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Cheng: When the smallpox spots first appear, they are indistinct and fleeting. The spirit is fatigued and restless. The condition resembles being stifled or trapped internally. Both the exterior and interior qi are not smooth and unobstructed. Although a dual-release method (releasing both exterior and interior) is appropriate, it should be assisted by aromatic substances to search out and expel the pathogenic factors, with the main goal of allowing the pent-up toxins to surface. (This is the treatment for "stifled eruption" when spots first appear). Zixue Dan (Purple Snow Pill).

Zhou: Heat has closed off the Pericardium collateral network. The eyes are wide open. The mouth is agape. The tongue is retracted. The hands are grasping at empty air. Spasms have occurred. Urination is clear but defecation is difficult. The blood level is severely damaged. It is the ninth day, a critical period. Following the prescribed method to seek a lucky recovery. Prescribed Zixue Dan (Purple Snow Pill), two qian, mixed with boiling water and administered slowly. Decocted using a tea pot. If consciousness returns and spasms subside, there will be hope for life.

Re-examination: Consciousness has returned. The tongue is crimson-purple and speech is hoarse/short. There is incessant thirst and desire to drink. Although the heat closure in the Pericardium has opened, the fluids and essence within are exhausted. Ancients stated that heart-heat causing polydipsia is mostly a manifestation of visceral yin deficiency. It is clear that purgative methods should not be used.
Fresh Rehmanniae Radix (Sheng Dihu) Heart of Bamboo Leaves (Zhuye Xin) Scrophulariae Radix (Xuanshen) Anemarrhenae Rhizoma (Zhimu) Silver Flower Dew (Yinhua Lu) Human Feces Decoction (Jinzhi) First use Zixue (one qian).

Gong: At the onset, the waist and feet were affected. The toxins accumulated in the Liver and Kidney could not vent outward. The eyes were cloudy and the tongue was coated. Subsequently, panting and urgency increased. This is a critical, untreatable condition of tightness and stifling. All physicians used Gypsum Fibrosum (Shigao) and Rheum Palmatum (Dahuang). However, these drugs only clear the stagnation of the Yangming Stomach fu organ; they cannot search out and expel the toxins from the extreme-yin organs of the Liver and Kidney. Reading Qian Zhongyang's *Zhijue* from the Song Dynasty, it states that toxins hidden in the yin can also be treated with purgation. The formula is called Zaobian Baixiang Wan. It is a method where one hopes for survival in one or two out of a hundred cases. (Treatment for Liver-Kidney toxin accumulation and stifling). Hongya Daji (Red-spotted Euphorbia Root, five qian) Red Dates (five pieces).
Boil in water until the dates are cooked. Remove the pits and the decoction of the Daji. Use only the date flesh, ground and dissolved in boiling water for administration.

Certain Patient: Toxins are hidden and refuse to vent. Qi stagnates and Blood coagulates. How can they erupt and form pustules? During the seventh or eighth day, a critical juncture. Examination shows swollen flesh and withered sores. The spirit is restless and uneasy. Propose to dredge internal stagnation and assist with invigorating Blood and penetrating the muscle layer.
Rhinoceros Horn (Xijiao) Arnebiae Radix seu Lithospermi Radix (Zicao) Stir-fried Hawthorn Seed (Chao Zha) Fresh Rehmanniae Radix (Xian Shengdi) Wine-soaked Rheum Palmatum (Jiu Jin Dahuang) Safflower (Honghua) Citri Reticulatae Pericarpium (Qingpi) Moutan Cortex (Danpi) Forsythiae Fructus (Lianqiao) Arctii Fructus (Niubang) Decoct with Reed Rhizome and Bamboo Shoot Tips soup as water.

Yu: Fever for five to six days. Restless and uneasy spirit. Abdominal distension, coughing and rebellious Qi. Inquiry reveals that two or three days ago, a few spots appeared on the glabella, resembling bran flakes. They subsequently disappeared and became hidden. This indicates heavy toxins obstructing and stifling. Even if they erupt, it belongs to severe danger. Moreover, the infant is only six months old, lacking Gu Qi (Grain Qi) in the Stomach, making it difficult to take herbal decoctions. Prescribe a small dose of Zixue Dan to search out and eliminate the accumulated pathogens, calming the spirit before further discussion. Zixue Dan (one fen).

Gao: Although the spots are dense, the base stands firm. Cold-natured drugs should not be too heavy. Maintenance and conclusion of treatment can be achieved.
Rhinoceros Horn (Xijiao) Forsythiae Fructus (Lianqiao) Arctii Fructus (Niubang) Stir-fried Hawthorn Seed (Chao Zha) Arnebiae Radix seu Lithospermi Radix (Zicao) Moutan Cortex (Danpi) Bombyx Batryticatus (Tianchong) Platycodonis Radix (Jiegeng)

Pang (Day 2): Fatigue, abdominal pain. Spots are numerous and messy, boundaries unclear. At this time, seasonal evil toxins and fire are combined and severe. Urgently apply dual-release method to slightly promote bowel movement. Once the Qi of the Six Fu organs is unobstructed, the smallpox toxins will vent outward, and treatment can be adjusted.
Rhinoceros Horn (Xijiao) Forsythiae Fructus (Lianqiao) Arctii Fructus (Niubang) Wine-processed Rheum Palmatum (Jiu Dahuang) Arnebiae Radix seu Lithospermi Radix (Zicao) Citri Reticulatae Pericarpium (Qinghua) Peach Kernel (Taoren) Stir-fried Hawthorn Seed (Chao Zha) Akebia Caulis (Mutong) Raw Gypsum Fibrosum (Sheng Shigao) Schizonepetae Spica (Jingjie) Bamboo Shoot Tips

Cheng: Spots form patches but do not stand erect. The apex is scorched black and stagnant. Liver and Lung toxins are heavy. Cannot swell up. How can toxins be transformed? Now panting and coughing alternate. The ninth day is hard to pass.
Antelope Horn (Lingyangjiao) Scrophulariae Radix (Xuanshen) Forsythiae Fructus (Lianqiao) Bombyx Batryticatus (Tianchong) Fritillaria Thunbergii Bulb (Tu Bei) Arnebiae Radix seu Lithospermi Radix (Zicao) Stir-fried Hawthorn Seed (Chao Zha) Moutan Cortex (Danpi) Decoct with Honeysuckle and Vinca Vine soup as water.

Qian (Day 3): Although not all erupted, the spots are dense and lusterless. Severe danger is undeniable. Currently, the rash has not fully subsided. Clearing and resolving is still appropriate.
Rhinoceros Horn (Xijiao) Raw Gypsum Fibrosum (Sheng Shigao) Stir-fried Hawthorn Seed (Chao Zha) Arnebiae Radix seu Lithospermi Radix (Zicao) Forsythiae Fructus (Lianqiao) Arctii Fructus (Niubang) Red Peony Root (Chishao) Platycodonis Radix (Jiegeng) Akebia Caulis (Mutong)

Cheng (Day 3): Small body, weak Qi. Dense distribution of spots. Medications should not be too cold-cooling. After five days, tonification and support can be applied, hoping for success.
Forsythiae Fructus (Lianqiao) Arctii Fructus (Niubang) Stir-fried Hawthorn Seed (Chao Zha) Safflower (Honghua) Bombyx Batryticatus (Tianchong) Ligusticum Chuanxiong Rhizome (Chuanxiong) Angelica Sinensis Radix Root (Guishen) Platycodonis Radix (Jiegeng) Stir-fried Dry Lotus Leaf (Chao Gan Heye)

Mao: Small body, weak Qi. Convulsions during pus formation indicate deficiency.
Ginseng Radix (Renshen) Stir-fried Angelica Sinensis Radix (Chao Guishen) Honey-fried Licorice Root (Zhigancao) Tangerine Peel (Guangpi) Stir-fried White Peony Root (Chao Baishao) Stir-fried Yellow Rice (Chao Huangmi)

Tong (Day 4): Spots adhere to the muscles, refusing to erupt and stand high. Plus, they are densely red with thin crusts. This is an intensification of seasonal fire toxins, combined with constitutionally deficient Yuan Qi. Regarding the six days prior to now, the epidemic pathogen was not fully resolved. Prioritize clearing heat, resolving stasis, and lifting the top. Hope for distinct separation of boundaries before further investigation.
Rhinoceros Horn (Xijiao) Antelope Horn (Lingyang) Scrophulariae Radix (Xuanshen) Moutan Cortex (Danpi) Stir-fried Hawthorn Seed (Chao Zha) Bark of Qin Tree (Qinpi) Purple Grass Velvet (Zicao Rong) Honeysuckle (Yinhua)

Zheng: Smallpox erupted while fever persists, accompanied by cough. Wind-warmth has entered the Lung and is not resolved. Palpation shows spots adhering uncomfortably. Warm pathogens stagnate Qi and Blood, compounded by constitutionally weak physique. Propose opening Lung Qi to ventilate, and invigorating Blood to move freely. Hope for full development of color and shape. If sinking and descending herbs are used immediately, good outcomes are unlikely.
Forsythiae Fructus (Lianqiao) Platycodonis Radix (Jiegeng) Safflower (Honghua) Arctii Fructus (Niubang) Licorice Root (Gancao) Stir-fried Hawthorn Seed (Chao Zha) Curcuma Aromatica Rhizome (Yujin) Moutan Cortex (Danpi) Cock Comb Blood (Jiguan Xue)

Re-examination: Yesterday, light, ascending, and blood-invigorating herbs were given. Spot shapes grew well. The concern is lack of luster. Fluffy and curled, with fear of drying up without pus. Tomorrow, atmospheric Qi will resolve, and Qi and Blood will function. Moreover, appetite is returning. Bitter-cold herbs not only freeze the toxins but also severely damage the stomach appetite. Ancients were more cautious with severe cases for this reason.
Ligusticum Chuanxiong Rhizome (Chuanxiong) Angelica Sinensis Radix (Danggui) Bombyx Batryticatus (Tianchong) Platycodonis Radix (Jiegeng) Licorice Root (Gancao) Thorny Twig (Jiaoci) Purple Grass Velvet (Zicao Rong) Moutan Cortex (Danpi) Stir-fried Hawthorn Seed (Chao Zha)

Re-examination (Day 6): Applied harmonizing Qi and Blood method. Color and shape slightly moist. Ultimately not plump or erupting. How can swelling and pus formation occur? Propose Shixuan San (Ten-Accumulation Powder).
Ginseng Radix (Renshen) Ligusticum Chuanxiong Rhizome (Chuanxiong) Angelica Sinensis Radix Root (Guishen) Tangerine Peel (Guangpi) Purple Grass Velvet (Zicao Rong) Bombyx Batryticatus (Tianchong)
Safflower (Honghua) White Angelica Root (Baizhi) Licorice Root (Gancao) Platycodonis Radix (Jiegeng)

Zhang (Day 4): Small boat carrying heavy load. Hard to achieve complete success. Tentatively prescribe Jiming San (Crowing Rooster Powder), two fen.

Lu (Day 5): Spots are not dense, but color is stagnant and shape is flaccid. Phlegm is abundant, choking and wheezing like a hoarse voice. Although spots have erupted, toxins remain inside. Rushing upward to Heart and Lung, hence panting, coughing, and restlessness. Apply cooling blood and penetrating toxin method.
Antelope Horn (Lingyangjiao) Platycodonis Radix (Jiegeng) Licorice Root (Gancao) Arnebiae Radix seu Lithospermi Radix (Zicao) Moutan Cortex (Danpi) Sichuan Fritillaria Bulb (Chuanbei) Forsythiae Fructus (Lianqiao) Scrophulariae Radix (Xuanshen) Belamcanda Rhizome (Shegan) Bombyx Batryticatus (Tianchong) Western Buffalo Calculus (Xi Niuhuang, one fen)

Zhu (Day 4)
Stir-fried Yellow Rice (Chao Huangmi) Stir-fried Hawthorn (Chao Shanzha) Safflower (Honghua) Bamboo Shoot Tips

Re-examination (Day 5): Small body, many spots. Yuan Qi is thinnest. Stomach has not accepted food. Herbal dosage is too heavy; worry about vomiting and diarrhea. Administer medicine in small amounts. Survive the turbulence of days eight and nine to achieve peace.
Ligusticum Chuanxiong Rhizome (Chuanxiong) Stir-fried Angelica Sinensis Radix (Chao Danggui) Platycodonis Radix (Jiegeng) Licorice Root (Gancao) Yellow Rice (Huangmi) Cock Comb Blood (Jiguan Xue)

Re-examination (Day 6): Thin and tender, no pus. Still need internal support.
Astragalus Membranaceus Root (Huangqi) Saposhnikovia Root (Fangfeng) Angelica Sinensis Radix Root (Guishen) Ligusticum Chuanxiong Rhizome (Chuanxiong) Purple Grass Velvet (Zicao Rong) Moutan Cortex (Danpi) Bombyx Batryticatus (Tianchong) Platycodonis Radix (Jiegeng) Licorice Root (Gancao) Cock Comb Blood (Jiguan Xue)

Song (Day 5): Cheeks resemble red sand. Remaining spots are dry and lusterless. Yesterday, cleared toxins and invigorated blood. Continuously erupted thousands of spots. Zhongren said heavy toxins block Qi and Blood, leading to dryness, scorching, and shrinking. Current Day 5 appearance is only similar to initial completion. Twelve days is the standard duration for smallpox. Already blocked and un-erupted for three days. With thin quality and weak spirit, fear it cannot last long. Even hoping for piled eruption and odor, it must be after ten days. Currently, total detoxification and cooling. Days eight and nine will be turbulent; human effort may not stabilize it completely.
Rhinoceros Horn (Xijiao) Antelope Horn (Lingyangjiao) Coptis Chinensis Rhizome (Chuanlian) Stir-fried Hawthorn Seed (Chao Zha) Fritillaria Thunbergii Bulb (Tu Bei) Purple Grass Velvet (Zicao Rong) Scrophulariae Radix (Xuanshen) Fresh Rehmanniae Radix (Xian Shengdi) Forsythiae Fructus (Lianqiao) Moutan Cortex (Danpi) Arctii Fructus (Niubangzi) Pig Tail Blood (Zhuwei Xue)

Wu (Day 5.5): Spots are distinct, originally pure. Concern is stagnant color and dryness. Fear itching and collapse on days eight and nine. Cooling herbs combined with blood-invigorating ones is the standard method. Vigilant care is best.
Antelope Horn (Lingyangjiao) Moutan Cortex (Danpi) Forsythiae Fructus (Lianqiao) Stir-fried Hawthorn Seed (Chao Zha) Purple Grass Velvet (Zicao Rong) Coptis Chinensis Rhizome (Huanglian) Scrophulariae Radix (Xuanshen) Bombyx Batryticatus (Tianchong) Rehmanniae Glutinosa Radix (Shengdi) Cock Comb Blood (Jiguan Xue)

Sun: Soft, white, and tender skin. Constitution is deficient. But smallpox distribution must be due to seasonal epidemics. The six Qi in the earth all transform into fire. Epidemic is external guest, mixing with Qi and Blood. Without clearing and resolving, how can it penetrate? Now color is oily red, pressing feels loose and fearful. Facial muscles swell first. Spot shape lacks swelling indication. Symptoms do not fit the pattern. Fear rapid advance and quick retreat. Cooling and detoxifying, assisted by lifting the top, is the method for days five and six. However, dangerous conditions change unpredictably; cannot rely on general rules.
Antelope Horn (Lingyangjiao) Forsythiae Fructus (Lianqiao) Moutan Cortex (Danpi) Bombyx Batryticatus (Tianchong) Raw Licorice Root (Sheng Gancao) Purple Grass Velvet (Zicao Rong) Coptis Chinensis Rhizome (Chuanlian) Stir-fried Hawthorn Seed (Chao Zha) Platycodonis Radix (Jiegeng)
Decoct with Honeysuckle soup, mix in a few drops of Cock Comb Blood.

Wang (Day 5): Spots are numerous and form patches. Color is purple and stagnant. Fire toxin is severe and dangerous. Rely on strong body Qi to support through fourteen critical days. Hope for foul-smelling, piled eruption. Then there is a chance for survival.
Rhinoceros Horn (Xijiao) Antelope Horn (Lingyangjiao) Platycodonis Radix (Jiegeng) Stir-fried Hawthorn Seed (Chao Zha) Forsythiae Fructus (Lianqiao) Bombyx Batryticatus (Tianchong) Purple Grass Velvet (Zicao Rong) Moutan Cortex (Danpi) Gypsum Fibrosum (Shigao) Honeysuckle (Yinhua) Vinca Vine (Diding) Arctii Fructus (Niubang)
Pig Tail Blood (Zhuwei Xue) Borneolum Syntheticum (Bingpian)

Re-examination (Day 6): Although Blood heat and heavy toxins, fortunately age eight and body is strong. Urgently clear heat, resolve toxins, and invigorate blood. Do not let phlegm obstruct and cause loss of appetite. Support piled eruption, hope for improvement. Follow previous prescription, remove Gypsum Fibrosum, Vinca Vine, Bombyx Batryticatus, Arctii Fructus. Add Coptis Chinensis Rhizome, Scrophulariae Radix, Fritillaria Thunbergii Bulb.

Cha: Pustules formed. Dampness accumulates in skin and hair, steaming with heat, internally affecting Lung. Erupted with covering rash. Avoid meat and fish. Lightly clear and regulate Lung. Mild diuresis to eliminate damp-heat. Constitution is very thin; avoid overdosing.
Coix Seed (Yiren) Poria (Fuling) Forsythiae Fructus (Lianqiao) Lycii Cortex (Digupi) Tetrapanacis Medulla (Tongcao) Mulberry Leaf (Sangye) White Sand Ginseng (Baishashen) Licorice Root (Gancao)

Gu: Eruption originates from collaterals. Toxins do not transform but sink back, also returning to collaterals. Contemporary doctors only know attack and tonify. Reading ancients' books, pungent-aromatic and warming methods are the major principle for treating toxin sinking.
Ginseng Radix (Renshen) Cinnamon Twig (Rougui) Honey-fried Licorice Root (Zhigancao) Clove (Dingxiang) Magnolia Bark (N Hou) Terminalia Chebula Retz. Fruit (Hezizi Pi)
Tangerine Peel (Guangpi) Aucklandiae Radix (Muxiang) Peucedani Radix (Qianhu) Poria (Fuling)

Xu: Has not eaten grain. Only taking herbal decoctions, hence continuous slippery diarrhea. Head tilted back, chest protruding, phlegm congestion, body heat. Lung heat not cleared. Cannot abruptly tonify. Weng Zhongren suggested that if diarrhea stabilizes, it is great deficiency with little toxin. Tentatively harmonize middle and clear throat for discussion.
Platycodonis Radix (Jiegeng) Licorice Root (Gancao) Stir-fried Angelica Sinensis Radix (Chao Gui) Ligusticum Chuanxiong Rhizome (Chuanxiong) Tangerine Peel (Guangpi) Stir-fried Hawthorn Seed (Chao Zha)
Decoct with Stir-fried Yellow Rice soup, mix in Cock Comb Blood.

Re-examination (Day 7): Small body, dense spots. Weak Qi cannot bear much. Although clear pus forms three or four times, protection must be careful. If not damaged or broken by days eight and nine, success is possible.
Ginseng Radix (Renshen) Astragalus Membranaceus Root (Huangqi) Honey-fried Licorice Root (Zhigancao) Purple Velvet (Zirong) Bombyx Batryticatus (Tianchong) Tangerine Peel (Guangpi) Ligusticum Chuanxiong Rhizome (Chuanxiong) Angelica Sinensis Radix Root (Guishen) Magnolia Bark (N Hou) Stir-fried Hawthorn Seed (Chao Zha) Add Stir-fried Winter Rice

Sun (Day 7): Delicate color, thin skin. Pus not filled. Due to small body and many spots, Qi and Blood are mutually deficient. Cannot transport toxins and transform pus. Days eight and nine have greatest fear of itching and collapse. Survive twelve days without change, then hope for success. Apply Shen-Gui-Lurong Tang method.
Ginseng Radix (Renshen) Angelica Sinensis Radix Root (Guishen) Deer Antler (Lurong) Raw Astragalus Membranaceus Root (Sheng Huangqi) Honey-fried Licorice Root (Zhigancao) Tangerine Peel (Guangpi) Magnolia Bark (N Hou) Calcined Aucklandiae Radix (Wei Muxiang)

Re-examination (Day 8): Follow previous prescription, add Nutmeg (Rouguo) and Stir-fried Winter Rice.

Re-examination: Clear pus four or five times, cannot fill. Because Yuan Qi is weak and listless, cannot refine toxins into pus. Fear internal sinking. Re-apply tonification and support. Hope for piled eruption, perhaps recover spring.
Ginseng Radix (Renshen) Astragalus Membranaceus Root (Huangqi) Tangerine Peel (Guangpi) Honey-fried Licorice Root (Zhigancao) Aucklandiae Radix (Muxiang) Deer Antler (Lurong) Angelica Sinensis Radix Root (Guishen) Nutmeg (Rouguo) Umbilical Cord (Kan) Cassia Twig (Guangui)

Re-examination (Day 13): Crusts are very thin, coagulated blood traces inside. Plus choking and retching. Food enters but appears undigested. This is deficiency with toxins, not purely tonifying or purely clearing.
Stir-fried Sichuan Fritillaria Bulb (Chuanbei) Stir-fried Honeysuckle (Chao Yinhua) Poria (Fuling) Coix Seed (Yiren) Licorice Root (Gancao) Lycii Cortex (Digupi)

Yang (Day 8): Broad, collapsed, sunken. Pus color is white, stagnant, and dull. Called Qi decline and toxin sinking. Hope for piled eruption and increased appetite, the only ray of hope.
Ginseng Radix (Renshen) Astragalus Membranaceus Root (Huangqi) Ligusticum Chuanxiong Rhizome (Chuanxiong) Angelica Sinensis Radix Root (Guishen) Aucklandiae Radix (Muxiang) Honey-fried Licorice Root (Zhigancao) Tangerine Peel (Guangpi) Cinnamon Heart (Guixin)

Re-examination (Day 11): Pus full, piled eruption. Limbs round and erupted. But weak Qi fears inability to crust. Must strengthen Spleen and promote urination as method.
Ginseng Radix (Renshen) Atractylodes Macrocephala Rhizome (Dongzhu) Honey-fried Licorice Root (Zhigancao) Poria (Fuling) Xinhui Peel (Xinhui Pi) White Peony Root (Baishao)

Re-examination (Day 13): Already piled eruption and eating. Signs of approaching safety. Loose, slippery stool. All caused by cold-cooling damaging interior intestines. Middle essence and filth descend naturally. In Spleen-Stomach medicines, add a little intestinal-astringing herb. If prolonged, it may lead to complications.
Ginseng Radix (Renshen) Prepared Atractylodes Rhizome (Shuzhu) Terminalia Chebula Retz. Fruit (Hezi) Tangerine Peel (Guangpi) Nutmeg (Rouguo) White Peony Root (Baishao) Aucklandiae Radix (Muxiang) Honey-fried Licorice Root (Zhigancao) Poria (Fuling)

Re-examination (Day 16): Food not digested, abdominal distension, white feces. Stomach stagnation should be eliminated. Spleen weakness should be tonified. Ancients called bloating and fullness related to Qi. Qi moves, stagnation clears. But post-smallpox deficient body, pure elimination still fears complications.
Ginseng Radix (Renshen) Charred Atractylodes Rhizome (Jiaozhu) Stir-fried Hawthorn Seed (Chao Zha) Aucklandiae Radix (Muxiang) Charred Barley Sprout (Jiaoma Ya) Tangerine Peel (Guangpi) Poria (Fuling) Alisma Rhizome (Zexie)

Bao (Day 9): Pus does not reach outside. Toxin wants to sink internally. Already grinding teeth. Slippery diarrhea, vomiting, nausea. Internal symptoms are all deeply feared. Days ten to twenty-four are total critical junctures. Smallpox toxins require strong Yuan Qi to push them out. Propose Chen's Muxiang San to save the interior and support expulsion of toxins.
Ginseng Radix (Renshen) Aucklandiae Radix (Muxiang) Clove (Dingxiang) Cassia Twig (Guangui) Stir-fried Angelica Sinensis Radix Root (Chao Guishen) Magnolia Bark (N Hou) Tangerine Peel (Guangpi) Nutmeg (Rouguo) Terminalia Chebula Retz. Fruit (Hezizi Pi)

Sun: Face swollen, eyes cloudy. Head shaking, slight vomiting. Liver wind leaves the body, riding upward to attack. This is transformation into convulsion, impending syncope. Ministerial fire resides in Liver and Gallbladder. Qi收敛s to form crusts. Should apply cooling resolution and toxin clearing. If slight heat subsides and appetite returns, then good news.
Antelope Horn (Lingyangjiao) Coptis Chinensis Rhizome (Chuanlian) Uncaria Ramulus cum Uncis (Gouteng) Acorus Tatarinowii Rhizome (Shichangpu) Black Gardenia Fruit (Hei Shanzhi) Areca Catalpae Semen (Danning) Gastrodia Elata (Tianma) Forsythiae Fructus (Lianqiao)

Re-examination: Liver wind and heat settled. Malnutrition erosion also slowed. Still should clear heat and detoxify. But do not offend the Stomach.
Antelope Horn (Lingyangjiao) Forsythiae Fructus (Lianqiao) Areca Catalpae Semen (Danning) Moutan Cortex (Danpi) Stir-fried Honeysuckle (Chao Yinhua) Dendrobium Officinale Stem (Jinshihu) Poria (Fuling)

Zhu (Day 13): Smallpox has crusted. But crusts fell too early. Fear residual toxins. Now diarrhea stopped, urination short. Should apply cooling, assisted by separating and draining.
Raw Coix Seed (Sheng Yiren) Lily Bulb (Baihe) Poria (Fuling) Chuan Dendrobium Stem (Chuan Hu) White Sand Ginseng (Baishashen) Stir-fried Ophiopogon Tuber (Chao Maidong)

Certain Patient: Already crusted. Should not continue tonics. Fear Qi and Blood stagnation, leading to residual toxin transformations. Follow Weng Zhongren's method of cooling to assist crusting.
Scutellariae Radix (Huangqin) Honeysuckle (Yinhua) Sichuan Fritillaria Bulb (Chuanbei) Licorice Root (Gancao) Lycii Cortex (Digupi) Platycodonis Radix (Jiegeng) Forsythiae Fructus (Lianqiao) Coix Seed (Yiren)

Hu (Day 15): Although piled eruption and crusting, teeth grinding and choking. Toxins not exhausted. Rushing upward to Heart and Lung. Tonifying and clearing are both difficult to administer. Survive past eighteen days. Carbuncle toxins can still be treated. If malnutrition erosion occurs, hard to fully heal.
Stir-fried Ophiopogon Tuber (Chao Maidong) White Sand Ginseng (Baishashen) Coix Seed (Yiren) Sichuan Fritillaria Bulb (Chuanbei) Stir-fried Honeysuckle (Chao Yinhua) Lycii Cortex (Digupi)

Shen (Day 13): Pus not full, suddenly dried up. This is inverted crusting. Teeth grinding, chills. Yuan Qi greatly depleted. Only strong tonification can salvage.
Ginseng Radix (Renshen) Deer Antler (Lurong) Stir-fried Angelica Sinensis Radix (Chao Danggui) Cinnamon Heart (Guixin) Longan Aril (Guiyuan) Calcined Aucklandiae Radix (Wei Muxiang)

Cheng: Crusting too early. Residual toxins flow to limbs. Arm and leg swelling and pain. Propose invigorating blood and detoxifying.
Forsythiae Fructus (Lianqiao) Little Fresh Rehmanniae Radix (Xiao Shengdi) Angelica Sinensis Radix (Danggui) Red Peony Root (Chishao) Tribulus Terrestris Fruit (Ciji Li) Moutan Cortex (Danpi) Prunella Vulgaris Spica (Xiakucao) Honeysuckle (Yinhua) Half small cup of wine

Wu (Day 14): Choking, coughing, vomiting, abdominal distension. All residual toxins internally closed. Urine scanty, stool loose, not smooth. If panting urgency adds, it becomes tricky. Must get ulcer toxins to vent externally to hope for recovery.
Mulberry Root Bark (Sangbaipi) Areca Peel (Dafupi) Mung Bean Skin (Lv Dou Pi) Poria Cocost Wood (Fuling Pi) Calcined Talcum (Fei Huashi) Raw Licorice Root Tip (Sheng Gancao Shao)

Cha: Rash after crusting. Lung heat not cleared. Should apply pungent-cool, assisted by resolving residual toxins.
Forsythiae Fructus (Lianqiao) Apricot Seed (Xingren) Mulberry Root Bark (Sangpi) Lycii Cortex (Digupi) Scutellariae Radix (Huangqin) Akebia Caulis (Mutong) Honeysuckle (Yinhua) Arctii Fructus (Niubang) Prunella Vulgaris Spica (Xiakucao)

Wu (Day 14): Thin pus, crusting. Toxins not transformed. Already malnutrition erosion risk. Reasonably apply clearing and resolving residual toxins. But barely eat thin porridge. Diarrhea not finished. Stomach not vigorous. Spleen Qi accumulated weakness. Propose permeating and draining to separate and eliminate. Imitate ancient idea that smallpox toxins should promote urination.
Mulberry Root Bark (Sangpi) Lycii Cortex (Digupi) Forsythiae Fructus (Lianqiao) Poria (Fuling) Sichuan Fritillaria Bulb (Chuanbei) Coix Seed (Yiren) Honeysuckle (Yinhua)

Certain Patient: Smallpox not shed crust. Rash fire internally forces panting.
Coptis Chinensis Rhizome (Chuanlian) Rhinoceros Horn (Xijiao) Forsythiae Fructus (Lianqiao) Honeysuckle (Yinhua) Scrophulariae Radix (Xuanshen) Large Fritillaria Bulb (Dabei) Moutan Cortex (Danpi) Lycii Cortex (Digupi)

Re-examination: Rash fire not cleared.
Coptis Chinensis Rhizome (Chuanlian) Scutellariae Radix (Huangqin) Gardenia Fruit (Shanzhi) Forsythiae Fructus (Lianqiao) Honeysuckle (Yinhua) Apricot Seed (Xingren) Licorice Root (Gancao)

Shen: Thin pus, crusting. Toxins not exhausted. Only clear Lung and detoxify.
Stir-fried Sichuan Fritillaria Bulb (Chuanbei) Poria (Fuling) Coix Seed (Yiren) Plantago Seed (Cheqian) Stir-fried Alisma Rhizome (Chao Zexie) Stir-fried Honeysuckle (Chao Yinhua)

Xu (Day 16): Malnutrition toxin erupted. Coughing and choking not stopped. Crusts fall like bran. Muscle color pale white. Although Qi and Blood mutually deficient, post-smallpox residual toxins cannot be abruptly tonified. Propose harmonizing Spleen-Stomach and promoting dampness. Malnutrition toxin should be treated quickly. Fear prolonged illness leads to greater deficiency, causing slow convulsion.
Coix Seed (Yiren) Chuan Dendrobium Stem (Chuan Hu) Poria (Fuling) Lily Bulb (Baihe) Tangerine Peel (Guangpi) Stir-fried Alisma Rhizome (Chao Zexie)

Shen (Day 21): Phlegm choking, loss of voice. Dislike food. Slightly peaceful during day. Restless at night. Lung heat not肃 (clear/settled). Endured many days. Body Qi Yang hyperactive, Yin deficient. Liver wind internally blazing. Sudden convulsion is concerning.
Lycii Cortex (Digupi) Licorice Root (Gancao) Charred Rehmanniae Glutinosa Radix (Sheng Dizhi) Mung Bean Skin (Lv Dou Pi) Stir-fried Moutan Cortex (Chao Danpi) Stir-fried Sichuan Fritillaria Bulb (Chao Chuanbei) Chuan Dendrobium Stem (Chuan Hu)

Li (Day 20): Eating causes vomiting. Spleen-Stomach disharmony. Liver wind internally moves. Limb floating, flesh swelling. Treatment should cultivate Earth to control Wood, to缓 (slow) Liver wind. Hope to avoid convulsion and malnutrition.
Ginseng Radix (Renshen) Poria (Fuling) Stir-fried Peony Root (Chao Shao) Raw Grain Sprout (Sheng Guya) Agastache Herb (Huoxiang) Tangerine Peel (Guangpi) Pinellia Fermented Paste (Banxia Qu)

Feng (Day 28): Crusts stick together. Spirit confused. Originally lacked due to pus leakage. Transforming into slow convulsion, impending collapse. All due to young age Yang hyperactive, Yin deficient. Shy eyes, wandering gaze. Liver Yin exhausted. Fear hard to revive.
Ginseng Radix (Renshen) Poria Cum Pine Root (Fushen) Ziziphus Jujuba Seed (Zaoren) Angelica Sinensis Radix Root (Guishen) Honey-fried Licorice Root (Zhigancao) Stir-fried Goji Berry (Chao Qizi)
Raw White Peony Root (Sheng Baishao)

Re-examination (Day 37): Extreme Yang causes vexation. Yin exhaustion causes agitation. Worse at night. Plan from Yin level. Tonify deficiency and harmonize Yang.
Ginseng Radix (Renshen) Prepared Rehmanniae Glutinosa Radix (Shudi) Euryale Seed (Qianshi) Poria (Fuling) Jian Lotus Seed (Jianlian) Polygala Root (Yuanzhi) Stir-fried Chinese Yam (Chao Shanyao) Schisandra Berry (Wuweizi)

Yang: Spots come irregularly. Apex has water marks, slightly scorched. Seasonal Qi transmission. Fetal toxin not erupted. This is Water-Red type smallpox.
Forsythiae Fructus (Lianqiao) Arctii Fructus (Niubang) Moutan Cortex (Danpi) Red Peony Root (Chishao) Calcined Talcum (Fei Huashi) Akebia Caulis (Mutong) Gardenia Fruit (Shanzhi) Licorice Root (Gancao)

Shao: Caught warm pathogen again during smallpox. Entered via mouth and nose. Spread from middle pathway to collaterals. Eyes cloudy, blindness. Left limb immobile. Lower abdomen protrudes, swollen. Both legs paralyzed. Inquiry reveals on sixth day of spots, suddenly head shaking, irritability. Urination dripping. Defecation gradually blocked. Jueyin Liver heat. Hernia masses lose their dispersing and draining. Internal wind rotates. Fu Yang not unobstructed. Classics say sudden swelling and distension are all wind-fire movements. As disease comes rapidly, ability to eat and digest means heat transforms and kills grain. Studying ancients' pungent-dispersing, sour-draining, sweet-slowing three methods, hard to plan for Fu-collateral obstruction. Zhang Zhongjing in Jueyin regulations has great warning: purging leading to non-stop diarrhea is death. Propose salty-bitter to unblock lower knot-heat. My view is thus. Discuss with experts for good treatment.
Toosendan Fruit (Chuanlianzi) Fennel Seed (Xiaohui) Aloe (Luhui) Gardenia Fruit (Shanzhi) Tangerine Peel (Juhong) Gentiana Scabra Root (Longdancao)
Fangzhu Water seven spoons.

Xu's Comment: All cases are close to reality. Peaceful yet capable of steady changes. Prepare what predecessors did not. Remove flaws and keep purity. Our county has such famous masters, yet do not follow their methods. Instead pick up the spittle of mediocre and absurd people. Regardless of person, regardless of deficiency or excess, always use Gypsum Fibrosum, Rheum Palmatum and various toxic drugs in large doses to灌 (force-feed)