陈文宿先生云∶痘疮作痒，抓破成疮，脓水淋漓者，由气血衰肌肉虚也，宜用木香散加丁香、肉桂及败草散。切忌
用牛粪灰。窃谓前症皆因气血虚弱所致，预为调护，使气血和平，庶无此患。又必察其外症色白者，用四君之类，色赤
者，用四物之类。若因咸味，宜用蝉蜕散之类。
一小儿口干作渴，脉浮而数，此血气虚而有热也，用参 四圣散加蝉蜕而痒止，用托里散加蝉蜕而脓贯，又用托里
散将靥，忽发热作渴而痒，此血虚也，用八珍汤、当归补血汤而愈。
一小儿痘赤作痒，脉弦，按之则数，此乃肝火血燥生风，先用柴胡麦门冬散加蝉蜕而痒止，又用托里散而痂脱。
后仍痒痕，用八珍汤倍加参 而愈。
一小儿痘疮作痒色赤，心肝二脉数而弦，此风热相搏而血热也，用四物、黄连、柴胡、丹皮而痒止；用八珍汤、当
归补血汤而疮愈。
一小儿痘后作痒，夜甚不寐，此脾经气血俱虚，用四君、归、 数剂而止。后伤食作泻，复痒不寐，仍用前药及
五味异功散而愈。
一小儿痘疮愈后，身痒脓水淋漓，内热口干，用四君、归、 ，及补中益气汤，并六味地黄丸而痊。
一小儿痘痕作痒，服祛风药，遍身皆痒，脓水淋漓，口噤发搐，而面色皎白，此气血俱虚，余用大补汤、参 四圣
散而愈。
一小儿痘疮已愈，而犯色欲，遍身作痒，痘痕赤色，气息奄奄，脉洪数无力，左尺为甚，先用大补汤，内用人参五
钱，数剂形气稍复，佐以大剂加减八味丸料，又五十余剂而痊。
一小儿痘将靥，身痒，脉浮数，按之无力，此真气不能荣于腠理，用补中益气汤渐愈，因功课劳心自汗，用六味汤
而愈。后烦躁面赤，自汗如雨，用当归补血、十全大补二汤而愈。
一小儿汗出如雨，手足发热，作渴饮冷，右关洪数有力，此胃经实热也，用清胃散一剂顿退。因食膏粱复痒，发
热饮冷，用泻黄散末一钱渴止；又用白术散去木香而痊。
一女子靥后身痒，脉浮大。此脾肺气虚也，朝用补中益气汤，夕用黄 六一汤而愈。经行复痒发热，用加味逍遥、
八珍汤而痊。
一男子痘愈而入房，身痒昏愦，脉大而无伦次，按之如无，用独参汤十五剂而苏，又大补汤二十余剂脉敛，又二十
余剂脉微细而畏寒，此火归经，又五十余剂而痊。
一妇人痘方愈，因劳发痒，服消风散，口噤流涎，余谓此日元气复伤，不信，乃服前药，更四肢发搐，余用十全大
补、加味逍遥而愈。
一小儿痘愈后作痒，服消风散，四肢发搐，口噤流涎，余谓脾土亏损，而肝木所克，果殁。
一小儿痘脓未满，面赤作痒，余谓气血虚而有热，欲行温补。不信，乃服清热之药而殁。
柴胡麦门冬散 治肝胆经有热，靥后不解。
柴胡 麦门冬（各一钱） 人参 玄参 龙胆草（各五分） 甘草（炒）
上水煎，量儿大小服。
参 四圣散 治痘疮不能长满生脓，或色白作痒。（方见腹胀气促）
五味异功散 治痘疮元气虚弱，肌肉消薄，荣卫短促而患疮疡，不能消散；或脾肺气虚，不能生肌收口。大凡
诸症，因脾气虚而不能愈者，皆宜服之，调补元气则自愈矣。（方见寒战切牙）
黄 六一汤 治疮疡后气虚作渴，愈后作渴，尤宜服之。
黄 （炙，六钱） 甘草（炙，一钱）
上水煎服。
柴胡栀子散 治肝胆经有热，疮毒不愈，或发热不止。
柴胡 山栀 牡丹皮（各一钱） 川芎 芍药 茯苓（各七分） 白术（炒） 甘草（各五分） 当归 牛蒡子（炒，
各七分）
上水煎，母子同服。
十全大补汤
独参汤、
参 四圣散 治痘疮不起，不能长满生脓；或作痒。（方见腹胀气促）
补中益气汤 治痘疮中气虚弱；或因克伐，以致身痒，恶寒发热，烦渴体倦，饮食少思，或不能结痂作痒者。
当归补血汤（二方见寒战切牙）
加味逍遥散（方见欲靥不靥）
四君子汤（方见不靥闷乱）
六味地黄丸（方见痘疮发热属阴阳）
四物汤（方见痘疮出迟）
泻黄散（方见靥后发热咽痛）
托里散（方见痘痈）
加减八味丸（即六味丸加用五味子、肉桂）
八珍汤（即四君、四物二方相合）
清胃散（方见痘痈）
Mr. Chen Wensu said: When smallpox lesions become itchy, break open from scratching, and ooze pus continuously, it is due to the deficiency of Qi and blood and the weakness of muscles. It is appropriate to use Muxiang San (Wood Fragrance Powder) added with Dingxiang (Clove), Rougui (Cinnamon Bark), as well as Baicao San (Decayed Grass Powder). One must strictly avoid using Niu Fenhui (Cow Dung Ash). I believe that the aforementioned symptoms are all caused by the deficiency of Qi and blood. Preventive care should be taken in advance to harmonize Qi and blood, so that such complications can be avoided. Furthermore, one must observe the external signs: if the complexion is pale, formulas similar to Sijunzi Tang (Four Gentlemen Decoction) should be used; if the complexion is red, formulas similar to Siwu Tang (Four Substance Decoction) should be used. If the condition arises from consuming salty foods, formulas similar to Chantui San (Cicada Slough Powder) are appropriate.
A child presented with dry mouth and thirst, and a floating and rapid pulse. This indicates Qi and blood deficiency with heat. Chan Tui (Cicada Slough) was added to Shenqi Sisheng San (Ginseng and Astragalus Four Saints Powder) to stop the itching. Tuoli San (Supporting Interior Powder) with Chan Tui was used to promote pus formation. Later, Tuoli San was used to facilitate scabbing. Suddenly, fever, thirst, and itching occurred, indicating blood deficiency. The child recovered after taking Bazhen Tang (Eight Treasures Decoction) and Danggui Buxue Tang (Angelica Sinensis Blood-Nourishing Decoction).
A child had red, itchy smallpox lesions and a wiry pulse that became rapid upon deep pressure. This signifies Liver fire causing blood dryness and generating wind. Chaihu Maidong San (Bupleurum and Ophiopogon Powder) with Chan Tui was first used to stop the itching, followed by Tuoli San to allow the scabs to fall off. Subsequently, Bazhen Tang with increased doses of Renshen (Ginseng) and Huangqi (Astragalus Root) cured the remaining itchy scars.
A child had red, itchy smallpox lesions, with rapid and wiry pulses in the Heart and Liver channels. This indicates Wind-Heat clashing and resulting in Blood Heat. Siwu Tang (Four Substance Decoction), Huanglian (Coptis Rhizome), Chaihu (Bupleurum Root), and Danpi (Moutan Cortex) were used to stop the itching; Bazhen Tang and Danggui Buxue Tang were used to heal the lesions.
A child experienced post-smallpox itching, worse at night with insomnia. This indicates dual deficiency of Qi and blood in the Spleen channel. Sijunzi Tang (Four Gentlemen Decoction), Danggui (Angelica Sinensis), and Huangqi (Astragalus Root) were administered for several doses to stop the symptoms. Later, due to food stagnation causing diarrhea, the itching and insomnia recurred. The previous herbs along with Wuwei Yigong San (Five-Flavor Yi Gong Powder) restored health.
After recovering from smallpox, a child suffered from body itching with continuous pus discharge, internal heat, and dry mouth. Sijunzi Tang (Four Gentlemen Decoction), Danggui (Angelica Sinensis), Huangqi (Astragalus Root), Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction), and Liuwei Dihuang Wan (Six-Ingredient Pill with Rehmannia) were used for recovery.
A child with itchy smallpox scars took wind-dispelling herbs, leading to generalized itching, copious pus discharge, trismus (lockjaw), and convulsions, yet the complexion remained pale. This indicates dual deficiency of Qi and blood. I treated this with Dabu Tang (Great Tonifying Decoction) and Shenqi Sisheng San (Ginseng and Astragalus Four Saints Powder), resulting in a cure.
A child whose smallpox had healed engaged in sexual activity, leading to generalized itching, red smallpox scars, weak breathing, and a flooding, rapid but forceless pulse, especially pronounced at the left Chi position. Dabu Tang (Great Tonifying Decoction) containing five qian of Renshen (Ginseng) was used initially. After several doses, the physical appearance and Qi improved slightly. This was supplemented with a large dose of Jiaban Bawei Wan (Modified Eight-Ingredient Pill), and after more than fifty doses, full recovery was achieved.
As a child's smallpox was about to scab, they experienced body itching with a floating, rapid pulse that was forceless upon deep pressure. This indicates that True Qi fails to nourish the Couli (pores and interstices). Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) gradually improved the condition. Due to mental exertion from studies causing spontaneous sweating, Liuyi Tang (Six-Ingredient Decoction, likely referring to Liuwei Dihuang Tang) cured the sweating. Later, irritability, red face, and profuse sweating like rain occurred. Danggui Buxue Tang (Angelica Sinensis Blood-Nourishing Decoction) and Shiquan Dabu Tang (Complete Ten Great Tonifying Decoction) brought about recovery.
A child sweated profusely like rain, had hot hands and feet, thirst for cold drinks, and a flooding, rapid, and forceful Right Guan pulse. This indicates Excess Heat in the Stomach channel. Qingwei San (Clear Stomach Powder) resolved the fever in one dose. Due to consuming rich foods, itching, fever, and thirst for cold drinks returned. Xiehuang San (Drain Yellow Powder) powder (one qian) stopped the thirst; Baixue San (White Atractylodes Powder) without Muxiang (Costus Root) cured the condition.
A woman experienced body itching after scabbing, with a floating and large pulse. This indicates Qi and Lung deficiency. She took Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) in the morning and Huangqi Liuyi Tang (Astragalus Six-to-One Powder) in the evening, achieving recovery. When menstruation began, itching and fever recurred. Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder) and Bazhen Tang (Eight Treasures Decoction) led to healing.
A man experienced body itching and faintness after engaging in intercourse following smallpox recovery. His pulse was large and irregular, feeling empty upon deep pressure. Shenyang Tang (Single Ginseng Decoction) for fifteen doses revived him. Dabu Tang (Great Tonifying Decoction) for over twenty doses constrained the pulse. Another twenty doses resulted in a fine, minute pulse with aversion to cold, indicating Huiguijing (Fire returning to its source). After another fifty doses, he recovered.
A woman developed itching due to labor shortly after smallpox recovery. She took Xiaofeng San (Eliminate Wind Powder), which caused trismus and salivation. I stated that her Yuanqi (Original Qi) was further injured. Disbelieving me, she took the previous medicine, leading to limb convulsions. I treated her with Shiquan Dabu Tang (Complete Ten Great Tonifying Decoction) and Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder), curing her.
A child experienced itching after smallpox recovery and took Xiaofeng San (Eliminate Wind Powder), resulting in limb convulsions, trismus, and salivation. I diagnosed Spleen Earth deficiency being overcome by Liver Wood. The child unfortunately died.
A child had incomplete pustules, a red face, and itching. I diagnosed Qi and blood deficiency with heat and proposed warm tonification. The family disbelieved and administered heat-clearing herbs, leading to death.
Chaihu Maidong San (Bupleurum and Ophiopogon Powder): Treats Heat in the Liver and Gallbladder channels persisting after scabbing.
Chaihu (Bupleurum Root), Maidong (Ophiopogon Tuber) (1 qian each); Renshen (Ginseng), Xuanshen (Scrophularia Root), Longdancao (Gentiana Root) (0.5 qian each); Gancao (Licorice Root) (fried).
Decoct in water and administer according to the child's age.
Shenqi Sisheng San (Ginseng and Astragalus Four Saints Powder): Treats smallpox that fails to fill or form pus, or presents with white color and itching. (Formula see Abdominal Distension and Shortness of Breath).
Wuwei Yigong San (Five-Flavor Yi Gong Powder): Treats weak Yuanqi from smallpox, thinning muscles, short Ying and Wei (Nutritive and Defensive Qi), and ulcers that cannot dissipate; or Spleen-Lung Qi deficiency failing to generate flesh and close wounds. Generally, any condition failing to heal due to Spleen Qi deficiency should take this formula; regulating and tonifying Yuanqi leads to self-healing. (Formula see Cold Tremors and Teeth Grinding).
Huangqi Liuyi Tang (Astragalus Six-to-One Decoction): Treats Qi deficiency thirst after ulcers or persistent thirst after recovery. Especially suitable.
Huangqi (Astragalus Root) (roasted, 6 qian); Gancao (Licorice Root) (roasted, 1 qian).
Decoct in water and take orally.
Chaizu Zisan (Bupleurum and Gardenia Powder): Treats Heat in the Liver and Gallbladder channels, persistent ulcer toxins, or unremitting fever.
Chaihu (Bupleurum Root), Shanzhi (Gardenia Fruit), Mudanpi (Moutan Cortex) (1 qian each); Chuanxiong (Szechwan Lovage Rhizome), Shaoyao (Peony Root), Fuling (Poria) (0.7 qian each); Baizhu (Atractylodes Macrocephala Rhizome) (fried), Gancao (Licorice Root) (0.5 qian each); Danggui (Angelica Sinensis), Niubangzi (Arctium Fruit) (fried, 0.7 qian each).
Decoct in water; mother and child take together.
Shiquan Dabu Tang (Complete Ten Great Tonifying Decoction)
Dushen Tang (Single Ginseng Decoction)
Shenqi Sisheng San (Ginseng and Astragalus Four Saints Powder): Treats smallpox that does not rise, fails to fill or form pus, or causes itching. (Formula see Abdominal Distension and Shortness of Breath).
Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction): Treats middle Qi deficiency from smallpox; or body itching, aversion to cold, fever, irritability, thirst, fatigue, poor appetite, or failure to scab and itch due to excessive purgation/attack.
Danggui Buxue Tang (Angelica Sinensis Blood-Nourishing Decoction) (See Cold Tremors and Teeth Grinding for two formulas)
Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder) (See Desire for Scabbing Without Success)
Sijunzi Tang (Four Gentlemen Decoction) (See Failure to Scab and Confusion)
Liuwei Dihuang Wan (Six-Ingredient Pill with Rehmannia) (See Smallpox Fever Belonging to Yin and Yang)
Siwu Tang (Four Substance Decoction) (See Delayed Eruption of Smallpox)
Xiehuang San (Drain Yellow Powder) (See Post-Scab Fever and Sore Throat)
Tuoli San (Supporting Interior Powder) (See Smallpox Abscess)
Jiaban Bawei Wan (Modified Eight-Ingredient Pill) (i.e., Liuwei Wan added with Wuweizi (Schisandra Berry) and Rougui (Cinnamon Bark))
Bazhen Tang (Eight Treasures Decoction) (Combination of Sijunzi and Siwu Tang)
Qingwei San (Clear Stomach Powder) (See Smallpox Abscess)