〔万〕痘疮之证，热三日，出三日，后方起发，此常论也。盖先出者先起，后出
者后起，痘疏毒轻，气禀浓者，自易出易发易靥。痘密毒重，气禀薄者，自难出难
发难靥，未可拘定日数。时师不知虚实补泻之理，但于起发之初，便用补脾，果内
气不足少食者，用之允当，若内实便秘能食之人，宁不党邪为恶乎，非徒无益，而
反害之。痘疮之出，有轻有重，观其形状，即可知之，如一发便出尽者必重也。疮
夹疹者，半轻半重也。出稀者轻。里外微红者轻。外黑里赤微重也。外白里黑者至
重也。疮端里黑点如针孔者势剧也。青干紫陷，昏睡汗出，烦躁热渴，腹胀啼喘，
大小便不通者困也。善用药者，能使轻者易安，重者不致大困，斯可谓之十全矣。
凡痘疮疏则无毒，密则有毒，痘疏毒少者，邪不胜正，其气和，其势顺，不须服药。
痘疏密布散，邪正相持，其气病，其势险，此宜抑邪扶正，使邪气亟夺，不为正气
之贼。痘稠密无缝，正不胜邪，其气乖，其势逆，善治者什可救其二三，不善治者
束手待毙而已。故顺者不必治，逆者不可治，险者贵治，此以下专言险逆者之证治
也。痘子轻者作三四次出，大小不一等，其起发亦先后循次，大小分明，不相连
串，颗粒尖圆，根窠红活，光壮肥泽，此表无病。饮食如常，小大便清润，此里无
病。表里无病，大吉之兆，不须服药。凡痘密者，多难起顶，但欲皮浓有脓，浆色
以灯影之，苟非皮薄水泡光润，虽平，亦无伤。
凡痘子出得稀疏者，自然易发易靥，不可妄治，若疮稠密，常患其发不能透，
宜细视之，但红活不甚长大者，气不足也，用四君子汤合匀气散、加烧人屎治之。
如肿色带红紫者，血热也，用四物汤（失血）合消毒饮（见形）加烧人屎治之。如不润泽而
干者，此血弱也，用活血散加消毒饮与之。如不起发，不红活，平 灰白者，此气
血俱虚也，用十全大补汤（汗）加烧人屎、牛蒡子与之。如有青干者，内服快 汤（见形）加
烧人屎、合夺命丹（见形）与之，外用四圣散（痘疔）合胭脂涂法，或用胡荽酒（俱见形），或
用水杨汤浴法，务求光壮红活而后已。如中间有成水泡者，防其痒 ，宜先补脾胃，疏
风泻火，使肌肉实，不作痒可也，十全大补汤（汗）加防风、大力子主之。
疮子起发，只以出匀为期，不可拘定日数，疮出以渐，其发亦以渐，谓之适中，
若已一齐涌出，便皮肉虚肿，一齐 发者，此表气虚，毒瓦斯奔溃而出，表虚不能收
敛，必生痒 ，或成溃烂，急宜救表，十宣散调无价散、活血散合消毒饮相间服
之。若出已尽，当起不起，或起不透，此里气虚，毒瓦斯留伏壅遏而不出，必增烦躁
腹满喘促，或后为痈毒，急宜救里，十全大补汤合匀气散，或参苓白术散调无价散
服之。痘至四五，停住不甚起者，少后力，宜助之，用生黄 三五钱，人参二三
钱，当归、鹿茸一二钱，煎服，或磨入木香少许，儿大者倍之，俟浆满足而止。
十宣散（见形）
活血散（即芎归汤）
当归 川芎（各等分）
上为细末。每服一钱，红花汤调服。
消毒饮（见形） 十全大补汤（汁） 匀气散（见形） 参苓白术散（渴） 无价散（倒
靥）
参 四圣散 治痘疮已出六七日，不能长，不生脓，或痒塌。
当归 芍药（炒） 黄 川芎（各五分） 白术 伏苓 紫草（如无红花代之） 木通
防风（各三分） 糯米（二百粒）
上，水煎。母同服。
胎元散 痘不起发，不红润，是血气俱虚。
胎元焙干为末，加麝香少许，酒调服三五分。
独参汤 治阳气虚弱，痘疮不起发，不红活，或脓清不满，或结痂迟缓，或痘痕色
白，或嫩软不固，或脓水不干，或时作痒，或畏风寒。
用好人参一两、生姜五片、大枣五枚、水二钟，煎八分，徐徐温服。婴儿乳母亦服。
〔干枯灰白红紫青黯〕〔丹〕如将出成就之际，却色淡不正者属血虚，宜用补血
药当归、川芎、白芍酒洗之类，或加红花。如将成就之际，却色紫不正者属热，宜
用凉药解毒，升麻、芩、连、桔梗、连翘之类，甚者用犀角屑（如用后项诸药，色仍不正者，宜
兼用二法治之。）
痘疮之毒，必气以 之、血以濡之，而后可得成熟也，故于起发之时光壮者，
气有余也。肥泽者，血有余也。气血有余，表里俱和，不须服药。如形长大而色枯
燥者，此气至而血不荣也，宜四物汤（失血）加人参、麦门冬。色红润而形平陷者，此血
至而气不充也，宜四君子汤（不能食）加黄 、官桂、川芎。形平陷，色枯萎者，此气血
俱不足也，宜十全大补汤（汗）合无价散（倒靥）主之。色灰白者，气虚也，四君子汤加黄 、
当归、官桂。色红紫者，血热也，四物汤加红花、地骨皮、牡丹皮。
凡痘疮起发迟滞，顶平，色灰白者，气虚也，其人平日食少，脾胃不足，人参
白术散（渴）去葛根、加桂，十全大补汤（汗）去地黄、加木香主之。如曾有吐泻，以致气弱
者，四君子汤（不能食）合益黄散（脾）主之。泻未止者，四君子汤吞肉豆蔻丸（泄利），甚者陈氏
木香散主之（泄利）。若红紫色 肿者，血热也，四物汤（失血）合消毒饮（见形）加红花，外用胭
脂涂法（见形）解之。干枯者，血虚也，四物汤加人参、麦门冬、地骨皮，外用胭脂涂
法、水杨汤浴法。（灰白另立门在下卷。）
起发之时，根窠红活，形色润泽者，此血随气行，灌注诸疮，自然红活肥泽，
不须服药。如虽起发，干枯无水，谓之不肥泽。带青紫黯色，谓之不红活。其变为
黑陷，乃血虚也，四物汤（失血）加人参及麦门冬、紫草、红花，间进，调无价散（倒靥）或
吞服夺命丹（见形），外用胭脂涂法（见形）。
水杨汤
水杨柳五斤，净洗，春冬用枝，秋夏用枝叶，锉断，用长流水一大釜，煎
六七沸，先将三分中一分，置浴盆内，以手试，不甚热，亦不可太温，先服宜用
汤药，然后浴洗，渐渐添汤，以痘起发光壮为度，不拘次数。
祛邪汤 痘号天花，最忌诸秽臭、恶血，五六朝间，痘本美丽鼎峻，而一时失防，或
触于腥血，或感于秽臭，倏忽更变，外宜祛邪汤浴之，而内服玉枢正气丹可也。
鸡毛（拔细软者） 升麻 荆芥 木通 紫苏 荔枝壳 水杨条
上，用水煎浓，去滓，洗浴。
玉枢正气丹
玉枢正气神功捷，生地红花并甘桔，参 须倍橘红扛，蝉蜕防风羲爱觅，寅谷
相朝嫩桃杪，五个和姜甘草列，煎浓投酒服须臾，不觉痘自还元吉。
〔顶陷〕起发之时不徐不疾，以渐长大，尖圆磊落，光壮坚实，根脚红活，此气
充足，载血而行，透彻诸疮，自然尖圆光壮，不须服药。如虽红活，顶平中陷，不
成尖圆，色嫩皮薄，不能坚浓，其变为痒 ，为留伏壅遏，乃气虚也，四君子汤（不能
食）合匀气散（见形）加黄 、官桂，或人参白术散（渴）加黄 、官桂、防风，或调元汤（大法）加
官桂、防风、白芷、荆芥穗，或十全大补汤（汗）去地黄、加防风、白芷，或十宣散（见形）
皆可选用。若疮皮薄，色娇，淫淫如湿者，此气不胜血，宜补气凉血，四君子汤、四
物汤去川芎、地黄，加黄 、官桂、防风、荆芥穗。如浮囊虚起，壳中无水者，此
气不根据血，血不附气，其变为痒 ，为痈肿，十全大补汤去白术，加大力子、连翘、
防风、烧人屎。痘疮起发，尖圆为贵，如四围起，中心平陷者，此有二种。有血化
成水，四围高起，心中略低凹者，俗呼为茱萸豆，此中气不足，发未透彻故耳，能
食者至养浆之时，尽充满而起矣，不能食者，宜扶中气，人参白术散主之。有四围
沸起，中心落陷无水，犹是死肉，其形如钱，宜急攻之，若待渐变黑点，不可为矣，
此名鬼痘，四君子汤合九味顺气散加烧人屎，或紫草饮（出不快），或紫草饮子，连进服
之，外更用胭脂涂法（见形）。出齐后，痘有小孔，自顶直下至脚，不黑不白，与痘色
相同，名为蛀痘，皆因表虚而腠理不密，成此证也，失于早治，大泄元气，不起不
发，祸不旋踵，急用保元汤下生糯米、川芎、肉桂、丁香，其孔自密，甚为快捷方式，
连进二三服，必待孔闭而痘自起。孔若黑色，则为疔矣。顶陷色白，皮薄晶光者，
气虚也，大下保元，倍加酒炒黄 、肉桂、川芎、丁香、茯苓皮、人乳、好酒、进之。
九味顺气散 （又名匀气散）
白术 白茯苓 青皮 白芷 陈皮 乌药 人参（各五分） 甘草（炙，二分半） 木香（一分半）
上锉细。水一盏，煎七分，去滓，温服。
紫草饮子
紫草茸 人参 白芍药 蝉蜕 甘草 穿山甲（土拌，炒。各等分）
上锉细。用水一盏，煎五分，作三四次温服。
内托散 治痘疮毒根在里，顶陷，灰白色，不起发，根窠不红，内托毒化，立验。
人参 甘草 肉桂 白芷 白芍药 川芎（各一两） 黄 （一两五钱） 桔梗 防风（各二两）
用当归（五钱） 木香（二钱）
上，水煎服。泻，加诃子内、肉豆蔻。有 ，减肉桂，加紫草、酒炒黄芩、
黄连、牛蒡子之类。
治痘塌陷不起，回阳丹
此方用于四五朝前，其效甚速，若用于六七日后，则噬脐矣。制法，将弥月将
生胞羊，酒洗净，随用黄麻缠拢一团，把腊糟裹外，置新瓦上四围炭火炙之，俟
其外糟焦了如墨样，削去其糟，再焙干，另为末，入官桂末、丁香末各五钱，
人参末一两，木香末三钱，再研极细。升麻煎酒浆调服，十岁以上服二钱，十岁
以下服一钱，十五岁以上服三钱，年多服多，年少服少，加减而用，无不获效。
若加大附子一两，去木香，则为附子回生丹。胞羊须预嘱屠肆，遇便收制，若特
杀伤生，大不祥。
〔顶凸〕痘疮起发，有心中凸起，四围干平无水者，或里红外黑者，此由平日
感受风寒，皮肤坚木，以致痘毒郁而不散，宜桂枝葛根汤（初热）十宣散（见形）以散表邪，
外用水杨汤浴之（见前）。
〔粘连〕痘疮起发，贵于颗粒分明，如其彼此相串，皮肿肉浮，或于本痘四傍，
旋出小痘，攒聚胖长，渐成一块，此候最重，宜以快 汤合消毒饮（俱见形）加烧人屎服
之，更宜禁忌，以防瘙痒之变。
〔陷伏〕凡痘疮，以起发光壮，红活肥泽为顺，若将起发之时，中间有干黑不
起者，须急治之，不可因循，以致传变加多，不可救药矣。
痘疮内而不出谓之伏，外而复入谓之陷，疮痘黑陷，当分四证。
一则感风寒肌窍闭塞，血凝而不行，必身痛，四肢微厥， 点不长，或变黑色，
或青紫瘾疹，此为倒伏也。宜温肌发散，桂枝葛根汤（初热）加麻黄、蝉蜕，或以紫草饮
（出不快）吞夺命丹（见形），外用胡荽酒喷之，须令温散寒邪，然后热气复行，则其 自长矣。
二则毒瓦斯太盛，内外蒸烁，毒复入里，必心烦狂躁，气喘妄言，如见鬼神，大
小便秘，渴而腹胀，此为倒陷伏也。病邪轻者，宜利小便解毒，连翘汤、通关散
（俱便闷），甚者以百祥丸、牛李膏（俱黑陷），以泻膀胱之毒，令阳气复还，脾胃温暖，服之
身温，欲饮水者可治，是脾强胜肾，陷者当复出矣，若加以寒战身冷汗出，耳尻反热，
死。然百祥丸太峻，今以宣风散（发热）、三乙承气汤（便闷）代之，外以水杨汤浴之（见前）。
三则内虚而不能使阳气以副荣卫者，出而复没， 点白色，或黑色，其人必不
能乳食，大便自利，或呕或厥，此胃虚而不出，谓之陷伏也，宜用温中之剂，令其
胃暖，荣卫复行，则当自出矣，宜调元汤（大法）加丁香、官桂，理中汤（泄利）加黄 、官
桂，甚则陈氏木香散（泄利）异攻散（出不快）皆可用也。外用胡荽酒（见形）喷之。或因误下
之后，毒瓦斯入里而黑陷者，则宜温养而表出之，先以理中汤温养其里，后以桂枝葛根汤疏解
于表也，不出，再加麻黄。
四则被房室等杂秽恶气冲触而黑陷者，则宜熏解之，内服紫草饮子（见前），外用胡荽
酒喷之，及茵陈熏法。（余详前禁忌条内）
茵陈熏法
用干茵陈研末，捣枣膏、和丸如鸡子大，晒干。烈火烧烟熏之。
〔大便〕痘疮自起发之后，大便常宜坚实，缘小儿脆弱，身热而大便不通者则
易实，大便自利者则易虚，虽四五日不便，无忧也，不能食者听其自便，赖旧谷气
为养，至五日后则脓成毒化，解利之剂可用也。能食者三日后不通，不腹满，不里
急后重，则亦不必攻之，可用胆导法（便闷）导之，不通，以当归丸（便闷）微令润过，使气
道升降，无壅遏之患，不可妄下。凡能食者，大便喜润，赖新谷以为养，而旧污之
不留，自然脏腑流利，血气和平，不可妄用温补，反增里热之证。胃主腐熟水谷，
大肠主传送已化之物，故食多少，可以知人谷气之虚实，大便滑涩，可以知人脏腑
[Wan Quan] Regarding the syndrome of smallpox, fever lasts for three days, eruption lasts for three days, and only then does the swelling and rising phase begin; this is the general theory. Generally, those that erupt first rise first, and those that erupt later rise later. If the pustules are sparse and the toxin is light, individuals with robust constitution will naturally have easy eruption, easy rising, and easy crusting. If the pustules are dense and the toxin is heavy, individuals with weak constitution will naturally have difficult eruption, difficult rising, and difficult crusting; one should not rigidly adhere to fixed days. Contemporary physicians do not understand the principles of deficiency/excess and tonification/draining. They merely use spleen-tonifying herbs at the initial stage of rising. If the interior qi is deficient and appetite is poor, this is appropriate. However, for those with interior excess, constipation, and good appetite, would this not support the pathogen and worsen the condition? It is not only ineffective but harmful. The eruption of smallpox varies in severity; its shape indicates the prognosis. For instance, if all pustules erupt at once, the condition is necessarily severe. Pustules accompanied by rashes indicate a moderate severity. Sparse eruption indicates mildness. Slight redness inside and out indicates mildness. Black exterior with red interior indicates slightly severe. White exterior with black interior indicates extremely severe. Black spots like needle holes at the tip of the pustule indicate a critical condition. Cyanosis, dryness, purple depression, lethargy with sweating, irritability, heat, thirst, abdominal distension, crying, wheezing, and obstruction of urination and defecation indicate a critical and difficult state. A skilled practitioner can make mild cases easily stable and prevent severe cases from becoming critically dangerous; this can be called perfect healing. Generally, sparse smallpox has no toxin, while dense smallpox has toxin. When pustules are sparse and toxin is light, the pathogen cannot overcome the healthy qi; the qi is harmonious, and the progression is smooth, requiring no medication. When pustules are sparse yet densely distributed, pathogen and healthy qi contend; the qi is diseased, and the progression is perilous. In such cases, one should suppress the pathogen and support the healthy qi, causing the pathogen to be quickly defeated so as not to become a thief to the healthy qi. When pustules are dense without gaps, healthy qi cannot overcome the pathogen; the qi is discordant, and the progression is adverse. A skilled healer might save two or three out of ten, while an unskilled one can only wait for death with hands tied. Therefore, favorable cases need not be treated, adverse cases are hard to treat, and perilous cases require treatment. The following specifically discusses the syndrome and treatment of perilous and adverse cases. Mild smallpox erupts in three or four batches, varying in size; their rising occurs sequentially, clearly distinguished by size, not connected in strings, with pointed and round granules, red and vibrant roots, and glossy, robust, and plump appearance, indicating no disease in the exterior. Normal diet and clear, moist urine and stool indicate no disease in the interior. No disease in exterior and interior is an auspicious sign, requiring no medication. Dense smallpox often struggles to rise to the peak; as long as the skin is thick with pus, and the color of the fluid appears normal under lamplight, even if flat, it causes no harm, provided it is not thin-skinned with watery blisters.
For sparse smallpox, eruption and crusting occur naturally; one must not treat rashly. If pustules are dense and often fail to erupt fully, examine carefully. If they are red and vibrant but do not grow significantly, it indicates qi deficiency; treat with Sijunzi Tang (Four Gentlemen Decoction) combined with Yunqi San (Harmonizing Qi Powder), adding burnt human feces. If swelling has a red-purple hue, it indicates blood heat; treat with Siwu Tang (Four Substances Decoction) combined with Xiaodu Yin (Detoxifying Decoction), adding burnt human feces. If not moist and dry, it indicates blood weakness; treat with Huoxue San (Invigorating Blood Powder) plus Xiaodu Yin. If there is no rising, no redness/vibrancy, and a flat grayish-white appearance, it indicates dual deficiency of qi and blood; treat with Shiquan Dabu Tang (Comprehensive Great Tonifying Decoction), adding burnt human feces and Niubangzi (Fructus Arctii). If cyanotic and dry, internally administer Kuaiban Tang (Rapid Eruption Decoction) with burnt human feces and Hedming Dan (Life-Restoring Pill); externally apply Six Saints Powder (for smallpox carbuncles) combined with Carminic Acid application, or use Huisu Jiu (Coriander Wine), or Yangliu Tang bath method, until the appearance becomes glossy, robust, red, and vibrant. If water blisters form in the center, preventing itching is crucial; first tonify spleen and stomach, disperse wind, and drain fire to solidify muscles and prevent itching; treat with Shiquan Dabu Tang, adding Fangfeng (Radix Saposhnikoviae) and Dalizi (Fructus Arctii).
The rising of pustules should aim for uniformity in eruption, not fixed days. Gradual eruption leads to gradual rising, which is considered moderate. If they erupt all at once, the skin and flesh become vacuously swollen; simultaneous rising indicates exterior qi deficiency, where toxin vapors burst forth, and exterior deficiency fails to consolidate, leading to itching or ulceration. Urgently rescue the exterior by alternating administration of Shixuan San (Ten Acupoints Powder) blended with Wujia San (Priceless Powder), Huoxue San, and Xiaodu Yin. If eruption is complete but rising fails or is incomplete, it indicates interior qi deficiency, where toxin vapors stagnate and obstruct, failing to emerge, leading to irritability, abdominal fullness, wheezing, or later carbuncles. Urgently rescue the interior with Shiquan Dabu Tang combined with Yunqi San, or Shenling Baizhu San blended with Wujia San. At four or five days, if smallpox stalls and does not rise much, strength is lacking; assist it with Sheng Huangqi (Raw Radix Astragali) 3-5 qian, Renshen (Radix Ginseng) 2-3 qian, Danggui (Radix Angelicae Sinensis) and Lurong (Cornu Cervi Pantotrichum) 1-2 qian, decocted and taken orally, or mixed with a little Muxiang (Radix Aucklandoniae); double the dose for older children; stop when the fluid is full.
Shixuan San (See Eruption Phase)
Huoxue San (i.e., Xiong Gui Tang)
Danggui, Chuanxiong (equal parts)
Grind into fine powder. Take 1 qian per dose, mixed with Honghua Tang (Safflower Decoction).
Xiaodu Yin (See Eruption Phase) Shiquan Dabu Tang (Juice) Yunqi San (See Eruption Phase) Shenling Baizhu San (Thirst) Wujia San (Inverted Crusting)
Can (Ginseng) Six Saints Powder: Treats smallpox erupted for six or seven days, unable to grow, produce pus, or suffering from itching/collapse.
Danggui, Shaoyao (stir-fried), Huangqi, Chuanxiong (each 5 fen), Baizhu, Fuling, Zicao (use Honghua if Zicao unavailable), Mutong, Fangfeng (each 3 fen), Nuomi (200 grains)
Decoct in water. Mother takes it together.
Taiyuan San: Smallpox fails to rise, lacks redness/radiance, indicating dual deficiency of qi and blood.
Bake Taiyuan (Placenta) until dry, grind into powder, add a little Shexiang (Musk), mix with wine, take 3-5 fen.
Dushen Tang: Treats yang qi deficiency, smallpox fails to rise, lacks redness/vibrancy, or pus is clear/incomplete, crusting is slow, scars are white, tender/soft/unstable, pus water doesn't dry up, occasional itching, or aversion to wind/cold.
Use high-quality Renshen 1 liang, Shengjiang (Fresh Ginger) 5 slices, Dazao (Jujube) 5 pieces, Water 2 zhong, decoct to 8 fen, take warm slowly. Infants' mothers also take it.
[Dry, Gray-White, Red-Purple, Cyan-Dark] [Tanba Genmyo] At the stage of nearing completion, if the color is pale and abnormal, it belongs to blood deficiency; use blood-tonifying herbs like Danggui, Chuanxiong, Baishao (wine-washed), possibly adding Honghua. If nearing completion, the color is purple and abnormal, it belongs to heat; use cooling detoxifying herbs like Shengma (Radix Cimicifugae), Qin (Radix Scutellariae), Lian (Radix Isatidis), Jiegeng (Radix Platycodi), Lianqiao (Fructus Forsythiae); for severe cases, use Xijiao Xie (Hornis Rhinocerotis). (If using the aforementioned herbs and the color remains abnormal, combine both treatments.)
The toxin of smallpox requires qi to push it and blood to nourish it to mature. Thus, at the rising stage, robustness indicates surplus qi; plumpness/moisture indicates surplus blood. Surplus qi and blood with harmony in exterior and interior require no medication. If large in shape but dry/pale, qi has arrived but blood does not nourish; use Siwu Tang plus Renshen and Maidong (Radix Ophiopogonis). If red/radiant but flat/depressed, blood has arrived but qi does not fill; use Sijunzi Tang plus Huangqi, Guigui (Cortex Cinnamomi), and Chuanxiong. If flat/depressed and withered, dual deficiency of qi and blood; use Shiquan Dabu Tang combined with Wujia San. Gray-white color indicates qi deficiency; Sijunzi Tang plus Huangqi, Danggui, Guigui. Red-purple color indicates blood heat; Siwu Tang plus Honghua, Digupi (Cortex Lycii), Mudanpi (Cortex Moutan).
Generally, delayed rising, flat peaks, and gray-white color indicate qi deficiency. Such patients usually eat little and have insufficient spleen/stomach. Use Ren Shen Bai Zhu San remove Gegen, add Gui; or Shiquan Dabu Tang remove Dihuang, add Muxiang. If there was vomiting/diarrhea leading to qi weakness, use Sijunzi Tang combined with Yihuang San. If diarrhea persists, swallow Roudoukou Wan with Sijunzi Tang; for severe cases, Chen's Muxiang San. If red-purple and swollen, blood heat; Siwu Tang combined with Xiaodu Yin plus Honghua, externally apply Carminic Acid method. Dry indicates blood deficiency; Siwu Tang plus Renshen, Maidong, Digupi, externally apply Carminic Acid method and Yangliu Tang bath. (Gray-white has a separate section in Volume 2.)
At the rising stage, red/vibrant roots and moist/glossy appearance indicate blood following qi, irrigating the pustules, naturally red/vibrant and plump/moist, requiring no medication. If risen but dry/waterless, it is called "not plump/moist." With cyan/purple/dark color, it is called "not red/vibrant." Transformation into black depression is due to blood deficiency; Siwu Tang plus Renshen, Maidong, Zicao, Honghua, taken intermittently, blended with Wujia San or swallowed with Hedming Dan, externally apply Carminic Acid method.
Yangliu Tang
Take 5 jin of Shuiyangliu (Salix matsudana), wash clean. Use branches in spring/winter, branches and leaves in autumn/summer. Chop. Use a large pot of running water, boil 6-7 times. Put one-third into the bath basin. Test with hand: not too hot, not too warm. First take herbal medicine, then bathe. Gradually add water until the smallpox rises, becomes glossy and robust. Number of baths unrestricted.
Quxie Tang: Smallpox, named Tianhua, most fears filth/odor and evil blood. Around day 5-6, although smallpox is beautiful and prominent, sudden negligence, contact with fishy blood, or exposure to filth/odor causes sudden changes. Externally bathe with Quxie Tang, internally take Yushu Zhengqi Dan.
Chicken feathers (fine/soft ones), Shengma, Jingjie (Herba Schizonepetae), Mutong, Zisu (Folium Perillae), Lizhi Qiao (Shell Litchi), Shuiyang Tiao (Twig Salix)
Decoct in water until concentrated, strain, bathe.
Yushu Zhengqi Dan
[Poem describing efficacy and ingredients: Jade Pivot Upright Qi Divine Power Swift, Shengdi, Honghua, Gancao, Jiegeng; Ginseng whiskers double Orange Peel, Cicada slough, Fangfeng sought; Morning valley meet tender peach tips, Five pieces with ginger and licorice arranged; Decoct strong, throw into wine, take shortly, unaware smallpox returns to origin auspicious.]
[Peak Depression] Rising stage, neither fast nor slow, gradually growing, pointed/round, glossy/robust/solid, red/vibrant roots, indicates sufficient qi carrying blood through all pustules, naturally pointed/round/glossy/robust, requiring no medication. If red/vibrant but peak flat/depressed, not pointed/round, tender/thin skin, unable to become firm/thick, transforming into itching or stagnation/obstruction, it is qi deficiency. Use Sijunzi Tang combined with Yunqi San plus Huangqi, Guigui; or Renshen Baizhu San plus Huangqi, Guigui, Fangfeng; or Tianyuan Tang plus Guigui, Fangfeng, Baizhu, Jingjie Sui; or Shiquan Dabu Tang remove Dihuang, add Fangfeng, Baizhu; or Shixuan San, all selectable. If pustule skin is thin, delicate, wet-looking, qi cannot control blood; tonify qi and cool blood: Sijunzi Tang, Siwu Tang remove Chuanxiong, Dihuang, add Huangqi, Guigui, Fangfeng, Jingjie Sui. If floating vesicles rise vacuously, empty shell, qi does not root in blood, blood does not attach to qi, transforming into itching/carbuncles: Shiquan Dabu Tang remove Baizhu, add Dalizi, Lianqiao, Fangfeng, burnt human feces. Smallpox rising values pointed/round shape. If surrounded by elevation but center flat/depressed, there are two types. One: blood transforms to water, surroundings high, center slightly concave, colloquially "Dogwood Bean," middle qi insufficient, eruption not thorough. Those who can eat will fill up during fluid-nourishing stage; those who cannot eat, tonify middle qi with Renshen Baizhu San. Two: surroundings boiling up, center collapsed empty, dead flesh, coin-shaped, urgently attack. If waiting for black spots, it is incurable. Named "Ghost Smallpox": Sijunzi Tang combined with Jiwei Shunqi San plus burnt human feces, or Zicao Yin, or Zicao Yinzi, continuous intake, externally Carminic Acid method. After complete eruption, smallpox has small holes from top to foot, not black/white, same color as smallpox, named "Worm Smallpox," due to exterior deficiency and loose pores. Delayed early treatment drains yuan qi, failure to rise/erupt, disaster follows swiftly. Urgently use Baoyuan Tang plus raw Nuomi, Chuanxiong, Rougui, Dingxiang; holes close spontaneously, very effective. Continue 2-3 doses until holes close and smallpox rises. If hole is black, it is a carbuncle. Peak depressed, white color, thin/crystalline skin, qi deficiency: Large dose of Baoyuan, double Jiuhuangqi, Rougui, Chuanxiong, Dingxiang, Fuling Pi, Renru (Human Milk), Haojiu (Good Wine), advance.
Jiwei Shunqi San (aka Yunqi San)
Baizhu, Baifuling, Qingpi, Baizhi, Chenpi, Wuyao, Renshen (each 5 fen), Gancao (roasted, 2.5 fen), Muxiang (1.5 fen)
Chop finely. Water 1 sheng, decoct to 7 fen, strain, take warm.
Zicao Yinzi
Zicao Rong, Renshen, Baishaoyao, Chantui (Cicada Slough), Gancao, Chuanshanjia (soil-mixed, fried, equal parts)
Chop finely. Water 1 sheng, decoct to 5 fen, take warm in 3-4 doses.
Neituo San: Treats smallpox toxin rooted in interior, peak depressed, gray-white, no rising, non-red roots, internal support for toxin transformation, immediate effect.
Renshen, Gancao, Rougui, Baizhi, Baishaoyao, Chuanxiong (each 1 liang), Huangqi (1.5 liang), Jiegeng, Fangfeng (each 2 liang)
Use Danggui (5 qian), Muxiang (2 qian)
Decoct in water. For diarrhea, add Heziren, Roudoukou. For heat, reduce Rougui, add Zicao, Jiuhuangqin, Huanglian, Niubangzi.
Treats smallpox collapse/no rising, Huiyang Dan
This formula is very fast if used before day 4-5; if used after day 6-7, it is too late. Preparation: Take a placental sheep near term, wash with wine, wrap in yellow hemp, surround with wax dregs, place on new tile, roast around with charcoal fire until outer dregs are black like ink. Remove dregs, bake dry, grind to powder. Add Guigui powder, Dingxiang powder each 5 qian, Renshen powder 1 liang, Muxiang powder 3 qian, grind extremely fine. Mix with Shengma decocted wine/juice. Over 10 years: 2 qian; Under 10 years: 1 qian; Over 15 years: 3 qian. Adjust based on age/year. No failure.
Add Fuzi 1 liang, remove Muxiang, becomes Fuzi Huisheng Dan. Sheep must be ordered from butcher beforehand; kill conveniently. Killing specially is highly inauspicious.
[Peak Protrusion] Smallpox rising, center protrudes, surroundings dry/flat/waterless, or red interior/black exterior, due to daily wind-cold exposure, stiff skin, causing toxin stagnation. Use Guizhi Gegen Tang plus Shixuan San to disperse exterior pathogen, externally Yangliu Tang bath.
[Adhesion] Smallpox rising values distinct granules. If interlinked, swollen skin/flesh, or small pustules appear around original ones, gathering and growing into a mass, this is heaviest syndrome. Use Kuaiban Tang combined with Xiaodu Yin plus burnt human feces. Strictly observe taboos to prevent itching changes.
[Depression/Submersion] Smallpox rising values glossy/robust, red/vibrant/plump/moist as favorable. If at rising stage, center is dry/black/no rising, treat urgently. Do not delay, lest transmission increases and becomes incurable.
Smallpox internal without emerging is called "Fu" (Submerged); external returning inward is called "Xian" (Depressed). Black depression of smallpox divides into four syndromes.
First: Wind-cold blocks muscle pores, blood coagulates/stagnates, body pain, slight cold limbs, spots don't grow, turn black, or cyan-purple urticaria. This is "Dao Fu" (Reversed Submersion). Warm muscle and disperse: Guizhi Gegen Tang plus Mahuang, Chantui; or Zicao Yin swallowing Hedming Dan, externally spray Huisu Jiu. Must warm-disperse cold pathogen, then heat qi returns, spots grow.
Second: Toxin vapor too strong, steaming inside/outside, toxin re-enters interior, irritability/manic restlessness, wheezing/hallucinations, constipation, thirst/abdominal distension. This is "Dao Xian Fu" (Reversed Depression/Submersion). Mild pathogen: promote urination/detoxify, Lianqiao Tang, Tongguan San. Severe: Baixiang Wan, Niuli Gao, drain bladder toxin, restore yang qi, warm spleen/stomach. Body warms, desires water: treatable (Spleen strong overcomes Kidney, depression re-emerges). Cold tremors/sweat/cool body, ears/buttocks hot: death. Baixiang Wan is too harsh; now replace with Xuanfeng San, Sanyi Chengqi Tang, externally Yangliu Tang bath.
Third: Interior deficiency, yang qi cannot assist Ying-Wei, emerges then sinks, spots white/black, unable to suck/eat, spontaneous diarrhea, vomiting/cold limbs. Stomach deficiency, no emergence, called "Xian Fu". Warm middle: Tianyuan Tang plus Dingxiang, Guigui; Lizhong Tang plus Huangqi, Guigui. Severe: Chen's Muxiang San, Yigong San. Externally spray Huisu Jiu. Due to mistaken purgation, toxin enters interior/black depression: warm/nourish and bring out via exterior. First Lizhong Tang warm interior, then Guizhi Gegen Tang disperse exterior. If no emergence, add Mahuang.
Fourth: Contact with sexual/filthy odors causing black depression: fumigate/dissolve. Internally Zicao Yinzi, externally spray Huisu Jiu, and Yinchen Fumigation. (Details in Taboos).
Yinchen Fumigation Method
Dry Yinchen grind to powder, mix with Jujube paste, pills like egg size, sun-dry. Burn strongly, fumigate smoke.
[Stool] After smallpox rising, stool should be firm. Children are fragile; fever with constipation makes it easy to become solid; spontaneous diarrhea makes it easy to become deficient. Even 4-5 days without stool, no worry. If unable to eat, let it pass naturally, relying on old grain qi for nourishment. After 5 days, pus forms/toxin transforms, resolving agents usable. If able to eat, no stool after 3 days, no abdominal fullness/tenesmus, no need to purge. Use Dan Dao Fa (Gallbladder Suppository) to guide. If no passage, Danggui Wan slightly moistens, regulating qi ascent/descent, avoiding stagnation. Do not purge rashly. Those who can eat prefer moist stool, relying on new grain, old waste not retained, natural organ flow/blood qi peace. Do not tonify warmth rashly, increasing interior heat. Stomach rots/ripens food; Large Intestine transmits processed matter. Food amount knows grain qi deficiency/excess; stool slipperiness/astringency knows organ status.