痘中夹疹因时气，毒火触动发其机，临期休将痘疮治，速将升葛透疹宜。
[注]
痘已见形，其中又有颗粒细密如麻子者，此夹疹也，
因出痘时恰遇天行时疫，感受其气，一时并发，不须治痘，当先治疹，
以升麻葛根汤，加荆芥，防风，蝉蜕，牛蒡，犀角，疹散而痘自起矣。
(升麻葛根汤) 方见发热证治。
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痘中杂证
片片结就如云头，毒伤阴血浮火游，表散荆防败毒剂，清热黄连解毒投。
[注]
□乃血之余也，因毒火郁遏伤于阴血，血热相搏，
故浮游之火散布皮肤之间，与痘相夹而出，片片如云头突起，谓之夹□，
以荆防败毒散主之，
七日后见此，谓之发□，乃血热不解故也，以黄连解毒汤主之。
(荆防败毒散) 羌活 独活 柴胡 前胡 荆芥 防风 生甘草 川芎
枳壳 麸炒 桔梗 赤茯苓 引用生姜水煎服。
(方歌)
夹□宜用疏解剂，荆防败毒进莫迟，羌独柴前荆防草，川芎枳桔赤苓宜。
(黄连解毒汤) 方见结痂落痂证治。
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痘中杂证
痧形发时粟一般，颗□形圆顶又尖，粒中含水清浆样，败毒调治自然安。
[注]
痧亦疹类，但形如粟米，尖圆白□，内含清水为异，
此亦热毒所发，往往夹痘而出，宜于疏散，以荆防败毒散主之。
(荆防败毒散) 方见夹□
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痘中杂证
Measles-like eruptions occurring alongside smallpox are caused by seasonal epidemic pathogens; toxic fire triggers the pathogenesis. At the time of onset, do not treat it as smallpox alone; instead, promptly use Shengma (Rhizoma Cimicifugae) and Gegen (Puerariae Radix) to vent the measles-like eruptions.
[Note]
When the smallpox lesions have appeared, if there are additionally fine, dense granules resembling millet seeds, this is termed "smallpox with measles" (Dou Zhong Jia Zhen).
This occurs because, during the eruption of smallpox, one happens to encounter a seasonal epidemic, contracting its qi, leading to simultaneous manifestation. There is no need to treat the smallpox itself; rather, one should first treat the measles-like eruptions.
Use Shengma Gegen Tang (Cinnamon Twig and Pueraria Root Decoction), added with Jingjie (Schizonepetae Herba), Fangfeng (Saposhnikoviae Radix), Chantui (Cicadae Periostracum), Niubangzi (Arctii Fructus), and Xijiao (Rhinocerotis Cornu). Once the measles-like eruptions dissipate, the smallpox will naturally emerge.
(The formula Shengma Gegen Tang is found in the section on treating fever.)
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Miscellaneous Syndromes in Smallpox
Lesions cluster in patches resembling cloud heads; toxic damage to Yin blood causes floating fire to wander. Use Jingjie and Fangfeng in Baidu San (Nettle and Saposhnikovia Powder to Overcome Toxins) for exterior dispersal, or employ Huanglian Jiedu Tang (Coptis Decoction to Relieve Toxicity) to clear heat.
[Note]
Hair is the surplus of blood. Due to toxic fire stagnation injuring Yin blood, blood heat struggles internally,
causing wandering fire to spread between the skin, erupting alongside the smallpox in patches like protruding cloud heads, termed "smallpox with Sha" (Dou Zhong Jia Sha).
Treat primarily with Jingfang Baidu San (Nettle and Saposhnikovia Powder to Overcome Toxins).
If this appears after seven days, it is called "fa Sha" (eruption of Sha), due to unresolved blood heat. Treat primarily with Huanglian Jiedu Tang (Coptis Decoction to Relieve Toxicity).
(Jingfang Baidu San) Qianghuo (Notopterygii Rhizoma et Radix), Duhuo (Angelicae Pubescentis Radix), Chaihu (Bupleuri Radix), Qianhu (Peucedani Radix), Jingjie (Schizonepetae Herba), Fangfeng (Saposhnikoviae Radix), Sheng Gancao (Glycyrrhizae Radix et Rhizoma), Chuanxiong (Ligustici Chuanxiong Rhizoma), Zhike (Aurantii Fructus, bran-fried), Jiegeng (Platycodonis Radix), Chi Fuling (Poria with Red Heart). Decoct with fresh ginger water as a guide.
(Prescription Song)
For Sha accompanying smallpox, suitable dispersing agents should be used; take Jingfang Baidu San without delay. Qianghuo, Duhuo, Chaihu, Qianhu, Jingjie, Fangfeng, Gancao, Chuanxiong, Zhike, Jiegeng, and Chi Fuling are appropriate.
(The formula Huanglian Jiedu Tang is found in the section on scabbing and falling off.)
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Miscellaneous Syndromes in Smallpox
When Sha erupts, it resembles millet grains; the particles are round with pointed tops, containing clear fluid resembling water. Treatment with Baidu San will bring natural peace.
[Note]
Sha belongs to the category of rashes, but differs in that its shape is like millet, round yet pointed, white, and containing clear fluid.
This is also caused by heat toxicity, often erupting alongside smallpox. It is suitable for dispersing treatment, primarily using Jingfang Baidu San (Nettle and Saposhnikovia Powder to Overcome Toxins).
(The formula Jingfang Baidu San is found in the section on Sha accompanying smallpox.)
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Miscellaneous Syndromes in Smallpox