凡疮未出而利者，邪气并于里，肠胃热甚，而传化失常也，黄芩汤主之。如自
利清白色者，为里寒，理中汤主之。
黄芩汤
黄芩（一钱半） 甘草（炙，一钱） 白芍药（六钱）
上锉细。加大枣二枚，水一盏，煎七分，温服，食前。
疮已出而利者，邪气并于表，正气方逐邪气，主乎表而不主里，则里气虚，不能停纳水谷，故亦自利也，
宜从气虚而治（九味理中汤倍人参，加黄 、白芍药）。
九味理中汤
人参（二钱） 白术 干姜（炮） 诃子肉 茯苓 木香 藿香叶 肉豆蔻（煨） 甘草（炙，各一钱）
水煎，食前通口服。
疮疹所忌，内虚泄泻，凡觉腹疼，或漉漉响趋小腹者，皆欲作利，宜先以法治
之（九味理中汤）。治之不止，此开肠洞泄，惟涩剂可以收之（豆蔻丸，不止，则用真鸦片配莲肉粉止之）。
庸医每不敢用涩药，恐涩住邪气，不知邪气之盛，莫如伤寒，而张仲景治挟热自利，每用石脂，盖涩剂之去滑，
犹寒剂之去热，热剂之去寒，是谓对证之药，今既滑泄不已，自当收涩，又何疑焉。如服涩剂而又不止，则根
本已拨，无能为矣。经曰∶仓廪不藏者，是门户不要也。《金匮要略》曰∶六腑气绝于外者，手足寒，五脏气绝
于内者，利不止。五夺之中，此为最甚，但正气内脱者淹延而死，邪气内陷者烦渴而死，此为异耳。
陈氏豆蔻丸 治痘疹泄泻。
木香 砂仁 白龙骨 诃子肉 肉豆蔻（面裹煨。各半两） 赤石脂 枯白矾（各七钱半）
上为末。糊丸，如黍米大。一岁三十丸，三岁百丸，温米饮下。泻止，勿服。
自起发以至收靥，大便常宜坚实，忽然自利者，理中汤丸主之。
理中汤丸
人参 白术 甘草 干姜（各等分）
上锉碎。水二盏，煎一盏，去滓，温服。若欲为丸，研细末，炼蜜丸，如弹子大。每用一丸，白汤化下。
参术丸 治小儿脾胃伤冷，外热里寒，不思饮食，身常壮热，大便或溏，色白。或患疮疹身有大热，
因食冷物或冷药过度，或泻，或腹胀，或已出疮疹瘢白无血色。此由里寒脾胃伏冷，荣卫不行，致令毒瓦斯内伏不出，
宜服之，其疮瘢白无血色者，皆从瘢白四围，红晕再起，作脓结痂而愈。
人参 白术 干姜（炮） 甘草（炙。各一分）
上为细末。米糕泡糊、为丸如麻子大。每服百余丸，温水吞下，或米饮亦得，乳食前服。前世之书如仲景诸论治伤
寒云∶轻者用理中汤，重者用四逆汤。此乃胃足阳明经而感寒邪，脾胃乃为中州之府，故用理中汤，曰辛甘发散为阳，
以退寒邪也。理中汤炼蜜丸而嚼下，曰理中丸，盖添蜜，甘以入脾胃，嚼而便化于中焦。今参术丸以粳米糕为丸，取
其难化，服在脾胃，渗漉渐得消化，则中焦得暖，脾土喜燥，其热自归，此所以能治热也。
胃主腐熟水谷，大肠主传送已化之物，故食多少，可以知人谷气之虚实，大便滑涩，可以知人脏腑之冷热，大便如
常，是亦疮疹之一顺也。如起发之时，忽然泄泻，此宜急止之，恐肠胃虚，真气脱也，须辨冷热虚实，如泻而手
足冷，面色青白，疮不红绽者，冷证也，理中汤丸、豆蔻丸、益黄散（脾），甚则陈氏木香散、异功散（出不快）皆可用
也。泻下之物黄又酸臭，渴，手足心热，面赤，疮红绽 发者，热证也，黄芩汤、五苓散（惊）主之。脾胃怯弱，精神
慢而不食者为虚，当温养之，益黄散。身热中满，渴而不食者为实，当清利之，五苓散。其人或脏气自脱，或因服寒
药，致令疮毒陷入大肠，泻下如豆汁，或便脓血，或便黑汁，口内臭气，唇焦目闭，加腹胀者，必死之证。
如因饮冷水自利者，所谓湿胜则濡泄也，宜温中利小便，以理中丸温中，以五苓散利小便去水。
如因伤食自利者，所出酸臭，所谓饮食自倍，肠胃乃伤也，宜先去其积，丁香脾积丸（伤食），后补脾胃，益
黄散（脾）。
如结痂之时暴泄不止者，消息所出之物，痂皮脓血者顺，水谷不分者逆，如利脓血不止者，此热毒下流也，
香连丸主之。
香连丸（一名香橘丸）
黄连（一两，以茱萸五钱同炒，去萸不用） 木香（半两） 石莲子（取肉，二钱半） 陈皮（半两）
上为末。醋调神曲糊、为丸如麻子大。每服二三十丸，陈仓米汤下。
〔丹〕陈牙儿十九岁，出痘，有红 ，吐泻而渴。
苍术（一钱） 白术（三钱） 阵皮（二钱） 黄 茯苓 甘草（炙） 缩砂 当归（各一钱半）
姜三片，同煎服。
从子六七岁时，患疮痘发热，微渴自利。一小方脉视之，用木香散，每帖又增丁香十粒，予切疑焉。观
其出迟，因问自利而气弱，察其所下皆臭滞陈积，因肠胃热蒸而下也，恐非有寒而虚，遂急止之，已投一帖矣。
继以黄连解毒汤加白术，与十帖以解丁香之热，利止疮亦出，其后肌常有微热，而手足生痈疖，与凉剂调补，
逾月而安。一男子十余岁出痘，热时出，根脚密，呕吐不食，腰背骨节痛，大渴喉痛，腹亦痛，全不食者半月余，
脉浮弦洪而数。与参、 、归、术、炙甘草、陈皮、半、茯、生姜煎服之。至五日色淡，又加桂些少，归、
再用酒制。至七日痒甚，加丁香三粒、附子些少，痒止。至八日九日渴大作而腹泄泻，痒甚。至十日寒战，
遂用白术为君， 、陈、苓、炙甘、芩、归为臣。至十一日不靥，或痒，或谵语，但守前药，半月后自吐出痰多而安。
〔陈〕十一味木香散 治疹痘腹胀、渴，其效如神。（必须审察的是寒证、六脉虚细、身不甚热，或发寒，
或呕吐肚腹痛，或身体四肢俱冷者可用。此方出《集验》）。
木香 大腹皮 人参 官桂 赤茯苓 青皮（去白） 前胡 诃子皮 半夏 丁香 甘草（炙。各三两）
上 咀。每服二钱，水一盏，姜三片煎，空心，温服。
异功散《集验方》疮痘头温足冷，腹胀泻渴。（方见痘出不快）
〔海〕疮疹不渴，藏寒下利，四君子加干姜减半主之。痘疹大便不固，痘渐黑陷，小儿乳母同服。
人参 白茯苓 肉豆蔻 黄 （各半两） 甘草（炙，二钱）
上 咀。每服一钱，水半盏，姜五片，枣一枚，煎三分。乳母倍服。若大泻手足厥冷，加附子，用验。
治中散 虚寒泻利，不进饮食。
黄 人参 茯苓 白术 川芎 当归 肉桂（各五钱） 肉豆蔻（面包煨熟取去油） 丁香（一
钱半） 木香（三钱）
上为末。每五岁用五分，好热酒调下，衣被盖暖，少顷，痘变红活而起。
凡是痘疮尚未发出而伴有腹泻的，是邪气并入体内，肠胃热盛，导致传化功能失常，应用黄芩汤主治。如果是自发性腹泻，排出清稀白色的粪便，属于里寒证，应用理中汤主治。
黄芩汤
黄芩（一钱半） 甘草（炙，一钱） 白芍药（六钱）
以上药材切碎细末。加大枣两枚，水一盏，煎至七分，温服，饭前服用。
痘疮已经发出而伴有腹泻的，是邪气并入体表，正气正在驱逐邪气，病机主要在于表而不在于里，因此里气虚弱，不能容纳和消化水谷，所以也会发生自发性腹泻，应当从气虚的角度进行治疗（使用九味理中汤，倍用人参，加入黄芪、白芍药）。
九味理中汤
人参（二钱） 白术 干姜（炮制） 诃子肉 茯苓 木香 藿香叶 肉豆蔻（煨制） 甘草（炙，各一钱）
用水煎煮，饭前通口服下。
痘疹治疗所禁忌的是内虚泄泻。凡是感觉腹痛，或者听到肠鸣漉漉作响并向小腹趋迫的，都是即将发生腹泻的先兆，应当先用药物干预治疗（使用九味理中汤）。如果治疗后腹泻不止，这是肠道洞开、滑脱不禁的危重情况，只有收敛固涩的药物可以止住它（使用豆蔻丸；如果仍不止，则用真鸦片配莲肉粉来止泻）。
庸医往往不敢使用收敛固涩的药物，担心会留滞邪气。他们不知道邪气炽盛，没有比伤寒更严重的了，而张仲景治疗夹杂热邪的自发性腹泻，经常使用赤石脂。可以说，收敛固涩药去除滑脱，就像寒凉药去除热邪、温热药去除寒邪一样，这叫做对症之药。现在既然滑泄不止，自然应当使用收涩之法，又有什么可怀疑的呢？如果服用了收敛固涩药后腹泻仍然不止，那么根本已经动摇，就无法救治了。《内经》说：“仓廪不藏者，是门户不要也。”《金匮要略》说：“六腑之气绝于外，表现为手足寒冷；五脏之气绝于内，表现为腹泻不止。”在五夺（五种极度虚损）之中，这是最严重的。只是正气内脱者会拖延而死，邪气内陷者会因烦渴而死，这只是死因不同罢了。
陈氏豆蔻丸 治疗痘疹泄泻。
木香 砂仁 白龙骨 诃子肉 肉豆蔻（面粉包裹煨制，各半两） 赤石脂 枯白矾（各七钱半）
以上药材研为细末。用糊剂制成丸药，如黍米大小。一岁的服用三十丸，三岁的服用一百丸，用温米汤送服。腹泻停止后，不要继续服用。
从痘疮起发到结痂脱落期间，大便通常应当坚实。如果突然发生自发性腹泻，应用理中汤或理中丸主治。
理中汤丸
人参 白术 甘草 干姜（炮制，各等分）
以上药材切碎。水二盏，煎至一盏，去渣，温服。如果想要做成丸药，将药材研成细末，用炼蜜制成丸药，如弹子大小。每次服用一丸，用白开水化开服用。
参术丸 治疗小儿脾胃受冷伤，外有热象内有寒象，不思饮食，身体常发高热，大便有时溏薄，颜色发白。或者患痘疹时身体有大热，因为食用生冷食物或过量服用寒凉药物，或者出现腹泻，或者腹胀，或者痘疮已出但瘢痕苍白无血色。这是由于里有寒邪，脾胃潜伏冷气，导致营卫运行不畅，致使毒瓦斯内伏而不能透出，应当服用此药。那些痘疮瘢痕苍白无血色的，都会从瘢痕四周重新出现红晕，化脓结痂而痊愈。
人参 白术 干姜（炮制） 甘草（炙，各一分）
以上药材研为细末。用米糕泡成的糊剂，制成如麻子大小的丸药。每次服用百余丸，温水吞服，或者用米汤送服也可以，在吃乳食之前服用。
前世的书籍如张仲景的各种论述治疗伤寒时说：轻症用理中汤，重症用四逆汤。这是因为足阳明胃经感受寒邪，脾胃是中州的府库，所以用理中汤，所谓“辛甘发散为阳”，用来退散寒邪。理中汤炼蜜制成丸药咀嚼服用，称为理中丸，因为添加了蜂蜜，甘味入脾胃，咀嚼后便在中焦迅速化解。现在的参术丸用粳米糕做丸药，取其难以消化的特性，服用后停留在脾胃之间，慢慢渗透消化，从而使中焦温暖，脾土喜欢干燥，体内的热邪自然归位，这就是它能治疗热证的原因。
胃主腐熟水谷，大肠主传送已消化的食物残渣，所以进食量的多少，可以知道人体谷气的虚实；大便的滑利或涩滞，可以知道脏腑的冷热。大便正常，也是痘疹病情顺遂的表现之一。如果在痘疮起发的时候，突然发生泄泻，此时应当紧急止泻，恐怕肠胃虚弱，真气脱失。必须辨别冷、热、虚、实：如果腹泻且手脚冰冷，面色青白，痘疮不红润绽开的，属于冷证，可以使用理中汤丸、豆蔻丸、益黄散（调理脾脏），严重时甚至可以使用陈氏木香散、异功散（用于痘出不快）。如果泻下的东西黄色且酸臭，口渴，手心发热，面赤，痘疮红润绽开发出的，属于热证，应用黄芩汤、五苓散（针对惊风）主治。脾胃怯弱，精神萎靡且不想吃东西的属于虚证，应当温养，用益黄散。身体发热且胸腹满闷，口渴但不想吃东西的属于实证，应当清利，用五苓散。如果此人脏气自行脱失，或者因为服用寒凉药物，导致痘毒陷入大肠，泻下如豆汁样，或者便脓血，或者便黑汁，口中有臭气，嘴唇焦裂，眼睛闭合，加上腹部胀满的，是必死的证候。
如果是因饮用冷水导致自发性腹泻的，这叫作湿胜则濡泄，应当温中并利小便，用理中丸温中，用五苓散利小便以去水湿。
如果是因伤食导致自发性腹泻的，排出的东西酸臭，这叫作“饮食自倍，肠胃乃伤”，应当先消除积滞，用丁香脾积丸（治疗伤食），然后再补益脾胃，用益黄散（调理脾脏）。
如果在结痂的时候突然暴泻不止，要观察排泄物的性质：如果是痂皮、脓血，属于顺证；如果是水谷不分，属于逆证。如果泻下脓血不止，这是热毒下注，应用香连丸主治。
香连丸（又名香橘丸）
黄连（一两，用吴茱萸五钱同炒，去掉茱萸不用） 木香（半两） 石莲子（取肉，二钱半） 陈皮（半两）
以上药材研为细末。用醋调神曲糊，制成如麻子大小的丸药。每次服用二三十丸，用陈仓米汤送服。
〔丹〕姓陈的牙儿十九岁，出痘，有红色痘疹，呕吐腹泻且口渴。
苍术（一钱） 白术（三钱） 陈皮（二钱） 黄芪 茯苓 甘草（炙） 缩砂仁 当归（各一钱半）
生姜三片，同煎服用。
我的侄子六七岁时，患疮痘发热，轻微口渴且自发性腹泻。一位小郎中诊治，使用木香散，每帖又增加丁香十粒，我对此深表怀疑。观察他痘疮发出迟缓，询问得知腹泻且气弱，检查他所下的粪便都是臭秽停滞的陈旧积滞，是因为肠胃热蒸腾而下，恐怕不是有寒且虚，于是急忙止泻，已经投了一帖药。接着用黄连解毒汤加白术，给予十帖以解除丁香的燥热，腹泻停止，痘疮也发出了。后来他的肌肤常有微热，且手足生痈疖，给予凉剂调补，过了一个月才安稳。
一个十多岁的男子出痘，发热时痘疮发出，根脚密集，呕吐不吃东西，腰背骨节疼痛，极度口渴咽喉痛，腹部也痛，完全不吃东西半个多月，脉象浮弦洪大而数。给予人参、黄芪、当归、白术、炙甘草、陈皮、半夏、茯苓、生姜煎服。到第五天痘色变淡，又加少许桂枝，当归再用酒制。到第七天瘙痒严重，加丁香三粒、少许附子，瘙痒停止。到第八九天口渴大作且腹部腹泻，瘙痒严重。到第十天寒战，于是用白术为君药，黄芪、陈皮、茯苓、炙甘草、黄芩、当归为臣药。到第十一天未结痂，有时痒，有时胡言乱语，只守前方不变，半个月后自己吐出很多痰而安宁。
〔陈〕十一味木香散 治疗疹痘腹胀、口渴，效果神奇。（必须仔细审察的是寒证、六脉虚细、身体不太热，或者发寒，或者呕吐肚腹痛，或者身体四肢都冷的患者可用。此方出自《集验》）。
木香 大腹皮 人参 官桂 赤茯苓 青皮（去白） 前胡 诃子皮 半夏 丁香 甘草（炙，各三两）
以上药材捣碎。每次服用二钱，水一盏，生姜三片煎煮，空腹，温服。
异功散《集验方》治疗疮痘头部温热足部寒冷，腹胀腹泻口渴。（方剂见痘出不快条下）
〔海〕疮疹不口渴，脏腑寒凉下利，四君子汤加干姜减半主治。痘疹大便不固，痘疮逐渐黑陷，小儿与乳母同时服用。
人参 白茯苓 肉豆蔻 黄芪（各半两） 甘草（炙，二钱）
以上药材捣碎。每次服用一钱，水半盏，生姜五片，大枣一枚，煎至三分。乳母加倍服用。如果严重腹泻且手脚厥冷，加附子，使用有效。
治中散 治疗虚寒性泻利，不进饮食。
黄芪 人参 茯苓 白术 川芎 当归 肉桂（各五钱） 肉豆蔻（面包煨熟取出去油） 丁香（一钱半） 木香（三钱）
以上药材研为细末。每五岁用量五分，用好热酒调服，穿衣盖被保暖，片刻之后，痘疮变红活而起发。
Whenever diarrhea occurs before the eruption of smallpox/variolae, it indicates that pathogenic factors have merged into the interior, causing excessive heat in the intestines and stomach (Changwei), leading to abnormal transmission and transformation functions. Huangqin Tang (Scutellaria Decoction) is the primary treatment. If there is spontaneous diarrhea with clear, white stools, it indicates interior cold (Lihan), and Lizhong Tang (Regulate the Middle Decoction) is the primary treatment.
Huangqin Tang (Scutellaria Decoction)
Huangqin (Radix Scutellariae, 1.5 qian) Gancao (Radix Glycyrrhizae Preparata, 1 qian) Baishao (Radix Paeoniae Alba, 6 qian)
The above herbs are finely chopped. Add two Jujubes (Fructus Ziziphi Jujubae), one lamp of water, decoct until seven-tenths remain, take warm, before meals.
When diarrhea occurs after the eruption of smallpox/variolae, it indicates that pathogenic factors have merged into the exterior, and the healthy qi (Zhengqi) is expelling the pathogenic factors. The pathology is primarily at the exterior rather than the interior, resulting in deficiency of interior qi, which cannot retain and process food and fluids, thus causing spontaneous diarrhea. Treatment should focus on qi deficiency (use Jiwei Lizhong Tang, doubling the dose of Renshen, adding Huangqi and Baishao).
Jiwei Lizhong Tang (Nine-Ingredient Regulate the Middle Decoction)
Renshen (Radix Ginseng, 2 qian) Baizhu (Rhizoma Atractylodis Macrocephalae) Ganjiang (Rhizoma Zingiberis Preparatum, processed) Hezi Rou (Semen Catechue) Fuling (Poria) Muxiang (Radix Aucklandiae) Huoxiang Ye (Folium Agastaches) Roudoukou (Nucis Arecae Semen Preparatum, baked) Gancao (Radix Glycyrrhizae Preparata, each 1 qian)
Decoct in water, take orally before meals.
Contraindications in treating variolae include internal deficiency with diarrhea. Whenever abdominal pain is felt, or borborygmus (intestinal rumbling) is heard moving towards the lower abdomen, these are precursors to impending diarrhea. Intervention with medication should be initiated first (use Jiwei Lizhong Tang). If diarrhea persists despite treatment, this indicates intestinal prolapse and uncontrolled slipping; only astringent agents can stop it (use Doukou Wan; if ineffective, use genuine Opium mixed with Lotus Seed Powder to stop diarrhea).
Quack doctors often dare not use astringent drugs, fearing they will trap pathogenic factors. They do not realize that among severe pathogenic excess, none surpasses Shanghan (Cold Damage). Zhang Zhongjing treated spontaneous diarrhea complicated by heat using Shizhi (Red Clay/Halloysitum Rubrum). It can be said that using astringents to treat slipping/diarrhea is analogous to using cold agents to treat heat or hot agents to treat cold; these are called specific remedies for specific syndromes. Since slippery discharge is now unceasing, astringency is naturally indicated; what is there to doubt? If diarrhea continues even after taking astringents, the root has been uprooted, and no cure is possible. The Classics state: "When the granaries cannot be stored, it is because the gates are not guarded." The Jingui Yaolue states: "When the qi of the six fu organs fails externally, hands and feet are cold; when the qi of the five zang organs fails internally, diarrhea is unceasing." Among the Five Depletions (Wuduo), this is the most severe. The difference lies only in whether death results from internal collapse of healthy qi (protracted) or internal entrapment of pathogenic factors (with restlessness and thirst).
Chen's Doukou Wan treats diarrhea due to variolae.
Muxiang (Radix Aucklandiae) Sharen (Fructus Amomi) Bailonggu (Os Draconis et Ossis Mammothi) Hezi Rou (Semen Catechue) Roudoukou (Nucis Arecae Semen Preparatum, wrapped in flour and baked, each half liang) Chishizhi (Halloysitum Rubrum) Kubai Fan (Alumen Exsiccatum, each seven qian and half)
Grind into powder. Make pills with paste, size of millet seeds. Thirty pills for one-year-olds, one hundred pills for three-year-olds, taken with warm rice drink. Stop administration once diarrhea ceases.
From the onset of eruption to scabbing, stools should normally be firm. Sudden spontaneous diarrhea should be treated with Lizhong Tang or Lizhong Wan.
Lizhong Tang/Wan
Renshen (Radix Ginseng) Baizhu (Rhizoma Atractylodis Macrocephalae) Gancao (Radix Glycyrrhizae Preparata) Ganjiang (Rhizoma Zingiberis Preparatum, processed, equal parts)
Chop finely. Two lamps of water, decoct to one lamp, strain, take warm. To make pills, grind to fine powder, mix with refined honey, form pills like bullet sizes. Take one pill per dose, dissolved in warm water.
Shenzhu Wan treats children with spleen-stomach cold injury, external heat with internal cold, anorexia, persistent high fever, loose stools that are pale in color. Or, during variolae with high fever, caused by excessive consumption of cold foods/medicines, leading to diarrhea, abdominal distension, or pale, bloodless varicellar scars. This is due to internal cold and latent cold in the spleen-stomach, causing stagnation of Ying and Wei (Nutritive and Defensive Qi), trapping toxic heat inside without eruption. Administration of this formula allows pale scars to develop red halos around them, suppurate, scab, and heal.
Renshen (Radix Ginseng) Baizhu (Rhizoma Atractylodis Macrocephalae) Ganjiang (Rhizoma Zingiberis Preparatum, processed) Gancao (Radix Glycyrrhizae Preparata, each one fen)
Grind to fine powder. Use steamed rice cake soaked in paste to form pills the size of sesame seeds. Take over one hundred pills per dose, swallowed with warm water or rice drink, before milk/food intake.
Ancient texts such as Zhang Zhongjing's discussions on Shanghan state: mild cases use Lizhong Tang, severe cases use Sini Tang. This addresses cold pathogenic factors invading the Foot-Yangming Stomach Meridian. As the spleen and stomach are the central fu organs, Lizhong Tang is used, based on the principle that "acrid-sweet dispersal generates yang" to dispel cold. Lizhong Wan is made by refining honey into pills for chewing, allowing the sweet flavor to enter the spleen-stomach and dissolve quickly in the middle jiao. Shenzhu Wan uses glutinous rice cake for pills, designed to be difficult to digest, staying in the spleen-stomach to slowly permeate and digest, thereby warming the middle jiao. Since spleen-earth prefers dryness, heat returns to its proper place, explaining its efficacy in treating heat.
The stomach governs the rotting and ripening of food and fluids; the large intestine governs the transmission of digested waste. Thus, food intake indicates the deficiency or excess of grain qi; stool consistency indicates the cold or heat of the zang-fu organs. Normal bowel movements are also a favorable sign in variolae. If sudden diarrhea occurs during the eruption phase, it must be stopped urgently to prevent depletion of true qi due to weak intestines and stomach. Differentiate between cold, heat, deficiency, and excess: Diarrhea with cold hands/feet, blue-white complexion, and non-everted red pustules indicates cold syndrome; Lizhong Tang/Wan, Doukou Wan, Yihuang San (for Spleen), or in severe cases Chen's Muxiang San, Yigong San (for slow eruption) may be used. Diarrhea of yellow, sour-smelling material, with thirst, hot palms/soles, red face, and everted red pustules indicates heat syndrome; Huangqin Tang and Wuling San (for fright) are indicated. Weak spleen-stomach with lethargy and anorexia is deficiency, requiring warming and nourishment with Yihuang San. Fever with fullness, thirst but no desire to eat is excess, requiring clearing and draining with Wuling San. If organ qi spontaneously collapses, or due to cold medicine causing toxin invasion of the large intestine, resulting in bean-water-like stools, pus/blood in stool, black fluid, foul breath, cracked lips, closed eyes, and abdominal distension, this is a fatal syndrome.
Spontaneous diarrhea from drinking cold water is termed "dampness excess causing loose stools"; treat by warming the middle and promoting urination, using Lizhong Wan to warm the middle and Wuling San to promote urination and remove water.
Spontaneous diarrhea from food stagnation presents with sour/foul odor, termed "doubling food intake injures the intestines and stomach"; first eliminate accumulation with Dingxiang Pi Ji Wan (for food stagnation), then tonify spleen-stomach with Yihuang San (for Spleen).
If violent unceasing diarrhea occurs during scabbing, observe the excrement: scabs/pus/blood is favorable; undigested food/water is unfavorable. Unceasing pus/blood diarrhea indicates downward flow of heat-toxin; Xianglian Wan is indicated.
Xianglian Wan (also known as Xiangju Wan)
Huanglian (Radix Coptidis, 1 liang, stir-fried with 5 qian Evodiae Fructus, discard Evodia) Muxiang (Radix Aucklandiae, half liang) Shilianzi (Semen Nelumbinis, flesh only, 2.5 qian) Chenpi (Pericarpium Citri Reticulatae, half liang)
Grind to powder. Mix with vinegar and Shenqu paste, form pills size of sesame seeds. Take 20-30 pills per dose, with aged brown rice soup.
[Dan] Chen Ya'er, age 19, had smallpox with red papules, vomiting, diarrhea, and thirst.
Cangzhu (Rhizoma Atractylodis Lanceae, 1 qian) Baizhu (Rhizoma Atractylodis Macrocephalae, 3 qian) Chenpi (Pericarpium Citri Reticulatae, 2 qian) Huangqi (Radix Astragali) Fuling (Poria) Gancao (Radix Glycyrrhizae Preparata) Suosha (Fructus Amomi Rotundus) Danggui (Radix Angelicae Sinensis, each 1.5 qian)
Three slices of ginger, decoct together and take.
My nephew, aged 6-7, suffered from febrile disease with variolae, slight thirst, and spontaneous diarrhea. A junior physician diagnosed him and prescribed Muxiang San, adding ten cloves (Dingxiang) per prescription. I suspected this. Observing his delayed eruption and asking about the diarrhea and weak qi, I examined the feces, finding them foul, stagnant, and old accumulation, driven down by intestinal-heat steaming. I doubted it was cold-deficiency, so I urgently stopped the diarrhea. One prescription had already been given. Subsequently, I administered Huanglian Jiedu Tang (Coptis Decoction to Resolve Toxicity) plus Baizhu for ten prescriptions to resolve the heat of Dingxiang. Diarrhea stopped, eruptions appeared. Later, he had persistent mild fever and boils on hands/feet; cool agents were used for regulation and tonification, and he stabilized after a month.
A man over ten years old had smallpox. Eruptions appeared during fever, with dense bases, vomiting, anorexia, back/joint pain, extreme thirst, sore throat, abdominal pain, and total anorexia for over half a month. Pulse was floating, wiry, surging, and rapid. Prescribed Renshen, Huangqi, Danggui, Baizhu, Zhi Gancao, Chenpi, Banxia, Fuling, Shengjiang decocted. By day 5, color faded; added a little Guizhi, wine-processed Danggui. By day 7, severe itching; added three Dingxiang and a little Fuzi; itching stopped. By days 8-9, intense thirst and abdominal diarrhea, severe itching. By day 10, chills; used Baizhu as sovereign herb, Huangqi, Chenpi, Fuling, Zhi Gancao, Huangqin, Danggui as minister herbs. By day 11, no scabbing, intermittent itching, delirium; adhered to previous formula. After half a month, he vomited much phlegm and recovered.
[Chen] Shi Yi Wei Muxiang San treats rash/smallpox with abdominal distension and thirst, with miraculous effect. (Must carefully examine: cold syndrome, deficient/thin pulse in all six positions, body not very hot, or aversion to cold, vomiting, abdominal pain, or cold limbs. Source: Jiyan Fang).
Muxiang (Radix Aucklandiae) Dafupi (Pericarpium Arecae) Renshen (Radix Ginseng) Guanzi Gui (Cortex Cinnamomi) Chifuling (Poria with Red Mycelium) Qingpi (Pericarpium Citri Reticulatae, white pith removed) Qianhu (Radix Peucedani) Hezi Pi (Pericarpium Catechue) Banxia (Rhizoma Pinelliae Preparatum) Dingxiang (Flos Caryophylli) Gancao (Radix Glycyrrhizae Preparata, each 3 liang)
Crush. Take 2 qian per dose, one lamp of water, three slices of ginger, decoct. Take warm on an empty stomach.
Yigong San (from Jiyan Fang) treats smallpox/rash with warm head/cold feet, abdominal distension, diarrhea, thirst. (See section on slow eruption).
[Hai] Smallpox/rash without thirst, internal cold with diarrhea: Sizijun Zi Tang (Four Gentlemen Decoction) plus Ganjiang, halved dosage. Smallpox with loose stools, darkening/sinking lesions: Child and wet nurse take together.
Renshen (Radix Ginseng) Baifuling (Poria) Roudoukou (Nucis Arecae Semen) Huangqi (Radix Astragali, each half liang) Gancao (Radix Glycyrrhizae Preparata, 2 qian)
Crush. Take 1 qian per dose, half lamp of water, five slices of ginger, one jujube, decoct to three-tenths. Wet nurse doubles dose. If severe diarrhea with cold extremities, add Fuzi; effective.
Zhizhong San treats deficiency-cold diarrhea/anorexia.
Huangqi (Radix Astragali) Renshen (Radix Ginseng) Fuling (Poria) Baizhu (Rhizoma Atractylodis Macrocephalae) Chuanxiong (Rhizoma Chuanxiong) Danggui (Radix Angelicae Sinensis) Rougui (Cortex Cinnamomi, each 5 qian) Roudoukou (Nucis Arecae Semen, bread-baked, oil removed) Dingxiang (Flos Caryophylli, 1.5 qian) Muxiang (Radix Aucklandiae, 3 qian)
Grind to powder. For every five years of age, take 0.5 fen, mixed with good hot wine. Cover warmly with clothes/blankets. Soon, lesions turn red/vibrant and rise.