张洁古先生云∶痘疹未有不因潮热而出者。观其热之时，知自何脏发出，寅卯辰时属肝，出水泡；巳午未时属心，
出疮；申酉戌时属肺，为脓泡；亥子丑时属脾，出疹子。惟肾独居腑下，不受秽浊，故无症耳。窃谓前症当察其虚实，
若壮热饮水，便秘，属实热也，少用清凉饮下之。发热饮冷，大便不秘，属虚热也，宜人参白术散补之。若下而发热愈
甚，此阴虚而阳无所附也，用四物、参、 之类补之。若下而潮热面赤者，血气发躁也，用当归补血汤补之。若见发搐
等症，乃肝虚而内生风也，用四物、天麻、钩藤钩补之。用发散之剂，而热愈甚，此表虚而外热也，用四君、当归、黄
补之。
一小儿先潮热，午前甚，面青痘赤，出而热不止，或时发搐，手足不热不冷，此阳明胃经症，为肝木所侮，先用补
中益气汤加钩藤钩，四剂而热止；痘色红活，乃去钩藤钩，又四剂而贯浆，又用八珍汤而痊。
一小儿痘红活，寅卯时潮热作渴，此肝经风热症，用柴胡栀子散末，三服热止浆贯，又用八珍汤、山栀、丹皮而靥。
一小儿靥后潮热，手足发冷，余谓胃气虚弱，用五味异功散，佐以补中益气汤而愈。因饮食过度，前症复作，更腹
胀，大便不实，小便重坠，此脾虚也，用补中益气汤而痊。
一小儿痘后，不时寒热噫气，饮食吞酸，服二陈、枳实、黄连，更寒热如疟，腹坠下气，此中气复伤而下陷也，
朝用补中益气汤，夕用五味异功散，各加干姜、木香而愈。
一儒者先潮热出痘，面青胁痛，此肝经之症，用四君、柴胡、当归、山栀，二剂胁痛稍缓，又佐以加味逍遥散而痛
止，却用托里散，浆贯而靥。后又潮热，用地黄丸而愈。
一妇人患此，误服寒凉之剂，烦躁作渴，饮沸汤而不知热，脉洪数，按之微细，此血气俱虚，用大剂十全大补汤加
姜、桂四剂，更恶寒切牙，此虚极而药力未能及也，于前药内，更加附子一片，二剂诸症顿退，乃去附子，又二剂将
安，去姜、桂常服而痊。
一小儿痘愈后，潮热，饮食少思，面色痿黄，久治不愈，热后面与手足如冰，余谓脾气虚寒，当用六君、姜、桂，
不信而死，手足皆黑。惜哉！
柴胡栀子散 治痘疮肝经有热，寅卯时发热，或寒热往来，或发热惊搐，或切牙不止，四肢劲强。（方见脓水
淋漓）
加味逍遥散（即逍遥散加牡丹皮、山栀） 治因乳母肝脾血虚发热，致儿发潮热，疮不能愈者。（方见欲靥不
靥）
人参白术散
六味地黄丸（二方见发热属阴阳）
八珍汤（方见顶陷灰白）
清凉饮（方见大便不通）
托里散（方见痘痈）
十全大补汤（方见腹胀气促）
四君子汤（方见不靥闷乱）
当归补血汤
补中益气汤
五味异功散（三方见寒战切牙）
四物汤（方见痘出迟）
Mr. Zhang Jiegu once said: There is no case of smallpox or measles that does not erupt due to tidal fever (tidal fever). By observing the time of fever, one can determine which organ it originates from: Yin, Mao, and Chen hours belong to the Liver, producing blisters; Si, Wu, and Wei hours belong to the Heart, producing sores; Shen, You, and Xu hours belong to the Lung, forming pustules; Hai, Zi, and Chou hours belong to the Spleen, producing maculopapular rashes. Only the Kidney resides alone in the lower jiao, unaffected by turbid pathogens, thus presenting no specific symptoms. I believe that for the aforementioned conditions, one must distinguish between deficiency and excess. If there is high fever with thirst and constipation, it is an excess-heat syndrome; a small amount of Qingliang Yin (Cooling Drink) should be used to purge. If there is fever with a desire for cold drinks but no constipation, it is a deficiency-heat syndrome; Renshen Baizhu San (Ginseng and Atractylodes Macrocephala Powder) should be used to tonify. If purging leads to intensified fever, this indicates yin deficiency with yang having no anchor; Siwu Tang (Four Substances Decoction) and Renshen (Ginseng) should be used to tonify. If tidal fever and facial flushing occur after purging, this indicates restlessness of blood and qi; Danggui Buxue Tang (Dong Quai Tonifying Blood Decoction) should be used to tonify. If convulsions and other symptoms appear, this indicates liver deficiency generating internal wind; Siwu Tang (Four Substances Decoction), Tianma (Gastrodia Rhizome), and Goutenggou (Uncaria Rhynchophylla) should be used to tonify. If dispersing agents cause increased fever, this indicates exterior deficiency with external heat; Sijunzi Tang (Four Gentlemen Decoction), Danggui (Angelica Sinensis), and Huangqi (Astragalus Root) should be used to tonify.
A child first presented with tidal fever, worsening before noon, with a cyanotic complexion and red lesions. After eruption, the fever persisted, accompanied by occasional convulsions and limbs that were neither hot nor cold. This is a syndrome of the Yangming Stomach meridian, suppressed by Liver wood. Initially, Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) with Goutenggou was administered for four doses, stopping the fever. When the lesions became bright red and vibrant, Goutenggou was removed, and another four doses were given until the lesions filled with pus. Finally, Bazhen Tang (Eight Treasures Decoction) was used to achieve recovery.
Another child had bright red lesions and experienced tidal fever with thirst during Yin and Mao hours. This is a Liver meridian wind-heat syndrome. Chaihu Zhizi San (Bupleurum and Gardenia Powder) was administered as a powder; after three doses, the fever ceased and lesions filled with pus. Bazhen Tang (Eight Treasures Decoction), Zhizi (Gardenia Fruit), and Danpi (Moutan Cortex) were then used until scabbing occurred.
A child presented with tidal fever and cold extremities after scabbing. I diagnosed weak stomach qi and treated with Wuyi Yigong San (Five Agents Extraordinary Efficacy Powder), assisted by Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction), resulting in recovery. Due to overeating, previous symptoms recurred with abdominal distension, loose stools, and a heavy sensation in urination, indicating Spleen deficiency. Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) was used to achieve recovery.
A child presented with intermittent chills and fever, belching, and acid regurgitation after smallpox. After taking Erchen Tang (Two Aged Decoction), Zhishi (Immature Bitter Orange), and Huanglian (Coptis Rhizome), the chills and fever resembled malaria, with abdominal heaviness and excessive flatulence. This indicated further injury to middle qi with sinking. Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) was administered in the morning, and Wuyi Yigong San (Five Agents Extraordinary Efficacy Powder) in the evening, each supplemented with Ganjiang (Dried Ginger) and Muxiang (Aucklandiae Radix), leading to recovery.
A scholar first presented with tidal fever followed by smallpox eruption, cyanotic complexion, and hypochondriac pain. This is a Liver meridian syndrome. Sijunzi Tang (Four Gentlemen Decoction), Chaihu (Bupleurum Root), Danggui (Angelica Sinensis), and Zhizi (Gardenia Fruit) were used; after two doses, hypochondriac pain eased slightly. Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder) was added to stop the pain. Tuoli San (Support the Interior Powder) was then used until lesions filled with pus and scabbed. Later, tidal fever recurred and was cured by Liuwei Dihuang Wan (Six-Ingredient Pill with Rehmannia).
A woman suffered from this condition and mistakenly took cold-natured medicines, resulting in irritability, thirst, and drinking boiling water without feeling heat. Her pulse was surging and rapid but fine upon deep pressure, indicating dual deficiency of blood and qi. A large dose of Shiquan Dabu Tang (Ten Complete Great Tonifying Decoction) with Shengjiang (Fresh Ginger) and Rougui (Cinnamon Bark) was administered for four doses. She then developed severe aversion to cold and teeth grinding, indicating extreme deficiency where the medicinal power had not yet reached its target. One slice of Fuzi (Prepared Aconite Lateral Root) was added to the previous prescription. After two doses, all symptoms subsided abruptly. Fuzi was removed, and after another two doses, she stabilized. Rougui and Shengjiang were discontinued, and she recovered with long-term administration.
A child presented with tidal fever, poor appetite, sallow complexion, and prolonged treatment failure after smallpox recovery. The face and extremities felt like ice after fever. I diagnosed Spleen qi deficiency and cold, recommending Liujunzi Tang (Six Gentlemen Decoction) with Shengjiang (Fresh Ginger) and Rougui (Cinnamon Bark). The patient did not believe and died; both hands and feet turned black. What a pity!
Chaihu Zhizi San (Bupleurum and Gardenia Powder): Treats liver meridian heat in smallpox/measles, fever during Yin/Mao hours, alternating chills and fever, fever with convulsions, continuous teeth grinding, and stiff limbs. (Formula see "Pus dripping profusely")
Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder [Xiaoyao San plus Mudanpi and Zhizi]): Treats tidal fever in infants caused by the nursing mother's liver-spleen blood deficiency and heat, preventing lesion healing. (Formula see "Desire to scab but unable to")
Renshen Baizhu San (Ginseng and Atractylodes Macrocephala Powder)
Liuwei Dihuang Wan (Six-Ingredient Pill with Rehmannia) [Both formulas see "Fever belonging to yin/yang"]
Bazhen Tang (Eight Treasures Decoction) [Formula see "Apex sunken, grayish-white"]
Qingliang Yin (Cooling Drink) [Formula see "Constipation"]
Tuoli San (Support the Interior Powder) [Formula see "Smallpox abscess"]
Shiquan Dabu Tang (Ten Complete Great Tonifying Decoction) [Formula see "Abdominal distension and shortness of breath"]
Sijunzi Tang (Four Gentlemen Decoction) [Formula see "Failure to scab, oppression and confusion"]
Danggui Buxue Tang (Dong Quai Tonifying Blood Decoction)
Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction)
Wuyi Yigong San (Five Agents Extraordinary Efficacy Powder) [These three formulas see "Chills and teeth grinding"]
Siwu Tang (Four Substances Decoction) [Formula see "Delayed eruption"]