陈文宿先生云∶痘疮出二三日，始出如粟米状，或绿豆大，似水珠光泽明净，根窠红者，不须服药。若四五日大小
不等，根窠光泽明净者，亦不须服药。如陷顶灰白泻渴者，服木香散。丹溪先生云∶痘疮灰白色，静者、怯者作寒看，
躁者、勇者、 发者作热看。若初出之时色白者，便须大补气血，参、 、芎、归、术、芍、甘草、升麻、木香、丁香；
泻者加诃子、肉豆蔻。若白色将靥如豆壳者，盖因初起，饮水过多，其靥不齐，俗呼倒靥，不妨，但须实表之剂自愈。
如毒郁于里，大小便秘者，随通利之。窃谓∶前症不起发，不红活者，此因脾胃气虚，用参 四圣散。顶陷灰白泻渴
者，脾肺虚寒，用木香散、异功散。若灰白色或痒而脓不贯，用紫草、四君、木香。色赤或痒而脓不贯，用紫草木通
汤。贯而脓清稀，用参 内托散；不应，加附子，缓则不救。已出危症，如出赠痘，多有生者。
一小儿色淡白痒塌，此脾肺气虚血弱也，用紫草快 汤、参、术各三钱二剂，稍应，又二剂，红活起发；又用托
里散、参、术各三钱，贯脓而愈。
一小儿九岁，痘色白，手足冷，此脾胃虚弱，用六君子汤加木香、当归、紫草四剂，又用参 四圣散加参、 各三
钱而靥。至十七日发热烦渴，脉洪大而虚，用八珍汤而愈。
一小儿十六岁，痘色白，脉虚浮，按之甚微而短，形气倦怠，饮食少思，此血气虚弱，用紫草木香散，内人参五钱
十剂，色微赤；又用独参汤而贯。乃用十全大补汤、补中益气汤，共享参二斤余而靥。随入科举毕，发热痕痒淡赤，
昏倦不食，急灌以独参汤而苏，又用斤余，却用十全大补汤、补中益气汤而安。
一小儿痘疮七日，变灰白色，手足并冷，腹痛泻渴，先君谓阳气虚寒，用十二味异功散。不信，已而饮沸汤不知
热，始投前药二剂，阳气顿复，却用独参汤、参 四圣散而愈。
一小儿十五岁，因科举劳伤元气，出痘色白，贯脓不靥，眼闭昏愦，饮食与之则食，手指轻捏不冷，重按良久则
冷，其脉轻诊而浮，重按如无，不及两寸，此阳气虚弱而无
邪耳。用人参一两，干姜一钱，枣五枚，二日进四剂，结靥眼开。又二剂其眼常开，呻吟不绝。再剂却佐以补中益气
汤，二十一日始言，但气短，云遍身痛如锥，索食，月余而靥。始末悉用前二汤，更无他饵。
一孕妇发热坠胎昏愦，遍身见痘灰白色，饮食药饵，到口即作呕，惟灌热汤则饮之，乃择壮年妇乳灌之不辍，日灌
数碗，旬余省索食，云胸腹胀满，此脾气虚而乳食壅滞，令细呷浓茶半钟，胸满即宽，四十余日而靥。后因劳心发热如
炙，用四君、参、 、炮姜而痊。
一男子年三十，发热头痛，四肢拘急。服解表之药热益甚，遍身红点，渐成脓，窠已灰白，此痘疮因气虚耳。用参
四圣散、托里散，色赤脓贯而靥。
一小儿第十日不红活，浆不满，先君谓气血虚弱，用参 托里散数剂出赠痘，红活起发，又用十全大补汤而愈。
十一味木香散
木香 大腹皮 人参 桂心 赤茯苓 青皮 前胡 诃黎勒（去核） 半夏 丁香 甘草（炙。各三钱）
上每服三钱，生姜三片，水煎，量大小服。
十二味异功散
木香 官桂（各三钱，去粗皮） 当归（三钱半） 人参 茯苓 陈皮 浓朴 白术（各二钱） 半夏 丁香
肉豆蔻（二钱半） 附子（炮，去皮，一钱）
上每服三五钱，姜五片，枣三枚，水煎，量大小服。此药家传五世，累经效验。
愚尝治痈疽阴症，凡杂症阳气脱陷，与寒气逼阳于外者，发热烦躁，口干作渴，投以姜、桂、附子之类，津液顿
生，烦热顿退，其应如响。人但不习而察之耳。
八珍汤 治痘疮气血俱虚者，此方主之。若因脾气虚弱而不能生血者，宜用异功散。
当归（一钱） 川芎（五分） 芍药（炒，七分） 熟地黄（酒拌） 人参 白术（炒） 茯苓（各一钱） 甘草
（炙，五分）
上每服二三钱，姜枣水煎。
豆蔻丸（方见切牙）
内托散（即托里散，方见痘痈）
紫草快 汤（方见大便不通）
四君子汤
六君子汤（二方见不靥）
参 内托散（方见腹胀气促）
紫草木香散（方见大便不通）
补中益气汤（方见寒战切牙）
四圣散（方见痘出不快）
参 四圣散
十全大补汤
独参汤（三方见腹胀气促）
紫草木通汤（方见痘出迟）
Mr. Chen Wensu said: Two to three days after the eruption of smallpox, if it initially appears like millet grains or mung beans, resembling water droplets with a bright and clear luster, and the base is red, no medication is required. If four to five days have passed, and although the lesions vary in size, the bases remain bright and clear, medication is also unnecessary. However, if the lesions present with sunken tops, grayish-white color, diarrhea, and thirst, administer Muxiang San (Aucklandia Powder). Mr. Danxi stated: For smallpox lesions that are grayish-white, quietness and timidity indicate a cold pattern; restlessness, vigor, and swelling indicate a heat pattern. If the lesions appear white upon initial eruption, substantial tonification of Qi and Blood is required, using Ren Shen (Ginseng), [missing character], Chuanxiong (Szechwan Lovage Rhizome), Dang Gui (Angelica Sinensis), Bai Zhu (Atractylodes Macrocephala Rhizome), Shao Yao (Peony Root), Gan Cao (Licorice Root), Sheng Ma (Cimicifuga Rhizome), Mu Xiang (Aucklandia Root), and Ding Xiang (Clove); for those with diarrhea, add He Zi (Chebula Fruit) and Rou Dou Kou (Nutmeg). If white lesions are about to crust over like bean shells, this is due to excessive fluid intake at the onset, resulting in uneven crusting, commonly called "Dao Ye" (Reverse Crusting); this is not serious, but requires formulas to consolidate the exterior, which will lead to self-healing. If toxins are stagnant internally causing constipation of both stool and urine, use purgative or diuretic agents as appropriate. I believe: In the aforementioned conditions where lesions fail to erupt or lack ruddy vitality, this is due to Spleen and Stomach Qi deficiency; use Can [missing character] Si Sheng San (Four Holy Powders). For cases with sunken tops, grayish-white color, diarrhea, and thirst, indicating Spleen and Lung Deficiency-Cold, use Muxiang San (Aucklandia Powder) or Yigong San (Extraordinary Efficacy Powder). For grayish-white or itchy lesions with incomplete pus formation, use Zi Cao (Arnebia Root/Lithospermum Root), Sizunzi Tang (Four Gentlemen Decoction), and Mu Xiang (Aucklandia Root). For red or itchy lesions with incomplete pus formation, use Zicao Mutong Tang (Arnebia and Akebia Decoction). For complete eruption but thin pus, use Can [missing character] Neituo San (Interior-Supporting Powder); if ineffective, add Fu Zi (Prepared Aconite Root); delay leads to untreatable conditions. Critical symptoms already manifested, such as "Zeng Du" (a specific type of smallpox presentation), often survive.
A child with pale complexion and itchy, collapsed lesions suffered from Spleen-Lung Qi deficiency and Blood weakness. Zicao Kuai [missing character] Tang (Arnebia Rapid-Resolving Decoction) was used, with Ren Shen (Ginseng) and Bai Zhu (Atractylodes Macrocephala Rhizome) each at 3 qian. After two doses, there was slight improvement; after another two doses, the lesions became ruddy and erupted. Then, Tuoli San (Interior-Supporting Powder) was used, with Ren Shen (Ginseng) and Bai Zhu (Atractylodes Macrocephala Rhizome) each at 3 qian, leading to pus formation and recovery.
A nine-year-old child presented with white lesions and cold extremities, indicating Spleen-Stomach deficiency. Liujunzi Tang (Six Gentlemen Decoction) was administered with added Mu Xiang (Aucklandia Root), Dang Gui (Angelica Sinensis), and Zi Cao (Arnebia Root/Lithospermum Root) for four doses. Subsequently, Can [missing character] Si Sheng San (Four Holy Powders) was used, adding Ren Shen (Ginseng) and [missing character] each at 3 qian, resulting in crusting. On the seventeenth day, fever, irritability, and thirst appeared with a flooding yet empty pulse; Bazhen Tang (Eight Treasures Decoction) cured him.
A sixteen-year-old child had white lesions, a floating and deficient pulse that was very faint and short upon pressure, fatigue, poor appetite, and lack of desire to eat, indicating Qi and Blood deficiency. Zicao Muxiang San (Arnebia and Aucklandia Powder) containing 5 qian of Ren Shen (Ginseng) was taken for ten doses, turning the lesions slightly red. Dushen Tang (Single Ginseng Decoction) was then used to promote pus formation. Finally, Shiquan Dabu Tang (Complete Great Tonifying Decoction) and Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) were used, consuming over two jin of Ren Shen (Ginseng) before crusting occurred. After completing imperial examinations, he developed fever, itchy scars, and pale redness, with drowsiness and anorexia. Emergency administration of Dushen Tang (Single Ginseng Decoction) revived him, followed by another jin-plus of Ren Shen (Ginseng), and stabilization with Shiquan Dabu Tang (Complete Great Tonifying Decoction) and Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction).
A child’s smallpox turned grayish-white on the seventh day, with cold hands and feet, abdominal pain, diarrhea, and thirst. My late father diagnosed Yang Qi Deficiency-Cold and prescribed Shi'erwei Yigong San (Twelve-Ingredient Extraordinary Efficacy Powder). The family did not believe this. Later, the child drank boiling water without feeling the heat. Only then was the previous prescription given for two doses, instantly restoring Yang Qi. Dushen Tang (Single Ginseng Decoction) and Can [missing character] Si Sheng San (Four Holy Powders) completed the cure.
A fifteen-year-old child, having damaged Yuan Qi through examination stress, presented with white lesions, incomplete pus formation, closed eyes, and confusion. Food was accepted when offered; fingers felt warm when lightly touched but cold after prolonged pressure. The pulse was superficial on light touch and imperceptible on deep pressure, extending less than two cun. This indicated Yang Qi deficiency without pathogenic factors. One liang of Ren Shen (Ginseng), one qian of Gan Jiang (Dried Ginger), and five Jujubes were administered, four doses over two days, leading to crusting and eye-opening. After two more doses, eyes remained open with continuous groaning. Two additional doses supplemented with Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) allowed speech on the twenty-first day, though shortness of breath and generalized stabbing pain persisted. Food was requested, and crusting occurred after more than a month. Throughout, only the first two decoctions were used, with no other medications.
A pregnant woman suffered fever, miscarriage, and confusion, with grayish-white smallpox lesions all over her body. She vomited immediately upon attempting food or medicine, accepting only hot liquids. Young women's breast milk was administered continuously, several bowls daily. After more than ten days, she regained consciousness, desired food, and complained of chest and abdominal fullness, indicating Spleen Qi deficiency with stagnation of milk and food. She was instructed to sip strong tea slowly, relieving the fullness immediately. Crusting occurred after forty-plus days. Later, mental exertion caused burning fever; Sizunzi Tang (Four Gentlemen Decoction) with Ren Shen (Ginseng), [missing character], and Pao Jiang (Prepared Ginger) cured her.
A thirty-year-old man presented with fever, headache, and limb stiffness. After taking exterior-releasing herbs, fever worsened, red spots appeared all over, gradually suppurating, with grayish-white bases. This was smallpox due to Qi deficiency. Can [missing character] Si Sheng San (Four Holy Powders) and Tuoli San (Interior-Supporting Powder) were used, turning lesions red, promoting pus formation, and achieving crusting.
A child on the tenth day had non-ruddy, under-filled lesions. My late father attributed this to Qi and Blood deficiency. Can [missing character] Tuoli San (Interior-Supporting Powder) was given for several doses, producing "Zeng Du," making lesions ruddy and erupted. Shiquan Dabu Tang (Complete Great Tonifying Decoction) completed the cure.
Eleven-Ingredient Muxiang San (Aucklandia Powder)
Mu Xiang (Aucklandia Root), Dafupi (Areca Peel), Ren Shen (Ginseng), Guixin (Cinnamon Twig), Chi Fuling (Red Poria), Qingpi (Green Tangerina Peel), Qianhu (Peucedani Radix), Helile (Chebulic Myrobalan Fruit, pitted), Banxia (Pinellia Tuber), Dingxiang (Clove), Gancao (Licorice Root, honey-fried). Each 3 qian.
Take 3 qian per dose, with 3 slices of fresh ginger, decocted in water. Dosage adjusted by age.
Twelve-Ingredient Yigong San (Extraordinary Efficacy Powder)
Mu Xiang (Aucklandia Root), Guanzi Gui (Cinnamon Bark, each 3 qian, coarse bark removed), Dang Gui (Angelica Sinensis, 3.5 qian), Ren Shen (Ginseng), Fuling (Poria), Chenpi (Tangerina Peel), Houpo (Magnolia Bark), Baizhu (Atractylodes Macrocephala Rhizome, each 2 qian), Banxia (Pinellia Tuber), Dingxiang (Clove), Roudoukou (Nutmeg, 2.5 qian), Fuzi (Prepared Aconite Root, processed, peeled, 1 qian).
Take 3-5 qian per dose, with 5 slices of ginger and 3 jujubes, decocted in water. Dosage adjusted by age. This formula has been passed down in my family for five generations and has proven effective repeatedly.
I have treated Yin-type carbuncles and ulcers. In miscellaneous diseases where Yang Qi collapses or is forced outward by cold, presenting with fever, irritability, dry mouth, and thirst, administering Ginger, Cinnamon, and Aconite generates fluids instantly and resolves fever rapidly. People simply fail to recognize and observe this.
Bazhen Tang (Eight Treasures Decoction) treats smallpox with combined Qi and Blood deficiency. Use this formula primarily. If blood generation fails due to Spleen Qi deficiency, use Yigong San (Extraordinary Efficacy Powder).
Dang Gui (Angelica Sinensis, 1 qian), Chuanxiong (Szechwan Lovage Rhizome, 0.5 qian), Shaoyao (Peony Root, stir-fried, 0.7 qian), Shu Dihuang (Prepared Rehmannia Root, wine-mixed), Ren Shen (Ginseng), Baizhu (Atractylodes Macrocephala Rhizome, stir-fried), Fuling (Poria, each 1 qian), Gancao (Licorice Root, honey-fried, 0.5 qian).
Take 2-3 qian per dose, decocted with ginger and jujubes in water.
Doukou Wan (Nutmeg Pill) (Formula see Teething)
Neituo San (Interior-Supporting Powder) (i.e., Tuoli San, Formula see Smallpox Carbuncle)
Zicao Kuai [missing character] Tang (Arnebia Rapid-Resolving Decoction) (Formula see Constipation)
Sizunzi Tang (Four Gentlemen Decoction)
Liujunzi Tang (Six Gentlemen Decoction) (Both formulas see Non-crusting)
Can [missing character] Neituo San (Interior-Supporting Powder) (Formula see Abdominal Distension and Shortness of Breath)
Zicao Muxiang San (Arnebia and Aucklandia Powder) (Formula see Constipation)
Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) (Formula see Chills and Teething)
Si Sheng San (Four Holy Powders) (Formula see Slow Smallpox Eruption)
Can [missing character] Si Sheng San (Four Holy Powders)
Shiquan Dabu Tang (Complete Great Tonifying Decoction)
Dushen Tang (Single Ginseng Decoction) (All three formulas see Abdominal Distension and Shortness of Breath)
Zicao Mutong Tang (Arnebia and Akebia Decoction) (Formula see Delayed Smallpox Eruption)