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If a child suffering from smallpox experiences pain, it is all due to the toxic heat failing to be fully dispersed and cleared. Dispersing and clearing is the excellent method; if extreme thirst occurs, Gegen Siwu Decoction should be used.

[Annotation]
The Classics state: "All pains belong to excess." It also states: "When heat is excessive, pain results."
This is because the fire of the smallpox toxin has not been completely resolved, causing intermittent pain.
When pain occurs at the initial eruption of the rash, it is because the toxin has not been fully expressed; Shengma Gegen Tang (Cimicifugae et Puerariae Decoction) is the primary formula.
When the rash is dense and painful, it indicates abundant toxin and heat in the blood; Jiawei Siwu Tang (Modified Four Substances Decoction) is the primary formula.
If severe pain accompanied by restlessness and confusion occurs during the crusting stage, it is incurable.

(Shengma Gegen Tang) See the section on Fever for the formula.
(Jiawei Siwu Tang) Composition: Danggui (Angelicae Sinensis Radix), Chishao (Moutan Cortex Radix), Jingjie Sui (Schizonepetae Spica), Fangfeng (Saposhnikoviae Radix), Honghua (Carthami Flos), Danpi (Moutan Cortex), fried Niubangzi (Arctii Fructus), Lianqiao (Forsythiae Fructus) with heart removed, Chuanxiong (Ligustici Chuanxiong Rhizoma), Shengdihuang (Rehmanniae Radix). Decoct in water and take orally.
(Rhyme Formula)
For abundant toxin, use Modified Four Substances Decoction,
Danggui and Chishao combined with Jingjie and Fangfeng,
Honghua, Danpi, and Niubangzi,
Lianqiao, Chuanxiong, and Shengdihuang.

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Miscellaneous Syndromes of Smallpox

Throughout the course of smallpox, clear voice is preferred; if toxic heat obstructs the throat leading to hoarseness or silence, treatment may not be necessary if there are lesions in the throat; however, if the toxin attacks the area, Ganjie Tang (Licorice and Platycodon Decoction) can soothe the throat.

[Annotation]
Voice is the sound of the Heart; Heart Qi ascends to the Lung to produce voice. If Lung Qi is clear, the voice is clear; if Lung Heat exists, the voice becomes hoarse.
If hoarseness occurs during the pustule-filling stage, this is because lesions in the throat obstruct the airway.
Wait until the external rash crusts over, and the internal lesions will naturally clear; no treatment is needed.
If hoarseness occurs before the pustule-filling stage, this is due to heat-toxin obstructing the Lung orifices; Jiawei Ganjie Tang (Modified Licorice and Platycodon Decoction) should be used.

(Jiawei Ganjie Tang) Composition: Shegan (Belamcandae Rhizoma), fried Niubangzi (Arctii Fructus), Xuanshen (Scrophulariae Radix), Lianqiao (Forsythiae Fructus) with heart removed, Maimendong (Ophiopogonis Tuber) with heart removed, fried Zhizi (Gardeniae Fructus), Kujiegeng (Platycodonis Radix), raw Gancao (Glycyrrhizae Radix et Rhizoma). Decoct in water and take orally.
(Rhyme Formula)
Modified Licorice and Platycodon Decoction treats loss of voice,
Shegan, Niubangzi, and Xuanshen,
Lianqiao, Maimendong, and fried Zhizi,
Jiegeng and Gancao harmonized together.

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Miscellaneous Syndromes of Smallpox

For epistaxis due to excessive heat, Xijiao Tang (Rhinoceros Horn Decoction) is used; for poor blood control by the Spleen, Renshen Baizhu San (Ginseng and Atractylodes Macrocephala Powder) is effective; for heat pouring into the Intestines and Stomach, Siwu Tang (Four Substances Decoction) treats it; for hematochezia due to Spleen deficiency, Guipi Tang (Restore the Spleen Decoction) can be tried.

[Annotation]
Blood belongs to Yin and nourishes all meridians; successful smallpox recovery depends on it. Once scorched by toxic fire,
blood moves with the fire and flows recklessly, exiting the vessels. Upward, it causes epistaxis; downward, it causes hematochezia.
If the rash color is purple and stagnant, accompanied by dryness, heat, thirst, and epistaxis, this is toxic fire punishing Metal (Lung); Xijiao Dihuang Tang (Rhinoceros Horn and Rehmannia Decoction) is the primary formula.
If epistaxis occurs after crusting due to residual toxin attacking the Spleen, this is Spleen deficiency failing to control blood returning to the vessels; Renshen Baizhu San (Ginseng and Atractylodes Macrocephala Powder) is the primary formula.
Externally, Fazhui San (Hair Ash Powder) can be blown into the nose.
If toxic fire is extremely intense and flows into the Large Intestine, causing hematochezia, Jiawei Siwu Tang (Modified Four Substances Decoction) is the primary formula.
If the rash color is gray-white and sunken with hematochezia, this is Spleen Qi deficiency failing to secure blood; Guipi Tang (Restore the Spleen Decoction) is the primary formula.
As for massive hematemesis, hematuria, or bleeding from the seven orifices, changes occur rapidly (in the time it takes to flip a hand); medication is unnecessary.

(Xijiao Dihuang Tang) Composition: Bang Xijiao (Hornis Rhinocerotis - *Note: Substitute with legal alternatives in modern practice*), Danpi (Moutan Cortex), Shengdi (Rehmanniae Radix), Baishao (Paeoniae Radix Alba). Decoct in water and take orally.
(Rhyme Formula)
Toxic fire rushing upward causes frequent epistaxis,
Xijiao Dihuang Tang acts swiftly;
Bang Xijiao and Mudanpi,
Shengdi and Baishao decocted together.
(Renshen Baizhu San) See the section on Asthma for the formula.
(Fazhui San)
Take hair from a young, healthy person without illness, wash off grease with water boiled with Gengjiao (Tofu Branches), dry by baking,
fill a new clay jar completely with the hair, cover the mouth with a clean tile, seal with salt mud,
surround half the jar with charcoal fire, calcine for the duration of one incense stick, remove, cool, and grind into fine powder.
Blow into the nose, or mix two parts hair ash with seven parts children's urine and three parts wine, then take orally; this can also stop bleeding.
(Jiawei Siwu Tang) Composition: Danggui (Angelicae Sinensis Radix), Jiuchao Baishao (Paeoniae Radix Alba fried with wine), Shengdi (Rehmanniae Radix), Mudanpi (Moutan Cortex), Chaohei Jingjie (Schizonepetae Spica fried until black), Chuanxiong (Ligustici Chuanxiong Rhizoma), Huangqin (Scutellariae Radix), Huanglian (Coptidis Rhizoma), Diyu (Sanguisorbae Radix). Decoct in water and take orally.
(Rhyme Formula)
Modified Four Substances Decoction regulates blood appropriately,
Guipai, Baishao, Shengdi, and Mudanpi,
Chaohei Jingjie paired with Chuanxiong,
Huangqin and Huanglian with Diyue.
(Guipi Tang) Composition: Renshen (Ginseng Radix et Rhizoma), Tuchao Baizhu (Atractylodis Macrocephalae Rhizoma stir-fried with soil), Zhi Gancao (Glycyrrhizae Radix et Rhizoma honey-roasted), Mi Zhi Huangqi (Astragali Radix honey-roasted), Zaoren (Zizyphi Semen) fried and ground, Yuanzhi (Polygalae Radix) with heart removed, Longyanrou (Longan Aril), Fushen (Poria with Wood), Danggui (Angelicae Sinensis Radix), Wei Muxiang (Aucklandiae Radix roasted). Use Ginger and Jujube water as guide, decoct and take orally.
(Rhyme Formula)
Guipi Tang treats Spleen Qi deficiency,
Renshen, Baizhu, Gancao, and Huangqi,
Zaoren, Yuanzhi, and Longyanrou,
Fushen, Danggui, and Muxiang are suitable.

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Miscellaneous Syndromes of Smallpox