Library

Mr. Zheng Chunhuan, the Grand Commandant of Censorate, had his eldest son who, at four years old, contracted smallpox (Dòuchuang). The pustules were dense and accompanied by restlessness. Physicians were numerous, scattered like stars, all believing it was excessive heat that would not subside, leading to a withered physique and purple complexion, with the tops of the pustules showing signs of scorching. This was considered a adverse syndrome (Nìzhèng), deemed incurable, and they were preparing to leave. Upon my arrival, I observed carefully and saw that both temples were round and clean, with vigorous and dense spiritual energy (Shénqì). I stated that urgent cooling of blood and detoxification were required. The prescription consisted of Chi Shaoyao (Radix Paeoniae Rubra) and Sheng Dihuang (Radix Rehmanniae Preparata) each at 3 qian, Zicao (Herba Leonuri) at 2 qian, Lianqiao (Fructus Forsythiae), Huangqin (Radix Scutellariae), Beimu (Bulbus Fritillariae Cirrhosae), Shanzha (Fructus Crataegi), Mutong (Caulis Akebiae) each at 1 qian, Chantui (Periostracum Cicadae) and Gancao (Radix Glycyrrhizae) each at 5 fen. After the medicine was prepared, the crowd stopped me, saying: "Treatment for measles should be cooling, while treatment for smallpox should be warming; thus, *Bo Ai Xin Jian* regards Baoyuan Tang as excellent. We intend to administer Baoyuan Tang, yet you alone advocate cold and cool herbs. What then is the purpose of Baoyuan Tang?" I replied: "Medication must suit the syndrome. Although Baoyuan Tang is good, it can only be used after the blood circulation improves and heat clears. Now, with severe blood heat and toxin accumulation, using warm tonics is like adding oil to a raging fire." They said: "If you worry that the toxin is not resolved, our method in the Tiaoxi region is very effective: use silkworm pupae (Sangchong) and rooster comb blood mixed with wine to drink, and the smallpox will rise immediately." Shen Shi, Wang Shi, and Mao Shi, all renowned specialists in smallpox in the Tiaoxi area, also advocated this view. I said: "This method can also be used after clearing heat and resolving toxins. The *Classic of Medicine* states: 'All pain and sores belong to Heart Fire.' Using [warm tonics] before the fire subsides is using toxin to attack toxin, which will intensify the condition. Therefore, I wish to clear heat and resolve toxins first, and then use Baoyuan Tang." Only Huang Guifeng, a scholar from Tongbi Mountain in Chu, who was an expert in treating smallpox, spoke privately to Mr. Zheng: "Master Sun's prescription truly matches the syndrome. The opinions of the others are rigid and fail to adapt. I only fear that the clearing and resolving agents were administered one day too late. Try brewing and taking it to observe the outcome." Mr. Zheng ordered his servant to brew it quickly. The others still insisted: "If we must take this prescription, we should remove Beimu and Shanzha." Mr. Zheng agreed to their reduction. By nightfall, I heard of this and told Guifeng: "Removing these two herbs may lead to other symptoms in seven or eight days." Guifeng asked: "Why?" I said: "The internal injury and external pathogenic factors in this smallpox case have not been cleared thoroughly. It is now emerging with heat, hence the abdomen remains distended. Removing Beimu risks throat obstruction (Qianghou); removing Shanzha risks diarrhea. Seven or eight days later, when the toxin is fully expelled, the abdomen will be empty, and changes will arise from deficiency. You gentlemen pride yourselves as smallpox specialists; why did you not consider this?" That night, after taking the medicine, the child fell into a deep sleep. At dawn, the color of the smallpox became bright and moist, the scorched tops receded, and the blood circulation gradually improved. However, vomiting, hiccups, and throat obstruction occurred. The crowd again blamed yesterday's overly cold prescription. I said: "This is because the fire toxin has not been completely cleared. One should administer Zhuru Tang." Shen Yunfeng angrily retorted: "My family has practiced smallpox treatment for generations, and I am seventy-five years old. I have never seen Zhuru used in treating smallpox." Lejin Gong, the younger brother of Chunhuan Gong, consulted the *Complete Book of Smallpox and Measles* to find references to Zhuru usage, silencing Shen, who left in anger. After administering the medicine, the hiccups ceased. On the eighth day, diarrhea and itching indeed occurred. I treated the diarrhea with Baoyuan Tang added with Baizhu, and stopped the itching by significantly adding Heshouwu. After one dose, the itching stopped. By the fourteenth day, the forehead and both cheeks had returned to pus formation and crusting, but the pus on both jawlines had not returned, and diarrhea persisted. Due to an accidental trip to the North Gate, upon returning half a day later, I found his mouth open, neck soft, and the qi of the smallpox on hands and feet completely collapsed, with re-distension occurring, indicating internal invasion. The whole family wept. I was at a loss and unable to devise a plan, sighing as I exited. Lejin Gong held my hand to see me off. After a short while, we bowed and parted, but I smelled the odor of smallpox in his clothes and said to Lejin Gong: "Do you smell the odor?" He replied: "Yes." I said: "There seems to be a sign of life. Hurry back to rescue him." I reasoned that the jawlines correspond to the Kidney meridian. The failure to return to pus indicated Kidney Yuan deficiency. Profoundly tonifying the Kidney Yuan might save him. First, I used Ziheche (Placenta Humana) at 1 qian, mixed with wine and rice gruel, to consolidate the primordial Qi; he slept after taking it. Subsequently, I prescribed Ren Shen (Radix Ginseng) at 1 liang, Huangqi (Radix Astragali), and Tusizi (Semen Cuscutae) each at 3 qian, in a large dose. Over one day and night, he consumed 1 liang 8 qian of Ren Shen. Huang Guifeng returned from Songjiang that night, around the fourth watch (midnight to 2 AM). He urgently knocked and entered. Mr. Zheng informed him of the change and the medication taken. Guifeng said: "Let me examine the condition." Seeing yellow pus filling the abdomen under the crusts and the smallpox rising entirely, Guifeng said: "It is completely secure! Only Master Sun could revive this patient." From then on, Guifeng grew closer to me; we traveled together by boat and slept in the same bed, verifying and correcting each other's medical knowledge for three years. Grateful, Mr. Zheng wrote a preface as a gift and inscribed it personally behind the register of Vice-Censor-in-Chief Sun, expressing that he would not forget the kindness.