妇女发痘遇经行，当期毒解不须惊，非期凉血解毒治，过期四物解毒从，
去血过多气血弱，十全大补服通灵。
[注]
女子出痘或遇经行，须间其是期非期，
如期而出者，则毒热随血解去，不须施治，其证自愈，
若非期而至者，此毒火内扰于胞中，致血妄行，以凉血解毒汤治之，
若过期不止，乃毒热乘入血室，以四物解毒汤加元参甘草主之，
若行浆时去血过多，此气血虚弱不能统摄也，急用十全大补汤，
治若稍缓，痘浆不行则无救矣。
(凉血解毒汤) 方见结痂落痂证治。
(四物解毒汤) 当归 白芍酒炒 生地 元参 栀子炒 川芎 生甘草
黄连酒炒 黄蘖酒炒 黄芩酒炒 水煎服。
(方歌)
四物解毒汤如神，归芍生地共元参，栀子川芎生甘草，黄连黄蘖共黄芩。
(十全大补汤) 方见结痂落痂证治。
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男妇年长出痘门
妊娠出痘势最难，母子相连掌握间，审其所因随证治，如圣安胎效通仙。
[注]
孕妇最忌出痘，
盖热能动胎，胎落则气血因之而伤，
又安望其起胀灌装结痂耶，故遇孕妇出痘，始终以安胎为上，
用如圣散随证加减治之，不可轻用犯胎之药，致有触动。
(如圣散) 当归身 陈皮 白术土炒 大腹皮 黄芩 缩砂仁连壳炒
甘草生 黑豆酒洗 桑上羊儿藤 水煎服。
初发热，加升麻，葛根，连翘。
出而稠密者，加酒炒黄连，牛蒡子，连翘，南山查。
不起发者，加牛蒡子，赤芍药。渴加麦门冬，知母，花粉。
血动者，四物汤加芩连。
脾虚食少，毒发不出者，千金内托汤去肉桂加参耆。
身热有外邪者，参苏饮加木香。
(方歌)
安胎如圣散最宜，归陈白术大腹皮，黄芩砂仁共甘草，黑豆羊藤服莫疑。
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男妇年长出痘门
When a woman develops smallpox/measles (dou) coinciding with menstruation, if it occurs during the expected period, the pathogenic toxin is resolved along with the menstrual blood, and there is no need for alarm. If it occurs outside the expected period, treatment should focus on cooling the blood and resolving toxins. If menstruation persists beyond the expected period, treatment should follow the principle of Siwu Decoction combined with toxin resolution.
If excessive blood loss leads to Qi and Blood deficiency, Shiquan Dabu Decoction should be administered to restore vitality.
[Note]
When a woman develops dou and encounters menstruation, one must distinguish whether it is on schedule or not.
If the menstruation arrives on schedule, the heat of the toxin dissipates with the flow of blood, requiring no specific treatment, and the condition will resolve spontaneously.
If it arrives off-schedule, this indicates that toxic fire disturbs the interior of the uterus (Baozhong), causing reckless bleeding; it should be treated with Liangxue Jiedu Tang (Cooling Blood and Resolving Toxin Decoction).
If menstruation persists beyond the expected period, it signifies that toxic heat has invaded the Blood Chamber (Xueshi); the primary treatment should be Siwu Jiedu Tang (Four Substances Toxin-Resolving Decoction) added with Xuanshen (Scrophulariae Radix) and Gancao (Licorice Root).
If excessive blood loss occurs during the pustule-filling stage, this is due to the weakness of Qi and Blood failing to control the blood; Shiquan Dabu Decoction (Ten Complete Tonifying Decoction) should be urgently administered.
If treatment is delayed even slightly, the pustules will fail to fill, and the case will become incurable.
(Liangxue Jiedu Tang) See the section on "Crusting and Scabbing" for the formula.
(Siwu Jiedu Tang) Composition: Danggui (Angelicae Sinensis Radix), Baishao (Paeoniae Radix Alba, stir-fried with wine), Shengdihuang (Rehmanniae Radix), Xuanshen (Scrophulariae Radix), Zhizi (Gardeniae Fructus, stir-fried), Chuanxiong (Ligustici Chuanxiong Rhizoma), Shenggancao (Raw Glycyrrhizae Radix et Rhizoma), Huanglian (Coptidis Rhizoma, stir-fried with wine), Huangbo (Phellodendri Cortex, stir-fried with wine), Huangqin (Scutellariae Radix). Decoct in water and take orally.
(Verse Formula)
Siwu Jiedu Tang works miraculously well,
Danggui, Baishao, Shengdihuang, and Xuanshen together prevail.
Zhizi, Chuanxiong, and raw Gancao are blended,
Huanglian, Huangbo, and Huangqin complete the blend.
(Shiquan Dabu Decoction) See the section on "Crusting and Scabbing" for the formula.
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Section on Dou for Men and Women of All Ages
The occurrence of dou during pregnancy presents the most difficult prognosis, as the lives of mother and child are intertwined. One must ascertain the cause and treat according to the syndrome. Using Rusheng San (Like-Sage Powder) to calm the fetus yields effects as miraculous as immortality.
[Note]
Pregnant women are most contraindicated for developing dou.
Heat can agitate the fetus; if the fetus falls, Qi and Blood are injured, making it impossible to expect the dou to swell, fill, and crust properly. Therefore, when pregnant women develop dou, calming the fetus is always the priority.
Rusheng San should be used with modifications based on the syndrome. One must not lightly use herbs that harm the fetus, which could disturb the fetal integrity.
(Rusheng San) Composition: Dangguishen (Body of Angelicae Sinensis Radix), Chenpi (Citri Reticulatae Pericarpium), Baizhu (Atractylodis Macrocephalae Rhizoma, stir-fried with earth), Dafupi (Arecae Pericarpium), Huangqin (Scutellariae Radix), Suasharen (Amomi Fructus, stir-fried with shell), Shenggancao (Raw Glycyrrhizae Radix et Rhizoma), Heidou (Sojae Semen Nigrum, washed with wine), Sangshangyangerteng (Celastrus Orbiculatus Caulis growing on Mulberry). Decoct in water and take orally.
For initial fever, add Shengma (Cimicifugae Rhizoma), Gegen (Puerariae Lobatae Radix), and Lianqiao (Forsythiae Fructus).
For dense eruptions, add Huanglian (Coptidis Rhizoma, stir-fried with wine), Niubangzi (Arctii Fructus), Lianqiao (Forsythiae Fructus), and Nanshan Zha (Crataegi Fructus).
For failure to erupt/swell, add Niubangzi (Arctii Fructus) and Chishaoyao (Paeoniae Radix Rubra).
For thirst, add Maidong (Ophiopogonis Radix), Zhimu (Anemarrhenae Rhizoma), and Huafen (Trichosanthis Radix).
For bleeding/disturbance of blood, use Siwu Tang (Four Substances Decoction) added with Huangqin (Scutellariae Radix) and Huanglian (Coptidis Rhizoma).
For Spleen deficiency with poor appetite and failure of toxin to erupt, use Qianjin Neituo Tang (Thousand Gold Interior-Supporting Decoction) removing Rougui (Cinnamomi Cortex) and adding Renshen (Ginseng Radix) and Huangqi (Astragali Radix).
For body heat with exterior pathogens, use Shen Su Yin (Ginseng and Perilla Drink) added with Muxiang (Aucklandiae Radix).
(Verse Formula)
Rusheng San is best for calming the fetus,
With Danggui, Chenpi, Baizhu, and Dafupi.
Huangqin, Sharen, and Gancao combine,
Heidou and Yangteng, take without doubt.
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Section on Dou for Men and Women of All Ages