外以胡荽酒洗足。
初八日 险痘二天半，但唇肿，右颧肿，心脾之火甚也。足已温，痘苗稍大者即顶陷。
犀角（五钱） 全归（二钱） 银花（五钱） 苦桔梗（三钱） 红花（八分） 紫地丁（五钱）
甘草
（钱半） 楂炭（钱半） 连翘（三钱） 牛蒡子（二钱） 广皮（八分） 猪尾膏（三匙） 白茅根（
一两）
按∶白茅根秉燥金之体，感风木而花，内异于众草，生发最速，其性喜洁，故能化毒开
清。
其味甘凉，故能走肺胃而不伤肺胃之阴。《本草》称其主衄症，盖言其所当然，而不言其所
以然也。但此物性平和，不假以重权不为功，凡一切清窍病，用之最良。而痘症中护眼护喉
，走清导血分为尤良也。
初九日 险痘三天半，两眼两颧肉肿，疮不肿，心脾之火太甚也。血无不活，故今日不
加血药。
犀角（五钱） 连翘（三钱） 元参（五钱） 羚羊角（五钱） 苦桔梗（六钱） 银花（五钱）
紫地
丁（五钱） 甘草（钱半） 细生地（三钱） 牛蒡子（五钱） 白茅根（一两） 谷精草（三钱） 白
芷（二钱）
初十日 重险痘四天半，额滞于颏，颏滞于身，此阳火有余之象，虽不必大下，仍以败
毒为主，而提顶次之。
犀角（五钱） 银花（五钱） 羚羊角（五钱） 紫地丁（五钱） 黄芩（三钱） 苦桔梗（五钱）
次
生地（五钱） 牛蒡子（二钱） 元参（二钱） 甘草（二钱） 谷精草（三钱） 山连（钱半） 白茅
根（一两）
十二茶杯水，煮成五杯，分十次服。
十一日 五天半，已有行浆之势，不必提顶托浆，但喉沙声哑，趁此犹系外感用事之时
，仍
用昨日方开提肺气败毒，减其蒸腾炼毒之火，使归于平和，即行此等汤火痘之浆法，所谓道
无定体者此也。高明以为何如？仍用昨日方一帖，限明日黎明服完。
十二日 六天半，面已有浆，四肢腰背皆空，五更大便两次，痛快而溏，今晚已入气血
用事之关，须渐进补托，兼与清毒。
炙绵 （三钱） 犀角（三钱） 白芷（二钱） 冬白术（二钱） 白茅根（六钱） 党参（钱半）
苦桔梗（一钱） 茯苓块（三钱） 银花（三钱） 广皮炭（一钱）
日入后服。
十三日 七天半，头面浆已七八，腰背不足，四肢尚空。今日正是气血当令，已有痒态
，必得扶其不及，多得一分浆，少得一分后患，此身小痘多之定法也。
生绵 （五钱） 白芷（二钱） 广皮炭（钱半） 党参（三钱） 炙甘草（钱半） 红花（一钱）
冬白术（三钱，土炒黄） 茯苓块（三钱） 广木香（一钱）
十四日 浆足九天，于前方内去红花。
十五日 十天浆足色苍，情势圆绽，四肢陆续上浆，皮肤扪之平和，不冷亦不过热，脉
洪数
有力，合观皆情理之正，其不食畏缩，皆痛象也。痘多浆亦多，炼气血而成浆，痛亦情理之
正，断非陷症，议补气以胜痛，活络以定痛法，似不歧于路矣。
生绵 （三钱） 熟 （三钱） 炙甘草（三钱） 人参（五分） 乳香（八分） 没药（八分）
茯苓
块（三钱） 冬术（三钱） 广木香（一钱） 广皮（一钱） 老浓朴（六分） 白芷（二钱） 红花（
四分）
十六日 十一天，大势已有成功之象，犹须防其泄泻作痒。
防风（二钱） 洋参（一钱，炒黄） 炒冬术（二钱） 茯苓块（三钱） 炙甘草（一钱） 广皮
（一钱半，炒黑） 广木香（一钱，煨） 焦白芍（二钱）
十七日 十二天，小便长，大便滞，暂与宣化肠胃。
茯苓块 防风（钱半） 谷精草（三钱） 五谷虫 老浓朴（一钱）
十九日 十四天，痘后肺液受伤，渴而咳。
白茅根 象贝
某男 二十六日 风温发热三天，耳冷尻冷，已有微点，谨防天花，法宜辛凉解肌，芳
香透络，最忌三阳表药，多汗致成塌痒。
苦桔梗 牛蒡子（二钱，炒研） 桑叶（三钱） 甘草 芥穗（钱半） 连翘（三钱） 薄荷
银花（三钱） 白茅根（三钱）
当日晚大泻水粪，加∶
黄芩（三钱）。泻止。
二十七日 虚寒，痘二朝，甫二日，热退其半，神气安静，大便溏泄，布痘不多，亦属
匀称。但痘形遍阔根松，色亦过淡，观其皮色，脾经素有饮食伤损，议异功保元合法。
人参（一钱） 生于术（二钱） 生绵 （三钱） 云苓块（三钱） 广皮（二钱） 炙甘草（二
钱） 广木香（钱半）
二十八日 仍用前方。
初七日 十二朝，痘虽稀少，浆行薄弱，腰下尚未结痂，乘此机会，再用保元以助余浆
。
人参（一钱） 云苓块（三钱） 绵 （三钱） 苡仁（三钱） 炙甘草（钱半）
初八日 仍用前方一帖。
补案 辛巳年述癸卯初夏，余有涟水之游，长女甫二龄，于四月十一日见点，至二十五
日，
已半月矣，余适回家，见其情势鼓立者半，顶陷者半，根抱者半，散者半，毫无汁浆。本系
谢宝灵兄调治，因请同看。伊芳立一方，余视之曰∶此方如上得浆起，甘受重罚，此方如上
不起浆，亦受重罚。谢兄愕然曰∶足下左右皆受重罚，何故？余曰∶今且不必明言，明日来
视浆色。伊芳去后，余仍用其方，照方制念帖，加燕窝十二两，（此味原方所无） 大公鸡一只
，重九斤，紫河车一具，（此二味亦原方所有，但加重耳。）并药共十余斤，先分九锅煎，去
渣后并一锅煎，自早至暮，不敢草率，成浓膏得两碗许，令乃母饮半茶杯，小人饮半酒杯。
二鼓时其母因乳胀，谓余曰∶药甚灵。余无乳者已数日，今忽蓬蓬，岂非药力乎。余曰∶可
急令小孩吮之。彼曰∶小孩不得寐者已数日，今方熟睡，可惊之乎？余曰∶限期已紧，所以
令汝服药，为以乳汁上浆也，今乳胀可急与之。因促之醒，痛吮一饱，少时又寐，漏下三鼓
，清浆如露矣。未至四鼓，又令母女服药如前，四鼓未罢，浆如蜡色。五鼓以后，又如茶色
浓浓，如及时之浆。天明已十七朝矣，又延谢先生至，彼一视曰∶奇哉？何因得此？余曰∶用
君原方。彼比曰∶只添得燕窝一味，何神至此？余曰∶余作日云此方上得起浆，甘受重罚者
，以先生七八朝即用此方，彼时气血方壮，毫无浆汗，今已十五朝，气血消耗，岂能上浆乎
？余又谓此方不能上浆，亦受重罚者，以先生之方如错，小女早不活矣。因令伊芳视方之背，
伊芳见照方二十帖之文，又令视诸药渣，因谢曰∶余实不能。
女 二十日 十九朝痘后便溏而频，久则脾肾两伤，补涩为稳。
真云苓（五钱） 白术（三钱，土炒） 肉果霜（三钱） 半夏（一钱） 诃子肉（三钱） 生苡
仁（五钱）
二十四日 实脾利水之中，兼化清气。
于术（三钱，土炒） 五谷虫（三钱） 云苓块（五钱） 晚蚕砂（三钱） 薏仁（五钱） 蝉衣
（七枚） 地骨皮（三钱）
初一日 三十一天痘后解毒肿溃，补托之中，加以败毒。
人参（一钱） 银花（三钱） 云苓（三钱） 黄 （三钱） 苡仁（五钱） 于术（三钱） 炙甘
草（钱半） 五谷虫（三钱）
初四日 痘后余毒肿溃，稍加银花败毒，大便即溏，议于前方去银花，加肉果霜、诃子
肉。
人参（一钱） 五谷虫（二钱） 肉果霜（钱半） 黄 （三钱） 诃子肉（三钱，炒） 白云苓
（三钱） 炙甘草（钱半） 于术（三钱） 木香（一钱） 薏仁（五钱）
初七日 三十六朝，痘毒溃烂，应照溃疡例，即用痘科门中之保元合异功法。
绵 （五钱） 于术（二钱） 广皮（一钱） 炙甘草（二钱） 苡仁（三钱） 人参（一钱） 云
苓（五钱）
初八日 伤食暮热呕吐，痘后太饱之故，与止渴消食，热自止。（夜间不可吃粥。）
地骨皮（三钱） 苡仁（三钱） 云苓（三钱） 炒神曲（钱半） 半夏（二钱） 炒广皮（一钱）
男 二十日 风木司天之年，又当风木司令之候，风木内含相火，时有痘疹。无论但
受风
温，身热而不发痘，或因风温而竟发痘。或发斑疹，皆忌辛温表药，惟与幸凉解肌透络最稳
，此时医所不知。盖风淫所胜，治以辛凉，佐以苦甘，《内经》之正法也。
苦桔梗（三钱） 大力子（钱半） 鲜芦根（五钱） 甘草（一钱） 桑叶（三钱） 薄荷（八分
汗多不用） 连翘（三钱） 芥穗（一钱） 银花（三钱）
二帖。此方治初痘起，最能化多为少，凉络而易出，见点亦服此。
二十一日申刻，险兼逆痘二天，痘色焰红，唇赤舌赤，见点繁琐，三五成群，毒参阳位
，勉与凉血败毒。
苦桔梗（三钱） 地龙（三钱） 连翘（三钱） 人中黄（三钱） 桃仁（三钱） 生石膏（八钱
，研
）银花（五钱） 犀尖（五钱） 白茅根（三钱） 丹皮（三钱） 生军（三钱，炒黑） 紫地丁（五
钱）
此案为钞录者失去十四帖，大意以犀角地黄汤加连翘、银花、茅根、细生地等，一味凉
血收功。至十五朝犹用犀角，十六朝以辛凉清余热，一方服至二十一朝。
赵姑 十二岁 六月二十二日 暑伤两太阴，身热而呕，舌白滑。
黄芩炭（二钱） 杏仁（三钱） 白蔻仁（一钱） 半夏（三钱） 生苡仁（三钱） 云苓皮（四
钱） 连翘（三钱） 藿叶（二钱） 银花（三钱）
二十三日 痘三天，顶平根松，色暗，夹虚夹毒之痘，与活血提顶败毒，扶到七天，方
好补托。
苦桔梗（三钱） 红花（二钱） 银花（三钱） 人中黄（钱半） 白芷（三钱） 楂炭（二钱）
大力子（二钱） 防风（三钱） 紫草茸（一钱） 全当归（二钱） 连翘（三钱） 紫地丁（二钱）
二十四日 痘四天，顶平根松色暗，便闭不食，昨用活血败毒宣络，今夜已见大便，热
退能
食，头面已有起胀之势，前后心续出盈千，皆根泛顶平，稍大者顶即陷。应照虚寒例治，与
宣气活络提顶，不得过用败毒清里，致令便溏内陷。
当归（二钱，土炒） 广皮炭（二钱） 穿山甲（一钱，炒） 顶红花（二钱） 广木香（一钱）
蘑菇（一钱） 白芷（三钱） 炒银花（三钱） 炙甘草（五分） 防风（二钱） 楂炭（二钱）
二十五日 痘五天，顶平带陷，根松色暗，昨日即照虚寒例治，而用温煦芳香，今日口
并不
渴，而舌苔白浓。盛暑之际，尚兼足太阴之暑湿。痘七日以前，外感用事，必视其何邪在何
脏腑而清之，以为七日以后上浆之地。
当归（土炒） 广皮炭（二钱） 生苡仁（三钱） 广木香（一钱） 藏红花 银花（四钱） 白
蔻仁（一钱） 六一散（三钱） 白芷 防风 茯苓皮（三钱）
煮四小杯，分四次服，头煎五杯水煎两杯，二煎五杯水煎两杯。
二十六日 痘六天，顶平多陷，根松色暗，头面之色已华，前后心尚多陷而暗，身痛口
不渴，与活血提顶，令其易于上浆。
当归（三钱，土炒） 乳香（二钱） 银花（五钱） 上红花（二钱） 没药（二钱） 公鸡冠血
（每
杯点三匙） 白芷（三钱） 广皮（三钱） 生绵 （五钱） 山甲（三钱） 广木香（二钱） 炙甘
草（三钱）
公鸡汤煎煮三杯，分三次服。
二十七日 七天已有行浆之势，平顶陷顶尚多，加补托以助之。
二十八日 痘八天，头面行浆已有七成，臂次于手，足次于胸，顺也。胸以下陷顶多，
面色灰，仍须温煦以助行浆之势。
绵黄 （八钱） 高丽参（三钱） 炙甘草（钱半） 当归（三钱，土炒） 广木香（三钱） 防
风（三钱） 上红花（二钱） 广皮（三钱） 云苓块（三钱） 白芷（三钱）
二十九日 痘九天，正在行浆之际，便频眼开，即是虚象，粘连之处，颜色即灰，非虚
而何。急急补托，而兼温煦为要。
炙绵 （一两） 广皮（三钱） 炙甘草（三钱） 人参（三钱） 广木香（二钱） 云苓块（三
钱） 白芷（三钱） 炒于术（三钱） 防风（三钱） 肉果霜（三钱）
七月初一日 十天虽已结痂，浆未十分满足，尚有正行浆之处，仍用前方，再为补托，
明日收痂未迟。
初二日 十一天，痘已结痂，浆未十分满足之故，皆因连日便频，受暑积滞而成痢积。
先拟
温下其积，今视四肢鼓立，胸前全陷，并非正结，恐一进沉降，并四肢而变陷矣。前方系必
不可不用之药，兹且暂停，勉与实脾利水以收痂，少加化积，俟十四日之后，痘势收场，如
积滞未化，再与下法。
云苓块（五钱，连皮） 黄芩炭（钱半） 炒神曲（三钱） 生苡仁（五钱） 南茶炭（二钱）
黄皮炭（三钱） 焦白术（二钱） 槟榔（二钱） 益智仁（二钱） 枯山连（一钱，姜炒）
初三日 痘十二天，仍服前原方。
初四日 痘十三天，业已结痂，原可妥当收功，不意盛暑流行之际，食物不化，致成欲
便先
Externally wash the feet with Hu Su wine (Coriander Wine).
On the 8th day, the dangerous smallpox has been present for two and a half days. Only the lips are swollen, and the right cheekbone is swollen; this indicates excessive Fire of the Heart and Spleen. The feet have warmed up. Those pustules that have slightly enlarged show depression at the apex.
Rhinoceros Horn (Wuji) (5 qian)
Whole Angelica Sinensis (Quanguidanggui) (2 qian)
Honeysuckle Flower (Jinyinhua) (5 qian)
Bitter Platycodon Root (Kujiegeng) (3 qian)
Safflower Honghua (Honghua) (8 fen)
Viola Yedoensis (Zididing) (5 qian)
Licorice Root Gancao (Gancao) (1.5 qian)
Charred Hawthorn Fruit (Zhitan) (1.5 qian)
Forsythia Fruit (Lianqiao) (3 qian)
Arctium Seed (Niubangzi) (2 qian)
Tangerine Peel Guangpi (Guangpi) (8 fen)
Pig Tail Paste (Zhuweigao) (3 spoons)
Imperata Rhizome (Baimaogen) (1 liang)
Commentary: Imperata Rhizome possesses the nature of Dry Metal, flowers upon sensing Wind Wood, and its internal nature differs from common grasses; it generates and rises most rapidly. Its nature prefers purity, thus it can resolve toxins and open clear orifices.
Its taste is sweet and cool, so it can traverse the Lung and Stomach without damaging their Yin fluids. The *Ben Cao* states it treats epistaxis, which refers to its effect but not its mechanism. However, this herb is mild in nature; without heavy dosage, it cannot achieve efficacy. For all diseases of the clear orifices, it is most excellent. In smallpox cases, protecting the eyes and throat, guiding clear Qi, and draining the blood level are particularly effective.
On the 9th day, the dangerous smallpox has been present for three and a half days. Both eyes and both cheekbones show muscle swelling, while the sores themselves do not swell; this indicates excessive Fire of the Heart and Spleen. Blood circulation is never stagnant, so no blood-activating herbs are added today.
Rhinoceros Horn (Wuji) (5 qian)
Forsythia Fruit (Lianqiao) (3 qian)
Scrophularia Root (Yuanshen) (5 qian)
Antelope Horn (Lingyangjiao) (5 qian)
Bitter Platycodon Root (Kujiegeng) (6 qian)
Honeysuckle Flower (Jinyinhua) (5 qian)
Viola Yedoensis (Zididing) (5 qian)
Licorice Root Gancao (Gancao) (1.5 qian)
Fine Rehmannia Root (Xishengdi) (3 qian)
Arctium Seed (Niubangzi) (5 qian)
Imperata Rhizome (Baimaogen) (1 liang)
Eriocaulon Flower Head (Gujingcao) (3 qian)
Angelica Dahurica (Baizhi) (2 qian)
On the 10th day, the severe dangerous smallpox has been present for four and a half days. Stagnation spreads from the forehead to the chin, and from the chin to the body; this is a sign of excess Yang Fire. Although drastic purgation is not necessary, the primary treatment remains detoxification, with lifting the apex as secondary.
Rhinoceros Horn (Wuji) (5 qian)
Honeysuckle Flower (Jinyinhua) (5 qian)
Antelope Horn (Lingyangjiao) (5 qian)
Viola Yedoensis (Zididing) (5 qian)
Scutellaria Root (Huangqin) (3 qian)
Bitter Platycodon Root (Kujiegeng) (5 qian)
Secondary Rehmannia Root (Cishengdi) (5 qian)
Arctium Seed (Niubangzi) (2 qian)
Scrophularia Root (Yuanshen) (2 qian)
Licorice Root Gancao (Gancao) (2 qian)
Eriocaulon Flower Head (Gujingcao) (3 qian)
Shanlian (Shanlian) (1.5 qian)
Imperata Rhizome (Baimaogen) (1 liang)
Decoct twelve tea-cupfuls of water until five cupfuls remain; divide into ten doses.
On the 11th day, on the fifth and a half day, there is already a trend toward pus formation. There is no need to forcibly lift the apex or support pus formation. However, the throat sounds hoarse and raspy. Taking advantage of this time when external pathogens still dominate, continue using yesterday's formula to raise Lung Qi and resolve toxins, reducing the steaming fire that refines toxins, bringing it back to balance. This allows for the pus formation method typical of "soup-fire" smallpox. This is what is meant by "the Dao has no fixed form." What do you think? Continue with one dose of yesterday's formula, to be finished by dawn tomorrow.
On the 12th day, on the sixth and a half day, the face already has pus, but the limbs, waist, and back are empty. Two bowel movements occurred at wu geng (3-5 AM), which were satisfying yet loose. Tonight, the condition enters the phase governed by Qi and Blood. Gradual tonification and support are needed, combined with clearing toxins.
Roasted Astragalus Root (Zhimianhuangqi) (3 qian)
Rhinoceros Horn (Wuji) (3 qian)
Angelica Dahurica (Baizhi) (2 qian)
Winter Atractylodes Rhizome (Dongbaizhu) (2 qian)
Imperata Rhizome (Baimaogen) (6 qian)
Codonopsis Root (Dangshen) (1.5 qian)
Bitter Platycodon Root (Kujiegeng) (1 qian)
Poria Block (Fulingkuai) (3 qian)
Honeysuckle Flower (Jinyinhua) (3 qian)
Charred Tangerine Peel (Guangpitao) (1 qian)
Take after sunset.
On the 13th day, on the seventh and a half day, the head and face have 70-80% pus coverage, but the waist and back are insufficient, and the limbs remain empty. Today is when Qi and Blood are dominant. Itching is appearing. We must support the deficiency; gaining more pus means fewer future complications. This is the standard method for small bodies with many pustules.
Raw Astragalus Root (Shengmianhuangqi) (5 qian)
Angelica Dahurica (Baizhi) (2 qian)
Charred Tangerine Peel (Guangpitao) (1.5 qian)
Codonopsis Root (Dangshen) (3 qian)
Roasted Licorice Root (Zhigancao) (1.5 qian)
Safflower Honghua (Honghua) (1 qian)
Winter Atractylodes Rhizome (Dongbaizhu) (3 qian, stir-fried with soil until yellow)
Poria Block (Fulingkuai) (3 qian)
Costus Root (Guangmuxiang) (1 qian)
On the 14th day, pus has been sufficient for nine days. Remove Safflower Honghua from the previous formula.
On the 15th day, on the tenth day, pus is sufficient and mature. The condition is round and bursting. Pus is forming successively on the limbs. The skin feels balanced—neither cold nor excessively hot. The pulse is surging, rapid, and forceful. All observations align with logical norms. The lack of appetite and shrinking posture are due to pain. Many pustules produce much pus; refining Qi and Blood to form pus causes pain, which is also normal. This is definitely not a collapsing syndrome. I propose tonifying Qi to overcome pain and activating collaterals to settle pain, which should not deviate from the correct path.
Raw Astragalus Root (Shengmianhuangqi) (3 qian)
Prepared Rehmannia Root (Shudihuang) (3 qian)
Roasted Licorice Root (Zhigancao) (3 qian)
Ginseng (Renshen) (0.5 qian)
Frankincense (Ruxiang) (0.8 fen)
Myrrh (Moyao) (0.8 fen)
Poria Block (Fulingkuai) (3 qian)
Winter Atractylodes (Dongzhu) (3 qian)
Costus Root (Guangmuxiang) (1 qian)
Tangerine Peel (Guangpi) (1 qian)
Old Magnolia Bark (Laohoupo) (0.6 fen)
Angelica Dahurica (Baizhi) (2 qian)
Safflower Honghua (Honghua) (0.4 fen)
On the 16th day, on the eleventh day, the major trend shows signs of success, but we must still guard against diarrhea and itching.
Saposhnikovia Root (Fangfeng) (2 qian)
American Ginseng (Yangshen) (1 qian, stir-fried yellow)
Stir-fried Winter Atractylodes (Chao Dongzhu) (2 qian)
Poria Block (Fulingkuai) (3 qian)
Roasted Licorice Root (Zhigancao) (1 qian)
Tangerine Peel (Guangpi) (1.5 qian, stir-fried black)
Costus Root (Guangmuxiang) (1 qian, baked)
Scorched Sour Jujube Kernel (Jiaobaishao) (2 qian)
On the 17th day, on the twelfth day, urination is prolonged, but defecation is sluggish. Temporarily administer herbs to diffuse and transform the intestines and stomach.
Poria Block (Fulingkuai)
Saposhnikovia Root (Fangfeng) (1.5 qian)
Eriocaulon Flower Head (Gujingcao) (3 qian)
Silkworm Larvae (Wuguchong)
Old Magnolia Bark (Laohoupo) (1 qian)
On the 19th day, on the fourteenth day, post-smallpox Lung fluid is injured, causing thirst and cough.
Imperata Rhizome (Baimaogen)
Fritillaria Thunbergii Bulb (Xiangbei)
Male patient On the 26th day, wind-warmth fever for three days. Ears and sacrum are cold. Tiny spots have appeared. Guard against variola (smallpox). The method should be acrid-cool to release the muscle layer, and aromatic to penetrate collaterals. Acrid-warm exterior-releasing drugs are strictly forbidden, as excessive sweating leads to collapse and itching.
Bitter Platycodon Root (Kujiegeng)
Arctium Seed (Niubangzi) (2 qian, stir-fried and ground)
Mulberry Leaf (Sangye) (3 qian)
Licorice Root Gancao (Gancao)
Schizonepeta Spike (Jiesui) (1.5 qian)
Forsythia Fruit (Lianqiao) (3 qian)
Mint (Bohe)
Honeysuckle Flower (Jinyinhua) (3 qian)
Imperata Rhizome (Baimaogen) (3 qian)
That night, profuse watery diarrhea occurred. Add:
Scutellaria Root (Huangqin) (3 qian). Diarrhea stopped.
On the 27th day, deficiency-cold. Smallpox on the second day. Just past two days, heat has receded by half. Spirit and Qi are calm. Stool is loose. Few pustules erupted, which is considered even. However, the pustule shape is broad with loose bases, and the color is too pale. Observing the skin color, the Spleen channel has long suffered from dietary injury. I propose combining Yigong San (Extraordinary Power Powder) with Baoyuan Tang (Preserve Origin Decoction).
Ginseng (Renshen) (1 qian)
Raw Atractylodes Macrocephala Rhizome (Sheng Baizhu) (2 qian)
Raw Astragalus Root (Shengmianhuangqi) (3 qian)
Cloud Poria Block (Yunlingkuai) (3 qian)
Tangerine Peel (Guangpi) (2 qian)
Roasted Licorice Root (Zhigancao) (2 qian)
Costus Root (Guangmuxiang) (1.5 qian)
On the 28th day, continue with the previous formula.
On the 7th day (of next month?), on the twelfth day. Although pustules are sparse, pus formation is weak. Below the waist, scabs have not yet formed. Seizing this opportunity, use Baoyuan Tang again to assist remaining pus formation.
Ginseng (Renshen) (1 qian)
Cloud Poria Block (Yunlingkuai) (3 qian)
Sheep Astragalus Root (Mianhuangqi) (3 qian)
Coix Seed (Yiren) (3 qian)
Roasted Licorice Root (Zhigancao) (1.5 qian)
On the 8th day, continue with one dose of the previous formula.
Supplementary Case: In the Xin Si year, recounting the early summer of Gui Mao, I traveled to Lianshui. My eldest daughter was just two years old. She showed spots on April 11th. By the 25th, half a month had passed. I happened to return home and saw her condition: half the pustules were bulging, half were depressed at the apex, half had tight bases, and half were scattered. There was absolutely no pus. Originally treated by Brother Xie Baoling, I invited him to view the case together. He immediately prescribed a formula. I looked at it and said: If this formula produces pus, I will accept heavy punishment; if it fails to produce pus, I will also accept heavy punishment. Brother Xie exclaimed: You will be punished heavily either way, why? I said: Let us not speak plainly now; come tomorrow to see the pus color. After he left, I continued using his formula, preparing twenty doses according to the prescription, adding Twelve taels of Bird's Nest (not in original formula), one large rooster weighing nine jin, and one placenta (Ziheche) (these two were in the original formula but with heavier dosages). The total weight of medicine exceeded ten jin. I decocted them in nine pots first, removed the dregs, then combined everything into one pot for further decoction from morning till evening, without negligence. I obtained about two bowls of thick paste. I had his mother drink half a tea-cup and a servant drink half a wine-glass.
At the second watch (9-11 PM), his mother told me due to breast distension: "The medicine is very effective." I had no milk for several days, but now it suddenly swells. Is this not the power of the medicine? I said: Quickly let the child suckle. She said: The child has not slept for days and is finally asleep; can we wake him? I said: The deadline is tight. That is why you took the medicine—to produce milk for pus formation. Now that breasts are full, give it immediately. So she woke him, and he sucked vigorously until full, then fell asleep again. At the third watch (11 PM-1 AM), clear pus flowed like dew. Before the fourth watch (1-3 AM), I had mother and daughter take medicine again as before. By the end of the fourth watch, pus was wax-colored. After the fifth watch (3-5 AM), it became thick like tea color, like timely pus. At dawn, it was the seventeenth day. I invited Mr. Xie again. He looked and said: Strange! How did this happen? I said: Used your original formula. He gestured: Only added Bird's Nest. How miraculous? I said: Yesterday I said if this formula produces pus, I accept punishment, because you used it on the 7th-8th day when Qi and Blood were strong, yet there was no pus. Now it is the 15th day, Qi and Blood are depleted, how could it produce pus? I also said if it fails to produce pus, I accept punishment, because if your formula was wrong, my daughter would have died long ago. I asked him to look at the back of the prescription. Seeing the note "twenty doses prepared according to formula," and seeing the herbal dregs, he thanked me and said: I truly cannot [explain it].
Female patient On the 20th day, nineteenth day post-smallpox. Loose and frequent stools. Long-term damage to Spleen and Kidney. Tonification and astringency is stable.
True Cloud Poria (Zhen Yunling) (5 qian)
Atractylodes Rhizome (Baizhu) (3 qian, stir-fried with soil)
Areca Nut Frost (Ruo guoshuang) (3 qian)
Pinellia Tuber (Banxia) (1 qian)
Chebulic Myrobalan Flesh (Hezirou) (3 qian)
Raw Coix Seed (Shengyiren) (5 qian)
On the 24th day, While strengthening the Spleen and promoting diuresis, simultaneously transform clear Qi.
Atractylodes Rhizome (Yuzhu) (3 qian, stir-fried with soil)
Silkworm Larvae (Wuguchong) (3 qian)
Cloud Poria Block (Yunlingkuai) (5 qian)
Late Silkworm Sand (Wancansha) (3 qian)
Coix Seed (Yiren) (5 qian)
Cicada Slough (Chanyi) (7 pieces)
Ground Tree Peony Root (Digupi) (3 qian)
On the 1st day, thirty-first day post-smallpox. Resolving toxin, swelling, and ulceration. Within tonification and support, add detoxification.
Ginseng (Renshen) (1 qian)
Honeysuckle Flower (Jinyinhua) (3 qian)
Cloud Poria (Yunling) (3 qian)
Astragalus Root (Huangqi) (3 qian)
Coix Seed (Yiren) (5 qian)
Atractylodes Rhizome (Yuzhu) (3 qian)
Roasted Licorice Root (Zhigancao) (1.5 qian)
Silkworm Larvae (Wuguchong) (3 qian)
On the 4th day, Post-smallpox residual toxin causes swelling and ulceration. Adding Honeysuckle for detoxification caused loose stools. Proposal: Remove Honeysuckle from previous formula, add Areca Nut Frost and Chebulic Myrobalan Flesh.
Ginseng (Renshen) (1 qian)
Silkworm Larvae (Wuguchong) (2 qian)
Areca Nut Frost (Ruo guoshuang) (1.5 qian)
Astragalus Root (Huangqi) (3 qian)
Chebulic Myrobalan Flesh (Hezirou) (3 qian, stir-fried)
White Cloud Poria (Baiyunling) (3 qian)
Roasted Licorice Root (Zhigancao) (1.5 qian)
Atractylodes Rhizome (Yuzhu) (3 qian)
Costus Root (Muxiang) (1 qian)
Coix Seed (Yiren) (5 qian)
On the 7th day, thirty-sixth day. Smallpox toxin ulcerates. Follow the ulcer protocol, using Baoyuan combined with Yigong method from the smallpox specialty.
Sheep Astragalus Root (Mianhuangqi) (5 qian)
Atractylodes Rhizome (Yuzhu) (2 qian)
Tangerine Peel (Guangpi) (1 qian)
Roasted Licorice Root (Zhigancao) (2 qian)
Coix Seed (Yiren) (3 qian)
Ginseng (Renshen) (1 qian)
Cloud Poria (Yunling) (5 qian)
On the 8th day, Food stagnation causes evening fever and vomiting due to overeating post-smallpox. Administer thirst-quenching and digestion-promoting herbs; fever will stop naturally. (Do not eat porridge at night.)
Ground Tree Peony Root (Digupi) (3 qian)
Coix Seed (Yiren) (3 qian)
Cloud Poria (Yunling) (3 qian)
Stir-fried Medicated Leaven (Chao Shenqu) (1.5 qian)
Pinellia Tuber (Banxia) (2 qian)
Stir-fried Tangerine Peel (Chao Guangpi) (1 qian)
Male patient On the 20th day. In a year where Wind Wood governs the Heaven, and during the period where Wind Wood commands, Wind Wood contains Ministerial Fire. Smallpox/rash occurs occasionally. Whether only affected by wind-warmth with fever but no smallpox, or developing smallpox due to wind-warmth, or developing macules and papules, acrid-warm exterior drugs are contraindicated. Only acrid-cool methods to release muscle and penetrate collaterals are safest. Physicians often do not know this. When Wind dominates, treat with acrid-cool, assisted by bitter-sweet. This is the correct method of the *Neijing*.
Bitter Platycodon Root (Kujiegeng) (3 qian)
Arctium Seed (Dali Zi) (1.5 qian)
Fresh Reed Rhizome (Xian Lugen) (5 qian)
Licorice Root Gancao (Gancao) (1 qian)
Mulberry Leaf (Sangye) (3 qian)
Mint (Bohe) (0.8 fen, omit if sweating excessively)
Forsythia Fruit (Lianqiao) (3 qian)
Schizonepeta Spike (Jiesui) (1 qian)
Honeysuckle Flower (Jinyinhua) (3 qian)
Two doses. This formula is best for initial smallpox eruption, transforming many into few, cooling collaterals for easy emergence. Take even when spots first appear.
On the 21st day, Shen hour. Dangerous and adverse smallpox for two days. Pustule color is flame-red. Lips and tongue are red. Spots are numerous, clustering in groups of three to five. Toxin involves Yang positions. Tentatively administer blood-cooling and detoxification.
Bitter Platycodon Root (Kujiegeng) (3 qian)
Earthworm (Dilong) (3 qian)
Forsythia Fruit (Lianqiao) (3 qian)
Human Waste Charcoal (Renzhonghuang) (3 qian)
Peach Kernel (Taoren) (3 qian)
Raw Gypsum Shijiao (Sheng Shigao) (8 qian, ground)
Honeysuckle Flower (Jinyinhua) (5 qian)
Rhinoceros Tip (Xijian) (5 qian)
Imperata Rhizome (Baimaogen) (3 qian)
Moutan Cortex (Danpi) (3 qian)
Raw Rhubarb (Sheng Jun) (3 qian, stir-fried black)
Viola Yedoensis (Zididing) (5 qian)
This case lost fourteen doses in transcription. The main idea uses Xijiao Dihuang Tang plus Forsythia, Honeysuckle, Imperata Rhizome, Fine Rehmannia, etc., focusing on blood-cooling to conclude treatment. Even on the fifteenth day, Rhinoceros Horn was used. On the sixteenth day, acrid-cool cleared residual heat. One formula was taken until the twenty-first day.
Miss Zhao, 12 years old. June 22nd. Summer-heat injures both Taiyin channels. Fever and vomiting. Tongue coating is white and slippery.
Scutellaria Root Charcoal (Huangqin Tan) (2 qian)
Almond (Xingren) (3 qian)
White Cardamom Seed (Baikourén) (1 qian)
Pinellia Tuber (Banxia) (3 qian)
Raw Coix Seed (Sheng Yiren) (3 qian)
Cloud Poria Peel (Yun Lingpi) (4 qian)
Forsythia Fruit (Lianqiao) (3 qian)
Perilla Leaf (Huoye) (2 qian)
Honeysuckle Flower (Jinyinhua) (3 qian)
On the 23rd day. Smallpox for three days. Apex flat, base loose, color dark. Smallpox mixed with deficiency and toxin. Administer blood-activation, apex-lifting, and detoxification. Support until the seventh day, then proceed with tonification and support.
Bitter Platycodon Root (Kujiegeng) (3 qian)
Safflower Honghua (Honghua) (2 qian)
Honeysuckle Flower (Jinyinhua) (3 qian)
Human Waste Charcoal (Ren zhong huang) (1.5 qian)
Angelica Dahurica (Baizhi) (3 qian)
Charred Hawthorn (Zha Tan) (2 qian)
Arctium Seed (Dali Zi) (2 qian)
Saposhnikovia Root (Fangfeng) (3 qian)
Arnebia Root (Zicao Rong) (1 qian)
Whole Angelica Sinensis (Quanguidanggui) (2 qian)
Forsythia Fruit (Lianqiao) (3 qian)
Viola Yedoensis (Zididing) (2 qian)
On the 24th day. Smallpox for four days. Apex flat, base loose, color dark. Constipation and anorexia. Yesterday used blood-activation, detoxification, and collateral-diffusion. Tonight, stool has passed, heat receded, appetite returned. Face shows signs of swelling. Thousands of spots emerged on chest and back. All have floating bases and flat apices; those slightly larger have depressed apices. Treat according to deficiency-cold protocol. Diffuse Qi, activate collaterals, lift apex. Do not overuse detoxification and interior-clearing to avoid loose stools and internal collapse.
Angelica Sinensis (Danggui) (2 qian, stir-fried with soil)
Charred Tangerine Peel (Guangpi Tan) (2 qian)
Pangolin Scale (Chuanshanjia) (1 qian, stir-fried)
Top Safflower (Ding Honghua) (2 qian)
Costus Root (Guangmuxiang) (1 qian)
Mushroom (Mogu) (1 qian)
Angelica Dahurica (Baizhi) (3 qian)
Stir-fried Honeysuckle (Chao Jinyinhua) (3 qian)
Roasted Licorice Root (Zhigancao) (0.5 fen)
Saposhnikovia Root (Fangfeng) (2 qian)
Charred Hawthorn (Zha Tan) (2 qian)
On the 25th day. Smallpox for five days. Apex flat with depression, base loose, color dark. Yesterday treated according to deficiency-cold protocol using warming and aromatic herbs. Today, mouth is not thirsty, but tongue coating is white and thick. During intense summer heat, damp-heat of Foot-Taiyin is also present. Before the seventh day of smallpox, external pathogens dominate. Must observe which pathogen affects which Zang-Fu and clear it, to prepare for pus formation after the seventh day.
Angelica Sinensis (Danggui, stir-fried)
Charred Tangerine Peel (Guangpi Tan) (2 qian)
Raw Coix Seed (Sheng Yiren) (3 qian)
Costus Root (Guangmuxiang) (1 qian)
Safflower Honghua (Canghonghua)
Honeysuckle Flower (Jinyinhua) (4 qian)
White Cardamom Seed (Baikourén) (1 qian)
Liuyisan (Liuyisan) (3 qian)
Angelica Dahurica (Baizhi)
Saposhnikovia Root (Fangfeng)
Poria Peel (Fulingpi) (3 qian)
Decoct four small cups, divide into four doses. First decoction: 5 cups water to 2 cups. Second decoction: 5 cups water to 2 cups.
On the 26th day. Smallpox for six days. Apex flat with many depressions, base loose, color dark. Head and face color is bright, but chest and back still have many depressions and are dark. Body ache, no thirst. Administer blood-activation and apex-lifting to facilitate pus formation.
Angelica Sinensis (Danggui) (3 qian, stir-fried with soil)
Frankincense (Ruxiang) (2 qian)
Honeysuckle Flower (Jinyinhua) (5 qian)
Top Safflower (Shang Honghua) (2 qian)
Myrrh (Moyao) (2 qian)
Rooster Comb Blood (Gongji Guanxue) (3 drops per cup)
Angelica Dahurica (Baizhi) (3 qian)
Tangerine Peel (Guangpi) (3 qian)
Raw Astragalus Root (Sheng Mianhuangqi) (5 qian)
Pangolin Scale (Shanjia) (3 qian)
Costus Root (Guangmuxiang) (2 qian)
Roasted Licorice Root (Zhigancao) (3 qian)
Decoct in rooster chicken soup to three cups, divide into three doses.
On the 27th day. Seven days, trend toward pus formation. Flat and depressed apices are still numerous. Add tonification and support to assist.
On the 28th day. Smallpox for eight days. Head and face 70% pus formation. Arms follow hands, legs follow chest. This is favorable. Below the chest, many depressed apices. Complexion is gray. Still need warming to assist pus formation.
Sheep Astragalus Root (Mian Huangqi) (8 qian)
Korean Ginseng (Gaolishen) (3 qian)
Roasted Licorice Root (Zhigancao) (1.5 qian)
Angelica Sinensis (Danggui) (3 qian, stir-fried with soil)
Costus Root (Guangmuxiang) (3 qian)
Saposhnikovia Root (Fangfeng) (3 qian)
Top Safflower (Shang Honghua) (2 qian)
Tangerine Peel (Guangpi) (3 qian)
Cloud Poria Block (Yunlingkuai) (3 qian)
Angelica Dahurica (Baizhi) (3 qian)
On the 29th day. Smallpox for nine days, at the peak of pus formation. Frequent stools and wide-open eyes indicate deficiency. Areas where pustules adhere turn gray; how else could this be interpreted than deficiency? Urgently tonify and support, combined with warming is essential.
Roasted Astragalus Root (Zhi Mianhuangqi) (1 liang)
Tangerine Peel (Guangpi) (3 qian)
Roasted Licorice Root (Zhigancao) (3 qian)
Ginseng (Renshen) (3 qian)
Costus Root (Guangmuxiang) (2 qian)
Cloud Poria Block (Yunlingkuai) (3 qian)
Angelica Dahurica (Baizhi) (3 qian)
Stir-fried Atractylodes (Chao Yuzhu) (3 qian)
Saposhnikovia Root (Fangfeng) (3 qian)
Areca Nut Frost (Ruoguo Shuang) (3 qian)
July 1st. Ten days, although scabs have formed, pus is not fully satisfied. There are still areas actively forming pus. Continue with previous formula for further tonification and support. Scabbing tomorrow is not too late.
2nd Day. Eleven days. Scabs have formed. Reason for unsatisfied pus: consecutive days of frequent stools, summer-heat accumulation leading to dysentery/stagnation. Initially planned to warm-purge the stagnation. Now observing bulging limbs and complete depression on chest, this is not proper scabbing. Fear that using sinking/depressing herbs will cause limbs to collapse too. Previous formula is indispensable. Pause it temporarily. Tentatively strengthen Spleen and promote diuresis to form scabs, adding slight stagnation-resolving herbs. Wait until after the 14th day when smallpox course ends. If stagnation remains, then purge.
Cloud Poria Block (Yunlingkuai) (5 qian, with peel)
Scutellaria Root Charcoal (Huangqin Tan) (1.5 qian)
Stir-fried Medicated Leaven (Chao Shenqu) (3 qian)
Raw Coix Seed (Sheng Yiren) (5 qian)
South Tea Charcoal (Nancha Tan) (2 qian)
Yellow Skin Charcoal (Huangpi Tan) (3 qian)
Scorched Atractylodes (Jiao Baizhu) (2 qian)
Betel Nut (Binglang) (2 qian)
Alpinia Oxyphylla Fruit (Yizhiren) (2 qian)
Withered Shanlian (Ku Shanlian) (1 qian, stir-fried with ginger)
3rd Day. Smallpox twelve days. Continue taking previous formula.
4th Day. Smallpox thirteen days. Already scabbed. Originally could conclude safely. Unexpectedly, during prevalent summer heat, food failed to digest, causing desire to defecate but...