冬月触冒寒毒者，至春始发病。病初至表，或已发汗吐下，而表证未罢，毒瓦斯不散，故发斑疮。
又冬月天气温暖，人感乖候之气，未即发病，至春又被积寒所折，毒瓦斯不得泄，至夏遇热，其春寒
已解，冬温毒始发，出于肌肤，斑烂隐 如锦文也。
治温毒发斑，大疫难救，兼治豌豆疮不出，地黄膏。
湿地黄（四两） 好豉（半升）
以猪膏一斤和匀，露一宿，煎五七沸，令三分去一，绞去滓，下雄黄末一钱匕，麝香末半钱匕，
搅匀，稍稍尽饮之，毒从皮中出则愈。小儿斟酌服。
冬温未即发病，至春被积寒所折，不得发，至夏得热，其春寒解，冬温毒始发于肌中，斑烂隐
如锦纹，而咳闷呕吐清水，宜服黄芩麻黄汤。
葛根 橘皮 杏仁（生） 麻黄 知母 黄芩 甘草（各半两）
咀，水二升，煮八合，去滓，温温分减服之。呕吐先定，便宜消息；不呕者去橘皮。
肺腑脏热，暴发气斑，（不可作煮散。）香豉石膏汤。
香豉（二合） 葱须（一两） 石膏（二两） 栀子（三分） 生姜（二两） 大青 升麻 芒
硝（各三分）
咀，水三升，煮取一升三合，去滓，下芒硝，温温分减服。
温病发斑，赤斑者五死一生，黑斑者十死一生，大疫难救，黑奴丸主之。（方在杂汗证中。）
冬温至夏发斑，咳而心闷，呕清汁，眼赤口疮，下部亦生疮，或自下利，黄连汤。
黄连（一两） 橘皮 杏仁（麸炒） 枳实 麻黄 葛根 浓朴 甘草（各一分）
咀，水三升，煮一升二合，去滓，温温分减服。下利先止，别当消息。小儿斟酌。
天行发斑疮，须臾遍身，皆戴白浆，此恶毒之气。世人云永徽四年，此疮自西域东流于海内，
但煮葵菜蒜齑啖之则止，鲜羊血入口即定。初患急食之，作菜下饭亦得。
小儿时行疮豆，恐相传染，先服漏芦汤下之。本治热毒痈疽，赤白诸丹，热毒疮疖。（以
下皆是小儿汤剂。）
漏芦叶（无，以山栀子代之） 连翘 白蔹 甘草 芒硝（各一分） 升麻 枳实 麻黄 黄芩
（各一分半） 大黄（四分）
咀，水二升，煮一升半，下大黄，煮一升，去滓，下芒硝，分减服，以利为度。大人服可倍
作。（大黄水浸，少时和水下之。）
庞曰∶凡觉冬温，至春夏必发斑豆，小儿辈须服漏芦汤下之，得下后，逐日空心饮甘草汁。三
岁以上一盏，儿小减之，直候腹疼乃止；未疼可饮至十日，则永不发。或下后饮羊血一盏，则不发。
治时行豌豆疮，桦皮饮子。
桦皮二两，细切，水一升，煮至半升，去滓饮汁，分减服。
庞曰∶初得病，便惊狂不眠，浑身 然汗出，问之身不憎寒，亦不恶风，其脉如数，以漏芦汤
下之；不甚数者，以大承气汤下之。非但疮豆，伤寒亦然。
治豆疮毒瓦斯不出，烦闷，热毒瓦斯攻腰，或腹胁痛不可忍，大便不通，五香汤主
之。
麝香（半分） 木香 丁香 沉香 乳香（各一分） 芍药 枳实 射干 连翘 黄芩 麻黄 升
麻甘草（各半两） 大黄（一两）
粗末，每服四钱，水一盏，竹沥半盏，煎八分，去滓，下朴硝一钱匕和服，以利为度。
天行热气生疮 ，身痛壮热，水解散。
麻黄（一两） 黄芩 桂枝 甘草（各半两）
细末，暖水调下二钱匕，小儿一钱，覆令小汗。热气在表，已发汗未解，或吐下后，热毒不散，
烦躁谬语，此为表虚里实，热气躁于外，故身体发斑如锦纹；或不因汗下，始得病一二日便发，皆
由温疫热毒瓦斯使然也。甚则发豌豆疮，其色白或赤，发于皮肤，头作浆戴白脓者，其毒则轻；有紫
黑色作根隐隐在肌肉里，其毒则重，十死一生，甚者五内七窍皆有疮形如豌豆，故以名焉。脉洪数
者，是其候也。
天行热毒未解，欲生豌豆，发热疼痛，宜服解肌出汗葛根石膏汤。
葛根 麻黄（各一两） 石膏（二两） 黄芩 芍药 桂枝 甘草（各半两）
粗末，每服四钱，水一盏半，煎八分，温服，取小汗。（自汗者去麻黄。）
斑豆始有白 ，忽搐入腹，渐作紫黑色，无脓，日夜叫烦乱者，郁金散。
郁金一枚（甘草一分，水半碗，煮干，去甘草，片切，焙干为细末） 真脑子（炒，半钱）
同研，每一钱匕，以生猪血五七滴，新汲水调下，不过二服。甚者毒瓦斯从手足心出，如痈状乃
瘥，此是五死一生候也。
此患小便涩，有血者中坏也。疮黑 无脓，十死不治；斑豆烦喘，小便不利，鳖甲汤。
灯心（一把） 鳖甲（二两）
水一升半，煎六合，去滓，温分作二服。
斑豆定烦喘，淡竹沥饮子。
淡竹沥
暖饮之，烦喘自汗，疮不作黑厌，可治。
定烦喘，麻黄甘草汤。
麻黄 杏仁 桑白皮 甘草（各一分）
咀，水一升，煎四合，放温分减服。若脉数有热，以竹沥代水一半煎之，嗽或喉痛加射干一
分。
斑豆疮出不快，红花汤。
红花子（一合，槌碎）
水半升，煎百沸，去滓，分减服之。
斑豆服凉药太过，咳嗽，手足冷，脉迟，甘草干姜汤。
干姜（半两） 甘草（一两）
咀，水一升半，煎六合，分作二服。
常行疮豆，紫草汤最良。患其服之太少不能中病，但多槌切好紫草。（以汤沃之，用物合
定，候温去滓，分减服。每紫草半升，用汤一升为准也。）
斑豆已出，不可止尔，发表更增斑烂，以表虚故也。
豌豆疮欲出，甘草汤。
甘草（四两）
细锉，水二升，煎一升，去滓，分减温服。觉腹中微利即止。
油饮子 饮清油一升即不生。
豌豆斑疮不快，表里不解，烦喘，大便秘气攻腹满，犀角升麻汤。
麻黄（一分半） 木香 犀角 升麻 芍药 甘草 杏仁 枳实 雄黄（各一分） 大黄（半两）
麝香（一钱）
咀，水二升，煎一升半，下大黄，再煎一升，去滓，下雄麝末沸匀，分作三服，以大便通为
度。
疮已出定方。
芒硝 猪胆
和研匀涂之，勿动痂落无瘢，仍卧黄土末上良。
天行疮豆，预服此则不发，三豆饮子。
赤小豆 黑豆 绿豆（各一升） 甘草（一两）
净淘水八升，煮熟，逐日空心任性食豆饮汁七日，永不发。
疮豆发斑，下利赤黄或脓血，遍身发热，栀子薤豉汤。
好豉（半升） 薤白（二两） 肥栀子（十六枚）
水二升半，煮栀子、薤白将烂，下豉再煮十数沸，去滓，分减服。解下恶物瘥。
Individuals who contract cold pathogens in winter may develop illness in spring. Initially, the pathogen is at the exterior level; even if sweating, emesis, or purgation therapies have been applied, if the exterior syndrome persists and the toxic qi fails to dissipate, macules and sores will erupt.
Another scenario involves individuals exposed to abnormal warmth in winter, contracting atypical climatic qi without immediate onset. In spring, accumulated cold suppresses this latent pathogen, preventing its release. When summer heat arrives and the spring cold has dissipated, the winter-warmth toxin emerges from the skin, manifesting as ulcerated lesions with patterns resembling brocade.
To treat macules caused by warm toxins, difficult-to-save cases of great epidemics, and eruptions of smallpox (variola) that fail to surface, apply Dihuang Gao (Rehmannia Ointment).
Ingredients: Dihuang (Rehmanniae Radix) 4 liang, Hao Chi (Prepared Soybean Fermented Product) 0.5 sheng.
Mix evenly with 1 jin of lard (pig fat), expose overnight, boil for five to seven cycles until reduced by one-third, strain, add Xionghuang Powder (Realgar Powder) 1 qianbi, and Shexiang Powder (Musk Powder) 0.5 qianbi. Stir well and drink slowly until finished. Recovery occurs when toxins exit through the skin. Dosage for children should be adjusted accordingly.
If winter-warmth toxin does not manifest immediately but is suppressed by accumulated cold in spring, and upon encountering summer heat—when spring cold has resolved—the winter-warmth toxin erupts within the muscles, causing macules resembling brocade, accompanied by cough, chest oppression, and vomiting of clear fluid, prescribe Huangqin Mahuang Tang (Scutellaria and Ephedra Decoction).
Ingredients: Gegen (Puerariae Radix), Ju Pi (Citri Reticulatae Pericarpium), Xing Ren (Armeniacae Semen), Mahuang (Ephedrae Herba), Zhi Mu (Anemarrhenae Rhizoma), Huangqin (Scutellariae Radix), Gan Cao (Glycyrrhizae Radix et Rhizoma), each 0.5 liang.
Decoct in 2 sheng of water to obtain 8 he, strain, and take warm in divided doses. If vomiting ceases first, adjust dosage; if no vomiting occurs, remove Ju Pi.
For sudden eruption of qi-macules due to heat in the lungs and viscera (do not prepare as a decoction powder), use Xiangshi Shigao Tang (Fermented Soybean and Gypsum Decoction).
Ingredients: Xiangshi (Prepared Soybean Fermented Product) 2 he, Cong Xu (Allii Cepae Bulbus radix part) 1 liang, Shigao (Gypsum Fibrosum) 2 liang, Zhizi (Gardeniae Fructus) 3 fen, Shengjiang (Zingiberis Rhizoma Recens) 2 liang, Da Qing (Isatidis Folium), Shengma (Cimicifugae Rhizoma), Mangxiao (Natrii Sulfas), each 3 fen.
Decoct in 3 sheng of water to obtain 1 sheng 3 he, strain, add Mangxiao, and take warm in divided doses.
In warm disease with macule eruption, red macules indicate a mortality rate of nine deaths to one survival; black macules indicate ten deaths to one survival. These are difficult to save in great epidemics. Treat with Heinu Wan (Black Slave Pill) (see formula in Miscellaneous Sweating Syndromes chapter).
When winter-warmth toxin erupts in summer with macules, cough, chest oppression, vomiting of clear fluid, red eyes, oral ulcers, lower body ulcers, or spontaneous diarrhea, prescribe Huanglian Tang (Coptis Decoction).
Ingredients: Huanglian (Coptidis Rhizoma) 1 liang, Ju Pi, Xing Ren (Stir-baked with bran), Zhishi (Aurantii Fructus Immaturus), Mahuang, Gegen, Houpo (Magnoliae Officinalis Cortex), Gan Cao, each 1 fen.
Decoct in 3 sheng of water to obtain 1 sheng 2 he, strain, and take warm in divided doses. If diarrhea stops first, adjust treatment. Adjust dosage for children.
In epidemic macule-sores appearing rapidly all over the body with white pus caps, this indicates malignant toxic qi. Historically recorded in the fourth year of Yonghui (653 AD), spreading from Western Regions to China, consumption of boiled okra and garlic paste can halt progression; fresh sheep blood ingested orally stabilizes symptoms. Consume urgently at onset, either alone or with rice.
For pediatric epidemic sores/pox fearing contagion, first administer Loulu Tang (Imperata Decoction) to purge. Originally treating heat-toxin carbuncles, erysipelas, and boils. (Below are pediatric decoctions.)
Ingredients: Loulu Ye (Leonuri Herba leaf substitute, use Zhizi if unavailable), Lianqiao (Forsythiae Fructus), Bai Lian (Ampelopsis Radix), Gan Cao, Mangxiao, each 1 fen; Shengma, Zhishi, Mahuang, Huangqin, each 1.5 fen; Dahuang (Rhei Radix et Rhizoma) 4 fen.
Decoct in 2 sheng of water to obtain 1.5 sheng, add Dahuang, boil to 1 sheng, strain, add Mangxiao, take in divided doses until bowel movement occurs. Adult dosage may double. (Soak Dahuwang briefly before adding water.)
Pang Anshi states: Upon sensing winter-warmth, macules/pox will likely erupt in spring/summer. Children must take Loulu Tang to purge. Post-purge, drink Gan Cao juice (Licorice Juice) daily on an empty stomach. For children over three years, one zhan; reduce for younger ones. Stop when abdominal pain occurs; if no pain, drink up to ten days to prevent recurrence. Alternatively, drink sheep blood post-purge to prevent eruption.
For epidemic pox, use Huapi Yinzi (Betula Bark Drink).
Ingredients: Huapi (Betulae Cortex) 2 liang, finely cut. Decoct in 1 sheng water to 0.5 sheng, strain, and drink in divided doses.
Pang Anshi notes: Initial symptoms include惊狂 (frightened mania), insomnia, profuse sweating, absence of aversion to cold/wind, and rapid pulse. Purge with Loulu Tang; if pulse is not excessively rapid, use Dachengqi Tang (Major Order the Qi Decoction). This applies to both pox and Taiyang Cold Damage.
For pox toxins failing to emerge, causing restlessness, heat-toxin attacking the waist, unbearable abdominal/flank pain, and constipation, treat with Wuxiang Tang (Five Fragrances Decoction).
Ingredients: Shexiang (Moschus) 0.5 fen, Muxiang (Aucklandiae Radix), Dingxiang (Syzygii Flos), Chenxiang (Aquilariae Lignum Resinatum), Ruxiang (Olibanum), each 1 fen; Shaoyao (Paeoniae Radix Alba), Zhishi, Shegan (Belamcandae Rhizoma), Lianqiao, Huangqin, Mahuang, Shengma, Gan Cao, each 0.5 liang; Dahuang 1 liang.
Coarse powder, take 4 qian per dose with 1 cup water and 0.5 cup bamboo sap, boil to 0.8 cup, strain, add Puxiao (Mirabilite) 1 qianbi, take until bowel movement occurs.
For epidemic heat generating sores, body pain, and high fever, use Shuijie San (Water-Dispersing Powder).
Ingredients: Mahuang 1 liang, Huangqin, Guizhi (Cinnamomi Ramulus), Gan Cao, each 0.5 liang.
Fine powder, mix with warm water, take 2 qianbi (children 1 qianbi), cover to induce slight sweat. Heat at exterior, unresolved after sweating, or post-emesis/purgation with lingering heat-toxin causing irritability and delirium, indicates exterior deficiency and interior excess. Heat agitates externally, causing brocade-like macules. Even without sweating/purgation, eruption within 1-2 days is due to epidemic heat-toxin. Severe cases present as pox with white/red color or white pus caps (lighter toxicity); purple/black roots deep in muscle (heavier toxicity, 9:1 mortality); severe cases affect internal organs/orifices with pea-sized sores. Pulse is surging and rapid.
For unresolved epidemic heat-toxin, impending pox, fever, and pain, use Jieji Chuhan Gegen Shigao Tang (Muscle-Releasing Sweat-Inducing Pueraria and Gypsum Decoction).
Ingredients: Gegen, Mahuang, each 1 liang; Shigao 2 liang; Huangqin, Shaoyao, Guizhi, Gan Cao, each 0.5 liang.
Coarse powder, take 4 qian with 1.5 cups water, boil to 0.8 cup, take warm to induce slight sweat. Remove Mahuang if spontaneous sweating occurs.
If pox initially shows white pustules then suddenly withdraws into abdomen, turning purple-black without pus, with day-night crying and agitation, use Yujin San (Curcuma Powder).
Ingredients: Yujin (Curcumae Radix) 1 piece (boiled dry with 0.5 bowl water containing 1 fen Gan Cao, remove Gan Cao, slice, dry, powder); Zhen Naozi (Borneolum Syntheticum, stir-fried) 0.5 qian.
Grind together, take 1 qianbi mixed with 5-7 drops fresh pig blood and new well water. Max two doses. Severe cases show toxins exiting via palms/soles like abscesses before recovery (9:1 mortality sign).
Urinary difficulty with blood indicates deterioration. Black sores without pus are incurable (10:1 mortality). For pox with irritability, panting, and urinary difficulty, use Biejia Tang (Trionycis Carapax Decoction).
Ingredients: Dengxin (Junci Medulla) 1 bundle, Biejia (Trionycis Carapax) 2 liang.
Decoct in 1.5 sheng water to 6 he, strain, take warm in two doses.
For settling irritability/panting in pox, use Danzhuli Yinzi (Light Bamboo Sap Drink).
Ingredients: Danzhuli (Bambusae Caulis in Taenia Succus).
Drink warm. Settles irritability/panting/spontaneous sweat; prevents black scabs; curable.
For settling irritability/panting, use Mahuang Gancao Tang (Ephedra and Licorice Decoction).
Ingredients: Mahuang, Xing Ren, Sangbaipi (Morus Cortex), Gan Cao, each 1 fen.
Decoct in 1 sheng water to 4 he, cool, take in divided doses. If rapid pulse with heat, substitute half water with bamboo sap. Add Shegan 1 fen for cough/sore throat.
For slow pox eruption, use Honghua Tang (Safflower Decoction).
Ingredients: Honghuazi (Carthami Flos) 1 he, crushed.
Decoct in 0.5 sheng water for 100 boils, strain, take in divided doses.
Excessive cooling herbs for pox causing cough, cold extremities, and slow pulse: treat with Gancao Ganjiang Tang (Licorice and Dried Ginger Decoction).
Ingredients: Ganjiang (Zingiberis Rhizoma) 0.5 liang, Gan Cao 1 liang.
Decoct in 1.5 sheng water to 6 he, take in two doses.
For common epidemic pox, Zicao Tang (Lithospermi Radix Decoction) is best. Insufficient dosage fails to cure; use ample crushed Zicao. Steep in boiling water, cover, cool, strain, take in divided doses. Ratio: 0.5 sheng Zicao to 1 sheng water.
Once pox erupts, do not stop it forcibly; releasing exterior may worsen macules due to exterior deficiency.
For impending pox eruption, use Gancao Tang (Licorice Decoction).
Ingredients: Gan Cao 4 liang.
Finely chop, decoct in 2 sheng water to 1 sheng, strain, take warm in divided doses. Stop if mild diarrhea occurs.
You Yinzi (Oil Drink): Drink 1 sheng of pure oil to prevent eruption.
For slow pox eruption, unresolved exterior/interior, irritability/panting, constipation, abdominal fullness/gas, use Xijiao Shengma Tang (Rhinoceros Horn and Cimicifuga Decoction).
Ingredients: Mahuang 1.5 fen, Muxiang, Xijiao (Rhinocerotis Cornu), Shengma, Shaoyao, Gan Cao, Xing Ren, Zhishi, Xionghuang, each 1 fen; Dahuang 0.5 liang; Shexiang 1 qian.
Decoct in 2 sheng water to 1.5 sheng, add Dahuang, boil to 1 sheng, strain, add Xionghuang and Shexiang powder, boil, divide into three doses. Take until bowel movement occurs.
Post-eruption care.
Ingredients: Mangxiao, Zhu Dan (Porcine Bile).
Mix and apply topically. Do not disturb scabs to avoid scarring. Sleeping on yellow earth powder is beneficial.
For epidemic pox prophylaxis, use Sandou Yinzi (Three Beans Drink).
Ingredients: Chixiaodou (Phaseoli Semen Rubrum), Heidou (Glycines Soja Seed Nigrum), Lüdou (Phaseoli Semen Aureum), each 1 sheng; Gan Cao 1 liang.
Wash clean, cook in 8 sheng water. Eat beans and drink juice freely on empty stomach for seven days to prevent eruption.
For pox with macules, bloody/yellow/purulent diarrhea, and generalized fever, use Zhizi Xiechi Tang (Gardenia and Allium Macrostemon Decoction).
Ingredients: Hao Chi 0.5 sheng, Xiebai (Allii Macrostemonis Bulbus) 2 liang, Fei Zhizi (Gardeniae Fructus) 16 pieces.
Decoct in 2.5 sheng water. Boil Zhizi and Xiebai until soft, add Chi, boil 10+ times, strain, take in divided doses. Recovery follows expulsion of foul matter.