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(Comprising forty-nine poems)

From where does the toxin of smallpox and chickenpox originate? It stems from the fire-toxin transmitted within the mother's womb. After birth, impure substances are swallowed and hidden within the Mingmen (Gate of Life). Once exposed to seasonal epidemic qi, it induces the ministerial fire to simmer and roast. The toxin emerges from the bone marrow to the skin surface, transmitting from person to person.

Each of the five zang organs has its own morphological signs and symptoms; recognition must be clear. Alternating chills and fever with drowsiness indicate Splei meridian involvement; yawning and sudden chest oppression indicate Liver conditions. Coughing and sneezing indicate Lung pathogen invasion; facial redness and palpitations belong to the Heart. Only the Kidney remains pure and tranquil, avoiding evil invasion, manifesting as coldness in the hands, feet, ears, and sacrum.

Each of the five zang organs has a primary syndrome, making treatment methods difficult to unify. The Liver is associated with water flooding affecting the Lungs, and blistering leading to pus; the forms of major and minor sores vary. Spleen syndromes manifest as rashes, while Heart meridian syndromes present as red macules. Kidney syndromes presenting as black depression are mostly ominous; even with miraculous elixirs, what use are they?

One must understand the favorable and unfavorable courses of smallpox and chickenpox, which follow the timing of heaven and human affairs. Generally, yang-fire serves as the foundation; yin-cold is unwelcome. Eruptions in spring and summer are mostly auspicious, while those in autumn and winter are undoubtedly unfavorable. Dense eruptions inevitably signal danger, whereas sparse ones are considered mild.

Current treatment methods are not fixed; the distinction between cooling and warming tonification is clear. Practitioners argue各执己见, claiming themselves as divine healers. Detoxification favors cooling purgation, while tonifying the center loves using acrid-warm agents. Without understanding seasonal timing and the primordial spirit (Yuan Shen), one merely grasps at shadows, working in vain.

If the weather is warm and hot, using acrid-warm agents causes disaster; using cooling resolvents in severe cold adds frost to snow, how can the patient withstand it? Tonifying warmth for the robust and using cold-coolants for the deficient leads to "deficiency creating deficiency," damaging the primordial yang, akin to scratching an itch through a boot—ineffective.

Observe seasonal epidemics: when heavenly heat is blazing, if spirit is robust, appetite good, detoxification and cooling are convenient. If wind-cold is excessive, with emaciation, vomiting, and continuous diarrhea, warming and tonification should be prioritized, relying on the physician's flexibility.

One must know the severity of smallpox/chickenpox and master favorable/unfavorable outcomes. Light toxin with few sores follows the normal course; decoctions should not be used recklessly. Dense sores with heavy toxin are unfavorable, with skin turning to pus inch by inch. Such manifestations are mostly ominous; careful nursing is essential, do not neglect.

Mild cases erupt three or four times, sparse on the head, face, chest, and back. Urine is clear, stool is firm, diet is normal and sufficient. Severe cases erupt all over the body, resembling hemp seeds or wheat bran. Throat pain, diarrhea, and oppressive discomfort make loss of appetite loathsome.

Many cases start mild then become severe due to exposure to wind-cold. Sexual indiscretion, contact with foul/fishy substances, and dietary extremes of cold/heat. Strangers carrying foul odors, and various animals lingering nearby. Quack doctors with shallow skills misprescribe pills/decoctions, causing the sores to transform abnormally.

How to turn severe cases mild? Keep clothing and bedding warm. Keep the room private with few visitors, advance diet appropriately. Avoid misprescribed medicines and reckless consumption of sour/foul foods. This is human effort seizing heavenly vitality; how can it be attributed to fate?

To recognize death signs of smallpox/chickenpox, nothing is clearer than five signs. Purple-black color, panting/thirst/oppression, itching/collapse, teeth-chattering/chills. Gray-white color, depressed crown, abdominal distension, tender skin breaking into pits. Diarrhea, shortness of breath, seeing ghosts/spirits, hoarse voice, cold head/face/feet.

Having recognized these five death signs, what are the auspicious diseases? Sores are full and form pus nests, unbreakable even by grinding. Roots around the perimeter are red and vibrant; sleep is peaceful, demeanor is calm. Luster is robust, crusting proceeds without delay; guaranteed no sequelae like scabies, healing without medicine.

Black depression and dryness indicate Kidney failure; teeth-chattering and shivering indicate Liver injury. Loss of voice and panting indicate Lung damage; diarrhea and abdominal distension indicate Spleen deficiency. Itching/collapse and confusion indicate Heart death; delirium and seeing ghosts indicate soul departure. Tender skin easily broken indicates Yang emptiness; bloody stool and yin collapse indicate Yin blood depletion.

Sweating and purging are contraindicated at the beginning and end. Sweating opens pores, allowing wind-cold to penetrate eroded sores, leading to uneven crusting and excess fire. Mistaken purging harms the Spleen/Stomach, causing internal injury unnecessarily. Diarrhea and black depression lead to collapse and death, wasting the soul.

Generally, before eruption, use Shengma Gegen Rensu Decoction. If still no sweat, urgently resolve; stop medication once red spots appear. If constipation, gently use Sishun Qingliang Decoction. If spontaneous diarrhea, attacking the innocent qi will surely invite death.

Regulating smallpox/chickenpox involves two methods: tonifying the center and detoxifying simultaneously. Tonifying center uses Ginseng, Atractylodes, Licorice, Poria; Zhi Shi and Hawthorn are effective. Detoxification uses Scutellaria, Coptis, Gardenia, Phellodendron; Forsythia, Zhi Shi, Saposhnikovia, and Schizonepeta. Chuanxiong and Angelica nourish blood miraculously; adjustments are predetermined.

Differentiate Qi and Blood deficiency/excess by observing sore color. Purple/swollen/red indicates Blood excess; add detoxifiers to Siwu Tang. Gray-white/depressed indicates Qi weakness; Sijunzi Tang is the strategy. Add slight detoxifiers to match; tonifying Qi and strengthening Spleen is error-free.

When sores first emerge, if heat is excessive with coma/waking alternation, use detoxifying/dispersing herbs first, do not wait until thirsty to dig a well. Platycodon, Cimicifuga, Kudzu root, Forsythia, Licorice, Scutellaria. Burdock, Gardenia, Akebia, Schizonepeta, Cicada slough, Saposhnikovia as guides.

If normal tidal fever, only Kudzu root and Cimicifuga are needed. Add Scutellaria, Coptis, Licorice, Red Peony; Burdock and Forsythia are priceless. Or use Rensu Yin, adding Tangerine peel and Costus root. One dose surpasses Ling Sha; stop when sores vent to the exterior.

Initial heat often causes convulsions; urgently use Daochi San to unblock. Akebia, Licorice, Saposhnikovia, Rehmannia together. Add Cinnabar mixed; rescue consciousness momentarily. This formula has divine power; execution is certain.

High fever without eruption, severe constipation. Mania, cracked lips, red eyes; this condition is ominous and heartbreaking. Urgently use Scutellaria, Coptis, Gardenia, Phellodendron; Rhubarb wine-fried to unblock middle. Forsythia, Burdock, Akebia, Cyathula, Belamcanda all used.

Thereafter, sores erupt densely; distinguish deficiency/excess for treatment. Deficient patients with diarrhea and gray color: Shiquan Dabu Decoction is suitable. If swollen/red/blooming: Scutellaria, Coptis, Gardenia, Phellodendron, Chuanxiong, Angelica. Forsythia, Burdock, Cimicifuga, Kudzu, dried Licorice are wondrous; this is the true secret.

Gray-white failing to rise, plus frequent diarrhea. Warming middle herbs should not stop; urgently support crisis. Angelica, Scutellaria, Peony, Licorice, Ginger, Ginseng. Costus, Gardenia, Green Tangerine peel, Chenpi, Cinnamon twig, Clove are effective.

Severe toxin often causes throat pain, making eating difficult. Belamcanda and Licorice root are most appropriate; Forsythia, Cimicifuga, Burdock. If sores cluster on the neck, named "Locking Chest" (Suoge), tragic. Once ruptured, life ends; transforms into aphonia and water blisters.

Rising stage resembling silkworm cocoons, dry without fluid. Named "Blood Exhaustion, Toxin Hidden"; untreated, death is inevitable. Angelica, Rehmannia nourish blood; Ginseng, Astragalus, Licorice warm and good. Forsythia, Burdock, Costus, Platycodon, Citrus peel promote rising.

During rising stage, frequently pinch/inspect sores to prevent black depression. If black depression appears, many topical applications work. Seven roasted peas, burnt hair mixed. Pearl soaked in water, cinnabar red; puncture and apply, swelling occurs naturally.

Topical applications worsening black depression bring mourners. Baixiang, Niu Li, and Xuanfeng San are empty boasts. Better to use human/cat/chicken/dog [parts], combined four types. Costus decoction guide is wondrous; method costs half a coin.

Itching at initial rising differs from collapse-itching. Wind-cold body itch retains exterior pathogen; sores are similar, do not marvel. Treat with dispersing wind/cooling blood: Schizonepeta, Saposhnikovia, Forsythia, Burdock, Chuanxiong, Ephedra. Rehmannia, Angelica, Kudzu efficacy is praiseworthy; Bamboo leaf, Akebia are priceless.

Generally, sores should be painful/swollen; void deficiency-itching. Due to dietary damp-toxin accumulation, Heart fire overcomes causing confusion. Exteriorly use Mugwort moxa; interiorly use Ginseng/Atractylodes decoctions/pills. If itching stops, condition is safe; scratching face skin is ominous.

Why fear itching on the face? Face contains essence of five zang. If damaged, truly lamentable; Qi scatters, Soul departs. Especially avoid injuring the forehead; Heart fire carries deficient evil. Tested repeatedly without error; advice to wise physicians to observe.

Ministerial Fire resides on the forehead; if puffy/robust appear first. If forehead sores connect continuously, mostly ominous soon. Favorable if cheeks/nose/mouth involved throughout; regardless of density/prolongation, ultimately no danger.

Rising to filling/crusting, suddenly attacked by diarrhea. Spleen/Stomach should not be empty here; myriad changes cause grief. Mostly internal injury from diet; seek divine drug efficacy. If swelling reduces but diarrhea thickens, parents weep at burial mound.

First use Renshen Baizhu San, Astragalus, honey-fried Licorice, baked Ginger. Poria, Yam, Costus; large dose decocted for warming/nourishing. If ineffective, next seek Cardamom, Costus, Euryale seed; good formula. Three iterations only Yigong San is good; this is the final measure.

Remember filling/crusting stage; most fear foul/fishy smells. Rhubarb and Atractylodes burned as smoke, resolving all foul odors. Interiorly use Tiaoyuan Yin: Astragalus, honey-fried Licorice, Ginseng. Angelica, Atractylodes, wine-fried Scutellaria/Coptis; encountering Schizonepeta/Saposhnikovia causes transformation.

When filling matures, according to time, all should crust. If rotting/stench increases, this is exterior deficiency, surprising. Urgently advance Ginseng, Astragalus, Angelica, Atractylodes, Schizonepeta, Saposhnikovia, Atractylodes, Kudzu, Cimicifuga. Forsythia, Burdock, Primula flower; do not confuse truth with falsehood.

If sores mature/rot, skin breaks, pus/blood drips. Interiorly use Angelica, Atractylodes, Ginseng, Astragalus, Burdock, Forsythia, Cinnamon twig. Exteriorly use old decayed grass, sun-dried, ground to ash. Spread on bed mat, apply freely; best resolves fire-toxin vapor.

Mature sores failing to heal, instead rotting into ulcers. Sudden burning pain hard to bear; ask how to treat? Take Licorice, Talcum, Chenzhou bean powder for cooling. Honey-mixed application brings health; this method is not recorded in books.

Some pure sores, why long duration in healing? Ask carefully for root cause, do not err temporarily. Perhaps injured by cold water, or constipation retaining heat. Two treatments sought separately, not wasting unique transmission.

If indeed injured by cold water, dampness injures Spleen/Stomach, both deficient. Spleen governs muscles/central region; no wonder blood/pus flows. Use Ginseng, Astragalus, White/Yellow Atractylodes, Green/Chen Tangerine peel, Licorice, Platycodon without restriction. Clove, Cinnamon twig have prescriptions; saving interior/exterior is wondrous.

If severe constipation, three days to seven days unpassed. This is internal heat steaming; thus toxin cannot open/release. Interiorly use Angelica, Rhubarb, Hemp seed; slight Rhubarb attack. Again use gallbladder suppository; wondrous effect, guaranteed crusting and removing obstruction.

Many residual symptoms after recovery; physicians must distinguish clearly. Toxin remaining in Liver causes eye carbuncles, nebula obscuring pupil. Toxin entering Lung/Spleen causes abscesses, responsibility lies in Hand/Foot Yangming meridians. Balance internal injury/external contraction to avoid strange diseases.

Sudden eye swelling/pain: sores toxin enters Liver meridian. Mild: floating nebula covers pupil; severe: lifelong disability. Remove nebula with Chrysanthemum, Cicada slough, Primula, Tribulus, Job's tears. Grind fine, mix evenly, decoct pork liver as guide.

Abscess/toxin on limbs/joints, often pus/blood never dries. Ignoring regulation leads to lifelong disability. Interiorly use Qianjin Tuoli Decoction; exteriorly apply Taiyi Golden Pill. Discharging pus/growing flesh is not difficult; worth any price.

After sores, bathing is contraindicated; scar skin is tender/easily injured. Ignoring taboos, catching cold/cool, whole body heat/pain/stiffness. Due to Shanghan relapse from labor, Cinnamon twig/Ephedra inappropriate. Only Jiwei Qianghuo Decoction needed, then Buzhong Yiqi for regulation.

After sores, dietary injury causes abdominal pain, not light. Downward purging harming Spleen meridian inappropriate; digestion/resolution is correct symptom treatment. Atractylodes, Ginseng, Zhi Shi, Scutellaria, Barley, Green/Chen peel. Hawthorn, White Poria, Amomum; accumulation resolved, pain settled.

Sores rotting unevenly, crusting; face pours pain/pus. Urgently prevent toxin attacking eyes; detoxification/cooling useful. Wine-fried Scutellaria/Coptis/Gardenia/Phellodendron, Forsythia, Cicada slough, Akebia. Cimicifuga, Burdock, Sophora root together; finely ground, wine pills, wine delivery.

Generally, one case of smallpox/chickenpox, named "Hundred-Year Holy Sore." Like dragon shedding bones/replacing heart/intestines, or cicada shedding shell. Eruption lustrous/robust, crusting smooth, scab falling color matches. Diet/cold/heat following Yin/Yang, from then on spirit grows robust.