典藏书目

Whenever a pregnant woman develops smallpox (or chickenpox), heat pathogens can easily disturb the fetal qi. If the fetus is lost, it will lead to the collapse of qi and blood, preventing the pustules from rising and filling with pus. Therefore, the treatment always focuses primarily on stabilizing the pregnancy. Externally, use soft cloth to tightly support the upper breasts. One must absolutely avoid using drying and heating substances such as Dingxiang (Caryophylli Flos, Clove) and Guirou (Cinnamomi Cortex, Cinnamon Bark), as well as consuming toxic foods like cow lice, to avoid triggering complications. For herbs suitable for the condition of smallpox, such as Huangqin (Scutellariae Radix, Scutellaria Root), Baizhu (Atractylodis Macrocephalae Rhizoma, Atractylodes Macrocephala Rhizome), Aye (Artemisiae Argyi Folium, Mugwort Leaf), and Sharen (Amomi Fructus, Cardamom Fruit), select and use them appropriately. During the initial fever stage, use Shen Su Yin (Ginseng and Perilla Decoction) to release the exterior. After the rash has erupted, frequently administer Antai Yin (Fetus-Stabilizing Decoction) to protect the fetus. For those with thirst, modify Ren Shen Bai Zhu San (Ginseng and Atractodes Powder). For those with diarrhea, use Huang Qin Tang (Scutellaria Decoction) combined with Si Jun Zi Tang (Four Gentlemen Decoction), adding Hezi (Chebulae Fructus, Chebulic Myrobalan). For blood deficiency, use Si Wu Tang (Four Substances Decoction) added with drugs that promote eruption and expel toxins. For those with grayish-white rashes and delayed eruption, use Shi Quan Da Bu Tang (Comprehensive Great Tonic Decoction) with Guirou (Cinnamon Twig) removed. In summary, regardless of severity, the primary approach is to clear heat and stabilize the fetus.

In cases where a pregnant woman with smallpox goes into labor during the peak of the eruption, both qi and blood will inevitably be deficient. The treatment should focus mainly on using Shi Quan Da Bu Tang (Comprehensive Great Tonic Decoction) to greatly tonify qi and blood. For those with deficiency-cold, add a small amount of Shu Fu Zi (Prepared Aconite Lateralis Radix, Prepared Aconite Root). If there is slight abdominal pain, this indicates that lochia has not yet cleared; Si Wu Tang (Four Substances Decoction) should be used with Gan Jiang (Zingiberis Rhizoma, Dried Ginger), Guixin (Cinnamomi Ramulus, Cinnamon Twig), Muxiang (Aucklandiae Radix, Aucklandia Root), and Heidou (Sojae Semen Nigrum, Black Soybean), using Shu Dihuang (Rehmanniae Radix Praeparata, Prepared Rehmannia Root) while removing Shaoyao (Paeoniae Radix, Peony Root). This is because cold-natured herbs might damage vital energy, although if necessary, they should be used after wine-frying. If chills, teeth grinding, abdominal distension without thirst, cold feet, and body heat occur, this indicates internal deficiency of the Spleen and Stomach with external false heat. Herbs such as Renshen (Ginseng Radix, Ginseng Root), [text missing in original], Guirou (Cinnamon Twig), Fuzi (Aconiti Lateralis Radix Praeparata, Prepared Aconite Root), and Muxiang (Aucklandia Root) are appropriate. Recovery within one or two doses is auspicious; failure to recover is ominous.

For obese pregnant women, qi resides at the surface while the interior is deficient. The dosage of Renshen (Ginseng Root) can be higher, while Huangqi (Astragali Radix, Astragalus Root) should be lower. Add more Suansha (Cardamomi Fructus, Cardamom Fruit) with shells. Absolutely avoid fruits detached from their stems. When the pus dries and scabs form, if sudden diarrhea occurs accompanied by thirst, desire to drink water, and scanty urine, but the pustules are full, robust, and red, this indicates internal heat. Use Wu Ling San (Five-Ingredient Powder with Poria) with added Huangqin (Scutellaria Root) and Shaoyao (Peony Root). If this progresses to intractable slippery diarrhea, reduced food intake, abdominal distension, cold feet, grayish-white pustules, and a fine, weak pulse, this constitutes the "Five Deficiencies" syndrome, which is invariably fatal.

For women who develop smallpox immediately after childbirth or around half a month postpartum, since there is no fetal burden, the issue is merely residual qi and blood deficiency. Treatment should focus on greatly tonifying Ying (Nutrient Qi) and Wei (Defensive Qi). If many pustules erupt, add Lianqiao (Forsythiae Fructus, Forsythia Fruit) and [text missing, likely Niubangzi]. If stools pass naturally, use Rougu (Myristicae Semen, Nutmeg) and Paojiang (Zingiberis Rhizoma Preparatum, Fried Ginger). Other conditions should be treated according to standard protocols without excessive doubt, which might cause further errors.

If the fetus is lost when the rash first appears, although qi and blood are severely depleted, the heat-toxin is also expelled along with the fetus. Since the rash has not yet swollen or filled with pus, the qi and blood have not been externally exhausted. If the case is not critical or inverted, treating with major tonic and interior-supporting methods often leads to survival. If the fetus is lost during the scabbing stage, the toxin has already emerged from the surface and dissipated, so there are usually no major issues. However, due to extreme deficiency and the ease of Yuan Qi (Original Qi) collapse, extra care in tonification is required. If the fetus is lost during the swelling and pus-filling stage, qi and blood collapse, leading to both internal and external deficiency. Unable to drive the toxin out, the toxin will attack inward due to the deficiency, and most such cases are incurable.

Huang Qin Tang (Scutellaria Decoction): Treats heat-dysentery. Huangqin (Scutellaria Root), Zhi Cao (Glycyrrhizae Radix et Rhizoma Preparata, Prepared Licorice Root), and Shaoyao (Peony Root) in equal parts; 5–7 Da Zao (Jujubae Fructus, Jujube Dates). Decoct in water and take orally.