便秘不食解毒汤，脾虚不食参术良，不食咽肿甘桔剂，伤食恶食平胃尝。
[注]
痘疮赖气血以成功，气血藉饮食以生化，
自起胀灌浆以至收靥结痂，俱以胃壮为根本，
故痘中遇不食之证，须要明辨，
如大便秘结，痘疮掀紫不食，此毒盛血热也，
宜凉血解毒汤，加黄芩，黄连，大黄主之，
若痘色灰白，泄泻不食，此脾气虚弱也，人参白术散主之，
行浆时欲食而复畏食，此咽门肿痛，难以下咽也，宜加味甘桔汤主之，
设喜食过多，恶食不食，乃内伤饮食，胃有宿滞也，
宜加味平胃散主之。
(凉血解毒汤)方见结痂落痂证治。
(人参白术散)方见喘证。
(加味甘桔汤)方见呛水
(加味平胃散)方见腹痛。
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痘中杂证
热少汗微荣卫畅，太过须防阴液亡，自汗不止保元剂，盗汗夜热六黄汤。
[注]
卫气乃护卫皮肤，固守津液，使不走泄者也，
痘证见此，是痘毒之火由里达表，干于卫气，腠理疏，故汗出矣，
初见有微汗者，是荣卫通畅，毒从汗解，实良候也，
但汗为血液，太过则阴液必亡，须紧防之，
如起胀后大汗不止，未行浆恐不能灌，既行浆恐不能靥，
既靥，恐气血虚脱，最为可畏，
自汗为阳虚，急于敛汗，以保元汤主之，
盗汗为阴虚，急于降火，以当归六黄汤主之。
(加味保元汤) 人参 黄耆蜜炙 浮小麦 甘草炙 广桂枝 白芍炒 水煎服。
(方歌)
阳虚汗出用保元，人参黄耆浮麦甘，广桂枝同白芍药，敛汗实腠此为先。
(当归六黄汤) 黄芩 黄蘖 黄连 生地 熟地 当归 黄耆生 水煎服。
(方歌)
六黄汤敛阴虚汗，黄芩黄蘖共黄连，生熟地黄当归配，黄耆偣用效通仙。
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痘中杂证
For constipation accompanied by anorexia, use Jiedu Tang (Detoxification Decoction); for anorexia due to Spleen deficiency, Renshen Baizhu San (Ginseng and Atractylodes Macrocephala Powder) is effective; for anorexia with pharyngeal swelling, use Ganjie Ji (Licorice and Platycodon Preparation); for food stagnation causing aversion to eating, use Pingwei San (Stomach-Pacifying Powder).
[Note]
Smallpox relies on Qi and Blood to achieve its therapeutic effect, while Qi and Blood depend on dietary intake for their generation and transformation. From the stage of swelling and pustule formation to scabbing and crusting, all stages are fundamentally rooted in strong Stomach Qi. Therefore, when encountering anorexia in smallpox cases, one must clearly differentiate the syndrome. If there is constipation, and the smallpox lesions are red, purple, and swollen with loss of appetite, this indicates excessive pathogenic toxins and blood heat. It is appropriate to treat with Liangxue Jiedu Tang (Cooling Blood and Detoxifying Decoction), adding Huangqin (Scutellariae Radix), Huanglian (Coptidis Rhizoma), and Dahuang (Rhei Radix et Rhizoma) as the main herbs. If the smallpox color is grayish-white, accompanied by diarrhea and anorexia, this indicates Spleen Qi deficiency, which should be treated primarily with Renshen Baizhu San (Ginseng and Atractylodes Macrocephala Powder). During the pus-filling stage, if the patient desires to eat but fears eating due to pain and swelling at the pharyngeal opening making swallowing difficult, it is appropriate to treat with Jiawei Ganjie Tang (Modified Licorice and Platycodon Decoction). If the patient eats excessively or has an aversion to food leading to inability to eat, this is internal injury from diet, with retained food stagnation in the Stomach. It is appropriate to treat with Jiawei Pingwei San (Modified Stomach-Pacifying Powder).
(Liangxue Jiedu Tang) See the section on Scabbing and Crust Falling for the formula.
(Renshen Baizhu San) See the section on Asthma for the formula.
(Jiawei Ganjie Tang) See the section on Choking on Water for the formula.
(Jiawei Pingwei San) See the section on Abdominal Pain for the formula.
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Miscellaneous Syndromes in Smallpox
Mild fever with slight sweating indicates smooth flow of Ying and Wei; excessive sweating requires vigilance against the depletion of Yin fluids. Persistent spontaneous sweating is treated with Baoyuan Tang, while night sweats with nocturnal heat are treated with Liu Huang Tang.
[Note]
Wei Qi (Defensive Qi) protects the skin and secures body fluids to prevent leakage. In smallpox, this manifestation indicates that the fire of the smallpox toxin has moved from the interior to the exterior, interfering with Wei Qi, causing loose interstices (Cou Li) and thus sweating. The initial appearance of slight sweating indicates smooth circulation of Ying and Wei, allowing toxins to resolve through sweat, which is actually a favorable sign. However, since sweat is derived from blood, excessive sweating will inevitably deplete Yin fluids, requiring strict prevention. For instance, if profuse sweating persists after the swelling stage begins, it may hinder fluid filling before the pus stage, or hinder scabbing after the pus stage. Even after scabbing, there is a fear of Qi and Blood collapse, which is most alarming. Spontaneous sweating belongs to Yang deficiency and requires urgent astringency to stop sweating, treated with Baoyuan Tang. Night sweats belong to Yin deficiency and require urgent fire-descending action, treated with Danggui Liu Huang Tang (Angelica Sinensis Six-Huang Decoction).
(Jiawei Baoyuan Tang) Renshen (Ginseng Radix et Rhizoma), Huangqi (Astragali Radix) honey-fried, Fuxiaomai (Tritici Levis Fructus), Gancao (Glycyrrhizae Radix et Rhizoma) honey-fried, Guang Guizhi (Cinnamomi Ramulus), Baishao (Paeoniae Radix Alba) stir-fried. Decoct in water and take orally.
(Formula Song)
Yang deficiency with sweating uses Baoyuan, Ginseng, Astragalus, Triticum fruit, and Licorise, Combined with Cinnamon twig and White Peony root, To astringe sweat and solidify interstices, this comes first.
(Danggui Liu Huang Tang) Huangqin (Scutellariae Radix), Huangbai (Phellodendri Cortex), Huanglian (Coptidis Rhizoma), Shengdi Huang (Rehmanniae Radix), Shudi Huang (Rehmanniae Radix Preparata), Danggui (Angelicae Sinensis Radix), Huangqi (Astragali Radix) raw. Decoct in water and take orally.
(Formula Song)
Liu Huang Tang astringes Yin-deficiency sweating, Scutellaria, Phellodendron, and Coptis together, Raw and Prepared Rehmannia paired with Angelica, Astragalus used effectively like immortal elixir.
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Miscellaneous Syndromes in Smallpox