Library

Diseases vary in severity, and the depth of medication must correspond accordingly. If the disease is deep but the medication is shallow, it cannot eliminate the pathogen; if the disease is shallow but the medication is too deep, it will damage the Zhenqi (True Qi). When observing sores and rashes to determine their severity for treatment: sparse smallpox lesions indicate a mild condition; lesions that are bright red both internally and externally indicate a mild condition; lesions that are black externally and white internally indicate a mild condition; smallpox mixed with measles indicates a condition of half-mild and half-severe nature; lesions that erupt all at once indicate a severe condition; lesions that are black externally and red internally indicate slightly severe; lesions that are white externally and black internally indicate very severe. If the tops of the lesions appear cyanotic, dry, and sunken, accompanied by drowsiness, profuse sweating, restlessness, fever, thirst, abdominal distension, crying and wheezing, and obstruction of urination and defecation, this constitutes a critical and distressed state. If the tips of the lesions turn black, appearing like needle holes with a purplish-cyan color, this indicates a severe manifestation. The method of medication should be determined based on severity: for mild cases, regulate Qi to allow natural eruption; for half-mild/half-severe cases, resolve toxicity, which will naturally lighten the condition; for heavy toxicity, promote diuresis; for extremely severe and acute cases, apply permeating and draining methods according to the syndrome. If heat qi rushes to the Heart, causing delirious speech, Zhusha (Cinnabar), Renshen (Ginseng), and Fuling (Poria) may be used; if heat steams the Liver, causing convulsions resembling epilepsy, Fangfeng (Saposhnikovia Root), Qianghuo (Notopterygium Rhizome), Tianma (Gastrodia Tuber), Quanxie (Scorpion), and Nanting (Arisaema Rhizome) may be used; if heat steams the Spleen, causing abdominal distension, thirst for water, constipation, and eyelid swelling, Zhike San (Bitter Orange Powder), Juqu (Citri Reticulatae Fermentum), Shanzhi (Gardeniae Fructus), and Dihuang (Rehmanniae Radix) may be used; if heat steams the Lung, causing rapid breathing, thirst, cough, and nasal dryness, Sangbaipi (Morus Alba Bark), Madouling (Aristolochiae Manshuriensis Radix), and Banxia (Pinelliae Rhizoma) may be used; if toxic qi returns to the Kidney, causing lesions to turn black and invert, Zhuiwei Gao (Pig Tail Paste) or Huoxue San (Blood-Invigorating Powder) should be urgently administered. Additionally, if Wind-Evil lodges and combats in the skin, preventing heat from venting, and the rash transforms into Urticaria (Nettle Rash) with itchy skin, the condition is mild. If internal heat is first accumulated and then connected with external Wind-Evil, combusting the Blood level results in red macules, indicating deep toxicity. Smallpox transformed from Shanghan (Cold Damage) occurs because the Cold Damage heat-toxin is intense, triggering sores. These sores are white or red, erupt on the skin, form pustules at the head, and those with white pus on top are mild; those with purple-black roots hidden deep within the muscles indicate very severe toxicity. In severe cases, sores appear in the five viscera and seven orifices, shaped like beans, hence the name. Generally, true smallpox arises from accumulation of filth received in the maternal womb, primarily due to internal excess leading to macular toxins. Contracting Wind or Cold manifests as Urticaria, macular toxins, or smallpox; these are all external pathogens taking advantage of internal deficiency to lie dormant in the Zang-Fu organs, resulting in internal and external heat, heat accumulation, blood stasis, obstruction, and conglomeration. Since the initial causes differ, how can they not be distinguished? True smallpox arising from internal excess has specific syndromes for each Zang organ, discussed in detail in previous chapters. How then to distinguish Shanghan from Shangfeng (Wind Strike)? Cyan face, slight coldness of limbs, absence of sweat with aversion to cold, and heat in ears and genitals indicate Shanghan; Shangfeng presents with a red face, restless limbs, runny nose, presence of sweat with aversion to wind. Both conditions require careful examination and early treatment, otherwise they will inevitably develop into sores and rashes. For infants harboring toxic qi in the womb, the *Qianjin Fang* states: upon birth, administer one shell's worth of raw Shengdihuang juice until black stool is passed. Furthermore, when sores are about to erupt but have not yet appeared, Shengma Tang ( Cimicifuga Decoction) is used to resolve the exterior; in winter warmth, Sandou Yinzi (Three Bean Drink) is used. For epidemic rashes where contagion is feared, Qiancaogen (Rubia Cordifolia Root) decoction is used to resolve toxicity. These are all appropriate treatments for sores and smallpox. Only when Shanghan or Shangfeng transforms into sores and smallpox is it due to the error of mistimed sweating or purging therapies.