Library

Shunxiang (auspicious signs) are the foundation of fortune; yaonie (monsters and omens) are the germination of disaster. In households where smallpox (Dou Chuang, 痘疮) is erupting, it is most appropriate to maintain solemnity and quietness inside and outside, which is an auspicious omen. If there is noise from crows and rats at the gates, firelight in desolate villages, bats fluttering into rooms amidst green onions, people hearing dogs crying incessantly, snakes appearing out of season, strange dreams occurring at night, or seeing dead people in dreams, these are all inauspicious omens. However, although external omens have manifested, if one cultivates oneself with caution and restraint internally, disaster can be turned into fortune.

Mild cases of smallpox naturally do not escalate; adverse and dangerous cases always have subsequent disasters. This is not because toxic pathogens originate from the root, but often due to errors in treatment.
Residual pathogens remaining after smallpox cause swelling and carbuncles, or form tubercles, which are discussed similarly. One must distinguish the depth of the toxic qi, preventing residual evil from penetrating the bone seams.
Use channel-guiding herbs according to the affected meridian; the treatment for swelling differs from that for ulceration. Tonifying the middle and supporting the interior requires distinguishing deficiency and excess; resolving toxins and draining pus depends on the depth of the toxin.
When toxins scatter on the skin leaving several scars, they may manifest as yinzhen (urticaria-like rashes) or chengdan (erysipelas-like redness). Danliu (nodular erysipelas)凝结 requires deep-level analysis, while scattered yinzhen is viewed as superficial.
How should diarrhea now be treated? Therapeutic methods cannot be rigidly confined to a single pattern. The ability to eat and excessive thirst indicate heat; a faint pulse and poor appetite indicate deficiency.
Ancients distinguished diarrhea: changgou (dysenteric discharge) and tangbian (loose stools) differentiate cold from heat. If pus and blood mix with scabs, avoid using decoctions or pills that lightly employ astringent methods to stop diarrhea.
If steaming fever persists without removal, treatment must be carefully examined to avoid error. Difficulty urinating, irritability, and thirst indicate excess; clear urine, hunger, and fatigue indicate deficiency.
Constant drowsiness resembling drunkenness, with delirious speech as if invaded by evil, indicates that heat has entered the Xinbaoluo (Pericardium). Jiedu Anshen (resolving toxins and calming the spirit), particularly the "Tai" principle, is exquisite.
Deep sleep unaware of surroundings, delusions regarding food and drink, unresponsive to calls, indicates that pathogenic toxins are now dispersing, and spirit gradually returns to peace.
After smallpox, one must know that Qi and Blood are deficient; various diseases require careful regulation. If accompanied by protruding scabs and red-purple scars, resolving toxins and cooling the Ying (Nutrient) level is considered treating excess.

Men and women suffering from smallpox are fundamentally no different. However, smallpox is primarily governed by Qi, with Blood as its accessory. Qi warms it, and Blood moistens it. If either is insufficient, complications arise. Women possess Yin constitution. For those who develop smallpox after age fourteen, one often fears the onset of Tiangui (menstruation). When Ying Blood flows away, Wei (Defensive) Qi follows and becomes deficient, leading to collapse and internalization (Xianfu, 陷伏), which is a unique difference.
However, if there is fever from smallpox-rash, yet it is not the time for menstruation, and menses suddenly begin, this is because toxic fire moves internally, disturbing the Xuehai (Sea of Blood), forcing the meridians to flow recklessly before their time. The sores will be numerous, and the toxicity severe. It is suitable to use Xuanshen Dihuang Tang (Scrophulariae and Rehmanniae Decoction), focusing on cooling Blood and resolving toxins, so that heat clears, toxins resolve, smallpox erupts, and menstruation stops, avoiding complications. If bleeding persists for a long time, Middle Qi becomes weak, leading to collapse; Shiquan Tang (Ten Complete Decoction) should be used to tonify and support.
Furthermore, if fever occurs precisely during the menstrual period, and menses arrive just then, this means accumulated filth is expelled, and toxicity is slightly resolved. Heat clears with the Blood, and sores emerge naturally. No treatment is needed, nor is it necessary to stop the bleeding. However, if it continues beyond four days, this indicates pathogenic factors taking advantage of the emptiness of the Xueshi (Blood Chamber) to force reckless blood flow, constituting a syndrome of internal movement and central deficiency. It is suitable to first administer Xiaochaihu Tang plus Sheng Dihuang Tang (Minor Bupleurum Decoction with Fresh Rehmannia) to clear heat from the Blood Chamber, followed by Shiquan Dabu Tang (Ten Complete Great Tonifying Decoction) to tonify Qi and Blood deficiency, allowing the rash to emerge, develop, and crust easily.
One must also fear that if menstruation flows, the deficient body may contact foul qi, causing the smallpox to change unpredictably due to deficiency. It is suitable to use Yansui decoction (Descurainia Soup) to wash the external genitalia. Then, take aromatic mugwort (Xiang Ai, 香艾), rub until soft, remove stems, wrap tightly in clean cloth, and insert firmly into the vagina, changing frequently. Additionally, administer Ren Shen (Ginseng), [missing character], Dang Gui (Angelica Sinensis), Di Huang (Rehmannia), Sheng Ma (Cimicifuga), Jiang Can (Bombyx Batryticatus), Chan Tui (Cicada Slough), etc. For deficiency-cold, add Chao Hei Gan Jiang (Stir-fried Blackged Ginger).