寒而邻于逆者也。以保元汤加芎、归、肉桂、山甲,数剂,绝无起势。乃加参三钱, 五钱,熟附五
分,日二剂,六日渐起,色渐红,囊渐苍老,肢体亦暖。参、 更加重,附至七分,幸不泻。又加熟地膏半盏,
鹿茸膏数匙,十日,浆肥脓成,神爽,寝食俱安,十四日收功。因痂干燥,防余毒,以参归化毒汤,重入忍冬
膏,调理而安。
费建中治姚氏子,秋夜忽吐泻三十余次,口不能合,两目失神,身不热,痘齐涌出,甚细密,仅得分珠,
颗粒圆满,却如水泡,有顶无盘。乃剧虚剧寒之症,形象固逆,幸气血未离,疏通之剂,断不宜用,即与保元
汤加白术、木香、当归、熟地、诃子等。服至六日如常,乃倍参、 ,加鹿茸、肉桂。至八日,身得温暖,窠
囊觉浓,浆水及半而不苍老,前方去鹿茸、肉桂、诃子,加白芍、茯苓、银花,神爽,进食而瘥矣。虚剧之症,
补之不足,尚可散乎?但今无是症矣。
徐仲光治疗一位患痘疮的患者,痘疹未能透发出来,呕吐和腹泻不止,服用升提发散药物后症状反而加重。这是虚证,应当用温补药配合升提法,以透肌散、六君子汤加入升麻、蝉蜕、生姜、肉桂、陈米、大枣而治愈,因为这样能使热势平息,使娇嫩的痘疹得以透发。如果固执于痘疹未出齐就不补益真元,反而会导致痘疹内伏下陷。
有一位患者痘疮之后出现呕吐和腹泻,症状类似霍乱,这是外感兼有内伤的情况,可用藿香正气散、藿香五苓散。因为兼有暑邪和食积,改用加味二陈汤治愈。
有一位患者痘疮之后吐出蛔虫,这是由于气血虚弱,没有谷气来滋养,蛔虫寻求食物而排出体外,用二陈汤加入连翘、黄连、大枣、生姜、白芍而治愈。
有一位患者痘疮起胀时吐出蛔虫,这是因为胃中有热且长期不能进食,虫子被热邪逼迫,只要闻到食物的气味就会向上涌出,用安蛔汤而治愈。然而这种情况大多难以治愈,即使痘疹分布均匀明亮,脓浆已经半满,如果长期不能进食,且服药后仍不止吐蛔,这是脾土虚弱而肝木乘虚克制所致,必然导致痘疮消退、眼睛闭合,倒陷而死。
费养恒治疗冯宪副的孙子患痘疮,两天后痘疹稠密无缝,皮薄颜色淡白,身体凉爽安静,睡觉时眼睛不合但感到困倦,面色光亮苍白,吐出几条蛔虫,都已经死了,这是虚寒证且接近逆证。使用保元汤加入川芎、当归、肉桂、穿山甲,几剂药后,痘疹完全没有起势。于是加入人参三钱,黄芪五钱,熟附子五分,每天服两剂,六天后痘疹逐渐起发,颜色逐渐变红,痘囊逐渐变得苍老坚实,肢体也温暖了。人参、黄芪更加重用,附子增至七分,幸好没有腹泻。又加入熟地黄膏半盏,鹿茸膏几匙,十天后,脓浆丰满成脓,精神清爽,睡眠饮食都安稳,十四天痊愈。因为结痂干燥,为了防止余毒,用人参归化汤,重加忍冬膏,调理后安然无恙。
费建中治疗姚家的儿子,秋夜突然呕吐腹泻三十多次,嘴巴无法合拢,两眼失去神采,身体不发热,痘疹全部涌出,非常细密,只能分出颗粒,颗粒圆满,却像水泡,有顶无底。这是极度虚弱、极度寒冷的病症,形象固然属于逆证,幸好气血尚未离散,疏通类的药剂绝对不宜使用,立即给予保元汤加入白术、木香、当归、熟地黄、诃子等。服用到第六天恢复正常,于是加倍人参、黄芪,加入鹿茸、肉桂。到第八天,身体得到温暖,痘窠痘囊感觉浓实,脓浆达到一半但还不够苍老坚实,前方去掉鹿茸、肉桂、诃子,加入白芍、茯苓、金银花,精神清爽,进食后病愈了。如此严重的虚证,补益尚且不足,还能用消散的方法吗?只是现在没有这样的病例了。
Xu Zhongguang treated a patient with smallpox whose lesions failed to erupt, accompanied by incessant vomiting and diarrhea. After taking ascending and dispersing medications, the symptoms worsened. This was a deficiency syndrome; it should be treated with warming and tonifying herbs combined with ascending methods. The patient was cured using Touji San (Skin-Penetrating Powder) and Liujunzi Tang (Six Gentlemen Decoction) augmented with Shengma (Cimicifugae Rhizoma), Chan Tui (Cicadae Periostracum), Shengjiang (Zingiberis Rhizoma Recens), Rougui (Cinnamomi Cortex), Chenmi (Rice aged for one year), and Dazao (Jujubae Fructus). This approach cooled the heat and allowed the delicate lesions to emerge. If one stubbornly refrained from tonifying the True Yuan (Original Qi) because the lesions were not yet fully erupted, it would instead cause the lesions to sink inward.
Another patient experienced vomiting and diarrhea after smallpox onset, resembling cholera. This was an external contraction complicated by internal injury. Huoxiang Zhengqi San (Agaricus Rectifying Powder) or Huoxiang Wuling San (Agaricus Five-Ingredient Powder) could be used. Because summerheat and food stagnation were also involved, Jia Wei Erchen Tang (Modified Two-Aged Decoction) was effective.
A patient vomited roundworms after smallpox onset due to deficiency of Qi and Blood and lack of grain Qi to nourish them; the worms sought food and emerged. This was cured with Erchen Tang (Two-Aged Decoction) augmented with Lianqiao (Forsythiae Fructus), Lian (Coptidis Rhizoma), Dazao (Jujubae Fructus), Shengjiang (Zingiberis Rhizoma Recens), and Shaoyao (Paeoniae Radix Alba).
A patient vomited roundworms during the swelling stage of smallpox due to stomach heat and prolonged inability to eat. The parasites were driven by heat and surged upward at the mere smell of food. Anwei Tang (Calming Worms Decoction) cured this. However, many such cases are untreatable. Even if the lesions are evenly distributed and bright, and the pus is half-full, if the patient cannot eat for a long time and vomiting of worms persists despite medication, it indicates Spleen Earth deficiency allowing Liver Wood to overact. This inevitably leads to lesion regression, eye closure, collapse, and death.
Fei Yangheng treated the grandson of Vice Commissioner Feng for smallpox. Within two days, the lesions became dense without gaps, thin-skinned, pale in color, with a cool and quiet body. The patient slept with eyes open but appeared fatigued, and the face was shiny and white. Several dead roundworms were vomited. This indicated a deficiency-cold syndrome bordering on adverse prognosis. Baoyuan Tang (Preserve the Origin Decoction) was administered with Chuanxiong (Ligustici Chuanxiong Rhizoma), Danggui (Angelicae Sinensis Radix), Rougui (Cinnamomi Cortex), and Shan Jia (Manis Squama). After several doses, there was no sign of improvement. Then, Renshen (Ginseng Radix et Rhizoma) 3 qian, Huangqi (Astragali Radix) 5 qian, and Shu Fuzi (Prepared Aconiti Lateralis Radix Praeparata) 0.5 fen were added, administered twice daily. By the sixth day, the lesions began to rise, turned redder, the pustules became tougher, and the limbs warmed. The dosages of Renshen and Huangqi were increased further, and Shu Fuzi to 0.7 fen; fortunately, diarrhea did not occur. Ban zhan of Shudi Gao (Rehmanniae Radix Praeparata Paste) and several spoons of Lurong Gao (Cervi Cornu Pantotrichum Paste) were added. By the tenth day, abundant pus formed, spirit was clear, and sleep and appetite were normal. Recovery was achieved on the fourteenth day. Due to dry scabs, to prevent residual toxins, Shenguang Huadu Tang (Ginseng and Angelica Detoxifying Decoction) heavily supplemented with Rendong Gao (Lonicerae Japonicae Flos Paste) was used for conditioning, leading to safety.
Fei Jianzhong treated a son of the Yao family who suddenly suffered vomiting and diarrhea more than thirty times on an autumn night. His mouth could not close, his eyes lost their spirit, his body was not hot, and all smallpox lesions erupted simultaneously. They were very fine and dense, distinguishable only as beads, round but resembling water blisters, with peaks but no bases. This was a severe deficiency and severe cold syndrome, inherently adverse. Fortunately, Qi and Blood had not yet dispersed. Purging and unblocking agents were strictly contraindicated. Immediately, Baoyuan Tang (Preserve the Origin Decoction) was given with Baizhu (Atractylodis Macrocephalae Rhizoma), Muxiang (Aucklandiae Radix), Danggui (Angelicae Sinensis Radix), Shudi (Rehmanniae Radix Praeparata), and Hezi (Terminaliae Chebulae Fructus). By the sixth day, he returned to normal. The dosages of Renshen (Ginseng Radix et Rhizoma) and Huangqi (Astragali Radix) were doubled, and Lurong (Cervi Cornu Pantotrichum) and Rougui (Cinnamomi Cortex) were added. By the eighth day, the body felt warm, the pustule bases felt thick, and the pus reached half-full but was not yet tough. Lurong, Rougui, and Hezi were removed from the previous formula, and Shaoyao (Paeoniae Radix Alba), Fuling (Poria), and Yinhua (Lonicerae Japonicae Flos) were added. The spirit cleared, eating resumed, and the illness resolved. For such severe deficiency syndromes, even tonification may be insufficient; how could dispersion be considered? Fortunately, such cases no longer exist.