钱氏消毒散、化毒汤、《活人》鼠粘子汤。（以上三方并见本条。中有鼠粘、荆芥、防风，皆发
痘之要剂也。）
上三方发疮痘，皆温平温凉药。钱氏所谓三日不出，或出不快，即微发之者是也。如微发不出
者，即就与前项药。该每服二钱者，即加至三四钱，该每日二服者，即加至三四服。如加药又不出者，
即用升麻、葛根、麻黄、桂枝大发之。如大发后不多，及脉平无事者，即疮稀不可更发。如脉洪有热，
有大热者，当用四圣、导赤、八正辈利小便。有大热者，当用芩、连及金花丸辈解毒。若利小便解毒
后又不快，则勿发勿下，止用抱龙丸治之，此皆钱氏心法也。
〔丹〕勉奴，痘已出第三日，色淡不肯发，此血气俱虚，与此方。
人参（一钱） 白术（炒） 黄 （酒炙） 归身（酒洗。各二钱） 陈皮（二分） 甘草（炙，少许）
诃子（煨，一钱） 豆蔻（煨，一钱半）
上煎，入好酒些饮之。
上治气血俱虚。
〔彭〕疹痘发未透，宜四君子汤加黄 、紫草、糯米煎。凡医百病不可损胃气，故用四君子及糯米
等助其胃气。（出阎孝忠续钱氏方中。）
〔世〕六一汤 专发痘疮之脓。
黄 （六钱） 甘草（炙，一钱）
上 咀，每服二钱，水六分，煎入酒二分，同煎至半盏，温服。更加橄榄同煎，尤好。加山药亦得。
上治气虚。
〔活〕活血散 治疮子或出不快。用白芍药末酒调，如欲止痛，只用温热水调，咽下。（海藏云∶张子
和之治四肢出不快，加防风大效，此症乃太阴药也。）
〔世〕四物汤 治痘疮出不快，不甚红活，不起根窠，缘血虚故也。此药能活血，调顺痘疾无如此方，
自古及今，用之如宝，只加甘草服之。
上治血虚。
〔丹〕女子疟后出痘，血气俱虚，又值冬寒，热易退不出。
丁香（五粒） 附子（五分） 桂（半钱） 甘草（炙，二分） 人参（半两） 黄 （一钱） 陈皮
当归（酒洗。各五分）
〔陈〕异功散 治痘疮已出之间，不光泽，不起发，根窠不红，谓之表虚。
木香 当归（各三钱） 桂枝 白术 茯苓（各二钱） 陈皮（去白） 浓朴（姜制） 人参（去芦）
肉蔻（各二钱半） 丁香（一钱半） 半夏（姜制，一钱半） 附子（炮，去皮，一钱半）
上 咀，每服二钱，水一盏，姜五片，枣三枚，煎服。
上治虚寒。（虚而不寒者，宜用前方血气俱虚之剂，不宜用此。必脉虚细，四肢身体冷者，方可用之。）
〔钱〕蓝根散 治疮疹出不快，及倒靥。一名二圣散，救小儿垂死。
板蓝根（一两） 甘草（炙，七钱半）
上末，每服半钱，取雄鸡冠血三两点，同温酒少许，食后调下，无时。甚则三五服，立效。（丹溪云∶蓝
能分散败血）
〔洁〕若出不快，清便自调，知其在表不在里，当微发之，宜升麻葛根汤。
〔钱〕消毒散 治疮未出，或已出未能匀遍。又治一切疮，凉膈去痰，治咽喉痛。
牛蒡子（炒，三两） 甘草（炙，半两） 荆芥穗（二钱半）
上同为粗末，每服三钱，水一盏半，去渣温服。（海藏云∶此药皆温平之剂，一法加防风、薄荷。）
〔《活》〕鼠粘子汤 治小儿痘疮，欲出未能得透，皮肤热，气攻咽喉，眼赤心烦。
鼠粘子（炒，四两） 荆芥穗 甘草（各一两） 防风（半两）
上为细末，沸汤点服，临卧。大利咽喉，化痰涎，止嗽，老幼皆宜。（海藏云∶太阳少阳之剂，
首论温平者此也。）
〔海〕又法 用牛蒡子炒熟为末，同荆芥煎服。
上三方，消毒饮加减法也。
〔《活》〕化毒汤 治小儿疮痘已出未出，并宜服之。
紫草茸 升麻 甘草（炙。各等分）
上 咀，水二钟，粳米五十粒，同煎，此阳明之药也。（海藏云∶出不快者，化毒汤。《本事方》用糯
米去粳米。）
〔丹〕亚玉，痘出两日，不甚透，食稍进，汗微出，热略减，但食物口中觉有恶味。此出得迟，发未透，
须微微表之。
升麻 甘草（炙） 紫草 白术 陈皮 芍药（炒，半钱）
作一帖，加少酒同煎。白芍须炒，见其大便虽出不多，却白带溏滑。
〔世〕透肌汤 治痘不透。
紫草 白芍药 升麻 秫米粉（炒。各半两）
上三方，皆化毒汤加减法也。
〔海〕太阳出不快（身之后也，）荆芥甘草防己汤。阳明出不快（身之前也），升麻加紫草汤。（《圣惠方》升麻、
葛根加紫草。）少阳出不快（身之侧也，）连翘防风汤。（即连翘散。）四肢出不快，防风芍药甘草汤。
痘疹烦不得眠者，甘桔加栀子汤。
桔梗 甘草 栀子 各等分，煎服。
〔《活》〕治痘出不快，烦躁不得眠者，水解散、麻黄黄芩汤、升麻黄芩汤主之。（海藏云∶莫若定其
气血，用石膏、栀子之类尤佳，麻黄黄芩汤、升麻黄芩汤，亦当求责的是太阳阳明，方可用之。）
水解散 治天行头疼壮热一二日，兼治 疮未出，烦躁，或出尚身体发热者。
麻黄（去节，四两） 大黄 黄芩 桂心 甘草（炙） 芍药（各二两）
上为粗末，患者以生熟汤浴讫，以暖水调下二钱，相次二服，得汗利便瘥。强人服二方寸匕。风实之人，
三伏中亦宜用之。若去大黄，春夏通用。
升麻黄芩汤治痘疮出不快，烦躁不得眠。麻黄黄芩汤治痘疮出不快，益烦躁昏愦，或出尚身疼热者。
（以上二方见小儿伤寒门。）
〔钱〕四圣散 治疮疹出不快，及倒靥。一方，有黄 。
紫草茸 木通 甘草（炙） 枳壳（麸炒）
上等分，为粗末，每服一钱，水一钟，煎至八分，温服无时。（刘提点云∶疹痘最要大小分晓，钱
氏四圣散用木通、枳壳极好。若大小流利，不必苦泥。）
〔田〕紫草回 散 小儿痘疹出不快，治倒靥，毒瓦斯入腹。
紫草茸 黄 桑白皮 木通 枳壳 白术（各等分）
上为粗末，每服三钱，水酒各半盏，麝香少许，同煎服。
〔海〕紫草木通散 治小儿疮疹。
紫草 木通 人参 茯苓 粳米（各等分） 甘草（减半）
上为末，每服四钱，水煎。此小便不利之剂也。
〔世〕人参蝉蜕散 治小便不利，疮痘不散，燥躁多渴，戛牙咬齿，气粗喘满。
人参 蝉蜕 白芍药 木通 赤茯苓 甘草 紫草茸（各等分） 水煎服。
〔钱〕紫草散 发 疹。
钩藤钩子 紫草茸（各等分）
上为细末，每服一字，或五分、一钱，温酒调下，无时。
〔海〕小儿疮疹出未快，可浓煎紫草汁服。
上紫草例，为通利腠理要药也。
疮不绽。黄狗蝇四五枚，用常酒研细，服之。未绽，再服。冬月在耳内取之。
〔直〕丝瓜汤 发疮疹最妙。
丝瓜连皮烧灰存性，百沸汤调下。
Qian's Xiaodu San (Disinfecting Powder), Huadu Tang (Detoxifying Decoction), and the Niuzangzi Tang (Burdock Seed Decoction) from *Liuren Shu* (The Book of Living Persons). (All three formulas are cited in this section. They contain Burdock Seed, Schizonepeta, and Saposhnikovia, which are key agents for promoting the eruption of smallpox.)
The above three formulas promote the eruption of sores and smallpox; they are all warm-neutral or warm-cool medicines. This corresponds to Qian Yi's statement: "If it does not appear within three days, or appears slowly, induce a mild sweating." If mild sweating fails to produce eruption, use the aforementioned medicines. If the dosage is two qian per dose, increase it to three or four qian; if taken twice daily, increase to three or four times daily. If eruption still does not occur after increasing the dosage, use Ephedra, Pueraria, Ephedra, and Cinnamon Twig to induce strong sweating. If, after strong sweating, the eruption remains sparse and the pulse is calm without abnormalities, it indicates that the eruption is already sparse and should not be forced again. If the pulse is surging with heat, or even high fever, use Sisheng San (Four Sacred Powders), Daochi San (Guide Out Redness Powder), Bazheng San (Eight Corrects Powder), etc., to promote urination. For high fever, use Scutellaria, Coptis, and Jinhua Wan (Golden Flower Pill) to resolve toxicity. If eruption remains slow after promoting urination and resolving toxicity, do not use sweating or purgation methods; instead, only use Baolong Wan (Embracing Dragon Pill). These are all Qian Yi's clinical insights.
[Zhu Danxi] Mian Nu: Smallpox appeared on the third day, but the color was pale and refused to erupt. This is deficiency of both Qi and Blood. Prescribe this formula:
Ginseng Radix et Rhizoma (1 qian) Atractylodis Macrocephalae Rhizoma (stir-fried) Astragali Membranacei Radix (wine-processed) Angelicae Sinensis Radix (wine-rinsed. Each 2 qian) Citri Reticulatae Pericarpium (2 fen) Glycyrrhizae Radix et Rhizoma (roasted, a little) Terminalia Chebulae Fructus (roasted, 1 qian) Myristicae Semen (roasted, 1.5 qian)
Decoct these ingredients, add a little good wine, and drink.
The above treatment addresses deficiency of both Qi and Blood.
[Peng Yongguang] When rashes and smallpox fail to erupt thoroughly, Si Jun Zi Tang (Four Gentlemen Decoction) added with Astragali Membranacei Radix, Lithospermi Radix et Rhizoma, and Oryza Glutinosa Grain is suitable. In treating any disease, one must not damage Stomach Qi; therefore, Si Jun Zi Tang and Oryza Glutinosa Grain are used to support Stomach Qi. (From Yan Xiaozhong's continuation of Qian's formulas.)
[Popular Formula] Liu Yi Tang (Six-to-One Decoction) is specifically used to promote the suppuration of smallpox.
Astragali Membranacei Radix (6 qian) Glycyrrhizae Radix et Rhizoma (roasted, 1 qian)
Chop the herbs. Take 2 qian per dose, with six parts water and two parts wine. Decoct together until half a cup remains, and take warm. Adding Olea Europaea Fruit is even better. Dioscoreae Rhizoma is also acceptable.
The above treatment addresses Qi deficiency.
[Zhang Yuansu/Haicang] Huoxue San (Invigorate Blood Powder) treats sores or slow eruption. Use Polygoni Multiflori Radix powder mixed with wine. To relieve pain, mix with warm water and swallow. (Haicang said: Zhang Hehe treated slow eruption of the four limbs by adding Saposhnikovia, with great effect. This syndrome belongs to the Taiyin channel medications.)
[Popular Formula] Si Wu Tang (Four Substances Decoction) treats smallpox with slow eruption, lacking redness and vitality, and failing to form roots, due to Blood deficiency. This formula invigorates Blood. No other formula is better for regulating smallpox; since ancient times, it has been treasured like a jewel. Simply add Glycyrrhizae Radix et Rhizoma and take it.
The above treatment addresses Blood deficiency.
[Zhu Danxi] A girl developed smallpox after malaria. Both Qi and Blood were deficient, and it was winter cold, so the heat easily subsided but the smallpox did not erupt.
Symplocapi Flos (5 grains) Aconiti Lateralis Radix Praeparata (5 fen) Cinnamomi Ramulus (0.5 qian) Glycyrrhizae Radix et Rhizoma (roasted, 2 fen) Ginseng Radix et Rhizoma (0.5 liang) Astragali Membranacei Radix (1 qian) Citri Reticulatae Pericarpium Angelicae Sinensis Radix (wine-rinsed. Each 5 fen)
[Chen Wenzhong] Yigong San (Extraordinary Works Powder) treats smallpox that has erupted but lacks luster, fails to rise, and has non-red roots, known as Exterior Deficiency.
Aquilariae Lignum Resinatum (Mu Xiang) Angelicae Sinensis Radix (Each 3 qian) Cinnamomi Ramulus Atractylodis Macrocephalae Rhizoma Poria (Each 2 qian) Citri Reticulatae Pericarpium (peel removed) Magnoliae Officinalis Cortex (ginger-processed) Ginseng Radix et Rhizoma (rhizome removed) Myristicae Semen (Each 2.5 qian) Symplocapi Flos (1.5 qian) Pinelliae Rhizoma (ginger-processed, 1.5 qian) Aconiti Lateralis Radix Praeparata (processed, peel removed, 1.5 qian)
Chop the herbs. Take 2 qian per dose, with one cup of water, five slices of Zingiberis Rhizoma Recens, and three dates. Decoct and take.
The above treatment addresses Deficient-Cold. (For deficiency without cold, use the previous formula for Qi and Blood deficiency; do not use this. It can only be used when the pulse is deficient and fine, and the four limbs and body are cold.)
[Qian Yi] Lan Gen San (Blue Root Powder) treats slow eruption of sores and rashes, and inverted crusts (retraction of lesions). Also known as Er Sheng San (Two Saints Powder), it saves critically ill children.
Isatidis Radix (1 liang) Glycyrrhizae Radix et Rhizoma (roasted, 7.5 qian)
Grind into fine powder. Take 0.5 qian per dose, mixed with three or two drops of Rooster Comb blood and a little warm wine. Take after meals, at any time. For severe cases, take three to five doses for immediate effect. (Danxi said: Isatis root can disperse stagnant blood.)
[Li Dongyuan] If eruption is slow but bowel movements and urination are normal, the pathogen is in the exterior, not the interior. Induce mild sweating using Shengma Gegen Tang (Ephedra and Kudzu Root Decoction).
[Qian Yi] Xiaodu San (Disinfecting Powder) treats sores before eruption or uneven eruption after appearance. It also treats all types of sores, clears the diaphragm, removes phlegm, and treats sore throat.
Arctii Fructus (stir-fried, 3 liang) Glycyrrhizae Radix et Rhizoma (roasted, 0.5 liang) Schizonepetae Spica (2.5 qian)
Grind into coarse powder. Take 3 qian per dose, with one and a half cups of water. Strain and take warm. (Haicang said: These are all warm-neutral agents. One method adds Saposhnikovia and Mentha.)
[*Liuren Shu*] Niuzangzi Tang (Burdock Seed Decoction) treats pediatric smallpox that wants to erupt but cannot penetrate, with hot skin, qi attacking the throat, red eyes, and vexation.
Arctii Fructus (stir-fried, 4 liang) Schizonepetae Spica Glycyrrhizae Radix et Rhizoma (Each 1 liang) Saposhnikoviae Radix (0.5 liang)
Grind into fine powder. Mix with boiling water and take before bed. It greatly benefits the throat, resolves phlegm-saliva, stops coughing, and is suitable for old and young alike. (Haicang said: This is a Shaoyang-Taiyang channel agent; it is the first discussed warm-neutral formula.)
[Zhang Yuansu] Another method: Stir-fry Arctii Fructus until cooked, grind into powder, and decoct with Schizonepetae Spica to take.
The above three formulas are modifications of Xiaodu Yin (Disinfecting Drink).
[*Liuren Shu*] Huadu Tang (Detoxifying Decoction) treats pediatric sores and smallpox, whether erupted or not, and is suitable for taking.
Lithospermi Radix et Rhizoma Cimicifugae Rhizoma Glycyrrhizae Radix et Rhizoma (roasted. Equal parts)
Chop the herbs. Use two zhong of water and fifty grains of Oryza Sativa Japonica Group. Decoct together. This is a Yangming channel medication. (Haicang said: For slow eruption, use Huadu Tang. *Ben Shi Fang* uses Oryza Glutinosa Grain instead of Oryza Sativa Japonica Group.)
[Zhu Danxi] Yayu: Smallpox appeared two days ago, not very thorough. Food intake slightly improved, slight sweating occurred, heat slightly reduced, but food tastes bad in the mouth. This is late eruption and incomplete release. Mild exterior release is required.
Cimicifugae Rhizoma Glycyrrhizae Radix et Rhizoma (roasted) Lithospermi Radix et Rhizoma Atractylodis Macrocephalae Rhizoma Citri Reticulatae Pericarpium Paeoniae Radix Alba (stir-fried, 0.5 qian)
Make one dose, add a little wine and decoct together. Paeoniae Radix Alba must be stir-fried because although bowel movements are infrequent, they are loose and slippery.
[Popular Formula] Touji Tang (Penetrate Muscle Decoction) treats unthorough smallpox eruption.
Lithospermi Radix et Rhizoma Paeoniae Radix Alba Cimicifugae Rhizoma Setariae Italicae Semen (stir-fried. Each 0.5 liang)
The above three formulas are all modifications of Huadu Tang.
[Zhang Yuansu] Slow eruption in the Taiyang channel (back of the body): Jingjie Gancao Fangji Tang (Schizonepeta, Licorice, and Pyrethrum Decoction). Slow eruption in the Yangming channel (front of the body): Shengma Jia Zicao Tang (Cimicifuga Added with Lithospermum Decoction). (*Shenghui Fang* uses Cimicifuga, Pueraria, plus Lithospermum). Slow eruption in the Shaoyang channel (side of the body): Lianqiao Fangfeng Tang (Forsythia and Saposhnikovia Decoction) (i.e., Lianqiao San). Slow eruption of the four limbs: Fangfeng Shaoyao Gancao Tang (Saposhnikovia, Peony, and Licorice Decoction).
Vexation and insomnia due to smallpox/rash: Ganjie Jia Zhizi Tang (Licorice, Platycodon, and Gardenia Decoction).
Platycodonis Radix Glycyrrhizae Radix et Rhizoma Gardeniae Fructus Equal parts. Decoct and take.
[*Liuren Shu*] For treating slow eruption of smallpox with vexation and insomnia, Shuijie San (Water Dissolving Powder), Mahuang Huangqin Tang (Ephedra and Scutellaria Decoction), and Shengma Huangqin Tang (Cimicifuga and Scutellaria Decoction) are the main treatments. (Haicang said: It is better to determine the state of Qi and Blood; using Shigypsum Fibrosum and Gardeniae Fructus is especially good. Mahuang Huangqin Tang and Shengma Huangqin Tang should only be used if confirmed as Taiyang-Yangming syndromes.)
Shuijie San treats epidemic headache and high fever for one or two days, and also treats sores before eruption with vexation, or sores that have erupted but the body is still hot.
Ephedrae Herba (nodes removed, 4 liang) Rheae Radix et Rhizoma Scutellariae Radix Cinnamomi Cortex Glycyrrhizae Radix et Rhizoma (roasted) Paeoniae Radix Alba (Each 2 liang)
Grind into coarse powder. After the patient bathes in raw and cooked water mixture, take 2 qian mixed with warm water. Follow with a second dose. Recovery occurs with sweating and free passage of urine and stool. Strong individuals take two fangcunbi. Individuals with wind-excess may also use it during the dog days of summer. If Rheae Radix et Rhizoma is removed, it is suitable for spring and summer.
Shengma Huangqin Tang treats slow eruption of smallpox with vexation and insomnia. Mahuang Huangqin Tang treats slow eruption of smallpox with increased vexation, confusion, or body pain and heat after eruption.
(Above two formulas see Pediatric Shanghan section.)
[Qian Yi] Sisheng San (Four Sacred Powders) treats slow eruption of sores and rashes, and inverted crusts. One version includes Astragali Membranacei Radix.
Lithospermi Radix et Rhizoma Akebiae Caulis Glycyrrhizae Radix et Rhizoma (roasted) Aurantii Fructus (bran-roasted)
Equal parts, grind into coarse powder. Take 1 qian per dose, with one zhong of water. Decoct until eight-tenths remain, take warm, at any time. (Director Liu said: For rashes and smallpox, it is most important to clarify the size [of bowel movements]. Qian's Sisheng San uses Akebiae Caulis and Aurantii Fructus excellently. If bowel movements are smooth, there is no need to forcibly obstruct them.)
[Tian's] Zicao Huichun San (Lithospermum Reviving Spring Powder) treats slow eruption of pediatric smallpox/rashes, inverted crusts, and toxic qi entering the abdomen.
Lithospermi Radix et Rhizoma Astragali Membranacei Radix Mori Cortex Akebiae Caulis Aurantii Fructus Atractylodis Macrocephalae Rhizoma (Equal parts)
Grind into coarse powder. Take 3 qian per dose, with half a cup of water and half a cup of wine, and a little Moschus. Decoct and take.
[Zhang Yuansu] Zicao Mutong San (Lithospermum and Akebia Decoction) treats pediatric sores and rashes.
Lithospermi Radix et Rhizoma Akebiae Caulis Ginseng Radix et Rhizoma Poria Oryza Sativa Japonica Group Equal parts Glycyrrhizae Radix et Rhizoma (half amount)
Grind into powder. Take 4 qian per dose, decoct with water. This is a formula for promoting urination.
[Popular Formula] Renshen Chantui San (Ginseng and Cicada Slough Powder) treats difficulty in urination, unresolved sores/smallpox, dryness and thirst, grinding teeth, rough breathing, and chest fullness.
Ginseng Radix et Rhizoma Cicadae Periopterum Paeoniae Radix Alba Akebiae Caulis Polyporus Glycyrrhizae Radix et Rhizoma Lithospermi Radix et Rhizoma (Equal parts) Decoct with water and take.
[Qian Yi] Zicao San (Lithospermum Powder) promotes rash eruption.
Uncariae Ramulus cum Uncis Lithospermi Radix et Rhizoma (Equal parts)
Grind into fine powder. Take one zi, or 5 fen, or 1 qian, mixed with warm wine, at any time.
[Zhang Yuansu] For pediatric sores/rashes with slow eruption, decoct Lithospermi Radix et Rhizoma juice thickly and take it.
The above examples of Lithospermi Radix et Rhizoma show it is a key medicine for unblocking interstices.
Sores do not open. Take 4-5 yellow dog flies, grind finely with ordinary wine, and take. If they do not open, take again. Collect them in the ear in winter.
[Zhi's] Sigua Tang (Loofah Decoction) is best for promoting sores and rashes.
Burn Luffae Fructus with skin until carbonized but retaining properties. Mix with boiling water and take.